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Shifting from Pro-UC to Anti-UC

I was asked how I came to be so against Unassisted (Child)Birth (UC) when I had had a UC for one of my own births. If you’ve read me for awhile, you get the gist of it, but I don’t think I have any one post chronicling the path. Let me see if I can outline it here.

When I had Tristan (in 1982), I had a typical hospital birth with Demerol for pain (epidurals weren’t an option) and a mediolateral episiotomy. At the time, I loved his birth! I loved it so much I wrote letters to the doctor, nurses and hospital President thanking them for such an awesome experience. I didn’t know any better.

Then we moved to Tacoma, Washington and, pregnant with Meghann, I found a Bradley instructor who was also a La Leche League leader and prenatal exercise teacher… Marie Foxton. She was amazing! I glommed onto everything she said, reading anything she offered voraciously. Included in the reading material were newsletters (The New Nativity) from Marilyn Moran, the American mother of UCs. Birth and the Dialogue of Love was Marilyn’s book about husband and wife birthing. Her spin on UCs was that only husbands should be with the woman, no doulas, no friends, no kids; just the man you made the baby with. (Even UCs can have fringe elements!) The idea resonated with me perfectly and I set out to have a, what was called then, Do It Yourself (DiTY) birth. I was supposed to have my baby at the military hospital at Ft. Lewis (Madigan) and continued with prenatal care there. Standing between sheeple and birth anarchist, I had my membranes stripped without my permission (unless taking my pants off designated consent) and contracted for many hours before active labor really kicked in. Not one to just hang out with one man, I’d invited several people to the birth, too. One, Marie’s daughter who took pictures of the event (you can see them here in Meghann’s UC Birth Story) and the other two friends from LLL and my exercise class. Both women had newer babies they brought to the birth as well.

Over the years, I’ve had judgment saying I didn’t really have a UC because there were other people there. That they influenced me and didn’t allow me to listen to my own instincts, which, by the way, would have led me to the hospital. But it was a UC; there was no medical/midwifery provider there. No one listened to fetal heart tones. No vaginal exams. No blood pressure taken. No thought about the baby’s journey, just my own. When I hear UCers talk about their reasons for wanting to have that type of birth, it is rare that anyone even mentions the baby, especially the safety of the baby. They might say they don’t want the baby poked and prodded or they don’t want the baby taken away from them, but those aren’t safety concerns; they’re inconveniences. No one says, “I’m doing this because I don’t want anyone there because I don’t want any neonatal resuscitation or medications for hemorrhage." They honestly don’t believe they will need such things or they will have time to get help if they need it. They are wrong.

Reading Meghann’s birth story, you can see that she was a shoulder dystocia and nearly died. Had I had a midwife there, we wouldn’t have had to call EMS and the transition after birth would have been much more fluid and gentle. Even still, I thought the birth was awesome for many years.

This is where the question comes in: What changed my mind?

Time, distance and experience. When I saw a mother die in 1987, that was a huge sobering experience that profoundly affected my understanding of mortality in birth, both maternal and neonatal. After that, I knew it would be many more years before I was ready to be a midwife. In fact, when I was finally licensed in 2005, my reason for not becoming licensed sooner (despite being in birth work since 1983) was that I had not been spiritually or emotionally mature enough to take two lives in my hands. I wonder if we ever really are.

When I had my UC, I thought I was extremely knowledgeable, having read so many natural birthing books including Spiritual Midwifery and Oxhorn-Foote’s Human Labor & Birth. I studied the second half of Spiritual Midwifery (the technical parts) more than I read the first half with stories. I really did think I knew a lot. But, through the years as a doula, then attending Casa de Nacimiento in 1993, it slowly dawned on me how little I really knew. While I was still very much of the belief that women needed to be protected by their doulas and partners and that technology was mostly out-of-place, I saw experiences in the hospital and birth center that technology never caused. It was clear that sometimes, shit just happened in birth, even when it was left alone… sometimes, because it was left alone.

In 2003 (or so), I started writing an updated Emergency Childbirth for UCers, a manual that talked about what to do with emergencies when alone, whether accidently or on purpose. I wanted to market it to those who might get stuck at home in snowstorms or for after an earthquake and submitted chapters, but no one bit.

In 2005, I helped put on a conference with the California Association of Midwives, International Cesarean Awareness Network and Birth Resource Network and became a speaker for a workshop on UCs. (I can’t remember the name I gave it, sorry.) I loved the workshop and really felt I gave great information about how to overcome emergencies during an Unassisted Birth. I talked about shoulder dystocia, hemorrhage and surprise breech among other less emergent issues. I talked about what to do with tears and how to get a birth certificate as well. After the presentation, I was talking with the participants and one very pregnant woman came up to me and said she was going to UC, but wanted to know if she needed anything, could she call me… like for suturing. Absolutely! I would be more than glad to offer whatever I can, even if it’s just phone help. She thanked me and then we moved on with the rest of the conference.

A few months later, there was a buzz in the community about a UC death, the baby died during a shoulder dystocia. Immediately, I thought about the woman at the conference and wondered if it was her. It was. A few months after hearing about the birth/death, the woman contacted me and we began a several week processing of her experience. (I have permission to talk about this.) This mom was as connected to her body and fearless as anyone I’d ever met; it was stunning she lost her 8-pound baby during a shoulder dystocia. While we talked, she off-handedly said, “Barbara, I did everything you said to do, but my baby still died.” And it was in that second that I realized what I said and did as a midwife could make the difference between life and death… even if I wasn’t at the birth. She meant nothing unkind, no blaming or anything, but I took what she said and beat myself up for years, worried I’d done or said something that encouraged her to go through with the UC. I know intellectually that she made her own decision and that she was going to UC no matter if we’d ever met or not, but maybe what I said bolstered her belief that she could handle any complication. I now feel I gave completely false hope that complications could be handled alone, without medical or midwifery assistance. My heart still aches about the lost baby.

Other parts about that birth come into play, too, because the hospital didn’t treat the death with all the gentleness they should have. Mom never got a photo of her baby, no lock of hair, no blanket… nothing. She can’t remember what he looked like when he was born because they didn’t respect the protocol of what to do when a baby dies. We’ll never know if she was punished because of the UC, but I still cry that she never got a picture of her precious son.

So, after this experience, I did a 180° change.

Shortly after, a dear Netfriend also lost her baby during a UC, a cord prolapse in second stage that was mismanaged by the 911 operator. Had a midwife been there, the baby would, almost certainly, have been alive.

I got my midwifery license in 2005 and worked hard to be a midwife for as many on the fringe as possible. I met a woman at an ICAN meeting who was going to UC and I begged her to please let me attend. A horrific shoulder dystocia of an 11+ pound VBAC baby and subsequent hemorrhage shook all of us up so much, my anti-UC stance was solidified. Every one of us, including the mother, knows if we’d have not been there, both mother and baby would probably not be here. Shook me to the core; I still have nightmares about that birth.

Earlier, before the conference, I’d become Netfriends with Janet Fraser. I was incredibly distressed to learn she lost her baby during her UC. I was also angry as hell. I wrote a piece called “An Open Letter to Janet Fraser” that was harsh and extremely angry. A few years later, I removed it and apologized for the crudeness of my words. I still feel angry that she lost a baby that didn’t need to die because of dogma.

So, there you have it; my transformation from pro-UC to anti-UC. Believe me, I understand that some women have limited to no choices about some aspects of their births, whether they are VBACs or breeches or twins or midwifery isn’t legal or there are no midwives in the area, but I feel so strongly that women should have an attendant that if there is no way to have a midwife (or doctor) at the home for the birth, they need to be in the hospital. I know that seems mean, but it’s far worse to offer condolences because of a dead baby.


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Reader Comments (20)

You mentioned a key word: Dogma. Dogmatism kills in all kinds of settings. In religion, it kills the spirit. In hospitals and at homebirths, it kills women, babies, and health.

I wanted to be a midwife to help women escape the dogmatism of the hospital, but then ran smack into dogmatic midwives. For me, the key word is balance: Balance knowledge and instinct; balance studies with anecdotes; balance the needs of the many with the needs of the individual.

These balances obviously lead us into ethics, which has a nice vocabulary for discussing these issues. One of my great frustrations is the refusal of some midwives (in their overall fit of anti-intellectualism) to learn that vocabulary, or even carry on the discussion.

Thank you for sharing your thought-process.

July 25, 2012 | Unregistered CommenterTrish Ross

Thank you.

Thank you for writing this.

July 25, 2012 | Unregistered CommenterEx-apprentice

dear ngm, i want to thank you for writing this. i know you and i havent agreed over the years about uc, and we still dont. but what you wrote is beautiful, considerate, and honest.
yes sometimes shit happens in birth. sometimes it happens and maybe it wouldnt have happened, or happened so badly if medical/midwifery assistance had been there.
you state your ethical considerations and principles clearly. we may not share the same ones completely, but i respect that yours are consistent and willing to be challenged by experience.
and i respect that there are mamas who are so grateful to have had access to medical models in giving birth. i respect their stories and their knowledge of their own bodies and what it needed. (i am not a crunchy girl, i take otc's and anything else when i feel like that is what is going to be best for my body)
and i respect janet fraser stating that her choice to uc was not about dogma. she too knows her body and her choices better than anyone.
sometimes a mama's intuition leads her to the hospital and sometimes it doesnt.

July 25, 2012 | Unregistered Commentermai'a

When we fall back too often on platitudes, it says to me the criticisms of our stance have some merit. "What matters is a healthy baby" is not so different as "birth is as safe as life gets", both are glossing over realities with some marketing slogan aimed to sway.

The psychology of birth cultures are deeply interesting to me. I see the loud polar opposites as more alike than unalike these days.

The one that speaks loudest to me is the unstated "you don't get to want anything emotionally if you value health", the other countering "you must get what you want in order to be emotionally healthy". We can do better than that, we can prioritise mothers including honouring the deep emotional and physical sacrifices they make for the survival, health, or wellbeing of their children, with no element of judging their character or their birthing success.

If you have personal experience of a birthing culture which is unhealthy, you know it. Personally I have got it from both ends, including first hand experience of the dogma of the person mentioned in the article. I do publicly judge the culture they created as unhealthy and dangerous and refrain out of respect for autonomy to comment publicly on their private choices. I mention this not to criticise for the sake of it, but because I think it is important to add another voice to the people who want to make a bigger space in the middle, where aspects of both approaches are valued.

July 25, 2012 | Unregistered Commentersomeone else

I so appreciate you chronicling your journey. What I found so telling is your statements that the baby's safety is not mentioned when UC'ers discuss their desires. You also point out the focus on convenience and not safety among UC'ers (and many homebirthers) as well. I think that is what galls so many in the medical community about the NCB crowd: the self-focused, ignorant goals that DO NOT PUT THE BABY'S HEALTH FIRST. Any yet, "someone else" makes some excellent points regarding extremes in both camps. It is important that a pregnant laboring woman should be treated with kindness and that mindless hospital protocols can be challenged to improve the birth experience where appropriate. Certainly, some hospitals work harder at this than others. Each of us, birth provider or not, is challenged to figure out how we can be part of changing the things that need to be changed and persuading others, where possible (and with some they will never be persuaded), to consider the facts of birth and the safety of their babies. Much work to be done, but noble, worthy, and absolutely necessary.

July 26, 2012 | Unregistered CommenterLaura

Amen sister!

July 26, 2012 | Unregistered CommenterTara

Thanks for sharing this.

July 27, 2012 | Unregistered CommenterRachel

Hi, UCer here. :)

I totally understand the fear of the "what ifs", but I wanted to clear up a few things. I'm injecting my thoughts to give another POV or diversify the dialogue. I don't mean to be too contrary, debate, or disrespect.

1) Yes, you had a UC, and if someone told you it wasn't truly a UC, perhaps they misspoke. Perhaps what they would mean to say is that your birth wasn't "undisturbed", since having several people there would on the physiological, primal level "disturb" the mother (a la explanations of Odent). I'm not totally in the Moran camp, because I myself feel comfortable kicking my husband out of the room. I suffer better alone.

2) A mother SHOULD learn everything she can about birth and how it works before the event, how to resolve various issues, etc. Ideally, I mean. Not to place judgment on those who thought they had it down and things didn't go as they expected (hey, I've been there before in my first births). It shouldn't be treated as secret, sacred guarded knowledge. That's elitist. I like the accessibility of books like Dr. White's, and I think your attempts back then to revamp it in your way would have been excellent. Like you said, if nothing more, than to help people calmly handle accidental UCs in emergencies. Being calm and knowing what to do is priceless-- these are survival skills. Yet we keep it from women and tell them that it's over their heads, and that only years and years of training would help them birth their own babies... blah blah blah. Look, expertise is one thing, and medical training is really awesome, but let's not condescend to women. Birth can be scary but it is usually the most scary when you have people there who don't know what the hell they are doing and believe they don't know what the hell they are doing. We need to give people knowledge AND confidence to reduce panic and fear. We'd save lives that way. People would also be more in tune with true emergencies and know how and when to appropriately react accordingly.

3) I often hear UCers talk about doing it for the baby. When you said they hardly ever talk about it, I thought that was odd. Then I thought, well, maybe she's right, because it was like she was saying... they tend to take it for granted that the birth will go fine. And we do. Because, for most of us, experience has taught us to relearn all we thought we knew and we finally get how to honor our needs (knowing well that it is healthier for the baby-- to us, it goes without saying, so that should explain the absence you noticed). We came to find out that the things which had happened to us before were unnecessary and harmful to both us AND our children. Not getting the baby taken away from you after birth and things like that are just bonuses, but those could be had in almost any setting, in home or hospital. It boils down to respect, in the end. People who don't respect your comfort and wishes may also not think twice about hitting you with procedure (however well-meaning) in a detrimental way. If something happens to you as a consequence, or a side effect, that is rarely given thought to since it is considered "normal". In severe cases or morbidity, of course, apologies and settlements are available, but that will hardly make up for things that didn't have to happen. I know we are all against senseless harm. We are just on total opposite ends of the spectrum at times.

4) Dogma... platitudes... etc. I keep hearing these words, and they aren't incorrect, but it always cuts both ways. So much of how we view the world is based on our experiences. We get deeply held convictions and beliefs, and who wouldn't? We've been shaken to the core with what we've seen. You had a UC that had complications. You also didn't do things in ways other UC proponents feel are the healthiest, easiest versions of the practice, yet you feel you can judge it. That's a little like borrowing a recipe that you don't follow to the T and then telling the owner that it's shit. People you knew had negative experiences, so for you that confirms it. You also have a lot of exposure via your research and training on the crises and what ifs that birth entails. Naturally you are going to err on the side of what you feel is caution. I had a midwife whose first birth was a beautiful UC, no complications, yet her years of experience in midwifery led her to caution me on my wish to UC. People who are taught to fear will. Your experiences shaped what you fear, as have mine. When you learned more, the direction of your learning and your experiences combined to confirm something in you and make you less and less okay with UC. I'm almost the total opposite of you. I started off doing everything by the book, believing UC was crazy. It was only through my experiences and MY further research (going in the opposite direction of your learning, it would seem) that I discovered how wrong and foolish I had been before, and I prepared for my UC, did it according to my needs and mammalian physiology which I already felt was so ME and in tune with my needs anyway, and it went beautifully. It really is all about perspective. Your path is your path. Mine is mine. I respect the woman who knows what she has to do and goes out and gets it. It's a hard world full of static and confusion, so many diversions from our paths and life lessons, but no one can live your life but you. No one can live my path but me. My choices were wise for me and the best thing I could have done, and I am proud of myself. Many other women aren't as lucky and live cycles of pain and trauma.

I'm sad you're anti-UC, but I understand why. I don't agree, but I can see why you arrived at it. There are so many stories out there... so many vast, different experiences... they all carry many truths, and everything is certainly not only as it seems. I just hope that you will consider that the kool aid may sometimes be laced with something else other than crazy. Maybe sometimes the kool aid is really just water. I don't know what else to say or if this will be approved, or appreciated... I just wanted another point of view to be voiced and hopefully understood or even respected. Thanks for listening.

July 27, 2012 | Unregistered CommenterElizabeth

Elizabeth, how many times have you given birth? How many times have you been present at a birth?

I began delivering babies in 1968, with a 7 year hiatus while I raised my own three babies. I either actually delivered, or participated in, approximately 80 deliveries a month, since I worked in hospital. It is almost physically impossible for a homebirth midwife to do more than 10 a month, even if the demand exists, which it doesn't. Many homebirth midwives do not have even one a month. Do the math.

Of course one's decisions and outlook are influenced by one's experience, as well as one's knowledge.

Which of us has a more realistic appraisal of birth? Who has seen what nature is capable of? I don't fear birth, but I respect it very much.

You simply played Russian Roulette, and both you and your children survived. You were lucky. You are an adult; if you had died, or had suffered major anatomical damage, it can be argued that you could accept the risk. But to risk your child, or children?

July 27, 2012 | Unregistered CommenterAntigonos CNM

"At the time, I loved his birth! I loved it so much I wrote letters to the doctor, nurses and hospital President thanking them for such an awesome experience. I didn’t know any better."

This is a serious question that I don't know how to make sound less snarky:

You don't find that...odd? What I'm reading is that you were happy with Tristan's birth, and then you got sucked into the NCB world and were essentially brainwashed to become unhappy about it. That statement perfectly illustrated why many people see the natural birth community is nothing more than a cult. How is it possible to be happy about something and then let someone convince you that it was bad, so much so that you went the UC route? It's one thing to learn that things could have been done better, but to feel that unhappy about it?

I can't stop shaking my head.

July 28, 2012 | Unregistered Commenterlalala

I answered that in another post, lalala... that I have since re-found my joy at Tristan's birth and am sad I spent any time thinking it was less than it really was.

It does speak volumes about the NBC that they had the gall to tell me my birth was awful, but it also speaks volumes about my gullibility. I've learned a lot through that experience.

July 28, 2012 | Registered CommenterNavelgazing Midwife

Antigonos, I had 3 births, only 1 of which was unassisted, and I have witnessed only 1 other human birth in addition. My UC was the best for me and my baby, and that was hardly a coincidence.

If it's a numbers game, I can find you people who've witnessed more than you have and offer a different opinion. Anecdote is a two way street.

Regarding the NCB and their plot to taint our memories of medical birth... you don't need anyone to make you feel bad. Either you believe them or you don't. There's a lot of shaming on both sides, but don't let anyone's perspective color your own truth as you know it. For me, I truly didn't know better than to be okay with my first birth. When I learned more and realized what I was truly capable of and what was unnecessary about prior experiences, I did feel differently (I felt wrong, cheated, and justified in my feelings of the something missing inside), and it wasn't evil NCB that made me feel that way. Previously, my ignorance was "bliss"... but then I woke up. I'm thankful I did. I'd rather know the truth for me in my life than just be complacent or "happy" with the status quo.

Russian roulette is in the eyes of the beholder.I think hospital goers play Russian roulette, but I don't go up to them and say that. I say, "congratulations", and I am happy and thankful that they are well and that they have a baby. I don't presume to tell them how to think about their births. Deep down I'm concerned, but what's done is done, and I can't change everyone's minds. I wouldn't dare insult them by letting them know I think they aren't informed of all the issues or that their births could have gone better, or that they are careless mothers for their choice. We all choose what we think is best, and I know that. Respect and love should be given and is deserved when mothers are doing their best according to their knowledge.

People who've seen more from a medical perspective tend to have a more medical view of birth, but that isn't because of the inherent danger of birth-- it's because of the conditions of the births they are witnessing. The cause and effect is all backward, and it's a logical fallacy.

The fact is, healthy birth is normal. That's why even most of my hospital goer friends make it out *relatively* unharmed, despite having (in my view) odds stacked against them. The best of normal and healthy birth is not something most caregivers get an opportunity to witness, so I don't consider them to be somehow more wise than a person who has honored physiology and recognizes on a scientific level what our needs are, and how to meet those needs to stack odds in favor of mother and child for best outcome.

Honestly, with these attitudes, why would anyone want a midwife? If I felt the way any of you did, I wouldn't even bother! Give me an OB and the drugs any day over this. It doesn't make sense to me. My OB was very caring and personable. If I want a medical experience, I'd go with her. If I want a natural experience, I definitely wouldn't choose a midwife with an OB's POV.

July 29, 2012 | Unregistered CommenterElizabeth

Between 1989 and 2001 [when the hospital went bankrupt and closed its doors], I was privileged to work in a maternity hospital which, while it had full facilities for any situation [including an NICU], "specialized" in low risk, unmedicated, low intervention [or none] births.

The C/S rate was around 20%. Some were, of course, elective repeat C/Ss [not every woman is a VBAC candidate]; a good many of our patients chose us because of previous pleasant experiences -- we were a small hospital and that encourages flexibility and good patient-staff relationships.

Nearly all the primary C/Ss were when unforeseen complications developed during labor: rapid and severe onset of pre-eclampsia without warning; abruptio placentae, prolapsed cord, and so forth. All these women were healthy; all expected to have uncomplicated births. Your statement "healthy birth is normal" needs an additional clause: "except when it isn't".

In the past, some of these conditions resulted in maternal death; some in the death of the baby, some in the death of both. Some would have rendered either the mother and/or the baby brain-dead or nearly so. And indeed, less than 100 years ago when everyone is alleged to have had glorious home births, women and infants died in numbers we have trouble imagining today.

And by the way, even back then, women did not deliver themselves; anatomically it isn't particularly feasible; this whole UC thing is just a fad, like Leboyer or giving birth in a [fecally contaminated] pool. Until the end of the 20th century, humans NEVER delivered under water. I cannot imagine a better way to cause fistulas and tears than trying to deliver without assistance, and as for the baby, if there is real shoulder dystocia, the mind boggles.

I repeat: you were lucky, that's all. You made dangerous birth choices , and survived, and so did your child.

July 30, 2012 | Unregistered CommenterAntigonos CNM

No, "healthy" was the key there. HEALTHY birth happens to be a pretty NORMAL event. The "except when it isn't" is the part is unnecessary, because that would automatically cancel out the "healthy". I am speaking as to the normalcy of how most births go, and I am including both in and out of hospital births (that is your "gimme" in this argument). I believe you were hoping to jump on "BIRTH is normal", which is where you love to add your "except when it isn't". Well, duh. No one is going to argue that-- it's a non-issue.

Whether you notice it or not, whether you recognize it or not, many of these emergencies are created by the environment and care received during labor. Your example of cord prolapse I will take, for instance, to illustrate my point. When people attempt to augment or expedite labor and break the bag of water before the baby is down enough or engaged, this is an event that is very conducive to cord prolapse and the inevitable "life saving" c-section. When you create the emergency and then become the savior, you don't get to call the entirety of birth "dangerous". The conditions were yours to manufacture. There is an unfairness and deception in that. That is what we have witnessed time and time again and it is that which we turn away from.

This is a more obvious example. Other examples are more subtle, and would only be apparent to those who have closely examined the science, the cause and effect of it all. If you are content to throw your hands up in the air and declare everything a mystery, nature's sick and cruel hand of fate making birth dangerous, that's a choice. Some of us ask WHY these things happen in the first place, and when we are able to identify a cause, we seek to remove it. Call that dangerous if you like... I call it doing our best and being responsible.

Anatomically delivering by yourself isn't feasible? I did, and it was very feasible. No one touched me, no one needed to touch me, and myself and my child have never been as unharmed as in that birth.

Humans "never" delivered underwater? It may be considered a modern invention, but how do you know? Did you witness all of humanity give birth? I say that humans have always operated under instinct (when not impeded). I say humans always were drawn to what would make the most sense and provide comfort. It's not unusual to me at all to see a human being looking at the water as a possibility for easing their labor, if they have access to it. It's as natural as looking at something soft and wanting to lie down for a moment's relief or rest.

There is a lot of arrogance in the anti camp. They seem very upset, very threatened, by what we believe in. They seem to take it personal. It isn't anything against any of you or your experiences. We are doing it because we are living our lives in the way which WE have figured out works best. You can ignore our facts, anecdotes, science, and what have you, but that absolutism being expressed is not scientific, compassionate, or even professional... it is completely egoic. You don't have to understand us, but you should strive to, and at the very least respect us. It's so much easier to dismiss us as loons so you don't even have to try to hear us, though. I challenge you to reach further than that.

July 30, 2012 | Unregistered CommenterElizabeth

Your example of cord prolapse I will take, for instance, to illustrate my point. When people attempt to augment or expedite labor and break the bag of water before the baby is down enough or engaged, this is an event that is very conducive to cord prolapse and the inevitable "life saving" c-section.

The vast majority of cord prolapses occur with SPONTANEOUS rupture of membranes when the presenting part isn't engaged. Indeed, when an AROM is done, it is deliberately done during a contraction so that the presenting part [ usually the vertex] is pressing against the cervix to prevent there being enough room for the cord to come down.

As for delivering underwater, it may amaze you to realize that humans breathe air, and that taking that first breath is essential for a number of physiologic changes in the baby to take place. [Crying has a purpose] NOWHERE in recorded history is there even the slightest indication of underwater birth. It is a fad, nothing else. I could probably write a book about the advantages of being suspended upside down from the ceiling by bungee cords attached to the mother's ankles and some idiots would think it a grand idea to give birth that way. Using water as a form of analgesia is something else entirely.

I cannot respect dangerous and uninformed choices that risk the life both of the laboring mother and her baby who has no choice in the matter.

I repeat: You. Were. Lucky. Barbara has seen deaths with UC. Indeed, two of the biggest advocates of it have lost children by that method. We know the statistics for homebirth, and even if incomplete, and, in the case of UC, deliberately unreported, it is a matter of FACT that more babies die in these situations.

You cannot decide, or plan not to have, complications in labor. A very wise doctor once told me that only in retrospect can a birth be described as uncomplicated or complicated. True, most births are uncomplicated. But just as every trip in your car does not include an accident, the potential for an accident always exists, that that is why you have insurance [in fact, you MUST have insurance, it is a legal requirement]. Having competent birth attendants is insurance for birth.

July 30, 2012 | Unregistered CommenterAntigonos CNM


The "natural" maternal mortality rate - just mothers, mind you, we're not even talking about dead babies here - statistically, has been estimated as being around 1,500 deaths per 100,000 births. The death rate in modern American hospitals is around 10 deaths per 100,000 births.

So what you call a "non-issue" I call "Wishing us back to a world where a maternal death is two orders of magnitude more likely."

July 31, 2012 | Unregistered CommenterSympatheticDad

Dad, don't be distracted by the language. Understand the meaning in fullness of anything anyone is saying to avoid confusion.

One, what are these statistics? Where are they coming from, and whom do they take into account? Statistics can be awfully misleading and be used to paint any picture anyone would like. Take them with a grain of salt. A healthy woman in the US with a normal pregnancy giving birth naturally or at home is going to have a very different experience from another woman if you change even just one of those variables. Every little thing is relative. All sorts of factors will determine how healthy a birth can be for woman and child. Generalizations are propaganda. Be careful about heeding statistics and lumping too much together into a group as a means to create fear. Either side can use numbers and figures to manipulate and mislead.

Two, it was a "non-issue" because it created an argument where there was actually an agreement. Take it in context, please. Re-read my comment to understand me better.

This doesn't have to become an argument in semantics for anyone to "win", does it?

Antigonos, I wasn't going to respond again, but since I'm here I'll just throw in this-- most women do not experience a spontaneous rupture of membranes prior to labor. Many more babies would actually be born in the caul if unhindered, and most women will experience their water breaking during actual labor rather than prior to, if left alone. However, many women in the hospital will experience artificial rupture of membranes. Further, the practice is mainly a part of the process of labor induction, and the woman will be lying down, and baby may not be down or engaged enough to have head-to-cervix. To me, common sense would seem to indicate that numbers and logistics alone would allow for more situations of cord prolapse in the medical environment.

However, part of planning for a home birth, or UC, or having any emergency preparedness plan just to be a responsible woman is knowing what to do in the event of a cord presentation, and all variety of scenarios. If nothing else, have quick-thinking, quick-acting, and above all NON-panicking parties when a "variation of normal" (<--- I know you love that) occurs. Don't you think that would be wise, regardless of your birth choice? Or do you feel this is info best kept private, to the professionals only?

August 1, 2012 | Unregistered CommenterElizabeth

I had a planned home birth (with experienced low-intervention midwives and a doula) that ended in a hospital transfer after 24 hours of labor and getting stuck at 5 cm for more than a day. They did EVERYTHING they could to turn him from OP and get him out at home. So technology didn't cause my posterior, asynclitic baby or my 41 hour labor, nor did it cause all the third degree tears I sustained. Rather, it allowed me to get him out without a c-section and without dying of exhaustion. Two hundred years ago I would not have made it out of there. I still support homebirth and I support the right of women to labor alone if that is what they want; as a doula and lawyer, I think how to give birth is a fundamental human right. But we all have to take responsibility for our choices. I'm sorry, but "birth is inherently risky" and "birth is healthy and normal" are BOTH wrong. The truth is, SOME births are risky and SOME are healthy and normal. And we don't know which one we're going to get until it happens. Throughout history, women of some Native American tribes went off (alone or with other women) to a birthing hut. Many of them had beautiful, successful, natural experiences. Some of them never came back. The Aztecs considered childbirth the female equivalent of warfare and honored women who died in childbirth as fallen warriors. Does our maternity care system have issues? Yes. Was it better a hundred years ago? Hell, no.

February 21, 2013 | Unregistered CommenterHeather

NgM: This is an old post, but I am new to your blog and have been exploring it along with your 20 years of Birth Stories blog. I am curious about something. I see that you are opposed to UC, specifically the aspect of having NO medically trained/experienced attendant present in case of emergencies. However, from reading some other stories and posts, it seems like you are pretty supportive of a undisturbed/minimally disturbed birth process--avoiding AROM, minimal/no vag checks, no one telling the mother exactly what to do and how to push?--provided there IS a a qualified medical attendant on hand if anything DOES go wrong. The story of Donna's birth from the beginning of your Birth Stories blog was especially striking in this regard, as you never did a vag exam or even touched the baby! And even your own story of your 3rd birth, how you never felt so aware in your births as that brief moment when you were completely alone.

I am asking this as a FTM, 6 mnths pregnant, planning for a homebirth with a CPM. I know CPMs are not all equal, but I think I have a good one who is well-trained, well-prepared, reasonable about when a hospital transfer is necessary. As much as I want a natural and, hopefully, waterbirth at home, I would not choose one if I didn't have confidence in the midwife's skills and the emergency backup plans. I do believe there's an important place for hospitals, drs, C-sections when necessary. I am NOT drawn to UC--seems especially bizarre given I have never been present at a birth, let alone given birth before! But, having as natural, undisturbed, and smooth a delivery as possible is, obviously, appealing. That said, I know in Donna's birth story, this was her 8th birth! So, I recognize that I might be in a different position as a FTM.

All that to say what are your recommendations to FTMs and their midwives in terms of having a safe but as minimally disturbed labor/delivery as possible? Are vag checks necessary and how often or when? When is AROM necessary or helpful? In your experience, is tearing less likely when no one is instructing when/how to push? Or is it more likely for a FTM to need a little urging to not push too early, etc? How helpful is it to be alone/unwatched for periods of time during the labor?

I guess I'm also asking you to explain more of your thoughts about what, to me, seems like positive side of the UC movement and what you DO actually seem to be in agreement with (and maybe what draws a lot of women to it): minimal intervention, minimal disturbance, being able to listen and surrender to your body and the labor process . (Again, saying this as someone who recognizes the importance of a trained, qualified person on hand to intervene when the natural process does not go well.)

Any insight you can give is welcome. If this is addressed in other posts that I haven't read yet, please point me that way.

September 2, 2013 | Unregistered CommenterLois

Hi Elizabeth,

Would you mind sharing (and I apologize if this has already been addressed, late in the game here...) what your medical credentials are? You speak of complications with familiarity. Are you in the medical profession?

Thanks, just trying to wrap my mind around all of this.

September 4, 2013 | Unregistered CommenterSuzyNICU

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