The healing comes from nature and not from the physician. Therefore the physician must start from nature with an open mind. ~Paracelsus

Prefer to Listen? Find the accompanying podcast episode on the Unschooled Homebirth podcast, Episode 55, wherever you get your podcasts!  

Midwifery is changing, and homebirth families are the first to be noticing these changes, probably because many homebirth families are looking for an unmanaged, hands-off birth. What they are finding is that in today's midwifery culture, this is less and less common, in part because of regulations, in part because we live in a fear-based society when it comes to birth and death, in part because of the approach to modern midwifery education, and so we are seeing the shifts of these aspects in homebirth quite regularly now. But is there another way? 

At this point in our system of midwifery in the US, more and more people are discovering that regulated homebirth midwifery is marching further and further into a hands-on experience. Most homebirths that occur in the US today have at least one, and usually several interventions before the birth of the baby.

Alongside this advancement into medicalization, we are also seeing yet another branch of midwifery crystalize into being, the birth of the autonomous or independent midwife, midwives who are foregoing licensure and regulation to serve families rather than their licensing agency. These autonomous midwives are often those who look to the laws of nature and physiology rather than the laws of man and research to inform their role and presence in the birth realm of families.

As the tree of midwifery grows, these branches are growing further and further apart while contemporary, standardized midwifery morphs more and more into an obstetrical, management focused model of care, complete with technology and pharmaceuticals to manage complication that may take place in the realms of the home.

Where the medical oriented midwives are there to "catch" your baby, rather than "deliver" your baby, an autonomous midwives sits back while you birth your baby into your own hands, or your partners hands, but make no mistake, her knowing hands are available should they be needed.

Where the medical oriented midwives will monitor your vitals and your baby's vitals to make sure labor is going smoothly, an autonomous midwife trusts you and your senses, and will use her senses to know if your labor is going smoothly.

Where the medical oriented midwives will document how long your contractions are, how long each stage of your labor is taking, your rate of cervical dilation (or your refusal of cervical checks), as well as the number of times of use the bathroom, and all the metrics they are responsible for, an autonomous midwife will document the story of your birth through her eyes, her ears, her heart so when you are back on this plane of consciousness, you can share all aspects of the journey together and celebrate your transformation of birth instead of simply your physical birth.

Where the medical oriented midwives will tell you that you have a choice in everything, in the end they often say something like, "if I say we go to the hospital, we go to the hospital", while an autonomous midwife will say "I will be transparent about anything that seems out of the ordinary, but you decide what to do about it."

Right now as I'm recording this, the organized, regulated midwives in my state are working on getting a Sunrise Review to expand the scope of medications midwives have access to.

While most will see efforts like this as a great advancement in midwifery, a step forward that demonstrates the success of modern midwives in claiming their rightful place in supporting homebirth, I can't help but wonder if this is also one more indicator of a line we have already crossed when licensed homebirth midwives came roaring into a medical model.

For some families and some births, having a medical oriented midwife is what they need to feel safe, to have a support system in place ready to maneuver them through what they feel is uncharted territory. These families, these hopeful homebirthers, they feel comfortable with out-of-hospital birth when someone else takes responsibility, and for these families, an in-home medical model might be the best approach, but it does create a space of vulnerability to what your midwife is comfortable with in regard to your birth, leaving you to hope that things go as planned.

But, for holistic homebirthers, who want to birth at home because they are comfortable with a nature-led birth, and they want to be responsible for their choices, and they want to be in charge of their body and the unfolding of their birth, these families are looking for something that exists outside our current midwifery model, and if that's you, a different kind of midwifery may be the key to truly experiencing an undisturbed, nature-led birth.

While a medically focused midwife will monitor and measure your and your baby's vitals, document the physical metrics of your birth, and catch your baby, because this is what is currently accepted as the safest way to manage birth, if this is her approach, she may also spend your prenatal visits and your birth focused on concerns, perhaps she is fearful of postpartum hemorrhage, or shoulder dystocia where a baby's shoulder get stuck in the pelvis, or meconium in the amniotic fluid. These are all reasons she is taking metrics and measurements and documenting her findings, documenting the interventions you refuse or accept, her actions become focused around her concern of postpartum hemorrhage, or shoulder dystocia, or meconium, and without realizing it, these actions can increase the potential of creating the situation she was trying to prevent.

I will repeat that, because it is really important to understand and something we address in the Natural Birth Compass approach as part of the Emotion-Belief-Action Cycle that I mentioned in a previous article. So again, in taking the actions a midwife might be taught or belief prevent a complication, she actually increases the risk of that situation being manifested.

This isn't because a mysterious law of attraction that works just because we are thinking about something. It happens because our emotions create our beliefs, and that creates our actions.

Let's dig in a little deeper, our beliefs and emotions about everything in our life, our work, our relationships, they dictate our actions because we form beliefs about the meanings or outcomes of these parts of our lives and that becomes an association at all levels, physiologically, mentally, emotionally, and probably spiritually. And these associations can start on any of those levels.

So for example, at some point in your life, you have probably experienced an episode where you got sick after eating something, maybe it was food poisoning, maybe it was a virus or bacteria, or maybe it was morning sickness. Sometimes after that happens, if it was close to the time you ate a specific food, you can develop a negative association that you shouldn't eat that food again. This is a subconscious belief, your thought patterns identified this food as dangerous, even though it isn't the food itself, unless you actually ate something poisonous, but in reality it was bacteria or mold, or morning sickness. So if you ate, spaghetti and then the spaghetti came back up 30 minutes later, you might feel nauseous every time you see, smell or even think about spaghetti, because that association became a belief in your subconscious that spaghetti is bad and now you avoid being around spaghetti, you take the action because a belief and a association were formed through an experience.

This happens with positive things too, chocolate, sugar, drugs, even alcohol, these stimulate a flow of positive endorphins and these endorphins feel good and so you create an association between the feel good stimulus and the feel good hormones so you take the action of seeking the stimulus.

Over time, these beliefs become a permanent fixture in our subconscious and we don't even think twice about avoiding the spaghetti or eating the chocolate until something happens that causes us to question the belief. Maybe you finally try the spaghetti years later and you like it, and you don't get sick, now you can change your belief. Or you read the label on your chocolate bar and realize it is quite high in sugar and maybe you need to adjust how much chocolate you eat or even try substituting it for something that's healthier and as you do that, your association of what makes you feel good changes and your belief changes, so your resulting actions change.

Changing beliefs is not easy, changing actions and habits is not easy, I'm sure you have tried to do this at some point in your life, exercise or diet or water intake so you know this can take some deep inner work to understand how the action was developed, where the belief came from, what emotion it's tied to, so you can explore how to shift it.

I talk about this a lot with my students in the Natural Birth Compass Program because it's an integral part of understanding their relationship to their pregnancy and their birth, where there beliefs around birth were formed and how that is shaping their actions, how that shapes whether they are making choices or they are just doing what they are told because they believe someone else knows what is best for them, and they can fall into the trap of going along with a suggestions from their midwife without question. For example, having their baby's heart tones measured at every prenatal visit in the second and third trimester, seems innocuous right? But is it? Have you considered what is lost when you develop the belief that you need an external device to tell you if your baby is ok?

When you recognize these beliefs and patterns in your actions, then things like, "I believe my midwife knows what I need so I won’t question it", becomes, "I wonder why this is necessary, so I will ask questions and I will check internally about what I feel about this technology being used in my pregnancy". Maybe you'll find you do want to have your baby's heart tones measured every visit, but maybe you'll find you prefer other measurements that you feel more comfortable with to feel your baby's wellbeing, leaving heart tones for any time you have a question from your intuition or some other internal indicator of how you're feeling and how baby's feeling. It's not about being a right or wrong technology, it's about what is right or wrong in that moment. When you have this skill, you can better assess when you need to take steps to evaluate your beliefs and your actions, and if you find you need to make changes, new actions naturally form with less effort.

Now back to where we started and what I really wanted to talk about here is that the effect of the Emotion-Belief-Action Cycle is evident in midwifery care, in all health care really, but it's especially clear in midwifery care.

So if we go back to the midwife who carries a concern about something like postpartum hemorrhage, now that we know about beliefs and actions, we can see how she might carry this concern to every birth. It usually starts with an event, maybe she had to manage a scary hemorrhage or maybe where she was educated in midwifery the was a lot of emphasis on management of hemorrhage taught through a fear-based lens and so the narrative becomes that hemorrhage is commonplace after birth. Now this midwife forms a belief that hemorrhage is common and she needs to be prepared to manage hemorrhage at all times. This belief now dictates how she acts in prenatal care and at births, she becomes hyper-focused on doing everything she can to prevent hemorrhage before it starts and at the same time, everytime she sees bleeding, she is jumping to announce hemorrhage and applying prophylactic measures.

But what happens? These prophylactic measures, like fundal massage and cord traction performed not because there is an acute, active hemorrhage, but only because she fears one, these actions increase the risk of a hemorrhage, because she is going against the cycle of birth, the cycle that is based on the cycle of nature, the laws of the ebb and flow of nature that are unchanging and that our physiology harmonizes with, until we interrupt it with unnecessary hands-on techniques or unnecessary drugs or unnecessary monitoring. We disrupt the body's innate wisdom that it has received from nature and try to interject our book knowledge into something that is often better left to harmonize with nature.

It can look and sound scary to a family to hear talk of hemorrhage, especially if the tension in the room rises and the words used are dark and dangerous. This is not to discount the few cases of true hemorrhage, where active support is warranted if the family chooses, but using these techniques prophylactically just in case this becomes something bigger, this isn't following the cycle of nature and is coming from the effect of the Emotion-Belief-Action Cycle of many medical trained birth attendants today, which is why so many families preparing for homebirth today feel like all they can do is hope their birth will be successful and they don't even know why that's the case, why is it left up to hope? Is that all there is?

Holistic homebirthers who have the insight to identify the Emotion-Belief-Action Cycle after harmonizing themselves with nature's cycle so they can discern a belief from something based in the unchanging laws of nature or physiology, these homebirthers are no longer simply hopeful because they have their inner knowing that guides them. They aren't dependent on anyone else or any external gadgets or measurements to tell them when things are going according to nature and when something might be off, and when they feel something isn't quite right using their Natural Birth Compass, they can seek the proper interventions to help them find answers because they are truly attuned with their pregnancy and their body and have clarity on what they are feeling.

This is health and wellbeing that comes from nature and not the physician midwife - birth is a natural event and there is no reason to view it as separate from the very cycle we live by every day of our lives.

So if you catch yourself saying this common hopeful homebirther phrase "I hope everything goes as planned so we can have a safe homebirth" then my hopeful homebirth friend, I encourage you to check your beliefs, turn to nature, and find nature's cycles and in so doing, you will be looking at the path to becoming a holistic homebirther who can bring together all aspects of nature inside and out to see beyond hope. If this has been helpful, let me know what resonated with you the most so I know what is the most helpful to you! Find me @naturalbirthcompass.

If you would like to start to explore a new paradigm of homebirth preparation, download the free guide Three Cycles You Need to Know for a More Confident and Intuitive Homebirth, get your free copy by clicking here!