“That a woman who is low-risk has access to a safe educated homebirth midwife if she so desires. Because most women who choose homebirth are willing to do so even with the risk of death.”

I’m sorry but this statement really rubs me the wrong way. “Most women who choose homebirth are willing to do so even with the risk of death?” Of course. And the next one:

“And conversely, that a woman has access to topnotch medical care and a hospital with 24/7 anesthesia on site if she so desires. Because women who fear death are willing to risk higher interventions and their complications.”

So we have two types of women, according to this author… one is an ignorant, selfish feminist willing to ignore the facts and have her way regardless of the consequences, and the other is a quivering, fearful,  equally selfish child who will do ANYTHING but make a truly informed choice. The same woman is described here, with different outcomes, and I am offended that another woman would characterize essentially all women in such light. “Poor baby, we need to make everything ok for her.” she seems to say.

No we don’t. There is not “WE” in choice. There is an “I”.

C H O “I” C E.

I’m tired of hearing BOTH camps tout the best way to fix the American maternity system. Because I have yet to hear a logical solution to the problem. Some say policy change, some say insurance companies are the problem, some say the entire social/cultural strudcture of the United States impacts the birth climate negatively. Maybe they are all right. Maybe they’re all wrong. Point is? It doesn’t matter.

Women have 2 choices:

Either we CHOOSE to be ignorant of the facts, the science, the safety, the risks of childbirth and reproductive health, or we CHOOSE to educate OURSELVES.

This whole idea of fixing the system is a bit tiring. We need to fix WOMEN. Once we get THAT done, the system will get fixed. Guaranteed. :) 

My husband recently came home with a large set of windchimes. I have admired them for some time but have never made the plunge to actually purchase the kind I like. I like the big ones, the ones that sound like cathedral bells, the ones that are… EXPENSIVE. But he loves me, and wanted to do it, so what can I say but thank you!?

I hung them in the garden at the front of the house in a tree. They don’t ring often but when they do their melodic chords offer just the right amount of “company” while I am weeding or pruning or picking something. Having studied music for some years though, their sound does not fall into the major or minor scales. It is arrythmic, out of balance, even chaotic at times when listened to with the ear of a trained musician. It reminded me of something. Can you guess what?

A woman in labor, following the “curve”, behaving as told, obedient little instrument, performing at the will of her attendants has an easy road. She is lucky. Not so with all woman, and I would dare say MOST woman do not fall into this “major or minor scale” of labor-music. Most women labor as the windchimes… arrythmic, slowing down, speeding up, even  *GASP* stopping all together for periods of time. Silence can be music too, you know. Their labor song is not one of 2 sharps or 3 flats played at an even 4/4 time scale. It is the song of the windchimes. The song of love, life, the chaotic, the extreme, the UNIQUE.  Even windchimes made by the same maker do NOT sound the same all the time!

These women’s labor-songs need the care and attention of an attendant willing to listen to HER SONG. Not compare it with others, to watch for the wind blowing too strong and tangling the delicate chimes yes, but not one who will hold them fast, strike them with a hammer and expect music to be the outcome. The message of letting go and letting be is one of the ages. The message of trust and freedom and birth rings true. Let us LISTEN.

Sorry I haven’t been too great at blogging consistently these past couple of months. I’ve been trying to “gestate in peace” and just be a mom. The calling to birth and women won’t leave me be though, so I’ll try harder to get it in on a weekly basis. Thank you for reading. Pass it along if you are moved by any of it. Trash it if it’s luke-warm. Email me if it makes you mad. All emotional responses (and logical ones) are welcome. :)                  ~Kelly

————————————————————-

I’ll tell you, this advocacy stuff is rough. I get emails from women all over the country sharing their birth trauma stories (and sorry, this is TRAUMA we’re talking about here, not a “bad experience”). I cry alot. It’s hard to do this while I’m pregnant. The idea of facing a hospital to birth again makes me queasy. Yeah… that’s a generalization I know. Not all hospitals are bad, not all doctors are terrible selfish money-grubbers. I know this. But the stories… how can I not be impacted by the horror of a mom being “reprimanded” by her OB for not agreeing to an episiotomy, so when she was being stitched up SANS numbing agents (which the OB refused to use saying, “You said you wanted natural, this is natural.”) had to also hear, “This is what you get for not letting me cut you.” And for the mom who, upon transferring from homebirth because of thick meconium in the water (good heartones though) had to listen to the attending OB nurse comment, after a 3 hour wait, “Well if you were still home nothing would be getting done for your baby so what’s the hurry?” Or the mom who was promised a VBAC only to get to the hospital in labor and find out a cesarean had been written into her chart at 20 weeks. When she balked the doctor said, “Listen, you were never going to get a VBAC. It’s ok. You’ll have your baby in your arms in an hour.” She walked out (WARRIOR WOMAN!!!) and had her baby at home, vaginally, assisted by her husband that same day. 3 hours later.

It sounds like I’m reporting from a 3rd world country doesn’t it? But I’m not. No… if only it were that easy. This is US. This is the United States of America where FREEDOM is supposed to RING TRUE. But it doesn’t. Heck, HONESTY doesn’t even ring true anymore. My sister had so many adhesions from her first cesarean that she was onthe table with her 2nd for 6 hours getting cleaned out. Even after that she was never told why that happened, that it was likely to happen again, and that her cesarean was not medically necessary. Informed consent? That’s the stuff fairy tales are made of. And you’re more likely to get it at a car lot than in an OB department.

But being the eternal optimist that I am, I know that however our births turn out, whatever bumps we face along the way, wherever these roads take us… the fact that we are HERE, together, talking about birth means that we care about humanity and the future of birth in our culture. Yeah. Uh-huh. That’s us. The broken, the healing, the healed. We care, and we’re not going to give up until someone listens, until things change, until we see that normal birth is safe for our daughters and grand-daughters.

In a 5-2 ruling yesterday, Missouri Supreme Court ruled on the constitutionality of a line in a 2007 law legalizing Certified Professional Midwives. Thank goodness.

A sigh of relief. After the ugly political tactics that I’m sure took place last session (I was only there twice but I saw enough…) I am relieved to see that justice did have it’s day afterall.

This issue isn’t about a handful of crunchy, granola eating, Burkenstock wearing women who want to birth their babies at home.

This issue isn’t about hating doctors, hospitals or the medical profession.

This issue isn’t about money, power or control.

This issue isn’t, TRULY, even about midwifery or homebirth at all.

This is is about personal choice and freedom. It is about having the right to exercise CHOICE over our bodies and how they are treated.

And I am glad that the Missouri Supreme Court heard the case for what it was. Doctors neither have the right to “represent patients” nor do they have the right to limit access to healthcare.

Whether or not you, or I,  agree with the philosophy behind homebirth is little more than a side dish in this debate. This issue is about freedom. I am relieved to see that the Missouri Supreme Court stands for those freedoms.

I was just reading Navelgazing Midwife’s blog entry on the infamous Dr. Amy’s blog regarding her blatant denial of birth trauma. She evidently does not believe it happens, or that the routine things done to women during birth do not effect women in a traumatic way unless there is a history of abuse in her past. Well, that’s a whole ‘nother subject. I’m too stunned by her assertations to reply at this point.

What really struck me was the list the Navergazer put down as hurtful or harmful for women - things said or done to them in labor. Not just by OB’s, Gyn’s, or nurses but also by midwives. It hit me like a ton of bricks. I’ve heard alot of those things said at homebirths. My question is, “When the woman will not cooperate or LISTEN to the beloved “informed consent” statements and will NOT take responsibility for her and her babies well-being, then what do we do? Step back with folded arms and let a baby be harmed?

I heard a story recounted by a fellow midwife of a woman who wanted to “do labor alone”. She wanted to be left alone to labor, had a plan, etc. When labor came however, it was a different story. For hours she fought her contractions. No progress. Then she began to hurt herself. She began biting herself amd hitting her head on the wall. For awhile the midwife watched, not wanting to interrupt or go against the mom’s pointed wishes. At last she cuold take no more of the high pitched screaming, head banging and biting. She intervened. She held the mom’s hands and caught her eyes with hers. She began to match her breathing, helping her cope. The mom said, “Thank you.” In the end, the baby was fine, the woman had only a couple of bite marks to show for her “independent labor” and no concussion.

It seems to me, that in the interest of fairness we need to realize that there will be women in our care as midwives that NEED intervention. I’m not talking about needles and sutures and episiotomies and continuous monitoring. I’m talking about emotional and psychological intervention. Because let’s face it. In our culture here in the midwest birthing is NOT seen as natural and women are NOT brought up to believe they are powerful, life-giving creatures. They are raised to believe they are victims, in need of salvation, by and large and it can take a lifetime of work to undo the belief system that leaves women helpless in the hands of their care providers.

The list of harmful things  Navelgazing Midwife  put out was SO eye-opening. Words are so powerful. They contain life and death. Thanks Navelgazer for putting that up (don’t know where you got it, maybe it’s original, if so… COOL!). Let’s think of healthy ways of saying things, if they need said, as we prepare and work towards a culture of powerful birthing mothers.

A good one (really… even despite the last post!)

I just replaced my outside water hydrant and am taking a sip of “pond water” (what my kids call my chlorophyll tainted water) and resting a bit before going out to plant my vegetables.

It’s 73 degrees and sunny outside.

My husband tilled the garden for me this morning while I worked. Readying it for a new fruitful season.

This is the children’s last day of school and I will have them all back to myself for the summer.

I’m pregnant again, and feeling the baby move everyday now. I am planning a homebirth. All of it a miracle. Truly. 15 years ago last month I was diagnosed with CPD after trying to birth my 8lb 12oz baby boy. They told me not to even consider a vaginal birth. Several of “them” did. I hired a doula 4 years later and had my first vaginal birth. Repeat 2 times. This will be my 4th VBAC. Guess I showed “them”.

It is fitting that I will be growing my garden while I’m growing this baby. It is a blessing… a fruitful time… the summer of my days.

I’m happy. Life is good.

Life is good.

is sickening and distasteful to me, in whatever form it takes. Many make arguments that “their prejudice is founded” like, “Chinese are always good in math.” or “African American women have big butts.” or “Women are too emotional to be in politics.” and recently, “You don’t know what you’re talking about because you’ve never had a homebirth.” or “You’re going to be a medically minded midwife because that’s all you know. Medical births.”

Ok. So I’ve never given birth at home. And that experience is just that: and EXPERIENCE. I admit fully that I do not have that personal experience. Does that make me a “junior” in all things homebirth? I don’t think so. Admittedly I don’t have the personal experience of having birthed at home, yet. But I take offense at the notion that I cannot understand how to “trust birth” because I’ve never had to. Bull. Here’s my “trust birth” story.

I layed in a hospital bed with my first child, who was posterior, for 31 hours after my water broke. The last 8 were Pitocin augmented. Hard contractions. No support. My husband went for a haircut, brought Hardee’s for his breakfast back to my room while I starved, and watched television. I had no pain relief. I wouldn’t take it. I pushed for 4 hours. Almost 5 until they wheeled me into the operating room for an “emergency cesarean” for CPD. No one told me until weeks later that he had been brow presenting. The forceps wouldn’t budge him, the vaccum extractor didn’t budge him. I couldn’t budge him. ( I know this was all the fault of my OB and the attending nurses for a meriad of reasons. That’s not the point of the story.)

I BELIEVED I could birth my baby. I TRUSTED my body to do what it needed to. All the way to the OR I believed we were making a mistake. Too tired to fight anymore I gave up and gave in. But I “trusted birth” while hindered, drugged, scared, manipulated and assaulted and betrayed by my former husband and caregivers. I TRUSTED BIRTH in the most trying of circumstances.

Again when my youngest had sticky shoulders and (again on my back because the OB refused to catch if I didn’t lay down). She was prepping the OR while I did the McRoberts maneuver on myself and popped him out.

For those mamas who have had the priviledge of never birthing in a hospital or at least it was a one-time experience of which they have happily erased many of the memories, I find it appalling that my thoughts, desires and opinions as a student midwife would be called into question simply because I have not had that same priviledge. Some of the comments haven’t been blatant about it, but in a patronizing, pat on the head sortof way I have heard the message, “You just don’t understand.”

I TRUST BIRTH. You can’t say you really do until you’ve had to. I’ve had to. I do. I will.

I think we’ve all heard about the horrific earthquake that rocked China on May 12th. Many children and babies were left homeless. This street policewoman decided to help how she could, when she could by breastfeeding some of the infants. She is nursing 8 infants and toddlers in an orphanage that does not have powdered milk. Having just given birth herself, she is considered a hero by many.

I must agree.

I guess I’m still reeling from a personal attack I faced last week regarding attendance at a birth. I can’t go into the details of it all but sufficient to say, my suggestions regarding concern over her rising blood pressure, swelling and general fatigue were met with scorn. Afterall… don’t I trust birth?

So the talk of me being “medically minded” might be true. I don’t know. All I know is that it is irresponsible to attend a birth without basic life-saving skills and equipment and the knowledge to implement it.

I will carry a suctioning device. In case I need it.

I would like to carry Pitocin or methergine and oxygen in the RARE, rare rare event that it is truly needed.

I will help my moms take care of themselves during pregnancy, watching their diet carefully together, tweaking as requested/needed for her and her babies optimal health.

I will keep my neonatal resuscitation certification up to date on a yearly basis.

I will continue my education as long as I am practicing, careful not to fall into the trap of “It’s worked for all these years, why change now?” and think I already know it all.

I do not consider myself a “med-wife” at all, though from the above list some would. I look at it like this:

I firmly believe in the innate knowledge and power that accompanies birth. And that nearly all births have the BEST outcomes when the mom is left alone. Totally.

Now here’s the but…

But! If I were to attend a birth where the baby needed resuscitation and I couldn’t do it? Or is he or she truly needed suctioning (thick mec/etc.) and I didn’t carry a suction device? Or if the mother hemorrhaged and none of my herbal or manual tactics were working? Or if the Mom’s diet was BAD and with this knowledge I did NOTHING TO HELP HER CORRECT IT?

Those rare instances, where life is hanging in the balance, are enough for me to be prepared. You know… like the Boy Scouts? Be prepared, with the firm belief and intention that those tools will rarely (and hopefully never) need to be employed. I believe anything less is irresponsible and careless. “Trust” has nothing to do with it. 

I’m not God. I have no desire to believe I am equal with Him. There are times a birth ends with death. I accept and acknowledge that God is the Father of all living and is in control of what happens at a birth. I realize and accept also, that all the tools in the medicine cabinet cannot save a life destined for heaven. I’ve seen that.

But I ask myself this question: “If a baby or mother died because I didn’t have these tools at my disposal, could I sleep well that night? Would I be consoled just knowing I “trusted birth” even though the evidence shows that life might have been saved had I been prepared?” I hope this question and the answer to it resonates deeply with many. Because frankly, what I am being accused of by being careful and watchful signals to me that the insistence to “Trust Birth” has gone a bit overboard.

I expect quite a bit of “flaming” over this post. I do. That’s ok. There’s room for disagreement (I think). This is my opinion and this is, afterall, just a blog.

A recent story in a British newspaper left me feeling bewildered at this tragic loss and wondering what I can learn from it. A 20-something mother died 6 hours after giving birth to her baby at home.

I am not one to ignore or **hide** the less-than-optimal outcomes that occasionally occur at homebirths as some of our opposition would assert. Rather, I wish to dissect it (as much as possible form the information given in the article which is, I’m sure, far from all of it) and learn the lessons that are there for the taking.

The mom suffered a massive hemmorhage after an inverted uterus began bleeding profusely. It seems that a huge factor in this woman’s death revolves around lack of communication between the hospital and the attending midwife at the time of transport.

One of the gynecologists on staff said, “The staff were expecting a retained placenta. If they had been told it was a complete inversion of the uterus then she would almost certainly have gone straight to theatre and I would have been ready for her.”

One thing that seems to be missing from this article is the answer to this question, which of course, could only be answered by the attending midwife: “How/why did the inversion occur?” As a training midwife, this question is of utmost importance to me. All of the study I’ve come across says they are almost always caused by interference of some sort. Not always, but generally.

I am skeptical of it being anything but an induced inversion because she was not (apparently) forthright in telling the ER staff of the woman’s condition. Did she pull on the cord or placenta? Perhaps the woman was hemorrhaging and the midwife attempted manual removal in order to stop the bleeding? 

Or was there no communication because she is an independent midwife and was greeted with hostility when she arrived with her client at the ER with paramedics?

And rather than blame the midwife, we should probably wonder why paramedics weren’t trained to cannulate? When they, perceivably, attend more massive bleed situations than a midwife would? Her assumption was the same as mine might have been as she was quoted as saying, “Knowing the ambulance was only a few minutes away I thought it was better to leave it for the proper paramedics who have expertise in this on a daily basis.”  While cannulating (inserting an iv and fluids) may not have saved this woman’s life, it could have bought more time for the hospital staff to figure out what was going on and act accordingly.

There is quite a bit of talk about this on certain people’s blogs, saying this is exactly why DEM’s shouldn’t be practicing and why homebirths are “inherently dangerous”. Again, I would say, a DEM is such a broad term that I prefer not to use it. I prefer to use the term “midwife” and then find out on an individual midwife’s training is. Some CNM’s (from personal experience) have no business catching babies. They simply took the extra training for the pay raise. I had one tell me this straight out. She was an OB RN and had caught enough she thought she “ought to be getting paid for it”. “I wouldn’t say it’s my passion, but it’s a good gig.” CNM’s can also get their certification online. I mention this since it seems to be a point of contention and an excuse for the “CPM’s training isn’t good enough” crowd. All DEM’s are not created equal, just as all OB’s are not. Gasp - horror!!!!! Did I just endorse OB’s? No, I said I won’t cast judgement on them all for the actions of some.

This is all, of course, an overstepping of my bounds in regards to making a judgement on this midwife and this homebirth. There is no way for me to calculate, based on one newspaper article, what went wrong, who is to blame, etc. Nor is there enough in one article to use it as fodder for a position that says “ban on all homebirths”. It is a sadly uneducated and narrow-minded person who would do so.