Grateful for Dogs?

Even though I have a punk-rocker scar on my head where no hair grows from being bit by Skippy when I was a year and a half and I though it was my ball but clearly he thought it was his - and he paid dearly for his mistake! But anyway, even though that, and a huge scar my mother always had on her elbow from a badly trained guard dog in Uganda, even though these bad dogs bit us, I am now very grateful for dogs and in particular for Stella pictured above. She has taught me about unconditional love, playing, guilt, and determination.

Ok, there we go. So I'm grateful for D for Dogs.

But what I really wanted to talk about was D for Dreams. How we are molded and folded and ultimately completely remade by our dreams. How our dreams make us what we are and in turn we remake our dreams to fit the new person that arises whenever a dream turns sour or gets different, as dreams do.

My first dream: I wanted to dance forever on the sand, wearing little clothing and having the constant presence of my Ayah who loved me (but of course now I realize that she must have had a whole other life and that her caring for me and loving me was only part of the colonial myth that my parents were living).

My second dream: After getting yanked from Uganda to Calgary where it snowed and people wore a lot of clothes, I had a dream. My dream was to be an astronaut. I studied the planets and the stars, bought a telescope, kept a journal where I marked the positions of the stars, built model rockets, and made a small spaceship in my closet where I would head off to space every so often.

My third dream: Adolescence is a bitch. I realized life was hard and no one really knew the truth. I decided it would be a good idea to change the world. I thought I would like to be a doctor.

Then, things went crazy, life intervened, I travelled, had babies, married, and decided I wanted to accompany women in childbirth.

My Birth Dream: 

I studied midwifery and obtained my Certified Professional Midwife qualification. I started studying in 1988, when I was pregnant with my third son. I continued my distance studies for ten years, and then started working as a doula. In 2004 I started the CPM program, and in 2014 just after my mother died, I passed my final exam and became a professional midwife.

Yay!

Except ... except that I had miscalculated and I hadn't really grasped the reality of having a CPM qualification in Canada, where legislation requires midwives to be university trained in order to be licensed in order to work legally.

And now here's the big question: who wants to work illegally as a midwife? If midwifery is actually illegal, you can hone your skills and use your technologies such. as they are (Pinard horn, fetoscope, doppler, palpation, suturing skills, episiotomy if necessary, cord cutting and the like), and then if you really need to, there's always the hospital where you can pretend to be the birthing woman's friend.

But in a situation where midwifery actually is legal but restricted, that makes it much harder for anyone to actually monitor a mother and baby when things start to move outside of the norm. And, despite all sorts of people's convictions, I believe there is a norm that birth usually happens within. There's a certain time span when the woman feels certain things, when baby descends and then emerges. Within that norm, there's a ton of variation, and within that norm there's no need for intervention at all. But when things stretch outside of the normal, that's when the restrictions become dangerous and that's when our hands are tied. Because there are always women, and even more so now that Covid restrictions have made homebirth even harder, there are always women who want to birth their way, in their own home, with whomever they want present. And they call me to ask if I will be their "fly on the wall" in case something happens.

What? How can I fly do anything if the shit's hitting the fan? Granted, shit doesn't tend to unfold at a normal birth.... well of course meconium happens sometimes and mamas poop... but that's not what women are asking me to do.

Let's just use logic here: 

1. First, let's remember that the original "concept" of the modern doula was the result of a flawed study on maternal-infant bonding. One of the researchers had provided verbal support to the mothers she was observing, and those mothers had quicker and easier labours. So I guess if a mother is planning a "fly on the wall" kind of birth and she wants someone present to encourage and reassure, then she might want to hire a doula
2. What shit might hit the fan? What are women afraid of? I've asked women and they tell me they're afraid of hemorrhage, of the cord being around the baby's neck, and of something happening with the placenta. Partners are afraid the mother and baby will die. But if a woman is actually worried about these things, why would she place her trust in someone who is actually not allowed to do anything about it? Or does she think that her perfect birth is worth that other woman's livelihood, marriage, and possibly her home?
3. The unassisted births I've heard about either before or afterwards are those where the mother and her partners decided to give birth either on their own or with select family or with a doula present. NOT with a trained by handcuffed birth attendant. 

There are tough choices to be made, all the time, in the land of the living. I myself always seem to be figuring out exactly how to live on a knife's edge. Yes, I provide prenatal guidance and support. Yes, I have been a "fly on the wall". Yes, I train doulas to accompany mothers to the hospital. Yes, I will tell you that I believe you should call your doctor, or get to a hospital, if I think that is right. No, I don't believe that nature is particularly gentle. No, I don't trust women's bodies. Not after millenia of patriarchy have inflicted deep, deep wounds on our abilities to recognize when it's right and when it's wrong. 

Would I risk everything for a birthing woman? I have and I will. But not for random shit that's hitting a fan that we ourselves turned on. 

Today, I am grateful for Dogs.

Birthing a Marathon?

mile 22

The way I see it, running a marathon and birthing a baby are very similar. I have attended well over 500 births (but under 1000 for those who are into numbers), and these three answers are the most common ones to the prenatal question I ask: "What is your greatest fear?"

• Dying
• Pooping in public
• Not being able to do it

I am a ravenous running nerd, and I read everything and anything to do with running, and I believe these are the three main fears of the marathon runner too: no one wants to die (hence the plethora of articles about people dying at races; no one wants to have to poop suddenly while running (more articles; EVERYONE worries about not finishing a race, for whatever reason.

When I am accompanying a pregnant woman, I may speak with her about her fears for the coming event. The number one fear is that her or the baby will die. Number two, fittingly, is that she will poop during the pushing phase. And number three, as in a marathon, is that she will have a DNF which actually is impossible in birth but, unfortunately, a definite possibility in every runner's mind.

Birthing and Running are the Same?

No, they're not the same, obviously, you can't compare a baby to a piece of bling!

You can compare some of the feelings, though. The hours, days, weeks and months of preparation. Finding a program or a method that matches your philosophy, or hiring a running coach (or a doula - we used to be called "birth coaches"); learning about nutrition; getting excited, then nervous, then depressed, then excited again; talking to other people who have done it ... of course, if this is your first baby or your first big race, all these feelings and choices will be felt and made in technicolor. If you're more experienced, you will still feel the same range of emotions, and you'll be "in the club".

That's where the similarities end, unfortunately.

Running the Drugs?

Runners, imagine this: You're at mile ten, almost half way through your marathon. You're keeping a good pace, maybe you started a little too fast, because this is your first. Your training went well, and you're feeling good. Mile eleven, you have to pee. You take a quick pee stop. At the next station you have a sip of Gatorade and you start to feel a little queasy, the way you ALWAYS DO when you have some carbs around miles ten to fifteen. You know this about yourself. It's a thing.

Suddenly, a car drives up and a bunch of people jump out, looking at their watches. "Your pace has slowed down too much! You're not gonna make your BQ! You might die!". In your head you know they're wrong, and you try to shut them out and run faster, anyway. But their worried expressions start to seep through your endorphin rush. "Oh, shit, does my heart feel weird?"

You let them know you're feeling a little tired, and you had that queasy feeling. All of a sudden, the car speeds up and they make you an offer: "Take some drugs, get in the back of the car, we'll drive you to the finish line, you'll get the bling anyway, all good, no shame, no worries." You protest - you're okay! But a voice in the back of your head says that actually, you're not okay. You need the drugs and you need the car ride. By this time, you're at mile 20 and you hit the wall. Take the drugs, get in the car.

Real Emergencies

Of course real emergencies exist, both during marathons and during birth. In those cases, there's no question that you need the damn car, preferably an ambulance, and you need drugs, and speedy medical intervention, and everything you could possibly grab for a life-saving conclusion to the RARE instance when you are actually in danger of losing your life (or if you're birthing, your baby's life).

Your Choice?

I'm not one of those airy-fairy militants who advocates a natural, candlelit birth for every woman. I've seen babies die, and I've seen women close to dying (Thank God for modern medicine!!). But I  do advocate CHOICE. I was just speaking to a fellow runner this morning. She's been running for twenty years and she's never gone further than 15k. She never races. She runs slow. Me, I've been running seriously for just over five years and I love to race. I push myself ... not too much ... but just enough.

I was at a race about a month ago - it was kind of tough: it was pretty cold and at one point the course turned into a muddy, icy puddle for about a kilometer, and it was a loop, so we had to do the puddle twice, once about the middle of the 21 k and once closer to the end. As I was coming up to the first mud puddle, I saw a runner with a weird gait... I got closer and I saw one of the yellow-jacketed medical people going over to him with a concerned air. The runner told him to go away. As I got closer, I heard him groaning with every step. He sounded like a woman in the deepest labor, feeling that baby's head right down low. A second medical person ran up to him: "Non, non, ça va, merci." ("No, no, it's okay, thank you!") I ran past him and didn't look back.

Here's the thing: I knew that if he was in that much pain already, there were two possibilities: either he would not finish the race, and spend months if not years fixing the damage he had wrought on his body; or he would finish the race and ditto. But, for whatever reason, he MADE THAT CHOICE and it was his to make. Obviously, if he was in cardiac arrest, or lying on the ground unable to move, the paramedics would be in there in a microsecond, doing what they need to do. But he was birthing a marathon HIS WAY.

Birth

I've witnessed a tiny number of births that ended up to be medical emergencies, where mother or baby could have died. But most of them are normal, scary, joyful, life-changing, painful, pleasurable, primal events. Unfortunately, the people who work in the maternity care field are usually unwilling to adopt the "marathon runner" model, and instead use the "air crash" model. In the latter, birth is simply an accident waiting to happen. In the "marathon runner" model, the birthing woman could be treated like a marathon runner: during the nine months before the event make sure you are healthy (I got a cardiac ultrasound done last year before starting my marathon training because of a risk of familial cardiomyopathy); create your team; and start preparing.

Let's skip ahead to the "event": the runner has been trainings for months. She followed a training program, or had a coach guide her through the realities of training to run 26 miles. The birthing woman has been preparing for this day for months as well, and she has been working with her team to make the upcoming event as pleasurable as possible.  Both the runner and the birthing woman have possibly been reading everything they can about their upcoming event, and both may have suffered setbacks along the way.

Running

And, now, what happens when you're running a marathon? You join a big, happy crowd of people, and you start. As you run the miles, you are handed water, energy drinks, yummy gels, bananas. All along the route there are smiling people, holding funny signs, cheering you on, giving you high fives ... letting you know you're doing great!

No one looks at you with a worried look, even if you're the oldest person in the race and the slowest (happened to me on my 60th birthday), they just keep on smiling and cheering, unless, like I said, you're on the ground.

Then why, oh why, did my lovely, young, strong, healthy, well-fed, happy labouring clients get the hairy eyeball from the staff when all they were doing was, basically, the marathon of the day. No smiles, no happy people handing you cute cups of water, no cute cups of energy drinks, no gels, no bananas, no funny signs, no high fives.

The epidural rate for first time mothers in Montreal hospitals is over 90% (don't look at the published statistics, they include second-timers who know better, and pull that statistic down to around 60%). Why? Because we focus on the fear aspect (YOU COULD DIE!!), instead of the fun aspect (YOU GO GIRL!!).

Fun Stuff

Yes, the truth is that running a marathon is just plain more fun, and more pleasurable, and better appreciated, than bringing another human into the world. Weird.

So, I guess that's why I don't attend births in the hospital too much anymore. It just kind of tickles me when I imagine birthing mamas being treated like runners - and how different it is from the reality:

"hey, I know you're planning on running the Barkely, but it looks really dangerous. I think you should run it attached to an IV pole."

Or, "hey, I know you're 60 and you're planning on competing in the World Marathon Challenge. This is super dangerous, why don't you just get really stoned and we will drive you around - you deserve it!"

Or, "you know you could die doing that? Running a marathon/birth/solo travel/sailing/(fill in the blank) is just too dangerous."

Yes, I know I'm gonna die one day, and I'll let you in on a secret - so are you. And so is everybody. But I really wanna have fun while I'm doing this crazy little thing called life. Spread the Love!

Shields, magic, bubbles, screens

 

One of the key qualities that a doula or a midwife seeks to make use of during her journey with a woman as she births is the ability to create shields, bubbles and screens. This quality is akin to magic, and it is hard to access and even harder to use skilfully. 

1. Shields can help prevent a birth attendant from bringing her own baggage to the birth room. To do this, we must place the birthing mother at the very center of the experience, so much so that our own desires, opinions, concerns, and emotional reactions do not really matter. At the same time, we must be constantly aware of the health and well-being of the mother and child, but not in an emotionally infused way. Rather, we have to notice what is happening, much like a Buddhist will notice emotions as they drift past during meditation.

2. Bubbles are wonderfully useful and I made so many of them when I was working as a doula in the hospital setting! A bubble is a protective sphere around the birthing woman. It can include her partner, you as the birth attendant, her midwife, her mother or whomever, but its main purpose is to maintain an emotional or spiritual "space" within which the birthing mother can find her way. Often the woman giving birth has other people's ideas and opinions floating around in her head, which can detract from the intensity of what she needs to do. The bubble will often give her the chance to be fully aware of what her body is doing, so that she can stop thinking through the event.

I will create a bubble by visualizing, but also with physical closeness to the woman (eye to eye contact, light massage), and also with carefully chosen words and a physical distancing (turning my back) from the people outside the bubble. Sometimes it will be necessary for the woman to move to a different room in order to fully accept and embrace the bubble.

3. Screens are effective when there is a danger of you, the birth attendant, becoming emotionally engaged with another person in the birth room. You must erect a mental screen so that your exchange with the other person doesn't infect the atmosphere in the room. For example, if the birth is taking place in a hospital and the nurse is feeling lonely and wants to chat about the patient in the next room, I always like to erect a friendly screen so that the nurse doesn't feel rejected but she knows that conversation isn't appropriate. On the other hand, if a member of the staff is being abusive to the birthing woman I will erect a very strong, impenetrable screen that shields the birthing mother and her family from the anger or ugliness that is taking place. This can be very difficult.

These methods can be used outside of the birth room as well, in stressful situations in all walks of life. Just get your magic on, and you can create a peaceful dwelling for yourself and those around you.

Finding Center

I lost my centre over the past few months and I'm not sure how. I've been feeling like a small boat in the middle of a big sea. The desires and defeats and dreams of others became my reality. I stepped up to a plate I don't really like.

Yesterday,  no it's last week now, I ran a half marathon, that's 13 miles. My phone had broken so I didn't have music to listen to, so I only had my own thoughts and the sounds of my feet, my breath, and other runners talking or the Canada Geese honking in the background. I thought about how I have gotten to where I am, and how my beliefs and convictions have changed and matured over time, but how they got mixed up and sidelined over the past year or so.

Women's reproductive health has always been very important to me. I've worked in the field of maternity care for over twenty years, mostly as a doula but also as a midwife. I am not registered to practice as a midwife here in Canada, so I've restricted my practice to other places and different ways of practicing. 

As the complications and controversies grew and thrived as we lived through a pandemic, I started to hear from women who did not want to go to the hospital to have their babies, and neither did they want to have their births attended by registered midwives. In their opinion, the restrictions put in place for birthing women and their families were oppressive and inhuman. So these women wanted to give birth on their own.

Most of the women who contacted me felt strongly that they did not want to wear a mask during labour; they did not want their partner or doula to be restricted; they do not believe that the Covid vaccine is necessary or valuable. The vaccine passport in Quebec is now required for a doula to accompany a woman to a hospital or birthing centre, and this is also part of the reasons why this group of women are seeking answers elsewhere.

My life has been devoted to a few things: my own family - my husband, my five sons, and their new families; my attempts to live a good life; and my desire to facilitate change for women, their children, and the world as a whole. For me, that desire became focused on working to find ways to make decent, safe, respectful, woman-centred health care available for every woman. 

So when women started calling me and wanting my assistance, advice, and companionship, I agreed that I would provide prenatal support - virtually - and I would accompany them along their decision-making paths to childbirth. You know what? That's insane, and reckless, and lacks consciousness, and that's why I believe that I somehow, somewhere, lost my center. The paradigm doesn't work. Because prenatal care is about touch, and attention, and the five senses, the sixth senses, and all the senses in between. Common sense, for one. 

If a woman wants to give birth on her own, for whatever reason, I actually support her in that choice. I don't like to tell people what to do, generally. But I also like to hold people accountable for their actions. And that means that if you're giving birth on your own, then you don't involve me. Why not? Let me explain: I've had many calls from women who want to give birth "outside of the system". And they want me to be a "fly on the wall." Why would they want that fly there? "In case anything goes wrong". Well, the fact is that, in fact, things DO go wrong during childbirth. And if you're giving birth on your own, you should recognize that and figure out what you're going to do in that situation. 

But it's not right to rely on the knowledge and experience of a fly, and it's not right for a doula to offer to be that fly. Because then when things do go wrong (which, yes, is very, very rare), then what's a fly supposed to do in an emergency? 

I'm taking time away from some things for the next little while, and I don't even know which things. I will be making some time for myself: time to think, to ponder, to meditate, to run, to declutter, to find peace, to find my center again.

Birth and the Fourth Trimester

With all the fuss and bother these days about where women are going to give birth and what will happen to them when they get there, or if they stay home if they will have competent support, or if they're giving birth on their own if they've prepared enough spiritually to accept whatever may or may not unfold ... with all the conflict and controversy about who is vaccinated and who isn't, and what restrictions have  or haven't been put in place been put in place ... with the removal of the woman from the center of the birth experience and the forgetting of this vital fact ... most importantly, we have forgotten that after the pregnancy and birth, there is usually a baby! 

Many, many women find themselves at home after their baby has been born, without much idea of what to do, what they should do, or how to do it. Personally, I was lucky. I came home after fairly difficult experiences with my hospital births, and the breastfeeding went exceptionally well, and my maternal instincts led the way. But over the years, I've seen that my experience isn't common, and I'm moved now to do as much as I can to teach birth companions and doulas about how to provide care during those important hours, days and weeks after the baby is born.

I'm teaching a course on this important time that will be starting on October 26. That's a Tuesday, and we'll be meeting online every Tuesday evening from five to eight pm EDT for eight weeks. The course covers what we will usually see during these days and weeks; how we can use all six of our senses to care for a new family; we will explore elemental ways of nourishing; we will be taking a good look at the family, the motherbaby dyad, and the newborn mother to truly understand how best to increase pleasure and strength during this seminal time.

Breastfeeding is a big part of many women's experience, so we will learn about that. But it isn't everyone's, so we'll look at other options. We need to learn about how to do proper housewifery: cleaning, cooking, tidying, calming. We will be exploring some uses of herbs and food. I am hoping that the members of our class will bring their own talents to share with us.

Please let me know if you would like to join us!

Home Can Be A Tower

I'm thinking a lot about home, and what home means to us. We moved our family to a medieval tower in 1988: it was the beginning of a long series of adventures, some cool and exciting, others devastating and dangerous. I pulled the Tower card this morning for my reading, which can mean change in a fundamental way. It can mean the destruction of one home and the creation of another. It can signal the breaking down of old habits and patterns to make way for new: an eruption, a revolution.

I work alongside women who are thinking deeply about how they want to give birth. Most of them want to birth at home, and many of them do. Last week, one of the women I have been working with over the summer gave birth at home, peacefully, in her place, with her partner alongside her. She came back to the city from abroad because she felt the need to give birth "at home". She didn't just mean in her own apartment, on her own bed. She meant "in her home". She missed the smells of her city; the bicycles; the streets and trees of the place she knew - she knows - as her own home.

When I am invited to accompany a woman during her reproductive experience, whether that is pregnancy, birth, miscarriage, abortion, infertility experiences, or the decision whether or not to have children, I try to facilitate a way that she can work her way back to her "home". We all have a centre place, a home, that we need to be able to return to. When we can't return, we get lost. We get lost in other peoples' needs and desires. We get lost in addictions. We get lost in our jobs. We get lost in cleaning up. We get lost in the search for money or new things. We get lost and then the Hungry Ghost finds us and we feel empty all the time, and hungry, and we don't even know what we are hungry for. But the answer is, we're missing our Home.

I've never felt I had a geographic home. I moved from one continent to the next all my life: Africa, North America, Europe. I love the Canadian Rockies. I feel at home when I'm on a trail. I love the desert. Give me temperatures at body temp or higher, and I'm happy. Then again, I love the challenge of a 20 k run in 20 below zero. 

But I wouldn't say I have a home, like, I don't feel "at home" anywhere. I am at home when I'm with any number of my five children and their spouses. I'm at home when I'm running a long distance. I'm at home ... when I'm on a plane, looking down at my planet.

I listen with awe to people who speak of missing their home, how they miss the taste of a place, or the feeling of the wind on their faces in their home place. My journey is different: because I've never felt the geographic pull of home, I seek to find my centre, and I accompany others on their own journeys to their centres. When a woman is birthing in her centre, she is birthing at home. When she gives birth in her power, at the centre of the event, she has found her home. My job is to navigate with her so she can find the path home. Sometimes there are huge prickly trees in front of the entranceway. Sometimes her home is very small, so small she can trip on it at night. Sometimes she needs to lose something in order to find her home. Sometimes she needs to let go of one place to journey to the other.

Peace.

Makeup for an Old Tomboy

You all probably know by now that I am a new grandma!!! I can't believe I am actually allowed to say that, but yes. It's true. I feel like it's a gigantic rite of passage, and an honour, and more joy than I thought I would be allowed.. but yes, the wheel is turning as it should. And I am growing older and my children are now having children. As it happens, as it should. So be it.

My moon cycle ended when I turned fifty, or rather, the bleeding part of it, because of course I am still led by the moon and she still affects my body. But the miracle of bleeding every month has passed, and it passed with a dramatic few months when every 23 days or so I would lose what seemed like a bathtub full of deep rich blood.

I gained a lot of extra weight after I had my fifth child at 44. I was miserable, and I was eating too much and badly. I was lonely and out of my element. I felt trapped and disgusted with myself. The younger smarter woman would have left the trap she found herself in, but the older and slower one didn't.

But it was fine, because then I started to run, and run, and run until in 2018, on Mother's Day, I ran 26.2 miles. I felt great! I have always been the type of person who wants a physical challenge: back when I had a farm and four little boys I would always be physically busy. Even being a birth companion is physical. But running long distances is the best! So I just kept running. Every day.

But then Covid happened, and although I kept on running, I entered into a new phase of my relationship with my body.

Maybe because I was always running alone. Maybe because I hurt my foot so I had to take a break. Maybe because my Covid stress came out this way, but I started going through the same kinds of feelings many of us go through as girls when we start to reach adolescence. I remember being so terribly shy; so embarrassed about myself; so uncomfortable with my new breasts.

And suddenly, at 64, my infernal mask started giving me a rash on my face that looked suspiciously like my teenage acne. I started feeling self-conscious when I was out running, sure that people were looking at me and wondering why the plump older lady was lumbering down the street with a running watch on. The nightmare of adolescent self-consciousness started to mix and match itself around in my head, until I realized that I had the answer.

I've never worn a lot of makeup. My mother wore it, but she never passed on any tips. I went through a heavy black eyeliner look when I was a hippie, and then when I flirted with punk. But mostly I love lipstick. I've always worn it - every different color from the lightest pink through deep red to almost purple, and a lighter orange for the summer. 

Covid meant that my lipsticks all disappeared into a drawer. I was wearing it for a while at the beginning until I realized that lipstick plus mask makes a mess. I've been going out every day into the world feeling somehow... naked? 

That's what Covid has done to us. We're all feeling naked, or something close to it. Threatened, maybe. Either by the virus itself or by peoples' reactions to it. People are acting wonderfully and awfully. The best of us has come out, and the worst. Our reality has been jolted, as it is when we go through a life change like puberty, pregnancy or menopause. We've been pushed out of our daily routines, our habits, the familiar ways we used to interact with people.

So I feel self-conscious and weird. So does my friend and my neighbour, and even the young woman at the gas station. We're wearing our masks, and no lipstick, and many of us have gained some weight especially around the belly because of our extra high cortisol levels.

But I think I am seeing a little pinprick of light at the end of the tunnel. I see people interacting in different ways, and trying to create a new, better place for us to live. Of course, I could equally go the darker way and note how much more oppression and repression and basic bullshit there is, which is undeniable. The social media have made us worse as a species, not better. But let's say things are getting better. Let's say every "smile with the eyes", every kind act, every time someone went out of their way in the tiniest way, let's say those little things did add up to a mountain of change, and let's say we are moving to a new er and better "normal". 

Most birth journeys include pain, or at least a few moments of .... to call it discomfort is to minimize it ... ok, let's call it intensity. Most of the birth journeys I have witnessed have had several of these moments: before, during and after the child is born. Maybe this is a time of birthing change. Maybe we are birthing a new world, and the intensity and transition that we all feel is part of it.

But lipstick helps. 

 

Birth Portals

 Today I am on the second letter ... and that would be B, and B stands for Birth Portals.

This was posted on Instagram by @catearth76 and it is so true! But, and I am so full of "but..." and "wait a minute..." and "sorry what?..." these days, but what about those women who don't use that portal to birth their babies?

No, I'm not talking about how wonderful gentle cesarean is and how it's so great that we can lie on the surgical table and do skin-to-skin. Neither am I talking about women whose babies might have died if they hadn't been intervened with.

I'm talking about women who are pushed, coerced, bullied, lied to, manipulated, scared, threatened into agreeing to surgical birth for their babies when there really wasn't any good medical reason for it. This is a fact, it's real, and it's happening in a hospital near you. Especially now that Covid restrictions have made it impossible for a woman to bring the support she needs into the hospital or birth center, and it's made medical workers much more jumpy and afraid.

What is the actual spiritual damage that is done to that miraculous portal when a baby is yanked out through a surgical cut nowhere near the portal? How can we repair that damage? How can we repair that damage to babies, to women, and to the world? 

This is a question I've been struggling with for decades. I started working as a doula in 1997, and I truly thought that accompanying women to the hospital and providing doula support was a valid option. And, yes, I did have a pretty decently low c-section rate (around 10 %, compared to 25% at the hospitals I attended births at). But watching these births wore me down. Watching intelligent, adult women being lied to and treated like children (actually, since when was it fine to manipulate and bully little children?) hurt my soul.

I quit attending births for a while, for various reasons. And now I've started again, and I'm very clear that I only will accompany women who want to KNOW that they hold a sacred portal between their legs, and they WILL NOT be bullied into messing with it. This is my own bias speaking, partly because I wasn't strong enough to do that - I let every Tom, Dick and Harry and their female counterparts bully their obstetric, know-it-all, fear-mongering way into my obstetric activities. And the reasons behind that are many and unsolvable and complex. But I believe that the way I work now is the way to open up that sacred power, so that women can come back to the recognition of their own selves and their own bodies.

Women contact me at various places in their pregnancy journeys. Since I have been back in the practice, I have spoken with women who want me to walk with them throughout their pregnancies, and others who have called me during pregnancy, during labour, or after giving birth. 

When I walk with a woman through pregnancy, we meet online every week and speak for an hour. Sometimes we could talk about books, or what seeds they're planting. Other times we talk about how the pregnancy is progressing, or where they've decided to give birth, and whom they want around them when they're birthing. We talk about their fears, dreams, desires. We try to plan the kinds of support they will have after the baby is born, and they try to imagine what life will be like when they're responsible for feeding and providing for their new baby.

Sometimes we talk about stuff that's happening in their lives, either in the present or in the past, and how that will affect their birthing. Serious abuse in the past affects how we live in the present, and it can definitely affect our ability to reach deep within to find the power it takes to open that sacred portal. Fighting and anger in the present can sometimes mean that a woman no longer has a home where she can feel safe to give birth in, so that is another hurdle for her to jump over. Physical challenges and illness can also affect our body's ability to give birth, but these are rare. Often women worry too much about the physical aspects of pregnancy and birth, and they don't consider the emotional and spiritual weight of their pregnancy, birth, and parenting.

So, I try to walk with a woman and her family through this important time in their lives while maintaining an open spirit and an open heart. My open heart reflects with theirs and together we can find a place where that shy but powerful portal will open. Women are being cut open for no reason. Placentas are being pulled out with no reason. Women are not listened to when they say they have a pain, for no reason. Women are being ignored when they say they are scared, for no reason.

Or, wait, is there a reason? Who could want to keep that portal scarred and closed? Who could want to stop that power from being unleashed in the world? Who could want a world where we all remembered that we are all birthed through a sacred, fiery, spiritual, creative, awe-inspiring portal? Who might be afraid of a world that was held together by witch power and magic? 

Oh, so I forgot - this is a gratitude note! So I am grateful for Birth Portals. I'm grateful for witches, for womanhood, for love. I'm grateful for the circle of women who surround me and protect me. I'm grateful for the moon and the stars.

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!

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.

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. 

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.