The Revolution Will Be Live

Last night I found myself in front of a cinema screen watching yet another film charting the drastic differences between women's experiences of accessing relationship focused models of pregnancy and birth care versus the purely outcome focused medical care that has become far too common everywhere in the industrialised world.

‘Born at Home’ is beautifully composed. Stories are woven by showing interviews with families in their pregnancies and postpartum and allowing us to witness the births of their babies. All of the babies are born right into the hearts of those families who, for the most part, had previously been hurt by birth within the system. We hear accounts of coercion and deep trauma and we witness healing through birth.

Such is the power of the hormonal blueprint of our innate birth physiology that allowing it to unfold can repair old wounds and render women and their families whole again.

Dotted through these family storylines and stunning birth footage are the words of renowned and celebrated midwives, scholars and researchers such as Dr Sarah Buckley who coined and explained to us in such meticulous detail the term ‘hormonal blueprint of birth’ and whose work I shared recently in my post ‘Bridging Hormonal Gaps' (another of Sarah's genius concepts).

We see Dr Rachel Reed whose contribution to birth education has impacted me since my student days and I still direct my clients to her outstanding blog ‘Midwife Thinking’ and Jenny Blyth whose ‘Down To Earth Birth Book’ has enjoyed a cherished and prominent place on my bookshelf ever since I sat next to her on a bus ride at a Spinning Babies event in St. Paul, Minnesota. 

I have always looked towards scholars who honour women over institutions. Scholars who look to nature first and speak to when medical interventions are truly useful and potentially life saving. Scholars who can provide women with the perspective they need in order to overcome the obstacles that are often thrown at them by medics and midwives who don't appear to have the same measured approach and who prioritise the institution over the woman. 

Last night wasn’t my first film night. 

I organised the first birth film night I ever attended back in 2008 in order to raise funds for my trip to meet Ina May Gaskin and Sara Wickham at The Farm in Summertown, Tennessee. It was a sneak preview of ‘The Business of Being Born’ and I’d say that I have seen most birth advocacy films released since then. 

What strikes me is that in 2008 I managed to mobilise support to sell almost two hundred tickets to the movie night. There was a discussion panel that was headed by two mothers, a consultant obstetrician and a senior midwife willing to speak up for birth physiology and choice. I would estimate that at least a third if not half of the tickets were sold to midwives from all over Northern Ireland; one of them was called to a birth during the event and she was excited about it! Her aim was to keep interventions at bay, doctors at the door; she’d call them if there was reason for concern. I was excited to follow her example, eagerly awaiting to be handed my First Class Honours degree and prize for best student in my year for clinical practice assessments. I planned to hit the ground running and join forces with the midwives who had supported me that evening.

For the most part, the midwives in those seats were happy to honour women in their choices and they were there to be inspired (knowing what I know now I reckon others were there to keep an eye on what was said and control the narrative if it came to it). It was far easier then to uphold women's autonomy since we hadn’t invented as many arbitrary risk factors and policies to go with them. We hadn’t yet inverted most of everything that is true about pregnancy and birth.

Birth trauma wasn’t as common as it is now. 

Last night at the cinema I counted two midwives, two beautiful women who have it in their hearts to give compassionate care centred around the families they cross paths with. I have no doubt that they’d be first in line to support the kind of family births we witnessed on the screen but there’s nowhere for them to go get a job as the kind of midwives they’d love to be. If there was, I’d be working there with them. The rest of the seats were filled with birth advocates and parents.

Doulas seem to be carrying the fire that midwives used to have in their bellies in days gone by.

I’d say midwives are worn and tired.

Others are so heavily invested in the medical narrative of birth that they’d rather watch 'One Born Every Minute' or 'Belfast Midwives' from the comfort of their own homes.

Born at Home is set in Australia and if you love birth you’ll love this movie.

I encourage you to watch it.

Coincidentally I happen to have been bingeing on an Australian based freebirth podcast in the last couple of weeks and I know that the kind of midwifery care the women on the screen enjoyed is not the norm in Australia either. Australian women and midwives are struggling with the same state-imposed obstacles to unconditional birth autonomy as women and midwives in most of the industrial world.

The podcast is called The Renegade Mama and it was recommended to me by a renegade mama. The interview with Norafiah Lever who, like me, is now an ex-midwife has been particularly interesting to me. Norafiah handed her registration back to her regulators after answering to seven separate events of having been reported to them by fellow midwives. Her ‘offences’ were rooted in her willingness to respect women’s choices unconditionally. They are petty and not one of the complaints was upheld in the end but she’d had enough.

The most frustrating thing about working as a registered midwife is that our institutions all pay lip service to ‘informed choice’ and ‘women centred care’ but when it comes down to it they won’t deliver it; not without attempts at coercion or at the very least not without subjecting women to being patronised and judged for their choices together with those who are willing to support them. 

I loved that Gloria Lemay had also been a guest on The Renegade Mama Podcast and I wish I’d listened to the podcast before writing about Gloria’s most recent exposure to Canadian midwifery regulators (you can read it by clicking here).

Having heard the accounts of both of these women I am certain that the regulators are not interested in the women, babies and families midwives serve. They are not interested in ‘safety’ either. Their one and only interest is in defending and upholding the medical model of birth.

This is about territory and principle, nothing else. 

It is a shame, really, because when individuals are willing to support it, the medical system (which is excellent at providing medical care when it is needed) and the holistic model (whose excellence lies in supporting our physiological blueprint of birth) can work together beautifully. 

After last night’s movie I joined a group of birth workers for a cuppa and I shared a story I had read in Sarah Schmid’s book ‘Alleingeburt ‘ (Freebirth). It is the story of the birth of a couple’s fifth baby. The woman had chosen a scan because her second pregnancy had been a twin pregnancy and she would have wanted to know if she was carrying twins this time. The woman is called Stephanie and she is a 41 year old nurse. During her scan the baby’s placenta was noted to be ‘low’. We are not told how low or what grade of placenta praevia she was dealing with but I imagine it would have been in the category of a minor placenta praevia (it is possible to have a natural birth with a minor placenta praevia and I remember looking after a woman in labour who did it - in hospital and with blood cross matched in the fridge). The German family in Sarah Schmid's book decided to plan for a freebirth despite the low lying placenta and they made this known at their clinic. 

Stephanie and her husband prepared extensively. They had planned measures in case of heavy postnatal bleeding and they had a team of midwives on standby to call if they needed them. They had also arranged that they'd call the hospital if they needed to transfer in.

Stephanie describes that this labour started somewhat atypically with the waters releasing. The baby moved from a head down position to a transverse position and Stephanie tried to encourage the baby to move her head down into the pelvis again. She waited for 32 hours and then she noted a trickle she initially interpreted as more amniotic fluid. Stephanie went to change her pad and saw that it was blood and because the blood seemed to trickle continuously she decided it was time to seek help.

Here’s the most astounding part of the story, the part that is testimony to an intact and mutually respectful relationship with her care providers. Stephanie picked up the phone to the labour ward and she said that she’d need an emergency section and for the medical team to please get the theatre ready. Her baby was born fit and healthy within thirty minutes of this phone call. 

How do you feel about this story?

Whether you are a mama or a birth worker, hearing this is a great litmus test for where you stand on the increasingly popular topic of birth sovereignty.

Would you trust yourself to carry this amount of responsibility?

If you are a midwife or doctor would you trust this woman and her husband?

Are you feeling any judgement towards this family?

Do you think this woman is selfish, do you think that she is taking too much risk? 

Thirty minutes between the phone call and the (most probably lifesaving) caesarean section is fantastic! How do you feel about this creative solution to saving time in case of an emergency?

Personally I am in awe of this family and their care team, I am not sure if I’d have the stomach for this path as a mother myself but that doesn’t matter and I wouldn’t allow it to impact how I support their decision making.

I thought about the potential for a cord prolapse with the waters having released and the baby not fixed in the pelvis and I know that my former colleagues will be thinking the same.

I don’t know the types of conversations that this family had with their care team. I don’t know if they had to fight or if they were facilitated adult to adult. 

I know how I would have the conversations with this family.

There would be honest talk about the potential for baby death in any pregnancy. I wouldn’t lay fear on them, I’d tell them honestly that I don’t have any statistics to help evaluate this choice with data. I would let them know that I thought that statistically speaking they were likely putting their baby at a disadvantage but that I trusted her instinct. I would let them know that by far the most likely outcome overall (particularly given such a solid plan) was that everyone would be fine. I would tell them that I’d stand by them regardless of what happens. I would listen carefully to their plan. I would respect their choice not to opt for elective caesarean in the first place and I would also support their choice to labour at home. It appears that the hospital was so near to their house that the potential advantage of starting labour in hospital could only have been small given that the baby was born within half an hour of Stephanie announcing her arrival by phone. 

The estimated incidence of placenta praevia at term is 1 in 200 pregnancies (RCOG, 2018), a statistic worth noting for those mamas who are sidestepping the system altogether and opting out of private ultrasound scans as well. Generally you’ll have signs of bleeding before labour or in early labour and there’d most likely be time to respond. However, there are definite advantages to having had this kind of collaboration or the overall experience and even the outcome of this birth could have been different. 

I wish this kind of communication was commonplace.

This is a very specific case and apart from Sarah’s own freebirth stories and a very comprehensive birth education section, Sarah Schmid’s book offers a variety of stories of planned freebirths, accidental freebirths, stories of freebirthing families who navigated different types of obstacles (that’s the section I found Stephanie’s story in) and also stories of baby loss.

Families have been choosing family centred unattended births for as long as I can think. The fist time I ever heard about it was back in Germany in the 90s and I elaborate on the story in my book (purchase link below).

There's a definite groundswell now as maternity providers are alienating more and more families with their approach to communication and attempts to control. Families are doing the maths and they want for the type of birth experience we saw on the movie screen.

Void of any real choice for relationship based home birth support (outside of very few exceptions) and fully aware of the limitations of the medical approach to birth, families increasingly choose to rely on themselves in order to protect each other from the potential harm that birth trauma can cause to the integrity of their relationships.

They do it discretely and in private and though most of it will not be captured for the silver screen the birth revolution is in full swing.

In Gil Scott-Heron's words:

'The revolution will not be televised
[...]
The revolution will be no re-run, [sisters]
The revolution will be live'

and it 'will put you in the driver seat'!

In the next few weeks I'll be co-hosting a family birth women's circle in Derry with the beautiful Faye from Birthfreedomproject.

I also have a few face to face aromatherapy sessions available in Belfast and in Dungannon and as there are some babies about to make the journey earth side very soon, there'll be spots available on my R.O.A.D. To Birth program (for remote support or as part of your massage package). 

Want in on any of it? Send me an email to [email protected]