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!

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Molly
CfM Blogger

Book Review: Into These Hands

Into These Hands: Wisdom from Midwives
Geradine Simkins
Paperback, 300 pages
Published by Spirituality & Health Publisher, 2011
ISBN: 9780981870854
Wisdom from Midwives

Reviewed by Molly Remer, Talk Birth

Into These Hands is an amazing anthology of midwives’ retrospectives about their careers and midwifery journey. You won’t find birth stories here–this is book about women’s lives and journeys to midwifery. A book of midwife stories–how women are birthed as midwives, rather than about births they attended–Into These Hands is great reading for aspiring midwives or for currently practicing midwives who wish to feel a sense of solidarity with their sisters. There are many paths, many lessons, many voices and each midwife clearly loves women and has a passion for birth.

From the press release:

We are eager for you to meet some modern-day wise women, healers, revolutionaries, and reformers. Into These Hands, Wisdom from Midwives© is a comprehensive anthology of the life stories of 25 remarkable women who have dedicated their lives and careers to the path of social change through midwifery. These exemplary midwives are all over 50 years of age with 25-40 years in the field. Collectively, they have over 800 years of experience and have assisted in over 35,000 births.

The midwives whose voices are included in the anthology come from diverse backgrounds, training, experiences, and range of practice settings. Quite a few of the stories are from “bridge club” members–women who began as direct entry midwives and later became CNMs. These midwives have a foot in both worlds and insight into the politics of the profession. In general, Into These Hands is a good look at the politics of midwifery both past and present. Almost all of the midwives in the book have homebirth roots or orientation.

Since there are lots of voices represented, the tone or style of some stories is more compelling than others. Some within-story chronology jumps were a little confusing and there were a couple of stories in which I had to do some re-reading for clarity.

Into These Hands is likely to be of particular interest to midwifery activists, aspiring midwives, or current/retired midwives and may hold less appeal for general birth enthusiasts, doulas, or childbirth educators. The stories are rich, insightful, thought-provoking, and diverse and they brought tears to my eyes several times. This book is a treasury of women’s wisdom and a powerful legacy for the generations of women to follow.

(An indicator of how much I like a book is how many page corners I turn down in order to come back to re-read those sections and write blog posts based on them/share quotes/etc. This is Into These Hands last night as I was finishing it...;-D)

–

Disclosure: I was provided with a complimentary copy of the book for review purposes.

Book Review: More Than a Midwife

More Than a Midwife: Stories of Grace, Glory, and Motherhood [Paperback]

by Mary Sommers
MavenMark Books (HenschelHAUS Publishing) (October 1, 2011), 148 pages
ISBN-13:978-1595981066

Reviewed by Molly Remer, Talk Birth

More Than a Midwife is a thoroughly delightful little volume by experienced and resourceful midwife, Mary Sommers. One of the things that makes the book particularly distinctive is the impressive diversity of Mary’s work experience. The book includes stories from her work as a midwife in urban Chicago as well as in Africa and Mexico. As always, glimpsing the dire situations facing birthing women cross-culturally is a sobering reminder of the immense challenges international midwives face with few physical resources—they accomplish an amazing level of care with only their heads, hands, and hearts.

Each story shared in the book is selected with care and has an important message to share. The stories are about unique women and their unique births and what Mary (and the reader) can learn from them. From empowering and exhilarating, to difficult and heartbreaking, particularly notable are the stories that remind us all to treat every woman with dignity and respect, regardless of her life’s circumstances or choices. Mary is clearly a midwife who loves women and birth and practices with sensitivity, respect, and positive regard.

More Than a Midwife is a slim paperback. It is nice size to hold easily and the stories are short and easy to read in small chunks of free time. It is occasionally erratic in the organization/flow of a story and in a few of them I had to re-read segments to understand chronology. However, this was a negligible issue in the context of this thoroughly enjoyable small book.

Mary Sommers has written a true gem of a book. I feel honored to have read More Than a Midwife and I highly recommend it to anyone interested in birth, homebirth, midwifery, or women’s health. Most excellent!

–

Disclosure: I was provided with a complimentary copy of the book for review purposes.

Women's Equality Day

It was on August 26, 1920, that women finally obtained the right to vote with passage in the U.S. Congress of the 19th Amendment!

According to the website of the National Women's History Project:

"The observance of Women's Equality Day not only commemorates the passage of the 19th Amendment, but also calls attention to women's continuing efforts toward full equality. Workplaces, libraries, organizations, and public facilities now participate with Women's Equality Day programs, displays, video showings, or other activities."

You've probably guessed what I'm going to say, but I would love to see all women have equal access to to quality birth care--that would include the Midwives Model of Care (equally applicable in hospital settings as well), the Six Healthy Birth Practices (Lamaze) as the standard of care, and simple respect of women's voices about their wishes in birth. As it is now, women are limited in this equal access by geographic region, insurance coverage, financial need, legal restrictions, VBAC bans, and lack of available midwives to name a few. Some people take a, "where there's a will there's a way approach--I'd do anything it took to pay for my midwife and have my baby at home," but I believe it is much more complicated and multifaceted than that.

As I think about Women's Equality Day, I also think about this quote from Raven Lang in her 1972 classic, Birth Book:

“Birth has not only reached the absurdity of having to be relearned, it also has the absurdity of becoming a criminal offense if we are to go ahead with our ideals and do things the way we desire. And so, because of the system, midwifery as practiced in this book is against the law. It has become political. We didn’t make it that way. For us it is a beautiful, personal, spiritual, sexual experience. And for us to have that, we become criminals.”

I shared this quote on the CfM Facebook page and several people commented that not much has changed today...

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Molly
CfM Blogger

Preconception Educators

“People can feel especially fragile about giving birth because they hate to think they ‘did it wrong.’ We may defend one way of doing it because it is too threatening to think that there might have been a better alternative to the way we gave birth…go gently, and avoid the impulse to polarize or convert. Encourage each person to speak of her own experience in ‘I’ statements…” --Sacred Circles

I shared this quote in another blog post some time ago. It reminds me that perhaps the best avenue for birth advocacy is to back up and start talking to young women in high school or college, and not in trying to “preach” to other adult women who in all likelihood have very complicated reasons for making the choices they are making (and not being “enlightened” as to the “empowering way!” is usually not one of those reasons). If birth advocates are actually going to make meaningful changes (instead of enemies, or at least making women feel “unheard,” unacknowledged, dismissed, or misunderstood) they/we probably need to reach women before they are in that “fragile” or defensive state with regard to their own experiences.

Then, I received a notice about the federal Preconception Peer Educators Program (A Healthy Baby Begins with You), which trains college students as peer educators. A training is being held in Chicago in September to coincide with Infant Mortality Awareness Month and the program is seeking: 500 students/advisors from 20 states and the breakdown is as follows:

• 20 states
• 5 universities per state
• 4 students and 1 advisor per university

They are also encouraging each school to send at least one male student, which I think is good.

The emphasis of the training and program seems to be on reducing infant mortality, which of course is an important goal, but also one that is inextricably linked to optimal care of the mother (i.e. the kind of care offered by the Midwives Model of Care). So, I would hope to see more content within the program about maternity care, midwifery care, and birth rights in general, but I think it sounds like a very interesting, important, and useful program!

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Molly
CfM Blogger

Childbirth Connection Tribute to Susan Hodges

How delightful to see a nice tribute to CfM's Susan Hodges in the most recent issue of the Childbirth Connection eNews! This is a great e-newsletter overall and I suggest checking it out by scrolling down to the bottom of the Childbirth Connection homepage.

I am reprinting the tribute below.

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Molly
CfM Blogger

A Tribute to Susan Hodges
Susan Hodges, co-founder of Citizens for Midwifery, has just stepped down after serving as the group’s president for 13 years.

We salute Susan for her many contributions to support the Midwives Model of Care, which includes:

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

Under Susan’s leadership, Citizens for Midwifery has supported such care by working collaboratively with like-minded organizations, maintaining a website, producing the Midwives Model of Care brochure, sending Grassroots Network email messages, publishing a newsletter, using social media, and many other means. We wish Susan and her family and Citizens for Midwifery well!

Grassroots Network: OB supports delayed cord clamping

Dear Friends,

As we try to change the way childbirth is conducted, the question of when the cord is clamped affects both mothers and babies. While immediate cord clamping is habitual in hospital-based obstetrics, midwives, especially out-of-hospital, typically delay cord clamping at least until the cord has stopped pulsing.

Now Nicholas Fogelson (an OB?) has written an excellent commentary on the need for this OB practice to change, including references:

http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/

Delayed Cord Clamping Should Be Standard Practice in Obstetrics
December 3, 2009

For anyone working to achieve this change in practice, this will be a good resource. And there are good comments to which Fogelson has promptly written thoughtful responses.

Yet another instance of midwives being ahead of the game!

Sincerely,
Susan Hodges "gatekeeper"

Thankful for Midwives!

Happy Thanksgiving to mothers, fathers, babies, birth activists, midwives, and advocates across the country!

Here is my birth world thankful list from 2008. I'm still thankful for many of these same things this year. I'm also thankful for two fabulously wonderful, amazing, enriching, inspiring new books. These two are true treasures and I'm thankful to have read them. The Power of Women by Sister Morningstar is an incredible gem and a testament to the strength and grace of birthing women. And then, Simply Give Birth by Heather Cushman-Dowdee (formely known as Hathor the Cowgoddess) is another new gem. I highly recommend both of them--what great holiday gifts for the special birthworkers in your lives. My complete reviews of both books will be published in the next two months, but for now, trust me. They are simply amazing and I couldn't let another minute pass without mentioning that fact.

Citizens for Midwifery has worked for over a decade promoting access to the midwives model of care. If you're reading this blog, I assume you're thankful for midwives in some way or another :)

I have never been so thankful for midwives as I was two weeks ago, following my recent second trimester miscarriage. The baby was born at home on Saturday, Nov. 7th, and by that evening I thought everything was all "over" physically speaking. However, five DAYS later I discovered that my placenta was still trying to come out, but would not fully detach (it was out of my uterus, but unwilling to leave my body). Obviously, I became very concerned because it had been so many days since the baby left us. After trying quite a few things to get it to come out, we almost dashed off the the ER, but my gut pulled me back. I did call the hospital, the OB floor, and medical clinic and they all recommended that I go to the ER for a D & C. Though I was concerned, I did not feel in danger. I didn't feel like the placenta really qualified as "retained" (because I could SEE it), I felt like a little bit of membrane/cord must be holding the placenta into my cervix and that it had gradually been working its way free since Saturday--not an emergency, but something I really desperately wanted to take care of. We had a scary night with little sleep worrying and trying to decide what to do.

The next morning, I decided to mobilize my other resources and for me that meant my midwifery contacts. It was very important for me to "do this" and avoid a D & C if at all possible and I couldn't believe I might be going to have to go that route after everything else I'd already done. I spoke with two wonderful midwives on the phone who helped quite a lot (and confirmed my own feelings about what was going on with the placenta). One of the midwives was able to ask her assistant midwife to meet me at her house and see what she could do. This midwife was incredibly kind and wonderful and gentle and helpful and helped me successfully remove the placenta--it was about the size of my fist and had deteriorated into large chunks and was being held in place by amniotic sac remnants, a little bit of which was still through my cervix and keeping it from being released (as I had suspected). I'm glad I trusted myself and my intuition. I'm also incredibly grateful for that midwife--we have no prior relationship at all, she had to drive 45 minutes one way to get to me (and I 40 minutes to get to her), and she wouldn't let me pay her.

Something that struck me particularly about this piece of the story is that this woman was able to kindly and competently do for me what the ER, the OB floor of the hospital, and my doctor's office said they could not do without surgery. How wonderful are midwives?!

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Molly
CfM Blogger

Where's My Midwife?

"The only midwifery program in Wilmington NC was dissolved last month leaving women days or weeks from their due dates without their chosen care provider. Members of Where's My Midwife illustrate their anger at having fewer maternity care options with a flashmob protest at the farmer's market Saturday. Visit www.wheresmymidwife.org for more details."



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Molly
CfM Blogger

Reducing Infant Mortality Film

A trailer is now available for Reducing Infant Mortality, a FREE film being made "about how our health care system is failing babies and mothers and what we can do about it." Here are some more details from the filmmakers:

The film will be out July 26th. It will be 10-12 minutes long, and is made for everyone one who wants to, to send to their representatives and senators. Our idea is that if people send the link to the film and the politicians receive many of them along with our personal messages about what kind of Health Care Reforms we want to see, we can help move toward a more humane way of bringing our babies into the world -- creating a model that includes an emphasis on skin to skin contact, bonding and breast feeding -- a model that supports the family and family connections.

The film is a carefully crafted proposal for a shift in the way we approach maternal infant medical care. Included in our proposal is the economic component, as well as the unnecessary cost of life and health. We go on to explain how the inclusion of midwives in the model makes sense on every level. It is all voiced by MDs with substantial degrees and positions, no one on the fringe, all with impeccable credentials. I believe that it helps our case to hear the words coming from people who are currently considered by the mainstream to be the experts on birth. It is, after all, the mainstream that we wish to influence. I did everything I could to make it totally credible for the fight that is happening in congress. All statistics have been researched. The March of Dimes gave us permission to use their graphics.

There are definitely a lot of experts interviewed for this film. It sounds like there are exciting plans for it to reach a wide audience.

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Molly
CfM Blogger

Grassroots Network: Join the M.A.M.A. Campaign!

Dear Friends,

Following up on Grassroots Message 906032, the M.A.M.A. Campaign website is up and running! Find information and links, and more will be added over time. But don’t wait -- there are easy ways to get involved and support this Campaign right now!

Sincerely,
Susan Hodges, “gatekeeper”


An Invitation to Join the Midwives and Mothers in Action (M.A.M.A.) Campaign:

Come visit our new website.


· Sign up to be part of the campaign

· Endorse the campaign as an Individual or as an Organization.

· Share your birth story.

· Contribute to this effort! Donate and volunteer.



Please forward this invitation to family and friends!

The goal of the Midwives and Mothers in Action (M.A.M.A.) Campaign is 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).

Contact Us: info@mamacampaign.org

MAMA Campaign
c/o NACPM
243 Banning Road
Putney VT 05346
or call Citizens for Midwifery's Info line at 888-236-4880

Grassroots Network: Health Care Reform Kick Off Events

Dear Friends,

Organizing for America, a website run by the Democratic Party, is working to get more people involved with Health Care Reform efforts. The activity is to have gatherings or house parties—Kick Off events -- on June 6 (yes, in just a couple of days!). You can host an event, or you can find one already scheduled in your town just by entering your zip code (see link below).

These gatherings do not have to be big and fancy, but they can focus attention on the importance of Maternity Care in health care reform, and in particular on Midwives, especially Certified Professional Midwives, as an important part of the solution.

President Obama has stated that real reform must uphold three core principles -- it must reduce costs, guarantee choice, and ensure quality care for every American.

Federal recognition of Certified Professional Midwives, so that they are eligible for Medicaid reimbursement, would address all three goals without costing anyone any additional money, and would actually save us all a lot of money.

Below are suggestions for participating in these Kick-Off events. Whether you host one or participate in one, you can talk about maternity care, midwifery and especially the financial and health benefits of increasing access to out of hospital birth with Certified Professional Midwives.

For additional useful facts and information:

CfM’s letter to Obama “Maternity Care: A Priority for Health Care Reform”

“State of American Childbirth”

“Out-of-Hospital Midwifery Care: Much Lower Rates of Cesarean Sections for Low-Risk Women"

“CPM Issue Brief - Certified Professional Midwives in the United States”

Additional factual information here (scroll down home page for Childbirth Connection’s “Health Care Reform Priorities for High Quality, High Value Maternity Care” and the Milbank Report on Evidence-based Maternity Care).

How to Participate in the Health Care Reform Kick Off Parties

1) Go to the Organizing for America website that is run the Democratic National Committee

2) Register if you do not already have a user name and password.

3) Click on "Host or Attend a Health Care Organizing Kick off"

4) Create your event, entitled, "Midwifery and Health Care Reform – (Your Town)." We would like all of the events to have the same name so that we will be more noticeable.

5) Follow the instructions to create your event, including inviting as many people as you can think of. Here is a description that you can use for your event:

"This 2 hour event will be designed to inform consumers and health care practitioners about the value of including midwifery in the upcoming Health Care Reform bills. We will discuss how everyone can get involved. Light refreshments will be served."

You can, however, say whatever you would like and plan whatever you would like.

6) Download or at least read online the instructions on how to host a Kick Off event. It will give you a little sense of what they are looking for. Our events will be more specific to midwifery. At some point during your event, you can have attendees log on to the Organizing for America site and write their stories. If you don’t want to host an event, attend one that is already scheduled and speak up about CPMs and home birth.

7) These kick offs are designed to mobilize people around spreading the word about health care reform. We want to mobilize people around spreading the word about how midwifery can be included in health care reform. Brainstorm ideas for talking to key legislators and policy makers in your area.

8) These kick offs are also wanting to inspire folks to do Health Care Service projects on June 27, 2009. Brainstorm how your group might “show off” how wonderful midwives are and could be in your community. How about collecting baby clothes donations for the homeless or low-income families. What about offering a free day of prenatal visits, massage and yoga. Be creative, be fun, be visible.

So…. Let’s be part of the national debate. We need to be concise, consistent and VISIBLE!! Have fun and let us know what happened!!

Sincerely,

Susan Hodges, “gatekeeper”

Birth-Day Giveaway!

I've set this post to publish at 2:45 a.m. on May 29th to commemorate that three years ago exactly I had just given birth to my second baby boy on the floor of my living room! He was received by the caring hands of my midwife, who was present for exactly 5 minutes of the birth. I didn't actually feel like I needed a midwife in labor or during birth, but I was profoundly grateful for her presence postpartum and also for her time and care during prenatal visits. She always spent at least an hour with me during prenatal visits and I had so much fun spending that time with someone who was interested in me, my pregnancy, and my baby. She treated me with such love and respect and much like a colleague, instead of a "patient." Then, postpartum, she helped me stand and carry my new baby to the bed. She perked me back up with smelling salts when I started to faint (I have a little "issue" with seeing blood). She lovingly sponge-bathed my arms and legs (this birth was triumphant and transformative, though also particularly bloody!). When I started to "slip" emotionally in the early days postpartum (baby blues), she offered me words of encouragement, kindness, and inspiration as well as her presence. She also thoughtfully helped me make an important decision about whether to visit my family physician regarding my physical recovery following the birth. These things were such gifts and were irreplaceable!

In honor of my son's third birthday and the anniversary of my swift and special homebirth with him, I'd like to offer a book giveaway (the first on this blog!). When I was pregnant, I was already very informed about pregnancy and birth (I became a certified childbirth educator in 2005) and I felt a need to seek out books that "went beyond" the average pregnancy and birth books. One such book is Rediscovering Birth by Sheila Kitzinger. To enter to win a hardback copy of this book just leave a comment on this post by midnight on June 9th letting me know something special that you valued about your midwife (or other birth caregiver). You can gain an additional entry to win by posting a link to this giveaway on your own blog (and posting to let me know about it).

Happy Birthday Zander!

(his complete birth story is posted here)

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Molly
CfM Blogger

Effectiveness of Childbirth Education

A recent study has been picked up by the media as proving that childbirth education "doesn't work" and this has been popping up in my Google Alerts all week. The BJOG study compared two groups of women--one group had 8 hours of childbirth classes that also included information about natural childbirth. The other group had classes that did not include natural childbirth information. The epidural rates for the two groups were the same and the couples' satisfaction levels with their births was also the same. Several birth bloggers have addressed the study in depth. The Science and Sensibility blog in a post titled Do Breathing Exercises Work? and The Family Way Publications in Natural Childbirth Class Not Useful?

What stood out to me in the article was the emphasis on breathing techniques. There is a lot more to childbirth education than "the breathing" and if that is all the “natural birth” classes had to offer, no wonder the results were what they were! As was noted in one of the blog cited above, it is also significant that the women were randomly assigned to either group, indicating that they did not have a strong interest in natural birth (if they did, why risk being assigned to the non-natural birth classes!), so that perhaps the personal investment element was missing. A woman has to want to experience natural childbirth in order to do so!

Another birth educator commenting on The Family Way's blog post, made an excellent observation that I think really got to the true heart of the issue. She said, " Until childbirth educators emphasize this key component of CONGRUENCY in their classes women will continue to seek 'care' from professionals and institutions incompatible with their professed desire for natural birth. (emphasis mine) All this study proved to my mind it that both types of classes offered were ineffectual in promoting the with-women model of care in labor and birth... Both types of classes failed to address the real crux of the matter…are you receiving care from a provider/institution compatible with the kind of birth you want?" I explain to people in my classes that in the hospital women’s coping mechanisms are often stripped away from them-–sometimes by force, sometimes by misinformation, sometimes by excuses. I tell them over and over again to “ask questions before their chile is roasted” (Pam England). People tell me they can fight for what they want or that their husbands are good at “standing up for me” and I remind them that birth is not a time in a woman’s life when she should have to fight for anything! The time to get good care is NOW, not while "fighting" during labor and not during the "next birth" either (see more thoughts about "the next birth" here).

I recently finished reading the very firey and passionate 1990's manifesto on VBAC, Open Season. The author bluntly addresses the issue of transparency in maternity care and also the effectiveness of childbirth education in this quote: "If childbirth classes really 'worked,' more women would be having babies without interference. More women would be recognizing the complete naturalness of birth and would remain at home, delivering their infants with feelings of confidence and trust. More and more, midwives would be demanded. The names of those hospitals and doctors who treated women and babies with anything less than absolute respect would be public knowledge, and childbirth classes would be the first place these names would be discussed. 'You're seeing What's-His-Face? He's a pig! In my opinion, of course,' I tell people who come to my classes. I then proceed to give them the names of people who have used Pig-face. They can always ask Dr. P. for the names of people who have used him and been satisfied with their births, for balance."

Speaking of Open Season, another quote in it addressed the idea of being in the "same camp" or having "opponents." I found the perspective really useful for thinking about maternity care issues: “The moment you start thinking about other people as opponents it becomes impossible to find a solution. ‘There are no opponents in a disagreement; there are simply two [sides] facing a common problem. In other words, they are not in opposite camps, there are in the same camp. The real opponent is the problem.’” The Woman-to-Woman CBE blog mused on something similar recently in this post: Same Team...Same Team?

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Molly
CfM Blogger

Grassroots Network: May 7th MOM Campaign Webinar Postponed

Dear Friends,

This message comes from the campaign steering committee.

The Webinar on Midwives and Health Care Reform previously announced for Thursday, May 7th at 8 p.m. EST has been postponed. (GNM 905023 included a “save the date” announcement.) Sorry for any inconvenience this postponement may have caused, but it couldn’t be helped. Keep your eyes open for a new webinar date and time.

Midwives & Mothers in Action (M.A.M.A) Campaign, previously Midwives Organizing for Mothers or M.O.M., is a new national campaign to secure federal recognition of Certified Professional Midwives. The M.A.M.A. Campaign Steering Committee includes the National Association of Certified Professional Midwives (NACPM), the Midwives Alliance of North America (MANA), the North American Registry of Midwives (NARM), the Midwifery Education Accreditation Council (MEAC), Citizens for Midwifery (CfM) and the International Center for Traditional Childbearing (ICTC). Mary Lawlor, of NACPM, and Susan Hodges, of CfM, are the co-leaders of the M.A.M.A Campaign.

We are seeking to work in cooperation with allies in the midwifery advocacy community. We hope you will help as well.

In the coming days and weeks, the M.A.M.A Campaign will be providing the midwifery and advocacy community with further information about the campaign and avenues to help raise awareness and secure a place for Certified Professional Midwives in the developing federal health care system.

Here are two things you can do now to help:

1. Encourage moms and other midwifery supporters to make posts on blogs, forums and social networking sites on Mother’s Day praising the wonderful care they received from their midwives.

2. Attend any local health care reform events and raise awareness of the importance of maternity care to the national health care system. Most officials do not realize that maternity care represents almost ¼ of hospital discharges- which makes it a critical part of the health care reform conversation. Midwives increase access to maternity care for mothers and babies. Praise the care CPMs provide and state the important role they play in providing high quality evidence based cost effective maternity care.

CfM’s President, Susan Hodges, and Vice President, Nasima Pfaffl, are the designated members of the M.A.M.A Campaign Steering Committee representing Citizens for Midwifery. The two of us just returned from a successful planning meeting in Washington DC. We (members of the Steering Committee) also met with various legislators and congressional committee members. Congress has laid out an ambitious timeline for achieving health care reform this year, and we are ready to be part of it!

Sincerely,
Susan Hodges, “gatekeeper”

Grassroots Network: PushNews: Flu and need for out-of-hospital midwives

Dear Friends,

The news of a pending flu epidemic is alarming. Even more so is the fact that national and state disaster preparedness plans have not given much attention to childbirth in the midst of any disaster, including an epidemic.

The Big Push has addressed this issue in a new "PushNews." You can read it here.

With health care reform around the corner, this is a great time to write letters to the editor, or op ed pieces for your local newspaper, and this is a newsworthy angle. Any positive mention of midwives (of any kind) in the newspaper is good! You can quote from the press release, and/or if you know a reporter at your local paper, you can give them a copy. When you write a letter to the editor, be sure to find out the word limit for your paper (so you can do any editing!). Find some "Tips for Writing Letters to the Editor" here.

The Big Push for Midwives is "a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico."

If you haven't already, to take a look at the Big Push website and you can sign up for PushAlerts here.

Sincerely,
Susan Hodges, "gatekeeper"

Language of Birth

I have a long term interest in how the language we use to talk about birth impacts our actual experiences of giving birth, as well as in the differences in the language used by the medical model and the midwifery model. For quite some time, I've wanted to share a section from the Our Bodies Ourselves: Pregnancy & Birth book on this subject:

The language used to describe pregnancy and childbirth reflects assumptions about women that set the stage for different styles of maternity care. Woman-centered terminology portrays women as active, healthy, and powerful, and labor as 'natural' and 'normal,' In this view, associated traditionally with the midwifery model, providers 'attend' women, 'assist' at births, and 'catch' babies. In contrast, some medical language depicts women as passive subjects, putting doctors in the role of 'managing labor' and 'delivering babies.' Medical terms such as 'failure to progress,' 'inadequate pelvis,' and 'incompetent cervix' imply that something is wrong with a woman's body. This influences how we see ourselves, how providers see us, and how the media portray birth.

On a related note, I've had the book Bearing Meaning: The Language of Birthon my Amazon wishlist for quite some time. I have a birthday coming up, so perhaps I'll finally get to read it! :)

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Molly
CfM Blogger

Happy Earth Day!

Peace on Earth Begins with Birth.

This phrase keeps turning around in my head today as I spent Earth Day outside with my two children and our friends. I wanted to share some quotes from the Midwifery Today book The Heart & Science of Homebirth (in the article "Remembering Why We are Midwives" by Judy Edmunds):

"...I believe in the beauty and dignity inherent in all women. I am awed by their strength and power and am fortunate to be able to attend births where these qualities are so clearly displayed. Having a share in drawing out that power, respecting that dignity and nurturing the spirit of courage is being privy to a bit of creation itself. It is an incredible privilege."

"Midwives try to convey these simple truths: Birth is not a clinical exercise. It is not a medical procedure. In nearly every instance, it should not be major surgery. Nor should it even routinely include minor surgery. Rather than being a time of weakness with beds, shots, fasting, IVs and wheelchairs, it is time of energy and strength. Raw power. Mightiness. Courage."

This is a beautiful summation. If more women and babies began their journeys together with this attitude towards birth behind them, perhaps we really would have peace on earth!

I also wanted to link to two great blog posts I read today. First, at Stand & Deliver, a review of the book Policing Pregnancy that includes a thought-provoking analysis of using the term "obstetric conflict" instead of "maternal-fetal conflict." Second, at The Unnecesarean a discussion about a new British study "Maternal Request Not Reason for Rising Cesarean Rate."

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Molly
CfM Blogger

Emotional & Physical Impact of Cesareans

As I've mentioned previously, April is Cesarean Awareness Month and I would like to share a couple of more related thoughts before April draws to a close.

Midwifery Today recently published a two part article by Pam Udy. The first article addresses the physical impact of cesareans and the second article addresses the emotional impact of cesareans. As the author notes, a cesarean "can scar her heart, as well as her uterus."

Among a variety of physical effects, "Mothers who have cesareans are less likely to breastfeed, for many reasons. Often mother and baby are separated, which means a delay in getting baby to breast. The mom is dealing with pain, fatigue, possibly stress, and even trauma. The incision itself causes the mom difficulty in finding a comfortable position in which to nurse. The baby may have respiratory issues." You can read an excerpt from the Physical Impact article here.

I particularly enjoyed this quote from the Emotional Impact article (which you can read a longer excerpt from at Midwifery Today):

In the continuum of life, pregnancy, birth and the postpartum period are milestone events. These experiences profoundly affect women, babies, fathers and families. They have important and long-lasting effects on society.

When a woman give birth, she has to reach down inside herself and give more than she thought she had. The limits of her existence are stretched...As she does it, she becomes someone new: a mother. If the birthing process is skipped or occurs in a hostile situation, or if the interventions become overwhelming, she becomes a different mother that she would have been if she had only a supportive, midwifery model of care.

The transition to motherhood is challenging on its own without adding in a host of additional physical and emotional recovery factors. Obviously, we are glad for cesareans when they are necessary, but as a country we can definitely do better than launching so many new mothers into an intense new role while they are simultaneously trying to heal in body and mind.

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Molly
CfM Blogger

BBC Articles

I wanted to share links to two articles that I accessed on the BBC News website today. The first, Home births 'as safe as hospital', shares that "The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife. Research from the Netherlands - which has a high rate of home births - found no difference in death rates of either mothers or babies in 530,000 births."

The second was originally published last month: Women 'unprepared for childbirth'. From the article's opener: "Many women are going into labour vastly underestimating how painful it can be and overly optimistic that they will be able to manage without drugs, a study suggests. How has this happened?"

As a childbirth educator, I definitely have lots of thoughts about this. In fact, there is a very telling segment later in the article: "Much evidence suggests, however, that women who are well supported by midwives and partners throughout their labour and made to feel at ease are the ones who manage their pain the most effectively and require the fewest drugs."

My short take on the question "How has this happened?" is that many hospitals simply do not support the six care practices that support normal birth (care practices that greatly add to women's ability to cope with labor) and that women's access to the Midwives Model of Care is very limited!

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Molly
CfM Blogger