Birth Without Fear

'They felt comfortable knowing that they had two knowledgeable and experienced midwifes and a doula to support them,' explained Ms Dives

Photo credit: Jackie Dives

I came across a beautiful set of photographs this morning, in the UK Daily Mail and wanted to share them with all of you. Check out the full article and photo series here.

Taken by fellow doula, Jackie Dives, these pictures really capture the beauty of a home birth. There is a level of bliss that seems only attainable in birth when a woman is truly comfortable, cared for and respected. It’s a pretty hard thing to achieve in a hospital setting but I see it every single time at home.

Obviously, home birth is only right for those who really want it – in other words, if you’ve done your research and you feel you’d be more comfortable in a hospital, then that’s where you should be – but for those who prefer it and who work with their midwives and are deemed good candidates for home birth, let no one call their choice “wild or erratic” again.

To learn more about home birth and the studies that have been done to determine its safety, check out my post (Home)Birth. Is. Safe.

Don’t Believe the Hype

This article from The Wall Street Journal provides some great historical information that connects meaningfully with my previous post (Home)Birth is Safe.

The author, Nathaniel Johnson notes that,

In 1923, Mary Breckinridge started the Frontier Nursing Service in rural Appalachia….Within a decade, the astonishing impact of that care was apparent. The women the Frontier Nursing Service cared for, who were desperately poor and usually gave birth at home, were 10 times less likely to die in childbirth than the average American at the time. The nation as a whole wouldn’t catch up until the 1950s, after the widespread acceptance of antiseptic and the discovery of antibiotics.

Given that antiseptic practices and the use of antibiotics are available and in use in midwife-attended home births today, it makes sense that, as Sheila Kitzinger has argued, it is not a high level of medicalization that makes birth safer – it is overall health: access to good pre-conception, prenatal and postpartum healthcare, good quality nutrition, access to clean water and access to skilled birth attendants. This has been borne out the world over, regardless of whether women are typically birthing at home or in hospitals. Access to medical interventions for the few women who actually need them is important, which is why midwives are thoroughly trained to detect possible complications before they become problematic and why they only support home births for women who are not at risk. Obstetricians are trained to deal with problems when they arise, but midwives are far more likely to be able to prevent them in the first place. Continue reading

A New Tool

I recently acquired an Obi-TENS unit to use with my clients. Many women swear by these devices as an alternative to pain medications and I am really excited to begin using it in my practice! They are frequently used by physiotherapists for helping individuals manage musculoskeletal pain and to help encourage blood circulation. As for use in labour, they tend to be very popular in the UK, where many hospitals have them available. In North America you need to have a doula who has one or buy one of your own. The unit is controlled by the birthing woman, which is helpful in encouraging her to feel in control and like an active participant, rather than a passive ‘patient’. As many of you are, I’m sure, aware, research shows that a sense of control is the key factor in how women report feeling about their birth experiences days, weeks and even years later.

Check out this handy blogpost about how TENS works for labour: http://www.meghanprice.ca/2012/11/03/handheld-magic-elle-tens-machine/

The Race to the Bottom?

Is anyone else tired of the controversy, the judging and the alleged “mommy wars” that are dominating media coverage of all things birth and baby related lately? Me too! Today I wanted to write about a subject that, while not without differing perspectives, is hopefully a topic that won’t make anyone feel judged or stressed out or guilty and that might help women to make healthy choices that fit their goals, their lifestyles and their parenting styles (whatever those may be).  Continue reading

Summer/Fall Prenatal Classes at the Centre for Social Innovation

If you are expecting a baby in later summer or fall of 2012 and are looking for prenatal education that works for you, you’re in luck! I am offering a full series of Prenatal Classes at the Centre for Social Innovation (Annex) from August 15th to September 19th, 2012. This is a six-week series, Wednesday evenings from 6:30-9:00 pm. People have already started registering for this series – I have, at present, room for four more couples (or singles with a support person). If you are interested in taking my summer course (May 30th to July 4th), there are still a couple of spots available in that series too.

Now, you may be asking yourself, “why would I pay for independent prenatal classes when I can just attend the free ones at the hospital?” This is a great question and there are a number of excellent reasons. Continue reading

Summer Prenatal Classes at the Centre for Social Innovation

If you are expecting a baby in later summer or fall of 2012 and are looking for prenatal education that works for you, you’re in luck! I am offering a full series of Prenatal Classes at the Centre for Social Innovation (Annex) from May 30th to July 4th, 2012. This is a six-week series, Wednesday evenings from 7:00-9:30 pm. This series is already half-full – I have, at present, room for three more couples (or singles with a support person).

Now, you may be asking yourself, “why would I pay for independent prenatal classes when I can just attend the free ones at the hospital?” This is a great question and there are a number of excellent reasons.

1. While the information provided by public health prenatal classes is useful, these courses often omit a large quantity of information that is considered “alternative” or that is not routine at that particular hospital. For example, while my prenatal classes cover labour coping techniques ranging from massage and acupressure, to breathing and vocalizations,to hydrotherapy and heat, to epidurals and other forms of pain medications, a hospital class will generally only cover the epidural with any depth. Even if you plan to have an epidural, there are still many useful options available to you that won’t be explored in a standard hospital course. This is just an example of how hospitals tend to teach to the norm, rather than to what is possible. It’s understandable given the number of people they have to teach, but not exactly desirable if you want your birth experience to be as satisfying and positive as possible.

2. Public health courses tend to be two-day “crash courses”. This may seem ideal – get it all done with in one weekend! – but a course that is drawn out over a number of weeks will give you the chance to really get to know other couples in the class (start building up that new-parent social network now, before the baby arrives) and also opens up the possibilities for asking the questions that matter to you, even if they don’t occur to you until four days after class. You’ll also retain more of the information, as you’ll only need to digest two hours of material at a time, with time to reflect in between each class. I also cap my attendance at twelve people so that there is time for more questions and to facilitate group interaction.

3. Many people report being frightened or discouraged by the content/approach of hospital prenatal classes. It is vital that you understand all of your options and what is happening to your/your partner’s body during labour and birth, but it is not helpful to hear horror stories or to be inundated with negative information. My classes provide clear and detailed, evidence-based information while focusing on the positives – helping you to feel informed and fully prepared, but also excited and optimistic, not afraid.

4. I tailor my courses to the participants in them. Upon registration I’ll send you a questionnaire that asks you about your pregnancy, your current level of knowledge, your interests and your hopes for the course. That way I can focus on areas of particular interest and reduce coverage of topics that people already understand.

Prenatal education is the first step to an empowering birth experience. Feeling like an active, informed decision-maker prior to and during your labour and childbirth is the key to birth satisfaction. Knowledge is essential for confidence and self-advocacy.

The cost for the entire series is $240.00 per couple. If you are interested in hiring a doula and would like to talk to me about the doula services I offer, I also provide package deals for doula clients who enrol in my prenatal classes.

Topics for the series include (but are not limited to):

-pain management and coping strategies for labour

-relationships and sexuality during pregnancy and in the postpartum period

-the physiology of labour and birth

-positioning for labour and birth

-risks and benefits of common interventions

-breastfeeding

-newborn care and characteristics

-nutrition and exercise

This course is ideal for people expecting to give birth between late July and September of 2012. Email me at heather@socialinnovation.ca to register or if you have any questions.

(Home)Birth. Is. Safe.

An important study was published recently on homebirth in the UK. The outcomes were very promising and should be reassuring to anyone planning a homebirth. Circumstances here in Ontario are, of course, different than in the UK but similar enough for the study’s findings to hold water for women here too, especially given that the findings echo a 2009 study of home births in Ontario from 2003-2006.

The Hackney Doula gives a great breakdown of the study’s findings and what they mean for women in various birth settings.The key findings of the study from the National Perinatal Epidemiology Unit are here. The Ontario study can be found here.

The bottom line for me: birth is safe. For the vast majority of women and babies, birth is safe, no matter where you give birth provided that you have quality care provided by midwives or doctors. For most women, birth at home is safer (yes, you read that right, not ‘almost as safe’, not ‘as safe’, safer) than birth in an obstetrical ward. While the risk of ‘poor outcomes’ for babies (a term that applies to many things, some serious, some not) was found in the UK study to be slightly higher with home births than hospital births, the risk of a poor outcome of any kind remained less than 1% in either case – 0.53% for hospital births, 0.93% for home-births. In the Ontario study, findings for babies were more specific – pertaining only to mortality or serious morbidity. There was no difference found between the two groups (hospital/home) with regard to serious morbidity and mortality for newborns in that study.

There is simply no argument against home birth, provided you are a healthy woman, having a healthy pregnancy in a region where you have access to midwives experienced in and supportive of home birth. That doesn’t mean you have to or ought to choose it if it doesn’t feel right for you, but it does mean that women who do opt to birth at home mustn’t be judged or criticized for their choice.

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