Winter 2014 - Home Birth Aotearoa
Transcription
Winter 2014 - Home Birth Aotearoa
1 REFLECTIONS Our Editorial. By Sian Hannagan Jun 2014 Birth in New Zealand has come a long way due to the efforts of the women and midwives before us. Since the Nurses Amendment Act was instated in 1990, women got a real choice in their place of birth. Annette King in her address at the 100th anniversary of Midwifery in NZ in 2004, said “Although the amendment to the Nurses Act was minor, the consequences for midwifery were significant. The most important outcome of that piece of legislation for midwifery was that it permitted midwives to operate as fully independent providers of pregnancy and childbirth services without reference to or supervision by medical practitioners.“ This amendment signalled a huge change in the birth culture of New Zealand. Prior to this change, birth looked very different. I remember talking to my mother in law about her births. When she was birthing my husband, she was told by the nurses to “hold on” and “keep her legs crossed” so that the Doctor had time to arrive and deliver her baby. He turned up, just in the nick of time, and smoked a cigarette while he watched her birth her baby and left shortly thereafter. He got paid a tidy sum for his attentive care. With the nurses amendment act, medical practitioners lost their monopoly on funding, causing the power balance to shift, the result being more choice for women. However, as we enter the 21st century, while the same law is in place, we still have to overcome obstacles when it comes to our view of birth. A culture of fear has permeated our birthing milieu. From alarmist reporting, 2 to emergency birth shows such as ‘One Born Every Minute’ and the activism of certain social interest groups there has been a shift in the language and the way we frame birth. Women are often defined by what they are ‘allowed’ and ‘not allowed’ to do during birth. These social signals, directly and indirectly, erode our birth choices, if not by law, by social pressure. Women choosing to birth at home are often subjected to professional and peer pressure, sometimes even pressure from their spouse to birth in a hospital environment. New Zealand is often held up to other countries as an example of good midwifery based birth-care, and we do have a great system. But if we aren’t aware of it and if we don’t utilise it, then is this enough alone? Given that many health and social services have changed significantly since the nursing amendment act. It is sometimes a surprise that our birth care has remained mostly unchanged. But can we rely on this to continue? The global culture of birth has become the forefront of feminist discussion. More and more we see women being treated as secondary to the infant when it comes to pregnancy and birth, more often than not, a mothers needs and an infants needs are pitted against one another as if they are mutually exclusive. This cultural and medical myth allows women to be marginalised in birth. The truth is that in birth, the mother and baby do not have greatly differing needs. By serving the mother, you serve the baby. Birth violence, for many women, has become the norm, so much so that women who have had traumatic experiences don’t speak out, or feel unable to speak out. It it seems that informed consent matters less for women giving birth than people receiving other hospital care. Many women experience coercion, and if they speak to this experience, they are silenced with phrases such as “Well, as long as baby is okay then there is no problem” and “you should be happy you’re alive and your baby is alive” sometimes these statements echo the statements made against feminists when they question patriarchy. As we might hear “not all men” we hear “not all birth professionals”, which while being ultimately true, does not undo the trauma experienced by women at the hands of some birth professionals, it is however an effective silencer. It ensures that women and their experiences do not get heard. Landmark law suits such as the Ternovsky vs Hungary case, are framing birth as a human rights issue. Is this what we need to do to ensure we 3 continue to be able to choose our place of birth? Take a legal stance? Things have not reached that level in New Zealand, but in our close neighbours Australia and further overseas in America, this is often the only recourse for women being denied their basic human rights when it comes to birth. More than ever we need the voices of our birth luminaries to continue to speak for the birthing mother as too often her voice is talked over by a culture of fear. It is now that we feel the loss of Marsden Wagner, a perinatologist and perinatal epidemiologist who served as a Director of Maternal and Child Health for the California State Health Department and was also the Director of the University of Copenhagen-UCLA Health Research Center, and Director of Women’s and Children’s Health for the World Health Organization. Wagner’s work supporting midwifery and birth rights was invaluable. He spoke of the movement against homebirth as a ‘global witch hunt’ and wrote a number of books that pulled apart our commercial birth model. He chaired three W.H.O consensus meetings, where the appropriate use of technology during birth was discussed. His mark on the birth world is indelible, and we are better for it. Another voice in birth that has recently left us is David Chamberlain, psychologist, author, and editor who has lectured on birth psychology in 20 countries. His work in exploring and resolving birth trauma experienced by the infant was landmark, and paved the way for our understanding that experiences of birth affect not just the mother, but the baby too. These are two great voices in the world of birth rights that have now fallen silent. Closer to home we remember Joan Donley, author of ‘Save the Midwife’. Joan Donley was a key visionary when it came to birth and midwifery in New Zealand in the 80’s and 90’s. Her tireless work led in no small part to the system we have now. Previous to the nursing amendment act, Joan felt that the role of the midwife had been undermined and could vanish altogether if not protected, in 1985 she published Save the Midwife (New Women’s Press), which charted the history of the profession and placed midwifery in New Zealand within the political sphere. Joan was also a founding member of the NZ Homebirth Association and in 1989 she played a key role in the establishment of the New Zealand College of Midwives. In the same year she was made an OBE in for her work in birth advocacy and midwifery. Her work placed New Zealand midwifery in a 4 position to be a world leading system. These successes were a result of tireless work and lobbying. As we reflect on these past challenges, we also need to look forwards. With the rights of women being challenged globally, it is not time to be complacent. Have vocal birth activists had their time?, or do we need them now more than ever? In his interview with Home Birth Aotearoa Michel Odent noted that it was a paradox that Countries like New Zealand had a strong natural birth movement, but that Caesarian rates were on the rise, have we made the best use of your resources and energy to drive change? What is the future of Home Birth in New Zealand? Sian Hannagan our Interim Editor A letter on Joan Donley – by Margo Townsend My first experience with Joan was at a tutorial at the Auckland Midwifery School in 1991. She was a guest speaker. I remember she covered many topics, not the least being the importance of “getting out of the hospital setting and into the community” where she felt was where Midwifery Skills and Confidence could be gained. Remember I am talking 1991 most of my class were looking towards hospital setting placements, thinking that was where we would get the experience we would need to become confident. Joan challenged that notion and suggested that by working outside the hospital setting we would discover our strengths and also would more readily be in a good position to support women in their choices around birth. She offered to take a student under her wing to experience the Home Birth scene. I was the very lucky student Midwife who got to go with Joan those were some of the best weeks of my life in midwifery. Joan was fearless in the protection of normal birth and women centred care. She often said things that were quiet deliberately challenging of the system of the day. She called obstetricians “the boys” said with humour, 5 not I feel in a disrespectful way, but rather in a frustrated way about some of the institution driven protocols that prevailed within the hospital setting. She enabled me and many others, midwives and women alike, to see that there were options outside of hospital and indeed even inside the hospital setting. She subscribed to the notion that women, given the chance, and support could (and did) birth naturally. She empowered me to be a midwife who held women central to the pregnancy and birth journey. She really made me think about being with and alongside women, at the same time she was mindful that I was a student and she made sure that I was exposed to as many experiences as possible: including making soup and scones and taking that meal along to a post natal visit. My first home birth with Joan was in the suburbs of Auckland. a young Samoan mother having her third child graciously let me in to her birth experience. The woman was surrounded by other women relatives and Joan took up her position in the corner of the room, watchful, calm and trusting the process of Birth. Joan did check the fetal heart with her Kauri “listening ear” and the woman let Joan know when the baby “danced”. I had come from a hospital setting where even ‘normal’ women were hooked up to the CTG for at least 20 minutes upon arrival in the delivery suite, so this was all new to me! And, a bit unsettling, but Joan had talked this through with me before we arrived at the house and she had gone through her box of homeopathy remedies as well, should they be needed, that would be my job to pass the remedy to Joan. My other job was to sit quietly and not fidget! The woman had her baby on the floor with Joan’s encouraging words. It was such a wonderful experience. Very removed from my own birth experiences or the hospital births I had witnessed GP’s being called in to deliver the baby etc. None of those here just encouraging words from family and Joan. A PPH of about 600mls followed and was sorted by Joan rubbing up the fundus and me passing the correct homeopathy bottle to Joan, and the woman emptying her bladder I was mentally ringing three bells in my head and waiting for the IV insertion and the room filling up with health professionals. But no, just Joan, me and the women, of course if further intervention had been required Joan would have responded she was a safe practitioner. That first experience taught me heaps. It taught me never to be anything but quietly vigilant and to have the confidence to intervene when necessary, to include the woman in all decisions, to acknowledge there are times when a cosy chat is inappropriate, that immediate response to an unfolding situation has to be dealt with in a timely way, but at the same time giving a running commentary to the woman as to what was happening and what we were doing about it ..Joan explained everything to the woman and did it whilst remaining calm and getting on with managing 6 the PPH. We stayed for about 5 hours post birth. We had tea and cheese biscuits in between supporting the woman to breastfeed and then later to shower and go to bed for a rest, baby tucked in besides her. When we went back the following day for a check up of baby and mum we were greeted with excitement. There were presents for Joan and for me, a hand stitched pillow slip for me and a bed set of hand stitched sheets for Joan cos she was ‘the woman who helped the birthing mum’ I was the ‘woman who came with the helper’. My experience with Joan taught me that when we enter a woman’s home we are the guest and were are women who know about the birth process but, we are not in control, we are not controlling the situation, we might even feel at times a little uncomfortable being outside of the hospital setting. Joan made a point of suggesting I reflect upon that and to remember that when women enter a hospital setting they should be met by a midwife who knows and remembers what it’s like to feel out of ones own comfort zone. Joan’s way of ‘being’ with women within their own environment showed me that women are powerful and well able to birth without lots of protocol driven interventions. My ‘homework’ was to challenge, not just for the sake of it but to really stop and think is this really necessary, what purpose is there to this task, whose needs am I meeting by imposing Guidelines/protocols on this woman, is what I am about to do enhancing the woman’s experience or hindering the birth process? Why, for instance am I putting the CTG machine on this perfectly no risk healthy woman. My time with Joan has stayed with me throughout my Midwifery days. The profession has a need for the Joan’s of this world. We need Midwives who dedicate their lives to thewell being of women and who are always prepared to ask the question Why are we doing this? Who are willing to challenge the system, even if it makes life a bit uncomfortable at times. Joan Donley’s book, save the midwife 7 Joan on Normal Birth – Margo Townsend I saw Joan work with Doctors in the homebirth situation. She was always gracious, but focused on the woman, not the doctor, which seemed to work well with the doctors I saw her work with. I do not know to this day really if she secretly was cross at having the GP there, she never touched upon that subject and I don’t believe I asked her. I do believe that at Midwifery Tutorial time some of the tutors were a wee bit nervous about what Joan might say.we all had to be mindful that hospital placements were hard fought for and that any comments/observations made by Midwives contrary to hospital policy might jeopardize further placement opportunities, but Joan I believe was also mindful of that, but was not prepared to be compromised by not saying what she thought. Mostly what I took away from Joan’s tutorial was to be sure of your facts, read heaps, speak up against practices that impacted on women in a negative way, trust women’s knowledge, accept women’s choices and maintain a safe nurturing environment for women and their families. She also thought women should birth at home if well and that far too many women were not informed of choice or supported in choice. When I trained the climate was very much the doctor and obstetric teams ran the show and even though midwives were respected we were not encouraged to question Interventions and in fact got told off for not phoning doctors in a timely manner to attend births in hospital. She believed Change occurs when the public, in this case ,women are fully informed and well supported by a vigorous passionate point of view around choice of how to birth and where to birth and Joan was a strong constant campaigner for change for women and a big advocate of Homebirth. She also thought that midwives should unite in a common cause and promote normal birth and be supportive of each other and not allow other professions to divide us. A note to Margo – by Joan Donley Get out of the hospital and find normal birth, when you find normal birth then you will know what to do with abnormal, you will recognise abnormal. Keep your hands to yourself unless invited to do otherwise…a mother knows what to do. If you start off in the hospital system you will loose confidence…how could you not…with so many things to do that fulfill someone else’s needs (certainly not the woman’s) how will you know how to trust the process trust the birthing women, honor and respect the birthing mother…you will be so busy kowtowing to the institution that she will be lost from your sight. 8 Obstetricians are good when you need them, but often, too often, you don’t need them it’s just that they fool you and themselves and the women that you can’t do without them….but that’s boys for you. If you ever think you know everything there is to know about Midwifery…run for the hills….you are no good to anyone when you think that. If you think you know everything about Birth then you have lost the excitement of Midwifery. If you say you are going to turn up for an appointment then you better make sure you do. Even if you are late. There is nothing worse than a no show midwife, how can a woman trust you if you don’t show up at her house? Sometimes you might have to take your shoes off so always good ideas to wear sox or have them in your bag.cold feet are a distraction. Most women like my homemade soup and I like making my homemade soup for most women. Be brave and challenge the system. If we don’t challenge the system we might as well pack up and do gardening. I want you to pick your battles, there will be plenty of them over the years so you have to pace yourself. Be a friend to yourself. If you can’t be a friend to yourself then find someone who will be your friend and give it to you straight like a friend should. If you don’t question yourself how will you know what to do next time round. “Be brave and challenge the system. If we don’t challenge the system we might as well pack up and do gardening. I want you to pick your battles, there will be plenty of them over the years so you have to pace yourself.” Good luck Margo, Work hard. Stay out of hospital. From, Joan. All letters and notes kindly supplied by Laura Madden, midwifery student. 9 RIPPLES Our News. By Home Birth Aotearoa Jun 2014 News from the HBA Trust New Website This winter, we celebrate the launch of our new website,www.homebirth.org.nz. The website has undergone a complete transformation and has been designed as a community space for both receiving and offering up knowledge. Spaces you can become involved include: Sharing your birth story add your birth story to the quilt directly via the website! The community forum, is an independent forum, to harness our fascinating and rich conversations in a more permanent way than facebook. To serve as a planning space for groups of local groups (pods) to coordinate and share local events and knowledge and as a way to share local events and knowledge. News is our blog, please jump in and comment or make suggestions for topic issues and recent events to highlight. Here we also present relevant and current suggested reading from across the web. Check out and contribute to our calendar of events. 10 About us what are the aims, goals, history and aspirations of our organisation? How can you be informed and contribute? Community what groups and support is their locally for you? What is your local group up to? Your midwife is our database of midwives. Using this database gives you assurance of the midwives home birth credentials. If you are a home birth midwife, come to this page to create your own listing. We look forward to further developing the site and getting the word out about homebirth in New Zealand. Board elections Join us in promoting, supporting and advocating for home birth in New Zealand. Our organisation is flourishing at the moment, and we need more hands on deck to help us continue the vision. Have your say and learn fantastic new skills in this supportive and inspiring environment! Nominations are open for trustees to Home Birth Aotearoa Trust. We welcome nominations from all members of our home birth community. Trusteeship is a voluntary position, strategically managing the activities of the trust in collaboration with our existing trustees and employees. Becoming a trustee is a valuable and honouring opportunity, where you can utilise your passion, knowledge and skills, whilst meeting new people 11 and gaining new skills. Full details on what being a trustee involves, and how to nominate yourself, can be found here: http://homebirth.org.nz/trustee-elections-2014/ News from the Regions Southern pod hui Over the weekend of the 17th and 18th of May, the Southern regional pod celebrated home birth together at Te Takutai o te Titi Marae (Colac Bay) in Southland, a stunning location. The Hui brought together Members from Queenstown, Te Anau, Dunedin, Invercargill and Bluff. Held overnight at the Marae, the hui was an inspiring experience for all attendees. A full run down of the conversations, ceremonies and speakers is on our blog. Sarah Buckley Wows Audience in Auckland B y Ra c ha e l O uw e jan Midwives, childbirth educators, doulas and students of birth (both formal and informal) from as far afield as Wellington gathered on a drizzly autumn day in Royal Oak to hear Dr Sarah Buckley present her ground-breaking material on the hormonal physiology of childbearing. Sarah showcased her wide knowledge of the complex dance of hormones in labour, an ever 12 present genuine smile, and an impressive dog whistle when needing to get the attention of a room full of sometimes chatty like minded people! Sarah believes there is a ripeness and readiness for the information she is working to disseminate on “Undisturbing Birth”. She was careful to refer to “physiological birth” throughout the workshop as opposed to using the term “natural birth” which has become politicised and subject to debate in the world of birth professionals and mothers. When discussing how oxytocin, beta-endorphin, adrenaline/noradrenaline and prolactin act together to enhance ease, pleasure and safety for mother and baby, the constant mantra during the day – which Sarah made participants chant aloud each time – was that for physiological birth to happen as nature intended mothers need to feel PRIVATE, SAFE, and UNOBSERVED. Some ground breaking research was presented and as the amazing jigsaw of pieces was put together every participant came away feeling they had learned something new. Sarah encourages us all to be well informed, to listen to our hearts and instincts, and to take our rightful place as the real experts in our bodies, our babies and our families. Conference participant Jayne Eddington commented: “Having completed the Paramana doula Course in London with Michel Odent several years ago, I was seeking renewed confirmation that there are others out that also believe that natural birth is possible and encouraged. I was not disappointed and I felt ever more empowered by the fact that Sarah Buckley is in fact a woman and has had the actual experience. I loved the room full of like minded individuals; it felt to me that there was a strength and resolve within the group that it is not only possible, but probable that more natural births will occur in the future.” Right now Sarah is finishing off a major report with Childbirth Connection in the US, The Hormonal Physiology of Childbearing, and is on track for release in September. This report is a seven-year labour of love, and is an expansion of the information presented at the workshop, with “a ton of evidence and implications”. It will be published in whole online. If you were unable to attend the workshop and would like to view the material presented, there was a version filmed in London in 2011 which is available on DVD here: 13 http://store.gentlenaturalbirth.com/products-/undisturbing-birth-dvd The extensive list of references and resources from the workhop is available online here: http://sarahbuckley.com/references-resources We welcome additions to our news section – tell us what has been happening in your area and we will publish it in our next seasonal magazine. Email web@homebrith.org.nz Sarah Buckley holds Rachel’s daughter at the workshop. Photo supplied by Rachael Ouwejan 14 One day film fest: On a rainy equinox Saturday a large group of mothers, babies, midwives and birthworkers gathered in a cosy warm room to enjoy ‘The essence of birth’ film festival (and some yummy food too, of course). Jenny Blyth, a birth worker with over 30 years experience traveled over from Australia to premiere her new film ‘A world of birthworkers’. This film documents birthworkers globally from Barbados to Laos, Turkey, and everywhere in between. It was a heartfelt and truly inspiring film. Jenny Blyth The next film documented an Israeli couple’s journey to birth at home. It was great to see that similar issues and questions come up for mums, dads and extended family across culture and environmental differences. Jenny then showed her beautiful, moving firm ‘ The big stretch sequel’. This film documents women and families journeys through some potentially challenging scenarios e.g breech and twin births at home. The film presents the stories with care and reminded us all of the beauty and power of women and birth. Jenny had copies of her books ‘The down to earth birth book’ and ‘Birthworks’ for sale. Both books are beautiful and inspiring for women and birth workers alike. She has sold copies of ‘The big stretch’ and ‘ The big stretch sequel’ as well as some Reboso cloths. A big thank you to the van full of gorgeous women (and bubbas) who braved the wintry weather and traveled down from Auckland. A heartfelt thank you to all who attended, what a blessing to share such an inspiring day with you all. If anyone would 15 like to purchase any of the books or DVDs they can do so by contacting Claire Stay tuned for further workshops with Jenny in the future also. Aroha nui - Claire Eccleston. The History of Wearing our Babies in Aotearoa. By Anna Hughes Jun 2014 Almost everywhere you look you’ll see babies peering over Dad’s shoulder, or a bundle with legs nestled into Mum’s chest while that Mum or Dad merrily swing their arms, hold an older child’s hand or carry their wares. Babywearing has become commonplace in New Zealand today but only 10 years ago it was a rare sight to see. Go back 38 years and you’d hear Tony Culling of Dunedin tell you that the ‘poor baby, won’t he suffocate?’ comments made very explicit the taboos of ‘wearing’ your baby in the 70’s. Yet it was that decade when babywearing really started its revival in the West. Many ‘soon to be parents’ are being given baby carriers by a friend who was in turn given it and didn’t have clue how to use it. There is a huge gap in babywearing knowledge that has come about through a long period in history when babywearing was barely evident. Understanding our history in terms of parenting, in this case wearing your baby, can help us to decide where we want to go in the future. So lets go back a bit further, say 15 million years. Early humans were nomadic hunter gather people. They carried their babies with them because to not meant probable death. Babies put down were vulnerable to attack from insects, animals and other people, but carrying them during migration was at the expense of food for 16 the tribe. In times of unknown food supply this would have been a tough decision. A Kali’na hunter with a woman gatherer. Scanned from Na’na Kali’na: Une histoire des Kali’na en Guyane. Used under permission of creative commons. One theory of how humans became hairless is the Naked Love Theory. As we know the feeling of skin against skin is desirable. Lack of sufficient grasp reflex and body hair in the modern human meant a baby needed to be held by the caregiver. Using just your arms uses three times as many calories as wearing them in a baby-carrying device so it’s assumed that a baby carrier would have been an essential first piece of clothing to be developed. Creative commons hunter gatherer tribe wearing baby. As cultivating food, farming and permanent villages developed babywearing became less essential. Many early farmers were aware that babywearing decreased mortality rates by allowing regular access to breastmilk, protection from insect and animal treats, security, comfort and 17 therefore low stress for a vulnerable baby and they continued its practice. Other ways of managing a baby developed. Older children and grandmothers looked after babies while capable mothers worked in the fields. Babies were reunited with Mum to breastfeed. Swaddling and cradleboards developed. A swaddled baby strapped to a board could be strapped to the mothers back to get to her place of work, then hang from a tree to keep them from danger. In early Greece and Rome swaddling was practiced and infant mortality rates were high. “Babies were often swaddled up to the age of 2 years and strapped to cradle boards.” (Golden, M. 1990). More babies died from abandonment than from all of the plagues combined in this era. There was still evidence of babywearing during this time. In Central and Northern Greece, “As the baby grew, his mother or nurse wore a sling to carry him around.” Nemet-Nejat, Karen Rhea. (1998). Throughout the ages babywearing was always evident in some sectors of society. Rembrandt’s ‘Beggars at the door’ painting in the 1600’s depicted a baby on the mothers back. When the pram was invented in the 1800’s babywearing still existed amongst the poor. This era also heralded the start of more medicalised birth in which chloroform was used and forceps were invented. Separation of mother and baby was increasingly common due to the effects of the medication. ‘Three Beggars at the Door of a House’ by Rembrandt van Rijn. Etching 18 During the colonization of New Zealand babywearing was evident amongst Maori mothers, fathers and grandparents. The British brought with them doctors who had taken up the role of ‘experts’ in the fields of birth and child rearing. This was due to high infant mortality rates and the opportunity to make money through the control of birth and early parenting. As the colony was made up of mostly young couples the support networks of mothers such as grandmothers and sisters were no longer available making a new mother reliant on childbirth ‘experts.’ A Maori woman was tapu (sacred) during pregnancy and birth. Babies were also considered tapu and were treated as such. “The first duty of a parent was to inculcate fearless energy of thought and action. Therefore a father would seldom chastise a boy lest he himself should be punished by other men, for children were tribal property, and it was important that the future warriors and warriors’ wives should grow up as bold and headstrong as they pleased.” (Tregear, E. 1904).Babywearing was common from as little as a day old. Mothers were the main carriers though “…an old man (if not a chief) might be seen toiling all day at his work with his little grandchild strapped on his back.” (Tregear, E. 1904). 19 Rihipete Nikorima and baby. Portrait of a young woman with a moko, carrying her baby on her back enclosed in her cloak (pikau) Photograph taken by William Henry Thomas Partington. ca 1900. National Library NZ Dr Frederick Truby King who formed the Plunket Society became known for his “scientific system of infant management” (Kedgley, S. 1996). Scheduled feeding and strict hygiene was recommended and mothers were advised to avoid all unnecessary attention and handling so as not to spread germs or cause behaviour problems. Although it went against a mothers instincts and thousands of years of responsive, attentive parenting evident amongst Maori eventually most mothers took King’s advice for fear of losing their baby in an era of high infant mortality. In the mid 1900’s woman started to question the advice they were getting from the experts. The Natural Birth Association (now The Parents Centre) developed antenatal classes where women learnt about natural birth by other women based on their experience and the book ‘Childbirth Without Fear’ written by British doctor Grantly Dick-Read. La Leche League (LLL) was established in New Zealand. The mother-led breastfeeding support organization also supported the resurgence of babywearing. A LLL magazine in the 70’s featured a pattern to make your own Asian style baby carrier the Mei tai. This decade saw an increase in childbirth inventions in hospital encouraging more women to return home to birth their babies. One of the biggest influences in the resurgence of babywearing in the West came in the form of a book written by American model Jean Liedloff who had spent 2.5 years living with the Yequana people of the South American jungle. She criticised the Western practice of leaving a baby alone in a cot, pram or car seat. She believed from her observation of the Yequana people that to be held by another human being is an evolutionary expectation that a human baby is born with. In speaking of a baby Liedloff says “…his place in arms is the expected place, known to his innermost sense as his place, and what he experiences while he is in arms is acceptable to his continuum, fulfills his current needs and contributes correctly to his development.” The concept of the ‘in arms’ phase of a baby’s life that Liedloff developed found support in LLL and the evolution of attachment parenting that came out of the attachment theory developed by psychologists. 20 Creative commons. Photo taken in 1979. Daily life in the Wayana village of Antecume Pata in French Guiana. A mother and her son Babywearing along with other attachment parenting techniques are finding their place in mainstream parenting. Many babywearing support groups that often include carrier libraries can be found around New Zealand and the world. For many midwives, childbirth educators and new parents babywearing is still a bit of a mystery. Recommended safety practices for babywearing are still not widely known nor are the dangers of some carriers. A couple of years ago my husband and I decided to combine our skills and create a multi-carrier, brand impartial babywearing instructional video to help educator and parents get started with babywearing. Wearing Your Baby. Techniques for holding your baby close and living life, features step-by-step video demonstrations for using baby carriers safely and confidently. It shows a number of common baby carriers, how to use them and best practice in safety and positioning for a baby’s healthy development. The video will be released in June 2014. For more information or to pre-order your copy, email info@wearingyourbaby.co.nz. We have a release special price of $25 including postage for the DVD, $20 for the downloadable version. You can also join our mailing list to receive the latest blog posts from our developing website atwww.wearingyourbaby.co.nz. You can also find us on Facebook at /WearingYourBaby. 21 The New DVD, Wearing Your Baby is due to be released at the end of July. This video is well constructed with 3.5 hours of comprehensive instruction on how to wear your baby. A real and amazing resource. Anna Hughes is an energetic contributor and luminary in the babywearing and natural parenting world. Her approach of being an advocate for conscious parenting, and providing a community to support other parents in their journey has been invaluable. Anna has written about and presented on babywearing for many years and is a key contributor to the babywearing community in Aotearoa. Her knowledge and wisdom has shaped our approach to healthy and achievable babywearing. Anna Hughes is also a huge supporter of Home Birth and birthed both boys at home with hypnobirthing. Anna and her husband Wayne of Pizzini Productions have created this video to bring babywearing to the wider community. This is a huge body of work which represents hours of mahi and research. 22 BIRTH ART Hummingbird Journey – Numinous Jane. By Jane Cunningham Jun 2014 This season we bring you ‘Hummingbird Journey’ by Jane Cunningham of ‘Numinous Jane’. You can keep up to date with her healing through stories journey on her facebook page. She also has her own website where she talks about the Numinous Soul “My job is to remind you of your numinous nature – remind you of the Divine spark that is uniquely yours.” Jane is: a woman who loves a good laugh, filling my cup in the natural world, with story, with community, with colour. a lover of this earth. Deeply connected to where I live (Te Tai Tokerau, New Zealand) and the beauty of this planet. 48 years old and i have seen some stuff, learned some stuff and have a call to share that in ways that are unique to me. a woman who sees the Divine, The Mystery, the presence of God, Goddess, All That Is in everything (sometimes you just got a look a little longer) intuitive a woman who values learning and growing and sometimes falling and always getting back up again. 23 always ready for the gift of synchronicity. a deep believer in magic. a prolific swearer 24 KORERO We talk to Marama Davidson about Home Birth. Jun 2014 Marama’s number 5 child, Horouta was born in 2007 in the East Coast small hospital Te Puia Springs. This birth and the hospital setting were similar to a homebirth and far removed from the hospital births she had had up until that stage. So that is why for her final number six child born 2008 (little Teina) she had decided on a homebirth. In her own words – “It was magnificent” Marama (Te Rarawa/Ngapuhi/Ngati Porou) is a powerful Maori woman with a strong political voice on all issues concerning Tangata Whenua and social justice. Marama is often in the parenting sphere offering her views and visions towards a better Aotearoa for all people. She is the Green Party candidate in Tāmaki Makaurau and is an active advocate for the wellbeing of whānau, hapu and iwi from a kaupapa Māori perspective. Her lens is from a wāhine Māori viewpoint that seeks to reclaim collective caring of our planet and our people. Marama has contributed to a huge body of social and cultural work and she also fronts indigenous rights movement, Idle no more. 25 “My kaupapa or birthing philosophy I guess is that I wish more and more women could be supported to have good births and that we are empowered by as much information as we can before pregnancy, to allow our bodies to help us have as natural a birthing process as is possible. Give and take the various birth histories of different families and that things just don’t always go as planned, I still believe that we have been led to far away from knowing our own power to work with our bodies and our babies. This is where I see homebirths and homebirth midwives being important. Also there is a lot of traditional Te Ao Maori knowledge that we have lost due to colonisation but we are slowly claiming back the benefits of this. Homebirth is a good way to infuse our traditional knowledge with birthing our babies.” What brought you to homebirth? It was the birth of our second to last child that ensured I would birth my last child at home. In Oct 2007 I gave birth to our 5thchild Horouta – at Te Puia Springs hospital on the East Coast. I was living in Ruatoria at the time. The environment and approach of that hospital was like nothing I’d ever experienced with my other children who were all born in city hospitals. It is a small hospital with room for only 2 birthing women at a time. I was the only one there at the time. It was more like being at home than in a hospital. Small and intimate environment, and a double bed! My husband was able to stay with me for the whole time. They fed us and looked after us. My two midwives had a great approach and I was fortunate to have a worry free birth which they could just ‘let happen’, they gave me lots of assurances along the way. I gave birth to my son in the bath after a short labour. I got good follow up care and breastfeeding help. My eldest daughter even came and stayed with us for a night, which was fantastic. Aside from that I guess I had been harbouring an organic interest in less intervention particularly because all my births had been relatively hassle free and I had amassed some confidence from that. Tell us about your home birth experience. …So when I found out I was pregnant again not long after my son’s birth at Te Puia hospital (he was just over 4 months old when I got pregnant) I knew straight away that I wanted the next birth to be at home. 26 We had moved back to Auckland by then. I went into labour in the morning, but it took a while for the real pains to come along. Both my mum and my stepmum were able to come over and be with me. They are both healers in (one in ninshinjitsu and the other is a bowen therapist) so I had them both working their magic on me to ease my labour pains when they got intense. Our other children were all at school and daycare, so during the daytime hours we just chilled out. I slept and ate while I was in less intense pain. Then I moved upstairs to my room as it got heavy, and eventually got into our bathtub. I knew I wanted another bathtub birth because that went so well for my son born just the year before. By the time I got into the bath a few more family had come over. When baby was born I had several people crowding my bathroom. Haha. My little girl was born into the bath and we just lay in there together for a while. My midwives kept the water warm while we waited for my placenta to come. Little Teina, as she came to be named, just nuzzled her way onto a breast pretty soon while we were in the bath. After the placenta was birthed they moved baby and I into my room. They had sorted my bed with plastic lining so I felt safe to get in it, haha. They just let Teina lie on my skin after checking she was fine, while they sorted a slight vaginal tear from delivery and sorted out my bleeding to make sure things were all normal. I had a laugh at my mum and stepmum at this stage who were doing their best to stuff a big giant black placenta into small a clay pot (ipu whenua) that I had made to bury the afterbirth in! The midwives remarked on how huge and dark it was! I think my mum and stepmum in the end had to find extra bagging to put around the ipu whenua because the placenta was spilling out over the sides, Oh dear. And no wonder. They weighed the baby and she was a rocking 10 pounds 2 ounces! I knew something big had happened when I saw that she had come out with wrist and ankle fat rolls – so gorgeous and huge! She did some feeding but mostly wanted to sleep. No one was very panicky about anything, we were all happy to let things happen because things were going well. Once they had checked we were all doing well I had a glorious shower and then my traditional tea and toast recovery food . All children were home just as the baby was being born so by now I was all clean, baby was all warm and wrapped and had fed a wee bit so was content just sleeping on whoever won the fight to hold her. I was able to 27 go downstairs and have a wonderful pasta dinner with everyone including the midwives who had been asked to stay for tea. They loved that. My homebirth was gorgeous. I wish I had done it for all my other children but I’m glad I got to experience that for my last. What does birth mean to you – at a more global or spiritual level? Birth is one of the most physically and spiritually challenging things I have ever had the privilege of doing. Birth is simple and raw and also hugely complex at the same time. In general I have had only good positive experiences of giving birth and feel privileged in that. I rremember after the first time I gave birth, I had this huge thought going through my mind which was “YOU MEAN TO TELL ME THAT EVERY ONE WHO HAS GIVEN BIRTH HAS DONE THAT?!?!?!” I could not believe the upheaval that my body had just been through – and my first birth was a sweet little number of a few hours of labour, and then out she came. And for my first child I was a young strong healthy and fit woman who recovered really quickly – but even with all that favouring me birth was just a phenomenal achievement in my eyes. Birth is ‘sorta nothing much’ because we do it every second of the day around the world. But it is also everything. The biggest thing ever. “Birth is ‘sorta nothing much’ because we do it every second of the day around the world. But it is also everything. The biggest thing ever.” The right to continuity of care and our midwifery system was something we fought for, how valuable do you think this is for birthing women in NZ? I think we owe those fighters a lot. I know things have changed from the time when my mother had us kids in the 70’s but I think we do mostly well here in Aotearoa. I really wanted to have a relationship with my midwives right through my pregnancy and for after the birth as well. Pregnancy and 28 birth and then the challenge of a newborn really can make us feel inadequate the second any little thing goes wrong. So continuity of care and people who can champion our wellbeing is essential. With regards to birth rights in New Zealand, it’s been a long journey. Our feeling is that we are not there yet. Do you you agree? What are your thoughts on birth rights in NZ. I know we have done heaps of work. Mostly I talk on our achievements in terms of being a Maori woman. I think it is now widely known that most Maori will want to take charge of our whenua (placenta) for symbolic burial. This is an example of knowledge that we’ve had to fight for to get broadly known. We’ve made some gains but we have plenty more to make. What does it mean to you, to be Maori and to give birth in New Zealand? Many Maori, probably most, are not aware of some of our cultural birthing practices. There are plenty of wisdoms that we are still recalling and reclaiming. The burial of our placenta as a practice stayed around mostly but many other practices have not weathered as well. Aside from birth practice – the broader implication of being Maori and giving birth in Aotearoa is about reaffirming our connection to this land, among many other things. Whenua is the word for our land and is the word for our placenta and we return our whenua to our whenua. And it is a profound connection to our tupuna and our whakapapa. The word ‘whanau’ refers to family connection and also refers to giving birth. Birth is a connecting act. In your mind, how can we protect traditional Maori Birth practices? I love what local marae and communities do to reclaim our practices and restore our knowledge. My ipu whenua for my homebirth was from a workshop held in Manurewa Marae. I also was able to source and prepare muka (flax fibre) for my last three births to be used to tie the cord off. I noticed that many non-Maori midwives are in the habit of using muka as an 29 option because it is kinder than a big nobbly piece of plastic peg that we normally use. So we just have to keep using these approaches so they spread. We should be resourcing training and research and specialisms for Maori midwives to maintain our practices. Do you think we do enough for our maori and pasifika birthing mothers? No. How can we do better? We just need more of things that are Maori and Pacific centered so we are at least providing that option. Many of our Maori people use generic services so there is probably a responsibility for all service providers to step up their own capacity in terms of better provision for Maori and Pacific mothers. The investment into relevant services would benefit all of us. If we get it right from the start we save money and pain in the long run If we get it wrong at the start we can ruin generations thereafter. Marama representing Idle No More 30 BIRTH CIRCLE Elemental & Ancestral. By Nadia Kersel Jul 2014 Descendants, transcendence and birth. FIRE “After just 3 or 4 generations of highly technological childbirth, it seems very possible that our human oxytocin system is weakening…In other words, our capacity to give birth is weakening” Michel Odent Wait…WHAT? Our capacity to give birth, birth cultivated over countless generations, is eroding? Nope. I won’t have it. Not on this branch of the family tree, and not on my watch! OK, I’ll admit that the task of reversing this phenomenon is not completely my responsibility. I’m not in total control over how this happens, even within my own family. But, it is not ok with me that in such a short time, the diversity of experience around one of humanity’s most crucial life events is close to being lost. Like all my work in home birth, my hope for this article is to be able to spark a flint of knowing and of possibility which 31 brings to light, even for one flashing moment, the ultimate truth – thatall all the wisdom of birth already exists within us. Furthermore, we can access and let that wisdom work, if we are open to nurturing that spark into flame. A version of this ultimate truth has been spoken and made manifest for me through my own experiences of birth. My intention here is to draw on those personal experiences and share my insights around how birth, and in particular, my choice to birth at home, has served as a catalyst – for my own growth and the creation of a deep connection to my lineage, cultural heritage and birth wisdom. EARTH “Now I walk in beauty. Beauty is before me. Beauty is behind me, above, and below me.” Navajo blessing Here’s some real deal, down-to-earth “birth capacity” for you: my Grandmother Anasoa gave birth at home in Samoa – 11 times over. It was her story that had me opening myself to the possibility that I could do the same – to birth, be happy and healthy at home. As far as I know, I am one of the first of her Grandchildren to birth at home too. This connection is one that has underpinned our relationship in recent years and she takes great, whooping pride in our shared birth prowess. My other Grandmother, Uatifoti, has birth wisdom coming out of her pores – she attended countless birthing women in her days as a nurse midwife in Samoa, and supported me both physically and spiritually during my third birth. I 32 absolutely depend on my connection to them, and their experiences to bring me through my births. So, here I stand, a couple of generations later, in Aotearoa with 3 home births under my stretchy belt – and feeling rather privileged. Firstly; because my modern lifestyle lends me the luxury of time and means to “do-up” birth – with all the whim and fancy, and nest-feathering I desire. Secondly; because all the while, I create the space and ability to draw, and rely on my foremothers’ birth wisdom through a rarely acknowledged, ancient and ethereal link. Our modern society life is an increasingly worldly one – where many people lament that nothing is sacred. Considering how “small” the world has become in terms of communication and in-your-face media, I maintain that it is an absolute necessity to demark a sacred space and time, especially during pregnancy and birth. It seems to me that the very lifestyle which allows the luxury of what may seem like pure fancy or aesthetics;actually creates the necessity for it. Decorating or preparing our physical environment is important. To me, it is an essential way of grounding and connecting with the environment, the Earth, and the way we do things as people – it reflects the comfort and humanity of our lives. Every culture on Earth has ways of doing this, from how we ritualistically mark the passing of time and life stages, to how we delineate our home spaces, and why we adorn ourselves to befit an occasion. “Doing up” my space, and myself for birth appeals to this human endeavour of making meaning from material things – using matter to symbolically appeal to the spirit and to declare what matters, to us, right now. More than simply “nesting”, these actions create a living marker for the time, energy and purpose of the birth space in our lives. The magic comes in how this actually helps us to access the divine, creating a link which goes beyond our worldly existence. I feel it as a liminal time-warp, where I can actively and even subconsciously, access the wisdom and truth from generations past, whilst becoming a vessel for bringing that truth into the future form of our family. To consciously compose a space, creates an experience or memory of that consciousness which serves as an anchor. This is the “home” that we come 33 back to, and where we find ourselves anew after surrendering and transcending to explore the spaces betwixt and between, and the energy/spirit of our birth experience. Here are a few ways that I choose to create a connection between my reality and my spirit, and to those from my lineage: No shoes Go to any Samoan household on this planet and chances are, there will be a no shoes rule – and this goes for anyone who comes into our homes. The outside grime stays outside! In my birth space, this is no different. I couldn’t stand the thought of being the only one with bare feet in my birth space. During birth, I am tapu (sacred), and so is my home. There is also something about bare feet that keeps the people around me grounded and humble. Music I include Samoan hymns and old chants in my playlist. I feel an instant, and multi-sensorial connection to my birth place, especially knowing that my grandmothers, and great-grandmothers sat on the grass, singing and chanting these same songs. Pupuni This is a curtain or cover which is hung up to define space. Traditional Samoan fale (houses) are one big open space, with no walls for separate rooms. A pupuni was used as temporary walls, for many occasions, but especially during birth. Most times it defines where the public space ends. In my births, I use them to demarcate the tapu birth space. I also do this to keep my whole self within that space, and not distracted by my usual “working” spaces. I really don’t want to look at my pile of dishes while I’m giving birth, and any water-pot filling or other work that my attendants are doing, can be done out of my line of vision. Birth Altar Pictures of the women of my family, and of my husband’s family are central to this altar, as well as images or objects that bring me peace, reverence or focus. This is where, in early labour, I pray and call on my faith, and on that of all the women, past and present, who have invested some of their life in me, either through shared lineage or shared heart bonds. 34 WATER Inumia, inumia, i ngā wai kaukau o o tūpuna: Drink, drink of the bathing waters of your ancestors. Maori proverb My gut-feeling for choosing home birth for my first baby was to uphold a sense of self determination and cultural autonomy. I felt that if my cultural identity and practises were not under threat, I would be more able to determine how and where to express those parts of myself – outside of approved norms, stereotypes or distinctions that others may hold. In hindsight, I see that rather than cultural “safety” it was, in fact, creating an opportunity for me to freely discover how my culture liveswithin me. Through home birth came the relief of being free from the shackles of my culture having to look a certain way. I could then embody a truth that, in birth, I do not have to let my choices be held ransom to someone else’s concept of normal. This is extremely important for me as my births have not fit within the approved “norm”. For all three of my births, my waters have broken “early” ranging from 2-5 days before birth. I choose to believe my own truth and my family’s truth, that is – the way that my body supports birth is well within the realms of healthy, and the potential of this has already been realised by other women in my family. This again, is an example of transcendence, from the worldly constructs of culture and norm, to the mystical, timeless aspect of human and spiritual connection – knowing that there exists a connection between our familial ancestral lineages, and that it holds an important function in our lives. Almost every possibility has been lived already. I rejoiced in making the choice to birth as my foremothers had, and in 35 doing so, was able to easily access the wisdom that they held, and that I believe, flowed into me through the process of birth. With each pregnancy and birth comes a deeper consciousness of what home birth offers, in its wholeness, to my aiga/whanau. As well as having the physical, emotional and conceptual space to birth with integrity and dignity; home birth also allows us the space and the self-determination to actively, knowingly, and reverently acknowledge and summon links with our ancestors, and our collective, longstanding truths. WIND “Ia fili e le tai se agavaʻa- The wind chooses the quickness of the canoe.” Samoan proverb While I could have tried to substantiate my insights with facts and references to great thinkers from the various “ologys”, I know that my story is powerful. All of our stories are. They hold the power to shape our perspectives. Familial stories, born from the lived experiences of those connected to us, can completely change the way we see ourselves. We have choices - which of those stories will we gather in our aid? And, what quality qualit y of story do we create to flow through to our children, especially our daughters, during their birth time? Precipice: The story of my surrender and transcendence in birth I stand at a precipice, the wind is wild and I can only see blurs, no form. But, I can hear someone’s ancient voice, through the wind (or is it the wind 36 itself?), asking “who are you?”. I know then that I have to surrender who I think I am, and reclaim who I truly am. When the wind blows me off the precipice (of what I once knew), I feel my “self” shattering into a million pieces. I have a knowing that some of those pieces will come back, and others will go with the gusts. The trick, I suppose, is in having the faith to trust that the pieces which wend their way back to me, will be enough to form a wholeness, whilst still leaving space for the mother in me to grow, and for the child in me to be born. I know that any pieces of myself, whether they remain or not, are not just my own, and that birth is not just mine – It is the embodiment of the lives and wisdom of those who have come before me. This has all culminated in my potential, or capacity, for birthing my baby and myself as mother, into being. My baby’s first breath is made of that wind and as it brings her life, it whispers to me, our shared truth – that when I am giving birth; it is giving to me. 37 WAVES The Herstory of Home Birth in Aotearoa. By Denise Hynd Jun 2014 Birth Images from Ancient Times is the first of theTimeless Way video series by Mother’s Advocate, which show images and explain birth practices from as far back as 20,000 years ago. This ‘herstory’ shows these communities know that women can give birth, because until the last 100 years or less (especially in rural communities), birth was part of everyday life and birth – and was fully in women’s domain. Image provided by Denise Hynds This was true in pre and early colonial New Zealand, as well as other European settlements in the new world. For generations, women who had given birth then supported others in their community during pregnancy, 38 labour and birth. Care of childbearing women by other women was an extension or consequence of the valued role of an experienced mother or grandmother. Most of the knowledge and practices learnt and shared between women, across and down through generations, was the basis of the practice of midwifery. Birth and midwifery training moved to hospitals only in the last century. The names each culture gave to their traditional maternity carers reflected their practices and esteem: ‘Midwife‘ is Old English meaning ‘with woman‘ whilst the French equivalent name ‘Sage Femme’translates as ‘Wise woman‘. Women supported other women emotionally and physically to labour, birth and breastfeed, usually in their homes. In some cultures, there were special places for birth, such as the birthing stones for Royal Hawaiian women. The birthplaces of many famous people around the world, including Beethoven, Thomas Edison, Margaret Thatcher, Nelson Mandela and New Zealand’s own Katherine Mansfield are evidence of the normality of home birth through 20 centuries. Historical sites where families lived and worked, such as castles, flourmills and river barges, were also the birthplaces of many generations for thousands of years. Kukaniloko Birthing Stones, photo by Andie. Creative commons. 39 Women pushed aside aside The fourth Timeless Way video explores historical records and images of the loss of traditional midwives’ knowledge and practices as men increasingly took control of hospital-based and state-regulated maternity services over the last century. Until the early 1900s in New Zealand, most women birthed at home attended by neighbours[1]. Then the newly created St Helens hospital midwives or others from hospital boards began to provide services for what they called ‘outdoor cases’ or ‘home confinements’, with little to no antenatal or postnatal care. When the 1938 Social Security Act introduced a ‘cradle to grave’ welfare system, including funding for all women to have their babies in hospital without charge, home births began to wane. By 1973, there were only 13 home births in the whole country, and only eight domiciliary midwives, most of whom gave only home based post-natal care, not birth services. With the loss of mother figures and other confident, familiar supporters, and the restrictions imposed on women’s ability to move or eat in labour when in alien hospital environments, childbirth became increasingly unbearable. This led to women accepting the offer of numbing drugs from doctors, nurses or midwives. Women’s acceptance of drugs and bed as ‘the place’ to labour unknowingly amplified their loss of control and supported doctors’ use of episiotomies, forceps and other surgical skills to save them or their babies. During this period, Dr Doris Gordon[2], a founder of the NZ Obstetrical Society, pioneered the use of ‘twilight sleep’ at her private Stratford hospital. From there, it spread across the country boosted by government funding under the 1951 Social Security Amendment Act. Throughout her career, Dr Gordon berated those who promoted natural childbirth and claimed motherhood is a woman’s duty as ‘in the womb of British womanhood lies the Empire’s progress and her strength’ so even stitches after a birth ‘do not hurt much’. While she promoted childbirth as the ultimate experience for women: ‘Chase all the careers you like…but you’ll die a disappointed woman unless you marry and go down this awful, painful, glorious road of suffering that new life may come from you’, the best maternity services were doctorcontrolled. It’s hardly surprising that in 1956, the recently formed Natural 40 Childbirth Association was renamed Parent Centres NZ and dropped support of home birth from its aims. Homebirth Rebirth During this time, some midwives, particularly in the UK andHolland, continued to support home birth and had positive outcomes for women. These women then pushed for more woman-friendly hospital options, beginning with having a ‘supportive’ partner present, being able to move in labour and eventually to birthing in water. Similarly, the 1970s in Aotearoa was the beginning of tremendous social change with the growing feminist movement starting to focus on health issues. Though the 1971 Nurses Act took autonomy from midwives, requiring they have medical oversight when providing care, Joan Donley challenged hospital midwives to “change their attitudes…from a hospital/sickness orientation and…play a large part in humanising maternity services”. In 1974, one Christchurch midwife and two in Auckland commenced full domiciliary practice to meet the demands of women who were beginning to consider themselves consumers rather than patients. The first Home Birth Association, with support groups in Auckland and Christchurch, formed in 1978. Home birth numbers increased to 534 in 1986, but there were few domiciliary midwives as they received less than half of the Unemployment Benefit for a 40-hour week. This left them reliant on the practical support of their clients to live. These midwives continued to earn much less than hospital-employed midwives until the 1990 Nurses Act, which returned autonomy of practice to midwives as well as ”Equal pay for equal work” and the right to become funded Lead Maternity Carers (LMC). Meanwhile, the nightmare consequences of previous decades of “Twilight Sleep” labours were forgotten by women still opting to birth in hospital; thus in the 1980s they began to accept the new technologies of fetal monitors, ultra-sounds and epidurals. These technologies impeded the regeneration and revaluing of hospital-trained midwives to unobtrusively observe, gently listen, and feel to assess the wellbeing of mother and fetus in the womb. Likewise, increasing Caesarean section rates have seen a diminishing of skills and confidence to vaginally deliver breech and multiple births. These losses have recently been recognised as contributing to the 41 outcomes of studies that incorrectly supported more surgical deliveries of these babies. Depiction of twilight birth. Source unknown. Depiction of Twilight Birth. Source unknown. Birth Today The 2010 New Zealand Department of Health’s Report on Maternity[3] was the first to publish the national home birth rate; which was 3.2% whilst another 10.8% of that year’s births occurred in primary care facilities. Meanwhile, 1 in 4 New Zealand women had a Caesarean delivery (23.6%) compared to 15.8% in 1995 and in 2010, 1 in 5 (19.8%) women were induced. The more alarming 2010 Maternity Clinical Indicators report[4] showed that a healthy primigravida risk of intervention varies depending on the hospital where they labour. Meanwhile, unless they have been ‘educated’ to go to hospital, women in less-developed countries often still have confidence in their abilities, trusting their instincts and, or traditional practices to birth even 42 in natural disasters such as a flood. However, the fact that this woman is doing what comes naturally is not acknowledged in media reports of this incident, rather it is likened to a ‘miraculous escape from death’.Similarly, when women in first world countries birth in unusual places or situations, it is reported as miraculous to “freakish” but never a celebration of women’s bodies or babies’ ability to naturally birth. The truth about risk Most European women are healthier today than those in previous centuries, but trust in their ability to grow and birth a baby (second smallest circle of risk) has been replaced by fear and misunderstandings about how to help themselves through this innate process. This fear is spreading around the world along with the adoption of technology oriented maternity services and its unquestioned support by mass media. Atlas of Risk NHS www.nhs.uk/Tools/Pages/NHSAtlasofrisk.aspx Statistically women are more at risk of death due to obesity (maroon circle) or a traffic accident (green circle), however there is no community 43 or individual fear about getting in a car, even when pregnant. Rather, fear of birth or “Tocophobia” is a modern epidemic such that the word ‘abnormal’ has been dropped from some explanations of its meaning. Thus many people now believe that “Childbirth isdangerous“, not a wondrous, evolved means to grow healthy individuals as experienced by home birth families and their midwives. Meanwhile science has shown that belief affects our health in many ways, including blocking our ability to birth or even to become pregnant. Many pregnant women hear only scary birth stories these days, and the MOH admits that in NZ hospitals: “Common procedures used during childbirth include: induction, epidural, episiotomy, manual removal of the placenta, and the management of postpartum haemorrhage . ……….. Nationally, there were 33 hysterectomies related to childbirth in 2007.” Midwifery in New Zealand As90% NZ women currently have a midwife LMC who gives all care through the woman’s pregnancy, labour and post-natal period, this reality more than suggests that many midwives do not know how to promote, protect or support natural birth in a hospital. This is despite the New Zealand College of Midwives Consensus statement: “Women who are experiencing normal pregnancies should be offered the option and encouraged to give birth in primary maternity facilities or at home. The evidence clearly demonstrates that women who receive effective antenatal care and are assessed to be at low risk for complications, will give birth to healthy babies and need fewer interventions if they are supported to give birth in a primary maternity unit or at home.” Many NZ midwives do not offer the option of home birth or primary unit care even for healthy women. Midwives, the MOH and media need to publicise the growingnumbers of studies which show home birth to be as safe as hospital birth, and a more satisfactory outcome for mothers and families. Home birth is about helping the woman and her family to labour and birth instinctively, the benefits and means to access labour hormones should be part of midwifery and DHB maternity information as well as influencing the layouts and decoration of maternity environments. Informed public debate around 44 Home Birth, the consequences and means to counter increasing rates of childbirth intervention needs to be a topic in the NZ media. Home birth and community The lessons of David Attenborough to respect and support the natural birthing instincts and needs of animals should be transferred to the care of labouring women, as we seem to be re-learning the value and ability of women to nurture their newborns. Reflecting on the above matters and, or attending a Home Birth Aotearoa support group and, or discussing any concerns with an experienced home birth midwife will help Kiwi couples to regain trust in birth. Women have shown me that those who make a heart and body connection with their baby in pregnancy then work with, or allow that knowledge and trust to guide them through labour to birth instinctively and powerfully. Judy Small’s song Full Circle and accompanyingHomebirth Australia video tells another version of our Herstory. Sculpture of birthing woman (model Britney Spears) done by sculptor Daniel Edwards. “My midwifery education and experiences in England, then Papua New Guinea, Australia and now Aotearoa/New Zealand (see below) have shown me that moving the labour of healthy women from home 45 to hospital, though done with the best intentions lacks an understanding of why and how humans like other species, need to ‘nest’ to have gentle, healthy and natural births.” [1] http://www.slideshare.net/abtfiles/maggie-banks-home-birth-in-newzealand-challenges-and-choices-yesteryear-and-today [2]http://www.teara.govt.nz/en/biographies/4g14/gordon-doris-clifton [3] http://www.health.govt.nz/publication/new-zealand-maternity-clinicalindicators-2009-revised-june-2012 [4] http://www.health.govt.nz/publication/new-zealand-maternity-clinicalindicators-2009-revised-june-2012 Denise Hynd after educating and practising as a nurse midwife in Australia for many years, has been practising as a midwife in New Zealand since May 2008, working mostly as a staff midwife in a local hospital until January 2012 when she moved to self-employed midwifery practice. She is the author of Maternity Manifesto and is a passionate advocate for autonomous birth. 46 http://www.gonative.co.nz/ 47 REVIEW Where the Heart Is, Stories of Home Birth in New Zealand. By Tess Trotter Jun 2014 Where the Heart Is: Stories of Home Birth in New Zealand Carla Sargent, published by Birth Rite, Hamilton, New Zealand. Reviewed by Tess Trotter It is with an obvious unbridled passion that midwife, mother and author Carla Sargent has compiled ‘Where the Heart Is’. I’m sure Carla could have just as, perhaps even more easily, written a fantastic book on her personal perspectives on birth. However, if her goal was as she states “ …to address the widespread fears and misconceptions that society has around birth in general, and home birth in particular” then the fact that she could think of no better way to do this than to share other’s inspirational stories speaks to her depth of understanding that birth is a deeply personal journey that differs for everyone. Many women spend pregnancies, as Carla did herself, snuggled up reading birth stories that help them to share, process and plan their own experiences. And many find, as some of the women who tell their stories here; that their births aren’t at all like they imagine them to be. None the less, our culture shrouds us in distrust and fear of our intuition and potential power as women, burying us in narratives of intervention and fear 48 based birth practices. Sharing a variety of inspirational and real experiences is an excellent balancing tool, equally for first time mothers and those who already have one, two or more births. This is a collection of New Zealand stories that ground us in our society – bringing with them a taste of familiarity and real homeliness. Told from a range of perspectives, each story is a glimpse into the experience of a woman giving birth and a baby coming earth side, in those precious first moments. Mothers, fathers, midwives and children all tell stories, and this range of eyes is refreshing and exciting as you move through the book. Covering a range of experiences and outcomes for each family, some ecstatic and joyful others devastatingly raw, the book is a series of journeys, individually brilliant and different, collectively awe inspiring. Two things struck me as particularly awe inspiring. First, the stories lay out representations of people choosing to exercise their innate capacity to make informed choices for themselves, informed through their own instincts and through partnership with each other, families, friends and midwives. Secondly, they illustrate the healing possible for families. Be this the processing and healing needed from a violent or traumatic birth, to dealing with the unexpected or death or merely the humanizing impact of becoming a parent. The stories told are split into five sections, covering a variety of experiences. “Home Birth From the Start” is a collection of ten stories (including three of Carla’s own) sharing uncomplicated first and subsequent births at home. Chapter two, ‘Healing Birth’ demonstrates the healing power of home birth experiences following previous trauma from birth. These are triumphant stories of strength and hold a message of hope. ‘Facing the Unexpected’ contains stories of unexpected challenges in birth, and the empowered way in which the women have chosen to tackle them. Chapter four, ‘Birth and Death’ holds two heart wrenching perspectives on death, a stillbirth and a newborn loss at just two and a half hours old. Tears flow throughout the book, however here I cried not only for the loss, but also with admiration for those families coping with such grace. I strongly recommend reading Carla’s own blog post on this, which can be found here. Lastly, chapter five, ‘Māori Birth’ provides an insight to traditional birthing practices, the reclaiming of ceremony and the meaning of birth to the wider whānau. 49 Carla also weaves her own perspectives and experiences into the book, outlining fundamental issues with our birthing culture and an excellent synopsis of where we can and should be heading, clearly a strong argument for homebirth. It’s more than a location though, isn’t it? It’s a frame of mind, and way of behaving, an ownership of our bodies and our experience. Thank you so much to those who shared their stories for this book, and share their stories in other places. The sharing of stories is a powerful medium, and one that Carla Sargent has captured eloquently. 50 BIRTH STORY Gaby Gives Birth. By Rachel Wallis Jun 2014 Ever since the labour of my first child, which I found quite astounding, I’ve been fascinated by the process of birth and our relationship with it. Many women, understandably, choose not to have a relationship with it, while some choose to experience it as fully as possible. Personally, I’ve always wanted to hear every intricate detail of my friends’ labours, partly to put my own births in context, but also because it seems that birth is one of the few experiences we’re offered in life that are enormously significant. About 18 months ago, my aspirations came true, and my friend invited me to attend her labour. I was pregnant with baby number three, and my good friend Gaby was having her third baby too. It was her second home birth, and she was feeling pretty fatalistic about it. “My labours are all hard and long, and my babies are all born between 4 and 5am,” she told me. Gaby’s a dancer, and it seems that even athletes are not spared the hard physical work of labour. At about 10pm one evening, I had a call from her partner, who said she was in established labour and it was a good time for me to come. I was going to look after their two preschoolers for the night, and they might wake up. I got into the car and realised my heart was beating rapidly. I was excited, but I was also nervous. I’d heard and read of cases where labours were stalled because of the presence of someone who shouldn’t have been 51 there, and in my own two births, I had shied away from having another person there at the last minute, instead just sticking with my husband and the two attending midwives. Gaby and Estevez live just 5 minutes down the road and outside their door, I took a few deep breaths to calm myself and then let myself in quietly. Upstairs, the lights were dimmed and they were in the bedroom. She was leaning over the bed, moaning softly, mid-contraction, and he was behind her, rubbing her back. The kids were asleep in the next room, where they would stay, it turned out, until morning, the first time they had ever both slept through the night! Birth magic never ceases to astonish me… Their house was already immaculate (Estevez did an epic pre-labour clean earlier that day) so there wasn’t much for me to do at this stage. I had a few quiet words with them and then left them in their special bubble and sat on the couch in their lounge. Estevez’s mother turned up about an hour later, and she joined me on the couch, where we talked but mostly just stayed quietly tuned in to what was going on. Soon there was a slight change in the sound of Gaby’s moaning, a lowering of tone that I recognised from my own births. Estevez said, “I think we should call Kerry now,” and I agreed. From here on, Gaby’s focus became quite definite and inward. They moved to the bathroom, and, as so commonly happens when you sit on the toilet, her contractions now started coming more intensely, and closer together. We could really hear the deepening of her sounds – that baby was moving down. The midwives arrived, and Kerry sat with Gaby initially, listening to baby’s heartbeat and watching her through a contraction. Lakshmi, her ‘back-up’ started unpacking their equipment and we talked a little about foetal positioning (a relevant topic because all Gaby’s babies had sat posterior, my first two had been posterior during labour, and I had just found out that my third was sitting posterior). Lakshmi told me that she advises all her clients to “get off the couch” at about 30 weeks (or at least to sit on the edge of the couch, leaning forward) so that baby doesn’t get too comfortable in the posterior ‘hammock’ position. I really took this advice to heart and for the next ten weeks I sat forward in ‘child’s pose ‘as often as I could, or back-to-front on a straight-backed chair. I missed relaxing back on the couch, especially 52 being so heavy and tired, but, coincidentally or not, my baby did turn within a few weeks of doing this and came out anterior in a very straightforward midday labour (my first experience of one of those, but that’s another story!) By now, Gaby was becoming quite guttural. I assumed she was in transition, the stage of labour I’d found extremely challenging in my own births. The atmosphere during transition was rich, beautiful and otherworldly. It was almost as if time had stopped, and here we were, suspended in this unrepeatable moment of importance. I had such a overwhelming sense of ‘rightness’ at this stage (similar to that glorious feeling you get when you know you’re on the right track in life and suddenly the path opens before you.) Estevez waved me into their bedroom and I chose to sit across the entranceway; not wanting to enter their space too much, trying to find the line between offering a peaceful presence but not interfering. They didn’t need my practical help – the kids were having their miraculous, labourdrugged slumber, her partner’s mother was warming the towels (she’s a nurse and her son was born by caesarean, so it’s a testament to the healing experience of a wonderful homebirth that she is now an advocate of homebirth), and the midwives were calmly doing their thing. Once Gaby started groaning deeply during her contractions, Estevez signalled for me to climb up onto the bed with them, and as she squatted, I took her weight on one side, he on the other, midwives and mother-in-law down the bottom end. A few contractions went by like this. By hospital standards, this was probably a slow second stage; Gaby was fatigued and the contractions were fading. I knew a slow second stage could be disheartening – with my first labour the second stage was 3.5 hours and with my second it was 2.5. Although I’ve never run a marathon, I imagine it’s like being a couple of kms from the finish line but not knowing if there is 1, 5, or 10kms to go. I think this is the stage when you need some guidance, either expert or loving. “Let’s try a different position”, said Kerry. Gaby wielded her body so her weight was on one side, and she tried this for a few weak contractions, while Kerry kept up her encouraging words. 53 “You’re doing so well Gaby, so well, and so is baby – he’s totally happy – and you’re almost there, you’re going to meet baby very soon”. Gaby seemed to locate this enormous well of energy from somewhere deep down inside and bore down hard with her next contraction. This was progress; we all knew it. In between she slumped down and released her whole body in preparation for the next one. A weak contraction came and went, shaped by another big effort by Gaby. Then another. And then, a roaring, powerful burst and out came his head. We were all crying out (and crying); a chorus of “Come on, here he comes, keep going, keep going!!” and then some more hard work by Gaby and out he slipped – a beautiful, perfectly formed little being. Estevez caught him and lifted him up and onto his Gaby’s chest. How do you describe this moment? The atmosphere of momentousness, the pride in Gaby’s mammoth accomplishment, the sacredness of this emerging soul… it defies words. As predicted, it was 4.30am, it was a longish labour and it was hard work. Gaby allowed her body to guide her through the natural, inevitable, and challenging process of having a baby. Nobody interfered, nobody even thought to question whether or not she could do it. It was just how it should and needed to be. What I’ve taken away, beyond the privilege of being at this massive life event, was how safe and right the whole experience felt. How, with loving guidance and support, we women are fully capable of taking this mountainous journey and persevering through the elements to achieve something beyond ourselves. In the end, I wasn’t really needed. Gaby had her wonderful partner, motherin-law, and midwives; and her children slept all night, just waking to meet their little brother in the morning. But, I was allowed to be present, and to glimpse something that I will remember for the rest of my life, as I’ll remember my own births (the third of which, Gaby was present). An experience like this, shared with another, can be inspiring and perhaps, if we let it be, life-changing. 54 KAUPAPA Women are the Source of Power. By Rhonda Tibble Baker Reid Jun 2014 These words I speak… Women are the source of life and power in their Whare Tangata. What were you told about the power of this? If you don’t have a name for your Whare Tangata – your power centre then you are looking for power in all the wrong places. Powerful yoni image by Hermann Foersterling http://www.foersterling.com/ 55 Where is the health in womens health? Not health screening, in this, every bit of your body is like a colonised third world country.When women stand up and say I am powerful from their Whare Tangata, when you feel your power there, you are doing your life purpose and it’s a turn on. The clitoris has 8000 nerve endings which is connected at the g-spot behind the pubic bone. It’s the sacred spot in ancient sanskrit, this sacred spot connects to the Clitoris the North pole and the sacred spot the South Pole. Those nerve endings in the sacred spot are connected through channels called Nadis that go up to the pineal gland and to enlightenment, to spirit. When you are connected with that, your leadership ability and your power increases astronomically. There is as much erectile tissue in the clitoris as in the penis. It’s just that its on the inside. The clitoris is the only organ in the male and female body which is primarily about pleasure, it is connected to erectile pleasure. When it is turned on by life. The body gets turned on in part by Nitric Oxide. It is elicited by the endothelial linings of the body, when you pursue something meaningful to you, pleasurable or connecting you to your soul it will increase the flow of nitric oxide. Aerobic exercise will increase its fix for 24 hours. It’s the uber transmitter for women. It raises endorphin levels and serotonin levels. All balanced out by the pursuit of joy and pleasure deliberately. So addictions keep you out of sustainable health and sustainable power. If these addictions did not exist – to put us out of our own power then hospitals would not exist. Absolute leadership and physical health is being in your power. 56 Photo of the red crater on Tongariro National Park, by Lian Pansino … 57 I am of Ngati Porou and Te Whanau a Apanui descent. I am married to Aaron and am a mother of two daughters aged 21 and 9 and, soon to be a grandmother in October. Very excited about reaching this milestone in my life. I was raised completely iwi-centrically as a Ngati Porou-ite from Ruatoria, Tikitiki, Rangitukia. I was schooled and domiciled in Gisborne. The eldest of four siblings, two boys and two girls. I am a highly competent bilingual bicultural citizen of Aotearoa. I enjoy immensely the fruits of my dual heritage where I can actively participate and contribute to the development of our nation through the work I do. I love to be a bridge between my intersecting world views Māori, Pākehā and the others. I have spent the past 20 years as an employee in the state public and private sectors of education in tertiary, secondary, primary and early childhood institutions. Over that time I have held coal face positions with students, union positions, advisory and specialist positions across the nation as well as senior management responsibilities. After all that; what I most enjoy is to teach both teenagers and adults. My specialist areas are, ICT Technologies, Te Reo Māori, Māori Culture and practice, Task deconstruction and reconstruction, accelerated learning technologies and Māori Traditional Healing (taking something old and making it new for todays needs). I had the great fortune to witness 18 births before in Gisborne Maternity hospital during my summer holiday of 1986 -1987 student job search position of Maternity Aide. I was straight out of 7th Form, Year 13 on my way to Waikato University. In that job, I had full exposure to the birth process and was solely responsible for cleaning up theatre in those days 58 post birth. Another interesting job I had was to check the placenta and ensure that all the lining was there in the sack and note any unusual features in it to tell the Matron. Oh boy I so loved that entire job. The screaming, the bearing down, the mess, the smell of brand new baby, the emotion – all of it was straight pure delight for the young girl in me. Having seen full on the realities of birth I was under no illusions as to the effort required to bring forth a child that women have to endure. Since then I have birthed my two daughters both naturally without medication other than oxygen. I was very mindful to be fully aware so that I could have the complete visceral experience of their, my daughters’ very different birth journeys. I believe it is part of the sacredness of the birthing process to connect the mother and her entourage (medical and non-medical) to the intuitive knowledge field of birthing. This knowledge belongs to us all and is in us all. We have forgotten to connect to it. Our bodies always have total physical responses to all the stimuli we are environed by. Yet, our senses in this area have become dulled. Unfortunately, much of how we learn today is counter productive to that kind of knowing. I wanted a water birth for my first child in 1992. Gisborne didn’t do that kind of thing in those days. Even so, I lived in my parents spa pool while I was carrying her. So I delivered her knees up bearing on her father, on a bed. My youngest was always going to be a water birth. This is my preferred birthing mode. Recently, I have been very bestowed with the responsibility to carry the gift of “Haputanga” handed down from lineage to lineage through the chosen ones of our Māori ancestors from the Tairawhiti (The eastern seaboard). I feel very privileged and honoured to be inducted in to the sacred work of Traditional Māori Pregnancy massage. It was not something I applied for. It feels surreal to have the editor ask me to contribute and then have this teaching arrive to me. I have had my own clinic of Māori healing for the past six years. The excerpt you see here comes from a face book post I shared on Marama Davidsons page some months ago. It came to the editors’ attention and so it is shared here. It gives you another take on the way I see the world and the majesty of what it means to be a woman today. Mauriora wahine mā. Kia noho a Ohinewaioranui ki a koutou katoa. May the life force be with you, by you, in you and for you. May the Spirit of the Great Divine Feminine be with you all. Rhonda Tibble Baker Reid BMPA, BA, Dip Tch, Dip Te Reo Māori, RSA Celta, Dip Massage HoD Māori Edgewater College Pakuranga Auckland 59 INSPIRATION Homeopathy for Pregnancy, Birth and Beyond.. By Louise Bell and Kathy Thomas Jun 2014 As a Midwife, of many years I have been blessed to participate and journey alongside women and witness the miracle of childbirth. Women innately know their bodies and know instinctively how to give birth. With the right support and environment a woman can tap into her power – the power to surrender, trust and let go in the transition into motherhood. Pregnant Belly. Photo by Towle Neu. Creative commons. I first observed and started to use homeopathic remedies when I joined a team of midwives working in one of the first ‘low risk’ birthing units in West 60 London in 2000. I was amazed to see how homeopathy helped support women through the phases of childbirth, especially profound when a woman was facing the most challenging and intense moments on both physical and mental/emotional levels before giving birth. I used homeopathy prior to and during the birth of my daughter. After my waters broke homeopathy helped strengthen and regulate my contractions and during transition, just before she was born and when fear overwhelmed me homeopathy provided a most miraculous gift. It took me to a safe place that instantly calmed and gave me the strength to release my fears and birth my daughter with courage and love. When I arrived in New Zealand in 2001 I dreamed of becoming a homeopath and integrating its science and art with my passion for supporting and enhancing a woman’s childbirth experience. In 2008 I qualified as a homeopath after 4 years of training at ‘The Bay of Plenty School of Homeopathy.’ I currently work in Dunedin as an LMC midwife and homeopath. Homeopathy runs alongside my practice and offers a nourishing healing alternative to supporting my clients during pregnancy, childbirth and after the birth of their babies. What is homeopathy? The word homeopathy comes from the Greek and means ‘similar suffering.’ It was developed by a German Physician and Chemist, called Samuel Hahnemann (1755-1843) over 200 years ago. The homeopathic concept of ‘like cures like’ dates back 2,500 years to the writings of Hippocrates. What this means is that medicines are made, in miniscule amounts, of the same substance that would cause the symptoms. For example: In homeopathy a medicine derived from the hot chilli pepper can be used to alleviate nasty burning sensations, such as heartburn, which is common during pregnancy. Remedies are derived mainly from plants and minerals. They are inexpensive and usually come in different potencies and take the form of sugar or lactose pillules. 61 Is homeopathy safe to use during childbirth? Homeopathy is perfectly safe to use during pregnancy, childbirth, the post natal period and for breastfeeding mums and their babies. It is one of many natural therapies that can enhance your body’s own healing ability, bringing balance and well-being and in most cases the elimination of symptoms and overall improvement in health. Homeopathy is very safe because it uses immeasurably small amounts of active ingredients that help stimulate your body’s own ability to heal itself. The medicines are derived mainly from plants and minerals. The active ingredient is diluted many times and shaken vigorously to produce the medicine. Unlike conventional drugs homeopathic medicines are non-addictive and have no dangerous side effects. Homeopathy doesn’t interfere with conventional medicine and is ideal to use at times when you might not want to use conventional drugs. Individualised Treatment. The concept of homeopathy is understanding and treating the whole person. It offers you a truly individual approach to healing and recognises both physical and mental/emotional are interdependent. Each remedy is individually chosen and a single remedy is picked to match your particular symptoms. What this means is that two people with the same symptoms can be prescribed completely different remedies because the treatment is based on you as an individual and not just your symptoms. Ten Commonly used Remedies for Childbirth and the Postnatal period Here is a brief introduction of ten of the most well-used homeopathic remedies. 62 Winter aconite. Photo by Bengt Nyman. Creative commons. Aconite: Fear and fright = Aconite. Extreme fear experienced during pregnancy. Contractions feel violent and intense, producing a state of fear and anxiety. Restless, agitated and fearful that they might die. Especially helpful during transitional phase of labour. Baby appears shocked and unsettled after birth. Very comforting for nervous fathers and grandparents. Arnica: Feeling sore and bruised during labour. They may not want to be touched. Relieves soft tissue damage (perineum and abdomen) following birth. Reduces swelling and bruising and risk of infection and promotes healing. Useful to reduce caput/swelling of baby’s head after birth. Bellis Perennis: Follows well after Arnica or if Arnica does not ease discomfort. Exceptional for bruised, sore, pelvic pain or abdominal tissues during pregnancy and following birth. Caulophylum: Can be used at term to help strengthen and tone the uterus and prepare and soften the cervix prior to birth. Also helpful if labour pains fail to dilate the cervix and contractions become irregular, short and spasmodic. Used to co ordinate and strengthen contractions. 63 Cimicfuga: Similar to Caulophyllum. The difference being it helps to produce coordinated contractions while allaying fear and anxiety. Encourages a woman to trust the birth process and open up both emotionally and physically. She may feel unable to endure labour. Common words might be “I can’t do it.” Incredibly useful for women who may have a painful or traumatic memory of a past pregnancy, birth, miscarriage etc. Gelsemium: Excellent remedy for dysfunctional labour with failure to progress, especially if baby is lying in a posterior position. There is weakness and exhaustion and muscles tremble with the effort of movement. Contractions are felt in the back. Especially helpful when there is fear or anticipation of birth. May be useful before birth to help ease anxiety. May also be useful to ease fear and anticipation of birth in fathers and grandparents. Hypericum: Shooting, nerve pains following caesarian section or perineal tears and episiotomy. Kali Carbonicum: Pain of contractions felt mainly in the back (especially posterior positioned babies). The backache may extend to the buttocks. Feel as if back would break and back pain is better for hard pressure. Often feels very chilly. Nux vomica: For contractions felt in the back that extend to the buttocks and thighs. They feel as if they want to move their bowels or urinate, but nothing much is passed. They are irritable, impatient and easily angered and offended. Sensitive to odors, light and noise. No pressure can be tolerated on the back and pain is worse from pressure (the opposite from Kali Carb). Staphisagria: Encourages the quick healing of incisions or lacerated wounds. Useful following incision, penetration or stretching of muscle fibers after 64 catheterisation and episiotomy. Relieves feelings of anger, resentment, disappointment and emotional upset that may follow a difficult labour and birth or caesarian section. Homeopathic help for breastfeeding problems Homeopathy will greatly help mothers with nursing and breastfeeding difficulties. These include mastitis, painful sore nipples, reduced milk supply, over abundant milk supply and emotional difficulties breastfeeding and bonding with their babies. Pulsatilla rubra, photo by Kristian Peters. Creative commons. Castor equi Excellent for cracked and ulcerated nipples. Lac caninum Helps to regulate milk supply if there is not enough milk or to regulate it if there is too much. Especially useful to help ease emotional difficulties if a mother is in conflict with nursing and the sexuality of her breasts. Phytolacca For sore, cracked nipples, which hurt when baby nurses. Also useful for breast infections (mastitis) where there are hard, sore, painful lumps. 65 Pulsatilla If there is an over production of milk or if milk supply is erratic. The mother may feel very weepy and needs lots of company and reassurance. Urtica urens If the milk production is slow to get going or if there is an over or under production. Can help establish a good milk supply. Guidelines for using Homeopathic Remedies Remedies • For BEST results homeopathic remedies should be taken on a clean palate. • Do not eat or drink 10 – 15 minutes before and after food and drink (apart from water). • Place the remedy under your tongue and leave to dissolve. • It is important to try and avoid strong flavors such as mint, coffee or toothpaste. These can interfere with the absorption of the medicine. • Remedies can be dissolved in pure water and given in liquid form. Crush two pillules between two teaspoons and dissolve in a glass of water. Sip when needed • Use the remedy that best matches the symptoms at the time. Not every symptom has to be present for the remedy to help. • During childbirth remedies can be given every 15 minutes if needed. If no improvement is seen after 3 doses then stop and change to the next best matching remedy. A 30c or 200c potency is recommended during labour and childbirth. • When using remedies after the birth take one dose every 1 – 4 hours until discomfort is relieved. If there is no improvement by the third dose then change to the next best indicated remedy. Once there is improvement re dose only if the pain returns. 66 • Storage: Store remedies in a cool, dark place away from strong smells, essential oils and direct sunlight. • IMPORTANT: Remedies to prepare the uterus for labour (Cimicifuga and Caulophyllum) should NEVER be used routinely in early pregnancy as they can potentially initiate contractions. It is advised that you discuss the use of these remedies in consultation with a trained homeopath prior to your birth. Homeopathy is a wonderful gentle companion, not only for childbirth but also common problems of pregnancy, breastfeeding and for baby’s first year. Louise Bell has been working as a midwife since 1987. She is passionate about women’s health and natural healing. She is also a qualified homeopath and massage practitioner and uses these in her practice. “I love the way this helps woman feel calm and supported during pregnancy and the birth process.” With 18 yrs experience Louise is comfortable caring and supporting women with medical conditions requiring hospital input. She gently provides gentle, trusting, personalized care throughout pregnancy, birth and the post natal period. Her goal as a midwife is to help women make choices that feel right for them and that keep mother and baby safe. If you would like to find out more about how homeopathy can help you during pregnancy, childbirth, the post natal period and for baby contact me on You can find Louise atBeautiful Births or on 03 478 0423 / 021 053 7010. Louise offers an hour birth/postnatal preparation session, which includes a pack of 12 of the most commonly indicated remedies. The session includes practical advice for you and your birthing team on the use of remedies prior to labour and birth and how to use homeopathy to help effectively manage and ease complications should they arise. 67 Homeopathy goes Deeper - by Kathy Thomas Photo generously gifted for us by Adre Hunter “If you’re having a baby, you want to give them the best possible start in life.”2 None of us would disagree with this advice from the Ministry of Health website, which goes on to provide links to pregnancy services and nutrition advice. But what about the mother’s mental and emotional health during the pregnancy? Sure, there are websites discussing existing psychiatric disorders pregnant woman may suffer from and the associated medications. However, changes to the mother’s mental and emotional state that are brought on by events during the pregnancy, including work pressures, bereavement and relationship issues are not discussed. Nor is the effect they might have on the nature of the developing foetus. Dr Linda Johnson, an American medical doctor and homeopath, has studied this effect in detail and says: “The close association, actually an intermingling, of the child and the mother during pregnancy has a 68 profound impact on the state of both…the mother’s energy state affects the growing child, even to the point of imprinting her state on the child.” 1 Here’s a brief example of this. When I was pregnant with my second child, I was organising the household (including major extensions to our house which were not finished until I went into hospital to give birth), looking after my 18 month-old son and running a small desk-top publishing business from home. I remember running around like a mad woman trying to get everything done in a short period of time. How did this affect my daughter once she was born? She was exhausted and slept for long periods initially – not that I complained! However, once she’d recovered from the exhaustion, she was a live-wire, always looking for something to do, running from toy to toy. She hated sitting around doing nothing. Once I recognised this state as being my state during pregnancy, I gave her a homeopathic remedy to deal with this overlay. The remedy took away her intense need for action. She still liked to be busy but it was no longer a frantic, out-of-balance busy. As well, she began to develop her own personality, not one compounded with my issues. For this reason, when homeopaths treat a young child they look closely at the mother’s state during pregnancy and any issues that may have come up for them. Of course, not all children take on their mother’s state while in the womb but it is very common. To illustrate this in depth, a case is presented below. Names have been changed and any identifying details removed. Permission has been given to use this case. When Danielle first came to see me she was nine years old. She had eczema. Her skin felt like sandpaper to touch and was red, itchy and stingy. There were deep cracks in her knuckles and fingers. Danielle’s lips were dry and flakey, as was the skin behind her knees and elbows. Typically she would scratch until her skin bled. As well, she suffered from a lot of ear infections, finally getting grommets at three years old. This is a common movement in pathology. If eczema is suppressed with cortisone creams, the pathology is driven deeper into the 69 body, leading to more severe ailments, like upper respiratory tract infections. Of course, if these are suppressed with antibiotics, children may develop worse symptoms again – asthma commonly. Back to Danielle… Conventional constitutional prescribing requires a homeopath to delve into the patient’s background, looking not simply for a symptom picture but also for a pattern of behaviour that the patient exhibits in their daily life, particularly how they repeatedly deal with problems or approach difficulties. This pattern (a combination of physical, mental, general and emotional symptoms) is matched to a similar pattern of behaviour ascribed to a homeopathic remedy. This form of individualisation gives homeopathy its uniqueness and is one of the reasons for its success as a treatment. So, I asked Danielle some questions to try and find out what her pattern of behaviour was. It was like drawing blood out of a stone. Danielle appeared to be very shy. She took ages to answer my questions and, immediately upon being asked a question, she would look to her Mum, Carla, as if wanting Carla to answer for her. Carla would then repeat the question I had asked, often several times and sometimes rephrasing. Then Danielle would spend a long time in silence, seemingly thinking about what to say. Her answers, when they finally came, were often monosyllabic or very short. This is very frustrating for a homeopath. Carla filled in a few gaps. She told me that Danielle is slow to complete tasks and that she likes to know exactly what is required before she does something. In the end, I gave Danielle repeated doses of Graphites 30C, a common remedy for eczema with cracked skin. I gave a low potency aimed simply at alleviating the physical symptoms because I was not confident I had discovered Danielle’s pattern of behaviour. The mental/emotional picture was still lacking. She did OK on this remedy. The eczema improved and then returned, less inflamed than before. This is common when physical prescriptions are administered. Until she returned for a follow-up, Danielle continued to take the remedy with some improvement. 70 At the follow-up, I probed deeper into Danielle’s psyche, even though it was still difficult to get lengthy answers from her. She continued to look at her Mum who answered for her or rephrased questions, indicating that her reticence or shyness had not been affected by the remedy. The breakthrough came when I asked Carla for more detail about the pregnancy. Two years prior to giving birth to Danielle, Carla became pregnant. Unfortunately, the baby was stillborn. Her medical specialists were unable to give a reason for this. Consequently, when Carla fell pregnant with Danielle, she was paranoid the same thing would happen again. The doctors gave her a list of instructions about what she could and couldn’t do; things she should avoid, like paint fumes and working for long stretches at the computer. Her midwife added to the list and recommended specific food plans. Her sisters and friends freely gave advice every time she saw them. This made Carla’s situation worse because, in the end, she didn’t really know what to do for the best. She felt anxious and tense the whole pregnancy. She said it was as if she had lost the ability to make a decision herself. She felt confused and unable to focus on some tasks. That’s when the penny dropped for me. Carla’s state during pregnancy was typical for the homeopathic remedy Alumina which is given to people who find it difficult to make decisions because they are confused by all the options. They look to others to make their decisions for them. Indian homeopath, Dr Rajan Sankaran, describes them as being confused about their identity: “Do I want to be me or do I want to be who you want me to be?” 3 This appeared to be the state Carla experienced during her pregnancy with Danielle. When I reviewed Danielle’s statements and the way she acted in clinic, I realised this was her state, too. Danielle couldn’t make a decision for herself. She always left it to her mother or her coach or her friends or sisters. People needing the remedy Alumina are slow answering questions, give vague answers and can’t be hurried. This is what I had observed about Danielle in clinic. It is also a big eczema remedy where the patient will scratch to the point of bleeding. 71 So, I gave Danielle a couple of doses of Alumina 200C over a period of weeks. There was great improvement. Her hands cleared up and she was able to straighten them easily. Her feet started looking better with only a small amount of eczema left on the top of her feet instead of the whole foot being covered in dry, scaly scabs. Her face and lips improved. Personalitywise, her mother said she seemed really happy and in a great mood. She seemed to be developing more of an independent streak. Over time, her eczema resolved completely. This case illustrates how the mother’s state during pregnancy can influence the child’s personality and pathology. Giving a homeopathic remedy based on this state can remove that overlay and allow the child to become well and develop their own personality. As Dr Johnson writes: “If the mother is not healthy or experiences a trauma or shocking event, the child can be affected. These things play a role as to what state the infant will be in and what remedy he requires.” 1 An expectant mother can’t always control what happens in her world or how she deals with it. However, she can be aware of how she is feeling, how she reacts to issues and how she deals with any trauma. Journaling during periods of stress can be a way of letting these feelings out and can be a useful tool for a homeopath, if needed later for either child or mother. And if her child is born with pathology or develops pathology in the first couple of years, she may consider homeopathic treatment which stimulates the body’s ability to heal itself, mentally, emotionally and physically by treating the root cause rather than suppressing. The child can then be free to develop as a healthy individual. References: 1. Johnson, L. (2010). The child’s world. Glasgow, Scotland. Saltire Books Limited. 2. Ministry of Health. (2014).Pregnancy. Retrieved from:http://www.health.govt.nz/your-health/healthy-living/pregnancy 72 3. Sankaran, R. (2005). Sankaran’s schema. Mumbai, India: Homeopathic Medical Publishers. Kathy Thomas has been practising homeopathy since 2002. She runs a clinic from her own home in West Auckland and is the Senior Homeopath at My Remedy (www.myremedy.co.nz), an integrated clinic, in Takapuna. Registered with the NZ Council of Homeopaths, Kathy is passionate about empowering patients to take control of their health and become the person they are meant to be. She is registered with the NZ Council of Homeopaths (RCHom) and the Natural Health Council. She is also certified in Touch for Health and Nutrition. To contact Kathy, email: kathy@myremedy.co.nz. Editors note: It is recognised that there is some controversy when it comes to Homeopathy as a treatment. This article is not designed to recommend homeopathy as an alternative to any other healthcare, but to offer information on complementary therapies in the interests of informed consent. It is the readers job to make personal health decisions based on research and personal requirements. It is important that if you choose to use homeopathy you seek treatment from someone who is registered and who knows when to refer you if further treatment is needed. It is worthy to note that homeopathy is considered a standard part of treatment in countries like India and France. More information found here. http://www.kegelmaster.co.nz/ 73 VOICES Climbing trees. By Alison Barrett Jun 2014 I was one of those kids who loved to climb trees. I grew up in Ontario, Canada, where some of the best climbing trees grow. The short growing season and cold winters create ideal conditions for slow growing hardwoods to flourish. What I didn’t know then was the impact climbing trees would have on my life. Creative commons Gillette, Bill, 1932-, Photographer 74 When my parents had to drag me inside and along to the homes of their friends, where they had boring adult conversations, I would look in their gardens hopefully for suitable trees to climb. The search began even as we would drive up the driveway. That was nothing new; I looked at every tree I ever saw in the world with the sole purpose of categorizing its climbability. I was a quiet child, and it would usually be a while before I was missed. Eventually, my parent’s friends would look out their windows and seeing me high above the ground they would say, “Should she be doing that?” “Aren’t you afraid?” “What if she falls?” They would make calculations in their heads: leg fracture height, neurological injury height, the height of probable death. My mother would crane her neck upwards, and say, “She’ll be fine”. I want to be clear: climbing trees was not, to me, about taking risks. There was nothing about tree climbing that felt risky, in fact, it felt very safe, to be cradled in the canopy of a tree. Besides feeling safe, I felt other things too. The solid branches underneath my hands and feet, warm from the sun. The bark: smoothness interrupted with the scarified design of leaf wounds, insect burrows, woodpecker holes. No art installation I’ve ever seen since could match the beauty of leaves which turned and rustled in the wind as sunlight skipped along them. In the canopy of a tree I could hear my own thoughts more clearly. Aloft, I felt steady and attached to the earth and to nature. That it felt safe was one thing. That it was safe, you might say, is another thing altogether. Some people think children should not climb trees. They’ve banned it in school yards. Today some might claim that my parents were irresponsible. Perhaps they would have reported my mother to CYFS. I might be given a tree climbing substitute: playground equipment, with safety nets and supervision. Harnesses might be procured, a helmet to protect my head. There are people who believe that risk shouldn’t be allowed in childbirth either. Since it involves an unborn child, who cannot consent, parents should be made to do the right thing. An innocent child, many quite rightfully believe, deserves protection from a parent’s bad decision making. After all, there are seatbelt laws, bike helmet laws, antismoking laws, and similar pieces of legislation in place to protect the public good from bad 75 decisions made by individuals. In the same vein some argue that homebirth should be made illegal because of risk. Atlas of risk, figures shown for females in 20-44 age range. Calculator sourced from NHS http://www.nhs.uk/Tools/Pages/NHSAtlasofrisk.aspx But if the risk model is applied to homebirth then it must be turned back on hospital birth also. There is a label we give to the harms caused by doctors: it is called iatrogenesis. Iatrogenesis has many forms: the side effects of prescribed drugs, the complications of surgery, or when people pick up an infectious illness in the hospital. Iatrogenesis in childbirth is huge problem. It stems from the fact that interventions are applied in the name of risk reduction to people who do not need them. We are not good enough in the prediction of complications to ensure that only those who need interventions get them. 76 Mum and baby after a traumatic hospital birth. There are some risks of hospital birth that the iatrogenesis model doesn’t take into account. These may be small risks, but if we counted each they could reach significance. Does the risk of hospital birth, for example, include the risks entailed when driving to the hospital in a car? How about the risk of driving home? Taken to the extreme, one can soon run into absurdities with a risk model. Life entails some risk, if we want to avoid it entirely we should stay in bed and send an avatar of ourselves into the world. (Though then, we’d risk developing blood clots in our legs from immobility). For the purposes of a thought experiment, if somehow we could factor all of these risks on either side precisely into a giant equation and come up with the definitive answer to the risk associated with the place of birth, we’d still be no further ahead in predicting the risk to ourselves. There are dangers of applying risks at 77 the population level to individual people. If the risk of a complication for a member of the population is 1 in 100, it is not the same as saying that your risk is 1 in 100. Your risk is dependent on your unique set of factors, and some of those factors are things about you that you alone know. Arguably more important are values that don’t show up on the balance sheet of risk. These values are the benefits, often immeasurable, that one gets from having experiences. What is it worth to you to have the feeling of being tucked into your own bed with your freshly birthed baby, minutes old, beside you? What price could be assigned to that feeling that some of us secretly know? The feeling, from the vantage point above fresh sheets and below a lovingly fluffed duvet, snuggled in with your baby: where you know with certainty that the whole world is made of two. When I look back, I am sure that climbing trees gave me some immeasurably important gifts. One was a belief in my own body. I’m not a star athlete; I don’t consider myself particularly stoic, or brave, or overconfident. That belief in my own body served me well later on during the birth of my children, and in attending the births of others. Years later, I remember the feeling you get from the vantage point of a crow looking out from the top of the highest tree in the heart of a stand of ancient Carolinian forest. It is the feeling that the whole world belongs to you. Climbing trees gave me the experience of trusting my own body and my own decisions, and of finding great and secret delight in an activity that others might forbid because of risk. Dr Alison Barrett BSc, MD, FRCS(C), FRANZCOG. has worked as a specialist obstetrician and gynaecologist for many years in both New Zealand and in Canada. She was the Chief of Obstetrics and Gynaecology in a rural hospital in Ontario, and an assistant professor in the Northern Ontario School of Medicine. She is currently working as a consultant obstetrician and gynaecologist in Hamilton New Zealand, where she is a RANZCOG training supervisor for junior doctors. Prior to entering medical school Dr Barrett studied ecology and biological sciences, and 78 these two fields continue to inform her clinical work. She has served on many committees addressing maternal and infant health issues including the National Breastfeeding Advisory Committee for the New Zealand Ministry of Health and the Infant Feeding Advisory Group for Health Canada. She is a member of the Professional Advisory Group of La Leche League New Zealand. 79 NURTURE We follow midwives and midwifery students. By L Kelly, L Pansino, A Towle & C Grace-Beck Jun 2014 Lian Pansino Pansino – 3rd year midwifery student student With Women The following reflection was written during 3rd year of midwifery elective placement in Te Marae Ora hospital in Rarotonga, Cook Islands. I spent six weeks working in the hospital and remaining on call for births. This reflection was written around my fourth week of placement. In total I attended 19 births; 17 normal vaginal births and two emergency caesarean sections. 80 Since beginning this placement I have struggled with myself at times about why I am here. The midwifery in this country is not autonomous. Much of my experience with women has been to bear witness to their care being dictated entirely through a one way conversation: the doctor telling the woman and midwives the plan of care. At times I have wanted to negotiate for an episiotomy not to be cut, an artificial rupture of membranes (ARM) not to be performed, or for syntocinon, a synthetic form of oxytocin used to increase uterine contractions, to be delayed just one hour longer. I rarely protest against these procedures as it is clear the decision is not up for discussion and am left asking myself ‘what am I gaining from this placement.’ Yesterday however I was reminded of why I love midwifery when I attended the labour and birth of three women. Regardless of the ARM’s, syntocinon, and pethidine* I saw used, I also saw women walking, rocking, and breathing through their labour. I saw the mothers, sisters, and aunties of these women come to their side to rub their low backs, wipe the sweat from their brow, and be present to meet the newest member of their families. I saw a woman’s vulnerability as she looked at me for guidance when her contractions grew ever stronger, and I reassured her, reminding her to breathe and that she is strong. As I witnessed these women labour I answered for myself what I am gaining from this placement. I am taking from this place just the simple act of being with women in labour. The most essential part of midwifery! For me, being ‘with women’ is probably one of the most challenging aspects of learning to be a midwife; how do you navigate through a woman’s birthing space. What to do? What not to do? What to Say? Where to touch? Where to stand? The more I am with women the more easily the answers to these questions come to me. I am finally beginning to feel some comfort being in this special place and for that I am grateful to this placement. *Pethedine is a synthetic opioid used in labour for pain management. Women often describe it as ineffective in reducing pain while leaving them feeling sleepy, distant, unable to articulate needs. 81 Lian in Rarotonga with (pictured left to right) Judith Couch, Tungane Kani, Moe, Maryann, Mo, Tahi, Sala, Lycee, and Louisa. In the centre, Lian with Tungane’s son, Connor. Christie GraceGrace-Beck – Midwifery Student. Where to start!? Half way through the 2nd year of midwifery studies and its been an absolute blur. The year kicked off with very minimal sleep and constant rearranging of plans. Everything kicked it up to the next level, and all of a sudden I’m in situations which challenge me and make me thoroughly question my knowledge base because I quickly need to be in action and make real-life decisions. My first few shifts in Queen Mary I walked around like I own the place, but have quickly had a reality check and feel a bit humbled. There are lots more skills to learn and lots of practice to do on skills I already know. There have been many incredible women who have allowed me to follow their pregnancy, labour and postpartum periods and I am indebted to them. I have marveled throughout these experiences at the generosity of our gender, somehow despite all their own commitments these women allow a student to absorb every bit of their experience also. I feel like a human sponge constantly 82 taking in information and trying to take as much away from practical situations as possible! Each second year student is paired with a midwife or two and I have been fortunate to work with a midwife that has challenged me, given me experiences and allowed room for me to grow. I keep coming around to the concept that we as students, midwives, women, mothers and daughters are part of a cycle and rely on one another for support, love and encouragement. So far I feel like I have been given so much from those who have facilitated my learning and have let me share their pregnancy journeys. Focusing on this generosity motivates me even more to graduate so that I too can contribute to the cycle and pay forward the support I have recieved. I’m semi-dreading the second half of the year, as assignments seem to be building up and while I have finished following women for now, the learning is crucial. Reading about midwifery is almost a leisurely activity for me so I’m sure I’ll survive! Lisa Kelly – Midwife Kia ora! I am Lisa Kelly, a Maori midwife from Torere on the East Coast. I have been married to my husband Geoff for 20 years and have four tamariki – three teenage girls and an eight-year-old boy. I have been practising as a midwife since 2002 and moved home to the coast to look after my own iwi nine years ago, a job that I absolutely love. Birth of our tamariki My three girls were born at home in Raglan, where we lived for 10 years in three different houses. My son was born at my mother’s home in Torere. He had broken the homebirth drought in Torere, as there had not been a home birth there for many many years. My first labour was 15 hours and our daughter was 9lb 7oz. My next three births were all very quick, with my midwives only just making it in time. Our 3rd daughter was two weeks overdue and weighed 10lb 7oz. 83 My mum has been at all our births, as have my children. My brother has even been to a few too. Why I became a homebirth midwife I was inspired to train as a midwife by my own midwife, Maureen Leong. I was studying natural therapies at the time, and it seemed like a natural follow through. Maureen was all about informed choice, and she gave me piles of information to read. I was happy with my choice to homebirth our first baby and also not to immunise our tamariki, despite all the negative comments. My midwife helped me to become empowered and stand strong about my choices. Thanks Maureen! Currently I offer homebirth and birthing unit services in our remote rural community. Sadly, my iwi and hapu are still stuck with the western belief that hospital is safer than home. At the moment all I can do is give positive reinforcement, heaps of information, and encourage women to talk to their whanau; after all, less than 80 years ago, most Maori were born at home! Home birth is still within us and the stories are still fresh in the minds of our Tipuna. My special services I provide continuity of care throughout the pregnancy, labour, birth, and postnatal period. I do not work in partnership with anyone, but I have several reliable midwives in my area available to back me up whenever I need. I encourage natural birth and do not provide epidural care. Encouraging women to use Kaupapa Maori birthing methods is a priority for me. This includes: healthy eating (including fresh kina) regular exercise such as walking, diving, collecting kaimoana and gardening using rongoa maori for any ailments kapahaka, weaving, waterbirth, romi romi and mirimiri. It is very important that Te Ao Maori is kept alive for our mokopuna. 84 And of course, our most treasured traditional practice – home birth, spending time with whanau, having a kai, sharing in the care of the mokopuna, he tino ataahua. Being a good influence My experience definitely has influenced those around me. My younger sister is a homebirth mama now, as well as other whanau members. Also home birth is more accepted amongst my iwi now as they have seen my own mahi first hand, and it reminds them how normal birth is and that it is not something to be afraid of. Improving New Zealand’s home birth future? We need more support from the government and NZCOM to endorse home birth. We also need more positive documentaries, not negative ones, about midwives. I believe more midwives should be involved in antenatal education through wananga and classes. I presently teach Te Ha Ora a Kaupapa Maori Childbirth and parenting programme, and it mainly focuses on the normality of birth and home birth as an option. There’s too much korero on what can go wrong in mainstream classes, and women are becoming afraid of birth. Midwives also need to stop being afraid. Nga mihi nui. 85 Lisa Kelly is part of Te ha Ora, a kaupapa Maori antenatal and parenting education programme for hapu mama and whanau throughout the Eastern Bay. Amy Towle – Midwife How do you make a baby? Making a baby usually (but not always) is done in private. In the presence of people who love and support each other, often dim lighting, away from public view and ears shot. In this space people connect, explore and trust each other. They show things they have never shown anyone else, do things they have never done. You do this in an environment you create to suit you, whether it be your bedroom, bathroom, lounge room floor or backyard, it makes you comfortable to express yourself. 86 When a man and woman come together, a great exchange takes place. They move in sync, exchange glances of love, make an energy connection, touch and most of all release a rush of powerful hormones cementing the connection between the them. For a woman this is oxytocin. The wondrous hormone of love. The rush of pleasure runs through her creating a feeling of utter ecstasy. How do you birth a baby? During pregnancy the levels of oxytocin increase, and come the day of labour a woman is absolutely saturated with oxytocin. She is literally filled with love. She needs to express this love and birth her baby. To allow the release of oxytocin a woman needs to be comfortable, feel safe and secure. In private, dim lights away from public eyes and ears. Surrounded by people who love and support her. In this space she will do things she has never done before, she can connect with her partner. They will move in sync, exchange glances of love, expand their energy connection, massage, hug, hold and allow the oxytocin to flow. Could you do this in a bright hospital room, hospital gown, strange smells, people knocking on the door, people talking in the corridor, doors opening and closing, clock watchers? Could you make love in a hospital birthing room? Baby’s come out the way they go in. The best way to have a positive birth experience, is to do it in a space you feel your most comfortable and open, with those who make you feel so. A fellow midwife once told me she plays two audio tracks to her antenatal class. One of a couple making love, the other a woman labouring. No one can tell the difference. Birthing can be a sacred, empowering experience for a woman. Holding her, her partner and their baby in arms of love. When choosing and creating your birth space, don’t forget to ask yourself, could I make love here? Wahine Toa Midwife https://www.facebook.com/wahinetoamidwife?ref_type=bookmark Thumbnail picture courtesy of Melissa Jean Photography www.melissajean.com.au 87 Amy Towle 88 Sticky Ginger and Fruit Pudding. By Mandy Tomlinson Jun 2014 Winter is a time when we take stock, harvest time is done and traditionally we would have looked to the larder for the summer fruits, bottled and stored in their red and golden glory, waiting for cold dark nights to add their sweetness and flavour. A taste of the sweetness and tartness of bottled fruit is enough to transport you back to the bounty of summer. This rich and delicious steamed pudding takes advantage of these stored treasures, turning them into a warm, nourishing treat. Ginger adds the kick that puts this pudding right into mid winter gluttony. This recipe is very forgiving and will easily be amended to become gluten or dairy free. Plums in a basket by Flagstaff Photos. Creative commons. 89 Ingredients 2 cups of plain flour 1/2 cup white sugar 1/2 cup soft brown sugar 2 teaspoons of baking powder 1 large thumb of fresh ginger, peeled and finely grated 100 grams of butter (oil can be used instead) 1 cup of milk (water or coconut milk can be used instead) 2 tablespoons of golden syrup (you can molasses for a richer taste or honey for a lighter taste) 1 jar or can of preserved fruit – any kind that suits, I like plums. Place all the dried ingredients in a bowl and combine them evenly, in a saucepan melt the butter and the golden syrup together. Add this along with the milk to the dried ingredients and mix until they are all incorporated. Don’t over-mix the batter, better to have a few threads of flour, than to be tough and rubbery. In your dish, lay your preserved fruit across the bottom and sides if it is a bowl shape. Spoon the batter over the top and spread it out. You can also do individual ramekins or dariole moulds if you want – this will reduce the cooking time a little. Once the batter has been evenly spread, you want to place your dish into a larger dish or oven tray that has been partially filled with water, this will give the pudding a lovely dense steamed texture when it has been cooked. 90 Topping 1 cup of boiling water 1/2 cup of brown sugar Extra grated ginger (fresh) 2 tablespoons of golden syrup (replacements as above) Once the batter is in the dish or dishes, mix the following together in a saucepan and stir over a medium heat until dissolved (you may as well use the same saucepan you melted the butter in). Carefully pour as much of this liquid as will fit onto the pudding before baking at 180 degrees Celsius for 50 minutes or until a skewer comes out clean. Reduce this time for individual puddings. Crock pot technique This pudding can be cooked in a crock pot, simply by finding a pudding basin that fits inside your crockpot, covering with baking paper and cooking on medium for 6-8 hours. It can also be cooked in a double boiler or stock pot by the same method, but for a shorter period of 1 and a half hours or less. Serve with whipped cream and toffee sauce. 91 92 POEM Cry – a poem.. By R N Purcell Jun 2014 All lost the ability to love dignity and reason. But they, a lifetime of each other’s bodies, crash overhead. But you, till drunk with beautiful harmony, accepting fully and finally with all the hope that they’re supposed to be. It’s so obvious. Listen, warrior men! Of what this day might bring! Stand good, mild easy easy of mind. To know, that the children are with the wild, so absolutely certain of her in each pain, burst Feel your true self hammering inside to get out, to get out. Something to break, 93 someone to start with; out of the dark. He does. It’s his medium, it’s their fare with our own torments and troubles and our share. Entirely a shelter that the nights have chosen, Shelter, a statement of hope in each other. This came and we, better and wiser getting our voyage going out in the vastness; beneath us, above, with stars. Her giving of a higher plane, and her name never lost. I am her she was me her story, full of us comes out to be me. We know these things; the spillover of light. Move in. Watch them breaking real; the true Adapted from Both Sides of the Moon by Alan Duff. 94 Poem to complement “Mother Moon” a mandala artwork done by Amy Haderer-Swagman of Mandala Journey. 95 SEASONS Winter. By Juliet Batten Jun 2014 Celebrating the seasons with Juliet Winter is the season of rest and renewal. As darkness increases, rain drums on the roof, gusts and storms lash the windows and walls, we seek warmth and cosiness indoors. As our energies turn draw inward we may want to find creative projects to enjoy. Lemon trees hang their little lights, reminding us that we need to bring in our own light at this time. Here are two favourite ways to bring light into your family over winter: Through creative play This is the season of stories, found either in books or in our imaginations. Little ones love to cuddle up while we make up stories about them, in which they have a part in creating. Here’s how a story might go with my granddaughter, who is six: Me: ‘What shall our story be about?’ Mira: ‘Fairies!’ 96 Me: OK. Once upon a time little Mira was sitting in her special hut under the leaves of the flax bush, and she heard a tiny voice, calling ‘Mira! Mira!’ Who do you think it was? Mira: A fairy. Me: Yes! She was the flax fairy. And what colour do you think she was wearing? . . . and so it goes. Other winter fun can be found in doing puzzles and craft projects, making huts inside, constructing fantasy worlds out of blocks or lego, playing board games, making card houses, cooking, and imaginative play of all kinds. Baking cookies with children is a lovely way to celebrate the cooler months, German Linzer cookies are a delicious treat that warm the soul. Photo by Sian Hannagan 97 Celebrating Solstice and Matariki Winter Solstice on June 21 is a traditional time to celebrate and feast with family, friends or community. This year our extended family tradition will continue, with a mid-winter potluck dinner of Christmassy food. I like to bring a steamed pudding, which I surround with holly. We turn off the lights, dowse the pudding with brandy and light it to make flickering blue flames. After feasting we settle down for story-telling around a cheerful fire. Image courtesy of Juliet Batten 98 Sticky steamed pudding, photo by Sian Hannagan Midwinter pudding, courtesy of Juliet Batten 99 Each person is asked to bring a story about winter. The children love to listen or join in when they are ready. A few years ago my daughter-in-law told a wonderful story about the invention of Chinese dumplings at winter solstice (It’s retold in my book, Dancing with the Seasons, p. 111) This year the theme will change to ‘a special gift’. Matariki After story-telling, we honour the return of Matariki (on 28 June this year), which is represented by little shells or cut out stars arranged in the pattern of the constellation. Someone can speak to the meaning of Matariki (see my two Seasons books for pointers) and everyone together can say, ‘Welcome Matariki’, or ‘Ka puta Matariki’ (Matariki reappears) The Pleiades in the night sky, courtesy of Juliet Batten Winter Solstice Then we each light a tea-light candle and make a winter wish. The little ones enjoy the magic (they can be helped with the lighting). The glow of all the candles, flickering in the dark, reminds us of the returning light of the sun. And so we celebrate winter as a season of creativity, stories, and warm family time of feasting and ceremony. 100 Midwinter candle, photo by Sian Hannagan 101 Winter Festivals: June 21: Winter Solstice, Te Maruaroa o te Takurua June 28: Matariki For further winter activities for children and communities, see my book, Celebrating the Southern Seasons. The revised edition, published by Random House in 1995, includes additional material for each of the eight seasonal festivals of the year. The sequel, Dancing with the Seasons, published in 2010, includes further activities as well as stories for the seasons. Children will enjoy hearing the origin of Chinese dumplings (p. 111), about bees in winter (p. 117), or the story of the three golden hairs (p. 122) To check out my books, go towww.julietbatten.co.nz https://www.facebook.com/JulietBattenBooks Or my blog www.seasonalinspiration.blogspot.com © Juliet Batten 2014 102 CALENDAR What’s on in Winter?. By Home Birth Aotearoa Jun 2014 These are our winter Home Birth events, for more info head over to our Calendar of Events. This calendar can be printed out and placed on your fridge. If you’re having trouble seeing it then click on the image to open it in another window and click again to enlarge it. If you want to add an event to this calendar or our website then please email admin@homebirth.org.nz. 103 104