Letters About Birth #2 (Midwives): Your Voice Counts Day

Your Voice Counts Day is a day going around the internet on which, for Thanksgiving, we are supposed to submit letters to our caregivers regarding our labors. We mail or hand them in to let them know how terrific or horrible our experiences were in the hopes that it raises awareness for the level of treatment we are receiving. I’ll be doing mine here, in a series of 3.

The reason I hesitate to actually send these consists of several reasons. One, I believe that mainstream people will disregard me. Two, many people are mentioned, and it isn’t overall praise or blame for the whole, and some are nameless.

Image by Flickr: Wonderlane. Contains a parable on the Buddha and praise/blame.

Three, some of these people already know how I feel. Four, at the end of the day, I’m not sure if this is more for me, or for them. Or maybe it’s for you. It’s not that I think I can’t make a difference, but it’s about too much wasted effort in one direction that feels like barking at the wind. Anyway, this series will stand here, and maybe it will help you, or maybe those people will actually find their way here and it will matter to them.

Just like in my book, names have been anonymized in part or completely to protect real identities. For those who read my book, this may be a nice accompaniment, but it’s not a prerequisite to appreciate this.

Dear D & L, LK, & Hospital Staff,

You are the main reason I do not believe in midwives anymore. I went this route which was meant to include homebirth because, inexplicably, I still believed in myself and my body. The prior hospital experience had crushed my spirit and proven me wrong, yet something inside me would not let go of the idea that I was meant for this and it was attainable and preferable. My experience with you I believed would empower me, and instead it sent me further into the abyss.

I don’t know if I can “blame” you. I think all in all there is a system problem, and you (just like all health care workers, including doctors) probably truly want to help people, and feel you do so every day. Just like OBs, you receive praise and adoration for your great works, but through my eyes it is not without its casualties.

After “40 weeks”, I had to undergo the hospital non-stress tests, even though the due date was not based on my body’s rhythms, but on flawed measurement tools. One flawed measuring tool, the ultrasound, indicated my fluid *might* be low. I wish you had listened to me and not these tests or guidelines. I was fine, the baby was fine, yet talk of induction began. You knew I didn’t want this. Yet you gave me less than 24 hours to drink water and take baths to replenish fluid you can’t even measure right or I was going to be admitted to the hospital for mandatory induction? I wish you hadn’t given me that ultimatum. It was dehumanizing.

I had waited forever for you, LK. I was hungry and angry at the thought of my birth being dictated to me. I didn’t even know you, we hadn’t met. You came to check my dilation when I was ready to walk out the door after so many hours. I never do that, by the way. I’m a good and obedient patient, to my own detriment. But you arrived just after my husband told them we were leaving… I guess that prompted you to drop whatever was keeping you and check me out. What I thought was just a dilation check became you stirring my membranes. I remember you saying, “I’m just going to stir things around down there,” with your fingers inserted already. I remember the pain, and I remember I said, “Okay,” not yet understanding what that meant, as it was happening. I thought you were being rough, because cervical checks were not always this painful. Then it was clear. You were doing me a favor, supposedly. You were trying to stir the membranes to manually induce labor, to “give” me the homebirth I wanted in time, before being coerced into a hospital induction.

I was furious after I left, when I understood what was happening to me. I didn’t want your “help”! I didn’t want to be induced at all! I wanted this baby to choose their own birthday! Don’t any of you get that? Why would you ever do that without making sure the person gave their full consent? I felt violated. You had done something to my body in a position of trust that was against my will. Later I was spotting blood and losing my plug. Even though membrane stirring is not proven to start labor (and is proven to introduce bacteria, cause pain, and create spotting), you did the practice on me anyway without my agreement in an act of trying to be *merciful* to me. You were wrong.

On the way home I called you, D, to tell you. I was out of breath, struggling with words, but obviously upset. I said that LK’s “help” was “not cool”. You agreed… because you had just been to a birth and were so tired, you wanted a chance to catch up on your sleep first before my baby came! D, that’s not at all the problem. I felt like an animal while everyone but me manipulated my body and made choices about it for me, without my consent.

The rage I felt that night, I cannot describe to you. I paced. I ranted. I processed. I confided in you, I trusted you, so I brainstormed out loud with you on the phone my plots. “We could just say I went into labor, and that the homebirth was still on, and that later on we figured it was false labor. We could just keep doing that until it’s the real thing, and they’ll never have to check or admit me or try to induce. ” After all, “false” labor happens all the time. As much as I hate lying, I was willing to do it to save myself. You told me D, that we couldn’t do that, and that if I tried to do that you would no longer be allowed to care for me.

No longer allowed! I would be completely without assistance for labor, simply because I told the hospital something which could or could not be truthful and no one would have any way of knowing. Except you, D, of course, if you were privy to this confidential choice by me. But you would admit it, or tell. I guess you would be scared… scared if something went wrong, it would come back on you, I would blame or sue you. Well, I wouldn’t have. I wouldn’t. I know you don’t know that, but I wouldn’t. I’m honorable. All I wanted was a healthy birth, and one that didn’t traumatize anyone, but that isn’t what I got. You were lawsuit-free but it broke me. It changed my life and caused a giant scar inside of me. It almost altered the future of my family. The consequences of these things are so much more severe than legal troubles or even job or money loss. It’s so much deeper than that. What was at stake for me was greater.

So that night, as more of an act of protest, I had sex to induce labor. I didn’t want even THIS manner of induction, but I had to take matters into my own hands. I had to feel in control again. Other people would NOT tell me what to do with my body, would not put their hands in or on me to make anything happen that I didn’t consent to. I did it because I wasn’t going to let anyone push me into a corner. I did it because if anything was going to induce me, it was going to be me. Immediately after, contractions began. I’ll never know for sure if it was the stressing rage I felt, the membrane stirring, the intercourse, or any combo of these, or maybe even none of these at all… but it seems like labor was indeed “induced” and that I may have been the one to effectively create it. That is bittersweet, because I will never know, and because I was put in a position to do something I didn’t want, but at least I was still in the driver’s seat and not going to let them take it away from me. I was going to have this baby naturally and at home. I would NOT be going to the hospital this time!

But that didn’t happen. I called you D, in the early morning, to let you know I was excited to be contracting all night and this was the day. I was feeling good. Sleep was nice. Labor so far was easy. I called D first because I was scared that you, L, would be too hands-on even though you were my primary. You were closer to me and you had asked to be called before D and we went against that. At the time we thought that D would give us more choices and more time. D after all had been the “fade into the woodwork” one, which I truly sensed I needed. When you were both here, it was intense. I was in hard labor. I needed to be alone but you wouldn’t leave me alone! Getting on my back for a check was excruciating but you “made” me anyway. Why? I was *this* close to having the baby! Let me do my thing, please. I was stripping off my clothing right in front of you, didn’t you notice I was almost there? If I tightened up, I’m sure it was the tension of being around people, being in painful positions, and submitting to checks.

Then that damn meconium showed up (possibly normal, possibly due to the stress), and you “had” to transfer me. Ugh! Legally, maybe you did, I don’t know. But it sucks. I know now that it is NOT an emergency, and while I know you would not want to be held liable if anything were to happen as a result, or maybe you’d get in trouble with the state or the hospital if anyone found out, this was even worse for me. This was the worst day of my life. I had to put on clothing, because the ambulance was coming. You might as well have asked me to tap dance. I had to crawl down the hall covered in piss, fluid, and blood because you thought the paramedics couldn’t fit the stretcher down my hall. If that’s true, DAMN, it still was an ordeal. Twenty minutes felt like an eternity. Could you have dragged me? Maybe you thought this was my last shot to be alone, my last shot to have the baby at home, and if so, I do appreciate that. It felt like I was in Hell, it was torture, and I’m not being dramatic. I wish you would have left me alone completely and let me labor in peace. I would have had a great birth and produced a healthy baby for you in no time. I wouldn’t have lost faith in myself and carried recurring memories with me to haunt me.

I needed quiet and solitude, and trust in me and my body and my instinct. I hope you can give more of that to other women you help. I hope you will take that away from my story. Some women don’t need to be encouraged or touched or told how good they are doing. Some women need to just be left the fuck alone, or it is like you are killing them just to be there. But that’s just the labor aspect. We do not need to be held hostage by the legalities of an archaic maternity system. We don’t need to be threatened into submission.

To the female paramedic, thank you so much for honoring my wishes and being a gentle spirit. You were so respectful and I could feel your mercy, and you let me lay on my side like I needed. I felt your kindness and gentleness. I wish I was in a position then to say so to you. I wanted to write you a letter and I did send a message to the hospital, so I hope it got to you. You made a huge difference.

To whoever covered me with a blanket when we entered the hospital doors, THANK YOU. My eyes were closed but I still didn’t appreciate my ass hanging out. That was very considerate and meant a lot.

In the hospital, the baby was right there. He came right away. No meconium aspiration, of course. Good fluid amount. Everything okay. He was perfect, sturdy as an ox (is that an expression?), and as angry as I felt inside. Just as soon as they were taking him away to check him, they were giving him right back. My husband and daughter missed the birth. My husband missed the birth of his first son.

I had a million strangers around me holding my legs, prepping the room in a hurry, and LK, you were there to deliver. You told me (ha!) to put my chin to my chest and push, and not to make any noise. As if you had any control at that point! Had you never seen the involuntary fury of a woman delivering without drugs? I did the opposite. I couldn’t have listened to you if I wanted to. I couldn’t have even tried. I DID make noise and I put my chin away from my chest, and I wasn’t pushing on your command, I was pushing because my body could do nothing else. You and your nurses were rough with the matter of placenta delivery and subsequent uterine massage. Your pitocin afterwards for bleeding was bullshit and unnecessary and only added to my pain. The aftershocks were hard. If you thought my blood loss was excessive, don’t do things that make people bleed. Please read more about a relaxed and natural third stage delivery. Thanks for not sewing me up too tight, even though I could feel you stitching me. You are an example to me of how just because a practitioner is a woman does not mean they are delicate.

Midwives: I know you have lives of your own and professions to protect, but you are supposed to be “with woman”. Who knows what I need better:  me, or the state of Florida? I needed you to believe in me and without you I no longer believed in myself. I gave my body and my trust over to you, and I deserved your trust in return. To understand horror truly and deep in your soul is a rare thing and should be rarer.

Hospital — please teach your staff how to handle with courtesy the patients. After what for me had been a horrific day, I needed sleep. I was in a lot of pain and trying to find the right meds to let me breastfeed but also sleep, and baby occasionally woke to be nursed. People calling me to demand I choose something from the menu waking me and the newborn up is not necessary. Please train your staff in appropriate behavior or hire people who are good with people.

I get shit for this one occasionally. People who’ve read my book or an excerpt act like I’m some diva slapping a tray out of someone’s hand, thinking myself precious.  No. Talk about missing the point because you feel like it. Like I’ve said before, I’m a timid patient and customer. I’m the type that can’t even send food back at a restaurant if something is wrong with it. All things in perspective. Those people don’t really deserve a response, but in the spirit of defending myself, let me clarify.

So– I’m in tons of pain with a newborn, and we are both trying to rest after the worst day of my life. It’s 6 am or so and still pretty dark when the phone startles me out of an already fragile sleep. Groggy and worn, I can barely detect the mumbling on the other side of the phone that I fumbled just picking up. “Huh,” I was like. And the lady on the other end, with an obvious chip on her shoulder and I’m guessing no clue what my state of health or mind was, yelled back, “Watchoo WANT for breakfuss??” I was at a loss for words. “I don’t even know what you have.” I said. Then she started listing shit off a menu. I had to interrupt her. “We’ll just get something to eat later.” I said, and hung up. That’s all paraphrased of course, ’cause that was like 3 years ago, but I trust that’s pretty accurate (albeit condensed).

Now, I’ve given birth at a hospital before. I’ve never had someone call me up at the crack of dawn just to ask me about food (and, it didn’t happen again, during my stay there), and with an attitude like I was inconveniencing them. People quietly enter and exit your room, to check on you and your health, to check on the baby. People don’t loudly make fusses or wake you out of needed sleep. Maybe my previous hospital was better, had more of a clue. If people want food, they’ll go get it or fill out a little paper or something, or call for it by phone or by nurse. If they’re in recovery, they don’t want to be dialed up over cheerios. That was all I meant.

Some have said, “it’s not their job to know what you’ve been through.” Oh, isn’t it? But apparently it is their job to call up every room and take orders? That’s an odd job duty. In fact, part of the reason I always thought nurses took care of our food for us was they knew how we were doing, what kind of allergies we had, what kind of medication we were on, etc. It’s not their job to know? So you mean to say if they call up a room with a coma patient, and the phone rings endlessly but no one picks up, that’s a smooth running operation– a hospital that really has their shit together? Whatever. The point is, if hospital staff (including cafeteria workers) have access to any recovering patient, yes they absolutely should know the patient’s status or condition before trying to engage them in anything. Don’t have access to reach me or affect me if you don’t know my condition or needs. That seems reasonable. And nothing they do should be jolting or disturbing, in the hospital, of all places! That’s how people get better.

So yeah, I was pissed that I got woken up and pissed for my baby too, big deal. (lol) And for the record, I never bitched anyone out about it, I just described my frustration over it in my book about my births, so excuse the hell out of me for recounting the memory. >:) *End rant*.

One more thing, Hospital. You “let” me go home early, because, you know, I wanted that homebirth, after all. How kind, right? Let me tell you something. If you have a hospital experience, the recovery and being taken care of is sometimes the best part. I think that very concept is what keeps some people from homebirthing at all. In my mind, how I felt, I needed that recovery. I had a scary and painful experience and had already had the lesser parts of the hospital birth experience; the upside was supposed to be the “vacation”. It was well earned, that’s for sure. Even though this hospital was sub-par compared to my last, I’ll be honest… I was reluctant to go home. I was hurt. I was sensitive. I needed the rest, the break, needed to be babied, and you cut me loose. Leave it up to the patient next time. They might actually want or need the standard stay.

Everyone, overall the fuss made over me was unnecessary and the commotion gave me an excruciatingly painful labor like nothing I would ever wish on anyone, and the psychological damage I am still astounded today that I had the strength to heal. Birth became my enemy that day, not just because I didn’t get what I envisioned, but because the pain itself was felt in the most terrible way as to test the very limits of what one thinks they are capable of enduring (and has no choice not to). And now I know it didn’t have to. The damage that implies is so utterly tremendous I cannot convey this with words. Birth doesn’t have to be anything at all like that. That birth was not special, not dangerous, but it was made so.  I know you feel you help a lot of people, but the standards and procedures are so very flawed. Care needs to be individualized to the woman, not based on arbitrary bullshit. Attentiveness to up to date science (not to be mistaken for “medicine”, which is its own category and a business) including acknowledging that we are mammals with specific needs and responses in labor is critical! Those MUST be honored and worked with, not against, or we are hurting women and babies. Please know that even if I’m only reflecting 1% of those you see, of every 99 women you help, you may be brutalizing 1. I have a feeling my story resonates with more than 1%, though.

I don’t want you to think I hate you, because I don’t. We’re all doing what we have to do and what we think is right, right…? Things have to change, though.

Sincerely, Elizabeth

Letters About Birth #1 (Hospital): Your Voice Counts Day

Your Voice Counts Day is a day going around the internet on which, for Thanksgiving, we are supposed to submit letters to our caregivers regarding our labors. We mail or hand them in to let them know how terrific or horrible our experiences were in the hopes that it raises awareness for the level of treatment we are receiving. I’ll be doing mine here, in a series of 3.

The reason I hesitate to actually send these consists of several reasons. One, I believe that mainstream people will disregard me. Two, many people are mentioned, and it isn’t overall praise or blame for the whole, and some are nameless. Three, some of these people already know how I feel. Four, at the end of the day, I’m not sure if this is more for me, or for them. Or maybe it’s for you. It’s not that I think I can’t make a difference, but it’s about too much wasted effort in one direction that feels like barking at the wind. Anyway, this series will stand here, and maybe it will help you, or maybe those people will actually find their way here and it will matter to them.

Just like in my book, names have been anonymized in part or completely to protect real identities. For those who read my book, this may be a nice accompaniment, but it’s not a prerequisite to appreciate this.

Dear Dr. L,  Thank you for your kindness, gentleness, and understanding. You were so pleasant and comfortable to be around. Visiting you was a great first experience for a first time mom. I have now given birth with doctors and midwives, and I think if I had to relive an attended birth, I would go back to you.

I came away from the birth feeling a sense of lack or emptiness. I thought it went well in some respects… in that I got to be numb, I got a seemingly healthy child from it, and I wasn’t too messed up afterwards. By conventional standards today, I think it was normal.

I have since found that Dr. L has settled out of court for malpractice. I really wonder what the case was. Did something she do harm someone in a terrible way?

I think our standards are too low. They make us thankful when maybe we should ask why more.

Several years and births later, I have learned a lot more about birth. I’m mad. I’m mad that at only “41 weeks” (which I thought could have been wrong, anyway, since my due date changed so much) I was induced, and with Christmas just a week away. I have contact with women regularly who are induced around the holidays. Obviously I can’t help but wonder if that played a part. I thought I was going to get at least the 42 weeks to wait. Ultrasound alone, even if it had shown anything potentially concerning, is a faulty measuring device for non-stress tests, and I wish they would only be taken with a grain of salt. Induction I feel is used for convenience, and it hurts people. It robs people of their chances at a truly natural birth, it rushes the baby, and it increases risk of emergency (moreso than simply waiting for baby). I have no doubt that the interventions which followed, including the epidural, were influenced heavily by the induction. Why didn’t we just wait? My placenta was not in bad shape. My baby was healthy. I was fine, and the pregnancy was fine.

It’s my fault, too. I know. I could have said no. But I was 21, I was dying to meet this baby, and I trusted you. I think those things overruled my better judgment and I went along with it. I am in nature a much more stubborn, opinionated, savvy person. I constantly read during my pregnancy, I ate only the right things, I cared so much about this baby and birth. I was totally committed and devoted, and I’m not usually gullible or foolish. You deal with impressionable young women every day, some less headstrong than me, some who don’t do any research on their own. Your role is vital.

2/3 of OB/GYN guidelines are not based in science, but are based more in medical liability issues or convenience, things themselves based largely on myth and tradition and sometimes selfishness, and not on birth physiology. These are the modern old wives tales. It’s hurting women. It’s hurt me. My daughter was affected. She and I suffered seizures and convulsions. Mine seemed to only last for about six months after the birth. Call it an extended epidural headache, a bit of a hiccup if you will. It didn’t feel like a hiccup when I was slamming my neck into a railing and I blacked out, but whatever. My daughter was less lucky. She didn’t take to breastfeeding, and was not thriving. My dreams of being a natural earth mother were dashed there too when I gave her formula. I cried but I wasn’t going to watch her starved, and the nurses and lactation consultants had done all they could do for me. She was sickly as a baby, constantly with some bug, constantly getting medication. Today she still has absence seizures, problems with concentration, and a slight speech impediment. I will always wonder if this was as a result of the birth, which I know it could be. We needed more time, and more nature.  Nothing about us was broken, we didn’t need tweaking, or fixing, or saving. And none of us can take it back now.

Please think twice before inducing women. Please read up on mammalian birth physiology and Dr. Michel Odent, Dr. Sarah Buckley too. Tell me what you think. Read Childbirth Without Fear, too, or Pushed, or Born in the USA. Please stop insisting women get strapped down and monitored and stuck in one place, especially when they’re totally healthy. Please allow women to eat and drink in labor. I know it might be inconvenient for you, but we need to do what is natural and keep up our energy during long labors. It makes us more sickly and weak and easier to give in when you don’t (which I hope isn’t a goal). Please find out more about delaying cord clamping and those benefits to the baby. Please encourage women to move more freely and give birth in whatever position is comfortable for them.

Image via Mamas and Babies

Please allow water births, even if it means the patient brings an outside pool into the birthing suite. Please stop performing episiotomies and find out why they are actually worse and not proven scientifically as being helpful. Women should not be lying on their backs to birth at all, unless it’s an emergency or they instinctively choose it. Please keep the birthing suites dim and quiet with as little hustle and bustle (staff presence and intrusion) as possible during hard active labor, as this disturbs the primal laboring mind and thus increases pain and danger. Please stop doing regular and routine vaginal checks for dilation and such, as they can actually stall birth and the 10 centimeter standard is somewhat arbitrary anyway. Please stop doing directed 1-10 pushing and let the woman take the reigns, because her body will do the work for both of you. Please do not rush the placenta delivery. Please do not sew women up too tight after labor. If you change their bodies too much, it makes it harder for them to have sex again.

All of these things and more would help you to really give women back their births, and I guarantee you would notice a change and healthier patients. If I had had all these things, I might not be a solo birther today. You would be doing a service and honor to women, and it would be particularly noble considering it may go against your training and your acquired education in the field.

I loved you and I know you could help people in ways you haven’t thought possible. As great as you were, if you take my words seriously, you could do so much more. I went on to have two more healthier babies afterwards, so I have seen the power of what we can do when we respect nature and respect the mother’s instinct, letting it lead the way.  Love, Elizabeth

Dear Nurses Amy & Lisa, Thank you so much for your warmth, kindness, pleasance, tenderness. You really made my experience that much sweeter and easier, and you can see that you really do this for love of women and babies. Your jobs really matter to you. I know the hospital has certain procedures and protocol, but some of the normal stuff done, the routine every day stuff, is actually causing harm. Amy, there are some things neonates need more than to be immediately weighed, and bathed, and measured, and pricked… they are cold and crying. They need to be with their mothers. Those first few moments and hours are critical and it’s a sacred time. They all long for peace. If everyone seems healthy, those things can wait. When this stage is disturbed, it has actually shown to have unexpected effects, such as increased risk of PPH (post partum hemorrhage) in mothers. I wish the hospital could adopt these standards more easily. Lisa, the reason women even try for natural birth is because it doesn’t have to be some horrific painfest, and we don’t want our babies negatively affected by the drugs. As amazing as it was to have you by my side, the biological missing pieces affecting my psyche after this birth stayed with me, puzzling me, for many years until I “got it right”. We are doing this to most women today in birth, even if they are not always conscious of it. We are robbing something from them that their biology recognizes even if their mentality cannot. Believe me, there is a beauty to natural birth that maybe isn’t so apparent in the hospital setting. Anyway, thanks ladies, for standing by me, and caring about me and my little girl. Love, Elizabeth

Dear Anesthesiologist from Heaven, You were my hero of the day. I have no idea what I would have done without you. You were a lifesaver. I literally thought I would go insane without your help. When you mentioned scoliosis and had trouble placing the needle, I thought I was going to cry and lose my mind. Your presence was one of gentleness and comfort, and after some of the horror stories I have heard, I am so thankful for your loving demeanor. Your drugs were quick and effective, and the little button I got to press gave me  security and control. My baby and I did suffer after-effects from the epidural, but I truly feel that when you are in the hospital, the conditions can make the labor so completely unbearable that having mercy on yourself is crucial. I am happy the drugs are there for those who find themselves in an impossible situation, for they truly need it. Thank you so much for being there for me. I know I’m *supposed to* (haha) see you as some paternalistic symbol of our obstetric model, saving the “damsel in distress”, but in that situation I needed you. I’m forever grateful. If I had one critique, it would just be to be there sooner for everyone, because when they need you, they need you five minutes ago, or maybe clone yourself. Love, Elizabeth

Dear Elderly Nurse,  I wish when I told you I couldn’t breathe, you hadn’t covered my mouth and nose with that rag. I needed space, not smothering. It would have been nice to have not been made to go to the bathroom and shower right after birth. I could barely walk. Letting me rest would have been better. When I almost fainted on you, you didn’t seem like being alone with me was the best situation for either of us. I would hate to think what it would be like for you with overweight patients in that scenario. But, thank you for saying that my breathing during labor was good.  Love, Elizabeth

Dear Bitch Nurse, I don’t know what your problem is, but you have no business working alongside women, especially new mothers. Your bedside manner was the worst memory I have from my first child’s birth. You were rude, accusatory, incorrect, and uncaring. I have no idea why you are even a nurse. You couldn’t even see how you were hurting people, or did you not care? A mother recovering after labor should not ever have to cry herself to sleep during her stay in the hospital. You’re horrible. Please find another profession that doesn’t involve interacting with the public. Sincerely, Elizabeth

Dear Formula Nurse, Thank you for breaking the news kindly and gently to me that my daughter was not thriving and needed formula. I am getting unexpectedly teary-eyed just thinking about it. You helped me do what she needed at that point in time. I would do anything for her. I just wanted you to know, though, that despite what everyone says, sometimes women just have sensitive nipples and sometimes breastfeeding does just hurt the first several weeks. I know it isn’t “supposed to”, but it can. With future children I discovered that, because I stuck it out and after 4-6 weeks, it finally felt natural because my nipples toughened. I bet it would help your patients to know that.  You saw us… the latch was correct, when she would even latch. Formula is expensive, so thank you for all the free samples. Love, Elizabeth

Dear Hospital, You’re a birthing suite, you are supposed to be comfortable and deluxe. People actually choose you because they feel it will be the most home-like environment in a clinical setting. I know I was happy to end up with you. As far as I was concerned, you were the best choice in the region.

via Sunshine is Delicious

When a woman has had a long labor without eating anything and it’s the middle of the night, it doesn’t matter if the cafeteria is closed. Food is needed for the patient… it’s part of their health. Please don’t make your nurses scrounge to get cereal boxes when they’re trying to help someone recover, or put new tired dads in the position of searching for a 24 hour store or restaurant in a hurry to get some food for everyone. Maybe consider keeping your cafe open all hours. I mean, what women go through is hard enough. Make it easier for them without turning everyone into sudden scavengers. Food is as basic as blankets for the beds or running water for the bathrooms, when you think about it. Plus, everything else I said to everyone above. Sincerely, Elizabeth

Getting Qualified Care: After A Loss

First, let’s consider what makes a person healthy or unhealthy in the grieving process.

If you suffered a loss, what kind of care would you seek? Does suffering a loss alone make one qualified to mentor another who has suffered a loss, too?

Mental health and emotional health are serious. If you are suffering a loss, it is very important to get help on a professional level, particularly if your grief is intense. At the minimum, you do want to make sure that the person you have helping you is in a healthy mental state. Even with the loosest interpretations of what makes one “qualified” to provide appropriate care, most of us can agree on this basic starting point. Please be careful whenever you are selecting any form of help or care.

Joining me again is Michelle, a pregnant mother of 4 who has experience with natural birth, home birth, and loss. I have watched Michelle come under fire by other loss moms in the anti natural birth groups for not automatically placing blame on her caregivers when her loss occurred.

Deb O'Connell is a CNM with Carrboro Midwifery in the area of Chapel Hill, North Carolina.

The same camp has taken offense to some of my writings about healing and trauma as well. The philosophy seems to be that nothing can heal you from the loss of a child.

I am reminded of one attacker in particular who told Michelle that she did not love her child not only because she had come to terms with it in peace, but mainly because she did not blame her midwives for her child’s stillbirth. In fact, what had begun as a peaceful conversation took a swift turn for the worse when the woman started in with obscenities and accusations, all a reaction to Michelle’s take on loss and the sharing of her own experiences.

Doulas ARE very natural childbirth-minded... most people don't find a need for doulas outside of that practice, because it would be too "woo". Most people giving birth in the mainstream don't feel so much of a need to have a doula; they have their doctors, nurses, significant others, and family members as their support.

This same woman wants to be a doula for women expecting a loss, and also has signed up to mentor loss parents through a program called Stillbirthday (featuring and run by people who are part of the anti natural birth movement). Are people with these philosophies in a good position to be offering qualified care to the bereaved?

Let’s start with a simple question:

How do you counsel the bereaved? What is best for them? What kind of guidance do they require?

Michelle says: Having been to a REAL therapist to deal with things like my loss, my childhood, and my abusive ex-husband, I have a somewhat good idea of what they do and why they do it that way. My therapist never projected anything on me. She listened to me and what I had to say and then ask questions which made me look at myself not anyone else. I think it is good for loss mothers to have a place to say how they feel and express some of the normal stages of grief ( and anger can be one of them). However, if what they are looking for is healing then I would recommend a professional who can deal with the psychological aspects of loss and its effects on people.

I do believe we are all entitled to enlist the help of those who we feel are best to serve us. To me, this goes beyond training and credentials and is a personal choice. I’ve made that quite clear. When it comes to birth, anti-NCBers cannot be more opposed to this philosophy, but do they extend the same strictness to mental health?

The importance and seriousness of good care does not end for the mother and child once the baby is born.

Most healthcare professionals could probably tell you that people become consumed by, addicted to, their grief. It’s a hard process and takes years of therapy for some to cope well. Surely nothing can be as devastating as the loss of a child, so it would be totally understandable to think that this could mentally and emotionally damage someone more than possibly anything. When a person is in pain, they are capable of inflicting pain on others, sometimes as a way of projecting their self-loathing. If a person is so deeply affected in a negative way by a crushing loss, are they in a position to help others in a truly healthy way to cope themselves?

To make a comparison, would we expect someone suffering from severe alcoholism– who admitted they saw no hope in sight for finding peace– to be an ideal mentor (or even “buddy”) to someone just entering Alcoholic Anonymous? When do two people suffering from the same disease no longer serve as a support system, and instead become the blind leading the blind?

Putting oneself in a position of sensitivity and responsibility to those in need when your own psychological needs are not being met and, in fact, one believes they cannot be met, may not be the quality of care the grieving deserve. However well meaning, if you were to fail at your responsibility, you are affecting lives and have the potential to do more harm than good. This would be like if a good midwife who means well were still not qualified enough to do her job. The results could be disastrous.

This is what I want to examine, and you’ll see that before I’ve even had a chance to get an answer to my questions, I am causing great offense for looking into this subject matter. But, in all earnestness, what could be more important than a mother’s mental well-being? You could have a dozen successful births of healthy children, but if the mother is unable to receive right care, everyone loses.

This is one of the anti natural birth pages, and the bottom comment is from the would-be doula and mentor for grieving mothers. She is seen here participating in the manner normal for her within these groups.

While we believe that you should be able to choose whomever you like for any form of your own care, regardless of title or degree, we do always urge that you exercise caution and common sense. Anti natural birth groups insist that certain classifications of midwife are unfit to practice, but they seem to feel that any laypeople in various stages of intense grief make good mentors to those who are just beginning their path. They do not seem to require any special qualifications– no degrees, no higher education, and not even psychological evaluations to conclude that said individuals are sound enough to be assisting the grieving.

In Search of the Perfect Birth and Michelle both ask,

Why the double standard?

To be continued…

Getting Qualified Care: Interview With a Stillbirth Mother

Joining me is Michelle, a pregnant mother of 4 who has experience with natural birth, home birth, and loss. She brings a unique perspective to the concept of what is “qualified” care.

You can read more about Michelle and her story over at My Journey to Healing Birth.  But now, here was our exchange.

Elizabeth: What role do you feel your faith or philosophies, religious or otherwise, played in the grieving and acceptance of your loss?

Michelle:  For me my religion played a huge role in my grieving process as well as accepting it. I am a Muslim convert (meaning that I was not brought up as a Muslim). Prior to getting pregnant that time I ran across a story of the Prophet Muhammad that says:

“By the One in Whose hand is my soul, truly the miscarried child will certainly drag its mother with its umbilical cord to Paradise, provided one expects recompense [for sabr (patience)].”

One of the fundamentals of faith in my religion is acceptance of the decree of the Creator. This means accepting the good and the bad because He is the one who controls what happens to us all. If I were to take the route of being angry at what happened it would equate to me being angry that my Lord allowed it to happen.

I also recently ran across a different story of the Prophet which states:

The Messenger of Allah (sal Allahu alaihi wa sallam) said: “When a person’s child dies, Allah the Most High asks His angels, ‘Have you taken out the life of the child of My slave?’* They reply in the affirmative. He then asks, ‘Have you taken the fruit of his heart?’ They reply in the affirmative. Thereupon he asks, ‘What has My slave said?’ They say: ‘He has praised You and said: Inna lillahi wa inna ilaihi raji’un (We belong to Allah and to Him we shall be returned).’ Allah says: ‘Build a house for My slave in Jannah (Paradise) and name it Bait-ul-Hamd (the House of Praise).’”

 So yes my religion and my faith play a huge role in my acceptance and my ability to move forward from my loss. I see it as a blessing and as a mercy not as something worthy of anger.

And faith, in my opinion, is not knowing everything will always be good. It is knowing that no matter what happens everything will be ok.

Elizabeth:  How do you feel this differs from others who have lashed out at you in relation to your own loss?

Michelle:   I think that if you have reached a level of peace within yourself you will not find it necessary to tear down those that are at peace. I think in some ways they are still in pain over what happened to them. It could be their perspectives are different from mine. It could be that those around them have encouraged anger rather than forgiveness. I know from my own experience many in my family wanted me to be mad and if I was easily influenced by them I could have easily gone down that road instead.

Elizabeth:  Do you feel these individuals are fit to help counsel others?

Michelle:  I think it is always comforting to have people that can relate to you in terms of what it is like to lose your baby. So on one hand I think it is necessary. On the other hand there has to be a balance in that not every individual will grieve the same way. We are all different. If you take a person under your wing and try to push your own pain onto theirs as a means of making yourself feel better this isn’t healthy for either individual. Special care must be taken into account when you are dealing with emotions like grief. Especially when it is new.

Elizabeth:  What impact do you feel an individual who has not fully healed themselves would have in connecting with and mentoring those just fresh in their grief?

Michelle:  As I stated above I think this is something that has the potential to do more harm than good. Everyone is at different levels in grief, however one must try to be empathetic to others experiences and realize that theirs is their own and no two situations are equal. I think it’s good to have those who just say I understand and leave it at that. Spreading venom though based on their own loss is not healthy for anyone. I just ran across a quote today that pretty much sums it up: “Resentment is like drinking poison and hoping the other person dies.” — St. Augustine.  Being mad about something you have no control over will not harm those you are mad at it will harm you the angry one.

Elizabeth:  Discuss a little about what happened in your birth when you experienced your loss, and tell us why you do not feel the midwives were at fault.

Michelle:   First I want to state that I had a strong instinct that this baby would never make it out of my womb alive. I had this feeling long before I decided to homebirth. It was that feeling actually that drove my decision. I needed to have a peaceful pregnancy if that was all I was going to get. I also was threatened with a tubal ligation by the OBs and I knew if this baby didn’t make it I would be devastated if I would never be able to have any more kids.

As for what happened in my birth, my labor was perfect and beautiful. I progressed nicely and there was no stall of labor at all. Every time heart-tones were checked he sounded perfect. I began to feel pressure and the need to push and I was checked only to find there was still a lip of cervix left. Heart rate was checked again and he was fine. My midwife broke my water to see if that would help get rid of my cervix. There was no indication at that time that the baby had any trouble. It wasn’t long before I really needed to push. I am unsure of how long I pushed before things went wrong. I know it wasn’t a long time though (it wasn’t even an hour). I had pushed the baby down to where he was essentially crowning and at that time heart-tones were checked and not found. When I heard that I immediately pushed with all of my might to birth him. His head was born and then my contractions stopped and I could not get the rest of him out. 911 was also called before the head was born. Once they arrived I had another contraction and was able to birth the body and he was born lifeless.

I did not ever feel that my midwife was negligent. The minute there was a sign of trouble she called 911 and did everything she could to get the baby out. I want to mention that I am not convinced that shoulder dystocia was what caused his death. I truly feel that it was the other way around. There is an excerpt in the book Spiritual Midwifery that touches on how hard it was to birth a stillborn baby because the mom couldn’t feel any energy from her baby. Babies must be active participants in the birth process meaning once the head is born the baby must rotate its body for the shoulders to be born. In my case my baby had a loss of heart-tones prior to delivery of the head so once his head was born he was no longer participating.

Elizabeth:  Do you feel you had quality care? How qualified were your midwives, and what made them qualified? What were their credentials?

Michelle:  Without a doubt I had quality care. In fact the care I received from her was a million times better than the care I have received from OBs. She had been a midwife for well over 30 years. She had personal connections with Jeannine Parvati Baker, Gloria Lemay, and many other highly regarded midwives. In all honesty though I chose her because of faith. I had trusted in the Almighty to give me a sign that this was the right path for me. I knew when I contacted her she had retired. What sealed the deal for me was finding out her home she purchased to retire in was literally 2 streets away from me. She was put on my doorstep. How could I ignore that sign? She was exactly what I needed in my life at that time and exactly what I needed for that birth. I have never had a single regret about choosing her and I am still very close to her. In fact every time I see people trash a midwife that attended a birth with a negative outcome it makes me think of her. Because they are still people and whether or not people believe it or not the loss affects them too.

I have used all three types of midwifery care. My first midwife was a lay midwife, my second was a CPM, and my third was a CNM (she is still my midwife this time also). All planned homebirths. The care I have received from all three of them have been equal in terms of quality so “titles” to me mean nothing.

Elizabeth:  Do you believe that any time a baby passes away, it is due to insufficient care?

Michelle:  Not at all and this goes for whatever place of birth you choose. Are there negligent providers (both midwives and OBs)? Absolutely. Does that mean every single one of them are negligent? No it doesn’t. In fact I would even venture to say that at times it could be as simple as making the wrong choice and not necessarily negligence. I think it is important to remember that doctors and midwives are people and therefore are not perfect. They do make mistakes. Most try their best to give the care you want while keeping everyone safe. Sometimes things do happen so fast there is nothing you can do. Other times they are totally negligent. But one must have the ability to separate the two.

Elizabeth:  What brought you to natural birth in the first place ? Were you “indoctrinated” by any “cult”, and do you subscribe to any NCB “dogma”?

Michelle:   I have actually always been “natural” minded. I had planned a natural childbirth with my first baby long before I was ever on the internet or knew anything about the world of the web. It unfortunately ended in a bullied unnecessary c-section.

Elizabeth:  Exactly. That’s just like me– I didn’t need any indoctrination, it was just something I was pulled toward without regard for how anyone else felt about it. I wasn’t even aware there was a club, nevermind cult. I didn’t get an unnecessary C-section, though… I wound up getting induced and taking the epidural. How did all that affect you?

Michelle:  This only furthered my desire for natural childbirth because I had seen what the opposite was and for me it was ugly.
Elizabeth:  Same here.

Michelle:  I tried again for a natural childbirth the second time only to end up with a c-section again. My loss was my first and only un-medicated birth and it was amazing. I loved every second of my labor. My 4^th and 5^th baby were also planned homebirths that ended up hospital births with epidurals and I really disliked them both. It was the one thing that I was disappointed over because I missed out on what I had the first natural birth. Hopefully I will finally have that “perfect birth” this time around .

I was never coerced into natural childbirth. I was drawn to it. I don’t know that I subscribe to any NCB dogma however I will suggest and encourage natural childbirth over non natural childbirth. Only because it is better for mother and baby overall to avoid unnatural chemicals into the body. I do however respect what other people choose. Like I said I have only had one natural un-medicated birth. I know sometimes the benefit of getting pain meds may outweigh the harm.

Elizabeth:  I’ve said before how grateful I was for the epidural, but I’m like you– having been through both versions, I do not recommend the medical way.

When getting care from a doctor or midwife, mentor or counselor, how important is it to research the individual and feel like you truly know them very well beforehand? Or can we ever really know everything about our providers?

Michelle:  I think it is important to for sure ask questions not only about them to others but ask them point blank to their face. I think that the relationship between a midwife and her client may differ from an OB and client simply because of the amount of time spent together prior to the birth.  I don’t think we can know everything and I am not sure we really have the right to know every single thing about them. What I really feel about this is that we should all trust our instincts. If it doesn’t feel right, it probably isn’t. I think as a society we have been somewhat trained to ignore our instincts and just do what other people tell us.

Elizabeth:  To anyone out there grieving hard, enraged, and blaming natural childbirth in general for their loss, what would you like to say to them, or what would you want them to know?

Michelle:  Honestly when I see people so full of anger over their loss I feel really sad for them. I wish they could let go of the anger and embrace what they have. I know it’s hard. I know it hurts. But being rage-filled only makes you feel worse not better. It hurts you not the one you are mad at. As I said earlier “Resentment is like drinking poison and hoping the other person dies.” — St. Augustine. I think society has made us feel like we have to blame someone/something for death rather than acknowledging that death is part of the cycle of life. There isn’t always an explanation or a reason.

 

Getting Qualified Care: Titles and Education

This is part of a series called Getting Qualified Care, where we examine the anti natural birther movement of storming the internet to dispel what participants within feel are lies and misinformation about birth. We are discussing just what constitutes quality care from qualified providers, the subtext being “who gets to decide this” — mainly, would you allow other individuals from a movement with their own set of biases choose for you what your standard of care should be?

What makes one “qualified”? Is it a prestigious educational background?

 Maybe it’s a rank or a title, like “Doctor”.

Amy is Harvard educated AND a doctor. Impressive.

Amy informs someone that college and medical background means you cannot disagree with them and possibly know what you're talking about. Interesting. Only a fool would disagree with a doctor!

Here is Amy telling us a Doctor is wrong.

Here is Amy telling us a Doctor is wrong.

Here is Amy telling us a Doctor is wrong.

Here is Amy beginning to tell us that yet another Doctor is wrong.

Don't want to ruin it for you, but, another wrong Doctor, according to Amy.

I could go on, but I think you get the point– Dr. Amy, 5, Other Doctors, 0.

It can’t be the Doctor credential and the years of medical training and background that is making people credible or qualified. Then again, I guess any glance at My OB Said What?! could have shown us that:

Just one example of real-life anecdotes submitted to popular website My OB Said What.

All doctors come to the table and present their “evidence”. How do you know who is telling the truth, especially in a world where we’ve considered that doctors are capable of being flawed?

Maybe it’s in the licensing of that title, to validate it.

Most of the “Fed Uppers” are on a(n in)quest to end midwifery that does not belong to the CNM (certified nurse midwife) category. They believe that all other forms of midwife (usually designated as CPM, or certified professional midwife) are a joke and disservice to women. It needs to be noted here that a lot of this stems from personal bias and bad experiences or trauma the women have faced with natural birth. Differing regions (particularly in the States) have varied regulation in terms of education and practice standards, but in general, much training and years of education are required for one to become a licensed midwife of any title. Yet, one of the main purposes this group claims to promote is eradication of what they deem less qualified midwifery in favor solely of the CNM model. Unfortunately, CNM’s largely practice in birthing centers and in hospitals. What I see as the real goal in mind is the eradication of home birth.

Is a midwife more qualified just for having gone to nursing school beforehand? Is a midwife more qualified for taking a more medical approach to birth? If no other midwife licensing is allowed or considered “qualified”, will that ensure everyone has more qualified care, or will it eliminate options and force women to choose between clinical birth and freebirth? Who gets to decide what kind of care a woman must receive, if not the woman herself? Who gets to mandate which one and only kind of education is valid and acceptable? What if midwifery as we know it became illegal?

Maybe it’s in the current state of practice.

Some argue that a midwife who refuses to renew her license recently is no longer a midwife and shouldn’t be allowed to practice. It doesn’t matter that her skills are still fresh in her memory, and that her choice to not renew is believed to be a political statement against mandating with whom and where women may give birth. To add controversy, suppose this midwife was unafraid of taking cases labeled “high risk” in order to give women more options for their labor, understanding the high risk cases could potentially result in a loss whether or not she presided over the care? If you knew a tragedy could be inevitable regardless, would you choose to stand by your patient, or would you CYA?

Others would argue that an out-of-practice OB/GYN who’s been retired for almost 20 years now, although still given the title “Dr.”, is no longer up to date enough to be giving accurate medical advice, opinions, nor to be weighing in on birth today and facts presented by others who are more current and active in the field. Indeed, birth has changed a lot since the 1990′s. For better or for worse, the skills, policies, drugs, and technology would be greatly different. A doctor who stopped practicing back then, in this fast-paced profession, would undoubtedly be considered old school or maybe obsolete to the hospital crowd.

Being fair, we could say that neither one has “lost” their skill set. Are either of them any less of a doctor or a midwife? Only in technicality. In our own minds, it’s up to our own judgment to ascertain this wisely. Who would you rather have– the latter, or the former– look after you? What would seem more “qualified” to you?

I think education is nice, licenses, degrees, and titles are all very nice… but at the end of the day, it isn’t any one thing that promises to provide you with “qualified care”. Everyone is equally capable of incompetence. Truly understanding this leads to resigned acceptance of freedom to choose the care you think is best, without harsh judgment or scorn.

Getting Qualified Care

Of course your care providers are *qualified*, but in the eyes of whom?

Most of us would agree that finding qualified care is of extreme importance. Where we diverge, however, is in how we define “qualified”. We could just leave it at that and live and let live. After all, we will never all agree on one set standard of what is acceptable. What you find to be proper I may find inappropriate, and we are all different people with different values and different needs.

However, there are people out there who are so obsessed with the care other women receive in birth that they are unwilling to give in to this, and frankly they are quite mad. The people I am talking about storm birth articles, pages, groups, forums, in addition to their own groups, forums, blogs, etc., in an organized front to rally against natural birth and what they believe to be some kind of natural birth cult-like movement. One of their main groups  even describes itself as being “Fed up with natural birth“, fronted by an infamous retired doctor, a former OB/GYN. This may not be very compelling in and of itself if not for the fact that nearly every naturally-inclined pregnant woman who hits the internet for information or camaraderie is bound to bump into (and, heads with) these individuals whether they’d like to or not. The level of force used is great, from the mischievous to the malicious, and people who disagree are automatically considered ignorant and bombarded with what some can only describe as hate speech. This is done in an attempt, they say, to be of service to women and babies.

My thoughts: We all want safe options for women, and we all do what we do because we think our information is correct, our stance the truly educated choice, but we don’t all impose our beliefs and standards upon others.

In this next series of posts I have titled Getting Qualified Care, I will take a deeper look into the anti-natural birther movement and their obsession with controlling how total strangers both view and give birth. Specifically, we will be bringing up points to cause readers to question whose definition of “qualified” should count, who gets to decide this, and just how qualified the people concerned are to dispense the info and services which they do.

One thing they stand firm on: They are doing it to help.
Let’s keep that in mind as we take a look at the people who want to make sure YOU are getting qualified care.

Neonatal Resuscitation

One of the biggest fears when talking about UC (unassisted childbirth) is how to respond to emergency scenarios. A common fear is that the baby will not be breathing or responsive at birth. I believe that having some idea of what you would do in a crisis is extremely important. Not only is it a life saver in the rare event that you face danger, but it’s invaluable for instilling the confidence and peace of mind needed for a truly relaxing birth for you and baby. After all, panic will help no one, even if you are presented with a challenge. Be prepared!

So, here are a few things to remember on the topic of neonatal resuscitation. This is not to be construed as medical advice; please research all subjects independently before making any decisions with regard to the health of you and your baby.

• Babies are instinctively stimulated by mother. You can read more about how mothers tend to do this to illicit a response here in Emergency Childbirth: A Manual, by Gregory J. White. Lisa Barrett (midwife) also remarks, “Rubbing a baby and gently blowing and talking is usually enough to ensure the baby opens her eyes to look and take a breath. There is usually no rush as with a cord pulsing the baby is normally getting plenty of oxygenation and will come into herself pretty soon.”   Keeping the baby warm and stimulating it are usually more than enough to achieve positive results.

• There can be a delay in crying, pinking up, or drawing first breath– don’t panic! The two previously quoted sources also support this and provide elaboration.

• Aggressive tactics for administering oxygen are no longer generally recommended, and are often not even used amongst the medical community/rescue services. The Lisa Barrett link as well as the Emergency Childbirth text will discuss this more, including how utilizing pure O2 has not been proven better for neonate resuscitation compared with blowing shallow breaths for the infant (this too can be instinctive). In fact, these days, using oxygen on a newborn is considered to do more harm than good and so is foregone in favor of the gentler revival techniques. The International Association for Maternal and Neonatal Health (IAMANEH) also state that an oxygen tank is NOT essential for neonatal resuscitation, that the mask and bag are more appropriate (which is equivalent to shallow mouth-mouth), and even warn against routine suctioning of mouth and nose of infants after delivery.

• Take action first, dial for help afterward. In an infant CPR video, EMT and Captain Nathan McConnell warns that if your baby needs help, your time is best spent attempting to stimulate and resuscitate. He recommends giving at least 2 minutes of care before stopping to call 911. Precious time could be wasted if you choose to dial emergency services first. By the time they respond and arrive, it could be too late, and since every second counts, immediate attention is key. Since life saving resuscitation techniques tend to be the same both at home and in the hospital, knowing how pros handle it will be critical to making sure you’ve done just as they would, and that you’ve done all that you can do.

•  IAMANEH details the appropriate steps to neonatal resuscitation and speak on it very practically. Basically the steps (see all the links and sources) involve stimulation of the infant, clearing the airways, breathing for the infant, gentle chest compressions, and repeating.

• Signs the resuscitation was successful include pinking of the tongue (lips alone are not indicative), overall raised APGAR scores, good pulse and good breathing. Resuscitation efforts can go on for up to 10 minutes or more, and 10-20 minutes is usually the period where further attempts would prove futile.
• Finally, understand that the majority of the time, everything is just fine. The odds of you having to do any of this are slim. Knowledge of neonatal resuscitation techniques can be there for you just in case. You need to learn them, know them, get familiar and comfortable with them, keep cheat sheets, and then put it out of your mind. Don’t dwell on a negative potential… focus your attention on the actual reality and remain calm and optimistic. You have every reason to believe that birth will go smoothly, so don’t worry yourself sick (it only distresses the baby and increases the chances for dilemmas).

Nothing beats taking a class. If you’re like me, you have taken a class several years back and even been certified, but keeping current could be beneficial for both increasing your confidence as well as hearing the updated recommendations (as these change from time to time). Hear what the pros have to say, and if possible, get certified. If you’re unsure of your ability to react quickly in an emergency, do drills. Include everyone you think will be present at the birth. Think of all possible scenarios and outcomes. Have Plans A, B, and C.

Like I usually say– even if you don’t plan on having a UC, being as prepared as you would need to be to have one is such a good idea, because you never know where you’ll find yourself and what will happen. Accidental UC’s happen all the time, and mothers who weren’t expecting it and were not prepared experience worse outcomes than intentional UCs that were thought out in advance. When it comes to birth and nerves, education is key. Never hesitate to transfer to a hospital if you suspect something is amiss with your neonate and they do not appear to be thriving. It’s always better safe than sorry.

Why One Midwife Doesn’t Want You to Learn Neonatal Resuscitation Skills

My article on Neonatal Resuscitation was removed from The Birthing Site because one midwife took issue.

Her argument is that laypeople cannot learn neonatal resuscitation.

Cannot, or should not?

I knew when I discussed with TBS about potentially writing for this subject that this particular topic was touchy. I asked them first. I let them know my intentions. I knew I was too much for people, not for everyone’s palate, and I knew that there could even be some concerns about liability surrounding this. Yet, I was enthusiastically received, published, and was praised both by them and other sites and members for writing a great article. People said it was helpful. It only took one professional to say “Nuh uh uh!” to have the information hurriedly snatched back, amidst apologies and thanks for their expert valid opinion.

Well, I’m not sorry. I did nothing wrong. I won’t apologize for writing it, and I won’t keep it from you. I will publish it again here. Look for the follow up to this piece.

Things in life sometimes ARE complicated. Our digestive system is complicated, yet we eat every day. Our nervous system is intricate, yet most of us move daily. Most things in life are a paradox, both simple and complex. Birth is one of those things. Neonatal resuscitation can be one of those things. There are probably 1 million and 1 things to know and learn about it, yet birth and resuscitation happens every day all over the world and largely without fuss. We need to find the balance between the intricate and the simple. The confidence to flow with the simplicity of nature, and appreciation for the complexity — we re-educate ourselves in an effort to regain the confidence stolen from us by the established businesses who hold authority over our heads. With it, they control our very life and death. I don’t know about you, but I’d like a little knowledge and a little say in that.

You can’t censor information. You can’t burn books, even if you’re afraid of what the commoners might think they’ve learned from it all. People in authority think information is dangerous. That’s the story of humanity. Choices and freedom are still for us to have. No one can “let” you do anything. You have the right to birth your way, and you have the right to read my article. What you do with that will always be your final choice. You are in control.

The facts are this:  Most mothers who feel the need to stimulate a response from baby achieve this naturally and with ease, unless someone has given them fears to hold, fears that they won’t know what to do, that they aren’t good enough to handle it on their own. That panic leads to death. Not being calm, irrational hesitation on your part leads to death. Not knowing when to call for outside help leads to death. Letting their fears contaminate your mental space is a graver danger than birthing without assistance.

Take back your power, think for yourself, and live.

I was the "liker" there, btw.

Now she's talking about breathing tubes? These are not a normal aspect of neonatal resuscitation. This woman is a midwife. I was not aware that midwives were trained and skilled with intubation. It is not recommended that people utllize intubation who are not skilled at doing it very regularly, since it can injure the throat (especially so for a neonate!). She is not making a case against UC, she is making a case against home birth.

I’ve read Samantha’s comments again and had this to add:  so much of what she is saying to do to stimulate the newborn is exactly what I am talking about (for example, rubbing). She and I are on the same page there. I am not sure how her info there is better or contrary to mine… it’s not. It’s in harmony with mine.

It terms of some things I found insulting… looks like a copy paste job? No, I wrote it all. I wrote it myself. That’s pretty inflammatory. That sounds accusatory. These are MY words. Never held a life in my hands? What on earth does that mean? I’ve been responsible for three newborn lives in my lifetime, the last of which was MY own UC. Of course I’ve held the life of a newborn in my hands! I would argue that every mother has.

So, I stand by my work, my good intentions, etc. Samantha having “UCers best interests at heart”? She is discouraging learning more. I am advocating it. She sympathizes with UCers. I am one. She’s a midwife who believes she is necessary. I believe you can DIY. I don’t think having their best interests at heart quite fits.

 

And this, my dears, is how one single person with a title after their name can silence others using fear.

 

Guilt is a Destroyer, Part 2

I see the problem here as guilt and denial. One feels guilt in incredible ways, and then lives in a state of denial about how all these other things are at fault. The denial is also, therefore, a denial that they had the primary role in their own life events. Rather than accepting that something just occurred and everyone was there and had a choice, there is a need to blame. Rather than blame oneself and admit the guilt that is plaguing oneself, one then opts to direct all or primary responsibility onto somebody else. It’s a coping mechanism. It goes a little something like…

Natural birth is at fault– it’s not that great, medical advancements are far better, what’s so great about vaginal drug free birth anyway, you aren’t winning a medal for it, it’s killing women and babies and is archaic and stupid.

Midwives are at fault– they aren’t educated, aren’t properly licensed, mine should have known I was in trouble.

The NCB community is at fault– they indoctrinate people, it’s like a cult, they all believe in BS and not in science, they guilt mothers into making wrong choices.  ETC.

It’s never up to the woman. Do you see? You can never “blame the mother”, or use “blame the mother mentality”… which is cried if anyone tries to further examine the mother’s choices in the event in light of tragedy. If blame is going to be placed at all, these are the questions that we need to be asking. Sorry.  It’s never her choice, her responsibility, her consequences. It’s always somebody else.  She is automatically innocent (and how dare you, btw), and somebody else is most definitely guilty. You see, I’m not just saying question the “guilt” of everyone… I’m saying consider that everyone is innocent.  Blame usually doesn’t have to take place at all, but if you are pointing the finger at me or damaging other people, someone has to step in and point out the accountability here. It’s gone too far, too long. There are worse things than blaming the mother. You could be blaming people who are just as accountable, less accountable, or not accountable at all.

For example, when a practitioner does their best to provide the service you have hired them for, that’s all you can ask of them. The rest is up to you.

IF you are present at a birth and you feel something is not right, it is your duty to yourself and child and all involved to act accordingly. IF something goes wrong, and you always had the final say, you must own up to your part in things. It is an admission of the truth and the first step to moving forward in a healthy way. As I see it, all normal-intelligence adults available are responsible in a time of need. This does not all rest on the shoulders of one. When you hire a midwife as your naturally-minded caregiver, it is not so she can take the fall in the event of misfortune. If one feels that way, one should not hire a midwife. If they have committed an indisputable count of negligence or abuse, obviously I think they deserve blame. However, if you still had a choice and didn’t make it or take it, you shoulder some of that responsibility. You have a voice.

[Recently I heard a troll say that the reason midwives should be properly licensed and insured is so that if a tragedy occurs, a lawyer would be willing to take the case because there would actually be money worthwhile to come of it. Ah, I see... So, everyone, get an OB so that if your child dies, you can properly get a lawyer and sue and at least get some $$$ from it. ] Good reason to change your birth plan, natural childbirthers.

So no, I am NOT advocating blame, but when I see projections and misdirections of anger, rage, hate, and guilt, I think we need a reality check. Midwives are trained professionals, but they DON’T know everything. Neither do OBs for that matter. The most important piece they are missing is YOU and your intuition. People, no matter how educated, make mistakes. It’s not all homicide, bloodshed, and manslaughter. Sometimes no matter how much it is KILLING you inside, these mistakes are completely innocent. You are ALL accountable for your choices. No ONE single person takes the fall, and no one always has to take the blame, automatically. A death should not automatically be assumed as the fault of anyone. Investigate, ask questions, but accept reality and live in it rather than create a false one where you are less accountable. Sooner or later, no matter how skilled a person is, they are going to witness a tragedy. Sometimes, these things just happen. You hate to hear it? Yeah, it sucks, but it’s true.

No, don’t blame yourself, don’t beat yourself up, but don’t do those things to ME either. Be brave, face your problems head on. It’s cowardly to direct the hurt you feel you deserve to instead hurt others.  I would never tell a mother how accountable she was in her child’s own death… until she starts pointing the finger at others. Those who believe it’s always the other guy’s fault, those who believe that with their pain comes a sense of entitlement, those are the only folks who need a reminder that they were also an adult in that room and also capable of making a choice. It’s something that could and should go without saying most of the time, unless you keep shoving it in the world’s face in order to create suffering and remove your own accountability in the process. My theory: you don’t hate me, you hate yourself for not making the choice you knew was right. I wish I could magically take away your pain, but I can’t. You need to get serious professional help if you are trolling the internet and calling it “helping others”.

Guilt, you see… it’s a destroyer. It will change your whole world. Friends become enemies, demons become friends. Things you used to believe in become false. You lose faith in whatever God you may have previously claimed. Activities that harm others become the norm. They do things which cause more pain for themselves and those who come into contact with them.  Others who love you feel put out or neglected by you. You are withdrawn, putting on a fake face to be acceptable in society while inside you feel you are someone else. You don’t have to suffer alone, and you don’t have to live with this intense pain your whole life. Your children, living and deceased, would not want that for you. You all deserve better in life.

 

People reject healing when they think the hurt seems insurmountable, or they are undeserving. This comes from self-loathing. A partly aware admission of accountability which translates as guilt says, “how could I let this have happened to my baby?”, and hate and beating yourself up follows. Guilt is a real bitch, but you had it coming, or so the logic goes. So, one resigns to a life of pain and guilt and blame, because they don’t see any other path clearly. They even think it would be disrespectful to the memory of their baby to NOT feel this way. I suggest that the worse disrespect is the mistreatment of other women, mothers, and babies in the process of your rage and guilt. Even the very midwife deemed the culprit is probably not so worthy of hate. Granted, it would take a lot of forgiveness to ever feel that way. Baby steps.

I’m telling you, people, there’s an imbalance here, and it’s not healthy and it’s not right. It’s toxic– to your mind, probably your body, and your soul, and it’s affecting others. You want consideration for your feelings and it’s been given to a fault, but even through the pain, you need to offer your consideration to your fellow (wo)man, because we all have pain, and you aren’t the only one (and this includes infant loss). It does NOT have to be this way, so ugly and nasty and cruel.

In any case, hate (which guilt has produced) is not productive or conducive to goodness or healing for you, or anyone. Some think healing from baby loss is impossible– so why bother, right?  If healing is impossible, why try to “help” anyone who has lost? I hear that a lot, about reaching out to others who have lost, as if that means anything. “I’m here for you.” What comfort is that with a dead baby? If nothing can fix it, why the community? Because you are looking for understanding and looking for something to feel even a tiny ounce better than the loneliness of your grief. You are living with the unreasonable burden of guilt. And let’s be real, here– it’d needn’t be. Other women have gone through losses and not reached the same conclusions. It is possible, but you have to want it. Your pain is not reality, it’s just your reality. There are other truths out there to explore if you would only let yourself. If you can accept this as true, you can also begin to see how other realities of other people– loss moms and other moms– are their truths. The healing stories, the stories of love and overcoming pain, are the ones that are going to be of service to people. We need to spread those, promote those, give hope, and help people get better. Instead of resisting those, maybe you could listen to those and when you are ready, believe in yourself once again and your ability to let go of guilt and have peace.

Quit letting your guilt destroy you, who you were, what you want to be for your family, and who you have become. Break the chains and ties that keep you part of a destructive lifestyle. Live and let live. Find the path to end bitterness and guilt now so that when you are an old lady and preparing to leave this life, you can look back with fondness and gratitude rather than wrath, and you will be surrounded by children and grandchildren and more, who lovingly embrace who you are and their time with you. You cannot get a dead baby back, but you cannot get back lost time, either. Every hour you’ve spent persecuting strangers on the internet is lost time. Pain is an addiction, an obsession. Find the road to recovery. I may never know your pain and I hope to never have to, but I do care about your well being and want you to find peace and joy. If I were in your shoes, I’d want someone to do the same thing for me.

Guilt is a Destroyer

Guilt– could anything be more damaging to the human psyche? Wise men and philosophers believe it is a useless emotion. Most of us claim to choose lives free from regret and fear. But, what do you do when the most precious thing in the world is gone, and you blame yourself?

Most of us will never know unless it happens to us.

As many of my readers are all too well-aware, there is a group of women out there who have many names who are at odds with natural birth in a serious and malicious way. I tend to call people by the names they first introduce themselves to me, so I call them Trolls. The trolls are made up of many, many women and their common bond is a hate and ridicule for women in the natural childbirth community. This comes in varying degrees as many of the women have had natural births themselves. However, the activities they partake in are the same. They are host and member to at least dozens of angry and mock sites on Facebook, blogs, and forums. This is all in the name of birth safety if you ask them, but when I watch them make fun of other people, their births, and their babies, it becomes clear that this is not all about keeping people safe… it’s about feeling okay with themselves.

Why does anyone ever make fun of anyone else? To feel better about themselves.

Why does anyone ever lash out at another for their opinions?  To feel more right about their own.

Why does anyone ever gang up on someone, bully, or threaten them?  To feel stronger about themselves.

And just like in school, you can guarantee that whenever a group of people get together to talk shit about somebody else, it’s to say to each other, “We’re okay for not being like that. In fact, we are better.” The word they use often, sanctimommy, is ridiculous to me… and no where is it more fitting than on those whose mouths and fingers it comes from.

But there’s something deeper going on here. Why are they so angry, and why do they need so desperately to feel better about themselves? Like most serious bullies, the lashing out comes from another pain they are dealing with (or running from).

Some of the so-called trolls are suffering from the loss of a child. This seems to give weight to their voice, and they are instantly influential and respected amongst those who listen. I listen to loss stories and I see their pictures and yes, I’ve cried. Who hasn’t? The worst part, for me, are the parts where they admit that they knew something wasn’t right but they did nothing. You know all that intuition you’re always telling people not to use? This was the time to use it. Hindsight is 20/20 and I would not be so heartless as to point this out if it weren’t for the fact that the trolls go after every single NCBer they come across like they are the enemy, but if you ask too many questions or give a differing view, you are automatically chastised and demeaned to be some horrible person. “You have no clue what you are talking about. She lost her baby.” “How dare you argue with her! She’s lost a baby, didn’t you know!” As if that explains anyone’s rightness in a discussion? Women who we already sympathize with, we are now expected to never contradict ever, even when they may be wrong or hurtful towards others, because to do so would be the height of insensitivity and equal to “spitting on her dead baby”. Today, one of the trolls in a Facebook discussion even said that life wasn’t fair, because if it were, one person who had shared a different opinion would be the one with a dead baby.

Most of us agreed this is not something we would wish even on our worst enemy, nevermind someone with a different view.

This is what I mean about guilt, and blame. If you don’t get the healing you need to keep living healthily, if you surround yourself with people who are also in pain and lashing out for whatever reason, you become destructive. Guilt is a destroyer. It’s a vicious cycle, with the same people feeding each other the emotions it takes to keep mocking, keep attacking, keep blaming. One of the loss moms keeps blaming me for a baby death that occurred back in Spring. The mother she had referenced, by the way, had never even spoken to me for advice. Every time I bring this up after being accused, it goes uncorrected, unchecked, and people go on as if I had never said it. For me, this casts doubt on every other label they are more than likely wrongly placing on others, just for the sake of being sensational. How can that be credible, or taken seriously? Like the boy who cried wolf,  “Baby Killer” seems to be the favorite cry of those suffering intense rage/guilt, and although I feel for them in their time of pain, I and others attacked are not deserving of such negative attention.

I’m trying to save babies, I promise. If more people would listen to their instincts, more babies would survive. I don’t know about you, but if I suspect that something is wrong with my labor or my baby, I’m in the hospital or getting a second opinion, regardless of what my medical professional is telling me. That’s what autonomy is about, that’s what free will and choice is about, that’s what self-education is about, and that’s what instinct is about. No one is perfect, and even someone like me who feels confident about natural birth could one day meet with wrong choices, or tragedy. I’m aware of that. This is why I am not critical of people who make mistakes or experience tragedy.  It’s also not my place to tell people where I think they erred. However, the time has come to shed light on this sensitive topic, because it’s getting out of hand. It’s people who only seek to shift blame in dramatic and hurtful ways that need to be spoken to about accountability.

Everyone keeps dodging that bullet, though, because it makes them feel bad and they get called out for it. Well, the time has come to be a little more open and honest about what guilt has wrought, because it ain’t pretty. I am not the bad guy, the evil midwife, and I’m not even sure the midwives are the evil midwives, to be honest. Mommy bloggers are not your midwives, and water birthers, homebirthers, and UCers are not crazy, dangerous people just killing babies left and right. It just isn’t true. This comes from deep places of insecurity and self-hate.

So, prepare yourselves, because I’m “going there”, but only because it needs to be said finally.

I’ve heard time and time again how not only the mother, but other witnesses present in loss stories knew something was wrong, and did nothing. I have asked some people point blank why they didn’t enter the hospital when they and others felt very deeply that there was a problem, and I receive no responses. Still, the common trait of these loss stories seems to be that “my midwife KILLED my baby”. Or, it might just be that your midwife, despite all her training, had an error in human judgment, as did all other adults involved.  Sometimes this includes husbands, friends, doulas, paramedics… all participants, all with a voice, but none held accountable for their own choices and actions when the tragedy strikes. Only one fall guy, one scapegoat… that seems to be the midwife.  I suspect that people know their role in this, and it eats them up inside, and that in order to simply get out of bed in the morning, they need a new target for their rage and their grief. This becomes the midwife, and natural birth, and anything or anyone else that seems somehow opposed to them. The alternative would be acceptance and healing, or one’s own demise. So, enter Bully & Mob mentality, and harassing absolute strangers on the internet as if it were a full time job.

I’d say “whatever helps you sleep at night…”, but a) I still don’t think such people are very happy with this way of existing. It is not healing them, it is not making them better, it is not taking the pain away, saving anybody, and it is NOT bringing their baby back, and b) you cannot get your rocks off at the expense of hurting other innocent people. Your pain is not a free pass to be cruel and tormenting to other people, especially just on the basis of not seeing eye to eye.

Now before you say, “Damn, Elizabeth! Are you really blaming loss mothers for their loss?” No, that’s not it, and that’s not what I’m advocating. I’m not advocating blame. I’m advocating right accountability and responsibility. Human beings are human beings. Forgive each other, and forgive yourselves.

 

To be continued…