As I continue along my journey in the birth field, I have evolved time and again. New information is found, new opinions formed, new facets of spirituality discovered. I’ve noticed a shift in my “birth consciousness” that was once all for an off-the-wall seemingly radical idea such as that spouted from the mouths of natural birth advocates, such as “Avoid doctors and Cesareans at all cost!”, “You have to have a midwife at a homebirth”, “Trust Birth”, “Birth is Safer than Not”, or Unassisted Birthers and their stand (I had even considered a UC). Now, I have again shifted my personal paradigm on birth to something seemingly even more radical.
I have read articles about UC women losing babies, of people who once advocated UC turning against it, fearing it. I have read over and over again the claims that birth is “inherently safe” and we’ve been doing it “by ourselves” forever. I have compared the “babies lost to UC” to “babies lost under midwifery supervision” to those lost under “OBGYN supervision”. There are varying numbers, but in all cases there are deaths. And in a recent essay I wrote, I talked on the connection between birth and death, and especially that of the role death plays in midwifery.
Before I continue, let me make it clear that I am not bashing, advocating, or any of the like any one “side” of the fence (because in my mind, there is no fence, it’s more like the lunch tables in the school cafeteria that are designated to each ‘clique’. Some people are at the hospitals and doctors are the only way table, some are at the pro-midwifery licensure table, some are at the anti-midwifery licensure table, some are at the “trust birth”, pro-UC table). I’ve found that I am at none of those tables, and seek to get people thinking. Let me explain.
I feel like saying slogans such as the aforementioned give women a false sense of security that sets them up for failure, or disappointment. But at the same time, I believe that it is possible, and biologically normal, for a woman to give birth on her own. However, I have a growing uneasiness in my gut about how this topic is being handled and gone about. The common scenario that I’ve come across is as follows: a woman is pregnant and decides that she wants to have a “natural” birth. She reviews her options. Attempting as “natural” a birth as possible in a hospital or birth center setting, having a midwife attended homebirth, or an “unassisted birth”. She is more inclined to a homebirth, and considers the options regarding that route. Midwife, or no midwife. Perhaps she can’t afford the midwife, lives in a state/area where there are no midwives/homebirth midwifery is illegal, etc. So she begins to look more at the UC route. Another scenario is that she, from the gate, heads straight for the UC route. Either way, she begins looking into it, trying to find out what she “needs to know”, and essentially begins to self-train herself as a midwife. And of course, there are those out there who do not believe in doing this, after all they “trust birth” as a “biological function” (which it is, I’m not arguing that point) and so they believe that they do not need to be educated in the ways of a midwife and that their bodies will handle everything accordingly. In the first instance, there is the woman who studies and crams as much knowledge as she can, hoping she hasn’t overlooked any vital piece or will forget something in the moment. This, to me, seems counterproductive to the seemingly common thought behind “natural” births as being able to let mom be free of worries and responsibilities and allowing her to be in her own headspace (and in my personal belief, her own spiritual place) while someone else is the one with the knowledge to utilize in the case of a possible emergency. And yes, a birth that is not intervened with, a mother who is allowed to move about as she pleases, eat and drink as she pleases, etc. is the best scenario for the best outcome—that of a smooth, complication-free birth. But it seems to me that a mother who plans a UC, and tries to become “knowledgeable enough” to undergo one, is in a sense a hypocrisy against the theory of “our bodies are capable on their own” and, also, takes the mother out of that worry-free, personal head/spiritual place in my personal opinion. And, it sets her up for potential trauma, disappointment, and failure if she were to happen to have a complication and she does not know how to respond, forgets how to respond, is incapable/incapacitated from being able to respond appropriately and her partner is not “trained” to handle the situation, and the result is a hospital transfer or even death of herself and/or the child. I have read story after story of UC-ers ending up with a hospital transfer, either due to just a “gut feeling” that something was wrong, or there was an actual complication during labor or delivery they couldn’t handle or weren’t prepared for, or even if they were, couldn’t make a difference. Then there are the deaths. And like I said earlier, death is inevitable, in any birthing situation, with any attendant (or none).
I think that instead of spouting slogans or teaching women that birth is safe and our bodies are capable at all times of giving birth without the need of assistance from an outside person (which not only gives women the assumption that they shouldn’t have a midwife, but also that they shouldn’t even have a doula, or in some circles even their partner, present at the birth)— that we should be talking about death. We should be teaching midwives and mothers about the death aspects of birth, the potential for death in birth, how to cope with and accept death, the rituals, chants, etc. (the spiritual side) around both birth and death. Not hiding from it, not trying to avoid it at all costs, even at the cost of quality of life, not setting up women for possible trauma, because that’s what’s being done.
Here is something to ponder on. I became pregnant with my first child at the age of 16, and subsequently went into preterm labor and delivered a 29 week baby. He was whisked away, unseen, not held to my chest, for almost three days. He was kept in a great NICU facility in a town an hour and a half away, had his ups and downs, and on one of his downs was transferred even farther away to a supposedly “better” hospital, which in my eyes seemed no better than a local hospital, and was a downgrade from the first. Throughout his three weeks of life, he was given intervention after intervention, was denied my breast, was denied my holding of him time and again. I held him, and not even how he should have been held (for hours, skin to skin) maybe a hand full of times in those three short weeks. And regardless of their technology and their efforts, he died. Actually, partially due to their technology, he died. And thinking back on it, with where I’m at right now in my beliefs, I would have done it differently. I would have asked to hold him immediately after birth. I would have made them let me keep him, would have held him naked to my bare chest and stuck my nipple in his mouth, whether he would be able to eat or not. I would have held him for every waking
moment, and probably the sleeping ones as well. And maybe he would have died anyway, maybe he would have lived. Maybe he would have thrived. (Kangaroo Care saves as much if not more infants, with a better quality of life, than our “technology” which studies have shown over and over). But regardless of the outcome, I would have at least have had those moments, I would have been with him for every second. He wouldn’t have died alone, three hours away from his parents. He may have died, but not alone. And I think that maybe I would have been able to cope with that trauma and be able to better overcome it in that alternative scenario. Maybe not, but I like to think that it would be better. And so many women don’t think about that, or maybe they do but they lock those thoughts and gut-feelings down inside because the “doctors know best”, and I think that needs to change.
I also believe wholeheartedly that we should stop shunning c-section mothers, stop snubbing them—those who chose a Cesarean and those who received emergency surgeries. We should instead be meeting women where they are, accepting them, being present for them, helping them to heal from that trauma (if healing is needed/it was traumatic, because it is possible it was not), and helping to guide them out of that place of ostracized outcast that they most often find themselves in the natural birth community. Help with trauma mending, help with information sharing on VBACs and even being present for them for a repeat c-section and helping them to be able to come to terms with it and make it a more “interactive” experience instead of one where they have no say from start to finish. This is something that I see quite frequently and that the attitude and treatment of needs severe 180 degree turn around on.
We should be teaching midwives to be able to be as hands-off as mothers want them to be, but to be able to step in in the case of a complication with quiet gentle guidance and quick skill. I wonder how many hospital transports for unassisted births (which include not just the transport and possible fetal/maternal hospitalization, but maternal/fetal separation, delayed nursing, etc.—all of the things that were set out to be avoided in the first place) could have been dealt with at home with someone who has the training, who could have been the quiet presence in the corner, allowing the mother to have her space and her freedom from the weight-bearing of “Will I remember what I learned?” and the like. They could have been dealt with, at home, and there would have been little to no negative side effects such as the aforementioned (of course, unless a dire emergency was indicated and transfer was needed). This is just one of my many personal and evolving views.
And, again personally, I believe we did not give birth “alone” in the past. Maybe, when we were Homo erectus in the plains of Africa, we did what mammals do—found a quiet, secluded place safe from predators and were left to our own devices to either come back with a baby, or not. But, looking historically, at least since recorded history, there are records across cultures of women being attended by women. And this was not necessarily just “medical” supervision, but just women-to-women, mother to daughter, grandmother to granddaughter, aunts and cousins and other female tribe members supporting, and being present, for the birthing mother. They were her chair, they were her arms, they were her spiritual support also, and probably most importantly. There may, or may not have been a midwife, but there were women who had birthed before there who knew some ways of birth, and if there wasn’t, or something was wrong, the midwife was called. But regardless, the mother was allowed to “be”, and whatever the outcome was, it was also allowed to “be”. This is my evidence for my argument against UC-ers who preach “birthing alone”, etc. in order to be a “true” UC-er. Yes, women are mammals and the actions behind mammalian birth is the same (quiet, safe, dark places, etc.) but this can be accomplished with a woman still being supported, cared for, adored and pampered, and spiritually supported.
We should also be looking more at the biology around labor, on a cultural level as well as a personal, woman by woman basis. If you want to claim birth is “biological” then act like it matters. Look at how we have changed biologically, physiologically, over the last few hundred years. How does that affect how we birth? Yes, women have “known” how to give birth since we evolved. But, how have we changed, physically (and mentally) that could hinder this natural, biological process? A major one: pelvic shapes. The major contributor? Diet. Diet has been probably the most drastic change humans have undergone in the shortest time, and even though birth is natural and we were capable of birthing, supposedly without midwives or other more-knowledgeable attendees, we are different now than when we were then. Even just compared to a few hundred years ago, or even less than a century ago. We should be looking at, and again training midwives and teaching mothers, and potential mothers, about how things in our lives could affect our capacity to birth, naturally. Diet I, and many others, believe is the main contributor, but also environmental factors such as chemical exposure, mental health, past traumas (whether birth related or not), etc. We should be trying to change these kinds of things, to help bring women back to the way it was before, when we could “birth naturally” instead of just saying “Oh, you can do it by yourself, no problem!” not even considering that even if that mother did everything “right” and still had a complication or her baby still died, no one thought to help her with a past trauma that re-surfaced during birth, or to talk to her about nutrition, before pregnancy or during. (Of course, even in antiquity, before the drastic lifestyle and diet changes of the mostly-Western world and those places that they have influenced, babies and mothers died. It was a part of life. And even if we can get back to a similar way of life or way of eating, death is inevitable at any time, for anyone, and takes me back to what I said earlier about the other key point that we are missing in regards to birth—death.)
And again, yes I believe that birth is a natural, biological function. I’ve even seen it mentioned a few times that if it didn’t “work” there wouldn’t be so many people. My radical thought on that? Doctors and technology is the reason for the outrageously high human population of this earth. Yes, birth “works” and more babies survive birth than they die during it, but with the increase in “life-saving” and “life-extending” technology, which is the field of doctors, more and more live (regardless of their potential quality of life). It has always been that babies die. Mothers die. And though populations steadily increased over time regardless, it was nothing compared to the last few hundred years with the advent of such “advanced” technology. And now, we have the ever-present looming fact, the elephant in the corner that everyone seems oblivious to, that our ecosystem (the Earth) has long-since reached its peak in population sustaining capabilities. In simple terms, the Earth cannot sustain us anymore at our current nor projected population growth rate.
And I understand, and am prepared for, how the aforementioned comments, personal beliefs, and theories will cause people to react. But, like those before me who went out on a limb and became “radicals” in their thinking, and their doing, so shall I take my turn, and perhaps, someone will read this and be able to think for themselves and possibly they will take their turn, and on it will go.
[And again, please take heed that I am NOT bashing or belittling anyone’s personal beliefs, or any one particular institute or organization’s beliefs or teachings. I am only stating my personal take, and hoping to get people thinking in a new light.]