I know this is going to differ based on what country you’re in, and where in that country you’re located.  Midwifery regulations are so different all over the world.

I’m in the United States so my experience of midwifery care is different than what a woman will experience in Canada, the UK, or elsewhere.

But here in the US midwives come in a few different varieties.  There are certified nurse-midwives who go through nursing school and then get additional training in birth.  There are also some states that license midwives based upon guidelines the state has determined; often these midwives are “lay midwives” meaning they’ve not gone through nursing or medical school.  They have, however, trained extensively.  There are also midwives who are not licensed and are lay midwives.  Some of them seek and independent certification which makes them certified professional midwives.  To get this certification they must pass rigorous testing (learn more at The North American Registry of Midwives).

So what are my thoughts on this?  I definitely think that women called to be midwives should not be required to go through nursing school first.  I  may be biased because neither of my midwives have gone the nursing route.  But in reality, in the US at least, most women who choose home birth are going to give birth with a “lay midwife” because most certified nurse-midwives deliver only in hospitals or birth centers.  Very few attend births at home.

I think that a lay midwife can and (in general) will know birth as well as a certified nurse-midwife.  They train extensively under midwives in the oldest way to learn a trade – apprenticeship.  A midwife will have attended many, many births before she begins to see clients on her own.

As for my thoughts on licensing:  I do not think a woman must be licensed to be a competent midwife.  However, I am in favor of licensing such as the Certified Professional Midwife licensing.  I believe it gives a level of assurance to the family seeking a midwife’s services.  It causes the midwife to keep current with studies, techniques, and literature.  It shows accountability and professionalism.

State (or national) licensing varies and at times it can be a hindrance – some states may say that women seeking a VBAC (vaginal birth after cesarean) cannot attempt a home delivery with a state licensed midwife.  Others say no twins.  A midwife who doesn’t follow state protocols for things could be penalized severely.  However, in general state licensing again provides a measure of reassurance to the family.  It creates accountability for the midwife, and can help bring midwives together into a unified network.

I am, in general, in favor of licensing midwives and I feel good about midwives who seek to be licensed in some way.  There are sometimes restrictions placed on these midwives that they (or their clients) would rather not have.  But in general licensing is a good thing from the viewpoint of the client.

Of course there will always be unlicensed lay midwives.  There will always be unassisted childbirth.  Women have the freedom to choose what they want.  But I do think that licensing is generally a good thing for families, and a good thing for midwives.

If you have an opinion (if you’re a woman using/considering a midwife, or if you’re a midwife) feel free to comment on this thread or contact me

One year ago today I was completely giddy with excitment.  I woke at 6am and made my way to the bathroom, shaking the whole way.  I continued to tremble as I tried desperately not to spill a cup of precious “FMU” (first morning urine, for those not hyper-focused on trying to conceive), dipped that little pregnancy test stick in the cup, lifted it out, and waited.  3 minutes later I convinced myself there was nothing.  I went back to bed.  Fast forward a few minutes and I couldn’t help but look again.  To see this:

A very, very faint line. But a line. I didn’t really believe it until I saw four more lines. Yes, I took five pregnancy tests. My temperature stayed high. No period arrived. I was thrilled to be pregnant.

One of the first things I started to think about was birth. 9 months off and it was at the forefront of my mind. I still think a lot about birth now, with my baby 3 months old.

I love the quote I put at the top of this post. It’s so true. Women are strong, and we are able to give birth to our babies.

I do think women should be able to give birth how they want. And if they want to be in a hospital, that’s fine. If they want to be with a doctor or midwife, that’s fine. If a woman really wants to elect a c-section or have drugs during childbirth, that’s really her prerogative.

But I think a lot of women and coerced. I think a lot of women are even lied to. The medical industry and even our governments hide the truth behind scare tactics.

I don’t understand why it’s so important to hide from women the fact that birth is an awesome experience. I love the women on my birth videos page. Even though some of these women are feeling pain while they’re giving birth you can see the incredible ecstasy on their faces as they hold their new babies.

It’s an awesome experience. Women are made for it, and to do it in full awareness. But our culture lies to women and says there is no purpose to the pain, and that the pain is inevitable.

I wouldn’t call Galen’s birth “orgasmic” or anything like that. “Orgasmic birth” has made a lot of headlines lately. But ecstatic? Yes. His birth was awesome. It was work. It was a lot of work. I even had self-doubt creep in. But what an amazing experience. It was awe-inspiring for me to know that I was opening up to welcome another human being.

While I was opening for Galen I kept telling myself I wanted it to get stronger, heavier, and I wanted to open for my baby. I was able to welcome what I was feeling and be totally part of the experience. I got to be aware of just what was going on, even getting to feel Galen’s head just before he began his descent.

I’m so glad for the births of each of my children, and I’m so glad that I was able to seek out women who told me the truth – that I am strong, and that birth is an awesome experience. I want more than anything to help other women realize that birth can be something to look forward to, something to empower them, something to grasp in awareness and confidence.

A year ago I could look forward to the dance of birth with my newly-conceived baby because I know the truth. Birth is good. And women are strong.

I chose to visualize the experience I most wanted to have in a lot of detail.  I tried to do all of my imagining from a first-person perspective – so that I was actually in my body, rather than just observing from the outside as if I were watching myself on screen.  I did this because during birth you are of course actually going to be in your body, having the baby yourself – not watching!

I also visualized several other scenarios I thought could possibly happen, just to feel more comfortable if they actually arose (for instance, we planned a water birth but I pictured birthing in our bedroom as well).  I also did some work with my own fears and as part of overcoming that fear I visualized and analyzed the “what if” situation (you can read more about my work through my fears, including c-section, in this post)

So I did imagine quite a few different ways of giving birth to my baby.  But the one I wanted most of all I spent the most time picturing (I tried to make time every day, usually during my afternoon rest time) and pictured in the most detail.  It’s important to let go of feeling foolish, or too optimistic – just let yourself imagine your very “best case” birth, your “ideal” birth so to speak.  You can explore other situations, as I did, but spend time picturing how you really want it to go.

This is a really powerful way to help your mind get ready for the birth.  It can become almost like a rehearsal for the birth, leaving you with the feeling that you’ve been through this before.

I’ve visualized before each of births because I believe it helps.  But I do really think that our minds are a powerful thing.  And I think Galen’s birth is one of the proofs of that.  When I visualized Galen’s birth, I always pictured the birth tub, myself, and Scott.  I pictured Galen coming into the world and being brought from the water in my hands and in Scott’s hands.

Now, in the back of my mind I always thought “the midwives are there somewhere, in the background” and also I generally thought the children would be there somewhere in the background too.  But I found myself unable to picture them actually right there, by the tub – I wanted Galen’s first moments to be for me and Scott, so I didn’t picture anyone else right there.

If you’ve read Galen’s birth story, you know that we ended up with an unassisted birth – in fact, my labor picked up almost as soon as our midwives left (because I was only 3cm).  As I reflect back over this I keep thinking about all the visualizing I did and how I always pictured just Scott and I there, and the midwives were just “somewhere” and never actually in the scene in my mind.  Almost everything was as I’d pictured it over and over again – the tub in the corner, the low light, the position I birthed in.  The only difference was that I always imagined Scott in the tub, and he didn’t have time to get in with me before Galen was born.  He was supporting me and holding my hands from the outside of the tub.

So I do think that what you picture in your mind – condition your mind to expect, so to speak – can have a powerful influence on your birth.  It’s why I think it’s very important to work through and let go of fears, so you can allow yourself to visualize the experience you’d like without fears creeping in.  But that visualization will help you explore possibilities and prepare for your birth in the closest way to actually being able to “practice” birth that you can.  Enjoy!

I’ve put my visualization and journaling exercises together in an easy-to-use workbook. Discover more about how Fearless Birth can help you:

I’ve done a lot of thinking about Galen’s amazing birth in those weeks.  It went really, really smoothly and was a wonderful experience for me.  Scott says it was a good experience for him too.

There were two major things that contributed to such a great birth – the first is my careful attention to my nutrition during pregnancy.  I have always felt strongly that good prenatal nutrition is vital, and I’ve written about it extensively in the blog and in articles on the site.   I “practice what I preach” and was really careful to eat well for my baby.  This resulted in him being healthy and vigorous, and in my body being in excellent condition to go through labor and birth.

The second thing I did was work through the Pink Kit with Scott.  All of the Pink Kit was helpful to us.  I used many of the labor positions that we learned.   And the breathing skills were vital for both Scott and I to know.  Scott was able to help me get my breathing under control several times.  I went from 3 centimeters to 10 centimeters and pushing Galen out in about 2 hours – 2 very intense hours.  Having Scott help me breathe turned out to be really important.

The biggest part of the Pink Kit to help us, however, was doing the Internal Work for the last 8 weeks of my pregnancy.  We were pretty faithful about it and worked through the exercise almost every night.  I felt it to be really helpful during pregnancy as I learned to relax all the muscles in my birthing area.

And after Galen was born I knew the Internal Work had been helpful – Galen was born in just two pushes and I had no episiotomy, no tearing, not even any “skid marks.”  I was able to begin kegels right after birthing him and my tissues have recovered much more quickly than they have with any of my other births.

I was able to really enjoy Galen’s birth.  Our Pink Kit work helped me to be really comfortable with myself.  I was able to reach and feel the curve of Galen’s head just before my water broke, and I was able to feel him move down through my birth canal.  I felt a slight sting as he crowned and his head was born and then I was able to feel the joy of his body sliding out and bringing him up into my arms.  I was able to be relaxed and aware, and Scott and I were able to communicate well through the entire labor and birth.  Scott was able to really be a part of things, and really really helped me (especially because it moved so fast and he was able to help me stay calm and working with my labor rather than against it).

Galen’s birth was really an awesome experience for me.  It was everything I’d hoped for and more.  I spent time doing birth visualizations as is suggested in the Pink Kit and many books on birthing.  I feel like that helped prepare my mind for the birth as well and it went very, very much like I’d imagined.  I think there’s a lot of power in preparing your body and your mind for birth.  Galen’s birth was so wonderful because we took the time to prepare – and because excellent resources and knowledge were available to us (and are available to you, too!)

Read Galen’s birth story, more about prenatal nutrition, and explore the Pink Kit!

It was another very interesting lesson, however.  We went through several techniques for creating more room in the pelvis by manipulating the bones of the pelvis themselves.  I was pretty amazed at how I could actually feel the slight movement.

Two movements felt best to me so I’ll talk about those.  The first was the Hip Lift.  A partner needs to help you do this one.  Your partner places one hand on the hip blade, and the other under the sit bone on the same side.  Your partner presses straight down on the hip bone and lifts the sit bone up at the same time.

It was really cool to feel just how much room this created when Scott did it slowly (and gently!)  We tried it with me relaxed and with me tensed up – big difference!!!

The Pink Kit recommends this for a baby who is not coming down, and suggests trying it for a few 3-second intervals, then allowing a few contractions to see what happens.  By doing it on the same side as the baby’s head is pressing (your baby comes into your pelvis at a slightly diagonal angle) you create more room for the baby to move through.

Since my sit bones are closer together I could really feel this.  During all of my labors there has been a point where it feels the baby was just not moving down, though I was ready.  Changing position helped one of them and my midwife doing some work helped the other two – but with pain for me!  I would much rather try the Hip Lift if this baby decides to slow down moving!

The PK encourages you and your partner to both try things so you both get a good understanding of it.  So I tried the Hip Lift on Scott.  Hah!  You can really tell that the female pelvis is meant to birth, and that the birth hormones are making the cartilage in my pelvis more flexible, because trying to do the Hip Lift on Scott was really hard!  I had to push down quite firmly on his hip bone for either of us to feel any movement.  It’s a very interesting thing.

The other movement I liked was a breath movement involving the tail bone.  I placed one finger on my tailbone and focused on breathing and expanding the area below my finger.  I could actually feel my tailbone (which is quite short!) moving out – which in labor would create more room for the baby’s head!  Other breathing exercises in this section helped me understand how to bring breath and relaxation all around my pelvic area to help open it up.

The Bony Pelvis – Movement section is another that I’ll revisit several times before the birth.  In addition to the techniques I mentioned there are quite a few more.  With the observation skills you develop and the awareness you bring forth as you work through the Pink Kit these techniques are really powerful because you’re truly able to feel the ones that help you.  I think I’ll benefit from practicing these and going through the various labor positions regularly as well.

Our next section focuses on the soft pelvis – the muscles and tissues involved in the birth.  Again I find myself looking forward to that.  And next week we begin even more of the PK resources… we’re starting to get closer and closer to our baby’s birth day – very exciting!!

Back to my Pink Kit Walkthrough

Our latest section was on positions for labor and birth. This is a really vital topic. Many natural childbirth education courses cover it. The Pink Kit difference is that before we started this section we had a section on the Bony Pelvis. This first section is significant because it gives you a chance to figure out what your own lower pelvis is like – the shape of the bones your baby will come through. After you’ve gotten a feel for that you get to work with many different positions for laboring and birthing – and you can feel which ones open you up the most!

I enjoyed this section of the video. It was great to see so many different positions actually demonstrated and many useful tips were explained. I know I’ll watch this section several more times, especially as the birth gets closer. I’m sure Scott enjoyed it because he got to watch me being silly and trying out all the different positions

Since watching the video I’ve been observing just how “open” my pelvis feels when I am in different positions. It’s interesting because there are positions where I really feel “closed” and know those wouldn’t be good to labor in. And I’ve been able to notice others that I feel good and open in.

I can’t believe how aware I’ve gotten since starting to use the Pink Kit. I really pay attention to my breathing and my body much more. The PK has given me a lot of good basic skills that I can practice in many situations. And again, I’m really glad for the video and the fact I’ll be able to practice with it to really get my skills down before the birth!

We’ll be moving on through more video sections – our next goes again the the bony pelvis, and how you can help make it more open and assist your baby’s descent. I find myself looking forward to learning even more!

Back to my Pink Kit Walkthrough

There are some parts of your pelvis that you just can’t feel – after all, they’re inside of you. But you can feel the outer pelvis, the lowest part, and you can feel some of the top of it.

It was pretty interesting to feel my own unique shape – what the Pink Kit calls “mapping the pelvis” – this is mapping the pelvic outlet. Some midwives and doctors do a similar assessment to determine how much “room” a woman has to let her baby out. This is much better in my opinion because well, it’s a lot easier to figure things out for yourself than having someone else poke around!

I found out that I have a lot of room front to back, but the area between my “sit bones” – side to side – is just about average for me. You measure by seeing if the width of your fist will fit between the sit bones (those two bits of pelvic bone you sit on!) – a fist width is about average. Scott’s fist is a lot wider than mine and he couldn’t fit his.

The video showed drawings of several common shapes (mine was there!) and talked a lot about figuring yours out. It also encouraged partners to figure their own shape out. Scott determined he would not be good at baby having :p Luckily, as the video pointed out, men and women tend to have slightly different pelvic shapes!

Our next section is on how different positions during labor can help you open up for your baby and work with your own body. I’m looking forward to it!

Back to my Pink Kit Walkthrough

Last night we started working through the “touch” section of New Focus – I think we’re going to hold off on the rest of that section until we work through the DVD portions explaining the pelvis – but we were able to do the first exercise of the touch section last night.

Now that was an amusing exercise.  We had to pick a spot on our thigh secretly.  We sat back-to-back.  Then we each had to try and find that spot on the other – without them doing anything but shaking their head “yes” or “no”  Hah!  I was laughing so hard trying to find Scott’s spot.  I kept saying “here? here? here?” and all I got was a shaking head!  It was close to impossible.

When it was his turn to find the spot on me I found it quite funny as well.  But during both instances it was a bit frustrating, too.  Not knowing where to touch, and not having him be able to find where to touch on me (and not being able to say), was a little frustrating.

The exercise demonstrated what it could be like during labor if you’re not prepared, and if your coach doesn’t understand how hard it might be for you to tell him (or her) just where and how you need to be touched/massaged/rubbed/etc.  And it’s true – there may be times in labor when you’re focusing so hard on working with your contractions that you can’t talk very well, and you can’t focus on your birth partner to tell him where you need touch.

The second part of the Pink Kit exercise had me pick a spot anywhere on me (I picked a spot on my lower back) and give Scott one try to find it.  Of course he didn’t lol (in fact my joker of a husband picked the tip of my nose…give me a break!)  After his one chance was up, I got to take his hand and put it on the spot and say “here” and “massage like this” – much, much, much quicker and more effective than him trying to guess!

The Pink Kit recommends that we keep practicing good touch and communicating it effectively.  I can see practical ways to do this – “can you scratch my back here?” (and move his hand to the area).  And I can see benefits to me… “let’s practice our Pink Kit skills…massage right here!”  Ah, the joys of childbirth education

Back to my Pink Kit Walkthrough

But the one that gets to me the very most is “you’re lucky you have good pregnancies and births.” I usually just smile and agree that I’m blessed. I am blessed. You’re blessed if you’ve had a great natural birth with your baby. Yet there’s more than that.

I titled this post because getting to that birth is not easy. It’s a process. It really is. And no matter how effortless your pregnancy and birth look to the others, you know it takes work.

You have to start with the obvious. Eat well, get some physical activity in. Take yourself to the midwife or doctor, or monitor yourself at home. And if you’re planning a natural birth you know you’re going to be monitoring yourself even if you’re not going unassisted for your prenatal care. It takes a lot of work to keep yourself in good physical condition. Sure you enjoy some treats and cravings But you’re really focusing on good nutrition and caring for your body and your baby.

Just the tip of the iceberg

But that is only the tip of the iceberg. When someone says “you’re so lucky” they’re not even usually considering the amount of work that goes into just that little bit.

And they certainly don’t fathom all the internal work. One of the reasons that I love pregnancy is it has the potential to be a time of intense internal growth and there’s really nothing like it. I feel bad for all the males striving for and writing about personal development because they just don’t get the opportunity to be pregnant.

But you know as a pregnant woman that a lot is going on inside. Even after you’ve got the physical care down to a routine, there’s still a lot to work through. First you have to develop the strength and conviction to stand behind your choices. Modern society is not, in general, friendly to choices of unassisted birth, home birth, or even natural birth in a hospital setting. You have to build strength and conviction to stand behind your choices.

You also need to develop trust. Wow. That one little word brings so very much with it for the pregnant woman. You have to learn to trust your choices. You have to trust your body. You have to trust your baby. You have to trust pregnancy. And you have to trust birth.

When you’re planning a natural birth you really can’t leave this up in the air. You need to work through your fears and your issues. You need to build that trust so it’s grounding you.

People who say “you’re lucky” just cannot fathom that. They can’t fathom the intense internal work and growth that it takes to come to that place.

Finding Trust

I’m well into my fourth pregnancy. I have had three babies at home naturally. I trust birth. I trust my body. But there are still fears that linger in the back of my mind. I still need to take time to work through my own fears.

I still find myself taking time in the quiet moments I get (however few and far between) to talk to my baby and to think. To think about the upcoming birth. To daydream. To go through all the things filed away in my mind and pick out what I’m fearful about, worried about, apprehensive about.

Parts of birth are unknown. You may always have some slight apprehension. But the big issues must be worked through. With my first pregnancy I was fearful. I’d been born by c-section and maybe since that was imprinted on my tiny body I wouldn’t be able to give birth vaginally. But I voiced this fear and I faced it. I researched birth, the physical process, and I also researched c-sections. And I came to realize and to know that I could give birth to my baby vaginally, that I could give her a gentle start.

And I did it. If I hadn’t taken the time to work through that fear I might have panicked a lot more during her long pushing stage. But I knew in my logical mind how birth worked (and that a long pushing stage is normal, especially for a first baby) – and I knew deep down inside me that I had what I needed to give birth to her naturally and in the best time for her and for me.

So there’s always the unknown. But if you’re planning a natural birth, you’re really working hard to build to that. The preparation to get past your own fears, worries, your own discomfort is monumental. And nobody really sees that. Often the only person that will see that is your partner or your midwife. But many women do this work inside themselves, only venturing to talk to their loved ones or like-minded friends every once in awhile. Sometimes this quiet isn’t best (and you should talk) – but other times it’s because this is a private journey between you and your baby and the growth you do is private.

Immeasurable and Infinite

So there’s the tip of the iceberg, and body of it. And then comes birth itself. And you find the massive base of the iceberg. And that’s really where things get mind-blowing. Because there, in birth, you are working. And you are working hard. And you are somewhere else. Between contractions (rushes, expansion, pick your word) you may be right there, laughing, chatting, asking for food. But when that wave comes over you, you are gone. Birth is an incredible experience and there is nothing, nothing else on earth that’s like it. The only thing that comes remotely close is lovemaking (and that only comes close in that place of complete adoration between lovers). Birth is growth of universal proportions wrapped into a few short hours.

There’s surrender in birth. Surrender to a process that is much, much bigger than you. Yet you and your baby can dance the dance so perfectly well. You sacrifice at times, you give up, and you let go. You open to your baby and you forget society at large. You forget social stigma and you forget what’s expected of you. You just give in and you ride a wave that’s been crashing through humanity for thousands of years. And what a beautiful, beautiful rush it is.

I’m not sure anything can match the awe and ecstasy, the absolute timelessness of that place where you are pushing your baby out and then there is a new being, a new person, a new soul coming into your life. If ever there was an ordinary miracle birth is it. If ever there was something to blow away the world outside of your awareness, it’s the birth of your baby.

What an experience in growth, in learning about yourself, in trust, and in surrender. In letting go and opening.

So when people say “you’re so lucky” you can just nod and smile. But you know the effort it’s taking, or it took you, to get to that birth. To get to that all encompassing and life changing experience that birth is.

My midwife told me during pregnancy with my third child “Kristen, the birth of this baby is going to change your life forever, and it’s going to change my life forever.” Birth is that powerful. And something so beautiful and powerful as that is not something that can be lightly passed off as luck. It’s faith. Love. Trust. And it’s work. It’s hard work.

OMG.  I’m pregnant!  So very exciting.

I joined my due date clubs on my forums today.  I’m really excited about that.  Actually I did it late last night but today I’m starting to get a feel of who else is in there with me.  I’m excited to see gals from my trying to conceive forums there too.

And part of me is still amazed and floored that we sent out an invitation to this little person, and this little person answered right away!  Wow.  Conscious conception is amazing.

But my thoughts are turning more towards prenatal care and even to birth now.  I would be lying if I said I’m not a little nervous about finding a midwife here.  I absolutely know how to take care of myself during pregnancy and I trust myself.  Me and my books and I’m good.  So long as I moderate my stress and my attitudes (live gratefully).  My first three pregnancies have taught me how to take care of myself and also how to trust myself.

So I’m a little apprehensive about finding a midwife here, that I do not know.  I’ve emailed a midwife here back and forth a few times but I’m still a little wary.  Maybe just because it’s not “my” midwife that was there for the first three.  I really sort of would like to just handle my pregnancy on my own though.  But I can’t do that and have a midwife at the birth.  And I’m not sure what my thoughts on that are.

In running NBBC I have done so much reading on birth.  Even more than I had during my pregnancies.  And I’ve learned so much about it.  And I trust birth.  I trust it implicitly.  And I trust my body.  I absolutely did NOT want to get pregnant at one point – and I had an anovulatory cycle that month.  This month I had every intention of getting pregnant and I did.  I am not trying to sound full of myself – I know unexpected things sometimes happen.  But I believe in my body and my ability to work with it.  And I’ve read a lot of stories from a lot of women who believed the same about themselves.  And their beliefs manifested in beautiful ways.

It’s something that will take a lot of thought on my part.  I will spend hours and hours and hours talking to my baby, thinking about our baby, thinking about the birth, and visualizing the birth in a million different ways.  I did this with my third pregnancy especially and had the most amazingly wonderful and peaceful birth.  So I’ll spend a lot of time on it.  And thankfully I have nine months to do so.

So now comes the thoughts, the self-care, the reading.  So much reading.  So much to do, to think.  On top of everything else, lol!  But I’m looking forward to it.  So very thankful I get this opportunity again.  Awed that I am so blessed.