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A Whole Different Side to Birth

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It is time for another installment of the Birth Philosophy Young Voices guest blog post series. In this piece, we hear how a global perspective can help to mold, shape and even change our impressions of birth. This account is written by Kristen Green, a Yale School of Nursing student.

As a future midwife, it embarrasses me to say that I can remember a time not too long ago when my friends and I bemoaned how we never, ever wanted to have babies. We decided that labor was simply too long, would hurt too much, and we also agreed that a human coming out from down there was just, well, scary. Granted, just about the only visual frame of reference we had for all this was some inadequate high school sex education and the episode of Friends where Rachel gives birth to Emma. As an only child, this fear was reinforced with stories my mom told me about how excruciating and awful labor was (i.e., two episiotomies, an ineffective epidural, and a male OB yelling at her that the pain couldn’t be that bad) – as she often put it, that’s why she just had me.

Despite my fear of birth, I was also secretly fascinated. I wondered how so many women go through labor – let alone women who don’t have access to hospitals, pain meds, or personal support systems. I simply couldn’t wrap my head around it.

In the fall of my junior year of college, I studied abroad in Ghana, and it was there that my ideas of pregnancy and birth were completely changed. I was able to intern at an HIV clinic and on my very first day, an expectant mother came in. She sat in the waiting area for hours, not knowing that the entire clinic staff was in a meeting across the street. When a nurse finally came back and noticed her, the woman explained that she was in labor, but, unfortunately, the clinic wasn’t equipped to deliver babies. The mom-to-be, already significantly dilated, merely laughed at her mistake, remained calm, and was prepared to take a tro-tro to the nearest hospital, which was a considerable distance away. This situation was nothing close to what I pictured real, live active labor to be like. I was absolutely floored by the woman’s composure and strength. I imagined that if I were in her place, I would probably have run (or quickly waddled) out the door in panic. However, the clinic doctor paid for her to take a taxi to the hospital and thankfully mom and baby ended up just fine.

Throughout my time in West Africa, I began to notice that most women treated their births as normal – even exciting – life events, and, from what I could tell, had far fewer thoughts of birth anxiety despite the fact that Ghana has a higher fetal and maternal mortality rate than the U.S. (not that our numbers are anything to be proud of either). It made me see how important it is for expectant moms to do their own research, if they can, and to have meaningful conversations with their care providers (and other women!) so that they can take charge and make informed choices.

Since returning from Ghana, I’ve seen several births and have done a fair amount of reading and internet searching, trying to find out all that I could on topics from morning sickness to epidurals to home birth to VBACs. I learned about the wonders of midwives and doulas, professions I never even knew existed. It was the culmination of my experiences – seeing the strength of so many women throughout such a physically and emotionally demanding time – that made me appreciate how natural, normal, and amazing birth actually is. It also, despite how cliché this may sound, made me realize just how much energy and power we all have inside of us – that our bodies can mold and hold another being for nine months and can create and endure the forces of contractions. It’s truly incredible.

I began to see that there is a whole different side to birth – a side that I feel is still largely hidden from so many women in the U.S. or maybe just more often dismissed as unorthodox, even unsafe, despite evidence to the contrary. Right now we live in a society that largely treats birth as a means to an end – something you have to endure in order to have your baby. We talk about the “ring of fire” as the baby crowns, the sleepless nights, and the emergency C-sections. But pregnancy and birth are more complicated and layered than that. The beauty of it is that it truly is different for every mom with every baby, and that’s why it’s so important for people to know what the possibilities are. It’s incredulous to me that what we discuss about birth is still largely veiled in fear, but I fully believe that the more we talk about the nuances of birth and the options that are available (the earlier, the better!), the less frightening and more empowering it will be.

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Kristen Green graduated in 2012 from New York University with a degree in Social and Cultural Analysis as well as Public Health and Policy. She is currently in her GEPN year at Yale School of Nursing and is 6 semesters away from becoming a Certified Nurse Midwife and Women’s Health Nurse Practitioner. She is incredibly excited to be joining a profession that helps women and their families through some of the most challenging and joyous times in their lives.

Birth is not a niche interest; it is everyone’s first story

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Birth Out Loud

A Young Voices guest post by Hannah Cressy

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I was the “birth girl” in college– which actually, at Wesleyan, wasn’t so strange.  Most college students don’t have their birth plans at the ready or procrastinate by researching rebozos and lactation classes, but I’ve been amazed at how interested my peers often become when I discuss birth.  Birth is one topic for which everyone has a story; we all come into this world in different circumstances, some fast and some slow, some alone and some with many siblings.  I was recently cooking dinner with five male friends, and we began talking about a birth that I recently attended as a doula.  Two hours later, these college guys were still asking me questions, telling their own birth stories or those of their siblings, and joining me in lamenting the injustices of America’s health care system.  Birth is not a niche interest; it is everyone’s first story.

I am drawn to birth because of its universality, its emotional weight, and its capacity to reveal women’s own power to themselves and to their families. I knew from age seven that I would somehow be involved with what I perceived as the magical and secretive process of pregnancy; I stayed with a neighbor after school every day who, during the stretch of time I was regularly present in their home, had several babies.  I watched her grow and change, practice babywearing, attend birth classes–but I wasn’t allowed to know the whole story of pregnancy, which of course, starts and ends with a naked woman.  I suppose I initially wanted to know everything about birth because birth was hidden from me.  So, from then on, I secretly learned as much as I could about birth, and told my parents when I was eleven years old that I would be a pediatrician.

I finally decided, at age 18, that I would be a midwife, and have since spent four years at Wesleyan preparing for this dream.  I became a birth doula and volunteered at San Francisco General Hospital for a summer, where I attended my first twelve births.  Finally working in the “birth world”, particularly with the midwives of that hospital, felt like home.  I needed to share this feeling with my peers at Wesleyan, but wondered if anyone was interested.  Along with some classmates, I helped organize a lecture and discussion facilitated by Maureen Whitman of Birth Philosophy and Maire MacLean of New Family Nurture, regarding birth and breastfeeding in the context of the current culture, media and medical models. The event was well attended, attracting a group of over 40 students.

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Realizing that the students at Wesleyan would be interested in a more in-depth exploration of these topics, I then applied to teach a credited Wesleyan class on the politics of birth and reproductive justice in America. I had to turn down dozens of people trying to join the seminar!  This is something that so many young people care about, once we’re exposed to the debates surrounding birth in America.  Just as I’d felt in second grade, I realized that this topic can sometimes remain silenced in the college atmosphere, assumed as something that we’re “too young to worry about”.  Yet, I do worry about birth because it will affect most of my friends, and affects the majority of women and families.  The seminar went amazingly well, and another student is hoping to teach it again in the coming school year.  This past year, I became an abortion doula as well as a postpartum doula and am currently starting my own postpartum doula business practice in Burlington, Vermont (see doulahannah.com).  I will soon be applying to graduate school to become a Certified Nurse Midwife (CNM).  I hope to continue to find ways to help women realize their own power by being in control of their reproductive decisions, and ways to make birth a conversation topic for everyone!

Hannah is a recent graduate of Wesleyan University, where she mixed Feminist/Gender/Sexuality studies, biology, and anthropology to learn about social justice and healing through many lenses.  She currently works as a postpartum doula and counselor in Burlington, Vermont, and plans to become a Certified Nurse Midwife.  

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Birth…it’s not just for pregnant people anymore!

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Here at Birth Philosophy, we feel that it is really important to not only invite, but highlight the voices of young students and professionals in our conversations about childbirth. As educators and advocates who support positive birth experiences and evidence based care we have to start including younger voices. These are the people who are emerging into places and positions where they can bring about change and influence their peers and communities. In her own words, Eliza Duggan explains why birth is not just for pregnant people anymore!

“Interesting! … What’s that?” This is a typical response that I received when I told people, especially my peers, that I was writing my senior thesis on midwifery. I became accustomed to saying, “I’m writing on midwifery – midwives,” since most people have at the very least heard the term “midwife.” The initial lack of knowledge was slightly discouraging, though unsurprising; however, the best parts of my project were the conversations that followed the introduction to midwifery. The more that I researched and wrote on midwifery, the more that it became clear to me that not only could young people be interested in birth and midwifery, this knowledge could be vital to our futures.

I have always been familiar with home birth since I grew up in a small town in Maine, a place where midwives are well known and well respected in the community. However, I did not really think about the political complexity of midwifery, nor the unique position that midwifery holds in relatively rural areas like mid-coast Maine, until I moved away. I went to Boston for college, and during the summer of 2011 took an internship with the women’s advocacy organization Our Bodies Ourselves. One of the projects on which I worked was promoting some midwifery legislation at the Massachusetts State House, work that I was proud to engage in. The more I dove into the issue, however, the more I became surprised at the ambivalent and sometimes even hostile reception I was getting to the very idea of midwifery. I was intrigued by this, since I had assumed that the famously liberal citizens of Massachusetts would generally have the same attitude towards midwives and home birth that I had. When beginning to brainstorm ideas for my senior honors thesis at Boston College, I felt compelled to investigate this issue further.

Thus, I began in the fall of 2012 by doing extensive research on the history of midwifery and how it had become so marginalized in Massachusetts. I then interviewed countless home birth midwives, nurse-midwives, childbirth educators, public health experts, and consumers in order to gauge the current state of maternity care in the state. One of the most troubling things that I found was that not only were few people (relative to the entire population) interested in this issue, the vast majority of the people who were involved had already had children. Not only were most people my age unfamiliar with midwives, they were generally unfamiliar with the topic of childbirth as a whole.

After any initial discomfort or confusion that my friends and classmates had, it was apparent young people are intensely curious about childbirth, and most people I talked with had a lot of questions. People are not invited to think about how they feel about childbirth before getting pregnant, so most young people do not have a sense of their options or a working knowledge of the process before the months they have to prepare. When talking with my friends and classmates about my research, I realized that there is need for more discussion about childbirth before getting pregnant, so that not only do we know our options, we can make informed decisions about how we want our children to be brought into the world. This, I believe, should be an easy fix, because young people are not averse to learning about these things. On the contrary, countless conversations I have had with my peers have demonstrated that pregnancy and birth are not only interesting to pregnant women; young men and women are eager for information.

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Eliza Duggan is a 2013 graduate of Boston College, where she majored in English and women’s studies. Her interest in feminism and home birth stems from her roots in Belfast, Maine, where she grew up. In college, she engaged with the Women’s Resource Center to help efforts like the Take Back the Night campaign against sexual violence on campus, and was a Teaching Assistant for the Introduction to Feminisms course. She also worked with Our Bodies Ourselves (The Boston Women’s Health Book Collective) on various projects, including advocating for midwifery legislation at the Massachusetts State House, promoting the Infertility Family Research Registry based in Dartmouth, and writing occasional guest posts for Our Bodies Our Blog. Her time at OBOS and her thesis work have inspired her to pursue women’s advocacy, which is why she will be a first year law student at the University of California at Berkeley Law School in the fall.  

Taking Responsibility~guest post from Wisdom and Birth

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One of the goals of Birth Philosophy is to seek out and highlight young voices who are taking the initiative to learn and share about birth related issues.  Many have always been interested or fascinated by birth. Others are questioning some of our systems and cultural beliefs and hope to be social change agents. Not surprisingly, some end up planning careers that will allow them to continue this work into the future. Today I would like to introduce you to one of those people.  Enjoy the following guest post from Randi McCallian (and read her bio at the end of the post).

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I will have my babies at home. I have known this for many years. I have had ample time, experience, and education to know what my birth choices are – and where and with whom I feel the most comfortable giving birth. I learned about birth far in advance of embarking on such a monumental journey… giving birth and becoming a mother. I believe every woman needs to know more about birth BEFORE she becomes pregnant!

I first began researching my birth options when I overheard a close relative discussing her elective cesarean delivery. In her first pregnancy her doctor had determined that her pelvis was too small to deliver vaginally…then he said, ‘once a cesarean, always a cesarean’; and she eventually had 3 scheduled cesareans. Being a petite woman myself, and knowing very strongly that I wanted to be a mother one day, I was terrified about having to deliver my babies surgically. I was determined to understand the physiology of birth and how to have my future babies vaginally.

We all need to take responsibility for our reproductive health and our reproductive rights, and the perfect time to begin is a lot earlier than most might think. We need to support young women and men learning about their body, hormones, desires, pleasures, sexual organs, and the process of reproduction. We need to have access to family planning methods and the knowledge of how to use them. It is unrealistic to expect a girl to become a woman if she is not given the capability to make decisions about her reproductive health, and for that woman to become a responsible mother if she is not trusted with the ability to make informed decisions about her body, baby, and delivery.

Culturally, our current expectation of women is that they learn about pregnancy, birth, breastfeeding, and infant care in the few short months between discovering the pregnancy and delivering the baby. This is unrealistic and it has led to a great majority of women (and men!) who don’t know what to expect from birth and new motherhood and then they are completely lost and disappointed by their birth and postpartum experience. This puts mothers and babies at a disadvantage. We can change this.

We should encourage women to become familiar with pregnancy and birth physiology; the various choices in childbirth location, provider, and labor management techniques; hospital and provider practices in their area and how to advocate for their best birth… and much of this can and should be considered well BEFORE a woman is pregnant. If a woman enters pregnancy and new motherhood with ample information and knowledge in her ‘toolbox’, then she enters this new journey with the confidence to make decisions for herself and her new family. She becomes an empowered mother.

As a sister, daughter, friend, peer, community member, and MCH professional, I strive to inform those around me about the current state of the maternity care system and what this may mean for their birth, or chosen birth environment. I encourage everyone to research and ask questions about the practices that interest them the most and to follow their gut when something doesn’t feel right, even if it means changing providers! I encourage all women to understand the common delivery practices of their hospital and provider; and I always recommend a doula.

We need to support the process of women becoming mothers, and long before they are pregnant. We can do this by fostering a culture of open-communication and shared ideas around motherhood and birth. Ideally a young woman will take responsibility for her family, long before she intends to have one; a young woman who is educated about her body, family planning, and the resources that are available in order to make the best choices for her situation.

As an emerging public health professional I have been charged with the mission to prevent. Whatever the circumstance, when it comes to health, prevention is key to a healthier and happier society. Right now there are large numbers of uninformed women who are unjustly more vulnerable to a disempowering birth and postpartum experience. I would like to prevent that.  All women deserve the knowledge, opportunities, and resources necessary to make empowered decisions and to advocate for herself and her family. Young women who are supported and empowered very early on to be responsible for their reproductive health will become responsible mothers who own their body, their birth, and their family!

guestblogger300x300duoRandi McCallian has been an advocate for mothers, babies, and families for almost 10 years and is completing her Master’s degree in public health, with a concentration in maternal and child health at the University of South Florida. Her background includes in-home therapy with children on the Autism Spectrum, in-home parent education for low-income families, certification as a labor doula and lactation counselor, and a bachelor’s degree in Psychology, with a minor in Biology, from Drake University. Randi currently works for the Florida Perinatal Quality Collaborative as a research assistant on a project to eliminate non-medically indicated deliveries before 39 weeks of gestation in the State of Florida, as well as being an intern with the Hillsborough County REACHUP where she leads community support groups and improves maternal and infant health in her community through action and advocacy. She has been awarded the Maternal and Child Health Leadership Trainee Scholarship at USF and is a former President elect of the Maternal and Child Health Student Organization.   Check out Randi’s blog at Wisdom and Birth.