Dayton's back

She tried before. And now she's trying again. Good grief! We knew it was coming, but it still makes me sick to hear about it.

Why is it that homebirth is so attacked and ridiculed by American OBs and the medical establishment? Why is it that British OBs (and the British National Health Service) view homebirth in such a different way? They actually want "to guarantee all eligible women a home birth by 2009" (emphasis added, source). Meanwhile, in the U.S., ACOG, most OBs, and their puppets are fighting tooth and nail to prevent women from choosing or even having the option of a homebirth! British OBs and midwives declare with confidence: "There is no reason why home birth should not be offered to women at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman’s likelihood of a birth that is both satisfying and safe"(source). How can the Atlantic Ocean make that much difference??!!

If you live in UT, act immediately! Dayton's new bill hits the senate floor tomorrow morning! Email your senators right away!

Move me to England... please...

Today I discovered some more old news that was news to me. And I discovered another reason why I wish I could move across the pond to England for all of my subsequent births. I discovered the Royal College of Obstetricians and Gynaecologists/Royal College of Midwives Joint statement No.2 on homebirth from April 2007. These two groups of British maternity care providers came together (they cooperated!) and produced a statement outlining their joint positions about the safety of homebirths. Here’s the summary at the top of the document:

“The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) support home birth for women with uncomplicated pregnancies. There is no reason why home birth should not be offered to women at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman’s likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby.”

How cool is that?! I’d be hard-pressed to find many obstetricians in the U.S. willing to sign their names to a document with those unequivocal statements in support of homebirth!

Here’s another crucial point I’d like to quote:

“Both the RCM and the RCOG believe that to achieve best practice within home birth services it is necessary that organisations’ systems and structures are built to fully support this service. These will include developing a shared philosophy, fostering a service culture of reciprocal valuing of all birth environments.”

How cool would it be if the organizations concerned about the wellbeing of homebirth babies and mothers would understand this concept. The more midwives and obstetricians and hospitals can coordinate and work together, the better off all mothers and babies will be. I wish there was a “culture of reciprocal valuing of all birth environments” here in the U.S. What a beautiful day it would be if a midwife transferring a patient to the hospital were seen as a competent professional doing what is best for her patient rather than being shoved aside and treated as a screw-up and evidence of “another failed homebirth.”

I’ve never given birth at home. I can’t say one way or another whether I ever will. But I never want to see a day when women don’t have homebirth as an option. I never want to see a day without midwives. How I wish our nation could wake up and recognize how vital and valuable these courageous women are! It brings me hope to see how the British maternity care system has managed to find a lovely balance. Doctors, midwives, and hospitals striving to work together peacefully and with their focus on the wellbeing (physical and emotional) of women and babies! It’s music to my ears!

Posterior Ponderings

My second baby came into this world upside down, or "sunny side up" as some people say. She was posterior (facing my front side) rather than the normal anterior position (facing my back). Her posteriority (I think I just invented a word!) brought with it some surprises. I had fully expected my second birth to happen very quickly. My sister's labors were each roughly half as long as the previous. My first daughter's birth lasted less than six hours, so I was expecting my second to come in less than three! I suspected she might be posterior, however, when that supposed-to-be-fast labor turned into an on-again-off-again roughly 28-hour labor.

Fortunately, for me and my baby, the planets aligned to make our birth experience smooth and uncomplicated. My labor started and stopped every few hours, eventually kicking into full gear after about 26 hours. I arrived at the hospital nearly 6 centimeters dilated and delivered my baby about two hours later. There was no need for forceps or vacuum to get her out, I pushed for less than 20 minutes (it wasn't until then that my midwife said the p-word and confirmed my suspicions about my baby's position), and I suffered only a minor tear. My recovery was terrific compared to my previous birth. My first baby was not born posterior, but I suffered extensive tearing followed by a very painful recovery. Ultimately, I succeeded in having a very satisfying unmedicated labor and delivery despite having a posterior baby.

I feel fortunate, because, for many women, a posterior position is a recipe for disaster. A 2005 article, "Digital/manual rotation reduces need for C-section," in OB/GYN News explains: "Previous epidemiologic studies have estimated the prevalence of the occipitoposterior position to be about 5%. Among such pregnancies, there is a high incidence of cesarean section, instrumental delivery, third- and fourth-degree perineal tear, postpartum hemorrhage, and puerperal infection" (source).

I shudder to think what my experience could have been like. If I had gone to the hospital earlier when my labor was periodically stalling, it is likely I would have been given Pitocin. The contractions produced by the Pitocin would likely have been too painful for me to handle without medication, so I would have likely asked for an epidural. Epidurals make the pushing stage more challenging for many mothers, particularly those with posterior babies, so it's highly likely I would have ended up with an instrumental or cesarean delivery. I feel so fortunate to have evaded those outcomes!

I will be forever grateful that I trusted my baby and my body enough to wait things out and let labor kick into full gear on its own. I spent most of my labor upright, moving, walking, rocking my pelvis, getting on my hands and knees--outdoors and in my own and family members' homes until the last couple of hours. Sometimes these measures will help a baby to turn. Sometimes babies just stay put. And that's okay. Don't let the "p-word" scare you. Having a posterior baby doesn't have to mean a horrible birth experience. For me it was smooth and satisfying. I believe it can be smooth and satisfying for most women when labor is allowed to progress without interference.

Love this!

I love this excellent parody/response to the ACOG anti-homebirth press release posted by Tienchinho on the MotheringDotCommune Forum. Here are my favorite excerpts:

"As a home birth after cesarean mom (HBACM), I reiterate my support of home births. While complications can arise with little or no warning even among women with low-risk pregnancies, childbirth is a normal physiologic process that most women experience without problems. Continuous monitoring of both the woman and the fetus during labor and delivery in a hospital or accredited birthing center has not improved maternal or fetal outcomes."

"Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre. Despite the rosy picture painted by hospital birth advocates, a highly medicalized labor and delivery can physically and emotionally scar both the mother and baby. . . . Unless a woman is in a supportive birth environment that allows the birth process to unfold on its own schedule, she puts herself and her baby's health and life at unnecessary risk."

"It should be emphasized that childbirth comes with inherent risks. Implying any guarantee otherwise is misleading and unjust to a birthing mother and her family. Although able to perform live-saving [sic] emergency cesarean deliveries and other surgical and medical procedures, board-certified obstetricians have been cornered into practice styles that perpetuate the need for these same measures. They have lost skills such as detecting and adjusting a baby in the occiput posterior position. Untreated, this condition can result in prolonged labors mislabeled as 'dystocia' and in cesarean sections. They minimize the profound impact of a woman’s birth experience on her future relationship with her children as well as her own view of herself. Since suicide and substance abuse are leading causes of maternal mortality, disregard for a mother’s emotional health can lead to tragic consequences for her and her baby."

Click here to check it out!

Birthrape

I learned a new term recently: birthrape. I'm not entirely sure who coined it, but Navelgazing Midwife has described it this way:

"The experience of having fingers, scissors, and/or tools put/pushed/shoved inside a woman's vagina or rectum without her direct (or indirect) permission.

"Being coerced, manipulated, or lied to regarding the health and safety of the baby or themselves so the midwife is able to do something to the mother's vagina, rectum, cervix, or perineum, usually with excuses; rarely with apologies."

Navelgazing Midwife is dedicated to raising awareness about the abuse countless women suffer at the hands of doctors, nurses, and midwives. If you're interested in learning more about this deeply pain-filled subject, check out Navelgazing Midwife's post here.

Just a few warnings... there is a photograph at the top of her blog with the breasts and belly of a naked pregnant woman laboring, just so you'll be prepared. Also, her post and the comments in response to it are full of very painful, difficult stories and experiences. It is not easy to read, but I feel that these stories need to be heard. It breaks my heart to hear of the horrific things that happen to women over and over again. It also fills me with a determination to stop the abuse!

When will we say ENOUGH?!

Obstetric trade union threatened by homebirth

[An opinion piece I recently sent to a local newspaper]

With Ricki Lake’s new film, “The Business of Being Born,” giving homebirth a high-profile legitimacy, the American College of Obstetricians and Gynecologists had to do something. As if their monopoly on maternity care in the U.S. wasn’t extensive enough, they felt a need to, once again, stake out their turf. On February 6, the ACOG issued a press release outlining their strong opposition to homebirth. They claim to be concerned for the well being of women and infants. Given the state of maternity care in this country, I find the ACOG’s supposed concern highly questionable.

The ACOG press release criticized mothers who choose homebirth for placing “the process of giving birth over the goal of having a healthy baby.” Women choosing homebirth are often accused in this way. How could they put their own comfort before the health of their baby? The problem with that accusation is that it should really be turned the other way. How can obstetricians put their comfort before the health of the baby?

Many prevalent hospital birth interventions including labor induction for non-medical reasons, elective cesarean section, continuous electronic fetal monitoring, routine use of IVs, early amniotomy (artificial breaking of water), episiotomy, and withholding of food and liquids have not been shown to improve outcomes and, in many cases, lead to other harmful complications for both infants and mothers (click here for more info). These interventions are warranted in rare cases, but they are being used excessively. When many of the most common birth interventions used by obstetricians in hospitals cause unnecessary harm, it is hard to believe that the ACOG’s concern for the well being of mothers and infants is at all genuine. Interestingly enough, most of these interventions reduce the amount of time doctors must spend attending a laboring mother and protect them from possible malpractice lawsuits. It is obstetricians that are putting babies and mothers at unnecessary risk for their own ease and comfort, not homebirth mothers.

The ACOG press release also erroneously claims that there are no scientifically rigorous studies demonstrating the safety of homebirth. There are, in fact, many reputable studies demonstrating that a midwife-attended homebirth is just as safe as a hospital birth for healthy women with normal pregnancies, and with much lower intervention and c-section rates. The most recent and largest of these studies was published in the British Medical Journal in 2005 (“Outcomes of planned home births with certified professional midwives: large prospective study in North America.” Kenneth C Johnson and Betty-Anne Daviss).

The United States is unique among developed nations in its obstetric-heavy maternity care system. The developed nations with the best birth outcomes, the lowest c-section rates, and the lowest rates of maternal and infant death have the majority of women attended by midwives and a significant portion of them giving birth at home. The United States trails behind 27 other developed countries in terms of maternal death and 35 other countries in terms of neonatal deaths.

Homebirth is not “trendy” as the ACOG would have you believe. Women have been giving birth in their homes for thousands of years. Being induced early or opting for an elective c-section are the truly dangerous trends. Women who choose homebirth do so after much research and soul-searching. They deserve our admiration and respect for their courageous choice to avoid the complications stemming from medical intervention and follow their birthing instincts. It is these informed women who will stem the tide of obstetric abuse. As Marsden Wagner, Director of Women’s and Children’s Health for the World Health Organization for 15 years, pointed out, “In every country where I have seen real progress in maternity care, it was women's groups working together with midwives that made the difference.”

Some old news that's new to me

A study conducted by researchers from the National Public Health Institute in Kuopio, Finland (published in 2000 in the Journal of Asthma) found that certain birth interventions and complications can increase a child's risk of developing asthma. The researchers found the following increased risks:

* Cesarean Section - 38% increase in asthma

* Vacuum Extraction - 32% increase in asthma

* Forceps Delivery - 114% increase in asthma

I was surprised by the huge increase resulting from forceps deliveries. I generally consider c-sections the most invasive and complicated of birth procedures, but apparently forceps can be even more so! In the past I might have thought I would prefer a forceps delivery to a c-section, but now I'll have to do some more digging and see if I still feel that way.

For so long I have thought of asthma as something you're "born with" or inherit--something you can't prevent or cure. The more I learn, the more I wonder how many cases of asthma are the result of experiences or environment. Just today I read in the news that breastfeeding mothers' exposure to allergens may protect their infants from developing allergies, including asthma. Check out that news story here.

The take home message from all of this if you want to maximize your child's chances of avoiding asthma? Well, have an uncomplicated birth and breastfeed, of course! ;-)

The OBs Fight Back

Yesterday, the American College of Obstetricians and Gynecologists issued this press release reiterating their strong opposition to home birth and non-nurse midwives. This is, no doubt, in response to Ricki Lake's film and the Big Push for Midwives press conference. It's no surprise that OBs would feel threatened by the growing publicity and support for homebirth. Let's remind ourselves, however, what Marsden Wagner had to say about this group called the American College of Obstetricians and Gynecologists:

To understand the absolute monopoly ACOG has established in American maternity care, it is helpful to look more closely at this organization. The American College of Obstetricians and Gynecologists is not a "college" in the usual sense: it is not an institution of higher learning. Nor is it a scientific body. With few exceptions, its members and leaders are not scientists but medical practitioners, and there is nothing in ACOG's mission statement about science. The ultimate proof that ACOG is not a scientific body? Too many of its policies and recommendations are not based on real science. . . .

In truth, ACOG is a "professional organization," which amounts to a trade union. Like every trade union, ACOG has two goals--to promote the interests of its members and to promote a better product, in this case, the well-being of women. But if there is a conflict between these two goals, the interests of its members come first. . . .

American maternity care, then, is under the control of tribal obstetrics. A small group, most of them men, are controlling birth in such a way as to preserve their own power and wealth while robbing women and families of control over one of the most important events in their lives. . . .

Power without wisdom is tyranny. There are plenty of intelligent obstetricians who have lots of knowledge, but intelligence and knowledge do not guarantee wisdom. I have known wise individual American obstetricians, but I see no evidence of wisdom in organized obstetrics in the United States. The maternity care we have in what we like to believe is our free country is obstetric tyranny.

(From Marsden Wagner's, Born in the USA: How a Broken Maternity System must Be Fixed to Put Women and Children First, p. 33, 35-36.)

For a look at the facts about homebirth, here's a nice overview from iVillage by Henci Goer.

Watch Ricki Lake on Larry King

Larry King interviews Ricki Lake about her past, her views on birth in America, and her new film, The Business of Being Born. Here's the link!

Share your thoughts and feelings about birth!

I just read about this call for submissions at Mothering.com:

Marisa Harder-Chapman and Kathleen Koegler are currently accepting submissions for an anthology on birth. They believe that

"...within each woman is inherent wisdom of the birth process, though it is often forgotten. Also commonly neglected are the meaningful and transformative aspects of birth. Birth is not just a physical way to continue the human population—the way a woman births and is transformed by birth has implications far beyond herself. We want more women to experience birth from a position of trusting birth and themselves... Your words and art may help women on their path toward trusting birth and have an impact on a new generation of mothers."

Please submit original (unpublished) written or visual expression of how you trust birth or how you have begun to travel this path. This may include essays, birth stories, poetry, artwork, or photography—any work that expresses your personal beliefs and feelings about the topic of trusting birth.

Length of poetry should no more than 750 words. Prose should be no more than 1250 words. Shorter lengths are welcome. Submissions will be edited for length and clarity. A letter of consent for publication must accompany all submissions. If you prefer to submit anonymously, please send your consent letter separately from your piece. Unless otherwise specified, first name, last initial, city and state will be included in the published work. Unused submissions along with their accompanying letters of consent will be destroyed after May 16, 2008. If you prefer to have your submission returned, please include a self addressed, stamped envelope.

Submissions are due February 15, 2008, via mail or e-mail. Please request a letter of consent with your submission. Contact Marisa or Kathleen with any questions:

Marisa Harder-Chapman
Kathleen Koegler
1501 S Elm St
Cambridge MN 55008

Marisa: 763-552-0547
Kathleen: 651-699-6454
birthexpressions@gmail.com

Midwives and Emergency Preparedness

Deborah Smithey makes a great point in her article, "The need for certified midwives," when she argues that midwives are a great asset to any city's emergency preparedness plan. Pregnant women are at great risk during and following natural or man-made disasters. When hospitals may be over-flowing with sick and injured survivors and electricity may not be available, women who would otherwise have given birth at the hospital will have to seek alternatives. Smithey explains how midwives are prepared to handle just such circumstances:

"Certified Professional Midwives are trained to work in homes and other out-of-hospital settings. Many midwives serve the Amish and Mennonite communities, and are accustomed to working without electricity or other modern conveniences."

Having certified midwives accessible throughout each community ensures that all pregnant women have access to high quality care regardless of any disaster that may occur. Read her full article here.

Labor is important

Ina May Gaskin, revered by many as "the greatest midwife in the world," explains:

Labor is important, because during labor, both the mother's and the baby's body is prepared for birth. The levels of certain hormones rise and ebb during labor. For instance, the mother's oxytocin levels rise markedly just before the baby is pushed out of her body. This protects her against postpartum hemorrhage. High oxytocin levels in the mother (which are accompanied by higher levels in the baby, too) prepare the nervous systems of both to be attuned to each other. . . . The euphoria that follows an unmedicated labor is a very special time for anyone who is privileged to witness it. It's even better for those who get to experience it.

When the mother experiences labor, she also has higher levels than usual of beta endorphin. This hormone then triggers another hormone, prolactin, which prompts her body to get ready for milk production at the same time that it prepares the baby's lungs for more efficient breathing.

Labor also gives the baby's torso a good squeeze, which helps to dry out the lungs and make them ready for breathing air in the outside world. Cesarean-born babies typically have wetter lungs, which can mean a higher rate of needing breathing assistance at birth. (Interview with Ina May Gaskin by Stacy Fine)

Birth in the Bible

I was thinking a while ago about what the scriptures say about birth. God told Eve that she would have "sorrow" (which, in the Hebrew, meant travail, pain) in bringing forth children. I think people have traditionally interpreted this as God cursing Eve and punishing her. But I don't think that's what He was doing at all.

When I read these scriptures, I see a loving Father explaining to Eve that because she will be leaving the Garden, He will be changing her body so that she will have the ability to bear children ("I will greatly multiply thy sorrow and thy conception (increase fertility, discomfort and size)") and He is letting her know that bearing children will be painful. He is preparing her and Adam for the trials ahead of them.

I believe that opposition is a necessary part of life--without pain and hardship, we cannot truly know happiness and joy. This is evidenced in the scriptures as God tells Adam that the difficulties he will encounter in the world are "for thy sake"--for his (and Eve's) benefit.

Isaiah described Christ's Atonement this way: "He shall see the travail of his soul, and shall be satisfied" (53:11). The word "travail" is generally associated with the pains of a woman in labor. When Christ suffered the Atonement, that act--suffering those pains for us--was the greatest act He ever performed and the one which ultimately brought the greatest joy imaginable. Imagine the aftertaste of that experience! "[He] shall be satisfied"... more satisfied than anyone has ever been, no doubt!

I don't believe God was cursing Eve, and He wasn't cursing Christ. Pain isn't inherently bad. Intense pain makes intense joy more possible. The more pain we experience, the more we can understand the profound Atonement of Jesus Christ. Not that we should hurt ourselves on purpose, but when pain comes to us through life, we can try to bear it with patience knowing that it will make our capacity to experience joy that much stronger.

In fact, pain is an ally in childbirth. When we experience pain, our bodies are bathed in endorphins--feel good hormones--and other important processes take place in our bodies to make the labor and delivery go smoothly and to prepare our babies for life outside the womb. It is all so intricate and well planned out. God knew what He was doing!

Most women who tell horror stories about labor aren't the ones who embraced birth, trusted their bodies, and experienced it the way our bodies were intended to experience it. They are usually the ones who cut themselves off from the pain (by choice or out of necessity), and consequently cut themselves off from an even greater joy. Women who give birth without drugs (by choice) are usually eager to talk about their birth experiences and describe birth as being very positive. They glory in their birth experiences even though (or, perhaps, because) they experienced more pain than they had previously experienced!

When I think about labor pain and the account of Adam and Eve, I don't think why did God do this to women??? I love Him more because I can see that He has all knowledge and His workmanship was designed perfectly. The process of birth was designed just as it should be, and, when we try to interfere with that process, it not only often causes birth complications, but it also interferes with our capacity to experience the profound ecstatic joy we can be bathed in when birth happens as it was intended to happen.