September 8, 2024
Spring 2024 Newsletter
In this newsletter
- Birth Story Film Screening
- Birth story: A little owl is born
- Article: Freebirth, risk and the spectre of obstetric violence
- Latest research: Water birth safe
- Upcoming events
- Spring recipe: Asparagus Stalk Pesto
- Notices
Birth Story Film Screening
Our cosy film screening of Birth Story: Ina May Gaskin and the Farm Midwives was a fundraising success! Thank you to everyone who came and helped support our organisation. We raised around $170 from online ticket sales (via Humanitix) alone.
If you're not familiar with Humanitix, they're a non-profit alternative to services like Eventbrite but unlike for-profit ticket sales services, 100% of Humanitix's profit goes to charities. So not only did the online ticket sales help fund our organisation but they also helped to fund other charities too!
Rose (Trustee) is still in the process of writing up the event report which will also include some additional funds received through door sales and item sales. The report will be posted on the website and our Facebook group once it's completed.
A big thank you to Petra, Rose and Athena for organising and helping with this, thank you to Auckland Women's Centre for hosting and AWC's Awatea for coming and doing the tech-check. And again, a big thank you to everyone who came and helped make this not only an enjoyable film to watch together, but make it a fundraising success.
Birth Story: A little owl is born
By Sarah Sue Roth
Originally posted on Home Birth Aotearoa
It’s Monday and I’ve got an appointment with my osteopath up the road to help encourage baby (aka “Owl,” as we called our bump) to drop into my pelvis. I’ve been having more frequent and stronger “practice contractions” (these are just “practice”, right?) but Owl is still quite high, so we’re going for a 30 minute walk through the bush for treatment. I felt great afterward while I waddled home, 42 weeks and 3 days past our “expected due date” (whatever that means – my cycles have always been inconsistent, ranging from 27 to 33 days so that means my EDD could span over literally six or eight weeks – or at least that’s how I justified it in those last few days!).
At home things became a little bit more regular. Mild and short surges were beginning to become more noticeable. I got dinner ready for my honey love when he arrived home from work, and then off to bed. In bed, I didn’t sleep well as the surges were waking me, and I wanted to get up and move around. I ended up with enough sleep to feel refreshed and full of energy on the Tuesday morning. I was meant to see my midwife for a check-up, but didn’t want to sit in the car, as well as my back-up-midwife for acupuncture to encourage Owl further down and to get labour on the way.
I called up our midwife to let her know I was definitely having surges and didn’t feel comfortable driving all the way into town from the beach while being taken by increasingly noticeable surges. So I asked my partner to stay home from work in case I needed him to drive. Turns out our back-up midwife was keen for the drive so she came out to the beach for a check-up and acupuncture (though in hindsight, labour was clearly underway at this point…at least the early stages of it). She and I had a nice catch up and acupuncture, followed by lunch. As she departed, she said, with all the confidence in the world behind her wise eyes, “I’ll see you later.”
Surges continued to strengthen and became more frequent. I was happy to have my honey at home to support me, though it wasn’t until about 5:30pm that I admitted to him I was in labour and he should start becoming more aware of how frequent the surges were, and how long they lasted. He was on it – the very next contraction he said “I’m going to let the midwife know things are heating up, you’re at less than 5 minutes between them, and they’re lasting almost a minute.”
“Okay”, I said, “Just tell her to not hurry – I don’t think we need her yet.”
Things carried on – I was feeling quite nauseous and had returned all of my lunch to the sink after one of the surges. Had I remembered to take the homeopathics that our midwife had left to help with the nausea, I would have likely not needed to clean up partially digested lunch! Anyway, food was unappealing but my partner was still making sure to offer me bits and pieces, and reminding me to drink when he thought of it…the sun was setting and I felt much more comfortable as the blanket of the night began to cloak us.
I completely lost track of time…according to my notes, our midwife showed up around 9:30pm. At this point, I was calling on my honey during each surge to massage my lower back and put pressure on my sacrum. I was also wearing big woolly socks, a comfy jumper and…no pants. This was probably quite a sight for our midwife, who checked Owl for heartrate here and there but overall was a just a wallflower who showed up when my honey was absent.
My favourite place to labour was at the kitchen bench – it was just the perfect height, with the table being too low and the tall boy a bit too tall. I felt a little like Goldilocks with my choice, but was so comfortable where I chose.
At some point my legs were trembling with each surge and I was feeling quite tired. So, I relieved myself between contractions by sitting on a Swiss ball, standing up between to breathe deep into the surge. At one point, our midwife recommended that I continue through the surge sitting on the Swiss ball…that was amazing. Initially, I didn’t think I would like it at all, but the shape of the ball and the weightlessness of my legs was all I needed to go deeper into myself. I vividly remember breathing through one surge and exhaling while saying “Ohhhhhh, it feels sooo (haha, laugh) gooooooooood! (giggle giggle)” Apparently our midwife thought I might orgasm the next surge, but I never quite got there…next time!
In the meantime, my partner and midwife were working to get the pool just perfect for Owl and me. I was loving the Swiss ball, but the surges were getting more and more powerful, my voice and breath deeper and stronger. At one point, I turned to the pool and said “I want to get in the pool now,” waited briefly for an affirmative response from our midwife and marched right in. Wow, what an amazing relief. I went to the dark corner of the pool and hung over the edge with a towel under my face for comfort. Recovery and relaxation here was just perfect. The next surge came and I uncontrollably began to “push”…but it wasn’t pushing how you would see in the movies. It was just so natural, so comfortable, not painful at all, and just exactly how it was supposed to be. I moaned and groaned deeply through these “pushing” surges, breathing down to Owl and saying this and that.
I remember Simon and Garfunkel playing, with our midwife singing along to one song after another, and myself bobbing along to the beats without realising while relaxing between surges. After each contraction, I requested a cold towel for my shoulders. It was hot work.
Our back-up midwife arrived. Progress must have been slow (I had no track of time in the moment, but apparently had been something like 1-1.5 hours on my knees leaning over the edge). I remember having a minor breakdown at one point: hyperventilating, screaming, scared. Our wonderful midwife was there to reassure me “it’s okay Sarah, you’re doing great, breath down to Owl, breath, breath deep, breath down”. I regained myself, or actually, I lost myself again into myself, into my body, into Owl and the moment…every moment, so present.
And so our midwives recommended a new position, and then another. With one foot lifted, then the other, with my pelvis shifted sideways and one leg supported out of the water like a lateral spread eagle, with all these suggestions Owl moved down a bit more then back up, bobbing in and out of the final stretch. I remember thinking “it’s never going to happen…we’re going to be working this hard forever! What’s wrong? I thought I was supposed to just breathe and the foetal ejection response would take over!” Then a supported squat, with my partner holding me up from under my arms was recommended.
This is when the hard work became harder, the groans deeper, longer and stronger. “You can do it Sarah, breath down and push to Owl! You got it, push! A little more…or wait for the next surge, whatever feels right,” reminded our midwife, supportively. I felt Owl’s head inside me – “Oh my god, it’s so squishy!”
The little ‘ring of fire’ was there: stingy, the only ‘painful”’ bit of the whole lot, but it wasn’t painful, it was just stingy – I relayed the information, “Owww, stingy.” And we worked and worked hard, Owl’s beautiful little heartbeat not even flinching…steady, strong, calm. Myself: breathing deeper, harder, stronger each surge…harder and stronger and gruntier was the work, more so than I had ever imagined it would be…but not painful, just work…hard work.
Then, Owl crowned. Our midwife was holding me and said “Owl is coming. If it feels right, wait for the next surge and let Owl stretch you. Owl won’t go back now, you’re almost there.”
“Okay,” I thought, “one more and then one more. We can wait, Owl is good…strong…and so am I.” At this point, no pain, just relaxation. It was incredible. The next surge came, I can’t remember how long it took but it felt fast. I push, breathed, groaned, breathed, pushed, groaned, groaned, breathed, GROOOOOANED and there…Owl’s head was out of me. My partner saw it all. I couldn’t believe it.
Another break, more relaxation, completely calm, waiting in the moment, knowing we were almost there. I was so close to meeting my baby who spent so long inside me, keeping us waiting, keeping us strong to our word, our healthy, perfect baby…here it was the next surge…the final push, groan, breathe, groan…done.
I picked Owl up from the water, Owl came to my chest, eyes wide open staring at me; me staring at those enormous eyes, those sinkholes of beauty, calm, amazement, curiosity, love, compassion. Such a small, perfect body – a little human – home grown, home birthed, the perfect recipe.
We sat there together, Owl and I, for quite some time…just staring. A few little noises and some raspy breathing but aside from that, silence: perfection. Someone asked about the gender – of course, let’s have a look! A little girl – our little Masha – our Maria Joyce – our mother’s mothers, all wrapped up in one little perfect package.
We stayed in the pool for some time, apparently 45 minutes. Masha wasn’t latching, and my contractions to birth the whenua were mild. So we got out of the pool and I heard her first voice, her first little cry as we left the water. “Yes, little one, this is your new life, a life outside the aqueous world, the aqueous world that is all you’ve ever known. Have no fears, little one, we’ll get through it together, always by each other’s’ side, I will not leave you alone,” I thought.
The whenua took 2.5 hours to birth – I had been pushing much of the labour on a full bladder and had no sensation to relieve myself despite letting the tap run, relaxing, visualisation, etc. Not to worry, our amazing midwives utilised a catheter in/out to drain the pesky pee and I was able to birth Owl’s whenua within minutes. It was healthy, with no sign of aging or calcification (despite being 42 weeks and 5 days) aside from the “ragged membranes” that resulted from the multiple ‘pops’ I heard of Owl’s waters breaking through the final stage of labour, again and again and again.
Masha was born with heavy meconium in the water, though her heartbeat never gave any indication of distress. Hear breathing cleared up as any healthy baby’s would, and she had no ill effects of the meconium. I was so far into the labour that I don’t even recall our midwofe informing me of the meconium; she asked if I wanted to seek medical help for the situation, which of course I denied – it’s all noted in my book.
Masha had a tummy full of amniotic fluid that she had to rid herself of; I think this is why she didn’t latch immediately. Since then (almost two weeks now) she has developed a healthy appetite, is a rock star latcher and has put on nearly 300g in her first week outside my body. We bask in her beauty, fall into her eyes each time she engages and giggle at all her cute sounds, from gulping at the breast to whimpering whilst in baby dreamland.
Thank you to the wonderful support that has enabled me to be so confident about the ability of my body to birth so naturally, as so many women have done before and so many will do in the future.
Aroha xxx.
Article: Freebirth, risk and the spectre of obstetric violence
Note: This article pertains to the UK however Aotearoa New Zealand statistics are similar as are the legal and maternity systems. For example, around a third of total NZ births result in birth trauma (calculated from reported estimate and the 2021 NZ birth rate). Photos and videos have been removed from this article since this newsletter is text only - you can read the full article at either the AHBA website or the original article on The Conversation
Gemma McKenzie, King's College London
In the UK, all antenatal care is voluntary. There is no legal obligation on any pregnant woman with full mental capacity to turn up at antenatal appointments or even to have a midwife or doctor attend her baby’s birth. Legally therefore, the NHS offers maternity care – blood tests, scans, inductions of labour – and women can accept or decline those offers as they see fit.
The lived experience, however, can be very different.
Society expects “good” mothers to pursue maternity care, agree to medical interventions proposed by healthcare professionals and to sacrifice whatever is necessary to avoid any risk to their unborn children. When women do not conform to this standard of behaviour, they may be vilified and considered reckless or deviant.
When women freebirth therefore - and by that, I mean intentionally give birth without doctors or midwives present – although they are acting legally, what they are doing is socially taboo. It is for this reason that it is not possible to know for certain how many women in the UK freebirth per year. Given the stigma, some women will tell no one but their husband or partner. Others will disguise their freebirths as birth before arrivals, and claim the baby was born quickly before the midwife arrived. This cultural taboo forces many freebirthing women to act secretly and to limit their sharing of experiences to closed social media groups.
Such secrecy lends itself well to wider society misunderstanding freebirth completely. Often when the topic of freebirth arises, the emphasis is on the risks associated with the act. But when researchers explore women’s freebirthing experiences, a constant theme is women’s concerns with maternity services and most notably with obstetric violence.
Obstetric violence is a sticky term that many authors deem inappropriate. It implies abusive health professionals acting violently towards those in their care. But the term incorporates much more than this. Yes, it includes poor interactions between healthcare professionals and pregnant women, but it is also emblematic of institutional and structural violence within maternity services.
Examples of this include expectations that women give birth on their backs, an emphasis on speeding up the birth process, and the withholding of some forms of pain relief – such as the the use of water or birth pools which can make labour more comfortable. For some women, compounding factors include racism and other forms of overt discrimination.
In my own research, women freebirthed for a range of reasons. This included having extremely fast labours in earlier pregnancies, which made a planned freebirth a necessity. Other women had previously experienced excellent NHS care, felt confident in their birthing abilities and after considerable thought, decided to birth at home without a midwife.
Yet these women were the minority. In contrast, women frequently freebirthed as a form of protection. Women reported previous vaginal examinations, episiotomies (cutting of the perineum) and breaking of the waters – all carried out by doctors and midwives without consent. Others were told that to arrange a home birth, they had to agree beforehand to vaginal examinations and monitoring. When women did not submit, some were threatened with social services. One woman was questioned by police officers investigating a possible offence.
This type of behaviour harms women and damages relations between them and their potential caregiver. It runs roughshod over their human rights and it is frightening to experience. The reality is that women in the UK (and globally) continue to be subjected to this type of abuse. It is a manifestation of wider misogyny in which society presumes access to women’s bodies, minimises their pain and normalises coercion and degradation in the birth room.
Coupled with this is an NHS maternity system on its knees. Midwives are leaving the profession in droves. Rates of caesarean sections and inductions have risen dramatically in the past 20 years, while midwifery-led birth units are closing. The number of women using doulas (birth supporters) is increasing as mothers-to-be seek an advocate whom they know and trust. Recently, in England, the Care Quality Commission categorised 67% of maternity units as either “requires improvement” or “inadequate” and maternity scandals continue to make headlines.
With regards to the consequences of women’s birthing experiences, it has been argued that 4% of women will experience post-traumatic stress disorder (PTSD) after birth. One UK study in 2020 estimated that 29% of their research participants experienced their birth as traumatic and 15% had met the full diagnostic criteria for PTSD.
Against this backdrop, the idea of risk becomes complex. When making their decision, freebirthing women are therefore weighing up all kinds of risks – risks that may go far beyond those perceived by healthcare professionals.
If people find the idea of freebirth worrying, they should focus less on the risks associated with the act, and more on the risks women are trying to avoid. Society needs to question what is so wrong with the NHS maternity system that some pregnant women are actively refusing to engage with it – even when the service on offer is free.
Punishment for women who freebirth – whether that is a threatened social services referral, the withholding of home midwifery attendance if during labour women change their mind, or general social condemnation – is not the answer. Instead, the UK government needs to listen to women’s concerns, invest in maternity services, and ensure that health care professionals can support women in ways that are both safe and respectful of women’s rights.
Gemma McKenzie, ESRC Post-Doctoral Fellow, King's College London
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Latest research: Water birth just as safe as land birth
A study in the International Journal of Obstetrics and Gynaecology that studied outcomes of births both in and out of water concluded birth in water shows no difference in the outcomes it looked at between birth in water and birth out of water.
Looking at a total of 73,229 women, the researchers looked at obstetric anal sphincter injury, neonatal mortality, and whether babies needed respiratory support or antibiotics in the first 48 hours after birth. They concluded:
Among women using water immersion during labour, remaining in the pool and giving birth in water was not associated with an increase in the incidence of adverse primary maternal or neonatal outcomes.
The full study can be read here:
Maternal and neonatal outcomes among spontaneous vaginal births occurring in or out of water following intrapartum water immersion: The POOL cohort study
Sanders et al. BJOG. 2024; 00: 1–10.
https://doi.org/10.1111/1471-0528.17878
Upcoming events
AHBA Monthly Meetings
Our meetings are the 2nd Tuesday of every month, 11am-1pm at Auckland Women's Centre in Grey Lynn. These meetings are inclusive safe spaces - partners, spouses, whanau, friends, babies, children.... all are always welcome!
This month we have Tineke from Nurture People talking to us with the theme "Conversations about Connection, Care and Consent". It will be amazing!
New to the group we'll have a "Free Table". You're most welcome to bring along kids clothing, maternity wear, extras from your garden, anything relevant that you would like to find a new home for.
- 🗓️ Tuesday 10 September
- 🕚 11:00am-1:00pm
- 📍 Auckland Women's Centre. 4 Warnock Street, Grey Lynn. [MAP]
Further dates for the rest of spring are:
- 8th October
- 12th November
AHBA stall at Te Atatū Peninsula Craft & Wellness Market
For something a little different, Rose (Trustee) will have an information and fundraiser stall selling oxytocin jewellery, birth combs, Tui balms, books and more! Come visit for a chat, support our organisation and check out some of the other craft and wellness products and services on offer at the market.
- 🗓️ Saturday 21 September
- 🕙 10:00am-3:00pm
- 📍 Te Atatū Peninsula Community Centre, 595 Te Atatu Rd, Te Atatu Peninsula
More information here:
Te Atatu Peninsula Craft & Wellness Market
Shopping event in Auckland, New Zealand by Crystal Visions Holistic Market on Saturday, September 21 2024
Other events of interest
The following events are not run by Auckland Home Birth Association but may be of interest to the home birth community.
North Auckland Homebirth Community Meet-up
"We are bringing our September catch-up to Warkworth! Join us at the Columbus Cafe at Mitre 10 Mega, corner Woodcocks Rd & Mansel Dr, Warkworth. They have a great selection of food and drink and both indoor and sheltered outdoor space depending on what the weather decides.
We are looking forward to reconnecting with those of you who have previously joined us, and meeting some new faces too! If you know others who you think would like to share this space and relaxed chats about pregnancy, birth, parenting and everything in-between, please invite them along. We are keen to keep growing this lovely community we are building!
As always, all are welcome to join - māmā and whānau, and birth workers alike."
- 🗓️ Tuesday 24 September
- 🕙 10:00am-1:00pm
- 📍 Mitre 10 Mega Warkworth, 70-80 Woodcocks Road, Warkworth.
Spring recipe
Asparagus Stalk Pesto
Asparagus comes into season in spring but don't throw out those woody stalk ends! Turn them into delicious pesto. Bonus, it's super easy to make!
Ingredients
- 1½ cups asparagus stalks (a bit more or less is fine)
- 1 cup loosely packed fresh basil (you can also substitute some or all of the basil with mint)
- ⅓ cup pine nuts or walnuts
- ¼ cup olive oil (extra virgin preferably)
- Zest and juice of a small lemon
- 1 clove of garlic
- Salt to taste (and pepper if you like it too)
- [Optional] ¼ cup parmesan cheese (vegan parmesan works too). Alternately you can add in 1 tablespoon (more or less depending on how much cheese flavour you want) of nutritional yeast. (Important note: this must be nutritional yeast, not baking or brewers yeast!!)
Method
1. Cook asparagus stalks until tender - you can boil, steam or microwave. If boiling, they take about 5 minutes. Drain and leave to cool.
2. While the asparagus is cooling prepare the other ingredients such as zesting and juicing the lemon, peeling the garlic clove, grating the cheese, etc.
3. Chuck everything, except the salt, into a blender and blend until a smooth purée. If the pesto looks dry, you can add a little more olive oil at a time till smooth.
4. Taste and add salt as needed, tasting each time to ensure you don't oversalt. You can also add more lemon juice if you like.
5. Serve!
This can keep in the fridge for up to three days or you can freeze it (including into ice cubes). Perfect for making ahead of time to pull out postpartum whenever you want some pesto deliciousness.
Notices
Pool coordinator
We are still looking for a pool coordinator for North Auckland and South Auckland. Some requirements are:
- Safe storage of four birth pools plus liners, accessories and repair kits
- Monitoring birth pool hire emails and using the online booking system
- Cleaning and repairing pools where needed
- Inspecting pools when they are returned
- Prepare pools ahead of hire
Pool bookings can vary in frequency from only once a month to multiple in a week. You must be responsible, reliable, have integrity, be able to work independently and use initiative, and be passionate about helping others. There is a small remuneration per pool hire. Training provided. Contact birthpools@ahba.org.nz if you would like more information.
Volunteers
As always we are looking for volunteers to help or if you have an idea you would like to see made happen, please let us know! hello@ahba.org.nz
We also have a Taiga kanban that you can view to see the sorts of things we are doing or want to do:
https://tree.taiga.io/project/aklhomebirth-informationsupport-projects/kanban
Future AHBA Newsletters
We would love to grow our newsletters but we can't do it by ourselves! If you would like to be a guest writer, want to post a birth notice for your baby, have events to share, a recipe to contribute, want to share your home birth story or just have a great idea for the newsletter, please let us know!
💌
newsletter@ahba.org.nz
AUCKLAND HOME BIRTH ASSOCIATION
discovering ⋅ empowering ⋅ celebrating
Auckland Home Birth Association is an inclusive, non-profit, volunteer-led community organisation supporting individuals, whānau/families and health providers with support, information, meetings, resources, and birth pool hire.
International evidence shows birth at home is a safe and gentle way to welcome babies, where families can be involved and connected. Home birth – it’s your choice!
www.ahba.org.nz | hello@ahba.org.nz
Auckland Home Birth Association is a registered Charitable Trust, charity no. CC60866
Unless otherwise stated, photos are © Copyright their respective owners and must not be downloaded or distributed. Content on the Auckland Home Birth Association website and newsletter archive is licensed under a Creative Commons BY-NC-SA 4.0 International License.