Hospital Birth Makes My Skin Crawl

I love birth but some aspects of birth are very triggering to me, it literally makes my skin crawl.  
 
I support women’s choice to birth wherever they feel most comfortable. The woods? I’m with that. Your house? Call me, I’ll show up! Birthing center? I support it, but you won’t be hiring me. The hospital? I support that choice too! – but I, physically cannot support you there. I have nothing to offer a woman that chooses a medicalized birth. Be it a birthing center, hospital, or any other assisted setting. 

Image from YouTube

If a woman births in these locations, she is literally signing her birth over to the provider’s power and discretion. If the provider feels mom needs an episiotomy, forceps use, a cesarean, etc., she will endure this and it will be legal, even if she is screaming “NO”. She can sue, but from what I see, she will not win. How can I support a woman with zero rights, who legally, cannot support herself? I’d be happy to explain, feel free to ask. 

Image form megancrown.com

The trauma that occurs in these facilities is not worth any set dollar amount for me to endure witnessing. I’m not down with the secondary trauma involved in assisted birth. Some women are strong enough to watch this all play out, and sleep at night – I cannot.  

Here’s something many people do not know; I have never attended in support at a hospital birth. This does not mean I have not seen hospital birth. Don’t get it twisted, sistah. I am triggered in this setting – it is hard for me to watch all that a hospital birth has to offer, play out. Even in social media shared videos or photos – I won’t look, I do not want to see that. In fact, I will not step foot into a facility unless there is a case of an emergency. In this case, I would be the most fierce guard dog for mom. This has not been necessary thus far. I personally will only attend births where the mother is 100% in control of her birth and choices being made.

Image found on google

When I see assisted birth photos or videos, the items listed below are what make me cringe. I literally want to throw up when I see these things. I wasn’t always this way! Only after learning what birth could be for women, do I cringe at the sight of anything less.
 
 
The room itself, the setup, the equipment, the tubes and cords, the bed, the baby table, the hazardous waste bin, and the privacy curtain.  

The needle in mom’s arm, taped to her with cords and tubes. 

The crowd of people in the room, most being random strangers mom has never met before, and the excessive energy that will impact mom. 

The harmful constant fetal monitoring bands on moms’ belly, penetrating baby constantly.  

The unnecessary interventions being performed by the medically mined provider. 

Mom confined on her back, like a helpless victim. 

Mom’s positioning during birth and there immediately after – often, legs spread, up in the air, with a light shining right on the women’s vagina. Very degrading and disempowering. 

The provider pulling baby from the vagina or interfering manually in any unnecessary sense.  

The Placenta being pulled/tugged only an hour or less after birth as if they cannot wait for the woman’s body to release it. 

The bracelets on mom. Plastic rubbing against laboring women’s skin. 

The horrid hospital gowns, making one look like an unwell patient of illness. 

Gloved hands being the hands welcoming baby earth side. 

The immediate wiping off of the baby. 

The separation of mom and baby immediately postpartum.  

The suctioning of baby’s mouth and unnecessary handling of baby. 

The staff uniforms, from the shirt to the shoes. 

The gloves and masks worn by people present, as if it is a toxic event. 

The rough handling of baby after birth. 

The plastic bands placed on the newborn’s arms and legs after arrival. 

The ointment in baby’s eyes, interfering with physiological bonding and wiping out all good flora/bacteria. 

The band aids on baby’s legs from the injections they snuck in almost immediately postpartum. 

The unnecessary and hindering hat placed on the newborn baby. 

The hustle and bustle immediately postpartum 

The PURE lacking of autonomy and biological normality’s in labor, birth, and postpartum.  

I could go on but it is impeding my energy.  

Image from Instagram

Nothing about any of the above or the actions occurring in this setting are physiological. It starts out medicalized from the second mom walks in. Putting plastic bands on her arms, needle in her arm, monitoring bands on her belly, and whatever else they can deem necessary. Almost as if there is some sort of emergency occurring, not a biological function. 

Image from Youtube

I am not comfortable with this, and that’s okay! Many women aren’t comfortable with unassisted birth either, I’m sure. Seeing something I know is often better off untouched, being touched and turned into a medicalized event, brings me so much anxiety. I stay away from settings that can contort my view of birth, give me anxiety, or are likely to leave me with secondary trauma and stress. The medicalized birth setting is not for me, I simply am not best fit to serve in this setting. It literally makes my skin crawl. 

 
*NOTE: This is simply my perspective and feelings surrounding hospital birth. I do not need your agreement or understanding to make them valid. I also know that not all of the list above occurs in all facility birth, no need to point out the obvious. 

Image from Google

Birthing Self Confidence – How your Birth Empowers Life Going Forward

It is beautiful watching women evolve through pregnancy and child birth. It is no secret that birth is transformational, though most have no idea how significant this transformation is. Most have no idea that their birth choices, especially place of birth, can impact their entire life going forward.

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Photo of Kara-Louise Hoppo and baby, freebirthed Jan. 2nd 2019

Some women leave their birth experience feeling traumatized. Many spend their postpartum trying to heal from their experience. Some left with PTSD for the rest of their life. This can impact postpartum, causing many women to become depressed or experience postpartum depression and/or anxiety.

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Photo of Hannah Lee and baby freebirthed on May 24th 2017

After a traumatic birth, many women feel broken, as if their body failed them or is faulty compared to the average woman. When really, it was not her body that failed. Most importantly, a traumatic birth can impact the way mom and baby bond. No good!

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Photo of Anonymous with baby freebirthed on August 1st 2018

Some women, on the other hand plan their birth. They self educate on pregnancy and physiological birth process, get familiar with what to expect in birth, they may or may not hire a provider, only after diligently questioning the provider to get a sense of their view of birth. They choose a location that feels safest to them, and they manifest a positive and healthy birth.

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Photo of myself (Desirae) and my first freebirth baby June 6th 2017

They experience their empowered birth, whatever that is for the woman, a planned cesarean or freebirth and everything in between! They are then left with something a woman cannot gather elsewhere. The empowerment and invincibility a woman carries for the rest of her days, after bringing forth life in empowerment, is irreplaceable.

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Photo of Anonymous and baby freebirthed on May 9th 2019

This is one of the most beautiful things I have ever witnessed as a Birthkeeper of unassisted and physiological birth. I see timid, modest, and ambivalent women blossom into unassailable, indomitable, secure, assertive, and self confident women. Women who used to be passive or acquiescent, transform into assertive, tenacious beings. Unafraid to stand ground and speak their own truth!

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Photo of Danielle Snelling and baby on August 11th 2015

I see women who previously did not see their worth go on to gain security in their own self and hold themselves on higher ground. These women transform into invincible powerhouses that will carry on through out the rest of their life. They are empowered – this is what empowerment is!

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Photo of Treva Ansbach and baby freebirthed on December 16th 2018

Birth is such a crucial experience, knowing what to expect and making educated choices for your birth is important! Your confidence and knowledge surrounding birth plays a huge roll on outcome.

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Photo of Jordan Cloyd and baby born April 3rd 2019

You do not want to be in labor, uneducated, just doing as instructed by a medical provider. That is how you end up with a traumatic experience. Be informed, know what to expect, choose your birth location and birth team with vigilance and diligence.

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Photo of Gloria and identical babies, freebirthed on March 9th 2019

What you choose absolutely will impact the rest of your life, set yourself up for success! As Ina May states, “Wherever and however you give birth, your experience will impact your emotions, your mind, your body, and your spirit for the rest of your life.”

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Photo of myself after my second freebirth on June 15th 2019

All women pictured I know personally and found empowerment in their birthing experience. Many of the births I was present for or showed up there after and I can tell you first hand, transformation was apparent, even in the moments immediately postpartum. These women are empowered for life, and you can be too!

Find out how you can empower yourself and other women to achieve this happiness and empowerment by visiting our freebirth course. And if you’d like to help other mothers achieve this empowerment, don’t forget to have a look at our birthkeeper course.
Be the change in birth, help women find this place of bliss and life time fulfillment of empowerment. Supporting women as they go through the journey and transformation of pregnancy and birth!
Join us – you won’t regret it!

Questions To Ask A Potential Midwife

Recently I have seen a rise in people claiming to be a home-birth midwife that are not trained or equipped to provide the services they offer – all across the US. This has resulted in multiple fetal deaths, maternal deaths/harm, and unnecessary birth trauma. These ‘midwives’ are something to shy away from – here is how you can avoid them for your own birth.

Midwives are not interchangeable; no two are the same. Most serve with a heart of true passion and care; some serve solely with a wallet to fill or ego to boost. Some will walk with women throughout their entire journey, and some will bail on them for various reasons. Some midwives undergo years of training/attending/learning/practicing. Some claim to be a midwife but has nowhere near enough training to do so. It is crucial to interview properly to make sure your midwife is a good fit for you. Don’t hire a woman who will be ‘a deer in the head lights’ when you or your baby needs assistance.

Keep in mind, a licensed midwife does NOT mean a well-trained and educated one. More often than not, it only limits how they can serve you. In my experience, it is the licensed midwives who can be fear ridden, as taught in their medicalized schooling – not all though! Again, none are the same. It should never be a degree or license you are looking for. You want one who is there to serve YOU, not serving the state or medicalized model of birth.

Here are a few questions that would be great to ask a possible Midwife. Be sure she has answers, if you have questions that go unanswered – you should not take this lightly. She should not be hired. Never ‘settle’ on a Midwife.

  1. What training have you had? Schools, degrees, certificates, preceptorships, internships, etc.?
    (You can look up their schooling history, degree, and certificates online. Do not take anything for face value. Do your research before signing a contract. Again, some midwives do lie about qualifications. If they attended internships/preceptorships, ask to reach out to their preceptors. Some are fired or let go before completion and choose not to disclose this information. You may want to know why.)
  2. Are you trained/certified in neonatal resuscitation? (You can ask to see their NRP certification card as proof. Yes, many birth workers do lie about their trainings!)
  3. How many times have you had to resuscitate in your career?
  4. How many births have you attended?
  5. Where can I find reviews for your services? (You want to be sure you hire someone who is backed by past clients. If she does not have reviews, this could be a red flag)
  6. How long have you been attending births as a primary midwife? (This asks how long they have been attending on their own, without a preceptor – someone guiding them)
  7. How many births do you attend per month?
  8. Do you have a backup midwife? Will I meet her? (Every midwife should have a backup. You should ask to meet this backup prior to labor if you do not want a stranger possibly walking into your home on birthing day)
  9. Do you have an assistant or will you be attending alone? (Some bring an assistant and some charge more for the assistant)
  10. How many times have you had to transfer during labor? (A midwife’s transfer rate says a great deal about her ability to serve women)
  11. Do you stay with mom once she is transferred? (Many midwives will transfer mom to the hospital then leave once she is admitted. This likely isn’t something you want, be sure it will not occur)
  12. How many times have you had to transfer mom/baby postpartum?
  13. Will you attend twin, breech, and VBAC births? Why or why not?
  14. What complications and emergencies have you seen and how were they handled? (i.e. prematurity, prolonged labor, fetal distress, breech, bleeding, dystocia)
  15. What circumstances/conditions would rule out your attendance? (In many states, especially with licensed midwives, they are required to drop you from their care for many unnecessary reasons. Do not get to 37 weeks and find out she is dropping you because your baby chooses to present breech. If she is not competent, or holds her license above your births wellbeing – she might be a MEDwife and might leave you hanging with no care or reimbursement.)
  16. Can you list each scenario that could possibly risk me out of your care?(Know ahead of time EVERY reason you could be released from her care. Depending on state, the midwife’s knowledge, her licensing, and her competence, there are many reasons they can drop you from care. Things that are not in your control Be aware of EVERY possibility before signing a contract)
  17. What complications/emergencies are you prepared to handle?
  18. Under what circumstances do you transfer to a hospital? (Some midwives are known to transfer women for silly reasons that are not science based. Be sure your midwife will not bail on you when you are vulnerable.)
  19. What percentage/exactly how many clients have had cesareans in your practice?
  20. Will you accompany us through a hospital birth if one was necessary?
  21. Do you offer prenatal care? What is your schedule for visits?
  22. What is included in prenatal care? (i.e. lab work, urine checks, blood pressure, fetal heart tones, fundal measurement, baby’s positioning, & vaginal exams & PAP)
  23. What type of nutrition counseling do you provide?
  24. Do you visit the home at any time before the birth?
  25. Am I required to complete any kind of testing? (Some Midwives require specific testings or they will drop you from care. This is not autonomy and likely not something you want to sign up for. You should have complete control and say over your prenatal care)
  26. Am I required to attend a certain amount of prenatal appointments?
  27. What happens if I refuse appointments, procedures, or suggested medications? (If they have an issue with your having say over your pregnancy and refusing XYZ, run the other way)
  28. When do you like to be called once labor has begun?
  29. When do you come to the home once labor has begun?
  30. What equipment do you bring and what must we provide? (You can tell a great deal about a midwife and the care she supplies by what she carries in her bag. Does she carry herbs and tinctures or does she simply carry Pitocin and oxygen. Know what she will be showing up with! Know what you are comfortable with being used.)
  31. What emergency equipment do you provide?
  32. How do you view the father’s role?
  33. What is your role during labor? birth?
  34. How do you feel about sibling participation in birth?
  35. What non-drug measures do you suggest for pain relief?
  36. How often do you listen to the baby’s heart rate during labor?
  37. How often do you check the mother’s blood pressure?
  38. Do you require vaginal checks at all, ever? (Vaginal checks can be harmful and mean nothing in regards to progression during labor. If she requires vaginal checks, she might not be a good fit. That would be a red flag that she does not support autonomy.)
  39. What is considered fetal distress in your opinion?
  40. What do you consider prolonged labor/birth pushing?
  41. Do you have preferences for labor/ birth positions? (This answer should always be “It’s the mother’s choice”. If she requires you to lay in a certain position, this is a concern.)
  42. How do you feel about water-birth? Have you attended any?
  43. What measures do you take to prevent tearing?
  44. Will you allow partner to “catch the baby” instead of you?
  45. Do you check for tears after delivery?
  46. Do you have local anesthetic & suturing equipment for this repair to be done without going to the hospital? Do you suture all tears or only major?
  47. How do you prevent/treat excessive postpartum bleeding?
  48. How do you handle the baby immediately after birth?
  49. How long do you stay after the birth? What do you check at this time?
  50. What is your schedule for follow-up care?
  51. Do you do the newborn screening tests?
  52. What are your thoughts regarding circumcision?
  53. How is the filing of the birth certificate handled?
  54. Do you routinely give me a copy of all my records after the birth?
  55. How much do you charge for your services?
  56. What services are not included in this fee?
  57. Do insurance plans cover your fee? Do you accept direct payment?
  58. When do you want the full fee paid?
  59. Are there any refunds if I risk out of care? (I see it occur so often that a mom “risks out” of care and mom is left with no midwife and no refund. 7K+ down the drain at no fault of her own, and no home birth to show for it. Know about her refund policy and make sure you agree before signing!)

Final Thoughts

Determine the midwife’s willingness to be open to communicate, explain things that you don’t understand, and willingness to let you make your own decisions. If she is unable to answer all questions without hesitation, be wary.

Be sure to reach out to your local birth community and ask around. Some providers will present themselves to be something they are not. Their abilities will reflect in their past client’s experiences. Read all reviews, ask questions.

Hiring a midwife is not a simple choice, this plays a HUGE role on birth outcome. Knowing the difference between a CNM, CPM, and traditional midwife is also helpful in making a midwife selection. Again, Midwives are not interchangeable – none are the same. Do not settle, find one that is a perfect fit for you!!

Why I will not Attend a Hospital Birth as a Birthkeeper

One of my largest biases when it comes to birth is location.
I am very biased on where a woman delivers her child – so much so, I refuse to attend births in a facility setting. I have no problem admitting this and speaking on why.

I’m sure many of the main stream birth providers will be angry about this as many are trained to accept and assist all walks of life, and that’s okay!

I personally choose to acknowledge and respect my biases in respect for the women I serve and for myself. Bias is something I previously spoke on if you are interested in learning more about it.

I (Desirae) am personally really not about hospital birth. I’ve had 2 myself and I am aware of what they have to offer. I know that once you get there, you put your birth into someone else’s hands, and with this, I do not agree.
This is not empowering.
This is not biological.
This is a disservice.

Why Do I Stay Away from Hospital Births?

You could have a perfect hospital birth that goes just the way you want! Sure, I’ve seen it! The issue with that is you won’t know for sure until delivery day. Your provider might respect you but then again, they might not. They might feel like an episiotomy is needed (when it is not), and that will be happening no matter what you say because they write it off as “medically necessary.” Say “NO” all you want, it doesn’t always stop them. I’ve seen this happen as well.

You can press charges, but good luck with that…

I’m not about secondary trauma either, I’ll pass. You literally couldn’t pay me to watch a woman endure the abuse that occurs during many hospital births. I will not stand next to a woman while a doctor reaches in to check her cervix when she is begging them to please not. I do not care to experience a woman being told “You must get the epidural or we will simply take you back for a cesarean”.

What a disruption to her birth energy! No thank you. That is NOT what I’m about to wake up for at 2 AM to go witness. I’d rather sleep. “Why is she there in the first place?”, is all that comes to mind.

When a law suit is drawn up over the abusive malpractice, I’d be dragged into it. Again, no thank you. I already know how those outcomes go.

I am not about trying to negotiate with a medically minded provider over their poor choices. It’s a waste of time trying to speak to someone with a “God complex” that feels they are most knowledgeable, I’ve done it. Their main goal (for most) is “keep my license” not, “follow mama’s birth plan”. Birth plans are nothing shy of a request during a hospital birth. Keeping licensure will always trump a mothers desires.

I do not attend births as a means of living. I do this on the side to assist women who feel empowered and trust in their body and baby. I only assist those who see birth for the spiritual and natural process that it is. I’m not about defending a birthing mother who does not trust her body enough to stay home. If she has fear, that means she has more research to do. Research is the answer. Not a hospital birth.

I always mention how insane it is that low risk women flock to hospitals to birth their young. Going to a place of emergency for a natural bodily function? Where’s the sense in that? Should I be showing up at a hospital so I can take a poop? I mean, I might get a hemorrhoid or get a tear in my anus. I should go there just to “be safe”, right?

I have no desire to support someone who doesn’t trust in their body’s ability. If you have fear, you need more knowledge, not more unnecessary assistance.

There are birth attendants and doulas that will attend those medically minded hospital births. There are many women who will attend hospital births and don’t mind watching the activity that occurs there.

I am not one.

I Love Home Birth

There is definitely a provider for everyone and I feel that is glorious! As for me, I support the small crowd of women who are empowered and see home birth as the only logical option.

Sometimes there are complications in the birth process, I get that, but let’s get back to the numbers… less than 5%. I feel hospital births happen out of fear. Fear from the birthing woman or her partner. It could also be because that is what the birthing mama was conditioned to believe was necessary!

Fear has no place in a soon-to-be mama’s heart. If she has fear, that is ok and normal by all means! She just needs more research. Not a hospital birth.

Hospitals have zero place in low risk births. If mama can’t trust herself at home, I can not assist her. & that’s ok! Ask someone else.

*I will also note that in the case of emergency, I would transfer with my clients. I will never put my desires above her emergency needs. I do know when to pull the plug and have zero problem doing so. I would go into that facility and defend her like a guard dog, as if my life depended on it. I’d literally push a medical doctor out of the way and run into the hall demanding a new one if mama and I did not agree with their practice. My passion runs deep. My past experiences would be set aside for her. In a true emergency, a hospital birth is the best bet. It can save lives, I will not deny. I’m simply saying that if a low risk mama doesn’t trust her body and baby enough, or realizing the safest place for a healthy birth is at home, I can not assist her; I am not the best fit.

-Desirae

Supine Hypotensive Syndrome: An Epidural Blackout

Imagine the horror as you welcome an epidural, relief, into your body after a long stretch of contractions (and having to hold a specific position for several minutes while the anesthesiologist placed a needle the size of your face into your spine), only to instantly start blacking out while you hear rapid, loud beeping in the background. The nurses faces start to get fuzzy and you notice your breathing getting slow and short, but you cannot seem to force your body to take a deep breath to help your oxygen flow…

This horror is not an allergic reaction.
This is not a labor complication.
Your body is not broken.

This is Supine Hypotensive Syndrome.

What is Supine Hypotensive Syndrome?

SHS is defined as a sudden drop of blood pressure in a pregnant woman when she lies on her back, due to Caval Compression (compression of the abdominal aorta – the main artery in the abdominal cavity – and the inferior vena cava.)

The only cure to this is to GET OFF YOUR BACK and GET INTO A DIFFERENT POSITION!

Have you experienced dizziness, nausea, shortness of breath, even fainting/unconsciousness when you lay on your back while pregnant? Has a doctor ever talked to you about why?

Position Matters!

Have you ever been told your body isn’t capable of birth?
What if it wasn’t your body, but instead your epidural restricting you to only laying on your back?
Or, what if it was the need to be monitored in the bed, on your back, every 20 minutes?
Did you push for a certain amount of time, only to become absolutely exhausted because it was so hard to breathe?
Did you/your baby’s heart rate drop so rapidly after the epidural that your birth resulted in a cesarean?
ALL of these ‘complications‘, and many others, could have simply been fixed by allowing you to move and change positions.

It’s infuriating to think that, isn’t it? I get it, because I have been there.

Final Thoughts

Doctors don’t talk about this, they likely don’t even know about it actually because their textbooks won’t tell them this, but I will. Even if they did know, would they say anything? Would they make the effort to roll you onto your side or encourage you to move around, if they knew it could allow you to have a birth that didn’t leave you with trauma? Or is it prime and optimal to have you lying on your back in stirrups for their convenience? They are well-trained surgeons so whats another cesarean to them?

And yes, YOU CAN move into a different position with an epidural. Ask for the lowest dose possible, and ask exactly what medication they are using for your epidural. Are you comfortable with Fentanyl, for example? A WALKING epidural can allow for much more movement, and quicker leg function and healing post-birth, too.

Have your support team help you get onto your hands and knees. You may put a ball or a stack of pillows in front of a bed placed in seated position, face the back portion of the bed, hold the ball or stack of pillows and rest comfortably on that, while still allowing gravity to do its job on your pelvis. Using a peanut ball in between your legs as you lay on your side can be optimal as well, as it keeps your pelvis open and ready for baby.

Take control of your birth with education, one step at a time!

The Science Behind Constant Electronic Fetal Monitoring

Did you have those two straps put on your belly when you were in labor? One monitoring contractions and the other monitoring fetal tone? Or, maybe you had an NST (Non Stress Test) done to “make sure everything was okay”? Did you know that these constant monitoring systems are not necessary? Were you aware that they are actually showing to be harmful in low risk pregnancies?

Let’s talk about it!

What is Electronic Fetal Monitoring?

Electronic Fetal Monitoring is an ultrasonic machine monitoring baby’s heart rate while a pressure sensor is monitoring mom’s contractions. The fetal monitoring creates a baseline and records how it changes with a contraction. The maternal monitoring tracks the duration and frequency of mom’s contractions. There are other variations of EFM (Electronic Fetal Monitoring), but we will stick to these two for today as they are most common. It became a ‘thing’ in hospitals in the 1970’s, without ever really being proven safe. It has been used ever since, in about 90% of births held in facilities! They have even gone as far as creating monitors that are wireless and waterproof so you can wear them in the shower. Let’s also note that these new updated monitors have very little research completed on them. A technological breakthrough or a disservice to a physiological function?

Studies completed show the slew of complications associated with constant EFM. Increased chances of cesarean, vacuum, and/or forceps delivery are a few of the interventions connected with continuous EFM use. And unfortunately, all these interventions carry a risk of serious birth injuries.

When it comes to the impact of EFM, statistics show us that cesarean rates in the US went from 5% to 32% from 1970 (when EFM began)-2016. And, coincidentally, “non-reassuring fetal heart tones” are the second most common reason for first-time cesareans in the U.S. – you don’t say?![R]

NST testing is also a form of constant EFM. They are called Non-Stress Tests because “it doesn’t inflict stress on the fetus”, even though this claim has not been proven. There is not a scenario where an NST would be the best option, in my opinion. If there were concerns of decreased fetal movement or fetal distress, an ultrasound would give a more accurate conclusion than that of an NST, especially if the possible issue would be related to oxygen/placenta/cord complication. Of course, that is merely my opinion. More on NST another day![R]

What are the Complications of EFM?

In 2009 the U.S. Preventive Services Task Force released a suggestion stating that “Low-risk women should not be candidates for continuous EFM. It does not improve long-term outcomes, and it increases operative deliveries”. Again, this began in the 1970’s with zero research or studies completed. Women were not informed that they were literal guinea pigs, trying something with zero safety studies. To this day, evidence on our updated technologies are not proven safe for the baby during labor.[R]

Why are we going this route? Especially when we have options of intermittent monitoring, such as fetal doppler and fetal stethoscope use!? There has only been one study completed thus far, as far as I am aware, comparing EFM use during labor to intermittent monitoring using a doppler or fetal stethoscope. The outcome was insane! The EFM group of constant monitoring detected 54% more abnormal fetal tones than either of the other methods. As a result, 28% more of those in the EFM group were subjected to a cesarean than in the intermittent monitoring group. The system is over active and creates more fear and concern than is necessary.[R]

Also, when evaluating an article from The Journal of Perinatal Education, I found “The indiscriminate use of EFM in the labor room is not improving outcomes, and is actually causing harm to healthy women with uncomplicated pregnancies. Employing a low-tech, high-touch approach needs to be the main philosophy while providing nursing care to most laboring women.”[R]

So, why is EFM Pushed So Hard?

Why is EFM used in facilities without being proven safe? Here are 7 reasons why:

  1. Liability
  2. Lack of resources
  3. Time
  4. Marketing
  5. Training
  6. Nurses views on monitoring
  7. Lack of leadership from professional organizations
    These are elaborated in great detail through Evidence Based Birth.

What is quite eye opening in my opinion, is that in other countries such as Canada or the UK (where health insurance is not a thing), they do not suggest constant electronic fetal monitoring for low risk women. This leads me to believe that revenue may be a factor in the equation.

Final Thoughts

How does constant fetal monitoring make you feel? Do you feel safe using these “tools” during labor? Does the idea of being strapped with bands on your contracting abdomen during labor sound like a brilliant idea to you? Especially when it has never been proven to improve the outcome, but likely worsen outcome in many cases. I don’t know about you, but I don’t want anyone touching me in labor. I do not even want any clothes touching me, let alone tight bands strapped around my belly that is contracting every few minutes.

Please research this topic in depth before consenting to its use, be sure your choice is fully informed. If you would like to learn more, I would suggest checking out the links below. The link to Evidence Based Birth sharing on EFM covers the topic in great detail, I’d start there. The last link is loaded with many studies on EFM as well. Make your own educated choice! There are a couple of other really good articles linked below.

Electronic Fetal Monitoring: The Risks – Birth Injury Guide
Fetal Monitoring: Creating a Culture of Safety with Informed Choice – NCBI

How To Have A Gentle C-Section

When you picture a cesarean, what words come to mind first?

Cold. Quiet. Bright. Scary. Scrubs. Scalpel. Shaky. Drugged Up. Curtain. No Skin to Skin. Sore. Inactive. 

But wait! Ending up with a C-Section, whether by emergency or by choice, does not mean that you have to miss out on being an active participant in your birth!

What is a Gentle C-Section?

While a gentle cesarean is not going to do much to change the postpartum recovery, it is still a major surgery, it can reduce the trauma or disappointment you may experience, if a c-section was not in your expected birth plan. And even if it was, how neat is it to have a more active and informed surgery, right?!

A gentle cesarean is something that should absolutely be discussed with your provider prior to you going into labor, whether you are planning to deliver at home or planning a scheduled c-section, everyone needs to be on board and knowledgable about your intentions in the event of a cesarean happening! OB/GYNs that do not routinely do cesareans need to be informed on their role during the cesarean and what things will be different, which will not be much on their part honestly – just a little extra time and flexibility. If you have a doula, she can aide you in advocating for your gentle cesarean, as you will be numb, but if not make sure your partner or support person is fully informed on what exactly it is that you are aiming for.

What Makes a Gentle C-Section Different?

First things first, you will still be prepped like every cesarean mama would be; you will need to sanitize your body to prevent your opening from becoming infected, and everyone coming into the room will be scrubbed up from head to toe to keep germs to a minimum. You will be given a form of pain medication in your spine to numb you; your best bet is to ask for a spinal block instead of the epidural or general anesthesia. This will be a shorter lived pain medication (about two hours) that will get you well through the surgery, but not linger as long as the epidural and generally does not have as many side effects.

Insist on a small, low transverse scar that is to be double sutured. If this is a repeat c-section, make sure they remove built up scar tissue before suturing, so you are less likely to experience placenta accreta on your scar tissue in future pregnancies. This will increase your likelihood of a successful VBAC, if that is potentially a future desire of yours. Babies can squeeze out of a hole the size of a bagel, trust me, they do not need to cut you from hip to hip.

Leave the shawl down or ask for a transparent sheet to go in between you and the OB/GYN operating, so that you can see everything happening! Ask the OB/GYN or a nurse to talk you through the procedure and everything that is going on to help keep you fully engaged in your baby’s entrance.

Music may play during the birth to encourage a loving and soft environment. If possible, you can request that the temperature be warmed and the lights reduced just for a few minutes as baby emerges. Of course, when the OB/GYN is opening and stitching you back up, you will want them to have full visual. Have monitors turned silent and away from your face so you can be relaxed and at peace.

Allow baby’s head to be pulled to the top of the opening and turned towards you, to emerge slowly and gently. If possible, you or your partner can do this part, and still deliver your own baby! They can still do the breast crawl this way or just be pulled up to your chest for skin to skin. Delayed cord clamping should absolutely still be an option and you can almost always keep your placenta. They should allow the placenta a few moments to attempt to detach naturally, before pulling or manually removing, and it should be removed gently as to not cause any damage to your uterus.

Simply have them place the placenta in a bowl or container next to your bed for delayed cord clamping and keeping the placenta. It should not be allowed to go to pathology, except for a small sliver, if they absolutely must test.

Baby should remain skin to skin with you or your partner while you are stitched back up. After they stitch you, be sure to ask for them to swab your vagina for vaginal seeding, this provides baby with probiotics and healthy culture from your vagina that they would normally get passing through the birth canal. Baby should not be washed, especially with soap! Rub their vernix and any other fluids into their skin.

If baby must be separated from you for any reason, have someone else provide skin to skin, or at minimum stay with them, especially if you are declining vaccinations, or eye ointment.

Check out this video as an example of a gentle cesarean:

 

 

The Birth Story Criticized Around The World

Recently, photos of Megan have filled the social media world, especially from free birth skeptics and doula groups that do not approve of a doula stepping out of scope to fully support all women. But did we really get the full story from a blog post that absolutely trashes any birth that occurs outside of the hospital? Did you know that the source from that article is a midwife that is well-known in the community for being completely medically minded and doesn’t actually follow the midwifery model of care, at all? The midwife is known for harassing local mom support groups that advocate for natural, home and VBAC births.

Well, we are here to shed a little light on Megan: a mother, a doula, a friend.
NOT a murderer.

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By supporting anti-home birth, anti-midwife, anti-natural lifestyle bloggers, we do a massive disservice to our community, so seriously, stop sharing it. Take the story and do with it as you will, you may still feel she was in the wrong, but at least her perspective was placed out there and we are happy to be the platform to do so.

Here is the story, straight from the source.

“I was recommended to the couple by our chiropractor. They wanted a home birth and so we began our doula appointments with that in mind. I gave them every home birth resource I had and they interviewed a few midwives. It was soon after that the mother confided in me that her husband had been beating her throughout their marriage, even landing her in the hospital during the pregnancy. However, this had apparently stopped since we began meeting. I asked her several times to find a safe place to go, if not for her, for her baby’s sake. She said she felt preparing for the birth was changing him and she felt safe. So we proceeded. 

As we began entering her due month, no midwife had yet been found. I asked what their plans were. They said they didn’t know, but there was no way they were going to the hospital. I reminded them that I was not a replacement for a midwife and I thought about recusing myself as their doula. I thought about it heavily. However, the abuse was deeply concerning and them being completely alone during the birth of their child seemed reckless. So I remained their doula.” 

A doula, after all, is not a medical professional, but a support person, and the parents knew this, it was absolutely a decision they made on their part to not find a midwife, but to proceed with an unassisted birth with a doula.

“I confided in a doula group. At the time, I was a member, I needed their prayers and their support. I kept quiet that they did not have a midwife, since this area is very political about birth and there is one particular hospital midwife who is known for terrorizing mothers. But I digress… 

The day came when the mother began having contractions. She seemed fine, but was throwing off signs of transition right away. I went over to see her to try and figure out what was going on. It was early labor. She was concerned about finishing laundry (this was at her aunts as she did not have a washer/dryer at her house) before she could have her baby. I wondered if this could be an emotional block to labor, so I helped her finish laundry. We arrived back at her home and contractions became steadier, confirming my theory. 

The first two days went by. I went home a few times to rest. She still felt good and contractions had not become strenuous, seeming that she was having prodromal labor. I returned the second day and as soon as I arrived, her contractions began getting harder and more intense. She felt that baby was in a posterior position so we practiced some spinning babies techniques and even filled up the birth pool to relieve pain” 

To be clear, posterior is not a dangerous position. It is simply a variation of normal.

“The next day was steady, but by the afternoon, she was tired and he was frustrated. We finally got her comfortable enough to nap. I left for a little snooze myself and was gone for only a few hours. I was on my way back when she called me, hysterical. Her husband had tried to rape her in the middle of this bout of labor and now refused to help at all since she wouldn’t have sex with him. Her contractions became much harder as a result and she began losing faith. I sent him to the store for groceries (we kept her eating through all of this to keep her nourished). I asked her very seriously if she needed to go to the hospital. Her husbands behavior was not okay and not justifiable in any way and that she would be safe from this happening again there. She gave me the same answer as she had before.. she felt safe because I was there and did not want to go to the hospital.” 

This is so common in domestic violence victims, they do not want to get their partner’s in trouble, because they are scared for staff to find out, then to be alone or have a negative interaction with CPS, and more. And narcissists typically act well and presentable in front of others that they are not currently abusing, so it absolutely makes sense that he would act fine in front of Megan and the woman to actually be safe around Megan, otherwise, both the sweet newborn AND mama could be dead, so why should Megan have abandoned the family because they refused to transfer? And calling the police can actually be even more dangerous to everyone involved, because some abusers will go as extreme as holding those in the home hostage and abuse or even kill them before the police can get a warrant to break in and help.

“I had no idea what to do. I prayed with all my might that her baby would be born soon I stayed over that night because there was no way I was leaving her. The event had left her unwilling to do anything. She finally ate after I told her otherwise we HAD to go to the hospital because I was concerned with her paleness. Her contractions lightened and she felt she could maybe sleep. I rubbed her sacrum and had the inspiration to press and push upward right above her sacrum. As I did so, I actually felt the baby turn right under my palms. Suddenly, she felt better, contractions were manageable and she threw up. She felt she could definitely sleep now. I too, went for a nap, laid down for about half an hour when her water broke! She was happy, alert and could feel her babys head in the birth canal.

As she tried relaxing between contractions, her husbands stubble irritated her, so I took his position behind her in the pool, supporting her. He would watch for the baby. She began pushing, and in about half an hour, pushed her baby right out! Sure enough, baby was all wrapped in her cord, around her belly and shoulders. We quickly got the cord unwrapped and put her to mamas chest. She cried well, was the most beautiful shade of pink and eventually opened her eyes and looked around at everyone. She was perfect, they named her Junia. 

I stayed, helped her to bed, shortly after she delivered her placenta. Junia nursed and seemed to be doing very well. I was helping clean up and about four hours after birth, I was ready to leave and just checking in on everyone and everything.” 

I read many critical comments about WHY was she there so long. Honestly, it is not uncommon for doulas to stay hours after birth. In my business I stay at least two to three hours following a birth, whether in the hospital or unassisted. When I am a midwifes assistant and cleaning and sterilizing everything, I am easily there three to five hours following birth. If you do not, good for you, but you should not be judging why she was.

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“As I peeked at Junia, I noticed that Junias nail beds were a little purple. She was still alert and pink, so I had them cover her up more and asked if they had a baby thermometer. They didn’t, so I asked the husband to get one from Walgreens. While he was gone, her color began to change. She began to get sleepy, which I knew was normal for newborns, but this did not seem right. She was ashy, her nails were still purple. I asked mom to lay her down. The first thing I could think to do was check her heart rate. I set my ear to her chest and her heart rate was slower than an adults and as I looked at her, she seemed to fall asleep. I tried rubbing her back to rouse her. Nothing worked. I asked the mom if she knew infant CPR, she did not, so I started CPR. Right then, the husband returned and I told him to call 911. Mucus started coming out during compressions and I did use a bulb syringe in attempt to get it out. All I could think was to keep her alive until emergency services got there. 

The paramedics got there quickly and I told them what I had been doing. They looked for a heart rate and could not find one. When the cops arrived they asked if I was a midwife and I declined. When they inquired where the midwife was, I panicked because I did not want the parents to get in trouble and advised she had left. Later on, I did tell Detective Sowards when he interviewed me and he assured me I did the right thing by telling the truth, now. 

The next part is a massive blur for me, except I remember calling my mom and praying to God to give the hospital staff the ability to bring her back to life. I got to the hospital where they attempted to revive her for 40 minutes. At 12:01am they called the time of death. Her parents and I just stood in shock for what seemed like the longest time. Eventually they asked to be alone and I told them I would check on them tomorrow. My mom had come to the hospital and I just crumpled into a ball of tears. 

Over the next few months, I helped her recover, look for someone to donate her milk to, held her while she cried, attended the funeral, and be as much of a support as I could. Her MIL and husband tried to have her committed for not healing fast enough, aka cleaning and cooking already, at just two weeks postpartum. I have texts from the mother and I that discussed things like how angry she was with me for making them take her baby to the hospital when she could have passed peacefully on her mamas chest, instead of being injected, shocked and monitored in a cold ER, or the fact that she never got to touch her baby again after I started CPR, and in a way, I stole those last touches from her. 

I couldn’t bear birth work anymore and went into a deep depression. Her family blamed me, the doula group blamed me. The local midwife I mentioned blamed me and began a smear campaign against me, saying I kill babies and am so anti-medicine that I ‘wouldn’t let them call 911.’ I even blamed me for a long time. I felt like I was cursed. I had committed to one other birth six months after and I didn’t know how I was going to get through it. 

It was about this time that former clients got wind of the rumors and asked me what happened. I was open with them. It was amazing. They all rallied around me, telling me what a difference I had made in their lives and could not quit. Then it came.. I got a call from Junias mom. She told me I should not blame myself and hoped I would become a midwife so they could have a safer birth next time. I thanked her and said I would think about it. I never really wanted to be a midwife. 

The birth of my last client came. It was quick. They were from my church and so we spent a good portion of her labor in prayer. I was grateful.. it gave me peace. She gave birth quickly to a baby girl. I cried. I felt like Junia all over again, but she was healthy, thank God. I came to check on them the next day and the mom gushed that, thanks to me, it was her best birth ever (this was #9 for her) and I should become a midwife. I cried again. 

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In March, I found out I was expecting again. The flashbacks, anxiety, stress, I did not take it well. My body has not done well and I truly feared bringing Junias birth with me into my own birth. Its a part of who I am now. Im trying very hard not to let it haunt my steps. 

I came to this area four years ago, only seeking to give women the same blessings I have been gifted with and I still believe the heart of the birth world here is good. But this particular group have been in search of control and power for years before I ever arrived. Now this has happened and its become an excuse for them to make an example of me. For a long time, I proceeded according to what I know to be right, which does not always fall in line with what they feel is proper. But I feel that to violate my moral code would be the worst infraction of all and I could never bring myself to, even at the risk of my livelihood.”

In the autopsy, the Chief Medical Examiner, Mr. Gustafon, whom came to interview Megan after he had done an autopsy stressed that the cause of death he found was unofficial but that her lungs looked like she had had severe pneumonia for at least two weeks, which was impossible at merely 6 hours old. His theory was that, the stress mama endured from abuse in the pregnancy, caused a release of meconium during pregnancy, that was somehow consumed and/or aspirated most of it by the time of delivery, which resulted in mamas waters being mostly clear, which allowed for an infection to grow turning into full blown pneumonia once exposed to oxygen. The catalyst would have been her first breath, which is why she did not have immediate respiratory issues. He guessed that a hospital may not have even known until it was too late or been able to save her, had she been born there.

In question of her status as a doula, she went through DONA training, and chose not to certify through them due to not aligning with their values and was complete with her training with Bradley Method, but was still in provisional stage of completion, not fully affiliated, which she was chastised for, which is absurd. As you can see, the provisional affiliation expired in 2015, while the second educator card did not expire until just last month, January 2019.

 

The parents struggled with finding a midwife because they were very conservatively Christian and many of the local midwives are Pagan/Wiccan.

In questions about the charges and why she was found guilty, “the six charges pressed against me, were about practicing medicine and not placing me at fault with the death, as so many have inferred. I pled guilty to the count citing the use of the bulb syringe because of the uncertainty and cost of the trial, unwilling to cause the parents to be subpoenaed as witnesses and because honestly, I felt it was fair and if using a bulb syringe on a baby is practicing medicine, then technically, I was guilty. I am not sorry that I tried to save her life, but I do feel that if I broke the law, I will not do anything to hide from it. I have been very upfront about what I have done wrong and on those accounts, I am sorry.”

Since, Megan and the mother of Junia have both gone on to have healthy babies.

 

 

We wanted to make this article because there are ALWAYS several sides to the story. We wanted to show that the charges did not stem from the parents blaming her, but an angry local midwife that simply does not see eye to eye with most doulas in the community, and takes it out on them whenever she gets an opportunity to do so.

Things could have absolutely been different, had the mother not been abused by a toxic male, point blank!!! So why do we not chastise domestic violence in the articles that bash Megan so harshly?

Domestic violence is the NUMBER ONE killer of pregnant women! Not car accidents, not a specific pregnancy complication, but their very own partner. It impacts women from every country, all around the world. Several studies done by WHO show that several countries fall into an average of 1 in 4-6 women are being abused during pregnancy, and in general. Not only does domestic violence increase the risk of fetal and maternal death, but increases the rate of IUGR, preterm labor, hemorrhage, miscarriage and postpartum depression/anxiety. Pregnant women who experience domestic violence have a 37% higher chance of complications in pregnancy. These are women who have hospital births, home births, unassisted births, NOT JUST UNASSISTED BIRTHS.

Domestic violence is on no part the doulas fault, and the doula did what is in her scope to do as far as support, she supported the moms autonomy and choices and did not force her to do anything, nor give medical advice by diagnosing or attempting to prevent any specific complication, because that is NOT her role. Megan provided many resources to the mom to reach out, but unfortunately, many Christian families are falsely taught that you must obey your husband, which to some, means ANY and EVERY thing, which is so toxic. I have even witnessed in some churches that they chastise a mother for being a single mom due to leaving a toxic situation because divorce and disobedience is frowned upon in their church. I do not believe all Christians are this way, absolutely not, but it is something that needs to be more openly discussed.

It may even be that the husband demanded an unassisted birth, simply because he did not want to return to the hospital that he sent the mother to in her pregnancy and threatened the mother with HARM had she chosen to go to the hospital.

Bottom line, it is not classy to tear apart a fellow birth worker, especially applauding and referencing the same type of people for criticizing her, that we would otherwise never in a million years agree with.

If you are wondering as a birth worker, how to avoid finding yourself in this situation, you COULD avoid unassisted births, but then there are still women who are having unassisted births that need support, too. Simply, it is best to never use a syringe on baby, the parents can do that upon their own discretion. It is best for the parents to be just as, if not MORE, educated than yourself, as you are just the support. They should be thoroughly researched on unassisted birth and emergency situations and feel comfortable acting as the sole leader in those emergency situations, and not relying on you to do a single thing, because you are not a medical professional! If something seems off, call 911 right away, even before starting CPR, they will guide you through CPR if they feel the situation warrants it and under their guidance, you cannot do wrong because you are being instructed to follow their protocol.

We stand with Megan, because we know that she did her best under the unfortunate circumstances and her intentions were purely to help a family and help sweet Junia. It truly makes us wonder, where are the people investigating the hospital where people, including moms and new babies, die every day, despite being monitored heavily and in the care of medical professionals? Hmmm.. seems a little one sided doesn’t it?

 

Are Doulas Only for Home Births?

The simple answer is NO! Doulas are great for everyone, regardless of your birth plan!

Regardless of where you deliver, a Doula is a great person to have on your team. Doulas are proven to play a large roll in birth outcome; just by having her knowledge and voice present to advocate and protect you.

Impact of Doulas on Healthy Birth Outcomes – NCBI

It is no secret that providers often suggest options during your pregnancy/birth that are not beneficial or are proven harmful. Having a Doula during your pregnancy, birth, and postpartum can help you make more healthy choices. Part of a Doula’s job is to share factual based information with you surrounding everything pregnancy, birth, and postpartum so that you can make a healthy choice for your growing family.

First do no Harm – Interventions During Labor and Maternal Satisfaction: A Descriptive Cross-Sectional Study – NCBI

Having her voice in the room could be the change in your birth outcome! For example: You have stated that you do not desire Pitocin during labor. You are in labor and it is taking a while to progress fully. Providers are known to hook up Pitocin to your IV without warning or consent (because you signed over rights for them treat as they see fit). If you have a Doula she would catch this slick action and make you aware. “Hey mama, the nurse is trying to hook up a Pitocin drip. Are you okay with this?”

When provider’s choices of care action are the 3rd leading cause of death and our maternal and infant mortality rates are the highest out of all developed countries, it may be in you and your infant’s best interest to have a Doula during pregnancy and present during labor!

Continuous Support for Women During Childbirth – NCBI

Especially for women in the following categories. These women are proven to have an increased chance of adverse birth outcomes:

  1. Socially disadvantaged women
  2. Low income women
  3. Unmarried women
  4. Primiparous (First time moms)
  5. Giving birth in a hospital without a companion
  6. Those who experience language/cultural barriers
  7. Hispanic and women of color

How Doula Care can Advance the Goals of the Affordable Care Act: A Snapshot from New York City – NCBI

If you are having a medication free hospital birth, a Doula would be great to have in your corner; seeing to it that your plan comes to be if at all possible. She can help you avoid pharmaceutical means of pain management by providing counter pressure and rebozo use.

If you have a planned cesarean, a Doula would be beneficial to have with you! She could update you on each step; giving you assurance and comfort that all is well while making sure your desires are advocated for and met.

If you are having a home birth, a Doula is great to have as well. She can help with other kiddos, getting you water/snacks, help starting dinner, assist in pain management techniques, and far more!

Regardless of social class, ethnicity, multiparous or primiparous, or desired birth plan, a Doula is for you!

Be sure to keep in mind that Doulas are not one size fits all, they are not equal. There is not a single Doula that is for everyone but there is a Doula out there for everyone who desires one! Be sure the one you choose is a good fit for you and your needs!