Speaking for Midwives at SLO's Historic Celebration

This is Nora Lewis the certified nurse midwife who caught my son at Sierra Vista Hospital in 1990. That birth changed my life forever and set me on the path to becoming a doula. When it was over I had many hurt and angry feelings and a million questions. After being part of many women's births over the years I have grown in my understanding of what occurred during my own labor and have come to a new perspective and deep appreciation for my midwife. Working side by side with many different midwives has given me a great respect for the women who answer the midwifery call and dedicate their professional lives to helping women all around the world. I was honored to give a speech about midwifery at the Birth & Baby Resource Network's historic celebration for the International Day of the Midwife and I was very grateful to be able to publicly thank Nora Lewis for her courageous stand with me that long ago August day.
My Speech.

Midwifery; a David and Goliath Tale

The story of midwifery in America is a classic power struggle for women’s rights, respect and choice; a tale of the clash of women’s culture and values with the male dominated spheres of science, medicine and finance. It is an ugly story laced with racism and class war fare. This struggle continues to walk the halls of political power and sits in insurance industry board rooms today.
It began as the eighteenth century was drawing to a close and the science of medicine was on the rise. Men for the first time began to move deeply into the privacy of the birth room, a place that in most cultures around the world is traditionally populated almost exclusively by women. This slow and determined encroachment into what had previously always been a woman’s world began the battle.

Before men became involved American midwives had always held a place of respect within their communities. Their skill at helping women during the birth process was of vital importance to all in the community. Women were encouraged to stay mobile as long as possible during the birth, the pain of the process was recognized but not believed to be insurmountable, the passage of time was noted but there were no standardized graphs labors had to abide by, and women utilized up-right physiologically sound positions for pushing a baby out.


When male doctors took over this all changed. Pain relieving drugs were used as an inducement to have doctors attend women’s births. These medications changed the balance of power forever; stripping the woman’s innate abilities. She became an object to practice medicine upon; someone who needed her baby delivered to her like a pizza instead of using her own physical power to bring her baby forth. Soon untested scientific “theories” blended with necessities created by using pain medications and women were routinely being cut and babies were being pulled out with forceps.

As the prestige of the medical profession rose, so did their power. In the end it came down to dollars and cents. In order to corner the market doctors began a campaign to stamp out midwifery. First they created a belief that birth was a medical event which could only be safe if attended by a physician. Doctors traveled in the upper circles of society. They convinced bankers, lawyers and other prominent society men to avail themselves of the best that the science of modern medicine could offer for their wives by using a physician. Men controlled the medical schools and women were not allowed to attend so female care providers slowly began to die out. In the early twentieth century not satisfied yet, they convinced the government to begin a propaganda campaign slandering midwives as dirty, illiterate, and ignorant. Eventually only poor women or newly arrived immigrants were still turning to midwives for care.


Meanwhile another huge shift in health care in our country was taking place. Hospitals were on the rise, with their bureaucracies, standardizations, schedules and sanitization of birth. Women were told it was best when labor began to leave their homes, where they had some control, and travel to a hospital, where they had no control. Hospitals lead to the immediate separation of the newborn from its mother and scheduled feedings. These disruptions in the process along with the drugs created babies who could not suck effectively, needing to be force fed from bottles. Soon the women of America thought their bodies were so defective they couldn’t even breastfeed their own children. Meanwhile the practice of midwifery was outlawed in most states.


But it’s hard to hold good women down. It is hard to stop women from answering the call to serve women; especially women in need. In the 1920’s nurses began to step forward to get additional training in the skills required to help low income women, the rural and urban poor. These were women who couldn’t pay doctors and hospitals, therefore providing them care did not threaten the medical establishment’s monopoly. They eventually founded specialized nurse midwifery schools and associations. From this branch was born the certified nurse midwife. In the 1960’s couples living on communes had turned their backs on many forms of the “establishment”. These female rebels began to birth their babies at home with the help of other women in their communities. The daring women who answered this call eventually became highly trained homebirth midwives. It took courage to be a midwife, to practice midwifery without a license. Not only could you lose everything, your home and your practice, you could be thrown in jail. In our county one traditional midwife was brought up on charges and convicted in 1982. Over time this branch of midwifery also adopted standards for training, created associations and worked hard to become legal once again. In California the legal battle culminated in 1993 in the creation of a system to license out of hospital midwives but it took 4 more years for the first group of midwives to be licensed by the state medical board.


All midwives are still fighting for the right to work as autonomous, respected members of the birth provider community. Whether they are CNMs who have made the choice to work in a doctor’s practice under his supervision because even if they could find a company willing to cover them medical malpractice insurance is prohibitive, or the LMs who can’t get insurance company’s to reimburse their clients for basic care the struggle continues. The California Medical Board is currently reviewing whether to change the language in the regulations governing LMs to allow them to order the life saving medications and tools they need to attend birthing women. And so the struggle continues.


This year on May 5th, the International Day of the Midwife, the women and their families who have been cared for so well for so many years by our community’s midwives will gather in Mission Plaza to honor 41 courageous, tireless, and caring professional women. The Birth & Baby Resource Network along with the co-sponsors of this year’s Birth & Baby Fair wish to invite you to join us at 10:30 for this historic event in the annuls of San Luis Obispo women’s rights.


Participate in BBRN’s on-line Midwifery Project at: www.bbrn.org.
Learn More about the History of Midwifery:
A Midwife’s Tale; Martha Ballard her Diary by Laurel Thatcher Ulrich
Motherwit; an Alabama Midwife’s Story by Onnie Lee Logan
Listen to Me Good; the Life Story of an Alabama Midwife by Margaret Charles Smith
Birth Matters; a Midwife’s Manifesta by Ina May Gaskin
A Short History of Midwifery: from Midwife Info an independent internet resource 
I am a Midwife, a movie trailer by the Midwives Alliance of North America
Fiction with Midwifery themes:
The Midwife's Apprentice by Karen Cushman
The Red Tent by Anita Diamant
Midwives by Chris Bohjalian

A Midwife's Story by Penny Armstrong and Sheryl Feldman

Homebirth & Saving the Earth: a Natural Fit

Many women who birth outside of a hospital setting are changed by that experience for the rest of their lives. It begins in pregnancy as they educate themselves about the choices they are making surrounding birth. In discussions with their midwife, a subtle paradigm shift happens which puts the pregnant woman in charge. A good midwife guides them to see that they need to look beyond what the medical institutions have presented as ‘truth’, and find their own. During a natural, unmedicated, and uninduced birth a woman must listen to her own rhythms of contraction and expansion and learn to work in harmony with them. She taps into a power within herself that until now has been hidden from her. It is an awe-inspiring power that deeply connects the woman to generations of women from the past and the future. From that time on, she knows this power lies within her and she can rely on it. The confidence this brings helps her to look at the world with new eyes. She may make new choices, such as deciding to have her baby sleep in bed with her and her partner even though her best friend says it is dangerous. She may simply feel more able to stick with a choice she already made, such as breastfeeding, even though the first several weeks are rough going.

So how does this help the earth? Well, first there are her choices surrounding parenting in the first weeks and months of her baby’s life, such as sleeping with the baby. Co-sleeping means no trees were cut down to build a cradle or toxic chemicals used to build a crib. On top of that, no fuel was spent to ship it to a store and then get it to your home. No energy was used to run the factory or store. No lights were used at home while putting the crib together.

Breastfeeding, though natural, can be challenging at first. Midwives traditionally promote breastfeeding and are an ongoing resource for nursing education and support. The impacts it can make on our environment are varied. First, it requires no excess packaging, processing, or shipping. There are no bottles to buy, transport, wash, and eventually throw away. This is a huge energy savings, plus there is no damage to our environment from the making and disposal of plastics or glass. Because breastmilk is nutritionally superior to formula, it grows stronger, healthier people who are less likely to need pharmaceuticals or mercury-laden fillings. The fats contained within breastmilk spur more brain growth than formula. We need smarter kids to help us out of the environmental dilemma we are in. On top of all that, exclusive breast-feeding prevents more births than all other forms of contraception combined, which helps slow our ever-climbing population explosion.

Empowered birth creates an empowered woman who has confidence in her physical and psychological abilities. A woman who knows she is capable and has the strength to follow through on those out-of-the-norm decisions, such as cloth diapering. Let’s face it: cloth diapering is a bit more work than disposables, but the small amount of effort required is easy compared to filling up our landfills.

Home birth creates a mother who listens to her own innate intuition. She can listen to herself as a guide instead of relying on ‘authorities’. She will make her own best choices for the survival of her children, even if that means making different choices than mainstream America. She might decide not to fill a prescription for antibiotics which end up in our water supply and create super bugs, and instead rely on rest and mommy love to get her baby through a cold.

Then there are the less obvious connections. A positive birth experience imparts to the couple confidence in parenting to the couple. It creates a solid foundation and unites them in their parenting journey. Midwives often encourage the couple to explore the components of Attachment Parenting, such as baby wearing, responsive parenting, and immediate bonding after birth. This style of parenting creates confident kids with a different world outlook. They tend to think about what the group needs, instead of feeling they would be better off looking out for themselves because no one else will.”

Who knows where a woman’s new-found sense of accomplishment will take her? Perhaps she will decide to roll up her sleeves and plant an organic garden, saving her kids from pesticides and lessening the world’s fuel consumption, or decide to take on the local water board when she finds out there are unsafe levels of chemicals in the tap water her family drinks. Maybe she will confront her local school board on buying more local organic fruits and vegetables for the lunch program. Perhaps she will start her own recycled kids’ clothing store, or get active with her local Earth Day committee. Perhaps she will sponsor a local kids’ sustainable community garden. These are just a few of the things I have seen local mothers do. The power and energy a positive out-of-hospital birth unleashes is tremendous. The possible choices of what to do with that power are endless. The positive effects that might bring for our planet are immeasurable. As a doula, one thing I have learned is to never underestimate the power of a mother!

Parenting in Labor

The Decision to Use Pain Medication in Labor:

For most of us from the very beginning being a mother is hard. It requires you to give of yourself in ways you never dreamed possible. It requires you to make difficult decisions every day. We make these decisions on the best information we have at the time and what we judge as the best balance between our needs and our child's. At the end of the day we need to try to let go of mistakes we may have made and understand we are human and mothering is hard. 

Parenting begins in earnest once we are in labor. The more a woman can stay connected to her baby throughout the process the better she will be able to understand and accept what her body needs to do.

If you decide to use pain medication: "Even if medication becomes necessary later on in labor, the longer a mother can postpone it, the better it will be for the baby and for her and for their recovery afterward. Each hour without it is a step in the right direction." ~  "On Becoming a Family" by T. Berry Brazelton, M.D. (pediatrician)

I love this quote because instead of feeling like a failure if a mom decides at some point in labor she needs pain medication she can focus on the hours she gave to her baby drug free. Mothers need to start mothering with as little guilt in their heart as possible. We will load ourselves down with guilt a plenty in the days, weeks and years of mothering to come.

Labor Pain Medications Affects:  Have you ever wondered how women were able to successfully breastfeed before there were lactation consultants? As much as I love our local lactation consultants and their passion for helping women and babies you need to understand why so many of your friends all needed professional help to achieve what should be a normal biologic function.

"The evidence that drugs given to relieve labor pain affect breastfeeding outcomes is rapidly accumulating." ~ 'The Impact of Birthing Practices on Breastfeeding' by Linda J. Smith & Mary Kroeger

"For breastfeeding to succeed, the baby must emerge from its internal gestation ready and able to feed, the mother must be able and willing to let her baby feed, and the stages of lactogenesis must proceed normally."  ~ Smith & Kroeger

For many years I have listened to anesthesiologist tell mothers not to worry because an epidural won't affect her baby, doesn't even reach her baby. I wish this were so but the uncomfortable truth is that this has been disproved in studies starting back in 1995.

"The route of administration-local, IV, or injected into the epidural space-has less influence on drug transfer to the fetus/infant than previously thought. IV drugs quickly enter the infant blood stream via placental profusion. Local injections also reach maternal circulation in a matter of seconds and are detectable in the newborn's urine at high levels. Injections into the epidural space are quickly detectable in cord blood." 'Impact of Birthing Practices on Breastfeeding'

Did you know that what goes into an epidural are the same drugs that go into an IV for labor pain relief? The only difference is where they are putting it in your body. For you it feels profoundly different but not so much for your baby.

Understanding Risk

Whose Risk are We Talking About?

"We must never underestimate the power fear of litigation holds over obstetricians. In my experience, as a motivational force it over shadows their desire to lower the maternal mortality rate." 

~ Dr. M. Wagner

The "Risks" of Home Birth: Why haven't we heard about this? 

"We now have good, solid scientific evidence that makes clear that planned home birth attended by a midwife is a perfectly safe option for the 80 to 90 percent of women who have had normal pregnancies...This study is by far the largest scientifically valid study of planned home birth ever conducted...In summary this prospective, highly reliable study, which followed the course of more than 7,000 pregnant women planning home births attended by CPMs (Certified Professional Midwives), collected data on more than 5,000 who intended home birth at the initiation of labor. Among these women, the obstetric intervention rates were far below the rates reported in low-risk hospital births. The combined intrapartum/neonatal death rate (babies dying during labor, birth or shortly following birth) was as low or lower than rates reported for low-risk hospital births. And the maternal mortality rate was zero." ~ Dr. Marsden Wagner Born in the USA. 

When I looked up this study I found that 12.1% of the women ended up needing to be transported to the hospital but many of the transported women still didn't need a cesarean. Of the total low-risk home birth women in the study only 3.7% needed a c-section. How does that compare with our hospitals? Visit my Hospital Statistics post to find out.

If this study was published in the Boston Medical Journal in 2005 (six years ago!) why don't more people know about it? Why isn't the whole medical community talking about it, trying to understand what this means about how hospital-based birth is conducted? Why aren't they trying to understand the lessons that can be learned from home birth and how to incorporate those lessons into their practices? To read more about this study visit the Boston Medical journal web site. 

Which Local Hospital is the Safest?

Why would the same OBs who delivered babies at Sierra Vista for years, before they had a Neonatal Intensive Care Unit, now being telling women that French Hospital is unsafe because they don't have a NICU? They never told women in the past they needed to go out of town to a hospital with a NICU to safely deliver their babies. Just saying??? Did you know both hospitals have special baby respiratory therapists at births as a safety precaution? Did you know the same pediatricians and neonatalogists will go to either hospital if a baby arrives in need of their services? 

Hospital Versus Home Birth: Accepting the fact of risk

"If the obstetric tribe says that out-of-hospital birth is not "safe", the implication, of course, is that a hospital birth is safe, which is not true. Newborn babies die in hospitals every day, sometimes because someone made a mistake. When the obstetrics establishment implies that this doesn't happen, the family naturally feels deceived when it does happen." More from Marsden Wagner's 'Born in the USA'.

One of the hallmarks of a good out-of-hospital midwife is that she explains that there are risks to birth and is clear that the parents need to be willing to accept those risks. The reality is with life comes the risk of death no matter where you are or who you are. 

Inductions & Due Dates: Things to think about for the women of San Luis Obispo!

Listen to Ina May Gaskin, master midwife, author and recipient of the Right Livelyhood Award, shares her wisdom about  induction and due dates.

Convenience Masquerading as Risk: Have you ever thought about induction from the doctors' and hospitals' management perspective? 

~ Marsden Wagner, MD "Induction of labor is an important convenience not only for obstetricians but also for hospitals, as it allows hospitals to organize an induction assembly line, with slots into which doctors can fit their patients."

Let's face it, spontaneous labor is inconvenient in lots of ways; from doctors’ sleep, time off and office hours interrupted, to hospital staffing, room availability, and work flow. This was made blindingly clear to me years ago. I had a doula client who was between 41 and 42 weeks pregnant. At her prenatal visit her Certified Nurse Midwife told her how dangerous it was for her to continue simply waiting for spontaneous labor to start. After a long discussion and lots of pressure the pregnant mother gave in and agreed to be induced. The midwife went to call the in San Luis Obispo hospital to schedule the induction for later that day. When she came back into the room she said there were no rooms at the hospital, so my client couldn't be induced that day. She said she was scheduling her for 3 days later. Why? Because we were there on a Friday and it wasn't convenient to induce her on the week-end!

My thoughts: What happened to the danger? If there were no rooms for an induction what were they going to do with women who spontaneously came into the hospital that day in labor? To schedule an induction means having enough nurses to cover the more time and labor intensive work of an un-natural, drug driven labor so perhaps it wasn't room but staffing that was the problem? I was angry, as was my client, and so grateful to be given a reprieve to go home to Grover Beach. We worked hard on creating the elements she needed to go into labor spontaneously and were rewarded with a spontaneous, un-medicated vaginal birth before Monday.

Due Dates~Inductions~Cesarean Sections: making the connections

Dr. Marsden Wagner's "Born in the USA"
"Now we are in big trouble, because forty-one weeks is entirely within normal pregnancy limits, and when we start inducing at forty-one weeks, we put large numbers of normal pregnancies at risk with an unnecessary procedure. At this point we have a situation in which the treatment is worse than the disease." 

Connecting the dots: This book was published in 2006. When I was pregnant with my son in 1990 my nurse midwife told me to EXPECT to go to 42 weeks, that this was NORMAL for first time mothers. Over the last 2 decades this assumption of 42 weeks as being normal has been replaced with an ever increasing fear based medical perspective for each day that the mother goes past 40 weeks. Perhaps it is just a coincidence that since 1990 the national cesarean rate has been climbing every year until reaching a rate of a whopping 32%! I don't think Dr. Wagner thinks it is just a coincidence. Do you? Compare my cesarean rates to our local hospitals in San Luis Obispo, Templeton and Santa Maria.

Baby Bonding and Attachment: Getting parenting off to a good start.

Food for Thought: "In the early months, in most families, the mother-infant attachment is more obvious and more intense than that between father and infant. This does not mean that fathers do not become deeply attached to their babies, but it is a different type of attachment. It's neither of lesser quality than a mother's nor better. It's just different." 

~ William Sears, MD and Martha Sears, RN, ‘The Attachment Parenting Book’. 

It is important to encourage both parents to connect with their baby, each in their own unique way. Each parent brings something wonderful to the growing relationship, something a child will treasure for a life time.

Doctor or Midwife: How to Chose Which is Right for You

Food for Thought: I have thought a lot about how women decide whether to use a midwife or doctor for their birth. I think it really comes down to life perspective. Do you focus on what can go wrong in life or on what can go right? This will be the defining reason for your choice. You will seek out and feel most comfortable with a care provider who mirrors your view of life. 

Here is Marsden Wagner, Ob-Gyn on the different perspectives of doctors and midwives. "Though midwives know what can go wrong during pregnancy and birth and know how to identify problems early and to cooperate with doctors in managing complications, their focus is on birth as a life-enhancing experience." This makes midwives a good match for women who naturally gravitate to a world and personal life view of staying in touch with everything that is right in the world and their bodies.

"Obstetricians, on the other hand, tend to focus on what can go wrong during pregnancy and birth. All doctors are trained to look for trouble (diagnose a problem) and decide what to do about it (decide on a treatment), and that is what comes naturally to obstetricians." So if your way of interacting with the world is to keep your eye focused on what can go wrong in life so as to prevent it from happening, then a doctor is a better fit for you.

Each choice can come at a price though. For a woman choosing a midwife it can be very difficult if the midwife finds an actual problem with the pregnancy or birth. The pregnant or birthing woman may have a hard time switching gears to focus on the problem in order to address it. Here is what Dr. Wagner says about the price the woman choosing a doctor pays, "In prenatal care they [doctors] take the same approach, focusing on what can go wrong and ordering numerous tests and screening procedures. This attitude casts a shadow over the maternity care a woman receives. When an obstetrician runs a test or gives a preemptive treatment, it is an unspoken vote of no confidence in the woman’s body.” I know women often feel each prenatal visit is like a pass/fail test. This is especially stressful on women who are high achievers. If they run into a perceived “failure”, at an office visit it can shake their confidence to their core and they may become obsessed with their fear of failure. This can lead to a rise in stress hormones which can spiral into more “failed” tests.  

I am a Community Lactivist

I believe in breastfeeding both for the healthy growth of a child and the healthy growth of a mother. When a new mother breastfeeds she learns to watch and listen to her child's cues. These simple facial expressions, body movements and vocalizations which trigger our innate response to nurture are the start of a life long conversation.With support the new mother comes to trust her baby's ability to know when they have a need and what it is they need. As she learns she can meet these needs through breastfeeding she gains confidence both in her mothering abilities and her baby's abilities. As she learns to let go of the need to quantify these abilities through weighing, measuring or lines on a chart she starts down the path of mothering wisdom. This path can teach her to relax. It can teach her to rely more on her child's wisdom than on professional experts. It can teach her she is more a witness to her child's life unfolding than a director. She is more an access to the resources needed  for her child to play their unique heart song than the leader of the band. Breastfeeding can be the key to a new way of parenting for life.

It is because I believe this in my heart that I am a Community Lactivist. I express my commitment to all the breastfeeding mothers out there by being an active member of several organizations that support breastfeeding in our community; La Leche League, Birth & Baby Resource Network and Central Coast Breastfeeding Coalition. I am proud to say San Luis Obispo has a very high breastfeeding initiation rate. Unfortunately like most of the country there is a steep drop off from the second week to two months. We have lots of support groups and resources in our community and yet women still can't seem to make it through the challenging first six to eight weeks and into the months of breastfeeding bliss. As Lactation Consultant Julie Merrill said at Thursday's Farmer's Market, "It breaks my heart to see so many babies in strollers with bottles." The Coalition has just printed a new breastfeeding resource brochure full of places, people, books and web sites mothers can turn to for guidance and encouragement. Look for their green and white cover around town, at your doctor or midwife's office and baby stores. 

This baby wants all new mommies to have this brochure!

Stepping out of the shadows

Breastfeeding mothers need our support. We need to step out of the shadows and take a stand that breastfeeding is normal; formula feeding is abnormal. Babies need to feed when they need to feed and mothers need to feel comfortable attending to those needs; even in public. This is a national health issue. By continuing to pay money to formula companies we are draining our economic resources, environmental resources and our nations future health. Don't be blinded by the "Well I was formula fed and I turned out ok", way of thinking. Look around you we have an obesity epidemic, while cancer, diabetes, and heart disease run rampant in our nation. We are overly dependent on antibiotics and medications. While these may not be the direct result of formula feeding the studies clearly indicate that all of these could be lessened if we only chose to breastfeed for the first few years of our children's lives. I firmly believe some day we will look back on these years of our nation suckling at the teat of the Nestle Corporation and compare it to the time of America's romance with cigarettes.

Our bodies grow smarter healthier babies.

August is National Breastfeeding Awareness Month. If you see a mom nursing her child, give her a thumbs up and a friendly smile. Each day she chooses to breastfeed she is giving her child a wonderful gift and performing a patriotic duty.

We gave a new meaning to "flash" mob at SLO's popular Thursday night Farmer's Market.An special thank you to Robyn Berry Photography.

Lactivistas come in all ages.

Educating the public on the benefits of breastmilk.

Demonstrating the miraculous work our breasts were perfectly designed to do.

Every baby deserves a booby!

Learning one generation to the next.

 Thank you to the mamas who chose to bare it all last night to demonstrate what breasts were actually designed to do.

Inspiring a new mommy.                BREASTFEEDING It Rocks!

 

Read about how I managed to juggle working and breastfeeding here.

This month's La Leche League meetings:

Monday, August 13th at 10 am:

Santa Lucia Birth Center 4251 S. Higuera Street in San Luis Obispo
Topic: Nutrition and Weaning

Monday, August 27th at 7 pm:
Santa Lucia Birth Center
Topic: Baby Arrives

Look for Los Osos meetings to start back in September!

Labor & Birth

Expectant mothers in my birth classes often worry about how long labor will last. Some of my doula clients fear labor will be like the San Luis Obispo marathon and others worry it will be a fast and furious sprint. Ina May Gaskin, master midwife, lecturer, author, and recipient of the Right Livelyhood Award shares her wisdom on the labor race and how long labor "should" take.

Think Twice Before You Say Yes to a C-Section Because Your Baby is Arriving Prematurely

Last week in the New York Times Roni Rabin reported on a new study coming out of John's Hopkins School of Medicine which throws a wrench into the machinery of conventional medical thinking. Until now doctors have believed that it is safer for your premie to be born via surgery. The study included 2,560 babies. When they compared babies born mother nature's way to those born in a surgery suite the babies delivered by C-section were 30 percent more likely to develop respiratory distress syndrome, a serious breathing disorder that can lead to organ damage.

It must be tough to be an Obstetrician. You are constantly practicing medicine on women with the best of intentions only to have studies prove that what you are doing is not only medically unnecessary but harmful. No doctor goes into medicine to harm women, so I have to wonder how they feel about it each time one of these issues comes to light and they have to reverse course. Do they think back over the women they sectioned who had complications? Do they remember the babies who ended up with serious respiratory infections and wonder if their belief in the "preventative" cesarean may have caused that baby to suffer? What about the extra stress on families separated even longer from their babies? What about all the money families spent on additional NICU care for premies with breathing issues? I wonder if someone will try to figure out what that bill was for our nation?

So how did OBs get into such a mess? It is grounded in the systemic belief which underlies much of the medical model thinking about birth that women's bodies are essentially unsafe for babies, especially the vagina. To understand where this bedrock of the medical view of the world came from you have to go back to male dominated religion, Eve, sin and the apple, the Greek belief in the perfection of the male body, and an unwavering belief in man & technology over nature and women's bodies. Time and time again this flawed way of thinking has led them into relying on drugs to fix problems only to learn later that they were harmful to mothers or babies. They rely on machines, tests and statistics to give us flawed due dates which lead to inductions of accidentally premie babies, continuous fetal monitoring which led to many more c-sections for fetal distress with no lowering of the fetal death rate, and windows of normal so narrow that fewer and fewer women can thread the needle of pregnancy & birth without being labeled as high risk. So this line of thinking led them to believe, without any studies being done, that it would be safer for premies to be saved from the rigors of a vaginal birth. It apparently never entered their minds that traveling through the vagina served a purpose in a complex system of birth, growth and life long health. Or that being squeezed would push fluid out of the lungs and that the sides of the vagina would coat the baby with beneficial flora. These two items may be why there are less respiritory infections in vaginal birth babies. Instead as the medical provider they donned their super hero robes and stepped in as saviour. The problem with being a super hero is the responsibility. So now they are left to face their responsibility. Of course I'm not looking for some kind of loud national apology. That never happened in the past and it won't happen now. Read the Times article below and then take Dr. Werner, the lead author of the study's advice and have a frank discussion with your doctor.

New York Times
February 9, 2012, 3:22 pm
C-Sections Pose Respiratory Risks for Some Small Preemies
By RONI CARYN RABIN

Small premature babies born by Caesarean section are at increased risk of respiratory distress syndrome, a new study has found.Very small babies delivered prematurely by Caesarean section because they were not growing properly in the womb developed more respiratory problems than those who had induced vaginal deliveries, a new study found. The study adds to growing concern over the high rate of Caesarean section deliveries in the United States, which reached 32 percent, or nearly one in three deliveries, in 2007.

On Wednesday, the federal secretary of health and human services, Kathleen Sebelius, announced a public health campaign to educate families that it is best for both the mother and the baby to let a problem-free pregnancy go for as long as possible, and to let labor start naturally. The campaign is a partnership that expands on a March of Dimes public awareness drive emphasizing that “healthy babies are worth the wait.”

The latest study looked at babies who were extremely small for their gestational age and not growing properly in utero, so waiting was not a medical option. But the findings raise new questions about the risks of Caesarean section.

For the study, researchers analyzed nine years of data from births in New York City, identifying 2,560 babies who were small for their gestational age and delivered between 25 and 34 weeks of pregnancy. Forty-six percent were delivered vaginally, and 54 percent by Caesarean section.

“The conventional thinking, though nobody really knew, was that maybe it would be less traumatic for this group to have a C-section, and they might benefit,” said Dr. Erika F. Werner, an assistant professor at Johns Hopkins School of Medicine and the study’s lead author. “Our study suggests that may not be true.”

In fact, the babies delivered by C-section were 30 percent more likely to develop respiratory distress syndrome, a serious breathing disorder that can lead to organ damage and that is more common in premature infants, Dr. Werner and colleagues from Brown and Yale Universities found.

The C-section deliveries were not associated with improved outcomes in terms of other complications, including hemorrhages, seizures, low Apgar scores and sepsis, the researchers found. Results were adjusted for differences in the mother’s age, ethnicity, education, health status and weight.

The findings are being presented today at the annual meeting of the Society for Maternal-Fetal Medicine in Dallas.

“The takeaway is that if you’re in this situation, you should have a frank discussion with your doctor that maybe a vaginal delivery is equivalent, or even better,” Dr. Werner said. “We need further research to determine if there is any benefit to C-section” for such infants, she said.

Another consideration is that when a woman has one baby born by Caesarean section, subsequent children are far more likely to be delivered by C-section as well.

As to why vaginal deliveries appear to improve respiratory function, Dr. Werner said, “We don’t have the perfect answer.” Some experts believe that the physical compression the baby experiences during labor helps remove fluid from the lungs and prepares the baby to breathe air.

Dr. Diane M. Ashton, deputy medical director of the March of Dimes, who has been overseeing the organization’s Prematurity Campaign to educate the public, said similarly improved outcomes are seen with infants delivered further along in a pregnancy.

“This is consistent with what is seen in infants even at 37 weeks,” she said. “They, too, have better respiratory outcomes when delivered vaginally versus C-delivery.”

Studies suggest that premature births of single babies have been increasing in recent years and that more are being delivered by Caesarean section, including C-sections that are not medically necessary. At the same time, recent research shows that a baby’s lungs and brain undergo important growth and development during the last few weeks of pregnancy, and that babies born just three to six weeks before their due dates are more likely to suffer disabilities or developmental delays in kindergarten.

Last year, the American College of Obstetricians and Gynecologists issued new medical guidelines meant to lower the rate of repeat Caesareans by making it easier for women to find doctors and hospitals that will let them attempt a vaginal delivery even when a previous baby was delivered by C-section. Although these women are at risk for a serious complication called uterine rupture, ruptures affect fewer than 1 percent of women, while C-sections, which involve major abdominal surgery, carry many other risks both to the mother and to the child.

Baby's First Bath: rethinking a tradition in light of the latest research.

(Ricky Martin gives his baby his first bath)

One hour old. One hour of holding and gazing. One hour of nuzzling, smelling, latching and sucking. One hour of “she has my ears” and “she definitely has your mother’s nose.” One hour of the most precious time in a new family’s life. Time stands still; generations collide; the universe contracts down to be held in the grasp of her impossibly tiny fingers wrapped around your hand and heart.

The pleasant nurse asks, “Would it be alright if I weigh and measure your baby now?” The young mother elated and tired from the birth relinquishes her vulnerable newborn to the waiting nurse’s capable hands. She is as anxious as everyone else to begin these next steps in the rituals of birth.

“Eight pounds 8 ounces,” announces the nurse. “My, she is a big girl!” The doula snaps a photo of the digital reading on the scale for the baby’s memory book. The brand new father excitedly posts the vital statistics on face book for the world to see what he has created.

After measuring her length and head size, the nurse carefully places her feet down on the paper, gently pressing each of her tiny toes to the page to capture her foot prints for the birth records; one set for the birth certificate and another set for the memory book.

Then she turns to the father and says, “Well it is time for her first bath. Would you like to help?” She fills the clear plastic isolette tub with warm water and gets out a bar of hospital antibacterial soap. She makes sure the warmer is heated up just right so the baby will have a warm dry place to go to as soon as the bath is over. She knows it puts a baby at risk to let them get chilled.

“Okay Dad, can you bring your daughter over here?” instructs the nurse. She confidently guides him through the process as he gingerly picks his daughter up for the first time; painfully aware of how fragile her tiny, perfect body feels in his suddenly over large hands. The experienced nurse talks him through what has become an important bonding ritual between fathers and their babies all over the U.S. She encourages him to not be afraid as together they gently scrub the baby all over with soap and water, cleaning away germs and bacteria. She teaches him how to lather her hair with shampoo and rinse it while protecting her face and eyes. When all traces of the birth have been cleaned from her baby soft skin she is laid on the warmer, dried, diapered and carefully dressed in the tiniest white t-shirt the dad has ever seen. Finally the nurse shows him how to swaddle the baby and puts her into his waiting arms.

This washing of the baby bonding ritual is repeated in hospitals everyday all across America. Sometimes siblings or grandparents are included in this sweet experience. But the time has come to take a closer more critical look at this tradition. Numerous studies show us that when it comes to intestinal bacteria babies are a clean slate immediately after birth. Within a very short time their gut has been colonized with the right bacteria for living a healthy life. Where do these bacteria come from? There are two main sources; the mother’s vaginal passage and her skin, especially around her nipples.

As the baby passes through the birth canal she is bathed in her mother’s bacteria. This starts an important process for life-long gut health. If she doesn’t pass through the canal, due to a surgical birth, the bacteria the baby first comes in contact with is from the surrounding environment; the air, other infants, doctors and the nursing staff. Studies show it may take up to 6 months for the cesarean baby to attain the correct balance of flora in her gut.

The next way bacteria are introduced to the baby is by latching onto mother’s breast for her first feeding. The bacteria present on the mother’s skin are swallowed and starts the process which will create vitamin K in the baby’s system. Vitamin K is critical for appropriate blood clotting.

On top of all this there are special properties in the mother’s colostrum which help the good bacteria to thrive in the baby and bad bacteria to suffer.

Although we have been trained to think of bacteria as bad the truth is there are many microbes which are beneficially for our health. We are meant to live in a state of balanced symbiosis with these beneficial bacteria. That process is meant to start during the birth and continue during the hours immediately after birth; just as the squeezing of the birth canal prepares the baby for the adjustment of breathing air into her lungs to oxygenate her own blood. If we think of bacteria as bad and the baby as “dirty” then of course we feel a need to wash her. What happens if we think of the baby as being in an important microbial transition time which may impact her overall future health?

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Since I wrote this more research has come out. Click here to read what the latest science says about our relationship with bacteria.

Need a Laugh?

Every mommy needs a good laugh now and then, otherwise we would go absolutely crazy! Here is a list of blogs and books to help you through the stressful days of pregnancy and parenting. All items on this list are parent tested and mommy approved.

Here is a blog that takes a humorous look at pregnancy and mommyhood. This piece is by a guest writer. She talks about some of the things she wished some one had told her before she went into labor about hospital births. Check it out: http://pregnantchicken.squarespace.com/pregnant-chicken-blog/2011/3/26/8-things-i-wish-someone-had-told-me-about-having-a-baby.html

Sh*tMyKidRuined.com

Amber Dusick: what it is like to change diapers (illustrated with crappy pictures!) http://www.amberdusick.com/

The new book "Go the f*** to sleep"

Scarymommy.com

Finding Your Path; two women's stories

A former doula & class client sent me a link to a blog piece by Cherylyn, a doula in Utah. Natalie knew I would be interested in this woman's journey of recovery from her first birth which was traumatic and left her feeling victimized and angry. Each of her next four births led her down a new path toward healing. On her journey she made many different choices for where, with whom and how to birth. Each birth was a necessary step in her process. In my classes and through my doula support I honor each woman's choice because I can't judge where she is on her path. It is my responsibility to give information and it is her responsibility to listen with an open heart for what resonates with her. Only she has the answers. Only she can access her intuition. It is my hope to support her in this process through my own intuitive listening so I can respond to her needs along the way. This is why I support women in all birth settings. This is why my classes are designed to teach couples no matter where, with whom or how they are planning to birth. My hope is to give them the tools to have a positive birth where ever they birth. Please read this article if you are preparing to birth or if you are in the process of physical and emotional recovery from a less than positive birth. Then sit quietly for a moment and take her message into your heart. Let it carry any feelings of guilt, doubt, or mistrust in yourself away.

Now let me tell you about Natalie. I met her and her husband, Tobin, at a Birth & Baby Resource Network event. When it came time in the circle for sharing their tears as they shared spoke volumes to me about the depth of their birth trauma. As the event broke up I approached them and encouraged Natalie to visit our SLO chapter of the International Cesarean Awareness Network, even though hers was not a cesarean birth. I knew that the circle of supportive women at their gatherings could help her heal her wounds. Unfortunately there is no local support group for women with negative birth stories except ICAN which is labeled a cesarean support network. Women with birth experiences like Natalie's aren't sure they would belong at an ICAN meeting. The women of ICAN would want me to stop here and say that these women absolutely are welcome and that supporting them is also part of their mission. Unfortunately the general public doesn't know that.

As Natalie's second pregnancy progressed we came to understand that not only had her birth left her with many emotional scars it had also left her with many physical ones. Like her emotional ones, these scars were hidden deep within her and they had the potential to threaten this new pregnancy. Bottom line; she was no longer the same inside and this pregnancy was therefore risky for Natalie and her baby. She was advised that the least dangerous route for her baby's birth was a cesarean. She listened to this advice. She listened to her intuition. She listened to her husband's fears. She listened to her desires. She listened to her body and she waited.

Natalie experienced an incredibly healthy pregnancy. She worked and mommied right through it. She blossomed and so did her baby; growing right on schedule, moving vigorously and letting her mom know she was doing fine. Natalie did a lot of talking, to Tobin, to me and to her doctor. She weighed all the different risks of having or not having a surgical birth; risks to her and risks to her baby. She knew what she wanted but was also willing to make needed changes or compromises. We brainstormed all kinds of possible scenarios for her birth. Then she wrote her birth plan. This plan was unique to her; not something you can download from the Internet with check off boxes. It encompassed many possible avenues for her birth to go. It was detailed. It was flexible. It was respectful and grateful to the people she knew she was going to need to rely on to see her safely through. Then she listened to her body and she waited.

When her water broke I believe all three of us held our breath and made a silent prayer that all would be well. Then Natalie and I released our breath and went to work creating as much normalcy to this labor as possible. But I don't believe Tobin let go of his breath until both mom and baby had come safely through. Natalie carried herself in labor as she does in life, with quiet unassuming strength and graciousness. You would never guess at the depth of her determination, or physical and emotional strength. Tobin told me she can be stubborn but he forgot to also tell me how courageous she is. Immediately after the vaginal birth of her beautiful baby girl she began to have an issue which required her doctor to step in and Tobin, the baby and I to step out. Natalie kept her composure throughout while Tobin died a thousand deaths holding his baby and waiting for news about his wife. For him life stood still and minutes felt like an eternity. All I could do was reassure him that she was in good hands. Dr. Yin and the French hospital staff knew how to take care of her; that's why she had chosen to birth here. In what was actually a very short time he received the news he was longing for; Natalie was fine and would be reunited with him soon. But I don't think Tobin breathed until he saw Natalie's pretty face again; all smiles and wanting to put her new baby girl to breast.

So why did I decide to tell you about Natalie? Because she knows a thing or two about healing, about listening to your intuition, about creating the birth that is just right for you and your baby. Your choices may be different than hers. You may listen to her story and think, "I would never put my baby at risk like that." That's fine. You are entitled to your feelings and if your heart had told you to make a different choice than Natalie's I would support you in that choice. But this was Natalie's choice and it brought her very far along her path as she journey's toward complete healing. So I understand why Cherylyn's story resonated with Natalie. I get it. Do you?

           Thank you to Natalie and Tobin for inviting me to accompany them on their journey!

To Read Cherylyn's piece about her choices as she journeyed toward healing visit her blog: Mamas and Babies

"To Clamp or Not to Clamp? That is the Question"

I've been explaining about delayed cord clamping and cutting in my classes for years. Leave it to master birth educator Penny Simkin to come up with a great visual demonstration to explain why this is so important. This isn't just a fad or a wild idea. There is basic physiologic science saying that it is healthier for your baby if no one cuts the cord until it has stopped pulsing. Listen as Penny explains.

Your Baby's First Latch: breast crawl video

This is a must see by all pregnant moms, their partners and anyone who will be helping them at their birth. Of course we can crawl to the nipple, latch on and nurse! It only makes sense. All mammals can do this with minimal guidance or help by mom. Why would we be the only mammal unable to do this? It only makes sense. If we birthed in a squatting position we would naturally reach down, put our hands under their little armpits, and bring them up to our breasts keeping their spine parallel to our own. Without towels or blankets they are much too wet and slippery to consider doing anything else.

How did mothers lose this knowledge of what to do immediately after birth to correctly begin the bonding and breastfeeding process? Drugs, doctors, fear of germs, bright lights, cold hospital rooms and schedules all played a role. You have the power to reclaim this piece of your birth and be amazed at the miraculous abilities of your newborn. Put your baby's spine in line with your own. It is as simple as that. Don't forget to cover, not swaddle, your baby with a warm blanket!

Why Should I Bother with Birth Classes?

Recently I have been asked this question by two very different women. Both are intelligent first time pregnant moms who desire natural non-interventive labor for themselves and gentle births for their babies. One has already done a considerable amount of reading, hired a midwife and has made the choice to birth at home. What more could she get out of classes, she wonders? The other has a belief in herself and birth which is rooted in her family history, her agricultural history and in her personality. She also witnessed a birth which went so differently than the Bradley birth her relative had planned that she feels her money is better spent on a doula.

I don't remember what I said to these women but here is what I wish I had the presence of mind to say in the moment. Yes, you should take classes! Classes serve many purposes. It is more than just learning the stages of labor. It is more than learning the normal psychological markers, the comfort measures or tools to help you flow with the intensity of the birth process. A good class should give you much, much more.

First as new parents it is vital to create community. Bringing forth a new life isn't just about the baby's life. You are literally bringing forth your own new lives. A new life means transition and transition is stressful. You will need to surround yourself with other new moms and dads. Now you're thinking, "But I have lots of friends who have already had babies." Great! Lots of wisdom can be drawn from friends and relatives who have kids, but talking with others who are just as confused and unsure at times as you creates a shared experience. This is support of a different kind. When you talk with them about lack of sleep, sore nipples, or the color of your baby's poop you'll be thinking, "Oh, you get what I am talking about because you are going through it too. I'm not alone. I'm not crazy." Every support group is founded on this principle.

A good childbirth class is a great place to start building community. It needs to be an environment that goes beyond simply giving you facts, advice & techniques. A good class fosters friendships through the sharing of thoughts & feelings, doing class activities or projects and breaking bread together. The class should bring both humor and intimacy to the subject of birth while always honoring each participant's unique journey toward the arrival of their child. This is an environment where friendships can blossom. After the babies arrive getting together for walks, talks, beach time or play time friendships can deepen. They show up at Andrea Heron's class or La Leche League. You walk into a SLO Parent Participation class or library story time and there they are. Your world suddenly seems smaller in a safe and secure way. This is building community within our larger community. New parents, new families need community.

Now what about the fact that many women who have decided they want a "natural" childbirth have already done a ton of reading? They have read great books, watched movies like The Business of Being Born, researched things on line and even watched You Tube videos of births. What more education could they need? All that is great but let's face it very few dads are motivated to share that particular journey with you. Sure you can corral them and ask them to watch this amazing You Tube birth or read them passages out of a book you are devouring from cover to cover but very few men are going to feel as compelled as their partner to steep themselves in birth, birth & more birth. As a matter of fact, the more she does, the more he may feel he doesn't have to because she is the one who is having the baby, right? She is doing such a bang up job getting educated so he can just relax. On top of that, if you are making decisions about the birth based on things you alone are reading and then telling him what you want, he may feel there is no point to reading or expressing his opinion; you've already made up your mind. These may be wonderfully supportive partners but they are hovering outside of the picture.

Classes help dads! I can't say that enough. Classes help dads. They invite them into the process. Men naturally come late to thinking about the birth. Actually they often come late to connecting with the baby in any concrete way. This is normal because they aren't the ones feeling it grow and move inside them. Believe it or not when they witness their baby being born it almost seems to take them by surprise that there really is a baby. A good class allows dads to connect with their own journey towards birth and parenthood. They gain the education they need through active participation instead of reading & research which suits many fathers better. There is time, space & support given for dads to express their feelings, beliefs, fears and desires surrounding the process and what lies ahead. They are honored as fathers, lovers and humans.

Classes most especially help dads who have witnessed past births that traveled down traumatic paths, such as c-sections or home birth transports. These dads need special care as they struggle to support a woman who is determined to have an un-medicated vaginal birth while carrying the fears left over from the past birth. It is vitally important that the couple has come together as much as possible before the birth and good classes help.

Good classes help you analyze and express your beliefs about the choices surrounding birth. They put you in touch with the values & fears that are informing your personal choices. Having to verbally express our values & fears can bring up buried thoughts, crystallize our perceptions and distill our feelings. Hearing what others value or fear is a powerful tool in learning about ourselves. Clarity of these issues on both sides can lead to respectful communication if your partner is of a different opinion. Clarity of values & fears can lead to a more open and empowering dialogue with your care provider.

Being pregnant is a process that unfolds over time. The way you feel about something at 12 weeks may be vastly different than the way you feel at 30 weeks or 38 weeks. The best time to take classes is the last 2 months of the pregnancy. The series needs to be 7 to 8 weeks long so that friendships have time to grow and so do the couples. Good classes encourage the couple to get in touch with where they are in the process now and where they would like to be eventually. They practice. They prepare. They rehearse. They live in the moment and open themselves to the possibilities of the future. Yes, you should take birth preparation classes. You will come away more confident in birth, more sure of yourselves and your abilities, more connected to your partner, more aware of your choices, more able to dialogue with your support team and just plain more ready.

These two expectant moms were right though. Many classes aren't worth taking. Classes that only focus on the physical biological aspects of birth are a waste of time. Classes that focus only on one tool or technique for labor are hopelessly incomplete. Classes that are only 4 weeks long give the couple no opportunity to grow or change. Classes that are taken the last month of pregnancy give the couple no opportunity to change course if they come to the realization through their class work that they want to go down a different path. Classes that honor only one vision of what birth should be like are disrespectful to the amazing complexity of the human race. Classes that only impart the guidelines and routines of the place of birth & care provider disrespect pregnant couples' abilities to make wise choices for themselves and their babies. These classes are an obvious attempt to dis-empower women and their partners. By all means take classes but choose wisely who you ask to "educate" you.

For more information about my classes. Also there are many excellent independent birth educators in SLO County. We each have a slightly different focus. It is important to find an educator you feel comfortable with. Most of them can be reached through the Birth & Baby Resource Network's on line Resource Guide.

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Here is another birth educator/blogger's take on this same issue.

From Mama Birth:
If You Are Asking My Opinion- Yes, You Need A Birth Class

In full disclosure, before I get started I should probably own the fact that I do teach natural childbirth classes for money. (I don't make much money at it, but you deserve to know that.) So you can take what I am about to say as just shameless self promotion and fear mongering.

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I often hear this sentiment :

"Women have been giving birth for 1000's of years. You don't need a class to give birth."

What is interesting about this quote is that I hear it both from medical doctors who are very intervention happy or dislike natural birth and from people planning to home birth.

At the risk of offending everybody who reads this, I have got to address this idea. Because frankly, this just usually is not the case. Let me tell you why.

Women HAVE been giving birth for 1000's of years-

Yes, women have been giving birth for a long long time. The mechanisms of birth worked the same with the first birth as they do today in the modern woman- contractions, dilation, pushing, baby, placenta. But the CULTURE of birth is constantly changing.
How many of you have attended a live birth? How many of you have attended multiple births in person? How many of your husbands have?

A woman a thousand years ago most likely was around birth. She was at the births of her siblings or cousins or nieces and nephews. She learned to help the mother after the labor. She saw women breastfeeding. A 1000 years ago women were actually AROUND birth. Birth was something that really only women understood.

They didn't hide it in hospitals and close it behind a door and a cloak of mystery and fear. It was a normal part of life.

Not only did they see it, they talked about it, supported each other in it, and had traditions surrounding it. We have traditions surrounding birth too, but they don't do much to teach women about the actual mechanics and how to cope with birth and labor naturally. Today when women talk about birth they talk about epidurals and pain and what they were allowed to do. This can be wonderfully helpful in preparing you for the typical hospital induction birth. It does not however do much to prepare you if you are planning on birthing naturally.

Women being surrounded by other women who had birthed naturally also creates a very different birth culture. Being in a weekly class with others in your same situation and with the same goals can re-create that "birth culture" for you today. Having a teacher who has done what you are planning a few times herself also gives you somebody to ask questions and proof that natural birth is possible, even if you don't know many people who have done it.

A 1000 years ago women didn't birth in the hospital-

A large part of the classes I teach focuses on preparing women to navigate the hospital system. The truth is, if you are planning on birth in the hospital and going natural, you need to really know what you are doing. You need to know how to relax well without medications in a place where they are readily available. You also need to be aware of the purpose and ways to avoid common interventions, drugs, and procedures in the hospital.
Women didn't have to do this 1000 years ago. There are huge advantages to hospital birthing- but combining it with a natural approach is often tricky. Thus the class.

And your partner? What was he doing a 1000 years ago?

The modern woman almost always wants her husband at the birth with her. Not only that she wants him to be involved, helpful, loving, and basically fantastic.

I don't know how to say this nice, but....good luck with that if he doesn't know a thing about birth and is scared crapless of the entire idea of something huge coming out of your vagina.

Many women are self motivated enough to learn about birth and study and practice relaxation on their own. After all, they realize that THEY are the ones who have to give birth. Women are often very invested in baby and the experience long before it happens.

Men a 1000 years ago were probably not part of the birth process. But today, women expect them to be there. If you want him to be helpful, to understand what is normal, to know what a crowning baby looks like, and to know how to do a double hip squeeze, he needs a class.

My classes focus on the partner a LOT. If I can get dad comfortable, excited, and confident in your ability as a couple to have a natural birth, then I feel much better about the couples ability to do this. If mom is looking forward to this and knows her stuff, but dad is scared, doesn't know why you sound like a ghost, and just wants you to get an epidural because he wants you to be helped but he doesn't know how to help you, then we have another beast altogether.

But I am birthing at home-

I know- I still think that a natural birth class can be helpful in preparing a mom to birth at home. There are two reasons for this.

1) A good class won't just cover birth- it will cover preparing for a healthy pregnancy and staying low risk. I have seen more than one home birth mama end up having a baby in the hospital because baby came early because of poor nutrition. Some things just go wrong and can't be prevented. But some things CAN be helped with an awesome diet. You can learn about this on your own, but I notice that people focus more on how they are taking care of themselves when they are asked about it weekly by their friendly birth teacher.

When I ask people to keep track of everything they eat, they really pay more attention than they do just because they read something about the Brewer Diet online. A class helps keep you accountable while surrounding you with a supportive group of women and men.

2) Even if you birth at home, you still need to actually LABOR. Birthing at home might prevent some common interventions, but it doesn't get you out of the work involved in birthing a baby. I have talked to many a midwife who has home birth mamas who have no coping mechanisms in place for their birth.
Losing control is a natural part of birth- but knowing how to relax and do it well can help keep that to the normal, baby is almost here, minimum. A mother who is very stressed out, fearful, and unfamiliar with the birth process, can have difficulty with laboring from the very beginning and throughout the entire process. If you throw in a partner who also is freaking out, you can really change the process in a negative way.

A good birth class doesn't just talk about what happens in a chart- it teaches you how to handle it.

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The truth is that not everyone really needs a class. I am not going to tell you that I KNOW that you do. But I do often see people who don't think they needed a class and it turns out they really could have benefited from the knowledge, the confidence, the time to prepare with their partner, the skill it gave their partner, and the nurturing friendships with like minded people.

One of my favorite things to see is how a couple's relationship grows in class. They learn to rely on one another. They learn to trust each other more. They grow together as we discuss relationship issues that arise during the time of pregnancy.

In the end a great childbirth class really just teaches you how to tune in to what you already know how to do innately. Then, you CAN birth more like women did 1000 years ago- naturally and with faith in your body.

For more information about my classes. Also there are many excellent independent birth educators in SLO County. We each have a slightly different focus. It is important to find an educator you feel comfortable with. Most of them can be reached through the Birth & Baby Resource Network's on line Resource Guide.