Why I Care

Some time ago I wrote a post about medical control as acceptable, in which I pondered the question of why do we care about birth, if many birthing women themselves don't really seem to care? Why do we make it any of our business what other women choose to do with their births?

Well, I've been doing some thinking and here is my list of why I care:

• Because women are suffering--birth trauma is real--see organizations like Solace for Mothers--and postpartum mood disorders are very common.
• Because babies are suffering--late pre-term births are increasingly common, many babies experience at least some post-birth separation from their mothers (which is not their biological expectation), and many babies spend time in the NICU. Infant mortality rates, especially for minority babies, are higher than in other industrialized countries.
• Because breastfeeding is suffering and thus public health is suffering (see my previous article on the birth-breastfeeding continuum)
• Because the physical costs of our current birth model are high--morality and morbidity rates are higher than necessary due to high volume of cesareans and many physicians and hospitals do not practice evidence-based care--continuing to deny laboring women food and drink and continuing to use Cytotec for inductions for example.
• Because the financial costs of our current birth model to society are high--birth is a multi-billion dollar a year industry. Some maternity care facts from CfM:
  • Over four million births in the US each year (26.4 births per 1000 women aged 15-44 years in 2004).
  • Second most common reason for hospitalization of women.
  • Care for mothers and babies combined rank 4^th for hospital expenses.
  • Hospital costs for deliveries mounted to more than $30 billion in 2004. More than 30% of births by cesarean section. ranking seventh highest total on the "national bill" for procedures (over $17 billion per year).
  • Of all births, 99% take place in hospitals, 90% are attended by obstetricians.
  • Over 6 million obstetric procedures are performed – the most common category of surgical procedures.

"The percentage of births paid for by Medicaid varies from state to state but can be as high as 50% or more in some states. Coverage by all insurers (Federal government, Medicaid, private, HMOs, etc.) varies; many will not reimburse for OOH births, and when midwives are covered, the reimbursement rate is only a percentage of the rate for physicians. We all pay for births, including unnecessary interventions and preventable complications and injuries, through our taxes, health insurance withholding, and individual policies."

• Because women's birth memories last a lifetime (see Simkin, Not just another day in a woman's life).
• Because women deserve better.
• Because I know in my heart that birth matters for women, for babies, for families, for culture, for society, and for the world.

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Molly
CfM Blogger

Being BOLD and Birthsmart...

Recently, the website/resource My Mommy Manual interviewed Karen Brody, founder of the BOLD movement and playwright of the play, Birth. The topic of the interview was "how to empower birthing mothers" and it was quite good. Brody placed great emphasis on the importance of having a "circle of women" and the importance of community and connection in increasing the odds of a positive birth experience. As part of this, she discussed the value of mother blessing ceremonies and I share her opinion of the importance of these ceremony. She also makes the point that body-centered preparation (such as yoga) helps you connect with the resources within you as well as surrounding you. I saw Birth in St. Louis last year and I'm looking forward to making another trek to see this powerful play again in St. Louis this year! (Sunday, August 29th at Schafly Bottleworks at 5:00!)

Related to empowering birthing women, birth activism, and raising awareness of the flaws within our current birth culture, check out this BirthsMart video by Heather Cushman-Dowdee (Hathor the Cowgoddess and compiler of a really wonderful book, Simply Give Birth).



I am looking forward to being at the CAPPA conference through the end of the week and will not be making my usual Friday post!

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Molly
CfM Blogger

Resources from Other Organizations

I have connections with a lot of wonderful organizations. While I've thought recently that perhaps I need to "throw my hat in" with one organization only (i.e. focus my efforts/energy), I also enjoy being a part of, and supporting, multiple organizations. I feel like each has something unique and valuable to offer and I have no problems networking with and being a member of--for example--almost all of the major childbirth education organizations, as well as multiple doula organizations, and others as well. I don't think it makes sense to be "exclusive" or competitive with each other--all of them wish to improve maternity care and birth choices for women and I like to help as much as I can! I also just love collecting information and resources and so it is delightful to be on all these e-newsletter mailing lists and so forth. Among many, here are a couple of resources that caught my eye this week:

1. Choices in Childbirth has a new service--a provider network (free for consumers to search and use, fee for professionals to list services). "Choices in Childbirth is an excellent tool for both mothers and mother-friendly care providers. We have hundreds of listings of midwives, doulas, acupuncturists, and more--everything a mother could need to create a mother-friendly birth experience that's right for her. For providers, it's a great way to advertise their services and promote the many options available to expectant parents." Speaking of Choices in Childbirth, one of my most favorite resources in the world to share with with parents in my birth classes is the Guide to a Healthy Birth.

2. The Family Violence Prevention Fund is hosting a free webinar called Building Health Care Leadership: A Systems Advocacy Approach to Addressing Domestic Violence in the Health Care System, July 29, 2010, 11am-12pm PDT. Considering that many women experience domestic violence for the first time during pregnancy and that pregnancy is the most common reason for women to be in the medical care system, this is a quite relevant webinar topic for maternity care activists!

3. One of my very favorite "basic" pregnancy and childbirth books, Pregnancy, Childbirth, and the Newborn by Penny Simkin is coming out in a new edition this month. I'm so excited! New with this edition is a really helpful looking companion website.

Enjoy!
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Molly
CfM Blogger

Medical Control as Acceptable

Still going through my saved-things-to-blog-about and want to share these thoughts from the book Brought to Bed: Childbearing in America 1750-1950 in the epilogue:

Many of birthing women's successes in increasing their powers over childbirth procedures have depended upon women reeducating themselves about childbirth. The enormous proliferation in recent decades of popular literature about giving birth, much of which advocates decreasing routine medical interventions, is evidence of women's attempts to reclaim knowledge previously more commonly held within women's world. When birth moved to the hospital and became dominated by technical interventions, women lost their understanding and familiarity with the processes of labor and delivery. Many women, realizing that their lack of knowledge distances them from their own bodies, are trying tor recover some of that lost knowledge through self-education in normal functions...

In addition to the women who completely challenge medical authority and those who want to find ways to work in cooperation with it, there is a third group of American women today who find medical control of childbirth as practiced in most hospitals perfectly acceptable. They find the prospect of delivering babies frightening or uninteresting, and they wish to experience as little of it as possible. They want to be assured of a healthy outcome, but they do not feel the need to participate actively in bringing it about. They, like many women of the 1920's and 1930's, eagerly turn over their decision-making power to their doctors, who, in turn, readily accept it. The women hope that medicine can provide a streamlined and easy experience and that they will not have to suffer too much either in the process of labor and delivery or in its aftermath. Many women enter the hospital and emerge from it with their babies without having given the experience itself very much thought. (emphasis mine)

This third group (as discussed in the second paragraph) is a conundrum to me and I think it is the main reason why the birth culture in the U.S. ISN'T changing rapidly in response to evidence-based information, great books, informative publications and websites, helpful doulas, awesome childbirth classes, etc. How do you reach women who just don't care? And, why as advocates, do we care if they don't? :( And, is it any of our business if a large subset of the population finds medical control of birth perfectly acceptable and even desirable?

I'd like to explore why I think it is our business in a later post, but first I have to clarify why exactly that is...

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Molly
CfM Blogger

Continuing Education Resources for Birth Professionals

I love how the internet brings such a wide variety of wonderful educational resources right to our fingertips! Earlier this week I posted a link on the CfM Facebook page to some great presentation downloads from the 2010 CIMS Forum. Then, check out all these free podcasts from MIDIRS (Midwives Information Resource Services). Site registration is required to listen to the podcasts.

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Molly
CfM Blogger