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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As a group whose every day bears witness to the entry into this world of many a newborn we enjoy hearing women’s descriptions of all things birth.  We tend to cringe hearing harsh language surrounding birth.  An irritable uterus?  What is that, a belly with angry eyes???

I remember Laura describing her daughter’s entry into the world as one where her cord was “creatively wrapped.”  What a difference it makes to view each birth with wonder, not as a risk.  I believe it is in the documentary by Patchwork Films called “Born In The USA” where Dr. Joanne Armstrong admits hospitals have low tolerance for viewing laboring women as anything but risk.

We spent a good portion of last year bringing awareness to the misleading presentations on technology in birth.  We will continue to do so as new “turf battles” with ACOG arise, but it’s time now to see the beauty of labor and birth as it really exists.  I know many believe “orgasmic birth an old midwive’s tale” or simply too extreme a description for what is otherwise only a reverential experience.  I have to smile to myself and just state the obvious: birth is personal and some take their personal view as the only view and are taken aback when their view isn’t just like someone else’s is.  Perhaps that’s why Ms. Moore fails to mention that Orgasmic Birth also contains the story of a mother who labored and labored and labored.  It wasn’t orgasmic in the sexual sense.  It was sexual as in liberating.  Had this woman labored in a hospital she would have been sectioned.  The only real point of discussion is that whether or not any of us feels she should have been sectioned is a matter of personal choice.  And that’s what we here at Independent Childbirth see as the reason why globally maternal care is so faulty: it does not have choice at the foundation.

Birth is.  Period.  That’s the true beautiful secret of birth.  Each birth is unique as well as being unique to the mother at that moment in time.  When she first birthed she was not the same woman that she is giving birth the following year or years later.  She is not the same woman giving birth two, three, four births later.  None of those babies are the same as the ones before.

When women fail to honor the different choices we each make we tear each other down.  Why else are the mommy wars the fodder of many a journalistic piece?  It makes for entertainment: judging each other for the decision to breastfeed even when it means dealing with people who cannot see breasts as anything other than sexual; judging each other for a mom who wants to both be a mother and have a successful career.

We need more appreciation for the turtle women.  Yes, turtle women.  There are turtle women specific to the birth world but I think turtle women abound in all aspects of our life.  They are the women who support, not criticize, our choices.  It does not mean they agree with every choice we make.  It does mean that they are wise enough to recognize the value of stirring every woman to think about her choices, why she made them and most importantly be confident in her own wisdom to adjust or make different choices because she has learned something new.

“Orgasmic Birth” is scheduled to be reviewed in a segment by ABC’s 20/20 tonight at long last.  Unfortunately it may be viewed as a part of a theme called “extreme mothering.”  Today’s journalism just isn’t journalism unless it’s sensationalist.  Sigh.

No matter.  Turtle women all the way down … enjoy!

“Home Birth Experience 1: Decision and Expectation” is a midwifery clinic teacher’s summary of her interviews with eight women who planned ahome birth in the recent decade.  Author Alison Andrews proposes that the birth experience leaves a very strong imprint on the woman’s mind, while the medicalization of birth has reduced the birth experience to terms relating to a consumer decision, i.e. “satisfaction” or “attitudes on intervention.”  It is the desire to experience birth as an organic experience leaving its memory on the mother’s whole self that is a strong basis for choosing home birth over medicalized birth.

Women will share their birth experience with great detail and acuity in the days immediately following the birth, be it a positive or a negative experience.  The quality of that experience is beginning to be recognized as having a lifetime impact in other areas of the mother’s life, including her marital relationship with whoever was her partner at the birth.  As birth moved into hospitals through historical industrial developments technology served to also separate mothers mentally and emotionally from the xperience, fewer and fewer natural birth experiences existed tobalance the case for home birth as a safe and healthy experience.

Birth “narratives” in fact, are an essential and typical skill for the midwife to have.  The medical profession would relay a birth only in terms of patient notes, regardless of whether the birth was organic birth or some interventions were introduced.  This is a detriment to improving maternal health care because a mother’s birth story is a valuable data source recording live testimony to maternal health care protocols enacted upon them.  Based upon this theorem, Ms. Andrews interviewed eight women from her home region of South Wales with backgrounds ranging from affluent to indigent, from rural to desolate.  Of these women, seven had previously birthed in a hospital and therefore provided that experience in relation to their choice to birth at home.

The results concluded n two themes, each with secondary threads for further discussion.  The two main topics that women related the strongest emotion to was the decision to have a home birth and the expectations they held for their home birth experience.  the reasons behind their decision to birth at home ranged from pragmatic – fewer worries about child care for the siblings of the new baby – to addressing the need for intimacy via familiarity of surroundings.  These mothers also considered the risks of home birth, and in some cases the risk carried less weight in their decision-making process.  One woman sought only to ensure her midwife had basic emergency care items, while another retorted that things go wrong in hospitals too.  All women undertook some form of birth education and preparation but the preparation was more about the physical location itself than about their own body’s preparation for the birth.  This is interesting to note in direct contrast to the often reported indicator for hospital birth being about women desiring to be near pain relief or help if their body cannot manage the labor.  In other words, labor is in the eye of the beholder and that’s another post in itself!  To continue, the women’s expectations themselves were not of as great a note as the importance of recognizing that women held expectations for their births both in terms of the birth itself and the care they would receive.

This last consideration, it was observed, led to both discussion about holding dialogue with their friends and families regarding their decision.  It also led to strife with hospital care providers, who viewed the decision to birth at home as a personal indictment of both their profession and their personal reputation, rather than an honest examination into the quality of care – which is the basis for many of these mothers’ decision to birth at home.  It is this sole perspective from proponents for hospital birth that casts light on the goal of the medical profession: to lobby strongly to keep births in hospitals, although there is little evidence that home birth is not safe for lowl-risk, otherwise healthy women.  If this trend continues, concludes Ms. Andrews,

… childbirth … (will no longer be) part of life in the community for most women and will remain so as long as birth remains centralized in the hospital setting.

She quotes the Welsh Assembly government paper, “Delivering the Future in Wales,”  which concludes the option of a home birth with a skilled midwife must be a protected option.  Further, Britain itself is pleding to strive fora goal of a ten percent (10%) home birth rate based on utilizing home birth as a safe option in maternal health care birth choices.  this humble goal is indicative of the  deft persuasion and patience that will be required to advance the view of home birth is a complementary option to medical obstetrics.

Are you listening ACOG?  Complementary.  Working together.  Is it really your goal to improve mother and infant birth outcomes in the spirit of care and concern for humanity?

For more on the home birth decision making thought processes at large look into the Nursing and Midwifery Council report of May 5, 2005.

Works Cited:  Andrews, Alison, “Home Birth Experience 1: Decision and Expecation”; August 2004, Brtish Journal of Midwifery, Volume 12, No 8

The appeal to the September 7, 2007 Cease & Desist decision (see our earlier post this blog) will be heard in New Britain Superior Court on Monday, September 17, 2008 at 2:00 p.m..

In this environment we are again denied public input.  That is why mothers, daughters, nieces, friends, we must continue to affect public opinion through the legislative sessions and, hopefully, a court who will base its decision on precedent and case law, not bias.  The nation was riveted to the case of a 16-year old boy fighting for the right to choose his own cancer care but considers a woman’s right to give birth in a setting proven safer than a setting where interventions are routine “controversial.”

Support your right to give birth where you feel you are physically, mentally and emotionally safe for our own health and for that of our soon to be born babies.  That right includes the option to give birth in a hospital.  Supporting the right for full access in order to make your own choice means allowing for both medically managed and whole health birth.

The proponents for hospital birth are pushing to restrict your federally protected right (as noted in the article referenced above) to choose your health care by persuading the public that homebirth is dangerous.  They are protecting their industry by striking your achilles heel: the safety of your baby.

Even if you don’t understand homebirth right now you can understand the right to educate yourself and make your own choice.  

Please tell the courts the Medical Examining Board is biased in their action and please help us remind them it has already been decided in the state of Connecticut that midwifery is not the practice of medicine.  Tell the MEB to stop their witch hunt.

Please support the right of birthing families to make educated choices about the births of their children.
*September 17, 2008 @ 2:00 PM*
* New Britain Superior Court*
* 20 Franklin Square*
* New Britain, CT 06501*