Wednesday, April 29, 2009

My dysfunctional love of statistics

I loved statistics so much in university. Honestly! I'm still such a geek, that I love to look at my client's stats...not at regular times of the year (like December 31st), mind you. I like to do it when the spirit moves me (the happy convergence of left and right brain.) Or might it be tax-procrastination time?

So, here's this past 12 month's basic statistics...

Of 62 clients, 43 (69%) had spontaneous vaginal births without any major pain medications (epidural or narcotics), 10 (16%) had spontaneous vaginal births WITH an epidural, 2 (3%) clients had assisted births (1 vacuum, 1 forceps), and 7 (11%) clients had cesareans (2 breech, 1 face presentation, 3 dystocia, 1 fetal distress). Take some time to think about that. Only 5 clients (8%) had unplanned cesareans. What's the average in BC?

The majority of hospital births were at BC Women's (46, 74%), followed by St. Pauls (9, 14.5%), Lion's Gate (2, 3%) and Royal Columbian (1, 2%). Five clients planned for a home birth. Of those, 4 were successful (one had to transfer to hospital for meconium at 10cm, but happily birthed then went back home). There was also 1 unplanned home birth (luckily, she had fast-moving midwives!) So, only 6.5% of births were at home. Okay...I need more home births!

As for who was caring for my clients, family doctors top the list with 37 (61%), followed by midwives at 16 (25%), and OBs (9, 14%). The BC Women's FPMS birth docs cared for a whopping 37% of my clients. Thanks to all who did such a great job of making slow births happen!

A lot of people think my clients stats must be so good because they are having second or third babies. Well, almost three-quarters (46, 74%) of my clients were having their first baby. Only 16 (26%) clients were having their second or third baby, and 12 (19%) of those were returning clients. Of the four new clients who were "multips," one had a home VBAC, one had a home water birth, another had a home birth after a traumatic first birth experience in another country, and one was over age 50!

You might also say that my clients have great births because they must all be very young and highly motivated. But, most are over age 35, many are over age 40, and most would have been fine with an epidural or cesarean if it was medically necessary.

But, after many months of working together, these women were all motivated to have a slow birth...to listen to and trust their bodies...to allow for the natural rhythm of birth. And, with good support, and a great team (who can sometimes collaborate silently, with only eyes and hands to communicate)...it just worked!

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet

Monday, April 27, 2009

In which a push mower acts as sweet music...

On Saturday afternoon, I was dropped off at a client's Co-op on the Downtown East Side. As I walked to their door, a nurse from the local InSite walked by and smiled at me, a man with a grocery cart full of his belongings rattled down the lane, and a siren began to wail.

Once I was inside the door, though, another series of sounds took over...the cry of a woman in labour with her first baby, the shouting and shrieking of children as they played in the Co-op playground out back, the unexpected rhythmic whirr of a push mower acting as sweet green music. I had entered a hidden oasis only a block from Hastings and Main. It was cool, calm and wonderful.

She laughed and asked if I could hear her from outside...

We added the sound of the fan to the mix, and helped her to move, rock, sway, stomp, go on tip-toes, shower. She became calm when I talked her through contractions. She was kind and gracious in labour, only snapping once as her husband came into the bedroom to ask if I'd like some lunch, while holding said food in his hand... "Out!" Yes, labour increases a woman's sense of smell!

With the sounds of children and the lawnmower and the woman and the fan blending together, all sense of time disappeared. We were outside of time. As the contractions became stronger, she became more and more calm, toning low and soft. She melted open.

One last time into the shower with the fan blowing steam out of the bathroom and cooling the air. Water spilled onto the floor. We heard her growling. We smiled. Her husband put his head down for one last moment of quiet.

Then we headed through the streets in my car, as she dozed in the back seat, head leaning on a homemade quilt which covered the birth ball. One contraction, two contractions. That's all she had in twenty minutes. She was in that quiet slow space before pushing...

Then, a hint of a sound like she wanted to push as we arrived at the hospital. 9+ centimetres!

And she rode upstairs and pushed and pushed and moved and worked, and never gave up, and then...more than 3 hours later...beautiful pink Josephine (named after her grandfather) arrived, head askew, looking up at her mum...born completely posterior!!! She called out in her sweet voice and cried to let everyone know that she had arrived.

What a day of sweet music!

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet



Friday, April 24, 2009

Slow Birth call to action

My goodness!

Dr. Lauren A. Plante, a US obstetrician, has written a wonderful article (a MUST read!) in response to the increasing industrialization of childbirth (wasn't Canada's own Dr. Andrew Kotaska one of the first to argue against "industrial birth"?) Dr. Plante asserts that on-demand cesareans do not represent the height of women's autonomy, but are, in fact, the opposite. She calls for true autonomy for women - the right to choose from a spectrum of choices.

At the end of the article, she links the Slow Movement to childbirth, and almost challenges women to start a grassroots birth revolution. This is the first academic article that I've found that mentions Slow Childbirth. Wahoo!

The Slow Birth movement is organically growing! Read the excerpt below, then click the link for the full article...think about how you can be part of the transformation...

Come on - bring forth the change!

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet


Plante, L.A. Mommy, What Did You Do in the Industrial Revolution? Meditations on the Rising Cesarean Rate. The International Journal of Feminist Approaches to Bioethics. Spring 2009;2(1):140-147.

Excerpt:
"As a reaction to industrial agriculture and food marketing, the Slow Food and locavore movements have recently been born. If de-escalation of our food production practices is healthier or more humane, why is intensification of our child production practices better than sustainable childbirth? I’m waiting for the birth of the revolution, or at least, the revolution of birth. Will women who are interested in Slow Food or cage-free eggs find their way to a Slow Childbirth movement? Imagine: educated upper-middle-class women who buy songbird-certified organic coffee and worry about their carbon footprint, just saying no to the quick-fix cesarean culture. If they’re not part of the problem, maybe they can be part of the solution. But the impetus must come from women themselves. Do we really believe that industrial obstetrics is the best model for ourselves and our children? We must clearly understand that real autonomy does not mean cesarean on request, but instead a spectrum of birth options that honor women’s authentic choices. Real autonomy also means, to borrow a sentiment from Gandhi, that women should bring forth the change they wish to see in the world."

Wednesday, April 22, 2009

The Green Generation

It's Earth Day today! And it's Isola's and Milo's birthdays, too! They are just two of my client's babies who are part of the "Green Generation." My hope is that they will grow up with the smallest carbon footprints possible. I think they're pretty special one year olds, so they might be able to do it and be worthy of the title.

Now is the time.

So, am I, as a doula, "green?" I try to work with clients who live within a small area. I can walk home from both birthing hospitals. In labour, I help clients in their own homes, usually arriving on foot or on a bike. I help clients stay out of the hospital system for as long as possible, while remaining connected to their caregivers by phone. My clients rarely need IVs, epidurals, drugs, or any major assistance. My clients often go home as soon as possible (or birth at home with midwives). The majority of my clients are able to breastfeed successfully, and don't need to buy bottles or formula. Most of my clients use cloth diapers (well...at least during the daytime!) They also need less future counseling as a result of their positive experiences.

Think of the cost savings, the environmental savings! That's what I call a "green birth!"

We might wash some of those savings down the drain with the amount of hot water that my clients use in labour...(but SHHH don't tell anyone!)

That's probably a small price to pay for the long-term joy that an amazing birth brings to a family.

And I discovered today that there's a residual "green" impact. Today, Isola's mum called me up on her daughter's birthday, and we both started to cry as she thanked me for all the help that I gave her during her pregnancy and birth. Think of the long-term ramifications of a "green birth" on her and her daughter, and her family!

This mother will always tell her daughter stories of her joyful undisturbed birth, and this little girl will probably have a "green birth" in her future. She's truly part of the "Green Generation."

So, Happy Earth Day! Wear some green!

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet

Thursday, April 16, 2009

Bike the Blossoms

"Abandon your fast life for another day of s l o w ..."

Whether you're pregnant or not (hey, I rode my bike until I was 8 months pregnant!) come and join other Slow Vancouverites at the Bike the Blossoms 23k ride sponsored by Slow Food Vancouver this Saturday, April 18th. It's only $10 each, and you'll be supporting the s l o w movement.

This self-guided tour is fun for the whole family! Enjoy a leisurely ride along boulevards of spring cherry blossoms, traveling through a diversity of neighbourhoods from the eastside to the westside, stopping at local community centres to meet local farmers, to sample local foods and refuel at slow food designated eateries, restaurants and cafes along the way.

Slow Birth will be there! Come join us!

(Apr. 19 - Well, that was fun! I saw lots of families with babies in various carriers riding through the city streets, but didn't spy any noticeably pregnant riders. And the weather stayed sunny and warm! The next day, at the Sun Run, I saw a LOT of pregnant participants - yahoo!)

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet

Slow Stories

I started to take notes during each birth after November 1, 1993. I know that because Kieran was born on that day. Kieran was a warrior baby. In fact, he was born face first. He never gave up with that chin-up attitude (and probably still hasn't to this day!)
The midwife did one final vaginal exam just before he was born. "Is that a bum?" she asked, just a little confused for a moment. "No, it couldn't be...you're hearing the heartbeat in the right place. It must be a mouth," I said. "It's the baby's lips!" she called out. So, Kieran was born, after a crazy challenging labour, with his mum on her high bed, holding up her silk dress (dad had grabbed a dress for her to wear, and I think it was one that she'd recently worn to a wedding).

Days later, when we tried to have "tea and debrief", Keiran's mum, my doula partner and friend, cried, as she tried to piece together our collective memories of what happened at the birth. Her first labour had been so smooth that we had expected a quick second labour. This days-long hard labour had been so relentless, with intense back pain, that we had all lost track of time.

She told me that she had keenly felt the loss when I had left her head and gone to help the midwife during those critical moments when we didn't know whether the baby was head down or breech. A woman needs another woman at her ear, whispering, "You are safe." I wasn't there for her as a doula in the end. I had become the second attendant.

We had no birth notes from those days of long hard labour - no framework from which to hang the memory. She was lost.

She asked me if I could write notes for all the women who would come in the future, so that no woman would ever have to wonder "What happened?"

So, now, I write as honest and true a story as I can write. I can only write what I observe, being on the outside of each woman's experience. I try to make sure that my handwriting is slow and calm. I watch my writing become larger and messier as the baby's birth moment approaches. Water drops on the page. A drop of blood smears. This is the external story of a birth.

I ask that each woman and her partner take some time to record their own experience, before I give them my birth notes as a gift. Each written account is part of the memory of the birth day. But, it's the woman's internal story which is paramount. Who cares that my notes say that she was in the bath for 5 hours. She believes that she laboured in the water through the night. She believes she was surrounded by candles (when candles are not allowed in the hospital) and peacock fans (when it was really a cardboard tray). She believes that she was rowing for a gold medal, not panting for hours. Her reality is the truth of the birth.

But my notes do provide something that she may never remember - her first words as her baby emerges. And now, most women don't cry because of a lost story, they cry with joy, when they read the words that they said to their newborn:

"I'm so glad to meet you!"
"That might have been the best thing I've done in my life!"
"You are so beautiful!"
"She sounds like a sheep!"
"Holy cow! It's a baby! Look! It's a baby!"
"You're sure a lot louder than I thought you'd be!"

Kieran's mum is moving back to the west coast very soon, so we'll have another "tea and debrief" very soon. And she'll probably tell me that my memory is faulty after all these years, that she actually wore her silk dress when her baby Zoe was born. And I'll tell her that, at the very least, my memory is clear about her strength in labour. The sound memories are clear, too. The garbage truck, the children outside. And I'll say I'm sorry that I left her head during Kieran's birth, and that I think of her every time I whisper, "You are safe," to each woman as she gives birth...

And then, we'll tell more slow stories of our lives...

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet

Tuesday, April 14, 2009

Life Cycle

Something as simple as a bike can save lives!

It only costs about $70 to purchase an International Planned Parenthood Federation Good Gift Bicycle for a midwife in a developing country.

If a midwife in a developing country owns a bike, she's able to visit more villages. Unfortunately, too many midwives lack cycle mobility, so, considering the local current price of a bicycle and its life-improving qualities for far-flung villagers, you couldn't deliver a better gift.

For us, riding a bike to visits is truly a luxury. But to midwives and other health care workers around the world, it's a necessity. Please think about making a donation!

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet

Slow Bike "Rounds"

I fulfilled a childhood dream yesterday. As a child, I always wanted to be one of those women who rides her bike to visit mums and babies.

I must have heard about it from my mum and her friends, talking about their pregnancies in the north of England in the 1950's and early 1960's. The image of the local village midwife, riding to visits on her bike, just stuck with me. It seemed slow, perfect, just the way someone should visit you when you have a new baby.

That (and reducing our carbon footprint) was why we moved back into town. But, it's only since I've had my shiny new yellow road racer that I've felt brave enough to do my client visits by bike.

So, when I realized that my son had my car, and I had to do a few visits in Yaletown, I bit the bullet, and headed out over the windy bridge. There's nothing more satisfying than going to visits in the busy downtown core and not having to worry about traffic, red lights, or parking. I even managed a whirl on the False Creek bikeway. Between visits, I stopped at a little French bistro, sat in the sun at a cafe table, and ate my lunch while answering the inevitable (but fun!) phone calls from two postpartum mums.

Thanks to my clients who didn't mind seeing me dressed just a little less professionally...what? my blue dragonfly jersey isn't totally business-like? Thanks also to my clients who didn't laugh at my helmet-head.

I rode home from my lovely visits with a parting gift of chocolates dangling from my handlebars, 30km/h (over the speed limit!) on the last bit of the bridge, past the Planetarium, under the bridge, past the Granville Island tourists, and up the hill to my home. Fabulous! Then the phone rang again. I put the kettle on and chatted some more. A pretty amazing realization of a childhood dream.

So, be forewarned...I'll probably be coming to see you on my bike very soon - glowing, shiny and smiling!

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet

Wednesday, April 08, 2009

Warrior Birth













"Next time I'm just booking a cesarean."

"My first birth was so traumatic - I want drugs the moment I start labour."
"I can't walk through the door of a hospital again."
"I think we'd better adopt our second child."

To all the women who say these words...
Please know that it wasn't your fault.
It wasn't your faulty body.
It wasn't your faulty mind.
It wasn't that you lacked will power.
It just wasn't a normal labour.
No guilt or blame.
It just wasn't a normal labour.

If you were surrounded by loving, caring people.
If you did the best you could, but the birth still shook you to your core.
If it was long and hard and unfathomable and didn't feel right...
there is usually a simple explanation.
Something just wasn't quite right.
It didn't have to be something big.
It could have been a sweet pair of hands by the baby's face,
or a head tilted to one side,
or facing out a hip,
or looking upwards.
Just bad luck on a big day.

This is the baby who didn't get the memo
about optimal positioning for birth.

Picture the baby who will come out simply and easily.
She's tucking her head down on her chest,
facing mum's bum,
has her hands in her pockets,
and is going to win the Olympic gold medal for the skeleton competition in 2030.
She's aerodynamic, flexible, adaptable,
and able to negotiate all turns with the grace of a pro.

She's lucky
born in the bathtub,
with her mum laughing.

Don't be hard on those babies who didn't get the memo,
those babies whose mums made those scary comments after the first birth.
These babies will never follow the crowd.
They'll be fiery and challenging, but totally brilliant (that's my girl!)
They're the ones who create great architecture, great music.
They are born with these passions tucked deep inside.
(Or maybe that's just me trying to put a positive spin on a difficult labour.)

The posterior/transverse/deflexed/asynclitic/compound presentation baby
tries to negotiate the birth canal
like a pine tree on the edge of a wind-swept cliff edge.
Bent, twisted.
He faces the hip, or faces forward, chin up, whatever the consequence.
This is not a birth for the faint of heart.
This is a warrior's birth.

So, when a woman calls to tell me about her first birth,
that long, epic first birth,
the one that she never thought would end,
and says that she can't ever do it again...

I ask her to thank her first baby for all the work that he or she has done.
We must not worry him or blame her.
First births are unrelenting in their demands,
because that is what is needed for us to be the best mothers to our children.
I remind her of her strength, her courage, her power as a mother.

She must have been a warrior to make it through
and out the other side.
She needs to know that it can be different,
oh, so different the next time.
I, too, have made it through that kind of a birth
then danced in the shower with my second.

She is not alone.

And, like Katie, she may choose to have her next baby at home, with the fan on, in the summer.

And, like Jasmine, she may not actually believe she's in labour until it's almost too late for a car ride, and then pant and blow through the tunnel to the hospital, and have the baby quickly on the other side.

And, like Lisa, she may find herself doing the "buzzard lope" around the house, and only get on a bed for the last few minutes of a beautiful labour.

And, like Trish, she may choose to have a vaginal birth after cesarean on her living room floor, while the trees blow outside.

And, like Shelley, she may not believe that her second birth could actually be easy until the last minute, and give birth standing up in the hospital bath-tub, then order baby back ribs for dinner.

She is not alone.
She can do this,
no matter what happens

This is her story.

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet

Tuesday, April 07, 2009

Food, glorious food!

Women often ask me if they can eat once they're in labour.

"The books say I shouldn't, but I'm such a hummingbird eater, that I'll keel over if I don't keep eating!"

"Oh, please listen to your body, and it will let you know what you should eat, and when you should eat," I answer.

Think of the fuel that your body needs to do this amazing work! It needs fuel and fluids to function properly. Can you imagine doing a marathon, triathlon, or long-distance bike race without any nourishment? You'd be the one saying, "I bonked so early, it was embarrassing!"

But hospitals are slow to change their policies. Some local hospitals provide lunch trays to women in labour, but others discourage food intake, "in case she needs general anesthetic." A client's husband (an anesthesiologist) recently reminded everyone that he provides general anesthesia to accident victims who've probably just eaten their dinner, and everything is fine. And, he asked, just how many times do labouring women require general anesthetic in labour? Probably not enough to make it necessary to starve all the other women.

I remember being at a midwifery conference 19 long years ago. A young British midwife had dared to study food intake in labour. She found that there were far more complications among women who didn't eat in labour. She also found that most women naturally throw up at around 5-6cm., and that it's better to throw up something than nothing - way less acidic! All the midwives stood and gave her a round of applause, and declared that this would put an end to giving women only ice chips in labour.

But, 19 years later, that paper, and all the subsequent research, hasn't totally filtered down to the community level. And, "don't eat in labour" is still in so many of the childbirth books!

The hundreds of stories that I could tell about eating in labour...

But, here's just four memorable ones...

The British woman who made me sit there while she finished making a full roast beef and yorkshire pudding dinner. When it was ready, she sat down, took a mouthful, took a break to huff and puff, then ate another mouthful, took a break to pant... She kept going until her plate was empty. Then, and only then, were we allowed to take her to the hospital.

The woman who lived on the top floor of an old house behind the Park Theatre. She grabbed a tupperware container full of scones, to eat in the car on the way to the hospital. The container was empty by the time we arrived at the hospital. Her water broke as she walked through the doorway. She was deaf, so she would laughingly ignore anyone who tried to tell her what she could or could not eat.

The woman in Yaletown who asked her husband to cook her "an omelette." Well, he made a 3 egg omelette thick with peppers, mushrooms, onions, and sausages. Unbelievable! She walloped it off! (Sorry, to translate - "walloped it off" means "ate it really fast!")

The Burnaby woman with a black belt in Tae Kwon Do who had her husband run to the market to buy her papayas. She ate two. (Little did she know that her natural urge had led her to eat a fruit which can increase the power of uterine contractions.)

These women all arrived at the hospital late in labour, and had their babies in short order.

Food, glorious food!

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet

Sunday, April 05, 2009

An adagio hits a day of speed at full force

I've noticed that I can manage most things as long as I move slowly through the day.

Within a few weeks, my children and parents will all be living within an easy bike ride.

I can walk or ride my bike to visit most of my clients. (Yes, you can expect helmet head when the weather is good!)

I can walk home from both BC Women's and St Paul's after births (there's nothing like breathing in the crisp early morning air as I walk over the Burrard Street bridge at 6am.)

The huge physical and emotional effort required to be intensely focused on a labouring woman and her family for hours and hours (sometimes days) is only possible when I live slowly, with intention, and gain strength by moving through the world using only the power of my legs.

Last week, I was reminded of how I used to live with the continual drain of moving at high speed. (How did I spend 17 years doing the 60km daily return commute from Tsawwassen?) So, there I was, driving along the highway to visit my best friend in Crescent Beach (I can only manage this 90km drive about once a month, now that we live a Slow Life). My iPhone alerted me to three email messages, two clients called to talk about miscarriage (on speaker), another called to let me know that she was in early labour, my mum called to say that my dad's blood test showed that his leukemia was gaining an upper hand and a blood transfusion would be needed soon, and a postpartum mum called to talk about her baby's latch.

And behind all of that, like a sound of a cellist playing Albinoni's Adagio in the background - pulsing, throbbing - was the vision of a client's beautiful 8-month-old daughter who had just lost her battle with an unknown lung disease. She is the first child ever lost to a client in 21 years.

The sad music of her mother's face.

I could have handled it all, if I'd been riding my bike, drawing on the strength of my body, the pumping of my heart, feeling connected with the world. But, somehow, it just all seemed too much, driving at 110km/h. 120 km/h. The adagio had hit this day of speed at full force.

I needed to be slow. I needed physical and emotional nourishment. I needed to be home. I needed to sleep long and deep. I needed to help a new mum and her baby that afternoon. I needed to visit a joyful pregnant woman. I needed to cry. I needed to hug. I needed to dig in the garden with my dad. I needed to help a baby come into the world. I needed to ride down a hill and breathe.

And, once I was back home, I was able to do all that, and more. I regained my footing, and I was able to be there, focused and strong, for everyone, and for myself. Slowly.

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet

Saturday, April 04, 2009

"The light is round like a ring and we move within its movement."










Inside the light

your soul circles
winding down until it dies out,
growing like the ringing of a bell.

And between dying and being born again
there is so little room, nor is the frontier
so harsh.

The light is round like a ring
and we move within its movement.

from Not Everything is Now by Pablo Neruda


How do I write about the hidden realities of pregnancy? How do I write about the "opposite of birth"? How do I write about that unknown space between life and death?

In this blog I focus on the joy of working with pregnant women, attending their amazing Slow Births, and helping them through their postpartum journeys. But there are other journeys that some must travel. I hear their stories. Now, it's time to start telling some of these stories.

Because so many clients stay in touch with me after their first birth, I'm often one of the first people to hear about the second pregnancy: "I'm signing you up right away this time!" I've even had some phone calls from the bathroom! "Guess what?!"

But, since it's estimated that up to 20% (or more?) of all pregnancies may actually result in miscarriage, I also receive a number of phone calls each month from those same women - as they experience early pregnancy loss. They call me from bathrooms, from cars, from bedrooms.

"I started spotting this afternoon. What does it mean?"
"I just felt such a strong sense of dread that I went to the ultrasound knowing that something was wrong."
"I thought I was 14 weeks, but it stopped growing at 8 weeks."
"They say it was an empty sac, an anembryonic pregnancy. They say it was never a baby."
"I wasn't feeling sick any more, and I just knew."
"I think I'm having a Slow Miscarriage."
"I took the misoprostol and NOTHING HAPPENED. Can't believe it."
"Tennis ball sized things (blood clots) were coming out. I collapsed."
"I'm really struggling."
"It all happened the way it was supposed to. It was sad and awful. But it was even more empowering and incredible than those more negative things."
"I don't really know how to move beyond this sadness."
"We will try again, soon, I hope."


Eight clients have traveled this journey of loss in the past month. One woman is going through her second loss since last October, when she lost twins. Some have gone for a D&C instantly. Some have waited for weeks for everything to happen naturally. One travelled to Ontario and miscarried in her mother's home. No one had a miscarriage that was what she expected. Each story is completely different.

Sometimes, a woman and her partner must travel this journey alone, because the pregnancy loss can happen so early that she's not even seen her doctor or midwife. She doesn't know where to go, what to do. The Early Pregnancy Loss Clinic at BC Women's Hospital offers medical care, support and guidance, and Family Physicians and Counselors can help with the changing emotions that follow miscarriage. But, often, my clients call me because they know I've been through this experience personally, and have gained wisdom from the stories gathered from other women. Each woman knows that I will focus on her alone and listen as she tells her story, listen when she gets angry, and listen when words just won't work any more.

We hold our stories up to the light. We tell our stories to each other. We won't forget.

To start, this is my story. I never had a hard time physically with miscarriage. Both times, everything came away quickly, deeply, with me sitting in a red bath at home. Thankfully, I never bled too much nor too long. The physical aspect did not scare me. It felt right, complete, connected. I healed gently.

But, the first time I miscarried, in March 1986, all I could think was - Where did the lost spirit go? What was the spirit's purpose? Would it ever come back again? Was this its only time here as a physical being? I couldn't get the image of the lost spirit out of my head. I needed some meaning. And I was lost.

My husband couldn't help me. He wanted to help, but his loss was different, more theoretical. I needed stories told by women. I asked women for their stories of pregnancy loss, and heard nothing. It was still a time of whispers - "I hear she lost her baby, poor thing." Only my mother told me her stories of loss, why there were five empty years between my brother and me, and why I had a mental snapshot of her being carried out of our bathroom by large men (another pregnancy loss after a car accident when I was two). Only after I'd heard all her stories was I able to integrate my experience and find understanding.

When I miscarried a second time, in March 1988, while I was still breastfeeding my second baby, I was relieved. Yes, relieved. I admit it. I was so thankful that I wouldn't have to give up precious time with my son, precious time with my daughter. Did this lost spirit come and go just to help me decide that I only wanted two children? I really didn't feel any sense of loss. I looked at guilt and chose not to let it in. The miscarriage felt necessary, right, complete, connected.

Those losses eventually merged with the intense joy of being alive, being able to look up at the sun shining through the trees, knowing that everything is connected. We are all connected.

Now, all these years later, in March 2009, eight women called to tell me their stories of loss. Just like all the women who have come before them, they continue to tell me their stories, so we don't forget. We hold each other up to the light with our stories.

Each telling and retelling makes life feel more real, more exquisitely beautiful for its fragility.

The light is round like a ring
and we move within its movement.

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet