“Remember this, for it is as true and true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.”
― Ina May Gaskin, Ina May's Guide to Childbirth: Updated With New Material
Womanhood for at least as long as mass media has been King has been fighting a battle from the moment they come to the knowing that their body is something to be looked upon as a thing of beauty or even a thing to be desired by another person. This battle is one with a fear that somehow we aren't beautiful enough. Somehow our body doesn't fit the bill. Somehow our body will let us down. It is a fear many of us are taught to have by our parents or conditioned to have by the representations of the female form in the media we consume on a daily basis. At some point in our development we are taught to distrust our body. It is something that few of us manage to avoid, and yet we all expect ourselves to exude confidence. Isn't that an appealing quality - confidence?
This fear permeates so many areas of our life. From a worry that a "bad" hair day will cause someone to think ill of us to a woman so worried about her size that she cannot be intimate with her husband. It comes in so many forms that some of us may not even realize we are affected by it.
How this fear takes form in our pregnancies and mothering can greatly affect the way we experience both birth and motherhood. By far, my most popular post at the old blog site is titled - My Body Wouldn't/Won't Dilate.
If you look at the comments section, you can see the huge concern, and even total belief that for some reason for some of the women who commented, they are dealing with a broken body. Their body is somehow a lemon. The blame of "failure to progress" goes to their body's inability to perform rather than a series of interventions, a situation that was less than optimal, or even a valid medical reason that was true for the pregnancy in question, but likely will not be a concern in a subsequent pregnancy. My heart feels heavy when I read each comment with my incapability of addressing them all or even to offer any sort of reassurance.
I have also experienced this in mothering when I speak with my mother's and grandmother's generations about why they did not breastfeed. I have been told that breastfeeding was what poor people did and they did not want to seem poor. The feeling that somehow the milk coming from our breasts is inferior or embarrassing. I have been told that some of these women were told their breasts were too small and inadequate to supply their large baby with enough to "fill them up". Again, their body just didn't measure up to the demands on it. Or so it seemed.
Mothers get so hung up on how much weight they are gaining during pregnancy and whether or not they look huge without instead focusing on the quality of food they are eating, or paying attention to the cues their bodies are giving them about their food intake. I'll never forget Shiva Rea's Prenatal Yoga DVD and her explaining how she gained 60 pounds during her pregnancy, not because she ate everything in sight, but because she listened to her body and knew that it was best for her and her baby. This svelte yoga goddess, gained a beautiful 60 pounds during pregnancy.
Beautiful Mama Tiffany!
It is of no wonder that when faced with one of the greatest challenges of a woman's life - labor and birth - that this distrust would greatly affect how we experience it. Reclaiming our acceptance and love for our bodies must be part of our preparation for childbirth. Recognizing our body as a Divine Vessel for the emergence of new life is the first step toward this new love of our body and an affinity toward self care that is an essential component of giving birth.
How do we overcome our experiences and the inundation of mistrust? Where can we look for reassurance? How do we come to love and celebrate our bodies?
I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well. Psalm 139:14 (NIV)
This is a verse that I looked to throughout my last pregnancy. You can choose a verse, poem, or affirmation that speaks personally to you. This one particularly made my heart sing because I was very much in awe of what my body was doing in pregnancy. I was amazed at how much I could do at 9 months pregnant, and how as I treated my body properly - feeding it well, moving and exploring its abilities, and resting it - I would shine with a radiance that I had at no other time in my life.
We are made fearfully because look at the incredible power pregnancy holds. It's a miracle of science and spirit that we still have yet to understand fully. Without us having to understand the how, our body performs. We are wonderfully made because of the excellence in both inner and outer beauty we can carry during our pregnancies and births. Look at the mothers pictured throughout this post. Each uniquely formed. Each of them carrying their precious babies differently and perfectly for their body and that pregnancy. Are they not each beautiful? Amazingly beautiful!
It is time for us all to think of ourselves as worthy of being the vessel in which a miracle is formed. Worthy of carrying a baby. Worthy of being treated with respect during pregnancy, labor, birth, and postpartum. Worthy of being supported to give birth how we see fit while listening to the inherent wisdom in our bodies. We are worthy. We are divinely beautiful!
Beautiful Mama Shaina!
"Alice laughed: "There's no use trying," she said; "one can't believe impossible things."
"I daresay you haven't had much practice," said the Queen. "When I was younger, I always did it for half an hour a day. Why, sometimes I've believed as many as six impossible things before breakfast." Lewis Carroll, Alice in Wonderland.
Beautiful Mama Shantana!
Believing you are deserving of a healthy pregnancy and birth is not an impossible feat. We can be self sacrificing and say we don't care how it happens as long as the baby is healthy. But, we have to remember that the journey matters. The journey matters and those who accompany us. Would we want to see our child dragged through the muck by an old mean, mangy dog as one of the many ways to get across the yard as long as they weren't permanently hurt by it? No, we'd rather see them skipping and singing. A positive mother who celebrates her body and the wonderful things it is doing for her and her forming baby will play an important role in how safe and secure a baby feels during pregnancy, labor, and birth. Balance is the word.
Research backs up this thinking. The World Health Organization has stated before that 85-95% of pregnancies can be expected to go normally. Current studies confirm this previous recommendation in that it seems a c-section rate higher than 15% does more harm than good.We can be thankful that we live in a time where our bodies can be supported in birth through intervention if it becomes medically necessary. However, we are harming ourselves by thinking that we should expect interventions or that we need to accept them without clear medical reason because our body hasn't met some mostly arbitrary deadline or is growing a big baby. If we are healthy, and have treated our bodies as well as was possible for us, then we should expect our births to be just the same in the vast majority of cases. Look again at these beautiful mothers! All of us reading these words are capable women. Our bodies are beautiful works of art. They are full of life before, during, and after pregnancy. We are worthy. Celebrate your body as you prepare for birth. Wallow in its strength. Stand in awe of its function. Enjoy your body. Call it beautiful!
At the end of November, I was honored to play a small role in the amazing homebirth of Hazel May. Her mother was fully empowered, prepared, and supported. It was a beautiful birth. I was so happy to hold vigil at my first homebirth as a doula. It was a great experience. What I am overjoyed about is that homebirth is once again an option in the mountains of southeastern Kentucky - the birthplace of nurse midwifery. For almost 2 generations now, homebirth has been rare in these hills that hold such a strong tradition of midwifery. I feel so very hopeful that the women of this region now have access to a fuller range of birthing options. I am so very thankful to Hazel's family for asking me to be a part of her birth story. It is truly an honor every time I have a client. I will be writing more on accessing birthing options soon. In the meantime, I invite you to visit my client's blog and read the story of the birth of Hazel May and share in her family's joy - Life Through the Looking Glass.
I am proud to say that homebirth is a safe option for so many birthing women as this story illustrates.
I also invite you, if you are local to the region, to come out this Saturday to learn more about the efforts of the Kentucky Homebirth Coalition
to license homebirth midwifery in the state of Kentucky. This effort will affect the women of the state profoundly and it is very important that the women of our region give a voice to this effort and express our needs and concerns. Learn more at this Facebook Event page
. Please, if you are not from our region, feel free to share your experiences with this process in the comments section of this post. We can all benefit from learning from the efforts of those who have gone before u
For anyone curious about what midwifery looked like in the recent past of the Kentucky hills, visit EKRHP and watch this twin birth attended by Lena Stephens in the home of the mother. It is absolutely awe-inspiring. Click the picture of Lena below to be taken to the EKRHP website featuring the Vimeo video of the birth.
Yesterday, I read a brilliant article in Pathways for Family Wellness magazine
by Charles Eisenstein called "Don't Should on Us". Eisenstein writes on the reasons he feels the environmentalist movement is falling short and why, if they don't change their approach, will continue to do so. His writing made me think of all the work so many of us are doing to promote evidence based childbirth
, and some of the things that I hear again and again are frustrating birth professionals of all types.
It is very often on Facebook groups, mothering circles, and in private conversations with those who share information with women and those who call themselves birth advocates/activists that I read or hear that they just do not understand why a particular woman isn't open to receiving information or why is she going ahead with that choice when she knows what a risk that is to her birth plan. I read and hear how they wish that women would accept responsibility for their births and understand that they can take direct action to affect the health and safety of their birth despite what their care provider or others might be suggesting they do. The question on so many lips is - "Why would she just blindly accept that?"
I personally know how sad it can make you feel when someone experiences the direct negative impact of non-evidence based practices, and especially so when you are their friend, family member, or a hired birth professional. Particularly when you have talked with them about what they want in birth and what the evidence about birth actually tells us. It is frustrating and can make some advocates feel like they work so hard and yet seem to fall short too often. I know since experiencing unnecessary c-section I feel so very protective of mothers in regards to avoiding the interventions that could lead to surgical birth.
As Stephanie Dawn
, the Sacred Birth Founder/Mentor, has described it, we are ushering in a New Paradigm of birth and driving out a deeply patriarchal and established Old Paradigm. That process is not going to be easy and it will be long. But, what we can find comfort in is that what we are espousing is the true nature of birth and in modern times combined with our greater understanding of birth and modern medical possibilities is safer for more women than ever before. We can find comfort that this is the Truth despite ridiculously high cesarean, induction, and preterm birth rates that we are experiencing in our external reality. Why? Because as Eisenstein shares in his article, it is our human nature (our spiritual nature) to gravitate toward what can be accomplished with simplicity in ways that utilize our true inner abundance of resources.
When we approach people with the energy of wanting what is truly in their best and highest interest, they will instinctively trust us. Sometimes, to be sure, a person must experience something in order to realize that isn't what they actually wanted. But the message will stay with them until the time comes for it to sprout. When we act from the knowledge that a person's "selfish" interest is actually toward simplicity, closeness to nature, and closeness to community, then our urgings lose any judgementality and assume the force of a trusted friend's support. - Charles Eisenstein, "Don't Should on Us", Pathways to Family Wellness, Issue 35/Fall 2012
This must become our approach. Let's look at this from the inner want of most every mentally healthy mother and many of those with compromised mental health - a healthy baby and a healthy birth, in that order. Our instinctive nature as mothers is to protect both our child and ourselves. Whatever gets us to a healthy baby will ultimately be okay. That is why a healthy birth will come secondly. Very few women would say that they would sacrifice that baby's life to experience a natural childbirth if it came down to it. The choices women make are instinctive whether one chooses to birth in the hospital via elective surgery or whether one chooses to freebirth
. I truly do believe that both of those choices at the opposite ends of the birthing spectrum come from the same root instinctive source - protection of the birthing environment and the assurance of a healthy baby. It is the pressures that they feel from society that directs how and where they feel giving birth is appropriate.
Eisenstein directs us that our "selfish" interest (or our instinct to self preserve and thrive - K.B.H)
lends itself to choices that are simple, close to nature, and close to community. In thinking of these three tendencies in the face of our current situation with mainstream birthing practices, it reveals how our scope of work as evidence-based birthing advocates much be much broader to amend and appeal to the women we encounter through our work.Toward Simplicity
This one is simple. As the female of the species our instinctive nature is going to ask us to prepare for the simplest means to getting our babes earthside. In terms of what is simple, preparing for a nonintervention vaginal birth in a location that is comfortable and safe would be optimal. Evidence tells us that avoiding intervention unless medically necessary is the safest way to give birth. So, as we should expect evidence supports our best and highest interest. However, from childhood humans presenting as females are taught by mainstream culture to not trust their body. We might get too fat. Our hair might be too frizzy. We need cosmetics. We must be ashamed of our menstruation. We must be careful how we express our sexuality and with whom. You need multiple diagnostic tests to confirm you are healthy enough to sustain a pregnancy without intervention and the baby has no anomalies. What if labor doesn't happen by your due date? What if you don't dilate? What if your baby gets stuck? Are your breasts too small to breastfeed? It is easy to see how this mistrust could turn into the thought that it might be easier to have a medically managed birth.Closeness to Nature
Again evidence supports our self preservation toward a closeness to nature or what is natural. In mainstream American culture, it can appear that we have lost this desire. It is, however, basic to who we are as a living being. What we can accomplish with the greatest simplicity is that which can be done with our natural ability. Evidence supports less intervention in birth. Pain medication as a routine is intervention that can be a source of complication in an otherwise healthy birth. We must see that as truth. However, I personally have accepted pain medication in labor and I as a doula have seen it help along a complicated labor. I know it has its place. What I also know personally and as a doula, is that when we are experiencing a variation of normal birth, unmedicated (which we are all capable of doing), and are supported fully by those around us - never suffering (this is the key), we will heal faster and our children will initiate their first instinctual functions and bonding sooner and with greater ease. My HBA2C was my easiest birth yet, despite it being a 34 hour active labor + pushing with a week of prodromal labor prior. It is what is normal, natural, and physiological. However, in our mainstream culture the vast majority of images of women giving birth in film and on television show a woman not coping and unsupported. Pregnant women are bombarded with horror stories complicated deliveries that when examined were often high intervention or a woman being neglected rather than supported. The meds are there, why wouldn't you take them? So, it is easy to see how our mainstream system sets women up for dis-empowerment.
.Closeness to Community
We are built to live in community. We are a social being. Our instinct is also to protect our place in whatever social group we belong to. The pictures and sculptures are many of the births of old. Women surrounded by women, in birthing ritual ( See Wisdom of the Elders - On Becoming a Mother by Liz Cheney).
Birth was a sacred dance. Experienced women counseled expecting mothers on what to expect of birth. What has changed in our culture is that birth is expected to be manipulated. It is no less so that experienced women counsel expecting mothers. However, beginning with our grandmothers fewer women have experienced birth as a rite of passage. In fact, many of our grandmothers do not remember giving birth at all because they did so in twilight sleep
. At some point in time, we (women) thought that in order to gain equality in our society women should be less aware of what they experience in childbirth. What resulted was actually the severe abuse of birthing women. As twilight sleep fell out of vogue, medicine sought to replace it with more palatable alternatives. Birth was looked at more like an injury to be avoided despite the physical capability of women to give birth without permanent injury when support in the right environment. Our back story has changed, and to dare to step back in time to retrieve some of the positive past related to birth is a scary venture. Not only are you stepping outside of societal norms, but you may have to disagree with medical professionals who in our culture are held in regard as those with authority over our decisions. Who are we to question how it has been done for our sisters, mothers, grandmothers, and for some of us great grandmothers? Those of us thinking of unmedicated birth are warned against it repeatedly. If the result of us stepping outside of these norms is anything less than perfect who is going to be blamed? Even when the results are normal, there is risk. We hear of mothers having their children taken from them for refusing c-sections.
It is not only the birthing women, but those who help them by giving them options who suffer in our society. The most recent one to hit the natural birth community hard was the undercover investigation and arrest of Brenda Capps in California.
A "lay" midwife who offered to support women in making their own choices as described here
. Even within the movement itself, communities are turning against their midwives and mothers who go beyond what the community is or have been told to be comfortable with to make their own choices. No, it is very easy to see how the risk of fighting through what should be a glorious life event - the birth of your child - could seem unappealing. It is easy to see how the risk to our place among our community places too much fear behind the choices that actually help us birth in evidence based ways.Our charge as advocates is bigger than sharing information, and being midwives, OBs, and doulas.
What we are doing is changing a paradigm. Releasing old ways that do not serve us anymore. We must work in a larger realm than sharing evidence based practices and then supporting those who find the capacity to choose those options.
The shortcomings of many childbirth education programs and well meaning information sharing is that we give information, offer support, but then we leave out how to go against our instinctual nature to protect ourselves in the world that is presenting itself to us to actually make the choice to act of this new information. We teach coping strategies, but we neglect to share how to actually release fears. We tell women that homebirth is safe, but we do not offer tools to help them protect their choice from their well-meaning community who have yet to understand it. We tell women that their "body is not a lemon", yet we don't share with them ways to learn to once again love and trust their female body.
To simply share evidence based options is not enough. Sharing facts is not enough. For some all they hear is as Eisenstein writes - "You should
do better... On the most obvious level, this approach backfires simply because people can always sense judgementality, and they naturally respond to it with hostility... Alternatively, some people are temperamentally inclined to buy into guilt and shame. The message works on such people, but it cannot spread beyond them." How are we going to actually change this old paradigm into one that gives the space for us to act on the Truth of who we are as women? How will our efforts help to bring balance to our society? Going back to Eisenstein's comment on how it is sometimes necessary for us to experience something to know that it isn't what we want, we can see that this is going to take time. Some women, such as myself, will have to have one birthing experience in this old paradigm to even realize it is wrong and cannot serve them in their goals. As advocates we need to fill our bags with tools to help mothers heal and find the empowered position they need to make the choices that protect birth and regain our society's reverence for it. But, most of all in this work we must find our patience.If you haven't already, and would like to know more about tools you can share with women to do just this, I highly suggest you check into the work of Stephanie Dawn. You may also find her on Facebook. Her work has totally changed my perspective on how best to support women as we usher in the paradigm of Birth Heaven.
"I refuse to live in a paradigm of fear." - Rixa Ann Spencer Freeze (author of the blog Stand and Deliver: Reflections on Pregnancy, Birth, and Mothering
When I read this quote in the essay of Rixa Ann Spencer Freeze's husband in the current issue of The Journal of Perinatal Education,
I wanted to cheer for her and him. I wanted to stand up and dance. The essay Eric Freeze, PhD. wrote about his experience of the poetry of his wife's body during their unassisted childbirth and the aftermath of interviews touched me beyond words. I had just seen the picture on the left-hand side of the screen of my Great Aunt Carol Ann (Johnson) Baker after the birth of my cousin Pamela. It is the first birthing picture that I have seen of any of my family matriarchs and as far as I am aware the only one that exists.
I haven't heard anyone talk about the births of the babies of our family much at all, even when prodded for more information. I have heard the most from my mother who gave birth to all three of her children via cesarean surgery. Of my birth, she said she couldn't dilate passed seven and I went into distress and had to be delivered in an emergency. Sometimes when she tells the story it sounds like her labor had been augmented. She doesn't know though and seems confused when I ask her about the possibility of pitocin being used. My maternal grandmother doesn't talk about giving birth and doesn't really seem up to it. My paternal grandmother talks very little about it. I know she was alone when she birthed my dad in a navy hospital. I know he was a vaginal birth and was 9 pounds. I know her doctor had her walking in the sand of the beaches of Coronado, California before his birth to prepare her body for labor. It is as if our lives didn't start until we came home from the hospital and the way we came into the world is a mystery.
Seeing this picture of my Aunt Carol filled me with unbounded joy. The look on her face, a combination of sass and happiness, is absolutely gorgeous to me. We've all heard the proverbial sayings - we fear what we cannot understand
, or we fear the unknown
. Nothing on her face speaks of birth being hardship or something to be withstood as the "lot" of womanhood. Her face projects only - look what I did
! There is no fear in this picture. How is it that every story I have heard about our birthdays contained either fear, loneliness, or both? Was Carol the exception? Despite my having both of my grandmothers and my mother earthside still, I'll probably never know the whole story of birth in our family. What I have known before is the fear that those births left with my mothers. I know when I was planning to VBAC both in my second and third births my mother and maternal grandmother held their breath, not believing it was possible for me to birth vaginally, like with my mother we'd somehow lost that ability. If it wasn't for my having been a part of natural, vaginal birth as a doula, I don't know if I wouldn't have believed that too.
When did we lose the belief that we were made to give birth? When did womanhood begin to birth in fear? Is fear in birth only prevalent in certain cultures and relatively absent in others? I can't answer any of these questions at this point in my work though I know further study will answer them for me. I can only speculate as to what womanhood lost in order for their to be an optimal environment created for fear to manifest and flourish. It was the moment we began to see birth as something apart from our body. Something that was being done to our body. Something for us to endure instead of experience. It was the moment when those attending our births began to have a perceived "authority" over us, instead of being simply "with woman."
In a time when we know so much more about the medical and anatomical sides of birth, it would seem like there would be less fear. It seems to me like there is much more. Many of us are happy to turn our births over to doctors or midwives and allow them to make the important decisions about how our babies make their entrance totally on their own. Others of us fear the pain we may experience in birth or that we will never go into labor on our own. There are some who fear the process so entirely that they want to know nothing about it. Pregnant women are often bombarded with horror stories when they should be lifted and supported by the stories they are told when preparing to birth. What is this paradigm of fear we have created? It is a dis-empowerment of women.
It could be a daily thing that those of us as birth professionals encourage women to refuse this paradigm of fear, to step into their own knowingness, and take up the strength that being a vessel for life gives them. We must at some point ask what are we doing for our daughters and young women to help them to never doubt that though it feels untamed, new, and expansive, that birth is another function of their beautiful and amazing female bodies long before pregnancy. How do we raise empowered women, so that birth isn't something we feel we must reclaim for ourselves or be paralyzed with fear? It does require a new paradigm of birth which so many of us are working to manifest.
Birth is a story we must tell. We must know the details of how we came into the world long before we become mothers ourselves. Options in birth must not be hidden from us. We have to learn how to have self-love as much as we mothers feel we must be self-sacrificing. Tell our daughters about their stories. Share with them the empowering stories of other women alongside those that ended in tears. Birth should not be a secret we keep from our daughter or our sons. Allow them to be unashamed about the capability of their body. We must refuse to live in a paradigm of fear by giving those attending us in birth the "power over" us.It isn't a woman's selflessness or over modesty mistaken for humbleness that allows her to give of herself in strength as a mother during birth. It is a deep reverence for her capability. It is the joy she has in her hard working body. It is the respect for herself as a vessel for bringing forth life. It is her self-love and the love for her sweet babe. Birth isn't about allowing your body to be torn, manipulated, and exhausted for the sake of your "healthy" baby. It is connecting with the inner knowing that only you know what is best and allowing your body in freedom to move, stretch, work, and growl for the gorgeous song that is healthy birth for both you and your baby. ~Kelli B. Haywood (from www.facebook.com/birthtrue)
We MUST refuse to live in a paradigm of fear... for our daughters.
I have been so happy with the responses to my birth story with Gweneth
and inspired by them to continue head on into my work with VBAC support and advocacy. I want to blog here more regularly and would like to begin by addressing this awesome comment to my birth story."I have so much respect for the women, families and birth attendants who take responsibility for being fully informed, managing risk using non-clinical methods and excellent preparation and accepting the consequences - the divine & sublime as well as the occasional less than perfect outcome." from L
What does it mean to be prepared for labor and birth? What does it mean to be prepared to accept the consequences of our choices?
I'm not sure if it is ever possible to be prepared for a bad outcome. It is fact that the reason we prepare at all is to hopefully avoid a bad outcome. The fact also is that no matter how much we prepare for birth, some of us will experience a "less than perfect" outcome.
When I was preparing for the birth of my second daughter, I spent all the time I could steeped in information on natural birth and homebirth after cesarean. We took Bradley Method classes. I chose for my birth team women who had also experienced VBAC. But, what I was lacking was the deep inner work that was needed to prepare me emotionally and mentally to actually do the work. It was one thing to have the book knowledge and another to apply it.
Looking back on my second pregnancy, while I felt like I did do so much that was great toward creating a situation conducive to a beautiful HBAC experience (it ultimately ended in another c-section), there was so much else I could have done. Not that I can do anything about that now, and not that I have regrets. I have learned that being well prepared for birth is a marriage between facts and connecting with the feelings of our innermost selves. How do we reach the point of empowerment? Because giving birth is not about bravery. In giving birth, it should not feel like we are going to war or fighting for our rights. A reliance on bravery in labor can fail us. It isn't only about physical strength. A woman who has a low pain threshold is just as equipped physically to give birth as a woman with a high threshold. It most certainly isn't knowing a lot about birth. You can know a lot but not have the wherewithal to do anything about it. How many times do we say 'I can't' or doubt that something is possible for us?
Let's look into the couple that create this marriage which allows us to become empowered pregnant and birthing women. It is a melding of masculine and feminine energies that when one is let to affect the other empowerment is born.
Many times for women knowing what you want out of pregnancy, labor, and birth comes intuitively, if you are in touch with that inner voice and not guided by fear. I truly believe that if more women were able to acknowledge their inner knowing, feel supported, and we weren't living in a fear based culture, that we would see more women asking for natural options in birth. I remember knowing from the moment I decided to try to become a mother that I wanted to give birth naturally. What wasn't in place for me during my first pregnancy and birth was the book knowledge and unfortunately the network connections to make my dreams happen. I simply knew I wanted to birth naturally. I wasn't afraid of pain, and I felt I could do it. So, when we were told at 38 weeks by our OB group (I unsuccessfully tried to find a midwife in our city despite the fact that they were there.) that it was too risky to birth my baby vaginally because of her size. I agreed to a c-section having not felt the first pang of labor. Ignorance was not bliss for me in this situation. It was heartache. I didn't know enough. I didn't even know that I didn't know. I signed the consent form in tears.
I could write a whole other post about the importance of making evidence based birth information transparent in our communities for all women, so I'm going to focus here on how the individual obtains the information they need to make informed choices. It isn't complicated if you are already looking for the information and can determine if what you are reading is a reliable source. There are countless books and internet sites out there about birth, and of course not all of them are trustworthy despite their appearance to be so. To obtain solid information take the following steps (click on the highlighted words for links to help you further):
- Choose a care provider and birth setting (birth team) that is comfortable with helping women access their options in childbirth.
- Explore your options and the risks and benefits of those choices.
- When talking about options/decisions with your care provider always use your BRAIN - Benefits, Risk, Alternatives, Intuition, Nothing/Not Now
- Take a childbirth education class of your choosing independent from the hospital classes you may find.
- Gather enough information that you can be solidly comfortable with the birthing options you choose both acknowledging the benefits of them and being prepared to handle the risks as well.
The key piece missing out of so many birth dreams is the acceptance of the feminine part of birth. Yes, it is so
common for women today to give birth totally out of touch with the feminine energy that they need to maintain their safety, their dignity, and the appropriate emotional responses in their experience. The breadth of our society so often seems to negate this feminine presence as a bunch of "hooey" or "softness" to the point that in important life situations both women and men can be stripped of just what they need to be truly powerful.
How do we regain this connection with the feminine? By acknowledging our need for self care and self love. My Sacred Birth Mentor, Stephanie Dawn
, reconnected me with this missing piece of my self when she said, "How can we expect to effectively serve others when our own well is dry?" Learning to love ourselves or relearning this can take some time and gentle patience, but having this in place will give you the strength to go wherever birth may take you. It will also give you the peace you need as a mother. Take the following steps:
- Connect with yourself deeply. Journal, pray, meditate, contemplate... whatever is appropriate for you. Do it daily or as often as you can. Don't be afraid to go there and love yourself through whatever may come up. It may become necessary to process with another person be it a close and wise friend or a spiritual counselor or therapist. Afford yourself that.
- Take care of your body. Eat good, quality food as much as possible. Move your body through natural forms of exercise (yoga, walking, hiking, swimming) and learn how amazing it is. While pregnant, explore just how much your pelvis can open and move.
- Be in your beauty. Have maternity pictures taken. Dress in colors that inspire you. Acknowledge your gorgeous parts. Acknowledge how amazing your body is. Don't allow shame in. Watch videos of beautiful birthing mothers.
- Be in your sexuality. Sexual expression created your baby. Embrace the healthy and positive nature of sexuality and express it confidently. Discard the shame and perversions placed on it by a fearful society and one that has forgotten how to revere and respect their sexual partners and objects of desire. Birth will ask you to let go and allow your body to be used in a mutual benefit of yourself and another.
- Build a fortress. Listen to your intuition. You are developing a mother's knowing. Create a space around you that is positive and nurturing. Anything that is not can be dealt with more fully after your birth if you so choose to take it up again.
By doing this work, you ensure that all parts of your birth plans are in place. You give yourself the freedom to birth without restraint so that regardless of what comes up during the process, you can approach it with a solid framework that is true to all parts of you. A framework that respect you the birthing mother and your desires for your birth and your baby.
Thursday morning came and my contractions once again spaced back out. I was beyond frustrated at that and way too tired to be home alone. My husband stayed home and we waited on my midwife to arrive. I napped a bit, but found I wasn’t able to eat much. Pudding and ice cream were about the only thing I could stand to put in my stomach.
My midwife arrived in the afternoon. She noticed right away that the baby was lower in my pelvis, so we checked on her head first. Her head was fully engaged in the pelvis! This was awesome news to me because my second c-section was due to malpositioning and a prolonged rupture of membranes and my baby never engaged the pelvis. We listened to her heartbeat. She sounded wonderful! With this news, I felt a renewed sense of strength. My body was doing this! I told my midwife that as long as the news was this good, I’d go on for however long it takes. She stayed with us almost four hours before she headed back home.
That evening contractions began again a little earlier this time than the previous evenings. They were again fifteen minutes apart, but were even more intense. My mind told me this was active labor, but I didn’t want to get my hopes up. As the night progressed, it was undeniable that I was in active labor. Contractions became closer together at ten minutes apart and some as close as five. My husband felt we should call our midwife to come back, but I worried that I would be calling her all the way back to our home for nothing. I didn’t want to bother her. My husband reminded me that it was her job and not a bother, and that he was pretty sure the baby was coming soon. He told my midwife that he wasn’t sure if I would make it until morning. She had only been home one hour from travelling back from our house when we called her to return. This was around 11pm. She asked to take a short rest before hitting the road again, and John agreed that we’d be fine and would call her if anything hastened or slowed down. We called Heather as well, and she returned to our home again right away. She had been with us earlier for the prenatal visit.
Nothing slowed down. Again, I was vocalizing through all my contractions and doing deep breathing. The vocalizing helped me to keep my breathing deep and my jaw loose. John helped me some with counter pressure, but mostly I just needed him to hold my hand. As we became even surer that this was it, my husband called my sister to make her trip. She was four hours away. I stayed in our room most of the night trying to rest, but it was pretty much impossible to sleep. I also started to vomit.
I heard our midwife come in at about 4am. I couldn’t go out to greet her, but I listened as she carried in all of her supplies and Heather helped her get settled in. The next morning when I emerged from my bedroom at daybreak, my midwife was asleep on the couch. Heather had taken over the care giving for our girls as I needed John’s full attention. They weren’t awake yet either, but I was in search of food. More pudding for me. Everyone began to stir and I continued to contract. This continued on all day and into the night. We checked in on Gwen periodically and she was always fine. We were finding her heartbeat lower and lower. I was so encouraged that labor was really happening. The day kinds of runs together, but I continued with more of the same – walking as I could, mostly laying on my side, using the restroom, and trying my best to stay hydrated as now my food was coming up always. It became too hard for me to eat, but my midwife encouraged me to try some protein. I ate most of a spoon of peanut butter. Also, my vocalizing had turned into a prayer – “Lord, help me please.” Sometime in the afternoon my sister arrived. Both she and Heather kept my girls occupied while I labored. That was a Godsend because the girls were becoming pretty impatient with the wait. They had been waiting too long already.
Toward late Friday evening I began to feel very weak. I was afraid that everything was going to be for naught. The contractions were changing once again and were feeling even more intense in my lower abdomen. Our midwife reminded me that these were normal sensations as there were times when I felt that I would explode. I didn’t expect for the fear of uterine rupture to come up during my labor as I knew the statistics well and trusted that everything was good with my body, but it did. Encouragement helped me so much in regards to this and I resolved to push through as long as everyone around me felt things were normal. My heart also knew things were normal. They say that women often go into a trance like state during the last parts of labor, but my thinking mind never left me. It was something I had to be present for in order to work through to the end. This was the part that I could not have prepared myself for - the emotional journey. It was the work I had done prior through prayer, meditation, affirmation, and healthy living that helped me prepare for the emotional journey during labor. I had decided early on that self care would be my key piece of making this pregnancy and birth my healthiest yet. Regardless of how things ended up, I’d be prepared emotionally, spiritually, and physically, knowing my body was just the vessel through which the Creator would do the work of bringing forth my Gweneth.
It was around this time that I decided to rest and let the contractions take over completely. I had used the analogy of riding a wave with women before as their doula, and this is what I decided to do. I decided to embrace the pain and to release myself into the process wherever it would take me – into a different plain of life or even death – as long as it brought my baby forth healthy and strong. I let go, and told my birth team that I was doing so. I can’t remember my exact words, but they knew I inherently knew it was time. I could tell the energy in the room changed.
After resolving to give in, I began to try other positions. I tried the birth ball a little while as I also tried to down the rest of my spoon of peanut butter. The birth ball made me more uncomfortable and awkward feeling. I then sat on the birth stool, which worked out really well. I would lean back with the contractions and they would become more tolerable at the same time they were super productive. It was strange how I could tell the difference as all the contractions in the labor of my second daughter seemed the same. During this time, my birth team gave us space. My midwife had noticed that labor seemed to progress more easily when I was left alone with John. So, my birth team took our girls outside to hang out.
Throughout this stage, I changed position about every thirty minutes. We stood outside awhile and sometime after that, my midwife convinced me that I should take some broth. I was feeling so tired and weak that I worried pushing would be difficult. I felt like I couldn’t stomach drinking broth, but I did it, and immediately started to feel better. Sometime around 10pm Friday night after getting the girls in bed, my midwife and doula decided to go to our landlord’s guest cabin to get a shower and some rest. John and I lay down on the couch to try and do the same, my sister taking our bed.
Not long after everyone left, I felt another shift in the contractions. They were much more forceful and my prayer became louder. John fell in and out of sleep and I was alone still holding his hands through every contraction. I didn’t know how I would go on, or what this shift meant. At this moment I became confused as to what was happening within. It suddenly felt like if anything were to go wrong at all that it would happen now. If my body were to give up, give out, or experience catastrophe, this would be the moment. I waited, contracted, and prayed there in the dark, knowing this was my journey alone. With each contraction a sweat broke across my body, and in between I was cold. I knew I’d go on and I didn’t need anyone in that moment, just my husband’s hand, but I also waited for the end of it all – the bad part where gravity hit me like a ton of bricks and I’d no longer be in control and I would either pass on or require emergency help. That time never came.
It occurred to me then that what I was feeling with such force were pushing contractions. I asked John to wake up Ariana, who came to look. She encouraged me to push down as my perineum was bulging with each contraction. I was still laying on my left side. I pushed like I had been told in classes, like you were going to have a giant bowel movement, but that didn’t feel appropriate. I had waited for the urge to push to be uncontrollable like blinking. That was how it was described to me in books and classes, but it never became that. I was afraid to push with any kind of might. Again, afraid my uterus would explode. My sister called my midwife to come back, telling her it was time to push. I could hardly believe we'd gotten this far!
My midwife and doula came shortly and watched as I pushed through a few contractions. My waters released completely as I did this. My midwife noticed that I was not connecting with my body and the contractions in the way that I should to effectively push. I cried out, “I’m going to rip in half!” Both she and my doula assured me that that is exactly what it should feel like. I couldn't help but think they didn’t understand what I meant. I felt like it was literally the end for me, but no one was seeing it. Then, my midwife said something to me that brought back all the prayer, meditation, visioning, and affirmation that I did prenatally. She told me to allow the power to overtake me and do its work. She asked me to let go of the control. To give it away and trust. She was the voice of God. For a VBAC mother, I think that might be the biggest obstacle. How do you give up control and come out on the other end intact and ok? How do you not stay vigilant and protect yourself and your baby? But, I remembered that I assembled a birth team that trusted the process and my body’s ability to birth. I remembered that they were my protectors. I remembered the work I did around my body being a vessel for the Creative Power. It was exactly what needed to be whether it meant I live or die. I willingly gave up my control in that moment and pushed with all my strength in a way that moved in the same direction as the contraction. It was perfect.
I pushed for awhile hearing the excitement in everyone’s voice. I went to the bathroom and pushed for a long while on the toilet. Soon, I realized that if I didn’t get up off the toilet, I’d push my baby out in it. I waddled to the living room and we checked in on the baby with the Doppler. She was coming through like a champ. I tried going to a hands and knees pushing position, but that felt very strange and painful so I stood again. I thought for a moment I’d lie down, but couldn’t. So, I pushed in a supported standing squat with my arms around John’s neck. He held my weight. My legs were so weak I didn’t know how I could possibly be doing this standing, but I was.
I felt Gweneth’s head start to emerge and someone went to wake up my girls. Everyone was so excited. I felt the “ring of fire” everyone had told me about, but it wasn’t at all as bad as I had imagined it to be. The sensation was more toward the front of my pubic area than in my perineum. I was able to support this area myself as I pushed. I reached down and felt my baby’s head! I was actually doing this and everything was normal! It was so surreal despite the fact that I always knew I was capable.
In the next few pushes, the wildest thing happened. As my sister and midwife prepared to catch the baby, her head came out completely and without the normal pause her body slid right out and she fell to the floor! I had been concerned that if anything were to go wrong for my baby, it would be shoulder dystocia. Everyone said afterwards that it was like her shoulders disappeared. The cord snapped, and my first words were, “Is she hurt?” My sister had grabbed her up and she and my midwife began an assessment. She was perfect! Her Apgar at one minute was 10!.
I settled in on the couch and they handed me my baby. She hardly cried at all. There wasn't a mark anywhere on her and no molding of the head. As she began to cough out fluids I held her face down over my arm and patted her back to help her out. My midwife worked to assess the bleeding where the baby was released with such force. She kept telling me to stay with her. I told them I would, but really felt like it didn’t matter if I did or not. It was in those moments that I went into the other world. Living and dying didn't matter. My baby was earthside, healthy, and everything was perfect. The Creator had done the work through me. It was awesome!
Quickly the bleeding was under control and no one was in danger in any way. Heather grabbed me some nuts and I ate while I nursed Gwen for the first time. My strength and my head returned as I downed the food. I was so elated. My husband and daughters were so full of joy. Everyone in the room was riding the high of birth. It was electric. All I could talk about was how that beat surgery any day and I was ready to do it all again.
After eating some steak and eggs that Heather made, we weighed Gwen. She weighed 9lbs. 1oz., 4 ounces more than the baby the OB told me would never fit through my pelvis. I had said I’d be happy if I could keep her around 9 pounds. I’d feel safe with that. I manifested that for us. It was just as it should be in every way.
Gweneth Lenore - Born 4:17am - 9lbs. 1oz. - 20 1/4in.
I could have never completely prepared for the experience that was birthing my Gweneth Lenore. The force that brought her into this world was a force like nothing I have experienced before or ever will experience again. I could not have possibly understood what I’d go through during her labor – the journey I would take – without having been right in the middle of it.
All through my pregnancy I focused on learning my body – its cues, subtle clues, how it is fearfully and wonderfully made. I knew that if I was going to vaginally/naturally birth after having two cesareans, I’d have to trust my body above all else. My body, I knew, was created to do the work of pregnancy, labor, and birth, and if I trusted in my body’s Creator, I had to trust the body and respect its capabilities. I knew that if at any point during the experience I allowed fear to replace that trust, then I could very likely sabotage myself out of the vaginal birth I and my baby deserved. This was the most important work I did toward preparing for giving birth.
The next most important thing was choosing where to give birth and who would be with me throughout the process. I realized right away that being at home for the birth was the only best way for me and my baby. I thoroughly investigated all other options within my range before settling down with an experienced midwife whom I trusted and respected, who wasn’t afraid of my choices or my scarred uterus. I had actually chosen her long before I became pregnant with Gweneth (at a time when the plan was for me not to have any more babies – Gweneth was a surprise), but it was important for me to filter through all the possibilities and make the final decision with clarity so I could rest confidently in that decision. Even though she lived three hours away, she agreed to attend me. I chose my dear friend and business partner (Heather) and my sister (Ariana), who is also a nurse, to be my doulas. We decided to remain as a family unit during the labor and birth, so I prepared my two daughters ages six and four for what they would witness. Then, toward the end of my pregnancy, I sealed my fortress deciding not to call anyone outside of the birth team until we could tell them that Gwen was earthside. The majority of my family was not confident in my ability to give birth vaginally (though all of our parents and grandparents knew we were birthing at home) and we chose not to share our detailed plans with most friends. I wanted to keep my pregnancy as peaceful as possible and did not feel like long conversations about why I was choosing homebirth was appropriate during my pregnancy (our families were used to the thought of my birthing at home as this was the choice I also made for my second pregnancy though it ended in a transfer to the hospital). Nor did I want to hear any negative comments that might be thrown my way.
I maintained my healthiest pregnancy yet by staying active through yoga and walking. I ate well and avoided sugar and most processed foods. We checked in on Gwen and the integrity of my scar one time through an ultrasound at 20 weeks. We learned she was a girl (our third girl!) and that everything looked perfect. I was measuring behind my original “due date” and another possible date was noted. So, when my first anxiety – going past my first “due date” came true, I knew I was healthy and Gwen was healthy. If I hadn’t felt we were, I could not have been as patient as I was.
My Sacred Birth mentor/teacher, Stephanie Dawn, helped me through guiding me through Sacred Birth Counseling. She helped me release fears through prayer and digging down to the root of the fear. She gave me space to cry, be angry, and to laugh. She encouraged me to embrace the life of Jesus the Christ and the example he gave of surrendering to your purpose – your Divine Purpose. I thought often about the Garden of Gethsemane and Christ’s prayer there. The resolve even in the midst of the unknowable.
My midwife helped me by reminding me that I am healthy. My baby is healthy. All is well. The Braxton Hicks contractions are doing work. I am ready when my baby is ready. I am beautiful. It was her stalwart faith in the process of birth that truly made me relax in my own knowing of the reliability of the process and the statistics on VBAC and other possible complications. She was the angel sitting with me through my pregnancy and birth.
On Sunday July 15th (4 days passed my original “due date”), I felt an overpowering need for space and fellowship with nature. So, on Monday my husband (John) and my girls took me on a hike to Bad Branch Falls a local nature preserve. The hike was a moderate mile to the falls and another mile to come back. During our hike to the falls there was a lot of crying from my oldest daughter about various things, which in turn made me cry. John was ready to turn around and go home, but I knew we were releasing pent up emotions and we needed to tread onward. We did. Sweaty, we reach the falls. John took the girls down in the water and I sat on a rock beside the falls as I couldn’t safely reach the water hole. It began to storm with a light rain. I was sitting under a crevice, so I could still take pictures. I took a final picture of my pregnant belly and pictures of my little family who would soon number five instead of four. The sound of the falls and the feeling of creation around me relaxed me deeply. I felt at ease.
Upon returning home, we were all exhausted, but I felt the need to make a big pot of vegetable beef soup. After making and eating the soup, I decided to take a shower before settling into the night. At the end of my shower, I felt fluid coming from my vagina that I knew was not shower water. I checked on the outside with my fingers and there was also some of what looked like a mucus plug. I thought that I might be leaking amniotic fluid, so I called for my husband. As I exited the shower, my husband noticed more leaking and it was tinged pink with blood. I dried off and went to the phone to call my midwife. I was so relieved and excited that labor would begin soon, and I faced my first test. My water had broken long before labor began with my second and was part of why I had to have a repeat c-section. I breathed into what I was feeling and maintained my positive state of mind. I had agreed to keep my midwife informed if even the smallest change occurred, so she would have plenty of time to get to me, and she welcomed my call. She instructed me to eat and rest and call her with any changes.
About 11pm, I went to bed. Sometime in the night I started having contractions that were stronger than the Braxton Hicks contractions that I had been having for the last three months. They stayed fifteen to thirty minutes apart all throughout the night and then spaced further apart when I woke in the morning. That morning I noticed that I was still spotting blood, but no longer seemed to be leaking fluids. I passed more of the mucus plug as well. Because I wasn’t in active labor or really needing any kind of hands on support, my husband decided to go on to work, so the day was spent just me and my girls. Tuesday evening I called to check in with my midwife and we agreed that I should continue to eat and rest – taking walks as I felt up to it. She also reassured me that the amount of bleeding I was seeing was normal.
Tuesday night the contractions began again and were now consistently fifteen minutes apart. It was becoming much more intense and it was very hard to sleep through the contractions. I managed to sleep in between them and work with them as they came up by breathing deeply and saying some affirmations. My body was made to give birth. My body and my baby are healthy and strong. I deserve a fast, easy, and comfortable VBAC birth (from a Hypnobabies CD I listened to a bit).
Wednesday morning I was upset that my contractions spaced back out. I was nervous that by the time active labor began I’d be too exhausted to deal with it well. But, we agreed that John should go on to work and I’d hang out with our girls again. I slept as I could and we spent the day on the couch watching movies. I’d breathe through contractions as they came very inconsistently. A strong storm came and caused flash flooding which damaged the road leading to our house. After the rain stopped, I took a walk with my girls and noticed that things inside felt a little different. The baby felt much lower and I had to walk very slowly. I had expected to be very active in labor by walking as much as possible outside and doing yoga. Surprisingly, my body directed me differently. Other than stretching my legs, I felt like the most appropriate laboring position for me was laying on the couch or bed on my left side. Contractions were stronger when I would take this position and it seemed like they were more effective.
Wednesday evening the contractions began to pick back up again before my husband made it home from work. I really wanted to not be alone with my other children and was so relieved when he walked in the door. Once again, all through the night the contractions were coming fifteen to ten minutes apart. I tried to listen to my Hypnobabies CD, but it was bothersome to me, so instead I listened to Elton John and James Taylor. I would now have to vocalize during contractions and hold on to the side of the bed. I began noticing a little more blood, so we decided to call my midwife at about 4am. Because of my tiredness and anxiousness for things to get started, the blood began to worry me a bit. After talking to me for quite awhile, hearing my sounds during a contraction, she reassured me again that everything was ok. We decided that the blood I was seeing was cervical scar tissue breaking apart from my last c-section and not of an amount that should worry me. It was determined that the scar tissue was likely what was taking labor so long to get consistent. We also agreed that if I hadn’t gone into active labor by Thursday that she would come and do a prenatal appointment with me to check on my baby.
Check back in tomorrow 8-29-12 for Part 2. :)
I hit the 20 week mark in my pregnancy on Wednesday of this week! I can't believe that it is halfway over already. Honestly, I'm looking forward to the later stages of pregnancy. They are my favorite part of being pregnant. I'm also really looking forward to experiencing labor again. Labor really is a magical thing as much hard work as it is.
The second trimester is a great time to start preparing yourself both mentally and physically for the task of labor and birth. At this point in pregnancy, there is plenty of time to solidify plans, evaluate those you have chosen as your caregivers, and to find a place of confidence from which you will draw during the labor and birth process. If you haven't already, the second trimester is the time to schedule your childbirth preparation classes, and to hire your doula if you are planning to do so.
I wanted to take a few moments this morning to share with you how I am preparing myself for labor and birth the third time around. Every pregnancy and birth is unique. Mothers will find that each pregnancy brings a different set of needs, ideas, and hopes. Because of this, I don't feel like relying on my past experiences with labor and birth, or even my experiences as a doula as enough to prepare for the birth of my third daughter. I have chosen to actively prepare once again for this once in a lifetime journey.
Earlier this week, I posted this quote on our Facebook page
:"As explained earlier, the degree of pain a woman experiences in labor is strongly affected by her emotional state, her environment, and the attitudes of her attendants. Particularly with a baby in a difficult position, these aspects must be optimal for her to move forward." - Elizabeth Davis (world renown midwife and author) This quote was taken from her book with Debra Pascali-Bonaro, Orgasmic Birth. I highly recommend the movie if you are planning to conceive or are on a pregnancy journey of your own. Taking into consideration this quote, we have some great advice to begin our preparations for labor and birth. For most women, one of the greatest concerns they have about labor is how they will manage their pain. It is fabulous to know that by doing a few simple things, you can create a situation for yourself that allows you to increase your pain threshold and reduce the need for outside medical interventions to decrease your experience of pain. This quote is the guiding light of my birth preparations at this point in my pregnancy.The Emotional State:Finding a place where you can birth with confidence is the best thing you can do for yourself in pregnancy. Spending your pregnancy exploring your relationship with yourself, your significant other, your children, and your extended family is so important. These people will be your life support throughout the journey of pregnancy and motherhood, and in many situations in the labor room as well. Reducing the possibility of tension between yourself and the people closest to you during the labor process is the first step in creating a state of emotional well-being."Making time to vent emotions, either by speaking them aloud or writing them down, is necessary in order to sort them out. Learning to differentiate your feelings from your partner's or any other intimate's is a principal lesson afforded by the Blood Mysteries (times of menstruation, pregnancy, and menopause), essential for finding your new self and new voice for the next phase of your life." - Elizabeth DavisOver the course of the last two months, I have surprised myself with outbursts of emotions that were held within and should have been given a voice long before now. I've been working on giving a voice to feelings and concerns I have. I had always thought that it was a sign of strength to not show emotion, but I have since found it weakens the body and the spirit. I now know that releasing those emotions is healthier than holding on to them indefinitely. Labor is not the time that you will want to just begin dealing with fears/emotions that might come up for you. Also, if you have experienced past birth trauma as I have, pregnancy is a time to revisit your feelings about what happened to you then, and how it may affect your labor and birth experience now. I am approaching this pregnancy and birth from a very strong place of healing regarding my past birth experiences, and I am excited to have a new experience to add to these past ones. Yet, I have found it necessary to approach this pregnancy and birth as a profound spiritual practice. I have been training with Stephanie Dawn, the creator of Sacred Birth and author of the Sacred Birth Workbook, for over a year now in order to offer this approach to expecting mothers who seek to use their pregnancy and birth as a spiritual practice and use their spirituality to prepare for birth. Her classes and workbook are my chosen childbirth preparation course this time around. I feel like I understand well what is happening physically to my body in birth, and with her work, I am nurturing a healthy emotional connection to labor and birth, as well as equipping myself with spiritual tools that I can use in labor such as prayer, meditation, and affirmations to help me cope with the sensations I will experience.The Environment:The environment where you will give birth can have the biggest impact on how you will experience labor and birth. The place and caregiver you choose for your birth is probably the most important decision you can make. This time around, I have chosen a caregiver who is very thorough with me and takes the time to answer all of my questions in detail. Because of my past experiences, and because I am a mother with special needs - VBAC (vaginal birth after cesarean) - I chose a caregiver who has extended experience in attending women such as myself in birth. I am completely comfortable with the caregiver I have chosen and the quality of care I will receive as well as my ability to be comfortable in the place where I will birth.Every woman's comfort level with care providers and places of birth will be different. For some, the hospital will be the most comfortable place, for others it might be home. It is important to look closely at the needs of your pregnancy and the possible needs of your labor and birth when choosing a birth setting and care provider. Interviewing care providers is a good idea before settling in to someone particular. Also, know it is ok to change your care provider if you no longer feel comfortable in their care.A really good addition to the birth environment can be a doula. I have chosen my business partner - Heather - as my doula this time around. My sister who is also a nurse will be with me as well. Part of a doula's job is keeping the birthing environment comfortable for the mother. For example, one of my strongest memories with my second labor was nurses laughing loudly in the hallway. I was having to vocalize loudly as I was experiencing back labor. I was a bit self-conscious of this, and I had convinced myself that the nurses were laughing at me. It made it very hard to concentrate on labor and it increased the pain I felt. It made me cry. My doula helped by telling the nurses that I was being disturbed by their congregating next to my room, and I calmed down as they moved on. The lesson here is to have a birth team who understands your environmental needs, and can help you create a sanctuary for the birth of your baby.The Attitudes of the Attendants:As mentioned previously, along with birthing environment, those who will be with you during your birth - the birth team - will be among the most important decisions you'll make for your birth. The most important of these will be your doctor or midwife and next your doula. You should always feel respected by these attendants, and safe in their care. You should always feel as if your thoughts and questions are heard and accounted for. If they come into your labor room with a negative attitude or speak to you in a manner that makes you feel like you are lesser than or being disrespected, then this will impact the progress of your labor. You will no longer feel you are in a safe environment or protected, and your labor may stall. For more information on Choosing a Care Provider and Choosing a Doula - click on the links. You always want to ensure that you feel like you are the most important person in the decision making surrounding any needs that might come up during labor and birth. Open communication is key to this. This sort of relationship with your care provider is fostered during your prenatal appointments. If you do not feel like you prenatal visits are adequate or what you would like for them to be, consider finding another care provider. Why? Think about what your labor and birth might be like with this same person that you already feel like is not giving you the care you feel you deserve.The next consideration is who else other than essential people will you have in the birthing room. My recommendation is that everyone have a job to do. You don't want to feel like a circus side show while you are trying to cope with labor. Your labor is not a spectator sport. You also don't want people in the room who are too nervous or overly emotional in difficult situations.I am planning on having my caregiver, my husband, doula, my sister, and my daughters (if all is going well and I still desire them there in labor). Also, remember that your caregiver will likely have an assistant or several nurses which they will require in the room during the pushing/birthing stage of labor. Most hospitals have a 3 person limit for non-personnel birth attendants, and that is a good rule. The hospital room can fill up fast with nurses and nursing assistants depending on your needs, you baby's needs, and the desire of your caregiver. With these things in place, I am feeling confident that I will be ready come the day of birth for my third daughter. It's so exciting and fun to plan for labor and birth. I'm feeling strong kicks as I write, and I'm overjoyed to have this opportunity again. I hope this helps you think about planning your labor and birth as well. If you have any questions, feel free to email me at email@example.com, or comment below. Many happy days...Kelli
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, you might already know that I (Kelli) am expecting my third little one sometime in the early parts of July. This pregnancy for me has been not much different than my other two so far in that the first trimester has been a roller coaster of not feeling well at all. During my first pregnancy, I had some scary bleeding which we went in to the ER for and felt the need to be really careful for awhile afterwards. For my second pregnancy, I vomited every day for about 5 months, most days several times. This time around, I have been very tired, nauseous, and extremely forgetful. Not to mention my immune system has been lower than normal so I've already had three seasonal illnesses. Yuck!What we know however, is that all of these things are not outside the scope of common experience for mamas in early pregnancy.
As we celebrate discovering our pregnancies and the adventure that awaits us, we soon notice as well that our body is going through some pretty drastic changes. It is so easy to want to get started right away with all the baby planning, preparation, fitness, eating right, and stuff the books tell us we should be doing to have a healthy pregnancy. But, the fact is... we just might not feel like it in the first trimester. If you do, that's awesome. If not, that's just fine too. What is the most important thing for you to do early in pregnancy and continuing throughout the entire 9 or so months, is to listen to your body. Tune into what your body and your baby need, and don't be afraid or feel guilty about listening. Why? This is the way you start establishing a framework for a healthy pregnancy. Our bodies and babies are built with a system of communicating our needs to us if we take the time to listen.
For example, if you are overly nauseous one day, consider whether or not you are drinking enough water. Dehydration can increase our experience of morning sickness
. Eating small meals as you can throughout the day that are high in protein can also help with upset stomach. The truth is though, that as long as we do our best to get in our folic acid and water, we can consider ourselves as doing ok. We only need about 300 extra daily calories to grow a baby, and those caloric needs don't fully establish themselves until later in the first and the beginning of the second trimester. I've found myself drinking quite a few peanut butter and whole milk homemade milkshakes sweetened with a low-glycemic coconut crystal extract. So far, so good.
What about exercise? Exercise is important in pregnancy. I had vowed to walk and do yoga daily throughout my entire pregnancy. I have to say I've done pretty well considering, but I haven't exercised everyday. Most weeks it has been anywhere from 2-5 days out of the week. The yoga is what I have been able to keep up with best of all. There were some days that all I could do was sleep on the couch. That seems to be passing now, and I am thankful. I was beginning to feel a bit slobby. The truth again though, is that when your body is going through so many big changes, extra rest and sleep is also very good. Your body knows best. Now, that the first trimester funk seems to be lifting, I am able to keep up better with what I want to do for exercise, and keep realistic goals.
So, what can you do to give yourself a foundation for a healthy pregnancy and birth in the first trimester that doesn't require too much physical agility or choking down spinach when all you seem to want to eat is dark chocolate? The first two things that you can do aside from bonding with you baby and listening to your body is - choose the caregiver and place of birth that is right for you
, and consider hiring a doula.
(Follow the links for more information on those topics.) You may learn more about what Birth True offers by looking over our Doula Services
page. Choosing who will care for you during your pregnancy and birth can make the world of difference in the outcome of both your pregnancy and birth. It is good to talk to several doctors or midwives before settling on one. It is also fine to change if you no longer feel comfortable with the care you are receiving. You might also take moment to look over all your options for childbirth education classes. There are so many different types and styles of classes, that you will find one to meet your needs and hopes for your birth.
While the 1st trimester of pregnancy has always been the hardest for me, it is a time to learn. Learn to listen to your body's cues, and to settle in with the fact that in no time at all the potential is there for you to be holding your baby in your arms. It is a time for cautious celebration, settling in, and as much as we can... flowing with the funk.
Childbirth in the United States was once in a very dire place. The outcomes for mothers and babies were poor to dismal (like in our part of the country - rural Appalachia). However, it did not remain that way. Pioneers in the care of women and children such as midwife and founder of the Frontier Nursing Service, Mary Breckinridge
worked hard to change that. Improvements in care included above all an approach that centered upon education of the women, their families, and their caregivers.
Using this approach, Breckinridge achieved better outcomes in her service than the physicians of the day were achieving in the hospitals.
The reality of childbirth improved for women in the US for a time. There have been dips and surges in the safety of childbirth and the outcomes of birth for mothers and babies, but what is concerning at the present is that the US and Canada both are "low on the list of optimal perinatal and maternal outcomes" when it comes to industrialized countries and even some developing countries
(Klein, The Journal of Perinatal Education,
20(4), 185-187, 2011).
Many attribute this change and poor outcomes for mothers and babies to the high rates of surgical birth (c-section) in the US - 34% or 1 in 3 women. But, a recent study conducted in Canada by Dr. Michael C. Klein, MD, CCFP, FAAP revealed that "a substantial number of women, even late in pregnancy, were uninformed about the risks and benefits of key procedures and approaches that might be used in birth." Dr. Klein wrote an editorial about his findings and his recommendations to address those findings in the most recent edition of The Journal of Perinatal Education
cited above. He also stated that, "Only 30% of the women had attended childbirth education classes; books and the Internet were their main sources of information."
Looking at the sources of information women are accessing during pregnancy and the fact that so many remain uninformed show a possible lack of finding truly useful or reliable information from the books they choose and the websites women visit and a disconnect between women and their care providers when it comes to patient education. There are many great books and websites for pregnancy and birth, but there are also many inaccurate information sources. We also have seen a reduction in the number of care providers offering complete childbirth education either through their private practice or the birthing facility. Many "childbirth classes" meet only a few times and include basically what to expect when it comes to hospital routine and policy as well as a tour of the maternity ward. These are important classes for women to take so that they can be prepared and anticipate certain experiences during their birth, but there is also a great need to have complete childbirth education including pregnancy nutrition/exercise, stages of labor, comfort techniques for labor including both natural and medical coping strategies, possible medical interventions that might be necessary and the risks and benefits of each, breastfeeding, postpartum, newborn procedures, and early newborn parenting. In order to cover all of these topics, it is imperative that women and their support persons meet with their educator over an extended period. Many childbirth educators who are certified through the various organizations in the numerous styles of education have a required amount of hours or equivalent of those hours that they must meet in order to label their classes as - Lamaze, Bradley, Hypnobirthing, Brio, CAPPA, ICEA, etc... This hourly requirement ensures that educators and the women they serve have the necessary time to cover all of these important topics that allow women to have the ability to act on the information they receive.
Another very disconcerting aspect of Dr. Klein's study revealed that obstetricians younger than forty "were less favorable to birth plans, less likely to acknowledge the importance of the woman's role in her own birth experience, and more likely to view cesarean surgery as 'just another way to have a baby'. They were also more likely to believe that women who had cesarean surgery 'did not miss an important life event.'" Physicians also had misinformed beliefs on cesarean surgery being "as safe or safer for mothers and babies as vaginal birth" - 20%. "Half of OBs were not supportive of doulas, and 70-80% of providers felt that home birth was unsafe. Epidural analgesia was another area where many providers, especially obstetricians, felt that the procedure did not interfere with labor or increase the frequency of instrumental birth (Klein)." This is despite the scientific evidence showing the contrary on all of the four points above. Klein points out however, that it is important to recognize that 20% of the OBs in the study had attitudes that aligned with midwives. So, we see that though a minority there are OBs who feel otherwise about routine intervention and the risks involved in normal birth. Klein found that women who were attending midwives for their care were less favorable to the use of technology and more supportive of women's roles in their birth experiences, possibly illustrating the difference between the obstetric and midwifery model of maternity care.
The following photo is linked to an interview with Julie Daniels, CNM of Frontier University describing the difference between the obstetric and midwifery models of care. This post is continued after the jump.
Dr. Klein questions "how informed decision making can take place when so many women approaching their first birth are ill-informed and so many care providers think they know, but what they believe is not evidence-based." Many organizations invested in childbirth education are making strides to empower women with scientifically based information, such as Lamaze International and their Six Healthy Birth Practices campaign
. But, Dr. Klein also asks, "how can you make a revolution when so few individuals are unhappy with current maternity care practices?" Dr. Klein believes that "The most unhappy and well-informed women select midwives, if available. The most fearful women select obstetricians." This may be so, but we must figure in the cultural norms and the fact that so many women are ill-informed. (I was one of those ill-informed women during my first pregnancy.) The famous quote from Diane Korte and Roberta Scaer, "If you don't know your options, you don't have any", says it all. Interjecting my personal experience here, I can't tell you how many times I get confused with being a midwife when I tell people that I am a doula. This is even after I describe what it is that I do and that it involves no medical or clinical responsibilities. There is so much misinformation that many don't understand what a midwife even does. This information is residual from the smear campaign of midwives in this country throughout the early 1900s, taking midwives from the primary maternity caregiver to almost non-existent.
Not that OBs are not great birth attendants. We need OBs and their services very much. OBs are trained surgeons and are trained to manage high-risk situations. In many situations, they are the best possible care provider. We need cesarean surgery to be available when it is medically necessary, but we also need to know that just like open heart surgery it is not physiologically normal and should be reserved for emergencies and true medical necessity and not used as a prophylactic. In a systematic review, there were 33 areas were c-section was found to cause more risk than vaginal birth and 4 areas where vaginal birth was found more risky than c-section.
Surgery is never a walk in the park. We can be thankful that c-section is a relatively safe major abdominal surgery, but we need to recognize it as surgery.
But, the real issue to address here is women having access to the information they need to make informed decisions and then the support they need to access their options. The beginning is the recognizing of a need for information. It is the recognizing that women deserve better. It is understanding that childbirth is a normal bodily function of the female body, and should not be treated as an illness, but as a very special time in which extra attention must be paid to health, safety, comfort, and proper support. What raises this recognition - education. It is so important for educators to reach both women and their care providers, for we are all working toward the same things - as positive outcomes as possible in individual situations, and satisfaction and dare I say pure joy in the experience of giving birth.