Dear Rachel,
Thanks for coming to my mail box.  When I stay off line for a couple of
days and get bombarded with days of reading.  Let's see if I can stick to
one letter & finish it at one sitting.  I know I owe a few notes to
others.  Hang in there.  I just lost my SIL to cancer.  Same age.

<original
Don't know if you saw my post in response to yours on Lactnet, but I am
curious about the source of your statement about squatting position for
birth in Sweden.  As I am a midwife in Norway I am always interested in
how
the rest of the world perceives Scandinavia.  It seems that Scandinavia
appears to be one united front from the outside, while there are
remarkable
differences between the countries despite our huge amount of common
ground.
Examples: strong, uninterrupted midwifery traditions in all countries,
but
nursing as minimum entry level in Norway and Sweden and direct entry only
in
Denmark; extensive involvement of midwives in all antenatal, postnatal
and
gynecologic care in Sweden, and almost no midwives in Norway doing
anything
but antenatal and intrapartum care.
There are more, but I need to help my son with his French homework!
regards
Rachel Myr
>Original>
Date:    Tue, 10 Oct 2000 18:37:16 +0200
From:    Rachel Myr <[log in to unmask]
>
Subject: deliveries and deliverances

I knew I shouldn't get back on yet, haven't even reached bottom in the
snail
mail pile after a week away, but this is so much more fun.
The word deliver in obstetrics has nothing to do with delivery of
freight.
It is used in the archaic way, meaning deliverance, such as 'deliver us
from
evil', and it is the birth attendant who delivers the mother.  She is
delivered of a child, or children in the case of multiples.  If she
doesn't
need help, she has delivered herself of a child.  The baby is not 'goods'
in
this use of the word.  And yes, I know it is universally used in this
incorrect way in North America, but that doesn't make it any more
correct.
I believe that language matters, and especially language about what
happens
to us and our children during their births.
There is a brilliant book called 'Delivered at home', written a few years
ago by Julia Allison, (former ?) General Secretary of the Royal College
of
Midwives in England (ISBN 1-5659-3352-4).  I resisted reading it for a
time
because I didn't like the allusion that women who gave birth at home were
delivered by anyone.  But when I finally read it, I learned that she
chose
the title from the birth logs of the Nottingham district midwives of the
time, and she interprets it in two ways.  They were delivered of their
babies at home, and they were delivered from the necessity of hospital
admission by the availability of a district midwifery service which by
the
way, had excellent statistics and results and continued to provide their
safe, woman-and-baby friendly care to the majority of women in Nottingham
until the 1970's when a number of other factors combined to make hospital
birth more common.  Women 'delivered' at home were generally poorer, less
healthy and less well educated than those who went into hospital, and
their
breastfeeding rates were consistently higher, another reflection of the
excellent care given by the midwives.

Phyllis wrote that most Swedish women are now delivering themselves in
the
squatting position, unless I have misunderstood her post.  Phyllis, what
is
the source of your information?  Most Scandinavian women have freedom of
movement throughout labor, but I am not aware that squatting is
particularly
preferred in Sweden, and in fact thought that kneeling or all fours was
more
popular.  But there are still plenty of midwives practicing who work in
the
bad old-fashioned way, woman in semi-reclining position with legs in the
air, unfortunately.  Even so, the babies manage to get breastfed.  It
isn't
just one thing that matters.  Where the whole society is committed to
breastfeeding, it takes a lot more to foil it.

Anyone else want to climb on the soapbox?  I think I've said enough for
now...
Rachel Myr
back in Kristiansand, Norway listening to autumn rainstorms at my window
and
wishing we had just a little of the Aegean weather here too.

<original>
 "With the intervention of epidurals & other meds. a woman can not
deliver in a natural squatting position where her pelvic area would be
opened 20 - 30% wider.  (This is how most Swedish women are now
delivering their own babies again with virtually no episiotomies either.)
"

Dr. Lennart Righard in his talk, Optimal Birth & Successful Breastfeeding
10/15/99 in Lawrence, MA , he discussed how less intervention results in
quicker latch on & more BF initiation & duration.  He mentioned how the
upright squatting position did indeed open pelvic bones 20 - 30% wider
and showed pictures of many women up on beds able to get into this
position because they weren't having epidurals & medical interventions
(fetal monitoring, etc.) (Sorry if I used the word "most' when 'more'
would have been accurate in your opinion, Rachel.)  He wanted to point
out that by being flat on one's back isn't a natural birthing position as
is seen mostly in this country.  There is less pain because the woman's
own pain killers works with her as the natural stretching process of
birthing unfolds.  Even large babies fit through the birth canal, without
episiotomies!  They don't tell our moms that other countries do it
differently & they don't rip.  (Anyone who sews knows that a little snip
makes it easier to tear material.)  If the mom wasn't on her back gravity
does much of the work.   And from what I've been hearing on this Net & in
Doula class, without IV's for hours on end the babies wouldn't be born
all puffed up by fluid shift.  Women would prefer drinking water to
having an IV IMO.  If US women were given all the information about
birthing many wouldn't be afraid and take a chance on natural positions
VS flat on the back.
He showed us the optimal birthing process, giving us hope that it could
take off here, someday.  He did mention how mostly midwives were in
attendance at birth, which sounded wonderful!  Many of us here in the USA
have only seen movies of women in 3rd world countries giving birth in the
bush.  Some recoiled at the thought of having a baby in such an
unsanitary environment and feared that the baby would drop on his head
and be dammaged or something.  Others thought, cool, that looks quick &
easy.  Being into SCUBA I'd opt. for a water birth.  But, back to
reality, hospitals here don't go for that simplicity.  Maybe the
insurance companies should compare costs & see if your way could $ave
them.
Personally, I was never told anything about delivering, 37 years ago.  I
wanted natural but my wishes were blown to dust & I was given something
to make me sleep.  I missed the whole thing!  And the episiotomy & tubes!
 Well, if I had only known about that from an honest person before hand,
I would never had gone to a hospital to birth I can honestly say.
Probably why I'm obsessed in telling moms in my BF class.
Having the freedom to move about during labor it is not always allowed
here where it is implied that your baby could be in trouble if monitoring
is not done.  Makes it easier for fewer personnel to keep an eye on more
moms in labor. (The bottom line) I am impressed how it's done in
Scandinavian countries.
One thing I wish you would also comment on is the maternal leave
Scandinavian countries have.  You have it all over the US.
I'd also like to know if your countries have always so pro. BF or have
you all had the same switch to bovine based formula at any time?
Regards,
P.Harris-Swenson, MA, IBCLC, Doula in training
Nutritionist & BF Coordinator
Still behind '69 spring cleaning & Lactnet mail!
Lowell, MA  USA
cc:  RM
cc:  Lactnet

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