I recently received a call from my niece, who's pregnant with her first child. She was nervous that she'd get to the hospital and wouldn't know what to do. At one point when we were talking about the stages of labor, she asked, "Is that when I'll scream?"
"You probably won't need to scream," I reassured her, remembering the peaceful natural delivery of my second child. "You'll be focused on your work: giving your son the time and space he needs to make his way into the world."
I was eager to share what I'd learned, in hopes my niece would have a very different experience than my first dehumanizing hospital labor -- memorable for a cascade of interventions that set me up for a cesarean. I'd ended up feeling like the least important person in the process, a bystander, exhausted from blood loss, shaking too hard to hold my newborn.
Later, when I complained about this experience, more than one person asked "Why do you care? You have a healthy baby."
But I did care -- very much. To me, giving birth is the mother's job, not the hospital's. I was determined to have a better birth the next time.
So I went on a quest -- with a friend who'd delivered at the same hospital, with the same doctor, and the same result -- to learn what we needed to know about natural birth. International Cesarean Awareness Network (known then as Cesarean Prevention Movement) pointed us to helpful books like Silent Knife: Cesarean Prevention and Vaginal Birth After Cesarean (VBAC), Birthing Normally, Transformation Through Birth: A Woman's Guide, and Spiritual Midwifery. It introduced us to doctors and midwives who support VBAC.
At one meeting, I wept through the entire ten minutes of Birth in the Squatting Position, broken hearted at the contrast between the births onscreen and my own experience. The film, recorded in Brazil in the late 1970s, shows five mothers near the end of labor who, one after another, squat to deliver their babies -- either into their own hands or onto a soft spot prepared to receive them -- without intervention.
In each case, the mother is clearly in that trance-like state a midwife I know calls "labor land," the place where birthing women go when they're free to labor unfettered.
Birth in The Squatting Position convinced me that self-directed labor was not only possible -- it was the way to go. I wanted to labor with a minimum of interruptions, on my own timetable, moving as I wished, instinctively choosing the position that was the most comfortable. In this duet between mother and child, the mother's job is to be a vessel for birth, to open, wait, let it happen. Relaxing her belly and visualizing her cervix opening like a flower (techniques I used) may seem counterintuitive in the midst of a contraction, but this makes it easier for the baby to move down.
The baby has its work, too. In my second labor, I felt my son plant his little feet at the top of my uterus, then dive, butting his head against my cervix.
Self-directed labor thrives in a quiet, softly lit setting. It requires attendants who are willing to wait, whose role is to support and encourage the mother so she can turn inward, produce the stress hormones that help her manage the pain, and move naturally toward birth.
Most doctors and hospitals won't allow this. Instead, at a time when a woman is most vulnerable -- and most needs a buffer between her and the outside world -- she's poked, prodded and repeatedly interrupted, confined to bed, the clock ticking. If her cervix doesn't dilate "efficiently," her labor is "augmented" with Pitocin or Misoprostol, which rapidly render contractions unbearable. There's ample evidence that these practices put women at risk for interventions, complications and often, surgery. I've often wondered why women put up with this.
Cesarean is a lifesaving alternative when the mother or the baby is in trouble. But the cesarean rate in this country is nearly 34%, far higher than it should be.
The renowned midwife and lecturer, Ina May Gaskin, who's attended thousands of births -- and whose birthing center has a cesarean rate of 1.7% -- points out that most people don't know any other way. In an interview in the January 2012 issue of The Sun, she explains that the births broadcast on television show the mother on her back (a position that's especially painful and completely disregards the role of gravity), hooked to an IV and a fetal monitor, her vagina blurred so viewers won't see it.
"Women... never see what their bodies can do, given a chance. What we aren't allowed to see then enters the imagination, and fear takes over."
No wonder so many women these days are leery of natural childbirth -- or even vaginal birth -- not realizing how perfectly their bodies are designed for it. As are babies.
Baby birds only thrive if they peck their way out of the shell themselves. Similarly, under normal circumstances, labor prepares human babies to thrive outside the womb, increasing blood flow to the baby's brain, heart and kidneys and facilitating bonding. The journey through the birth canal presses amniotic fluid from their lungs, readying them to breathe, and provides protective bacteria that help them form a balanced immune system. The struggle to be born is a baby's first life lesson and an affirmation that he or she can succeed.
As I explained to my niece, her job is to let this happen. "Imagine you're a mother animal in the wild," I urged. "Don't worry about what might go wrong. Pick a safe place, surround yourself with people who'll support you, then trust your body."