Third births: finally getting it right

This came in as a comment on my blog post “What’s a Poor Midwife to Do?” but I think it should have it’s own blog space. Gloria

Gloria, this jumped off the page for me: “Something to notice is that for many women, it takes two screwed up births to get the third birth somewhat acceptable.

This is me. I had two coerced c/s without labour and thereby two premature babies, the first of which was so premature that his skull would mold to my hands while I breastfed him and from sleeping so that I spent weeks gently re-forming his skull manually. He had breathing problems until 6 months pp, and his skin was so soft that I couldn’t even feel it under my fingertips.

I look at pictures of him now and see how obviously premature he was. He was my first and a c/s because otherwise, “if I [went] into labour, he could [have] die[d]” from his frank breech position. His brother was also a no-labour c/s for the very same positioning ‘reason.’

For my third baby, I saw an OB in my 1st trimester (midwives wouldn’t even talk to me seriously- I’d had ‘shared care’ for the first two pregnancies after breech was indicated in the 3rd trimester) but left his office and never returned.

I freebirthed the next baby with my first labour- at 46+3, a 9 hour painless birth. It was GLORIOUS! He was 10lbs 3oz, strong and beautiful. 🙂

I then freebirthed another boy at 42+3 at the tail end of a flu that my whole family had. It was a precipitous labour- 3 minutes long, and he was 10lbs 8oz. Also beautifully formed and strong.

Now I am 45 weeks tomorrow with our fifth baby.

Our first 4 were born in Ontario and now I am in a Canadian territory. I would not even consider asking a midwife to be present at my births after the first two. I have a deep respect for midwifery and have seen through years of research that began after my second c/s, how it has collapsed as a woman-centered and truly beneficial art.

Just the hockey-bag-sized tote of intervention paraphernalia that a midwife in Ontario was required to have present at births was extremely off-putting. If birth is safe, and midwives support that reality, then why the hospital-in-a-bag???

My then mw, who became a friend, a few yrs later said that she felt like OBs hands, like she was expected to go through all the same motions with all the same cautions and procedures, but just on a much more rigorous schedule. She felt used- doing more work for less pay, enduring the upheaval of her whole family to be present for her clients, and then being highly scrutinized by the OBs who were her overseers. She was only a few yrs in, and already burning out. 🙁 She began with passion and an overflowing heart for loving the families she worked with.

Anyway, I don’t need any pity. I enjoy freebirthing and happen to prefer to be alone anyway, and if someone even tried to examine me during labour, I’d likely send *her/him* to the hospital, lol- not intentionally of course, but I am very focused and mama-bear-like in labour and pp since my 3rd birth experience.

BUT the lack of truly woman-centred midwifery has obviously left a huge vacuum for the majority of women in childbirth.

Natalie, I didn’t know my dates for my first two because I was taking birth control pills and had bleeds while pregnant. So, I was ‘required’ to do u/s for dating, which ended up being waaaaay off and obviously not helpful when two premature babies were taken early because of it. The first was extreme, and the second child not so much, but still obviously early.

Also, my surgical records indicate nothing (even though I spent time in the ICU for full-body anaesthesia paralysis and a heart rate that wouldn’t go above 38 bpm after the surgery- for three hours) and the hospital staff refused to admit that my child was obviously premature and instead just told me that I cannot take my eyes off of him ever- not to pee, not to eat or leave the room at all- ever, not for a second. So I didn’t.

I tended a baby and brought him to health at a stage of growth and development that would have usually meant him living still in my womb, and in the worst case scenario, in the nicu for at least a month or longer. It was very, very difficult and it has taken me seven years to recover my own health from those experiences- and with a huge amount of diligent effort, not passive recovery.

My midwife was then just newly practicing and we grieved this whole scenario together. She didn’t know the horrors of the medical industry so intimately previously. She was not prepared for it, and the medical industry representatives (OBs) took full advantage.

Gloria, thank you for your willingness to address these issues. And thank you for being available to discuss them openly. I have tried to talk people out of supporting the regulation of midwifery where I live, but I have not found a single sympathetic ear. It may be more helpful to attend to how it is regulated, I don’t know, but it would be better to have a better model in place before regulating so that midwifery doesn’t end up swallowed whole, like it will be if this goes through.

I am sad for what will happen once midwifery is regulated and it’s “available to all” through gov’t funding. I’d rather pay the $2500 out of pocket and receive actual care than pay more with my life and births than I’ll ever be able to recover. But that’s just me. The women here want the regulation for funding. 🙁 They don’t know how much that will change things- how it will create the conflict of interest that plagues midwifery in Canada where this has already happened.

After my 3rd birth, I was asked to do a lecture from the perspective of a (finally) educated former client on the state of midwifery by the College. I was also asked to consider becoming a midwife. I declined both: the first because I was due with my third child during the conference, and the second because I could not adhere to the stipulations and counter-conscience requirements placed on midwives.

If it were legal (here it still is), I would only consider lay-midwifery and my clientele would have to choose my offer of service based on their own perspectives on their needs and whether or not I am suitable to meet them. This would be the only chance we’d have at enjoying a mutually fulfilling and compatible relationship.

I wish you well, and again, thank you. 🙂
Imogen

Update Dec 2014: Adding this exquisite film from Slovenia of a family birth of a 4th baby. The mother had her first baby in hospital and, after that, three home births.

15 thoughts on “Third births: finally getting it right

  1. Gloria, thank you for posting along these lines. I’m feeling firsthand how frustrating regulated midwifery care can be for the client. I am a proven VBAC pregnant with my third baby (fourth child), and want a home birth. I know you will appreciate that I want this not for my own experience alone, but for the safety of myself and my baby. VBAC home birth is within the BC College of Midwives’ scope of practice in their guidelines, but can I find a regulated midwife willing to attend one?
    Not on your life.
    When OBs do this kind of thing, we call it unethical and expect them to refer us to someone who WILL attend our birth, but when midwives do it, it’s somehow different?
    It’s quite obvious to me that the obstetrical view of birth as a dangerous event, or complicated until proven otherwise, has infiltrated the BC regulated midwifery community. This is ridiculous. What are the midwives now, mini OBs? With long hair and funky skirts? Get real.
    I wish midwifery in BC would stop trying so desperately to make itself fit in and be acceptable to allopathic, traditional obstetrics, and get back to belief in birth and women’s bodies.

    One of the midwives I visited this week on initial consultation said, “Well, your pelvis has been proven to 10 lbs, but you shouldn’t go beyond that.” (a) my pelvis has nothing to prove to you, and (b) I don’t order my baby’s size like a big mac at MacDonald’s, jeepers. And (c) what do you know about whether my pelvis can handle more than 10 lbs? I grow big babies! I don’t have GD! Get out of my face with your paternalistic drivel!!!

    Whew. That was great to get off my chest. Thanks…

    • I think one difference between OBs and midwives is that if a family experiences a less than ideal outcome with an OB, popular opinion and the legal system say “oh well, they did everything they could,” while a less than ideal outcome with a midwife = witch hunt, jail, etc. I appreciate a midwife willing to lay her freedom on the line to help me, but I can understand a midwife who won’t. (I’m in the U.S.)

  2. Gloria, yesterday you posted on FB, asking whether or not midwifery should be a licensed or regulated profession. Every time I read comments like the above, I feel more strongly that it should not be. My response:

    No no no. The only way I could see regulation as being a good thing would be if midwives would protect each other…but wait, I don’t see that happening, possibly because midwives are deeply divided on what serves mothers and babies best. Better to let the parents decide what serves THEM best, be it hospital, licensed midwife, independent midwife… See More or unassisted. My favourite quote on this subject:
    “Midwives really should not get involved in the argument for professional status because professionalism has its roots in the patriarchal power and control that alienated women from the birth process in the beginning. The erosion of the autonomous role of the midwife restricts choice for women and promotes birth as a pathological process.”
    -Ann Oakley, Susanne Houd, Midwifery Today (1990)

    Off to listen to your radio program.

  3. What I find incredibly shocking is that here in NB, there has been a midwifery board set up (we still have no university trained midwives here) and sitting on the board is a pharmacist (hmmm….what drugs shall our midwives carry and peddle) and an OB…I have heard that this is unusual and hasn’t been the case in other provinces who’ve legislated. The only good that’s come from legislation here is that it’s opened New Brunswickers’ eyes to the idea that homebirth might be safe, and midwives might be a good idea.

  4. thank you for that story, imogen. you are a powerful woman.

    I also had to experience two stupid births before my third birth, a wonderful freebirth. thankfully I didnt have to go through the trauma that you did, only some stupidness. I always get tingly with glee when I see a woman finding the right path during her FIRST pregnancy!

  5. I live in the Yukon and am the founder of Yukoners for Funded Midwifery (YFFM). We’ve been having this conversation here for a while, about the benefits and risks of integrating midwifery into the health care system here. Imogen, are you in the Yukon? If so, please do submit your feedback to the government in the public consultation around regulating midwifery (if you haven’t already). You can read the response from YFFM at http://www.yukonmidwifery.blogspot.com

    I initially started YFFM because myself and many other women I knew wanted a midwife but found the cost of private fee for service midwifery to be prohibitive. We were told by the government that the only way to get midwifery funded is to get it regulated. Since then I’ve learned a LOT about regulations, and the government here in the Yukon is in a public consultation process asking the question, “should midwifery be regulated?”

    The core members of YFFM definitely do not want to see choices for women restricted. When I started YFFM I had had one previous birth in the hospital, which went well as these things go (you can read about it at http://www.mothersofchange.com/2010/05/becoming-mothers-of-change.html) but which I knew I did not want to repeat. I hired one of the two local midwives for the next birth, cost be damned.

    I will never go back. I’ve had two amazing home births, and I’ve seen how great midwifery is in the territory. I know that if midwifery regulations here restricted my choices, such as a breech home birth or twin home birth, and I was pregnant again with something like that, I would most likely choose to birth at home whether or not a midwife could attend me, rather than go to the hospital with all the risks the hospital environment presents.

    Right now our group is looking at how we can preserve women’s choice if the government does decide to regulate. We are not sure if they will move forward with regulating, but it seems likely. We think there are two very important points that need to be part of how midwifery is regulated:

    1) a woman in the care of a midwife should never be left unattended to birth, even if her choices are not considered optimal by the midwife or other health care providers. Midwives should not be liable because they stayed with a woman rather than abandoning her.
    2) registered midwives should be government funded and comply with regulations, while it should also still be legal for midwives to provide private fee for service midwifery outside of regulations.

    We anticipate that if these two provisos were in place women’s choice and the traditional practice of midwifery would have greater protection.

    Our goal is to expand access and choices for women.

    What do you think, Gloria?

  6. Im interested in your point #2, asheya. has that system been used somewhere? it’s an interesting idea, Ive never heard of it.

    as far as not being able to afford midwifery care, I dont think there are really a great number of people in canada who cant rustle up a few thousand dollars somehow if it’s for a really important reason. I think if women were really taking responsibility for their own births, the cost wouldnt seem like such a big deal to avoid all the dangers that hospitals pose for their babies and themselves. anyway, freebirth is always, you know, free.

    are there women somewhere who are being abandoned by their midwives? I wasnt aware of that phenomenon. I know my midwives wanted to transfer me to an OB because they werent comfortable with my choices, but that’s not technically abandonment. in any case, I wouldnt want a midwife at my birth who was nervous and freaking out that I was going to die the whole time Im in labour! Id rather be abandoned, honestly!

    • I know its been awhile – but I wish to speak my peace about it.

      I disagree with you. If anyone knows what the alternatives in care that are available, if anyone is ACTUALLY, truly, a ‘with woman’ midwife: then she wouldn’t be throwing her client to the wolves. That midwife wouldn’t be doing a doctors dirty work – traipsing all over mothers – regulating them, scoring them, judging them unfit- then shipping them off to the trying-to-be-avoided-unknown land either of a Doctor or alone. not every woman is ready to make the leap to unattended birth.

      I was ‘fired’ from a midwife. I chose to have an unattended birth after the few remaining midwives in town wouldn’t speak to me -because she had dismissed me. REAL team players….I always wanted to have an unattended birth, but hadnt the courage or support.

  7. Asheya I don’t know if you’re aware of the UK safeguards on women’s right to refusal? While a great deal of pressure is brought to bear on some women who choose homebirth within the NHS, their right to refusal and the onus on midwives to support women still exists.

    There’s no such notion in Australia and publicly funded homebirth has been the bullshit carrot offered up to placate those who want homebirth to be available to birthing women. Of course almost no one qualifies and very few women manage to stay on the program which is a constant testing process to disqualify those who made it onto the program in the first place.

    Once the government and regulatory bodies are involved in any way, birth becomes about regulation and nothing to do with women. Be very very careful what you wish for. Read up on homebirth in Australia at the moment and you’ll see why it’s such a baaaaaaaaaaad idea.

  8. Wow, this really hit home. I too had a similar experience. My first two children were unneccesary cesareans and went on to find a provider who would take me on as a VBA2C, of course that is about impossible. The midwives at the hospital couldnt take me because the “doctors above them said I was risky”. I eventually decided to UC after searching for provider for a long time. At 33 weeks I found a lay homebirth midwife but even she was “scared”. We have no laws on lay midwives here (Nebraska) but CNM’s arent allowed to do homebirths. There are no laws here but if you ARE caught they will give you a cease and dissist order so they have to lay low. As I approached 42 weeks she had me to castor oil and stripped my membranes. When I did go into labor at 42 weeks exactly she came over did all the things I was hoping to stay away from, (checking me often, breaking my water) I was so discouraged and couldnt get into a zone because they wouldnt leave me alone. So all in all after 24 hours of labor at home she “got rid of me” in fear of her getting caught I presume and transfered me to the hospital. You can imagine how that went. I was a leper. A 42 week transfer VBA2C who hadnt had a prenatal appt since 25 weeks with a doctor and had broken waters. It was a mess. I WAS educated though, I knew my rights and I stood up for myself, it was the worst fight in my life while contractions were one of top of the other but I did it. I fought for three hours for them to “let” me try to VBA2C. Finally they found a doctor willing since they couldnt legally say no. I did indeed birth her about an hour after the fight. Needless to say it wasn’t the BEST birth ever but it was very liberating.
    So whats a woman to do with this messed up system we will in?! Freebirth. That is about my only peaceful option here where even the lay midwives are scared to go to jail. So we find ourselves pregnant again with baby number 4 and we are having an unassisted childbirth. I only wish we had midwives like you here, who arent afraid to stand up for themselves and dont pressure induction.
    With love,
    Katie

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  10. thanks for this great story, and the courage and beauty of soul of all those women who have chosen freebirth in the face of medical scorn of our bodies. It is an interesting dance as a midwife in nz to maintain integrity within a system of government-subsidised midwifery based on adhering to the ‘guidelines’ of our maternity agreement. However, informed decision-making is fully protected by legislation, and my documentation sometimes smacks of ‘defensive note-taking’, despite the often unorthodox nature of the choices my clients make. However, what makes me sad is to think that some women are forced to choose freebirth because no other women are willing to be with them. I want freebirth to be a free choice, based on what feels best, not the only option left to families whose choices fall outside the medical paradigm. I aim to instil a degree of confidence in my clients so they know they can birth with or without me, so that if they ring me on the night it’s because they actually want me there. I dream of the day when all families own the knowing and experience of birth, and can invite others into the experience out of a wish to share that magic moment, rather than a fear of what lies ahead.

  11. Hello all. I know this post is older now, but I forgot to come back and comment! I’m so sorry for that; placenta brain!!!

    My update is that I did freebirth my fifth baby: a sweet, pink, darling girl. My labour was 4 hours with a 45 minute nap in the middle. She was 9 lbs even, and alert right away. She nursed perfectly, in spite of a tongue tie (that we had clipped, twice now), and at just past her 2nd birthday, she still nurses perfectly. The birth was peaceful, and exactly right for us. Her daddy woke her four brothers to meet her. We were and are still so thrilled! A GIRL! I didn’t think we made those! 😉

    Some details that stand out to me still: like her brothers, she didn’t engage in my pelvis, but my cervix still dilated to completely floppy with no tension in it anymore, until the amniotic sac bulged, but no baby head. I couldn’t even feel it. After my nap, I decided that it was time to get her down, so I lifted my belly up with one hand during the next contraction, tilted my pelvis, and gave her a gentle, but firm push down from the top of my belly with my other hand. She slid right down and began her exit with each contraction.

    She was born with both hands against her face as she emerged, and her presenting part was her elbow. It was a strange feeling, but she came so quickly at the end that it wasn’t any more strenuous than the usual top of the head presentation, and she was smaller than my other vaginal births. I was quite perplexed by the feeling of her elbow, admittedly, but it made more sense as she emerged more. I could feel that she was alert as she wiggled and strained to push herself out by pushing with her feet. Once out, she stretched her arms out above her head right away, and then put her little hands back on her face, where she usually kept them inside my womb as well.

    I can’t imagine what sort of freak out would happen with hospital people seeing an elbow emerging, but it wasn’t any big deal at all for me or her.

    I made the best decision for me and my baby, but I want to encourage all women to really weigh their needs in birthing. I am introverted and draw my strength from within myself, preferring to not have input from others while birthing. I have a dear friend who loves having other women with whom to consult and that she trusts to make decisions while she focuses solely on the feelings of birthing. Freebirthing for her is like a version of a nightmare she would wake from, crying and devastated. For me, it’s total freedom, love and bliss. We both have a love of birth, and different needs, both perfect for each of us.

    Thank you so much, once again, Gloria, for the work you do; it and you, are beautiful, and the world is better because of your love for families and your dedication to educating and advocating for real, genuine choices for how our precious children arrive earth-side. Thank you for this blog and website. For everything that you do and are, I offer you my deepest gratitude, respect, and appreciation, Gloria. Thank you, thank you, thank you a million times. <3

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