Äpfel schütteln

"Komm, wir wollen Apfel schütteln,
Äpfel schütteln;
alle Kinder helfen rütteln.
Ria, ria, ria, rums."

This German children's song would be perfect to sing while shaking a woman's hips with your hands in labour. One of the many indigenous practices used for centuries to loosen the pelvic muscles and ease a baby's journey through the pelvis, "shaking the apples" works really well with first time mums in early labour, as well as multips as they approach birth.

I heard the term "Äpfel schütteln" used by an older German midwife about 15 years ago. We were in the attic of an old Kitsilano house, trying to fix the malposition of a baby late in labour. My client had hit a plateau at 8 cm, and, after a good half hour of vigourous hip shaking by the midwife, the woman said, "Did you hear that thunk?!" Then the labour took off, we all dashed to the hospital, and the baby was born.

I "shake the apples" to help second-time mums release muscles and allow the baby to be born. Sometimes, it just takes a two-minute shake, then she says, "It's coming!" Most times, she's sure the shaking knocked at least half an hour off the labour time.

Think of the speed that a paint can shakes in the machine at the hardware store...or the speed of a woman's hips during a Tahitian dance...

And it feels so good!

Walking the Labyrinth

"You are a gift to me beloved
trust my body
trust my baby
breathe..."


Last night, friends and family painted the labyrinth in the living room of a woman in early labour, hoping that she would have a chance to walk the labyrinth as the labour progressed. But her labour skyrocketed and her baby was born sweetly before the paint had time to fully dry!

But I think she had been metaphorically "walking the labyrinth" for a long time and was fully ready. There were no blocks. She trusted her body, trusted her baby, and held firm and fast to her husband, whose hands held the baby's head as it slid out into the flickering light of a candle.

With a labyrinth there is only one choice to be made. The choice is to enter or not. With the smooth and quick birth of this beautiful boy, the choice was made. What a joyful entry to the world.

Breastfeeding Tips for Dads

As part of their Breastfeeding Counsellor's course, Sarah Munro and Ann Marcoux created a podcast of breastfeeding tips and tricks for men. They interviewed three local dads and let them do the talking. So, click and listen to Breastfeeding Tips for Dads.

And...

Geared to all dads, whether they're at home or not, Man in the Moon dad and baby groups in Vancouver offer support and fun with books for dads and their babies on evenings and weekends. Offered at most Vancouver libraries, these groups start their next session mid-January 2008. Check your local library for details.

Meet Carly

As a doula, I am invited into the homes of so many wonderful and creative people. This past year's client list has included an amazing collection of writers, artists, counsellors, dancers, environmental crusaders, yoga instructors, entrepreneurs (and lots of lawyers.)

I love watching my clients' postpartum transformations, as they find ways to reconcile mothering with their "pre-baby" careers. Many former clients become consultants or start new businesses, and others strike out in entirely new directions. I support and applaud their efforts to find balance in their lives.

One such former client is Carly Fleming. She has recently branched out on a career path that I believe will fill a gap in perinatal services in Vancouver. I encourage you to call her if you feel in need of expert counselling assistance during the childbearing year - and beyond.

Carly provides pre-conception, prenatal, and postpartum counselling to women and men who need some additional support as they travel through their childbearing journey. Her services are aimed at individuals who are having difficulties coping or adjusting to pregnancy and parenthood or who are experiencing emotions that are preventing them from moving forward in a productive and fulfilled way.

She offers clients the choice of having her come to their home to conduct the counselling session or meeting with them in a private counselling office (locations are Kits and downtown).

Keep her contact info handy:
Carly Fleming, M.Ed., RCC
Prenatal and Postpartum Counselling
604-808-9587
carly.fleming@gmail.com
www.carlyfleming.ca

Crossing the Portal, the Old School Way

I stood still in Pottery Barn the other week, in front of a phone that looked just like the lovely heavy black phone that we had when I was little. You know, the one with the rotary dial that, when you needed to dial 9-1-1, took such a long time for that 9 to rotate. No wonder they didn't stick with the British emergency code of 9-9-9. The emergency would have been over before the dialing was done.

So, still standing there, lost in space and time, I started to think about my low-tech childhood in the '60s and '70s, how I skipped to Kerrisdale elementary school in my skirt and walked through old door marked "Girls", and how my parents decided that it was totally unnecessary to have all the new high-tech things that were in the stores - how we shared a party line, had no answering machine, no voicemail, no calculators, no computers, no videos or DVDs, no recording devices, dishwasher or washer/dryer. We just had one little black and white TV with rabbit ears, a clothes line, and a hand cranked mangle to make life easier. (I laughed when I heard the editor of Canadian House and Home say just last week that her laundry room would not be complete without her most luxurious appliance - the mangle. Well, this one's electric, and it presses sheets, but hey...) It was truly an "Old School" childhood, and time was our ally.

So, I really noticed those multi-coloured cut-out letters stuck on the window at BC Women's Hospital the other day - "I DO IT OLD SCHOOL - ASK ME HOW". I kept thinking about those words as I helped a client through an almost 48-hour unmedicated, uncomplicated birth. After 31 hours at home, we went to the hospital to birth "old school" style. The tools at hand were our hands and eyes and ears and wisdom (other than my client and her husband, "We" also included nurse "Wendy" aka Michelle, and the Family Practice Group 2 docs Ron and Sheena, who all have the guts to go "old school"). Time, on this day, was our ally, for we needed a lot of it to accomplish the goal. The high-tech equipment didn't seem to know how to behave with us. The blood pressure cuff kept pumping itself up even when no one was there, and that brand-fangled-new monitor didn't work as well as the doptone, so it was turned off.

So, things were kept as simple as possible. On and on...dancing in the shower, rockin' an rollin' on the ball, just one contraction at a time, one breath at a time, listening to lovely music. To get rid of a puffy cervix at 9cm, we used the Trendelenburg position on the bed (no epidural necessary) and lots of encouragement. We used hip squeezes, hip shakes, swirling and spiralling hips, visualization, trance-inducing techniques, foot rubs, endorphin sleep and dreams, squatting, kneeling, walking, tears, hands, eyes, and love....liberally. And this amazing labouring woman drew on the strength of all her life, with the aid of a few sherpas, and did what all women have the power to do, climb the highest mountain ever - birthed her baby with arms outstretched to touch his body.

And when that baby came, it was pure joy. No exhaustion, just sparkling laughter and smiles and "I'm as high as a kite!" (love those endorphins) and an eager, wide-awake little boy who came out with his meaty fist stretched to the sky. Ahaa! The culprit - just one little hand had slowed things down. We knew it! But, with time, this little man and his mum had worked it out.

When the pediatrician came later to say "Hi", she actually bowed down before the woman, saying "I am not worthy." And the doctors agreed that, if any drugs had been used, it probably would have been a cesarean. And the nurses outside were in awe, knowing that there's an initiative in the hospital to reduce the intervention and cesarean rates by encouraging low tech/high touch birthing, and wishing that they could have seen how it was done.

I am in awe of the couple at the centre of the whirlwind, this vortex of birth. I thank them for trusting in birth, for trusting in the body, for trusting their baby, for trusting me to calm their spirit and their wild eyes, when I'd say, "It's fine, it's normal, you are safe, you can do it," or "She's safe, she has the strength to do this."

On this day, I think all three crossed the portal, the old school way.

- Jacquie Munro, Vancouver Doula

October 2, 1940

Maurice was born
during the Battle of Britain
mum
gave birth to him in a basement
nurses helping
having walked to work
after going to the pictures

now
bombs
falling on the engineering works around the hospital

the babies were put in boxes
pushed into the cabinets in the wall
of the morgue

the new mothers sat together
in their nighties on the floor
incendiary bombs falling

dad took us
to the bottom of the road
‘that’s where your mother is’
as we watched the flames
all red
rise in the dark sky
across Manchester

the next day
we walked
to see the new baby
walked the road
five miles past the burning
past the rubble
past the children running in pyjamas
alone

say welcome to the new baby
in the hospital
standing
white
all by itself
in the city

I think that’s why Maurice has always been
nervous

This is just one of the many family stories of birth that I have collected over the years. My own mum told this story about her brother's birth during one of the heaviest bombing raids on Manchester during the Battle of Britain. As a child, I loved hearing this story because it told me that the people in our family are strong, resilient.

I used to love hearing that my grandfather kept his family together - wouldn't let the children be evacuated. "If we go, we all go together." I like to think that our family is stronger as a result - that my own children are stronger because of this.

But it also told me that we are profoundly impacted by the stories of our births - that we believe certain personality traits are borne out of our experience of that day. Is Maurice nervous because he was born in a bombing raid? Or is he nervous because it has been an expectation of the story that has been told over and over again? What are your family stories of birth? What stories will you be telling your daughters and sons? Are they stories of resilience and empowerment? Are they stories of loss or victimization?

I hope that we carefully frame the stories that we tell, so the listeners will find strength in our words. We need to especially watch the particular words that we use when we talk to our daughters about birth, remembering that these epic stories will weave themselves into her thoughts as she is giving birth. I know that I saw visions of the bombs falling around the hospital as I gave birth to my own children. It didn't make me fearful, it made me strong. "Gran did it...I can do it... Gran did it...I can do it..."

- Jacquie Munro, Vancouver Doula

From the desk of Jacquie's daughter...

Two years ago I decided to make a drastic lifestyle change. I had spent the past six years depending on a common prescription drug. I began taking it daily at 16, not realizing the global impact it would have on my health. There were months where I felt numb, as though my hormones were sealed off. It made me feel disconnected from my body, my rhythms, and normal emotions. Every girl I knew in university depended on the same drug. Fifty years ago, we would have been revolutionary feminists, taking control of our bodies and reproductive choices. But I felt like my body was out of control – a sensory-deprivation chamber.

The pill is an odd thing. It comes in packaging of different shapes and sizes, but mine were in round packets with pills in three colours. Popping one out each night at 10 pm felt like a grotesque simulation of a Christmas ritual – opening the door to an advent calendar and eating the chocolate within. The only complaint I ever heard from other girls was how annoying it was having to remember to take the pill every day. Some spoke of how they wanted to switch to the patch or take a shot, or even have their periods disappear completely.

While dating in university, I remembered my mum telling me as a kid that the pill can inhibit and alter one’s normal sex hormones, suppressing sexual interest and responses. I wondered if my pheromone responses were messed up and if I’d ever been attracted to the right guys.

Then, I had a moment of reckoning. After Christmas, two years ago, finished with both the advent calendar and my packet of pills, I asked my doctor if there were any reliable alternatives for contraception that wouldn’t impact my hormones. When I she told me about copper IUD’s, my first thoughts were of medieval torture gadgets and pelvic inflammatory disorder. My doctor assured me that this wasn’t the 70’s anymore, all the women in her office used them, and she had used IUD’s herself for over 20 years.

“So, what’s the catch?” I asked.

“There is none.”

This seemed ridiculous. I felt completely betrayed. None of my previous doctors had mentioned IUD’s before – why weren’t they throwing these things at women like party favours?

“They’re just not a hot consumer item because prescription drug companies don’t make any money off of them compared to the pill.”

Then I looked at the statistics: Less than 1.5% of Canadian women aged 15-45 use IUD’s. The failure rate is very low - between 0.09 and 0.25 % - even less than the pill. It's slim, tiny, and undetectable. I paid only $90 for mine, which I think was partially covered by my extended medical plan, and it stays in for 5 years. There are no hormone imbalances, no alarms going off every night at 10 pm, no increased risks of cancer, etc., although it's best not to use an IUD unless in a monogamous relationship - it makes it riskier to catch STD's. Most care providers don't have up-to-date information on IUD's or know how to insert them - another reason why they are so uncommon. There isn't just a huge consumer influence on the public to use the pill, care providers are pushed in that direction as well.

Yes, it in hurt like hell for a minute when the doctor put it in – but that was it, one minute – and yes, I had strong period cramps for a few months. But knowing that I was drug-free, I was myself, and that my body was normal again, was amazing. Plus, I was sticking it to the pharmaceutical companies! My period is like clockwork and when we one day decide to get pregnant, out it comes at the doctor’s office and we can start trying right away.

It's sad to realize that I never really knew myself, my body, during those 6 years. But now I know that when I explode into tears, or want to curl up in a nest, it's just because I'll have my period in two days, and not because of the side effects of the pill. I feel like I'll be more in tune with the changes of pregnancy, when I'm there one day. - Sarah Munro

(photo: "Flying IUD" sculpture, University of California, Santa Cruz)

(Note from Jacquie: I asked Sarah to write a post on IUDs because, in all my years as a doula, I can only remember one client who had used an IUD prior to a first baby. Most women aren't told the real story about IUDs - that they are a safe choice for many women to consider, that they can be fitted prior to childbearing, that they can be used safely while breastfeeding, that the copper IUDs keep your body clean of BCP hormones...that they are about living autonomously. Check out more info online, including contraindications.)

"Meet your new brother..."

I just melted when I saw this photo of a client with her two sons. It brings back memories of her youngest son's birth, at home, in the heat of a summer night, the fan blowing hot air around the room, the cool sound of the water in the tub, the midwife fanning herself, the speed with which this little one came... I believe the birth was everything that they could have hoped for. Complete joy.

But, what this photo also brings to mind are the many phone calls and emails I receive from clients who have just had their second baby...whose births were so beautiful, but are now reeling from how busy life has become, how challenging it is to manage two children, how guilty they feel at giving less than 100% to their firstborn child, how it tears at their hearts when their firstborn just wants grandma or daddy, "NOT mummy!"

They ask me if they're the only one who is feeling torn between the love for their firstborn, and the awe that they have for their new baby. They are missing their partners, who invariably have to go to work. They are wondering how they can cope when grandma leaves. They can't remember what seemed so engaging about newborns. This new baby doesn't seem as entertaining as his older sister, who, at age four, is dramatic and articulate (certainly VERY articulate about "how life would be much better without that baby") and fun...and so very confused about this new life.

These clients ask when life will return "to normal." It won't. A "new normal" will gradually emerge. Grafting a new limb onto a strong and vigorous tree takes time. It will happen, but slowly, and definitely with some challenges. And at some later date, after the postpartum fog has cleared, clients call me and say: "Before, we were a couple with a child...now, we are a family."

Just know this...when you're in the fog of postpartum and you see another mum out on a walk, laughing while carrying her two babies - you're just looking at a moment of her day. What you don't see are her tears when the door closes behind her, or her midnight fears, or that she got home from that walk and called me, and said, "I was carrying both girls in slings because Lola wouldn't sleep and Addie wanted to pretend she was a baby, and I just wanted to cry. Then, I saw a woman, pushing a sleeping baby in a stroller, with an older child holding on, and wished I was her. I laughed at how I must look to her - how she would admire my chutzpah at carrying the girls. She wasn't seeing the truth of it."

The transition from one child to two is different for every family. It depends on the age difference, the childrens' temperaments, family dynamics, and so many other things. Draw strength from other new mums with two babes during this time, and don't forget to call me. I'll connect you with someone close by who's sharing a similar journey.

- Jacquie Munro, Vancouver Doula

Tandem "Sling Girls"

My clients are so creative! Here's a recent comment from a wonderful two-time client:

"I loved reading your most recent blog entry. I haven't used a stroller in months (actually a couple of times, but just to carry the shopping bags, so that doesn't count) and use slings instead. Hannah even naps in it when we are out. Happier baby, happier mummy. I think every new mother should be given a sling (or some other carrier) when she gives birth!"

The Pact...or how to keep your family environmental footprint small

Most clients know that I like to do without too much “stuff”...evidenced by our gradual downsizing, leading to our ultimate purchase of a small loft in Vancouver. Our internal and external spaces are now filled with what we do, not what we have.

This shift wasn’t just driven by our need to find a personal solution to the environmental challenge on our planet. It is the continuation of a parenting plan that was born on the tidal flats of Point Roberts in 1982 - before our first was born, and long before the words “environmental footprint” or “sustainability” were commonplace.

My husband and I walked in the howling wind, hoods pulled up around our faces, wearing our matching blue Goretex jackets. We faced each other, put our hoods together, and looked like a full-sized Rorschach test. There, we made a pact that the people in our immediate family had to come first - before things, before jobs. We’d make what we could, keep things simple, and remember that we were our children’s first teachers. We would teach them by example. In the 1980’s, an era full of big ideas, splashy consumerism, wide shoulder pads and the dawn of huge “toys” (both for kids and adults), this was a step away from the norm.

It was a challenge to go against the flow, to avoid the hoops that society expected us to jump through... but, we did it. I think (I hope) our kids are better off as a result. (They are, most certainly, better recyclers than we were!)

Today, I like to think that it’s getting just a little bit easier to follow the path towards sustainability. Sure, there are people who will try to get you to fall for their product placement, to “buy, buy, buy” what they say you must in order to be a good consumer. But, there are an increasing number of people convinced that more is not better, bigger is not better, and that the environment must be our overriding concern.

So, here’s a list of some “stuff” that will help you on your path towards a more sustainable family life:

Your Body is Free

1. Your Lap - Not only warm, it makes a great portable changing table, a non-slip holder for the baby in the family bath, and a bounce-machine for a fussy baby. No batteries needed.
2. Your Chest - Provides a self-regulating temperature sleep space, complete with built-in tic-toc white noise for the baby who won’t sleep easily.
3. Your Arms - with a little help from all the “new age but old as time” baby wearing gear, your baby can view the world from an adult perspective. Buy local and check out Cheeky Monkey for a wide range. Remember, in time, most parents discover that strollers are for the groceries and that the kids just want to be carried.
4. Your Legs - Leave the car at home, then walk or ride bikes everywhere. With Car2Go and the Modo in Vancouver, you can even do without having a car of your own. Think of keeping your environmental footprint small - live, work and play in a small geographic area. Buy an e-bike, a bike carrier or baby trailer on Craigslist (if you're lucky!). Vancouver’s bike routes are fantastic.
5. Your Brain - Fill up with your maximum weekly allowed books for all the family at the library. Challenge your mind, think outside the box by going to a new shelf each week. Share these ideas with your newborn. Remember that in the first 18 months, the baby’s brain is still in a remarkable growth period. Feed the brain!
6. Your Voice - Singing, talking, whispering, reading aloud from the newpaper... Whatever you do, just TALK! This is a priceless gift that you can give your children. Studies have shown that talking to infants enriches their brain development, their ability to learn, and their power in using language.
7. Your Breasts - When the placenta goes, the breasts picks up the slack, and are fully capable of sustaining the wee one for years. The benefits are immeasurable!

Some Good Stuff (not all free, but at least worth it!)

1. gDiapers - These flushable diapers were the first Consumer Packaged Good to earn Cradle to Cradle certification by the sustainability gurus at MBDC. Available over the internet and, finally, at Whole Foods in Canada (yes, you have to use too much gas to drive to their Park Royal store.)
2. Hook-on Chair - Remember that kids don’t know that they’re kids - they see themselves as a full and equal member of the family. So, let them share the table with you (at home, at friends houses, at a campsite, or in a restaurant) and you’ll never need a high chair. These can cost as little as $20. And while you’re at it, consider baby-led weaning.
3. The Corner Cupboard - Remember loving that corner cupboard with the lazy-Susan filled with Tupperware when you were a kid? I lived in the skinny cupboard between the oven and the fridge. Boy, was it cozy and warm! The kitchen, if made safe and kid-friendly, can be the best exploration zone, from Tupperware becoming shakers and building blocks, to cornstarch and water becoming fun ooze. I taught my son to write by moving his hand through flour on a tray. Being a tactile learner, he caught on faster than if we’d used a paper and pencil. Remember, the possibilities are only limited by your imagination.
4. Handmade Puppets - what a way to explore role-playing at an early age! When a younger sibling arrives, the first born can safely share feelings with a monkey puppet. Buy B.C. if possible...check out places like Natural Pod.
5. The Outdoors - Cheaper than anything in Vancouver - the ocean, the forest, the parks, the beach. There’s nothing better on a Fall weekend than leaf-pile jumping at Jericho. And, if you have a boy...remember the "let boys run for 4 hours a day" rule!

The Jars (or how to get through real life smoothly)

1. The To-Do Jar - introducing The Jar Concept! Since you should only do “one thing” a day with wee ones, burn your lists and write down any tasks on slips of paper and place them in a jar. Stick your hand in the Job Jar each morning and see what you (or your partner) can do. You have the right to decide if you don’t want to do this task! Just stick in your hand, and draw out another task! You can even make postpartum visitors draw out a task whenever they visit (mums don’t need to do anything for, oh, say, 6 weeks after giving birth - let everyone else do the work.) Lists will become a thing of the past, and you’ll be free to go through life more naturally - without time constraints or artificial deadlines. Your kids will thank you!
2. The Fun Jar - This one is great - a jar filled with fun family ideas and activities. For example, when the Georgia Straight comes out each week, you can check the family section for fun and free activities, cut out each one, then draw them out at will! You can expand this to include a magical mystery tour to Iona Island to watch the planes landing, a hike or bike ride in Pacific Spirit Park, tobogganing at Cypress...unlimited fun! Make sure one activity per week is saved for the entire mum’s group.

Back to the Beach
When my husband and I made our pact on the beach 25 years ago, it would have been seen as just a bit flakey. Now it’s seen as just another part of the West Coast family-focused environmental revolution.

For twenty years, clients have called me long after their babies are in school, just to check in with me, another mum (now grandma) who’s “gone before”. We sometimes talk for over an hour. Just like I did during their labours, I try to teach by example. They, in turn, teach me more. They tell me that they’ve discovered that babies and children just want love, how the body is free, how almost-free “stuff” is somehow a greater gift to give our children than expensive “stuff”. They tell me that once you get the hang of it, thinking outside the box becomes easier.

And I tell them that the challenge is to keep it up as your children’s worlds grow - as they meet new people, as they enter school. By then, you might be thinking about home schooling, co-op child care, working from home, flexible work schedules, community gardening... Just do what you can. The path is challenging, but worth it.

- Jacquie Munro, Vancouver Doula

A New Definition of Doula

I was talking with a client yesterday, going over her home birth. She thanked me for being with her through that night.

She tried to put into words what it was that made the difference - what I do.

"You..." and she paused, "...inhabited the labour with me."

Yes, that's just right.

- Jacquie Munro, Vancouver Doula

The Divine Blessings of Bread

Okay, so it's been one crazy week.

When I had my first few hours to do what I pleased, my husband asked what I'd like to do. "Well, let's go for a walk by the water first...then...I feel the need to go to Meinhardt's."

The walk by the water is pretty self-explanatory after all the water births, rain, water breaking, etc., this week. In Vancouver, we all feel drawn to the water. I had to go there.

But Meinhardt's? It had been in a dream this week. I'd run into the store, picking out lots of little things. And bread. I had to get bread in the dream.

So, off we went for our walk along Kits beach in the wind and the rain...then to Meinhardt's. I bought some Ukranian Rye bread...which reminded me of the wonderful bread we buy at the Cardboard House Bakery on Hornby Island in the summer.

But this morning, ready to slice into the bread, I turned to read the label...

"Bread has always played a role in many Ukranian folk customs. No significant family event takes place without it. Bread is used to bring divine blessings to the commencement of farm tasks, the marriage ceremony, the birth of a child..."

I eat the bread with intention....slowly...

- Jacquie Munro, Vancouver Doula

We Rode the Ling Ling Storm

Five babies came as Tropical Storm Ling Ling washed across the Pacific.

Three at home - Anna, Ruby and Sami...

Two at hospital - Jack and Thompson...

Was it the low pressure system that made these babies - due from September 27 to October 28th - come in one week? Did they surrender to the draw of the new moon? Was it both? Or did these babies just tumble to earth in this month's enthusiastic group arrival?

Whenever babies are born in a storm, it makes me remember the summer solstice weekend when five babies came within 48 hours....no overlap. I drove across the Lions Gate Bridge in a lightning storm. I drove across deep floods of water, a woman moaning in the back seat with her husband. Water everywhere. Rain lashing the windshield. Water breaking as the thunder crashed. The babies kept coming, one after another. Five weeks early. Three weeks early. The storm drew the babies into the world.

The beautiful labours that I witnessed this week were connected by water. The heavens opened. These women rocked in birthing pools, danced in showers, laughed in surprise as their waters broke. Only one woman found her greatest strength on dry land as the rain poured outside her home.

And one baby, today's baby, came wet, swirling, spiraling into the world...just as the tropical storm spiraled across the Pacific.

Thank you to all the women who taught me so much this week.

And to the midwives from Pacific Midwifery and Pomegranate who dragged their birthing equipment through puddles...to the second attendants who navigated the dark streets...to the doctors who climbed out of their beds...to my daughter who, by chance, attended the last birth with me...thank you all for respecting the flow, the wash, of labour.

Birth - as powerful, as natural, and as awe-inspiring, as a storm.

- Jacquie Munro, Vancouver Doula

...she jumped up and grabbed onto the edge of the note.

Singing in labour is sacred. In the middle of a contraction, without warning, the note rises out of the woman. She sings to the baby, to herself, to all women. Her song can connect her to both the earth and the sky.

This past week, without planning, each woman has found her voice in labour, grabbed onto the edge of a note, and used it to take her through to the end of the contraction.

On Monday...we might not have heard her sing aloud in labour, but my first client this week drew power from the Dixie Chicks and others, by candlelight...

Then, on Wednesday, came Hushabye Mountain... "The winds of night so softly are sighing/soon they will fly your troubles to sea." She was in the shower, and the pure notes merged with the sound of the water. A nurse walked into the darkened room where I was sitting, and she stopped, stood still, and listened....then walked away. The tune found a reprise when she was pushing.

On Saturday, a woman hummed a secret tune while in the birthing pool...then continued to tone "aaahhh...oohhhh..." while waiting for her long wanted baby.

Then, on Sunday, the humming and toning and singing grew until it became an amazing birth roar. The power of the roar helped her to soar crazily to the peak of transition, then shift into the bearing down. No longer confused, she grabbed onto that low note and dug deep into the earth to birth her baby. She laughed.

The women this week make me think of the other voices that I have heard in labour...and one in particular which remains sacred in my memory. Listen to Seemi sing the Suras. See her as I remember her, a sacred voice at home in the shower, in labour...the room steamy...me, a guardian, lying on the carpeted floor, drifting in and out of sleep.

Thank you to the women in labour who sing... - Jacquie Munro, Vancouver Doula

Give Birth a Chance!

There was a little challenge on the Maternity Care Discussion Group to come up with an alternative to VBAC (vaginal birth after cesarean). The winner was a good one...GBAC...as in "Give Birth a Chance!"

Love it! ...and its allusion to John Lennon's song...

Birth with Joy

I always say that the decor doesn't matter during birth. What matters is that you are surrounded by loving people who will stand back while you birth, trusting you to labour in your own way, in your own time, without interference. Then, you can birth with joy.

Take a look at two births from "Future Midwife." They show the potential joy in birth.

Go to Youtube and search for "Birth 8" to view a one-minute joyful birth from France, and "Birth 6" to view an untouched twin birth at the same hospital.

I wonder if haptonomy has anything to do with what is happening in these clips? Okay, ready, set...research!

Note: You might have to affirm that you are old enough to watch (i.e. log in or register), but it's worth it! - Jacquie Munro, Vancouver Doula

Why do babies come in groups?

Do they get inspired by other babies that have made it through recently, and decide to come early just to join in the fun? It's a funny image, but it kept coming to me recently as seven babies came in a steady stream. The due dates ranged from August 28th to October 14th...but they all decided to come in a 10 day period. So funny :)

When I have time, I'll write more about the amazing lessons that we all learned from these babies...

But let's just recap the past 6 months...
Of the births that I attended, there were:
32 beautiful babies
31 labours (yes, there was a set of twins in there)
30 vaginal births (yes, just one cesarean - 3.1%...not the twins!)
23 (74%) totally undisturbed births (i.e. just go into labour, have someone listen to baby, rare vaginal exams at the mother's request, and that's all)
4 epidurals (that includes the cesarean)

As each woman's birth story became reality, I would tell my other clients, hoping to inspire confidence.

These stories seemed to have a cumulative effect...with amazing results.

We are all in awe. - Jacquie Munro, Vancouver Doula

Kaleidoscope

"For we live with those retrievals from childhood that coalesce and echo throughout our lives, the way shattered pieces of glass in a kaleidoscope reappear in new forms and are songlike in their refrains and rhymes, making up a single monologue. We live permanently in the recurrence of our own stories, whatever story we tell." - from Divisadero by Michael Ondaatje

Shattering reflective pieces of a kaleidoscope tumble in my mind's eye. These are a million moments of experience, random sounds from births - a cry, a laugh, tumbling beside facts, data, then mingling with sparkling words from literature, history, and art. Our experience of life is beautiful and complex and always changing.

And yet, our lives are a monologue of recurring spirals of experience and emotion...constantly returning yet pushing forward. Our stories may keep recurring, but they shift and change with each new telling.

In my work as a doula, I must take my own experiences in birth and share them as stories that I gift to each client to become part of her personal monologue - a few stories for each woman to guide her forward on her own spiraling quest. Some stories are shared more often than others. Other stories are packed away in a shining lined box in my memory, to be shared infrequently. These are the potent stories tucked away for those especially challenging births.

This past week has been all about storytelling...stories of patience. Two women labouring, one woman in waiting... One woman's journey to birth took five days of incredible patience, interspersed with all the stories I could tell.

I told her the story of the woman who went through two days of oxytocin, only to bolt from the hospital, be found on the path to Oak Street, return, and give birth within half an hour. I told the story of the woman who went through a whole day of IV oxytocin before she signed all the release forms needed, and went home. Her labour began naturally a week later and only took four hours. I told the story of the woman who waited 10 days after her water broke before having the baby. I told stories of patience, of trust. I told stories from my kaleidoscope to support her own wishes. She asked for more stories. And when her baby came beautifully, in a sudden blinding flash of speed, I took her story...

...and gave it as a gift to the next woman...her friend, who went into labour a few days later. "She had her baby already? But she was due after me!" "Yes," and it was a triumph of patience. So this next woman took her friend’s story, gained strength from it, and pieced together her own story full of water and wind and patience. Water, wind, patience...those are the three things that kept her moving forward through labour. And her baby slid out beautifully, while her two feet were planted firmly on the ground. She was amazed at her own strength.

And I continue to tell stories to the woman who remains, in waiting, eleven days past her due date - climbing stairs, playing with her son, patient. Through her actions, she shares her stories with me.

To be a witness, a keeper of these stories, and to watch them form into a kaleidoscope of lives and lessons...that is one of my greatest joys in life.

…now…off to a birth…and another story for the kaleidoscope… - Jacquie Munro, Vancouver Doula

Back at Work

After a lovely recharging month off...I'm back on call.
When will the first baby come?
I'm ready when you are :)

An Argument for Non-Linear Thinking

I just love how our brains work. Well, I actually only know how my brain, a woman's brain, works. And it's totally non-linear. My daughter's brain works like mine, and people laugh when they hear us talking, shifting from one subject to another without any apparent link. Ah, but we independently followed the link from five minutes earlier in our conversation.

Birth is also feminine, non-linear. It works like a woman's brain. There are multiple tasks being accomplished at any one time - descent, rotation, softening, opening. Almost ESP-like communication can take place between a woman and a wise caregiver - this is the "monkey-brain" or "reptile-brain" at work. Thoughts, memories, past experiences, and current understanding are accommodated, merged, drawn upon.

"It's in the core," she says. "Yes, I can hear the baby descending," I say. "No more than twenty minutes. Hear me." "Yes, I feel it. It's right there," she says. "Safe," I say. "Okay."

There is so much going on beneath the surface in birth. Getting the right flow in labour is like searching for the point on a radio dial where there's no static, where the signal is pure. Intervention, too much noise, or touch can increase the static. A woman needs empty space in her brain in order to birth in her own way.

This makes my brain jump (in a non-linear manner) to a blog post that I read by Carl Honore yesterday. He had just been at an IdeaCity conference in Toronto and wrote: "One of the comments that has struck me most came from a physicist. (Note: Most probably he was thinking about physicist, Lawrence Krauss, and his discussion of dark energy.) He explained that 75% of the energy in the universe comes from empty space. This is wonderfully counter-intuitive. I may be stretching things here but it also seems like a nifty metaphor for the power that is unleashed by slowing down. When we become still, it looks like nothing is happening but in fact, beneath the surface, all kinds of extraordinary thinking and exploring is going on."

A woman's body in labour is like the universe. She gains most of her power in labour from the empty space, or dark energy. She is only able to access her full potential when she slows down to her basic self, when she is uninterrupted, untouched. We hardly know anything about dark energy. But Lawrence Krauss says that "It could be that dark energy reflects the anthropic nature of our universe, which implies there are other universes. If we could get evidence for their existence, this would be a remarkable breakthrough."

We've always been told that we only use a small part of our brains. We now also know that we only understand a small part of how our universe works. Only 4 percent of the universe is made of the kind of matter we have always assumed it to be - that part which is solid, us, our planet, the stars. 96 percent of the universe is, as yet, unknown.

So, it follows that we can only know a small part of how birth works. When we think we know it all, we really have no idea. I think only women in labour have a glimpse of the potential of birth. In labour, we know we are experiencing something almost unknowable. We know that we want to be undisturbed, deep inside ourselves. We can almost touch the doorway between life and death when we are in labour.

In labour, we accept the existence of other universes. It is huge, it can be scary, but it is us at our most elemental. There is so much dark energy in labour - as much as is present in the universe.

Dark, not as in negative or bad, but unknown, unwritten.

If, in labour, we are able to slow down our brain, be still within ourselves, and avoid the interruption of static, we might be able to firmly touch this untapped dark energy in labour. The power is both unknowable and knowable. Totally amazing. Pure physics.

Totally non-linear. - Jacquie Munro, Vancouver Doula

L'Arbre et Le Fruit

Here's a little excerpt from an article by Dr. Michel Odent, noted French obstetrician.

"According to traditional wisdom in rural France, a baby in the womb should be compared to fruit on the tree. Not all the fruit on the same tree is ripe at the same time. A fruit that has been picked before it is ripe will never be fit to eat and will quickly go bad. It is the same with a baby. In other words, we must accept that some babies need a much longer time than others before they are ready to be born. If you have some apple trees in your garden, you will listen to your common sense and choose an individualized and selective approach: you will not pick all the apples on the same day."

A recent client was concerned that she would be induced, as she had been in her first pregnancy. I had the confidence to tell her that her physician would not induce labour, even if she reached 42 weeks, as long as she and the baby were well. I could say that with confidence because I have been working closely with this particular group of family doctors for almost 20 years. This gave her peace, and she was able to relax. Soon after, she went into labour on her own, well after the typical "10 day limit" imposed in most North American hospitals. All was well. She could hardly believe the wonderful difference from her previous, induced, labour.

I live in a bubble, working as I do with midwives and family doctors who respect the current research, dare to challenge hospital protocols, and fully respect their clients' rights. I am fortunate to work in collaboration with caregivers who dare to wait, who only induce women if it is truly medically indicated (even if it causes a fuss with other staff!) In reality, this means I rarely see a woman face induction.

I am glad that I only work with caregivers who follow the best care practices. We work in concert with each woman and her body. Labours start on their own, women dance and move freely, women are continuously supported, women do not face regular interventions, women give birth standing, kneeling, or wherever they choose, and the women reach to pull the babies to their breasts. (Left brain dominant? Click here.)

In birth, we are not the keepers of the power, each woman's body is. Yes, we have to do our homework and ensure that everything we do is supported by the best evidence. But, after a while, the 21st century knowledge is only a backdrop to the ancient truth of birth.

So, if a woman's body is the tree, then the apple will fall, as it should, whenever it is ready, and will rest on soft safe ground. And the orchard keepers will be sitting, as they should, with their hands beneath them, in the shade of the tree. - Jacquie Munro, Vancouver Doula

Once

Wow! I don't generally talk about "non-birth" things on this blog...but we walked to Fifth Avenue Cinema last night to see "Once"...wow...

The link to birth is that it made me smile, hand over face, just the way I do when I'm witnessing a women deep in labour...

Brilliant!

7 in the month before 7/7/07...things are going swimmingly...

In the month before 7/7/07, I attended 7 births.

To honour these families, here are the condensed stories...

1. In labour, trying to make sure the men renovating her house wouldn't notice ("we waited so long for them to come and do the fireplace"), she dashes over to the contractor's house...only to be told by me to run down the stairs, get into a car, and meet me at the hospital. I could almost hear the dilation in her voice, and feel the baby's descent... So, we did perhaps the first "doula on headset" birth, dad and I driving to converge at the hospital, my voice quietly speaking into her ear through each contraction...and calling the hospital and doctor on my other cell phone. Dad remained calm...mum remained calm...and the baby was born in short order upon arrival at BC Women's. Phew!

2. Contractions were still "do-able" at 3am...we wait for the moment when the contractions make her "move"... Back circles, hip shakes at 4:30 should make the difference...ah, yes...dancing, moving...all the right signs by 5am...born at 5:30...9lb 5oz..."No wonder that hurt!" Baby suckling on mum's neck at 6am. A lovely night.

3. She walked to and from the hospital...with a husband on crutches. Need I say more? They're all amazing!

4. If her phone had packed it in a few minutes sooner, she would have given birth alone in an upstairs room. Luckily, there was just enough time for her to call her partner and I, get to the hospital, dash up to the best room in the house, have a shower, then have a baby - sunnyside up, no less! Thanks to Wendy for being such an amazing nurse, coming in just for us, and helping to facilitate yet another untouched birth.

5. When a woman is sick with a cold or flu, the body seems to take pity on her, and make the labour that much faster. Well, it worked again. Another quick birth. Softly breathing through each contraction, accepting each wave as it came, she birthed a beautiful baby boy before too long...then he peed all over dad's pants! "Hey pumpkin, what do you think?"

6. Dark hot night, fan blowing... She labours in the tub, moving with the contractions. The power builds, the midwife arrives...she now believes it can happen...legs "wide open like wings"...and the baby slides out into dad's hands. Milk and chocolate afters. "Just lovely," says mum.

7. This little one waited until he was good and ready. And no induction this time! Mum and son were at the beach...I walked to her house, and she gave birth with the sand still between her toes 2 1/2 hours later. Thanks to the nurses who believed me when I said the baby was coming FAST! Thanks to Dad for getting little one to sleep for his afternoon nap, so he could make it to the birth! Okay...now the next one should be at home.

It was an honour to be a part of these births. Welcome to the 5 boys and 2 girls!

On "Beyond Evidence: The Complexity of Maternity Care"

I must say that I've had a long-standing passion for Murray Enkin. I was first "introduced" to him in 1987, when he was an obstetrics professor at McMaster University, and was writing "A Guide to Effective Care in Pregnancy and Childbirth". His book became my "bible". The underlying thesis of the book is that evidence from well-controlled trials should encourage the adoption of useful measures and the abandonment of those that are useless or harmful. The full text of the 2000 Edition is available online, courtesy of the authors!

Dr. Enkin's insightful comments in the "Guide" made me respect his judgment. His pragmatic review of the research helped to guide me in my role as a doula. I would photocopy pages of the book to give to clients, to help them negotiate the best care during pregnancy. Over the years, I have always checked in on his current research, and tried to follow his teachings.

I only recently learned that Murray Enkin mentored my family physician when she was at medical school at McMaster University. She said that his nurturing taught her how to respect the value of research, while honouring the complexity of life, the effect of random variation, and the nuance required when providing health care at the highest level.

So, it didn't surprise me when I stumbled onto a Guest Editorial by Murray Enkin, published in December 2006 in "Birth" called "Beyond Evidence: The Complexity of Maternity Care". Once again, here was Murray Enkin encouraging us to move forward from our dogmatic approach to research. Thank you, Murray!!!

There has been a movement afoot to solely rely on "evidence-based care" in obstetrics. This phrase quickly became a buzzword in midwifery schools and doula circles. Dr. Enkin argues that there is a fundamental mistake in using this approach in obstetrics. The complexity of obstetrics demands a different approach, one that considers the complex interrelationships among the separate elements at play.

"It is not simply the woman or the setting, the attendant or the policies, that influence the outcome" in labour. He argues that this renewed understanding can "point us to the steps we can take to move forward. First and foremost, we need to accept the uncomfortable reality that there are no comprehensive formulas. A cookbook for maternity is not in the cards."

"We must learn to think of the relationships among the disparate factors that influence each birth, each setting, each situation, rather than of the factors in isolation. We must allow new forms of research to evolve, to produce new kinds of evidence, and to accept the value of this new evidence."

As a doula, I need to keep current. I need to know that I'm providing my clients with all the information they need to make the best choices during their pregnancies and births. To do that, I read the MCDG list daily, consult MIDIRS, Birth, The Cochrane Library, and the world's major research institutes (I'm especially fond of Canada's own Journal of the Association for Research on Mothering). I branch out and draw on essays and writings from different areas – literature, history, anthropology, comparative religion – to discover more holistic answers to birth's questions. I also GoogleScholar any topic my clients ask about, to ensure that I'm up to date. I call on my most trusted midwives, family physicians, spirit medicine providers, and others, as I continually search for new ways of approaching birth. Oh, and I can now call on my daughter, currently a writer/researcher with the Rural Maternity Care Research NET, when I need a sounding board.

I also trust that my attendance at close to 70 births per year counts for something in terms of continuous experiential research. I must negotiate the myriad differences and inter-relationships evident at each birth – with different babies, women, partners, caregivers, hospital staff, and family members.

I must practice "evidence-based care"…but I like to think I go beyond that, to consider a higher, more complex level of care, as Murray Enkin suggested.

Thanks, Murray, for keeping my passion alive, and for teaching me that wisdom is worth nurturing as much as research.

- Jacquie Munro, Vancouver Doula

Grace and Beauty

'All things of grace and beauty such that one holds them to one's heart have a common provenance in pain.'

Cormac McCarthy

Well, that was quick...700 is here!

Faster than a speeding bullet...well, not quite...

Client #700 has had her baby! The birth was powerful, beautiful, joyful, challenging, and quite unbelievable for mum. Her first labour was more than two days...this one was only 5 1/2 hours.

And that wry sense of humour that I wrote about in the post from earlier today? This little girl decided to come sunny side up! Easily, too!

Wow!

To epidural or not to epidural...

That is the question...

I had two back to back calls the other day, regarding epidurals. The first was a last-minute possible client who called to say she wasn't going to need my services after all...because she'd just had her baby that morning (in very short order). She was quite surprised how quick and simple birth was - surprising since, as a family doctor, she'd been attending births for some time, and had anticipated...well, something more hellish than she encountered. She said she now understands that the decision to have an epidural isn't one that can be made before birth...it's all about responding to the needs of the day.

The other call was from a woman interested in hiring me as a doula. She had read my "Statistics for the Utterly Confused" and just wondered if I had an agenda to eliminate epidurals (since my client epidural rate is significantly lower than the general population). Um...nope. My clients who labour without epidurals aren't self-flagellating ascetics or martyrs (as TV may have you believe). They are women (with the help of a doula and doctor/midwife who trust in birth) who happen to have straight-forward normal births, and then say, "Hey! I didn't even think about meds. Interesting..."

A smooth and simple birth requires you to be present, conscious, and conscientious on the day of labour. In that mindset, you will make the right choices, and use the necessary tools for the day, simple or otherwise. Most days, all that's required to help a woman give birth are love, eyes, ears, hands and wisdom. But, if the day throws some major "curveball" at you, then a few more tools (including an epidural and more than a pinch of pragmatism) might be required.
- Jacquie Munro, Vancouver Doula

Putting the Vancouver in Vancouver Doula

I'm going to have to time the ride to be more precise, but the trip from Vancouver Doula's new home to either St. Paul's or BC Women's Hospitals takes about...4 minutes.

Add that to the fact that the majority of my clients will now live within 15 minutes of me...and the result will be even better care.

I'll be able to pop over to check on clients having long prodromal labours, do emergency breastfeeding visits, actually get to meet former clients for tea (right, Brooke?), or even walk to "meet and greet" visits on South Granville or in Kits.

Think of the reduced environmental footprint! (Still toying with the idea of getting a scooter...)

All of this ties in with my philosophy of being conscious and conscientious about all things, and putting family first. By moving into town, we're saving gas and time consumption, and bringing our family closer together (one sister even lives upstairs)!

All of this will coincide with the birth of "my 700th baby." Client #699 gave birth just the other day (she lives so close to the hospital that she walked there after her water broke), with a whirlwind "the head's right there!" finish.

Here's hoping that Client 700 won't give birth on moving day. But, since babies tend to have a wry sense of humour, I'll kind of expect it...

See you in Vancouver on the 27th!

Statistics for the Utterly Confused

I usually wait for a full year to pass before doing my client stats, but a lot of doctors, nurses, doulas, childbirth educators, and clients have recently been expressing concern about the high epidural rate (reports are as high as 80%) at local hospitals. A recent article in The Vancouver Sun also reported that the cesarean rate in B.C. had climbed to almost a third of all births, far in excess of what the World Health Organization deems acceptable.

So, here's a glimpse into my own client outcomes from January 1/07 to June 7/07. Now, remember, these are not a special group (i.e. highly motivated multips under age 30 with a history of fast births). These are 30 women with an average age of 36, most (73%) having their first baby, who hired me to help them and their partners. The majority entered the process without hard and fast expectations about the birth experience. They all hoped to "do their best on the day", some wanting an epidural at the door (and not needing it), and some wanting to avoid a cesarean (and needing it). They are all capable and amazing women.

30 clients
Ages 27-42 (average age is 36, with only one woman under age 30)
22 (73%) primips (including 1 twin SVB)
8 (27%) multips (all SVB, including 3 successful VBACs, no epidurals for any multip)
4 (13%) cesarean births (2 after many hours (one 5 hrs.) of pushing, both posterior babies - 9lb6oz and 10lb, 1 placental abruption, and 1 with malpresentation and incoordinate contractions from large fibroids)
9 (30%) overall epidural rate - all primips, this includes 4 later resulting in cesareans, plus 1 prophylactically for SVB twins, and 4 for pain management with subsequent SVB)
13/22 (60%) of primips had no epidural

Other facts:
18 (60%) arrived at hospital at, or close to, full dilation (Please note: This is not an aim, but a side-effect of the fast labours that often occur with a doula. Clients are encouraged to attend hospital when they feel it is "time," or if they feel anxious, unsafe, or worried about the baby.)
7 (23%) are medical personnel (including 3 family practice doctors, all primips)
1 (3%) client (primip) had her baby at home before I could reach her!
19 (63%) had family doctors (of these, 89% were SVB, with a 21% epidural rate for FP group)
8 (26%) had obstetricians (all primips with OBs had epidurals, only one cesarean in OB group)
3 (1%) had midwives (1 cesarean, 1 vacuum, 1 SVB)

No editorial comments here...analyze at will... - Jacquie Munro, Vancouver Doula

Note: SVB means "spontaneous vaginal birth"

Lessons from a Happy Flying Baby (Advanced Level)

Did I tell you that I think that labour lasts as long as you need to learn all the lessons required for this particular child? There’s perhaps a little extra time added to work through some particularly tricky past life experiences. The baby’s personality has a lot to do with this...

One of the family doctors I know, said that all three of her boys had labours to fit their personalities. One came flying so fast that his cord broke. And that’s how he goes through life - flying headlong into things (both physically and emotionally). Another son takes his time, considers all his options, then considers them some more. As a result, his labour took a long, long time.

My daughter is strong, powerful, never wanting to follow the crowd. When I was in labour, her head was trying to forge a new, totally different path - out my hip. Later, her high school math teacher said that she would pound away at a problem for a long time, only to later discover that if she just turned the equation around, the answer was there - and simple. That sounded just like her labour, since she eventually tilted her head, and came easily.

It’s interesting, but my clients who have the quickest births often have the hardest time adjusting to parenthood. They often tell me that they just can’t figure out their baby. In a 15-minute labour, there’s not much time to learn the lessons that you need to parent this child.

So, be thankful if you have a long, gradual labour. There are many benefits to the lessons learned during this time - lessons that you will draw upon for a lifetime. You might even begin to understand that labour and birth is something that’s out of your hands, and that's okay. When things are slow, it's not "your fault." It might just be your baby speaking to you through your body...

So, listen. - Jacquie Munro, Vancouver Doula

Dear Luc

Thank you for letting me talk
with your mum and dad tonight.
You were so patient.

Sorry that I couldn't play
the frog game with you.

I do hope you enjoy your big brother class
at the hospital.

See you later, alligator!

Oh, yes
You really remind me
of the "little bean" that you were
when you were born!

On egos, ideal births, and leaving your stuff at the door

We all have shakey egos. So, it's always lovely to hear, "You're a life saver!" But, for me, along with the squishy good feeling I get from that comment, I also have a quiet little cry. The credit shouldn't go to me. The ultimate strength comes from within each woman in labour.

So, I'm really happiest when I talk with a client, months after her baby's birth, and she stops mid-sentence and says, "Did I ever tell you how wonderful that foot massage was? It helped me to be in my body, to focus on the work I was doing. It made me feel powerful."

For me, being a doula is all about reminding the woman that it's all HER power - internally and externally. As well as owning the power of her labour, she also has rights and responsibilities, which she's fully capable of exercising.

I've had my births, I've worked through my own stuff. And like my daughter says, "You check your stuff at the door." For me, being a doula isn't about "giving" a woman the birth I think she needs. It's about helping her to access her own truth, drawing on her own life experiences. She has nine months to do the work of establishing her own boundaries, re-evaluating relationships, and preparing for the emotional work of birth. Because, contrary to popular belief, this is not a physical game, it's a mental and emotional game. And the demons are ones that you've met before...

One former client thought I could guarantee her a quick, painless labour, and achieve an "ideal birth." Sorry, I can't do that...

I can translate what's happening, tease out the meaning in the medical jargon, de-mystify the logic of the body, anticipate possible scenarios. I can help facilitate the transition INTO labour and THROUGH labour. But I can't alter a woman's own life experience, her beliefs and expectations, or the variable reality of this particular birth day.

It would be presumptuous (and egotistical) to think that I could make any guarantees, or have as a goal to help each woman achieve an "ideal birth." Who is to say what is the "ideal birth" for each woman? I really believe that each of us has the labour that fits us. I don't think that belief is a cop-out or just me being fatalistic. I need to support each woman through her own experience of birth, without ego or judgement. If I can't support her choices (which would place her or her baby at extreme risk), then I must be honest about my own limits, and respectfully decline care.

As a doula, I carry with me the experience of hundreds of births. Each birth teaches me something more about women's lives, our bodies, our strengths, our weaknesses. Each birth teaches me even more about relationships, communication, and random interaction.

My job is to sift through all the gifts I've been given from each birth, to help each woman find her own way through her own birth experience. My job is to fade into the background as she discovers her own power. My job is also to provide her partner with the tools that he or she needs on that day, so that they can work together with the baby through the process.

As part of my care, I do a final "dress rehearsal" visit to each family's home. We try out positions, see what pieces of furniture might work well to lean on, if there's a "circuit" in the house to pace, how wonderful the cold tiles feel on the feet. Yesterday, I knew things were serious when the phone call came, "She's doing tippy toes! Oh, and she only made it half way up the stairs before the next contraction came! We'll meet you at the hospital." Rather than questioning their decision, I knew that, having given them the tools to recognize strong active labour, they were right on track.

When we met at the hospital, one nurse said, "I knew they must be with you. They knew what to do, and she wasn't worried about making noise. Did you tell her to make so much noise that we'd bypass admitting? (I grinned) Well, it worked! She's in Room 1."

It's so wonderful to do all the prep work with clients - to give them the tools that they need to labour in their own way. This morning, I encouraged the dad to rock his wife's hips, while she lay on her side, oxygen mask on, breathing calmly and deeply, waiting for the baby's heartrate to rise. He was able to feel the direct impact of his hands on the baby's heartrate. The rocking stimulated the baby, and kept the baby safe.

When we were all tired, we welcomed the body-building nurse, as he held the woman in his arms, chanting as she pushed, "Yeyeyeyeye... goodygoodygoodygoody... ohhh... ohhh... that's good!" The dad and I grinned at each other. We were working as a team, to honour the woman's wishes.

As wind-surfers, this couple understand the need for working with the wind, whichever way it blows. That understanding helped them to cope with the challenging labour that they faced. They were able to achieve the birth that was right for them and their daughter.

After birth, this baby, who had spent most of the labour star-gazing (aka "posterior"), laid on her back on her mum's tummy, tilting her head back to view the nurse, smiling quietly, then turning her gaze to her mum.

Then mother and daughter practised sticking their tongues out at each other, while dad giggled.

It was that family's "ideal birth." They had witnessed the body's power, the power of labour, and the power of great communication and understanding. It will take them a long way in their journey as a family.

...and I happily slipped away.

- Jacquie Munro, Vancouver Doula

Birthing from Above

From the desk of Jacquie's daughter

Growing up surrounded by my mum's work in childbirth, I had a slightly different introduction to the subject of reproduction than most children. Instead of reading "Where Did I Come From?" I looked through a plethora of illustrated Sheila Kitzinger and midwifery texts. I thought it was fascinating that the egg that was fertilized to make me was in my mum's ovaries when she was born, and was thus formed inside my grandmother! Wild. When she taught prenatal classes, I would come along and play with the infant-sized dolls in her teaching materials, using the plastic pelvis as a cradle. Then, as she began to do more labour support, I would act as her secretary and run into the kitchen to intercept calls before anyone else, often to hear a flustered dad drop the phone, with his wife moaning in the background -- "Mum, it's for you."

It was only a matter of time before I felt the need to leave my role as an earnest spectator and take part in my mum's work. On New Year's Eve, 2006 -- just a few months ago -- I shadowed mum at my first birth as an apprentice doula. It brought to life everything that I had merely heard about for twenty-three years. This sealed the deal. I was sucked in and needed to learn everything I possibly could about childbirth. Or, more precisely, I needed to fill in the gaps of all the knowledge my mum had slyly been teaching me over the years. Little did I know that in giving me those midwifery texts, taking me to classes, and leaving me to chat with clients, she had been training me to one day work with her. Cheeky monkey.

So, with the advent of 2007, I began the final semester of my Master's degree in Literature at UBC and decided that I would complete my university career with a directed reading in the language of childbirth guides -- to both fill in the blanks and end my degree with a fun project. I received such a fantastic education from my mum growing up. She had given me all the right materials to read, but I wondered, what were other women reading? My guess was that most women don't pick up "Ina May Gaskin's Guide to Childbirth" during their summer breaks or watch "Homebirths in Holland" on Friday nights. I turned to popular pregnancy guides, the sort of books that you find on the shelves at Chapters or are lent by a friend. I pulled together a list of about 20 bestsellers, narrowed my focus to the hot topic of caesarean birth, and began reading with some questions in mind:

What sort of language do these books employ? What themes, messages, social beliefs, and institutions do the discourses in these books support? Are women reading from the perspective I was raised, that childbirth can be sacred, empowering, and, above all, normal? With caesarean rates reaching over 30% in parts of Canada, what are popular pregnancy guides saying about surgical births?

I won't give away my entire paper (please email my mum if you want a pdf copy,) but one conclusion I did reach after reading these popular books was that, on the whole, authors don't view birth as normal. They describe caesarean births as a medical solution to "pathological" pregnancy.

My first reaction was to get completely wound up and militant: "We've got to do something about this, mum! Our culture no longer cares about the natural processes of the body. We've turned into a fast food society that wants its babies to be 'delivered' from above. Yet all over the world women have babies at home with midwives, without medical interventions, and their births are statistically safer!"

Then I realized that there was a simple way to counter the line of thinking present in pregnancy guides. Use language as a tool to reclaim birth from degrading discourses. That's why I like the term "caesarean birth," as opposed to caesarean section, c-section, c-sec, or C, or capitalizing Caesarean. By changing the language we use, we change our mindset.

I've known my whole life that birth in hospitals or through surgery has the potential to be sacred and empowering. Mum helps make that possible with the language she uses -- clients reading this know what I mean. She translates medical terminology into something a woman and her body can understand. Using positive phrases and non-judging words, she attempts to take the fear out of birth and make it normal, relatable, possible.

Why can't pregnancy guides do this? Because in our North American culture, birth isn't normal, relatable, possible. And that's a load of bunk. Don't read them, just use them as doorstops (except those by Kitzinger, Gaskin, Gurmukh, and the Dr. Sears family -- they're a'ight). Just read books during pregnancy that shut off your thinking brain and allow you to listen to the rhythms and instincts of your body. Children's books and trashy romances work well.

Oh, and hire my mum.

And just wait until our book comes out!

- Sarah Munro