Elements of The Body's Way

Posted on April 27, 2008 by Kathy

Yeah, this piqued my interest, too.

First, there are many reasons why it would be beneficial or helpful or preferable to be able to check your progress without having a vaginal exam. The most obvious is the discomfort of having someone (as I read on another blog) “search for my tonsils via my lady parts.” Also, vaginal exams increase the risk of infection if the water has broken — even when sterile gloves are used, there are bacteria on your body that get on the sterile gloves and then are given a free ride up to your cervix. Before sanitation (even simple hand-washing) was practiced by birth attendants, it was common for women to die of “childbed fever” due to germs being introduced directly into the uterus this way.

[As an aside, when you hear people decry modern homebirth because "women used to die all the time before they started having their babies in the hospital," you now know that the high maternal death rate was at least partially attributable to doctors' dirty hands infecting scores of women. It was common practice to teach medical students how to do vaginal exams by using cadavers -- dead women (who frequently were victims of childbed fever) -- and then to go down the hall to where women were laboring and without washing their hands, perform vaginal exams on them, directly introducing the germs from a dead person into the body of a living person.]

But another reason would be to assess where you are in your dilation so that you know when to go to the hospital (if you’re planning a hospital birth). A frequent concern of women is that they’ll go to the hospital (or call the midwife) too soon…. or else too late. In the first case, they may be turned away until they are dilated more; and in the second case, they may have a harrowing ride to the hospital with a white-knuckled husband fighting his way through traffic while she tries not to push.

On this thread at Midwifery and More, there are a few different ways mentioned, but the one I want to talk about most is one that Anne Frye wrote about in Holistic Midwifery, Vol. II, p. 376. Sarah Wallbaum mentioned it on our childbirth educators email list, and it intrigued me. Here’s how it works:

During a contraction and with mom on her back, determine how many fingerbreadths of space are between the fundus [top of the uterus] and xiphoid process [the triangular tip of the breastbone] at the height of a contraction.

5 fb = no dilation
4 fb = 2 cm
3 fb = 4 cm
2 fb = 6 cm
1 fb = 8 cm
0 fm = complete

She said that she has practiced this for accuracy with a midwife, and has both found it to be fairly accurate, but that if a mom is very obese, it would be difficult to use. Even if it just gives a “ballpark figure” it just feels empowering to me to be able to know this information without having somebody else’s hand stuck up inside me. Remember also, that the World Health Organization’s guidelines for Safe Motherhood says that vaginal exams should be kept to a strict minimum, and in the first stage of labor once every four hours should be enough (3.3

hi there! so earlier this year i was contemplating my own path as a doula and birth worker and a friend asked me to write a manifesta for a radical education project she was creating. well, i wrote this little manifesta about the type of midwife i am. and a few other women that i know are. but i know that we are a tiny tiny minority in the natural alternative birth-y world...oh well...anyways. i wanted to share with you guys. i would love to hear your response.
what do you agree with? what do you disagree with? what leaves you unsure? what would you add to it?
are you an outlaw midwife?
can wait to hear what you think!
thanks for reading this... ;)
-------------------------------------

Outlaw Midwives: A Manifesta
LIFE AND DEATH
Every child will not be born alive or may die in infanthood.
Early motherhood is the interplay of life and death and sometimes filled with sadness and loss, with joy and sweetness.
Always death is interwoven in to the fabric of the living moment. Cells reproduce and die like the rhythm of breathing, like the opening and closing of a gate.
We center, not simply the biology of birth, but relationships we have with people we take care of and those that take care of us.
And mourn daily the dead and the missing, the actions of our governments and other powerful entities that kill and maim babies and mothers, the destruction of resistance communities’ next generation. That destruction privileges many of us with resources allowing us more reproductive choices.
The pro-life movement focuses on birth control and abortions, we go deeper. We ought to be able to decide when, and how we will conceive and with whom, who and what practices will be part of our pregnancy, what we allow into our body, where we give birth and with whom, how we feed our children, etc. Our intelligence, agency, and subjectivity are central. The health of the next generation depends on the psychological, physical and spiritual health of the mother today, our levels of stress, support networks, confidence and joy.
MEDICAL VIOLENCE
The medical system’s structural and physical violence denies us the full expression of our agency. Doctors and nurses routinely manipulate information for the convenience of the medical system and its workers. They force us to have strangers’ hands, medical instruments and machines on our body, to undergo unnecessary and dangerous procedures such as hormonal birth control, surgery, genital mutilation and sterilization, experiment on our bodies and psyches, verbally threaten the ours and children’s lives, lie to them, and sexually harass and abuse us with little impunity. They deny us our basic human rights, humanity, moral expression, personal and communal wisdom, cultural understandings of body and being, full access to the power of reproduction and creation, and our connection to our children, loved ones, culture, kinships and cosmos.
In order to realize resistance and liberatory revolutionary communities that care for all their members, we co-create respectful spaces for folks to make their decisions about their body, family, communities, life and death.
NATURAL AND NORMAL CHILDBIRTH
The concept of ‘natural’ childbirth or lifestyle is dependent on the concept of the ‘artificial and that the ‘normal’ birth concept is dependent on the existence of the technological and medical models of birth. So natural/normal birth did not exist before modern western birth culture.
Mostly pregnant middle and upper class educated white women have the economic and racial privilege and choices to have a ‘natural/normal’ birth. These women, a small segment of the global birthing world creates their natural experiences by exoticising, fetishizing, imitating and co-opting the practices and images of 3rd world brown women childbearing cultures. Natural/normal concept is really code for ‘preferred’, it is the elite white women who have the preferred childbirth and normal body. Their body, lifestyle, childbearing, mothering, and inevitably, their children set the standard through their privilege and access for what is normal and natural.
It’s not about ‘natural’ birth, vs. medical interventions vs. Cesarean. It is about empowerment.
Many midwives in the West have fought so hard for legal recognition for their craft that all other considerations about birth have become secondary or tertiary. The privileging of ‘certified’ and ‘insured’ midwives has been not only negligent but destructive to women of color, the queer community, sexual and trauma survivors, imprisoned women, folks with disabilities and many more marginalized peoples in the birth community and in the world at large.
Imagine for most of human history midwives were just women who had given birth or were the sister or the mother or had been around for births and knew the rituals, the songs, the calls that that community had developed around the emergence of a new being into the world. Perhaps a well of community knowledge held by various men and women in the community. Some oral traditions. Drawings that acted as guides and recorders of history. Helpful herbs. Folks had watched other mammals bring forth their young. Most likely they knew the particular woman giving birth. Her temperment, her favorite foods, her moods.
They were the mother, sister, aunt, cousin, grandmother, neighbour who came by and helped. The women who had a knack. Who were in charge of gathering and drying herbs. Who took it upon themselves to care.
We cannot afford to romanticize the past, nor believe in an edenic before, but this is the way birth still is happening in a good many parts of the world right now.
Right now 300,000 women are giving birth. Most of the babies will live. A few will die.
It is a joyful sad knowledge.
A LACK OF EXPERTISE
We are not the authority, nor the expert. It is that lack of authority and expertise that is our greatest strength. We know what we know, do not claim to know more than we know, and we follow the birthing person’s leadership.
A community is only as empowered as its mothers.
Before the beginning of human history, human beings have controlled their reproductive lives. Folks found leaves, roots, sap, smoke, dance, prayers, animals and more that helped to regulate fertility and those processes continue to this day. They choose persons and processes that honor their reproductive lives. And we are willing to break the law and go to prison to honor and empower the mother, the child, and the community.
It can be difficult to receive that training and apprenticeship when doors refuse to open because we are from a marginalized community. Access is not solely (or even primarily) dependent upon our passion, ethics, intelligence, or dedication. We get all the training that we can. Teach each other. Read everything we can. Talk to everyone who will talk to us. Develop a strong intuition with our own bodies, minds, lives, with the universe. We never stop learning, because the more we know, the more that we can offer. But we don’t deny folks the right to choose for themselves what kind of pregnancy, birth, and child caring they want. We explain to folks what we know and what we don’t know and let them make their decision.
CREATING REVOLUTIONARY COMMUNITIES OF LOVE
We envision anti-violence safer communities where mothers and children heal from reproductive violence, because it is when we are whole and confident in our own leadership, are we able to co-create healthy communities.
Communities in which loyalty to a mother’s choice is 99 percent of being a midwife and in which we define ‘motherhood’ as love by any means necessary.
Communities in which we care for ourselves developing spiritual and physical awareness so that we can hold the space, the energy, the vision for folks to make decisions that center freedom, community and revolutionary love.
We must mother ourselves. Hold ourselves the way that we hold our children. And know that our wisdom is stronger and more knowledgeable and relevant than outside expertise. We must live the lives that are given to us. And trust others to do the same. For the sake of our survival. For the sake of our ancestresses. For the sake of our communities. For the sake of love

Maia

Doulas of Color

By Um Yaqoob

It was 9 p.m. when the nurse wheeled me to my bed, one of six in the Omani hospital ward. After a full day of labor, I thought I would finally settle down with my sleeping newborn and get some rest.

The first few cries from the baby in the adjoining bed didn't bother me. The mother responded quickly, and I was able to doze off. When he howled for the second, third, fourth, fifth, and then I-don't-know-what-number time, the mother let out an audible "tsk" before she went to pick him up. Her nerves were beginning to fray. By 3 a.m., so were mine and those of the other four women on the ward. The later it got, the longer it took the woman to pick up her son. The nurse came to talk to her. "He wants to nurse," she said.
"I keep feeding him. There is no milk." The woman raised her voice, a heavy accent coloring her English. She was near to tears.
"There doesn't need to be any milk. He just needs you."
"I'm tired! I can't keep getting up to nurse him! Please, can you give him a bottle?"
"No." The answer was very firm. "Breastfeeding is not just about milk, Mother. Your breast is all that baby knows. He needs the colostrum that is there now. Even if you don't feel it, it's there."
The mother moaned and fell back onto the bed. "I can't stand any more of this."
I felt sorry for her. I felt sorry for all of us. Her baby was keeping all the mothers, and our newborns, from getting our rest. Yet I imagined her nipples were sore by then, and her fatigue was aggravating her impatience with her baby's need to suck.
The doctor came. "What's wrong, Mother? Your baby won't nurse?"
"He nurses! That's the problem! That's all he wants to do. He won't sleep because he's not getting any milk. Please, doctor, tell the nurse I need to give him a bottle."
The doctor shook his head. "I cannot do that. Your baby is sick. He has a fever. That is why he won't sleep. He needs what is coming from your breast now. It is the only medicine we have for him."
She started to cry.
"You are a mother of five now. You know all of this. Please. You must feed your baby." He picked up the whimpering baby and gave him to his mother. "Feed your baby, Mother."
Finally, after several more wakings, the baby became quiet. He was quiet for so long, in fact, that I could not sleep in the sudden silence. Looking over to see what had calmed him, I saw that the woman had fallen asleep with the baby at her breast. Her arm was around him. If he awoke, what he needed was right in front of him.
Morning came just two hours later. Before the nurses had even come to change the beds, the occupants of bed number one had a visitor. A tall woman stood sternly over the mother and sick baby. The woman began to speak in excited Arabic.
"What is this the nurse is telling me? You were asking for a bottle for the baby?"
"He couldn't sleep. He was hungry."
The visitor shook her head. "Yes, he was hungry--hungry for his mother! Do you want to stay here for a month with a sick baby? Your other children are crying for you, and you are just lying here in the bed!"
"I cannot feed him anymore! I'm tired."
"Give him to me, then. I have milk. I'll nurse him." The tall woman lifted the baby from his bassinet and sat down.
By now all of the other mothers, including me, were sitting up to watch the scene. The tall woman had the baby in position, ready to latch on, when the mother said, "Give him to me."
"Why? You said he needs milk. Here is milk." She drew the baby close again.
The mother reached for her child. "I'll feed him."
Slowly, her eyes set straight on the mother, the woman handed the baby over. "Feed him, then. No more talk about bottles. No nephew of mine will have a bottle before he has even left the hospital!" After a few minutes, satisfied the new mother would indeed devote herself to breastfeeding, the visitor left.
The mother scarcely put the baby down the rest of the day. He sucked at her breast even as she sat dozing in her chair, even as she ate her food. Except for an occasional fuss from the other babies, the ward was quiet.
Evening came, and with it arrived the doctor. "Well, Mother, I see your medicine worked. The fever is down, and if it stays down you can go home tomorrow."
Relief flooded the woman's face. "Alhamdu lillah [thanks be to God]!" she proclaimed. After the doctor left, I heard the woman sniffling. She was crying, kissing the baby, saying "Alhamdu lillah" over and over.
Before the Sultanate of Oman opened its eyes to the modern world, a great number of babies died of disease or dehydration, either at home or in what was the country's only hospital. Many deaths were caused by bad water mixed with too little formula. Malnourished and dehydrated from diarrhea, the babies simply had no strength to fight other illnesses that came their way.
In 1970, a new leader took the reins of the country. Sultan Qaboos felt deeply for the plight of his people and immediately earmarked a large portion of the country's modest oil wealth to setting up modern hospitals and clinics throughout the country. Along with this, a campaign of immunization and education about child health care was launched. Infant mortality rates fell. However, many children were still born sick or became ill in infancy from water-borne diseases. Oman's Ministry of Health decided to fight back with tough medicine.
Today, when any woman, whether Omani or a foreigner, gives birth in an Omani hospital, the baby's needs take precedence over the mother's decision about whether or not to breastfeed in the first days. Unless there is a good reason for providing artificial nutrition, such as maternal illness or a sucking problem, no formula or bottle-fed supplementation is allowed. Nurses are instructed not to permit pacifiers in the crucial first days. The only food is colostrum, the only source of sucking satisfaction the breast. Only when a woman is discharged is the decision hers--bottle or breast--although she is strongly encouraged to nurse for as close to two years as she can, with solids not being introduced until the fifth month. As long as she is in the hospital, the rule is: breast only!
This may seem severe and unfair to mothers who do not wish to breastfeed, but few health specialists doubt that this breastfeeding program is helping to cut down on infant illnesses and deaths.
When Sukayna al-Ghaithy visits a friend with a newborn, she will "ooh" and "aah" only for the first few minutes. Then comes the inevitable question: "You are breastfeeding, my love, aren't you?"
To those women who answer "yes," Sukayna offers full support and encouragement. Those who answer "no" also receive encouragement, but of a different kind: "You must at least try!" she counsels. "It is your baby's right." If the baby starts to cry for any reason, Sukayna will smile with wide eyes and say, "See? She wants you!"
This is Sukayna's job, whether she's on or off duty. An Omani national and a former midwife, she now works with UNICEF and the World Health Organization to bring the breastfeeding program into the most remote parts of the nation. Sukayna has seen many babies sick with the types of illnesses, such as jaundice and dysentery, that breastfeeding can alleviate or prevent. It is because of this that she feels so strongly about the program. She feels that it saves lives--many lives--through antibody protection of the infant, cleanliness of the milk, and calorie content.
More than this, however, Sukayna feels deeply about breastfeeding because of her Muslim beliefs. "The Qur'an tells us to feed our babies two full years. For a Muslim, it's an act of worship to nurse a baby," she says. Indeed, a major reason for the program's success is that it appeals to the Omanis' conservative Islamic faith; in addition, the message is delivered to them by someone who understands their religious sentiments.
Another reason is the obvious physical results. Dr. M. V. Joseph, director of the program, stops short of saying that breastfeeding alone has reduced infant mortality, but he sees a clear connection between improved health care and the encouragement of extended nursing. "Particularly when we look at the diarrheal diseases, we can say that breastfeeding has contributed significantly to improving the health of many Omani children," he says.
Perhaps none of this would work if the mothers did not receive so much support. Although most Omani women do not work outside of the home, those who do are allowed long maternity leaves to establish a firm nursing relationship; once back at work, they are given time during the day to go home and feed their babies. Employers are generally compliant, and even those mothers who work far from their homes find that they can continue breastfeeding well through the first year with minimal supplementation with formula.
Women are also eager to nurse in the early months because of breastfeeding's contraceptive effects. In a society where large families are common and contraception is not widely practiced, most women are aware that exclusive nursing can delay the return of menstruation and will breastfeed for that reason alone.
Breastfeeding support groups are a tremendous component of the program's success. These groups operate at the grassroots level, with volunteers serving their own villages and neighborhoods to bring the program's message to all new mothers and their families. Professionals like Sukayna travel throughout the country to educate the volunteers, but most of the work is done by familiar faces within the communities.
Volunteers share their own experiences as breastfeeding mothers and add to it the wisdom of women who never used a bottle for feeding. As one woman commented, "In one village that I came across, an elderly woman knew a lot more about proper positioning of the baby for breastfeeding than I did."1 Volunteers operate through daily neighborhood women's gatherings as well as poster campaigns in clinics, well-illustrated and culturally sensitive pamphlets, and home visits.
In addition to helping babies and mothers, the breastfeeding program has added a new dimension to the lives of the many Omani women who volunteer in the support groups. Such women speak of feeling that they're a vital part of their community, that they serve an important function. "Now I am not just one of many," one volunteer says. "I stand out, I'm special. I'm a unique individual with something to offer."2 Another speaks of the satisfaction of becoming close to the children: "Touching children, becoming intimate with the world of children, is a delicious experience, and we may offer help to this beautiful new world."3 One woman sums up the feelings expressed by many: "Before, we knew only ten households and never visited the others. But now the circle has widened."4
These pioneers--volunteers, mothers, and their babies--have achieved a remarkable goal, but there remain many battles to fight. One of them is the lingering impression among many women of previous generations that bottle feeding is more "modern" and thus "better." These older women seem more experienced and their advice is respected, so a new mother is likely to accept the idea that babies need supplementation with formula and water or even that they need no breastmilk at all.
There is also a reluctance to use a backup form of birth control, so many women become pregnant before they've finished nursing a baby for a full two years. This is due to ambivalence on the part of both men and women, combined with an ignorance of the limited birth control permitted by Islamic law (for instance, to allow a woman to breastfeed an infant or to allow the mother to recover from giving birth). Furthermore, many older mothers are reluctant to take the advice of younger women, whom they see as inexperienced and naïve.
Obviously, further education and encouragement is needed, but roots have taken hold in a very Omani way. Says one volunteer, "We're now like the palm tree, which has roots in the ground and cannot be uprooted."5
NOTES
1. The Circle Has Widened: Community Support Group Volunteers in the Sultanate of Oman (Muscat, Oman: Ministry of Health and UNICEF, 1999), 12.
2. Ibid., 8.
3. Ibid., 8.
4. Ibid., 11.
5. Ibid., 17.
For more information about breastfeeding in other cultures, see the following article in a past issue of Mothering: "The Politics of Infant Formula," no. 60.
Um Yaqoob is an American Muslim who has lived in Oman since 1993. She and her husband, Yousuf Al-Mohamed, have five children: Nassima (10), Yaqoob (9), Zainab (5), Ayah (3), and Yahya (10 months). The three older children are homeschooled in Arabic, using the curriculum of the Omani schools.
Published: Issue 106, May/June 2001

If you are pregnant and you live in the Washington DC Metro area and seeking a care provider, you might want to Visit the Birth Options Alliance and choose a Midwife

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Distended Stomach and Other Annoyances In the last year I have had the delight to become an “auntie” because many of my friends have become mothers. As an “auntie” I get questions about what to do about medical and nutrition related issues from my friends.
Since I am not yet a mom I can’t comment from personal experience but I do draw wisdom from working with pregnant and new moms in my practice. A common question I get is about colic. Colic is described as a cramp-like, intermittent abdominal pain that occurs mainly in babies and small children according to the book An Encyclopedia of Natural Healing for Children and Infants written by Mary Bove, ND. Colic may present with the child crying uncontrollably for hours, usually in the evening time. They may also clench the fists or pull up their legs. Colic can be related to digestive discomfort, food allergies to mom’s diet or formula, emotional distress or difficulty with feeding (lactation or bottle) or other causes. Colic is hard and exhausting for the baby and the parents so I wanted to share some ideas that might help soothe you both.
Babies love massage! Massaging the tummy in a clockwise motion can help any gas or bowel movements move their way out of the body. If you want to use massage, it is a good idea to make it part of your feeding time routine each time you feed the baby. If you only massage when the baby's stomach is upset they will associate it with the pain in the stomach and they won’t enjoy being touched on their belly. Mom’s that are breastfeeding should watch what they eat because chemicals from the food pass to the baby. Members of the cabbage family, spicy foods, garlic, coffee, dairy, alcohol and beans tend to cause gas in babies so they should be avoided in colic. Any food allergies from the mom need to be avoided as well. Just as there are foods to be avoided there are spices and teas that can sooth the stomach and will be delivered through the breastmilk (you can brew a weak tea and deliver to the baby if formula is being used to feed). Fennel, dill, catnip, cinnamon or lemon balm teas are great choices to drink throughout the day to help reduce colic. If you need more specific help, consider a naturopathic doctor that works with children. It can make all the difference!
Live Vibrantly,
Dr. Dae
Dr. Dae's website: www.healthydaes.org
Dr. Dae's book: Daelicious! Recipes for Vibrant Living can be purchased @ www.amazon.com or www.healthydaes.org
Dr. Dae's Bio:
Daemon "Dr. Dae" (pronounced Dr. Day) Jones is a Naturopathic Physician who completed her training at the University of Bridgeport College of Naturopathic Medicine. She is certified as a General Practitioner by the North American Board of Naturopathic Examiners (NABNE). Dr. Dae provides tailored treatment to meet the unique needs of every individual she sees in her practice. She also provides specialized support for persons challenged by nutritional deficiencies, weight problems, hormonal and reproductive system disorders, attention deficit disorder and those experiencing chronic diseases. Dr. Dae is an adjunct faculty member for Smith Farm Center for Healing and the Arts. She is the author of Daelicious! Recipes for Vibrant Living, The Healthydaes Newsletter, and is a regularly featured writer for the Elite GoogleNews Website empowher.com where she shares her personal and professional vision for living whole and living well. To learn more about Dr. Dae, her products and services, please visit her on the Web at www.Healthydaes.org

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A mom singing at 10 cm.  I think this shows how birth can be calm, peaceful and even beautiful!

Thanks to Midwifery Ramblings,

Utilizing the birth ball for labor...please visit my website at www.serenitybirth.com and www.noplacelikeohm.com Pregnant model, Leigh Hetherington