Monday, September 26, 2016

Running from Mountain Lions

A few weeks ago, I found myself having a conversation with a woman who had had an unintentional natural birth. She was horrified by the experience. She couldn't understand why anyone would ever have a natural birth on purpose. I've spent some time pondering that conversation and I'd like to share my thoughts.

When I was pregnant with my first baby almost 21 years ago, I was terrified of birth. I took the "epidural class" and, fortuately, I gave birth not feeling a thing. What I hadn't planned for were those few hours of contractions before going to the hospital. I had ZERO coping tools. It was awful. I cried when I got to the hospital, not because I was in so much pain, but because I could finally have the drugs. I was dilated to a 3 and 90% effaced. I can't imagine doing the whole thing without drugs as ill-prepared as I was. 

With my second baby, I got educated. I prepared mentally, physically, and emotionally for the experience. I put a good birth team together and I was ready for the experience. I went in feeling confident, unlike my first birth where I would tense up with every contraction, scared of what was happening.

Let's use a little example. Stay with me. I've moved to the beautiful Black Hills of South Dakota. The mountain lions are prevelant. A neighbor took this picture of prints she found in the morning near her house. We hear them at night. It sounds like a woman screaming in the forest. Really, it's terrifying.

Naturally, I've developed a fear of the mountain lions. What if I were hiking and one was lurking in the trees and pounced? What if I came upon a lion on the trail? What if I were chased by a mountain lion? I'm not sure I could run to my mailbox, let alone outrun a mountain lion! 

Education about these animals has helped ease my fear, but I still hope I never come upon one in the wild. 

What does this have to do with birth? Let's keep with this example of running. Running because you are afraid and are forced to run - if you stop you'll die - is a completely different experience than running because you trained for it. (Or so I've been told! In case you couldn't tell, I'm not a runner.)

Labor is still labor, birth is still birth, and running is still just running. It's the preparation that makes you feel differently about it. Fear versus confidence. It's the "why" you are doing it. Is it just to get through it, or are you enjoying the journey because you enjoyed the preparation? You know what to expect along the way. That alleviates so much of the fear. 

I've taken a year off of teaching childbirth classes (still busy training instructors though) as I've settled into my new home. If you are in the Black Hills region and want to prepare for your birth, let's talk! No one wants to have to outrun a mountain lion in their birth!

Monday, August 29, 2016

Retraumatization of Sexual Abuse Survivors

I invited Carol Meadows to write this post for me when she posted her opinion on one of our Birth Boot Camp Instructor Facebook groups regarding this subject. Let's start a discussion. The treatment of all pregnant and laboring women is important. Read on!

Pregnancy, labor, and delivery can be difficult and trying times for any pregnant individual. This time can have its ups and downs, it can be difficult to navigate. This is even more true for survivors of sexual violence and abuse. While maternity care, and the practices that it entails, are well intentioned, it can make this time in a survivor's life more difficult.

When Survivors Give Birth, written by Penny Simpkin and Phyllis Klaus, is required reading for Birth Boot Camp Instructors. Although I have been passionate about birth since 2009, preparing for my workshop in 2015 was the first time I had encountered this book. The book is written primarily for caregivers, doulas, childbirth educators etc., but mentions a few times that this book could be used as a reference for survivors as well.  For those who haven't read the book the three points below are important for the understanding of the rest of the blog post.

  • Survivors may have problems with things that are routine maternity care, that they might find it distressing and that these actions can bring back feelings related to their abuse. (Simpkin and Klaus, 31)
  • How an individual in labor is treated by those that love her, and the professionals present "can make the difference between confirmation of her self worth and retraumatization." (Simpkin and Klaus, 34)
  • Survivors may equate being abused with feelings of helplessness and loss of control, and therefore having control of a situation is a priority for many. (Simpkin and Klaus, 75)

Before I continue, I would like to say that I do not believe that When Survivors Give Birth is a bad book and should not be read. It absolutely needs to be read. Some people will really benefit from this book. There are birth workers who commit microaggressions towards survivors of sexual abuse every day, and they may not even be aware. A microaggression is an action that is directed at a minority, in this case survivors of sexual abuse, that is offensive in a subtle way, and is usually unintentional. When Survivors Give Birth has examples of that, which some birth workers need to be made aware of.

The problem with the book is it that it seems like many of the suggestions rely on the pregnant and laboring mother to disclose the fact that she has been sexually abused. I think this, in and of itself, is a problem. Is it fair to ask a person to tell strangers that they have been sexually abused?

Imagine yourself as a pregnant woman who has been abused. Imagine that you have thought long and hard about things that are routine maternity care. Because it is invasive and common, I am going to pick cervical checks. Many practitioners will do cervical checks routinely in the last weeks of pregnancy, and they are also done in labor to determine how dilated a woman is in labor. So here you are this pregnant woman you go in at 37-40 weeks and there is a sheet ready for you in the patient room. Your nurse tells you to remove everything off from the waist down for a cervical check to see how dilated you are. You have already decided to forgo cervical checks. This isn't a willy-nilly decision. This is a serious trigger. A trigger is something that reminds you of something from your past, in this case previous sexual abuse. It could be anything. It could be multiple things. It could be things you are not aware of.

Imagine you as a teenager were raped by your boyfriend. Someone you trusted, someone who you thought respected you. You are helpless and on your back, crying. You can fill in your own blanks of what happened. Imagine it is years later, that sometimes when you are intimate with your partner of 10 years that you are randomly triggered by the experience. Nothing out of the ordinary for you and your partner occurred. Suddenly you want to fight, you want to scream and lash out. You want to push your partner off you, run to the bathroom, bolt the door and cry. You are with a person you love, cherish, and have chosen to have a family with, and you are still triggered, taken back to an event that happened 15 years ago.

There is no way that you are comfortable with a stranger, even your care provider, reaching up inside you - not always very gently - as deep as they can go, feeling around for dilation and effacement, while you are on your back naked from the waist down, very exposed.

So, you keep your pants on. You have done your research, you know that your cervix is not a crystal ball. You know that how dilated you are today doesn't matter. It doesn't tell you when you are going to go into labor. So your doctor comes in, slightly surprised you still have your pants on. You tell them you have decided to forego cervical checks. Your provider tells you that is fine, but they will have to be done in the hospital. So you take a deep breath. You tell him or her nicely but firmly that you prefer not to have to cervical checks at all, during pregnancy and labor. You take a few more deep breaths. You open your mouth and very bravely tell them that you have been raped, and that the idea is abhorrent to you. You hope to make the doctor understand, even though it is hard to even talk about 15 years later, because every time you talk about it, you think about it. Even just mentioning it can take you back.

Why would we do that to a woman? Why should we have to? Why does a doctor need a reason to respect the wishes of their patient? Why should, as Simpkin and Klaus suggest, a survivor "be willing to remind the caregiver of her background of sexual abuse, and of what they previously discussed," assuming she could speak of the abuse at all? It is stated that "even within the context of short appointments and multiple caregivers, good communication is possible when both parties are willing to try." (Simpkin and Klaus, 150)

"Willing to try." Meaning, have a woman disclose over and over and over to each member of the practice that she is a survivor. What if it took that woman 8 years to tell her partner the details of that experience, because even just mentioning it was too much? Yet she should be expected to mention it to 3-6 individuals because they might be at the birth of her child? How is this fair to the survivor?

Another suggestion is that the survivor put the fact that she was abused in her birth plan so that she doesn't verbally have to tell the professionals involved in her care during labor and delivery. (Simpkin and Klaus, 151) On one hand this seems like a good idea. If her birth plan reads as demanding, the fact that she disclosed that she is a survivor would make the requests seem understandable. This might be more apparent in a survivor who feels the need to maintain control of a situation. Again though it begs the question of why does a survivor need to disclose this information to get compassionate care? You may be thinking that this is a worthy trade off, and for some survivors it might be.

However, what if the survivor lived in a small town? I had a baby when my youngest was in kindergarten. One of my attending nurses had a child in that same class. Of course HIPPA prevents the nurse from discussing it, but living in a small town you see people all the time. I would always see the senior nurse from my doctor’s office at the grocery store. That mom was at every class party. What if the survivor worked for the hospital? Should she have to disclose to her colleagues that she is a survivor? Again HIPPA would prevent them from talking about it, but put yourself in the survivor’s shoes. How would you feel if you felt like everyone knew something you didn't want them to know, but you disclosed the information so you could, hopefully, get compassionate care?

What if, despite telling people, it didn't matter? Put yourself back in the scenario in which the survivor was raped as a teenager. What if, after being so very brave, you were told that you would still need to have cervical checks. That you would need to have one at admission and then every hour or two to see how you were progressing in labor. You will have to be subjected to a triggering action multiple times during a time that is supposed to be joyful. The very thought of it makes you want to weep. It might not be cervical checks. The trigger might be having to be confined to the bed for electronic fetal monitoring. Your body tells you you need to be up and moving. The nurse comes in and admonishes you, telling you to lie down, that they can't get a good reading on the baby. You are fighting the contractions, you feel helpless, confined. It hurts to lay down during contractions. You are not allowed to listen to your body.

Why are we retraumatizing survivors? Why do we do it? Depending on the statistics, 1 out of every 5 or 1 out of every 6 women are victims of attempted rape or completed rape. That is a lot of women. As we have seen, in the case of being a survivor of sexual violence, labor and birth can become an obstacle for various reasons. I find it unacceptable that many of these women are further traumatized by their caregivers during their stay in L&D. It is enough of a systemic problem that there are birthing centers opening specifically for victims of sexual abuse. This whole blog post was inspired by this article. When I first read it my reaction was, "These need to be everywhere!" It was followed by, "Why do survivors need to go to a special clinic to get compassionate care? Maybe we need to fix how we treat pregnant and laboring mothers."

In 2011 Penny Simpkin wrote an article published on the blog Science and Sensibility. In it she talks about how childbirth can be traumatic for mothers and that it can lead to PTSD. Depending on the survey 18-33% of women report having traumatic birth experiences. Of the women surveyed, 3-9% of women developed PTSD after childbirth. An important note is made that the trauma may only be seen through the eyes of the individual giving birth.

What does PTSD after birth look like? "Key symptoms of PTSD include insomnia, irritability and angry outbursts, panic attacks, nightmares about the birth, a desire to avoid the baby or anything relating to the birth, feelings of detachment from loved ones, and a sense that some other disaster is imminent." How do you think that affects the postpartum period?

Imagine you are the survivor again. You just had an experience in which you were confined to a bed when you didn't wish to be. You were invaded over and over again by multiple doctors and nurses because you labored at the time of shift change. You had people in your room you had never previously met, never seen, and they didn't even introduce themselves. How do you feel about your birth? Do you feel like you were supported? Do you feel like your self worth was boosted or were you retraumatized?

We need to do better. We need to provide maternity care that doesn't retraumatize the survivor again and again and again. We need compassionate care for pregnant and laboring women, regardless of their circumstances, in which their autonomy is valued and respected. We should not require women to justify their choices.

Carol Meadows is a certified Birth Boot Camp Instructor. She lives on Colorado's beautiful front range, and teaches classes in the Colorado Springs/Pueblo area. Carol has been passionate about labor and birth since 2008, when she birthed her first daughter. Her knowledge and passion for birth has grown throughout the years. She penned this blog post as part of her ongoing effort to improve birth for everyone. She can be found at Meadow Mama Birth and on Facebook

Monday, July 25, 2016

Soothed by Tim McGraw (Even From the Womb)

Funny story to tell. When I was pregnant with my last baby, it was the year Tim McGraw came out with the 'Live Like You Were Dying' album. To this day, it's still my very favorite album. I listened to it a cazillion times that year it came out. Not exagurating. I am not a singer, but I sang my heart out to that album. You get the picture.

Fast forward a few months. My darling Darcy was born, and she was just about perfect. She was a few month old -- maybe about 5 months -- and we were on a family trip in Indiana. She was crying in her car seat, and I happened to put that CD in the player. She instantly stopped crying. We did an experiment and took the CD out. She cried. Back in? Quiet. She recognized Tim! 

And so it was for over another year. In fact, my dad died unexpectedly when Darcy was 16 months old. We threw everything in a suitcase and jumped on a plane. We rented a car and quickly realized that we had left all of our (Tim) CDs in the car back at the DFW airport. We stopped in at a Target and grabbed the 2 Tim CDs Darcy was most familiar with. Needless to say, that's all we listened to for 2 weeks, from New Mexico to Illinois and back to Texas. It beat listening to her cry! And let's face it, I was in heaven. The rest of the family, not so much... 

The moral of this story? Your babies hear from the womb! They hear your voices AND your music! Choose carefully, as it may be all you listen to for the first couple of years of their life!

Tuesday, June 21, 2016

Which is Right for You - Homebirth or Birth Center?

To birth at home or at a birth center... That is the question for couples wanting an out-of-hospital birth. We devote an entire class at Birth Boot Camp to birth places, care providers, and policies that may affect your birth, but I felt a blog post of questions might be helpful, too. Of course, where is you live is likely a factor and these options may not be available to you depending on your state laws and insurance coverage.

Photo Credit: Birth Boot Camp

Here is a nice little list of questions and considerations:

Birthing in a Birth Center:

1. Do they charge more, or less, to birth there? 

I've seen this go both ways. I've seen a discount given if a couple is willing to come to the birth center, but I've also seen midwives charge a lot more money (as in over $1000) to birth at the birth center. If I were a midwife, I'd want everyone to come to me at the birth center. I'd know where all my supplies are and not have to haul them all over town. That being said, I'd also have to do the clean up and disinfecting for the next couple. 

2. How long will you be allowed/encouraged to stay at the birth center? Under what conditions might you stay longer? Who is watching after mom and baby in the immediate postpartum period?

It's pretty typical to be out of the birth center within 3-6 hours. Are you OK with that? Does the midwife stay with you, or someone else? What is their training and expertise? 

3. Who and where is their emergency backup? 

Often, the birth centers choose locations that are close to their emergency backup, but not always. You need to ask. If you need to transfer, will your insurance cover their backup hospital and/or care provider? I've heard many couples complain of paying for their birth twice.

4. Do you have your own space to labor? What if someone else is in labor at the same time? What about your family? Will they be sharing space?

How do you feel about the possibility of sharing space, even if you are in separate rooms? Will you feel self-conscious if you are vocal? Do you each have your own bathroom, too? A lot of women like to labor at length in the bathroom...

5. Speaking of family... Are siblings welcome? Or just tolerated? 

If you are wanting your other children at your birth, take a Birth Boot Camp Sibling Birth Prep class, or even just pick up a workbook. You won't regret it. Has your child(ren) met the midwife and toured the facilities with you? If not, make sure that happens before the big day.

Photo Credit: Birth Boot Camp

Birthing at Home:
Many of the same questions apply, but there are some other things to consider. 

1. If an emergency were to arise, where is the closest hospital? Are they friendly towards homebirthers and your midwife? How does your midwife feel towards them? Is it her usual backup? Is she familiar with their protocols, or will you be met with uncertainty and hostility? 

Under normal circumstances and great preparation, I don't expect anyone to transfer, but I believe the fear of the unknown can play into your emotional relaxation. Knowing the answers to these questions is important.

2. Who does the cleanup? 

I've seen some midwives clean everything up, down to draining the tub and putting fresh sheets on the bed. I've also seen midwives do nothing. This is a good thing to know so there aren't angry feelings because of unmet expectations. 

3. If your labor is on the long side, does your midwife have space to rest? Are you feeding her meals and snacks? 

If you are birthing at the birth center, she will have her own space and food. Discuss this with her at your home visit. You both will be glad you did.

4. Are you the type of person that is going to be stressed out about cleaning beforehand? Is this going to be how you spend your early labor - cleaning? If things aren't cleaned up, are you going to have a hard time relaxing with "visitors" in your house?

You know yourself better than anyone. The times I have seen this become an issue is when labor came on fast and furious and there was no time to straighten up. Once the baby came, mom was up and cleaning before the midwives were even out the door, instead of bonding with her baby.

5. This isn't really a question, but more of a comment. Many people (especially dads) take comfort in driving somewhere. Truth is, generally, in a homebirth, the midwife is just bringing everything to you.

In most cases, there really isn't much difference except those things I've listed here. They are important, however, and they should all be carefully and thoughtfully considered and answered. 

Friday, May 27, 2016


The first "adulting" meme I saw was this:

I actually thought it was hilarious. Life is hard. Sometimes running away seems like a great option.

But then, I started seeing more and more of them.

You get the idea. If you google "adulting memes," there are literally dozens of them. What do these messages say to our children? Many children and teens are on social media, and these memes are impossible to escape. They want to feel secure in their world, that they are being led by capable adults. How scary to think that adults wish they were children, that they don't feel capable of leading others, or they can't even function in their own lives.

It got me thinking - If social media had been around when I was growing up, I can't imagine what I would have thought if I had had messages like this posted by adults (even my own parents) that I was expected to respect. 

We are responsible for raising the next generation. How can we expect them to become responsible adults when they are bombarded with these messages? Didn't we just give them an "out?" What do they have to look forward to?

My 17-year-old and I were talking about this the other day. She couldn't believe all these memes. She's actually the one who brought up adults expecting to be respected and how impossible it is when they post stuff like this. She said she sees them in a totally different light after they've posted one of these memes. 

As adults, we all know that life has its ups and downs. I'm not trying to convince anyone that life is easy. But honestly, would any of us want to go back? NO! Even at 45, I wouldn't want to go back to 35, or even 25, let alone 15! We have responsibilities and bills to pay, but we grow from these experiences and learn from these challenges.

In the meme above, she's "adult" enough to drink a bottle of wine by herself, but NOT adult enough to carry on with her day. It's appalling. Give me a break! Grow up! You ARE an adult! Act like one! Show the next generation how it's done! 

As an adult, I'm kind of offended that "adult" is used in a negative way. When driving down the highway and a building is titled "Adult Bookstore" or "Adult Videos," it seems to assume that all adults view pornography. It's just a little something that, as a responsible adult, annoys me. 

If you actually feel this way, the adults in your newsfeed may find it humorous and even agree with you, but remember - they are very likely not the only ones reading your posts. We have a responsibility to the next generation and these memes undermine the awesomeness of adulthood. And it is awesome! Someone make a meme about it!

Friday, May 6, 2016

A New Place

Do you like the facelift my blog received this morning? It was time. I'm in a very different place - literally and figuratively - than I was when I wrote this blog on a regular basis. My kids are older now, ranging from 11-19, so I'm not doing the baby thing anymore or attending play groups.

My husband took a job in Rapid City, SD, so we uprooted and moved to the Black Hills. For real - we actually live in the Black Hills National Forest. It's so beautiful here and the ski area is about 45 minutes from my home.

It's also like going back in time about 10 years. DVD shops are alive and well here. We can't stream video in the Hills. I have to stay in the kitchen near the cell booster to make a call. We are about 20 minutes out of town, sharing pasture with deer and horses. My life is very different than it was in Ft. Worth, to say the least.

Not streaming video has changed my family's life, too. My teenagers aren't all hooked up with the current YouTubers, but they've picked up a lot more books. They've hung out in the kitchen talking to the family a lot more, too. Hmmm.... Maybe this isn't so bad afterall!

When we moved up here, we lived in a hotel for 6 weeks with almost none of our belongings. That was an eye opening experience as well. After straightening up in the morning, we were free to get out and explore. It made me realize how much time all of our "stuff" steals away from us. I'm trying to become a minimalist, but it's extremely difficult.

Birth Boot Camp has grown so much, it's a full time job. I haven't integrated into the birth community here, and I'm not sure I will. I still have lots to say, lots of observations to speak about though. Expect a post at least once a month here. I'm back!

Thursday, March 24, 2016

Happy 4th Birthday Birth Boot Camp - A Personal Post

Hard to believe my baby is FOUR. I feel rather sentimental about it. I wanted to share a few of my thoughts on this special day.

I wrote this blog for many years as a childbirth educator and I loved it. This was my baby. I am truly sad that I have let it go. It was never my intention. Nor was not teaching childbirth classes. Sometimes if we could see the evolution of something, we can look back and realize we might have done things a little differently, or even not at all. I'm not saying that I wouldn't have started Birth Boot Camp, but there are downsides that I didn't see coming. I honestly had no idea I was getting a more-than-full-time job! Ignorance is sometime blissful, not to mention necessary!

Ironically, I keep a list of blog topics in my phone - last count was 13 - that I'd like to write about, but I just haven't gotten over to it. I have made a decision to write once a month though. If you've read my blog, ever, you know I don't do it for SEO or to make money. This is just a simple place for me to share my thoughts, no matter how unpopular they may be! So be on the lookout once a month. I'm going to do this!

Back to Birth Boot Camp ... Just to refresh your memory, I had all my childbirth classes on DVDs and was shipping them all over the world. It was crazy! I was like Blockbuster burning DVDs and renting them out! I told my good friend, Ceci Massa, that I wanted them to just be on the internet. She said she could help me with that. I started writing curriculum and shared it with another good friend, Hannah Reasoner, and she declared she'd like to teach it! Oh my. This took things a different direction, for sure.

I knew I couldn't do this by myself. I pulled in several people, including my good friend, Sarah Clark (you might know her as Mama Birth) but I'd known her long before either of us were childbirth educators. It was the best move I made in this endeavor! She's a machine! And I love her dearly.

We held a Launch Party from my house in Mansfield, TX, showing off the materials and online classes. It was quite a day! I remember feeling so proud and excited, but also anxious. We had our internet launch on Monday, March 26, and almost immediately online class registrations started rolling in. I knew we were on to something big!

Some highlights you might enjoy -

We've trained nearly 200 instructors from about 40 states. It has been an absolute pleasure to get to know all these women from all different backgrounds. I am honored and humbled to work alongside them.

Our inital materials were rather dark in color, but adding the doula program pushed us to change our materials and brighten things up. This is a prime example of if you knew how much work something was going to be, you might reconsider starting the whole thing! Well, it was worth it and I'm glad we did it. I can say that now that it's done!

Oh wait, we keep coming up with great ideas! We aren't done! 

We've just recently announced two new classes, our Early Pregnancy Class and a Sibling Birth Prep Class, complete with beautiful workbooks. You can take a live class which will include much more, or you can just buy a workbook and study at home with your partner or family. These were so much work for Sarah and I, but we could not be more proud! We keep having babies!

I'm incredibly lucky to work with such a diverse and talented group of women who put their heart and soul into Birth Boot Camp.

And finally, look for two HUGE announcements in June. We can't wait to share them with you!

I've often said, especially before launching Birth Boot Camp, that I wish I had a crystal ball and could see what things would look like for the company a year from now, 5 years from now, 20 years from now. At 4 years in, I have to say, I am incredibly proud of all that we have accomplished. It looks very different than what I expected, but I wouldn't change a thing! We are exactly where we need to be at this exact time. We have dealt with some ugliness, our product has been copied, we've seen some people come and go. But at the end of the day, I believe that if you go forward with integrity and kindness, that will trump all negativity.

Here's to another incredible 4 years!  If you are interested in becoming a Birth Boot Camp Instructor, read about our requirements here and apply here.

Dying to become a Birth Boot Camp DOULA? Our program is the BEST! Register today!

Pregnant and wanting a supportive online community? Join the conversation at Your AMAZING Pregnancy Facebook group. Join us on all forms of social media. If it exists, we are there!

Happy birthday Birth Boot Camp!