Introduction

Following are the notes I wrote before our very first Trust Birth meeting.  In the end, I put it in outline format, so this isn't EXACTLY what was said, but I wanted to get a clear idea of what I wanted to say.  Five women attended, and we had a great time!

I'm so glad to see all of you here tonight! Since it's our first meeting, I thought I would share with you why I have such a passion for Trust Birth. See, I am a very unlikely person to spread the word that natural birth is safe. Though I've always believed that in theory, I've never actually experienced an unhindered birth, even though I have three children. I do however know all about the risk of interventions. During my first birth, I had both demerol, which made me so loopy I lost several hours of the labour experience, and an epidural as well, all because I was assigned a hostile l&d nurse. I had already been in labour for more than 24 hours, and I was tired. When this nurse checked me to see how dilated I was, I was given the absolute worst pelvic exam of my life. I mean we're talking excruciating pain. I had this idea that I was going to have a drug-free birth, and she completely broke my spirit with a heavy hand. I think a lot of us forget about that factor. You spend all this time picking your doctor and developing a relationship with him or her, and they're really not the people who are going to affect your labour. And if you're anything like me, they may not even be there at all. When your baby arrives at 6:02 in the morning, you're going to be pot luck in the doctor department. The doctor on call at my first birth was also a real gem. I won't go into details, because it could be a trigger subject, but if you're interested in exactly what happened, let me know and I'll tell you.

My second birth went much smoother. My blood pressure was getting a bit high, and I was retaining more water than a sea sponge. I think my feet were roughly the size of cantaloupes, I was having contractions pretty religiously every 15 minutes for the last month of my pregnancy, and I was already dilated to a four when I went in for my prenatal exam on a Friday afternoon. My doctor recommended that we induce, so we scheduled a date for the following Wednesday. After the doctor fiasco with my first birth, ensuring that MY doctor would be at this one sounded like music to my ears.

Fast forward 11 years to the birth of this little guy here. I have a wonderful husband, (this is my second marriage, by the way, so my hubby wasn't present at either of my girls' births) and he knew that my first labour had not gone so smoothly, and I just sort of assumed that he would be assertive enough to take care of me when I was in labour, because I'm just not. Some women really are able to voice what kind of birth they want and stick to it, but I'm not one of those women. I am in other things. I mean, don't even think about telling me that my kid should eat in the bathroom because you might catch a glimpse of boob. But during childbirth, not so much. So I really should have spelled it out for my husband. If there's someone in that room bringing me down, I need you to kick them out. I don't care who they are, we can be reassigned. But I didn't tell him that, and even though he knew I was upset, I think he just assumed it was because I was nervous, and I tend to be high-strung when I'm nervous. Anyway, we knew that Zachariah was likely to be a big baby. My second child was a full two pounds bigger than my first one, and my husband was a 10 plus pound baby. So if babies get subsequently bigger, this one could potentially be a pretty good size. When I got to 39 weeks and was dilated to a four again, inducing sounded like a pretty good idea. I enjoyed my induction with my second child. I mean, as much as you can enjoy being hooked up to an IV with drugs giving you killer contractions. But this labour did not go as smoothly as that one did. Once again, I had a nurse who was condescending, and controlling. She had me in tears before I even had the hospital gown on. Honestly, I wanted to turn around and go home, but I felt committed to it at that point. Now, my husband and I had taken the hospital tour, and I expected to be able to do things like use a birthing ball, and you know, actually go to the bathroom to pee. Not with this nurse. She did let me sit in a rocking chair once, because I asked when my doctor was in the room. And man, if looks could kill, I would be stone dead now. But that was what it took to get anything out of this woman. I had been begging for water for what felt like hours, and only got some when my doctor was there, too. After a while, I needed to go to the restroom, and asked if I could. The nurse brought me a bedpan. Seriously. Because she didn't want to have to hook me back up to the monitors when I was finished. I asked for an epidural after that. Because peeing in a bedpan is humiliating, and I would rather be catheterised. Basically, it all went downhill from there. My blood pressure dropped really low, which caused Zachariah's heart rate to drop as well. They gave me oxygen, and I think it must have been cranked pretty high, because I could barely keep my eyes open. After several hours of laying in bed doing nothing,I completely stopped progressing. As a matter of fact, I actually moved backwards. My cervix swelled. The doctor called it CPD, which means that the baby's head is too large to move through the mom's pelvis. So after 12 hours on pitocin, they wheeled me into an OR, and I had a cesarean. That had been my worst fear for the entire pregnancy, and it happened. He weighed 9 pounds, which is admittedly more than the middle child was, but with a significantly smaller head circumference.

Now I'm not telling you all of this to scare you, or to be a negative Nellie. Certainly the choices I made like being induced affected the outcome of my birth, so a lot of my problems I brought on myself. I know that people can, and DO have really positive experiences giving birth in hospitals. But talking to other mothers, I realised that my experiences were not exactly unique. Women all over the country are checking into hospitals wanting one thing, but getting something completely different. You know, if there's one thing you should never have to fight for, it's the right not to be mistreated when you're birthing a baby.

Which is what brought me here. It took me three times to get the message, but I finally realised that birth is NOT supposed to be this way. I blogged about my experience, and one of my close friends shared it in some of the natural birthing communities that she's a part of, and I met a midwife named Carla Hartley. She is actually the lady who started the Trust Birth Initiative. I looked for a group meeting here in Dallas hoping to find some healing there, and discovered that there wasn't one. As unlikely as I am for this task, I hoped that by sharing my experiences – those decisions I made that lead me to crummy birth experiences, could maybe help other women from making those same mistakes. Since having my son, I've talked to a lot of moms who had also had traumatising birth experiences, and it's an epidemic! Women are being diagnosed with Post Traumatic Stress Syndrome from childbirth. This is not right. And our society, as a whole has the medical model of childbirth so entrenched that some people will actually get angry when you suggest that labour can happen without a bunch of professionals interfering. We really need to get back to the basics of birth here in the US.

During the seventeenth and eighteenth centuries, about 1 percent of all births ended in the mother's death as a result of exhaustion, dehydration, infection, hemorrhage, or convulsions. Today 1 in 3 births will end in a cesarean section. Yep, I'm right in line with those statistics. Three births, one ending in a C. OK, so I'm sorry, but that doesn't compute. So 300 years ago only 1 percent of births ended in disaster, but today 30 percent can't cut it? What are we de-evolving?

I want to read you an excerpt from an essay written by

Judith Lothian is a childbirth educator in Brooklyn, New York, and the Chair of the Lamaze International Certification Council.

In the last month of pregnancy, the cervix softens and ripens like a piece of fruit. Contractions of the uterus become noticeable, and the baby settles into the pelvis. The contractions become stronger, the cervix stretches and opens, and the baby moves lower and rotates, eventually moving down the birth canal. With each contraction, pain sends a signal to the brain and oxytocin is released. With the release of oxytocin, the contractions increase in intensity. As the pain of contractions increases, more oxytocin is released and the contractions become harder.

The pain of labor is what most women worry about. It is important to understand that the pain of the contractions in labor is valuable. It is an important way in which nature actually helps women find their own ways of facilitating birth. In a very real sense, the pain of each contraction becomes a guide for the laboring woman. The positions and activities she chooses in response to what she feels actually help labor progress by increasing the strength and efficiency of the contractions and encouraging the baby to settle in and move down the birth canal. When the pain is entirely removed, the feedback system is disrupted and labor is likely to slow down and become less efficient. As labor progresses and pain increases, endorphins (much more potent than morphine) are released in increasing amounts. The result is a decrease in pain perception, quite naturally. Nature's narcotic! The rising level of endorphins also contributes to a shift from a thinking, rational mind-set to a more instinctive one. Endorphins create a dream-like state, which actually helps women manage the tasks of birthing. Inner experiences become more important than the external environment. As labor progresses and the pain of labor increases, women “go into themselves,” become much less aware and, at the same time, much more focused on the work of labor, and are able to tap into an inner wisdom.

A woman surrounded by family, friends, and health care providers who remind her of the power of labor and encourage her quietly and patiently is a woman who is not afraid. Her support team is totally present and comforts her as she does the hard work of labor. She eats and drinks and, even if labor lasts a long time, she has the energy she needs to persevere. She rests between contractions. No one looks at the clock. Everyone trusts the process of birth and believes that she has the strength and the wisdom to give birth.

The woman moves in response to what she feels. Whether she gives birth in a hospital, birthing center, or at home, she is able to use a wide variety of comfort measures; for example, moving freely, listening to music, taking a shower or bath, and having her feet and hands massaged. She is able to create an environment that is just what she needs as she does the hard work of labor and birth. She pushes her baby down the birth canal, responding now to the pressure of contractions and the baby as he rotates through the pelvis and moves down the birth canal. She moves, changes position, and grunts, sometimes holding her breath—all in response to what she is feeling. In this way, she not only protects the muscles of the birth canal and perineum but also protects her baby as he is born. A great surge of adrenaline insures that the mother is alert, even if her labor has been long. She is totally focused on her baby, ready and eager to embrace him. Baby is eager and alert, too. The stimulation of his journey has primed him for the transition to life outside the womb.

With her baby in her arms, the mother is engrossed, excited, at peace, proud, and astounded at the miracle she has produced. No one tells her what to do. They know that she knows what to do—not because she and her baby have read the books or attended Lamaze class, but because their journey has physically and emotionally prepared them both for this moment. The weight of her baby on her belly helps her uterus contract and expel the placenta. Baby stays warm in his mother's arms. Baby knows just what to do to survive in the world he has entered. He is awake and looks around. Within seconds or minutes, he has his hands in his mouth and is smacking his lips. Unpressured, he slowly but methodically crawls to his mother's breast and self-attaches. As he nurses, his mother's uterus contracts, insuring that bleeding will not be excessive. The two greet each other unhurried, confident, and unpressured. Together, over the next hours and days, they will get to know each other and fall in love.

For all of its simplicity, nature's plan for birth actually requires a fair amount of flexibility. Each mother and each baby are different. While the anatomy and physiology are standard, how each labor and birth proceeds is fine-tuned through the active involvement of the laboring woman. All through labor, her body tells her what is happening and helps her discover what she needs to do to help. The active involvement of the laboring woman is a critical piece of nature's plan for birth, and it is the least understood. The hard work of labor is not meant to be accomplished alone. Changing position, avoiding exhaustion, and staying adequately nourished require assistance. So across the world, women giving birth are supported, encouraged, and comforted by family, friends, and professional birth attendants. Giving birth as nature intended is not “biting the bullet and letting it happen.”

Childbirth is an intense act of love and passion. Interfering with the process can really hinder things. The best way – the very best way to have that natural birth that you want is going to be to stay out of the hospital. Really, stay home. Because that's where you're going to be the most comfortable. Nowhere else are you going to be free to let loose and labour the way you need to labour. But I know that idea takes a little getting used to, and there are lots of other alternatives out there. We're actually really fortunate here in DFW, because there are a dozen or so birthing centres in the area that are staffed with midwives and can be a happy medium for moms who don't want to go to a hospital, but can't quite get used to the idea of birthing at home. And if that's still too far out there for you, there are a select few midwives who practise out of Baylor Dallas, McKinney Medical Centre, and Presby Allen. And I know there are probably some of you here who may be risked out of a home birth, or a birth centre. You may have health conditions that require you to birth with an OB. But most of you can still have a natural birth if that's what you really want. Remember that 1 percent in the 18^th century? You can find an OB who's natural birth friendly. Honestly, if I had it to do all over again and HAD to have a hospital birth, I would stick with the same doctor I had, because I really just love her. What I wouldn't do is agree to an induction. That really, really, really increases your chances of having a cesarean. I would also hire a doula. Doulas take the pressure off of you and your partner. They go to bat for you with those L&D nurses and remind them of your desires for birth. They can also be the bad guy for you and refuse the interventions that you don't want.

And while we're on the subject of interventions, you can refuse those, you know. Those vaginal exams that you get every week for the last month of your pregnancy don't tell you anything. I've walked around for DAYS for all three of my pregnancies dilated to 4 centemetres. Doesn't mean a thing. And there are very few real reasons for an induction. So do your research, and know what interventions you're willing to have and which ones you're not, and exercise your right to say no. That doctor you hired? Remember that YOU hired THEM. Not the other way around. You're giving them their paycheck. And if they won't work with you to provide you the kind of care you want, you can fire them. Keep that in mind when you're deciding who will or won't be present at your birth. Just because you've always gone to that doctor, or because your mother, or your sister or your best friend's aunt, or whoever used that doctor, or midwife... If you're not clicking with that person, then mama, you need to find a new care provider.

Look, I'm no expert. I'm just an average momma who had what unfortunately has become typical birth experiences. I certainly don't have all the answers. But there has to be a better way than what is happening now, and it's not going to change if we don't speak up and start demanding better. Our babies deserve to have a better entrance into the world than loud shouts of “push, push”. Or worse yet, the bright lights of an OR. I'm so glad you all came here tonight. We may be small now, but I hope that we can all spread the word that birth doesn't have to be this big scary thing. It can be beautiful, and spiritual. It's time for women to get back to the simplicity of birth the way it was designed to be.