Home Birth Advocates Triumph Over Opposition

In the beginning of December, 2009, a friend shared a link with me to an article Oprah's website about alternative birth methods. The informative article covered the pros and cons of birth centers, home birth and discussed the growing numbers of women who are searching for a more "hands on" approach to prenatal care and labor. They were doing so by seeing midwives, hiring doulas, and over all becoming more involved in the process of learning about and planning for their birth. Hurray to self-advocacy!

After reading the article and scrolled down to the comment section. Just published, there were only three. One in particular, stood out strong. I'd seen her work elsewhere online and shuttered as I read her anti-home birth claims. This woman's (a retired doctor, actually) view of birth is that it is so "inherently" dangerous, that she's actually on a campaign against home birth.

I had to write something. Had to push back.

I couldn't stand the thought of women being scared out of the option to birth at home because of one woman's opinion. Unfortunately, there were a limited number of "characters" or words, one was allowed to post. So I did what I had to do - I wrote up a short version there, and a longer version at my blog at My Best Birth. I used the doctor's name in the title of the post, hoping to draw her out of the 'internet woods' to see and comment on the article. I knew if she had Google Analytics, she would be notified that her name was typed in my blog, bringing her attention to the My Best Birth (< that is a link to the article) community.

Well, it worked. The same day, there was Amy, commenting on the post. This was December 3rd. Over the days, and weeks a passionate discussion unfolded. I watched, stunned as the thread hit 100 comments, 200, and finally resting at over 330. Ricki Lake sent me a private message thanking me for taking the subject on and Tweeted the link to her fans. Countless contributors shared their thoughts, bringing the community of home birthers together tight through arguments and bitterness, insights and a lot of new information was brought to light.

For now, it seems the debate has come to a close. I made the last comment, taking stock and making a summary of what we'd learned. Here it is:

"Whew, Amy, you are piece-of-work. Seriously...did you read my entire post or only what you wanted to read in order to post this trash? I didn't actually say that we "won." Here, I'll re-post if for you:

"...but there is definitely improvements to be made in the educational standards to make sure ALL midwives are providing safe care to their patients. And we have agreed that there is also much work to be done on the hospital front. We've also come to the consensus that the relationship between midwives and doctors needs to be improved for the complete well being of mother/baby.

Until these measures take place (and it will be a long process, but we should PUSH for all of it!) we can only do our best to encourage new mothers looking into home birth to do their due diligence when finding a midwife by spreading information - by being teachers and "mothers of mothers" both online and off."

I even went on to thank you for your participation (through clenched teeth, might I add).

Let us agree to disagree. Because, for one, we don't believe childbirth is inherently dangerous. That's just not the first thought that comes to mind when thinking of childbirth or labor. We like to think of it as sacred, special, intense, challenging, beautiful, natural and have respect for the process.

Throughout this conversation, our eyes have been opened to the shortcomings of home birth and hospital birth, thus we have come to the consensus that there is much work to be done and we will be steadfast in advocating education and research.

You stand alone, unwilling to compromise, see other's points of view, empathize with personal situations, nor will you shed light on how to make birth better for women in any environment. You're not helping anyone by being this way. Far from it. You're alienating yourself from a community of women who otherwise might have had something to gain from your knowledge. I for one, have no respect for your authority. I thanked you for being a part of this dialog because it forced us to look deeper and search for reasons to believe in the betterment of the care of laboring women.

But gawd, enough is enough now. Once again, have a Happy New Year everybody!"


We'll see if the conversation ends there. Somehow I have a feeling it might not be over yet...

The Best Gift of 2009

A lot happened in 2009. We say that every year, but it's true. So much happens.

Last Christmas, I was pregnant and planning and anticipating my due date a little over a month away. This Christmas was our daughter's first. She played more with the wrapping paper than the gifts.

As I look to the coming year, there is much to look forward to. My fiance is working with a company who plans to launch a new product of which he'll have a percentage of ownership. I'm looking forward to experiencing Portland Spring, and with it the visit of my grandmother and mom, and perhaps even my mother-in-law to be too.

It is going to be a year full of new. Ella will walk. Begin saying more words and comprehending life's complexities at her alarmingly fast rate. Then she will run...and near the beginning of August we'll move back home, once again sharing our little girl with the rest of our families.

August is always a special time for one reason: Harrisville. A family tradition since I was 14. I don't think I've ever looked forward to the trip more than this summer because Ella will be there. She'll be sitting on Daddy's shoulders as he wades in Lake Huron. Joining us 'round the campfire and the ice-cream shop. Ella makes everything more fun.


I don't have any supreme goals for 2010. Just to keep trucking on, learning about myself and "getting better." As special of a year as it will be, 2009 will always have a special place in my heart - the year when life's greatest gift was given: Ella Rose Walker was born.

A Friend's Prenatal Experience - What Have Midwives Become?

Talking to a good friend on the phone after not talking for a while sure feels good. This was the case for me this evening; the phone call lasted just over an hour and we had a blast chatting and laughing.

My friend, we'll call her 'M,' is pregnant with her first. Like myself, she's carrying a "love baby," one who came along as fate intended.

M was the friend who came over on the afternoon that my contractions started to burn me music to listen to during labor. She and I timed them together between conversation and giggles of anticipation for the next. It was such an exciting time.

Now 6 months pregnant herself, she's anticipating her own start of labor, thinking about it often, as first time mothers do. She's thinking about having a home birth. Says I've really inspired her with the way I did things (you can read about my home birth story). But of course, that is not the only reason why she (and her husband) are planning for this option. She can't imagine being able to relax in a hospital. That's a big sign that she won't be laboring there - it's how I felt when trying to picture it...I couldn't even picture it. Neither can she.

Many women where she lives (and where I lived when expecting) are often referred to who I will call Mrs. Finch. "Oh, are you going to Mrs. Finch?" is a commonly asked question in those parts. She's a popular midwife who works with two other midwives in a local hospital. These are who M is currently seeing for her prenatal care.

Upon meeting Mrs. Finch, she asked M if she was looking forward to her due date and how she felt about it - whether she was nervous and/or excited. Of course, M said excited and a little nervous, as is natural for a first time mom who doesn't know what to expect from labor (and labor and delivery are always met with a mixture of these emotions). Mrs. Finch replied, "well don't worry, we have plenty of drugs."

Huh? That calls for a "whoa, wait a minute..." No discussion of whether M is planning for a natural birth or how she feels about induction. Just, "we have plenty of drugs." Outrageous! I still can't believe it. And this came from a midwife!

So M is looking into home birth. I'll keep ya posted.

A Place to Read & Share Home Birth Stories

Bring Birth Home is a site I created to empower and educate women about the choice and option to birth at home through home birth stories, video, art, pictures and other general home birth information.

Home birth is as safe as hospital birth for low risk women with a qualified and experienced midwife. Read more about the three different types of midwives to choose the right care provider for you.

Read through several women's home birth stories at the blog. They are beautiful and inspiring. Many of these women are now my friends through this mutual passion grown from the experience of birthing at home.

Have you had a successful home birth story and would like to share it on the site? I would be honored (dads perspective is welcome too!).

Please email me your story, with pictures: kaitlinrose@bringbirthhome.com

The Birth of My Child - A Poem

No blue hospital gown. No sterile drapes.


When I give birth, I want to be naked. No enema. No antiseptic wash. No shaving of pubic hair. If I wanted to shave something, I'd shave my head. Like Jean-Luc Picard. I've always wanted to be captain of a star ship.


When I give birth, I explore uncharted territory, I move and writhe into new worlds. I want to go where no man has gone before.In 1872, an English doctor named John Braxton Hicks discovered pre-labor contractions. This was sort of like Columbus discovering America. Some people already knew it was there. 


No drugs. No epidural. I want to feel the baby moving, his hard head pushing through layers of me. My bones shifting, my uterus contracting.  


I want to feel birth. I want to know fire.  


No episiotomy. No amniotomy. I don't want anything that rhymes with lobotomy.  


I prefer to stretch slowly, burning in a rim of panting breaths, around my baby's head.  


No Pitocin drip. No synthetic hormone to stimulate labor. Let my baby choose his own birthday. My body does not recognize the ticking of the clock on the wall.  


I don't want to control my body. I want to surrender. Let the pulse of that unborn voice throb through me.  


I don't want a needle stuck in my hand. If my labor slows, I prefer to get my hormones the primitive way.  


No electric fetal monitor. I don't need a machine to tell me how my baby is doing.  


He kicks, he twists, he somersaults inside of me.  


No bright lights. No noise. No softball cheers. Don't give me instructions. My body knows what to do. 


Birth is not a team sport. I don't want a coach.  


I want my husband's presence. His hands to grip. His arms a sling to lean the baby bulk against. His face a mirror in which I can watch my baby emerging.  


No stupid jokes. No cheerful chatter. No television, please. I want to listen to the moans rising in my throat.  


No delivery table. I am not a plate of spaghetti. Let me give birth on the bed. A table works fine for conception, but it's way too hard and far too awkward for birth.  


I know what I want for my baby. No nursery. No pacifier. No bottles. No crib. No cheerful, white-coated, well-scrubbed, briskly walking, thermometer-wielding nurses, please.  


Let the baby sleep against my skin, nurse from my breast, wrap his wrinkled blue limbs in the heat of my body.  


Nothing intrauterine, nothing intravenous. I prefer to give birth in simple words. Breathe. Push. Touch. Pain. Wet. Stretch. Birth. Yes.  


A woman knows.  


The mystery is too overwhelming.  


When the baby's head crowns, I want to touch the wrinkled scalp. I want to cradle the head in my palms while he is still inside of me.  


My moans will be the guide I need to pull him out of myself.  


Hot compresses.  


Yes.  


Dim lights, a bathtub of warm water.  


Yes.  


Hands massaging me.  


Yes.  


My husband lying next to me, solid to lean against.  


Yes.  


The smell and feel of a slippery newborn baby wriggling against my naked skin.  


Yes.  


This poem was shared with me by a friend.

Ina May Gaskin Interview

2006 interview with Ina May Gaskin, author of Spiritual Midwifery,Ina May's Guide to Childbirth, and Ina May's Guide to Breastfeeding.

She is often called the "world's greatest midwife." Here is the interview:

How do you define "midwife"?
IMG: A midwife provides prenatal care and education, attends women as they give birth, and cares for them and their babies during the postpartum period. In hospitals, sometimes some of these jobs are performed by nurses or pediatricians.

How did you become a midwife?
IMG: My first birth took place in 1966, and I was very surprised to find out that as a first-time mother, my obstetrician was unwilling to allow my baby to be born without medication. This was because he intended to use forceps (whether they were truly necessary or not), because most US obstetricians then believed that this was safer for mother and baby than allowing the normal birth process to take place. This idea was obviously revised a few years later, but I had no choice in the matter for this particular birth. Because I was a graduate student in English literature, I was aware that many women and babies had been injured during forceps deliveries. Besides, I was sure that women's bodies could function better than my obstetrician had been taught they could. That whole experience really opened my eyes to how little scientific evidence underlay the obstetrical beliefs and procedures that were commonly used.

Around that time, I heard a few women tell their home birth stories. Invariably, these were empowering stories. I was awed by these women who found ways to give birth at home — most of them pressured a friend, who happened to be a labor and delivery nurse, to sit with them during labor. After hearing a couple of women's stories, I knew that I wanted a home birth myself and that if there were any way for me to become a midwife, I would like to be one.

It wasn't long before I had a chance to observe my first birth. The woman refused to go to a hospital and wanted me to stay with her. Her husband was prepared to catch the baby. I was lucky enough to see what seemed to me to be a short, relatively easy labor that ended with a perfectly healthy baby. There was no time to be worried during labor because it went so quickly.

There were several other women who were aware of this birth, and when it was finished, it seemed that they were ready to regard me as a midwife. So, one by one, these women gave birth, and after the birth of the third baby, I was offered a seminar in emergency childbirth by a generous obstetrician. That seminar prepared me for the birth of the fourth baby, who needed resuscitation at birth and his mother, whose bleeding had to be stopped just after birth.

How did the Gaskin Maneuver come to be?
IMG: About six years after I began assisting at home birth, I had a chance to go to Guatemala to do some development work following a tremendous earthquake. While there, I met a midwife, who happened to be the district supervisor of indigenous midwives. These indigenous midwives were too poor to have been able to go to school, so they were illiterate. However, the district midwife, whose midwifery education had taken place in Belize, along the lines of the British model, told me that the indigenous midwives had a better technique than what she had been taught to deal with the much-feared complication when the baby's shoulders get stuck after the birth of the head. She told me that instead of twisting and trying to rotate the baby, they merely got the mother to turn over from her back to a hands and knees position with her back arched. This change of position usually solves the problem of stuck shoulders and the mother is able to push her baby out without further ado. Occasionally, additional maneuvers are necessary, such as delivering one of the arms.

I have had several obstetricians tell me that the positional change was the only technique that freed a badly stuck baby.

What are the big challenges midwives face today?
IMG: Currently, midwives in the US are attending only 10 percent of all the births. About 1 percent of these take place at home. When there are such low rates of midwife-assisted birth and out of hospital birth, there is automatically a great deal of fear and ignorance about allowing labor and birth to proceed without disturbance. Most nurses and physicians never see undisturbed birth during their training period. This makes them unlikely to allow it, even if their hospitals would allow such deviations from the usual way of doing things. Add to this a for profit medical industry, with little or no accountability built into the system and a situation in which insurance companies and hospital chains have more influence in creating medical policy in certain areas than physicians (and certainly midwives) have, and you have a recipe for too many interventions in birth and rates of infant and maternal mortality and morbidity that are getting worse instead of improving.

Nationally and internationally, the biggest challenge is that women of the current generation no longer (for the most part) have a healthy fear of unnecessary surgery. This opens the door to an ever-increasing use of cesarean, which is now increasingly being performed for non-medical reasons, even though good data show that this trend could triple or quadruple maternal deaths.

As the cesarean rate rises higher and higher, obstetrical skills that were once considered essential can no longer be passed on to the next generation of physicians, and with the loss of these skills, certain categories of births which could once have been delivered vaginally must be cesareans because of the lack of obstetrical skills.

What are some new trends in midwifery?
IMG: One new trend in midwifery is that more and more nurse-midwives are beginning to attend home births in cities in which hospital midwifery practices have been closed down. For more information, see www.midwife.org

Another is that certified professional midwives have become legal in two or three new states, bringing the number of states in which certified professional midwives can work up to 25. For more information about this, see www.narm.org

Care to discuss your work with the Amish community?
IMG: Our midwifery center is located a few miles away from a large Old Order Amish community that consists of approximately 1500 people. Women in this community continue to plan to give birth at home. When we first moved to Tennessee, these women were assisted in birth by a family practice doctor (now deceased), who eventually handed his practice over to our group of midwives. Some of the women in this community give birth attended by our midwives, while others are assisted by midwives who have emerged from their own community (who were taught additional skills and procedures by our midwives in order to improve their safety standards). Women in this community are not allowed to practice any form of birth control, so it is common for women to have as many as 12-14 babies. Fortunately, cesareans are rarely needed for this group of women, as they place a high priority on their ability to give birth at home. (Amish people have no form of health insurance, as they will not accept any form of coverage that is means-tested).

Why is labor important?
IMG: Labor is important, because during labor, both the mother's and the baby's body is prepared for birth. The levels of certain hormones rise and ebb during labor. For instance, the mother's oxytocin levels rise markedly just before the baby is pushed out of her body. This protects her against postpartum hemorrhage. High oxytocin levels in the mother (which are accompanied by higher levels in the baby, too) prepare the nervous systems of both to be attuned to each other. This creates a special "sensitive" period during which these special hormones remain at high levels in undisturbed birth, and this period is best spent by mother and baby in skin-to-skin contact with each other as the baby begins to nuzzle and nick the mother's breast or the two just look into each other's eyes and adore each other. The euphoria that follows an unmedicated labor is a very special time for anyone who is privileged to witness it. It's even better for those who get to experience it.

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

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

If a woman is scheduling a section can she arrange to have some labor too? Is that safe?
IMG: This could be safe in certain situations. Far too many cesareans are scheduled these days for reasons that have nothing to do with the welfare of mother or baby. But let's say that the cesarean was scheduled because there was a total placenta previa. In that case, any labor would be dangerous to both mother and baby.

If, on the other hand, the cesarean was scheduled because the baby was breech, it might be good for the mother and the baby to experience some labor together. For the baby, the difference is that labor helps the baby's lungs to be better prepared for breathing and it can help the mother pump up her beta endorphin levels so that she experiences less postpartum pain after the surgery.

So, the short answer is: it depends on the reason for the scheduling of the cesarean.

What are some current statistics regarding birth in America? What percentage of births are cesarean? Will that ever change?
Both maternal and infant mortality are currently rising in the US. Maternal death rates have not improved, according to the Centers for Disease Control, since 1982. That's a long time to have had no progress, despite all of the technological innovations that have taken place since then. Part of the problem in this sector is that the US has never created a system of accurate reporting of the data necessary to find out what mistakes we might be making so that we can analyze them and then make policy that reduces the likelihood of mistakes being repeated. The United Kingdom (England, Scotland, Wales, and Northern Ireland) have had such a system in place since 1952, which is probably why their maternal death rate is significantly lower than ours in the US. I don't know of any European country in which maternal death classification is done according to an honor system, but that is exactly what is done in almost every US state. There is no audit, and autopsies are less likely to be performed here than in European countries.

The World Health Organization reported in 2003 that 30 other countries have recorded lower maternal mortality rates than in the US. This is even worse when you consider that most of these countries have national health insurance systems, in which accountability is built in. This means that there is a far greater likelihood of maternal deaths being accurately classified than in the US, where epidemiologists from the Centers for Disease Control have reported that maternal deaths in the US are "grossly underreported."

The cesarean rate in the US was last reported to be 29.1%, which represented a rather sharp rise from the previous year. The World Health Organization has recommended that the ideal cesarean rate be between 10 and 15 percent, because when this rate goes beyond that upper limit, it begins to represent a danger, not a safety factor, to women and their babies.

In 2000, I began working on what I call the Safe Motherhood Quilt Project, which was inspired by the "Names Project" for people who had died of HIV/AIDS. My goal for this project is that we in the US follow the model set out by the UK in its system of Confidential Enquiries into Maternal Deaths so that we, too, can begin to reduce instead of to increase, the rate of maternal deaths in this country. Our Healthy People 2010 goal is that the maternal death rate should be 3.3 deaths per each 100,000 live births (it is currently 12.1 deaths per 100,000 live births, but please remember that this rate, by the admission of the CDC is "grossly" inaccurate; in some areas, the maternal death rate is 33-35 deaths per 100,000 live births).

Please check out my website: www.inamay.com and click on The Safe Motherhood Quilt Project and once there, click on the Virtual Quilt.

During my second pregnancy (attempting a VBAC) you recommended doing some birth art. Should every pregnant person do some? Why?
IMG: Doing birth art helps the pregnant woman connect with her right brain and helps to get her out of the more goal-oriented, control freak part of her brain—in short, the part of the brain that needs to be de-activated during the birth process. Doing art also helps her to visualize what she wants to happen, and this visualization, in turn, helps to bring that reality about.

What are 3 things you tell your pregnant clients?
IMG:
1-Remember that you are as well made as any monkey.
2-Don't forget to bring your sense of humor to your labor.
3-Smiling as your baby's head is coming out helps to relax your perineum and therefore makes it less likely that you'll tear.

Who are your heroes?
IMG: Ignaz Semmelweis (who figured out how to save women's lives by making physicians wash their hands, but who was ignored during his own lifetime), Sojourner Truth, Nelson Mandela, Margaret Charles Smith (co-author of "Listen to Me Good", she died 2 years ago at the age of 99, was a grand midwife from Alabama), Howard Zinn, Grantly Dick-Read, Catharina Schrader (17th century Frisian midwife), Ann Hutchinson (17th century American colonial midwife), Jill Correy, Cesar Millan, Elizabeth Cady Stanton, Margaret Sanger

Can anybody have a baby at The Farm?
IMG: There is a screening process for women wanting to come to the Farm Midwifery Center to give birth. It's best to go to the website www.thefarmcommunity.com and click on the Farm Midwifery Center to get contact information.

There are a few medical conditions which would rule out an out-of-hospital birth and thus birth care at the FMC.

Balancing an 11 Month Old

So they say life is a balancing act. Got that right!
Life is like balancing an 11 month old. It's a little wobbly and only stays for a few seconds. That's life these days, anyway.
I put away the toys and minutes later, they're scattered once again. And this is with an 11 month old.
Setting her down has been like playing roulette lately...she's teething and needs comfort. I feel for her. But geeze, a couple days of this in a row and this mom needs a break!
I adore my little darling. She's my booty-boo. Mama's just tired.


Oh yeah, I almost forgot. Welcome to my blog. This is my first post. The rest will be much cheerier. Maybe. At least I hope so!


How little bit of information about me:

Well, to start with, I'm a stay at home mom.
My fiance and I are currently living in Portland, OR - it's temporary due to a large project he's working on with a growing company.
We're originally from Michigan.
Our little girl, Ella Rose, is just shy of 11 months. She was born at home on February 4th, (her due date!) 2008. She's the love of our lives.
I'm an animal lover, an artist, songwriter and singer, a home birth activist, and a friend to a close few, including my mother, whom I am very close to. My grandmother is my hero. I love Bob Dylan and Phillip Glass. Enjoy making and writing cards and writing on various blogs.
I'm also addicted to Facebook. The first step is admittance...


Current serious project: Bring Birth Home, a site featuring home birth stories to empower and educate women about the option to home birth.