Planning a natural hospital birth? Bill Murray gives his advice to Birth Boot Camp students in Monterey, CA.

My husband is a huge Bill Murray fan. One of the things he does for fun is this for charity:

I am also a fan, but I'm more of a Lost In Translation fan than Ghostbusters. What's important here, is that when my students shared the following story, Eric and I LOVED it. Bill Murray, love, talking about birth... double love! And he actually gave amazing advice! 

Melissa and Dan took my Salinas Spring 2015 class. At the first class they shared that they had just met Bill Murray, and seeing that Melissa was pregnant, he gave them some birth advice. Unsolicited birth advice is usually not very helpful, "Oh you will be begging for that epidural," "You are having a home birth? I would have died if I was at home," "You are pregnant? Let me share my most traumatic birth experience with you!" Rarely do women get practical, positive birth advice from a stranger.

Unless that stranger is Bill Murray.

Bill Murray's advice:

"Bring a fan because Moms in labor get hot."

"Tell everyone you are due a month after your real due date."

"Bring something to hang on the hospital wall to make it look nice."

"Bring night lights because the hospital lighting can be really bright and intense."

Seriously... Bill Murry is moonlighting as a doula. This is the solid advice of a seasoned professional! He is also the father of six boys, but I just can't believe how on it he was with these unique and genuinely helpful tips. I just have to share why.  

"Bring a fan because Moms in labor get hot."
Moms DO get hot, especially in transition. Mom may go from comfortable to intense hot flashes with very little warning so being prepared for those shifts is key. I shared a friend and Birth Boot Camp grad's birth where she suddenly got very hot and her doula had to use her teeth to help her get out of her gown. Another favorite. Be prepared with ice packs, misters, fans, cold drinks and easy to remove clothing.

"Tell everyone you are due a month after your real due date."
The controversial due date. One mom in Melissa and Dan's class actually DID tell everyone she was due a month later than she was. This is brilliant. Normal gestation is 37-42 weeks, but it's not uncommon for friends and family to freak out if mom passes her due date, even though this is totally normal.

"Bring something to hang on the hospital wall to make it look nice."
During a hospital birth, make the space your own. Sights and smells from home can help mom feel safe, lessen anxiety, and stimulate hormones essential to birth. Many women have some anxiety about being in the hospital, making the room look less sterile can help mom relax. Have friends make affirmation flags at your baby shower. Create some birth art while envisioning what your ideal birth looks like. Personalizing your birth space isn't just for mom's benefit, it can communicate to hospital staff that they are entering your sacred space in a very non-confrontational way.

"Bring night lights because the hospital lightning can be really bright and intense."
Yes Bill Murray, you are once again right on! The lighting in a hospital room was designed with hospital procedures and not laboring women in mind. Hopefully during labor there are few procedures being done so turn those lights down and use night lights. Oxytocin, the hormone that causes contractions and creates a feeling of well being for laboring women, works best when mom is in a dark warm space. Humans, like animals, labor best with privacy. Nurses will usually respect a woman's desire to labor in this way, but if lights are turned on partners can turn them down again once the nurse steps out.

I so enjoyed this list. It also appears that Bill Murray also loves babies. The weekend that Bill Murray was in town some of my friends posted pictures of him posing with their babies, interactions he initiated.

Do you have a great Bill Murray or celebrity birth advice story? Please share!

When I hear about a natural birth from a friend or birth professional at one of our local hospitals where natural births feel more like blue moons... there are two questions I always ask: How long was she there? (the answer is usually less than 8 hours) And what position did she birth in? (most women are made to birth on their back there). I plan to keep asking because I TRULY HOPE that one day the answers will change! But for now, when I ask the latter, it's not uncommon to hear "She was pushing upright, or in a squat, and the nurse asked her to get in a lying squat... it all went great!"

The first time I heard this... I needed the doula to clarify... you might need that too...

Are we all familiar with a birth squat? See the picture. This position is one that many women will get into to birth their babies if they have not been conditioned by their culture to lie on their backs. In other cultures it's a position that people use often... you'll see men squatting during their smoking breaks, people waiting at the bus stop in a squat, and they go to the bathroom in a squat. This is a very healthy exercise to incorporate into your day... I pick up toys, change diapers, sometimes watch tv in a squat and I encourage my students to practice often as well. You can read more about the benefits of squatting here, back to the birth squat...

I also share the many benefits of birthing in an upright position. This can be a squat, which opens the pelvis by 30%, or with one knee down for support, on all fours... lots of options. Here is a list of advantages compiled by Giving Birth Naturally, you can see the whole post here:

"Advantages:

• Squatting opens the pelvis by up to 30% compared to lying down (1). (Just that one on its own is good enough reason for me!)
• Squatting is reportedly less painful than lying down. (2)
• Squatting ‘straightens' the birth canal as it helps the pelvic bones to line up, rather than emphasizing the u-turn caused by the lithotomy position or the semi-sitting position.
• Squatting to give birth makes use of gravity. If you think the effect of gravity is negligible, it isn't. Ever had that experience where you're lying down and the moment you stand up you desperately need to pee? That's gravity!
• All of the above help to shorten the pushing phase of labour. (3, 4, 5,6)
• Which means that less oxytocin is required to speed things up. (2)
• Squatting also decreases the need for the use of forceps when compared to the semi-sitting position. (5
• The dangling squat also helps to lengthen the body which can give the baby space to get into a better position.
• Some studies mention that squatting prevents tearing (3, 6), although some mention that tearing rates are the same (2) or higher (4, 7). As mentioned before I think that increased tearing is due to lack of support, as mentioned by the researchers themselves (4), as well as, in my hopefully well researched opinion, incorrect squatting technique (See above).
• Squatting can decrease episiotomy rates. (2, 3, 6)"
  
  

Squatting sounds like a good deal to me! So what is a lying squat and does is carry the same advantages?

When studies have been done on upright vs non-upright birth positions, the non-upright positions included are usually lying flat on the back (lithotomy), semi-sitting, like leaning back in the bed, and side lying. To imagine what a lying squat is if you haven't heard a nurse tell you to get in the position, or heard your client be told to get in the position... take a woman in a birth squat and put her on her back. Or lean her back into the bed.

Imagining it? Oh geeze... what does that look an awful lot like? A woman birthing on her back or in a semi-sitting position...

Friends... the lying squat is just nurses and doctors using our language against us. They are making women feel like they are getting what they want when in reality they are being manipulated into rejecting what their body is telling them to do and doing what is convenient or comfortable for the provider. The benefits that a woman enjoys in an upright birth position are lost in a lying squat! Who cares what the staff calls it! Lets call a spade a spade here ok?

Why aren't an upright and lying squat the same?

A squat is not all about the position of the legs. Even though in these two positions the mom's legs may be positioned similarly... the lying squat (whether with mom fully on her back, or lying back into a raised bed) compresses the pelvis, changing the size and shape of the pelvic outlet. Gravity is no longer on mom and baby's side. Mom will still experience all of the discomforts of lying on her back.

Most importantly... to me at least... the woman is no longer listening to her body. Also, many women who know enough to get into a squat during a hospital birth has most likely done her research and has decided that she does not want to birth on her back... women are vulnerable and highly susceptible to suggestions in labor, shame on every nurse and provider who uses this kind of language to talk a woman out of the birth she desires.

I've noticed some apathy from some doulas on this subject. I don't know why... because it makes me really mad. We are working SO HARD to inform women, give them options, give them the tools and the vocabulary to communicate openly to their providers what THEY WANT for their birth. This is simply a trick to get women to comply without resistance. It's not fair. We need to warn women just as we warn women about breastfeeding "booby traps" put out by formula companies. Lets remember whose corner we are in.

Moms, doulas, birth educators... it's ok to be mad! Let's not be so quick to give up and get on our backs! Saying "Well I/she pushed upright for some of the time." So? Did you/she want to BIRTH upright? If that's was the desire, and it was not allowed, that is not a victory! That is not progress... because YOU/SHE only births that baby once.

So let's not buy into the "lying squat" ok? Let's not be ok with putting women on their backs when they don't want to be there. Lets choose and praise the birth places who consistently support women in birthing how they desire.

Ok I feel better now... thanks for reading guys!

I am a childbirth educator because I love to talk about birth and help couples achieve their birth goals. So when a friend asks my advice on pregnancy, natural birth, or breastfeeding... I love it. I love it just as much as when a couple signs up for my class because for me, this is about the information, not the money or a business, even if those are necessary aspects of this work. However, no matter how many messages we exchange, my friendship and my advice aren't enough to help you have a natural birth.

Natural Birth Requires Commitment
Some couples do zero preparation and still have a natural birth, I'm not denying that it's possible. However, with the social, cultural, and medical obstacles to normal birth couples face today, there's usually a great deal of luck involved when that happens. Commitment can come in the form of the financial commitment of hiring a doula, midwife, purchasing books and taking a birth class; the time commitment of traveling for access to a supportive provider, taking a comprehensive natural childbirth class, practicing relaxation exercises and following up on resources your teacher gives you; and the commitment to take responsibility for your birth by getting the information you need to make informed decisions. In a birth class I provide information that I expect couples to take in, process, and make their own. When you are in the thick of birth you won't remember what I posted about two months ago, it has to be something you have intentionally learned about, in context, and made the information apart of you.

Natural Birth Requires Context
Do you remember what it was like to take a college class? There was an order to learning the subject. Your professor had specific information that came in the beginning of the course, then built upon that information over the semester, and then finally at the end, if you showed up and did the work, you had an understanding of the subject. If your professor just gave you random articles and answered questions as you thought of them without providing context with a structured curriculum, your knowledge of the material would be disjointed and likely inadequate. This is one of the reasons why taking a class is so important. I can't speak for every curriculum, but each of the ten Birth Boot Camp classes play a part in preparing couples for a natural birth. The information is built upon, strategically presented so it makes sense and is easy to learn. Will I withhold information I teach in a class from my friend who asks, absolutely not, but my advice lacks context so it may not be as valuable as it may seem.

Natural Birth Requires Forethought
If you posted or texted me that you are in labor chances are I'll be up refreshing the screen until you post a birth announcement... so calling me at 2am because you need advice isn't an issue. I've answered those calls, I will give it my all every time... but I'm sad to say it usually doesn't help if the couple hasn't prepared beforehand. When you are blindsided by an induction or cesarean recommendation in the final weeks of pregnancy, or your water breaks at the onset of labor but you had planned to labor at home... it's too late to consult google, or me, or that book you promised yourself that you'd read. Now it's happening, your emotions are involved, maybe your provider or partner is playing on your fears and you are questioning everything... but even if you find the right advice for that moment, lacking the reasons behind the advice will make it very hard to follow.

I'm not that doctor who rolls their eyes when someone says "hey can you look at this?" at a party. I love to talk about my work and I want you to ask me questions. But without making the decisions necessary for a natural birth like taking a class and hiring a supportive provider, my advice will not be enough. It sure would be flattering if it was. I hope my rants on social media and blog posts inspire my friends to learn more and take responsibility. I'm cheering you all on from my computer screen!

I posted this to my personal blog when I was preparing for the natural hospital birth of my first baby and I've gone back to reference this list with every pregnancy. With each baby I've added to my list with each baby, and figured out what I don't need (pads, diapers for baby, they'll have that stuff). Many couples preparing for a natural birth plan to leave for the hospital late in labor to avoid routine interventions, which is smart, but sometimes baby has other plans and you may labor at the hospital longer than expected. Come prepared, most hospitals are not equipped to help naturally laboring mothers so what you bring is important. Is there something you found comforting in your natural birth that I left off? Share your story!

October 13, 2009
I've been talking about packing for the hospital like every day for 2 weeks. I got the bag, I got the stuff, I just need to introduce them, but for SOME reason this is hard to do. I guess my laziness is pretty epic right now. I am nearly positive that I will not start packing until I'm in labor... Eric agrees. I just keep thinking, "Well I need to pack this... oh but I might need it, I'll wait." I think that makes sense.

Anyhow how, to create the illusion of progress, I'm going to blog about packing... instead of doing it. I'll pack tomorrow... maybe.

I have two smallish bags, a labor bag and postpartum bag. This makes it much easier for your partner to find whatever mom needs quickly.

In my labor bag I have:
• My birth plan, a few copies
• Tape so I can tape a birth plan to my door
• Birth Boot Camp Field Manual for affirmations
• Something for Dad to occasionally time contractions, there's an app for that
• A pad and pencil to write down questions for staff
• A super comfy robe & slippers
• Something to wear in the tub
• Pillows
• Hair ties and butterfly clip
• Lip balm (deep breathing = dry lips)
• Super soft wash cloth, for sweaty face wiping
• Tennis ball for counter pressure and massage
• Awesome smelling massage lotion or essential oil (fave: peppermint!)
• Hard candies (faves: peppermints and orange)
• Snacks: protein bars (fave: Luna Bars), oranges, drinkable yogurt, honey sticks
• Coconut water (has electrolytes!) and chocolate milk (great recovery drink!)
• Small ice chest (we have one that is a bag) with cold packs, hospital may be able to supply them so ask at the tour. We brought our own.
• Small crockpot and at least 2 herbal rice wraps (one can be warmed in the crockpot while mom uses the other) You doula might have these
• Birthing ball, ok I can't really pack it, but it's coming. You might find the size or softness of the hospital's ball uncomfortable.
• iPod, ear buds, & dock
• Camera & charger
• Cell charger

*If you have hired a doula (highly recommend) she may have a lot of this stuff, so talk to her about what you should bring.

In my postpartum bag:
• Nursing bras and pads
• Jammies
• Leggings (fave: Secret Belly Leggings)
• Slippers (in case the others got wet)
• Cute sweatsuit set for going home
• Contacts & contact stuff
• Toothbrush and toothpaste
• Travel shampoo, conditioner... etc
• Make-up, brush, hair dryer and straightener (yes, I use them)
• Razor
• Mirror to put on bed tray, so I can get pretty in bed
• More snacks! Breastfeeding moms are hungry!
• Change of clothes & toiletries for Dad
• Going home outfit for baby
• Receiving blanket
• Laptop, in case we have a long stay

Well, those are my favorites! Please share yours!

A birth plan for couples planning a natural hospital birth can be a double edged sword. It is a great tool to help you and your partner decide what interventions you want to avoid, who will cut the cord, etc. It's a great way to organize your wishes and begin a discussion with your provider about them.

However, a birth plan can also give couples a false sense of security. Some couples think that their birth plan is a shield that will protect them from unwanted interventions. Unfortunately that is not the case. Think of your birth plan as a list of requests. You may get everything, you may get nothing, in most hospitals you will probably get some requests honored, and that mostly depends where you are birthing and who is attending the birth. This uncertainty is scary for most couples, as it should be! So what are couples planning a natural hospital birth to do?

Learn Your Options
Don't google "natural birth plan" and just copy what you find online. You need to learn your options, the reasons behind hospital interventions, and what alternatives are available. The best way to do that is with a natural birth class. A weekend course will not give you enough information if you are planning a natural birth. One thing you will learn in a comprehensive class will be the impact each intervention has on birth. Instead of just writing "no IV" and hoping for the best, your childbirth educator can give you concrete suggestions on how to avoid this intervention without fighting with the staff. No mother should have to fight while she is in labor!

Make a Plan With Your Partner
Sit down with your partner and figure out which options are important to you. Once in labor, mom will need to focus on being relaxed and open, so it's important that dad knows mom's wishes and can advocate for her.

Take Your Plan to Your Provider
Do this early! Not at 37 weeks... as early as it occurs to you that you want a natural birth. Pay close attention to your provider's reaction and be prepared to switch. Just because you have liked your provider up to this point does not mean they will be supportive of your desire for a low intervention birth, which may be inconvenient for them or make them feel vulnerable to malpractice suits.

Listen to what your provider says and how they say it. If you want freedom to birth in whatever position is most comfortable and your provider says "well you can push standing on your head for all I care," that is not support! That is sarcasm. They are not taking your wishes seriously and you should not expect to be respected any more than this in labor. If your provider is skeptical or unsupportive, then there is a very good chance that once in labor, your birth plan will not be respected, or even looked at.

Consider switching, it may feel awkward, but I assure you, he or she will probably never think about you again and the switch can be done without ever telling them face to face. Just find a supprotive provider and have their office call for your records. Contact your local Birth Network or ask your childbirth educator about providers that are supportive of natural birth. Your birth plan should help you find a provider that will help you achieve your desired birth.

Choose a Supportive Practice
If you have a supportive provider, make sure that if they rotate call with a team of other providers that they are also supportive of natural birth and mother-friendly care. If your doctor agrees to intermittent monitoring, even signing your birth plan and putting it on your chart, but the on call OB is uncomfortable with it because they are ignorant of the research on intermittent monitoring or because of malpractice fears, then there is a good chance you will be monitored continuously. If you are in an unsupportive practice then the thought of finding a whole group of providers that believe in natural birth may feel daunting, but they do exist! Getting the "wrong" doctor in a practice can be the difference between the natural birth you desire and a c-section.

Take Your Plan to Your Hospital
Sometimes your provider may be supportive of your birth plan, but the hospital is not. You will not be able to change hospital policy with your list of requests. Take a tour, bring your plan, and instead of asking if the hospital will "let" you do what's on your list, see if their standard policies match your desires. Is it standard that babies are given right to mom after the birth? Or is it standard that they are taken to a warmer and brought to mom later? Even if they say they will bring the baby to you, though it's not standard policy, there is a good chance that the nurses will forget and whisk your baby away, because that's what they do for every other birth. If it's hospital policy that once your water is broken you have only 12 hours until you are given a c-section, even if you are strong willed and plan to refuse it, It can be an impossible battle to fight in labor. Doctors and nurses can be very persuasive, especially if they bring up a possibly dead baby.

Use your birth plan to find a hospital that is used to accommodating naturally birthing mothers, otherwise a day that should be beautiful might be filled with conflict and disappointment. Keep in mind that a hospital is a business and they want you as a customer, they may initially tell you what you want to hear. Be a very skeptical consumer and shop around. It is not unreasonable to travel 30 minutes to an hour for a supportive hospital.

Can't We Refuse?
In a hospital nothing can be done to you without your consent, so why can't you simply refuse to lay in the bed or to get an IV? Well, you can, but you probably won't be able to stick to your guns in labor, or continue to labor while sticking to your guns.

A laboring woman requires a safe, peaceful environment for the hormone that causes effective contractions, oxytocin, to flow. Conflict may cause an adrenaline rush which inhibits oxytocin. Labor may stall, so mom may need Pitocin to start labor again, but then she will need an IV, continuous monitoring, maybe an epidural to cope with being confined to the bed and the stronger "Pit" contractions.

Conflict will also cause her to be tense, making contractions much more painful, causing her to likely need chemical pain relief. The fight itself ends up robbing her of the natural birth she was fighting for.

You are also not the first couple to refuse an intervention that the hospital staff truly believes will help you birth more safely. They know exactly what to say to change your mind. And remember, mentally you will not be where you are right now reading this, you will be in a very vulnerable state.

Another possibility is that you will never be given the opportunity to refuse. My first birth plan was 2 pages of "we do not consent to..." Like many other couples we believed it would protect us in a hospital that was not supportive of natural birth. The on call Dr. did not look at it and broke my water before I even knew what he was doing. Once my son was born, they cut his cord immediately, even though we asked for delayed clamping and for my husband to cut the cord (they let him trim it later, very anti-climactic). This is not uncommon.

Keep It Simple
Once you have chosen a supportive provider and birth place, keep your plan simple and easy to read. One paper posted on your door with a "yes please" and a "no thank you" column will be just enough to remind the staff that you are having a natural birth. I love these visual options some couples are choosing.

Promise: Indication of something favorable to come.

Affirmation: Something declared to be true.

Faith: Trust, hope and belief in the goodness or trustworthiness, of a person, concept or entity.

Most of us have truths we lean on in life. When it comes to birth, these are my scriptures and my marriage vows. They are promises that I feel have earned my faith in and inspired my passion for birth. I thought I might revisit them as we wait for our third little one to choose his or her birthday, and share them here with you

 "We are made to do this work and it's not easy... pain is part of the glory, or the tremendous mystery of life. And that if anything, it's a kind of privilege to stand so close to such an incredible miracle." - Simone in Klasson 2001

"And the courage that she showed, the endurance, the sheer power of getting through contraction after contraction, I was just so inspired, so touched to be so close to something so primal and raw and vulnerable as she was during those hours, so thankful that she let me be a part of it. And I knew I would never be the same person after having witnessed it. I got home about an hour later, my face a mess of tears and snot, and told Jon, 'I can't wait to give you what that birth just gave me.'" - Heather Armstrong, blogger, dooce.com

"Woman really doesn't need to be rescued, it’s not the place for the night in shining armor. It’s the place for her to face her darkest moment and lay claim to her victory." - Cara Muhlhahn, Certified Nurse Midwife, The Business of Being Born

“It is as great a crime to leave a woman alone in her agony and deny her relief from her suffering as it is to insist upon dulling the consciousness of a natural mother who desires above all things to be aware of the final reward of her efforts, whose ambition is to be present, in full possession of her senses, when the infant she already adores greets her with its first loud cry and the soft touch of its restless body upon her limbs.” - Grantly Dick-Read, Childbirth Without Fear

"...for that half-minute before birth I held her hands and for that duration we three were undivided." - William S. Wilson

“Remember this, for it is as true and true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.” - Ina May Gaskin, Ina May's Guide to Childbirth

“How you approach birth is intimately connected with how you approach life” - William Sears, The Pregnancy Book

"Nothing compares to the privilege of giving life and the responsibility of that. Nothing. So if you don’t have the reverence and respect for that, where do you go from there?" - Nadine Goodman, public health expert, The Business of Being Born

“The power and intensity of your contractions cannot be stronger than you, because it is you.” - Unknown

"Birth is not only about making babies. It's about making mothers; strong, competent, capable mothers who trust themselves and believe in their own inner strength." - Barbara Katz Rothman

"Nature is kind, and always gives breaks." ~ Dr. Robert Bradley, Husband-Coached Childbirth

Being born is important
You who have stood at the bedposts
and seen a mother on her high harvest day,
the day of the most golden of harvest moons for her.

You who have seen the new wet child
dried behind the ears,
swaddled in soft fresh garments,
pursing its lips and sending a groping mouth
toward nipples where white milk is ready.

You who have seen this love’s payday
of wild toiling and sweet agonizing.

You know being born is important.
You know that nothing else was ever so important to you.
You understand that the payday of love is so old,
So involved, so traced with circles of the moon,
So cunning with the secrets of the salts of the blood.
It must be older than the moon, older than salt.
          - Carl Sandburg, "Being Born is Important"

And I thought I'd share one of my favorite birth videos. I love the joy in Whitney's voice when she lifts up baby Austen, and her midwives words:
                 "This is it. She's chosen this birth. She's chosen this birth."

Last year I ran my first half marathon (13.1 miles). I had never run more than 6 miles, but 8 weeks after Ash was born and 12 weeks before the race, I signed up. I googled "half marathon training," picked out a schedule at random, bought some shoes, and hit the roads. A few weeks into training I was experiencing a lot of hip pain, but running hurts right? I pressed on. I lost 3 toe nails, nursed blisters, battled numb toes and endured persistent ankle, knee and hip pain. Race day came and 6 miles in I had shaved a full minute off each of my mile times, 7 miles in I realized I had made the novice mistake of not pacing myself properly. I was too low on energy to effectively take on the hill the stretched from 6.5-8 miles and had to walk.

My goal had been to run the whole thing and to finish in under 3 hours. I finished the race in 2 hours and 48 minutes. I should have just been happy with the end result, but I was unsatisfied with the experience and felt ill aftwards so I wasn't able to really celebrate with the other runners. No one told me it was essential you don't drink just water during the race and I was nauseated and dizzy. There were so many things I could have done to improve the experience and perhaps even the outcome if I had sought professional guidance before hand.

If I were a gazelle, this would have been no problem. Animals that are meant to run go from womb to ground ready to get their legs under them. A coach doesn't circle around giving tips, they just know. Just as soon as little ducklings crack through their eggs and dry they are ready to hit the water, mom is not lining anyone up for swimming lessons.

For my second half marathon I signed up for a 12 week training program. Under the guidance of skilled coaches I experienced fewer injuries, improved my performance, and I gained a toolbox full of solutions for common running challenges. I completed my second half marathon 13 weeks pregnant, improved my time by 20 minutes and felt GOOD afterwards. Honestly, it's amazing I finished my first race at all considering how uninformed I was! I can make a similar comparison with my first and second birth!

It's scary that something as important as giving birth is our responsibilty to learn, but we are well prepared for the task. Before birth moved to hospitals, women taught women to birth. Daughters grew up comfortable with the normal processes of labor, perhaps even attended the births of her siblings. 

The fear of the unknown, of what happens behind those sterile doors, did not exist. She saw skilled women bring babies into the world safely and women working hard, perhaps experiencing pain, but she saw that women's bodies were capable (yes women died in childbirth, but not necessarily because they were at home or attended to by women).