It's Almost Labor Day!

And that means it is almost time for productions of Karen Brody's play, Birth, to begin all across the country. BOLD (Birth on Labor Day), was founded by Brody in 2006 and is based on a "theater for social change" model. Beginning in 2009, BOLD performances will be taking place all year, instead of only in the month of September. Brody also has a blog that I enjoy reading.

It looks like at least 38 cities are hosting performances of Birth in Sept, or early October, and 28 cities are holding BOLD Red Tent events at some point during the year. This makes my little activist heart sing!

One of my goals in life is to someday see, or organize, a BOLD event in my own community!

While perusing the BOLD website I came across a link to a new program that I was previously unaware of--Earth Birth: A Global Women's Health Collective. Establishing birth clinics in Africa and training traditional midwives to provide holistic health care is the goal and there is a pilot program in Uganda serving the "child mothers," girls who were abducted from their homes, raped, and made into the "wives" of soldiers.

Thin Air Media's BORN

A little while ago I learned that Thin Air Media has produced a new radio documentary called BORN--a one hour public radio journey about the postpartum experience in America. The show will be distributed by Public Radio International in Sept. 2008. Please call you local public radio station to request that BORN be aired in your local community!

Last year, my local public radio station aired The Birth Tour ("part one" of sorts of this series from Thin Air Media). I got to hear it and it was quite interesting. I'm thrilled to see them address postpartum, because this is often overlooked transition point in our society. From my vantage point, postpartum is even more neglected than birth is in mainstream media and American culture.

The Birth Survey has Launched Nationwide!

Well, the moment we have been waiting for has arrived. The Birth Survey project has launched nationwide. This is an exciting moment!

Here are all the details and information about how you can help from the CIMS Grassroots Advocates Committee:

The Birth Survey Now Available Nationwide!

For years, consumers have enthusiastically shared online reviews of movies, restaurants, products and services, but readily available information about maternity care providers and birth settings was nearly unattainable--but no longer. The Birth Survey is now available to all women in the US who have given birth in the last three years. Women can now give consumer reviews of doctors, midwives, hospitals, and birth centers, learn about the choices and birth experiences of others, and view data on hospital and birth center standard practices and intervention rates.

Thank you to all the tireless volunteers who have worked so hard since 2006 to make this project a reality. And thank you to all our new project ambassadors and friends who are helping to make the Transparency in Maternity Care Project: The Birth Survey a reality.

To help spread the word about The Birth Survey, please:

• Send E-mails out to your contacts encouraging them to take thesurvey (e-mail text provided at end of this message). Suggested language is provided below. An automated “Invite a Friend” email tool can be accessed here. Invite your friends with a personalized message!
• Post the downloadable web banners and buttons to The Birth Survey on your personal or organizational websites. Download these here.
• Add a link to The Birth Survey Project in your email signature and on your website.
• Distribute postcards inviting women to take The Birth Survey. These cards can be downloaded here and printed as needed or preprinted cards can be ordered from CIMS here. Preprinted materials are currently being printed and will be mailed out in about two weeks.
• Send Press Releases to local press outlets. Press releases will be sent out nationally on Monday morning 8/18. A pdf press release that can be used for distribution by anyone will be available here on Monday. We encourage those of you who have been trained as a Marketing Ambassador and have signed a MOU to request a customizable press release by e-mailing admin@thebirthsurvey.com. We will provide these ambassadors with a customizable press release in which their personal contact information can be added if they plan to act as a local press contact.
  

Thank you all for your support of this project. If you have questions please e-mail admin@thebirthsurvey.com.

Language for Distribution Below:

Longer Project Description for Distribution:

For years, consumers have enthusiastically shared online reviews of movies, restaurants, products and services, but readily available information about maternity care services was nearly unattainable—but no longer. The Coalition for Improving Maternity Services (CIMS) has developed www.TheBirthSurvey.com, a consumer feedback website where women provide information about the maternity care they received from specific doctors, midwives, hospitals, and birth centers. Families choosing where and with whom to birth can utilize this consumer feedback, along with data on hospital and birth center standard practices and intervention rates, to make more informed health care choices.

Have You Given Birth in the Last Three Years?

If so, take The Birth Survey and provide feedback on your doctor, midwife, birth center or hospital at www.TheBirthSurvey.com.

Help Spread the Word About The Birth Survey!

Forward this e-mail and download buttons, banners, and promo cards at www.thebirthsurvey.com. Are you interested in helping to get the word out about The Birth Survey in your community or working to obtain official facility level intervention rates? To get involved, contact us at info@thebirthsurvey.com.

Support this non-profit project by the Coalition for Improving Maternity Services (CIMS) by donating or becoming a member here and sign up for e-cims newsletter here.

For information visit www.thebirthsurvey.com or email info@thebirthsurvey.com.

Short Email Template for distribution:

Hi!

I found this great site, check out www.thebirthsurvey.com

The Birth Survey works by asking birthing women nationwide to provide feedback about their doctor, midwife, hospital, birth center or homebirth service. Responses are made available online free to other women who are deciding where and with whom to birth.

The Birth Survey is…

• FREE
• Available to women who have given birth in the US in the last three years
• Accessible online 24/7 at www.thebirthsurvey.com

Take the Birth Survey and provide feedback on your maternity care experience at www.thebirthsurvey.com. Help women in your community or around the US find quality providers and birth settings that are compatible with their needs and philosophies.

Help spread the word about The Birth Survey! Forward this e-mail and download buttons, banners, and promo cards at www.thebirthsurvey.com.

Support this non-profit project by the Coalition for Improving Maternity Services (CIMS) by donating or becoming a member at http://www.motherfriendly.org/online_contribution.php and sign up for e-cims newsletter at http://www.motherfriendly.org/e-cims.php

Congressional Candidate on Homebirth + Other Recent News

There was a nice little press release available recently from a congressional candidate (Dr. Mike Hargadon [dentist]) in Maryland responding to the AMA resolution against homebirth. I really like the closing comments based on his family's personal experiences:

"Many families, including my own, have decided that they're unhappy with the traditional hospital birth experience and find that midwives give them a better experience for low-risk births. My first child was born in a hospital over 30 years ago, while the doctor was complaining about missing the Colts' game and trying to induce labor. So our next three children were born in the presence of midwives. The births of those three, who were born at their own pace, were a much more beautiful life experience than a time management 'problem.'"

There was also a compendium of comments about Missouri midwifery in the Riverfront Times this week called "There's no birthplace like home."

Blogs referencing CfM recently include:

1. Birthing Your Baby on "Choosing a Care Provider and Birth Place":

"...Citizens for Midwifery offers a chart Ideals vs. Reality in U.S. Births, which compares the WHO recommendations, CIMS recommendations, and U.S. reality as of 2004.....So that's my highlight of information that could help a mother (and her partner) choose the kind of care provider and birth setting that will work the best for them, as well as information on interviewing/choosing a specific provider and setting."

2. Matt & Katie on News From the Birth World.

3. CfM was also referenced in a recent newspaper article, "The Birth of a Movement,"in the Rutland Hearld regarding midwifery in Vermont

Grassroots Network: TIME Magazine: “Giving Birth at Home” article!

Dear Friends,

The issue of TIME on newsstands TODAY includes this article: Giving Birth at Home By Ada Calhoun, Thursday, Aug. 07, 2008

Any publicity is “good”! So while this article could have been a little more accurate and better, it is remarkably even-handed, and brings more national attention to this topic!

It’s time to get out your pen (or keyboard!) and write Letters to the Editor at TIME!

If a lot of us write letters to the editor it will indicate to TIME that home birth and midwifery are of high interest to their readers. So it is good to acknowledge that we are glad they are covering this topic.

At the same time, there are a number of incorrect statements and our letters can address these. A lot of regular readers consistently read the Letters to the Editor, so this is also a way to bring correct information to the readers, depending on what letters are published.

This message includes some QUICK TIPS, more detailed GENERAL WRITING GUIDELINES and SUGGESTED WRITING POINTS posted by Colette Bernhard, an Illinois birth activist, followed by a list of quotes from the article noting incorrect information etc. I’m sure you all will think of more angles, points to make, but this is a start.

Happy writing!!

QUICK TIPS

Time should hear from us! You can e-mail a letter to the editor by clicking on the author’s name on the on-line version, or writing to: letters@time.com.
· Make one or two main points clearly; do not try to address everything.
· Do not send attachments.
· Include your full name, address, home phone
· Note that your letter may be edited.
· If you look at letters that are published, they tend to be pretty short and are likely to have a bit of a punch or humor.
· The main point is that they should hear from a lot of us, whether or not any of our letters actually make the cut for publication.

GENERAL WRITING GUIDELINES

~ Keep it short. The longer your response, the more likely you will be edited or not published.

~ Start by acknowledging on their coverage of home birth. For example, you can thank them for covering home birth, or state that you're surprised by, or disappointed in, their coverage of the home birth maternity care crisis. (What was your first reaction when reading it? Sometimes it's best to describe that.)

~ Include the title of the story and the date.

~ Try to avoid putting a negative term next to "midwife" or "homebirth".
(Example: instead of saying "death rates at home are low," say "home birth is as safe as hospital birth".)

~ Be sure to list any professoinal or advanced academnic credentials after your name, especially if it's health care related (MD, DC, RN, Doula)

~ Pick a writing point in the list below add and introduction and reword it as much as possible in your own words, to avoid the appearance of a form letter.

SUGGESTED WRITING POINTS (Do not copy put into your own words!)

* For a variety of profound reasons, some women are always going to choose home birth, and we need care providers to be recognized by all 50 states so home birth can be better integrated into the healthcare system, and so that there will be enough providers to attend home birth. Simply put: home birth women need certified professional midwives. (If you can, briefly summarize your own difficulties in accessing home birth midwifery care.)

* There is a lot of literature showing home birth with midwives is very safe, and in some ways safer. Organized medicine is comparing apples to oranges in the 2 or 3 flawed studies they cite. Only poor, uncontrolled studies misrepresent planned home birth with a midwife in an unfairly bad light. (Pang study from Washington State included unplanned emergency births. Australian study involved women living in very rural Australia and included higher risk categories.) Property conducted studies all show home birth as safe as hospital (excluding women with medical problems)

* All the states (and Canadian provinces) that license certified professional midwives for home birth show good results. Laws licensing CPMs are renewed instead of repealed, and in some states the practice is actively encouraged.

* The American College of Obstetricians and Gynecologists is in stark contrast to their Canadian and British counterparts (Royal College of OB/Gyns and Society of OB/GYNs of Canda). In Canada and Britian the OB groups embrace midwifes as the experts in normal, natural birth, including home birth. In Great Britian it's a woman's officially recognized civil RIGHT to have a home birth.

* Complication statistics quoted by physicians are based on birth that has been chemically or mechanically manipulated by hospital and medical procedures. Those same complications have a lower risk at home with a midwife. Therefore, it's understandable that hospital OBs fail to understand home birth; doctors are used to riskier hospital birth, and then using their surgical skills to fix the problems they created in the first place. At home, the midwife herself is there through much of the labor, carefully monitoring to make sure things are proceeding normally. In addition to lower risk of complications to begin with at home, many things may be detected sooner with one-on-one care that does not exist in hospitals. (If you can personally or professionally speak to wonder how doctors would know how quickly problems arise in a birth, since they're not there in hospital births until the last x# of minutes.)

Susan’s thoughts and observations…
Below are some quotes that include incorrect information:

"Legislating against home birth is totally un-American and unfair," says Joan Bryson, who has worked as a midwife in New York City for 17 years. "We rank 42nd in the world in live births, and we spend more money than anyone else. You can't blame it on home birth."
This is likely a typo. For infant mortality stats in TIME! See: Why Do US Infants Die Too Often? May 13, 2008 at http://www.time.com/time/health/article/0,8599,1736042,00.html?iid=sphere-inline-sidebar

“While home birthing still accounts for less than 1% of U.S. births, there's a movement afoot to license more lay midwives to attend home births. Concerned by this development, the American Medical Association (AMA) is urging lawmakers to curb the home-birthing movement, including having the licensing of so-called direct-entry midwives--who do not have nursing degrees--overseen by a state medical-practitioner board.”
The effort is to license Certified Professional Midwives, who must meet rigourous requirements for knowledge, skills and experience. This credential is the only maternity care credential requiring experience in out-of-hospital settings. (The author never mentions CPMs in the article)

“But it's those precious minutes that have obstetricians alarmed. "Unless there's ready access to certain emergency personnel and equipment and even surgery, you're potentially endangering babies' and moms' health and lives," says Dr. Erin Tracy, an ob-gyn at Boston's Massachusetts General Hospital who authored two anti-home-birth resolutions approved by the AMA in June. "We've all seen scenarios where mothers came in, after very major blood loss, in a very catastrophic state," she says. "By the time they arrive in the hospital, you're sort of behind the eight ball in trying to resuscitate these patients. The same thing with neonatal outcome."
No evidence for this. We know from the CPM 2000 study (see summary fact sheet at http://www.cfmidwifery.org/pdf/CPM2000.pdf ) that hospital transport for major blood loss is extremely rare, but OBs frequently make statements like these with no basis in fact. In fact, very few of home birth transports for hospital care are for actual emergencies most are for exhaustion or mother’s desire for pharmaceutical pain relief.

“After birthing moved to hospitals en masse in the 1950s, the maternal mortality rate plummeted, from 376 per 100,000 live births in 1940 to 37.1 per 100,000 in 1960.”
At the same time that birth was moving to the hospital (over the first half of the 20^th century), public sanitation was improved, antibiotics were developed, and blood transfusion technology became available. These factors were most significant in saving mothers’ lives, not moving birth to the hospital per se as implied by this quote. The quote is an example of mistakenly making a leap from observations that are merely associated to an assumption that there is a causal relationship.

“This summer, Missouri reversed its 25-year ban on non-nurse midwives. Twenty states have similar legislation they are either introducing or planning.
“Twenty-six states now recognize direct-entry midwives in statute, 24 through licensure.” (Issue Brief: Certified Professional Midwives in the United States at http://mana.org/pdfs/CPMIssueBrief.pdf ). Of these ,twenty- two states specifically recognize the CPM as a basis for regulation and/or use the CPM examination as the state licensing exam. While Missouri advocates are continuing to work on legislation to provide for licensing, the “reversal” this summer was decriminalization, and Missouri is currently almost alone in having this kind of legislation.

“Meanwhile, many obstetricians are trying to meet women halfway, through hospital-affiliated natural-birth centers.
This is news to me! In any case, there are way too few birth centers, and they are not evenly distributed, so most women do not have access.

A final thought: Since the vast majority of obstetricians have never observed an undisturbed, physiological or natural birth and are trained to perform unnecessary and harmful, complication-causing protocols and interventions on laboring women, and since the obstetric community controls more than 95% of births in the US but finds it necessary to drug, induce and/or perform surgery on the majority of healthy pregnant women during childbirth with outcomes for mothers and babies that are far worse than most other developed countries, is this a profession that is even competent to have any authority over normal birth?

Remember, pick just ONE point to make in your letter!

Sincerely,
Susan Hodges, “gatekeeper”

Grassroots Network: ACNM responds to AMA Resolutions

Dear Friends,

The American College of Nurse Midwives has responded to recent AMA Resolutions (regarding home birth and regarding doctor supervision of midwives) with a letter to the AMA and addenda. While these are understandably written from ACNM’s viewpoint and interests in the CNM and CM credentials, overall the documents are excellent, and do a good job of affirming home birth and pointing out the outrageousness of ACOG/AMA behavior regarding these issues. The addenda are organized by topic and the statements are well-documented. In my opinion the ACNM has done an outstanding job of refuting all the main issues raised by the AMA’s Resolutions, especially the anti-home birth resolution 205 (see Grassroots messages 806032, 806033, 806037 and 807038). The addenda in particular should prove to be excellent resources (including all the references) for supporting the option of planned home birth.

You can read (and download) these documents here:

Letter to AMA
Addenda

Sincerely,
Susan Hodges, “gatekeeper”

Grassroots Network: CPM Issue Brief posted

Dear Friends,

The announcement below introduces a new authoritative document about the CPM credential and the organizations associated with it. Produced jointly by MANA, NARM, MEAC and NACPM, this will be an invaluable resource for everyone who is working on getting CPMs legal and accessible.

A copy of the Issue Brief: Certified Professional Midwives in the United States can be accessed here.

Do read the full announcement below!

Sincerely,
Susan Hodges, “Gatekeeper”

Announcement:


The North American Registry of Midwives, the Midwifery Education Accreditation Council, the National Association of Certified Professional Midwives, and the Midwives Alliance of North America are pleased to announce the release of An Issue Brief: Certified Professional Midwives in the United States. We have produced a concise and accurate document that provides the background necessary to understand the genesis of the CPM and its implementation as well as address issues related to the professionalization of direct-entry midwifery in the United States. The national organizations that collaborated in the writing of this document have played essential roles in the formation of the Certified Professional Midwife (CPM) credential and in the ongoing support for the development of the profession.

A new era in midwifery in the United States began in 1995 with the implementation of the CPM credential. Today these well-trained professionals serve more and more families. CPMs bring a deep understanding of normal birth, and the care that fosters normal birth, to the women they serve.

CPMs are a rapidly growing group of maternity care providers.
This document is an authoritative source in describing the education, qualifications and scope of practice of CPMs for the benefit of childbearing women and families, other maternity care professionals, as well as legislators, insurers, and policy makers. We believe it also timely to describe the unique contributions that CPMs are making to national discussions about how to educate the numbers of midwives who will be needed to meet the needs of women in the next decades. And, perhaps most essential, it is important to describe the contribution that CPMs are making to the health care system itself by offering maternity care that is high quality, cost-effective and safe in an era when the efficient use of healthcare personnel and resources has become paramount.

A copy of the Issue Brief: Certified Professional Midwives in the United States can be accessed here.

We hope that this Issue Brief will serve women as well as policy makers, and we invite inquiries. Responses, comments and questions sent to cpm.issue.brief@gmail.com will be shared with all authoring organizations.
For mothers and babies,


Ida Darragh, Board Chair
North American Registry of Midwives (NARM)

Jo Anne Myers-Ciecko, Executive Director
Midwifery Education Accreditation Council (MEAC)

Mary Lawlor, President
National Association of Certified Professional Midwives (NACPM)

Geradine Simkins, President
Midwives Alliance of North America (MANA)

Grassroots Network: “New Mothers Speak Out” report from Childbirth Connection

Childbirth Connection has just announced the release of their New Mothers Speak Out survey report, the third report in their Listening to Mothers series.

Childbirth Connection wrote:

“The report was developed from pertinent results from the Listening to Mothers II survey and from the follow-up Listening to Mothers II Postpartum survey six months later. We found that women with young children face a broad range of challenges in the United States at this time. The results have notable implications for policy, practice and programs. The first step is awareness, and we would be grateful for your help in getting the word out to your networks. The survey report and companion documents [including a fact sheet and a press release] can be found by going [here].

“A story in today’s [August 5, 2008] Wall Street Journal focused on the maternal mental health results, and there is a companion podcast interview with Cheryl Tatano Beck. You can read the article and hear the podcast [here]

With the release of the New Mothers Speak Out report, Childbirth Connection is now making the Listening to Mothers II report available as a PDF file at NO CHARGE. All three reports are available in Quick Links box on the main LTM page.

The Listening to Mothers surveys are excellent resources that have demonstrated the high rates of interventions and explore issues not found in government statistics. In particular the LTM II survey includes the key evidence that almost no mothers are actually requesting cesarean sections, contradicting with hard evidence the opinions expressed by OBs and others that such requests account for a significant amount of the increase in the cesarean rate.

Sincerely,
Susan Hodges, “gatekeeper”

More about Childbirth Connection:

Transforming Maternity Care: A High Value Proposition

Childbirth Connection’s 90th anniversary symposium, April 2009

Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care for all women and their families.

Midwives & Breastfeeding

Continuing my theme of World Breastfeeding Week, I wanted to comment on how midwives support breastfeeding--primarily through a model of care that supports healthy birth. Healthy, undisturbed birth leads naturally to healthy, undisturbed breastfeeding.

"Solid scientific evidence shows that returning to birthing practices that preserve normalcy can accomplish many things: faster, easier births; healthier, more active and alert mothers and newborns; and mother-baby pairs physiologically and optimally ready to breastfeed." -Impact of Birthing Practices on Breastfeeding, by Mary Kroeger

The midwives model of care humanizes birth and involves fewer routine practices and interventions that interfere with breastfeeding. You can read more about this topic in a previous post.

The Midwives Model of Care involves:

• Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
• Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
• Minimizing technological interventions
• Identifying and referring women who require obstetrical attention

I would be remiss in posting about World Breastfeeding Week without mentioning La Leche League International (LLLI). LLL is the world's foremost authority on breastfeeding and has been offering mother-to-mother support for over 50 years! LLL is also a core partner with WABA who is the originator of the WBW celebrations. LLL is a single purpose organization--breastfeeding--but has roots in the birth movement as well, having been founded during a time in the U.S. when giving birth involved heavy sedation and very managed "deliveries." Many of the LLL Founders had homebirths during the early 50's. When I read birth books that reference birth practices of the 50's, I often get the impression that NO ONE was having homebirths in the 50's, but the LLL Founders certainly were! They chose to focus on advocating breastfeeding and mothering through breastfeeding. Mother-to-mother support is the hallmark of LLL and no one does it better! To check for a breastfeeding support group near you, visit LLL online.

World Breastfeeding Week

It's World Breastfeeding Week! World Breastfeeding Week (WBW) is celebrated annually in 120 countries around the world. The official dates of WBW are August 1-7 annually, but communities can choose to acknowledge WBW on dates most convenient to them.

World Breastfeeding Week celebrates the “signing of the Innocenti Declaration, produced and adopted in 1990 by participants at the WHO/UNICEF meeting on ‘Breastfeeding in the 1990s: A Global Initiative on the Protection, Promotion and Support of Breastfeeding.’ The document lists the benefits of breastfeeding, plus global and governmental goals” (LLLUSA).

Each year WBW has a theme and “[in] conjunction with the Olympics in August, the theme for LLL in the USA 2008 WBWC is Mother Support: Going for the Gold. These celebrations recognize the importance of supporting mothers so they can achieve the gold standard of infant feeding: breastfeeding exclusively for six months, and providing appropriate complementary foods with continued breastfeeding for up to two years or beyond. Even as young athletes can only emerge from a healthy start on life, there is no question that optimal infant and young child feeding is essential for optimal growth and development.”

World Breastfeeding Week is a great opportunity to draw attention to the relationship between birth and breastfeeding and to emphasize that breastfeeding is the “gold standard” for infant feeding and that lack of breastfeeding affects the child, mother, community, and healthcare system.

Here are some ideas for celebrating WBW in your own community:

• Create a poster or handout about “why your baby’s birth matters” and distribute it in classes or display it in the setting in which you teach (Diane Wiessinger, MS, IBCLC has a number of wonderful handouts and articles exploring this subject on her website).
• Hospital based childbirth educators can make a poster display to set up in the hospital lobby or hallway during WBW. Either choose to focus on the birth-breastfeeding continuum, or focus on this year’s WBW theme in general.
• Attend your local WBW picnic or other event to show to your support. If there isn’t an event, plan one!
• Make a display for use in the public library or fitness center (many libraries maintain a rotating, informative window display).
• Be a “day sponsor” on your local public radio station honoring WBW (instead of the more usual birthday or anniversary day sponsorships).
• Organize a “march” in a local park of health care professionals in support of breastfeeding. Gather advocates together and take a symbolic walk together in honor of breastfeeding.
  

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Portions of this post originally appeared in my article "Celebrating World Breastfeeding Week & The Birth-Breastfeeding Continuum" in ICEA's International Journal of Childbirth Education in June, 2008.