My new hero – Ina May Gaskin!

Yesterday, I finished reading a wonderful book by Ina May Gaskin, Ina May’s Guide to Childbirth.  It was amazing, educational and inspirational.  I absolutely loved it.  Like The Business of Being Born documentary that I mentioned in this post, I so wish I had read this book during my first pregnancy.  Better late than never. 🙂  I wish all pregnant women would take time to read this – it really could be transforming for anyone who takes to heart Ina May’s wisdom and advice.

For those who don’t know, Ina May is the founder and director of the Farm Midwifery Center, located in Summertown, TN in The Farm community.  This birthing center emphasizes a natural, spiritual, low-intervention approach to childbirth, and Ina May is world renowned for her experience and expertise in the field of midwifery. 

When I began reading the book, two statistics immediately jumped out at me, both of which convinced me that I was reading the right book.  From the time it opened in 1970 through the year 2000, the Farm Midwifery Center had a c-section rate of 1.4% (compared to an average national rate of about 25% during those years – now the national rate is over 30%).  Additionally, 108 VBACs were attempted at the Farm, and of those 106 were successful. 

!!!!!!!!! 

Those are pretty incredible statistics.  Can I please have this next baby at The Farm?  Please?  Please?  Please?

I took notes as I was reading because there was just SO much goodness to take in, and I will likely read this book again as I approach my due date.  As I was reading, I thought of several new questions that I want to bring to my midwife and doula (oh, we hired Wendy Dean as our doula, by the way – I am so glad!  I think she’ll be great!).   I also noted a couple of chapters that I want DJ to read.  Get ready to read about vaginas, honey!

Here are a few of my notes and thoughts on some parts of the book that I found most interesting.  Out of respect for Ina May and her publisher, I am not including all of my notes here.  Anyone interested in this subject would be much better served reading the book for themselves, and I’m sure Ina May and the good folks at Bantam Books would rather people go out and buy the book rather than rely on my crib notes for all the information. 🙂  So yes, everyone, please go out and buy the book!  It will be money well spent.

 

A few of my thoughts on Ina May’s Guide to Childbirth

The first 131 pages of this book are dedicated to birth stories – that is, first hand accounts of labor and delivery written by the women and their caregivers who experienced them.  There are a lot of stories, all of them unique and very inspiring, about women from all walks of life, of different ethnicities, ages, etc… I never got tired of reading them despite the fact that I was so eager to move on to Ina May’s scoop later in the book.  These stories beautifully illustrate the fact that women’s bodies were created to give birth naturally.  I have gained so much confidence in myself after reading them, and I no longer feel that my desire for natural childbirth is unusual or crazy.  As Ina May writes at the end of the book, “Your body is not a lemon!”  These stories are evidence to that fact. 

The first chapter – The Powerful Mind/Body Connection – is one of the two chapters I want DJ to read.  I found Ina May’s explanation of the relationship between the mind and the body during labor/delivery to be so moving… and to make so much sense!  This was not something to which I gave much consideration during my first pregnancy, but it sure clicked for me (and really without any prompting – it just very naturally occurred to me) a few months after Jolie was born when I realized I wanted to attempt a natural birth next time.   A couple of quotes that I jotted down from this chapter:

“True words spoken can sometimes relax pelvic muscles by discarging emotions that effectively block further progress in labor.” page 135

“…the presence of even one person who is not exquisitely attuned to the mother’s feelings can stop some women’s labors… Many labors stopped or slowed down when someone entered the birth room who was not intimate with the laboring mother’s feelings.” page 138

Note to self: allow only DJ, Doula Wendy, my nurse and my midwife to be present during labor (barring some unexpected event, of course…).

Chapter four is about Sphincter Law, something I was not familiar with (except for that joke in the movie Wayne’s World, “A sphincter says what?”).  Sphincters are muscle groups that ordinarily remain contracted to keep certain organs closed but open when something needs to pass through (things such as poop, pee… and babies!).  According to Sphincter Law, which many midwives assume during labor, “labors that don’t result in a normal birth after a ‘reasonable’ amount of time are often slowed or stalled because of lack of privacy, fear, and simulation of the wrong part of the women’s brain”. (p. 168)  Apparently, this law isn’t something often taught in medical school, but rather, OBs more frequently follow the Law of the Three Ps (Ps being Passenger [baby], Passage [pelvis and vagina] and Powers [strength of uterine contractions]).  According to the Law of the Three Ps, if a woman’s labor doesn’t produce a baby in the time allotted, it is because either “she grew too big a baby, has too small a vagina or too weak a uterus.” (p. 168)

Wow, that sounds familiar!

“You know, Jill, we think your baby was probably just too big, which caused your labor to stall and resulted in your c-section.”   😦

No, no, no, no, no…

Or this…

“Yeah, you have somewhat of a narrow pelvic opening, Jill, so I don’t foresee you being able to push out much more than an 8-pound baby.”

No, no, no, no, no…

Maybe I’m in denial here, but I would at least like the opportunity to go into labor on my own and at least TRY to push.  Especially after hearing from my midwife that my pelvic opening is just fine, thankyouverymuch. 🙂

Anyway, Ina May talks at length about the importance of Sphincter Law in birthing babies and refers back to that mind/body connection again quite frequently in this chapter – the mind being a key agent in allowing the sphincters to open.  And if sphincters don’t open, it’s kinda hard to deliver a baby, I understand… 

Interesting tidbit – apparently the relaxation of the mouth and jaw are directly correlated to the ability of the cervix, vagina and anus to open fully. (p. 178)  One really funny thing before moving on.  Ina May gives suggestions for how to relax the mouth/throat in order to avoid tearing and to aid in dilation and pushing.  One of the tips for how to effectively achieve such relaxation is to moo like a cow.  LOL.  This just really makes me laugh.  I keep getting this visual of me on my hands and knees on the hospital bed mooing along with DJ and Doula Wendy.  That’s funny.  But as Ina May says, it’s okay if that seems funny, because to laugh at this behavior during labor would actually be a good thing.  🙂

Chapter seven is on Giving Birth.  I took a lot of notes here.  My favorite part of this chapter was the 9 or 10 suggestions for maximizing your chances of having an unmedicated labor and birth in a hospital.  Number one – hire a doula.  Amen, sister, we did that!  Another suggestion – visualizing yourself as a large, wild animal giving birth.  Well that oughta be easy since I’ll be as big as an ox by that point anyway. 

In chapter eight – Forgotten Vaginal Powers – I found something really remarkable that I had to write down:

“I’ve never seen a tear in a woman who was kissing her way through the pushing phase of labor or touching herself as her baby emerged.” (p. 251) 

The link between sexuality and birth was a bit foreign to me but seems logical (and why wouldn’t it be, given that sex is the origin of the entire process…?), particularly after understanding the parallels Ina May draws between having sex and giving birth.  Think of it – the mind/body connection involved in having sex is hugely important.  If you aren’t in the proper state of mind before having sex, it probably isn’t going to be all that satisfying- and sometimes not even possible, particularly if you’re a man.  A man has to be in the right mind frame before his major sex organ is able to function properly (that being his penis becoming erect, for those who need it spelled out 😉 ).  If a man is full of fear and worried that his penis might explode during an erection, he’s probably not going to have one…  The same reasoning would make sense for women, would it not?  How is a woman’s major sex organ supposed to function properly (ie, dilate and allow a baby to pass through) if she’s petrified by the notion that her vagina might tear in two before it’s all said and done?  And no one seems to be bothered by the fact that a man’s penis can magically grow during an erection, yet many people can’t quite fathom that a woman’s vagina similarly grows to an enlarged state during dilation. Hmmm… 

The sad thing is that this kind of fear is instilled in women thanks to media (think of those maternity ward reality shows on TV that depict the agony of labor – it’s okay, I used to watch them constantly during my first pregnancy and always taped the especially horrible stories for DJ to watch).  Then there’s also the lovely birth horror stories passed along by relatives, friends, etc. of the mother-to-be.  I fondly remember my mother telling me my own birth story, especially the part about how she thought she was “going to die” from the pain.  Awesome! 🙂  Ina May dedicates some of the book talking about the influence of media and other sources of negativity, all of which can be detrimental to a positive birth experience.

But anyway, as for the mind/body/sexuality connection again – I am curious to know if my midwives or Doula Wendy have ever witnessed clients using some of these more sexual techniques (ie, kissing, nipple stimulation, masturbation) during labor and, if so, how effective they were in allowing labor to progress.  I’ll have to ask!

And then chapter twelve – the other chapter I’d like DJ to read – is all about the VBAC.  Lots of history here on VBACs and why obstetric policy has changed in many places despite the fact that VBAC in a healthy mother is safer than a c-section in a healthy mother.  Ina May provides a list of suggestions for maximizing chances for having a VBAC (p. 302-303).  Here are just a few of those, including my thoughts:

1. Choose a caregiver with a VBAC rate of 70%.  Ummm… my midwife’s is about 50%.  But I’m not sure I have much other choice… unless I venture off to Tennessee in late August and deliver at the Farm.  🙂

2. Choose a caregiver that allows eating and drinking during labor.  This is something I’ll have to double-check on.  I know I can drink as long as I don’t have an epidural, which I will not be doing anyway… but I’m not sure on the eating.  That’s okay, if they don’t let me eat in the room maybe I’ll hide a turkey sandwich in the bathroom. 

3. Resist the epidural.  Yes!

4. Maintain positive energy.  Love your uterus and your baby.  Mmmm…. loving my uterus as we speak…. 

 

 That’s all!  Thank you, Ina May, for creating such an amazing and encouraging book!  It was perfect for someone like me. 🙂