The Importance of Excluding Onlookers From Freebirths

13 12 2013

If you’re going to be of service to women and want to be taken seriously, having a well-rounded education is important. There are many things you’ll want to know before you can safely feel adequate to provide “care”. One important thing to know on laboring women is, when it comes to witnessing their homebirth, UC (unassisted childbirth) is not a spectator sport.

ImageEven if you allege to be hands off, the problem of the observer is one hopefully known to all UCers and would-be UCers. It is one of the reasons (maybe even a main reason) why many women decide on freebirth at all. One of my favorite writers on natural birth, Michel Odent, talks frequently of the mammalian needs in birth. Of our four basic needs, privacy is one of them. Without it, the mother senses danger and this complicates the labor.

‘To give birth to her baby, the mother needs privacy. She needs to feel unobserved.” –Birth and Breastfeeding, Michel Odent. Any doula, midwife, or doctor should read this book. 

You can read more here: Do Not Disturb: The Importance of Privacy in Labor, Judith A. Lothian, RN, PhD, LCCE, FACCE, The Journal of Perinatal Education- Advancing Normal Birth, from the US National Library of Medicine- National Institutes of Health (PubMed Central). Sidenote: This link also discusses the fetal ejection reflex, for the interested.

Now some may argue that it is possible to give a woman a feeling (or an illusion) of privacy and still have onlookers or caregivers. I will not debate that at this time, but I will state that if one is trying to observe a birth to determine their own readiness to venture into the fields of midwifery and the like, this learning experience is a detriment to the mother.

“There is no privacy without a feeling of security.” –Birth and Breastfeeding, Odent.

Anything you bring into the birthing space, the mother can sense. Any fears, hesitations, reservations, doubts, lack of confidence, lack of understanding of anything, lack of skill, lack of intuition, she spots like a dog smells fear. She taps into her primal state and the neocortex (rational, human, intellectual thought) attempts to disengage. If she has the awareness in any aspect of her consciousness that you are here to test yourself, this can generate feelings of insecurity in the mother. This is particularly true if you are not in an intimate relationship with her. Feelings of insecurity and lack of privacy will, again, complicate labor.

“Most women who understand what is going on are keen observers not only of their own actions, but of the reactions of those about them to every fresh event or incident. I have laid stress upon the sensitiveness of the mind of a parturient woman; if you wish to deceive them, you will fail.”

Confidence rests upon the knowledge of perfect preparation.”

“During labor, women spot doubt in a doctor’s mind as quickly as a kestrel sees a rat in the stubble… However good an actor or however suave a humbug, confidence has no counterfeit.” – these quotes from Childbirth Without Fear, Grantly Dick-Read.

The woman in labor, sensing any lack or fear on the part of anyone present, is hormonally receptive to those suggestions. This initiates the Fear-Tension-Pain cycle. Labor becomes hard or even dangerous for woman and child.

It is more important that we honor and respect the birthing space of the laboring woman and her most basic, primal needs as a mammal than to use her as a test subject for our own reassurance and education.

There are other ways we will be able to give ourselves a proper education on birth and physiology in order to ascertain in what capacity we may be of assistance to birthing women. Like the saying goes, “reading is fundamental”. I urge people to read, read, read, and learn everything they possibly can about true physiological, natural birth and the actual needs of a birthing woman in labor.

Privacy is one very basic and simple method of providing safety in the birth space of a well-prepared woman. We live in a culture, though, where the most basic methods of prevention are overlooked in favor of the most technical hands-on repairs we can put our logical minds to. But, what if we could avoid those dilemmas?

For example– Instead of relying on knowledge of which massage, drug, or herb will treat a post partum hemorrhage, what about understanding the seemingly invisible causes? The brain-body connection has a lot to do with our most commonly feared childbirth complications, and yet our culture does precious little to recognize and avoid creating the issues to begin with. We must look to the interconnectedness of our systems, hormonal responses to environment and stimuli, etc. If we were to know the birth process from an unhindered, natural, physiological perspective, know the stages of labor through all non-intrusive signs, and respect the mother’s primal birth space needs, our shopping lists and interference levels would dramatically decrease. Healthy, normal births would be the result.

I have noticed that there are many UCers or those researching UC are preoccupied with the fix-it methods, though. They read almost exclusively midwifery and obstetrics texts (if they read at all), they focus on which tools or drugs or herbs can be used in a pinch to solve a dilemma or crisis. In the process, we are neglecting the very root of why freebirth is so important– the undisturbed aspect of birth only it can provide. When we more fully grasp what is primal and physiological, our tools and medicines become more and more useless and unnecessary. This is  such a worthy goal! To lose sight of that and to attempt to mimic health care professionals in all regards in many ways defeats the purpose. We aren’t trying to take over their work, we are trying to transcend their methods.

In other words… If I wanted a medical approach to my care, I would hire a medical professional. But, I digress. Because I associate onlooking with interference, I have touched upon the issue of hands-on as relating to eyes-on. Getting back on track–

For anyone questioning if they could handle the pressure of attending births for a living, I would strongly advise they find their confidence elsewhere than at a woman’s freebirth. I would suggest educating oneself to the utmost of one’s abilities, reading books like the ones quoted here (as opposed to a lot of the more mainstream, feel-good, interference-happy “natural birth” literature). I would recommend reading things which are very pro-unassisted childbirth, where lack of attendants is understood and encouraged on a scientific level, because this will provide technical and biological knowledge and a foundation for what makes this birth safe. That is knowledge that would become confidence-instilling for anyone of the right composition to attend women.

Even starting as a trusted doula for attended births of people you are personally close with (at home or in hospital) can give one an idea of their own abilities. Anything… anything to avoid adding hindrance to what could otherwise be an undisturbed birth. This would be one of the gravest insults to natural birth and the natural birthing woman. The needs of a woman in birth are more important than any education we hope to glean from their experience for our own gain.

In order to properly care for a woman, we must first be able to put her needs above our own wants. Anyone unwilling to do that already has the answer to their own question– they are not prepared to attend her. Let us not behave the way that doctors have which caused us to leave the hospital environment in the first place.

“Every woman is different, and so are her needs in childbirth,” you might say. Yes and no. Psychologically every woman is different. The complex thought processes that make up our personalities and make us especially human varies. On the primal level, however, all of our needs are the same.

We are all mammals, we have built-in instincts designed to protect ourselves and the species. We do not deny our other needs as “individual”– whether a woman needs food, water, oxygen, sleep, and shelter is not up for debate based on her individuality. We all require these things as our physiology dictates. As mammals, we have physiological and hormonal reactions to childbirth events and our environment– even over the subtlest of things– that may go unrecognized or misunderstood to the untrained eye. Since it is the primal nature which gives birth, not who we are psychologically, it is the primal which we should be careful to honor!

What a woman chooses is her right, but it sometimes becomes a battle of what she is willing to partake in on the psychological level versus her most primitive instincts. I would not want to battle with the instincts, personally. You cannot reason with them.

So, even if a woman planning a homebirth or freebirth is gracious enough to invite someone to her birth as an observer or onlooker, this does not mean it will not in some way have a negative impact on her birth. A woman would be unfair to herself to promise someone that she would be comfortable with their presence (and it would be unfair for the onlooker to accept, with that knowledge). The primal need for privacy and the intuition of the laboring woman will strongly overtake most conscious psychological desires she has to be sharing, educational, brave, outgoing, or accommodating. Even a peaceful, knowledgeable, and experienced freebirther may find such an invitation to be a naive and inhibiting undertaking in hindsight. Whether it becomes merely a nuisance or precipitates a crisis, the would-be birth attendant must ask themselves, “is it worth it?”

Anyone considering UC for themselves should likewise acknowledge and honor their deepest needs in childbirth and respect the science of the process. This is the way you give yourself the best, safest chance at the healthiest birth.

Getting Qualified Care: Titles and Education

13 01 2012

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

12 01 2012

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.

Video Blog: “Why I Don’t Believe in the UC Elite”

20 06 2011

Women should really know what their options are in childbirth. All too often they will count themselves out for this or for that, because another woman discouraged them about it, or a doctor tried to dissuade them from it. There are often ulterior motives here at worst, or just gross misconceptions at best. I wanted to talk about it a little, particularly as it relates to UC. This also can be said of/translate to women who want merely a natural birth, a home birth, or a VBAC (vaginal birth after cesarean). So, although the topic does center around unassisted birth, it has a much more universal appeal.

That sounds so silly to say. Does it get much more “universal” than unassisted? 🙂 Ask the universe.