Wednesday, November 23, 2011

When Pregnancy Blows

A lovely client of mine recently made an important observation about the tone of many natural, holistic books on pregnancy and birth. She said, "The statement 'You're pregnant! Congratulations! You are now a sacred vessel of life.' makes me angry. Why is it that the act of carrying a baby is what makes me sacred? Am I not already sacred without the need of a pregnancy to create or justify my sacredness?" Indeed.

I believe the intent of the sacred vessel statement is to help women embrace how great it is to be gestating a kid, affirming that they are special, worthy of extra self-nurturing. It's not malicious. However, this belief that pregnancy renders us sacred vessels puts an awful lot of pressure on women to match this projected beatific state with beatific behaviour...even when they're just not feeling it.

For the most part, most of the women I work with enjoy their pregnancies very much. Sure, they experience some of the uncomfortable symptoms like troopers, but are ultimately quite enthralled with their ripe states. And others absolutely can't stand being pregnant.

I have sometimes heard incredibly judgemental statements from the "You are now a sacred vessel" crowd regarding the women who experience their pregnancies negatively. I have heard people, many whom have never even experienced pregnancy before say things like, "Other women have been trying for years to have children and can't. You should be grateful to be pregnant at all." Or, "Your negative feelings are bad for the baby. You should work through why you are being so negative for your baby's sake." Way to blame! This is the same thinking which blocks a woman's grief over a disappointing birth experience, encouraging her to basically "get over it" because she and her baby are healthy, and that's the most important thing. Well, duh, it's the most important thing. No woman would prefer the alternative of a fabulous birth but an unhealthy baby. But can't we just take a woman's gratitude for granted and give her the space to authentically express her emotions in spite of a good clinical outcome?

Most books on birth don't have a chapter called "When Pregnancy Blows" (though I'm writing one). And I assure you, having worked with hundreds of pregnant women, I know sometimes it really does. Sure, there are some people in the world who are whiners by nature and turn a normal experience into one of abject misery by focusing entirely on the negative. Upon examination, you would see that this is the way they are in their everyday lives, not just in pregnancy. But in my experience, most women do their best to downplay the more negative aspects of their pregnancies for fear of being perceived as ungrateful.

The truth is that sometimes pregnancy is beyond challenging. Sometimes it's downright awful. I have known some women to be so floored by pregnancy that they spend an entire nine months either hospitalized on IVs or lying on their couches wrapped around a barf bowl containing upchucked Diclectin pills. I have seen women literally crippled by their pregnancies, suffering the excruciating pain of pelvic girdle dysfunction. Others develop complications, either minor or otherwise, which turn them from the vital, active women they are into what they feel are bedridden, vulnerable shadows of their former selves, wreaking incredible emotional havoc. To some, the act of expanding in girth is not just a vanity issue, but a deep seated terror rooted in past trauma. Very few women admit this to the general public, but sometimes those whose pregnancies put them into an unusual state of suffering have feelings of "I don't know if this is really worth it," and have literally considered terminating. Sometimes they get resentful of the presence of the baby inside who makes them feel utterly miserable, and begrudge their bodies for "failing" them when their friends are bopping around taking spinning classes until their due dates. Does this make them unworthy of being sacred vessels? Absolutely not.

Many women are shocked when they discover their pregnancies are less than they were cracked up to be because we are so adverse as a culture to talking about it. Letting women know in advance that pregnancy can be really rough on some is not going to make it happen or "give permission" to women to "whine" more about minor complaints. This is the same logic as saying, "If we talk about labour as being painful, then this will make labour painful. Labour is natural, natural shouldn't hurt, and the perception of pain is simply enculturated."

Do these women who suffer greatly feel guilty for these feelings? You bet they do. It is unsafe in proper company to speak so negatively of one's pregnancy without evoking judgement from others who don't understand. I heard one woman on Facebook say that she had had some itchy skin condition while pregnant and SHE never complained, so she couldn't understand why so many women complained so much about THEIR pregnancies, and that pregnancy was a time to be grateful and NOT complain. I'm sure this lady meant no harm and simply has not been exposed to some moms of twins who don't feel as stoic when they cannot lie down at all in the final weeks without throwing up, losing weight rapidly due to an inability to keep down food, or to ladies who are in wheelchairs because of severe pelvic and back pain.

Women who are not feeling great about being pregnant often also feel guilty that their negative perceptions are somehow harming their babies. But I think forcing positivity when it doesn't always exist or not giving vent to some of the authentic feelings that come up, such as extreme vulnerability, anger, resentment, and depression, can create worse problems. Stuffing back real feelings causes stress within the body, and stress has definitely been shown to have an impact upon the pregnancy and Baby's in-utero development. Instead of putting on a brave face when inside she's crying, it's probably healthier overall for a mother struggling with difficult feelings to be able to unburden herself in the presence of someone who will listen with empathy and compassion. Simply being able to have an emotionally safe space held for the acknowledging and accepting of not feeling at all like a sacred vessel can be deeply healing. After all, if you look at it up close, most of the time these feelings are appropriate reactions to crappy situations. If the mom weren't pregnant, the expression of feelings such as these in relation to a challenging life situation would be encouraged. But because she's a "sacred vessel", our culture seeks to look askance at her expression, and it is unfair.

When women repress their real emotions for fear of judgement, they tend to creep up uncontrollably, blossoming into the more socially appropriate condition of postpartum depression. While more well known and accepted than pregnancy negativity, make no mistake; postpartum depression is a serious state and has a far higher impact on the baby at that point. The longer a mother remains depressed postpartum, the larger the impact upon her baby, who very much needs to be emotionally attached to her for optimal development.

As a culture it is important for us to accept and honour the fact that while YES, pregnancy is mostly beautiful, amazing, transformative, and fun, there are lots of pregnancies that just blow. It is usually entirely beyond the mom's control, and she is often sitting on the sidelines wishing she were one of those shiny happy mommies-to-be. If we can meet those furtive admissions of suffering with understanding and compassion, perhaps the experience can be made just a little bit easier. We need to embrace all experiences of pregnancy and be inclusive of all women's feelings, not just the "sacred vessel" ones.

Saturday, November 19, 2011

Doulas: Women of Story

I often tell my students at the end of my doula training program that one of the most poignant aspects of being a doula is about becoming rich with story. Stories of people bringing new life into their families are juicy. They can be mellow or wrought with drama, but they are always meaningful, always interesting. It never fails to fill my heart at the honour it is to be present for the unfolding of each unique and special story. Doing the regular doula stuff, like holding hands, soothing, wiping tears and breathing with are only a small part of the role. It is the BE-ing a witness and participant at the beginning of a family's story, and following up to process it with them, watching them revel in their own reaction to it, that is for me the most meaningful part of my work.

I have held the space for so many stories; triumphs, tragedies, healings, and growth. Most of the stories are wonderful, full of the amazement of women owning their own power as they roar their babies ecstatically into the world. These stories lend the entire world a little grace and our culture a little healing in that moment the mother/s, father/s and child/ren discover each other in an oxytocin haze, a new family member and citizen born. Some stories are of trauma, either due to an unexpected emergency or at the hands of others, these traumas being worked through partly by the doula's gentle whisper, "You have the right to grieve. I take it for granted you are grateful for a healthy baby and will never remind you of the fact to block your tears." A few end in disappointment. "It just wasn't what I wanted." It is what it is and we breathe that in as a reality and work on happy mothering anyway. Rarely, some end before they have even begun. There are angel babies I hold in my heart, having witnessed first hand their passing. I have seen caregivers shaking in shock while I shake in my own and we have sometimes held each other in tears, human and powerless in the face of another's overwhelming sorrow. It is true what Ina May says: your heart will get broken. But I have learned to love better because it, and savour the joys more deeply. A few end in utter surprise with me catching a baby just before the ambulance arrives or before a resident, without backup in an overcrowded hospital, gets her gloves on. Many are first babies, one was even a 12th baby (though it came before I got there, "the fastest yet", the mother said). Some are journeys of deep healing, a reclamation of wholeness to restore faith in one's body that was previously thought to be defunct until the emergence of a precious child. And some are the bitter sweetness of hello and goodbye as the surrogate gives the child she's lovingly carried to his mother, or he goes with the social worker to be given to another family, me left tearful in the wake of some grief, but at the incredible spirit of wisdom and generosity of some birthers too.

It is the stories I have been privileged to have been invited to be part of that make me a woman of story, and which grace me with the honour of being an "experienced doula". It is one thing to start out bright eyed and bushy tailed at the thought of going to births and seeing new babies come out, ensuring a safe, natural passage with your presence. Then it is another to learn the crazy ropes of hospital politics and how to play the game (resentfully at first), as many seem to hate you even before you open your mouth, as well as see that sometimes you can pull out every single one of your cool doula tricks and not have anything go better birthwise for the mother as she goes off for the Cesarean. These are the days of, "What did I get myself into?" when after 40 hours of labour support, your mommy deprived kids at home, and an overburdened partner, you are unsure of your place in this unpredictable world of birth. Then, as you gather up enough story to you and your face becomes more familiar within the places you work, you feel lighter, more in your element, having found your endurance and your stride. You don't feel hated really...maybe just a little misunderstood sometimes, but more appreciated too. And you are able to let go of the fact that you truly don't have any control over how a birth goes. You glean comfort from knowing your support meant that a hard situation will be remembered better, or that the hours, sweat, and tears you put into rubbing someones back through each contraction contributed to that unmedicated birth the family wanted. Finally, even when it seems everyone in the hospital is nuts that day and it feels like nothing you're doing for the family is working at all, you can stand back, breathe, and love. Just love. All of them. Sometimes it's all we can do. And it is good. Good for you, good for them. It is Presence in action, and it is more powerful than you can imagine.

As a teacher I get to witness others as they witness their first births, those first stories being the true initiation into the world of doula-dom. I see the the tears of their joy at seeing new life emerge, the frustration of long hours of pulling out all stops then the birth ending in surgery anyway, the shock of hearing unconscious words or seeing disrespectful treatment sometimes, to them or to the parents, and the bleakness of some family situations. As much as it is an honour to witness birth stories, ALL birth stories, it is an honour to witness others on the path to becoming experienced doulas, to see the shifts that occur as they grow from newbies to women of story. It takes a lot of time and effort to become an experienced doula and to have snippets of story from most situations imaginable, but it is well worth the effort. The more experienced I see my former students and present colleagues become, the more in love with the work they seem to fall. I know I do. Each experience inspires me to recommit. If you're in the beginning phases and feel a little isolated, drop us a line. Sisterhood is far reaching. Here's to you becoming rich in story too.

Friday, November 18, 2011

More Business of Being Born: Bridging the Divide in the Montreal Birthing Community

It is with great excitement Betsy Thomas (of Bummis fame, whom I have had the pleasure of knowing for many years) and I (founder and director of MotherWit Doula Care) are joining forces to bring the first screening of Ricki Lake's and Abby Epstein's More Business of Being Born to Montreal.

There are a variety of reasons we wanted to do this. One is that it is always fun to inform parents-to-be or those considering parenthood about their options for birthing. The film we have chosen to show is one of a series of four, and it is entitled Doulas, Birth Centres, and C-Sections. It is an exploration of the options families have to choose from when making decisions about their birth experiences. Now granted, this film is American, so it will be important for us to put the options into Quebecois context. For example, many women have no idea that giving birth in a Birthing Centre or at home with a midwife is an option that is covered by Medicare here. And others may know this, but may not be aware that by the time their nausea has passed and they begin to think about their birth options, it will be way too late for them to acquire the services of a midwife as the demand for midwifery care FAR outweighs the supply here in Montreal. The vast majority of women who want the option of an out of hospital birth experience with a midwife will not have it. In and of it itself, this is a huge issue we as a community need to address and strive to remedy.

Another reason Betsy and I were excited about screening More Business of Being Born was that a gathering of "birthies" is always a lively, passionate affair. Bringing together the community of parents-to-be, new parents, birth activists, and birth attendants always creates the opportunity for rich discussion. It is through gatherings such as these that positive change can be made towards improving birth experiences for all families, no matter what they choose. It is for this reason I have organized a panel of birth attendants together for an after-screening discussion. I am so pleased to have on board my own beloved midwife for my fourth kid and author of Naissance Heureuse, Isabelle Brabant. Representing the crucial role of obstetric nurses in maternity care is Luisa Ciofani. Luisa has been practicing as a nurse for many many years at the Royal Victoria Hospital and is also a teacher of women's reproductive health as well as a certified lactation consultant. When a woman gives birth in a hospital, it is the nurse from whom she receives the most attention and care. We are also pleased to have Dre. Stephanie Morel from St. Mary's Hospital who is a family doctor specializing in maternal and newborn care. For women wanting a hospital birth but one that is typically lower in interventions and more open to maternal comfort (support for natural birth, support for birthing in mother chosen positions, support for delayed cord cutting and immediate skin to skin contact with Baby), the care of a family doctor is a wonderful option. The obstetrician on the panel is still to be confirmed. This is an important voice to have in a discussion among various birth attendants and consumers of medical care. Many couples feel most comfortable with the presence of a highly skilled surgeon at their births for "just in case" scenarios, and many must have the presence of an obstetrician at their births because of the high risk nature of their pregnancies. It is also important to remember that what contributes to the safety of our midwife and family doctor attended births is the available safety net of excellent back up obstetric care.

I will be representing the role of the doula in maternity care on the panel. I feel very fortunate in my work as a doula, which spans nearly two decades, in that I walk among the different "worlds". I may rush from a water birth with a midwife at Maison de Naissance to an elective Cesarean for a breech baby with an obstetrician. I may be at an induced labour of twins with the presence of a family doctor, an obstetrician, and two feisty nurses and then the next day witness a home birth in which the midwife skillfully catches a fast baby over the toilet. I may transfer with a labouring mom from Maison de Naissance to the hospital for a minor concern, and then continue supporting her while the family doctor eventually catches her baby (a VBAC) while she is on her hands and knees and the nurse turns off the light to facilitate a gentle bonding time for Parents and Baby. In all of these scenarios, my mandate is this: to support a family in having the best possible birth experience within whatever setting and with whatever caregivers are present. In my work as a doula, I have come to deeply value each and every role of the key players in birth attending, and it is with great honour I get to sit with some of them on a panel. Unlike everyone else on the panel, my role is entirely supportive, and entirely NON clinnical. My two cents has mostly to do with my having a deep understanding, given the closeness, hours of contact, and rapport I build with the families in my care, how they feel about their birth experiences; how it was impacted for the better or for the worse by the environment they birthed within.

The theme of this gathering, as well as to watch a highly anticipated new birth movie, is about bridging the divides in the birth community. Many members active in the birth community, from birth attendants to passionate birth activists, have criticisms about other members: their approaches, their choices, their methods, and their beliefs. This is the nature of having strong beliefs and opinions. However, I have personally witnessed midwives bash obstetricians, obstetricians bash midwives, nurses bash family doctors, doulas bash nurses, natural birthers bash those who loved their epidurals, pro Cesarean advocates bash those who want natural birth, breastfeeders bash bottle feeders, formula feeders bash intactivists, and so on and so on and so on. Personally, I'm tired of the bashing. There doesn't seem to be healing in that. What I want to see is a truthful but respectful discussion about what women want for their births, what collectively they have found to be most wonderful or hurtful to their experiences, what safe really means and what a family's responsibility is in making safe choices, and how everyone can work towards making the experience of childbearing as good, as joyful, and as pleasurable as possible NO MATTER where and with whom a baby ends up being born. It is important for people to know where birth practitioners are coming from, what motivates their decisions, what changes can be made to support what families want (and what perhaps cannot), and ultimately how to serve birthing families not only clinically, but supportively as well.

Our evening will be MCed by the lovely Shari Okeke, a reporter who has been with CBC Montreal for over 10 years. She will mediate the panel discussion and keep our evening running smoothly. Essentially, she will be our "event doula"!

Another important intent behind the screening of More Business of Being Born is to raise funds for Maison Bleue, and organization staffed by a midwife (Isabelle Brabant), family doctors, a social worker, nurse, and special educator ( ). These dedicated members work together to create a safe, nurturing, and empowering environment for families living under precarious conditions to birth and parent their babies within, thus preventing many of the associated risks. All profits from this screening will go to Maison Bleue. Representatives from Maison Bleue will be present at our event to take donations as well.

In order to create an opportunity for even more fundraising, small community businesses who serve the Montreal community will donate some of their products/services for a silent auction to be held in the theatre.

The Bummis and MotherWit teams really hope to see you there! A great night for a great cause!

30 November · 19:00 - 22:00
Doors will open at 18:30

La Maison Theatre
245 Rue Ontario Est
Montreal, QC

Please note that space for this one of a kind event is very limited!
Tickets are $15 and must be purchased in advance at: in person at Boutique Bummis:
4302, Boulevard St- Laurent
Montreal, QC H2W 1Z3
(514) 289-9415
*tickets will not be shipped but have to be picked-up at the door on the day of the screening*

Thursday, November 3, 2011

Illustrating the Need for Change

More Business of Being Born, four more films by Ricki Lake and Abby Epstein, is about to be released on November 8th. I wanted to take a minute to reflect upon how Business of Being Born has impacted my work as a doula.

While I was in the middle of watching the original Business of Being Born at a screening here in Montreal, I was called out to a birth. It was a first time mom, who had begun having contractions at about 37 weeks gestation. Right from the get go, things were speeding along, so I had to leave during the scene where the Woodstock hippies are dancing around. I was disappointed that I had to leave what was going to be a great night complete with a long awaited birth movie and a panel discussion, but hey, a baby was on the way. The knowledge that I was going to see a new being into the world quickly soothed my disappointment. I arrived at the hospital and Baby Danica was born smoothly and naturally very soon afterwards to her lioness of a mom.

A friend of mine had bought a dvd of BOBB, so I had the opportunity to catch up on what I had missed.

BOBB has impacted my work significantly. As a birth doula, my concern is with contributing to the necessary healing of our birth culture, which, in my humble opinion, is extremely challenged. Natural birth is seen as radical, and even crazy to the average person. More and more healthy babies are being delivered of healthy mothers via major abdominal surgery, grossly overreaching the 15% Cesarean rate the WHO recommends. The epidural rate for first time mothers in many Montreal hospitals is 98%. The vast majority of women receive some kind of hormonal stimulation to increase the "efficacy" of their contractions. Woman are delivering in positions that are antithetical to the natural mechanics of their birthing bodies. The way labouring mothers are engaged with intellectually, the room often filled with idle chatter or conversations which should be taken outside, when what they need is support for their primal brains to come to the forefront, impinges upon the natural flow of oxytocin, thus impacting a birth experience for the negative much of the time. Birth is essentially contained within an environment which places far more trust in the technology and medications than in the process itself. Ultimately, though, what frightens me the most is how the average woman views even the idea of normal birth as something actually unnatural, really having no idea of what the physical/emotional/and psychological benefits of normal birth are. When normal, physiological birth is held in contempt even by the women themselves, it is clear we have lost our way.

Business of Being Born serves as a critical and necessary change agent, illuminating the problems with modern North American birth practices. It teaches us how despite our oodles of technological obstetric know how, medications, and hospital beds, our birth outcomes are inferior to countries such as Holland and Norway which use midwives to support normal birth, and obstetricians mostly for treating pathologies in birth. The film shows evidence of the iatrogenic problems that can arise in birth when there is simply too much medical interference with a process that goes normally the vast majority of the time. We also get a necessary wake up call by witnessing American women being interviewed at random in New York City, being asked if they'd ever have a midwife. Not only do most say "no", but many look startled and begin extolling the virtues of planned Cesareans because they eliminate the big messy unpredictability of childbirth. I know many women AND obstetricians who watched this film with eyes wide open, the glimmering of an understanding of how essential change is if we want to protect the act of straight up, garden variety, unmedicated vaginal birth from becoming obsolete. Because honestly, in North America, we are almost there.

Not only does Business of Being Born depict the problems and illustrate the need for change, narrated by midwives AND obstetricians, it also lets us know how deeply moving, empowering, and incredible natural birth can be. Yeah, it hurts. Fair enough. But how that wonderful dance of hormones and baby love transforms women into powerful mothers when the journey is over is at the heart of this film.

What I found most important about Business of Being Born was that it isn't just a film which preaches to the choir. Sure, every "birthie" in town saw it, but so did many pregnant women and mothers who were not yet "converted" to regarding the possibility of natural birth as a desired thing. This film reached out to everyone, and many heard the message loud and clear. Personally, my clientele increased because more women were now savvy of what to expect for a hospital birth and wanted to come in with a presence who supported their desires for their experience, as well as honoured the safety net obstetrics and hospitals are seen to provide. BOBB emphasises how critical the support of a doula is for birthing, especially in hospital birth. The presence of a doula helps to increase one's chances of a more positive birth experience. Many of my initial contacts from my clients begin with their saying, "I watched this film called Business of Being Born, and I need your help to give birth within the hospital system".

One of the greatest gifts of this film, I felt, was the sharing of the personal birth stories of the creators, Ricki Lake and Abby Epstein. Ricki Lake is a well known public figure. She's been in films and has her own talk show. She discussed the birth of her first child, which was a hospital birth and not something she felt went the way she wanted. So she chose to have her second baby at home with a midwife. She honestly describes the struggle and pain of her natural birth, and her desire to quit a few times, as most of us do in labour, yet keeps on going with the encouragement of her partner and midwife. Ricki generously shares with us the image of her naked self in the bathtub of her home, birthing her baby, as something natural, beautiful, and absolutely triumphant, as an experience that helped her reclaim the power she felt she didn't have during her first birth. Hers is a story of healing and inspiration. Using her inspiration and her status as a public figure to illuminate the challenges of our birth culture, giving us a glimpse of how amazing birth can be by showing us her own story, has inspired thousands upon thousands of women to examine their own desires for their births. I wanted to stand up and applaud that someone whom, as a celebrity, celebrities being mostly viewed at the "too posh to push" types, was willing to share something so intimate for the purpose of illumination.

Abby's birth story happens near the end of BOBB. She goes into premature, very fast active labour with a breech baby. We follow her from her home where her midwife lets her know it's time to get to the hospital, to the lobby of her apartment where she is on her knees of the floor vocalizing with her friend Ricki doula-ing her, to the cab in which her waters break. She makes it to the hospital in time to have the Cesarean she and her obstetrician have agreed upon, and delivers a baby who is very underweight and with major breastfeeding challenges who has to spend time in the NICU. While she is sad that her experience was not the birth she was hoping for, this part of the film does clearly embrace the fact that problems DO occur in labour, and that our safety net of hospitals and obstetricians are clearly a good thing that we can celebrate, even as we move as a culture towards the idea of exploring more natural options for birth.

Business of Being Born presents two distinctly different worlds: midwife attended natural births, mostly at home, and highly medicated hospital births with obstetricians. One of the criticisms of the film I encoutered was that it gave Medicine a bad rap. Some of my doctor and nurse friends felt hurt. While they know there definitely major problems with the hospital system, their intent is never to do "bad" to mothers. As a developed nation, we do have the luxury of embracing home birth as a great option because of the safety net obstetrics provides if complications occur. They felt there was a suggestion in the film that midwife attented home birth is mostly good, and OB attended hospital birth is mostly bad. I would like to see a world in which both choices can be consistently fantastic and meet every mother's personal needs/desires.

As a doula, my challenge is to strike a balance between the two worlds and embrace the possibilities in both. While I do get to work with midwives outside of the hospital, the vast majority of my clients are hospital birthers. Many of these women wish to have, or must have due to health risks or lack of midwifery resources, their babies in the hospital. There are no pools to birth in, no opportunities to birth on the floor or a bathtub or by the side of the bed, and a lot of interruption from strangers. My goal is to bridge this gap, to facilitate the best, most natural birth process we can within this challenging hospital environment. A lot of the time, while women still receive the benefits of my tlc, they don't have the birth they wanted because they simply didn't have the control over the environment they wished to. I can do my best, but it takes two to tango. For the best hospital birth possible, medical caregivers need to be on board and respectful of the mother's wishes. There must be more openness to the mother's desire for more control over her environment, such as remaining quiet and observant whenever possible, following the mother instead of insisting she do what is easiest for the caregiver, and encouraging unmedicated birth if the mother wishes as well as unrestricted bonding with the newborn. The wonderful thing is that an openness is just beginning within the hospital system, as evidenced by many of the happy births I have been witnessing of late.

This is the exciting thing: several doctors I work with have seen BOBB as well. While it is never easy and can make one initially feel prickly to be lumped into the collective "problem" and negatively scrutinized when all you're trying to do is your work of keeping everyone safe and actually doing some great life saving work, I have certainly seen the acknowledgement of the need for change, and some changes in action. I have seen a general shift of more consciousness towards protecting the experiences of the family, more openness to women birthing naturally and in different positions, and more compassionate treatment. Many of the physicians I work with agree that the medical system is extremely challenged. While they are going to continue doing what they do, there are more who are trying to do it in a way that honours the importance of the experience of birth, not only focusing on a good clinical outcome. Obviously, as a mainly hospital birth doula, this shift in consciousness impacts my life immensely for the positive. While challenges are still rampant and there is much work to be done, I do feel the tides turning slowly.

In my lifetime, I doubt I will see a mass exodus from the hospital back to a homebirth majority. But hopefully I will see an environment where women can have what they feel is the best of both worlds: mostly uninterfered with, undirected births, but with quick access to the medicine and technology they want close by. If Dr. Michel Odent could create this environment within his clinic in France and enjoy both fabulous clinical outcomes and triumphant new families, maybe, just maybe, we can dream this hope into reality in North America for those who want and/or need a hospital birth. I am myself a home birther. This is where I feel safest and most confident. I am an avid supporter of the midwifery model of care, and hope there will soon be enough midwives in and out of hospital births to meet women's demands for them. But most women don't feel this way in North America. These ladies who prefer the hospital make up the majority of the beloved clients I provide support for. For the sense of security they get from being in the hospital, which is essential to their personal sense of safety, it is my wish they should never have to pay the exhorbitant physical and emotional price of having their decent birth experiences potentially put at risk with an often overuse of medical interventions without proper informed consent, an impersonal environment, and caregivers who are sometimes unaware of good birth etiquette. So instead of dividing the two worlds, for the sake of most women and not just the ones who are on either end of the majority, I strive to work on healing the divide so that everyone can have the best chance at a beautiful birth.

It is my greatest hope that this impetus towards a healing of our birth culture continues. The more awareness we bring to issues in and potential of birth, the greater the healing will be. I offer many thanks to all the creators and participants of Business of Being Born for having generated this necessary awareness on a huge scale, and am very much looking forward to More Business of Being Born to keep the momentum going.

Lesley Everest