It is February 19, 2000. I am sitting here at about 38 weeks pregnant. I am not ready to have birth. I have not finished enjoying this pregnancy. If I were to birth tonight, I will be ready in my environment. However, ultimately I would heavily grieve the end of the pregnancy. I have only just begun to truly feel pregnant and enjoy the experience while getting to know my little one growing inside.

This has been a pregnancy of stress and inner struggle. Not due to the pregnancy itself, it is a very healthy pregnancy. What has happened has been I have become aware of what it means to carry a child, look forward to the birth (and every sensation that birth can bring), and revel in the new beginnings of life.

Trusting in my body and in my faith that I have been beautifully designed to do all that my body is capable to nurture my child during birth and afterwards.

So where is the stress coming from? Why the inner struggles?

I have come to realize, in reflection, that this pregnancy has been used to try to role model to other women that birth can be wonderful. That is if left to its own devices and trusted with total body and mind. I have felt proud to state that this babe will be born at home. That bravery has nothing to do with homebirth, and that, babies do better under the care of midwives who ultimately trust and understand the true ways of the female body and birth.

What I have encountered during this pregnancy is the typical reaction of ignorance by the general birthing public in relation the primitive aspects of birth. The complete faith placed in strangers when it comes to bringing forth their babies is astounding. Moreover, the heavy reliance on medication to make them safe and comfortable. When meeting up with this ignorance, I try to educate.

That is where the stress comes in. 

The struggle comes from inside, in trying to respect the opinions that the birthing community and the medical community have when it comes to birth. But, everywhere I go I see misinformation. I see women having difficulty birthing and not turning and blaming the system for ill informing them of what really happens during birth. I hear examples of women having slow labor, the need for forceps, emergency c-sections, upon delving just a bit I also hear about the epidural they "just had to have", because their coping with labor was ineffective. One nurse upon hearing of my homebirth beliefs stated "Well, we are the post-partum hemorrhage (bleeding heavily after birth) place". I stood there in the hospital hallway wondering if she actually heard herself.

Yes, postpartum hemorrhage happens. I just wonder did she correlate the high intervention and epidural rate to this high rate of bleeding. I think not. There is too much trust in the medical system, and too little faith in birth. Women entering the birth arena with birth plan in hand and none of the tools (i.e. education and/or support persons) to ensure that the plan can be maintained, are no better off than the woman who gives herself totally to the care of the system.

I struggle with trying to understand why women do not question the drugs and intervention as being the reason they had problems birthing. Why is the use of drugs in birth not questioned, when they will have the most profound effect on the babe as he or she attempts to take those first breaths or tries to nurse the breast. Instead, the narcotic cupboard is flung wide open. However, in ignorance they are usually so grateful to have the healthy child, after all the emergency measures are taken, that they do not reflect on what caused the problem in the first place. I shudder watching a mother cooing and commenting on her docile child. Commenting on how "good", he is. Does she not see that he is stoned to the gills? Is not it odd that he does not react to the fact that he has a broken clavicle from the vacuum extraction that occurred due to the physicians rush to end the pushing phase of birth. It is only three days later that he responds to the pain in his body. Women have been conditioned. They do not to see the intervention as the problem, but to see themselves as the problem.

An example of how the system dishonors the process of birth reflected in this situation. My client's obstetrician comes in and checks my client's cervical progress. Her membranes are intact, and baby is positioned transverse in the pelvis (that means baby in the process of rotating from posterior to anterior is at present midway in his rotation), and the mom is at approximately nine cms dilation. The OB breaks the waters (for no reason I could fathom). What happens next is that baby loses the nice cushion of water he was turning on and gets stuck against a cervix that is yet to be fully dilated. Now the mom gets the strong urge to push, which of course she is told not to do because she is not fully dilated. For an hour, this goes on. Finally, she is told she can push, but by then, she has lost so much energy holding back that the baby needs to be suctioned out. (By the way she did this all without drugs, just two very helpful doulas and a loving husband and lots of faith.)

For exercise, this pregnancy I decided to do prenatal auquasize. Oh, it was wonderful. All those wonderful growing bellies all around me. The potential to share what I know about birth. Well, in the end after every class, I would end up physically sick. So sick I would have to stay away. In the end I just gave up and never returned. It was so heart breaking to hear about the births that would not progress and ended in cesareans. In my mind, I would be thinking, "she had an epidural too early", or "she was not aware that she had gone to hospital too soon which slowed or stopped dilation". On and on my mind would spin. Birth is just not that hard a thing to do. I cringed hearing about women chemically induced at little over 40 weeks, the docs having no trust in the fact that pregnancy could go longer quite safely. Mothers not realizing that the emotion of wanting the pregnancy over is part of the experience of coping with labor. Time after time I kept hearing stories of faulty birth. The only one I heard that went quickly was the home birth my auquasize instructor was to attend. I just kept seeing all these women and feeling that the most important element of their birth knowledge was just not available to them. Why was it not? Because the system does not teach what I have come to realize and know in it's routine childbirth classes. These women were missing generations of birth knowledge that had been wiped out within this century alone.

I have birthed twice before. Each time I can say that I was innocently ignorant of what REALLY happened to make birth easy. I just knew that I had to give in let go and trust that my body would know what to do. I had not fear. I did not realize all I know today. I was lucky. VERY lucky. This is, unfortunately, not the story for 99.9% of the birthing women in the city I live in. I have had to actively search for the knowledge I have. Who out there can honestly say they understand the birth philosophy of Michel Odent, let alone even know who he is. Though I can guarantee you that every pregnant in this city woman has heard of "What to Expect When You Are Expecting". This is a sad case for birth knowledge. Women are given limited information and then told that the choice is up to them. They make their choices with a lack of real information. There are too many women out there in this world that want drug free births, but are just not told how to do it, or supported in it when they present in labor. Why is this? Because once they are in labor and the forces of labor emotions are in play, women do not want to feel the intensity of the contractions. They want it over with as soon as possible. What they encounter is the interventions to assist them in their height of labor desires. They rarely encounter a nurse that is committed to getting them through the hardest part of labor without drugs. They encounter a nurse that "respects the  mother's choices in birth" (though she does not really know the mother) and puts the call into the anesthetist for yet another epidural. Did you know that one of the fastest growing fields in medicine is obstetrical anesthesia?

I can honestly say that after 2 years of nurses training and with doing a two month obstetrical rotation that I knew nothing but the mechanics of birth. I knew that drugs should be avoided, but for some women they helped her dilate after hours of being stalled at certain dilation. (Not until researching the "why" of this phenomenon did I realize that the drug "made" the mother shut off her brain so her body could get on with the task of birthing.) Not once did I even contemplate that having me do an "educational" cervical check would precede the stall in dilation. Not once did I think that the strange intern appearing on the scene to ask if he could watch the birth mattered to the rate of dilation. Moreover, not once did I think it mattered that induction of labor could ultimately harm the baby. And, OHHHHHHHH how I loved to watch that machine (the electronic fetal monitor), how I came to rely on it to tell me all I needed to know about baby's well being. I actually prided myself on being to read a strip of paper and notice if baby was having distress. But did I learn how my words effected her? NO. Did I learn that peace, dark, and quiet would speed the birth? NO. I left my internship (in 1994) crazy about birth, but with not a clue as to the real meaning. I can only imagine how much less the average birthing woman knew. When I had graduated from my perinatal course (June 1999), elements about birthing care had changed and information about birth emotions and their effects on dilation were taught. Mind you I had already learned about this on my own having had my homebirth prior to taking the course. What had not changed was the inconsistent care women continue to receive in the system. Though doctors and hospitals were welcoming birth plans, women still have to shoulder the burden of discovering what birth really is all about on their own. In addition, the information presented to them, though better than before, is still lacking greatly. The majority of women still do not know that midwives work in this town and what kind of care they receive with a midwife. A doula is still a foreign word to many. Women continue to be shifted from stranger to stranger during their hospital birth experience. She is still not sure if the doctor she is attending during her pregnancy will be the one to attend her birth. She will not know the range of nurses that will care for her during her labor (Shifts change and if your not near the end of the birth, you will get a different nurse. This in itself may stall your labor.) . She will have no control over the personality of the person caring for her in such an intimate moment. And, she will not know the range of persons caring for her and her baby after the baby is born. What she will encounter is the body's primitive, automatic reflexes to all this strangeness (Read stalled labor, augmentation, increased pain, epidural, possible surgical removal of baby.). In the end, she will ultimately experience the consequences during the birth and breastfeeding process.

When I became pregnant with my first-born child. I sailed through the pregnancy. Not really giving it much attention (as most women). I spent most of that time at my mom's bedside while she slowly died of breast cancer (ladies reading this please do your monthly breast exams!). I was 30 weeks when she passed away. It is only in hind sight do I see that not once during that time did any of the hospital nurses ask if I was being cared for (I was from out of town). Not once did one medical professional ask if I needed anything in regards to pregnancy. As my belly grew I needed new clothes, not once did the nurses suggest where I could go to get some. Yes, pregnancy is a normal state of being. Though I found it so odd to be amongst my ìown kindî and have to fend for myself when it came to dealing with my mother dying and being pregnant with her first grandchild. As I said only in hindsight do I see this.

My son's birth was wonderful (Birth Issues '97). I was lucky that the doctor on call was who she was. If it had not been I do not know and do not even want to imagine what would have happened. I do know that the nurse that took me to a birth room put me on the monitor and left to see if I could have something for pain did not once inquire about my birth plans. The routine is so set that all mothers are treated pretty much the same. Even to the point of birthing in the same "sit on your butt with legs spread" position that the bed is designed to place you in. Well, this is not so bad to the majority of those who might be reading this. And HEY I was more than willing at the time to bare my butt against my pre-birth wishes of a drug free birth. Man, this contraction stuff was not very much fun. Especially having to be lying in bed with that damn monitor on (you remember the same one I so loved and depended on in training for nursing). Thank God, I was assessed at two cms and was sent home. This proved to be the best thing. Once out of the hospital my waning contractions picked up and I was back two hours later. Three pushes and my baby was in my arms (so to speak). At that moment, I learned that one does not need machines, drugs or a whole lot of nurses and doctors looking at your nether parts to birth. It just happens when you have faith and peace of mind that all is well.

Pregnant six months later, home birth was suggested to me. And my life with midwifery took off. I can still say that I birthed in innocent ignorance at home with my midwives, doula and husband. I had blind faith that they would do the best for me and that I had a fully functioning body that could expel this child if I just let it. I could afford this innocent ignorance, I had people around me that knew the ways of birth and did not interfere with an alternate agenda that was their own (nothing being done just for policy sake). The birth was wonderful. I could not believe that something so natural as birthing at home was perceived as such a dangerous, out of bounds thing to do. I think this was the first time I realized that I chose home birth to model that birth was a safe thing. And that if the right people were around you, and you had trust, that no "machines that go BING" were necessary. After this, I began to campaign to help promote midwifery and home birth. I spent the next two years being involved in the natural birth community. I also went back to school to get my perinatal nursing so I could have the credentials to let people know I knew what I was talking about. Thus began my struggle. (Oddly enough, I had been with the same doctors group as I had with my first child. I was not made aware the midwives that worked in the same office. Not once was midwifery was never suggested during my first pregnancy. That says a lot about how little we women are informed of our options.)

After my community involvement in trying to get women to open their eyes, and see that there was a better way, I realized that often my words fell on deaf ears. Women in the majority wanted to have their epidurals and believed them to be safe, and that birth outside of hospital was just excessively risky. The "birth needs machines near by to be safe" crowd I call them. Then there is the crowd that is totally opposed to hospital birth (yeah, I am one of them), and believe that women are beautifully designed to birth. I have found that in the two years I have worked in this environment that one group is very happy to just keep the status quo (read 85% epidural rate). The other is beating its head against a brick wall in its efforts to educate the masses about how safe homebirth and midwifery really is, and that it is the norm around the world.

All this brings me to the pregnancy that is within me now. My little one inside has decided s/he does not like to be upside down. I felt that everything I stood for was about to be taken away from me or at least challenged. I would have to enter the medical system if baby did not turn, or at least enter it to have baby turned by a doctor. My head was spinning. I was feeling loss of control of my pregnancy, my body. I had two weeks to see if baby would turn. In this two weeks I came to see that my faith was being tested.

My beliefs were on trial. Exactly whom was I depending on to make this baby and I "safe"? Certainly, it was not I. My midwife and her apprentice addressed the issue during my 35-week visit. I no longer felt that innocent ignorance about birth.

I now sit here at 38 weeks pregnant. What are the conclusions I have come to? Well my faith has been restored. I have regained my birthing confidence. Will I have this baby turned manually? NO WAY!!! The medical community says, a breech is better off being birthed through a surgical incision or being manually turned. Not so for me!!!! I trust my body and my baby. I do not want to place my baby is jeopardy by subjecting this little one to an external version (manually turning baby). The jeopardy being that something could go wrong (that is the reason they monitor the procedure). I would be happy to push this baby out butt first. After all breech is only a variation of normal birth. I have come to see that I need to respect my baby from the very start. If baby needs to come out butt firs, then who am I to say different. If baby stays breech, I will have to birth in a hospital according to my midwifeís regulations. No, I'm not looking forward to the transfer up the hill to the designated hospital, but if that is the way it is to be then that is the way it is to be. This I have to accept (I am not the unassisted birthing type, yet). I just hope I will be respected for the *knowledgeable* choices I have made in birthing this babe. I hope that the nurses that frown on home birth will see that I would have done this at home had my midwife been *allowed* to attend me. I am not birthing with innocent ignorance this time around.

I have seen what happens to great many women when they follow the traditional birthing system. That system that is filled with holes and is so inconsistent in its approach in its care (although it tries to be consistent) that women every day end up with unnecessary interventions and problems with breastfeeding. I was lucky. Not all women are. For we, as a society, are not taught that birth is not a danger to be avoided. We are taught about the mechanics of birth, but not the emotions. We can birth well not knowing the mechanics, if we are aware of the emotions, but it does not work the other way around. Just as we have no knowledge of what sexual intercourse would feel like when we were virgins, we do not know what labor will be like until it happens. We can not anticipate our needs until they are before us. Think what would your view of sex be like if all you heard were stories about rape and molestation. Your approach to sex would not be of something to be enjoyed, but endured and best avoided. All babies would be conceived by invitro-fertilization. Would you even know to try to seek out the possibility that sex could be joyful and pleasurable? This is what has happened to birth.

Birth has become a mechanical process that creates stories fraught with danger and fear. An example of when this fear starts was when my 5-year-old niece asked if I was scared to have the baby I now carry. I asked her "what is there to be afraid of"? She said "the needles" . How sad. Of course, I told her that ladies do not need needles to have a baby. She was very interested to learn that her cousin would be born at home. The birthing system does not have in play the resources to meet the needs of women that desire drug free birth. We shun midwifery, the one profession that knows how to keep birth normal and uncomplicated. Midwifery and natural birth advocates know that even the lowest risk pregnancy can turn into the highest risk birth once the woman accepts interventions (read epidural, continuous monitoring, and induction to name a few). It is too late to educate the average woman if she is already pregnant and soon to birth. If she is not already looking for an alternative to what she has heard about or what she has already experienced, there is nothing I, or anyone else for that matter, can tell her that will change her birth beliefs. If she believes epidurals and c-sections are safe methods of birthing, then I have no chance to educate her.

It is in educating the yet-to-be pregnant women, that the future holds promise for better birth. Women need to be aware of how their body works in conception, birth and breastfeeding to have a healthy approach to the processes. They must learn that birth is a normal part of them. They need the education. They can not just remain "innocently ignorant" that they will be properly cared for by the medical person who just happens to practice obstetrics or by the specialist in high-risk birth. By educating all women early in life, it is hoped that they will be able to make informed choices with "researched based" information. There will always be the population that does not view the process of birth as a special event that will effect the child for the rest of his or her life. So, let us protect the women that desire to have normal birth, the ones that see birth as a wonderful event, the ones that want to keep their babies free from drugs and trauma. Let us educate them so that they do not end up in labor and experiencing fear. Let us guide them from ignorance of birth so that they understand the emotions and the chemical symphony that that is in play in their body and guiding them. Let us help them experience birth as a sensation not to be feared. In education, the woman will not just believe and follow the mass of consumer demand for intervention to save them from the rigors of birth. They, like the rest of the world, will enter pregnancy and birth with a positive view. A view that will help bring our future children into this world with less drugs, less trauma, and less fear. It is not until these elements of today's birthing society are removed, can women truly return to birthing with innocent ignorance.