Long before there were 'birth professionals', women were giving birth. Before the doctors and the midwives were the so called 'experts', women relied on other women to get information about and gather support for the birth of their babies. This is the way it has been, and in reality, this is how it still is. Beyond a doctor telling you what the lab results say, beyond a midwife showing you lots of good 'positions' to birth in, women still share with one another- their stories of triumph, their stories of fear, their stories of loss. Women still 'feel' what is right or wrong, and process those stories with one another. Sit with a group of new moms and you will inevitably hear a story or two about birth. From the moment that a women reveals that she is pregnant she is surrounded by women telling their birth tales: in line, in the bathroom, in the park, over lunch; women participate in the ritual process of recounting birth experiences, forming those experiences out of the threads of memory and pieces of stories left after the birth itself. Pregnant women (and anyone around them who will listen) become members of a narrative ring; bound by the body, contracted by motherhood to hear, to tell and retell what others insidiously, joyously, and often anxiously- tell and retell.
In the United States, pregnant women have two choices, to birth at a hospital with an obstetrician or midwife, or to birth at home or birth center with a midwife. Only one percent of the population chooses the latter. Choice is often rooted in privilege, and feeling free to choose where, how and with whom to birth is no different. Because western culture privileges medicalized, technological and interventionist birth over natural birth, it is ironically most often only the privileged who have access to ‘natural’ birthing options.
And even those women often 'lose control' in the face of medical authority. Where we work in Uganda, women have no option but to have a 'natural' birth (ie, no pain medication), but that doesn't mean they have non interventionist birth. In fact, the medical model has moved so far into the hearts and minds of women around the world that most resort to pushing flat on their backs- even if there is no medical 'authority' around telling them to do so. Episiotomy is still routinely cut by midwives in many hospitals. And yet, having access to hospitals, or life saving technology like an emergency C-section is just not always an option. The three hour ride down the road to a hospital, the lack of cars, the amount of money that it costs are all barriers for women to access care that might save their lives.
Such are the ironies of birth in our time. Yet, across race and class disparities, across lots of time zones and seas, women still tell stories as a way of knowing. And this is what our friend Roanna Rosewod has done with her book, 'Cut, Stapled and Mended'. She takes us on a raw journey through her births, from unwanted and unecessary C-section, to necessary C-section, to triumphant home birth in her bathtub, Roanna bravely shares her story. And in sharing it, she offers it to us as a tool for thinking through our own options, for challenging the system, and for becoming the 'experts' of our own bodies, our own births.
We were honored to host Roanna at our birth center in Uganda in 2009, and are honored today to be standing behind Roanna in the birth of her story, her book. She has put together an incredible ONE DAY ONLY package of gifts that you get FREE if you purchase her book today. Download a collection of music sung by the midwives at our birth house, seminars from Dr. Christiane Northrup, Pam England, Karen Brody, MamAmor Dolls, Barbara Harper, Rebecca Wood, Susan Weed, Sheri Winston, and other incredible
visionaries in giving away more than $1,000.00 worth of valuable gifts to everyone who joins us, right now.. Whether you’re impassioned about birth, women’s health and empowerment or simply want to honor an important mother in your life, this is for you!Go to http://www.cutstapledandmended.com/ and join us, today!
Amy Lint traveled to the Mother Health International clinic in Uganda in October to give birth to her third child. Her story is below.
Discovering I was pregnant again after we had just moved back to Kenya came as quite a surprise. It presented quite a dilemma as to choosing the best birthing option for us. We wanted a midwife and non hospital setting, sadly this gave us very few options in all of East Africa. Getting in contact with Rachel at Mother Health International helped solve our problem.
Rachel warmly welcomed us to come and stay at their centre as long as we needed. At first we dismissed the idea of birthing there because it was so far, but later saw it as an opportunity for our family to take a great road trip exploring new places we have never seen before.
The centre offered a rural setting, dedicated to self sustainability, yet a safe and fully equipped birthing facility including custom made birthing tubs! Located in Acholi land, people with similar culture and language to my husband and where we stay in Kenya. They could offer us extra reassurance of birthing with midwives who have trained in the US thus overall seemed to be a good fit for us.
Several months later We left our home in Bondo, Kenya at 7:30pm and in just over 24 hours and 3 long bus rides, we had made it safely to the Ugandan birth center outside of Atiak. .Getting there just after the sun had set and not really even that sure where the centre was, we were relieved to be greeted by friendly faces, soon to be known as Nitey and Paul.Relieved that we made it safely before the birth we could now relax and enjoy our stay. We had an amazing full two weeks before our baby was born. We were blessed to spend a lot of time getting to know our new midwife, Rhonda and student midwife, Erin, as well as the traditional midwives. We kept busy helping weed the peanut fields, took evening walks through the village, planting vegetables, learning how to knit, and watching the local soccer matches in town.
The birthing day came and all things seems to fall into place. My two older children joined me for a swim as I labored in the tub. I gave birth in the tub to our second son before the day was too hot. Grateful for the support of our midwives as they were quick to assist in all ways possible. Everyone in the community came to greet me and see our new baby.
We spent another week settling down and bonding with our new family member until we headed back home. It was a Once in a lifetime birthing experience that I wouldn't have done differently. Mother Health International is doing important work by offering safe birthing experiences in areas of extreme need. Let us all work together to see that they can offer more sites globally in support of women and children and birth that works. I am forever grateful, apuoya! (Acholi/luo word for I praise/deeply thank you)"
Please enjoy some glimpses into midwife Brenda Burke's experience at our clinic in Uganda!
"Before I set foot on the beautiful red soil of northern Uganda I often wondered what this journey would hold, what
adventures I would carry forth in my heart and what are the unknown details of this work we were about to undertake.
Service that asks everything of your heart, body and mind. Service that lays claim to your spirit.
Our journey, (with amazing Ida, an inspiring young woman who has made her way around birth since the age of 9),
began in early December and concluded in late February. We shared one amazing month at Mother Health International and are forever in gratitude for the graciousness and splendor of the community built there. Here are a few of the many experiences we shared, in the form of compiled notes to loved ones back home.
Rachel, Ida and I are heading off to the deep bush today for prenatals in one of the villages. We spent last evening
watching 'Babies" in our hut, with our brooding hen 'Jocelyn' who will hatch her babies in the next two weeks.
Birth yesterday of a sweet boy, and his mama is a niece of one of the local midwives:) Love, love, love the sister
midwives here, so generous and helpful and patient as I fumble through my first attempts at words.
Learning about an amazing herb to treat UTI symptoms and it also scans the body to support whatever systems are
Ida and Nighty, (our amazing cook) are working on developing two new prototype projects to help Mother Health International become
self -sustaining (baby wraps and beaded curtains).
MHI is so deeply thoughtful at every level with their commitment toward sustainability (gardens, bee's, local
employment, reuse of all water systems, solar power, etc....)
22 mamas are visited today in a group 'centering' prenatal circle. Two sets of twins likely, one mama will birth with us
during our stay, (first time mama, 16). So love that all the women sharing and learning together:) In this lovely circle
today there were 2 traditional midwifes who live in the community. We were exploring the contrast between what
a tummy looks like when a baby is face up verses face down (anterior/posterior). It was so fun to have lots and lots of
tummy's to show this difference with:) (Gail if you are reading this we began to explore 'Spinning Babies' concepts)!
Ida is so wonderful with the mama's and midwives. Everyone is loving Ida and there are learning opportunities abound
for us all. A bit joyfully exhausted after all this wonderful exchange:) It is so hard to put into words how amazing this sacred space and journey has been.
Rachel is preparing to leave in a few days and I have so much to learn from her yet, (she and Olivia). My heart already
knew, on day one, that I would be coming back to serve again:)Thanks so much for all the support and love from home, it truly sustains us here.
This morning we took at trip to the local heath care unit in Atiak. Two days ago when we walked in the only person on
staff was the male circumciser/nursing assistant who was there to care for the sick and catch babies, (yes catch all the
babies). We took one of our mama's in today for a scan for lack of growth. We walked in on a birth in process with the
circumciser ready to catch, (mama flat on back, in stirrups), we helped mama up and received a lovely baby boy who
needed a decent amount of recess/close observation for about an hour. Next mama laboring outside comes in and her
labor stalls as she is pushing. Another mama walks in and hop's on to the bed right next to her and we receive a sweet
girl. I hear the mama whose labor had stalled beginning to push and I pop behind the curtain to check in with her.
Ninety seconds later as I cross the curtain again to see how that mama who just birthed is doing I see a beautiful shinny
orb emerging from her body and we receive her second daughter, surprise twin’s. Our stalled mama is weak from lack
of food, rest and hydration. We bring her back to MHI for some food, fresh water and rest, (there was no
running water at the govt health clinic). Mama gives birth after getting some nourishment and rest to a very large baby:) So 4 babies in 3.5 hours, (set of twins to boot:). Ida is such a wonderful natural , her hands were full of babies, placentas and mama's:). So it is 2:30 in the afternoon here and I wonder what the rest of the day holds for us:)
The morning began with a lovely labor at 4:30 a.m. She was an experienced mama who labored best in privacy, so we
rested on the wonderful hammocks just outside her room. Sweet baby born into her mother’s hands at 7:26:) Lucky Ida
has now had two babies named after her:) Nighty and Patricia are taking turns interpreting for us in the wee hours of
the morning with there little ones in tow Both
Yesterday began with several hours of prenatals in a local village. Ida conducted 7 of the prenatal visits:) At one point I
heard a loud click clonk down the corridor and was greeted by a large pregnant mama cow walking down the hall; you
just never know who is going to show up on prenatal days.
Today was so sweet. Lovely first time mama (16) labored so beautifully with lots of love from Ida who went on to
received her first baby with a four handed catch:) Ida is well on her way:)
Walked to town center to listen to services and song in a completely new language. Ida was able to record all the songs:)
Smiling while I harvested fresh calendula for a new mama's postpartum bath.
Savored Ina May Gaskin's new book in the hammock.
Took a lovely evening stroll and chatted with children along the way (practicing my new few Achole words; all the giggles
let me know I have a ways to go:)
Indulged in a sunset outdoor shower, water warmed by mama earth.
Sipping on homemade pineapple/passion fruit wine while preparing chapattis topped with cheese, fresh avocado,
tomato, onion and garlic:)
Love and smiles from Uganda:)
Ebb and flow,
Tuesday began with great promise; a lovely long mornings walk and opportunity to practice a few new
words of Acholie; a scheduled meeting with all the lovely midwife sisters from the surrounding villages (30); then the
joy of two calls for laboring mama's. Oh my heart sang with anticipation for what the day was holding. As life can,
shifts occurred. Our ambulance (4 wheel drive Toyota) broke while picking up a mama. Earth Birth has one of the only
automobiles in the entire region. We called a boda-boda (motorcycle) and were able to transport one of the laboring
mama’s back home where she birthed with her local midwife; her labor was progressing to quickly to get her to Earth
Birth. The other mama also birthed before we could reach her. Our hearts mourned a few hours later when we learned
that the first mama's baby had been born full of life and then passed away 90 minutes later. We do not know the cause
of this little ones passing and will visit with mama very soon. We have learned that she feels that this loss would have
occurred regardless of where she had her baby and is in a place of acceptance. So many mamas have lost one or more
of their children here. The rate is so high for this sort of grief. Knowing the contrast of all the available resources in
our homeland, it feels completely unacceptable to see that most mama's completely prepare for the fact that they will
probably loose a baby/child at some point in there life.
My words and descriptions feel so inadequate as I try to covey the deep and powerful work of MHI, reducing
these losses and suffering/grief for families and bringing safe, gentle, holistic maternity care to the region. All this
beautiful work is steeped in cultural competence and sustainability efforts on all levels.
The loss of our vehicle also
meant the large midwives meeting would be postponed as we could not pick-up several of the far reaching midwives to
bring them in for the meeting.
The day turns again. The sky's opened and in 24 hours we had a total of 8 birth calls. One strong and mighty mama, who was well under 5', labored for 52 hours and brought her firstborn into the world with such power and strength; we wept tears as her baby emerged.
Exhausted on every level, we joyfully slipped into bed for the first time in 2 days for 2 hours before we woke up to travel to Gulu, the closest city, to do our supply shopping and get our Toyota repaired. Mechanic let us know that the repair will take sometime, so a surprise overnight stay in the city. Ida and I have had so much fun discovering the sights and sounds of this very busy city and already long to return to the sweet peace of MHI. Friday morning here now and we send our love to you all.
Two sweet Xmas babies yesterday. One mama who was welcoming her 9th baby arrived, complete (10cm) at 6am and
followed her bodies lead beautifully (resting, eating, hydrating, walking, squatting), her baby decided that 1:03 pm was
the perfect time to be born:)
The second baby had a bit of a snug cord and extended shoulders and asked us to help
her be born just a bit. We were able to birth with the cord intact, which she really appreciated for the extra 02 while
we supported her transition to this wonderful outer world.
Both mama's choose the name Mary & Merry as the perfect
fit for being born on this special day.
Ida and I ended the day with a special meal of chapatti based pizza's, bits of dark
chocolate drizzled with fresh Carmel and a sip of Baileys. All very, very special treats here:) We ate under the canopy of
a vast star filled sky.
The night is dark and our space is candle lit. Esther and I share this sacred space that call’s our full and total presence.
Eyes wide, she lay’s on the matt on the floor, her choice of place to birth. She reached for my hand and places it on top
of her large round tummy. “See, see, see” she says rubbing my hand on her rounded belly, “baby is to big, you must
cut me, please you must cut me. My friends say I must be cut to have a baby. Please cut me”. I tell her that her body
will make way for this beautiful baby, that she can and is birthing her baby very soon. She rocks her head back and forth
and again pleds with me to cut her. Our hands join and do not part again. We share this dance of fear/belief until the
threshold is crossed and her baby is slowly passing through her body to this outer world. Oh the joy that emerged from
within this fresh mama. She has seen and experienced her full power as woman and I was so blessed to be her witness.
As the sunset yesterday afternoon, I was showering outside and looking at the purple shadowed outline
of mountains many miles away. I had a moment to look up and saw, for the first time, the beauty of a dozen or so
humming birds fluttering around the papaya tree. Oh my heart danced as I watched their beautiful ballet. I began to
reflect on all the life cohabiting here at Earth Birth. Two days ago a small herd of goats wondered into our compound
and spent the days walking around in a sisterhood cluster, as if they have always belonged. This morning 4 new chicks
hatched and are waddling after their mama, so sweet and fuzzy. We have: bee's; black wasps; snakes; scorpions; rats;
mice; butterflies; a cat named 'Baby Jesus, who is pregnant with her first litter, 2 pigeons, a roster name 'Bonaparte'
who is regal and tolerant, many hens, innumerable insects and the life force of thousands of plants. Even the dousing of
constant dust from the passing vehicles (that casts a dirt hazy like heavy fog or smog), cannot put to sleep the balance
of harmony and life all around here.
Five-labor calls in the past 24 hours and 2 mamas’ were able to make it in on the
motorcycle. Two lovely girls are added to the world, within an hour of each other:)
News of our ambulance being fixed
today has us hopeful that we can again serve all whom call:)
Ida has been working on clearing new space for more
planting of garden and creating the most amazing sewing projects that other mama's can make and sell to support MHI(Baby Hammock's, Cushioned Computer bags in the most wonderful fabrics, baby dresses, pouches, etc.... All this
and she creates space to be present for prenatals and births:)
Love and warmth from Uganda
How did someone from Oregon by way of Brooklyn end up delivering babies in Uganda?
It's a long and twisty narrative, but the short version is that I was invited to come to Uganda by a fellow New York birth worker in 2007 to volunteer in a government-funded hospital. What I witnessed there was devastating. The hospital was functioning at what the WHO estimated to be over ten times its capacity. Women were turned away in labor or sent to walk home minutes after giving birth, often bleeding to death on the road home. Women who were admitted to the hospital were often treated violently by the hospital staff for not pushing fast enough or failing to bring their own piece of plastic to give birth on. These conditions made for a traumatic and dangerous place to give birth in an area that has been ravaged by war. I founded Earth Birth with my partner, midwife Olivia Kimball, the next year.
What kind of services does Earth Birth provide?
We provide prenatal care, labor and delivery; post partum, family planning and HIV/STD treatment. Women do not need to pay to receive services, but rather, they must involve themselves in a project that sustains the clinic. For example, they can choose to work in our community garden. The food that is grown there goes back to the women and the excess is sold in the market to pay for supplies at the clinic. We also have the only ambulance in the region so we are able to transport women to the closest hospital (50km away!) when a situation occurs that we cannot handle in-house.
Uganda, particularly in the north, has been devastated by civil war over the last two decades. Would you say war is exponentially harder on women?
Yes. Absolutely yes. Women are often used as tools of war. In Northern Uganda for two generations women have been used either as sex slaves for the rebel army or as reproductive machines, abducted and forced to give birth to as many babies as possible to build up the army with child soldiers. Women giving birth in captivity are faced with lack of prenatal and obstetrical care, severe starvation, untreated STDs, physical mutilation and extreme emotional trauma, among other issues. Not surprisingly, Northern Uganda has one of the highest birth rates in the world, and also one of the highest maternal and perinatal mortality rates.
Situated in one of the largest Internally Displaced Persons camps in Northern Uganda, not only does the Earth Birth birthing clinic provide maternity care to local women, it's also become a safe space for those displaced by war to gather and work on projects. Founded in 2008 by Brooklynite Rachel Zaslow, the clinic is home to around five births a day and sees up to 50 women daily for pre-natal care. A large part of Earth Birth's staffing consists of traditional birth attendants, women who practice midwifery as it has been handed down to them from generation to generation; the World Health Organization (WHO) estimates that 80 percent of Uganda's population has passed through the hands of a traditional midwife.
How is the most basic human act—giving birth—also a political act?
Well, it has to do with vaginas, and I find that almost anything related to the vagina tends to become politicized. But on a serious level, childbirth is completely embedded in issues of class, race, education and privilege. Women without money or education or community support networks don't tend to have a lot of options and as such, have higher rates of complications and mortality. That's true in Uganda and it's true in New York. Have you ever felt in danger as you worked?
Sometimes I am in the middle of a situation and I think “I really shouldn't tell my mother about this”— like the time I had to transport a woman with a stuck second twin to the hospital in the middle of the night. We were driving down the road that was the pathway for the rebel army to abduct people—and had to pull over because the feet of the baby started coming out. My partner midwife Olivia and I had to stick our butts out the window of the car so that we could reach the woman, catch and resuscitate the baby, and the thought did cross my mind, “this is really
dangerous.” For the most part though, our clinic site is really peaceful and safe. My daughter runs around naked and chases chickens. What lessons from Uganda have you been able to apply to your midwifery back here in New York?
My focus in NY right now is academic. I am finishing a PhD in Women's and Gender Studies. I am writing about childbirth, displacement and the problem of humanitarian aid. I don't think enough midwives write about the importance of what we do in a way that the academic community can hear. This ultimately affects the way we work together with the medical community, which ultimately affects the options that women have— so it's all just one big political act. Also posted at The L Magazine
The baby's tiny head emerged, quickly followed by the rest of her, and yet the mountain of Alice’s belly still loomed before us, undiminished. As her body called her to push again, she believed the placenta would be born, yet instead, tiny feet made their appearance, then disappeared again to be replaced by another, tinier head. Then the second little girl was born, followed immediately by those persistent, delicate little feet that had tried to cut the line. And then there were three. Three tiny, beautiful little girls, instead of the last, single child that Alice had been expecting.
Alice arrived in the Eleventh hour. Literally, translated from the Acholi language, 5 am is called the Eleventh hour, with 6 am being the Twelfth and 7 am being the First hour; the first hour of light and a new day. She arrived in what she believed would be her Ninth and final labor. Having walked about 6 miles to reach help, she was ready to push shortly after arrival. Her body was tired, she had barely eaten the previous day, and was encouraged to drink sweet tea to give her energy for the push.
The first days were challenging, but the babies, named in Acholi tradition: Apiyo (first born), Acen (second born) and Adoch (born breech) were strong spirits, all able to latch and nurse well. Apiyo was 2 kg/ 4.4 lbs, Acen 1.8 kg/ 3.9 lbs, and tiny Adoch was only .9 kg/ 1.9 lbs. Alice was very despondent at first, overwhelmed with the reality before her. She was reluctant to hold them or nurse them, believing that at least one or more would surely die, afraid to love them. Her tired body refused to cooperate, and two, three, four days passed and still her milk failed to come in. We fed her, gave her teas, vitamins, homeopathics and loving support... yet still her milk did not come.
Needless to say it was a bit of a shock, to all involved. Earlier in the pregnancy, Alice's husband had divorced her, after bearing him 5 live children. He maintained that because he had used condoms with Alice when they had intimate relations, he had nothing to do with this new pregnancy, and sent her back to her fathers village with all of her children. She found herself suddenly single, now with 8 children all under the age of 12.
By the second day, the babies were crying in hunger, so we supplemented their milk, always having them first nurse for some time on Alice to continue stimulating her milk supply. The most difficult in the beginning was Adoch. She was so weak, it would take her five minutes of dripping milk into her mouth for her to gain enough strength to suck. By the third night of sleep deprivation, Alice asked me to take Adoch at night, and I was happy to, because I could see that as the weakest, unable to express her needs, she was wasting at night while the other two grew slowly stronger.
It took 6 long days for Alice's milk to come, but thankfully it did, as we knew it must. She was able to fully nurse Apiyo, but we had to continue helping her with Acen, who developed reflux, and needed to be fed small quantities in an upright position and then burped and held upright for 10 minutes after each frequent feeding. As for Adoch, more and more Alice asked that she remain with us midwives. She expressed her belief that she might be unable to care for all of her many children, collect firewood, cook, wash, find food for so many with three small babies. Who would carry the other two while she worked with one on her back? How would she manage while they were still so small and unable to be worn on the back? Several days later, her milk supply was still not adequate for three, not even quite enough for two, no matter how much we fed and hydrated her.
One afternoon, as I sat bathing the babies with her, Alice looked me in the eye, told me about her concerns and asked if I would like to have Adoch. I asked her if she was serious. She said she knew now that she could not take care of these babies alone. Could I, or someone else take one or even two of them?
With Adoch bound to my chest, and my own one-year-old daughter on my hip, I went to my co-midwife Rachel, to cry the pain in my heart because I knew I could not take this baby, yet I knew if I did not, she would surely die. And as she often does, Rachel inspired me... what if we could find an adoptive family? And as soon as we put the word out to the universe, a miracle was provided! A wonderful couple who had been trying to have their own child for years without success would like to adopt two of the babies!
Two weeks postpartum, a grateful and stronger Alice returned to her village with Apiyo, the first and strongest of the baby girls. Acen and Adoch grew steadily with us, and just a couple of days later met their new mother. Although the legal process in Uganda is lengthy, the new parents are committed to give their daughters the very best and are sticking with it through thick and thin.
At 2 1/2 months old, all the girls are now over 4 kg/ 8 1/2 lbs , healthy, strong and beautiful.
Olivia Kimball, Traditional Midwife
And she thrived, sleeping on my chest at night and spending the day curled up with her sisters, by a week old she was starting to gain on them.