Keith Roberts is unfazed by the attention given him as the first man to be certified as a doula by DONA.  He has has spent over 30 years in the field of holistic care, specifically focusing on pregnancy massage therapy and birth support for the last fourteen.  The prenatal massage work he does was a segue to following one mother right into labor where he found expert massage therapy was extremely beneficial to her in labor.  She was the first of fifteen more mothers he supported in labor before he determined to pursue certification as a doula.

Keith is perhaps more determined than female doulas to not replace fathers at birth.  The female support presence is invaluable because she is female and yet that bond is one that many a father may meet with trepidation: a club that he can’t be a member of by virtue of his gender.  Keith recalls an image that influences his genuine welcome of the father, an old cover of International Doula.  The cover’s image showed a mother embraced by her doula and the father is in the background.  Many a father today may not care to be present for labor but just as many men know there was a battle fought by Dr. Robert Bradley and the Hathaways to protect a father’s right to be in the labor and delivery rooms.

Those men who do want to be present for their child’s birth are already engaged in a checklist of all that they are expected to be today: he is to know everything about birth because he will be the mother’s advocate allowing her to focus on her labor; this he must accomplish while also providing physical, mental and emotional comfort.  Then after the baby is born he must strike the perfect balance between staying with mother throughout third stage and going with his baby should there be a medical reason to separate mother and baby.  As many a partner has put it, he/she must be everywhere, have eyes in the back of their heads and know how to play football, delivery room football that is.

Keith’s role is primarily for physical comfort.  It is easy for mom to choose between the two males present for her emotional and mental support….dad is her intimate partner.  “(Partners) are a reflection of mother’s state-of-mind; they tend to follow her lead and birth is just as much of an unknown to them as it is for mom.  They (dads) have as much a desire to meet birth at mother’s level of comfortability and she will want dad in front of her, to see him and be held by him.”  Further, for all of the reasons listed above, men appreciate having another male present in the primarily female energy until and unless a male obstetrician walks in for a few minutes of observation, medical speak and then exits.

When asked how he perceived the choice of a woman to invite doulas, let alone a male doula, to their births over their mothers even Keith’s keen observation of relationships is quick to surface.  In his experience few mothers want their own mothers present because they will feel a need to perform or meet parental expectations whether real or imagined.  Having their own mothers present is often an overwhelming thought no matter how comedic, true or polite the response is expressed!

Keith’s own intimate insight into birth as someone who could not experience birth for themselves but supports laboring women gives invaluable advice to partners.  These are his experienced Natural Birth Critical Factors:

  • Once you are in labor you cannot stop the flow of birth care you signed up for.  Choose wisely.
  • Read. Read. Read.  Take a natural childbirth class and read some more! A natural childbirth experienced and focused birth class leaves mothers and their partners with less “unkowns” and less fear of those unknowns.
  • Learn about fetal positioning.  The more you know about baby presentations and how to encourage optimal ones and work with less than optimal ones the more sense prudent changing of positions in labor makes.
  • Your choice of birth care practitioner directly relates to your odds of having a cesarean!
  • Keep the bag of waters intact!  Artificial rupturing of membranes (AROM) or artificially breaking the bag of waters is trivialized.  EVERY practitioner knows that within a short while of breaking the bag of waters labor intensifies in a ratcheted manner (versus a natural progression) and the majority of women will subsequently ask for an epidural.
  • Hire a doula for the purpose you want be it physiological support, birth knowledge, support for dad.  In all cases the doula can alleviate what stresses you most leaving you better able to meet labor’s demands with all of your own energy.
  • It is very hard to buck the system therefore, go back to Critical item number one.
  • Lastly, but more importantly, he reminds mothers that they have their own voice.  A doula will provide his/her opinion if asked but will never make a mother’s choice for her.  Mom must convey her choice directly to her careprovider and partners must be prepared to be be the first line of support echoing mother’s choice and minimize the number of minutes he/she might otherwise spend playing football by putting all that you’ve learned in a natural childbirth class into action.  Learn more about how your doula can best help you.

Through supporting women in labor hands on, so to speak, Keith has gained a whole new appreciation for the courage of women and for the hospital birth experience.  He concurs with Penny Simkin’s address at the DONA conference in Washington D.C. three years ago where stated the doula backlash is very real.  Keith advises new doulas to be mindful of their standards of practice and ethics.  Unless they have an established relationship with local practitioners then their voice, necessary for the support of laboring women, must be viewed as respectful of the practitioner and facility as well.  Birth is a hands on experience for the obstetricians and nurses themselves.  This is an opportunity for them to observe truly natural childbirth and learn.  If the doula is not respectful and professional in conveying her knowledge and experiences then the entire birth community suffers the backlash.

While we don’t normally publish consecutive posts on the same topic we thought today’s post warranted release.  We are committed to increasing international awareness of the issues and controversies in birth care protocols, advances in birth policy legislation, best practices and alternative options available to mothers.  To that end I recently authored a paper for submission to the international database resource available for the summit on Respecting Childbirth.  The summit took place in France during our Mother’s Day week event, the week of May 11, 2009.  We are all pleased to announce the paper was accepted for their database and some light is being shed on the truth of the state of maternity care in the USA.  It is our desire to raise awareness internationally that although America spends a lot of money on technology it does not mean that all American technology is to be accepted on face value as being beneficial.  The link to the summit (above) will bring you to the link on the paper, Home Birth: The Gold Standard of Cesarean Prevention or you may click the title link to download the paper and distribute it in your community, to your legislators as you move forward protecting your birth options where you live.  The first link in this post will also provide you with a tri-fold brochure you may wish to distribute by email or hard copy to your state’s legislators as well.

One thing we loved about the documentary Orgasmic Birth, is how it complements Business of Being Born’s consumerism awareness and vice versa because the woman herself was the focus.  Her power.  Her ability to birth.  No focus on who is catching the baby.  AND…the births take place in America in the mother’s own time and her space.  A Disney film attempted to show waterbirth with dolphins and took place in scenery meant to be exotic and far away, but took a toll on both the dolphins and the women and families birthing in the name of cinematography in the process instead.  Disney, we don’t need to sell birth in an infomercial, but birth is of global interest.

Practitioners are selling fear of birth.  The truth is birth is simple and we do more harm just by using words to put a fear of the unknown in place rather than the empowerment of experiencing the new.  Birth is not an unknown UNLESS you throw interventions into the mix.  Then you’re on a whole ‘nother flowchart.

I think we, natural childbirth educators and advocates, are accused of “selling” natural childbirth by careproviders annoyed that they’ve lost another customer. 

When birth is allowed to just happen it is not only an experience of wonderment for all in its presence it is also an experience in appreciation for a woman to be “a” woman, one not one of many.  For a baby to be the individual human welcomed, not one of many.

I loved “Kerstin’s Birth Story” which is the birth story of our own Olivia Sporinsky now living in Texas with her husband and family on his military base.  Olivia tells us of her birth experience in Germany where the careproviders believed something definite about American women.  Still, they were open to allowing Olivia to birth her way even though it differed from what they believed to be true about American women and how they birthed.

I recalled Henci Goer during the NIH conference on elective cesarean.  The panel was quick to say “more research is needed”, the typical wishy-washy answer so as not raise the ire of an industry that has a heavy interest in the public perception of cesareans.  However, Henci, in her usual to the point manner, asked, “What are careproviders telling women about labor, birth?”  Her viewpoint being if we only look at “elective” cesarean as a “whatever you’d like” versus talking to women about labor as a healthy and safe process; VBAC labor as one where we support natural labor as the healthiest route even more so; talking to women about how normal it is to have trepidation about natural birth and recommend resources for them to learn more about the birth process, well then, of course you breed more fear of birth.  Careproviders themselves are actually talking themselves into being afraid of the laboring woman as pure risk.

Here’s to you Olivia and Kerstin.  May the international birth community and women around the world know that technology is good to have but do not attach technology as a necessity for American women, for any woman.  America’s maternity care has misplaced faith in technology and other countries need not follow.  There are American women who are not afraid of birth and every day these women are a hands-on lesson for society and practitioners every day.  Humble and wiser is the practitioner who gives the mother her due for a most satisfying labor only she can do.

In January 2005 I found out that I was expecting my 3rd child.  Being stationed in Germany with my husband I was excited about giving birth outside of the US.  I was assigned a German OB and also sought out a midwife.  Home birth was finally an option with my insurance.  The funny thing was that the insurance insisted that I continue to see the OB even though I was seeing a midwife.  I eventually stopped seeing the OB because it was a waste of my time to go to 2 appointments for the exact same thing. 
 
In my 8th month the midwife informed me that due to some legal technicalities she could not attend my birth on the Army base.  It is considered US soil, and there was some question about whether she could lose her license if she attended a birth there.  I would have been the first home birth on the base.  I then returned to the OB who sent me to register at my choice of hospitals.  I chose St Hildegardis-Krankenhaus I would be attended by midwives at the hospital and an OB would only be called in if there were a problem.
 
On September 8th I drove a friend home, about 20 minutes from my home.  On the way back I had a strong contraction.  I thought to myself, “if I have many more like this before I get home I won’t be able to drive”.  I returned home, climbed the 3 flights to my apartment and sat down on the couch.  A couple minutes later I had another contraction that made me jump off of the couch.  I said to my husband that that was the 2nd strong contraction like that I had had.  It was now about 9:45 in the evening.  He asked if we should call the neighbor to come take our other 2 for the night and I said no, it will probably be a while yet.  The first 2 contractions were about 20 minutes apart and the next few were strong, not painful and about 10 minutes apart.  I spent my time sitting on the toilet, the most comfortable position for me, but also a good position since it opened the pelvis.  I prayed that this labor, which felt so different from my 2 previous, would go quickly.  God granted my prayer request.  Around 10:20 or so I said he needed to call the neighbors and let them know he would be bringing the kids over.  When he asked for the number, and wanted me to call, I couldn’t form a complete thought.  I pointed him to the list of emergency numbers to call.  After he carried our second child over, I realized I could not wait for him to come back upstairs to get me.  I gathered my bag, his wallet and the keys and was waiting in the parking lot for him.  He looked at me as if I’d lost my mind, but I knew we needed to leave then.  The normally 26 minute drive took 45 minutes that night, and the car ride through the country to the “big city” was painful.  Every bump in the road hurt. 
 
We arrived at the hospital, around 11:20, and he dropped me at the door and then went to park the car.  I rang the bell for the night watchman (not all German hospitals have “emergency” rooms, we went to a private hospital that handled scheduled procedures and birth), told him in my very broken German that I was in labor.  As he went to get a wheelchair I waved him off and said I couldn’t sit anymore.  We made our way slowly upstairs, pausing every 2 minutes or so for a contraction.  When we arrived in the labor area, I rang the bell and told the midwife I was American.  She returned with an English speaking midwife who watched me through one contraction and said we needed to be in the birth room.  The next words she said shocked me.  She said, “we should call the anesthesiologist, yes?”  I responded with “No, please don’t”  She then said, “you are American, yes?”.  I said that I was but I really preferred to do this without any drugs.  It wasn’t until later that I realized the full implication of what she had asked me.  She asked if they could check to see how far I was dilated, and I agreed, again, curiosity getting the better of me.  I think I was 6 or 7.  I requested that they break my waters, my other 2 had come so quickly after the release.  She grudgingly agreed and did it the German way–no amniohook, just pinched the bag during a contraction and popped it–never again will I request that!  They wanted to get a good read on the baby, so I allowed them to hook up the EFM.  The room (at the hospital) was wonderful.  I had all the tools at my fingertips that I needed.  The midwives then left me to labor quietly, peacefully.  I spent most of my time swaying, doing the belly dance, and chanting “baby out, baby out”.  My husband wonderful as he is, is not a great labor companion.  He kept saying that he wished he could get the baby out.  I didn’t want him to do anything, I just needed to say it.  Suddenly there was a flurry of activity in the room and I realized that they were pulling out the internal monitor.  I couldn’t verbalize that I knew where the baby was, that all was ok with her/him.  There was no way that I was letting them screw that electrode into my baby’s head.  I knew it meant that my 4 hour recovery stay would turn into 24.  All I could say was that I would have 1 more contraction and push.  I climbed on the bed on all fours, had one contraction, rolled over and in a half-sitting position pushed before the midwife knew what was happening.  My husband was frantically ringing for the other midwife to come in.  She ran in just as my baby’s head was born.  They all stood there and stared at me.  After a short time, 2 minutes, she that I needed to push again to birth the body.  I’m not sure if she was concerned that the shoulders were stuck, or what, but when I felt the urge, I birthed the body.  They allowed me to reach down and pick up the baby, who was a girl.  She was born at 12:28 am.  They nestled us skin to skin and covered us with warm blankets.  Then came the next crazy (in my opinion) question:  “did you remember to bring your own formula?”  I pointed at my breasts and said “I have 2 of these and they work great!”  The lights were turned up a bit when they took baby Kerstin across the room to weigh her and do her exams.  They dressed her and brought her back where she happily nursed away.  They continued to bring us warm blankets until about 5:30 when they took me to my room, holding the baby in my bed.  I then had the option to take her to the nursery while I showered.  I shared a room with 2 other women, neither of whom had her baby in the room and both were sleeping.  I showered, got my baby, and ate breakfast.  While I waited for  my husband to come pick us up, I noticed that there were several nurses who kept pausing at our door.  I started listening to their conversations (oh, the joy of understanding a foreign language) and realized they were all talking about me–the American who didn’t have drugs and was breastfeeding.  I also insisted on leaving that morning, 9 hours after her birth, we left for home.  The Germans typically stay for a week until the birth certificate is ready, they leave rested, and prepared to care for a baby. 
 
I finally understood understood why the midwives were so surprised that I refused the drugs.  Most of the American spouses who deliver there demand drugs, the German women don’t.  I started asking all the Germans I knew, they all had home births, or non-medicated hospital births.  It also made me so sad that American women are seen as weak, not able to handle labor.  The Germans don’t see it as painful, just a necessary process to have a baby.  So what if it hurts a little?  They accomplished it.  I’ve often said if I were to have another baby I would hop a flight across the Atlantic if I could not have a home birth. 

So, I just attended a very traumatic twin birth.  After watching the WHO film on vaginal breech delivery I was completely horrified at the lack of skill shown by these doctors.  The whole ‘hands off the breech’ was not present at all, nor was anything else for that matter. 

Here’s the short version as I am very tired.  Mom was a primip pushed beautifully…  She allowed her epidural to wear off to the point where she felt the pain of contractions enough to really push effectively.  She began pushing at 12:15a and baby A was born head first one hour later without incident.  Doctor did a completely unnecessary episiotomy without consent or even informing mom she was going to do it.  Nothing was said at all.  Baby B was transverse and that is when things got ugly.  The docs said they were okay with delivering him breech, but were very aggressive about getting him to turn.   The doctors hand was completely inside the uterus trying to grab an appendage.  The baby’s water wasn’t even broken, what did she think she was going to get a hold of!!!!  She finally broke moms water after 6 minutes of this manual attempt to turn the baby.  After the water broke, the doc grabbed the baby’s feet and pulled him through the vagina.  She continued to pull and pull on the baby and turn and pull on the baby, while the other doc pushed on the fundus and mom gasped she couldn’t breath.  Horrid!  Then, they both started pulling on the baby to get his head out.  They heard a pop when they broke this poor little 4 lbs 8 oz baby’s arm. His humeris.  I just can’t believe it!  They turned him nearly 360* using his body, pulling on his legs.  It was the most disgusting lack of skill I have ever witnessed.  It took two minutes, he was born barely 20 minutes after his sibling.  The rationalizations the docs gave were of course ‘well a broken arm is better than brain damage’ …  I am heartbroken. ~ B 

We were discussing a different subject just before B shared her doula birth story when an observation was made: many babies stop fussing when the person holding them stands up.  Perhaps, Ruth Trode mused, as a baby fusses or the environment is less than optimal for the person holding the baby that negative energy builds.  In that sitting position this energy finds pockets to “sit” in (think standing water).  When the adult stands up the energy is dredged and flows out into the air instead.

Have you ever noticed that a baby who sees its mother upset also becomes upset?  How is that?  A baby supposedly isn’t born feeling (else why would practitioners use invasive tools such as internal fetal monitors, IUPCs and pitocin?) so how would they have learned this facial expression means “sad” or which one means “happy?”  

Instantly I thought of babies during labor and how they show signs of stress first from interventions on mothers.  We know babies experience their mothers’ emotions.  They obviously experience energy …. why do I think this? Because they are not physically seeing the situation their mother is experiencing. They are in the womb.  It’s the ENERGY that they are feeling.  They are on a totally different plane than we are.  Then they are born and susceptible to losing the acuity of their intuitiveness and will instead learn how to compartmentalize instead.

This brought to mind how contrast colors grab newborns attentions, but blending colors don’t hold their attention as well. To me, I see that their world is so fluid in color, texture, sound and energy–there are ebbs and flows. It is only when we start defining the difference from black to white, here to there, me to you that we start down the path of seeing the world and the things in it as separate. Oh to be a baby again and see nothing as being separate.  ~Ruth, Musing on a cold, snowy day

It seemed to me that it is only we humans who have “evolved” (cynical) to see anything as seperate.  Witness this mother gorilla mourning the death of her baby .  Elephants also have a capacity many of us humans do not.  They also have a reverence for the life of their own.  They are who I think of when I hear the phrase “singing the bones.”

As we “listened” to B’s doula birth story what we felt in our hearts was more than the heartache of knowing this birth didn’t have to be this way.  Giving birth in anything less than humane care will tear us down as a society.  I seriously question who or which of us is the one that is “evolved.”

What deep wounds ever closed without a scar? ~ George Gordon, Lord Byron, Child Harold’s Pilgrimage

We continued to feel the reason for our being.  It’s not about restricting women’s choices or judging their choices.  It’s about whether or not THEY made the choice.  It’s not about what babies can tolerate.  It’s about why do they need to tolerate what practitioners impose on them?  

So begins a new year of sharing our message, how we give birth matters.  Not giving birth vaginally does not make a mother less of a woman.  Hearing us say this may surprise many who would claim we are inflexible wanting natural birth for all.  The practitioners who want to claim that we do not want to allow medications or believe cesareans are evil would rather you just turned away from us less you begin seeing those generalized statements for what they are: fear mongering of the worst kind; meant to stifle freedom.  When it permeates the laboring woman’s environment creating “atmosfear” that energy does make its way to the baby inside.

Thinking on our discussion of how babies sense and absorb the energies of their immediate and intimate space the twin birth story came rolling in causing great shock to us hearing the story and emphasized our entire past 24-hour discussion:  how we birth and how we are born matters.

Peace on earth can begin at birth.

For more on the newborn birth experience visit Birth Psychology and Newborn Breath.

Fear is a primal tool for humans to use to protect themselves and our overuse of it is causing Americans to stop thinking rationally in order to make educated choices.  All too often American public policy is driven by fear and that is the worst motivation for action.  Fear motivated calls to action have historically led to both famous and infamous events which we must stop and examine in an effort to avoid failures in American government which leads to personal tragedies in our lives.  We are bombarded every day with messages telling us the right thing to do implying we bring negative consequences upon ourselves ~ and sometimes on others around us ~ if we don’t.  

I first heard this acronym for fear, False Evidence Appearing to be Real, when I began researching the banning of VBACs (vaginal birth after cesarean) in America’s hospitals.  The rate of uterine rupture with a trial of labor ranged anywhere from 0.2 to as high as 1.5 percent (Rinehart).  A uterine rupture sounds horrible and it is.  However, that was the sole impetus for driving a policy to ban VBACs: let’s avoid it by just doing repeat c-sections.  Upon closer inspection however, it is the methods used for managing labor that leads to most uterine ruptures.  An often ignored and misused but very important tool for assessing the risks of labor induction is the Bishop’s Score (University Klinikum Bonn).  This system not only indicates the likelihood of an induction being successful it also provides for induction methods to be avoided. Yes, the original interpretation actually calls for avoiding induction if the bag of waters has ruptured and to consider no induction as an option if mom is a first-time laboring mother.  Boston’s famed research clearly concludes induction is contraindicated for a VBAC, yet induction with VBAC is still done and it is a major cause of uterine rupture.  Women who are unaware that inductions and augmentation in VBACs are a no-no and doctors do NOT have the patience for an unmanaged birth agree to repeat C/S.  Their decision is driven by the atmosfear driving OBs to make more money in less time and by-passing due diligence in confirming a procedure is both safe and justified.  In this example, you see, fear of uterine rupture caused a ban on VBACs in hospitals rather than ensuring medical protocol follows evidence-based research.

The 1940s and 1950s brought us McCarthyism, the fear of communism which is in direct conflict with the American ideology of democracy.  It eventually led to our nation’s Cold War whereby we fought wars on foreign soils in the name of stopping the spread of communism.  We can never forget the tragedy of the Vietnam War nor the total cost to the world over four decades.  The cost of both American troops’ lives and that of both soldiers and civilians in Vietnam including children lives on in infamy (PBS).  Decades of fear driven international policy on foreign soil.  The use of unproven and unsafe technology on women today, or as these mad scientists would call women “maternal environments”, is akin to the Cold War.  As long as its done on someone else’s body in a way that the doctor does not see the depth of his/her actions, well, then it is rationalized to be simply a necessary cost.

Finally, we have the fear of spreading illness as the leading motivator for vaccinating newborns, babies and young women in spite of the record numbers of injury to children in the form of Autism and death to girls and women from the new Gardasil vaccine.  The public should be demanding vaccine manufacturers undertake more expensive but quality trials as well as demand the pharmaceutical companies prove just cause for an aggressive vaccination schedule.  Instead, we continue to push for the restriction of parental rights by actually posing a poll question of whether or not parents who decline vaccinations should be jailed.  Sadly, our government heard the pharmaceutical companies and allowed for them to be protected from major lawsuits before conceding vaccines may be a direct cause of autism.

Fear robs us of our greatest natural skill for protecting ourselves.  Just because the people we face today are not carrying a literal bayonet it doesn’t mean our lives and our babies’ lives are not at stake literally.  In America today women must take the step to seek independent counsel on their birth care options.  We must protect our right to credible information in order to make informed decisions not fear driven decisions.

The ICAN offer below is a genuine offer and has been posted through VBACtivism, an organized yahoo support group.  It is our understanding that you should contact the group below if you are seeking help protecting your access to VBAC health care because you have been denied the right to VBAC.  You will be asked to provide information pertinent to your situation and a determination will be made as to whether or not you have a case.  Please, if you’re thinking about contacting the email below, do it!  Just the fact that you are thinking about it is enough to warrant following through.  You and your baby deserve to exercise your rights to choose your health care for yourself.  Write a letter to your careprovider first but don’t wait for a response that may never come, learn more now!

I’m a lawyer with the Northwest Women’s Law Center in Seattle.  I’m investigating possible legal responses to bans on vaginal birth after cesarean at hospitals in the northwest states – Alaska, Idaho, Montana,Washington and Oregon.  If you are currently pregnant and want to have a VBAC, but are facing a hospital policy that would require you to have a c-section regardless of whether you want it and whether it is medically necessary, and are willing to consider working with a lawyer on this, we’d like to talk with you.  Please email us at vbacbanhelp@ican-online.org.  Our services will be provided free of charge.  

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*