This post is a little different to my usual posts (I apologise to those wanting some physiology and links to research). Instead, I have written about something that keeps cropping up in my conversations with mothers and birth workers. I would be interested in other perspectives and opinions – so, please comment and let me know your thoughts. The post is basically my own thoughts about how we judge ourselves and birth.
Birthing Behaviour
Artwork by Amanda Greavette: http://amandagreavette.com
Women’s behaviour has been judged and controlled throughout history. We are supposed to be ‘good girls’ – do as we are told and not create any problems for others. However, the act of giving birth is primal and ‘wild’. Our birthing behaviour originates in the limbic system, the area of the brain shared by all mammals. To labour well we need to shut down our neo-cortex – the thinking human part of the brain. The result is instinctive ‘animalistic’ birthing behaviour. Because we are individuals, our birthing behaviour is also individual. Some women become quiet, withdrawn and ‘in control’. Others become loud, wild and ‘out of control’. For many it is somewhere in-between, or both, at different times during labour. Just like behaviour during sex (also controlled by the limbic system) there are similarities between humans, but we all behave slightly differently.
The idea that there is a ‘right’ way to behave or worse, a ‘wrong’ way to behave is unhelpful and judgemental. It seems that being quiet and ‘controlled’ is considered to be the best way to birth. How many times have you heard a woman’s labour described in a positive way because she was ‘so in control and quietly breathed her baby out’? In contrast, the loud woman is encouraged to breath (ie. stop screaming/shouting) and focus. This happens often in the hospital setting where midwives attempt to keep a woman quiet so as not to ‘frighten the other women’. These women are often described as ‘not coping’ – when in fact they are coping just fine… but loudly. It is those around them who are not coping. Michel Odent suggests that the intense fear and sense of ‘losing it’ often experienced near the end of labour facilitates the fetal ejection reflex. Not many women experience this because midwives (or others) intervene to calm the woman and help her gain control of herself.
It’s not just midwives, but also mothers who judge themselves for ‘losing control’ and making noise. I find it sad to hear a birthing woman apologise for her instinctive behaviour – but they do. Indeed there are childbirth preparation programs aimed at learning how to be quiet and in control during birth. Unfortunately, some women who have undergone this training feel like failures when their instincts take over and they become vocal. Perhaps we (society/culture) are afraid of the primal power expressed during birth – here is a woman connected to, and expressing the immense power and strength of woman. The response is to shut her up and encourage her to act like a ‘good girl’ so as not to upset anyone (including herself).
Here is a beautiful example of a mother birthing instinctively and loudly:
So, lets honour our birthing behaviour whatever it may be. Whether you are a quiet, breathing birther, or a loud and wild birther – you are equally, but differently amazing. Midwives need to learn to distinguish between a woman who is expressing her wild birthing instincts, from a woman who genuinely needs reassurance and calming. Talking with her before birth about what she will say if she really does need ‘help’ can be useful. In addition make sure she knows that you will not judge anything she says or does during labour. It is also important that women hear and see birth stories that show a range of birthing behaviours – not just the quiet and in control types.
Birthing Choices and Experiences
Artwork by Amy Swagman: http://themandalajourney.com
Women are also judged (and judge themselves) on their birth choices. Here, you really can’t win. If you choose an elective c-section for no medical reason – you will be judged. If you choose to freebirth your baby – you will be judged. And for every birth choice in-between others will have an opinion and judgement about what you do, or don’t do. There is no right way to birth. For healthy women and babies a physiological, undisturbed birth is probably the safest option in terms of outcomes. However, some women don’t want this – or are unable to have this. Any birth choice a woman makes based on an assessment of the benefits/risks and her own situation/needs should be respected. The focus should be on ensuring women have access to adequate information on which to base their choice – not on the choice itself.
How the birth looks on paper may be very different to how it was perceived by the mother. I learned quickly as a community midwife doing postnatal visits that the ‘birth report’ had no connection to the woman’s perceptions of her birth. Women who had experiences such as ‘failed forceps’ and then a c-section could emerge feeling empowered and more than happy with their experience. On the other hand, women who had experienced ‘normal’ vaginal births without intervention could be traumatised. I find it is best to ask a woman how she feels about her birth rather than making assumptions based on the events. Often feelings centre around the care and respect, or lack of that was given during the birth journey rather than what happened.
Every birth experience is valuable – even those that don’t go as expected or planned. Hindsight is a wonderful thing, and we often look back and wish we’d known X because we wouldn’t have made the choice Y and ended up with Z. Many women choose homebirth based on a previous birth experience that with hindsight could have been very different. It is only because of that previous experience that they have explored and learned about birth and themselves. That previously disappointing (and in some cases traumatic) experience has provided the foundation for self-growth.
Sometimes birth does not go as planned because if left to unfold as nature intended the result would be a poor outcome. Appropriate intervention can, and does save women and babies. However, women are often left doubting their body and can then judge themselves and their birth experience as a ‘failure’. I have recently been discussing this issue lots with my lovely Doula friend Pernille. Her insights into this matter are interesting and I would like to share them (please let me know P if I’ve mis-interpreted you). For these women, the choice of intervention can represent the ultimate expression of motherhood. For example, allowing your own body to be cut open to save your baby is surely the epitome of mothering.
Summary
There is no correct way to birth, or to behave during birth. As women and mothers we are subjected to more than enough judgement from others and ourselves. Perhaps it is time to start nurturing and supporting ourselves and others instead.
This post is also available in Spanish at Placentera.
Very interesting and, for me, rather topical.
I was at a birth in the early hours of Thursday and for the first time in five years had a “screamer”. The MW kept telling her not to scream and in fact was trying to encourage purple pushing. I looked at my client and had a calm moment of clarity and told her to do what she needed to do and to go with her body.
I see the moment of fear in my ladies but this was the first real screamer. I have been guilty in the past of “calming” my clients but that birth and now this blog has given me pause for thought. Thank you.
Lol I still remember my second birth as a student midwife- I had a ‘screamer’ – she seemed to do just fine to me, although it was rather difficult to hear what the lovely experienced midwifery sister, Helen, was telling me to do! Helen said afterwards that in her experience, women who screamed had no hang ups and usually pushed well without having to use vulsalva- which of course what everyone was instructed to do at the time. What wisdom from Helen…
A gem of a homebirther, Karin – I birthed all 3 of her babies at home – stomped rhythmically, swinging her hips, and grunted and groaned in a wonderful expression of strength during her contractions, before sinking into the birth pool when she felt the urge to push. She was silent during stage 2 each time, she told me afterwards, she needed to focus and birth peacefully, but when in pain it was important for her to let it out.
Valsalva!
How did you birth her babies?
Thanks for addressing this topic. I beleive the woman should do what she wants to do during labor because she’s the one going through the process, she’s in her non-rational, non-linear mind and the more we support that, the more we support birth. During my birth I was fearce at times. I told the midwife’s assistant to leave and shut the door on her because she kept going on about “being a warrior woman” when at that stage of my labor I was in a different space. In transition, I surrendered and was very sweet, open, letting go. The person who supported me the most was a friend who simply sat with me and mirrored what I was going through. Judgement contracts us in labor.
First of all I just wanted to say a huge thankyou for your blogs- I’ve been following them for a few months now and they are both thought-provoking and inspiring.
As a newly-qualified midwife stuck in the drudgery of a disempowering ‘high-risk’ unit, your blogs always give me time to think and reflect about the way I practise, and to gain some perspective on the things I see on a daily basis. It gives me hope that true women-centred midwives still exist.
I agree that we need to give women the time and space to labour in the way that is right for them, and to trust them in this, but as you mentioned some vocal behaviour is perhaps not as constructive as it could be. For example I usually only actively ‘calm’ someone if their vocal pitch becomes high (indicating fear) rather then low (indicating a birth ‘song’ and a way of coping). Women who scream in the true sense of the word (in my fairl limited experience) are usually crying out like that because they are afraid and need some reassurance.
Thankyou again for this post! It has made me think about how I judge (if I should be judging at all 😉 the way a woman chooses to cope with her labour.
xxx
Yes sometimes creaming high can mean fear, or perhaps it means she just needs to scream. I had a client beg and scream for an epidural. She actually got up off the bed where she was pushing and walked away saying she wouldn’t give birth till we gave her an epidural. One ctx later she was squatting back on the bed with the baby’s head between her legs. She was so grateful and said she felt very in control. I was not so sure at the time when she was begging/demanding an epidural but she insists that she had a good experience and a great birth.
I love this response. I agree completely! I knew there was something I wanted to say, and you said it for me here. 🙂
I agree with all three of you. My third birth, the first at home without an epidural, I was a screamer. Much louder than I thought I’d be. I was also very afraid. One of the great things about my birth choice was that I had created a safe space where I could have moments of weakness without being rescued. When my screams became high pitched I was occasionally reminded that it would help if I used a lower tone. When I expressed my fear, I was gently reminded that I knew exactly what I was doing. When I begged for and epidural or at one point even a c-section my team smiled kindly. They understood that I just needed to express myself.
I just wanted to point out to those midwives that get ‘a screamer’, be sure to ask the woman first what is going on with her, how she’s feeling emotionally, before you make assumptions. I was ‘the screamer’ in my birth, and the only reason I had high-pitched screams was because it relieved the pain more than low-pitched moaning or grunting. My midwife kept trying to get me to change, luckily I didn’t listen to her. I was not afraid, just in a lot of pain.
It is such a delight to read your blog as always and I agree wholeheartedly that we should stop controlling or judging ourselves and each other particularly with regards to how we birth. I see birth as a time to let go of our inner critic and release our instinctive urges – to find a deep connection to the person we truly are and to our inner wisdom. In that way we are able to access the birthing expert that lurks inside us all (as Michel Odent explains in ‘The Scientification of Love’ – it is in the primitive brain structures that control the fine details of birth and these are most active when there is a reduction in the stimulation of the neocortex , the more intellectual part of the brain). And in doing so we have the potential to unlock something inside ourselves and to feel such a sense of empowerment in doing so. That’s why it’s so important to feel uninhibited during birth. By trying to conform to what we perceive to be someone else’s idea of the ideal way to birth we are denying ourselves this potential. Definitely it’s time we stood together and focused on supporting and nurturing each other rather than judging.
Great blog, as always. What fascinates me is how the woman’s experience can be so different to the birth attender’s experience. I’ve had very quiet women say “I’m sorry I was so noisy, I was shouting so much” (yeah, I know – annoying that they are apologetic) and I’ve had lovely, vocal and noisy women say “really? I made noises?”. The birthing mum really is in a different place to the rest of us in the room! 🙂
Lovely respectful post, as always Rachel.
I agree with your comments 100%.
My practice is to discuss self expression with a woman (and her partner/support people), explaining that everyone is individual and that as far as that goes, however women give birth, is their way.
I explain that to me, birth is normal and so however a woman is expressing herself, whatever her behaviour is normal until she tells me otherwise. I ask her what she expects of me and note that information. I say that she needs to tell me if she is unhappy because I won’t know and won’t make assumptions.
I let her and her partner know that my role is to sit and be with her, take the necessary observations and support her process.
Even though I’ve worked one to one with women for thirty years, I’m currently working in a private hospital and find the same approach helpful and acceptable to the couples I’m privileged to be with in that venue.
Women have sung – for example one woman sang the song “Everything’s all right” from Jesus Christ Superstar – beautifully too, I might add, through transition and second stage 🙂
In terms of a woman screaming in labour, one of my most amazing learning experiences was with a woman (during my private practice years) who screamed the whole time from beginning to end of labour (her second child). Her husband had left her in early pregnancy and she had been incredibly ”controlled” during her pregnancy. I knew she was screaming her emotional pain, so wasn’t concerned. She put her birth notice in the paper saying “a screaming success”.
Another fascinating use of sound occurred when I was working many years ago as a hospital midwife on night duty (I’m not going to say how many years ago!)
A woman informed me very seriously when I admitted her in labour, that she intended to make noises in labour as she had read that making noise was useful to labour well. As it turned out, she was a vet. She bellowed like a cow (she was a large animal vet) with each contraction and laboured quickly. The women in the other labour rooms asked me what was going on. When I explained that the woman was a vet and was using sound to help her manage her labour, the other women clearly felt less inhibited and before long, started making sounds too. We had the noisiest labour ward that night that anyone had ever experienced.
The folk from neonatal intensive care down the hallway commented on the noise. I had a bit of explaining to do.
Of course, they thought we (the midwives) weren’t managing the women well and that the obviously needed pain relief. Interestingly, all the women birthed well, including the vet.
The experiences of that night really influenced my thinking and perspective on the use of sound in labour.
I laughed out loud to hear how the rest of the birthing women started to make their own sounds! Imagine contagious birth noise as an alternative to drugs and other useless interventions! Thanks for sharing that story, Carolyn.
Yes Diane, the environment is so important isn’t it? Does the environment encourage free self expression or does it exude an expectation of self control? That’s why home is such a great place to give birth (for those who feel safe there). I like what someone said that leaving home is the first intervention in birth
“The first intervention in birth that a healthy woman makes is when she walks out the front door of her home in labor. From that first intervention all others will follow”
Michael Rosenthal (OB/GY)
I love that quote too.
Thanks for sharing your experiences!
In the UK I looked after women from all over the world and there were some interesting cultural differences regarding expectations of behaviour in labour.
I was informed that I sounded like a cow myself (luckily afterwards). I birthed my second baby in a small Tyneside flat with neighbours on all sides. My husband had to go and inform the neighbours that he had not just slaughtered a cow in the sitting room – I had just had a baby. 🙂
The way that culture influences a woman’s self expression in labour is fascinating. I had the privilege of working at a hospital called Crown Street in Sydney (had the first birth centre in Australia – started in 76 if I remember rightly). Crown Street had a rich ethnic population and varied groups, from hippies to North Shore socialites accessing maternity care there. Women from Italy and Greece made lots of noise in labour – I understand there are lots of cultural reasons behind that phenomenon. At the time I was at Crown Street, Vietnamese women beginning to give birth at the hospital as the war wound down and refugees from that country arrived post war. I found the Vietnamese women entrancing to support in labour. The only way I could tell they were nearing birth was the tiny line of perspiration I noted on their upper lip just before they gave their first push. They would sit and breathe, eyes shut; their breaths becoming almost imperceptibly deeper during ‘transition’ contractions. I was totally in awe of those women (as I am with all birthing women). Working in the Crown Street birth centre was fascinating too. There were three rooms and the midwife went from room to room to support the couples in labour (this was also in the days when men in birthing rooms was unusual). One memorable occasion, there were Hare Krishnas with bells and chanting in one room, born again Christians in another and the third was a couple who were country and western fans, complete with guitar! I had to do a personality state change as I entered each room to ‘fit’ the mood of the room. All beautifully normal.
What fantastic experiences! I really miss the ethnic/cultural diversity I was able to enjoy in the UK. The majority of our community case load were migrants or second generation migrants from all over the world but mostly Bangladesh and the Middle East. I learned so much from those women and their families… and ate some amazing food on my visits (it was rude to say no).
I love this! I used to try to picture myself as an animal during labor. It helped me remember that birth is a natural process.
Wow, Rachel, great post. This is my favorite topic at the moment 🙂 It is in my opinion such an important message to get out there for women to contemplate. I don’t want, in any way, to disrespect women who have had difficult and traumatic experiences, but I would love it for everyone to acknowledge that every birth takes all our womanhood and mother instinct to go through, whether it is a smooth sailing, straight forward vaginal home birth or a emergency caesarean after days of posterior labour. And I hope that all women at some point can get in there and feel that. My hope is that if we can all reconnect with this place we might stop judging ourselves to harshly, and thereby not needing to judge others as well.
A caesarean will still be very disappointing for a woman who really wanted a normal natural birth, but there is such an empowerment in connecting with your womanly strength, not that it will take away your disappointment and maybe even grief, but it can, I think, maybe take away that critical inner judge. We can’t control birth, having right or wrong ways to birth is controlling and it doesn’t help anyone. Anyway, I could go on forever. Thank you for putting it out there Rach.
I find the general rule of thumb for making noise has to do with a woman’s sexual style. If she is a noisy lovemaking person, then chances are it will feel natural for her to express herself loudly while in labour. If she is a quiet lovemaking person, then she will follow suit when she is in labour. We birth in accordance with the way that we live.
I have often encouraged my clients to misbehave while they are in labour, in order to break through their inhibitions.
A very interesting read, thanks. As a doula and educator I feel its important to remember this and take stock of everything ‘besides’ or as well as the birth outcome (as Pernille mentioned). Sometimes a doula may feel its a lot of her responsibility to help this woman achieve what she has her hopes and heart set on. And I feel part of that is a natural response, but in reality there is only so much the woman can, the doula can do, the partner, the midwife, the baby can do….. sometimes it doesn’t unfold in the manner altho all the intentions, energy, effort, education, empowerment, inner work, environment, headspace have been worked on and ‘checked’.
It saddens me how strong a mother can grieve for the ‘natural normal / home / vbac birth’ when it doesn’t happen as desired. Its a big grief that doesn’t get near enough attention because it slowly becomes all about the baby. But for the mother it never goes away. Sometimes it takes the next pregnancy for her to acknowledge either she could have made different choices (with the right information) that could have lead to a different outcome or she has been on such a very personal journey to empowerment for next time that things are often likely to be different.
One (big) thing I say to women and their partners in my work is – if you ask questions, find out your choices, look deeper into yourselves, do your research, get educated, seek advice, seek opinions, physically prepare, work on fears, emotionally discover, nurture yourselves truly, enjoy all the processes, become aware of the ‘what if’s’, the cascade of intervention, the ‘system’ of hospital birthing, open your eyes and ears….then what happens at the end of the day, there is little or no room for regret or blame. I’ve seen this happen, and the difference postnatally is remarkable. They did everything in their power before the birth, so even though their outcome was not as desired, they still felt very much ‘OK’ with things, albeit disappointed but still ‘ok’. They even said seeing themselves ON that cascade of intervention wasn’t so frightening because they ‘knew’ what to expect and what was coming next because they had been educated.
There was no wondering. ” I wonder if I had been fitter/not anaemic during my pregnancy I could have had more endurance” (probably) “I wonder if I had done perineal stretching exercises/massage leading up to the birth, I wouldn’t have needed that episiotomy or torn so badly” (maybe) “I wonder if I had really known about what ‘else’ came along with that epidural, I would have taken it” (probably/maybe) “I wonder if I had chosen the birth centre instead of the hospital I would have had a different labour?” (maybe) ” I wonder if I would have coped differently if I had a doula with us” (probably).
Nobody can say for sure that the experience you have for doing your pre-birth homework will be different to that if you hadn’t, but given the statistics and trends in the birthing culture of today, I feel confident in saying IT WILL/IT DOES.
I believe it’s important this pre-birth work is done for many reasons, but one that women don’t rightfully realise till after the birth is to lessen the regret, blame, guilt, ‘what-ifs’, feelings of failure, inadequacies etc etc..
I hope all that made sense – rambling 😉
I too personally, was VERY LOUD with my second labour/birth at home. It was a very short, intense and fast labour 1.5-2hours. These increased substantially in 2nd stage when I was in the pool. I could hear my ‘roars’, ‘song’ resonating from our high ceilings and back off again from the floor tiles of our living area. It felt amazing and necessary. In between these 2nd stage contractions I was silent as a mouse, then came the build up, almost like a chant, a roar of power – i get goosebumps watching and listening to it back on the video we took! It was a release, an expression, a primal purpose!
Love your blog. Reading this post reminded me how my dear husband commented after my second birth (first homebirth) that I sounded a lot like Dory from Finding Nemo when she was trying to talk whale! Well suffice to say, I had a beautiful, empowering birth. My daughter was a compound presentation but active labour was fairly short.
I had a giggle at one of the posts above about the vet sounding like a bellowing cow in labour. If I had been in hospital, perhaps I could have started a whale sing-a-long!!
Jacinta
humpback?
This is something that has been on my mind lately. I recently attended two births that were very loud and animalistic. Both of them I did calm down a bit, but more for fear of hyperventilation and because I saw a way to be more productive in getting the baby out. And, well, when I woman is screaming for us to help her and to get the F*ing baby out, I’m certainly willing to make a few suggestions. In the end though, both of them apologized for their behavior. I remember telling them that there was no reason to apologize as these are the sounds of labor. Their birth song was theirs, it was pure and natural. Though it may take other people in the room off guard it is important to remember that this IS THE most primal thing we will ever do with our bodies. If there was ever a time to get loud, labor is it.
As far as the decision making thing goes, I do at times find it hard not to make judgments – though often time I will keep them to myself out of respect for the other person. I often dig for the story behind it and most of the time find that misinformation or lack of information is the root cause. I often say ‘I don’t care WHAT you choose….as long as it is an informed decision based on the safety of you and your baby’. And, I mean that. My only issue comes when people choose to do things based on either misinformation (or lack thereof) or “because everyone else does it”. We should be demanding better for ourselves and our children.
GREAT article, by the way. I think this is something that need to be discussed more often. <3
I screamed because from the time active labor started until my baby was born was only 4 hours and it was my first baby. So, yeah, intense. The midwife came in after her apprentice to find me screaming at the top of my lungs during contractions and told me that screaming moves the muscles up so I needed to make low tones and move things down. I went from screaming for a few seconds to making low tones almost nonstop until I was ready to push. At which point my husband said I began making noises like a bear, but I thought it was just the sound of being extraordinarily constipated. Even though I was making sounds that had someone just heard me would assume I was having the biggest bowel movement ever recorded, I felt like I was in total control of myself and I began being able to think clearly again. During contractions I felt completely out of control and had no idea what was really going on. Perhaps women gain more clarity at that point because the baby is about to come out and they need to make sure there’s a good landing spot?
During my first labor the midwife admonished me for making so much noise. Not knowing better and believing that she was the expert, I tried to quiet myself. Consequently, because I was fighting my own body, the labor and birth were very difficult. I too felt ashamed of my behavior, but then I started learning about primal birth and changed my mind. There wasn’t anything wrong with me; being loud and wild and expressing emotions in a “negative” way are just how I power through it. So for my next birth I hired a midwife who promised to leave me alone. I bellowed and yodeled and screeched (OH NO, higher registers!!!.) I wailed, “HELP MEEE!” then when the contraction was over fixed the midwife in the eye and said “NOT YOU.” We laughed about that later. 🙂 That birth was comparatively much easier and more normal. My next two, which were unobserved, were even more so, because I was able to be completely unselfconscious about my behavior. Sometimes the best intentions of helping are just getting in the way. That’s why it’s so important not to have preconditioned notions (tradition, convention, schooling) about what’s “right” and let the primal body lead the way. The mother needs to listen to and trust her body to tell her what to do, and the midwife needs to listen to and trust the mother. Until midwives allow that to happen, even despite all their experience and training they’re not going to know what normal birth looks like.
I’ve started telling my doula clients that any coping techniques (patterned breathing, etc.) that they learn in childbirth education classes will help them through early labor. But, once they get into active labor, in a supportive environment (dim lights, privacy, those present speaking quietly) their rational brains will let go and they will spontaneously move and adopt positions that feel best and make sounds to help them cope.
There is a sound many of my clients begin to spontaneously make as they go through contractions, and I’ve seen this in dozens of youtube videos online as well. I’ve started calling it “the labor song” because it almost seems musical to me. There is some variation in the sounds made between women, but it seems easily recognizable to me now. When I start to hear clients doing this I get very happy, because that means things are really cooking. I stop talking to them to disturb them as little as possible, and instead use touch to communicate that I am still with them.
I recently attended the birth of a first time Mom whom I had encouraged to watch videos of women laboring and giving birth on youtube, so that she could see how women spontaneously cope. I arrived at the hospital and she was 8 cm, constantly shifting from a squatting position to hands and knees and groaning loudly. She did not want me to touch her or talk to her, so I couldn’t do much for her but offer water after each push. She told after she gave birth and was nursing her newborn that the perspective I had given her, that she didn’t need to “learn” how to labor and give birth beforehand, and to trust her body, was extremely helpful and not one given in her class.
Cassandra —
“During the very last contractions preceding birth, both a mother and her baby have a peak release of adrenaline hormones. One of the effects of this sudden adrenaline release is that the mother is alert when her baby is born.” — Michel Odent
This was very interesting! Especially since my midwives’ practice required its patients to take a class on hypnobirth and we watched a few videos of women peacefully and quietly laboring, most of them pushing their babies out without a single sound. I don’t doubt that hypnobirth helped me during my labor, but honestly during pushing I wanted nothing more than to scream! Great post though and honestly with my next pregnancy (whenever that will be!) I will no doubt just try to do what feels natural to me.
Can I just say that I hate Hypnobirthing? I think its a gimmick and that it is a sales pitch that sets up women to fail just like the Lamaze of old did. If you don’t have a painless silent birth you have failed. Also, I don’t find the classes to be particularly educational about birth itself.
Like any class the skill/experience of the facilitator is important. I teach a hypnotic childbirth class and used the techniques myself for an incredibly empowering homebirth. It was neither completely painfree nor was I silent. I just followed my body’s lead. Nobody can guarantee a painfree birth – not even the most skilled anesthetist but sometimes they do happen and its the icing on the cake. But the goal is fear free birth and hypnosis can be a very powerful tool in helping some women to achieve that.
I can’t speak about Hypnobirthing, but I took a Hypnobabies home study course and it did not teach that we needed to be quiet. I personally found the relaxation techniques to be invaluable – I do not typically relax easily. I did not have a “painless silent birth,” but I did have a complication-free, drug-free vaginal birth, which was my goal.
Just my 2 cents.
Suzan – I am not ‘bagging’ any particular program. I think it more about how the information is delivered and received. I know lots of women like you who have used the ‘tools’ to birth the way they wanted to, which is great.
Thanks for your response. 🙂 I really enjoy your blog; your posts are always thought-provoking.
I have no desire to be “helped” to conceptualize my cesarean as a birth, because it was not a birth. My son was born by being removed from my body by another person, without my aid. I no more birthed him than I would birth my kidney if that was also removed surgically. He was born, but I did not birth him.
Krista – I have changed the words in the post to better reflect what I meant. Not that an experience is not traumatic but that the woman is strong. I know from my own birth experiences that I learned how resilient and strong I was from a birth that did not go as I planned. That doesn’t make the experience any better. x
I agree. My cesarean sucked. SUCKED and so did my postpartum because of it. But, the experience was part of motherhood and made me a mother and birthed me as a mother. And I think thats what she’s saying, its not always what we think will make us a mother, its not what we hope for or expect, its just what happens and we become a mother in the process. And if we stop judging ourselves for whatever we think we might have done then perhaps we will have room to see that our experience holds infinite value because it is OUR experience.
Blessings
I really wish I had read this article before I gave birth! I was nearly to the end but screaming alot and my husband and the nurse kept getting in my face and ordering me to breath, and I felt so discuraged, because I wasnt able to “do it that way” and eventually just caved in and got the epidural
Slowly but surely Nature is taking back over. Great read, I especially like the point of women needing to be exposed to all kinds of child birth. It is important to remember that proper education is needed before a behavior of one’s own can happen. Otherwise, humans tend to behave in the way they’ve been conditioned to behave. Thanks.
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“This happens often in the hospital setting where midwives attempt to keep a woman quiet so as not to ‘frighten the other women’. These women are often described as ‘not coping’ – when in fact they are coping just fine… but loudly. It is those around them who are not coping.” That was 100% my experience with my 1st child! The RN came in and told me to “settle down” because I was frightening the other women in triage. Ugh! I was a LOUD, FOUL MOUTHED birther for sure! Hahahahaha! I even told my husband that I wanted him there, but I didn’t want him to look at me and he needed to face the wall! LOL!!! Poor man! I’m having a homebirth with this pregnancy and it’s because I want to be left to birth the way I feel I need to….whatever that looks like. Thank you for the great post!
God I love this blog!
I have seen many noisy women during labour who I still consider to be in control – I don’t consider vocalising to be a measure of control.
Thank you.
During my emergency c-section I screamed. In fact I screamed from the moment the drip was placed by the ambulance nurse, all the way to the hospital (over the siren), right til I went to recovery.
It was respected by all the persons involved (Yes IN A HOSPITAL), they even let me have a moment to be able to say; “okay I’m ready for it, let’s do it, go get her”. I later read they brought in a panicky woman. I’m far from panicky. I was panicked and with good reason.
But I was treated with respect that’s what matters. No one tried to hush me except at one point, to hear my baby’s voice. I stopped for just half a minute and went on. I think it wasn’t pleasant for my daughter, but I couldn’t help myself.
Matter of fact, I often state that most things are better with sound!
So thank you for this post!!!
Regards, Maria Anna
Thank you for this post. Especially the latter part about birthing experiences. I just had my 3rd child a little less than a month ago. Two prior natural in-hospital births (because assisted homebirth wasn’t a legal option in their state) without complications. This time in a state where I could legally get a midwife to assist me in my home, we expected a fast birth. When 48 hours passed without a baby after my waters broke and contractions were non-existent and crazy intense and nowhere in between, I made the choice to transfer to a hospital for pain management and augmentation. I felt good about that decision because it was my decision. I was still able to have a vaginal birth (though would have been accepting – yet unhappy – if a surgical birth was necessary, and there were many not-so-great things about the experience. But it was my choice and what was best at the time. I never once thought I was a failure… until my midwife gave me the “some women whose births don’t go as planned feel like a failure… and you shouldn’t” talk a week later. I felt nothing but empowered by MY decision to transfer, MY decision to get pain relief and MY decision to allow labor augmentation with pitocin until the idea was placed in my head that maybe I shouldn’t have felt that way. And now I struggle with it a lot. I wish, instead of jumping to the “don’t feel like a failure” pep-talk, I would have been asked how I was feeling about the whole situation.
Thanks for reminding me about an important area of judgement and assumption. I have added a paragraph to the post to reflect this. Only the mother knows how she feels about her birth.
I am co-writing a book about Ann Kelly, a natural birth midwife here in Ireland, who has been hounded through the courts for the last 13 years because she facilitates women to birth naturally in their own time in the place of their choosing. The hospitals are hugely threatened by this and do not understand how the mother’s choice or the intuition and experience of the midwife can have any part to play in the “dangerous” job of getting that baby out. Ann was exonerated in 2002 after a lengthy fitness to practice hearing which nevertheless slapped a Censure on her record, and is currently prohibited from practising while another Fitness to Practice drones its way onward. This last concerns a stillbirth. The parents have since had a second baby in hospital and have attested on oath that despite the trajic loss of their first baby, the level of care from Ann far superceded the care they got in the hospital. Over 600 statements from women who back Ann Kelly and her wonderful skills, have been ignored while the lawyers and midwife tutors argue over her note taking and resusitation skills. We all know that stillbirths never happen in hospitals.
Sound was an enormous help to me when I was birthing and I know that I would have felt inhibited making those sounds in a hospital setting, as I would have been conscious of other women around me. I feel deeply angry that at this most powerful moment of our lives, nature is not given its rightful respect, and machinery and fear of litigation are far higher up the pecking order.
Rose
The ‘witch hunt’ is happening worldwide. Australian homebirth midwives are being targeted at the moment following the recent changes in regulation. I am sorry to read about Ann Kelly and wish her strength and justice. Can you imagine if stillbirths occurring in hospitals got as much attention and finger pointing? Then again, they happen despite being in hospital whereas at homebirths stillbirth happens because they are at home… makes me angry too.
I was one of the lucky lucky women who was cared for & honoured to have Ann Kelly as my midwife for the birth of my first daughter at home. I could have been considered an at-risk pregnancy (being 35 with my first), but this highly experienced, professional, intuitive, amazingly gentle & respectful woman guided me to “go with the flow”.
I yelled & wailed & cried out – for many or most of the 28+ hours – & gave birth to a beautiful daughter naturally (she was posterior & born star-gazing, so had an interesting shaped head) & … I was totally hoarse for a day or so afterward!
I can NOT believe that the witch hunt continued & that Ann has now lost the second fitness to practice hearing. It is immoral & inhuman & totally disrespectful. She is faultless & empowers women & is highly professional in all her dealings. I was so blessed to have her in my life.
When I was in active labor with my first child I started to vocalize. I remember thinking how good it felt, but I was also concerned that I might offend someone and worried about being “too loud.” Thank goodness the nurse that was with me leaned in and said “honey, if that feels good to you, just keep on doing it.” What a relief! I was able to really let go and it felt great! If it wasn’t for my nurse, I’m not sure what I would have done.
I have been told i sounded like Chewbacca from star wars during the birth of my second baby. Makes me laugh every time i think of it! thanks for the wonderful words. I will be reading your posts more often. You rock!
Thank you for your post! I was a screamer with all three of my healthy home births. My first the only thing anyone said about it was “honey, you are going to loose your voice.” when I replied “I don’t care!” they left it alone. With my second we did “unassisted” and our labor helper was a trained doula. We had prepared for this “unassisted” birth together with my midwife who was going to be out of town for the birth. Though the birth was healthy I felt terrible when my helper started telling me that I should not cry or scream but only make low moaning sounds. I had not planed on being instructed on how to birth, I had already birthed once and I was fine following my own instinct. It felt as though someone was telling me that i was birthing wrong and it was very very hurtful. She seemed to be telling me in the middle of my child’s birth that i wasn’t being strong and wrongly assumed because i was letting out some of my pain by crying that i was giving up. To me there is nothing more important than telling a mom that she is doing well because there is nothing more guilt ridden than parenting.
I love your stories, and I am planning an unassisted birth for my first baby . I too have hired a certified doula, and hadn’t really thought about her interfereing in my process. I get the sense that she’s extremely respectful and doesn’t do much instructing, but it will be a good thing for me to discuss with her prior to BDay!!!
By the way, Rachel, I love this website. You have been such an amazing source of easy to understand information, I absolutly love you!
xoxo
As a momma who has birthed twice, thank you for this! Every pregnant woman should read something to this effect!
With my first birth (a home birth), I had studied Bradley and was pretty quiet until transition when I moaned and complained and begged for the narcotics shot the midwife carried (didn’t get it though because I was already 9 cm. and too far). Relaxing and releasing the tension was ok for that birth- I was a first-time mom and wasn’t sure what to expect in the pain/intensity department so I just rode along and took at as it came.
Then, during my second birth (in a hospital because we’d moved to an area with no close home birth midwives and living 50 miles from the hospital- something I wasn’t comfortable with) a little more 6 weeks ago, I think I went in with more of a “take the bull by the horns” attitude when it came to labor. I knew kind of what to expect. I trusted my body and it’s ability to handle the intensity. So when active labor started I went ahead and moaned through the contractions just because it felt good. It felt purposeful. Then, as I progressed into transition, I ROARED because it freakin’ hurt and it was the one thing that remotely felt good. I would love to know what was going through the nurse’s mind as they don’t get a whole lot of of natural birthers through this very small, rural hospital and I was putting on a noisy, nekkid dancing show. I did apologize a few times, but mostly because I thought that if I had been another woman in labor, I would have freaked and gotten the epi as soon as I heard that scary noise! Thankfully there was no one else laboring at the same time I was, or it may have held me back. But still, the roaring and growling and dancing felt purposeful and I felt like I was doing something besides just trying to breeeeeeeeeathe through it. Of course, I also went from less than a 7 to pushing in less than 20 minutes, so who knows if I would have actually been able to breathe through that. It was intense. At one point I actually bit DH’s arm a little bit because I just the need to chomp down on something! I begged for someone to make it stop, to just get me the drugs- I’d done it naturally once, didn’t need to do it again, but DH knew that as my signpost for transition and my doctor never made a move to go get those drugs for me. Yeah, safe to say, I was totally out of control. But when that insane rectal pressure got to be too much, I squatted (I have no idea why, just did it) and was suddenly pushing and my sweet daughter was born less than 60 seconds later, caught from behind as stood next to the bed.
Looking back, I feel much more powerful when thinking of birth #2 because I CONQUERED (or maybe, it conquered me) and with birth #1 I felt more like, “I SURVIVED!”
And then I read those hypno stories where the mom felt totally in control the whole time and only felt pressure, no pain, and I think, “Wow, maybe I really wasn’t THAT strong. Maybe I should have been more in control.” And then I remember that animals make noise while birthing and they never go through special classes and what I did was just fine and wonderful.
I was a loud laborer. It scared my husband but the nurse was very reassuring to him and was very good and making sure I was ok and working on helping me become more comfortable in my labor. I started to hyper stimulate because they upped my pitocin and didn’t tell me so I couldn’t tell them I didn’t want them to. So I was VERY vocal at that point. I chose an epidural at that point and explained to the anesthesiologist that I was going to yell when he stuck me because that is how I focus off of the sensation and fear of the epidural. It really freaked him out and I told him that if there was something off, I’d let him know, but that was how I focused out of my fear. The nurse did mention that she was glad that we were in the afternoon hours and not in the middle of the night as to not wake other patients. 🙂 I’m ok about being vocal but hope that next time I can work on my breathing. I hyperventilated and when I got the epidural and relaxed, I almost passed out and lost the feelings in my hands. Once I got O2 it was a world of difference.
Thanks for this lovely post. As a junior midwife I struggle sometimes in the hospital environment, and this has reassured me that when a woman is making a lot of noise, I am right in not necessarily being concerned. It has also made me think about when am I being judgemental in my own practice.
A number of times I’ve been looking after women who are feeling the need to be vocal, particularly when pushing, and I find a lot of the more senior midwives view this as a problem. So I’ll be looking after a woman who is doing really well and the next thing I know I have another midwife (or sometimes a doctor) in the room encouraging the woman to do valsalva pushing or breathe through the contractions or asking if she would like some pain relief, depending on the situation. It can be frustrating at times, especially since this is a vunerable time for women where the people who are supporting them are supposed to be going with the woman’s flow (for want of a better word) rather than their own. When this flow is interrupted you can clear see the effect as the woman stops being instinctive and starts following instructions. I find that once the instinctive frame of mind is interrupted it is hard for the woman to get back there. Of course, change of shift is another time when this can happen, because a new set of midwives means a new set of judgements and thoughts about labour and birth.
Once again, thank you for this thought provoking blog and thank you to everyone who has posted replies, they are fascinating and educational.
I fully agree that each birth is unique, and therefore each woman will cope differently. That said, I think that we all carry a certain level of fear into the birth process which can alter the course of things if not dealt with. Essentially, fear can cause us to fight against the process which can cause more pain. I view this to be more factual than a judgement, and I gather you do too because you mention how it is a birth attendants job to calm the mother down when necessary. I personally believe though, that preparation programs can help women be more proactive in this area.
I agree with some that has already been said in the comments, about how a lot of these programs help more with the early stage than the active part. That was the case for me. The program I used got me all the way to transition comfortably, and then my body took over. I used the mediation along with loud vocalization to get me through it. I felt no shame either. I knew going into it that this was the reality of givng birth.
I guess I’m a little lost though as to why people view birthing programs, like the one I used, in a negative light. Is it that women are feeling let down, or is this judgement being made based on observation and word of mouth? Just curious.
I am pleased that your childbirth preparation worked for you – it does for many women. I just have issues with any program or person telling women how to birth or behave during birth. Women know how to birth. Fear has always been a part of birth in all cultures which is why there are so many rituals associated with birth. Rather than deny fear I think it is more helpful to acknowledge and embrace it. Extreme fear can interfere with the birth process but ‘freaking out’ or being loud and ‘out of control’ is not necessarily fear, and can be helpful for some women (read the comments above). I can’t speak for others but I don’t view programs in a negative light if they are not prescriptive about how birth should be. My judgement here is based on being with women in labour or de-briefing women afterwards who felt they ‘failed’ because they were unable to birth the way their program told them they should. Some women also feel that they ended up with a c-section because they couldn’t ‘hold it together and breathe’ in the way they were taught. This results in self blame which is unhelpful.
Cesareans are different in nature. It is harder to get to the root due to all the cultural beliefs and practices that go on (cultural, political, medical). In my opinion, in cases like that it would better serve a woman if someone more experienced shared with her that there are simply things beyond our control. Whether it be a physical limitation or some intervention that changed the course of labor, it really is best to accept that these things happen and learn how to avoid them if possible. Like you said in your piece, hindsight helps us to do better. I really do agree and respect most that you have written, I just could not get down with some of the small details.
With my first pregnancy, I had a hard time coping those last few weeks. So much so that I begged to be induced. Then, I couldn’t relax between contractions. So going into my second pregnancy I knew I needed help connecting to the process. I needed help learning now to relax not only during the birth, but during those last few weeks of pregnancy that I struggled so much with before (it was hell). Does that make me less than women who go without guidance? Given your comment I can tell you get where I’m coming from. I just didn’t feel that way when I first read your initial thoughts. Thanks for your response.
Your comment: ‘Does that make me less than women who go without guidance?’ worries me, and kind of makes my point. Why do we insist on judging ourselves and others regarding how we birth? Of course I don’t think you are ‘less’ or ‘more’ due to your preparation. You did something based on your prior birth experience that worked for you… an individual… which may, or may not work for another woman. There is nothing wrong with learning to relax during birth with the help of breathing or any other technique. These techniques are extremely helpful for many women. However, if they become prescriptive and women feel like that is the only way, or that they must not lose control then they can cause harm. As you found in your own experience the techniques can work up to a point for some women. You did not worry that your body took over at the end of labour. However I know some women how consider their body taking over at the end as a failure to remain in control. It makes me sad when women express disappointment because they ‘lost it’ just at the end.
It really depends on the program and the practitioner and the interpretation of the mother. Some are great – others are not so great. I hope that makes things clearer and does not imply any judgement from me about your birth 🙂
I was my own instructor so there you go. I didn’t feel right about relying on someone else so I did the Hypnobabies home study program and did my own research in addition.
I see what you are saying, but my motivation to seek more was a result of feeling disconnected from the process. In my heart I knew that there was a better way. A way that worked alongside nature/God.
It was only the beginning of my journey because I desired more. I found Ina May and Grantly Dick Read (among others). It was the compilation of concepts based on experiences that helped me to further my understanding of the mind/body connection.
Maybe that does not align with what you have witnessed, but it was reality for me. My only regret was not changing midwives when I sensed differences between us there in the end.
I’ve just had an AhA moment…it is a lot like religion, isn’t it. When a doctrine is handed out it makes it very difficult for people to find their own path. I think that is what you’re saying, right 😉
Exactly! You did not take a prescription. You found your own (and perfect) path by following your heart – not someone else’s doctrine.
So glad we reached an understanding. Thanks for responding 🙂
Thanks for this – I’m feeling a little more empowered as I recollect my desperate, hysterical repetition of “get her out! get her out! get her out!” as I pushed out my 8lb 14oz posterior baby, who had her arms crossed over her neck to boot! Also, I distinctly remember before transition I had quite a bit of pain, and “went into” myself to deal with it. I heard the woman in the next room screaming bloody murder and felt relieved that that wasn’t me. Guess who was screaming bloody murder about 20 minutes later? 😀
I am most interested in the comments and the way the focus is unwittingly the care provider and not the woman. Story telling is important but since birth is just birth I don’t know why the story would contain much reference to noise in birth ( because it just IS) and every story seems centred on how well the midwife did when dealing or accepting it. This is why we don’t have, even at lots of homebirth, great unhindered intuitive births. The fact that we even have to discuss it as a problem or not is weird. Great post though.
Can I also say that choices in child birth are great, do you choose home or hospital, to get drugged up or keep your baby safe. Pool or land. HOWEVER section for no medical reason isn’t a choice, it’s an emergency procedure and part of our western problem is we put it on equal footing with birthing through the vagina. It is major abdo surgery and not a choice in childbirth.
Yes it is very telling and sad that mothers are grateful to have midwives who ‘allow’ them to birth as they need to. I really wish I knew how to turn this one around so that women expect more and take responsibility for their birth power.
As for c-section. We have a world where women and babies die because of lack of access to the emergency op, whilst other women choose to put themselves and their babies at risk for no medical reason. It is not on an equal footing in any way, but the reality is that for many women it is their choice. It is offered in the private system as a legitimate ‘easy’ choice. Their choice may be based on fear, misinformation, lack of support, lack of confidence in themselves etc. but it is a choice. I don’t think it is then helpful to demonise them personally for that choice. Instead we need to work on the factors that led them to choose unnecessary surgery. We have such a disgraceful birth culture that some women are unable to get to a place of trust in themselves.
I don’t think it is demonising them to say that an elective section isn’t a choice it’s an emergency procedure. It’s like asking to have your faeces removed surgically because you cannot face getting it out. Part of the problem is that we excuse it by blaming the culture instead of understanding that what is said as midwives in the hospital and at home ARE the culture. Partly they chose it out of fear but mostly they chose it because we tell them it is a choice. Every time a midwife hears a doctor or colleague saying this to a woman and she doesn’t speak up then she is complicit in her actions and a big part of the problem.
Women are intelligent and all western women have access to information on tap, they have to take part of the responsibility if they don’t educate themselves on their own bodies.
I will never tell a woman who had an elective section that she made a good or safe choice. I also understand that many women at the time of section have no alternative but they must take responsibility in their part of the decision making process.
I would love to meet the woman that feels empowered after a failed forcep and a ceasarian.
Midwives must also start taking responsibility for their decisions not to fully inform themselves or their clients in the birth process. For holding up employment and their registration as an excuse to witness buterchy and assault while getting upset in the tea room but never speaking out. Why is the sympathy vote with them. Would you walk past an assault in the street?
I would not tell a woman who chose an elective c-section that she had made a good or safe choice. And there is no sympathy vote from me for midwives who maintain the current birth culture (not sure where I indicated there was). Midwives are part of the culture, and the problem and need to stand ‘with woman’ not ‘with institution’. The vast majority of midwives in Australia are afraid of birth. They dont even homebirth their own babies!
Women also need to access the readily available information about their bodies and birth. But to disregard the social and cultural barriers to empowerment is unfair to those who are unable to do so. The reality is that some women are disadvantaged when it comes to accessing their power. I wouldn’t walk past an assault in the street, but neither would I blame the victim.
It saddens me that you would never tell a women who had an elective CS that she had made a good choice. I elected for one because I knew there was a problem, I listened to my baby and to my body and I demanded a CS at odds with my Dr’s advice. Surprise, surprise it turned out the baby was malpresented and would not have been born naturally. Choosing a CS is a birth choice which I felt empowered making, I knew what my body and baby were telling me, and I was right.
After having gone through labour until 8cm naturally (except for a bit of gas), and then having a placental abruption and a very emergency c-section, I have left behind my judgement and preconception of women who elect a c-section. Yes, sometimes it’s frustrating to hear someone say they are CHOOSING to have a c-section.
But why wouldn’t some people choose to when birth is presented in our society in such a horrid manner?
We also need to be aware of the emotional precursors to a woman choosing a c-section.
Has she been a victim of sexual assault in the past where having a vaginal birth forces her to re-live the trauma?
Did she have a horribly traumatic first birth?
Did she in fact have a c-section and feels a sense of mistrust and defeatedness about her own body?
I know my approach to a second birth is going to be a difficult road if I elect a VBAC, starting with the fact that the hospital I had my first at doesn’t allow VBACS.
The issue is not incomplicated. With that being said, if a woman told me she was electing a c-section, I would be curious as to why and advise her of the health benefits to her and her baby in natural birthing. I would suggest a course like the one I did: Calmbirth. It wasn’t about being quiet or anything like that. It was about knowing your body and surrendering to the birth process, whatever that may be.
Perhaps I need to further explain… I would not tell any woman that any birth choice is ‘safe’ or ‘good’. It is not about my perceptions. It is her birth and her perceptions of ‘safety’ and ‘good’.
I see blame and responsibility as very different.
I agree totally about the fear culture surrounding Australian midwives. In this country the only social and cultural barriers to empowerment is the belief that the care provider has the power to give. I think that social and cultural fear/ barriers is one of those midwife excuses that stops them having to take responsibility for their inability to stand with and for women.
It’s great to get people talking about these important topics. Thanks you.
I also wanted to add that in my experience being rather quiet and in control led me to not have the support and understanding I needed from my care providers. In fact, during my most recent birth, it was only when I was starting to have real problems and cry out that I got my care providers to listen to what I had been telling them, but at that point it was too late to change anything and a stat section followed quickly.
I’ve now been told that if your birthing in a hospital and need something (like having cervidel removed!) it’s best to “make a fuss”.
At one point in my labor at the hospital I was standing on top of the bed, making out with my husband. And with both of my births, as my babies crowned I yelled “fuck” at the top of my lungs until my throat was sore. I think I would have exploded if I tried to hold that in! To be a fly on the wall at the nurses’ station right then…
Thank you for another great post.
Some women I have supported in birth, who have done the courses you describe, can experience performance anxiety prior to labour, worrying about whether they will achieve the “calm” state they have been taught is required for effective birthing.
I find in these cases a little “unlearning” is required, encouraging the woman (and her partner) to trust that they will respond as they need to when the time comes.
I think if we teach women that birthing is something you can train for, we mislead them. Women can be prepared for birth, they can be opened up to the possibilities, but as soon as techniques are taught, I believe it leads women away from themselves.
I have read these tales with a lot of interest and have found myself reflecting on a few things. Nothing requires anwering – they are just my ponderings. My questions are: How is it that with all of the collective knowledge, experience and faith in the birth process that midwives world wide stand for, and there is still a culture of interference in any birth situation? Would birth attendents be viewed as being neglectful if there was no interference or perceived support or ‘doing something’? Is is hard for women to birth ‘instinctivly’ because of today’s lack of ‘body awareness’? When we say educate – who are we to ‘educate’ someone else’s primal experience? What do women/midwives/doulas/nurses/families need to be ‘allowed’ to express themselves in liberating ways? Is society exposed to enough ‘normal’ birthing experiences? Do we acknowledge and listen when talking about birth? Is one birthing technique right and helpful for all? And after all is said and done, if we have judged/interfered/been on the receiving end of ‘misplaced’ help, can we forgive? Is the culture ‘expert’/not ‘expert’ the culprit here?
You have posed some great questions. I think culturally we look outside ourselves for expertise in many areas of our lives – including birth. ‘Education’ (if there is any) about birth should be about connecting to that inner expert and building self-trust. Not in universal techniques for something that is instinctual/primal. In my experience not ‘doing’ can be perceived as lack of support by women who have an expectation that you will take control and responsibility for their birth. That is why your ‘role’ as midwife needs to be clarified during your relationship-building. This is impossible without continuity of care. The word ‘allowed’ is banned from my classes 🙂
I am a screamer. I screamed through all 4 of my births. My last birth, my doula told me to scream lower. It worked throughout labor until I jumped out of the tub and climbed onto all fours as she was crowning. I screamed a high pitched note during (alternating with oh eff and a few other choice words) each contraction as she was crowning. It worked for me. It wasn’t fear, it helped me through it. Later my doula told me she would never tell someone how to sound out again. She said she learned a great lesson.
Being quiet isn’t coping and being loud isn’t coping either–coping is something much deeper.
Thank you for writing that great blog. I am becoming a midwife in Germany in a hospital with lots of interventions, i.e. peridural anaesthesias. With theses PDA it is often so hard for the woman to feel “right”. And even if she could get up, she prefers to lay flat in bed( with/and without PDA). Unfortunately it is very common in our hospital to use the valsalva. Probably one reason is that she has loost the feeling when to push or whatever is right in that moment.
What a wonderful article. I have just become pregnant with my second child, and since my first birth, I have felt that I have needed to make the next one a better experience. Your article has helped me realise that I have the power to tell the midwife to piss off and stop telling me to push, and to trust my own instincts. (I’m not bagging out midwifes, I have often contemplated it as a career choice…) I just have the feeling that if I followed my instincts and let my body take its time with the first bub, I probably would not have torn in 3 places!
Thank you for such an informative and fascinating blog. A very good read.
Fascinating about the fetal ejection reflex. When I got to 10cm with my second I totally went primal- it was very much like I was an outsider watching my body do what it was doing without my control. Kinda freaky as it was SO different from my delivery with epidural of my first. But I couldn’t do anything about it if I’d wanted to. Honestly, the fact that I’m deaf probably helped. My MWs and husband may have been coaching, or talking or trying to soothe me… if they were I didn’t hear them, but I got through it and thought the animalistic part was by far the most powerful of anything I went through looking back. Looking forward to my body taking over again with this one due in a month.
Thank you so much for this post. The issue of perception really resonates with me after I supported my first birth ending in c section recently. The woman reflected so positively because she felt she had the space to make informed choices and felt listened to and well supported. As we were in theatre after the staff had introduced themselves to her by first name and ‘failed forceps’ had been abandoned, she was talking about how ‘next time we’ll have a home birth’ …..while at the other side of the screen, her womb was being cut open…she went on to nail breastfeeding even with a baby with a significant tongue tie and is excited about having another baby ‘soon’. In contrast I am going to be working with a second time mum who on paper had the birth that the rest of her NCT group had hoped and planned for but didn’t get. On paper she got her home birth but she was left feeling like it was an awful ordeal and not remotely like the empowering experience she’d been led to believe it would be because she wasn’t happy with the care she received. Her NCT friends all had what would on paper considered more difficult or ‘worse’ experiences yet she reflected negatively and they didn’t….
Something my own midwife told me before I homebirthed my lil one…
“Open mouth = Open cervix.”
I took that to heart. My first (and only) labor and birthing was slightly short of 7 hours. I “Omm”ed through nearly every contraction. We did notify our neighbors (we lived in a duplex) in advance, so they wouldn’t freak out and call the cops, heh 🙂
This has been just true in my experience. “On paper” my first birth was a quiet, calm, natural hospital birth–beautiful, right? Wrong. It was the worst day of my life. http://www.facebook.com/note.php?note_id=10150282717379056
My second birth “on paper” was the natural birth experience that everyone fears and dreads but to me was the most profound and wonderful day of my life–can hardly wait to do it again! http://www.facebook.com/note.php?note_id=10150282861089056
Amber, your stories are so powerful. They have moved me tremendously. Thank you so much for sharing your experiences. What you have said is so valuable for midwives and student midwives to hear, important for all of us who work with women during their childbearing experience. Thank you again. You are very clear in your writing and obviously an amazing woman.
What Carolyn said 🙂
Thank you both so very much! It is such an important topic, and one that resonates very deeply with me. 🙂
This is so awesome! For a large portion of my childhood – I was told that I was “not allowed to make noises” if I ever had a child… I was told while being at the hospital for other family’s births that the women who were making noises were being “absolutely ridiculous.”
This all coming from my grandmother – who was basically like my 2nd mother… It was one of the reasons I never wanted children… Got pregnant, and signed up for classes…. it was until then that I found out my grandmother had a spinal with all her births… Up until the point that someone told me noises could help me in labor – I was really worried because “what if I couldn’t stop myself from being loud????!!!!”
Luckily – I was recommended some great resources… had a beautiful home birth… and my life is now completely changed. I now teach classes, and am getting prepared for my 2nd home birth in the fall… noises and all!
Enjoy your wonderful (and noisy) 2nd homebirth 🙂
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This thread makes me laugh, remembering my last (home) birth where I felt very conscious that I needed to curb my language because I thought my (devoutly Christian) MW would be shocked. Actually she would have taken it in her stride but censoring myself sort of helped me focus and gain a bit of control in those last few minutes where I thought I was splitting open. My 4.3 kg baby was born really quickly on a birth stool, which I don’t recommend these days due to greater likelihood of tearing etc. Next day I had such a sore throat due to all the grunting I’d been doing (apparently – who knew?). It was a peak experience anyway!
With my first VBAC, I screamed near the end of pushing. It didn’t hurt, I wasn’t “out of control”, I wasn’t afraid…I just felt like screaming. With my second, I just kind of cried in pain and begged my husband to kill me. The second was the more difficult labour. I’m hoping this time around will go about the speed of the second and the intensity of the first. lol
I am finding this a fabulous post to read. I have just returned to work on a busy, chaotic maternity unit (Australia) after a year off having 2nd baby. On my 1st shift back I was reminiscing about my labour (a lady I was looking after was in the room I birthed my son in).
Hilariously, during my labour, I apparently struck a prolonged operatic note. I do remember at one stage in the labour thinking “life is kind of like an orgasm-sometimes you get there, sometimes you don’t” – and I think THAT is when I hit the operatic note!!! I wonder what the other women in the maternity unit were thinking that night?!
Thank you for this. I found your blog a few days after I had my baby, when I was beating myself up for screaming so loudly and not having the “control” that I had envisioned. Reading this snapped me out of it.
Thank you so much for this blog. It is such an important message and I love the video you chose. Such beautiful power in that mums expression of her birth.
Thanks to Ann Kelly, Irish Independent Midwife, I experienced two beautiful births in my home. I recognise that I am one of the lucky ones, as home birth in Ireland is becoming a rare event. Insurance is the first practical threat with companies only agreeing to provide Indemnity to midwives attending mothers who fulfil strict criteria and the Irish Nursing Board have come up with a spectacular set of guidelines for independent midwives – with not one independent midwife being part of the team who devised these guidelines. Women are not fools, and this bullying by the authorities will only fool some of the people some of the time. Unfortunately this may mean women choosing to birth at home alone rather than venturing into a hospital where they are not deemed to be the expert over their own body or their baby’s wellbeing.
Rose
It seems this is a global problem. Regulating midwives out of being ‘with woman’. 🙁
Thanks for your article.
I have to admit i was a complete “nightmare” birthing woman. I insisted on pissing in the Petrie dish things, refused monitoring, nearly set the hospital sprinklers off when the acupuncturist used moxibustion, insisted the oxytocin drip would do nothing (it didn’t) and told the doctor they had no “fucking respect for midwifery”! In fairness the hospital really tried to let me do things my way. But I knew they were waiting in the wings for a c section, and after 36 hours I had lost the will to live and let them do whatever the hell they wanted. Meconium, awkward positioning vs mothers intuition that all was fine and a strong baby heartbeat. They felt it was only a matter of time before it turned into an emergency. I felt all I needed was a midwife strong enough to enter the mystery with me. I remain conflicted about the birth to this day. But somehow these experiences are just another thing women bear. Xxx
What an amazing, beautiful and wisdom filled piece of writing this is, thankyou so much. It is amazing that the idea of respecting and supporting a woman through her birth and empowering her in all her choices still seems a radical idea! I wish that every person who shares in the incredible privilege of supporting a woman to give birth reads this article!
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Great post! I’ve had to learn as a doula the importance of accepting every type of woman, parent and labor choice. I really think we are all just doing the best we can!
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Oh how I wish I had read this before my baby was born 7 months ago. I had a wonderful independent midwife and we planned to labour at home, however I ended up with PET and was admitted to hospital at 35 weeks. Labour was induced at 37 weeks and after the second apllication of gel progressed very quickly. The hospital midwives didn’t believe that I was in labour and told me I was over reacting. What had actually happened was that I had progressed from 0-6cm dilated in just over an hour. My independent midwife was finishing another birth as was the back up midwife so I was stuck with these horrible women until either of my wonderful ladies could make it to me. By the time the back up midwife arrived I felt so out of control and unsupported by the hospital staff and by the time my midwife arrived I just wanted it to be over. I was so conscious of the noise I was making and didn’t want others to hear me. In short I ended up with an epidural and an emergency c-section. I have a beautiful healthy baby boy (for which I am very grateful) and post traumatic stress disorder. I am completely unable to even drive past the hospital he was born in and on the occassions I have had to go in have had massive anxiety attacks. I can’t sleep at night due to reliving the labour and delivery and now question whether I can do it again! I am so grateful though to live in a country where independent midwives are the norm and we adore our midwife, she became part of our family for 9 months.
This was my first time reading your blog and I am so grateful that you decided to address this topic! I gave birth naturally in December 2011 to our first and I was so loud – a ‘screamer’ as everyone has been calling it. I’ve been feeling bad about how loud I was and felt like I must have been doing something wrong to have the need to scream like that. But in fact I never once felt scared or worried – it was just how my body naturally coped with the pain. I don’t think I could have stopped the noise if I wanted to. Anyway, thanks for the sweet reminder that us ‘Screamers’ are OK too!
As a ‘screamer’ you are in good company… although I was more of a moo’er 😉
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Thank you for writing this. I was directed to this post by my HBC (Homebirth Cesarean) community. Your words warm my heart. Thank you.
This really resonates with me – as a new (ish) mother (I still feel new most of the time!) I find that these judgments from all and sundry can really weigh you down, whether they be about birth, nappies, sleep, or any other topic that comes up. I have learnt to keep my opinions very quiet unless I’m in close company – I remember after the birth of my first baby, in the water and without pain relief, my husband’s aunt who was pregnant and a midwife (!!!!) scoffed and told me she had seen enough labours and had no desire to experience it herself and was going for an elective c-section as she had nothing to prove. I realised then that you just can’t win!
I did feel fantastic in labour and in my second I think I was in control, but certainly not quiet in any way. I used Ina May Gaskin’s horse lips during the first few hours of bitey contractions, with my husband urging me to go louder and louder as the contractions got stronger. I’m sure it sounded ridiculous but it worked a treat, it didn’t even occur to me to ask for pain relief as I was too busy making noise and I dilated really quickly.
Anyway, thanks again for a very poignant post.
🙂
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I love this article. During my second birth, while in transition i hollered! EVERYONE was telling me to stop and breath and calm down! I didn’t understand why because hollering was taking so much pain away and just felt really good! I was too scared about speaking up about it then, as I thought I was “doing it wrong”. The breathing techniques I was being instructed to use did NOT help me at all but just made it hard for me to focus on breathing right and dealing with the pain at the same time. I wish I would have just told everyone where to shove it! 😉
This is very interesting. I have been told things like if I shout I will ‘slow it down’, and there does seem to be focus on quiet birth – NOT from ob/gyn advice, but from more pro-natural influences whom I have approached for advice (in the UK). My cynical side wonders if they feel they would struggle to encourage some women to ‘do it naturally’ if they embraced the less neat/palatable side of things.
Several of my (usually polite) friends have cheerfully informed me they shouted and swore and stomped around and “no one batted an eyelid”. I’ve also heard several stories where epidurals were used etc’ and mum and baby felt informed and safe… yet others sneer. To me, to be listened to and to do what feels right (provided all is safe) seems more natural than candles and silence.
I have seen the opposite happen on a few occasions ie. a woman trying to quietly breath (as taught in classes) and labouring very slowly, then when given ‘permission’ to make noise the labour speeding up along with her energy.
Woman judging herself, being judged by others, and judging other women, are symptoms of a patriarchal society built on a profit-driven economy that depends on the unpaid labour of women as care-givers. The maternity care system is a reflection, or indeed an agent, of our misogynistic society that tolerates and excuses violence against women.
I loved the sentiment of this article and despite running a program called The Calm Birth School. Everything that you have just said about timing into your feelings as a birthing woman and no way being the ‘right/best’ way is what we teach. We view our version of Calm Birth as the anti fear, with the only objective to be creating a positive experience regardless of how the baby enters the world.
I also really appreciate your thoughts on judgement ‘despite there perhaps being a little evident in the post’. The mantra for us is ‘never justify, do not judge’. When a woman doesn’t feel the need to defend her position i believe it gives other women permission not to feel the need to justify or defend there own. Birth belongs to all of us and whilst I do have personal beliefs about why the increase in routine c-sections is a problem, I believe by educating women about birth as a natural and normal process will help to relieve fear, make birth a more enjoyable process where women’s default becomes to believe in themselves and this magnificent process and therefore, contribute towards encouraging to think twice before opting for a medically managed birth.
Thanks once again for your thoughtful insights.
Oh I love this post. This topic is close to my heart. There are so many lovely and attractive techniques out there being taught to birthing women, but these are only half the preparation a woman really needs to be really prepared for birth. If what we focus on is that women should have natural births, then we might teach just that, and forget about the ones that failed. But if we are trying to help woman have good births, not necessarily natural and to minimise trauma, then we need a whole different layer of much deeper self exploration. You can teach a woman what an epidural is and how it is given, but this doesn’t help a woman, who was trying so hard to avoid it, if she has one anyway. Not speaking about it as not to manifest it, wont help her either. This is a missing part of most childbirth preparation today and a huge part of women’s issues and judgment of themselves afterwards.
Childbirth is a rite of passage, but that does not only apply to natural birth. All kinds of births are!!! And no matter what kind of childbirth preparation a woman gets, some births will leave her wounded and then we need to gather her up as a community and support her to move on and grow. Birth is something we can influence but we can’t control it and it is very important that we don’t give women the impression that she can just breathe or just think positively or just listen to this tape or just not be fearful and birth will be right or calm or natural, or controlled.
Women have worked so incredibly hard in the natural birth movement for many years and have come very far in many places. But this is a political issue, and not appropriate for birth preparation. It is important to have all the information, but as I said before we are missing the self exploration part of most childbirth preparation where women are supported to find her way and her resources and her sore areas emotionally, so she can cope with whatever she needs to cope with in whatever way she personally copes,in her Rite of Passage, which is unknown to everyone until she has done it. And that is generally what we are all a bit scared of.
🙂 x
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I can relate to having a different experience compared to the staff. I had an induction with some problems and complications but I did birth my daughter and unlike many people I didn’t find it that painful even with pitocin. I did get physically and mentally tired and I mainly had nitrous oxide gas to give myself some mental space rather than feeling less pain. I did tear my cervix and my vagina in two different ways and one of the vaginal tears led to bleeding which led to me being stitched up in an operating room rather than in the birthing room. That part was tough but still something I felt I could cope with.
I was so proud after my birth since I have almost a hospital phobia, fear of medical staff and a fear of the induction itself as so many people said it was the worst thing they ever experienced even though they had given birth many times. And I did it! I gave birth to my daughter despite all these fears and problems. She was here safe and I got treated well in general by staff and the operation in itself was apparently pretty easy once I was no longer bleeding. I asked the doctor who stitched me up if he knew why I bled so much and he said that he could not say anything other than very bad luck. He had seen the type of tear I had many times and it usually does not bleed this way.
My midwife and the nurses at the hospital afterwards all seemed to pity me and my hard birth and they seemed very surprised that I said yes, I did not like being away from my daughter but the rest was fine. I know it was not perfect but I am happy. My midwife was great when I gave birth but it seemed very confusing to her how I was so relaxed over the things that happened other than being separated. I tried to explain and while she said she was happy for me she did seem to believe that I would change my mind once I started thinking about it and kept reminding me of opportunities to debrief the birth. I thanked her, it is really very good that women can discuss their birth but I had no need to discuss it with the staff at the hospital. I almost felt like they were trying to make me feel bad for the birth I felt good about. I would not say it was traumatic but I did feel sad about them not being able to see the beauty I saw. As I was so happy I think I would rather have liked her to share this happiness with me since I really felt she helped me a lot during the last part of labor. I strangely felt more supported by the male doctor who stitched me up and his senior colleague who also came and checked in and told me he had been consulted as an extra precaution and that he was very sure they had made sure I would heal properly. They both didn’t really pity me and seemed glad just to see that I was OK. That worked better for me. They told me their side and answered my questions and said that I had a beautiful daughter and I felt done with that.
I have thought about this birth a lot since I got pregnant again and I still like my birth. I am still scared of hospitals and can’t have a home birth for different reasons but this time I know I have done it once and it was good so there is hope I will be able to do as well or preferably better.
I have enjoyed many of your articles, including this one. Thank you.
I had my six sons at home and unassisted(in the U.S.) Each time we considered using a midwife. I just did not want to be told what to do in labor and birth. I thought a midwife may make me tense and cause complications. Some midwives seem to want to be in charge and take control away from mothers(similar to Doctors.) You seem different. Thank you
I was a ‘screamer’ (I would have been mortified if I knew midwives labelled women like that) who was not afraid and who coped very well. I pushed out a baby who was so big and solid he stretched my ligaments apart where I had a lot of scar tissue built up from accidents to my lower back and pelvis. it felt like I was being ripped apart. I had never before imagined pain like that. It took over 6 months for the SI ligaments to heal. But I did it. I was being loud, but I wasn’t being weak. I knew exactly what i had to do and I did it. My previous birth had involved a shoulder dystocia that had very nearly ended badly. I was birthing at 42 weeks while struggling with symptoms of POTS and dysautonomia, even during labour. I had asked for an induction at 41 weeks, and even had days of panic when I entered prodromal labour with a breech baby and could not get anyone to reassure me because I wasn’t in labour yet, so i turned him myself. Pre-birth, no-one would listen to my concerns, so i ended up with a birth that was very hard and all natural, but thankfully once it came to active labour, i had fantastic midwives who put any discomfort or judgements of me or any doubts aside and just calmly stayed close and followed my requests immediately, and took the time to ask before doing anything. Having midwives who were not visibly phased by the level of noise allowed me to do what I needed to. I thanked them for it afterward, telling them I had not been scared but just needed the freedom to let the pain out, and they simply smiled and said they understood. Perfect support.
I spent the night labouring and the next day was rather like another sort of big night out – I had a sore throat from all the noise I made. Reading the comments is making me reflect on how we decide these things – how we become a quiet or a loud labouring woman. For me, making noise felt so natural. It really facilitated that separation – filling my world with noise during contractions gave me a silence in a weird way – no one was talking to me or fussing me. I could just hear the sound of myself, it made me feel very grounded. I was long and loud and moo-y in my noises.
I wonder where it came from – I’m quite quiet in other areas. I wonder if part of it was my Mum? The stories I heard about labour growing up were really positive – and I know that my mum “made a racket”. But that her births had been fine and that I’d be born in hospital but that my younger sister was born at home and how lovely it was. My favourite story about her births had been that the midwife made her breakfast during first stage because “she was going to have a busy day”. My other favourite was that the midwife left her after my sister was orn and came to check back that evening and told her to just take it easy, no visitors until tomorrow. But that when she came back the windowsills in the bedroom were covered in empty wine glasses. I’d love to know something about the inter-generational stories of labour and how it affects birth.
I’ve started talking to my toddler about how she was born and it has been really interesting turning it into a story – the process has been surprising. I don’t tell her the bits I feel conflicted on – how late she was and how conflicted I felt on induction (she was born at 42+5, I had a pessary start of induction but was in active labour only a few hours later and had no other intervention, I wish I’d held out one more day). Her favourite parts are that I was loud and shouty, she thinks it great I made funny noises like cows (though she says “but you were inside! Mummy you should shout outside!”), she’s fascinated by the idea that I was awake all night long. But no labour stories can beat her delight that straight away after she was born she did a poo on my tummy (she’s two – poo is the height of humour).
Birth stories have such an influence on individuals and on birth culture. It is lovely that you are sharing your birth story with your daughter 🙂
I too love your blogs. I do see how this plays out..will engage this in my doula work. Krista..l do hear you if csections done to save baby ok..that is so rare..almost alWays done due to protocol or doctor preference or damage from hospital interventons..we have allowed ourselves to be treated as victims of our bodies..time to reclai
I appreciate this conversation. As a 5 yr L&D nurse, I’ve been instructed to keep birthing mothers quiet and in control. I personally was a quiet birther, but I’ve observed that most women naturally aren’t quiet. It doesn’t bother me to hear them, as long as they aren’t kicking or flailing, which would be unsafe. Screaming or grunting doesn’t seem to prolong the labor, but most of my coworkers won’t allow it. Some of them will yell and scream at the mother to stop. I feel that screaming at them is insulting, and could be traumatizing, so I don’t do it. I’m sure that I’m criticized by my colleagues for not “controlling” my patient at times. Your opinions have validated my feelings. I know that if the woman is yelling “NO, I won’t push!” I need to help guide her, but instinctive screaming with pushing is understandable. I want my clients to feel respected, and enjoy their experience as much as possible. Thanks to all of you who honestly shared your thoughts.
How sad for the Moms! Where are you? Don’t almost all have epidurals?
Michigan. Yes, more than 90% of my mothers get epidurals, but not all of them are completely effective. The goal of the epidural is for the mother to feel pelvic pressure as the baby descends, so she can guide her pushing. I instruct them to not fear that pressure, if they feel it.
Great post to read!
I was a little prejudiced in my first birth – birthing basically alone, vocalising low “chants” and then growling with pushing contractions I felt like a really successful natural birther. Like I did it right.
So when I was transported to a hospital after having delivered my firstborn in a car with only husband there for support, I did feel very judgemental about women in labour screaming on the top of their lungs. I didn’t necessarily just look down on them, but because of my experience I felt they may profit from focusing their voice a little, if that makes sense, because it really sounded hysteric. Now I’ve learned not everything is as it sounds – which is useful to keep in mind. 🙂
On the other hand I also had the opposite experience. Because as a first time mum-to-be I was coping wel, could keep my calm between the contractions pretty far into active labour and was not freaking out about it, everyone (including my doula and for some time even myself) assumed I was not very far along. It was only when she heard me on the phone DURING the contraction, that she realised we might not have that much time.
In the end I was happy to birth relatively undisturbed, but it became clear to me, that even being ‘in control’ can sometimes be counterproductive as you can’t get your needs met, if you’re not heard and taken seriously first.
Thanks for this article. I don’t know a tonne about preparing for child birth. I looked up some breathing techniques and practiced prior to my recent first baby delivery. It progressed quickly and within 2 hours of contractions becoming consistent every 5 minutes, my son was born. I tried my best to relax and breathe through contractions but once I was close to transition with no pain meds I began to moan loudly and eventually let out a long consistent yell. This felt natural and necessary, as the breathing wasn’t cutting it. The yelling helped me cope. Luckily the volume of my bellowing got the nurses in action as I was still in triage and 9.5cm dilated. No one believed my husband when he told them my contractions were suddenly every 2 minutes lasting the whole 2 minutes… my body did what it needed to do and I got the help i needed. I felt a lot of embarassment as my family heard the whole thing from the waiting room. I feel better knowing that making a lot of noise can be natural and helpful for other women.