Birth Wars & Restaurant Wars

Sheridan at the Enjoy Birth blog wrote a wonderful post, starting with:

Imagine the year is 2035.  People rarely cook at home anymore for a few different reasons.  They have gotten too busy and because of subsidies from the food industry eating at a restaurant is less expensive.  They actually pay more out of pocket to eat at home.  Many people look back and remember, “People actually prepared meals AT HOME!  It is amazing that they were willing to go through all that time and energy and that so many survived.”

It is an excellent analogy to the current “birth wars” that Jennifer Block wrote about here, discussing home birth versus hospital birth.

Both articles are must-reads!

 

The Independent Birth Center

There are many variations on the only thesis available to opponents of home birth: What do the statistics say? Despite the enticement of a warm, peaceful and private birth that a home birth offers, the perceived importance of missing technology lingers like impending doom. In America, less than 1% of births takes place in homes. It is difficult for the other 99% of Americans to make the transition from technology as the benchmark for establishing worldwide leadership to the reality that the human body is designed to give birth and it has evolved to make many variations in labor and birth look so easy.

The Stockholm Birth Center Study followed one birth center’s outcomes over a ten-year period culminating in 2000 and comparing the outcomes to the associated hospital’s birth outcomes. The one strong observation in this study is the truism that many women will choose a birth center because of the perceived safety in having a hospital nearby. However, it is a mistake to conclude the birth center is free of institutional intervention. The study’s results are negated because of the influence of the obstetrical backup. Every woman who chose the birth center for her birth location was still subjected to the institutional care package. This is the most influential determinant in whether or not a woman is “risked out” of laboring and ultimately delivering in the birth center.

A birth center so closely associated with a hospital is not autonomous and must operate under strict supervision by institutional birth practitioners. The authors themselves state they did not study the effect of individual labor and delivery protocols, but rather the care documented in each case as a “package.” In addition, they have correctly remarked standards of maternity care do not exist, but they have again missed the mark on the importance of this statement. This is critical to interpreting the outcomes, because one solitary intervention can turn out to be the predictor of a birth outcome. For example, every care provider practices according to their comfort level; although every care provider will monitor a baby’s heart tones in labor, how the monitoring is done varies by care provider. Continuous electronic fetal monitoring (EFM) can range in definition from ten minutes hooked up to a monitor every hour on the hour to a handheld doppler check through a contraction every few hours to a telemetry unit (a girdlelike band outfitted to wirelessly transmit fetal monitoring data) that allows the mother walk more freely.

The ability to walk freely even under continuous monitoring allows the mother greater mobility for finding a position that increases her ability to cope with her contractions. Setting aside the U.S. Preventative Service’s Task Force’s findings and stance that continuous fetal monitoring provides no benefit at all – and the data showing that continuous EFM results in more cesareans – it can be argued that fetal monitoring that limits a mother’s mobility is therefore more likely to result in more intervention as the mother shows signs of distress and therefore the baby does as well.

The authors of the Stockholm Birth Center study argue that many other studies have reached conclusions similar to theirs. In the same publication we are offered a Cochrane Systematic Review of Home-Like versus Conventional Institutional Settings for Birth. Here the reviewers concluded births in home-like settings compared to purely hospital settings “provided only modest benefits including reduced medical interventions and increased maternal satisfaction.”

A hasty read of this data by institutional birth practitioners correctly supports their ingrained training that routine intervention is acceptable and “safe.” However, the paper actually clearly demonstrates that all births taking place in a hospital are going to meet up with interventions at some point during labor, and it is the overuse of technology that needs to be analyzed. Indeed that message is there somewhat cryptically as the authors instead hinder the possibility of improving on the scope of research by advising “caregivers and clients should be vigilant for signs of complications.” It is difficult for any woman who has given birth or who respects her body to hear such little value placed on the differences the studies do reveal, such as the “modest benefits” of “reduced medical interventions” and “increased maternal satisfaction.” Surely even one avoided episiotomy would be appreciated by the woman whose perineum would have been cut and would find several women healing from receiving an unnecessary episiotomy envious.

In 1998, a study of infant mortality in planned home births was conducted in Australia. Author Hilda Bastion reviewed these outcomes as neither hospital nor home births have defined what constitutes standard care. She reviewed both midwives and medical practitioners, registered and unregistered, minimal experience and heavy case load. Also included in the study were births that would be deemed risky by virtue of poor health in the mothers or other underlying health conditions. This is crucial to understanding the bias of many hospital birth proponents: It is not the intent of home birth advocates to claim home birth is best for everyone, but rather a viable option for low-risk and otherwise healthy women. The author goes so far as to note it is a disturbing trend that midwives may be encouraging and willing to take high-risk births because of the high number of low birth-weight infants counted in the statistics. In fact, it is quite possible that a woman who cannot afford good nutrition may also not be able to afford hospital birth care, and perhaps a midwife is her better choice than no care at all.

In general, birth care is divided into either purely institutional care or modified institutional care. No research exists on pure, spontaneous vaginal birth over an intact perineum without induction agents, drugs, surgery and instruments. What is available is mounds of research on what a mother or baby can “tolerate” in labor and what interventions have achieved an acceptable degree of risk. The acceptable degree of risk is not defined by an independent counsel but often influenced by the strongest or loudest lobbying effort, as witnessed by the American College of Obstetricians and Gynecologists’ (ACOG) August 2007 statement on the advance of midwifery options for consumers. ACOG’s bottom line is midwifery options must be controlled and home birth as an option must be eliminated. The average consumer misses the bias and conflict of interest: A rise in home births means a decrease in income for a field already plagued by the reality that there is no money to be made in natural childbirth.

In addition to a lack of studies of organic birth as defined above, there are no long-term, randomized longitudinal studies to confirm or deny the correlation of many interventions. For example, the impact of a mother’s drug use in labor on emotional bonding, breast-feeding, postpartum depression, later drug abuse (baby as a young adult), etc. In the 1970s, Doris Haire, the President of the American Foundation for Maternal and Child Health, said, “No drug has been proven safe and effective for use during pregnancy or childbirth.” Considering that 25% of drugs introduced in the market today are recalled or pulled off the market in 1 to 5 years, this statement has never been more true. Until such time that midwifery care can be studied with a critical but appreciative eye, we will find only the weakest of studies boxed in by outdated beliefs that American women cannot afford to birth outside of a medical institution. In fact, it is our country that cannot afford to NOT offer free standing birth centers as a birth care option for American women.

Works Cited
Bastian, Hilda, “Perinatal Death Associated with Planned Home Birth in Australia Population Based Study”: BMJ 1998; 317: 384-8

Hodnett, E.D and S. Downe and N. Edwards and D. Walsh, “Selected Cochrane Systematic Reviews: Home-like versus Conventional Institutional Settings for Birth”; BIRTH Issue 32:2; June 2005

Waldenstrom, Ulla and Charlotta Grunewald, “The Safety of Birth Centers Responses to a
Critique of the Stockholm Birth Center Study”; BIRTH Issue 32:2; June 2005

 

Stay tuned ……

Stay tuned for our upcoming International Birth Wisdom week!  

FLEX (Spain) currently airs this ad campaign for their mattresses.  A lovely homebirth on a FLEX mattress because where you sleep, your home, is the most important place in the world.  The place that welcomes a new life into this world is a special place and the memory lingers there!

Our thanks to Birth Activist for one of many birth community members to find this ad!

 

Overcoming Fear of Childbirth

One thing that has been on my mind lately, is the fear of childbirth (technical name, tocophobia).

Sometimes women are afraid of childbirth prior to having any children, and this is not really surprising — after all, the average woman will have seen few actual births, but only those portrayed in movies and on soap operas. Of course, those are all not just dramatized (fake) but are typically dramatic — water breaks and the woman has to get in the hospital this instant or the world will come to an end!! Or she’s stuck in the backside of nowhere in labor with just her husband (yes, I still remember when Jennifer had Abby on Days of Our Lives, and Jack was the only other person in the cabin, with serious snow outside), and everybody is panicking. Or labor is portrayed as the worst and most awful thing that it is possible to endure, until the magic epidural comes and makes everything all right. The other thing that is now available on TV, that I didn’t have as a child, are shows like “A Baby Story” which do portray actual births, but I notice that an inordinantly high number of those end in a C-section, or are otherwise highly interventive; and I’m not surprised that this leads to a fear of birth prior to the woman’s actually giving birth the first time. And this doesn’t even begin to touch on all the labor and birth horror stories that mothers for some reason feel so imperative to scare first-time pregnant women with.

Other women, however, have given birth before, and this experience has made them scared to have any more. Some women may choose never to have any more children at all (this happened to a friend of mine; her daughter is now about 8-9 years old). Or they may choose a C-section because they can accept pain from surgery and the attendant post-op pain (which may be manageable by narcotics), but they fear the lengthy but intermittent pain from labor. But there are other options.

After her first very painful birth, this woman was terrified to give birth again, but she chose to overcome her fears by using hypnosis to relax during labor. If you watch the video on that link, you’ll notice that they show a few clips from an online video of a woman using hypnosis during labor. That woman in the video was Independent Childbirth Educator Sheridan from EnjoyBirth blog whose painless childbirth using hypnosis (Hypnobabies) was what this Georgia mom saw that gave her the courage to try to give birth again. [I'll clarify that although the news story referred to hypnosis during birth as "HypnoBirth," that is a name for a particular type of childbirth hypnosis, and Hypnobabies is another, and it was this type that Sheridan used during birth, and what she teaches.]

The fear of childbirth is very real. And it’s understandable, considering all the negative images surrounding birth that we are bombarded by almost from our own births — and considering that most of us were born in less-than-ideal circumstances ourselves (my mom was under general anesthesia and given an episiotomy, and I assume I was dragged out of her womb by my head), perhaps it might be not too big of a stretch to say that we are surrounded with negative birth images from the time of our birth. But all too often, doctors are just willing to tell women who are afraid of childbirth, “Oh, don’t worry about a thing — if you don’t want to give birth, we can give you a C-section.” While I can accept that women should have the right to choose to give birth as they wish, I wish that doctors (and others) would give a little extra time to ask a woman why she’s afraid, and see if they can work through her fears, rather than just cutting her open unnecessarily. If her fear is irrational yet she holds onto it, fine, give her a C-section; but if she has a rational but misguided fear (for example, I heard recently of women who want a C-section because of a fear of their “vaginas exploding”), then get to the root of the fear! Instead of treating her like a little child who is afraid of getting her dress mussed by going outside, treat her like the rational woman she is, and give her true information to combat the

F-alse

E-ducation

A-ppearing

R-eal.

 

Never again

Preconceived notions are… interesting. I’m in the middle of watching the wonderful A&E version of Jane Austen’s Pride and Prejudice and the theme is, of course, Darcy’s and Elizabeth’s mistaken first impressions about each other, and working through the negative prejudice each had about the other, to get to the truth about themselves and each other. Sometimes first impressions can be very accurate; but sometimes they can be completely wrong.

When it comes to choosing a care provider, it is important not to blindly accept anyone’s recommendation, nor to follow merely a “first impression,” but to closely examine the person who is to be caring for you during pregnancy, labor, and birth. Just as Elizabeth learned that Wickham was not the kind, honest, and honorable person he appeared to be at first, so you may find that your midwife or obstetrician may not be exactly what she appears to be.

A friend recently mentioned that she was going to be trying a “natural” induction method (castor oil), and I didn’t say anything about the negative observations I had just recently heard about it; and I’m afraid it may have negatively affected the baby. At one point, it was “touch and go” for the baby. I said, “never again” — regardless of how much I think the mother may resist my input.

A fellow childbirth educator had an experience some years ago when a friend of hers mentioned that she hadn’t felt her baby move much lately. Not wanting to make her unnecessarily worried, she did not suggest that she go get checked out, although she herself had had a necessary preterm C-section for just the same thing. The friend’s baby was stillborn a few days later. “Never again.”

You read here about a birth educator who attended a vaginal twin birth as a doula, and both she and the pregnant woman were so glad to find a doctor willing to allow a vaginal birth, instead of insisting on a C-section, that neither one questioned whether the doctor had the experience necessary to attend a twin birth. As happens with some frequency, the second-born baby was breech, and the birth of the baby was quite traumatic, with the doctor showing his or her inexperience, and ultimately, fear. But the doctor told the mother afterwards — and perhaps the doctor believed it as well — that the trauma the baby endured was better than being brain damaged or dead; so the mother believed that the doctor ultimately saved the baby, and is content with what happened, although it was very unnecessary. “Never again.”

We do hear from time to time that we, as natural childbirth advocates, are extreme.  We’ve heard many a commentary that compares natural childbirth to a throwback to living like a pioneer.  We’ve all had the experience of having women who know we are natural childbirth and birth rights advocates walk away from us quickly or politely (sometimes not) shut us down.

We wonder sometimes if it’s worth risking having people try to paint us in that radical light to keep doing what we do: quelling preventable mother and/or newborn injury ~ physically, mentally and emotionally ~ including death.

Never again.

 

We Ain’t Broke. Don’t Fix Us.

In a recent discussion we have had on our independent childbirth educators email list, the topic turned to one of the basic differences between supporting a woman through labor, and medicating a woman through labor; between listening to a woman’s complaints, and “fixing” a woman’s complaints; between most home births and far too many hospital births.

One woman told of an experience in supporting a woman through her labor.  The mother turned to her doula and husband once and said, “This sucks!” The doula answered, “Yes, I know it hurts, but you can do it.”  The mother responded, “Yes, I know I can do it. I just wanted to let you know it sucks!”

How many nurses, husbands, or other birth-support people would have heard the woman say that, and offered her medication to “fix her problem”? She wasn’t needing anything fixed — she just wanted to communicate. Isn’t there a whole industry in attempting to help men and women communicate, especially in marriage and other personal relationships? Why should we think that doctors (who are typically trained in the all-male tradition of med school for generations) and the medical establishment will know how to communicate in the all-female world of birthing mothers?  Men tend to want to know the answer. Doctors are also trained in how to fix problems, medically. Mothers want to talk about it first.

So many women just want to be listened to. These basic differences will not just disappear because women are in labor. Some people — both men and women, although men tend to fall into this much more easily than do women — just want to know the answer and use it to fix problems, even if the “fix” is something unwanted by the person who is dealing with the situation.

When a woman’s birth-support team moves too quickly from listening and encouraging – and the other basic tenets of female relationships and female support – they may undermine a woman’s innate courage and strength.  This can happen regardless of the sex of those who surround her in birth.

What if, instead of telling her “you can do this,” the doula had responded, “would you like an epidural?”  The mother may have heard, “You’re not strong enough to handle labor without drugs, so just go ahead and get an epidural before it gets any worse.”  For my part, I’m very vulnerable to suggestion during labor.  A question like that — as innocent as it sounds — may have been enough to make me say “okay.”  Because, after all, if the people who are watching me labor think I need an epidural, then maybe I do!

Fortunately, nothing like that happened during either of my labors.  Instead, the midwives asked open-ended questions, like, “What do you want to do?”  Every time they asked a question or made a suggestion (like getting into or out of the labor tub) I obeyed it as much as if it were a command; questioning it no more than if they had asked me if I wanted some cake, or if I should breathe.

Sometimes, women just want acknowledgement of what they’re going through, rather than changing what they’re going through.  At times labor hurts, it’s intense, you just can’t get comfortable and there is no way in hell you would call what you’re doing relaxation.  It can suck.  It’s time to honor that too.  Don’t fix us.  We’re not broken.

 

Orgasmic Birth: Our Review

This movie, Orgasmic Birth, focuses on the women giving birth, and that’s something the public has been waiting for a long time!! Every woman you’ve ever shared birth with is in this film. There is the mother who believes you trust doctors for everything and she ends up with an induction, epidural and baby finally born after two vacuum attempts … and she believes the doc saved her. You see the mom who also believes the same, is induced, and has a cesarean. However, the movie starts and ends with the mothers who have believed in the birth process, their bodies and that how they birth matters to their babies. You hear from fathers who love that their babies were born surrounded by their home and loved ones…their natural environment to begin life in.

Instead of the black/white contrast of The Business of Being Born, you have a sophisticated segue in the sense that the commentator’s information is presented around the story told so the dots are connected fully because these women tell their own story and the commentator fills in the ‘real’ story. It’s not told fear based, it’s told from a know natural birth perspective. No rant. It just is.

We believe that it is also the intent to interview everyone in a home or home-like atmosphere, with the exception of hospital footage for those two moms with routine medicalized birth … and that’s a smooth, thinking contrast. Every person is speaking softly even when venting on medical birth. Love the moment that Dr. Northrup tells us with medical intervention we “screw it up” — “it” being normal birth.

It is also one of the first films presented to the public to show a wonderful birth class outside of the hospital. We don’t know if it is the producer’s intent but perhaps the film is trying to turn Lamaze around and portray Lamaze in the Institute for Normal Birth light. We say this because the producers limited themselves to Lamaze. They did also keep footage of someone mentioning a Lamaze in-hospital class that they didn’t like.

We wish more had been done to represent other independent birth ed options as independent childbirth educators are among the most deeply anchored normal birth supporters in America and have always known that hospital preferred birth classes are a disservice to women, hindering their access to unbiased information and, many argue, used only for props to keep women birthing in hospitals. Around the world, normal birth education may not be done in the traditional setting that we in America are accustomed to but it is still independent of medical fear and bias, with knowledge transfer occurring rather as a woman to woman knowledge share with midwives as the informational conduit.

We do wish the film included reflection on mothers who are second or even third generation homebirthers as well. These women kept normal birth in America from completely fading away. There really needs to be a film as a tribute to these women pioneers. In other words, it is important that nations, especially America, fully recognize that home birth, normal birth is not something new; that women have believed in and enjoyed their normal births before 2008.

The births shown are wonderful. One of the best births is the mom who talks about childbirth as a mother’s sacrifice. You might cringe because you start thinking here we go… “Birth is painful. Birth is a sacrifice. Birth is about a medal.” However, to our delight, this mother delivers within a pretty normal window for active labor, 26 hours, she’s birthing at home and the midwife says outright in a hospital she would have been given pitocin and c-sectioned by now. The great thing is the mom talking afterwards about enjoying that birth for its own challenge for her if not for any great spiritual or relaxing birth story.

This is a great contrast to the mom who I mentioned above with the vacuum baby who says not until closer to her due date and hiring a doula did she hear anyone talk about embracing contractions. Until then everyone talked about labor as a difficult thing. You really do get the full connection of the contrast between the two women’s births… some of the responsibility lies with women doing the work to face and/or overcome fears… some of the responsibility lies with careproviders’ attitudes about birth and their inability to provide humanized birth. It’s not only about medical vs. normal birth. It’s also about what women are told, have been told and how it’s still quite accidental for women to hear about birth as an enjoyable event in their lives.

The abuse survivor’s birth and another homebirth will make you cry. The very personalized births will leave you smiling and swaying with the moms. Very cool.

We can’t wait to share it with you and we hope to see you at our screenings!! Just check our “Birth Events Near You” page on this blog.

 

Are you pregnant with abuse in your past?

Imagine yourself in labor, and suddenly a very painful memory intrudes your mind and consumes your thoughts. Imagine how distracted you would become. Your contractions could slow down and stop. The physical intensity of labor might be overcome with the emotional pain of your past.

But it doesn’t have to happen this way. You can prepare yourself during pregnancy by reading When Survivors Give Birth by Penny Simkin and Phyllis Klaus and Survivor Moms by Mickey Sperlich and Julia Seng.

If you have been abused or even just suspect that abuse may have occurred, you are highly encouraged to discuss it with your entire birth team. This includes your doctor or midwife, birth partner, doula and childbirth educator.

Remember, all of your care providers have a responsibility to protect your privacy and rights. If they believe it to be in your best interest, they may also go out of their way to help you obtain appropriate services. Open communication is important and will certainly make a difference in your over-all pregnancy and birth experience.

If you are able to share specific details, those caring for you will be able to make better judgments and be more sensitive to your needs. There are some things that might trigger your memories of abuse. Some are obvious things such as being in bed during labor or breastfeeding after the birth. But other triggers, unique to your situation, might not be so easy to identify. This is where communication between you and your caregivers can prove extremely beneficial.

Having vaginal exams are common during labor and at the end of pregnancy. But having them might put you in an extremely vulnerable position. If you let your medical team know about your history of abuse, they will be exceptionally sensitive to your particular situation and comfort level. You have the right to opt out of this particular intervention, and your choice should be respected.

Fortunately, there are many resources available today that help shed light and understanding on the problem of sexual abuse. Care providers typically maintain a list of resources that include local therapists or counselors that specialize in abuse. They may also have books, recommend websites, and provide educational materials.

get help

There are several options you can pursue in order to promote health and wellbeing. What may work for one mother, may not be the best method for another. Sometimes, you may need to experiment with several techniques before discovering which is the most helpful. A care provider should always be consulted prior to trying any form of therapy

• counseling
• talk therapy
• Hypnosis
• Emotional Freedom Technique (EFT)
• Reiki
• Massage
• Art
• Meditation
• Naturopathy
• Homeopathy

This is the first in a multi-part series on pregnancy, birth and sexual abuse. This article is written for the pregnant woman with a history of abuse. Future articles will be written for those who work with pregnant women and will address ways to help a woman during pregnancy and birth.

About the author: Lasi Leavy has 15 years of working with at risk adolescents. She is an ALACE Birth Doula and Hypnobabies Childbirth Hypnosis Instructor.

 

A Kangaroo Courts New England

Winter is still here in Connecticut. I drove to Capitol Avenue to formally hear the opinion of the Connecticut Medical Examining Board regarding midwifery, specifically Direct Entry and Certified Practicing Midwives. It began with the lot of us being told the doors were being opened for us to to come in but we need to keep the noisemakers, meaning the children, out. Dennis O’Neill, MD, Chairman of the Board explained the acoustics were so poor in the Conference Room they could barely hear each other let alone the audience who might speak.

 

At this point in time we know only that the charges stemmed from a transport case, a transport that was timely and resulted in a positive outcome.

 

It has been reported by members in the midwifery community that the case was not the result of poor care, a complaint from the parents, nor was there a maternal or fetal death. Although I never caught the actual root of this case I did meet Donna Vedam who had been through this procedure before and realized her case was why we found ourselves here again. In her case, parents who were more than overjoyed with their birth experience wrote their insurance company asking them to consider covering homebirth in the future and wrote how homebirth saved money, reduced the use of interventions, and improved birth outcomes. Someone somewhere in the insurance company read the letter and thought this must be illegal! They forwarded the letter to the State to look into and Donna was accused of practicing medicine. That charge was dismissed as it was determined that she was practicing midwifery and midwifery is not medicine.

 

Since that precedence already exists, the Board has to step up the charge and go for practicing nurse midwifery without a license. It is a step toward regulating midwifery in Connecticut — and make no mistake about it — a step towards eliminating the “problem” of midwives enticing women away from OB income, and opening the window to the proven dangers of many routine interventions.

 

In less than four minutes total the issue was brought up and voted on. Dr. O’Neill relayed that the case was dragged out over 21 months with only 8 actual days of hearing, after which there was no explanation as to why it took this long to finally bring the motion to a vote. Dr. O’Neill simply said “it eventually lay around held up in some office somewhere …(until now).” As for this writer, what the summation hints to me is that the testimony presented during those 8 days took a lot of time and energy for the medical community to understand.

 

A doctor raised his hand to move to uphold, another seconded, and then all of the Board Members unanimously declared to uphold the decision.

 

Neither the motion nor the decision were ever actually stated, but it was to cease and desist, don’t do it again — “it” being practicing medicine without a license. What this hints to me, the writer, is that formally stating the decision would require an explanation supporting the decision and no one was prepared to do so, either as a subversive tactic for the day (we were actually thrown out, prevented from taking a peaceful group photo in the lobby), or as an ongoing tactic of “because we can.”

 

What is important for all women to know is that the board isn’t made up of consumers or consumer advocates. If it were, it would have members such as homebirthers Jennifer Wisner, Tammy Gallo, Tara McElfresh, Lisa Breton, Aja McCarty, and Bruce and Randy Neely who were here with their homebirthing daughter, Kendra Smith. They might have included a gentle birth La Leche League leader like Rebecca Cronon.

 

I think the Board’s worst fear, though, is that a member of their own community, someone like Susan Parker, RN, CEN might have been on the Board. As a hospital-based nurse, Susan has seen “the worst of the worst including witnessing a maternal death just six months before” she herself gavebirth. The experience left her even more determined to birth at home.

 

Which hospital you ask? Avoiding that hospital in particular won’t keep you any safer in birth. Maternal deaths in hospitals are everywhere like Hawaii, California, and New Jersey, as well as many other states and the truth behind the stories aren’t being told. Consider this, embolism is one of the leading causes of maternal death. Risk of embolism increases with surgical procedures and the cesarean rate is climbing steadily!

 

We are not arguing that no one ever needs to birth in a hospital nor that everyone needs to birth at home. The point is that we have medics who do not know normal, natural childbirth, but they are making unfounded decisions about a non-medical event. This, while they are forgetting to investigate their own at the least, and turn a blind eye to their own at worst.

 

The midwives’ next step is an appeal or to argue for the right to argue the decision. 

 

I may not have been alive in 1692 but what transpired over the past few years and culminated in today’s five minutes in Hartford, Connecticut, could only have been done better were the Board Members in period costume.

 

The Role of a Doula

Recently The New York Times wrote about doulas and the article left a negative impression about doulas, and tossed in a criticizing lactation consultant comment as an aside. To take the view that the New York Times article does–as an across-the-board view that doulas are problems–is an error. The paper presented a complaint rather than pursuing a couple of viable angles: the many expectations that mothers and partners have of labor support today, and the licensure of female support at birth such as midwives, birth educators in the role of birth support, monitrices (someone who has been trained to provide some clinical assessment in labor usually while mother is at home) and doulas.

There are now many birth support and whole birth health care options for women to learn about, choose from and advocate for change. Midwives, independent childbirth educators, doulas, birth centers, homebirth and breastfeeding are now more commonplace subjects to bring up when planning birth. Women today are realizing that they need to avoid interventions such as induction which carries a higher risk for cesarean or just arriving at the hospital too early; and there are options available to support their refusal to fall in line with industrialized birth. In response, hospitals are trying to offer more and more amenities but many parents recognize that in spite of measures by hospitals to draw them in by offering a luxury tub or more comfortable birth room furniture, hospital birth is still hospital birth. Seeing the smoke and mirrors, women who still choose to birth in a hospital may seek additional independent female support in birth which has been shown to be a positive influence on outcomes. However the benefits of the additional birth support is very clear in the birth community and we hope the media will take the time to do more in-depth articles on the anthropology of women in birth, culturally and traditionally.

It is confusing for the public to read contradictory articles posted by the same journalism venue such as this one from CNN that says doulas advocate for you and then CNN also posted this article stating “doulas are not supposed to offer a medical opinion….strictly to motivate the mother.” What remains the focus for women is that we still need to think independently, make our own choices and employ those who support our choices from birth care to birth itself. Women have many different reasons for hiring a doula besides strictly whether or not to ask them to advocate. Doulas can make fathers and siblings comfortable with birth and help them enjoy birth too! There are obstetricians, midwives and labor and delivery nurses who have witnessed doulas as an extra pair of caring hands so that all participating in the birth remain fresh and positive during a labor and birth–especially an intense birth. Doulas help military moms birthing without their partners. Doulas are sometimes even interpreters! This is a day that many never imagined: birth support, midwives, homebirth, unassisted birth, informed birth, etc. are all in the headlines!

In many states women’s choices are being restricted and the birth community continues to work together for the greater benefit of society at large ~ improving mother and baby outcomes ~ and for the mothers and babies where you live!