Choosing your birthplace
Women in Ontario currently have two options when they are preparing for the birth of their babies. If women choose an OB or a family physician as their health care provider, they will birth in a hospital setting. Women who elect care from a midwife will be presented with both options: home or hospital birth.
Although homebirths are wonderful experiences and women do choose that option, there are a number of women and families who are not comfortable birthing at home. Not everyone is in love with the idea of going to a hospital either where they are surrounded by illness when they themselves are not sick but starting a family. Imagine if you were going to give birth in a hospital at the time of the SARS outbreak…many women were denied labour support (whether it was their doula, some even their partners) and many families were concerned about the health of their babies. Newborns are still developing their immune systems and could easily catch an illness (although breastfeeding does help, but that’s another topic).
The Association of Ontario Midwives is advocating for a third option, which would be community birthing centres. These would be independently run and would look more like home. Currently, those who choose midwives as their health care provider increase their chances of normal birth. In Ontario, approximately 1 in 3 women will give birth to their babies through a caesarean delivery. This doubles the recommendation by the World Health Organization that says it should be less than 15% of births.
Last November, I had the pleasure of speaking at the conference Enfanter le monde (Birthing the World) in Quebec City. I was also able to connect with many professionals and learn about the success of the “maisons de naissances” (birth houses). They look like homes on the outside but have the necessary equipment and staff to handle normal births. They have also been able to provide other services to the community including prenatal yoga, prenatal classes, classes for parents with young children and much more. The midwives also spoke about their methods of care that were empowering women to take charge and own their pregnancy and health. The province of Quebec is planning on adding more of these “maisons de naissances” as it is seeing the success in health and in cutting health care costs.
Would it be safe not to be in a hospital? These are some women who are classified as high-risk in their pregnancies. Those women would benefit from the care and the added technology that would be found in a hospital setting. Most women find themselves in the low-risk category. For the women who are low-risk, birth centres or home birth are both safe options.
Of course, there is also the issue of money. Birth centres would only be open when they needed to be since midwives are on-call for their clients and could meet her and her family there. Simply having a midwifery care during pregnancy reduces your chances of a c-section (and the cost associated with the surgery). Women would be able to return to their homes sooner because clients with midwives get home visits for the first week or so after birth. This means that they are provided with more follow up in the early postpartum than those chosing to birth in a hospital with an OB.
Would you like to read more about birth centres in Ontario? The Association of Ontario Midwives have published this brochure with more information about the initiative.
The choice is yours. Where would you feel most comfortable having your baby? I’d love to hear your thoughts!
Sounds of Birth
At a birth I attended recently, mom was in active labour and she was moaning loudly. Her friend was also supporting her and she had her 6 month old son with her. Her son was completely calm as he listened to her labour, as she worked hard. The midwife attending her said that it is adults who are afraid of what labour sounds like, not children.
I can’t count how many times women have told me before labour that they are afraid of making noise…or how many have apologized for being vocal during their labour. We have become conditioned to think that speaking up is wrong, that listening to our bodies is wrong, and most of all we have been taught that we should be silent.
Some women do find power in their silence. The majority of women that I have worked with feel great once they let go of those inhibitions and find their voice. It is usually a low, mama bear sound. One birth I attended, where mom was feeling reserved, especially while in triage to make sound, I reasurred her about how normal it is for women only to have a nurse rush in and tell her she must be in a great deal of pain and hurried to have her admitted. After the nurse left, the mom said she no longer felt that it was normal.
Sadly, staff at many of our local hospitals are used to silent birth…silent only in the fact that mom is usually on an epidural and sleeping. She isn’t moaning, asking questions, or otherwise asking for attention. As adults, even those who work in labour and delivery, those sounds can be frightening. Partners become afraid too. It can be difficult to be with someone you love go through some very hard work. That’s what it is though…hard work. It will come to an end and those sounds mean the work is being done.
What do you do to empower women’s voices? How do you make partners comfortable with those sounds? One thing I often do as a doula while supporting women is to make those sounds with her. I match her voice, her rhythym and I work with her. I let her guide me. It also brings us together very quickly. Try it!
Happy Mother’s Day
When I hear the word ‘Mother’, many words come to mind: determined, creative, dedicated, supportive, teacher, and even patient.
There are many ways to be a mother and biology is one of those many options. Within our culture, you can be a co-parent, step -parent, an adoptive parent, a guardian, and probably more terms than I can imagine.
You can be a mother without having children of your own - you can be an entrepreneur, an artist, or take on a new project at work. It is the energy behind it that makes a difference and brings that mothering quality into what you do.
I think one of the best teachers we have out there is Mother Nature, who has an infinite patience with us. She takes her time to reveal what she has to say and we only get the message when we pay attention to her over time. She teaches, but doesn’t push unless she needs to. Mother Nature shows us her creativity in all of the creatures around us, the endless number of plants we are still discovering. She nurtures us with her energies today even when she isn’t happy about how we are making use of things she has to offer. Mother Nature teaches us many ways to be parents – some animals co-parent and others adopt.
Today I acknowledge that we all have mothering abilities, no matter our biological sex, no matter our decision or ability to have children. For everyone who nutures these qualities in others, who show patience with someone no matter how many times you have explained the same thing, who are dedicated to their cause…today is a day to celebrate that energy. Happy Mother’s Day!
International Doula Month Challenge
May is International Doula Month!
I love providing doula care to women and families because everyday, I meet new people, hold a very sacred space, and I am a witness to new life. It is fitting for this month that celebrates doulas be in May – if we look out the window here in Ontario, the flowers are starting to bloom and new life is coming out of the dark Earth. This is the beauty I witness everytime I meet a mother in labour or a mother home with her new child.
I would like to challenge each of you to tell at least one person what a doula is so we can continue to share that gift with our community and change the face of maternity care for all the women in our lives. Imagine if we did this how different birth may be for our daughters? Having a daughter myself, I often wonder what birth could be like for her…will there be birth centers in Ontario providing her more options on where she can birth? Will there be easier access to midwives? Could she choose a hospital waterbirth? Will her health care provider have seen many natural births?
This is a short video depicting just some of the works doulas do. To every doula who is out there serving women and their birthing community, I wish to extend my most sincere thanks and appreciation for being wonderful colleagues and friends but mostly for empowering women’s choices in childbirth. Of course, to the best teachers in my life, the women that I have served, thank you for inviting me to be a witness but mostly for teaching me every step of the way.
