I've been a practicing midwife for over twenty years, my entry into midwifery
was not intentional. In the early 1970s I was invited to attend the births
of a few friends. Then more friends became pregnant and asked me to be
their midwife. It was common for women to have their babies at home at
that time. Pretty soon I had more experience than anyone else in the area.
I realized I needed to learn more, so I began studying and training with
a female M.D. who ran a childbirth clinic in the town two hours from where
I lived in rural British Columbia.
In 1981 I attended the fifth water birth in the United States. It was
for a couple who were part of the rebirthing community in San Francisco.
Rebirthing is a breathing technique that is used to help resolve traumas
that can happen during birth. This couple wanted the gentlest birth experience
they could create for themselves and their baby.
A filmmaker was invited to film the birth
for the couple. There was a TV screen set up in the next room, where their
friends could watch. Waterbirth was new, and I wasn't sure about it.
A pediatrician was there as well; we both decided we would do the birth
if the other one of us stayed. Everyone ended up in the birthing room.
We were all profoundly affected--seeing a woman laboring in water totally
relaxed and open, with no tension whatsoever, saying positive affirmations
as she delivered her baby. There was so much love.
After her head was born, the baby opened her
eyes, looked around and connected with everyone. She was born to her waist,
and then slowly and gently came out into the water. The dad supported her
underwater while I monitored her heart rate. Once I saw a relaxation response
and felt she was fully in her body, she was gently brought up to her mother's
arms to take her first breath. That took just ten to fifteen seconds--not
a long time.
Karil, the filmmaker, was so inspired by the
experience that she decided to go to France to film Michele Odent, a doctor
who was doing lots of water births at a center outside of Paris. Then she
went to Russia and filmed Igor Charkovsky, who had started doing water
births back in the 1970s when his daughter was born prematurely. Although
he was told that she had no chance of surviving, he was inspired to put
her in a tub of warm water. She was there for twenty-four hours a day,
and thrived. He found that if the body doesn't have to deal with gravity--and
gravity is a form of stress--then it is better able to heal itself.
Over a five year period, Karil created the documentary:
"Water Baby: Experiences of Water Birth." It starts with the water birth
in San Francisco and includes footage of Michele Odent, Igor Charkovsky
and Michael Rosenthal. Rosenthal had a water-birth center just outside
of LA. He has attended thousands of water births, and has gathered statistics
to show their safety for both moms and babies.
A tub of warm water is an ideal place for
a laboring woman. It helps her to relax and tune into her instincts. It
is very effective for pain control. The more relaxed a woman is during
her labor, the more her hormones and endorphins can flow, allowing the
birth to progress naturally. It is very difficult to be tense when you
are floating in warm water!
For about five years I stopped practicing midwifery, after realizing
that I was infertile. This discovery was incredibly traumatic and painful
for me. I tried to become pregnant using in vitro fertilization
The door that opened for us to have our family
was through open adoption. We were blessed with the arrival of a beautiful
baby boy, Benjamin Raphael, whom we adopted at birth. I was able to nurse
Benjamin and produced about seventy percent of the milk he needed. The
rest was donated breast milk given to him via a supplemental nursing system.
Later we switched to goat's milk, to which I added nutritional supplements
according to a naturopath's recipe.
One day I received a call from a pregnant
woman who wanted to have a waterbirth. I was the only midwife in the area
with waterbirth experience, though I had only attended seven or so at the
time. Another midwife was willing to facilitate the birth if I would assist.
It turned out that this midwife was in a car accident and couldn't use
one arm--and she had three women due within the next week. She begged me
to come and help her, so I agreed. Once again I was drawn back into midwifery.
In 1988, I challenged the Arizona midwifery licensing program, and
passed the state exam, becoming the first midwife in Arizona who was licensed
through apprenticeship. My family and I moved back to California in 1991.
After the Licensed Midwifery Practice Act was passed here in 1993, a challenge
process was also developed. This means that both nurse-midwives and licensed
midwives can now legally attend home and hospital births in California.
The difference is that certified nurse-midwives are nurses first, who then
go through a midwifery program, whereas licensed midwives learn only midwifery.
I passed the California challenge process in 1997, becoming number sixty-four
in the state.
From the beginning of time, women have been
supporting other women in birthing . The traditional midwife safeguards
the natural process of pregnancy, labor, and birth. Midwifery is an art--taught
woman-to-woman--the art of empowering women. We help women to trust in
themselves and their ability to be a channel for life.
Obstetrics has only been around for 100 years
or so. We often think that birth was made safer when it was moved to the
hospital, but this isn't true. Safety is a result of improved hygiene,
economic status, nutrition and access to prenatal care, not a result of
hospitalization. In fact, the move to the hospital created more life-threatening
infections for birthing women until doctors learned to use chemicals to
clean their hands and instruments.
As a midwife I want to establish a relationship of trust with the pregnant
woman. It is important to get to know her intimately: How is her relationship
with her partner? How is her home situation? What is her emotional make-up?
How does she deal with stress and with pain? Everything in her life becomes
a factor in how she will give birth. Those are all things that a midwife
Whatever tension she has in her life will
affect her ability to give birth, and needs to be dealt with. If she needs
more emotional support, I may suggest that she seek counseling. It is important
for her to safely give voice to feelings that come up around birth. A pregnant
woman needs someone to listen to her, to tell her that she is doing fine,
and to help her find her resources. She needs to be encouraged to reach
out to her family and friends for support.
I spend two hours at a first prenatal visit.
We go through everything in great detail, including nutrition. Nutrition
is the number-one gift a mom can give her unborn, so I give it the time
it deserves. I schedule an hour for each follow-up prenatal. That's a long
time to spend, but I feel that it's important. I encourage dads to come,
and the kids. The whole family is involved.
Most of us did not see babies being
born as we were growing up; we didn't have an opportunity to see what normal,
natural birth is like so that we could trust the wisdom of the body. Children
are usually removed from witnessing birth, death and even illness. Natural
events that could be part of their lives become mysterious and secret medical
events. What we see instead, in movies and television, are frightening
images of birthing women totally out of control. These need to be replaced
with healthier images.
In childbirth, I often see women replay their own births--generally
subconsciously. It is helpful for women to find out what happened when
their mothers birthed them, and to heal unresolved issues from past abortions,
infertility, or difficulties giving birth. In this way, giving birth
won't bring up so much fear from past pain.
The infant's nervous system is totally open at birth;
the birth imprint affects them physically, emotionally and mentally. Whether
gentle or traumatic, birth is like a flavor that carries forward, leaving
an impression of what being alive and being in the world is like.
Birth is a sacred event. It is the time
when spirit--not just the body--comes into manifestation. Like death, it
is a huge, deep, profound transition. If birth is not approached as sacred,
the baby will feel, "What is going on here? Why am I not being honored
for who I am as a spiritual being?" A non-sacred approach to birth causes
confusion and trauma for that incoming spirit. Being born and having the
opportunity to live, learn, give of ourselves, and connect with other people
is a gift to be honored from the very beginning.
Indigenous cultures know and recognize the
sacredness of birth, but our culture tends to approach it as a technological
event. If the baby and the mother are alive and not sick, then that's considered
a successful birth. Well, it's not! It's just a beginning. A much deeper
perspective is necessary to heal the split we've created between the body
Because many women have to focus on basic survival needs, they don't
get into the spiritual reality of birth. This is a tragedy. The child that
is coming forth is a gift for everyone, not just "another mouth to feed."
The entire community needs to rally around the pregnant woman, so she doesn't
experience a sense of isolation.
A doula is an advocate for the birthing woman. Doula
means "mothering the mother." She is there during labor, birth and also
postpartum. Research studies show that women who have doulas present are
able to handle the pain of labor more successfully, and their ability to
have natural, vaginal deliveries is much greater.
Our ancient wisdom needs to be brought back
into modern birth practices. During labor, a woman's instinctual self knows
what to do--how to breathe, how to move and how to birth her baby. When
we direct a birthing woman too much, we give her the message that knowledge
of her body is outside of herself. For her to access her intuitive instincts,
she needs a natural environment--low lights, quiet atmosphere, non-intrusiveness--
allowing her and her supporter(s) to have a sense of privacy and co-empowerment.
As a midwife, I remind myself to stay out of the picture (while monitoring
for problems) as much as possible. I hold the space of knowing that the
mother already knows how to give birth. Some women want me to be actively
involved, but many don't need that.
Birth is a very intimate experience--a sensual/sexual
experience. A birthing woman is luscious, full and ripe. She needs to be
given privacy and respect so she can get in touch with her birth energy.
It's so easy to interrupt, disrupt and interfere. If the sacred space is
intact during labor and birth, then she will be strong and beautiful in
her birth work, even when it is difficult.
During labor and birth, a woman is very sensitive
to changes in her environment. In the hospital, it's disruptive when one
nurse's shift ends and a new one comes on duty. The doula and/or midwife,
maintains continuity by staying with a woman throughout her labor and birth.
I ask the women I work with about their dreams, because dreams are a
strong indicator of their unconscious feelings and thoughts. If a pregnant
woman has frightening dreams about her baby, talking about them helps her
to deal with those fears. Acknowledging the fear is often all she needs
to do to release it. Sharing joyful dreams gives her the opportunity to
express the magic of her unconscious, intuitive side. Dreams are a powerful
avenue for doing the healing inner work that needs to be done. As healing
progresses, this is reflected in the dream life.
Some people approach dreams by trying to understand
the meaning of symbols, but symbols are different for different people.
For me, the feeling in the dream is what is most important. This approach
provides a simple way to access what a dream is about.
People wonder why childbirth has to be painful. It's an interesting
question. Why couldn't God/Goddess have made the pelvis one centimeter
bigger to make things easier? I feel that the pain of childbirth forces
a woman to surrender to something higher than herself. You can't give birth
while you are in control. It's impossible. So a woman has to surrender,
surrender, surrender. The hormones flow; the endorphins come in, life comes
through. That incredibly beautiful experience is the reward.
Giving birth teaches humility, patience, surrender
and perseverance. Through selflessness, a woman experiences true giving.
Birth demands being totally present with each moment. If she starts worrying
about the next moment she will surely "lose it." So the pain of childbirth
forces her to experience many spiritual truths directly--making a woman
a great mother, a strong mother. This gift of wisdom only comes when she
is allowed to give birth from inside of herself.
Trying to make sense of my own infertility,
I asked myself, "Why should I have to go through this as a midwife? Here
I am, serving other women who are having this great experience that I am
not allowed to have." For whatever reason, infertility has been my avenue
for birth and surrender. I couldn't control my ability to become pregnant.
I had to surrender, trust, and learn that in humility. The same spiritual
lessons of childbirth are available to us in whatever experience life brings
us--poverty, illness, wealth. Life's truth and wisdom transcends the small
perspective of our ego.
The Native Americans say that the mother-child is the first environment.
If we don't honor that first environment as sacred, then the family becomes
ill, becomes diseased. Then the community becomes diseased; the environment
and the whole planet become diseased. A culture that does not honor the
primary unit will have problems--major problems.
A child is born complete: an individual with
its own thoughts, beliefs and feelings. When an adult treats a child as
if he or she is nothing, the child feels stifled. How can this child grow
up with self-respect? In my experience as a child, when I voiced my thoughts
I was often told, "Oh no! You are just a child. What do you know?" The
truth is that children often see things more clearly than adults who are
shut down to their own beauty and knowing.
After birth, when a baby cries, a person may
think, "Isn't that great? She is opening up her lungs." But even in crying,
babies are communicating to us. We need to listen to children, and hear
what they have to say. We say "no" to children's spirits by considering
their thoughts or feelings as silly or childish. This causes children to
distrust themselves. If children are forced to go outside their inner knowing
to find what is real, it creates a kind of schizophrenia--anxiety, neurosis,
all types of disease and illness. If we see and encourage the innate goodness
in them, children will live their lives from that place of goodness.
In the hospital a woman's body is treated like a machine. She is hooked
up to other machines that evaluate her body's function or malfunction.
An IV becomes the umbilical cord attaching her to the hospital--to regulate
her labor with pitocin, or to hydrate her because she isn't allowed to
eat and drink anything. Although IV's aren't routine, too many women end
up with them.
Continuous fetal heart monitors are routine
and inhibit a woman's ability to move freely. If the baby is doing OK,
the mother is monitored fifteen minutes each hour. Nurses can monitor a
whole ward from the nurse's station. Crazy! As everyone watches machines,
the focus is removed from the woman's own knowing, and her trust in her
Here in the United States, where ninety-five
percent of births are attended by physicians in hospitals, we spend the
most money on maternity care per capita and use more technology than any
other country. Yet out of twenty-five industrialized nations, the US ranks
3rd from the bottom in safety for babies living through the first month
of life. What does this teach us? One intervention typically leads to another,
and this cascade of technology puts the mother and baby at risk. Seventy
percent of US hospital deliveries are instrument assisted--either forceps,
vacuum extraction, or cesarean section.
In developed countries that have the best
outcomes for mothers and babies, seventy percent of births are attended
by midwives. Worldwide, midwives attend eighty percent of all births.
Contrary to what most people believe, statistics
consistently show that midwife attended births and homebirths are
as safe or safer than doctor-attended hospital births. Homebirth only becomes
dangerous when doctors and hospitals refuse to provide backup care.
Obstetricians are trained to look for and manage
complications. Their job is important in high-risk situations, but this
small minority can usually be screened during pregnancy and/or delivery.
During normal births OBs tend to intervene unnecessarily.
"Active management of childbirth" means regulating
a woman's labor with pitocin, a synthetic hormone, according to a preset
schedule, (Friedman's curve), not her internal rhythm. Pitocin induced
contractions are much more painful and difficult to manage than natural
ones--making a woman much more likely to need pain medication, which leads
to further complications.
Obstetricians do episiotomies on about sixty
percent of all women and ninety percent of first-time moms. A midwife helps
a woman to prepare for birth so that she will not tear. She works with
breathing, provides perineal support, and uses warm cloths and oil on the
In hospital births, women are often given
pain medications such as Demerol or epidurals. At least fifty-percent deliver
with epidural anesthesia. Women aren't told about the adverse and dangerous
effects of these drugs--such as lengthening labor, lowering blood pressure,
causing fetal distress, making pushing ineffective, and causing breathing
problems for the infant after birth. A medicated woman is much more likely
to end up with a forceps delivery, vacuum extraction, or cesarean birth.
Drugs are considered normal during birth. Yet, if
a woman were to use drugs, smoke or drink alcohol during her pregnancy,
she would be criticized. Any woman in heavy labor or transition will think
that she can't deal with the pain. She will want help. That's natural.
But if she has prepared for the birth and has the support she needs, she'll
know that transition doesn't last very long and that she can most likely
manage without medication.
Drugs also interfere with the instinct of
bonding, and create a tendency toward depression, anxiety, drug addiction,
and violence. A Swedish study published in the British Medical Journal
in 1998 showed that individuals who committed violent suicides were subjected
to about twice as many interventions at birth than their siblings. They
were also more prone to depression, substance abuse, and schizophrenia.
There are many reasons to re-evaluate our
approach to childbirth, and for giving women more information to help them
make informed choices. I used to think that double-blind studies and statistics
would change medical practices. In spite of the many studies proving that
the midwifery approach to childbirth is safer than the medical approach,
the bias against midwives persists.
I sympathize with the predicament of the obstetrical
profession. Our cultural conditioning to expect perfect outcomes from every
birth is unrealistic. It forces doctors to pay ridiculous premiums for
liability insurance and to perform procedures just to protect themselves
legally. But death and illness are natural to life.
The evidence is clear that professional midwives
should be the care providers during normal pregnancy, birth and postpartum.
When medical intervention is indicated, the midwife would consult or transfer
care to an obstetrician. This system, recommended by the World Health Organization,
makes the best use of the expertise of both professions. The result would
be less medical intervention, fewer cesareans, better maternal-infant outcomes--at
a savings to our health care system of thirteen to twenty billion
dollars per year.
As a midwife supporting natural childbirth, I wanted to find a system
of medicine in alignment with the laws of nature. I began to study homeopathy,
and eventually became a certified homeopath. Homeopathy rebalances a person's
immune system so that they can heal naturally. Since homeopathy addresses
inherited patterns of health and disease, the ideal time to get homeopathic
treatment is prior to conception. The healthier the parents are, the healthier
their child will be. However, homeopathy can be safely and effectively
used at any time during pregnancy and birth.
Homeopathy is a complete system of medicine
and is widely used throughout the world. At the turn of the century, about
100 medical schools in the U.S. taught homeopathy, and there were about
about twenty-two homeopathic hospitals. However, due to the competitiveness
of allopathic medicine, funding was withdrawn
from homeopathic institutions and doctors were forbidden to practice or
consult with homeopaths. This was not the case in other parts of the world.
My book, The Homeopathic Childbirth Manual,
teaches childbirth professionals (whether beginning or experienced homeopaths)
how to use specific remedies. During birth, homeopathy can prevent hemorrhaging,
help expel the placenta, start labor, turn a breech or posterior baby,
ease a woman's sensitivity to pain, prevent or heal tearing, episiotomy
or caesarean section. The list goes on. In newborns, it can be used for
shock, birth trauma and breathing problems, and later for colic, teething
pain and infections, etc.