15 Things I wish I had been told before birth

1. My doctor wasn't going to be with me during labor. Doctors don't labor-sit.
2. My birth plan was most likely going to be ignored.
3. Nurses and doctors prefer an epiduralized patient for a number of reasons.
4. Resident doctors at university hospitals need to practice of lot of procedures that most
women don't need and that I am considered fodder for "practice."
5. Hospitals routinely under staff ALL nursing units in order to save money.
6. Doctors practice obstetrics the way they were taught. No matter what the evidence to the
contrary may be.
7. Obstetrics is very slow to change.
8. Obstetricians don't prefer to collaborate with their patient regarding labor and birth. An
informed patient is often seen as a threat.
9. Women obstetricians can be harsher than males. Depending on where they did their
residency, they may have had to work twice as hard to be considered half as good.
10. Obstetricians do not typically trust women or their bodies to do what they were made to do.
11. Obstetricians rarely view labor and birth as normal, safe, life events.
12. Most obstetricians practice in a CYA manner. Many are more concerned with not getting
sued than providing the best, evidenced based care possible.
13. No matter what a doctor says to you or agrees to, they want to be in control and have the
final say.
14. 38 weeks is considered full term. 40 weeks is considered over-due.
15. Induction at 38 weeks is considered good obstetric practice.

Birth of a woman

When I was nineteen I hadn't been married very long and I certainly wasn’t thinking about having babies, a friend of mine invited me to participate in the home birth of her second child. That event changed my life. I had never before seen a baby being born. It was powerful and beautiful. The doctor and midwife who attended my friend collaborated with her every step of the way. That birth became the standard by which I judged how birth should be.

A couple of years later when I was pregnant, I wanted to have a birth similar to the one in which I had participated at my friend's home. I read everything I could get my hands on. There was not much literature published at the time that supported home birth, but there were some books available about "natural" childbirth.

I chose the same doctor who had attended my friend's birth. He was one of a very few doctors who participated in out-of-hospital births and was open to natural birth in general. The midwife who worked for him had trained in England and was working as his "assistant." At that time few midwives could be licensed in the United States so her practice was clandestine; she functioned under the protective umbrella of the doctor as a lowly handmaiden. Although she did most of my prenatal care she could not be at mine because she was not allowed to attend any hospital births. She assisted the doctor at the home births only and my husband and I weren't ready for the responsibility of having a baby at home, so we naively planned a natural childbirth in a hospital.

Shortly before my due date, I felt the baby stop moving. That didn't seem right to me, but some friends who had babies assured me I was overreacting. They said it was natural for a growing baby who is running out of room to stop moving. I was young and inexperienced enough to think that I would be bothering the doctor if I called him to discuss my fears. I didn't know any better and tried to quiet the still, small voice inside that said something was very wrong. But somewhere, deep inside, a spark went out. I did not know it in my mind and could not have articulated what I felt, but from then until the birth, I just seemed to be going through the motions. My denial was strong as my mind worked overtime not to allow my true feelings of fear to surface. I kept telling myself over and over that everything was fine. A couple of days later I went into labor.

At the hospital, the nurses were having a hard time finding my baby's heartbeat with the stethoscope, so they placed an electric fetal heart monitor on my big, pregnant belly. This was 1975, it was a fairly new device at the time and was very unfamiliar to us. The monitor produces a graph of the baby's heartbeat and uterine contractions on a continuously moving strip of graph paper. The squiggly top line is a depiction of the heartbeat and the lower line, which looks like a range of softly rounded mountains, is the image of the contractions.

My husband used the contraction graph to help with his coaching. He could see a contraction starting before I could feel it and would tell me to start breathing and relaxing. But we didn't know how to decipher all of the markings. I saw the continuous flat line on the top portion of the graph and wondered what it meant. I asked him what he thought it was. I don't recall what he said, but I do remember that we both looked away from it and never said another word about that flat line. I think we both knew what it meant, but were afraid to face it. I had to get through labor and I think I would have given up if I knew that all my work was to be in vain.

The nurses did not inform me of their findings that my baby had died. Instead, they kept offering me narcotics that I adamantly refused, again and again. It wasn't easy, by any means, to continue refusing their pharmaceutical pain-relief. My labor had been induced with Pitocin, and one contraction would turn into three without a pause between them. The monitor strip showed these as "triple peaks." Just as I thought the contraction should be going away, another would start up and become even stronger than the first one, then start to subside, then a third would begin, and again become stronger yet. This is common with Pitocin labors, making them incredibly difficult to cope with. There is nothing, no classes, no films, and no books that could have prepared me for what labor felt like. I was shocked at the intensity and sheer power of those contractions.

Despite the pain of labor, I was determined to have this baby without any narcotics or regional anesthetics. I wanted to be awake during labor and I knew that narcotics would make me groggy. I wanted to be an active participant in my birth! I wanted to feel the entire process. After eleven hours of chemically enhanced labor, my body was finally ready to birth my baby.

After pushing a couple of times in the labor room, the nurses saw that I was making very rapid progress which necessitated moving me to the delivery room. The nurses brought in a gurney and said, "Just hop on over, sweetie!" Without any concern for the sensations I was engulfed in, they made me push my weary body onto a gurney and then, after being rolled into the delivery room, I had to move onto the delivery table. I don't really remember how I did it; I was so engrossed in the overwhelming feelings of birthing that everything else was secondary.

Once I was on the delivery table, the nurses grabbed my legs to put them in the stirrups and strapped them down to keep me from being able to move them. Now I was flat on my back with my legs elevated and wide apart. I protested about how uncomfortable the position was but the nurses weren't interested in what I wanted. But I didn't have much time to fret about it. I had to PUSH!

With each contraction I had my husband hold me up in a semi-sitting position to help me push more effectively. What a strange feeling pushing was! I could feel my pelvis adjusting to accommodate the baby's head. But it felt like I was coming apart at the seams. In my childbirth classes the teacher had assured us that pushing would feel good. I kept saying over and over, "I thought this was supposed to feel good!" Good is not the word I would use to describe it at all. Extremely intense, feeling like I was pushing out a watermelon, feeling like my body was going to split open, but not good. I liked the active involvement pushing required and in the abdominal area it felt better to push than trying to relax during contractions. But the intense pelvic pressure overpowered those feelings.

I did not have to push for very long, and with the final push my sweet baby was born--still, perfect, quiet, white, and limp. She didn't cry, and she didn't move. The doctor laid her on my belly and I asked, "Is she alive?" He responded, "I think you know the answer to that." He was right. I did know. I had known in my body all along. But, I hadn't consciously known. It had been buried deep in my subconscious where I could ignore it and pretend it wasn't true. But whether I knew or not, it did not make it any easier to cope with.

My husband and I gazed at our daughter in disbelief and shock; stunned and helpless. Neither the nurses nor the doctor encouraged us to hold her or touch her or to grieve. Not one of them in that delivery room asked, "Do you want to hold her?" No one wrapped her in a blanket to help ease the harsh reality. No one said, "I'm so sorry. You must really be hurting." No one said anything, as if avoiding the subject would make it go away or make it easier for them. We just stared at our baby as the nurses stared at us. Finally I told them, "You can take her now." There seemed to be a time limit. I felt a lot of pressure to hurry up and be done with it already. The nurses seemed to be disgusted by this cold, dead baby, my lifeless firstborn; unabashedly disgusted. One of them picked up my still, wet, naked baby by one arm and one leg, carrying her off with her head and body dangling as if she were some piece of meat and not my precious daughter.

I was twenty-one and I was devastated. I still hurt from this. Not just from the intolerable experience of losing a child, but from the heartless and uncompassionate actions of the nurses in that delivery room.

Returning home to the room full of baby clothes and all that goes with it was like rubbing salt into my deeply wounded soul. My arms were empty. My heart was broken. The depth of my sorrow is beyond description. Oddly though, I felt another, equally powerful realization as well. Deep inside my self, I knew I had become a woman. I had birthed a baby. Interwoven with the grief, I felt powerful. I had labored and given birth without any drugs, under my own power, with my own strength. It had been a difficult labor because of the Pitocin and the death, but I had made it through with integrity. I had entered into it with the ideal of not using any drugs and had accomplished it. It felt like I had gone through an incredibly tough rite of passage and now I was on the other side.

I had joined the long line of strong women throughout history that birthed their babies with an impassioned strength that saturated my being and made it clear that I was a woman.

I am a midwife

I am a midwife. Midwife means "with woman". Midwives are women who assist other women in giving birth to their babies. They educate them, empower them, and provide knowledge, guidance and support as well as the skills of their trade as needed. They help other women create sacred space within which to have their babies. Midwives are as their name implies, "with woman."

I love being "with woman." I love being "with woman" as she labors. I love being "with woman" when she asks for a cool, wet cloth to wipe her sweaty brow. I love being "with woman" when she holds on to me to steady herself during another wave of pain, as she buries her head in my neck, moaning until the pain subsides. I love being "with woman" when she grabs the father of the baby by the chest hairs and yells, "YOU! YOU DID THIS TO ME!" I love being "with woman" when she is pushing, grunting, screaming her baby out and looks at me with daggers saying, "Can't you just take this baby out, N O W!" I love being "with woman" when her slippery, wet baby emerges from her body as she shrieks with relief and reaches down to embrace it for the first time. I love being "with woman" when, holding her newly birthed baby, the mother looks lovingly at her partner and tells him how she cherishes him. I love being "with woman"!

Being a midwife has impacted my life in many ways. It has become for me a profound expression of my feminist beliefs; beliefs that honor the true worth of "women's work". Work that is woman's alone--the work of birthing, breastfeeding, and mothering.

Midwifery is a political act. Being "with woman" helps women reclaim the power over their own bodies. The issue of safety has been used for years to legitimize medical intervention and control over women's bodies as they labor and give birth. When a woman gives birth at home, it is a demonstration of civil and medical disobedience that affirms the legitimacy of low-tech birth.

Midwifery is a spiritual act. Being "with woman" is more than just a physical presence. It requires attending to and respecting the magnificent energy and holiness at every birth.

Midwifery is a social act. Being "with woman" often involves many members of the birthing mother's family, her partner's family and often lots of friends.

Midwifery is a multicultural act. Women from many different cultures call on a midwife for assistance. Not only must I be sensitive to culture, I am often asked to participate fully in birthing ceremonies. Examples include such things as pouring water from the Ganges river on the baby's head as it emerges into the world or “laying hands” on the woman's pregnant belly as God is called upon to be present.

Midwifery is a physical act. The physicality of birthing and assisting with birthing is second to none. There is blood, sweat (lots of sweat), and tears; pushing, pulling, holding, supporting, watching and waiting.

Midwifery is an emotional act. I have never been so deeply touched as I have with my own birthings and the birthings I have had the good fortune to attend, either as midwife, assistant, photographer or friend.

Midwifery is an act of faith. It is faith in the ability of a woman's body to do what it was created to be able to do and faith in the process of birth itself.

We are all connected through the miracle of birth. Birth connects humans through time, distance, generations, countries and cultures. There is a ripple effect to birthing; it touches everyone in some way or other. The experience of being born may linger in the subconscious or in our body-memory, but it is present. The collective unconscious memories of the birthed and birthing becomes a universal, shared experience that binds us together and is capable of empowering us.

Every one of us has been given birth to; we have all been born. How we are birthed affects us profoundly in every aspect of our lives. How we are birthed affects how we cope with life from that point on. How we are birthed and how we choose to give birth impacts our entire culture, our relationship to the earth and our future as a species.

Birth is one of the most significant and consequential events in life. Therefore, I feel very strongly that every woman must have the freedom and support to give birth with dignity, surrounded by the people of her choosing, in the place of her choice.

I was so profoundly impacted by my own births, by the manner in which I was treated during my births, and by how much control the institution was able to exert over me, regardless of my desires. I have experienced first-hand the feeling of helplessness within the hospital system that subordinates the needs of the birthing mother to its own procedures and policies.

Shortly after my babies were born I promised myself that I would become involved in the childbirth movement that was active at that time. I didn't want women to have to endure such horrendous situations as I did while having their babies. I wanted to empower women to have their babies with dignity, to choreograph the birth the way they want it, not just be at the mercy of hospital policies and physician preferences.

For the last thirty years I have been involved in helping birthing women in a variety of ways: birth photographer, childbirth educator, nurse, lay midwife, doula, and lactation consultant.

Although I no longer am able to be present at many births, through teaching I am still able to be “with woman” in a very significant way. If I can help a woman fully realize the extent of her inherent creative power, to access the deep awareness of her body and tap into her inner wisdom as she labors and gives birth, then I am “with woman”. I am a midwife.

Balance

I am old enough to know that birth is not perfect. I had two early losses prior to giving birth the first time. My full-term, 8 pound, two ounce, perfect baby girl was born still on a beautiful November morning the year I was 21. That birth cemented for me the incredible power my body held - the inner strength I had, and the massive power of birth. At the same time I discovered the insensitive control the medical machine has over women during this vulnerable, yet powerful time in their lives. Since that time I have worked to support women in having the births that they want, that they orchestrate.

Birth is as safe as life gets and we must accept it all – the happy and healthy, and the sad, not so healthy moments that are sometimes unavoidable. For without darkness we cannot appreciate the light, without coldness we would not appreciate warmth, without death, we would not value life.

When life/birth results in unexpected outcomes such as my stillbirth, over time these events can be seen as worthy of our respect in many ways. Grief is a harsh taskmaster, but some of our greatest life lessons are learned through the biggest challenges. Side by side, laughter and grief, love and fear, in balance. What we seek is balance and trust – to dig deep within ourselves and find the inner knowing that exists but has in many cases, been overwhelmed by cultural “shoulds,” “oughts,” and fear mongering by the medical establishment.

When we women trust ourselves, we open to the knowledge within that can guide us through our embodied life in a far smoother fashion than listening to the culturally derived and medically promoted fear that our bodies need doctors to mediate our experiences.