Top Fifteen List: Birthing Songs

Its time to start getting excited about my baby's upcoming birth. This pregnancy has been nice, albeit slightly confusing because I feel like I have very little to prepare. We've got all the stuff for either gender of baby. I know exactly where it is and know that it can be set up quickly when the time is closer. Knowledge wise, I'm prepared. If anything I know too much and it can get in the way of enjoying a nice normal healthy pregnancy. My birth path is solid and secure. I'm approaching this new birth with confidence that I know how to birth babies and I'm trusting that I am prepared for whatever is coming my way (knowing that its probably going to awesome).

The confusing part is the wait. What do I do with myself in the meantime? 9 months is a long time for feeling prepared and ready and needing to put off the basics until later on. My answer has been in a combination of distraction/keeping myself busy (which I've been doing through certifying as a doula and midwife apprenticing) and inner work.

One thing I felt like I could early on in the pregnancy (starting about 15 weeks) was to expose the new baby to the voices of his/her life and music. From my daughter's pregnancy, I have a birthing playlist of music that I love and enjoying listening to during labor. Why not start listening as soon as the baby has ears to hear? During the day, I put the playlist on for background music or I put in my earphones and sing my favorite songs. Many of these songs have a message that reminds me of the special sacredness of carrying and birthing a baby or contains a message that I would like my children to internalize, or its reminds me of my feelings in labor and gives me a form of expression to those feelings, or its just a song that makes me happy regardless of what is going on around me (for example, Bohemian Rhapsody is on there).

The list contains 60+ songs for about 4 hours of music. I won't list them all for you, but I'll share my favorites. I couldn't fit it into a Top Ten list, so here's my Top Fifteen songs to enjoy while in labor*:

1. Hear You Me (May Angels Bring You in)-- Jimmy Eat World

This one reminds me of singing a baby into its new home, as well as singing a loved one into the afterlife. Listening to this song makes me think of my dad and remembering that he's not on the earth to share grandparenthood with my children always makes me sad. But I'm also reminded that I believe that he's in a new existence on a different plane and that he knows and loves my children and he continues to love me. I'm also reminded of the circle of life that as loved ones die, I'm blessed to be in my childbearing years and I can balance the losses with the gains of new family members. This song serves to invite my dad into my birthing space and to know that we are being looked over by angels.

2. It is You (I Have Loved): Dana Glover from the Shrek Soundtrack

I've blogged about this song before and why I find it so meaningful. Because I had encountered a good deal of loss before my children were born, I didn't feel very connected to this life. It felt like I had nothing keeping me tied to the earth when it felt like my whole family was gone already. I wish I could say that falling in love with my husband made me feel connected to earth life, but it wasn't until my son was born that I felt like my place was here and I was needed for an important purpose. Turns out that it was my children that I loved all along and I needed them to come into my life to feel connected to life. I hope that also serves to explain the tagline of my blog to you.

3. Good Morning Starshine: Oliver

If I could cue any song to play at the moment of my child's birth, it would be this one. I'm not planning anythings elaborate to ensure that happens, but I love how easy the song is to sing to a small child. Its especially poignant to sing this as the child's welcome to the world. For each child, I have designated a special song that I sing throughout the pregnancy and continue to sing to them after their birth. For Willem, it was "It is You I Have Loved." For Belle, it was "For the Beauty of the Earth." And for whoever this one is, its "Good Morning Starshine." I expect I'll be able to annoy the pants off a teenager who does not want to wake up by singing this song at wake-up time in a few years.

4. I Want to Break Free: Queen

This one just makes me laugh. I imagine a fetus experiencing contractions and working its way into the world would share the sentiment of this song. I also find this song appropriate when I get to that point in labor where I just want it to be over and have my new baby in my arms.

5. There's A Song in My Tummy: Laurie Berkner

When I was pregnant with my daughter, I adapted this song so it could be sung "There's a baby in my belly and she wants to come out...and when she does she's going to cry and shout..." Thusly, it deserves a place on my playlist and on my favorites as well. Its fun to sing this through pregnancy and labor to remind me what I'm looking forward to when the labor part is done, and the real work begins.

6. Drive: Incubus

This one I find most appropriate because of the atmosphere of fear and conformity that surrounds birth. After my first experience giving birth, I realized that I couldn't trust the predominant culture when it came to birthing choice. I struck out on my own, chose my own path and felt like I had taken ownership of my birthing responsibilities and it gave me the confidence to continue taking ownership of many other aspects of my life. While in labor and during pregnancy, this song gives me confidence in my choices and reminds me of why I make the decisions I do.

7. Best Years of Our Live: Baha Men

Because you need some happy, upbeat dance music during labor. My husband and I seriously love our lives together and these years wouldn't be the best years of our lives without our children. Its the perfect song of celebration at the birth of a new baby and makes me happy every time I hear it.

8. Pardon Me: Incubus

This song encompasses the anger and frustration that I feel regarding the cultural influences that are working against homebirth and women's rights to choose where and with whom she gives birth. As I'm in labor and I hear this song, I feel vindicated and like I'm expressing my freedom to be different, to do what is right for me and my family. There's something immensely satisfying about belting during pregnancy and labor, "I've had enough of the world and its people's mindless games. So pardon me while I burn and rise above the flame. Pardon me, pardon me... I'll never be the same!"

9. I'm not Doubling Back Now: Jason Mraz

This song inspires perseverance and determination in me while I'm in labor. The last thing I'm going to do when I'm working to get my baby out is to double back and go back the way I came. This helps me visualize constantly moving forward, advancing the baby through my pelvis and closer to my arms. Its got a good beat and is enjoyable to dance to in labor which is only going to help position and move the baby down.

10. Arise and Shine Forth: Relief Society Soundtrack

There is nothing like a strong, spiritual anthem. Its this type of testimony of Christ that I want to pass on to my children: a vibrant, energetic joy that has the rafters filled with powerful, optimistic voices. I love singing my testimony in this song and hearing it reminds me of the fire that burns within me and gives me strength to do whatever is required of me.

11. Don't Stop Me Now: Queen

More high energy here that matches my fiery personality. When I'm faced with a challenge and its doing work I find rewarding, I get really determined and this song (at least the chorus, and maybe the first verse) is something like a personal anthem for me when I'm working hard to accomplish a goal. I find it perfect to inspire determination in me during labor. This song says to me, "I'm having my baby. Don't mess with me!"

12: Sleeping to Dream: Jason Mraz

I spend my pregnancies fantasizing what this new little being with be like so this song captures that wistfulness, as well as that bit of frustration that comes at the end of pregnancy when mama isn’t sleeping well and just wants to meet her baby already. There’s also a point in labor when all I want to do between contractions is to sleep and I’m wishing so much to have the birth process be over and have the baby already that its practically a dream mixed with that euphoric delirium of laborland. I sing this to my baby during labor to communicate just how much I look forward to his/her birth.

13. Happy Together: The Turtles

This song is obviously written about the love between a man and a woman, but I find myself wishing for that kind of love as expressed in the song to exist between myself and my children. Before my children were born, I loved thinking of my love for my husband in terms of this song, but I find that love just grows and becomes all that more sweet when I think of including my children in that circle. Do you remember that commercial with the video game characters skipping through a sunny meadow with this music in the background? That’s the kind of joyful exuberance I want to share with my children.

14. Do You Believe in Magic?: The Lovin' Spoonful

There’s something undeniably magical about giving birth to a human being and seeing that little human learn and grow. This song just makes me happy since it makes me think of all the magical, happy times that accompanies parenthood. I hope that my children have childhoods that are optimized by this song so I consider this another song of welcoming to my new little one as s/he enters our family.

15: Sacred Birth: http://www.youtube.com/watch?v=9ukEN4O7RhA

I wish this one were on iTunes so I could buy it and add it to my birthing playlist. This song is an original work by the singer in the video. She also happens to be a sister LDS birth worker. There's not much music specifically about the power and beauty of birth out there. There needs to be more. And this needs to be available on iTunes!

* You'll probably discover I have a slightly quirky preference for labor music and you'll either think I'm crazy or be amused. You might even find something fun that you would want to add to your birthing playlist.

Opening the Back

Jamaican midwives having a saying that when the back opens the baby comes. This is referring to the period of time around the fetal ejection reflex where the baby moves down to crowning and birth. Opening the back occurs when the sacrum moves backward to allow more room for the baby to move through the pelvis. Its amazing to learn how much space is gained by this--up to 4 cms in some places! I had never come across it before in any of the other reading I have done on birth. I thought this is so cool, I can share it here. Especially since I can even tell a personal story about it.

I encountered this term in my copy of Holistic Midwifery Volume II written by Anne Frey. It is one of the texts in my midwifery program and covers extensively (its almost 2,000 pages!) the physiology and care of labor and birth.

I remember when this happened during Belle's birth. I even commented on it when I wrote her  birth story. I didn't know the name of it then so I'm pleased to learn about it now. At the time I described it as:

I felt tightness radiating down into my thighs and it felt like the bones of my pelvis and hip were being stretched outwards.

I later thought that this might have something to do with the hip pain that lingered after that pregnancy. I learned that it might be SI dsyfunction (sacroiliac joint) and posted about it here. Finding out that it was an actually physiological process that is part of normal birth helped me feel that the strange sensation wasn't an injury but my body working as it was designed to.

I thought at the time that when I felt my hips spread during Belle's birth that something unnatural had happened. I still think that maybe my SI issues have something to do with this spreading. It happened so quickly--it was like my SI joints abruptly slid out as far as they could like sticky slide locks on a door. Perhaps they slid more forcefully and quickly than is typical when the sacrum moves and the back opens.

This phenomenon is only observed when upright birth is allowed. When a woman in laying on her back in bed, the sacrum is prevented from moving and the pelvis does not expand in conjunction with the fetal ejection reflex.

I don't recall feeling this happen when giving birth to my son. Not surprising, since I felt pressured into birthing on my back. The only way I felt that I had been able to reposition more comfortably as he was descending and crowing was by twisting my hips so that I was more on my side.

Someday I may find more detailed description of this phenomenon. It seems like it hasn't been described or investigated by researchers enough to know what is normal "opening of the back" and what is extreme. As it is, the term is hardly known except in some circles. Hospital birth attendants and medical researchers wouldn't see it because the vast majority of birthing women they see are on their backs. Upright/vertical birth isn't even an option in many hospital birth environments.

Have any of my readers heard of this? Care to theorize with me on the possibility of normal opening of the back and extreme opening on the back?

What will they (I hope) say about me when I die?

also posted on my spirituality blog: Jenneology

I am lifting the following exercise from a recent post on Feminist Mormon Housewives. A new self-help book aiming to assist people of my generation to find their purpose in life provided the exercise. What follows are my answers:

Thought Experiment: You’ve died. You are at your own funeral. What do you want your friends and family to say about you? What did you do with your life? Write down five things you hope people say about the legacy that you’ve left. Write down five things you hope people say about your personality.

1. She was a seeker of truth and was open-minded, and respectful in the finding of it. She embraced the belief in the gospel that all good things come from God and that all truth can be circumscribed into one great whole. She would embrace truth, quite literally, wherever it could be found--in Islam, Unitarian Universalism, Paganism, Gnosticism, Physics, Astronomy and Chemistry. She was a student of life and found great joy in it.

2. She wanted to make a difference in the world and she worked diligently to address some of the injustices and inequalities that people, especially women throughout the world face. Her involvement in non-profit organizations and humanitarian works helped the lives of many. One of the things she was fond of saying was that she didn't want to make a difference in the life of a child, but she wanted to make a difference in the life of many. She worked at the systems level to address the root causes of poverty, abuse and barriers to living a full and happy life.

3. She prioritized her family while at the same time set the example to them to be anxiously engaged in a good cause (or in her case, many). Her children were involved with her and shared her with the people of the world. They had the opportunity to see and do many things that provided service to others because of the example and encouragement of their mother. She was actively involved with them at all levels of their lives and somehow found a balance in the limited hours of each day to show them they were loved and benefited from her presence and involvement in their lives.

4. She was a believer in the radical Jesus: the Jesus who was friends with the sinners and who was compassionate to their experiences, the socialist who believed in complete redistribution of wealth, the empowerment and equality of women and the Christ-like love that each person needs to achieve their potential.

5. She knew hardship, difficulty, pain and injustice and she was able to find strength from her experiences and turn them around to be compassionate towards others, to support and comfort them.

5 personality traits: tenacious, determined, creative, compassionate, advocate

Core Values: Discover what drives you. What principles guide your actions and ideal self? Try to strip away all cultural conditioning and/or religious rhetoric and assess five core values by which you live your life and inform who you want to be. Write these down. Evaluate if there any disconnect between what you wrote down in step one and step two.

Maybe I already did this up above. Just pulling from there, we find that I value: openness to truth/goodness, compassion, advocacy, social justice and idealism.

Find Your Purpose: Why does what you are doing matter? What motivates and inspires you to keep following these values? Chose a purpose. It can be big or small, but has to be intentional. It is the reason for your goals and can change over time. If you are struggling to find your purpose try this experiment. Write down your five most valuable gifts and talents. Next, write below those what each of these can be used for. Finally, evaluate what types of careers or activities you would enjoy that would utilize some of these talents.

I'm already doing many of the things I hope to be remembered for so my purpose is described above. Involvement in Solace for Mothers, LDS WAVE, The Coalition for Improving Maternity Services already address some of those values that I hold so deeply. I would someday like to turn those desires and abilities into paid employment and I hope that it will be doing something that addresses the root causes of injustice in the world. I would love to work in humanitarian aid (whether it is at the local, national or global scene) but at the systems level. One of my skills is to look at big picture and see ways to build coalitions and to bring people together, to create ways that people from very different viewpoints can interface with each other in cooperative ways. Most of my efforts are somehow related to system building and connecting people in large communities to harness their combined power into a stronger more unified voice.

Test Your Purpose: Today my purpose will be _____________. To accomplish that I will use my gifts for ________________ to accomplish these specific goals_______________. Later change the timeline to week, month, and year.

Today my purpose will be two fold:

1) to connect with my children and show them the value of caring for others

2) learn about how to structure my family economically so we can be Equal Shared Parenting and Radical Homemaking folks.

To accomplish that I will use my gifts for being involved in national organizations and reading to accomplish these specific goals:

1) I will walk with my children in the March of Dimes walk, teach them to sew and make things we can sell on Talents of Sisters.

2) start reading the book Equally Shared Parenting and discuss with my husband the possibilities that our interests lead us to.

Otherwise, I would say that my goals are year long, or at the very least, seasonal. This year I hope to create an online community for birth advocates that can become a hub for the thousands who care birth issues in our world. This season, we hope to grow some of our own food and make some of our own household products to develop our skills and save money.

Write It All Down: Once you have a purpose you can stick with, write it all down and it will remind your of who you are and what you want to be. I.e.My five core values are ____________. My five core talents are ______________. In the next ten years my purpose will be ______________. The key features of my personal mission statement are ______________.

My five core values are openness to truth/goodness, compassion, advocacy, social justice and idealism.

My five core talents are:

1) building community and cooperation around advocacy efforts

2) addressing root causes of social issues

3) looking at the big picture

4) being respectful and open to differing view points

5) embracing and valuing the good that is inherent in differing perspectives

In the next ten years my purpose will be to:

1) achieve equal partnership in my marriage

2) find paid part-time employment in advocacy work

3) support and contribute to organizations addressing global poverty

4) continue to develop current advocacy organizations

5) educate my children through experiential learning in living the gospel of the radical Jesus.

The key features of my personal mission statement are make a difference in the world, aspire to the ideal, encourage potential, and value balance and compassion to oneself and others.

Living Blog at CIMS "Reframing Birth and Breastfeeding"

The Coalition for Improving Maternity Service is co-hosting a conference with the Breastfeeding Feminism Symposia Series this weekend in Chapel Hill North Carolina. I'm there and I'm live blogging on my facebook page.

The topic is "Reframing Birth and Breastfeeding: Moving Forward" with great speakers like Eugene Declereq, Penny Simkin, Robbie-Davis Floyd and other experts in public health, breastfeeding, advocacy and birth.

Late Announcement

I failed to post on my blog that I bit the bullet and enrolled in midwifery school. If you've been following my Facebook page, this is old news. I just haven't gotten around to telling my blog readers about it.

After my first child was born, I got fascinated by learning about childbirth. I learned that while the physiological process is pretty simple, the cultural process of pregnancy and birth for a woman is much more complicated. Being a birth junkie became a hobby and my blog here was its product. If you are a regular reader here you know the process I've gone through. If you are a new reader, it doesn't take long to get an idea.

There came a certain point where I knew that my knowledge about birth had hit a plateau. In preparing for my second child's birth, my husband and I basically took a childbirth education class that was more like a crash course in emergency midwifery skills taught privately by our midwife's assistant. After my daughter was born, my midwife told me that if I ever wanted to attend a birth with her all I needed to do was ask.

I felt uncomfortable with that offer, though appreciative and excited at the same time. I didn't feel right inviting myself into a woman's labor because I had a compulsion to see birth as a witness rather than the subject. Attending a birth in that way would give me no official standing, no reason to be there other than voyeur. I would not welcome a person into my birthing space for that reason, I wasn't about to enter someone else's.

Perhaps though, it was my midwife's attempt to lead me into an apprenticeship. Now that I'm a midwifery student, I feel I have that official standing and the desire to become an apprentice formally. I'm hoping in the near future that I'll take her up on the offer and be available for prenatal visits as well.

Details, you ask?

I've enrolled in Ancient Arts Midwifery Institute in their Advanced Midwifery Studies certificate program. The school is owned and operated by Carla Hartley, founder of the Trust Birth Initiative and force behind the Trust Birth Conference. Its a 42 month program and an apprenticeship is not required during that time. Just in time for Christmas 2013, I will need to be done with the coursework.

The program started out as the Midwifery Homestudy Course which means that then, and now, its an independent study, apprentice based program where students get their book learning through completing the coursework and get their practical experience through apprenticeship and in person skills labs offered periodically.

Its perfect for me because I am dedicated to staying home and caring for my young children. I'm also dedicated to my sanity and developing my skills and talents. This course provides me with the balance to be anxiously engaged in a good cause though learning by study as well as being present with my children and their primary care provider. If I was able to complete a master's degree with the support of my husband while gestating two babies, I can do this program with his support as well.

I had been contemplating enrolling for awhile because I recognized the value of the education. Its very affordable in comparison to all on-campus midwifery programs. I also endorse the philosophy of practice and share the believes that birth belongs to mothers, not midwives or doctors or even the dominant culture. Earlier this summer, Carla was offering discounts to people in various places to enroll and I jumped at it. I later learned that she uses this trick to get potential students to take the step to enrollment. Clever and I'm glad she did it.

Part of the decision to enroll came because I had applied to PhD programs at the University of Washington to start this fall but I did not get in. I felt strongly that I needed some form of continued education and learning so when that didn't pan out, I saw the wisdom in becoming trained as a midwife as it would serve me in my academic career later. I think it might also help me get accepted into a PhD program in the future as well. I'm not disappointed that I'm not able to pursue a PhD at this time and I'm excited to immerse myself in birth at a new level.

My goals in becoming a midwife are not to own and operate a busy independent midwifery service. I'm not interested in maintaining a business. I'm more interested in the research, public policy and advocacy that will help midwifery become a more recognized and respected profession and provide a warning voice on the pitfalls of licensure and regulation. My birth experiences will continue to greatly inform my ideas as a birth advocate and I pray that I will never forget the primary need for the woman to consent and be the ultimate decision maker for her births. Please correct me if you ever suspect that I'm drifting from that position.

That's my hope for my future involvement in birth. To have the knowledge of a midwife which will inform academic research. When the time comes for me to apply to PhD programs again, I'll be looking at public health, women's studies, human development and public policy. Until then I'll be learning, serving as a midwifery assistant in a limited capacity and loving and enjoying my children.

I already had the chance to participate in the Basic Midwifery Skills Lab. These labs are taught a few times throughout the year in various locations across the country. In July, one was being held an hour from my home so I jumped at the chance to attend. In the lab, we were taught about the basics of midwifery practice as well as the hands-on skills of giving injections, starting IVs, suturing, inserting catheters, palpating fetuses, listening with fetoscopes, assessing blood pressure. The highlight, perhaps, was my introduction to the Vagina in a Box. I later learned that the midwifery and nursing students at the University of Washington wished that the nursing school would invest in this teaching aid. That was an indication to me that I'll be getting a better education than CNMs at one of the nation's top universities.

I met some amazing women at the SkillsLab. i even won a half price discount to the 2012 Trust Birth Conference. I've become friends with one of the women who lives just a couple of hours away from me. Together, we are planning to attend the Advanced Skill Lab being held in Oregon next year as well as rooming together at the conference.

If you've got any questions about the AAMI program, let me know, or if there's anything I left out or you want to know more about.

A hole in the heart, a hole in the family

A little dark haired girl is wearing purple sweatpants with matching sweatshirt. Her dad, wait that's my dad but much younger, so the little girl must be me, is holding her hand as they walk through some sliding electric doors into the dim light of a corridor with an information desk and waiting rooms off to the side.

Why would this be my first memory?

I was not quite two years old. It was September of 1986 so I was 22 months old. The only reason why I know this is because that's when my brother died. Those doors opened to the hospital where my mother learned that her 38 week gestation baby was dead and that even though labor had started, she would be birthing a stillborn. Somehow, I picked up on the emotions of my loved ones and knew something was very wrong and that memory stuck.

Later my mom told me that her loss was so great that her desire to live only remained because of me.

Growing up, the explanation for why my brother died was unclear. As a teenager, I learned that he had a heart defect that, obviously, was not compatible with life. I heard different things: he had a hole in his heart, one of his arteries was not connected correctly and his heart formed inside out.

I didn't know that when I was 10, my dad had requested the medical records as well as the autopsy report. I also didn't know that I would find those records when I was cleaning out my mother's garage this summer.

Cause of death: Complete transposition of the aorta and pulmonary arteries.

Of course, I didn't know much about what that meant so I set out to learn.

I learned this defect is most commonly called Transposition of the Great Arteries or vessels. What is means is:

Babies with TGA have two separate circuits -- one that circulates oxygen-poor (blue) blood from the body back to the body, and another that recirculates oxygen-rich (red) blood from the lungs back to the lungs. Without an additional heart defect that allows mixing of oxygen-poor (blue) and oxygen-rich (red) blood, such as an atrial or ventricular septal defect, infants with TGA will have oxygen-poor (blue) blood circulating through the body, a situation that is critical. Even with an additional defect present that allows mixing, babies with transposition of the great arteries may not have enough oxygen in the bloodstream to meet the body's demands.(1)

The first question I had after obtaining that information was how did he even live as long as he did. This diagram illustrates how there is some mixing of blood in the atria (upper segments of the heart).



I also learned that in most cases TGA is not determined until after the baby is born and they are blue and floppy without pinking up over time and with treatment. This was a surprise to me because here I am learning that most babies survive birth with this condition and my brother did not.

It can be corrected early with surgery and most babies with the condition survive and unfortunately our family didn't get that opportunity. I perhaps more so than other young children have felt his loss because with his death I became and remained an only child. I often felt the hole in our family from not having a sibling and knowing that we came so close and suffered such a devastating loss that made it so.

I've also wondered if my parents could have known prenatally that the baby had a defect that was life threatening. My mom had told me after I became a mother that she had not had an ultrasound with my brother's pregnancy because it hadn't seemed warranted. In 1986, it hadn't yet become standard practice to conduct the 20 week anatomy check.

Could a routine mid-pregnancy ultrasound have caught it?

This question of routine ultrasound is still be discussed hotly in the scientific literature, as well as among expectant parents. Each couple or mother has to come to that decision for her/themselves and it will often be based on the values and perception of risk for the individuals.

My mom given her knowledge at the time decided to avoid a sonogram during that pregnancy, and none of the doctors pushed for it. Its not like now where its the exception to forgo the 20 week anatomy scan. Its within a family rights to choose one or the other. I've had to consider it myself and working through this experience gives me some more insights into the decision making process.

From what I've been able to learn about TGA, early ultrasound can detect it (2). A study using ultrasound to detect TGA prenatally started in 1986 and out of 68 fetuses with suspected TGA, 57 truly did (3). That's a pretty good detection rate. And according to the authors, mortality rates were lower when it could be anticipated before birth. They caution however that the technician must be adequately trained to detect fetal heart anomalies and the emotional upheaval of knowing ought to be weighed against nature taking its course.

I am now picturing the high-risk hell that my mother may have experienced in knowing early that my brother had this defect. Maybe it would have been discovered at 20 weeks and biweekly biophysicial profiles and non-stress tests would have been conducted to give him time to mature but then to end his gestation at the first sign of distress. If he died in utero between 32-34 weeks, that is a really early premature baby and in his case, one in acute need of open heart surgery to repair the defect.

A high chance of death anyway, a long NICU stay, recovery from a repeat c-section with a toddler at home, emotional trauma from the fear and horror of parenting a sick premie, the stress of the hospital bills--that could have been my family's alternate reality.

I've spent enough time at Solace for Mothers to know the pain, suffering and difficulty that comes from a birth experience like that. Knowing myself the trauma that comes from a negative birth experience, I can't choose which I would prefer. I know, from observation and from my own loss, the grief that comes from the loss of a stillborn baby. Would I choose that because its familiar? Because I recognize that the laws of nature are a crapshoot and sometimes babies die? That maybe facing his loss the way it happened was going to somehow be better than losing him after the trauma of a premature birth? The chance that my mother herself could have died given the increased risk of maternity mortality for cesareans over vaginal birth?

Of course, a question I've asked myself is what was the cause of the defect.

I've blogged before about the possibility that my mom's previous c-section could have contributed to my brother's stillbirth, though I have not found any evidence suggesting that a prior c-section can predict a congenital heart defect. Environmental contaminants have been named as a possible explanation (4)(5). In talking with my mother, I learned that she remembers smelling the solvents in the inks used in her workplace during her pregnancy with my brother. I already found the work of organizations like Environmental Working Group and Pesticide Action Network compelling but this further adds to my awareness of the effects of environmental contaminants. Not only do I find their ubiquity insidious but I am angered at the cover-ups employed to deny the facts and the lack of regulation and ethics that have caused so much damage already that the public is only beginning to learn about now.

I have to remind myself though, "Most of the time this heart defect occurs sporadically (by chance), with no clear reason for its development" (6).

And of course, nothing changes the reality. My mother continues to cling to me for her hope and happiness and I'm learning what being a sibling is like through watching my children. Comfort is found in the plan of salvation as taught by the LDS Church that my brother belongs to our family for eternity and that I will have the opportunity to know him in the next life. I already sense that my father, upon his death, was welcomed to the spirit world by his son.


(1) Children's Hospital Boston "Transposition of the Great Arteries"
(2) Role of Ultrasonography in Early Gestation in the Diagnosis of Congenital Heart... Abu-Rustum et al. J Ultrasound Med.2010; 29: 817-821
(3) Detection of Transposition of the Great Arteries in Fetuses
Reduces Neonatal Morbidity and Mortality in the journal Circulation 1999;99;916-918
(4) Having Faith: An Ecologist's Journey to Motherhood by Sandra Steingraber
(5) The Body Toxic by Nena Baker
(6) Children's Hospital Boston "Transposition of the Great Arteries"

Do Birth Workers Know What Women are Reading?

Rixa at Stand and Deliver blogged recently about how obstetricians come to their beliefs about homebirth which reminded me of a question I asked myself a few months back.

Do obstetricians and L&D nurses know what women are reading about birth?

And, if they did, how would that change their practice?

Beyond the texts recommended by obstetricians and What to Expect When You're Expecting, it appears to me that many women planning hospital births are reading information on natural childbirth with books like:

Ina May's Guide to Childbirth
The Birth Partner
Hypnobirthing
A Thinking Woman's Guide to a Better Birth
Gentle Birth, Gentle Mothering
My Best Birth
The Birth Book
Birthing From Within
Spiritual Midwifery

A common thread of these books is arguments against using obstetric intervention through replacing interventions with simple strategies employed by the mother and her support people. Most of these strategies require advance preparation and knowledge regarding them though gaining this knowledge really doesn't take much time. Simply reading about it in a book, or even a website makes one qualified to change positions or to breathe deeply or soften one's jaw. It even qualifies someone present to suggest it to a laboring woman.

Now this is where I think this plays into Rixa's discussion. I'm going to theorize that one reason hospital birth workers are not supportive of homebirth (in addition the other reasons suggested by Rixa and her readers) is that homebirth is the epitome of natural birth where it becomes clear how very little knowledge and expertise is needed (except for when it is). This idea would feel like a threat to their livelihood, their career choice and might breed just a little bit of resentment towards other professionals who have not slaved through the initiation rite of medical school and residency to end up doing very similar work.

Doctors might shy away from asking themselves the question: "If birth were simple and reading a few books qualified a person to attend births, then what was the point of all that education? It can't possibly be as easy as these books say it is."

And then, as I continue on this pretend inner-monologue, perhaps hospital workers then would get frustrated with their female patients: "How could they possibly think they know enough and think that reading some silly books are going to qualify them?"

But, now I'm dreaming, what would happen if hospital birth workers read these books with an open mind? Would they be compelled to try some of these strategies or to suggest them during a woman's labor?

Are these books written compellingly enough to convince an obstetrician that maybe hands and knees for pushing is worth the try?


Or--now I'm really dreaming--what if these books became required reading for OB residents and L&D nursing students? Just so they knew what "fluff" pregnant women are filling their minds with as they prepare for birth. Perhaps, the assignment could be given with the intent to debunk the misinformation and to encourage doctors to reflect and prepare for how they will respond when women present these ideas in prenatal appointment.


And, if the less academic, popular press reading is too unpalatable for our esteemed birth workers, perhaps the expose of childbirth in America written by journalist Jennifer Block "Pushed: The Painful Truth About Childbirth and Modern Maternity Care" could be recommended first as it provides thoughtful insights into each side of the topic.

In any degree, from a pregnant woman's perspective, this would be more beneficial from dismissing them all together or pretending like they don't exist. Not recognizing their influence creates a vacuum of information, a empty divide where patient and doctor are trying to yell across but the message keeps getting lost.

However, I would hazard to guess that, if hospital birth workers could open their minds a little bit, many of them could recognize the value of the information and see how the paradigm fits together to make the idea of homebirth and non-interventive, unmedicated birth plausible and attainable in relation to relative risk and safety.

Or at least perhaps, we could stop talking past each and be on the same page.

My husband's tribute for Mother's Day

My husband shared this with me for Mother's Day as a tribute for my role as mother to our children. I love it! And so will you...

To see the full view, click on the title and it will take you to Youtube.

If I could do it all over again Part 1: Preparing for Childbirth

I've learned so much from becoming a mother and my blog is somewhat of a catalog of that learning. Since I posted my review of Birth as an American Rite of Passage, I've been thinking about what I know now that I wish I had known before Willem was born. So much of it comes from what I wish I had read. I have often thought that if someone had told me that I could come away from giving birth traumatized by having to fight for an unmedicated birth, I wouldn't have believed them. I would have needed to read the right books to be fully convinced. I think I've now found a reading list that would have convinced me if I were to have read them while I was pregnant the first time.

Birth as an American Rite of Passage by Robbie Davis-Floyd

This has been a very influential book for me. Framing the obstetric culture in terms of technology over nature was a very helpful framework for me to see the potential battle that birth can be between a mother and hospital workers. If I had read the book while pregnant the first time, I would have know that I was in the wholistic camp, believing that a woman's body is capable of working properly to birth a baby. Viewing birth as a rite of passage also likely would have illuminated the spiritual aspect of birth in a way might have compelled me to view the upcoming event as a spiritual event as well. The women stories in the book also very clearly describe common hospital practices that upon reading, I would have known I wanted to avoid. Homebirth was clearly shown by the mothers stories to be one of the only viable ways of really avoiding those practices.

Rediscovering Birth by Sheila Kitzinger

The strength of this book comes from the cross-cultural descriptions of birth practices, as well as covering the history of childbirth. Kitzinger places the natural process of birth as the foundation of the book and so when describing the migration from homebirth to hospital, it becomes very clear to the reader how unnecessary a hospital birth is in the majority of births while respecting their usefulness is certain situations. As a first time mother, I had had no exposure to the cultural context of hospital birth. I believe, like circumcision, if I had known the history behind the practice, I would not have been accepting to engage in it. This book also highlights the spiritual and emotional aspects of birth, which as I've said, would be very helpful for me.

Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block

While Rediscovery Birth examines the history of the way childbirth has been handled across societies, Pushed examines the current issues confronting childbearing women in our society. Like Birth as an American Rite of Passage, I believe I would have clearly seen the incongruent care being given to childbearing women and how that can lead to avoidable harms. Block gives a sense of the whole picture that comprises all the parts of maternity care and how each part in interrelated from hospital administration to insurance companies, malpractice lawyers, midwives and law-makers. I feel that the book shows very convincing how women can be painted into a corner when it comes to making decisions for birth. As it was so extensively researched with up to date information, I believe I would have been very convinced by Block's reporting.

Gentle Birth, Gentle Mothering by Sarah J. Buckley

Buckley describes the biology of childbirth and describes very well the type of environment needed to allow the process to occur most successfully. I feel that her presentation of the physiology defines why privacy, familiarity and no intervention is so important in childbirth.

From this book, I also would have learned the whys of babywearing and been introduced to the concept of elimination communication, which I may have been intrigued enough to try it as soon as Willem was born.

Ina May's Guide to Childbirth by Ina May Gaskin

If I could have read one book on how to cope with and prepare for the physical sensations of childbirth, this would have been it. It would have been very helpful for me to know about "the sphincter rule," the value of cuddling and "smooching" during labor, "horse lips" and maintaining a relaxed mouth and throat. The Hypnobirthing preparation I did do during my first pregnancy was helpful in learning how to relax and breathe but I feel that Ina May's Guide covers that very well, with more applicable information for the continuous motion often helpful during labor.

Also the normalcy of home and out of hospital would have been reinforced and added to how convinced I would have been to avoid the hospital.

A Thinking Woman's Guide to a Better Birth by Henci Goer

Not only is this book convincing for why common obstetric practices should not be routinely employed, it also works to prepare a woman who may need to have a hospital birth for whatever reason. I think through reading this book in conjunction with the others, my confidence in my knowledge of what I want to avoid would have been bolstered and I also would have been prepared to deal with the hospital if I had needed to.

If I had read all of these books relating to childbirth during my pregnancy (or before), I still would have needed to convey the information to my husband. He is more difficult to convince than I am when it comes to information that it outside of cultural norms or claims to be scientific in anyway. Like I found between my pregnancies, he did learn a great deal from the times when I stopped reading and couldn't help but tell him about the frustrating, funny, interesting fact that I had just learned. That strategy went a long way, but it did come to a point where he told me to stop talking about birth (more because it reminded him of the trauma he experienced from Willem's birth). Because of his limited time as a graduate student, I would have needed to pick one source of information on childbirth to share with him.

The Business of Being Born produced by Rikki Lake and Abby Epstein

This documentary provides a DVD format and covers all of the main points of the books I've listed. Its animation of the "technocracy's cascade of interventions" is useful in the quick way it describes the drawbacks of hospital birth. The history of hospital birth provides enough information to see just how money driven, patriarchal and unjust hospital birth's origins are.

My husband has seen the documentary and though he was convinced by the information regarding what is wrong with the hospital based maternity care system, he still was not completely convinced about a homebirth. HIs preference would be to fix the hospital system so unmedicated birth is the norm, but I think even he realizes that is not going to happen in time for births in our family. He accepted the homebirth option because he didn't see a better way, in the moment, that I was comfortable with. I think this is what is called "opting-out." Even still, I'm not sure whether he would have been convinced regarding homebirth without first witnessing the down-right abuse I experienced in the hospital giving birth to our first child.


All of the books, and the DVD, I discussed in this post are available on the amazon associates store that I posted at the bottom on my blog. There's reading list widgets for blogs or there's shopping directly from a blog, I chose the latter--saves time for the reader. That's also my explanation for why I didn't link individually to each item or post pictures, its all there, just below the post.

Healthy Birth Carnival: Avoid Interventions that are not medically necessary.

I'm choosing to participate in the Science and Sensibility Blog Carnival where the current topic for bloggers to address is Lamaze's Healthy Birth Practice #4: Avoid interventions that are not medically necessary



Going into Willem's birth, I was aware of and planning to avoid unnecessary interventions. I thought I was making the prudent decision of working with midwives instead of an obstetrician and on a number of occasions throughout my pregnancy attempted to discuss my desires to follow this recommendation for my son's birth. I was also under the mistaken belief that midwives would not recommend interventions that were not based in medical need. How naive I was!

My son's labor was, no surprise, lengthy and slow to progress just as is common among first time mothers. I tried to avoid the mistake of going to the hospital too soon but had a prenatal appointment the morning that contractions began. At the appointment, the midwife was very excited and counseled me to go straight to Labor and Delivery where I could be admitted. I felt at the time that it was too soon in labor to go but trusted her recommendation. I spent the next 8 hours at 3 cm. And in that time, I was bullied, harassed, threatened and manipulated into accepting pitocin augmentation and AROM. I knew it was not necessary and I felt no need--physical or emotional--to speed up my labor. I was coping well and was trusting the natural process that birth is.

Eventually as I was so adamantly refusing to consent, I was summarily kicked out of the hospital. I say it that way because there was no gentleness or supportiveness in the attitude of the attendants. They used it as a threat to get me to cooperate. When I didn't, they rudely told me to leave and left it at that.

To read my complete birth story, read here: Descent into Motherhood: Willem's Birth Story

I came away from my son's birth traumatized by the way in which I was treated by the midwife on call. I felt that she was threatening to take away my power to make decisions for myself and coerce me into giving control over my body to her. The situation felt very much like someone unjustly wielding power over another. I was able to imagine just what it would be like be threatened with rape, or with watching the murder of someone I love. To read more about my reactions to the treatment, read: I Came out With a Baby, Crash Course in Birth TRUTH, My Experiences with PTSD after childbirth and Recognizing Birth Rape.

Since then I've learned that I was fighting over the principle of informed consent. Like most rational people, I believed I had the ultimate power to make decisions over which treatments I would accept or refuse. I've come to believe that violating the principle of informed consent is a form of abuse; a violent misuse of power and authority.

Now to relate my story to the Lamaze Healthy Birth Practice of Avoid Interventions that are not medically necessary:

Since interventions in childbirth are frequently used more often than necessary, it can be beneficial to remember that pregnant and laboring women have the right to refuse treatment and to first use alternatives to interventions before consenting to a intervention.

But beware, some providers will not be respectful of that right and will attempt to manipulate a woman into cooperating, no matter how hard she tries to avoid unnecessary interventions. A woman may find that it is not possible (or severely challenging) to avoid them based on the attitudes and practices of their provider. They may have no indication beforehand that they will encounter a provider who will push these interventions and emotionally manipulate her into consenting to unneeded and unwanted interventions.

Experiencing this sort of situation can be emotionally traumatic. PTSD after childbirth can be clinically diagnosed in between 1 and 6% of women (Beck, 2004 and Ayers,2001 ) and up to 34% of women have been found to exhibit some trauma symptoms (Soet, Brack & Dilorio, 2008). If that statistic is true, that means that over 1.3 million women are traumatized by their birth experience in the United States each year. That rate is HIGHER than the C-section rate. However, birth trauma is not widely recognized.

In my experience and from what other mothers who have experienced birth trauma have told me, getting help can be very difficult and not being able to find people who understand is very lonely. It was for that reason that, when I had the opportunity, I helped created the Solace for Mothers Online Community for Healing Birth Trauma.

In my work for Solace for Mothers, we have put together a list of questions to ask maternity care providers on the topic of informed consent. Essentially interviewing a provider to determine how respectful they will be of an individual's right to determine the course of her labor and to choose which interventions to accept or refuse may be more helpful than trying to find a provider who doesn't often use interventions in their care.

Much work needs to be done to give women the due respect they deserve to make decisions for themselves. While there is power in consumers (in this case pregnant women) demanding the type of care promoted by the Lamaze Healthy Birth Practices, providers have the responsibility to change the way in which they practice so women are not having to fight off providers who are pushing interventions that are unnecessary and introduce unneeded risks.

If providers were to follow the informed consent guidelines closely and promote evidence based practice, the trauma rates would be dramatically reduced and unnecessary interventions would not be offered as often as they currently are.

What does birth mean to me?

We are celebrating the birthday of my first child. It was three years ago today that I became a mother. Three years ago, I fought for an unmedicated, vaginal birth. Three years ago, that I breastfed for the first time. Why then am I still writing and talking about birth?

There is something profoundly special about birth and in recent months there has been alot of talk about what that something is. Rixa clued me this discussion with her post "Thinking No Conclusions Yet". I was also inspired by this post by Keyboard Revolutionary and how she describes how birth impacted her as a maturing, developing individual and mother.

I originally wrote the following statement about birth in April of 2009 when I was 8 months pregnant with my little girl. The top paragraph is a statement of what I believe about birth followed by the logical implications I could think of as well as explanation for why I believe my statements to be true. This post is an exercise for me to see if my thoughts have changed in anyway now that I've given birth a second time and grown in my logic, knowledge and though processes regarding the life event.

Birth is a normal process in a woman's life much like the menstrual cycle. Typically, in the majority of cases, it is a process that women can handle on their own without medical assistance. Sometimes the process goes outside the normal range so its a very good thing that traditional and medical knowledge and intervention is available for consultation and judicious use. Menstruation, like birth, can be a painful (intensely painful) experience for some, even most experience pain in relation to that womanly process. Therefore it is perfectly reasonable for women to seek out ways to minimize that pain.

What are some of the implications of this belief?:
1) Drs, hospitals and midwives are not necessary in most cases for birth. It would be like going to a hospital when menstruation starts and staying for the duration of the bleeding cycle while efforts are made to speed the shedding of the uterine lining, reduce pain and discomfort and prevent excessive bleeding.

2) Sometimes consultation is needed when something is varying widely from normal and its a good thing that those experts and facilities exist.

3) Those facilities and trained experts need to exist, know the role they are intended to play and use practices that are based in logic, evidence, safety and effectiveness with minimum intervention. I cannot say that I believe that current obstetric and even midwifery practices support this.

4) I'm not going to begrudge anyone who seeks to find pain relief for either womanly process, but I will point out that the big guns of anesthesia are not typically warranted for pain associated with such a normal event (and I'm going to say it) everyday event.

5) Birth is not treated like an everyday event in our world, but in many ways it is. Its a normal part of life that is filled with significance and symbolism, but its just birth like defecating is just taking a poop and menstruating is just the shedding of the uterine lining.

6) There needs to be levels of involvement based on need when something is going wrong. The first response to derivations from normal is the individual relying on knowledge sought and shared by peers and women who have taught her about the process. Self-comfort measures, then possibly herbs, then possibly stronger pain relievers, then consultation with an outside trained consultant who offers the minimum of support for a normal process. As more is needed, those services can escalate to meet the need presented before them. But prophylaxis is not really warranted. Treatment of symptoms and finding the root cause while supporting the overall process ought to be maintained as the standard of care. What this implies is that midwives need to be able to consult freely and make referrals to obstetricians without fear or reprisal. OBs need to remember their place in the process not as the director but as consultant. Women need to accept and act on the belief that help and assistance is not needed and its something that they, their bodies and their babies do as an everyday fact of life.

7) Where does trauma fall into this? When things goes serious wrong with any health related concern, the emotional trauma can be profound. Women in childbirth aren't the only ones who are traumatized by a major health crisis: cancer, injury, surgery, hemorrage all are scary because there is a threat to our sense of safety within our own bodies. Those crises are scary and its no wonder that people have long term emotional effects from those experiences. For birth, there's also another cause for trauma besides the pain, besides the fear of when things go wrong. There is what happens when people who shouldn't be meddling in a normal process get involved and screw things up. Providers don't realize the physical and emotional damage they are doing when they push for unecessary and not evidence based practices to control and process that they are afraid of. Its not something to be afraid of in most cases. Yes, sometimes it can be scary but that doesn't mean that every poop needs to be closely monitored and controlled. Doing things that don't need to be done will just make things worse.

Since experiencing Belle's birth, I have to say that the similes between birth, menstruation, and defecation hold true for me. Her birth was such a normal and as I experienced, pedestrian process that it was in some ways boring for me. It certainly doesn't make for an exciting story, there was little drama. Just an emergence and a completion for a normal bodily process.

I did fail to state in my original writing however to emphasize that birth is altogether a more physically demanding bodily process and it is a very special life event for a mother. I do not believe that it the most important events of a mother's life like Jan Tritten states, as I believe that it is overstating a simple transition from one state to another. As a mother who as been traumatized by events relating to childbirth, I know too well the long-lasting emotional effects that a mismanaged, "pushed" birth produces in a woman.

For the baby, the birth (and the manner thereof) is important bio-chemically and throughout development. This is reflected in the research suggesting that babies exposed to pain relief drugs in childbirth are more likely to become drug addicts when they become adults, as well as the research linking birth practices to autism and maladaptive attachment between parents and child. But to say that the events of childbirth are a strong predictor of child's health, well-being and capability as an adult ignores the functional adults (often the mothers who are now fighting for natural births themselves) who experienced less than ideal births when they were babies. It is safe to say that most of the adults up to at least age 70 were brought into this world not in the way that research shows as optimal for development and bonding. How one was born does not often make that child less capable of facing their life's challenges.

So if I just stated the ways that birth is not special, why is it special and what does it mean to me?

Birth is special because it was the moment I got to meet my children. The emotions, environment, thoughts and feelings of my body are still strong in my consciousness as I remember what it was like to bring them into the world and hold them in my arms for the first time. With Willem, I was frustrated with the people around me that is caused my focus to not be solely on my child and I still resent that he was born into a moment of bitterness and frustration. With Belle, the laughter and excitement of the final moments of her birth and the joy of having my husband and child look on still cause me to relive those feelings. With Willem's birth, when I relived his birth. It was in the form of flashbacks and PTSD. With Belle, I relive her birthday and I know joy.

Birth is a woman's battleground where the inherent and supremely unique strength of womanhood is exerted in its fullest. A woman each time she gives birth "walks through the valley of the shadow of death" because there is the possibility that she will die bringing life into the world. So in a sense, a woman faces death and walks away conquerer bearing new life in her arms. Its amazing! No wonder, Goddess worship is common throughout history! She faces fear and pain, discouragement, exhausted and comes out experiencing the highest high of her life (granted she's not facing the commonly disturbed birth environments of today). With both of my children, I fought to bring them into the world without experiencing things that I felt could be damaging to their health. One the fight took place while I was laboring. The other I fought and prepared and schemed before labor so the actual event of her birth could be peaceful and private.

Its because I had to fight, and that all women who are seeking a normal birth the way nature is intended are having to fight for it, that is why birth is so important to me. That its become a cause that I feel like I have something I can do to keep other women from experiencing the emotional suffering and stress that I experienced. Its a matter of right and wrong for me too. Its simply wrong for a woman to be told by authority figures that she is not capable of making decisions for herself. Its wrong that an entire system is structured in a way that many women and babies suffer unnecessary risk, damage, ill-health and distress in the name of what is culturally acceptable. Its these issues that I'm taking on and that I want to work to correct for my daughter and my sister-women so they can give birth undisturbed, in joy and have access to the help they need when it is appropriate.

What does birth mean to you?
How is it special?
In the course of life, how important is it?
How important is mode of entry (vaginal, cesarean, medicated or not)?

Review of "Pregnant in America"

For Christmas, I was given a copy of Pregnant in America a documentary film that chronicles an expectant couple as they learn about the process of birth and their options as parents and consumers. Over the course of the pregnancy, they unearth the whole drama that is choosing between hospital and out of hospital birth with all the propaganda employed against parents who desire to become apart of the statistical exception.

In some ways, I liked this movie more than the Business of Being Born. I like that the film follows the journey of a family and especially enjoyed how the filmmaker connected personally to the experts that he interviewed. Robbie Davis Floyd was featured in a touching interview where she turned it around and became the interviewer anthropologist that she is. I was touched by her compassion, astuteness and understanding. Another interview that I found very compelling took place outside the FDA offices where Maddie Oden delivered a petition to stop the administering of Cytotec to pregnant women. It highlights the story of the Tatia Oden French Foundation in such a way that the issue is made clear how its misuse can harm families.

The facts and statistics presented were consistent with all that I've read and learned about birth and provides a companion film to the Business of Being Born and Orgasmic Birth.

All three are great movies to share with expectant families who may be among the uninitiated in the discrepancy between evidence and practice. In a way, I feel that Pregnant in American is more convincing on this score, showing how the choice to birth at home is a valid choice where help when needed is effective and accessible.


*Spoiler* The family chooses to transfer to the hospital after a peaceful home birth because of concern over the baby's breathing. The transfer may not have been necessary, but the parents chose to consult with experts over a valid concern. They, and the viewers, learned how a transfer can occur smoothly, without harm coming to baby or mother and that emergency care is available when needed.

The style of the documentary imitates the style of Michael Moore pretty closely. I don't have a problem with this because I had been hoping that the controversy with birth issues would be presented in the same style. In fact, if Michael Moore tackled the topic, I don't think he would have done it as well. Michael Moore enjoys being over the top and for birth, that's not necessary. The tone of Pregnant in America is sweet and endearing with just enough anger and frustration to highlight the injustice inherent in the American maternity system.

I'm hoping to host a screening of this movie soon for a Meet-up group I belong to.

Cool en utero photographs

A friend passed this link on to me showing photographs of various mammals en utero. Techinically, the shark is not a mammal or en utero, because they gestate in egg cases inside the mother and are then born live, but I only know that because my husband is in the process of becoming a shark expert.

These photos come from a National Geographic documentary viewing various gestations of animals aside from humans, for more information on it, see here.

Recent birth news

There has been a lot going on in news about birth in the last couple of weeks.

First there was the mom in Australia who had police show up at her door after she chose not to show up for the induction that her doctors scheduled her for. Her doctors decided to call the police to escort her in.

Later, the hospital issued her an apology. Ironically, they claimed that they were not trying to pressure her into an induction. Right..sending police isn't an intimidation tactic?

If The Birth Survey was available for mothers around the world to take, I'm sure Rochelle would be able to report that she did in fact feel pressure to induce from her providers.

Then there was the mom who is going to court over being court-ordered to remain on bedrest while confined in a hospital and undergo a mandatory C-section.

Both of these stories are disturbing to me because it shows the lengths that medical professionals will take to force women to act according to their recommendations.

I have been on the mothers end of disagreeing with the medical professionals I'm paying to advise me on my health. In the two cases described above I see enough evidence to know that the mothers were informed about the research and known risks of the proposed treatments and in good conscience chose what was actually more evidenced based and better for them personally. My experience fighting to prevent an induction leads me to empathize with these two women who experienced much stronger attempts to manipulate their choices and force them into things that they knew they had the right to refuse.

It may be unfair to expect, but I would not be surprised with either of these women were traumatized by these experiences where they had to fight for their bodily integrity and to make health choices for themselves; without fear of reprisal. I hope that if they are experiencing trauma, that they will find the support they need and know about Solace for Mothers as a resource for women who have been traumatized by experiences relating to childbirth.

To quote directly from an ACOG publication:

"Even if a woman's autonomous decision seems not to promote beneficence-based obligations (of the woman or the physician) to the fetus,...the obstetrician must respect the patient's autonomy, continue to care for the pregnant woman, and not intervene against the patient's wishes, regardless of the consquences."

Belle's Birth Story

I feel like I should start her story with Peter's return home on Wednesday night. He was so tired and sad but relieved to be home. The last two weeks have had him experiencing the most intense and varied emotions. He got a day to recover before a whole new range of emotions swept by him.

Or I could start Belle's birth story the same way Willem's starts. "Thursday night, sex did it..."

I hoped that the prostaglandins in the semen wouldn't start contractions, or that if they started they would stop after a while. At 3:30 I woke up feeling a mild contractions. At that point, they were seven minutes apart. Within a half hour, they were 3 minutes apart. I decided then that I wouldn't be sleeping anymore that night and got up to ready the house for the birth. I put towels in the washing machine, finished making my laborades (lavender lemonade and sweet rose tea) and started inflating the birth tub. At 4:45, the contractions were getting stronger but still at 3 minutes apart. I decided to wake Peter up and get him to take over inflating the pool. He was completely groggy and too was hoping that the contractions would stop and that we’d be going back to bed.

While he pumped up the pool (we were using a manual bike pump, efficient but we wished we had purchased an electric), I straightened and gathered supplies while pausing for contractions.

At 6:30, Willem woke up and “helped” me through contractions. I was on my hands and knees on the floor and he curled up underneath me. When the pool was filled with air, he was ready to get in. We started filling it with water and when it was the depth of a normal bath, Willem and I got in together. He was so excited to be in a “warm bath downstairs with Mama.” Peter started boiling water on the stove and periodically added more water.

While the pool filled with water, I asked Peter for a priesthood blessing, in part to gauge the rightness of calling the midwives for any unseen reason. The blessing was one of comfort and reassurance: that my body was strong and I could be confident in my ability to birth the baby. I was counseled to meditate and use the relaxation techniques I had learned from my studies. During the pregnancy, I had listened to the Hypnobabies scripts but I did not turn them on during labor. I applied principles of visualization, affirmations and prayer throughout the process. I spoke to the baby and breathed deeply through contractions. As they built, I found the visualization of getting to the peak of a hill helpful because I could feel when the "steepness" changed and I knew I was headed back down the hill again.

The pool was filled using a garden hose attached to the kitchen sink and then run across the kitchen, through the pass through that separates the kitchen and dining area and into the pool. That was about 7:00, I stayed in the pool only getting out to trek upstairs to the bathroom. While on the toilet, I felt the beginnings of pushing sensations but attributed it to a bowel movement. I checked to see if I could find the baby’s station and I think I felt a head with bulging waters. I didn’t even try to determine dilation because knowing that there was a head there was enough for me. Contractions were 2 minutes apart.

Around this time, Peter admitted that this was truly labor and it wasn’t going to stop until the baby was born. Both he and I thought that we would have several more hours. I then remembered that we had been remiss throughout the pregnancy and hadn’t documented it with pregnancy pictures. I had been completely unclothed in the pool so on one trip upstairs to the bathroom. I pulled out the maternity bathing suit that my friend had lent me. On the way downstairs, I told Peter he should start getting some pictures before it was too late.

Between 8:30 and 9:00, Willem started getting antsy in the house so we started preparing him to go to a friends house. This was about the time that I moaned to Peter “I want to take a break. It’d be nice if I could have three minutes between the contractions again.” I don’t really remember his response but I remember it was sympathetic. I think I heard Willem one time say “Mama sad” and I moaned through contractions, and I tried to explain that I wasn’t sad. I was just working hard to get the baby to come out of my body. We think looking back that was transition.

Around this time, I asked if Peter felt like he wanted the midwives to be present and he said that everything was going so well—and it would probably be awhile until the baby was born anyway—that he didn’t feel the need to call them. I knew I didn’t and reflected on what it might be like if they were present. I imagined that they’d be pleasant, supportive and kind but that they’d be gathered in the living room watching me and I did not like the idea of being watched, even if by benign and happy presences such as my midwife and her assistant. I didn’t need it, didn’t want it, and was doing the whole process as it was made to unfold for me.

This was when I realized that with every contraction, I needed to flip over to my hands and knees to get through it. I felt tightness radiating down into my thighs and it felt like the bones of my pelvis and hip were being stretched outwards. I did not experience any back labor, and contractions were low, tightening with pressure. This part is hard for me to explain, I was pushing gently with contractions but I’m not sure if I was doing because I felt like it or if it felt good. My thighs were getting very tired and at one point, I felt like asking Peter for some double-hip squeezing but he was busy trying to wrestle Willem into some pants. Somewhere in this time, I felt like I was getting more rest between contractions, even though they were any further apart. Looking back, I think it was an example of “ask and ye shall receive.” Maybe it was the actualization of a positive thought. Whatever it was, I was grateful for it!

As Peter was on the phone with our neighbor who was going to watch Willem for us, I checked the baby’s station again and I felt her head as deep as the middle knuckle on my index finger. When I told Peter that, he was shocked! To him, he had just barely begun to believe that this was really the birth of his baby.

Again I checked to feel if the amniotic sac was still intact and attempted to pinch it with my finger nails (I don’t really know why), I got a hold of something that might have been sac and pulled gently. And then I realized that I had just pulled baby’s hair! Oops! But based on that, I have no idea when my waters broke. I was hoping I’d know and be able to experience that sensation as it happened. This event was one of the decisions I regretted from Willem’s birth because I consented to AROM. I either wanted to know and feel it as it happened on its own or if it was a decision I made on my own, without feeling pressured by others around me.

A few minutes later, as they were about to walk out the backdoor, I yelled “the baby is crowning!” I roared a couple of times as the new sensations took over. I felt my first undeniable urge to bear down, immediately followed by sharp stinging in my tissues on either side of the baby’s head (not like the ring of fire). Instinctively, I stopped pushing and snapped my knees together. Then I laughed at myself, squatted and focused on letting the baby ease down. I felt another undeniable urge to push and the baby’s head was out. At this point, Peter was standing over the birth pool with Willem in his arms and they watched. There was a pause after the baby’s head was out and then another urge to push, a little more stinging, a shoulder, a shoulder and then another slight push for the chest (her chest is broader than her head circumference). I reached down and pulled her to the surface of the water, and then leaned back with her cradled in my arms. This was 9:31 am (I didn’t look at the clock until 9:34, so Peter verified the time).

I realized I saw the cord around her arm, and then her neck. I got a little confused as I figured out it was over her right shoulder across her neck, under her left armpit and wrapped around her arm. I unwrapped her and then noticed that she was looking pretty purple and was quiet. I wasn’t surprised that she would be quiet, especially as I could hear and see her breathing, with mucus clearing itself from her sinuses and mouth. But the purple was a little concerning. Peter noticed too and gently told me to hold her against my chest and rub her back. I did and she started crying, and then turned pink.

We saw a gush of blood into the water—which concerned Willem—and then we commented that we had failed to do the hemorrhage test in water. We knew what 200 CCs and 500 CCs of blood looked like on a chux pad but not in a pool of water. It was then that we decided that I should get out of the tub to monitor bleeding (and by that point I didn’t want to be sitting in bloody water anyway). Twenty minutes after she emerged, I squatted against the side of the pool and the placenta came out looking amazing. The membranes of the amniotic sac were trailing behind but came out easily too.

I had planned on using some purple cording to tie off the umbilical cord after the placenta had emerged. Earlier while I had been gathering supplies, I went to find the cording and couldn’t. I poked into my sewing box and found some white cording that I had intended to use on the bodice of my wedding dress but hadn’t. I felt it was very appropriate and meaningful instead to use it during the birth of our baby. Peter and I each tied off the cord (two ties with about two inches between), and then Willem held the scissor handles while Peter cut the cord.

I leaned against the wall, sitting on the chux pad to monitor bleeding while I suggested that I call the midwives for the newborn exam and filling out the birth certificate. I hadn’t known beforehand when I wanted to call them but at that moment, it felt good to welcome them and share the happiness. I called them while Peter took Willem to our neighbor’s house.

They arrived around 10:45, bearing a huge bouquet of flowers from the midwife’s garden—evidently I called her while she was out watering this morning. They were so happy for me, and so cheerful. This was also when I realized that the day before, my friend and I agreed that she’d come over Friday at 11 am so the kids could play together. I called her while she was on her way over and told her that the baby had been born and she was welcome to meet the baby and could she please supervise Willem on the playground outback for a little while. She came, she did just that (bearing Jamba Juice!) and washed dishes for us during the newborn exam. It was wonderful!

When they all arrived, I had settled on the couch with a blanket. That was where the newborn exam was performed. She weighed 7 lbs 6 oz, a half pound more than Willem at his birth. Before she was weighed, I asked Peter what his guess would be based on her appearance and he guessed exactly that! Length was 20 ¾ inches long. She has a lot of dark hair: like Willem did at his birth. We expect that hers too will change to blonde. She’s got the same butt-chin as Willem—they inherit that from Peter’s mother. And she has Peter’s dimple in her right cheek.

So far our babymoon has been lovely. The midwives helped me settle into bed upstairs and told me to stay horizontal for the next three days. I spent the rest of yesterday cuddling my new baby and nursing (her latch is pretty good for a beginner). I called friends and family then got a visit from my chiropractor. Before getting pregnant, she said that she’d like to visit the day my next baby was born so I took her up on it! It was so nice to see her!

Belle slept soundly last night from 1 am to 6 am and then again from 10 am to 1 pm. I slept with her during those times and then napped with her this evening between 7:30 and 10. She’s been sleeping soundly next to me while I’ve typed this out.

Today we had a little bit of an adventure when I was showering. Peter came in and said he was concerned that there was a gas leak in the house so he was going outside. He told me to be quick. As I stepped out of the bathroom, I smelled when he meant and hurried to get dressed. I met them outside and found a spot in the shade. Peter then told me that a plastic plate had gotten too close to a heated burner on the stove and had melted. I laid outside on a blanket, leaning against a pillow outside, talking to neighbors and nursing while the apartment was aired out. It felt so good that I didn’t want to go back inside so we were outside under the shade for 3 hours. During that time, my friend Shawnette and her mother visiting from my hometown in California dropped by to say hi and we enjoyed the fresh air together. We also broke into the cheesecake that I had made for Peter while he was out of town. I had intended to eat some for energy during labor, but it happened too fast to do so! I didn’t need it!

Bottom Line About Birth

I haave been trying to come up with a short statement that describes my beliefs about birth. I've been thinking of it kind of a guiding statement that can inform my efforts. This is what I've come up with so far but I know that it will evolve. Originally this was posted in an online discussion board. At the end of the statement, I discussed the implication of my belief statement.

Birth is a normal process in a woman's life much like the menstrual cycle. Typically, in the majority of cases, it is a process that women can handle on their own without medical assistance. Sometimes the process goes outside the normal range so its a very good thing that traditional and medical knowledge and intervention is available for consultation and judicious use. Menstruation, like birth, can be a painful (intensely painful) experience for some, even most experience pain in relation to that womanly process. Therefore it is perfectly reasonable for women to seek out ways to minimize that pain (unfortunately a tylenol isn't so effective in labor as Morphine!).

What are some of the implications of this belief?:
1) Drs, hospitals and midwives are not necessary in most cases for birth. It would be like going to a hospital when menstruation starts and staying for the duration of the bleeding cycle while efforts are made to speed the shedding of the uterine lining, reduce pain and discomfort and prevent excessive bleeding.

2) Sometimes consultation is needed when something is varying widely from normal and its a good thing that those experts and facilities exist.

3) Those facilities and trained experts need to exist, know the role they are intended to play and use practices that are based in logic, evidence, safety and effectiveness with minimum intervention. I cannot say that I believe that current obstetric and even midwifery practices support this.

4) I'm not going to begrudge anyone who seeks to find pain relief for either womanly process, but I will point out that the big guns of anesthesia are not typically warranted for pain associated with such a normal event (and I'm going to say it) everyday event.

5) Birth is not treated like an everyday event in our world, but in many ways it is. Its a normal part of life that is filled with significance and symbolism, but its just birth like defecating is just taking a poop and menstruating is just the shedding of the uterine lining.

6) There needs to be levels of involvement based on need when something is going wrong. The first response to derivations from normal is the individual relying on knowledge sought and shared by peers and women who have taught her about the process. Self-comfort measures, then possibly herbs, then possibly stronger pain relievers, then consultation with an outside trained consultant who offers the minimum of support for a normal process. As more is needed, those services can escalate to meet the need presented before them. But prophylaxis is not really warranted. Treatment of symptoms and finding the root cause while supporting the overall process ought to be maintained as the standard of care. What this implies is that midwives need to be able to consult freely and make referrals to obstetricians without fear or reprisal. OBs need to remember their place in the process not as the director but as consultant. Women need to accept and act on the belief that help and assistance is not needed and its something that they, their bodies and their babies do as an everyday fact of life.

7) Where does trauma fall into this? When things goes serious wrong with any health related concern, the emotional trauma can be profound. Women in childbirth aren't the only ones who are traumatized by a major health crisis: cancer, injury, surgery, hemorrage all are scary because there is a threat to our sense of safety within our own bodies. Those crises are scary and its no wonder that people have long term emotional effects from those experiences. For birth, there's also another cause for trauma besides the pain, besides the fear of when things go wrong. There is what happens when people who shouldn't be meddling in a normal process get involved and screw things up. Providers don't realize the physical and emotional damage they are doing when they push for unecessary and not evidence based practices to control and process that they are afraid of. Its not something to be afraid of in most cases. Yes, sometimes it can be scary but that doesn't mean that every poop needs to be closely monitored and controlled. Doing things that don't need to be done will just make things worse.