Categories
Birth Pregnancy

Natural Sacred Birth

Natural childbirth for healthy, low-risk women is the only natural function of the human body that typically occurs in the hospital. “Why is that?”, you may ask. Because our culture has co-opted Birth, babies, and women’s bodies for the benefit of capitalism – Big Pharma, Insurance companies, and Hospitals – the Trifecta of the medical-industrial complex. That is the only reasonable explanation as Women’s bodies have been successfully birthing live babies for literally millennia – else how would we be here? Birth has only been happening inside hospitals for about one hundred years and studies have shown that it’s safer to birth outside the hospital to avoid the unnecessary interventions that lead to worse outcomes. 1,2

Doctors are taught to fear birth

Medical schools have also contributed to the situation by instilling a climate of fear surrounding Birth mostly related to potential litigation. They believe that if the doctor is taught how to control birth, then they have control over being sued. In addition, natural birth is not taught to OBs because their focus is surgery. They are surgeons; the interventions they advocate frequently lead to surgery, and this is where they shine. Obstetricians are surgeons and if you are seeking the care of a surgeon, you are likely to have surgery. Very simple.

Birth cannot be controlled

Interventions in childbirth give the illusion of control over a natural bodily function that cannot be controlled. Women’s bodies will open and release the baby inside when the body and the baby are ready. This is normal, natural childbirth in a nutshell. Even the women doing the opening and releasing have no control over the process. The only control that is possible and productive is the act of surrender to this most basic bodily function. When a woman is able to fully surrender to every aspect – when and how – then when her body and the baby are ready, it will happen. The more surrendered a woman is to the process, the more efficient it is.

Thirty-eight percent cesareans in Palm Beach County

Our community (and there are many like ours) has not embraced this principle. It is very typical for women to be induced at 38 or 39 weeks of pregnancy for a myriad of reasons. We know that when labor is induced before the body and baby are ready, then things can go wrong. The body may not fully dilate no matter how much cervical ripening is chemically encouraged or how much Pitocin is given. Often the baby will not be able to tolerate the cocktail of chemicals involved between the induction drugs and the inevitable epidural. A woman may enter the hospital wanting a natural birth, but very few are able to tolerate the torture of hours of fasting, limited mobility and abnormally strong and consistent contractions, not to mention the flow of strangers into the room, the bright lights, uncomfortable bed, etc. An epidural is the only relief she can get in the hopes of maintaining her dream of vaginal birth. Palm Beach County has an average Cesarean rate of about 38%. That’s more than 1:3 women walking into the hospital expecting a vaginal birth and ending up having surgery to have their baby!This is NOT because Birth is dangerous. This is because our community has a culture of meddling with an otherwise normal, natural process. And that meddling leads to dangerous birth.

ACOG supports VBAC

The national organizations that oversee and regulate birth providers have reasonable recommendations regarding things such as vaginal birth after cesarean and breech birth. But the local OBs tend to disregard these reasonable and evidence-based recommendations. One example of how our local OB community rejects recommendations by ACOG (American College of Obstetricians and Gynecologists, the national organization for obstetricians and gynecologists), is with VBAC (Vaginal Birth After Cesarean) candidates. ACOG recommends that doctors offer vaginal birth to women who have had 1 or 2 previous cesareans. They also don’t recommend inducing labors for VBAC candidates. Yet many OBs in our community still recommend repeat surgery for these women or insist that they birth by 39 weeks. They routinely induce VBAC candidates at 39 or 40 weeks which can lead to the very complication that they fear – a ruptured uterus. Also, there is no solid evidence that a woman with more than 2 cesareans is not a good candidate for a VBAC, but there are very few OBs that are willing to “allow” these women to attempt a vaginal birth.

ACOG supports out of hospital birth

Another example of how our community defies the national recommendations is through a document is known as The Levels of Care document that was endorsed by both ACOG and SMFM (Society of Maternal and Fetal Medicine, the obstetric specialists). In this document, it is recommended that all healthy, low-risk women birth outside the hospital in Birth Centers. If the situation changes, the woman is transferred to a higher level of care – one where the ability to perform a cesarean or other interventions such as Pitocin or epidural is available. There are even higher levels of care such as Intensive Care where caring for someone who is on life support machines is available and not all community hospitals have this option for women during or after childbirth, so she would have to be transferred from the lower level hospital to a higher one. The idea is that we have lots of birth centers, less of the community hospitals and only one or two regional centers to care for the very complicated cases. However, our local OBs do not encourage their healthy, low-risk women to birth outside the hospital. Rather, they look for reasons to elevate a woman’s risk and encourage interventions such as unnecessary inductions.

Birth is sacred

Birth is a sacred event that happens to each of us only once as we enter the world. How it happens is important for the one being born and for the one giving birth. If we are going to see a world that is healed from all of the devastations of poverty, war, climate change, and abuse it has to start with how we care for those giving birth and being born. I have grown up in my Midwifery career hearing the saying that ‘Peace on Earth begins with Birth’. We have to honor the process and respect both mother and baby by not causing pain and trauma but rather supporting, facilitating, and protecting the process. This can happen more easily out of the hospital in a woman’s home or in a birth center. However, I have not given up hope that we can shift the culture of childbirth within the hospital by spreading information and demonstrating a better way. We do this by supporting birth centers and encouraging the growth in the number of birth centers in our community.

Support the ‘birth’ of Gentle Birth Centers

I’m happy to announce the addition of a new birth center in Wellington – opening soon. Gentle Birth Centers will be teaming up with Midwife360 to create an integrated practice of home, birth center, and hospital care for healthy, low-risk candidates. We plan to open this spring and are located within a mile of the nearest hospital. Let’s change birth together!

Categories
Pregnancy

Birth Similar to Love Making?

Pregnant couple relaxing on bed at home

Birth Similar to Love Making?

Pregnant couple relaxing on bed at home

Birth Similar to Love Making?

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Natural Sacred Birth

Natural childbirth for healthy, low-risk women is the only natural function of the human body that typically occurs in the hospital. “Why is that?”, you

What to Expect From a Home Birth

So you’ve decided to have your baby in the comfort of your own home. What should you expect? As a CNM who has provided home birth services for nearly 6 years, I am going to provide you with an overview of the general expectations that await you in this experience.

What to Expect from a Hospital Birth

What happens when you choose to have your baby in the hospital? The specific answers to this question depend on whether you are sent there for induction or are arriving in labor. It also depends on your planned mode of birth – vaginal or cesarean. We will talk about planned vaginal birth in this article.

I believe that giving birth is similar to making love.

Normal, low-risk childbirth is very difficult to achieve in the hospital setting. Even when you have the most amazing provider, the very atmosphere prevents it. I believe the reason for this is related to the fact that childbirth is similar to making love. It’s not really such a wild idea if you think about it like this… For most people with a natural pregnancy, lovemaking is the act that starts the whole process. Pregnancy ensues and the body nurtures and grows the seed into a baby and through the maturation process until the appropriate time to release it into the world.

There is believed to be a multifactorial triggering process that is not well understood. However, it is common knowledge that once it gets going, labor responds well to dim lighting, quiet surroundings, and the soothing, loving support especially from the birthing person’s partner. Sound familiar?

What doesn’t work

When frightened, our mammal cousins have been known to stop their labors in order to move to safety. The same is true for humans, which is why there is an epidemic of Pitocin in use in most hospital Labor and Delivery units around the world. Normal labor does not respond well to bright lights, loud noises, and strangers. This has been discussed at length by obstetric greats such as Grantly Dick-Read and Michel Odent – both ardent proponents of unmolested birthing. Imagine trying to make love and achieve orgasm with all of that activity going on around you!

Your Partner

Another parallel between love-making and childbirthing has to do with the birthing person’s partner. Of course, the partner is included and involved with all aspects of the process as they were an integral part of making it happen. (What other hospital-based care takes place with the ‘patient’ AND their partner? No surgical procedures or any other procedures are a family event unless it’s a small child who needs a parent present for comfort.) In the majority of cases, the partner was present and responsible for planting the seed, and therefore is integral to the birthing process.

They have a bond in their union making the partner the one unique person in the room who is intimate with the birthing person. When the partner lovingly strokes and massages, whispers loving words of encouragement and is just completely present to the process, it causes the birthing person to release oxytocin which in turn causes the labor to intensify. Also, just like in love-making, the need for single-minded concentration is paramount to achieve the level of trust, openness, and surrender that is necessary for birth to happen.

Uncomfortable & Fearful

The combination of poorly designed rooms and standard interventions that are not evidence-based has created the need for using a dangerous drug on nearly all normal labors! When birthing people are not comfortable or if they are fearful, they will not be able to achieve the level of relaxation and focus required for efficient birthing.

Pitocin

Pitocin is the synthetic version of oxytocin – also known as the ‘love’ hormone. It is produced by our bodies when we hug another person (or animal) or make love, and it is this hormone that causes the uterus to contract and expel the baby.

We have discovered that we can give the synthetic version to pregnant individuals to start labor or make contractions stronger and closer together. But it is not without risks. It is a dangerous drug that can cause contractions that are too close together and too strong creating distress for the baby.

Pitocin is the reason for many emergency cesareans in labor. Having Pitocin creates the need for other non-evidence based interventions such as continuous monitoring and IV which in turn lead to another non-evidence based intervention – immobility, being stuck in the bed, usually on the back – all of these being extremely unhelpful to the laboring person. Another downside to Pitocin is the accompanying liters of IV fluids that the laboring person tends to receive.

It is not uncommon for someone to get 4, 5, even 6 liters of fluid during an induction, especially if they elect to get an epidural. All of this fluid can cause swelling and difficult breastfeeding due to the extreme engorgement that occurs. So instead of giving a dangerous drug to augment labor when people come into the hospital, why not redesign the physical space to encourage natural labor to do the job?

Let’s change things

We have birthed successfully without Pitocin for millennia before birth entered the hospital in the early decades of the 1900s. Let’s alter the external physical space and encourage practices that support the human body and psyche to birth naturally. The only people who require drugs to enable lovemaking are those with hormonal imbalances, it should be the same for normal, low-risk childbirth.

I propose that labor and delivery units set aside a block of rooms with dimmers on all the light switches, electronic candles sprinkled throughout the room, handheld dopplers for intermittent monitoring, multiple options for hydrotherapy including showers big enough for 2 people and a birth ball or shower chair and labor/birth tubs. They should have a welcoming attitude for partners and doulas; no standard IV or continuous monitoring; and healthy snacks. I believe that providers would find less of a need to augment labors and we could reduce our overall cesarean rates while improving client satisfaction.

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Pinterest
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On Key

Related Posts

COVID-19 and Pregnancy

This is a crazy time that we are living in. Although it is not surprising for those who have been paying attention… mono-farming crops practices

Midwife360 and the Scoop on IUDs

Many of my clients ask about birth control options that do not have hormones. There are a few, mostly they are the barrier methods like condoms (male and female), diaphragms, and cervical caps, or surgery. But the copper IUD is the only one that is long term and reversible and does not have any hormones. Since the copper IUD is not the only long term, reversible contraceptive, I wanted to break it down here for you.

Natural Sacred Birth

Natural childbirth for healthy, low-risk women is the only natural function of the human body that typically occurs in the hospital. “Why is that?”, you

What to Expect From a Home Birth

So you’ve decided to have your baby in the comfort of your own home. What should you expect? As a CNM who has provided home birth services for nearly 6 years, I am going to provide you with an overview of the general expectations that await you in this experience.

What to Expect from a Hospital Birth

What happens when you choose to have your baby in the hospital? The specific answers to this question depend on whether you are sent there for induction or are arriving in labor. It also depends on your planned mode of birth – vaginal or cesarean. We will talk about planned vaginal birth in this article.

I believe that giving birth is similar to making love.

Normal, low-risk childbirth is very difficult to achieve in the hospital setting. Even when you have the most amazing provider, the very atmosphere prevents it. I believe the reason for this is related to the fact that childbirth is similar to making love. It’s not really such a wild idea if you think about it like this… For most people with a natural pregnancy, lovemaking is the act that starts the whole process. Pregnancy ensues and the body nurtures and grows the seed into a baby and through the maturation process until the appropriate time to release it into the world.

There is believed to be a multifactorial triggering process that is not well understood. However, it is common knowledge that once it gets going, labor responds well to dim lighting, quiet surroundings, and the soothing, loving support especially from the birthing person’s partner. Sound familiar?

What doesn’t work

When frightened, our mammal cousins have been known to stop their labors in order to move to safety. The same is true for humans, which is why there is an epidemic of Pitocin in use in most hospital Labor and Delivery units around the world. Normal labor does not respond well to bright lights, loud noises, and strangers. This has been discussed at length by obstetric greats such as Grantly Dick-Read and Michel Odent – both ardent proponents of unmolested birthing. Imagine trying to make love and achieve orgasm with all of that activity going on around you!

Your Partner

Another parallel between love-making and childbirthing has to do with the birthing person’s partner. Of course, the partner is included and involved with all aspects of the process as they were an integral part of making it happen. (What other hospital-based care takes place with the ‘patient’ AND their partner? No surgical procedures or any other procedures are a family event unless it’s a small child who needs a parent present for comfort.) In the majority of cases, the partner was present and responsible for planting the seed, and therefore is integral to the birthing process.

They have a bond in their union making the partner the one unique person in the room who is intimate with the birthing person. When the partner lovingly strokes and massages, whispers loving words of encouragement and is just completely present to the process, it causes the birthing person to release oxytocin which in turn causes the labor to intensify. Also, just like in love-making, the need for single-minded concentration is paramount to achieve the level of trust, openness, and surrender that is necessary for birth to happen.

Uncomfortable & Fearful

The combination of poorly designed rooms and standard interventions that are not evidence-based has created the need for using a dangerous drug on nearly all normal labors! When birthing people are not comfortable or if they are fearful, they will not be able to achieve the level of relaxation and focus required for efficient birthing.

Pitocin

Pitocin is the synthetic version of oxytocin – also known as the ‘love’ hormone. It is produced by our bodies when we hug another person (or animal) or make love, and it is this hormone that causes the uterus to contract and expel the baby.

We have discovered that we can give the synthetic version to pregnant individuals to start labor or make contractions stronger and closer together. But it is not without risks. It is a dangerous drug that can cause contractions that are too close together and too strong creating distress for the baby.

Pitocin is the reason for many emergency cesareans in labor. Having Pitocin creates the need for other non-evidence based interventions such as continuous monitoring and IV which in turn lead to another non-evidence based intervention – immobility, being stuck in the bed, usually on the back – all of these being extremely unhelpful to the laboring person. Another downside to Pitocin is the accompanying liters of IV fluids that the laboring person tends to receive.

It is not uncommon for someone to get 4, 5, even 6 liters of fluid during an induction, especially if they elect to get an epidural. All of this fluid can cause swelling and difficult breastfeeding due to the extreme engorgement that occurs. So instead of giving a dangerous drug to augment labor when people come into the hospital, why not redesign the physical space to encourage natural labor to do the job?

Let’s change things

We have birthed successfully without Pitocin for millennia before birth entered the hospital in the early decades of the 1900s. Let’s alter the external physical space and encourage practices that support the human body and psyche to birth naturally. The only people who require drugs to enable lovemaking are those with hormonal imbalances, it should be the same for normal, low-risk childbirth.

I propose that labor and delivery units set aside a block of rooms with dimmers on all the light switches, electronic candles sprinkled throughout the room, handheld dopplers for intermittent monitoring, multiple options for hydrotherapy including showers big enough for 2 people and a birth ball or shower chair and labor/birth tubs. They should have a welcoming attitude for partners and doulas; no standard IV or continuous monitoring; and healthy snacks. I believe that providers would find less of a need to augment labors and we could reduce our overall cesarean rates while improving client satisfaction.

Categories
Pregnancy

Creating Value in Childbirth

Costs of Care Creating Value Challenge

In 2007, the Institute for Healthcare Improvement (IHI) proposed a framework for optimizing health system performance known as the “triple aim”. The three components are:

  • Improve the experience of care
  • Improve the health of populations
  • Reduce the per capita costs of healthcare

At Midwife360 we hit the bullseye on all three! Now, where is that friendly OB who wants to play with us?

It’s time to apply the IHI triple aim to childbirth!

It is well known that the American childbirth culture is very expensive with very poor performance AND little of what happens to birthing people in hospitals is evidence-based.

Childbirth for low-risk healthy women (who comprise the majority of people giving birth) benefits from less, rather than more technology. It is, after all, the only physiologic human function that has been relegated to hospital care. Achieving good outcomes usually goes hand in hand with a positive experience of care and this can be done in a very low-tech, inexpensive way by creating teams of home birth midwives and OBs.

Comfort is key

ACOG approves of home birth under certain conditions – choosing the appropriate client, with a CNM, in an integrated environment. As giving birth is much like making love, it is easier to imagine this happening in an environment where the birthing person feels the most comfortable – whether that be her home, a birthing center, or a hospital. So creating a culture that truly supports choice for birthing people without removing the option of access to a higher level of care can be accomplished by having a care team of a homebirth midwife and OB with hospital privileges.

Recreating home

Short of that, making hospital labor rooms more homelike – dimmers on the main lights, several options for water immersion (large shower, birthing tubs), small refrigerators in the room, and a second bed for family members or the doula to use – and updating care to reflect the evidence and patient preference are all absolutely necessary to achieve the IHI triple aim.