Fight or Surrender, what next?

Today is my daughter’s 10^th birthday. She was my first home birth. It was a difficult experience that has lead to amazing things. Her whole life so far has been an difficult experience that has lead to amazing things. Now I have to remind myself exactly those lessons today. My mother called to wish her happy birthday, she was lucky to even get that. She also informed me that because her and her husband are behind on her taxes, her financial advisor has told her that she is not to co-sign for any more of my student loans. I am $11,500 short for the 2012-2013 year. I have no idea where I am going to come up with that money. I am basically, excuse my Foul language, FUCKED. I am scared, disappointed, wanting to roll in a ball and feel sorry for myself. But I don’t have time for this. I want to finish my college education. It means a lot to me. I don’t know how much harder I am can work to make it happen and still be able to continue my commitments for assignments with AAMI. I regret joining too soon, I should have waited until I was done with college. But now, now, it might mean I make a hard decision to quit college, get a job and get focused on midwifery sooner than I expected. It might mean that I call Carla, tell her what is going on, hope for some mercy and take a pause in my studies. I hate that my update this week is so focused on ways I might fail instead of all the things I completed and succeeded at this week.

Photo by: Tambako the Jaguar

This week I turned in a 20 page Zine project on VBACs that helped me learn so much. This week, my friend, another student midwife, called me to schedule a visit to process a recent birth she attended and said, “ I just need to talk to another midwife.” Referring to me… I was flabbergasted, I know I am still a student, but she knows, in my heart, I am still a midwife and she honors me as such. So much she has asked me to be her partner in surrogacy as she was just accepted by a company and is in the process of being matched to parents and she wants me to partner with her through her pregnancy to be her support person. I am available to be on call to attend births in August and September and I have been reading the latest issue of Midwifery Today. I am so focused, so excited, so determined to make something out of all this, I can’t believe that I may not be able to complete my degree and walk. It means so much to me. I want the education, I love my classes, my teachers, the experience of being in college and learning and questioning and challenging and meeting exciting people and having opportunities to learn things I have never been exposed to before. I feel like I am thriving but I am floundering at the same time. It is terribly difficult and terribly exhilarating at the same time.

I am transforming so much right now it is overwhelming…  My heart is full.

"Anti Science Hippie Moms...."

A friend of mine posted on Facebook today asking for positive thoughts of comfort for her 17 yr old sister who was having a baby in a hospital with no doula or support people around her. She was concerned because of her own experience as a young woman birthing in the hospital with little choices offered and no one to help empower her. Her's was similar to mine, forced episiotomy, student OB's, a lot of interventions that were never quite explained and a lot of pain and suffering afterwards. A commenter on her post suggested that " I know the anti-science anti-doctor meme in the hippy community has some merit - however some docs are the reason baby and mom survived !" This is the last kind of comment a mother of 3, who has had 3 different births in 3 different settings and knows from experience what happens in a large portion of mother's experiences needs to hear from a "friend."

Please don't assume that people who support natural birth and dont advocate for healthy, low risk women to birth in hospitals don't do their homework, there is plenty of science that supports it. But yes, we are blessed when there are the couple of doctors who really do provide good support. But really, how long is the doctor there for? There are hours and hours for most first time moms with no support at hospitals and scientific studies show that when interrupted in labor by strangers, the physiological conditions that support a healthy biologically correct birth get disturbed and that does cause the complications that often require the help of the doctor to "save them" as she put it.

This article by Alice Dregger, so eloquently points out the misunderstanding fueled by the unethical treatment of women by doctors in the birthing business. 

Credit for pic and a great article can be found here.

" in the U.S., "obstetricians are the experts and the experts have come to see birth as dangerous and frightening." De Vries suggests that the organization of maternity care in this country -- "the limited choices that American women have for bringing their baby into the world, what women are not told about dangers of intervening in birth, and the misuse of science to support the new technologies of birth" -- actually constitutes an ethical problem, although we typically do not recognize it as one."
There are many people who also are under the misconception that midwives are not educated or do not have scientific studies to back up the "witchcraft" that they support. Yet time and time again, studies point to less intervention, less disruption, less meddling and better outcomes for both mothers and babies, long term.  The use of inductions , routine fetal monitoring, epidurals, and the inability to eat or move around freely has disrupted the normal processes of birth, increasing risks to the point that the Royal College of Obstetrics has made claim that there are too many babies born in hospitals.  

 Hospitals around the country are at the beginning phases of implementing a new paradigm into the birth culture of their institutions.  This is a wonderful starting point to shift the commonly held belief that birth is inherently risky and we NEED interventions to be safe. There are 30 other countries that have a better maternal mortality rate than the USA. Obviously, we can improve this. 

When a friend expresses her concern for a loved one, obviously, insulting them with stereotypes is not the nicest thing to do, but even more than that, carrying around this attitude and spreading it is dangerous. When it is already so hard to make decisions and swim through the information that you have to search for because it is not readily offered by your paid professionals in so many cases, the perception of your peers can influence the decisions that are made. If you are going to give advice to someone, please make sure it is accurate, you could be doing more harm than good. And if you made some of the decisions that have been proven to be not as safe as we think, and nothing bad happened to you, consider yourself lucky. This is the exception, not the rule, and it is very invalidating to be talked to like you don't have a reason to be concerned, when you are following your instincts and doing your homework. Being concerned when you have this knowledge is healthy. 

Safe Motherhood Quilt Project

AHHHHHHH..... the sigh of relief as I sit here after completing my finals for Winter term and welcome the next 2 weeks of relaxation. Wait. Oh ya, no relaxation for me! I have a browser with 11 tabs open, most of which are midwifery related articles waiting to be read and filed, a few more are autism related articles waiting to be read and discussed with the old man about possible solutions to help with our 9 year old and I have a pile of work upstairs waiting to be organized so I can get to midwifery studies in a few days. 


The life of a midwifery student is exciting and exhausting but oh so rewarding. Especially when you open your computer to see one of the biggest inspirations to your calling being interviewed by Amy Goodman on Democracy Now.  Ina May Gaskin is a pioneer for American Midwives. She has made leaps and bounds in bringing awareness, advocacy and education to mothers for over 30 years. She makes so many articulate points in this interview and is so inspiring. 


One of the things she discusses in this interview is her Safe Motherhood Quilt Project described as, "The Safe Motherhood Quilt Project is a national effort developed to draw public attention to the current maternal death rates, as well as to the gross underreporting of maternal deaths in the United States, and to honor those women who have died of pregnancy-related causes since 1982." There is a list of facts as well as more info on how to get involved and spread the word on the website. Please visit it and learn about how we can prevent maternal mortality and improve the outcomes for many women and families in our country.

Some stats that are important to remember when thinking about maternal mortality rates are :

• At least 30 other countries have lower maternal death rates than the U.S.
• There has been no reduction in the maternal death rate in the U.S. since 1982.
• The CDC acknowledges that we have a massive problem of underreporting of maternal deaths in the U.S. and that our reported rate may be only 1/3 to 1/2 of the actual total number.
• Maternal death rates are four times as high in the African-American community as in the Caucasian community.
• There is no federal requirement that the states carry out a confidential review of all maternal deaths in order to be sure that all are counted, to analyze the principle causes of preventable deaths and to make policy recommendations to prevent such deaths in the future. In most countries with lower maternal death rates than ours, maternal deaths are systematically reviewed and there are lower levels of underreporting of such deaths than the CDC says we have in the U.S.

Please visit http://www.rememberthemothers.org/ for more info!

What are the Conditions for a Physiological Birth?

This is knowledge from the beginning of time that we have had disrupt and prove to be sure that nature had it right... Time and time again, I here professionals who have had more experience than you can imagine, quote scientific studies that tell us that Mother Nature already knew what we needed to survive and only when mankind turned to "man" did we forget the old ways or disrupt them enough that we have to prove it over and over again in as many ways as we can that women know how to birth if left to their own accord.

Antique midwifery texts dating back to the 1600's written by European physicians, male physicians, knew already what midwives are trying to bring back to the women of our communities today.  They describe in great detail the passion of labor, the needs of a woman while she is birthing, the effects of disruption to the mother, the psychedelic state of mind that she enters, the Ecstasy right after labor of an uninterrupted birth and the very little help that one must give other than making sure the mother is well nourished and hydrated and has emotional support if she chooses.

Let's relearn what is already written in our genes, what we were born with, unlearning the fear and accept Birth.

Breastfeeding is a matter of Public Health!

This should not be coming as a surprise, nor should it take a public service announcement to make it common knowledge that Breastfeeding is the best choice for your baby.

Please know, if you or a loved one is having problems breastfeeding, there is loads of places to find support. Your local La Leche League is the first place to look but if that is too "crunchy" for you, please call your local lactation consultants from the nearest hospital. 

Please also be aware there are milk banks and Eats on Feets groups popping up all over the country where you can get donated milk for your baby if you are unable to breastfeed.

"The wealth of new data about the effects of breast-feeding influenced the AAP to update its guidelines. Researchers have found that breast-fed babies have a decreased risk of dying of SIDS, fewer ear infections, less likelihood of obesity or cardiovascular disease And fewer hospitalizations for pneumonia; mothers benefit from decreased risk of breast, ovarian and uterine cancers. Duration is important: “The longer you do it and the more exclusive it is, some of these effects become even more significant,” says Schanler. “Hospitalization for pneumonia is significantly reduced if you exclusively breast-feed for six months as opposed to less than four months. How can you say that’s not important?”

Read more: http://healthland.time.com/2012/02/29/why-pediatricians-say-breast-feeding-is-about-public-health-not-just-lifestyle/#ixzz1np1CIE5A

Surrender

The most amazing thing I have learned about birth so far is that regardless of the planning, the knowledge you obtain, the plans you make the visualizations you rehearse, when you are in the moment in birthing, surrendering to the forces in your body takes work. If the mother fights the surrendering, she will suffer more, become irrational, and experience the birth in ways she was not expecting. This goes for the period right before labor as well, the days in which she tries to get things going, induces medically or “naturally” with herbs or procedures. Surrendering is probably the most important skill to practice, meditation, breathing, letting go. Surrendering isn’t just the responsibility of the mother to learn though, it is important for the whole team of people, should she chose to have one, to be able to surrender with her, leave things alone, let her be primal and instinctual, allow her room to move and vocalize and not get uncomfortable if the sounds she makes are scary or unexpected. The midwife needs to surrender to the time the mother and baby need to make the dance of emergence happen, the family needs to surrender to the idea that their requested presence is all they need to provide and they cannot make the mother’s work easier any other way, the father has to surrender to the power moving through his partner’s body to bring forth this baby and let go of needing to fix anything and just be with her. 

For a wonderful pregnancy meditation click here. 

Surrendering does not mean you cannot be present or make decisions should you need to, part of surrendering is listening to your body and acting on the messages you receive, without expectation of what you think you will hear or what will happen. This goes again for the witnesses, listening, acting on the requests of the mother, understanding the messages that are not verbal, like when to leave her alone and when to support her, when she is scared or when something does require assistance. But if you are too busy thinking, having expectations, you will miss those bits of communication you can only pick up with a clear mind in the moment.

A long time ago, I was on a quest for a vision while meditating with Reiki attunements. I really wanted to receive a message from a spirit guide. I sat and waited, and “watched” with eyes closed, trying to make something out of the shapes that floated behind my eyes. I sat for what seemed like hours, “trying” to have a vision. It wasn’t until I surrendered, what felt like giving up at the time, letting go o the expectation, that I finally saw something and it was so quick, so fleeting, yet so detailed and meaningful I became so excited when it happened, it was gone as soon as I realized it was there. The split second vision I had has stayed with me since then, the lesson has followed and reminds me in many situations about the power of surrendering and the gifts that accomplishing the surrender can bring. 

Childbirth Experiences Have a Lot to Do With Expectations

This is a paper I wrote for a sociology class in reference to this study http://www.ingentaconnect.com/content/routledg/cjri/2008/00000026/00000004/art00004

The expectations and experiences that mothers face can be related to the type of care and the culture that the expectant mother is exposed to. The study, “Childbirth expectations and experiences in Belgian and Dutch models of maternity care” conducted by Wendy Christianens, Mieke Verhaeghe and Piet Brake (Journal of Reproductive and Infant Psychology, Vol 26, No 4, Nov 2008, 309-322, Department of Sociology, Ghent University, Belgium) sought to confirm how a mother’s exposure to societal norms, previous experiences, other people’s stories and the way their care giver attend to the perceived needs and expectations account for the actual event’s experience and the level of satisfaction on the mother’s behalf. Belgium and Dutch women develop different patterns of expectations during their pregnancies and tend to have diverging birth experiences according to the care provided to them during their gestational and postpartum periods. The researchers expected that Dutch women would have a more positive outlook about childbirth than Belgium women, though there was no expectation of difference of experiences versus expectation between Belgium and Netherlands due to the socialization processes as a function of the maternity systems.

            The researchers used a variety previous data dating back  from 1982 to present to determine how to conduct the study and what variables they would use. There was a questionnaire made to be distributed to women in both Belgium and Dutch Maternity care systems. There was one questionnaire given at about 30 weeks gestation and another given at 2 weeks postpartum. These questionnaires were used to determine the expectations and outcomes of the mothers, planning on birthing in a hospital setting or in a home or birth center setting. The fixed factors were time, country and place of birth.

            In Dutch maternity care, it is common to have home births (30% of births), low medical intervention, and short hospital stays if the mothers do plan to attend hospitals. The Midwifery Model of care is used that is woman and baby centered, viewing birth as a normal, natural physiological process.

            Belgium is contrasting in the way that home births are uncommon and the medical model of care is highly practiced having a 98% hospital birth rate. The society there sees birth as risky and that hospital births will ensure a safe delivery. Birth has become a medical event in need of supervision by specialists and it is common to use interventions such as epidural pain relief and surgical birth.

            Data was collected within 4 groups of women. Women who planned their births in either the hospital or home in both Belgium and Dutch care systems. There were 5 hospitals and 27 midwifery practices with similar socio-economical factors. Midwives and Obstetricians asked their clients to participate. The main factors of eligibility were that they had to speak Dutch and be 18 years or older in age. The questionnaire was conducted in an anonymous manner.

            The Questionnaire was designed to learn if the subjects felt anxious about the upcoming birth and labeled the choices as unknown, uncontrollable and unavoidable. The language of “expectation” meant that women had to answer about what they thought would happen, not what they hoped would happen. The outcomes of the score would show people with a higher number were feeling more negative towards their expectations and experience and the lower score would show more optimism.

            Of the 827 questionnaires filled out during the prenatal stage, only 611 participated in the follow up questionnaire 2 weeks after birth, 265 were Belgium women and 346 were Dutch. Participating women were between the ages of 19 and 44, the mean being 31 years old. First time moms were 54% of the respondents and the study reported that more Belgium than Dutch women had a higher education with 77% of Belgian and 40.5% Dutch, though almost equal percentage (85%) of the women were employed. This raised a question for me personally about the way that higher education seems to be correlated with the increased use to medical intervention because of affordability or access to that kind of care.

            The results show that both countries had a expectation that was more negative than the actual experience even though the expectation were significantly different between the subject groups. The results concluded that “expectations and experiences are positively associated and the relation is rather strong. Expectations are a strong predictor of a woman’s experience of childbirth.” In the majority of cases the experience was better than the woman’s predictions. Some of the significant findings were that women planning on giving birth at home had the lower scores showing less anxiety about the process and also showed a higher level of satisfaction after the birth had happened.  This analysis conformed the hypothesis. What was also found in this study was that when replaced by the actual place of birth from the planned place of birth, the home birth subjects had a more positive experience than the hospital subject groups “showing that midwifery care is more satisfactory than care by doctors.” The findings were relevant to how policy is created when caring for pregnant women in a way that supports having a strategy to reduce negative experiences and is more encouraging of optimistic expectations. This would be a preventative approach that can be applied to maternity care systems worldwide.

            The researchers approach was a functionalist approach. The research was based on the idea of how the maternity system functions effect the satisfaction of the people who are receiving care through it. I found this study to be very pertinent to my main focus of education which is midwifery. The level of satisfaction that a mother experiences through her birth effects many parts of society. Her ability to raise a healthy human being is essential to the integrity of the future of our survival on this planet. If she is dissatisfied, that experience can lead to depression, detachment, breastfeeding problems, marital issues just to name a few. The baby could suffer from neurological damage from a traumatic birth,  not having a healthy mother or care giver, nutritional issues from not having built a strong breastfeeding relationship and social issues from lack of bonding due to birth trauma. These effects of birth on society are coming into a larger awareness as we are able to conduct more and more studies about the biology of birth and neurodevelopment and how our society benefits from cooperating with nature’s intended way of babies to be born. Additional research I would like to see on this subject is a longitudinal study of emotional and physical health of babies born in and out of hospitals, the rate of postpartum depression amongst women who have birthed in both settings and the incidence of long term emotional dysfunction (PTSD)from the women who viewed their birth in the higher negative range. 

Kaire Downin 2012