I was talking with my dear friend, Carol Gautschi, who is a very experienced midwife. We were talking about how to make hospital birth better and more physiological—more like homebirth. Carol was pondering the following question that she’d read on an online medical board referring to improving hospital practices and making the hospital more like home for laboring women: “What should be the management? What are the obstacles to doing this?” As we discussed this I said, “First of all, the word ‘management’ needs to be gotten rid of. You can’t ‘manage’ labor.” Carol replied that this is exactly what she’d written on the online discussion board. I was thrilled that we had both used the same concept of “you don’t manage labor.”
Here is what Carol had to say to the other birth professionals discussing this issue:
I believe most of the obstacles will be not managing their (the laboring mothers’) care, and allowing them their space, to a degree, to unfold to the processes of birth by themselves. Start with amazing prenatal care, with awareness on how that builds a foundation for the crescendo of birth. Have guidance that explicitly helps practitioners recognize the woman’s ability to give to birth. [Hospital birth professionals will need to] have belief, patience and intuitive artistry, which is not as easily accomplished in an institutional setting. I think if we all work hard enough in allowing a paradigm shift to occur, it is very doable.
Perhaps if hospital personnel stopped using the word “manage” to describe labor, a change in bad practices might follow. When it comes to talking about a birth practitioner’s role in labor, instead of “manage,” let’s say watch, listen, care, observe, love and respect (or should we shout respect?). Trying to manage women has led to the some of the worst birth practices the world has ever known. Take induction, for instance. Inducing women so babies can be born in someone else’s time frame is the violation of a woman’s rights, and even if she wants to be induced, it is a violation of her baby’s rights.
The word “manage” sneaked into childbirth nomenclature. If it wasn’t so serious and damaging it would be hilarious. You manage labor like you herd cats. In other words, you don’t. Labor is a physiological process and you do not manage it without doing all sorts of untold damage, way more than we realize. It would be like managing breathing, sneezing or sex. How did that word get there in the first place? And how do we get rid of it?
[Editor’s Note: Carol Gautschi teaches at many Midwifery Today conferences. Come experience her wisdom in Eugene, Oregon, March 30 – April 3, 2011. Our Eugene conference theme is, “Gentle Birth Is a Human Rights Issue.” Carol also will be at Bad Wildbad, Germany, October 19–23, 2011.]
— Jan Tritten, mother of Midwifery Today
Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.
Jan’s blog: community.midwiferytoday.com/blogs/jan/default.aspx
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International Alliance of Midwives on Facebook: facebook.com/IAMbirth
Freedom for Family Wellness: the Conference for Conscious Choice
Connect, collaborate and expand at this enlightening event for leaders in the vitalistic movement.
October 21–24, Washington, DC: Holistic Practitioners: DCs, NDs, MDs, PhDs, OBs, Midwives, Doulas, Homeopaths, Acupuncturists, Family Wellness Counselors, Consultants and Therapists. Advocates for Informed Choice: leaders of national groups and their members… Visit http://familywellnessfirst.org/.
Following C-section, Immediate Skin-to-skin Contact Between Baby and Parents Fosters Earlier Vocal Interaction
Researchers in Sweden have found another benefit to immediate, skin-to-skin contact between an infant and its parents following an elective c-section.
The Swedish researchers studied a total of 37 healthy infants born to first-time mothers in a Stockholm, Sweden hospital, who were exposed to 30 minutes of skin-to-skin contact with either the mother or father after a 5-minute period of skin-to-skin contact with just the mother immediately following an elective c-section. The study was published in the September 2010 issue of the perinatal care journal, Birth. “When placed in skin-to-skin contact and exposed to the parents’ speech, the infants initiated communication with soliciting calls with the parents within approximately 15 minutes after birth,” the researchers noted in their conclusions.
The authors, who were researching early vocal interaction in conjunction with a larger study on parent-infant interaction following a c-section, concluded that, “these findings give reason to encourage parents to keep the newborn in skin-to-skin contact after cesarean section, to support the early onset of the first vocal communication.”
— Velandia, M., et al. 2010. Onset of Vocal Interaction between Parents and Newborns in Skin-to-Skin Contact Immediately After Elective Cesarean Section. Birth 37(3): 192–201.
You want to be a midwife, but where do you start?
Are you an aspiring midwife who’s looking for the right school? Or maybe you’re trying to decide if midwifery is the path for you. Visit our Better Birth Education Opportunities page to discover ways to start or continue your education.
Nearly 70 years ago, Grantly Dick-Read wrote in Childbirth without Fear that laboring women often experience a cycle of: Fear > Tension > Pain. This is a cycle with which many of us are familiar, and we’ve developed a myriad of ways to break the cycle since Dick-Read first published his seminal work in 1942. However, less attention has been focused on the emotional roller-coaster fathers experience throughout pregnancy and birth, and it’s this area that I’d like to explore in greater depth.
Although a man cannot feel the same pain as a laboring woman, I believe that many men experience a similar cycle of emotions in the birthing space to that which Dick-Read described, with a slightly different end product, namely: Fear > Tension > Panic. A man who is not confident in his partner’s birthing abilities, who is poorly informed, and/or who is poorly supported, becomes increasingly tense; and if this tension is not eased, then he spirals into an irreversible state of panic. This panic manifests differently in different men: some men become paralyzed by their fear (the familiar specter of the terrified dad sitting stock-still at the foot of the bed), while others spring into hyperactivity, bringing endless cups of water or becoming obsessively concerned with the temperature of the birth pool.
The root of this panic is fear, and it’s a fear which often begins to grow long before the first contraction is felt. As such, we need to think about ways that we can address and minimize this fear in the days and months preceding birth. …
How can we, as birth workers, stop the vicious Fear > Tension > Panic cycle? While we may never be able to eliminate fathers’ concerns completely, I believe that a change in the way we structure and implement antenatal preparation can help men to feel calmer and more confident about birth. It is important for men to have at least a basic understanding of female anatomy and the stages of labor, but even more importantly, antenatal workshops must:
- Confront the origins of men’s fears about childbirth. For example, each man might be asked to share the story of his own birth with the group, such as it was told to him, or to share a friend’s or colleague’s birth story that affected him in a particular way. This exercise could serve as a useful starting point from which to examine our preconceived notions about birth and could lead to a frank analysis of which notions are based on fact and which are fiction.
- Teach practical coping techniques. In the class I attended, many men were desperate to find out how they could lessen their partner’s pain during childbirth. In addition to teaching simple massage and relaxation techniques, a birth educator might do well to emphasize practical ways in which a man can create and “hold” a safe, private birth space for his partner. Many of the men I’ve worked with have been delighted to embrace this role as guardian of the birth space and have been keen to find out how an atmosphere of peaceful privacy can actually ease their partner’s perception of pain.
Encourage open dialogue between parents. Ask women to be open about the role they expect their partner to play, but also encourage men to be honest about their capabilities. Although men have been welcomed back into the birth space in the last few decades, the expectations placed on them have grown almost unrealistically onerous: fathers often feel pressure to be an all-knowing birth partner, medical liaison, masseur, lover, protector and friend, while simultaneously being expected to “relax and enjoy” the birth experience. Antenatal preparation must incorporate an honest dialogue between parents, where expectations are expressed, but where limits are also respected. Crucially, we must also help parents to feel safe in acknowledging that, for men who cannot overcome negative emotions around birth, opting out of the birth space and paving the way for another supporter (such as a doula or friend) may actually be the most helpful thing they can do.
— Leah Hazard
Excerpted from "Beyond Fear, Tension and Panic: Helping Men Enjoy the Birth Experience," Midwifery Today, Issue 95
View table of contents / Order the back issue
Author Leah Hazard is the author of The Father’s Home Birth Handbook. For more information, visit www.homebirthbook.com.
Let Miss Margaret inspire you!
|Margaret Charles Smith caught her first baby when she was five years old, then went on to become one of the last great “Granny” midwives in the United States. Watch this DVD to learn about the woman Ina May Gaskin called a “national treasure.” You’ll be inspired by her courage, perseverance and motherwit. To Order|
Discover The Power of Women!
When you read this new book by Sister MorningStar, you’ll discover how healing words and empowering stories help women listen to their instincts during childbirth. Filled with inspiring, moving stories, The Power of Women will lift the veils from your eyes and let you view the world in a new way. Give it to the pregnant women you know. Help them see the power that resides within them.
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Midwifery Today Back Issues have the information you need!
From second stage and prematurity to birth change and natural remedies, back issues of Midwifery Today print magazine are packed with informative articles that will help you improve your practice. You’ll also find inspiring birth stories, birth news, poetry and stunning black and white photography. Choose from these available back issues.
Now on DVD—Normalizing the Breech Delivery
If you attend pregnant women, you need basic knowledge of the breech delivery. In this DVD, Midwives Valerie El Halta and Rahima Baldwin Dancy share their expertise in a clear, detailed manner. You’ll learn a Breech Scoring System to help evaluate risk, various positions for the mother in delivering a breech baby, the key points for diagnosing and delivering a frank breech and more. Perfect for midwifery training programs and self-study by both student and experienced midwives, Normalizing the Breech Delivery is a must-have for every birth library. Order the video.
Be Prepared for Hemorrhage
Order The Hemorrhage Handbook and you’ll learn the tricks, remedies and philosophy of care involved in hemorrhage and hemorrhage prevention during the childbearing year.
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Q: I recently had a mom with a Bandl’s ring just above the cervix, which held the baby up high and would close to 5 cm with a strong contraction. [Editor’s note: A Bandl’s ring is an atypical thickening of the normal retraction ring that occurs during an obstructed labor. If a Bandl’s ring is palpable abdominally, it is a sign of imminent uterine rupture.] She had to have a c-section. My question is: Will this repeat with another pregnancy? This was her sixth pregnancy, but the first time she has had a Bandl’s ring. Has anyone had experience with a mother who has had a pregnancy after having had a Bandl’s ring during a previous labor?
— Judy, CPM
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