Tag Archive | birth

Birth Talk

Oct19

As I have referenced several times before I have a special interest in the language of birth. That is part of the reason my blog/business is so-named—because is it is a blog that “talks birth” (as in, “let’s get together and talk birth!”), but also because the way you talk about birth matters. I have also referenced before that it was originally going to be called Birth Talk, but when I went to get the gmail address, it was already taken (by a childbirth educator I coincidentally later came to know!). I’ve come to really “bond” with my Talk Birth name and now “birth talk” sounds slightly odd to me (though “talk birth” is really the odder phrasing).

A couple of months ago, I read an interesting article by Debra Bingham about Taking Birth Back. It it, she asks you to consider–when talking about birth–how your basic assumptions affect your discourse (the way you talk about birth):

1. Does your discourse include stories about the power of women?
2. Or do the stories shift the locus of control away from women and their bodies to other authority figures such as nurses, physicians, or machines?
3. Does your discourse assume that women are physiologically capable of giving birth and nourishing their own children?
4. Or does your discourse assume that women’s bodies are fundamentally flawed and in need of medical attention and intervention?

I am frequently attempting to shift the locus of control from “authority” figures back to women–it is shocking to me how ingrained the terminology is about medical care providers (even midwives!), “letting” someone do something, etc.

And, an enormous part of my life revolves around stories about the power of women, so I think I have that one down 😉

The prevailing social discourse about birth assumes a locus of control external to the woman and you rarely hear stories about the “power of women” amongst the general public or mainstream media. Ditto for the assumption of women’s bodies as fundamentally flawed, except replace “rarely” with “frequently.” These messages are so dominating that I think it is hard for women to really “hear” positive birth talk–it seems like a “joyful birth” must be a myth or impossible. Likewise, when a woman is striving to keep the birth talk around her positive, it can be very difficult to override the predominately negative messages coming at her from every side. I see this in my classes, “I believe birth is a natural event, etc., etc. BUT….” (followed by a  “I trust my doctor’s judgment and if he wants me to have this GTT test or this extra ultrasound to check my fluid level, etc. I guess I will do it…” comment that contributes to the “climate of doubt” in her life). There are also the woman’s own “inner voices” to contend with—I hypothesize that the loudly-shouted cultural voices about birth contribute a good deal to the “negative voice” in her inner dialog.

I don’t know any way to “fix” this  other than to continue “talking birth”–good, healthy, positive, normal, humanistic, natural, joyful birth–as widely and frequently as I can!

Birth as a Rite of Passage & ‘Digging Deeper’

Oct16

July 2015 135Childbirth is a powerful rite of passage. One of my favorite resources, The Pink Kit, has some great reflections on this rite of passage and the words we use to describe the powerful, indescribable act of giving birth:

Whatever the culture, when a woman surrenders to the process, accepts the intense sensations, works through each contraction, and digs deep within herself to achieve the end goal–giving birth–she is touched by the Unknown and Unknowable. Many traditional cultures send their young men into initiation rites where they, too, can learn to understand humbleness and achieve the self-control that women learn in childbirth.

All cultures believe that women become better and more generous through the process of giving birth. That is why some cultures use words such as ‘sacrifice,’ ‘suffering’ and ‘labour.’ These terms can seem overwhelming and to be avoided’ however, seen from a different viewpoint, childbirth helps us to become strong, resourceful and determined.

In a modern world, ‘getting through’ labour without numbing or dumbing the process can be a very powerful experience for a woman, and very challenging.

I like the concept of “digging deeper.” This how The Pink Kit explains it:

You might avoid the pain in labour by moving into a position which is comfortable for you (i.e. reduces the sensations), but it slows labour down and then you stay there for hours. Doing that will increase the likelihood of medical intervention because you will become tired, bored, or frightened, and labour doesn’t progress. Instead, consider remaining in positions that keep you open and the labour progressing, while using your skills to manage the sensations. This is ‘digging deeper’.

I have noticed an emphasis in other natural birth preparation books and explanations about finding positions that are “comfortable.” I very much like the concept of finding positions that help you feel “open”—these positions may certainly also comfortable (and that is great!), but if you remain mindful of “staying open,” it may lead you “dig deeper” and find positions that really help move the baby. In my classes, I encourage women to welcome labor “getting bigger” (not more “painful” or “difficult,” but make it “bigger” and be excited by that change!). I think this idea goes hand in hand with digging deeper.

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.

Let labor begin on its own…

Oct9

One of my blog posts that gets the most hits and is a consistently searched for topic is one that I wrote called “how do I know I’m really in labor?” I revised it recently for participation in a blog carnival at Science and Sensibility about letting labor begin on its own. Let Labor Begin on Its Own is the first of Lamaze’s Six Healthy Birth Practices. Why is letting labor begin on its own so important? Well, the onset of labor is a complex biological system that has its own wisdom–when a woman’s body is pushed into labor on someone else’s timetable rather than her own, the whole biochemical “dance” of labor and birth is impacted. What may seem like a harmless “jump start,” actually has a cascading effect on the rest of the birth (and has an impact on the baby as well). A significant impact is that induced labors are often much more painful than spontaneous labors. If a woman is planning an unmedicated birth, the increased intensity of artificial induced contractions coupled with the lack of the biologically trigged endorphin release that helps birthing women naturally cope with pain, often leads directly into a request for medications. The woman is then sometimes left feeling like she “failed” in her “natural birth” plans and that she “wimped out” and “just couldn’t handle it.” However, she was dealing with something much different than a “natural” labor and so it makes sense that a “natural” birth then didn’t happen. Of course, the cascade of other interventions that accompany an induction, such as an IV and continuous monitoring also severely restrict a woman’s mobility (which also has a dramatic impact on her ability to cope).

I am saddened when I hear women blaming themselves for “not being able to handle it” (or, conversely being angry at “natural birth zealots” for misleading them…), when they were actually just missing significant pieces of their “pain coping pie” as well as dealing with a (probably) more difficult labor. We need to remember to look at the overall healthy birth climate of the birth setting and the use of the six healthy birth practices, rather than at personal “failure.”

There are a lot of excellent links on letting labor begin on its own in the rest of the blog carnival!

More Birth Quotes

Oct5

Reposting some of the quotes I’ve recently shared via my Facebook page…I’m surprised by how many hits my blog gets for people looking for “birth quotes.” I think as long as I bother typing them into Facebook, I might as well then copy them here for those people searching for birth quotes to find! (Here is a link to a previous post with more birth quotes.)

“For far too many women pregnancy and birth is something that happens to them rather than something they set out consciously and joyfully to do themselves.” –Sheila Kitzinger

“Labor is all about finding your threshold and learning you can go beyond it.” –Father quoted in the book Fathers at Birth

“Wise women mean a spicier, more interesting world, not guided simply by linear reasoning and accomplishment, but by intuition, internal self-agreement and fiece creative love.” –Sareanda Lourdes

“Giving birth and being born brings us into the essence of creation, where the human spirit is courageous and bold and the body, a miracle of wisdom.” –Harriette Hartigan

“I believe in the power of accurate information to help women make the wisest choices for themselves.” – Judy Norsigian

“Humanity cannot invent a drug that can work better than a mother’s body can manufacture or a knife that is sharper than her instinctual nature.” –Patrick Houser

“It has been said that if each of us went out into the world tomorrow and shared our love with two people, ‘such that they got it, and they in turn went out the next day and shared it with two more…following that progression, in less than… 33 days we would reach the entire planet.’ *Thirty-three days*. It begins at the beginning. At birth. A peaceful birth, where there are no hunters and no game.” –Nancy Wainer

“Let parents know that they don’t need special techniques and gadgets to give birth safely and happily. Make sure to communicate to every mother you help, that she has all the essential ingredients for a safe, healthy birth within herself. …A womb, a baby, a vagina, and a few warm pieces of fabric make an excellent, complete birth kit.” –Laura Morgan

“Women’s bodies have their own wisdom, and a system of birth refined over 100,000 generations is not so easily overpowered.” –Sarah Buckley

How do I know I’m really in labor?

Sep28

Mollyblessingway 042When I was in early labor with my first son, I spent quite some time upstairs in our computer room googling, “how to know you’re really in labor” or, “signs of true labor,” or “the difference between false labor and real labor,” or, “how do I know I’m in labor,” or, “how to know I’m in labor.” I would do this between contractions and then when I had a contraction I would think, “Wow! This is definitely it!” Then, it would ease, and I’d start googling again, certain I must just really be experiencing “false labor.” One of my biggest fears was arriving at the birth center and only being two centimeters dilated (or possibly not in labor at all!). So, in honor of my former self, I offer a list of some ways to to gauge whether you are experiencing true labor.

It is true labor if/when:

  • Your contractions fall into a regular pattern. And, that pattern involves contractions that are lasting longer, feeling stronger, and occurring closer together.
  • If when you walk around or otherwise increase your activity, the contractions also increase.
  • And if changing positions and drinking plenty of fluids also do not cause the contractions to ease…
  • The sensation begins in your lower back and spreads like a band around your belly causing a peak of tightness and discomfort in the front and then fades away again.
  • You have been feeling some gastrointestinal upset and may be experiencing diarrhea also.
  • You have pinkish or blood streaked, mucousy discharge.
  • Your membranes have ruptured (keep in mind that labor only begins in this way for roughly 10% of women. So, if your waters have not released, do not be discouraged thinking that you must not be in “real labor.” Many women do not experience their waters breaking until they are pushing or are starting to feel like pushing).
  • Truly, I think that the best sign that you are in labor is if you really feel like you are in labor. This is one of those things that doesn’t feel that helpful to a first-time mom—“yes, but how will I know?! What if I’m in labor and don’t know it until the baby is coming out?!” I promise that for the wide majority of you, at a certain point, you will just know that you are in labor and there will be no more questions about whether this is “really it”—that is the best sign, when you stop wondering “is this really it?” My observation is that this point comes along when you enter active labor and enter your “birth brain” instead of your analytical, logical brain.

Is this really it?

If you are still wondering, “is this really it?” my best piece of advice is to ignore it! Pretend like nothing is happening. Go about your normal day and your normal routine. If you would normally be sleeping, sleep. If you would normally be eating, eat. Go for a walk, water the plants, feed the dog, bake something, go to the store, etc. When your contractions need your full attention, they will ask for it 🙂

Symptoms of pre-labor (“false labor”)

Some “symptoms” that what you are experiencing is instead practice labor, pre-labor, or “false labor” (I do not usually use the phrase “false labor” because I think it is dismissive of women’s experiences. All contractions are doing something and so I refer to them as “practice” rather than “false.” Another good phrase to use is “pre-labor” contractions. My midwife with my second baby referred to them as “toning contractions”):

  • The contractions are irregular (no pattern) and are not increasing in frequency or intensity.
  • If you change positions or drink two large glasses of juice, water, or tea, the contractions subside.
  • The contractions center in your lower abdomen and do not involve your back.
  • The contractions go away if you take a walk, take a shower, or lie down.

This is also a popular question in birth classes. Because labor is a new event for you, it can be hard to know what to expect until it actually happens! There is  pdf handout here with some additional signs and information. There is also a helpful handout with a sort of flowchart of signs/symptoms here.

Oh, and by the way, when I did finally go to the birth center, I was 10 centimeters dilated and started pushing about 30 minutes later!

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What about induction?!

On a closely related topic, why bother with all this guessing about whether or not you’re in labor? Why not be induced instead? Good questions! There are numerous reasons why you should let labor begin on it’s own—labor that begins on its own is usually safer and healthier for both mother and baby. Also, it is less painful than a labor that is induced with medications such as Pitocin. For more information about letting labor begin on its own, check out Lamaze’s Healthy Birth Practice #1, or this video clip from Mother’s Advocate:

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Quick Births

Sep19

I recently finished reading the book Permission to Mother by Denise Punger (you can read my full review in an upcoming issue of the CAPPA Quarterly). In one of the Appendices of the book, she addresses “Herbal Inductions–Are They Safe?” Her response is “no” and she adds “A homebirth does not equal a ‘natural birth’ if Blue and Black Cohosh are used to induce.” She opens the section by referencing her third labor which was over 12 hours and gave her “time to emotionally adjust to the escalating physical demands and surprise of my labor” and then goes on to say, “Over and over…I am hearing about intense labors that occur in two hours or less! Women often express delight about their miraculously quick labors (as if a quick labor were the goal). But I don’t sense any emotional, physical, or spiritual satisfaction accompanying these seemingly precipitous deliveries.” She also shares that a commonality in these stories is the use of herbals to induce or augment labor.

This section caught my eye, because I had a very quick birth with my second baby. I also was intrigued by the presumptiveness of dismissing a quick birth as not emotionally, physically, or spiritually satisfying—it seems like someone who is seeing through their own “lens” of 12+ hour labors and can’t imagine another type of timeline for birth. For the past several days I’ve been pondering this issue and considering my own experiences. I also did a variety of google searches looking for information about “emotional impact” of “fast labor” or “precipitous birth.” I turned up surprisingly little information—there was one article that popped up several times titled “The experience of precipitate labor” in the journal Birth. However, I was not able to access the full text of the article to read what it actually says. The results were described as: “The experience of precipitate labor was categorized in terms of physical experience (perception of labor length and contractions), psychological experience (relationship of how women perceived birth to their prenatal expectations, and emotional trajectory of disbelief, alarm, panic, and relief), and external factors (support persons and hospital system).”

My searches also turned up personal birth stories, excerpts from nursing textbooks or emergency medicine texts about handling precipitous birth, and message board discussion threads. The most commonly shared pieces of information about rapid labors is that they can be physically shocking and can be difficult to “catch up with” emotionally, as well as stressful because the mothers often are thinking, “if this is early labor, how I can possibly handle another 12 hours?!” They also reference increased change of hemorrhage. I did not see the questions raised by the Permission to Mother segment directly addressed anywhere. So, I want to know–if you experienced a quick birth what physical, emotional, and spiritual satisfaction did you experience, if any? What about external factors? (support persons, birth environment.) How about your psychological experience and “emotional trajectory”?

My own experiences are as follows:

Second baby, total labor two hours. Forty weeks pregnant. No herbal induction methods used. About 45 minutes were “serious labor.” It was very intense and I’ve said several times before that it felt a bit like a train rushing past and that I had run to catch up with it (emotionally and mentally).

Physical Satisfaction:

I was extremely proud of my body and its super-awesomeness 🙂 I felt that my sense of birth trust was physically manifested in my actual birth experience. My body was a powerful and unstoppable force and I had to get out of my own way and let it happen! I felt driven to my hands and knees–like a power was holding me there. After the birth my body felt weak and “run over by a truck”—I felt powerful and like a warrior during the birth, but afterward it was a physical “crash” of sorts. I did not have excessive bleeding, but I did almost faint several times after getting up (hindsight says, why didn’t I just stay down a while longer?!). I experienced labial tearing (no perineal tearing) and a lot of swelling as well as bruising, that I surmise was a direct result of my son’s rapid birth.

Emotional Satisfaction:

The birth was very emotionally satisfying. I did feel as if I never made it to “labor land” though–that hazy, dreamy, unreal state that I associate with my first son’s birth (and longer labor). I did not feel scared or overwhelmed or out of control as such (I did consciously let go of control—I think these are two different things) . I felt proud of myself. I felt amazed. I felt phenomenal. I felt ecstatic. I felt powerful. I felt empowered. I felt triumphant. I was pleased with how I’d verbally coached myself through labor—telling myself “it’s okay, you’re okay” and “be a clear, open channel for birth” and “relax your legs.” I felt excited and enjoyed the “drama” of already holding my baby after only a short while before thinking, “maybe I’m in labor.” It felt like a wonderful, fulfilling adventure.  I didn’t feel like a “victim,” but I did feel like something “happened to me”–as I said, I had to just get out of my own way and let the power roll through me. Later, I felt emotionally upset about the tears and the bruising. This felt like my piece of “failure,” because I had hoped and planned not to tear again.

Spiritual Satisfaction:

This is related to the above for me. I felt like a force of nature–like I was one with the powers of the universe. I was happy with my ability to get out of my head and “be in the now” with the energy of birth. My son’s birth was the most powerful and transformative experience of my life. I think that counts as sprititual satisfaction 🙂

External Factors:

I gave birth at home. If I hadn’t planned a homebirth, I think there would have been more stress and fear involved with trying to get to the hospital (and possibly a car birth, as we live 30 minutes from the hospital). My husband was very physically there with me–holding and supporting me–I felt like we were one person. My mother was present towards the end and held my older son. They felt overwhelmed and surprised by the intensity, but they got out of my way and let me birth! My midwife was present for 5 minutes–enough time to catch the baby. She was calm and a gentle presence.  She was very physically supportive postpartum. No one tried to influence or control what I was doing, where I was, or how I was laboring and giving birth. I had complete freedom and control over my environment.

Emotional Trajectory:

I went from excitement—“I hope this is really it!”—to, “Oh my goodness, we don’t have time to fill up the birth pool—just get me my birth shirt, my blessingway bracelet, and my ponytail holder!” and wading deeply in to the rushing waves of energy. The experience became completely encompassing–I was no longer in my left-brain, but was instead holding on to the train and catching up. I did not feel panicked or alarmed and I did not feel relieved when it was over, I felt amazed and happy and blissful and powerful.

What to Expect When You Go to the Hospital for a Natural Childbirth

Sep9

I’ve been debating about whether to share this post or not. I’m concerned that it may come across as unnecessarily negative, pessimistic, or even “combative” or “anti-hospital.”  However, I do think it is honest and I’ve decided to share it. There is a fairly “normal” course of events for women having a natural birth in a hospital setting. In order to be truly prepared to give birth in the hospital, it is important to be prepared for “what to expect” there and to know how to deal with hospital procedures. All hospital procedures/routines can be refused, but this requires being informed, being strong, and really paying attention to what is happening. I hope this list of “what to expect” with help you talk with your medical care provider in advance about hospital routines and your own personal choices, as well as help prevent unpleasant surprises upon actually showing up in the birthing room. This list is modified from material found in the book Woman-Centered Pregnancy and Birth. I am not saying that is how your specific hospital operates, but that many American hospitals function in this manner.

  • Expect to have at least some separation from the person who brought you to the hospital, whether this separation is due to filling out admission paperwork, parking the car, giving a urine sample, being examined in triage, etc.
  • Expect to remove all your clothing and put on a hospital gown that ties in the back.
  • Expect to have staff talk over you, not to you, and to have many different people walk into your room whenever they want without your permission and without introducing themselves.
  • Expect to have your cervix examined by a nurse upon admission and approximately every hour thereafter. Sometimes you may have multiple vaginal exams per hour by more than one person.
  • Expect to have an IV inserted into your arm, or at minimum a saline lock (sometimes called a Hep lock).
  • Expect to be denied food and drink (at best, expect clear liquids or ice).
  • Expect to give a urine sample and perhaps a blood sample.
  • Expect to have an ID bracelet attached to your arm.
  • Expect to have to sign a consent form for birth and for application of a fetal monitor that states that your doctor will be responsible for making the decisions about your care (not you).
  • Expect to have a fetal heart rate monitor attached around your belly—two round discs on straps that will often stay with you continuously until you give birth (or, at best, for 15 minutes out of each hour of your labor).
  • Expect to have your water manually broken at about 4 centimeters (or at least, strongly suggested that you allow it to be broken). After this point, expect to be encourage to have an electrode screwed into the baby’s scalp to measure the heartbeat and a tube places in your uterus to measure your contractions.
  • Expect to be offered pain medications repeatedly.
  • Expect to receive Pitocin at some point during your labor–“to speed things up.”
  • Expect to be encouraged (or even ordered) to remain in your bed through much of labor, especially pushing.
  • Expect to either have your legs put in stirrups or held at a 90 degree angle at the hips.
  • Expect to be told you are not pushing correctly.
  • Expect to hold your baby on your chest for a few minutes, before it is taken away to be dried, warmed, and checked over.
  • Expect the baby to have antibiotic eye ointment put into its eyes (without telling you first).
  • Expect to have your baby suctioned repeatedly.
  • Expect to be given a shot of Pitocin to make your uterus contract and deliver the placenta.
  • Expect not to be shown the placenta.
  • Expect your baby to be given a vitamin K injection.

I think it is important to note that what you can expect is often different than what you deserve and that what you can expect often reduces or eliminates your chances of getting what you deserve. In my classes, I’ve made a conscious decision to present what women deserve in birth and though I also talk about what they can expect and how to work with that, I think sometimes they are left surprised that what they actually experience in the hospital. At minimum, what you deserve are Six Healthy Birth Practices (as articulated by Lamaze):

  1. Let Labor Begin on Its Own – Download PDF
  2. Walk, Move & Change Positions – Download PDF
  3. Have Continuous Support – Download PDF
  4. Avoid Unnecessary Interventions – Download PDF
  5. Get Upright & Follow Urges to Push – Download PDF
  6. Keep Your Baby With You – Download PDF

As an example of what I mean about what you can expect clashing with what you deserve, consider the second healthy birth practice “Walk, Move Around, and Change Positions”—monitoring and IVs directly conflict with the smooth implementation of a practice based on freedom of movement throughout labor.

So, how do you work with or around these routine expectations and your desire for a natural birth?

  • Discuss in advance the type of nursing care you would like and request that your doctor put any modifications to the normal routines in your chart as “Doctor’s Orders” (if your doctor is unwilling to do so, seek a new medical care provider!)
  • Labor at home until labor is very well-established.
  • Go through the above list of “what to expect” and make a decision about how to handle each one on a case by case—you may choose to actively refuse something, you may be okay with accepting certain procedures or routines, and you can develop a coping plan for how specifically to work with any particular issue.
  • Take independent childbirth classes and learn a variety of techniques and pain coping practices so that your “toolbox” for working with labor is well stocked.
  • Hire a doula, or bring a knowledgeable, helpful, experienced friend with you. It can help to have a strong advocate with you (this may or may not be a role your husband or partner is willing to take on).
  • Another tactic is to “never ask permission to do what you want, but to go ahead and do it unless the hospital staff actively stops you.” (An example of this is of getting up and walking around during labor)
  • “Many people, if they can find no other way to get around a dangerous or unpleasant hospital policy, unobtrusively ignore it”—a good example of this is with regard to eating and drinking during labor. Restricting birthing women to ice chips or clear liquids is not evidence-based care. Bring light foods and drinks and quietly partake as you please.
  • Leave the hospital early, rather than remaining the full length of stay post-birth. This can minimize separation from baby and other routines you may wish to avoid.
  • For some additional ideas see my post, “Can I really expect to have a great birth?“


Finally, and most importantly, “birth is not a time in a woman’s life when she should have to FIGHT for anything,” so if you find that you feel you are preparing yourself for “hospital self-defense” I encourage you to explore your options in birth places and care providers, rather than preparing for a “battle” and hoping for the best. If you feel like you are going to have to fight for your rights in birth, STRONGLY consider the implications of birthing in that setting. Also, as The Pink Kit says, “hope is not a plan”—so if you find yourself saying “I hope I can get what I want” it is time to take another, serious look at your plans and choices for your baby’s birth.

Beautiful Homebirth Slideshow

Sep8

Today I was sent a link to a lovely homebirth slideshow (scroll down through the photos and story to get to the slideshow link—-the story is worth reading too. It has some good observations about why birth matters: “If you have scene the movie The Business of Being Born there is a seen where one of the OBs being interviewed states in so many words that the process of birth is unimportant that it’s the outcome that is important – a healthy baby and a healthy mom. And while he is correct that a healthy baby and a healthy mom are always the most important end result he is dead wrong about the process. The process matters – -immensely. Physically the birth process is extremely important for the long term health of the mother and the baby, emotionally and psychologically the birth process will affect a woman for the rest of her life.” Can I just say, Amen!)

I absolutely love the joyful expressions on the mother’s face immediately after birth. So beautiful! Plus, it brings that feeling from my own births back to me. On Labor Day, CAPPA posed the question:


“Happy ‘LABOR’ day from CAPPA. What I loved about labor was________________!”
My response was: The feeling of personal power at the end—the “I climbed my mountain,” I DID IT feeling. And that moment of ecstasy of holding my new baby and saying, “my baby, my baby, oh my baby” over and over 🙂 Brings tears to my eyes thinking about it!

Watching the slideshow above, also brought the memory of that same “my baby, my baby” rapture back to me.