The more a midwife speaks to a mother and spends quality time with her, the more likely a mother is to open up and reveal more of her daily routines and habits that can affect her pregnancy and birth.  For example, the midwife will ask a mother the most basic yet critical questions like what is she eating and follow up with nutritional counseling, a topic in which the midwife owns expertise. She’ll ask her what is occurring in her life today, yesterday, expecting for tomorrow. A mother’s every day peace and stress contributes to her body’s sense of well-being and reaching the point where mother and her body believe it is time now to give birth safely and securely.

The psychology of labor is addressed during the med school L&D rotation by incorporating finding other resources for emotional and mental support.  Subsequently we have a number of practitioners in all fields lacking in bedside manner today, but in birth this aspect has an impact intangible to the practitioner but very real to the mother and her family.  The average obstetrical course of education includes fewer than three credit hours in understanding nutrition.  The focus on prenatal nutrition is only a small portion of the syllabus (do your homework choosing a careprovider!).  The home birth midwife also follows the mother into the immediate postpartum and continues home visits to see how mother and baby function as a unit.

It is the midwife who is better versed in delivering babies in various but normal birth situations.  A breech baby can be birthed safer in the hands of a midwife than a hospital attendant.  She has not let her skills fall behind because medico-legal liability has dictated a breech birth to be enough of a risk as to deem a cesarean to be the required course of action; therefore, she continues to hone both her observational and palpating skills.

The American College of Obstetricians and Gynecologists (ACOG), America’s leading organization promoting the benefits of clinical obstetrics in the sterile rooms of trained physicians, has found itself in a dilemma.  The technology and protocols ACOG promotes are the very ones that directly influence our birth statistics negatively.  The birth technology ACOG promotes to prevent or lower risks in birth for both mothers and their babies has not been proven to be beneficial, yet it is used profusely.  Birth in America rarely includes the intimacy of the act that culminated in procreation.  Images of an infant gently caught into its own mother’s arms are so rare that they cause the general public to question the safety of such an event. Debate for and against the licensing of midwifery – and the definition of midwifery itself – is gaining momentum, because statistics for hands off care of normal, natural childbirth are far better than those of managed birth.

In fact, Rebecca Watson of the New Mexico Department of Health has stated, “I sometimes wonder why [we bother compiling statistics on midwives], since their statistics are so much better than everyone else’s.”

While home birth is stereotyped as dangerous because of the lack of medical supervision, it is the lack of that technology and medicine that actually makes birth at home safer than birth in a hospital under today’s protocols.

Studies have shown that once a technology is introduced and mandated, it is difficult to remove it from care practice despite being proven unsafe or unnecessary.  For instance, although the rates involving an episiotomy (cutting the perineum to create a larger opening for the baby to pass through) have dropped drastically since 1980, it is still a common practice.  Ironically, episiotomy rates today are justified as integral to the higher use of vacuum-assisted deliveries or unfounded fears that a baby is stuck because it is a large baby or presenting in a less than optimal position, (posteriors, for example, where a baby faces away from the mother’s back during labor).

America is one of the few nations where birth is managed more with technology than with the hands and eyes of the care provider, but other countries will soon catch up. In a country that boasts technology superior to other developed nations and is not known for undernourishing its citizens, our mothers and babies are faring no better at birth than underdeveloped nations such as Croatia. No improvements have been made in the maternal mortality rate in America since 1982, and  America’s infant mortality rate in the past two decades also has not improved. Our birth technology has increased and the number of routine prenatal screening tests have multiplied since the early 1960s, but our maternal and fetal outcomes have gone progressively backward.

“Despite a significant improvement in the U.S. maternal mortality ratio since the early 1900s, it still represents a substantial and frustrating burden, particularly given the fact that – essentially – no progress has been made in most U.S. states since 1982. Additionally, the U.S. Centers for Disease Control and Prevention has stated that most cases are probably preventable.” states C.T. Lang in a 2008 obstetrics and gynecology report.  Further, the Centers for Disease Control (CDC) reported in 1983 that the maternal mortality rate in the U.S. was 8.0 for every 100,000 live births (Monthly Vital Statistics Report).  In 1993, the rate was 12.0/100,000 live births (CDC).

Among the causal deaths that could be prevented were those that involve both underlying health issues such as poor nutrition and high blood pressure (World Health Organization) as well as those that are physician-caused including infection and hemorrhage.  Bacterium can be introduced first by the mother arriving in an environment where diseases are being treated as well as from infiltrating the natural barriers we have against infection through vaginal exams and, of course, surgical delivery. In addition, there are higher incidences of hemorrhage from forced delivery of the placenta as when a care provider intentionally pulls on an umbilical cord to tear the placenta away from the uterine wall of the mother’s womb. In all instances, normal birth evidence training of the professional birth attendant is critical.

Injuries and deaths related to the physician’s care range from the off-label use of medicine such as Cytotec (also known as Misoprostol) for the inducing of labor as well as the sanctified use of surgical delivery, which gives us embolism, one of the leading causes of maternal mortality and a risk directly associated with cesareans.  Cesarean rates for delivery rose by 46 percent from 1995 to 2006.

Women around the world, the time to look again at the image of women birthing with women versus a medical obstetrical group in normal birth is now. WE can improve global maternal and newborn birth outcomes and experiences. WE know birth. WE know women’s hopes and fears.  A new generation of birth wisdom and experiences is here!

Wishing you a truly happy Mother’s Day secure in the knowledge of your body’s innate wisdom!

Learn more about the wisdom of utilizing your best resource: an Independent Childbirth member led birth education class like Dorene Vaughn’s All Natural Baby!

Visit our comments section (this post) to find some of the most awesome birth wisdom posts our readers have found on the web and to add the ones you’ve found!

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There are many variations on the only thesis available to opponents of home birth: What do the statistics say? Despite the enticement of a warm, peaceful and private birth that a home birth offers, the perceived importance of missing technology lingers like impending doom. In America, less than 1% of births takes place in homes. It is difficult for the other 99% of Americans to make the transition from technology as the benchmark for establishing worldwide leadership to the reality that the human body is designed to give birth and it has evolved to make many variations in labor and birth look so easy.

The Stockholm Birth Center Study followed one birth center’s outcomes over a ten-year period culminating in 2000 and comparing the outcomes to the associated hospital’s birth outcomes. The one strong observation in this study is the truism that many women will choose a birth center because of the perceived safety in having a hospital nearby. However, it is a mistake to conclude the birth center is free of institutional intervention. The study’s results are negated because of the influence of the obstetrical backup. Every woman who chose the birth center for her birth location was still subjected to the institutional care package. This is the most influential determinant in whether or not a woman is “risked out” of laboring and ultimately delivering in the birth center.

A birth center so closely associated with a hospital is not autonomous and must operate under strict supervision by institutional birth practitioners. The authors themselves state they did not study the effect of individual labor and delivery protocols, but rather the care documented in each case as a “package.” In addition, they have correctly remarked standards of maternity care do not exist, but they have again missed the mark on the importance of this statement. This is critical to interpreting the outcomes, because one solitary intervention can turn out to be the predictor of a birth outcome. For example, every care provider practices according to their comfort level; although every care provider will monitor a baby’s heart tones in labor, how the monitoring is done varies by care provider. Continuous electronic fetal monitoring (EFM) can range in definition from ten minutes hooked up to a monitor every hour on the hour to a handheld doppler check through a contraction every few hours to a telemetry unit (a girdlelike band outfitted to wirelessly transmit fetal monitoring data) that allows the mother walk more freely.

The ability to walk freely even under continuous monitoring allows the mother greater mobility for finding a position that increases her ability to cope with her contractions. Setting aside the U.S. Preventative Service’s Task Force’s findings and stance that continuous fetal monitoring provides no benefit at all – and the data showing that continuous EFM results in more cesareans – it can be argued that fetal monitoring that limits a mother’s mobility is therefore more likely to result in more intervention as the mother shows signs of distress and therefore the baby does as well.

The authors of the Stockholm Birth Center study argue that many other studies have reached conclusions similar to theirs. In the same publication we are offered a Cochrane Systematic Review of Home-Like versus Conventional Institutional Settings for Birth. Here the reviewers concluded births in home-like settings compared to purely hospital settings “provided only modest benefits including reduced medical interventions and increased maternal satisfaction.”

A hasty read of this data by institutional birth practitioners correctly supports their ingrained training that routine intervention is acceptable and “safe.” However, the paper actually clearly demonstrates that all births taking place in a hospital are going to meet up with interventions at some point during labor, and it is the overuse of technology that needs to be analyzed. Indeed that message is there somewhat cryptically as the authors instead hinder the possibility of improving on the scope of research by advising “caregivers and clients should be vigilant for signs of complications.” It is difficult for any woman who has given birth or who respects her body to hear such little value placed on the differences the studies do reveal, such as the “modest benefits” of “reduced medical interventions” and “increased maternal satisfaction.” Surely even one avoided episiotomy would be appreciated by the woman whose perineum would have been cut and would find several women healing from receiving an unnecessary episiotomy envious.

In 1998, a study of infant mortality in planned home births was conducted in Australia. Author Hilda Bastion reviewed these outcomes as neither hospital nor home births have defined what constitutes standard care. She reviewed both midwives and medical practitioners, registered and unregistered, minimal experience and heavy case load. Also included in the study were births that would be deemed risky by virtue of poor health in the mothers or other underlying health conditions. This is crucial to understanding the bias of many hospital birth proponents: It is not the intent of home birth advocates to claim home birth is best for everyone, but rather a viable option for low-risk and otherwise healthy women. The author goes so far as to note it is a disturbing trend that midwives may be encouraging and willing to take high-risk births because of the high number of low birth-weight infants counted in the statistics. In fact, it is quite possible that a woman who cannot afford good nutrition may also not be able to afford hospital birth care, and perhaps a midwife is her better choice than no care at all.

In general, birth care is divided into either purely institutional care or modified institutional care. No research exists on pure, spontaneous vaginal birth over an intact perineum without induction agents, drugs, surgery and instruments. What is available is mounds of research on what a mother or baby can “tolerate” in labor and what interventions have achieved an acceptable degree of risk. The acceptable degree of risk is not defined by an independent counsel but often influenced by the strongest or loudest lobbying effort, as witnessed by the American College of Obstetricians and Gynecologists’ (ACOG) August 2007 statement on the advance of midwifery options for consumers. ACOG’s bottom line is midwifery options must be controlled and home birth as an option must be eliminated. The average consumer misses the bias and conflict of interest: A rise in home births means a decrease in income for a field already plagued by the reality that there is no money to be made in natural childbirth.

In addition to a lack of studies of organic birth as defined above, there are no long-term, randomized longitudinal studies to confirm or deny the correlation of many interventions. For example, the impact of a mother’s drug use in labor on emotional bonding, breast-feeding, postpartum depression, later drug abuse (baby as a young adult), etc. In the 1970s, Doris Haire, the President of the American Foundation for Maternal and Child Health, said, “No drug has been proven safe and effective for use during pregnancy or childbirth.” Considering that 25% of drugs introduced in the market today are recalled or pulled off the market in 1 to 5 years, this statement has never been more true. Until such time that midwifery care can be studied with a critical but appreciative eye, we will find only the weakest of studies boxed in by outdated beliefs that American women cannot afford to birth outside of a medical institution. In fact, it is our country that cannot afford to NOT offer free standing birth centers as a birth care option for American women.

Works Cited
Bastian, Hilda, “Perinatal Death Associated with Planned Home Birth in Australia Population Based Study”: BMJ 1998; 317: 384-8

Hodnett, E.D and S. Downe and N. Edwards and D. Walsh, “Selected Cochrane Systematic Reviews: Home-like versus Conventional Institutional Settings for Birth”; BIRTH Issue 32:2; June 2005

Waldenstrom, Ulla and Charlotta Grunewald, “The Safety of Birth Centers Responses to a
Critique of the Stockholm Birth Center Study”; BIRTH Issue 32:2; June 2005

This post was prompted by another blog I read several days ago, in which the blogger said that we were. Although I have no intention of linking to said blog, you can take my word for it that this woman is well-known to natural-birth circles as being among the meanest anti-homebirth people out there, so this coming from her made me laugh.

But it got me to thinking. Undoubtedly, there are some mean pro-natural or pro-homebirth people — those who would demean the choices of women who choose to give birth in the hospital or to have drugs. But there are very many people who demean the choices of women to give birth at home or who refuse drugs. As a natural-birth advocate and a home-birth advocate, I am acutely aware of this kind of person, having had to explain myself and my choices numerous times to people who severely disagree with me.

This antagonism is not good. For either side. And it tends to exacerbate the differences until they seem to be huge and insurmountable, and indeed to make women who agree about a great many things into some sort of enemies, and to become super-sensitive to statements, when they ought not be. An example — on my own blog, one of my readers took exception to something I said about “not understanding why” a woman would choose an unnecessary Cesarean. She took it to mean, somehow, that I was saying that women who chose a C-section when they didn’t have to were somehow bad mothers. I meant nothing of the sort, and was just talking about practical, concrete matters like having a recovery of several weeks as opposed to several days, etc. Absolutely nothing about “motherhood”… but she read that into it. After my explanation, she commented again, thanking me for explaining my position and said she was sensitive on the subject, because of some harsh criticism she had endured in the past for her choice.

I know some people find that every difference in opinion or action must mean that they’re doing something either better or worse than someone else. But thinking about this further, let me take this to a ridiculous extreme. I had chicken enchiladas last night, did you? I’m planning on making pizza tomorrow night, are you? Do you feel like you made a bad decision to have tacos or spaghetti, or to go out to eat last night, now that you know that I made chicken enchiladas? I sure hope not! Do you think that I would have done better to have made what you had for supper last night? If you do, I beg to differ! I hope you’re at least smiling now. The point is, just because somebody does something different, it doesn’t always mean that we think we’re the best and you’re the worst because we’ve done it differently.

In our group of Independent Childbirth Educators, we have a several commonalities among us, but that doesn’t mean we’re all cookie-cutters in everything. Take diapering as an example. (It doesn’t come up much, so I don’t know for sure how many people do total cloth vs. total disposables, or are like me and do some of each, but I do remember at least one woman saying that after her emergency C-section, her baby was brought to her “in a disposable diaper, of all things!”) Why do some people use cloth diapers for their babies? Cost for one. (Does that mean that you’re a horrid spendthrift if you use disposables? No! That simply may not be a factor for you, although it might be for others.) Environmental concerns is another reason. (But that doesn’t mean that we think you’re “raping our beautiful planet” by using disposables.) Cloth diapers may possibly healthier for the baby — in terms of diaper rash (my sister-in-law’s son was horribly allergic to all disposables), or the chemicals used in making disposables being right on their skin 24/7. (But that doesn’t mean that we think you’re a dangerous mother for putting your baby in disposables.)

The point is, “different” doesn’t mean “bad”, and saying why we’ve chosen different things doesn’t mean that we’re “mean.” For one thing, our reasons for choosing the things we did may not be reasons for you. For another thing, we might be wrong in our conclusions, though based on the best research we could find at the time. And finally, in these types of choices, in the final analysis, it often just comes down to pure opinion. Just because you’ve chosen differently from me (and believe me, there are a lot of differences among the women of this group), it doesn’t mean that I think you’re a horrible person. And although I have reasons why I do the things I do, just because your conclusion is different, doesn’t mean your reasoning is faulty or your decision is wrong. Just different. And that’s okay.

Two years ago I was teaching a Bradley Method natural childbirth class and posed the question, why the Bradley Method?  I like having some insight on what parents are thinking about when they choose a birth class as well as getting to know what are their expectations of a birth class.  One mother responded one of her relatives is a retired Connecticut OB-GYN and had told her, when she announced her pregnancy, that our state’s c-section rate is at 40%.  One year later a mother who was also, at that time, doing her surgical residency at Yale-New Haven stated the hospital is “aiming for” a 40% c-section rate.  The interesting fact to me is that the CDC’s 2006 preliminary reports cites a 34.1% rate for my state.  Yet, another mother in my class who works in a patient advocate office gave me a 2007 “unscrubbed” rate of 38%.  Unscrubbed?  Scrubbed?

What the public doesn’t know about the reported C-Section rates: they are confusing because no one is taking on the cause of telling the stories behind the numbers in a way that is clear to the consumer.  Therefore, we who are in the field supporting laboring women will tell you the shameful truth behind the organizations that can’t get out of their own way and are hobbling themselves at every turn in providing women with quality maternity health care.

I began by asking the CDC to clarify their data received and how it is sorted.  Here is their response:

“From: CDC-INFO
To: allgroupmail@comcast.net
Subject: RE: RE: YBFW: Stats
Date: Mon, 7 Jul 2008 21:08:12 +0000
> Thank you for your inquiry to CDC-INFO. Please find below information in
> response to your request on why Cesarean sections are performed.
>
> The National Center for Health Statistics (NCHS) collects and publishes data.
> NCHS does not make policy comments or interpret data, nor does NCHS conduct
> research.
>
> NCHS can provide you with data on Cesarean sections. However, we cannot
> translate the data.
>
> For more information about birth data, please visit the CDC website:
> http://www.cdc.gov/nchs/data/ad/ad385.pdf
>
> Thank you for contacting CDC-INFO Contact Center. Please do not hesitate to
call 1-800-CDC-INFO, e-mail cdcinfo@cdc.gov or visit http://www.cdc.gov if you have
> any additional questions.
>
> CDC-INFO is a service of the Centers for Disease Control and Prevention (CDC)
> and the Agency for Toxic Substances and Disease Registry (ATSDR). This
service is provided by Vangent, Inc. under contract to CDC and ATSDR.”

They do NOT conduct research.  They only tell you what they are told they can tell: the numbers as given to them.

Here’s what Independent Childbirth does know: not all hospitals participate in programs for reporting their statistics to the state.  That’s right.  Not everyone is giving their information therefore the CDC’s report does not include ALL of the data that is out there; only what is given to them.

The data provided to the CDC is reviewed by hospital staff and administrators to determine what is reported how.  That is to say the data is “scrubbed.”  How does that affect the reporting of the numbers?  Let’s give you a clear cut example.  Independent Childbirth member Louise Delaney relays this story told at this year’s CAPPA conference in response to our online discussion the scrubbing of statistics: “At the CAPPA conference this weekend someone brought up that stats at her hospital were indeed scrubbed.  For instance, if a c/s was done due to placental abruption, it was listed as a PA, NOT a c/s.  So there are FAR more c/s being done than are reported. ”

To which another member responded that Placental Abruption is not a mode of delivery so how could that c/s be listed under PA and not C/S.  Well, you see that is the point (and which she was underscoring with  incredulity).  Each person working in the hospital system has a worldview limited to their patient, their office at the point of time in which she is delivering.  That’s it.  Period.  They do not look at what others are doing therefore they lose the benefit of learning from dialogue.  That is not a surprise to Independent Childbirth.  We have been reading for years about new methods of training for medical personnel across all field to teach them communication skills!!  I’ve walked into one hospital to support a premature birth and had to explain to the doctor that another hospital in our state uses blood analysis to determine lung maturation versus just assuming the baby’s lungs are not mature and trying to persuade the mother to consent to mag sulfate, a drug with horrible effects and unproven benefits to the baby.  In fact the evidence points to more deaths from its use!  D. Bernucca: Helping Women Avoid Unnecessary Interventions; Midwifery Today, Number 85 Spring 2008

More importantly, while many would assume that placental abruption can only mean cesarean it’s simply not true.  Perhaps today that is the protocol  However, either it wasn’t so eleven years ago when my youngest was born vaginally 8-weeks premature (at 32+ weeks) or the lack of dialogue is proven right here: everyone is making their own assumptions regarding outcomes.  Incidentally, my son’s premature birth was the consequence of placental abruption due to a cesarean birth two births earlier.  That’s right.  I’ve birthed two babies vaginally after one cesarean!!  Again, the stats are confusing because numbers are open to the interpretation of the very small worldview of the individual practitioner.

That limited worldview has wave upon wave of reverberations to the public.  When you say you trust your careprovider you limit yourself to their worldview and interpretation.  While that sounds noble, you trust your careprovider, the fact is your careprovider may not have the time, the environment nor the skills for dialoging with others in their field in order to stay on top of the research.  Case in point, repeat C-section rates are also soaring, 88.7%, yet data “support(ing) the notion that VBAC is unsafe” is still lacking (Lynda DeArmond, MD Waco Family Practice Residency Program, Waco TX).  Further, “the most recent Cochrane Review … concluded that no trial existes to adequately help women and their caregivers make an informed decision between the two (VBAC or repeat c-section).”  Lastly, Dr. DeArmond points out the flaw of the risk rate of 2.7% quoted the most in VBAC articles, “it is based on one (1) prospective nonrandomized cohort trial and one (1) retrospective cohort study.” (VBAC Rockville MD, Agency for Healthcare Research and Quality, 2003 and McMahon, Luther, Bowes, Olshan; Comparison of a trial of labor with an elective second cesarean section, NEJM 1996, 335:689-965).

Unless the maternal health policy makers start talking to each other honestly, forthrightly and bluntly “women’s healthcare options” remains an oxymoron and we are literally bound (to the delivery tables) and gagged (with unnecessary narcotics).

On Sunday, August 31, 2008 I was awakened at 3:57am with a phone call from a father whose wife was in labor at that very moment with a nurse insisting mom lie on her back in the bed so the monitors would stay in place.  This mother presented at Hartford Hospital for IV antibiotics as she had consented to do for her GBS+ status.  However, mom had NOT signed up for “birth my way” via Nurse Ruth who stated she’d been an L&D nurse for 37 years, attended thousands of births and she knew this was best, had coerced mom into pitocin and was now prepping mom for an Internal Fetal Monitor and a c-section via her negative commentary on how labor was progressing.  A quick review of the facts of what mom was feeling with her contractions and her previous birth experience (I was their birth educator for that vaginal birth result) and I told dad roll mom over on her hands and knees with her butt up in the air … no one can force medical interventions on you and by the way if you’re still okay with pitocin make sure that pit isn’t being cranked up.  Call me again in two hours and I’ll be on my way to the hospital if you need me.

At 5:05am while I was in the shower the phone rang and recorded a joyfully tearful message from dad … a beautiful little boy (6lbs) vaginally.  I spoke to dad later in the day allowing the family to have their bonding time.  Dad relayed the following: “I requested the presence of the charge nurse and dispatched with Nurse Ruth.  L turned over to hands and knees in the hospital bed and the pitocin was turned off.  She had one huge contraction and with the next huge contraction she said she wanted to push  … I thought how could that be?  She was only 1cm when I called you.  The new nurse volunteered to check because L could very well be ready to push.  She did a vaginal exam and found L to be 10cm and the baby was born with just a couple of pushes after that.”  Oh, and I totally forgot to ask where the doctor was because honestly I figured if he/she was being told L is only 1cm then I’m pretty sure he/she was nowhere near the hospital on this Labor Day weekend.

From a Labor Day weekend cesarean to vaginal birth in less than one hour.  Dad advocated for mom’s patient rights and helped her roll over to her hands and knees!!  Is it any wonder the overall cesarean rate from 1995 to 2006 increased by 46%??  

I recently stated to my online group that the real cesarean rate for the USA is 35% probably higher and was questioned on the validity of that stat versus the 2006 national reported rate of 31%.  I may not be the Centers for Disease Control, the American College of Obstetrics and Gynecology, nor the American Medical Association.  I am however independent counsel for laboring women.  We are Independent Childbirth.  WE ARE the source.  WE ARE at the greatest variety of births in the greatest variety of settings.  We are literally supporting mothers.  We are members of a group who keeps REAL stats for REAL women for REAL options for their very REAL births.

Find an Independent Childbirth member for an independent childbirth class near you!!  Mom’s ability to exercise her patient rights once she is in labor is no small feat.  In fact, legally her every consent could be considered compromised.  Attempts to deny her independent birth care counsel and support via her partner, her family or a doula is a serious red flag!  Her birth support needs to understand labor, her birth care environment and how it impacts her choices.

Don’t be just another number!  Talk!  Let your birth help tell the story behind the numbers!  Don’t let organizations that don’t speak to each other speak for you!

Share your positive birth experience and lessons learned!!

Independent Childbirth is sponsoring Orgasmic Birth screenings across the country. One mother shared a copy of a VBAC Consent Form she was asked to sign.  Many hospitals ban VBAC altogether either legally because their insurance carriers will not protect them or with a “de facto” (in practice) ban.   Some hospitals do still allow them, and this form does a fair job of pointing out the risks and benefits of both a repeat C-section and a VBAC. However, it does not point out that women have up to a 3.6x higher risk of death if they have a C-section versus a vaginal birth. Here is a more complete and detailed list of the risks and benefits of both an attempted VBAC and a repeat C-section, based on the available research. Nowhere on the list does it list the risks of cesarean to the unborn baby. Did you know that your future babies’ health in utero is at risk when a cesarean is performed? This is because the growth of scar tissue cannot be controlled. We know of babies born prematurely as their placentas could not adhere at the scar tissue site from mom’s previous c-section. No, we don’t provide this information to scare you out of having a cesarean. If it’s necessary, it’s necessary. Please, the decision to have a cesarean is a serious one. You deserve to know all of the risks and you deserve to know what care practices can lead to unnecessary cesareans, repeat, unnecessary cesareans.

Many doctors state they don’t want to scare women about the risks of the procedures they use for birth care. Doctor, you need practice in communication skills. Women can handle hearing the truth! The risk of death to their baby is nearly 3 times that of vaginal birth. (This is for low-risk women!) Or, what about these risks now or in the future?

Here is a slightly different VBAC informed consent form, and the preface reads like this, in part:

Although the risks of a uterine rupture with a prior low-transverse uterine scar are not higher than the unanticipated risks of other complications that may arise during childbirth, in some communities, women who wish to try for a VBAC rather than schedule an elective repeat cesarean are often expected to assume responsibility for any or all negative outcomes.

To lower the risk of liability, some malpractice insurance companies in the United States have developed VBAC consent forms that physicians are required to discuss with patients who wish to labor after one or more cesareans. Some of these consent forms overstate the risks for laboring for a VBAC or minimize the risks for planning an elective repeat cesarean.

But some “informed consent” forms just ignore the risks of a C-section altogether! This webpage is just such an example, but it has been annotated by someone who is obviously very pro-VBAC to discuss more of the risk-benefit ratio of the two procedures.

The greatest obstacle to women’s health today is lack of public dialogue. Get yourself to an independent childbirth class where we want to hear YOU. We can provide answers outright and answers that help you discover for yourself what you want from your birth.

This movie, Orgasmic Birth, focuses on the women giving birth, and that’s something the public has been waiting for a long time!! Every woman you’ve ever shared birth with is in this film. There is the mother who believes you trust doctors for everything and she ends up with an induction, epidural and baby finally born after two vacuum attempts … and she believes the doc saved her. You see the mom who also believes the same, is induced, and has a cesarean. However, the movie starts and ends with the mothers who have believed in the birth process, their bodies and that how they birth matters to their babies. You hear from fathers who love that their babies were born surrounded by their home and loved ones…their natural environment to begin life in.

Instead of the black/white contrast of The Business of Being Born, you have a sophisticated segue in the sense that the commentator’s information is presented around the story told so the dots are connected fully because these women tell their own story and the commentator fills in the ‘real’ story. It’s not told fear based, it’s told from a know natural birth perspective. No rant. It just is.

We believe that it is also the intent to interview everyone in a home or home-like atmosphere, with the exception of hospital footage for those two moms with routine medicalized birth … and that’s a smooth, thinking contrast. Every person is speaking softly even when venting on medical birth. Love the moment that Dr. Northrup tells us with medical intervention we “screw it up” — “it” being normal birth.

It is also one of the first films presented to the public to show a wonderful birth class outside of the hospital. We don’t know if it is the producer’s intent but perhaps the film is trying to turn Lamaze around and portray Lamaze in the Institute for Normal Birth light. We say this because the producers limited themselves to Lamaze. They did also keep footage of someone mentioning a Lamaze in-hospital class that they didn’t like.

We wish more had been done to represent other independent birth ed options as independent childbirth educators are among the most deeply anchored normal birth supporters in America and have always known that hospital preferred birth classes are a disservice to women, hindering their access to unbiased information and, many argue, used only for props to keep women birthing in hospitals. Around the world, normal birth education may not be done in the traditional setting that we in America are accustomed to but it is still independent of medical fear and bias, with knowledge transfer occurring rather as a woman to woman knowledge share with midwives as the informational conduit.

We do wish the film included reflection on mothers who are second or even third generation homebirthers as well. These women kept normal birth in America from completely fading away. There really needs to be a film as a tribute to these women pioneers. In other words, it is important that nations, especially America, fully recognize that home birth, normal birth is not something new; that women have believed in and enjoyed their normal births before 2008.

The births shown are wonderful. One of the best births is the mom who talks about childbirth as a mother’s sacrifice. You might cringe because you start thinking here we go… “Birth is painful. Birth is a sacrifice. Birth is about a medal.” However, to our delight, this mother delivers within a pretty normal window for active labor, 26 hours, she’s birthing at home and the midwife says outright in a hospital she would have been given pitocin and c-sectioned by now. The great thing is the mom talking afterwards about enjoying that birth for its own challenge for her if not for any great spiritual or relaxing birth story.

This is a great contrast to the mom who I mentioned above with the vacuum baby who says not until closer to her due date and hiring a doula did she hear anyone talk about embracing contractions. Until then everyone talked about labor as a difficult thing. You really do get the full connection of the contrast between the two women’s births… some of the responsibility lies with women doing the work to face and/or overcome fears… some of the responsibility lies with careproviders’ attitudes about birth and their inability to provide humanized birth. It’s not only about medical vs. normal birth. It’s also about what women are told, have been told and how it’s still quite accidental for women to hear about birth as an enjoyable event in their lives.

The abuse survivor’s birth and another homebirth will make you cry. The very personalized births will leave you smiling and swaying with the moms. Very cool.

We can’t wait to share it with you and we hope to see you at our screenings!! Just check our “Birth Events Near You” page on this blog.

Recently The New York Times wrote about doulas and the article left a negative impression about doulas, and tossed in a criticizing lactation consultant comment as an aside. To take the view that the New York Times article does–as an across-the-board view that doulas are problems–is an error. The paper presented a complaint rather than pursuing a couple of viable angles: the many expectations that mothers and partners have of labor support today, and the licensure of female support at birth such as midwives, birth educators in the role of birth support, monitrices (someone who has been trained to provide some clinical assessment in labor usually while mother is at home) and doulas.

There are now many birth support and whole birth health care options for women to learn about, choose from and advocate for change. Midwives, independent childbirth educators, doulas, birth centers, homebirth and breastfeeding are now more commonplace subjects to bring up when planning birth. Women today are realizing that they need to avoid interventions such as induction which carries a higher risk for cesarean or just arriving at the hospital too early; and there are options available to support their refusal to fall in line with industrialized birth. In response, hospitals are trying to offer more and more amenities but many parents recognize that in spite of measures by hospitals to draw them in by offering a luxury tub or more comfortable birth room furniture, hospital birth is still hospital birth. Seeing the smoke and mirrors, women who still choose to birth in a hospital may seek additional independent female support in birth which has been shown to be a positive influence on outcomes. However the benefits of the additional birth support is very clear in the birth community and we hope the media will take the time to do more in-depth articles on the anthropology of women in birth, culturally and traditionally.

It is confusing for the public to read contradictory articles posted by the same journalism venue such as this one from CNN that says doulas advocate for you and then CNN also posted this article stating “doulas are not supposed to offer a medical opinion….strictly to motivate the mother.” What remains the focus for women is that we still need to think independently, make our own choices and employ those who support our choices from birth care to birth itself. Women have many different reasons for hiring a doula besides strictly whether or not to ask them to advocate. Doulas can make fathers and siblings comfortable with birth and help them enjoy birth too! There are obstetricians, midwives and labor and delivery nurses who have witnessed doulas as an extra pair of caring hands so that all participating in the birth remain fresh and positive during a labor and birth–especially an intense birth. Doulas help military moms birthing without their partners. Doulas are sometimes even interpreters! This is a day that many never imagined: birth support, midwives, homebirth, unassisted birth, informed birth, etc. are all in the headlines!

In many states women’s choices are being restricted and the birth community continues to work together for the greater benefit of society at large ~ improving mother and baby outcomes ~ and for the mothers and babies where you live!