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In preparation for the birth of our third baby, I have been rereading all of the birth books I found helpful during my first pregnancy, as well as others I didn’t manage to get to at that time. It’s been a few years since I read them, and especially after a difficult labor with my second daughter, I’ve been needing a little reassurance and guidance this time around.

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Since I’ve read several childbirth books in a relatively short period of time, I’d like to give you a little review of what I would consider to be the best natural childbirth book for women who only have time to read one book.

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Although I have discovered invaluable information in each book I’ve read, the winner has to be… drumroll… Ina May’s Guide to Childbirth by Ina May Gaskin.

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Here’s why:

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Most childbirth books tend to focus on one of two things: either the feelings of the birth experience and how to achieve a gentle birth through relaxation, or, instead, on the medical establishment and all of the interventions routinely performed on women. The first approach can leave a woman unprepared and uneducated in the face of a different birth than planned. Especially when complications arise. The second can unnecessarily frighten her and make her completely averse to doctors even in a true life-threatening situation, or it can train her to become an acquiescent patient in a hospital.

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Ina May’s book leans to neither extreme. She addresses both aspects thoroughly.

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Considered the nation’s leading midwife, Ina May Gaskin began her midwifery career in the hippie days, when everyone wanted a homebirth away from the “establishment.” She attended countless births over the years. Her wealth of knowledge and experience is truly incredible, and she has witnessed natural births that most traditionally-trained medical doctors and nurses have never seen or conceived of.

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The first part of the book is birth stories from many mothers who had natural births. This may not seem important, but in our culture of labor as a “medical emergency” and childbirth as “the worst pain you’ve ever experienced,” I think it is so important that pregnant women hear (or read, in this case) accounts of what a normal birth can look like. Each woman’s experience is different, but all of them fly in the face of the horror stories that everyone – from the media to veteran mothers – likes to inflict on a pregnant woman.

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In Part 2, Ms. Gaskin explains some history of birth in the last several thousand years, and how our society ended up with such a skewed perception of what giving birth is all about. She then talks about the process of labor, what’s happening in the body and mind, and even discusses nearly unheard of “orgasmic” or “pain free” birth. (Side note, there are unedited photographs of vaginas and women laboring or giving birth throughout the book, just so you know). Ina May explains how laboring in an unfamiliar place with unfamiliar people can lengthen or completely stop labor, and why an intimate setting with people you trust is the best place to bring new life into the world. She talks about this from both a biological and emotional standpoint. I should note that she discusses birth in both home and hospital settings.

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In the second part Ms. Gaskin also covers a myriad of tests and interventions normally performed or offered during pregnancy or labor, as well as VBAC (vaginal birth after cesarean) and tips for choosing a traditional caregiver, midwife, or doula. She also talks about birthing positions around the world, and has drawings of women in each.

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Throughout the book Ina May remains true to her earthy roots. She writes frankly and insightfully about birth and about the labor process. She is engaging and down-to-earth, and provides an incredible amount of information. This book now holds a permanent place on my shelf.  If I could only give one book about childbirth to any pregnant woman, Ina May’s Guide to Childbirth is the one I would choose.

So, I just looked at the calendar and realized that my third baby is due in roughly three weeks. Also, I realized that I’ve been slacking on my writing and had better get a move on since I’m sure I won’t be doing much in the month following the birth! I shall attempt to line up several posts and set them up to publish one every Tuesday morning. We’ll see how that turns out.

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Today I made one of the staples of my pregnancy diet, so thought I would share the benefits and “how to” with you. The following is technically made as an “infusion,” similar to sun tea, but most people call it Red Raspberry Leaf Tea.

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Benefits of Red Raspberry Leaf

Leaves from the Red Raspberry plant are an incredible source of nutrients during pregnancy and beyond. Chock full of vitamins A, B complex, C, and E, this herb also contains beneficial minerals such as phosphorus, potassium, as well as easily assimilated calcium and iron. If taken during pregnancy, the leaf helps provide relief from morning sickness, nausea, and vomiting, while also preventing miscarriage and easing labor. Taken postpartum, it smoothes out the hormonal mood swings and helps alleviate postpartum depression. In a non-pregnant woman, Red Raspberry also helps reduce menstrual flow. When combined with Red Clover as an infusion, the combination promotes fertility for both men and women. Basically, Red Raspberry is the herb for women’s reproductive health.

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If you buy a pregnancy tea from the store, Red Raspberry Leaf is invariably one of the ingredients. However, it is an expensive way to go, especially if you do drink it nearly every day. It also doesn’t work quite as well as making your own. So, here is the cheapest and simplest way to get some extra pregnancy nutrition.

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How to make Red Raspberry Leaf Tea

(as an infusion)

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What you will need:

Loose red raspberry leaves*

Glass jar with a metal screw-on lid**

Boiling water

Strainer

*Can be purchased in bulk at most health food stores, or online at a store such as Mountain Rose Herbs.

**I use an old applesauce jar. Isn’t it lovely?

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Instructions

Step 1.

Boil water. Place a small handful of leaves in the glass jar.

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Step 2.

Pour boiling water over the tea leaves and immediately screw on the lid. It doesn’t have to be an exact measurement. You will dilute the tea later to suit your taste. I usually fill my applesauce jar about half full of water. Swirl the contents around a bit to wet the leaves. It will look something like this:

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Step 3

Allow your tea to sit at room temperature for a few hours until cooled. It is most beneficial once the leaves have completely infused their nutrients into the water.

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Step 4

Pour your Red Raspberry Tea through the strainer into a glass, then dilute with water to taste. It may take a little trial and error at first to get the right combination of tea and water. Feel free to sweeten with honey, although I personally think it tastes best without anything added. Leave the remaining water and leaves in the jar for the next day’s drink.


Here is my glass of Red Raspberry, diluted how I like it. 

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Drink one glass of tea each day (at the strength you enjoy). If you have trouble with too many contractions as I tend to, drinking an extra glass or two as needed will help reduce them, both with hydration (dehydration causes contractions) and the vitamins, which keep the uterus healthy.

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Red Raspberry Tea will last roughly three days on the counter without going bad, although during the summer it will stay fresh better in the fridge if the room is hot.

Epidurals

One of the most common interventions requested by a laboring woman in the US is an epidural. Many cannot imagine going through labor without receiving one. However, not many women know what it is, why it started as a labor drug, and what the benefits and risks are in using an epidural. So, here we go! Let’s explore this intervention.

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What is an epidural and why is it used?

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The first epidural was administered in 1885, when a doctor in New York injected cocaine into the back of a suffering (not pregnant) patient. Much later, doctors decided to try it on laboring women, and since then the use has skyrocketed.

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The goal of an epidural is to provide pain relief for a laboring mother who feels that she cannot cope with the labor process. It is administered through a spinal block, meaning that the drugs are injected directly into the spinal column instead of orally or through the bloodstream. The woman sits on the bed and a large needle is placed into the small of her back. Some women say they feel pressure when the needle is inserted.

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The drugs in an epidural are local anesthetics, which are most often given in combination with analgesics. The anesthesia numbs the lower body. The analgesia reduces the perception of pain, similar to narcotics. They include drugs such as epinephrine and morphine.

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Does an epidural work?

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Well, it depends on who you ask. About 25% of epidurals are “perfect.” Meaning, they provide pain relief for as long as needed, there was no feeling on both sides of the body, and the needle was placed correctly without accidentally hitting a nerve or causing damage. The other 75% either wear off quickly so that more drugs need to be added, only numb one side of the body, or cause nerve damage.  10% of epidurals don’t work at all. However, so many women are terrified of birth thanks to the media, doctors, and horror stories from other mothers, that we continue to ask for epidurals because we think we cannot handle the excruciating pain we know it will be.

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How does it affect normal labor?

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Many studies have been performed on how an epidural affects normal labor for a healthy woman. One of the first noted is that the use of an epidural prolongs labor. This is most likely due to several factors that work together: a woman is limited in her movement, her uterine muscles are somewhat numbed by the drugs and are unable to contract properly, and the woman cannot feel when her body is ready to push, so has to rely on nurses to tell her when. All of these factors play into the lengthening of labor.

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Epidurals also increase the need for Pitocin to restart labor once it has stalled. Contractions caused by Pitocin are much harder and longer than normal contractions, so this also frequently leads to the need for more drugs via epidural.

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When a woman is in labor, her body releases endorphins that help her to transcend pain. They send her into an altered state that allows her to tune in to her body and her baby. The rest of the world fades away and she is in her own world throughout the labor. It is nature’s pain relief. An epidural reduces the release of these labor hormones and makes women more docile and silent during labor. Sarah J. Buckley, a leading Australian physician, mused that “perhaps the widespread use of epidurals reflects our difficulty with supporting women in this altered state, and our cultural preference for laboring women to be quiet and acquiescent.”

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In addition to these ways in which an epidural affects labor in general, there are several other ways in which epidurals negatively affect both the mother and baby. Now, I do not list these to frighten anyone unnecessarily, but I do believe that it is extremely important to fully know what you’re agreeing to before allowing someone to mess with your body.

Side effects

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Mother:

Close to a quarter of all women who receive an epidural experience complication. And they can be serious. A woman who has had an epidural is three times as likely to die as a woman who did not have one. One in five hundred women will experience short-term paralysis that can last days, and in half a million epidurals, one will be left permanently paralyzed.

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The most common side effect is a drop in blood pressure. Because it is so common, nurses generally administer fluids via IV before placing the epidural, although still roughly half of women experience low blood pressure. This leads from mild side effects such as feeling faint, to more serious problems such as maternal cardiac arrest and lowered blood supply for the unborn baby. Shivering, nausea, vomiting, and severe headaches are also common after an epidural. One major UK study found that a woman was twice as likely to hemorrhage after giving birth with an epidural than was one who did not have an epidural.

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Finally, epidurals increase the risk of other interventions, especially a cesarean, which is major abdominal surgery, presents it’s own set of risks to both mother and baby, and requires weeks of recovery.

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Baby:

Although I have heard both doctors and mothers say over and over again that epidural drugs do not reach or affect the baby, study after study shows otherwise.

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First, the placenta is not a barrier between the mother and baby. It is a conduit. What goes into the mother also reaches her unborn child. That is why, during pregnancy, women are cautioned to eat a healthy diet, and to avoid or limit over-the-counter-drugs, caffeine, alcohol, sugar, or exposure to chemicals and smoke. Why, then, do all of those rules go out the window during labor when there is no medical need to use any drugs except in women who truly do have medical complications?

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…regional anesthetic agents do not remain regional in their distribution. Measurable levels of these drugs appear in maternal blood from 1-7 minutes after instillation and measurable levels appear shortly thereafter in fetal blood regardless of the type of regional anesthesia or the agent employed.

~Dr. Howard Fox, University of Kansas Medical Center, Division of Neonatal Medicine

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If the drugs do enter the baby within 10-15 minutes after an epidural, what do they do?

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A lot, actually. Fetal distress is one of the most common side effects of epidurals in labor, and it is also the most common reason cited for emergency c-sections. Changes in the fetal heart rate are very common, which indicate that the baby does not have adequate oxygen or blood. Babies exposed to epidural drugs can also experience respiratory problems, and at birth have even higher drug levels in their systems than even their mothers do.

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I cannot tell you how many times I’ve heard and read women declare that they had to have an emergency c-section due to fetal distress, and that they were so thankful they were in a hospital so that the doctor could save their babies. What they don’t realize is that the drugs given to them by that doctor were the very things that caused the emergency in the first place.

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Is there any way to relieve pain without drugs?

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Absolutely! Pain relief in itself is not necessarily a bad thing. When drugs are not used, a woman, given freedom to labor how she chooses, will move into positions she finds most comfortable. Be that walking, sitting, resting in warm water, on hands and knees, or in one of the myriad other positions she will find a way to adjust herself that feels right. Her movement also helps her baby move down the birth canal into the correct position for birth. This is not possible with an epidural because women are confined to their backs on a bed, which by far the worst possible position for giving birth because it closes the pelvic opening, making it much more difficult for the baby to get through. Lying on her back also ensures that she is working against gravity, rather than with gravity.

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Many midwives and doulas use soothing herbal scents or tinctures to help soothe a laboring woman, as well as massage or acupressure. Laboring women also frequently find music and dim lighting to be calming as they work to bring new life into the world. Fear of labor and laboring in an unfamiliar place with unfamiliar people can increase both pain and length of labor. Seeing birth as a normal and natural part of your passage into motherhood helps tremendously.

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Additional side effects

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In order to be completely thorough, here are additional side effects for both mother and baby not mentioned above, in no particular order:

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Severe postpartum depression

Death of baby

Increased likelihood of: being induced, using forceps, and episiotomy

Feelings of emotional detachment

Decreased mother-infant bonding

Complications to baby

Chronic back pain

Fetal drowsiness

Chronic migraine headaches

Chronic “pins and needles”

Loss of consciousness

Convulsions

Septic or bacterial meningitis

Fecal and urinary incontinence

Seizures/Trauma

Inability to push out baby

Misplaced catheter

Accidental injection of anesthetic into bloodstream

Punctured dura

Allergic reaction

Fetal hyperthermia

Neonatal jaundice

Poor fetal muscle strength

Neurological complications

Permanent nerve damage

Loss of sensation and sexual function

Damage to spinal cord

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The decision whether or not to use an epidural is completely up to you. In some cases it is truly necessary, such as for a cesarean birth. Other times it is personal preference or because another intervention made contractions too much to handle. Just know the possible negative side effects so that your choice is fully informed. And also realize that introducing one intervention often leads to more interventions that you may not have planned on or wanted.

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References:

The American Pregnancy Association

Born in the USA by Marsden Wagner

“The Hidden Risks of Epidurals” by Sarah J. Buckley as reported in Mothering Magazine

“Effects of Maternal Analgesia on Neonatal Morbidity.” By Howard Fox, University of Kansas, Neonatal Division

The Bradley Method by Marjie Hathaway, et al.

Pregnancy in America, documentary 

I apologize for the long time between posts. My husband currently works at a school around children, and brought home a nasty bug that has made the rounds in our household. I haven’t had time to do much. So, finally, here is a much overdue post.

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What is natural childbirth?

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Generally, women who choose to have a natural birth are those who view childbirth as a natural, normal process; one that doesn’t generally need outside intervention in order to have a healthy baby. They (or we) have confidence in the fact that our bodies are designed to birth new life, and we realize that women have been doing this for centuries without assistance, and in most places around the world they still do it that way.

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In the United States, this mindset is not normal by any means. We, as a country, have turned this normal process into a medical “condition” that requires a surgeon’s expertise (that is what an OB/GYN is, after all: a surgeon trained in the surgical repair or removal of female body parts). Women are taught to fear the prospect of labor, and are told to trust a surgeon to safely deliver their babies. Doctors frequently perform “emergency” cesareans and “save” the baby or mother from certain death. Of course, these “emergencies” mainly occur due to the doctor’s medical intervention in the first place, but more on that later.

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Natural childbirth does not rely primarily on surgeons, but on the woman’s own body. When I say “natural childbirth,” I mean a birth that is completely drug-free, during which the woman is allowed to labor and give birth in a position she chooses, rather than one that is forced upon her. In all situations, unless there is a real medical reason to have to perform a cesarean, a natural birth is many times safer for both the mother and baby than births that rely on drugs or other interventions (induction, forceps, suction). The reason for this is that drugs always have side effects, and many of them are not only unpleasant, but downright dangerous for mother or baby.

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The Purpose of this Blog

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In future posts I will be going over how to successfully have a natural birth, from nutrition during pregnancy to the best labor positions and relaxation techniques. I want to provide a myriad of resources to childbirth classes and reading material that may help you in your own birth journey. I will also cover each common intervention such as epidurals, induction via pitocin or cytotec, twilight drugs, forced removal of the baby vaginally, and cesareans. My goal is for women to go into labor knowing their options, knowing the risks and benefits associated with each drug, when that drug is likely to be used, and to have the ability to make decisions for themselves.

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What I desire for you

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I want you to know the truth, and then to make your own decision based on facts. Although I am, admittedly, an advocate for natural childbirth and firmly believe it is best and safest in the majority of cases, I don’t just want you to have a natural childbirth. Although I love homebirth, I don’t necessarily want you to have a homebirth. What I desire is that you have the information so that you are able to choose how to birth your baby with your eyes wide open, rather than out of fear or intimidation or ignorance. Whether that be with drugs or without, in a hospital, birth center, or at home, my goal is twofold: one, for you to know why you’re making the decisions you make and, two, not to fear childbirth but to welcome it as the miraculous event it truly is.

Cytotec (generic name Misoprostol) first hit the market as a prescription drug for the prevention of ulcers. It was supposed to counteract the unfortunate side effects of certain medications for arthritis and pain relief that cause a higher rate of ulcers (I think I’d rather have the arthritis, personally!). The FDA ran trials and approved it for this use only.

However, it was soon discovered that, given to a pregnant woman, a low dose of Cytotec will successfully start labor contractions at a fraction of the cost of pitocin. So, doctors began giving the drug “off-label” to millions of women.

So, what’s the big deal? you may ask. It works, doesn’t it? Well, I’ll tell you what the big deal is.

Cytotec kills women and babies.

That’s a pretty big deal, right?

I’ll say it again: using Cytotec for induction can kill or seriously injure both the mother and baby.

One unfortunate side effect of misoprostol is that it can cause uterine rupture, which is life-threatening because the uterus detaches from the mother’s body. It causes severe bleeding, fetal distress, and the baby or placenta can be delivered into the mother’s abdominal cavity, rather than through the birth canal. Mothers who experience uterine rupture need an immediate cesarean to get the baby out and to repair or remove the uterus. The mortality rate for women who have a uterine rupture is extremely high, and their babies either die or are left seriously disabled.

The deaths of healthy mothers and babies should be enough to keep doctors from giving the pill to anyone. However, it gets worse. The most shocking part of the use of Cytotec in this way is that the manufacturing company, Pfizer, clearly labels each bottle with a warning against using the drug on pregnant women. When doctors ignored it, they sent out an extra warning to all healthcare practitioners involved in prenatal care and childbirth:

The purpose of this letter is to remind you that Cytotec administration by any route is contraindicated in women who are pregnant because it can cause abortion…

Serious adverse events reported following off-label use of Cytotec in pregnant women include maternal or fetal death; uterine hyperstimulation, rupture or perforation requiring uterine surgical repair, hysterectomy, or salpingo-oophorectomy; amniotic fluid embolism; severe vaginal bleeding, retained placenta, shock, fetal bradycardia and pelvic pain.

(This excerpt was taken from the actual letter. If I knew how I would scan the whole letter and add it to the post, but I’m not quite that technologically adept yet).

With all the reasons not to give Cytotec to any pregnant woman, you would think that no doctor would ever do so. And yet, even with the warnings and evidence of danger, women are still given this drug to induce labor and the fatalities continue.

The biggest question is, of course, why?! If it causes so much damage, why on earth would doctors continue to prescribe it? There are only two reasons I can think of that Cytotec would be given for induction rather than pitocin: money and convenience. Cytotec is much cheaper than pitocin to induce labor, and it is also extremely easy to use: just pop a pill early in the morning, and the baby is out by evening. Or dead by evening.

To all mothers-to-be, please, please do not allow anyone to give you Cytotec! Remember, it is also called misoprostol. If you choose to be medically induced for any reason, make sure you are given pitocin via IV rather than a pill that is either taken orally or placed in the vaginal opening. It is not worth the risk to you or your baby.

Created to Birth

You see it on TV, in movies, through the birth stories of other women: childbirth is awful! It is painful; so excruciating, in fact, that even the most mild-mannered woman will scream obscenities at her husband: I hate you! You did this to me!  Women scream and groan and ask for drugs as portrayed in the media. Probably the worst when I was pregnant with my first was all the horror stories older mothers felt compelled to relay. Their experiences were so painful and the baby wouldn’t come out and so they had to have an emergency c-section… I can imagine that anyone who has ever been pregnant knows what I’m talking about. You know, those stories that absolutely terrify you and make you wish you had never gotten pregnant!

Throughout the United States, childbirth is viewed as a horrible, painful ordeal that requires medical assistance. Although in 1900 over 95% of women gave birth at home, usually with a midwife in attendance, by 1960, roughly the same percentage of women were giving birth in hospitals with drugs. Why? Women were seen as incapable in both the act of childbirth and of assisting in childbirth as midwives. Also, obstetricians had sought to establish themselves as the only experts in the field for the majority of the early 20th century. So, in a very short time, childbirth moved out of the hands of women (both mothers and midwives) and into the hands of men. Doctors, instead of assisting and supporting a woman through the process of childbirth, turned it into a medical ordeal. They essentially used the “knock ‘em out, drag ‘em out” approach. Women were drugged, laid on a table with sheets covering everything except the vaginal opening, and their babies were extracted while they stayed in their drugged state. Unfortunately, that idea has continued in the American consciousness, although many midwives and doctors have fought for the right of women to take back childbirth as their own.

For much of history, women have given birth with the help of other women, usually older women who had already given birth to their own children. Unlike the current status of birth as a medical condition that always requires a doctor and hospital, birth was viewed as a natural process. And, in other countries around the world, it is viewed in the same light: normal. Childbirth is not something to fear. It is not an abnormal part of life. It is part of who we are as women. Biologically, we are perfectly capable of giving birth to a child without medical intervention.

Now, I’m not saying that no women ever need doctors during their pregnancies and births. In fact, some women really, truly do need medical intervention in order to safely have their babies. That is what doctors are for: to help those who actually need their knowledge. However, quite honestly, most women don’t. In fact, medical intervention tends to create more problems than it solves in a healthy mother.

A woman’s body is truly phenomenal. Life begins within our bodies, and is sustained while each new human being develops. When the baby is ready, our bodies begin to change and every little step falls into place – in perfect order – for a new life to be born. One midwife, while explaining the process to me, said that it is a miracle that the thousand things that must happen in order for a baby to be born do happen, in the exact order they need to, during the relatively short span of labor. Not to mention the previous months of preparation. And it truly is a miracle; a process that should inspire awe in all who witness birth.

So, pregnant women, do not be afraid! Your body was designed to give birth to babies. Your body adjusts and alters itself to accommodate the life growing inside, and your body inherently knows the perfect way to bring that new life into the world. There is so much to learn about childbirth, and how incredibly capable we truly are. And there is much you can do to prepare so that you are no longer assaulted by fear of the unknown or swayed by the fear of others.

My blogging beginnings

Hello!

This is my first venture into the world of blogging, so I imagine I’ll stumble around a bit before getting into the groove. It probably doesn’t help that I haven’t written much of anything since graduating college four years ago. I know, that doesn’t seem like a very long time, but when your life in the intervening time is filled primarily with infants and toddlers, your brain tends to go a little mushy. At least, mine has. I’m sure being pregnant again doesn’t help, either!

Anyway, I am working on posts, so I promise this will be up and running soon!