I am a Midwife Campaign

MANA has a great educational campaign going on right now called I am a Midwife. The campaign involves a series of short videos released once a week about a variety of topics. More than just a general education campaign, each video includes a variety of different women--midwives, mothers, public health activists, maternity care activists, authors---speaking out on important topics in maternity care. Each woman also identifies, "I am a Midwife." This week's video is about health disparities in maternity care, which is a very important and too-often ignored topic. It raises the concern that African American women and their babies are more likely to die than their Caucasian counterparts even when other variables are equalized (i.e. same socioeconomic status, same education, etc.) and moves into wider discussions about racism and the treatment of minority group members. It then focuses on the value and role of midwifery care in addressing these concerns.


As MANA states in relationship to this campaign: "For midwives, sharing is daring. We dare to challenge the status quo. We dare to speak up for women's innate wisdom in pregnancy and birth. We dare to assert that there is a better way for our babies to be born. And we dare to insist that birth belongs to families."

Absolutely! The I am a Midwife public education campaign is extremely powerful. I have to confess that when it originally launched, I didn't personally make time to watch the videos right away, somehow assuming that they were "generic" videos with a "rah, midwives!" type of message. Don't make the same mistake I did. These are quality videos with important messages, powerful voices, and essential education and information. You will definitely learn something from watching them!

--
Molly
CfM Blogger

GRN: Home Birth Rate Up 20% in Four Years

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!

Grassroots Network: NIH Consensus Development Conference on VBAC

Dear Friends,

As most of you know by now, the National Institutes of Health (NIH) convened a Consensus Development Conference on VBAC (vaginal birth after cesarean) in Bethesda, MD on March 8-10, 2010. I felt privileged to represented CfM and be one of the voices for consumers, trying to keep the focus on what is best for women and babies rather than the concerns and pressures that hospitals experience.

It was clear that many of the presenters really understood the problem of VBAC bans, especially Rita Rubin who gave a powerful presentation of women's stories. There was plenty of frustration, too, especially near the end when the panel ethicist refused to acknowledge a pregnant woman's right to refuse surgery, even when she has appropriately weighed the risks to herself and her baby.

All in all, I think the conference really moved the VBAC conversation in the context of other problems in maternity care. It remains to be seen just how much medical practice - and culture - will change as a result of the panel recommendations.

This Grassroots Message includes CfM's response to the NIH Consensus Report on VBAC. At the bottom, I've included links to the NIH conference documents, media coverage. Happy reading! Citizens for Midwifery on the 2010 NIH Consensus Development Conference on VBAC

Our overall assessment of the NIH report can be found below and links to much of the media coverage below that. A full analysis can be found here.

The NIH panel recommendations urge two courses of action that, if implemented, would go a long way toward improving the situation for women with prior cesareans. They state that their goal is to "support pregnant women with a prior transverse uterine incision to make informed decisions about TOL [trial of labor] and ERCD [elective repeat cesarean delivery]". To do that, they (1) urge evidence-based practice, and they (2) urge ACOG to reconsider "ACOG #5". CfM agrees. We would also like to see the following actions:

* All hospitals and OBs should start supporting VBACs, not just "offering" and "encouraging". CfM believes the Midwives Model of Care represents that support of physiologically normal birth.

* ACOG should rescind "ACOG #5" immediately. In doing so, insurance companies would no longer have a basis for dropping or threatening to drop malpractice insurance or raising insurance rates on practitioners and hospitals that offer VBAC, as those individuals and institutions will merely be responding to both the evidence and the guidelines. By rescinding "ACOG #5", ACOG and its members would be taking a step toward earning back the trust and confidence of the women they serve.

* Informed consent must be based on an honest risk assessment, including information about provider outcomes, provider bias and conflicts of interest, as well as the research evidence, in order to support all women, not just VBACing women, to have healthy births.

Willa Powell

CfM President

---
The NIH documents can all be reached from their press release, including the full report, the full evidence report, and recorded webcasts of the conference:

http://www.nih.gov/news/health/mar2010/od-10.htm

There has been a great deal of news coverage, including:

http://www.nytimes.com/2010/03/11/health/11birth.html

http://www.npr.org/templates/story/story.php?storyId=124542025

http://www.msmagazine.com/news/uswirestory.asp?ID=12295

Many organizations are developing press releases and responses including ICAN and Lamaze:

http://ican-online.org/print/node

Lamaze

A running blog discussion from the conference can be found at

http://thefeministbreeder.com/once-a-cesarean-rarely-a-choice

http://thefeministbreeder.com/nihvbac

and several blog postings with ongoing discussion can be found here:

http://www.theunnecesarean.com/blog/2010/3/10/nih-vbac-consensus-development-conference-gift-horse-or-troj.html

This article anticipated the NIH conference and very much supports CfM's philosophy:

http://www.nytimes.com/2010/03/07/health/07birth.html?partner=rss&emc=rss

A fairly comprehensive list of articles on this conference is available at:

http://birthaction.org/Blogs/tabid/66/EntryId/64/Articles-and-blogs-on-the-NIH-VBAC-Consensus-Panel.aspx

There's even a petition: http://www.petitiononline.com/VBAC2010/petition.html

Cesarean Article

Cesarean section linked to increased risk for maternal death, serious complications

By Ingrid Grasmo

25 January 2010

Lancet 2010; Advance online publication

MedWire News: The risk for maternal death and serious complications is high for women undergoing cesarean section and should therefore be done only when medically indicated, show findings from the third phase of World Health Organization (WHO) global survey on maternal and perinatal health.

For the survey, Metin Gulmezoglu (WHO, Switzerland) and co-authors analyzed 107,950 deliveries reported in 122 facilities from nine Asian countries.

The overall rate of cesarean section was 27.3 percent, while that of operative vaginal delivery was 3.2 percent. Facilities in China, Sri Lanka, Vietnam, and Thailand had higher rates of cesarean section than did those in Cambodia, India, Japan, Nepal, and the Philippines.

Women undergoing operative vaginal delivery had a 2.1-fold increased risk for maternal mortality and morbidity index (at least one of: maternal mortality, admission to intensive care unit [ICU], blood transfusion, hysterectomy, or internal iliac artery ligation) compared with women delivering spontaneously.

An increased risk was also seen for all types of cesarean section, with respective odds ratios (ORs) of 2.7, 10.6, 14.2, and 14.5 for antepartum delivery without indication, antepartum delivery with indication, intrapartum without indication, and intrapartum with indication, respectively.

However, cesarean section was associated with improved perinatal outcomes for breech presentation (OR = 0.2 antepartum and 0.3 intrapartum), but also with an increased risk for stay in neonatal ICU (2.0, and 2.1, respectively).

The researchers conclude: “Cesarean section should be done only when there is a medical indication to improve the outcome for the mother or the baby.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Journal abstract

Laboring Under an Illusion update

In October, I posted my review of the film Laboring Under an Illusion by filmmaker and anthropologist Vicki Elson. I really enjoyed this film and my birth class students love it too--it is one of the most frequently checked out videos from my lending library and they all say the same things after watching it, "it was funny" and "it really brought home some good points." Humor should not be underestimated as an important teaching tool. It can really help important messages sink in and "stick" in a way that other mediums may not. I'm a fan!

Anyway, I wanted to post that I'd received an update from the filmmaker and to increase access she's lowered the price. So now, $39.95 is for ANY use (except broadcast): personal, public screening, classroom, etc. And, an order of 5 or more DVD's is $19.95 each.

Check it out here!

--
Molly
CfM Blogger

Grassroots Network: Australian home birth study

Dear Friends,

A new home birth study based on data from South Australia has just been published. Of course, an editorial on the topic in the same issue of the journal, penned by the President of the Australian Medical Association ("which is opposed to home birth in Australia") helped to "spin" the findings to show that home birth is much more dangerous than hospital birth, even though the actual data show no such thing.

You can read the whole article here: "Planned home and hospital births in South Australia, 1991-2006: differences in outcomes" (Robyn Kennare, Marc Keirse, Graeme Tucker and Annabelle Chan, MJA 192(2), 18 January 2009).

You can also find some great analysis of what the study actually tells us. If you are interested in reading research critically and understanding how data and results can be twisted (on purpose or by not thinking about what they mean), these analyses are worth your time:

"That Homebirth Study in South Australia"
by Lauredhel on January 16, 2010

“More critique of the homebirth study and its reporting by the media"
January 20, 2010 – 7:58 pm, by Croakey

You can be sure that US medical organizations, especially ACOG, are well aware of this study, and the chances are we’ll see and hear references to it in the weeks and months ahead; we can be prepared!

Sincerely,
Susan Hodges, “gatekeeper”

Doula Article

Felt the need to post a link to this article about doctors' objecting to doulas in the birth room. The champion opening line was what hooked me:

"Like some ancient wounded creature, the male medical establishment occasionally lashes out in uncomprehending fury at 'patient-led' developments in medical care that threaten to undermine its power."

;-D

--
Molly
CfM Blogger

Articles of Interest

I have a lot of projects going on lately that are taking precedence over blogging here in a frequent or creative way (I am pregnant with my third baby and recently started teaching college classes. I also teach birth classes on a regular basis, homeschool my two boys, etc., etc., etc.). Bear with me and in January I should have more blog-time again!

So, this week I wanted to share some links to articles I read recently:

Three Minute Interview with Ginger Garner (yoga therapist) from the National Association of Mothers' Centers focusing on "Childbirth in America: Why it Needs to Change."

A quote I enjoyed from the article: "Birth is valuable. It gives rise to our entire future. There is power in our ability to give birth to the future of our planet. We need to reclaim that power."

Pregnant Prisoners article. In one residential parenting program mentioned in the article, "Another perk for pregnant women at the prison is access to a volunteer doula program. A non-profit group called The Birth Attendants offers monthly prenatal care, labor and delivery assistance, postpartum services, and family planning education courses."

Also getting a lot of attention in birth activism blogs are the new international infant mortality rankings.

Available at: http://www.cdc.gov/nchs/

Or directly from: http://www.cdc.gov/nchs/data/databriefs/db23.htm

Key findings

Infant mortality rates for preterm (less than 37 weeks of gestation) infants are lower in the United States than in most European countries; however, infant mortality rates for infants born at 37 weeks of gestation or more are higher in the United States than in most European countries.

One in 8 births in the United States were born preterm, compared with 1 in 18 births in Ireland and Finland.

If the United States had Sweden’s distribution of births by gestational age, nearly 8,000 infant deaths would be averted each year and the U.S. infant mortality rate would be one-third lower.

The main cause of the United States’ high infant mortality rate when compared with Europe is the very high percentage of preterm births in the United States.

--
Molly
CfM Blogger

Birth, Breastfeeding and Feminism?

Earlier this year a birth activist contacted me for information about feminism and birth. Her "fire" was to write an article was lit by recent (at the time) articles praising elective cesareans. Her article was going to be about feminism and its history in birthwork as well as what she is seeing a current "backlash" against the work of doulas, chidlbirth educators, and midwives (so, elective cesarean being framed as a "feminist" choice in some articles). She asked me for additional articles about similar issues and questions.

I never received an update as to whether she finished her article--I'd certainly love to read it when it is finished! I sent her some suggestions of other articles and resources to assist with the preparation of her article and I wanted to share those links here as well (since I bothered writing them all down!).

From the same site as "In Praise of the C-Section," there is another one about natural vs. medicated birth that critiques the "cult" of natural childbirth.

Then, a much older piece from Salon called I Believed in the Breast, which is basically a critique of La Leche League, but touches on feminism and breastfeeding as well. Speaking of breastfeeding as a feminist issue, I previously posted here about this French article about whether or not breastfeeding is feminist.

There is an extensive thread on the subject of birth and feminism on the AllDoulas messages boards that is extremely fascinating. If it won't let you see the messages without registering, you can register and then search for the thread called Feminism, Birth, and Breastfeeding. It is quite long and represents a LOT of differences in thought about the subject (some of them are disturbing to me, actually).

Then, this blog has a whole series of posts/thoughts about feminist theory and birth that are just great.

And then this is another radical feminist doula blog.

A book I enjoy that explores these ideas (and that yes, talks about the feminists promotion of Twilight Sleep and the paternalism of early birth prep methods) is: In Labor: Women and Power in the Birthplace by Barbara Katz Rothman.

An article that was published since our conversation that is also relevant is Jennifer Block's Birth Wars article.

Several articles that prompted the original question were:

Tova Mirvis, "In Praise of the C-Section: I’m not sorry I didn’t have a natural birth" (March 2009)

Hanna Rosin, "The Case Against Breastfeeding," in The Atlantic. (March 2009)

"Baby Food: If breast is best, why are women bottling their milk?" by Jill Lepore, New Yorker, January 19, 2009

Extreme Birth: The fearless—some say too fearless—new leader of the home-birth movement. By Andrew Goldman (March 2009)

"A Doula Makes Four" by Pamela Paul, New York Times (March 2008)

The Way We Live Now: 10-31-99:; Pay on Delivery By Margaret Talbot,

On a related note, I also received an email about a conference about Breastfeeding and Feminism: Rethinking Public Health Approaches to be held in March, 2010.

--
Molly
CfM Blogger

Celebrity Webisodes on My Best Birth

I confess to having been a fairly devoted fan of the Buffy, the Vampire Slayer TV show. So, imagine my delight to discover a "Celebrity Birth Webisode" on the MyBestBirth website featuring Alyson Hannigan (Willow in Buffy, now known for playing other roles, but Willow to me!) and her husband Alexis Denisof (Wesley on Buffy). In part 1, they discuss choosing to have a homebirth and the concerns/questions of people around them ("where is Alexis going to sit?" was a popular one from Alyson's mother) and also the reaction of their doctor when they asked him to provide hombirth backup (fear tactics). I look forward to seeing part 2 when it is available.

Also in the series are episodes with Cindy Crawford and Melissa Joan Hart.

I also confess to being a Xena fan--Lucy Lawless had a homebirth as well, so perhaps she'll be in a webisode next and make my fangirl heart content :)

--
Molly
CfM Blogger

*Note that to get the videos to play, I had to open them in Explorer instead of Firefox.

The Media & Midwifery

On Thursday, a good article called "Media out of focus on midwifery" was published in the New Haven Register. Written by a professor of midwifery at Yale, the article includes some excellent observations such as:

"It is puzzling that these stories often do not cite well-documented evidence about outcomes of the practice of midwifery in the United States, nor invite representatives of the American College of Nurse-Midwives or the National Association of Certified Professional Midwives to comment."

and my favorite,

"Women are not seeking 'designer' births. They are looking for humanistic care during pregnancy, labor and birth and are increasingly having difficulty finding that in many hospitals."

--
Molly
CfM Blogger

Ukrainian Birth Blog and Natural Papa Blog

Late last month I posted about the apparently common birth practice in the Ukraine of routinely pulling out the woman's cervix to examine immediately postpartum (wince). Today, I'd like to share a link to a blog specifically about birth in the Ukraine. The writer is an aspiring midwife, doula, and childbirth educator, and is a missionary living in Kiev, Ukraine.

I also want to share a link to the Natural Papa blog, which I stumbled across last week via the post "Homebirth Dads: 10 Questions with Jerry Shannon." Lots of interesting posts about various aspects of natural living from a father's perspective.

Christiane Northrup, MD, has an article in The Huffington Post today called A Woman's Nation: Reclaim Your Right To Birth Right. The article primarily looks at the risks of intervention with birth. The article has a lot of comments--read them at your own risk! (I get extremely frustrated when reading article comments and try to avoid it, because it isn't worth the rise in blood pressure that results...)

Finally, a quick link to an article about a woman who is driving 350 miles to have a VBAC. What stands out to me about this article is that it is from CNN--it is great to have attention paid to VBAC bans in the "mainstream" media. The article even links to Lamaze's healthy birth practice papers for "information on getting the birth you want."

--
Molly
CfM Blogger

Grassroots Network: Great deal on Childbirth Connection's Birth Atlas and more

Dear Friends,

I am passing along a notice from Childbirth Connection (see below) for your benefit!

Sincerely,
Susan Hodges, "gatekeeper"

Note from Molly: This is a great deal! I just called and ordered my package of materials. Make sure to dial 7 as the extension to get to the right person to place the order :)
-------------------------------------------

For years, Childbirth Connection's publications have been a trusted source for childbirth educators, health professionals, women and their families. However, effective immediately, Childbirth Connection is discontinuing publication of The Birth Atlas and The Growing Uterus Charts.

To help clear out our existing inventory, we are offering a package deal to our childbirth advocacy colleagues and their members:

* The Birth Atlas: A Childbirth Connection international classic since 1940, this childbirth education resource contains life-size, high-quality, classic photographic reproductions of Robert Latou Dickinson, MD, and Abram Belskie's famous sculptures with explanations of the baby's development.

* Growing Uterus Seven Chart Set and Guide: A must for educators, this full color set of poster-sized charts beautifully illustrates the stages of pregnancy.

* The Rights of Childbearing Women: Brochures enumerating a 20-point list of rights of childbearing women, most of which are legal rights that women are entitled to. These rights are supported by the best research and are based on the principles of consideration and respect for every woman under all circumstances.

The Birth Atlas + The Growing Uterus Charts + 100 copies of The Rights of Childbearing Women brochure, a $150 value, packaged together for $50, including shipping within the United States.

Clearance orders may be placed by faxing in the attached order form to 212-777-9320, by phone (212-777-5000), or email (info@childbirthconnection.org). If ordering by phone or email, please
include the following promotion code: CC2009.

We sincerely appreciate your continued business and look forward to hearing from you soon!


Jess Larsen
Executive Assistant
Childbirth Connection
281 Park Avenue South, 5th Floor
New York, NY 10010
T 212-777-5000 x7, F 212-777-9320
larsen@childbirthconnection.org
www.childbirthconnection.org
Please join our Maternity Quality Matters Campaign! Add your name to our
list of supporters:
www.childbirthconnection.org/joinmaternityqualitymatters

PBS Newshour Segment Referencing Homebirth

A great piece on home birth and health care reform was done on PBS’ McNeil Lehrer Newhour on (10/7). They featured the Netherlands and talked about home birth as part of the country’s cost savings and quality care. They mentioned how low their neonatal mortality is compared to the US. Really a good plug for home birth without the show being about that topic. Go to this link to see the transcript or you can download the segment titled “Health Care in The Netherlands.” It is vastly better than the recent Today show piece. Just as birth advocates organized to decry the terrible reporting of the TODAY show, we should work to thank the “Newshour” for their positive coverage of this topic. If people want to thank the McNeil Lehrer Newshour for their excellent coverage, you can give feedback here: http://www.pbs.org/newshour/letters.html.

--
Molly
CfM Blogger

Film Review: Laboring Under an Illusion

Laboring Under an Illusion: Mass Media Childbirth vs. The Real Thing
Filmmaker: Vicki Elson
50 minutes, $39.99 (any use except broadcast, so personal, public screening, classroom, etc.)
An order of 5 of more DVDs and they are $19.99 each
www.birth-media.com

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

Laboring under an Illusion is a treasure trove of discussion-provoking material. Filmmaker Vicki Elson is an anthropologist and childbirth educator who has created a striking documentary exploring media-generated myths about childbirth. As a childbirth educator, I often reference in my classes how our attitudes and expectations about birth are shaped by media messages—birth is an emergency, etc. This film eloquently and entertainingly provides 50 minutes of backup material for the idea!

The film blends media messages from comedy shows like Murphy Brown, Mad About You, and I Love Lucy, movie clips such as Juno, Coneheads, and Nine Months, along with “reality” based shows on Discovery Health with the inherently contrasting messages in clips of beautiful births from films like Birth as We Know It, The Business of Being Born, and Orgasmic Birth. It also contains brief voiceover narrations from “regular” women about birth. Occasionally, there is a scene with the filmmaker speaking directly to the viewer about concepts raised in the film. These scenes are less entertaining than the popular media clips and the friends with whom I watched the film wanted to fast-forward these segments—the media clips chosen so clearly speak for themselves that they don’t really need explanation, at least to the already birth-savvy viewer. Because of some strong language in the media clips, I caution parents are to preview the film before sharing it with children.

Laboring Under an Illusion is an entertaining and illuminating film for consumers as well as for birth educators, doulas, and midwives. I highly recommend it!

CIMS Letter to The Today Show

Citizens for Midwifery was pleased to join with many other birth organizations as a signer of the well-crafted and intelligent letter composed by CIMS in response to The Today Show "Perils of Midwifery segment recently aired. You can read this "One Voice" response as a pdf file here. The letter is also reprinted below:

Sept. 22, 2009

Dear Producers of The Today Show,

The Coalition for Improving Maternity Services (CIMS) and the undersigned organizations are disappointed with The Today Show’s misrepresentation of midwives and home birth that aired on Sept. 11, in a segment titled “The Perils of Midwifery,” later changed to “The Perils of Home Birth.” This biased and sensational segment inaccurately implied that hospitals are the safest place to give birth even for low-risk women and mischaracterized women who choose a home birth with a midwife as "hedonistic," going so far as to suggest that these women are putting their birth experiences above the safety of their babies. Neither could be further from the truth.

Unfortunately, The Today Show did not do its homework on the evidence regarding the safety of home birth and midwifery care. The segment featured an obstetrician who presented only the American College of Obstetricians and Gynecologists’ (ACOG) position in opposition to home birth, but it did not make any attempt to present the different viewpoints held by the many organizations that are committed to improving the quality of maternity care in the US. We are deeply saddened that the show did not take the opportunity to note that both CIMS and The National Perinatal Association respect the rights of women to choose home births and midwifery care, and that the respected Cochrane Collaboration recommends midwifery care because it results in excellent outcomes.

There is no evidence to support the ACOG position that hospital birth for low-risk women is safer than giving birth with midwives at home. What the research does show is that the routine use of medical interventions in childbirth without medical necessity can cause more harm than good, while also inflating the cost of childbirth. However, the current health system design offers little incentive for physicians and hospitals to improve access to maternity care practices that have been proven to maximize maternal and infant health.

“Birth is safest when midwives and doctors work together respectfully, communicate well, and when a transfer from home to hospital is needed, it is appropriately handled,” says Ruth Wilf, CNM, PhD, a member of the CIMS Leadership Team.

That is why the national health services of countries such as Britain, Ireland, Canada, and the Netherlands support home birth. In those countries, midwives are respected and integrated into the maternity care system. They work collaboratively with physicians in or out of the hospital, and they are not the target of modern day witch hunts. These countries have better outcomes for mothers and babies than the US.

Childbirth is the leading reason for admission to US hospitals, and hospitalization is the most costly health care component. Combined hospital charges for birthing women and newborns ($75,187,000,000 in 2004) far exceed charges for any other condition. In 2004, fully 27% of hospital charges to Medicaid and 16% of charges to private insurance were for birthing women and newborns, the most expensive conditions for both payers. The burden on public budgets, taxpayers and employers is considerable.

As US birth outcomes continue to worsen, it should come as no surprise to The Today Show that childbearing women are seeking alternatives to standard maternity care. After all, American women and babies are paying the highest price of all—their health—for these unnecessary interventions, which include increasing rates of elective inductions of labor and cesarean sections without medical indication.

To the detriment of childbearing families, the segment “The Perils of Midwifery” totally disregarded the evidence. Although the reporters acknowledged that research shows home birth for low-risk women is safe, that message was overshadowed by many negative messages, leaving viewers with a biased perception of midwifery care and home birth. CIMS makes these points not to promote the interests of any particular profession, but rather to raise a strong voice in support of maternity care practices that promote the health and well-being of mothers and babies.

One of the ten Institute of Medicine recommendations for improving health care is to provide consumers with evidence-based information in order to help them make informed decisions. The Institute recommends that decisions be made by consumers, not solely by health care providers. The Institute maintains that transparency and true choice are essential to improving health care. We remain hopeful that the medical community will soon recognize the rights of childbearing women when it comes to their choices in childbirth and will respect and support these choices in the interest of the best possible continuity and coordination of care for all.

We urge The Today Show to provide childbearing women with fair and accurate coverage of this important issue by giving equal time to midwives, public health professionals, researchers of evidence- based maternity care, and especially to parents who have made choices about different models of care and places of birth.

Sincerely,
Coalition for Improving Maternity Services
Academy of Certified Birth Educators
Alaska Birth Network
Alaska Family Health and Birth Center
American Association of Birth Centers
American College of Community Midwives
American College of Nurse-Midwives
Bay Area Birth Information
Birth Network of Santa Cruz County
Birth Works International
Birthing From Within, LLC
BirthNet
BirthNetwork National
BirthNetwork of Idaho Falls
BirthNetwork of NW Arkansas
Choices in Childbirth
Citizens for Midwifery
DONA International
Doulas Association of Southern California
Evansville BirthNetwork
Harmony Birth & Family
Idaho Midwifery Council
Idahoans for Midwives
InJoy Birth and Parenting Education
International Childbirth Education Association
International MotherBaby Childbirth Organization
Lamaze International
Madison Birth Center
Midwives Alliance of North America
Motherbaby International Film Festival
Nashville BirthNetwork
National Association of Certified Professional Midwives
North American Registry of Midwives
Oklahoma BirthNetwork
Perinatal Education Associates, Inc.
Reading Birth & Women's Center
Rochester Area Birth Network
Sage Femme
The Big Push for Midwives Campaign
The Tatia Oden French Memorial Foundation
Triangle Birth Network
Truckee Meadows BirthNetwork

About Us
The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and wellbeing of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. The CIMS Mother-Friendly Childbirth Initiative is an evidence-based mother-, baby-, and family- friendly model of care which focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs.

References:
1. The Perils of Home Births, http://www.msnbc.msn.com/id/21134540/vp/32795933#32795933
2. Birth Can Safely Take Place at Home and in Birthing Centers,
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2409129&blobtype=pdf
3. Offers All Birthing Mothers Unrestricted Access to Birth Companions, Labor Support, Professional Midwifery Care, http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2409134&blobtype=pdf
4. ACOG Place of Birth Policies Limit Women's Choices Without Justification and Contrary to the Evidence, http://childbirthconnection.com/article.aspClickedLink=790&ck=10465&area=27
5. Ratifiers and Endorsers of The Mother-Friendly Childbirth Initiative,
http://www.motherfriendly.org/ratifiers.php
6. Choice of Birth Setting, http://www.nationalperinatal.org/advocacy/pdf/Choice-of-Birth-Setting.pdf
7. Position Statement on Midwifery, http://www.nationalperinatal.org/advocacy/pdf/Midwifery.pdf
8. Midwife-led versus other models of care for childbearing women,
http://cochrane.org/reviews/en/ab004667.html
9. Evidence-Based Maternity Care: What It Is And What It Can Achieve,
http://childbirthconnection.com/pdfs/evidence-based-maternity-care.pdf
10. Lamaze Healthy Birth Practices,
http://www.lamaze.org/ChildbirthProfessionals/ResourcesforProfessionals/CarePracticePapers/tabid/90/Default.aspx
11. Millennium Development Goals Indicators, United Nations, http://mdgs.un.org/unsd/mdg/Data.aspx
12. National Vital Statistics System, Birth Data, http://www.cdc.gov/nchs/births.htm
13. Induction By Request, http://www.marchofdimes.com/prematurity/21239_20203.asp
14. Cesarean Birth By Request, http://www.marchofdimes.com/prematurity/21239_19673.asp
15. Crossing the Quality Chasm: A New Health System for the 21st Century,
http://www.iom.edu/CMS/8089/5432.aspx
16. The Mother-Friendly Childbirth Initiative, http://www.motherfriendly.org/mfci.php

Coalition for Improving Maternity Services
1500 Sunday Drive, Suite 102
Raleigh, NC 27607

Tel: 919-863-9482
Fax: 919-787-4916

www.MotherFriendly.org

Making Mother-Friendly Care A Reality
CIMS is a not-for-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3). Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs.

Media & Birth Petition

I'm not sure exactly how I personally feel about this approach, but I wanted to share this announcement from Choices in Childbirth about accuracy in media reporting about birth:

"Two weeks ago, NBC's The Today Show ran a deeply biased and poorly-researched report entitled "The Perils of Midwifery," which depicted midwife-assisted home birth as a dangerous celebrity-driven fad. At Choices in Childbirth and the New Space for Women's Health, we know better, and we know that it's never been more important to support midwives and the other members of New York City's birth community.

Pleas sign our petition to demand accurate reporting on all available childbirth options. We'll be delivering it in person to The Today Show on October 9, but before then, we're aiming for 5000 signatures. Make sure yours is one of them!

Here's the link."

Massachusetts Friends of Midwives Video

A nice video tribute to Massachusetts Midwives (hat tip to Bellies and Babies for the link):

Mass Friends of Midwives Tribute

--
Molly
CfM Blogger

Grassroots Network: TODAY show in bed with ACOG

Dear Friends,

Friday morning’s TODAY show included a segment about the “perils of home birth.” The show included a sad home birth (with a nurse-midwife) where the baby died of a cord accident, without mentioning that such deaths can happen in the hospital also, or addressing the US’s high perinatal mortality rate. Representatives of ACOG described home birth as “the equivalent of a spa treatment”! Definitely not even-handed reporting, but looks like ACOG is out to get media for their biased beliefs.

You can watch the segment at http://today.msnbc.msn.com/id/26184891/vp/32795933#32795933

You can read comments about the show (and add your own) at: http://www.newsvine.com/_question/2009/09/11/3252633-is-choosing-a-home-birth-with-a-midwife-worth-the-potential-risk. Almost all of the comments are pro-midwife.

And if you want to e-mail the Today show and let them know the real reasons more women are choosing home birth, or that you’d like to see an HONEST segment on home birth, you can write to them at Today@NBCUNI.com.

Finally, true to form, the Big Push has fired off an eloquent Push Alert (see previous post).

As the saying goes, any attention is good attention, or at least a great opportunity for getting more and better attention!

Thank you to the several individuals who brought this to my attention, including the links.

Sincerely,

Susan Hodges, “gatekeeper”

The Big Push Press Release: Physicians Take Anti-Midwife Smear Campaign to the Airwaves

I was getting ready to write about this myself--thinking of calling it, "ACOG Makes a New Friend"--but the indomitable Big Push Campaign beat me to it and their release is so pointed that I have nothing more to add!

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If you have difficulty viewing this message, please visit the PushNewsroom.

Home Birth Mothers, Celebrities, Insulted on National TV FOR IMMEDIATE RELEASE WASHINGTON, D.C. (September 11, 2009) – Referring to women who choose to give birth in out-of-hospital settings as "hedonistic" and likening childbirth to a "spa treatment," members of the American College of Obstetricians and Gynecologists, a trade group representing the professional and financial interests of OB/GYNs, took their anti-midwife campaign to the airwaves in a Today Show segment rife with insults, stereotypes, and misinformation, using one family's tragedy as a platform for the organization's well-funded assault against choices in childbirth. "About the only thing ACOG has right is that women are choosing out-of-hospital deliveries in record numbers," said Steff Hedenkamp of The Big Push for Midwives Campaign. "What Erin Tracy and other apologists for the group's anti-midwife position fail to see is that one of the forces driving women to seek out-of-hospital care is the paternalistic, profit-driven model of maternity care that far too many of its own members provide." During the segment ACOG reiterated its claim, which has been thoroughly debunked by a large and growing body of medical literature, that out-of-hospital delivery is unsafe. Describing women who choose to give birth in private homes and freestanding birth centers as "hedonistic" mothers who knowingly put the lives of their babies at risk for the sake of an "experience" they believe will be like a "spa treatment," members of the group echoed last year's position statement claiming that women who choose out-of-hospital deliveries base their decisions on what's "fashionable" or "trendy." "ACOG clings to this ridiculous fantasy that women choose to deliver their babies outside of the hospital because they want to be like Ricki Lake, Demi Moore or Meryl Streep and that if women would only watch enough fear-mongering stories on morning television they'll be brainwashed back into hospitals," said Katherine Prown, Campaign Manager of The Big Push for Midwives. "Insulting our intelligence and promoting policies that deny us choices in maternity care are not exactly winning strategies for stemming the tide of women seeking alternatives to standard OB care." Earlier this year, a New York City couple lost their baby during a planned home birth under the care of a Certified Nurse-Midwife. Licensed and regulated in all 50 states, Certified Nurse-Midwives are trained to provide hospital-based maternity care. By contrast, Certified Professional Midwives, who undergo specialized clinical training in out-of-hospital birth, are legally authorized to provide care in 26 states, although outdated regulations effectively prevent them qualifying for licensure in the state of New York. Legislation to license and regulate Certified Professional Midwives is currently pending in an additional 18 states, despite staunch opposition from the American Medical Association, which has joined with ACOG in adopting position statements that would deny families who choose out-of-hospital maternity care legal access to nationally credentialed midwives with specialized training to provide it. The Big Push for Midwives Campaign represents thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push includes educating national policymakers about the reduced costs and improved outcomes associated with out-of-hospital birth and advocating for including the services of Certified Professional Midwives in health care reform. Media inquiries: Katherine Prown (414) 550-8025, katie@thebigpushformidwives.org ### The Big Push for Midwives Campaign | 2300 M Street, N.W., Suite 800 Washington, D.C. 20037-1434 | TheBigPushforMidwives.org