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Discussion Starter · #1 ·
I currently work at a birth center and this topic came up today and it got me thinking. I am a birth assistant and plan on completing school to be a midwife eventually. I always felt like unassisted birth was a viable option for people that felt it was what they wanted and that midwives are a viable option for people not quite ready for that leap.

Anyway after the chat today at work I thought more deeply about it. For example, I used to think that it would be an option I would consider for myself after my first baby as I have some experience now working in this field for the last four years and plan to continue in it (I have no children as of yet).

But now thinking about this logically I'm just wondering exactly how this would work because if a situation actually came up, how in the world would I be able to explain to my DP what to do and, even more importantly, would I want to put that kind of responsibility on him? I can take that responsiblity myself, but I know my DP would not be able to live with himself if something were to happen to me or the baby. For example, a severe hemorrage, unexpected breech, tight nuchal cord, prolapse, or dystocia (I know these are extreme examples, but they are all possible). These are things that I imagine would be pretty much impossible to handle myself even with experience with them and describing in the moment to my DP (who is very smart none-the-less) would be very difficult. Any thoughts?
 

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Well, I think you fall into the category of knowing too much.


Don't forget to factor in your own intuition about the birth. If you felt as though UC was unsafe, I think your body would tell you and you would change your birthing space.

Those situations would be tough to deal with with a midwife, or in the hospital with an OB. They are the rare circumstances, you know?

And, who knows what you would do instincively when one of those things happen at your UC. You might just handle it fine.

Good thoughts! Personally, I never considered UC an option for me because in all my births, I liked someone else there to help. A midwife fit that description perfectly!
 

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Discussion Starter · #3 ·
Its sort of a theoretical question really. I would have a homebirth with a midwife at least in the next room ;-) I'm just wondering how UCers think it through.
 

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I agree - I think many UCers try not to do a crash course in midwifery while pregnant. it could be why so many midwives make such difficult birthing mamas sometimes - we overthink and tend to be in our heads during labor because we need to "know". I think it's really hard for birth workers to just let go.

I would imagine it would be easier if we knew LESS about birth. That way, there is more focus on our intuitive brain rather than that crazy new monkey brain that is overanalyzing and thinking too much. Our intuition will tell us much more than our skills or knowledge.

That said, the only way I could possibly even think of ever birthing again would be to birth unassisted - and quite possibly alone. I can't imagine having anyone - even my partner - present and bringing anything additional into the bubble of the birth. I would think I would have too much to fight against just being a midwife that any interruption or distraction could take me out of my body too easily and bring me into my head.
 

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I hope somebody can fill me in here since I can't find a list for the shorthand around here.....I know that UC means unasissted birth, but what does the "C" stand for? It's been bugging me!
Thanks!

Amy
 

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C= childbirth


OP I do think you are over thinking the whole process, which sometimes is hard not to do. My 3rd birth (1st UC) I really didn't think about too much. I read a few books but really relied very heavily on my instincts. I had much more fear over being in the hospital or having someone at my home directing me than I did about birthing on my own.

I can definetly see how having so much knowledge already being in the field could bring about a ton of questions and an element of fear, especially for someone who has not birthed their own yet. This is one of those things that is very internal. You have a lot of time to figure it out and make a decision, and you can always change your mind right up until you pop that kid out
 

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Discussion Starter · #7 ·
I am definately not afraid of birth, and not afraid of birthing even with others around me (I would not have a problem asking anyone to leave if I felt that I needed it). But, birth throughout history has been a social event between women. This helped younger women to trust birth when it was there turn.

I don't think not thinking too much about what could happen is the answer. For example, when the midwife I work with asked Ina May if she treats for GBS or gives Vitamin K Ina May said "we didn't used to until a baby almost died from hemorragic (sp) of the newborn. NOw we treat for Vitamin K." Well, that seems like the same sort of rational to me. Remember I'm just hashing this out in my own brain, this is just my opinion. I have never really thought that knowing too much can be a problem for anything, usually its knowing too little.
 

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Quote:
I am definately not afraid of birth, and not afraid of birthing even with others around me (I would not have a problem asking anyone to leave if I felt that I needed it).
That's great. Some women do have a difficult time expressing their needs in labor, and getting out of the "hostess" and "nice girl" and "good patient" roles that have been conditioned into them.

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But, birth throughout history has been a social event between women. This helped younger women to trust birth when it was there turn.
More than that, it helped solidify bonds between women and gave women an element of power by exclusion of the male, both important in partriarchal societies. It may have had a more insidious and unconscious purpose that ultimately served the aggressive nature of patriarchal societies, in that disturbance of the birth process (through ritual and guidance) interrupt the flow of hormones that make birth easy and facilitate mother-child bonding. (See Michel Odent for more on this.)

The conscious justifications for social birth are not necessarily relevant in a society in which women value autonomy, in which they do not have an intimate sisterhood, or in which the society itself is not patriarchal. From what we know of matriarchal or earth-centered non-aggressive societies (very little, as only a few still exist,) women experience far more autonomy in birth, and less disruption of the birth and postpartum.

I'm one of those women that doesn't have an intimate sisterhood. I do not have friends or family who I feel secure with witnessing me giving birth and giving support. Our relationships, though loving and caring, exist in a relatively superficial place; we don't share primal or sexual things with each other. We're also not adept at nurturing each other -- that's something that is extremely rare for women in our culture. We're not brought up that way. We're brought up to be independant. Some midwives (unfortunately I would say a minority) have a personality that enables them to fill this role, but it's still artificial in that it is fundamentally a professional-client relationship, not a sister-to-sister relationship, and it is not deep or lasting. It is a surface relationship designed to mitigate a sense of selfconsciousness and create an illusion of trust. We need to find a way to make ourselves believe that, in order to let this person witness such a personal thing and touch us in personal ways, and not be emotionally disturbed by it, and not close up during the birth. For many women, though, the reality descends on them once the midwife has left, and they experience grief, anger, and a sense of loss or abandonment. The effects of pretending that we are doing the same thing as women have done for thousands of years can be devastating.

If I did have a truly intimate sisterhood, and they sent me only the most perfect supportive vibes, and I could be completely unselfconscious with them and go into myself with them around, then I might consider having attendants. But none of that is true for me.

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I don't think not thinking too much about what could happen is the answer.
I agree, it's important to come to terms with these things. I think what PPs have meant is that it can be difficult for a birth worker to UC because they can't get out of their heads enough in order for their instincts to take over. I am far more educated about birth than the average woman, even more so than many birth workers, and I will not deny the importance of that to me. All the same, it was crucial for me to not be midwifing myself during labor.

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For example, when the midwife I work with asked Ina May if she treats for GBS or gives Vitamin K Ina May said "we didn't used to until a baby almost died from hemorragic (sp) of the newborn. NOw we treat for Vitamin K."
A little OT, and I don't mean to be snotty, but that sort of reasoning seems typical for people of a medical mindset, and Ina May definitely has a foot in both worlds. "One in 10,000 people has X condition, so let's treat the other 9,999 for it just in case."

Of course, if we knew that giving a baby levels of vitamin K over levels of what were normal for him was totally safe, there would be no issue. But we don't. Could there possibly be a reason nature has not provided babies with higher levels of vitamin K than they normally (when breastfed) have?

There is more on the controversy here: http://www.gentlebirth.org/archives/vitktop.html
 

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:

Now I don't have to bother with a long response.


I've done both.
 

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Quote:

Originally Posted by jlpetitte
Its sort of a theoretical question really. I would have a homebirth with a midwife at least in the next room ;-) I'm just wondering how UCers think it through.
If you want to know what UCers think, you might try posting in the UC forum. Not a lot of UCers are going to be venturing into a forum for birth professionals.


Quote:
But now thinking about this logically I'm just wondering exactly how this would work because if a situation actually came up, how in the world would I be able to explain to my DP what to do and, even more importantly, would I want to put that kind of responsibility on him? I can take that responsiblity myself, but I know my DP would not be able to live with himself if something were to happen to me or the baby. For example, a severe hemorrage, unexpected breech, tight nuchal cord, prolapse, or dystocia (I know these are extreme examples, but they are all possible). These are things that I imagine would be pretty much impossible to handle myself even with experience with them and describing in the moment to my DP (who is very smart none-the-less) would be very difficult. Any thoughts?
Often unexpected events (that would be labeled "complications" in a medical setting) do happen in UC. Usually the mother is able to instinctively know what is needed, or instinctively feels the need to transfer long before symptoms of a problem show up. The level of intuition available iis remarkable in women who are not waiting to be told what to do or waiting to be taken care of. Start reading UC stories, you'll begin to see what I mean.

But UCers feel that in undisturbed birth (see Sarah Buckley) many problems are not going to come up to begin with, and their individual circumstances will preclude others. For example, my baby was well engaged going into labor, so cord prolapse was something I didn't need to be worrying about. A normal (undisturbed) physiological second stage is quick, so no need to worry about a tight cord (and I personally think asphyxiation is unlikely in any case. Pamamidwife explains why here: http://www.mothering.com/discussions...rd#post5481834)

My hips are wide and my babies relatively small (<8.5 lbs.) and I would be laboring freely and instinctively so would go into optimal positions; no need to worry about shoulder dystocia. Why would I hemorrhage -- why would the placenta fail to detach properly -- if there was nothing to interfere with the hormonal release that regulates this process? Etc. There are certainly freak events that no one can predict, and nothing is guaranteed. But given the extremely small risk of complications in an unhindered birth in a healthy mother, and weighing that against the risk of environment- or management-induced complications, UC comes out ahead for me. Having medical care means increasing the chances of needing it. I feel more comfortable taking my chances with nature.
 

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I am a thinker, an overthinker really, with one foot each in the midwifery and medical camp... there is your fair warning.


Anyhoo, I think your questions in your original post are good ones. I have friends who have UC'ed (very successfully) and loved it. Part of me respects that and is happy for them, we should all have what we want in birth surely. The other part of me thanks the Goddesses of birth that nothing went wrong, for them in particular. Yes dystocia, hemmorhage, extreme fetal distress are difficult situations for everyone, midwives and ob's included, but midwives and ob's are trained to deal with those situations quickly and competently, and I see them do so often in my work as a doula, usually to the benefit of mom and babe. It is a question to ask yourself in ANY birth, "what am I able to be responsible for?", This includes using your intuition, being assertive about your wants and needs, and proactive in your choices, wheter you hire a practitioner or not. Yeah you can have a doc or midwife and follow them blindly, highly irresponsible in my book. Or you can hire one and work together, share your smarts and put it together for a positive supportive relationship. IMO the answer is to be responsible for all of it however you see fit. Some are fine with birthing on their own, some feel better with practitioners. All are taking responsibility for their children equally.
 

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I feel that I know quite a bit (obviously nothing on the level of MW) and I can tell you that knowing brings with it a lot of responsibility... but I for one, don't shy from that, in particular with birth. Part of what I think is leading to so many suits and such is that the parents or Mom is not taking enough responsibility. Sure most people hire an OB/MW, etc. for your care and birth - but they are not a guarantee... yet so many people don't understand that. They aren't the safety net... they went to school but it doesn't mean you won't end with a tragic outcome, or whatever. I don't think ignorance is bliss.

As the one laboring you can't teach DH/DP or anyone else what to do - so maybe you would be more comfortable with a hands-off MW that can be trusted. I am sort of in this catagory b/c my DH would probably loose his mind if he "was in charge" even though I keep telling him he's not, and something happened to the baby or me. Our MW won't be in the same room and I won't even see her unless we have an emergency I don't feel we can handle (basically if I can't resolve a shoulder distocia, bleeding or we need oxygen)... but it's taken me 2 births and a long time of talking with DH to get to this point.

I have had dreams of giving birth totally alone, so I'm not sure that that won't happen... I don't know why, maybe it's the primal side of me that desires that, but it's in my heart, I can feel it.

So there you go.
That is my reasoning as a someday-MW and current doula and Mom-to-be shortly.
~Julie
 

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Quote:

Originally Posted by jlpetitte
I am definately not afraid of birth, and not afraid of birthing even with others around me (I would not have a problem asking anyone to leave if I felt that I needed it). But, birth throughout history has been a social event between women. This helped younger women to trust birth when it was there turn
Very true, and its unfortunate we do not have this siterhood anymore.

Quote:
I don't think not thinking too much about what could happen is the answer. For example, when the midwife I work with asked Ina May if she treats for GBS or gives Vitamin K Ina May said "we didn't used to until a baby almost died from hemorragic (sp) of the newborn. NOw we treat for Vitamin K." Well, that seems like the same sort of rational to me. Remember I'm just hashing this out in my own brain, this is just my opinion. I have never really thought that knowing too much can be a problem for anything, usually its knowing too little.
Frankly, and I am not trying to be rude here, but Ina May is not someone I look to as a model of a midwife. She has become VERY interventionist and very med-wifey vs her earlier years.

I don't think inherently knowing too much can be a bad thing, but it can set you up for all the "what if's?" that tend to bring about the fear cycle. I am not suggesting someone go into UC not knowing anything, I do think they need to be aware of the possibilities of what can happen in a birth, and know within themselves how much responsibility they are willing to take, kwim?
 

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Discussion Starter · #14 ·
What a great discussion! And a very important one for us working in birth. So, all of you pro-UCer's (me possibley also being pro-UC), why are we going into this field? This is a question I have asked myself in the past. Is there a need for doulas, midwives, obs, doctors, paramedics, childbirth instructors, lactation couselors, etc...? Should we be actually working to phase these careers out?

(Sorry, I'm sure you can tell I love philosophizing and debating and questioning my own rationale).

BTW- I find you all to be very brilliant.
 

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I have to admit, I think women who attend births are most often more fearful of complications because we have seen them, even in very "hands off" labor and births.

At the same time, I have been a lurker and sometimes poster on the UC forum and have learned a great deal from the women there. I really appreciate their perspective and wisdom. Some women I know who have had UC's frankly scare me...but some have indeed gained my respect.

I DO have the sisterhood, and do believe in the bonding and exchange of wisdom attending women during labor/birth and breastfeeding...anything inherently female for that matter.

The reality is, that most women DON'T want to be alone during birth, and those who do...are in the minority....having a UC is a option definitely for birthing women...but I would also like to see Midwife attend births be the majority vs. OB/hospital births.

Mary
 

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I am a doula and a to-be UCer. I personally came to UC out of necessity. No hb midwives in my area would take me because i am a vba2c and i just didn't feel like the medical establishment could give me unbiased, evidence-based care because of fear of litigation. I was arguing with my doctor over my due date (because i knew when i ovulated) and they wanted to base it on a 19 wk ultrasound. Uh, no. But because the almighty machine said it, it must be true. This doesn't exactly boost my confidence for a no-intervention hospy birth.

But i really feel called to doula-work because as long as there are reasonable women who choose an assisted birth, they need that support and empowerment to advocate for themselves.

I personally am using a doula for this birth. She is the one who really helped me to see that i did have choices, although i viewed UC as really scary option at the time. But i have sat with it, and although it involves more responsbility on my part, i know it is what i have to do. Because no one knows what is better for me than myself.
 

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I agree with so much of what's already been written.

A lot of UC comes from just learning to listen to your body. As a student midwife, you are used to seeing things happen, not feeling them happen which I believe to be quite different. It does help to have an education behind you before giving birth, but with UC the important part isn't about knowledge of things that could go wrong, or even what is going on from a third person perspective. The main principles of UC is being in touch with yourself and knowing your body well enough to trust that it's doing what its supposed to. I'm sure alot of people go into UC with at least some fear of the unknown. (ie, complications you mentioned above) Getting past that is very important, and having trust in your body, your "god", and whomever you choose to be present when you give birth is key. If you feel that having others there will disrupt this, then it's likely UC is a good choice.
 

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I agree with BirthFree, ignorance is not bliss. It is ignorance. And even without knowing "too much" like those of us who work in birth, the great responsibility still lies with the parents, whether they shoulder that or not... Practitioners who see that parents are not going to take responsibility or make choices for themselves make choices for them, sometimes to their benefit. So yeah it pays to read up and be assertive, no matter how you birth or with/out whom... I admire all expectant parents for learning and making choices for themselves. It is the main point that I teach in my classes.

Yes, in seeing lots of births you do end up seeing the emergencies, and it can make one wary to a fault. Therein lies the challenge of trying to maintain the postive, trusting attitude that we feel is important. I try to learn from the more dire situations and keep it in my back pocket if that knowledge needs to be called upon. I get annoyed when someone throws that patent "oh trust birth and all will be well" line at me... it implies that I do not trust birth because I sought competant training and knowledge, added to my skills and fulfilled my desire to learn more and work with a wider range of people. The mainstreamers need doulas and midwives too! Ina May has been my inspiration for the 15 some-odd years since I first encountered her work; Spiritual Midwifery is my favorite book of all time.. I admire that she has learned, studied and taught soooo much. Of course her attitudes and practice have changed, but I think her original dedication and philosophy have not. She loves and trusts birth, and uses her vast experience. She has evolved, as we all should over time, and with maturity. Her clients are free to decline the tests, services, etc and they should read up and know what they want IMO. Just b/c she offers them does not mean she has become an OB. Sometimes those skills and knowledge prevent disaster and save lives, a fact that is conveniently ignored by many in the alternative birth world. Luckily it works very well on its own, and I have every respect for that, but I have equal respect for those who know how to help when it is needed.
 

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Quote:

Originally Posted by jlpetitte
What a great discussion! And a very important one for us working in birth. So, all of you pro-UCer's (me possibley also being pro-UC), why are we going into this field? This is a question I have asked myself in the past. Is there a need for doulas, midwives, obs, doctors, paramedics, childbirth instructors, lactation couselors, etc...? Should we be actually working to phase these careers out?

Good question, and my answer is not short.

While I think UC is great for many women, there are many more who are not and may never be ready to take that leap of faith. Those women need midwives. I would like to see midwife attended births to be the norm with OBs there for the small percentage of actual high risk pregnancies, as it should be.

Why do I want to be a midwife, its one step into ultimately fulfilling my dream. I love birth, its an ache deep in me that I can't even explain. I want to help educate and empower women, even if it means losing "clients" to a UC. I am not in this for the money but for the love.

My ultimate goal is to have a "halfway home" type of place for unwed and pregnant teens/young adults. I want to be able to help them on their way, show them they have options, give them the education they most likely would not get in an OB setting. Will there be girls there who will want a hospital/OB birth? I am sure and that will be their choice, and that's the point. I want them to know there is a choice and how to make an educated decision on where they feel is the best place for them. Altho I hope they would want to birth in their "home" with their sisterhood, or even alone, ultimately the choice and power will be theirs.

I am also hoping to be able to provide job training/placement as well as helping them into a home of their own after the birth. Much of this comes from my own experiences of living in this type of home when I was pregnant with my first. They unfortunately fell short in so many ways (clinic OBs only, push medicated births, no pregnancy/birth education, no breastfeeding education, their "library" was sorely lacking, once you birthed you were kicked out of the home and many of the girls had nowhere to go...I could go on)

Obviously this will be a very big undertaking as I will need help and support from the community. It's also many years away as I have to wait for DH to retire from the Navy so we can actually settle down in a stable long term home. Until then I just keep dreaming and fantasizing about what i will do and how I will accomplish it.
 
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