A midwife and "Birthing From Within" mentor, I am passionate about informed decision making and helping moms and partners birth in awareness. My blog chronicles my journey from cesarean to vaginal birth after cesarean and my quest for information to help families have EMPOWERING births.
Read thisarticle on the latest study comparing home and hospital births. I did have to giggle a bit when I read this line: "babies born at home are more likely to be hospitalized, usually because of infant jaundice." Of COURSE home born babies are hospitalized more often for jaundice. Babies born in hospitals who have jaundice are already in the hospital so they can't be hospitalized.
There are so many posts in my head after attending the Birthing from Within workshop, and I will try to tackle them one at a time. I have a bit to say about pelvic floors too as I am going through pelvic floor therapy. FIrst I need to be with my kids and get the house together, and that will take some time, so I will begin by sharing a piece of a Rumi poem spoken at the workshop. I think it is useful to birthing moms, especially to those birthing in a way that is not (yet) the norm for their community.
Those who don't feel this Love pulling them like a river, those who don't drink dawn like a cup of spring water or take in sunset like supper, those who don't want to change, let them sleep.
I must admit that I don't know how to knit or crochet (and feel a tiny bit intimidated by the process) but I will be gathering with a group of women on September 5th to learn (I've already bought yarn and a knitting friend gave me two needles!) and to crochet some hats.
In this beautiful story, skin to skin contact saves a child's life: "Parents 'Last Good Bye' Saved Their Baby's Life." What is a sad about this story is that the doctors had no hope. I've read/heard many a midwife's story where the midwife asks the parents to talk to a baby who is struggling to live and tell their baby they love him and welcome him and the baby lets out a cough and pinks right up. Midwives have faith in the will to live and the power of love (and yes, they do use oxygen etc. too).
Please read this article, the feature article in Harper's Bazaar, and share with friends, "My Wife DIed After Giving BIrth." According to the article, "the rate of maternal death related to pregnancy or birth almost doubled between 1990 and 2005."1 Midwives help lower the rate of maternal death by checking in on mom regularly during the immediate post-partum period (and by having a low cesarean rate!).
Jenna Gabrial Gallagher, "My Wife Died After Giving BIrth" Harper's Bazaar, online, http://www.harpersbazaar.com/magazine/feature-articles/wife-died-after-childbirth-0909.
Anyone heard this comment before? I heard it again today and it got me thinking. I remember I heard that phrase frequently when anticipating my first VBAC, from friends as well as care providers (not my midwife). The comment was in reference to the rate of uterine rupture and went something like this "the rate of uterine rupture may be less then 1% for most moms who VBAC but it is 100% for you if your uterus ruptures." I wonder why no one ever says, to the mom opting for a repeat cesarean, "I know the rate of maternal death is at least two to four times that of women with vaginal births but if you are the one that dies, it is 100%." (For more info on the risks of cesarean, please see the International Cesarean Awareness Network's Cesarean Fact Sheet.) I would just like to know why the only "scary" risks seem to be the risks associated with vaginal birth or with opting out of a particular medical test.
A friend and fellow doula once told me she was going to stop attending hospital births because women needed to have a challenging hospital experience in order to find their path to empowering birth. At the time, my friend's proclamation shocked me, but as I struggled to write a review of The Doula Guide to BIrth by Ananda Lowe and Rachel Zimmerman, her words bounced around in my head. Does Ananda believe women should birth without doulas? Indeed not! But I suspect she would agree with what my friend was trying to say, that doulas shouldn't try to save people. The Doula Guide to Birth doesn't try to convince people they shouldn't have unnecessary interventions, it provides information on topics (the option of refusing vaginal exams, pushing with no added force, and walking epidurals) that have had little coverage in other birth books and it fully explores what a doula is and does and how one might work for you. The authors of The Doula Guide to Birth remind moms that no matter how we birth, we need support, and gently encourage you forward on the path toward empowered birthing.
Die-hard natural birth junkies might find themselves wondering (as I initially did) why this book doesn't use stronger language when they discuss subjects such as being a guest of the hospital or in their sample birth plans. When I read the section titled "Being a Guest of the Hospital" (15) I thought, wait a minute! It is your birth, take back your birth! But then I realized that hospitals are private institutions and they have the right to create policies that we may not agree with and it will take a lot more then simply a line in a birth plan to change those policies. And then it hit me, maybe, by reminding readers they are the guest of the hospital perhaps, the authors are saying, if you buy the hospital ticket, you will take the hospital ride (which might, of course, be the perfect ride for you), but saying it in a way that respects women's choices.
The Doula Guide to Birth provides many tips (backed by solid research) that will make the hospital ride smoother. They gently remind you that if your provider isn't open to the birth experience you desire, perhaps you should change providers. And they suggest that there is an alternative: "if you want the most control and the least restrictions on your behavior...learn about the option of giving birth at home or in a freestanding birth center (16). The authors make it clear that you cannot hire a doula (or use a birth plan) to save you from all interventions, especially at hospitals with high medical intervention rates. When unplanned interventions do happen, this book has some wonderful ideas about how to reflect back on your experience (as well as an excellent form in the Appendix, The Evaluation of Your Birth, to help you start processing the experience).
The Doula Guide to Birth has something for everyone, the lesbian couple, grandparents, women birthing with disabilities, moms who will be placing their baby for adoption... and some fantastic book recommendations. I loved the focus on pushing "with your body's own rhythm." It reminded me that pushing is often left out of the birth plan. As a VBAC mom I definitely approved of the VBAC section. I also loved the practical stuff, some of my favorites are below:
How to have a frank conversation with your provider about doulas
When to really go to the hospital (moving beyond the 311 rule)
Twelve alternatives to a vaginal exam (another topic that gets fantastic and much needed coverage)
What to do when your water breaks (finally, a mainstream childbirth book that questions the 24 hour rule!)
Real talk about birth plans (i.e., just because it is in the plan doesn't mean it will happen)
If I had to change one thing about this book, it would be the section on walking epidurals. While I agree that moms absolutely should know about the position changes possible with an epidural and be supported by hospital staff so that they can squat, etc. with an epidural, I have yet to meet a mom who has actually had a walking epidural. Perhaps if more moms would discuss this option with their care provider before the birth (as the authors suggest) "walking" epidurals would become more prevalent. An advanced training class for doulas (and hospital staff!) that fully covers supporting mom through position changes with an epidural would also be helpful. I would have liked to see more focus on the risks of epidurals but as Ananda Lowe pointed out in an email conversation, there are plenty of books that cover that topic. None-the-less, I might have included a form similar to this Epidural Agreement in the Appendix. And after reading this book, I would definitely pick up a copy of Henci Goer's The Thinking Woman's Guide to a Better Birth.
I would also put in a word of caution regarding the use of night nurses or overnight nannies so that you can get some sleep. I am not a breast-feeding expert but I do know that the pump doesn't work for everyone and that the use of a night nurse could potentially affect milk supply. As an alternative, I might also suggest bringing baby to bed or, as the authors do suggest, hiring a post-partum doula (or other help) so that you can sleep when baby sleeps. The BIGGER discussion is how can our culture be more supportive of new moms (paid maternity leave perhaps so that moms don't have to worry as much about night sleep the first month, ok, I digress, that is another post).
So who should read this book? When I first heard the title, my thought was, is it for doulas or moms? My answer is both! I think this book has lots of tips for newer doulas (including a section on insurance reimbursement for doulas). It is a great book to suggest to clients who aren't sure about whether they will hire a doula or a partner who thinks he/she will be replaced if a doula is hired. I do think moms who are planning a hospital birth will get more out of this book but ALL moms will take something away from this book.
It wasn't just my friend's comment about doulas and hospital births that was floating through my head while preparing this review. I recently made a decision to attend the Birthing from Within Introductory Workshop. As preparation for the workshop we are required to come up with our deepest question and we learn what our deepest question is not. On the CD "Mentor's Introduction" that we must listen to before attending the workshop, Pam England notes that our deepest question cannot be, for example "how can I save clients from interventions." Did I want Ananda to use stronger language so that her book would "save clients" from unnecessary interventions? I think the honest answer to that question is yes. But the reality is books that use strong language have the potential to turn away moms whose journey includes planning for the epidural, and surely that would not be a good thing because all moms can take something away from this book.
Ananda Lowe and Rachel Zimmerman, The Doula Guide to Birth, Secrets Every Pregnant Woman Should Know, New York: Bantam, 2009.
Check out this great article on why midwives NEED to be a part of health care reform by Jennifer Block, Where's the Birth Plan? This isn't an easy job when most women in the U.S. don't give birth with midwives, despite the fact that the "best available research suggests that low-risk women and infants who work with midwives have comparable and possibly better outcomes and receive fewer interventions than similar women who work with physicians" (Childbirth Connection, "What is the Bottom Line"?) We need more midwives!
I have a friend who is anticipating her VBAC after two cesareans. I am going to send her this link but wanted to post it here too. This video reminded me of the pain I still sometimes feel because I did not hold Khady in the first hour of her life and of the triumph I felt after my first VBAC. Let's take back that hour! It belongs to us, and to our babies. Thanks Alexandra for sharing your story!