Mama Musings: My Journey To Choosing Home Birth and a Provider

This post is the first in a series I hope to complete before the arrival of my second child, who I plan to birth in our home under the care of a midwife in the coming weeks.  I’m always a bit reticent and feel somewhat tender when discussing birth preferences and experiences (my own and those of others) because I full-heartedly feel that birth preferences and experiences are sacred things, things to be respected and honored, no matter what your birth looks like. It’s in that spirit that I compose these posts–in a spirit that respects and honors this milestone in my family’s life and in a spirit that perhaps respects and honors your curiosity and concerns about the processes involved in home birth.  These posts are not intended to be prescriptive, but rather as a peek into what has informed my decisions so far. Please tread gently.

A bit ago I wrote a post sharing my question about where to birth my daughter–in the hospital or in my home.   Several of you shared your insight and support on that matter, and I’m genuinely grateful for the time you took to lend some perspective. A couple of weeks after that post my husband and I came to our  decision: we chose to plan a home birth, and I transferred my records from my obstetrician to a midwife.

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photo credit: eyeliam, Flickr Creative Commons

Briefly, these are the factors that bolstered my interest in and my ultimate decision to pursue a home birth: I want to  have a birth experience that is inclusive and supportive of the whole family; I wanted a provider who felt more like an invested partner in my maternity care, rather than the commander-in-chief of my care; I had an unmedicated vaginal birth with my son, and I feel confident in my ability to do this again; my previous pregnancy was and my current pregnancy is healthy and low-risk; and my previous birth experience (in a hospital) was supportive and generally pretty positive, illustrating clearly to me how invaluable this amplitude of support can be during birthing. My decision to pursue home birth was never made from an anti-maternity establishment frame of mind, as some have assumed; it was my positive hospital birth experience with my first pregnancy, in fact, that underscored how invaluable and necessary respect, support, comfort, and confidence are in any birth experience.

There is an overwhelming amount of fear-mongering about birth out in the vast interwebz. Trust me, I stepped in a lot of steaming, fear-stoking crap as I forged my path to my birth choice both times.  You owe it to yourself and your baby to be thoroughly educated about your options and the procedures and processes involved in birthing, no matter where/how you plan to have your baby. You are not merely a passenger in your birth experience. And if you are reading this as someone, like me, who struggled to get and/or stay pregnant, you especially deserve to reclaim some power on your path to motherhood; there is much about the infertility and loss experience that erodes our sense of self-determination and our confidence in our body’s capacity to get things right.

There is a good amount of insightful, balanced reading out there for those seeking to shore up a decent perspective on birth options. My favorite book (I read it during my first  pregnancy and then revisited it for my current one) is The Thinking Woman’s Guide to a Better Birth by Henci Goer. I also enjoyed Active Birth: The New Approach to Giving Birth Naturally by Janet Balaskas. I read many others, but these were the standouts for me. Other very popular and instantly recommended books in the”natural” childbirth community are those written by renowned midwife Ina May Gaskin. (You can also find some additional birth education recommendations from TOBB here.)

Finding My Provider

My initial debate surrounding the venue of this birth had much to do with being in a brand new city with limited insight into community resources surrounding birth and a limited understanding of the  birth culture in this new locale. I’ve always been attracted to the midwifery model of care. It pretty much sounds like a dream come true, no? (I think this brochure is a perfect frame of reference for selecting any prenatal care provider, even if you feel more comfortable with or have a medical indication requiring obstetrical care.)

I had an OB for my first pregnancy because there were only two certified nurse midwives practicing in my small former home city, and both of them practiced in large OB practices. My professional experience as a hospital social worker on a women’s & children’s unit (L&D, mother-baby, NICU, pediatrics) gave me priceless perspective on the limitations of large OB practices, and  I knew I would not be pursing prenatal care with either of those big practices. Instead, I sought out an  OB who practiced independently, as I felt this would give me a better shot at individualized care. Sure, either of those midwives at the other practices would have been able to give me this kind of care…but only on their rotation. I knew that a merry-go-round of OBs (with several of whom I’d repeatedly had dissatisfied professional experiences) was not for me. I didn’t want to run the risk that one of these disliked OBs would be on call the day my birthing began, because that would have been my luck.

So, now here in St. Louis and apparently pregnant, I immediately began asking other moms for recommendations for prenatal care providers, hoping to find a certified nurse midwife this go ’round. I was advised that there is only ONE certified nurse midwife in all of St. Louis who delivers in the hospital. (How is that even possible in a city this size with not one, but TWO schools of medicine?) I belong to an attachment parenting group here, so I lobbed my prenatal care quandary at those moms, knowing that we likely shared some of the same gentle birth ideas and that these women have had broad birth experiences–hospital/birth center/home/high-risk/low-risk/vaginal/with pain support and without/emergency cesarean/planned cesarean. They were a wellspring of knowledge. And this is where I learned that the majority of the other midwives practicing in the STL area are certified professional midwives who deliver babies at home.

There is a difference between certified nurse midwives and certified professional midwives (and lay midwives and direct entry midwives, etc.). Did you know there were so many types? I didn’t. This explains the differences in experience, education and credentialing.

Many of the moms I talked to had birthed their babies at home, and while home birth wasn’t something I’d been considering at the time, I listened to their experiences with an open mind. And I jotted down their providers’ names, just in case.

As I mentioned, I began my prenatal care for this second pregnancy at a small “natural birth-friendly” OB office (with two OBs) in my insurance’s network while I continued to suss out additional resources. At this point in time I was planning to attempt to repeat my previous birth experience: an unmedicated, Hypnobabies-bolstered, doula-assisted hospital birth surrounded by caregivers who value individualized care and who are experienced in supporting mothers through this kind of birth. As my appointments ticked away from 8 weeks to 20 weeks, it became evident to me that my hopes were a little too high for this particular office. I was constantly being shuffled to the nurse practitioner instead of my OB for appointments, even when I had specifically requested to see the OB and had been told I would see the OB; the nurse practitioner told me she was unable to answer many of my birth-related questions because she was not the provider who would be attending my birth, and instead she gave me vague and contradicting answers. In the appointments I was able to have with my OB, she was non-committal and dodgy in her answers:

“I would really like to try a water birth; how do you help manage water births at your hospital?”

–Well, I can’t say right now that you can have a water birth. There are lots of things that could happen that might prohibit that. You just never know. 

Ummm-hmmm. While this is clearly true–you simply can’t guarantee how a birth will unfold–an ongoing pattern of this kind of answer and attitude made my care feel like a bait-and-switch deal. There are better/kinder/gentler ways to convey the message that birthing is not predictable and that perhaps we might discover that I am not a good candidate for this means of birthing support. All of my questions were met with these evasive and glass-half-empty answers. It made me uncomfortable, to say the least. Especially coming from a provider who described herself as “natural birth-friendly.” If *this* was friendly…

Maybe this sounds nit-pitcky. Perhaps to some it is. But what I deeply felt is that I did not want to approach my birth with apprehension about a lack of support or with a foreboding expectation that I’d have to arm wrestle my OB and nurses for consideration of my birth preferences…while laboring.

I began interviewing recommended area midwives, one of which is heading up the opening of a birth center about an hour outside of the city. She was warm, encouraging, and insightful. The birth center’s opening had been pushed back again–this has been an ongoing three-year effort, apparently–and this midwife (a certified nurse midwife) was still delivering babies at home in the meantime. She (and the birth center) are located about an hour from where I live. Not exactly ideal. She casually said, “You do know that you have a couple of exceptional midwives in your very own neighborhood, don’t you?” And she specifically recommended one of these midwives to me. (This particular midwife had also been recommended repeatedly by other mamas in that AP group.)

I interviewed her next. I was instantly comfortable with her–her style, her personality, her frank and articulate answers to my questions, even her office environment. And I especially liked that she was trained/experienced in two skills that were non-negotiable for me: neonatal resuscitation and  stitching. I had a third degree tear with my son, who was both posterior and compound. I recognize it’s likely that I will tear again. And I am not a “let it heal naturally” kind of girl if the tear is significant.

I combed the interwebz for interview questions for my midwife interviews, and culled a list of questions from here and here. Our interview (because, yes, she was also interviewing me–was *I* a good candidate for homebirth?) was more of a comfortable conversation, and halfway through, this midwife asked for my list of questions and just went down the list, answering completely each and every question I’d brought. This was such a contrast to my OB experience, where the answers to my questions were foggy, and where questions, in general, felt like an intrusion on her time.

A few weeks passed before I made the switch from my OB to my midwife. I am an over-processor by nature, constantly turning something over in my hands to an anxious, nauseating fault. For me, historically, it’s the process of making the decision that overwhelms me.  And then, one morning, I woke up and realized, This is what I want and need to do. Once I filtered out all the static, the picture was clear. And when I walked into my OB’s office to fill out paperwork to transfer my records to my new provider, I did it confidently and comfortably and with a great measure of relief. Listening to your gut–honoring your instincts–is a feeling that can’t be overstated.

In the term of my care under my midwife, I’ve done the same kinds of tests that I would have received under my OB’s care, such as a glucose tolerance  and GBS tests. She takes my blood pressure and pulse, checks my urine and weighs me, and listens to the baby with either a fetoscope or doppler. She measures my fundal height and palpates to determine the baby’s position. The difference in the care, wholly, is the quality of the interaction. This kind of maternity care has been a good fit for me.

And that’s ultimately what it comes down to–what feels like a good fit for you? What kind/venue of care makes you feel more supported about birth? Because if giving birth in your home feels scary or uncertain, it’s not for you. You need to feel confident, and sometimes that confidence comes from knowing you can deliver in home-like environment (a birth center) or within the structure of the medical model (hospital). Wherever makes you feel emboldened and safe about birthing is where you need to be.   If home birth is something that appeals to you here are a couple of  posts written by other home birth mamas about their experiences: here and here and here.

Tell us about your birth experience: Where did you birth/where are you planning to birth? What informed your decision? How did you find your provider? Do you have any suggestions for handy resources for informing yourself about birthing? 

Rhianna's biopic

Rhianna is currently 39 weeks pregnant and feeling every bit of it. There’s an inflatable birth pool in her closet and a length of hose coiled next to her bathroom sink, and she is ready to put them to use. Stay tuned for her next post on home birth supplies and her home birth to-do list. She lives in St. Louis with her husband and two-year old.

Hospital or Home: How Did You Decide Where to Birth Your Baby?

As I creep towards the halfway mark of my second pregnancy, I’m confronted by questions around which I’ve been tip-toeing: Where, oh where, will my baby be born? Should I go the hospital route again? Should I get my homebirth on this time?

Between my heavy crush on the idea of birthing my baby in the intimacy of my own home and the biting admonitions of a certain blogging skeptical obstetrician, I’m kind of, well, lost. I know what I want, and I know what I absolutely do not want, and I’m feeling a bit uptight and weary about the ability to marry the two.

You see, I got a whole lotta love for my first birthing experience. It was  empowering, awe-stoking, and filled with support and respect. My birth plan was honored nearly to the letter (there was a small hiccup with my request for delayed cord clamping), and even if I could I wouldn’t change a single thing about how my unmedicated, doula-assisted, Hypnobabies-bolstered hospital birth unfolded. (Okay, maybe I could have done without the stubbornly posterior bebe and the third degree tear.)

2012 National Rally for Change in St. Louis, MO, advocating for informed consent and evidence-based maternity care.*

But what I recognize about my hospital birth is this: the circumstances of my hospital birth experience aren’t du jour. In fact, I don’t think it’d be improper to describe those circumstances as exceptional. I worked in the women’s and children’s care center in the hospital where I delivered my son. Day in and day out for years preceeding my pregnancy and my son’s birth, I worked elbow-to-elbow with those professionals–the L&D/postpartum care/NICU nurses, lactation consultants, obstetricians, neonatologists, and pediatricians– in the position to care for me and my baby.

When the time came for me to choose an OB, I already had a pretty sound understanding, based on my professional experience, of which ones I didn’t want anywhere near my vag. When I had questions about how experienced my nurse co-workers were in supporting a patient aiming for an unmedicated birth, or how receptive they would be to the presence of my doula, or if I would be able to take my placenta home with me, I simply walked a few short strides from my office to that of the L&D nurse manager, plopped my pregnant rump down across from her, and asked my questions. When I had questions about breastfeeding resources and support, all I had to do was wave over one of my fantastic lactation consultant colleagues, and they eagerly shared their insight. I had a ton of support and intel at my fingertips long before I was wheeled up to L&D rockin’ 9cm of righteous dilation in my amniotic fluid-soaked yoga pants.

I will openly admit that I enjoyed an uncommon measure of comfort, privilege and preferential treatment birthing my baby and recovering amongst my hospital friends and co-workers. I do not hesitate to credit my unique circumstances for much of the ease I experienced navigating hospital birthing care. The biggest takeaway from my birth experience was this: the relationship you have with your care providers is integral, immeasurable, and irreplaceable.

Happy birthday, my sweet boy

I left that employment for stay-home mamahood, and our family has since relocated out of state to St. Louis. While I understand that each pregnancy and birthing experience is unique, I am acutely aware that the level of care and support I received in the past simply cannot be replicated here. And I have deeply felt reservations about a hospital birth this go ’round.

I’m currently under the care of an OB who as a reputation for supporting patients who desire a less interventive birthing, but I’m full of uncertainty about the hospital where she delivers. Sure, I could switch care providers; I could select an OB who delivers at a hospital with a better rep. Even still, I am nail-biting my way around the implicit fact that a hospital birth here would involve a few things on which I do not wish to compromise. (For example, I want my son to be integrated, when appropriate, into the birth experience of his sibling. And I do not want to be seperated from him for any great length of time, and especially not overnight. We’ve never spent a night apart.)

All signs seem to point to homebirth. Except, you know, those angrily flashing ones on the blog of a certain skeptical obstetrician. I fell down that rabbit hole, reading post after post about the inherent irresponsibility and acute risk of birthing your baby anywhere but a hospital. My cage? Rattled.

I interviewed a highly and repeatedly recommended certified professional midwife here in my neighhborhood, and I left feeling a bit lighter about the prospect of a homebirth. I am considering transferring to her care. In the coming days I will be following up with my insurance company to ascertain the extent of my benefits for an out-of-hospital birth. If nothing was covered at all and I needed to pay the full cost out of pocket, the math shows that I’d be spending just a couple of hundred dollars more than what I paid for my OB and hospital birth with my son. Cost, as I understand it at this point, is not a deterrent.

There is a birthing center scheduled to open this fall about an hour’s drive from where I live in the city. I’ve spoken with the certified nurse midwife heading up that effort, and she, too, was lovely and resourceful. Still, I’m uncertain about the idea of driving an hour away to have my baby. But maybe it’d be worth it?

Help a hormotional pregnant lady out: Did you struggle with the question of where to birth your baby/ies? What helped you confidently forge a decision? What resources/reading did you find particularly helpful?

*Wanna know more about informed consent and evidence-based maternity care? Check it out here.

Rhianna blogs from her adopted hometown of St. Louis, and never before has she missed her former hometown (and its awesome nurses) as much as she does right now. Things keeping her awake at night: crane-kicks to the kidneys courtesy of her bedsharing toddler; in utero dance party courtesy of wiggly fetus; and the anxiety surrounding the place in which the two will meet for the first time.

The Hoped For, Yet Unexpected Second Baby

We trudged down a long, rugged road to conceive our son, and while future children were always in our hearts and hopes, we had anticipated a similarly turbulent course to further expanding our fam.  That disheartening path of our family-building past has undoubtedly shaped my parenting ethic and has emboldened my aspiration to be an attached, gentle mama. One specific element of my personal parenting ethic–breastfeeding–grew to become a profound and potent combination of attachment and empowerment.  Becoming a mama was such a long-held dream, and breastfeeding had become so meaningful; I made these things–dwelling in my blissfully realized motherhood and nurturing my nursing relationship with my son–my priorities.

When discussions about adding to our brood would crop up between me and my husband, these conversations were always left open-ended. I wondered about child spacing. Worried that we’d get lost on that too-familiar, dark and long path again, I wondered if it’d be prudent to wean my son altogether in order to get a jump-start on trying for another baby. In the end, I found peace in focusing my energy and attention on the relationship with the child I was already so fortunate to have. (Zero judgement towards anyone who has decided differently. That is some seriously heart-wringing stuff, and I have the utmost respect for people who have to contend with making that decision.)

Life, as it tends to do so masterfully sometimes, demonstrated disregard for our difficult decision to table growing our family. My period returned on its own at 14 months postpartum, and after three postpartum cycles, I discovered I was pregnant. It was a surprise that spun my head and world around, one that filled me with a jaw-dropping, Niagra-sized waterfall of disbelief, awe and question.

I was saturated in competing emotions: joy and trepidation; peace and anxiety; gratitude and ambivalence. I suppose these confusing feelings are par for the course when life grants a hope you long ago released. As I now trek into the 17th week of this pregnancy, that deluge of conflicting emotions has evaporated, leaving only faint water marks in its wake–now nearly invisible reminders of how stunned we were by this deeply wanted, yet entirely unexpected bit of fruit in my ute.   

In so many ways–from conception to morning sickness to support system–this  pregnancy has been strikingly different from my last. Though I’ve experienced pregnancy and childbirth before, I feel like I’m learning entirely new lessons this time. It’s exciting. And humbling. 

If you’ll join me, I hope to take you along for this journey. This pregnancy has already thrust us into big changes–my toddler is now fully night-weaned (I will share that story soon). I’m currently navigating the decision about where to birth this bundle of bebe, preparing emotionally and physically for a new bambino, and hoping to learn what attached, natural, gentle parenting looks like when you’ve got two to snuggle and wrangle. I hope that we can trade insights…

How about you? Did a struggle to conceive/sustain a pregnancy influence your parenting ethic? Have you ever debated altering your attachment tools in order to grow your family? Ever had your world rocked by a pregnancy–first, second or otherwise? How did you manage these experiences?

Rhianna blogs from her adopted hometown of St. Louis. She gives thanks to the Goddess of Elastic-banded Pants for her roundly unattractive, but so, so comfortable apparel.  Now if only the Goddess of Morning Sickness would heed her pukey pleas…

A Peek Into the Past: A History of Birth Choices and Practices

Once upon a time, Miriam and I wrote a book. And in that book, we had over 400 pages of material. Our vision, however, was to give new and expecting moms a nursing companion–a book they could hold in one hand. We had to face it: four hundred pages is awkward.

So we snipped. And trimmed. And cut. (Miriam was the better cutter. I acted as if my limbs were being torn from me every time she suggested a section for the chopping block.) It’s hard to say no to hundreds of hours of work, but thankfully, all’s not entirely lost. We’re bringing you some of our largest unseen sections from TOBB, in a series of blog posts.

“A Peek into the Past” is a pithy round-up of our societal evolution of parenting practices, mostly in the U.S. You’ll learn about the history of birth, breastfeeding, potty training, co-sleeping and more–eight posts for our eight chapters. Enjoy, ask questions, and share with friends!

~Megan

A Peek Into The Past: Birth
Just 100 years ago, American childbirth was considered a normal, natural process. Our great-grandmothers didn’t need to enroll in childbirth education classes; they were supported by their mothers, sisters, cousins, and neighbors. Since women attended other births as a regular life event, like weddings and funerals, new mothers were often well-versed in labor and delivery. Babies were born at home with the help of family, friends, and often a skilled midwife.

Toward the end of the 1930s, male Obstetricians (OBs) launched a crusade marketing campaign to glamorize hospital births. For extra oomph, they ran a smear campaign to put fear in the hearts of birthing women. Cities were plastered with posters featuring photos of ugly, dirty and ragged women–“midwives.” Middle and upper class women soon jumped ship. Hospital births, along with complete anesthetization (read: mamas were knocked out!), became the norm. Women were often strapped down and given narcotics like morphine and scopolamine, which erased all memory of the experience. Expectant fathers passed laboring hours in waiting rooms, and when babies were delivered, nurses whisked them away to nurseries.

But not everyone joined this bleak birthing bandwagon. In 1944, Dr. Dick-Reed, author of Childbirth without Fear: The Principles and Practice of Natural Childbirth, coined the phrase “natural childbirth,” reintroducing labor without anesthesia. A decade later, the work of Dr. Fernand Lamaze began bringing fathers back into the delivery room. Labor and delivery began to be seen again as normal processes, and though hospital births still accounted for an overwhelming majority, the days of intense maternal disempowerment, ended.

Ina May Gaskin was another player who helped us reclaim birth as a normal, natural process. After attending out-of-hospital births of women in her community, Ina May and several midwives founded The Farm Midwifery Center, one of the first birthing centers in the U.S. She went on to author Spiritual Midwifery and Ina May’s Guide to Childbirth. Editor of Midwifery Today Jan Tritten dubbed Ina May “the mother of modern midwifery.”

The debate over homebirth heated up in the 1970s; the American Congress of Obstetricians and Gynecologists opposing, and the women’s movement demanding a return to midwifery and demedicalizing birth.

Birthing centers began popping up on America’s east and west coasts in the 1970s, allowing moms a more flexible birth experience not restricted to a hospital bed. Unfortunately, in the 80s and 90s, many health insurance companies streamlined their support of OB-facilitated hospital births by reducing coverage of midwife-related costs, and ditching support of certified nurse midwives altogether. Their decisions reduced out-of-hospital options for moms.

Today, the U.S. birthing system leaves much to be desired. No central set of licensing standards governs midwives, and independent practitioners of midwifery aren’t legally allowed to practice in several states. Despite these barriers, homebirth rose a dramatic 20% from 2004 to 2008, with almost 30,000 mothers opting to give birth at home in 2008.[i] In the same year, former talk show host Ricki Lake produced The Business of Being Born, a frank examination of the politics behind birthing in our country, followed by other documentaries advocating home births. While it’s too soon to tell, we suspect these educational films have increased the number of women considering home or natural births. As concern about high rates of interventions persists, more women are reclaiming birth as a normal, natural process.

For a deeper look at the history of birth, check out these sites:

Birthologie

Digital History: Childbirth in Early America

Midwifery Today: A History of Midwifery and Childbirth

Are Midwives the New (Fill in the Blank) Trend?

Are midwives becoming trendy, like juice cleanses and Tom’s shoes? It seems that way, at least among certain well-dressed pockets of New York society, where midwifery is no longer seen as a weird, fringe practice favored by crunchy types, but as an enlightened, more natural choice for the famous and fashionable. ~DANIELLE PERGAMENT, New York Times

I recently read the above quote in an online New York Times article called “The Midwife Becomes a Fashion Symbol For the Hip.” In it, the author states that more and more celebrities, as well as the financially well-set, are seeking midwives for home and hospital births. Several of the more popular midwifery groups in NYC actually have to turn away clients because their popularity has increased so much recently. And this concerns me.

I don’t want to be trendy. 

I didn’t make the difficult choice to use a midwife because it would look cool. My decision to birth naturally certainly didn’t garner me much support from those who questioned my sanity. And for goodness sakes, there is an alarmingly big difference between picking out a pair of shoes (Toms, as mentioned in the quote) and choosing how to bring a child into the world.

Midwife-supported childbirth is a beautiful, time-honored tradition, but this article has reduced it to being just another fad.

If more people knew that 100 years ago nearly all women used a midwife, would it seem so trendy? Or would it be the norm? We, as a society, have become so confused as to what constitutes a normal birth that hospital, OB/GYN-led births are standard and midwifery care is the newest trend.

My concern is that if midwifery care becomes associated with celebrities and the wealthy that there will be a misconception in society that midwives aren’t for everyone. It is almost laughable to think of midwifery being a choice only for the wealthy and elite. In reality, many midwives offer their services for a fraction of the cost of a hospital and are willing to work out deals for those without health insurance.

My hope is that when choosing your healthcare provider, you look beyond what celebrities are doing or the choices of your friends.

Feel empowered.

You, just like Gisele Bundchen or Christy Turlington, have a right to choose, a choice far more powerful and long-lasting than a pair of canvas shoes. Unlike many other trends, the right to birth how you want,where you want, and with whom you choose, is a “fad” I sincerely hope never fades away.

Kate is decidedly untrendy, and she prefers it that way. When she’s not responding to misguided but well-intentioned New York Times articles, she enjoys exploring off-the-radar neighborhoods and enjoying new experiences with her sweet 15-month-old, Vivi, and husband, Kirk.

Carnival: Embracing Your Birth Experience.

Welcome to the June 2012 Carnival of Natural Parenting: Embracing Your Birth Experience

This post was written for inclusion in the monthly Carnival of Natural Parenting hosted by Code Name: Mama and Hobo Mama. This month our participants have written about at least one part of their birth experience that they can hold up and cherish.

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Photo credit: S. Kuster 2010

“Do your work, then step back. The only path to serenity”

-from the Tao Te Ching as translated by Stephen Mitchell

Giving birth is extraordinary. On the ever-changing evolutionary tree, it is one of the characteristics that binds us Mammals together. We are different. We are wonderful. On the moment that new life emerges from our womb, we can connect, suckle, soothe, and bond. There is no time for sitting on the nest. There is no room for laying eggs only to go on our way to leave them to the fate of the world. Each mammal from the tiniest mouse to the largest elephant shares a kinship in live birth and we each have our own birth story to tell.

Humans have a special place in the mammalian world. Over the course of a few million years (2Ma to present) there have been approximately 12 species of human prior to modern Homo sapiens sapiens (i.e., you and me!). How do we know this? Paleoanthropologists (the scientists that study human evolution) have examined prehistoric skeletal specimens from around the world and painstakingly put the pieces together on how humans have evolved through time. Each new skeletal find yields exciting additions to the always-developing human story. As we look at the course of human evolution from 2 million years ago to the moment that you are reading this post, there are two characteristics that stand out above all others concerning the birth process: increase in brain size and the narrowing of the pelvis.

What a combo! Homo sapiens sapiens have huge brains compared to their body size (and our brains are getting bigger!). If you look around you, this is major plus. Our technological advances are beyond compare. We have culture, computers (and, thus, The Other Baby Blog), and can fly to the moon. However, if we look at our skeletons, a problem begins to emerge. Whereas our brains have gotten larger (and, thus, our skulls as well), our pelves have not. As humans began to walk upright (on two legs), the mechanical changes required a narrowing of the pelvis (for more information on the Obstetrical Dilemma click here) for more efficient locomtion. However, if you cannot fit a fetus’ head through the birth canal, you cannot give birth (until recently, of course), and species population suffers.

The pelves of other mammals are large in comparison to the head size of the emerging baby, whereas human baby heads completely fill and expand the birth canal an astounding amount. The message is clear. Compared to the rest of the mammal world, humans have a painful and sometimes dangerous disadvantage for giving birth successfully.

But, we do it! And we do it with vigor and a primal excitement unlike any other we will ever experience. There is no perfect birth. All labor is work. It’s hard. We do our work as the Tao Te Ching suggests. No matter what happens during the journey of birth, whether you manage completely unaided or have to receive an epidural or cesearean section, we all strive towards one outcome: a healthy baby and a healthy momma at the other end. Be flexible! We are all in the trenches!

Wonderful women! Stand back from your work and embrace what you have accomplished. I have. Thank the people who have helped you through your birthing journey. You and I are now part of a long lineage of Homo sapiens who have taken part in an extraordinary (and anatomically amazing!) feat. And it feels amazing.

As you hold your newborn baby, put your toddler to sleep, or smile at your teenager from across the dinner table, it gives you a chance every day to stand back from your work and feel the serenity of what you have accomplished. Birth is just the beginning.

Stephanie’s favorite field seasons were spent at the Olorgesailie prehistoric site in the Great Rift Valley of Kenya. She studied the geology of an ancient lake littered with stone tools created by our ancestor, Homo Erectus, about 1 million years ago. 

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Carnival of Natural Parenting -- Hobo Mama and Code Name: MamaVisit Code Name: Mama and Hobo Mama to find out how you can participate in the next Carnival of Natural Parenting!

Please take time to read the submissions by the other carnival participants:


Stop the Pregnancy Hazing Already!

Are you pregnant now? Have you ever been pregnant? Chances are, if you fall into one of the those two categories, some well-meaning person has decided it was their duty to tell you some childbirth horror stories. Or to tell you that you’ll catch up on your sleep in about twenty years. Or to remind you that your body will never, ever look the same as it did pre-pregnancy. Even celebrities, such as Jessica Simpson, cave to fear-based decision-making in the last moments of pregnancy. Negativity, more often than not, surrounds what should be a happy and joyous experience.

And really, who is to blame for our society’s often negative view of childbirth? We could certainly blame it on the media. Childbirth and motherhood are sensationalized, and TV shows portray pregnant women being rushed to the ER, babies in distress, and slovenly and exhausted moms with a bunch of bratty kids in tow. If we truly believed the negative press on childbirth and motherhood, who would ever have kids?

So let’s get a few things straight and talk about it honestly. Yes, childbirth can be painful. Yes, parenting is a tough 24/7 job that lasts a lifetime. But to focus solely on those two points to the exclusion of everything else is an exercise in emotional and mental hazing.

What would it take to change our societal view of childbirth and parenthood? What would it take to stop the ritualized “hazing” that takes places in the supermarket, at the park, and from your co-workers, friends, family, even strangers? A few months ago, a pregnant acquaintance of mine told me of how many people criticized her decision to homebirth. Yet no one stepped forward to tell this first time mama what a joy it is to give birth naturally and to feel the harmonious sensation of your little one skin to skin for the first time. No one told her to follow her instinct to birth at home. And certainly, no one trusted her instincts either.

My experience was no different. I had a “well-meaning” co-worker (whom I wasn’t even close with) debate my decision to birth naturally in front of other faculty at a holiday party. Multiple people told me that I would be begging for an epidural and questioned my decision to use a midwife rather than an OB/GYN. If not for the support of my classmates from a Bradley Method childbirth class, I might not have stayed true to my instincts.

Unfortunately, we cannot rely on the media to change the way childbirth and motherhood are portrayed. But we, the mothers and fathers who have experienced it, can. No matter how you gave birth or where, support a pregnant friend in her decision-making. Encourage her to trust her instinct. Give her (and her partner) what the media cannot: a positive, supportive experience based in love, not fear.

Kate is a first-time mama who experienced her fair share of pregnancy hazing, including a stranger in the grocery line encouraging her husband to “force her to get an epidural.” When she’s not advocating for others’ childbirth and parenting decisions, she enjoys sewing, researching different parenting philosophies, and playing “animals” with her sweet little girl.

Super Moon……Super Delivery

Hello Friends!

My name is Molly. I’ve been eager to write my first posts for The Other Baby Blog, and was sure that it would be about breastfeeding advice (I’ll be the Ask the LC expert in the coming weeks). But I’m starting with my son’s birth story instead! My husband and I wrote it from each of our perspectives. Throughout the entire pregnancy we had a feeling that this baby would come on a full moon, low and behold exactly 1 week and 1 day “late,” Montgomery Charles made his entry into the world under the light of the moon. Enjoy!

Monty’s Birth 5/6/2012

From Dad’s view

Written 5/9/2012

Snuggling skin to skin with Daddy……check out the moon!

It all started at almost exactly midnight.  I came in to bed and Molly said that she was having a contraction.  She got up to go to the bathroom and had another contraction while she was there.  She then stated that if she had another contraction like the last two that it would be it.  I asked her if I should get up and make myself some coffee and she said no, that we would try to go back to sleep.   The next thing I kew, Molly announced, “I am in labor”.

I got the Kindle which had a contraction timer app and started recording her contractions.  The first two contractions came around 4 minutes apart.  I ran to get some coffee started and she had a contraction before I could get back.  I guess the next one was between 3 and 4 minutes apart.  I got dressed and missed another contraction and realized that the contractions were consistently close together.   I kept expecting that the contractions would vary in their timing since it was so quick, but they never wavered from the 3-4 minute spacing.

Molly wanted to labor for a while in the bath.  After her bath, she came out to the front room in her robe and rocked back and forth on the exercise ball for a couple of minutes.  She asked me to make her some hot water, so I put on the kettle.  During this time I loaded the suitcase into the car.  Molly never touched the hot water (big surprise).  This whole time she kept contracting at around 3 minutes apart.  I asked her a couple of times if we could get moving to the hospital.  She was worried that we would get there and they would say she was only 4 cm and overly dramatic.  She ended up being pretty dramatic anyways.

The moon that night was called a “Super Moon.” It was a full moon and also much closer than usual.  We thought that the moon might have an impact on when we gave birth, and it might have.

Molly walked outside to see the moon in her robe and stood there swaying beautiful below the moon for a minute.  Then all at once her water broke outside under the moon.  The image of her under the moon is one of the images that I will always remember from that night.   I wanted to get directly into the car and drive to the hospital but Molly was sure she wanted to take a shower and get cleaned up before we got there.  She did okay me to call in to the hospital and get Gretchen there.  I was so nervous when I called it took me two tries to get my information across to the person on the other line.  Almost immediately after the call Molly changed her mind about having time for the shower.  She did want to get dressed though and I tried my best to help but I was getting more and more nervous and fumbled a bit.

Then we were out the door as quickly as possible.  I took a second to scoop up our music and my coffee.  Then we were in the car but I didn’t have keys and had to run back to grab them.  As we pulled down the driveway, Molly said “Pushing!” and I stopped for a second to ask should I pull over.  She said, “Just get there!” and I was off.  I probably could have gone faster but I did not want to jostle her around the turns.  I think I was going 40 or so through the subdivision and just rolled right through the stop signs.  Once I got onto Crystal Lake Road, I pushed it up to around 70 or so.  I remember that the music was on and I remember how hard my heart was beating in my chest.  I don’t think that I was scared but whatever I was feeling it was pretty close.  I do remember that I was conscious to drink some of my coffee (which was probably pretty silly) so that I would not be too tired it we had a very long night.  When we got to the Bull Valley light I had to wait for a car to cross the intersection and then I blew the red light.  I kept expecting to see police lights behind me especially after I rolled the light.  Molly said that I should pull into the emergency room entrance and I managed to pass the first entrance (damn!) but then we were there.

The whole time I was driving I could tell that Molly was in active labor.  She told me that she was pushing sometime during the middle of the trip and I did offer to pull over but she told me no.  During most of the time Molly had her head out the window letting the wind wash over her.

As we pulled up to the emergency room entrance, Molly exclaimed “It’s the ring of fire!” since Johnny Cash’s Ring of Fire had just started playing on the radio (which can mean that a baby is crowning).  Molly tried to get up and I told her to sit down and I would grab a wheel chair.  I ran around the car and was relieved to see wheelchairs just inside the entrance but when I got back to the car Molly looked like she definitely did not want to get in the wheelchair.  I learned later that was probably due to the baby basically crowning at that time.  After looking at the chair for a couple of seconds I got the attention of a young girl in the ER and told her to alert the ER of a labor patient.  Molly ditched the chair and we walked carefully into the ER.

The crazy lady at the ER reception area started asking us a lot of basic questions that we truly did not have time for.  Questions like  “Who is your doctor?” etc.  Then all at once Gretchen was there along with some of the OB nurses and they whisked Molly off.  They led her to the nearest room and Molly quickly stripped her pants.  I handed off the camera to a nurse and Molly yelled, “I feel the head!”  Molly had positioned herself with just one leg on the bed.  Gretchen ran over and started to catch the baby.  She called me over but due to the position we were in, I was unable to catch the baby.  When Monty came out he had his umbilical cord across his shoulder and I was afraid for his neck.  To get the baby untangled Gretchen rotated the baby and passed him forward directly under Molly. I was so relieved to hear the baby start to cry almost immediately.  The next thing I remember hearing is Molly saying.  “Hi Baby!  It’s a boy!”  After that it was much more relaxed.  Molly put the baby directly on her chest and the baby stayed there for an hour or two more.

After the actual delivery around 1:10 am things were more or less normal.  Nobody ever tried to take him away from us and he was perfect.  The doctors let us go within the day and we were home around 3:00 pm.   Thank you Monty for giving us this wonderful adventure and showing people how to come into the world in style.

Mom’s Side of the Story…………….

While sitting at Veteran Acres watching Oliver play in the splash park on a hot August afternoon, I had a very special secret. I was going to have a baby! That night I came home and told your daddy and he was very excited! We shared the news with the rest of the family over the next several days and everyone was thrilled. For 13 people on the Wallin side of the family the pattern was girl, boy, girl, boy ending with Perry so we all assumed that you would be a girl, daddy and I wanted to keep it a surprise.

Over the next 8 months you grew and grew and grew inside of me. We liked imagining what you would look like, feeling your kicks and hiccoughs and what your name would be. April 28,  your due date, came and went with no signs of you. We all thought you might come on Cinco de Mayo since we all like to celebrate this day and we were planning your birth party. Saturday May 5th we woke up and went to the farmers market. We walked all around and you stayed safe inside my tummy. My friends from work called and said we should get things started, so Avery and Oliver went with Gi Gi for the night and Daddy and I went to the hospital to meet Gretchen she stripped my membranes with the hope of getting you to come out! Then Daddy and I went to the library to look around and pick out some music to listen to. We came home and watched a little t.v. before going out for Cinco de Mayo dinner. It was a beautiful night so we went for a walk. It felt so great so we kept on walking all around the neighborhood. I had a few contractions but nothing too intense. At about 10:45 I went to sleep, sure that another day had come and gone and you stayed put inside my belly!

Daddy stayed up and played some video games but came to bed around midnight. I decided that since I wasn’t quite asleep, I’dget up and go potty. I had a contraction on my way to the bathroom that was stronger than what I’d had before so I decide to try and get some rest and go back to bed. I crawled into bed to have another very strong contraction. It didn’t feel good to lay in bed so Daddy made me a warm bath to relax in and turned on some music. It didn’t feel very good in the bath either so Daddy helped me out and put on my robe. Daddy timed my contractions and rubbed my back. He made some coffee because we thought we were in for a long night of labor and put the suitcase in the car so we would be ready. The ball felt better than the tub, but I was so hot and everyone had been talking about the super moon that was expected to be beautiful and bright, so I went outside to look at it.

Daddy came out to see too, but was bustling about getting ready for the hospital and reminding me that the contractions were coming quick. He suggested we go to the hospital several times but I wasn’t convinced that you were coming quite yet. I rocked and swayed under the moon and my water bag broke. It felt very good and I had some relief from the pressure in my belly. I decided to come in and shower before heading to the hospital and Daddy called the unit to tell them we’d be on our way shortly. Before I could get into the shower my contractions became more intense so we decided to go then. Daddy helped me get dressed but I think he was a little nervous because he put my underpants on sideways. Once I was dressed, Daddy grabbed the camera and music and we were out the door. I got into the car and buckled my seatbelt and Daddy grabbed his coffee and we were out the door. We only made it to the end of the block before I felt myself starting to push. Uh-Oh, I’m pushing! I yelled to Daddy hurry! Dad offered to turn around or to pull over but I told him to drive FAST! I rolled down the window so that I could feel the air on my face.

I started pushing again right in front of the hospital. Daddy offered again to pull over but I told him to drive to the Emergency Room entrance. I waited through another contraction before I got out of the car but before getting out I hear the beginning of Johnny Cash’s Ring of Fire coming on to the radio…..a perfect song for the moment. I looked at the wheelchair and tried to sit down but it was just too uncomfortable! I held onto it for another contraction and thought that you might just come outside the ER because I didn’t see how I could walk one more step. Somehow Dad took my hand and we began walking inside. The admission lady asked me who I was and who my doctor was and lots of other questions but I just wanted to push. I looked up and saw Gretchen and she rubbed my back and asked me if I thought I could make it upstairs and I said no. So she asked the nurse for a room to put me in we went one way and then turned around and went to a corner room. Daddy threw his keys at the front desk and told them to move the car.

As soon as I was in the room I began taking off my pants, I wanted to climb into bed so that I could push again but was only able to put one leg up on the bed before I reached down and felt your head coming out. I calmly announced that you were ready and I was so HAPPY because I couldn’t wait to meet you! I pushed once strong and hard and felt your head deliver into my hands and felt Gretchen’s hand on my back coaching me to push the rest of your body out. In one more push I felt your body slide out from mine and you were on the bed in front of me. I kissed you and dried you off and then saw that you were a boy. I was so happy. I quickly took off my shirt and picked you up and put you on my warm skin. You looked perfect and you felt soooo good against me. Daddy was so happy too and was checking you over. The girls from OB had come down to help too and were congratulating me and covering me up with warm blankets and listening to your heart. Daddy was kissing you and me and we were all so thrilled that you had come. We had waited so long to meet you and then you came into our lives like lightning, about an hour after my first contraction!

You nursed for the first time in the elevator on the way up to the OB unit. They checked me over and you over again while you nursed and nursed. We could see the bright moon outside of our window. After you were done nursing I took a shower and Daddy held you on his skin while we called to share our news! No one could believe how quickly you came in to this world. I was completely euphoric. All the planning for your delivery, making the special song list and preparing special oils….no time for any of it! We did listen to music once we got to the OB unit and you seemed to enjoy it as much as me. That morning I snuck into the locker room before all of my nurse friends got there and shouted surprise. They couldn’t believe you were here! They all held you and loved you too! At lunch time after meeting your brother and sister and Gigi and Pops we decided it was time to bring you home.  I felt amazing. Really Amazing! Each time I tell this story or think of it I remember something new, I’m so proud of how you got here, it is exciting and fun and …words just can not describe! There was never any pain only this wonderful energy that helped me bring you here. Your Daddy was amazing, and calm and has been so wonderful in taking care of you and me and your brother and sister. We are all so excited that you are here Montgomery! Welcome and Thank you!

My husband also made a slideshow of the event which can be viewed at:

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Did you know The Other Baby Book: A Natural Approach to Baby’s First Year is now for sale? Are you interested in learning more about gentle, mom and baby-friendly practices that foster a joyful, connected relationship? Want to introduce a pregnant friend to natural parenting? Check out our website or head over to Amazon to grab your copy today!
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Part I–(Postpartum) Depression: Let’s Talk

Wordle: Let's Talk PPD

No one wants to talk about depression.  In all of my talking with other moms, in all of the threads on all of the mother- and baby-boards I’ve visited, I’ve encountered little discussion of depression of any sort.   Why don’t we talk about it?  Perhaps it is because depression has no measurable, tangible or visible symptoms, like high blood pressure, a cough or a rash, so why go to the doctor if you’re just in a funk?  Or maybe it’s because so many people, including some of those with depression, feel that it’s just a bad mood, and it should simply be a matter of “snapping out of it”.  But that just isn’t the case.  Depression (see also “clinical depression” or “major depressive disorder”) is a very real and very serious illness affecting millions of people around the world, and is especially prevalent among women.  For example, an estimated 13% of women will experience postpartum depression (PPD).  Think of all the women who gave birth in your town, on the same day that you (or your partner) did.  More than one out of every ten of those new mothers experienced PPD.

Postpartum depression is a particularly nasty bit of work.  Unlike “the baby blues”, which are comparatively mild and last only a few weeks, postpartum depression (or PPD) is an episode of true depression occurring in the first year after pregnancy and lasting more than two weeks.  In addition to the normal run of symptoms associated with depression, a woman experiencing PPD may also feel a lack of interest in her baby, or even have thoughts of hurting her baby!  Then there’s the guilt for feeling that way, or having those thoughts.  And all of this is at a time when the mother is already exhausted, drained, and sleep deprived.  It’s a nightmare, and can definitely interfere with the mother’s ability to care for her child.

I can tell you from first hand experience that depression is a bitch, and PPD is even worse.  I have struggled with depression intermittently since I was a pre-teen.  I can’t tell you how many trips we made from my small hometown to near-by Orlando, visiting different doctors: a child psychiatrist, a counselor, an eating disorder specialist. I’d been on three or four different antidepressants by the time I graduated high school, during which time I acquired a new doctor and a new therapist.  I went off the meds in college, but saw the on-campus counselor for several months.  I went back on the meds after moving to Germany with my husband,   but improved enough during my first pregnancy to leave off of the antidepressants completely. That only lasted until my baby was about a year old, at which point I had my doctor put me back on Zoloft.  A few months after that, I became pregnant with my second child and my doctor switched me to Prozac.  I had a bad spell during the pregnancy, but it was smooth sailing in the months after my second daughter was born.  I stayed on a low dose of Prozac throughout*.

Now, I’m still fighting it.  It can still creep up on me, slow and subtle and insidious.  Life will start to lose its luster, activities that I enjoy will start to lose their appeal.  I start letting the house work slide, and the meals that I prepare become simpler and simpler.  I play with my children less, and lose my temper more.  I lose the ability to moderate my emotions, so that I fall apart at the slightest bump in the road.  Even the simplest tasks begin seem overwhelming. I find myself ruled by lethargy, sadness, frustration, and guilt that I’m not doing what I know I should.  Then I start to realize that I’ve been living for weeks in a gray murk.  I begin to recognize that things are not as they should be, and at that point, I seek help.  That is the important thing, especially now that I’m a parent.  I go back on the meds, or I raise my dosage, or I go back to counseling, and the murk begins to clear.

That’s where I am now in my fight against depression.  I’m clearing the murk and wondering, how many other women are walking this path with me?  How many women are not seeking and receiving help, because they don’t know that they should, because they are ashamed, or because they don’t know who to turn to?  Those are the women who break my heart, and those are the women I want to be talking to right now.  Take a look at some of the links below for information about depression in general, and PPD in particular. Try to evaluate your recent feelings and behaviors.  If you are depressed, there is absolutely nothing to be ashamed of.  (Should a diabetic be ashamed that he needs a doctor to help him manage his blood sugar?)  If you don’t know where to start, ask your doctor or try talking to a loved one.  But please, do something.  There is no reason for you to suffer.

In addition to being a veteran of PPD, Adrienne is a craft junkie, Navy wife, and stay at home mother to two beautiful little girls near Norfolk, Virginia.  She blogs about it all at http://the-green-world.blogspot.com/ .

*According to the Ask Dr. Sears article on PPD, either Zoloft or Paxil would have been safer during breastfeeding, but I’d not heard that until now.  I plan to ask my current doctor about it at my next appointment.

Sources:

The Mayo Clinic on PPD

Dr. Sears on PPD

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Did you know The Other Baby Book: A Natural Approach to Baby’s First Year is now for sale? Are you interested in learning more about gentle, mom and baby-friendly practices that foster a joyful, connected relationship? Want to introduce a pregnant friend to natural parenting? Check out our website or head over to Amazon to grab your copy today!
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Should Health Insurance Call the Shots?

What do you remember most about your child’s birth and the days that followed? Was it the moment she was laid on your stomach and you counted her tiny fingers? Was it when you held him in your arms, claiming his nose and mouth as yours and conceding his hair and eyes to your partner?

I sincerely hope your memories aren’t of worrying how to pay for the birth or hearing that insurance won’t cover rapidly adding up expenses. But sadly, for many of us, that is one of the memories that cannot be erased from among so many happy ones.

In 2009, the average national cost for a vaginal hospital birth (no complications or anesthesia) was $9716, with a cesarean costing nearly $22k! The alternatives to giving birth in the current healthcare dictated system are to not use health insurance and use the hospital’s cash rate, try to negotiate a better rate, or opt out completely and have a home birth.

Although my husband and I are not in a rush for number two, this is a very real issue for the birth of our next child. Our health insurance changed recently and won’t really cover a birth at our choice hospital, which has an amazing team of certified nurse-midwives on staff. Which leaves us with only a few options:

  • birth at a not-so-great but covered hospital
  • birth at the better hospital, but pay minimum $7-8k, but potentially much more, out of pocket (which is just not really an option for us)
  • birth at home

Regardless of what we decide, the underlying issue remains:

At some point in history, our right as women to birth how we want, where we want, and with whom we want, was taken away. I may be just one person fighting her insurance company, but I hope I’m not the only one. As more of us demand midwife-covered births and birth centers, we are more likely to change the very broken birth system in this country. We owe it to ourselves and to our daughters and sons who deserve better.

How has health insurance, or the lack thereof, affected your ability to birth how you wanted? Or are you pregnant now and facing some difficult decisions?

Kate is passionate about women having the birth experience they desire and supports the inclusion of midwifery into the OB/GYN-dominated model. She writes about family life and her inspiring little peanut at Boomerang Mama.