BrooklynDoula’s blog

I have written so few birth stories in the last few months, passing through the 50 births attended mark and on to my 60th without writing about any of them! I've had some really wonderful births in the last months and I need to catch up with some story telling.

Two recent VBACs really stick in my mind because of the overwhelming joy of both of the laboring moms, but also because of the triumph expressed by the people who love them, and were so proud of them for having the birth they wanted. For example, at one of these births, the mom labored slowly throughout the day, calling me to join them in the middle of the night. After several hours in the hospital, she was able to push her baby out, crying "I did it!" as he entered the world. Minutes later her mother appeared outside the door and we waved her in to join us. She came through the door with an enormous smile on her face, tears on her cheeks and scooped her daughter up into a big hug, exclaiming, "You did it! You did exactly what you wanted!" Her mother had been nervous about her daughter trying for a VBAC but was overcome with joy and filled with pride when she accomplished it. I almost never cry at births, but these two women embracing and marveling at the accomplishment of having her baby the way she wanted brough tears to my eyes.

Two months later I attended another VBAC with a similar sense of triump, this time from the proud father. This mother began laboring and called me in the morning to let me know. A few hours later the contractions picked up in intensity and she asked me to join her. We labored in her home for several hours and then transferred to the hospital to meet with her midwife. She continued to labor in the hospital until her baby was down low and ready to be born. She was strong and focused, pushing her baby down with each contraction. When her husand first heard the mdwife report being able to see the baby, her husband traded places with me so that he could get his camera and have a better view of the the birth. A few pushes later, the baby made a turn during a contraction and made a dramatic amount of progress. The father, with tears in his eyes was cheering for his wife, telling her how amazing she was as she pushed their baby out. It was wonderful to see how proud he was and what a transformative and triumphant experience it was not only for the mom, but also for her partner.

Denise Spatafora, a mom of two, business/life coach, and creator of the BornClear childbirth education course, just released her new book, Better Birth: The Ultimate Guide to Childbirth from Home Births to Hospitals. In this book she details her approach to having an empowering and satisfying birth. In her introduction is states: "My gift is that I can feel, hear, and see all that is limiting a person and/or business as well as their gifts" and she reports that through coaching she helps people to "uncover and actualize their commitments and dreams" (4). She writes that has both individual and global goals for this text, stating that she wants this book to be a comprehensive resource to help women become fully prepared for childbirth and also that she wants the book to help people to 'grow personally' (6). In addition to these individual goals, she states that her global goal is to change how people around the world are talking about and understanding childbirth, a goal she explains is "nothing short of creating a movement" (8).

In Better Birth, she lays out how she has approached this goal in her BornClear method, stating that the core values of this program are to prepare you for childbirth emotionally, intellectually, spiritually and physically through seven basic lessons. The text reads largely as an explanation of these seven lessons:

1. Understanding the mind-body connection and how it relates to pregnancy.
2. Determining what you deeply desire for you own birth experience.
3. Having tools (called "the BornClear toolbox") to help you through conception, pregnancy and childbirth.
4. Connecting and aligning with your baby during pregnancy to create emotional, spiritual and health bonds that will last a lifetime.
5. Learning how your body works during pregnancy and childbirth.
6. Having the ability to plan ahead for every contingency.
7. Envisioning the first year after birth through learning your options.
(p. 6-7)

The chapters of her book largely follow this order, guiding parents-to-be through the seven basic lessons. For example, chapter four lays out a variety of options to experiment with including visualizations, meditations, affirmations, writing and art projects, breathing techniques, and physical and personal growth exercises. With pictures and descriptions, these sections offer a variety of methods that parents can try to find things that fit with their own needs.

In birth, I find that having a variety of options that you have tried out and found to work well for you is the most useful. I encourage parents to try out different techniques, positions, and options together so that they can discover, for example, that they hate visualizations but love massage and supportive words or that they find great relief from yoga positions but feel distracted by massage. Many of the relaxation techniques listed, such as feng shui, relaxation tapes, guided visualizations, candles and scents in your home, and collage making, are not those I found most useful as a pregnant and laboring woman, nor those I see most often in my own clients. That said, she offer options to pick and choose from, many of which I have found more useful, such as seeking acupressure or acupuncture, massage, yoga and movement, and breathing/relaxation techniques. By laying them all out, she offers a wide range such that parents-to-be can begin to personalize for their own pregnancy and in preparation for their birth experience.

In Chapters 6 and 7 she details the signs and stages of labor, possible interventions or augmentations offered in hospitals, and an exhaustive series of questions to guide planning for every stage of labor in a variety of contexts. This provides a great foundation for understanding what is going on in your body during labor, what possible augmentations (like pitocin) could be suggested and how they work, and the types of preferences you might consider for labor itself. I disagree with Spatafora that all moms-to-be need to "not only create but expertly write out" their "new context" for birthing so that everyone knows exactly what they want and I also don't think that partners must be "completely aligned" in order to get the birth you want. I do, however, think that planning for and consciously considering the available options, the possible constraints on those options, and the ideals for you birth are really helpful exercises. Her lists of questions about what you might or might not want for you birth are more comprehensive than I might consider necessary, but they provide a foundation for considering what you do or do not care about planning out in advance of your labor and birth.

As well, in this text Spatafora also describes what hospitals, birth centers, home births, OBs, midwives, and doulas have to offer, giving parents a clear perspective about the choices in childbirth they can make and how those choices impact the options available and the types of care they will receive. She includes lists such what to pack in your birth bag for the hospital, foods to consider having on hand for after the birth, things she wishes she had known before, and a list of what to buy for your baby. Like all of these sorts of lists, parents should take from them what is useful for themselves and not consider them as blueprints for parenting. I don't agree, for example, that a crib, breastpump, bottles, stroller, highchair, two diaper bags, and a baby rocking chair are necessarily essential parenting gear that should be purchased by all. Instead, I typically encourage parents to state with the basic (clothing, a blanket for swaddling, some diapers, a sling or carrier of some sort, and a car seat) and then expand from there as they get to know their child and their child's needs.

Spatafora's new book, Better Birth, is a comprehensive text for new parents, covering all the basics about choices in childbirth, the processes in the body, techniques for labor, and preparing for a new baby, and as such, I think it is wonderful to have this new resource. Her own lovely homebirths are available as videos on her website and I think her preference for homebirths and midwifery models of care are apparent throughout the book. Her book reads to me like a self-help manual, with incredible focus on using pregnancy as a time for emotional and spiritual growth, and it might not surprise readers to know that this is not typically my style. That said, I support women and their partners through childbirth who come from a wide range of perspectives and who draw on the gamut of tools through their pregnancy, labor, and postpartum period and I do so without judgment about the types of support needed or the approaches taken for enjoying pregnancy, coping with childbirth, and adjusting in the postpartum period. For many women, this book might be incredibly useful, providing insights and options from conception and throughout the first year and for others, it might not be a good match for their personality or needs.

I think as birth professionals, we always walk a fine line between giving women information and tools that might be helpful and burdening people with guilt or unneeded pressure. It is not uncommon in my practice for women to worry that the stress they feel or their emotional state is having a negative impact on their baby. They have read and heard that they need to be relaxed, peaceful, clam, and filled with joy in order to have a healthy baby and a satisfying birth. And yet, I have been in prenatal appointments with women in tears, with partners who are fighting, and recently, in a house with a ceiling that had collapsed. These women all have beautiful, satisfying births and happy, healthy babies despite fears that their emotional states might wreck them. So, to the extent that this book empowers women to take control of their pregnancies and birth experiences, making choices that work for them and building trust in their bodies and in their birth partners, I applaud it. For women who are draw to books about personal growth, mind-body connection, and emotional and spiritual exploration, I think it is a wonderful match. Like all things in life, what works for some people is not the right answer for all people and the availability of options is key - thanks Denise for giving us one more option!

I had a birth this week that was super fast - so fast that the drive to the hospital in the city was almost too long. The mom was so amazing through her labor and so able to relax while we worked together. It was a really wonderful experience for me and she had the most beautiful, vernix covered little baby girl! This work is so affirming.

Last month Patsy Harman emailed me to see if I was interested in reading her new memoir, The Blue Cotton Gown: A Midwife's Memoir. I was excited to receive the copy in the mail the following week but then it sat on the corner of my desk unread for several weeks. When I finally cracked it up, I was spellbound. This book is so readable, so real. I loved the highs and lows of Patsy's life, the harsh honest about her love, fear, pleasure, and pain, and the details of her experiences helping women not only in their births but through the other cycles of women's lives. This book was rich in detail and filled with the joys and sorrows women face and resonated deeply for me.

I highly recommend this book to anyone who likes a good read.

The Blue Cotton Gown: A Midwife's Memoir

Patricia Harman

This month I have been behind a lot. I have missed posting about several wonderful births and I have forgotten to write about many of the subjects I have thought deserved blogging. I'll catch up soon!

I read an awesome post by a midwife today. For context, the discussion was about birthing at home with a midwife or without any trained attendant (freebirthing or unassisted childbirth). When several midwives said they did not recommend this, it was suggested that they did not "trust birth". She wrote in response:

I trust birth. I trust it as much as I trust any other bodily function or force of nature. I trust birth to be birth just like I trust the sea to be the sea and the wind to be wind and the rain to be rain. Which means, most of the time, I can sit back and gaze in awe at the elemental power and beauty of the sea, the rain, the wind and the birth. But I also know that within that power and beauty there is a force of nature that is beyond my, and anyone else's, control.

I carry an umbrella in my car, just in case the rain demonstrates that wild, unpredictable side.

I watch my kids closely when they are swimming in the sea, just in case that beautiful, blue water becomes suddenly rough or has hidden under-currents that they happily step into and suddenly pull them away.

I shutter my windows and bring in my pets and remove lawn chairs when the wind threatens to become a hurricane or tropical storm.

And I watch birth, ready to shelter her with my umbrella, or lift her from the currents, or really batten down the hatches and face the storm head on when that force becomes a force to be reckoned with.

So, yeah, I trust birth, but even more, I respect the fact that it's a force of nature that can be wild, unpredictable, and powerful in mostly beautiful and sometimes destructive ways.

I'm not going to say anyone who had a succesful UC was "lucky". The odds are stacked in your favour that your birth, just like the sea or the wind or the rain, will be beautiful and safe. I don't think it's foolhardy or stupid to go swim at the beach or take a walk in a gentle summer rain, but if g-d forbid, you get swept away in an undertow you really don't want to be the only one on the beach who knows how to swim.