On the second visit, we had the same doctor I had in my first appointment. She must have thought that a natural birth was Ash’s idea because when he mentioned it, she told him that they could do it, but they would tie a string to his balls and pull every time I had a contraction. Now, some cultures do that, but we were shocked that Ash’s balls came up at an OB visit.

Hopefully, you haven’t run into a practice THIS cruel, but there are all levels of ‘manner’ out there.  Choose your practitioner wisely.  They are out there and the most professional of practitioners are beginning to speak up and let it be known that there are wise practitioners.

Let Independent Childbirth help you find one!

We’ll have more stories to share though not all will be on the YouTube!  In the meantime if you haven’t been to one here’s a winter share:

And so, today, while talking to a friend on the phone and gazing out one of my back windows for the zillionth time I saw, wonder of wonders, that a hummingbird has returned to our garden.  Perhaps it was only a fly-by, still the sugar water has been boiled and sits cooling on the counter.  The hummingbird feeder from two dry summers ago has been washed in hot soapy water and is air-drying.

Welcome back Flick.  And thank you for reminding me, that no matter how troubling life might find me the sun will go down, evening fall, and a new day arise.

Pitocin is most likely to be introduced to you as a means to either induce your labor, an additional medical protocol to induce your labor (you may have a prostaglandin gel on your cervix first, pitocin added via IV later) or as a means to speeding up your labor.  Pitocin is a synthetic version of the human hormone oxytocin.

No doubt there will be many L&D practitioners who will deny they abuse oxytocin.  Ask them what their protocol is: what is the dosage, how often is it increased, how likely are they to turn it off once your contractions reach an established pattern and what is their definition of a good contraction pattern?  Most likely the answers they give you will actually constitute abuse of pitocin.  They just don’t know that they’re abusing pitocin because they are simply doing what they were taught to do by people whom they trusted and believed they had no reason to question what they were learning.

I would never tell parents that all obstetricians are bad and all midwives are wonderful.  That would be a lie benefitting no one, least of all the mothers and their babies.  Instead, I will tell you that you must keep an open mind and learn to ask questions.  You can best learn how to ask the right questions when you learn about the topic you’re inquiring of, that is why I posed the questions above as a sample of what you can ask your careprovider about their use of pitocin.

If you, like many mothers, are planning to push your baby out of your body under your own power by having the freedom to use different positions for second stage then you need to learn about natural labor in first stage.  If you, like many mothers, are planning to hold your newborn baby for at least an hour after birth, then you need to learn about natural labor in first stage.  If you, like many mothers, are planning to delay cord clamping until either the cord stops pulsating or you’ve delivered your placenta naturally, then you need to learn about natural labor in first stage.

Inductions will put your first stage of labor on a very different flowchart for labor progress.  Ultimately it can turn your birth plans into fodder for a good fire in the winter.  Remember there are wise birth practitioners out there.  Have the courage to find a wise one whose comfort level with birth makes your birth plans theirs, not vice versa.  Have an abnormal first stage labor and you raise the odds of giving permission to become an un-necesarean statistic.

Her second birth experience, this wise mother, chose to birth completely away from the scene of her first trauma.  She chose a home birth with Birth and Beyond and was so positive about how different this experience would be for her and for every mom that she called A Baby Story.  Yes, they chose her birth to record and it was a beautiful home birth.

I’m happy that Baby Story chose her birth but I’m more grateful that mom believed in herself so much so that she KNEW that first birth didn’t have to be that way.  She KNEW she was more than capable to birth.  She KNEW the practitioners were wrong and she chose to shout out the truth to the world.

Thank you ‘G’.  You captured my soul with this experience, a kindred spirit.  I teach natural childbirth because I KNEW I wasn’t wrong 15 years ago when I set out to accomplish my first VBAC (completely spontaneous and natural labor).  Here’s to a continued wave of energy reaching out to more women.  We can!

It is this woman powered effort that provided the support and incentive to prepare a report on the state of maternal and newborn outcomes in America, Home Birth: The Gold Standard for Cesarean Prevention.  This report is available globally as a part of a documents resource library.  In addition, we prepared an outreach document for distribution to our government who is currently keen on health care reform.   Great health care begins with meeting the UN Millennium Project Goal 5: Improve Maternal Health.  A global issue is your local issue.  It’s a small world.

Please download then distribute either or both of the above documents to your legislators.  We believe they are willing to listen but the medical lobbyists’ attempts to drown us out are often more successful.

As is usual with a single purpose track, one thing is noticed but how it occurred or what else is happening is disregarded.  All that was seen was someone breathing differently.

In the 1950s ‘prepared’ birth classes began in hospitals.  I wish I had been a fly on the wall when the introduction of birth classes in a hospital setting came about.  Today there are hospital based birth educators who will tell you they do ‘talk about’ natural birth in their classes.  I’m sure they do ‘talk about’ natural labor.  Let me tell you about one such woman who ‘talked about’ natural childbirth in her hospital birth classes.

The scene:  We are a group of women preparing for a presentation of Birth – The Play aka Birth On Labor Day (BOLD).  We meet twice a week for a couple of weeks leading up to the play date.  Of course during this time we are all sharing birth experiences and experiences with birthing women.  Among our cast is a woman who has never given birth but she is the most enthusiastic of us all.  She is excited just thinking about giving birth some day.  Among our cast is also a woman who gives childbirth classes at CCOG, a local hospital.  In our discussions about birth we do eventually get around to various birth videos.  Obviously one such video clip we bring in for everyone to see is the hospital birth clip from Monty Python’s Meaning of Life, Miracle of Birth as it is a part of the play itself, the machine that goes “ping.”  I love Monty Python.  They can send a real zinger of a message in the funny lines, classic, expert comedy relief.  Then the discussion comes around to a recent birth video, Psalm & Zoya: The Unassisted Birth of Our Twins.  In this film you see a woman experiencing the hormones of labor as she sounds her way through transition into pushing for each baby’s birth.  We are discussing this film because one of the Birth characters must also produce vocals for labor.  That actress is the hospital birth educator.

I cringe still today as I recall her dramatically re-enacting labor vocals.  She is dramatic, not simply “into” the role.  Dramatic.  Flamboyant.  An actress through and through.  She decides to share her experience with a woman sounding her way through labor.  She recalls a first time mother who ‘called out’ Jesus’ name during labor.  She recalled how everyone was out in the hallway giggling to themselves and cracking jokes about praying in labor.  What she didn’t know was that the young mother was one of my birth clients.  She is Christian and her faith is the center of her world.  Very lovely mother.  In fact she had shared her birth story with me and how powerful she felt with each growing contraction and how she’d chanted her way through with the name of her Savior being the perfect punctuation and pitch to her sounds.  She had loved her birth experience and couldn’t wait to share it with others.

Two very different views of the same labor.  Really, the one that matters is mother’s.  The one though that would cause the greatest harm is that of the birth educator, also a woman, who was present.  Hers is a tale of dramatic, made-for-tv drama labor and, I’m sure, jokes about ‘real’ childbirth.  

Two years later I came across a woman who’d had a c-section at CCOG.  Her first birth.  She told me about her childbirth classes and we both identified her birth educator as this woman who had been in the play with me.  She told me just how funny this woman was and how she showed some crazy waterbirth video.  This mother also told me how she’d eaten poorly during her pregnancy, worked extended hours and extended travel during her pregnancy, been induced for labor, had a catheter and so on and so on.

Yes, I’m certain hospital-based birth classes ‘talk about’ natural childbirth.  That’s all they do, talk.

I scoff at journals who write prepared childbirth classes have no effect on birth outcomes.  Of course they don’t when the main thesis is the breathing.  As my husband and I humorously recall the scene in A Christmas Story where the family is seeking bread in a Chinese restaurant I think the same of hospital birth classes.  Many a colleague of mine has remarked the same on some variation of that scene, basically you don’t order Chinese food in an Italian restaurant, sushi in a Mexican restaurant, etc.

Nine months to grow a baby who can breathe and pump blood through their own bodies on their own.  A two-hour hospital class on how to complete admission papers, the dogma of the smallest possibility of a spinal headache (right) from an epidural, how long your baby will be away from you and how soon you can go home.  All this as though you’ve never even considered otherwise.  Learn about real birth.  Period.

A benefit was recently held to raise funds for a little girl whose facial nerves were injured during a forceps delivery.  Forceps injuries are not uncommon.  Reading about them in the news is.  Why?  A comment from a colleague seeking to start a birth circle in her community provided some insight.  It seems that a first birth information evening was met with some caution as some mothers were uncomfortable with the picture of cesarean as a medical intervention to be avoided.  So much was their aversion that my colleague’s co-host thought perhaps they should ‘pretty up’ the birth message.  

I do know that health practitioners also seek ways to ‘soften’ the risks message.  Unfortunately, ‘softening’ leads to the omission of important information.  It may be scary to hear a risk of cesarean delivery is death during the procedure itself or afterwards (i.e. embolism or a baby that is born too early and not able to live outside the womb).  That is not a good reason to not let mothers know death is a risk of cesarean surgery.  It’s scary to hear epidural catheters have been placed as to paralyze a woman’s heart and/or lungs causing death.  That’s not a good reason to not tell a woman there are risks involved with epidural use beyond that of the drugs themselves.

A large scale global debate on the reporting of the U.S. ranking poorly in Maternal and Infant Mortality rates is of no help in promoting truth in informed consent.  The red herring is the definition of mortality as it relates to birth.  The definition has little to do with how correct the vital statistics reports are.  

The U.S.’s world rank in mother and infant mortality is worse than reported and the current ‘debate’ regarding the definitions of birth mortality rates actually serves to make the U.S. look better.  The advances in technology do not serve any of the main causes of maternal and infant mortalities anywhere in the world, much less our home country.

…the CDC reported the MMR in 1983 as 8.0/100,000.  The inquiry into the misclassification on birth certificates from 1977 to 1984 shows the rate actually to be 10.9/100,000, a difference of almost 3 percent.  The CDC finds that the problem persists into 1996, stating, “In this report, maternal mortality ratios are based solely on vital statistics data and are underestimates because of misclassification. The number of deaths attributed to pregnancy and its complications is estimated to be 1.3 to three times that reported in vital statistics records. ~ Home Birth: The Gold Standard of Cesarean Prevention

One year ago I supported a VBAC mother through both a natural childbirth series of classes and as her labor support.  Her labor began spontaneously at 41 weeks.  She called to let me know she was in labor so that I could make arrangements for my family’s care.  Around 3pm that afternoon Dad called to say she would like me there now.  I arrived to her moaning through contractions yet speaking to me in between.  She let me know how she was feeling, what she was feeling, what she’d been doing to cope and how being on her hands and knees felt so good right now.  Her biggest concern?  That she would dirty the brand new slate flooring!  Around 8:00 p.m. she decided she was ready to go to the hospital.  We left a clean home and we arrived at the hospital with her bearing down.  The midwife on call wanted mom on her back for an exam.  Mom went to her side, midwife propped one of mom’s leg’s up, saw the baby’s head and decided there was a dystocia.  Dad stated mom did not want an episiotomy, midwife said she’d let mom have one more push.  After the next push contraction the midwife cut an episiotomy and proceeded to ‘guide’ the little baby girl (just under 8 pounds) out.  We were all subjected to a lecture on how mother’s previous C/S was due to ‘failure to progress’ and she probably had pelvic issues.  FACT:  This mom’s ‘failure to progress’ was in actuality a posterior presenting baby whose birth had been augmented with pitocin and the back-up OB for this subsequent VBAC birth was on his/her way in to the hospital.

Two years ago I provided labor support for a VBAC mother whose labor began very slowly at 40 weeks.  Her first birth was a scheduled cesarean without labor for twins with Baby A presenting breech.   At the 12 hour mark with mother wanting nothing more than to just hang out at home Dad became fearful…both family and friends were calling to tell him he was crazy not getting her to the hospital right now.  We arrrived at the hospital shortly thereafter and mother proceeded to labor at the hospital for 48+ hours.  Again, the labor was never intense.  She did not experience the classic, intense transition.  More than once cesarean was brought up, not by the doctor.  Rather a second cesarean was ’offered’ by her husband and sister who was now also present for the labor.  The doctor did however bring up time.  Mom went through two doctors’ shifts and two other women’s deliveries by c/s for failure to progress.  Mom’s sister’s c/s had also been for failure to progress as she had ‘made it’ to second stage (with an epidural) and after almost two hours of pushing had made no progress.  Fortunately for mom, Dr. Carolyn Zelop of the Boston study on VBACs (and co-author of the most recent ACOG VBAC practice guidelines) was on and in the hospital (she is not affiliated with the primary careprovider) for this labor.  Dr. Zelop smiled at mom and stated the best care for VBAC is to allow for the labor to progress gently and naturally.  Were it not for two women secure in their knowledge of the birth process this mom would have been coaxed into a second cesarean.  FACT:  This mother was experiencing labor for the first time.  She labored spontaneously, naturally and consistently slowly as is typical of most first labors.  The coping mother did wasn’t easy to see because the physical aspect was not the main influence.  In other words, mother’s mind was not reflecting on pain, but rather that it was truly laboring, something she didn’t ‘know’ her body would do and did not believe her body was doing until the final release of her son into her arms.abor is physiological and nowhere is the power of the mother’s frame of mind stronger and a greater aspect to appreciate than that of the VBAC mother.  Patience and respect for the mother’s sense of security in her body are crucial to the positive VBAC experience.

Women reading this post are likely to be aware for the first time of two pieces of birth consumerisms: posterior labor knowledge is scarce among the medical birth trained practitioners and that natural, spontaneous labor is a good thing for VBACs and are likely to lead to healthy outcomes.  Families and friends reading this post are mulling over their fears over some aspects of the births and probably empathizing with the father and sister in the second birth.  Practitioners are thinking one thing and one thing only:  these mothers labored without any hands on medical observation or protocols which equates with ‘not under their control’ and therefore, must be stopped.

Have these births had an impact on VBAC care?  Yessss, in a way.  The midwifery group mentioned in the first and second births continues to support their client’s informed choice but their back-up OB group is now pushing (no pun intended) to have VBAC birth plans submitted for their review/scrutiny and approval/counterfire.  The practice mentioned in the third birth no longer takes VBAC mothers. 

The VBAC mother continues to confound the medical birth world.  She is in the precarious predicament of representing evidence of and liability for the obstetrician’s or his/her colleague’s previous actions.

More birth consumer’isms’ – VBAC mothers require mental and emotional support on a greater level than the physical coping with labor.  Medically trained birth practitioners offer little by way of mental and emotional support for laboring women as that is not in their scope of care admittedly.   A medically trained birth practitioner as the primary careprovider is NOT the best choice for VBAC labors.   It is difficult for a mother to find a VBAC pracitioner at all let alone one who has the vision to see that the midwifery model of care can provide the support VBAC mothers need and can fill the void in hospital-focused birth advocate’s call for improving maternity health care.