Protect Birth

So I was studying the placenta yesterday and I just have to share with you how amazing this organ is.

First let me point out that the placenta is a foreign organ in the mother’s body.  It belongs to the baby.  Logically, the mother’s body should reject the placenta.  But it doesn’t.  Early in pregnancy the placenta anchors itself into the lining of the uterus (via protein).  The lining, in turn, protects the mother’s body from making abortive cells and rejecting the placenta and baby.

The function of the placenta is to provide the baby with nutrients and nicely oxygenated blood in exchange for waste and deoxygenated blood.  Here’s how it works:

Mom’s blood temporarily leaves her circulation and pools beneath the placenta.  There it is projected into the placenta in tiny jets.  Once inside the placenta, mom’s blood bathes the part that houses baby’s blood circulating through.  Then mom’s blood reenters her circulation through uterine veins.  The other half of this process is baby’s blood, which enters the placenta through arteries in the umbilical cord.  Down in the placenta, baby’s blood exchanges nutrients and wastes and reenters the baby’s circulatory system through the vein in the umbilical cord.

As technical as the process may sound, the two most important things to learn from this process aren’t very technical.  First, all of this happens with absolutely no effort on anyone’s part, save the being who created us.  That’s right, yet another part of the birth process that works flawlessly and we have nothing to do with it.  The second lesson is this, mom’s blood makes the placenta work, and her blood cannot do its job without proper nutrition!  Yet another reason among the countless others why nutrition is THE most important part of pregnancy.

I simply adore the placenta.  I always have, even before this.  But this deeper understanding I have of such an amazing organ and process has made me adore it even more.  At every birth I attend, I respect the placenta greatly.  I wait respectfully for the placenta to let go of the uterine wall and birth itself.  I talk to it and let it know that it has done a wonderful job and can let go of its attachment to mom.   When parents ask me what should be done with the placenta, I let them know that I would prefer it not be thrown away or destroyed, and if that is their choice I ask permission to take it so that it can be buried.

I am amazed by the process, but even more amazed by the fact that it continues to amaze me even more.

“The first intervention in birth that a healthy woman takes, is when she walks out the front door of her home in labor. From that first intervention all others will follow.” ~Dr. Michael Rosenthal OB/GYN

Now I’m a huge fan of Dr. Rosenthal’s. Actually, I am a huge fan of absolutely anyone who is working to further the birth cause. (Yep, that means you!) And I am amiss to make any statement even slightly contrary to such wise words. Even so, I’d like to put this out there. Because this is something midwives MUST remember.

WE are an intervention. We are a foreign introduction to the birthing woman’s environment.

Time and time again we hear proponents of gentle birth say it, birthing women need privacy, security, and an undisturbed environment. I don’t know if you’ve seen it, but I’ve read many a time that birthing is like having sex (gasp!). And I don’t know about you, but I don’t invite spectators into my bedroom when my partner and I are doing the deed. It’s an intimate time. We know it by heart. No one needs to critique our love making, offer position ideas, remind us to breathe, or let us know when it is time to climax. I’m not sure how we’ve managed all these years without this guidance, but we make do.

Am I saying I don’t think midwives belong at birth?

Certainly not.

But I do think we have to remember to stay invisible unless our presence is needed. We have to keep in mind that all of our work for a birth should have been done over the prior 8-9 months while caring for and educating the birthing woman. When midwives do their jobs well prenatally, our presence at a birth is rarely actually required. And until it is…hands off, mouth shut, lights down low. Any person who was not in the house at the time of conception is a foreigner. That’s usually mom, dad, and any children they may have already been blessed enough to be parenting.

What about support? What about checking on the well-being of mom and baby? Even then, you’re still a foreigner but don’t act like a tourist. Upset mom’s environment as little as possible. Speak softly in low, sure tones. Keep your energy in check and slow your speech down. In emergencies, use the same tones and look mom in the eye as much as you can. And talk to the baby. Babies are the partners in the lovemaking ritual of birth.

Staying quiet and keeping our intrusions to ourselves helps us tune into our intuition in birth as well. Makes balancing intuition versus clinical knowledge seem like a much less daunting task.

Being an intervention isn’t meant to be an insult. We are invited, we are welcome. If we are not, then we don’t belong there. But this doesn’t mean we aren’t doing women a disservice when we insist they birth our way, or interrupt the birth process continually because of our fears.

While walking out the door of the home in labor is sometimes the first intervention, also is walking in. Remembering this can make all the difference in the world.