Unitarian Universalist Sermon on Birth Part 5: Sermon

Let’s start with a survey. Raise your hand if you:

* Have given birth?
* Been there when your partner gave birth?
* Seen another person besides your partner give birth?
* Seen an animal being born?

Many of you are ahead of me on this journey. The only birth I have ever witnessed was our class pet Carmel the Guinea Pig during a math test in fifth grade.

Now let me give you the results of some surveys. But before I do that, I wanted to give a little disclaimer. Birth is messy and bloody and often painful. So in this sermon about birth I’m going to talk quite a bit about medical conditions and women’s body parts and maybe even touch on how babies are made in the first place. So you might not hear the paralyzed “paralyzed bowel” in a typical sermon, but this is not your typical sermon.

Back to the first survey. According to the Listening to Mothers survey conducted by the advocacy group Citizens for Midwifery in 2006 (1):

* Electronic fetal monitoring, what Monty Python called “the machine that goes ‘Ping!’” in the movie The Meaning of Life, is used in almost all (94%) births, despite being classified as having “a trade-off between beneficial and adverse effects” in a review of medical literature. (2)
* Epidural anesthesia is used in three-fourths (76%) of all births, despite also being classified as having “a trade-off between beneficial and adverse effects” by the same study. (2)
* Hooking the mother up to an intravenous drip (IV) for delivery of nutrients is used in 83% of all births, despite being classified by the same study as being “unlikely to be beneficial”. (2)
* Episiotomy is used in one-third (33%) of births, despite being classified as “likely to be ineffective or harmful” when used routinely. (2)
* And the mother of all birth interventions, the cesarean section, is used in 31% of all births. (3)

Here are the results of another survey. (My husband wanted me to include this statistic because it’s so powerful.) According to the Centers for Disease Control, babies are more than half again (1.6 times) more likely to be born on a weekday than a weekend. The CDC even has a name for this phenomenon. They call it “the weekend deficit” (4) as in "the weekend deficit keeps going up" or "the weekend deficit is more pronounced for c-sections than vaginal births".

So what does this survey tell us? That, in this country at this time, a lot of women are having highly medicalized births even though the medical evidence says that it might not be the best for their health or the health of their babies.

Now for some women, “highly medicalized” is exactly what they need. In fact, CDC data analyzed by the advocacy group Childbirth Connection (5) say that nearly one a fifth (17%) of women fall into the “high risk” category and need these interventions.

For other women, these interventions are not what they need, but they’re what they want. I don’t know if you’ve heard this, but childbirth can be quite painful. And for the benefit of pain relief that an epidural brings, many women will happily make the trade-off.

But for other women, the consequences of these interventions can be disastrous.

Take, for example, cesarean sections. And I don’t mean to pick on cesarean sections, but there are a lot of data on their risks, yet often these data are not presented to women when they are making their choices.

Oh, and all of the numbers that I’m giving you today come from either government vital statistics data or peer-reviewed articles published in medical journals. So I have a more rigorous standard than “I read it on the Internet. It must be true!” And you can look up these studies yourself because I’ve included all the references for all these numbers in the written version of my sermon, which will be posted on the church website and on my own blog.

Where was I? Ah, yes, caesarean sections, which is how nearly one-third of babies in the U.S. enter the world. Yet with c-sections, there is a 4.5% rate of major complications for the mother, which include severe hemorrhage, need for another surgery to find out what’s causing the severe hemorrhage, pelvic infection, pneumonia, blood poisoning, blood clotting too much and blood clotting too little. In addition, there is a nearly one-third rate of minor complications for the mother, which include fever, hemorrhage, blood-filled swelling, urinary infection, uterine infection, leg clots, and paralyzed bowel or bladder. (I don’t know why paralyzed bowel or bladder is classified as a minor complication. It seems pretty major to me.) There is even a 1% rate of the baby being cut by the surgeon’s scalpel. (6)

In addition to physical wounds from this type of intervention, psychological wounds can be just as profound, if not more so. Problems include difficulty caring for the newborn; difficulty caring for older siblings; disappointment, anger, frustration and sadness at the missed opportunity for a vaginal birth; a feeling of being disfigured; and painful intercourse or a lack of interest in sex that often contributes to marital stress. For some women, the psychological problems are so bad that they experience post-traumatic stress disorder (PTSD) with symptoms of nightmares, flashbacks, a deep fear of getting pregnant again, and difficulty forming an attachment to the new baby.

Plus, many women who have these problems experience a trivialization of their physical and psychological pain by medical professionals and well-meaning family and friends. One woman writes in the book Caesarean Voices (7): “They all think you are just lucky to have a healthy baby and you should count your blessings.” So in addition to all these other negative feelings, you can add guilt to the list.

Our country’s over-medicalization of birth is one of many factors in another alarming statistic: maternal death. More women are dying in childbirth in the U.S. than they used to. Let me say that again, because most people don’t believe it because they think it cannot possibly be true. But this is what the data show: both the rate and the absolute number of women dying in childbirth in this country has doubled over the past decade. (8)

The alarming rise in maternal deaths prompted Ina May Gaskin, who wrote the mediation from Spiritual Midwifery that I read earlier, to launch the Safe Motherhood Quilt Project. Similar to the AIDS Quilt, the Safe Motherhood Quilt is comprised of panels, each commemorating a woman who died of pregnancy-related causes in the U.S. since 1982. The quilt now has almost 200 panels online and even more as part of the physical quilt. (9)

So why should we, as Unitarian Unviersalists, care about these births? Why should you care? Especially if you have no children and have no plans to, or are done having your babies? Because respect for birth is yet one more way to manifest the Seven Principles. And lack of respect for birth is yet one more way that the Seven Principles are violated.

The women who tell their stories in Cesarean Voices, for example, were not treated with inherent worth and dignity of every human being (the First Principle). They did not have a voice in their own care (the Fifth Principle). Because of the lack of information or misinformation they were given, they were denied their right to search for their own truth and decide what option was right for them (the Fourth Principle).

We should care about these women because they are in the interdependent web of which we all are a part (the Seventh Principle). That’s why I asked John to give his perspective on our son’s birth. Because the birth experience is important not just to the mom, but to per partner, the children she gives birth to, her family and her entire community.

Now at this point, I want to stop and make something very clear. If you had a highly medicalized birth (whether by medical necessity or your own choice or both) and you have no physical or psychological wounds, consider yourself blessed. The last thing I want to do in this sermon is to cause anyone to feel bad because of the choices they’ve made.

But what I do want to communicate to you is that other women are not as blessed. These women are wounded, and they need your help.

But don’t despair, because help is on the way.

One form of help is a group called Birth Options Alliance, which was founded six years ago in nearby Takoma Park by playwright Karen Brody and has now grown to over 600 members. The group educates expectant parents on their choices, provides support to expectant parents through monthly meetings and an active e-mail group, fights against threats to birth options in the DC area, and works to expand options. You can join Birth Options Alliance, anyone can, for free, simply by signing up for the Yahoo group. (10)

Another form of help is the effort to start a birth center in Takoma Park on the campus of Washington Adventist Hospital, which will be relocating in 2013. And, as many of you know from my relentless e-mail campaign, I am leading this effort. (11)

Believe me, when I was giving birth to my babies on those warm summer nights in 2002 and 2005, I never expected that that this would become, as I described in my e-mails, “my new mission in life”.

But I feel that I have been called to do this. Most women who become birth activists do so because of a horrible birth experience (like those described in Caesarean Voices). But not me. I had two great births at the Maternity Center.

But the Maternity Center closed in May 2007. And, that same month, a midwife practice in Takoma Park that delivered babies at Sibley Hospital, called Takoma Midwives, also closed.

So the option that I had for my babies’ births has been taken away. So I feel that I have been called to restore that option to women here in this area.

But I’m not the only one at UUCSS working on this issue. Our Youth Coordinator Dawn Star Borchelt teaches childbirth preparation classes. Former UUCSS member Carolyn Dutcher was a midwife at Takoma Midwives, and delivered quite a few children of this congregation who are downstairs in RE right now. Church members Meredith Massey, Kathryn Leete, Alexa Fraser and Sarah Torrell have all pledged some combination of their time and their talent and their money to support the new birth center.

I even got the idea for the name “Seasons of Life Women’s Health and Birth Center” from the quilts that you’re looking at right now in this sanctuary. I wanted a name that would reflect the breadth of the center’s mission, that it would provide care for all phases of a woman’s life: from the onset of menstruation (including teen sexuality issues), through the childbearing years (including birth, birth control and fertility assistance), to elder years (including menopause).

This church and this congregation have supported me in my “new mission in life”. So I just wanted to say thank you. But, you know, from the eight years that I’ve been a part of this church and the eight years that I’ve been a Unitarian Universalist, I’m actually not surprised. Making the world a better place is what we UUs do. It is the Sixth Principle, after all.

Ina May Gaskin wrote in our meditation that “each and every birth is the birth of the Christ child”. And Mary McAnally, in our poem of opening words, equated each laboring woman to the Great Mother Goddess.

So let us embrace the sacredness of each and every birth. Do it for yourself, for your wife, for your partner, for your daughters and sisters and neighbors and co-workers and friends. Do it for the woman who gave birth to the child you adopted, even if you never met her, even if you never even knew her name.

Ina May Gaskin also wrote in our meditation that “Each birth is holy.” and that those who attend births have a “daily acquaintance with miracles”.

So miracles really do happen every day: 11,000 miracles every day in the U.S. on average. Some are empowering and life-changing. Some are terrible. Some are tragic. But they all are miraculous.

So let us all try to be more reverent of those miracles. The Great Mother Goddess within us all deserves no less.

-Amy Polk

Endnotes:

(1) Listening to Mothers II Survey (Citizens for Midwifery, 2006) http://www.cfmidwifery.org/
(2) A Guide to Effective Care in Pregnancy and Childbirth, Third Edition (Oxford University Press, 2000) http://www.childbirthconnection.org/article.asp?ClickedLink=194&ck=10218&area=2
(3) 2006 data. Centers for Disease Control and Prevention, National Vital Statistics System http://www.cdc.gov/nchs/births.htm.
(4) National Vital Statistics Report, Volume 65, Number 6 (Centers for Disease Control and Prevention, December 5, 2007) http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_06.pdf.
(5) 2006 data compiled by Childbirth Connection. Presentation at the American Association of Birth Centers (AABC) 2007 Annual Meeting.
(6) The Thinking Woman’s Guide to a Better Birth by Henci Goer (Penguin Putnam, 1999), p. 23.
(7) Caesarean Voices (International Caesarean Awareness Network, 2007), p. 56. http://www.ican-online.org/.
(8) Maternal Mortality and Related Concepts, Series 3, Number 33 (Centers for Disease Control and Prevention, National Center for Health Statistics, February 2007) http://www.cdc.gov/nchs/data/series/sr_03/sr03_033.pdf
(9) Safe Motherhood Quilt Project http://rememberthemothers.net/.
(10) Birth Options Alliance http://www.birthoptionsalliance.org/.
(11) Seasons of Life Women’s Health and Birth Center http://www.seasonsoflifebirthcenter.org/.

Unitarian Universalist Sermon on Birth Part 6: Closing Words

From Birth, a play by Karen Brody

My pregnancy and birth mantra was, My Body Rocks! Maybe it wasn’t realistic to so profoundly believe “My body rocks,” but I grew up with strong female role models. Being a woman means… being strong. So when I went into labor, whenever my uterus felt like two cymbals had just smashed up against its sides during a contraction and I couldn’t see the finish line, I’d think: “My body rocks… my body rocks!”

Unitarian Universalist Sermon on Birth Part 4: The Seven Principles of Unitarian Universalism

Unitarian Universalists do not require conformance to a creed, i.e., there is not one set of beliefs about God and spirituality that we recite each Sunday as something we all believe. Instead, each person is encouraged in a life-long search for spiritual truth. However, there are Seven Principles that we affirm and promote (Source: Unitarian Universalist Association, http://www.uua.org/visitors/6798.shtml). I refer to these principles in my sermon. -Amy Polk

* First Principle: The inherent worth and dignity of every person
* Second Principle: Justice, equity and compassion in human relations
* Third Principle: Acceptance of one another and encouragement to spiritual growth in our congregations
* Fourth Principle: A free and responsible search for truth and meaning
* Fifth Principle: The right of conscience and the use of the democratic process within our congregations and in society at large
* Sixth Principle: The goal of world community with peace, liberty, and justice for all
* Seventh Principle: Respect for the interdependent web of all existence of which we are a part

Unitarian Universalist Sermon on Birth Part 3: The Story of a Birth

Amy's husband John Robinette gives his perspective on the birth of their second child.

On our way through Silver Spring, up Georgia Avenue and to the beltway, I timed the contractions. They were coming quickly, lasting over a minute, and were intense. This was not, repeat, not a drill. We arrived at the Maternity Center.

It was 10:30 p.m.

The Maternity Center was a midwives practice, in Bethesda, for low-risk pregnancies. The mom gives birth in a regular bed; in a regular bed room. Parents typically spend the night together with the new baby. Not only do Dad's and partners get to spend the entire time with the mom, they are active participants in the various birthing methods taught and supported through the center.

Anne Seifert, our midwife, greeted us and showed us to our room. Amy was having steady, very strong contractions. She didn't want to be touched or moved during a contraction which was now most of the time. Amy was in a good deal of pain. It took a couple minutes to get Amy to the bed. Once in bed, Anne checked Amy's vitals and listened to the baby's heart beat with an external monitor. All were normal.

"You're eight centimeters dilated, Amy,” Anne announced, “this baby is coming soon."

She turned to me.

"I paged the on-call assistant but she won't get here in time. You,” she declared with her figure pointing at my chest, “are going to be my assistant."

I don't remember being nervous. But I also don't remember not being nervous.

"Um, should I wash my hands?"

"It's your germs, your baby and your choice," replied Anne.

Lacking any better ideas, I went to the bathroom to wash my hands.

As I finished, Amy let out a rather forceful groan. Her water broke.

It was 10:45 p.m.

There was meconium in the amniotic fluid. Not much but enough that Anne announced we'd have to suction out the baby's lungs for any fluids. Meconium is a combination of the baby's stool and the amniotic fluid. The first stool usually passes after birth, but sometimes before. But what this means for me, Anne explained, is as the assistant I get to work the suction pump. We'll suction the lungs after the head emerges, but before he is completely birthed, before he takes his first breath. She'd feed the tube down his little nose and tell me when to apply suction. She told me all this as she demonstrated the process. Simple enough.

Events unfolded rapidly. With each contraction Amy would push and plant her right foot on my left thigh. Anne, now playing catcher and coaxing us along, kneeled with her right knee up so Amy could plant her other leg on Anne’s thigh. Playing umpire I was able to position myself above and behind Anne, reach over, and let Amy grab my hands. The real pushing started.

With each contraction Amy would bear down; we'd plant ourselves and Anne would guide us. Between contractions, as Amy would try catching her breath, Anne monitored the baby's heart rate with the portable ultrasound heart monitor. Anne would hold the probe end while I'd turn it on and off. Then another contraction; then we'd do it again.

I don't remember how many times Amy pushed. Four, maybe five times? With each successive push a little more of the baby's head would appear. And between each push we’d monitor the baby’s heart rate. The baby's heart rate had dropped from 150 beats per minute down to the 70-80. As stressful as all this is on us, the stress on the baby passing through the birth canal is tremendous. This is critical time.

A baby gets all nutrients, and oxygen, from the placenta through the umbilical cord. During a contraction, oxygen from the mother to the placenta is temporarily cut off. The baby is essentially holding its breath. The baby is designed for this and between contractions the oxygen flow is restored. With long contractions the first indication that the baby is not getting enough oxygen is a drop in heart rate.

"Amy you are doing great and you need to push that baby out now," Anne firmly but calmly directed. I don't know if the heart rate was getting too low at 70 beats per minute, but clearly no one was interested in prolonging this.

The next contraction came. We were in position. Amy bore down hard and groaned loudly with the push. This was going to have to be it. Bryan's head, coaxed by Anne, slipped through. Now we had to pause quickly to suction the lungs before the next contraction. Had this been my first child, I imagine I'd have been quite distressed. When the baby's head comes out, he isn't breathing yet and the skin color isn't pink. It's gray. It doesn't look so good. But the placenta is still running the show, so no need to panic, but events are moving quickly. I turned on the pump and Anne fed the thin hose through each nostril and instructed me when to apply suction. It all went as Anne described. Then with one final push, Bryan Joseph Robinette was born.

As miraculous and awesome as Adam's birth was, our first child, in some ways Bryan's was more so. I had already seen how Adam had grown in the three years prior and the total joy he brought to our lives. Having this precognition for Bryan's birth elevated the experience to a profound level. In the moment I was overcome. Amy and I held each other, now with a new little creature on her belly, and wept. What an incredible experience.

The time was 11:12 p.m.

-John Robinette

Unitarian Universalist Sermon on Birth Part 2: Meditation in Words

From Spiritual Midwifery by Ina May Gaskin

Every birth is holy. I think that a midwife must be religious because the energy she’s dealing with is holy. She needs to know that other people’s energy is sacred.

Spiritual midwifery recognizes that each and every birth is the birth of the Christ child...

By religious, I mean that compassion must be a way of life for her. Her religion has to come forth in her practice, in the way she makes her day-to-day, her moment-to-moment decisions. It cannot be just theory. Truly caring for other people cannot be a part-time job.

During a birthing, there may be fantastic physical changes that you can’t call anything but miraculous. This daily acquaintance with miracles – not in the sense that it would be devalued by its commonness, but that its sacredness be recognized – has to be a part of the tools of the midwife’s trade. Great changes can be brought about with the passing of a few words between people or by a midwife’s touching a woman or the baby in such a way that great physical changes can happen.

For this touch to carry power that it must, the midwife must keep herself in a state of grace. She has to take spiritual vows just the same as a yogi or a monk or a nun takes inner vows that deal with how they carry out every aspect of their life. A person who lives by a code that is congruent with life in compassion and truth actually keys in and agrees with the millions-of-years-old biological process of childbirth.

Unitarian Universalist Sermon on Birth Part 1: Opening Words

Our Mother’s Body Is the Earth by Mary McAnally
From the anthology The Book of Birth Poetry edited by Charlotte Otten

Our mother’s body is the earth,
her aura is the air, her spirit
is in the middle, round like an egg,
and she contains all good things in herself,
like a honeycomb.
She squats and the rivers flow;
her breasts are the hills,
her nipples the trees.
Her breath scatters leaves
on the shifting sands of her belly,
and her knees roll out caverns and canyons below.
Her menses make the ocean floor shift,
and tidal waves proclaim her pain.
When we, her children, return to her,
in ash or in dust,
her flesh is scarred with accepting us back,
and her intestines growl at our death.
Mountains erupt with her agony
and pour us back into the sea
to hiss and spume her convulsions.

Note: The final word of the poem is actually "orgasm", but I couldn't bring myself to say the word "orgasm" in a church service, even a Unitarian Universalist one. -Amy Polk

APHA Annual Meeting Recap

Seasons of Life Women's Health and Birth Center board member Kandra Strauss Riggs attended the American Public Health Association (APHA) Annual Meeting November 7-11 in Philadelphia and offers her observations.

The American Public Health Association annual meeting is always an uplifting experience for me. Rooms are packed with public health advocates, nurses, students, doctors, educators – all of us with a passion to improve the health and well being of others. At APHA, I feel that I am surrounded by, “my people.” I proudly wore my “Listen to Women” blue button distributed by the American College of Nurse Midwives and had an opportunity to tell many public health advocates about our plans for Seasons of Life – everyone I met was very impressed. Some highlights that can inform our work in establishing Seasons of Life include:

* Meeting Dr. Miriam Labbok who leads the Carolina Breastfeeding Institute at the University of North Carolina – the nation’s only academic institute dedicated to the promotion and research of breastfeeding. They are hosting a conference entitled Breastfeeding and Feminism in March, 2010.

* Learning about a pre-conceptional health promotion program that is helping to improve the infant mortality rates in central Pennsylvania and could be replicated in a more urban setting.

* Hearing about the Text4Baby initiative which is launching in 2010. It is a free texting service that sends pregnant women and new mothers a weekly text health message.

* Amazingly, Georgetown University has a maternal and child health library: http://www.mchlibrary.info/ where we can find all kinds of data to support our work.

I was very proud and happy to distribute information about Seasons of Life at this year’s APHA meeting. Many thanks for the opportunity.

- Kandra Strauss-Riggs, MPH