Friday, October 31, 2008

Fear & Birth

Since it is Halloween today, I wanted to post about fear and birth. I encounter a lot of women who are very scared of birth, particularly of the pain of birth. Grantly Dick-Read's Fear-Tension-Pain cycle has influenced the teachings of most natural birth educators and most people readily connect to the idea that fear leads to elevated tension in body which leads to increased pain.

One of my favorite birth books, Birthing from Within, has several sections about coping with fear. The author's idea is that by naming fears and looking them in the eye rather than denying they exist, you shift your thinking from frozen, fear-based, thoughts to more fluid, adaptable coping-mechanisms. There is a useful handout based on her ideas available at the Transition to Parenthood site.

I also thought of this quote from Jennifer Block:

"Why is it that the very things that cause birth related morbidity rates to rise are seen as the 'safe' way to go? Why aren’t women and their doctors terrified of the chemicals that are dripped into their spines and veins—the same substances that have been shown to lead to more c-sections?” Why aren’t they worried about the harm these drugs might be doing to the future health of their children, as some studies are indicating might be the case? Why aren’t they afraid of picking up drug-resistant staphylococcus infections in the hospital? And why, of all things, aren’t women terrified of being cut open?"

I was afraid of these things, which is part of why I didn't go to a hospital to have my babies!

I hope some day all women will be able to greet birth with confidence and joy, instead of fear and anxiety. This does NOT mean denying the possibility of interventions or that cesareans can save lives. Indeed, I just read a relevant quote in the textbook Childbirth Education: Research, Practice, & Theory: "...if women trust their ability to give birth, cesarean birth is not viewed as a failure but as a sophisticated intervention in response to their bodies' protection of the baby."

I have much more I could say on this topic, but it is time to put my little sugar-wild children to bed. Happy Halloween!

CfM's Annual Meeting

This year, Citizens for Midwifery will hold its annual meeting in Rolla, MO and any and all interested birth activists are welcome to join us!

FoMM/MMA's very own Mary Ueland and Debbie Smithey have been nominated to receive the annual Susan Hodges award for excellence in consumer activism and that will be given during the public portion of the annual meeting.

This year our Annual Membership Meeting, including the election of members of the Board of Directors, will be held in Rolla, Missouri, on Saturday, November 8, 2008, from 1-2 pm, followed by a Gathering with other birth activists in the area from 2-4pm. The CfM Board members will be meeting in person throughout the weekend.

Location: These meetings will be held at Baymont Inn and Suites, 1801 Martin Springs Drive in Rolla, Missouri. Hotel phone: 573-364-7000.

Our Annual Meeting affords us the chance to review the past year and look ahead to the coming years – your questions and ideas are important! This is a great opportunity to meet with and talk to CfM’s Board of Directors in person. And of course we’ll count the ballots for the election of Board Members for the next year

Following the Annual Membership Meeting, a Birth Activist Gathering will bring together CfM members with Friends of Missouri Midwives and anyone else who is interested, including other consumer activists, midwives, and other birth professionals. CfM will give a brief presentation about our current work and projects, including our response to the AMA Resolution, an open discussion about "what’s next in MO" and how CfM can help, and how we can work together to sustain birth advocacy. This event is free and light refreshments will be served.

Please RSVP to if you plan to attend the meetings. CfM’s Board of Directors looks forward to hearing from many of you, and even seeing some of you in November!

Please pass this message along to other interested persons or organizations (including activists in our neighboring states of IL and KS, if you have contacts there).

Mark your calendars! I hope to see you there.

Thursday, October 23, 2008

Giving Birth in Place

While most women in the U.S. plan to give birth in hospitals, it makes sense for all women to prepare for the possibility of giving birth out-of-the hospital due to unforeseen circumstances of any type. This is referred to as "giving birth in place."

The American College of Nurse Midwives (ACNM) has an interesting and useful pdf handout available on their website about giving birth in place--basically, being prepared to have a baby wherever and whenever you happen to be.

Midwifery advocates have shared concerns for some time that during a pandemic illness, or natural disaster, or military conflict, women need to have access to out-of-hospital care providers (like CPMs), because in these kinds of emergency situations hospitals are not the most appropriate or accessible settings for pregnant women to be in.

ACNM has a variety of "Share with Women" handouts available on their site. These are a great resource about a range of topics, presented in a simple, easy-to-follow format.

Grassroots Network: New Infant Mortality Stats & Comparisons, and C-section death in Boston

Dear Friends,

A maternal death resulting from a cesarean section was reported in Boston, a very sad event. You can read a report here.

This event and the report are a reminder that women are 4 times as likely to die in connection with a cesarean compared to the risk of death with a vaginal birth. Another reason the work for changes in maternity care.

The CDC has just issued a new report: “Recent Trends in Infant Mortality in the United States” which you can find here. The report includes many bar graphs, and includes international comparisons, demonstrating the US’s poor standing. You can also read the excellent New York Times article on this report.

After reading these, all I can think about is how widespread use of the Midwives Model of Care would result in more healthy, living mothers and more healthy, full term, full weight living infants…

Susan Hodges “gatekeeper”

Saturday, October 18, 2008

Homebirth Coloring Book

For some time, I've been meaning to post that North Carolina Homebirth has a free pdf coloring book for kids available on their website called There's a New Baby in My House.

This is a nice resource for families planning homebirths. It can be difficulty to find books or other children's materials that present out-of-hospital birth options.


Teen Dating Violence Webinar

You Are Invited to A Special Online Preview of
The 2009 Teen Dating Violence Prevention Campaign

Please join Cindy Dyer of the U.S. Department of Justice’s Office on Violence Against Women (OVW) and Esta Soler of the Family Violence Prevention Fund for an informative web event on teen dating violence.

Wednesday, October 22, 2008
11:00 AM ET

OVW’s upcoming prevention campaign, launching in early 2009, will address teen dating violence. This web conference will review the research shaping the new campaign, including qualitative research on social norms and dating behaviors among teens. It also will include an overview of the elements of the innovative new campaign.

You must REGISTER if you are planning to participate in this web conference, co-hosted by the California Coalition Against Sexual Assault. The number of participants is limited, so be sure to register now! A toll-free telephone number and webinar link will be sent to you via email after you register.

The presentation will be available on and following the web conference

Friday, October 17, 2008

New Midwifery Fact Sheet from CfM!

Citizens for Midwifery has prepared another summary fact sheet based on the Evidence Basis for the 10 Steps of Mother-Friendly Care (an extensive analysis that was published by Lamaze last year). This new fact sheet highlights the evidence regarding access to midwifery care and out-of-hospital birth.

Earlier this year, CfM and BirthNetwork National partnered to prepare a two page fact sheet summarizing the highlights from entire Evidence Basis document.

All of these documents are great resources and the fact sheets make good conference table handouts!

Saturday, October 11, 2008

Labor of Love

Last week I finished a review copy of Cara Muhlhahn's brand new midwifery memoir, Labor of Love. Cara is the CNM who was featured in The Business of Being Born. I will review this book in more depth for the spring issue of CfM News. This book was an engaging and fast-paced read, though very different than Lady's Hands, Lion's Heart, the other midwife's memoir I recently finished.

I wanted to share a quote I enjoyed:

"Although homebirth is an option for almost anyone who has a normal pregnancy, I have noticed that the subgroup of women who tend to choose it often exhibit certain characteristics, such as comfort within their own bodies, a desire to have a birth experience that is more poetic than clinical, as well as a desire to return what we all feel is some seriously missing humanity to the experience of having a baby. Often, women who choose homebirth have an ability to step into a completely new experience without being held back by excessive fear or anxiety. This ability proceeds from a view of childbirth as a natural, physiological event, not a medically mediated one. Many midwives recognize the value of a birthing mother's own mom having birthed successfully. Story after story reveals that daughters of women who gave birth vaginally or breastfed, bring a certain inner confidence to childbirth that is handed down from the mother's experience. Imagine the rare gem of a woman who was actually born at home."

Well, I'm one of those "rare gems" :-D I was born at home in the 70's (my mom had all four of her children at home) and breastfed for about 14 months. She had read Spiritual Midwifery and everything. Occasionally, she expresses dismay and surprise that the issues that she also cared about as a young, childbearing women are still struggling so mightily today--she thought it would have all been fixed by now and that women would not still have have such difficulty accessing midwifery care or choosing homebirth.

Friday, October 10, 2008

Birth Violence & Birth Consumerism

Following my post from last week about Domestic Violence Awareness Month, which led me to consider the violence women may experience in the birth place, I came across some relevant quotes in the book Giving Birth by Sheila Kitzinger. The book is an older one (late 80's), but the quotes are strikingly on target for birth issues today:

"We are only now discovering the long-term destructive effect on human beings and families of treating women as if they were merely containers, to be opened and relieved of their contents; and of concentrating attention on a bag of muscle and a birth canal, rather than relating to, and caring for, the person to whom they belong. The violence which is a common element in childbirth today leaves many women feeling that birth has been a kind of rape. This sort of experience is not easily forgotten. It can shatter a woman's self-confidence, make her doubt her ability to mother her baby, destroy joy in the expression of her sexuality, and attack her very sense of self--the roots of her identity. It is psychologically mutilating."

I have posted before about birth as a consumer issue. CfM is the consumer organization dedicated to promoting the midwives model of care. Interestingly, this book takes a different angle on this than I have before:

"Increasingly, obstetricians have been forced by pressure from women to aim to 'satisfy the consumer,' as if they were running a supermarket...But a fundamental change in attitude is necessary. Women, after all, are not 'consumers.' They are producers. They give birth to babies. The commercial model is an unsuitable one. We need instead to develop a model of care based on a sense of community of service to support the natural process of birth and respond to women's needs."

I'd say this is a need filled by the midwives model of care!

Another interesting quote from this book is with regard to "old wives' tales."

"'Old wives' tales,' says the Oxford dictionary, are 'trivial stories, such as are told by garrulous old women.' It is significant that no one ever talks about 'old husbands' tales' or 'old doctors' tales.' Women are blamed instead. It is implied that there is poison in their speech and that the only safe thing to do is remain silent. The experiences that women share with other women are thus rejected and trivialized...In reality, it is not other women who instill and fuel anxiety in most pregnant women, but the medical system itself."

I think we should start to acknowledge the existence of "old doctors' tales." I've certainly heard a number of them!

A final quote from this book that feels relevant, "a good obstetrician works much better when he or she can work with the mother and not just on her."

Grassroots Network: "Choose a Midwife" postage stamps

Dear Friends,

This was posted this week on a list I'm on, and I thought you'd be interested!

Mon Oct 6, 2008 10:51 pm (PDT)
"Stamps are a simple way of making a statement. Now, with the launch of
midwifery-themed postage stamps, supporters of midwives can send their
message across the country: 'Choose a Midwife.' The American College of
Nurse-Midwives is unveiling the new stamps in conjunction with National
Midwifery Week, October 5-11. Stamps are available for purchase online."

I have not checked out these stamps yet myself, but one person commented: "A rather brilliant bit of public relations on the part of ACNM. Check out these cool stamps. And only one of the four images is ACNM-specific. The other say "choose a midwife." Great photos, too.I am very impressed. I've got my Christmas card stamps now."

Susan Hodges, "gatekeeper"

Grassroots Network: Talk about Health Care Reform on radio talk shows!

Dear Friends,

Families USA has compiled a lot of information about participating and speaking up on radio talk shows, about health care reform. Whatever your leanings, you can use these resources to make opportunities to speak up about the role midwives could and should have in ANY plan for health care reform!

Susan Hodges, "gatekeeper"

From Families USA:

I don't have to tell you that the health of our nation and our economy
depend on meaningful health care reform.

Far too many people are being left behind due to high costs and limited
access to quality affordable health care. Reform simply has to be the
top domestic priority of the next Administration and Congress.

With the elections only one month away, let's take this message to the

We've created an online resource that lists radio talk shows where you
can make your voice heard on the need for health care reform. The
resource includes call-in information for over 40 nationally syndicated
and regional shows as well as numerous local shows in select states.
Eventually we plan to expand our list of local talk shows to more states.

Conservatives have spent years amplifying their message through talk
radio, and it has proven to be highly effective. But if we want a
progressive solution to the health care crisis, we'll need to take the
airwaves back.

So call in and make your voice heard. Talk about how you are facing
rising costs in a sinking economy, too many of your friends and
neighbors have inadequate coverage or no coverage at all, or have faced
unfair denials due to pre-existing conditions, and so on. Urge listeners
to get involved, speak up, and take action to make sure health care is a
top priority for the next President and the next Congress.

Thank you,

Jeff Gordon
Field Director


Visit the web address below to tell your friends to Stand Up for Health

If you received this message from a friend, you can sign up for Families
USA <>.

Families USA | 1201 New York Ave., NW, Suite 1100, Washington, DC 20005 <> |

Wednesday, October 8, 2008

Grassroots Network: Milbank Report on Evidence-Based Maternity Care

Dear Friends,

I have just received the e-mail below from Carol Sakala of Childbirth Connection announcing the release of this new Milbank Report. I've only glanced through, and it looks like it will be a gold mine of data and figures to make the case for maternity care reforms, in addition to its analyses and policy recommendations!

The authors are Carol Sakala and Maureen Corey, senior staff at Childbirth Connection.

The entire 128-page report is on the Childbirth Connection website, free! Do read it!

Susan Hodges, "gatekeeper"

Dear Friends,

I am writing to announce the release today of a new report, Evidence-Based Maternity Care: What It Is and What It Can Achieve.

The report takes stock of the U.S. maternity care system, identifies many opportunities for improving the quality, outcomes, and value of maternity care, and presents policy recommendations. It was developed through a collaboration among Childbirth Connection, the Reforming States Group, and the Milbank Memorial Fund.

For access to the report, please go here
(this appears within a new section on our website, Maternity Quality Matters).

The report was covered in two articles in today's USA Today:

Consumer Reports also posted an article and a quiz.

We would be grateful for your help in alerting colleagues to the availability of Evidence-Based Maternity Care.

Best wishes,