One World Birth

If you haven't been let in the loop about this awesome project, it's time you knew about it. One World Birth will be celebrating its launch by Facebook on Sept 1st. Will you be 'there'?

Failure to Progress... part two

Failure to Progress... Such an obtuse, erroneous, and deceptive term when used in conjunction with a woman's labor.

Let's take the term one word at a time.

Failure - omission of occurrence or performance; a failing to perform a duty or expected action; a state of inability to perform a normal function; a fracturing or giving way under stress; lack of success; a falling short : deficiency : deterioration, decay; one that has failed - Merriam-Webster Dictionary

to - used as a function word to indicate the result of an action or a process - Merriam-Webster Dictionary

Progress - to move forward : proceed; to develop to a higher, better, or more advanced stage; gradual betterment - Merriam-Webster Dictionary

So, failure to progress means 'an inability to, lacking of, falling short of, or otherwise deterioration of'... 'a forward movement, a higher better or more advanced stage; a gradual betterment'.

Hmmm....

With all due respect (and some amount of lack thereof), I would have to deem that the American Congress of Obstetrics and Gynecologists have failed to progress.


The ACOG's failure to progress has resulted in their recent very courageous admission that only 1/3 of their clinical guidelines are evidence-based practices. This means that the majority of obstetrical practices and recommendations for pregnant and birthing women is based on opinion and inconsistency.

I say courageous because it takes a lot of ovaries to admit:

Our findings highlight the difficulties in developing high-quality clinical guidelines. Although guidelines do not equate with standard of care and cannot replace clinical judgment, the College's recommendations clearly strongly influence the practice of obstetrics and gynecology ... clinicians must remain mindful of the limitations of guidelines. There is an urgent need to continue to conduct high-quality research in obstetrics and gynecology and to provide the funding to undertake such research.

Here is a short list of some of the practices that are based on limited or inconsistent evidence or are purely based on consensus and opinion (i.e. not evidence based practices):

• Routine IVs/Heplocks
• Continuous Fetal Monitoring
• Erythromycin for all newborns
• Routine cervical exams before labor
• Routine cervical exams throughout labor
• Routine administration of pitocin (augmentation or postpartum)
• Coached pushing
• Time constraints on labor
• Time constraints on pushing
• VBAC bans
• Routine Induction after 42 weeks
• Accepting 40 weeks as 'due' or 'term'
• Late-term ultrasound for gestational accuracy and fetal weight
• Elective cesarean
• Elective induction
• Non Per Oris
• AROM
• Calling homebirth risky
• Newborn circumcision
• Automatic Cesarean for breech presentation
• Induction for (full term (37-42 weeks), big baby, low or high amniotic fluid, etc... etc...)
• Lithotomy position for 2nd stage
• Cervical ripening by Cytotec /Misoprostol
• Restrictive or Required Weight Gain
• Premature Clamping and Cutting of the Umbilical Cord

This is not to poo-poo on the ACOG; this is a reminder to women that, again, you are responsible for your healthcare.

"Many women... carry fear of being responsible for their own healthcare and the healths of their unborn children, so they relinquish that responsibility to doctors and hospitals, blindly trusting that those doctors have their best interests in mind. They fail to take into account, or choose to ignore, that the vast majority of obstetrical practices are not founded on infallibility, on evidence-based practices, or are without the personal ambitions, impatience, bias', and sometimes even greed of the individual hospital or care provider." - Fear

Be sure to hire a midwife or doctor who you trust to give you honest information regarding those options and recommendations which are rooted in evidence/science, those that have limited or inconsistent evidence, and those practices which are purely their opinion.

Further Reading:
Talk It Out
Tricky Research
If We Can't Make it Illegal
Profit of Pain Relief
Birth Partners
Quick History of Medication
GBS
US Childbearing Healthcare Crisis
The First Cut is The...
VBAmC
The length of uncomplicated human gestation
Perinatal Pitocin as an early ADHD biomarker

Failure to Progress... part one

Failure to Progress... a blanket diagnosis used in obstetrics to declare a woman unfit to deliver without a cesarean. Medically, the definition is:

"no fetal descent or cervical change (with adequate contractions) for more than 2 hours."

eh? (insert quizzical expression). Any person who has spent any amount of time with women experiencing normal, physiological labor can attest to the fact that women can take anywhere from 4 hours of labor, to many days of labor (I'm talking, like 56 hours or more), and still achieve safe, healthy, vaginal birth without complications or interventions. In fact, the average first time mom will experience 18 hours of labor. This means that any number of hours on either side can be seen as normal and natural.


I hate that term. I can say hate, can't I? Talk about putting all the blame on the woman's shoulders (or cervix and uterus)! The part that irks me most about this is that the label of FTP rarely is truly the uterus, cervix, or babies 'failure'.

There are a large number of reasons, other than failure to progress, as to why a woman might not dilate by the book.

One of the biggest reasons for a woman's inability to dilate or move baby down further within the allotted time could simply be because she didn't read the book, and thus her body didn't know the 'rules'. Another way of saying this is to consider that our bodies don't follow Friedman's Curve because we are not medical textbooks, but organic beings that, because of variations in babies and bodies, we might need different amounts of time to accomplish the work of labor.

"Women today are held to a half-century-old labor standard called the Friedman curve, one of the first things obstetrics students learn in their training.


Emanuel Friedman wasn't yet 30 when he plotted the eponymous scale in 1953, during his residency training in obstetrics and gynecology in New York. Friedman found that, on average, it took 2½ hours for the cervix to dilate from 4 to 10 centimeters.

"In the last 50 years, the Friedman curve pretty much dictated obstetric practice, at least in the United States," says Jun Zhang, an epidemiologist at the National Institute for Child Health and Human Development.

Several reports suggest that many cesareans performed for dystocia might be unnecessary. When labor appears to be stalled, doctors -- as well as patients -- often give up too quickly and move on to a C-section.

For example, a study of deliveries at 30 Los Angeles and Iowa hospitals found that about one-quarter of women who had cesareans for lack of progress were only in the very first phase of labor, called the latent phase, when the procedure was performed. Some hadn't begun to dilate.

That doesn't square with the American College of Obstetricians and Gynecologists' definition of dystocia: no dilation of the cervix and no descent of the baby for at least two hours during active labor.

Maybe, the Los Angeles and Iowa researchers suggest, doctors have become so comfortable performing C-sections that they've relaxed their definition of lack of progress in labor." - FTP

In other words, we should be more patient.

Variations that can influence a woman's dilation and babies descent beyond simple patience include:

• mom's energy level - if she has not been eating or drinking, she may be dehydrated and have no energy to work the uterine muscle. If mom eats a high energy snack, drinks some fluids, and rests, she might start dilating and bringing baby down after she recoups her energy.
• babies/mom's position - a baby in a posterior, asynclitic, or breech position might take longer to dilate mom's cervix and move down. This is exacerbated by mom's position. If she is mostly laboring lying down or, heaven forbid, on her back, a baby cannot wiggle and move into the best position as easily as (s)he could if mom was upright and 'showing' baby the exit route and shape through movement and gravity.
• mom's physical make-up - a woman who is less physically fit might need more time to allow her body to dilate as her body might not be as physically efficient at muscular contractions and endurance as someone more physically fit. Additionally, women all have different pelvic shapes. Some shapes might require more time for baby to move through. If there are ligament or muscular torsions, or spinal subluxations, again, her body might need more time to fully open and move baby down.
• mom's emotional state - if a woman is fearful or anxious, she might simply be holding her baby in because of the presence of adrenaline. This is common when a woman moves from her home (laboring) to her place of birth (hospital or birth center) because she needs time and privacy to get re-acclimated to the work of labor and birth. Labor also has a way of bringing up other issues and concerns... so it might mean mom needs to talk about any fears vs faith that she has running through her heart and mind. Additionally, this is another reason why choosing your birth team wisely is so important.
• induction - when a woman's body or baby is not ready for labor but is being forced into the event, it might take longer for her body and baby to make the journey. This preemptive decision may, truly lead to failure to progress (and cesarean) if the mother and baby are truly not ready to birth. This is why it is so important to truly weigh the benefits and risks before agreeing to a routine induction based on 'post-dates'.
• Other - I liken this to the very strong prevalence of iatrogenic complications indicating failure to progress. This can include induction (see above), hospital policy requiring mom to stay immobile on the bed during routine monitoring, medications used during birth which require mom to stay in bed, AROM, and others.

All in all, there are very few times in which a woman truly 'fails' to progress. All of the above can be remedied by patience and knowledge of the human body and personal needs of the laboring woman and baby. Autonomy and patience. Seems simple, right?

If she goes into spontaneous labor, remains upright and mobile, hydrated and nourished, has a supportive and loving birth team protecting her emotional and physical self, and she is educated and confident in the process of labor and birth, her odds of 'failing' to progress are greatly diminished.

Up next in part two is a totally different twist on the term "Failure to Progress"...

Some Related Additional Reading:
A nifty pdf about FTP
Risk Factors, a medical paper

Interviews, aka Getting to the Heart of the Matter

I have often been asked what questions you would typically ask at a doula interview. There are a great number of sites available that have detailed lists but, in my humble opinion, too often they don't get to the heart of the matter.

For that reason, I decided to compile a list of my own interview questions.These are not, per sae, questions that I have been asked, but rather, some I have been asked and some I wish I were asked.

Tell me why you became a doula?
This will give you insight into her, personally. This will also give you a good indication of her emotional health going into births.

What is your personal philosophy about pregnancy, labor and birth?
You may uncover some of that in the prior question, but this will also give you a passionate look into her personality and attitudes surrounding the birth event.

What is your personal definition of a doula and her role?
This is a good one. The Greek term is so generic, it misses the point of the heart and depth behind what a doula truly is. We are more than labor support professionals, more than women's servants.

Have you received training as a doula?
I prefer this question to 'are you certified' because there are many doulas who have extensive experience, chose to decertify, or are beyond certification in their practices that may miss out on clientele simply because the question is phrased wrong. Likewise, there are some doulas who get a 'free ride' on their certification, but could really use a little more experience... and even others who are newly certified, but are very competent and  experienced. 


Have you taken any additional training/education?
Some doulas have taken massage therapy classes, homeopathy, counseling, trauma assessment, IBCLC, CPR/AED, Midwifery assistant/apprenticeship, childbirth education, personal training, nutritional counseling, or other pertinent training that might be helpful.

Can you give me an example of a more challenging birth, why it was challenging, and how you worked within that atmosphere/challenge?

This will give the doula you are interviewing a chance to both give you examples of her work, how she handles adversity, and a chance to showcase her experience.


Can you give me an example of a blissful/beautiful birth and why it was blissful/beautiful?
This will give the doula you are interviewing a chance to both give you examples of her work, a happy birth story, and also give you, the mother, some ideas of what you might want to incorporate into your birthing time.

Do you have references? 
2-3 past clients and 1-2 professional (peer) references are ideal.

Can you give me an example of what your services include (phone, email, prenatals, postpartum, etc..)?
This should include information on information/accessibility prior to your prenatal visits, what is covered in your prenatals, when you will have her at your birth, how long she stays afterward, and what postpartum services she offers. Additionally, this should include 'other' services she offers to you as a doula.

Do you have back up? 
This one is important. Many doulas work independent of other doulas. Cooperation/back-up with at least one other doula is ideal as this ensures that, if she is unavailable for any reason (emergency, illness, etc...) you will still have birth support. There should also be a way for you to be able to meet with them. 



What is the most important tool you bring to women/a birth?
This will vary by doula. It helps you to know their philosophy and strengths. 

Likewise, this is the basic information that the doula you are interviewing would like to know in order to know if she would be a good fit for you:

• What is your estimate due date (EDD)?
• Where are you planning on giving birth and who is your care provider?
• Do you have any other children and, if so, what was their birth(s) like?
• What are your hopes for your birthing time? (medicated, unmedicated, etc..)

I hope that my doula interview questions have helped give you some ideas for your interviews. If you have any other suggestions or thoughts, I would love to hear them!

Breech Options

In the last 2 months, I have assisted 3 moms with breech babies. I don't know if it is the weather, the season, the heavens... I have no idea.

I can tell you, though, that there are four breech presentations: footling, kneeling, frank, and complete.

There are also many reasons why a baby might be breech: emotional reasons, short cords, bicornate uteri or other anatomical shape of the womb, maternal ligament or muscular torsion, maternal skeletal subluxations, placental placement, maternal abdominal muscle tone, amniotic fluid levels, or maternal family history all can play a role.  (for more information see here).

I can also tell you that it has given me a lot of time to consider options for women who have breech babies and all the ways we can try to help women know their options.

From about the mid-70's until recently, it used to be no questions asked, breech birth meant cesarean. In the past few months, though, numerous doctors have been questioning this knee-jerk reaction and Canada has published new guidelines for breech birth, as well as has been promoting and producing numerous breech workshops throughout Canada to raise awareness and training for vaginal breech birth.

For the vast majority of U.S. women planning a hospital birth, when they hear the news that they are carrying a breech baby, their doctor or hospital-based midwife will schedule a breech cesarean between 37-39 weeks. There are other options though.

Concisely, here are your choices:

• To have a planned cesarean for breechness
• Working to change babies position from breech to head down (vertex).
• To change providers to one who will deliver breech babies vaginally
• To wait to go into spontaneous labor before checking to see if baby is still breech and then opting for a cesarean. 
• Or a combination of any of these (i.e. work to change babies position from breech to vertex for the last few weeks for pregnancy... but ultimately wait for labor to start on it's own before reassessing babies position and then, if baby is still breech, opt for cesarean).

Elective Cesarean
My readers have heard me harp on them enough to know that I am never a supporter of elective cesarean ( = without medical justification), so I will let someone else do the harping for a change.

"The Coalition for Improving Maternity Services (CIMS) is concerned about the dramatic increase and ongoing overuse of cesarean section. Since 1983, one in five women or more has given birth by this major abdominal surgery. Today, one in four or 25% of women have a cesarean for the birth of their baby. The rate for first-time mothers may approach one in three. Studies show that the cesarean rate could safely be halved.

The World Health Organization recommends no more than a 15% cesarean rate. With a million women having cesarean sections every year, this means that 400,000 to 500,000 of them were unnecessary. No evidence supports the idea that cesareans are as safe as vaginal birth for mother or baby. In fact, the increase in cesarean births risks the health and well being of childbearing women and their babies." - For more information read here.

This is why I am writing this post. I want women to know their options so that they can be  sure that they are in agreement with the majority of American doctors that believe a breech presentation is medical justification for a cesarean. And, if they are not in agreement with them, I want women to know what other options that they have.

Trying to Change Babies Position

The exercises herein outline the least to most aggressive means for encouraging baby to change his/her position to head-down. Easy examples of these types of exercises can range from daily habits (i.e. if mom has low amniotic fluid, drink more, if mom has postural issues, adjust accordingly) to specific methods and practices (chiropractic, manual movement, acupuncture).

Emotional State - The first thing that I touch on when a woman tells me she is carrying a breech baby is her emotional and mental state. The least aggressive means of encouraging baby to turn are emotional/and mental relaxation. Many midwives swear that a large number of babies that are carried breech are in that position for emotional or mental disquiet. 

These can include:

• the mom-to-be fearing becoming a mother
• the mom-to-be and her mother having unresolved conflict
• the mom-to-be not wanting to 'give up' carrying her baby

When a woman is not sure if this might be the reason for her baby's position, I encourage her to spend some time mother-centered journaling. This means that mom would set apart a time where she will not be interrupted to write. She should have water on hand, have recently emptied her bladder, have a few sheets of fresh paper, and a pen. During her journaling, she can ask herself to be honest about her feelings toward her mother, being a mother, and not being pregnant anymore. Then, during her writing time, she will write without pause - freely allowing her words to come from her mind and heart to her pen, no grammatical corrections and no crossing out.

After completing the exercise, she can talk with her midwife, doula, close friend, sister, or partner/spouse to find out how to resolve anything that might have come up during her writing time. Additionally, she can pray, meditate, visualize, and ask baby to turn.

I have watched women get into a warm tub of water in a dark bathroom with nothing but candlelight and, while touching/rubbing their bellies, listening to their bodies, and talking to baby, seen their babies turn vertex.

Beyond emotional and physical relaxation, the most common ways to change babies presentation from breech to vertex is to try positional exercises.

Inversions - the key to inversions are to do them as long as comfortable. These can include table inversions, knee-chest positions, water inversions, or dumping.

Table inversions are just what they sound like, inversions on a table-like surface. Some midwives will combine inversion tables with other methods of working to turn baby's position. This can be done at home on a piece of plywood or ironing board, or on an actual inversion table.

Example of knee-chest position (and moxibustion)

Water Inversion

 

Two examples of dumping

Rebozos - Rebozos give almost any position an added 'umph' by encouraging baby through demonstration of how to wiggle or jiggle into a head-down position. There are two rebozo breech moves in particular. One is a knee-chest combined with ribozo to put pressure on baby's head and encourage them to move. (see picture to the right).

The second is a breech sifting. Follow the position in the picture to the left. Then, with the 'rebozo' in place, have a partner/friend 'sift' your baby. The basic movement is more like a rhythmic step than a swing.  You are not swinging the mothers hips from side to side.  Instead you are slightly pulling one end of the rebozo, then the other, back and forth rather quickly.  This basic movement should be relaxing to mom. This causes a jerk to the baby which encourages movement to the desired position.  

Now, if you make it here without any of the above working, continue to try the positional exercises in conjunction with the methods below as they will increase the odds of one of them working (i.e., try dumping right before the Webster).

Yoga - yoga is body work and, since we are trying to encourage baby's body to move, it makes sense that yoga works well for this purpose. A guest blogger wrote a wonderful article on yoga and how it can help when baby is breech here. Specifically, I love the last picture in that post.

Acupuncture/Moxibustion - You can see an example of moxibustion in the video referenced earlier in this post. This acupuncture technique involves burning moxa sticks over a certain acupressure point on your little toe every day for 10 days. Alternately, this can be done with a fingernail head of a ballpoint pen on that same point on the little toe (BL67). Some report success rates as high as 80%, while others report success as low as 50%. 

Chiropractic Care - There is a chiropractic treatment called the Webster Technique which encourages the mother’s pelvis to become straight and aligned. This would decrease the chance that mom's skeletal alignment 'holds' baby in a breech position. It is very gentle and noninvasive. The success rate for this technique is shown to be anywhere from 75-95%. Additionally, there are other techniques with great success including Bagnell's Technique, Malott's Technique, and others.

Homeopathics - There are some homeopathics, including Pulsatilla and Arnica, that have been shown to encourage a baby to turn head down. These are best used in conjunction with other methods of turning baby vertex. As I am not a licensed homeopath, I encourage you to contact a local herbalist, homeopath, or midwife in your area for more information on their uses, dosages, risks, and contraindications.

External Cephalic Version (ECV) - An ECV involves a care provider physically manipulating baby through the mother's abdomen to encourage baby to flip head-down.

Some doctors 'require' that mom have an epidural in place or other relaxation medication (such as morphine or stadol/nubaine/demerol), and most will 'require' that, immediately after the ECV, mom will either be induced (if baby goes head down) or be given a cesarean (if it is not successful). I say 'require' because you can always refuse. An example can be seen here:




Vaginal Breech Birth
There are certain criteria when considering a vaginal breech birth. The very biggest being making sure that your birth team has experience with vaginal breech birth. Additionally, reducing risk for breech vaginal birth includes candidates who meet the following:

• Attempts to turn the breech baby to a head down position were unsuccessful, or not chosen.
• The baby was estimated to be heavier than 5lb 8oz and lighter than 8lb 13 oz.
• The baby was in a frank breech (baby's legs extended up with their feet near their ears) or a complete (or flexed) breech position, ie. baby's legs down, and crossed over. This decreased the chances of complications, such as cord prolapse. Positions are explained in depth in types of breech positions.
• The caregiver was experienced in delivering breech babies vaginally.
• The woman was keen to have a vaginal birth.
• The woman's pelvis is believed to be an adequate size. - Birth.com

Other protocols and guidelines can be read about on Spinning Babies, Birth Light,and the SOGC.

Let Baby Decide
Some women, for whatever their reasons might be, choose not to change providers to one familiar with breech birth. For these women, a good option might be to wait and let baby decide. This simply means that, rather than scheduling an automatic cesarean at 37-39 weeks for breechness, waiting until labor begins on it's own.

At that point, mom can work through early labor, and then, during active labor, reassess baby's position. If baby is still breech, the care provider would go ahead with the cesarean and, if baby has moved into a vertex position, mom can go ahead with labor and birth vaginally.

In Conclusion:
If you happen to be one of the women who get the news that their baby is sitting breech in the womb, know that you do have more options than a scheduled cesarean. Also know that there are women in your area who will love and support you through every option that you have.

If you are specifically in the Houston area and need information on breech-friendly doctors and midwives, just give me a call. I also have a list of midwives and doctors who will do ECV as out-patient (without requiring immediate cesarean or induction afterward), chiropractors familiar with Webster and other breech-turning chiropractic techniques, acupuncturists, and more.

And finally, for encouragement:



Further Reading:
Head's Up
Breech Birth Statistics
Spinning Babies
A Breech in the System
Stand and Deliver: Dance of the Breech

Baby 101 - Winners!

Alright readers! Here are the two winners for the Baby 101 DVD Giveaway!

B.A.S.I.L!!!

Lisa!!

Congratulations ladies! I look forward to hearing from you so that I can get these in the mail to you!

Cut

This is a topic that raises strong emotions on both ends of the spectrum. In fact, this topic has been known to divide households, spouses/partners, and long-term friendships. But, the fact remains, this topic needs to be discussed more.

There is a newer movie out called "Cut", and I highly recommend taking an hour to watch it. It is one of the best I have seen.



There is also a great article that I just came upon called When Intact, Don't Retract... what a great catchy line, and what great information it gives on the intact male and how to care for intact babies.

For my clients, if, after watching the movie above, you have additional questions, I am more than happy to share our journey through this subject, answer your questions as well as possible, and will lend out additional resources (articles, studies, and videos) to help you make a more informed choice.

For further reading:
NOCIRC
Intact America
NOHARMM
CIRP
CRC
History of Circumcision 
Peaceful Parenting Posts on Circumcision

Memoirs of a Singing Birth is Now In Print!

I originally reviewed Elena's book here. I'll let the original review speak for itself, but I highly encourage birth activists and mamas to have this beautiful book on their book shelves!



To see more information on it go here.

Fear

A woman is like a tea bag- you never know how strong she is until she gets in hot water. ~ Eleanor Roosevelt

I find a disturbing and insightful pattern emerging from our culture. I have known about it, worked with women through it, and in every interaction, class, and workshop, attempted to dispel it... FEAR.

Fear is a huge part of our culture. We are so afraid to feel emotional or physical discomfort that we remove ourselves from it, sometimes before it even begins, medicating it or simply refusing to acknowledge, or greet, these sensations. Fear of the flu, fear of pain, fear of relationship hurt, fear of confrontation...

FEAR: a distressing emotion aroused by impending danger, evil, pain, etc., whether the threat is real or imagined; the feeling or condition of being afraid.

When it comes to pregnancy and the birthing event, women of Western culture are just as fearful, if not more so. I have seen women stare in disbelief, shaking their heads, even becoming physical squeamish over the sight of a woman giving birth, and yet, they don't have the same reaction to watching a baby be surgically removed from the abdomen.

Many women even carry fear of being responsible for their own healthcare and the healths of their unborn children, so they relinquish that responsibility to doctors and hospitals, blindly trusting that those doctors have their best interests in mind. They fail to take into account, or choose to ignore, that the vast majority of obstetrical practices are not founded on infallibility, on evidence-based practices, or are without the personal ambitions, impatience, bias', and sometimes even greed of the individual hospital or care provider.

It's not what you call me, but what I answer to. ~ African proverb

Women have been taught, through our cultures unbalanced mix of over-sexualizing the female body and disempowering the event, to the point of sciolism, to not trust their bodies, the sensations that it brings, and to even fear that the event itself is routinely dangerous and life-threatening, or in the very least, horrendous and unimaginable.  

Our deepest fear is not that we are inadequate - our deepest fear is that we are powerful beyond measure. ~ Marianne Williamson

For women to understand that the process, that the sensations, and that the uncontrollably powerful experience is not something to be feared, we must first reconnect women with their bodies. This can be accomplished best by placing women in a right-brained, left-bodied, creative, emotional, feminine, and physical space in which women can move freely.

If we don't change, we don't grow. If we don't grow, we are not really living. Growth demands a temporary surrender of security. ~ Gail Sheehy

Oftentimes, when I begin working with women, they are inhibited from moving their bodies, speaking their minds, or allowing their emotions to surface. Some women are afraid to sing, to dance, to cry, to get angry, or to make noise. The most rudimentary lessons I teach is "uninhibited woman". Ina May Gaskin calls it our "inner monkey".

To find our "uninhibited woman", we must get rid of inhibitions. Some of these are rooted in lack of use or cultural/social conditioning... these are more easily shed. 

www.caryyork.com

But most of these are rooted in fear and physical conditioning. 

There came a time when the risk to remain tight in the bud was more painful than the risk it took to blossom. ~ Anais Nin

To want to face these fears, a woman must see the physical and emotional freedom that we offer. The best way to do this is to give loving encouragement and positive birth stories that show women making courageous decisions and having powerful births. This incites desire. Most women seek a doula, midwife, or childbirth educator with desire already in hand.

Once she has desire, in order to face these fears, women must find courage. 

Courage is not the absence of fear, but the triumph over it. ~ Nelson Mandela

Around 1/3 of women have been so engrained into this belief that their bodies and their power, their strength and their intuition are so broken and inadequate that they have been given primary cesareans. So we, as birth educators are not only battling against powers and principalities, but misinformations that have taken on the guise of truth and flesh. 


Other women have been so engrained into this belief that their bodies and their power, their strength and their intuition are so broken and inadequate that they literally flee, either physically, emotionally, or conversationally, from situations that might challenge them to confront those fears.


And still other women will react with distain or outright anger at the possibility that their overt hostile reactions are actually secondary reactions to a deeper emotion - fear.

Courage is like a muscle. We strengthen it with use. ~ Ruth Gordon

I employ the use of Yoga Nidra sessions with my clients. We walk through the progressive mental and physical relaxation that allows them to become aware of heartfelt desires, engrained or intuitive beliefs, and intentions of their bodies and birthing times. 

You must learn to be still in the midst of activity and to be vibrantly alive in repose. ~ Indira Ghandi

This breaks down the levels of constraints that our physical and social/communal lives put on us on a day to day basis and allows us to tap into our true emotional, physical and mental self.

I employ voice with my clients. I encourage them to write, journal, speak, yell, yop, hum, and growl. I encourage them to speak "I feel", "I want", "I fear", "I know" on a daily basis. When they can look at their words, when they can feel them in their throats and on their tongues, and when they can hear their own words outside of their heads, they can begin to strip away those things that are relative and those things which are subjective.  

I employ movement with my clients. Allowing and encouraging women to dance, with abandon, reconnects them to their bodies and their babies. Teaching women to hone in on their cores, to find those 'tight spots' in their bodies, will give them insight into what is binding them emotionally and mentally. Demonstrating to women the practice of moving and dancing with others teaches them the power that they have even in the midst of disempowering situations.

Darkness can not drive out darkness only light can do that. Hate cannot drive out hate only love can do that. ~ Martin Luther King, Jr.

And finally, I teach the women that I work with about their choices, and always in love. I have the choice of presenting them the information in a non-confrontational, non-judgmental way, sharing a balanced view of the benefits and risks of each option, or I can provide them with the same information in a fearful, judgmental way. The latter does  not allow for their truest, deepest self to make the choice for them, because it is tainted. 

There are two kinds of light - the glow that illumines, and the glare that obscures. ~ James Thurber

I choose to always give light that illuminates the dark, not the harsh light that obscures personal truths for personal journeys.

Fear grows in darkness; if you think there's a bogeyman around, turn on the light. ~ Dorothy Thompson

Loving education provides women with all of their options so that, when faced with choices, when fear rears its head during their pregnancy or birthing time, they have the tool with which to illuminate the situation: dispelling mistruths, personal ambitions, and fearful coercion.

We never know how high we are Till we are called to rise; And then, if we are true to plan, Our statures touch the skies. ~ Emily Dickinson

My deepest heartfelt desire is that every woman would not have my ideal birth, but that she would have the ideal birth for them. One which is free of fear, full of power, and helps her to positively grow into the capable mother, lover, and courageous woman that she truly is.



For more information, keep an eye out for Karen Brody's new childbirth curriculum, Fear to Freedom. This innovative program incorporates all of the educational components discussed herein and is now available in the Houston area through Sage Beginnings.

The Beauty of Homebirth

It is hard to capture (on film) the gentleness and serene welcome that home birth offers. This video does a beautiful job of just that!



If you are in the Houston area and want recommendations for out-of-hospital birth options, feel free to contact me.