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Maternal Death and the United States {Birth Without Fear}

Maternal Death and the United States {Birth Without Fear}

Maternal Death – the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. (WHO)

This is a subject no one really wants to talk about. Mothers die. Mothers die in pregnancy and childbirth and just after birth. The weight of that reality is just so heavy and heart breaking. In our current birth culture, fear reigns. However, fear reigns without reason or knowledge of what really needs fear. And of course – all of us hope to Birth Without Fear. And so, I approach this subject with a heavy heart but hope as well.

Samantha's Birth

Where Does It Happen?

In short, it happens everywhere. However, some areas are more prone than others. This can be due to lack of care – think of sub-Saharan Africa or rural villages in some undeveloped countries. Maternal death in those areas is an unfortunate fact of life (though organizations are striving to change this).

But apart from the “obvious” places, where do you suppose it happens? Perhaps war-stricken places, or those places without advanced medical facilities? Would it surprise you to know that the United States has one of the highest maternal mortality rates in the developed world?

Yes – you read that right. Our current maternal mortality rate is 21 deaths per 100,000 live births as of 2010 (WHO). This rate went up from 2005 (18/100,000). The 2010 “Healthy People” Goal for the United States was set at 4.3/100,000 – we grievously missed that by a large margin. The 2020 goal is 11.4/100,000, which would only be a 10% decrease from what the US considers to be its current statistic (the 12.7/100,000). I find it interesting that the government decided after they missed the 2010 goal that maybe they should try less to save mothers, since their efforts before had no effect and saw a rise in deaths.

The WHO number is adjusted from the number reported by the CDC (12.7/100,000) – this is because the United States does not have a universal system of reporting maternal deaths and the CDC admits that our numbers are drastically under reported due to this lack of uniformity in reporting (See this CDC publication, specifically page 20). Currently, only 25 states make it mandatory to state that a death was pregnancy related on the death certificate – and even this method is questionable due to lack of doctor training in filling out certificates and the great fear of litigation in the medical system. Ina May Gaskin writes about the lack of reporting here.

Other countries have much better standards of reporting. The “gold standard” is considered to the be reporting system in place in the United Kingdom. The UK ensures that not only is every death reported, but they also compile the deaths and reasons for them in a report every three years. This report is available to the public and the locations and names of the deaths remain confidential. This allows the nation and the nation’s health workers to look at the issues without fear of litigation – meaning they have no reason to hide maternal deaths.

To provide some perspective, here are the rates of some other countries:

  • Australia: 7/100,000
  • Brazil: 56/100,000
  • Denmark: 12/100,000
  • Germany: 7/100,000
  • Israel: 7/100,000
  • Japan: 5/100,000
  • Netherlands: 6/100,000 – note that about 30% of all births here are at home.
  • United Kingdom: 12/100,000

As you can see, we are rather behind many other countries – and don’t worry, I am going to come back to Brazil and why I included that statistic which is very high for an industrialized country (as is the USA’s number).

Why Are Mothers Dying?

This question is hard to answer since as mentioned above the reporting methods are varied and not always followed. We do know that some deaths are simply not preventable, this is just a fact of life. However, looking at the much lower numbers in other comparable nations we know that unpreventable deaths are not the reason for the very high numbers in the United States.

We know that it is not from lack of care in general – reports show that over 99% of all women in the United States receive prenatal care. However, we have to look at the level of care women are receiving. We have to ask, does a 5 minute rushed visit with your actual doctor count as adequate care? Does more diagnostic testing equal better care? Does spending more money equal quality care? (The numbers say no – we spend more than any other country in the world on birth).

We see a HUGE disparity in death rates in regards to ethnicity. An African-American woman is 3.3 times more likely to die in childbirth than a white woman. This is simply not acceptable in a country as advanced as ours, and one that is supposedly equal. Midwives such as Jennie Joseph are helping to implement ways to combat this disparity – her creation of The JJ Way is an example of how we can work to correct this travesty.

A big question that needs to be asked in the United States has to do with who is providing this care – care that is obviously not saving as many mothers as it should. In the United States women overwhelmingly see Obstetricians. While Obstetricians are amazing for complicated and high-risk pregnancies, they don’t have much training in plain old boring pregnancy and birth.

A majority of the time pregnancy will proceed in a normal fashion, and birth will follow in the normal fashion. When we use care providers who are trained to search for problems there tends to be a trend of finding problems whether they exist or not, or whether they are actually emergencies or not. As the saying goes, “Give a boy a hammer and he will find something which needs to be hammered.”

We can see that in countries were the majority of care is given by midwives (or that country’s equivalent care provider) the maternal mortality rate is lower (and the infant mortality rate is lower as well). The United Kingdom is a great example of this. They are comparable to us in many ways (general health and population structure), and yet consistently have better maternal outcomes. And they use the midwife model of care in which all women start with midwives and only transfer if problems arise. (Note that a woman can opt for an OB to start with, however most do not).

Now for the elephant in the room: the United States cesarean rate. Our current cesarean rate is 32.8% (CDC). Yes – basically 1/3 of all babies in the US are born through cesarean. So are 1/3 of all US women somehow “broken”? Unable to birth? Producing massive or stubborn babies? NO – of course not. If 1/3 of all women in the US were “broken” then those numbers would be reflected all over the world, and the statistics show this is not the case. In the same vein, we are not producing massive babies either – in fact the average birth weight has gone down as the cesarean rates have gone up (and is independent of that rise or that of induction).

Remember when I said I would come back to why I included Brazil? Brazil has a rather good medical system and is considered a developed country, so why the massive maternal death rate (56/100,000)? Take a look at their cesarean rate – 52.3%. Yes – over 50%. Brazil is an interesting case since most of these surgeries are elective, even for the first time mothers. The fear of childbirth is so deeply engrained in Brazilian culture that women jump at the opportunity to have a cesarean and avoid labor totally. A vaginal birth is seen, culturally, as something only poor women do because they can not afford a cesarean.

That mortality rate could be the United States’ future. We see a fear of birth in the US, and a huge cultural love of telling horror stories about labor and birth. We see more interest in elective cesareans (though elective first time cesareans are not significantly altering the rates). As VBACs are “allowed” in fewer and fewer places and malpractice issues continue to rise we see more and more women forced into surgeries they do not want or need. Our rates are heading right up to that of Brazil’s, and our maternal mortality rates will be sure to follow. A Cesarean increases the risk of death significantly in comparison to vaginal birth.

In comparison, the rate of cesarean in the UK is 25%, the Netherlands has a rate of 14%. As I stated before, the UK has 12/100,000 rate and the Netherlands 6/100,000 – rather interesting that as the rate of cesarean is almost half in the Netherlands and their rate of maternal death is also half that of the UK. While in some countries a higher cesarean rate does not correlate to a significantly higher mortality rate, those countries with very high rates of cesarean typically have higher (or rising) mortality rates.

We also cannot forget postnatal care. The postpartum period is one that needs care just as much as the prenatal time period. In the US, typically a woman is seen in the day or two after birth, at two weeks or so, and then at six weeks…and that is about it. This is simply not enough during this time of life when hormones are changing, the body is attempting to heal from creating another life, and things like retained placenta or clots can cause major issues. A much better plan of postpartum care must be put in place.

What Can We Do?

Be Educated. That is the number one thing you can do to not only help yourself have a safe pregnancy and birth, but also to help the women around you as well. When you learn, share the information. Break down the myths that pervade this culture – break down the assumption that VBACs are dangerous, or that “big babies” need surgical birth. Share the studies and articles you read.

Be Fearless. Help to eradicate fear of birth. Can birth end in tragedy? Yes. Unfortunately is does happen. But with proper and evidence-based care we give ourselves and our babies the best chance. Share the positive birth stories you hear. Share your positive birth. How does this help? It helps women to not fall into a fear based decision that increases her risks of complications – namely induction and cesarean. When a woman can start her pregnancy and birth journey from a positive place it gives her more space for growth and research. Absence of fear is not ignorance of risks – it is not being beholden to the fear of risk.

Those two things hand-in-hand – education and fearlessness – can go a long way towards helping this mortality rate go down. An educated woman is better able to avoid situations or care providers that increase her risks, and a fearless woman is better able to stand up for herself and decipher what is really in need of intervention and what is not without cultural fears clouding her view. Lets do our part to save mothers.


Grief And Guilt {The Birth Trauma Experience}

Grief And Guilt {The Birth Trauma Experience}

Trauma after the birth of a baby is a ‘special’ kind of trauma.

It’s a bittersweet kind of trauma. It’s a silent kind of trauma. It’s an invisible kind of trauma.

And if your baby is healthy, it is usually considered an unjustified kind of trauma.

I suffered from birth trauma. It was agonising, painful, and heartbreaking. I was alone, and misunderstood. It began the first night, a few short hours after the birth of my first daughter, from the moment my partner went home for the night. I was alone in the dark in my single room with this tiny little newborn. I held this chubby baby girl in my arms, and felt nothing but sadness at the experience we had gone through together to bring her into this world. I’d feel a stab of shame every now and then, and scold myself for being so ungrateful – my baby was here, wriggling in my arms, and I had the nerve to even consider mourning the experience that brought her to me. I would quickly go back to the sadness, mourning the loss of a dream – a beautiful and empowering birth experience. That night was the beginning of a four year battle with birth trauma.

My grief was deep, and some days I felt I was drowning in it. I floundered, being hit by waves of sadness, disappointment, and anger. I replayed the labour over and over in my head. I beat myself up with ‘what if’ and ‘if only’. I felt responsible; I blamed myself. I felt cheated, let down; I blamed my partner, I blamed the midwife, I blamed everyone. I tried to pinpoint where it went ‘wrong’, where I  went wrong. News about new babies had me sobbing, even watching birth scenes in movies was painful. A phone call from my sister, hours after the birth of her son, left me feeling like I’d been hit by a truck, and I hid behind shelves in the department store I was in and I just cried and cried. I bitterly wished for every woman to have a horrifying experience, and I felt an unimaginable hurt when I saw women emerging from birth empowered and ecstatic. It wasn’t that I wanted every woman to experience the pain of birth trauma, but I just wanted to them to know my pain.


I suffered terrible postnatal depression and post-traumatic stress disorder, even though my trauma largely went unacknowledged. Where it was acknowledged, it was usually deemed unwarranted. My experienced was pushed away and minimised by well-meaning but hurtful comments from others…

 “Years ago, you both would have died. Thank goodness for modern medicine.”

“It’s just one day in your life.”

“You were probably never going to give birth naturally anyway.”

“It’s probably because of your birth plan. You can’t control birth, you know. If you didn’t have such high expectations, you wouldn’t be so disappointed.”

“At least you are both alive and healthy, that’s what really matters.”

The comments were so hurtful. I felt like very few people understood. What about me? I would think. How can you say I am healthy? I feel like I am falling apart. Does my mental health not matter? I should have been overwhelmed with love for this tiny little bundle of joy, but instead I would hold her, look at her, and wish that I felt something. I was numb.

Sometimes I retold my birth story. I rarely came across anyone who had a story like mine, and people would cringe and exclaim “oh my goodness that’s terrible”, and then tell me their story. Sometimes they would have their own war story to tell, and I would listen and we would joke about never doing that again… But that wasn’t what I wanted.

I craved validation. I craved acknowledgement. I just wanted to tell someone my story, have them hold me as I cry, and look me in the eye and say: “I’m so sorry. You were cheated. You deserved better. You should have been able to birth the way you wanted. Your pain is justified. You have every right to grieve, without guilt.”


Maybe your birth trauma hit you straight away, or maybe it slowly grew, beginning as a nagging feeling you didn’t quite understand and growing into a deeper pain. Maybe your plan for birth went way off course, or maybe you didn’t have a birth plan but you wished that you had. Maybe you sometimes think that you weren’t informed about your choices, or maybe you think your pain could have been eased if you knew, and expected, less.

Maybe you had a caesarean. Maybe you had an instrumental vaginal birth. Maybe you had an unmedicated birth. Maybe you birthed in a hospital. Maybe you didn’t make it to hospital. Maybe you birthed in a birth centre. Maybe you had a planned homebirth. Maybe you asked for pain medication, and didn’t get any. Maybe you asked for support in a drug-free birth but was pressured into using medication. Maybe you had an unexpectedly fast labour, or an unexpectedly slow labour. Maybe you refused a procedure, but it happened anyway. Maybe you wanted a certain procedure, but no one listened…

Or maybe, none of this happened. Maybe it’s not about how you birthed. Maybe you birthed exactly as planned – but your trauma relates to how the nurse spoke to you or looked at you or ignored you…

Maybe you feel unsupported, alone, unjustified, silly, or even selfish. Maybe you’re sad. Disappointed. Angry. Hurt. Jealous. Afraid. Ashamed. Guilty. Responsible. Maybe you don’t feel any of those things…

Birth trauma can happen to anyone, in any situation. Birth trauma can happen to you, and even to your partner. Your experience is totally unique, and it doesn’t matter how anyone else feels about their birth or what anyone else would have done. Birth trauma is about how YOU feel about YOUR birth. Birth trauma is about YOU and YOU alone.

But make no mistake, you aren’t alone. Right now, thousands are alongside you, silent in their trauma and suffering.

Birth trauma is real. And needs real support.

To the mothers out there, dealing with birth trauma, I want to offer you my empathy, and my deepest condolences. Birth trauma is real. Your pain is real. Your pain is justified. You deserved a wonderful birth experience, and it is unfair that you didn’t get that. You deserve support. You have the right to grieve without guilt.

To the partners, friends, family, midwives, doulas, doctors, nurses, acquaintances… offer your empathy, and your deepest condolences. Birth trauma is real. Their pain is real. Their pain is justified. They deserved a wonderful birth experience, and it is unfair that they didn’t get that. They deserve support. They have the right to grieve without guilt.


A Home Water Birth Based on Faith and Evidence Based Care

A Home Water Birth Based on Faith and Evidence Based Care

Around my daughter’s first birthday in December, it was placed heavily my heart to have another child. I had just graduated college, and the timing seemed perfect. My husband agreed and we found out we were expecting in January with an estimated due date of around September 17! I immediately started researching home birth midwifery options. I had an all natural, un-medicated hospital birth attended by a midwife with my daughter. I was at the hospital less than an hour before she was born, because I knew I needed to wait as long as possible before going in to be able to stick to the birth plan. It felt weird to not have a care provider with me while I was laboring. The post partum care was disappointing with my hospital midwives. So I knew I wanted to give myself something more with this baby. We deserved the best care possible. I found a homebirth Certified Nurse Midwife in my state, and she took me on as a client.

I was incredibly blessed with an easy pregnancy. I didn’t have HG this time; in fact, I never even threw up once. I was able to work out until the middle of the third trimester as well. This was such a difference than my pregnancy with my daughter, which was great because having a 1 year old and being pregnant at the same time is quite challenging! We had an anatomy scan with the maternal fetal medicine doctor that does the ultrasounds at the birth center and found out we were having a healthy son. I still tear up thinking about that day. I knew God had a plan for us to have a son, and to keep him whole and intact. He was created perfectly, and I would not change that by circumcising him! I felt instantly connected to him the moment I saw him on the screen. I knew at that moment I would do anything to protect him!

maternity shot for birth story

Having my midwife come to my house for all my appointments was so nice. I never had to make childcare arrangements for our daughter, and it was simply convenient! I also had regular chiropractic care during this pregnancy, which alleviated a lot of aches and pains. Also, I treated myself to pedicures with my girlfriends which was fun!

Once September came I had some episodes of prodromal labor. I knew my baby was getting ready to enter the world, but each time the prodromal labor would end without me actually going into labor, it was disappointing. He had been posterior most of the pregnancy, so I figured it was him trying to get into the best position.

The early morning hours of my due date, I started having contractions that I knew weren’t Braxton hicks. I knew Berkley was coming to meet us. I was timing them and getting so excited. I cleaned and lit candles, prayed and told my husband. He needed some convincing that it was time, but once he realized it was, he started blowing up the birth pool. It was around 3:30AM at this point. We called our midwife and told her we believed I was in labor. We also sent text messages to the doula and photographer. We were so excited!

birth pool for story

My midwife called around 6:00AM to let us know she was on her way. She told me my labor may stall a bit once my toddler woke up, and recommended sending her to Grandma and Grandpa’s so I could get on with my labor. In her experience, mothers of small toddlers can get out of the labor when they mother their toddler. And I was so ready, so off she went to Grandma and Grandpa’s. I remember sitting with her on the rocking chair, where I nursed her for her first year of life, telling her mommy loves her so much, and she will always be my baby girl. It was such an intense moment knowing when she would arrive back home she would be a big sister.

My midwife was right. My labor slowed way down once Faith woke up. I went almost 2 hours with no contractions. My midwife still set up all her equipment though. She suggested I take a walk, use the breast pump, take a shower, all to get things moving again. I asked for a cervical check and I was 4 centimeters dilated and 80% effaced and baby was at minus 2 station.

Hours passed with pretty minimal contractions. My midwife went to go eat some lunch around 11:00AM to give us some space. It was so weird having such irregular contractions, yet they were so intense. I was pretty confused about the situation. When my midwife arrived back, I told her I would like an intervention of some sort to get labor moving. Once my doula arrived, I consented to a stripping of the membranes. Literally, once that happened, things picked up so fast. The contractions were coming so quickly. I could barely breathe and talk through them. I noticed all my hypnobirthing techniques weren’t helping to cope. I told my husband to call the photographer, I knew it would be soon that we would be meeting our baby boy!

My midwife didn’t want me getting into the birth pool prematurely. So when I asked her if I could get in and she said yes, I knew it would be close. This was around 2:45PM. I already felt so tired from being up all night with contractions. The pool was very relaxing, I am so glad I got that thing! It was nice being able to stretch out in it. The contractions were coming so quickly. I didn’t know how much more I could handle. I felt like I was loosing it. We put on my hypnobirthing tracks which helped a little. I even said I wanted to transfer to the hospital. Looking back, I know this is a “sign post” that means that the baby is coming soon, but I couldn’t think at that point. I just didn’t know how I could handle any more labor. The photographer walked in and I couldn’t even say hi. I felt so rude! I was sobbing. I was a mess. I felt like I was failing at my peaceful birth.

janet hugging me

labor in pool 3

birth story photo 1


labor in pool 2

I felt nauseated (which again, usually means baby is coming SOON) so my doula did some aromatherapy which did help.  I asked to get out of the pool. I went into my room and was crying some more. My midwife came and gave me a big hug and told me I just needed a little more courage and the baby would be here. I told her she was right, that I was scared. Looking back at my photos of that moment, I realize I definitely picked the right care provider. She hugged me and told me everything I needed to hear.

laboring on ball

Right at that moment, my water broke. My midwife called her assistant in to chart the time. It was clear fluid. I felt so much better once my water broke, but then the contractions kept coming even more frequently. I started having bright red blood drip down my leg. My midwife immediately (yet calmly) figured out I was involuntarily pushing against a cervical lip. I asked if it were too late to get back in the pool. Of course not! So I ran back into the pool. The bleeding stopped just as soon as it started. Everyone was right there with me. I told my midwife I felt like I had to have a bowel movement. Again, a sign the baby is right there. She just told me “poop the baby out”, “it’s okay!”, “you can do this”.

labor in pool 4

labor in the pool 3

The pushing was an experience I had not really had before. With my daughter, she came very quickly with no pushing stage, and I had 3 first degree tears. I wanted to be in the water to minimalize tearing. It is amazing how natural it is to push. I didn’t need any directed coaching about how long to push or how to push. If given the opportunity, it comes naturally!


Within just a few minutes, he was born! I did it! I leaned against the back of the birth pool and he was right on my chest. He had vernix! He was so cute and tiny! It’s amazing how quickly you forget how tiny they are! He got a 9 and a 10 on his APGARs. He was so beautiful and calm. My photographer said when he was born, I was saying “We wanted you so much, We wanted you!”.

group shot at birth

birth of c 2

birth of C


after birth of c 2

I felt like I didn’t have a lot of traction sitting in the birth pool with him, so I asked to move to my bed. We went to the bed and just cuddled, hugged, breastfed, everything that should be done in that golden hour. When we were ready, my midwife checked me and I didn’t tear! She weighed our boy and he was 7 pounds 12.5 ounces and 20.5 inches long. There were no hands on him other than mine and my husbands until we consented to his exam. She didn’t even have to draw blood to test his blood type, she collected a sample from his umbilical cord! It was such a private birth, this was the experience I wanted, the experience we deserved. I know God designed me to be able to give birth, and having a midwife with so much experience and evidence-based practices made the home birth decision even more excellent. I know my fast recovery and lack of PPD can be attributed to such a peaceful birth and loving care from my midwife and family.

we did it

kale at birth

Maternity Photo by Brink Street Photography

Birth Photography by Aperture Grrl

A Healing Hospital Birth {After a Delivery that Resulted in PTSD and Birth Trauma}

A Healing Hospital Birth {After a Delivery that Resulted in PTSD and Birth Trauma}

This birth story of my daughter Kayla was my healing birth after having suffered a traumatic birth experience with my son Alex in December of 2011. When I gave birth to Alex, it was a traumatic, intense birth to say the least. I struggled with PPD and PTSD as a result of his birth.  I wanted Kayla’s birth to be different and healing.

I had hoped and planned for a homebirth. I suffered HG my entire pregnancy and because of that my hemoglobin was dangerously low, too low in the state of Wyoming to be “allowed” to birth at home.  Because my labors and births with Blake and Alex were so fast we still prepared and educated ourselves to have this baby unassisted. To be completely honest, I wanted nothing more than my husband to catch Kayla.

I had been contracting every 4 to 6 minutes from 6:00PM or 7:00PM the night before.   As morning approached they were becoming much more intense and harder to work through.  When my husband woke up at 6:30AM I informed him of this and we both made the decision that we would pack and drop off our boys and make the 45 minute drive to our midwife.  I had an appointment with her at 2:00PM that day but didn’t think I could make it that long and didn’t want to give birth on the interstate.

I was checked in to triage.  I knew that on the drive over my contractions had gotten much worse but was shocked to see on the monitor they were every 2-3 minutes lasting 30 seconds to a minute. I felt as though I was leaking amniotic fluid so made sure to tell the OB but the two tests they did right there were negative and they also sent a third to the lab. I was dilated 3cm which was an improvement from 2cm but still only 50% thin and minus one station.  I was told to walk the halls and come back to be re-checked.

Jimmy and I walked and walked and walked. I was very disappointed but not shocked that my contractions were slowing down and becoming much less intense. This always seems to happen to me when I arrive at the hospital.  We eventually made our way back to triage and just knew there would be no change but I also knew that just because there was no change now doesn’t mean that I may not be in full blown labor later that day or night.  I was re-checked and sure enough still 3cm and -1 station and I was 60% thinned out.

I was getting ready to be released when Kayla’s heart rate jumped to the low 170’s. Her normal heart rate is usually late 140’s to low 150’s and I know this because I checked it often at home on my Doppler. Many of the labor and delivery nurses had commented on how beautiful her heart rate usually was and joked that she was just showing off. They opted to keep me in triage for a while to monitor her and see what would happen.  I had texted my doulas earlier that morning to let them know what was going on and kept giving them updates.  They were trying to decide at this point if they should make the hour drive to join me.  I told them not quite yet, I would let them know if and when I needed them so they were on stand by.  Jimmy was updating my mom and sister who were watching Blake and Alex.

The doctor ordered a bio-physical profile to be done.  The tech didn’t give us any clue as to what was happening but she made a comment to the effect of “they will take good care of you here” as she was leaving.  After that comment was made I just had that “feeling” she had found something on the BPP.   We waited a bit and then my nurse came in and said,  “Do you want to have your baby today?”.

She walked me to a labor and delivery suite and started an IV.  I agreed to this because I knew with my hemoglobin and hematocrit level being so low I was in danger of bleeding out after birth.  The doctor came in and informed me that I had no fluid.  My heart immediately sank because I knew that I was at risk for the cascade of interventions being started. The doctor said that her recommendation would be to start Pitocin but I stood my ground and said no, especially with Kayla’s heart rate being so high and the fact that I had no fluid. She agreed to try and stretch my cervix as much as she could.  She was able to get it to 4-5cm and at this point I was 90% effaced.  I let my doulas know that I needed them as well as my mom and sister.

My mom and sister arrived with my boys around noon, about 15 minutes before my doulas did.  Once they arrived the doctor came back in and asked how much time I felt like I needed to get things moving and we said two hours.  I don’t think she was happy about it but she agreed and she also agreed to “let” me get out of bed as long as I stayed on the monitor.  This meant I could only go as far as the cords let me.

As soon as they left the room my doulas had me get up and start moving.  I was doing squats, figure 8’s, lunges, bouncing on the ball and all fours in my bed.  I knew as long as I kept moving and upright there was a very good chance that I would get things going on my own without the Pitocin. I had an amazing nurse that day and I do think God was looking out for me.  She came in countless times to re-adjust the monitor and never once complained or ordered me back to bed.

Two hours later the doctor came back and I was so scared but almost positive I had made a change.  I was approximately 5 to 6 centimeters dilated at this point and 100% effaced.  We were all elated.  I continued to do what I had been doing and my doulas made sure I stayed hydrated and nourished at all times.

The doctor continued to come back every two hours to check me and every check there was change.  At some point in time I made the very difficult decision to have a fetal scalp monitor placed so I could be a bit more mobile and wouldn’t have to worry about the monitor not staying on.  I must say that this doctor was amazing and truly she restored my faith that there are still “good” doctors out there.  She respected my wishes. She would always tell us what her opinion was but never once pushed anything on me. She never violated me and would always ask before doing a cervical check if it was okay and if I was having a contraction would wait until I told her it was over.

One of my doulas took the clock down so it would not be a distraction to me.  My mom and sister unfortunately had to leave and go home 45 miles away with my kids.  It made me sad they wouldn’t be there for the arrival of the baby.

The atmosphere during my labor was consistently calm and relaxing, the lights were dim and we used candles. It was the kind of atmosphere I needed.  My husband was putting tons of counter pressure on my back and was using cold rags to help with the pain and also because I was hot.  I found the most comfortable position to be on the ball and I stayed there most of my labor.  Things hadn’t got intense yet and I was easily breathing and moaning through the contractions.  I made sure to stay on top of them and really, really focus. I remember thinking at one point “could it really be this easy all the way to the end?”.  There was one point and I think it was around the time I hit transition that the journey become emotional, very emotional.  It caught me off guard.  I was having flashbacks to Alex’s birth and realizing that I was facing this fear head on.

It was when I hit 8 centimeters that things got bad and I really started doubting my ability to do this naturally.  I had made the move from the ball to the bed for that check and was still doing somewhat okay.  The doctor let me know she was slightly concerned because although I was dilating and thinned out Kayla’s head was still -1.   She let me know that if it stayed that high there was nothing she could do to help get her out vaginally and it would have to be a cesarean section.  I remained calm because I trusted my body. I trusted Kayla and I remembered something a different labor and delivery nurse had told me when I was pregnant with Alex. Some babies do not drop until moments before birth.

The doctor brought up the idea of Pitocin and it stirred a lot of fear within me. I was reassured that I would not need much at all.  I agreed to it but was absolutely terrified because I have heard so many stories how unbearable Pitocin makes contractions. I was suddenly hit by the worst contraction ever. I couldn’t get my focus back and I lost control.  I started begging for the epidural, saying I could not do this and yelling at the nurse to stop the Pitocin.  To this day I am not sure if I received it or not, I know the bag was hung but not sure it ever entered my body.  The nurse said she had barely hit the start button when I yelled to stop it.  So, if I got any at all it was a very small amount. I know now this was transition because of the intensity and fear that just took over. What made it worse is I lost my focus. I had been so calm up until that point but the idea of Pitocin and a possible cesarean section sent me over the edge.  Deep down I knew she would drop.

I could feel Kayla’s head getting lower.  I could feel that I was leaking what little fluid I did have left and I knew I was pooping.  I was embarrassed but there was nothing I could do. I started screaming, “She’s coming, she’s coming”. My husband knew from my previous birth that when I start saying that the baby is close very close to being born.  He let them know someone needed to get the doctor right away.

She came in and did a cervical check. I was 10 centimeters, her head had dropped and she was about to crown.  The doctor barely had time to get dressed.  I told her I had to push and I pushed once.  I felt the ring of fire but was so confused why it wouldn’t stop. I know now that it is because she flew out all in that one push and flew out so fast her body hit the bed.  I screamed and the next thing I knew she was on my chest.

I began bawling and couldn’t stop; it was surreal.  I could not believe I had just given birth un-medicated and I survived! Although this was not the birth I envisioned or planned, it was wonderful. It was healing and most of all it was empowering and in that moment my natural birth high began.

Empowering Hospital Birth after birth trauma


The Skinny Mom: Does She Think She’s Better Than You?

The Skinny Mom: Does She Think She’s Better Than You?

“When my daughter was about a week old I was at the grocery store and a woman asked how old my baby was, I told her one week with a smile. Her response was “well you don’t look like you f***ing had a baby a week ago.” and turned and walked away from me. It hurts to be ostracized by other mothers in that way.” – Jonelle, of Aware Beginnings Doula Services, commenting on Mothering the Mother Part II: How Postpartum Care Helps Us Love Our Bodies

I’m a skinny mom. Not too skinny. But on the slender side.

I gained about 25 lbs in each of my two pregnancies and shed it within a few weeks of giving birth.

When I’m pregnant, people tell me I don’t look it.

I fit into my pre-pregnancy jeans until seven months in.

I wore a short black dress to a party a few days before our second was born.


My K’taan is a size small, I can still squeeze into the back seat between my two babies’ carseats, and I still have no stretch marks.

Do you hate me yet?

What if I told you that I don’t diet and my only exercise is babywearing? Would you hate me then?

My body looks the way it does for a number of reasons (including socio-economic status and access to real food) but mostly because of a genetic lottery. In the eyes of our society, it’s a lottery I’ve won. But ‘winning’ isn’t everything. I have a history of starving, purging, cutting, and risking my body. This history is invisible when you look at me. It can be covered up by a short black dress and gold high heels.

Maybe you assume that I have my shit together, that I am in control; maybe you think I’m happy.
Maybe you assume that I am superficial.
Maybe you assume that I diet constantly.
Maybe you assume that I diet constantly even when I’m pregnant and therefore do not have my baby’s best interest at heart.
Maybe you assume that I’m mean and manipulative.
Maybe you just know that I think I’m better than you. (I don’t. And I don’t think the skinnier mom standing next to me is better than me, either.)

Other people’s ugly assumptions aside, I know and enjoy the advantages of being a skinny mom:

I still get to be seen as cute and slightly sexy (even though I’m a mom, which is, apparently, the least sexy thing in the world).
I don’t have to buy a new wardrobe when I get pregnant.
When I look at pictures of mothers in magazines and advertisements, they look like me (I also happen to be caucasian and able-bodied. Bonus!).
I wasn’t automatically classed as a ‘high risk’ pregnancy due to my weight.
I could satisfy all my pregnancy cravings without feeling guilty.
I receive most of the advantages of being a skinny girl – I get served first at deli counters, customs officers are always nice to me, my in-laws think me an appropriate match – but since I’m a mom, these days I get a lot less harassment from skeezy men.

These are important social advantages. It will be hard for me to lose them as I get older. But they’re all from the outside. Inside is a different landscape.

Some nights I tell my husband I don’t want to have sex because I’m tired and covered in milk and I imagine my body has been taken over by a hungry parasite who just also happens to be a baby I love. It feels there is no more space in my body for receiving or giving anything.
If I do compare myself to the mothers in an advertisement, they are still thinner than me, happier than me, prettier than me, less milk-stained than me. I am still lacking.
I wasn’t classified as ‘high-risk’, but I had to pay three months’ rent for out-of-pocket for decent healthcare during my last pregnancy. It was hard to convince myself that my baby and I were worth it.
I could satisfy all my pregnancy cravings without feeling guilty, but I didn’t (I still satisfied them – I just felt guilty).
I don’t do it anymore, but I have thrown up or skipped more meals than I can count. Other people liking your body doesn’t make you love your body.
I’m a happy person but I still feel out of control sometimes – especially when my toddler is eating spaghetti with a spoon.
I love breastfeeding now, but when I first lactated colostrum, I felt disgusted by my pregnant body.
The flip side of being told I don’t look pregnant is people thinking that I am not my baby’s mom. “Is this your baby?” they ask, and I try to take it as a compliment but I know there’s an edge in my voice when I answer, “Yes, this is my baby. This is my baby.” This is my body that birthed this baby and I hate that you looked at it and thought otherwise.

My body is real and I am learning to love my postpartum pooch (below: a few days PP in ye olde disposable panties).


My claim is not that, “I too, my full-bodied sisters, am a daily victim of unfair physical ideals!” I know that, on the whole, I benefit from them. And I’m not saying that BWF should have a ‘skinny moms’ day for every plus-sized mama day. I know that every day is ‘skinny mom day’ in all the rest of social media. I’m just saying that in a country where at least 80% of women dislike their bodies and Miss America is perpetually malnourished, we are all capable of hating ourselves. You don’t know how someone feels about their body just by looking at them. You only know how you feel about their body. And your own.

In my better days, this is how I like to think of my body: as a powerful vessel. A vessel for my thoughts and actions; a vessel for my creativity; and of course, a vessel for my babies. It is through this body that I show my love for other people. This body lets me laugh. This vessel has (love) handles but it is tall and deep. It will get old and its enamel will crack. Someday it will disintegrate entirely. I can only hope that when it does, I’m not worried about how it looks.

So, do you hate me yet?

Mothering the Mother, Part II: How Postpartum Care Helps Us Love Our Bodies

Mothering the Mother, Part II: How Postpartum Care Helps Us Love Our Bodies

“A safe pregnancy is a human right for every woman regardless of race or income.” – Amnesty International

“I have horrible [postpartum] stretch marks that I feel the need to cover and of course my breasts are nowhere near where I would like them to be.” – Courtney, Beauty Revealed Project.

So here I am, sitting cross-legged with a computer in my lap, typing around the soft belly that still protrudes (that always will protrude), while my seven week-old daughter sleeps in the next room. I’ve got a clean cloth diaper stuffed into my bra and I’m thinking about the talk I will give at the upcoming BWF Conference in October.

(((Registration is open! You should come! I want to meet you!)))

My topic is ‘Mothering the Mother’, an expansion of my most popular blog post ever, decrying the lack of postpartum care provided to American women. And I am being sponsored by the Beauty Revealed Project, a fantastic community and an online collection of photos and stories celebrating women’s real postpartum bodies.

Darien McGuire Photography

To some, this may seem like a strange fit: What, one might ask, does postpartum care have to do with bodily self-acceptance? If I bring a new mother a big pot of soup, is she suddenly going to love her stretch marks?

The answer is no; the answer is yes.

Our society-wide refusal to acknowledge the changes that come with motherhood is one of our greatest acts of misogyny. The bare facts: The United States is one of four countries in the world refusing paid maternity leave to its new mothers (the others are Liberia, Swaziland, and Papua New Guinea). Despite 20 year-old research stating that changes in our healthcare model would soon require in-home postpartum support, American women do not receive postpartum care beyond a six week check-up. And our maternal mortality rate is the highest in the Western world.

These policies and their resulting tragedies perpetuate a widespread distaste for the childbearing process. Somehow, it has become OK to force a woman back to work just a few days after a human being came out of her body. To cut it open (routine episiotomies, routine cesareans) and leave it untended for six weeks or more. To let women – especially poor women, and women of colour – die preventable deaths after they have created life. The birthing woman’s body, not perceived as an economic resource, removed from its dubious status as a sexual object, is just not valued.

Sweet Serenity Photography

This devaluation spreads to other non-essential aspects of women’s postpartum bodies. The postpartum pooch. The stretch marks. The sagging flesh, the milky leakiness, the scars. There is nothing ugly about these body parts. But google any one of them and the instructions you find will be on how to hide it. How to get that ‘pre-baby body back’, terminology which I find so offensive because, really, where did that body ‘go’? It’s still here. Right here. My body did not disappear into some Platonic realm from which it must be reclaimed. No. My body, my (fortunate, privileged) healthy body birthed a baby.

It is so hard to see one’s own culture(s) because these are beliefs we are born into, ideas by which we live and die. So I’d like to try a little experiment. Let’s imagine the cover of a celebrity-ogling magazine. You know, the kind that watches bumps like my toddler watches diggers.

The cover shows a glamorous new mother.

She is lying in bed, her body relaxed and comfortable.

She is not groomed because she does not need to be, it is not expected of her.

She is not lifting weights or on her way to yogafit class; she is nursing her baby.

The headline reads, “K. Kardishian, New Mother! Inside: pics of her beautiful baby and fabulous new stretch marks!”

Yeah. I can’t imagine it either.

But I maintain that the physical manifestations of having birthed a child do not need to be hidden. They could, hypothetically, be celebrated. I swear they could be seen as sexy. I have heard they can be markers of status. Or simply perceived as healthy, normal, even unremarkable.

open book studios

What would it take for any of these to happen? We would have to start with the postpartum period. With gently caring for women who are gently caring for their newborn babies. With giving their bodies space to recuperate. With touch and massage, actions which tell them that their bodies are OK. With giving them nourishment and love. Showing mothers that we care about them will allow them to internalize that care and to care about themselves. Bodily self-acceptance cannot be far behind.

I have been lucky to receive incredible postpartum care over the past two months. I had midwives and friends, community to bring me meals and a partner to look after me. I did not have to get back up on my feet and do the impossible. I could rest. My body and my heart both show the benefits of this care. And as I sit here and feel my milk let down, telling me that my infant daughter will soon wake up and call me in to nurse, I feel grateful that my body birthed a baby. I know deep inside that my body is more than a cog in a machine, or something to be looked at. That it is strong, powerful beyond measure.

The health of our bodies has everything to do with how we feel about them.

KaylaMarie Photography


The Beauty Revealed Project is on Facebook and online at The staff of this wonderful, encouraging page accept photo and story submissions from postpartum mothers. They also assist in the arrangement of free or low-cost postpartum portraiture sessions with professional photographers. The Beauty Revealed Project is a not-for-profit organization and a labour of love.   

Pregnancy After An Eating Disorder

Pregnancy After An Eating Disorder

I have tried to write this at least a dozen times. It never turns out the way I want. In the beginning I tried to approach it like an informative article, a place people could go to find facts, research and information… but I get caught up in my own experience, and it ends up a jumbled mess… No, I can’t write an informative article. Not yet. Not until I tell my story…

So here it is. I had anorexia for over 7 years. ‘Had’ anorexia is the right way to write it, but the reality is that it had me…

I was 13 when it ‘started’. It was slow; an incessant nag in the back of my mind, slowly wearing me down, like the way a constant water drip smashes into concrete, slowly working a hole through… you’re not good enough, that’s not good enough, you’re not good enough, do it better… like a drip, these thoughts came, slowly, until they wore me down. Eventually I was swimming in them. Or more accurately, drowning in them. Everything was so out of my control, I had no idea where these thoughts were coming from, but they were inside me and they would not stop. Food became the thing I could control. While everything seemed crazy, and out of my control, I could control food. And my weight. Except, of course, that I had lost all control. I was completely and utterly powerless against this disorder.

[2003 – 17 years old: after I was discharged from a hospital stay, and when I graduated from high school]

teenage anorexia

At my worst, I was 39kg (85lbs), and at 156cm (5’2”), and this was a devastating weight to be. I couldn’t see it though. Even at 39kg, I could see extra weight; bulges and bumps that I needed to lose to be better. I lived with other anorexic girls on my many hospital admissions, and felt obese compared to their emaciated figures. Eating disorders are bizarre like that; I never could see myself for what I truly was. I saw these girls and I thought I was not controlling my food enough. Even though at one point I existed on a handful of oats soaked in water (but never cooked, because I wanted my body to burn my energy digesting them) and drinking iced water (because I wanted my body to burn more energy to warm it back up to body temperature). I wondered why my parents worried so much, I was frustrated and angry at people trying to ‘help’, and every single time I walked into the ‘Eating Disorders Clinic’ I felt like a fraud.

Thankfully, after years of suffering, I was given the help I needed and eventually I was ‘weight restored’ to 54kg, and ‘recovered’. Which is a misleading word which just means that you aren’t drowning in self-hatred – but it doesn’t mean that the drip isn’t there, or even the occasional downpour or flash flood of thoughts. My experience with  recovery from anorexia is similar to an alcoholics experience with recovery – we can triumph over it, but never let our guards down and we must always be aware of triggers. I have many triggers, but my biggest trigger was yet to come… but it wasn’t pregnancy.

I met my partner in 2006, and began trying to start a family in 2007. I always wanted to have children, and was excited about being pregnant. But I was nervous. My body was going to grow, in a way that I had absolutely no control over. I would have to surrender control, but keep control. I could not allow myself to be swept away in a flood of thoughts. I could not skip meals. I could not run until my muscles were burning. I had to look after myself, and I had to look after my baby. Could I do it? I was strong, but was I that strong? I was recovered, but… was I *that* recovered? Was I ready? Would I ever be ready?

I was lucky that physically, the years of disordered eating and being malnourished did not affect my fertility or my ability to sustain a pregnancy, although that isn’t the case for everyone.

My first pregnancy came with a wonderful sense of ease; in relation to the eating disorder at least. This was surprising, as I was always acutely self-conscious and self-critical pre-pregnancy, but my growing belly was something I cherished. For once my body was meant to be growing, and I let it grow. I was relaxed. I loved the life and energy flowing from me. I loved that eating was ‘for the baby’, and I could argue with the thoughts in my head. “I must eat”, I would think, “I must eat, for the baby”. And I did. I gained a lot of weight, and I didn’t let myself worry about it. I knew that if I acknowledged the amount of weight I had gained, it would rain-pour-flood, and I would drown. And I could not let that happen. I gained a lot of weight – over 20kg (44lb). Part of this weight gain was because I couldn’t restrict what I ate – if I did, it would just begin a barrage of thoughts that I might not have been able to fight. Another part of this weight gain was like me saying a big f**k you to the thoughts – kind of like, “you’ve controlled me for long enough, look what I am doing now”.

Unfortunately, throughout my first pregnancy I suffered with antenatal depression that extended into postnatal depression and anxiety, mixed in with some PTSD. I was lucky that they eating disorder did not take hold in a negative way. I know that many women react to pregnancy differently – the changes in hormones and body shape can be a huge trigger for eating disordered thoughts and behaviours – and even after recovery they have trouble keeping the thoughts and behaviours at bay. Women need to be aware of their strengths and their limitations when it comes to their recovery, always inform care providers and try to let people know or ask for help when they are struggling.

I birthed my daughter via cesarean in August 2008. It was an emergency cesarean; very unplanned, and very unwanted. Because I had gained so much weight, I did not just ‘bounce back’ to my pre-pregnancy weight. Well, I don’t think many women do just ‘bounce back’, but regardless, I was devastated. My belly is covered in stretch marks, my stomach shrunk down after the cesarean my skin crumpled in a sea of raw pink lines and I had a ‘hang’ on one side of the scar. I was carrying extra weight across my whole body, and I felt like a disgusting puffy crumpled-up mess. Breastfeeding did NOT help me lose weight, despite the belief that it does, and I was wearing maternity clothes for some months while I struggled with whether I would ever get to wear my pre-pregnancy clothes again.


mother and daughter after eating disorder

I develop severe postnatal depression and anxiety. Even though I had dealt with depression and anxiety for years, I couldn’t recognise how much I needed help. I struggled, and I had a baby who existed on 2 hour blocks of sleep (if I was lucky!) and constant feeding. I was a mess, and some days were so dark I could barely see a way out. I dealt with it for years, and I fought so hard for the first two years to not relapse or go back into disordered eating. The thoughts were there, and they were strong , and I believed each and every thought that entered my head: they would be better off without you, they don’t need you, you’re nothing, you’re nothing, you’re a bad mother and your daughter knows it… For two years I fought those thoughts, but eventually I was worn.

[August 2010]

mother and baby recovery from anorexia

It was around the end of 2010 when it started again. I don’t really remember it well, but it was a tough time for us all. A multitude of things tumbled together and crashed into me and knocked me off my feet…  I lost all the weight I was carrying, and was back down to me pre-pregnancy weight. I pushed myself to my limits, all the while believing that it was never enough, I was never enough, I could do enough, be good enough, smart enough, strong enough… People told me I was losing weight but I couldn’t see it of course. Each morning I would get up, and cry as I made my coffee, then sob as I said goodbye to my daughter. I’d cry as I drove to work. On the drive to work, I’d pass cars and powerpoles, I’d drive over bridges, I’d take careless risks through roundabouts and traffic lights, wondering if I could just accelerate, lose control, drive into or drive off at the right moment, and it would all be over. I didn’t, of course, and it was probably because I knew I didn’t want to die, but I told myself I wasn’t strong enough, I was too weak, and for being too weak I deserved to keep living in hell. I usually held it together at work, and I’d come home and be angry, and cry myself to sleep.

My partner would be there, sometimes frustrated and angry, sometimes caring, but always there. Despite that, I felt alone. And so powerless and weak. And ashamed that I had let it take me again. And hopeless. She watched as I fell into a pit of despair. I pushed her away, but she stayed anyway. There was one night when she sat down next to me, with a look I’ll never forget, it was fear, she looked at me with fear. She asked me if I was going to be ok, and it broke my heart. She sobbed, and we cried together. She said I needed help. She wanted to help. She didn’t want to lose me. I told her I was strong. I could do this.

I fought and gained some control back. It was hard, but we did it together, my partner and I. She reached in and helped me out again.

[January 2012]

mother and daughter

I was pregnant with our second daughter early 2012.

This pregnancy was difficult. The first 14-15 weeks were full of vomiting and constant nausea. It was difficult to force myself to eat when I knew I would be bringing it back up in half an hour. I couldn’t work for almost 6 weeks. Things quietened down in second trimester, except for a few scares that left me in the birth suite with a fluid leak and infection.

At 28 weeks I was diagnosed with Gestational Diabetes and that was hard. I almost lost it. It was hard for me to keep hold of the eating disorder when I had to engage in the very behaviours that I were so disastrous to me for years. I had to keep track of my food, grams of carbohydrates, balance my meals, and religiously test and keep track of my blood sugar levels and weight. I had to keep it all in check. The obsessive part of me broke out, and I counted carbs to a key. I got to a point where I was 34 weeks pregnant, 62kg (136lb) and I wasn’t gaining weight and it was difficult. In my first pregnancy I found it easy to let my body gain the weight, I let myself eat, and I didn’t let myself think about it. This time, I was surrounded by triggers, and I couldn’t just ignore it, I couldn’t just eat, like in my first pregnancy. I had an acute awareness of my food, the nutritional value of my food, my weight… 

The hardest part was admitting it. I don’t like admitting when there’s something out of my control, I like being able to just take care of myself, and I won’t ask for help. Even when asked, I won’t admit I’m struggling. So telling my partner was tough. She already knew, of course. She knows my triggers, she knew what was happening in my head. We worked through it together, with a lot of support from her. I had a VBAC in November 2012, and with it, I gained a new sense of worth, achievement, and power. 

For me, the hardest part of this whole journey through pregnancy after eating disorders is relinquishing control. Through the years I lived with anorexia, I tried to control, I wanted control. Even through recovery, I hold on to the fact that I am controlling the eating disorder, I am in control of myself. But there’s an element to pregnancy and birth and postpartum that is uncontrollable. It is about trust and faith, it is about letting go and embracing the chaos. It is a fine balance between letting go and riding the wave, but knowing when to hold on again so I don’t start drowning. Even now, I struggle with knowing when I need to be in control and when I need to let go. Having a good support team around me to remind me to hold on or let go is essential.

It was also hard to get used to my new body. Things changed. A lot. Even being back to pre-pregnancy weight I am not the same as I once was. I’m softer and squishier, and I never expected that. And oh the stretch marks, so many stretch marks everywhere. No one told me my thighs would get stretchmarks, and yet as my hips widened, they did! My breasts are marked as well. And as my body shrunk back down my skin did not follow, and there is loose skin and dimples and crinkles… And I am one of the ones who don’t lose weight while breastfeeding, so that was a little disappointing as well!

post partum belly

I am 4 months postpartum now, and things seem clearer second time around. I am more confident, and I like my body. Some days I love my body. I know it deserves to be loved all the time, and I do my best. I am happier. Brighter. I still struggle with control – hold on, let go, hold on, let go…? The thoughts are there, although I wish I could say they weren’t, and they get to me sometimes. I can’t see this as something I will ever ‘get over’. Every now and then the thoughts get quieter and I live more freely, and sometimes they are deafening, and every minute is a struggle. I have to be aware of my triggers. We don’t own scales, and I don’t think there will ever be a time where I can have a set of scales in the house full-time – I can barely walk past scales on the shelf at a department store without wanting to stand on it. I can say with confidence that I will never be able to ‘diet’ or engage in any kind of radical detox program without having to fights the thoughts to take “one step further”, which is the path the leads to disordered eating. Exercise is difficult – I love running but have a tendency to push myself too far. I joined a gym once, a few months into an attempt at recovery, in an attempt to exercise in moderate and be ‘healthy’, but that didn’t end well.

But right now I am strong, and I am ok.

Written by Alisia, wife and mum to two kids in Australia.

post partum belly and baby

Community Support and Breastfeeding {Make a Difference}

Community Support and Breastfeeding {Make a Difference}

I would like to start this post with a story.

Imagine a mother – a fresh new mother – with a baby just barely 24 hours old. She drives to another city the day after her birth for her first post-birth checkup with her midwife. After leaving the appointment she and her husband decide to stop for lunch. It is late afternoon, so they have their pick of places as none are crowded. A Red Lobster is calling mom’s name – she is famished after the long work of labor the day before and seafood just sounds heavenly. And maybe a little indulgent too!

Mom, Dad, and newborn are seated right away and order their food. Mom orders crab legs (her favorite!) since baby is sleeping peacefully in his wrap against her chest. Surely he will stay asleep long enough for her to shell the crab and eat. (More experienced moms are probably giggling right now!)

The food comes out, hot and steaming. On cue, baby wakes up and wants to nurse. Mom stares longingly at her plate, knowing she can’t bother with it right now because it takes two hands to get this newborn latched and stable for the whole feed. Dad offers to help her but mom declines – at least one of them should get a hot meal after all.

The server comes out to check that everything is going well. She sees mom’s predicament and says she will be right back. She comes back, with gloves on, and starts to shell all of the mother’s crab legs for her. All the while she talks to the couple about her children, her nursing experiences, and how great it is to see a young mother breastfeeding. She also shares stories of many cold meals because of the uncanny ability of babies to wake just when dinner comes out.

She finishes shelling the still steaming crab and gives the plate to mom. Mom figures out how to support baby’s head with the wrap so she can slide one hand out to eat her still hot dinner! Mom and dad get full bellies with hot food, and so does baby. What could have ended in mom sadly eating stone-cold crab legs instead has a happy ending.

That mother was me. I have *never* forgotten that server’s support and love in that moment, and I never will. One mother, reaching out to another giving simple and practical support. That one encounter gave me the pride and hope and confidence to nurse in public in the years that followed. That one encounter helped my husband to feel 100% comfortable with nursing in public as well – knowing that people would not always be rude to his wife. While we have had rude encounters, I can always look back to this first one and radiate with joy.

The support of the community can make a huge difference for mothers who take the journey through breastfeeding. In fact, in studies and interviews women tend to rate social support as more important than professional support on the duration of their breastfeeding experience 5. Why is this?

The answer is simple – we spend far more time in the world at large than sitting in a professional’s office. We need support from our partners, family, and community at large. We need to feel supported by other mothers. When a person feels like they are doing something alone – no matter what it is – they are far less likely to succeed or meet goals. Emotionally, we feel more able to succeed with social support.

The United States has some of the lowest rates of breastfeeding in the world among developed nations, and when you look at the rates of exclusive breastfeeding it becomes especially dismal. While about 75% of woman initiate breastfeeding – this is a very large category and a bit misleading. This includes one attempt in the first days of life. While this is great (so many mothers attempting to breastfeed!), it gives false hope as the total rates of breastfeeding. In 2007, at 6 months of age the rate of exclusive breastfeeding was only 13% 1. Lets keep in mind that six months of nothing but breastmilk is the current recommendation from every major group with an interest in infant health (this includes the AAP and WHO). What is happening to cause a drop from 75% of women attempting to breastfeed, to only 13% succeeding at 6 months?

The simple answer for most cases – lack of proper support. Study after study shows that our support network is vital to breastfeeding success. For most women, one caring and helpful IBCLC cannot undo the “work” of a society that does not really support breastfeeding. While it is possible for a woman to physically or psychologically be unable to breastfeed that sub-section of woman is statistically small – most certainly not 87% of woman or the human race would not have made it very far.

The Surgeon General put out a “Call to Action” in 2011, urging America to support breastfeeding. Much of the document focuses on increasing community support across the board – from the family unit, to the care provider, to society as a whole. Some highlights from the document include:

“Women with friends who have breastfed successfully are more likely to choose to breastfeed. On the other hand, negative attitudes of family and friends can pose a barrier to breastfeeding. Some mothers say that they do not ask for help from their family and friends because of the contradictory information they receive from these sources.” (pg 22)

What this little gem tells us is that mother’s who DO succeed in breastfeeding need to talk about it. We need to share our wonderful experience – it actually encourages other mother’s to more seriously consider breastfeeding in the first place. This also tells us that hearing conflicting and outdated information from “well meaning” family and friends is NOT helpful. (Big surprise there, right?)

Now, there is a whole section on Embarrassment. Yes, in the great nation of America, the Surgeon General actually has to address embarrassment as a barrier to breastfeeding.

“A study that analyzed data from a national public opinion survey conducted in 2001 found that only 43% of U.S. adults believed that women should have the right to breastfeed in public places. Restaurant and shopping center managers have reported that they would either discourage breastfeeding anywhere in their facilities or would suggest that breastfeeding mothers move to an area that was more secluded. When they have breastfed in public places, many mothers have been asked to stop breastfeeding or to leave. Such situations make women feel embarrassed and fearful of being stigmatized by people around them when they breastfeed. Embarrassment remains a formidable barrier to breastfeeding in the United States and closely related to the disapproval of breastfeeding in public. Embarrassment about breastfeeding is not limited to public settings however. Women may find themselves excluded from social interactions when they are breastfeeding because others are reluctant to be in the same room while they breastfeed. For many women, the feeling of embarrassment restricts their activites and is cited as a reason for choosing to feed supplementary formula or to give up breastfeeding altogether.” (pg 23)

This section goes on more but let me pause here. No matter how you choose to feed your child, I hope that above statement leaves a bad taste in your mouth. Only 43% of adults feel that a mother should feed her baby in public. Lets not even give the cop out of breastfeeding and “modesty”. This statistic literally translates to mean that 57% of Americans are uncomfortable with a baby being fed in public in a normal way. Only 28% in this particular study believed that breastfeeding should be portrayed on television 4.

Then we see proof that managers and business owners do ask women to leave if they breastfeed and refuse to move or stop. We see this in the news from time to time, but many people think it is rare. Is it really going to be a rare occurrence when over half of all Americans are uncomfortable seeing normal infant feeding? It also goes on to say that we are not just talking about public situations, that last section literally means that within their own homes and social units, women are being made to feel uncomfortable because they breastfeed. What woman is likely to keep breastfeeding if she doesn’t even have acceptance in her own home or social group?

To continue with the “Embarrassment” section:

” In American culture, breasts have often been regarded primarily as sexual objects, while their nurturing function is downplayed. Although focusing on the sexuality of female breasts is common in mass media, visual images of breastfeeding are rare, and a mother may never have seen a woman breastfeeding. As shown in both quantitative and qualitative studies, the perception of breasts as sexual objects may lead women to feel uncomfortable about breastfeeding in public. As a result, women may feel the need to conceal breastfeeding, but they have difficulty finding comfortable and accessible breastfeeding facilities in public places.” (pg 23)

This section speaks to how our breasts are viewed. First and foremost in our culture they are viewed as sexual. This context of breasts as primarily sexual is actually not the predominate view in the world as a whole by the way 3. This portion also speaks to an issue that comes up more and more with social media – the posting and viewing of breastfeeding photos. These studies and surveys prove that women need to see breastfeeding. The more you see it, the more normal it becomes.

Our sexual view of breasts did not just evolve from thin air – it evolved through a constant presence of sexual images of breasts in our culture. Simply put, the more we can promote and share the non-sexual view of breasts, the less sexual our breasts will become in the culture as a whole. I, for one, would be very happy to see that happen – not only for breastfeeding rates but also for the self-worth of women in general.

In the last sentence, the Surgeon General notes that even though women may feel compelled to hide breastfeeding because of these pressures, there is no where to hide! Our society seems to insist that we breastfeed “somewhere else” but where exactly is this wonderful place we are supposed to hide? Very few places, especially outside of large cities, have breastfeeding spaces. When was the last time you saw a breastfeeding room at your local grocery?

In the section of the document about ways to help increase breastfeeding rates, special attention is given to educating the fathers/partners and grandmothers. Studies show that lack of support from those two sources can lead to shortened breastfeeding (or never starting). There is also special attention given to strengthening and supporting woman-to-woman support groups, such as local La Leche Leagues or other community breastfeeding groups. Those two actions in our communities would be especially helpful to low-income women, where studies show that social support and acceptance are paramount to breastfeeding success 2.

Now I would like to switch gears. We know that community support can make a difference, but we hear little about it. Normally, we only see stories of mothers being harrassed for feeding their babies. If positive stories and experiences with breastfeeding can make a difference in breastfeeding rates, then we need to share them. I reached out to our support group and got many stories and photos, all about positive experiences with nursing in public!

“The first time I ever breastfed in public was last summer when my daughter was 8 months old. My family and I were on vacation in Austin, TX and we were on a tour in some underground natural caverns.  We were at a resting area and I chose a rock to sit on and started nursing her.  I was so nervous that someone would give me a dirty look or say something rude, but a woman came up to me and thanked me for nursing my baby.  That one little comment gave me the confidence I needed to keep nursing her in public and I have been doing so ever since.” – Jennifer


“Over Memorial Day weekend there is a big festival by the beach where we live, so my husband and I invited our folks to join us and our 2 month old daughter. It was HOT with very little shade! My daughter was getting fussy so I sat down on a bench behind one of the vender’s who had an umbrella up. My mom, who is easily embarrassed, kept trying to give me a cover but I told her no and proceeded to nurse my baby. The vender turns around to see me nursing my daughter and says, “Good for you! Not enough mother’s breastfeed any more! Keep doing what’s best for your kid.”‘ – Beverly


“We took a vacation to Vegas with our daughter. We had just finished a limousine ride, and walked back into our hotel. I sat in the lobby and started to breastfeed my little girl. A lady came by and told me breastfeeding is the most beautiful thing in the world! I wish I had taken a picture with her. It was such a positive experience for me.” – Krystal

Below is Brianna nursing at Disneyland. Just a fun fact, from a former Cast Member – Disney Cast Members are instructed specifically in training about the importance of nursing in public and that it is 100% legal and acceptable for women to do so anywhere in the parks or property. Some companies do care!

breastfeeding at Disneyland

Below is Katelyn nursing her son at the aquarium, her supportive husband at her side!


If you have a positive nursing in public experience, please share it with us! And remember that the “other person” in these stories is someone just like you. Just one person reaching out to another and saying “Good Job” – it can literally change a mother’s whole outlook on breastfeeding. Next time you see a mother nursing in public – no matter how she chooses to do it – give her a smile or even better, a kind word.


  1. U.S Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: U.S Department of Health and Human Services, Office of Surgeon General; 2011.
  2. Pugh, L., Milligan, R., Frick, K., Spatz, D., & Bronner, Y. (2002). Breastfeeding Duration, Costs, and Benefits of a Support Program for Low-Income Breastfeeding Women. Birth: Issues In Perinatal Care, 29(2), 95-100. doi:10.1046/j.1523-536X.2002.00169.x
  3. Wolf, J. H. (2008). Got milk? Not in public!. International Breastfeeding Journal, 31-3. doi:10.1186/1746-4358-3-11
  4. Pettis, C. T., & Miller, M. K. (2007). PROMOTING BREAST-FEEDING THROUGH SOCIAL CHANGE. Women’s Policy Journal Of Harvard, 439-47.
  5. McInnes RJ, Chambers JA. (2008). Supporting Breastfeeding Mothers: Qualitative Synthesis. J Adv Nurs. 2008 May; 62(4):407-27. doi: 10.1111/j.1365-2648.2008.04618.x.

Mental Illness and Pregnancy

Mental Illness and Pregnancy

“I’ve debated telling this story. I’m afraid of being judged and perhaps even… yelled at.  But my story is just as important as yours. My story is the one that no one talks about. My story is about being pregnant with a mental illness.” -B 

My story starts a good 10 years ago, when I was officially diagnosed with Borderline Personality Disorder. In a nut shell, Borderline Personality disorder is all encompassing. Its not usually diagnosed, and some psychiatrists don’t even believe its exists. It includes things like fear of abandonment, mistrust, harmful thoughts, and fast moving emotional thought process that I have no control over. I have very little control over what I think, do, and how I react to things emotionally. Medication makes things easier, but these things will always be a struggle for me. Anyways… 

At that time I had no future. The world was dark. No one cared and everyone else was a hypocrite. I had no future. And honestly it was only a matter of time, before the drugs, alcohol, and cutting caught up to me. Sooner or later… and I didn’t care that much. 

Then I met my husband. He held my hand and offered me a choice. Did I want to continue being miserable, angry and alone, or did I want the future he was offering me? With a career, and a home and maybe even a baby? I had always wanted a baby. If I wanted that, I had to start medication. That was my choice. I was tired of all of it, and I had nothing to loose, so I chose him.   

I was stable for 3 years. Properly medicated with regular therapy and we both felt it was time to have a baby. We wanted a baby and we knew it would be hard. We knew it would be hard because of my illness, but we decided as a team to take the risk. We wanted a baby boy. Maybe it was selfish to want something so badly, especially since I knew I would not be able to go off my medication. My psychiatrist assured me it was safe though, so we quadrupled my folic acid intake to counter act the medication I was already on. And within a few weeks I was pregnant! 

We were thrilled. Nervous, scared. We were parents. There was life growing inside me!!! 

This lasted all of 2 weeks. Then I got sick. 

Typical pregnancy symptoms I was told. They will pass, “you have life growing inside you”. Not so simple for someone like me. For the first 3 months, I was so nauseous I couldn’t eat. I lost 15lbs. Luckily I had enough to spare. Something as simple as not being able to eat was hard for my mind to accept. I cried often. 

The second trimester was worse. “Its ok, it’ll pass, its just part of being pregnant, you have life growing inside you!!” I had a migraine for 3 months straight. Nothing I did alleviated the pain. It only went away when I was sleeping and I wasn’t sleeping all that well either. I cried because I was in pain and tired. 

Please don’t misunderstand. Of course I had moments of elation. Every time he moved. Every time we listened to music together and he danced. We still dance! He amazed me. He was growing inside me and it truly is an amazing thing!  These moments gave me the strength to carry him longer then I wanted to. These moments were very special for me. 

The third trimester, although relieved by the fact that finally after 12 weeks my migraine had went away and I was able to eat again, now the depression kicked in. I hadn’t slept in God knows how long, I was miserable every single day, I ached everywhere I could hardly move. I cried every day because I felt so sick of life. My mental illness had taken over my thought processes, and more then once I threatened to cut my baby out of me! People thought it was funny for me to say that. “You have life growing inside of you. It’ll all be worth it in the end.” They all said. But I had never had a baby before, I didn’t know what they meant, and as far as I was concerned at that point, nothing was worth the pain I was feeling physically and emotionally. I was so unhappy and so depressed and my thought processes were so disturbed. I felt bad for how I was feeling because I knew my son could tell. Every time I cried he got quiet and I knew he knew how I felt about him. So I also felt ashamed. I should love my baby. I grew him and he’s special, but I didn’t. I didn’t even like him anymore! He had put me through a lot already and I was very angry at him.  

At 40 weeks 2 days I called my doctor and begged him to induce me. Once again stating that I was totally serious about cutting him out myself. He finally obliged  and I was scheduled for an induction the next day. I was so incredibly grateful! The induction worked and within a few hours I was in full labour! 

It hurt like a bitch but I was so happy to finally be in the final stretch of things. Morphine, epidural yes please!  

Time is a daze but I think I was in labour for about 14 hours before I started pushing. The nurse has mentioned that I could up the epidural so I did and by 9:00am I was ready to start pushing but I couldn’t feel anything so I did the best I could. 

My doctor showed up and tried to vacuum. It didn’t work, it fell off 3 times and baby wasn’t bugging. Finally he concluded that baby was stuck and we had to have an emergency c-section. Up until this point I was doing fine. My mood had elevated for obvious reasons and I was in the home stretch! This baby that had been tormenting me for 40 weeks would soon be out and maybe then we could start our relationship over.  

They said C-section and everything changed. Now I got scared. I turned to my husband and said, “can you call my parents?” Now I was crying, for the first time throughout the entire labour. I had prepared myself for everything except that. Everyone told me that I had the hips to birth a baby, but my baby was now stuck between them and was not coming out on his own.  

So they did the c-section and everything went smoothly. I was embarrassed because I was laying on the table completely naked and exposed. Nothing covered except my head, but I felt like I didn’t have a choice. I pushed it down like I had pushed all my feelings and emotions down for so long and just let them do what they had to do. 

They tugged and pulled and the anesthesiologist commented over and over again, “just a little bit more tugging.” I guess baby was really stuck. I felt my body move with each tug, but they eventually got him out and he cried and we were happy. I was so happy he was finally out! 

My husband held him for the first half hour while they stitched and stapled me up. My parents came right away because the C-section was a shock to them too. Apparently my mother was hysterical, “my baby is being cut open!!!”. So they held him too. I don’t remember if they held him before me. I wasn’t opposed to it. I guess I was happy. I was more relieved. 

The one thing I remember is how invasive the nurses were. They wanted to put me on Demerol so I would stop shaking because of course by this time my body had gone into shock. My OB said no right away (the one good thing about the entire experience) and just put me under a heated blanket. Within half hour my shaking had stopped. 

As the nurses cleaned me up, my body completely numb and still fat from pregnancy, one of them commented on my scars. I have about a dozen that are noticeable because of my mental illness and the first thing I thought was, didn’t you read my file?  Must I explain this to you? But I quickly did. Calmly. It was not what I needed to hear, nor was it something I wanted to explain at that precise moment. I mean I had just had a baby literally ripped from my body. Clean me up and keep your comments to yourself! 

newborn after cesarean

Well from here on in, nothing went right. I didn’t sleep for 4 day, because they insisted on having a bright night light on all night long. I was exhausted! Baby wasn’t eating and was unable to nurse because my milk refused to come in.  I looked and felt like shit and this baby would not stop crying! We supplemented. We had to. 

Because of all the drugs, my face broke out in cold sores. I’m prone to them to begin with, I get them quite seriously actually but this time, I had over a hundred! I had them in my eyes, on my cheeks, on my nose, my chin. The glands in my neck had swelled up so much I could hardly move my head, and since the herpes virus can actually kill newborns, I was restricted in how often I could hold my baby. Needless to say, we did not bond..

Now the depression hit a high. We were finally home, still not breastfeeding, or sleeping. I couldn’t move because of the surgery, he was crying because he was so hungry. I was crying because in my mind, I was a failure. I couldn’t birth my baby, I couldn’t feed my baby, I couldn’t even hold my baby. I said to my husband, “if your’e holding him, who’s holding me? ” And I meant it! I felt so incredibly alone and shameful. I thought often of just stuffing the baby in the freezer. Often. If it wasn’t the freezer it was the washing machine… Often. And that scared me.  In my screwed up mind, this baby was the cause of everything bad that had happened for the last 42 weeks of my life and if he just wasn’t here anymore… I felt horrible. What made me feel worse was the fact that I knew he knew exactly how I felt and it was obvious that he didn’t trust me.  

I still cried every day. It was a very difficult time for my husband. I put on a brave face for all the family that came to visit us, but as soon as we were alone everything fell apart…. 

So here’s where the story gets better.

We were sitting on the couch one night, just hanging out watching tv. He was 2 weeks old, and I just looked at him. This was the first time I had actually just looked at him. He looked back and I said, “there is something so familiar in your eyes.” As I looked harder, I realized he had my eyes. I was looking into a mirror! My heart melted. I said, “I guess you aren’t so bad…maybe this isn’t your fault.” And his glare did not faultier. “Can we start over?” And turned his head and started rooting, “You want to try just one more time?” So for the first time I nursed him.

He latched and he drank big gulps and he looked at me and I could tell that for the first time he forgave me. He understood and I promised him then that no matter what I thought, no matter what the voices told me to do I wouldn’t do them. He trusted me now and I couldn’t betray that. The thoughts haunt me on a daily basis even now but he trusts me and he loves me and he cuddles me and he forgave me and now he doesn’t even remember and as time goes by, the thoughts dwindle and they aren’t as strong. That night I fell in love with my son for the first time. He looks just me, so how couldn’t I love him.  

Some days for me are harder then others. My son is my reason now. My reason to stay strong, to take my medication and to go to therapy. He needs me  to do these things not only for myself but for him. Every time I look into his milk chocolate eyes, my eyes,  I’m reminded of where I was, where I could be and where I am now I’m more confident as a mom and more secure as a woman, and its all because of him. I’m so lucky. My husband has been incredibly supportive throughout this entire journey and I have him to thank as well. 

I still don’t know how I’m going to explain things to him as he gets older. Why I need to take medication, what the scars mean, why I get so angry sometimes or cry uncontrollably, and why I can’t control certain aspects of my emotions. I don’t know. But I figure I’ll just take every day as it comes. As a blessing. I grew him inside me. He’s mine and regardless of how I felt about him in the beginning, its not how I feel about him now. He’s the absolute love of my life and I tell him every single day. 

mother and son

pregnancy and mental illness

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