MAYD to Birth: At Your Doorstep

Promoting gentle, empowering mother journies…

Pondering Fear

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I’ve had a number of conversations both online and in real life recently about why women and our society in general is so afraid of birth, and so convinced that it a horrific and painful experience that requires medication every single time.  (and I’m not trying to say that women should NEVER use medications, they are a fabulous tool in some situations, but they also have risks and repercussions that seem to be largely ignored).

I have been thinking that far too often it feels like by the time women are actually having babies their fears of giving birth are already so entrenched that it is difficult to undo.  As I talked about this to a friend lately I started thinking about a video I had seen recently, it was supposed to be funny, it was just a group of teenagers all facing a screen, the narrator tells us that they are in health class watching a birth video.  The girls are all screaming and covering their eyes, horrified at what they are watching.  I thought it was so sad.  I wondered what kind of video it was and how it portrayed birth and thought about what we watched in our health class.  I realized that often times birth is presented to teenagers as a deterrent to having sex (or at least to encourage them to use birth control) and is made out to be a painful, miserable experience.  I guess the hope is to motivate these girls to avoid pregnancy and the subsequent ‘horrors’ that come with childbirth.  I think these messages create fears that stick and then when women are ready to become mothers they go to great lengths to try and dissociate themselves from the horrors they expect with giving birth.  Usually just by having an epidural as soon as possible, but sometimes by insisting on a c-section or even avoiding having children altogether.
 
I know I felt this way before I had my first baby.  A man I worked with suggested that a home birth was a wonderful way to go and I told him that “I wasn’t crazy, I was having an epidural”!  When I got the hospital and suffered through contractions lying on my back with no support and no clue how to help myself, my belief that birth is intolerably painful was confirmed.  Of course nobody suggested that I walk around, stand up, have a hot pack, any of the things that might have really helped, and I certainly didn’t know how much my fear and tension was making it worse.  It took a lot of reading, several years, witnessing some births first hand, and finally the desperation to have a VBAC (and the conviction that I needed to be at home for it to happen) to really get me to accept birthing unmedicated.  Obviously when it turned out to be a completely comfortable experience (thanks self-hypnosis!) I was definitely convinced that birth is totally do-able, but it would have been tough to convince me of that 8 years ago.
 
So why was I so afraid and why are most of the women I know so afraid?  How is the information being presented in health class to high school kids and how can we convince educators to give kids a more balanced view?  (ironically, my own father was a health teacher for years, so I will be having this conversation with him for sure)  How we do we counteract all those crazy dramatic births that they show on TV and in the movies?  How can we ‘infiltrate’ the colleges and present the idea of birth being normal?
 
How can we get them to see this video:
instead of The Baby Story?

I wish I had the answers, sometimes it feels like it an impossible task to make birth a more ‘treasured’ experience in this country.  I feel like people put so much effort, time, though and preparation into their weddings, but do none of the above for the births.  How can people spend thousands for their weddings, but get bent out of shape at the idea that they might have to pay to give birth to their children?  They want and expect insurance to pay for all of it and are happy to let their insurance companies dictate which hospital they can go to and which provider they can see?  Would women accept the same situations at their weddings “sorry honey, but I’m paying for this wedding and this where your getting married and this is the person who is doing it”.  I can’t see a lot of brides being very happy about that situations why are prospective mothers okay with taking whatever is given to them for their births?

(okay now I realize this analogy is kind of bad because some people don’t have fancy weddings and don’t spend much money on that either – I am one of those people – but I’m speaking in generalizations here and on average Americans spend $20000 on their weddings.  Shocking to me, I got married in Las Vegas at  $50 chapel, but even people who don’t spend anywhere near this much still spend easily a couple of grand out of pocket, but most people FREAK OUT at the idea of spending $2000 out of pocket for their births.  (oh and i’m talking Utah dollars here, double that if you live back East))

I would just really like to see women feeling as empowered about giving birth as they do about planning their weddings.  Brides do tons of research, they pay for a wedding planner to be their expert guides, read all the reviews, visit all the receptions centers, they OWN that wedding.  I want women to OWN their births too.  I want them to know all their options and be as excited about the idea that it is going to be a beautiful and positive day in their life, not just a day that they have to get through.

Apologies for this being a rambling post without much purpose, I’m digging through all these thoughts in my head and spewing them out into this blog hoping that somehow I’ll be inspired about where to find answers.

Another Retreat Weekend ~ "Disability World" Conversation Continues Next Week and Some Thoughts on Upcoming topics…

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Hello everyone!  I had hoped to get the next “Disability” parenting related post up before this weekend but it isn’t going to happen.  I am leaving this afternoon for yet another “Working Retreat” with my internship group and instructors.  I actually love these weekends but they are a tremendous lot of work and there is a lot of preparation that has to go into them as well so, I haven’t had time to write anything else this week.  

In addition to writing about parenting children with disabilities, I’m also writing about another of my concerns and interests over on my Kneelingwoman blog this next week: Perinatal Hospice.  This is a relatively new concept in palliative care that is centered on meeting the needs of families caring for a pregnancy and infant diagnosed with a condition that is life-limiting.  Having been through the process of being pregnant with, and giving birth to, an infant who is not going to live long, I am acutely aware of the pain and suffering involved and of the needs these families have.  Working alongside a friend who is in charge of several of the area Hospice organizations, I am trying to put together a “Perinatal Hospice” Service that will combine the best aspects of Midwifery care, that being “Knowledgeable Companionship” and loving, compassionate presence in providing Childbirth Education, Birth attendance as a “Special Care Doula” and Postpartum Doula Care to the family which also includes skilled Bereavement and Grief care and support.  The mothers who carry and give birth to these infants suffer more than I can tell you, especially given the fact that our culture’s fear and anxiety about death is even more embedded and distorted than it’s attitudes about birth!  A woman pregnant with a dying infant is often extremely isolated as no one knows how to be with her, or how to deal with the pregnancy; it’s very complicated and heartbreaking.  Many people think of Perinatal Hospice as being politically aligned with the “pro life” or anti-abortion movement, comprised largely of parents who will not abort a pregnancy with a negative diagnosis for religious reasons but, most of the parents who choose to carry to term do so for one simple reason that perhaps goes to the heart of what true “religion” ( a word that means, literally, “what you are yoked to” ) is, or should be: love.  These are parents who love their child, pure and simple.  
I did not invent the concept of perinatal hospice, nor is my particular model new or original.  There are a few groups and women around who offer similar services.  What I hope will be “new” is that I am trying to create not only an on-call service of one-on-one care for these families, but  I would like to set up specific training programs established for “Special-Care Doulas” that are comprehensive and include appropriate and sensitive private birth education, and postpartum support that lasts a minimum of a year and yes, is covered by private and public insurance.  These are needed services and excellent examples of the kind of “simple, sustainable” alternatives in health care that I believe are possible, and desirable, and  could also be expanded, as a model, to families with children born with various disabilities who also need skilled and knowledgeable, hands-on support.  We ask too much of these families and the stress and exhaustion that can, and often do, occur take an enormous toll and represent genuine health risks to the parents and other children in the home. 
  Women need other women around the time of birth–that is the essence of “Authentic Midwifery” as I have known and practiced it and this essential quality surpasses political aspirations for a Profession and is more of an orientation of character and temperment than a job description.  At the end of the day, it’s all about the women and families and the Midwifery Model of Care need not be limited in scope to place or type of birth, or status of provider, or whether or not the “Profession” ever receives the validation of the medical community or the public at large.  The relationship of Midwife, Mother and Child is Sacred, and that relationship cannot, and should not, lose what is at it’s ‘root’, that being a radical love for the childbearing family in all it’s complexity.
Until next week~~Every day, we are one step closer to Spring!
Your Kneelingwoman

Time reports on VBAC

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I have been letting this poor blog get ignored these days as I focus on other things.  Stuff that might have gone up here before is now going up on the Utah Friends of Midwives blog
This article needs to be splashed around the web as much as possible.  Not enough people are aware of the problems facing women wanting a VBAC.  

http://www.time.com/time/magazine/article/0,9171,1880665-2,00.html

In my experience the comment in the article about the doctors leading towards women towards the c-section is true.  When the doctor has so much to gain by doing the surgery – he gets paid more, spends only an hour of his precious time, has less liability – then he isn’t in a position to give the women the risks and benefits without being biased.  Not to mention the subtle cues that they give women about their babies seeming big, their pelvises being small or just asking each week if they are ready to schedule yet (when women are big and tired of being pregnant that’s a big temptation!).  They have sway and most of them are surgeons first, of course that is going to be their preferred method.
All the more reason for every woman to have a midwife as the primary care provider.  She can keep things normal, screen for the abnormal and collaborate when the expertise of a surgeon is truly necessary.

Myth #783 – Birth is Scary

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After she had her baby (Charlie, my 800th baby) the other day, this new mum said, “You know, once you’re in it, labour isn’t scary! You just do it!”

I have so many clients who have carried the fear of childbirth with them for years and years. Some even postpone the event for as long as possible, just because their friends (or families) have told such horror stories over the years.

I tell my clients that our bodies aren’t going to spring something TOTALLY NEW on us when we’re in labour. Birth is something you know! Contrary to popular belief, labour really feels like period cramps, low down, way down there, NOT all over your body. And it comes and goes (unlike period cramps which are continuous and can last for days). Yes, it gets very strong, but, as long as the birth is normal and you have continuous support, it is totally do-able (not totally fun). (Remember, the World Health Organization believe that 10% of birth should be cesareans, no more. That means that 90% of births should be “do-able”.)

Surprisingly, labour can be frustrating, even BORING, at the beginning. Your body hasn’t taken pity on you and started the endorphin surge yet (ah, when it comes, SO good). Until those endorphins kick in, you’re fully present, fully raw, feeling and thinking and using your left brain (nasty left brain). You start to think, “If it’s like this now, I’ll never be able to take it when it’s 10 times worse.” It shouldn’t be scary if your doula is talking you through this part on the phone, or popping over to your house, if necessary. But, hang on, if birth is undisturbed (that’s the key!), then it never gives you more than you can bear. Active labour begins, your endorphins kick in, and your body goes into auto-pilot…no thinking…you just “do”. And you can do it!

Your friends probably found labour scary because they didn’t have the assistance of a doula or midwife, didn’t have an undisturbed birth, didn’t work through their fears in advance…nine out of ten times you’ll find that the couple were on their own, left to stumble through it alone. Now that’s scary!

So, the other day, we headed to the hospital when her contractions were close together and very strong. Bloody show – check. Feeling pressure – check. Contractions palpate as strong – check! She was at the “frickety! frickety!” stage (as one mum described it). She loved standing by the sink, both at home, then at the hospital. We got through the passing request for an epidural (always happens at 5cm) and out the other side (I was thankfully backed up by our amazing nurse). As her labour progressed and the endorphins kicked in (big time!), her face became smoother, she began to sway her hips, she became calm and quiet. The lights were low. It was beautiful to watch her labour progress undisturbed. I knew everything would be fine.

This is a woman who had thought that labour would be very scary. But, with support, she found that this was something that she’d done so many different times over her lifetime – labour was a challenge which she could meet. She had the mental fortitude, life experience, and the tools at hand. Birth was something she knew. I don’t think she’ll be scared about anything again.

Crashing through our fears and our cultural myths is what’s scary – Birth isn’t.

- Jacquie Munro, Vancouver Doula…and SlowBirth

Have a Natural Childbirth Today!