“So many times our culture gives us not only negative ideas about women in labor but also of how men act (squeamish, grossed out, uninterested in seeing the birth, faint, etc.) My husband was absolutely fantastic during labor. When I pushed her out I was so pleased (yet happily surprised!) to see that he had climbed into the tub with me for delivery! It was a real testimony to how strong and involved a man can be. I’m so blessed to have a husband who is so hands on right from their first breath!”

The Sunday Photo Album is a regular feature of the Safe Birth Blog. If you would like to submit a picture, please email soracolvin@gmail.com.

If you’re going to the hospital for the birth of your choice, you’re going to  the wrong place… they don’t sell that there.
Carla Hartley (HT: Hathor the Cow Goddess)

Chuck Graham, the Missouri State Senator who filibustered a midwifery licensure bill last year, is being challenged in his primary race by pro-home birth OB-GYN Elizabeth Alleman.

Graham says he’s “prepared to defend his stand against midwifery”, calling Alleman a “one-issue candidate.”

The UK’s Times Online has an article today in which home birth advocates respond to a doctor who has written a book advocating — apparently — pre-labor epidurals for every mother. Dr. Grant, the director of obstetric anesthesia at New York University Medical Center and the author of Enjoy Your Labor, slams the “multi-million dollar natural childbirth industry”, says opposition to anesthesia is misogynistic, and compares an unmedicated birth to an unmedicated appendectomy.

The author of the article apears to agree with Grant — “I’ll never forget the “post-match analysis” at my antenatal class, where intelligent, educated women offered grovelling apologies to our childbirth instructor for their “second rate” (i.e, anaesthetised) births. I couldn’t help feeling that two thirds of the class had forked out £150 to be made to feel like bad mothers before their babies had taken their first breath.” — but offers equal space to responses from Sheila Kitzinger and Michel Odent.

It appears to me that Grant’s view of the matter — a view that is hardly any less subject to bias and “vested interest” than that of the childbirth educators he maligns — is wildly anachronistic, pitting the straw man Puritan preacher thundering about the curse of Eve against a modern version of the feminist groups who crusaded for access to Twilight Sleep.

Let me be clear: I have no objection to any woman making an informed choice to use epidural anesthesia during labor. What I do object to is a maternity care system that systemically undermines physiologic childbirth and denies most women the opportunity to make a real choice. I object to the notion that the unhindered, unmedicated births of my babies — painful, empowering, overwhelming, unforgettable — are comparable to an appendectomy or a tooth extraction for which one might as well be numbed. 

Do we really have an epidemic number of epidural-seeking women denied pain relief by the “Natural Childbirth Industry”? The 2006 Listening To Mothers survey shows that 76% of women surveyed had an epidural — three times as many as “walked around” after they were admitted to the hospital and more than 12 times as many as used water immersion for pain relief. 7% reported “pressure from a health professional” to get an epidural. Dr. Grant’s problem with the “Natural Childbirth Industry” is not that women are being denied access to requested pain relief in labor. No, he doesn’t like the fact that women “receive incomplete and innacurate information” and have “guilt and fear” about epidurals.  I agree that complete and accurate information is  absolutely vital in giving women genuinely informed choice in childbirth, but I think I differ with him on where the culture of “guilt and fear” about birth is originating. In my experience, women seeking unmedicated childbirth tend to have educated themselves very thoroughly and there is much more widespread fear of the natural process of labor and childbirth than there is of epidurals.

I also suspect that anesthetists make more money from epidurals than childbirth educators do from labor pain.

What does our culture believe about birth? What kind of message do we give expectant mothers? How does this impact their choices and experiences in childbirth?The Sunday Photo Album is a regular feature of the Safe Birth Blog. If you would like to submit a picture, please email soracolvin@gmail.com.

“As doulas “reframe” the birth experience for their clients, they are also shielding the hospital and its care providers from criticism and complaint. [Birth doula] Hedley did her job so well that even though she felt her client was “abused,” her client will go right back to the same obstetrician and hospital for the next pregnancy. “The unanswered, fundamental question is whether [doulas] are making birth better for women, or just making women feel better about their births,” write sociologists Bari Meltzer Narman and Barbara Katz Rothman. They raise a fair critique of the doula as an enabler. By supplementing the handholding and informed consent conversations that nurses and doctors should be doing, and by buffering the level of intervention, they are perpetuating the very system that they are in the business of changing.” Jennifer Block, Pushed, pg 160

I found this quote — midway through a book that chronicles in meticulously researched detail the problems with modern American obstetric practice — extremely thought-provoking. Klaus and Kennell’s research certainly shows doulas make a difference in actual outcomes and rates of intervention, not just in mother’s feelings about their births. But when I took Penny Simpkin’s doula training course, way back in 1996, I certainly came away with the idea that, despite my inability as a doula to truly protect my client from bad obstetric practice or hospital protocols that might negatively impact her labor, I could profoundly influence the way she felt about her birth — feelings and memories that she would carry with her for the rest of her life, and that would color the beginning of her relationship with her newborn.

Penny Simpkin’s website boasts, “Nurturing Positive Birth Memories Since 1968.” I agree with Simpkin that this is important and meaningful work… but it is not enough. Even if every woman who was subjected to non-medically-indicated inductions and cesareans had a doula holding her hand and helping her come to terms with her birth experience it would not be enough.

The Cincinnati-area Ohio Families for Safe Birth meeting this coming Saturday will be held at the Madeira Public Library. Please come out to get an update on what’s happened since our last meeting, plan for the coming year, and help choose a Cincinnati-area representative for the OFSB Board.

Date: Saturday March 29, 2008
Time: 10:30 am - 12:30 pm
Location: Madeira Public Library
7200 Miami Ave, Cincinnati, OH 45243

Seems like most of the news stories from the UK picked up by Google alerts are dealing with midwife shortages and preventable tragedies in understaffed maternity units. So it was very refreshing to read this story about the increase in home births.

Folks in the greater Cincinnati area please mark your calendars and plan to attend our next meeting on Saturday, March 29 from 10:30 - 12:30. (Location to be determined shortly.)At this meeting, we will:

• catch everyone up on what’s been happening since we last gathered
• decide on a Cincinnati-area representative to the Ohio Families for Safe Birth Board of Directors
• lay out a game plan for the months ahead to build toward an effective legislative campaign

Last November, more than 35 moms, dads, children and midwives crammed themselves into a Wild Oats community room on a dreary Sunday to hear more about the situation with Jerren Helwig and the fledgling Ohio Families for Safe Birth. It’s time to update you, present a plan for moving forward through the spring and summer and into the fall to lay the necessary groundwork for a successful legislative campaign. It’s also time to choose someone from the Columbus region to serve on the Ohio Families for Safe Birth Board. Please come out and join us for an action-packed meeting at the Hilliard Library meeting room on Saturday, April 12 from 10:00 a.m. to 12:00 p.m. The address is 4772 Cemetery Rd, Hilliard, Ohio, 43026. Looking forward to seeing some familiar faces and new ones too!