Ann Jamison, co-founder of Homebirth Cesarean International, recently joined us for a LIVE chat right on our Facebook page to help celebrate our one year Blogoversary! Here’s what she had to say… Homebirth Cesarean International: Hi everyone! I'm so excited to be here. Congratulations to Momma Trauma on her Blogoversary! Momma Trauma: Thanks so much! I'm very excited about it! Thanks for joining us today, your network is so important to so many! I have some questions I've come up with for you, I hope our communities will add some questions as we go along, too! So I was checking out your page and it says HBC was founded on Dec. 14, 2011, Almost TWO years young!!! (I love birthdays.) What caused you to create this network? Homebirth Cesarean International: Great question. Homebirth Cesarean is a term first coined by our co-founder, Courtney Jarecki, to describe her own birth- a planned homebirth that ended in cesarean. Courtney's experience and background in birth work led her to begin researching a book about Homebirth Cesareans, and to create a closed Facebook page that would provide support for mothers, and a space where birth workers could come and listen and learn From those roots, the idea for an organization that would continue the work of education and support was born. Courtney and I began work on establishing HBCI this year, and we're currently seeking non-profit status.
Momma Trauma: Hi Sara! Great question, thanks for joining us!
Homebirth Cesarean International: One correction to the above- we are registered as a non-profit but are currently seeking exempt status. Momma Trauma: Ann, I absolutely agree. In my experience, it's kind of the top hush-hush thing in the birth world. Mindy S.: How often does it happen that women, who plan HBAC end up in HBC? Homebirth Cesarean International: I agree. I think that we want so much to believe that if we plan things just so, we can control every aspect of our birth experience. Birth is a big unknown! A huge event in the life of a woman. Of course we want to do our homework and work to get the "best" outcome- whatever that looks like to us. I think for many of us, we find ourselves believing that planning a birth at home will ensure we'll bypass a lot of unwanted interventions. Certainly, we think, we'll be able to have a vaginal birth. But that is not always the case, for a variety of reasons. Women who plan out of hospital births who then must transfer and meet their babies through surgery are often devastated by the huge gap between what they planned, and what happened. It is a lot to process, physically and mentally. We as birth activists have to find a way to talk critically about the high cesarean rate while still making room for cesarean as a very real possibility- one that isn't seen as a kind of failure. Hi Mindy - I'm sorry I didn't see your question sooner here! Mindy S.:That's alright! Momma Trauma: Love that, because as much as we don't want to talk about cesareans in a positive light, they absolutely play an important role in maternity care when truly needed. Mindy’s question is great (Hi Mindy!). She asked: How often does it happen that women, who plan HBAC end up in HBC? Sara, we'll come right back to yours. I have it noted! Homebirth Cesarean International: The statistics on these things are very hard to find. Unlike countries like the UK, we don't have a consistent way of gathering birth statistics across states. In addition, some women live in states where homebirth midwifery is under serious threat, and for legal reasons cannot or won't admit to being an HBAC. The short answer is we don't really know how many women that happens to. What we do know is that women who attempt HBAC and transfer to the hospital for cesarean feel the impact of that transfer experience on a deep level, and often report a need for greater postpartum support and a wish that their preparation for birth had been more open to all possible outcomes. HBC mamas we hear from often share with us that they did not read the cesarean chapter, and did not discuss cesarean with their midwives. Many believed this would not happen to them. When it did, they did not have the power of informed choice, because they lacked information about cesarean. Sara hello! One more thing for Mindy before I get to Sara's question. Mindy S.: That's my main fear, of being transferred. However, I keep telling myself, if I have too, I have to, and I will accept it. I just often wonder, how much will I accept it? I do live in Canada, so I'm not sure if the statistics are any different than the states. Homebirth Cesarean International: The data we have been able to get a hold of does show that midwives estimate that half of their transports end in cesarean. That of course, does not speak to the HBAC question specifically, but it's a related statistic. HBCI's plans. Oh yes! We recently released guided meditations for mothers healing from difficult births. These were created in partnership with a world-renowned hypnotherapist and are for *all* mothers who need healing- not just HBC moms. You can find those on our website. Courtney has also been involved in teaching classes for midwives on the homebirth cesarean experience, and continues to offer those through our website. (For any MW's out there- Courtney loves to travel! If you want classes in your area, just contact us through Facebook or our website!) Mindy S.: Is that a transfer of previous c-sections, or in general? Homebirth Cesarean International: We're also working on launching local support programs that will allow HBC mothers and other interested volunteers to receive training from HBCI in offering peer support to other HBC mamas in their communities. Mindy- it's just in general. I think that the fact that you're thinking about it as a real possibility is huge. I can tell you that I wouldn't even allow myself to consider it. And looking back, I wish I had worked on greater mental flexibility, I wish I had written a "plan C." Mindy S.: Does it matter why the previous c-sections were done, on whether or not a VBAC will be successful or not? Hope that question makes sense. lol Oh Sorry Sara! Homebirth Cesarean International: You might find that if you transfer, that you have complicated feelings surrounding your experience. After all, if you start at home, it's clear that the operating room is not your first choice by any means. My advice, sent lovingly, is to believe in your power as a birthing woman to meet whatever challenges you must face in your birthing journey. Arm yourself with oodles of information and with helpers you trust, and know that you have what it takes to make the tough calls, if they have to be made. I should also mention that HBCI is going to be offering an HBC Mothers' Weekend coming up this Spring. It will be a healing weekend retreat in the state of Washington. More details will be coming up about that on our website and Facebook. Sara M.: No worries, Mindy!! Ask all the questions you want! Homebirth Cesarean International: Mindy- good question re: VBACs. I'm not entirely sure of the answer. What I will say is that if you are considering a HBAC, that is exactly the kind of question you'll want to ask your midwife so that you are fully aware of your risks and options. Good for you for asking the right questions and learning about your options! Momma Trauma: Ann, are there any birth complications that are more common than others that you've noticed with HBC families? Mindy S.: Thanks Sara! I didn't mean to cut you off! Thanks! I appreciate your information! So nice to see there is in fact support out there these days for ALL kinds of birth! Homebirth Cesarean International: The risk for postpartum mental health issues is increased. This includes PTSD as well as postpartum depression and anxiety. It is also important to note than many families end up feeling increased financial strain. Many have paid out of pocket for the homebirth, then are faced with a large hospital bill. This is just another stressor in an already stressful situation. Momma Trauma:Certainly makes sense! Homebirth Cesarean International: I think if I had to name one huge complication it would be isolation. HBC mamas spent their pregnancies, usually, embedded in natural childbirth communities, whether it was at their birth center or their local homebirth peer group. When they have cesarean births, they often feel uncomfortable, or like they don't quite belong with their previous peer group, but they also don't feel at home at hospital-based postpartum moms' groups. (Even returning to the physical place of the hospital can be a huge challenge.) Momma Trauma: How about complications that resulted in the transfer and thus the cesarean delivery? Are there any commonalities in families there? Sara M.: Mindy - it's in no way researched, but in my experience of other mothers, I've noticed VBAC seem to be common when a prior c-section was elective (due to preeclamsia, etc) or because of a one-time emergency. I have a feeling it's all pretty much chance, though. Homebirth Cesarean International: So they feel like they're in a no woman's land. They need community and recognition if they are to find a way to integrate their experiences into their new identity as mother. Momma Trauma: Absolutely, I find that A LOT (probably the majority) of birth trauma families regardless of type of birth just cannot stand returning to the hospital, it's a huge trigger. Homebirth Cesarean International: Ah, I see- you mean the reasons behind the transfer? We hear from mothers with all kinds of reasons. Sometimes it's an emergency, and mama travels to the hospital in an ambulance and is under general anesthesia for the birth. Sometimes breech is discovered at home, and the decision is made to go to the hospital, particularly if the midwife who is attending does not feel comfortable midwifing a breech at-home birth (not all have training in this). Some women feel their transfers weren't necessary, and that their midwives made the wrong call. For others, like me, there is no real clear-cut reason. In my own personal case, I labored at home for 3 days with a very painful back labor. I never got a normal labor pattern going. We tried all kinds of things to get baby to come out and he just wouldn't. He wasn't optimally positioned and was good and stuck. There is no other reason. We just needed more tools to get him out than what was available at home. In general, malpositioning is a big one we see. But I also hesitate to identify that one directly, because we run the risk of adding that to the list of more things we need to "perfect" in pregnancy to avoid cesarean. Avoiding cesarean is a fine goal to have. But we must also remember that there are wildcards in birth, and that not everything will be in our control. I did chiropractic care and yoga in pregnancy to position my baby well, and the little fella still tried to come out ear first. For HBCI, our mamas are usually highly educated. They did their research and know the risks of cesarean, and do a lot to have a natural, intervention-free birth. So for us, working with this population, we know they've prepared for the best. How do we help them have a low to no-trauma birth in a situation that's not the best? Mindy S.: My first was failure to progress, i was pumped full of drugs. Didn't get passed 6cm. So i'm hoping if I avoid any intervention, i can birth at home. Most importantly, I just want the opportunity to try at home. Homebirth Cesarean International: I completely understand that desire, Mindy. My midwife said something after my birth that was helpful to me. She mentioned something along the lines of how much easier it was to heal from a birth that didn't go the way you wanted if you could look back and know you tried all you wanted to try. We can get that in the hospital, but I think for many of us, the opportunity to try everything else first feels more in-reach at home. Mindy S.: I agree 100%! I really feel I can do it, but I know sometimes things just can't be perfect. If my midwife says we need to go, we go. If I feel like its time to transfer then we will. I don't think I will be happy with it, but in the end I want my baby safe. I really just dont the recovery. I had an awful recovery with my first, I think thats mostly my fear more than anything. Sara M.: I didn't get past 5 with my first - after 5 days. After 24 hours with my second I made it to 8. She was in a much better position, but heart rate issues caused them to push a RCS. I still think my body can do it. Momma Trauma: I am going to hop over to the chat with Kathi from Birth Anarchy here in a minute, but Ann I wanted to thank you so much for celebrating our blogoversary with us and joining us for today's chat! This is such an important topic and mission! I have one last question I'd like to leave you with if that's alright: For pregnant moms planning a home birth, what could you suggest to her to be prepared for birth? Sara M.: Oh Mindy! My second recovery was so much easier than the first. I didn't expect that, but I was proud of my body healing so I could jump right back into mommyhood. Kate D.: Hey Ann, a question. Besides just being awesome in general and holding the space for women in the support group, how else is HBCI moving to create change in the NCB community? Homebirth Cesarean International: Recovery from cesarean is a whole other can of worms. That's one thing we focus on a lot- are the specialized needs of HBC moms in the postpartum. Many of the basic self-care tasks moms need to perform are next to impossible with a major surgical incision. Great question, Kate! I think Courtney's book will go a very long way to telling the story of HBC and raising awareness around these kinds of births. Mindy S.: Oh Sara! Thats fantastic to hear! That makes me feel positive! It took me 14 months, with homecare nurses daily, and hernia repair surgery and close up my original c-section wound 9 months later. Homebirth Cesarean International: As an organization, we want to train birth workers to better understand the needs of HBC moms, and to learn how to talk about cesarean as a very real and sometimes useful tool for birth. In other words- to not discuss cesarean as the "thing that cannot be named." But rather as a tool that a woman can understand how to judiciously make use of if she needs it. Momma Trauma: (PS, please feel free to stick around if you wish! No rush!) Mindy S.: So true Ann! Homebirth Cesarean International: The change has to come from removing stigma as well. We've got to end the language of failure surrounding cesarean. We've got to start telling our stories. Birth workers need to share HBC stories on their pages with the same triumphant language they use to talk about moms who had births at home. Both women worked hard and gave everything to their babies. Both women deserve celebration. Homebirth Cesarean International: HBCI does some of this work already by sharing HBC stories online and by discussing HBC with birth workers. We also continue to work on speaking engagements and sharing our vision through writing (some of which appeared on Momma Trauma!). Kate D. And since we're close to the topic... what does HBCI need from us to better reach it's goals? Homebirth Cesarean International: We're working right now on a volunteer application and manual, which will make it possible for those who want to get involved to find a place in our organization. We need help with social media outreach, administrative tasks, research, and many others. A webpage will be coming soon with an application and open positions. Beyond that, what we need is for the HBC mamas to be exactly the women they are. Brave, vulnerable, and fierce. We need HBC mamas to seek out their healing and to claim their power and worthiness as birth warriors, and to offer that affirmation to their sisters. The HBC community's main work is always going to boil down to that- to making it possible for women to heal themselves, and in turn, change the conversation that surrounds them, and make the road smoother for the women who come next. Sara M. I'm so sorry, Mindy! Regardless of how it ends up, I'll be sending you positive vibes for a much easier, healthy birth experience. Mindy S. Thank you Sara! Means alot! Thank you Ann, for sharing very much valuable information! Momma Trauma: Thanks so much Ann for sharing your story and HBCI with us today! Kate D. Thanks everyone. Mindy, I wish you all the best. Just know that the effort you put into one birth is more than most people put into anything in their entire lives. The fact that you want another speaks volumes to your strength, courage, and bravery. Mindy S. Thank you Kate! Ann wrote for us last year to help us understand Homebirth Cesarean and her organization. You can read it here: Homebirth Cesarean: "I was still an authentic mother."
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