Dear Childbirth Care Provider

Dear Doctor, Midwife, Mother, Sister, Husband, Childbirth Care Provider,

These letters are a compilation of letters that have been shared with me from some of my clients' journals. I ask many of the women I work with to start writing... forgiveness letters, truth letters, anger letters, secret letters... healing letters that allow them to be honest about what they are holding in their hearts.

Some of these letters make it into the hands of their intended recipients... sometimes not... 

Dear Care Provider,

I hope you take the time to read this. I really do. I hope you prove me and every other woman wrong who believes you might think yourself just a little too busy to take the time out to listen to the concerns of one. lone. pregnant. woman.

But the thing is, I'm not alone. My words are echoed in the stories and recounts I hear from many, many women who have been pregnant. This letter might be sent from just one woman, but I echo the sentiments of many.

I don't think that you are mean, I don't think that you are a bad person. I don't think that you are stupid or even that you really have it out for us. I am trying my hardest not to make generalities, but know I come from a place of deep hurt.

Just as you are (enter first name) (enter last name), I am an individual as well. Just as you have hobbies, passions, things that keep you up at night, make you feel deeply, and love strongly, so do I.

I might be a file number in your office, but I am a person, autonomous and individual. It doesn't matter how much money I make, how many months I have been breathing, or how many humans I have birthed. It doesn't matter if the sperm donor is my close companion or a distant memory. It doesn't matter my color, my heritage, my body modifications, or my education level - I deserve to not have assumptions made about me. 

If you want to know something, ask me, not my chart.  And don't assume that I really want your opinion or recommendation. Offering is fine, but I am not a child, you are not my parent, you are not my spiritual adviser, and you are not my employer.

Please realize, I am a woman. A strong, competent, resourceful, educated, inquisitive, evolving woman. I am working at, not only growing a baby, but becoming a capable, confident, and competent parent. So please don't treat me like an inferior.

Now, before you get angry, remember: I sought your services out. I hired you. Which means that I saw or heard something that made me come to you out of an interest in having you at the most important moment of my current life: the birth of my baby. And if I didn't see or hear something, and I am seeing you out of necessity, it doesn't negate that I still deserve to be treated with deference and respect because I still did hire you.

I understand that you have spent countless hours pouring over medical texts, seen countless births and situations that have shaped your bias, and may have even seen enough birth that you have lost sight of the reason you first became a childbirth care provider.

But you invested your heart and soul into this business for some reason - that early spark and passion, the one that made you commit many years of your life to this study... but that is what I had hoped to have hired. I want the provider with that fresh passion and love for women and babies.. not a jaded, biased, arrogant, overworked, and exhausted professional that sees me as a patient and a paycheck.

You might think I am annoying with all of my questions, requests, or desires. You might see me as naive, incapable, or even foolish. But, like I said before, I am not only making a human, I am making a mother - a mother who wants to know, learn, be respected, and be engaged.

And I want a provider with heart. You might say 'you didn't hire me to care, you hired me to deliver a healthy baby'. No, I hired a person who, at one time, did care.

I want a care provider who will respect me, so that I can respect you. I want someone who will listen with an open heart and open eyes, seeing me as a fresh and new person with fresh and new ideas.. no matter how many times you have seen and heard this same thing before.

I want a care provider who will concede that their way is not the only way... even if you don't agree with me on my choices, that you will earnestly respect them and adhere to them.

I want a care provider who will give me facts, not opinions and exaggerations. If you don't like my sources, provide your own. If you don't like my books, actually read them before you can base an opinion on them. Don't try to coerce me or manipulate me into agreeing on a course of care or treatment, if I wanted a salesman, I would have gone to a used car lot.

I want a care provider who wants an educated client. I want you to encourage me, not discourage me, to read and learn, watch and see, study and ask questions! This is my body and my baby - I have to live with the consequences of my choices, so let them be my choices.

You're right, you know pregnancy and birth, but you don't know my pregnancy and birth. You are an expert in anatomy and physiology, but, unless you take the time to get to know me, you don't know my anatomy or physiology. You have seen many things that I haven't, but you haven't seen my birth.

Be open to the wonder, to the first time, the only time, of this, my birth event that we are looking forward to right now. Not Sally, who had a cesarean, or Kirsten who needed that epidural, or Jenny who pushed on her back - me and my story.

And, in return, I promise to remember that you do have extensive knowledge and skills that I might be in need of, I promise to remember that you are an individual human, maybe with a family, who has demands and emotional situations and circumstances outside of this office.

I promise to really take your suggestions to heart and weigh them with my personal beliefs and present situation.

I promise to give you the respect that you deserve as a partner in my healthcare and to consider your opinions and suggestions along the way. 

Your thousandth primapara, 

First Time Mom

Update: this mom ended up becoming a childbirth educator and is now training to become a doula. She has more children. She still births in a hospital, with an OB. And yes, she did share this letter with him. He regularly shares it with his colleagues and peers. 

Dear Husband

Dear Doctor, Midwife, Mother, Sister, Husband, Childbirth Care Provider,

These letters are a compilation of letters that have been shared with me from some of my clients' journals. I ask many of the women I work with to start writing... forgiveness letters, truth letters, anger letters, secret letters... healing letters that allow them to be honest about what they are holding in their hearts.

Some of these letters make it into the hands of their intended recipients... sometimes not... 

Dear Husband,

You'll probably never get this letter. No, I know you'll never get this letter. How can I tell you what's really in my heart when I know it would only break yours?

Or possibly even break our marriage.

You wanted a son almost as long as I did. When you married me, you promised to care for and love RiLeigh as your own, and you do. But, when we decided to try to get pregnant for another baby, we both wanted a son.

When we found out it was a boy? Wow, we were over the moon! I started planning right away, a home water birth, like RiLeigh's was!

But, you started having second thoughts. You were worried about how we might be risking our babies life. I gave you tons of material to read and invited you to come to my appointments with me to ask the midwife any questions you might have.

You declined.

You had a strong opinion of how I should birth, but you weren't willing to let it become an educated opinion.

After 3 months of coercion and arguing, we switched my care to a doctor, in a hospital. You were relieved, I was in mourning.

During my labor, you were so worried for me and my health that you stopped helping me and started questioning me.

Could I do it?

Was I in too much pain?

Should I get a cesarean?

You even stopped asking me and started going directly to my nurse. My nurse went to the doctor. The doctor was more than happy to jump on the 'epidural and a cesarean' wagon. But not me. In labor, I fought for my right to simply birth my baby, and I won.

We were supposed to be a team, but instead, when the going got tough, you tucked your tail and ran to the opposing team, divulging our secrets, our weaknesses, and our strategies... but I still won the game.

That was disappointing, but not really hurtful. What really hurt was what you did to our baby boy. We had talked and talked about all of the labor and birth options, what I wanted and didn't, what we wanted for our little boy... and I guess I just assumed that, like our choice to wait on vaccinations and other injections, you would want to protect our son from the pain of circumcision. It was my fault for assuming.

But, a few hours after birth, while I am trying to get him nursing, you chose to jump in happily when the nurse asked if we would be circumcising our son and announce 'of course!'.

We talked, we argued, we fought. I broke down into tears and begged. But you were adamant that no son of yours would be the weird one in the locker room, the one who couldn't get a date, the one whose penis was ugly. You threw in your whole hand when you spat out 'it's my only child, and you would deny me the right to be his parent?!'

I was heartbroken. Your only child? What about RiLeigh, who you had cared for since infancy?

Torn between the two men in my life: my son, who I loved and, unlike you, thought was perfect and beautiful the way nature intended him to be, and you, my lover, who could say such hurtful things, and want to purposefully inflict pain on our son.

I felt guilty for wanting to keep him uncircumcised and angry for being pushed into a corner. I felt so very sad for our little boy and heartbroken that I was being made to be the enemy for wanting to protect him.

So, I signed the paperwork.

My birth experience? Forgiveable, I was still able to do it in my own strength. It was only done to me, an adult... but our son's body? He can never get back what he lost two days later, strapped on a board in a sterile room.

I know I should forgive you. But I can't. Does that make me a horrible wife? I want you to feel remorse, I want you to want forgiveness. I want you to be sorry for hurting me, our son, and the moments of labor, birth, and those precious first days.

But I don't think this wound will ever be able to heal, because you don't understand that you not only chose to carve off a piece of our son's body that day, but part of my trust and love for you as well.

Sincerely,

The Circumcised Heart

Update: This letter was written in mom's journal shortly after the birth of their son. I didn't influence her decision to write this letter as it was written before I even met her. Mom ended up pregnant again and she did end up giving it to him the day after she found out that the baby she was carrying was, again, a boy. They went to counseling and they scheduled appointments with a urologist to talk about the research surrounding circumcision and the purpose of the foreskin.

Although she still didn't get a repeat home birth, for the third birth they negotiated and came to an agreement to have a water birth in a local birth center. He also admitted his need to have someone there to help him even moreso than her. So, they hired me as their doula.

Dad agreed to wait to make a decision on circumcision until he was sure that his reasons for wanting it to be done were worth the pain that it was going to cause his child, the potential risks it might incur, his wife's emotional pain, and the permanent alteration that would result from the procedure.

Their second son is now 3 and still intact.

Dad has apologized.

Mom has forgiven. 

Dear Sister

Dear Doctor, Midwife, Mother, Sister, Husband, Childbirth Care Provider,

These letters are a compilation of letters that have been shared with me from some of my clients' journals. I ask many of the women I work with to start writing... forgiveness letters, truth letters, anger letters, secret letters... healing letters that allow them to be honest about what they are holding in their hearts.

Some of these letters make it into the hands of their intended recipients... sometimes not... 

Dear Sister,

It was never about you. I know that sounds mean, but I don't know how else to say it. It was never about you. It has always been about me. This was my pregnancy, my birth plans, and my baby.

I never asked for your advice, and I never gave you any of mine. With Ella's birth, I found that I needed healing. My cesarean was emotionally and physically traumatic. Do you even remember my months in counseling, the family being on watch to make sure I didn't hurt Ella or myself and my deeper depression after I found I couldn't nurse anymore?

Maybe you thought you were trying to help me when you told me to just schedule a cesarean. Maybe you thought it was being supportive and keeping me from dwelling on how baby got here. Perhaps you were only trying to help save me from disappointment when you kept harping on me about the ease of a cesarean.

But I wanted more!

When I found out I was pregnant with Roscoe, I wanted a healing birth. When I told the family about my plans for a VBAC, they were all. so. negative.... and you included. I needed someone to tell me I could do it. But everyone said

Remember what you went through before? Just schedule a cesarean!

Come on. Your my sister. But it doesn't mean we want the same things. You were happy with your scheduled cesarean for both of your babies. You were happy with formula feeding and day care scheduling.. but I wanted to birth, I wanted to nurse, and I wanted to stay home and raise my children my way. I loved and supported you through your choices, whether or not I agreed with them, why didn't you do the same for me?

And then, at my baby shower and during girl's nights' out... when you found out you couldn't convince me to go under the knife again, you started planting the fear; in front of everyone:

"It's so dangerous!"
"What if you BURST your uterus wide open?!" 
"You're being selfish to risk the life of your child for an experience!"

Did you ever even read any of the studies and material I gave you? I don't think you did, otherwise you would know that your opinion was only that, opinion. Otherwise, you would have known that this was very much my choice - and a safe one at that.

And then, after Roscoe was born (born MY way) you never congratulated me, never apologized. In fact, the only thing I remember when you held him for the first time is what you said to him:

"Aw, poor baby! Look at that cone head! If your mama had listened to me you would have this pretty little perfect round head."

I was so hurt. Hurt at the insult to my son and hurt at the insult to my body and my achievement. MY moment.

And finally, breastfeeding. Yes, I said breastfeeding. You hate the idea of, as you put it so kindly in front of our friends, the "nasty nipple stretching, boob sagging" event of letting my little one "suck on [your] tits in public". You said it was like watching someone have sex... or go the bathroom... you said that knowing your little nephew you was eating my bodily fluids grossed you out and made you afraid to hold him for fear he would spit up on you.

And I won't even start on your whole "my sister is going to turn into one of those boring housewives with nothing to talk about but her kids".

What does all this mean? It means I think you are being selfish. It means that I am done being your whipping post for all of your opinionated lashings. Its fine to have your own opinion, but I am going to start giving you mine.

• Formula feeding is selfish. Especially without a good reason for it. Breastfeeding doesn't change my boobs, the hormones of pregnancy do. Breastmilk is the best food for my baby, and yours! You are giving your baby less than the best simply because of your own sexual hang ups
• Vaginal birth was the best thing for my baby and myself. Physically and emotionally, we are both so much more healthy for it. I may have failed, but at least I would have tried... which is more than I can say for you. And I did it! You should be congratulating me and my smart, amazing, powerful body! You not doing it only shows one of two things: either you are jealous or sad because I got something you didn't and you wanted, or you are too insecure to admit when you are wrong.
• Being a homemaker is great in my opinion. I can go to the gym whenever I want, make home made healthy meals for my family, and home school them so that they are smarter than the neighbor kids! And, although I might have more to talk about than my kids, I only want to talk about my kids - because I am around them enough to know how very awesome they are. I will be there for their first step, first tooth, first bruise, first everything. And I wouldn't miss that for the world. 

Guess what? I am going to be very vocal about my opinion, as well as the facts from now on. So, I encourage you to read up on those facts so that you are well equipped to try to keep up with me when we debate in front of our friends and family - since you like to make my business and your opinion so very much a public affair.

P.S. (please see the research and medical studies of interest attached to this letter).

Love,

Your twin sister

Update: This mom never gave her sister the letter. She did, though, do exactly what she said she was going to and began speaking up. Since that time, her sister has stopped the opinionated comments in public. The trade off is that the mom is sad she knows that there are some things that she and her sister can never discuss: parenting choices and birth choices.

Their mutual friends have told her on many occasions that her birthing and parenting styles have encouraged them to consider their options. As a result, she has attended two of their closest friend's births as a photographer and helped one friend to get breastfeeding help through their local LLL. She is regularly asked for help with researching medical studies, pediatricians, and birth options from friends and family. Her sister has not been given these same opportunities.

Dear Mother

Dear Doctor, Midwife, Mother, Sister, Husband, Childbirth Care Provider,

These letters are a compilation of letters that have been shared with me from some of my clients' journals. I ask many of the women I work with to start writing... forgiveness letters, truth letters, anger letters, secret letters... healing letters that allow them to be honest about what they are holding in their hearts.

Some of these letters make it into the hands of their intended recipients... sometimes not... 

Dear Mother,

Hi mom. I bet you are sitting at your kitchen chair right now wondering what in the world I am writing a letter to you for. Why not an email? Why not a phone call?

Well, my doula gave me a project, that is to write to people who I need to tell something to. So, you, among many people, are getting a letter. She said I could blame her for any hurt feelings, but it was my choice to mail this letter and I am going to own my own choice and feelings in this letter. This is not my doula's fault, it is my feelings and my choice.

I love you mom. You are an awesome mom. When I was little, you taught me so many things: how to be strong, how to not be afraid of trying something just because I was a girl, how to be proud of myself and how to see myself as beautiful when I was always the tomboy and never the prom date.

You helped me get my first job and were there for my first award. You cheered me on from the side lines and stood with me in my wedding when dad couldn't be there. You have always been wonderful to me.

But this, for some reason this has changed things. This 'pregnancy thing' as you like to call it, it has put a wound between us that I don't see being healed before our little one is born.

It started when I told you my (in my eyes) exciting news
"Are you sure this is a good idea?"

That's what you said. I called you right after I shared the news with my husband and that is what you said. I was blubbering with happiness and excitement over your first grandbaby and you asked if I was sure if my baby was a good idea. 

Yes, we are still newlyweds, and yes, I am still newer in my career, but it really is none of your business if me and my husband decide to have a baby. We are ecstatic, can't you be? Or at least keep your opinion and shitty comments to yourself?

It continued when we went to our ultrasound appointment
I thought how cool would it be to have grandma there for the ultrasound, after all, you never got to have one and had never seen one. So I invited you. You said you would love to but could I reschedule because you had lunch with a friend planned for that time. Really? I invite you to a huge moment for me and you want me to reschedule for your standing lunch that you always have on the same time and day every week?

I said that to you and you balked 'of course! If you know my schedule so well, you should've known better in the first place'. Long story short, thanks mom, for missing one lunch with your friend so you could see your grandbaby for the first time.

But then, while we were there, we had already told you we weren't finding out the sex, and you waited until I was all jellied up to start the argument. The nurse asked if we wanted to know the sex and we said no. You leaned in and said 'but you can tell the Grandma'. We said no, she couldn't.

You started actually pouting, arguing that how were you going to buy things for 'it' if you didn't know what sex 'it' was, everyone knows the sex of their baby, and how were we going to pick a good name if we didn't know... were we going to just give 'it' some 'spontaneous and weird name' at birth?

The nurse looked so uncomfortable. She gave me a paper towel,said she printed us some pictures, and left. I missed nearly the whole thing because I was arguing with you. Thankfully I have pictures. And even then, you wanted to take them right away and make copies, saying I was so unreliable I might not get it done in a reasonable amount of time and you had to have something to show for the time you spent there with us.

And finally, the birth
Yes, I am going to give birth at a birth center. No, I don't need an epidural. Yes, I know the risks, and I also know the benefits. No, I probably won't need a cesarean like you did. Yes, I will probably deliver in water. And yes, with a midwife and a doula. No, my doula would not have taken your place, if anything, she would have made it easier on you, either helping you to help me or simply enjoy the experience.

I say would have mom, because you are not invited to the birth.

I am not doing this to be mean, but because your recent actions has shown me that there is something going on that we can't seem to fix, or even talk about, right now. If we can't fix it before the birth (which is only about a month away) I can't have that drama or that 'something' in the room while I am trying to give birth to my baby.

You can say you will behave, but I can't risk it. I can't risk it because, if you don't behave, you will ruin my birth... and I can't get that experience back, I can't redo it. I can't chance your nervous, untrusting attitude of my pregnancy and birthing choices won't influence everything. I can't have you pacing, and crying, and pouting, and making rude comments to everyone. I can't have you trying to change my opinion, or supersede my choices. And I can't let this be about you. Because it is about me, the mother, and my baby.

I love you. I don't hate you. I am not punishing you. But, ever since you found out your little girl was going to become a mom herself, you seem to have forgotten how independent, competent, smart, educated, self-sufficient, powerful, proud, well-adjusted, and sound you raised me to be!

I'm not a child that needs parenting, I am a woman who wanted her friend, who happens to be her mother, to share in a special moment with her. But, for whatever reason, you have become the parent you never were or ever wanted to be when I was growing up: manipulative, conniving, coercive, pouting, flaunting, and dramatic.

Where did my friend go? I don't know, but I need that person in the birthing room with me, not whatever this is.

I can't wait to see you fall in love with your grand-baby, we have you on the doula's list to call when I am near the end of labor. That way, you can get to the birth center before anyone else does and see our baby. I have the outfit you picked out for the first outfit, and we will be taking lots of pictures so you can see them if you ever want to. We might even video tape it, although I joke I don't ever want to see it.

I would love to go to lunch sometime this week and talk. I really want to, but I need you to know all of this and choose to come to lunch with me. If you choose to go to lunch with me, please know that you are showing me that you acknowledge my feelings and want to talk about this. It won't guarantee you a place at my birth, but your willingness will guarantee you a place in my heart and mind of respect and gratitude.

Sincerely always, 

Your Daughter, who is about to become a Mother

Update: mom did end up giving this letter to her mom. Her mom declined the invitation to go to lunch. Her mom was not at the birth and missed the first few days of her grandbaby's life. She did call many days afterward to come see the baby. She also did end up asking to see the birth video many months after the birth, itself. Mom and mother are still working to define boundaries and roles. Mom describes it as a work in progress.

Dear Midwife

Dear Doctor, Midwife, Mother, Sister, Husband, Childbirth Care Provider,

These letters are a compilation of letters that have been shared with me from some of my clients' journals. I ask many of the women I work with to start writing... forgiveness letters, truth letters, anger letters, secret letters... healing letters that allow them to be honest about what they are holding in their hearts.

Some of these letters make it into the hands of their intended recipients... sometimes not... 

Dear Midwife,

I hope you don't mind me asking that you take just a moment to read this letter. I wasn't going to write to you, but I was encouraged to do so, so here you are.

I, first, wanted to thank you for helping to bring my beautiful little boy into the world. He has been here for 8 months already and he continues to surprise me with what a little person he is. He is so wonderful! He brings joy to my life at every moment I look at him. For that I will be forever grateful.

But this letter isn't about that, it is about my birth.

I hope you can look at all of this through my eyes, because I am not trying to second-guess you or offend you in any way. I am sharing this with you, hoping that you will take it all in and see if my point of view might help you to reconsider your practices in a new light.

When you came in to my home, during my labor, you told me we had to find out my 'baseline' for how the night would progress. This meant baby heart checks, a cervix check, and blood pressure. I knew this was part of it, but I didn't expect how you went about it.

Paper rustling, texting your husband and daughter, answering a call from another woman who had an appointment later that day... all right in the room with me. Sure, you left my lights off and my candles lit, but that is the only sense of peace I got from you.

You sent my husband to get me some water when he couldn't tell you the last time I had drank something. Again, I get why you sent him to do that, but why did he have to leave me right when you were going to check my cervix? I wanted him with me, but I didn't know how to tell you that.

When you checked me, you were rough. I understand that you need that information, but when I told you I needed you to stop, you only squeezed my knee and said 'just a little longer' and pushed your fingers up in my harder.

We talked so much about our relationship, but, in the heat of labor, you threw my trust and our mutual respect right out the window for a cervix check.

And then, after you were done, you patted my knee and said I was 'only a 3, we have a long day ahead of us'. Then you sighed, pulled out your chart, wrote something, and said you had to make a phone call, leaving me lying on my couch and feeling deflated.

I was so proud of all the work I had done before we called you, I felt proud of my labor pattern and certain of the time we said we were ready to have you come be with us. And now I felt disfunctional, unproductive, and guilty for calling you too soon.

Thankfully, my labor started to get earnest again when you left for lunch. When you came back afterward, I declined your request for another check. You got this pained look on your face like I had offended you, but I couldn't let it happen again and didn't have the time to tell you why I was saying no.

So, there is my explanation. I'm sorry I offended you and talked to you sharply, but I had been hurt by you physically and emotionally - and that was where I was coming from.

When I started pushing, I was really comfortable in the position I was in. But you told me to get up on hands and knees. I said I would rather not because I was comfortable where I was and you said 'you don't want to birth like women in the hospital do, let's get you up!'.

I felt chastised and insignificant. On the one hand, I was comfortable where I was, but you were right, on the other hand, I was not in the hospital. I was second guessing myself... so I let you grab my leg and arm and hoist me up on to my hands and knees.

I didn't like it though, I couldn't see my baby be born. I said I wanted to see, and you sent my husband to get the mirror. He couldn't get it positioned right, though, and even though I kept telling you both that, he couldn't get it right and you couldn't be bothered to help him.

I missed seeing the birth of my baby because I was on all fours.

When he was born, I wanted to just look at him. He wanted to look at me... but you grabbed a hat and shoved it down over his eyes, grabbed my breast, and immediately started aggressively trying to shove it into his mouth.

He wasn't interested and I told you that I didn't think he was. You said he was, and I had missed his earlier cue of his tongue sticking out. We 'worked on breastfeeding' until my placenta came out, and then 'worked on it' some more. He didn't end up nursing for an hour and a half after birth. I could have been spending that time loving on him and admiring him instead of working on forcing him to eat.

So, in a recap, by the end of my labor, I felt guilted for standing up for my own needs, second guessed my own intuition, regretted giving up my power to you, missed the birth of my own child, felt like my body and my knowledge were inadequate, and then was told that I didn't know my own child's needs more than another woman did.

I felt like a failure.

I love the fact I had a home birth and a midwife, considering how much more I would have regretted and been hurt had I been in the hospital. But it doesn't change that I was still hurt and have regrets.

Don't worry, you haven't lost a client, in fact, the closing of this letter is to let you know that we are pregnant again. And yes, we want you to be our midwife again. But, this time I have certain requests.

I want you to know I will be doing my own cervix checks, I would like you to teach me how to do it. I want to catch my own baby. This means I can't be on all fours. I will probably squat or be on my side, but I might also like to be in the position I was before and that is ok with me, please respect that.

In labor, I don't want Jon to leave me. We made this baby and it is his experience as much as mine. If I need water, we go together or you can get it. If I need nourishment, we go together or you can get it. And finally, when this baby is born, let us breastfeed without time limits, please. When this baby shows interest, even if I miss the first cues, let us figure it out. If I need help, I know you are very knowledgeable and I know I can ask for it.

Thank you so much for having an open heart and mind. Thank you for not being offended. Thank you for being my midwife and someone I respect and love enough that I feel I can be honest with about my feelings.

Your friend,
Homebirth mom

Dear Doctor

Dear Doctor, Midwife, Mother, Sister, Husband, Childbirth Care Provider,

These letters are a compilation of letters that have been shared with me from some of my clients' journals. I ask many of the women I work with to start writing... forgiveness letters, truth letters, anger letters, secret letters... healing letters that allow them to be honest about what they are holding in their hearts.

Some of these letters make it into the hands of their intended recipients... sometimes not... 

Dear Doctor,

I came into your office today. 9:30 am, just like the little card that was mailed to me a month ago said. I was ecstatic when I came in - I have wanted and hoped for this baby since I was a little girl dreaming of being a mommy someday.

The card said 'arrive 5 minutes early for your paperwork'. I got there 10 minutes early. I was so excited, I felt like my face was going to split from excitement. The woman at the desk, perhaps she was having a bad day, but she really didn't need to ignore me like that, or glare at me like that when I couldn't find my insurance card right away... or make me feel chided just because I wanted to share why I was there.

I filled out my paperwork, returned it to the counter, and waited... and waited... and waited. I finally got back to the room 45 minutes after my appointment time. The nurse was nice, but didn't look me in the eyes. She gave me a paper towel and told me to put it on. 'Put it on'? How can you put a paper towel on? Why would I be sitting around in a paper towel anyway? I asked why and she just smiled like she pitied my naivete and said, 'the doctor will be in to see you in a moment'.

I waited, and waited, and waited some more... 20 minutes after that, I finally put my coat on because I was cold, and then you walked in. You chided me for keeping my bra on under the paper towel and made me feel silly before we even got introduced. I have to tell you, it is more than a little intimidating that, on a first meeting, I meet you disrobed and in a paper towel and you meet me in business attire.

Talk about defining expected roles.

Then you gave me your name, opened my file, and read out of it for the rest of the prenatal. Yes, I was pregnant. Yes, I was young. Yes, I wanted 'it'. You recommended considering my options, like me being pregnant and young made me more apt to not want... 'it'.

I said I had questions. You said to make an appointment to talk with the nurse about them. I said I wanted to know your feelings about some pregnancy and birth options. You told me to stop reading my books and, instead, to read your office's packet of information my nurse would give me on my way out.

I was stirruped, felt up, felt around, made greasy, given another paper towel to wipe off with, and out the door you went before I had even put my feet back down out of the stirrups.

I dressed, slower and less enthusiastic this time, and put my purse in my lap. I felt shell-shocked. I waited over an hour for 10 minutes of groping, beratement, and belittlement. I was so excited about this first step toward becoming a parent... and now I just felt like a naked child with their legs spread wide and a goopy bottom who was scolded to be seen and not heard.

I left with my 5 pages of information, which included information on pregnancy control, when I should expect to come back throughout my pregnancy, what constitutes a pregnancy emergency, and a prescription. Nothing about me. Nothing about my wonder, my joy, my baby! Just your expectations of me.

I understand that this is your livelihood, your business, and that you see many women just like me every day.

But this is my life-lihood, this is my future, and I am an individual, not an appointment.

Sincerely, 

Recommended to Another Practice of Mother-centered Provider

Interview with a Birth Mama pt 1

After making this post, I received an email from Christie, the star of the breech video I linked back to. She was amazingly driven to educate women to their options in birth when faced with the possibility of birth with a breech presentation.

I then asked for an interview, to help her in her pursuit to educate the public. Read on...

Christie - you had two breech babies born via cesarean before you opted for a homebirth with midwives for your 3rd baby - a vaginally born breech baby. What changed between babies 2 and 3 that made you able to claim a vaginal birth?

In a word, empowerment. I finally took ownership of my births. In my first pregnancy, I had been told that I had a breech baby, and that I wouldn't find an obstetrician on the East Coast who would deliver a breech baby vaginally. Even though intuitively I didn't understand the need for a sweeping recommendation for a cesarean, I accepted this as truth. I was not at all internet savvy at the time, and when I inquired about a support group for cesareans, I was practically laughed at. For my 2nd pregnancy, I put all of my focus into finding VBAC supportive providers and *avoiding* a breech baby, as I had been told that my unique uterus (septate) likely did not cause my son to be breech.

About a year after my daughter's birth, I stumbled upon ICAN (the International Cesarean Awareness Network). Finally, I was surrounded by women who understood my grief over how my children were born. Moreover, those same women were willing to ask the hard questions about modern obstetrical practices. No longer could I dismiss home birth as a reckless choice, and furthermore, I finally had an avenue to explore the safety of vaginal breech birth.

While you were researching your options during your pregnancies, what resources helped you the most in deciding to have your breech baby vaginally?

Without a doubt, the most influential source was Henci Goer's "Thinking Woman's Guide to a Better Birth". I read the chapters on out of hospital birth, VBAC and breech over and over. I also scoured the internet, including pubmed, for research on breech birth, and came to believe that with a competent and experienced provider, a breech birth was a reasonably safe option.

You mention you had home birth midwives. Were they CPM, LM/DEM or CNM? Why did you choose them?

... The most senior midwife was a [DEM], preparing to sit for the licensure exam to become a [CNM] (she is now licensed). I called every home birth midwife I could find and asked questions about their comfort with VBAC after multiple cesareans and breech birth. Only my midwife had enough experience with breech. She was also incredibly supportive and conveyed a belief in my ability to birth my baby.

Why did you choose a home birth rather than a hospital birth?

Over time, I came to have serious concerns about hospital protocols. I believe that many of them have more to do with provider convenience than about mother/baby safety. Additionally, the hospital practice I found that would attend a VBAC after 2 cesareans would only do so if the baby was vertex.

What, in YOUR estimation, is the predominant reason why women across the US have cesareans for breech presentation instead of vaginal births?

Lack of requisite skills for breech birth on the part of maternity care providers.

If you had the chance to do it all over again, would you do anything different with any of your children's births?

I regret not taking the lead in doing the research myself regarding the safety of breech birth. I particularly regret that my daughter was born surgically, as she was in nearly the exact position as her younger brother. During that pregnancy, I can claim ignorance about neither the possibility of a cesarean, nor its physical and emotional impacts. I have *no* regrets about my youngest son's birth. It was an incredible experience.

Any closing thoughts?

I believe that in order for the culture of breech birth to change, women must start demanding that their care providers are skilled in breech. If women make it clear that this is expected, more practitioners will seek training in this important skill set.

For more information / support for breech births:

• Ronnie Falcao's Midwifery Archives
• Heads Up - breech information

Thanks, Christie, for your continued passion and pursuit to educate the public.