She's had four natural births: two days of labor at home concluded with a hospital birth, a water birth in a birth center, a home birth, and, by accident, an unassisted home birth. Her name is Sarah Clark and she is a natural childbirth educator, also known as the Birth Boot Camp instructor. Throughout her classes and her gorgeously informative blog, Mama Birth, Sarah inspires us to learn what we can innately do with our own bodies and minds throughout the pregnancy, birthing and parenting process.
Sarah's classes are educational, fun and interactive; with dolls, scarves, condoms and more, she constantly keeps each mother and father-to-be full of engaging inquisition. She takes couples through the many stages of pregnancy, labor and postpartum experiences covering various aspects of labor, spousal support, doula and midwife education, natural induction methods, relaxation techniques practiced in-class and at home, breast feeding benefits and how-tos, along with videos and personal stories. Sarah provides each couple with a small tote filled with a pen, a few labor snacks, two breastfeeding DVDs and a book, full of information such as summaries of labor stages, positive affirmations, kegel and food trackers, newborn procedures, and a guide to belly mapping - a way to connect with your baby and discover its often-changing position.
Eager to share her knowledge with others, Sarah happily agreed for an interview. After putting her youngest down for bed and nestling her other three with full bellies on the couch to watch The Princess Bride, she conveyed a bit of her experience and views on the power of women, men, children and entire cultures and how we are all a part of the birth process …
Jessica: Often women relate by sharing birthing stories, even though they've experienced various births. How have your personal births helped you educate women about birth and the body?
Sarah: Each birth that you get to experience is different. I think birth is always very humbling because you never know what will happen, no matter how well you prepare. With each birth, I've learned things about myself and been able to relate to other women. I remember with my first, I prepared really well and I had always wanted a natural birth. But when it was over (and I had a really long birth) I understood why people had epidurals; I realized how differently it could have gone if I hadn't been blessed with the knowledge that I had going into my birth.
That is partly why education is so important to me. Even with my fourth, and I had been teaching for years by then, it was a completely different experience, and for me, the first time I actually wanted pain medication. That was also humbling and eye opening for me. I was at home and that was partly why I had a natural birth, but also I realized if I hadn't had the confidence from my previous births, I wouldn't have believed I could have gone through that labor because it was more painful than my others. I thought if I was a first time and that was my first birth, it would have been so hard, I would have gotten the epidural if I were in the hospital. Now as I meet other women that have been through my class who have experienced a posterior labor that was painful, I am able to relate to them better.
Jessica: As a mother who has birthed naturally, you mention that you can understand how women have wanted an epidural when you personally experienced a level of pain with your last birth. What are your thoughts of women who have had medical interventions? Do you find yourself more or less judgmental?
Sarah: I think a lot of things when I hear people's birth stories (Sarah laughs). I think having more children has helped me a lot and made me more accepting in some ways. I still feel strongly that natural birth is the best option. I see some people, in the birth community in particular that have the attitude as if - everything is ok, as long as you do what's best for you. I don't believe that. I do believe natural birth is the best way, and I believe that because I am a natural birthing mother.
But as I meet women and I hear their stories, I care about them and I can find a way to understand why people make different choices - that doesn't mean I always agree with them. I always feel sad for somebody who I know really wanted a natural birth and didn't get it because I know it was important to them.
J: I often find some women proud to share their experience, while others feel ashamed of their birth stories. Why do many women take their births personally?
Sarah: Birth by its nature involves our bodies and our hormones and our emotions and everything in us. If everything doesn't go as some women wanted, they often feel betrayed by their bodies.Sometimes even the language women use, such as saying, "the baby wouldn't move, the baby wouldn't drop down, the baby was stubborn" reveals an issue that the mother might possibly have felt that baby wouldn't cooperate. It's very personal.
For a lot of women, it's hard not to have body issues in our culture already - from the way we view women and the way we expect women's bodies to be or to fit into a certain mold. If the birth doesn't go as planned, often the blame is put on the mother with comments such as, "the mother wasn't big enough" or "the baby wouldn't handle labor with the mother."
And lastly, I think a lot of women feel judged by other women. While some of that is real, some of it can be doubt about our own choices and feeling as if others are judging us because we're not sure we made the right choice. There are a lot of reasons why things go the way they do, and some of that can be our choices - but it can also be the choice of care provider or the choice of birthplace. And often a large part of how things go is totally out of our control. Sadly, I notice there's always someone to blame when it doesn't go as planned, and often that blame is placed on the mother who probably feels hurt already.
J: People often think birth is a woman's experience. You're teaching others that it is not only the woman's experience, but also the man, the baby, even other support circles such as a birth center or a doula can impact the birth experience. Can you explain the importance or reasoning for this more communal approach?
Sarah: Depending on whom you ask, people would answer it differently. For me, I view birth as the life event. It is part of my belief system that family is important and birth is the expanding of the family, so to me it is sacred and involves more than one person. It always involves the child, if there is more than one child, it involves the others too, and the partner. Since I teach couples, it's amazing to see the growth, the way they work together and how much happier they are when they are able to go through birth together.
It's really tragic for a family when things spiral out of control and the partner feels completely helpless. I often hear women mad at their partner because he didn't say the right thing or do the right thing - or because he slept in the corner and didn't know what to do. It can be really traumatic for dad if he feels useless and doesn't know what is going on. If men are not prepared, that is often what happens, and it's not a great start for a new family. I would want the birth to be a great experience for the entire family that brings them together, makes them love each other more and gives them the confidence to start parenthood - because parenting is much harder than birth. If you got through it together (often people fear it) and it was a good experience, that gives you the confidence for the things that are going to happen down the road. It's crucial for the couple's relationship together and for the parenting relationship with the child. So yes, it is much more than an experience just for the Mom. It's a family experience.
One thing that's happened since the 1950s since men were brought into the delivery room is that we now expect men to be in the delivery room, but the sad thing is we haven't prepared them how to be there. Women want men to be a part of the birth experience, yet almost always, they go in not knowing anything - about labor, about how things work in the hospital, about how she'll act, the noises she may make. It's tragic because we want him to be there, but we don't give him any tools, which isn't fair to anybody involved. No matter what people are planning, no matter how they want to birth, each couple should take a comprehensive class to help prepare them so they aren't blindsided by the overwhelming experiences.
J: How do women work through fears of birth? Are there any common fears?
Sarah: As an educator, I think a huge part of it is education and understanding the process biologically what happens, emotionally what happens, even knowing what to expect from your care provider. All of that knowledge is helpful and will combat most of those fears. Knowing what's normal and talking to other women who've had good experiences versus reading the bad stories or watching what television feeds us empowers women as well. Often women share negative birth experiences, which builds fear. Building a community of supportive people is crucial so you can hear positive stories. You can do it in a class, with your birth team, or friends and family.
As far as common fears, for women who are birthing in the hospital, they worry about who their care provider is going to be. Almost every hospital and care provider in the country rotates call. This leaves women usually with a group of doctors and unable to know ahead of time who will be there at their birth. That's a newer thing. Fifty years ago, when you had an obstetrician, he was your OB and he come to your birth, even if it was in the middle of the night. Obstetrics has really moved away from that, as well as hospital midwifery. I can see the professional reason for this change and the difficulty in working on-call, showing up on holidays, and I can see the need as far as insurance reimbursement and the need to spread out care, but it is a disservice to women. Honestly, I think that's one of the reasons women chose a home birth because they know who will be at their birth.
Another fear is pooping in labor. For many women, that seems like such a private thing and people don't want to do that in front of a nurse they've never met, a doctor or even their spouse. But that goes back to the importance of feeling safe about where you are birthing and with whom you are birthing. If you don't know who you're having your baby with, it can be scarier to know that you will literally let go in every way in front of them. Many women that are secure where they are birthing are not afraid of that, although there are a lot of factors that pertain to that fear. Ultimately, many women are afraid of losing control.
J: How do men or partners work through fears of birth? Are there any common fears?
Sarah: I feel as though I keep giving the same answer…education is huge for men. Often they want to know what's happening in her body and to understand what the process is like. Almost across the board, when I've completed a class, men are no longer afraid because they understand the process. The process of birth is something even women don't understand - it's not something we often talk about.Even seeing a picture and seeing birth movies show how different women labor and the sounds that they make really helps men overcome many fears.
A big fear that men have is watching her suffer, watching her in pain. Often partners want to be able to save each other from something hard. I think that's universal. Not only to men want to save their partner, women want to save their partner too. Men just need tools [no pun intended] so they can know specific ways to help - ways to touch, things to say say, things to do and working together even before the birth so they go in with confidence. Men want to know they can do this as a partner, they can help her and they can make her feel better. It gives the partner, the dad, confidence.
J: So what are verbal cues that are helpful for women during labor?
Sarah: I include many in the book I give to all couples in my birthing classes. Being positive is crucial. Telling her, "You're going a great job, I love you, you are amazing, I am so proud of you, I am amazed by your power and strength, we are doing this together, breath for the baby, I am right here with you" and "My hand is right here" are some words of encouragement women want to hear. But some women aren't going to want to be talked to.
The other positive thing about using positive words or affirmations is that it might make her feel better, even if she's not asking for it, because often women don't feel like they're doing well. They may be quiet, but in their head they feel crazy. So just hearing, "you're doing great" is helpful. If dad is saying, "look at her, she's a natural, she's so good at this," nobody is going to argue with him and say, "no she's not." But if he says nothing, somebody might say, "Oh, honey, you look tired. Do you want something to take the edge off?"
J: With all the medical advancements, why would women want to have a natural birth?
Sarah: It's the best way to do it! Unless something goes very wrong - it's great to have the medical advancements, but there were not invented just to be used willy-nilly on everybody. The purpose of a cesarean section or some sort of pain relief, in my mind is only for the people that need it, not to be used on everybody. And research tends to support that - natural birth, if possible, is the safest for mom and baby. Obviously there will be situations where it's not, where the safest thing is a C-section or Mom needs an epidural to relax so that labor can progress. I know that happens and I am grateful it exists, but right now we are using the "what ifs" for every day and using it on everybody. There is some desire for that too, some people don't want to experience all the sensations of labor.
J: Our culture promotes spending hours of planning a wedding, but many of us do not take the time to plan our births (besides decorating the nursery and buying cute outfits). Why do you think that is and do you think this way of thinking can shift?
Sarah: I think people don't realize how important birth is until they have one. They don't realize how much it is going to affect them, the way they feel, even the way they feel about themselves. I think people don't realize the emotional impact that it is going to have on them and they can't even really imagine it. I talk to some people that can't get the money together for a class. I understand they are on a tight budget, but I have done it and I also understand the money is worth it. But you can't always communicate that or convince others. And some women have to come to that on their own after a hard birth. I do not feel that it is my role to force it on anybody. When people really want to learn something, they'll learn it. If they don't want to learn it, they're not going to - some women will come to it and some women won't. I am opinionated about birth...I really think there is nothing wrong in having a strong opinion, in being passionate about something. But I respect people's different opinions. You can't make somebody have a natural birth.
J: My favorite final question to all my interviews: If you could teach people one thing you've learned in life, what would it be?
Sarah: We have less control than we think we do. You prepare as much as you can, so that you can control as much as you can. Even with birth. You stack the cards in your favor, but you have to recognize that you don't always get to pick happens. But you can still do your best - do your best with your spouse, do your best with your children - and then let go of the rest because you can't control everything. You can't control other people, and we all live with or around other people. There's always going to be an element that is out of our control.
Since this interview, I have given birth and begun to raise a beautiful little boy. Nothing I planned happened. I was transported from my home to the hospital, the decelerating heartbeat taken from my abdomen. His birth, though not as I'd expected, was exactly how it was meant to happen. "I think birth is always very humbling because you never know what will happen, no matter how well you prepare." These words that Sarah spoke to me over a hear ago now ring oh so true. Humbling. How humbling birth is, motherhood - this whole journey. But, though humbling and hard, it does not mean we can't care, we can't try, we can't hope. We birth children squatting in homes, lying in hospital beds; we are ripped open and cut open, we are mended and healed. Each of us is stronger, braver and wiser through our birth - no matter what the outcome. That is what this journey is all about - our hope, our expectations and our trying and trying again and again, carrying us through our beautifully imperfect lives.
Get in touch with Sarah Clark on her blog, Mama Birth, or learn more about Birth Boot Camp near you.
Photo credit: HC Photography