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Thursday
Aug022007

Unassisted Birth Buzz

I'm sure most of you in Blog World have already read the Washington Post article on Unassisted Birth, but if you haven't, there it is for you. I encourage you to also read the after-chat between Laura Shanley and Mairi Breen-Rothman, CNM found here.

I wish wish wish I could stick my nose in all the places the articles and their comments are occuring because of my own experience with Meghann, but because I can't, I will remind you all here, in a shortened synopsis, what it was.

After Tristan's (hospital) birth, which I thought was fabulous and terrific, I moved to Tacoma, Washington and went to an exercise class that was run by a Bradley teacher and La Leche League leader and was slowly un-brainwashed/brainwashed (as the case may be) into understanding natural childbirth and its perfection.

I was introduced to the work of Marilyn Moran, who is the TRUE mother of the Unassisted Childbirth movement, NOT Laura Shanley as she likes to profess herself to be. Anyway. I read Marilyn's book Birth and the Dialogue of Love and was highly encouraged to have a DiTY Birth (as they were called then). I actually called several midwives in the Seattle area but could not find one to take me on at my late gestation, my extreme weight and my deep poverty level.

(I hear myself on the other end of the phone often and it definitely influences my decision to help a woman in need.)

Because I couldn't find a midwife, I chose to have an unassisted birth - not called a UC back then, but we'll call it that now for ease's sake and to use the terminology of today.

I continued getting prenatal care at Madigan Army Regional Medical Center and also gathered things to prepare for a homebirth. I was going to have my Bradley/La Leche League leader as my doula ("Doula" also being a word not yet invented back in 1984) along with another 2 girlfriends, one a former L&D nurse and another Bradley teacher. My own Bradley teacher's 16-year old daughter was also attending to be my photographer. The two ancillary women's nursing babies were also attending.

After a birth-assaultive stripping at Madigan, I began labor and all the players finally came to the house (except my Bradley teacher who was camping as it was Memorial Day weekend) where I ended up laboring a total of 39 hours.

I pushed for 2 hours and Meggie was born, a gnarly shoulder dystocia that required quite a bit of resuscitation. Someone called the ambulance (no 911 at that time) and far too slowly, the fire department, police department and finally an ambulance descended onto our tiny house where, by the time they arrived, Meghann was breathing and doing okay. Eight men stood around staring at naked me sitting on the floor with my placenta still attached, their wanting to take me to the hospital. My former husband had to argue with the ambulance driver that I was fine and he would take me in himself. Someone put a glove on and tried to pull my placenta out by the cord. No one else was paying attention but me and I yelled at them to stop it and go away.

If I'd have had a midwife there, none of that scenario would have happened. The shoulder dystocia would have been taken care of appropriately. The resuscitation would have been deftly handled and I wouldn't have had the rude interruption of those gawking men, the arguments, the self-protection - the absolute massive intrusion of negative, cruel energy - all because I didn't have a midwife there.

Granted, my reasons for not having a midwife there were very different than many women's reasons. I had a UC because I was not going to go to a hospital with a 50% cesarean rate (and I would have absolutely had a cesarean) and my choices were limited to one: a UC - because no midwife would take me on.

I've read and listened to the multitude of other reasons for UCs including privacy with one's spouse, the belief in the perfection of birth if left alone and the pain of birth trauma/birthrape and the need to be removed from The System (including midwives) in order to birth with any sense of power. Of all the reasons to UC, the birth trauma issue is the one that I can wrap my head around as the most viable. Of course, "YOUR" reason for choosing is the most correct, but that's pretty normal.

In real life, I've known one UC death. In cyber world, I've known another. I've never seen a fetal death because of the disgusting crap foisted upon women and babies in the hospital. I'm sure I will get a lot of flack for saying that, but it's my truth. I don't deny the amazing amounts of abuse, trauma, assault and even rape that happens in the hospital, but I do believe the survival of babies is higher in the hospital than when left in the hands of UCers. I believe I am trained well enough to know when to transfer so babies and mothers are kept safe and when the unexpected happens, I am prepared to keep a mom and baby in a place of safety until help arrives and we can get them to where further help is available.

I can hear the arguments. Why not avoid the possibilities of transfer at all? Why not just be in the hospital in the first place? This quote from my post Oh, the homebirth debate blog... (is more annoying than words) describes why that isn't an emotional possibility for so many women:

It would be wonderful to demonstrate a completely natural birth in the hospital (NOT a homebirth in the hospital as many would want to call it) and watch all the care providers squirm with discomfort as their jobs became almost useless "just" sitting and observing. It would take an incredibly strong woman to be able to withstand the intense tension brewing, but it would be a great lesson for hospital personnel to witness. I believe it could never be done - and that's just so sad. It's sad that not only could we not even demonstrate a normal birth, but that nothing like it would ever occur in the hospital setting. The closest I have seen is in in-hospital birth centers, but even that is difficult to compare to a homebirth.

(end quote)

So much fear operates around birth with doctors and nurses (and many CNMs and even midwives), I do understand the drive for UCers to birth alone, to maintain the stance of strength and autonomy.

But, I believe a re-education of those that are birth workers is what is necessary. It seems absurd and daunting, sure. I know it seems crazy to think we can re-train that horribly evil doctor that slices open every woman's perineum and has a 45% cesarean rate. I don't have the exact answer HOW to do it, I just believe in the answer that we have to do it. Maybe it is in "seeing" that we need to do it. Aren't we all mad enough at The System? Don't we want it to change yet? Don't we want birth abuse/birth assault/birth rape to stop yet? Don't we want the reasons for women to have to choose UC to stop being created? Until we end the trauma, UCs will multiply.

In the commentaries and blogs, don't the masses hear themselves? Don't they hear how they sound saying it doesn't matter how the baby comes out, that the misery a mom and baby experience doesn't matter, just that they both are alive in the end? Isn't that horrible? How can people who whimsically subject themselves to plastic surgery for beauty or schedule cesareans because they don't want to feel the pain say it doesn't matter how a woman FEELS when it comes to her own birth experience? How can that 95% or more who gets an epidural say that? It's absurd!

Still, even though women are "made" to have babies, women don't traditionally birth alone. Many mammals don't birth alone, some even having "midwives" with them as they bring their offspring forth. A midwife is merely someone who knows a little more than you do about a subject. It doesn't mean you are stupid or wrong or ignorant or less than. It just means she has more experience because she has studied more on the subject and/or been around it more. Myself, I've been to right around 900 births. While you do know your Self best, I still have quite a bit of experience around birth and bet I can share a thing or two with you.

A hairdresser knows a bit about hair... even though it's yours. She doesn't know ALL about hair. She doesn't know all about YOUR hair. But, she can cut your hair in a nice way given guidance from you.

A brain surgeon doesn't ask your opinion at all, yet has a damn good idea what to do inside your skull if she's inside there.

Ah, but those aren't "natural" things. I gotcha.

What if you are hemorrhaging between periods. What if you are hemorrhaging postpartum. What if you have a breast lump.

You get the picture.

Where does "natural" end and "un-natural" begin? Who decides? Laura Shanley?

I think one of the most offensive aspects of the UC movement is the rabid Us vs. Them (Black/White) and the true inability for any discussion regarding UC and the possibility of finding a midwife who might actually support a woman's need and desire for autonomy - which, they (the UCers) profess, is their true desire. It is only in the past few months that I have seen any discussion that has included outsiders and, surprisingly, the interviews have been coherent and inoffensive. Good for Shanley.

Perhaps it will take the UC movement to wake up The System to the birth assault that's occurring and affect the change that's necessary for women to get their needs met - so they are able to have a birth worthy of themselves. Birth should be gentle, beautiful, loving and respected - no matter where it happens. There is so, so much to do to make change happen. I keep writing about this and there doesn't seem to be any change (except with finding Dr. Wonderful!). I wonder what more I can do.

What are YOU doing to affect change? How best can each of us use our talents to bring forth change? Ponder on it. Use your energies to imagine a world where respect for women is a given. Let's stop putting energy towards the negative crap they foist upon us, eh? Let's "see" what we want and create it... even if it takes small steps.

We can do it.

References (2)

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  • Response
    Some really great information, Gladiolus I noticed this. "Life is divided into the horrible and the miserable." by Woody Allen.

Reader Comments (42)

I am one of those women who had one horrendous hospital birth (Shoulder dystocia) and one beautiful hospital birth. I struggle with reconciling both. I want to be a be part of the discussion, but the people talking about birth are so biased against hospital birth, I feel like if I speak I am automatically disqualified. And everyone else doesn't want to discuss it. Where do I fit in?

I love your writing! You always make me think and question everything.

Thank you for your thoughts.

August 2, 2007 | Unregistered CommenterAnonymous

I appreciate this post more than you will ever know. I almost hesitate to not go "anonymous", but I am going to be myself and just leave my blog-name up here.

We had an attempted UC due to poverty with our last baby. NOBODY knows this, not my bestest freinds, noone. Not a soul. But we were so high/empowered off of our HBAC with midwife with our baby #3, that when our surprise baby #4 came along, we thought we could do it alone.
Amidst so many fricking lies and twisted tales ovet the past year and a half, I feel a strong need to confess this on your blog! Wierdo that I am...

About 8 hours into the labor, I just chickened out. Of course that is an understatement to a big story that may never see the light of day, but we went to the hospital and yup C Section. Again, I am vastly condensing a story but midwives are incredibly, incredibly important.

I tried like hell to get all into the UC chats on Mothering dot commune, to get all into Shanley and the like, but I worried. I worried that my partner was worried. Ordering the birth kit seemed eerie. By the 9th month (looking back, always the hindsight being so clear, right?)we were really strange to each other, with mild "accusations" flying back and forth each evening instead of backrubs...(How could you watch TV when you should be reading Emergency Childbirth!)

It sucked.
The c section (my secind in 5 years) sucked
the fear sucked
Attempting UCing for lack of money sucked

I enjoyed the Unnassited prenatal care bit. I took good care of myself and felt able to do that. I know for some women, that would be the big outrageous thing. For us, it felt really empowering. But to deny the need for a midwife, and what she did for us with our homeborn baby, even thiough she was very hands off, those last few weeks, and the solid advice, and the shoulder to cry in, and the knowledge and wisdom and all of it---we couldnt have more regrets about not calling her again, it would not be humanly possible.

Ok i have written a novel, but great great post. You ALWAYS write about the stuff that others dont. You fill a great void and need and your voice is super important!
LOVE and thanks

August 2, 2007 | Unregistered CommenterHousefairy

I really struggle with this whole thing. If I ever have another baby I just can't even imagine anyone there with me. I don't even want my husband there really, I just want to be totally alone. I am afraid to have another after what happened the first time (birthrape = PTSD). But, I'm scared of doing it on my own. I want someone to take care of me before and after the birth. I want someone to clean up, and help with breastfeeding if I need it. I just want reassurance. I want someone to talk to afterward about what just happened, and I might want to talk about it days and weeks and months later, and I don't want to be the only one who knows the story. But for the actual birth I can't imagine anyone being there with me, "checking" me, or doing anything at all to me, the thought of that just makes me want to puke. I don't know how I can ever trust anyone to be there, yet I don't know how I can do it alone. I don't think I could trust myself to do it alone. I'm just not that in-tuned with myself and my baby, or at least I wasn't last time, so I just cant trust that I would know if there was a problem. I also don't want to end up transferring to the hospital just because I am afraid that there might be a problem. The hospital is the last place I would ever want to be to give birth in again, and I want to do everything in my power to avoid it. I would rather have a midwife there who can help me just in case. I guess the compromise I've come up with is hiring a midwife and making her just stay somewhere in another room of my house in case I need her. But could I really find a midwife to do that? Could I really ever trust that she would respect my wishes in the moment? The idea of UC is very romantic, and I flirt with it often. However, in reality, I just don't think I could do it. Yet, I also don't know how I could ever invite anyone into that birth space with me ever again after it went so wrong the first time. So where does that leave me? With no more children I guess.

August 2, 2007 | Unregistered CommenterJennifer

You know, these comments alone speak volumes about what never gets discussed in the media--the powerful emotions around labor and how we birth. And why.

I was so alone and vulnerable at my son's birth; my midwives were the medwife kind, and I had to go to the hospital, and now I have the scar on my belly and the one on my heart to show for it. I remember when I was pregnant longing for a "mom" to go through labor with me. Longing to be mothered.

My own mother had "twilight sleep" births with all of us in the bad old days, and never even really witnessed her own births (!). I know no woman in my family who has had a natural birth--lots of c/secs, everything in the hospital. It was part of my pain that I tried, and failed, to do it a better way--but I also know a good midwife could have at least given me a better chance and better support. I just didn't have one.

I have sometimes thought if I did it again, I would be able to UC because, like jennifer, the hospital was so bad that I'd rather be alone than do that again. But I don't want to be totally alone, even though I know more. I want someone there with me besides my scared husband (and aren't they always scared?) Maybe not a mom but a sister, after the first time. Someone strong and loving for me. I don't think a lot of spouses are capable of not being afraid, and fear is deadly.

August 3, 2007 | Unregistered Commenteremjaybee

It's a complicated debate, to be sure.

I know that I could never give birth without a professional. By that I mean, midwife.

August 3, 2007 | Unregistered Commenterradical mama

Of course, I arrogantly like to believe I am of the midwife, sisterly, loving type - and know of a couple of more in my own community - but what can *I* do to help the cause along besides write more? What more can I do when midwives say, "Nuh uh, not me. That isn't me. I'm a great midwife!" Even when I have *seen*, with my own eyes, what they have done to women - and continue hearing about what they are doing to women. What do I do? What is my responsibility?

My partner says it is the responsibility of our midwifery community via Peer Review to censure these women, to reign them in and force them to act humane and decent towards women during birth and afterwards. I agree, but how?

What would me to do? How would you see me doing something? How would YOU see the midwives you DO trust doing/saying something? Without creating more anger/misogyny in the midwives that touch (literally and figuratively) unknowing birthing goddesses every day.

Your ideas are welcome.

August 3, 2007 | Unregistered CommenterNavelgazing Midwife

Ugh, last post by Dawn about t-18 screen and OB hospital birth...

August 3, 2007 | Unregistered CommenterAnonymous

I don't want a homebirth because we have 5 kids, it's crazy, and I actually get quieter time at the hospital. I have always had an ob, and this time we are "high risk" due to previous miscarriage, 37 year old, and a positive trisomy 18 screen (no amnio). I also have an anterior placenta that was low lying but is higher, and a transverse baby at 34 weeks who better turn. My plan is to go all the way to labor before agreeing to any intervention on this transverse thing. Oh, I would allow a version, that is intervention, but no induction or c-section just because baby hasn't turned yet. I want my OB to know that a grand multipara may have a used uterus, but that doesn't mean baby won't turn. I want her to know I can safely begin labor (my water always breaks as the head comes out...at least it has the last three deliveries) so if we keep it intact, no prolapse. I want her to witness no iv, no stuck on the bed, no drugs. I want her to see my 6th born enter the world, and if we have trisomy 18 and baby lives to birth, I want her to witness me love on that baby with all my strength. If baby is healthy, I want her to see how nursing can contract my uterus and how I won't bleed to death without an injection of meds. Of course, I cannot control all of this, but I am going to try my best to keep her pit out of my body, and keep her knife off of me unless I need it. She's young, and because I have been with her for another baby, I can see how time and her practice is making her more interventionalist as time goes on.

How can I convince her that my tested uterus can deliver a breech if baby turns out this way? She doesn't act like she would do a delivery with a breech...

August 3, 2007 | Unregistered CommenterAnonymous

You don´t sound too respectful when you talk about Shanley. You had one bad experience with UC, but she has empowered many many women by telling about her five UC births.

In both cases mentioned (in your post and in a commentary) it seems that the biggest problem with UC, is how you get to the actual birth and what is your motivation.

I read Shanley´s book and she seem to get quite ready for her births... Not only by learning how to deal in case of emergency but also by working on her beliefs.

We all have our demons and I truly believe that to be able to birth one needs to confront all the fears and negative concepts that one has about giving birth, about confidence on our own abilities, about becoming a mother, etc.

Someone mentioned that she wanted to be mothered... personally I don´t find that as a good idea to have at birth. At birth you are the mother, and unless you are very sure of that you will not be a good candidate for UC, because you do not want to be the one in charge.

On the other hand, I just have a question, maybe if you would have had less people around there would have been less panic and maybe the ambulance wouldn´t have to attend... after all everything you do (getting baby out and resucitating him) is exactly what a midwife or doctor would have done....

just my 2 cents. Mother of 2. Amazing homebirths w/ respectful (hands off) midwives. If I have baby#3, I would like to have an UC.

August 3, 2007 | Unregistered CommenterAnonymous

Despite my disagreement with some of your stance, I truly appreciated your post. Methinks I just found a new blog to read!

As far as uc goes...

I had a pretty good hospital birth experience with my first baby. It was attended by midwives. I was induced, though, because the Jr. Midwife in the practice panicked about my bloop-pressure and, being impatient and still believing that there was no way I could possibly be right and she be wrong, I didn't go home and do some research first, I just went in an signed over my desires. Thankfully, the Sr. Midwife attended me and everything went fine, although I did not, as it turns out, have Pre-E (which was the *fear*) and my mw ended up *appologizing* to me for inadvertently ruining my birthplans. See, I went through a *lot* of trouble to find the *one* hospital/mw in my area that "allowed" waterbirths. Too bad, so sad, you *have* to wear a monitor, no waterbirth for you. But overall, it was a really positive experience.

But

It wasn't what I wanted and it was not really satisfactory. I've been studying midwifery/birth/etc for 15years. I did even MORE research and realized that if I even wanted a homebirth, it was going to have to be UC. I just don't have 4k to pay somebody to stand by a phone and dial 911 in the event something came up that she couldn't handle...and honestly, anything she COULD handle...so could I.

In the end, I had a UC @ 36wks gest. My baby was born footling breech and was 4lbs 10oz. Some people would say "OMG you fool!!" But...I appreciated not being forced to have a c-section. I appreciated my baby not being forced to be separated from me because she was under 5lbs and slow to start. I appreciated the opportunity to nurse my baby right away, too. Nobody stabbed her with little needles, shoved tubes down her throat or threatened her life by cutting her cord so *they* could work on her more conveniently. When she was a lil slow to start, I knew what to do and I did it. When she presented feet first (suprise!) I didn't panic, I stayed standing. When I couldn't push her out right away, we realized her hands were *in front of her face* lil fartnocker, and my dh did what *any* mw would have done and simply hooked an arm and pulled it down.

All I'm saying is that in the vast majority of cases, any reasonably well educated woman can birth a baby on her own. You proved this yourself when you resuscitated your own baby and ended up with a houseful of useless people humiliating you. What would a mw have done for distocia? Nothing that you could not have done with the help of your mate or a few friends (in my case, I had three friends in attendance to be my birth slaves and follow orders). The *only* thing that may have been useful in your situation (that a mw would have and many laywomen don't have access to) is oxygen and the knowledge of how to use it. But it wasn't needed. Your OWN birth story proves the point.

Now, flip side, I am not one of those mw hating uc'ers. Someday, perhaps when my own children are grown, I too will join the ranks of midwives who, like yourself, truly wish to be "with women" and not "in charge of birth". It is not fair to say that all women SHOULD uc, anymore than it is fair to say that all women SHOULD homebirth! I agree wholeheartedly; the system needs to change. WE do need to do something. I chose to do it by not giving money to the system, educating myself and hopefully others, and taking charge of my own birth. But that isn't the only way and really, it shouldn't be the only way. Someday I hope to be a mw that will continue to educate and support women to birth the way *they* feel most safe, most comfortable.

As for you and suggestions on how you can influence things...that's a toughy. I personally feel that it's important to model what you want to see and it seems you are doing that. For me, when/if I can join the ranks, it will be education. I will encourage my clients to do things their way, to take charge of their own birth, care, etc. I WILL fight the establishment. I will do everything in my power to educate and encourage mother's to trust their own intelligence. There is certainly something to be said for experience and I do consider it to be valuable. Maybe if I was not in a state where hb midwifes aren't precisely legal, and those that practice anyway didn't cost two months worth of my husbands salary, I'd have used one! And what about the women here, like me, that cant just drop a few grand but don';t WANT to uc? Why should they feel they have to choose between fear of the unknown and a fight to avoid birthrape?

Ok, longest comment ever, sorry, I'll stop rambling now.

Good post, you bring up some good points. I'm still gonna have to support uc, though, it's a perfectly legitimate option for the woman who is willing to really educate herself and take responsibility (including transfer, if necessary) for her birth.

August 3, 2007 | Unregistered CommenterRebekah

I'm hopefully only days off from my freebirth (I hesitate to say UC as I will have a very experienced doula and my partner in attendance). I have been so disheartened by the rabid attacks on freebirth in the media here recently, the idea that freebirthers are mavericks and irresponsible. I have been scarred by 2 midwives now. My first screwed me over big time and I ended up with am unnecessary c-sec, and I hired a homebirth mw for this time who dumped me because she didn't trust me. I tried to find a backup but it was all on her conditions, and that didn't suit me with what I've already been through.

I can't help but take it a little personally when I read things like this. Maybe there needs to be more flexibility among the services midwives offer, so women aren't driven to freebirth. I won't even talk about the system, I'm staying out of it unless I need to transfer. Perhaps it's this inherent "ownership" of birth that some midwives seem to espouse that sits badly with women who choose UC. I have certainly come up against this attitude. IMO, responsibility for this birth lies with me, not with anyone else, and that would be the case midwife or not. FWIW, I am envious of women who have managed to develop great relationships with their midwives, I now wonder if I'm to be forever marked because of what has happened in my birthing journeys. Hopefully if I have a third, and choose to have a midwife, I will find the perfect midwife for me and will be able to heal from the abuse of my trust from the first 2 experiences.

August 3, 2007 | Unregistered Commenteranastasia_wolf

sometimes it's not about midwives needing to be more honoring about unhindered birth (but we still need to work on that!). sometimes it's about TRUE CHOICE.

and for every person that says, "oh I knew an unassisted baby that died" there are three saying, "oh I knew a homebirthed baby that died".

it's not about hindsight or about you needing to caution people based on your own experience. it's about true, blissful choice. CHOICE.

plain and simple. just like the right to birth with a CNM at home, or a "lay midwife" or your mother who used to be a midwife 20 years ago is a CHOICE, so is birthing on your own.

this concept will never go away. what I wonder, though, is what makes it so threatening to other midwives? even Ina May starts turning into a "well it's not safe!" person...she sounds like the multitude of hospital based providers that belittle our role in birth.

August 3, 2007 | Unregistered CommenterSage Femme

What would we have you do as a midwife? I think that's going to depend on your situation.

But you know, every profession has good and bad actors; raising the quality of the profession is usually a matter of good recruitment, good training, and yeah, good review. But midwifery isn't homogenous--CNMs, CPMs, lay midwives, all are trained differently and bring their own issues. I don't see how you can fix that all by yourself!

Maybe you could write books or give talks at midwifery conferences, if you felt you had a lot to say. Or form a midwife's organization dedicated to such goals. You know, in your free time. :-)

August 3, 2007 | Unregistered Commenteremjaybee

I don't think there was "panic" when Meggie was born. There was purposefulness, but not panic. Marilyn Moran did say she felt only my former husband and I should have been there and that is why I had a shoulder dystocia, but why then did the other two UC babies I know die of shoulder dystocia? Those babies were just with their mothers and fathers... shouldn't that have meant they were in the perfect setting to birth?

I don't buy the If-You-Just-Had-Thus-and-So excuse for "imperfect" births. I get tired of the blaming that happens against women. It is cruel of you to try and blame ME for my child's mis-negotiated entrance into the world. (Nor should she be blamed.)

It annoys me when some of the UC Holier-Than-Thou-ers try and make my introspection and subsequent thoughts on their "leader" seen as wrong. (Not all UCers are like this... I have many UC friends.) It is annoying, though, to have such amazingly mean things said like the comment by Anonymous above . Kind of like someone saying stupid or mean things at THEIR births, isn't it?

I do, however, very much enjoy *discussion* as the next three comments bring. Thank you. Dissent is perfectly fine. Of course it's obvious I don't agree with those that UC, but I don't believe it is because I am a power-hungry midwife. (I'm smiling writing this because it's so typical to hear me say this!) It's because of what I know and what I've seen.

It is not true that a birthing woman can do the same thing a midwife can do - a birthing woman cannot do supra-pubic pressure on herself. She cannot un-wedge a shoulder dystocia herself. She cannot stop a hemorrhage herself. I could not resuscitate my own baby when she needed to be brought to life - someone else had to do that for me. You may think I abdicated responsibility, but it is how I am in birth - in an other-worldly place - and I find many women in that place... just like when making love... swirly, twirly, flying high and loving their out-of-body experience. For some women, it would be an assault/insult to expect them to remain inside their bodies/heads to physically caretake themselves during labor and birth. I think it's important for each of us to know what kind of woman we are and be TRUTHFUL about it and not apologize if we choose (homage to Pamela) to have an attendant even if everyone around us espouses birthing alone.

When Pamela (Sage Femme) says that women should have the right to choose... I cannot agree more, but I want women to KNOW what they are choosing. And I mean from the shit that's found in the hospital to the lack of what they will have in a UC. And also, what I have - and don't have. I try to be honest in who I am... what I offer... what I can't do... where my strengths are... what my weaknesses are. More and more, I am encouraging clients to read my blogs so they can get to know me from the inside, learn what questions to ask, "see" me for who I am and so I can just BE... I think it's helped a lot, even if I share some really, really private things sometimes. I think it is important for other midwives/care providers to try to be honest about who they are, too. But, alas, it probably isn't going to happen very often... I believe, mostly because people don't often look so introspectively or disclose so much with their clients. Certainly not with docs and nurses (and many/most who work in hospitals) because they don't have to. It's a risk I choose to take - sometimes get burned for, but a risk I continue taking anyway.

Onward.

August 3, 2007 | Unregistered CommenterNavelgazing Midwife

There is much I could respond to here but after spending several somewhat difficult months dealing with the media, I've made a conscious decision tonight to put birth aside for now and try to deal with the rest of my life. My birth work has essentially turned into a full-time unpaid job and it's gotten to be too much for me. I'm often misquoted in articles or my words are misunderstood. And now that UC has gotten into mainstream papers, the angry letters are starting to come in. It's time for me to take a break. (I do not approach the media, by the way, but will do interviews when I'm asked.)

That being said, someone alerted me to your blog tonight and so I stopped by. I generally do not respond to negative comments that are made about me on blogs but I did want to address your comment about my claiming to be the mother of the UC movement. I have never made this claim. I wrote my book and put up a web site because I felt I had something I wanted to share. I didn't discover Marilyn Moran's writings until I was in the middle of writing my book (long after my babies were born). I certainly gave Marilyn credit for the work she did, and actually would have loved to post more of her writings on my site. Unfortunately her family wouldn't let me, as they weren't supportive of her work.
Laura

August 3, 2007 | Unregistered CommenterLaura Shanley

Laura,

That's good to know, about Marilyn. Everything I've read about and by you made it seem as if you'd not even known she existed, so nice to know you acknowledge her place.

During my pregnancy with Meghann, I spent many hours talking with Marilyn on the phone and then, on top of that, we also shared correspondence (oh how I wish I could find those letters!! They got lost during a military move!). She and I didn't see eye to eye, either, she being extremely fundamentalist Christian and I a pretty mainstream woman who would, within the next three years, leave her husband and come out as a lesbian for the rest of her life. Marilyn would crap and blame Meggie's "screwed up" birth on my divorce and my lesbianism - I can hear her now, even from the other side!

As much as we don't have in common, Laura, we probably *do* have in common, too. I bet we could sit down and yack for hours and hours and make each other laugh and smile a lot. Our mutual goal for women's autonomy and our respect for their spirits and bodies, I believe, speaks far louder than our differences. Don't you?

I hope that in your "postpartum" rest, you find the peace you need. I know what it feels like to be picked apart by the birds... certainly not quite to the extent you are experiencing right now, but in other ways. I wish you a complete healing.

I do hope, too, that, even in our differences, you are able to keep your heart open (as I work so hard to do) and know that there are always things you might "hear" or learn that can add to your wealth of knowledge. "Your" troops teach me much - learning never ends.

Thank you for writing, Laura. Rest well.

August 3, 2007 | Unregistered CommenterNavelgazing Midwife

I agree with you, something in the system (doctors and midwives) needs to change. Many women don't feel that care providers have their best interests at heart. There is a huge UC tide in the VBAC realm. I understand where they're coming from, especially for those women who trusted an OB and got cut for no good reason. I know I for damn sure would plan a UC before being coerced into another section. Thank goodness when it's my turn again, I live in a community with many homebirth midwives. Many women do not.

And that's really, really sad to me.


Oh, and you KNOW I'm going to be wanting the dirt on which midwives you mean in your post. You know it. ;-)

August 3, 2007 | Unregistered CommenterJess

First of all my eariler post was not meant to shame you or judge in anyway. Please accept my apologies if I caused you any discomfort. It was not my intent.

I had a wonderful and healthy pregnancy and a beatiful homebirth with my first child, and when he was 8 months old he was diagnosed with a neuronal migration disorder. He is 7 now and doesn´t talk, doesn´t walk, doesn´t feed himself, etc. One lesson life tought me is that what ifs do not work, because there are certain situations that just are the way they are and we have no say on them, no explanations. I think SD with your daughter is one of those situations.

From your post I understood that you did everything that had to be done, and the only thing a midwife would have done is to assure you that the ambulance wasn´t needed, so you would have not had to deal with a bunch of strangers in your house. I don´t take this reassuarance lightly. After my first son was born I thought I would have an UC with my second baby, but after receiving his diagnose I chose another homebirth with a midwife. My point is: you know best whatever is that you need, but you can´t unvalidate somebody elses choice for UC, based on your own experience. We are not in the same set of mind given certain circunstances...This same debate could be taken between women who can´t envision themselves or others, birthing outside a hospital.

The other thing I felt important to analize, are the motivations we have for chosing an UC birth. I don´t think the luck of money is the right motivation as I don´t think that wanted to be mothered is ther right motivation to have a midwife. I don´t consider myeslf a "UC Holier-Than-Thou-ers" (as I said I had no experience with UC, even if I delivered my 2nd child by myself with a midwife present) and I don´t have Shanley as a leader as you impply. I just respect how coherent she seems to be with her ideas and her commitment to support this type of choice.

What really intrigues me about UC, is the journey that these women go through not only gathering information about the "mechanics" of birth but specially about trusting themselves, analizing intuition, re-educating belifs, etc.

I think that no matter what birth you decide to have, we can all take advantge of this experience.

Please know that I cherish this dialogie.

Anonymous in Spain.

August 4, 2007 | Unregistered CommenterAnonymous

I appreciate your continued dialogue... and that of the others (wish there was more!)... and don't just direct words towards you (the Holier-Than-Thou, etc. ones), but they come up when listening to what you say... like, "oh yeah, that, too!" sort of things. So, I hope that doesn't squash our continued discussion, either.

Interestingly, if you haven't read my third birth, I was going to have a homebirth with a midwife, but had SROM 7 days before labor started and my midwife said she couldn't keep me as a client. I then had to go to the military CNMs, but stayed home and labored alone the whole 8 hours (literally, since my former husband was either asleep or with the older children) before we left for the hospital while I was pushing. I birthed in the car in the parking lot at the hospital, the doctor (that I know) and a CNM were in attendance and I'd orchestrated it so that I got every single birth wish I wanted except a Vitamin K shot before leaving the hospital 3 hours postpartum.

Was that essentially a UC? Sometimes I think so. (In my sideways, squinty-eyed, rosey-glassied way.)

August 4, 2007 | Unregistered CommenterNavelgazing Midwife

I frequently hang out on UC boards because as a midwife, I find it important to "hear" what the UC community has to say about why they feel so strongly that birthing alone, even without the support of other women, is what is best for them. I rarely post, because as a midwife I am biased towards women seeking and benefitting from support from other women, but it is important to hear where they are coming from.

I have "heard' many stories of shame, mutilation, fear, terror, coersion, mocking, cutting, violation and abuse. I have also heard some pretty ridiculous blaming (My labour stalled because my midwife breathed too loud! My labour was more painful because my midwife answered her phone! My midwife ruined my birth because she didn't know what I wanted without my asking...shouldn't she have been more in-tuned with my outward signs?)

As much as some would like to portray us (midwives) as groovy, psychically connected, intuitive, hip, or whatever preconceived notion of who a midwife is, we are simply human beings who cannot read minds and rely on verbal communication as much as the next woman.

I've seen women who have had, to my eye, horrifically traumatic births, but after the baby was in their arms, they positively beamed about how AMAZING their birth was. I've seen women who breathed beatifically, barely moaned, and silently eased their babies out, who said it was the most painful, horrible thing they have ever done. Looking at them, they appeared to have had the "ideal" birth, peaceful, painless, and soft as melted butter.

I have an issue with the word "empower", as in "I want to empower women" or "Midwives should empower women". It sounds romantic, but NOBODY can empower any one else, it is extremely egocentric to think we have the power to empower another woman. Her empowerment comes from within, not from the books she reads, not from her careproviders, not from anywhere but her own spirit. We can provide information (and this is another issue I have, with what passes for informed consent in and out of hospital birth, grrrrr!), we can provide alternatives, but we can only do those things, it's up to the woman to empower herself.

Here's another issue I have....Ladies, there is no Birthing Guru. There is no woman or man alive or dead that can tell another woman how she should birth, or if she did this, that, or the other, she would have a better birth, a painless birth, an empowered birth, a more spiritual birth. There is no one who can tell you how your body and your baby will work together, how your emotions will be, how much pain you should be in, or how long it should take, or who you should have (or not have)present.


We all have to accept that our experiences are our own, and we have to learn and grow from them, acknowledge what was wrong about them, including our own attitudes and mis-conceptions, let them go, and make it better the next time. Accept that even when you do everything "right", that sometimes birth will throw you for a loop and surprise you with another lesson to be learned. Sometimes, you just have to give it up and let it unfold, or as my dear friend and twice client says, "Let go, and let God."

We also need to stop blaming women, especially those of us blessed with easy births. I've been gifted with a pelvis you can drive a Volkswagon through, but I cannot say my easy births were due to anything but dumb luck, cooperative babies, and genetics, it wasn't the books I read, the midwife I chose, the people I surrounded myself with, or my state of personal enlightenment. I have a big pelvis and babies who kindly got themselves into a good position. How could I look at you and tell you you had too much fear? Not enough trust? You didn't read the books I read or share my philospophy, so therefore you got a lousy birth?

Most of the time birth works. We can all agree on that. Sometimes it's highly spiritual and transcendental, most of the time, it's hard work. As I like to say to Moms working their butts off, "Why do you think they call it labour, and not "vacation"?"

I have a few more thoughts, but right now, like Old Mother Hubbard, my cupboards are bare.

anonymous, it may have been wrong for *you* to want mothering in birth...but it wasn't, for me. It was what I needed, and didn't get. I needed an older, wiser woman to be my guide, because I had no community, no "birth slaves" (scared husband, inexperienced doula, and a bunch of medwives/hospital people do NOT count). I had never been through birth, knew no women who had done it naturally in my family (which was 100s of miles away) or friends (mostly male and/or childless). And as I said, now that I have experienced labor at least, and know myself as a mother, I would not need that exact guidance again.

Perhaps my situation was utterly unique and no other woman would feel the way I did. But I doubt it. And I doubt there's anything *wrong* in having those kinds of needs in birth, as your comments seem to imply. I will never forget how alone and terrified I felt, and I do not accept that those feelings were somehow my fault. Given our culture, they are entirely likely.

(sorry to derail, navelgazer...)

August 4, 2007 | Unregistered Commenteremjaybee

Thanks for your nice response! If you read my book (Unassisted Childbirth) you'll find more information and quotes about Marilyn. I used to sell her books "Birth and the Dialogue of Love" and "Happy Birth Days" on my site, but now they're out of print. Her third book, "Pleasurable Husband/Wife Childbirth: The Real Consummation of Married Love" didn't appeal to me for many reasons. For one, I didn't feel it spoke to women like you, for instance, who were not husband and wife. And even if you were, why should the husband come first?!

Marilyn was also very critical of me because I caught several of my babies myself, when that "should" have been David's job. Towards the end of her life she said she realized that was actually OK because David and I weren't "really" married (we've lived together for 30 years but have never been officially married). Marilyn also didn't believe in waterbirth, or having children at a birth.

Still, I did learn much from Marilyn and wanted to post more of her writings on my site. I approached her family after she died and her daughter told me that they were not interested in helping to promote Marilyn's work because they didn't believe in it. She stressed that Marilyn did NOT have a happy marriage - in spite of the fact that she had an unassisted birth. Contrary to what Marilyn had written, UC does not heal all wounds or ensure that a couple will stay together forever.

I went ahead and posted one of Marilyn's articles anyway. If her family wants me to take it down I will, but so far they haven't contacted me. http://www.unassistedchildbirth.com/sensual/marilyn.html

Laura
(who is proud of herself for not turning her computer on until 2pm today!)

August 4, 2007 | Unregistered CommenterLaura Shanley

Navelgazer,
You've done it again. Opened a very interesting can of worms. What a great discussion. After six fabulous homebirths, I've often thought if I had another baby, I could do it UC, but if I did get pregnant again, I don't know if I would or not. I suppose it comforts me just to know I have the option. As Sage Femme said, true choice. My baby, my birth, my choice.

August 4, 2007 | Unregistered CommenterLaborpayne

http://ratemds.com/

Is a website where you can rate your doctor, midwife, chiropractor. People may want to visit it and use it as a way to release some of their pain related to these traumatic births. And as a way to get more midwives talked about in a positive way.

Just a thought.

August 4, 2007 | Unregistered CommenterAnonymous

"I don't buy the If-You-Just-Had-Thus-and-So excuse for "imperfect" births. I get tired of the blaming that happens against women. It is cruel of you to try and blame ME for my child's mis-negotiated entrance into the world. (Nor should she be blamed.)"
Navelgazing Midwife

I just love this quote.

I am a former UPer who planned a UC to then change my mind and hire a hands off DEM. My son had a fatal s.d. delivery and nobody was to blame. The mw was never panicked, she did everything right. The worst still happens. I hate the arrogance (that everything will work out) I sometimes see in UC land, but I still respect the choice and can understand it completely. I think you can say all the positive affirmations and believe in your body and still have a bad outcome. And talk about not fitting in? I don't fit anywhere, but I am at a point where I really don't care. I agree that we need to stop blaming women & that there is definitely no "birthing guru."

The most important thing in a birth, to me, is knowing that as the mother, you are making the decisions that you feel most comfortable with & that if you are with a mw or OB, that you are constantly being treated with the most respect. You are the one making decisions, and if things get hairy, you don't feel forgotten. This is how one woman can have a beautiful cesarean and another can have a traumatic homebirth. Making a decision to UC out of fear of bad treatment can be as detrimental as having a first c/s out of fear of birth.

August 5, 2007 | Unregistered Commenterclara

Ha. I myself was born at Madigan Army Hospital in 1973. My mother had taken Lamaze classes and was committed to a natural childbirth (quite a revolution especially in an army hospital at that time). She did not even feel safe sucking on her hard candy and spit it across the room when she heard the nurse entering LOL. I am not surprised that the cesarean rate was at 50%. Makes me appreciate my own mother's natural delivery of me even more :)

August 6, 2007 | Unregistered Commenterkristina

So much to read! What a great discussion.

I am not sure where I fit in. I had 3 midwife births at home, with the same midwife. The 4th birth with that midwife was horrid. For homebirth #5, I desparately wanted UC, I knew I could do it, and was afraid a midwife would not leave me to birth as I needed to. I found a midwife, on line of all places, who promised to follow my lead, and only help if I really felt I needed it. She ended up observing and never touching me or my baby during the birth or in the hours post-partum before she left. She gave us her scale to weigh our baby, left us with a clamp and scissors to cut the cord if and when we wanted.

So, people have asked me, "How did you know she would do what you wanted?" The answer is, I didn't. I had to take a leap of faith, and hope that my jugdement was accurate.

When I got pregnant with my 9th baby, I had no problem telling the same midwife that I wanted her for this birth. I also had a deep feeling of fear during this pregnancy. I KNEW I needed my midwife with me. I KNEW I would need her support at sometime, because I KNEW something was going to happen. As it turned out, it was a very bad shoulder dystocia. Now, I have had a shoulder dystocia before, my 1st homebirth. My 10lb 2oz baby boy's collarbone broke during that birth. He needed no rescusitation, and was fine immediately afterward. I went on to have 4 more babies with no issue, all those babies being over 9 pounds, including one who was 10lb 7oz that literally shot out with ease.

My 9th baby, though, would not be as easy. She was a stuu-uuck baby. My midwife was there, not doing anything but taking pictures, until I told her that the baby wasn't coming out. She gave suggestions, and then I told her I needed help. The camera was put down, and she did exactly what I needed. She got my baby out. I really don't think I could have done it. We tried everything for me to get her out myself, and she wasn't budging. As it turned out, my hip became dislocated from the birth. She needed to be rescusitated after she was born. Now, I am Neonatal Rescusitation Certified, but I was not thinking very clearly at tht point, and I couldn't remember the first thing about it, as I looked at my limp baby on my chest. This was the exact reason my midwife was there. She respected my abilities and desires to give birth uninterrupted, but was there when I needed help.

August 6, 2007 | Unregistered CommenterDonna

I think one of the things that people often do not understand is that the uc's of women who have them are as unique as the women themselves.

The issue of dystocia. I was *prepared* for dystocia!!! It's only like, the greatest of the birth fears for a good reason, right?! I would agree that suprapubic pressue isn't possible on yourself (or at least, I know I couldn't do it!). As such my dh and I studied the maneuvers and understood how to do them. My dh was comfortable with that knowledge and that was enough for us.

And for every person that says "I know of uc babies that died from dystocia" I say "Yeah? So what? I know of dystocia babies that died in homebirths and yes, even some that died while in a hospital!!!" That's such a pat thing to say.

Fact: Babies die from dystocia. It's scary, it's tragic and it happens no matter where you birth. Whether you are trusting in a mw, a doctor or a partner, dystocia's sometimes aren't resolvable. That's the big fear, right? Without knowing, for 100% certain, that the women who chose to uc and had their baby's die from *dystocia* didn't do everything the mw or doctor would have done, that's a really unfair, blanket statement to make. Dystocia is unpredictable and unpreventable (except, of course, for the argument of maternal positioning, which I do feel may play a role in some circumstances). Sometimes it just happens. While I think it is completely possible that some uc babies have died from dystocia unecessarily, I think it's just as likely that there have been plenty of situations where it was simply an un-fixable tragedy.

It's just a ridiculous thing to say. "Oh yeah? Well...I know of baby's dying at uc's!!"

Ok. I know of baby's dying in hospitals because the doctor/nurse made an "oopsie" too. I've heard of cases where babies died at home because mw's made an oopsie. I've heard of all sorts of crazy things. They are all irrelevant, the real issue is choice.

All of that being said, I personally believe that without a really solid education in birthing, how it works, how your body works, etc and (for me) a partner who is willing and able to assist as needed, uc *can* be a foolish choice. As I said, personally, I was as prepared for dystocia as anyone could be...and I got to keep my 4k. :)

August 8, 2007 | Unregistered CommenterRebekah

If that's what you wanted to do... learn how to be a midwife, be alert during your birth instead of BE in your birth and flow with it, resuscitate your own child... if $4000 was worth all that to you... then I am glad you have that choice, too.

But for many, if not most women, it might not be worth it (monetary or spiritually) to become their own midwives.

I still understand the issues of control and needing to make (literally) a midwife keep her hands to herself. But maybe midwives are understanding, more and more, the need to do that. I am. Others seem to be.

*sigh*

It just doesn't seem to be as easy an answer as "learn to be your own midwife." Not everyone IS going to read Varney's Midwifery and learn how to do all the steps to manage a shoulder dystocia. Some women feel that learning about dystocias *creates* them!

Yes, it's true that women die from hemorrhages and babies die from dystocias. But wouldn't you like to know you did the best you possibly could to save your child's life before they died? Wouldn't your partner like to know they did their best to try and save you before you bled out before their eyes?

One UC woman I know acquired pitocin for herself. How many do that? Is that too medical? Or is that *really* taking care of yourself in all the capacities you can with the available resources you have today? Who's to say.

I'd be very, very careful about tossing out "I know babies who..." stories when they are hypothetical. I used to do that. And then years ago, realized that those hypothetical babies didn't really exist, but *could* exist - but didn't. Be VERY clear about babies that have died that you know of - not third, fourth, fifth Net Legend-hand stories that don't really exist. It doesn't do the UC community any favors to flippantly use fake baby deaths because of hospital negligence in shoulder dystocias when real baby deaths in shoulder dystocia UC births can be held up as examples.

I'm not saying death doesn't happen in the hospital, I know it does. It's horrible no matter where it happens. And horribly sad. And I know there is negligence.

But, can't there be negligence in a UC, too?

If your spouse is an auto mechanic by trade, why would you entrust your computer to him to fix? Or your electrical system in your house? Why not get an expert? Why would you expect him to learn everything about it before going after the problem? What if he tackled the wrong problem?

What if that hemorrhage wasn't the uterine wall at all? What if it was an artery? What if there was retained placenta? What if you didn't need pitocin, but needed methergine?

What if'n the world...

And a homebirth midwife wouldn't cure it all either. I know. Docs would shake their heads and say, "Why not just give birth in the hospital?"

I get why not that.

I just still have such a painful time with UC... I understand when there is no choice of a hands-off midwife, or another care provider at all, but just because you want to save money? That I can't wrap my head around.

August 8, 2007 | Unregistered CommenterNavelgazing Midwife

This is such an amazing discussion. Thank you so much Navelgazing Midwife for getting the ladies talking!

This debate strikes home for me because I suddenly find myself pregnant in a state where homebirth is basically illegal. After my first son was born on my living room floor in CA (with two great CPMs) it is hard to imagine giving birth anyplace other than home. And yet, the very few unlicensed midwives (two?) who practice in my city are unable to have access to the same medical supplies that my CPMs in California have. That means no Pit for hemorrhaging; no GBS testing; not even lidocaine for any needed stitches. These are probably things UC moms feel are unneeded. But to me, it was the access to those types of medical supplies coupled with the ultimate trust in my midwives that made my home feel like the safest place for me to birth.

I think it is a tragedy that there are not options for every women in every state to have the birth she chooses. I think it is crazy that it is perfectly legal to have a UC here, but not a homebirth attended by a professional.

Not that I think UC is crazy...because I respect every women's rights to make a rational and educated decision regarding her health and the health of her children. I guess when it boils down to it I am just angry that the choice I would make has been denied me.

SO, I have decided (tentatively as I am only 11 weeks along) to have a hospital birth attended by a local family practice doc who gets rave reviews and considers himself "a big hairy midwife at heart". Yea for non-interventive docs who "get it"!

But, the quote from the Homebirth Debate Blog that was cited in this post keeps replaying itself over and over in my mind. Am I strong enough to show the hospital staff how natural birth is done? Is it even possible in the hospital? And this is where I start imagining myself giving birth at home with just my hubby...

But the truth is meconium happens. Shoulder dystocia, prolapsed cord, excessive meconium aspiration, a true nuchal chord that restricts decent, hemorrhaging, babies that need serious resuscitation...

And it isn't that I don't trust in birth or my body's ability to get the job done. I labored for 44 hours at home with an asynclitic baby. I know my body can be trusted to straighten things out. Literally. ;-)

But, the unexpected happens. And more than anything else in the world, I want this baby to be healthy. More than anything. Not that I think I should have to give up a good birth experience in exchange...

Therefore, maybe what I can do to change the system is to be the strong woman that refuses the IV, the continuous fetal heart monitoring, the 41 week induction, the episiotomy. I have done A LOT to educate myself on childbirth (I am one birth away from being a DONA certified doula!) and I know the hospital is FAR from my ideal birth local; but somehow, under these circumstances, it seems like the safest place for my baby to be born. Now that is crazy!

Wish me luck, I'm going to need it.

But you know, whether you’re giving birth at home, in the hospital, or UC it's the same dose of luck we all need.

PS, Navalgazing Midwife, do you have any desire to come to the Midwest for a leap year baby next February? ;-)

August 8, 2007 | Unregistered CommenterRebecca

Email me. I might already have a baby due at that time, but we can certainly talk. I'm honored that you would think of me. And I LOVE travelling to births!

August 8, 2007 | Unregistered CommenterNavelgazing Midwife

Thanks for this. I came to visit because I haven't been in quite some time. I don't pay much attention to the news especially mainstream print media, so I hadn't realized that there was an article about UC. The romantic in me likes the concept of UC. But the realist likes the idea of midwives present at a homebirth, not active or central, but around, in and out of the room, checking and engaging making sure that everything meant to occue naturally and according to the creator's larger plan is actually going just that way.

As a fairly radical left, I indentify with the UCers and understand their role as a make-shift opposition party, as a canary in the mine shaft, as the radicals who so badly scar the ones on the extreme right and who make the ones hovering around center take a stand somewhere and encourage the lefties to break open new ground and ask for some more concessions from those who hold power. Will homebirth end up being dominated by UCers? Nah. Will homebirthers become a little more radical and expect more autonomy from their midwives? Probably? Will wimmin given to birthing in hospitals rethink their timidity and maybe opt to have some more power in their own hands regardless of where they give birth? Definitely. UCers are necessary for change to come about. They are serving a purpose even they might not be able to fully understand. Although, I'm not about to give birth unassisted, I'm glad for their presence and for their balls.

August 11, 2007 | Unregistered CommenterDark Daughta

Navelgazing, thank you so much for the wonderful and calm post. After a rather chaotic day arguing over UCs with a message board I've been with for a long time, I really needed a breath of calm over this over-emotional situation.

I'm pregnant with my 4th baby, due around Christmas. My first was an unnecessary c-section after a botched 35 week induction due to very mild pre-e. I should've insisted on a 2-part induction as my cervix was just not ready to give up my son yet - my OB was eager to get home to her family for dinner at 6. My c-section was at 5:12pm and she made it almost in time.

My next 2 babies were hospital VBACs. The first was an improvement over the section, but that MW wasn't very supportive or interested in what I wanted - she performed a 2nd degree episiotomy without even informing me she was doing it; no urgency prompted her action, she later told me she "just wanted to help me out." I felt violated.

My last VBAC though was with a really wonderful MW at a really wonderful clinic and though the hospital had some silly VBAC rules, like constant fetal monitoring and staying in bed, my MW worked around that - she didn't admit me until she broke my water at 7cm. As long as I wasn't admitted, I was free to do whatever the heck I wanted. I love that woman! :)

Now the clinic has changed their VBAC policy - all women attempting VBAC have to be seen by and delivered by the OBs. Those OBs, though officially attend VBACs, are very hostile toward them. I met with the head OB in an attempt to discuss my objections to the policy and was told he didn't understand why it was so important to me to VBAC again - c-sections were much safer. My friends wonder where my dislike of OBs in general comes from.

There are no other hospitals in our area that allow MWs to deliver VBACs. The OBs that do them are very textbook, nonsupportive. There are no homebirthing MWs in our area. There are 2 about 2 hours away that I was ever so willing to travel to - being due around Christmas stinks; they're both too busy with the holidays to take me on.

I really can't see an OB - my experiences with them have left me horribly distrustful and anxious about them. People look at me like I have 2 heads when I tell them I refuse to see an OB. I really believe if I do I will give myself PIH and possibly pre-e again. With my last baby I started out seeing one of the local OBs; he was an arrogant moron who didn't think women knew a single thing about pregnancy. My BP climbed up and up at each appointment. It was 140/90 when I finally decided to switch to the MW group 45 min away - 2 appointments with those ladies and my BP went back down to 120/60 where it remained. My BP this pregnancy? 120/60 with the MWs. The one appointment I had with the head OB? 152/70. For me, seeing an OB basically ensures that I will have a complicated pregnancy. Yet however much proof I present, it seems no one believes me.

Now I'm stuck. I have to choose. I've chosen to continue the pregnancy and delivery unassisted. I've come to terms with the risks and fears surrounding that. It's been impossible for me so far to come to terms with the resistance I've met with everyone else. To know that my friends think I'm selfishly risking my son's life kills me. It is the most heartbreaking thing I could ever imagine feeling. So much so that I find myself searching online about the OBs and hospitals in our area, wondering if I'm really a strong enough person to rebel so much against the norm.

In some ways I feel like I've run off and joined a cult. I've had to cut ties with my friends because I can't bear the negativity anymore if I have any hope of coming through this okay. I'm being attacked for "radical" beliefs and being made to feel like I only care about MY birthing experience and not my son's life.

I believe birthing method and place is a choice, and I have nothing bad to say to women who choose UC. It wasn't my first choice. I *love* having a supportive MW at my side, just as you said, so I don't have to worry about the what-ifs. I know the what-ifs have a slim chance of happening. So what? Someone has to get the short end of the stick. I like having a friendly face next to me who can be a wall of calm and seriousness if it's needed. I can't believe that was taken away from me just because of what was done to me by some idiot OB years ago.

I'm neurotic about self-education. I do own a copy of Varney's (where's the embarassed smiley when you need him? heh). I'm going to be doing my own prenatal "visits" - BP check, weight check, fetal heartbeat (I knew the cost of that doppler would finally redeem itself! lol), fundal height, urinalysis and symptom review. But again, if there's a MW out there who can be here for me as a friend and only help out if she's needed, I'd jump at the chance. That's not possible, so I have to do my own cost-benefit analysis and make a choice.

I wish someone would change the medical system. Never going to happen though until the majority of women realize that something needs changing. Being a rebel sucks. It's such an emotional battle I often wonder if I'm causing myself more stress than if I just gave up and saw an OB like a good little girl. But I can't. I have to stick it out and do what I feel is right, no matter what anyone thinks. I just wish people wouldn't think so harshly.

Sorry for rambling, but I guess my whole point in this was to THANK YOU for such an eloquent post; for not really agreeing with UCs, but for not making me feel like a subhuman for planning one.

August 13, 2007 | Unregistered CommenterChris

thank you- I too had the hair raising UC (also before the term UC) due to lack of midwife in the area- #3 was a great midwife attended home birth after -
I have had more bad experieces I guess with the UC community- I have had personal experieces with atleast 4 neonatal deaths due to UC-- and know of many more as well as maternal deaths. There are a few reports about unattended births in the lit and they all say about the same amount of infant mortality 1-2 baby deaths per 100and this number held out even on the MDC list when they were collecting that data-
the studies show INTERMITENT MONITORING to be safest for low risk birth not the NO monitoring that often goes along with an unattended birth--
when Laura Shanley said that the death rate was mostly for city folks that is not true- even here in the US we had high infant mortality rural was certainly less than urban but was still very high- closer to what we see in 3rd world countries today and that includes high maternal mortality rates as well- I think that she like most people have not done much study of the subject-- and I may even quibble with paid attendants world wide- many of the attendants are paid in food or services- fitting with the culture they live in- so if a midwife is family or extended family member it may be you are building a house or chopping wood for many years it is a trade of services including a social bond of responsibility to the valuable aging population-- what do we do for the old women in our society? how are they provided for or not provided for? since we operate with symbolic trade(money) then we probably are actually paid less than what a useful knowledgable attendant may be paid in a 3rd world country-because their payment is ongoing and intertwined- part of the social structure.
thanks again for an interesting topic and your perspective.
anon

August 14, 2007 | Unregistered CommenterAnonymous

"But for many, if not most women, it might not be worth it (monetary or spiritually) to become their own midwives."

"It doesn't do the UC community any favors to flippantly use fake baby deaths because of hospital negligence in shoulder dystocias when real baby deaths in shoulder dystocia UC births can be held up as examples."
~Navelgazing Midwife

I think you open the same can of worms to assume your first statement. That 'most women' may not find it worth it to take complete responsibility for their births. 900 births is awesome, but it still does not make you an expert on what 'most women' want. You are not privy to their inner thoughts and feelings. I am quite sure that my former midwife has no idea how unhappy I was with her care.

I have stepped into this realm twice. The first time was as a home birthing mama with a lay midwife. I was called irresponsible and stupid. I was told that I was putting my baby's life at risk for an "experience". I was told it didn't matter how I was treated at the hospital, all that mattered was that no one died. They understood WHY I wanted to go there, they simply thought the risk was too great.

Funny that I hear those exact same things about my UC from the very community that embraced me for my attended home birth!

Here I am again, irresponsible, dangerous, unreasonable.

I *do* know first hand of babies dying while in the hands of doctors and midwives. Not Internet lore, but real people that I actually know. Funny, I know not one of my personal UC friends with a death. And yet, personal experience do not statistics make. We should all be aware of that when basing the safety of UC on our personal experiences.

I believe that true UCers are in the minority. By that, I mean women who choose UC freely and are not being forced into it because their only other option is a knife-happy OB. From my experience on MDC's forum, it seems that we all think a little differently. And I believe that to be valid. It's not wrong to need or want an attended birth. I am not one of those who believes that every woman needs to birth unassisted. But I also believe that it's not wrong to know that you need to birth alone. To know that the presence of a midwife will inhibit you and cause your labor to stall or even stop. Even if hands off midwives were lined up around the block offering their services for free, many of the women on the UC forum would still choose to birth alone or with only family. They believe this is the best way to bring their child into the world. And I trust that they know themselves well enough to know what they need.

I had a UP/UC 8 months ago. It was a perfect, lovely, wonderful birth. It was also completely dysfunctional and would have certainly resulted in a c-section had I been attended by anyone. Baby girl was born a little slow to start, but otherwise she was fine. I knew what to do to encourage her earthside and did so with no issues. My happy ending doesn't make me think UC is perfectly safe. But then, the healthy babies I brought home from the hospital didn't convince me hospital birth was safe either.

August 17, 2007 | Unregistered CommenterCNH

Rebekah:
The issue of dystocia. I was *prepared* for dystocia!!! It's only like, the greatest of the birth fears for a good reason, right?! I would agree that suprapubic pressue isn't possible on yourself (or at least, I know I couldn't do it!). As such my dh and I studied the maneuvers and understood how to do them. My dh was comfortable with that knowledge and that was enough for us.

Hi Rebekah,

I have had a homebirth attended by a family doctor and midwife that involved no interventions and luckily no complications. That is what mostly happens. I am currently pregnany and we are planning another homebirth.

My husband is a doctor however and there is no way that he would have been happy to be responsible for assisting if there were complications in birth of his child. Does he know what to do about shoulder dystocia? Yes. It's not common so in the births he has attended. He has also manually removed a retained placenta in a woman with severe haemorrage, saving her life. Would he want to do any of that in the context of the birth of his first child? No way.

In this era doctors are taught not to be arrogant enough to expect that they can separate their emotions from their practice and are advised not to treat family members. You just cannot expect to act as calmly and objectively with the people you love, even if you have actually performed that skill in the past. To be honest I think it is a bit insulting to put all that midwives and doctors do down to some manouvres that can be learned from a book, when so much of it is experience and diagnosis.

Also - what would your partner do if the baby needed recussitation and you were having a haemorrage at the same time? (this is why many midwives practice with a second midwife as a backup).

Finally somebody wrote that
"Maybe there needs to be more flexibility among the services midwives offer, so women aren't driven to freebirth."
In Australia where I am midwives have struggled to get professional indemnity insurance to work in homebirths and the decisions that they have had to make as professionals in order to work safely, to protect their livihoods and still work with integrity means that the services that are offered won't always suit everyone. It is all very well to say that one takes responsibility for their child's birth but the reality is that all professionals need to take their own ethical decisions about what they are willing to be a part of.

September 2, 2007 | Unregistered CommenterFiona

Fiona:

You bring up points that UCers cannot possibly pick up on until the moment hits them - the intimacy can become a blockade to movement towards action. I've seen well-trained care providers stand immobilized with fear - and they knew exactly what was going on!

And you are right about having two people at a birth - with a shoulder dystocia often comes a hemorrhage. Babies of shoulder dystocias typically require resuscitation... who gets care? Baby or mom? Is this when 911 gets called? Wouldn't it have been better to have someone *qualified* to take care of it in the first place who would have kept things calm and kept everyone at home? No, the midwife might not have been able to avoid a shoulder dystocia (although I believe I have avoided at least a couple by positioning and keeping a baby from from rotating his/her shoulders), but there are more hands - SKILLED hands - that recognize *early* signs that a shoulder dystocia might be coming, get ready for a resuscitation and a hemorrhage.

It is a fine line we walk, this trying to please women while also protecting our livelihoods. If we do everything in our souls for women and we lose our licenses, then we get to do nothing ever again for any woman. If we do nothing outside of the line of legal for any woman, then we don't get to stretch for the women outside of the boundaries of "normal." Every midwife I know does neither. We ALL go outside the law - with consents from the women - we ALL despise the constraints the law puts on us - we ALL wish we could do more More MORE for women... and do the absolute best we can within our comfort levels. When it goes outside our range of comfort, we do not hesitate to refer to another midwife we know *will* be okay with that particular circumstance.

At least that's how I know it in my community. And in the other communities where I have worked.

Thank you, Fiona... great, great thoughts.

September 4, 2007 | Unregistered CommenterNavelgazing Midwife

I frequent Laura Shanley's forum and I have never encountered any kind of hostility or "better than thou" attitude there. In fact, we've banned people from the forum for attacking other members who ended up birthing in the hospital.

We have had several members opt to birth with a midwife (myself included) or in the hospital and several who transfered to the hospital during labor. A few had c-sections in the last 1.5 years I've been on the boards. The attidute of the other members toward them has always been kind and loving.

The women there are all intelligent and well informed about their choices and risks. Most of them don't jump into UC blindly. They are not out to prove anything to anyone.

We have several midwifes on the boards and appreciate their input. You are more than welcome to join.

I might just be biased and brainwashed, of course, but I've found the UC community (or rather, Laura's forums in particular) to be one of the nicest, most loving and accepting places to be on the net, no matter what your birth choices are.

Olesja

December 5, 2007 | Unregistered CommenterOlesja

I think this is very dangerous, a midwife or someone that knows what to do incase of an emergency should be present, what if your baby didn't start breathing and had brain damage or worse death and it would have been your fault because you were selfish and wanted to do it without a professional, i have a very hard time with this and am trying to take legal action against this entire cult of women that do this.

March 23, 2008 | Unregistered CommenterAnonymous

"Anonymous said...

I think this is very dangerous, a midwife or someone that knows what to do incase of an emergency should be present, what if your baby didn't start breathing and had brain damage or worse death and it would have been your fault because you were selfish and wanted to do it without a professional, i have a very hard time with this and am trying to take legal action against this entire cult of women that do this."

So it's ok to put your faith in someone else that can/do make fatal mistakes all the time? People who want to UC are not selfish, they want the best for their babies, we just have different veiws of what that is. Why don't you pick up a book and read about some of the common dangerous interventions hospitals routinely preform. Why can't we ban those? (not hospitals just the dangerous interventions)

July 4, 2008 | Unregistered CommenterAnonymous

I personally know two UC moms who had to deal with shoulder dystocia during their births and while their labor wasn't wonderful, they did think quickly on their feet, used their instincts and their babies were fine and they did not have post-partum hemhorrage.

UCers except what most others cannot accept - that death is a part of life and you can't escape that this could happen during your birth.

While it is true that you cannot learn the art of midwifery from a textbook, you also will never be able to know a birthing mom's body/mind and soul as well as she knows herself. That gives the birthing mom a huge advantage over you which is why even Dr.Marsden from the WHO argues that the birthing woman should always be in control and calling the shots.

No textbook or clinical experience will make you the expert of any individual birthing mother. That is the edge that many UCing mothers have - they have the peace and privacy to listen to that inner voice. It is much harder to listen to your inner voice when you have someone else present, even your partner. But who is more likely to respect your need to be alone - your partner or a midwife? I'm sure there are many midwives who would leave a birthing woman alone at her request but wouldn't hesitate to jump in if they thought it necessary (even when the birthing woman herself would think it unnecessary, or even intrusive).

I'd love to know which mammals birth with a "midwife". Every vet I have ever talked to told me that animals need to birth in privacy or their labor is stalled.

Michel Odent writes that his own wife gave birth smoothly alone, when he went off to run a quick errand for her.

He himself advocates for the quiet, out of the picture, hands off midwife - but how many of those actually exist? Any midwife that is recognized and regulated by the government is typically governed by rules set out by OBs (i.e. midwives in Canada as well as nurse midwives in the US). Lay midwives are in fact illegal in Canada.

You may know the technicalities of birth - but it is from whatever perspective that you studies (allopathic, clinical, etc).

How do you know how best birth plays out? How do you know that biologically, mammals do give birth best when it is undisturbed, and private? I really wonder how much midwives really do learn about undisturbed birth, considering that much of the formal training (in Canada at least) centers around intervening, even if it is just to check heart tones.

And what is intermittent - here in CAnada, midwives are required to check heartt ones ever 15 min. Hardly intermittent.

You also forget that as human society (especially Western culture) moved more towards reliance on technology, we have supressed and nearly forgotten our instinctual selves.

How can you say with certainty that a woman who is able to tap into her instinctual, most primal self, does not know as much, if not more, about how well her baby is doing, than a midwife checking heart tones?

How have we survived as a species, as mammals, for thousands of years, when we have only been checking heart tones for less than 100 years?

How can you also be certain of how humans have evolved to birth without actually doing an indepth anthropological study. How many cultures had midwives. In how many cultures did a woman leave her tribe to go birth alone and then later return to her tribe?

You can't just answer those questions point blank without years and years of research. The point is we don't know what the best way to give birth, we are all guessing.

You can't say a midwife assissted birth is any safer than an unassissted birth simply because there are far more unanswered questions than you'd like.

To say that a midwife assissted birth is safer, is to view birth from a clinical, objective perspective and completely erase the spirtual and instinctive perspectives which has helped our species to evolve over thousands of years - just because we are losing touch with these perspectives now that we live in a technocratic world doesn't mean that they haven't helped our species survive.

I think it is quite egotistical to assume that having a midwife present at birth is safer - we simply don't know. A lot of the emergencies you bring up have been greatly debated as to their root cause. Perhaps a truly unhindered birth would not result in these emergencies as often because a mother would have privacy, and the ability to listen to her own inner voice without outside interference.

You just don't know. You really don't know WHAT causes these emergencies so how can you say that the midwife figure is the hero? Perhaps without the midwife figure, these emergencies would be far rarer than they are in today's birth culture.

April 5, 2009 | Unregistered CommenterJoy

I wanted to add, it is extremly bias to say that objective/rational knowledge that the midwife brings to birth (from textbook as well as clinical experience) is superior to the innate knowledge of the birthing mother.

This has long been the subject of great philosophical debates and the very acceptance of objective/rational knowledge as being superior to intuitive/innate knowledge is highly patriarchal. Teachings from eastern philosophy have given much more weight, credit and importance to innate intuitive knowledge which has influenced many postmodern philosophers from Heideggar on.

Western culture hasn't caught on, but eastern philosophy has influened us enough to open up new fields in phenomenology, for example. Maurice Merleau-Ponty, who was one of the most prominant philosophers who introduced western culture to the concepts of phenomenology is one of the western thinkers (influenced by Nietszche, and Heideggar) to rethinking our concept of knowledge and epistimology.

You simply cannot make a blanket statement that a midwife has more knowledge than a birthing mother because a midwife is equipped with objective and rational knowledge and experience.

To say rational and objective knowledge is superior to innate and intuitive knowledge is to really not understand epistimology as it influences the human condition.

When you bring up the midwife vs the UCer debate, you are really opening up an epistimological debate about the superiority of knowledge.

Midwives beliefe their clinical knowledge is superior while the UCer believes that her innate knowledge is superior.

Who is right, who is wrong? Well since the philosophers can't agree on this one, and since birthing women and attendants seldom agree, I really think you ought to put the arguement to a rest and give the birthing woman enough autonomy and respect to make the choice for herself.

April 5, 2009 | Unregistered CommenterJoy

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