Citizens for Midwifery

Happy New Year!

2011-12-27T16:51:00.006-06:00

When I began writing this blog for Citizens for Midwifery, one of my goals was to be collaborative in terms of networking with other maternity care activists across the country. To me, that means giving acknowledgement, praise, and congratulations to other organizations that are making a real difference and to sharing ideas, credit, and resources with each other. It makes complete sense to me to create a climate in which organizations are mutually supportive of one another, rather than in competition with one another. To that end, I'd like to highlight the year-end fundraising requests of some great organizations working on behalf of mothers, babies, motherbabies, midwifery, women's health, or birth activism. There are many worthy organizations out there working tirelessly on behalf of the women in this country and beyond our borders. I hope you will help to support any or all of them in some way so that we can greet 2012 with a strong camaraderie as our complementary efforts to improve maternity care continue to survive, thrive, and blossom into hopeful and beautiful fullness. To make a donation to Citizens for Midwifery, please visit this link and become, at minimum, a "citizen" supporter yourself!

CIMS shares some great information:

This year has been an eventful one for maternity care advocates. Ina May Gaskin, noted midwife and author of Spiritual Midwifery and Birth Matters won the Right Livelihood Award, (also known as the “Alternative Nobel Prize”) for 'outstanding vision and work on behalf of our planet and its people'. Robin Lim, an American midwife working in Indonesia, won the CNN Hero of the Year award. Ricki Lake and Abby Epstein released their new film “More Business of Being Born.”

The Coalition for Improving Maternity Services (CIMS) has had an eventful year as well. With the end of the grant funding that CIMS was fortunate to have for the past few years, CIMS is now transitioning into a leaner organization and we are sharpening our focus more than ever on improving maternity care and promoting the principles of the Mother-Friendly Childbirth Initiative (MFCI).

In March, CIMS-along with the Breastfeeding and Feminism Symposium-co-hosted our Forum “Reframing Birth and Breastfeeding-Moving Forward” in Raleigh, North Carolina. Forum attendees were privileged to hear cutting edge presentations on a wide variety of the latest topics in birth and breastfeeding from stellar speakers such as:

Eugene Declercq, PhD, MBA, Boston University School of Public Health, “Where We Stand in Improving Maternity Care, Blue Print for Action”
Penny Simkin, noted Author, Doula, Childbirth Educator, Birth Counselor, "What's New With Doulas? Challenges and Opportunities"
Bettina Lauf Forbes and Danielle Rigg, Co-Founders, Best for Babes Foundation, “Changing Frames: Giving Breastfeeding a Makeover”
Geradine Simkins, CNM, MSN, current President of Midwives Alliance of North America, "What Matters to Women, Matters to Midwives”
Kirsti Kreutzer, Doula, Filmmaker, one of the founders of “Where’s My Midwife?” "Social Media and Activism: 'Where's My Midwife?' Calls For a Revolution"

As always, the CIMS Forum facilitated many exchanges of ideas and professional learning from leaders in their fields. (Click here to learn more about what sessions were offered or to purchase audio recordings from the Forum). CIMS was also honored to host two luncheons for CIMS’ Organizational Members, and facilitate discussions for collaborative learning and sharing ideas between many of the major birth organizations from around the country.

The Mother-Friendly model of care continues to set the standard for maternity care across the United States. CIMS is proud to continue to grow and promote The Birth Survey, which has amassed a huge database of women's birth experiences that are invaluable to researchers and care providers and encourages women and their families to seek out Mother-Friendly maternity care.

You can be a part of the growth and positive change in maternal infant health by partnering with CIMS as we continue to be a voice for Mother-Friendly care. If you haven’t already, won’t you join us by either becoming a member or making a tax-deductible donation to CIMS before the end of this year?

Thank you for all that you do to improve and promote Mother-Friendly care!

I also heard from the women at National Association of Mother's Centers (make sure to check out their 12 Days of Christmas video!)

What are you grateful for this year? Perhaps it's the birth of a new baby, or the purchase of a new home, the start of a new job, or maybe the giggles of your kids or grandkids.

For many mothers across the country, being grateful for the Mothers' Center is at the top of their list this year. They are thankful they have a place where they can come to share in the joys and challenges of motherhood and gain friendship, support and sisterhood during what can be one of the most isolating experiences of our lives.

If you are feeling grateful for your family this year, please consider making a donation in honor of that gratitude to the National Association of Mothers' Centers. With your help, we can continue our work helping mothers across the country.

And as a holiday treat - we've created this short video:A Mother's 12 Days of Christmas. Enjoy!

Choices in Childbirth is another amazing favorite of mine. I'm in love with their Guide to a Healthy Birth. Seriously. In love.

As you make your year-end chartiable contributions, please consider a gift to support Choices in Childbirth in our endeavor to improve maternity care by ensuring that women and families have access to the full range of birth options and helping women make informed decisions about childbirth. To ensure that your gift is tax-deductible for 2011, make a secure online contribution by December 31.

Thank you for your dedication to healthy birth.
P.S. Are you on Facebook? Join our Cause and start your own Holiday Wish Fundraising Page to benefit CiC!

Also, we love the Transforming Maternity Care initiative of Childbirth Connection!

As the year comes to an end, we want to say one last thank you to everyone who has remained passionate about transforming maternity care in 2011. As we wrote last week, our efforts are starting to pay off.

Let's keep this momentum going in 2012. We have the collective vision, and we know how to get there. Leaders and legislators are listening and women are activated because they know they deserve better.

There's still time to make a tax-deductible donation to support Childbirth Connection. Every dollar counts and every dollar will be used to transform maternity care.

CfM Board member Hillary and I both have our pictures on the cover of the newest edition of the women's health classic, Our Bodies, Ourselves:

"We want women to say: I read a book and it changed my life."

That's how our Turkish partner, Mavi Kalem, approached the challenge of creating Bedenlerimiz Biziz, the first Turkish adaptation of Our Bodies, Ourselves.

Slated for release in 2012, this new edition explores the social norms and laws, traditional practices and religious edicts that make it difficult for Turkish women and girls to exercise their health and human rights.

This holiday season, please give as generously as you can — $100, $250, or more — to Our Bodies Ourselves.

Your generous contribution sustains our legacy of educational activism on behalf women and girls in every region of the world.

For donations of $150 or more, we will send a signed copy of the new U.S. edition of Our Bodies, Ourselves, selected by Library Journal as one of the Best Books of 2011. Keep it for yourself or share it with friends, your local library, or community health clinic.

La Leche League has a long history of advocacy for mothers and babies and they are close to meeting their year-end fundraising campaign goal:

We have one last challenge match on the table! Between now and December 31st all donations will be matched dollar-for-dollar up to $5,000! Gifts can be made either online or by mail.

We already have an original challenge of all gifts being matched dollar-for-dollar up to $100,000, so any gift you make this last week of our campaign will go three times as far in helping mothers and babies.

These are just a handful of the many high quality organizations out there working on behalf of compatible purposes. We wish them all the best in 2012!

May the dawning of 2012 find you with warm hearts, treasured companionship, and lots of love. And, may women, babies, and families have access to quality maternity care and healthy birth choices throughout the world.

--
Molly
CfM Blogger

Doulas & Homebirth

2011-12-23T15:58:00.004-06:00

Earlier this month I posted to the CfM Facebook page asking for opinions about doulas at homebirths. I am the editor of the Friends of Missouri Midwives newsletter and was seeking contributions for the winter issue with the theme of Doulas. I received some excellent feedback from the CfM page "likers" as well as from the FoMM membership. As an extended companion piece to the article that eventually went into the newsletter, we ran the full article on the Friends of Missouri Midwives blog. Since CfM fans were contributors, I felt it appropriate to share the full article on this blog as well! Thanks to all who contributed their stories and ideas. We appreciate each one!

Doulas and Homebirth

Compiled by Molly Remer

The decision to hire a doula is a personal one, regardless of in which setting you give birth. My first baby was born at a birth center with the presence of a midwife, a doctor, my doula, a friend, my mother, and my husband. In hindsight, I felt like it had been too many people and that the doula hadn’t really been needed. For my second birth, at home, it was extremely important to me to have as few people present as possible. My husband, my mom, and my son greeted the arrival of my second son. My midwife arrived five minutes before his birth—just in time to catch! My midwife for this birth was so amazing, that I didn’t feel the need for any other professional care. I still miss her! For my third birth also at home, this time a second trimester miscarriage with only my husband present, I really wished I had a doula there for emotional support and supportive physical care tasks (not medical support, but tea bringing and towel washing). And, finally, with my last baby, while I liked and respected my midwife I didn't have the same warm bond with her and really wanted to hire a doula, precisely because I was missing some of the emotional component I value so highly in midwifery care. It is really the little things that make doula care so special. In the included photo my doula (FoMM President, Summer!) puts warm socks on me after my baby’s January birth.

Despite my own range of personal experiences, when calling for contributions for this article, I still anticipated receiving a number of responses suggesting that doulas at homebirth are unnecessary, or redundant. After all, an emotional connection and secure trust is often the hallmark of what differentiates the midwifery model from the medical model. However, the responses I received were overwhelmingly in favor of hiring a doula for a homebirth.

Finding inner power instead of crumbling in pain

Jami writes:
As I eagerly awaited my homebirth, I never considered getting a doula. I had two midwives assisting me, so I figured that would be enough, wasn’t that the same thing anyway? When labor hit in the middle of the night I could hardly function, I was in so much pain. Everything I learned in childbirth class went right out the window, and the same thing happened for my husband when it came to trying to help me. One of my midwives didn’t show up for a few more hours, so I was alone struggling with my blinding pain that whole time. Once she did arrive, and started walking me through my contractions, it made a world of difference. My homebirth ended up turning into a hospital transfer due to decelerations in my baby’s heartbeat during every contraction, and a doula was called out to stay with us while our midwives couldn’t. I don’t know what I would have done without her… Having to transfer to the hospital was a very scary experience, and when my much hoped-for homebirth turned into a much dreaded c-section, my doula was there as a voice of reason as well as much-needed emotional support. Looking back on the whole turn of events, I’m so grateful she was there and I have a whole new outlook on the work of a doula. There’s no way I’ll go through labor without one again. I had to get an epidural for the c-section, and that turned out to be the most terrible, painful part of the whole experience – much worse than labor by a long shot. Ever since my experience, I’ve been encouraging all of my friends to hire a doula for their births, whether they choose to go to a hospital or not. If they want a sure shot at avoiding drugs, a doula is the way to go at a hospital. And it makes sense at a hospital, but why would a home birth mom consider a doula? There aren’t any drugs or negatively persuasive doctors or medical staff to avoid there, and isn’t that the biggest reason to have a doula? I thought so, anyway. But doulas offer much more than a voice of reason against pressuring medical personnel. They help you find your inner power when you could easily crumble under the pain of labor. They erase fear that can easily find its way into your mind if you’re laboring without support. And, speaking from personal experience, they change labor from “painful” to “empowering”, turning it into the beautiful, positive experience it should be – you’re bringing a baby into the world! Something so wonderful shouldn’t be tagged with such a negative word as “painful”, and doulas make that possible. Labor is labor, no matter what your location is when you’re experiencing it, and having a doula there during it makes a huge difference.

A lasting legacy

Mandy writes: Hanging on my fridge is a note that reads, call me if you need groceries, a hug or anything! My doula put that there after I gave birth at home. For most of my pregnancy, I thought I would not need a doula at my homebirth; afterall, I had a wonderful midwife and assistant. As my pregnancy became more and more uncomfortable, I thought having extra support at my homebirth would be wise. I wanted the full attention from my partner, and I knew I would need my midwives to be able to focus their energy on the progression of my labor and on how well both our baby I were working together. My doula helped to support us as a family caring for my partner, our other child, as well as the much needed emotional and physical support that I ended up needing. It takes a lot of compassion and wise intuition to find the balance to meet the needs of both my family and the midwives. She provided massage, position suggestions, hydrotherapy, encouragement and cleaned, cooked, fetched things that were needed and even made coffee for everyone. While the midwives and I were caught up in the whirlwind of a difficult labor, she stood in the back keeping the peace. Every time I look at the note on my fridge, I smile and think about how deeply grateful I am to have had her with us on our birth journey.

And, Fabiane shares: My doula was my angel, she helped me through it. My labor lasted 36 hours and she was there all the way. She didn’t sleep, and I felt bad for her, she held me when I was in pain and scared, she told me everything was going to be fine. Her support made all the difference. Her kind words when I had to be transferred to the hospital made me realize I was not a failure for doing that. Meredith B. you are my angel!!!

Comparing experiences

Several women wrote sharing their experiences with both hospital births and homebirths and of a doula’s special touch.

Becky wrote to share:

We had a doula for four of our births, and a midwife for the last three. We had a midwife and a doula for one of them. We had a doctor who did housecalls for two of the births. We had a hospital birth that made us decide that the rest needed to be home births. We didn't have a doula for that one. I honestly wonder how differently that birth would have been if we had had a doula. Because the housecall doctor was much like a midwife would have been (although a different gender than most midwives), having a doula wasn't as important as if it had been hospital. However, having a female there was a lot better than a male doctor, and she stayed with me for the hours and hours (and hours) that I was in labor before we called the doctor.

Sara writes:
I had the same doula at both my hospital birth and my homebirth and it was well worth it in both cases. At the homebirth she obviously didn't have to function as a warrior/advocate like she did at the hospital birth, but it was still wonderful to have her there in a supportive role. My husband was there to give support as well, but there is just a different kind of support that comes from another woman, especially one whom you know has experienced what you are going through at that moment. It also seemed at both births that she knew just what to say at the right moment when I was having trouble, whether it was how to take the edge off of the contractions, or helping things move along when my pushing was ineffective. Having a doula there for mental and physical support provided comfort and assurance, while allowing my husband to be "in the moment" with me while my midwife could focus on the particulars of the labor and delivery themselves. I wouldn't have had things any other way and I would highly recommend having a doula at any birth, home or hospital.

The benefits of a doula:

Angela shares:

The midwife team I had for my homebirth were trained doulas. I didn't know exactly what would be midwife roles and what would be them acting as doulas. In hindsight I think having a doula with the midwives may have been a little nicer since it was my first homebirth/natural birth and the midwife seemed to be having to do a little more "technical" stuff than I expected but it probably depends on lots of factors. Either way, I did fine and the baby came out! My husband was there too doing his best. I look at it as a learning curve so I hope to have more kids and have less and less worry and pain with each birth! (doula or not!)

A midwife’s perspective

Debbie offered the following perspective on doulas at homebirth: I think doulas are wonderful for women choosing hospital birth. The kind of care the laboring woman gets from the hospital staff can really be supplemented by a doula. In that situation, a doula is a great benefit to the mother. I have a lot of doula friends, and I do not mean to disrespect them in any way. They go places and do work that I cannot emotionally handle. I am a homebirth midwife. I have had a couple interviews where a woman has asked if she should have a doula at her home birth. If someone wants to hire me and a doula, I will not try to talk them out of it. But I see my work as being a doula plus a midwife. I bring an assistant to every birth. If it’s a VBAC, I bring another fully-trained midwife. I don’t know what I would be doing during the birth if there was a doula there, too. If I had to sit in the corner and my only work was to check heart tones and catch the baby, I would feel like an obstetrician! I don’t want to do birth that way! I love birth! I love helping the woman through her contractions as they build and build. I love rubbing her back, holding her up, giving her bites of food and sips of drink, helping her squat, and breathing with her. During a birth I get tired, sore muscles from squatting and bending, sweaty from the heat, humidity and heavy lifting. But I wouldn’t have it any other way. I love my work!

Susan also wrote with the opinion that a midwife fills the doula role well: My experience of three homebirths is that the midwives play the role of doula as well. It seems to me that often one midwife is more "doula" and the other more "doctor", if that makes sense. The two together make a great team, and I'm sure their roles vary from birth to birth. If, perchance, there were only one midwife attending a birth, I believe a doula would be a wonderful addition.

A father’s perspective

Ben wrote to share his family’s experiences with doulas: Our first birth was in the hospital and it was horrific. I had been raised in an environment friendly to home-birth, but when it was my first child, I over-rode my wife's wishes and we had a hospital birth. It's one of the few things in my life I truly regret.

Our second and subsequent births were at home. We used a doctor who made housecalls on our first two home-births, but we also asked some old family friends to help out. They were doulas. I didn't even know what a "doula" was at the time.

From a male perspective, a doula is a life-saver. There I am, the 'extraneous' member of the family (during birth, at least)--but one who is wracked with emotions for the safety of my wife and child. My wife leans on me for her emotional support--and I was just as much an emotional wreck as she was, with that "I'm hiding my insecurities in machismo" facade. The doulas were as much a comfort to me as they were to her. Kind words, a hug, a held hand, those life-saver words, "It's okay, this is normal," a gentle suggestion to step away for a few moments. And when the baby came, when the emotions flooded over us both and all we could do is kiss and cry and hug and hold our life's joy in our arms together, the doulas were there to settle the room, soften the lights, take away the trash and clutter and afterbirth and details and all that myriad of things that neither one of us could even think about. While the doctor or midwife (we had both depending on the birth) was there to do all the technicals, to check on the health, the doulas were there to comfort, to settle, to relax the chaos of our lives and let us truly experience the first moments with our most precious treasure.

Men think about the costs, the finances, the harsh realities of life. If I were to give an expectant father advice about the new baby: Pay for a good midwife, pay for a good doula, make sure your wife is comfortable with both of them and slather the baby's bottom and diaper with vaseline for a week after birth (meconium was a real shock till I learned that trick). :)

Doulas weigh in

Genevieve: My favorite place to doula is at homebirths. I give my clients a discount for having a homebirth because, as I always tell them, it is easier on everyone! It's easier for the mom, baby, dad, doula, and midwife!

Hillary: I am a doula who has attended homebirths. It's a different thing. I find myself arriving before the midwife. Providing support for long labors so the midwife can conserve her energy for the important work she might need to do during the actual birth and immediately after. I find myself doula-ing the birth team. Making tea, providing support to the dad, taking pics and of course, supporting the mom as she wishes. I had a doula at my last birth and I relied on her a lot for emotional support during pregnancy. I'm so glad she was there.

I also posted to the Citizens for Midwifery Facebook page asking for input on the doula’s role at homebirth. While the responses were more varied, many women were squarely in favor of doula support during homebirth.

Opinions from the larger birth community

Gillian: As long as the doula understands that homebirths often need the doula to "do" less and "be" more I think it can be a great help to the client and the midwives. I did go to one birth with a control-freak doula who couldn't stop trying to fix everything but I think that was an anomaly.
What I notice, as a midwife, is that most clients are already paying for their homebirth care out-of-pocket and the idea of paying for additional support seems like quite a stretch. I haven't had any clients choose doula care for their homebirths unless the doula was also a friend or family member working attending for free out of love. I think I give really good support as a midwife so I don't think that my clients are lacking but during some births, especially the long ones, I can really see the benefit of someone else who can support while the midwife takes a snooze!

Christine: I was a doula before I ever got pregnant, so I actually had two at my first birth (one I had hired and one I had apprenticed with). Two was overkill, but my husband really appreciated having them there, probably more than I did! My next two births were fairly precipitous, so no doulas (although I had arranged to have one for the second birth). I loved being a doula at homebirths, and suspect that they are as useful at home (or maybe more so?) as they are in hospital. A doula empties the birth pool or makes supper for everyone, starts a load of laundry and rocks the baby while mom showers; basically does what needs to be done, so that everyone else can concentrate on their specific jobs...

Fonda: My last two were at home. Having to shell out nearly $4k out of pocket each time, paying for doula on top of that would have been impossible. That said, being at home I didn't really need one.

Maria: I had a homebirth but no doula. My midwife had two assistants and they acted very much like doulas, doing things like laundry, breakfast, partner support, etc. I also had a very fast labour, and think a doula would have been excessive. I recommend doulas all the time to my preggo friends, although I don't see myself ever hiring one...

Laura: I think one difference between home and hospital is that generally you know more what you are getting in advance in terms of support in a homebirth situation--usually you have one or maybe two midwives in a practice whom you already know fairly well prenatally, and perhaps an assistant or apprentice who works with the midwife. So you have a pretty good idea before you go into labor how much support and what type of support your particular midwife/practice will provide. In a hospital setting, the L&D nurse is really the primary potential support person besides a spouse or family member--and that is somebody you don't know until going into the hospital and it's a wild card how supportive or unsupportive the L&D nurse will be of your wishes or how much that person can/will do in terms of emotional support or comfort measures. I think doulas are more critical/necessary for that reason in a hospital setting than in a homebirth setting.

That said, I think it also depends on the particulars of your own homebirth situation. I hired a doula for my last homebirth because I had a midwife who worked alone (no assistant or apprentice) and I wanted to make sure there was an extra pair of hands/extra person available in case of 1) a long labor where my midwife and husband needed a break, 2) a complication of any sort, 3) as a backup support person for my older child in case her babysitter wasn't available to come and be there with/for her (no family nearby who could be with her during the birth).

Katie: I planned a homebirth with my twins, and did not have a doula. I ended up with a (pretty terrible) hospital birth and I WISH I had a doula. I will have a doula if I ever birth again, no matter where I birth (but hopefully it will be HBAC!), and I recommend EVERY mother I know to have a doula, no matter where she births.

Natalie: My midwife had an assistant at my three homebirths. I felt no need for a doula, but if I had a solo midwife or was planning a hospital birth I would want one.

Raissa: I had the same doula for my first (surgical) and second (home birth) and wouldn't have wanted it any other way. At home she came several hours before the midwife and really gave peace of mind for me and took some of the pressure off my husband. Worth every penny! (I literally paid for her with my babysitting money.) And, since the midwife got stuck in traffic, she unpacked the birth kit and almost got to catch the baby!

Elizabeth: We had our baby at home with the help of two midwives and a doula. Our doula was amazing. She is still the person from our birth team that I talk to the most -- it has been 18 months since the birth of our child. Her care and concern for my family's welfare has been ongoing and consistent. I strongly encourage any pregnant woman, regardless of where they intend to give birth, to hire a doula or search for volunteer doulas if hiring one is not financially feasible. I can't imagine having a baby in a hospital without a doula.

Kasey: I don't remember if the doula showed up during my labor or after to help my midwife, but my placenta wouldn't come out and I had to have a catheter put in, and since my husband was caring for the baby, the doula filled in (I'm petrified of needles and the like) and I have to say, I was very grateful she was there. If my husband couldn't have been there for whatever reason, I would definitely want a doula present, no doubt about that.

I really appreciate all the people who lent their voices to this article. I very much valued the specific and customized postpartum care my doula provided to me after my last homebirth and I’ve concluded that a doula has the potential to offer something unique and precious to families, in whatever setting the birth takes place. I also agree with Elizabeth’s remark above, that it does seem like the doula is the most likely member of the birth team to remain in contact with the family in the future. Perhaps it is because, even given the friendliness of the midwifery model, there is less of a "power differential" between mother and doula.

As we prepare to greet a new year, I propose this toast: Here’s to beautiful, empowering, healthy, fulfilling births for all women, in all settings, with the birth companions of their heart’s desire.

Book Review: Evolve…a woman’s journey

2011-09-06T09:50:00.002-05:00

Book Review: Evolve…a woman’s journey
by Patrick Stull
Stull Visual Arts, 2011
Hardcover, 164 pages, $44.95
Also available as an iPad app and as an iBook in Itunes for $9.99.
http://www.patrickstull.com/books/

Reviewed by Molly Remer

A combination of stirring photography celebrating the creative journey of pregnancy and lyrical ode to women, Evolve is a unique book presented by artist Patrick Stull. The author-photographer’s love, respect, and honor for women shines through on every page. The photographs are arresting and dramatic and the prose is poetic and beautiful. The book is part of a multimedia exhibit taking place in 2012. I would love to see the full exhibit, which involves full body casts as well as images and voice recordings.

Why would a man prepare a project such as this? According to his introduction, due to “this insatiable desire to be part of something that excludes me…I have found something within me that one might call love, though I think it is more a sense of attachment to something that makes me whole. I have fallen in love with this creature and she has left her imprint on my being, casting me out to share the love—the humanity I have found.” Later he also shares that: “I have discovered nothing more stunning, nothing more emotionally stirring, nothing more intriguing than a woman as she creates life.” He also has an activist purpose behind his work, asserting that one mission of the Evolve project is to help people recognize the strength and value that all women possess. Stull states, “I also want people to consider the daily injustices to women and children all over the world, and how often they suffer the greatest costs of conflict. Why are women treated so cruelly?”

The early photographs shared are the faces of the women we follow throughout the rest of the book. A short snippet of information about the woman’s life accompanies each portrait. One woman is a midwife and several mothers had homebirths and/or hired doulas or midwives for their births. Evolve is a high quality hardback book that would be a great addition to a birth center waiting room or midwife’s office. If the price for the hardback book is out of your budget, luckily there is an affordable iBook version available.

The overwhelming message received through Evolve is of pregnancy as an active process. The pictures are very active and dynamic in feel, celebrating form and motion. Evolve is not a book of “belly pictures,” it is a book about women and their lives in the act of creation.

—

Disclosure: I received a complimentary copy of this book for review purposes.

World Breastfeeding Week: Impact of Birthing Practices on Breastfeeding

2011-08-04T13:11:00.004-05:00

It is World Breastfeeding Week this week! I hope everyone has found a way to celebrate the event in their own communities, or is communicating about WBW with their networks, including social networks. When it comes to breastfeeding, birth matters! La Leche League has a free podcast available with Linda Smith (author of Impact of Birthing Practices on Breastfeeding). During the podcast she mentions midwives and also talks about doulas. Last year, I wrote an article about the birth-breastfeeding continuum and also another post about birth practices and breastfeeding.

In the past I've also written about Diane Wiessinger and her wonderful presentations about mammals, birth, and breastfeeding. So, it is also exciting to me that LLL has a free podcast available from Diane! The podcast is called, "What other mammals can tell us about nursing."

There are many more wonderful podcasts available for free on the LLLI website. What a great resource!

In my own community our local LLL Group is celebrating World Breastfeeding Week by hosting a family picnic in the park and a Big Latch On event. Here is more about WBW from La Leche League USA:

LLL USA’s World Breastfeeding Week Celebration’s 2011 focus will be to:

Connect with other breastfeeding advocates.
Utilize the Big Latch On to bring awareness of breastfeeding and show solidarity with all nursing mothers.
Contact local communicators to help them raise awareness and offer our expertise.
Show how the mother/baby breastfeeding dyad is the beginning of lifelong communication.

Join with us in supporting WBWC 2011 and in communicating the importance of breastfeeding and the vital need for support available from La Leche League.

OBJECTIVES OF WORLD BREASTFEEDING WEEK CELEBRATIONS 2011
*To increase communication about breastfeeding in a variety of ways.
*To raise funds for La Leche League USA, with emphasis on local communities.
*To raise awareness that breastfeeding prepares humans for life.
*To raise awareness that the lack of breastfeeding affects the child, mother, community and health care systems.
*To raise awareness that La Leche League Leaders and Groups offer breastfeeding information and support to all.

I'd like to close with two quotes from Diane Wiessinger about the importance of a physiological birth to babies and to the breastfeeding relationship:

“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.”

--
Molly
CfM Blogger

GRN: Transforming Maternity Care: Connecting Consumer Activists to the Larger Picture

2011-08-03T11:14:00.001-05:00

Hello Friends,

A new web tool - called Transforming Maternity Care - was launched this spring on the premise that a high-quality, high-value maternity care system is within reach. The web-based project is a collaborative effort of more than 100 diverse health care leaders, with the goal of pulling together high quality tools and resources to transform maternity care in the US.

Citizens for Midwifery is excited and hopeful about the web tool, which offers a vision, a blueprint, and action steps for groups and individuals. Progress is highlighted and resources are organized and offered to interested participants. We look forward to integrating our work into each of the key steps. This project is a critical step to pulling together the incredible energy of the birth movement right now, and we are happy to see how they are recognizing the key role that you - the citizen activist - can play in transforming birth.

Amy Romano, project director, says, "...the aim was to foster, accelerate and coordinate implementation of the consensus Blueprint for Action. There's so much work to be done, but there are also unprecedented opportunities and many examples of individuals, facilities, organizations, and agencies doing great work and making measurable improvements, so we want to shine a spotlight on those examples and make it easier for others to replicate and adapt successful programs."

This project symbolizes a new level of maturity reached by the maternal health and childbirth community. With the high level of coordination provided by this project, the efforts of the birth advocacy movement can be effectively coordinated to ensure the best possible maternity care for women.

You can help too! Visit the Transforming Maternity Care website and become familiar with the vision and blueprint. We dug into the project and wanted to highlight ways that you--a consumer activist-- can help take part in the Transforming Maternity Care project.

Here's what you should check out:

Take Action Page for Consumer Advocates
Toolkit Resource Page
The Data Center
Share Your Story
TMC Blog featuring news and analysis from Childbirth Connection staff

Consumer advocates drive health care change and it's important that we work together to create a safe maternity health care system that works for all women. Kudos to Childbirth Connection creating a tremendous resource and *thank you* for your tireless efforts. Together we are creating healthy and safe birth options for women and their babies.

Warmly,

Hillary Boucher

P.S. Now is a great time to enter your project in the Share Your Story section. For a limited time, qualifying entries will receive a gift from Childbirth Connection's Bookstore.

Connecting with Doulas: Come Meet Us at DONA 11 and Online

2011-07-18T13:31:00.013-05:00

Doulas are best known for their ability to reduce interventions and improve maternal satisfaction in birth. But doulas play other important roles, too, such as educating women about their birth options, including midwifery care. Doulas also tend be very active in their local birth communities, helping with local and statewide efforts to improve maternal health. Where appropriate, doulas help mothers transform their birth experiences, gently guiding women to activism.

This is why Citizens for Midwifery is so excited to attend the Doulas of North America (DONA) International conference in Boston, MA this week. We’ll be in exhibitors area, sharing information about Citizens for Midwifery and meeting doulas from across the nation.

At the conference, we’ll also be holding Citizens for Midwifery’s first ever friendraiser, creating as many “virtual” friends as possible! We’ll be reaching out to doulas with two goals.

For those already using social media, we hope to build and connect our virtual networks. Together, we can significantly increase our reach, educating more mothers with evidence-based information about birth and key policy issues.
For those not yet active with social media, or just learning the ropes, we’ll have our laptops fired up, ready to show you how to get signed on!

Why a friendraiser? Because all of the impactful things that a doula does face-to-face - educating families, empowering mothers, connecting women to critical policy issues - can and are being done on social media. Doulas have been among the first birth professionals to embrace these new tools. We want to connect our communities, share tools, and make healthy birth - and midwifery care - go viral!

Three ways to participate in the CfM friendraiser:

Share this post on your networks and encourage your family and friends to like us on facebook, follow us on twitter and sign up for our free email list. (Make sure you're connected up too!)
If you're at DONA this weekend tweet make sure you're signed up for Twitter and tweet under the #DONA11 hashtag. Follow us and give us a shout out by mentioning @cfmidwifery and we'll make sure to retweet and follow you back. Similarly, mention us in a facebook status or post on our facebook page. Watch for conference give-aways and come introduce yourself.
If you are not attending DONA help spread the amazing information that will be coming out of the conference by following the #DONA11 hashtag on twitter. Come swing by our facebook page--we'll be posting pics and updates throughout the week.

Bonus! If you share this post on your facebook page tag us and we'll head over to like your page AND post your birth page on our wall. This way we can all grow our networks!

When we make these powerful connections--online and in-person-- we're helping to promote the Midwives Model of Care and organizing for future legislative pushes.

Your participation is important and greatly appreciated.

A big thanks to YourDoulaBag.com, Mama Pear Designs and Jillian's Drawers for donating items for us to give-away to friendraiser and conference participants.

Guest Post: The World Needs Midwives – Now More Than Ever

2011-07-08T08:18:00.002-05:00

This post is republished from the blog of the Bill & Melinda Gates Foundation:

The World Needs Midwives – Now More Than Ever

It was 1980 in a nomadic community in Mauritania that I first attended a woman during birth. There, I experienced with her the fragile balance of life and death and the sweet joy of a mother embracing her healthy newborn daughter.

Midwife. In the olde English it meant “with woman.” It’s why I became a midwife – to be with women through skilled care and support before, during and after pregnancy and childbirth, so that all women and families everywhere experience the joy and celebration of safe motherhood.

Today is the International Day of the Midwife. But today, like every day, nearly 1000 women will die giving life; and many of their babies will not survive beyond the first hours and days after birth. That’s more than 350,000 women and 5 million infants every year whose lives are lost as a result of preventable complications of pregnancy and childbirth.

And while 99 percent of these deaths happen in developing countries, the United States is not exempt. Thousands of American families suffer the tragedy of maternal and newborn mortality every year.

No mother should have to risk her life or that of her unborn baby going through childbirth without expert care. Yet, globally, one in three women gives birth without a skilled birth attendant. The World Health Organization estimates that more than 3.5 million more health workers – including a million midwives – are needed by 2015. Without them, millions of mothers and children have no one to diagnose and treat illnesses, dispense treatment, or provide immunizations and advice on how to stay healthy and prevent disease.

The International Confederation of Midwives (ICM) has embraced this in their campaign – The World Needs Midwives Now More than Ever and with a commitment to march in honor of women. The theme for this year’s march is The Road to Durban: Midwives Walking for the Women of the World.

Today, around the world, women will walk “for the women of the world.” It’s a journey that starts on the “Road to Durban,” and culminates on the 18th of June at the ICM Congress in South Africa. At the Congress, more than 3,000 midwives will meet to share their knowledge and skills about better quality care and strategies to intensify the fight against maternal and newborn mortality. There too will be the release of the long awaited State of the World’s Midwifery Report and the powerful, poignant Stories of Midwives.

We join with tens of thousands of midwives, today, in walks across the globe to demonstrate our shared commitment to safe motherhood. We walk to show zero tolerance for needless deaths of mothers and newborns. We walk to publicize the urgent need for investments in maternal and newborn health. We walk on this Road to Durban so that one day pregnancy and birth will not mean the road to death for mothers and their babies.

To borrow from the American College of Nurse-Midwives, let’s show the world that together we are “With women, for a lifetime.”

Theresa Shaver is the President and Executive Director of the White Ribbon Alliance for Safe Motherhood.

The Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives. Safeguarding the health of mothers and young children is one of the world’s most urgent priorities and a core focus of the foundation’s work; especially in the developing world.

Happy Father's Day!

2011-06-17T12:52:00.005-05:00

For in the child lies the future of the world. Mother must hold the baby close so that he knows that it is his world. Father must take him to the highest hill to see what his world is like.

This quote came from the end of the touching Father's Day Flashmob in Denver video organized by Dads Adventure. Make sure to check out the associated article The Dignity of Being a Dad and read about the new brotherhood of dads initiative.

Here are some previous father-specific posts from the CfM blog:

Fatherhood challenges us, but it also enlarges us and reshapes our perception of what is important in the world around us. As we take stock of this new world, we find that doing our job as a dad is inherently honorable and respectful, and brings to us the dignity that goes with the territory. Far from being emasculating, being a dad makes us men in the finest sense of the term. --Dads Adventure

--
Molly
CfM Blogger

GRN: Home Birth Rate Up 20% in Four Years

2011-05-23T11:39:00.001-05:00

Hello Friends,

Mothers are clearly calling for a variety of birth options: According to newly released data from the CDC, home birth rates have risen 20% in a four year period (2004-2008). This substantial increase has caught the interest of health care practitioners and policy makers, as well as the mainstream media.

MSNBC and USA Today covered the news and Today Moms, the online parenting network of The Today Show, featured an article called "Why Women Shouldn't Fear Home Birth" by celebrity, Mayim Bialik, who birthed at home.

We are very happy to see this conversation reaching a wider audience and as always, we will continue to work towards ensuring women have access to well-trained midwives in the setting of their choice. You can help by using the CfM Tool Kit: Stand Up for Healthy Birth and Home Birth in your own local community. Please share your efforts with us and the Citizens for Midwifery community on our facebook page.

This clear demand for midwives in various settings is yet another reason why the federal legislation -- "Access to Certified Professional Midwives Act of 2011" (HR 1054) -- is an integral part of creating optimal health outcomes for mothers by securing better access to the high quality care of well-trained midwives.

If you have not already please join the MAMA campaign.

Sincerely,

Hillary Boucher, CfM

P.S. Citizens for Midwifery relies on your generous donations. Please consider supporting us--Click Here to Donate Today!

Book Review: Arms Wide Open: A Midwife’s Journey

2011-05-22T18:46:00.002-05:00

Book Review: Arms Wide Open: A Midwife’s Journey

By Patricia Harman
Beacon Press, 2011
ISBN: 978-0807001387
324 pages, paperback, $16.47 (Amazon)
http://www.beacon.org

Reviewed by Molly Remer, MSW, ICCE, CCCE
http://talkbirth.wordpress.com

I very much enjoyed Patricia Harman’s first book, The Blue Cotton Gown, and was delighted to learn about her new memoir, Arms Wide Open which is, in a sense, both a prequel and sequel to her first memoir. The first half of Arms Wide Open chronicles Patsy’s experiences with homesteading and communal living as a young hippie mother in the 1970’s. It also explores her thoughts and experiences with peace activism and her passion for an eco-friendly life. During this time, she attends her first birth and dives into her midwifery journey and eventually becomes a CNM practicing with her hippie-farmer-turned-OB/GYN husband in West Virginia. Her experiences with their years in a joint women’s health practice are described in The Blue Cotton Gown. Readers who, like me, wondered what happened where The Blue Cotton Gown left off, can find out in the second half of Arms Wide Open, which is a narrative of Patsy’s ongoing work with women through 2009 and includes her emotional painful moments in her marriage, as her husband struggles with fears of another lawsuit as well as with chronic pelvic pain patients who abuse his trust (chronic pelvic pain is a specialty of their practice).

I did feel as if there was a large chunk of story missing as the book somewhat abruptly skips from 1978 to 2008. We miss learning about any of Patsy’s experiences in nurse-midwifery school, nor do we learn much about her practice when she was a CNM attending births. The book transitions from her years as a self-taught midwife considering going to school to become a CNM, straight to her present-day years as a CNM in a private women’s health practice.

Harman’s writing style is lyrical and engaging as well as candid. The book is based on personal journals and reading it feels like eavesdropping on someone’s very private thoughts and feelings. The book is much more of a look at a woman’s feelings about her life, than it is a “manifesto” about birth or about the practice of midwifery. In this manner, I feel like you receive a much more complete picture of a midwife’s life and journey, rather than reading a sequence of birth stories. Patsy has a lot of life in addition to birth. While definitely not a “feel good” book, Arms Wide Open is a deeply touching and very honest exploration of one woman’s personal journey in life, love, motherhood, and midwifery.

Disclosure: I received a complimentary copy of this book for review purposes.

Multimedia Review: A Book for Midwives

2011-05-17T17:59:00.003-05:00

Multimedia Review: A Book for Midwives
Hesperian Foundation
CD-Rom, 2011
544 page pdf book in English and Spanish
by Susan Klein, Suellen Miller, and Fiona Thomson
ISBN13: 978-0942364-24-8, $16.00
www.hesperian.org

Reviewed by Molly Remer, MSW, ICCE
http://talkbirth.wordpress.com

As a child, I was fascinated by my father’s copy of the book, Where There is No Doctor. Fast forward twenty or so years and imagine my glee when as a birth activist adult, I then discovered A Book for Midwives, also published by the Hesperian Foundation. Hesperian's goal “is to promote health and self-determination in poor communities throughout the world by making health information accessible. [They] work toward that goal by producing books and other educational resources for community-based health.” In keeping with this goal, A Book for Midwives is available for FREE download on the Hesperian site. (Personally, I appreciate the professionally printed version of the book I purchased, because I think it would cost more same in ink to print it myself, but without the nice cover!).

A Book for Midwives is excellent; a true community resource. It is also a very sobering look at the reality of women's health and health care in other countries. It contains reminders such as "do not hit or slap a woman in labor," and other things that can make you cringe. A Book for Midwives is basically a textbook for midwives, health care workers, or educators working in developing countries and/or with very limited resources. I appreciate how it makes information available that is sometimes "hidden" in other books--i.e. explicitly technical content and “how to’s” that are normally reserved only for "professional" people. It is simply written and extremely blunt. There is no fluff and nothing romanticized about pregnancy, labor, and birth. In a way, it was hard to read a book that makes it so very clear how very, very difficult things are for midwives and women in impoverished areas (living in the US, I am used to the "normal, healthy pregnant women" approach to midwifery care). The book covers a wide range of information from preventing infection, treating obstetrical emergencies, doing pelvic exams, and breastfeeding to HIV/AIDS, testing for STDs and cervical cancer, and IUD insertion. There is also a section in the back of the book about medications, medication administration, giving injections, and other topics. It is an extremely comprehensive resource. (Just a side note, in the section on contraceptives, the book is heavily in favor of hormonal methods such as pills as well as very positive about IUDs and sterilization.)

Recently, Hesperian made A Book for Midwives available for purchase on CD. The CD includes the 544 page book as a pdf file in both English and Spanish. Both high resolution and low resolution versions of the book (in both languages) are included on the disk. This format makes it easy for the book to travel with you via laptop for trainings or presentations. I was particularly excited to convert it for my Kindle, making it readily available for travel and reference.

--
Disclosure: I received a complimentary copy of the CD for review purposes.

Celebrating Midwives & Mothers!

2011-05-05T09:19:00.000-05:00

Hello Friends,

This is an exciting week here at CfM because two of our favorite things--midwives and mothers--are being celebrated!

Today, May 5th, is International Day of the Midwife. We are so grateful for the amazing work that midwives do to keep women healthy and safe all over the world. To learn more about the International Day of the Midwife visit the International Confederation of Midwives. You can also participate in the Virtual International Day of the Midwife (VIDM)--an online conference happening all day today.

One way we can thank our midwives and ensure that women have better access to midwives is to support the important federal legislation HR 1054, the "Access to Certified Professional Midwives Act of 2011". We're proud to be working with Midwives & Mothers in Action (M.A.M.A.) to increase women’s access to midwives and to quality, affordable maternity care by securing federal recognition of Certified Professional Midwives (CPMs).

The MAMA Campaign, is a partnership between the National Association of Certified Professional Midwives (NACPM), Midwives Alliance of North America (MANA), Citizens for Midwifery (CfM), International Center for Traditional Childbearing (ICTC), North American Registry of Midwives (NARM), and the Midwifery Education Accreditation Council (MEAC).

Sunday, May 8th, is Mother's Day and we want to honor the amazing ways that mothers care for their families, their communities and for the world. Mother's Day is particularly special to us because CfM was founded by mothers and we work to ensure that all mothers have access to the Midwives Model of Care. We are honored to work alongside you and thank you for being an amazing mother and ally in this work to ensure access to midwives.

This Mother's Day weekend take some time to check out the Every Mother Counts campaign. Getting informed and taking action is an outstanding way to honor ourselves as mothers, the mothers in our lives and mothers all over the world.

Have a great Midwives & Mother's Day!

Warmly,

Hillary Boucher, CfM

International Day of the Midwife

2011-04-27T11:01:00.003-05:00

International Day of the Midwife is approaching on May 5th and I encourage you to check out the free online conference offering a day-long roster of speakers and events around this year's theme, The World Needs Midwives Today More Than Ever!

This is so incredibly true. I listened to a birth story yesterday that really made me think about the irreplaceable value of skilled midwifery care. Truly, there is no substitute for it---while, yes, some women also need OB care, I really think all women deserve midwifery care (so, even those high-women who need to see OBs or who need to have cesareans, they still deserve a midwife too!)

On a related note, an online friend/colleague of mine, Kelli Haywood, just wrote a great article about the closing of rural maternity wards and made a clear case for why we need more midwives (now more than ever!).

--
Molly
CfM Blogger

Book Review: Home/Birth: a poemic

2011-04-21T09:20:00.001-05:00

Book Review: Home/Birth: a poemic
By Arielle Greenberg and Rachel Zucker
1913 Press, 2011
ISBN 978-0-9779351-7-8
208 pages, softcover, $11
http://www.1913press.org

http://www.facebook.com/pages/HomeBirth-A-Poemic/

Reviewed by Molly Remer, MSW, ICCE, CCCE
http://talkbirth.wordpress.com

Co-authored by a pair of long-time friends, the “poemic” book Home/Birth reads as if you are eavesdropping on a lengthy, juicy, engaging, thought-provoking conversation about homebirth, birth in America, maternity care, and feminism. The book has a lyric, narrative, stream of consciousness format linked together with segments of poetry.

The text does not differentiate between the two speakers/writers, though through the “call and response,” back-and-forth exchange between the two authors, you quickly begin to recognize two distinct voices (as well as other fragments from birth books, bumper stickers, midwives, etc.).

The book was written during Arielle’s second pregnancy, which ends in the stillbirth of her baby boy. Arielle had one prior homebirth and one subsequent homebirth. Rachel had two hospital births and a homebirth prior to the writing of the book.

While the style in which it is written takes some time to get used to, once you tune in to its rhythm, Home/Birth is a unique and fascinating journey. Because it is so distinctive, I find it difficult to describe in writing—you need to make sure to read it for yourself!

--

Disclosure: I received a complimentary copy of this book for review purposes.

GRN: The Access to Certified Professional Midwives Act of 2011

2011-03-18T15:29:00.001-05:00

Grassroots News Message 2011-03-18 no 2

Historic news from the MAMA Campaign: “The Access to Certified Professional Midwives Act of 2011” introduced in Congress. Citizens for Midwifery is a coalition partner in the MAMA Campaign and has been working hard to increase access to midwifery care for families through federal recognition of CPMs. We are thrilled to have reached this historic milestone. Read more from the MAMA Campaign below.

CPM Bill Introduced: A Milestone for Mothers and Midwives!  

Join the Celebration for HR 1054 !

We are thrilled to announce that Congresswoman Chellie Pingree (D-ME-1) has introduced HR 1054, the “Access to Certified Professional Midwives Act of 2011” in the U.S. House of Representatives.

Photo of Rep. Chellie Pingree  

“I believe it’s important that women are able to have the birth experience they want, regardless of where they live and how much money they make. That is why it’s important that women with Medicaid coverage have the same access to high quality, safe, and cost-effective services,” Congresswoman Pingree said. The Congresswoman is known in Maine and Washington, DC as a sensitive, independent voice for social and health issues that affect families everywhere.   

The Midwives and Mothers in Action (MAMA) Campaign expresses our sincerest appreciation to Congresswoman Pingree and celebrates this milestone in the history of direct-entry midwifery in the United States.

MAMA is also deeply grateful to Rep. Gwen Moore (D-WI-4) and Rep. Jim McDermott (D-WA-7) for their support and leadership in co-sponsoring HR 1054 with Representative Pingree.

Increasing women’s access to the care of CPMs will support better outcomes for mothers and babies, reduced disparities in outcomes for vulnerable populations, and provide significant cost savings for Medicaid and the health care system.

We are most grateful to Representative Pingree for her vision and support for childbearing women and their families.   

This is Your Milestone! 

Your support, your letters to members of Congress, meetings with your legislators in Washington, DC and in-district, and all of the dollars that you have contributed to this cause have made possible the introduction of HR 1054. You should be proud of yourselves – the MAMA Campaign Steering Committee thanks you!

Now the Work Begins….

MAMA will be counting on your energy and involvement in the coming weeks and months as this train gains steam and we forge ahead to garner the support of Congress for enacting HR 1054 into law. Our next steps include securing additional co-sponsors, obtaining support from the leading advocates for change in maternity care, raising the funds, and motivating the volunteers necessary to see this campaign through to victory. Together we will steadily move this important piece of legislation forward, Congress member by Congress member, for the benefit of women and babies.

Coming Soon From MAMA:

Letter-writing guidelines for soliciting your Congress members to become co-sponsors
Invitations to participate in visits to the Hill in Washington, DC and organize in-district visits to your Representatives
Advice on how you can become more involved as the MAMA Campaign gathers support in key Congressional committees

 
MAMA’s New Look

MAMA is getting a “make-over” with a new color scheme, updated logo and website and a fresh look to our materials. Check MAMA out at www.mamacampaign.org. We’re also implementing a new web platform that will make it easier for us to stay in touch with you and for you to post your thoughts, write your representatives, and make donations to the campaign.  

MAMA Is Growing

With the introduction of HR 1054, MAMA is seeking to hire a self-starting, energetic, and driven team member as Administrative Assistant to the Campaign. Take a look at the Job Posting and help us find the right person to provide this support to the Campaign.  

Keep MAMA Going in 2011!

Just one year ago, MAMA celebrated a significant victory in our campaign for federal recognition of CPMs! Since that time, we have been working quietly to secure the initial sponsors of HR 1054 and solicit support from major donors who understood the need to invest in MAMA’s long-term success. As a result, we are already halfway toward meeting our expenses in 2011! Now we need the support of our grassroots – mothers and fathers, grandparents, midwives, doulas, and other advocates – to keep our momentum going. Please celebrate with us – show Congress you care, too – by making your contribution today. We will put your dollars to work, making a difference for mothers and babies! Together we can move mountains!   Donate Today!

GRN: ACOG Is Not Qualified to Evaluate the Practice of Midwives

2011-03-17T23:39:00.000-05:00

Grassroots News Message 2011-03-16

"ACOG Is Not Qualified to Evaluate the Practice of Midwives"

March 11, 2011
Grassroots Network Message
ACOG Releases Opinion on Homebirth

Hello Friends,

After a January press release announcement, the American Congress of Obstetricians and Gynecologists (ACOG) officially issued its current statement on the safety of homebirth in February (ACOG, 2011.). The numerous challenges posed by a physician’s trade organization releasing an opinion about homebirths (which most obstetricians do not attend), based on unsound research, will be explored below.

In the statement, ACOG acknowledges that they “respect the rights of a woman to make a medically informed decision about delivery,” but again asserts its long-held belief that hospitals and birth centers are the safest settings for birth.

ACOG’s opinion on homebirth is based largely on results from a poorly conducted, scientifically weak meta-analytic review (Wax et al., 2010).

This paper has been roundly criticized for its methodological flaws and shortcomings, rendering its conclusions inaccurate at best. You can check out these links for critiques:

The Big Push
Science and Sensibility
Our Bodies Our Blog
Midwifery Today
Scribd

That ACOG would use poor quality science is a testament to the fact that ACOG is a private trade organization, not a scientific organization, whose primary goal is to support the interests of its members (for more on this). Perhaps even more important, ACOG, as a group, lacks any comprehensive knowledge of or experience with midwifery practice. ACOG is not qualified to evaluate the practices of midwives given the vast differences between modern obstetric practice and midwifery practice. Most obstetricians have never observed a single woman labor and give birth without any medical intervention, let alone in her own home. It is essential to keep these considerations in mind when evaluating recommendations from a trade organization such as ACOG.

While ACOG’s opinion on homebirth is not surprising, it is important to consider the potential negative impact it could have on the future of women’s access to homebirth. Some may recall the 1999 ACOG practice bulletin recommending that VBACs (vaginal birth after cesarean) only be attempted in hospitals with immediately available emergency surgical teams. This recommendation had an immediate (and long lasting) chilling effect on the number of VBACs occurring in the United States (see the figure below, reprinted from Roberts et al., 2007.). If ACOG’s statement on homebirth is used to set policies in the same way that the VBAC opinion was, access to homebirth could be jeopardized for many women for a long time to come.

In the statement, ACOG asserts that several of the current, well-conducted empirical studies illustrating the safety of homebirth cannot be generalized to the United States, given that they were conducted in countries in which midwifery is well integrated into the health care system. In light of this assertion, we call on ACOG as well as national and state medical societies to understand that criticism and to begin to support (rather than obstruct) efforts to license and integrate well-trained professional midwives into main stream health care delivery in the United States.

Sincerely,
Lauren Korfine, PhD
for CfM

References:

American College of Obstetricians and Gynecologists, Committee on Obstetric Practice (2011). Committee Opinion: Planned Home Birth, Obstetrics and Gynecology, 117(2), 1-4

Roberts, R. G., Deutchman, M., King, V. J., Fryer, G. E., & Miyoshi, T. J. (2007). Changing policies on vaginal birth after cesarean: impact on access. Birth, 34, 316-322

Wax, J.R., Lucas, F.L., Lamont, M., Pinette, M.G., Cartin, A., Blackstone, J. (2010). Maternal and newborn outcomes in planned homebirth vs. planned hospital births: A metaanalysis. American Journal of Obstetrics and Gynecology, 243, e1-8.)

From Roberts et al., 2007. Number of births by cesarean section over time. Note the sharp decline in VBACs after 1999, the year ACOG issued its VBAC practice bulletin that lead to VBAC bans in many hospitals.

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Breech Resources

2011-03-11T15:15:00.003-06:00

I got the following information from a birth email list I belong to and thought these resources were interesting/valuable:

Great photos of a breech home birth (mother kneeling) with Australian Midwife
Lisa Barrett

New organization for the UK promoting education in Breech Birth for Midwives and
Obstetricians and Informed Consent for mothers. Stories invited.

PowerPoint by Shawn Walker RM as well.

--
Molly
CfM Blogger

International Women's Day

2011-03-07T16:09:00.005-06:00

"If ever the world sees a time when women shall come together purely and simply for the benefit of humanity it will be a power such as the world has never known." --Matthew Arnold

"I long to speak out the intense inspiration that comes to me from the lives of strong women." –Ruth Benedict

Tomorrow is the 100th anniversary of the first International Women's Day. For more information about celebrating check out the International Women's Day website. Or, visit the Imagine a Woman website to read this blog post or to check out this handout about 50 things to do to celebrate International Women's Day, Women's History Month, yourself, and the women who inspire you.

To bring it back to birth, you might also enjoy watching these helpful midwifery/birth videos from strong women on the Midwifery Today youtube channel.

“I believe that these circles of women around us weave invisible nets of love that carry us when we're weak and sing with us when we're strong.” --SARK, Succulent Wild Woman

"Loving, knowing, and respecting our bodies is a powerful and invincible act of rebellion in this society." --Inga Muscio

In honor of International Women's Day---and every day---let us celebrate our bodies, honor our mothers, and trust in the nets of love woven around us by a multitude of remarkable, powerful, everyday women.

--
Molly
CfM Blogger
(photo from my blessingway in January 2011, 38 weeks pregnant with my baby girl!)

Legislative Alert from AABC

2011-02-23T12:22:00.003-06:00

Passing along a legislative alert from the American Association of Birth Centers:

Women and Children Lose in Budget Cuts: We need your help!

It always is a shock to me that Women and Children's Programs are at the top of Federal and State budget cuts. Republicans in the U.S. House of Representatives have passed large cuts in health services to women, infants, and children (H.R.1):

Hundreds of millions from WIC (Women, Infants, and Children):
WIC provides Federal grants to States for supplemental food, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.

Hundreds of millions from Maternal and Child Health Block Grants:
This Block Grant referred to as Title V is a public health program that reaches across economic lines to improve the health of all mothers and children, train providers and support services for children with special healthcare needs, offers newborn screening and genetic services, lead poisoning and injury prevention, and health and safety promotion in child care settings.

More than a billion from Community Health Centers:
Community Health Centers are key partners for many Birth Centers. They exist to fill the void in underserved communities and vulnerable populations by assuring access to comprehensive, culturally competent, quality primary care services.

This federal quandary is shared by many states: Demand for health services is growing and states are cutting Medicaid budgets for the poor and disabled. Medicaid accounts for approximately 25 percent of state spending when federal matching dollars are included according to the National Association of State Budget Officers.

PLEASE DO NOT SIT BACK AND DO NOTHING. WOMAN AND CHILDREN NEED OUR HELP NOW. This is not a Republican, Democrat, or Independent position. This is the moral and ethical action to take now.
ACTION STEPS
1. Call your U.S. Senators -( U.S. Capitol Switchboard: 202-224-3121).
Ask to speak to your Senator's health legislative aide.
2. Call your State Governor, Senators and Representatives
3. Tell them you are NOT in support of cuts to women and children's health! The deficit can be reduced by cutting waste in other areas.
4. Please let Karen Fennell (AABC's lobbyist) know of your contacts with legislators.
Tell her who you talked with and any comments or additional information requested. Call Karen at 301-830-3910; Send email to fennell.karen.s@gmail.com

Suggested Talking Points

WIC Program: This is one of the most efficient programs to improve child nutrition. The program gives expectant mothers with very small children important education on how to eat healthy during their pregnancy and how to feed their children healthy meals. And it provides them with coupons to incentivize them to purchase the best foods for their children. Research shows that without this intervention the nutritional intake of these children would be higher in fats, salts and sugars, according to a recent U.S. Food and Nutrition Services study. Instead if spending $1,400 a month in extra medical care for an obese child, for just $41 per month this program shifts these mothers and children into healthy eating patterns, says the Centers for Disease Control and Prevention. Clearly, the WIC approach is a useful and relatively cheap way to stem the rising tide of childhood obesity and a healthy pregnancy.

Maternal and Child Health Block Program: The program has been cut by 30%. This program is the safety-net care for women and children. The block grant pays for child immunizations and prenatal care for tens of thousands women and children. It is obvious that without access to immunizations more dollars will have to be spent to care for kids sick with easily preventable illnesses. Reducing access to prenatal care is both life-threatening and costly. A preemie baby's health costs are 10 times higher than a full-term, healthy-weight child, according to the March of Dimes. It makes no sense to cut a program that has a proven track record of delivering health to babies and driving down America's health care costs.

Community Health Centers: Funding for community health centers will be cut in half. Senator Orrin Hatch (R-UT), who was a cosponsor of the legislation responding to President George W. Bush's call to expand funding for these centers in 2008, says that "since 2001, additional funding has allowed health centers in more than 750 communities nationwide to provide care to about four million new patients. These centers provide affordable and quality care to at-risk Americans who otherwise might have to might have to do without." As state by the Center for American Progress, "No health care costs will be avoided by cutting this $1 billion out of the budget because the absence of care doesn't stop you from getting sick. It simply means you get sicker and you turn up at the emergency room or hospitals when your illness has progressed to the point that you care needs are exorbitantly expensive.

State Medicaid Cuts: Most States have budget proposals to cut funding for Medicaid. Talk to staff about what you know best - health and costs implications of a lack of prenatal and newborn care. A useful resource is the article Ten Myths About Medicaid published by The Kaiser Commission on Medicaid and the Uninsured.
--

Jill Alliman, CNM, MSN

Chair, Legislative Committee

American Association of Birth Centers

Snow Baby

2011-02-18T16:23:00.009-06:00

Guest article by Katie Tonarely

When Kara Kay started feeling crampy contractions on a Tuesday, she didn’t call a hospital or obstetrician. She didn’t have one. Instead, around 11 a.m. on Tuesday, February 1, Kara called her husband, Mike Benedict, and her Certified Professional Midwife, Deborah Smithey. Then, she sat back, enjoying the early feelings that she knew would eventually bring her her baby. While she waited comfortably inside, the worst blizzard in 100 years raged outside, and Deborah and Mike worked to make their way to Kara.

Choosing a Midwife
A hospital birth was never an option for Kara. “I’ve never been really comfortable with a hospital,” she says. “I never imagined I would have a birth in a hospital.” Mike agrees. After typical hospital experiences with his first two children, he was ready for a change. “It allows the father to be much more involved,” he says of his home birth experience.

A Certified Professional Midwife provides more in-depth care, Deborah says. Prenatal visits usually last an hour or more, and whatever is on the mom’s mind is up for discussion. Of course the CPM also checks how the mother is doing physically: blood pressure, pulse, fetal heart rate and growth. Midwives also focus on a lot on nutrition and overall health during pregnancy.

For Kara and Mike, the safety of home birth was a big factor for them, too. “I feel it’s safer overall, because there aren’t any doctors to force you to take unnecessary drugs or inventions that tend to cause more problems that solve them,” Mike says. Deborah cites a 2009 study that confirms these claims. The study, “Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America” by Kenneth C Johnson and Betty-Anne Daviss, found that birth at home is safer, has better outcomes and fewer interventions.

Getting There
Mike knew the storm was coming and was planning to come home from work early anyway, but when he got the call from Kara, he left so he could get home to be with his wife. Getting there, though, proved to be a challenge, as the snow fell and cars and trucks slid into ditches on either side of the highway. “It was just white; you couldn’t see anything,” he said. After his own car ended up in a ditch, someone picked him up, but that car ended up in a ditch, too. Not really sure what he should do next, Mike started walking and running the mile-and-a-half home. “When I saw the tow-trucks and 18-wheelers stuck in the snow, I started to panic. That’s when I started to get anxious.” The couple of mile journey too him over an hour. “By that time, I was pretty nervous. I was ready to get home,” he says.

The midwife’s journey took even longer. She and her husband left Stockton at about 1 p.m. Normally, her drive to Carthage takes about an hour. They drove a four-wheel-drive truck to maneuver through the 13 inches of snow, with more falling by the minute. In the back seat of the truck, she had her midwifery supplies packed. “The roads became more and more treacherous as we went,” she says. “At one point, we couldn’t see the road at all.” To break through the snow drifts, they had to drive fast, but were also sure to go slow enough, so as not to lose control.

When they finally made it to the highway, they expected to it be clear. Normally, highway 71 is a four-lane highway, but only one lane was moving. “Semi-trucks and pick-ups were stranded on both sides of the road, and some were even stopped in the road,” Deborah says. “I have never seen anything like it.”

Deborah and her husband made it to Kara at 4:30 p.m. The one-hour journey took three hours.

Labor Land
Pregnant with her first, Kara expected a longer labor. Though the world outside was urgent with worries of weather and time, Kara sat comfortably in her home, not worried at all. “I just didn’t realize how bad the weather was,” she says. “I wasn’t concerned.”

As labor progressed through the afternoon and night, Kara used what she had learned in her Bradley Method class. She worked on breathing slowly and had visualizations and mantras ready to help her get through the tough times. “I’m just in labor land; I’m just passing through, “she repeated.

When it was finally time to push the next morning, February 2, Kara worked hard. She says, though, that she never felt the head descend. She counted on Mike and Deborah’s encouraging words. “I didn’t feel like I was getting anywhere,” she says.

Once the baby’s head came out, the midwife helped deliver the baby’s stuck shoulders. Called shoulder dystocia, this complication can be rather painful, yet Kara didn’t know it was happening until later. She continued to rely on her midwife’s encouragement. “Deborah reached up; it wasn’t invasive at all,” Mike says. “At that point, I was really glad that Deborah braved the storm.”

Snow Baby
Mike caught his daughter, Kaliyah Winter, at 7:49 a.m.. She weighed 9 pounds, 12 ounces. “I don’t think this experience will ever leave my mind,” he says.

For her post-partum care, Kara stayed put and was able to enjoy time with Kaliyah. “The midwife came to us,” Mike says. “I didn’t have to lug my baby out in the cold and snow.”

After she realized the snow’s devastation, Kara couldn’t help but be grateful for the midwifery model of care. “This just shows the dedication, loyalty and passion of midwives,” she says. “I’m totally thankful to Deborah and her husband.”

When there’s a natural disaster, Deborah asserts that midwives are best to handle birth. She asserts that it would be ideal for every Missouri county to have a Certified Professional Midwife ready to handle births in an emergency. “Common sense tells us that it would be far safer for a midwife to travel to a birthing mother then have a mother risk delivering along the side of the road in horrible conditions,” she says. In addition, CPMs are trained to handle common complications, such as cord entanglement, shoulder dystocia and post-partum hemorrhage.

For Mike and Kara, the intensity of the storm outside was nothing to compare to the positive feelings associated with bringing a new baby peacefully into the world. “It’s just a miracle, and I’m thankful everything turned out,” Kara says.

--
In addition to being a wife and mother to two boys with another due in May, Katie Tonarely spends her time writing for several publications, including Springfield, Missouri's "News-Leader" and "Moms Like Me." She also does web content writing for Demand Media Studios.

For more about homebirth and midwifery in Missouri see:
http://www.friendsofmomidwives.org

"Birth Witnesses" Guest Post

2010-12-30T15:55:00.002-06:00

I very much enjoy maintaining the Citizens for Midwifery Facebook page. I share relevant quotes there almost every day and really appreciate the dynamic, vibrant responses I get from the various "likers" present on the page. Recently, I shared this quote:

“Please, choose your birth attendant and place of birth carefully. Search hard for the attendant that you connect well with. You and your baby deserve to be treated with utmost respect and dignity. There are attendants who believe in the sacredness and sanctity of birth. You may, however, need to act as a detective to find them.” –Janice Marsh-Prelesnik (The Roots of Natural Mothering)

This quote resonated with me because of the final line—I am very familiar with that feeling of needing to be a “detective” in order to unearth the kind of care needed/desired/deserved by my family. The quote then prompted some great comments about the value of inviting women (other than formal birth attendants) to witness our birth experiences—sisters, friends, nieces. A commenter named Bonnie shared her ideas that one of the very best ways for young women to learn what birth is really like is to be invited to witness a real birth. And, that this may be one of our most transformative keys to making true and lasting changes in our current birth culture. I was fascinated with her ideas and invited her to write a guest blog post about them. She graciously agreed and her wonderful article on the subject is now available to read here.

Enjoy!

Molly

CfM Blogger

Happy Holidays!

2010-12-20T18:25:00.001-06:00

As you gather with your family for the 2010 Holiday Season, we wish you love, joy, and memories to last a lifetime, and we thank you for your support of Citizens for Midwifery. As we greet 2011, we hope every day brings new wonders and a promise of a more peaceful world for birthing women, babies, and families around the world.

Warmest Wishes!

--
Molly
CfM Blogger

CfM e-newsletter & FREE membership!

2010-12-15T10:41:00.003-06:00

Citizens for Midwifery is pleased to have launched our new e-newsletter! You can read the newsletter online here. A printable version is available here. You can also subscribe to the newsletter via Facebook by going to the CfM Facebook page and clicking on the tab that says Email Signup.

An especially important announcement from this first edition is that membership in Citizens for Midwifery is now FREE! Here are the details:

Anyone who signs up with CfM either on our signup page, on Facebook, or CfM’s “Grassroots News” yahoo group will now all be considered members of CfM and will receive the free CfM e-news. In this day and age of social networking the concept of CfM membership needed to evolve to include all the ways people communicate and participate in CfM’s activities. We hope you will be excited by this open membership structure and will encourage all your friends, clients, Facebook friends and associates to sign up for a free membership with CfM today.

Membership is now free, but CfM still needs your financial support. Please donate today! We are so grateful to all the individuals and midwifery practices who have been paid members with CfM over the years. Many of you have been faithful members for years. Your support has made all our work on behalf of consumers, midwifery, and the Midwives Model of Care possible. We hope you will continue to support CfM with an annual donation. If you are a midwife who has been giving “Gift Memberships” to your clients we hope you will continue to make a donation to CfM in honor of each of your clients and encourage your clients to sign up for free with CfM. Donations of any amount are greatly appreciated!

Your donations are fully tax deductible. Donate at our suggested giving levels, or in any amount you can. Donate today on the CfM website or by mail Thank you for your support.

Grassroots Network: Effective Health Care Program Update: New Draft Key Questions and a Draft Review Are Now Available for Comment

2010-12-07T18:45:00.000-06:00

Dear Friends,

The federal Agency for Healthcare Research and Quality (AHRQ) is preparing a review document about “interventions” that are effective in reducing cesarean sections, and all of us have a chance to give input!

ARHQ has drafted 4 key questions for members of the public to answer on-line, plus you can also upload a document. Go to: < http://www.effectivehealthcare.ahrq.gov/index.cfm/research-available-for-comment/comment-key-questions/?pageaction=displayquestions&topicid=263&questionset=147 >.

Scroll down below the questions to read the draft review (not too long). This will help you to see where they are starting from. For example, the word “intervention” is really used to denote any action (or non-action) that is being studied for its effect on reducing cesarean rates, even if you don’t normally think of it as an intervention. Also, it is apparent that routine hospital practices (that we know can interfere with labor) aren’t really mentioned in the list of “interventions”…

NOTE: The deadline for comments is December 29!

Wonderful that AHRQ is looking seriously at the topic of how to reduce the cesarean section rate, and that they are inviting comments from the public! I would encourage you to be respectful and informative in your comments, so that they are helpful and useful for the purpose of this review.

Please feel free to pass this on to other relevant lists you may be on!

Sincerely,

Susan Hodges, “gatekeeper”
For CfM

Grassroots Network: Premature birth rate down

2010-12-01T20:04:00.002-06:00

Hello Friends,

We hope you all enjoyed a wonderful Thanksgiving holiday!

This grassroots news message contains good news! According to March of Dimes analysis of 2008 birth data, the United States rate of premature births, or babies born before 37 weeks gestation, has declined for the second year in a row. This two-year decline comes after a 30-year increase in the rate of premature births. In 2006, the rate was 12.8% and in 2008, the rate fell to 12.3%.

Below is a link to a report from USA today that offers a more detailed description of the decline. We also include the link to the March of Dimes news source that not only notes the decline in premature births for 2008, but also includes an update on the state of births in 2010 as well as information on efforts to further decrease the number of babies born prematurely in the US. As you'll see in both articles, the decline is largely attributed to policy changes that prevent cesarean sections and labor inductions before 39 weeks gestation.

USA Today: http://www.usatoday.com/yourlife/parenting-family/babies/2010-11-18-premature18_ST_N.htm

March of Dimes: http://www.marchofdimes.com/nov17_2010.html

We hope you all continue to send us information that you wish to share with the group. We can be reached at info@cfmidwifery.org.

Sincerely,
Stephanie Hucker for Citizens for Midwifery

Grassroots Network: CPM BILL TO BE INTRODUCED IN CONGRESS THIS WEEK!

2010-11-30T13:29:00.000-06:00

Dear Friends,

If you are not getting the MAMA Campaign e-news messages, here is the latest!

The e-blast begins:

“The Midwives And Mothers In Action (MAMA) Campaign is very pleased to announce that a bill to amend the Social Security Act to mandate reimbursement for all CPM services for women insured by Medicaid will be introduced in the House of Representatives this week!”

This is the bill that, when passed, will mean that licensed Certified Professional Midwives will be reimbursed for services provided to women on Medicaid. Medicaid reimbursement will make CPMs more attractive to state governments (where they are not already licensed), plus the health insurance industry pays attention to what is covered by Medicaid.

Read details about this bill and more in the rest of the MAMA e-blast at: http://mamacampaign.squarespace.com/grapevine/2010/11/30/cpm-bill-to-be-introduced-in-congress-this-week.html

You can easily sign up to receive the MAMA e-mails directly at the same url -- see the sign up link on the right.

Citizens for Midwifery is a member of the Campaign coalition and actively supports this work, and we encourage you to support it too! Donations of any size are needed and greatly appreciated by the Campaign!

Sincerely,
Susan Hodges, for CfM

Grassroots Network: Help PUSH for CPMs in Illinois!

2010-11-15T10:22:00.000-06:00

Dear Friends,

Please read the Big Push Alert notice below, and if you live in Illinois, or know anyone there, please make calls ASAP!

Sincerely,
Susan Hodges, "gatekeeper"

A PUSH ALERT from the Big Push For Midwives

http://www.thebigpushformidwives.org/index.cfm?fuseaction=enews.signup

NOV 15, 2010 -- There is amazing pushing afoot! It is URGENT that we all push together to help Illinois fill the terrible shortage of home birth providers. Together, we can do it!!

The Home Birth Safety Act (SB 3712) to license CPMs in Illinois is being voted on in the House of Representatives this week, even as early as Wednesday, Nov. 16!

We need everyone in Illinois to call their Representatives and to forward this message to their family and friends in Illinois TODAY.

Here is the message that every Representative in Illinois needs to hear:

"I want to let the Representative know that Speaker Madigan has just reviewed the Home Birth Safety Act and improved the bill with an amendment. The bill is definitely going to be called this week. Will the Representative vote Yes for the bill on the House Floor?"

If anyone tells you "this is not the right act," tell them the Home Birth text is in House amendment 001.

Legislators can be looked up (Legislator Lookup) here: http://www.elections.il.gov/DistrictLocator/DistrictOfficialSearchByAddress.aspx
If you can call Monday, please call the Representative's district office, and if Tuesday is better, call his/her Springfield office.

The Illinois State Medical Society has been spreading misinformation saying the bill will not be voted on. NOT TRUE. House leadership has assured us a vote, but we need the grassroots to bring it home.

So make the call today and spread the word to everyone you know in Illinois!

After you make your calls, please send a text to report the results to me at the phone number below. Otherwise, please send an email to the email address.

Thank you from all of us Pushers in Illinois!

Rachel Dolan Wickersham, CD(DONA), LCCE
President, Coalition for Illinois Midwifery
Vice President, Illinois Council of Certified Professional Midwives
Jiandra@aol.com
630-750-9444

P.S. Again, please spread this far and wide - to your friends, family, and to all other lists! Even to folks outside of the birthing community. We look forward to keeping you informed of our progress thanks to your support!

Guest Post: American Childbirth Culture

2010-10-29T10:51:00.003-05:00

I am pleased to have a guest post today from blogger and activist, Anna Guthrie. (I am accepting guest posts for this blog while I'm on maternity leave--feel free to email me with your ideas!)

-------
American Childbirth Culture

A couple of months ago, Molly posted some great thoughts about “why” all of this (childbirth/midwifery education) is so important, especially considering that so many people don’t seem to want to change the way things are. That’s the number one question I’ve pondered in all my years of “activism” for normal, natural, or “physiological” birth (as I’ve heard it called most recently).

The next most interesting question I’ve heard is one that has been asked me by many women: “What is so wrong with the [medically dominated] way I gave birth?” The first couple of times, it took me by surprise since I had never said that nor was meaning to be offensive at all in expressing my opinion. I also had no good answer-I’d think, what’s wrong with what’s considered “normal” childbirth in our country? Everything! Where should I start?! But, then I realized that these women were not just asking a question, they were on the defensive…immediately, without even hearing a word I said and they were the ones who had asked me. They had initiated the conversation about birth with a sincere desire to know what I had to say, but couldn’t get beyond their own births. That’s when it hit me…

This is all about our American childbirth culture-it goes deeper than all the statistics and conferences and symposiums. (Although I realize that those things are essential, and thank goodness there are so many people out there doing their part to create a change). I realized I’m interested in the psychological aspect of a woman’s relationship to birth, how the dynamics of our cultural history has shaped that, and how that can be changed.

The medical world that dominates childbirth in this country as well as the social and cultural environment we are born into teaches us from a young age to trust it without question. I just saw a billboard on the side of the freeway in Emeryville, CA (the first of many similar ones now being used by different hospitals). It features a picture of a happy, carefree woman, dressed in a flowing blouse, half-reclined in the grass so that her pregnant belly is obvious, and smiling at her little toddler on her lap. It reads, "Kaiser Permanente...DELIVERS". I couldn’t believe it-anyway, I thought MOTHERS delivered babies J-it’s almost as if they are purposely launching a counter-attack on any recent progress in childbirth education, natural birth, home birth, and midwifery! This is the hold the medical world has on our society. There is so much damage to undo here that it's hard to know where to start.

A woman’s birth is so personal to her and that’s one thing that drives many women to question and reject the status quo; but, it also works against those efforts. So many women give birth without ever hearing anything about this and they never have the opportunity to make a different choice. So that personal relationship to their birth is so sensitive-even more than they comprehend-that they don’t want to know what they are missing, or missed. So, we need to come full circle: instead of girls growing up within this false belief system of “medicalized” childbirth and then trying to shift their paradigm as adults, we need to work to change our culture from the ground up. Girls (and boys) should grow up understanding birth from the healthy perspective of natural, physiological birth being the ideal and medical intervention as merely the benefit of living in the 21st century and out of necessity or personal choice. So, that brings us back to the ultimate question, “why?”… So that the joy of childbirth can be fully experienced by everyone in our society because it is naturally woven into the fabric of our culture.

--
Anna Guthrie is a mother of three, homemaker, artist, and childbirth education activist. http://americanchildbirthculture.blogspot.com/

Domestic Violence Resources

2010-10-06T15:57:00.003-05:00

As I have noted several times, my first professional interest was in domestic violence. Domestic violence during pregnancy is unfortunately very common (though often overlooked during screenings) and, indeed, often the first incidence of intimate partner violence in a relationship occurs during the woman's pregnancy. In 2003, I wrote a short book about talking to battered women (nothing specifically about pregnancy) and it is available as a free e-book version here.

I think all birthworkers have a professional responsibility to be informed about intimate partner violence and its incidence during pregnancy. (I've also previously written about violence and birth, as it is sanctioned by the American medical care system.) Several helpful free DV resources for professionals came to my attention recently and I decided it was time for another post on the subject!

From an email list, I received this announcement:

Power and Control: Domestic Violence in America is a comprehensive and timely exploration of the shocking persistence of domestic violence in our society. The complex issues around domestic abuse are refracted through the story of Kim, a mother of three in Duluth, MN. Kim's journey takes her from a domestic violence shelter, to a promising fresh start, and then through a disturbing final twist.

The film also tells the story of the leaders who created the hugely influential "Duluth Model," the set of domestic violence policies that have been widely adopted around the world. Today the Duluth approach faces a challenge from increasingly vocal outside critics. At the same time the leaders of the battered women's movement are struggling to maintain the spirit of sisterhood that has
propelled the movement for 30 years.

For more about the film, including 40 interview excerpts with survivors, advocates, police, health care providers, batterers and founders of the battered women's movement, visit: http://www.powerandcontrolfilm.com/

For your free screening (good for 2 days for each user), visit: http://bit.ly/PowerAndControl

Additionally, the Family Violence Prevention Fund has a serious of free webinars about domestic violence available here.

--
Molly
CfM Blogger

Book Review: Survivor Moms

2010-09-13T08:54:00.002-05:00

Book Review: Survivor Moms: Women’s Stories of Birthing, Mothering and Healing after Sexual Abuse
By Mickey Sperlich & Julia Seng
Motherbaby Press, 2008
ISBN 978-1-89-044641-3
245 pages, softcover
http://www.midwiferytoday.com

Reviewed by Molly Remer, MSW, CCCE
http://talkbirth.wordpress.com

Past sexual abuse is an unfortunately common experience for women. Anyone who works with women of childbearing age should be mindful and informed of the effects of an abuse history on the woman’s experience of pregnancy, birthing, and mothering. Indeed, I consider this awareness to be a fundamental professional responsibility. Enter Survivor Moms, published by Motherbaby Press. This book is an incredibly in-depth look at the experiences and need of survivors of sexual abuse during the childbearing year.

One of the best and most unique features of the book is the “tab” format used for much of the clinical, research-based, or fact-based content in the book. Rather than lengthy chapters reviewing research and analyzing the phenomenon, textboxes containing quick facts and reference material are printed in the margins of many of the pages. The bulk of the narrative information in the main body of the text is then in the voices of mothers themselves, interspersed with commentary by the authors linking concepts, explaining ideas, and clarifying essentials. This is a powerful format that makes information readily and quickly available for reference as well as making the overall book very readable and approachable.

As someone with no personal abuse history who is currently pregnant, I did find the book to be a very emotionally difficult, intense, and almost overwhelming read at times. This is not a criticism in any way—sexual abuse is not a light or cheerful topic and it can be one that many people prefer to avoid. This is all the more reason for birth professionals to make a specific effort to be educated and informed.

Written both for mothers themselves and for the professionals who work with them, Survivor Moms is an essential part of any birth professional’s library. As noted in the book’s introduction, “We need to understand the impact of childhood abuse on birthing and mothering deeply, from hearing women’s stories. We also need to understand it broadly—from looking at the impact on samples and populations, on the body and on the culture.” Survivor Moms offers an accessible way of hearing those critically important stories and developing the necessary understanding to care compassionately for birthing women.

--
Disclosure: I received a complimentary copy of this book for review purposes.

Posting Hiatus

2010-09-12T14:23:00.000-05:00

I have once again come to a point in my life where, "something's gotta give." As someone who is deeply committed to multiple causes, I reach this point several times a year and have to take some steps back to assess my life's path and priorities! I read somewhere--and agree--that it is BORING to hear about how "busy" someone else is, so I'm not going to give a laundry list of all my other commitments, responsibilities, and callings (and perhaps some "excuses" as well!), but I do want to post this notification that I am going to take a posting hiatus from writing this blog until after my new baby is born in January. I have struggled a bit with writing this post, because the last time I wrote something similar (fall of last year), I then had a miscarriage at 15 weeks, followed two months later by a miscarriage at 6 weeks. I'm now 21 weeks into my fifth pregnancy and finally feel like I probably really will have a living, healthy baby in the next couple of months! A new baby brings necessary downshifting into one's life and I'm attempting to alter my schedule as much in advance of the birth as possible to be able to joyfully welcome new life as well as to take time for self-care and self-nurturing. I am planning another homebirth and look forward to yet another opportunity to experience this powerful rite of passage and life transformation. I also look forward to sharing the experience with my other children. This baby is eagerly anticipated and already much loved and there has been more heartache along the childbearing journey for our family than I could have imagined several years ago.

During my break, I welcome guest posts for this blog--they can be submitted to me here and I will gladly consider them. Please make sure any guest post is specifically relevant to midwives, midwifery, the midwives model of care, homebirth, or birth activism. I am not usually interested in "generic"/101-type posts about pregnancy or childbirth.

I will continue to post regularly to the Citizens for Midwifery Facebook page where I greatly enjoy hearing from midwifery supporters across the country. Please take a moment to touch base with CfM there!

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Molly
CfM Blogger

Book Review: My Name is Mary Sutter

2010-09-01T09:10:00.002-05:00

Book Review: My Name is Mary Sutter
By Robin Oliveira
Viking, 2010
ISBN 978-0670021673
384 pages, hardcover, $26.95

Reviewed by Molly Remer, MSW, CCCE
http://talkbirth.wordpress.com /posts

My Name is Mary Sutter is a new novel about a young Civil War era midwife who longs to be a surgeon, but is denied entry to medical school because she is female. Historical fiction has always been a favorite genre of mine, but historical fiction about a midwife? The best! After some initial chapters involving midwifery and family life, the main character, Mary Sutter, seeks work first as a nurse in desperately undersupplied and overworked Civil War hospitals and then directly on the battlefield following the soldiers with a cart of medical supplies. Mary is a strong female protagonist and there are some complicated male (doctor) characters as well. A couple of mild love stories serve as sub plots.

Midwifery quickly takes a back seat in the saga as Mary becomes a nurse on the bloody battlefields of the Civil War. However, her work continues to be informed by her midwifery experiences--for example she uses memories of turning malpositioned babies as inspiration for finding the right spot to amputate wounded legs.

Some famous historical figures like President Lincoln, Clara Barton, and Dorothea Dix make appearances in the tale. The slaughter on the (famous) battlefields is tightly wrought and makes you feel as if you’ve “been there.” The reader feels exhausted and battle weary right along with Mary. The novel is a third person narrative throughout, but it almost felt like a first person account—as if the author was writing from personal experience. Be prepared for a variety of personal losses for the main character.

Riveting, well constructed, and tightly paced, My Name is Mary Sutter is a gripping story of one woman’s tenacious will and her drive both to learn and to serve.

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Disclosure: I received a complimentary copy of this book for review purposes.