Tag Archive | birth activism

Tuesday Tidbits: International Day of the Midwife

Today is International Day of the Midwife and I find myself reflecting on the many midwives I have known and the incredibly diversity and gifts of the women who join this profession. In addition to the midwives I had for prenatal and postpartum care for each of my births, I’ve been privileged to know many midwives on the state and national level through our shared interest in maternity care activism and birth rights. With my first baby, I had prenatal and birth care with a family practice physician and a CPM. The CPM was gray-haired, pretty, soft-spoken and wryly witty and pretty much exactly what you picture a stereotypical midwife looking like! My prenatal care with this team was excellent, birth care so-so (I didn’t need much), but my postpartum care left a lot to be desired and I felt very cast adrift after the birth. I became very embroiled with midwifery activism and birth work after this birth and as a result my experiences with all subsequent midwives has been an interesting blend of collegial + consumer. My first birth was the only one for which I was consumer only. Though I’m not a midwife myself, my subsequent experiences all involved being a sister birthworker AND client, rather than solely a client. This has both benefits and disadvantages.

My midwife with my second baby was amazing. I loved her so much and I have felt a gap in every pregnancy following that I was not able to have her as a midwife again. She was gentle and caring and passionate and inspiring and wonderful. Cute and upbeat, full-figured, and intelligent, she had a soft and reassuring presence and gave wonderful hugs! We became good friends and she was a very important part of my life. My prenatal care and birth care with her was excellent. She was also helpful with postpartum care, but I don’t think I “allowed” her to be as helpful as she could have been because I couldn’t allow myself to be as vulnerable and needy as I actually felt.

When I was pregnant with my third baby, my much-loved midwife had moved away and found myself at a loss for who to choose for pregnancy and birth care. This baby died early in my second trimester and I found myself calling on the sisterhood of midwives for help when I desperately needed it. From the very busy midwife who talked to me kindly and patiently when I was freaking out over a retained placenta, to the Mennonite midwife who helped me from the road as she was driving to another state and connected me to yet another midwife several hours away who drove in to town to meet and help me when I was very scared and alone, it was during this experience that I realized very viscerally how much we need midwives in our lives. When I was pregnant again, I decided to choose the Mennonite midwife for my prenatal care and immediate postpartum care. She is a very capable and determined and intelligent midwife, but I felt an unbridgeable gap between us spiritually speaking and so was never able to fully connect with her emotionally. She embodied the gray-haired, no-nonsense “granny midwife” archetype. She provided great prenatal care and was very respectful of my wish for immediate postpartum care, but an unassisted birth. Postpartum follow-up care was limited due to snowstorms.

With my last baby, I felt a powerful need to feel taken care of again. I really needed to have some set aside time, space, and energy that was just focused on me and my baby. I knew that I needed a midwife! While I could have used the same midwife as with the baby before, this time it was important to me to develop the emotional connection I had with my second midwife—I needed a midwife with whom I could feel “safe” with all of me, instead of feeling like I had to hide my goddess sculptures when she came over! 😉 It took some work, but I was able to find that. With this experience, I came to accept that the blur between colleague-consumer is my reality and I will never re-capture the feeling of being client only and being completely focused on in that respect, because I’m simply not just a client only. That’s okay. This midwife has long brown hair, wears lots of skirts and had the hippie-ish midwife feel I was craving. She is funny and talkative and connected to the roots of what midwifery is all about. I was safe with her in the way I needed. I really appreciated the midwife’s prenatal care (and the opportunity to focus on my pregnancy and baby), her respect of my wish for immediate postpartum care rather than birth care, and her postpartum follow-up care. I felt like this midwife offered the most complete postpartum care of all of my birth experiences.

I’ve mentioned before that the only vaginal exam I had during six pregnancies was at ten centimeters dilated when I went to the birth center to push out my baby (I also had to have one for a manual clot extraction following his birth and one for help removing the placenta after my miscarriage-birth of my third baby). This is totally cool with me. Somehow I’ve managed to labor and birth four full-term babies without ever knowing how dilated I am in labor! So, I loved reading this article about the pointlessness of vaginal exams in labor and the cultural attachment, even in midwifery circles, to cervix-focused childbirth:

“…There is also reluctance to change hospital policies, underpinned by a need to maintain cultural norms. The Cochrane review on the use of partograms on the one hand states that they cannot be recommended for use during ‘standard labour care’, and on the other hand states: “Given the fact that the partogram is currently in widespread use and generally accepted, it appears reasonable, until stronger evidence is available, that partogram use should be locally determined.” Once again, an intervention implemented without evidence requires ‘strong’ evidence before it is removed. The reality is that we are unlikely to get what is considered ‘strong evidence’ (ie. randomised controlled trials) due to research ethics and the culture of maternity systems. Guidelines for care in labour continue to advocate ‘4 hourly VEs’ and reference each other rather than any actual research to support this (NICE, Queensland Health). Interesting whilst Queensland Health guidelines recommend 4 hourly VEs, their parent information leaflet states: “While a VE can provide information about how a woman has progressed so far in labour, it cannot predict how much longer you will be in labour…” and that there are “…other factors such as the strength, duration and length of contractions as well as a woman’s behaviour and wellbeing that can indicate progress in labour”. Which begs the question ‘why bother doing a VE’?

The cervical-centric discourse is so embedded that it is evident everywhere. Despite telling women to ‘trust themselves’ and ‘listen to their body’, midwives define women’s labours in centimetres “She’s not in labour, she’s only 2cm dilated”. We do this despite having many experiences of cervixes misleading us ie. being only 2cm and suddenly a baby appears, or being 9cm and no baby for hours. Women’s birth stories are often peppered with cervical measurements “I was 8cm by the time I got to the hospital”. Even women choosing birth outside of the mainstream maternity system are not immune to the cervical-centric discourse. Regardless of previous knowledge and beliefs, once in labour women often revert to cultural norms (Machin & Scamell 1997). Women want to know their labour is progressing and there is a deep subconscious belief that the cervix can provide the answer. Most of the VEs I have carried out in recent years have been at the insistence of labouring women – women who know that their cervix is not a good indicator of ‘where they are at’ but still need that number. One woman even said “I know it doesn’t mean anything but I want you to do it”. Of course, her cervix was still fat and obvious (I didn’t estimate dilatation)… her baby was born within an hour…”

Vaginal examinations: a symptom of a cervical-centric birth culture | MidwifeThinking

I also read this article about the now late, great midwife and activist, Sheila Kitzinger and how she connected her birthwork to feminism (as do I). I despise the article’s title, but it is still worth a read!

…In the Seventies, I was viewed as a radical for saying that birth was being depersonalised and treated as if it were a pathological event, rather than a normal life process.

To my surprise, it wasn’t just obstetricians who dismissed what I had to say. I also found myself in conflict with feminists, who saw birth in very simplistic terms.

Why? Because they claimed it was every woman’s right to give birth painlessly.

An article in Spare Rib, the radical campaigning feminist magazine, went further.

Without any evidence, the authors asserted: ‘Undoubtedly, hospitals, with all their faults, are the safest places in which to give birth. For this reason, we think we should press for improvements in hospitals rather than support a move to more home confinements.’

I was appalled at how my sister-feminists could fail to support woman-centred birth. Polly Toynbee, writing in The Guardian, was particularly virulent, dismissing me as a lentil-eating earth goddess…

via Sheila Kitzinger on why feminists HATE natural childbirth and why it’s harmful | Daily Mail Online.

Lentil-eating earth goddesses unite! Unlike Kitzinger’s experiences with the distance between some expressions of feminism and birth-care, I find that many midwives, whether explicitly or implicitly, understand the deep connection between midwifery care, birth activism, and feminism.

“Midwifery work is feminist work. That is to say, midwives recognize that women’s health care has been subordinated to men’s care by a historically male, physician-dominated medical industry. Midwifery values woman-centered care and puts mothers’ needs first. Though not all midwives embrace the word feminism (the term admittedly carries some baggage), I maintain that providing midwifery care is an expression of feminism’s core values (that women are people who have intrinsic rights).

–Jon Lasser, in Diversity & Social Justice in Maternity Care as an Ethical Concern, Midwifery Today, issue 100, Winter 2011/2012

via Midwifery & Feminism | Talk Birth

Perhaps this is because midwives care so deeply about mothers and feminists might actually make the best mothers…

…As a mother who works extensively with other mothers, I appreciated Caron’s acknowledgement that raising children is a feminist act with potential to create change as well. “Another strategy for change is through raising children to be just and caring people. A media image portrays feminists as being against motherhood—but in fact, feminists make the best mothers. They raise children aware of themselves and the world, of options and values, of what justice means and how to work toward it, and how to be self-critical and self-respecting” (p. 203-204). Caron also explains that “in a just society, women would be free to make whatever decisions they needed to, for however long they needed to, in relation to political action in the public and the private sphere. All people would participate in the decision-making, and women would be supported in their decisions rather than, as sometimes happens, made to feel guilty for not doing enough or not valued for what they do.”

via Thesis Tidbits: Feminism, Midwifery, and Motherhood | Talk Birth.

Happy International Day of the Midwife! Thank you for bearing witness to our journeys and for holding the space for the continually unfolding spiral of life.

“…As we ready ourselves to accept new life into our hands,
Let us be reminded of our place in the dance of creation.
Let us be protectors of courage.
Let us be observers of beauty.
Let us be guardians of the passage.
Let us be witnesses to the unfolding…”

—Cathy Moore (in Sisters Singing)

via National Midwifery Week! | Talk Birth.

In addition to midwives, we’re also celebrating mothers all week this week! First on our lineup of activities is our gift to you: our first ever coupon code for $5 off purchases over $15. Use code: MOTHER.

We’ve also got a giveaway upcoming, two new product launches, a new Facebook group, and two class announcements! Stay tuned…

Sheila Kitzinger

Apr13

‘Sheila taught me, from an early age, that the personal was political – not just by what she said but by what she did. As I was growing up I learnt from her campaigns for freedom and choice in childbirth that passionate and committed individuals can create social change. She never hesitated to speak truth to power. –Prof. Celia Kitzinger, Sheila’s oldest daughter

via Sheila Kitzinger 1929-2015 | Pinter & Martin Publishers.

Yesterday morning, I learned that childbirth education trailblazer, maternity activist, and phenomenally influential author, Sheila Kitzinger has died. By the end of the evening, her name was coming up as “trending” on Facebook, which is the first time I’ve ever noticed anything flagged for me as trending that wasn’t mainstream celebrity-related, holiday, sporting-event, OR horrible tragedy, disaster, or scandal related. So, Sheila continues to break new ground in maternity care activism!

My own work with birth and my philosophy of birth education and activism has been deeply shaped by this marvelous woman. She is one of my all-time favorite childbirth authors and may be the most quoted person on my blog! In fact, as I was scrolling through old posts to find some to share in memorial, I had to quit looking after the fourth page of search results because there were simply too many. Here are some of the ones I did find:

I agree with anthropologist Sheila Kitzinger who said that, “In any society, the way a woman gives birth and the kind of care given to her and the baby points as sharply as an arrowhead to the key values of the culture.” Our current birth culture does not value women and children. Though my focus is usually on the women, it also doesn’t much value men or fathers either. I also agree with Kitzinger’s assessment that, “Woman-to-woman help through the rites of passage that are important in every birth has significance not only for the individuals directly involved, but for the whole community. The task in which the women are engaged is political. It forms the warp and weft of society.”

via A Blessing…and more… | Talk Birth.

Same quotes used in two other posts:

These concepts—and the lack of a similar one in American culture—reminds me of a quote from Sheila Kitzinger that I use when talking about postpartum: “In any society, the way a woman gives birth and the kind of care given to her and the baby points as sharply as an arrowhead to the key values of the culture.”

via Some reminders for postpartum mamas & those who love them | Talk Birth.

And, Rites of Passage… Celebrating Real Women’s Wisdom | Talk Birth.

Touching on the political aspects of birth culture:

“In acknowledging woman-to-woman help it is important to recognize that power, within the family and elsewhere, can be used vindictively, and that it is not only powerful men who abuse women; women with power may also abuse other women.” –Sheila Kitzinger

via Birth Quotes of the Week | Talk Birth.

Personally influential to my own labors:

During my first labor, I experienced what Sheila Kitzinger calls the “rest and be thankful stage” after reaching full dilation and before I pushed out my baby. The “rest and be thankful stage” is the lull in labor that some women experience after full dilation and before feeling the physiological urge to push. While commonly described in Kitzinger’s writings and in some other sources, mention of this stage is absent from many birth resources and many women have not heard of it.

via The Rest and Be Thankful Stage | Talk Birth.

And, my own personal postpartum care: Ceremonial Bath and Sealing Ceremony | Talk Birth.

Her books shaped birth HERstory:

Women’s (Birth) History Month | Talk Birth.

And, my own birth education philosophy (as well as my core value in working with women):

Labour is a highly personal experience, and every woman has a right to her own experience and to be honest about the emotions she feels. Joy tends to be catching, and when a teacher has enjoyed her own births this is valuable because she infuses her own sense of wonder and keen pleasure into her relations with those she teachers. But she must go on from there, learn how difficult labour can be for some women, and develop an understanding of all the stresses that may be involved.

via Sheila Kitzinger on a Woman’s Right to Her Own Experience | Talk Birth.

And, she celebrated birth:

I hope all of the women I know who are giving birth in the upcoming season discover that, as Sheila Kitzinger said, “Birth isn’t something we suffer, but something we actively do and exult in.” (from promo for One World Birth)

via Invisible Nets | Talk Birth.

Thanks for everything, Sheila! You’re amazing!

“Childbirth takes place at the intersection of time; in all cultures it links past, present and future. In traditional cultures birth unites the world of ‘now’ with the world of the ancestors, and is part of the great tree of life extending in time and eternity.” –Sheila Kitzinger

via Tuesday Tidbits: Tree Mother | Talk Birth.

Thoughts About “Let”

Mar28

“The effort to separate the physical experience of childbirth from the mental, emotional, and spiritual aspects of this event has served to disempower and violate women.” –Mary Rucklos Hampton

Related to my recent birth consumer post, I wanted to write a little bit more about the word “let.” One of my strongest birth-related pet peeves is the use of the word “let” when applied to birthing women. Women and providers and even doulas and CBEs often use terminology like “well, they let me get up for a while and walk around” or “my doctor is going to let me go to 41 weeks” or “the nurse let her get off the monitor for about 30 minutes” or “my husband won’t let me have a homebirth.” I do not like this phrase because of the “victim” mentality I feel like it conveys—-that women are passive and things are being “done to” them and they have no power of their own. I feel like it removes autonomy and empowerment and women’s control over their own bodies and births.

I often remind people that birth is not a time in a woman’s life when she should have to fight for anything. I also like to gently remind clients that no one can “let” them do anything. With colleagues, I occasionally have to clarify or explain my perception of the term as disempowering. Though in the end, sometimes I need to let (!) it go and realize that some people are perfectly satisfied with the term. And, I also have to acknowledge that the word DOES accurately describe many women’s experiences-—they are “let” or “not let” to do things even if I think it should be different and think they should have more power and control during their own births!

New Post…

Mar20

I spent quite some time writing a new post yesterday and then it disappeared without a trace! I like to make a post here at least once a week, so I’m going to have to just link to the other post I wrote yesterday as part of the Women’s History Month blog carnival from Birth Activist. Birth Activist was the very first birth blog I ever started reading and the blog that sparked my own interest in blogging (a couple of years later).

In addition to teaching the Young Parents classes, which is a new venture for me, I also start teaching my second college class next week. This one is at a college branch about an hour from me, so I’m going to be doing a lot of driving in addition to all the preparation work. I think blogging is going to have to slip down my list of priorities for a while and so I may not be making new posts for a little while—I hope my readers don’t abandon me! Have no fear, I’ve managed to work birth activism into my class in a very appropriate way—I’m going to show them the Reducing Infant Mortality film and possibily The Doula Story as well, during my section of the class on teen pregnancy.

Small Stone Birth Activism

Oct9

Edited to say that I’ve now added the 2009 version of the article here: Small Stone Birth Activism

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In 2008, I wrote an article called Small Stone Birth Activism for Citizens for Midwifery News. I revised the article in 2009 and it was published in the Fall 2009 edition of the International Journal of Childbirth Education (ICEA’s publication). It begins on page 8. I also have an older version uploaded here. This version is also slightly edited from the original version that appeared in CfM News.