Tag Archive | homebirth

Book Review: Birth Space, Safe Place

Birth Space, Safe Place: Emotional Well-Being through Pregnancy & Birth
By Adela Stockton
Findhorn Press, 2009
ISBN 978-1-84409-165-2

102 pages, paperback, $14.95

Reviewed by Molly Remer, MSW, ICCE

Appropriate for first time mothers as well as women having subsequent children, Birth Space, Safe Place is a slim and succinct little volume with a sole center: emotional well-being throughout pregnancy and birth. This very specific purpose is what makes the book special. It focuses on creating the emotional space for a gentle birth as well as a physical environment conducive to gentle, physiological birth. However, there is a broad range of topics covered within this specific focus including pain, fear, support, the “cocktail” of labor hormones, avoiding physiological disturbances of the birth process, optimal fetal positioning, and blessingways.

The chronology of the book flows from “conscious conception” through making decisions about birth location, preparing for labor, support during birth, “the spirit of birth,” and “early parenting joys and griefs” which addresses birth processing and postpartum recovery. The chapter on “cleansing the past” briefly addresses prior loss and bereavement, difficult previous birth experiences, and issues of abuse. Each section contains brief personal anecdotes, some from the author and some from mothers she has worked with. The exploration of each topic is brief, but is an adequate overview.

The author is a “childbirth homeopath” and so there are several sections about homeopathic remedies for specific symptoms or concerns. Aside from the homeopathic content, I did not feel as if I learned anything particularly new from the book, however it was very nice to have information about a specific element of pregnancy and birth preparation all pulled together into one nurturing place.

Birth Space, Safe Place is very supportive of doulas—for both labor and postpartum—and also of midwifery care and homebirth.

The book contains three appendices, endnotes, references, a glossary, and resource listing. The book is written in the UK (author is in Scotland), so National Health Service care is assumed and that system of maternity care, midwifery, and homebirth. The first appendix briefly addresses differences in US and Australian midwives compared to the UK.

And, make sure to check out my giveaway of Birth Space, Safe Place here!

Disclosure: I received a 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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Simply Give Birth: A Mini-Review

Only about a week following my miscarriage, I received a review copy of a new book by Heather Cushman-Dowdee (also known as Hathor the Cowgoddess). I have a pile of birth-related books waiting for me to review. However, I found that this soon post-miscarriage when I go to read them, my heart just isn’t in it, and I set them down again. However, Heather’s book was a different experience. Titled Simply Give Birth, the book is a beautiful collection of powerful birth stories (mostly unassisted births). When I got the book, I thought, “well, I’ll just flip through this a bit, even though my heart isn’t in it.” Well, I was instantly entranced in spite of myself. I didn’t finish reading it that week, but I picked it back up the following week and read it all the way through. What a treasure. It was very, very good and I really recommend it.

As I have briefly referenced here, I was struck by how the experience of “unassisted natural home miscarriage” parallels that of unassisted birth. Immediately after my body released my little baby, I felt strong and brave and powerful and like, “wow! I did it!” even though the outcome was not what I ever planned for or wanted. I rarely see feelings like that expressed in the many hospital/D & C miscarriage stories I’ve been reading lately and I feel happy that I was able to give myself and my baby the gift of “letting go” in our own dear home.

Reading Heather’s introduction about telling a new story about birth made me think there are new stories to be told about miscarriage as well. She says about the stories she selected for her book: “…all birth stories…prove what can be done. We can birth our babies and relish it too. We’re not stoic or fanatical, we’re mothers doing what mothers have always done, giving birth; with grace and spirit, and chutzpah, and moxie…they shared their grief, their passions, their exhaultation, and their fears. It takes massive courage to write about this most personal of moments with such candor and intensity and then be willing to share…”

Simply Give Birth is simply amazing. If hope you are lucky and find it in your Christmas stocking this year. If you don’t, or if you just can’t wait to read it, pop on over to the website and buy it ASAP!

Beautiful Homebirth Slideshow

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.

A Father’s Role

I recently finished reading the new book Labor of Love by Cara Muhlhahn and I was struck by this quote:

“Anyone would cry to see the way families interact around a homebirth. In a home environment, the intimacy and integrity of the family, especially the father or partner, often have pivotal roles to play. In the hospital, these key players are mostly cast aside except to hold the woman’s hand and cheer her on: ‘Push!” At home, they can support the mother in any number of invaluable ways, from regulating the temperature of the water in the pool to preparing food or choosing her favorite music.”

I have noticed this as well–I recently watched the new documentary Orgasmic Birth and was struck by the glaring differences in how fathers behaved at home compared to in hospitals. At home, they embraced their wives. They danced, they murmured, they stroked, they kissed, they held. At the hospital, they held her hand or tentatively stroked her back (with body at a distance–just a hand reaching out to lightly touch her). I’ve seen this in real life as well. I tell men in my classes not to be “scared” of their wives in labor, but to walk through the waves (of discomfort, anxiety, whatever) and just hold and love her. I tell them that they do not need to be “trained” to be more “special” or different than they are. They don’t need to be doulas. What they need to do is love her the way they love her and reach out to her to show her that. I tell them that hospitals can be intimidating and it can be awkward to show physical affection in that setting, but to do reach past that and do it anyway. I’ve read a number of posts and emails recently about whether fathers belong at birth–I think they do, but I also think that the hospital climate too often discourages them from having a real role or being valuable. I think they can be stripped of their position as “lover” and “father” and left feeling helpless and useless.

Birth Talk Podcast

Late last month I participated in a fun podcast interview with childbirth educator Donyale Abe of Birth Talk. You can download the podcast here. We had a great time chatting about birth, fear, homebirth, educating women, ACOG’s statement against homebirth, and our passion for birth and for talking with other women about birth! The audio is a little difficult to hear sometimes when I am talking (maybe that is just on my computer).

As a funny side note, the whole reason this blog ended up being called “Talk Birth” instead of “Birth Talk” is because when I went to get a gmail address, “birthtalk” was already taken. So, I settled for my second choice, “talkbirth.” Later, I set up this site/blog and called it the same thing as my gmail address for consistency 🙂 Then, several months after that I ended up making contact with Donyale via some blog posts I’d made and discovered during our emails to each other that lo and behold, SHE was the person who has the “birthtalk” gmail address I’d originally tried to get! How funny!