Grassroots Network--New Websites of Interest

From Susan Hodges, CfM President...

The Midwives Alliance of North America has just announced a beautiful new public education website Mothers Naturally, which also includes listings of midwives, information about natural pregnancy, home birth, midwives and birth stories. The site is a work in progress, with
plans to expand content.

Another interesting and beautiful new website is Conscious Woman. This site is a source for interactive online workshops, at moderate prices (with CEUs) with an awesome array of presenters. If you are interested in hearing and seeing Diane Wiessinger speak for yourself, her session "What Would Mammals Do?" is one of the upcoming workshops available from Conscious Woman. You can also sign up for a half hour, free session that introduces and lets you try out the WebEx technology used for the sessions. Plus there are forums.

Many of you probably have seen Ricki Lake's new film The Business of Being Born. On the site is a trailer for the film, information about how you can schedule a screening, where it is being
shown, Ricki's blog, and more to come.

Did you get a chance to read Jennifer Block's excellent book Pushed: The Painful Truth About Childbirth and Modern Maternity Care? Block has an excellent site as well: Pushed Birth. While clearly one part of its function is to market the book, she also keeps an active blog that
highlights key news articles and other new information – a good site to check out frequently!

Ken Johnson and Betty-Anne Daviss, authors of the study on birth outcomes for Certified Professional Midwives that was published in the British Medical Journal, now have a website. Probably of greatest interest is the "Answers to Questions" page, where they answer clearly and in some detail some questions people have had about the study. Even if you did not have questions, this page is very educational. (If you are not familiar with this study, check out CfM's summary online)

If you are not on the Grassroots Network email list, you may easily join!

The Waterbirth Book

Janet Balaskas is the author of the classic childbirth book Active Birth. Less well-known is her also excellent, The Waterbirth Book, which was published in 2004. In this book, Janet Balaskas offers a comprehensive & inspiring guide to waterbirth for both parents & midwives. Her book is detailed, straightforward, and supportive.

The book contains sections about historical and cultural perspectives of waterbirth, the benefits of water in labor and birth, what to expect and how to prepare for a waterbirth, personal stories, how to choose and use a birth pool, information about the use of water during each stage of labor, and specific information/instructions for midwives.

The Waterbirth Book is quite good, comprehensive, and informative. It also has some nice black & white photos. It is very up to date. It is geared toward a UK audience, so some of the language/stats are based on that audience (for example, it assumes that midwives are legal & that one will readily be present at your birth--I wish the same were true in all US states!).

Book Reviews

Over the next several days, we will be posting a series of short book reviews. We hope this might be fun or helpful for people seeking excellent gifts for their doulas or midwives or for their birth educator or birth activist friends!

The first brief review is of the book Rediscovering Birth by Sheila Kitzinger. This book is a large hardcover coffee table type of book with many wonderful photos. The photos are the best aspect of this book and one that can keep you busy for hours! This book is not really designed as a "preparation for birth" book or as a guide to birth, but as a celebration of the beauty of birth and of pregnant women. It is also an anthropological, sociocultural, and historical look at birth. My observation is that many people are unaware of this book and as such it would make an interesting and unusual addition to a personal or professional library! It is an excellent read for people wishing to go beyond "the same old thing."

Rediscovering Birth is also on the required reading list for BirthWorks childbirth educator certification.

Becoming an Informed Birth Consumer

There are several helpful ways to become an informed birth consumer:

Read a book such as Henci Goer's The Thinking Woman's Guide to a Better Birth.

Hire an Independent Childbirth Educator (someone who works independently and is hired by you, not by a hospital). Some organizations that certify childbirth educators are The Association of Labor Assistants and Childbirth Educators (ALACE), Childbirth and Postpartum Professionals Association (CAPPA), BirthWorks, Bradley, Birthing From Within, Lamaze, and Childbirth International. Regardless of the certifying organization, it is important to take classes from an independent educator who does not teach in a hospital.

Consider hiring a doula-- a doula is an experienced non-medical labor support provider who offers her continuous emotional and physical presence during your labor and birth. Organizations that train doulas include ALACE, CAPPA, and DONA.

Join birth organizations specifically for consumers such as Citizens for Midwifery or Birth Network National.

Talk to other women in your community. Ask them what they liked about their births and about their care providers. Ask them what they wish had been different.

Ask your provider questions. Ask lots of questions. Make sure your philosophies align. If it isn't a match, switch care providers. This is not the time for misplaced loyalty. Your baby will only be born once, don't dismiss concerns your may have over the care you receive or decide that you can make different choices "next time."

Find a care provider that supports the Six Care Practices that Support Normal Birth and is willing to speak with you seriously about them:

• Labor begins on its own
• Freedom of movement throughout labor
• Continuous labor support
• No routine interventions
• Spontaneous pushing in upright or gravity-neutral positions
• No separation of mother and baby after birth, with unlimited opportunities for breastfeeding

Remember that birth is YOURS--it is not the exclusive territory of the doctor, the hospital, the nurse, the midwife, the doula, or the childbirth educator. These people are all paid consultants--hired by you to help you (and what helps you, helps your baby!).

Birth is a Consumer Issue

When speaking about their experiences with labor and birth, it is very common to hear women say, "they won't let you do that here" (such as regarding active birth--moving during labor). They seem to have forgotten that they are customers receiving a service, hiring a service provider not a "boss." If you went to a grocery store and were told at the entrance that you couldn't bring your list in with you, that the expert shopping professional would choose your items for you, would you continue to shop in that store? No! If you hired a plumber to fix your toilet and he refused and said he was just going to work on your shower instead, would you pay him, or hire him to work for you again? No! In birth as in the rest of life, YOU are the expert on your own life. In this case, the expert on your body, your labor, your birth, and your baby. The rest are "paid consultants," not experts whose opinions, ideas, and preferences override your own.

As Mary Rucklos Hampton says (quoted in CfM News):

"The effort to separate the physical experience of childbirth from the mental, emotional, and spiritual aspects of this event has served to disempower and violate women."

Fall Issue of CfM News!

The fall issue of CfM News is now available and contains a variety of articles and reviews. We have articles about the BOLD movement, about the launch of The Birth Survey in NYC this summer, an update about midwifery legislation in Missouri, an article about domestic violence during pregnancy (and abuse of pregnant women in the medical setting), summaries of CfM's experiences at recent conferences, legislative workshops in South Dakota (whose consumer group has a website with several excellent and useful fact sheets!), and the two page new Mother Friendly Childbirth Initiative "highlights of the evidence" fact sheet.

Reviews included of:

The new Ricki Lake and Abby Epstein film The Business of Being Born.

The ICAN published hard-hitting book Cesarean Voices.

The educational edition of the beautiful film Birth as We Know It.

The widely appealing book The Official Lamaze Guide: Giving Birth with Confidence--a short review is: Excellent! I think the Lamaze name gives this book widespread appeal and acceptability to the "mainstream." I wish it was in the hands of all the pregnant women in my town!

CfM Vision + Ideals vs. Reality

CfM has a Vision: The Midwives Model of Care is universally recognized as the optimal kind of care for pregnancy and birth, and is available to all childbearing women and their families. To achieve this vision, CfM promotes the Midwives Model of Care by providing public education about midwifery, the Midwives Model of Care and related childbirth issues, and by encouraging and supporting effective grassroots action.

The World Health Organization (WHO) and the Coalition for Improving Maternity Services (CIMS) both recognize midwives as the appropriate birth attendant for normal births. WHO recommends out-of-hospital birth as preferred and CIMS recommends the location for birth that is preferred by the mother. Based on 2004 data, the ideal is much different than the reality for most women in the United States where less than 8% of births are attended by midwives and 99% of births take place in hospitals. WHO and CIMS also recommend that electronic fetal monitoring (EFM) *not* be used routinely, though when last accounted for 85% of women experienced EFM during their labors. The organizations also recommends against the routine use of pain relief medications during labor and 80% of women in the US used pain medications in labor. The suggested induction rate is 10% or less when in reality it is at least twice that percentage (48% according to the 2005 Listening to Mothers II report). The WHO states that the systematic use of episiotomy is not justified, but the US women still have a 23% chance of having one. Finally, the cesarean rate recommended by the WHO and suggested by CIMS is 10-15%, where is has reached 32% in the United States as a whole (and is much higher in some areas and hospitals).

Many women feel their experiences and the interventions involved with their births were unique to them, when they actually experienced what Naomi Wolf terms a "stereotypical bad birth."

LLL of MO Conference

Last weekend I attended the LLL of MO conference (the lovely conference logo to the right was designed by the talented Summer Hill). I was thrilled to attend several presentations by Diane Wiessinger. Diane is a gifted speaker with lots of powerful insights about birth and breastfeeding (or, as the other headline speaker, Dia Michels, said "we should have a new word--birthandbreastfeeding"). The two are inextricably linked and it DOES matter how and where you give birth. As Diane said, "It's the birth, silly!"

With regard to birth and the impact of birthing practices on breastfeeding Diane makes comparisons to other mammals. Human mother and baby pairs are also mammal pairs and are biological primed to expect certain things and to thrive in some circumstances and not in others. One of her analogies is of moving a mother dog to another setting to give birth:

"Your pet dog is in labor. Instead of leaving her in the quiet corner she has chosen, you bundle her into the car and take her to a strange, brightly lit house bustling with strangers who keep poking and peering at her. As each puppy is born, it is positioned at one of her teats for a few minutes to see if it will latch on. If it doesn't latch immediately, it's washed, wrapped, and put in a separate box until later."

Would we expect this dog mother to have an easy labor and birth? Would we expect her well-wrapped baby to suckle well when returned to her after several hours of separation? Would we be the best people suited to determining when and how often the puppies needed to nurse and how often their mother should be with them? NO! The mother's biology and the puppies' biology are what facilitates smoothness in birth and breastfeeding, NOT the things that are done to them by others.

Diane also shared the following description of why your baby's birth matters:

"A trip to a strange place with strange smells. Bright lights, busy people. Numbness. A carefully cleaned and wrapped baby who doesn't stay with Mama. Any other mammal would reject her baby after a beginning like that. Which means that most American mothers have to welcome their newborns with their heads and not their hearts. Not the best start for confident mothering. Not the best start for breastfeeding. Not the best start for love."

She also says, "Don't be fooled by the Birth Channel. A normal birth is not a medical event or a source of horrible pain. It happens on its own, with the woman moving in whatever way feels right to her, feeling the labor and feeling--being--in charge. Find someone who will support this." (Hint: A provider who practices The Midwives Model of Care supports normal birth like this!)

An interesting new website called Conscious Woman has recently been launched. This site is a source for interactive online workshops. If you are interested in hearing and seeing Diane Wiessinger speak for yourself, her session "What Would Mammals Do?" is one of the upcoming workshops available from Conscious Woman! How neat to have a site available like this to bring important speakers and sessions right into the comfort of your own home.

MANA Conference

Susan & Nasima recently attended the MANA conference in Florida. They found the plenary panel on racism important and consciousness raising and were glad to attend. Attending conferences and networking with other childbirth-related organizations is an important element of our aim of "getting the word out" about midwives and the Midwives Model of Care.