Location, Location, Location

Location is everything. Especially when it comes to giving birth.

If you've taken the time to envision what your best birth experience looks like, then you must also do the research to determine where you have the most likely chance to achieve your vision. In my state, women have three viable options for giving birth.

In a Hospital
Contrary to popular strategy, I highly recommend choosing a hospital before choosing a doctor or midwife. The reason for this is simple: if you deliver your baby in a hospital, then the majority of your care during labor will be determined by the hospital's standard procedures and administered by the nurses on duty, NOT by your primary physician. Most of the time, the doctor shows up when the mother is ready to push the baby out, i.e., at the very end of labor. It is the hospital's policies and the hospital's nurses who can dramatically affect the course your labor will take.

Take time to research and tour the various hospitals in your area. Ask questions related to anything that can influence labor and delivery, including the rate of interventions and cesarean sections, if the hospital has a "time limit" on how long a woman is allowed to labor, if a birth tub is available (for waterbirth), policies regarding eating and drinking during labor, the hospital's feelings about doulas, and any after-care concerns. Personal recommendations from friends who have had positive hospital births can also inform your choice.

Hospital policies vary greatly so I cannot stress the importance of doing thorough research enough. For example, in my city, one hospital has a 37% rate of c-sections (the national average is 32.8%) and an 80% rate of any intervention. This means that, in this hospital, only 2 out of 10 women give birth naturally and more than 1 in 3 births end in c-section. But less than 10 miles away is another hospital with a 13% cesarean rate and only a 30% rate of intervention. In that hospital, 7 out of 10 women achieve a natural birth and just slightly more than 1 in 10 end in c-section. Two hospitals, within 10 miles of each other, yet with radically different birth statistics.

Know the type of labor experience you want. Know the hospital that is most likely to provide it.

In a Birth Center
Birth centers are more recently appearing in my area and provide a home-like experience with some of the privileges of a hospital birth. Birth centers provide a private bedroom where mothers can wear their own clothing and labor in any way that is comfortable for them, including in a tub (where they can also choose to give birth). Centers can be staffed by midwives and nurses who often have privileges at a nearby hospital in case of a need to transfer.

Birth centers are an excellent option for moms who want to labor naturally within a more comfortable home setting, as no interventions are available in the center. The midwife who is on-call when a mom begins her labor will stay with the mom through the entire birth, providing a consistent presence and care for the delivery. Some centers are overseen by or work in partnership with obstetricians, pediatricians, lactation consultants and other specialists as needed so that parents have access to services similar to hospital births.

If you know that you want a natural birth experience and holistic midwifery care but are hesitant to be out of a hospital, find out if there are birth centers in your area. Again, just like hospitals, the policies and staff vary from center to center, so it is important to research, tour, and talk to the various centers available. Also, since birth centers are relatively new, some insurance companies do not cover the costs of labor and delivery, so be sure to check with your insurance provider if money is a concern.

Or, Give Birth at Home!
Homebirth deserves a post all of its own, especially since it is near and dear to my heart and yet incredibly misunderstood by the majority public. In some states, homebirth is not a legal option, but for those where it is possible, I highly encourage any woman who wants a natural and empowering birth experience to consider this a valid option.

Let me state clearly, however, that homebirth is not for everyone. By this I mean that, unlike hospital births, homebirth mothers and midwives actually self-select in order to achieve the best possible outcome. Homebirth midwives, just like hospitals and birth centers, vary in their experience and comfort level with risk factors involved with births. A mother's personal health history, previous births or miscarriages, and current health during pregnancy may preclude her from being able to have a homebirth. Additionally, at any time during prenatal care, if a midwife feels that the mother or child is at risk, she will (or should) refer the mom to an obstetrician for more involved care.

With all that said, however, if you are a healthy mom with a low-risk pregnancy who wants the comfort and control of delivering her baby naturally, then you are an excellent candidate for homebirth. Some benefits of homebirth include being assured that the same pair of midwives who care for you during pregnancy will be present for your baby's birth; an increased involvement of the baby's father (just ask my husband - homebirth is alot of work for the dad!); and the security of your own familiar environment during labor. Not to mention the fact that you are guaranteed a natural delivery, unless you transport to a hospital.

The point is, where you choose to have your baby will impact how you have your baby - and how you may feel about yourself and your experience afterwards. Take the time to understand the options available to you and to imagine the possible outcomes at the locations you investigate. This is your body, your baby, and your birth experience; you deserve to make a choice that is most comfortable to you and which allows you to be in charge of the route your experience will take. Even though we cannot predict the type of labor we will have, we can plan the place where it will happen. And that decision lays the foundation for all of the choices we will (or will not) have once labor actually begins. Choose wisely!

Begin with the End in Mind

1. Get pregnant
2. Find a doctor
3. Write a birth plan
4. Give birth at the doctor's preferred hospital

In general, this is the order in which most women approach their pregnancies and birth experiences. But, in my opinion, this is completely backwards. 

Consider how we usually approach other major life decisions. For example, how did you decide where to attend college? Realizing that factors such as cost and distance from home come into play, we still usually select a school based on our long-term goals. Our process looks more like this:

1. Decide on a career
2. Determine what undergraduate/graduate work needs to be accomplished to pursue this career
3. Research and choose a school with a good program in this field

Generally speaking, we make the most important decisions in our lives based on the end goal. So my advice to women who want a positive birth experience is to begin with the end in mind.

1. Have a birth plan - what does my best birth look like?
2. Research and choose the location that is most likely to achieve this experience
3. Research and choose a caregiver that supports this plan

My next post(s) will discuss points #2 and #3 but right now I'd like to focus on #1 - dreaming about the best possible birth experience.

I believe it's important to visualize and articulate the most ideal birth experience for you because this goal can and should inform all the other decisions you make regarding your prenatal and labor care. In order to do this, though, you must begin by reflecting on how you perceive pregnancy and birth. What comes to mind when you hear the term "labor"? What worries you the most about being pregnant and/or giving birth? How do you feel about becoming a parent? 

While there are probably many resources to facilitate such reflection, I highly recommend the book Birthing from Within, written by a registered nurse and certified nurse midwife. This book treats childbirth as an act of self-discovery and provides some phenomenal (often artistic) exercises such as journaling, meditation, and painting to help women analyze their thoughts and fears surrounding pregnancy and birth, as well as a discussion on labor techniques and the role of the doctor/midwife and father.

As you analyze the values and desires you have about giving birth, you can then begin to decide what type of experience you want to have and determine what factors need to be in place to achieve this goal. This includes your opinions about various drugs, labor positions and birthing options (such as waterbirth), who will be present, and how you want to deliver your baby. 

I highly suggest talking to other mothers about the choices they made, why they made those decisions, and what they may have done differently. Watch the incredible documentaries The Business of Being Born and Orgasmic Birth. Read books about pregnancy and birth (my absolute favorite is Ina May's Guide to Childbirth, which is definitely bent towards natural birth but includes birth stories, practical advice, and the full range of information regarding birth practices).

The point is, be informed about birth before you make decisions related to it. Even if you are already pregnant and seeing a doctor, if you discover new information and want to make a different decision about your care, you can change your mind.

For all of you moms out there - what other advice or resources do you suggest for yet-to-be-mothers? What do you wish you had known before you were pregnant/gave birth? 

I'm Writing For You!

Before I continue with this series of posts on pregnancy and birth, I thought I should take a moment to clarify who I hope will benefit from it.

If you had a positive pregnancy and birth experience, then I’m writing for you.

Because of the negative expectations surrounding pregnancy and birth, I’ve found that those of us who enjoy this season and achieve the births we want are often silenced in our stories. I’m continually amazed, when I share my joyful experience with groups of women, how most of the group will assume I am some kind of special exception to their war stories, and how, later, one woman will quietly pull me aside and thank me for speaking up. She will comment, in one form or another, that she rarely shares her wonderful experience because her friends make her feel guilty for not having endured their pain.

But if, as I contend, there is so much fear in our society about birth, then shouldn’t our response be to tell as many brave, victorious stories as possible? If women have been created by a God who designed our bodies to create, sustain, and bring forth new life, then shouldn’t we sing praises for the beautiful times that this occurs?

So I am writing this series to encourage those of you who were blessed with peaceful pregnancies and glorious births to tell your stories! Give hope to the women coming after us and share the wisdom that you learned in your birth journeys.  

If you had a less-than-ideal or traumatic pregnancy and birth experience, them I’m writing for you.

While I celebrate the incredible stories of the women above, I must also acknowledge that a great deal of women feel guilt, shame, discouragement, and disappointment with their pregnancy and birth experiences. I want to be clear that my series in no way intends to disgrace or dishonor you. I also want you to know that there is a God of HOPE who desires you to move beyond shame into freedom, to release guilt into surrender, and to exchange discouragement for comfort. I believe that God is powerful enough to achieve this for you!

At the same time, I earnestly pray that my series encourages you to honestly reflect on your experience so that you, too, can tell your stories and share wisdom with the women coming after us. If you can evaluate the many factors that played into your experience, then you can help prepare other women and, perhaps, guide them towards a different outcome. Sometimes, genetic heritage plays a significantly larger part in the destiny of your experience; but often, knowledge and informed decision-making can contribute even more. You have knowledge! Share it!

Most importantly, if you have not yet conceived but one day hope to experience pregnancy and birth, then I am especially writing to you.

Consider this: in the first trimester of your pregnancy, you are exhausted. All of the time. So exhausted, in fact, that you can fall asleep anywhere, and when you’re awake, your mind is falling asleep even if your body somehow manages to keep your eyes open. You are hormonally unpredictable. And you have an entire range of emotions surrounding the fact that you are, in fact, now pregnant and responsible for another human life.

This is not exactly the most ideal time to start thinking and making decisions about the most intense, intimate experience of your life – giving birth. Yet, for most women, it is not until they achieve pregnancy that they even begin considering the immense weight of these types of decisions. Many women have not healthily evaluated their own fears, desires, and questions surrounding pregnancy and birth until they are forced to find a prenatal care provider and choose a hospital.

So my own personal prayer, with this series, is that all the women who are not yet carrying babies will begin their journeys towards pregnancy RIGHT NOW. Gather information from a variety of sources before you have an emotional or personal stake in the matter. Take some time to find out your family history and reflect on what you think about pregnancy/birth. Where did those ideas come from? What information do you wish you knew?

I welcome and invite comments, suggestions, and questions from all of you! I have plenty of ideas of what I’d like to cover in this series, but because I want this to be an encouragement for story-telling and a source of information for yet-to-be moms, your feedback will help me write for our entire community and not just what’s in my head. J

p.s. I am not intentionally discounting men from this series, particularly if you are a married man but not yet a father. Information is power, so I hope that this series can be informative for you as a partner in parenting and broaden your ideas of how women can experience this incredible miracle.  

Let's Start At the Very Beginning

NOTE: The views contained in this post are purely the opinions of the author, who is not a medical professional or a trained birth consultant. Most of what is written here should fall into the "common sense" category of knowledge, but it is up to you, the reader, to think critically about the statements made here and to pursue additional research to refute or support these claims.  

If giving birth is like running a marathon, then how does one achieve the best possible birth experience? I believe that the nature of a woman’s pregnancy and birth is determined primarily by three factors, all of which began long before she was carrying a baby:

Some % Genetic Heritage.

How a woman’s sisters, mother, aunts, and maternal grandmother experienced their pregnancies and births is certainly no guarantee, but it can give her some indication of how her own experience may go. Additional genetic considerations include personal health such as allergies, food sensitivities, general and reproductive health, and any other physical ailments that you may be dealing with prior to pregnancy. None of us begins from "ground zero"; our family and personal health history factor in to any new stage of our physical bodies, especially one as major as pregnancy. 

My mother carried five children through healthy pregnancies to our due dates (or beyond); she delivered all of us vaginally, with minimal interventions, and very quickly (eight hours was her longest labor). And she gave birth to her last child at age 40! Both she and I have exceedingly healthy immune systems, no allergies, and regular menstrual cycles. Thus far, my own pregnancies and labor have been very similar to my mother’s, so I have to believe that it’s not all because of my own choices. However, I do believe that I have -

Some % Personal Responsibility.

The way that a woman cares for her body – long before she conceives – and during her pregnancy have a significant effect on the health and happiness of her pregnancy, as well as the ease of her labor. If you have a history of eating processed and fast food, drinking caffeinated or sugary beverages, smoking or drinking alcohol to excess, and minimal or no exercise, then your body, long before it carried a baby, was already in a less-than-ideal state. You may not have perceived any negative affects from these choices, but your body, over time, was running on cheap fuel. 

Again, consider the marathon training analogy. No marathon runner would consider McDonalds, Coke, and extra helpings of ice cream to be an appropriate diet in preparation for running 26.2 miles. Yet, when a woman is pregnant, we often only think of the affects such food and drink would have on our babies, without considering the cost on our own bodies. If we want to be prepared for a lengthy, exhausting labor, then we should be fueling our bodies with strengthening, healthy food. 

Doctors generally agree that whatever level of exercise was present prior to pregnancy can be carried into pregnancy as long as the woman is comfortable. I know runners, dancers, and other active women who continued these demanding physical activities well into their seventh or even eighth month of pregnancy. I believe that exercise not only prepares our bodies for labor but it also makes us more aware of ourselves and in tune with the sensations of pushing through our physical limitations. Even if you have not had a regular exercise routine prior to pregnancy, you can train your body during those 9 months, just as non-runners train for marathons every year. 

In the end, however, I believe the largest contributing factor to the pregnancy and birth experience is

100% Mental and Emotional Preparedness

The majority of women in the U.S. "know" about birth through completely false means - via an actress, who is portrayed in excruciating pain, usually angry at her partner, and surrounded by nurses and doctors who swoop in at the slightest sign of worry. 

Contrast this to most of human history, and current experiences in other parts of the world, in which birth was a normal, communal, feminine event. When a woman had a baby, she was surrounded by her sisters, daughters, cousins, mother, grandmother, and 'midwives' - the women of her tribe, so to speak. Most girls grew up seeing and experiencing birth long before it happened to them, and they knew what to expect based on personal, firsthand knowledge.   

I am convinced that the #1 reason so many women have less-than-ideal birth experiences in this country is because they approach pregnancy and birth with limited understanding and quite a dose of unaddressed fear. As a result, they make choices based on cultural norms instead of personal confidence and trust someone else to tell them what to do and how to experience their own bodies. They spend little or no time preparing their minds and hearts to handle birth. 

Studies have long demonstrated the incredible connection between what the mind believes and what the body experiences. One recent study on runners actually "demonstrated that the brain can be trained to allow the body to physically handle more." Researchers examined how mental fatigue affected the perception of physical fatigue during exercise and noted that "overall, it seems that exercise performance is ultimately limited by perception of effort rather than [other factors]. Therefore, the brain gave up and subsequently sent signals to the body to also cease, even though the body showed no physical signs of complete exhaustion" (emphasis mine). 

Any marathon runner knows that, in addition to the physical training, she must train her mind as well, or she will not cross that finish line. The state of her mind and emotions will allow her to keep going and finish strong or convince her to collapse in defeat. Yet, not nearly enough women approach birth in this way. In subsequent posts, I will discuss in more detail how to prepare your mind and heart for pregnancy and birth, but let me encourage you with these words:

"If you are going to win any battle you have to do one thing. You have to make the mind run the body. Never let the body tell the mind what to do. The body will always give up. It is always tired morning, noon, and night. But the body is never tired if the mind is not tired. When you were younger the mind could make you dance all night, and the body was never tired...You've always got to make the mind take over and keep going."

 ~ General George S. Patton, 1912 Olympian

I'm About To Run A Marathon!

Imagine you have decided to run a marathon in 6 months.

You reason, “People run marathons all the time! I don’t need to do anything special to get ready for it; we all cross the finish line in the end.” So you don’t train. You don’t change your diet or exercise; you don’t recruit a running buddy or put together a playlist on your ipod.

The morning of the race, you join the mass of other runners. Your husband is on the sidelines to cheer you on, but otherwise you’re alone in the crowd. You start at a good pace, full of adrenaline and excitement. But pretty quickly, your body starts to weaken. After all, you haven’t run long distances before and you’re feeling parts of your body that you never really knew existed! There are pit stops along the course, but when you check in, you’re not offered any water or energy drinks. Instead, someone checks your pulse and blood pressure, reads off some stats, and sends you on your way.

It doesn’t take long for your muscles to cramp up and for you to experience an intense amount of pain. You seriously doubt you can run another mile. When you look for your husband, instead of feeling reassured, you grow more worried because of the anxious look on his face. In fact, it seems like everyone around you is concerned that you aren’t going to make it. At each pit stop, a volunteer mentions that you aren’t doing too well, aren’t running very fast, and politely suggests that you might need some ‘help’ finishing.

You decide to push on but every muscle in your body is fighting against you and your husband looks desperate. The moment you arrive at the next pit stop, you leap onto the stretcher that’s offered. You know you cannot run a single moment more. A kind volunteer offers to push you, on the stretcher, to the finish line, where your husband greets you with happy relief.

Yes, you completed the marathon. And your body recovered from the shock and pain of it. But most people would consider you foolish for neglecting to train the past 6 months, and you will most likely want to push this experience far from your memory.

Giving birth is like running a marathon.
If you properly train and prepare for it, then you can actually enjoy it! Just like marathon runners, women can experience the exhilaration, power, and accomplishment of giving birth, if they have wisely disciplined themselves ahead of time.

"I've learned that finishing a marathon isn't just an athletic achievement. It's a state of mind; a state of mind that says anything is possible." - John Hanc

Training for a marathon does not eliminate the pain of running it. Your muscles will still ache, you will still doubt along the way, and you will want to eat a horse once you’ve finished! But proper preparation teaches you how to manage the pain and puts YOU in control of how you will finish.

Sadly, too many women in the U.S. approach giving birth in the way I described this marathon runner. Then, they are left feeling cheapened or cheated by their experiences. In subsequent posts, I will share what I consider to be the most necessary information for women to consider as they approach pregnancy and birth.

In the meantime, I have almost completed my own training! It helps that I've done this before. My body is healthy and strong; I've gathered my running team and prepared the course. Now, I just have to run!

Daddy's Girl

As I eagerly await the arrival of our second daughter, I all the more appreciate the special bond that my husband and 3.5 year old little girl already enjoy. Not only do they spend some amazing quality time together each week, but they also have so many wonderful similarities! I thought it would be fun to share some here.

1. Clean Hands!
Both my husband and my daughter must have, at all meal times, a napkin or wet washcloth next to them. Their hands must never be sticky, messy, gooey, or otherwise unclean.

2. Must Love Animals
We've always joked that my husband should have been a veterinarian or some animal whisperer because he just genuinely loves (and connects with) all animals. Our daughter shares this delight, whether it's the loud macaw at the pet store, the baby goats at the zoo, every dog we ever see, the birds at the Raptor Center, or the hermit crabs at the kiosk in the MOA.
*Note* Both parties also have a shared hatred and fear of winged insects, especially those that sting.

3. This is the Best Day EVER!
Over the last 3 months, every single day, my daughter will exclaim with incredible joy, "This is the best day ever!" First of all, let me clearly state that she does NOT get this from me. I was a very serious kid, just as I am a pretty serious (read: not fun) adult. So her exuberance is a clear reflection of the positivity and joy that my husband most definitely has.
But it is also a component of their personalities (for those of you with MBTI insight: both of them have the SP temperament). My husband and daughter both live in the moment, so whatever activity they happen to be doing is always the "best" thing they could be doing. Once they get involved - in a movie, a playdate, a party, a shopping trip - it is FUN and it should NEVER END.

4. Snuggle Sleepers
Every since our daughter was born, she could snuggle into the crook of Daddy's arm and they could both sleep soundly for hours. To this day, they can sleep very close together (i.e., in her little twin bed) all night long, undisturbed by loud noises, light, or any other sound. This amazes me. And, I think, will be very handy when a new, crying baby comes around.

Of course, our daughter has many of my traits as well, but her perspective and experience of life is much more similar to her father. Which works out just fine for me, since I fell in love with him, (generally) understand him, and like hanging out with the guy.

I look forward to getting to know this second one and learning her ways!

Who's In Charge?

Every morning, I am greeted by a sweet, happy 3-year-old voice whose first question is, "what are we doing today, Mama?"

I have always appreciated the enthusiasm and energy with which my daughter has met each day, but as I have been reflecting on Jesus' challenging statement that I must be transformed into a little child in order to enter his kingdom, Maren's attitude has dramatically influenced me.


While there are many characteristics of children that I could focus on as I close my meditation on Jesus' words (recorded in the gospel according to Matthew, chapter 18), my daughter's simple morning greeting teaches me 3 things that I believe Jesus wants me to know [understand, put into practice]:


1. She is not in control. By asking me what the day holds, my daughter demonstrates her understanding that I'm responsible for what happens to her that day. She doesn't expect to be in charge of the day's agenda but rather, anticipates my leading and oversight. 


How different would my days be if I began them by asking my heavenly Father, "what are we doing today, Daddy? what is on your mind, what are your plans?"  


2. She trusts my plans. The joyful anticipation in her question reflects her trust that I have planned something good for her. She starts the day eager to know what I have in store for her, which reflects her past experiences with me and the relationship that we have built. 


Do I believe that God's plans for me are good? Do I trust him with the circumstances and details of my days?


3. She wants to spend the day with me. This will probably change as she grows up, which may be one of many reasons why Jesus references a child of this age. But right now, my daughter expects that she will be with me all day long, that we will experience the day together, and that our shared time will be part of the fun that day.


How eager am I to spend my day with Jesus? How much do I invite him into what's happening to me each day?


The innocent simplicity with which a 3 year old opens her day is incredibly humbling. That's the kind of heart attitude that God wants from me! And the fact is, if I were more like a child, in this way, then I would certainly experience more of God's Fatherly affection for me. Right? The more that I look to God to guide, plan, and walk with me through each day, the more I enjoy his presence and provision.


So right now, I am praying that I can learn from my daughter. I am praying that the Spirit of God would transform me into an eager, joyful, trusting child who can't stand the thought of spending a day without my Daddy. I pray this for you, too!