Safe Birth Initiative

Finally, here is the low down on the post I've been meaning to write. However, it's the short version because once again I have to jet here in a few minutes.

Here's what happened: I had a final project for a PR class. What I wanted to do was something that would convince venues to sponsor movie nights for pregnant women, in which they see empowering, gentle birthing videos. Believe it or not, that's a hard sell; the reason being that in order to promote wonderful, orgasmic birth, it first has to be acknowledged that birth in the US has been anything but.

So, my presentation started out addressing the main problems women face.

The Bad News? (many of you already know this)

nOver 30% rate of surgical births

n42 countries have lower infant mortality rates

29 countries have lower maternal mortality rates

n56% first time moms feel confused and a little afraid

The good news?

We know how to fix it. We know what makes birth safer and more comfortable, and it isn't non-evidence based care. We also know that change in obstetrics has always come about by consumer demand. I listed several examples in my PPP.

My contention is that women just want accurate information on which to base decisions, and respect. They don't want empowered birth, or orgasmic birth, or even comfortable birth without drugs, because they don't believe it's possible. In order to even conceive of it, so they can believe in it, they have to see it. Hence the movies.

The PPP spoke to why how we birth is important, with sources, and and information from my survey on what women said they wanted to see.

I also covered why it is in the best interest of the venue to host such events. All in all, it really was a good presentation.

Afterwards, my prof. said something to the effect of, 'Who are your publics?'

I said pregnant women and the venues that can reach them.

He repeated the question. Apparently I was incorrect.

He asked where women can be found.

I insisted college campuses were the place to reach them. I still think it's a fine place to start.

He suggested another area.

He pointed out that HR departments of employers are where the changes are now being made. I questioned how that could be. He said that companies are trying to cut back on health care costs, and prevention is a hot topic. Ok, fair enough. (I was getting excited as I saw where he was going with this!)

And then he said, 'Have you ever talked to someone who said they'd like to hire a midwife, but their insurance wouldn't cover it?'

I got so excited I could hardly stand it! That happens all the time! His answer to that was, make it affordable and easy, and people will choose it. The way to do that is NOT by reaching the women. It's NOT by going after the insurance companies, or to hire midwifery lobbyists, or to try to get the U.S. Govt. to use common sense. The answer is HUMAN RESOURCES.

He gave me names, and ideas and so much I couldn't write fast enough. It all made sense!
And now I have to run. More later.

Passion flowers

I have buds! The plant wants to be outside so bad, but it has just been too cold. Still, it's got a bud big enough that it might even bloom by this weekend.

It may seem like a silly thing to get excited about, but I love this vine. Here is a picture of a flower my dau took last year:



The flowers are about 3-4 inches across and have a subtle scent that (to me) is like lemon and ginger combined. They bloom and are gone in 24 hours. I have tried everything (drying and pressing and that stuff that's like sand that draws the moisture out) to preserve them and nothing works. It doesn't matter if you put them in water or leave them on the vine, they close up after a day. So, when I get to enjoy a bloom, I'm happy.

The Birth of a Morel

We got skunked!

As per my last entry, we did get out to the woods today. As we were leaving, we found one sad little 'shroom, just being born. The cap hadn't even popped out all the way yet! He had no friends we could invite for dinner, so we left him.


However, when we arrived home, there was an email from my brother in MI. this is what they found:

Now, keeping in mind the prices I mentioned in the post below, that could be a $500 haul. They had to give much of it away. Sadly, not to us. I don't even know how you'd ship fresh morels. If they are successful in drying any, or if they get another haul like this, we may get some. I hope we can find our own. It is so fun to find them like this!

So, for dinner we had no wild mushroom fettuccine and steak. We had a spinach dish with water chestnuts, scallions and regular mushrooms, all wrapped in phyllo. For desert I tried Sticky Toffee Pudding. I think I'll try to find a recipe for individually made, smaller servings next time. It made huge batch. I guess we'll see how it freezes. I'd really love to know how to tell if I did it right, though. It was good, but the people on the Food Network raved. There were several recipes; how do I know which one is closest to the real deal? I guess if it tastes ok, it's ok.

Hunting the Wild Morel

It may be too early, too cold or too dry, but some folks are finding the little buggers!
In Michigan it was a rite of Spring to go 'shroomin' as often as possible between about now and the end of May or so. However, there was never a spring when we didn't go, and we had a secret 'spot', so it was just a matter of whether or not they were poppin'. Here in WI, we've got not clue as to where they actually may be, so its a much bigger adventure.

We did find about 35 or so last year, by accident. Fortunately, a few can go a long way. We had Morel Fettuccine Alfredo, steak on the grill and red wine. Yum. In days past we would get so many we'd toss them in flour and fry them in butter and communally eat them by the plate. Everyone would grab a fork and snitch at will from the pile of hot fried fungus.

We have no idea what we'll find today, only that we won't be paying the $20/lb. they are going for at local farmer's markets, so I hear, or the $46/lb. they are fetching online. A pound isn't much. It sounds like it, but morels are about 90% water, so they're kinda heavy. It probably ends up costing about $2 per 'shroom. I'm sort of in the same place about them as I was about the Johnny Depp search; I'm willing to go look for them, but there's a limit to the madness. There's a certain excitement to the hunt that makes the experience that much more enjoyable.

So, we're about to jet. When I get back I'll try to write something on the birthing revolution I've been promising. I got to knitting a wrist warmer for my dau this weekend (I've been promising forever but have been too busy for that too) and dealing with some computer issues that are stressing me out, so I didn't get to blog. That particular one is going to take a bit of composition and research. (read: TIME that is at a premium currently)

Later...

The Survey

Ok, here are the results of the survey, with commentary on why I asked what I did:

81.2% of respondents were experienced moms
4.7% were first time moms
1.2% were CPMs
1.2% were CNMs
11.8% were 'other', which consisted of doulas, people who have no children, and people who actually fit into the categories provided but for whatever reason chose 'other' anyway

Of the first time moms, 44.4 said they felt confident regarding the information they were receiving in pregnancy, while 55.6 said they were confused and a little afraid. However, I'm not sure how this breaks down, since there were more than twice as many responses here than for the women who identified themselves as first time moms in the first question.

Of the experienced moms, 72.6 said they felt confident they made their own best decisions, while 27.4 said they wondered if things might have been different. Again, the number of experienced mothers from the first question didn't match with the number of responses here, but it was because fewer answered this question than identified themselves as experienced.

Now, for the 'biased' questions. I had someone write to me and say that as a communications professional, she had a problem with these questions because we are all biased. I agreed with her 100%. We do all view the world through a lens of our own experience that makes our view biased. However, most people do not seem to use the term 'biased' as it is defined, especially when it comes to birth. I bring this up in my book before even moving into the birth information because I see it all the time. Therefore, the questions I asked may have seemed redundant, but I asked essentially the same question in a number of different ways for a reason.

94.1% of respondents said that they felt cable birthing programs were biased
81.2% said that factual information on all safe birthing options would be unbiased
97.6% said that information that provides only selected information, or that excludes or misrepresents factual information on all options is biased
67.1% said that if only one side of an issue has been represented, a source providing only the opposing side provides balance
91.8% said that information, even if not widely available, popular or pleasant, but factual and independently verifiable is unbiased

Now, the reason I asked these questions was that I'm trying to figure out why people watch the propaganda that is the cable birth programming, and reject documentaries like The Business of Being Born, Born in the U.S.A or Gentle Birth Choices. Comments I've heard from parents are that these movies, and books like Mother's Intention (which fosters critical thinking regarding birth options) or Obstetrical Myths versus Research Realities (which is all about the scientific data) or Born in the U.S.A (which is an inside look by a doctor of how U.S. maternity care currently fails women and babies) are that they felt these works were 'biased', 'negative', or 'unbalanced'. Yet in everyone of these cases you will find independently verifiable facts and the opinion that the optimum functioning maternity care system needs both midwives and the surgical specialty of obstetrics. Yet in 17 years in birthing, I've yet to hear a doctor, after an initial visit, tell a client, "You know, you are so low risk, you should see the midwife down the street for a consult" and parents will still say that they specifically only seriously consider information that comes directly from their doctor or hospital based childbirth class because it's 'balanced' and 'unbiased'. ACOG has issued position statements that are diametrically opposed to the actual facts of homebirth and midwifery, and this is as far as the vast majority of doctors are going to go to get their information. That is hardly 'unbiased'.

Of the selections above, not one of them says hospitals or doctors are bad. What they say is that what we are doing to women and babies in this country doesn't make sense, based on the evidence. What they say is we can't fix a problem unless we acknowledge a problem exists. So they expose the elephant in the kitchen. Then they propose a solution that gets the elephant out of the kitchen, but certainly doesn't kill the elephant.

72.9% of respondents said that if they encountered information that challenged their core beliefs, they would independently verify it.

52.9% said there is no way they'd watch cable birthing programs

I wish I had asked where and with whom these respondents had birthed. I highly suspect that these were homebirth moms, because these programs aren't still on because no one is watching. In every one of my classes parents sheepishly admit they watch. I tell them if they must, use it as a learning opportunity. Notice how often intervention is often unnecessary and leads to complications.

The order of preference for other birth DVDs was:

90.6% Gentle Birth Choices (home, hospital, birthing center, water-birth)

84.4% The Business of Being Born (home-birth, hospital-birth, comparison of U.S. outcomes with outcomes of other countries)

77.6% Born in the U.S.A. (birth in U.S. compared to other countries)

73.5% Birth As We Know It (water-birth, orgasmic birth)

63.5% Special Delivery (home, hospital, birthing center)

One of the things I wanted to see is if there would be a decent turn out for public viewing of all safe birthing options were made available. These figures would suggest yes, if this indeed was a fair representation of expectant parents, which I unfortunately think it didn't end up being. Home birth mothers, HypnoBirthing(R) mothers, moms who have hired doulas; they have already set themselves apart by questioning all they've been told and rejecting what insults their souls.

Another possible reason for the discrepancy between the data and mainstream outcomes is that some women know that they have safe options, but don't choose those options for some other reason. Often I have people in class who will say they would like to have a homebirth, or birth with midwives as an area hospital that I recommend often, but their insurance won't cover it.

Here is where we get to my next blog entry...how to help these women!

But that will have to wait until this weekend.

Speaking of Einstein...

The recent Depp excursion was about so much more than a visit to a movie set. It was an opportunity for my daughter and I to spend time together actually relating. As any parent of a teen knows, those moments grow few and far between. That's one of the reasons I'm so glad I prioritized our time together when she was younger.

So we were chatting over lunch at our fav location in Oshkosh (Water City Grill) and talking about gawkers like us, and my dau comments that she and Johnny would be bff's. She hates chat-speak and she's a smart ass, something we nurture to the fullest, so I thought she was kidding. My response was to laugh and say 'Yeah, right. You and every other person stalking him right now.'

She (quite seriously) responded that she wasn't kidding, and further, she'd also be bff's with Einstein. At this point I just had to ask her if she was now in the habit of hanging out with old men, and in what universe might it be normal for a 16 year old girl to want to hang out with old, or dead, men. (Not that JD is old; he's not much older than me, and much younger than my husband, but when you are a teen, 30 is ancient, much less 45. And frankly, if she was in the habit of hanging out with 45 year old men, I'd be concerned.)

Anyway, we continued with this "If you could have a conversation with anyone, living or dead, who would it be and why" conversation for some time. And actually, I think it entirely possible she would enjoy the company of both. She's not a typical teen. We've nurtured her non-conformity since birth, and she just doesn't think like 'normal' kids her age. She's mature beyond her years and possesses rapier wit. (Where that comes from, I have no idea. Her dad is funny, but I have zero sense of humor. I appreciate her perspective and enjoy her wry humor, but I'm not quick enough to come up with that stuff.) She abhors vacuity and is extraordinarily creative, which tends to be seen as 'odd' in the teen years. That is not to say she can't relate to many age groups, she just has a comfort zone that is much wider than the narrow peer group most kids stay in.

While other kids are getting drunk and getting laid (or at least talking about it), she prefers to write. I wish she'd let more people read what she writes, because there is such depth to her characters and she writes in such a unique style, with dialog that just draws the reader into the story. She's never said, but I wonder if she ever thought about Depp as one of her on-going characters. She told me a little about this character, and I've read small snippets laying about, but she won't let me read the whole story. I can't remember his name, but I know he's a vampire. Not a campy vampire, or even 'traditional'. He's a soulful vampire with a conscience. He craves relationships that he can't have because of who he is. Its not about sucking blood or archetypal themes of everlasting life or sexuality, though as a vampire there must be some of that. Maybe she just hasnt' shared those parts with me. What it seems to be is a story from inside the skin of someone who questions why he is who he is. When I read what little I did, I guess I pictured someone much younger than Depp, but he does have a timeless quality. In any case, it explores psychological and sociological themes that are truly fascinating (and frankly, beyond her years...again, I have to wonder where that comes from). I know, I know, she's my daughter, I think she's brilliant. But honestly, if someone would just read it (or rather, if she would LET anyone read it) it would be obvious that this is not just a mother's opinion. I'm really not one of those mothers that believes that my child is perfect (though you wouldn't guess it from these posts...I just wouldn't humiliate her by posting the bad stuff). I don't believe we do our children any favors when we shield them from reality. If her work was crap, I wouldn't tell her that exactly that way, but I might gently suggest she rethink how she spends her time.

A Depp, Burton, Wildner production would be her dream come true. For all her talk, I don't know that she'd dream that big for herself, but I could totally see that for her.

Synchronicity

I don't believe that things happen by accident. Even when painful things have happened in my life, I was confident that there was a reason and that I would understand it eventually. There is no such thing as coincidence.

Here is what I see as an example of my magical thinking (which I understand some use in a derogatory way, but I LIKE the way it sounds):

In my last post, I pondered our collective reaction to people we perceive as famous. I choose that wording carefully. Perception is reality. To Johnny Depp's mother, he is a son. To his sibs, maybe is was (or is) an annoying brother or protector (as my brother has been by turns), I'm sure. His children still probably think he's a god (at least until they become teenagers, at which point he'll instantly become incredibly stupid), and when his wife looks at him, she likely has a burst of oxytocin that makes her heart go pitter-pat; when she doesn't want to stick a fork in his head, at least if he's anything like my husband. And I've got one of the good ones!

So, it is our perception that creates OUR reality. Depp's reality is entirely something else. He's just living a life and doing a job like everyone else. We all have the same basic needs and fears.

In any case, I wondered on this blog last week what it is we want from famous people. A few days later, I was reading A New Earth: Awakening to Your Life's Purpose by Eckhart Tolle. I've been following along with Oprah's webcasts as I read, but not on the same schedule. Therefore, while they are on like chapter 7 I think, I'm still on chapter 3, The Core of the Ego. But like I said, there are no accidents, so when I came to 'Ego and Fame' I was not surprised. Says Tolle:

"The bane of being famous in this world is that who you are becomes totally obscured by a collective mental image. Most people you meet want to enhance their identity--the mental image of who they are--though association with you. They themselves may not know that they are not interested in you at all, but only in strengthening their ultimately fictitious sense of self. They believe that through you they can become more. They are looking to complete themselves through you, or rather through the mental image they have of you as a famous person, a larger-than-life collective conceptual identity." (pp. 83)

Ask and it is answered! I love that!

Tolle also tells us that Einstein, "...never identified with the image the collective mind had created of him. He remained humble, egoless" and quotes him as speaking of, "a grotesque contradiction between what people consider to be my achievements and abilities and the reality of who I am and what I am capable of." (pp. 84) I had to wonder if that's the sort of attitude that keeps JD grounded (or at least seeming that way).

Again, this post isn't birth related, at least on the surface, and I have no idea if the experience might be at some point. I'm a bit myopic that way. Of course, this experience was not primarily mine either. So, we wait for the Universes to reveal what we are to learn from our encounter. I never thought much about any of this before, but maybe there's a reason I'm supposed to. Maybe my daughter will become photographer to the rich and famous. Maybe her friend Fern will become a high end designer. Maybe Sara's amazing voice will take her far. Chelsea and her friends have serious talent, and as long as they don't think of themselves as less than what they aspire to be, and always believe that they can attain what they desire most, they could be dealing with fame and fortune. They are funny and insightful too. I look at the work they produce now, at 16, and I am astounded. With support, who knows where they will go. Oh well. I'll know when I'm meant to know.

I do have a post though, (about birth!) regarding a 'chance' encounter that may lead to big things for birthing in the U.S. Who would have thought I'd get a brilliant idea about advancing midwifery as a safe option from a business professor in an adult learners undergrad program?

But once again. I'm tired. Life has been so busy it seems I never get a chance to finish one thought before another intrudes, demanding attention. I will get to it though. I also need to post about the survey yet, which is why that damn pop up window is still popping. I dont' want to delete the survey until I can let participants know what it was all about and what the responses were. I hope to have time tomorrow.

Measles Confirmed in Wisconsin

Is the news in business to inform, or to promote an agenda?

According to WISN TV 12 last night, a case of measles in a toddler has been confirmed. We are then warned that '1 in 1000 measles infections results in death'. Several other sources have since repeated that measles was a ‘leading cause of death’ before vaccines.

Now, that figure is different from the numbers on the Merck MMR package insert which says 1 in 2000. Still alarmingly high to be sure, although not as bad as the doctor who, in trying to convince me to vaccinate my then infant (the vaccine is not proven to be safe or effective under the age of 12 months) told me that ‘every child he’d ever met with measles died’. I told him I found that unbelievable because I had measles, as had every kid I knew, and we were all very much alive. He backed off then, a bit flustered, but I fired him anyway just because I detest manipulation through the use of fear.

In any case, TMJ then quotes Dr. Michael Chusid as saying, "It's one of the most contagious of the viral diseases that we have, so just breathing the air of someone that had been in the room is enough"

I found that interesting because a few years ago my husband went to Germany and after he got home, it was discovered that he had been on a plane from Austria to the U.S. (like a 10 hour flight) with someone who had measles. I called our doctor to ask if my husband was in danger, since I had already researched the issue and discovered vaccine immunity only lasted 10 to 12 years and he had been immunized as a kid. She said no, because he would have had to have been in direct contact with water droplets. In other words, if he was not directly coughed on or sneezed on there was no danger. TMJ4 put adult minds at rest for a different reason, though, by informing us, “Good news for grown-ups: if you were vaccinated as a child, the vaccines are very often still effective, even 40 years later.”

Reading that, I wondered if there was some new research regarding the vaccine’s effectiveness since my husband’s experience 5 years ago or so. Nope. No new evidence. In fact, just a year ago the Archives of Pediatrics & Adolescent Medicine (Vol. 161 No. 3, March 2007) reported, “It has been suggested that protection offered by vaccination is life-long, however this is based on data from times when the wild-type virus was still circulating and thus boosting immunity. There is limited evidence on the persistence of immunity where the natural disease has been eliminated.”

WISN TV 12 also reassured parents that there is no concern if parents have immunized their child. But according to the Merck MMR package insert, “As for any vaccine, vaccination with M-M-R II may not result in protection in 100% of vaccinees.”

Also according to WISN TV 12, “About one case in 1,000 leads to death, but other complications include encephalitis and pneumonia.” Ok, that tells us there are risks to the disease, but what are the risks of the vaccine? Wouldn’t unbiased reporting also include those? From the Merck package insert, some risks include:

Atypical measles (in other words the vaccine can give you the measles)

Encephalitis

Pneumonia

Death

In other words, the same problems as with the disease, except that the list of other possible complications for the vaccine is about a page long.

These ‘news’ reports are supposed warn parents to vaccinate their children, because measles is deadly, but the girl is ‘expected to make a full recovery’. What I find even more interesting is that whether or not this little girl was immunized is never mentioned. If the girl got sick, supposedly, because her parents failed to vaccinate her, would be a strong illustration of why vaccination is important. If she got sick despite being immunized, simply not mentioning her vaccination status would allow her case to be used to push an agenda. That makes me wonder, cynic that I am, if the girl actually WAS vaccinated and got measles anyway. As stated above, the vaccine has not been proven 100% effective and can cause measles. Likewise, every case of polio in the US since 1979 has been caused by the vaccine.

Now, I’m not saying that people shouldn’t vaccinate, although anyone who is trying to make an informed decision might want to hear what the speaker for Vaccine Injured Children has to say April 9^th in Beaver Dam or check out 'the other side' of the story.

Or at the very least, not rely on biased and inaccurate news that is repeated nearly verbatim (without any actual investigation it would seem) on every channel. What that often shows is that some organization that wants to promote an issue has issued a 'press release' and no one bothered to verify anything in it.

And just to be clear, my husband still travels for work. He goes to places where he could conceivably contract a disease and bring it home. Therefore, he is vaccinated. We did vaccinate our daughter, but not until we were satisfied that her immune system had a chance to fully develop. I am not 'anti' vaccine. I am PRO informed consent. More importantly, I am vehemently opposed to the 'news' being used as a vehicle to promote an agenda.

Born In the U.S.A.

I finally did order Born In the U.S.A., even though I hadn't seen it and wasn't sure if it was worth the investment required in order to purchase the right to show it. (BTW, the trailer for this this movie is still not available to embed via YouTube, but the link in the hyper-linked title above will take you to their website where they do have a clip.)
I was interested in this movie because it was featured on the Oxygen Network, and in Fit Pregnancy and Self magazines. It was shown on PBS, and a couple of my favorite doctors had this to say (from PatchWorks Films website):

"The best film on birth in America."
——Marsden Wagner, Former Director, Maternal and Child Health, W.H.O.
"Every man, woman, and child in this country should see this film."
—Christiane Northrup, MD,
Author, Women’s Bodies, Women’s Wisdom

I do respect these opinions, though I guess I'm not quite as enthusiastic about the film after seeing it. It's good. I'm not sure its the best. I felt the same way about Giving Birth: Challenges and Choices, by Suzanne Arms. It was good. I liked it. It was beautifully done. It just isn't my 'go to' movie. Maybe I should have a baby/birthing movie marathon and see what my opinion is when I see them all together. It has been years since I watched the Arms movie.
I've been thinking I might have a mother's 'tea' once a month just to watch uplifting birth/parenting videos and talk about the concerns of expectant moms. They can be such a wealth of information and support for each other, and I have so many resources I could share. One friend in CA is doing something similar and has great attendance. If any local women would like to see something like this, let me know. Maybe we could do something once in a while like learn how to knit a baby hat or make natural baby wipes or something. It could be fun.

Book Review

Permission to Mother: Going Beyond the Standard-of-Care to Nurture Our Children

Denise Punger, MD, FAAFP, IBCLC

Outskirts Press, 2007

There are two main reasons that Dr. Punger’s book is important. The first is that she started out with the same culturally imposed beliefs about birth and breastfeeding that most American mothers have. Often, mainstream mothers assume that ‘alternative’ mothers have always had ‘far out’ ideas. Yet the journey from culturally accepted parenting beliefs to heart-centered intuitive parenting doesn’t happen overnight or without good reason. Often it is the result of a great deal of research and soulful exploration. Permission to Mother is Dr. Punger’s journey. Part of this journey includes her medical training (and that of her physician husband), which is the second reason this work is so important.

People tend to assume that support of all safe birthing options, including homebirth, automatically requires that someone be ‘anti’-doctor or ‘anti’-hospital. Likewise, to advocate for breastfeeding is often taken as an ‘anti-woman’ stance. Somehow it doesn’t occur to certain folks that it is only their own erroneous assumptions about birth and breastfeeding that could lead to such conclusions. In any case, in this book, they are challenged. Dr. Punger IS a doctor. She is married to a doctor. Her father-in-law is a retired obstetrician. Obviously she isn’t anti-doctor. Yet she supports homebirth and doulas. She is a working woman; yet she’s a breastfeeding advocate. Her story is vitally important in putting to rest the ‘us’ against ‘them’ mindset once and for all.

Punger shares with us her education, training and early experiences. We hear first-hand just how little doctors learn about truly normal, natural birth and breastfeeding. She asks important questions about why obstetricians so often jump to surgical solutions when other, less invasive options abound for many variations (sometimes called complications). Her own breech home-birth ends up being part of that process of questioning.

Likewise, her discovery of Dr. Brewer’s advice which led to the elimination of toxemia from his own OB practice prompted her to ask, “Why does the medical community ignore his evidence?” Good question; midwives have been using this advice to help mothers to be healthy for decades. The information is there, and it is so simple. Why the resistance?

Perhaps the best part of this book is “Finding Breastfeeding Medicine”. Dr. Punger’s own breastfeeding experiences led her to supplement her education to become an International Board Certified Lactation Consultant (IBCLC). We learn elsewhere in the book that medical ‘training’ in breastfeeding may include an hour or two of instruction and continuing education sponsored by formula companies. What I want to know is why every single doctor (or nurse) that will discuss infant feeding with new mothers isn’t required to be a lactation consultant? Why isn’t every obstetrician, pediatrician and family practice physician required to be able to fully inform mothers of the benefits of breastfeeding and understand how to overcome challenges when they occur? How can they actually educate women if this isn’t part of their own education? How can they be of assistance if they don’t have the motivation to go above and beyond as Dr. Punger chose to do?

I love that the author shows that being a working woman doesn’t mean you can’t breastfeed. I love that she herself is so dedicated to her boys that she would have them brought to work to nurse them when she couldn’t be home. I actually chose my own daughter’s pediatrician for exactly that reason: the doctor’s husband brought her children to the hospital when she couldn’t go home to nurse them.

Because of this level of knowledge of breastfeeding, Punger is also able to address issues such as adoptive nursing and other special situations, as well as introduce the concept of breast-milk donation, which may be a new idea to some readers.

Finally, I’m excited about this book because also home-birthed, cloth diapered, breastfed, co-slept and unschooled my own daughter (who, by the way, is an intelligent, compassionate, independent young adult now, despite dire warnings of where our ‘weird’ parenting choices would lead). It’s nice to find a kindred soul.

My Favorite Physicians

Some people who are immersed in the fear-based paradigm of our collective cultural beliefs about birth see gentle birthing advocates as 'anti' establishment. They are very threatened with what they see as 'alternative' views. But there are some allopathic practitioners, both physicians and nurses, who are out there advocating for all the things that make babies and mothers healthier, happier and safer. They often face a great deal of pressure from their peers when their views are outside of 'tribal' agreement: i.e. they support options like homebirth, advocate for breastfeeding, are vocal about their beliefs about ecstatic birth, are anti-circumcision .
These doctors and nurses deserve a pat on the back.
Dr. Marsden Wagner tops my list. He's been advocating for midwifery for years. He can be seen in Gentle Birth Choices and The Business of Being Born. He is the author of several wonderful, fact-filled books, the latest Born in the U.S.A.: How a broken maternity system must be fixed to put women and children first.
Dr. Michel Odent is also in TBoBB and has worked ceaselessly for gentle birth. He has likewise authored several books.
Dr. Weil, from the Program in Integrative Medicine in AZ.
Dr. Jack Newman, breastfeeding advocate with a great collection of articles on his website. His site is especially helpful for women who wish to re-lactate or who plan to nurse an adoptive child, but he has a TON of information any mother who wishes to have factual information on just about every breastfeeding situation you can think of.
Dr. Lorne Campbell teaches medical students in GA. He is a gentle and compassionate doctor who receives babies that mothers birth. He knows the wonders of HypnoBirthing(R) and speaks about it often.
Dr. Margaret Gustafson, OB/GYN practices in MI and is so supportive of informed choices.
Dr. Kari Leikert, my daughter's pediatrician throughout her childhood. We didn't always agree (for instance on vaccination), but she was always respectful in saying, "I don't agree with you on this, but I respect your decision." Because of that, I admire her greatly.
Dr. Sarah Buckley, who wrote Gentle Birth, Gentle Mothering.
Dr. Lewis Mehl-Madrona, who has conducted research on safer birthing options.
Dr. Christiane Northrup who is all about women's empowerment and gentle birth.
Drs. Sears, Americas Family of Pediatricians. (I love that!)
Dr. Mercola, always questioning the status quo.
Drs. Coquelet & Punger, walking the talk.
Dr. Paul Fleiss, anti-circumcision educator
Finally, the doctor I was seeing in Greenville, MI in 1992 who refused to give me antibiotics just because I insisted I needed them. I don't remember his name, but he took the time to explain to me why I was wrong and why there was danger in over-using antibiotics...years before anyone else recognized the problem.
Some nurses who are fighting the good fight:
Barbara Harper, RN
Faith Gibson, CNM. The College of Midwives website that she maintains is one of the most massive collections of fact-based maternity care information available.
Doris Haire, CNM
There are so many! I'll add more as run across them, but if you know of someone who belongs on this hall of fame, medical professionals who are insisting on a higher standard of care for women and babies based on evidence, please send me names and links to their works, sites or blogs.
These are people on the inside who see where the system needs improvement. They obviously aren't anti-hospital or anti-medicine, as is often the (erroneous) assertion regarding those of us non-medical professionals who advocate for change in maternity care.

Book Review

She Births: A Modern Woman’s Guidebook for An Ancient Rite of Passage, by Marcie Macari
Infinity Publishing, 2006
ISBN 0-7414-3390-7

Before reviewing this book, I have to say that I had dozens of little notes about all of the things I wanted to say about this book before I got to the last chapter and found a quote from MY book. I swear, I didn’t know I was quoted and everything I am about to say about it I was going to say before I discovered I was. I do not know the author or the publisher. I just had to make that clear in the spirit of full-disclosure.

That out of the way, I will start right off by saying that the title of this book describes the content perfectly! Each chapter addresses some spiritual aspect of the process of birth, followed by a meditation, and then journal exercises that allow the reader to explore feelings and insights further. While the Feminine Divine is acknowledged, all interpretations of Spirit are honored as ‘Creative Source’ in the meditations.

The messages are clear. Babies come out. Women are strong. There is a purpose to the way women are designed to give birth, and it is more than just a physical design that works. Thus ‘Birth’-with a capital ‘B’ throughout-is not just a verb; it is a force with transformative possibility.

This empowered Birth is also seen as a gift to our babies. As the author explains, it allows our babies to be born “…onto this planet with dignity and a gentle transition…” that is “…a priceless gift to our yet unborn.” (Ch. 1, pp. 15) This chapter ends with guided journaling asking us to carefully consider the baby’s experience.

Chapter 5, ‘At the Feet of the Wise’ contains birth stories, which the author sees, and I agree, as vitally important in the way women currently perceive the mystery that is Birth. At first I was unsure about how I felt about the first and last selections. The first, because I thought if I were pregnant and reading this story I’d be scared out of my wits! ‘Unbearable’ and ‘agonizing’ are just a few of the descriptive terms. The final story is of a mother’s natural birth, and loss, of preemie triplets that made my heart ache. However, as I thought about it, I realized that while hard to read, the shadow side of birth is important. While I think women hear enough of horror stories about how difficult birth can be, sadly for too many women, it is. When birth is challenging, however, instead of suffering we can choose to use that as an opportunity for growth, and the author provides exercises for doing so.

What I loved about this book is that while these births took me aback at first, there is also the acknowledgment that while birth CAN be painful it doesn’t always have to be. Whether it is by a different interpretation of the sensation, or by controlling variables that can make birth painful, painless birth is also depicted. As a matter of fact, the second story is a wonderful HypnoBirthing!

Macari stresses personal responsibility, clearing the way for baby by forgiving and letting go of anger, and honoring of the sacredness of this process. In our culture, birth has come to be just a physical process for so many people; a way of getting baby from point A to point B. She Births helps the reader to understand that there are so many gifts available to women through birth that are lost when they choose to reduce this powerful rite of passage to such simple terms.

Dad feels blessed

Another fast and easy birth!


Dad delivers baby in bathroom

Resources were wasted in rushing emergency personnel to the scene when babies just come out. The mother and baby were fine. Dad didn't need to tell her to push. Mom's body was doing what it needed to do, what it was built to do. That poor dad had no reason to panic! All he needed to do was get those dry towels and receive his little girl.

I love that he feels blessed to be the first one to touch her!

The Business of Being Born

The Business of Being Born was amazing!

Before I even begin to talk about the movie though, I have to thank Toshia Parker and Stacey Feiner for inviting me. I also want to say, if you are anywhere near SW/S Central Wisconsin, please attend any event these women are hosting! They are exceptional women bringing great things. They inspire me.

Stacey runs Harmony (a non-profit group promoting natural birth) with two equally phenomenal women; her sisters Renata and Nicole. They are three moms with three different birthing stories who bring a wealth of experience to their endeavors to help women create their own best births. I'm honored to know them. Toshia, like me, is a HypnoBirthing educator and hypnotist. Her business is Wellness from Within.

Anyway, the movie is a must see! If it is showing locally, please go see it whether you are pregnant or not! We are all either mothers, or children of mothers. As such, this topic does impact all of us, even if it doesn't seem to at first.

What did I like about it? Finally a voice for sane birth that more people will listen to! Good or not, people tend to listen to celebrities. One thing the film pointed out was that the celebrities that have been vocal about their elective cesareans are impacting choices right now. We need homebirth celebrities to be as vocal! Joely Fisher and Thandie Newton have been, as has Cindy Crawford and obviously Ricki Lake, but did you know that Demi Moore & Bruce Willis, Meryl Streep, Micheal Landon's wife, Noah Wylie's wife, Carrie Ann Moss, Laura Dern, Patricia Arquette, Stephen & Tabitha King, Lucy Lawless, Pamela Anderson & Tommy Lee (also HypnoBirthers!), John Leguiziamo's wife, Lisa Bonet & Lenny Kravitz, Kelly Preston & John Travolta, , Charlotte Church and Julianne Moore all had homebirths?

Therefor, I love that this movie will get people talking.

I have heard complaints that the movie is 'biased' because it didn't show that people have 'good' births in the hospital too. I guess my question there would be, "Does your OB tell you that the midwives down the street might be a better fit for your low risk situation?" Do hospitals have pictures of wonderful homebirths in their waiting rooms? Of course not. It's a business. Why would they send you to their competitors? The Business of Being Born is an expose' of a broken system, and as such it is as even-handed as it can be and still provide the facts. It shows, through Abby's birth, that technology is lifesaving when used appropriately. However, it also gives evidence showing that it is NOT used appropriately, nor is current practice based on science, and what's more, it shows what the consequences of this mix are. It advocates for a system of choice between viable options, nothing more.

Having said that, I also didn't find it perfect. I realize that subject is enormous in scope and it isn't possible to to address every issue. However, I was disappointed that that every birth was such agony. Because most women believe that is what birth must be, maybe they didn't want to challenge too many core beliefs at one time. Maybe because that was their experience of birth, they also hold that belief, and what they wanted to convey was that there is empowerment in beating the pain. In fact, Robbie Davis-Floyd says something to the effect that there can be no empowerment without the pain. Now, don't get me wrong; I love Robbie Davis-Floyd. I just disagree with her on this point. That is why I was disappointed to see all of the births playing into the fear that most women have already: That birth is so excruciating they feel like they are going to die. The reason women say they want their epidural at the door is because they are sure that's what they will face, and they really don't care about empowerment.

Make no mistake, some will experience that, but not all. Knowing what creates pain birth (and it's not always the birth process itself) means we can avoid the pain, or at least control intensity if we can control the variables that create pain. HypnoBirthing mothers do it all the time. Sometimes homebirth mothers encounter painless birthing accidentally just by controlling some of the variables. Again, not all. I had a homebirth, and I did experience pain. (Long before HypnoBirthing.) I did find empowerment, I did NOT suffer, and found it a spiritual turning point in my life. Since that time I've just seen too many ways in which our beliefs create that experience. So now I believe that women have to know what is possible in birth. You CAN have the empowerment without the pain.

Suggesting that painless birth is possible, perhaps part of our perfect design, does not negate the experience of women who perceive birth as painful. There are historical references to painless birth and there are stories of painless birth from around the world, yet pain can be, and has been, painful for most women. Far too many. We can change that though.

There are many satirical works comparing sex and birth. The comparison is valid considering both can be altered by similar factors. I'd like to take that comparison one step further.

Women's experience of sex:

Some women enjoy orgasmic sex
Some are multi-orgasmic
Some are non-orgasmic
Some experience female ejaculation
Some experience painful intercourse

Some have perfunctory sex

Women's experience of birth:
Some enjoy orgasmic birth
For some birth is painful
For some, long births are normal
For some, short births are
For some giving birth is just a means to an end

In both cases 'position' (in the case of birth both mother and baby's position), partner (in the case of birth, both the actual partner and anyone on the birth team) and practice (in birth today women may only have one or two children, so a fact-baased childbirth class like HypnoBirthing class would have to take the place of life-experience) play a huge role in how events unfold. A woman with vulvodynia is likely going to find sex painful. A virgin is likely to find sex painful. A women who is being raped is going to experience pain. A young girl who is physically immature is going to find sex painful. A physically mature woman who is tense is likely to find sex painful. A woman who is with an unexperienced partner may find birth painful. A woman who is not producing lubrication due to a hormonal imbalance may find sex painful. That doesn't mean sex is painful, yet no one would deny that these women experienced sex as painful. No one would argue that sex is painful by design or that women who enjoy sex are somehow just lucky or somehow exceptional. I don't know anyone who would argue that sex is painful for a lot of women because there is some inherent design flaw, and then set about 'proving' it without questioning why some women find it painful while others either enjoy it or least find it not completely objectionable.

Women who experience sex as painful, who want to enjoy sex more fully (and not everyone does...some women are perfectly happy with their sex lives even if they've never experienced an orgasm, maybe because they don't know what they are missing, poor things) can fix the underlying problem to improve their sex lives. In the case of a medical problem, it would be fixed if possible. If it was an emotional issue from a past experience, that would have to be addressed. For a woman who just didn't know what 'makes her tick', education and exploration would be key. For a women who is simply incompatible with her partner, a new partner could change the experience.

Suggesting that women can have a more enjoyable experience doesn't mean it is expected that every woman will have the SAME experience. It simply means that if you learn how your body works and control the variables, you can improve your experience IF YOU WANT TO. If you knew the secret to mind-blowing orgasms, and later your friends found out that you knew this and didn't share the secret, do you think they'd be upset? Yet when people like me try to share the secret of mind-blowing birth, we are sometimes told we are judgmental, or trying to inflict guilt or that we're being biased. I find that odd. If we told a woman she could have a better sex life, we wouldn't be accused of telling her she was doing it 'wrong' before. Why is it any different for birth?

In the case of birth, it is slightly different because we are talking about improving the experience for both mother and baby. Not only that, but many of the variables that contribute to a fearful, painful, dangerous situation in birth can be long lasting in their consequences to the baby.

So I have to wonder, if the difference between a comfortable natural birth and excruciating natural birth (or putting babies at risk) is simply a matter of learning what makes birth painful so one can avoid it, why don't more women want to know? Perhaps not every woman will have an orgasmic birth, or even painless, but quicker and more manageable is surely possible...without drugs. AND women would still get the 'love cocktail' that The Business of Being Born talks about. How great is that?! Why wouldn't women want to know this?!

Perhaps just seeing the ecstasy that comes from un-medicated birth will help us reach a tipping point where women will choose natural birth and experience painless by accident. Maybe that's enough for now. Maybe that's all this movie will do, because it does show the ecstasy of natural birth. It does show a little bit about how our culture came to view birth the way we do (as a dangerous medical event) as a result of a very well planned smear campaign. It also uses valid statistics to show that it has been to the detriment of women and babies that we do see birth this way.

It breaks up these sobering facts with humor in all the right places. It really was enjoyable to see the audience respond to the film. Both events had decent sized crowds, and both were very well orchestrated. There were expert panels for questions following the showing, and opportunities for more education and ways to become active in expanding women's options.

I'm so glad I was able to attend!

Blizzard Baby

Another baby was almost born on the way to the hospital, this time during a huge snow storm that buried us here in Wisconsin.
It was on the news, channel 12 I think. I didn't take notes because I figured I'd just find the details on their site and post the link, but I can't seem to find it anywhere.
The intro made no sense to me. They said the baby surprised the parents by making an early arrival. Yet they said the mother was scheduled to be induced in a couple of days. The baby appeared to be full term.
In any event, the dad was out shoveling snow like the rest of us. (It seems a never ending job the last few days.) His wife comes out and tells him they have to go to the hospital, RIGHT NOW. Visibility is near zero. It's a raging storm that is dumping snow snow so fast, malls, churches, colleges, schools and stores are closed and people are stranded. Yet these parents are so freaked out, they get in the car and risk their lives to get to the hospital.
Click here to see what these people ventured into.
What if they'd been stuck in that mess? Would they have known what to do? I'm sure not if it made more sense to them to risk death than just stay home and give birth where they would be warm and safe.
What have we done to women that they fear this natural process so?

More Quick and Easy Births

I went looking for a news story today, about a local backseat birth, and I found several! I didn't find the one I was looking for, though.

Last week, I was teaching a HypnoBirthing class, and a dad is concerned about a backseat birth, so we've talked about it a little every week now for 5 weeks, trying to reassure him that if the baby is coming that fast and easy, it's not a problem. This is a common concern for parents, especially HypnoBirthing parents, because if birth is comfortable for mom, and they aren't sure they are in labor, they figure they might not leave in time to get where they are going. We address that concern in class, (even the moms who do have completely painless births still have sensation , just not pain) but truly, although I've got maybe a dozen stories total here on the blog and we hear about one of these on the news about once a month, if you think about how many babies are born, it just isn't something that happens all that often. I've been teaching childbirth classes since 1991, and none of my parents have ever birthed in the car (since I began teaching HypnBirthing though, most do arrive at the hospital at 7-9 cm because they don't think they are really in labor until they are quite far into it).

So they come in last week and tell me that their heater broke in their car, and they were in getting it fixed. One of the mechanics, I believe, sees my client is pregnant and tells her about his exciting weekend.

He had just bought a new car (and I got the impression that for the dad, this was a very important element in the story; that he had to have his car detailed because it was brand new) and his wife was scheduled for a cesarean on Monday for pre-eclampsia (and here is a fun fact, women who actually have pre-elampsia are very sick... getting the baby out quickly is the only way to keep the mother from having seizures and possibly dying. An emergency cesarean is imperative, not 'oh, go ahead and have your baby shower this weekend and we'll schedule surgery for first thing next week').

In any case, after the baby shower, the mom 'felt funny'. She didn't feel like she was in labor, just 'funny'. And since she'd been told she was sick (and may well have been getting sick) she thought it was a good idea to go to the hospital. But by the time they got to the car, she said something felt really odd, and asked her husband to take a peek. She was wearing his boxers, and when Dad looked, he was just in time to catch the baby; the head was already out. I don't know how big the baby was or anything, but mom and baby are going fine. In the retelling of the story, it did seem that dad thought catching his own baby was very cool. Maybe it made up for the wet back seat in his new car.

Now, you'd think this would be news, but there was nothing on it when I looked. Perhaps the family is just private that way. Which makes you wonder how many people this might happen to who just don't want the attention.

However, while I was looking it up, there were TWO OTHERS that happened in the last two weeks. One was in Ohio. A little peanut baby at 4 lb. 3 oz. One was in Michigan. This one just "sort of fell out" at 7 lb. 7 oz.

I also found another I didn't have in the first list. This one happened 2 years ago, and the archive just has the first two sentences, but that gives us the basics. There is a picture of the baby boy, but no weight. He looks to be about 6 lbs.

I actually hope more and more of these happen so people will realize that these quick, easy birth are the way we are designed to birth! However, I fear that if women aren't really thinking things through, their fear will still prevent them from thinking critically.

Years ago, there was some movie star talking about her near car-birth on The View. One of the women said something like, "we hear you have quite a scary story to tell about the birth of your baby". She said yes, then proceeded to tell them that she had surges (contractions) all day, but she didn't think she was in labor. It didn't hurt, so she just went about her daily business.

Eventually, she realized that the sensations were just a few minutes apart, so they headed to the hospital. On the expressway, she felt like the baby was going to fall out, so she got on her knees and told her husband to drive like a maniac. Within minutes of arriving at the hospital, the baby did indeed 'fall out'. I had one client who had a similar story from a previous birth.

In both cases, the doctor's advice was that next time, they should come in two weeks early and be induced to avoid such a scenario again. Fortunately, my client saw the illogic in this, but the movie star in The View thought that sounded like a great idea!

Her labor was so painless, she didn't know she was IN labor. Her baby almost FELL out. So instead of having a homebirth with a midwife next time to avoid a repeat, she thought it would be better to introduce a multitude of risks? Induction is so common these days many are under the impression that there is little or no risk to elective induction. That's simply not true.

First of all, planning to induce two weeks early, as determined by ultrasound, risks preventable prematurity. Ultrasound can be off by two weeks on either side of a 'due date' which itself is actually a 'due month'. "Due" is anytime between from 38 weeks to 42 weeks. 38 weeks is not 'early' and 'late' isn't until 42 weeks 1 day. Less than 5% of women actually give birth on their 'due date'.

After 28 weeks, an ultrasound can be off by as much as 3 weeks and is not supposed to be used for dating after that time. Yet I hear women all the time saying, "Well, my due date changed again." Your 'due date' doesn't change! I always ask them how many times their conception date has changed. You are the same amount pregnant regardless of what the machine says!

So, if someone is induced 2 weeks early based on an ultrasound date, they actually might be FIVE weeks early. Prematurity has considerable risks for the baby, and iatrogenic (doctor caused) prematurity due to increased inductions is a concern for the doctors who have to try to save these babies.

"Elective induction of labor, either for medical convenience or at the patient's request, and the practice of cesarean birth on demand have become increasingly common.10,11 The National Center for Health Statistics reports that 19.9% of all labors are induced; the rates have doubled since the last report in 1989.12 Although many inductions are for medical indications, it has been suggested that two thirds are performed for nonmedical indications.10,13 For example, the American College of Obstetricians and Gynecologists (ACOG) has classified psychosocial issues as an acceptable indication for induction.14 Further, after careful consideration, a woman's right to choose a cesarean delivery is also supported by ACOG.15

Although a scheduled birth may be convenient for the parents and the obstetrician, it is often painfully inconvenient for the infant who is not ready for prime time. Anyone who practiced in the '70s and '80s knows all too well that there is an increased risk of iatrogenic prematurity with elective deliveries, particularly those without lung maturity studies 16; the risk of RDS is also increased in infants delivered by cesarean especially in the absence of labor.16,17 One study reported that 18.2% of the cesarean births in their population were elective; 38% were performed at maternal request.18" (Buus-Frank, 2005. pp 233)

But that's just the beginning. IF the mother isn't actually anywhere near her 'due date', induction will fail. There is actually something called a "Bishop's Score" to determine how likely it is that induction will work. If the cervix is not in a forward position, is not soft, is not already effacing and dilating, and the baby is not low in the pelvis, induction will fail, leading to an unnecessary cesarean. Well, by that time it will be necessary because pitocin and/or cytotec will have likely led to a life or death emergency. So a better word might be an avoidable surgery. Then there is the maternal mortality (death) rate for 'elective cesarean' that is 3 times higher than for a natural vaginal birth. (Wagner, pp. 68)

Part of what causes such risk with pitocin is that it causes contractions that are longer, stronger and closer together, meaning they are very painful. Remember, we were talking here about babies who were born so fast and easy because their mothers were so comfortable they didn't realize they were in labor.

So now, instead of the logical option of staying home with the next baby and letting the baby fall with a midwife to watch over them, we are looking at what might happen if they choose to be induced two weeks early, which is the suggestion of the doctor.

Once pain is introduced with the pitocin, a mother is likely to beg for an epidural or other 'labor drug', which is really a misnomer, like Demerol which also creates risk.

Let me take a slight detour to explain the illogic of 'labor drugs'.

My best friend broke her tail bone while pregnant and "4 days overdue" (meaning she was NOT overdue) and asked for something for the pain. She was told they couldn't give her anything because anything strong enough to help her would be harmful for the baby. BUT if she let them induce her, she could have something for the pain. She asked why she couldn't have those same drugs now, for the pain she was already in. Because they are 'labor drugs' she was told. I love her response.

She said, "So, let me understand this. I'm in pain now, but the drugs are bad for the baby?"

"Yes." said the nurse.

"But you can induce me, create pain, and give me drugs?"

"Yes."

"And these are the same drugs I can't have for the pain I have now, because they are dangerous."

"Yes."

"So, in 30 minutes these drugs become less dangerous?"

"No."

"Then why can't I have them now?"

"You aren't in labor."

My friend was stunned, and the nurse never did comprehend what the problem was. My friend went home and used hypnosis for the pain. She had an hour and a half labor and birth a 10 lb. 4 oz. baby boy in a tub at home 4 days later (8 days past her 'due date').

I haven't even addressed the risk of the epidural this woman might also choose, and actually I'm not going to because I have to run. However, for anyone interested, Dr. Mehl-Madrona has research paper title Medical Risks of Epidural Anesthesia During Childbirth that you can access by clicking on the title.

I think the point has been made that inducing 2 weeks early to avoid the 'problem' of the next baby falling out too easily and quickly is the height of idiocy.

Buus-Frank, M., (2005). The great imposter [sic]. Advances in Neonatal Care: The Official Journal of the National Association of Neonatal Nurses. 5(5):233-236.

Wagner, M., (2006). Born in the USA: How a broken maternity system must be fixed to put women and children first. University of California Press. Berkeley.

Maslow’s Hierarchy of Needs

In watching the clip of The View, where Ricki Lake talks about The Business of Being Born (below), there is a comment by Barbara Walters that interested me. Lake is explaining how having a natural birth at home with midwives empowered her; Walters is confused by that.

This started me thinking about how many women do (or don’t) take childbirth classes and why that might be. Of course, partially that is because I’ve had this poll on the blog asking people if they took classes and why or why not. At the time of this writing, 52% did not take a class, and most respondents who didn’t take class said it was because they didn’t need one.

Of course, you know I’m going to ask ‘why’ next, right? Did they feel they didn’t need one because they figured they’d blindly trust whatever their OB told them? Did they not understand the purpose of a childbirth class? (Hint, it has nothing to do with ‘breathing’…you must know how to breathe already or you’d be dead and I hate to say it, but there is no magic breath that gets babies out.) Did they have a midwife as a caregiver, and had everything explained to them (and had actually helpful books recommended to them so they could educate themselves) so that a childbirth class was redundant? Did the non-hospital childbirth classes not market themselves well?

It was this last question that was on my mind when Maslow’s Hierarchy of Needs came up in conversation. Now, this pyramid of needs has tickled the back of my brain several times in recent months, as it’s come up in regard to effective marketing and in sociology. This time, I realized why it kept bothering me.

First, here’s a visual of Maslow’s theory: (if you click on the image it will open up a full-sized image you can read)

The basic idea is that when we make a decision about something, these are the factors that will motivate us.

First, we are concerned with survival issues. If our basic needs are not being met, we don’t really care about the other stuff.

Next, we need to know we are safe and secure. We need some order in our life, some predictability and to be part of a larger whole. This is also about survival to a certain extent. Being part of the larger group is an evolutionary desire. We are tribal by nature. Solitary humans don’t do well, not just because we need others to be most effective at hunting, gathering, farming, etc., but we need social stimulation for the sake of our brains. If we don’t interact, we go a little bit nuts. Think of the movie Cast-a-way with Tom Hanks.

Beyond that even, we need to fit in with our family, peer and work groups. We have a need to feel appreciated and loved.

We can survive if the only the first two needs on the pyramid are met, but without the third, we probably would be slightly maladjusted.

Next, we have the need to feel special. We want to feel respected and to be able to feel pride in our accomplishments. Finally, we reach a state of enlightenment or our full realized potential. Some say not many of us get to that point, except maybe Oprah. J

Ok, so how does this relate to birth, childbirth classes and Barbara Walter’s bewilderment? Here’s my theory:

Most American women are still making decisions at the first two or three levels. They believe birth is a dangerous, excruciating medical event. They want to be able to predict exactly what will happen each step of the way, even if the security is an illusion. If they do what every body else does, not only can they have a plan, but its familiar because it’s what everyone they know has done. They are following a blueprint. Sadly, because they do what everyone else does, they get the experience everyone else got, which is likely the painful medical event. But that’s ok with them, because they all have the same war story to tell. They fit in. They also get admiration for ‘surviving’ such a harrowing event.

Those of us who make the decision to birth at home, or who take a class that advertises gentle and empowering birth, are doing so because we are not operating from a place of fear. Make no mistake I am NOT saying we are ‘better’ or ‘higher’. I’m saying because we are confident that we are safe, and our babies are safe, we are not operating from survival need. Because we know what the research says BIRTH is safe, we are not operating at security need. Hence OUR confusion when someone says, “You birthed at home? Oh, you are so brave! I could never do that!” We, of course, are thinking, “Sure you could.” We don’t consider ourselves brave at all. We are just doing what makes sense, personally and per the evidence.

We are working from the ‘esteem’ level, because if we can. We feel a need for a sense of accomplishment like anyone else. We feel a need to be respected by our spouse or our home-birthing friends and to feel unique. Now, we all have these needs, but what I’m saying is that we can make our birthing decisions from this level because we don’t have to worry about the first three needs. To try to empower a woman who is operating at a survival or security level will not work. She has other things to worry about. Not to mention, if she is in an unsafe environment, or doesn’t have access to nutritious food, or is in some way actually not healthy, she actually is at risk for complications, which means she’s operating at exactly the level at which she needs to be operating. This is why it is absurd when people say homebirth supporters are trying to ‘make people feel guilty’. Even the most strident homebirth advocates realize hospital birth is the only place to be for about 10-15% of women. Homebirth should be an option because it’s safe, not because it’s right for everyone.

Think about it like this: You feel education is important. You improve the schools, and you make attendance mandatory. But one kid just doesn’t seem to care. He is often truant, and when he is there he doesn’t make much of an effort. You try to tutor him. You try special classes. You try rewards and punishments, but nothing works. He just doesn’t seem to value education.

What if you found out the kid was homeless? What if he’s being beaten at home, or doesn’t get to eat every day? What if he was convinced he was worthless because he was told he was, every day? If you met the more basic needs, from the bottom up, he might be more interested, and able, to operate at a higher level on the needs hierarchy. Otherwise, he simply can’t. He has to meet his basic needs first.

So, when we talk to women about the empowerment of natural birthing, they are confused. Sometimes they’re angry, but they may not be sure why. I believe it is because there is cognitive dissonance because on some level they know that the fear they feel is disproportionate to the actual risk. Because there is someone who doesn’t feel that same fear, it makes them question why they have it. Not consciously, of course, but if they become aware that some women can birth with dignity, comfortably, maybe painlessly, even ecstatically, and still be safe, but they believe that they must sacrifice all that for safety, it suggests that their suffering was for nothing. That’s not a comforting idea. It would make me angry too.

This brings us to the question of how we can help them meet their needs so they can feel the ecstasy and empowerment we know is so transformative. Right now they don’t even care about that. You don’t know what you’re missing if you’ve never had it. You won’t even try for it if you don’t believe it’s really possible for you. Can you see how bubbling over with enthusiasm about your positively transformational birth experience comes across as lunacy to someone who is convinced they “would have died” if they’d done what you did? It doesn’t matter if it’s true or not, it’s what they believe.

It doesn’t matter if they had an epidural that caused a sudden drop in blood pressure, that caused fetal distress that required a cesarean that saved their life. The only part of that equation that is important is the last part. It doesn’t matter that the medical management of their birth lead to the problem in the first place. What matters is the medical management saved their life…and it did. It doesn’t matter that they almost died of hemorrhage due to an elective cesarean, what matters is that modern medicine saved their life. Undoubtedly it did. It doesn’t matter that their baby almost died from a cord prolapse that coincidently happened just after artificially rupturing the membranes. What matters is that modern medicine saved their baby from certain death. It did. And because they are operating at that place of survival, it makes sense that is what they would focus on, it’s what’s important. They aren’t even going to question it unless they are operating from the 4^th level. If they are, they are going to wonder how things got so askew. Many do. These are the women who have a couple of horrible experiences and then come to a HypnoBirthing class. Or, the women who hire CNM for VBACs after questionable cesareans. Or, the woman who has seen several of her friends suffer from birth-related PTSD who decides to explore the option of homebirth. No one is right or wrong; they are just making decisions based on their where they are on the pyramid of needs.

What that means to childbirth educators, midwives, doulas, etc., is that we need to consider this in our marketing and in our interactions with others. No wonder we haven't reached a 'tipping point' yet. Maybe The Business of Being Born with be that tipping point that will allow more women to feel safe enough to work from a different need level?

What Makes Us Tick

From a sociological perspective, our cultural beliefs about birth and many early parenting issues are incredibly fascinating. We don’t often stop to consider that our culture shapes our decisions. We have this idea that we are choosing to do things a certain way of our own volition. Rarely is that the case.

Macionis, in Sociology: The Basics, says that the greater a person’s marginality, (meaning someone is not part of the dominant group) the greater the ability to see things other people don’t see, or using a sociological perspective. I guess I qualify as an outsider in many ways. He lists things like gender, age, sexual orientation, and disability as things that can marginalize a person. Other than the fact that I am a woman, I’m not marginalized by any of those things. I’m pretty typical. I’m married to a man, am able bodied and am of middle age. However, I belong to several ‘subcultures’; groups that are different from my dominant group, which for the purposes of this exploration would be an American Parent. Certainly I could be classified in many ways, but for simplicity, I’m picking this one.

Practically nothing I’ve done is in step with the dominant culture. Why? I have no clue. I question everything. My favorite quote is ‘Examine everything you’ve been told. Reject what insults your soul’ which is how I live. If something doesn’t make sense to me, I want to know why, and then I want to see if there is something that does make sense, and then I want to know if there is hard, verifiable evidence to support the alternative.

In most cases, I’m actually not very concerned about what someone else thinks of my choices. By the time I’ve made a choice, I’ve done enough research, from a global perspective, that I’m very sure I’m making the right choice for me and my family based on all of the evidence available to me. Some people won’t even consider information that doesn’t originate in the U.S. I think that’s a huge mistake. Other countries have much to teach us. It is arrogant to think otherwise, which is why so many people around the globe hate us. But I digress.

Back to my alternative choices, which include:

Homebirth

Breastfeeding

Selective Vaccination

Homeschooling

And if I’d had a boy, I would have rejected circumcision

These choices put me in specific subcultures. These subcultures may not be easily recognizable through commonalities such as dress or ways that other subcultures are identified, yet they fit the definition of subculture because by questioning the status quo, they set themselves apart to a certain extent.

This is very threatening to the dominant culture. I’ve been called judgmental and told that I’m trying to ‘make people feel guilty’ because I made different choices and want to expose people to the idea that they can too. I’ve never said my choices are right for everyone. I can’t impose guilt on anyone. It’s an internal emotion, and I don’t try to shame anyone for making any decision they feel is right for them. I do use a lot of statistics that call into question why certain decisions have become the norm, but that doesn’t mean I really care about anyone else’s personal decisions. Sociologically though, suppose I’m looking for the general in the specific.

What I do care about is needless suffering, and many of the decisions made in the childbearing year cause problems that lead to suffering. So it baffles me when simply trying to educate people draws such an angry response sometimes. No one has to agree with me. No one needs to defend their choices to me. My opinion should mean nothing to anyone. Lots of people disagree, sometimes vehemently, with the choices I’ve made. I’m ok with that. I have no need to defend those choices because I have no regrets in having made them. No one can shame me for not making the choices they’ve made, because I take responsibility for my choices, and mine alone. I just wish everyone could feel that confidence. I wish that through informed consumerism, parents could really understand what their options are, and that a lot of what they think are parenting options are not really options at all, as well as why certain parenting decisions are influenced a lot more by culture than anything else. We tend to think that just because many, or most, people do things a certain way, it’s the “right” way. So much so we may not consider there are alternatives.

These are things that are important because they influence patterns of health and illness, both emotional and physical, in our society. For example, we have an epidemic of childhood obesity and diabetes currently, which will eventually lead to an adult population with serious health issues. The roots may well begin at birth with breastfeeding (or rather lack thereof), but if we can’t be open to questioning infant feeding choices (a parenting option), we can’t address it fully.

On 1/14/08, USA Today ran an article in the ‘Life’ section that listed the complications of the obesity and diabetes and gave parents some concrete ways to help children stay healthy. They included: limiting television, limiting junk food, making nutritious food available, and encouraging exercise; all excellent ideas. Yes, they will all lower the incidence of obesity and diabetes. However, not once was breastfeeding mentioned. Not once was it mentioned that one of the main ingredients in formula, besides cow’s milk, is sugar. There were no resources explaining to parents that this culturally induced idea that formula and mother’s milk perform exactly the same function isn’t based on science, but politics and social mores.

From a structural-functional sociological perspective, there is a consequence to this social pattern that disrupts society as a whole. This approach also explains why this is such a heated topic: bottle feeding is a social structure that serves many functions besides feeding a baby (the manifest function). It allows women to be in the work force (a latent function). To suggest it isn’t good for babies creates a conflict, because were it not available, there would be a disruption in the way society currently operates. But another latent function is illness, which also disrupts society.

Any of the counter-cultural parenting options I chose pose the same threat. It makes people uncomfortable to think there might not be a logical reason for the things we do as a culture. This discomfort creates social conflict between the different groups, but this is important and necessary. The presence of these countercultures is a good thing, because without them, change would not be possible. If no one is willing to speak out against the needless suffering of women and babies, why would it stop? The culture at large isn’t even aware the suffering exists. The suffering is considered ‘normal’.

However, many of the problems that new mothers encounter are not common natural occurrences; they are created by the choices made in birth and shortly thereafter, many without the women even knowing they’ve made a choice.

This creates issues, and mothers talk about these issues, and because they all have the same issues, it is considered ‘normal’. Thus, no one bothers to consider that they aren’t, or that there are predictable ways of behaving that will reduce or eliminate the issues. This is how we have 70% of women anguishing over the ‘fact’ that they ‘can’t’ breastfeed. They have constructed the reality through their interactions-according to the symbolic-interaction approach. It never occurs to them that the reason they suffered was because of birthing decisions, bad advice or simply the cultural acceptance of an inferior substitute to human milk.

Another example might be the idea that birth is supposed to be excruciatingly painful. Empirical evidence tells us this is so. Right? We see it. We hear about it. The idea is accepted as something ‘every body knows’, or just pain common sense.

So, what we talk about and study is why birth is painful and how we can anesthetize the pain. It never occurs to us to wonder if the pain must be present, and if not, why not.

So, we come to conclusions that birth is painful, and perhaps dangerous, because we have big brains. We dismiss any evidence that lots of people give birth painlessly without drugs, either by chance or by design. We attribute any danger encountered, not with the multitude of variables that could have played a part, but with birth itself. We form all sorts of scientific ideas about pain, we write papers or even books about it; we measure it and draft policy to deal with it. But all along, we are asking the wrong questions because the premise with which we began was flawed.

Surely, there is a correlation between birth and pain. But is birth the CAUSE of the pain? If it is, all women would experience pain in birth. They don’t. At least 30% of HypnoBirthing mothers don’t, and there are many others who naturally don’t. Then it can’t be the process of birth that causes the pain. If birth doesn’t have to be painful and dangerous, then a ‘big head’ has nothing to do with anything. What causes pain during birth is actually very predictable and often avoidable, even with 11 lb. babies with truly big heads! Why on earth do people resist this idea, even when they can see statistics and videos of painless births (or even orgasmic births)? Because it disrupts the way their world works. People don’t like change, and this idea, while it seems deeply personal, has a ripple effect on many systems in our non-material culture.

Our patriotism is called into question if we are confronted with the idea that we don’t have the best maternity care system. We don’t even come close to the best.

Our ideas of freedom are called in question if we learn we have rights and responsibilities as a pregnant patient, yet are denied those rights when we try to exert them. This also makes us question our ideas of a benevolent health care system that we’d like to think puts our best interests first. We have many cherished ideas about what to expect of babies and motherhood. People who make different choices make us question our own, and the ideas that preceded them. Our very values and beliefs are challenged and that is very threatening.

Sometimes cognitive dissonance occurs when a core cultural value contradicts a belief. For instance, we (as a culture) have come to believe that epidurals are safe and justified. So, when a woman has an epidural that slows down her labor, necessitating pitocin which causes fetal distress and leads to a cesarean, there will likely be no acknowledgment that the epidural was the cause of the surgery. Birth will be blamed, because a cultural core belief is that birth is dangerous. Volia! Cognitive dissonance gone, to be replaced with denial and perpetuation of a harmful practice. In this instance, two birds are killed with one stone, because we have a cultural belief that breastfeeding is difficult too. Epidurals create breastfeeding problems, which reinforces the belief.

There has been a cultural lag regarding this issue. We got to where we are through invention, though our ethics have not kept pace. Through discovery and much research we know how to bring balance. Much of the information required for women to have easier, more comfortable safer birth and smoother postpartum transitions can be found in this blog. Now we need to allow diffusion, the spreading of ideas from places where birth is safer to create change on a larger scale. This diffusion also must happen within our boundaries. I hope that Ricki Lake’s movie, The Business of Being Born (trailer on this blog) may be the impetus for that diffusion. Once women understand that their best and loving mothering intentions are being sabotaged before their babies are even born, there will be a revolution! When women realize they can have the healthy baby prize without sacrificing their body integrity, their sex lives or their dignity, man, will they be pissed!

Thus far they’ve been socialized by their mothers, sisters, friends, and media to accept what’s been done to them; to be good little girls and buck up. As long as we can fix what we break, don’t worry about us breaking it. We know best, dear. All of your friends are doing it this way. Your mother did it this way and it turned out just fine…unless of course we x-rayed her (and told her it was safe) or gave her DES (and told her it was safe) or gave her thalidomide (and told her it was safe), or use Cytotec on her (and told her it was safe), or gave her a routine episitomy (and told her it was necessary).

We say that we value mothers and babies above all else. We hold that as a cultural value, in fact. If we really mean it, we must offer safe alternatives in childbirth. We must demand evidence-based care. We must have people appointed/elected to government offices at all levels who will be committed to actually putting our efforts toward what we say our values are. We must support and protect the mother-baby nursing relationship. We must admit that what we are doing now isn’t working. We can’t fix the problem until we acknowledge it. Some orgs that are already doing so can be found here:

http://www.cdc.gov/breastfeeding/data/maternity_care.htm

http://www.cfmidwifery.org/pdf/OverviewofMatCareApr2003.pdf

http://www.narm.org/aphares.htm