The value of a positive childbirth experience...

The other morning at work a subscriber canceled her magazine subscription because as she put it “I am tired of reading about birth and how important the experience is, its only one day in the grand scheme of things.” Let me first start of by saying I respect the opinions and beliefs of others-of course-that goes without saying HOWEVER, as a doula, CBE, and a mother who has had a relatively negative birth experience and most recently an extraordinarily empowering experience I say-is she kidding?!

I was inspired to write a response to this event but in truth I have been grappling with this question for quite some time now. I live in Santa Fe, NM. In terms of national averages New Mexico has one of the lowest rates of Cesarean deliveries. I was raised in NJ where many of my lifelong friends are having their babies. Their experiences are profoundly different from what I have witnessed here. New Jersey births are highly medicalized-I would know-my first son was born there. I would go so far as to say (and this relates only to the group of women I am in contact with) 95% of my friends having babies are doing so via Cesarean sections. I am not here to devalue their experiences but it often raises this question for me and I am not sure if I have yet to uncover any answers. I have done quite a bit of research over the last few weeks on this subject and one thing seems clear-we do not fully understand the significant benefits of a well-supported, normal birth.

Quick Comment about Birth in the Media

I am not the type of person you will ever find reading, watching or paying much attention to celebrities, their birth experiences, or their children (though I have been known to get fired up when some celebrity opts for an elective cesarean and goes public about it).  Therefore I have been avoiding this Gisele Bundchen birth story like the plague...until last night.

On my way home my family and I were listening to the radio in the car. My son insists on listening to a few select stations-very mainstream. During the break they were talking about the upcoming morning program and this is what I heard:

"Listen up ladies-Giselle Bundchen just had her baby at home and in the water.  She said she did not experience any pain-she said birth did not hurt at all. And get this-she did not use any pain medication.  The second day she was up and walking around and doing dishes." 

I will admit there was a hint of excitement when I heard this statement-not for any reason other than the fact that if I heard it on the radio-SO MANY other women heard it as well.  Movies and television spend so much time trying to scare us about childbirth-water breaks, panic sets in, rush to the hospital, and the screams begin-inevidebly something goes wrong or the woman is screaming for her pain meds.  Rarely do we ever get a different image of birth.  As unfortunate as it may be-people, especially women listen when celebrities talk and thankfully this time-this one has something positive and powerful to just this one time I hope this celebrity mom keeps it coming...

Gentle Birth in Haiti-Yayasan Bumi Sehat to Set Up Permanent Clinic

In June 2008 while visiting Bali with my family I made a visit to Yayasan Bumi Sehat.  I was under the impression we were visiting a birthing center, I was soon to find out that this clinic was so much more.  I was inspired by what I encountered at Bumi Sehat and by Robin Lim.  As it turns out the vision, generosity, and passion of this organization and her founders has extended itself to the people of Haiti.

I want to give you a little taste of the history behind this organization. In 1994 Robin Lim lived in Ubud in Bali, Indonesia where she began seeing pregnant women and their babies free of charge. As could only be expected as time went on and word spread more and more people came to see her. By 2006 “Yayasan Bumi Sehat” was in full effect. These days not only do they provide a space for women to have “peaceful, gentle births", (Indonesia has one of the highest maternal and infant mortality rates in Southeast Asia according to the World Health Organization) they work with the community in many other ways as well. In addition they provide general health services, capacity building, and community outreach. They are committed to working with and supporting the people in and around Ubud and of course at their center in Aceh, Indonesia.

It did not take long for the people of Bumi Sehat to respond to the emergency in Haiti.  According to the United Nations approximately 15% of the 63,000 pregnant women in the earthquake affected areas are at high risk for life threatening complications.  In addition for the 7,000 that will give birth within the next month the risk factors are even higher.  Though the earthquake has intensified the situation for women and children in Haiti the infant and maternal mortality rate before the crisis was the highest in the Western Hemisphere according to the United Nations. 

The class that wouldn't speak...

I have been teaching childbirth education classes for a about a year and a half.  At the beginning of each series there is always a hint of nervousness-most of my anxieties dissipate the moment the pregnant couples start to walk in the room.  Once we get through the introductions everyone is at ease, comfortable. The dialogue begins, questions are asked, group activities commence.  

From time to time I find myself in a class setting where dialogue doesn't begin, questions are not asked and the group activities are done with reluctance.  I recently agreed to teach a few classes for a local non-profit.  The director of the organization received a generous grant to start a doula program.  They have had great success with this program and have been able to provide doula care for a particular population of women for free. They asked me to come in to teach a weekly childbirth education class which I accepted with great enthusiasm. I was looking forward to working with this demographic of women and could not wait to get started.  Thus far there have been a few challenges; I am used to teaching a class where women are usually in their third trimester-in my last class I had one woman due the following day and another woman who just found out she was pregnant. However, the biggest challenge thus far has been lack of participation.  I have experienced a less than enthusiastic class in the past but I have never experienced this level of-I am not sure what to call it-hesitation.  I have tried all sorts of tricks and maneuvers; nothing I have done has been successful in breaching the barrier.  I spoke to a few of the doulas that work in the program and they have assured me they have encountered the same situation.

Eating And Drinking In Labor

Trust your instincts-as a doula and childbirth educator I find myself advising my clients to listen to their gut often. In fact, had I not heeded that advice myself eight months ago my son may have been born without our midwife present.  Laboring women however are not always “allowed” to follow their instincts especially when it comes to eating and drinking in labor.  Its funny-you wouldn’t dream of advising an athlete against hydration or obtaining a little extra energy through food (it has been said that giving birth is like running a marathon).  But in hospitals worldwide women are told they cannot eat or drink once they are admitted.  Some hospitals allow a clear, liquid diet and others don’t allow laboring women anything other than ice chips-no matter how long their labor!

This practice is decades old and was implemented to prevent Mendelson’s syndrome which can occur (rare-but fatal) if a patient undergoes general anesthesia.  The fear is that if a woman has eaten or drank anything the contents of her stomach could be drawn into her lungs while she is under.  The message here is that every woman in labor is at risk for a cesarean section. It’s not just a cesarean that is the driving force (for which an epidural/regional anesthesia would be used) but an emergency cesarean where time is a factor. Instinctually it would seem women are missing out on the benefits of fluids and food in labor for a lot of what ifs!

Call For Appropriate Infant and Child Feeding in Haiti

In response to the emergency situation in Haiti- UNICEF, The World Health Organization and The World Food Programme have called for the support of “appropriate infant and young child feeding.”  UNICEF, WHO, and WFP have also advised attention be paid to the “unnecessary and potentially harmful donations and use of breast-milk substitutes.” Without the attention of such organizations the dangers specific to mothers and their babies could easily and unintentionally be overlooked. 

Call for Support for Appropriate Infant and Young Child Feeding in Haiti

In response to the emergency situation in Haiti- UNICEF, The World Health Organization and The World Food Programme have called for the support of “appropriate infant and young child feeding.”  UNICEF, WHO, and WFP have also advised attention be paid to the “unnecessary and potentially harmful donations and use of breast-milk substitutes.” Without the attention of such organizations the dangers specific to mothers and their babies could easily and unintentionally be overlooked. 

Urgent Call for Human Milk Donations for Haiti Infants

Washington, DC -- The Human Milk Banking Association of North America (HMBANA), United States Breastfeeding Committee (USBC), International Lactation Consultant Association/United States Lactation Consultant Association (ILCA/USLCA), and La Leche League International (LLLI) are jointly issuing an urgent call for human milk donations for premature infants in Haiti, as well as sick and premature infants in the United States.

Lamaze And ICEA Bring Together The Birthing Community

WASHINGTON, DC, December 03, 2009; 24-7 PressRelease

Lamaze International and the International Childbirth Education Association (ICEA) are joining together in Milwaukee, Wis., September 30 - October 3, 2010, to celebrate their 50-year anniversaries. The 50th Anniversary Mega Conference, Celebrating Our Pasts, Uniting for the Future of Birth, will unify the birthing community in an unprecedented event that combines education, research, networking and social activities.