Nursing Birth

One Labor & Delivery Nurse’s View From the Inside

My Philosophy: Birth, Breastfeeding, and Advocacy April 25, 2009

 

I am honored, humbled, and excited to report that just a few days ago my blog had over 1,500 hits in just one day.  I was floored when I saw the number and almost choked on my Cheerios J!  When I started this blog in February I was feeling lost, frustrated, burnt out, defeated, and disempowered regarding my role in the current maternity care system in America.  The day I wrote my very first post, NursingBirth is BORN!, was only one week after I almost up and quit my job after I had witnessed a very traumatic assault and battery against a woman I was caring for as her obstetrician performed a pudendal block against her will as she and her husband were screaming for him to stop. 

 

(Side Note: This is one situation that I still have not been able to bring myself to write about.  The fact is that assault & battery on patients in health care happen DOES happen and it was the first time I had ever witnessed such an event.  I cried for days, ran the story over and over and over again in my head, wondering what I could have done differently, wishing I had the courage to throw myself over her to physically prevent him from violating her, instead of just saying “Stop!”.  I am getting pretty choked up even thinking about it so for now, I will have to continue to process that event and hopefully one day, I will be able to write about it.)

 

My intention for this blog was simple…if I could reach one mother, just one, who might stumble upon my blog and be inspired to learn more about labor, childbirth, and birth options, to realize that she has options and rights regarding her experiences and her body, I would then feel triumphant.  I had convinced myself that for months or maybe even years the readers of my blog would probably only be my husband and sister-in-law J.  I conceded to using this blog as just catharsis and a way to process my experiences.  What I never imagined was that more than just a few people would ever read, never mind enjoy and keep reading, this blog!

 

So MANY THANKS are owed to all of my readers, who have turned out to not only be moms, but grandmothers, nurses, doctors, doulas, childbirth educators, midwives, and other people in the birth advocacy community.  THANK YOU, for reading!  Thank you to those who find themselves sharing many of my interests and beliefs!!  I love networking with all of you and learning more every day about how to better serve childbearing families.  And thank you to those of you who not only disagree with me but tell me about it too!!  You keep me thinking and on my toes.  Great things come out of great discussions and a discussion isn’t quite as interesting if everyone has the same opinion. 

 

THANK YOU!  THANK YOU!  THANK YOU!

 

With all of that being said I feel that it is time to share a bit more about my personal philosophy regarding birth, breastfeeding, and advocacy.  Of course my opinions do shine through in my writing (after all, it is my blog J) but with all of this “success” (haha, take that with a grain of salt please J) I have found that many people are beginning to label me with thoughts, feelings, and beliefs that I do not hold.  Contrary to what some readers have implied, my goal in writing this blog was not to push my own agenda or to bully women into believing everything I do.  (For example, one mom linked to a lighthearted post on my blog entitled Top Ten Things Women Say/Do During Labor on a popular baby website and wrote something to the effect of “Beware of the rest of her posts because she is pretty hippy-crunchy.”  Another person commented that my blog was something to avoid because I was a “crunchier than thou/more natural than thou natural birth Nazi.”)  Please note that I am NOT writing about these comments to start a flame war, nor did they hurt my feelings (I work in L&D after all, I have a pretty tough skin!  Haha!)

 

However, I did feel compelled to outline what my personal philosophy is so my intentions are clearer in future posts and since it is my blog that is exactly what I am going to do!  I feel that it is better for me to “fill in the holes” rather than have readers “guess” at where I am coming from.  That being said, I DO NOT expect everyone in the world to share the same philosophy.  The beliefs I have written below are meant to be provocative, that is, I am not trying to hide or sugar coat anything to make it have universal appeal.  Also, although I strongly believe in these statements, I can also understand the other side of the story.  For example, although I am a supporter and advocate of spontaneous, un-medicated labor and birth as well as VBACs, I do not condemn any woman for getting an epidural, taking pain medication, or scheduling a repeat cesarean.  I know there are some people out there that would, but I do not feel that way.  In reality more so than anything else, it’s not the epidural, pain medication, or repeat cesarean that bothers me; instead, it’s the women who request these things but have never even researched their safety or risks.  Like author Henci Goer, one of my goals in writing this blog is to never hear another women ever say, “But I didn’t know that was an option” or “I never would have agreed if I had known that could happen.”  You wouldn’t believe me if I told you how often I actually hear women speak these exact words because I hear it ALL THE TIME.  Also, I would like to point out that this is not a completely exhaustive list.  Regardless, here it is!!

 

(Note: Many of these statements are taken or adapted from the following resources)

v     Childbirth Connection’s Rights of Childbearing Women

v     BirthNetwork National’s Mission & Philosophy

v     Coalition for Improving Maternity Services’ Mother-Friendly Childbirth Initiative (MFCI)

 

My Personal and Professional Birth, Breastfeeding, and Advocacy Philosophy

 

Pregnancy, Birth, & Breastfeeding

1)     I believe that pregnancy and birth are normal, healthy processes and should not be treated as illness or disease.

2)     I believe women and babies have the inherent wisdom necessary for birth.

3)     I believe that pregnancy, birth, and the postpartum period are milestone events in the continuum of life that profoundly affect women, babies, fathers, and families, and have important and long-lasting effects on society.

4)     I believe that breastfeeding provides the optimum nourishment for newborns and infants which does NOT mean that I am not grateful for the advancements in artificial milk for those mothers and infants who truly require it.

5)     I believe that every woman has the right to virtually uninterrupted contact with her newborn from the moment of birth, as long as she and her baby are healthy and do not need care that requires separation.

6)     I believe that for the majority of women, VBAC (or vaginal birth after cesarean) is a safe option that should be available to all women in all birth settings who safely qualify.

 

The Obstetric vs. Midwifery Model of Care

7)     I believe that uncomplicated, healthy pregnancies far outnumber pregnancies that have complications and hence, the technology and techniques utilized to maintain the safety of mother and baby in high risk pregnancies should not be automatically or routinely applied to low risk pregnancies.

8.)     I believe that the current maternity and newborn practices in the United States that contribute to high costs and inferior outcomes include the inappropriate application of technology and routine procedures that are not based on scientific evidence.

9)     I believe that although you cannot make blanket generalizations about the model of care that a birth attendant follows just by their credentials, typically speaking I believe OBGYNs tend to follow an obstetrics model of care while midwives tend to follow a midwifery model of care based on the very nature of their education.  After all, obstetricians are surgical specialists trained in the pathology of pregnancy and women’s reproductive organs.

10) I believe that per the very nature, philosophy, and experiences of medical education/obstetrical residency and midwifery education/apprenticeship, midwives should be the only health care providers attending normal, healthy, uncomplicated labors & births while obstetricians should be called to consult or transfer care to if and only if a problem or complication out of the scope of midwifery practice arises.

11) I believe that women need access to professional midwives whose educational and credentialing process provides them with expertise in out-of-hospital birth as well as hospital-based and clinical care that extends beyond the childbearing cycle.

12) I believe that midwives can obtain quality education and experience in a variety of ways and programs, including certified nurse midwifery and direct-entry midwifery. 

13) I believe that integrity of the mother-child relationship as well as the safety of our mothers and babies is compromised by the pervasive over-medicalized, obstetrics model of maternity care in this country.

 

Interventions & Natural Birth

14) I believe that research supports the reality that both a mother’s body as well as her baby will initiate the beginning of labor when the baby is ready to be born and that women should not have their labor induced for any elective reason unless the health of the woman or baby is found to be in immediate danger if the pregnancy is allowed to continue. 

15) I believe that empowering and safe births can and do take place in a variety of settings including birth centers, hospitals, and homes.

16) I believe that every woman should have the opportunity to give birth as she wishes in an environment in which she feels nurtured and secure and her emotional well-being, privacy, and personal preferences are respected, whether that be in a hospital, birthing center, or at home.

17) I believe the research supports that a minimal to no intervention, medication free, spontaneous vaginal delivery is the safest birthing option for the vast majority of both mothers and babies.

18) I believe that the obstetrical model of maternity care plus a pervasive American cultural phenomenon that teaches women to fear childbirth, doubt their innate ability and power to give birth, and be ashamed of their bodies and their sexuality is responsible for many women opting relinquish all control over their birth experiences to others and consent to unnecessary interventions that seem to provide a way to escape.

19) I believe that every woman has the right to create her own birth plan and that her birth attendants and labor companions have the responsibility to assist her in making it a reality as best and safely as they can.  I also understand that for some women, their birth plan does not include a medication or intervention free labor and childbirth and I support this as long as the women has been provided with informed consent, including all the risks and benefits of her requests.

 

Autonomy & Empowerment

20) I believe women are entitled to complete, accurate, and up-to-date information that is supported by evidenced based research on their full range of options, including all procedures, drugs, and tests suggested for use during for pregnancy, birth, post-partum and breastfeeding.

21) I believe that women have a right to make health care decisions for themselves and their babies and that this right includes informed consent as well as informed refusal.

22) I believe that interventions (i.e. many standard medical tests, procedures, technologies, and drugs including narcotic medications for pain relief in labor, epidurals, labor inductions, primary & repeat cesarean sections) should not be applied routinely during pregnancy, birth, or the postpartum period and in my opinion should be avoided in the absence of specific indications and true necessity for their use.

23) I believe that said interventions have life saving potential and are necessary in certain circumstances (which I am entirely grateful for) but are often abused and misused.

24) I believe that maternity care practice should not be based on the needs of the caregiver or provider, but solely on the needs of the mother and child.

25) I believe that every woman has the right to health care before, during and after pregnancy and childbirth.

26) I can admit that (probably related to my educational background, experiences, and values) I am not entirely comfortable with the “free-birth” or “unassisted childbirth” movement but I can also admit that I know little to nothing about the movement and I am open-minded to learning more.

27) I believe that every woman has the right to receive continuous social, emotional and physical support during labor and birth from a caregiver who has been trained in labor support and I believe that the current obstetrical education in this country does not train physicians to provide labor support.

28) I believe that every women has the right to have how ever many supportive labor companions and birth attendants of her choice (as she deems necessary) attend her labor and birth, has the right to change her mind at any time, and has the right to decline the care or presence of any unnecessary personnel during her labor and birth.

 

In closing, I am NOT anti-obstetrician, anti-hospital, anti-intervention, anti-induction, anti-epidural, anti-pain medication, or anti-cesarean.  Quite the contrary I am PRO the appropriate use of such interventions when they are necessary to support the health and safety of the mother-baby unit and facilitate a safe and empowering (hopefully vaginal) birth.  I have found my passion in assisting women and families during the intrapartum period and my number one goal in my job is to support, facilitate, and encourage a natural-as-possible, empowering, and safe birth experience, however that may be, for all those involved.

 

Thanks for reading.

 

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58 Responses to “My Philosophy: Birth, Breastfeeding, and Advocacy”

  1. Rixa Says:

    I do get tired of labels that people apply, especially when they only “know” you from what you say on a blog! I appreciate your writing down these thoughts. I have found your posts quite powerful. Disturbing, too, but I think and hope we can learn from other people’s stories, even if they are not what we’d want to happen to us.

    Have you submitted a complaint about that doctor’s behavior? That is assault and battery and hopefully the hospital staff (and parents) will make noise about it.

    You might enjoy reading my PhD dissertation about unassisted birth (linked on the side bar of my blog). I think that it will help you understand why women make that choice, even if you don’t completely agree with it. I had an unassisted birth with my first, but I wouldn’t say that I’m an outright advocate of it; I think that the choice to have a UC is a very personal one and not something that we can make generalizations about, the way we can with, say, birth centers or home birth or whatever. Anyway, if you ever do get around to reading it, I’d love to hear your thoughts!

    • nursingbirth Says:

      Rixa, thank you for the resources about UC. I will definitely take a look at it and when I do, I’ll let you know!! 🙂 I appreciate you reading my blog and all of your comments. And you are right, a lot of what I write about is disturbing but unfortunately it is true. And the reason I write about it is that I think it is important for people to realize it IS TRUE! 🙂

  2. Kim Says:

    It seems to me in the world of birth there are far too many with way too strong opinions. It seems to be that ‘if you don’t agree with my opinion, you are wrong and must be told the truth.’

    The reason I decided to become a regular to your blog is because you seem to be able to accept most types of experiences as long as the mother and baby are happy in their choices.

    I think it’s refreshing in a spectrum that says either ‘you can only have an empowering birth at home/by yourself/with a midwife/etc’ or ‘you’re crazy/selfish/uninformed/stupid/risking the life of your baby if you don’t….’

    I mostly come from the ‘crunchy’ homebirth side of the spectrum. But it’s been healthy for me to see that not everyone in a hospital is Satan and not all the care providers there are money grubbing, obsessive compulsive, power mongers.

    I probably would still like to give birth at home, but I wouldn’t be completely adverse to getting extra help if I need it. Transfer isn’t is curse word, and despite all the hubbub, I think most providers truly are concerned about helping rather than pushing their own agenda. I also imagine if I made my desires clear I could get a perfectly wonderful hospital experience.

    The reason I appreciate your blog is because it seems to be balanced. It recognizes the benefits of natural choices, the necessity of occasional intervention, and the supreme importance of the mother’s autonomy and having the best experience possible for her situation.

    I hope you continue to share your experiences with us, regardless of the passionate end-of-spectrum comments.

    • nursingbirth Says:

      Kim, you write, “The reason I appreciate your blog is because it seems to be balanced. It recognizes the benefits of natural choices, the necessity of occasional intervention, and the supreme importance of the mother’s autonomy and having the best experience possible for her situation.”

      Your comment really means a lot to me. Thank you!

  3. Shotgun_Mary Says:

    Congratulations on your milestone! I’m new to blogging as well and I’ve discovered that because birth is such a highly personal activity, there is lots of room for bruised egos. I had no idea when I began that if I made a declaration about what was right for me, it could be seen as stepping on the toes of someone else who made different choices/held different beliefs. Kudos to you for spelling out your beliefs and doing what you do. I love your blog.

    • nursingbirth Says:

      Shotgun_Mary, you write, “I had no idea when I began that if I made a declaration about what was right for me, it could be seen as stepping on the toes of someone else who made different choices/held different beliefs. ” I totally agree with you. It is such a shame that people feel that way, that they feel like if they read about someone who did something a different way than they did that it is a personal attack on them. Thanks for commenting and thanks for reading! (P.S. I have checked out your blog and I love the title of it 🙂 )

  4. BirthingBeautifulIdeas Says:

    NursingBirth, I am SO EXCITED about all of the success that you are having with your blog. You should be so proud of yourself that you are making a *real* difference in the lives of birthing women everywhere–and not just the women who are blessed to have you as their nurse!

    For what it’s worth, I think that you are also doing a fantastic job of presenting your opinions in a way that is appropriately gentle, balanced, and well-informed. You support women’s *autonomy* in their birth choices, and this is something to be respected and admired!

  5. Cynthia Says:

    My only experience with childbirth was when I had my two children. The only thing I want to add is how a patient should interact with their nurse.

    I stress with both my children that please and thank you go a long way, and that no one was put on this earth to wait on them. I don’t think that patients realize that nurses really are the gems of the hospital and should be thought of that way.

    In all my interactions, I try not to be needy. If there’s something I need or want and I can do it myself, I ask permission to do it and then I’m on my way. But what’s truly amazing (and not rocket science) is that you get what you give. I’ve always had wonderful interactions with my nurses and if they can slide a needle in without me feeling it, I make sure to tell them that’s they’re a great vampire!

    Your blog is wonderful, keep it up and good luck!

    • nursingbirth Says:

      Cynthia, you crack me up!! I would like add something to go along with what you said…I feel that nurses should always remember that too, that being ” You get what you give.” Like my grandmother (a very smart lady) always said “Kill them with kindness.” I really appreciate you outlook and wish all of the people I met in the hospital had your attitude 🙂

  6. EG Says:

    Okay, I’m going to have to come back and finish the list later, it’s a big one!

    But you should know that a 8 with a closed parenthesis ) makes a sunglasses smiley face. So you might want to change that one.

  7. kaymidwife Says:

    A nursing student in my class alerted me to your blog…she even suggested linking it to my course materials….and I will beginning in May for the summer semester…what a gold mine!!!

    • nursingbirth Says:

      kaymidwife, what an honor! Thank you! One of my career goals is to one day teach nursing students and your post just made me feel like I might already be able to make a difference! Wow! Thanks!

  8. Jessica Says:

    That’s hilarious…those comments made about your blog! For what it’s worth, I truly admire you for what you do. After all, so many mommas out there can’t or don’t want to go to a midwife and WANT to have a natural birth in a hospital setting, yet their plans are thwarted by the system. Those women need more nurses like you! Someone to support and advocate for them within the system, to help them carry out the ideas that they had for their birth experience. What a relief it would be for a woman to arrive and find that they don’t have to fight the staff for the birth that they envision! I’m also impressed at how you balance your so-called “birth crunchiness” with the opposite side of the spectrum. That’s one thing I’m not so sure that I’d be good at. Could I watch a momma come in the door with a medical birth planned and ask for an epidural and agree to every intervention without thinking twice without trying to convince her otherwise? I don’t know. I guess that’s something I should search myself about. Anyhoo, I really appreciate your blog, and thanks to Rixa for linking it in her blog, which is where I found it in the first place. You give me food for thought and ideas for the future. You write in such a way that I share your happiness and sadness, anger and triumph, and genuine concern for the families under your care.

    • nursingbirth Says:

      Jessica, thanks for the encouragement!! You wrote, “What a relief it would be for a woman to arrive and find that they don’t have to fight the staff for the birth that they envision! ” I dream about that world 🙂 And thanks to Rixa too!

  9. Kelly Says:

    I just found your blog and it’s a breath of FRESH air to hear a L&D nurse say that birth is a “natural” process and doesn’t necessarily constitute interventions. I’m not a mom yet, but when I do get pregnant, how can I get YOU as my nurse??

    Also: I really hope the MD you witnessed assault that mother has gotten written up!

    Thanks for your honesty and keep advocating for moms and babies!

    • nursingbirth Says:

      Kelly, this doctor gets written up ALL THE TIME, and I did write him up for this. Unfortunately when dealing with management and the hospital “big wigs” nothing ever seems to come out of it. But we all still keep writing them! Thanks for reading!

      • Lily Says:

        I’ve been reading your blog a bit. Please, please, please write reviews of this doctor (and any you find to be preferable) for people like me to read about on the various review sites (healthgrades, google, etc). It is so hard to find reviews, and the ones that are available are so vague. “Great! He really reassured me.” Reassured you how? That he knew what was best… or that you really can do this the way you want to?

        It would be so helpful if more nurses would be more open with information about doctors (OB or otherwise). If you think he’s a bad caregiver, chances are the patients will, too.

        And, thanks for the blog. I’m just about to stop “trying not to” and it is so hard to find rational information amongst all the hyperbolic fear-mongering on all sides of this. I personally don’t feel very empowered by the crunchy birth movement… just horrified and insulted. If I don’t do this the way they think I should, I’m just a mindless automaton who is just rolling over for some asshole doctor. What if I can’t have a natural birth? What if (DISASTER!) I have to have a c-section? Good to read that someone out there doesn’t think I’m going to burst into flames.

  10. bel Says:

    “…if I could reach one mother, just one, who might stumble upon my blog and be inspired to learn more about labor, childbirth, and birth options, to realize that she has options and rights regarding her experiences and her body, I would then feel triumphant.”

    Please feel triumphant then. I’m 11 weeks and 1 day along with my second child (after a difficult first delivery 10 years ago) and voraciously researching every option I have. This is, in no small part, thanks to your writing. After I found your blog, I actually went back and read every post from the beginning and bookmarked several of them.

    And I’m sure I’m not the only one.

    • nursingbirth Says:

      bel, your comment means so much to me! CONGRATS on your pregnancy and it makes me SO HAPPY that you are researching all of your options!! 11 weeks…wow!! Almost out of the first trimester already!! 🙂

  11. BrAmPa Says:

    I was an L&D nurse, working in high risk, for 5 years, then I went to midwifery school. Now I live and work in New Zealand. Midwifery is “the norm” here- when you find out you are pregnant you pick a midwife and all of your prenatal, labor and postpartum care (including 6-10 home visits PP!!!) is FREE. If you decide you’d rather have an OB that is your choice, but you have to pay for it (minimum $4K). If you become high risk you can see the high risk OBs for free and still have a midwife catch your baby – the best of both modalities!

    That said, midwives here face many of the same struggles as we did back home.

    Thanks for being a voice of reason (I feel like I’m back home again!).

    • nursingbirth Says:

      BrAmPa, thank you so much for your comment. The way you describe maternity care in New Zealand just makes SENSE to me…so much SENSE! It frustrates me that in America, with the healthcare and financial CRISES that we are in, that insurance companies will cover an obstetrician for a normal healthy pregnancy but won’t cover all midwives in all states for same said normal healthy pregnancy. Thanks for reminding me that things can be different and better!

  12. enjoybirth Says:

    I love your blog. I try to be balanced in accepting all types of birth as I teach my Hypnobabies classes and as I support moms as their doula. Most of my students are wanting an un-medicated birth. Some are just wanting their tools to have a VBAC, or overcome their anxiety of birth.

    I have been lucky enough to have experienced 3 types of birth, cesarean, epidural vaginal and un-medicated vaginal. They were all different, but all good, because I had a healthy baby at the end of each.

    My cesarean was very necessary, as my baby was under extreme stress, so I know indeed they are often life saving. But I also know that many cesareans are not necessary, or become necessary because of choices made during the birth. So I really try to emphasize the idea of CHOICES and the importance of them during births.

    Your blog and the stories you share show how those choices come into play and the great effect they can have! Informed consent is SO crucial, but I see time and time again that it isn’t really happening in hospital births. Moms are not told the risks, they aren’t really being empowered to make choices, rather they are being told what to do, or sometimes even scared into doing things.

    So thank you for writing your experiences!

    • nursingbirth Says:

      enjoybirth, thank you so much!! I hope that your students appreciate what an amazing wealth of information you are regarding all three of your very different birth experiences…cesarean! VBAC! epidural! natural! Woah! Crazy!!!! And thank you to YOU for all the work you do to help childbearing families!!!

  13. Expecting #2 Says:

    I just wanted to say THANK YOU! Your blog has been such a great thing for me. My first birth went pretty much as planned. I was induced at 40+1, by choice. I received an epidural (I went in thinking, I’ll try it without, but I won’t rule out the option). I was given a small episiotomy (sp?) when pushing. I thought that I was very happy with my birth experience. Until days later when I still could not get out of bed due to the effects of the epidural. It took about a week to regain use of my right leg, and 4 months to regain use of my left. I still have some permenant numbness in my left leg. Did I know this was a possible outcome? NO! Did I know the possible outcomes of being induced? NO! Would I have made the same decisions if I had known? I really don’t know. I may have. What really angers me it the fact that I didn’t know there were any other options. I was powerless in that I was information-less. This time around I am approaching the birth of my child in a much different manner. I am seeing a Midwife who is very supportive of my choices (no more epidurals for me 🙂 ). I have hired a doula to help me through labor. I feel so much more confident and empowered, and I haven’t even given birth yet!
    So, again, thank you for your stories. They help remind me that I have the power in the birth of my baby. I have the final say in what is done. I have a right to know all of the options and their consequences. I also have the right to expect others to respect my choices and follow them.
    Thank you!

    • nursingbirth Says:

      Expecting #2….WOW you’ve got me all choked up!! You write, “So, again, thank you for your stories. They help remind me that I have the power in the birth of my baby. I have the final say in what is done. I have a right to know all of the options and their consequences. I also have the right to expect others to respect my choices and follow them.” I know that I don’t even know you but I am SO PROUD of you!!! I am just swelling with happiness 🙂 Thank you for sharing your experience with us and for commenting so honestly. I am so excited for you!!! I also applaud you for doing your homework this time around!!! Please know that you are already triumphant just because you are taking control of your body and your birth!!!

  14. Joy Says:

    I think we have share the same brain! Just because our hearts are more set on one path (i.e. natural, unmedicated) doesn’t mean we condemn or don’t agree with other ways of giving birth (c-sec, induction, etc.).

    Your blog is awesome. Your writing style and the depth you share of birth stories is awesome. Keep at it! And NEVER quit!

    • nursingbirth Says:

      Joy, maybe we are twins who were seperated at birth!! Haha! You write, “Just because our hearts are more set on one path (i.e. natural, unmedicated) doesn’t mean we condemn or don’t agree with other ways of giving birth (c-sec, induction, etc.)” and I really think you hit the nail on the head with the way I feel! Thanks!!

  15. I started with the “just one” philosophy, too. If I reach just one woman, especially a primip, who was in my shoes three and a half years ago being bullied into a c-section for suspected macrosomia and she can make a decision based on the actual evidence rather than scare tactics, then I’d be happy. Whether that decision is a vaginal birth or proceeding with the elective cesarean recommendation, my hope is that that one woman will feel good having weighed her ACTUAL risks and have a great birth either way.

    I can write until I’m blue in the fingertips trying to inspire sweeping cultural change, but in my heart is hoping that one woman finds the info that I struggled to find and piece together three and a half years ago.

    A tad corny but true. =)

    • nursingbirth Says:

      Jill-Unnecesarean, as one reader so kindly told me, I will tell you….I hope you feel happy and successful because I know you have touched the lives of way more than just one woman 🙂 You were one of the first birth blogs I ever heard about or read. Thanks for reading mine!! (I feel like a celebrity is reading my blog…just like when “At Your Cervix” comments on my writing!!) Haha! 🙂

  16. Wow. I feel truly blessed to work in a hospital with a huge midwifery practice (they deliver 30% of all births) where I witness birth empowerment every day. I also feel cursed to work in an environment with some practitioners who still feel episiotomies and epidurals are standards of care. This is why sites like Nursing Birth and Unnecesarean exist. Keep up the good word!

  17. Arwen Says:

    I have been enjoying your blog and appreciate your writing. It is good to hear about different options and be reminded that it is a patient’s right to say no. I have to admit, though, that reading your stories can be a little scary. It seems like all of the OB’s at your hospital are cut-happy bullies. Do you have any more positive stories your could intersperse with the “Don’t let this happen to you” stories? I am giving birth in the next few weeks to #2, and was feeling pretty confident about things up until recently, but now I am getting worried. I like my doctors, but a recent tour of the hospital made me wonder what kind of nurses I will have. The nurse giving the tour had some strange reactions when I asked about things like moving around and staying hydrated without an IV.

    I’m started to ramble. Sorry. I live in a small town and don’t have a lot of choices about where to give birth. It’s either this hospital or drive three hours to the closest big city. Who wants to give birth three hours from home?

    • nursingbirth Says:

      Arwen, I appreciate your comment and can understand your worry. You are not alone in the fact that you lack many choices in where you give birth. I can also understand your need for more positive birth stories, one I have already written comes to mind and is called ““I Needed to Know My Body Could Do It!”: A VBAC Story”. Its a story about VBAC but a VBAC is a vaginal birth so even though you wont be having a VBAC, hopefully you will be as inspired by it as I was!

      Also, I noticed that you wrote that reading my stories are “worrying you”. This might seem like a negative to you, but to me, it seems like a positive. Why? Because as Pam England says in her book Birthing From Within, “worrying is a mother’s work!” What does that mean? It means that I encourage you to EXPLORE your worries because they are very real worries that you could LEARN a lot from. In these next few weeks I encourage you to EXPLORE your worries and not just sweep them under the rug.

      For example, you write you are worried about the nurse that might be assigned to you and that she might not be supportive of your natural birth choices (no IV walking around etc). So I encourage you to explore this worry in the next few weeks and ask yourself, “What if I get an unsupportive nurse? Would I feel comfortable advocating for myself? Would any of my labor coaches feel comfortable advocating for me? Should I consider hiring a doula? Would I feel comfortable asking for a new nurse? What could I say if a nurse insists on putting in an IV? What could I say if a nurse insists on continuous monitoring? Do I feel comfortable doing most of the laboring at home and coming into the hospital when I am pretty far along? Should I write a birth plan? etc etc etc.) I guess what I am trying to say is dont be afraid to EXPLORE the worries that you might be feeling. If you do, you might find yourself even MORE empowered to have the birth experience you desire instead of just trying to ignore your worries.

      Also if you are looking to read more positive birth stories (which I think is a great idea!!!!) I encourage you to check out the book “Ina May’s Guide to Chidbirth”. Also one of my readers, a Hypnobabies instructor, alerted me to a website called http://www.pregnancybirthandbabies.com where she has some birth videos and over 200 birth stories. Another blog called Empowering Birth Blog has many great birth stories on it as well. I hope these resources help since at the moment my website is mostly dedicated to the situations one wants to avoid 🙂

      Oh and one more thing….early CONGRATS on your birth, new baby, and new found role as a mother!

  18. MrsW Says:

    “…if I could reach one mother, just one, who might stumble upon my blog and be inspired to learn more about labor, childbirth, and birth options, to realize that she has options and rights regarding her experiences and her body, I would then feel triumphant.”

    Mark me up as another one. I’m nine weeks along with our very unexpected first, and while I had always known that I wanted to “see what I could handle” before resorting to interventions like epidurals, your blog has really opened my eyes to things like inductions, amniotomy, pitocin, unnecessary C-sections, etc. Since I didn’t plan for this pregnancy, I hadn’t researched ANYTHING and it’s so nice to have this resource.

    My mother had 3 C-Sections (one was an attempted VBAC, with one failed induction 2 weeks before the actual birth), and I never really understood what it was she had to go through — it convinces me that *I* really want to avoid that if at all possible.

    One thing I’d like to see you write about, if you don’t mind, is the necessity of C-sections for oddly-angled babies. My friend’s wife had an unplanned C-section last year because something was wrong with the baby’s position (he said something about it getting “lodged” somewhere). When do C-sections actually need to be done if that’s the case?
    Or maybe you could just do a post on “Reasons you might actually NEED to have a C-section,” as a way of letting us all know when a doctor is giving a bogus reason for one.

    Thanks again!!

    • nursingbirth Says:

      Mrs. W, I am so happy you have found my blog, are finding it helpful, and most importantly, are doing your research!! CONGRATS on your surprise pregnancy 🙂 (I have a special place in my heart for little surprises as I was a very very big surprise to my family, haha!) You have so many great questions and I hope to one day write a post that tackles those issues. But until I do here is some informationt that might be very helpful:
      -ICAN (International Cesarean Awareness Network)= http://www.ican-online.org/ [They have a lot of great info on CPD or “cephalopelvic disproportion”]
      – UNnecesarean.com = http://www.unnecesarean.com/ [This writer also has a lot of great info on CPD, shoulder dystocia etc]

      Also, one more point I would like to make is that to assure that your doctor won’t be giving you any bogus reasons for needing a cesarean is to RESEARCH, RESERACH, RESEARCH your provider. And you are so early along, even if you have already gone to a prenatal visit, it is not too late to RESEARCH your options regarding your care provider/birth attendant. I actually just posted a post today called “Must Read Blog: It’s Your Birth Right!!” that talks about how to pick the right provider. Providers who truly follow a midwifery model of care, a model that by the very nature of its values and beliefs trusts that mothers and babies have the inherent wisdom necessary for birth, have the STATISTICS to prove it, that is, less interventions including inductions, cesareans, episiotomies, and more successful VBACs. (Let me give you an example, I work with one particularly amazing physician who I believe follows a midwivery model of care and his actions, statistics, and bedside manner support this. So when he looks at me and says “Melissa, I think we need to go to the OR for a C/S” I trust him, and if I bring up any other suggestions or questions, he never ignores me or brushes me off, he acknowledges me and explains to all, including the patient, his reasons. Unfortunately for pregnant women, they do not get this type of “inside look”. But that just means that RESEARCH is that much more important. I hope this helps!!!

  19. Katelin Says:

    I share everyone of your personal philosophies regarding pregnancy/labor and I think that you are doing a great job of being balanced. Sometimes I fear being judged in a certain light because of the way I mother, give birth naturally, breastfeed, etc…. but I’m starting to realize that USUALLY when people are judging me it’s more of a reflection of themselves and may be upsetting to them because of an unresolved issue they have with themselves and their own experience. OR maybe it’s the first time they realize that they have options reqarding childbirth and they are feeling mislead and betrayed about it.
    I came to my philosophies about birth during the pregnancy, and after the birth, of my 2nd child (daughter Adaira), here’s a link to the slideshow if you would like to veiw it; http://mammashere.blogspot.com/2008/08/slide-show.html
    My first child, (son Paxon) was an “accidental” natural hospital birth. I say ‘accidental’ because I was going to ‘try’ it naturally and see how far I got, but asked for the epidural at about an 8 and neither my body nor baby had time to wait for the anesthesiologist to get there. The doctor cut an episiotomy and used forceps to deliver him. (I’m pretty sure that was all unnecessary.) I could have certainly been better prepared for the natural birth with my son, but wasn’t AT ALL.
    I loved my midwife with my 2nd pregnancy. We talked a lot about how to handle the pain during labor and my fears, trepidatious feelings, and my excitements.
    My journey to realize that childbirth is usually a natural process in a child-bearing woman’s life was slow, but it did happen. In wonder in reading your blog how to get this information ‘out’ to the first time moms OR even the women who aren’t even thinking about motherhood yet? Our culture has such fear behind childbirth, which is what I felt with my 1st pregnancy… I still saught out information, but didn’t ever get ‘fully there’ before giving birth. How do you reach those moms (like myself)? and Do more women need to be speaking out about their own unsatisfying birth experiences with OBs? I think money talks and I wonder if women started bringing up lawsuits against these OBs, would it change? My son still has a bump on his head (he’s 3 now) from the forceps and I’ve often thought about bringing this to a lawyer although I am extremely doubtful that we would be able to prove any misconduct by the doctor….
    Okay, sorry for rambling! BUT Keep up the great blog!!

    • nursingbirth Says:

      Katelin, I just watched your birth story slide show and I was so moved!! Thank you so much for sharing it with me! The pictures of your son and daughter together are absolutely adorable. I am so happy you had the birth experience you had worked so hard for!

      As far as your comments to me, I think you nailed it when you wrote, “Sometimes I fear being judged in a certain light because of the way I mother, give birth naturally, breastfeed, etc…. but I’m starting to realize that USUALLY when people are judging me it’s more of a reflection of themselves and may be upsetting to them because of an unresolved issue they have with themselves and their own experience. OR maybe it’s the first time they realize that they have options reqarding childbirth and they are feeling mislead and betrayed about it.”

      I am so happy you evaluated your first experience and researched and found a birth attendant that held your same values and beliefs. You write, “In wonder in reading your blog how to get this information ‘out’ to the first time moms OR even the women who aren’t even thinking about motherhood yet? Our culture has such fear behind childbirth, which is what I felt with my 1st pregnancy… I still saught out information, but didn’t ever get ‘fully there’ before giving birth. How do you reach those moms (like myself)?” And my response is, I HEAR YA GIRL!! I struggle with the same thing. I hope my blog is making a difference to some but I know it’s impact is small. But i figure, better small than no impact at all! I have toyed around with the idea of trying to see if I could make presentations at local highschools or colleges about birth (not just how to prevent pregnancy you know) to try to counteract this culture of fear we live in but i havent quite figured out how yet since I am relatively new to the area I live in and have few “connections”.

      You also write, Do more women need to be speaking out about their own unsatisfying birth experiences with OBs? and all i have to say is YES YES YES YES YES YES YES!!!! TOO MANY women just accept that they have gotten “a baby out of the deal” and dont realize that they have a right to have the best birth experience they can have. So please, keep telling your story!!!!!

  20. Heather Says:

    I’m planning a home birth for #1 who is due in about 6 weeks. I’m obviously biased 🙂 What I love about your blog is that you’re supporting moms and what *they* want. So many care providers are just moving women through the system. It’s refreshing to see someone advocate for them and help to let people know what really might go on once they get to the hospital.

  21. Marissa Says:

    MrsW from some of my research, it is possible for the baby to get stuck because their head is tilted to the side and can’t get into the pelvis. it is, however, possible for the baby to straighten out if the membranes haven’t ruptured. Early rupture of the membranes means the baby can no longer maneuver as well, and if they are not already in a good position, they can get stuck.

  22. BCB Says:

    I’m a nursing student and I just wanted to say how much I love reading your blog. Your stories are sad but inspiring. I enjoy reading about how you truly advocate for your women.

    I entered nursing school already an ameture “birth junkie” and I was really looking forward to my rotation to the L&D unit during clinicals this semester. I ended up disapointed with quite a lot of the nurse behavior and attitude I observed. Based on comments and conversations at the nurses station, seems like they mostly could not understand why anyone would not want an epidural, and they seemed uncomfortable about supporting natural childbirth. Do you think it’s a nurse thing? Nurses want their patients to behappy, smiling, and pain-free, and childbirth defies all of those desires.

    Thank you for writing, for telling your stories, and for helping me understand that Labor Nurses can be awesome people!

    • nursingbirth Says:

      BCB, thanks for your comment!! I too was a bit disillusioned with part of my L&D clinical rotation. I don’t think it’s necessarily a “nurse” thing, because I have met many nurses on my side, but you have to remember that L&D nurses work in hospitals and hospitals are a place where the medical model of maternity care began and is running rampant! I think it’s a “cultural” thing, regarding the culture of the area or hospital you work in too. You learn what you live, ya know! So if all you work around is cut happy OBs (like in my hospital where the C/S rate is almost 40%!!!!) and you never hear things any other way, I can totally see how you start to believe it can only be that way. When I watched the Business of Being Born for the first time I was already starting to get sucked in a bit to my hospital’s high risk culture, that is, although I have always had a gut feeling that there was nothing crazy about natural childbirth and thought all the technology we were using was kinda crazy, I was totally resistant to the home birth idea because the nurses I worked with outright condemned it openly. Thank God I didn’t get all the way sucked in!! 🙂

  23. aisha Says:

    Its so irritating to me that just because you believe in the natural order of things like normal childbirth or breastfeeding people want to label you as a “crunchy”, “hippie” or just plain weird. I eat my fair share of meats, I do organic when its affordable and available, and I shop at big retailers like anyone else. I believe in natural or “normal” child birth and I am 100% in favor of breastfeeding, but I am no where near “crunchy” or hippie, I would characterize myself is as balanced. I do believe that there are times when interventions are absolutely necessary especially when the health of the mother and/or child is compromised. These interventions were created or designed for that purpose only, to save a life.
    I get offended when a doctor treats me like an uneducated weak woman that can’t understand “why” and I absolutely HATE when people do or agree on things out of CONVENIENCE rather than necessity.
    Maybe we think similarly but I in no-way have read your posts thinking that you are biased towards one way or another, I think that you come accross more like a fairness-advocate, or a conscientious-caregiver. THANK YOU!!!
    I could keep going on and on, but just, Thank you!

    • nursingbirth Says:

      Aisha, no THANK YOU! I really appreciate your comment and I like how you consider yourself “balanced”. I really like your outlook!!! Now if I could just get the other nurses I work with to stop calling me the “young hippie nurse” and roll their eyes when I get choked up after being a part of a particularly inspiring and empowering birth, we’d be okay. Honestly now! Haha! 🙂

  24. Renee Says:

    Congrats! This had certainly fast become one of my favorite blogs. I don’t see how that could be flame worthy, but I’m sure someone will turn it that way. Such is the nature of the interwebs! You certainly made an impact on me with your post on grieving the loss of a vaginal birth, and the sharing of the other post that you linked to. I cried when I read it because it put in words how I felt but couldn’t quite put right in my head. We will be trying for #2 in the fall and plan on a VBAC. I knew there were feelings that I had that I need to work through to be mentally and emotionally prepared of it and this was a stepping stone that I needed and will come back to when I need help working through the issues in the future. Your other post about VBAC’s, Cytotec, and rupture risk also put my mind at ease. I did not believe that VBAC’s are dangerous, but I didn’t want the “propaganda doubt” creeping in and hearing that side of it was great. Thank you so much! (If you have any other insight links regarding the loss of a vaginal birth I would love to hear them!)

    • nursingbirth Says:

      Renee, I am so happy you are enjoying my blog!! You wrote, “I did not believe that VBAC’s are dangerous, but I didn’t want the “propaganda doubt” creeping in and hearing that side of it was great. ” Have you ever read the book “Silent Knife”? Its a book about Cesarean prevention and VBAC. I have wanted to read it for a long time and just started reading it today and I am blown away by it! So far I think it is a must read for any mom planning a VBAC 🙂 I hope you keep reading and HAPPY BABYMAKING!! 🙂 (Enjoy it 🙂 )

  25. maria Says:

    This may be controversial, and I am certainly not done thinking about this issue, but when reading this post, what you wrote about OB versus midwifery model of care struck a cord. In principal I agree with you. There seem to be so many danger however in making any model of care the model of care when our insurance climate and all that ties into it, has such an important role in any regulated form of health care. I don’t mind any regulated model of health care as long as there is room for individual and autonomous choices. I am afraid that an across the board unification of midwives under one model of care which then also defines that model, is risky.
    Anyway, here my blog about this, and like I said I am not done writing about this, but would love your thoughts on it.
    http://maria22000.xanga.com/699842101/what-about-midwifery/
    I keep coming back here and reading your blog. I will link yours to mine 🙂 You have such valuable information to share. People don’t always want to listen to a crazy UC-er.

  26. Wheeee! I’m comment #50. Where’s my prize?

    You are too funny! I felt the exact same way when Rixa commented on my blog for the first time. Then AYC linked to me and I gasped.

    You are doing a fantastic job and obviously filling a need in peoples’ hearts to understand what it was that happened to them when they checked in for childbirth at their hospital.

  27. Hello, I’m pleased to tell you that i stole your birthing philosophy because it’s perfect, said just as I would!!!

    I gave you 100% credit, and changed United States to Canada and America to North America.

    At this point I am a new doula, aspiring midwife, and an RN who was recently robbed out of a natural home birth because of the legal acceptance of midwifery here in my home province. When the law accepted midwifery and it became regulated, my midwife who was US trained and had no hospital cirriculum in her program was de-throned. Thus began my journey to make sure no other woman will suffer a forced-hospital birth under my guise.

    But I hear you on being an RN and having a natural birth as well as exercising caution because of our professional designation and tendency to allow the intrusive thoughts and experiences to permeate your practice. It’s good to use evidence-based practice, but I know that sometimes you follow the sheep and grind your teeth just to keep the peace… at least I do!

    Anyways, I’m closer to your philosophy and I really, really dig your blog.

    Also, I resent that people compare us to Nazism. I got labeled a breastfeeding Nazi and almost busted a nut – seriously? Where in my breastfeeding philosophy does it say anything about a final solution? I think that, in itself, is disturbing that people attach that term to such a positive and well-intentioned belief.

  28. rachel Says:

    Wow – this blog post and comment stream are fabulous! We’re starting to build out a website resource about birthing centers and alternative birthing methods. We’re just getting started, but we’d love your feedback and suggestions.

  29. […] For more information on my personal philosophy please check out: My Philosophy: Birth, Breastfeeding, and Advocacy […]

  30. Jill Says:

    WOOHOOO! What a great post! Who knew that it was possible to be an advocate for all mothers and babies without being staunchly pro-one side or pro-the other? 😉

    This made me tear up a little as it is a subject that has been weighing on my mind recently:

    “I believe that the obstetrical model of maternity care plus a pervasive American cultural phenomenon that teaches women to fear childbirth, doubt their innate ability and power to give birth, and be ashamed of their bodies and their sexuality is responsible for many women opting relinquish all control over their birth experiences to others and consent to unnecessary interventions that seem to provide a way to escape.”

    It’s so sad and it’s something I have been itching to write about but just can’t find the words. Maybe this little snippet will help me.

  31. Melanie Says:

    Thank you so much for all the time and work you put into this blog. I have been slowly making my way through all the posts, and I find them so helpful to my thinking. My husband and I have been planning to have a baby for the last year or so; and in that time, I have been trying to educate myself about all the different medical options during birth. I have found your blog to be a comprehensive yet succienct source of information.

    I have also been highly encouraged to read that a nurse in a “large metropolis in the Northeast” with such views exists. We moved to Boston from Oregon a few years ago, and I find the cultural differences, especially the attitude toward medicine, to be a little overwhelming. It gives me hope that should I end up in a hospital during birth for one reason or another, there is a chance that I would have an attendant who would be respectful of my views.


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