Last night at the Natural Birth Meetup in Fayetteville, we talked about different topics. The main topic of the night was Placenta Encapsulation, but it morphed into many other subtopics, as these meetings always do. I am always so refreshed to hear other women’s experiences, and to share some of my own. I felt compelled to share the experience I had with our OB when I was pregnant with Sydney, and during my birth. I stated that often, women do not ask the right questions, so this post is going to be a guide, of sorts, in dialogue form, to help you with the right questions to ask your provider.
The Wrong Questions:
Sally: I need to ask you some questions, do you have time?
Provider: Sure, (glances at watch).
Sally (feeling rushed and embarrassed for even asking): My partner/husband and I would like to do a natural birth, are you okay with this?
Provider: Of course.
Sally (feeling more confident, now): We would like to remain pregnant until 42 weeks, do you see any problems with this?
Provider: No, not really.
Sally: We would like to avoid induction, unless medically necessary, will you suggest medically unnecessary induction?
Provider: No, we do inductions that are necessary.
Sally: We would like to avoid c-section at all costs, do you have ways to help us do that?
Provider: Yes, we have many ways.
Sally: I would like to push in a different position than on my back, is this okay?
Provider: Sure, why not?
Sally: We request skin-to-skin bonding, where the baby is placed on my belly/chest immediately after birth, will you do this for us?
Sally: We would like for the cord to stop pulsating before clamped or cut, will you honor this request?
Provider: Um, sure.
Sally: (Feeling peppy and like she’s chosen the right provider) Thank you so much!!! We know we have chosen the right provider for us!
This line of questioning could go on forever, I could list so many more, but this line of questioning is all wrong. Notice how the provider does not say much, provides no detail, and really is not answering the questions. This is no indication of how the doctor might respond during birth. The questions Sally is asking are the right questions, but need much more detailed answers. She asks closed ended questions, or questions that do not require much more than a one or 2 word answer. So I will outline the correct line of questioning. This puts the ball in your court, and you can make a much more educated decision about your baby, your birth, and your provider or your place of birth.
The Right Questions
Sally: Dr. Moe, my pregnancy and birth experience are very important to me, so I would like to ask you some questions quickly (pulls out a sheet of paper and pen).
Provider: Um, Ok. (Sits)
Sally (feeling empowered and confident.): My husband/partner and I are preparing for a normal physiological birth (expound as much as needed: intervention free, few interventions, pain meds free, whatever you want to say), how many of the births that you’ve attended have been this way? And, how will you help me to achieve this?
Provider: (Slightly taken aback with this open ended question) Most of the births I attend at Candy Hill Hospital are medicated with epidural or some other form of pain management. I have only attended maybe 10 unmedicated births. I am willing to help you achieve this by allowing you to labor for as long as possible without intervention.
Sally: Okay… We would like to remain pregnant until 42 weeks, unless it is medically necessary to take action before hand. How many of your mothers have you allowed to continue being pregnant until 42 weeks? And what are your reasons as a provider for requesting birth sooner?
Provider: We generally don’t allow women to remain pregnant until 42 weeks, our cut off is 41 weeks. We don’t like women to continue pregnancy until 42 weeks because the risks of a larger baby/aging placenta/elevated blood pressure/etc go up.
Sally: (Red flags going up, immediately, she’s done her research): Okay, I understand your reasoning, and I’d love to see some written research to support this reasoning. But, in our case, we would like to request a non-stress test following 41 weeks to ensure everything is fine with baby and me, and to ensure that everything is going smoothly in my pregnancy so we can go until 42 weeks.
Provider: I guess we could do that, we will talk about it more as time gets nearer.
Sally: Sounds pretty good. Since we would like a normal physiological birth, we would like to avoid induction, unless medically necessary. What is your induction rate? And what are the reasons you induce?
Provider: Our induction rate is pretty high. We induce because the baby is too big, the baby is late, there are medical problems with the mom such as high blood pressure, diabetes, other issues, and to help the mother to be more comfortable.
Sally: Oh, ok. (Increasingly more uncomfortable with the answers her provider is giving) We would like to avoid c-section, unless medically necessary, first, what is your c-section rate? And, how would you help us to avoid c-section?
Provider: Our c-section rate is right along with the national average of 32-33%. We would monitor you and baby, to make sure that both are okay, and allow you your trial of labor, until it is deemed that c-section may be the best option.
Sally: (Thinks she may want to switch providers, at this point) All right… I would like to push in a position other than semi-sitting or flat on my back. How many births have you attended in which the mother was in an alternate position for pushing?
Provider: Since most of the patients I attend have had an epidural, we require the mother to lie flat during birth. I have not attended many births where the mother wanted to push in a different position, but I guess I’d be okay with it.
Sally: Okay. We would like our baby to come directly to my belly/chest following birth for immediate skin-to-skin bonding. Are there reasons you would not allow this? If so, what are they?
Provider: We generally take the baby directly to the warmer to do the assessments of the baby. While we understand skin-to-skin bonding is beneficial, we like to get the assessments done as quickly as possible so you can have your baby following. We could maybe do skin-to-skin bonding for a few minutes.
Sally: (Disheartened) Wow. Okay. We would like for the cord to stop pulsating before it is cut or clamped. Will you honor this for us? If so, why not?
Provider: We like to clamp the cord and cut it immediately, so the assessments can be done on the baby, and with the baby attached to the cord, we cannot do that. I guess we could do that so you could have a few minutes with your baby before we have to do the assessments.
Sally: (Feeling disheartened, discouraged, and frustrated, yet she knows she can switch providers) Thank you so much for answering these very important questions, we have some decisions to make.
Like I said, the questions are endless, and they all depend on what is important to you. In this line of questioning, Sally receives the complete picture of what her provider is like during labor and birth, and is able to make more educated decisions about whether she would like to switch providers.
Let me say something else, if you decide to switch providers, it is YOUR decision. You will not hurt feelings or step on toes, and if you do (Say this out loud to yourself), “IT IS MY BIRTH”. What happens at your birth should be the well thought out plans you’ve decided on, not that your provider has decided on.
My personal experience with this was much more like the first line of questioning. I can blame it on being a first time mom, being uninformed, or whatever I’d like it to be about, but what it came down to was I chose my provider for the wrong reasons. My neighbor at the time wanted a fully medicated birth, and said her provider was “really nice”. Well, most providers are really nice, they wouldn’t have much of a practice if they were ogres. So my decision was made because my neighbor, who wanted a totally different birthing experience than I did, suggested the doctor to me. If you want an intervention free birth, unmedicated birth, natural birth, normal physiological birth, however you want to describe it, DO NOT CHOOSE YOUR PROVIDER BASED ON THE CRITERIA OF “NICE”. Ask open ended, detailed questions that will require thought, words, and an indication of the actions your provider will take.
Also, remember that you may always decline any procedure. Simply say no, stand firm, and ask to sign a document saying you declined, if necessary. Again, I will say this, and again, I want you to say this out loud (let this be your mantra), “THIS IS MY BIRTH.”
Please share comments, experiences, input, whatever you want to say, myself and my readers would love to read it.
Thank you so much for reading. Have a beautiful day!
I read an article today that really lit a fire under my butt, made me extremely frustrated, and wanting to say a lot. The article was about how a member of the media “delivered” his baby at home, and how it was made to be so dramatic. This spurred me to think about my passion for birth, how much birth is made out to be an emergency, a medical event, or something that needs to be managed or fixed, and about how little truth women tell other women about how they gave birth. The natural birthing community is often shunned because of how people who had medicated births perceive the natural birthers’ stories as bragging. Come on, now, people! We need to hear more of the natural birthing stories, they often have so much more vivid detail than the medicated birth stories. Wonder why?! Because the women who give birth without the use of medication actually remember their births. That’s one reason, but I think that women who have given birth with the use of medication don’t necessarily want to tell the WHOLE story. I know that after I had my epidural (after not planning or foreseeing such a thing taking place in my labor), that I didn’t want to tell the details.
Now, please, don’t get me wrong, I know there is a time and a place for interventions such as medication to be used during labor. Sadly, though, these interventions have been so overused that now it’s a problem, a BIG problem. Women and babies are suffering, and some are dying, because of the overuse. Babies are being forced out of their mothers’ wombs because they are “too big”, “too late”, and for many other reasons that are not medically related, and this has affected their health, growth, and has caused some of them to die. Mothers are not being given time and patience to labor and birth, instead, they are put on hospital clocks, and often hurried along with the use of induction and augmentation drugs, which ends in cesarean sections. While cesarean sections are sometimes very much needed, they also have MAJOR risks, and repeat cesareans put women at further risks. Women are dying because of the overuse of cesarean sections. Yes, interventions are sometimes needed, I know that, but not routinely.
What we need to do, as a society, is expose women to what birth is intended to be. Make birth this glorious event, instead of an event that’s shrouded in dark mystery, with hints of disaster and doom. So here is what birth is, to me.
Like all mammals, humans are designed to give birth, and in most cases, women are able to give birth, with little or no intervention. There are many things that must happen within the body for labor to begin, one of which is that the baby must be ready. Because the woman’s body is so perfectly designed, with a flexible pelvis, that moves to accommodate her baby, birth is entirely possible. If a woman is able to let go of all fear, the muscles in her birthing body should work correctly, and a sort of birth dance happens, where muscles work together in perfect harmony, to help the baby move down, turn, maneuver to a perfect position for birth, and finally be born. The mother’s perineum, which is strong and muscular, if it has been massaged adequately in the weeks leading up to birth will stretch perfectly for the baby to make his entrance. The baby is so perfectly designed for birth, the skeletal structure is pliable, and the bone plates in the head (fontanels) are able to overlap each other to make descent into the vaginal canal, and out of the body possible. Much more happens in the body, cervical changes that include so much more than dilation and effacement, and oh how I WISH providers would teach this to their expectant couples! Hormones (specifically oxytocin, the love hormone) work in the body to drive off stress and fear, and make birthing easier, help the cervix to open, help the labor to progress, help the baby to be born, help the mother to BOND with the baby, and help the mother to feel protective toward her baby. Many other things in life produce oxytocin (love, like-minded women communing, intercourse, breastfeeding, etc). As I said before, this is the watered down version of what birth truly is, what it’s meant to be.
So let’s look at what happens when women do not go this route (for whatever reason). And let’s address that many women are told (by media, friends, culture, family, doctors, language, their own experiences, etc) that they are not capable of giving birth without the use of interventions/medications. Women who give birth with the use of interventions are mammals, still, there is no denying that, but different things happen in the body once medication and other interventions are introduced. The lovely love hormone, oxytocin, that I talked about above, when pitocin (artificial oxytocin), epidurals, and other drugs are introduced is cut off. This means that the lovey, floaty, euphoric feeling that some women feel during labor, that counteracts pain, is gone. What I didn’t say about the hormones in the body, above, is that these also help the baby, because what a mother experiences, so does the baby (if a mother is experiencing a comfortable labor, so is the baby, and conversely, is a mother is experiencing a painful pitocin driven labor, the baby no longer has a hormonal love cushion to protect him). Epidurals also cut off the oxytocin, and cause the baby to feel a much more painful labor and birth. And when mothers feel threatened in labor, their bodies stop working in perfect harmony, the cervix will not want to open (a protective instinctual mechanism to keep baby from harm), and labor stalls. The mother’s pelvis and baby’s fontanels still function, but once an epidural is introduced, babies often have to be born when their mothers are on their backs (the least conducive birthing position, because baby has to go against gravity to be born). This is the version of interventive/medicated birth that people often describe, without the “what happens in the body” mumbo jumbo. I will tell you more… Here is the part we often do not hear.
With pitocin, contractions, or surges as HypnoBirthing calls them, often feel like they never end. I’ve heard pitocin contractions described as one big one that never let the mother regain composure, catch her breath, and was extremely painful. So when we hear about inductions and augmentations, the whole truth is not being told, I fear. And with pitocin, epidurals are often right behind, because labor is so traumatic with pitocin, that it’s like cruel and unusual punishment to have pitocin WITHOUT an epidural. And with pitocin and epidural, especially combined, cesarean section rates rise.
With epidurals, tearing is a lot more prevalent, as is malposition of the baby (baby’s face not facing his mother’s back). Episiotomy (cutting of the perineal tissue) is more common as well. And here’s the kicker, because the mother is numbed, many things can be done, without her knowing anything is wrong (legs being cranked back so far that hip damage is possible, episiotomy, breaking of the bag of waters, or release of membranes as HypnoBirthing calls it, etc.)
Cesarean section is a major surgery that has a long and painful healing course. The art of VBAC (Vaginal Birth After Cesarean) is being lost among obstetricians, and so women who have primary cesareans are often put under the knife for no medical reason, other than the primary cesarean, for subsequent babies. And the hard truth about cesarean sections, though some of them are truly needed, is that some mothers die following surgery.
My own experience was not what I expected it would be, partly because of Sydney being turned “sunny side up”, with her head resting on my tailbone, which made my labor much longer than I’m sure it would have been. After 20 hours of unmedicated, unmessed with labor, I asked for an epidural, after having researched the risks and benefits. What I never anticipated was how it would affect me, how it still affects me now. Because I could not feel anything, my OB was getting my perineum ready for birth (which we had explicitly asked not be done (perineal massage) during labor, in our birth plan), and she tore me. My legs were cranked back to my ears when I was pushing, to “make more room for the baby”, and I still have hip issues today (stiffness, pain, loss of flexibility). After Sydney was born, I felt emotionally dead, all of my protective instincts I thought I would have were deadened by the narcotics present in the epidural. Bonding with Sydney was near impossible, and took at least a month, if not more. She had a poor latch to begin with, because of the drugs in her system from the epidural. Sydney cried incessantly for about the first month, and I’m convinced that she had some sort of birth trauma from not being cushioned by my cocktail of love hormones during labor and birth. I felt distant from her, and did not want to hold her, comfort her, and be with her, nor did I make an effort to learn how to. I could probably go on, but you might imagine that this tore at me as a mother, and still does. I don’t view myself as a failure at all, because at hour 20 of my labor, my body had reached a level of exhaustion it had never reached, and was ready to give up, and I was quickly heading for a cesarean. So as a mother, I look back on my experience, and want desperately to do better, do more, educate other mothers, help mothers, help babies, just speak about this.
My point in saying all of this is that birth is not supposed to be scary, dramatized, medical, or an emergency. When it is made to be these things, women lose their ability to think about what their babies might need, and instead think of simply getting through it. With interventions come risks and consequences (lower rates of bonding, harder times bonding, lowered protective instincts in mothers to protect their babies, lower breastfeeding rates, higher infant and maternal mortality rates, higher infant and maternal morbidity rates, birth defects, emotional trauma, physical trauma, and the list goes on). So here is my challenge for you. Research everything, if you’re having a baby, research everything (your provider, hospital, interventions, alternatives, birth plans, having a doula, how your partner can better support you, etc). And for those of you who have had beautiful experiences, PLEASE share your story (post it online, share it on Facebook, I’ll share it too!)!!!!
As always, thank you so much for reading this, and your input is always appreciated!
Recently, I’ve encountered some very real, natural life occurrences. And as I have encountered them, I have realized the similarities between birth and death, and realized there are huge, vast differences between the two as well. As I teach HypnoBirthing classes to excited expectant parents, I also know that there are people preparing for death. Everyone dies, but it seems that we, as Americans are so afraid of death, that we keep it a secret.
I’ve had a challenge in explaining to my daughter, who will be 4 this year, the realities of life. I don’t know how much she understands, but I am as honest as I can be, at an age appropriate level for her. I answer questions when she asks, while sometimes inside, I have questions too. It seems that in this past week, I’ve reached a level of comfort and clarity with the end of life. I’ve also discovered that I have almost as much passion for end of life issues as I do for birth.
I think this passion grows out of my Social Work background, and the belief that everyone has the right to dignity. At the beginning of life, mothers choose to birth their babies in a manner that is most comfortable to them. Dignity is present when mothers’ wishes are honored. At the end of life, many people prepare an advanced directive, decide what they would like to have happen, and how they would like to be treated. Dignity is present when the wishes of the dying are honored.
Sometimes, though, wishes are not honored. Many providers who care for pregnant women have a skewed view of what normal birth is, and so their methods do not mesh with the wishes of mothers. Many times, birth is hurried, labor is induced, babies are rushed, when this is medically unnecessary. A similar situation arises with the end of life, hospitals are so concerned with saving life, that even in situations where patients wish for no intervention, intervention is ever present. Advanced directives can be helpful, as can Do Not Resuscitate orders, but if they are not in hand, they cannot be honored. Procedures are performed to keep people alive, because a large part of the medical system is there to “fix” what is wrong. In dealing with birth and death, since they are both natural occurrences, there is nothing to fix.
I understand that we, as humans, are extremely selfish. We want our babies here NOW, and we want our loved ones to stay with us forever. The thought of saying goodbye is excruciating, but it is a reality that we must face. Allowing people to be born and to die on their own time is essential. It provides a balance to life, but it also provides dignity to those who are entering or leaving our lives.
With death especially, we must remember that there are some things that death has no power over. Death cannot change the love we feel and it cannot take our memories.
For those of you preparing for the birth of a baby or the death of a loved one, I pray for the wisdom for you to know that it will happen in its own time. I pray for you to feel the comfort of just letting things stay as they are, now. I pray for you to understand that you cannot control what or how it happens, though you may feel an intense need to. I pray for you to soak in every moment of waiting, allow it to saturate your very being. I pray for you to just be. Allow yourself to not rush or prolong what is inevitable, it will happen, and when it does, just breathe.
Think about the kind of birth you want for yourself, your birth partner, and your baby.
Take a birthing class.
Create a birth plan.
Talk to your provider at length about your wishes during labor and birth (if he/she does not agree or seem on board, switch providers/hospitals or both).
Be confident in what your body was created to do.
Be flexible in your approach to labor and birth.
Hire a Doula.
Talk to family about your wishes.
Create an Advanced Directive, detailing your wishes (on paper).
Decide on details concerning what will happen to your body, before you pass on.
Know that no matter how much everyone prepares, this will not be easy on anyone.
Have the confidence to express your details to those you love.
Determine whether Hospice would be a viable option for you in your final journey in life.
Talking to my friend online about her birth reminds me that there are different views of birth. There are the people who go to medical school to attend very medicalized births of frightened women who may or may not be prepared for the challenges of childbirth. These same people attend births that are largely medicated in one form or another, and because of this, they see this as “normal”. The women who give birth in this setting often have to fight for their birth wishes. Even if women don’t come armed with birth plans, some have desires that they would like met, but in the face of having to defend their wishes in the presence of staff, they give up.
The normal that the other group of people see is totally and completely different. We see birth as nothing short of a miracle. Birth is normal, it is natural, and it is healthy. Birth is meant to happen to women, and women were built to give birth. We grow babies that are the perfect size for our bodies. The normal birth that this group sees has every confidence in birth. Birth is not a medical event, and it certainly is not an emergency. The women who give birth among this group of attendees often simply drift through birth without a fight. These births are peaceful, calm, quiet (sometimes eerily so), and have a sacred feel to them. Women feel loved, at peace, protected, nurtured, and surrender to their birthing energy.
I love talking birth, probably more than anything else in this world (except for sharing stories about Sydney, of couse!). My passion comes out, I get fired up, and I want for others to feel what I feel about this subject. There are certain things about birth that anger me, some that make me so proud to be a woman, and some that just sadden me.
I think back to my own labor, when I felt totally in control. And even upon arrival at the hospital, in San Ramon, CA, I felt the same. The team of people I had supporting me was incredible. Never did anyone treat the impending birth of Sydney like it was an emergency, or even a medical event. I self hydrated, walked, did many position changes, had intermittent monitoring, and never heard a mention of my pain. Going through labor was a time in my life when I felt the most vulnerable, but knew I was so loved and supported. Sydney’s birth was at the very least challenging. But it was also a time that defined much of my life now, it was a time that empowered me, and bonded us together as a family.
Birth is a time when women must feel supported, loved, and vulnerable. Our birthing energy must be focused, intent, and committed. We must labor with conviction, with a knowledge that we can do this. Women who lose this energy, this conviction become easily steered in directions they may not want to go. This does not make them weak at all, it just makes their path to birth different, and sometimes a bit more challenging, and sometimes still, more dangerous.
The births that OBs and L&D nurses see are dramatized because of the environment in which they are. They are closely monitored, managed, and manipulated. These births are mere fragments of what births should be. Many of these births are not at all what the mothers or the babies want, but sometimes, mothers truly know no different. Often times mothers are convinced of what they should want because of stories they have seen and heard from others (friends, family, media sources, etc), which creates fear in them, and they lose confidence and are convinced they need anesthetic assistance to get through birth.
Medicalized birth certainly has its place, it has its time, it has its necessity. But it is not a majority of the time. Healthy full-term mothers have a right to be fully apprised of how their bodies function, and how to work with their bodies and babies to have a birth with as few interventions as possible.
So here are some of my suggestions for a healthier birthing experience.
Take ownership for how you want to give birth. Decide now, and follow through.
Eliminate the words “Delivery” and “Deliver” from your vocabulary. They allow you no responsibility as a birthing mother.
Create a birth plan.
Research, research, research.
Consider options you may not have considered before (home birth, birthing center, water birth, different hospital etc).
Choose a care provider that is completely supportive of what you want. If he/she is not, find another one.
Prepare for birth by taking a birthing class that fits well with you and your birth partner.
Believe in your abilities to give birth.
Hire a doula.
Be flexible about labor and birth, accept that some things in birth may shift a bit.
Envision your birth, just the way you want it to be.
Ask for positive birth stories only. Walk away if people share anything less.
Do NOT watch shows like Maternity Ward or A Baby Story.
Arrange everything ahead of time so when birthing time nears, your life is free of undue stress.
When labor begins, stay at home as long as you are comfortable.
Have a happy, healthy, and safe birth.
Take time following birth to talk about your birth to a person who respects you and will not judge.
Do not feel like a failure if you chose to have interventions that you previously thought you would not. You are NOT a failure.
Sydney’s friend’s mother asked me the other day how I came to this profession. No one had ever asked me that, and I guess I’d never really told anyone. The truth is, if someone had asked me what I was going to do with my life, I certainly would never have thought that I’d be doing THIS. In fact, at the age of 18, with the world before my feet, I ventured off to college in Greensboro, NC, where I was ready to take on the world. Social Work was my major, and I wanted to be a Marriage and Family Therapist. Today, I do not believe that’s where my gifts and passions lie, nor do I want to do anything like that.
But, it was in college that I first heard about HypnoBirthing, and became dedicated to a gentle birth for my future children. Little did I know that I’d become a HypnoBirthing Childbirth Educator. It was in 2007, when I was with my mother in Babies R Us at a Breastfeeding Fair, which was meant to be a pitstop on the way to Barnes and Noble to buy the HypnoBirthing book, because I had no idea that there were classes to help me along my journey to the gentle birth. As I was filling out a raffle to win all kinds of baby items, I happened to glance at a sheet of paper that had the word HypnoBirthing on it. I picked the piece of paper up, and saw that classes were offered in my area, so I flagged down the manager and asked where the distributor of the flyer was. I was directed to Nicole, who taught my HypnoBirthing classes, attended our birth, and continues to be one of my friends.
Fast forward to my labor and birth. July 16, 2007, at about 5:30pm, I began to feel the first of the surges, accompanied by diarrhea. They began at 20 minutes apart, sped up to 10 minutes apart (which is when I ate dinner), then accelerated to 3 minutes apart upon entering the bath tub to relax. My mother in law informed my husband that I was in labor upstairs in the tub, and that I was surging at 10 minutes apart, so when my husband came into the bathroom and heard me say, “I think it’s time to go”, imagine his shock. About an hour later, we were on the way to the hospital, and were soon checked in. We had Birth Preferences that were given to the nurse who would attend, and I was given the privacy to labor, with intermittent monitoring, vaginal exams only at my request, no mention of moving or hurrying things along, and freedom from an IV. There were no references to pain, only to comfort level and how it could be improved, and my team was with me (husband, mother-in-law, and Nicole).
Relaxing during labor
As labor continued, exhaustion began to set in, and my focus became diverted to what was beginning to be translated as discomfort, and my relaxation was dwindling. Position changes, sitting on the toilet, moving, walking, squatting, swaying, moaning, breathing, swaying, moving, moving, moving… Baby come out. At hour 17 of labor, I said I needed “help”, and everyone in the room knew what that meant, but no one acknowledged it, they instead encouraged me, stayed with me, loved me, comforted me, took me on the journey of labor. At hour 20, all relaxation had left, and I again spoke of needing “help”, and out of exhaustion, cried and begged. Jeremy and I talked about it, and I told him I could not get our baby out of my body without first resting, and I was getting none with my extreme exhaustion and surges that were doing their job.
At hour 20, when help was requested, I was 10 centimeters open, but our sweet baby was not moving, no progression, just sitting there, and at hour 20, the nurse told us our baby was “sunny side up” (OP – Occiput Posterior, back of baby’s head on my back, not the optimal position for birthing a baby). We tried one last position to get the baby to drop out of my pelvis so she could reposition correctly for birth, but to no avail. Shortly after, help was delivered, and I drifted in and out of sleep. I rested, and eventually was awakened so our baby could be born. The doctor arrived, and was extremely hurried, so much so that the understanding nature, beautiful bedside manner were all gone. Instead, the person who sat with her fingers in my vagina, stretching my perineum was a stranger to me. Because of being medicated through epidural, I was not able to feel my natural impulses to aid my body in birthing my baby, so I had to use forced pushing. About 2 and a half hours after beginning to push, our beautiful Sydney was born.
Skin to Skin Bonding
It was at that very moment that my life changed, and I know everyone says that, but a shift took place in my life. We had never known that we would have a girl, and at that instant that she was there on my naked skin, something in me began to heal. Years of tattered relationships with women in my life, years of hurt from my own relationship with my mother, years of anger toward her, years of not forgiving her, years of pain, were welling over with a healing power I had never experienced. It was at that moment, when I looked at my daughter, that I knew my role as woman had been defined. I felt an overwhelming sense of appreciation and love for her.
It was not until much later that I decided I needed to help women to give birth in a conscious, gentle manner. I am so thankful I’ve made this choice, and so grateful for the support of my Sydney and my husband to do what I am so passionate about. For me, birth was my defining moment, it was when I’ve felt strongest in my life, it was when I felt most empowered, most in control, and above all, I knew my body was built to give birth. Never in my mind was there a doubt about my ability to birth my baby vaginally. Sydney’s birth is the reason I do what I do today, it is my reason for looking forward to doing it all over again when I’m blessed to do so. It is the reason I tell women and their birth companions that they can do it, that they are made to do it, that it is normal, natural and healthy to give birth freely, gently, consciously…
The births I have attended as a doula have all reaffirmed my belief in the power of birth. I’ve witnessed as women became women, men became men, and they together became parents, nurturers, providers, givers, unconditional lovers of their new little life that they created together.
I do this because it has to be done, I do this because Sydney’s birth guided me to it, I do this because I believe in my entire being that women have a right to know they can give birth gently, I do this because women are powerful beings, I do this because I love it.
Birth changes me everyday.
A very special thanks to the couples who have welcomed me into their births, and to my Sydney who is the catalyst for this change. You’ll never know how much this all means.
My goal for 2010 was to complete doula training. This goal is under way, because of a suggestion from a lovely midwife I know who suggested toLabor, a doula training organization, previously known as ALACE. So beginning this Friday, June 25 until June 27, I will be completing my doula training workshop in Virginia. toLabor’s training allows me to use the two (soon to be three) previous births (prior to the workshop) that I have attended to count toward my total of six that I must attend to become certified as a birth doula.
I also have some fantastic books that I am in the process of reading. To see this list of books and the other certification requirements, click here.
Since last posting, I had the opportunity to attend a birth at a local hospital. This mother was one of my HypnoBirthing moms, and she was facing a deadline of 41 weeks (the hospital’s policy is to give birth before 41 weeks, or an induction will be ordered), and instead, went into labor the day before her induction date. She did a fantastic job of getting all the way through her labor, while using the support of her husband, her friend and me. Her baby boy was born early on the morning of the 9th, and was completely unmedicated. Beautiful reason to want to be a doula.
I will be offering “in-training” doula rates as I complete my training, so if you’re interested in being one of my six births, please contact me! I am not completely sure of how much the rate will be, but I will post that after I complete my workshop.
Please share this blog post with the people you care about… Whether they breastfed or formula fed. The information must get out there! Help me raise awareness.
This blog post is written in honor of Melissa Taylor. You truly inspire me.
As I was awaiting my daughter’s arrival, in 2007, I distinctly remember telling EVERYONE I knew that I intended to breastfeed. My reasoning behind this, was because I knew that many women face challenges with breastfeeding, including stigma, soreness, blistering, bleeding, mastitis and more, and I wanted to be successful at nursing my daughter, until she was ready to wean herself. I also knew that if I had the support of my friends and family, that my rate of success would be greater than if I didn’t have any support. The more education and support a woman receives, the more successful she will be at nursing her baby.
Sydney was born, and I had some challenges, because of a poor latch, and the information I received from the hospital was conflicting. One nurse would tell me to do it one way, while another nurse would inform me of another way that didn’t make sense. In the end, I left the hospital not feeling well informed, and at the one week mark, I could not nurse from my right breast, because of blistering. I called my friend Maggie who had successfully nursed her daughter, and she brought a book to me, and helped Sydney achieve a proper latch!!! I was so overjoyed. I knew I would be successful at nursing.
Breastfeeding, for me was full of joy, and the bond that Sydney and I developed was incredible. She self-weaned at 13 months of age, and between birth and 13 months, we had quite the journey. Breastfeeding in America can be filled with negativity toward the mother, and people think breastfeeding is somehow strange.
Melissa Taylor, of Tampa, Florida was told recently that it was inappropriate to nurse her two year old daughter in the lobby of her daughter’s school. As I read this story, and learned more about the challenges she was facing, I became incredibly angry at how misinformed and ignorant people sounded as they responded to one particular online news story.
How is it that breastfeeding is an issue at all (much less breastfeeding in public)?! Are there not bigger issues than breastfeeding? And where do these issues come from? Are people offended by the act of feeding a baby from a body part that has been so over-sexualized in our society, and/or is it that women have been so marginalized and sexualized that breasts are now viewed exclusively as sexual objects? Should we not be fired up and angry that an estimated 16.7 million children do not receive adequate nutrition and often go to bed hungry in America?!And equally, should we not be infuriated that children are experiencing obesity at alarming rates?! There are huge, monumental problems having to do with food in the United States, and breastfeeding should not be included in those problems.
According to the Centers for Disease Control and Prevention, 73.9% of all American women begin breastfeeding. By three months, only 33.1% are breastfeeding exclusively, and the rates drop off as the time progresses. At 6 months, 13.6% of all moms are still breastfeeding exclusively, and 43.4% are breastfed with other forms of nutrition also being given. At 12 months of age, 22.7% of mothers are still breastfeeding. To read more, and see the CDC’s statistical data, please visit their Breastfeeding page. Please also view your state’s breastfeeding rates; click here.
Obviously, with these statistics, there is a disconnect. So much is fed to women, about parenting in general, but breastfeeding especially seems to have a lot of societal stigma attached to it. Along with stigma, there is misinformation, a lack of education, and a lack of support of new mothers to breastfeed. It seems easier for new moms (according to the results of studies and evidenced by the statistics of the CDC) to move to formula as their babies’ nutrition. Infant formula companies make a killing yearly, and spend extravagant amounts of money to market their product to families. It is suggested by formula companies that the second choice behind breastfeeding is formula, but this is untrue. The second choice is breast milk expressed in some way and then fed to the baby, the third being the human breast milk of another mother, and the last choice is formula feeding.
BARRIERS TO BREASTFEEDING
In the United States, 98%-99% of all births take place in hospitals, and our maternity care system has protocols and policies in place that are not evidence based and will either help or hinder (most of the time hinder) the breastfeeding initiation. For instance, it is well known that medications during labor affect breastfeeding (if a baby is lethargic because of drugs in his or her system, latching on may be nearly impossible). Separation of mother and baby is also known to hinder breastfeeding (no skin-to-skin bonding) (Please watch the video below concerning breastfeeding and the effects medicated birth and separation have on the baby’s ability to breastfeed). And what about hospitals sending formula home with families “just in case”. The first 24 hours is vitally important to establish a breastfeeding relationship, and it’s a shame that protocols of our maternity care system often retard this relationship.
There seems to be a huge lack of support and education surrounding breastfeeding. Because people do not know anyone who did it, and they may not know where to turn for resources and help, it becomes easy to look to what is familiar.
Our schools do not teach about breastfeeding as a normal, natural and healthy way to nourish our children. In the case of Melissa Taylor in Tampa, Florida, it was clearly seen as inappropriate (I’m guessing viewed as sexually inappropriate) in the lobby of her daughter’s school.
Women often think that since they were not breastfed, they turned out “all right”, and don’t need to breastfeed their children. Can you think of the potential in our society if more children were breastfed?! And what about the potential of the moms who turned out “all right”, could they not have been fantastic, incredible, genius, unbelievable, instead of just “all right”?
Formula companies so vigorously market themselves, that their ads are appearing as “breastfeeding help” on webpage and blog ads. Can you imagine the effect this has on a desperate mother who is not firm in her breastfeeding relationship? It is intentional misleading advertising by the formula companies, but they profit hugely from it. Please visit the following site to learn more about this misleading information. PhD in Parenting – Sabotage
I spoke to an expectant mother about whether she will breast feed or formula feed. She stated she would formula feed, to which I asked some questions. Here is what she told me: she does not know anyone personally who breastfeeds or has breastfed, she was not breastfed as a baby, nor were her siblings, she thinks it will be difficult and inconvenient to breastfeed/pump as she continues with college. And my guess is, because she knows no one that has breastfed, there is little support and education about breastfeeding in her community, and in her direct environment. (While this is her choice to formula feed, because of lack of education and support about breastfeeding surrounding her, it is a largely uninformed decision. Most of decisions made out of lack of support and education are made out of fear. Mothers who are in this situation are not to blame, instead, we must look at who is accountable for the lack of education and support concerning breastfeeding, and also at the huge formula companies that market their product in a seemingly appealing way.)
We live in a society of instant gratification, and formula feeding caters to this society. While breastfeeding proves to be much easier in the long-run than formula feeding, the hump women have to get over to get there is not instantly gratifying to most women. So, because of lack of support, education, and confidence to push through the challenges of breastfeeding, they choose to formula feed.
THE COST OF FORMULA FEEDING
Childhood obesity is on the rise. According to Breastfeeding Fights Obesity, in Atlanta, it is estimated that 15%-20% of obesity could have been prevented by breastfeeding.
Childhood illnesses and diseases (ear infections, diarrhea, asthma, respiratory problems, SIDS (Sudden Infant Death Syndrome), Type-1 Diabetes, multiple sclerosis, breast cancer in girls, Hodgkin’s Disease, Juvenile Rheumatoid Arthritis, Gastro-esophageal reflux disease (GERD), urinary tract infections, vision problems, tooth decay, to name quite a few) that are preventable by breastfeeding account for $3.6 BILLION in insurance costs by both public and private insurers. This doesn’t only effect insurance costs, but also effects the amount of time mothers of formula fed babies spend out of work (which then accounts for the additional health claims made by employers).
Not breastfeeding can cause health problems in the mother, to include: excessive bleeding after giving birth (this is caused because oxytocin is not produced to help the blood vessels in the uterus clamp down properly), ovarian cancer, breast cancer before menopause, for mothers who had gestational diabetes, the risk of developing type 2 diabetes is higher, and osteoporosis.)
Formula feeding also has a HUGE impact on the environment! Not only does it contribute to factory farming and the waste that comes from that, but it also creates a lot of pollution because of the packaging of the product.
MISLEADING FORMULA ADS
If the costs of formula feeding are not enough to convince you that breastfeeding is a more nutritionally sound and superior option, please consider the following. Formula companies have made bogus claims about the superpowers of their products. Sure, I understand that they need people to buy formula, but to misinform the public is criminal, and frankly, for you formula moms out there, you should be OUTRAGED! One such company is Mead Johnson, the company that manufactures Enfamil. Mead Johnson has been caught making bogus claims about their formula FIVE times (and lost 3 federal lawsuits concerning these bogus claims), with the latest claim being that theirs is the only formula that promotes brain growth and eye development. Enfamil Premium has NOT been proven to be superior to other formulas in the performance areas suggested. On the contrary, all formula companies receive their ingredients from the same supplier. Refer to Strike Five for more information about this.
Breast milk will always be the best, most nutritionally sound first food for your baby.
Breastfeeding provides a lower risk of SIDS (Sudden Infant Death Syndrome). Hugely important reason to consider breastfeeding if you are not right now!
Infant mortality rates in the first year of life are reduced by 21% in breastfed babies. (Again, epic reason to consider breastfeeding).
Breastfeeding enhances the effectiveness of some vaccinations.
Immune system booster through white blood cells provided through breast milk help to fight off infections.
Reduction in the diseases and illnesses listed above in bold and italics.
Less environmental impact (no waste associated with packaging). Does not contribute to factory farming and the pollution associated with that.
Lower private and public insurance costs for families who breastfeed. (Less work missed, too).
Reduction in the risk of type 2 diabetes.
Reduction in childhood cancers (Hodgkin’s and leukemia)
Reduces high blood pressure, obesity, and bad cholesterol levels later in life.
Eczema and asthma rates are lower in infants who breastfeed exclusively for 4 months.
Lowered incidence of bowel disease (Crohn’s Disease, ulcerative colitis)
In premature babies, breast milk helps the brain stem to mature.
In premature babies, hospital costs and the length of stay are reduced significantly as well.
For the mother, less bleeding following birth, again, because of the oxytocin levels.
In some, but not all women who breastfeed exclusively, delayed ovulation and menstruation for up to 20-30 weeks. This is nature’s way of caring for the baby, and protecting the bond between mother and baby (thus ensuring the survival of the species).
Bonding is enhanced with mothers who breastfeed (again, oxytocin, and there is a special, empowering feeling of sustaining life through breast milk that mothers produce.)
Lowered risk of heart disease, type 2 diabetes (in women without a history of gestational diabetes), pre-menopausal breast cancer, and ovarian cancers. These risks lower the longer a woman breastfeeds.
HOW LONG CAN/SHOULD BABIES/CHILDREN BE BREASTFED?
According to the La Leche League’s website, the World Health Organization (WHO) recommends breastfeeding babies exclusively for six months, and for two years or more beyond that, coupled with a nutritionally balanced diet. The page I found on the La Leche League’s website is super informative, and for that reason, I will use their quotations, because there is no possible way I can state better what they have so clearly stated: (La Leche League – Breastfeeding Toddlers)
A breastfed baby is dependent on his mother for both food and comfort. This may frighten people in cultures that place a high value on self-sufficiency. A breastfed baby will not be satisfied with anyone other than his mother, and therefore may be regarded by some as a liability, when in fact, a baby simply knows what he needs for his own good.
Some cultures fear that continuing to breastfeed until a child weans on his own will make him more dependent on his mother. Instead of viewing extended nursing as something to question, perhaps the real query should be, “What is there to be gained by abruptly putting an end to the breastfeeding relationship?” It’s interesting that some people think that a child won’t grow out of breastfeeding unless he is forced. In reality, it’s a natural process for children to outgrow breastfeeding on their own. Independence, not dependence, is one outstanding trait that breastfed children who self-wean have in common (Ferguson 1987).
The benefits (for the toddler) of breastfeeding toddlers are huge. Breastfeeding toddlers enriches all of the following areas: Immune system health, Oral development, IQ score, Independence, and Self-Esteem. Again, I am quoting the La Leche League’s website, because the information is so complete (La Leche League – Breastfeeding Toddlers):
Human milk is the primary source of nutrition during a baby’s first year. It becomes a supplement to solids during the second year, but it maintains nutritional value, as well emotional benefits for toddlers.
Immune system: It takes between two and six years for a child’s immune system to fully mature. Human milk continues to complement and boost the immune system for as long as it is offered (AAP 1997; Goldman 1983; Gulick 1986; Mohrbacher and Stock 2003; Saarinen 1982). Research on the incidence of illness in breastfed or weaned toddlers reflects these dynamics. Breastfeeding toddlers between 16 and 30 months old have been found to have fewer types and shorter duration of illness and to require less medical care than their non-breastfeeding peers (Gulick 1986).
Oral development: Breastfeeding provides a natural outlet for non-nutritive sucking that promotes proper oral development, which has been found to improve speech (Davis 1991; Labbok and Hendershot 1987; Broad and Duganzich 1983).
IQ score: Extensive research on the relationship between cognitive achievement (IQ scores, grades in school) and breastfeeding has shown the greatest gains for those children breastfed the longest (van den Bogaard 1991).
Independence: The process that children go through while growing toward independence is a difficult one. Breastfeeding can provide feelings of love, comfort, and protection. When a mother makes herself available to nurse her child through a situation that he can’t handle alone, he will likely develop independence based on faith that mother will be there to help. As a child gets older, there are fewer and fewer such situations. Provided a child isn’t prevented from exercising his developing capabilities, independence comes with his increasing competence (Bumgarner 2000).
Self-Esteem: Babies and young children nurse when they are lonely, frightened, or in pain and responsive mothering through breastfeeding leads to enhanced bonding. Allowing a toddler to nurse (or wean) at his own pace is an expression of trust that contributes to his self-esteem.
Breastfeeding toddlers also benefits the mother too! These are some of the advantages for mom: Stress relieving qualities to nursing a toddler, bonding quiet time during hectic days, decreased disease risk (pre-menopausal breast cancer for women who breastfeed children for several years, a reduced risk of osteoporosis), and decreased fertility during nursing relationship (lactational amenorrhea) (La Leche League – Breastfeeding Toddlers).
Parenting is an exhausting business. When a mother says how tired or stressed she is, some people may point to breastfeeding as the culprit. In reality, there are many benefits of extended nursing to mothers, some of which include:
Stress relieving qualities: Breast-feeding suppresses the nervous system’s hormonal response to stress, which is why many mothers recognize that they feel calmer and better able to cope with whatever comes along while nursing.
A few guaranteed calm moments in a day: Parenting can be hectic. Toddlers are bursting with energy and find a lot of interesting things to keep them busy. There are times — however brief — when a mother can count on breastfeeding to provide soothing quality time to calm an upset toddler or to reconnect and bond with her child.
Decreased risk of diseases: One study found a decreased risk of breast cancer among breastfeeding mothers, with the greatest risk reduction seen in women whose total amount of breastfeeding for one or more children totals several years (Collaborative Group on Hormonal Factors in Breast Cancer 2002). A mother’s risk of osteoporosis (and other diseases) is also reduced by extended breastfeeding (Gwinn et al. 1990; Hartge et al. 1989; Rosenblatt, Thomas, and WHO 1993).
Amenorrhea: The amount of natural infertility experienced while breastfeeding is known as lactational amenorrhea. Many mothers experience reduced fertility when nursing past a year, with some women going as long as two years or more without menstruating.
Even after the time during which nursing alone is a reliable contraceptive has passed, many mothers continue to enjoy freedom from menstruation and from the physical and emotional effects of ovulation and menstruation” (Bumgarner 2000).
The following is also from the La Leche League website, concerning myths about extended breastfeeding.
Myths about Entending Nursing and Late Weaning
Myth: A child will never wean on his own.
Fact: Children grow and change dramatically in the first several years of life, and their interest in nursing changes as they do. Children want to nurse only as long as it fills a need for them. Sometimes this need will last for several years, sometimes far less. A need that is filled will go away.
Myth: A child who is still nursing is too dependent.
Fact: Toddlers have many needs that linger from babyhood, including the need to cuddle, the need to be comforted, and the need for help when falling asleep. These needs are all naturally met through nursing, and it is a wise mother who recognizes and honors her child’s need to be dependent. Trusting the child in this way builds self-confidence needed for later independence.
Myth: Extended nursing is a sign of sexual problems.
Fact: Children who nurse for several years do not appear to be affected in any way in their sexual development. They may actually grow up to be more comfortable with their bodies and with relationships.
Myth: An older nursing child won’t learn self-comforting skills.
Fact: Giving your child the comfort of breastfeeding is actually the best way to teach self-comforting skills in the long run. It is from this early relationship with you that he learns much about his needs and how to get them met in constructive, self-initiated ways.
Myth: Prolonged nursing is too fatiguing for a mother.
Fact: Many mothers find that nursing is one way they are able to rest, since nursing assures that there are a few times in every day when the mother can put her feet up and relax with her child.
Myth: The longer you wait to wean, the harder it will be.
Fact: As children get older, encouraging weaning often gets easier, not harder, since older children have a greater ability to reason and a wider repertoire of interests. When your child is ready to wean, it will be easy.
Myth: It’s better to wean suddenly and get it over with.
Fact: Weaning slowly is one of the many areas in your relationship with your child where going slowly pays off in the long term. There are no instant fixes that don’t have a cost. By weaning gradually and employing gentle techniques, you will maintain your child’s inner security and trust for you.
Myth: A mother who nurses an older child is doing it to fill some need in herself.
Fact: Many mothers explain that their satisfaction and pleasure in nursing declines as the child gets older, and if they continue to nurse, it is primarily because it is important to their child. Older children are usually not coerced to nurse, they are allowed to nurse.
Source: Bengson 1999
The following are stories that have influenced the breastfeeding relationships between mothers and their babies. These stories are both positive and negative. It should be noted that if a woman has not established a positive nursing relationship with her baby, negative comments have a HUGE, GIANT detrimental impact on the nursing relationship. Mothers who are well established in breastfeeding often use negative comments as fuel for their fire to continue, and/or seek to educate the person who is making the negative comment.
My husband’s family was so incredibly welcoming, accomomdating, loving, and kind as I established my nursing relationship with Sydney. If they entered the room while I was nursing, they praised me, smiled at me, and never made a big deal out of it. They knew I was feeding my baby, and it was extremely normal in their home. My husband was nursed as a baby, as was his brother. On a couple of instances, his grandfather walked into the room, and I tried to cover myself with a blanket, he was so kind to tell me that was not necessary. After that, I felt so comfortable with nursing.
My grandmother, who is a southern lady and thinks modesty is important encouraged me not to nurse in public. While I appreciated her point of view, I knew that if Sydney was hungry and needed to nurse, no matter where we were, I was going to nurse her. I always felt the need to use a nursing cover when I was out in public, and I realize now, that I brought much more attention to myself than I would have if I had just simply nursed her without it.
A young female soldier at Ft. Bragg, one day, in a food court laughed and pointed at me as I nursed Sydney. I continued to nurse Sydney, but I remember being very uncomfortable and self-conscious about nursing her.
Sydney’s pediatrician, whom we respect and like, told us at 8 months of age, that she was not growing properly, and that she needed to be put on formula to gain weight. Being a new mom, and not knowing what to research, or even where to start, I started her on formula. (She still did not gain weight). I argued the point that she was breastfed, that she has two petite parents, and that she was on par developmentally in every other area, and still this made no difference to the pediatrician. Sydney still is small for her age, so the amount of nourishment she was receiving had little to do with her growth curve, instead it had everything to do with the medical community needing to chart, graph, and compare her to every other child, based on formula fed babies’ growth curves.
A lady in a restaurant stopped to ask questions about nursing, and my nursing cover. She thought it was a wonderful gift that I was giving to Sydney. I, of course, agreed.
I am 37, and currently breastfeeding my second son, Braden (he is turning 1 this weekend). He was born without meds in Virginia. I breastfed my first son, Bridger, until he was a few months shy of 3 years old (by that time it was mostly nap/bed time). I received a lot of questions from girlfriends, funny looks, back-handed comments… Mostly “Sharon, are you STILL nursing him?” or “When are you going to STOP nursing him, Sharon?”
I was surprised my well-educated peers, friends, and neighbors are skeptical about extended breastfeeding. They have MBAs, one is a lawyer, one is an IT manager, they are married to doctors — WHY do these women think an extended breastfeeding relationship is strange? That I am codependent on my baby? Why are we so willing to get degrees and become educated in other areas, but FORGET what’s natural?
Surprisingly, I found perfect strangers to be less difficult. For instance, in stores, such as Target or Wal-Mart, I would tell the dressing room attendant, “I need to nurse my baby, would be it be okay to use a room?” and most of the time never even saw a raised eyebrow.
SO WHAT CAN I DO TO INCREASE AWARENESS?
Write to your local legislature concerning breastfeeding.
Learn more about your state laws about breastfeeding.
Write to your local school, school board, all the way up to the Department of Education to inform them of the importance of breastfeeding being taught in schools, and of a breastfeeding policy in schools.
Educate the people who make negative comments.
Teach your children that breastfeeding is appropriate, normal, natural, and healthy.
Write to your local hospitals and encourage them to stop passing out formula to every woman who gives birth.
Become a lactation consultant, counselor, or even just a friend who is helpful to new breastfeeding mothers.
Pass on information, literature, education, support, etc to those new to breastfeeding.
DID YOU KNOW?!
Breastfeeding often does not cause breast sagginess. Genetics, age, the size and consistency of the breasts, and the actual pregnancy (or multiple pregnancies) have more to do with it than breastfeeding. So if you’re thinking your breasts might be ruined if you breastfeed, this will depend on several factors, not the breastfeeding itself, so go for it, it’s for an excellent cause.
The United States has one of the highest rates of babies being fed infant formula in the world!!!
It is entirely possible to breastfeed AND work a full-time job. One of my best friends has been doing it for the past 16 months. She is one of my heroes, she breastfeeds when she is with her little girl, pumps for when she won’t be available, and works a full-time job.
Breastfeeding burns up to 500 calories per day!!!!!!