What can a birth atendant learn from UCers?

[paloma]

how can I better assist families?

[cottonwood]

I'm going to think about this a bit before I answer, but I have to say that I'm not sure how well I will be able to, because I think so little in terms of attended/assisted birth anymore. I would be more inclined to come at it from a different angle: what have birth attendants learned from UCers? Pamamidwife could probably write us a book on this.

Jan Tritten wrote about how she felt after her unintended UC:

"This few minutes was one of the most glorious high points of my life. [...] About 10 minutes later my dear partners arrived. The problem was that because they had missed the birth they came in chatting and excited. The energy and commotion pierced and stole my bonding time. I felt guilty for wanting them, my best friends, to go home. I could feel this critical time, our first hour of falling in love, slipping out of my yearning grip. I never recovered that first hour. It taught me on a cellular level how to behave when a new baby graces the planet. The birthing room is sacred ground. The first hour is a most holy time and space."

[pamamidwife]

I feel like I *could* write a book on this topic, however right now I'm' going out to breakfast with my family. Perhaps I'll write more later.

[paloma]

Mmmm, breakfast. I just shoveled two feet of drifted snow. I am still trying to find my car in all of this.

Thank you for responding. I hope that I never chat too much or make anything about me. I try to be super sensitive and never forget what an honor it is to be there.

Also, I know that people are not necessarily inclined to complain or exactly put their finger on what is wrong.

If I were to do it again, I would go unassisted.

[amyjeans]

Originally Posted by blueviolet

Jan Tritten wrote about how she felt after her unintended UC:

[i

"This few minutes was one of the most glorious high points of my life. [...] About 10 minutes later my dear partners arrived. The problem was that because they had missed the birth they came in chatting and excited. The energy and commotion pierced and stole my bonding time. I felt guilty for wanting them, my best friends, to go home. I could feel this critical time, our first hour of falling in love, slipping out of my yearning grip. I never recovered that first hour. It taught me on a cellular level how to behave when a new baby graces the planet. The birthing room is sacred ground. The first hour is a most holy time and space."[/i]

kinda OT
That quote, brought me to tears. How eloquent and exact she was in that statement. I am sitting here holding Sydney and remembering that first hour. That very first hour was indeed sacred and perfect. I was at the peak of my existence at that moment.


Thanks for sharing that Blueviolet.
(I need to read more of her writing- do you have any links? )

[lizzie]

This is a bit OT, but that quote from Amyjeans from Blue Violet made me think of something..

When I was first pg with my first baby, I was ready to invite my entire family in with us in the "delivery room". My dh was appalled, and insisted it be just us and the docs/nurses. I didn't know what to think of that, but then during and after the birth, I was so grateful for his attitude towards it, that it was just so special, and it was a time meant only for us and our baby to bond and learn about each other and become this little family(we were the only ones there, as per his request). So now.. reading that beautiful quote, I think I've got the best ammunition ever to get him on my side 100%... HIS OWN REASONING!! teehee! How can he argue with that?

lizzie

[majazama]

How can I better assist families, you asked.

Well, I think birth attendants should really try and help the pregnant woman to believe in her body's ability, not just try and find things that could be wrong (low iron, diabetes). I would have liked to have someone that I could have really trusted at my birth (first MW assisted). I think she thought I was a freak (which I'm not) because I told her at the beginning of my pregnancy that I was considering going unassisted. So when it came time for the baby to be born, I felt like she pushed her weight around to prove that assistance is neccessary. She made me give birth on my back, becasue she said the baby would come too fast if I was standing (as I wanted to birth). I think she was totally *wrong*, and I have a lot of resentment towards her because she made me birth like that.

Basically, my opinion is that women who are giving birth and pregnant are quite a bit more sensitive to all sorts of energies, and when there is someone at a birth who is taking the women's power to make the decisions for her, it really screws up the whole experience. That's just me, and maybe not everyone gets that sensitive, but I doubt it.

Giving birth is such a major spiritual, physical, emotional, and energetical experience, and I think birth attendant should just let women birth, rather than "managing" it. You are so OPEN when you give birth, and it should be respected when I woman wants to do, or not to do something while in that exteremly vulnerable place.

[paloma]

I think that i am realising the magnitude of this, especially when an aquaintance has asked me to catch her baby. ( I will be "allowed" to at a local birth center)

Maybe its my recent heightened sensitivity in the wake of my last birth, but I am caught up in my socks being humbled off (if that can happen) for the first time in my life.

Thank you for the responded. I look forward to continuing it if anyone wishes.

[doctorjen]

As a birth attendant, I feel I have learned a lot of listening to the UCers here. I've certainly tried much hard to get out of a woman's way more, and I'm more sensitive to the mood a family has during labor and birth. I've become very sensitive to the language I use. I have nearly completely given up coaching pushing especially. I also try hard to encourage women to listen to there bodies, and do what feels right to them. This has led to some beautiful births.
Unfortunately, I'm also much more aware of how much of what we do in the hospital is so intrusive in a normal birth. I attend mostly what would probably be seen as "good" hospital births. I monitor intermittently, limit cervical exams, almost never break someone's water, don't do episiotomies, etc., etc. but still, just being in the hospital and having someone there "monitoring" you changes everything. Most of the women I care for could never imagine being unassisted and look to me to provide guidance. Many expect me to "do something" at birth. I've had a few dads especially be disappointed at how little I do!
I'd love any ideas on how to encourage women to be more in control.
We had an OB interviewing for a job at our hospital recently. On of the hospital administrators was showing her around. I attended the administrator's lovely quick birth of a her 4th baby in the fall. It was her only unmedicated birth, her largest baby, and was really wonderful and enjoyable. I sort of sat around in the background until she was obviously pushing, then sat on the end of her bed and helped pass her the baby while she pushed him out. She positively glowed during labor and after, and didn't stop smiling once for 2 days. She introduced me to the OB candidate, and said "This is Dr. T, she delivered my baby!" I just cringed and said quietly "No, YOU delivered your baby. I was just there." She smiled and said "You know, you're right!" And the OB looked at me like I was crazy - so I'm hoping she chooses a different job and I don't have to deal with her!
I'd love to know how to encourage everyone to know they have the ability to birth their baby, and to feel the power of doing something so momentous.
Any ideas?

[alegna]

A little bit of a different perspective here. Only one babe/birth here so far, and it was attended, but the midwife I ended up with (switched at 30 weeks) had all of her babies unassisted, so I can tell you what I think that did for her.

#1. You are an addition to the process. Possibly a positive one. Possibly a helpful one. Perhaps a needed one. Perhaps an inconvient one. It's not up to you whether you're needed or not. It is up to you whether or not you are positive, helpful or disruptive.

#2. We have a powerful inner voice. Encourage women to find theirs and listen to it. It is much wiser than you are.

#3. Women are different. Births are different. Respect that. Avoid standards for the sake of standards.

#4. Most births, if left alone, will go perfectly. If they didn't we would have died out as a species. Don't go looking for trouble.

that's all I can come up with off the top of my head

I think you're headed in the right direction asking these questions though.

-Angela

[majazama]

yes, i too am quite happy and suprised that there are birth attendants willing to learn something from us UCers, and not bring us down.

thank-you
-------------------------------------------
I guess a lot of the empowering should come from the woman herself, and I realize that a lot of women just don't want to know what their body is doing while they are giving birth and can't fathom the energy that they can channel.

I know a good doctor, who told me that she urges her patients while they are in labour to try different positions, and encourages them to give birth squatting etc., but they for the most part refuse, prefering good ol' lithomy position . I think part of that could be averted by the mother having good info on why it makes birthing easier to squat or go on all fours. Maybe some printouts that they could bring home from their appointments would be a good idea.

I also think that MW's and doctors should really be in tune with their patients, rather than trying to do tests and answer questions from such a cold far-away position. You know, doctor is in charge, patient is below them. I guess I think optimally, pregnant women should feel like their assistant is on the same page as them, equals, friends.

I guess there is all sorts of different kinds of women who birth all in their own way. Some seem to like having tonnes of people around, but maybe they are not seeing something in themselves that needs sacred primative privacy.

There are a lot of things to talk about on this subject, that's for sure!

[paloma]

I have found that even amongst homebirth midwives, there is a lot of difference in how they practice.

[pamamidwife]

My journey with unassisted birth starts back about nine years ago. I was a frequent poster on hipMama, back in the day when there were about 40 or so of us.

I remember one day posting that I had caught my first baby. Suddenly, this woman was there telling me that all the joy and beauty that I experienced escorting that new life into a new world was not meant for me. That it was meant only for a mother and father and that I stole that experience from them.

Thus began a rather immature (on my part) dialogue with Laurie Morgan about unassisted birth.

As a student midwife, I doubt I could really talk about birth in ways that made me feel like it was completely safe or normal. Being in midwifery school often brought up a heightened feeling of anxiety around birth. My preceptor was really anxious right at the time of birth, telling me to get this, do that, do this....it was chaos. This was what I knew of "normal" birth - but in my eyes, it was beautiful because it was different than the hospital's version of normal.

It wasn't until this interaction with Laurie that my eyes began to open. Sure, I was resistant to what Laurie was saying - not every woman wants an unassisted birth! some people want a midwife! I totally missed what Laurie was telling me: that every woman deserves to find empowerment for herself. That my role as a midwife isn't to hand over empowerment to women. I cannot "give" a woman a good birth experience. I can, however, really screw up a woman's birth experience just by being a midwife.

My lessons continued with my dear friend, Linda. We became friends and were instantly smitten - I had never known someone to be so passionate about birth, yet not be a midwife or in midwifery school. Linda talked about the emotional pieces of giving birth, not the mechanics. This is the side of birth that my $12,000 midwifery education omitted.

Linda and I butt heads many times. It took me a long time to get over myself. Even in the beginning, I felt myself wanting to be available to unassisted birthers to "save" them. To "help" them. Because, goddess knows, I had the damn textbooks! I could give them information that they NEEDED!

Needless to say, my ego was bruised many times on that bumpy road!

I went from being up close and personal with women in birth to standing in the shadows. I could see when they needed my assistance - many times, in fact, they asked for me to help (can you imagine??). I stopped assuming that every woman needed ME to be there, to guide them through each and every contraction. They didn't need me - and my director role often made the partners fall back in the shadows.

I have left women's homes during labor. That's right. I sometimes leave. I have an incredible apprentice/assistant who really encouraged me to do this. When labors are slow and moms are feeling like they need to "perform", we leave. Go get coffee. We're not far, but we're out of the house.

I don't come to women's homes in early, early labor often. I will if they ask, but I rarely stay. I usually like to come when contractions are every four minutes. I found that before this time, women are too susceptible to my arrival. The energy changes, there's a noticeable difference in contractions. If I wait until active labor is really kicked in, I can often set up and be in the house without a mother ever knowing it.

Spending more time away from a woman's laboring space has also empowered partners. They do the labor together. In the end, when the six week visit is over, I'm history. The memory should be of THEM doing it together.

My views on perineal support and support during pushing has changed radically from my training. I no longer do much support, if at all. It's pretty quiet during second stage, except for encouraging words from me or my apprentice.

The immediate postpartum experience is different. I'm really working on the "don't wake the mother!" aspect after birth. No more baby hats, no putting a stethoscope between mom & baby. No bulb syringe. I am working towards more quiet, less light during this time. It's hard.

After all my lessons, I'm still learning. I love that I can be challenged in ways I'd never dreamed of. To me, the greatest gift I could receive at a six week postpartum is a woman telling me that they could have done it themselves! Of course, some of my clients go on to have unassisted births, too.

I realized, too, that by really seeking out my truth and walking with integrity, I'm empowering myself. Only an empowered midwife can support an empowered woman!

[amyjeans]

Pamela-
you rock.

[paloma]

Thanks to everyone for the responses. Pamela, have you shared this with any publications? I encourage you to do so.

[erindaugherty]

Listen to your patient

I am doing UC next time because of how I was treated with my first baby. It's on this site under Birth Stories, "A nightmare Birth" or my blog http://mybirthstory.blogspot.com. Anyways, I think a woman should be listened to. I only wanted interventions is there was an emergency. BUT unecessary interventions caused a downward spiral. My advise to a birth attendant is to leave the mama alone unless it's life or death.

Also, when you do need to intervene...talk to the mama and explain what's going on and what her options are. I had a 45 minute surgical repair without anesthesia I had no idea I had a right to pain control because no one told me the option. If your patient is screaming during surgery, something's wrong. That sounds obvious but I think hospital birth attendants are so desensitized they don't see the obvious.

[majazama]

erin~ OUCH! I guess when you have your UC, you will be sure to only get the the experience that you want.

[sprinkle pocket]

Originally Posted by paloma

Thanks to everyone for the responses. Pamela, have you shared this with any publications? I encourage you to do so.

your post reads like a really nice base for an article! thanks for so humbly sharing your thoughts.

[fourgrtkidos]

Any one want to revive this thread with some more thoughts??? It changed my view of midwifery.

[Aura_Kitten]

nak!

pamamidwife ~ you're superneato!

for me ~ and from what i've seen of others ~ women who choose to birth unassisted are fiercely independant, free-thinking, women, with deeply personal reasons for choosing freebirth.

with that said, i think the single biggest thing a care provider can learn from uc'ers is to listen to the pregnant mama and respect her wishes. if she doesn't want to be touched, don't touch her. if she wants to be loud let her be loud. and so on.

women's bodies are made for this motherwork ~ starting w/ growing babies & birthing them. your best jumping off point: respect that truth.