Happy Homebirth

 

This week we’re speaking with an incredible woman, Ginny Yurtich, founder of 1000 hours outsideJih, and mother of 5 children with very different birth stories.  In her first birth, Ginny’s pre-eclampsia “disqualified” her from her birth center experience, and we’ll see just how she handled this in subsequent births. 

 

 

 

Follow Ginny: @1000hoursoutside

Ginny's website: www.1000hoursoutside.com

What surprised you most about your homebirth?  Was it… the way you vocalized during your surges?  Or maybe it was how incredibly accomplished you felt afterward?  Or… was it the number of babies that you gave birth to?

 

This week we’re speaking to Elizabeth Parsons, who really brought the surprise factor to her fourth birth and first homebirth. 

 

Episode Roundup:

Can you imagine that experience?  The shock of thinking you’re pushing out a placenta, but then being handed a second baby?  Absolutely incredible.  As we head into this week’s episode roundup, I wanted to focus on a few things that came up.

 

Today's guest: Dr Rachel Reed is a midwife, academic, author, and international speaker who focuses on childbirth physiology, midwifery practice, and women's rights (and rites). She has provided midwifery care for many women and has attended births in a wide range of settings and circumstances. Rachel is the author of the award-winning blog MidwifeThinking and the co-host of The Midwives' Cauldron podcast. She has published widely in journals and magazines, and her first book Why Induction Matters is a popular resource for women and care providers. Her most recent book Reclaiming Childbirth as a Rite of Passage: weaving ancient wisdom with modern knowledge will be published early 2021. Further information about Rachel and her work is available at www.rachel-reed.website. and….she’s just delightful. 

 

I find myself getting sucked into her blog archives for hours at a time, and for today’s episode I decided to ask her about several topics that she covers quite wonderfully there.  I know you’re going to deeply enjoy this episode.  With that, let’s jump in! 

 

 

Most women having homebirth in Australia have “big” babies, and they’re not scary. 

In hospital, however, it can be a different story.  If a doctor diagnoses a mother with a “big baby” on ultrasound, it can begin to cause stress and fear for her.

Dr. Reed mentions that the research does not separate healthy, normal big babies from those whose mothers have gestational diabetes.  These babies tend to have bigger shoulders and can have more difficulty coming out (though most of them come out just fine, too).

“Big babies don’t scare me, but what people do about big babies does scare me.”

Women who are told they have a big baby: C sections, tearing, poorer outcomes are more likely— so it’s the outside causing the problem.

A care provider’s fear of the big baby can cause many of the interventions

 

Gestational Diabetes as a label— fairly nonsensical

If there are abnormally high blood glucose levels circulating, that does impact the baby and potentially the birth.  However, the blood glucose levels being used are not evidence-based

In Australia, around 17% of women are now labeled as a gestational diabetic.

When Dr. Reed was training, we only tested those who had risk factors.

The issues with challenge tests: it’s an abnormal test— many pregnant women are not drinking sugary drinks, so the tests results can be very off.

 

Is this as dangerous as the medical community seems to happen?

Research related to this is mixed with those who are having inductions and those who are not— when we remove those who are having inductions, we see the already small number of issues become all the smaller.

Statistically a <1% chance of uterine rupture, compared to all of the issues that may occur during a Cesarean (there is a higher chance of losing the uterus due to hemorrhage during c-section than having a uterine rupture).

Inside the hospital, there’s been higher support for VBACs… if it’s done the right way: prepared for surgery, continuous monitoring, etc.

Many women are choosing to have home births because they’re having VBACs to avoid all of the issues that can occur in the hospital

 

The woman is the decision-maker.  It’s her body, her baby, her experience.  Dr. Reed discusses how the care provider’s role is to support the woman in whatever decisions she is making.

 

It’s so important to make sure that the midwife and client are on the same page at the very beginning of the relationship. 

 

“This is who I am, this is what I want, this is what I expect of you” from both client and midwife.

 

 

Dr. Reed considers fear to be an important aspect regarding birth, as ancestrally we always would have had some amount of respect/fear for birth.

 

 

Separation Phase (early labor)— There’s anxiety and stress because you’re feeling the contractions begin.  The neocortex needs to be functioning at that time to prepare your surroundings.

 

Liminal Phase (active labor)— High endorphins, you look stoned— a woman should not be frightened significantly during this phase

 

Emergence Phase (birthing baby)— Requires neocortex function again, as you need to be able to push out your baby and then care it. 

 

How does this happen? (transition)  The body sends a huge serge of adrenaline— many people experience this as fear.  “I can’t do it” “help me” “I’ve had enough”

 

 

Preparation phase— all about the woman building self-trust.  Instead of trying to get rid of fear, we should focus on nurturing self-trust.  What do YOU need in order to trust that you can do this?

 

 

It’s been a very long labor, post dates!

 

Herstory

Legacy

Blood Mysteries

Childbirth as a Rite of Passage

Preparation (physiology, rites of passage, rites of protection,

Separation

Liminality

Emergence

Integration

Medical Birth Rites

 

 

 

I really want to end today’s episode focusing on the first two words in the title of Dr. Reed’s upcoming book: Reclaiming Birth.  What does that mean to you, to reclaim birth?  The honest truth is that this momentous event, this life-altering rite of passage has indeed been stolen from mothers.  Generations of women didn’t even realize this, and many in my own generation still do not see that their power to be decision-makers in their own birthing experiences has been removed.  But… now, there’s such easier access to information.  Now we can look back, see the atrocities of the medical system in regards to birth, and CHOOSE something different.  We can choose to be in charge of our care, in charge of our birthing experience, in charge of our motherhood.  I want to thank Dr. Reed for adding to the evidence with her continued work. 

 

 

 

Christine and Andrew started their pregnancy journey traditionally with OB care.  However, as the pregnancy progressed, they began feeling more and more frustrated about the fact that appointments were fast and shallow.  There was not in-depth preparation for childbirth, and they felt there must be something missing.

The couple decided to begin their own research, which led them to switch to midwifery care and homebirth.

Their commitment to giving birth at home grew as they became closer with their midwife, and as she answered their questions and prepared them deeply on what to expect during the entire process.  Both Christine and Andrew recognized the added layers of safety in their homebirth experience because they did know their midwife so well.

Whenever there were questions about what happens if something goes wrong, their midwife always had a quality answer on what to expect and the protocol.

Christine expected to go beyond 40 weeks, for at 38 weeks she and Andrew decided to go camping.  On the trip, her water began leaking.  They went home the next morning and prepared for the onset of labor.

Throughout the process of labor, Christine and Andrew worked together.  He kept up with what she needed and encouraged her through contractions— reminding her to breathe and relax.  This was incredibly helpful during Christine’s long and arduous pushing phase.

Andrew recalled how amazing it was that the midwife was able to recognize when to step in and provide feedback and when to stay back and remain an observer.

He truly understood that it was his duty to be Christine’s support person.

After baby was born, he needed resuscitative breaths.  Christine and Andrew were calm and confident during this experience.

Once he was breathing and stable, the midwives began tended to Christine, as she was bleeding a good bit.

After a while, the midwives had to perform an internal examination of the uterus to see what was causing the bleeding.

Though uncomfortable, Christine and Andrew both felt completely calm during what could have otherwise been a traumatic experience, as the felt heard, understood, and like the most important people on the birth team.

 

 

I am so appreciative of this episode and the perspective it brings.  It’s so important to focus on mothers and their experience of birth, yes, but what a disservice we are doing if we’re not showing up for dads and helping them see how they fit into the equation.  Christine and Andrew worked together so beautifully before, during and after their birthing experience, and Andrew’s understanding of his responsibilities as the birth partner certainly added massive value to their homebirth.  I hope this episode acts as inspiration and as a roadmap for other fathers who are looking for ways to be involved in the birthing experience.  You’re part of this team, and you’re incredibly important.

 

 

 

I sure didn't with my first daughter, and there's absolutely no way I would have been able to take the death grip off of my husband to do any such thing.

 

But Emily... Emily planned and prepared for a mindful homebirth, and her goal was to catch her own baby (her first birth!).  She was a founding member of Happy Homebirth Academy, and I'm so excited to say that darn it, she did it!  Listen in to hear just how she achieved her goal.

 

Show Notes:

 

Emily's start to motherhood was different from the traditional route: She and her husband were called to foster-to-adopt immediately after Emily met her son at work.  She knew he was hers, and she would do anything for him.

 

After a long and stressful road, their son finally legally became a part of the family.  At this point, he was 3 years old.  Emily was suddenly hit with baby fever!

 

Emily began looking into homebirth.  She had had a traumatic time in the hospital at 19 and did not feel that it would be a healing place to have a baby.

 

After watching Katelyn's birth video of her second baby, Lillian, Emily decided she wanted to have the same type of empowering birth.  She joined Happy Homebirth Academy and put in all of the effort required to achieve her goal.

 

Emily woke up at 2:30 am in active labor.  She labored on her side for several hours, knowing that this was the position she was comfortable in.

Once she moved to the tub, she stayed in the same kneeling position for the remainder of her labor... except when she did her best to switch positions for just a moment.  Although she decided to return back to her previous spot, this movement was enough to dislodge her baby's head (turns out she way asynclitic!) and begin the process of crowning.

Emily reached down and caught her own baby--triumphantly!

 

 

Enter Lily Nichols, RDN, CDE.  Lily is an expert on all things nutrition pertaining to the pregnant mother.  She is the author of two books: Real Food for Gestational Diabetes, and Real Food for Pregnancy.

 

Lily sheds light on what it looks like to eat nutrient dense foods, how our food choices affect ourselves and our babies, and how real food can set us up for real success in the postpartum period.

 

Check out these links from the show!

 

 

 

In this week’s episode, we’ll be taking a look at the past, the history of midwifery and women’s care as it pertains specifically to the United States, and delving into some of the reasons that compared to many other westernized countries, women and babies in the US have abysmal outcomes. We’ll be sharing just how lost we’ve become when it comes to maternity care, and how we should really turn this car around.

 

Janelle Alier is a Certified nurse midwife local to me, and one of the coolest women around.  As she’ll explain momentarily, she’s worked with moms and babies in a number of capacities, and she recently opened her own homebirth practice, Paris Mountain Midwifery.

 

 

Anciently (ex. Ancient Greece), women were held in high regard and valued as healers.  When the mindset began to change, in a way this was the beginning of the end.  This change corresponded more with religious and theological changes, not the dawn of medicine.

Protestants burning “witches”—women healers

Much of the knowledge gained over time began was lost with these women

 

Colonial America- childbirth attendants were women/midwives/family matriarchs

 

1800s- medical schools are popping up.  Physicians were around, but not trying to be involved at all

 

19^th century—we could charge a fee! Began being interested in birth.  Obstetrics

 

Midwifery predates medicine: Rachel’s midwife is mentioned in Genesis

 

Varney’s Midwifery includes transcripts from Doctors meetings talking about the “midwife problem”

 

One doctor said the answer was to “educate the ignorants”.  This started a campaign to portray midwives as dirty and uneducated.

 

Laws began to change—it became illegal for midwives to practice the way they had.  They now had to obtain licensure by the state, which was almost impossible to do. 

 

What’s happening to birth at this time?  Physicians recognize that the midwives are more skilled and have better outcomes, but they did not try to work with or learn from the midwives.

 

Obstetrics in its infancy—it’s not going great!  Many deaths in the early years are now attributed to anesthesia

 

They were giving morphine and narcotics, which we now know doesn’t lessen the pain, it just makes you care less… and forget.

 

Culturally there was not a lot of accountability.  Family members were told that the women didn’t survive because “birth is dangerous.”

 

Late 50’s, early 60’s- nearly all birth occurred in the hospital

 

In the late 60’s and 70’s, there was a small subset of the population who revived the natural childbirth movement, but by that point, the medical model was so mainstream that this movement was considered radical

 

80’s and 90’s- c section rates soared

 

In the last few years, we’ve realized we’ve lost our way.  The profession of midwifery is becoming more organized, though there’s not tons of money for research, scholarships etc. as there are for medical students.

 

In South Carolina, Black Grand Midwives were the women delivering babies and taking care of the communities.

 

What do we do?

 

More midwives,  more midwives of color, better integration of midwives and the hospital setting  (if a mother needs to transport to the hospital, that should be easy).

 

In other areas of the Westernized world (Europe, Scandanavia, the UK, Australia, New Zealand etc.) midwifery wasn’t wiped out the same way it was in the United States. And their outcomes are much better than ours. 

 

In the UK—there are 5-6 times more midwives than OBs.  Everyone starts with a midwife, and if you need a physician, you get referred by your midwife.  The OBs manage higher risk care while midwives manage low risk birth.

 

In the US, only 10% of births are attended by midwives.  In Alaska, it’s up to 30%, whereas in Arkansas, it’s more like 1-2%. 

 

If you overlay a map of birth out comes by state and the integration of midwives… you see that where there are more midwives practicing, there are better birth outcomes.

 

In the US, we have 1% of planned homebirths in the home.  Most American midwives work in the hospital.  Globally, not only do they have more midwives, but they also have more options.  You can have a midwife at home, or she can follow you into the hospital and continue care (this is not the case in the US). 

 

 

 

 

Laura is a mother of 3, and she and her husband were newly married when they became unexpectedly pregnant.  They had recently moved, and found themselves moving back into Laura's parents' house as they got their finances in order. 

 

Because she had never spent time around babies, Laura took a nannying job for a newborn during her pregnancy.  When he napped, she would read books.  A family member gave her Ina May's Guide to Childbirth, and at 35 weeks her entire outlook on birth shifted.  She even considered a homebirth, but soon realized this would not be possible in her family's house.

 

Laura switched to midwifery care within the hospital and had a beautiful natural birth.  She wanted to give birth in the water, which she did.

 

When she became pregnant again 11 months later, she prayed for a shorter birthing time.  That's exactly what she got-- though the experience left her reeling and feeling out of control, even slightly scared of birth.  She did have a natural birth, and it was short, but it was quite stressful for her.

 

During this postpartum experience, Laura struggled immensely.  She had an incredibly emotional time and leaned on her faith like never before.  She learned about grace on a personal level, and worked through many problems and emotions that had previously never seen the light of day.  Finally, she felt like she could see the light at the end of the tunnel....

 

And then Laura found out that she was pregnant again.  This came as a massive shock to her, as she and her husband were not planning for this.  While the realization that she was carrying new life initially thrilled her, once the thought set in, Laura began to panic with fear that she would have to go through all of this postpartum pain and suffering again.  She worried that she was nutritionally depleted, and that this third pregnancy would cause more depletion.

 

Laura continued to rely on her faith and her husband, and she prayed about her upcoming birth.  She was finally going to be able to have a homebirth, and she wanted this experience to be not only spiritual, but also pain free.  She dedicated time and prayer to this end, and she created space for this to happen.

 

When Laura had her third baby, all were shocked to see her raising her hands in worship during her contractions.  When her baby crowned, and then the head was born, Laura truly did not realize it had happened.  Her birth was 100% pain-free.

 

Laura emphasized the fact that this can be the case for anyone-- creating space for this type of positive outcome is so important.

 

 

I wanted to touch once again on this idea on creating space for the positive experiences.  I love that Laura cleared her fears when necessary and focused on the notion that she could indeed have a beautiful, pain-free experience.  It's a great reminder for us all: Clear fears and create space for the beautiful experience that birth can be!

 

 

Resources:

Ina May's Guide to Childbirth

 

 

This week we're speaking to Sara, who lives in Travelers Rest, South Carolina with her husband Rob, their first child and son, Charlie, and their two big all american mutts, Captain and Bucky. Sara and her husband Rob strive to live a gospel-centered and holistic/ancestral lifestyle to create the best and safest environment for their children to learn and thrive. Homebirth was their Plan A and Charlie’s birth Story wasn’t exactly what Sara envisioned, it was BETTER and one of the best and most intimate memories she and Rob will ever share together.

 

 

Episode Roundup: