Organically Inclined » pregnancy

Congratulations to Katie Allison Granju!

Mish — Mon, 28 Jun 2010 13:03:50 +0000

Katie Allison Granju, author of Mamapundit.com has had her baby girl – a tad early. It appears, according to this post by her, though, that all is well with mother and daughter.

After the tragic death of her oldest son Henry, it is so nice to see this family get a blessing or two! Please send them your good wishes and visit her blog.

-Mish

Technorati Tags: henry granju, katie allison granju, mamapundit

A Birth Anthropologist…Baby #1.

Mish — Wed, 10 Feb 2010 14:57:45 +0000

Perhaps. Perhaps I am a birth anthropologist. At least, that’s what the doctor who delivered my 7th baby called me. Why? Because each of my births has been unique…not all of them were fabulous, but they were all unique. Today, I’m writing about my first birthing experience – the one that sent me searching to find out what a midwife was and whether or not it was legal to use one!

My first birth was pretty normal by today’s “hideous hospital birth” standards. I was 19. I was married and eagerly looking forward to becoming a mother for the first time. My “care” providers were a group of 9 OB/GYNs who I rotated through for each appointment – rarely seeing each one more than once or twice. I had all of the tests and was very healthy and normal – easy when your 19. Of course, the day I went into labor, the one physician I really didn’t like was the one I got. Even though I had attended childbirth classes and had gotten a tour of the new-fangled birthing facilities at the hospital (where they were supposedly so into natural childbirth), I had no idea what to expect. After walking around for a few hours, I was told to lay down and be put on a monitor. I graciously complied. I was flat on my back and starting to get really uncomfortable. I had been pretty committed to a natural birth until this point, but pretty much thought that if it was going to get worse than I was feeling right now (I was starting to writhe around and whine quite a bit) then I would, quite simply, die.

I asked for the drugs. Oops! Too late – I was 10 cm. My writhing around was transition, but no one told me that of course, they were all too busy rushing in and out of the room.

I begged the nurses to let me sit up – my back was in excruciating pain. No, better to lay down they said. No, I’m pretty sure, I said, that I would feel better if I was sitting up. Nope. Lay down. Wanting to be the perfect patient – I complacently agreed, writhed around some more, and then learned how to push an 8lb. baby out complete with awful episiotomy and the woman doctor from hell poking her finger – well places I’d really rather not have people poke their finger.

After his birth I was left in the stirrups – no blanket, no nothing…bleeding and gross – joyous about my screaming baby and shaking and shivering uncontrollably. Not that anyone cared. They couldn’t find the right needle to sew me up. So after not warning me about the whole pushing me in the belly thing. Ick!

Fortunately, I was so in love with my new baby boy (Matthew) that I was able to endure the next two weeks of excruciating pain – having to sit on pillows, hardly able to walk and trying to figure out breastfeeding on my own…because the lactation consultant charged $70 an hour!

Not the best experience…but I knew better now and the birth of #2 was so different that I almost cried from the peacefulness of it all.

Technorati Tags: birth story

10 Commandments of a Good Birth

Mish — Tue, 23 Jun 2009 13:10:01 +0000

From Jan Tritten – At Midwifery Today…

A good midwife is worth her weight in gold if you want a good birth experience. Shop carefully and pay her well.
Thou shalt eat a healthy diet: 80-100 grams of protein, salt food to taste and lots of fruits and veggies and eat seafood; and be happy.
Trust Birth, trust yourself. You can do it.
Prenatal care is what you do between your visits to your care provider. Eat well. Love lots. Reduce stress. Your baby will appreciate it!
Homebirth: the gold standard. If possible, stay home for your birth. Birth centers are a good option, too. When necessary, hospitals save lives.
Avoid unnecessary technology like the plague. It may be the plague – including ultrasound (Dopplers and scans) during pregnancy!
Just say no to drugs and intervention.
Your body is perfectly designed to carry, grow and birth your baby. If that isnâ€™t enough, your body can feed your baby too!!
Birth Works; let it. Know that you can do it. It is an awesome and important step to motherhood – Â a miracle you can achieve.
Thou shalt breastfeed your baby for as long as possible. The health benefit for motherbaby is unsurpassed by any other act. Breast is best.

Jan Tritten

Midwifery Today

Technorati Tags: birth, pregnancy

Why I Choose Natural Childbirth

Mish — Wed, 20 May 2009 14:00:36 +0000

Because I have given birth so often and am getting ready to do it again, I am often asked about my birth “stories.” It surprises me that I haven’t written about them, but truthfully, my births have been fairly unremarkable. Of course, being pregnant with my seventh, I don’t want to jinx it, but I have only had one birth that was traumatic in any way.

And yes, I have given birth to all six of my children naturally – without any intervention of any kind. Was it painful? Oh my yes! I’ve read about women who have “orgasmic” childbirths…I am definitely not one of those women.

Further, I believe that it is possible in almost every situation to have a natural childbirth. Now, I know it’s controversial for me to say this – and I know that everyone has a story. Most people will say, “I wanted to have a natural childbirth, but I was different because…” And that’s fine. I’m not writing to this judge, just to give a perspective and a few resources.

Let me put it this way, I have heard the stories of women who have had epidurals and c-sections. I have heard about their lengthy recoveries and other issues. Do I enjoy the pain of labor – of course not! But let me say this, after going through labor and then finally having the baby, I feel better immediately. Right after the birth, while I’m still getting “cleaned up,” I feel 100 percent better. No more back pain. No more labor pain. No more nothing except a beautiful sweet baby. The endorphins kick in and I’m as happy as a clam…ready to take on the world, well, mostly.

While I appreciate the desire for pain relief, going down that road rarely leads to anything but more interventions. Women who have epidurals have longer pushing stages – which endangers the baby and gives the mother a higher risk of c-section or forcep or vacuum extracted birth.

It just seems like a lot to risk, just to save the pain. Now, I know, I’ll hear from many who will say, “yes, but you weren’t in labor as long as I was…” and that’s valid. But remember, this post is in response to those who ask how I could give birth without drugs six times. That’s how – and why. I simply think it’s odd that some women would choose a c-section, or choose an epidural, before even giving labor a try. I hate to see women set themselves up to “fail” – and that’s how a lot of women describe it to me – before giving themselves a chance.

Further, it surprises me that the same women who say they would throw themselves under a train for their child, will not endure pain to bring them into the world – risking both their own lives and their baby’s. I also find it odd that we, as mothers, will scold any woman who even looks at a glass of wine during her pregnancy, but will totally understand someone willing to put drugs in her (and her child’s) body just because she’s in labor.

Here are a number of the side effects of epidurals, listed at Childbirth.org

I have had a home birth – and a water birth – five pretty standard hospital births – and have been grateful for the assistance of wonderful nurses and midwives each time (except the first time). I am also not knocking doctors. I am glad they are around and willing to help out in a pinch! I am glad for medicines and oxygen masks and all the other accoutrements available to save mine and my baby’s life should need be (especially since I’m pregnant again and I don’t want to jinx anything!). I know that things can go wrong – and I am glad for knowledgeable midwives and doctors when they do. However, I also believe childbirth is a natural process – not a medical one most of the time – and I think natural birth is safe with proper preparation and education.

Trusting in our bodies is difficult, especially, when we, as a society, are taught that so much is wrong with them! But give your body a chance to work, it might surprise you.

Technorati Tags: birth, childbirth, epidurals, labor, natural childbirth, pregnancy

Elective C-Section – Would you do it?

Mish — Tue, 03 Mar 2009 16:01:59 +0000

It’s the latest thing. As fashionable as Kabbalah, without all the studying. Madonna did it. So did Elizabeth Hurley. Cesarean section by choice has become almost a fad of sorts. Do Yoga at 8 a.m. Have your baby at 10 a.m. It not only fits your schedule, but your doctor’s and you get the added benefit of avoiding anything remotely like a labor pain.

Sandy, 34, had an elective Cesarean section and frequently encourages other women to do the same.

“It is so exciting to finally hear other women and members of the obstetric community saying what I have said for the last six years,” she said. “I had an elective Cesarean section with my first pregnancy because I had a wonderful female OB who respected my desire to avoid vaginal and pelvic floor trauma. My section was awesome – wide awake and no pain, I was up walking in less than 8 hours.”

Diverse attitudes between doctors and mothers about the “right” way to deliver a baby are not only causing confusion for new mothers who are frightened about their first labor and delivery experience, but divisiveness among feminists. For many years feminists fought for the right to take control of their bodies once again and deliver babies naturally without the unnecessary medical intervention that women throughout much of the twentieth century were subjected to. Now, a new generation of feminists assert that it is also their right to choose to deliver their baby without pain. But how safe is an elective Cesarean section?

Some studies and doctors claim that elective Cesarean is just as safe if not more so than a vaginal delivery and that the possible side effects of a vaginal delivery make c-section even more attractive.

Dr. Jennifer Berman, a urologist, author and television personality, said that she elected to have a Cesarean section with her second child and wished she had done so with her first.

“I had a very difficult time with the delivery of my son, Max in December, 1999. I was in labor for 18 hours, which was made more difficult by the fact that I had an epidural too early, which in turn caused the birth process to slow down.

“Max was supposed to have been a seven-pound baby, but was actually nine pounds, eight ounces. His head and shoulders got stuck in the birth canal and he suffered fetal distress. Given my body habitus, he should have been delivered c-section, but I persevered and delivered vaginally.

“My second reason for choosing c-section stems from the work I’ve done as a urologist. During a reconstructive surgery fellowship last year, I saw women who suffered the effects of incontinence and prolapse. These effects are directly related to vaginal delivery.

“In cases where women are predisposed to incontinence and prolapse, doctors are willing to perform c-section. I experienced incontinence for seven months after Max’s birth and it began to recur during this pregnancy.

“Had I seen patients with such problems before Max was born, I would have elected to have a c-section with him, too. I decided that I didn’t want to risk more incontinence or prolapse in the future.”

A study performed by H. P. Dietz, MD (Heidelberg) and M. J. Bennett, MD (UCT) and published in the August 2003 issue of Obstetrics and Gynecology, the journal of the American College of Obstetricians and Gynecologists, concluded that: Vaginal birth, in particular operative delivery, negatively affects pelvic organ support. This appears to be true for all three vaginal compartments. All forms of cesarean delivery were associated with relatively less pelvic organ descent. These findings may partly explain the protective effect of elective cesarean delivery for future symptoms of pelvic floor disorders.”

Dietz and Bennett studied a total of 200 women, recruited early in their first pregnancy, and examined them during the first and early second trimester, the late third trimester and between two and five months postpartum. A total of 169 women or 84.5 percent showed highly significant increases in organ mobility. In addition, the length of the second stage of labor correlated with an increase in pelvic organ descent, suggesting that vaginal delivery is a major contributor to pelvic organ prolapse.

However, what many advocates of elective Cesarean section do not mention is the fact that the same study also states that the most significant pelvic floor damage occurred in women who experienced an operative vaginal delivery.In particular, women whose babies were delivered with the help of forceps or vacuum extraction experienced the highest degree of damage. In addition, Dr. W. Benson Harer, Jr., president of the American College of Obstetricians and Gynecologists, while maintaining that every woman should have the right to choose between a Cesarean section and a vaginal delivery, also concedes that many pelvic floor issues (urinary incontinence, uterine and bladder prolapse) can be prevented by improved labor and birth techniques.

Episiotomies are also associated with pelvic floor damage and long-term complications. They have been proven to be unnecessary and harmful in most births, yet the majority of American women are still subjected to this surgical procedure during a vaginal birth.

The belief that Cesarean section is much safer for the baby is also contentious. In fact, the risks to the baby can be substantial. Cesarean section is major surgery and brings with it many risks to both mother and child. Babies born by Cesarean section do not receive the natural stimulation that comes from moving down the birth canal, and therefore must often be given oxygen or a rub down to help them breathe. They also miss out on the natural hormones that are released during vaginal birth to help the baby during his first moments of life.

According to the Mayo Clinic’s Complete Book of Pregnancy & Baby’s First Year the risks of Cesarean section are substantial for mother and child:

1. Premature birth. If the due date was not accurately calculated, the baby could be delivered too early.

2. Breathing problems. Babies born by Cesarean are more likely to develop breathing problems such as transient tachypnea [abnormally fast breathing during the first few days after birth].

3. Low Apgar scores. Babies born by Cesarean sometimes have low Apgar scores. The low score can be an effect of the anesthesia and Cesarean birth, or the baby may have been in distress to begin with. Or perhaps the baby was not stimulated as he or she would have been by vaginal birth.

4. Fetal injury. Although rare, the surgeon can accidentally nick the baby while making the uterine incision.

Risks to the mother are more common and include:

1. Infection. The uterus or nearby pelvic organs such as the bladder or kidneys can become infected.
2. Increased blood loss. Blood loss on the average is about twice as much with Cesarean birth as with vaginal birth. However, blood transfusions are rarely needed during a Cesarean.
3. Decreased bowel function. The bowel sometimes slows down for several days after surgery, resulting in distention, bloating and discomfort.
4.Respiratory complications. General anesthesia can sometimes lead to pneumonia.
5. Longer hospital stay and recovery time. Three to five days in the hospital is the common length of stay, whereas it is less than one to three days for a vaginal birth.
6. Reactions to anesthesia. The mother’s health could be endangered by unexpected responses (such as blood pressure that drops quickly) to anesthesia or other medications during the surgery.
7. Risk of additional surgeries. For example, hysterectomy and bladder repair.Researchers at the Wake Forest University School of Medicine also studied the effects of Cesarean section and the results were alarming. After a seven year, population-based, case-control study in North Carolina, the researchers concluded that Cesarean sections cause two to four times more women to die as a result of childbirth than in vaginal deliveries.The authors looked at many factors: demographics, medical risk factor, pre-term delivery, use of prenatal care and health care services, including mode of delivery, to determine what factors were associated with maternal mortality. Style of birth (Cesarean or vaginal) was the most significant factor related to maternal mortality, although whether or not the mother sought prenatal care also had an effect. The study found that the pregnancy-related mortality rate among women with Cesarean deliveries was 35.9 deaths per 100,000 Cesarean deliveries with a live-birth outcome compared to 9.8 deaths per 100,000 vaginal deliveries without complications. The mortality rate for the population presumed to have had elective Cesareans was 18.4 per 100,000 Cesarean deliveries.They concluded, “Removing barriers to and actively promoting use of prenatal care services and decreasing the rate of Cesarean deliveries could decrease the number of pregnancy-related deaths.”
The increase in Cesarean section births, whether electively or by doctor’s order, in the United States is staggering. The World Health Organization (WHO) states, No region in the world is justified in having a Cesarean rate greater than 10 to 15 percent.Â However, more than one fourth of all children born in the United States in 2002 were delivered by Cesarean; the total Cesarean delivery rate of 26.1 percent was the highest level ever reported in the United States. While the Cesarean delivery rate declined during the late 1980s through the mid-1990s, it has been on the rise since 1996. In addition, the number of Cesarean births to women with no previous Cesarean birth jumped 7 percent and the rate of vaginal births after previous Cesarean delivery (VBACs) dropped 23 percent.

Despite all of the efforts to convince mothers that Cesarean section is just as safeÂ if not more safeÂ for mother and child than vaginal delivery, the United States still ranks 8 in infant mortality among industrialized nations (behind the Czech Republic and Cuba) as of 1998.in the world for maternal death. However the Centers for Disease Control (CDC) estimates that maternal deaths are underreported by one half to two thirds, and that half of US maternal deaths are preventable. The rate of death due to childbirth has not decreased since 1982, and increased in 1999.

In an editorial for Obstetrics and Gynecology, Dr. Ingrid Nygaard and Dr. Dwight Cruickshank argue that while they believe offering healthy women who plan small families an elective Cesarean section is justifiable, they do not condone such a recommendation on a routine basis.

“There are many unanswered questions regarding elective Cesarean delivery at term, and it is important that we try to answer them before making this part of the informed consent process. How should we manage the woman who goes into labor before 39 weeks? Is there a point in labor (dilatation and descent) at which time it is too late for Cesarean delivery to benefit the pelvic floor? At least in terms of anorectal physiology, the protective effect of Cesarean delivery is pronounced only if delivery is affected before a cervical dilatation of 8 cm. Is there a fetal size or gestational age below which vaginal delivery is not deleterious to the pelvic floor? As more US women become obese, will the risks of elective Cesarean delivery be greater than anticipated? Obesity itself is a risk factor for urinary incontinence, which may further decrease the value of preventive Cesarean delivery in this population. Given that some racial and ethnic groups are more predisposed to prolapse and incontinence than others, do we manage all patients similarly, or do we take such considerations into account? How should we analyze the economics of Cesarean delivery on demand? Projecting future cost should not rely on the arbitrary charge structure in place today. How do we balance the cost of elective Cesarean delivery with that of treatments for pelvic floor disorders?

“Given the absence of rigorous scientific evidence, we believe that it is currently ill advised to routinely give all prenatal patients the choice of their desired mode of delivery. What appears to be a fairly low-risk proposition in non-obese healthy women having only one or two children is likely not inconsequential in obese women, women with poor nutritional states or medical illnesses, or women who will have several Cesarean deliveries.”

What most obstetricians and midwives do agree on, whether for or against elective Cesarean section, is that mothers need to be informed about all of their options and the benefits and risks of both. Childbirth, even in the 21^st century, is still risky business and having all of the information available is the only way mothers can be certain they are receiving the best care.

Technorati Tags: birth, c-section, childbirth, natural childbirth

Diagnosis: Placenta Previa

Mish — Thu, 22 Jan 2009 15:16:30 +0000

I am currently 16 weeks pregnant with my 7th child – in case you missed that info. I am in a new city (well, I lived here before but that was over 6 years ago) and there is only one certified nurse midwife. Only one! Anyway, going with my new insurance provider network, I selected an OB/GYN firm of three women to have my first appointment here in my new town. So far so good. I really like my new doctor – she is very “midwifey” in spirit – although she did have me do a dating ultrasound right off the bat (but was cool with my refusal of other tests).

During the ultrasound, it was discovered that I have a complete placenta previa as of right now. According to the Mayo Clinic placenta previa is: “Early in pregnancy, the placenta may implant in the lower part of the uterus. As the uterus grows, the placenta usually moves up and away from the opening of the uterus (cervix). If it doesn’t, the cervix may be blocked. This is known as placenta previa.

“If you have placenta previa, the placenta will detach from the lower part of the uterus as the cervix begins to open in preparation for labor. This can cause severe vaginal bleeding. Thankfully, placenta previa is nearly always detected before a woman or her baby is in significant danger.”

I have heard some encouraging words on the Mothering.com Discussion Boards, and there is a possibility that the placenta is centered over my cervix but anterior, so that it’s really not complete – but it doesn’t look that way. A few people said that it may move, but that’s doubtful as well. One very helpful student midwife explained it like this: picture a postage stamp on a deflated balloon. Once the balloon is inflated, the stamp may stretch, but essentially it remains implanted in the same place.

I don’t have to tell you (but I will anyway, as is my nature) that I’m frightened of the idea of a c-section. I have always done everything I can to encourage women to labor and birth naturally. I have always been able to do so myself. The idea of scheduling a surgery is very scary for a person who has never had a surgery of any kind. I, knock wood, have never even broken a bone!

On the other hand – I understand the very real danger of this complication and – just like when Alex, my 12 year old was diagnosed with Type 1 diabetes – have come to appreciate medical doctors much more than I did in the past. I am so grateful that there are ways to deal with such situations – and that I won’t just die of a hemorrage or something trying to birth “through” a previa – like I would have say, 100 years ago.

I must say that I am particularly worried because I tend to have a lot of Braxton-Hicks in my last few months – which it appears can aggravate the condition and cause more bleeding.

The Mayo Clinic also says that: “Placenta previa occurs when the placenta implants in the lower part of the uterus and then grows to cover the cervix. Theories about placenta previa link the condition to:

Scars in the lining of the uterus (endometrium)
A large placenta, such as with a multiple pregnancy
An abnormally shaped uterus

Placenta previa is more common among women who:

Have already delivered at least one baby
Had a previous C-section
Had placenta previa with a previous pregnancy
Are age 35 or older
Smoke
Are carrying twins, triplets or other multiples
Have had a previous uterine surgery, such as myomectomy to remove uterine fibroids or dilation and curettage (D and C) to scrape the uterine lining”

Obviously, I have a few of the risk factors – I’m 36, have delivered more than one baby and had a D & C after my miscarriage in ‘06 (between Jack and Kiara). So, it’s not like it’s unheard of – and I suppose when you get pregnant 7 (actually 8 times) there are bound to be complications with one of them. I must say, too, that even more than a c-section, I am really scared about having a premature baby. Just because I know how hard it is for a premie to survive and all of the struggles they go through.

Anyway – wish me luck and if you have experience with this condition please let me know!

Technorati Tags: birth, c-section, natural childbirth

A First Trimester Rant…

Mish — Mon, 24 Nov 2008 14:37:34 +0000

One would really think that I would be used to the symptoms of pregnancy by now. Really – I mean this is my 8th pregnancy (one ended in miscarriage). You’d think after being pregnant this many times, I would have strategies for coping with morning sickness – which I get all day and very severely – and being exhausted. So far, all I’ve come up with is sitting on the couch with my laptop. Sometimes I lay down and moan.

I do get up to pee a lot – so that forces me to walk past loads of laundry that need to be folded. Sometimes I fold them. Most times I go, “Ugh…later.”

I have tried everything to quell my queasiness – sea bands, ginger root, ginger ale, saltines, dry toast, eating before I get up in the morning, eating protein, you name it.

The only thing that seems to work is sleeping through it – which is not really a possibility with three homeschoolers, expecting me to teach them something and a toddler! Fortunately, my teenage daughter doesn’t require much assistance – except that I’ve agreed to coach her basketball team. I’m hoping it gives me something else to focus on besides how cruddy I feel!

So, let’s see, I’ve been pregnant about 8 weeks now and already I can’t fit into any of the pants I just got back into after having Kiara, I’m exhausted and nodding off at the drop of a hat, the only food that turns me on right now are Rolos, I cry for no reason at all (OK, well, my husband kissing me on the cheek instead of the lips seemed like a perfectly good reason to cry at the time…) and Kiara still wants to nurse which is painful and driving me a little crazy!

OK – I’m done now. Did I mention that I’m really happy to be pregnant and can’t wait for the second trimester to begin? Well, if I didn’t – I am, and I can’t!

Technorati Tags: first trimester, morning sickness, pregnancy

Have a Homebirth – 5 Reasons Why

Mish — Thu, 04 Sep 2008 14:24:53 +0000

Is this really a frugal tip? You better believe it.

And I’ll be upfront – I’ve only had one homebirth. Mostly because I have a very nice birthing center close by and I really like it there (after all, I’ve been there often enough).

But I loved my homebirth too – and would certainly do it again. In fact, I would encourage all mothers and mothers to be to look into homebirthing – especially the movie The Business of Being Born.

Here are 5 reasons to consider having a homebirth:

1. It’s cheaper. No, really. An average hospital birth costs between $3,500 and $15,000. An average homebirth? $1,500.

2. You’re in control (well, until the pushing starts). You can control what goes on in your home. No matter what they tell you during the hospital tour, you feel like a guest there – a patient, no less – and if you’re anything like me, you’ll want to be accommodating. I have a natural tendency to be the “good” patient. The one that doesn’t yell, doesn’t demand too much. But this is not to your benefit. Stay home and you’ll feel comfortable enough to demand what you want! And you’ll get it too (sorry partners…)

3. Reduced chance of infection. Because hospitals are known for spreading staph and other infections, you and your baby will be bundled up safely with the germs you already know!

4. You will avoid unnecessary medical interventions. According to Mothering Magazine (a magazine I highly recommend for all moms and dads!): “A carefully conducted study compared the cesarean section rates between patients who used midwifery services for their homebirths from The Farm, a well-respected birth center in Tennessee, to physician-attended hospital births. The hospital c-section rates were 16.46 percent of all the births. The Farm had a c-section rate of only 1.46 percent! Many other studies have confirmed the markedly lower c-section rates in homebirths.”

5. You’ll recover quicker. Because you won’t have had any drugs or other interventions (it took me two weeks to recover from the immediate pain of an episiotomy – and I still haven’t recovered mentally from it – the experience will remain burned in my mind forever), you’ll feel better sooner. In all of my subsequent births (all natural), I always feel energetic and in good spirits after the birth. And I’m usually out of the house and going places within a day or two.

Technorati Tags: birth, childbirth, homebirth, natural childbirth

A Beautiful Birth Story…

mishakennedy — Fri, 23 May 2008 12:22:46 +0000

Mama Nomad has posted the story of the birth of her new little one…

Check it out here.

Technorati Tags: , birth, childbirth, homebirth, natural childbirth

26 Ways to Change Birth Globally

mishakennedy — Mon, 31 Mar 2008 13:45:36 +0000

Sara Wickham wrote this for Midwifery Today and I thought I would share it with you.

“This action list of small things all midwives can do to change societal attitudes toward birth and to promote midwifery and the midwifery model was derived from some research I carried out a few years ago. All the suggestions are either free or very low cost, and none will take too much time or effort. Some things on the list won’t be new ideas to you, but they might act as a gentle reminder that simple, everyday things might have a positive impact on the way our society sees birth and midwifery.

If you are interested in why they work, here is a brief lowdown of some of the main factors involved:

The more people are exposed to hearing about midwifery and gentle birth, the more it will become a norm for them.
Attitudes are formed in childhood; therefore, we need to ensure that children are exposed to these ideas at an early stage.
Experience is an important part in attitude change—if you can encourage people to experience something for themselves, it is much more powerful than telling them about it.
People are more likely to listen to those who appear to understand and sympathise with the other side of the argument. Appearing to be unbiased means you will appear more credible than if you come across as feeling very passionate about your cause (even though the majority of us do feel this way).
Talking to people who support birthing women (partners, grandparents) is just as important as talking to women themselves, because these are the people who influence women’s decisions.
Reflecting on past decisions and their outcomes helps us think more logically about why a situation might have happened and discourages us from making (possibly incorrect) assumptions.

Action List

Get a bumper sticker that supports midwifery and gentle birth.
Wear a T-shirt that does the same!
Talk to everybody you meet about what you do and why you do it.
Be able to cite the evidence for midwifery care, homebirth and so on.
Offer women free/low-cost experiences of midwifery services (free tours, short talks or pregnancy testing). This can enable women to meet midwives for themselves or bring potential clients into a birth center to see what they could be experiencing.
Talk to people in an unbiased way.
Talk to children/school audiences.
Offer workshops/talks to the public.
Breastfeed in public.
Offer to go on local TV/radio.
Write short articles for local newspapers.
Write to TV shows that misrepresent birth.
Create and distribute information leaflets about midwifery/gentle birth.
Target partners and grandparents as well as women themselves.
Arrange to have your births listed in the local papers—offer photos on special occasions (e.g., first baby of the new year).
Enable women to reflect on their experiences.
Encourage others to reflect on their practice.
Encourage people to visit your place of work.
Develop a team of birth change agents in your area, to work together and support each other.
Ensure that women you know understand the enormity of the decisions they need to make.
Seek opportunities to speak to teenage girls.
Be able to lend books/videos.
Know your enemy and practice his argument!
Foster a dialogue with women’s groups.
Ask everybody you midwife to tell a friend about their experience of midwifery and about their birth.
Sponsor a couple of miles of highway—in return for clearing up the rubbish, you can have the name of your practice or group displayed for all to see!

Sara Wickham, MA, BA (Hons), RM, is a direct-entry midwife who has practised in both the United Kingdom and the United States. She is currently a lecturer in midwifery at Anglia Polytechnic University, England, and is the UK country contact and a contributing editor for Midwifery Today. She can be reached at withwomanuk@yahoo.co.uk

Technorati Tags: attachment parenting, birth, childbirth, midwifery, mothering