Birth and Community

Dancers, by Donna Bodnar Papenhausen

In the end, birth is a solitary journey. You alone face and stretch your limits. You alone access the knowledge you need in the moment. This work is hard, unscripted, sacred, and vital to the health of your community. And it takes the support, guidance, and protection of a community to enable you to fully dive into it - and fully resurface.

In ancient times, and any time that women’s traditions have remained uncompromised, this feminine community support was woven into women’s lives. Midwives, shamans, priestesses, and grandmothers were keepers of wisdom which they transmitted to younger generations through storytelling, mentoring, ceremony and rites of passage. Instead of birth- and postpartum doulas, women gathered to serve one another during what was understood to be a vulnerable and significant time in the life of the mother, the baby, the family, and the community. Of course, we live in a modern post-industrial society and cannot return to ancient times, nor should we. We have passed through very dark times in the history of birth, and we are now in a fruitful moment in which we can, and are, creating new ways of mentoring, supporting, and protecting one another. We are looking to ancient wisdom for guidance - but creating something never before seen.

My first pregnancy, labor, and postpartum experience was a very solitary one. During my second pregnancy, I discovered Pam England’s ground-breaking book Birthing From Within. Just a few pages into the book, I was in tears. I realized what I had missed the first time around. It was such a relief to know that at least one other person saw birth as not just a medical event, but one that brought a woman into the unbroken chain of mothers - mothers who had deep wisdom to share, who knew the significance of the transformation, who had completed the journey and returned “with dirt under their nails.” For this second journey, I had this book, I had a meditation group, I had a yoga group that really lifted me up (thank you, Steve Koc and all my kundalini friends!) I had a doula. And during my postpartum period, I had a friend who was also a new mother. (You know who you are! How I miss those endless days of nursing and chatting!) As I started to emerge from the postpartum haze, I felt called to bring community back into birth and have been working toward that goal ever since. Unbelievably, my baby turns ten this week!


Support during each crucial phase

If we look at birth as a rite of passage, we can divide it into three parts. Preparation (or Severance), is the part where you get ready to leave behind your old life and step into the unknown. Labor and postpartum occur during the Descent (or Liminal) phase. During this time you are deep in the unknown, you face challenges that erase the old parts of yourself. You are just being. With proper support, you gradually begin to re-incorporate yourself, to make sense of what you have learned. At some point (many months later), you emerge, ready to share your new gifts and strengths with the world (Incorporation). Without community support during each of these phases, women are unlikely to complete the journey.

Preparation

Women once taught each other about birth through storytelling and ritual. We still do teach one another through stories, but something got broken along the way and these stories are so often wounded stories - whether stories of trauma or pride - which only serve to plant more seeds of trauma. Choose your mentors with care. Mine their stories for the medicine you seek. Ask about what they learned about themselves from the experience. Ask about moments of surprising strength. Ask about the first time they experienced a connection with their baby. Ask about a moment when they felt completely supported. This will help them see their story in a much different way, and their answers will provide wisdom that you can guide you well.

With so much information available online, women also teach themselves by gathering facts about birth. That, along with busy lifestyles, has led to a decline in the popularity of childbirth classes. I urge expectant parents to look to childbirth classes as a way to deepen their relationship, relieve stress, build a support group, and connect with their baby. A good childbirth class will allow parents to learn in a deep way about themselves and how they may cope with unknown challenges.

Labor  - solitary work, within a container of support

The evidence for the importance of continuous labor support is strong. Hodnett et al (2012) reviewed studies of over 15,000 women and concluded that “Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth.” These benefits include higher likelihood of spontaneous vaginal birth, less likelihood of using pain medication, and higher satisfaction with the birth. Continuously supported women also had shorter labors and fewer Cesarean births. A less-complicated and more emotionally satisfying birth is indeed something to strive for, but also consider the longer-term  benefits of being well-supported when a birth is medically complicated or physically and emotionally traumatic.

Klaus et al (2012) shares the results of several studies that found highly significant longer-term effects of continuous labor support. He finds that, compared to women who did not have labor doulas, women with doulas had less incidence of anxiety, depression, and feeding problems. They were more likely to say that their relationship had improved since the birth and reported more satisfaction with their partner. Women with doulas were found to have an increase in positive perceptions of self and baby at six weeks. Think of the difference we would see in the emotional health of an entire generation of mothers, and the benefits their children would enjoy, if they all received continuous labor support!

Postpartum - the newborn mother

About one million new mothers experience postpartum depression each year in the U.S. (Stone, 2010). Continuous labor support is one factor that can reduce these numbers. I believe that community support during the postpartum period can further reduce the incidence of postpartum depression.

Countless cultures around the world have, or used to have, a tradition of mothers and babies staying home, resting, eating special foods, and being cared for for 40 days after birth. In the U.S., we have the tradition of the six-week medical checkup, to see if the mother’s body has healed properly and screen for postpartum depression. But what has been going on during those 40 days? How has her physical healing been supported? How have her emotions been supported? Who has guided or witnessed the huge shift she is going through? Who has been taking care of her so that she simply enjoy falling in love with her baby?

In this country it may seem impossible, for some even undesirable, to stay in the sanctuary of your own home, free from outside responsibilities, for six entire weeks. But if we truly value the work of mothers, we will find creative solutions to bring a modern version of la cuarentena to our newborn mothers. Peer-to-peer support is an important step in the right direction. La Leche League https://www.facebook.com/groups/LLLSalem/ offers on-line and group peer-to-peer breastfeeding support. The Salem Hospital hosts a weekly New Moms group (503-814-2432). The Salem area has a new local peer-to-peer postpartum depression support group called Postpartum Community Wellness. Mothers and fathers can call the warm line (971) 301-2159 anytime to get in touch with a peer support volunteer. In addition to taking advantage of these groups, be sure to request AND accept help from friends and mentors that have walked this way before you.

Emerging - rejoining the community

In a culture that understands rites of passage, this Return would be recognized and celebrated. In the U.S., however, it is more likely that your Return will be expected quite soon after birth and that you will be expected to “return to normal” rather than transformed (which necessarily changes everyone around you, like it or not). Rather than a cultural rite of passage, birth in the U.S. is more of a solitary Hero’s Journey that the community is unaware of, or actively resists. Again, we need to be creative and come up with ways to welcome, celebrate and learn from our Returning mothers. Preparing mothers, fathers, and other family members with the understanding that this lengthy period of resurfacing is normal, essential,  and not to be rushed would be a good start. It would be tremendously helpful if mothers could count on a couple of friends or mentors to remind them where they are in their journey when they feel frustrated or confused, and to celebrate with her when they see her finally step over that threshold into the “new normal.”

Community is inclusive

When I talk about a circle of support for the childbearing year, I am not talking about something that is only for a certain type of privileged woman. Birth and postpartum education and support are not luxuries, they are the right of every woman. Everyone has that right as a member of a community. This is not just for the benefit of the individual. Diving whole-heartedly  into the work of birth is vital to the health of the community. Without sufficient knowledge and support, we run the risk of women not completing the rite of passage and remaining in a place of brokenness. When this happens generation after generation, it creates deep wounds in the community. With support, women can come out the other side of birth stronger, wiser, and more open-hearted - and give this gift to their community and future generations.

In order to build a healthy, thriving community, it is essential that we support its most vulnerable members. Women with few resources, women coping with numerous risk factors, and women that have recently arrived in this country should be surrounded by helping hands and open hearts, especially while they are doing the work of becoming mothers. For those that have felt disempowered in their life, the transition to motherhood has the potential to build confidence and agency - or to reinforce negative messages of the past. This is why I see it as a crucial time for community support. Additionally, pregnant women that are new to this country need to be guided through the doubly--unknown terrain of birthing in a foreign country.

Portland and Seattle provide examples of what inclusive birth support could look like. St. Vincent Providence Women’s Clinic in Portland includes doulas as a part of their Pregnancy Care Package. Seattle’s Swedish Medical Center also offers a Doula Package which can be paid for using a FSA or HSA. Programs like these are normalizing the role of professional birth support and making it more accessible to all. Non-profit community outreach programs are another way to bring needed support to all members of our community. The International Center for Traditional Childbearing, in Portland, has a community-based doula program for African-American mothers and works to increase diversity in perinatal professionals. Open Arms Perinatal Services, in Seattle, offers no-cost support during pregnancy, labor, and early parenting. Their program includes community-based doula services, which means that Native, Latina, African-American, and Somali doulas serve women from their own community which helps to bridge cultural and linguistic barriers to accessing services.

Here in the Salem area, we are starting to see more volunteer-based support for mothers. Beginnings Refugee Birth Support (http://beginningsbirthsupport.weebly.com/) provides birth doulas, postpartum doulas, childbirth classes, and mother-baby groups for refugee women. Willamette Family Medical Center and Silverton Health Midwives offer the Centering Pregnancy model of prenatal care. Centering Pregnancy combines prenatal checkups with group support and childbirth preparation, including Spanish-language groups. The New Moms group, La Leche League, and Postpartum Community Wellness are free and available to everyone. We can do even more to support and protect the most vulnerable in our community. We need to become the elders we seek.

A community for birth-workers

Doulas dedicate themselves to supporting women through the journey of childbirth. Many doulas work independently and do their work in isolation. They can experience intense emotions and challenges just like birthing parents. In fact, the same could be said about doulas and mothers: You alone face and stretch your limits. You alone access the knowledge you need in the moment. This work is hard, unscripted, sacred, and vital to the health of your community. And it takes the support, guidance, and protection of a community to enable you to fully dive into it - and fully resurface.

Much of what doulas do in the birth room is modeling. They model a confident, sensitive, nurturing attitude, which helps fathers, and even hospital staff, do the same. By mothering the mother, they model a caregiving approach that mothers are then more likely to emulate with their babies (Klaus et al 2012). And so it’s just as important that they surround themselves with a community of support. Doula Sarah Wort expresses the birth worker’s need for community in this way: “On the advice of a friend and doula, I waited until my boys were at school before I started on the path to become a doula. I knew I needed to find my village. My community widened and I now feel secure and supported, which, of course, goes both ways.”  Doulas can guide each other in processing birth experiences, they can share their knowledge and skills, and work together to create a thriving birth community, which in turn will support a thriving mothering community.

A new feminine framework

It seems that humans are coming to the end of a long period of a masculine-dominated thought. People all over the world are noticing this change and it has caused a lot of fear and resistance. Change means leaving behind the comfortable, known world (full of beliefs and strategies) and crossing a threshold into the unknown. Sound familiar? What would a world guided by a feminine framework look like? When we experience the type of support that enables us to jump wholeheartedly into the unknown challenges of birth, and to make our slow, steep ascent out of Laborland, we learn what this looks and feels like.  In the humble act of creating a circle of support around each new mother we are sowing  the seeds of a new future.








Hodnett et al, 2012. Found in https://www.ncbi.nlm.nih.gov/pubmed/23076901

Klaus et al, 2012.The Doula Book (3rd ed.). Da Capo, Philadelphia.

Stone, Katherine, 2010. How Many Women get Postpartum Depression? The Statistics on PPD.  
       Found in
http://www.postpartumprogress.com/how-many-women-get-postpartum-depression-the-statistics-on-ppd