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

Dear Friends,

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

The e-blast begins:

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

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

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

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

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

Sincerely,
Susan Hodges, for CfM

Grassroots Network: Help PUSH for CPMs in Illinois!

Dear Friends,

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

Sincerely,
Susan Hodges, "gatekeeper"

A PUSH ALERT from the Big Push For Midwives

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

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

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

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

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

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

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

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

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

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

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

Thank you from all of us Pushers in Illinois!

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

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

Guest Post: American Childbirth Culture

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

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American Childbirth Culture

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

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

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

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

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

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

Domestic Violence Resources

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

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

From an email list, I received this announcement:

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

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

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

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

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

--
Molly
CfM Blogger

Book Review: Survivor Moms

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

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

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

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

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

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

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

Posting Hiatus

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

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

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

--
Molly
CfM Blogger

Book Review: My Name is Mary Sutter

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

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

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

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

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

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

--
Disclosure: I received a complimentary copy of this 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...

--
Molly
CfM Blogger

The Magic of Mothering

In Raven Lang's classic Birth Book, there is a section in it about "imprinting" (I think it has been established that human "imprinting" after birth doesn't technically exist, but when this book was written in 1972 it was one of the ideas). Anyway, there was a section about research done with baby goats done to look at the ability of a mother to protect her offspring from environmental stress. They separated twin goats and put some in rooms alone and the others in rooms with their mothers. The only difference in the room was the presence of the mother. An artificial stress environment was created involving turning off the lights every two minutes and shocking the baby goats on the legs ( :( ). After the babies were conditioned like this, they were tested again two years later. This time all the babies (now adult goats) were in rooms alone and were again "treated" to the lights off and shock routine. The goats who had been with their mothers during the early experience showed no evidence of abnormal behavior in the stressful environment. The ones who had not been with their mothers did show "definite neurotic behavior." Somehow, the presence of the mother alone served to protect the baby goats from the traumatic influences and keep them from being "psychologically" disturbed in adulthood.

Except for feeling sorry for the baby goats, I thought this information was very cool. How magic are mothers that just by being there we can help our babies--even if there is still something stressful going on, our simple presence helps our babies not be stressed by it and continue to feel safe. Magic!

This was included in the book because of the idea that birth may be a stressful environment for a baby and if the continuity of motherbaby is maintained after birth (immediate skin-to-skin contact and opportunity for breastfeeding), the baby does not become stressed or "neurotic." But...if the continuity for mother and baby is broken by separation (baby whisked away for weighing or whatever), both mother and baby are stressed by this and it may have an impact on their future relationship and behavior. The book also talks about how the sound of the baby's first cry has a sort of "imprinting" effect on the mother in that her uterus immediately begins to contract and involute after hearing her baby's first cry, whereas mothers who are immediately separated from their babies and do not make contact with them have a higher likelihood of postpartum hemorrhage (I have no idea if this has been debunked or not since the book was written in 1972, but it was an interesting idea to read about).

--

Molly

CfM Blogger

Perennial Favorites

Recently, on the CfM Facebook page I posed the question: do you have a favorite birth book that you can re-read over and over, each time being engaged anew and/or learning something fresh from familiar words?

I asked the question because I am currently re-reading Birthing from Within for the sixth time. When I read this book, I find I always learn something new, gain fresh insight, or have ideas reinforced/validated. I read it for the first time during my first pregnancy and have read it during two subsequent pregnancies (and now again, during my fifth pregnancy) as well as two other times seeking insights and application for the birth classes I teach.

I asked this question and then went out of town for the day. When I returned, it absolutely made my day to see many responses to my question with lots of great books listed. Three other commenters shared that Birthing from Within is their favorite too and then there were over 30 other posts with other people's perennial favorites! Here is the list--I hope it will remind you to revisit some old treasures in your personal library.

• Ina May's Guide to Childbirth (this, and/or Spiritual Midwifery received NINETEEN recommendations!)
• Gentle Birth, Gentle Mothering by Sarah Buckley MD (x's 2)
  
• Journey into Motherhood, edited by Sheri Menelli. The commenter said, "LOVED it. read it over and over. Full of inspiring, uplifting, wonderful birth stories."
• Heart and Hands, by Elizabeth Davis (x's 2)
  
• "Anything written by Sheila Kitzinger. She is my fave birthy authoress!" [note from Molly: she is definitely one of my top favorites as well!]
• Hypnobirthing, by Marie Mongan (x's 3)
  
• Birth: The Surprising History of How We Are Born, by Tina Cassidy
• The Birth Partner, by Penny Simkin (x's 4)
• Your Best Birth, by Ricki Lake
• Gentle Birth Choices, by Barbara Harper (x's 2). Comment from FB fan: "It's the book I give to non-birth nuts to help them understand why I do what I do."
• Open Season, by Nancy Wainer. Comment from fan: "get's at the heart of things on every level-body, mind and politics" [note from Molly: I LOVE this book too. Very fire-y!]
• Orgasmic Birth, by Debra Pascali-Bonaro
• Osceola Guide to Natural Childbirth
• Birthing in the Spirit, by Cathy Daub
• Under the Apple Tree, by Helen Wessel
• Rediscovering Birth, by Sheila Kitzinger. Comment from fan: "that was the book that really opened my eyes when pregnant with my second child. It's a beautiful book." [I agree!]
• The Thinking Woman's Guide to a Better Birth, by Henci Goer
  
• Baby Catcher (x's 2)
• Birth Book, by Raven Lang. Comment from fan: "Just ordered another copy and I am 60!! I had it with my first born 34 years ago! Gave it away~thought it was out of print and discovered how to get a copy. It influenced me more than any other!" [Note: Birth Book is available in a limited edition from CfM!] Another fan then shared this nice story: "OOOOOH, I do love that one. I married into the most amazing family. My father-in-law's sisters gave me that one and this heirloom copy of Spiritual Midwifery (held together with tape and hairbands) when I married their nephew, to make sure I walked a clear road to birth! (OK...even typing this story has me tearing up! Never fails!)"
• The Vital Touch, by Sharon Heller was recommended as, "Not so much a 'birth book' per se, but more of a 'importance of touch and listening to our infants and children' kind of a book.
  

I hope this list inspires you to contemplate your own bookshelf!

--
Molly
CfM Blogger
P.S. I kept accidentally typing "perineal favorites" as my title ;-D

Cesarean Awareness

Some time ago, I connected online with a new Lamaze childbirth educator named Kelli Haywood. Recently, she notified me about her cesarean awareness radio piece that aired on Mountain News and World Report. The piece is 30 minutes long and contains a lot of information about cesareans, necessary cesareans, informed consent, and so forth. As well as the childbirth educator speaking and sharing her personal story of her first birth by cesarean, she interviewed an obstetrician, CNM, and a CPM for the piece. And, a local mother shares her story of necessary cesarean.

As Kelli noted, "While the piece is particular to Kentucky and the mountain region, however, it also applies on the broader nationwide scope." I agree! It was definitely worth the listen and I enjoyed all of the perspectives shared. I was interested by some statements made by the OB that epidurals are perfectly safe and in some studies "lower the cesarean rate" (!?)--he then notes that this is, "probably because the patients are more compliant." (emphasis mine). Ah ha! This epidural information was followed up with additional information and resources from the CBE and CNM questioning the widespread use of epidural anesthesia.

The story is called Cesarean Birth and the Women of the KY Mountains and Nationwide.

There is also a companion article with additional resources available on Kelli's blog, Birth True.

--
Molly
CfM Blogger

Why I Care

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

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

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

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

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

--
Molly
CfM Blogger

Being BOLD and Birthsmart...

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

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



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

--
Molly
CfM Blogger

Resources from Other Organizations

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

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

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

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

Enjoy!
--
Molly
CfM Blogger

Medical Control as Acceptable

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

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

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

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

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

--
Molly
CfM Blogger

Continuing Education Resources for Birth Professionals

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

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Molly
CfM Blogger

Grassroots News: Good News for Kansas CPMs!

Dear friends,

Good news from Kansas! CPM's were officially recognized as legal practitioners in Kansas birth centers. Congrats, Kansas! Below is more information on the history of CPM's in Kansas, and the specificities of their recognition. As always, if you have any news items that you would like to share, please e-mail info@cfmidwifery.org.

History: a 1996 Kansas Supreme Court ruling stated that in the case presented against a direct-entry midwife, she was not violating the Medical Practices Act because midwifery was not the practice of medicine and she was working in conjunction with a supervising physician. This led many to interpret the law as meaning that direct entry midwives were legal but unregulated in Kansas. Others disagreed with the broadness of that interpretation, with concern that it applied only in that case and that it was contingent on working with physician back-up. Nevertheless, midwives have not been harassed in Kansas and have worked openly.

Previous regulations for birth centers in Kansas required that the center be owned and operated by a physician or CNM, and be staffed with physicians and CNMs. One unique and brilliant CNM, Cathy Gordon, and her compatriot, Debbie Perry, CPM, have worked tirelessly for over two years to revise the birth center regulations to officially allow CPMs to work in them. These regulations just passed! Now, CPMs are legal practitioners in Kansas birth centers. Though not addressing home birth, these regulations provide a definite legal status for CPMs in Kansas. Since regulations hold the power of law, this is one more state where CPMs are recognized as legal providers of care.

Additionally, the language added by MAMA Campaign efforts to the birth center provision in the new healthcare law requires states to provide Medicaid reimbursement to any healthcare provider recognized by state law who is providing services in a licensed birth center. The CPMs in Kansas now fall under that definition!

The full text will not be on the web until July 9. If anyone wants the whole document as a pdf, should contact Ida Darragh at ivd@aol.com.

The language specifically designating CPMs as providers is:

Page 1024:
(f) ''Certified professional midwife'' means an individual who is educated in the discipline of midwifery and who is currently certified by the North American registry of midwives.
(g) ''Clinical director'' means an individual who is appointed by the licensee and is responsible for the direction and oversight of clinical services at a birth center as specified in K.A.R. 28-4-1305.
(h) ''Clinical staff member'' means an individual employed by or serving as a consultant to the birth center who is one of the following:
(1) The clinical director or acting clinical director;
(2) a licensed physician;
(3) a certified nurse-midwife;
(4) a certified professional midwife;
(5) a certified midwife; or
(6) a registered professional nurse.

Page 1029:
(m) Each patient shall be admitted for labor and delivery by a physician, a certified nurse-midwife, a certified professional midwife, or a certified midwife.

Way to go, Kansas!

Sincerely,
Stephanie Hucker and Willa Powell
Citizens for Midwifery

Maternal and Infant Mortality

Last month, I wrote a brief post about the Preconception Educators program sponsored by the US office of Minority Health. Since then, several other things have come to my attention that are related to either maternal or infant mortality. The Unnecesarean blog pointed out that there is an excellent video about infant mortality in the African-American population available from the Minority Health office. In fact, The Unnecesarean is also hosting a blog carnival about this video! (to run July 4th.)

The video is called Crisis in the Crib and emphasizes this fact: "The rate of death for black babies before their first birthday is twice the rate of white babies and greatly outpaces the national average."

Then, a friend sent me a link to an article about childbirth deaths focusing on the "350,000 women lose their lives each year giving birth or through complications of childbearing."

And, in the summer issue of Midwifery Today I read about the new report from Amnesty International called "Deadly Delivery" about the maternal health crisis in the US: "Mothers die not because the United States can't provide good care, but because it lacks the political will to make sure good care is available to all women." Bringing it full circle back to the Crisis in the Crib, I think we could amend that sentence to read, "mothers and babies die...because it lacks the political will to make sure good care is available to all women and their children."

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Molly

CfM Blogger

Grassroots Network: Survey for Patients/Consumers on Overtreatment

Survey for Patients/Consumers on Overtreatment

Dear Friends,

Hope you all are enjoying the start of summer!

First of all, we at CfM apologize that our Grassroots News Messages have been so sparse lately. Much has been going on in all of our lives, and unfortunately our news messages have taken a back seat. In the coming months, we promise to refocus our energy and use this network to spread the news about maternity care. If you have anything that you are interested in sharing, we encourage you to contact us at info@cfmidwifery.org. Additionally, if you would be interested in helping regularly with the Grassroots Network messages, we’d love to hear from you.

Below is information regarding a survey from TreatmentTrap.org and Consumer Union's Safe Patient Project dealing with overtreatment. While the site doesn't specifically mention childbirth, overtreatment, unnecessary treatment and other errors are frequent in maternal health care in the U.S. We encourage you to share your experiences with these incidents, especially as they relate to childbirth. The survey reflects the beginning of attention to overtreatment in general, and an awareness of related issues such as a lack of informed consent and being given misleading medical information. This is a chance for all of us to draw the attention of the sponsoring organizations to the severe and costly problem of unnecessary and overtreatment in maternity care in particular. Through raising these issues, we can actively support a woman's right to the childbirth she sees fit, and her right to be treated honestly and respectfully by her care providers, both of which are essential for improving the state of maternal health care in the US.

Please read the information below and participate in the Survey!

Sincerely,
Stephanie Hucker and Susan Hodges of Citizens for Midwifery

New Survey Launched to Query Patients/Consumers on Overtreatment

A new survey is being launched to enable patients to share their experience of overtreatment, an emerging quality and patient safety issue in health care today.

The survey is a partnership between TreatmentTrap.

org and Consumer Union's Safe Patient Project. While not a scientific survey, it aims to elicit patient experiences of overtreatment to raise public awareness. Patient experiences of overtreatment can be useful to health care leaders and policy makers as they establish priorities to reduce overuse.

The survey can be found by going to: www.treatmenttrap.org. Click on "Share Your Story" and you will be directed to the CU Safe Patient Project survey.

The "Share Your Story" survey asks two questions: "Have you had medical care you thought was unnecessary?" and "Have you declined medical care you thought was unnecessary and obtained a medically appropriate alternative?"

The survey prompts respondents to share experiences of overuse including those identified as overused by the National Quality Forum's National Priorities Partnership. These procedures include: spine surgery, heart bypass surgery, hysterectomy and prostatectomy.

For further information, contact Rosemary Gibson at rosemarygibson100@gmail.com

Book Review: Breastfeeding Facts for Fathers

Since Father's Day is this weekend, I thought this was a perfect book review to share!

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

Since partner support of a breastfeeding mother is one of the most important factors in breastfeeding success, the short book Breastfeeding Facts for Fathers is a valuable book indeed. Written in a clear, straightforward format, brief one-page sections address topics like, “why you want your baby breastfed,” “is formula really so bad,” “a happier, healthier mom,” “sex and the breastfeeding woman,” and “when breastfeeding is not advised.” There is also a brief segment about safe co-sleeping. These sections are followed by a brief FAQ addressing topics such as how often mom should breastfeed, how to know baby is getting enough milk, how long to breastfeed, nipple piercing, breast implants, alcohol, and breastfeeding in public.

As a quote in the book states, “Having a father is critical to the healthy development of a child. Being a father is critical to the healthy development of a man.” Providing breastfeeding information specific to fathers, Breastfeeding Facts for Fathers supports this healthy development of father, mother, and baby.

A Spanish edition, a low-literacy (abridged) version, an ebook edition, and a hospital edition (co-sleeping information omitted) of Breastfeeding Facts for Fathers are all available at various affordable prices from Platypus Media.

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