Thank you Dr. Fisk (change #4 continued)

Humane Cesarean, continued.

The idea of "humane cesarean" or "natural cesarean" was conceived by Professor Nicholas Fisk, formerly a consultant obstetrician at Queen Charlotte's Hospital in London, in response to the rising numbers of cesareans in the UK.

Fisk showed that when a cesarean is performed slowly the baby is able to “auto-resuscitate” - start breathing unaided - while still attached to the placenta, just as it would in vaginal birth. The baby is “half-delivered” by the surgeon from her body and the baby's vigorous wriggles allow the lungs to expel fluid in a similar way to a vaginal birth. This reduces the risk of the cesarean-born baby needing help to breathe (a common occurrence after a cesarean).

Please, learn more. Read more about this online. Google! And... take the next step. Start talking to birth people and parents about what is possible. Make it happen -- in your home town!

Love,
Pam

(Still in Melbourne, Australia. Be home soon!)

#4 CHANGE BIRTH CHANGE CESAREAN CUSTOMS

Virginia and I are about to close BIRTHING FROM WITHIN’s very first Introduction to Mentoring workshop in Australia!! We were privileged to meet 24 amazing and interesting women (one came all the way from Abu Dhabi), many of whom will join the BFW program and family—and become childbirth mentor ‘pioneers’ in Australia.

After presenting our module, “Cesarean Birth in Awareness,” Maggie, a warm and experienced midwife told us a story about a seed change in Australian birth culture.

Three years ago midwives at Canberra Hospital (Canberra is the capital of Australia) pushed for a humane change in how families experience cesareans. Now, at Canberra Hospital, cesarean-born babies are no longer separated from their mothers in theatre (operating room). When a baby is born healthy, it is immediately placed on its mother’s chest, skin-to-skin, wet and sticky. There is no blanket barrier between the mother and baby; the baby is not swaddled. Most of the time, the baby breastfeeds during the first half hour in the operating room! When the mother is taken to recovery, her baby is tucked inside her gown, skin-to-skin.

How did this change come about? It wasn’t easy. “There was a big fight before this could happen,” Maggie recounted. “Some of the midwives wanted to continue swaddling the babies before they were placed on the mother, while other midwives believed the babies could go directly to their mothers.”

Maggie told me her own story about adapting to this radical change in policy. She had taken a leave from her position as hospital midwife for a few years and returned after this policy had changed. During her orientation, Maggie’s mentor told her that now all babies—including babies born by cesarean—stayed with their mothers continuously and would be put directly on the mother after birth.

“So the first cesarean I attended, I dutifully took baby from surgeon, wrapped it, and then took it to mother. My mentor came over, unwrapped the baby and placed it on its mother so there was skin-to-skin contact. My mentor left the room and I swaddled the baby again because it was so engrained in me that babies had to be wrapped up because theatre is cold. So we had a dance: my mentor unwrapping baby, and I wrapping baby. It took me a while to understand skin-to-skin meant whole body contact,” not just the face.

The other change at the Canberra Hospital is making the theatre (operating room) warmer so the mother and baby are warmer. The new temperature is about 23°C, or 73° F. Other midwives in our workshop shared that a lot of hospitals in Australia no longer routinely separate babies from mothers, even in cesarean birth.

WHEN WE TALK ABOUT CHANGING BIRTH IN OUR CULTURE, EVERYBODY'S SMALL AND GRAND EFFORTS MATTER. BIRTH TOUCHES EVERYBODY. SO EVERYBODY MUST SPEAK UP: MOTHERS, FATHERS, GRANDMOTHERS, DOCTORS, MIDWIVES, DOULAS, NURSES, WRITERS, AND ARTISTS. WE CANNOT WAIT FOR THE POWERS THAT BE TO CHANGE BIRTH FOR US. WHEN MILLIONS OF US CHANGE OUR ATTITUDE AND EXPECTATIONS, AND WE SPEAK UP, WE BECOME THE CHANGE WE ARE WAITING FOR.

Stay tuned this week for more blogs related to changing birth in our culture by changing cesarean birth. Looking forward to reading your comments and experiences as we all “dance” between old thinking and new thinking.

Love from “down under,”
Pam and Virginia

Good Prenatal Diet Prevents Puny Pancreases and Little Livers

Hi Birth Peeps,

This week each one of us can change birth in our culture by helping motivate (not guilt trip)--and lovingly feed--even one pregnant mom to eat well during pregnancy.

The pancreas normally secretes varying amounts of insulin in response to blood sugar levels. Diabetes occurs when the pancreas does not secrete sufficient insulin to regulate the blood sugar.


A lot of attention has been given to maternal weight gain and the baby’s birth weight as a measure of healthy growth and development. Research in the past fifteen years is showing how even a normal birth weight does not always reflect organogenesis—a fancy word that means the cellular development of organs in the fetus.

Diabetes is on the rise in young people. There are two kinds of diabetes. Type 1 (also known as Juvenile Diabetes, and thought to be primarily genetic) and Type II (also known as adult-onset) which is due to environmental factors. In this article, I am referring to Type II. There’s a lot of research being done to find out why some kids and adults develop diabetes, even when they are seemingly healthy, of normal weight, or without a family history of diabetes.

Researchers at Joslin Diabetes Center in Boston found a link between prenatal nutrition and diabetes. Pregnant mice were fed low protein diets in the third trimester (many people mistakenly think that after the first trimester, nutrition doesn’t matter any more); not surprisingly, they gave birth to low birth weight pups. Fed a healthy diet after birth, the pups gained weight and appeared as healthy as the mice fed a prenatal diet rich in protein. However, as adult mice, the majority of the low protein (LP) group developed diabetes. Why?

Normally, the pancreas secretes the right amount of insulin in response to varying blood sugar levels. Scientists discovered that in the LP group, the pancreas could secrete insulin, but it could only secrete a limited amount of insulin regardless of the blood sugar levels. In other studies, researchers found that when the prenatal diet was low in protein, pancreatic cells were smaller and fewer in number. And, that even when fed a good diet after birth, the abnormal pancreas cellular damage was irreversible.

So, eat a well-balanced, protein rich diet throughout pregnancy—grow healthy organs in your baby.


LITTLE LIVERS

The growth and development of fetal livers is dependent on many factors: genes, a healthy placenta, and maternal factors including a good diet. During the prolific growth and development of a baby's liver during pregnancy, the liver is sensitive to damange from malnutrition, infection and other chemical.

In one study where pregnant rats were give low protein diets in late gestation, the pups were born with smaller livers and abnormal liver function. 

The size and health of the liver is not evident at birth, or in the baby's birth weight, but the size and healthy function of the liver is set before birth and follows us throughout life.

Virginia and I are in Sydney, Australia today. I am pleased to see our Peeps are growing in numbers. It's a bit difficult to find internet in some places, so I may not be back for a few days... Thinking of all of you all the same,

Pam

Many references are available: ¹ http://yourhealthcounts.net/good-prenatal-nutrition-the-importance-of-it

#3 of 50 Ways to Change Birth in Our Culture: NUTRITION

Greetings Birth Peeps,
Today is our #3 way to change birth in our culture. Prenatal Nutrition. It may not seem all that exciting, and it is just that attitude that earned it top billing in our list of 50 Ways to Change Birth in Our Culture.

As a childbirth educator/mentor, I have been asking mothers for almost 30 years to tell me what they eat, and if they have received nutritional counseling from their doctor or midwife. This is how I know that our culture does not value the impact good nutrition has on the mother's health and well-being during the childbearing year. It is RARE to talk to a mother who has received sound nutritional counseling during prenatal care. Mothers more often report that their birth attendant dismisses their concerns about whether they are eating enough. One mother was told them to "trust her appetite," another was advised not to worry about it because "the baby is so small, it doesn't need much." (Both of these mothers were eating good food, but not enough protein or calories to nourish the baby and placenta, and all the changes occurring in their body during pregnancy.)

A lot of people think that after the first trimester, the baby is fully formed and is not as dependent on good nutrition. The baby's organs are continually growing and developing, not just in first trimester, but also important changes are still occurring in third trimester. So sound nutrition is important throughout the pregnancy.

Technology and advanced (intensive) baby care can do a lot for us... but as a culture, we shouldn't become passive and dependent on that kind of life-saving management. Instead, all of us--mothers, and people who feed and care for pregnant mothers--should do our part to nourish the mother and the life within.

If you have any inspired facts, research, good books or resources to motivate and feed our interest in this topic, please write in.

Pam

Magical Placenta Previa-Premie Story

Another peep for Birth Peeps,

I am enjoying reading your stories and insights. How can we make a really difficult birth into a Magical Birth Story? Fortunately, we have a few years to process and integrate what happened "to us" and "in us" before our child can understand language to hear the Magical Story. So, if you can't imagine anything about the experience translating into a "sweet story" at first, you have time to heal.

My mother had five children, she was Catholic and a nurse, so she knew hospital policy which becomes relevant in the story. During her third pregnancy she developed a partial placenta previa and began to bleed around the seventh month. She was admitted to the hospital. I never knew too many details about what happened except this one poignant scene she felt compelled to tell me:

"I was bleeding, weak, kept falling asleep [in labor]. When I opened my eyes, I saw your father sitting in a chair against the wall saying the rosary. They only let fathers into the labor ward when the mother was dying, so I knew I was dying, but I wasn't afraid."

What an image! But to my child mind, oddly, it was kind of a Catholic, romantic, love story. My mother was alive and well when she telling me, so her fleeting thought was not a reality. Her reverie was a reflection on a powerful moment in her life, and it translated in my mind that we often brush death but are not taken, and life goes on. And, I remember thinking how odd that a father only comes in if his wife is dying and not if she is birthing.

This little story also reminds me to tell you one more thing. The story a storyteller tells is not necessarily the one the listener hears. Not every child would take an image of philosophical musings from the story I just told you. Another child might have heard a message about birth being dangerous, or your birth almost killed me.

As we are learning from the postings on this blog, one of the most important tasks of prenatal preparation is to consider not only our First Birth Story (stories) but, what we told ourselves about the story and birth in general as a child! The second half of this task of preparation is to inquire if that childhood assumption, belief, or promise absolutely true, relatively true, and what else is true. This changes our dialogue, our listening, and our new learning.

Can you see that if we don't begin at the beginning and hear our inner-Child's old-thinking,  in some way, what we avoid and what we "choose," and the birth plan we are making now may be a comfortable continuation of the First Birth Plan made by the Child of little understanding. When we consider the meaning we gave our First Birth Story long ago, it may give our adult, or inner Love Warrior, a chance to show up, to step up, and and to participate more fully.

Coming Soon, Change #3 in 50 Ways to Change Birth in Our Culture.

Love,
Pam

P.S.  I almost forgot to tell you the Premie in the Oven part of the Magical Story. Over fifty years ago when my sister was born prematurely(because of the previa), there was little that could be done in the hospital. My tiny, frail, ruddy-skinned sister, around two pounds, was sent home--to live or die. To keep her warm, she was swaddled and placed in a drawer on the open door of our electric oven. She was fed with an eye-dropper for a while. My mother, grandma and aunties kept constant vigil, sitting in front of the bundle in the drawer on the open oven door. A tall priest came to the house in his black robes and funny hat with the pom pom on it to give last rites. There was crying and more waiting. ... My sister lived and was as healthy as the rest of us. It is a remarkable story.

My First Birth Story

Dear Birth Peeps,

Today Virginia read me a lovely story from a woman who recalled her own birth story through her father's eyes. It was deeply touching. I thought perhaps you would like to know my First Birth Story.

One afternoon, when I was seven or eight years old, I was watching a western on a black and white television. A pregnant woman was walking slowly around the camp at night, holding her back and looking uncomfortable. She climbed into a covered wagon. It shook a little from side to side; I could hear sounds of breathing, moaning, and suddenly the cry of a newly born baby!

My eyes opened wide as I realized this pioneer woman just had a baby by herself in a covered wagon in the middle of the desert! My hero!  This woman was so brave! A feeling of awe and respect for strong women stirred within me. As I instantly embodied this brief scene in a western, I imagined myself giving birth alone and being strong.

Within minutes, my mind began to turn a new question, “How did the pioneer woman give birth without a doctor?” It seemed impossible, brave, even dangerous all of a sudden. I ran to another room where my mother was ironing to ask her how it was possible for a woman to have a baby without a doctor.

My mother, in a matter-of-fact, almost impatient manner, said, “Women have been having babies for a lot longer than doctors have been around. We’ve had babies without doctors for thousands of years. Birth is just something your body knows how to do!”

Wow! My faith was restored. My body knows how to have a baby!  I am awestruck with this news. I tell myself, "One day I will be powerful and invincible like the pioneer mother."

Within minutes my mind began to turn this piece over and a few minutes later I went back to ask my mother another question; she was ironing sheets.  “Mom, did you give birth without a doctor?” I knew she had given birth in a hospital, but did she have a doctor? Suddenly there was a gap in logic or truth between her first answer and how she may have given birth—and like children do, I found the gap and latched on to it.

My mother answered, flatly, while folding the sheet, “No. I gave birth in the hospital. A doctor delivered all of you. But I was born at home, my mother had me in an apartment. And her mother [my grandmother] had seven babies in a small upstairs apartment in Chicago.”

In an unforgettable moment, I felt oddly betrayed by my mother. In contrast to the pioneer woman and my grandmothers who were (according to my innocent child understanding) self-determined and brave, I suddenly saw my own mother as “weak.” At seven years old, where did that perception come from? I remember walking out of the room, going back to the western on television, a bit crestfallen and confused.

On that day I think two things happened:  (1) The seed for being a birth activist was planted, and (2) I made my First Birth Plan: to be "strong and brave" like the pioneer woman when I grew up and gave birth. As children do, I quickly forgot about this little initiation. Yet, it seems this moment in time must have played a part in my decision to become a midwife so I could assist women in home birth, and my decisions to have a home birth (even after a cesarean birth). 

It’s a matter of timing and luck to be exposed to a certain message at a certain time. If my First Birth Story had been a traumatic birth story instead of the pioneer mother in the western—my first, core agreement about birth would have been very different. There is no telling how my experiences as a mother or my life-work in birth would have unfolded. 

Looking forward to hearing your First Birth Stories, and the agreements and promises you made to yourself.

In-Love and On the Birth Wagon!

Pam

Change #2: Tell Children a Magical Story of Their Birth

Dear Birth Peeps,
As you are thinking about your first birth story (stories), I'll continue with a few more thoughts about how change begins with our children.

CHANGE 2:   TELL CHILDREN A MAGICAL STORY of THEIR BIRTH

My mother told us several versions of her, our, birth stories. I relished the "magical" stories about the day we were born. For my younger sister, Laura, my mother would say, "You brought the first snow... You were born in the night and when the sun came up, there was a white blanket of snow on the earth." I still think of that story and image every year on the first snow, "my sister brought the first snow."

When a child hears a story that conveys that the day they were born was the worst, most painful day of their mother's life, that their birth hurt their mother, "almost killed her," or details of unwished-for interventions that she had to suffer--what do you think the child feels?

Young children are in "magical" thinking which means they think "they" cause things to happen, that something they did causes their parents to fight, cry, get divorced, or suffer in labor. They carry this guilt and grief, and from their innocent, misguided beliefs they create a constellation of stories about their world, relationships, who they are, and about birth.

No matter what happened in labor, a child wants to know about "their" birth and that their arrival was special. So, find something that was special about the day your child was born, something you thought about, something funny that happened, or something the child did that was endearing, funny, or cute.

Imagine telling a child their birth story as a child's version, a sweet, Magical Story of the day they were born.

A Magical Story is meant for the Child. It is not a medical, factual story, it's not fantasy, and it's not a "lie." It is a unique version of the story that focuses on something special about that child's birth-day: it is a story a small child can hear, and wants to hear. As the child grows up and becomes an adult, there will be plenty of time for adult stories about birth--when they have enough life experience to understand a more complex story.

Some parents tell the Magical Birth Story on the child's birth day, a kind of birth day celebration ritual. My boys love their birth-day story. Each year, it is told a little differently. Each year the child hears it differently. Maybe as they grow up, a few more details will be added. My 19 year-old son smiled when he heard his birth story this year, and he heard something he's never "heard" before. It is still his Magical birth story.

Love,

Pam

Change #1: How We Tell Birth Stories To, or Around, Children

Hi Birth Peeps,

Over the years, you have probably heard a lot of birth stories. Perhaps you have heard so many, you almost take them for granted. When you listen to a story, you may even have the feeling you "know where this one is going" even before you hear the end of the story.  This is especially true for birth peeps, birth junkies, and birth activists who read, think, and talk about birth in our culture--all the time.

In fact, birth story telling has become very casual and impersonal. Birth stories are told everywhere and anywhere. Someone even felt compelled to tell me their birth story during a workshop break when we occupied adjacent stalls in the bathroom! Birth stories are told around children, who we think are playing and are not listening or don't understand. Children love stories, especially juicy ones; they are always listening. And it is true, they won't fully understand the story and that is where the problem begins.

I am proposing that the first way to change birth in our culture is to change how we tell children their first story, or stories, about birth. Not only the stories we tell children directly, but also to become aware of the birth stories we are telling adults within earshot of young children.

When an adult hears a birth story, they make mental pictures of it, or make sense of it, based on complex layers of life experience and adult understanding. If a hundred randomly chosen adults were to hear the same birth story (at the same time) and they were polled, I expect we would find shared agreement about what was said. Even so, based on each listener's past experiences and beliefs, there would be differences among listeners about how they felt about the story, about the mental images the story evoked, and their conclusions. 

What happens when a child hears a birth story? Try this:

1. Go back in time. Go back to a time, as a small child, when you were innocent, trusting, and had absolutely no idea or understanding about where babies came from, about doctors, hospitals, medical interventions or birth politics. Your little world was what was day-to-day; what was, was, always was, and always would be. Now picture yourself as a little girl or a little boy who knows nothing about  where babies come from. 

2. Think of the last birth story you heard or told, it could be "positive" or traumatic. 

3. As you replay the story in your mind, try to imagine hearing this story as that small child with no template for birth stories. Try to feel the feelings your "Little Child" might have, or the mental pictures you might make, and the meaning you might give the story--as that small child with little understanding.

4. Contemplate what you saw, felt or believed from a place of innocence. What assumptions or promises might you have made as a child hearing that story?

I welcome you to share your experience with this little exercise. We'll spend a few days on Change #1.

Warmly,

Pam

50 WAYS TO CHANGE BIRTH IN OUR CULTURE

Good Morning Birth Peeps,

The first "theme" of this blog will be 50 Ways to Change Birth in Our Culture. I will present one to three change-ideas per week. I'm looking forward to hearing from you. Let us know how you used the idea to promote change and what happened, or if you found the idea outrageously ludicrous and why.

Tell everyone you know about this "project." When lots of people share an idea, tipping point is reached and collective thinking and behavior shifts.

It's time for that shift within each of us, and for the next generation!
Love,

Pam

P.S.  If you were hoping for one of the other topics to be the theme, you will have your wish fulfilled during the next phase of our journey together.

Waiting for Change

Hi Birth Peeps,
So far just two votes for the year's theme.

Whether Fifty Ways to Change Birth in Our Culture or Birth as a Heroine's Journey is chosen.... we have to begin at the beginning... we have turn our attention back before the birth, even before conception and pregnancy.

Everywhere there is talk about changing the corporate medical model of birth. There is a sense of futility and frustration because the medical model is a very big Dragon, symbolically speaking. It is fed with billions of dollars and entrenched in an old system. No matter how passionately an individual swings her "sword," her truth, counter research and logic, seems pointless; she begins to believe her sword is merely a toy in the face of such a huge system.

My son, Sky, was telling me various ways social change can come about. As a society, we are passively oriented to power. We believe that the power to bring about change begins at the top and trickles down. In this mindset, we "wait" for change to come from authorities, whether that is a political or religious leader, or a medical expert. We wait for those at the top to see the light and do the right thing. We are in a sense "followers" and "waiters." We grumble down below, but do not realize our power in numbers. And so we wait.

The dominant model or belief in a culture does not necessarily need to change first from above. Change is (non-violently) forced when the majority of people say, "No mas. We don't want this anymore, We won't take part."

The system is a product of everyone's participation.

Change can come through a gradual chipping away at the foundation. We don't need to "behead the leader" or knock down doors.

But we do need to begin with understanding. Tolstoy wrote:
"To understand everything is to forgive everything."

Pam

Pam