by Jillian Hanson

Simkin has mixed feelings about current, mainstream trends in birth. "Well, I'm more hopeful now than I was five years ago," she says, referring to the growing doula movement, and also her work with others in the field who have come together as the Coalition for Improving Maternity Services (CIMS). Out of growing concern over the kind of care mothers and babies typically receive in this country, CIMS formed a few years ago to produce a document called, "The Mother Friendly Childbirth Initiative," which they hope will be adopted by hospitals and birth centers nationwide. The initiative defines mother-friendly maternity services as those which promote birth as a normal process; empower women and provide them the freedom to make informed choices; do no harm by applying unnecessary interventions; and take responsibility for quality of care. It also outlines 10 important steps for hospitals, birth centers and home birth services to take to become mother-friendly. As chair of CIMS's education committee, Simkin hopes to drum up as much publicity for the Mother Friendly Childbirth Initiative as possible.

"It's time to give mothers the kind of care they need. So we're hoping this is a groundswell. There are many wonderful people involved in the effort to revolutionize maternity care in the US, so I feel hopeful -- even though most women don't have a lot of confidence in their own ability to give birth and many don't see why they should bother to do it themselves. Through better education of both care providers and of the public, through nurturing, support, and humane care during childbirth, and through the application of scientific findings on safety in childbirth, women will gain confidence. This [initiative] is based on scientific research which proves the effectiveness of mother-friendly care. It also saves money and is safe. So I think we may be able to get another philosophy of care prevailing in this country." In general, however, Simkin seems to feel that American beliefs and practices around birth still have a long way to go.

"Many women have no confidence in themselves in giving birth, and little motivation to do it themselves. And that's depressing. The epidural is safer than it used to be, but it is not safe enough yet, in my opinion, for everybody. A lot of anesthesiologists would disagree with me, but I'm right. And I think that prenatal care emphasizes that women are always in danger of complications: We're going to test you for this, test you for that. Let's see if you're normal after these tests. No one among conventional caregivers encourages women that pregnancy and birth are normal, that they can do it.

"In terms of safe, cost effective and non-invasive methods of care, we're in bad shape, even compared to Canada, right next door. You may know the USA is tied for 21st place, which is last, among the industrialized nations, in terms of our infant mortality rates. We're not doing well compared to other nations. To achieve a positive change, we need more of a consumer movement than we've had. It's been pretty dead for the past 15 years or so. We definitely need more interest taken by the public in how women give birth and how babies are brought into the world."

"I'd really like to remind all expectant parents, especially each expectant mother, that her experience in giving birth is something she will never, ever forget."
- Penny Simkin

An unforgettable experience
Simkin knows, personally and professionally, how important the birth experience is for each woman who goes through it.

"I'd really like to remind all expectant parents, especially each expectant mother, that her experience in giving birth is something she will never, ever forget. And it will have a tremendous impact on her, not only her feelings about birth, but even her feelings about herself. The potential for positive impact is great, but it takes planning, advance preparation, and safe, respectful nurturing at the time. I'd urge women to take their upcoming childbirth very seriously. It matters too much to turn the experience of a lifetime over to someone else."


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Penny Simkin is a physical therapist, childbirth educator, author, and doula. She is highly regarded both nationally and internationally in the field of childbirth and labor support and has published several books for expectant parents and childbirth professionals promoting woman-centered childbirth. Simkin, an unassuming woman, is humble about her success and passionate about her work. She is also a one-woman force for woman-centered labor and childbirth practices. In 1992, Simkin founded Doulas of North America (DONA), an international organization that certifies doulas (trained labor support people) and provides its members with support and continuing education. At "almost 60," she is still going strong: writing, teaching, traveling, lecturing, and counseling expectant mothers who are survivors of sexual abuse and women who have had disappointing birth experiences.

About the Author: Jillian Hanson is a freelance writer and mother living in western Massachusetts.