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Always a good reminder for all involved with birth: Healthy babies do not need to cry at birth. Crying is a sign of disress and not a necessary part of birth. And, under normal circumstances, it should not be forced.

 I sometimes loose sight of that as I am with a family and a newborn at a hospital. I can always feel the room’s sigh of relief once the baby cries, usually after bulb-syringing babies’ nasal passages.

As a Doula and aspiring midwife it is my responsibility to educate, as much as mom is willing to be open, about what to expect after birth and try to shift her expectations from a technical birth to one where motherbaby are respected as a single, solid unit of love and respect for each other. 


Ultrasound - What Every Mom Needs to Know

~ Conclusive scientific evidence that routine (and by routine I mean scanning to see baby's position at every prenatal in the last weeks of pregnancy, or 3-D ultrasounds to "meet your baby" in the womb) use of ultrasounds are safe does not exist. Its use is very familiar to the use of X-rays. 50 years went by assuming that X-rays were safe for pregnant women before hard lessons were learned. A textbook on prenatal care published in 1937 has this to say about X-rays: "It has been frequently asked whether there is any danger to the life of the child by the passage of X-rays through it; it can be said at once there is none if the examination is carried out by a competent radiologist or radiographer".

In 1978 that same textbook, after seeing the dangers of X-raying babies, revised its stance: "It is now known that the unrestricted use of X-rays through the fetus caused childhood cancer".
This mimics the current textbook view on ultrasounds: "One of the great virtues of diagnostic ultrasound has been its apparent safety. At present energy levels, diagnostic ultrasound appears to be without injurious effect ... all the available evidence suggests that it is a very safe modality".

~ Lancet, A current British medical journal, has this to say about Ultrasounds: "There have been no randomized controlled trials of adequate size to assess whether there are adverse effects on growth and development of children exposed in utero to ultrasound. Indeed, the necessary studies to ascertain safety may never be done, because of lack of interest in such research".

~ The output of ultrasound plays a huge part in the affects on baby, however there are no controls in place as to what is a safe amount even though low outputs have been shown to be just as effective as high outputs.

~The skill of the technician performing the ultrasounds matters tremendously, yet there is no licensing or certification process for operators of the machines.

~Training midwives and doctors in the skills of palpation - using their own hands to feel baby's position is just as effective as a machine. Not only is this low-tech and inexpensive, it also helps care giver and mom physically connect.

As an aside: I had a friend tell me of someone she knows who has gone through 2 pregnancies and the first time a care giver ever even touched her belly was well into the 2 pregnancy! I haven't heard anything sadder since then in awhile.

Ask Ask Ask your caregiver why they are requesting an ultrasound. Ask what are the risks of an ultrasound. Ask what research their answer is based on. And then ask what are the risks of not getting an ultrasound. You may be surprised at the answers.


Induction - Not so Hot

I'm excited by this article! I’ve placed it in my Resource Notebook and plan to give to Doula clients whose doctors are talking induction. Gail Hart is one of my favorite midwife authors and I love reading anything by her. This article really gave me more foundation for what I have already been telling moms about induction. In addition, she provides ways women can help themselves prevent pre-term labor by cultivating a healthy vaginal floriculture. I think everyone should read this article:


Maya Massage

Ann Hirsch writes about her experiences with Maya Massage in Midwifery Today  and provides client and personal examples of how it has worked remarkably well for pregnant moms. If you've not heard of this ancient, powerful massage for women, read on.

I have had numerous treatments and performed self-care with Maya Massage for several months and did not see any change in the dysmenorrhea I was trying to eliminate. Though I certainly enjoyed the massage and did feel adhesion breaking up, it just didn’t help with my specific issue at that specific time. I intuitively know that this is powerful stuff, it just wasn't all I needed at the time.

When it is applied to pregnant moms, I think it can make a difference very fast because of the open and receiving state that moms are in emotionally, not to mention the hormones that cause ligaments to relax later on in pregnancy.

I fully agree with Ann when she says that this technique allows a midwife to practice an alternative form of gynecological care for women. No longer do you have to tell moms, “Keep up the Kegels” when you visit them on that last postpartum visit. Maya Massage allows a midwife and mom to have physical contact, and the best part is that teaching a mom how to practice self-care is easy. Now mom has her own tools to help her uterus.

I would love to know more about the technical aspects of Maya Massage, so I’ll be checking out: to find out more info. This article has also inspired me to look into being trained myself, so I can offer yet another healing modality to my clients.


Stages of Labor Mirror Pregnancy and Motherhood

Verena Schmid, an Italian Midwife,  believes that pregnancy patterns have the same rhythm as stages of labor. That doesn’t mean if a mother’s first trimester was difficult, then the first stage of labor will be the same way. Instead, Verena speaks about the instinctual rhythms of women, pregnancy and birth.

A woman’s first trimester and first stage of labor are very similar because at both times mom is learning to create inner space for her baby. Second trimester and second stage are both about learning to open up; opening in pregnancy as the baby is growing inside or opening during birth as baby moves to open the cervix. The third trimester and third stage of labor are about learning to let baby go and let her be born. 

Verena continues with this theory, stating that once a baby is born the stages begin again. The baby adapts to mom and to life outside the womb, while mom adapts to baby and motherhood.  Months 3 - 6 are often a time for mom and baby to live peacefully together with very little stresses. Finally, 6 - 9 months after baby is born, she starts to be more explorative and mom learns to let go.

I never looked at birth from this perspective and find it quite fascinating. Reading this short interview has definitely changed the way I look at birth and mothering.

The actual interview that Midwifery Today publisded in 2002 with forward-thinking Verena Schmid can be found here if you are interested in reading more than the summary above:

The Active Management of Labor

The above link takes you to an excellent article written by Marsden Wagner. He started out as a neonatologist and is now a consultant for WHO. He fully supports natural birth, midwives and midwifery and you may have seen him in birth movies - he's the over-educated elfin guy who is fun to listen to.

I've jotted some highlights from the article and added my own thoughts on it.

From my own personal experience, I agree that most health care providers no longer know what a non-medicalized birth is. Their training rarely covers natural hospital births and almost never brings the medical student into a free-standing birth center or home to observe birth.

As a result of lack of exposure to natural birth, hospital staff often believe that labor is something that happens to women rather than something women do that can be empowering and a rite of passage. Because labor is involuntary and unpredictable, many doctors and nurses interpret that as birth being out of control.

It’s sad to read the example of a hospital considering birth normal even if it includes an amniotomy, induction, augmentation, epidural or episiotomy. I feel that the list can go on to include continuous fetal monitoring, IV, withholding of food, drink and privacy, numerous cervical checks and disregard to birth preferences. What is even sadder is that most women today have accepted those same standards and also believe that birth with serious intervention is normal.

I found it interesting to read how the clock has quickened. Marsden states that the definition of the normal upper limit to labor has been reduced from 36 hours in the 1950s to 24 hours in the 60s and now holds steady at 12 hours since 1972, when active management was introduced. He also mentions that these random times were based on clinical concerns and not scientific evidence. With this scenario on hand, women adjust to the hospital and not the other way around.

My head was shaking when Marsden compared active management to inventing cars that can be driven too fast and then when the speed causes accidents, rather than change the cars, we invent speed bumps and as a result of the speed bumps people hit their heads on the car ceiling and we give them pain medication.

I think a better comparison would be the creation of entire task forces whose job is to monitor speeders and catch them in the act so they can then ticket them and make money from their speeding. That feels similar to hospitals making money from highly medicalized births.

Marsden concludes that hospital staff can never tell a woman that a certain procedure is safe because that person is not taking chances. A safety determination can only be made by the one accepting the procedure and that is the woman taking the chance.