Losing Your Self

Back in the fall, I went to a birth. It was the first birth I'd been to in a long time. It was wonderful! But it was very different from how I imagined it would be.

I always love the feeling that I am doing exactly what I was meant to do: accompany women during childbirth. The most important lesson about birth is that it is very much like life: you can't really plan for it. Meconium happens. Stuff gets broken. People get lost. Suddenly you turn a corner and there is the most beautiful sunset you've ever seen.

Here is a picture of an obstetrician waiting for an unsuspecting pregnant woman. She is being pulled along to the birthing room by her husband...dropping her slipper like Cinderella...he is rushing to punch the clock ... I'm late! I'm late!

The doctor holds a limp pair of forceps in his hand. He is going to get this baby out, for once and for all!!!

Of course, birth doesn't usually happen according to our plans, or according to anyone's schedule or hourly rate. Babies come when they want, or when they need to leave their mother's womb, or when the womb needs to expel them. Who knows. But they don't generally show up when we plan for them to.

And then when they do, the birth unfolds in a different way from what people had been expecting or planning. Which is why I still don't believe that birth plans are useful. Not because birth shouldn't be thought about and considered deeply, that choices shouldn't be made about where you want to give birth and with which people around you. But because the unfolding of your birth experience, of any birth experience, is unpredictable and can't - shouldn't - be pinned down. Because if you try to capture it with a plan, you could miss out on something extraordinary that you hadn't thought about, that couldn't be contained by your plan.

So, what does that mean for us attendants? How do we plan our days and our lives? 

Birth attendants are often on call day and night. Doulas may be on call for months at a time, unless they structure their work effectively by creating a doula collective which involves sharing care. But most doula clients want the continuity of care that means that one doula is always available. So there go your plans for family events, sleep, trips....

But in a deeper sense, when you are actually attending a birth, when the labouring woman is there deeply in the process of birth, then what? Are you thinking about what groceries you are going to buy tomorrow? No, you are with the labouring woman. You are providing support for her and her family, her partner, whomever. Even if you are sitting in a comfy chair knitting: your intention, your senses, your compassion, your heart and all of your focus are bound up with the birth process and the safe place you are creating for the newborn family to move through.

And then you lose yourself. You forget about your worries, strengths, failures, envies, moods. Your only task is to serve birth. You are serving the woman as she moves through her experience of birth, as she becomes a mother. And are you the most important person in the room? Is the obstetrician the buck upon which stuff stops? Of course not. The most important people in the birth room are: the mother and the baby. And how they are treated by everyone else is the most important aspect of the whole process. So, the less we all worry about ourselves, and the more we focus, truly focus, upon the family-to-be, the better off everyone will be in the end. Losing yourself is just the beginning!

Gentle Birth

I saw my favorite birth film again the other day. It's an old film, only ten minutes long, not too dramatic or brash. Just very calm, quiet, gentle images of women giving birth.

It's called Birth in the Squatting Position, and the voice-over makes it clear that this is definitely the best position to birth in, not only from the woman's point of view but also from the baby's. It is the position that we see in images that are centuries, even millenia old, and when we think of traditional ancient midwifery, we think of a woman squatting on a stool or on the ground with her attendants around her.

In this film, the women squat on small stools like meditation cushions. Under her is a soft pad, and the baby lands on the pad. In a few of the births, you see the attendant's hand gently cushion the baby's head as it lands.

What strikes me about these births is that there is no excessive emotion. The women do not grab their babies, or have their babies given to them. The baby lies there, the woman watches, then she reaches down and strokes or picks up her newborn. The attendant does nothing.

I am not a great advocate of the squatting position - it's value is overshadowed by all the greater obstacles we have to struggle with. If a woman manages to give birth vaginally and without drugs, that is already a great achievement, and sometimes the smaller details are let go.

But I am an advocate of gentle birth. I am an advocate of silence in the birthing room. Of a hands-off approach. Of respect. Of allowing a woman to greet her new child the way she wants to.

A doula can facilitate this gentleness and respect even when everyone else is busy with their hands on, in and around the birthing woman. She can put her mouth close to the woman's ear and whisper encouragement. She can let her know that it is okay if the newborn just nuzzles and does not exhibit a perfect latch within the first few minutes. She can create a bubble of calm and comfort around the birthing woman, her partner, and her new baby.

Let's all work together towards gentle birth!

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!