Monday, May 10, 2021

A Cautionary Tale

I'm starting another Gratitude Alphabet. I first did one back in 2014, after my mother died. I think now is the time for another one: this past year has been foggy and strange for everyone, and sometimes we need to remind ourselves we are grateful.

I'm starting this alphabet with A for A Cautionary Tale.

In January 2020, I decided to start a run streak. That means that I would run at least a mile every single day. I ended up running a total of 1,111 miles during that year, and it was good. It helped me get out of the house; it gave me my much-needed solitude - living with a houseful of related males was fun and sometimes too much; it kept me fit.

In January 2021, I realized that my foot hurt pretty badly. And my muscles were cramping all the time: something was up! I am lucky - I have a family doctor, so I called her up and she sent me for an x-ray of my foot.

The day after the x-ray, I got a scary call. Severe Osteoporosis! No running, huge amounts of calcium and vitamin D, and a bone scan. I also added in some magnesium as I knew that the balance of calcium and magnesium needed to be maintained. My muscle cramps disappeared. My foot continued to hurt. I spent February sitting on the couch in the evenings having a drink (never more than one). Exercise wasn't happening. Oh, yea, I did the Plank Challenge. I can plank for two minutes. 

Bone scan happened. Three weeks passed! That's several different cocktail recipes. I wondered if I would ever be able to run again. Foot hurt. I got a fancy gizmo to wear on my toes. I was still on my feet every day working at my cafe.

March. My doctor calls me and says Oooops, weird. No osteoporosis, in fact my risk level is very very very low. I didn't bother asking why they said at first that I had the severe osteoporosis. Maybe because I'm 64, or who knows. Anyway, I don't have it so that's great! I started running again, short runs. I still want to do a 50k for my 65th birthday. But ... I am running very, very slowly. I feel weird when I run. Sluggish. I wonder if I have Covid. I can't seem to make my muscles move properly, but I'm not tired. Just "sluggish".

I kept running and decided it's the price you have to pay for taking an injury break. My running group leader said that it's the price I have to pay for doing a running streak. I'm just not convinced. Everyone's telling me different things, but none of it really adds up to how I'm actually feeling.

I teach a doula course. One of the main values that guides my practice, as a birth companion and as a teacher, is that we really only have our senses to guide us in this practice. One of our most valuable senses is the sense of intuition. I was chatting with one of my students about her main project, and she randomly mentioned that she takes magnesium at night after a stressful day: it helps her muscles relax and helps her sleep.

The next day, I stopped taking magnesium. A few days after that, I went for a run. I felt so different! I was back to my normal self! Yes, I'm not a fast runner, but I'm surely not a tortoise. I was literally poisoning myself with magnesium because of a suggestion that my doctor had made, on the basis of a false diagnosis!

My advice to you: 

  • Know your body. If it feels weird, then it is weird. Something's wrong. If someone tells you something is happening in your body that just doesn't seem right, then try and figure out what's going on. 
  • Be careful! Don't take supplements, herbs or anything unless you are very sure that it is safe and useful.
  • Trust other people, but not 100%! Even a doctor can be wrong sometimes.
  • If you're an older woman, perhaps a run streak isn't for you. Since my streak, I have been intrigued by how much of our advice in the sports and athletic world (and nutrition, and medication, and medicine...) is based on the adult male body. Women, especially older women, need to train differently from men. They have more stamina, but they burn energy differently, and most importantly, they recover differently. I was doing myself a disservice by emulating my heroes' run streaks, as I wasn't actually listening to what MY body needs. My body needs a day every week to recover and rest. 
I am grateful today for my healthy body, for the time I have to spend, for my lovely doula students.... oh, I am going way beyond A... tomorrow will be B.

Sunday, April 11, 2021

Cesarean Awareness Month

It's funny they would have a month for a surgical operation. I have the same feeling about Black History Month. Like, if it's important, shouldn't we learn about black history every day we learn about history? Like, shouldn't the history books be rewritten? They're certainly biased....

I digress. Let's deconstruct history another way:

Pithiviers, France, is remembered by some French Jews as the place where their relatives or friends of the family were sent after the Nazis occupied France. There was an internment camp there where families were separated and the adults were sent to Auschwitz to be killed.

We also remember Pithiviers as the place where Michel Odent was head of the maternity ward from 1962 to 1985. Here, he fashioned his notions of natural birth, by creating an environment where women could give birth in an undisturbed way. He provided singing sessions during the prenatal period, birthing pools, and skin-to-skin contact after birth.

Years ago, I was part of a group of birth workers who brought Dr Odent to Montreal to speak. I remember being so shocked when he suggested that there was a causal relationship between the murder and violent crimes rates in some cities in the world, and the cesarean rates. Effectively, he was suggesting that if you have your baby by cesarean, then they are more likely to become a violent criminal. I immediately took a dislike to him and his silly ideas, and, more importantly, I asked myself why there was a whole room of healthy, young women absolutely worshipping his words? There he was, a shrunken old white guy, talking about how babies needed to go through the vagina and arrogantly proclaiming that women who have cesareans are going down the path to hell, and dragging their newborns along with them.

Fast forward a few years and I was up on the stage. We were doing a little panel about VBACs. A woman stood up from the audience and said that she was newly pregnant with her second, hoping for a vaginal birth after a brutal c-section with her first. She wanted advice from a midwife on the panel. This is what she got: "If you want to give birth vaginally, you have to put your big girl panties on and fight for what you want."

And I remember teaching a class to a group of doula students, and the woman teaching with me said that, generally, women who have repeat cesareans have a lot of unprocessed resentment to deal with, and if they dealt with it their chances of VBAC increases. 

So, in a nutshell, three birth professionals said: women who birth their babies by c-section are driving up the crime rates because their children are more likely to be criminals (also, in an article he wrote in 2008, Odent suggested that cesarean birth may produce more male homosexuals); that women who want a vaginal birth after a previous c-section should somehow grow up so that they can achieve this; and that women who have c-sections may be dealing with repressed feelings, and that repression or other negative feelings such as resentment could be the reason for the surgeries.

If we look at these criticisms from a feminist perspective, they seem very similar to the rape dilemma - don't wear provocative clothing, don't go out at night alone, don't drink, or you will become a victim.

There's a feeling amongst the "natural" birth movement that a woman can have a "natural" birth if she wants it hard enough. We can read of powerful, transcendent, wild, free births where a woman moves through portals to meet her child. These are lovely, indeed, but not everyone can have or would want to have that experience.

In my opinion, giving birth is a very private act. It is so varied, the ways in which we birth, almost as varied as, for example, the shapes of our noses, or the leafiness of our labia. Some women want to birth alone, or just with their partner present. Others want their children there too. Some want a doula or two, and a midwife. Other women prefer a physician, and they want to be in a hospital. Some want to have a midwife follow them, and they want a water birth in the birthing centre.

All of these possibilities should be respected as valid, informed choices. So why are they not? Because, often, if a woman chooses to be followed by a medically trained midwife or a doctor, she ends up giving up her right to informed choice and she gets put on a conveyor belt where she is no longer the central person in this sacred, primal event, and she gets things done to her. The birth process gets put on a schedule; the body is examined time and time again; this or that intervention is done until finally all the options have been exhausted and she is wheeled into the operating room.

Yes, having a doula present will decrease your chances of c-section by a decent percentage, especially if you are a mid- to high-income woman living in an affluent country (https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003766.pub6/full

Women choose to go the hospital to have their babies for many different reasons, and none of these reasons are an excuse for an unwanted and unnecessary c-section. What could these reasons be? 

  • they want the security of being in a hospital
  • they wanted to have a midwife follow them but couldn't find one
  • they don't have health insurance and/or can't afford a midwife
  • they don't have a home that is suitable for a home birth (think abuse, living with a lot of other people who aren't supportive, and those kinds of things)
  • they don't know their options
  • they are forced to because no one will attend them at home because they're carrying twins, or have had several c-sections, or they're obese, or are substance abusers
  • they are followed by a midwife but get transferred to the hospital because of government regulations (labour too long, pregnancy too long, suspected this or that)
  • covid-related issues reduce their choices
Any number of these women could end up being part of the 25-30% of women who give birth in the hospital who end up with a c-section. The WHO suggests that 15% is a reasonable rate. I insist that here in our affluent country, a c-section rate of 5% would adequately save the lives that have to be saved by obstetric surgery.

How can you avoid an unwanted c-section? Ask questions. Hire a doula, or find one for free. Contact me and I will do my very best to connect you to the people you need. Find a midwife. Get a doctor who hears what you're saying. Say no. Don't do anything that seems wrong. 

Let's work together to put the Cesarean section back where it belongs - in the realm of emergency surgery!


Monday, April 5, 2021

Blast from the Past


You know when you decide to do some spring cleaning and before you know it you're deep in yesteryear, smiling over some things, scowling at others (how did I ever think that colour suited me?!?) ... well, that happens to me all the time with my writing and I've been doing a cleanup, getting my Doula Program running better (now that it's virtual I have more to play with but less at the same time...).
Anyway one of my most amazing yesteryear memories was the 13 years (2003-2016) that I was honoured to lead the Montreal Birth Companions. If you read StarHawk's Truth or Dare, you will realize why an anarchist such as myself made structural errors in designing an organization, so that when a seismic event like a sexual assault or even a power struggle hit the structure, it crumbled. People don't do well with anarchy in action, and so my beloved MBC died a natural death. BUT when she was alive, she was powerful, strong, and the MBC doulas literally changed so many women's lives with their kindness, skill, love, and caring.
So, here's a trip down memory lane. 

And if you're in the mood, give me a shout and we can start her up again! There are always, always women in need who cannot afford to pay for a doula. This blog post is from 2013:

provides free doula services, prenatal and postpartum support, and resources for refugee, non-status, and other marginalized women in Montreal.

We are in need of birth companions ... please contact me if you are willing and able to devote some time to our worthy cause.
If you are a doula and you can donate one birth every six months to MBC, we would be happy to have you on board!
We are looking especially for birth companions who are fluent in different languages. We would love to have more doulas from our diverse Montreal communities. We welcome everyone who has an open heart and is willing to donate their time and energy.

The women we serve appreciate the companionship, support and kindness that her doula provides. Women come from many backgrounds, walks of life, stories and histories. But the birthing year is the same: we want to give birth to a healthy baby, and we would like to have that experience to be filled with joy. This is not always possible if it is a sad time in the mother's life, but the presence of a birth companion can help spread the love.

We have clients from all around the world. Right now we are serving women from: Algeria, Haiti, St. Vincent, Germany, India, Nigeria, Philippines, Mali, Senegal, Guinee, and Quebec. Next month, we could receive requests from China, Cameroon, Mexico, the US, or Russia ... we never know where our clients will come from or when they will find us. We have had calls from women in their first trimester, and from women in labor!

Many midwifery students try to gain experience as interns in other countries. Volunteering for MBC is a way that doulas and aspiring midwives can gain experience working with women whose cultural attitudes and lives are very different from their own. It is a way that these doulas and aspiring midwives can really understand that the birth experience is universal, and that accompanying a woman in labor transcends language and reaches across boundaries.

photo used with permission



Wednesday, March 10, 2021

Birth Uprising Manifesto



I have been thinking a lot about my basic values, and I've come to the understanding that these five simple words spell out my goals, in terms of my life work with families through the childbearing year, and specifically with women through their reproductive life journeys.


Safe and Sacred Birth Choices.


Let’s start at the end and work backwards to the beginning!


1. Choices

2. Birth

3. Sacred

4. and

5. Safe


1. Choice


Choices are so important! And in our reproductive lives these days, we do have many, many options and choices. But sometimes we’re presented with choices that we feel have been already made for us, or we don’t understand what choices we have. This is where the idea of informed choice comes in.

Informed choice and informed consent are often used together in a medical setting, but they’re not the same at all. Informed consent means that you’re agreeing to something that someone has explained to you. I said yes to something that you kind of explained was an absolutely necessary thing I had to do.

Consent means I said yes. The informed part can be really vague.

Informed choice can mean that too, but real informed choice means that all of the options are explained to you so that you fully understand them - and their consequences. And then you can make a choice.

A real choice. And that choice, just like in what we like to call consensual sex, might be “no”. "No", I don't want to have a child right now. No, I don't want to be induced. No, I don't want you to do that.


I want choices to be informed, respected, and real for women during their reproductive lives.


2. Birth


Well, birth is where we all come from so it’s pretty important. But birth choices, for a woman, can also mean making the choice not to give birth. Ever. Or not to give birth right away. Our choices around birth start with whether to have a baby or not and move through the whole process after that choice has been made, and beyond.

If you decide to have a baby, then the complex choices start: where will I give birth? Who do I want with me during this childbearing year? How do I want to be treated while I am pregnant and birthing? Why am I being offered this medical choice, or another one? When will my baby arrive? Can I decide when I’m going to give birth? Why does my labour not start? Why does this hurt? What should I do?

There is so much education and respect that is not available for women during their childbearing year.


I want every woman cared for with respect, humility, love, and compassion.


3. Sacred

The word sacred can mean different things to different people. Lots of you might feel some resistance or annoyance with the word. That’s okay. Except that this word might be a key to understanding the childbearing year, women’s reproductive life, and even life in general in a different way. In a way that recognizes and affirms that we are not ultimately in control, that there is something bigger and more wild growing and living through us. Even if it’s chemical reactions, or hormones, or nature (whatever that is) or Spirit, Creator, Universe or God…. if we start to imagine that we aren’t the captain of this boat, ESPECIALLY if we are attending a woman during her childbearing year, then that humility will lead us to a place where we can actually provide better care. If we understand that the body isn’t just the body, and it is made up of physical things and also things that we can’t really name, like emotions, intuitions and thoughts. And that the body and those more unnameable things work together to make not only that human being you are accompanying, but also yourself; So that we come as humans to assist, to attend, to accompany other humans, but never as a higher power or an authority.


Sacred care in birth leads to better physical outcomes, happier babies, happier mothers and a better world.


4. and


"and" can open up so much possibility … I just included it because it’s one of the five words …and why shouldn’t a simple conjunction mean as much as another fancier word? And for me, this is the truth of working with women throughout their reproductive life; again, it’s a question of humility. Who am I, fancy person with years of study, to think of myself as fancier than a simple person who has asked for my assistance? If I decide that she can no longer teach me anything, then I’ve closed the door to real healing. That little word “and” can teach us a lot: it’s a little insignificant word but it binds the two parts of the sentence together. Like love.


Every birthing mother deserves to birth in love.


5. Safe


I’m not going to talk right now about the dangers of childbirth. Just ask Dr Google and you can scare yourself silly. I won’t tell you all the scary statistics or tell you the horror stories. But what I will tell you is that our maternity system, the global maternity system that we have in place right now, is hurting women and babies. The affluent women are surviving technology-led birthing practices that take no account of the whole human beings in front of them. The less affluent women, and the black and coloured women in the US, are being treated worse than animals and are being denied decent care, either because of poverty, racism or both.


I want a maternity care culture where the safety: physical, mental, emotional and spiritual, safety of the woman who is birthing the child (or children) is the absolutely most important thing in the world at those moments, for the people attending her.


I am working hard towards this goal.


This week, I’m crying for the mothers I’ve served. The details aren’t necessary for now but I’ve spoken to six women this week; one with a tragedy; one with rage against her doctors; one with a potentially fatal diagnostic error; one with a natural birth that was interfered with; one is expecting to birth alone; one setting her boundaries hard and high.


Women shouldn’t have to fight for their right to have good, respectful care during their childbearing year.


My demands are:


Birth attendants (doctors, midwives, nurses, doulas), do you know that there is a whole movement of women who don’t want to be cared for by you, because they don’t want to be treated badly? They are not children, they are humans with whole lives, and they want to be able to make choices that may be different from yours. These women also deserve SAFE care. Here are some suggestions:


Take some lessons in self-care. This is not an option. You can’t care for others, especially for those who are bringing a new life into this world, if you do not care for yourself.


Cultivate your ability to love others. Love is not an option. You must love the woman you are supporting.


Leave your ego at the door of the birthing room. No, you are not in control. No, you are not the captain, and, no, the buck doesn’t stop with you. You are an assistant, a vessel, maybe even a highly trained one. But your job isn’t to provide judgement.


Be honest. If you don’t want to take extra time before you reach in with an intervention, take the time to explain why and ask yourself honestly if you know what the consequences would be if you waited. If you’ve never waited, and there are no studies to show what happens when you wait, then it’s all superstition and you don’t really know. If you say, “I’m not comfortable with not waiting, but there are no studies to back me up” then a dialogue can begin. If you say, “We have to do blah blah or your baby will die.” then there’s no dialogue, just fear and power and ego.


Be curious. Maybe some of the methods and theories suggested by others are actually valid. Have a look; open your eyes; don’t do a knee-jerk “NO!”. This goes for all of you – I’m not targeting doctors here. I know enough alternative practitioners who are quick to judge as well.


Be attentive. Medical practitioners have forgotten how to be attentive with their senses, and not with their machines: Sight, smell, touch, listening are the four senses we use (and we leave taste for dinner!). And intuition, and the important sense of humour! I don’t know of any kind of healer, where they’re a specialist with sixty years experience or a beginning midwife, who does not value the kinds of messages their intuition will give them, if they’re open.


Listen to the woman who is birthing. Who is she? What does she want? What does she know?


And here's some advice for all you women out there, trying to navigate the realities of your reproductive lives:


Be curious. Ask around and find the path that suits YOU, not your friend, your mother, sister, or even your partner.


Learn and keep on learning. Knowledge is power!


Reach out! There is a whole world out there, and there are people who might be able to give you the answers you are looking for.


Don’t be shamed! Whatever you choose for your journey is your very own choice, based on who you are, who you were and who you will be. Whether to bear a child, where, with whom, and how are all personal choices that don’t belong to anyone except you and your partner. If you feel shamed by a friend, a group or a professional, stay away!


Listen to your body.


Demand choices! Demand your rights! Don’t be bullied, even when you are labouring. If something doesn’t feel right, stand up and say no! If you can’t do that on your own, then hire a doula. If you can't afford a doula, find a free one! I guarantee you I will find you a free doula if you want one…


Know that we love you! Find a community, we are around.


For more information about Birth Uprising, leave a comment or reach out, you can find me!


Love, power, peace and love again.



Sunday, February 21, 2021

Impostor?

"Coming out" is one of those phrases that is specific to the 20th and 21st century. It means disclosing a personal, private part of oneself to others. Some keep it private and let just their family know about their sexual orientation or their gender identity. Others have a big party, either in real life (pre pandemic of course) or on the social media.

But I've realized it can come to mean other kinds of disclosures: telling people about parts of yourself that you're afraid they won't like, or that will change their image of you, or that will actually put you in real danger. In the work I'm doing now, accompanying women during their reproductive journeys, I spend months having weekly check-ins with them, and one of the themes is always that they don't feel honoured, or even ready, in their task of making choices about their reproductive life. Whether to have a child, or to have a child without a partner, or to have a baby in the hospital, at home, in a birthing center, with midwives or a doctor or completely on their own; whether to have an ultrasound, or not; whether to keep the placenta, eat it, burn the cord; to breastfeed or not: all of these valid choices that should simply be informed choices, are bound up in fear. Fear because this person or the other person will not like you any more, or won't be your friend, or that you'll lose a community. Fear of being "cancelled". Fear of never, ever being good enough. Fear of being judged.

Impostor Syndrome is a phenomenon that has been recognized in the world of psychology since the late 1970's, but it isn't yet a classified disease in the DSM. This term describes a phenomenon that is increasingly common in "high-achieving" individuals. It is when you feel like you've only gotten where you are because you are basically a wily impostor. And by "getting ahead", I'm not just describing the traditional late-capitalist machine where women and men scramble and scratch their way to the top. No, none of us are off the hook here. It can happen to the most radical, kindest, authentic and all-around wonderful person as well.

Studies show that this syndrome is more prevalent amongst certain groups. My interest is and always has been and will be women, so I'm just going to talk about how it possibly evolves for us. Let's begin with what women are taught. We're taught that we should "get ahead". We can have a career, good looks, a doting partner, children: we can have everything! Especially if we're white! We are also taught, however, that it's not nice to make a scene. That assertiveness can be named "bitchiness" in the blink of an eye. And who wants to be thought of as a bitch? Or, in the case of a Jewish woman I know who was a successful professional, who wants to be thought of as a money-grabber? Or, for a Black friend of mine who is very successful at her job and managed to also create a beautiful family, who wants to be thought of an exotic sexy bird that somehow got lucky? Or that Asian woman who worked hard to get into her field, and does well at it, but everyone "knows" that her family just bought her into it. You get the picture. 

Ok, so it seems to me that this syndrome has a lot to do with WHAT OTHER PEOPLE THINK about you. Or what you imagine they imagine about you. It's the same, really, as the concept of Coming Out. A person's sexual orientation or gender shouldn't actually be anyone else's business. You're a boy? A girl? You like women? Or men? Great, good, and wonderful. Just don't hurt anyone, and we are good to go. Wear what you want, do what you want in the bedroom and in the world beyond, but care for others and be kind. Or at least that's how it would be in MY ideal world. But, of course, we are living in an aquarium-oriented world, where everything we do or say (and even anything we might believe for five minutes and post on the social media) can be and usually is held against us. Or used as a building block to create that persona that someone else creates about you.

Instagram bios are short: cute, to the point, often using interesting words that may or may not describe the person. What do we actually do on Instagram? We share information, we tell tiny stories, but most of all, we persuade other people to like us. Everyone knows that we create personas; avatars; versions of ourselves that we want to present to the world. We do it in real life, and we do it online. We want people to like us so badly that we create images of ourselves that aren't true at all. "Well, maybe you do that, but I don't" I'm sure will be a common response to this statement. And indeed, it's awful to think that you would actually lie, or falsify who you really are, or create a nicer version of yourself - especially if you work in a caring profession, as I do, as a birth companion who is expected to be honest and upfront.

But here's the thing, even if you have all the best intentions, people will always create a picture of you based on what they imagine they see, rather than looking at the "you" who really exists in front of them. In fact, one of the most important lessons I teach my students is to never form judgements of the woman you are accompanying on her reproductive journey.  You will hear the most surprising things if you keep your ears and your heart open.

I'm getting to the Impostor Syndrome, in a slow sideways manner. 

"Mr. Drake Puddle-Duck advanced in a slow sideways manner, and picked up the various articles. But he put them on himself! They fitted him even worse than Tom Kitten. "It's a very fine morning!" said Mr Drake Puddle-Duck." (Beatrix Potter "The Tale of Tom Kitten")

An outfit drops from the sky. It looks okay. You pick it up, put it on, and figure it fits. You walk around in it for years, until one day it gets too tight and you realize it's just not you. We feel like impostors not because we haven't done the work, but in spite of it. The Impostor feels like she has ended up in the wrong (successful) place, just because of her looks, or her lies, or the fact that she can spin a good yarn. She feels like people imagine she knows more than she really does (even though she actually does know a lot). 

She keeps these doubts inside though, of course, and continues to put her best impression forward. She is the woman with the great career, or the mother-earth type, or the one who has children AND a career, or the one who does everything singlehanded. Whatever role or persona she has chosen for herself, she has to hide her doubts and flaws in the outside world, or in the virtual world, because those doubts and flaws would PROVE that she's an impostor! Does our culture insist upon everyone feeling like a badly reflected image of who they "really" are? Because we crave authenticity and the "real experience"? And we aren't interested in the kind of life that is thrust upon us, one where everyone has their roles clearly mapped out for them. 

I spent some time in a cult (yep. I've been along so many roads in my life; it's one of the reasons why I a: can meet people where they are and b: never expect people to be who I imagine they are). Anyway, the beauty of belonging to a cult is that you never have to question what you're supposed to do. You just do it, because that's what you do. That's what you're told to do: what GOD told you to do! You never have to decide anything for yourself, and you certainly don't tell anyone about your real dreams, desires or inner self. That's an extreme example, but I think that in the past people lived much narrower lives, where certain aspects of yourself were never exposed (hence the modern ceremony of "coming out"). 

Well, I suffer every day feeling like an Impostor - in so many spheres of my life - as a runner, a wife, a midwife, a woman, a cook, an Italian speaker ... you name it, I'm a fake. But the way that I have chosen NOT to wriggle out of that uncomfortable feeling is to tell everyone all about my stuff. 

I've decided that the best way for me to travel through this life will be to keep myself to myself; learn from my experiences; and, above all, be open to others. And if that's the life of an Impostor, so be it. 



Sunday, February 14, 2021

The Elusive VBAC

 

I love to listen to birth stories. Many of the stories that I hear are a testimony to the pregnant woman’s great ability to “animal out” on her attendants. One of my favourites is the story of a young woman who had her first daughter by cesarean section. She became pregnant again the same month (yes, I know … but true), and it turned out she was carrying twins. Her doctor was very alarmed and booked her for a cesarean at 38 weeks. She went into labor at 36 weeks and delivered two lovely girls, vaginally.

 

Two remarks have stayed with me over the years, and these were both delivered by obstetricians to a labouring woman: “Childbirth is like war, and I am on the front line” is one. “This is Monday morning in a busy hospital. There are road accidents, emergencies…” is the other. This was said to a woman who wanted to labor a little more before going to surgery, implying that the birth of a child had to be scheduled in somehow between a messy car accident and some other horrific case.

 

Why did the first man want to become an obstetrician? How did he feel about his “patients”? How had he been born? What was it about birth that gave him images of war? The second remark came from a woman. What was it about birth that frightened her so much? How could the birth of a child be imagined in the same breath as a car accident?

 

What is it about childbirth that makes people think in terms of war, accidents, and death? Is it just fear? And if it is, what exactly is everyone afraid of? And, more importantly, where does the midwife fit into this mosaic of fear, or does she fit in at all?

 

The doctors and midwives who are afraid of childbirth are partly afraid because of their training. Allopathic medicine teaches about pathology rather than about the whole healthy being. In obstetrics, pregnancy is often seen as a pathologic condition that can throw the whole system out of sync.

 

If we look deeper, however, we can see that there is another, more complex root of this fear, and it has to do with the fact that Western medical training teaches health workers to rely only upon their own knowledge. How can this lead to fear?

 

Let me explain. During childbirth there is something present that is outside of us as individuals; outside our knowledge; even outside our experience or our skills. That “something” has to do with faith. It is only with a leap of faith that you can appreciate or even accept that a new human being comes out of a woman’s vagina. Without that leap of faith, what happens? Two things: more obviously, you have to interfere: pull it out, or cut it out another way.


Another thing happens as well. Strangely, your faith (most of us have faith in something) gets turned inwards. As an obstetrician, or as a midwife, you begin to have faith only in your own skill. And that is what is frightening – that an event that cries out for the presence of the Divine (or whatever it is that you would name that) gets reduced to the simply human.

 

I know that there are obstetricians who work differently, but I think that it is easier for a midwife to accept that there is something else, something larger than herself, working through a birthing woman. It is quite noticeable how many midwives do live in sight of that something which many of us name God.

 

But what happens to a sympathetic midwife or physician who is working within the medical system? What happens to her sensitivity to that Other that touches us when we give birth?

 

What do we see in a hospital? We see, first of all, an exaggerated reliance upon technology. The use of technology has a snowballing effect, creating the need for more and more complicated interventions. Secondly, the hospital maintains a rigid hierarchical structure in which usually one person is calling the shots. Finally, we see the “spiritual” infrastructure, upon which this hierarchy is based, to be inward-looking and grounded only in human knowledge.

 

What happens in the hospital when things start to “go wrong”, when things don’t follow the prescribed path? When I went into hospital in labor with my first child, the nurse, who was actually a Scottish midwife, touched my belly and said cheerfully: “This baby will be born by noon!” As time went on, she touched me less and less. By the next morning at the start of her shift, she didn’t even greet me. As the nurses let me eat and drink less and less, my cervix closed tighter and tighter. I was touched less and I began to feel more and more isolated. Finally, I was only touched when absolutely necessary. The baby’s heartbeat was checked less often. I began to feel abandoned.

 

Our national cesarean section rate is quite a bit higher than the rate suggested by the WHO, which is 10-15%. In Canada overall, the rate is closer to 25%. I’m not interested in exploring why the rate has shot up so precipitously in the past 30 years, leave that to others who love statistics and platitudes. What I am interested in, is threefold:

To create an environment in which every woman has access to a safe and sacred birth.

To provide access to first-time mothers to be able to experience a vaginal birth BEFORE cesarean.

To facilitate VBAC (vaginal birth after cesarean) for women who are seeking that route: to provide information, support, informed choices and LOVE.

 

Here is some advice to midwives, doulas, and physicians who are working with women who want to give birth vaginally after a cesarean:

Remember that the previous cesarean(s) have left scars not so much on the uterus as on the woman’s sense that she is capable of giving birth. Accept that having a cesarean can hurt.

Please don’t describe to her how a ruptured uterus may feel. Watch for danger signs yourself; keep your concerns to yourself and your co-attendants.

Remember that “failure to progress” means that a woman was probably afraid and stressed. She does not need to be reminded of her failure.

Keep things easy when they get tough. Remember that a woman working for a VBAC will do well in the comfort and security of her own home.

Remember that she may need to work on building confidence, on throwing away fear, on finding her “animal” self.

Tell her you love her. Give her and her partner some time to be alone together during labor.

 

Remember as well, that if she ends up giving birth by cesarean another time, don’t abandon her. Give her the support through the birth and afterwards that you would give to any birthing woman.

 



Thursday, January 28, 2021

Placenta Magic


"I knew a placenta once. She was a big gal. Knew how to hold her space. I considered inviting her home but others said "oh no - no, no, no.," and then she was gone, just like that."


Most women these days who give birth surrounded by doctors or midwives don't learn anything about the placenta before they give birth, and then afterwards it disappears just like the one Sarah described above. She birthed in the hospital, was followed by midwives, and had no idea that her baby's magical organ would simply disappear into the bowels of the hospital.

The placenta is a unique organ that provides nourishment for the fetus during their time in the womb. It is attached to the mother's body; it works as a filter between the mother's blood and the fetus'; it provides the fetus with oxygen-rich blood from the mother's body, and allows for the transportation of oxygen-depleted blood to leave the fetus' circulation and get transported back to the mother's circulatory system.

After the baby is born, the uterus works to expel the placenta, and if the umbilical cord has not been cut, then the attached placenta separates from the baby's body within a few days to a week after birth. However, it is very common practice now to cut the umbilical cord even before the placenta is born, thus depriving the newborn of some of the oxygen that it could have had access to without the separation.

Many women do not know about the placenta. I've created a Mini Series about this magical organ on my Baby Magic Podcast. Listen up on the 9, 16 and 23 of February, 2021 for a look at the placenta: 
On February 9 we will be guided by Patricia Edmonds, midwife of over 40 years, who will answer the question: What is the placenta? 
On February 16 I will be chatting with two women who decided on Lotus Birth for their babies. One of these women gave birth in a hospital, and the other at home.
And on February 23 two business partners from Australia will enlighten us on placental encapsulation and the benefits of ingesting placenta.

Listen up! I hope our meanderings through the world of women's bodies, justice, and love are pleasing to you.