Looking Deeper into a Negative Birth Story

This blog piece is in direct response to the recent piece in the Huffington Post, “My True Feelings Regarding My Home Birth Experience” by Ashley Martin. Please take the time to read her birth story before you read my response.

This is a sad story. As a doula I have listened to many sad birth stories over the years. Sad stories from home births. Sad stories from hospital births. Unfortunately negative births happen all too often although the vast majority of births in the U.S. have positive outcomes; healthy moms and healthy babies. When I hear a disturbing story I have learned to pause and think. To put it in context with all the birth stories I have heard and all the births I have witnessed. I have learned to dig deeper while at the same time to not judge either the mother, place or care providers. It is important to remember that this is HER story. Her perception of home birth based on her two experiences of home birth. I wish her title had been, "What MY Home Birth Was Like". This birth lives large in her mind and heart; although she had previously birthed at home and I can only assume it went well because she chose to birth this baby at home as well. The trauma of this second home birth has indelibly imprinted its personal message in her psyche. If we were to hear her midwife's or doula’s perception it might be vastly different.

When birth turns high risk it instantly becomes traumatic for mom and dad no matter where it takes place. No matter how blissful the labor. No matter how much they trust those around them or themselves or a higher power. Naturally parents are extremely grateful to the person or people who they perceive as "saving" their baby. I put saving in quotes because I paused and put this birth into context. I used this mom's words about the actual timeline to direct my thinking. I thought about the births I have attended in hospitals that suddenly took a turn into trauma. I thought about what I know about neonatal resuscitation and procedures and time lines.

It is very difficult for parents when they feel let down by ANYONE at their birth. It is even more devastating when it happens in the middle of a high risk situation. When one group of care providers points fingers and lays blame at another during the process, rather than working as a seamless safety net for mom and baby, then things really begin to unravel emotionally for parents. Through this mother’s words I can hear the echoes of the hospital staff blaming the care she was provided, although they were not their to witness it, before she entered their doors. I have walked the halls of our San Luis Obispo hospitals. I have heard these words of blame and yet I only hear words of support for all involved echoing down the hospital halls when one of their births suddenly turns into a dangerous mess. Even when a baby dies. Our culture is always looking for “the other”, the one who is different. The one we can safely blame because they are not like us.

When we add the fact that our culture insists on a perfect baby every time in every birth place AND a perfect experience, AND someone must be to blame when that doesn't happen it often surprises me that anyone is willing to help birthing women at all. When things go bad the people providing care have put their lives, their livelihoods and their families in the line of fire. This has happened in our community. It has happened to both midwives and doctors. Good people providing good care as best they could.

Now we need to look more deeply into this mother’s birth. Here are the facts she presented. She had a very rare presentation. We are not told when during the birth process this was discovered or what steps or actions were done based on this information. It may have been missed until the baby was close to crowning, especially if her pushing phase was rapid or she hired a midwife who believed in a hands out of vagina birth. It is easy to immediately jump to the conclusion that if it was missed it must mean that her midwife was not qualified or was somehow negligent. But consider that I have been at 2 different breech situations where, despite numerous vaginal checks by doctors, midwives and nurses, no one realized that the babies were breech during labor until mom was fully dilated. If they had come rapidly after reaching 10 centimeters we would have had accidental vaginal breech births. Breeches happen much more often than brow presentations so presumably all of these providers had had the opportunity to feel what a breech feels like; whereas very few providers have ever felt a brow presentation.

Her second difficulty was the shoulder dystocia. Now I know from my son's birth that shoulder dystocia is scary even in the hospital. Everyone in the room goes on high alert. I have seen this dealt with quickly, smoothly and successfully both at home and in the hospital. Actually as scary as it was for her it appears since her baby is fine that it was dealt with successfully at her birth too. She mentions receiving fundal pressure to help get her baby out. I too received fundal pressure. Is fundal pressure risky for mom? You betcha. I learned this long after my birth. Have I seen doctors and midwives deal with shoulder dystocia successfully with no further complications for mom and baby? Plenty! Can shoulder dystocia go horribly wrong? Yes. I know of 2 cases in our county where it went horribly wrong. One at a home birth with a qualified midwife and one in a hospital with an extremely qualified and well respected doctor. She says her baby was stuck for 9 minutes. I assume she means head out body trapped inside behind the shoulder trapped behind her pubic bone. What steps can one take at this point in a birth anywhere. You can move mom into different positions. You can reach inside and try to free the trapped shoulder or turn baby into a new position. You can push back on the shoulder to break the clavicle. Were these tried? We don't know. What we do know is you can not get a cesarean in under 9 minutes in a labor bed.

Then she says 911 was called at 1 minute after birth. That is a very quick response from a midwife and right in line with MOST hospitals. Currently our local hospitals have baby respiratory specialists standing by at all births. Don't let this fool you. This has only been the case in our community in the last few years. Before that, like many hospitals around the country, labor nurses would have been taking care of this baby until a specialist could be called in. Normally at a birth, home or hospital, babies are given help if breathing is difficult or heart rate is low. As the baby is worked on it is constantly assessed every 30 seconds to see if it is responding to the intervention. If not, a swift decision is made to continue and/or go the next step. This midwife knew in 1 minute that this baby needed more help than they could offer at home and the call was made. She did the RIGHT thing and called an ambulance to transport. The ambulance arrived, assessed and transferred baby into the ambulance by 6 minutes! Not sure how that is possible but bravo! I have seen respiratory specialist teams struggle much, much longer at the hospital bedside before transferring into the Neonatal Intensive Care Unit.

What happened during the first minute? Was the baby dried and stimulated? This is the first step taken with any baby in trouble. Yes I can see by the photos this was done immediately. I see the assistant about to put the baby stethoscope on and listen to the heart rate. The mother tells us the assistant was warned to listen carefully and be sure of her assessment. Was this baby suctioned? Did they use only a bulb syringe or the DeLee which the hospital would have used? This mom doesn't say. Was the baby given oxygen? Yes. I know this from the photos. I can also see the baby has the slightest bit of pinking up beginning to show which indicates that his system is trying to circulate blood and that blood is oxygenated. They are also in the process of cutting the cord. This might be done if they are about to start CPR and therefore need to move the baby to a firm surface. Did the baby require CPR? Did the baby respond to CPR? The mother doesn’t tell us. Perhaps because she was in too much shock to take it in. She also doesn't tell us how long she pushed or what the baby's heart rate was during labor; especially pushing. Without all of this important information I have no way to assess the quality of the care provided by her midwife or if anything would have been different about her birth if it had taken place in a hospital. This may be an excellent midwife taking exactly the same steps they would have taken at the hospital in the same order and with the same rapidity.

We also don’t know what “life-saving” steps were taken by the traditional medical staff. Did the EMT need to do infant CPR when they arrived? How did the baby respond? What was the baby's condition when it arrived at the hospital? Did they need to intubate this baby so it could breathe? Perhaps, but there is no sign of that in the photos. The baby appears to have a line of fluids going in indicating medication of some type. Could this simply be the antibiotics so often given to home birth transport babies because of the perceived bias of a “dirty” home environment? Perhaps. Perhaps not.

She also feels that she almost died during this process. Women can die during birth. It happens due to hemorrhage. When a woman hemorrhages there is blood. There is LOTS of blood everywhere. This mom mentions no blood. Remember her description of the bathroom floor? She talks about baby poop being everywhere but not blood. Could she have bled too much? Perhaps. I have been with moms who have bled too much. Most of them were in the hospital. They received the same medication and physical manipulation a mom would receive at a home birth. As a birth assistant at a home birth I have held the medication drawn up in a syringe ready to go as the midwife monitored the bleeding and made a careful assessment about how much blood the mom was losing. Did this mom need medication and receive it? Did she need it and not receive it? We don't know. There is so much about this birth that we don't know. Making ANY decisions about the quality of care she received or the safety or risk of home birth is impossible based on the facts she has given us, no matter how compelling her story is. No matter how much it tugs at our hearts or shocks us.

This woman's perception of her son's birth IS important to me. It makes my heart ache but it doesn't cause me to believe more or less in place of birth. It DOES get me thinking more about what a woman needs to feel positively about her experience. The importance of having quality communication before, during and after a birth is very important. When a birth becomes traumatic or suddenly high risk this is a critical component that often gets lost. This is where I know this mother was let down. No woman should feel she was not listened to during her birth or have to "fight" to get her records. No woman should ever feel the need to make the statement, "I was misled, lied too, and manipulated. Informed consent? Hah. I wish. I left my birth feeling broken, beaten down, cheated." Unfortunately I have seen this too often with too many care providers in too many places. It is their fear response. They go on the defensive because they fear for themselves and their families.

To help a mother heal from trauma it is critical to keep blame, of the mother or any of the people who helped her, out of the conversation. Listening to her truth. Helping her sort through and understand the facts. Helping her go beyond her fear and shock and pain. This is important. Unfortunately rather than seeing this birth as unfolding just as it should; a hard labor followed by swift action to turn around a potentially bad situation by her midwife, the EMTs, the doctors and nurses, with a healthy mom and baby in the end, she is stuck in the negative feelings of guilt, blame and shame.

I do not know Ashley Martin. I do not know her midwife. I do not know what happened at her birth. I do know how she feels about it. I also know my own birth experience which took place in a hospital and included a posterior labor and a long pushing phase and a scary shoulder dystocia and in the end a happy healthy mom and baby. It took me 20 years and witnessing 100 births to stop blaming myself and/or my midwife. I can now confidently say we both did everything we could and my birth unfolded just as it should and I am grateful to my midwife and proud of my strength. I can finally claim the words "birth warrior" for myself.

I do believe many women are told, or choose to only hear, the roses and fantasy of fairy tale

birth. Let’s get real ladies. Birth isn't all orgasms and euphoria. Birth may have that, but birth is life and life is messy and risky and that is why it is miraculous. It is time we embraced the miraculous.

For another perspective and some of the missing puzzle pieces of this birth please check out the birth photographer's account. Remember we are not sitting in judgement. We are NOT trying to decide whose account is the "truth". For this mom, in despair over her birth, her truth is ALL that matters to her. I would caution anyone who would judge all of home birth through the lens of this one birth.

What a VBAC Calculator Shows

This morning I noticed this intriguing post in our local ICAN group's Facebook page:

I know this isn't an active group, but this is the only one of my groups where it seems appropriate to post this. Does anyone know where I can find info about the VBAC rates for home births and hospital births? I found this cool VBAC calculator, but it doesn't account for birth setting.https://mfmu.bsc.gwu.edu/PublicBSC/MFMU/VGBirthCalc/vagbirth.html

A Vaginal Birth After Cesarean calculator? Really? So I decided to try it.

It is always important to know who you are playing with so I investigated who created this calculator. OK it says it is based on data collected from an article "Development of a nomogram for prediction of vaginal birth after cesarean". A nomogram? Huh? That is just a geometric way of looking at multiple variables. The data set came from the Maternal-Fetal Medicine Unit Network. Here is their mission statement: "The MFMU Network conducts clinical studies to improve maternal, fetal and neonatal health emphasizing randomized-controlled trials. The aims of the Network are to reduce maternal, fetal and infant morbidity related to preterm birth, fetal growth abnormalities and maternal complications and to provide the rationale for evidence-based, cost-effective, obstetric practice." They are a network of university based hospitals. These teaching hospitals are where the births happened that form the statistics to base this calculator upon.

First the questions they ask to help them calculate are telling. They want your age and body mass index. Don't know your BMI? Don't worry they'll calculate it for you. They want to know if you have a "proven pelvis". What's that? It is a woman who has either had a vaginal birth before or after a cesarean. In other words at some point a baby "fit" through. They want to know if your cesarean was for lack of progress dilating, lack of progress moving the baby through your pelvis or some other reason. Other reasons could be twins, breech, high blood pressure, fetal distress, maternal fever, etc. They just lump all the other reasons into one category. Most distressing to me are their questions about race. They break it down by African-American, Hispanic and all others lumped together. What the hell? What on earth should race have to do with it?

So here is what I found when I did some calculations.  I kept all other factors the same except the one I was looking at. Trying to compare apples to apples. Let's look at age first.

Age 
They obviously feel age matters. I changed the age from 18 to 30 to 35. 
I had between 7% to 10% less chance of successfully VBACing at 30 than at 18 years old. The low end reflects women who progressed on their predetermined schedule. The top end reflects women who fell off the time chart plus were heavier. At 35 it drops again. Now I have 10% to 15% less chance depending on the other factors. Ugh! Obviously age is NOT something you can do something about or can you? How many 35 year-olds do you know? I have worked with many and some have the physical health of a 40 year old while others could pass for being in their twenties.

Weight
By adding 70 pounds to a white woman with no previous vaginal births and allowable progress during labor/pushing she has lowered her chances of VBAC success by 12%. If she had a "failed" labor the numbers move down to 16% because of the additional pounds alone. This may make some sense because weight can cause confounding health issues, such as high blood pressure.So if you want to VBAC stack the decks in your favor by starting at a healthy weight. Oh wait! If you want to avoid that first section be a healthy weight before you get pregnant and then work with someone who knows about pregnancy nutrition to stay on track.

Arrest of Labor
This is defined as absence of progress. So of course one must FIRST note that progress is a very subjective animal. The good news is this calculator says if you had a surgical birth for arrest or "failure" either during dilation or pushing your chances are only 9% to 12% less than the woman who didn't. As a doula I know it is critically important to look at WHY you stopped progressing or weren't progressing fast enough. Was the baby in a poor position? Was this a failed induction? Why were you induced? Too long past due date? How far was too long? Baby "suspected" of being too large? How large was he or she really? Induced for other health concerns, blood pressure, diabetes, etc.? Perhaps your water broke and labor didn't start quickly enough so you were given labor initiating drugs. Did you have an epidural? At what point in the labor? I can't stress how important it is to obtain ALL your records and to go over them with an experienced doula or midwife. Perhaps your "failure" to progress was actually THEIR failure. 

Race
Here is where they doubly fail women. Be prepared to get angry.
I went back and changed only race as a factor. So let's look back at the age issue WITH race added in. If I am a 30 year old woman of color I had a 10 to 16% less chance than an 18 year old. While a white 30 year old has a 7% to10% less chance.  And at 35 I as a white woman would have 10% to 15% worse odds but as a woman of color it plummets to a 21% less chance of success. Excuse me? What about race with weight? If I am a 30 year old white woman with healthy weight, no vaginal births and no "failure" the calculator predicts I have a 80% success rate in their hospitals. That same woman of color? 67.2%! That is a difference of about 13%. If  I am 70 pounds heavier I have a 16% worse chance of success than my white sister. 

So now I compared the best case scenario; 18 years old, healthy weight, no arrested labor c-section, vaginal birth before and after surgical birth, White to Black or Hispanic. Shockingly the numbers say a woman of color automatically gets 4% worse chance of birthing vaginally. That my friends is systemic racism in its most insidious form. It is in how they are treated from the moment they are in their doctor's offices until the moment they are discharged from the hospital. I have witnessed this unequal treatment. Every time it has angered me. Usually it appears to anger me more than the woman trapped in it. Perhaps because she has only her own experience to compare, whereas I can compare her to the white women I have supported. But here the numbers are; in black and white for all to see. A disgrace.

I did not intend for this to be a post about race. I started in thinking I was going to check out this calculator and compare hospital stats with homebirth stats. But the numbers took me a different direction. Here are two links for those of you who wish to compare homebirth and hospital birth numbers. They were posted by Terri Woods of SLO Doula Connection  in response to the ICAN query. She rightly warns that homebirth midwives automatically risk out a variety of complications and so it isn't exactly apples to apples. Still it is worth noting that out of 1,354 VBAC women 87% were successful. There is no way for me to do a straight comparison because I don't know anything about age, weight, reasons for prior sections or if they have had a vaginal birth either before or after their surgical birth. 

Science and Sensibility looks at the MANA homebirth study 

Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009

Planning to VBAC? Hire a doula. Plan a home birth. Hire a midwife. Get healthy and stay healthy. Finally question, question, question; especially if you are a Black or Hispanic woman. 

Listen to National Experts: What the Birthing Women of San Luis Obispo Need to Think About!

These posts originally appeared as my Food for Thought series on Facebook. I wanted to provoke the women of San Luis Obispo county into thinking about their birth and parenting choices. By quoting directly from books I wish to stimulate discussion and encourage women to seek out information and become more educated. My hope is you will empower yourself through this process.

“Our lives begin to end 

the day we become silent about things 

that matter.”

~ Martin Luther King, Jr. 

from his unforgettable

 "I Have a Dream" speech

Doctor or midwife: How to choose which is right for you.

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

Induction and Due Dates: What you need to know to keep anyone from scaring you into a decision.

Understanding Risks: Learning more so you can choose the risks you are most comfortable taking.

Parenting in Labor: Things to know about the decision to use pain medication.

Labor & Birth: Things to remember about normal labor and birth.

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

Comparing Approaches to Pregnancy & Birth

"The techno-medical model of maternity care, unlike the midwifery model, is comparatively new on the world scene, having existed for barely two centuries. This male-derived framework for care is a product of the industrial revolution. As anthropologist Robbie Davis-Floyd has described in detail, underlying the technocratic mode of care of our own time is an assumption that the human body is a machine and that the female body in particular is a machine full of shortcomings and defects. Pregnancy and labor are seen as illnesses, which, in order not to be harmful to mother or baby, must be treated with drugs and medical equipment. Within the techno-medical model of birth, some medical intervention is considered necessary for every birth, and birth is safe only in retrospect." — Ina May Gaskin (Ina May's Guide to Childbirth)

A Good Midwife

Today I stumbled upon an online debate over different views of midwifery. As commonly happens in arguments each side seemed to think it was all or nothing. You must either believe totally in the rightness of their side or you were evil; a danger to your unsuspecting clients.

This got me thinking. As a doula I have been in the unique position of watching many different midwives and doctors working with birthing women. I have been present in hospitals, homes and a birth center. I have listened to women grieving and traumatized by their births. Contrary to popular homebirth myth these did not all happen in hospitals. There are times when women suffer terribly after their homebirth. Sometimes they are speaking to me during those early postpartum weeks and sometimes it is years later during their next pregnancy.


After listening and watching here are some of the things I believe makes a good midwife no matter where she practices.

A midwife needs to know when to keep her hands out of a client and when to put her hands in.

A midwife needs to have the ability to be patient, to move slowly and carefully and the ability to move quickly, decisively and without hesitation.

A midwife needs to absolutely trust birth, and a woman's instincts and birth intuitions, and yet be skilled enough to know when a woman needs guidance.

A midwife needs to know how to let the laboring woman be center stage, the lead in the play, while she is prepared to step in as needed in the supporting role, as the hero or just make a cameo appearance.

A midwife balances equally the importance of the mother's experience with the mother's and baby's safety.

A midwife needs to know when to lead and when to follow.

A midwife needs to know the depth of the waters she is swimming in and is prepared to transfer care when she is out of her depth.

A midwife needs to know how to guide without taking over control.

A midwife needs to know all the variations of normal, what they look like, what they sound like, what they feel like so she can help her clients be unafraid.

A midwife needs to know how to help without rescuing. A midwife needs to have the skills and character to rescue when it is needed.

A midwife needs to be skilled at suturing tears and vigilant at trying to prevent them.

A midwife needs to be able to monitor the health of the mom and baby through skilled and timely assessments, heart rate, blood pressure, and temperature without interrupting the flow of labor.

A midwife needs to understand every birth follows its own unique timeline and plan and that sometimes that plan includes transferring care or surgical birth.

A midwife needs to create a relationship of trust with her clients and has a responsibility to not break that trust.

A midwife needs to be able to speak to both the instincts and the intellects of her clients.


I have a deep respect for all the midwives I have watched supporting, guiding and sometimes rescuing my clients over the years. The work is complex, physical, emotional and draining. When births go as planned the midwife will be an adored friend for life. When births aren't the fantasy a woman imagined, the midwife will be blamed forever. It is often very difficult for the birthing woman to grasp all the pieces of what happened and why because she was in the thick of labor. Without real understanding, it is natural to blame the person she imagined was to keep all bad things from happening; the midwife. There are no perfect midwives, just as there are no perfect people. They are simply flawed humans with strengths and weaknesses just like the rest of us.


Thank you to Edana Hall, Brenda Ramler, Sandy Rodriguez, Tiffany Dietrich, Lisa Winick, Linda Seeley, Helen Cominos, and JoAnne Tarkington for devoting your careers to caring about women.

Do you have thoughts on what makes a good midwife? Comment here or email me: jjmstover@sbcglobal.net.

Having a Baby? Read these books...

One April a few years ago I picked up the phone. It was Brenda Ramler, a local midwife calling.

"Hi. I'm working on a recommended reading list. Do you have any books you think I should include?" Brenda is someone you can always count on to get straight to the point; a real straight shooter. One of the straightest shooters I have known in my life.

"Why? What's up?" I on the other hand am an information gatherer. I never like to express my opinion until I feel I know all the facts. You know, a lay of the land type person.

"I'm working on something to hand out at the Fair. I have a list but I'm looking for new ideas to add to it." She was talking about Birth & Baby Resource Network's annual Birth & Baby Fair. This fair was almost as old as BBRN itself and Brenda & I had been involved in some way every year since its founding.

That's another thing about Brenda, she is a worker. She never sees something she feels needs to be done and says, "I'm too tired" or "too busy." Besides that she is an organizational wizard and perhaps one of the most detail oriented people I know. On top of that she is passionate about birth. I should say natural birth. Birth the way she feels it was meant to be. Her vision of birth encompasses pregnancy, birth and parenting. To her birth is one piece of the whole; not an isolated, stand alone event.

She has strong opinions about all of it and doesn't mind sharing them. Actually I believe she feels it is her calling to share them with women and their families; a duty to herself and to God. Of course she shared them with her clients, but she would also share them with pregnant women she met at a coffee shop or in line at the grocery store. She moves through the world strong in her beliefs that women need to know. Why? So they can be responsible for themselves, for their births and for their babies.

This is not a unique belief in the "alternative" birth world. It is the founding principle of BBRN and many other organizations, but Brenda is unique in her power of conviction and willingness to clearly state the truth without fear of repercussions. Many people find this not an endearing trait. But as far as I can tell it never fazed Brenda what other people thought of her. She brought that power, conviction and confidence to every birth. It served her clients well.

She safely caught lots of San Luis Obispo county babies during her years here. She educated many women in their birthing and mothering abilities. She made an impact in our world one family at a time. She also impacted our birth community; educating assistants, doulas, teachers, and even doctors and midwives. I was one of those people. I was lucky enough to doula at a few homebirths with Brenda and she always made herself available to discussclient issues or situations. Now she has moved on to new adventures in new places with her husband. The women whose lives she touched will never forget her. Myself included.

Recently I found a copy of the list of books Brenda and I spoke about that day on the phone. I was in the home of one of her assistants who is currently training to be a midwife. I recognized it as soon as I saw it and asked Heather if I could have a copy. Many of these books are classics. The basics of birth and parenting do not change but the context of the cultural/financial politics which surround it continually changes. These books continue to be relevant because the underlying foundation of greed, power and mistrust of women's bodies remain as a constant at the core of our birth culture. I am happy to announce that these books and many others will soon be on loan again through the Birth & Baby Resource Network in the library at the Santa Lucia Birth Center.

Here is Brenda's Recommended Reading List:
Nutrition/Exercise
***********
Active Birth
Janet Balaskas

The Vegetarian Mother's Cookbook
local author Cathi Olson

Pregnancy & Childbirth
************
American Way of Birth
Jessica Mitford

A Wise Birth
Penny Armstrong

Birth as an American Rite of Passage
Robbie Davis-Floyd

Birth Reborn
Michel Odent

Gentle Birth Choices
Barbara Harper

Immaculate Deception II
Suzanne Armstrong

Natural Childbirth the Bradley Way
Susan McCutcheon

Pursuing the Birth Machine
Marsden Wagner

Special Delivery
Rahima Baldwin

Pregnant Feelings
Rahima Baldwin

Choosing Waterbirth
L. Bertram

Seasons of Change: Growing through Pregnancy & Birth
Suzanne Arms

Creating a Joyful Birth
Lucia Capprioni

Mind Over Labor
Carl Jones

Cesarean/VBAC
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Open Season
Nancy Cohen

Birthing from Within
Pam England & Robin Horowitz

Rights & Responsibilities
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Birthing Normally
Gayle Peterson

Birth Your Way
Shiela Kitzinger

Obstetric Myths Versus Research Realities
Henci Goer

The Thinking Woman's Guide to a Better Birth
Henci Goer

Breastfeeding
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The Womanly Art of Breastfeeding
La Leche League International

The Nursing Mother's Companion
local author Kathleen Huggins

Babies & Children
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Natural Medicine for Children
J. Scott

Take Charge of Your Child's Health
G. Wootan

The Baby Book
Dr. Sears

Homebirth: Listening to a Master Midwife

Ina May Gaskin is America's premier midwife.If not for her I don't know what would have happened to birth in this country. Her book, "Spiritual Midwifery" reignited the flame of natural woman centered birth. Her personal life story is amazing and what she has achieved is incredible. The numbers of women's lives that she has impacted is unknowable. Like a pebble tossed into a pool her courage and belief in women has flowed outward in never ending rings. Take a moment to sit at the feet of a master and listen to the wisdom she has learned by witnessing women birth. Then visit her website at:http://www.inamay.com/ or buy her book, "Ina May's Guide to Childbirth" from my library.

Home Birth—Why It's Necessary

By Ina May Gaskin, CPM
Originally published by Ina May Gaskin Productions, 2007-01-14
Simply put, when there is no home birth in a society, or when home birth is driven completely underground, essential knowledge of women’s capacities in birth is lost to the people of that society—to professional caregivers, as well as to the women of childbearing age themselves. The disappearance of knowledge once commonly held paves the way for over-medicalization of birth and the risks which this poses. Nothing in medical literature today communicates the idea that women’s bodies are well designed for birth. Ignorance of the capacities of women’s bodies can flourish and quickly spread into popular culture when the medical profession is unable to distinguish between ancient wisdom and superstitious belief. To illustrate, I would cite a National Geographic article (1) which states that, “…we [humans] can give birth to babies with big brains, but only through great pain and risk.” The writer, depending upon the work of two U.S. anthropologists, explains that the fact that our species walks upright causes inevitable pain and risk during birth, forgetting how easily we can go to our hands and knees if need be.

I would have had no way to know how well healthy women’s bodies can work in labor and birth had I not experienced a rediscovery of women’s capacities in birth, along with several hundred other people, as we established a midwifery service in our newly founded community in 1970. Most people would have predicted that my diving headlong into attending home births for friends and then training a group of midwives to work with me would have ended in disaster, given that I came into midwifery only with the training afforded by two degrees in English literature. What happened instead is that I received timely and essential help from a few generous, wise physicians, and our service was able to help the first 186 women give birth vaginally (without instruments or other medical interventions) before our first cesarean was necessary. It was not until birth #324 that the second became necessary. All of this was accomplished without negative consequences to mothers or babies.

This degree of success is hard for many physicians to believe, because it runs counter to what they have been taught. For many decades, physicians have been taught that the female pelvis is often too small to permit the safe passage of a term baby through it. Still, over the last three and a half decades, more than 2400 births have been attended within our midwifery service, with our cesarean and instrumental delivery rates combined still below 2 percent, in sharp contrast to the U.S. cesarean rate, which is now nearly 30 percent and climbing.

The publication of our early data in my first book, Spiritual Midwifery, in 1975, helped to encourage the natural childbirth movement that began in North America during the late 1960s. (2) This movement caused U.S. hospitals to radically reassess their maternity care policies during the 1970s and 1980s, leading them, for the first time, to allow family members to be present at births; to allow women, for the first time, to choose midwives as birth attendants; and to change—again for the first time, their policy of mandatory episiotomy. The natural childbirth movement, which was greatly inspired by home birth pioneers, also had the effect of drastically reducing the incidence of forceps deliveries, which had previously been used in more than 40 percent of U.S. births.

Midwifery care blossomed in the U.S. because of the home birth movement, as women who didn’t themselves want home births but who did want care that did not involve routine and unnecessary medical interventions and practices, such as pubic shaving, enemas, being forced to remain still while lying supine during labor (the painful position possible) and often mandatory pain medication, wanted to be able to choose the midwifery model of care in the hospitals where they would give birth. Women themselves began to force these changes by opting for midwifery care and by insisting upon doula care. All of these transformations demonstrated both to laboring women and to their caregivers that women are fully capable of giving birth without the mandatory use of several interventions once considered by U.S. obstetricians to be not only important but essential to the health of mother or baby.

I have not yet mentioned the long list of techniques and practices common to home birth midwifery, which have made their way into progressive hospital maternity care practice. Among these are the use of water tubs for alleviation of pain during labor, the all-fours position (sometimes called the Gaskin maneuver) to resolve the serious complication of shoulder dystocia (3-5), upright positions for labor and birth, the safety of allowing almost all women to enter labor without induction, the use of nipple stimulation to release the body’s natural oxytocin to augment labor (6,7) and the possibility of sleeping, eating and drinking during labor. It is no exaggeration to say that none of these techniques would have been adopted into hospital practice, had it not been for their having first been developed and tested in the “laboratory” of home birth practice. Medical research is expensive and thus rarely focuses on preventive measures or those which don’t rely upon pharmaceutical or technological products.

Another extremely important concept that arises from home birth practice is the recognition of what I call “sphincter law.” (8) This concept describes the common phenomenon, which occurs often in women’s labors, in which stress sometimes causes the cervix, once dilated in labor, to suddenly close, or for labor to stop. Having first observed this phenomenon in the early years of my practice, I found that other midwifery colleagues working in and out of hospitals and many labor and delivery nurses were also familiar with it. We found that such cases could safely resolve themselves, without medical intervention, by waiting for labor to resume in less stressful circumstances. Looking deeper into medical books written during the period when home birth was the norm, I found many 19th century authors who had also documented this physiological phenomenon, which is dependent upon an imbalance of maternal hormones during labor which can take place when the woman feels greatly stressed during the birth process. If current medical knowledge included these concepts which it once did, fewer women would be subjected to the risks of induction drugs, the use of which has increased sharply over the last fifteen years—not always with good results. (9)

Of course, this is not to say that women should be required to have home births. However, the option to give birth in the place of choice should be open to those women who desire it, as long as their physical condition permits it as a safe choice. The body of knowledge available to all maternity caregivers depends upon a full range of choices being available to childbearing women.

Notes

1. Ackerman J. The downside of upright. National Geographic July 2006, 126-145.

2. Gaskin IM. Spiritual Midwifery (1975) Summertown, TN: The Book Publishing Company.

3. Meenan A and Gaskin IM, et al. A new (old) maneuver for the management of shoulder dystocia, The Journal of Family Practice, 1991: 32:625-29.

4. Bruner J and Gaskin IM, et al. All-fours maneuver for reducing shoulder dystocia, The Journal of Reproductive Medicine, 1998; 43:439-43.

5. Gabbe SG, Niebyl JR, and Simpson JL. Obstetrics: Normal & Problem Pregnancies, 4th ed. New York: Churchill Livingstone, 2002.

6. Curtis P. A comparison of breast stimulation and intravenous oxytocin for the augmentation of labor, Birth, June 1999; 26:115-122.

7. Curtis P. Breast Stimulation to Augment Labor: History, Mystery, and Culture. Birth, June 1999; 26: 123-6.

8. Gaskin, Ina May. Understanding birth and Sphincter Law, British Journal of Midwifery, Volume 12, Number 9, September 2004.
9. Wagner M. Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First (2005) Berkeley, CA: University of California Press.

A Chance to Do Something I've Never Done Before or Is this What it is Like to be a Nurse?

One morning recently I was getting ready to go to a La Leche League meeting when the phone rang. It was another doula, a friend, and she needed some help.She was stuck at an airport far away and one of her client's had just called to say her water had broken. Unfortunately her back up doula had been at another birth all night. Would I go to the birth? Of course! My friend said she would connect with her birth client and let them know I would be calling.

So as I pulled my pick up truck onto the freeway in Pismo Beach I answered a call back from the dad. He was fairly calm. We discussed how mom was doing. He said she was in labor but handling contractions well. I asked if he wanted me to come right over to their place? No, he thought I should go on to my LLL meeting as planned. I asked if I could talk to her? When he took the phone to her I could hear the labor sounds she was making; a deep breathy moan. Hmmmm...I'm thinking. Then dad came back on the phone and said she couldn't talk now. Hmmmm...I'm thinking. He said he would see me when the meeting was done. Hmmm...as I drove towards SLO I'm thinking that didn't sound like a mom in early labor. Hmmm...My gut said I don't think you're going to League today. So I drove past SLO and on over the grade to their place.

Driving down their windy country road I wondered what this would be like. I had never supported a woman I had never met. Usually I have spent many hours with my moms sitting in their homes, chatting, educating, answering questions, calming fears, instilling confidence and creating relationship. As the birth nears I become a unique blend of confidante, experienced guide, friend and mother hen. So I wondered what would this be like? Could I be effective? Would she respond to me, a total stranger?

When I pulled into their driveway dad came around the corner with a puzzled look. I introduced myself and he visibly relaxed. He took me to the sunny deck where mom sat leaning back in a chaise lounge looking very uncomfortable and obviously contracting. After the contraction subsided I introduced myself and told them their doula was very sorry she couldn't be there with her. Then we got down to business.

I suggested she would be more comfortable in a different position. Could I help her move? After getting her into a leaning forward position I began to gently rub her shoulders as I assessed where she might be in her labor by the rhythm of the contractions, her response to them, her flushed face and unfocused eyes. I thought either this was going to be a long difficult posterior labor or things were moving very quickly.

"When had she last been to the bathroom" I asked? "Could she try to do that with me?" We slowly worked our way through the sliding glass door and into their bedroom. From the deck across their bedroom to the bathroom counter was 3 contractions. We never made it past the bathroom counter. Leaning onto its' smooth surface with me giving sacral counter pressure she swayed and moaned and contractions flowed through her like a torrent.

I turned to dad and calmly asked when he had spoken to their midwife and what she had said. He informed me that she said she would come some time this morning and check how things were progressing. I instructed him to call her again and tell her I said it was time to come. He left the room.

Alone together my hands sent waves of quiet calm into her being. Then I felt her knees begin to buckle with the power of her contractions. Her body was being lead in the primal birth dance, rocking, swaying, head rolling, opening to the flood of sensations that would bring her baby. Having been a birth dance partner for many women I could sense where we were in our journey together, so I was not surprised when I heard her give a soft grunt with the next contraction letting me know her uterus was pushing.

Dad came in and I inquired what the midwife had said. "She's on our road" he announced. "and will be here any minute." I breathed a sigh of relief. I am a doula not a midwife. I am not trained in catching babies. I have non of the necessary equipment. A few contractions later the midwife walked in, assessed what was going on and calmly went into action readying her supplies, talking to the mom and dad and smoothly stepping into the primary support role.

Usually a midwife has a trained assistant but it was clear to us that this baby wasn't going to wait for an assistant to arrive. As best I could I worked with the midwife, getting supplies, holding things, and handing things, while at the same time talking to the mom to give her confidence in her abilities to birth her baby, taking photos, and guiding dad into positions where he could remain a connected part of the process. Very soon a beautiful baby girl emerged into this world and into her moms waiting arms, healthy and happy.

I continued in my new dual role during the mother's repair and clean up, alternately fetching for the midwife, stroking mom's hair, taking more photos, cleaning up their rug, putting their towels in the washing machine. Finally it was time to go. Mom, dad and baby were in bed glowing and in love. Food and drink were at hand, family was arriving. They thanked me once again for being there, for not listening to dad's suggestion to go ahead to the League meeting and for everything I had done. Then I walked out of their door.

It has taken me weeks to process this new experience. I still don't know why she listened to me. Why she willingly followed my every suggestion. Why did she have confidence in me?

Is this what it is like to be a labor & delivery nurse? You walk into a room with people you don't know and yet you need to be able to guide them during one of the most intimate and intense moments of their lives. You have to assess where the laboring woman is in the process in order to call the doctor or midwife to come in time for pushing. When they arrive you have to support the mom at the same time playing step and fetch it for the doctor. When it's all done the family walks back out of your life and the connection is broken.

I can tell you I have worked along side some excellent labor nurses. Women that have known how to seamlessly flow from one role to another. The best ones are able to instill confidence and a sense of caring within minutes of entering the room. They are able to enter a room without disturbing its' energy or the rhythm of the labor. They listen to the mother as she progresses through labor and will try to encourage the doctor or midwife to honor the mother's wishes for her birth. Apparently I have learned a lot from these wonderful nurses.

Of course I have learned just as much from struggling with nurses that do not have an aptitude for being with birthing women. They don't generate the right kind of energy for laboring with a woman.

A good doula or nurse needs to be able to emanate confidant guidance without taking control. Their presence needs to create a sacred space in which the woman feels secure to birth. They become the mother's sanctuary in the storm. Now I know this can happen within minutes of meeting if the labor guide brings an open & intuitive heart to the birth.

A Quick Homebirth

Baby's First Latch
I love catching this precious moment on film. Welcome Desiree!
Born on 8/9/10

We never know how birth will go. At classes we try to prepare first time parents for the idea that things can go very quickly, the 50 yard dash babies, or very slowly, the marathon babies. Accepting whatever you are experiencing and going with the flow is the important thing. If a couple is having a fast birth the dads are often left one step behind because they were mentally preparing for a marathon. When the baby arrives they are astounded! It's done? The babies here? How can that be?

Desiree James was born at home one unassuming Monday morning. Daddy went off to work. I mentioned that I was feeling "A little uncomfortable". Two short hours later my water broke and I called him back. I laboured quickly. Like Superwoman, Jennifer arrived and gave us the leadership and support we needed. I was having surges so closely together that my partner was unsure of how to help me. Jennifer immediately helped us into a more suitable birthing position. She used her calming voice and loving hands to ease our labour and reassure our progress. What a magical day it was. We had our baby girl in our arms, and all in the comfort of our own home. Thank you Jennifer for your professional and loving care!


There is nothing sweeter than being able to tuck a mom, dad and baby into their own bed after the birth is done. Leaving the house cleaned up, food available and supportive family at the ready feels just right. I'm a believer in what Dorothy said, "There's no place like home. There's no place like home. There's no place like home."

The Challenges of Being in Labor While Being a Mommy

I love this humorous account of a local homebirth. The humor comes from her no nonsense down to earth truth telling about the challenges of laboring and mothering at the same time. This is one of the difficult parts of having another baby. Women don't get the luxury of stopping motherhood while pregnant, birthing or recovering. No matter how many times I tell my experienced moms to have things arranged so you can drop everything, including your older child/children and zoom to the hospital I always arrive there before them! And then there is the issue of assuming this birth will be like the last birth; right? Enjoy Kelly's story!

Our little Alubia (bean in Spanish) was born on Aug.27, 2010; weighing 6 lbs 14 oz and measuring only 18 ¾ inches. She’s soooo small, but so cute. She has a full head of black hair and adorable chubby cheeks. We have named her Maui (Maria Luisa) and sometimes manage to NOT call her Alubia. Thanks, Maui, for the name.

Her birth story is very different than I imagined it would be, but it is still perfect (well, mostly). It turns out this labor stuff is complicated and having had a child only makes it more complicated. Who knew? This is the way things are supposed to be with a second birth: 1) The mother should know when labor starts. 2) The mother should remain calm during labor, because after all, she’s done this before and should be able to relax and breathe correctly. 3) The first child is NOT supposed to randomly start vomiting once labor starts and need his daddy. 4) The mother should be able to handle labor just fine if the father is temporarily needed by the older child. You know, the !Kung women only have birth attendants with their first child. After that, they go into nature and give birth alone and walk back to the village. So what’s a few contractions with no hubby, right? Well, none of that worked out well for me. And, I’ve also found out that the fact that everybody says that second labors can progress rapidly once they actually begin actually has a bit of a negative spin. They can take forever to “actually begin” and you should probably simply store your birth personnel (midwives, doulas, babysitters) in the garage or office or something so that everyone is ready to go right when you need them.

So here’s how it started. Wednesday at noon, I went to put Xavi down for his nap, but just couldn’t. I had absolutely no way of keeping my eyes open. So I pulled out a comforter and pillow and lay down on the floor and tried to convince him to nap with me. No such luck. Under those circumstances, he wants to lay on top of you with you on your back and I just couldn’t do it while pregnant. Finally, I texted Eneko to come and put Xavi down for his nap. He did and then returned to work while I went and laid down. And then started vomiting and having very continuous Braxton Hicks contractions and feeling like I was going to die. So he returned home and worked from home, watching Xavi while I made friends with the toilet (like we haven’t spent enough time together during this pregnancy). I felt so icky and wretched, way worse than with any stomach flu I’ve ever had, but a little like I was in labor, but not for any real definable reason. Kristi came over to check me and said not yet and drink the following liquids and we all went to bed (not together, she went home, obviously). A little later that night, the vomiting and ickiness went away and real contractions began. So that happened for most of the night and by morning, I was sure the baby was coming that same day, on Thursday. So when Eneko woke up, I told him the good news and we started getting the house ready for the baby and then I went to lay down to rest between contractions. It was wonderful. I let Laura, our doula, know what was happening and that we would call her when we needed her. Meredith, our babysitter, was able to get her in-laws to come care for her son until when her husband got off work and she kept me company until Megan could come check me and tell me… ehhh, maybe it will turn into active labor, but maybe not today since it was in the early stages. Stay hydrated, well-fed, rested and probably tonight, after Xavi was in bed.

Discouraging, but Eneko, Xavi and I decided to do those final things before the baby arrived. We ate lunch, went to Trader Joe’s to get some stuff, got Alubia’s birthday for Xavi present from Whiz Kids (love that store!!!), went to Doc Burstein’s one last time to get ice cream (I imagine I will be dairy-free with this little girl too so gotta eat the good stuff while I can) and then came home to rest while California Pizza Chicken (according to Eneko) was delivered. All this time, I was having fairly regular contractions that were pretty strong and I was doing a good job of relaxing during them, visualizing progress and all that good stuff. And on Thursday night, NOTHING! No baby snuggling in bed with us when we woke up in the morning on Friday.

So after a contractiony breakfast, the decision was made to send Eneko to work. Who knows when this labor will start so we’re going to have to go on with our lives, just pausing to breathe every little bit. Xavi and I went to gymnastics and the contractions were pretty controllable while we were there and then we came home, prepared dinner and had our naps and our lunch (staying rested and well-fueled like advised). I was pretty miserable by now, but didn’t want to waste my last days of one to one attention with Xavi, so we went to Avila Valley Barn to feed the animals, ride on the tractor and get some "I-sheem." That tractor ride almost killed me. When we got home it was close to five, so we finished dinner and then sat on the sofa to read (Xavi is in the phase where he loves to have marathon reading sessions, having you read a book to him over and over and over and then choosing another and having you read that one over and over and over. Up til now this had been great for pregnancy because how often do you get to sit with a toddler???). By now, I’m moaning through the contractions and trying to read to Xavi. “A cow says Moo, A sheep says Baaa. Three singing pigs say AHHHHHHHHHHHHHHHHHH” and Xavi is getting upset and crying because that isn’t how the book goes and Eneko sends me a message saying he’ll be staying a little late to finish some stuff and I’m about to cry… But we survived that extra half-hour with no daddy and when he got home, he took Xavi on a bike ride and I got to have a few contractions without someone crying through them and flailing on my lap. Things seemed bearable once again. Eneko would be home all weekend and hopefully we would have a baby. Then during dinner, Eneko tells me about all the stuff happening in the office that weekend and I start freaking out. If he needs to work, he needs to work. Life can’t stop because I’m having contractions. But SERIOUSLY, it is sooooo hard caring for a toddler and having contractions. Should I call Sabrina to watch Xavi Saturday? But she needs to move and it’s her day off and she has her own family to take care of. And what if this goes on for days? weeks? It’s getting reaaalllly hard to relax during the contractions since it was getting really hard to relax period! And when you’re tense, they hurt so much more. And I was getting to my mental breaking point.

So my poor husband is trying to help and he offers to call one of the midwives to examine me and I say no, we have to wait until we are actually in labor. He offers to examine me and I say, no. Then I change my mind and decide that once Xavi is in bed, that would be a good idea and then I went to moan my way through the contractions in bed while he put Xavi to bed. By the time Xavi was asleep, I was so restless, moving from the ball, to walking, to laying on my side and just not feeling too great anywhere, knowing it was my fault, if I could just relax I wouldn’t have a hard time. So Eneko, around 8:30, checks and he says, “Not a 2 or a 5. A 3 or 4.” And I almost cried. Or maybe I did. Can’t remember. If it’s a 3, that means NOTHING. But if it’s a 4, then we’re in labor. But what if it’s a 3 and I stay like this for weeks???? He calls Kristi, against my advice, and reports his findings and asks for someone to come. And says he will set up the birth pool. I’m dead set against this, because, what if I’m not in labor? He wants to call Laura and Meredith too and I say no! And then beg for the pool because I can’t take it anymore and I need something to help. So he sets up the pool and it was like heaven getting into the warm water, but I still couldn’t relax because now we had an inflatable pool set up in the dining room in a house with a toddler and a cat (what could possibly go wrong there?) and what if this wasn’t even labor and if you can’t relax the contractions hurt and aren’t as effective which causes you to tense up more, which causes them to hurt more.

Poor Eneko is doing all of the last minute birth preparations for the house and wanting to call in reinforcements and I’m still saying no, not until we know for sure. Around 10, Megan and Edana arrive and begin unloading all the equipment for the birth and I am soooo frustrated because they might just have to pack all that stuff up and take it with them. I had thought one person would just come and do a quick exam. But, it turns out, surprise, it was labor. Finally Eneko gets to start calling help when Xavi wakes up. So Eneko is trying to call people and things aren’t working out. Meredith’s husband is working that night of all nights and Sabrina has to bring her little girl who is throwing up and he didn’t want that because it’s contagious. Turns out, I had understood that incorrectly. The reason Xavi kept waking was because HE was the one who was throwing up (probably what I had on Wednesday). So no babysitter. And I am freaking out again, because I really needed Eneko to help ME but it turns out it is hard to arrange for childcare via telephone while taking care of a vomiting child and massaging your wife’s back in the birthpool at the same time. Why isn’t there an app for that? Everything else seemed to happen in some kind of crazy blur. It seems like Laura, Meredith and Sabrina arrived about the same time, right when they were needed most and Eneko was able to focus on one thing, me, since Xavi was now in good hands :). Things were moving so fast at that time, or at least it seemed like it from my perspective. The contractions got crazy strong very suddenly and for two or three contractions it was really overwhelming and then we adjusted and the birth went on well. But certainly not gracefully. I was never really calm or centered or focused, even having to be reminded to breathe on way more than one occasion. I remember Xavi’s birth as being so peaceful but this one I think I will remember as more chaotic (entirely my own fault though). I think she was born just a little while later, totally covered in vernix, but adorable. And then we got those great moments you dream of in your pregnancy: time has stopped, you’re sitting in the pool, holding each other and your new baby, not feeling like pushing out the placenta, but knowing you will have to. And, yeah, after she was born, I was informed that it had indeed been labor :)

Anyhow, everything ended up perfect and everyone came through and then some, making our night exceptionally special. We got some amazing pictures, though all seem to have some kind of nudity, and it was great to see how my friends who had come to take care of Xavi ended up helping out with everything, as did our doula. It was so wonderful to birth our little Maui among friends.

Now I have a feeling that if we have any more kids, I will not be allowed to participate in any decisions about phone calls. So unfair! I only messed up one time. Like the one time (our first “date”) when the action movie we went to see ended up being a graphic (or pornographic depending on your definition) movie about gay bank robbers. And now I’m not allowed to choose movies for us to go see anymore. People should really get more chances in life.

Home Birth... Why I Did It (& I'm Not a Hippie)

Not sure about where to birth, hospital or home? When trying to decide where to birth I always advise my clients to look deep into their hearts and listen to what it is telling them. Where will you feel safest? For some moms that is the hospital and for others it is at home.

Recently I had a client who was preparing for the birth of her second child. She was having a difficult time deciding between Sierra Vista or French Hospitals. She had a lot of negative feelings about her first birth but was choosing to return to the same hospital, even though she dreaded it, because of fears about safety issues for her baby. Her heart was conflicted. I encouraged her to listen to her heart and decide. She planned to return to the hospital of her first birth. That was the plan. It was all settled. Everyone knew that was the plan . . . until she was on the way to the hospital. Then her heart spoke to her again and said, "you have nothing to fear for your baby. She is fine and healthy. Go to the hospital where you think you can labor best." And that is what she did. She changed her plan.

Read one Illinois mom's thoughts about making her choice posted August 4, 2010 on Ireport at CNN.com

I gave birth to my son at home.

And no, I’m not a hippie. I’m a college educated, business minded woman who made an informed choice about the labor and delivery of my second child.

Giuseppe Massimo “Max” entered this world at 11:46 pm on March 4th, 2010 in our bedroom of our Northbrook, IL home. I wouldn’t change a thing about the labor and delivery. It was one of the most incredible moments a family can have. I’d like to tell you a little more about what led up to that special moment.

When my husband and I first learned I was pregnant a second time, We weren’t even considering a natural birth, let alone a home birth. My first child was born in the hospital, I had been given an epidural, and I just assumed I’d do the same for the second. A few months later I learned that one of our neighbors had delivered all three of her children at home. I’m sad to say that my first reaction was “why in the world would anyone ever want to do that??” But something kept creeping up in my mind, I was truly intrigued by the idea. A few weeks later I talked with a friend who had done a natural birth. I’ll never forget the day when we met over coffee and I heard her birth story and the emotions she had around her natural childbirth. I was amazed by her story and yet sad when I realized my feelings about my first birth were nowhere near that happy, passionate or memorable. Don’t get me wrong, I love my daughter dearly, but her birth was not as I had always envisioned. I then started to open my mind about the idea of natural childbirth and began doing some detailed research. What I found both elated and saddened me. I was thrilled to learn about all of the wonderful benefits for both mom and baby when childbirth is left to naturally run its course. But I felt so dismayed that the majority of women are never exposed to this information. They don’t really know they have a choice. Society puts so much pressure on them to have a fast labor, make sure it’s painless, and get in and out of the hospital quickly. There are so few natural birth advocates out there, likely because hardly anyone is doing it as its not likely to be covered by insurance or endorsed by your OB/GYN. Plus there’s a stigma. As I mentioned, I’m not a hippie, but everyone assumes you are some free lovin’, incense-burning, crazy lady that has no regard for her or her unborn’s health when you tell them you are having a home birth. The reality is that for healthy women with no pregnancy complications, natural childbirth is much safer and healthier for both mom and child (when the birth is attended by a certified midwife). If you think about it, people go to hospitals because they are sick, childbirth is the only thing they go there for that is a completely natural process. Why is that? Well, it all has to do with the mighty dollar. It’s a big business and insurance companies and doctors solve for the riskiest cases, and then apply that logic and methodology for all. Patients assume this is best, but its simply not. History has shown this time and time again.

I encourage you to do your own research on childbirth, but I’ll give you a bit of the basic info that I’ve learned over the last year. There’s more to childbirth then simply getting the baby out. A complex chain of events occurs with the mom and baby as labor and delivery progress. When left untouched, natural hormones enter the mother and baby that make the birth easier for both and also create a stronger bond with mom and baby. Natural birth babies are more responsive and much more likely to successfully breastfeed. Passage through the birth canal helps squeeze all of the fluids out of the baby’s lungs enabling better breathing after birth. The benefits of natural birth go on and on, all leading to a happier, healthier baby and mom.

So, why at home then? Sure you can have a natural birth in the hospital, right? Not always. You may go in with a birth plan, but hospitals have their own agendas. They minimize the risk and get you out quickly so they can get a new mom in. With 1/3, yes ONE THIRD of women in the US now having c-sections, I didn’t want to take my chances. The rate was under 5% in 1965 when hospitals began to keep track of the numbers. Now it’s over 30%! What happened? Well it’s not that women are smaller, or babies are that much bigger, it’s now a matter of convenience. But not for the mom, its for the hospital, doctors and insurance companies. C-section rates are actually highest at 5 pm and 10 pm. Why? So doctors can get the birth over with and get home for dinner or bed. They can opt for the c-section and be out of the hospital on their way home in less than 30 minutes. And at that point, weary moms are likely not to argue. You simply assume the doctor knows best.

I’m guessing that even with my natural birth plan, if I had been in the hospital I would have ended up with Pitocin (drug used to speed up labor, but reduces the mom’s natural birth hormones) and likely a c-section. At home it took me 30 hours to labor Max down. And at 9 lbs, it took me over an hour of pushing. Likely not something a doctor would have the patience to wait out. But my midwife stayed calm and relaxed, she knew the baby would eventually emerge. She was a great coach and I felt confident she had the experience to handle any situation. This is important to note, as I don't believe in unattended home births. A home birth should always have an experienced midwife present.

And sure, it was painful, REALLY painful. But the instant my son was born, I felt 100 times better than I did with my first baby. My connection with him was instant and he immediately latched on to breastfeed. My husband also enjoyed the experience much more at home. First, he always wondered why I didn’t seem to show a strong connection with my daughter when she was first born. With Max he was in awe of the immediate deep bond. Additionally, he was able to really participate. He was able to help much more at home and actually catch the baby as he emerged. Plus, we all got to sleep in our own bed that night. We wouldn’t trade the entire experience for the world.

My hope is that by sharing my story, I may encourage at least one mom to do her own research so she can make the best decision for her childbirth experience. Women need to start reclaiming their baby’s births. I’m certain almost all women are capable of a natural birth, and if they take back that right, we will have healthier and happier moms, dads and babies out there.

What speaks to your heart? Where will you feel safest?