When women start out on the path of birth work, they fear they won’t know what to say to the birthing woman. Quiet is more important than talking. A few words spoken at the right time can renew a woman’s sense of safety and resolve. Practicing saying soothing things out loud will make the words come easy when the time is right. Some things that might be appropriate to encourage a birthing mother:
“It’s safe to let go”
“You only have to do this one”
“Breathe right down into it, it’s safe to go there”
“Breathe oxygen down to your thighs, that’s it. . . breathe in oxygen and breathe out with loose lips.”
“What you’re doing is ancient. . . your mother, your grandmother and your great grandmothers all the way back have done this. They’re all proud of you tonight.”
“If you’re doing this well now, I know you’ll make it through. Each sensation brings you closer to holding your baby in your arms”.
“I’m so proud of you. You’re doing beautifully”.
“Let’s begin this birth anew. Just let your breath wash away the past 5 hours and let’s begin now at the beginning.”
“Breathe some good oxygen breaths for your baby.”
“There’s lots of room for the baby to come through”.
“You’re stretching beautifully. . there’s more space than you know”
“Just let the baby get itself born, you get out of the way”
Gloria Lemay, Vancouver BC Canada
I wanted to share this memory with you, Ted. I don’t know if you remember this incident but I’ve told it to so many people and it always makes me laugh so I thought you might enjoy this trip down memory lane.
Many years ago, when we both had young kids and you were married to Karen, I bumped into you in the parking lot of the “7-11” on West Fourth Ave. We exchanged small talk for a while and, all of a sudden, you got a strange look on your face and blurted out the following, unforgettable (to me) sentence: “Gloria, is it true you were a topless dancer in China?” I couldn’t fathom how that thought could ever enter someone’s head. I’ve been accused of many things in my life but that was pretty far-fetched—I had never been to the Orient, I had never been to the local nude beach, none of what you said made any sense at all. But, somewhere in there, I started thinking “How could this husband of another birth attendant have gotten this idea in his head?”
Then, I remembered a birth that I had called Karen out to one evening. It was the second vaginal birth for the woman. When Karen arrived at the home, I went through the woman’s chart with her. The only surgery the birthing woman had ever had was a breast augmentation. She was a Caucasian woman who was married to a Japanese man. I explained to Karen that the couple had met in Japan and the first child had been born in a Japanese hospital, completely natural birth. The woman had been in Japan because she had taken a job as a hostess in a nightclub in Japan.
Now, they were living in Vancouver and having their second child. The baby was born just after midnight and I sent Karen home soon after.
I’m guessing that what happened is that she crawled into bed with you, Ted, and you must have asked her “how did the birth go?” There wasn’t much to tell except that bit about her previous breast augmentation surgery so perhaps Karen told you about that. Somehow, in your sleepy state, that got changed into “Gloria Lemay was a topless dancer in China”.
Once I had retraced the strange pathway of that statement, I said to you: “You know, Ted, that’s not true about me BUT it’s way more interesting than my real life. Will you, please, spread that rumour about me!”
Thanks for the special moments and laughs that knowing you has added to my life. I love you and your dear family.
Every once in a long while, I get a letter like this that re-inspires me to keep going on my heart’s desired goal of equal rights for baby boys. Protection from mutilating surgery. I’m posting this to inspire others to keep on talking and trusting that the parents of today will eventually find the way to setting aside genital cutting. Love Gloria
I decided I needed to write to you to let you know that all of your efforts towards ending circumcision are not in vain. I’m sure you already know that, but perhaps a story of victory will be of encouragement. When we met, I had honestly never heard anyone stand against the concept of male circumcision. I had never considered it anything like female circumcision. I grew up in a Christian home, where we leaned pretty Jewish in our theology and circumcision was considered incredibly important. When my brother was born my parents had a Christian doctor who was terribly against circumcision and they heeded his advice and left my brother intact. My mom especially has always regretted that decision, and felt that she wronged my brother by being persuaded by the doctor. My brother has had many obstacles in his life and somehow these obstacles were all directed back to the “lack of blessing”.
When you explained your stance I began a rigorous examination of what I had always held to be the only way. At first glance my stance was only fortified because the scripture that refers to circumcision is so clear. Through this act you will receive the blessings bestowed upon Abraham and his generations and without it you will be cut off from any blessings and considered outside of the family. It wasn’t until I started to research what circumcision really looked like at that time that I realized the problem. You may already know this, but in antiquity circumcision was a cut at the base of the foreskin with a heated knife and then a partial pulling away, with the fingernails, which left the foreskin attached at the top. When the battles began between the Greeks and the Jews over circumcision (Jewish women and children slaughtered by the Greeks over circumcision, therefore Jews hiding it or not circumcising, and Jewish zealots forcing circumcision on any Jew found in tact) the Jewish zealots began to enforce the full removal of the foreskin in order to prevent Jews from “hiding” by pulling the foreskin down over the tip.
I also learned that this full removal in North America was used as a form of physiological control over the population, doctors suggesting to use no pain relief in order to associate pain with that region and “curb sexual desires”. Pretty messed up.
The part that really got me was that the original concept of circumcision was a blood covenant. I knew it was a covenant but I had missed this crucial point. You see the Rabbis would suck a drop of blood from the site of the wound and spit it out as a sign of now belonging to the same blood covenant as Abraham.
The problem with this today is that currently Jewish culture does no blood rituals. They stopped when the temple was destroyed, and let’s be honest if the temple was rebuilt they would have a big challenge on their hands because culture has changed and this is no longer acceptable. What this blood covenant means to me as a Christian is that I cannot partake in this ritual because I am under the blood covenant of Jesus and what He did on the cross. I would be choosing a lesser covenant, with Abraham, for my child.
Now that all sounds pretty fanatical and religious and obviously there would be other factors in my decision making process but these concepts were still lurking there in my mind. I was over the moon excited to have a baby girl, partly because I REALLY wanted another daughter, and partly because I still didn’t know what to do by the time she was born. I finally feel completely freed from this concept. I actually strongly believe most of what the Jewish culture followed in antiquity was based on the atrocities that already occurred around them in neighboring cultures. I believe the regulations God gave them prevented them from doing terrible things that were considered normal and that over the years as they were drawn away from those cultures and into the culture of Heaven they were released more and more from these old regulations. I believe God is about compassion, love, justice, kindness and protecting the weak; and the darkness of our culture is a remnant from choosing to walk away from God in the garden.
It therefore does not make sense for this tradition to continue, a tradition that seems to tie itself with the darkness of a past age we have thankfully walked away from. However, it is imperative that people really walk out the process of making that decision for themselves so they do not end up, like my mom was for a season, blaming their choice on someone else’s coercion. The reason I wanted to share all of this with you is because the arguments you were using to explain why circumcision needed to stop were not completely shifting my viewpoint. You see growing up a Christian in a non-Christian culture there were a lot of things I had to choose to do that no one else understood, like waiting until I got married to have sex. Friends scoffed at me that I could never “make it” but I did. I have a pretty determined personality and I am capable of holding strong to a conviction without making a lot of noise about it. It is similar to my convictions against vaccines and on limiting medical interference in life, I have wonderful family members who are so passionately against me in this area that it can feel normal to go against someone else’s convictions. I wondered if knowing a tipping point for someone like me, might give you better tools to help someone in the future to rethink their position.
I hope this does not make you think less of me. You made it clear (when we first met) how against it you were, and I took that to heart. I felt that this was not something to be ignored when you so passionately battle to see it eradicated. I can now confidently say I agree with you wholeheartedly. From a Christian perspective I can say I believe it is wrong, and thought I do not know exactly how to work out the details I am pretty confident it is also no longer necessary for those of Jewish decent. I believe this concept of Bris Shalom would more than adequately cover the need for covenant and adhering to the bestowing of generational blessings. But, that is not my path to walk out.
Even before I completely agreed with you I was so impressed by your stance. I am honoured to know someone like you who is willing to protect these little lives no matter what the personal cost might be. I have so much respect for you. Thank you for what you do, -in birth and in protecting little boys. Shifting mind sets is no easy task. You are a true history maker. Love, Lydia
For more information on a naming ceremony that doesn’t involve any cutting or bleeding see: http://www.beyondthebris.com/2011/07/brit-shalom-alternative-naming-ceremony.html
= below normal levels of oxygen
= restriction in blood supply to tissues, causing a shortage of oxygen and glucose needed for cellular metabolism (to keep tissue alive)
= a disease in which the functioning of the brain is affected by some agent or condition
HIE Help Center
Mar 7, 2017
Dear Ms. Lemay,
My name is Genevieve and I’m writing to you as a fan of Wise Woman Way of Birth and a contributor to a new website devoted to childhood disability. Our website specializes in helping parents care for their children with HIE. We know that your posts approach a number of different topics surrounding birth, and we found the post “$70 Million Birth Injury Case” to be quite similar to our website’s platform and goals.
We understand that many parents may be going to your site and reading about birth injuries, perhaps after facing a diagnosis they aren’t sure about themselves. We would thus be so grateful if you considered adding a link to our page, which discusses HIE, a neonatal brain injury that causes disability throughout childhood and adulthood. I help run www.HIEHelpCenter.org, an informational website for parents of kids that were recently diagnosed with hypoxic-ischemic encephalopathy (HIE). Our website is one of the only sites devoted to HIE on the Internet, and in order to raise awareness of this particular disability, we wanted to ask you if you would consider including us as a link on your blog in a blog post.
Thank you for your time!
HIE Help Center Community Outreach Coordinator
From: Gloria Lemay
June 10, 2017
Hi Genevieve, you wrote to me some time ago and I have just now been able to go and see your site. I looked over the “prevention” section and was surprised to NOT see two of the prevention things that I think are most crucial to making sure that infants get all the oxygen to their brains that they need.
1. leaving the umbilical cord alone (not cutting) until it has fully stopped pulsing. (Resuscitation can be done, if necessary, right on the mother’s abdomen and the cord is the baby’s life line)
2. avoiding the use of pain meds in birth. The mother has been so careful to not drink alcohol, take drugs unnecessarily, and eat well. Then, on the day of the birth, she is medicated for many hours with an epidural which freezes her from her breasts to her thighs. This is right where the baby is located. That baby is getting all that numbing medication, too. Moral support and less systemic meds would be a better way to go. Any woman who knows that her baby might be brain injured by an epidural would say “no” to it. Better to have a day of pain than a lifetime of suffering for the child. Most women don’t know about that and the doctors don’t realize it because they don’t see the problems that the child faces.
I think this is the type of information that could really give your readers power in the face of HIE. Gloria Lemay, Vancouver BC Canada
“$70 Million Birth Injury Case”
This short video with commentary, might be helpful to student midwives. Gloria
These photos are a great demonstration of how the placenta, cord and baby keep working together after the birth when left intact. They were donated by a family to their midwives and I share them here with permission. If you’d like to see them on the original website, the link is http://www.nurturingheartsbirthservices.com/blog/?p=1542
The first picture was taken within the first minute or so of the birth….and then, pictures were taken “every so often” about every 3-5 minutes when the cord had changed a little more. The last picture was taken about 15-20 minutes after the birth.
Please credit or link to the original website if you share any of these photos. Thanks, Gloria.
“Adaptation to life outside the womb is the major physiological task for the baby in third stage. In utero, the wondrous placenta fulfills the functions of lungs, kidney, gut and liver for our babies. Blood flow to these organs is minimal until the baby takes a first breath, at which time huge changes begin in the organisation of the circulatory system.
Within the baby’s body, blood becomes, over several minutes, diverted away from the umbilical cord and placenta and, as the lungs fill with air, blood is sucked into the pulmonary (lung) circulation. Mother Nature ensures a reservoir of blood in the cord and placenta that provides the additional blood necessary for these newly-perfused pulmonary and organ systems.”
Sarah Buckley, M.D.
You’ll have to view this little two minute video of a mother deer giving birth to twins on FB by going to the date link below. Here’s a photo as a sneak peek. Gloria
Be sure to click on the highlighted DATE, not Debbie’s name.
Midwifery Care for the VBAC Woman
by Gloria Lemay
© 2001 Midwifery Today, Inc. All rights reserved.
[This article first appeared in Midwifery Today Issue 57, Spring 2001.]
Someone asked me recently what things are done differently with vaginal births after cesarean (VBAC) as opposed to a first baby. Midwives usually reply to this question with a reassuring, “Oh, we treat you normally,” but there are differences in the two situations that can be distinguished in midwifery practice.
The full history of the events leading to the cesarean is very important. With a VBAC client, ask her to get her operative record, nurse’s notes, anesthetist’s report, pediatric report—get all the records and go over them thoroughly. Often the couple did not get full or accurate information about what was going on. Sometimes there’s a little “clue” as to what went wrong that could help to prevent a cesarean from recurring. Sometimes there is a big chunk of information that didn’t get communicated. I saw one set of records where the only indication for the cesarean was the note from the obstetrician that “this woman is a natural childbirth fanatic.” Another set of cesarean records had no indicator whatsoever of why the woman received abdominal surgery when she had given birth at l9 years old. When she told her parents that the midwife was perplexed and could see no reason for the surgery, her father admitted to her that he had stayed in the visitor’s lounge all day and had been verbally threatening to the doctor: “If anything happens to my daughter, I’ll sue you!” This helped the daughter to understand what had happened to her and also helped her to be firm with her father that he was to be nowhere near her VBAC birth.
With VBAC births it is important for the midwife to work with the dad prenatally. A VBAC father is in a horrible position because, despite the fact that his wife had an operation and a long recovery, he still got a live wife and baby at the end of it all. VBAC dads are often “fantasy bonded” to the medical system and terrified of childbirth in general.
The good thing is that they listen very carefully and really know when the care is better and more thorough and when the practitioner is authentically on their team. I find that if the midwife talks to them very honestly, they can trust and be fully supportive when the birth time arrives.
If the woman has dilated past five centimeters in the first birth, I plan for it to be fairly fast—like any second baby. If the woman has not gone into the birth process or not dilated past five the first time, that’s all right, she’ll still give birth vaginally, but we have extra midwives on call to bring fresh energy if the others get discouraged or tired. We plan for it to be like going to two births in a row. The point that the woman reached in her first birth is often a psychological hurdle for her. If she dilated to six centimeters the first time, the news that she is seven or eight will be a relief and a breakthrough. One of our clients, a minister’s wife, said over and over again in her pregnancy: “I just want to feel what pushing is. If I only get to push, I’ll be happy. I just want to know what other women mean when they say they had to push.” She’d had a Bandl’s ring in the first birth process and the cesarean was done at five centimeters. We were praying that the complication wouldn’t repeat. She dilated smoothly and began to push. With each push she would exclaim “Thank you Jesus, thank you Jesus!” What a wonder it was to watch her push out the baby, a girl whom she named Faith.
All humans have a certain propensity to self-sabotage, and the VBAC woman must be on guard against her own defeating patterns. The midwife must be bold in pointing out ways that the woman is repeating dumb moves—there’s no place for us being “nice” if it will mean another cesarean. An example of this: If the woman had a cesarean with five support people, she will be cautioned to keep her VBAC private.
Privacy and quiet are a must, and we will be very forceful about setting up logistics before the birth so that the woman can birth in peace. In short, the VBAC is high priority because this woman’s whole obstetrical future rides on its success.
We show the couple lots of videos of beautiful VBAC births because one video is worth a thousand words. If you don’t have your own, purchase a copy of my dvd “Birth with Gloria Lemay” which shows a beautiful VBAC waterbirth. Art therapy is helpful in creating the environment before the birth day. I place a big sheet of drawing paper in front of the father and mother with lots of colored pencils and instruct them to, “Draw your birth cave” or, “Color your birth.” When they are finished, I write the date on the two drawings and put them away in my files. After the birth, we take them out and are amazed at the details that were drawn weeks before and later manifested in the actual birth.
I schedule longer appointments with VBAC women because they seem to need to obsess. I don’t have solutions to many of their fears but it seems to help to just be able to talk to someone who cares and understands. I usually also ask them to, “Tell me how you know that this time you’re going to have a vaginal birth?” The answers always amaze me. One woman said, “Because this time I’m not depending on my doctor or my midwives—me and my husband are going to have this baby.” I suggested that she give up depending on her husband, too. She looked terrified at that idea but I could see that she understood; she looked me in the eye and said, “Right!” That was the moment I knew she would do it. She’s had three water homebirth VBACs since then, and after each birth her first words were, “I did it.”
VBAC women are so grateful for the opportunity to birth normally that they are often shy to ask for the extra things that make a birth beautiful, such as a Blessingway ceremony or a waterbirth. The midwife must remember to offer and encourage the mother to think “really beautiful birth” rather than “bare minimum birth.” I find it helpful to ask, “This is the only second baby you will ever have—what would make it really special?”
The Day of the Birth
In my practice, no one gets induced in any way or gets pain medication. This policy is very important for all women but especially for VBAC women. If there is a small chance of uterine rupture, we must have everything on our side to prevent it (the rate of VBAC uterine rupture without induction is 0.4 percent or less than one in 200*). It is beyond my comprehension how anyone could give a VBAC woman misoprostol (Cytotec), oxytocin or castor oil or strip the membranes or use any other form of induction when that would triple her chance of having a uterine rupture.
I believe that VBAC women have longer, gentler births because Nature is compensating for the scar. There is no hurrying. I would be terrified to induce a VBAC woman but feel safe to attend her at home if her body is pacing itself naturally. We keep it in the back of our heads that the signs of rupture are stabbing pain, unusual bleeding, decels of the baby’s heart, or a peculiar shape of the abdomen but we don’t look for problems if they don’t exist.
We are especially careful with the birth of the placenta in a VBAC because there is a slightly increased chance that the placenta might be adhered to the scar, and we do not want to have a uterine prolapse caused by pulling.
After the birth, VBAC women need to be told that they can walk upright. They can’t believe that they can straighten at the waist right after giving birth. Then, they can’t believe it when we ask them to do sit-ups and leg raises on day one. Usually by day three when we go to visit, their husbands say, “Oh, she’s gone to the gym.” With VBAC women, the complaints are very few in the postpartum period because they are comparing to post-surgery pain and any minor scrapes and bruises seem like nothing.
In the years following the birth, these women and men send us more clients than anyone else, and if we’re in legal trouble, they’ll be at all the rallies, raise money, stamp the envelopes, write letters to legislators, and be our true friends for life. A VBAC is an amazing experience for the birth attendants as well as the family. Very Beautiful And Courageous (VBAC).
Q & A: VBAC
Two Types of Pelvises
by Gloria Lemay
Q: From a midwife: A great many Asian women are very small and small-footed, yet I hear that many of them birth vaginally. Would you comment on pelvic size?
A: When I get a VBAC client and she is endlessly self-psychoanalyzing and beating herself up for having a c-section, I usually say, “Look you made two big mistakes! First you were born in the wrong country, and second you were born in the wrong century—if you’d been born and raised l00 years ago in France, for instance, you would have given birth vaginally.” When I teach my workshops, I tell the students there are two types of pelvises in allopathic medicine: l) contracted, and 2) adequate. In midwifery, there are two types of pelvises as well: l) roomy, ample, and 2) you could get a pony through there!
Gloria Lemay is a Private Birth Attendant in Vancouver, British Columbia, Canada and a frequent contributor to Midwifery Today and The Birthkit.
This is a question that comes up a lot in pregnancy. . .”What kind of iron supplements should I be taking? My practitioner says I’m anemic.” It turns out that a lot of practitioners mistakenly diagnose anemia based on old information and lack of understanding of the physiology of the pregnant woman.
This information from Dr. Michel Odent is very helpful:
Question for Dr. Michel Odent:
My hemoglobin is now 11.4 in week of gestation 19. A friend of mine has 7.8. Do I have to take ferrum? Is there a hemoglobin-limit?
Answer from M. Odent
It is probable that from now on your hemoglobin concentration will decrease. The placenta – which is ‘the advocate of the baby’ – will send you hormonal messages so that you dilute your blood in order to make it more fluid. Your blood volume will increase dramatically (up to 40% to 50%). Although you’ll still have the same amount of hemoglobin available, its concentration in your blood will be lower if the placenta is working well. The most authoritative published study on this issue involved more than 150 000 thousands births (Steer P, Alam MA, Wadsworth J, Welch A. Relation between maternal hemoglobin concentration and birth weight in different ethnic groups. BMJ 1995; 310: 389-91). According to this huge study a hemoglobin concentration between 8.5 and 9.5 during the second half of a pregnancy is associated with the best possible birth outcomes. Furthermore, when the hemoglobin concentration fails to fall below 10.5 there is an increased risk of low birth weight, premature birth and pre-eclampsia.
The regrettable consequence of misinterpreting this test is that, all over the world, millions of pregnant women are wrongly told that they are anemic and are given iron supplements. There is a tendency both to overlook the side effects of iron (constipation, diarrhea, heartburn, etc.) and to forget that iron inhibits the absorption of such an important growth factor as zinc. Furthermore, iron is a powerful oxidative substance that can exacerbate the production of free radicals. The disease pre-eclampsia is associated with an ‘oxidative stress’. Pregnant women need antioxidants (provided in particular by fruit and vegetable) rather than oxidative substances.
You should print the abstract of the study I mentioned (you’ll find it via PubMed, for example) in order to be in a position to discuss with practitioners who might tell you that you are anemic and that you need iron supplements. Don’t take iron supplements as long as your iron deficiency has not been proven by specific tests (ferritin in particular).
I cannot comment on the hemoglobin concentration of your friend, first because I don’t know if she is at the beginning or at the end of her pregnancy, and also because data regarding her lifestyle and data provided by a clinical exam should prevail upon the results of one laboratory test; this test should probably be repeated and completed, according to the context. (end of Dr. Odent’s comments)
Here is the link to the study he talks about:
This study is another piece of the puzzle that more women should know about:
University of Turin researchers have found that women who take iron
supplements during mid-pregnancy have a higher risk of gestational diabetes,
hypertension and metabolic syndrome. The study assessed iron
supplementation, along with other factors, for 1000 women-half with
gestational diabetes and half with normal glycemic levels-between 24 and 28
weeks gestation. Of the women studied, 212 were taking iron supplements,
mostly in the form of ferrous sulphate.
The researchers concluded, “Routine iron supplementation in pregnancy is a
matter of controversy and debate. The increasing reporting of harmful
effects for unnecessary iron supplementation should be carefully considered.
Further studies on larger cohorts are warranted to confirm these results,
but glucose values should at least be monitored in iron-supplemented
The full report can be accessed online at:
– American Journal of Obstetrics and Gynecology, 201(2): 158.e1-6, 2009