Thursday, June 4, 2020

Safe Birth?

These days, we have all become experts at reading articles in medical journals, or studies, and we casually use words like "exponentially" and "virus shedding" and "evidence-based". So, I am not going to go that route again, and quote this or that Cochrane review that will further convince you that I'm right. I don't even want to think in terms of who's right and who's wrong. I want to go deeper than that. Way deeper. I want to explore what makes birth sacred, and what keeps it sacred, and therefore safe.

I have witnessed three newborn deaths in my doula practice. Two in particular stand out for me. One took place in a birthing centre, and the birth was attended by midwives. I was the doula. When it was clear that the baby was in serious trouble, the midwives, in their fear and panic, became insensitive to the mother's emotional needs. They told me, the doula, to leave. Mother felt isolated, abandoned, and traumatized even more than she had to be. These midwives, don't get me wrong, did everything they should have done medically, to try to save baby's life. But they completely ignored the spiritual, emotional, transcendent nature of birth. Conversely, I was present when another baby died soon after birth in the hospital. The medical staff provided a space where the parents could hold their child and say goodbye. The parents wanted me there, so I hovered, as a good doula does. The fact that they even had spiritual needs was fully honoured by the doctor, the nurses, and the orderly. 

Both mamas lost their babies. Both mamas grieved. But both mamas were not traumatized for years. Because one mother felt safe during her birth experience, and the other did not.

So, what can we do to keep birth sacred? I believe if the sacred nature of birth is remembered at all times, then the attendants will be naturally drawn to keeping the mother safe at all times. Sacred. Just play with the letters a little bit. Scared. Being scared during childbirth is something that has a physiologic root. When our bodies release the stress hormones that initiate the "ejection reflex", our busy brains interpret those feelings as "scared". I have attended the most natural, undisturbed, physiologic births where I have seen the mother become afraid at that moment. It passes, it's transient because it's just a reaction to a physiologic event.

But I've also attended too many births where the birthing mother was actually afraid. She was actually made to feel afraid by the words or actions of her attendants. I often found my job as a doula to be one of shielding, holding the sacred space, creating a human sound barrier between the abusive staff and the birthing mama. Scared destroys sacred. It degrades sacred, pulls it down, tears it apart. Scared does not belong anywhere a mother is giving birth. Even if you're the primary attendant, and you are scared because of something that's happening, your priority is to keep that fear from entering the space.

If a birth attendant doesn't believe that birth itself is sacred, then we run into problems. If you think it's just another medical procedure, then it makes it more complicated. But every doctor knows that a happy patient heals quicker and better than an angry or lonely one. So even if we're not talking "sacred" because some people are scared by the word, we can still try to keep the birthing mother happy, right? And a happy mother feels safe.

Our maternity care system is broken. Too many women go into the experience with no understanding, and they trust their medical caregivers of course, because why not? And they are sadly betrayed. They're told all sorts of scary things: your baby is too big, you're too old, you have a something percent of this or that horrible thing happening, you won't be able to stand the pain, your baby is too small, you live too far for a home birth, there are no midwives, you have to pay $10,000 before you can even think of birthing here, and on and on. Many, many women give birth just fine within the medical system, often with the loving attendance of a doula. These women are a testament to the strength of the birthing mother. But too many do not give birth just fine. They leave the hospital or the birthing centre traumatized and confused. Some traumatic birthing experiences literally take years to recover from. Other women live their whole lives with feelings of inferiority and a damaged sense of worth. Still others spend their whole lives to make the birth experience sacred and safe for other women (Yours truly!). 

There is a growing number of women who are taking the situation into their own hands, and their own homes. They are saying "no" to maternity care that is based on fear, and they're giving birth on their own terms, in their own homes, with people around them who they trust. Keeping birth sacred. 

I don't believe a normal pregnancy and birth belongs in a hospital. Hospitals are places where you go when your health is at risk, or you need surgery. Normal birth is sacred and belongs at home. The undisturbed mother feels safe, and everyone around her participates in the sacredness of the event. This has become clear during the current crisis, where the role of the hospital has been clarified by the event. 

But if we bring birth home, where it belongs, then are we sacrificing another kind of safety? If we don't have midwives who are trained in the art and science of attending Sacred Birth, then every home birth will be a "freebirth". Which is fine for those mothers who want that. But many birthing women want to have someone present, who knows about the things that can and do happen during birth, when it is important to have someone attending who knows how to respond.  

I'm asking questions. I don't have practical answers yet. I am grateful for you doulas out there who are still attending births in the hospitals, and I strive to support you as much as I can. I am grateful to the birthing women I attended throughout my practice, who taught and continue to teach me so much about Sacred Birth. 

Let's talk this out! Let's strive for answers! Let's change birth and keep it Sacred!


Wednesday, June 3, 2020

I am Listening for a Heartbeat

When Ahmaud Arbery went for a run in February, he was shot and killed. In the running world, a global campaign went up to run 2.23 miles to remember his birthday, February 23, which was a few days after he died. Later, I noticed the #runwithmaud hashtag on my running feeds, so I checked it out.

On Instagram someone I follow had proudly posted a picture of a 2.23 mile run, with the hashtag. The comments were in the hundreds. Having time on my hands, more time than usual anyway, I scrolled down a little until I got to something interesting, and terrifying. There was actually a conversation going on about whether or not Arbery was a "real" runner, since according to the poster, he was wearing khaki shorts and boots (he wasn't, actually, but anyway). The conversation proceeded about "who is a runner?" and "do you have to wear fancy expensive clothing if you're a runner?" (By the way, the answer is no, you could run naked if you want.) No, but that's not the point, is it? The actual argument was: if he wasn't wearing "runner" clothes, and he was wearing "thief" clothes, then somehow that made it alright to shoot him twice in the chest? Because he was a Black man running?

Most people by now know about the most recently famous racist atrocity to come out of the U.S., and I'm sure there have been more in the interim, and before, and after. The fires are burning, the people are on the move, justice is being called for. Lives are at stake. We know that "I can't breathe" was not something someone said when they were ill with Covid19. We know that George Floyd was murdered by a white man, and that the end of his life he called out to his mother.

As a white person, in fact one of the last colonialists in Africa (I was born in Kampala in 1956, when it was part of a British Protectorate), I am fully aware of my privilege. I am also fully aware that, as a feminist, I am offended and supremely annoyed by the spectacle of a man declaring how much of a feminist he is, and explaining my politics to others. A man cannot understand why I am a feminist down to my core. That's that, end of discussion.

That discussion feeds my understanding of exactly how I should approach the movement, the resistance against racism (institutionalized and personalized), the demonstrations, the anger. I am not going to shout out my support. Neither will I say that racism goes both ways, or that it's us, the people, against them, the racists (and colour doesn't enter into it). No, I don't want to be in the limelight as that amazing white woman who supports Black Lives Matter. I don't need to fill the limelight so that the people who really have something to say are, again, silenced. 

We all posted a black square on Instagram today. With the unfortunate use of the hashtag #blacklivesmatter, we inadvertently covered up important information that is covered by that hashtag. I believe that is a metaphor for what white people are always doing, with our louder voices and our automatic membership in the club of privilege. 

I think we all need to take a good look at ourselves, an honest look with a touch of humour, and figure out what exactly we are doing with our support. Are you giving money? Or are you posting a selfie of yourself at a demonstration and taking up space? Are you providing care for your black friends, or are you proclaiming to everyone about how many black friends you have? Are you clarifying stuff for your white friends, or are you keeping quiet and letting black people speak?

So, here I am, with all my black, brown, yellow and beige friends, patting myself on the back and being oh so PC. But I really only wanted to say one thing: 

I worked as a birth attendant for twenty years. I've listened to hundreds of heartbeats; I have looked into the eyes of hundred of birthing mamas; I've witnessed hundreds of babies being born. Every single baby is a special being; every single birth is a miraculous event. We are born the same: naked, from our mother's wombs. From the moment we are born, we have the potential to love each other or not. Choose love! White mothers, it is up to you to teach your children well. A naked, tiny baby doesn't deserve to be taught how to hate. And a naked, tiny baby doesn't deserve to be hated. 

I'm not prepared to pat myself on the back right now so that I can feel better about how I'm not part of the problem. The problem is such a stinking, complicated mess that OF COURSE I am part of it. For what it's worth, I support the fight for justice, for peace, and against racism. I submit my support with the understanding that no one needs or wants it. That your anger may be greater than my "support". In the meantime, I'm going to continue to work towards a world where every baby can grow up loved, cherished and fulfilled. Where mothers of babies can be loved and honoured and valued. Where people are not measured by the colour of their skin. Let this pain be the final labour pain in the birth of a just world. 

I am dedicating this to the innocent black people killed in the US, and to the innocent babies who want to grow up free, and to the mothers who have lost their children, everywhere.