Tag Archive | giving birth

Becoming an Informed Birth Consumer

Though it may not often seem so, birth is a consumer issue. When speaking about their experiences with labor and birth, it is very common to hear women say, “they won’t let you do that here” (such as regarding active birth–moving during labor). They seem to have forgotten that they are customers receiving a service, hiring a service provider not a “boss.” If you went to a grocery store and were told at the entrance that you couldn’t bring your list in with you, that the expert shopping professional would choose your items for you, would you continue to shop in that store? No! If you hired a plumber to fix your toilet and he refused and said he was just going to work on your shower instead, would you pay him, or hire him to work for you again? No! In birth as in the rest of life, YOU are the expert on your own life. In this case, the expert on your body, your labor, your birth, and your baby. The rest are “paid consultants,” not experts whose opinions, ideas, and preferences override your own.

There are several helpful ways to become an informed birth consumer:

  • Read great books such as Henci Goer’s The Thinking Woman’s Guide to a Better Birth or Pushed by Jennifer Block.
  • Hire an Independent Childbirth Educator (someone who works independently and is hired by you, not by a hospital). Some organizations that certify childbirth educators are Childbirth and Postpartum Professionals Association (CAPPA), BirthWorks, Bradley, Birthing From Within, Lamaze, and Childbirth International. Regardless of the certifying organization, it is important to take classes from an independent educator who does not teach in a hospital. (I’m sure there are lots of great educators who work in hospitals, but in order to make sure you are not getting a “co-opted” class that is based on “hospital obedience training” rather than informed choice, an independent educator is a good bet.)
  • Consider hiring a doula—a doula is an experienced non-medical labor support provider who offers her continuous emotional and physical presence during your labor and birth. Organizations that train doulas include CAPPA, DONA, and Birth Arts.
  • Join birth organizations specifically for consumers such as Citizens for Midwifery or Birth Network National.
  • Talk to other women in your community. Ask them what they liked about their births and about their care providers. Ask them what they wish had been different.
  • Ask your provider questions. Ask lots of questions. Make sure your philosophies align. If it isn’t a match, switch care providers. This is not the time for misplaced loyalty. Your baby will only be born once, don’t dismiss concerns your may have over the care you receive or decide that you can make different choices “next time.”
  • Find a care provider that supports Lamaze’s Six Healthy Birth Practices and is willing to speak with you seriously about them:
  1. Let labor begin on its own
  2. Walk, move around and change positions throughout labor
  3. Bring a loved one, friend or doula for continuous support
  4. Avoid interventions that are not medically necessary
  5. Avoid giving birth on your back and follow your body’s urges to push
  6. Keep mother and baby together – It’s best for mother, baby and breastfeeding

Remember that birth is YOURS—it is not the exclusive territory of the doctor, the hospital, the nurse, the midwife, the doula, or the childbirth educator. These people are all paid consultants—hired by you to help you (and what helps you, helps your baby!).

Birth Violence

“‘Old wives’ tales,’ says the Oxford dictionary, are ‘trivial stories, such as are told by garrulous old women.’ It is significant that no one ever talks about ‘old husbands’ tales’ or ‘old doctors’ tales.’ Women are blamed instead. It is implied that there is poison in their speech and that the only safe thing to do is remain silent. The experiences that women share with other women are thus rejected and trivialized…In reality, it is not other women who instill and fuel anxiety in most pregnant women, but the medical system itself.” This quote from the 1980’s book, Giving Birth, by Sheila Kitzinger, remains strikingly relevant today. When women in the United States today enter the hospital to give birth, many experience some form of institutional violence. They may not explicitly define it as violence, but listening to their stories provides a disheartening picture of maternity care today.

What kinds of violence occur in the birth place? Here are a few possible examples of “normative abuse” women may experience when giving birth in U.S. hospital setting

• Restriction of movement
• Restriction of nourishment
• Domination by those in positions of authority—must obey even when it is against her own best interests.
• Routine, forced interventions such as IVs
• Repeated, possibly painful, vaginal examinations by many different people
• Denial of option for VBAC (vaginal birth after cesarean)
• At the most extreme example of overriding patient rights, a forced cesarean section
• Vaginal cutting (episiotomy)
• Abusive language
• Separation from family/restriction of companionship
• Lack of respectful treatment
• Voice and wishes disregarded/unheard
• Emotional manipulation using baby as a “card” to force compliance (“you want a healthy baby don’t you?” No mother doesn’t. It is degrading and dehumanizing to suggest that she doesn’t.)
• Forced separation of mother and baby
• Administration of medications without consent
• Cord traction and interference with third stage (placenta) that may lead to hemorrhage.

The emotional treatment of women in labor is the most significant factor contributing to their satisfaction with their birth experiences (emotional factors of highest importance include having good support from caregivers and being treated with respect). According to Kitzinger, “We are only now discovering the long-term destructive effect on human beings and families of treating women as if they were merely containers, to be opened and relieved of their contents; and of concentrating attention on a bag of muscle and a birth canal, rather than relating to, and caring for, the person to whom they belong. The violence which is a common element in childbirth today leaves many women feeling that birth has been a kind of rape. This sort of experience is not easily forgotten. It can shatter a woman’s self-confidence, make her doubt her ability to mother her baby, destroy joy in the expression of her sexuality, and attack her very sense of self–the roots of her identity. It is psychologically mutilating.”

And, as Mary Rucklos Hampton says, “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.”


Molly Remer, MSW, ICCE is a certified childbirth educator and activist who blogs about birth at https://talkbirth.wordpress.com and midwifery at http://cfmidwifery.blogspot.com.

Note: In 2009, I wrote an article about birth violence for International Women’s Day, but it appears to have never been published. So, I decided to post it here (and on the CFM blog in honor of this year’s International Women’s Day on March 8th). I also read two relevant articles recently: How childbirth caused my PTSD and Birth Trauma: An Introduction.

Birth & Culture & Pregnant Feelings

“Giving birth is not an isolated event in a person’s life. A woman births with both her mind and her body and participates in the attitudes toward childbearing of her culture and her family.”

This quote from the book Pregnant Feelings by Rahima Baldwin reminds me of two other relevant quotes about culture, birth, and women’s choices:

“Although pregnancy and birth is a richly intuitive and instinctive process, a woman will prepare her ‘nest’ and birth according to the style of her culture, in the same way that a particular species of bird will build its nest with whatever is available.” –Pam England

“One does not give birth in a void, but rather in a cultural and political context. Laws, professional codes, religious sanctions, and ethnic traditions all affect women’s choices concerning childbirth.” –Adrienne Rich

I think we get onto slippery ground when we start talking about how women just need to “educate themselves” and then they will make different (i.e. “enlightened like ours”) choices. If education was all that was needed, we would see much different things in our present birth culture (more on this later!). As Pam England would also say (paraphrased), thousands of factors seen and unseen go into the resulting birth experience, it is hard to point to one, two, or three factors and say “that was it! I have it all figured out.” (Reminds me of another quote that women birth as they live.) With regard to the second quote, I have to ask myself whether couples truly have a free choice of where to give birth? Ultimately speaking, yes they do, but according to my clients’ perspectives insurance companies and the political climate surrounding midwifery in our state dictate their birth location, as well as opinions of family, friends, books, and so forth. I do a “pain pie” exercise during my classes and after I do it, I always talk about how sometimes choices are actively stripped away from women and we need to keep that in mind when we hear “bad” birth stories—not, “she ‘failed’ or made the ‘wrong’ choices” but that her pieces of the pie were taken away from her (sometimes forcibly!).

The reason I initially marked Rahima Baldwin’s quote is because I am fascinated by how my birth experiences continue to inform the rest of my life–while not the defining moment of motherhood for me, I continue to draw upon the lessons of birth throughout the rest of  my life, as well as retaining a total fascination with the subject. I wonder why I’m so “stuck” on birth? Why fixate on this one element of a lifespan? Does it mean I’m not “moving on” somehow—like a high school football player still reliving the glory of that touchdown from 10 years ago? I think it is because birth touches something else. Something deep and raw and true and we glimpse something that we rarely glimpse in everyday life. A touch of the sacred perhaps. Magic. Mystery. Or is it a sense of personal power and satisfaction in being a woman? I know that the “birth power” experience is a rare one for me—I have never felt so powerful and capable and amazing as I did giving birth. I like to think about how this “birth power” sense could be drawn into the rest of my life—how can I live a powerful and affirming and amazing life, not just as a birth giver, but as a woman? Lately, I am finding some answers in feminine spirituality, but it is a question I love to consider and hope to write more about in the future.

Okay, moving back to Rahima and the quotes from Pregnant Feelings:

Anthropologists’ reports of women working the fields, going to a sheltered spot to drop their babies without any ‘preparation’ and then returning to work describe a kind of mythical natural childbirth that is nearly impossible for Western women. We are far too cerebral, and our twentieth-century consciousness intrudes between us and our instinctual selves. The fact that we question both how to birth and how to parent shows how awake our consciousness is. We must of necessity involve our minds in understanding what we do and create, for it is impossible to turn them off. Nor can we simply erase, or afford to ignore, our culture’s view that giving birth is a dangerous and painful event requiring intervention and technology. Rather, we must consciously replace that view with new knowledge and new images if we are going to be able to reclaim our ability to birth with harmony of mind and body.

Loved this. The mythical woman giving birth by the side of the road and popping back into the field to work is strongly ingrained amongst “natural birth” advocates. Some women draw strength from the image—“if she could just squat in the field, so can I!” Others make a joke of it—“are you one of those nuts who encourages women to just squat in the field?!” And others are doubtful that it has any basis in reality. I also suspect that if said women did ever exist they did not return quickly to the fields because they wanted to do so, but because of the framework of their culture and those seen and unseen factors that shape our lives—perhaps their other children would starve if they didn’t run back to the field, perhaps the overseer would beat them, etc., etc. It doesn’t mean those women were stronger or more capable, but perhaps less valued and less cared for than they should have been.

Okay, back to Rahima again:

Our task is to integrate our minds and bodies, so we can give birth in a way that feels whole and nurturing—to ourselves as parents and to our babies…We cannot go back to ‘natural childbirth’ in which we just let it happen. There must be knowledge of birth and an assumption of responsibility for our own health care and for decisions affecting ourselves and our children. There exists for us the exciting possibility of giving birth with full awareness, participating in the joy and exhilaration of working in harmony with the tremendous energy of creation. But it does not occur automatically or unconsciously…

The potential for conscious birthing can exist independently of the place of birth, although some places require more watchfulness than others….Let us just say that it is actively giving birth in an environment which is woman-centered and child-centered, in which the cues are taken from the birthing woman while she experiences fully the sensations and emotions of new life coming into the world through her. She is not medically managed or manipulated, but is supported with the knowledge, love and experience of her attendants (doctors, midwives, husband, other support people) to birth in a way which is safe, yet does not deny the intense physical, emotional, and spiritual aspects of giving birth.

Birthing in this way is rare in today’s culture…less than 5 percent of women in this country today experience ‘purebirth’ [positive birthing/conscious birthing]…

Given the wealth of images of birth that surround us, our task is to recognize that none of them adequately denies or exhausts the potential of birth. Perhaps their infinite variety can help to free us from any one fixed idea of giving birth and help us to realize our freedom to birth in the way that is right for us. We cannot control the energy of birth, but we can control our response to it by deciding to be open, relaxed positive, noisy, grouchy, whatever. We don’t need to behave in a certain way and we can accept ourselves and our births without self-judgment.

What caught me about this section was the mention of not being able to go back to a time when we could just “let it happen.” Though I feel like getting out of my own way and “letting it happen,” was a personal key to my own births—that the surrender is what gets the job done—I agree with her point that there is no letting it happen in today’s culture. A long time ago someone mentioned in an online forum that they were not planning to take birth classes or read any birth books because they felt like they should just let it happen and not have any preconceived notions; that cluttering up their heads with this other information would cloud their ability to do so. While I hear the motive and feeling behind this sentiment and believe there is some (perhaps idealized) truth to it, I simultaneously feel like it is impossible to do this, because women do not give birth in a void or outside of their culture. Women give birth in a context, usually involving other people (even with unassisted births, there is usually someone else there). If you enter the birth room (the aforementioned woman was planning to give birth in a hospital, not unassisted) without any ideas or pre-knowledge about what to expect or what you want, the stories and dramas and ideas and myths and preconceived notions and reading and media-exposure of all the other people present DO enter the room and impact your birth. You cannot just “let it happen,” because they will not just let it happen. Right or wrong, this is the environment in which many of us our building our birth nests.

I’d like to close my thoughts with another quote. This one is from one of my favorite birth books, Transformation Through Birth by Claudia Panuthos. In giving birth, regardless of our nest and our choices and all the seen and unseen elements shaping our lives, perhaps we can simply, “…celebrate ourselves for our courage to birth. The real question becomes not, ‘Have you done your breathing exercises?’ but rather, ‘Can you love yourself no matter how your birth, where you birth, or what the outcome?'”

Book Review: Dance of the Womb

Dance of the Womb book cover

Book Review: Dance of the Womb: The Essential Guide to Belly Dance for Pregnancy and Birth
By Maha Al Musa, 2008
ISBN 978-0-646-48705-2
260 page hardcover book, $49.95 (AUS)
http://www.bellydanceforbirth.com

Reviewed by Molly Remer, MSW, ICCE

Some books simply feel good to hold in your hands. Dance of the Womb is one such book: it is beautiful, both in content and appearance. While priced a little higher than some birth books, I cannot emphasize enough what a high quality book it is—-it is not a traditional trade paperback, it is of textbook quality and size. Hardbound with a lovely cover and endpapers, Dance of the Womb is packed with full color, detailed, step-by-step instructional photographs leading the reader through a “belly dance for birth” journey.

Dance of the Womb is divided into several segments. The first section summarizes the benefits of belly dance and explores the physiology of birth. The next section walks the reader through a series of gentle warm-up exercises while the following sections progress through a variety of different specific belly dance movements. Nearing the conclusion of the text is a segment about labor movements with positions. Each section of the book is lavishly illustrated with very clear, easy to follow, step-by-step photographs.

The author’s own journey through pregnancy, birth, and mothering is skillfully interwoven throughout the text as well as her own feminine passage into understanding herself as a complete woman. Interspersed with the photographs and belly dance instructions, is the exploration of the author’s pregnancy and birth experiences, her relationship with her own mother and her parents’ culture. The book contains her personal birth stories as well as perspectives on belly dance for birth from three midwives.

The author, Maha Al Musa lives in Australia. Her interest in Middle Eastern Dance was sparked by her Palestinian/Lebanese roots and birthplace as well as her pilgrimage to explore her heritage and reconnect with her long-separated mother. Maha has also developed a Dance of the Womb step-by-step instructional belly dancing DVD (sold separately, review to follow) that includes a video of her own homebirth journey with her third child. She is also developing a one day foundation course in “bellydancebirth” for birth professionals with a plan to go international in 2011.

Dance of the Womb is a great introduction to not just the basic physical elements of prenatal belly dance, but also to the spiritual aspects of giving birth and life as a woman. It is written with an intimate tone that makes the reader feel as if the author has reached out across the miles to form a direct, personal connection. This book feels like a rich treasure to hold and is a gentle, nurturing, encouraging, and enriching voyage for pregnant women or the people who serve them.

—-

Disclosure: I received a complimentary copy of this book for review purposes.

Does Water Slow Down Labor?

il_570xN.684257213_8rjiA concern commonly expressed about using water during labor is that immersion in a tub of warm, soothing water has the potential to slow down or even stop labor, particularly in the early stage. For many women, this is not a desirable effect!

The Waterbirth International website (www.waterbirth.org) shares this information about choosing when to get into the water:

A woman should be encouraged to use the labor pool whenever she wants. However, if a mother chooses to get into the water in early labor, before her contractions are strong and close together, the water may relax her enough to slow or stop labor altogether.  That is why some practitioners limit the use of the pool until labor patterns are established and the cervix is dilated to at least 5 centimeters.

There is some physiological data that supports this rule, but each and every situation must be evaluated on its own.

Some mothers find a bath in early labor useful for its calming effect and to determine if labor has actually started. If contractions are strong and regular, no matter how dilated the cervix is, a bath might be in order to help the mother to relax enough to facilitate dilation.

Therefore, it has been suggested that the bath be used in a ‘trial of water’ for at least one hour and allow the mother to judge its effectiveness. Midwives report that some women can go from 1 cm to complete dilation within the first hour or two of immersion.  The first hour of relaxation in the pool is usually the best and can often help a woman achieve complete dilation quickly.

In the book, Birth Day: A Pediatrician Explores the Science, Mystery, and Wonder of Childbirth, Dr. Mark Sloan explores the biochemical reason why water immersion can slow down labor. I found the explanation interesting as well as logical:

When a laboring woman climbs into a bath, the refreshing buoyancy she feels sets off a chain of physical and hormonal events. As her muscles relax, her catecholamine levels—the ‘fight or flight’ hormones that rise in labor—decrease. This can actually help her labor progress, as excessive levels of catecholamines are known to slow down uterine contractions.

But countering that lowered-catecholamine labor boost is the effect that water pressure has on other maternal hormones. When a mother sinks deep into a tub, the weight of the water on her body forces fluid contained in her tissues into her bloodstream, thus increasing her blood volume. Sounds like a good idea—increased blood volume means increased cardiac output and oxygen-carrying capacity, and oxygen is a good thing to have coursing through your arteries when you’re trying to have a baby.

But the weight of the water on a woman’s body also causes a ‘pooling’ effect in the blood vessels inside her chest, because the rib cage protects the lungs from the water-pressure squeeze exerted on the softer tissues of the limbs and abdomen. Over time this leads to a complicated hormonal chain reaction that results in decreased secretion of oxytocin, the uterine-contraction hormone, from the pituitary gland within the brain. With less oxytocin circulating than before she climbed in the tub, a woman’s labor can slow down significantly.

The labor-slowing effect of taking a bath seems to be a problem only if the bath is taken early in labor, though. Once a woman is in active labor, the oxytocin surges are strong enough that no bath in the world can derail them.

The author goes on to explain that current research isn’t clear on when exactly oxytocin levels are high enough to prevent labor from slowing down, but suggests that it is “prudent to hold off on baths until the cervix has dilated to about five centimeters.” He also notes that water immersion during labor does not increase the infection risk for either mother or baby, and that as long as water is kept at body temperature, there is no risk to either of overheating.

I also decided to ask the real experts—birthing women—what their experiences were with water in labor. I posted the question to my Facebook Talk Birth “fan” page and received a few responses:

“I feel like it definitely helped me. I couldn’t find a comfortable position, but when I got out of the water it was definitely worse. It didn’t seem to slow anything down; C was born a few hours after I got in. I plan to blow the ol’ gal up again for the next baby.”–SE

“I have such fast, easy labor that I only get in the water for transition and delivery. I will not do it any other way and kick myself for not doing it with all my births!!! It definitely takes the edge off for me (and no ring of fire either). I think it actually does slow me down a bit, but my births are crazy fast, so that is a good thing.”–NA

“I feel like for first time moms it’s hard to know how to push when you don’t have all of the pressure. I labored in the water with Ashton but delivered him out of the water when things just weren’t finishing. With Brice I knew what I was doing so had no problems pushing Brice out in the water. I really liked the water but haven’t labored without it for transition. My [midwife] also has found that first time moms many times need to get out of the water to deliver and that it can slow down labor.”–RK

“I had a waterbirth with my 2nd, and due to her malpositioning it was by far my most painful birth. Most people say the water really relaxes them and eases pain, but that was not the case with me. Also, one thing I did not realize about water birth babies is that often they are not full of color when they are born. Some people say this is because they have an easier transition into the air. I’m not sure of the reason, but this was very startling for my husband. I just talked to her and rubbed her vigorously, and she pinked up soon after.”–GC

Personally, think the laboring woman should be the guide. If she feels like getting into the water, then it seems like the right time to me! With my second baby, I had a birth pool on hand thinking I may like to try it, but my labor progressed so rapidly that there was no time to blow up the pool, let alone fill it up or deliberate about when to get into it. As midwife Judy Edmunds says, “Waterbirth is one of many lovely ways to enter the world.”

Originally written for the FoMM newsletter.

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And Even More Birth Quotes

Continuing my semi-regular addition of birth quotes I’ve used on the Talk Birth Facebook page recently.

“When women understand what’s available to us at birth, then we won’t ever give that over to an ‘expert’ the birth power, the orgasmic power that’s in our bodies” –Christiane Northrup

“Women have the inner power and the inner knowledge of giving birth. There is a parallel of sexuality and giving birth. Women who are giving birth, trust yourselves. Trust your inner power. Trust your ability to give life. This is something absolutely sacred that is inside all women in the world.” –Ricardo Jones, MD

“If women experienced the ecstasy of birth, they would have the high that would get them through the hormonal changes of the next week. Your body and your inner wisdom give you that high.” –-Christiane Northrup

“While many of us believe that encouraging a laboring woman to move when and how she wants to is healthier and safer than making her stay in bed, waiting for evidence that it produces better health outcomes is putting a burden of proof on normal birth that has never been applied to routine intervention.–Amy Romano

“Pay attention to the pregnant woman! There is no one as important as she!” –Chagga saying, Uganda

“A pregnant woman is like a beautiful flowering tree, but take care when it comes time for the harvest that you do not shake or bruise the tree, for in doing so, you may harm both the tree and its fruit.” –Peter Jackson

“Can we create a world where all needs are met with dignity and individual culture is retained; where a baby anywhere in the world is born nonviolently and according to the instincts of its mother; where people progress in directions of full potential and spirit is not sacrificed; where women no longer obey, submit and apologize for who they are?” –Sister MorningStar

“If birth were a medical disaster in waiting, routine medical intervention would not disrupt the process. It does. If technology were integral to the process of birth, routine technology would improve outcomes. It hasn’t. If birth were inherently painful, all women would suffer without medicine. They don’t. The initial assumption[s] are proven faulty.” –Kim Wildner

“Having a baby [is] an opportunity to transform a life, because in the moments of labor and birth all the forces of the universe are flowing through a woman’s body…’If you have 12 babies you only get 12 of those opportunities. This is big fun.'” –Sister MorningStar

“I think that women can be just completely surprised by the change in them from giving birth—you have something powerful in you—that fierce thing comes up—and I think babies need moms to have that fierceness—you feel like you can do anything and that’s the feeling we want moms to have.” –Ina May Gaskin

“Birth has been broken. The spirit of women with respect to their innate birthing power has been broken. We can do nothing about the millions of broken births that have already taken place, but by seriously looking at the effect of fear–the powerful emotion that clouds our thinking and causes the birthing body to break down–perhaps we can keep the finely tuned, precision bodies of women whole for future generations…” –Marie Mongan

“When you destroy midwives, you also destroy a body of knowledge that is shared by women, that can’t be put together by a bunch of surgeons or a bunch of male obstetricians, because physiologically, birth doesn’t happen the same way around surgeons, medically trained doctors, as it does around sympathetic women.” –Ina May Gaskin

“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.” –The Pink Kit

“When it comes to pregnancy and birth, we as a culture and as individuals need to wake up and claim our right to literally birth right!” –-Christiane Northrup

“Birth may bring you face-to-face with your insecurities, doubts, inadequacies and fears, as well as your joy, determination, willingness and courage.” –The Pink Kit

“$13 to $20 billion a year could be saved in health care costs by demedicalizing childbirth, developing midwifery, and encouraging breastfeeding.” –Frank Oski, MD

“Let us initiate our daughters into the beauty and mystery of being strong and confident women who claim their right to give birth and raise their children with dignity, power, love, and joy.” –Barbara Harper

When it comes to birth classes, “restricting yourself to what ‘everyone else does’ will only get you what everyone else got. The numbers say this is a very sad limitation to place on yourself.” –-Kim Wildner

“In the absence of the medical indication for which they were developed, birth interventions are at best worthless, at worst, harmful.” –Kim Wildner

“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

 

 

Moving During Labor

The second Healthy Birth Blog carnival is up on Lamaze’s Science & Sensibility blog. It is a great collection of links to posts about the importance of Healthy Birth Practice #2: Walk, Move Around, and Change Positions During Labor. For the blog carnival I contributed a post/handout I made last year called How to Use a Hospital Bed Without Lying Down. We spend quite some time on the subject in my classes and I encourage my clients to treat the bed like a “tool,” rather than a place to lie down. I also encourage strategizing about ways to both meet the needs of the hospital staff for “confinement” as well as the needs of the birthing woman for mobility (so, sitting on birth ball right NEXT to the bed and monitor, instead of lying back in the bed—both sets of needs can be met this way).

When reading through some of the other links in the blog carnival, I particularly enjoyed the one at The Unnecesarean about Women Describe Walking, Moving and Changing Positions in Labor. In the post, Jill points out “For first time mothers who have had no exposure to a birth, the time between, ‘I felt a contraction!’ and ‘I have to push!’ is often a total mystery.” How true is this! How many birth documentaries and shows (even very good ones), essentially only show a few minutes in early labor and then the baby being pushed out? What happened during the other 12 hours?? Obviously, we can have an episode or documentary that lasts 12 hours and shows every single detail, but I do think this gap means it is hard for first time mothers to really get a “vision” of what labor and birth is really like—the “long haul” picture.

Of course, that post made me think about my own births and how movement played an important role in both of them. I think it was equally significant/important for both, but since I was in labor longer with my first baby I used movement much more. In early labor, I sat on the floor cross legged with my back straight (working to keep the baby in “optimal” fetal alignment :), while I ate dinner and watched a movie. Then, I walked in the hallway to see if walking would stimulate any increased contractions. I also sat on the birth ball. As labor moved on, I ONCE tried lying down on my side in bed to “go to sleep” (at the suggestion of my doctor and doula) and that was IT. I had one contraction lying down and it was the worst contraction I’ve ever experienced (both babies). I never laid down again during either birthing! No possible way! When I got tired, I did kneel on the bed with a pile of pillows in front of me and rested my head/arms on the pillows. I also spent a lot of time kneeling by the side of the bed with my head resting on my arms on it. (This was my own bed at home.) I sat and rocked in the rocking chair with my eyes closed. I sat on the floor (briefly) with the rice sock under my belly and husband sitting behind me.When I went to the birth center, I sat in the rocking chair (oh wait, I did lie down one more time, for my sole cervical check of either pregnancy/birth). I also went back to kneeling on the floor with my head on the bed. Then I gave birth to my first son in a semi-sitting position on the birth center bed with my husband behind me/to the side. (Not the position I would have instinctively chosen, I think I would have actually birthed him kneeling by the side of the bed, but I was encouraged to get up into the bed. See his birth story.)

With my second baby, I walked around (again, “testing” out whether labor was “real” and going to intensify) in our kitchen. I squatted down several times (again, “testing” and trying to “make it bigger“). Then, I sat on my birth ball in the living room. I only stayed there for a few contractions and then stood up and wanted something to lean on—I leaned on the back of the (too rocky) recliner. Then, I ended up kind of hanging on my husband for a while—my arms around his neck and my legs dropping kind of outward. I then felt “driven to my knees” and got on my hands and knees on the floor with my arms and head on my birth ball. I quickly decided I didn’t want the ball and got just on my hands and knees with my husband in front of me with his arms around me. My son was born while I was on my hands and knees in this way.

I think when women think about “active birth” or “freedom of movement throughout labor,” sometimes they think this means walking the whole time or squatting up and down and up and down, or literally being *standing up* and moving around “aggressively” throughout labor. My own experiences were “active birth,” but the freedom of movement includes being able to sit in a rocking chair and “meditate” through contractions, or resting on your knees with your head on the bed. The “activity” we’re really talking about is really not lying down-–having the body upright/torso above the pelvis.