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The CBU Story: The Journey

My journey to the founding of Childbirth U started decades ago with the difference in experience between the births of my first two children.

I had a healthy pregnancy, with my first child, and an uneventful vaginal birth from the medical standpoint. Nevertheless,  the barrage of restrictions, procedures, and drugs left me feeling disempowered and incompetent during the experience. Afterwards, I felt  angry, disappointed in myself, disconnected from my baby and lacking confidence in my ability to meet the challenges of motherhood. I assumed it was the nature of the beast and that however unpleasant and distressing, it had all been necessary for my baby’s and my health. When I became pregnant for the second time, though, and began reading and thinking in anticipation of that birth, I discovered my assumptions were wrong. Everything that had made my experience so difficult was not only not beneficial but actively harmful.

For my second child, I wanted a “natural” childbirth. I intended to follow my body’s instincts unless, of course, a problem arose that demanded a change from that plan. I wanted, as I put it at the time, a “home birth in the hospital,” not realizing that it was possible to have a home birth at home. I found a progressive obstetrician who pretty much gave me exactly that. This time I emerged from the birth feeling on top of the world, in love with my baby, and for the first time in my life, feeling strong, capable, and loving my body for having done this amazing, challenging, miraculous thing. The first time, I had thanked my doctor for “delivering” my baby. This time, I gave birth. Oh, I was grateful to my doctor for making the experience possible, but I was clear on who had done the wonderful thing. To quote Barbara Katz-Rothman, this time I was the “magician,” not the “hat.”1

After that life-changing experience, I wanted to tell other women what I had learned: the choices you make can have a profound effect on how you end up feeling about yourself, your partner, and your baby. I decided to train to become  a Lamaze teacher once my baby was older. In the meantime, I began working with a group of activist women and doctors and midwives in my community who were starting a birth resource center and freestanding birth center, and attending births as what would later come to be called a doula. (In that era, the idea of one-to-one continuous labor support from a knowledgeable and experienced woman was in its infancy.)  

Once I began teaching, I quickly discovered that the women in my classes were in the same boat as I had been during my first pregnancy. They accepted without question that highly medicalized management was required to ensure a healthy baby. I knew differently. I knew from reading the obstetric research and from my work with midwives and progressive doctors that intervening medically only when supportive care and patience proves inadequate to resolve a problem is by far the better approach.

The recognition of that knowledge gap launched me into what has become my life’s work: giving women and birth professionals access to what the research establishes as safe, effective, satisfying care so that expectant mothers can judge the validity of their care providers’ recommendations and make informed decisions about their care.

Three books and countless articles, posts, pamphlets, and speaking engagements later, my recognition is as relevant today as it was when I first began my maternity care reform efforts over 30 years ago. The gap–well, more of a chasm really–between optimal care and typical management continues, and women by-and-large don’t know it is there.  

To see my evidence for the gap between optimal care and typical management, sign up for

“The Thinking Woman’s Guide to Optimal Care”

The CBU Story: The Vision

I developed CBU to continue my work and make it possible for more pregnant women to have access to:

  • analyses laying out what the best obstetric research establishes as optimal care, so they can fact check what others recommend or advise.
  • summaries of the research evidence supporting my assertions and arguments, so they can form their own opinion as to who has the right of it.
  • practical recommendations, so they can apply what they’ve learned to making and implementing plans.

An online presence allows students to learn at their own pace at and at their own convenience. It also offers the opportunity to interact with me and other students despite being thousands of miles apart. Finally, unlike books, course lectures are easily updated to keep them current.

My vision, too, is to have a true “university.” I want to include additional “faculty” who can tackle topics that aren’t my areas of knowledge or expertise.  

I truly have no investment in what decisions a woman makes. I only care that she makes them with complete and accurate knowledge of the potential benefits and harms of her choices as well as knowledge of the full range of those choices. I grieve for the woman who says, “I didn’t know that could happen,” or “I didn’t know that was an option,” and even more for the woman who never even knew she had a choice. CBU is the continuation of my efforts to reduce the number of women for whom these are the case, and one of my great pleasures is the occasional woman who lets me know that I have succeeded.

  1. Katz-Rothman B. The social construction of birth. In: Eakins PS, ed. The American Way of Birth. Philadelphia: Temple University Press; 1986.

Optimal Care in Childbirth

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