Why “Call The Midwife” is so accurate

Terri Coates is an experienced midwife who advises the production team for the

BBC TV show.  She also draws on her relationships with retired midwives and

doctors who worked during the late 1950’s and early 1960’s, when the show is set.

The birth scenes are simulated, but they’re so well done that many viewers assume

that they’re real.

The show (based pretty closely on the memoir of midwife Jennifer Worth) has vastly

increased the number of students applying for midwifery training, because it

highlights the inspiring combination of skill, teamwork, and compassion that the

profession requires.

Those of us who critique media portrayal of childbirth are thrilled by “Call the

Midwife.”  Plus…don’t you just love Chummy?

Read about Terri Coates in The Guardian

Skin-to-skin for all births, cesareans included!


“This feels so good – is it even legal?” I routinely embarrass my adult children by talking about the life-changingly blissful experience of having them placed on my naked chest at the moment of birth.

After the intensely hard work of each labor, a warm, wet, wiggly, complete human being came out of my body (wow!) and nestled under my chin. Somebody put a blanket over us, and my body helped my babies thermoregulate to a perfect 98.6.

The midwives did the newborn exam without taking my babies from my arms – it was a gift that I will never forget. Together, the babies and I figured out breastfeeding, just like puppies and kittens and orangutans do.

Then they peed on me and pooped on me, and I still loved them. That’s a life-changing experience right there.   I was, in fact, thrilled to see that their little bodies worked so well.

Now, decades later, scientists at the World Health Organization and UNICEF are recommending “SSC” (immediate skin-to-skin contact) following all vaginal births, and as soon as the mother is alert and responsive following cesareans.

There are some small measures recommended to ensure that this ancient mammalian behavior is safe: making sure the baby’s nostrils aren’t buried in the mom’s flesh (duh), and keeping a watchful eye to make sure the baby’s getting off to a good start. Other than that, there’s no potential “downside,” and SSC facilitates bonding, breastfeeding, and mother-infant communication. It may lower mothers’ perception of pain, and mitigate their “depressive symtomatology,” especially post-cesarean. Clearly, it makes both mothers and babies happy.

It’s gratifying (even though it seems like such a no-brainer) to see some hospitals implementing routine SSC for vaginal births. I watched one nurse’s face the first time she witnessed SSC when it was a brand-new policy where she worked – there were tears of rapture in her eyes.

But what about cesareans? It’s trickier to implement SSC in the operating room, mostly because the staff needs to be trained to support it, and an extra nurse might be required. This blog is based on an excellent 2014 survey article in Maternal and Child Nutrition, which also includes a set of “How-To’s” for medical staff. There are also wonderful videos about the importance and the logistics of supporting SSC here.

Cesarean birth is considered essential in a maximum of 10-15% of births (according to the WHO). But the cesarean rate in the US is currently around 32% (compared to less than 5% in 1965). That means that there are a whole lot of medically unnecessary surgical births.

Advocating for post-cesarean SSC is not an endorsement of high cesarean rates. But it is a humane and medically sound recommendation, so that all babies (medical conditions permitting) might have the opportunity for this primal moment, and all mothers might have the opportunity to embarrass their children as I do.


More at www.birth-media.com.


Building A Resilient Brain: How Early Parenting Makes A Lifelong Difference


As a baby’s brain develops, neural connections strengthen – or shrivel up – depending on interactions with adults. These early connections form the foundation for all future learning, affecting intelligence, behavior, social skills, and health.

When adults make eye contact and engage with babies, reflecting and responding playfully to babbling, facial expressions, and gestures, neural connections grow. When adults fail to respond reassuringly to babies’ stress, neural connections break down.

When you take plenty of time to play with a baby, and when you make sure a baby feels loved and comforted in times of stress, you’re doing more than cooing, cuddling, smiling, and mirroring each other. You’re building a strong foundation for a growing brain.

Amazon messed me up!

Amazon messed me up! So I haven’t been able to sell my film for 4 months. It’s a long story (which I will describe below in case any other filmmakers are having the same problem) but meanwhile…if you tried to rent, download, or purchase the film and it didn’t work, try again by clicking “order the film” above.  THANKS!

If you care, the problem was that back in September, Amazon decided that sellers now need to apply to sell DVD’s that are purchased from a distributor, or that have a MSRP of $39 or so, as I recall. While my DVD price has always been $19.99, Amazon’s default MSRP for all DVD’s is $39.99. To find that setting, you have to go to Details, and then to MORE Details, and scroll down to MSRP. Since I wasn’t born knowing that, and they didn’t tell me, it took a while to figure out what was wrong! The good news is that they call you back right away. You might be on hold for a while, but they are more responsive than I had hoped.

East Bay Community Birth Support Project Indiegogo Campaign

I just contributed to the official launch of the East Bay Community Birth Support Project Indiegogo campaign. It’s a beautiful program training doulas of color to support moms in ALL communities. Doula trainings can be expensive, and this program removes one barrier!

This program in California could be replicated anywhere. May it be the start of a movement!

There’s a lovely video and donation info here. It’s easy! Any amount helps!

Childbirth Education Essentials workshops in November

“Childbirth Education Essentials,” a one-day workshop for experienced childbirth professionals and enthusiastic newcomers, will be offered twice next month: in Northampton, MA on Sunday, November 2, and in Jamaica Plain, MA on Sunday, November 16. The workshop runs from 9am to 6 pm.

It’s a practical and inspiring introduction to teaching about birth in any setting. The material is global and local, a mix of art, science, business, and joy.

Instructor Vicki Elson, MA, CCE, CD has worked with pregnant people for 32 years, including teaching community classes, working with incarcerated moms, training childbirth educators nationwide, and offering labor support in many settings. Her award-winning film, Laboring Under An Illusion: Mass Media Childbirth vs. The Real Thing, is popular worldwide.

In the interest of making high-quality childbirth education accessible to every pregnant person, the workshop costs only $150, including a workbook full of ideas, articles, and handouts, and a DVD of Vicki’s film. The optional childbirth educator certification process (online or by mail) is only an additional $100. Details at www.birth-media.com. Click on “For Birth Professionals/ Students.”

To enroll, email vickielson@gmail.com with your name, phone number, email, and a note describing what you want to get out of the workshop. Payment is due on the day of the workshop.

Please bring your lunch, snacks, and beverages (sharing is encouraged). If you’re new to the world of childbirth, please read Pregnancy, Childbirth and the Newborn by Simkin and/or Our Bodies Ourselves: Pregnancy and Birth before the workshop. Quiet sleepy little babies are welcome, but since we’ll want to stay focused, older children should have other arrangements.

Healthy Birth Practices vs. Reality

Experts agree on what “healthy birth” requires. But what’s really happening?

This article by Sharon Muza from Science and Sensibility compares the well-respected Lamaze Healthy Birth Practices with the realities reported in Childbirth Connection’s 2013 Listening To Mothers III Report, a survey of 2400 U.S. mothers.

My notes below are just to pique your interest. Take a look at the original article for details.

Healthy Birth Practice 1: Let Labor Begin on Its Own

Only 69% in the study did not induce labor medically.

Some of the reasons for induction:
30% wanted their pregnancies over with, or wanted to control the timing of the birth.
16% were induced for a suspected large baby — but the average weight of these babies was less than 8 lbs.
18% were induced for being “overdue” — but the average gestational age of these was less than 40 weeks.

Healthy Birth Practice 2: Walk, Move Around and Change Positions in Labor

Only 43% walked around after being admitted to the hospital.
Only 40% used movement or position changes as a form of non-pharmacological pain relief.

Healthy Birth Practice 3: Bring a Loved One, Friend or Doula for Continuous Support

99% brought support! Hooray!
6% used a doula.
75% knew what a doula is, and of those, 27% wished they’d had a doula.

Healthy Birth Practice 4: Avoid Interventions That are Not Medically Necessary

87% had at least one of the five big interventions (attempted labor induction, epidural, pitocin augmentation, assisted delivery with vacuum or forceps, or cesarean).
60% had at least two of the five.

(Of course, interventions are necessary in some cases, but there is no evidence suggesting that they are needed in the majority of cases, nor would our species have survived if that had been the case.)

Healthy Birth Practice 5: Avoid Giving Birth on Your Back and Follow Your Body’s Urges to Push

68% birthed on their backs.

Healthy Birth Practice 6: Keep Mother and Baby Together; It’s Best for Mother, Baby and Breastfeeding

Only 47% of mothers had their babies in their arms within the first hour.
49% of mothers who stated that they intended to exclusively breastfeed were given formula samples or offers.

So, parents, care providers, and policymakers, the take-home here is that we still need to do our homework so we can make better informed evidence-based decisions. As for me, back to fear-busting!

Vicki Elson, MA, CCE, CD

“Orange is the New Black” : Predictions for New Season

Filming is complete, but there’s still no release date for Season 2 of the acclaimed Netflix series “Orange is the New Black.” It looks like we’ll have to wait till mid-2014.

What are your predictions? I have zero insider information, but here are mine anyway!

1. The show will continue to make jail look much more entertaining than it really is. That’s show biz!

2. There will be even deeper exploration of many diverse characters and their backstories. This is the glory of the show. Audiences will grow more compassionate, and the millions of incarcerated Americans won’t seem so much like faceless strangers.

3. The “war on drugs” will be evident as a major player in characters’ stories. Their stories will explore its abject failure in terms of preventing drug abuse, and its huge success in terms of generating profits for both drug dealers and corporate prison-builders.

4. A pregnant character will have a hard time with jail food and bedding. She will get in trouble for squirreling away extra cartons of milk. Her family will be unable to put money into her telephone and commissary accounts.

5. As in the first season, homeless characters will return to jail because the food, bedding, safety, and health care are better than the streets. (The show was filmed before the recent slashing of food stamp / SNAP cuts — perhaps Season 3 will see hungry people committing crimes so they can eat jail food.)

6. There will be a birth scene that explores the issues that incarcerated mothers face: lack of contact with family, strip searches, shackling, the presence of an armed officer during labor, and the excruciating moment of separation from the newborn. Perhaps some characters will gently support the mother throughout this ordeal. (In real life, that’s what prison doula projects are for. But there are only a handful of us nationwide so far.) Perhaps the new mother will endure abrupt methadone or subutex withdrawal once the baby is born, and perhaps she will be placed in segregation during that time. Perhaps the baby will go to intensive care unit to be treated for neonatal abstinence syndrome.

7. There will be more exploration of what happens to the children of incarcerated mothers. We saw just a bit of that in Season 1 (Sophia’s son), and in Season 2 we’ll see babies, toddlers, and teens cope with various custody and visiting arrangements.

8. There will be at least one professional, skillful, and ethical corrections officer who isn’t eaten alive by incarcerated women, colleagues, or the show itself. This humane character will explore the personal and professional challenges of working with a population so disproportionately affected by trauma, abuse, oppression, and poverty, in a setting that is by definition yet another trauma. She will explore the purpose of incarceration: rehabilitation? punishment? revenge? She will embody the highest standards of safety, respect, and healing. She will be skeptical of liars, sensible about prison politics, and sensitive to the hidden emotional agendas of everyone she encounters.

Oh, wait, that would be if the Betazoid empath Lt. Commander Deanna Troi left Star Trek for Orange. I always liked her.


These CRANKY KID suggestions are great, but:

A. They left out PROTEIN, which in my experience is #1.

Hypoglycemic kids (and adults) are no fun and can’t think straight. My daughter’s first sentence was “Amy protein now!”

Desperate? Float a wooden bowl of cottage cheese and applesauce in the bathtub. Name it “Fun.” Shovel it in to their little mouths while asking, “Who wants to have some more fun?” Applesauce brings up blood sugar fast, while cottage cheese does the protein trick.

Everybody needs protein mid-afternoon. Why don’t we know that? After school, kids think they need carbs, but they need cheese, nuts, or whatever slab of protein you can get into them.

B. Sitting and bouncing on one of those big exercise balls while holding your baby or toddler is really fun and makes everybody feel better.

C. If you must take a drive to calm a child, please consider whether burning fossil fuels is in your child’s best interest in the long run.


The Three Parts of Pain

The Three Parts of Pain

Long after my last baby was born, I learned that childbirth is not the worst pain a

person can have.

After a surgical mishap, I had two weeks of relentless pain. I used heavy medicines,

which helped a little but made me so stupid I almost forgot to keep breathing. I even

demanded an epidural just to get a break from it. The epidural didn’t work.

I had plenty of time to think about pain then. I discovered that there are three parts

of pain, which I named…

1. Feeling: the actual physical sensation

2. Figuring Out/Fixing: the search for meaning — what is this telling me? what

should I fix? what should I be doing differently?

3.Fear of the Future: the worry that it will get worse or go on forever — or both.

Of the three parts, I had no control over the Feeling, but Figuring Out/Fixing and

Fear of the Future were just thoughts, and therefore I did have some control

over them. I relied on my loved ones to help me through, and they made all the

difference. I was not alone, they held my hand, and sometimes they told jokes.

I hope that this might help somebody through childbirth or other challenges. In

labor, the Feeling is just there, but there’s nothing to Figure Out or Fix. It’s a normal,

natural process.

As for Fear of the Future, it’s really helpful if your labor team can help you stay

in the present moment – if you’re thinking about all the labor that you’ve had,

and what’s still to come, it’s too much to wrap your mind around. What’s in this

moment, and this one, and this one, is not nearly as scary as your worries would

have you believe.