Why Some Midwives Need Shovels

As I am writing this, today, June, 6th, 2024, the world is celebrating International Home Birth Day and I am just back from a celebration with the Southern Trust Birth at Home Team (aka the BaH team) here in Northern Ireland.

Once more I am in awe of the midwives on this team.

I got a tiny stint with them just over a year ago and I LOVED the team. For a moment I flirted with the idea of letting go of Essentially Birth to become a permanent member of that team but I could see that they were shovelling away at the same pile of dung that has been dumped at the doors of midwifery services not just in the tiny corner of the world that I have been calling home for neigh on three decades but everywhere. There's nowhere in institutionalised maternity care that I can think of anywhere in the world where midwives are not either fighting or admitting defeat (looks like Australia will be next in loosing independent midwifery) and I have promised myself that I wouldn't do either anymore.

I will not go into the obstacles that this team faces in this week's blog. There are plenty of examples of what the pile of dung is made of in my previous blogs. Instead I want to speak of the incredible potential that is there for all birthing women when they are supported by women with unshakeable faith in birth.

As I see it, midwives must be biased towards physiology for women and their babies to thrive in birth. The idea of the unbiased practitioner is a pipe-dream. There's bias everywhere in birth and, sadly, modern midwives have become so biased towards medicalisation that they have forgotten their ways. That's not to say that we don't need any high tech medical midwives at all. I do think it is commendable that some midwives strive to provide the best possible experience for those women who either choose to medicalise their births or those women who need their births medicalised in an emergency. As you read on, you'll see that this would be very few women if we allowed labour and birth to unfold without meddling with it. Birth works, midwifery works and I do think that it would be beneficial for everyone to finally go ahead and make the distinction between midwifery and obstetric nursing. Women who want to medicalise their births, even if it is for the fact that they want to have an epidural in labour, need more of a specialist maternity nurse practitioner rather than what would traditionally have been considered a midwife. 

There are women, though, who yearn for a traditional low tech, visceral kind of midwifery either because they tried the high tech version before and didn't like it or because that's just what they intuitively know they want. 

That's the kind of midwifery that I love and it is the kind of midwifery that the BaH team midwives bring to the homes of the women they care for. Medical midwifery is reserved only for when it is needed.

This kind of work belongs into the community and the reason I love this team so much is that they fully understand the potential in this for the women and families they care for so lovingly. These midwives are fully aligned with what the woman wants and dreams of for her birth, no matter what. They fully believe in each woman's ability to give birth to her baby. Living up to this conviction from within regulated midwifery is difficult, particularly if women want to forego all technology for instinct and these midwives are there for it regardless.

Thankfully the team have a truly committed ally within the hierarchical structure; their consultant midwife! She helps tirelessly with out of guideline care plans and provides support to the midwives on the ground. Together these women demonstrate that all a woman really needs is a midwife with a shovel who will be a loving presence when the time of birth comes.

The women love the team and the birth stories speak for themselves. Time after time, the women who are cared for by this team *just* give birth. In fact out of all the women they cared for in pregnancy, almost 95% had a physiological birth. Just over 19% of the women transferred their care prior to labour, generally for induction of labour and one woman for an elective caesarean. And I just learned today that none of the remaining 80% of women who started to labour at home had a caesarean section (if you listened to my stories on social media yesterday, this is a correction, I read this part wrong on the graphic!).

That's what is possible in birth! 

Oh, and might I add that over 40% of these women had 'risk factors' meaning that their home births were out of guideline home births. In fact navigating the bureaucracy associated with providing out of guideline care makes up a huge part of the dung shovelling that goes on for teams like this and although there is a high personal price to pay for each and every midwife who contributed to this stellar service, it's worth it for the women who are lucky enough to receive their care.

Today was evidence for the overwhelming support this team have rallied in the community since they first started. For instance, one of the women who spoke of her experience at today’s event had had a caesarean birth with her first baby and then she birthed her second baby at home. She declined any monitoring of the baby’s heartbeat because, in her own words, she ‘couldn’t find any evidence to support it’. And the truth is, there really isn’t any evidence to support the idea that listening to the baby’s heartbeat in labour improves birth outcomes. She said that she felt nothing but support from the team.

They respected her wishes without any attempts at coercion because they know that this woman’s stance is reasonable. They are familiar with the resources that women have access to today and they can hold those kinds of conversations without attempting to sway and coerce the woman into complying with guidelines instead. It’s often not the actual suggestion of ‘risk’ that women get upset about nor is it the reference to guidelines, it is how this kind of conversation is framed and this team and their consultant midwife seem to have a magic sauce that works.

The first time mum who spoke could barely hold back her tears when she recounted the story of her waters having been open for somewhere close to three days before the baby came at home. Her gratitude to the team was immeasurable because she knew that without the steadfast presence of those midwives in her corner it would have been so much harder to advocate for herself when she went to get checked over at various stages. 

The story that struck me most today is that of the woman who had her third baby at home after two hospital births. She said that she had thought of her hospital births as good experiences (and she still does) but there was just no comparison to homebirth. The funny thing was that she stumbled across the idea of home birth entirely by accident and she was never too fussed over whether or not it actually happened. She admitted that at one time in her life she actually thought that home birth was a little nuts.

Then she gave birth to her baby at home.

She totally lit up when she talked about this birth and she is now shouting from the rooftops.

The reason it was so different is, of course, our innate hormonal matrix that I have written about in my blog ‘Bridging Hormonal Gaps’.

But birth doesn’t just happen on a physical and mental level.

Birth happens on an energetic and spiritual level, too.

As a massage therapist, aromatherapist and yoga teacher, I know that medicine has a view of the body that is overall rather crude. And as a former midwife I know that midwives are not generally encouraged to look beyond this. 

'What more is there?',  you may be asking.

Let's consider the way that we look at our organs and organ systems for example. Once we really start taking it under the microscope and ask some questions, it doesn’t all hold up to scrutiny.

Here's an example:

I was taught that the brain is in charge of all of our functions in the body.

Is that really true?

It certainly isn't the case when we are still zygotes and embryos. At that point there seems to be a universal intelligence that governs our cells. Is this all-over-the-body-intelligence lost once our bodies are fully formed? When does the brain take over as the ultimate command centre thus turning our bodies into nothing more than mechanical meat suits? 

Does it ever?

We know that a baby’s heart tissue starts to contract somewhere between five and six weeks gestation. At that point the central nervous system, which is formed from the neural plate, only just begins to fold into the neural tube. The actual brain starts to take shape at around seven weeks. If the brain were in charge of everything, wouldn’t it have to form before the heart starts beating?

There are practitioners all over the world who are asking these kinds of questions and they are at the forefront of understanding the fascia system of the body. Personally, I have been learning about this amazing collagen crystalloid type system from around 2015 when I came across Tom Myers' work and I truly believe that the fascia system with its trillions and trillions of cells and ability to communicate impulses through the body may play a bigger role than our brain when it comes to integrating all of the various simultaneous processes that happen in our bodies at any given moment in time.

In the last few months I have finally shifted my approach in Essentially Birth towards following tension patterns in the fascia rather than muscular tension with unbelievable results!

Just a few weeks ago one of my R.O.A.D. To Birth clients came to me after the birth of her baby. I knew that her pregnancy had been one that was laced with anxiety for various reasons and although her regular sessions with me gave her relief in the body and mind, she couldn’t shake an underlying worry that would accompany her right until she finally held her little baby in her arms.

After she had the baby she had a terrible headache. All of the common reasons had been explored by her doctors and she had seen an osteopath, too. She felt really nauseous and she was salivating all the time. When I saw her, I noticed that her right lip was drawing up. After asking her if she had seen her doctor about it to exclude some of the big reasons for this kind of asymmetry in the face (she had) we decided to work on her body from the head down.

From how she was holding herself it occurred to me that her anxiety had meant that she had formed so much tension in her fascia all the way through pregnancy that her organs hadn’t been able to settle back down from under her diaphragm and into her abdominal cavity.

I contributed her nausea to this theory and so we decided to release her diaphragm after working on her head and face for about half an hour.

After just one session her headache had subsided, her salivating had settled, her face had relaxed and her nausea was gone. When she came back the next week, she was so happy to report that she had had no symptoms all week.

This is the power of fascia!

Fascia work is as much about the intention that you bring to the touch as it is about the touch itself. Our bodies are mostly water and water conducts energy. This is where fascia comes in when we look at birth as an energetic and spiritual experience. Your 'vibe' matters when you attend a birth. Whether you trust it or fear it matters and that is exactly why I think the BaH midwives are seeing such outstanding results in their birth work.

They never doubt that the baby will be born, they never transmit fear.

And they LOVE birth, they see how much power there is in integral birth for the entire family.

They may not know it but by exuding this belief and by honouring the women they serve so fully and completely, they are under cover facia workers! 

Do you know your fascia?

To let me know or to find out more about my pregnancy and postnatal massages in Belfast and Dungannon, send me an email to [email protected].