A Quiet Place

In October 2009, Barbara Loe Fisher awarded me the Courage in Journalism Award of the National Vaccine Information Center (NVIC). The award certificate reads: “. . . for her vision and journalistic integrity in defending a mother’s right to raise her children in the holistic health tradition.” When Barbara presented me with the award, she added, “for her dedication to improving the health and well-being of mothers and children; for her honest, accurate, and insightful coverage of the vaccine-safety and informed-consent debate; for her leadership in empowering young mothers to make educated, independent health decisions for their children.”

The following is an edited, abridged version of the opening talk I gave at the NVIC conference in Washington, DC, where the award was presented. For the original speech in its entirety, go to my blog, http://mothering.com/peggyomara/
2009/10, where I also talk about other speeches from the conference.

As new parents, we believe that society will take care of us, has our best interests at heart, and will protect us. I want new parents to believe this, but health-care policy in the US is focused on eradicating rather than preventing disease. It is fear-based, interventionist, and compromised by economic considerations. At this time in history, assuming that society will protect you can be a dangerous belief.

It was new parents who, in 1976, founded Mothering in the mountains of southern Colorado. We were natural-living pioneers who had gone “back to the land.” Many of us tried to grow our own food, can fruits and vegetables, keep chickens and goats, and heat with wood. This was a time when one could find children’s cotton pajamas only at a secondhand store—newer pajamas for children were required, by law, to be made with flame retardants that were later found to be toxic. There were no natural personal-care products, and no packaged herbal teas or organic produce in grocery stores. Natural-living pioneers preferred to use peppermint oil or willow bark instead of aspirin for a headache, and were particularly cautious about the use of antibiotics. We often chose not to circumcise our male infants, and usually breastfed. When vaccinations were suggested for our babies, we had questions.

Mothering magazine was born out of these and other questions that natural parents had in the mid-1970s. Then as well as now, one of the most popular topics in the letters to the editor section was that of vaccination. In 1980, we published our first full-length article on the subject: Roxanne Bank’s “A Mother Researches Immunization.”

When we began covering the issue of vaccination in Mothering, we were asking legitimate questions raised by the community of natural-living pioneers. I never thought the issue would become of such wide concern, though I did anticipate its political significance when I subtitled our first anthology of reprinted articles on this subject The Issue of Our Times.

But that was before Congressman Dan Burton’s (R-IN) hearings of the late 1990s and early 2000s. That was before 1997, when the EPA set a reference dose for mercury in biologics. That was before July 1999, when the American Academy of Pediatrics (AAP) and the US Public Health Service called for the elimination of mercury from childhood vaccines.

It is concern for children that is at the root of the new health journalism. The new health journalists are participant observers reporting on their own lives. Some have medical backgrounds that help them in their search to find out what’s wrong with their children; others become scientists along the way.

When we publish articles about vaccines and autism, grateful mothers call me, in tears, and tell me that they now have something they can show to their relatives, to all the people who doubt them or who think they’re crazy. I know that these mothers are not crazy. I know they are telling the truth, because by the time a mother has reached the conclusion that her child has autism because of vaccines, she has considered and thrown out every other possible explanation. She did not want to come to this conclusion—she has dragged herself to it, kicking and screaming. If a mother has decided that vaccines caused her child’s symptoms of autism, then there is no question but that she is right—because she so badly wants to be wrong.

The mother always knows.

It is these heartbroken mothers and fathers who have gotten on the Web and told each other what is going on, compared symptoms, and put the pieces together. It is their experience that challenges the status quo.

Since 1980, Mothering has published hundreds of articles and letters about vaccines. In the early days of the magazine, this content was about reconciling vaccines with a natural-living philosophy. By the mid-1990s, it had become evident to me that parents were feeling oppressed on all sides. A mom sat in my office, weeping as she told me that she had no idea what her point of view was regarding vaccines. She felt pressured by her family to vaccinate, and pressured by her health practitioner not to.

When, in 1999, the AAP called for the elimination of mercury from vaccines, everyone took notice. It was also in the late 1990s that we began to hear in earnest from the community of families whose children’s autism was caused by vaccines, and to publish their stories. We were the first magazine to publish articles on hopeful treatments for children with vaccine-induced autism.

With 140,000 members, our discussion community on Mothering.com is the largest one for parents on the World Wide Web. Our vaccine forum has 24,000 threads and 263,000 posts. Before the Internet, there was no way for so many like-minded people to so easily exchange information about an issue. Unlike industrial media, which require special skills, special equipment, and considerable financial resources, digital media require no special knowledge or equipment, are immediate, and can be quickly updated.

In the leading textbook about the Internet, The Wealth of Networks: How Social Production Transforms Markets and Freedom (Yale University Press, 2006), author Yochai Benkler writes, “It seems passé today to speak of ‘the Internet revolution.’ . . . But it should not be. The change brought about by the networked information environment is deep. . . . It goes to the very foundations of how liberal markets and liberal democracies have coevolved for almost two centuries.” According to Benkler, we are shifting from a mass-
mediated public sphere to a networked public sphere. 
“I suggest,” he says, “that the networked public sphere enables many more individuals to communicate their observations and their viewpoints to many others, and to do so in a way that cannot be controlled by media owners and is not as easily corruptible by money as were the mass media.”

No better example of this exists than the proliferation of vaccine information on the Internet. It takes me hours now to do the research that, before the Internet, used to take weeks. Because of the networked nature of the Web, when an important observation is made within the online vaccine community, it is quickly picked up by other sites, and then by bigger sites. Before you know it, it’s on The Huffington Post, and then there’s an interview on Larry King Live. According to Christopher Harper, co-director of Temple University’s Multimedia Urban Reporting Lab, “Until recently, only a small number of people owned a news organization. Today, digital tools have empowered many people to own a news organization.”

Barbara Loe Fisher asked me if I have suffered for challenging the status quo. My job as a mother is to challenge the status quo. If I am lucky enough to have a child who is perfect and one of a kind, it is not my job to make my child be like everyone else. It is not my job to follow the current fashions, but to forge my own way, to develop my own personal ethic of parenting. As a journalist, my job is the same: to challenge the status quo. It’s not the media giants that need protection. It is the common man. As the journalist Finley Peter Dunne said a century ago, “the job of the newspaper is to comfort the afflicted and to afflict the comfortable.”

Because I own Mothering and am both its editor and publisher, I don’t have to answer to anyone, and seldom have to negotiate my point of view among my staff. But Mothering has suffered financially for our advocacy and our standards. Independent magazines are not the norm in the US. Most, if not all, of our competitors are owned by companies that publish multiple titles and therefore enjoy greater economies of scale. They are often driven by advertising, and seldom have a strong point of view.

We don’t take advantage of the ad dollars spent in other parenting magazines by formula companies and pharmaceutical manufacturers because we don’t accept ads for those products. In the magazine industry today, such a policy is almost unheard of. Our mission at Mothering magazine and Mothering.com is not to sell products to parents, though we hope that the products we do advertise are useful. Our mission is to help parents make informed choices.

The current trend toward patients’ rights, informed consent, and the new health journalism is about “we, the people.” We—all of you—have brought the issue of vaccine safety to center stage in the US, and it is only a matter of time before the new health journalism becomes the status quo. Don’t be deceived by the backlash—the last gasp of tyranny is always the loudest.

Issue 156 – September/October 2009

It’s safe to say that the No. 1 worry for most pregnant women is pain during labor. Secretly, you ask yourself, “Will I be able to handle it?” But it’s hard to know if you’ll be able to handle something you’ve never experienced before, especially when the cultural messages about birth in the US do not inspire confidence.

It’s understandable that you might be afraid of the unknown, but your experience of pain in labor may be more within your control than you realize. The amount of pain you feel during labor is affected by your perceptions of pain in general, and your beliefs about pregnancy and birth in particular. A supportive environment during pregnancy can help you to change these perceptions so that you feel more ready for a natural birth, which is, by definition, drug-free.

But what is labor pain like, anyway? Its nature is so couched in mystery and overdramatized by the media that you’re probably terrified of it. Pain in labor is the result of the dilation of the lower, narrow portion of the uterus, called the cervix, which must open to a diameter of 10 centimeters in order to allow the baby to pass through. In labor, the job of the cervix is to stretch from an opening the size of the tip of your nose to an opening the size of a circle drawn on the palm of your hand. No wonder you feel a stinging sensation as this is happening.

This dilation of the cervix happens gradually and rhythmically. During a natural childbirth, the contractions that stretch the cervix last for only 45 to 90 seconds, and peak in intensity at about 30 seconds. There are breaks between contractions during which there is no pain at all. The reason you can have confidence in your ability to handle these contractions is because of their very rhythmic nature. You have to handle only one at a time!

Pain in labor is not like the pain from an injury—persistent, constant pain that requires attention. Tooth pain, for example, is throbbing and relentless. You have to get to the dentist. Unlike tooth pain, pain in labor lets up. It is not aching but stretching. A toothache hurts; labor stings.

If you’ve ever had a massage, particularly a Rolfing session, you may have experienced what it feels like when a knot in a tight muscle is smoothed out by the strong pressure of someone’s fingers. There is a distinct stinging sensation, depending on the degree of pressure. You squirm from the stinging, but you can handle it. You can handle it because the practitioner tells you to breathe with it, and because it’s over quickly. It’s the same during labor: The pain is manageable because it doesn’t suddenly begin as a gripping pain at full intensity. It generally starts as a mild tightening that slowly builds, in strength and intensity, to a burning sensation. The contractions come in waves.

Although I can give you a general description of labor pains, no two women experience it in exactly the same way. In fact, the perception of pain in labor is uniquely subjective. In one study, a group of pregnant American women were compared with a similar group of women from the Netherlands. Each woman was given the same information beforehand about the risks of pain medication during labor. Only about 33 percent of the Dutch women asked for pain medication during labor, while 83 percent of the US women did. Forty-eight hours after birth, the American women noted that they had generally anticipated a painful birth and the need for drugs, whereas the Dutch women had anticipated less pain, and thus less likelihood 
of the need for drugs.

This study tells us a lot about how our expectations can affect our experience of labor. We are affected not only by our expectations about what birth will be like, but also by the perceptions and beliefs about birth we have inherited from family and culture. You can examine your own perceptions and beliefs about pregnancy and birth by asking yourself the questions in the box on this page.

Perhaps the most important factor in reducing your perception of pain in labor is to reduce your experience of stress. One important way to reduce your stress is to have the companionship of another woman during labor. A number of well-designed studies show that continuous labor support is one of the most effective methods for reducing pain in labor. One study reported a 30 percent reduction in requests for pain medication among women who used a doula for labor support. Clearly, you’ll be less likely to want drugs if you don’t feel alone.

Women who take childbirth-education classes also tend to request less pain medication. Most such classes teach breathing techniques, the purpose of which is to give you something other than the pain to focus on during the contractions and to help you stay in the moment. Practicing meditation is another way to learn to be in the moment, and can help prepare you to take labor contractions one at a time.

During labor, there are many things you can do to soothe the discomfort of the dilation of the cervix. You may enjoy a shower or bath in early labor, or a birthing tub as labor progresses. You can ask your partner to use the tips of the fingers to lightly and rhythmically stroke the bare skin of your abdomen, back, or thighs. This will help you to relax and focus. Massaging the inner thighs, buttocks, or lower back can also help to relieve pressure during labor.

Scent is another natural labor soother. Some essential oils are relaxing, and reduce sensations of pain by increasing the production of endorphins, the body’s natural pain relievers. Examples are lavender, chamomile, sweet geranium, jasmine, neroli, rosewood, lemon balm, mandarin, and cedarwood. Try them during pregnancy and choose ones that appeal to you.

One of the most important ways to relieve discomfort during labor is to change positions. Get off your back. Birthing upright can make labor shorter and less painful. Alternate among sitting, standing, and squatting; squatting can widen the pelvic outlet by 25 percent. Walk around during early labor. Get up on your hands and knees during contractions.

A number of acupressure points can also afford pain relief. In China, acupuncture is used instead of epidural anesthesia in 98 percent of births. The homeopathic remedy arnica, indicated for sore muscles, can be used effectively during labor. The herbs skullcap and catnip relieve pain, and calm and relax the body. Chamomile tea helps to control pain by relieving tension. Nutritional supplements such as calcium, vitamin E, essential fatty acids, and magnesium can ease labor discomfort. Ask your birth attendant for herbal, homeopathic, and nutritional recommendations specifically for you.

If it isn’t obvious by now, pain in labor is intensified by fear and tension. Tension can be the result of poor expectations regarding birth, and you can become fearful when you feel disturbed during childbirth. Childbirth is an involuntary process, and no one can help an involuntary process. The point is not to disturb it.

If you feel disturbed during your labor you will produce adrenaline, which slows the production of the hormones of labor: Your body, assuming you are in trouble, prepares to stop labor, and start again at a more opportune time. The uterus is the only muscle in the body that contains two opposing muscle groups: one to contract and open the cervix during labor, and another to close and tighten the cervix to stop labor. If your body produces adrenaline at the same time that your uterus is contracting, you will feel more pain.

If, on the other hand, you are undisturbed during birth, your body will release a cocktail of chemicals that will alleviate pain, give you an ecstatic rush after childbirth, make your baby irresistible to you, and help your breastmilk to let down. This cocktail is one of the many benefits of drug-free birth.

Drugs in labor unequivocally disturb the labor process. The cocktail of local anesthetics used for epidural blocks can cause varying degrees of maternal, fetal, and neonatal toxicity, according to the Physicians’ Desk Reference. While the efficiency of pain-relief methods during labor has been studied more than any other medical aspect of pregnancy, the adverse effects of these drugs on mother and baby have hardly been studied at all. We do know, however, that while the placenta reduces the effects on the baby of drugs given the mother, about 70 percent of any medication given the mother does reach the baby.

Narcotic analgesics such as Demerol, Nubain, and Stadol slow the baby’s heart rate and affect her respiratory system while she’s still in the womb, and, if given too close to birth, can also affect her breathing after birth. Babies of mothers who receive such narcotics show general sluggishness and sometimes have trouble in the early days. Remnants of the narcotics stay in the baby’s bloodstream for weeks. Long-term consequences of narcotics on the baby’s health are unknown, although a well-designed case-control study in Stockholm showed an increased risk of drug addiction among children exposed to pain-relieving drugs during labor.

I know you’re afraid of the pain of childbirth. I was too. We all are. Even after I’d had my first child, I always dreaded it. But the pain was never bad enough to make me want to stop having babies. I handled it.

It’s something you, too, can handle. Don’t let others underestimate you, and don’t underestimate yourself. You can’t expect yourself to know everything, especially if this pregnancy is your first. Find another woman in your area who has experienced drug-free birth and ask her to be your guide. Allow yourself to be supported and nurtured during your pregnancy. Model your pregnancy after the pregnancies of those who have had successful natural births. Find a practitioner who has lots of experience with drug-free birth and who believes in you. Believe in yourself. Your baby does.

Pregnancy and Birth

A look at your own perceptions and beliefs

1. What do you believe about your own birth?
2. What does your mother believe about your birth?
3. How would the women in your family complete this statement: “The women in our family are _______.”?
4. How would the women in your family complete this statement: “Childbirth is _______.”?
5. What do you believe about sex?
6. What do you believe about 
pregnancy?
7. What have friends told you about pregnancy and birth?
8. What three words do you associate with pain?
9. What are your three most secret thoughts about childbirth?
10. What do you fear most?