Birthing with Confidence
Many new mothers that I speak to are often scared of birth. For some, I would even use the word terrified. Birth has become the great unknown, hidden behind the walls of a hospital, with sharp tools and expensive electronics. We get to see only the end result when the women and new babies are leaving, bundled up and getting into a car, not completely understanding what just happened.
Where is this coming from? As women, our bodies have become objects through the media. Although this isn’t the first time you have heard that famous statement, it did mean that when it came to birth, professionals felt they could treat women’s bodies differently. Treatments were harsh and uncalled for, often resulting in worse results for the women and newborns. We are starting to stand up for ourselves as women but we still have not taken back our control when it comes to birth. Women willingly walk in to the hospital, ask few questions about their medical care, and let themselves get carried on this conveyor belt called “birth”. We do it because this is what we know. This is what we are taught about birth from television, books, and most of all, other women. We are counselled by women in shopping malls to take the drugs right away, that our babies look too big to fit through our pelvis, that the ultrasounds are wrong and we are having twins (maybe triplets), and that horrible tears are on the horizon. We love to hear horror stories and are glad to share them. We don’t leave out details. It is the same idea as when you hear those tires screech around the corner, you can’t find your shoes fast enough to be outside watching the accident.
Yet in the shadows are women who have birthed their babies in hospitals and at home with stories of great success and triumph. Ones where they took ownership of their experience, no matter what that included. Women who trusted their minds and bodies to make the decisions they needed for their families. These are often the same women who stay quiet. Sadly, these are the stories that pregnant women don’t get to hear. Some of these empowering stories are shared in a smaller number of books. A few favourites of mine include Ina May’s Guide to Childbirth and Bearing Witness. If you have only a few minutes, I also really enjoy this video of birth affirmations set to music.
It is important to build your confidence in your own body and your body’s ability to birth your way. Not only does this confidence help as you begin the labour process, but it also allows you to trust yourself and your instincts when it comes to parenting your new child. Another way would be to invite a doula – a professional woman who has attended a number of births and can support you, help you prepare, and believe in you even when you may not believe in yourself.
You can shape your birth experience and it is never too late to start so you can birth with confidence – confidence in yourself, your partner, your health care team, and your choices.
Fertility Journey
It is National Inferfility Awareness Week and I know that this is something that touches a number of men and women around the world. It is a difficult journey to want children and feel as though your body is failing you. Some people make the assumption that it is older women who have problems with their fertility, but it can touch anyone – you just can’t see it. I wanted to share a bit of my journey with you…
I conceived very easily with my daughter. She was born a few weeks too early and we navigated the NICU and there are days I still feel that we are having it a little rough. We were hoping to have about 2 years between children and started trying again closer to her second birth day. We did get a positive on the pregnancy test…but less than 3 days after came the bleeding. I assumed I was having a miscarriage, but I was wrong. The pregnancy tests still had positives. We connected with an early pregnancy clinic and began a series of blood work and ultrasounds until we were told we had a molar pregnancy (which can turn out to be cancerous) and that a D&C would be recommended. When we went in for the D&C, we were told that they reviewed the results again and changed their mind – the doctors had no idea what was happening. That evening, while out of town to try and escape the stress of this pregnancy, I was in terrible pain. It was only 4 days later that I was told I had an ectopic pregnancy. This is a pregnancy that implants outside of the uterus – in my case, it ruptured one of my fallopian tubes. It was an emergency surgery followed by a blood transfusion.
We waited the standard 3 months the pregnancy hormones to be out of my system and my cycles return to normal before trying again. It was the same scenario, except I was able to avoid the surgery and take a chemotherapy drug, keeping my remaining fallopian tube intact.
All I could do was wonder why me? I am not even 30 years old and my body didn’t carry my first baby to term and now my baby can’t implant where he/she should. I couldn’t figure out what I was doing wrong. There was a great deal of self-blame on this journey until I decided to take matters into my own hands. I began to see my naturopath again and she said something that broke my heart. She told me to wait a full year before trying again. I wanted that baby now! I had already lost two children and now someone else wants me to delay the only thing I can think of. I agreed but in the back of my mind, I wasn’t happy. This began the weekly acupuncture treatments and time seemed to pass quickly. I began to do more research and came across information about different foods that can play into your fertility. I was eating lots of the main culprits thanks to them being widely available and quick to prepare having a young one at home. This is when I ordered the book Fertile Kitchen. I also did some research into the emotional side and began using Circle + Bloom’s program before bed.
We connected with a reproductive endocrinologist (fertility specialist) and he booked me in for an HSG – a procedure where they put dye into your uterus and use x-ray to see where it flows. This would have told me if my fallopian tube is open. Personally, I was afraid of this test. I had a sonohystogram (where they put in saline and use ultrasound) which I found to be painful and I was didn’t want a similar experience. It isn’t conclusive about fallopian tubes though, so for me, useless. The first month this was booked, I had to cancel because I was supporting a mom through an induction at the time. This was a blessing in disguise.
I never ended up booking that test…because I was pregnant. We were nervous…but with the support of our midwife, she got us an early ultrasound to confirm that the baby was indeed in the uterus and blood work that was rising nicely. I can now say that this week is 30 weeks into the pregnancy. I am still shocked but thrilled…it was a long road but it was certainly worth the wait, the extra care and attention to my own health, and being able to connect with amazing women who have been through similar experiences.
The push to avoid tears
The perineum is a delicate area for many women, especially when they learn about birthing their babies. Women share their horror stories about how bad their tears or episiotomies (a cut in the perineum) were and how long it took for them to heal. Tears so not have to happen. A supportive care provider, a good position, and letting the baby come down slowly can all help (amoung other things).
Naturally, when the baby descends for birth, they do a little bit of a dance – two steps forward, one step back. Repeat. This slow movement gives the perineum time to stretch as the baby’s head passes through the birth canal and into your arms.
In a typical hospital birth, you will find what many doulas/midwives will term as purple pushing. This is when you are told to hold your breath, push for 10 seconds (usually on your back), and repeat three times per contraction. When using this type of pushing, tearing is more frequent because it is longer and stronger than the way a woman would push normally, if she were not coached. Being on your back also increases those odds even further. Some options to consider may be on your hands and knees or even side lying, which has been a good comprimise for many OBs.
When a woman is not coached in her pushing, she will naturally push for somewhere between 5-6 seconds on average, which is part of her hardwired system to ensure that she is getting enough oxygen for herself and her baby and minimize the exhaustion that often accompanies women who are doing “purple pushing”. This also brings the baby down gently and slowly.
Even when births are fast, they can be done without damage to the perineum. A health care provider who will support the perineum with a either a warm compress or a compress with olive oil can make a big difference for some women. The heat brings extra blood flow to the area allowing it to stretch even a little bit further. Many women find that warmth soothing. It is always a good idea to talk to your care provider about how/if they support the perineum and what your wishes are. These small discussions can help change the entire outcome of your birth.
Birth without the politics of fear
In Canada, we are currently in the midst of a federal election (and soon provincial). Every party is trying to have their voice heard using many different techniques.
Birth politics are the same – and yes, there are a ton of politics surrounding birth. Some people who advocate for women do it on a personal level by empowering each of the women they work with. Those women will then become stronger in their own right and it will touch the people they care about. Others, like big business hospitals, use fear tactics. This has been common practice for hospitals, especially obstetrics since their inception.
Now, I have nothing against any health care provider who follows their scope of practice and their code of ethics – and yes, doulas have those too. It is when we overstep those boundaries that the problems begin and we may be putting our clients at risk.
Recently, a hospital in Barrie Ontario has been having patients (birthing parents) sign a waiver if they choose to have a doula attend their birth. This waiver states that the patient acknowledges that having their “practitioner” may result in bodily harm or death. That seems awfully strong and it shows how little they know about doula care.
A doula cannot (and will not) change your care plan with your health care provider. She will however encourage you to discuss with them any concerns you may have and maybe even help facilitate safe space for that discussion. A doula will provide physical and emotional support which may include massage, encouragement, and options birthing positions.
Research actually shows the opposite! Having a doula can decrease your risk of a caesarian, forceps or vacuum, but it can also increase breastfeeding success, maternal and fetal health, and reduce the risk of postpartum depression. The latest of these studies is found here: Cochrane 2011 report.
The big question is how can the hospitals be allowed to make these policies without being informed? Doulas are always advocating women to make informed decisions about their health care. Hospitals are making this more difficult by putting policies in place where they aren’t even making informed decisions.
It doesn’t mean that this will stay in place forever – there are many women right now working to try and resolve this issue but it is the reality for many women and hospitals all around the world. Speak up about what you believe and do your research. Talk to your local hospital about getting on a board that they may have about women and children’s health. Here is where you can make a big difference because it is where the decisions are being made. As a member of the public and a health consumer, your voice helps to bring balance and serves as a reality check.
All women deserve the right to birth without fear, which if you read the last post, increases adrenaline and slows the labour process! When fear is used as a motivator, it is not TRUE informed consent. One should not feel coerced or feel that there is a power differential.
I hope to be able to post a happy resolution to this issue – but I am afraid the battle is only beginning and we need to step up to the plate before this becomes an issue for women and babies nation-wide.
Birth Matters
I recently had the pleasure of attending the Birth Matters seminar held at the University of Toronto where Ina May Gaskin took centre stage. She was discussing her new book, Birth Matters: a midwife’s manifesta. I want to share with you some of the inspiration that she poured out for us as birth professionals.
Birthing is still instinctual as it was at the beginning of time. Women who are not fighting against protocols and procedures are able to manage very well with their labours. The body naturally produces both oxytocin (a hormone that helps the uterus contract but is also a loving hormone) and beta-endorphins, a type of opiate that helps alleviate pain. If there is fear in the woman’s mind, or even in her presence, then her adrenaline levels will rise and counteract this duo of hormones. Being in an unfamiliar environment can certainly be stressful enough to begin the rush of adrenaline, slowing down the labour process.
How can we counteract this?
A few options are available depending on your situation. If you have a midwife as a primary health care provider, you could choose a homebirth where you stay in your own environment and they come to you with all the necessary equipment. If you have a physician attending your birth, some women find it helpful to stay home as long as they are comfortable. Others like to bring many of the comforts of home with them – this can include familiar pictures, music you enjoy listening to, wearing your own clothes, etc.
Adrenaline competes with oxytocin. If adrenaline is high, oxytocin is not, and vice versa. Partners can help increase oxytocin in the body by being connected in the moment, giving her hugs, kisses (especially those long passionate ones), dim the lights, and anything else that works to increase those “loving feelings”.
The biggest message from Ina May is that birth still matters – and we all need to work together to have our voices heard and create the change we want to see.
