For several months, I’ve heard the legend of Dr Robert ‘Dr Wonderful’ Biter. There’s even an ‘I love Dr Biter’ Facebook group. Being a natural sceptic I reserved judgement until Thursday night, when I volunteered at Mamafest, San Diego. He arrived fashionably late and seized the stage with a powerful, heartfelt address to the mothers and birth aficionados present. And then I saw what the fuss was about. Here was a charismatic man with something deeply important to say and alluding to horrifying oppression.

I don’t want to paraphrase and I didn’t take notes, but the message I received is that birth is sacred: Women have a special and wonderful power in birth. And it is being stolen from them. Dr Biter blamed fear. Fear and anger. Charitably, he didn’t blame greed, but I would guess that greed is the third culprit in this cruel trinity.

Dr Biter’s patients leave dazzling testimonials. He gives them choice in how they give birth. He doesn’t railroad them into unnecessary caesareans or pump them with artificial hormones to force or urge on labour. Others allow fear to overrule choice. Birth cannot be micromanaged and risk can never be erased. Too often, meddling introduces new risk.

Dr Biter gives his patients time and allows their bodies to work. He has never had a malpractice suit against him.

Yet he has now lost his privileges to deliver babies at Scripps Encinitas hospital. This was the reason he was late to Mamafest. He had to meet with lawyers. He truly is being oppressed.

Why? Well, the reason is confidential. But there are many questions. Is it because he doesn’t bring enough revenue in through unnecessary caesareans? Is it that other doctors are losing their patients to ‘Dr Wonderful’? Is it simply that he makes others look bad because he shows faith and confidence in his patients, treating them as intelligent, incredible humans who are capable of birthing their own babies, while others see birth as a process which requires intervention and management to work?

Shinemama has thrown away scepticism because all I heard from Dr Biter was sense. And in the last two days, I have heard he is willing to work unpaid as a doula to his existing clients at another hospital. A doctor working as a doula! Where others would let ego get in the way, this is a man who has put his patients first.

So I joined more than a hundred others outside Scripps Encinitas this Mothers’ Day morning to rally in support. Present were Biter-delivered babies, birth professionals of all stripes and people who recognise injustice.

Scripps Encinitas remain silent.

Support birth choices. Support doctors who support birth choices. Support Dr Biter.

Facebook has threatened the fantastic lactivist group Hey Facebook, breastfeeding is not obscene! with closure for ’sexually explicit’ pictures – yet nowhere in law could the pictures posted meet with the definitions for explicitness.

With a quarter of a million members making this one of the strongest and devoted Facebook campaigns, plus dozens of other pro-breastfeeding groups, it is absurd that such adolescent threats can pop up in an otherwise savvy corporation.

The irony is that Facebook could not even ask a breastfeeding woman to move from the sidewalk outside their building, such is the strength of legal protection for breastfeeding in California where both Facebook and Shinemama are based.

I’m tempted to take a trip to Palo Alto to sit out there myself and breastfeed. Time for a nurse-in?

Breastfeeding and natural birth are emotive subjects and sadly surrounded in controversy.

These two subjects trigger all kinds of feelings in women and for those who wanted to breastfeed or who wanted a ‘natural’ delivery but did not succeed, for whatever reason, those feelings are often tinged with deep sadness, regret and guilt which can contribute heavily to postnatal depression.

This poses a great dilemma for educators. We are charged with not building up ‘unreal expectations’

Why natural birth is ‘difficult’

In American hospitals, the chips are stacked against anyone wanting a delivery without interventions as labour without augmentation with pitocin (artificially increasing the intensity and regularity of contractions) is increasingly rare. The spiral of interventions is fast and furious. Pitocin often makes contractions unmanageable by the body’s own hormones, which makes epidural pain control essential, which restricts the body’s ability to push and the woman’s ability to move and remain upright.

Why breastfeeding is ‘difficult’

Similarly, breastfeeding is challenged by unfair tactics – caesareans make breastfeeding more difficult, criticism of bedsharing threatens one of the most natural ways for you and your baby to share closeness, triggering hormones which aid milk production and more subversively, marketing of formula milk (free samples on the labour ward for example) hints that it is condoned by medical professionals, that it is just as good as breast milk. Most critical of all is the lack of support. Few of us are lucky enough to have experienced family around us who can help out with breastfeeding. Not enough professional breastfeeding counsellors are available (although the NCT in the UK or La Leche League in the US are always great places to shout for help with breastfeeding if you need it!) and maternity wards are understaffed – they simply don’t have the time or resources to give every woman the support she needs to breastfeed. According to the USA’s CDC figures for 2003, 71% of women tried to breastfeed in hospital. By 6 months, only 36% of women are still breastfeeding at all and only 14% still breastfeeding exclusively. Figures for the UK Office for National Statistics 2005 are worse, showing only 35% of women exclusively breastfeeding at one week and only 3% at five months.

The World Health Organisation recommends breastfeeding until two years and exclusive breastfeeding up to six months.

It’s a gloomy picture isn’t it? And for educators teaching to a hospital curriculum, the challenge is nearly insurmountable. How can we tell women they can have the birth they want and feed in the way they want when the odds are so heavily against them? Aren’t we just setting them up for failure? Isn’t the guilt just compounded when we teach that bottlefeeding increases their baby’s risk of SIDS or leukemia.

Can you plan for birth?

One argument I come across is that birth is ‘random’ and that birth plans are frequently laughed at by hospital staff. “The one way to jinx your birth is to write a plan” they say. Well, while it is true that birth can be unpredictable, it’s not the same as saying that it is completely out of control. A percentage of births are easy – labour is relatively short and the baby comes without too much effort. Another percentage of births are very difficult. No matter what the mother or the staff do, the baby is badly positioned or ’stuck’ and needs intervention to be delivered. I would suggest that a large percentage of births fall somewhere in between – that a natural delivery is feasible, but if poorly managed, they may be written off as a ‘failure to progress’ and progress to caesarean or instrumental delivery. It is for this large group that active birth is so crucial. Staying upright, moving around, drinking raspberry leaf tea, using a doula, using a birth ball, swaying the pelvis, relaxation and visualisation may all swing the balance, stave off stress and help labour to take its natural course.

Breastfeeding is very similar. A small amount of women may never be able to breastfeed, another percentage will find it easy. Most will need some support and to overcome a few obstacles to really settle into it. Once again, the right support can really swing the balance, yet as we have seen that support is frequently lacking.

The real difficulty for educators is that attitude makes a difference. Imagine a scale from one to ten, when 1 is “I don’t want to breastfeed”, 10 is “I definitely want to breastfeed” and 5 is “I want to give breastfeeding a try.” Those pregnant women who score themselves nearer to 10 are more likely to succeed in breastfeeding than those who score a 5. They are more likely to seek help, support and push on through difficulties. Similarly, a scale from 1 to 10 might exist for giving birth without an epidural. Those who are dead set against an epidural will be likely to try anything else first.

Of course, in both cases, nothing is guaranteed, no matter how determined you are. And it is possible that someone scoring a ‘1′ that they don’t want to breastfeed might have a change of heart and try anyway, or someone scoring a ‘1′ that they definitely want an epidural might realise in the delivery room that they are coping fine without. But scoring higher definitely boosts the chance of success.

Education is likely to raise those expectations. A woman who originally scored a ‘5′ that she might like to try breastfeeding (perhaps her family all formula-fed) could well shift her score up a few notches if she learned how it might benefit her baby. Similarly, a woman might become more determined to try birthing without an epidural if she learned more about the pro’s and con’s.

The difficulty here is that it sounds as if I’m arguing that success depends on determination. I do believe determination plays a part in both birth and breastfeeding, but as I have already pointed out, it is only part of the equation. Occasionally birth or breastfeeding have real physical reasons why they cannot work. Sometimes the support just isn’t there and sometimes women just don’t have access to the information they really need (their doctor perhaps tells them that an epidural is very safe and that they don’t need to suffer).

I would love to see the guilt taken out of these aspects of parenting. I would love to see women feel comfortable and happy with their choices. What stood out for me is that in the UK’s 2000 birth survey published by the Department of Health, ninety percent of women who gave up breastfeeding in the first six weeks wanted to continue. So who is to blame when it goes wrong? Clearly not these mothers.

The answer is complex. It comes down to a lack of support, from maternity wards to policymakers, from employers to public baby ‘unfriendly’ venues, from formula marketeers to family. There is a great need for education and for professional support. There is a massive demand for breastfeeding counsellors and consultants. I hear so many stories of women whose ‘milk never came in’ when they weren’t shown attachment techniques, skin-to-skin contact, frequent feeding, co-sleeping and so on. When they thought colustrum wasn’t enough. Similarly, where birth is concerned, there is a need for education, for evidence-based decision making in hospitals rather than unhelpful policies and procedures, for doulas and for the opportunity for women to really get active and work with their bodies rather than with hospital demands for restrictive monitoring, fasting or bedrest when not strictly needed.

What we need is to stop blaming ourselves. To have strength, determination and hope so that it can go right whenever it is possible, and when it occasionally doesn’t, we can be gentle on ourselves, and once we have mourned what was not to be, we can regroup and move forward.

xx

Pink, white, zebra striped

The Facebook statuses rolled this week as people responded to one of those silly memes. The first wave went. ‘Post your bra colour, don’t tell the boys!’

The second wave went, ‘Post your bra colour, don’t tell the boys, it’s for BREAST CANCER AWARENESS.’

Hmm. Now, putting aside feminist rhetoric, I thought the first version was some lighthearted, childish fun.

The second wave I found more sinister and I’m going to try and articulate why.

Almost all of us know someone who has been affected by breast cancer and we all want to do our bit to help. However, we are all very well aware of breast cancer. This meme isn’t going to fund research and it isn’t educating women. I find it astounding that people will exploit this wish to ‘do good’ to get their friends to join in with a game. What does it say about our need to belong and to make others belong that we will use emotive subjects like this?

Now, I heard one theory that suggests people have a lot of sympathy for breast cancer because it is so random, there is nothing you can do to protect yourself from it (apart from try to live a healthy lifestyle).

Now this is partly true. Fit, healthy women get breast cancer. Men get breast cancer.

But there IS one other thing you can do to protect yourself AND your daughter from breast cancer.

Breastfeed.

Breastfeeding has some great health benefits for all women, but this is particularly important for premenopausal women who have a close family member (mother, sister) who has had breast cancer. Did you know that a recent study found breastfeeding for these women cuts their risk of getting premenopausal breast cancer by a staggering 59%? (Stuebe at University of North Carolina, published in the Archivesof Internal Medicine, Aug. 2009)

Additionally, it cuts your risk of heart disease, osteoporosis, cervical and ovarian cancer and high blood pressure.

Even more staggeringly, if you breastfeed your daughter (even if only for a short term) you cut her risk of developing breast cancer by 25%. (“Exposure to breast milk in infancy and the risk of breast cancer” Freudenheim, J. 1994)

Additionally, if you breastfeed your baby for ONE month, you cut their risk of childhood leukemia by 21%. Keep on for six months, you cut that risk by 30%. (Robison, L. at University of Minnesota, 1999)

Breastfed babies also have lower lifetime risk of obesity, diabetes, asthma, SIDS, ear infection, respiratory infection, bacterial meningitis, rheumatoid arthritis, Crohn’s etc. etc. They also have fewer admissions to hospital.

Sadly, bottle v. breast is often seen as a lifestyle choice, and even more sadly, those who want to breastfeed are very frequently not given the support they need. Lactation counsellors are few and far between and hospitals don’t have the time or energy to help new mothers breastfeed. Formula manufacturers market in unethical ways and to new vulnerable mothers, implying their product is the same as breast milk (which as we can see, it isn’t.) And new mothers aren’t always protected in their choice to breastfeed. California has laws protecting breastfeeding mothers in public places, sadly not all of the US follows suit.

Most women WANT to breastfeed. Nine out of ten mothers gives up breastfeeding before they hoped to. Most just weren’t given the support they needed to combat simple problems like thrush, a poor latch or blocked ducts (all of which can seem like agony but can be overcome with support.) Many were fed myths or unnecessarily worried by health professionals tutting over such vague things as ‘poor weight gain’ or ‘milk not coming in’ (diagnosed far more frequently than actual occurrence.) Some have had their breastfeeding relationship interrupted by custody or immigration or incarceration or hospitalisation. Some have been sabotaged by nipple confusion caused by unnecessary pacifiers or bottles.

I don’t blame mothers for not breastfeeding. It is tough at first. It needs support, from our family, from society, from experienced breastfeeders, from the government, from the policymakers of society.
Most of us don’t have that support.

Breastfeeding is a matter of public health. It should be an absolute priority for public health officials, the government and health care professionals of all stripes.

So, it’s not just about ‘awareness’ – there is something we can actually DO about breast cancer and about the health of our babies in general. We can educate on the importance of breastfeeding. We can show people where to get the help they need to be successful breastfeeding (La Leche League or the National Childbirth Trust (in the UK) are both good starting points.)

We can and should urge policy-makers to understand how important this is. If you could reduce childhood leukemia by 25%, wouldn’t you?

I took a note from Empowered Birth and changed my facebook status from ‘zebra striped’ to this:

Breastfeeding reduces your chance of getting breast cancer (and the longer you breastfeed, the lower your risk). AND it also helps your daughter reduce HER chances of getting breast cancer. So post THIS instead of your bra colour today.

I feel much more comfortable with that.

Hope you’ve all had a restful holiday. Here’s to a happy and SHINEy new year to all you wonderful Shinemamas.

Katharyne x

A couple of weeks ago, I had the opportunity to drink coffee with two ladies who run a small women’s group for women in their twenties and thirties. I am now preparing as they kindly invited me to address the rest of their group tomorrow on the subject of pregnancy and birth. None of the group currently have children and many are now trying to conceive or thinking about it.

One subject that cropped up during our chat was fear. The fear of childbirth (tokophobia), fear of pregnancy and even the fear of trying for a baby.

When you think about it, these fears are justified. Pregnancy and birth is a life changing and somewhat unpredictable process. Infertility is deeply upsetting. Miscarriage is surprisingly common. Many of us live far from our mother or sisters and are the first of our social group to have children. Our first real experience of pregnancy and babies comes with our own. Yet there is a counter-argument that it is all completely normal and that women have been giving birth since the human race began.

But pregnancy isn’t all that normal in our society. Most women in the UK and the US will only do it once or twice in their lifetime, compared to some countries where women have an average of 6 or even 7 babies. (Niger has a birth rate of 7.19 and Afghanistan has 7.07 compared to the US at 2.10 and the UK at 1.66). My ‘hometown’ of Guernsey ranks only a little above China’s birth rate at 1.40.

Neither is the process of childbirth seen as normal, instead the American norm requires intrusive tests throughout pregnancy and a highly medicalised labour and birth which is ‘managed’ in order to proceed along a tightly defined curve and frequently results in major surgery.

Of course we all want the best outcome possible during pregnancy and childbirth, but our quest for perfection leads down some very odd routes and the climate of fear begins at preconception. “What if I can’t get pregnant?” My rather flippant answer of course is, “You’ll never know if you don’t try!” but this is where it all starts.

The ‘rules’ are laid down at the start and most of them are sensible and easy to follow – taking folic acid for example prevents a number of birth defects. Avoiding unpasteurised cheese reduces the likelihood of contracting listeria, stopping smoking improves outcomes immensely. But it doesn’t stop there. Many of the ‘rules’ are not evidence based. In fact, many of the ‘better safe than sorry’ rules (such as avoiding all alcohol during pregnancy or avoiding eggs altogether) arise from absolutely no evidence – just a misguided extrapolation that ‘excess alcohol is bad, therefore ALL alcohol is bad’ or ‘raw eggs are bad therefore better to avoid even possibly undercooking an egg.’

I have seen some immense anxiety because a woman had a couple of drinks before realising she was pregnant. The drinks were unlikely to do any harm at all, yet the fear kicked in. Fear and anxiety certainly have a negative effect – on blood pressure, heart rate and mood, all of which can also effect the baby. Yet the media feed on this fear, day after day feeding out non-stories based on misinterpretations of data and on theories rather than studies. Similarly, the medical profession fuel this climate of fear, abetted by lawyers and insurance companies. Pregnancy as an illness is a lucrative concept.

Another source of fear is the weighty sense of responsibility that goes with having a child. There is a perfect balance of physical fitness, ideal weight, financial stability, a suitable home, a secure relationship and career security that many of us long to attain before trying for a baby. Achieving these factors together is very difficult for most of us. When you throw in the time limits of peak fertility ages, it starts to look impossible. Then you have the woeful stories which await any woman who dares to get pregnant in her forties.

Of course we want the best for our baby, but sometimes you just have to go with ‘good enough’ – many women feel healthier and fitter naturally during pregnancy – the body does wonderful things to prepare itself for birth. And money and housing can be stretched.

Tokophobia, the fear of childbirth is the biggest fear of all for some women. It is considered a valid reason for an elective caesarean section and it is a fairly reasonable fear – after all, childbirth hurts. The situation is not helped by the portrayal of birth on television or by often exaggerated horror stories of birth. However ’secondary’ tokophobia is increasingly common. This is a fear which occurs in second or third pregnancies (or even later) and is rooted in previous birth trauma.

Birth trauma rates are rising dramatically and contribute to postnatal depression and other mood disorders. Birth trauma also significantly affects breastfeeding and bonding and has similar symptoms to post-traumatic stress disorder. While the term a ‘negative’ birth experience is somewhat vague, the causes may be very specific to a woman experiencing it. A sense of aloneness during labour, a sense of not being listened to, an arrogant or dismissive medical professional. Many women report that birth trauma arises from a sense of violation – a procedure or intervention that was conducted without their consent. For example, several women I have spoken to have found the amniotomy – breaking the amniotic sac with a ‘crochet hook’ like instrument to encourage labour to have been particularly traumatising, both visually and physically, although this is a common hospital intervention, albeit with limited medical evidence supporting its usage.

It is amazing to me that mortality rates are relatively low, yet birth fear is rising. Yet it is totally understandable. A normal hospital birth carries a high risk of birth trauma. Home births, birth centre births and doula attended births are all showed to greatly increase the mother’s feeling of satisfaction with the birth experience and reduce rates of postnatal depression.

The only way to ease the fear is to normalise birth. To show that it can be a safe, family centred event. To stop marginalising natural childbirth as a hippy or bohemian concept. To educate women that birth is a normal life event.

And most importantly that when left to its own devices, the body can do wonderful things. All the pitocin and medication are poor substitutes for the body’s natural hormones which are inhibited by fear and an artificial environment. When we labour in safety, our own endorphins are released freely and are a natural painkiller, helping us through the process.

What is clear is that in any stage from preconception right through to parenting a teenager, fear, anxiety and guilt are destructive, psychologically and physically. Take up yoga, take a hot bath, have a beer. But do try to relax.

It’s good for you!

The topic of cosleeping hit the headlines last week once again following a new study published in the British Medical Journal (BMJ article.)

Reports were mixed, with the BBC news using soundbites from FSID to berate parents for ‘ignoring advice’ not to bedshare. Meanwhile, The Telegraph carried the headline, ‘Sharing a bed with a baby does not increase risk of cot death, research shows’.

The Guardian goes one step further to argue that the ’science’ is being badly misinterpreted and used to demonise parents.

So what is the truth? Well, the BMJ study doesn’t tell us much we don’t already know. Their conclusion is as follows:

Many of the SIDS infants had coslept in a hazardous environment. The major influences on risk, regardless of markers for socioeconomic deprivation, are amenable to change and specific advice needs to be given, particularly on use of alcohol or drugs before cosleeping and cosleeping on a sofa.

The problem we have in finding the truth is that none of the big cosleeping studies have separated out those bedsharing safely with their babies (no drugs or alcohol for parents and a safe space for baby, free from pillows and excess covers) from those who have fallen asleep on a sofa, possibly in a drunken or overtired state.

Consistently, studies have found the vast majority of ‘cosleeping’ deaths have been sofa-sleepers, where the baby has been smothered or suffocated whilst sharing a sofa with a parent. These really aren’t true SIDS or cot death cases as there is a clear cause of death. Similarly, we know that smoking and alcohol consumption in parents are linked to incidents of SIDS.

There is no evidence that planned bedsharing is in any way harmful.

What we DO know however is that the original study which FSID quote repeatedly and which was aimed at finding a link to cosleeping and SIDS was funded in a large part by the JPMA – The Juvenile Product Manufacturers’ Association who described themselves:

JPMA is a national trade organization representing 95% of the prenatal to preschool industry. Today, JPMA represents 250 companies in the United States, Canada, and Mexico who manufacture, import and/or distribute infant products such as cribs, car seats, strollers, bedding, and a wide range of accessories and decorative items.

Hardly an uninterested party. Though none of these studies have actually proven any link to bedsharing and SIDS, the party line is still not to bedshare.

Fortunately, a few voices of reason have spoken up. The National Childbirth Trust (NCT) Chief Executive, Belinda Phipps has said, “The findings sound extremely significant. We are really pleased to see that evidence about the safety of co-sleeping is building, because we know it improves breastfeeding rates. We also know a lot of parents prefer to do it but feel guilty because they are unsure about the risks”. (The Telegraph, 2009)

Similarly, Dr Peter Blair from UNICEF has said, “This study shows that it is not co-sleeping that is unsafe, but the circumstances under which some parents co-sleep that create risks”.

So why is this so important to parents?

Well, we know that half of parents bedshare at least once in the first six months. A quarter of parents bedshare regularly. Many are made to feel guilty about it. This guilt is mired in the belief of FSID that it is better to tell parents never to cosleep at all rather than expect them to understand a few common sense precautions. Yet this sledgehammer approach is dangerous because bedsharing carries considerable, known benefits.

• Bedsharing supports the breastfeeding relationship between mother and infant. Mothers who bedshare are more likely to feed on demand and continue feeding for longer. Proximity of the baby helps the mother produce prolactin which keeps milk supply high.
• Bedsharing is comforting, normal and natural. Most other cultures outside the US and UK bedshare, many with very low incidences of SIDS. The practice was discouraged by the Victorians. Babies aren’t designed to be alone.
• It’s easy! No getting out of bed to fetch and feed the baby.
• It’s safe. Feeding then falling asleep on the sofa isn’t.
• There is evidence bedsharing can help regulate the baby’s breathing, temperature and heart rate as well as reduce stress hormones.
• It may mean a much better night’s sleep for mum and baby. A known factor in decreasing postnatal depression.
• A secure baby with a close maternal attachment is likely to not suffer separation anxiety, so is more likely be a secure, independent, happy child.

Deborah Jackson’s book Three in a Bed was a groundbreaking book on the benefits of bedsharing. It’s a great read for parents wanting to know more on the subject. I am a strong believer in bedsharing and am sharing with #3. #1 and #2 moved on to their own bed cheerfully when they were ready.

There are just a few common sense guidelines:

• Avoid drinking, drugs or cigarettes if you are bedsharing.
• Make a safe space for the baby… no pillows or excess covers, no cracks they can get wedged in.
• Don’t cosleep on the sofa

Is there anything nicer than seeing your baby’s face grinning back at you when you wake up?

It’s September and throughout much of the world, children are settling back into school and the littlest ones have started their intrepid journey into their schooldays for the very first time. In most Western society, this is a time for change, where for several hours a day, parents entrust the care of their children to other adults. Five year olds have to step away from the apron strings and negotiate a new world that looks, smells, feels different. They must figure out where to hang their coat, who to sit with for lunch and how to cope with a grazed knee when mum isn’t around.

It’s an exciting time, full of opportunities and new experiences, but with a few challenges along the way.

I’ve been following a popular parenting forum and over the last few weeks, the threads have cropped up where little ones run into a ‘challenge’ at school that is outside the realm of expected adjustments to school rules and life. A little boy comes home with a sore stomach because the teacher didn’t help him straighten his trousers which have rucked up. A five year old is made to stand against a wall for talking in line.

Too many schools are an exercise in crowd control and box-ticking. The child starts school and is thrown into a room of around 30 other children. They ride a conveyor belt hurtling rapidly into the world of conformity to uniform and rules, examinations, tests and grades. They need to keep quiet to prevent bedlam. They need to walk in orderly lines and wear the right uniform. Adherence to the rules is paramount.

How did we get here? School presents a wonderful opportunity to learn about new social norms, but the transition needs to be gradual. Is it really beneficial for a five year old to plunge into the deep end?

In Maslow’s hierarchy of leads, peak learning can only happen when all the learner’s other needs have been fulfilled. It is well recognised by psychologists that a learner must not only be fed, watered and comfortable, but also feel safe, secure and share trust and respect with all those around him or her. If these conditions aren’t met, then learning will be stunted. Yet schools prefer children to be fiddling with itchy collars and ties, worrying about receiving humiliating punishments and filling out endless worksheets that keep them in line with their classmates.

So what should schools be doing? Maria Montessori proposed that education should be an ‘aid to life.’ She believed all children carry within themselves the person they will eventually become and they should be allowed the freedom to explore, create and learn so they might meet their potential. This freedom is an important concept – the conveyor belt child has little freedom. They have a rigid curriculum with key stages to tick off and standards to achieve.

What purpose are these standards serving? In the UK, six and seven year olds sit SAT exams. Ed Balls, the government’s school secretary reportedly said that children should absolutely not be told the purpose of these examinations.

So not only do we stress our children with these tests but we ignore their basic rights by being told to be dishonest with them. No, these tests don’t serve any purpose for the children – instead, they are used as political indicators to decide which schools need funding – as is attendance. So, while you may believe that a family trip to a foreign country is beneficial for your child, the school may be furious – not because it is damaging your child, but because missing a day at school affects their standing and funding.

These schools are not child centred. They are acting in self-interest.

The problem is that in mainstream schools, children are offered a homogenous curriculum. The UK’s National Curriculum sets out the ‘perfect formula’ – a spoonful of science, a drop of religious education and a dash of ICT… and so on. This perfect formula supposedly nourishes every child and forms the basis of the perfect citizen. Or does it?

As adults, our interests lie in different areas. Some of us will cut hair. Some of us will write novels. Some of us will manage banks. At university, we are allowed to devise very specific courses of study. Yet in childhood, we have to follow this very rigid structure, no matter our interests or aspirations.

This is where the child-centred options come in. Of course, we all want our children to know how to cope with life – to read, write and manage basic maths. To grasp the basics of science and scientific and critical thinking, to know about their country, culture and a little about other cultures. But none of these things are rigid. We all have different learning styles and different interests – some practitioners have proposed the three learning styles – auditory, visual and kinaesthetic (touch/physical practice). Each of us learns slightly differently and a truly child-centred approach should recognise these differences, allowing children to learn in their own way and to follow their interests as far as they desire. In a perfect classroom, Janie might be devising a project on Ancient Egypt while Johnny researches earthquakes. Ideally, there will be trust between the children and between the children and teachers so that they may share their ideas and learn from one another.

These ideas are nothing new – before formal schools developed, we learned by doing, by watching, by listening. And I strongly believe that children need experiences – they need to cook at home, they should travel, they should visit and explore and most of all, they should talk and co-operate.

Children are amazing. They are also all as unique as we are as adults. This is why we shouldn’t settle for conveyor belt education. This is why we need to trust them, respect them and meet their needs for comfort and support so that they can make the best of every learning opportunity they encounter, whether at school or in the home.

BLW is the new buzzword in baby feeding in the UK and it’s slowly starting to catch on in the US. Elsewhere in the world, parents have been BLWing as long as anyone can remember.

My first two babies were raised on jars of mush. Pear and apple mush, sweet potato and carrot mush, fruity yoghurt mush. Lots of mush, warmed slightly and fed with a spoon. Messy and mushy.

This time round, I walked down the baby food aisles and saw Gerber, Gerber, Gerber (owned by Nestle for the politically or ethically inclined) .

The funny thing is, according to BLW champion, Gill Rapley, no research has ever actually been done to suggest weaning babies in stages (puree, then small lumps, then bigger lumps) is developmentally beneficial to babies. It’s just the accepted way of doing things. It’s how it’s done. Yet we’ve all seen the baby confused by the introduction of ‘lumps’ – the thbpt, thbpt, thbpt as spat out bits of macaroni or peas fly across the kitchen.

So what’s the alternative? Well, it’s surprisingly simple… and it doesn’t involve blenders, ice cube trays or mixing up special recipes. Your baby is cleverer than you think! Around the age of 6 months, they’ll let you know what to do as they make a grab for your broccoli or your cheese sandwich.

‘But they’ll choke!’ Well… no, they may gag a bit initially, but choking is rare. And after all, baby will need to figure out solid food before they hit college, so now is as good a time as any! Really? Really! The theory of BLW goes that actually, the baby has a great gag reflex – much further forward than older children. This gag reflex makes them spit out the food pretty sharpish if it goes down the wrong way.

The benefits of BLW are right up there – first of all, you can enjoy a meal with your baby! Leave off the salt and they can share your pasta, your fruit salad, a sweet potato fry. Secondly, it is normal – this is how a baby learns! Why do babies put everything in their mouth? Well, to see if it’s edible. Why would nature do this if they couldn’t possibly handle food?

More significantly, BLW introduces babies to food, rather than mush. The baby quickly becomes dextrous enough to handle a strawberry, a piece of mango or a broccoli floret. They study the shape, colour, size and take the time to explore it before chewing it. Their pincer grip develops with their capacity to eat small things and they grow up familiar with making good food choices. Also, when the baby is offered several foods, they will opt for the food that is right for them, rather than licking up indistinguishable mush.

Think about it, would you like to have that shoved into your mouth, without being able to examine, identify or savour what you are eating? The BLW baby will really have the chance to enjoy their food.

Personally, I was doubtful at first. I heard the grave warnings from doubters, but when I looked at who was funding these doubters, some of my fears were alleviated. When I saw the UK’s National Health Service recommends finger foods from 6 months, I was even more assured. So I tried it. Well, my baby tried it. We were at a buffet in Las Vegas and he started grabbing my food. So with a chunk of watermelon, a chunk of cantaloupe and a strawberry, he sat there, examining them, then giving them a suck. Gradually, over the coming weeks, he started to try other foods – lots of fruit, pasta, cheese, then crunchy things like toast, even a little cake. Homemade blueberry pancakes were a quick favourite! And how wonderful to be able to go to a restaurant and offer him some noodles or a piece of bread and butter.

Baby led weaning is such a delightful experience, and such a journey. The ‘rules’ are simple:

• Keep salt intake minimal
• Don’t wean until the baby shows readiness to eat solids (World Health Organisation suggests 6 months, and certainly no solids before 4 months)
• Be careful of foods that are hard and difficult to chew – apples, carrots etc. should be steamed, cooked or grated. Grapes, peanuts etc. are an obvious choking hazard due to their size and shape.
• Babies should eat sitting upright, not leaning back
• No ‘posting’ food into their mouths. Offer the baby food on a tray or a blanket and allow them to choose and explore the food in their own time. If they are not interested, then that’s ok. There’s no rush to get them onto solid food. Take your time! And let the baby take his or her time!

One great tip is to make everything into a manageable size and shape – broccoli for example should have the stem kept on to act as a handle. Crinkle cutters could be used to make mango sticks more graspable.

Good luck if you decide to BLW. It really is the easiest option. And probably the most fun! (although I can’t guarantee it’s any less messy!)

6-7 month old baby Sid enjoying figs, strawberries, banana and noodles!

More information about baby led weaning can be found here:

Or buy Gill Rapley’s book, ‘Baby Led Weaning’

Disclaimer: I am not a doctor. Consult your health care provider for their recommendations about feeding your baby.

As an advocate for home birth, I have faced incredulity and confusion from a culture that believes that hospital is the safest place for birth. As a woman who has given birth at home, I have also faced a usually unspoken accusation. An accusation that what I did was selfish – that I was risking my baby’s life on a whim.

When faced with this and explaining why I chose to give birth at home, I have had to pick my arguments carefully. I can argue with statistics and science. I can argue emotively. Or I can tell my story.

And BIRTH, The Play makes its argument with stories. Eight women tell their stories of giving birth in the USA. Much like The Vagina Monologues, the stories are based upon interviews with over one hundred women and are presented as monologues with moments of dialogue.

As in reality, each birth in the play is different. Each woman has her own feelings and preferences, each pregnancy presents with different challenges and each woman has a different home life and social support system.

BIRTH takes away the statistics and looks at the notion of choice and the emotion of each birth. There are moments of beauty and moments of absolute terror. One woman described her progress through labour against the odds of a clockwatching, doubtful obstetrician, the baby finally crowning and her exultation as she was about to push it into the world, only to scream, “Don’t cut me! Don’t cut me!” as the doctor insisted on an apparently unnecessary episiotomy at the last moment.

The sense of despair, terror and violation was palpable, and it was these moments that were so chilling and resonated in the audience.

The play was not anti-intervention. One woman was satisfied with her planned caesarean birth and went on to repeat it. Yet another woman’s caesarean under undue pressure saw the sinister green cloth raised and her tears and bitterness. She described the removal of the baby as a death, that her body was pregnant one moment then empty the next. The shock of BIRTH was in these moments where a choice was denied and the woman’s body violated without consent. The moments when a woman was lied to about the size of her baby or pressured into unwanted interventions. These moments were nothing short of horror.

BIRTH explores the great contrast of births. Against these moments of fear, it also considers pain. That pain is anguishing and impossible in a context of fear, but that it can be good and positive when the fear is removed. We see the triumph and joy of a functioning body when it is allowed to function. The woman who shouts, ‘MY BODY ROCKS!’

Having dismissed the cliches of sitcom births, BIRTH managed to show how things could be different. Indeed, the woman with the terrifying caesarean considered running away to Tennessee with her mother-in-law to birth at Ina May Gaskin’s fabled ‘Farm’ birth centre. It wasn’t to be, but the audience could imagine the flight of fantasy, and we identified with her yearning to escape the operating theatre and the restraints of the table.

Catharsis came in the final birth story – the fourth birth of Jillian who finally achieved a home birth, surrounded by her closest friends, whispering good wishes until her baby arrives in a final triumphant moment, a moment more subtle and gentle than the ‘MY BODY ROCKS!’ lady, but the sentiment no less powerful.

BIRTH was performed by a group of birth professionals, midwives, doulas and other women committed to making birth positive. It was authentic and compelling, with moments that any woman who has given birth could identify with. It didn’t write off caesareans, doctors or intervention as evil but it showed them honestly – we saw a moment of panic as an epidural caused blood pressure to drop. We saw the fear of a paralysed bowel, a caesarean complication. But we also saw the relief as an epidural took away the pain in labour. BIRTH was honest about the benefits and risks of such, without resorting to statistics.

And that’s what BIRTH is – the human face of statistics. I can show you many figures that show that home birth is safe. Indeed, the latest research fresh in from Canada is a study of 13,000 low risk women – just the sort of women that BIRTH is about. It shows home birth to have a slightly lower rate of perinatal (infant) mortality, and far lower rates of complications including haemorhage, infection, serious tears and uterine rupture. In short, that home birth is safer.

These statistics sound impressive and might win an argument of logic but they’re only half of the story.

The true story is that birth is an important, vital event. In BIRTH, it is described as ‘Just one day’ – that a woman can suffer for ‘just one day’ and can put up with a doctor she hates, who can’t remember her name, for ‘just one day’ – but what we learn is that the events of that day will change her life completely, mentally and physically. That it will be engraved in her memory indelibly. Whether she felt loved and supported or whether she suffered.

So perhaps I need the statistics to prove that I’m not being ’selfish’ in a choice to home birth and that it is a sensible, considered option, but I also need the story to show why. Why I accepted the ‘pain’ rather than opting for a caesarean or an epidural. Why giving birth is so important. In BIRTH, every story had an impact, but the most empty story to me was the planned caesarean. It was quick, easy and the mother had a healthy baby and painful but manageable recovery. She chose to repeat the experience uneventfully. But this story felt like it had something missing. No real moment of triumph or ecstasy to compare with the women who pushed their babies out and screamed with joy. Risks and benefits, medical pros and cons aside, this moment was to me conspicuous in its absence. But that is a personal feeling, and as BIRTH so neatly pointed out, giving birth is a personal decision, but should be a decision freely made, and fully informed – and the reason that birth activists are so fiercely trying to make women aware of their power to choose is that this information is not as easily come by (or as honestly given) as we might think.

This play was an important community event, presented by women on the front line of birth to a room including a great many pregnant women. At a time when healthcare is so hotly debated, this issue should not be swept aside – women, their babies and their partners deserve more, and they deserve the birth they want. After all, it’s just one day.