Birth Conspiracy?

I remember seeing a medical student who was attending his first birth. It was a normal, natural hospital birth. The woman was on the bed, her husband was by her side, I was next to him, there was an intern helping with the delivery, a nurse, the physician in charge, and a young medical student. The baby came out, everyone was happy, the new parents were exhilarated and crying, and then the medical student exclaimed loudly: “Look! Look! Look at its little toes! Look! They’re like real toes. They’re just like real toes!”
The attending physician looked at him and whispered: “Philip, get a grip!”, but I was hoping that that simple amazement and wonder would stay with him throughout his career.
For some people, this story may be full of problems and issues. What do I mean by a “normal, natural hospital birth”? Can a woman have a natural birth in a hospital? I remember hearing from an obstetrician that among some women in our city a “natural” birth was when you didn’t wear much makeup when you gave birth. What is a normal birth? If a hospital has a 90% epidural rate, does that mean getting an epidural is normal?
And certainly, we can’t have trained professionals going gaga over newborn’s toes, can we?

We are living in an age when we are terribly concerned with our health, yet it is an age when human life expectancy is at its highest. We worry and fret endlessly about our children, but have difficulty finding time to spend with them. We are living a life that is far from nature, yet we yearn for the “natural” and the “green”. We are so divorced from our own bodies that a surprising number of pregnant women do not know where their cervix is or how a baby is supposed to come out.
In our world, human life has become so complicated that every simple activity has a huge structure built up around it. This structure is built upon a foundation of information supplied by an army of experts. Simple processes such as eating, healing, making love, giving birth, breastfeeding, caring for children, have all become complicated and institutionalized. When a woman decides she wants to have a child, one of the first things she will encounter is the structure we have built up around birth. She will be met with a mountain of information and much of it will be conflicting.
In the birth world everyone wants to have a little piece of the birth experience. The birth practitioner wants a piece of even the most physical and elemental. Here is an example: It is often very tempting to do a vaginal exam. Why? We want to know what’s going on; if the baby is moving down, if the cervix is opening, where the baby’s head is positioned. What most practitioners will not admit is that this intimate physical connection with a woman is important to them: it is an amazing thing, to feel a baby’s head coming down the birth canal! But how often is it really necessary? Does the laboring woman actually want to have so many exams? How many vaginal exams are done for the sake of the birthing woman, and how many are done for the attendant?
The birth practitioner, or any birth “expert”, also wants a little piece of the bigger picture: we want the woman to have a natural birth, with no epidural and no interventions. Or perhaps we want her to have an epidural so that she can be more comfortable. Or we are convinced that surgery will be less risky. Either way, we want to convince her that we know best. In fact, we do know best: we are more educated, we have seen more births, we have seen more pregnant women and we know what to do.
Or do we?
The Birth Conspiracy is this: It is an understanding, created by all of us, that we cannot function without experts. We cannot give birth without birth experts. We cannot labor without assistance, without classes and checklists. We cannot make our own decisions, or accept consequences for our own actions. It is a way we can avoid responsibility for our lives. Those of us who are experts want and need to control the process. It is very hard to sit on your hands and wait while a woman labors. It is much easier to interfere, to preach, to suggest, and to control.

Interested? You can order your copy of The Birth Conspiracy soon - watch this space!

The Final Push!!!

I am feeling like I am almost there - the baby will be born soon - but worried about the shoulders.
My book is going to be on the shelves, speaking for itself, and I am proud but anxious. The new mother feels just that. For nine months or more, she has lived with another person inside her body, creating the bones, muscles and nerves with her own body. But the baby has its own, what? Some call it a soul, others an independent central nervous system.
Whatever it is, when the baby is born, he is definitely separated from the womb, even if his mother has a Lotus Birth, where the placenta is kept attached to the baby until it organically falls off.
And when that happens, the new mother feels proud, happy, and satisfied, but also anxious, worried, and not a little nervous - how will this tiny creature make his way in the world?
So, what this space! The Birth Conspiracy will be out soon!

Old Scars

The cesarean section epidemic has been growing in intensity and numbers since the 1970's, in most of the western world, and increasingly in China, India, and South America.

It is a given in most conservative medical circles that the scarred uterus is more fragile during subsequent pregnancies and may rupture during labor. While I do not believe a healthy, though scarred, uterus will rupture without provocation, I have witnessed severe psychological and emotional scars from unnecessary surgery. The World Health Organization suggested in 1985 that a 15% cesarean rate would be optimal. I believe that in countries where mothers and babies and generally healthy (this may exclude the U.S. because of high obesity rates), an optimum emergency c-section rate would be under 5%.

All sorts of shocks and aftershocks have been linked to cesarean sections. Failure to bond, failure to thrive, autism, asthma, breastfeeding problems, PTSD, ADHD, you name it, unnecessary surgery has been implicated.

But what about the effects on a woman as a woman? What about the women who have been having this surgery over the past thirty years? The young ones may mistakenly believe that it is easier on the body for the baby to be extracted surgically; that the low transverse scar just above the pubic bone will heal and remain an almost-invisible thin white line; that urinary and fecal incontinence will be miraculously avoided; that their vaginal muscles will be tight and virginal forever. The middle-aged ones, the menopausal ones, the ladies who have had possibly multiple cesareans, based on the old "once a cesarean, always a cesarean" dictate of the 70's and 80's; these women represent the tip of the cesarean iceberg and their numbers are growing as this rate increases.

Much has been said, especially by men, about the effects of menopause on a woman's emotional state. The old stale jokes abound. But the fact is, that many women start to feel anxious and disoriented about their new status as non-reproductive beings.

I didn't. I have five sons and I am very happy about my contribution to the ongoing human race but I was content to let menstruation go. I do feel ambivalence about growing older - after all, who wants to die? As we age, we do march slowly but surely towards the next big chapter.

So, with the loss of our reproductive capabilities, as we get used to our bodies and ourselves during this phase of life, it is difficult to have to watch the little white bikini line grow into a larger, lumpier line where no matter how many times we march off to the gym, the pleasant softness of middle age insists on bulging unpleasantly underneath and over the top, as if a tight elastic were stretched just above the pubic bone. And it hurts - it still hurts - even after twenty, thirty and forty years.

Birth and Fear

As I listen with exhilaration and with horror to the events that are happening in Egypt, I am reminded of what takes place so often in our hospitals when women give birth.
When I suggest that the masses in Tahrir Square may be a new force - a mass of people dedicated to peace and prosperity, some people look at me with pity, like
I am a naive fool. Who would think that people are generally good and peaceful creatures? Who would think that a woman could give birth to a huge baby without help?
Whoever is interfering in this generally peaceful process is working from a place of fear. Fear is always real, but it does not need to have the power we give to it. Birth can be frightening as well, but we do not have to act out of fear.
A few years ago, I was called to the hospital to accompany a lady who had already birthed a few babies naturally, so I wondered why she needed me there. It turned out that her family doc had bumped her up to OB care because of the suspected size of the baby - huge!
The woman was a tall, statuesque lady but not heavy. Her husband was also well over six feet. She was young and in good health.I will call her Helen. She labored for a while on her own and then called me to the hospital. When I arrived she was in good labor and progressing well. The OB on call was in and out of the room, feeling Helen's abdomen and shaking her head. They did an ultrasound which did show a large and active baby.
After about an hour, the Obstetrics resident came into the room and sat on the bed to chat. He suggested to Helen that the best route of delivery would be a Cesarian section. Helen laughed at his suggestion but became serious when he implied that the baby could die if she tried to give birth vaginally.
I decided to join in the conversation and I asked the resident, "What is the biggest baby you have ever seen delivered vaginally?"
"Around 8 1/2 pounds" was the answer.
He continued to say that if we just "let things go", we don't know what could happen - it was very frightening - we just don't know. I suggested that he never saw a vaginal birth of a bigger baby because he always intervened. And after all, eight pounders are the norm these days. Here was a resident who was embarking on a career of Surgical obstetrics! He was clear with us that it was the feeling of not knowing that was frightening for him. To his credit, he agreed to let things go for a while and see how the scary future unfolded.

Soon Helen was ready to push and she pushed her twelve pound, seven ounce baby into the world without a scratch.

We need to be aware and alert to possible dangers but we cannot let our own fears create monsters that do not exist. Let us be midwives of change - sit on our hands, watch, encourage, and assist only when needed.

Egypt

I spent time in Egypt years ago, when I felt free to roam where I wanted. We explored the pathways behind the tourist spots and made some good friends during our stay there. It's hard to believe that it is the children of our (then) young Egyptian friends who are now exulting in the possibility of change in their fascinating country. Egypt has a history of great and powerful regimes, great thinkers, and a physical reality based on extremes of sand and water. Whatever happens, it will resonate worldwide.


Change is always painful, though. We humans like stability and we are, most of us, creatures of habit. I have witnessed the change that happens when a new baby enters the world, and although it is an experience full of joy and exhilaration, and power, and love ... it almost always contains an element of pain, sadness, or regret. Ties are broken, new ones are created.



Whatever happens in a country, revolutions, wars, or a long stretch of peace and prosperity, children are always being born, and women continue to give birth. This physical reality never changes.


How we perceive that reality can change, and what we do with it. Are we to continue to suggest to women that the best way to bring a child into the world is to be drugged, to feel no pain, or to have the baby removed like a diseased organ? Or are we going to take hold of an exuberance, the joy of being alive, and recognize that birth is like life, powerful, transcendent, revolutionary.

Shame!

In April of 2010, the National Post reported Stephen Harper announcing that “Canada will only fund maternal health projects in developing countries as long as the projects don’t divide Canadians.” This was harperspeak for saying that Canada will not be part of any initiative that funds safe abortion in developing countries.
Just this morning, Harper left for Geneva where he will co-chair a new UN accountability commission on child and maternal health in the Third World.
The president of the International Confederation of Midwives, praised the initiative: “… we need accountability. We need to know that the monies being spent are doing the right thing, that they're actually improving health care at the community level. And I think that it's really a coup for Canada."
Lynch said several developing nations have begun to take maternal and child health seriously as a barometer of their overall development and that Canada is well-placed to keep that momentum going.
Shame on you, Bridget Lynch, for not doing your homework! Where do Stephen Harper’s real loyalties rest, and how do they intersect with government planning at the highest level?
In 1981 I went to visit a young woman who was lucky enough to have survived her coat hanger abortion and was lying in a clean enough hospital in southern Africa. In the village, a scandal had just developed because a highly placed government official had been found with an eleven year old girl. These horrible things happen in Canada as well, and here we are allowed access to safe, clean hospitals and legal abortions. Why restrict these rights to the developed world?
It is our duty as women, as midwives, and as Canadians to help to make sure this woman’s daughters and granddaughters have access to all the health care services they need, and we cannot let our ideology and false morality get in the way.