The Power of Birth Language

30 APRIL 2010.

http://bringbirthhome.com/guest-writers/the-power-of-birth-language/

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Birth Safety as a Binary Condition

by guest blogger Morgan A. McLaughlin McFarland 

The ways in which we choose to describe a situation or relationship often shed light on our beliefs (be they conscious or subconscious) about the balance of power within that situation or relationship. The language that we use also shapes how we perceive a situation and how we will act when confronted with it.

Consider if you will, the word “let” when applied to a birth or a care provider/birthing mother relationship.

How broad is the gulf between “my care provider supports my plan to give birth in water” and “my care provider is letting me give birth in water?” Both describe the same situation–a mother and her midwife/doctor both agree on the safety/efficacy of the water birth–but while the first statement places the power in the hands of the mother, the second places it in the hands of the doctor.

In the first statement, the mother has come to a decision and then conferred with her care provider, who agrees with and supports that mother’s choice to birth as she sees fit. In the second statement, the mother has sought and been granted permission to pursue a certain type of birth.

Another word that misplaces the power of birth is “deliver.”

The same birth could be described in two ways: “I gave birth to my baby [in the care of Dr. Smith]” or “Dr. Smith delivered my baby.” Where is the mother in the second statement? The difference in the balance of power in those two statements is obvious, because in the second, the mother is presented as irrelevant to the birth, which exists only as a relationship, a delivery, between the baby and doctor.

Do our babies really need to be delivered from us, liberated or saved from our bodies? Should we deliver our babies into the hands of others, as though they were pizzas or packages places in someone else’s care? An empowered mother births or gives birth to her baby; she is not delivered by a doctor or midwife. Using this language, she is the initiator of the experience, an active participant in the action, and the care provider’s role is to attend the birth or assist the birthing mother.

We believe birthing women are clients of the care provider and that the care provider works for the mother, rather than seeing birthing women as patients of a doctor/midwife authority figure to whom they must defer.

As adult women preparing to bring another life into the world, we must be empowered enough to stop seeking permission from doctors, nurses, and midwives. We must not put ours births into their hands for delivery, but claim our rightful place as the source of the birth experience. We must be careful in the language we use to describe, not just our own pregnancies/births, but the pregnancies/births of others.

If we are to own our birth experiences, we must remember that care providers require our permission to act, not the other way around.

While changing your language can’t guarantee a perfect birth experience for yourself or anyone else, being aware of your word choice can help you be more empowered through even a less than ideal birth experience. Women who believe in their right to weigh the costs/benefits of interventions, choosing the course of action they believe is safest for their babies and themselves, are less likely to feel a sense of disempowerment and anger after the birth is over.

Even if choice is between a rock and a hard place, simply owning the responsibility to make that choice is empowering. Owning your birth experience can give immeasurable strength. The first step to that ownership is language.

Take a moment to consider why you might choose words like “let/allow” and “deliver” to describe a birth experience, especially if you’re using those words in the context of expectations for an impending birth.

If you are wondering if your midwife/doctor will let you do something, consider examining why you, as an intelligent, empowered adult, need permission to do something your body already knows how to do. If you think of the birth process as a delivery, consider questioning why you frame it within the context of that language.

Giving away our power verbally or in writing creates a paradigm in which we condition ourselves to surrender our power in actuality. When your language paradigm shifts to place mothers and babies at the center, and providers on the periphery, so, too, will your beliefs shift.

As you think and write and speak, so shall you live. As you live, so shall you birth.

Home Birth is Safe says new study

By Amanda Gardner, HealthDay http://www.usatoday.com/news/health/2009-09-03-midwife-home-birth_N.htm

Having your baby at home with a registered midwife is just as safe as a conventional hospital birth, a new study says.

In fact, planned home births of this kind may have a lower rate of complications, according to the study published in the Sept. 15 issue of CMAJ.

Even though the study was conducted in Canada, where attitudes toward midwifery are more accepting than in some other countries, the findings may help to calm an ongoing controversy in the United States and elsewhere.

The American College of Obstetricians and Gynecologists is opposed to home births, as are certain organizations in Australia and New Zealand. More organizations in Great Britain are supportive and Canadian provinces are currently transitioning to midwifery, said study lead author Patricia Janssen, director of the Master of Public Health Program at the University of British Columbia.

Janssen, a registered nurse who has midwife training though not certification, said: "People who function as independent midwives are not necessarily tightly regulated [in the U.S.] depending on which state you're in, so there may not be a guarantee that they have had an adequate level of training or a certified diploma or anything like that. And they may not be monitored and regulated by a particular professional college."

The controversy has resulted in a lack of clear regulation and licensing requirements in the United States, said Dr. Marjorie Greenfield, associate professor of obstetrics and gynecology at University Hospitals Case Medical Center in Cleveland.

According to Greenfield, the National Association of Certified Professional Midwives does have a certification process but many states don't recognize it. "If you're a woman who wants to have a home birth, how do you determine if this person has appropriate qualifications?" she said.

The authors of the new study compared three different groups of planned births in British Columbia from the beginning of 2000 to the end of 2004: home births attended by registered midwives (midwives are registered in Canada), hospital births attended by the same group of registered midwives, and hospital births attended by physicians. In all, the study included almost 13,000 births.

The mortality rate per 1,000 births was 0.35 in the home birth group, 0.57 in hospital births attended by midwives, and 0.64 among those attended by physicians, according to the study.

Women who gave birth at home were less likely to need interventions or to have problems such as vaginal tearing or hemorrhaging. These babies were also less likely to need oxygen therapy or resuscitation, the study found.

The authors acknowledge that "self-selection" could have skewed the study results, in that women who prefer home deliveries tend to be healthier and otherwise more fit to have a home birth.

Janssen said she hoped "this article will have a major impact in the U.S." But there is a definite "establishment" bias against home births. And the issue is an emotionally charged one, she said.

"There is a political and economic issue about controlling where birth happens, but also a deep belief by physicians that it's not safe to have your baby at home," Greenfield said. "Doctors see every home-birth patient who had a complication, but we don't see the ones that have these beautiful, fabulous babies at home who may breast-feed better or have less hospital-acquired infections. There may be medical benefits," she added.

"Midwifery needs to be regulated. It can't be under the radar because then it's dangerous," Greenfield said. "There has to be a regulatory process and a licensure process [to protect] women who are going to choose home birth anyway."

5 Ways Pitocin is different than oxytocin

The numbers of inductions of labor using artificial means likePitocin and other medications has gone up dramatically in the last few years. A hospital in my area says that 90 of the women have their labors induced. Since science shows us that inducing labor can increase the numbers of complications in the labor and with the baby, you might be surprised to note that many of the inductions are not for medical reasons, but rather reasons of convenience, practitioner or mother, known as social induction.

One of the things that women tell me is that they are lead to believe that induction is completely safe and relatively easy, after all, Pitocin is just another form of the body's own oxytocin, right?

While this statement is generally true, artificially created hormones, including Pitocin do not act identically to the hormones in ones body. For example, in pregnancy both the mother and the baby produce oxytocin. The oxytocin produced by each reacts differently in the body because they each have separate jobs.

Here are five things that you may not know about Pitocin and how it can effect your labor:

• Pitocin is released differently. 
  Oxytocin is released into your body in a pulsing action. It comes intermittently to allow your body a break. Pitocin is given in an IV in a continuous manner. This can cause contractions to be longer and stronger than your baby or placenta can handle, depriving your baby of oxygen.
• Pitocin prevents your body from offering endorphins. 
  When you are in labor naturally, your body responds to the contractions and oxytocin with the release of endorphins, a morphine like substance that helps prevent and counteract pain. When you receive Pitocin, your body does not know to release the endorphins, despite the fact that you are in pain.
• Pitocin isn't as effective at dilating the cervix. 
  When the baby releases oxytocin it works really well on the uterine muscle, causing the cervix to dilate. Pitocin works much more slowly and with less effect, meaning it takes more Pitocin to work.
• Pitocin lacks a peak at birth. 
  In natural labor, the body provides a spike in oxytocin at the birth, stimulating the fetal ejection reflex, allowing for a faster and easier birth. Pitocin is regulated by a pump and not able to offer this boost at the end.

• Pitocin can interfere with bonding. 
  When the body releases oxytocin, also known as the love hormone, it promotes bonding with the baby after birth. Pitocin interferes with the internal release of oxytocin, which can disturb the bonding process.

Your body's own natural oxytocin is superior in many ways to Pitocin. There are also ways to increase the release of this natural oxytocin including skin-to-skin contact, lovemaking, breastfeeding, and others.

So, if you are presented with the option of an induction of labor, you might want to ask your provider about whether or not it is being done for a medical reason or if it's something that a bit of time and patience will help alleviate.

_Sources:

_{American College of Obstetricians and Gynecologists [ACOG]. (2004). ACOG Practice Bulletin No. 55: Management of postterm pregnancy. Obstetrics and Gynecology, 104(3), 639-646.}

_{Glantz, J. C. (2005). Elective induction vs. spontaneous labor associations and outcomes. Journal of Reproductive Medicine, 50(4), 235-240.}

_{Kramer, M. S., Rouleau, J., Baskett, T. F., & Joseph, K. S. (2006). Amniotic-fluid embolism and medical induction of labor: A retrospective, population-based cohort study. The Lancet, 368(9545), 1444-1448.}

_{Leaphart, W. L., Meyer, M. C., & Capeless, E. L. (1997). Labor induction with a prenatal diagnosis of fetal macrosomia. The Journal of Maternal-Fetal Medicine, 6(2), 99-102.}

_{March of Dimes. (2006). If you’re pregnant: Induction by request. Retrieved May 15, 2007, fromwww.marchofdimes.com/prematurity/21239_20203.asp}

_{Sanchez-Ramos, L., Bernstein, S., & Kaunitz, A. M. (2002). Expectant management versus labor induction for suspected fetal macrosomia: A systematic review. Obstetrics & Gynecology, 100(5), 997-1002.}

_{Vahratian, A., Zhang, J., Troendle, J. F., Sciscione, A. C., & Hoffman, M. K. (2005). Labor progression and risk of cesarean delivery in electively induced nulliparas. Obstetrics & Gynecology, 105(4), 698-704.}

_{Vrouenraets, F. P., Roumen, F. J., Dehing, C. J., van den Akker, E. S., Aarts, M. J., & Scheve, E. J. (2005). Bishop score and risk of cesarean delivery after induction of labor in nulliparous women. Obstetrics & Gynecology, 105(4), 690-697.}