Monday, December 22, 2008

Orgasms During Childbirth?

By Lisa Belkin
childbirthIllustration by Barry Falls

First thing next month (Friday January 2) will be the primetime debut of a film that has been making the “under the radar” rounds of women and film festivals since May. ABC’s 20/20 will air the documentary “Orgasmic Birth”, by Debra Pascali-Bonaro, a childbirth educator and a doula, which asks the question: What would happen if women were taught to enjoy birth rather than endure it?

Some women will see this film as a declaration of emancipation from the medicalization of childbirth. Others will see it as yet one more way to raise expectations and make new mothers feel inadequate if they do not experience the “ideal” birth.

The message of the film is “that women can journey through labor and birth in all different ways. And there are a lot more options out there, to make this a positive and pleasurable experience,” Pascali-Bonaro tells ABC. “I hope women watching and men watching don’t feel that what we’re saying is every woman should have an orgasmic birth.”

But the title certainly catches attention, referring to what Pascali-Bonaro calls “the best kept secret” of child birth – that some women report having an orgasm as the baby exits the birth canal.

Tamra Larter experienced that while Pascali-Bonaro’s cameras were rolling. She and her husband, Simon, opted to have their second child in their suburban New Jersey home, and through most of the hours of labor the couple was kissing and caressing.

“The phyical touch and nurturing was just really comforting to me,” Larter told ABC. Of the orgasmic birth that resulted she said: “It was happening, and I could hardly breathe, and it was like, ‘oh, that feels good.’ That’s all I could say really.”

Christine Northrup, an OB-GYN and author of “Women’s Bodies, Women’s Wisdom” explains in the film that orgasms during labor are the results of chemistry and anatomy: “When the baby’s coming down the birth canal, remember, it’s going through the exact same positions as something going in, the penis going into the vagina, to cause an orgasm. And labor itself is associated with a huge hormonal change in the body, way more prolactin, way more oxytocin, way more beta-endorphins — these are the molecules of ecstasy.”

And on that note I open up the comments for your thoughts …

Sunday, November 09, 2008

Better Birth for less $$$

$13 to $20 billion a year could be saved in health care costs by demedicalizing childbirth, developing midwifery, and encouraging breastfeeding.
Frank Oski, MD, Professor and Director, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD

Thursday, November 06, 2008


Hi Lisa & Kari:
I tried to write my birth story out, but all that came was a poem. If you like, please post to your blog, or just keep it for your records. In any case, thought I would share it with you both.

I gave birth
Too large of a baby
Too flat of a pelvis
Said I couldn’t do it
I gave birth
Too risky they said
Too much overdue
C-Section scar
I gave birth
Glucose intolerant
Group B positive
What’s your end game?
I gave birth
Without their interventions
Without their fears
Surrounded by calm peaceful love
I gave birth
Let that contraction go
Listen to your body
Holding hands
I gave birth
Birth stool in my kitchen
Birth tub on the floor
Trusting it all
I gave birth
Strong pain
Stronger support
Moaning low
I gave birth
My body isn’t broken
My spirit is healed
My heart is so thankful

Monday, November 03, 2008

Even a little caffeine may harm fetus, study finds

Michael Kahn, Reuters

LONDON (Reuters) - Pregnant women who consume caffeine -- even about a cup of coffee daily -- are at higher risk of giving birth to an underweight baby, researchers said on Monday.

The new findings published in the British Medical Journal (BMJ) also linked any source of caffeine, including that from tea, cola, chocolate and some prescription drugs, to relatively slower fetal growth.

The findings are the latest in mounting evidence indicating the amount of caffeine a person consumes may directly impact one's health, especially when pregnant.

n January, U.S. researchers found that pregnant women who drink two or more cups of coffee a day are at twice the risk of having a miscarriage as those women who avoid caffeine.

Monday, October 27, 2008

Meet your perfect Doula!

Birth Rhythm has just finished training 10! new certified doulas for Saskatoon and area.

We will be having an open house to meet all the currently practicing Doulas and welcome the new ones into our birth community. All expectant families and other birth professionals are welcome. We will also have two great vendors present:

Maternal Source will be selling amazing pregnancy and birth resources

A Soft Landing with their as organic and fair trade baby products.

November 19th 8-10 pm
502 Main Street
Call 242-5029 to register for this free event.

Sunday, October 26, 2008

Canada's C-section rate at record high: 1 in 5 Saskatchewan women have c-sections!

Sharon Kirkey, Canwest News Service

Canada's pregnancy specialists are calling on doctors to curb the fast-growing use of caesarean sections to deliver babies, saying the worrisome trend is exposing mothers and infants to more risk, not less.

With one in four births now occurring by C-section - 92,799 babies a year - it is time to get "back to the basics," says Dr. Vyta Senikas, associate executive vice-president of the Society of Obstetricians and Gynaecologists of Canada.

The group is urging doctors and women to choose a C-section only when there is a medical reason to justify one. "Safety of a woman and a baby should be the driving decisions here," Senikas said.


Ashley Fraser/Canwest News Service

Font:****"We have to come back to the basics, and the basics are that 90 per cent of women will have a nice vaginal delivery without any problems to produce a healthy mother and baby."

Friday, October 17, 2008

Midwife-led versus other models of care for childbearing women

Excerpt from the Cochrane Library: Evidence for health care decision making
Midwife-led care confers benefits for pregnant women and their babies and is recommended.

In many parts of the world, midwives are the primary providers of care for childbearing women. Elsewhere it may be medical doctors or family physicians who have the main responsibility for care, or the responsibility may be shared. The underpinning philosophy of midwife-led care is normality and being cared for by a known and trusted midwife during labour. There is an emphasis on the natural ability of women to experience birth with minimum intervention. Some models of midwife-led care provide a service through a team of midwives sharing a caseload, often called 'team' midwifery. Another model is 'caseload midwifery', where the aim is to offer greater continuity of caregiver throughout the episode of care. Caseload midwifery aims to ensure that the woman receives all her care from one midwife or her/his practice partner. By contrast, medical-led models of care are where an obstetrician or family physician is primarily responsible for care. In shared-care models, responsibility is shared between different healthcare professionals.

The review of midwife-led care covered midwives providing care antenatally, during labour and postnatally. This was compared with models of medical-led care and shared care, and identified 11 trials, involving 12,276 women. Midwife-led care was associated with several benefits for mothers and babies, and had no identified adverse effects. The main benefits were a reduced risk of losing a baby before 24 weeks. Also during labour, there was a reduced use of regional analgesia, with fewer episiotomies or instrumental births. Midwife-led care also increased the woman's chance of being cared for in labour by a midwife she had got to know. It also increased the chance of a spontaneous vaginal birth and initiation of breastfeeding. In addition, midwife-led care led to more women feeling they were in control during labour. There was no difference in risk of a mother losing her baby after 24 weeks. The review concluded that all women should be offered midwife-led models of care.

Friday, October 03, 2008

Saturday, September 27, 2008

Gloria Lemay's Blog

An excerpt of her September 17th entry:

A cesarean rate of 30% means that the pendulum of risk/benefit has swung way too far toward the risk side in N. American hospitals. Medical management of birth has become more dangerous than ever, despite the belief system of the public and the medical profession. The best research (largest numbers studied) done on the subject of place of birth was by Marjorie Tew, a Glasgow (Scotland) University professor of statistics. Her book “Safer Childbirth” documents her own scepticism about homebirth safety and how she came full circle to urging women to stay out of large hospitals. She found that even very ill women and premature babies did better if they were born at home or in small clinics.

Here’s more information on Marjorie Tew.

Do obstetric intranatal interventions make birth safer?

British Journal Obstet Gynaecol 1986 Jul;93(7):659-74
By Marjorie Tew

Marjorie Tew argues that statistical analysis shows that the shift to hospital birth, and increased obstetric intervention, has not made birth safer, but more dangerous. She suggests that improvements in perinatal mortality are due to healthier mothers, rather than improved maternity care.

Abstract in full:

Impartial analyses of the evidence from official statistics, national surveys and specific studies consistently find that perinatal mortality is much higher when obstetric intranatal interventions are used, as in consultant hospitals, than when they are little used, as in unattached general practitioner maternity units and at home. The conclusion holds even after allowance has been made for the higher pre-delivery risk status of hospital births as a result of the booking and transfer policies. It holds even more strongly for births at high than at low predicted risk. It follows that the increased use of interventions, implied by increased hospitalization, could not have been the cause of the decline in the national perinatal mortality rate over the last 50 years and analysis of results by different methods confirms that the latter would have declined more in the absence of the former. Data are presented which point to the deleterious effect of interventions on the incidence of low birthweight and short gestation and their associated mortality. Also presented are data supporting the alternative explanation of the decline in perinatal mortality, namely the improvement in the health status of mothers built up over several generations. The organization of the maternity service stands indicted by the evidence. Despite the beliefs of those responsible, it has not promoted, and cannot promote, the objective of reducing perinatal mortality.

I keep hearing from doulas who say “I’m not going to be attending any more hospital births.”

The feeling of futility and complicity in the rape of women is too overwhelming to face any longer. This should tell consumers something.

It’s all gone too far. We can’t lie and cover it up any longer.

Friday, September 12, 2008

Time, respect, and dignity- a cross post from one of my favourite blogs.

Here is a post from The True Face of Birth:

It's easy to sit around and bemoan all that is wrong with childbirth in the United States. But one woman is doing something about it: 81-year old midwife Ruth Lubic. She opened a midwifery clinic in Washington, D.C., where the infant mortality rate is twice the national average. She sees primarily low-income women on Medicaid in one of the poorest areas of the city. So far, all 800 babies have survived, and she has halved the prematurity rate. Her secret?

She believes low-income women, many on Medicaid, need the prenatal education that midwives provide. Everything from posture, to nutrition, to how the baby grows....

"Do you think it boils down to just the time you spend with them," Andrews asked Lubic.

"I think so," she replied. "I'm convinced that's what it is. It's time, respect, it's treating people with dignity."

Read the rest here: Midwife On a Mission. And thanks to Fearless Birth for pointing it out!
Posted by Rixa at 1:04 PM 5 comments Links to this post

Wednesday, August 13, 2008

The worst position for birth

"Except for being hanged by the feet, the supine position is the worst
conceivable position for labor and delivery." (Dr. Roberto
Caldeyro-Barcia, The Family Practice News, 1975:11

Friday, August 01, 2008

Midwifery becoming mainstream in Canada


Immediately after delivering baby Benjamin, Melissa Boraski's midwife knew something was wrong.

The newborn's colour was quite dusky, his breathing too shallow. An hour after birth into the comfort of his mother's home, he was whisked off to Toronto's Hospital for Sick Children -- the place Boraski had least expected to be.

Little Benjamin underwent open heart surgery and his mother didn't hold him again for two weeks. Two years have gone by and now, he's a healthy toddler. And Boraski is swaddling a second babe, seven-month-old Alice.

Despite the shock that accompanied the arrival of her first-born, she used a midwife again and said she'd recommend it to anyone.

"I felt having a baby wasn't something I wanted to be treated like a medical emergency," Boraski said, acknowledging she did have initial reservations the second time.

"It went really smoothly," she said. "It kind of redeemed the (first) experience. I had a lot of hope for that ideal of having a baby at home. I knew it could be a great experience."

Boraski, 28, is among a growing number of Canadian women turning to a midwife during pregnancy instead of a doctor or obstetrician. She said the more intimate, personalized care, plus the fact it's funded by the Ontario government, made it an obvious choice.

She found her midwife at a practice called Riverdale Community Midwives in Toronto.

"I feel like every midwife I met at the practice was really compassionate and they really loved women and loved the care of women," she said. "Just the idea of birth being a family thing, it can happen in the home, it's safe, it can be a spiritual experience. I felt like the midwives honoured that tradition."

Midwifery's proponents say it's no longer a fringe option. It's also necessary, as a looming maternity care crisis has cropped up in Canada because many family physicians don't deliver babies and there is only a finite number of practising obstetricians -- many nearing retirement age.

There are approximately 700 midwives practising in Canada.

More than half of them are in Ontario, the province that led the charge to install midwifery as a regulated profession.

Regulations took effect on Dec. 31, 1993 and about 60 women were officially recognized as midwives. Seven provinces and two territories have since followed suit.

Secrets: How to have the best care during pregnancy, childbirth–and beyond

Here are five ways to get the help you need for a positive birth experience

by: Sydney Loney

Pre- and post-natal care
Take a childbirth education class, available through hospitals, birth centers or separate organizations, such as Lamaze International.
When choosing a caregiver, decide who can support you best in the decisions that you're making. Ask questions to find out whether they'll respect your personal birth philosophy.
A doula can be your one constant source of support when nursing shifts change and you're suddenly confronted by a new set of faces mid-labor.
Many hospitals offer daily breastfeeding clinics, so find out ahead of time when and where they take place so you're not scrambling post-delivery.

Related stories
1. Creating a Birth Plan
2. Overcoming your fears of giving birth
3. Morning sickness survival guide

From where to deliver to how to choose the best healthcare professional, moms-to-be have a lot of important decisions to make–and it can be overwhelming. "You really need to plan ahead to create the most positive experience for you and your baby," says author and childbirth educator Gail J. Dahl. Here are five things you can do to ensure you get the best pre- and post-natal care possible.

1. Do your homework
"Reading a good childbirth book (and not just a book about pregnancy) is very important," says Dahl. "Women make better choices in birth when they have more information." Find out what all your childbirth options are and decide what makes the most sense for you. Dahl recommends seeking out a qualified childbirth educator. Childbirth education classes are available through hospitals, birth centers or separate organizations or associations (such as Lamaze International or the International Childbirth Education Association).
"You need a tremendous amount of information to be a good medical consumer during childbirth," she says. "Rather than just learning about a procedure, such as induction of labor or episiotomies, you can find out the pros and cons and why you may or may not want it." Childbirth classes usually include information on things such as signs of labor and techniques for coping with pain, but it's important to research the class to ensure it fits your own childbirth philosophy.

2. Pick your professional
One of the keys to a positive pregnancy and birth is finding a good healthcare provider, says Dahl. "It's important to create a whole health team around you so that you have good support and good information throughout your pregnancy." A lot of women don't realize they have a choice when it comes to caregivers, she says. "You can choose to have either a doctor or midwife and it's up to you to decide who can support you best in the decisions that you're making." Here are some things to keep in mind when making your decision:

Midwives usually take a more holistic approach to childbirth and offer women with healthy, low-risk pregnancies the choice of having their babies at home or in a hospital or birth center.
Midwives offer the same standard tests as doctors, although their appointments tend to be longer (usually about 45 minutes) and some of these appointments may even take place in your home. They are also usually available for questions or concerns 24 hours a day by pager.
Whoever you choose to assist you, find out all you can about them. "We spend more time finding contractors for our homes and researching their qualifications than we do when choosing a person to be in charge of our births," says Dahl. Don't be afraid to ask the hard questions, she says.
If you're interviewing a doctor, find out what their C-section rate is and how they feel about induction and drug-free births. If you're quizzing a midwife, ask her to explain all the alternative options open to you, such as water births or hypno-birthing.
To find the best doctor, interview three doulas and see who they like working with the most, she says. And talk to a midwife's patients about their experiences–word of mouth is often a safe bet.
Regardless of whether you're choosing a doctor or midwife, you need to look at personality. "If you feel you're not being respected by your caregiver, then that is not the caregiver for you," says Dahl. "And you can switch to someone new right up to the time you give birth."
3. Hire a doula
"One of the best ways to have a positive birth experience is to hire a doula, especially if you don't have access to a midwife" says Dahl. A doula is a professional birth assistant who supports you during labor and sometimes post-partum. Many doulas also teach prenatal classes or act as lactation consultants. Unlike midwives, doulas do not have professional standing at hospitals and can't attend births on their own.
"A doula assists you and your partner, helps you stick to your birth plan, is your advocate, friend and birth coach," says Dahl. "Many women think their doctor will be there for them throughout labor only to discover it's just them and their partner in the room for most of the time." Doctors have many patients at a time and your ob/gyn is unlikely to be the person who actually delivers your baby. A doula can be your one constant source of support when nursing shifts change and you're suddenly confronted by a new set of faces mid-labor. If you can't afford to hire a doula, Dahl recommends contacting a doula association as beginning doulas often work for free in order to gain the experience they need to be certified.

4. Create a birth plan
"A birth plan is good because it gives you something to discuss with your caregivers–it's your negotiating document," says Dahl. "When you have a birth plan, you can be confident that the support group around you are all clear about what you want."
Your birth plan may include everything from what position you want to be in during labor to how you want your baby's heart rate monitored. [To create and save your own birth plan, go to] Reviewing your birth plan with your caregiver also helps ensure you're both on the same wavelength. You'll find out what their views are and will discover whether they're willing to respect yours if they differ. "You have to take some responsibility on your own and having it down on paper can help you have the strength to say, ‘that's not the way I want the birth to happen,'" says Dahl.

5. Set up breastfeeding support

If you're planning to nurse your baby, Dahl recommends finding out as much as you can about breastfeeding before you deliver. Many women get through labor and delivery just fine, only to be overwhelmed by the difficulty of breastfeeding. Before you give birth, talk to a lactation consultant, join a breastfeeding support group and even attend one of their meetings where you can watch women nurse. La Leche League ( is a great breastfeeding resource. Many hospitals offer daily breastfeeding clinics for new moms, so find out ahead of time when and where they take place so you're not scrambling post-delivery. Most of all, have a breastfeeding support person lined up (whether it's a doula, nurse or lactation consultant) to make sure you get the best start possible.

Meet our expert:
Gail J. Dahl is a childbirth researcher and educator, an advocate for safe and gentle childbirth and the national bestselling author of Pregnancy & Childbirth Secrets (Innovative Publishing, 2007). She has received the YWCA Woman of Distinction Award, the Woman of Vision Award and the Great Women of the 21st Century Award for her work in women's health and education. Nominated for Community Advocate: Organization and Signature Award for exceptional achievements.

Take a look at this tremendously helpful new website for new moms when you have a moment at "Just the Facts Baby":

Wednesday, July 16, 2008

It's funny (almost) what people will say....

I just read this blog today for the first time, WOW! There are many similarities to our own Large teaching hospital in Saskatoon. ..but that is for another day. I think it is great that this nurse tells it like it is. Enjoy the read.

....when you reveal to them that you are a L&D nurse.

I was chatting with a fellow mom at the swimming area/beach at the lake yesterday. We were chatting off and on for an hour or so, and the subject of birthing came up. When I mentioned that I work on L&D as a nurse, let me just say, the floodgates opened..... MORE

Birth and the God complex | Homebirth: Midwife Mutiny in South Australia

Birth and the God complex | Homebirth: Midwife Mutiny in South Australia

Sunday, July 13, 2008

Delay cutting the cord: Study

Dr. Cynthia Maxwell holds Graham Berry’s umbilical cord moments after his delivery at Mount Sinai Hospital in Toronto last month.
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Joseph Hall health reporter
A few more minutes of maternal attachment may give newborns months of significant health benefits, according to a new McMaster University study that urges doctors not to cut umbilical cords immediately after birth.
In their efforts to "tidy things up" as quickly as possible, many doctors and midwives clamp and cut off umbilical cords as soon as babies have been delivered, said McMaster researcher Eileen Hutton.
But waiting at least two minutes would allow precious red and white blood cells to be transferred to the infant from the placenta before it is expelled from the womb, says Hutton, whose study was published yesterday in the Journal of the American Medical Association.
"We really haven't given a lot of consideration in the past to the fact that there may be some value to the placenta (remaining attached)," said Hutton, an epidemiologist and assistant dean of the Hamilton school's midwifery program.

" ...The baby's born and the next thing you do is clamp the cord, and people haven't really thought about whether this is a good thing or not a good thing."
But delaying the cut could protect against anemia and irregular breathing for weeks and months after delivery, she said.

"If you increase the overall volume of blood (in the infant), you're increasing the iron stores and the number of red blood cells," Hutton said. "Also, the white blood cells, which contribute to immunities." The study could change the way babies are delivered in this country, said Dr. Donald Davis, president of the Society of Obstetricians and Gynecologists of Canada.
Umbilical cords are typically cut within 30 to 60 seconds after normal deliveries, but leaving them intact for a few minutes might benefit babies, especially those whose mothers did not eat nutritious food while pregnant.

"I don't think there would be a problem waiting two minutes and certainly there are benefits," he said. "If these babies have a little bit better iron stores, a little bit higher hemoglobin, then they're going to fare better ... their blood is going to be able to carry more oxygen to vital and growing tissues like the heart and the brain."

The society is interested in Hutton's research and, if it recommends the study's findings, delayed cord cutting could become standard procedure in Canada.

"Most certainly, the society is interested in studies like this ... and this will definitely be examined," said Davis.

The placenta, which grows attached to the wall of the uterus, is a temporary organ that allows the transfer of nutrients from mother to fetus via the umbilical cord and becomes part of the baby's circulatory system. It typically remains within the womb for several minutes after birth until continued uterine contractions expel it.

According to the study, between 25 and 60 per cent of a newborn's blood supply stays in the placenta and cord after birth. But the womb can act like a pump, moving more blood from the placenta to the infant.

"Depending on when you do the clamping, the baby will have more or less of what is, in fact, its own blood," Hutton said.

There was not enough information in the study to determine whether babies born through caesarean section would benefit equally from prolonged placental attachment.
The delay would have no negative health impacts on the mother during a normal, full-term birth. The umbilical cord is long enough in most cases that the mother can hold her infant on her stomach until it is cut.

Meanwhile, normal postnatal care of the newborn can be administered while the infant is still attached.

"It's an intervention that has the potential to have a (positive) impact on a large number of babies and at a very low cost," Hutton said. "This benefits the baby without any real down sides for mom."

The study, co-authored by University of British Columbia researchers, looked at 15 earlier papers involving almost 2,000 newborns in 11 countries.

Hutton said it gives parents the information they need to start discussing when to cut the cord with doctors before delivery.

"It's one of those areas where parents can have probably quite a large influence in terms of changing practice."

Thursday, June 19, 2008

Secrets - Cytotec Danger

Cytotec: Black Box Warnings

use in pregnant women can cause abortion, premature birth, or birth defects; uterine rupture reported w/ use to induce labor or abortion past 8th wk of pregnancy; do not use to decr. NSAID ulcer risk in pregnant pts; advise pts of abortifacient property and warn not to give to others

Take a look at this link to read about one of the latest lawsuits against physicians using Cytotec on pregnant women at:

Please forward this e-newsletter on to alert more women to the dangers of cytotec birth induction.

"Without a doubt, inducing birth for any reason, by any method and by anyone, including physician or midwife, has no scientific or medical basis of benefit in any case and will most likely decrease the health of a mother and baby. First-time mothers easily need up to 42 weeks and longer to prevent premature birth. Allowing labor to begin spontaneously provides the best results." Gail J. Dahl, Award Winning Author, Researcher and Childbirth Educator, "Pregnancy & Childbirth Secrets"

Cytotec (also called Misoprostol or Miso)

Who is given drug or procedure and why? Pregnant women who are overdue by 1 1/2 weeks.

What does the drug or procedure do? Cytotec is a tablet that is inserted in the vagina. It softens the cervix and induces contractions. Once inserted it cannot be removed.

Contraindication/Possible Adverse Side Effect:

1. Cytotec has been known to cause tears in the uterus, called uterine rupture and hyperstimulation of the uterus and fetus, (when the uterus contracts too fast, or too many times in a short period of time and when the baby’s heart beat is too fast or too slow) when it is used to induce labor past the 8th week of pregnancy.

2. Cytotec should never be used if you have had a prior C-section.

3. Serious reactions include abortion, miscarriage and teratogenicity (fetal malformation). In rare cases it has been known to cause cardiac arrest, anaphylaxis (life-threatening respiratory distress) Myocardial Infarction (MI) (when the blood flow to the heart is stopped) and irregular heartbeat.

4. Cytotec can also cause AFE-amniotic fluid embolism (amniotic fluid, fetal cells, hair or other debris enter the mother’s circulation, causing cardio-respiratory collapse leading to the death of both mother and baby).

5. Cytotec is in the FDA pregnancy category “X”, meaning it is known to be harmful to an unborn baby. Death of mothers and babies have been reported with this drug.

6. Cytotec is a drug approved only for the prevention of ulcers and to treat chronic constipation. Cytotec is being commonly used for early termination of pregnancy and to induce labor, despite not being FDA approved for use in pregnancy. For this reason, there is inadequate data on the risks and benefits of this drug for use in labor.

Mission: The Tatia Oden French Memorial Foundation is dedicated to empowering women, specifically in the area of childbirth and pregnancy. We are dedicated to saving the lives of those giving life to others.The Tatia Oden French Memorial Foundation is presently focusing on the issues of informed consent, the off-label use of drugs, and maternal mortality.

Dedication: The Tatia Oden French Memorial Foundation dedicates this site to ALL mothers and children who have been damaged, injured, or lost their lives due to medical interventions and drugs given during childbirth – without full knowledge of what they needed to know before these interventions were used or given to them.

Copyright 2008, Secrets Newsletter 2008, by Award Winning Author, Gail J. Dahl “Pregnancy & Childbirth Secrets” This article may be reprinted or reposted on the internet for the purpose of childbirth education when references are included. The information contained in or provided through this publication is intended for general consumer understanding and education only and is not intended to be, and is not provided as, a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your midwife, physician, nurse or other qualified health care provider before you undergo any treatment or for answers to any questions you may have regarding any medical condition.

Friday, May 16, 2008

Everything you ever wanted to know about your amniotic sac (and then some)

Everything you ever wanted to know about your amniotic sac (and then some)

I wrote this for the pregnant community today, but prasava said that I could share it here, as well. It's really geared towards women who have a more mainstream approach to their pregnancies (ie. follow a standard medical model of care), who may not know that amniotomy has risks involved or that having their waters break without starting labor doesn't automatically mean induction.

The topic of ruptured membranes, particularly having a "fore bag" of waters that breaks while an inner layers remains intact, has been brought up in several recent posts. I thought you might find this interested and helpful as you approach the end of your pregnancies.

Your baby isn't enclosed in a simple, single membranous layer. The "bag of waters" (amniotic sac) surrounding him/her/them is comprised of two layers: the chorion and the amnion. Other membranes have also surrounded your baby at different points in his/her development, and have helped with the development of the placenta and the umbilical cord.

The amnion is the innermost of the embryonic or fetal membranes, the sac in which the embryo is suspended. Early in the pregnancy, this membrane is in close contact with the developing embryo, but expands and moves away into a protective bubble as amniotic fluid production increases. This is your "inner bag" or "hind bag" of waters, the sac in which the baby is directly contained. When one is talking about the amniotic sac, this is what one is normally thinking of. For the sake of rupture of membranes, this is the one that really "counts" as having had your water break.

The chorion is the tougher outer membrane enclosing the embryo. It contributes to the development of the placenta. The chorionic villi (what is sampled in a CVS procedure) emerge from the chorion, invade the endometrium, and allow transfer of nutrients from maternal blood to fetal blood.

Identical twins may share a chorion or both a chorion AND an amnion, while fraternal twins each have their own chorion and amnion. In about 70% of identical twins, the twins will share a chorion (monochorionic), though some may also share an amnion (monoamniotic). Twins can share a placenta without being monoamniotic. The rare phenomenon known as twin-to-twin transfusion can sometimes occur in monoamniotic twins with a shared placenta, where twins receive an unequal amount of nutrition through the placenta.

Some women may actually have a true double bag of waters (two chorions and two amnions). This is uncommon and in some cases may be the result of a twin pregnancy where one twin was reabsorbed very early in the pregnancy, leaving one empty sac and one healthy developing baby.

The chorion and amnion are in contact with each other by the end of the pregnancy, often fused together so that when one breaks, so does the other, but they also can have a thin layer of amniotic fluid in between them. Many of you may have heard about women's bags of water "springing a leak" and then "resealing" -- in many of these cases, the chorion has developed a slight tear, allowing a minimal amount of fluid to escape. As the torn portions of membranes come into contact with each other again, however, they overlap and stick together, much like plastic wrap/cling film does when doubled over on itself. This is one reason why you will often see the more naturally-minded among us encouraging you not to rush to the hospital immediately, but wait to see if the fluid leakage stops.

This is one reason why women may experience a breaking of waters, sometimes one that seems pretty significant in its amount, only to be told by a doctor or nurse at the hospital that their waters are intact OR that only one layer has broken. I experienced this first hand, so I know the frustration of rushing to the hospital (as your care provider has told you) only to discover that you went much earlier than you needed to. Sometimes you will simply be sent home, but your care provider may also present the option of amniotomy (artificial rupture of membranes or AROM) to fully break your waters, especially if you are having contractions. Amniotomy has many disadvantages* and some advantages, and is a medical intervention you should research for yourself before the situation arises, to decide under what circumstances you would/would not feel comfortable having the procedure performed.

Remember that breaking waters (in a full term pregnancy) doesn't have to put you on a clock. There is no hard and fast rule regarding at which point the risk of infection increases, but the best way to avoid infection is simply not to insert anything into the vagina. If your water breaks, but contractions don't start right away, you might consider avoiding internal exams to check for dilation. Internal exams can introduce new bacteria/viruses into the vagina or push pre-existing bacteria/viruses further into the vagina. You always have a right to decline an internal exam, an induction, or any other procedure. If your labor has not started after a certain period of time after your waters have broken, ask your care provider about alternatives to induction, such as IV or oral antibiotics, or periodic monitoring of your health and your baby's. Your baby won't run out of amniotic fluid; it is constantly replenishing! The pockets of amniotic fluid can be measured via ultrasound; even for those of you who prefer to limit or avoid ultrasounds during pregnancy, this may be a preferable alternative to induction for those of you with care providers pushing for interventions.

I hope this hasn't been too boring and has answered some of your questions about the amniotic sac. I'm by no means a medical professional, but as an unassisted homebirther, I have made it my goal to learn as much about how my body works as possible, and to answer the many lingering questions I had about the many interventions performed (both with and without my consent) during my first birth (which was in a hospital).

*Amniotomy may also contribute to malpositioning of the baby, a disadvantage not listed in the link above.

Lilah Monger - - AAMI Student Midwife #1769

New Student Advisor, Mentor Program Director, and Reading Room Coordinator

Thursday, May 01, 2008

Guest Post : Judgment, Fear, and Focus

Laureen is the technical editor and online community advocate for and at Sun Microsystems, a freelance editor for Hunt Press, and a contributor to several peer-reviewed group blogs. She's a blogger, a podcaster, a website manager, and an enthusiastic geek enabler. She's the mother of two gorgeous children, and the wife of a man who understands her birth passion. She's had one iatrogenic unnecesarean, and one triumphant HBAC.

Judgment, Fear, and Focus

For only having two children, I have pretty much the range of birth experience; my first was a planned birth center birth turned hospital transfer with epidural turned cesarean. So there's the complete spectrum of medicalized birth. (At the time I was planning it, I thought my birth center birth was non-medicalized. I learned the hard way about medical midwifery.) My cesarean was brilliant, as these things go. The doctor was near retirement, had a 40% cesarean rate in his private practice, and knew what he was doing. I was too ignorant to even ask for things, but upon examination of my medical records, I got a Cadillac of a cesarean. Sheer dumb luck, that was. But despite that, due to hospital protocols, my baby spent the first four hours of his life with strangers; four hours we'll never get back.

For my second birth, I had an unassisted pregnancy, followed by a home birth with a midwife.

The move from home to hospital for birth in our culture involved a paradigm shift, whereby medical professionals convinced women that they were incompetent to birth without assistance, despite millennia of successful field testing to the contrary. The move to reclaim women's power by bringing birth back under their control is involving another paradigm shift, and that's going to be uncomfortable, and it's going to upset people. I think it matters that I know all kinds of women who've gone from hospital births to home births, but only two who've gone the other way, even if the home birthers ended up transferring ultimately. Because of my own experience, I am strongly biased towards home birth, and I admit that up front. On the other hand, because of the experiences of women I know personally, I would rather gnaw off my own arm than deny women the right to choose to birth in a hospital.

One of the things that really bothers me about the comment-foo on Rixa's blog is the complete abandonment of logic. Instead of classical logic, symbolic logic, the construction of actual arguments based on fact, we saw logical fallacies. Use of fallacy in argument invalidates the whole thing, in addition to bringing the entire discussion down to blows in short order. This does nothing to contribute to the betterment of women and babies; it sets us against each other for no purpose whatsoever. The thing about a good, solid, well-constructed argument is that invariably, both sides of the issue learn something and see further into their opponent's mindset. Everyone is bettered, perspective is gained, and we're that much closer to being a unified force...unified behind the true betterment of the situation here for mothers and babies.

I'd like to address a few of the real arguments brought up in the course of the commentary on Rixa's post...

Always be suspicious of motive when someone tries to make you do something that makes a lot of money for them

Maternity "care" is critical to the profitability of a hospital, and the more this can be managed, the more profit a hospital makes. The cesarean rate in the US is at levels so high (31.1% in 2006) that the World Health Organization considers it to be a "crisis." Scheduled cesareans are the epitome of optimally profitable managed birth. UnitedHealthcare sends maternity patients a brochure in late second trimester, offering them the option of a scheduled 39-week cesarean.

My cesarean, NICU stay, and hospital stay netted the hospital nearly $27,000, the anesthesiologists nearly $11,000, and a heap of other people other monies, and cost my insurance company a bundle.

My home birth cost my insurance company $3,000. Period.

So who stands to make money off my choice of birth? Hmm...

"You should be grateful you have a healthy baby/All that matters is a healthy baby"

Well, yeah, of course. But that's so not the whole story. Read Gretchen Humphries' brilliant essay "You Should Be Grateful."

There is room in this world for good experiences for both.

"Birth is about the baby, not the mother"

This letter, published in the ICAN eNews a little while back, says it all.

I am a lawyer who went to a top ten law school and then to a top tier firm. I used to be very mainstream in my views. I thought women who chose to give birth at home were reckless. When I got pregnant and was given the option of having a c-section, I readily agreed. I never went into labor and my c-section went flawlessly. I researched it, so I expected that my arms would be tied down, that I would likely shake from the anesthesia, and that I would not be able to hold my baby. That was ok, because I was ready for it. I handled the drugs well and, as a result, actually remember the first 24 hours. My recovery was uncomplicated.

My daughter, however, got the worst of it--which isn't even really that bad considering other stories I've heard. She was so sleepy and zoned out from the drugs that we had to put ice on her bare skin to wake her up enough to feed. She developed jaundice as a result of not eating enough. Because she couldn't feed properly (because she was so drugged), my milk never came in properly--which was a problem since it turned out she was allergic to all of the formulas they had. Given her allergies, breast milk would have really helped. She kept losing weight. She was diagnosed with failure to thrive. It was a very scary time, because we thought she might die.

On a long term basis, because she never came through the birth canal, her gut didn't get colonized with the right bacteria. That translates into the gut and immune system dysfunction she has today and the medicine that we give our 3.5 year old 5 to 6 times a day. She is also on a severely restricted diet--no wheat/gluten, dairy/casein, soy, citrus, etc. Bacteriologists say that the first germs that the baby is exposed to will set the tone for the baby's life. Those germs really need to come from the vagina.

The c-section went well for me, personally. I was very, very lucky as you will see from other stories you read. It did NOT go well for my daughter. I am now pregnant with a second child and plan to do all I can to deliver vaginally. A c-section still seems like an easy choice sometimes. Indeed, if I were giving birth to a tumor, not a baby, I might be inclined to do it, in spite of the crazy risks. But I will not put this baby at risk.

I'm a litigator and I love evidence. Crazily enough, the evidence is strongly in favor of vaginal birth. I believe that the cavalier attitude of OBs toward this major surgery is a result of a combination of factors (preference for control, fear of malpractice, higher payment, surgery is more "fun," lack of education on natural birth as opposed to how to manage an impending crisis, etc.). But carefully look at the evidence first, before you make up your mind. The evidence really does speak for itself and I'll let someone else who is better versed in the evidence point you in the right direction.

And with cesarean delivery, the baby itself is more likely to die. The US has the second worst newborn death rate in the developed world, despite the fact that we spend more money on "medical care."

How is it that we forgot that babies and mothers are a dyad? You can't truly separate the well-being of the mother from the well-being of the baby, not even with a scalpel. Go ahead; tell me that a mother who lives and a baby who dies, or a baby who lives and a mother who dies, deserve to be a separate statistic. I don't know a mother or a child in either circumstance who doesn't have a little bit of them die too, even if the statistics don't neatly account for it.

"But women used to die in childbirth!"

Read the news; they're dying now. Ask the families of Tatia Oden French, Valerie Scythes, Melissa Farah, Caroline Wiren, how they feel about the safety of hospital birth. Ask Claudia Mejia. Ask Amber Marlowe. Ask Dennis Quaid how safe hospitals are for babies.

Disaster can strike anywhere. But the idea that hospitals are inherently safe is not valid, and demonstrably so. There is no choice you can make that's an automatic get-out-of-jail-free card. The reason most women default to hospital birth is because that choice is presented as being blameless. If something happens in the hospital, well, that's just bad luck, but if it happens at home, that's bad decision making, with the mother occupying the role of bad guy, all by herself. This is not fact, this is not logic; this is marketing spin.

On Judgment

I have been told that my cesarean was a personal failure. I have been told that having a midwife present for my second birth was a personal failure. I have seen fully-medicalized birthers rip midwifery advocates apart, both live and online. I have seen women spend an ungodly amount of energy and time shredding at each other.

For what? I deeply believe that women who choose hospital birth do so because they want the safest and best for their babies. I deeply believe the same thing of the home birth set. So why are we still attacking each other?

Fear. And Judgment.

In the final analysis, birthing carries risk. Living carries risk. There are no guarantees anywhere that if you make all the "right" choices, you and yours will be saved from tragedy. Lightning strikes, and all the planning and research and analysis in the world will not save you from that. It comes down, in the end, to supporting each other the best we possibly can, to making our choices from a place of confidence, not a place of fear. If you're birthing in a hospital, do so because that's what feels safest to you. If you're birthing unassisted at home, do so because it speaks to you and feels right to you. Fear has no place in any decision about birthing.

A friend of mine who just had what she calls her "victorious homebirth after two cesareans" says:

Since our life-changing home birth I've encountered so much more support than we imagined possible. I cannot believe how many friends and acquaintances have said, "I sure wish WE had seriously considered birthing our children at home." Obviously there is a slow shift being made in the birthing climate of America. But there are also many other comments we've heard like, "I'm glad it worked out for you," which I now see as such a pitiful way to view birth--like it's a matter of luck. But I know that's the reality for most people. If these critics knew the amount of time, prayer, and research we put into this decision and into the type of provider we selected, they might have to consider why EVERYONE doesn't invest that kind of time and prayer in their own birthing decisions. For us, the search was priceless and ultimately put us in far better control of our decisions. And beyond the stats and truths we uncovered during this journey, we discovered something far more valuable: faith. After asking for guidance, begging for deliverance, and recognizing our answer, I was overcome with a peace that I have to say I've never experienced after praying before--and as the preacher's daughter I've spent a good many years on my knees in prayer. It was amazing to simply ask and to find the undeniable peace we so desperately desired. So THIS is what answered prayer feels like. I understand that's not much of a factor in modern society, which makes me incredibly sad.

We've also had to endure a number of horrible birth stories where someone nearly died "even in a hospital birth" (the fetal and maternal monitors didn't discover there was a problem until it was too late). I'm never sure how to take this kind of response to the introduction of our new baby. If these tactics are in an effort to get me to debate the home vs. hospital issue, I'm not taking the bait. My decision isn't up for debate--especially with those who've invested little in the search for truth other than personal experience and hearsay. I can respect your birthing decision if you can respect mine.

Standing together, we can do so much more good for everyone, than we can by compartmentalizing each other and shredding on anyone who doesn't share our precise set of birth circumstances. Different does not have to equal wrong. But the way things are right now, fear is controlling the cards, and we need to put down our differences, and stand together for a set of choices in birth and baby care that puts the U.S. back up at least in the top 10, because when it all comes down...the choice between home and hospital is not the point. The point is that women and babies are dying in utterly unacceptable numbers, and they're dying because our social, medical, and economic systems are not supporting women.

And women are not supporting women either. So let's focus on what matters.
Posted by Rixa at 7:41 AM 20 comments Links to this post

Sunday, April 06, 2008


Birth! Film Festival

Presented by the Doulas SK Network and the Midwifery Association of Saskatchewan

MAy 4th @ the Odeon Evens Center in Saskatoon. For Ticket info call 477-SOFT

Birth! Film Festival Summaries

Section One: Trusting Birth

Birth As We Know It

... is a treat for both the heart and mind, comfortably intertwined on a path toward realizing the full potential of birth. A new style of documentary film creates a refreshing arena for the story of Birth to unfold. A triumphant orchestration of stunning cinematography, empowering instrumentation, and a calming narrative, warms our hearts as we are reminded of the beauty of Life, and awakened to the ultimate possibilities of Birth! This groundbreaking new film is aimed at illuminating future parents on the impact of conscious conception, pregnancy and birth. In this stunningly beautiful video, Director Elena Tonetti-Vladimirova shares her experiences as one of the co-creators of the "Conscious Birth" movement in Russia during the early 1980's.

For Your Own Good (Man in Labor)

With typical Spanish humor, Iciar Bollain presents a man in labor delivering a baby. This short film is in Spanish with English subtitles.

Waterbirth in the 21st Century

By showing you these pictures we try to give you useful objective information about how the waterbirths are done by our team in Ostend. More than 18 years of experience and 3500 waterbirths gave us an increasing confidence in a positive physical and psychological effects of a warm aquatic environment. Our water birth-team in Ostend consists of a variety of different professionals who provide a adequate prenatal aquatic preparation and give the possibility afterwards for the new parents to help their baby get further accustomed to the aquatic environment.
Producer Fabien Raes

Kangaroo Care

This is the "How-To, Why-To" video that summarizes the latest research to prove that the newborn thrives best on his mother's chest. How to wrap the baby to mother's chest is also shown. Kangaroo Mother Care enables baby to relax, improves the heart rate and body temperature. By Nils Bergman, M.D.

Baby-Led Breastfeeding

Kittie Frantz RN, and Christina Smillie, MD — long time experts in the field of breastfeeding — created this film to provide us with the baby's perspective. She stimulates us to think about the secret drives of the infant in this intimate relationship between mother and infant. Kittie Frantz, RN; Christina Smillie, MD Producers

Section Two: The Issues of Birth

This favorite short birth video, beloved by parents, childbirth educators and midwives, captures the beauty of a homebirth filmed in the countryside of Xalapa, Mexico. This is the video men love. This is the video that will pass from one generation to another empowering every viewer.
Narrated by mother and midwife, Naoli Vinaver Diana Paul, Producer/Director

It's My Body, My Baby, My Birth
Midwife Maria Iorillo gives us a peek at her very multicultural practice. Seven Mothers, their partners, midwives and an obstetrician take us on a rare journey which ends in natural childbirth.

Birth of Sabine
Sabine’s video shows us the excitement and anticipation of a mom’s first pregnancy. The story follows Stephanie and James from the positive pregnancy test, prenatal visits with their midwife, a belly cast, to the unexpected surprise of her water breaking days before labor begins. This is how one family navigates the ins and outs of pregnancy, labor and birth. James Westby, Andaluz Waterbirth Center

Section Three: Special Screening


Birth is a miracle, a rite of passage, a natural part of life. But birth is also big business. Compelled to explore the subject after the delivery of her first child, actress Ricki Lake recruits filmmaker Abby Epstein to question the way American women have babies. Epstein gains access to several pregnant New York City women as they weigh their options. Some of these women are or will become clients of Cara Muhlhahn, a charismatic midwife who, between birth events, shares both memories and footage of her own birth experience. Footage of women having babies punctuates THE BUSINESS OF BEING BORN. Each experience is unique; all are equally beautiful and equally surprising. Giving birth is clearly the most physically challenging event these women have ever gone through, but it is also the most emotionally rewarding. Along the way, Epstein conducts interviews with a number of obstetricians, experts and advocates about the history, culture and economics of childbirth. The film’s fundamental question: should most births be viewed as a natural life process, or should every delivery be treated as a potential medical emergency? As Epstein uncovers some surprising answers, her own pregnancy adds a very personal dimension to THE BUSINESS OF BEING BORN, a must-see movie for anyone even thinking about having a baby. A film by Abby Epstein; Executive Produced by Ricki Lake.

Thursday, April 03, 2008

What is a Doula?

What is A doula?

This is a brief video interview with several families, explaining who and what a doula is. Enjoy!

Friday, March 21, 2008

March Book Review- A Must HAve!

Interview with Dr. Sarah Buckley, author of Gentle Birth, Gentle Mothering:

1. What is it about childbirth that leaves so many questions unanswered, despite the fact that women have been doing this for millennia?

Dr. Sarah Buckley: I think that childbirth has changed drastically in the last twenty years or so, becoming a medical procedure with a lot of difficult decisions that our grandmothers never had to make. It has also changed because childbirth no longer happens in our communities and we don’t get the chance to see what it is really like until it’s our own turn. I think that we would be less scared if we all had the chance to witness the normal birth of our siblings, friends or sisters.

2. What is so great about Gail’s book that sets it apart from other books?

Dr. Sarah Buckley: I love Pregnancy and Childbirth Secrets because Gail presents the information that women need in such a straightforward way. Women will love the mix of practical and medical information, based on real life, and the ongoing support for new mothers from the breastfeeding and newborn tips. Other books presume that women will want to go along with everything that their carers or hospital suggest, whereas this book gives power and information back to women so that they can make the best choices for themselves, their babies and families.

3. It seems very practical, and grassroots, coming from moms rather than coming directly from physicians and nurses, or experts who haven’t given birth...a nice complement to what already exists.... what do you think?

Dr. Sarah Buckley: Yes, as above. Gail has a delightfully friendly and practical approach that also covers the serious side.

4. What advice can you give to first time (or multiple-time moms)?

Dr. Sarah Buckley: Remember that your body is the temporary home for your baby, and look after yourself and your body really well before, during and after pregnancy and birth. Eat the absolutely best diet that you can, with good quantities of healthy fats to build your baby’s brain; keep your work or life as low in stress as possible; consider yoga or other gentle exercise; also consider scheduling a regular massage- a fantastic investment for you and your baby; make sure you have time for resting and dreaming, and for tuning into your baby. Especially if you have other children, organize help for the first six weeks so that you can just rest and get to know your baby.

Copyright 2008, Copyright released with references. “Pregnancy & Childbirth Secrets” by National Bestselling Author Gail J. Dahl. Now available across North America at major retailers like Barnes & Noble, Borders, Chapters, Coles and Indigo Books & Music. For more great secrets see the video website at: The information contained in or provided through this publication is intended for general consumer understanding and education only and is not intended to be, and is not provided as, a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your midwife, physician, nurse or other qualified health care provider before you undergo any treatment or for answers to any questions you may have regarding any medical condition.

Thursday, March 20, 2008

Rixa's Blog- If you haven't read it yet, try it!

Upright birth in hospitals

I am taking the liberty of reposting some comments from doctorjen from my earlier post Get Off Your Back--References about how she facilitates upright and active births in a hospital environment, including when women have epidurals. I'd love to hear from other people who attend births in hospitals about how they make this possible.

It seems that there are two major factors important for making this happen in a hospital setting:
1) The hospital staff must have a strong commitment to active, upright labor.
2) The staff must also have first-hand experience facilitating this, especially for moms who have epidurals, IVs, fetal monitors, etc.

Okay, enough of me. Here's doctorjen: MORE>>>

Friday, March 14, 2008

You want to eat during labor


You want to eat during labor

A seeker once asked a Zen master how he knew he had attained enlightenment. "I eat when I am hungry and I drink when I am thirsty" was the reply.

Zen proverb

What we have, once again, is an obstetric belief system that defines childbirth as a medical-surgical event. Eating and drinking do not fit this model. IVs do.

Henci Goer, The Thinking Woman's Guide to a Better Birth

"I won't be any trouble, because I don't eat a thing!"

Dorothy, in Noel Langley's The Wizard of Oz

We can dispatch with this chapter in the time it takes to read what's worth reading in the weekday New York Times.

If you give birth in a hospital, you will probably be allowed to eat nothing but Jell-O cubes during labor. These Jell-O cubes will be provided by nurses who believe that Jell-O is food.

Although the majority of hospital personnel consider Jell-O to be food (a nonpoisonous ingestible substance), other nonpoisonous ingestible substances that actually are food, such as avocados, tomatoes, lettuce, tahini, apples, oranges, pears, etc., will be denied you. Thus you will find yourself spinning down the vortex of the following Catch 22 oxymorons: nourishing nonfood (Jell-O), nonnourishing food (vegetables, fruit, etc.), and noncaregiving caregivers (nonfood-providing, nourishment-withholding, nonnursing nurses).

The justification for the oxymoronic behavior of giving solely Jell-O to a laboring woman is simple and straightforward in the hospital mind. It is the belief that, because Jell-O turns quickly into liquid, you won't be likely to choke on it and die if you throw up.

Will you, by the same reasoning, be allowed to put your veggie sandwich in a blender and press "liquefy"? Sorry. Against hospital policy. What is hospital policy? A conglomeration of beliefs the majority of which have withstood the test of time but not science. (For an insightful treatise on the anti-scientific, anti-common sense nature of the Western hospital, see Robert Mendelsohn's book, Confessions of a Medical Heretic, especially his chapter, "The Temples of Doom.")

In short, although there is no reasoning behind it, Jell-O is your predictable fate in the hospital maternity ward.

Don't make me puke

Let us examine the hospital policy of "nothing by mouth" (NPO) in the light of reason and obstetric history.

Is there any rationale at all behind NPO?

Actually, once upon a time there was. NPO was an intervention created to attempt to correct a flaw, not in nature, but in another obstetric intervention – general anesthesia. In the old days, general anesthesia was given by mask. If a woman laboring on her back (also a cultural intervention) threw up into the mask, she ran a substantial risk of choking on, and dying from, her own vomit. Doctors, ever ready to save women from nature (vomiting), but not from culture (the backlying position, nauseating anesthesia, and death-dealing masks), devised the callous coup, "nothing by mouth," to remedy a much more simply remedied problem.

The unsympathetic intervention of "nothing by mouth" ostensibly ensured laboring women an empty stomach and, it was believed, risk-free retching. In fact, all it did was make women hungry.

Science, a field of endeavor given short shrift by modern medicine, was not originally given the chance to weigh in on the modern hospital policy of "nothing by mouth." Today, finally having led the horse back in front of the cart, science tells us that no amount of fasting necessarily empties the stomach. In an article interestingly titled, "Nutrition and position in labour," C. Johnson, et al. conclude: "No time interval between the last meal and the onset of labour guarantees a stomach volume of less than 100 ml." In other words, a laboring woman could fast for the entire duration of her labor, and her stomach might still carry contents enough to fatally choke her, were she unfortunate enough to throw up while lying down.

Thus, another routine hospital obstetric procedure is found to be based, not on science, but on belief. What belief? The belief in a defective nature, summarized in this way: "Since, according to nature's law, women are throwing up on themselves, we'll just have to starve them to save them from themselves."

NPO is another way for techno-advocates to cloak women in the darksome myth of female incompetence. That this myth might be turned into medical gold goes without saying, but unfortunately not without doing.

Choking down the numbers

Today, it is no longer necessary to give general anesthesia by mask. Thus, aspiration (choking on one's vomit) has become an event so rare that even as long as 30 years ago it was the sole cause of maternal death in only 2.6 out of 1,000,000 births. Today, even those 2.6 women survive labor choking-free.

These days, aspiration during labor is simply unheard of. In three large studies recently conducted in the U.S., women who ate freely during labor had no choking problems. In 78,000 cases, not a single case of aspiration occurred. Indeed, not a single case of maternal death from aspiration can be found in the medical literature in the last 30 years.

But modern-day hospital staff, ever ready to do the right thing – even if the right thing is the wrong thing – will deny you food, as your body, working overtime in the exhausting maternity ward, cries out for nourishment. On the extremely unlikely chance that at some point in your labor you might need general anesthesia (as opposed to the more commonly administered regional anesthesia, such as an epidural), hospital staff will starve you. And they will starve you in good conscience, for they live in the belief that all hospital policy has reason behind it.

But NPO has no rational foundation of any kind. No process of reason ends with the conclusion, "And therefore, NPO is medically indicated." As far as reason and science are concerned, "nothing by mouth" benefits no one.

Even if NPO did have demonstrable benefits for laboring women, one would still have to weigh those benefits against the risks. And what science tells us is that 1) NPO benefits do not exist and 2) NPO risks exist in great number. So weighing benefits against risks still sends NPO to the locker room.

"Oh, no, NPO!"

Being deprived of nourishment during labor may be hazardous to your health.

Severe restriction of oral intake can lead to ketosis. Ketosis is an abnormal increase in chemicals that your body produces after it has used up its available store of glycogen (blood sugar) and begins to burn fat. Maternal fat-burning results in acid buildup, which if allowed to proceed unchecked can result in maternal vomiting, coma, and even death.

Is your hospital staff concerned? In no way. They're happy to believe in the touted benefits of NPO, even if it could result in such "side-effects" as coma or death. (Am I making this up? I wish I were.)

Prolonged lack of food can be dangerous to your in utero baby, as well. Research shows that NPO may result in infant oxygen deprivation. Infant oxygen deprivation can lead to infant brain damage.

Although the 1999 World Health Organization report, Care in Normal Birth, informs us that ketosis and its unfavorable sequelae for both mother and fetus can be prevented by offering the mother "light meals" during labor, your obstetrician probably has not read this report. Why should he? No birth is "normal" in his eyes. His training has told him that birth is by definition pathological and that care is synonymous with intervention.

To a hospital obstetrician, the WHO report Care in Normal Birth contains an oxymoron in its title. The only normal birth your obstetrician knows is the one that miraculously didn't go wrong. And as your obstetrician's Brother In The White Coat, Dr. Robert Galser at the University of Pennsylvania Medical Center reassuringly asserts, "Only a small minority of women find not being allowed to eat stressful." This charming sentiment is backed up by . . . well . . . nothing at all.

Delving further into scientific research, far from the quick-fix quips and gymnastic quunks of the indoctrinated and madding mediclown crowd, we find that NPO may even slow the progress of labor. This makes sense. Inadequate consumption of complex carbohydrates results in low blood sugar, which results in less effective (and sometimes painful) uterine contractions. Less effective contractions slow labor and may contribute to your chances of receiving the dreaded diagnosis "failure to progress," which significantly increases your chances of receiving a cesarean section, along with its common maternal complications (hemorrhage, infection, hematoma, pneumonia, blood poisoning), as well as infant injury, infection, bond-breaking isolation, formula feeding, respiratory distress, and so on. (For a more "full-bodied" list of maternal and infant complications from cesarean section, see Reason #3, "You don't want a cesarean section.")

At this point in your labor (which has failed to progress), the intervention of NPO – itself the ostensible solution to a prior intervention – justifies yet another intervention: IV placement.

In the warm and fuzzy myth of the safety and efficacy of hospital childbirth, the cavalry IV brings life-saving "nutrients" to the depleted maternal bloodstream. In fact, an intravenous simple-sugar solution brings empty calories to an empty host, as well as a plethora of risks that justify – you guessed it – further interventions. (For a deeper look at the hazards of using IV sugar-water to remedy the "no water" part of NPO, see Reason #41, "You want to drink during labor.")

Big daddy

Since its inception, the standard policy of "nothing by mouth" has been a bad idea through and through. Like most routine hospital obstetric policies, it is based on myth and scornful of science. The best that can be said about it is that, because it results in so many additional interventions, it gives hospital staff something to do to make themselves feel useful.

NPO is another example in an endless catalog of examples of the hospital institution's attempt to dehumanize you, to turn you into a patient, to strip away your comforting and competent humanity, to force you to find identity as the daughter of an institutional father.

NPO is yet one more example of modern medicine's century-long endeavor to convince women that their bodies are not their own and that their powerful fecundity must be manhandled if creation is to occur. Starving you to the point of pain, your hospital obstetric caregivers will cheerfully show you their concern by performing further interventions to save you from their myth-based ignorance, interventions that could have been avoided with a little research and a will to care.

But research requires effort, especially effort of the mind. And effort of the mind is verboten in the mindless maternity ward, where reason long ago gave way to myth. And caring requires effort, too – effort of the heart. And the heart has no place in the modern-day hospital maternity ward, where "the standard of care," not love, runs the show.

(The above is excerpted from Jock Doubleday's book, Spontaneous Creation: 101 Reasons Not to Have Your Baby in a Hospital, Vol. 1: A Book about Natural Childbirth and the Birth of Wisdom and Power in Childbearing Women,

Tuesday, February 26, 2008

Trust BIrth Conference

These photos were taken by Gloria Lemay

at the Trust Birth Conference in Redondo Beach California. March 6 to 10, 2008.

This was an unprecedented gathering of concerned citizens from all over the planet, coming together at the invitation of Carla Hartley, director of Ancient Arts Midwifery Institute. Carla has taught distance education for midwives for the past 30 years.

PASte this into your browser for more:

The Illusion of Midwifery in Saskatchewan; written by Lisa Wass

There are good reasons to celebrate the recent regulation and funding for midwifery services in Saskatchewan. Acknowledgement by our provincial health care system that homebirth is safe and that midwifery is a credible and necessary profession has been a long time coming.

For many years, health care professionals who considered midwifery unscientific and irresponsible have mistreated those who have chosen the midwifery model of care. As a consequence, mothers and babies have been very limited in their birth choices for decades. Truth be known, midwifery care is a scientifically sound, natural approach to normal pregnancy, birth and early parenting. It provides a standard of care that cannot be duplicated by any other system; indeed, midwives are specialists in normal birth.

The greater concern now is that the government has left it up to each individual health region to hire midwives and develop delivery systems. Saskatoon and Regina are set to hire midwives, but are having trouble recruiting the minimum numbers needed—a news release erroneously identified that each city had already recruited four midwives. In fact, no hiring has been verified.

Furthermore, there is a national shortage of midwives. Even Manitoba (whose midwifery system Saskatchewan is modeled after) has yet to meet the numbers required since its implementation in 2003. It is conceivable that, while highly desirable, funded midwifery care will not be readily accessible in Saskatchewan for perhaps more than a decade.

Midwives hired by Saskatchewan health regions will also be subject to strict restrictions on their home birth practice. In urban areas such as Saskatoon, midwives will not be permitted to serve women in a home birth capacity outside of the city limits. This is a rural province; more than half of all midwifery clients in Saskatchewan reside in rural areas.

There is room in the legislation for independent midwives to continue to work outside of the regional health districts. However, the added exorbitant cost of liability insurance, coupled with the fact that Saskatchewan health has chosen not to fund private practice, will be yet another limiting factor to accessing midwifery care. Independent midwives will need to charge more than double their currents rates just to break even under the new regulations. So, while the provincial government should be applauded for funding midwifery, effectively half of the current consumer base has just lost access to the birth services they hold dear.

Experience from other provinces, like B.C.—which has taken this same funding and jurisdiction route—would indicate that Saskatchewan can expect an increase in the number of unregulated midwives and ‘unassisted’ home births, as women scramble for options outside of hospital settings to bring their children into the world. Without consumer outcry for more flexible implementation and local midwifery education programs to combat the shortage, accessible and funded midwifery care in Saskatchewan is merely an illusion.
5a. Trusting the Process
Posted by: "Tia Rich" innerserenitybirth
Tue Feb 26, 2008 10:30 am (PST)
So I am in post recovery from a birth yesterday as a Doula. This
entire last weekend I have been pondering the birthing process and the
journey it is. How we treat it in our world. So here is a the story of
the birth....

I had a client begin laboring on Feb 11th and on the 12th was 3cm
60% effaced... She lost her mucous plug and so we all thought
soon... I told her to rest, hydrate and eat. She took walks with her
mate and looked forward to the day... Well time passed and she would
have periods of regular contractions that by bedtime when she was
tired would just slide away... By the 22nd after losing two mucous
plugs and having bloody show off and on for a week. she began
contracting at 1am (Friday) 5 min apart, she rested, ate drank and
just hung through them.... This continued through the weekend...
intensity building...(baby reactive and doing well through it all)
Monday the 25th 5:30 am I get a phone call that they are pretty
intense 2 min. apart... so it's time to go to her home.... We labor at
home till I see the dilated pupils and wild look in her eyes, her
water had broken 30 minutes before... time to go Transition has
arrived... At the hospital she is 7 cm and goes to 10 within 30
minutes... Beautiful chubby baby born 90 min. later... With a thick
healthy placenta... Oh and her caregivers honored her plans (push in
whatever position, late cord clamping, mother/baby/daddy bare skin
contact without time limits, no Vacc or interventions etc...) This in
a 90% epidural rate hospital....

OK so my client knows that without me to sound her out and reassure
her she would have gone to her caregiver and would have been in the
hospital many days before this one... She was being seen by two CNM's
and a OB in practice together. She knows she most likely would have
ended up on Pitocin and much more had they known about her pattern of
labor... I find this sad that "I" was their saving grace from that

None of the books that most people read really talk about labor and
birth looking like this... So how are mothers to know that what their
body is doing is perfectly normal. This woman happened to be highly
attuned to her body and baby. More so than most woman, I truly believe
that is part of what let her slowly labor her baby out. She labored
for hours and hours over the weekend and would sleep when she needed
it, her body and adapting to those needs...

She did so much of the work of labor calmly, relaxed, smiling... The
intense part was very intense, but also very short in comparison to
the whole process... In all this woman and her mate had an experience
full of respect and beauty without fear and manipulation.

This is a pattern we need our caregivers and ourselves to honor, that
we need to write about and teach... I believe even midwives need to
really look at this, and learn to trust and honor the birth process. I
see many who fear the process that is not "normal". So what is normal?
That is not a simple answer, normal is as different as each individual
person is.

This journey I shared in was natural and very normal, not
maladaptive... Instead of seeing the normal pattern, most see problems
and look for reasons why the baby isn't popping out in the 14 hr
medical time plan...Of course back in the 60's normal labor was
thought to last as long as 36-38 hrs... In the 80's it was knocked
down to 24hrs, we now expect it to last 14 hrs... Have our bodies
changed so much?

Tia Rich

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