A Woman's Birth Deserves Respect

I've hinted at a few things people have told me about my freebirth, but one that is permanently fixed in my mind is someone giving my baby a nickname having to do with the color of the water when she was born.

Someone decided to give her the nickname "Jello baby" because the water was red when my husband sent out the announcement picture.  She had been born less than 10 minutes before, so we were still in the pool, and yes, I bled in the water (which happens in a waterbirth) so the water was red.

Now, if this nickname was because she's a chubby baby, I wouldn't care.  I never thought I would have a chubby baby and I'm loving it, so the nickname for that would be endearing to me.  But simply because you are making fun of how she was born because it's not a common choice?  That is not okay on any level.

Let's say I had a hospital birth or another cesarean, whether scheduled or not.  If our announcement of her birth had been sent out with me in the hospital holding her, or of her in the OR, or anything like that, no one would dare make a nickname based on that.  There would be no jokes about how the room looked, how she looked, what I was wearing or where I had her.  Everyone would be so supportive of our choice to have her in a setting they understand.

The thing is, it doesn't bug me as much as it did when I heard the nickname the first time.  What bugs me is that women that give birth in a situation others don't understand have to face scrutiny for it.  Sneers and jokes and comments about bravery and risks.  It doesn't stop.

Just like how we need to take control of our own births, we need to respect the births of others and not poke fun at them if they are different than the "normal" birth we imagine.

There is a huge difference between spreading information on birth choices and picking the births apart for a joke.  There is a huge difference between sharing links and resources with someone looking for change or hoping to help someone feel empowered in their own choices and hoping they don't see the underlying mean spirit.

I am not ashamed of my birth choices.  What makes me feel ashamed is how others treat those choices.  When other homebirthing mothers call me brave and roll their eyes, I wonder what I am lacking in their eyes.  When women hear about my birth and then instantly change the subject it makes me wonder what was so wrong with my choice that I can't talk about it like I could if I had chosen to have my baby in the hospital.

I hate that I feel I have to justify my choice to others.

No woman should have to justify her choice for her birth.  You may not agree, I know I don't agree with many choices others make, but that doesn't give anyone the right to make them feel less because of it.

If we want to change the way that women birth, we have to believe their birth was special.  It doesn't matter how they birth, it was special.  A mother is created, and a baby is born.  How is that not one of the most special things that anyone can do in their life?  Creating life should be treated as the sacred act that it is, regardless of how that came about.

We all deserve to take power from our births, and that starts with changing the way we treat the births of others.

Sullivan's Fast & Furious Home Birth or Why You Cannot 'Doula Yourself'

Saturdays, around our house, are known as 'Daddy Days', basically meaning that Kevin gets up early with Oliver, the two have breakfast together then go out on the town to do 'guy stuff' while I get to sleep in and then take myself out to the farmer's market and for a brunch date with a book. 

That Saturday I invited my best friend and doula partner, Nena, who would be attending my birth, out on my Me-Date. Looking back on my texts from that day I was already showing some early labour signs: 

"True. Lol.... Ok. Braiding my hair, starting laundry, then leaving my house. Slowly. You may even beat me there."... "Ok. Psa. I laid down in my towel with some Braxton hicks and haven't gotten back up. Sloooow. Haha"

I did eventually get out of bed and walked the 4-5 blocks to the market to meet Nena. I had a crepe from my favourite food truck, we roamed the market, bought some produce,  joked with friends we passed that I was still pregnant, then walked back to the coffee shop on my street for a tea.  

While we were there I couldn't stand long enough to wait for my order at the counter and when we sat down finally I couldn't sit still and before we were finished I started feeling 'weird'. It was too hot, I was nauseous and dizzy, something just wasn't 'right'. I knew my blood sugar was fine since I'd just eaten and I was hydrated and it wasn't a hot day so I dashed across the street to the pharmacy to check my blood pressure thinking maybe it had dipped but it was normal so I figured maybe I'd just over exerted myself and went home for a nap.

Knowing Nena had plans for the rest of the day and a wedding out of town that evening  I joked that I would wait until next week to have the baby. But she was really adamant that I not hesitate to call and interrupt her if I needed her. Apparently right after leaving me she made arrangements for all her other commitments & responsibilities for the weekend. 

On this 'Daddy day' Oliver and Kevin went to see some crazy hillbilly mud racing monster truck thing, leaving me with the house to myself all day. I took it easy, I did some laundry, I napped, I read, I watched TV. And eventually started feeling better. throughout all this I was having some sporadic surging but nothing even remotely 'productive'. I did have a bit of mucus and 'show' but it was such a small amount I dismissed it. 

I texted my other doula, Kim, about it and then assured her she should still take her kids to an event 45 minutes away but to maybe just keep her phone close in case anything changed (as if us doulas ever leave them far away). 

By the time Oliver and Kevin came home around 5pm I was starting to feel some downward pressure every 10-15 minutes but I still wasn't calling them 'contractions'. I felt nothing 'up top' or in my back where most of the intensity had been when I laboured with Oliver so I figured it was just baby moving or getting into position. We ate supper, we watched the first 3 quarters of the 'Rider (CFL Football) game, and then I took Oliver up to bed at about 8:30.

I nursed Oliver down that night and the moment he latched I knew if something hadn't already started it was starting now. In the 15 minutes that he was at my breast the 'pressure' went from about 10-15 minutes apart to about 3-4 minutes apart (i never timed them, just guessing) and I had to focus on my breathing to get through each one. 

I texted Kim again while I was laying there, I told her I didn't know if it was actual surging because I still couldn't feel anything except for the intense downward pressure on my cervix. She told me to put my hand on top of my stomach during the next one to see if I could feel the tightening that way. The second another pressure started with my hand resting there I knew for sure they were 'real contractions'. The light pressure of my hand felt unbearable and I could definitely feel the tightening of my uterus from the outside. But I was still convinced it was early and could go away at any moment so Kim suggested I eat something, take a walk, and then try to get some sleep.

Once Oliver was asleep I went downstairs (stopping twice on the stairs to breathe through more pressure) and tried to eat but wasn't hungry, I took a walk around the main floor of my house (stopping every few feet to breathe through more pressure) then got onto my knees and leaned into my couch thinking if I just stopped moving around they would go away. 

Kevin, who had been watching me quietly since I came down the stairs asked if I should call the midwife. I laughed and told him if this was it then it was really early and maybe I would think of calling once the pressure was a consistent 3-1-1 (three minutes apart, lasting a minute, for over an hour). He, in his totally straight faced take-no-bullshit way, asked how I would know when that was if I wasn't timing any contractions. I promised him I would track some and text my doulas again while he gathered the supplies on our 'Homebirth List' the midwives had given us. 

I didn't really time anything, or text either of my doulas. I just hung out there swaying my hips asking myself if I was ready for this and thinking of all the ways I could make it stop and wait for another day. I decided a bath would be the ticket. Everyone knows if you get in the tub too early it can totally slow everything down. 

Before going up to the bathroom I texted Nena:

 "Hey so like. Don't jump in your car or anything. Enjoy the wedding. But like. Don't accidentally get drunk because there are surges happening... Fairly close-ish together. Keep your phone close?" 

and to Kim:

 "can't decide if I want to stop this or encourage it. Getting in the tub to slow down" 

I was in the tub only a few minutes when the intensity picked up again. Kevin came in and timed a few surges. They were 2-3 minutes apart lasting a minute or more but because it was only 9pm and therefore not over an hour I still didn't want to call the midwife. I compromised and told Kim: 

"I think I may need you ... 3min apart lasting 50-80sec for half an hour. Trying to get Kevin to wait the hour and see but he's jumpy.... And they're getting intense for me to reassure him"

Then told Kevin I would call the midwife after Kim came and told me this was real. It could still be in my head, I needed someone (not Kevin) to tell me this was real. I also texted Nena who had apparently anticipated me and was already on her way back from her out-of-town reception. 

Kevin lit some candles and sat with me through a few more surges applying counter pressure to my back (which was suddenly in for the ride) and around the point I started needing to vocalize through the surges he called the midwife anyways even though I was still in denial. 

Kim showed up right as Kevin got off the phone and I remember complaining to her that the midwife would get there and check me and I would only be 3 centimetres and that would mean more checks later and I really didn't want to be checked at all so couldn't we have waited until I was more active? This was at about 10pm I think. 

Not long after the water in the tub just wasn't doing it for me anymore and, having resigned myself to getting a vaginal exam, I decided to get out of the tub and go to my bed to settle in where the midwife could do her assessment without moving me and I could try and sleep a bit when it turned out I was only 3cm. I was really convinced I was only at 3. 

But when I stood up everything got even more intense. I had to pee. No I had to poop. But I couldn't -No really I COULD NOT- sit on the toilet. 

My 'doula brain' thought: How many times have I insisted to my clients that the toilet was a great place to labour? Why had I said that? The toilet was an awful position to be in! With Kevin applying pressure to my back as I hovered over it backwards I was barely able to stand it long enough to push out a few drops of pee but much to my disappointment 'emptying' by bladder did nothing to relieve the suddenly constant pressure I was feeling. I'd been joking around only minutes before and suddenly I was pacing and muttering and for some reason apologizing profusely to Kim for no reason at all. I put my dress back on and fell into my bed on my side and moaned like a banshee through a few more surges praying for my butt to just fall off already. 

At some point in this the midwife got there. I told her something vaguely coherent about the pressure and I think I told her quite seriously that there was NO WAY it was the baby, I just had to poop. She asked if she could check and I agreed but wouldn't move to my back so she must have checked with me on my side. I don't remember feeling her check she just said 'No that's definitely your baby' and then something about a cervical lip but by the time she finished her sentence an uncontrollable grunt pushed its way through my body and was so loud to my ears I thought I must be roaring or something.

The spontaneous push did not feel good. My 'doula brain' quickly latched onto the midwife saying 'cervical lip' and tried to tell my primal brain not to push but my primal brain was like 'F*ck you this is happening'. 

I tried my best to keep breathing and vocalizing through each surge, I remember Kim telling me to 'slow it down, deep breaths, slow it down' but I just couldn't, the pressure was SO intense, at one point I asked the midwife to break my water (my 'doula brain' gasped in horror at the suggestion) but she just shook her head. Later she told me that the membranes were stretched so tight over baby's head that she wouldn't have been able to rupture them even if she'd wanted to. 

I remember at this point being really concerned that all of my begging for AROM and yell-moaning was going to wake Oliver in the next room but almost the moment I thought that someone told me that Nena had arrived and I was able to relax knowing that if Oliver woke up someone he trusted would be able to tell him what was happening and reassure him that his mother wasn't possessed, that writhing around on the bed yelling about pressure an butts falling off was a normal part of having a baby. 

Around that same time the second midwife showed up so my primary checked again to see if I was still grunt-pushing against cervix. I could have told her that I was still pushing against cervix. I could feel that lip with every uncontrollable grunt and my 'doula brain' was not at all happy about it but she was not in control. My primal brain was pushing, my body thought it was ready. The midwives then told me that I could either change positions to see if that helped or they could try and push the lip away with the next contraction. My primal brain, which was the one connected to my mouth, said 'no I can't move'. And my 'doula brain' threw up her hands in frustration. 

After just one surge baring down with the midwife trying to move my cervix primal brain caught up and realized her mistake (OUCH!) so I moved onto hands and knees. 

The second I got to my knees my membranes finally, mercifully, gloriously ruptured on their own but the relief was really short lived because with the next surge I yelled 'there he is!' and I felt his head, then for some reason second guessed myself and asked 'what is that!?' (I laugh at myself for this now. Of course it was him! What else would it be!?) with the next surge I felt his shoulders rotate and suddenly there he was. 

At 11:15pm The midwife guided him from my womb under my legs and up into my arms. I looked up at Kevin first as if to say 'holy f*ck that just happened'. Then down at my baby. 

The first thing I said after Oliver was born was 'oh my god look at all that hair!' and apparently I was expecting the same for this baby because the first words out if my mouth were 'where's all your hair!? You're bald!' And really I think the most shocking thing to me about Sullivan is how very different he is from Oliver. His pregnancy, birth, postpartum, appearance, temperament, everything is so very very different. I am a new mom all over again. 

I don't know where people get this idea that second or subsequent babies make you a 'seasoned' parent. I am 'seasoned' at parenting Oliver, but I've never parented this little guy before and I am learning everything fresh just like I did the first time. 

Anyways. Once the initial meeting was over I turned to lay back and rest him on my chest to hopefully get him nursing. The midwife asked if she could cut the cord and I said to leave it for now since it was long enough to bring him up to my chest. He bobbed and looked around and made a few moves in the direction of my breast but didn't seem ready to eat so we just rested and gazed at each other. 

A few minutes later I started to get uncomfortable and told the midwife I was ready to push the placenta so she clamped the cord and offered Kevin a cut. He said no and I jumped in and said I wanted to but I was shaking too much so I handed the scissors back to the midwife. As soon as that was done I pushed and coughed a few times to deliver the placenta. 

Needless to say after pushing against that cervical lip and how fast he came once I moved to hands and knees, and the previous perineal damage from Oliver's birth there were stitches to be had but its amazing how much less that part sucks when you're at home in your own bed and there aren't any nurses trying to take your baby away for 'assessments' or trying to tell you it will 'be more comfortable' to hold them once that's all done, or, in Oliver's case, whisking them off to NICU. I just snuggled in and loved on my new baby and chatted with my husband and my friends and occasionally asked the midwife for more freezing.  

After that because I was still bleeding a bit and Sullivan still wasn't latching I accepted a shot of synthetic oxytocin. God I hate that stuff. Immediately felt awful and the after pains got way worse but it did its job and soon I was ready to get up and get cleaned up while the midwives did the newborn check.  

8lbs 7oz, 20.5 inches long, great tone and colour, heart good, chest a bit mucous-y from the fast delivery but not enough to worry. 

Shortly after that the midwives snuck away to the other room to fill out their paperwork, Kevin and Nena cleaned up a bit while Kim (an IBCLC as well as my doula) helped me try a few tricks to get Sullivan latching. 

We knew going in that he would likely be tongue and lip tied like Oliver and even though Sully was sliding around and sucking air and doing all the worrying things Oliver did it felt amazing to have Kim there to reassure me that it would be ok and make a plan so I could stay confident. (That's all a different story for another day)

It was 3am by the time everyone packed up and went on their way and I drifted off to sleep with Sullivan while Kevin went to crawl in with Oliver for the rest of the night. 

Why I Support Out of Hospital Birth

I've never had a home birth and I'm not sure I ever will. I thought I should get that out at the beginning, just in the interest of complete honesty, because what I want to address is the topic of out of hospital births and I think it's important for others to know that I don't have personal experience with out of hospital births. What I do have personal experience with is the anxiety a mother feels while making her birth decisions and I think every woman should have the right to choose the birth environment that makes sense to her.

I have known at least four smart, well-researched women who have had births at home or free standing birth center births and I fully supported them in those births and would support anyone else who also chose to birth outside of a hospital and here's why: Home birth does not equal a nineteenth century birth that eschews all modern medicine. Home birth just means a birth that occurs at home. (If any interventions had seemed necessary or if complications such as infection, bleeding, or anything else had arisen, I know that each of them would have been at the hospital in a minute! In fact, one of my friends did have some hemorrhaging and she did not hesitate to go to the hospital because that is what hospitals are for--helping people who need modern medicine or interventions before, during, or after birth!) People who choose to home birth are not necessarily anti-interventions and anti-medicine, they are just anti-interventions unless they are necessary and appropriate.

A person who home births is no less anti-necessary medicine than a person who tries safe, effective home remedies for a cold or an injury before going to the hospital. The truth is that for most healthy women who are at low risk for complications and whose baby is at low risk for complications, the hospital with all of its bells and whistles is not necessary and being in the hospital (many argue) puts that low risk woman in danger of interventions that might be unnecessary in a lower stress, more familiar environment like the home. Home is also usually within a comfortable driving distance of a hospital. After all, we trust our home to be safe enough that if any kind of dangerous accident happens there (like a tree falling, or a poisoning, or a fall down the stairs, or a knife/chainsaw/lawn mower incident--all of which, by the way, are more common than a catastrophic birth experience), we will get to the hospital in time or we wouldn't buy that home to begin with.

I get why people are nervous about home births. The thought of anything happening to a newborn baby is too awful to contemplate. If you are that afraid that something will happen in your birth or with your newborn that it will need immediate attention and cannot wait the ten or fifteen minute car ride to a hospital (or whatever distance the nearest birth center or your home is from the hospital), than you are absolutely correct to birth in a hospital. You have decided that you are fine with a twenty percent increased risk of getting a c-section and a much higher risk of having some other kind of intervention, and I don't think anyone will judge you for it. You weighed your risks and your options and you made a choice that the ability to have interventions if you need them is more important to you than the risk of having interventions you don't need. That's fine. Conversely, if you have researched it and you are willing to take the risk that the distance your house is from the nearest emergency room might be too much if something catastrophic happens in your birth, than I think you should have the right to take that risk without judgment as well. A mother who chooses home birth or an out of hospital birth has probably weighed her risk options and used the same kind of reasoning, love, and care to come to her own decision. No one should assume she hasn't. She isn't being selfish. She just chose to take a slight risk of something happening without immediate intervention, over a much higher risk of an intervention happening without it being necessary.

I also understand why many doctors and nurses are anti-home birth and don't understand why anyone would choose it. I have known a couple of nurses who work in NICUs or labor units in hospitals and they cringe to think about babies born outside of hospitals because in their line of work they have only ever seen home birth babies and mothers with complications. However, that's because the only time out of hospital birthing babies or mothers come to the hospital is when there is a complication. Nurses and doctors know very little about healthy home births because they have never been involved in them. Because only about .67 percent of women in the US had home births in 2011, I have to believe that most hospital interventions and NICU resources are used for hospital births. In fact, elective inductions (choosing to have your labor induced when it is past your due date or for another non-medical reason--a trend that has grown to nearly 30% of all births in some hospitals) result in more babies being placed in the NICU than home births.

However, what I don't understand is people who get angry with women and try to take their right to choose their place of birth away from them simply because they would not make that same choice themselves. It is not as if most of these women are denying medical help when they need it; they are simply denying medical help unless or until they need it. There is a world of difference between those two statements. I respect women's rights to make their own, educated medical decisions no matter if their choices agree with mine or not. Other people should do the same; it's not like they are trying to take away the right to choose birth in hospitals.

Thanks for reading,

Shawna

How Our Homebirth Saved Christmas

Growing up, Christmas was my favorite holiday. My family, thankfully, never emphasized the commercial aspect. We simply enjoyed spending time together and exchanging heartfelt gifts. Since I got married, the holidays have been increasingly stressful. With double the family, our time is spent rushing hurriedly from one gathering to another, staying for long enough to make an appearance. Adding kids to the mix made it increasingly difficult. The stress was hard on the kids, and I felt guilty for putting them through the ringer each year. I had come to dread the entire month of December. This year, I received a special gift--one that caused me to slow down and reconsider what's really important.

On Christmas day, I was 36 weeks, 5 days pregnant. I woke up feeling a little pressure down low, but didn't think anything of it. I am a firm believer in letting a baby come when he's ready, and had bookmarked a link about why at least 39 weeks of pregnancy is better for baby. I planned to share it when people started asking, "Have you had that baby yet?!" By about 10 that morning, I knew that I would have no need to share it. It took a few more hours to convince myself and my labor support that this was the real deal.

By 10, I was having regular contractions--about 3-5 minutes apart--but I could talk through them. I have had pretty regular Braxton-Hicks contractions in the past, and I certainly didn't want to birth my baby so early. Plus, I didn't want to disrupt anyone's Christmas unless I was completely sure. We decided that I would rest on my side for a while and see if things continued to progress. My husband took the kids out visiting. This slowed my contractions to between 5 and 7 minutes apart. They stayed that way as long as I didn't get up. By around 6 in the evening, the family had finished their visiting and my parents were free to take our three older kids to their house.

That's when I got vertical. Anyone who tries to tell you that position is not important during labor is wrong! Assisted by gravity, my contractions went from somewhat painful and 3 or 4 minutes apart to almost unbearable and 2 minutes apart. I slumped over the birthing ball some, sat on it some, swayed and rocked a lot, and paced back and forth to the toilet over and over again. Nothing seemed to work for comfort. I decided to soak in the tub for a while to help relieve the pain. It slowed things down again, but they soon picked back up and then, whoah, did they pick up! After a day of questioning myself, I finally felt sure that I was in active labor. We called our midwife and asked her to come.

Our midwife arrived around 7:30 and determined that I was 4-5 centimeters dilated. She gave me about 30 minutes alone with my husband to work through labor, but by that point, I did not feel there was any working through it. I did not want him to touch me, and I could not hold still. Then again, it hurt too much to move. I had been through transition before, and this was it. How did I ever go through this lying in bed or strapped into a car seat? After 45 minutes or less, I was pretty sure I felt ready to push, and asked him bring the midwife into the bathroom. "Are you sure?" he asked. That's when I yelled at him (sorry, babe!). After a long day of self-doubt, I was over being questioned. I was ready!

After hearing me yell, the midwife was as sure as I was. She went straight to our bedroom and prepared for the delivery. I wanted to try squatting on a birthing stool, but it hurt too much, and I ended up lying on my side instead. I decided to try a push or two, after which my water broke. Suddenly, the pain subsided and my body could do nothing but push. It was beyond my conscious control. As our midwife turned around to ready her supplies, my husband saw our baby's head emerge and jumped quickly to catch it. Two pushes later, my youngest son was born into my husband's hands on Christmas night, right there in our own bedroom. Shortly after, we were cleaned up and snuggled into our own cozy bed.

I truly believe that our homebirth made a positive difference. The whole birth experience was so peaceful and free from drama. So far, I have seen this reflected in my little guy's calm demeanor and in my own easy recovery. It even seems to have cast a peace over the household. Best of all, my Christmas baby has turned the holiday around for me. From now on, the stress of the holidays will be overshadowed by the memory of this special Christmas night. I will remember cuddling my 8-pound bundle of hope and looking forward to the promise that his new life represents. He reminds me that what is at the very heart of Christmas--and of life itself--is love. When a child is welcomed into the world surrounded by love, he can grow to spread that love to family, friends, and maybe even to all mankind. I can't think of a better way to give him that start.

Do You Know The Risks?

"Well, as long as you know the risks of birthing at home, I'm sure you'll be fine"

Women that birth at home are some of the most informed and educated women I know.  I'm not trying to put down other groups of women, but working with this group specifically, I see how incredibly smart they all are.

At prenatal appointments they ask insightful questions, they have done research on their own, and they are prepared and understand the "risks" as so many put it of birthing at home.  They are taking charge of their birth and bringing their baby into the world in the most calm, peaceful, and gentle way they know.

They prepare their bodies for labor and birth.  They learn about labor, about what is normal and what isn't.  They form a very special closeness to those that will be attending this very intimate and sacred event.  I count myself so lucky every day that these women allow me to view their births.

When people give you that line, not only does it put down the women that are truly taking control of their birth, it shows how very little faith you have in them.

No woman I know would purposely put herself and her unborn child at risk.  Even if they want a great birth experience, they would not put themselves or their child in danger just to get it.  That isn't how motherhood works.

You are implying that these women might be smart enough to gauge for themselves what the risks are, but you aren't really sure.  When the fact is, most of the people that say things like that have no idea what is even involved in a homebirth.  They wouldn't have the slightest idea what a midwife brings or what is at home.  A lot of them actually think that all homebirth midwives wear ridiculous hippie clothes, bring a piece of leather for the mother to bite, bring sheets and towels and buckets of hot water, and chant in the corner to keep the evil spirits at bay!

If it wasn't so sad and ridiculous, it would be funny!

Instead, what if the tables were turned?  If you told someone you were birthing in the hospital, and they asked if you knew the risks, would you know how to answer?  Do you *truly* know the risks of birthing in the hospital?

Regardless of what people say, it isn't the safest place to have a child.  Women are dying in childbirth, as are babies.  The very horrible thing is that more women are dying now compared to 1982.  The United States is one of the worst first world countries to have a baby.  With all the advancements in science and medicine, you would think it is the opposite.

Birth is meant to be left alone, to happen on its own.  When you start messing with a natural body function, you can make it so much worse.

Imagine a set of dominoes.  You line them all up so you can push the first and start a chain reaction to have them all fall over.  You have them set up, and then someone walks by and decides to change the middle domino.  Even moving that domino an inch can mean that either the chain will stop there, keep going, or it will veer down another path.  Would you want to take the chance to mess up all that work just to see if things will still come out the same?

It goes the same with childbirth.  You have a great pregnancy, are still low risk, and *wham*!  You are induced, augmented, or taken for a cesarean, for a very non-medical and non-emergency reason.  Your dominoes were lined up, they were moving together and had almost reached the end.  And then someone decided to move that middle domino.

So, I repeat, do you know the risks of a hospital birth?  Have you researched your hospital, not just your doctor or midwife?  Do you know the nurses, the standard procedures?  Do you understand informed consent and refusal?

In a homebirth, you get to know your midwife very very well.  You meet her assistant and her back-ups.  You are in your *own* home, your place of safety and trust.  Most midwives end up friends with their clients for years after the birth.  They create a friendship, a bond.

Do you have that relationship with your OB?  Do you sit and giggle and talk in prenatal appointments for an hour or more?  Are you friends when you leave, still talking to them regularly about every day things?  How about your nurses?

Birth is about so much more than the "risks" that people perceive.

No matter where you are birthing, whether in a hospital, birthing center, hotel, car, airplane, under a tree or home, you need to educate yourself on the benefits, the risks, the middle ground.  It isn't anyone else's job to tell you that you should be fine as long as you know the "risks".

It is your birth, take control of it!  Whether that means sitting down with your OB and truly becoming friends or having a midwife that you can be yourself with.

Your birth needs to be about you and your child and your family.  No one can take it away from you, and you will carry this birth with you for the rest of your life.

Be an active part of it.

Even if that means going against the grain, learning the "risks", and having a homebirth.

Humanizing Healthcare: Maternal Care and Choice

It is strange to me that when discussing the issue of health care reform, I'm often met with morbid statistics regarding cancer outcomes in European countries and told I have to pay to have the best health care system in the world. I'm not getting into the subject of cost today, because that is an entirely different Pandora's box. Today I want to focus on the strange compulsion to view this debate as a worst case scenario twisted into a best case scenario situation. It seems those that oppose universal public health care think a strong argument against socializing medicine is to cite how it will affect our ability to receive care for life threatening forms of cancer and other diseases. This is something to ponder. I could get into an argument about access to care and cost and preventative medicine, but many others have done so more eloquently than I. Instead I thought I would approach this from a less cynical and morbid viewpoint.

Homebirth Hypocrisy

As I was driving down the road today, I literally had to pull over to change my facebook status after being hit by something so obvious I just had to blurt it out.

After going through the past months with my grandpa, and as I have witnessed a few times in my life, I have come to realize something...

When a person chooses to remain at home to see an end to their days and die at home, they are not only allowed to do so, but are given assistance by a nursing service to maintain their dignity and privacy during this time. Hospice will send nurses or assistants to check in on the person and the family is even given a kit with various 'just in case' items, such as morphine, to ease the transition at the end if necessary. You're given a number to call, and at times a box with a button that will simply connect you directly to a skilled person who can assist you. Everyone speaks so kindly about you being at home, where it's 'comfortable' and you can be 'surrounded by loved ones'. Being put on hospice as opposed to being placed in a nursing home is viewed as a wonderful thing... no need for intervention.. this is a normal part of life.

However....

Who Cleans The Mess?

I am a Homebirth Midwifery Apprentice. As of right now I am doing self-study and shadowing a midwife that I love! I attend the prenatals, the birth, and the postpartum checks, and mainly am in an assistant setting, all the while learning as I go.

I was never pro-homebirth. Growing up, I thought only hippies still did it, if people even still had babies at home at all. My mother had cesarean sections with my brother and me, and even though she labored with me, I never once had a second thought about having surgery to give birth. It was normal to me.

I had a cesarean section with my daughter, and a lot of problems ensued, from PPD to PTSD from her NICU stay, and not knowing what was missing from our relationship.

About a year later I was set on the path to becoming a midwife for homebirths, and I never had the thoughts that people do concerning birth.

I researched like crazy, I learned everything I didn't bother learning when I was pregnant with my daughter. Since I was researching birth on my own, I didn't have others suddenly talking about it with me. I didn't have the questions people do since I dipped my own feet into the topic. I wasn't worried about safety or the mess or emergencies.

The midwife I am apprenticing with was a guest speaker at a college class last week, and a lot of the questions were so surprising to me. Since I have been studying nothing but pregnancy and birth for the last two years, I had forgotten that the very vast majority of people don't have the same grasp on the subject as I do, and even then my grasp isn't as large as others.

A few questions were always on safety, especially dealing with emergencies. Birth is seen as a very dangerous time in our culture, which has changed from how it used to be. Yes, people used to die a lot more in childbirth, but not all of those would have been saved with our current technology. Our maternal and infant mortality rates prove that.

There were a few questions on tears, a few on transfers, and then one question came up that I had never actually ever considered.

A girl behind me raised her hand and asked very worried, "Who cleans up the mess?"

I feel bad, because I wasn't speaking, I was strictly there as a guest, and I instantly burst up and semi-yelled, "Me!" It got a laugh, and the midwife introduced me as her apprentice and that I was very good at getting blood out of carpet. Which got even more laughs.

The midwife started discussing what really happens at a homebirth, and how long she stays after the birth. Since I have been apprenticing with her, the soonest we have left after a birth is three hours. And we never *ever* leave a house dirty.

The last birth I assisted at, we drained the birth pool, I cleaned up the few spots of blood that were on the carpet from when the mom went from the pool to the bed, we put in a load of laundry, made sure mom was fed and had something to drink, we repacked the bags with all the birth items, and we went home. When we walk in for a birth, we always walk out with it looking like a baby hadn't been born there.

I guess I take it for granted. I never thought of who would clean after, even at the first birth I helped at, I started cleaning without even a second thought. The mom and dad have a new baby, the midwife is helping them and making sure things are okay. Unless I was needed, cleaning was a way for me to help the family so they didn't have to worry about anything.

When you have a homebirth, at least with my midwife and many others I know, you aren't supposed to be worried about how your home looks. You aren't supposed to be worried about if the blood on the carpet will be there in the morning. Your only job (and I am strictly speaking to the mother) is to nurse your baby. Cuddle your baby. Enjoy this period. It is not your job to do laundry, or cook, or clean.

So, to those that are worried about the mess from a homebirth and using it as a reason to not have one, just know this.

Yes, birth can be messy. I have actually seen it more messy in the hospital, but don't fret. Your house will not have blood stains. You won't have to worry about people knowing what you "did" in your living room or bathroom or bedroom. You don't have to worry about the towels we used or your sheets if you give birth on your bed.

Birth is a beautiful time, and it isn't your job to worry about what it looks like, besides that gorgeous baby that you will be holding.

Leave the mess to us, and seriously, you won't even know if there were any accidents anywhere.

A Call to Labor

Meet my daughter - the big baby.  The one that would surely clock in at over 10 lbs.  She was called "fat," "macrosomic" and "chubby" before she ever graced this world with her adorable presence.  Unfortunately for the doctor, the big baby card didn't fly with me, so I started getting told about cord prolapse, dystocia, stillbirth until my confidence in my own instinct was worn down and I agreed to go in for induction, which resulted in two, yep two, inductions, and a repeat cesarean.  I was told the cards were stacked against me, but the biggest card was losing my faith in myself.

Connected Daughter arrived after several bags of I.V. fluid and who knows how much pitocin, weighing 8 lbs, 11 oz on her due date.  By the next day, her weight was down to 8 lbs 4 oz, which I believe would have been her birth weight (Henci Goer discusses how intravenous fluids artificially inflate birth weight.)  So much for that big baby I was sure I could birth vaginally if I was just left well enough alone.

Despite education, my birth didn't go as planned, and I will be the first to admit there were risk factors, but three months later there is one thing that haunts me.  My decision to allow them to induce me.  In that moment I gave over control.  Something I regret.  Control is something so many caregivers believe they need.  Even caring, informed caregivers fall victim to this need for control.  And the easiest way to ensure control over birth is to induce labor.

I'm still kicking myself for giving up control over what may be the most important aspect of birth - the start of labor.  Because that decision instantly removed all hopes for normal birth. Normal birth cannot begin with induction.

I should pause for a moment and say that there is a place for induction.  There are truly situations that develop that require this intervention, and I do believe women should try for that before electing for a cesarean.  However,  truly necessary inductions are about as rare as truly emergency c-sections.  No one ever needed to be induced for a big baby, or discomfort, or getting too close to their due date.

We're being sold on induction in this country by physicians who want to control the spontaneous process of birth.  Take a moment and ask yourself how many times you remember hearing of a woman going into labor recently.  Now how many times have you heard of a woman being induced?

The desire to induce isn't part of some maniacal ill will toward women by doctors.  I think that somewhere we've started to believe that women's bodies have forgotten how to birth babies.  Instead of laboring in birth, we're laboring under the false assumption that fetal monitors, pitocin, I.V.s, hospital beds, and sterile rooms are necessary for birth.  The reality is that doctors have forgotten how to attend birth.  Many of them never even learned how.  Because a birth attendant needs to know one thing: what normal birth looks like.  When we were interviewing midwives, we met with CPM Anita Woods, former President of ICAN, and she said something that has always stuck with me.  The FBI doesn't learn how to spot counterfeit money by studying counterfeit money.  They learn by studying the real thing.  They can spot counterfeit money because they know, really know, what the real thing looks like.  A good birth attendant works the same way.  They are so well-versed in normal birth that they can spot a problem days, weeks, sometimes months in advance.  By becoming so quick to induce, doctors no longer have that knowledge.  Instead of treating birth as a normal, natural event, it's a crisis from the get go.  The most important thing we can do to change birth practice in America is to stop inducing pregnant women.  We must get back to the normal process of childbirth.  Doctors need to see normal birth and women need to experience it.

Recently I posted a piece on Coping with Birth Disappointment.  It's been by far the most read piece on my site.  What a bittersweet accomplishment.  I'm so glad I could offer encouragement to women struggling with birth disappointment, but so sad to see how many women it affects.  In America, we so often treat the symptoms without curing the cause of a problem.  I hope my thoughts on birth disappointment touched women dealing with it, but it is my duty as a birth advocate to take this issue a step further.

What I'm proposing is radical, because not only do I believe that we must stop inducing women, I believe me must stop patronizing physicians who actively use unnecessary interventions.  It's a simple economic principle.  If you want to see results, hurt them in the pocketbook.  Obstetricians need to realize that lip service to changing ideology is not enough and that we will hold them accountable for their decisions if we hope to teach them the patience necessary to stand back and observe birth.  We have to get birth back to normal if they are ever going to learn what truly normal birth is, only then will they be able to differentiate between high-risk, emergency situations and the process of birth.

Now I realize this is all such a lovely, impractical idea.  After all, am I asking you to fire your OB and hope everything goes a-okay?  Not at all.  I'm suggesting you find a provider who has seen normal birth, whose studied it, who attends and promotes it.  Find a midwife.  And if you're an OB reading this, I'm asking that you consider how important this truly is.  I'm asking for the humility in a profession of arrogance to recognize how you are failing your patients and then I ask you to go find a midwife and do a real internship.  Learn how to let birth happen. 

Above all else, if you are expecting or trying to conceive, get to know your body.  Listen to it.  Nourish it.  Marvel at its complexity.  Revel in your cycles, your fluids, your twinges and feelings.  Rediscover your own awesome, natural power.  So that when the moment comes you know your body as well as an old friend who's sentences you finish, and you know the right decision, because truly you are the person most qualified then to make it.