10 posts tagged “pregnancy”
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!
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.
When I was more heavily involved in my academic pursuits, I wrote a paper about reproduction and procreation that argued that the facts of life needed to be more thoroughly investigated as our understandings of procreation and reproduction are saturated with cultural meanings including gendered politics and ideologies about sex difference and sexualities. In that paper I stated that procreation and reproduction hold a unique place in Western constructions of kinship, gender, and sexuality: central to bio-gentic notions of kinship, embedded in and naturalizing a binary of sexed bodies (and therefore gender), and marking off 'natural sex' (coitus) and (hetero)sexuality from 'unnatural' and deviant forms. Given this power, I agrued that anthropologists engaged in denaturalizing projects were repeatedly identifying cultural conceptualizations of procreation and reproduction as productive of the naturalized beliefs that they were seeking to challenege. This repeated stumbling upon our understandings of the 'facts of liffe' was circumscribing their analytical efforts and as such, limiting the scope of their theorectical interventions. Calling into question the stability and naturalness of these processes and constructing alternative visions of each was the goal of my analysis in that essay.
I love the feeling of being on call - of knowing that there is a woman out there who is preparing for labor in the coming days and some time soon she will call me to come share in her birth day. For many years I worked in Rape Crisis and Victim's Assistance and when I was on-call then, it was a whole different feel. While the work was important and I was always happy ot be able to help a woman when she needed it, no one gets excited about a woman being raped or a child being victimized or a domestic abuse. But birth is exciting and beautiful and an amazing gift to be a part of.
Last night I was reading a physiology text about the changes in the body during pregnancy and I was struck by the issues of agency and the language of conflict being employed. For example, in discussing the way other organs move to accomidate the growing uterus, the book repeatedly talked about "pushing" or "forcing" rather than more cooperative language. Instead of seeing the whole of a pregnant woman's body as an amazing example of the body working in sync, this text employed language that sent the subtle message of conflict or competition within the body.
I was speaking with a women today about the birth of her son 6 years ago and the damage that her epidural did to her back. When talking about the decision to get the epidural, she told me about a long list of interventions beginning with induction, IV pitocin, rupture of membranes, and more. She explained to me that she was terrified of giving birth - not only all the way through her labor, but through her entire pregnancy and even throughout her life, starting as a young girl. I asked her if there was something that happened when she was young that made her so afriad and she thought for a minute before telling me that her mother often told horror stories about childbirth.
There is much attention to getting informed consent for medical procedures and while there is still much work to be done to actually achieve a level of education about procedures and alternatives that would be considered informed consent, I think there is even less attention to informed refusal. Assuming what should be questioned; built into the notion of getting informed consent is the idea that once informed one will consent to the procedure – a certainty that should not exists. Informed refusal is the notion that once informed one might also chose to refuse the procedure.
Considering the huge number of not necessary medical procedures performed on US American pregnant women everyday in this country, perhaps it is time to start emphasizing the role of informed refusal in the medical management of pregnancy and childbirth. One in five pregnancies result in a c-section – that is one million women who deliver surgically every year in the US. At least half, and likely more, of these c-sections are unnecessary. That I over a half million women who could have delivered vaginally and had a major surgery instead. Further, episiotomies are routinely used in many hospitals still, even though no medical evidence supports their usefulness in childbirth and the dangers and damage done is well documented. Nearly a third of birthing mothers are cut during labor. The list goes on with IVs, antibiotics, vacuum suction, forceps, monitors, and more. Each of these procedures absolutely has a place when there is evidence to suggest they are needed but the routine use of these procedures begs the question of why there is so much attention to informed consent and so little attention to informed refusal.
When my grandparents were having babies, my grandfather was wholly outside of the process -- it was only at the end when the gender of the baby was announced that he had any role at all. He did not actively participate in pregnancy, there were not childbirth education classes, he did not have a role in the birth, and, largely, he was outside of the parenting of the newborn. He was a great man, but at that time, this was his role.
There is so often this emphasis on information and on knowing more. With my first I had most of the tests, two ultrasounds, lots of doppler heartbeats, and I also turned down many available screenigs. What troubles me about this notion of 'information' is the sense that is it value-nuetral and benign when in fact these are forms of information that all but demand response in so many cases. Further, it is information that is so often wrong. Rapp's book Testing Women, Testing the Fetus speaks so nicely to this issue of testing being presented as simply information when it is so much more than that for the women who end up with the test results.
