Why I Chose Midwifery Care

I am five months pregnant and have not seen a doctor.

The Lion and I enjoy a primal lifestyle. Of course, we also enjoy a lot of what modern technology has to offer (including running water, electricity, and the internet!), but we also appreciate the more primitive aspects of being human, like being outside and getting sun, avoiding processed foods, sweating, sleeping with the sun cycle, and generally being introspective and in-tune with our mental and emotional needs. Along those lines, a birth that is heavily medicated, in an unfamiliar setting, with hospital lighting bearing down and the smell of chemicals and sterility surrounded by strangers watching me pee/poop/fart does not sound like an experience that I would enjoy (I mean, if I’m going to pee/poop/fart with an audience then it might as well be with people I feel relatively more comfortable with, right? : )!

My first exposure to midwifery care was through a book called Baby Catcher, recommended to me by a friend who had a homebirth with their son a few years ago in LA. The book is a collection of stories and experiences by the author, Peggy Vincent, a California midwife. Baby Catcher made me laugh out loud and cry, and it really opened my eyes to the possibility of giving birth naturally, at home, with someone you trust, and with as little intervention as needed. Thus, when I became pregnant, I decided to research more about midwifery care and what it entails to determine if it really was the right path for me.

When I saw what the midwifery model of care entailed, I was hooked:

The midwifery model of care is based on the fact that pregnancy and birth are normal life events. The midwifery model of care includes: monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle; providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support; minimizing technological interventions; and identifying and referring women who require obstetrical attention. The application of this woman-centered model has been proven to reduce the incidence of birth injury, trauma, and cesarean section. —The Midwifery Task Force

The first sentence in the midwifery model of care struck me as unusual because I had never heard or thought of birth and pregnancy as “normal life events,” but indeed, birth is a natural “instinctive act.” Our bodies have evolved through million of years to provide the best possible outcomes for mothers and babies, provided that we understand and care for our bodies the way that nature intended during this normal physiological process. As many of you probably know, women’s hormones are changing drastically during pregnancy, and that’s no different for during childbirth and afterwards too. The brain is producing hormones related to excitement (epinephrine/norepinehprine), love (oxytocin), mothering (prolactin), and pleasure (endorphins) during pregnancy, labor, and childbirth to elicit instinctive mothering behavior in humans. Oxytocin also causes the uterus to contract, adrenaline increases heart rate and makes us feel courageous, giving laboring women the “power” necessary for the final pushes, and endorphins rise and help block the reception of pain.Physically, the laboring mama is driven to move more, and sometimes, even to sing, grunt, groan, moan, or to shower/relax in a bath. Those options are not always available to women who choose to give birth in hospitals (as Vincent recalls in Baby Catcher). Women who are feeling afraid or self-conscious [in front of strangers] tend to secrete hormones that delay birth. In quiet, semidark, private conditions, the laboring mama can let down her guard and let her instincts take over. I knew that working with a midwife was a first step to accomplishing this, where I would be allowed to have the lights lowered, to stay in a comfortable place (my home), to move about freely as needed, and to be with loved and trusted ones as I begin one of the most challenging times of my life.

I also knew that I wanted the individualized care of a midwife (or in the case of the birth center I’m working with, three midwives!), hands-on care, and postpartum support. I am a unique person who has had a unique health history and will have a unique pregnancy and birthing story, so why shouldn’t my care be tailored to me? My most recent experiences with doctors in the dental industry were not pleasant; my dentist told me that nutrition is unrelated to teeth health, that I shouldn’t believe everything on the internet (I read books, not webpages), and did not ask a single question about my dental history. The endodontists I visited seemed impatient with my questions and complimented me on being a “biochemical major” when I asked questions. One of the endodontists I visited had even started pulling out her tools, ready to perform the “routine root canal procedure” the day of my consultation! So, this was certainly not the type of experience and attitude I wanted throughout my pregnancy or at the birth of our first child. When I go to my prenatal appointments, I wait no more than 10 minutes in the waiting room. The staff at the birth center know me by name and face. They know The Lion by name and face. The midwives ask me how I’m feeling, they listen and commiserate, they host picnics and events for everyone to interact (the midwives, the parents, the doulas, the birth assistants, the staff), and they ask for my health and nutrition history. I get the feeling that they are mother- and baby-centric; I trust that when I go into labor, I can call them for help or advice, even if it isn’t during office hours. I trust that I have a choice and won’t be pressured to make a biased one. This is the kind of help and promise that I want and appreciate as a newbie mom. When I interviewed the head midwife of my birth center, I asked her what she expects of her clients. She responded, “I expect them to stay healthy, educated, and relaxed.” This is exactly the kind of pregnancy and childbirth that I want to have!!

As for minimizing technological intervention but also encouraging women who need obstetrical attention to seek it, this is a big point that I think many people have missed of midwifery. When I first told my family that I plan to birth with a midwife, they immediately became concerned of the risks of birthing out of hospital. Luckily, the midwives aren’t above asking for help when they (or the laboring mama) need it! The Lion and I live very close to a hospital, and we have discussed what will happen should I need to be transferred to the hospital. Furthermore, the midwives at my birth center are certified nurse midwives. In other words, they know and can perform the same duties as a doctor, except surgery. I hope to have an “undisturbed birth.” As described above with the hormonal processes, birth is a very complex physiological process, and it is extremely sensitive to outside influences. Many techniques that are used in hospitals to monitor a laboring woman is painful or uncomfortable and usually involve strangers overstepping personal/bodily boundaries. In addition to the distrust of a woman’s birthing ability and their body’s natural processes, these are ingredients for a difficult birth. This is not to say I will have a solitary or isolated birth. I believe that once I am in labor, I will need all the help and support (physical, mental, emotional) I can get to cope with the pain! But a midwife’s method to coping with pain is not to medicate, but rather to understand where the sensation originates from and whether a change of position, attitude, atmosphere in the birth room, or another factor can help mitigate this discomfort.

My main concern with this pregnancy and birth experience is NOT to avoid pain at all costs, but rather to have a healthy baby in the most natural, healthy, accepting way possible. I am so excited to have these midwives be my advocates and guardians during childbirth!!

(I don’t cover the risks of cesarean surgery, epidurals, opiate painkillers, synthetic oxytocin and other synthetic hormones, ultrasounds, early clamping, and inductions here because they require their own blog post and more astute meta-analysis. Buckley’s book (link below) provides a much more in-depth analysis of these and other common interventions of birth. I hope to write a review/summary of her book at a later date.)

Notes – Real Food for Mother and Baby

Real Food for Mother and Baby

by Nina Planck, published 2016

This was one of the first books I read on fertility/pregnancy because we already had it in our library (see The Lion’s review of it).  Planck’s book dispelled some commonly held beliefs on what pregnant can/cannot consume and further confirmed that the way I eat currently is optimal to maintaining good health. Some interesting/important points I found throughout her book:

  • Exercising during pregnancy is good for mother and baby. Walking, running, swimming, dancing, cycling, rowing, hiking–but never to the point of fatigue. Listen to your body and rest as needed.
  • In the second trimester, the growing baby needs protein and calcium to build bone and muscle, so take cod liver oil, eat protein and saturated fats, and drink milk and eat sour cream and cheeses. Raw is better than pasteurized, and supplements are not as effective. Drink the best milk you can afford.
  • Swelling in the hands and feet is a sign of protein deficiency, so try to eat 100g daily of meat/poultry (skin + bones), fish, eggs, and milk.
  • Salt your food freely (with unrefined sea salt) because blood and amniotic fluid are briny! And eat plenty of fresh produce for potassium
  • Keep up the calcium intake even though the baby’s skeleton has formed by six months because the bones are still bulking up. Eat oysters and beef for zinc, and eat protein (meat, dairy, eggs) to prevent swelling and prematurity. Obviously, drink lots of water and eat tons of fish to aid in baby’s brain development!
  • “Don’t avoid fish, just methylmercury.” No shark, swordfish, King mackerel, or tilefish. Two to three times per week, consume anchovy, common mackerel, salmon, catfish, trout, tilapia (wild caught and fresh) and be generous with the butter and cream (creamy clam chowder for days, yum…).
  • On Birth Day: the atmosphere should be dark, private, and quiet. After birth, hold the baby naked against your skin and ask to delay bathing and weighing. Let the baby look at you, smell you. Newborns aren’t dirty, but if bathing is necessary, do so gently without removing the white stuff (vernix). Try not to cut the cord until the placenta is delivered.
  • The mama’s hormones are working on realigning after birth, so emotions may still be up and down. Continue the diet of red meat, fish, and liver to prevent worsening the baby blues.
  • Get lots of help on practical matters so you can gently surrender to your baby’s needs, unpredictable as they are.
  • Breastfeed [exclusively] if possible (and for as long as possible! At least for 6-12 mos) because breastmilk contains probiotics, antibodies, amylase, and boosts immunity for the newborn. Keep eating well.
  • From four to ten months (once they can sit up), babies can try real food, as long as theres not vomiting or diarrhea. At seven months, the baby can eat seafood, pork and dairy. At one year, time for the baby to start his/her cod liver oil supplements!
  • Let the baby choose what he/she wants to eat, don’t micromanage/point/stare/direct. Do less, RELAX.
  • Surrender your old life temporarily to be the mother that nature intended. Ask for help (cooking, cleaning, grocery shopping), and nurse on cue (aka when the baby asks).
  • Watch the baby, not the clock! There is no schedule for breastfeeding.
  • Bread and chocolate (grains and sugar) are inevitable, so try to find ones with good, clean ingredients. Let your child know over time why you favor certain foods over others. Try not to let the child fill up on bread before fats and protein.

TL;DR Avoid trans fats and pesticides. Buy organics and avoid hydrogenated vegetable oils, margarine, vegetable shortening, and cheap fried foods.

TL;DR2 Breast feed your baby. Nurse after the baby starts eating. Delay or skip vaccinations. Spend time on farms and outside in the dirt. Touch animals. Drink raw milk.

Hollywood’s Version of Childbirth

The Lion and I are enjoying watching Scrubs, an American medical comedy-drama TV series, lately. The show is entertaining but also somewhat discouraging, given that it is reportedly the most accurate medical TV show when compared to House, Grey’s Anatomy, and ER (so… McDreamy and McSteamy don’t actually exist?!). As a preggo woman, I found this bit particularly entertaining (and particularly disappointing…)!

The following video is one of the fantasy sequences from Season 2 (text script after the jump):

 

Randy and Jackie, the parents, are beaming in the background.

Narrator: Congratulations! You’re expecting! Don’t worry — your doctor will tell you everything you need to know.

J.D. steps into camera shot in a lab coat and horn-rimmed glasses.

Narrator: Hi, Doctor!

J.D.: You’ll fart, pee, puke, and poop in front of ten complete strangers who’ll be staring intently at your vagina — which, by the way, has an eighty percent chance of tearing!


It is true that a pregnant woman will likely fart, pee, and poop during childbirth, but it certainly doesn’t have to be in front of ten complete strangers. And the vagina is much more flexible than this short sequence makes it out to be. Oh, and your Dr will definitely not tell you everything you need to know because, well, you’re a woman and not a doctor or scientist and definitely incapable of research and rational thought, and if you really cared about your baby, you’d listen to the experts!

What the video doesn’t tell its audience is that episiotomies (the procedure involving cutting the perineum to enlarge the vaginal opening) are routinely performed and recommended by doctors themselves (they are the ones encouraging intervention and injury!). According to Ina May Gaskin, a Certified Professional Midwife and described as “the mother of midwifery,” most women are well equipped to give birth without the slightest injury, as long as they have the appropriate help, preparation, atmosphere, and consideration. As Gaskin quips in her Guide to Childbirth book, 

Men take it for granted that their sexual organs can greatly increase in size and then become small again without being ruined. If obstetricians (and women) could understand that women’s genitals have similar abilities, episiotomy and laceration rates in North America might go down overnight.

Furthermore, [the perception of] ten complete strangers judging your bodily excretions as you perform a miracle certainly does not constitute the appropriate atmosphere! The techno-medical model of maternity care sees the female body as full of shortcomings and defects, and pregnancy and labor are seen as illnesses which must be treated with drugs, medical equipment, and technological intervention. Doctors and obstetricians commonly believe that birth is only safe in retrospect, and mind and body are considered separate. Because of this belief, emotional ambience and psychological well-being is only important in terms of marketing and not actually comforting to the woman. When I think of hospital births, I imagine a woman laboring in an unfamiliar bed smelling like bleach or other cleaning chemicals in an unfamiliar, uncomfortable gown, hooked up to electronic fetal monitors, intravenous tubes, and other pressure- or heart-rate reading devices, devices that the average woman does not know how to operate (and wouldn’t be allowed to operate anyway, as a patient). During labor, the woman is restricted from eating, moving, or drinking, and since labor pain is unacceptable and indicative of weakness, analgesia and anesthesia are encouraged. The woman is a passive object, she is the barrier to the baby’s birth, and there is no room for individual variation. Her decision-making ability is seen as part of her shortcomings, and she must defer to the doctor/obstetrician “if she truly cares about her baby.”

Since the aforementioned is the common belief of hospital staff and obstetricians, then yes, I completely agree with the sentiments expressed in this video–childbirth is indeed scary and unpleasant!

Of course, now that I know these things, my birth plan will be a little different… I will attempt to briefly explain the advantages that midwifery care has in a separate, later post 🙂

Video – The Truth About Breastfeeding

We plan to breastfeed our infant. This video provides a lot of information about the benefits of breastfeeding. It doesn’t discuss any “risks”, although I am not sure that is a meaningful concept when analyzing an evolutionary biology-based parenting practice. Below the video is a summary of some of the key points if you do not wish to watch the video:

  • The benefits of breastfeeding imply exclusive use, ie, no supplementation with bottle feeding, formula or solid foods
  • Breast milk is the most complete form of nutrition for infants; it also allows the mother to pass her antibodies to the baby to improve its immunity to disease
  • The skin-to-skin contact of breastfeeding creates hormonal release that leads to bonding
  • Breastfeeding is connected to improved brain development in infants (compared to non-breastfeeding), especially with regards to language development, emotional function and cognition
  • The hormonal release also assists with post-partum healing of the mother’s body and delays the return of ovulation during breastfeeding, preserving the mother’s stores of iron and creating “natural” spacing between pregnancies
  • Childbearing and breastfeeding have shown significant decreases in a woman’s risk of developing different forms of cancer in clinical studies

Review – Real Food For Mother And Baby

Real Food For Mother And Baby

by Nina Planck, published 2009

For me, reading this book simply resulted in confirming a lot of biases I already have regarding ideal nutritional practices. Those confirmed biases could be reduced down to:

  • make most of what you eat yourself
  • when eating animals, use as much of the animal as you can (including bone, skin, organs, etc.)
  • when eating fruits and vegetables, use what is in season when possible
  • focus on organics and other traditionally raised and cultivated foods
  • avoid eating things that were not regularly consumed 100 years ago
  • avoid anything processed, “packaged” sweetened or artificially preserved
  • eat more fat than you’re “supposed to” and don’t get your nutritional advice from headline news or the government

There’s more to it than that, but that’s a good start to revolutionizing the way most moderns/Americans eat in the West.

The book is essentially 200pgs of these broad outlines and a few more specific guidelines, along with basic scientific information on why this is the right way to eat and how various research agrees. The advice is good for women (and men) planning to conceive, women in pregnancy, nursing mothers and babies ready to eat things besides breast milk.

In other words, the “best” diet for fertility, childbirth and infancy, is also the best diet for children and adults in terms of achieving optimum health outcomes and maximizing genetic fitness and expression.

The weakest part of the book is the author’s condoning of various “cheats” and nutritional oversights based on the arbitrary logic of “a little poison now and then won’t kill you”, and it was a let down to learn that after following these nutritional practices she still ended up getting drugged out and giving birth by C-section during her own pregnancy.

Mothers to be will probably find the affirmative tone and validative diction of the book enjoyable. And for some this will be a revelation. For me, I didn’t get a lot new. It did get me to think about how hopeless health (and intelligence?) outcomes must be for generations of people in communities without the knowledge, incentives or resources to eat this way. It also got me thinking about how easy it is to overdo good nutrition, to obsess about it and give it undue consideration. It’s important, yet spending your life on feeding yourself doesn’t leave time for much else which to me is like luxurious primitivism.

The ‘Downs’ of Pregnancy

“What goes up, must come down.” That saying certainly applies to my mood, especially during pregnancy when a woman’s hormones are going crazy!

My last post on how pregnancy is going so far was a mostly positive one, and I think I had written it on an ‘Up’ day. Today was a bit of a ‘Down’ day, continued from a couple of days ago. On Friday, I had noticed a considerable shift in mood. The day started out well, I walked our dog before it got too hot out, I went to breakfast with a good friend, and then I met my MIL to do some furniture shopping. All in all, a good morning. But as the day wore on, and as the sun grew more intense, I started feeling more and more overwhelmed by everything. I had chores and errands to do that weren’t laborious, and I had the rest of the afternoon to do them, but for some reason, it was difficult for me to get the motivation up to complete them. One chore that really held me up that day was meal planning; my project was to come up with a dinner plan for the evening and meal plans for the weekend and then go shop for groceries, but lately I’ve been feeling uninspired by my cooking, making the task of meal planning extremely draining, frustrating, and disappointing. Eventually though, I settled on a few meal ideas and finished my errands, but not without some tears.

I don’t remember much of what yesterday was like, but in the evening, the Lion and I drove up to LA to have dinner with a couple of friends. It was a really good time, but we ate a lot of rich and heavy foods* (friend entrees, bread and crackers, ice cream, and presumably inordinate amounts of sugar), and we didn’t get to bed until almost midnight. This morning, we slept in until 9AM, and I woke up with the makings of a headache already in place. My headache today has waxed and waned, but it has been noticeable enough for me to consider today to be a ‘Down’ day 😦

I consider myself very fortunate to not have had constant morning sickness or heartburn during pregnancy (though I’ve heard heartburn can begin in third trimester…), but these headaches are certainly a contender for causing discomfort, annoyance, and generally being day-ruiners!! Since I don’t want to take any medicine during pregnancy, I try to combat these headaches with quiet time, massaging my temples, Chinese medicinal oil (/eucalyptus oil), and short naps. These methods help me get through the day, but they don’t cure the headache. Oh, another method is early bedtime. Speaking of which…

*During this pregnancy, I’ve noticed that when I overload on sugar (eg, a bottle of soda at our July 4th dinner) or gluten (eg, a bowl of leftover udon noodles for lunch), a headache will develop almost instantly. And this constant heat does NOT help.

Experiencing Pregnancy as a Woman

(The Lion’s version: Experiencing Pregnancy as a Man)

It’s funny how greetings change as your life does. I went from hearing, “How’s wedding planning going?” every day for a year until our wedding date to “How are you feeling?” now that I’ve announced my pregnancy on social media. I guess it is more personal than the “How are you today?” that we receive every where so I can’t complain. Plus, most of the people who have asked me how I am feeling are genuinely curious and ready to hear me explain how I’m actually feeling, and for that patience and thoughtfulness, I am grateful and appreciative.

My pregnancy (17 weeks, day 1 today) has been great so far.  It hasn’t been all great these last four months, as I’ve had about 3-4 outstanding rough days (including one day of pretty terrible morning sickness) that included headache and crankiness and feeling generally uncomfortable, but overall, I feel happy and content.

I don’t feel like there has been a [huge] shift in my personality or mood, although I have noticed that I am crankier when I don’t get 2-3 naps in throughout the day. I am eating slightly less meat (I used to eat about a half pound of protein per meal), I find that I crave vegetables more (salads, veggie sticks and dip, and more salads), and I prefer to eat smaller meals throughout the day rather than three big meals (read: I love snacks!). I haven’t had any weird cravings for dirt, chalk, fast food, tuna ice cream, or much sweet stuff (now, that’s not to say that I wouldn’t eat In-N-Out if it was right in front of me!). And I’ve found that if I DO have cravings for fast food or sweet stuff, I can find something else desirable to snack on, like apples and almond butter or a couple pieces of dark chocolate or some cheese and nuts, and feel satisfied enough to stave off the craving. I am also continuing my aerial dance workouts. Mostly because I see all of my good friends there, but also because I always leave the class feeling accomplished and happy. I used to train “hardcore,” approximately 3-4x per week for 1-3hours each time, but I’ve noticed a mental shift since I’ve been pregnant: my desire is no longer to “train” or learn new death-defying tricks, but rather to perfect the basics (like learning to do the same moves but on my less dominant side), to feel the music, and to just dance. I think this helps me to tune into what my body is feeling, and it has helped me to gain acceptance of the changes that’s going on physically and mentally. It also helps a lot that many women who are in my classes are moms themselves and have also experienced this change!

I believe a lot of what is contributing to my positive experience of pregnancy so far is my diet and exercise regimen. I eat a lot of protein (grass-fed, pasture-raised, wild-caught) and fresh vegetables (organic), and I eat a little fruit (also organic, and seasonal) for dessert. I drink fresh squeezed orange juice, whole milk (raw milk, occasionally), and homemade bone broth and kombucha. I exercise every day by taking our dog on a morning walk and an afternoon walk (sometimes also an evening walk, but a lot of times I’m asleep already :), and I am at the aerial fitness studio 3-4x per week stretching, dancing, and weight training.

I am also preparing mentally and emotionally by reading a variety of books on pregnancy nutrition, child birthing, and child raising (all to be reviewed on this blog at a later date…). These books help give me an idea of what to expect, realistically, and how to accept these changes instead of fighting them. I believe that because I have this knowledge of what pregnancy is like, I am less anxious about what is happening to my body. Furthermore, being prepared with a plan on how we want to raise our child means less stress during pregnancy!

Now, on to research about what pregnancy pillow is best for sleeping…