Thursday, May 29, 2008

Men at birth, Odent's view


Dr. Michel Odent was interviewed on his view about men in the birthing room. His view is that men should not be present at birth. Read the article.
There has been a lot of buzz in the local emails and I thought I'd share my response.

This freedom from ideological shoulding at birth is what we observe when a woman gets to be intuitive and voice her needs. When she is heard and respected. Its not about who is there, but about how they are in their being there, if you follow.

Hey, maybe what Odent is talking about is should dystocia. There is a need to reflect on how too much mental activity at birth, as in, trying to do everything right, is inhibitive.
(My next book could be called Resolving Should Dystocia. ;)

There is a place for leaders in movements to make strong statements. I think the media makes these strong statements even more ideological than the person sometimes intends. Though, in this case, it seems that Dr. Odent is quite adamant.

Odent is all about deep, hormonal intactness. If he isn't going to be loyal to that stand, then the point will not be made anywhere. He says similar things about doulas and fetal positioning preparation. He sees the importance of undisturbed birth, even describing Christ's birth in the manger as an inspiration to avoid the inevitable physiological interference that having helpers would entail. Such helpful interference that drying and warming and bundling incurs to skin-to-skin contact and breastfeeding and bonding .

Odent has a beautiful point about undisturbed birth. Lets not lose sight of his gift to us because his warnings are hard to integrate with what is current in birth practices. He is a visionary speaking.

We can bring the message closer to heart and start to remove the obstacles in our own words and actions to physiologic birthing, including our midwife and doula Care that is sometimes an obstacle.

Being in the present (right brain) and away from the should (left brain) during prenatals and labor would be so helpful towards promoting an environment safe for physiological, private and orgasmic birthing. Being in the kitchen might help, too! :)

Sunday, May 18, 2008

updating site


Hang on, I'm updating the shareware for SpinningBabies.com
It will look different and be different. You may not find what you've seen before.
If you can't find something important to you, email me and I'll work on it.

Be warned, though, I am not researching or giving advice on pregnancy and postpartum aspects that don't have to do with fetal positioning issues. There are better sources for you on general and unusual pregnancy questions than me.

The links will take a long time to grow back up again. Sorry, I hope to have many more links soon.

Saturday, May 10, 2008

Intervention and support in difficult childbirth

More thoughts on how we give support in a long or difficult labor.

Too often, birthing families are pressed between the policy and the clock. Care providers are concerned with how a labor looks on paper, in the chart. How will this labor look in court? Their concerns overshadow the relationship they have with the mother and the mother is forced to submit to their comfort in their career. Suddenly we hear Dr.s, nurses and midwives yelling or cheerleading.

This very action pushes them further from the mother. They separate themselves from the mother by their perspective of what can she do for them, rather than what can they do for her. Can she hurry? Can she agree to intervention? What will I say at the desk? How will I chart this or write my report?

How can the busy hospital nurse, doctor or midwife support the birthing woman who is experiencing a long and/or difficult labor? It may be that they have to "act as if." They show a calm and trusting face to the woman. They sit down across the room from her and enter in to the rhythm of breathing. They smile, that half smile of contentment with what is occuring.

Of course, I am talking about when labor may be long, but there is no emergency. If you are reading this with strain and thinking, "but what if?" I would invite you to take a deep slow breath and let go of the adrenaline through which you filter birth. Breath in the endorphine state that gets babies out. Adrenaline holds babies in. Why would an entire culture of birth surround itself around the substance known for labor dystocia?



On the other hand, too much help can be distracting, too. The mother surrounded by too many caring people has to filter their words, actions and sometimes, chatter. They prop her up with morale building effort.

There are times in a long labor that a mother may have to go within herself to reflect. So support in a long labor can be required to ebb and flow. Rest is necessary, mentally as well as physically. The support person or people must be able to observe the needs of the mother, before she does, and adjust themselves accordingly.

The father may be present or not, depending on the situation, this discussion doesn't exclude him. The mate, both calm and attentive without asking too many questions, can be the determining factor in whether a woman feels safe to continue a long, challenging labor.

One constant person is often required. If so she needs to be in that midbrain state of the rhythm of labor. The mate may need her presence to model his. He observes and absorbes her calm. He falls into the rhythm of breathing, at least, when reminded.

Sometimes rhythm is missing from the labor, as sometimes happens when there is an asynclitic presentation, even in a calm, trusting laboring woman. Then that calm, mature woman becomes the rhythm. She holds the concept of peace and birth within her eye. Her breath reveals the rhythm, as does her movements and her half closed eyes that gaze beyond the woman.

Two womens' labors and the quality of care

Two women asked me about CPD earlier this week.
CPD is cephelopelvic-disproportion, meaning the baby doesn't fit the pelvis.

One woman was a first time mother working with our home birth midwifery group. She was at the end of her pregnancy with an OP baby. Body work hadn't helped her baby get turned to face her hip or back. The baby hadn't engaged. Being well read, she was now concerned that the baby wouldn't enter the pelvis and a cesarean would then be necessary.

Another woman emailed from the UK. She was pregnant with her second and remembering her first birth. The baby hadn't engaged. She had an early urge to push. Her midwife yelled at her, her words, to stop pushing. This went on and on. An epidural gave relief, but too much, she was put on her back and now had little ability to push when the time did come to do so. A vacuum, or ventouse, extraction was done. She was a bit afraid to hope for the coming birth of her second child.

Our first time mom had a strong urge to push before her cervix was fully opened as well. Instead of trying to stop her, we observed. Later, we encouraged her to push along with the urges. We alternated with asking her to breath through some contractions without pushing. Then, again, she let her body push spontaneously.

Her baby's head needed time to mold, so we asked her not to add to her body's spontaneous pushing. An asynclitic angle (tipped like listening) of the head was a significant factor in the length of time, so we asked her to push. We were exploring what might be the best way to help her. We tried varying how she pushed because this urge went on and on, like the UK woman's labor.

All the time her loving husband stayed at her side, patient and attentive. Her doulas stayed near. Her midwives honored the needs of the birth and introduced a very pointed conversation, gently. By stating that we wanted her to get what she needed, she took that idea around in her mind for a couple of contractions and replied that she was ready to explore what the hospital might have to offer her labor. IV fluids, Pitocin (Sintocin).

In the hospital there were a few more hours until, finally, the cervix was gone. The baby's head had molded enough and the mom's voluntary pushing now became effective. Now she pushed hard enough to realign the plates of California. Her baby was born, healthy and strong.

Both women had difficult births. Both were able to birth without surgery. One woman feels raped. One woman feels empowered.

Penny Simkin says we can't control how labor will go, whether difficult or not, but we can control how we care for women. She was referring to the respect, words and tone we use when talking with pregnant and birthing women. (Postpartum, too!)

I'll add that we can seek to honor the needs of labor, too. The clock is not a good guide for intervention. Giving the woman, in a non emergency situation, time to decide when its time for an intervention (perhaps as a tool for a long labor) considers her needs in the psychological transformation that partuition is. She needs to know her midwives not only hear her, but trust and know the variations in birthing.

Her decision is made not only from her physical and mental state, but made within her support community. She makes decisions among people who are important to her. This is part of her mother-making. A key part.

How the dream birth becomes the real birth is how the dream of her mothering becomes the mothering she actaully experiences. How her support people, including her midwives and doctors and nurses, respond to her needs and how they nurture her changing birth plan reflects on her acceptance of herself as a woman and a mother in her circle.

Choosing transport and an intervention doesn't mean that all her effort is done. There is more effort, more work. Contractions continue and the mother continues to labor. She is brought to yet another level of challenge. The challenge of having thought an intervention would remove effort and finding that it does not. It may help effort, but it does not remove the mother from the work of becoming a mother. She is in the midst of hard work. Work that is rewarded with a conscious connection to her child and to her awareness of the process of mothering.

All mothers deserve to be rewarded in the art of surrendering themselves for the needs of their children. There is not a mother that doesn't deserve our respect for that. Its not a question of the worth and beauty of mothers.

Its a question of how we care for women as they become mothers and the effects of our care on the quality of life for mothers and their babies.

Tuesday, May 6, 2008

Benefits of volunary licensure of midwives

In an email to a politically active friend here in Minnesota, I said something I'd like to share in general:

I would like to take this opportunity to praise our voluntary licensure for traditional midwives. The voluntary status of licensing traditional midwives in our state protects ALL midwives from:
  • Restrictions against helping women with normal birth including OB trends to label as high risks women with a certain maternal height and pregnancy weight gain combination, parity, etc.
  • Restrictions against helping women with a variation of normal; such as, weight gain, VBAC, Breech, Posterior (some physicians section women beginning labor/presenting in late pregnancy with a baby in an OP position) etc.
  • A monopolization of ideology in practice yet while promoting better practice standards,
  • Total adaptation of medical model midwifery because the traditional one faded away under the afore mentioned trends

Changing the Earth by supporting Birth

Mothers bring forth life; medical corporations do not. Birth can be simple, powerful and loving. Fetal positioning, natural birthing and practical help for normal birth.