Accepting the Unexpected

I prepared for my first birth (and am preparing for my second) with the help of Hypnobirthing, the Mongan Method.  Part of the practice “regimen” is listening to a 25-minute track of Marie Mongan reading birth affirmations–positive statements about birth–over and over again.  The idea of affirmations is that the more you hear something, the more you tend to believe it and the less resistance you have to its message.  Pregnant women are exposed to a plethora of negative messages about what their births will be like, and the positive affirmation track is there to counter that.

I suppose every woman has a few affirmations that speak to her more than the others.  For me, the crux of the collection was this:

I am prepared to calmly meet whatever turn my birthing may take.

I didn’t have a lot of expectations for my birth.  I wasn’t expecting it to be short or easy.  I kept an open mind about Mongan’s claim about birth not needing to be painful, and knew that I would deal with the birth beautifully whether it was painful or not.  But I really, really, really wanted my homebirth.  I was terrified of needing a hospital transfer.  I was terrified of needing a C-section.  I was terrified of letting go of my dream.

I am prepared to calmly meet whatever turn my birthing may take.

I just  couldn’t hear it enough.

But a few weeks before my birth, I came across a very unusual birth story.  It goes as follows.

Sivan was pregnant with her fourth child and preparing for a homebirth.  She was diagnosed with gestational diabetes in the middle of her pregnancy, but she did not let that worry her.  Her 39-week ultrasound estimated the baby’s size at an impressive 4.4 kg (9.7 lbs).  This did not bother her either; she knew how notorious ultrasounds are for being inaccurate.

But her midwife was concerned.  She took a good look at all the factors involved, and told her that with all the data she had, she did not feel safe accepting this birth at home, and with great sympathy told her that in her professional opinion, a C-section would be the safest course for this particular baby.

Sivan was shocked.  She trusted her midwife and knew that she would never recommend a planned C-section without a really good reason, but she couldn’t grasp the idea that her midwife would tell her such a thing.  What about the inaccuracy of ultrasounds?  What about the inaccuracy of the glucose tolerance test?  What about the idea that women’s bodies have been doing this for millenia and know how to birth big babies too?

Eventually she began to accept that her midwife was not just being over-cautious.  In the case of gestational diabetes, it is the shoulders of the baby that put on a lot of weight, and the risk of true shoulder dystocia in this case was too high to ignore.  She did not want to put her baby at risk.

But a C-section?  After all her hopes for a perfect homebirth?

Sivan described going to the beach and watching the waves and wanting to just give birth there, alone, trusting her body to do what it knew how to do, proving to everyone how wrong they were.  She cried for the loss of her dream birth, feeling helpless, hopeless and disempowered.

As she sat there, she got a call from her midwife.  “Just wanted to check in on you.  I know you will be okay.  You’re not the type of person who gets stuck in the past, I got that feeling from you long ago.  Just remember one thing: at the surgery, despite all the disappointment, you are still going to meet your baby.  Remember?  It’s a celebration!  Go in celebration!”

From that moment, something changed.

Sivan went home and informed the hospital that she would not be coming that day, but on Sunday.  And that her surgery would not be on Sunday, but on Tuesday.  Why?  Because that’s what she wanted.  She was taking this birth into her hands.  Who said a C-section couldn’t be an active birth?!

She and her husband arrived at the hospital like a pair of celebrities arriving for their premiere, all dressed up and full of joy.  They asked every staff member for his or her name and chatted with them.  Sivan insisted on sitting, not lying down, on the bed as she was wheeled into the OR.  As the surgeon prepared for the incision, she asked him to tell her exactly what he was doing.  She described the moments of joy as her son was born, and when he was brought to her from across the curtain and put next to her cheek; how she wriggled her arm out of the restraint and stroked him.  Her husband waited with the baby carrier, took the baby and never left his side as the operation was completed.  Sivan insisted on giving the surgeon a hug before she was wheeled to recovery.  Determined to recover and see her baby, as soon as she felt some sensation in her legs she tried to move them, and she expressed some colostrum to prepare her breasts for nursing.  She refused morphium for the pain and had them give her Ibuprofin instead.  The staff was in shock at her quick recovery and determination to function.  When her beautiful, 9.8-pound boy was finally brought to her, she didn’t wait even one minute before attaching him to her breast.  “Don’t you want to wait until we reach the ward?”  The orderly asked in amazement.  No.  Not a chance.

She turned one of the worst nightmares of any homebirther into a positive, happy experience.  A celebration.  After all, a birth is a birth.

I am prepared to calmly meet whatever turn my birthing may take.

After I read that story, something changed in me as well.  I realized that the lack of control I had over my birth did not mean I was helpless.  There is always a choice, and the choice is in your response to the situation you are in.  You can choose to see a C-section as a failure, a nightmare.  Or you can choose to see it as a birth; not what you wanted, not ideal, but a birth nonetheless.

Suddenly, I was able to let go.

And my birth was amazing.

Intuitive Eating in Motherhood

After speaking with my midwife the other day, we came to the conclusion that I may need to eat more foods rich in iron. I did not take a formal test or anything but just have been feeling tired again lately. In a pregnant woman’s second and third trimester, it is really important to increase her protein intake because this is when the baby is growing the fastest. This will also help keep the mother’s energy levels up.

I am proud to say that this had been on my radar before my midwife suggested it. And that in general, pregnancy has made me a better eater. I was never a bad eater, always leaning towards the healthy side of things. There was an 8-year stint where I was a vegetarian after declaring one day in junior high school that I didn’t like meat. And I was a strict, young vegetarian, never consuming ANY products with meat (including fish) in them. During that, there were short times when I tried to be vegan because I love animals so much but I love cheese, chocolate, and ice cream more. Then there was a long stretch of college where I thought I was superwoman and worked full time and attended school more than full time (18-21 credits per semester). This ended the vegetarianism. I was too burnt out, and too poor to afford expensive veggie protein to feed myself properly, and too busy to be creative with meal choices to increase my protein so I turned to the dark side and ate some chicken. Fast-forward about 7 years and now I enjoy all foods equally and still have a soft spot in my heart and belly for veggie delights!

My point is; through my life of relatively healthy eating, I have never felt as healthy as I do since becoming a mom (which I count as finding out I was pregnant with my first baby). From that point on, my eating changed from what I want to eat, to what my baby needs to eat and what foods my baby needs to nurse and grow big and strong. I have developed a way of eating that I call “intuitive eating”. I did not read a book about this though I know that they exist. I literally, just plan out my meals, shop for foods, and stand in front of my refrigerator and think “what does my body need right now?”, “what does the baby need right now?” “Have I had my protein for the day?” “My grains?” “My fruits and veggies?” etc…I eat really clean, part for my love of the farmer’s market and part because it’s easiest for me. I buy a bunch of fruits and veggies for the week, protein for each day in the week, and dairy (and dairy alternatives). I always have healthy fats (peanut butter, avocado, olive oil, butter, etc ) and grains in stock. Each day I put together whatever combination of what I have based on my hunger and nutritional needs for the day.

When I was pregnant with daughter #1, I gained 35 lbs. I did not try/ try not to gain this amount of weight, I just listened to what my body needed and in return it gave me an easy natural labor and birth process and a healthy baby girl. My midwife said that “every woman’s body is perfect for her baby” when women get snarky comments from observers for “looking too big, too small, etc. I love this. Anyway, after she was born I lost 20 lbs of it almost instantly (baby’s weight, uterus, fluids, placenta) and then breastfed her. In addition to the 35 lbs I gained, I lost an extra 15. I did not “work out”. I just listened to what my body needed, ate healthily, consciously, and the weight came off. There were times where I would pass on dessert and that’s pretty much it.

When you have a baby that you nourish through nursing, you are responsible for how they are growing. Even if I wanted to, was tempted to, for my daughter’s well being I could not develop an unhealthy way of eating. It truly saddens me that women are blasted with media that talks about “getting your body back after baby” and that celebrities flaunt their bikini-ready bodies weeks after birth. In my experience, there was no way I was going to work out on a consistent basis with a newborn. AND there was no way I was willing to try ANY kind of diet. What I look like in a skimpy outfit is not important, what is important is the health of my child and myself. What worked for me is truly listening to my body’s needs, my baby’s needs, and making conscious choices.

Cord Blood Banking, a Decision That May Save a Life

from Zimbio.com

When I was pregnant with my first daughter, cord blood banking was one of my two top priorities, natural birth being the other one. Today, cord blood is being used to treat such life-threatening diseases as leukemia and other cancers, as well as certain blood and immune disorders that formerly necessitated a bone marrow transplant.

A quick overview about cord blood banking:

1) Cord blood is the blood that remains in the newborn’s umbilical cord after the cord has been cut. Doctors have identified that cord blood is a rich source for stem cells, which can be used in medical treatments. Cord blood is routinely discarded after birth but a process known as cord blood banking allows families to save their newborn’s cord blood for potential future medical use.

2) Cord blood stem cells are unique! In comparison to adult stem cells, cord blood cells have higher rates of proliferation, immunological immaturity, and reduced exposure to viruses and aging.

4) Cord blood banking is an once-in-a-lifetime opportunity for parents to save the stems cells found in the blood of their newborn’s umbilical cord. Cord blood banking is safe for both the mother and the newborn since the cord blood is collected after the baby is born and the umbilical cord has been clamped and cut. Once the cord blood has been collected, it is sent to a laboratory for processing and storage.

5) In cord blood “processing”, the facility can determine how many usable stem cells were collected, the higher the amount, the greater chance that the family may have positive outcomes if they ever need to use them for future medical treatments. In traditional transplant medicine, having more cells available for treatment may help the patient recover faster, experience fewer complications, and ultimately, increase the chance for survival. A doctor will use all of the stem cells in transplant in order to give the patient the best chance for rapid regeneration of their blood and immune system.In Regenerative Medicine, a higher number of cells may offer the ability to have multiple treatments.

My husband did our research and came upon the decision to bank our daughters cord blood based on a couple of factors.

1) My husband’s mother died when he was a teen of cervical cancer so we have a cancer link in our family genealogy though we are aware that heredity and cancer links are unknown.

2) We thought…this is something that could potentially save our daughter or other members of our family (if they are a match) from life-threatening illnesses. It would be disgarded otherwise.

We decided to go with CBR (Cord Blood Registry) based on experience, storage facility details, collection and processing made easy, and their commitment to ongoing research.

There are a couple of things about cord blood banking that we weighed with our decision making.

1) It is expensive. We paid roughly $2,200 and then there is an annual storage fee of about $150

2) With the midwifery model of care, the cord is usually left on as long as possible until it stops pulsing so that the baby gets the maximum amount of blood in it’s body and waiting longer to cut the cord after birth is said to reduce traumatic impact.With cord-blood banking, the cord needs to be cut sooner to secure the maximum amount of stem cell collection.

I hope that my readers find this informative and that it helps open up your mind to new possibilities with birth.

My intuition tells me that we made the right choice for my family and it helps me sleep a bit sounder at night knowing that we have this in the back of our tool belt. Happy Cord Blood Awareness Month (July)!

P.S. You can also choose to donate your baby’s cord blood which may be used for life-saving research or may be given to families in need. Even if you do not want to store it, please consider doing something to help another human.

Amy

Preparedness

Preparedness refers to the state of being prepared for specific or unpredictable events or situations. Preparedness is an important quality in achieving goals and in avoiding and mitigating negative outcomes.

While working on a mural I am painting for my daughter’s room this week, I was thinking about how I am in the “nesting” phase of pregnancy. I am actually preparing a new space for my older daughter and the new baby will move into the current nursery after a period of co-sleeping with my husband and I.

This got me thinking about how women prepare for birth. Do many pregnant women feel they are prepared for labor? Do women enter labor in a calm state of mind and feel confident that they know what to do, their partner knows what to do, and they have full trust in their care providers?

We prepare everything else for a new baby. We buy mass amounts of baby gear after doing hours upon hours of research about the “safest” and the most functional brands. We gather tons of baby clothes and blankets and wash them before hand. We buy an infant seat and put it in our car weeks before our due dates AND we prepare the baby’s nursery.

But do many American women feel prepared for labor? How about the ability to labor naturally, without intervention?

The answer is no. American women are scared of birth. Fear has been set into us at an early age. Pitocin, epidurals, and C-sections are part of our culture. Why would we try to birth naturally when we don’t have to be prepared? We go to the hospital and they take care of things for us. The job is out of our hands once the heavy contractions start. And we aren’t allowed to make decisions when we are “in that state” anyway.

What if we made child birthing classes mandatory? What if we showed all those wonderful natural birthing videos that birthing advocate mommas and caregivers have seen? What if women left feeling empowered to have the strength and courage to labor naturally? There may be less medical interventions and c-sections! There may be less premature babies and babies may be born in a less traumatic way! Breastfeeding may be easier! Why, it may just turn the healthcare industry upside down!!

Fear and helplessness is running our birthing community. Shout it from the rooftops, and educate women that they are strong, birth is empowering, and most importantly, that they have a choice. Tell them it is a good idea to prepare your mind and body for birth, just like you prepare the baby clothing and a place for the baby to sleep.

Preparedness refers to the state of being prepared for specific or unpredictable events or situations. Preparedness is an important quality in achieving goals and in avoiding and mitigating negative outcomes.

My daughter's mural

Mama Knows Best

What a week.

You know, I started out my motherhood with this amazing, incredible natural birth that left me glowing with power.  I was a first-time mother, but I was pretty confident in my ability to know what was best for my son.  For the first three months of his life I was totally in tune with him; I knew instinctively, as I had during the pregnancy and the birth, that everything was fine, that he was growing beautifully despite being born quite small, that he would nurse like a champion, that his development would be right on schedule.  I knew because I was the mother, and that was that.

And then he was diagnosed with bilateral congenital cataracts.  He had been totally blind for the first three months of his life.

Kind of pulls the rug out from under your feet, doesn’t it.

I don’t need to describe to you the struggles of the nine months that have since passed.  No one can really tell you what it’s like to place your three-month-old baby on an operating table and watch him scream and struggle as a mask is placed over him, then just sort of fade away.  Or to digest the fact that he will always be visually impaired, even if not too seriously.  Or to understand that his nystagmus–jerky, involuntary eye movements–will probably never go away, only improve.  Or to drag him to various specialists and therapists trying to intervene early, make up for lost time in his visual development and encourage his motor development which had fallen behind as a result.  But if you are a mother, you will understand when I say the word guilt.  That I should have known.  That I deprived my son of three months of vision by not knowing, by letting the pediatrician’s recommendation to double check that red reflex get lost in the shuffle because we thought–and had been told by the nurses who had recently checked him at six weeks–that he was tracking.

Maybe I didn’t know best after all.

In the past week my son has been very ill–high, high fevers and severe discomfort.  At the start of it all my husband took him to the emergency center, where a terse doctor ignored his recent history of ear infections and the antibiotics he had been taking, grudgingly confirmed our diagnosis that it was indeed another ear infection and prescribed the same antibiotics as last time.  The first thing I asked upon this report was “And she knew he was just on it?”  To me it seemed pretty clear that this infection was leftover from the one just two weeks ago, which in and of itself had been leftover from one a week and a half before it–and that what was needed was stronger antibiotics.

In the days that followed and the many pediatrician visits therein, I didn’t think to mention this because I figured that the pediatrician–who’d probably seen hundreds of ear infections–would know if the infection wasn’t clearing up.  But just today when I called to let him know that my son’s fever had again spiked to 102.2, he said he wanted us to see the ENT to make sure the ear infection had really passed.  Lo and behold, it hadn’t.  “Get this kid some stronger antibiotics!”

Yeah.  Sometimes we’re wrong.  Sometimes we just lack the experience or medical knowledge to sense that something isn’t right.  But most of the time we do anyway.  It’s that same inner voice that tells us what to do during birth, leading our bodies to move and change positions exactly right to ease our babies’ passage into the world.  It’s that same inner whisper that wakes us five seconds before our child starts crying, or sets off the let-down reflex when our babies are hungry even if they are miles away.

Mama knows best, and nothing will ever change that.

Distortion of Natural Birth

I was so happy to follow up on Ashley’s Midwife Vs. Medwife post because I really feel as though this will be a little piggy back on the subject. Last night I tuned into ABC’s hit series Private Practice, and during the episode I seriously started to wonder why I continue to watch the show that makes my blood boil.

But what really ate at me was they way they portrayed a mother who was working towards a natural birth. Which made me think about the way that the public views the natural birth community, as well as women who simply want a natural birth for themselves.

They treated this woman in the episode like the butt of all the jokes in the episode until the emotionally charged climax of her birth viewed by perfect strangers that would have been a major HIPAA Violation.  The episode shows this woman with a multi-page birth plan, grinding on the door frame of the birth suite trying to squat to help her labor, joking about how she had been in labor for 3+ days, all of which as a mother who has labored naturally, I found offensive.  The character was essentially the comedy of the episode.

It made me think about the perception the American public is going to get from this message, as well as their views on women who do choose to give birth naturally. Do they think we are all just a bunch of hippies that bite on sticks until we drop a baby out in the middle of a meadow while singing show tunes?  Come on!

The problem is shows like this.
The problem is the myths about who has natural births.
The problem is typical stereotypes.

Where do we start?
How do we start to re-educate and properly educate the public so they don’t think all moms who want to have a natural birth aren’t ding bats like this character was?

I really hope that shows like this, and Grey’s Anatomy, and other medical drama’s take the time to fix the American stereotype of birthing naturally. Women from all walks of life do it!

Just on a side note, the character who was attending this woman’s birth “Dell” a “student midwife” came off as a Student OB/GYN if anything. He had no type of midwife qualities in him what so ever and I think that is another huge slap to the natural birth community. He at best was a “medwife” if that!

Epidurals vs. Unmedicated

I was talking to someone today who was trying to decide if an epidural was right for her in her upcoming labor.  She was well read and still had some concerns on the topic.  But in part of our correspondence she said something that made me realize that she felt it was the epidural or do nothing.  We had a long talk about how women who choose to go without an epidural don’t just sit there writhing in pain until the baby suddenly falls out – they prepare and actively participate.

I explained that if she had any intention of going without an epidural, even a slim chance, that she should find a childbirth class that was designed for women who did NOT want an epidural.  Then she would be prepared, but that if she changed her mind and wanted an epidural she could always have one.  I told her that there were many things that women do to cope with pain in labor including:

• positioning
• movement
• massage
• relaxation
• encouragement
• water
• heat
• cold
• TENS

What would you have told her?

Why Our Women are Afraid of Birth

Deliver Me

It is Tuesday, at 10pm while I settle in after getting my little ones to bed. I flip through the channels and settle on discovery healthy which is a personal favorite of mine, but it really has only recently become a favorite because of shows like I didn’t know I was pregnant. It fascinates me that women could make it though a full term pregnancy and not know they were pregnant, but that is just me, and the experiences that I had with my children is what makes me wonder how the heck women could not know they were pregnant.  But that is completely besides my point today.
So as I watch this show, I am noticing a trend. High risk, high risk, high risk, previous cesarean section, scheduled cesarean section, high risk, healthy first time mother, scheduled cesarean, high risk. Well I mean, that is how it is in Los Angeles right?  You would think so!  But apparently because only these crazy, scary, uncommon births make something called ratings, that is all they are going to feature on TV. Because in reality, no one wants to watch a natural birth or a home birth because no one is running around with a scalpel screaming about the emergency that childbirth is. Nor is the mother screaming for her epidural because she just cant deal with the pain of the 3 hours of labor so far.
But what we should be thinking about most importantly is the message this is sending. What is this teaching first time mothers or even young women that may not be planning on having children soon but will some day?  It is teaching them how scary, dangerous, and medical birth is supposed to be. But is that really how birth is? Of course not. Anyone who has taken the time to read the studies, and just not follow what mainstream society thinks is the right way to handle pregnancy will know that birth is not scary or dangerous or a huge emergency. While it can be in some cases, in most cases it can and will be beautiful when just left alone.

When a woman becomes pregnant today, if they do not already have an Obstetrician they have been seeing for well women care since 16, or whatever age their parent decided it was the right them for them, what is the first thing that they do? They ask around their circle of female friends for the best Doctor out there because isn’t that what we all want? We want the one who is the BMW of pre natal care. Little do women know that they are really going to end up with the 1990 Dodge Dynasty when they take this route because hands off is better.
But because our society has told us this is the way things should be, they run off like lemmings right off the cliff of medical interventions landing in the valley of cesarean sections.

Maybe if the television channels like Discovery health followed a dozen home births or even aired The Business of Being Born they could get a popular, and controversial other side to what they are constantly airing. Maybe it will boost their ratings even more, maybe not?  But what it will do is give the other side of the whole issue. Let’s get Marsden Wagner to do a half hour special on Birth in The United States and see how many women run off to the midwives.  Instead they air these disgustingly inaccurate “Freebirthing” shows. They find the one idiot who is going to make women who choose unassisted birth look like a bunch of uneducated yokels.  Which is exactly what they did with their special on Unassisted birth.

I guess in the end, like anything else the television airs, it is biased and we shouldn’t expect much different.

No Intervention Necessary: Woman Has Surprise HBAC

This surprise out-of-hospital birth story focused on the toddler-as-midwife angle. Just as interesting, however, was the fact that this woman avoided surgery. She was scheduled for her fourth cesarean on December 6, 2009.

Congratulations to the family.

Two-year-old Jeremiha Taylor doesn’t have to ask his mother where babies come from — he helped deliver his little brother at the foot of his family’s living room couch.

“He’s my little hero,” Jeremiha’s mom, Bobbye Favazza, 27, of Olive Branch, said Tuesday. “It was like he knew what to do.”

Favazza gave birth to a 7-pound, 4-ounce baby boy, Kamron Taylor, on Friday morning. Firefighters arrived moments later to cut the umbilical cord.

Greg Mynatt, an emergency services supervisor with the city, said the 911 call about Favazza was probably the third this year about a woman in labor, but usually the mother makes it to the hospital before delivery.

Even rarer is a child assisting with delivery. Mynatt did not recall it ever happening here.

“This would probably be the first,” he said.

Jeremiha can count to five, feed himself and go to the potty himself. He communicates in short sentences.

Of course, nothing about his brief childhood had prepared him to assist in delivering a baby, but Favazza said that of her four children, Jeremiha is the bold one, the one who “will try anything.”

Favazza had made proper plans. Baptist Memorial Hospital-DeSoto was expecting her — on Dec. 6, for her fourth caesarian section — not on Friday the 13th.

Looking back, Favazza realized she was in labor all through the night before the birth, but she did not realize it at the time. The discomfort was minor compared to the labor pains she remembered before giving birth to her sons, ages 2 and 3, and daughter, 5.

On Friday morning, Favazza complained to her mother, Leigh Favazza, about the pain, but neither woman believed delivery was imminent.

Leigh Favazza considered taking the day off from her sales job if indeed her daughter was going to give birth, but first she had to get her granddaughter, Keely Taylor, settled at school.

Leigh Favazza left the house to take the 5-year-old to the bus stop at the end of Maury Drive, then she headed for Olive Branch Elementary School to drop off snacks for her granddaughter’s classroom. While en route, Bobbye Favazza called.

“Mom, I’m having the baby,” Bobbye Favazza said.

Leigh Favazza hung up and called 911. It was 8:26 a.m. She was frantic. Her daughter was alone in the house with a 2-year-old, a 3-year-old, a bull mastiff and a poodle and her water had just broken.

Bobbye Favazza’s oldest son, 3-year-old Jamison Taylor, had awakened to discover his mother bleeding and in pain.

“He sat on the couch right here and cried,” Bobbye Favazza said. “He was terrified. He’s my emotional one.”

The 2-year-old was calm.

“I laid on the couch and he went and got a towel,” Bobbye Favazza said. “He grabbed a towel on his own.

“It happened so fast. My water broke and the baby came two to three minutes later. I just pushed and he caught him.”

Bobbye Favazza said she held her baby, still attached to her by the cord, as she walked a few feet to unlock the front door for emergency personnel. They cut the cord.

Jeremiha, quizzed about the birth of his brother, can point to the spot at the end of the couch where Kamron Taylor was born.

“Over there,” he said.

“Sometimes these things happen, especially to mothers who’ve had multiple births,” said Mynatt, the city’s emergency services supervisor. “The time gets less and less with each delivery.”

Mother and son were discharged from Baptist-DeSoto. Neither suffered any complications.

“I’ve had three,” said Leigh Favazza, the proud grandmother, “and I can’t imagine having any of them like this.”

Bring a Loved One, Friend, or Doula for Continuous Support

When discussion of doula care surfaces on the Internet, it is always surprising how many commenters dismiss continuous labor support by a trained professional as unscientific fluff. Couples who hire a doula are sometimes labeled as selfish, out for “the experience” and elitist.

When a person believes that a pregnant woman (who is not planning a cesarean) checks into a hospital in labor to have a medical procedure performed on her, the idea of labor support seems superfluous. You wouldn’t bring a doula to heart surgery, the naysayers grumble. However, hospital birth should be an opportunity to allow a physiological process to take place in a location in which skilled professionals are readily available to intervene immediately if necessary. A primary goal of maternity care should be determining exactly what is optimal in supporting this physiological process, then ensuring that women in institutional settings have access to whatever best supports the normal process of birth.

Until the 1970’s, most American women labored alone, separated from her loved ones. Advocates, vocal consumers, obstetricians like Robert Bradley and childbirth educators fought hard for the right to labor with a partner. In Birth as an American Rite of Passage, Robbie Davis-Floyd wrote, “Hospitals tolerance of fathers’ presence increased as it was discovered that when fathers are educated and prepared for birth, the support they provide the laboring woman enables her to cope with her labor in more socially acceptable ways (breathing instead of screaming, for example), thus helping her and making it easier for hospital personnel to cope with her.”

While the normalization of epidural anesthesia has filled the role of allowing hospital staff to cope with laboring women, often multiple laboring women at one time, many women would still prefer to optimize support of the physiological process of birth and are not given the chance to do so in hospitals or are discouraged from hiring a doula by those who claim that birth is best left to science.

Fortunately, everyone wins with continuous labor support, the efficacy of which is supported by scientific evidence. According to Childbirth Connection, women who received continuous support were less likely than women who did not to:

• have regional analgesia
• have any analgesia/anesthesia
• give birth with vacuum extraction or forceps
• give birth by cesarean
• report dissatisfaction or a negative rating of their experience.

Here are just a handful of links that detail the evidence supporting continuous support of laboring women. And, really, is support of laboring women something that needs scientific evidence to justify its normalization?

Cochrane Review on Effects of Continuous Labor Support (Childbirth Connection)

Best Evidence: Labor Support (Childbirth Connection)

Healthy Birth Practice #3: Bring a Loved One, Friend, or Doula for Continuous Support (Lamaze)

A Doula at Your Birth (VBAC.com)

CAPPA Position Paper: Evidence-based Labor Doula Care (pdf)

OBs denying doula access: Where’s the SCIENCE!!!1!? (Hoyden About Town)