Thursday, December 5, 2013

Book Reaction: Cut, Stapled, and Mended

To be honest, I wasn't sure what to expect from Roanna Rosewood's memoir, Cut, Stapled, and Mended. After it arrived I actually wondered if I should have agreed to review it, because I have so many things to read, things to think about, and interests that are calling me---do I really need to read a memoir about someone's cesareans? I've already read so many books about birth, do I really want to read another one? Well...the answer was YES, I did need to read it. After I finished the book, I felt almost speechless at how deeply it had touched me. This book was a surprise all the way through, from the opening Orgasmic Amazon Queen sex scene, to a session with a psychic healer who tapped in to Roanna's past life abdominal wound, to her dogged quest to open herself to her own feminine wisdom, to her birth experiences---all soul-shattering in their own way---this book touched me profoundly. I was shocked to find myself with tears in my eyes at many different points and eventually truly unable to put it down.

Orgasmic Amazon Queen notwithstanding, Roanna comes across as a practical and down-to-earth narrator, who in her quest to understand herself, her body, her inner wisdom, and her birth experiences, makes a decidedly not down-to-earth personal journey through a variety of healing modalities and nontraditional experiences and perspectives. I really loved the balance she struck between the spiritual and metaphysical experiences she describes and the nitty-gritty reality of doing this thing, giving birth. In a perfect example of what I mean, she writes:
You think I would run out of poop but I don't. It's endless poop. 

My ego, having (literally) had enough of this shit, quits. It gets up and walks right out the door. What is left of me poops in the tub. Looking down, I say, 'ewwwww.' I say it as if it wasn't me who just shat in the tub. I say it as if I just happened to come across poop in my bath one day. 'Ewwww' or not, I'm never getting out of the tub ever again. If this tub were full of nothing but shit mud, I would still stay right here (p. 144).
And, just a few pages later, the experience I already quoted in a prior post:
Only then does the Divine come, taking my body as her own. I am no longer alone. There is no fear…I experience completeness. I find religion. Infinity is tangible. Generations of children, their dreams, passions, defeats and glories—they all pass through me, converging here, between my thighs… (p. 146-147).
via Thesis Tidbits: Cut, Stapled, and Mended | Talk Birth
Despite planning homebirths, Roanna experiences two cesareans and her journey towards VBAC is an arduous one:
Deep inside, I feel the screams of birth echoing off the sides of my skull. Softer and softer they fade, becoming a faint whisper, then disappearing completely.
I open my mouth. 'Please,' I whisper-scream-beg-cry, 'please come back.'
She does not.
I am, once again, mortal. (p. 155)
While I would likely proceed with some degree of caution if reading this memoir as a pregnant first-time mom, there is much to be learned from Roanna's experiences. Her narrative is rich, deep, compelling, scary, dramatic, poignant, and powerful. I highly recommend it!

Disclosure: I received a complimentary copy of this book for review purposes. Crossposted at Talk Birth.

Saturday, October 5, 2013

Film Reaction: Birth Story

(Crossposted at Talk Birth)
Prenatal visit
I have never met anyone with more than a passing interest in birth activism who has not heard of Ina May Gaskin. She isn’t referred to as a the world’s most legendary midwife for nothing! But, how did she get this way? The new documentary film, Birth Story, helps explore that question.

“The feature-length documentary BIRTH STORY: INA MAY GASKIN & THE FARM MIDWIVES tells the story of counterculture heroine Ina May Gaskin and her spirited friends, who began delivering each other’s babies in 1970, on a caravan of hippie school buses, headed to a patch of rural Tennessee land. With Ina May as their leader, the women taught themselves midwifery from the ground up, and, with their families, founded an entirely communal, agricultural society called The Farm. They grew their own food, built their own houses, published their own books, and, as word of their social experiment spread, created a model of care for women and babies that changed a generation’s approach to childbirth.

Forty years ago Ina May led the charge away from isolated hospital birthing rooms, where husbands were not allowed and mandatory forceps deliveries were the norm. Today, as nearly one third of all US babies are born via C-section, she fights to preserve her community’s hard-won knowledge. With incredible access to the midwives’ archival video collection, the film not only captures the unique sisterhood at The Farm Clinic–from its heyday into the present–but shows childbirth the way most people have never seen it–unadorned, unabashed, and awe-inspiring.” 

inamaystephenI really enjoyed Birth Story. It skillfully weaves together vintage footage, commentary, and births with a present day shadowing of Ina May in her natural environment: at the Farm. The documentary shows her working in her kitchen, eating, talking to her husband, watering plants, riding her bicycle, teaching workshops, training midwives, going to prenatal visits, and finally, attending a very hands-off gentle waterbirth. It also lets us peek at images from the early days of The Farm community, the caravan of buses, the dreams of Stephen Gaskin and the “hippies” who followed him to Tennessee. Birth Story is not just a film about Ina May though, it chronicles the experiences of several other Farm midwives as well, and I loved hearing the commentary and opinions of the less-famous midwives who helped transform the birth world.
I found footage of Ina May with Stephen to be particularly poignant and very much enjoyed the vintage photos and footage. I also find it interesting how The Farm began because of Stephen’s leadership and ideas and yet Ina May took off as the ongoing famous person in the family. Of Stephen, Ina May explains: “He thought women we supposed to be uppity—this was great relief, I didn’t like being held down.”

Ina May describes her own first birth explaining that in typical birth climates, “there’s nothing about the special energy of birth and that’s kind of the most important thing…I felt like I was doing something sacred.” She also makes the basic and crucial point that the number one rule of maternity care should be Be Nice and laughs as she asks us to consider how just those two words could change maternity wards. There are only a handful of actual births in the film, three of which are from sometime in the 1980′s. We see a breech birth (a lot more hands-on than I think of present-day midwifery practice) and a shoulder dystocia, both rare occurrences in birth films. We also see brief footage of Ina May’s Safe Motherhood quilt project and a brief discussion of disparities in maternal mortality rates.

inamayandbabyAnother highlight of the film for me was midwife Pamela, whose birth we also see on-screen. She is shown telling us about an early birth she attended saying, “I fell in love with women. How can you see someone be so strong and not fall in love?” Exactly. My doula and friend, Summer, who watched the film with me, developed her reaction to this quote in a lovely blog post and it reminds me of my own past post about my own former midwife who helped me see that midwife means loves women. Ina May explains that she learned how to be a midwife by allowing herself to be instructed by the women themselves and then she trained other midwives. As I watched Birth Story I found myself feeling a little sad, nostalgic, and bittersweet, because I feel like the world that these beautiful midwives envisioned has yet to really be birthed and that in some ways we’ve gotten so far away from the relationship-oriented and community living/engagement model upon which The Farm was based.

My initial feeling as I watched the film was that it would be primarily of interest to people already very familiar with Ina May, thinking that it  may not appeal to or interest “regular” people. However, the friends I viewed the film with had totally different perspectives. One friend told me she thought her husband would really have liked the documentary, particularly for the emphasis on community. The one husband who was present reported that he thought everyone should see the film and not just people who are already “birth junkies.” So, I stand corrected, and will now say that Birth Story has the capacity to engage with many people!

In 2007, I had the opportunity to listen to Ina May speak in person at the La Leche League International conference in Chicago. She talked about sphincter law and made the association with our bodies’ capacity for bowel movements and women’s physical capacity to rebound from childbirth. I will never forget her saying: “I don’t know about you, but my butt closes back up after I poop.” That summed her up for me: plainspoken, real, matter-of-fact, and practical. She’s a legend!

Starstruck? Oh, yes I am. My husband said, “these people are like your *celebrities.*"

Disclosure: I received a complimentary screening copy of the film for review purposes.

Sunday, May 12, 2013

Happy Mother's Day!

“Blessed be all the mothers of mothers.
Blessed be all the daughters of daughters.
Blessed be all the daughters of mothers.
Blessed be all the mothers of daughters.
Now and forever, wherever we are.” –Diann L. Neu

In Uganda there is a special word that means "mother of a newborn"--nakawere. According to the book Mothering the New Mother, "this word and the special treatment that goes with it apply to a woman following every birth, not only the first one. The massages, the foods, the care, 'they have to take care of you in a special way for about a month.'"

There is a special word in Korea as well. Referring to the "mother of a newborn child," san mo describes "a woman every time she has had a baby. Extended family and neighbors who act as family care for older children and for the new mother. 'This lasts about twenty-one days...they take special care of you.'"

These concepts--and the lack of a similar one in American culture--remind me of a quote from Sheila Kitzinger that I use when talking about postpartum: "In any society, the way a woman gives birth and the kind of care given to her and the baby points as sharply as an arrowhead to the key values of the culture." Another quote I use is an Asian proverb paraphrased in the book Fathers at Birth: "The way a woman cares for herself postpartum determines how long she will live."

Dana Raphael, the author of Breastfeeding: The Tender Gift, who is best known for coining the word "doula" as it is presently used, also coined another valuable term: matrescense. "Nothing changes life as dramatically as having a child. And there was no word to describe that. So we invented the word--matrescence--becoming a mother."

Happy Mother's Day to mothers around the world!

Want to find out what mothers really want? Check out the newest Listening to Mothers survey results: Listening to Mothers III: Report of the Third National U.S. Survey of Women’s Childbearing Experiences

Other Mother's Day reads:
Womenergy (Womanergy)
Prayer for Mothers
What If…She’s Stronger than She Knows…
This is a modified repost of a previous post for Citizens for Midwifery. It is being crossposted today at CfM, Talk Birth, and Pagan Families.

Friday, February 15, 2013

Documentary: The Mama Sherpas

A CfM Facebook fan recently posted to share some information about an interesting sounding new documentary about Nurse-Midwives:

The Mama Sherpas follows nurse midwives, the doctors they work with, and their patients, in the DC area over the course of two years. The documentary will provide a personal glimpse into what midwives can bring into the birthing process in the hospital system.

Maher focuses on four “collaborative care” practices where doctors and midwives manage women’s care together. Although there is few collaborative care efforts in the United States, research proves that this method provides better outcomes for mother and baby as well as lowers the C-section rate, which has skyrocketed in recent years.

The documentary’s subject is one that explores two of the most heated debates - Women’s Issues and Health Care. This will be an important contribution to women’s films as a genre because knowledge about medical options has often been withheld from women. Additionally, this film will serve as an educational tool to inform women about their own health and bodies.

For information on partnership or sponsoring visit Also, visit for photos, videos, and updates.

Here are a few ways you can help with our outreach:
1. Add a logo of our film to your website
2. Blog about our film
3. Suggest participants
4. Tweet, Link to our website, and share our Fb page
5. Watch and share the scenes (clips are on the FB page)
6. Suggest possible stories to follow! For instance, “I’d like to see how dad’s prepare for labor.” We’ll add it to our story queue!
7. Host a fundraiser in your community
8. Host an Discussion Group about the film and film scenes centered on a topic area
9. Connect us with a community organization in your area
10. And...

Trish is a midwife at Physician and Midwife in Alexandria

Wednesday, February 13, 2013

GRN: How Consumers Can Help Birth Centers Become A Reality for Every Community

The National Birth Center Study II

Hello Friends,

While the whole nation has been watching the cesarean section rate and cost of maternity care climb ever-higher, midwife-led birth centers have been providing low-risk women with a safe, low-cost model of care with excellent outcomes and a c-section rate orders of magnitude lower than the national average.

The long-awaited National Birth Center Study II (Stapleton et al., 2013), published today in The Journal of Midwifery and Women’s Health (the journal of the American College of Nurse Midwives), reported on outcomes of over 15,000 women planning to give birth at birth centers around the country between the years of 2007 and 2010. The American Association of Birth Centers has published an excellent summary of the study results for consumers.

Briefly, the main results showed:
  • 84% of women who started labor at the birth center, had their babies at the birth center.
  • 94% of women had vaginal births (whether they remained at the birth center or transferred to a hospital), with no evidence of compromised outcomes for babies.   (That is, only 6% of women who started labor at a birth center had a cesarean birth.)
  • The national average is 32.8%. According to the authors, the national c-section rate for low-risk women comparable to this sample is 27%.
  • The fetal and neonatal death rate was extremely low and comparable to what has been reported in other studies of low-risk populations.

Why is this study important for consumers to know about? The overall number of birth centers has been growing over the last ten years. However, if you Google the phrase, “birth center closing,” you will see story after story of communities around the country despairing as their birth centers were closing their doors for all sorts of reasons.

In some states, the regulations for birth centers represent barriers to getting them started. In others, the financial or physician back-up structure was not sustainable. The loss of birth centers leaves significant gaps in the continuum of care options for women, leaving them to choose care that is not optimally suited to their situation.

The solution to lowering the cesarean section rate and the astronomical maternity care costs in this country will be multifaceted, for sure. Today we have been given empirical evidence that support for birth centers, with their low-cost and excellent outcomes, should be a substantial piece of the equation.

What Can You Do?

If you already have a birth center in your community:
  • Support it! Send them love today on Facebook, host a fundraiser, become their champion.
If your community does not have a birth center:
  • Read the article and the consumer summary and share them on social media.
  • Host a meeting to gather energy, information, and support.
  • Learn about birth center regulations in your state and what the potential barriers may be.
  • Send a copy of the article to local doctors and hospital administrators.
As Amy Romano of Childbirth Connection said in her Transforming Maternity Care post, “Birth centers have met their moment.”

For midwife-led birth centers to thrive in the U.S., they need consumer champions. That's you!

How do you plan to support midwife-led birth centers? Tell us on Facebook and Twitter today and please share this message widely!

Yours in safe and respectful maternity care,
Lauren Korfine, PhD, & The CfMidwifery Team

Stapleton, S.R., Osborne, C., and Illuzzi, J. (2013). Outcomes of care in birth centers: Demonstration of a Durable Model. Journal of Midwifery and Women’s Health, January/February, 2013.

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If you find news, resources, or other valuable information that you think should be posted on the Grassroots Network, please send it to info@cfmidwifery. org... with "For the grassroots network" in the subject line. We will definitely consider using them!

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Wednesday, January 23, 2013

Postpartum Survival Tips

324“In western society, the baby gets attention while the mother is given lectures. Pregnancy is considered an illness; once the ‘illness’ is over, interest in her wanes. Mothers in ‘civilized’ countries often have no or very little help with a new baby. Women tend to be home alone to fend for themselves and the children. They are typically isolated socially & expected to complete their usual chores…while being the sole person to care for the infant…” –Milk, Money, & Madness
I recently shared this quote on my Facebook page and a reader responded expressing her fear at preparing to face this exact situation. I responded that it is an unfortunately realistic fear and suggested she check out some resources for postpartum planning that might help work through the fear as well as plan for a nurturing postpartum instead of a stressful one. She then responded that she has a very minimal local support system and that got me thinking about postpartum survival tips for when one’s local support system is limited…

My ideas:
  •  Suggest to your out of town friends and family that they contribute to a “babymoon” for you and all pitch in to hire a postpartum doula.
  • Tactfully remind people that even if they’re too far away to bring you a meal, they can certainly call up a local restaurant and order a delivery for you! I think a lot of us forget that is an option for a long distance family member (that we would bring food to if they were local). In my experience, getting enough food is a huge issue postpartum! I remember long distance friends having babies a variety of times and wishing I was close enough to bring them dinner. Duh. Many restaurants do, in fact, deliver food!
  • Be your own “best friend” by preparing and freezing meals and snacks now. I know I sound obsessed with food, but it is totally one the hardest things to take care of postpartum, but so important!
  • Put together a mama survival kit for yourself that you can then open up when you need it. Some ideas here and more ideas of variable quality here.
  • If you don’t have a sense of community work, actively work on building one—go to La Leche League meetings, Holistic Moms Network, Mothers of Preschoolers, Attachment Parenting International, or other mothers’ groups. Go BEFORE you have your baby if you can.
Other ideas for helpers:
  • In addition to my idea of ordering delivery for a postpartum family as a way of bringing them dinner long distance, is to order a dinner through the mail via the business Spoonful of Comfort. They will send fresh chicken soup, rolls, cookies, and a baby present via Priority Mail (packed with freezer packs). I send it with a note saying, “this is me, bringing you dinner!” Friendly tip from unfortunate personal experience: if you are doing this for a friend make SURE you enter THEIR address as the shipping address and not your OWN address, or you will then be forced to enjoy their postpartum meal and feel like a total idiot at the same time.
  • Don’t forget about other meals—breakfast = awesome. Muffins = awesome.
  • Pay it forward–I think sometimes people feel like they don’t know someone well enough to bring them food, or maybe they even do a mental “tally” and think, “well, she won’t be bringing me food ever, so why should I take time to bring it to her” or, “she didn’t make anything for me when I had my last baby, so I’m off the hook on this one.” When I had Alaina, a mother who had literally JUST moved to town and that I had not yet met, sent a hot breakfast casserole to me (that my lovely doula delivered to my lovely mother at the snowy end of my gravel road).  I think of that generosity when I bring a postpartum meal to a mama from whom I will never end up getting a reciprocal meal. Who cares. She needs it. You can do it!
  • Another doula commented on my post: “Do you know a mom that is about to have a baby? Or maybe a momma who just gave birth recently? Don’t even ‘offer’ just show up with a bucket of cleaning supplies, a bag of healthy food, and maybe something nice for her. Go tuck her in bed with baby, and get to work on her home.. When she wakes, she has nothing to do but nurse that baby. (If she has other kids, delegate chores with them, if to young, call mutual friends to sit for them! Our Mom’s need this, up through 6-9weeks pp, Mom’s need help, even longer for some. There is a reason the US has the highest Post Partum Depression issues in the developed world… Create your community! DO IT!” I would add that if you do not know mom well, do not plan to engage in a deep cleaning project and stay for a long time doing such project.
I also posted to the Citizens for Midwifery Facebook page asking for contributions for postpartum survival tips when your local support system is limited. What beautiful, helpful women we have on that page! While I didn’t get many suggestions specifically for minimal local support systems, I did get a nice collection of survival tip ideas:
  • Trust your own instincts. Many women have great advice but if your heart is telling you something else, go with it.
  • Craniosacral therapy… one session for you and one for the baby.
  • In addition to lots of suggestions to hire a postpartum doula, there were lots and lots and lots of shout-outs for placenta encapsulation. I echo it myself.
  • Get out of the house alone! For me, it’s been crucial to my sanity to leave my home, by myself, even if only for an hour or two between nursings. Just a Target run was therapeutic!
  • Kangaroo care for high needs babies.
  • Lots of mentions of it being okay to accept help and okay to ask for help.
  • A lot of new moms get really overwhelmed by family and friends coming by to see baby, and it’s important for them to remember that they can always put out a sign that says “mom and baby sleeping!” (even if they aren’t) anytime they need a break.
  • Watch only positive stuff without violence on TV (cooking shows, home improvement) as regular TV is really violent for new mamas and she may be watching more with all the nursing/healing.
  • Have homemade high protein frozen meals (and snacks) in the freezer before birth so anyone can warm them up for the household after birth. If breastfeeding, get much more rest than you think you need from day one to ensure an abundant milk supply (*note from Molly: it is true that prolactin receptors are “laid down” during the first days of breastfeeding. Breastfeeding “early and often” makes sure that there are an ample supply of receptors in your brain.)
  • Have a sign up sheet for family and friends to choose which chores to help with, gift certificates to a cleaning service, stocking up on disposable plates and dinnerware…
  • A new mommy group can be a life saver. Just knowing that other mommies are going through the same thing help
  • Food registries such as mealtrain and mealbaby. Not enough families know about these amazing and free services. (*note from Molly: we often use Care Calendar locally.)
  • Plan ahead and freeze several of your favorite freeze-able meals. Let the clothes be a little wrinkled. Use paper and plastic ware instead of worrying over dishes. Stay laying down first 3 days postpartum (preferably naked: it gives a certain message and is better for baby anyway) and the first week stay in pajamas. Enjoy frequent rest times, even if you can’t sleep.
  • Baby wearing….lots of time in bed, sleeping cuddling and feeding babe skin to skin…brest friend nursing pillow
  • Send a subliminal message to the limited visitors you’ll have (set limits early with partner) by wearing your robe for several weeks
  • Eat well, accept all offers of help and food, get out of the house alone!
  • I loved getting meals brought by friends, but I didn’t always want to socialize. So, someone to run interference, or maybe a drop-off location for leaving food. (*note from Molly: my doula was the perfect person for this job.)
  • Ask for help! No one will know what you need if you don’t speak up.
  • Don’t go without showering for more than four or five days. Brush your teeth once a day no matter what, even if it ends up being at a weird time. Take your vitamins/ herbal supplements/tea. HYDRATE! Nap with baby if you need to, arrange childcare for older siblings sometimes, but also listen to your instincts—one of my worst baby blues moments was with my third when my older two were gone and I wanted them home!
  • LOVE yourself, nap when you can , Yes you are doing it right, No it’s no ones business (breastfeeding/cosleeping/pumping etc.) allow opinions and advice to slide off, drink lots of water , eat small snacks/meals, love your baby look into their beautiful eyes and connect, skin to skin whenever even with dad or siblings (safely) cherish these moments they don’t last forever, the laundry will get done, the dishes will be get cleaned …
  • Take a “babymoon”. Put on a robe when someone comes to the door–even if you have real clothes underneath. Sleep when the baby sleeps. Don’t answer the phone. Remember, self-care is essential for you to be able to care for your baby.
  • I loved having herbal soaked pad (frozen) to wear afterwards, felt soooo good. Have easy one-handed snacks available and a BIG water bottle.
  • In those last few months of pregnancy I prepare meals to freeze (I start about month 5 or 6). I make up 6 weeks worth of dinners (they always last longer since we have a great church family and friends that bring us meals). After baby is born I can put 2-3 dinners in the refrigerator (to thaw) a few days before I need them. Then all I have to do is pop one in the oven and BAM….dinner’s ready. I love “Don’t Panic, Dinner’s In The Freezer” I & II. The recipes are amazing and all freeze well. Hope that helps!
  • Skin-to-skin in bed for as long as possible; 40 days of rest, recuperation, establishing breastfeeding, bonding, limited visitors, and limited activity; drink when the baby nurses; sleep when the baby sleeps; nurse on demand; learn to wear your baby; and use a peri bottle when peeing! A postpartum herb bath and massage are nice, too.
  • Hot water bottle for afterpains
  • Placenta encapsulation and WishGarden Herbs ReBalance tincture!
  • Chiropractic adjustments, ASAP
  • Call in your mom. My mom’s job after my second was born was to keep me fed and to spend some quality time with my older child.
  • Drag oneself outside and BREATHE! :)
  • Water… tub, shower, steam, pool, raindrops, snow, sauna, bath, river, stream, ocean, lake! If you can, immerse yourself, if you cannot, imagine yourself floating :-)
  • Lots of water, lots of protein and healthy fats, placenta encapsulation and low expectations of anything other than bonding time with baby.
  • Don’t try to impress others with how quickly you can get up and going, even if you can, just take it easy!!!!
  • It’s not in the asking for help; its in the accepting…
Surround her with support!
Surround her with support!

Check out these previous posts:

Mothers Matter–Creating a Postpartum Plan

Planning for Postpartum

Some reminders for postpartum mamas & those who love them

and a great one for helpers written by my own doula:

The Incredible Importance of Postpartum Support

And, remember…

“The first few months after a baby comes can be a lot like floating in a jar of honey—very sweet and golden, but very sticky too.”
–American College of Nurse-Midwives

This post is crossposted at Talk Birth.