Natural Childbirth In An Unnatural World

A thoughtful, and thought-provoking blog from Stephanie Morrow of BlogHer.com makes the plea to modern women everywhere to make an informed decision about their birth in an "unnatural world." We are constantly surrounded by the images of mothers in horrible pain when labor begins and dramatic moments of the water breaking.  While all that makes for good drama on television- it's not reality for most births!  She certainly lays the groundwork for good research points, and closes it up with something that we definitely believe in here at Embrace Birth Midwifery Care & Birth Center: "YOUR body, YOUR baby, YOUR decision."

Photo Credit: stephanie2morrow

Why You Won't Have a Natural Birth

By: Stephanie Morrow

I rarely rant. I almost never rave. If I seem taller than usual, it's more likely from my new sparkly summer wedges than from standing on a soapbox. But ... well ... I want to say something that's going to make some of you furious and others of you feel justified:

Natural childbirth is not possible in an unnatural world.

And we do live in an unnatural world -- X-Men, Photoshop, reality tv, fast food, Donald Trump's hair -- and we believe what we see. (Except maybe for the hair.)

Our culture encourages those same "unreal" perceptions regarding childbirth. Movies and tv shows tell us labor will begin with intense pain and agony. We are shown images of women screaming and begging to be medicated. We told to freak out when water breaks and rush to the hospital. We listen to the horror stories of our "friends." We ignorantly put ourselves in the hands of people who are exceptionally well-trained to handle abnormalities and emergencies, hence all our births have become such abnormalities and emergencies.

And that's just not reality.

We are NOT educating ourselves. We have lost our communal knowledge of the art of birthing and have chosen instead to simply trust the medical profession to decide what is best for us.

You can SAY all day long, "I want a natural birth," but if you aren't educating yourself, your chances of actually HAVING one are practically nonexistent. I mean, if you want to be a safe driver, but you don't read the Driver's Manual, or learn to operate a vehicle from someone who knows how, or even take a driver's ed class, you MIGHT get in the car and know WHERE you want to go, but what are the chances of actually making it there safely? Probably about the same as having an uneducated natural birth.

Now, by "educating yourself," I do NOT mean taking the hospital class that tours you through Labor & Delivery, makes you watch the epidural video and discusses all the things that "could go wrong" and how the hospital will deal with them. NO. NO. An emphatic NO.

Read for yourself: Literature from both ends of the spectrum, from Twinkle Ding-Dong Yoga Birthing to Shut Up and Put Your Feet in the Stirrups. Go ahead and take the Labor & Delivery tour at the hospital, then go to an independent childbirth class. Drink in A Baby Story on TLC, then chase it with The Business of Being Born on Netflix.

Read up on epidurals and episiotomies; C-sections and vitamin K shots; vaccinations and circumcisions; fetal monitoring and forceps; meconium and mucous plugs; contractions and colostrum; dilation and doulas; VBAC and PRoM; breech babies and birth positions; posterior presentation, placentas, pitocin & postpartum depression, and for heaven's sake, PARENTING.

What determines the outcome of your labor hinges sharply on choosing to educate yourself and surround yourself with the support you need.  And, as a doula, while I heavily advocate drug-free birthing, my job is to help you have the experience you want. Schedule a C-section, squat in a cornfield, whatever. It is, after all, YOUR body, YOUR baby, YOUR decision.

Just please, please, please make it an INFORMED one.

To view the original blog post, click here.

10 Things RVA First-Time Moms Can Do To Reduce Stress

Photo Credit: Bumpbirthandbabyphotography.com

I love first-time moms.  I love their bright eyes, their curiosity, their eagerness to do everything “just right”.  I love their excitement about shopping for the nursery, and their nervousness about labor.  I love the honor of being the one to guide them through the most transformative and intense periods of their lives.

But, with all that excitement comes a level of stress and worry that really doesn't serve them well.  It bogs them down as they search Google and Babycenter,  trying to find the “right” answers.

If first-time moms could just know...

1.         Because of your great love for the new life growing inside you, everything seems tied to the pregnancy. But that twinge in your left toe?  Probably not because of the baby.

2.         Tell everyone your due date is a week later than it actually is.  The average first-time mom in America gives birth 10 days after their due date (if they are not induced before then!)  Add a week and save yourself all those “Are you still pregnant?!” calls.

3.         The mucous plug?  I'm sorry to break this to you, but it means...nothing.  Absolutely nothing.  It can come out, and it can still be weeks until labor.  Now, if it comes with bright red bloody show...we may be in business!

4.         On the signs of labor...nesting, diarrhea, nausea, twinges, cramps?  You've been misled.  These are not signs of labor.  Not yet. They can be signs that labor may come in the next day, or two, or 10...but not yet.  This is also true of cervical checks in the last few weeks.  You can be 4 cm or 0 cm, and no one can predict when labor will start.  No one.

5.         Prodromal labor can last days, and days, and days.  This is the time when you may have a few hours of contractions, and yes, they may be intense, but they are still spaced out and they go away with rest, or a warm bath, or a dose of magnesium (Calm Magnesium Supplement is magic and I recommend all my clients have it on hand)  You've heard of midwives or doctor telling a mom to have a glass of wine and go to bed.  It's because they are pretty sure that mama is in prodromal labor. No worries, if it progresses into real labor, it will wake you up when it needs you.  I've never heard of a mom sleeping through her home birth. If you wake up and the sun is shining, then know your body did some work last night to get ready for the real thing.

6.         If you are asking yourself if it is labor, it is NOT LABOR.  When it is labor, you will not miss it. You will not be fooled into thinking it is Braxton Hicks, or indigestion, or something you ate.  It will grab your attention, and you will not longer have a single doubt in your mind that you.are.in.labor. Try to “not” be in labor until you have to be.  Ignore it.  Deny it. Say it IS indigestion.  Don't give in to it until you can't NOT give in to it.

7.         This brings me to when you are in labor.  Do not announce your labor on Facebook, or Twitter, or through a group email.  Do not put yourself on someone else's clock.  Not only is it distracting for you or the daddy to continually be answering inquiries, it gives all those people the ability to put in their opinion.  Is something wrong?  Has the baby come yet? Hasn't  it been too long?  Should you go to the hospital?  During birth, you need to relax, and you need to be fully supported by your partner.  Announce your baby, not the labor.

8.         You will be your most beautiful, and your most disheveled, in labor.  You will not care if your hair is done, or your lipstick is on.  Come ready to work hard, and we will freshen you up afterward. Athletes don't primp for triathlons, and mama, you are an athlete!

9.         The much-feared tear is more under your control than mine.  I can (and will!) use warm cloths, and oil, and perineal support, and all my other tricks...but really, studies tell us that none of it makes much difference.  You know what helps?  Perineal massage in the last 4-6 weeks, and slow, gentle pushing.  This allows those tissues to stretch.

10.   Your baby needs you.  Just...you.  And you need food and water.  Not a crib, a playpen, a swing, a vibrating seat, the perfect blankets and matching curtains, etc, etc, etc.  Mothers today are overwhelmed with all the things a new baby “needs”,  Here's the real deal: someway to wear your baby, diapers, a car seat and a safe place to sleep (which can be in bed with you!) All the rest is extra.  I'm not saying to not buy those adorable things.  Do it!  Enjoy!  It's exciting.  But, don't put yourself in debt.  Don't think your baby needs every gadget, every toy, every color shoes. Your baby will never know if he wears white onesies and sleeps in a laundry basket for the first 3 months (unless you tell him when he's older!)

So, Relax.  Enjoy.  Accept that 99% of what is going on is natural, and normal, and part of the process. Keep a “when to call the midwife” list on your frig, and know the warning signs of trouble, but don't go looking for it.   Have faith in your body and your baby.  Just like you knew how to conceive that baby, your body knows how to grow it, birth it, nurse it.  You're going to be a mama of a little one soon, and you're going to be brilliant!


- Corina Hossle
Founder, Clinical Director & Midwife

The Birth Center Difference

We'd love to answer any and all questions you may have about what kind of care our Birth Center, Midwives, and Doulas can provide for you!  We offer tours twice a week- Tuesday afternoons at 1 pm and Saturday mornings at 9 am.  We also offer lots of classes, workshops, and opportunities to meet our talented and trained staff. Check our calendar for daily events!  We know our care can make your birth experience everything you hope it will be!

Doulas Provide Emotional, Physical and Educational Support

Our Doula interns had a great time at the Doula Speed Dating event last night, we were happy to help those couples with their questions about the benefits of a doula.  Every doula is there for educational, emotional and physical support both during and after pregnancy.  Some have backgrounds in physical therapy, others in yoga or massage, but they all share a passion for giving you the experience you want and support without judgment!

NBC12 News Coverage!

We got a great write up and video from NBC 12!

CHESTERFIELD, VA (WWBT) -
The first free-standing, midwife-led birth center just opened its doors in Chesterfield.

The Embrace Midwifery Birth Care and Resource Center and Embrace Wellness Collective opened this week off Buford Road. The facility hosts a number of services, but the focus is prenatal care, birth, and care in the weeks that follow.

“We have a lot of different services,” said Corina Hossle. “Our midwifery care covers all prenatal care, labor, birth, and post-partum care. We have two birth suites. So, we have the whole gamut of the child-bearing year covered.”

Hossle is a licensed midwife, so she also cares for mothers and babies for six weeks after birth.

“We have a nurse midwife who is offering well-woman care, birth control, IUDs, all the hormonal replacements for perimenopausal and menopausal women,” said Hossle.  “We have a wellness collective with the green baby store going in. We have doulas, we have a doula internship program, we have yoga, and child-bearing classes. We have lactation support, we’re really working hard to be a one-stop-shop for Richmond families in the area.”

What's different is the hands-on, low-intervention philosophy. We're told moms can catch their own babies. The practice also promotes skin-to-skin bonding. And they say IVs don't get started unless they are really medically required.

“We are so committed to parents and unmedicated, empowered birth. So, our job here is to just give them another option. Healthy moms having healthy babies can have babies out of hospitals and we believe that that's a good option for them," said Hossle, who she already has more than a dozen babies booked to be born at the facility. “Women are really starting to seek out an alternative birth experience. They want to be in charge of their birth and not be delivered of their babies.  So, this gives them the opportunity to really step into that space.”

For those unfamiliar with how an independent birth center might work, we asked her about what they do in an emergency.

“We do all the same tests that a doctor can do,” said Hossle. “We order all the same labs that a hospital would require, but we truly believe that interventions need to be truly required to stop into that space.”

Hossle also pointed to the ambulance crew directly across the street and she says they have a transfer agreement in place with some hospitals.

“We ask them to give us a call and we’ll talk with them a little bit on the phone and we will be offering tours on a weekly basis so they can come and see the birth centers, see if it is the right option- ask their questions. We offer free consultations and interviews so they truly can see if we’re who they want to choose for their providers. And then they begin care with us.”

Hossle says they are Medicaid providers and they also have an insurance billing program in place.

Doula Speed Dating

Are you thinking about using a doula as a part of your birth plan?  Then please come to our Doula Speed Dating event this Wednesday at 6pm to meet and greet with Embrace Birth's Doula team! Whether you're an Embrace client or not, we invite all expecting families to join us for light refreshments and a chance to meet your local doulas.  Doulas are like birthing coaches, they can help you with techniques to manage pain during labor and are there to give you emotional, physical and informational support before, during, and after your birth.  Come learn all the benefits of having a doula and get an opportunity to meet....The Right One!

A Woman's Right to Birth

We love this Letter to the Editor from a brave mother sent to The Washington Post.  It is our goal to inform and empower women with choice.  Articles like these feed on all of the unfounded fears of having a natural birth, frowning on "natural" as an inferior method, once again undermining a woman's right to choose.  We believe that birth is intuitive to all women and with the proper guidance from a knowledgable and well-trained midwife, mothers can be informed to make the best decision for their bodies.  We are one of the only birth centers anywhere that has a direct collaboration with a Registered Nurse, Jessica Jordan, who is able to provide medications on a consultation basis.  We have had less than a 1 percent transfer rate, a 6 percent C-section rate, and a 15 percent transfer rate for reasons such as pain management, or the baby being in a less than ideal position.  We are proud of those numbers and are thankful for modern medicine to bring healthy babies into this world under such circumstances.  There is no shame about it!

(Paul Giamou/iStock)

Women Should Be Listened to About the Childbirth Process

As a mother who has birthed two children, I found Amy Tuteur wrong on many fronts in her May 8 Outlook essay, “The natural-birth industrial complex.” Perhaps her most egregious — and tired — assertion about childbirth is the “healthy baby and mother” argument.

Implying that women should be satisfied simply with a healthy baby-healthy mom outcome is dismissive of women and their birth experiences, especially when they are grieving events that are sad, disappointing or traumatic. Of course every mother wants a healthy baby, but when women are ignored, disrespected or violated during labor and birth, then birth may not be a beautiful experience for them.

We can set the bar higher. Birth teaches us that we are not in control, but that doesn’t mean women don’t have choices. Women are absolutely right to ask for more in terms of prenatal and postnatal care and labor and birth options. This applies to home, birth center and hospital births — because women should be respected and listened to no matter what the birth setting.

Sarah Farr, Silver Spring

To read the full article, click here.

Pelvic Floor Therapy Demystified

I wrote this article several years ago during the period when I saw a pelvic floor therapist. I still discuss pelvic floor therapy regularly and with everyone (yes neighbors too) with the hopes that more women will seek out this amazing option. Ask an Embrace Midwife for a recommendation or check out the links below!

-Kathryn Haines, CPM

Pelvic Floor Therapy Demystified

My amazing pelvic floor was not so amazing after carrying three babies.  After my second baby, I managed to control and then stop occasional loss of urine by doing kegels. When I experienced urine loss after my third birth, I assumed that it was only a matter of time before I was dry again. As the months and then a full year went by, and I continued to change pad after pad after pad, I became concerned. A bottle of tea tree oil and vinegar by the toilet helped keep the odor away but there is something very discouraging about being incontinent when you are thirty-five.

At a visit with my local midwives (midwives are my go-to for well-woman care), Mairi and Erin asked if I had any other questions.  I disclosed my incontinence and they said suggested I see a physical therapist who specializes in pelvic floors.  A few weeks later I sat sheepishly in Pat Strott-Wheatley's office, marveling over the fact that I had been so busy taking care of my three little ones, my husband, and the house (not to mention midwifery!) that I had forgotten to take care of myself (sound familiar anyone?).

In the first visit, Pat mentioned that most people were able to stay dry 85% to 90% (or more) of the time upon faithful completion of pelvic floor therapy.  The first week began with writing down everything I ate and drank as well as each trip to the toilet.  The next assignment was to go to the toilet every hour in an attempt to stay dry.  I was shocked to realize that I often couldn't even go one hour without leaking and I found it humorous how hard it was to pee every hour.  Days at the pool were the most challenging. My eldest swims but not well enough to leave alone in a pool and of course I couldn't leave my three or one year old alone.  So our daily routine went something like this.  "Ok (for the fourth hour in a row) everyone, out of the pool (grumble, grumble, grumble, why mommy), mom has to pee!" Writing down the times I peed was another roadblock.  Do you know how hard it is to pack for a family of five at the pool?  Adding my "Bladder Diary" to the bag with the suits and swimmies and lotions and shampoos and plates and snacks just did not happen. Somehow I made it through the week.

At my second appointment, I was hooked up to a computer that measured how strong my kegels were, determined the extent to which I was relaxing between kegels and made sure I was using the appropriate muscles.  I learned that while I kegeled well under the watchful eyes of Pat, at home I was not adequately relaxing between kegels.  I was so focused on getting my kegels in that I was contracting beautifully, but not fully relaxing. Remember, biofeedback works!  A hand on the belly reminds you to relax.

I also watched a movie on the amazing pelvic floor.  Did you know that the urge to pee lasts 14 seconds and instead of rushing to the bathroom when you feel the urge (this makes you leak) you should first take a breath and kegel? Pat sent me home with new homework, pee every hour and a half and add pelvic floor exercises, three sets, contract for 8 seconds, relax for eight seconds.

Visit three, PROGRESS! The pelvic floor exercises were working!  I was able to stay dry peeing every hour and a half and during a conference where I just couldn't slip out to pee, I found myself doing extra kegels and staying dry for about two hours!  I noticed a few leaks that occurred when I had my morning latte and Pat suggested that I switch to half-caff (a painful switch but I am adjusting and you bet I will NOT be drinking half-caff at a birth.)  I was hooked up to the computer again and the program detected that I had greatly increased the strength of my kegels in just one week!  More homework.  Pee every two hours and kegel four times a day, contract 10 seconds, relax ten seconds.

Week four. I forgot my sensor today and so I am scheduled for a final session in one month (probably a good thing as I will not slack on my kegels).  The good news, when I kegel regularly (and appropriately!) I no longer leak!  I will need to kegel for the rest of my life, and regularly (at least one set four times a day) but staying dry is worth the effort.  And there are other benefits too!  Developing strong pelvic floor muscles helps alleviate constipation and leads to better sex (among other things).  If you are kegeling and it isn't working, I HIGHLY recommend visiting a physical therapist who specializes in pelvic floors.  They will make sure you are kegeling properly, offer advice on how to kegel more effectively, and suggest things in your diet (like caffeine) that might be adding to the problem.

A disclaimer, I made a dramatic improvement in a short amount of time (four visits over the course of less than two months).  This is because I had rather strong pelvic floor muscles at the start.  It can take several months to see improvement and you have to be very diligent about doing your homework.  If I don't kegel regularly, I leak, it is as simple as that.

I would love to see all midwives talk about the correct way to kegel (equal emphasis on relaxing as well as contracting) with their clients prenatally and post-partum.  My gut feeling is that there are a lot of women out there who are incontinent and don't realize that a physical therapist can help you learn how to stay dry.  I am a convert! Check out these websites to find a great pelvic floor therapist: https://hermanwallace.com/practitioner-directory, http://www.womenshealthapta.org/pt-locator/.