For my wife, pregnancy started even before she was pregnant. It may have begun the first day she told me, on a snowy walk fit for a Cialis commercial, that she had been thinking: A couple friends had recently had babies, and one of those friends had trouble with the late stages of her pregnancy, and it probably had something to do with her being 35, and my wife herself was 34, and well, if we were going to do this, maybe we'd want to do it soon ...
I stalled for six months. In that time, though, I'd estimate that at least a half of all conversations 10 minutes or longer included a reference to "pregnancy," or "being pregnant." Mentally, she was with child.
For me, on the other hand, pregnancy didn't even start with conception. Nor did it start the night she came into the room after taking her fourth pregnancy test in a week and a half and presented the little stick to me with a triumphant and tearful "I knew it." (How could three other tests have been wrong?) Nor did it start when I told my parents, or friends, or co-workers.
Pregnancy for me began on Nov. 19, 2008, when Cara was four months along. That's the night I sat down under the fluorescent lights of a Memorial Hospital building to hear pitches from 11 people within the baby business. The discussion was called "Choices in Childbirth," maybe six or eight couples were attending, and the panelists were listed as follows:
• birth doula
• certified nurse midwife
• homebirth midwife
• lactation consultant
• NoCirc representative
• certified childbirth educators
• postpartum doula
Nine professions. I knew what three of them were.
Cara was already seeing a chiropractor, and I knew we'd be taking childbirth classes. But an acupuncturist? And all the others? Wouldn't we be just fine with a good doctor and a clean hospital room?
Seven months and one lovely little boy later, here's my answer: I have no idea.
As the kind of people known to buy organic carrots, we were all but spoken for. There was no way we would be going standard-issue childbirth. In the eyes of Colorado Springs' "mother-friendly" birth community, we were easy recruits.
It's a tight-knit, surprisingly sizable congregation of true believers: believers in alternative health, believers in the life-affirming potential of childbirth, believers in the idea that mainstream medicine has failed parents when they need it most. Their interests, training and fields of expertise vary widely, and their scope of service ranges from early pregnancy to a few weeks thereafter. But if any single thing unites them, it's frustration that so many births today involve surgery or drugs. According to the Centers for Disease Control and Prevention, the American cesarean rate climbed to 31.8 percent in 2007, the 11th straight annual increase. And then there are drugs to start, quicken, or take the pain away from labor; no independent body seems to track their use, but advocates of "choices in childbirth" estimate it could top 95 percent. In most cases, they feel, these interventions do a disservice to mother, child and birth experience.
They've found a charter of sorts in the Mother-Friendly Childbirth Initiative, a 13-year-old document that most of us have never heard of. Designed by a mass of interested parties — doctors, breastfeeding advocates, activists, parents, etc. — from across North America, it's full of questions that moms should ask their health care providers ("What position do you suggest for birth?"), as well as answers to seek ("Mother-friendly settings almost never put a woman flat on her back with legs up in stirrups").
Many local mother-friendly advocates have formally pledged their support of the MFCI by joining the Colorado Springs chapter of the BirthNetwork, the nonprofit behind November's panel discussion. Despite being only four years old, it counts about 60 professional members, making it among the largest in the country, according to co-leader and co-founder Laura Tefertiller. As importantly, its public profile is growing. Tefertiller says their monthly meetings at an east side Whole Foods Market, promoted almost solely by word of mouth, have attracted up to 40 people.
"I know from personal experience, from talking with other pregnant women coming to meetings, they've said, 'Wow, I didn't realize I had all these options,'" Tefertiller says. "Or [they feel] more empowered to take charge, to become an active consumer in their birth."
An active consumer in birth? I didn't even know there was a marketplace.
What follows is a glimpse at what it looks like.
It started at 'Namaste'
A full month before that panel discussion, Cara attended her first prenatal yoga class at Westside Yoga Studio and Massage. About 13 weeks along at the time, she fell for the class immediately.
"It was the first place my pregnancy felt normal," she says. "I didn't feel like a big fat cow. I felt special. It felt like a very neat experience, instead of a lonely kind of one."
The class covers more than hip-opening and squatting poses. At the beginning of each night, teacher Marie-Louise See goes around the room and invites each woman to talk about what they're feeling. It's a half-hour "check-in" devoted to both the physiological and psychological aspects of pregnancy, and See says the bonding that happens "is profound."
"And that," she adds, "is why I do not let the husband be a part of this class."
See first started teaching prenatal yoga locally at Yoga Journeys in the late '90s, when it was one of maybe two or three studios in town. When she started her own prenatal massage therapy business on West Colorado Avenue, she tacked on a yoga class, leading three or four women at a time in a borrowed conference room.
Today, more than half of the Springs' dozen yoga studios offer some kind of prenatal yoga. And there seems to be enough business to go around: on a typical Tuesday or Wednesday night, as many as 16 pregnant women may show up for class at Westside.
"I am moving next month to a bigger space," See says, "because I am bursting at the seams with pregnant mommies."
Her new location, at 617 N. 17th St., will welcome 25 to 30 women at once, which should help both her prenatal and postpartum mother-and-baby classes spread out.
So during these yoga classes, my wife picked up some pregnancy pointers from See, as well as her fellow students. The biggest: We ought to consider seeing a certified nurse midwife, a professionally trained nurse who could do everything necessary for prenatal care, as well as handle most routine labors.
Since our first doctor never so much as looked at me during our visits, I figured it couldn't hurt. And sure enough, everything felt different at Blue Skies Center for Women. Both midwives on staff were professional, knowledgeable, very down-to-earth and fine with hearing that we wanted to deliver in a hospital. They did typical doctor's office stuff, like testing urine samples and checking weight. And they asked us questions about our families and our jobs, and took all the time necessary to answer our questions.
This was maybe a couple weeks after that panel discussion, the one at which I discovered that I didn't even know what midwives did. And now we had not one midwife, but two.
No parlor tricks
Cara remembers that even before we got a positive pregnancy test, she started worrying about the pain of labor. It was in yoga class that she heard, and actually started believing, that with strategies for pain management, she could deal.
So when two Bradley Method childbirth educators spoke at that BirthNetwork discussion, Cara liked what she heard. One of them, Jessica Hulin, said that she knew of Bradley mothers who'd arrived at the hospital so calm that nurses insisted they couldn't be in labor. We signed up for her next class.
The Bradley Method, devised by the late farmboy-turned-Denver-obstetrician Robert Bradley, posits that the body knows exactly what to do during childbirth, and that in the vast majority of cases, the mother shouldn't need drugs. What the woman needs, really, is a good "coach" — counterintuitively, it's also called "husband-coached childbirth" — as well as a clear birth plan, and plenty of time and tools (birthing balls, showers, squat bars, etc.) with which to labor.
In fact, the American Academy of Husband-Coached Childbirth, which certifies Bradley instructors, claims that 86 percent of its couples achieve "spontaneous, unmedicated vaginal births."
Totally one of the freakiest phrases I'd ever seen.
But I was kind of freaked, anyway: As a child of TV sitcoms, I'd always kind of assumed that everyone who took a childbirth class just took Lamaze, and learned the funny breathing. That I'd never heard of Bradley, I thought, was curious.
Curiouser, I've since counted nine different types of classes: Lamaze, Bradley, the Association of Labor Assistants and Childbirth Educators (ALACE), International Childbirth Education Association (ICEA), HypnoBirthing, HypnoBabies, BirthWorks, Birthing from Within and the Alexander Technique. Other classes comprise a fusion of philosophies.
You'd think there'd be a clearinghouse for all this. So I approached Better Birth America, billed as "America's leading resource on birth options available to expecting parents across the country."
The e-mail response, via founder Jackie Belau: "There are many different childbirth education classes taught in Colorado Springs and by the nature of these classes and the population they serve, they are happening all of the time ... we unfortunately can not list all of the classes happening because the list would be overwhelming."
As best we can tell, Colorado Springs has teachers certified to lead Lamaze, Bradley, ALACE, ICEA and HypnoBirthing. Based on name alone, the last definitely shoots the eyebrows highest.
That's one reason why Cara never told me she'd considered it.
"You need to understand," says Shanda Hickman, who leads a HypnoBirthing class for four to six couples out of her west side home most months. "It's really, essentially, a deep state of relaxation, instead of parlor tricks and making you cluck like a chicken."
In HypnoBirthing, the mother learns techniques for visualization and self-hypnosis, leading to a state Hickman likens to meditation or prayer. From there, as her Web site claims, she learns "to explode the myth that pain is a necessary accompaniment to labor."
"The point isn't that it's necessarily pain-free," Hickman explains, "but that [pain] is not synonymous with birth; that pain isn't necessary to give birth."
Bradley taught the same thing, though Hulin wouldn't stress that so much. In fact, we'd ease into discussion of labor itself; first, we'd cover diet (short story: eat lots of protein), exercise (do it) and massage (get your partner to do it).
Our first class went as most of the next 10 would go: five or six couples at a chiropractor's office near Interquest Parkway, sitting in a circle on the floor, talking through fears, anatomical lessons and workbook exercises. Equal parts intimate and awkward. Now that I expected.
From DVD to doula
In that first class, Jessica mentioned that she'd be applying for certification through Doulas of North America (DONA), and needed to attend births as a doula as part of her training. To that end, she told all of us that if we wanted her as a doula, she'd charge just $50, maybe one-tenth of what doulas often charge.
I was determined to stand firm. Here I was in a class put on by the American Academy of Husband-Coached Childbirth. I'd be learning to stock our home and hospital with the right CDs, scents and snacks; to say the right things during labor; to massage my wife for hours if necessary.
Cara had to endure childbirth, and all I had to do was coach, support and advocate for her. If we hired a doula, I'd be calling for non-medical backup, be it emotional, physical and/or informational, months before labor even began.
And then Hulin popped in the class' first childbirth DVD.
For anyone still bearing a scar from a middle-school health class video, let me note: Very little has changed. People who allow their births to be filmed for wide distribution are still, on the whole, unsightly, without much makeup work done during labor. There's lots of moaning, lots of nakedness (from wife and husband, oddly enough), and lots of ... fluid.
Head in hands, I asked myself: I was going to be the voice of reason in that environment? I was going to be all she needed? I might be asked to get naked, in the name of teamwork or something?
Well, shit. It was just $50.
I guess this is why at least seven different organizations certify doulas. And, as DONA doula Keith Roberts says, why even those can't account for all doulas.
"There are many, many doulas in Colorado Springs, some who are certified and some who are not," he says. "And that line gets really blurred when a friend just goes with a friend to be at her birth and to help her. She's acting as a doula — she doesn't have training, but you could call her a doula, too.
"Certified doulas, [there are] maybe 15."
As late as 1992, he explains, there weren't any — because there were no certifying organizations. He got his certification in the mid-'90s.
"Fourteen years ago if you said 'doula,' nobody knew what you were talking about," he says. "Now everybody knows what doulas are, and what they do."
As with See, massage work got Roberts into the birth community. After 31 years of classroom teaching, he earned certification in prenatal massage and found himself invited to a number of his clients' births. (The first tenet of the MFCI is that a laboring woman should be allowed to choose whom she wants present, even in the hospital.) In that environment, he realized he felt at home, and went through the DONA process.
The home he built on the west side houses a handful of different studios, including one for his wife's business and one for his massage business. But he spends most of his time in his darkroom.
"Two years after I started doing the pregnancy massage," he says, "it dawned on me that, 'Gee, this would be beautiful in black and white.'"
Cara and I saw Roberts' prenatal and parent-and-child photos at Westside Yoga, Blue Skies and Memorial Hospital during pregnancy. They're also at Memorial North and several other doctors' offices. In fact, had we chosen to visit the office of Dr. John Baer and certified midwife Sharon Ruyak — other stars of the mother-friendly birth community — we could have seen one of Roberts' newer creations: a copper cast of a pregnant belly.
Roberts says he's done about a dozen of them now, each taking five or six weeks. It's a five-generation process that costs $640 — which, he notes, is about half of what his casting instructor charges, and about a quarter of what you might pay for one in a gallery.
So I guess I should be happy that Cara only wanted some photos. I just didn't realize how much she wanted them until her friend Kathryn Mathis, from network member Sweet Feet Photography, came over.
My modest wife, she of the Springs' finest turtleneck sweater collection, suddenly was walking around our bedroom topless and directing me into poses next to, behind and wrapped around her. I'd like to think that in any other situation, I'd count my blessings and roll with it. With a photographer in the room, though — and with her very Catholic grandmother, her churchgoing mother, two aunts and a cousin elsewhere in the house, decompressing from a baby shower — I was nearly mortified.
She says the yoga had something to do with the way she grew to appreciate her body, and that the childbirth classes helped her feel energized by, and not afraid of, its changes. Rather than fear the belly for the labor that was coming, she could appreciate it for what it was at that moment.
And, as I realized when talking with Tefertiller, it could have been much worse.
"The pictures that I've seen from women's births," she says, "are just incredible and I think very much treasured later on. And I've certainly heard from some women that they wish they'd done something like that."
Milk and money
Though normalcy had been completely hijacked by the final weeks, I still struggled with spending one of our last child-free Saturday nights watching a Ricki Lake movie. Yet somehow, though every couple in our Bradley class had decided on hospital births, we'd agreed that we could benefit from a viewing of The Business of Being Born — described by slate.com as Lake's "valentine to the home-birth movement."
The documentary was only the night's first attraction, though. We also were to hear a presentation on "Diapering your Baby."
Hulin's handout broke down this way: One page on disposable diapers, with 20 words devoted to their "pros" and more than 250 to their "cons." And then four pages on cloth diapers that wrapped up as follows: "If given the choice, most reasonable adults would choose to wear comfortable, cloth garments for their underwear instead of disposable underwear made of paper and plastic, 24 hours a day. Wouldn't you want the same for your baby?"
Well, geez, when you put it that way ...
Actually, thanks mostly to my cheap streak, we had been leaning toward cloth diapers. (I'd read that you'll probably go through 7,000 diapers in the baby's first two years of life.) The same could be said for breastfeeding, versus formula feeding. The difference, though, is that the natural birth clan has more statistical backup in this realm than in almost any other.
The American Academy of Pediatrics recommends exclusive breast-feeding for a baby's first six months. The federal government would like to see 75 percent of moms breastfeeding for at least some time, since breastfed babies are said to be healthier than formula-fed ones.
The Centers for Disease Control and Prevention keep track of those stats, and found in last year's "Breastfeeding Report Card" that 74 percent did, up from just 68 percent in 1999 and 24 percent in 1971, the year the federal government started keeping stats.
Cara heard it advocated in yoga. We heard it in our Bradley class. And we heard it in a BirthNetwork seminar on breastfeeding. Of course, even in areas of near-consensus, there are extremes: Some "experts" insist that even if you give babies breast milk, it has to come from the breast; otherwise, the kid can wind up with "nipple confusion" and not know what to do when Mom holds him close. But since Cara has to work, that wasn't really an option. So during one of our 6,000 weekend trips to Babies 'R' Us, we explored the nuances of more than a half-dozen types of breast pumps. Single-breast or dual? Closed-system or open? With travel pack?
"Looking at breast pumps today," I texted my buddy Mike. "SUPER HOT."
"Wait til you see it in action," he replied.
Push comes to push
When Cara went into labor at 1 a.m. on a Wednesday, she started assuming a "relaxing" laboring position on her hands and knees. When her lower back started hurting, I massaged it, as I'd been taught. I kept record of the contractions — how long they were, and how far apart — so that we wouldn't go to the hospital until she was almost ready to birth.
At 4 a.m. Thursday, contraction notebook in hand, we drove to Memorial Central. At 5 a.m., after hearing Cara was a half-centimeter dilated, we were sent back home, to our exercise-turned-birth ball and bathtub.
It was another day before we called Hulin, who spent all of Friday with us. She walked us around the block, took Cara to a chiropractor, and called the hospital ahead of time to request a natural-birth-friendly nurse. At 6 p.m. we were admitted, our bags strained by wave-crashing CDs, lavender oil and electrolyte-infused water.
But there were limits to our patience with the natural process. As Friday turned to Saturday, after 71 hours of labor on 90 minutes of sleep, the baby was still not "dropping" enough. To let Cara rest, and to help her body relax, we chose an epidural.
At 10 a.m., the story was the same. So at the gentle suggestion of Dr. Andrew Fowler, who was on call for Blue Skies that night, we opted for a cesarean section. Donovan Daniel Woundy was born just after noon that day.
It's kind of the story of our entire pregnancy experience; I guess you could say that in the natural birth marketplace, we were selective shoppers. Chiropractic care and yoga helped, but we never saw an acupuncturist. Our nurse midwives were great, but we never had reason to talk with a home midwife. Our labor doula made the longest hours bearable, all the way through the birth, but we never discussed a postpartum doula, who, as far as I can tell, acts as a short-term nanny.
Nor did we consider placenta encapsulation (!), or cease laughing immaturely at the guy from Colorado NoCirc, whose organization vows to "make the world safer for children" by preventing boys from being circumcised. (If you get a minute, visit coloradonocirc.org and click on the "Guess Who Isn't Circumcised" box. Mr. T. and Harry Truman? Amazing!)
At 10 weeks old, Donovan's in cloth diapers, at least most of the time. He's breastfed, and despite taking some of the milk out of a bottle, has suffered no obvious "confusion." Cara's planning to return to Westside for postnatal yoga.
And three of those black-and-white photos are framed.
But I still haven't put them on the wall.