By Ina May Gaskin
Originally published by www.inamay.com, 2004-02-20
Grandmothers often brag about their grandchildren, and I’m no exception. Still, I would like to share with you the story and some photos (which I took) of my grandson’s birth. This story is remarkable because my son’s girlfriend Cheyenne, found an innovative way to give birth that worked very well for her. The photos will show Cheyenne in labor, not the actual emergence of the baby. As the baby’s birth approached, I had to put my camera down, as I was the midwife.
Cheyenne drew upon multiple sources of inspiration as she faced the challenge of her first birth. Cheyenne had previous experience as a doula and which certainly helped a lot. Additionally, a few days before her labor began, I gave Cheyenne an excellent birth preparation video called Belly Dancing During Pregnancy. I had advised women in labor before that it would be good to swing their hips around during the strongest rushes (contractions), but this was the first time that I had such a video available to show someone who was still pregnant. Cheyenne had also seen indigenous birthing techniques illustrated in my latest book, Ina May’s Guide to Childbirth. The book includes illustrations from 19th century medical doctors who observed indigenous births in various parts of the world.
Modern women can learn much about good birthing strategies from understanding something about indigenous birth techniques. Remember, no one strategy is going to work for every woman, but there are general principles that are conducive to successful labor. Upright positions and movement are generally good strategies for the first part of labor.
I was happy when Cheyenne decided to have her baby here at The Farm. I thought that she would do well in labor, but I wasn’t prepared for how brilliantly she in fact did it. She was truly a birth innovator. She made labor with a great big first baby look like fun. This was a first for me. I had been with a few women who had first babies as big as hers, but no one I had witnessed before ever made it seem like fun.
Moving forward now to the way Cheyenne’s labor went: When I arrived and Cheyenne was in real, active labor, she had the staff in hand. This first photo was the only one that I took between rushes. All of the rest were taken during very strong ones.
These still photos don’t really give the idea of how much Cheyenne was moving. Most of the time she was moving her hips in figure-eights with her favorite music playing, using the staff to give her balance and stability.
I have often offered women the chance to pull from a rope that is strongly anchored above them during rushes. This pulling helps a woman keep her bottom loose, What Cheyenne said that she like about the staff was that it accomplished this same purpose, but that it made it possible for her to move around the house and to be wherever she wanted to be. She could have gone outside with it if she had wanted to.
Samuel, who is a personal trainer, asked Cheyenne once around this time if her last rush had been a good one. “Yes!” she replied enthusiastically, with a big smile on her face. “It was the very best one so far!” Her enthusiasm was infectious.
Cheyenne chose to sit on the birthing ball, still holding the staff, as the baby’s head moved deeper into her pelvis. Now she was rolling forwards and backwards, in a movement that could be accurately described as “supported humping”. The staff gave her the stability she needed, and the ball allowed her to rest between rushes.
Many women raised in western cultures (but not Brazil) are taught from earliest childhood that pelvic motion is a shameful, even “dirty” thing to do. This is a true shame, as pelvic motion is really important to many women if they want to give birth with a minimum of pain and discomfort. I think that every pregnant woman should practice exploring the range of motion of their pelvis.
Cheyenne smiling, with her staff.
Cheyenne had to push only forty minutes. This is a very short pushing stage for such a large first baby. We have no photos of this part, since I had to put down my camera and put on my sterile gloves.
Gustavo’s head was on the perineum pretty quickly. Cheyenne was able to give birth to his head very slowly, which meant that she had no tear, no episiotomy. His forehead sort of resembled a Klingon from Star Trek for the first hour after birth, but babies’ heads are designed to make this sort of accommodation during birth without injury to the baby.
The moulding that you see in Gustavo’s head (which measured 37.5 centimeters, half a centimeter less than the largest head I’ve ever seen) is absolutely centered. This told me that Chey’s belly dancing pelvic movements had brought his big head into the very best possible diameter for smooth birthing. If his head had been aimed in an oblique direction, relative to her pelvis, this movement would tend to move it into a better position.
Here is Cheyenne’s account of her labor:
I don’t really remember being scared of childbirth. Perhaps one of the reasons is that I don’t have memories of people coming up to me and telling me horrible birth stories, even though I grew up in Brazil, a country where the rate of voluntary cesarean section is extremely high. In some private hospitals, the rate of cesarean section is more than 90 percent. The reason so many women expose themselves to major surgery and its serious risks is that they don’t know anyone in their generation and financial class who had a vaginal birth, and unfortunately their doctors reinforce and amplify their fears. Informing them of the most rare cases and complications of vaginal delivery gives the erroneous impression that vaginal birth is more dangerous than major surgery.
The other reason was that my mother would always tell me stories of this place called the Farm, where I was born and lived for the first three years of my life. I grew up curious about my place of birth and went to check it out when I was 18 years old ( I live here on The Farm to this day).
When I first moved here, I was submerged in a very loving birth culture community. I read Spiritual Midwifery then just to be acquainted with the local culture. After reading it, I was confident and happy to be a woman and to be able to experience childbirth.
After three years of living on The Farm, I moved to Boston and had the opportunity to work as a doula at a hospital prior to and during my pregnancy. Watching other women give birth helped me greatly in choosing what kind of birthing to have. By this I mean to choose at least what was in my power to choose, for instance, the kind of care to receive during pregnancy and the kind of attitude to have during labor.
From the little experience I had accompanying women during their prenatal period, I learned about hospital policies. I watched women accept or reject these policies and learned from the outcomes of these labors that it doesn’t make sense to standardize labor, especially when it comes to deciding how long any woman should be allowed to labor.
The first labor I watched during my doula training was one in which the mom was anesthetized from the waist down. Because she was numb to the sensations that help the baby be born, she had to listen to a crowd of hysterical-sounding nurses yelling at her. They had to pay particular attention to the electronic monitor to see when a contraction was about to start. The mother, who often looked disoriented, had to respond quickly to their commands, since she had to tell her body to do something when she couldn’t really feel anything. It was as if she had woken up blind that morning and had to orient herself through once familiar but now new and obscure territory.
The second birth I attended involved a mom who decided not to accept any of the drugs that were offered. When she felt the sensation of her baby’s head emerging from her body, she said out loud, “What a wonderful pain!” That birthing was so touching that I was very happy afterwards and felt inspired to have that kind of good experience myself.
There was a first-time mom who did not want to lie down on the bed because she found the bed too scary. She chose the floor instead and cuddled with her friend. She was very calm and seemed to enjoy the experience. She gave birth in a rather short time. She told me that the reason she did not take any drugs was that she wanted to be good to the baby.
Because the next mother took twelve hours to slowly reach 5 centimeters of dilation, her doctor called that “failure to progress” and ordered a cesarean. I was shocked to see the tools they used, the way they manually tore her incision wider than the cut already made with the blade, to hear the casual conversation about their vacations as they worked and the sounds of the suctioning instruments. I didn’t find it surprising that different women would progress at different paces and thought that hospital policies were too generalized. My opinion was that this mother might have been able to avoid major surgery and its risks if they had allowed her enough time to let her body do it.
I was very inspired by the births I attended (which were all for Brazilian women) so that when it came my time to have my baby, I wanted have a good time like many moms seemed to have. I decided that I would do everything I could to be healthy and be able to have my baby at home.
I faced my pre-labor and labor with excitement and a strong conviction about the need for movement during labor. After a couple of days at 3 centimeters of dilation, my partner and I went for a hike in the woods shortly after breakfast. Samuel gave me a walking stick that he found in the woods, and I used it to lean on when I felt a contraction coming. I liked the stick so much that I brought it home and placed it beside the door. When Samuel realized that I had saved that “rotten stick”, he wanted to know why. I told him that I wanted to use it during labor, because it had been so helpful in relaxing during the contractions I felt during the hike. He told me about a staff he had carved out of cedar for his dad fifteen years earlier and went to pick it up.
That night my sensations picked up. I grabbed the staff and leaned over it with all my weight, stretching my back and swaying my hips. It was wonderful to have something so sturdy that I knew I could put all of my weight on it all night long and not have to worry that it might break or that I might ruin it. If I wanted to put all of my weight on a person, even someone very strong, I would have to worry about their well-being. This staff had more endurance than a person.
So there I stood, with my staff in hand, doing belly dance moves with my hips (full moon and figure 8’s). I also sat on the birthing ball a lot. That was a good way to rest and keep moving at the same time.
I spent about 9 hours changing from one position to another. Then I felt a strong urge to poop, and so I did. However, I kept having this urge. Because my cervix was a bit swollen, I was advised to wait before pushing. (I spent this part in the toilet thinking I had to poop some more) Sitting on the toilet waiting for this elimination process to finish was really the only hard part of labor, as I could no longer relax my bottom. It was like having to poop but your guest is taking a bath in the only bathroom available. So you uncomfortably wait and wait…
Finally, I started pushing. I was on my knees on the floor leaning against Sam, who was sitting on the bed. Pushing felt like pooping so I knew how to do it. It felt great. After 40 minutes my baby was born. He was a bit gray but looking healthy. His little hands and feet were a bit wrinkly, and he just cried the sweetest of cries. I was so happy, that, with a big silly smile, I just watched him sleep for a long time.
Here's Gustavo at 5 months.
