Finally! I am a certified birth doula(DONA International)
I am so excited that my certification is complete. It took just over a year to finish my certification process and I couldn't be happier. The only sad thing is that I'm not practicing at the moment. Hopefully I will be practicing again soon!
Thank you to everyone who helped make this happen. Especially Celeste R., Aya K., Genelee and Cody S., The PATH Clinic of Honolulu, Tara, Mike and Dylan B., Annie R., Suzette L., Herbert and Akeem H., Dr. S. Hartman, Rina C., Uta M., and all of my family and friends for the support!
Monday, August 31, 2009
Friday, August 28, 2009
Medicalization of Childbirth
Over the past 100 years, birth in the United States has changed drastically. Some argue that birthing today is better than ever because we are taking advantage of technological advances to make birth safer for women and babies. However, we must also examine and recognize the affect that these changes have on women and their birth experiences. Is our “improved” way of birthing really a change for the better? Feminist theory explores the many existing challenges American women face when they birth in the United States.
In the 1700s, 1800s and early 1900s, women all over the world gave birth at home. Although it was not exactly their choice to do so, women gave birth in their own homes, barns, sheds, and even on street corners with friends and family by their sides. One midwife, Martha Ballard, kept records of her experiences while attending births. She noted that of 814 births she attended from 1785 to 1812, no mothers died during childbirth, only 5 died in days after birth, 14 babies were stillborns, and 5 babies died shortly after birth (Chase & Rogers) This may seem like too many deaths but we must take into consideration the high likelihood of this midwife’s lack of medical training, and access to technology and equipment.
In the early 1900s, male doctors suddenly became a part of the womanly process of giving birth. It was seen as an improvement in one area of birth, as doctors provided a “safer” environment if anything were to go wrong. Along with this came the struggle for women to birth in their own ways, the ways they had been for so many years. The power was swiftly shifted from women to men.
One example of this power shift is birthing positions. For hundreds of years, women had birthed in any way they were comfortable, including squatting, sitting, laying, standing, and even on their hands and knees. As soon as men entered the delivery room, women were told to lay flat on their backs with their legs up and open. The flat on the back position of giving birth became standard. Women were ultimately brainwashed into thinking that this was the best and only way to birth. This new standard birth position often caused more pain for women and led to slower progression of the baby down the birth canal.
By the 1940’s hospitals became the hot spot for childbirth. Half of all births took place in a hospital because taking advantage of a clean, safe facility filled with doctors seemed like the most logical thing to do. However, often times, the doctors who were in charge of caring for laboring women were unfamiliar with the normalcy of live birth as they had little or no hands on experience taking care of women in labor and delivering babies. This resulted in very poor care for laboring women. By 1960, the hospital birth rate was almost 100%.
One major problem with this drastic shift from homebirth to hospital birth was the weeding out of midwives. In many other countries, when birth moved into the hospital, with the women went the midwives. However, this did not happen in the United States. Many doctors did not support the attendance of midwives at birth as it was often seen as unnecessary seeing as the doctor would be available when needed. To understand the problem with this, one must recognize the major difference in care provided by the two.
Lay midwives were women who attended birth to oversee the progression of the laboring woman and her baby. Although these women were not trained properly, medically speaking, they had perfected the effective ways to comfort a women giving birth by witnessing many births and hands on experience. A person who properly comforts a woman during labor and delivery can make all the difference in the outcome of a birth experience. This is what was lost when hospitals and male physicians became the main place and method of delivery.
Another result of medicalized birth is a high rate of intervention, which often times leads to more intervention and is usually unnecessary in the first place. Interventions such as twilight sleep (in the early 1900s), inductions, episiotomies and cesarean sections (C-sections) are some of the common happenings at hospitals. Normal, natural and usually perfectly healthy events such as slow progression of labor and trouble pushing the baby through the vagina are excuses frequently used by doctors to step in and intervene.
Many women in the 60s, 70s, and 80s lived through traumatizing events during their births. One woman shared her birth experience from 1972, “Upon arrival, I was taken to a small, barren room to be “prepped,” meaning my pubic hair was shaved and I was given an enema. I didn’t get a vote in this process; it was standard procedure for al laboring women…from this moment forward, I couldn’t leave the bed, sit, stand, roll over, or leave the room” (Seelhoff, 42). This type of practice is an example of birthing protocol in many hospitals during this time.
In the 1970s, after too many women went through experiences similar or equivalent to the latter, they joined forces and initiated the Women’s Health Movement and the Natural Childbirth Movement. Women began to take control of their bodies, and their births. Homebirth and midwives made a come back and birthing centers were established as an alternative to hospitals and provided a safe, comfortable, homelike place for women to give birth. Women attended each other’s births to provide emotional support and physical comfort for one another.
While a small percentage supported the Natural Childbirth Movement, the majority women stayed where they thought they belonged, in the hospital. The C-section rate was climbing and the quality of care of declining. By 1990, the C-section rate was 23.5% and many of these were elective. Many people began to see the C-section option as a safe alternative to going through the pains of childbirth. What many people did not realize was the amount of risks associated with an elective C-section, such as infection, injury to mother’s internal organs, heavy blood loss, a painful recovery and the recurrence of C-section. These risks are often hidden or kept “hush hush” to keep up the façade that hospitals and doctors are the safest best.
Today, we see the vast majority of women in America give birth in a hospital. Less than 1% of women give birth at home, and midwives attend only 8% of births. Feminist views of birth in the United States include the theory that birth has become medicalized and is illogically seen as risky. Within this theory is idea that women have lost control of power when it comes to giving birth since male doctors began attending birth in the early 1900s. Birth can be a natural, beautiful process if we let it be. Unfortunately for our women and babies, today this is not the norm.
Media is also very fond of portraying birth as a dangerous process, one that needs to be handled by doctors, and doctors only. We often see dramatic births on TV in shows like ER, and Grey’s Anatomy. This gives us a distorted view of the way birth really is. Another problem is the celebrity trends regarding birth. Many celebrity icons including Britney Spears, Angelina Jolie and Madonna have given birth via elective C-section and are very publicly honest about it. This has created the false thinking that an elective C-section is the best, safest, and pain free way to go. This is a major problem because it means more women surrendering power to their doctors and not taking initiative to make informed decisions about their births.
Many people believe there are no choices about giving birth. We have seen a lack of education among the American people about the benefits of using a midwife and/or having a homebirth. We do, however, see the hospital birth represented as the best way for every woman to give birth. Although many people do not know this, today midwives are medically trained to handle most instances in which something has gone wrong in the birthing process or with the baby or mother. The rare cases when something occurs that a midwife cannot handle are few and far between. When this does occur, midwives have a back up hospital and doctor available and can transfer the woman to ensure she has the best medical care.
The unfortunate truth is that birth in the United States has become extremely medicalized. We must see that it is very important for women to have the information that allows them to make the choices for how they want to give birth. It is a right that every woman deserves and through educational support, we can work toward providing these empowering choices for women in the United States.
In the 1700s, 1800s and early 1900s, women all over the world gave birth at home. Although it was not exactly their choice to do so, women gave birth in their own homes, barns, sheds, and even on street corners with friends and family by their sides. One midwife, Martha Ballard, kept records of her experiences while attending births. She noted that of 814 births she attended from 1785 to 1812, no mothers died during childbirth, only 5 died in days after birth, 14 babies were stillborns, and 5 babies died shortly after birth (Chase & Rogers) This may seem like too many deaths but we must take into consideration the high likelihood of this midwife’s lack of medical training, and access to technology and equipment.
In the early 1900s, male doctors suddenly became a part of the womanly process of giving birth. It was seen as an improvement in one area of birth, as doctors provided a “safer” environment if anything were to go wrong. Along with this came the struggle for women to birth in their own ways, the ways they had been for so many years. The power was swiftly shifted from women to men.
One example of this power shift is birthing positions. For hundreds of years, women had birthed in any way they were comfortable, including squatting, sitting, laying, standing, and even on their hands and knees. As soon as men entered the delivery room, women were told to lay flat on their backs with their legs up and open. The flat on the back position of giving birth became standard. Women were ultimately brainwashed into thinking that this was the best and only way to birth. This new standard birth position often caused more pain for women and led to slower progression of the baby down the birth canal.
By the 1940’s hospitals became the hot spot for childbirth. Half of all births took place in a hospital because taking advantage of a clean, safe facility filled with doctors seemed like the most logical thing to do. However, often times, the doctors who were in charge of caring for laboring women were unfamiliar with the normalcy of live birth as they had little or no hands on experience taking care of women in labor and delivering babies. This resulted in very poor care for laboring women. By 1960, the hospital birth rate was almost 100%.
One major problem with this drastic shift from homebirth to hospital birth was the weeding out of midwives. In many other countries, when birth moved into the hospital, with the women went the midwives. However, this did not happen in the United States. Many doctors did not support the attendance of midwives at birth as it was often seen as unnecessary seeing as the doctor would be available when needed. To understand the problem with this, one must recognize the major difference in care provided by the two.
Lay midwives were women who attended birth to oversee the progression of the laboring woman and her baby. Although these women were not trained properly, medically speaking, they had perfected the effective ways to comfort a women giving birth by witnessing many births and hands on experience. A person who properly comforts a woman during labor and delivery can make all the difference in the outcome of a birth experience. This is what was lost when hospitals and male physicians became the main place and method of delivery.
Another result of medicalized birth is a high rate of intervention, which often times leads to more intervention and is usually unnecessary in the first place. Interventions such as twilight sleep (in the early 1900s), inductions, episiotomies and cesarean sections (C-sections) are some of the common happenings at hospitals. Normal, natural and usually perfectly healthy events such as slow progression of labor and trouble pushing the baby through the vagina are excuses frequently used by doctors to step in and intervene.
Many women in the 60s, 70s, and 80s lived through traumatizing events during their births. One woman shared her birth experience from 1972, “Upon arrival, I was taken to a small, barren room to be “prepped,” meaning my pubic hair was shaved and I was given an enema. I didn’t get a vote in this process; it was standard procedure for al laboring women…from this moment forward, I couldn’t leave the bed, sit, stand, roll over, or leave the room” (Seelhoff, 42). This type of practice is an example of birthing protocol in many hospitals during this time.
In the 1970s, after too many women went through experiences similar or equivalent to the latter, they joined forces and initiated the Women’s Health Movement and the Natural Childbirth Movement. Women began to take control of their bodies, and their births. Homebirth and midwives made a come back and birthing centers were established as an alternative to hospitals and provided a safe, comfortable, homelike place for women to give birth. Women attended each other’s births to provide emotional support and physical comfort for one another.
While a small percentage supported the Natural Childbirth Movement, the majority women stayed where they thought they belonged, in the hospital. The C-section rate was climbing and the quality of care of declining. By 1990, the C-section rate was 23.5% and many of these were elective. Many people began to see the C-section option as a safe alternative to going through the pains of childbirth. What many people did not realize was the amount of risks associated with an elective C-section, such as infection, injury to mother’s internal organs, heavy blood loss, a painful recovery and the recurrence of C-section. These risks are often hidden or kept “hush hush” to keep up the façade that hospitals and doctors are the safest best.
Today, we see the vast majority of women in America give birth in a hospital. Less than 1% of women give birth at home, and midwives attend only 8% of births. Feminist views of birth in the United States include the theory that birth has become medicalized and is illogically seen as risky. Within this theory is idea that women have lost control of power when it comes to giving birth since male doctors began attending birth in the early 1900s. Birth can be a natural, beautiful process if we let it be. Unfortunately for our women and babies, today this is not the norm.
Media is also very fond of portraying birth as a dangerous process, one that needs to be handled by doctors, and doctors only. We often see dramatic births on TV in shows like ER, and Grey’s Anatomy. This gives us a distorted view of the way birth really is. Another problem is the celebrity trends regarding birth. Many celebrity icons including Britney Spears, Angelina Jolie and Madonna have given birth via elective C-section and are very publicly honest about it. This has created the false thinking that an elective C-section is the best, safest, and pain free way to go. This is a major problem because it means more women surrendering power to their doctors and not taking initiative to make informed decisions about their births.
Many people believe there are no choices about giving birth. We have seen a lack of education among the American people about the benefits of using a midwife and/or having a homebirth. We do, however, see the hospital birth represented as the best way for every woman to give birth. Although many people do not know this, today midwives are medically trained to handle most instances in which something has gone wrong in the birthing process or with the baby or mother. The rare cases when something occurs that a midwife cannot handle are few and far between. When this does occur, midwives have a back up hospital and doctor available and can transfer the woman to ensure she has the best medical care.
The unfortunate truth is that birth in the United States has become extremely medicalized. We must see that it is very important for women to have the information that allows them to make the choices for how they want to give birth. It is a right that every woman deserves and through educational support, we can work toward providing these empowering choices for women in the United States.
The Purpose and Value of (Labor) Support
The Purpose and Value of (Labor) Support
Often times the littlest things can have the biggest impact. Emotional, physical and educational labor support is something that is too frequently overlooked and sometimes even seen as unnecessary. However, doulas, and most childbirth educators, midwives, nurses, and obstetricians know that effective labor support can make the difference between an ordinary birth experience and one that is extraordinary and often times empowering and life-changing for the mother and father. In my work as a birth doula I have had the opportunity to see the tremendous benefit that this type of support provides women and families.
The only thing I have to compare birth to is my small (relatively speaking) accomplishment on December 20, 2008. Although it is not exactly comparable, I feel that this experience could not have been completed without the amazing support that I received and for that reason, I feel it was similar to the journey of childbirth.
When I decided to run the Honolulu Marathon I was excited, but definitely nervous. I knew I could do it but was scared nonetheless of the long 26.2 mile journey ahead of me. Before I began my training, I knew I needed to find a reliable, supportive, and determined team to train with. I found a friend, Abby, who had run a marathon before and asked her if she wanted to be my training partner. She agreed and so the preparing began. Another friend, Jen, joined in the beginning stages of our training program even though she wasn’t planning on running in the big race. A few weeks into it, we managed to convince Jen to sign up and officially join our training team. Training was a journey in and of itself. We spent countless hours together, running around the city of Honolulu, hoping it would pay off. Some days I was completely unmotivated to run but my two partners kept me positive and enthusiastic. A week before the big day, we set out of our longest and second to last run. It was tough but exhilarating and got me excited for the marathon.
The morning of the marathon, I woke up at 3 am. Feelings of excitement came over me, as I realized it was the day I had been waiting and training for. I also felt scared and uncertain about what the next 7 or 10 hours might bring. When my boyfriend and I got into the car to head to the marathon start line, I started to get really nervous and had butterflies flying about my stomach. When we arrived at Jen’s house, she and Abby got into the car. I immediately felt a sense of comfort and relief, knowing that these two strong ladies would be there to accompany me on my 26.2 mile run. I was entering an unfamiliar world, one that I was beginning to wish I had never signed up for, until I saw their smiling faces.
When we arrived at the starting line I felt ready, even though I was still a little anxious. Abby looked at Jen and I and said “don’t worry, you can do it”. That was all I needed to hear. When the gun went off, we took off. Within minutes, Abby was gone, as she was a much stronger racer than both Jen and I. We stayed together for almost 14 miles, encouraging one another and keeping the energy between us strong and positive. After I lost Jen, I had a hard time. I hit “the wall” and I was all alone. My legs were burning and I was just plain tired of running. Just when I was on the brink of giving up, I found comfort in the faces and words of the locals who sat outside their homes on this rainy Honolulu morning just to cheer us on. The support made all the difference. I finished after 5 hours with a smile on my face even though my body was in pain. When I found Jen after the race, we hugged and congratulated each other on our big accomplishment.
When I began my training as a birth doula, I realized that the value of labor support is very necessary and actually quite invaluable, similar to the support I received when I was training and racing. When a pregnant or laboring woman has the unconditional support of another individual who has the passion and energy for the remarkable journey and process of pregnancy and childbirth, she feels safer and has more confidence in herself. When she has this confidence, she can find the inner strength to complete her amazing task of giving birth, whichever way is most satisfying for her. As long as we are there, to provide her with she needs and wants, whether it is a cool cloth, a back or foot rub, or just some kind words of encouragement, she will feel that she has been cared for. Too often these little but significant details are overlooked and not seen as an important part of caring for women in labor. We, as doulas, know better. We know the value of continuous, unconditional (labor) support.
Often times the littlest things can have the biggest impact. Emotional, physical and educational labor support is something that is too frequently overlooked and sometimes even seen as unnecessary. However, doulas, and most childbirth educators, midwives, nurses, and obstetricians know that effective labor support can make the difference between an ordinary birth experience and one that is extraordinary and often times empowering and life-changing for the mother and father. In my work as a birth doula I have had the opportunity to see the tremendous benefit that this type of support provides women and families.
The only thing I have to compare birth to is my small (relatively speaking) accomplishment on December 20, 2008. Although it is not exactly comparable, I feel that this experience could not have been completed without the amazing support that I received and for that reason, I feel it was similar to the journey of childbirth.
When I decided to run the Honolulu Marathon I was excited, but definitely nervous. I knew I could do it but was scared nonetheless of the long 26.2 mile journey ahead of me. Before I began my training, I knew I needed to find a reliable, supportive, and determined team to train with. I found a friend, Abby, who had run a marathon before and asked her if she wanted to be my training partner. She agreed and so the preparing began. Another friend, Jen, joined in the beginning stages of our training program even though she wasn’t planning on running in the big race. A few weeks into it, we managed to convince Jen to sign up and officially join our training team. Training was a journey in and of itself. We spent countless hours together, running around the city of Honolulu, hoping it would pay off. Some days I was completely unmotivated to run but my two partners kept me positive and enthusiastic. A week before the big day, we set out of our longest and second to last run. It was tough but exhilarating and got me excited for the marathon.
The morning of the marathon, I woke up at 3 am. Feelings of excitement came over me, as I realized it was the day I had been waiting and training for. I also felt scared and uncertain about what the next 7 or 10 hours might bring. When my boyfriend and I got into the car to head to the marathon start line, I started to get really nervous and had butterflies flying about my stomach. When we arrived at Jen’s house, she and Abby got into the car. I immediately felt a sense of comfort and relief, knowing that these two strong ladies would be there to accompany me on my 26.2 mile run. I was entering an unfamiliar world, one that I was beginning to wish I had never signed up for, until I saw their smiling faces.
When we arrived at the starting line I felt ready, even though I was still a little anxious. Abby looked at Jen and I and said “don’t worry, you can do it”. That was all I needed to hear. When the gun went off, we took off. Within minutes, Abby was gone, as she was a much stronger racer than both Jen and I. We stayed together for almost 14 miles, encouraging one another and keeping the energy between us strong and positive. After I lost Jen, I had a hard time. I hit “the wall” and I was all alone. My legs were burning and I was just plain tired of running. Just when I was on the brink of giving up, I found comfort in the faces and words of the locals who sat outside their homes on this rainy Honolulu morning just to cheer us on. The support made all the difference. I finished after 5 hours with a smile on my face even though my body was in pain. When I found Jen after the race, we hugged and congratulated each other on our big accomplishment.
When I began my training as a birth doula, I realized that the value of labor support is very necessary and actually quite invaluable, similar to the support I received when I was training and racing. When a pregnant or laboring woman has the unconditional support of another individual who has the passion and energy for the remarkable journey and process of pregnancy and childbirth, she feels safer and has more confidence in herself. When she has this confidence, she can find the inner strength to complete her amazing task of giving birth, whichever way is most satisfying for her. As long as we are there, to provide her with she needs and wants, whether it is a cool cloth, a back or foot rub, or just some kind words of encouragement, she will feel that she has been cared for. Too often these little but significant details are overlooked and not seen as an important part of caring for women in labor. We, as doulas, know better. We know the value of continuous, unconditional (labor) support.
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