Our Deepest Fear Is That We Are Powerful Beyond Measure

"Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness, that most frightens us. We ask, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? "

I love hearing women, moments after they have given birth, reflect on their amazing strength. They say with wonder that they never knew they had it in them.

And after reading the above excerpt from a prayer by Marianne Williamson, I asked myself, what if women knew this about themselves before going into labor? Maybe some do, but they are unconscious to their strength. Maybe some have an inkling, but they don't have the self-confidence to admit it fully. Perhaps some are afraid of seeming boastful, particularly in regards to childbirth, an event that they may not have experienced before.

There is powerful fear about childbirth and pain. "Laboring Under an Illusion" is only one of the commentaries out there that examines the way popular media depicts birth, and how those depictions shape our beliefs about labor and delivery. Prime time TV, Lifetime Television, and The Discovery Channel show women giving birth in car accidents, under the threat of a medical complication, or in klutzy, slapstick fashion that parodies our accepted assumption that childbirth is inherently dangerous and humanly impossible without medical intervention.

I work with clients prenatally to acknowledge their previous experiences of strength and endurance, both physical and mental, mind-over-matter, sheer will. I try to help them see how there is a strength within them that they have already called upon. And although we almost always have some point of reference that proves to them their power, the image of television birth and the war stories told to them by their friends are pervasive and creep into the little cracks of their otherwise solid foundation.

And so when a woman is marveling at her own power moments after she has given birth, at the miracle of what her body has made, I want to whisper to her: "You knew it all along."

The entire poem by Reverend Marianne Williamson can be found here.

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Don't Push The River...It Flows By Itself

A beautiful blog post by Lindsay, who poetically describes how she discovered her own strength and the "vastness of her spirit."

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Women Must Be Informed, Political Collaborators in Their Own Care

Dr. Tiller's clinic in Witchita, KS, one of the few in the country that provides late-term abortions, is closing. With his murder, in addition to wiping out the life of a husband and father, the anti-choice movement has taken away women's access to critical, necessary services. And while the current political make-up shows that the anti-choice movement cannot overturn Roe v. Wade, Dr. Tiller's death is a reminder that all it takes is a sniper to reduce our choices even further. And since OB-GYN's aren't racing to provide abortion services at the risk of their own lives, Dr. Tiller's practice may not ever be replaced.

When I'm not a doula, I work as an abortion counselor. Although most of the women I meet with are between 4 and 7 weeks pregnant, the clinic where I work provides abortion services up until the 23rd week of pregnancy, which is the legal limit of abortion care in the state of Massachusetts.

Your reaction may be visceral, no doubt. At 23 weeks, abortion can be extremely difficult to understand or justify, and it is not uncommon to shake your head and say "I have a real problem with that," even if you are pro-choice. It is tempting, if not comforting, to separate yourself from a woman who would make this choice by assuming that she must be a monster. And I'll be honest and say that once I sat down with a woman who seemingly had no feelings about having an abortion in her 23rd week of pregnancy. It chilled me, her apparent lack of feeling. But many more times than just once, I have sat down with couples who are heartbroken: a routine ultrasound in the 20th week discovers massive deformities; an amniocentesis details profound genetic abnormalities that at are incompatible with all but the briefest of life, and suffering is certain; a doppler at 22 weeks returns no heartbeat, reducing a wanted and cherished baby into a diagnosis of fetal demise. And sometimes, due to the time it takes to run tests, or to the human inconsistencies of those who administer those tests, or the varying reliability of technology, a pregnant woman in those situations can be beyond 23 weeks. And so what do we do in the state of Massachusetts? We tell her she can deliver her dead, deformed, or doomed baby in a labor and delivery unit of a hospital -- which is as monstrous as it sounds -- or we recommend she travel immediately to one of the few clinics in the United States that can terminate her pregnancy. And with the death of Dr. Tiller and the closing of his clinic, there is now one less place where a woman in this delicate and devastating situation can go for care that is humane and treats her with dignity.

And on the other end of pregnancy, women are also losing choices in childbirth. In my line of work, I hear many birth stories from women, and the majority of them have the same eerie arc: first, induction; second, confinement to a bed; third, bone-crushing pain; finally, forced pushing while lying on their backs. Statistically, more than 30% of those stories end in c-section, and these are in pregnancies that had been normal, low-risk, and healthy. It's also the basic formula for reality birth shows on cable TV, where birth is boiled down to a medical event that skirts death practically every time.

VBACs are becoming harder to access, despite evidence that indicates that VBAC is lower risk than repeat C-section. Providers, among both OB's and L&D nurses, have attended fewer and fewer low-risk, healthy childbirths that are purposefully unmedicated and without interventions. What results over time is that if a laboring woman wants a natural birth, she could go to a hospital and have no medical professionals with the experience or willingness to support her desires. Birth centers are losing funding, and homebirth is either criminalized or unregulated in half of the US. In the other half of the country, the standards of care that do govern it are so limiting that its practice is nearly impossible but for a few renegade midwives who are essentially providing care without the benefit of professional support in case of a true obstetric emergency. Healthy women who could experience the normal physiological process of birth are beholden to the artificial constructs of time, liability, and television drama. The art of childbirth, and the choices that encourage birth as a safe, non-medical event, are being lost.

Unless we have a vision that is greater than the arguments of pro-life vs. pro-choice, homebirth vs. hospital, natural birth vs. epidural, we will lose what is truly at stake at the heart of these issues: choices. The quality of women's health care is dependent upon choices and access to qualified care providers, and women must expect no less than to be informed, political collaborators in their own care.

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What's in the Bag?

As a doula, I know the value of a held hand, whispered encouragement, and a guided breath. There is research out there stating that simply having a doula in the room -- even if she sits there and only observes -- increases birth outcomes. But still, what's in the bag?

In my doula bag, I've got heating pads -- the kind that are activated by air. I would like to carry a silk, rice-filled pouch that can be heated in the microwave and molded to a woman's body, but most hospitals don't allow them anymore. But the heat can feel wonderful against the back or belly during contractions. Conversely, I also carry cold packs, the kind that you squeeze until something inside pops, then shake, and the square becomes ice-cold. I don't use these too often, but when I do, it's often at the site of the IV or hep-lock (the port to attach an IV quickly). Some laboring moms like the ice on their foreheads or necks, when labor has them heating up, but I find that cold, wet towels are better for cooling them off. These are single-use plastic and chemical packs, so not very green; but in a hospital room, use of heat and cold is limited if available at all.

I carry essential oils. If the mom wants a massage, I'll mix the essential oils into grapeseed oil (essential oils can't be used directly on the skin). Clary sage oil is reported to regulate the uterus and organize contractions, and lavender oil encourages relaxation. Lemon verbena oil can also cut right through a woman's nausea. I don't know what the science is behind aromatherapy, whether it achieves what aromatherapists claim, but they sure do smell good, and sometimes the smells of an antiseptic hospital, or the raw smells of birth, can make laboring women uncomfortable (remember that laboring women can have acute reactions to scents, however!). Any of these oils can go on the aforementioned wet towel, or on cotton balls, which are also in my doula bag.

I carry a deflated birthing ball and pump. If there's a ball already in the labor room, great! --but mine is always there just in case.

I bring a gardener's kneeling pad, so if mom is laboring on her knees, she's not on the hard linoleum.

I have a 6 foot long beautiful shawl, which can be draped over mom if she gets chills. The texture and colors are rich and luxurious, very pleasing to the senses. One of these days, I'd like to get a rebozo training, too.

I have two combs, one that mom can squeeze in each fist during contractions. When held perfectly, the teeth on the comb stimulate acupressure meridians that encourage labor to progress. And mom can squeeze them as tightly as she likes, dispersing the sensations of contractions as much or as little as she pleases.

Two cosmetics bag -- one for me, with saline solution, a contact lens case, tooth brush, toothpaste, hairband, and breakfast bars for quick energy; one for mom with hard candies, new lip balm, and a hair band for her.

And a hand mirror. Some moms want to see their baby's heads emerging. It can be great encouragement for only a few more pushes when she feels like she's got nothing left, and it can provide a view of that once-in-a-lifetime moment as the baby crowns. Hospitals haven't figured out yet that hand-mirrors are easier. Instead, they lug these heavy mirrors on rolling stands. Such a bother, and many laboring women still don't want people to "fuss" over them.

What's in yours?
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Ummm, WHO delivered that baby?

I have been co-moderating a mothers e-group for a few years. It is a wonderful, supportive, and caring resource of information for moms in Boston. Every now and then, a newly pregnant mom asks for recommendations on an OB or midwife (usually an OB). The responses come pouring in, women sharing their stories about the tender prenatal care they received from one provider or the wonderful support given by the OB who happened to be on-call when they went into labor. But the one thing that makes me crazy is that this is said, over and over again: "Dr. (insert name) delivered my baby."

It doesn't matter how it happened: medicated or unmedicated, induced or spontaneous, vacuums or forceps. Mothers deliver their babies. Doctors and midwives attend births, assist births, catch babies, and perform procedures, but Mothers Deliver Their Babies! Even the babies who are born via the surgical skills of high-risk OB's, their mothers deliver them from the safety of their bodies, releasing them into the big, wide open, world to give them life.