In the last two weeks there has been much panic among mothers planning home births, plenty of heated debate on mumsnet and other online chat rooms as everyone asks is home birth really safe? This comes after The British Medical Journal’s publication of the UK’s biggest ever study of the safety of different maternity settings.
In response to some requests I have now read the study, the media reports, the comments and here is my interpretation and summary for you.
The study of almost 65,000 births across England’s health care trusts, led by professor Peter Brocklehurst, examined the risk of rare but serious adverse outcomes for babies born with no known complications in different maternity settings comparing home, freestanding midwife-led units, midwife-led units attached to obstetric wards and obstetric led units.
The findings were these:
1. Birth was safe wherever it happened with the chance of harm befalling your baby less than 1% in any birth setting.
2. The care in a Midwife-led unit was much more likely to lead to a normal birth than obstetric care.
3. For a first birth the risk to a baby born at home was slightly higher than a baby born in hospital. 5 out of 1000 babies having serious complications for the baby in hospital, and 9 out of 1000 at home.
4. For a second and subsequent birth there was no difference in the risk to babies whether born in an obstetric unit, a midwife-led unit or at home.
All the above is good news. It means we finally know that homebirth is nearly as safe as hospital for first time mothers and as safe as hospital for mothers birthing for a second or further time. We also know that midwife led care is superior and better for mother and baby with no known complications than obstetric care.
However the British Newspapers felt that highlighting the dangers of home birthing was a much more readable story:
The BBC Website headline read : Home Birth Carries Higher Risk for First Time Mothers
This was moderate compared to the dreadful health reporting of The Daily Mail which said:
First Time Mothers who opt for Home Birth face Triple the Risk of Death or Brain Damage to their Child
Unacceptable misrepresentation and sensationalism
This is plainly untrue as the risk of serious adverse outcome (not death) is not three times as they quote, and not quite even double, but 5 out of 1000 as opposed to 9 out of 1000. That is less than 1%.
The Mail went on to say erroneously that almost half of all women who home birthed transferred in because of complications going on to infer that those complications led to emergency situations.
This is what the study actually said:
About 45% of women planning to have their first baby at home were transferred during labour, although this was mainly because of delays in giving birth and the need for an epidural pain-relief injection, rather than because the baby was in distress.
Instead The Mail’s readership will misleadingly assume that birth is inherently complicated and home birth dangerous.
The Daily Telegraph took a similarly negative position with:
First Time Mothers Warned Over Home Birth Risks
What people should be asking is why was there an increase in home births incidents which is not unexplained by the survey.
The Guardian who headlined with a much more sensible headline:
Women with Low-Risk Pregnancies should have Birth Choices
asked study-leader Professor Brocklehurst to explain the slight increase:
“I don’t know why. We don’t know which aspects of the care or the site contributed to this,” said Brocklehurst. “It could be to do with the sort of women who chose home birth, who tended to be white, slightly older, better educated and live in more affluent areas, the midwife’s experience, problems in transferring to hospital in an emergency or something else entirely. More work would be needed to establish what was happening.”
Certainly giving birth for first time mothers is longer, and therefore more challenging and more prone to complications than birth for multiparous women which explains the high transfer rate.
Perhaps even more worrying are some of the responses from obstetric professionals on The BMJ website including one obstetrician who writes: Public funding of home births should be stopped.” He goes on to say that money could be diverted to more forceps and caesarean deliveries.
Just what a new mother facing birth wants to hear.
What should have been the headlining story emerging from this study is that there were more adverse outcomes in hospitals than midwife-led centers – 5.3 per 1000 in hospital compared to 4.5 in birth centers.
This means labour wards pose a greater risk to our babies than mid-wife led units. In the case of birthing doctor does not know best.
For mothers the hospital experience comes with much greater intervention:
Healthy, low-risk women will have over 40% chance of an intervention like a caesarean or assisted delivery in an obstetric unit. In a midwife-led unit in a hospital there’s a 24% chance which decreases to 17% in free-standing midwife-led care and right down to 10% for home birthers.
Of course no-one is going to go around saying, ooh, you don’t want to have your baby in hospital, it’s terribly dangerous you know…
Currently 90% of women favour a hospital birth.
But as any mother who has birthed can tell you, safety is not everything – especially when it undermines the birth itself. As one mother told me:
I found it hard to read this report as everyone I know who’s had a home birth has had a great experience whilst so many of my friends have had a terrible hospital one.
It is no good strapping a mother to a bed with a constant monitor, tubes in her veins, artificial stimulants in her veins and forceps in her vagina, undermining her innate birth rhythms and traumatising her otherwise healthy baby just to make certain the baby is safe and out on time. Which seems, so often, to be the case these days with four women in ten ending up with either a cesarean or instrumental delivery.
So instead of running in a moral panic back to the clinical safety of the hospital lets use the information contained in this study as a basis for an informed conversation about birthing venues. Lets explore more the rise in home birth risk and look at ways to make this optimum way of birthing even safer for first time mothers. Home birth has the lowest costs for the nHS and the best rates of ‘normal’ birth. This study has really demonstrated what a safe and excellent birth model it is.
Other ways forward for the maternity services based on the findings of the study might include:
1. More midwife led units and more mothers going through them. They are so often empty while the labour wards are full.
2. Let’s keep the obstetricians for the genuine labour emergencies and return normal birthing to its rightful guardians – the midwifes.
3. Look at expanding the midwife role so that she can cope with minor emergencies.
4. Actively encourage more home births especially for multiparous women.
5. Initiate an inquiry into the challenges facing midwifes and first-time mothers home-birthing and see how this birth option can be made as safe as the hospital.
If all these measures were successfully initiated, the statistics for birth experience, maternal wellbeing, successful breastfeeding and normal birthing would almost certainly improve – alongside safety.
Finally, a word on the study’s conclusions which was this:
Our results support a policy of offering healthy nulliparous and multiparous women with low risk pregnancies a choice of birth settings… Adverse perinatal outcomes are uncommon in ALL settings while interventions during labour and birth are much less common for births planned in non-obstetric unit settings.
That is the bottom line, giving birth is safer than it has ever been – not 100% guaranteed – it can never be but safer than its ever been – especially if you’ve done it before.
Why didn’t the English headlines say that?
What did the guru say to the hot dog vender
Make me one with everything.
Why couldn’t the yogi operate his vacuum cleaner?
He’d lost all his attachments.
How many Iyengar students does it take to changes a light bulb?
Only one, but she’ll need four blankets, a chair, two bolsters, six blocks, two straps and a cushion.
Talking of props… this week is restorative week across all my yoga classes. Restorative poses, for those of you not yet familiar with this particular branch of yoga, have a particular ability to leave us nourished and well rested. These postures are usually deeply supported by blankets, blocks, or other props and are held for minutes rather than breaths.
See you there.
Nadia
Yogasms (orgasm directly derived from yoga practice) are the latest yoga must-have in America.
It seems that American yoga practitioners (a little more open that we sexually restrained/repressed Brits), are outing themselves by the bus-load as having experienced Yogasms in class.
It is certainly possible. Regular practice of Moola bandah and pelvic floor exercises coupled with movements like pelvic rocking and asana like Baddha Konasana will bring blood to the pelvic muscles and organs. This will, in turn, energise Svadishthana chakra which will create increased sensitivity and therefore an improved sex life. (At least initially) But on the mat? In Downward Dog? It’s not a tangible goal for many. Maybe in Gormukasana – perched on the edge of a block… for the minority… only
Could it be that the Yogasm phenomenon in the states (it hasn’t made it over here yet) is describing some other kind of bliss or excitation?
A quick search online reveals that the Yogasm means different things to different people:
After or during Yoga you may experience a Yogasm as…
1. The euphoria experienced in the body after a deep and intense stretch is released
2. The general all-over-body-mind bliss felt after a really strong class and deep relaxation
3. A physical and emotional sensation experienced at the peak of sexual excitation, usually resulting from stimulation of the sexual organ (but not if its a Yogasm)
So there you have it. A broadening of the use of the word Orgasm. Most of us are having Yogasms (shall we call it endorphic release) coming out of Pigeon pose or Blissgasms lying in Savasana and some of us are are being sexually excited too.
So which is better the Orgasm, the Yogasm or the Blissgasm?
While orgasm is definitely not the goal of yoga, (the traditional yogis will be horrified), if a yogasm does chance upon you in the middle of an asana class what will you do?
A) Keep schtum about the whole thing but feel secretly very pleased with yourself
B) Throw your head back and Chant ARRRRRRRR very loudly
C) Grab the person nearest to you and practice couples yoga
D) Come into Childs Pose – he he he
E) I could go on. I am enjoying this too much…
Love and Peace
In the papers this weekend a story worth flagging up. A young woman “discreetly” breastfeeding her baby in a Debenhams store was approached by an official and told her behaviour was “inappropriate” and asked to move. When she asked them to wait until her four week old baby had finished, a second store official approached and asked her to stop breastfeeding.
Its not like she was urinating in public. She was giving her baby the nourishment it needed to continue to thrive. Moreover she was doing it discreetly.
“I told her there was no way I was going to move until my baby had finished and that there was a law in place to protect my right to breastfeed,’ she said.
Luckily for 25-year-old Emily, a mother of two, she knew her rights but many don’t and are successfully persuaded to stop breastfeeding because others find it “inappropriate.”
Said Emily: “It undermines your confidence when breastfeeding in public and makes you think twice about doing it,” she said.
Thankfully, for Debenhams, they have distanced themselves from the small-minded puritannism of the two employees, made Emily an official apology, and even offered to throw a party this weekend for any nursing mothers as a celebration of breastfeeding.
Lets hope Debenhams Clapham have been briefed. Breastfeeding mothers must be supported and celebrated in teh wonderful life-giving work they do.
Clapham mums please share your stories. Which stores and cafes support breastfeeding and which organisations don’t?
Maybe it was because I was pregnant with a girl (although consciously I did not know this yet), maybe it was the womens’ Shaman circle I had recently attended or maybe it was a growing awareness, through the sessions I run, of the power of group energy, either way, as my skin settled itself around my 6 month-stretched belly, I decided to celebrate this pregnancy with a Blessingway.
A Blessingway is a ceremonial gathering of women to honor, celebrate and empower the pregnant woman on her path to Motherhood. The tradition of the Blessingway stems from an ancient Navajo ceremony which celebrated a woman’s transition into motherhood. The Navajo have a saying, “whatever happens here on Earth must first be dreamed”, and that’s exactly what a Blessingway does – it acknowledges or dreams the birth and transition to motherhood that it is to come.
Any woman can have a Blessingway irrespective of her religious/spiritual/secular belief system. She will connect to the experience on the basis of that belief system. However you experience it, as a gathering of women, a divine ceremony or a celebration of your self, a Blessingway is an experience you will never forget.
Not ordinarily given to parties, least of all my own, I was surprised and amused by the joyful vigor with which I embraced this event. Despite no previous direct experience I had a very clear idea of what I wanted: a circle of women; all the wonderful women I was blessed to have in my life, a group meditation, a decorated pregnant belly, I wanted someone to preside over the ceremonial part of the day and I definitely did not want that someone to be me. Luckily, I knew just the person, my dear friend Alex Field; a naturopath and intuitive healer who regularly organised monthly moon meetings.
We talked about how the ceremony might unfold . We decided the ceremony would comprise of three main events; a group meditation, which she would lead; a bracelet-beading session (each person contributing a bead to the bracelet which I would then wear during labour) and the circle of blessings from friends and family which would be given one by one to me – each blessing – marked by the lighting of a candle. To finish, there would be vegetarian food, prepared and brought by everyone, washed down with non-alcoholic drinks. Uncharacteristically for me and parties… I could not wait.
The wonderful thing about ceremony is that it cuts to the chase. Like a baby shower, a Blessingway consists of a group of women sitting around a room talking but what they say and how they say it are very different indeed. A blessing is essentially a prayer. A Blessingway is an organised group prayer. The chat comes, inevitably, but after the ceremony.
I remember every powerful, wonderful and amusing detail of my Blessingway; the table filled with sumptuous superfood salads, lovingly prepared home-made breads and cakes, bright flower arrangements and delicious puddings, I recall vividly the women marveling at the beautiful sequined henna patterns on their ankles and arms, and at my own fabulous henna belly and I can still hear the laughter ringing out as a mobile phone went AWOL in the midst of a silent meditation. A lovely light moment to lift the seriousness of the circle as the guilty party slunk across the sacred circle in order to switch it off.
The ceremony itself was deeply moving as one by one the women I loved locked eyes with me and shared their wishes and prayers for me before lighting a tealight and stringing a bead. At the best of time, we are not given to speak in such a direct way to each other. My heart swelled as the tray before me filled with a circle of illuminated tealights and the bracelet grew into a necklace.
The love and energy in my sun-drenched sitting room that afternoon was thick and tangible. It did funny things to the women in there. All professed to being moved in ways they had not expected. One even attributing the start of her daughters period that same afternoon to the energy in the room, another allowed herself to grieve for a lost baby; as she sobbed we pulled her into the circle and we held the space for her to release her grief. The power of loving non-judgmental acceptance was palpable. All felt reconnected to their womanhood and their hearts in a way they had not felt in a long time.
As the ceremony closed, i knew I had experienced a very special event, a highly charged moment which would imprint on my body and spirit for life. I felt bouyont for weeks riding on the energy of that special afternoon.
How would it be if all women could be honored in this way as they approached motherhood? For its not just the tips you learn in the birth education classes that get you through labour, it’s your faith in the miraculous process of birth and your belief in your own body and womanhood that gets your through. Blessingways forge that belief in the fire of ceremony. And unlike the babyshower which operates at surface level, in a ceremony, alchemy happens at cellular level.
When labour finally came a few months later, as I hesitantly relit each of those candles in the early hours of the morning, the strength and love of those women returned to carry me. Even As I grabbed the fireside mantlepiece where I had built my home birth alter, focusing through my breath as another contraction of cyclonic proportions tore through me, my eyes locked upon the bracelet and the 26 tealights and I knew that I would be okay.
Freya was born less than one hour later at home next to the fire. I will give her the bracelet one day.
by Nadia Raafat
Blessingway Ideas
Use these ideas or develop your own special ideas for blessing and nurturing the mother-to-be.
a group meditation/visualisation which grounds the group and brings them together
Prayers, Poems, and Blessings: a traditional way to bless somebody is to say a prayer/wish for them, to write and/or read a poem for them.
You can compile the prayers/poems/blessings into a notebook for the mother.
Beads: Have each person invited bring or send a bead that they have picked for the mother. The bead should be something the guest has picked with the mother in mind. At the blessingway string all the beads onto a cord for the mother to wear during labor.
Another way is to simply have each guest bring a bead for a necklace you will bead during labour.
Henna Belly Painting: You can use henna paints or any non-toxic (preferably natural) body paints. The mother may have a design she would like, something of special significance.
Lighting Candles: Lighting a candle at the blessingway is a lovely way to bring a sacred feel to the atmosphere. Or you can ask each guest to bring a candle to light during their blessing for the mother.
Make “Help” Lists: write down a meal that they are committed to bringing for the mother after her baby is born or any other offers of help that can be committed to.
Inspiring me this week is Snow by one of my favourite poets, Louis MacNeice. MacNeice was, like so many poets, pulled towards capturing the beautiful, as he saw it, expressed in the world.
In this poem he masterfully mixes diametrically different ideas and images to capture the intensity and complexity that can explode and fill a single visual moment.
Enjoy:
Snow
The room was suddenly rich and the great bay-window was
Spawning snow and pink rose against it
Soundlessly collateral and incompatible:
World is suddener than we fancy it.
World is crazier and more of it than we think
Incorrigibly plural. I peel and portion
A tangerine and spit the pips and feel
The drunkenness of things being various.
And the fire flames with a bubbling sound for world
Is more spiteful and gay than one supposes -
On the tongue on the eyes on the ears in the palm of one’s hands –
There is more than glass between the snow and the huge roses.
END
p.s share your favourites with me by leaving a reply in the box below
Nadia
Despite the fact that quite a few of the Braziers regulars were missing, this weekend must rank as one of my favourite yoga retreats.
The weather for one thing – not a drop of rain in sight. Instead, plenty of late September sunshine to warm the silent walkers and many readers lounging in the grounds on Saturday afternoon.
The presence of children is another; this was a kid-friendly retreat. So alongside the 22 adults were six children to keep our three company. Children’s highlights included the “training centre,” a woodland adventure playground, a ‘noisy walk’ and staying up late beneath a clear starry sky to build a fire with Angus, toast marshmallows and, best of all, eat them.
Once the children had bedded down, out came the wine and soon after the song!
But what makes a retreat are the people. Maybe it’s because there were sisters on board this time – two sets – bringing family solidarity to the group; maybe the three couples attending brought a love-vibe with them that spread amongst the Batterseayogis or, maybe, just seeing so many friendly faces, returning yet again to settle comfortably back into Braziers, did it? Either way the connection between everyone seemed effortless.
Having attended a retreat myself this summer where there was little yogic glue connecting the 40 or so attendees, I am delighted to notice how friendly the BatterseaYoga retreat experience is.
Long may they continue.
Nadia
Until I became a parent I did not realise just how many issues I had.
Cruising along in my twenties, I was blissfully unaware that I harboured a rather strong neurotic, perfectionist, obsessive despotic streak. Not yet elicited by circumstance she slept happily somewhere in the depths of my unconscious.
With my first breastfed, carried, co-slept and adored child, I wafted around feeling like the cleverest mother in the world. This mothering lark was so easy! I thought.
Then I had two. With two terrible toddlers, came endless tantrums, tardiness and the obliteration of my tidy home. The despot was awakened.
Now I’ve got three. My naive pre-parenting fantasies of happy afternoons of children gathering quietly together after school to play board games, bake biscuits and complete their homework dutifully and with enthusiasm have been dashed. More often than not I am to be found sore-breasted and baggy-eyed berating my boys for their messy rooms, the half-finished homework, the crumbs and food-wrappings all over the sofa and the mess! mess! MESS!
And this is the reality of parenting; small children are messy, they are unpredictable and life with them can be chaotic.
When we resist this, parenting is painful and difficult. As we, using sticks, carrots, and any our other desperate measures we can lay our hands on, try to persuade, coerce, tempt, bully and usually order our children into the narrow expectations we have for them based on our past conditioning.
Underneath our behaviour is the belief that they have everything to learn from us and we have nothing to learn from then. Its a one-way road – and not a peaceful one at that.
The good news is that there is a model of parenting which invites us to do the opposite.
Conscious Parenting suggests that we turn the spotlight back on ourselves. Instead of forcing our children to live up to impossible ideals, resisting how they are and controlling them (because we can), Conscious Parenting asks us, each time, we find ourselves being pulled from our yogic centres, to explore why? Which button in us is being pressed?
Dr Shefali Tsabary who has written extensively on Conscious Parenting says she sees children as our Awakeners:
“Sometimes they awaken us to our tardiness. Other times to our obsessions (whether it is with cleanliness or tidiness), yet others to our anxieties, our need for perfection, our desire for control, our inability to say either ‘yes or no’, our power issues, dependency issues, our marital troubles, our addictions.
Most often they teach us how unable we are to be still.”
It’s so easy to feel bountiful and blissful, wise and insightful when you are lying in sivasana or sitting in meditation – but that’s the easy part. Bringing it home to the dirty kitchen, mountainous laundry pile, squabbling children and crying baby – that’s when we need to be awake. There’s our opportunity for transformation.
And as Dr Tsabaray writes: It is our spiritual obligation to be transformed by our children.
To read more on this fascinating subject why not start with Dr Tsabary’s fascinating book:
The Conscious Parent
www.namastepublishing.com
On an altogether different note, it’s time for our Autumn Oxfordshire weekend yoga retreat.
These yogic weekends co-hosted by myself and Angus at a beautiful Gothic house in Oxfordshire (complete with vegetable garden, resident pigs, woods to walk in and a bonfire and piano to congregate around on Saturday night) are a wonderful way to discover some of the other branches of the yoga tree; meditation, nidra yoga and yoga philosophy. That’s in addition to four hours of yoga per day, silent country walks and the non-obligatory, but very popular, weekend massage.
If you haven’t already joined us, its a wonderful way to discover the retreat experience.
My Saturday morning classes at the Battersea Arts Centre will continue as normal, covered by the wonderful Lee Carter.
With Love
A quite annoying article worth reading
Last week the Guardian Newspaper published a rather humourous article by yoga teacher Sarah Miller whose motivation in writing seems to be purely mischevous. Nothing to promote, no spiritual agenda – just the opposite actually – a rant against some of the more annoying behaviour habits of yoga students and teachers alike.
Some of her observations are ridiculous (I’ve never been in a studio that smells of onions and cat’s pee) but others are well-observed (actually its impossible to miss them) and accurately depicted. She identifies the yogic over-acheivers, we all know them; the ones doing handstand variations when everyone else is bunny hopping. She also identifies the lingering huggers (look out for them), “the ones whose hugs go on all afternoon,” but funniest and most annoying of all she mocks the teachers: the generic yoga vocabulary, the smugness and the determination of yoga teachers to link your lack of flexibility to your retarded spiritual/emotional development.
There is a certain smugness in the yoga world that those who are outside it must find so frustrating. No wonder the Guardian published this piece. Its so cynical – which journalism inherently is – especially about yoga.
Read it for yourself and see:
http://www.guardian.co.uk/lifeandstyle/2011/sep/06/yoga-is-annoying
On an altogether different note, I would like to remind you that my 1.5 hr Saturday morning dynamic hatha class is now open this term so please come on down and join me on Saturday mornings:
11.30am-1pm at the Battersea Arts Centre, Lavender Hill SW11.
Its a drop in class and ten class tickets are also welcome.
I promise not to hug you too long (or below the waist !)
Nadia (the BY blogger)













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