The Original Birth Attendants

I’ve often heard midwives say that midwives were the original birth attendants or that midwifery is the world’s oldest profession (or second oldest profession, as the case may be). Some also claim that we know midwifery is “natural” because even animals have “midwives.” And while I certainly give midwives credit for helping women give birth - both now and in the past - none of the above statements are true. The original birth attendants were friends or family members of the woman giving birth.

Judith Goldsmith writes in her book Childbirth Wisdom from the World’s Oldest Societies that, “Many students of childbirth, however, speak of the midwife as woman's first helper. In reality, though, even the midwife is a relative newcomer on the scene. In those tribal communities where birth is aided, the assistant is most commonly the woman's own mother.....A casual reading of anthropology does not always make these close family ties apparent, because often the European writer, seeing things in the light of his own background, referred to the person assisting the mother as the ‘midwife’ whether or not she was called this or considered as such by her own society. Further examination, however, reveals that the so-called midwife was very often a close relative of the mother, with no more special knowledge of birth than any other mother in the tribe. This underlines an important point: in a large part of the world, except in difficult cases, a birth required no more specialized help than the members of a woman’s own family could provide."

Michel Odent, M.D. echoes these sentiments in his recently released book The Functions of the Orgasms: “The concept of a birth attendant is more recent than is commonly believed, although a mother or mother figure was probably around when a woman was giving birth in primitive societies. This was mostly to protect the privacy of the birth woman against the presence of wandering men or animals. No doubt this is how midwifery began.”

Odent also claims that “Everywhere in the world there has been a tendency to dramatically alter the original role of the birth attendant, to deny the birthing woman’s need for privacy and to socialize childbirth. More often than not, the midwife has become an agent of the cultural milieu, transmitting its specific beliefs and rituals.”

Veronika Sophia Robinson, publisher of the UK magazine The Mother, expresses similar views in her book The Birthkeepers: Reclaiming an Ancient Tradition: “We’ve been led to believe that midwifery is the oldest profession, but this is a romanticized notion, and not a fact. It is perpetuated by practitioners of midwifery and childbirth. When assisted and observed birth did start becoming common place in our history, the attendant was not a specialist in birth, but most usually the mother of the woman in labour.”

As far as animals, some do give birth in the presence of other animals (although most seek seclusion). But these animals cannot be considered “midwives” in any sense of the word. As with tribal cultures, the animals “attending” are simply other members of the pack or herd. You can be sure that none of these “attendants” are sticking their paws inside the mother animal’s vagina, or telling her when and when not to push.

So why does this matter? It matters because as unassisted childbirth grows in popularity, I and other unassisted birth advocates are hearing from more and more midwives and midwife supporters who claim that we’re infringing on their territory or that unassisted birth isn’t “natural.” Some even write that (in the case of an unassisted birth gone wrong) we’re “giving homebirth a bad name.” But the truth is, not only is unassisted childbirth natural, it’s also safe, provided a woman doesn’t live in poverty, and the birth isn’t interfered with either physically or psychologically. Throughout history, healthy tribal women have successfully given birth without medical assistance.

I recognize that many women find the presence of a midwife helpful in birth, and I hope that midwives will continue to be available - to those who want them. But birth doesn’t “belong” to midwives. Nor does it belong to doctors, the AMA or the state. Birth belongs to mothers and babies – and ideally to fathers should they choose to be involved, and it’s time this truth was recognized.

An Unconvention and a new book about unassisted childbirth

I'm excited to announce that plans are in the works for an "UnConvention"! Featured speakers will include yours truly speaking about unassisted homebirth, Lee Stranahan speaking about unjobbing (earning a living without a job), and Sandra Dodd speaking about unschooling. Lee and Lauren Stranahan, the primary organizers, have put up a website and created an email list for those wishing to stay informed about this exciting event! I'd also encourage you to check out Lee and Sandra's personal websites.

I've only recently become aware of Sandra's wonderful work, but have "known" Lee and Lauren for several years. In addition to being unassisted birthers and unschoolers, Lee is also a writer, photographer and independent filmmaker. He recently quit his job as a graphic artist for NBC and is determined to earn a living doing what he loves. As a recent unjobber myself (in January I closed my nanny placement service), I'm especially interested in hearing what Lee has to say!

In other news, Veronika Robinson, publisher of The Mother magazine , has just released her fabulous new book - The Birthkeepers: Reclaiming an Ancient Tradition. I can't say enough good things about this book! Veronika's words are both soothing and inspiring, as are those of the women whose lovely birth stories are featured in the book. Since I'm not much of a reviewer, here is the "official" description:

"The Birthkeepers is a personal invitation to birthing with ecstasy. Veronika Robinson, editor of The Mother magazine, reveals the three secrets to easy, natural vaginal birth. Through examining childbirth history ~ our evolutionary blueprint ~ and reading stories from modern day birthkeepers, we can begin to reclaim an ancient birthing tradition, and make birth safe and sacred again. Despite a dominant birth culture and media images which portray birth as deeply traumatic, painful, deadly and dangerous, this isn't how evolution designed our entry into motherhood. How we give birth, and the experience we have, isn't just a matter of luck or having the best medical attendants. We can all choose to give birth in peace, painlessly, and with pleasure. This exploration of unobserved (unassisted) childbirth shows that what's good for the birthing mother, is also good for the baby arriving birthside. The Birthkeepers is the first UK book on unassisted childbirth."

In the next few weeks I'll be adding it to my bookstore but for now those wishing to buy it can send me $25.95 ($21.95 plus $4.00 postage) via Paypal - laurashanley@comcast.net. If you're in the UK I'd recommend buying it from Veronika directly.

Orgasmic birth on "The Doctors" (CBS TV) 1/26/09

Last week I took a quick trip to Hollywood where I spoke ever so briefly about orgasmic birth on The Doctors (CBS TV). The show airs this Monday (Jan. 26th). Because it's syndicated, in some areas it airs on other networks. For local listings click here.

While most of the recent press I've done has been about unassisted childbirth, orgasmic birth is actually a subject I've long been passionate about. I first wrote about it in my 1994 book, Unassisted Childbirth and newsletter "Letters From Home." My article Orgasmic Childbirth has been on my web site since 2000, along with several other articles about the sexual nature of birth. In 2002, The Mother Magazine (UK) published my article Orgasmic Childbirth! What's the Secret? and in 2005, I was interviewed about it by the London Times. I also spoke about it in 1999 in the unassisted childbirth documentary A Clear Road to Birth and have done several radio shows about it over the years. Most recently, I was interviewed about it by the Huffington Post.

My interview for this show was quite short - I believe they asked me 3 or 4 questions. They may also be showing a short clip from my first homebirth. Of course, I would have loved to have shared more of my thoughts on the subject. But for the most part, I felt good about the interview and thought the doctors were fairly receptive to what I had to say. All in all, it was a fun trip!

Thoughts on 20/20's Extreme Motherhood show

Last Friday, "20/20" (ABC TV) finally aired their "Extreme Motherhood" show. All of the segments are now online (click on the videos in the articles): Unassisted Childbirth and Homebirth with Midwives, Orgasmic Birth and Long-term Breastfeeding. (There were also segments on "fake babies" and "serial surrogates" but they didn't interest me and I didn't watch them.)

The homebirth piece was quite short (5 minutes) but I was happy with how I was presented, and felt that the essence of what I wanted to convey came through! The beautiful opening shots of the mountains were taken near my home in Boulder.

There's been somewhat of an uproar in the homebirth community because there was no distinction made between unassisted and midwife assisted homebirth. This surprised me, as the producer had read my book (Unassisted Childbirth) and spent several hours (both on and off camera) interviewing me. I'm sure she knew they were two different things. Perhaps it was an editing mistake, or maybe they didn't feel it was important to distinguish between the two approaches to birth. Yesterday I wrote to ABC and encouraged them to do another show, specifically about unassisted childbirth. Actually, the producer that originally contacted me last year had hopes of doing an hour-long show completely devoted to unassisted childbirth. But apparently the higher-ups nixed the idea.

Most homebirthers were also disappointed by how Abby Epstein's birth was presented. Abby directed Ricki Lake's film The Business of Being Born. Because Abby transferred to the hospital (after going into labor prematurely and discovering that her baby was breech), her story was used as an example of a homebirth gone horribly wrong. While it's true that Abby was fairly panicky in the cab ride to the hospital, in the actual film I didn't get the impression that she or her baby were in grave danger. Her midwife felt there was a problem, and they headed to the hospital. In any case, I was glad to see the film mentioned, and thought Ricki did a nice job answering Elizabeth Vargas's questions.

The orgasmic birth segment was excellent! Debra Pascali-Bonaro, producer of the new film Orgasmic Birth, did a great job explaining the concepts behind the film. Amber Hartnell, whose incredible birth was featured in the film, spoke eloquently, as well, as did Christiane Northrup, MD, author of "Women's Bodies, Women's Wisdom." I was interviewed for this segment also, but didn't make the final cut. A couple good articles have been posted about orgasmic birth in the past few days: Orgasmic Birth: The Natural Reality Behind The Hype by Lee Stranahan for the Huffington Post (I was interviewed for this one) and Orgasms During Childbirth? It Happens by Yvonne Fulbright for Fox News.

I was pleasantly surprised to see my dear friend Veronika Robinson, publisher of the Mother Magazine (UK), in the breastfeeding segment! I didn't feel this segment was as positive as the others but Veronika spoke beautifully, as usual.

While the show left a lot to be desired, I was happy to see these subjects dealt with on national television. It was a good introduction, if nothing else.

Homebirth on ABC's "20/20" Jan. 2nd

Jan. 2nd I will be speaking about unassisted childbirth on ABC TV's "20/20" as part of a segment on homebirth (both unassisted and midwife-assisted). There will also be segments on orgasmic birth and long-term breastfeeding. This week, several articles in connection with the program have been posted on the ABC news web site:

Unassisted childbirth and homebirth with midwives: Mothers-to-Be Saying No to Modern Medicine

Orgasmic birth: Labor Orgasms Called 'Best-Kept Secret'

Video about long-term breastfeeding: Extreme Breastfeeding

As usual, there will be negative comments from those who disapprove of these practices, but hopefully some truth will get through. If nothing else, it should get people talking!

"Freebirthing" to air on the Discovery Health Channel

The unassisted childbirth documentary originally titled "Outlaw Births" and now renamed "Freebirthing" will be airing on the Discovery Health Channel on Oct. 21st. As far as I know, the only things that have changed are the title and perhaps the narration. I enjoyed the British version, but as expected, there were numerous unsubstantiated comments from medical professionals about the supposed safety of hospital birth and the dangers of homebirth (specifically unassisted homebirth). In my interview with the producers last summer I addressed many of their concerns but most of my comments ended up on the cutting room floor.

I've posted clips from the British version of the program on a web page I put up called Freebirthing.org. To see the Discovery Health Channel's page about the program click here.

It will be interesting to see what, if any, changes will be made to the US version. A producer from Discovery Health contacted me a few weeks ago to see if some of the "facts" presented in the program were indeed facts. I wrote him a long letter telling him more than he probably wanted to know! I've included some of my comments below. I'd actually be suprised if any changes were made to the program, but we'll find out soon!

Dear Emil,
I’m glad to hear it will be airing in the US. Overall I thought it was good, although I felt they were wrong to say that 50,000 UK women hemorrhage each year, without adding that much of this is due to medical intervention – epidurals, pitocin, aggressive management of the third stage of labor, c-sections, etc. Without bringing in this fact, it makes it appear that large numbers of women will naturally hemorrhage if a birth isn’t medically assisted.

Nine pregnant women were actually interviewed for the documentary (although most weren’t featured), and all nine went on to successfully give birth unassisted. None of the women hemorrhaged, and only two sought medical care after the birth – Heather, for a placenta that was slow to come out (but came out without assistance in the hospital), and another woman who tore and decided to get stitches. Heather is now sorry she went into the hospital, as many women that give birth at home deliver the placenta hours (and occasionally, days) after the birth with no problems. There really was no reason for concern. And so I would dispute the narration that accompanied this segment, as they implied (if not outright stated) that Heather was in serious danger.

Regarding the statement that “80% of women say that childbirth is more painful than they ever imagined," I googled “childbirth more painful than imagined” and found several references to a UK study from 2002. However, the article states that of the women in the study, “Almost a quarter had had a Caesarean and 96 per cent gave birth in hospital with a variety of technical assistance including forceps, suction and epidurals. Only 6 per cent reported having a 'completely natural birth.'”

As far as the accuracy of the comment in the end of the program that "For Laura Shanley the responsibility rests on the medical community to offer a different kind of support to women," this actually bothered me, as I would never make a statement like this. I believe the responsibility rests on women. If women truly want to have a better birth experience, they need to educate themselves as to why birth can sometimes be problematic. From the research I have done, I believe it can be traced to three main causes: poverty, unnecessary medical intervention, and fear (which triggers the fight/flight response and shuts down labor). We cannot depend on the medical profession to “save” us from birth, as we really don’t need to be saved – and their idea of saving (inductions, c-sections, etc.) brings with it a new set of problems that are actually causing an increase in both maternal and infant mortality. And so I encourage women to overcome their fears, believe in their own abilities and allow their bodies to work the way they were designed.

The producers of the documentary did ask me what doctors, midwives and doulas can do, and I told them they can help women to believe in themselves (and this is the clip they showed after making that statement). But I would never put the responsibility on the medical community, as I do not believe birth is a medical event. Contrary to what many reporters are saying, the unassisted childbirth (UC) movement isn’t simply a reaction to over-medicalized birth (although that’s certainly a factor). I think interest in UC is growing because women are wanting to take responsibility for themselves in all aspects of their lives. They no longer feel comfortable turning themselves over to the “authorities.” The idea that “doctor knows best” doesn’t sit right with many people anymore. Yes, doctors are necessary and sometimes their services are needed. But when it comes to birth these days, I believe they are creating more problems than they’re fixing.

Please let me know if there’s anything else I can do. Dare I say, there were several other statements made in the documentary that I didn’t agree with – and actually addressed in the hours of interviews I did with the UK crew. Unfortunately, most of that ended up on the cutting room floor. Still, I’m thankful that I was able to say as much as I did (I did a 4-hour interview with the Seoul Broadcasting System a few years ago, and when the documentary aired a year later my part was 15 seconds long). I also felt the British did a nice job presenting the women’s stories. I don’t object to them including negative comments from doctors, but many of the comments made simply weren’t true.

Best wishes,
Laura Shanley

Reviews and clips of "Outlaw Births"

The unassisted childbirth documentary “Outlaw Births” aired in the UK on Wed. night and by all accounts was an interesting program! As usual, there were numerous negative comments throughout from medical professionals but that’s to be expected. There was also too much emphasis (by most accounts) on the problems one American woman, Heather, had on delivering her placenta. The placenta was slow in coming so Heather went to the hospital. While this actually wasn’t an emergency, it was presented as such in the program. Still, in most people’s minds this didn’t overshadow the beauty of Heather’s homebirth.

Two clips have been posted on YouTube. The clips feature UK UCer Clair and her partner Yasmin, but in the beginning of the first clip you’ll see 2-second shots of 2 other UC’s – Josephine’s and Monique’s. There is also a shot of my friend Cassie looking euphoric as she holds her baby just after the birth, and a few shots of Heather and another UK UCer, Clio in labor. Click here and here.

I’ve already received numerous letters from people around the world who would like to watch the program. Unfortunately at this point it isn’t for sale, although I’ve been told that eventually it will be shown in other (as of now unknown) countries. Those who live in the UK can view the program free here.

I’m enclosing two reviews below, one from my UK friend Cassie, and another by a writer for the Guardian newspaper. Unfortunately the production company has yet to send me a copy so I can’t add my own comments.

From Cassie:
Channel 5 is one of 5 channels available to everyone within the United Kingdom with a TV set. I was extremely pleased and impressed by the program overall. Three births were shown. Clair, our very own Heather and also Clio of Evolution Expands Consciousness.

It started out badly edited really, chopping between Clair (ex nurse in London planning a UC) and three medics - one head midwife from Colorado, a male consultant here in London and a female consultant also based in London. The three medics were obviously saying how dangerous it was, how women die, how "interventions make birth safe" and that the tools they have prevent mothers and babies from dying in childbirth. They also said about 50,000 people each year suffer from PPH (post-partum hemorrhage) in the UK. Didn't mention the fact this was probably due to them yanking out placentas and cutting women up with episiotomies whilst they were strapped to their backs and immobile through epidurals....

The program hinted for a good part of the hour long documentary...that the practice may not be legal in the UK. They even avoided having their own film crew at Clio's birth...just in case the film crew was prosecuted. This continued right up until Clair went to see Beverly Beech, Chair of AIMS (Association for Improvements in Maternity Services). At that point Beverly said quite clearly that anyone telling a pregnant woman that UC was illegal was either 'ignorant or lying.' The program misquoted the wrong piece of legislation associated with possible prosecution...saying it was 1997...when in actual fact it's 2001.

Clair I felt was featured most centrally. She is an ex nurse and also a lesbian. They didn't make as big of an issue out of this as I had expected them to, which was nice. She put herself across on the documentary quite well, being very honest in her fears and her hopes. She went for a class with the British Red Cross...and the man who gave her lessons on how to resuscitate a baby did not at all seem phased when she pointed out there would be no midwife at her birth. He just made sure she understood what he had taught her and seemed quite confident he had equipped her with the knowledge to save her child, should the occurrence arise. She birthed at home with her partner alone. Bit of screaming when the head crowned, but she was ecstatic and far happier it seems with this birth than her previous two experiences.

Clio - was AMAZING. Quiet, serene, peaceful. Positively empowered and never uttering once about negativities.

Heather - beautiful! Was filmed with our dear Laura at a gathering that was held at Laura’s home with other women. The birth was beautiful. Unfortunately out of all of them, this is where the negative spin came when Heather still hadn't birthed the placenta. The ominous narration of 'this is the most dangerous time and Heather is seriously at risk from PPH and infection of her and her baby.' It was the only time I yelled at the TV. Of course everything was fine but it almost gave the impression of 'thank god...see how lucky she is.' It also showed Heather, checking her blood pressure in Wal-Mart lol, and her meeting with a midwife to learn how to resuscitate a baby if needed. The midwife was quite negative when interviewed afterwards and said she needed more support. I wanted to slap her a bit lol.

Laura was interviewed. The website shown and apparently...Laura...you have a 'cult' following. There was footage shown of Laura’s birth back in 1978. The interview bits that were shown of you were not as choppy as some of the others done with 'experts.' You probably got as much if not more coverage as the female UK medic. A basic view of UC came across very nicely from you, as well as your additions on what you hoped Dr's, midwives and doulas should learn about supporting women. ALSO the UK female medic acknowledged the fact that women were turning to UC because the standard of care they received in NHS hospitals was poor and that needed to change!

So it wasn't a parade of freaks as some of these documentaries tend to do. It portrayed 3, educated, empowered and confident women giving birth to their babies without assistance. It showed their fears, concerns, hopes and dreams through their plans and births. It also addressed the legal and medical concerns surrounding UC. Overall...as I said....a very good piece on unassisted childbirth.

It also has the net in a spin. I have been dropping hints about the programs on a number of mainstream boards. They are buzzing about it. Even though many of them wouldn't personally choose to go UC themselves, they admire the births, do not condemn women for choosing to go UC. I can count on probably 1 hand the negative comments I have seen made after the airing of the show (so far) and all of them can generally be put down to that individual’s own personal horrific hospital experience. Well done and congratulations to everyone who was involved in the making of the program!

From Anne Pickard of the Guardian newspaper:
The women in Outlaw Births weren't criminals. They just delivered their babies their own way
Thursday July 10, 2008

Anyone wondering if childbirth really is as painful as everyone says would have found their answer in Extraordinary People: Outlaw Births (Five). In at least two out of three cases, yes, it really did look that painful. And messy. And not for the squeamish. But it was at least a real and unflinching portrait of natural childbirth - as well as a reminder of how unusual it is to see uncensored images of women giving birth and breastfeeding on primetime TV.

Of course, to get it into the schedules, it had to be given a stupid name. Outlaw Births? The programme highlighted the fact that unassisted births in the UK exist in a legally grey area - but "outlaw"? I half-expected to see mothers popping out little black-hatted baddies with sawn-off shotguns shouting: "Put 'em up, this is a robbery!"

Clair MacVean, a quietly passionate ex-nurse, was sad that her friends thought her mad and that her grandmother would worry. But she wasn't to be shaken out of her opinions. "Births are overmanaged, over-medicalised and midwives seem to have lost their empathy," she said. When her NHS trust refused her a home-birthing kit after she refused their midwife, she took herself off to a medical-supplies shop to buy sterile scissors for cutting the umbilical cord. "And who's going to do it?" said the nice lady in the medical-supplies shop. "Me, probably!" Clair replied, cheerfully. "Oh!" said the nice lady, lost for words.

Two other women shared their experiences and, even though you sensed that nothing bad was going to happen, you knew that it could. And you knew they knew, too. Clio Howie gave birth in the company of her husband and children in a remote cottage in Wales, half an hour from the nearest doctor. In almost complete silence, her baby slipped into the birthing pool and emerged the right way up, the right colour and softly crying as he was laid on her breast.

Clair and the third freebirthing mother, Heather, fared less well. They spent hours screaming and contorted, but both ended up with a tiny, perfect person. Every now and again, an obstetrician or a high-ranking midwife appeared and said: "Our problem with this is that it could be dangerous and someone could die and we don't want mothers to put themselves and their babies in situations of unacceptable risk."

Their unsupportive attitude became shockingly clear when Heather, worried that the placenta had not followed the baby out, took herself off to a hospital. There she was treated with disdain. "Well, what do you expect us to do now?" her doctor said. Still, whether you believe these women are taking unacceptable risks or not, their calm dedication made for an absorbing film. "I've had several cups of tea, he's had several little breastfeeds; it's been a lovely morning - wake up, have a baby, and ... " said Clair, waving her hands, "this is the way it should be. Birth is part of life."