Ancient Beginnings:

ShanUna Dillard Interview

We went down to ShaUna‘s place on a cold rainy June day and arrived to Japanese shakuhachi music and big mugs of spicy tea. From her windows, she told us, you could see Mount Monadnock. Well we were in low rain clouds that day. T’was a good day for dragons.
ShaUna speaks with great enthusiasim, many words lengthened, and accented to convey enphasis. So some words you’ll find underlined to indicate her enphasis.

 

W.To start off could you give me a little idea of your personal philosophy about childbirth?

S. Well, I recently went to this conference on women’s reproductive rights and until now there was never any representation of birth. It’s always abortion rights or birth control, but this year was different. I went there and had a table and there were other midwives speaking, and birth became a part of a conference that has been happening for 25 years. There is a whole feminist perspective on the birth process and how we can take it back. Marsdon Wagner, MD the former Director of Women’s and Children’s Health at the World Health Organization speaks about the interrelationship of the autonomy of women and the autonomy of midwives. Until women decide that having a birth, their birth, could be with a midwife, midwife assisted births won’t be a majority of the births. Now only 7% of births in this country are midwife attended and 11/2 % are at home. So it is really a small percentage. My whole coming in to midwifery; I was an herbalist and friend invited me to her birth. I had been to my first birth just 3 weeks prior as labor support for another friend. Luckily I had been to this first birth because the midwives did not make it in time and I caught her baby girl. It was then that I knew my life’s work…it fell right into my hands. I believe that peace on earth can truly start with birth

W. You used the line “until women take back childbirth”. Does that mean that you think that at some point women lost control of the process?

S. Yes. It’s very cultural. Birth is very cultural. By being at a birth in any culture you can really see the essence of that culture. Here in this country it has become a fear based process. One of my clients went to a doctor and after leaving she cried for days because they made everything so scary. So in that way we have lost control. Pregnant women are at a vulnerable time in their life. A time when they want to do everything that is best for their baby. If there is energy around them saying, “If you don’t do this, this could happen to your baby”. Modern medicine has come in and said this is the best way to have your baby. Scientifically proven. The safest. And if you don’t do this it’s like child abuse Studies, however, now are showing that homebirth with a trained professional is as safe as hospital birth. This is what the latest statistical studies have shown. Which is very positive as far as showing homebirth/midwifery as a safe choice for childbirth.

W. What do you see as the major differences between the homebirth and the hospital birth experience?

S. Every hospital is different, and every homebirth is different. Sometimes they can get so close on the scale. Depending on the hospital and the family and depending on the midwife and the family. It’s hard to generalize but if I were to generalize, in the hospital, obstetricians are trained to manage births, which might be perfect for someone who is high risk. For instance someone who has diabetes or high blood pressure that is not managed with diet. But for a normal healthy women to be taken care of by a obstetrician for the most part doesn’t make sense. They hyper-manage the pregnancy and the birth and the out comes often aren’t what the family wants. For instance, giving birth in the hospital, you may be having a perfectly normal birth pattern, my friend was having a totally normal labor pattern but in the hospital they were saying “Oh, you’ve slowed down.” So they gave her a synthetic prostaglandin to speed up her dilation. Then they gave her pitocin, a synthetic hormone, to increase her contractions. The drug induced contractions were so intense that she ended up deciding to have an epidural. Her baby went into distress and she had a cesarean section. I have seen this downward spiral in the hospital too many times. If she was at home, I believe she would have had a beautiful natural birth. At home, the woman is supported in her own process and her own intuition and the midwife stands there in support of that. If anything goes way outside the bounds of normal the midwife can step in and give guidance. So it’s like a circle around the woman and the father and the baby. In the hospital the woman and the family are down there and the professionals are up here (moves her hands to show the different levels). It’s like they know more than the woman knows, more than her body knows. It’s much more of a partnership having a midwife. The midwife give the family options and choices and tells them what she perceives and they can make choices together. In the hospital that’s not the way it works.

W. What have you seen to be the effects of different types of childbirth for the child, for the mother, and for their relationship? How much difference does the birthing process make?

S. There are so many levels to that. For a women to give birth the way she chooses is very empowering. “I can give birth. My body knows how to do it. I can trust my body. I’m a powerful woman.” I think it gives women the sense of strength they need to be a mother.
To be a mother is the biggest commitments. In order to really bond with the baby and to take on that responsibility the birth is important.

W. In some states isn’t the practice of midwives assisting homebirth illegal? Any thoughts about this?

S. Yes.. It varies from state to state and there are also different certifications for midwives. There are certified midwives, direct entry midwives, and there are certified nurse midwives. In New York someone can get a felony charge, there are midwives going to jail, for just assisting families in homebirth. It reminds me of witch burnings. Women are being persecuted for knowing how to assist families to give birth at home. For knowing how to use plants. For not being dependent on modern medicine. I think having that innate, ancient wisdom is threatening. The A.M.A. is threatened by it. My prayer is that we will all work together. If I feel that something is a little out of the range of normal, which is what I specialize in, I can call for an obstetrician and get the help my client might need. That is what they are doing in Sweden, Australia, and New Zealand to name a few. They all work together to have the best situations for the birthing families. That’s the important thing. I do feel we’re making leaps and bounds in this country. More midwives are becoming legal and licensed and midwives are gathering together to agree on what skills and knowledge we need to know to for the safest births possible.

W. Scheduled caesarians seem to be becoming more common in the US, Japan, and Brazil. Unscheduled caesarians are, in some hospitals, 50% or more of the deliveries. What are your feelings about this? Which way are we headed?

S. Yes. It’s really sad to me. I have a friend who was born by caesarian. In her life she was struggling to push through, to become what she wanted to be. She attributed it to the fact that she never did the work of being born. Someone just came in a took her out. She was waiting for someone to come and make her herself. Babies work really hard to get born. It’s not just the mother working to push the baby out, the baby works too. If there were more awareness...maybe if people knew that there are psychological impacts on the baby and on the mother, maybe they would be making different decisions. There doesn’t seem to be enough wisdom about this out there.

W. In becoming a midwife, what has been the hardest thing for you to do or experience?

S. For me the hardest thing was getting trained. Surprisingly challenging to get good training. I’ve always felt strong in my journey as a midwife. Absolutely the most important thing as a midwife, for me, was to make sure that I knew how to prevent harm to the mom or the baby, If a woman is bleeding, how could I help her stop bleeding? If the placenta does not come out how do I get the placenta to come out? If the baby is not breathing how do I help the baby to breathe?Turning to your trip to Senegal: How did you come to take your journey to Senegal?

I had originally wanted to go to Guatemala. I was drawn to the ancient Mayan birthing practices. But the language barrier was so great. You had to know Spanish well, but then they don’t really speak Spanish there. They speak a traditional Mayan dialect. So I began doing research to see where else I could go. I wanted to go where traditional midwifery was still vital, where I could still learn the ancient practices. Eventually I found the woman who started the African Birth Collective. Her name is Kaya Skye . And I talked to her. She told me that they’ve lost their traditional birthing practices in Senegal. The reason I wanted to go to another place just flipped for me and I then wanted to go there because they didn’t have their traditional birthing practices. Because I wanted to give them what we do know. (It’s interesting to me how much midwives here still do have of traditional birthing practices). I went there to share what I know and to learn what they know. And to create a cultural bridge. To talk birth.

W.In Senegal do you think that Muslim and Christian influenced values pushed out the more traditional ones?

S. There are still tribal people living right there. I look forward in future trips to potentially to be able to connect with this community. They really live on the edge and don’t engage much with other people. So that might be quite a challenge. I really attribute the birthing practices in Senegal to the British influence. The French came in and took over West Africa and in Senegal they used the British model of midwifery care. In Jamaica they use the same model. All the Caribbean Islands use this same model of midwifery care. So it isn’t Islamic or Christian, it’s British. The laying down, and the aggressive techniques. The whole sage-femme, matron......

W.So were there homebirths in the area you were in?

S. Sure. I didn’t get to go to a homebirth while I was there but people who had homebirths, sometimes came into to the clinic afterwards, for whatever reason. Maybe the baby wasn’t thriving. One baby came in who was very thin and his family was concerned, so they came to the clinic for care.
Women there have baby after baby after baby. They don’t use any form of birth control (in town some women do use birth control, but out of the town they don’t) and there is usually someone in the community who is the midwife. There is no official training but this women is a grandmother and has seen so many births happen. Or maybe it just them and their mother and auntie. But they know how to do it. Everyone has done it so many times. Sometimes things don’t go well, there is no trained assistant but their faith in God is so strong. They trust that that was God’s wish and they move on. They grieve and move on. Death, there, is a part of life. It isn’t for us here. Most people here have never seen anyone die. It is something they see as a part of life. There is death. It takes a lot of the pressure off the midwifes. (Laughs) We had some babies die while I was there and the families would come up to us and say, “Thank you so much. Thank you so much”. They knew that we did everything possible to save the baby. But the baby wasn’t saved and the baby died. They trust that we did everything we could and know that God is the creator and God makes these choices. The midwives can’t make that choice, the mother can’t make that choice. They grieve and move on. Very powerful. It would be different here. You would probably get sued, and lose your license. Very different.

W. Was childbirth at the clinic “free”?

S. It’s not free. They have to buy their card. Everyone has a card and they get so many prenatal visits, the birth and so many post partum visits. They do have to have the initial amount of money but it’s very little. It’s affordable for even poor families. And there is some form of aid.

W. You wrote that often they wouldn’t “transport” to the hospital and you thought the reason was financial concerns....

S. Totally.

W. ...and they wouldn’t transport at all for the baby?

S. I never even saw anyone talk about transporting for the baby. I feel it awful to even say this but some women are having so many babies it really....I mean they’re sad if their baby don’t live but there is part of them that feels relief. One less mouth to feed. Ten babies later and no money.....

W. What might be the reason that women must go into the birthing room by themselves? Could you explain this practice?

S. That was really hard. I have one specific vivid memory of this one very young girl, maybe fourteen, with her mother during her labor and now she was about to give birth and so moved from the labor room into the birthing room. In the birthing room no family was allowed to come in...the young girl was crying for her mother. It was really hard. I was asking the matron, “Why can’t her mother come in?” She replied, “This is not the way we do things here in Senegal”.

W. Until very recently it wasn’t the way things were done in the west either, was it?

S. True. Fathers were out pacing in the halls...mothers with nobody but the doctors....Very strange. The labor room, on the other hand, was so much fun. Oh my gosh! Like a party! Food and tea, sometimes the whole family was there, all the sisters all their kids, never quiet (laughs).
Then birth was a family event?The men weren’t really around. Sometimes they would check in and sometimes come in after the baby was born and whisper a prayer into the baby’s earAnd the fathers would bury the placenta the next day?I’ll bet it’s in a lot of cultures. The men’s connection with the birthing.

W. In Japan when babies are first born they are put into a warm bath. Some believe that this contributes to Japan’s low infant mortality rates. What is the reason for the cold water baths in Senegal? Is it to clean the baby?

S. Yes.

W. Was there no way to heat the water?

S. Well I asked about that. Yes, there was a way to get warm water to come through but they didn’t care. It seemed like some of the midwives were just harsh. It’s the way that it was. They didn’t have any desire to be gentle, “life is not easy. Might as well find out about it right away. Put you in the cold water, slap you a few times. It’s not a gentle reality here.” That was my impression.

W. Could you talk about the post partum treatment of 1. American women in an “average” hospital, 2. the clinic you worked in Senegal, 3. Home delivery in the North East?

S. In Senegal if it was the middle of night they’d stay for the night but they would stay long. They had their families to take care of them, and it didn’t seem that they would rest for very long. They would be up and working pretty soon afterward. Midwives would clean and wrap the babies chord. I never saw them checking the moms post partum. Just the babies a few times. Making sure the chord is healing well.
In hospital women stay for 24 hours for a vaginal birth and three days for a c section. One thing that’s nice about the hospital is that all your food is there.(Laughs). People wash you and take care of you while you are there. People actually appreciate that. Some hospitals don’t have good breast feeding support. In the hospital some women have a hard time with their milk let down, just like having a hard time opening up to give birth. It’s not a real nurturing place. Not like home where you can feel really comfortable. All the lights, all the beeps, all the people you don’t know coming in and out, and in and out, blood pressure and...I think it can be hard for people to let go and letting their hormones...so often women don’t start to produce milk right away. It might be the biggest complaint about hospital births: post partum.
After a homebirth I visit the woman and baby at 24 hours, 3 days, 1 week, 2 weeks, 6 weeks, and more if need be…all home visits. It is nice because the mom and baby get to stay cozily snuggled in at home, I can check on mom’s healing and baby’s health, throw in some laundry, cook up some tea and food for mom, maybe watch the baby while she showers or takes a bath. It is a great way for moms to bond with the baby and stay home to rest and heal.

W. Do you feel that supporting homebirth is a social issue and being a midwife is a form of social activism?

S. Definitely. It is a global issue. I feel I am constantly educating. “You’re a midwife? You help people have babies at home? People still do that? I didn’t know you could do that?”I have a great bumper sticker that reads “Midwives help people out”. People ask me about it quite a lot…at the grocery store, at the gas station, at the post office. I think that just letting people know that I am a midwife helps to raise awareness. That they do have a choice. I really love that aspect about being a midwife; offering families a choice about how they want to give birth.

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