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!


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.

survivormoms_214_matte.gifImagine yourself in labor, and suddenly a very painful memory intrudes your mind and consumes your thoughts. Imagine how distracted you would become. Your contractions could slow down and stop. The physical intensity of labor might be overcome with the emotional pain of your past.

But it doesn’t have to happen this way. You can prepare yourself during pregnancy by reading When Survivors Give Birth by Penny Simkin and Phyllis Klaus and Survivor Moms by Mickey Sperlich and Julia Seng.

If you have been abused or even just suspect that abuse may have occurred, you are highly encouraged to discuss it with your entire birth team. This includes your doctor or midwife, birth partner, doula and childbirth educator.

Remember, all of your care providers have a responsibility to protect your privacy and rights. If they believe it to be in your best interest, they may also go out of their way to help you obtain appropriate services. Open communication is important and will certainly make a difference in your over-all pregnancy and birth experience.

If you are able to share specific details, those caring for you will be able to make better judgments and be more sensitive to your needs. There are some things that might trigger your memories of abuse. Some are obvious things such as being in bed during labor or breastfeeding after the birth. But other triggers, unique to your situation, might not be so easy to identify. This is where when-survivors.jpgcommunication between you and your caregivers can prove extremely beneficial.

Having vaginal exams are common during labor and at the end of pregnancy. But having them might put you in an extremely vulnerable position. If you let your medical team know about your history of abuse, they will be exceptionally sensitive to your particular situation and comfort level. You have the right to opt out of this particular intervention, and your choice should be respected.

Fortunately, there are many resources available today that help shed light and understanding on the problem of sexual abuse. Care providers typically maintain a list of resources that include local therapists or counselors that specialize in abuse. They may also have books, recommend websites, and provide educational materials.

get help

There are several options you can pursue in order to promote health and wellbeing. What may work for one mother, may not be the best method for another. Sometimes, you may need to experiment with several techniques before discovering which is the most helpful. A care provider should always be consulted prior to trying any form of therapy

This is the first in a multi-part series on pregnancy, birth and sexual abuse. This article is written for the pregnant woman with a history of abuse. Future articles will be written for those who work with pregnant women and will address ways to help a woman during pregnancy and birth.

About the author: Lasi Leavy has 15 years of working with at risk adolescents. She is an ALACE Birth Doula and Hypnobabies Childbirth Hypnosis Instructor.

Laborist noun; from Louis Weinstein, Thomas Jefferson University Hospital 1. (employment for Generation X and Y): depending on the hospital for one’s livelihood ~ income or resources 2. ( individual): doctors who work full time in the hospital, do only labor and delivery and work shifts of no more than 12 hours (from Arnold Cohen, Albert Einstein Medical Center): specialization, predictability

There’s a new doc in town. But mom probably won’t meet this obstetrician until her labor pains start.

This article poses Generation X and Y as the fall people for the economics of maternity care being in need of enhancement. If we are to believe this then we are to blame this same generation for assembly-line birth (start at induction and end your flow chart at episitiomy+forceps/vacuum or cesarean), obstetricians requiring a greater number of births in order to bill for and be able to pay for malpractice insurance (whether for poor use of interventions or mistakes made by lack of sleep) and office overhead costs and the dehumanization of birth.

Those are some heavy charges to lodge against these young people, and on behalf of the many young and older parents who have come through our birth classes we feel a need to set the record straight. Parents are searching for “care” providers. Knowledgeable, skilled and normal-birth experienced men and women who still hold a baby’s first seconds and moments in our world as being wondrous, joyful and sacred.

Parents are searching for men and women who refuse to work robotically, pushing crowds of women down a birth chute without names, identities or beliefs. Parents, who while appreciating the conveniences of technology for things such as researching information, have never stopped believing that healthcare should consist of nurturing the whole body and preserving whole health with invasive procedures as a final option. America may not rank up there with Cuba and other countries with better maternal and infant mortality outcomes but we do not believe that Americans or parents around the world prefer medical birth to normal, human birth.

The Midwives Model of Care™, defined by the Midwifery Task Force, is alive and well, although if journalistic pieces such as Division of Labor continue to make it through the editorial process it may be harder for the public to learn about it (and some might argue that the dehumanization of birth will continue to rise as a fault of the media’s integrity).

Under the Midwives Model of Care™, which is “based on the fact that pregnancy and birth are normal life processes”, quality birth care includes:

  • Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
  • Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • Minimizing technological interventions
  • Identifying and referring women who require obstetrical attention “The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.”
Across all other fields of health care there is a return to patient-led care. So we ponder what is going on behind the scenes that the medical schools churning out obstetricians feel a need to keep women and babies in the operating rooms but to pay med school bills. Here are some more links for further information on this topic: Hospitalists Review Essay; and Laborists, nocturnalists, weekendists: Will the “ists” preserve the rewards of OB practice?