Birth: Part One.

Dearest Loves.

I'm writing this note to offer whatever useful information I can to any of you who will ever give birth, or help facilitate someone else's birth, and to anyone who is interested in a very personal take on the ins and outs of homebirth in the modern world.

I had an amazing, well-supported pregnancy and the most ideal birth I could have imagined this past July, followed by easy breastfeeding and a relatively quick postpartum recovery. Some portion of that is certainly luck, but the rest is the result of several years of research, planning, and sticking to my guns. If there's any part of my experience that could help anyone else make the necessary choices to have their version of the same, I want to provide the straight story of the things that worked: good advice I received, my understanding of choices, preparations and outcomes, things to consider, and things to avoid. I discovered a lot during the months of pregnancy that I never found in any book. (There was also a ton of great information in particular books and websites, & I'll name those here as well, as there are countless forums with wildly conflicting opinions and books claiming to be The Book and it can be a loaded and confusing rabbit hole to navigate, so I can at least recommend the ones I found especially great.)

Again: I'm aware of what role good fortune played in my outcomes and certainly don't take any of this for granted, and also must champion the role of preparation to meet and elicit good fortune as much as possible.

Please take this for what it is, which is one person's highly subjective perceptions and opinions. It goes without saying that every birthing person is completely different, and what worked for me may have nothing to do with what will work for you. My intention is for anyone reading this to please take anything that feels right, and to let go of the rest. Nothing to fight about here.

Also, this contains a lot of information. Among other things, I'm going to be talking about my VAGINA. Because that is where babies - at the time of this writing, the majority of babies - come out, and it is where my baby made her grand exit from my body and into the open air. Dig? If that is TMI for you, don’t read this. You have been warned.

I went into my pregnancy having trained years before as a doula and then having assisted a handful of the births of close friends, all first births, all in hospitals in Los Angeles. Out of those handful, 3 went to an unplanned caesarian section (meaning that those women had not intended and scheduled it, as many do - they had wanted vaginal deliveries), and I think it's fair to say that those women were traumatized to one extent or another by the way they were handled. The 4th went beautifully until a resident (a doctor in training doing his clinical rounds) decided, without the attending midwives' knowledge, to try to dislodge the placenta: he pulled the umbilical cord and prolapsed my friend's uterus (which resulted in her needing to have her second baby as a scheduled caesarian some years later to avoid the risk of another prolapse.) The 5th was the best possible outcome, a beautiful experience with only relatively minor hassling and rushing on the part of the hospital staff: she was given a slowly elevating steady dose of pitocin to move things faster, asked for and got an epidural when the many hours of intensifying labor became overwhelming, and managed to get some sleep; we went through 3 or 4 shifts of nurses during the 24 hours we were there, and most were helpful and sensitive and kind; upon being checked in the morning after some hours of rest, her cervix had dilated beautifully; the doctor showed up in time to suit up and catch the baby. Everyone was healthy. 

I learned a great deal from doctor #5 about waiting during pushing, and saw that my friend barely tore at all as a result of not rushing, giving her tissues ample time in between contractions to stretch around her emerging baby. From nearly every other primary caregiver, I learned a great deal about what NOT to do: how not to scare a birthing woman or her family, how not to abruptly deliver bad news to the birthing person, how not to rush the placenta delivery, how not to lie, how not to refuse to pass a birth on to one's partner despite exhaustion after several deliveries in a row, how not to look at one's watch and push for things to hurry along based on one's own desire to make it to a date that night (yes, that really happened.)

I saw that the culture of each shift of nurses is distinct from the shifts that preceded and followed it, and that the nurses, unless challenged directly by another caregiver, will often make somewhat arbitrary decisions based on what they believe is the best care. Some will lie and be assholes to defend their decisions. My job as a doula with those nurses, who I've found to be a consistent minority, was to run interference and defend the space and agency of the birthing woman. With caregivers who were genuinely supportive of the birthing woman's own process, I helped, watched, and learned a lot as an ally and another set of capable hands. There are plenty of both kinds in the hospitals, as there are good and bad practitioners in any profession. The difference in a hospital setting is that it is completely unpredictable who will show up and when - and when someone unsympathetic to your needs shows up as your nurse in a hospital, it’s can be a hell of a lot of work to move the necessary pieces around to not have to deal with that person, or with those who are invested in them and their authority.

My conclusion is that, as a doula, I want to support everyone I love who chooses to birth in a hospital. For many of us, it really is the place where we feel safest, especially in as wild a state as one is in going through labor for the first time - it's great to be somewhere that feels so utterly capable of determining normalcy and handling problems. And for those of us with high risk pregnancies and predictably complicated births, those of us who encounter emergencies, and those of us who just want to schedule a caesarian, hospitals are a godsend. 

So. I would recommend to anyone reading this who DOES feel the safest in a hospital to BY ALL MEANS PLAN ON A HOSPITAL BIRTH. 100%.

Feeling safe is necessary for feeling relaxed, and relaxing as much as is humanly possible - not having to vigilantly ensure your own safety while trying to birth a baby - is the best way to have an uncomplicated and successful birth. Feeling in control and well taken care of, whatever that means to you, is the golden key to the best possible birth experience.

In no particular order of importance, I passionately recommend the following to anyone who wants a hospital birth:

1) Do proper research into the policies and outcomes at the different hospitals in your area - they vary enormously. 

Unless you're planning a caesarian, where do they really work their asses off to ensure vaginal delivery whenever possible? Where do they offer walking epidurals, in which the anaesthesiologists will scale down the intensity of the numbing to let the birthing woman feel her legs and control her own movement, which is essential for moving the baby's head into an engaged position in the pelvis and dilating the cervix? Where do they train their nurses to help position a laboring woman with an epidural to effectively move the baby down into that engaged position in the pelvis? What is their position on routine episiotomy, which should be that they do not perform them unless absolutely necessary? What are their recent statistics on C section outcomes? Will they allow you to eat and drink as much as you wish during labor to keep up your calories and energy, as they should?

Be very thorough with your questions, even if you feel like you're being a pain in the ass - please remember that you are considering who to employ to assist you with one of the biggest events of your life. You are beholden to no one. 

2) It must be said: births, especially first births, can be scary as fuck. Birth is beyond psychedelics. It is beyond extreme sports. It is the great leveler. So intense is it that, having now done it unmedicated, I have great respect for all of the reasons that that is a rare decision. It is a tectonic rupture in time and space, unprecedented in scope and depth, heralding an entirely new reality, comparable to a one way ride to another planet. 

That said, it is COMPLETELY UNDERSTANDABLE that most of us, raised as we are in a medicalized culture - raised to accept the authority and expertise of doctors, and to feel profoundly reassured by it - are much more comfortable having that experience managed for us. A doctor will tell you, from their experience, whether or not everything is normal and healthy, what to do and how to do it, and has in their back pocket a lot of tools for shaping the labor and delivery, including drugs and surgery. 

That said, PLEASE: CHOOSE YOUR DOCTOR WISELY. They're really not all the same. They have extremely different opinions on how things should go down. Please put your care into the hands of a person you agree with and trust, preferably someone who's recommended firsthand by someone who has comparable priorities to yours. Don't assume a doctor will rise to the occasion to do something different for you in the moment than they normally would, because they won't. They will do exactly what they have consistently done all along. So find out what that is. Ask around. If you want to work with midwives, ask them which doctors they love and recommend to have as their backup - they'll always know the best ones. You want to know in your gut that whatever interventions are being recommended are actually necessary, not merely convenient. 

3) At the risk of repeating myself: if you have never had a baby or seen a birth, you might not really know that it will be the most bonkers experience of your life. We've all seen the movies, but movies are always about something happening to someone else.

So: in all births, but especially in a hospital setting, you want to build in everything you possibly can to ensure that you will have all of the peace and support that you want. You will not be able to keep people out of the room in a hospital, but there are wonderful tricks to making sure it goes as well as possible. Mammals are not built to give birth under observation, so ensuring a maximum of privacy and quiet for your ease in a setting where there is generally very little of either is absolutely key. It is the trick of building a dark cave in the middle of a busy train station.

One such trick which I learned in a birthing class, the best I have ever heard and one I for sure would have used had I ended up in hospital, is to have whoever is filling out the intake paperwork state front and center that the birthing woman has PTSD. Whether she actually does or not (and it's really not for anyone else to say, frankly), saying that she does will ensure that the hospital staff act with much greater care and quiet and respect for space than they ordinarily might: i.e., they will knock before entering, keep voices down, and in general act in a manner that they should be acting anyways, in order to not trigger a freakout. This is a buffer that you want and need. Please don't underestimate the value of this.

4) Get an experienced doula. Seriously. Whether a partner is present or not. Having a seasoned advocate and badass support person whose entire job is to have your back under all circumstances is a tremendous, amazing boon in a situation where the birthing woman is very vulnerable and in a setting where things can happen very quickly. No to mention the arsenal of tricks that doulas have for relieving pain and moving the baby and every other thing one needs in labor. The doula is the person who will stay with you most or all of the time, whereas the doctor and sometimes even the midwife will arrive in time for the pushing and the catch. 

5) Birth is a hurricane of raw emotions and huge sensations and high stakes, and success relies upon being able to relax without self-consciousness into the wildness of all of that.

Therefore: Do Not Have ANYONE Present In Whose Company You Will Not Be Comfortable In An Altered State.  

What this means in reality is that if your mom, for example, wants to be there, but you know in your heart of hearts that you do not have a relaxed and easy time with your mom, NO MATTER WHAT, EVEN IF IT HURTS HER FEELINGS, DO NOT ALLOW HER TO BE PRESENT DURING YOUR LABOR. If she knows anything about anything, she will support you in whatever you need at this time, even if she doesn't necessarily like it. Because it's YOUR BIRTH, and is therefore about YOU. Please accept this Get Out Of Emotional Jail Free card from me. At no other time are you more wholly allowed to be entirely selfish in your choices, so - I implore you - don't let anybody get away with guilt tripping you about this. I have witnessed firsthand and heard endlessly about this exact dynamic: usually parents (but sometimes partners or siblings or others whose closeness "should" be OK but frankly isn't) in the room or at the hospital somewhere waiting and whose presence creates enough stress that the birthing body cannot relax enough to do its thing. The direct and quantifiable result of this is that the labor will stall. It won't happen to everybody this way, but it is frequent enough that it's a commonly told story. 

So: your mom, or whoever fits this description in your world, can come when the baby has been born and bring food and kvell with you. Find a way to say no. Create the buffer. Even if it's your partner. Even if it's your BFF. Examine your heart with great honesty about this, and only allow people to be with you in whose presence you can relax, for real.

6) If you would prefer to not have a C-section, I strongly strongly recommend prepping and birthing with a midwife, as they offer very different care than OBGYNs, and have a skill set that incredibly few doctors in this country are able to match. It was explained to me by an MD while I was pregnant that MDs are trained to intervene in a problematic birth, but not really ever trained in how to facilitate a normal healthy birth without intervening. Many midwives are able to administer drugs (although epidurals are only available in hospitals, as they are delivered by a line into the spinal cord rather than by injection or IV and are therefore more complex to deliver and monitor appropriately.) However: the midwife's expertise is how to employ every trick in the book to get things moving in the right direction without resorting to the surgery and drugs which are the doctor's provenance and are at best never needed, in my opinion. Midwives know how to do a ton of shit most doctors have no idea about and will tell you cannot be done. A perfect example is that it's a rare doctor who will deliver a breech baby - and yet midwives abound who, upon checking and finding out the position of the baby some weeks before the due date, can do a number of things to turn the baby into a more optimal position and/or deliver a breech baby without blinking an eye about it. 

And - you can absolutely have midwives as your primary caregivers in a hospital setting. There are a number of hospitals where that is on offer. So, again: research your options. 

7) Routine episiotomies are, in my opinion and in the opinion of the most experienced midwives I've ever met, a bunch of bullshit. They do not prevent tearing and in fact make tearing worse. There are women whose perineums are so godalmighty muscular and gangster that an episiotomy may be indicated during a delivery, but those occasions are rare. The comparison I was given by my midwife was the notion of trying to tear an intact piece of fabric versus trying to tear a piece of fabric that already has a cut in it - if you've ever tried to rip through something, you know how much easier it is when there is already a cut. Her opinion, as a midwife who's been catching babies since 1975, is that episiotomies performed routinely cause some of the worst damage and the most horrible recovery periods for birthing moms of anything that could happen, including caesarians, and are to be avoided. And, having pushed an average-sized baby out myself now, I concur: I had 2 stitches, was able to have sex after 6 weeks or so, have had minimal scar tissue formation, and my pelvic floor is more or less fully recovered at 4 months out. It is to some extent luck of the draw, but that doesn't make precautions and preparations irrelevant.

Part Two coming soon. Stay tuned, family.

xoxo

Bio: The Hydrated Version.

About me.

My work as a bodyworker and educator began as the silver lining of exploring and transforming my own wounds.

As a dancer in a rigorous conservatory program in college, I developed a chronic injury so severe that I was unable to stand still without searing pain and spasms in both of my hips, and was brought over the course of 2 years to a complete physical crisis that forced me to stop dancing. MDs told me that they could find nothing structurally wrong to explain what was happening to me. Upon their recommendation, I worked briefly with a physical therapist and found that the repetitive exercises were a blunt instrument which, in the absence of understanding, made my condition worse.

The first true relief I experienced was in the sitting meditation practice I cultivated while studying Buddhist philosophy and practice in India and Nepal the following year. The teaching I was blessed to receive during that time from the immensely kind teachers and translators I met turned my entire world toward an unprecedented era of rightness. As I trained my attention, my body began to calm down. It was a vital lesson in subtle awareness and control, in allowing and witnessing my mind amidst all the comings and goings of discomfort, and in our amazing malleability as ordinary human beings.

The second gift of that journey was to receive hands-on Feldenkrais work for the first time from a friend and traveling companion who hipped me to the incredibly rich world of sensation to be discovered in the body’s tiniest movements. The hands-on meditation on micromovement and perception that Feldenkrais offers, and particularly what arose for me in the permissive presence of a loving witness, made a profound impact on my sense of the exponential deepening of healing that becomes possible when attending to oneself at the body’s own pace, and in good company.

As soon as I could get my ass out of school, I enrolled in an accelerated massage therapy program with the idea that I intended ultimately to become an acupuncturist, and wanted to be able to perceive capably with my hands before working with tools. I loved entering into an altered state with people in sessions, both giving and receiving, and began to perceive the body’s structure as the layered material form of someone’s consciousness over time. For the first time I witnessed clients as they experienced shifts of perception which rippled instantly through their bodies, clearly discernible to my hands. 

The next lightning bolt hit in the form of the titan who became my Core Energetics therapist, a person who is still a central inspiration to me. I had recently dropped to my knees in the middle of a sidewalk and received a stern talking-to by a council of Gods while under the influence of psychedelics at Mardi Gras in New Orleans, and as the gifts of massively expanded identity and hyperawareness I felt began to fade in the midst of everyday life, I hunted for a way to sustain myself and learn to live in that state of openness all the time.  A trusted friend recommended me to the Institute for Core Energetics, and I was introduced to the work of Wilhelm Reich and his protege John Pierrakos via the fearless presence and teaching of Warren Moe. Reich and Pierrakos’s respective works with human (and global) bioenergetics remain the cornerstone of what I see as the true scope of the human capacity to heal. The total authority and unmistakeable honesty of the body’s knowledge is what makes Core Energetics, and other somatic or body-based forms of therapy, effective where I've found talk therapy inadequate. There was nothing to talk about except what the body revealed, and no amount of posturing, theorizing, explaining or intellectualizing was able to touch what a single instance of somatic recall achieved. I was completely changed by this experience.

Upon moving back to Los Angeles, I simultaneously began to study at the Shiatsu School, which was a hub for renegade geniuses like Dr. Vincent Medici and Ellen Heed, and to work at Play Mountain Place, the oldest free school in the United States and a sister school to Summerhill, the first democratic school for children in the world.  At the Shiatsu School I was plunged into Traditional Chinese Medicine theory and practice. More centrally, Dr. Medici introduced us to his Rule of Four as a thorough, elegant working method for the assessment of dysfunction, and trained us in a hands-on approach to the high-charge psychoemotional centers of the human body. As a new Play Mountain teacher, I was led to study the work of Carl Rogers, and began to recognize the developmental basis of bioenergetic constrictions in the body. I also started to see an alternative to the culture of containment and suppression to which most people are entrained from birth. Play Mountain’s focus on nonviolent communication, parallel with its permissiveness toward and intelligent direction of violent emotions in all people through the same kind of technology I’d experienced in Core Energetics, was hugely eye-opening. I saw adults becoming healthy and treating children with the respect that they had themselves been deprived of as young people, and saw children who were able to be fully and exactly themselves. It was and is a place of enormous wisdom.

I began to study Visionary Craniosacral work with the wizardly Hugh Milne, who guided me to a level of self-trust and self-love that I had never encountered anywhere else. In addition to neuroanatomy and the subtle techniques which allow the body to unwind, much of his teaching focuses on cultivating the intuitive faculties of the healer, and on the tremendous impact of bodywork upon the unconscious aspects of the self when it is presented as a loving act of ritual. I also studied with and then began to teach beside Elizabeth Guilliams, an intensely talented energy worker and intuitive whose use of crystals as living tools for transformation became a pillar of my understanding of the human bioenergetic field and its expressions across the material plane. Liz and I have taught children and adults together for well over a decade, and our work is a continuously unfolding marvel in my life, a lens of unwavering clarity and an effortless invitation to play with the constant brilliance of Life. 

I began to work as a volunteer sex educator for Planned Parenthood, teaching their curriculum on sexuality and anatomy and answering anonymous questions in 9th grade classrooms all over Los Angeles. The anatomy geek in me really bloomed when I began to delve into sexual anatomy. I discovered the radical literature of the Federation for Feminist Women’s Healthcare which began in the early 70s, when women began to teach themselves and their communities gynecological self-care in order to take control of their own sexual well being. That, and Ellen Heed’s then-nascent work with sacred female sexuality, inspired a deep inquiry into birth control methods that could be both female-controlled and non-disruptive to the delicate harmony of the neuroendocrine system. Despite my immense respect for Planned Parenthood's hard-won political clout and the adherence to mainstream medical practice that allows for their radical work, I quit when I couldn’t justify teaching 14 year old girls that their only good option is to take synthetic hormones to prevent pregnancy in lieu of a proper education about their bodies. As someone who champions the agency and intelligence of young people, I felt strongly that there had to be another way to move forward. The beginning of a new sex ed curriculum for teenagers began to form, one that proposed developmentally appropriate ways to discuss barrier methods, the cycle of fertility, the spectrum of gender, an exploration of consent, and pleasure as something that’s essential to human health. 

I began to learn from friends about the politics of pregnancy and birth in the United States, and trained as an Orgasmic Birth doula with the amazing Debra Pascali-Bonaro, who showed me for the first time in my life that a peaceful, empowered, normal birth is actually well within reach for the majority of birthing people - and that it is far from the usual state of play in the US. She planted some essential seeds of revolution in my heart, handed me a set of effective tools for supporting birthing families in both the hospital and home, and kicked me out the door to go see for myself and change the world. 

Over the subsequent years I assisted with the births of my friends, all in hospital, and saw firsthand the limitations and boons of the kind of care MDs and hospitals have to offer to the huge majority of birthing people in the modern world. I also saw information withheld that could have prevented unnecessary interventions, and a general lack of interest in helping people who had experienced their birth as traumatic, or who had suffered birth injuries which set up patterns of dysfunction that would be with them, according to their doctors, for the rest of their lives. In particular, I witnessed a flavor of shaming around vaginal injuries, especially  those that prevented pleasure, that provoked a really deep ire in me. The need for a feminist model of healthcare became all the more evident in the context of the banality of birthing practices that are violent towards women and trans people, and I committed myself to becoming an axis for accurate information and stalwart support across the spectrum of our changing needs and desires. I began to escort at abortion clinics on major church holidays when protesters would come out in force, and began to comprehend more completely the realities of a culture that has only recently begun to contemplate its emergence from a belief system in which women and people of color are the property of white men. 

In a spontaneous ritual, I invoked what I would need in order to serve the needs of the people who were showing up in my practice and in my life, and the Gods disrupted my entire life by granting my wishes. I went to study Holistic Pelvic Care with the incredible edge-walker who is Tami Lynn Kent, and immediately afterwards immersed myself in the world of Rosita Arvigo’s Maya Abdominal Therapy. Within two weeks of my return home to my beloved partner, and having just been turned upside down by unexpectedly and unmistakably falling in love with a fellow Arvigo student, I got pregnant for the first time ever after 15 incident-free years of tracking my cycle and using a cervical cap as my primary methods of birth control. During pregnancy, I enrolled in the California Sexological Bodywork certification program through the Institute for the Advanced Study of Human Sexuality, and in my second trimester I traveled to San Fransisco for the intensive hands-on portion of the certificate course. I was the only pregnant person who had ever participated in the program, and became a state-certified Somatic Sex Educator (SSE/CSB) less than a month before our daughter was born. 

Kora’s birth was the most insane and extraordinary experience I have ever had, and I couldn’t have asked for a better experience: fortune smiled upon us and we were able to go through the portal in the privacy and safety of our home. I was free of complications beyond my control, and handled the complications within my control with solid research and excellent help. And, maybe most importantly, I was cared for through the birth by my dearest beloveds, who acted as my capable and loving doulas, and was delivered by an indomitable mountain of a midwife. I had minimal tearing, received excellent scar tissue remediation care (and, more recently, essential formal training) from Ellen Heed and Kimberly Ann Johnson, and healed quickly. If you want to read a more detailed account of my pregnancy and birth, it can be found here.

There is much to say and a great difficulty in adequately expressing the transformations of the past 14 months. As a woman with an expanding identity, as a parent to a willful, clever daughter, as a sexual animal, as a partner to two spectacular and very different people, as an educator and practitioner and somatic researcher, it’s fair to say that the past couple of years has had the pace and wildness of travel on a rocketship, one which seems most of the time to be copiloted by angels. These days are filled with wonder. It's perhaps enough to say for now that the urgency I felt previous to pregnancy and birth, the desire to burn the patriarchy to the ground and bring this long age of fear and shame to an end, and my readiness to throw my weight behind creating a culture of power and pleasure and self-liberation, for everyone, here and now, and as the legacy we'll live out and hand to our kids - the force of that desire has drowned out my fears and hesitations, and it is the light I’m walking toward at the end of this crazy tunnel. 

Please feel free to contact me if any of this resonates with something in you. I’m here to connect.