Thursday, December 27, 2007

A Happy Year, Indeed

Happy New Year, Dear Readers
I look forward to the many changes the new year will bring. I continue to work diligently on my book. Not quite ready for a send out yet, for those who have volunteered for my reading group. I'm excited about the possibilities this book brings. I just booked my first speaking gig for 2008 (my agent negotiated a very lucrative deal)! I also sent an article to The Birth Project, a Michigan publication. This year will also mark the second anniversary of this blog. Whodda thunk it? My work in this world is beginning to take shape at last. I'm more excited about birth than ever, and the possibility of delivering my message to those who desperately need to hear it (women and care providers alike) makes me feel vibrant and alive.
To think, an annoying an inconvenient pregnancy at the grand old age of 45 has initiated all this. As an extra bonus, we have a 1 year old toddler who makes a mess of everything in his line of sight, and also just happens to be the light of our lives.
Maybe God knows what she's doing after all.
Peace to you all in the coming year.

Sunday, December 16, 2007

World Traveller

I got in! Next month at the end of January, I will be attending the US Breastfeeding Committee meeting in Washington DC. Now I was not chosen for one of the freebie slots offered to two people from each state (my buddy Charlene got one of those) but I was selected for on "Open Slot" which just means I pay my own way. Unfortunately this means I won't get to go to Mexico for the San Miguel Walk. Both events happen over the same weekend. I'll miss Mexico and San Miguel.

My favorite memory of both times is watching from across the street as hundreds stream into the local parrochia (church) to participate in the special mass and recieve the special blessing before the walk begins. It is pitch black 0utside and the moon is high. Its about 4:30 am and the air is cool. We are all dressed in layers since the temperature will reach about 80 degrees at midday, but at the start of the day a hat and gloves are needed. We mill around our truck as the cook hands out atole (a hot corn meal based drink that is thick and reminds me of hot chocolate) and tamales (usually cheese tamales for breakfast, at first I don't care for the taste of them and stuff two of them into my pockets, several hours later during the walk, I am ravished and they taste like mana from heaven) We will walk about 8 hours today, the first 5-6 before we stop for lunch. The mood is quite festive and as the walk officially begins at sunrise, it appears the whole town has come out to see us off. They line both sides of the streets as the walkers or peligrinos (pilgrams) as we are called head off into the great distance on the road out of town. We are preceded by native dancers and municiple bands. There is a great clamor of humanity as 10,000 souls stream out of San Miguel on the road to San Juan De Los Lagos in the neighboring state of Jalisco (actually there is no road, we mostly travel through mountain ranges and cow pastures- somehow the leaders know the way). Onlookers press oranges and bottle water into our hands, it is said to be a blessing to give something to the pilgrams during their journey. One of those oranges becomes a blessing to me. The thin air and high altitude are hard on a midwestern girl. At one point I am dizzy and tired from dehydration and low blood sugar. I remember the orange in my pocket, peel it and gulp it down. Its sweet juices immediately revive me as I continue walking... The town of San Miguel seems a second home to me. Its streets are sweet and familiar. I have a favorite park, a favorite restaurant, favorite shops, a bank I prefer, and an internet cafe where gringas are warmly welcomed by the owner. When I return I would like to stay a month and attend language school. The locals are used to foreigners and are very patient with those who don't speak the language well. I get stares on the street because I wear my hair very close-cropped and because I am dark-skinned. I'm sure they don't see much of either. I take to wearing a straw hat or serape over my head to keep from drawing so much attention from my nearly bald head. I am head and shoulders above most of the indiginous indians, even the men. I am so tall and so fat- this too makes me stand out. Estrella, my American guide reminds me to smile to soften my face and put them at ease, or else I look severe to them. She is right, when I smile, they always smile back. All this and so much more I will miss of San Miguel when I am not there next month. The street vendors selling my favorite snack, cool peeled cucumber drenched in lime juice and sprinkled with red pepper. Sitting down to miskas (mexican scrambled eggs with vegetables and torilla strips cooked into the eggs) at my favorite haunt. The slower and decidedly different time frame. I usually started my day with fresh fruit at around 7am but didn't have a real breakfast till nearly noon. Amazingly (to me) all the restaurants were still offering breakfast at noon. Lunch time didn't start until around 2pm. Here in KC, you'll get no breakfast after 10:30 unless you find a restaurant that serves breakfast all day. Dinner time was about the time I usually went to bed! I would purchase cheap and abundant avocados and tiny flavorful limes along with handfuls of fresh cilantro and make my own guacamole for snacks or meals at tiny little store front shops that were located about every other block. Or for a few pesos, I could buy a freshly made tortilla stuffed with chicken, napoles (cactus), and beans from a street vendor. Can one be homesick for a place that is not actually their home? My heart, my head, (and now my stomach) tells me that it must be so.

Tuesday, December 04, 2007

The Value of Worth

I had dinner with a midwife last night. We chewed the fat about how things were going and I reflected on the first time we met... I had invited her to my office for a meet and greet. This was around 2002 or 2003. She accepted my invitation and we sat and chatted a couple of hours. (I often meet people this way. If I want to get to know someone, I simply call them up and invite them out to coffee or lunch or something.) During our conversation I asked how her collaborating physician was compensated, and she confided that he got what seemed like more than his fair share of what she made. "What !?!" I yelled without stopping to censure myself, "that's more like pimp and prostitute than doctor and midwife!" I pictured some middle-aged guy in a lab coat but sporting a purple feathered fedora and two-toned wingtips... I chuckle about it now, but that was really a defining moment for me. I wanted to help women have better births and more options, but the work of the midwife seemed so unfairly compensated. I also saw midwives getting little respect from their OB colleagues while doing twice the work for half the pay. I dropped in on a local meeting of CPMs last week and found them discussing compensation for their work. They laughed about how clients would say they could not afford their fees and yet would miss appointments because their pedicures were still wet, or their massage appointment ran late. If we want to be valued for what we do, we must first value ourselves and the work we do. I want to help women, help themselves. I want to help careproviders provide better care AND I want to be well compensated for it. Do those values seem at odds? They are not. They are both essential to a quality life.

Sunday, December 02, 2007

Midwives locally, breasts globally

The United States Breastfeeding Committee is once more planning its annual conference for state breastfeeding coalitions. They sponsor two attendees from every state to come with expenses covered. I did not get one of those slots, so I applied to attend in one of the limited open slots (which means I pay my own way). I'm hoping to get a slot and attend in January since they have some special training they are doing on lactation support in the workplace. A member of my breastfeeding committee, Charlene, was selected to attend last year, and may be selected again this year, so at least Kansas City will have someone there if I don't make it. It would be so cool to meet breastfeeding coalition members from all the US states and territories (and Tribal Nations). I'm keeping my fingers crossed, its a very selective (and costly) event.

I got an email from a reader in my area looking for a certified nurse midwife to do a homebirth.
She had mentioned that she wanted a 'legal' homebirth and therefore only wanted to interview CNMs since CPMs are not legal in Missouri. (Though technically, the illegality is on the part of the CPM for attending her, not on her part for hiring one.) I encouraged her to interview the two CNMs she was aware of but also to consider this option:

"If you are considering a homebirth with a CNM, I think you might find Sage Femme and its midwives a pleasant surprise. It provides a lovely birthing environment and Kirsten Miller was my midwife for my homebirth last year (she no longer does births at home). I think she is wonderful and ditto for Sage Femme. It is a jewel and a well kept secret. If I were you I would appeal to my insurance company- they may very well cover a birth center birth. I went through the appeal process with my insurance company, who at first refused to pay anything. They eventually (it took a year!) covered 100% of the cost of my homebirth- even though their policy was not to pay for them. To speak to your comment, "I was afraid that my options might be limited" - they are. That is why we as birthing women must be willing to negotiate for what we want in birth- and fight if need be. Let there be no doubt- women are losing their options in birth. If we don't work to keep those options open, no one else will. "

Though I really don't want to steer this woman away from homebirth (I hope she'll be happy with one of the two midwives she has to choose from), I was happy to be able to offer another option. Women like this are exactly why I'm writing my book. I can't tell you how many women I meet or hear of who are interested in homebirth but drop the idea because they can't find a midwife to attend them or buckle under the pressure of opposition. My book won't create midwives where there are none, but I'm hoping it will help women find the resources they need to make their births happen in an out of hospital birth environment. (For instance, I'll have a whole chapter dedicated to dealing with insurance companies.) Homebirth and Birth Center birth are the real options to hospital birth. What can we do to make them more accessible to more women?

Saturday, November 17, 2007

Read and Feed (back)

Here's the plan for those who have volunteered to be in the reading group-
  1. Around Christmas vacation time, I will send out via email, the confidentiality agreements to sign.
  2. When they are returned, I will email 3 consecutive book chapters to each volunteer reader along with the evaluation tool.
  3. Readers will have 2-3 weeks to return the evaluations with feedback.

Also in the works:

Yesterday I met with the midwives of Sage Femme- a local birth center. I have been talking with them about possibly doing some births there (as an L&D nurse). Ever since I visited there I can't stop thinking that I'd like to be involved with it in some way. I've been on a birth fast for a year now (since Josiah's birth) and I think I may be ready to go back and do a few births- maybe. I will be on call for this month and the next, try a few births, and see how it goes. I promised myself I would not sit bedside at birth again if it meant hurting women. Of course I expect this to be different, but I'm still nervous. I would love to update and sharpen my L&D skills and it would be the first place I've ever worked where the emphasis is on client care and not monitor-sitting. I need to see with my own eyes what birthcenter birth is like, however my time is so limited. I'll try a couple of births, see what its like, then decide whether or not to take it on as a parttime job. If I don't find that I care to do L&D work, I might switch to marketing and promotions. Either way, I think it will be a grand opportunity.

Thursday, November 15, 2007

Practice Makes Perfect

I was watching The Practice last night. I watched it specifically because there were going to be three births on it (okay, I watch it anyway). I was pleasantly surprised. The show actually had 3 unmedicated births (I hesitate to use the word 'natural' since the situations were so surreal- for example, crazed gun-woman birthing in the midst of committing a felony). One was even a waterbirth. None of the 3 births took place in a hospital. It really made me think about the premise of this show- not the relationships among the characters- they're all neurotic- but where the hell is this practice? I don't mean the city, I mean the theoretical framework. Their practice appeared to be set up to do births in their office. I have never heard of such a thing- have any of you? I know their office is not inside a hospital- I don't know if they are supposed to be near a hospital or not, but they have rooms with beds inside their offices. Did I miss some important element of the plot about where they are located, because they seem to do things in their offices they I didn't think docs did in offices. Another thing- I love that their practice is multi-specialty. Wow- is this really happening somewhere? I think its a great idea. Who needs a practice with 13 OBs that all have the same philosophy? They just sort of cross-refer on the spot (although I can see where this can become a problem, even compromise confidentiality). Anyway, enough marveling, back to the births:
One waterbirth with a woman whose husband had recently died (she sorta relives her loss during labor). The pretty but repressed doctor complains that waterbirths are icky, but in the heat of the moment, she jumps into the pool fully dressed to give physical support to the distressed mother ( I was really proud of that character for that). I was also really proud of the birthing mom who was very authoritative and took control of her birth. She was actually directing everything (until she lost it during transition, calling for her dead husband)
One office birth for a woman having baby number 4- she is expecting a long awaited girl but instead gets another boy- and she's not pleased. The male nurse actually catches the baby when she labors very quickly and the doctors duck out of the room to develop secondary plots.
One young woman births while robbing a convenience store- and oh get this- the doc doesn't just happen to walk into the convenience store, he's answering a house call- a house call! Has anyone out there every had a doc do a housecall??? (Actually I have, but its been more than 10 years ago)
This show really had me thinking about how healthcare is delivered. (It also made me think about how friends shouldn't be having sex with one another- but that's another blog entry- in another blog!) I've complained for a long time about the lack of innovation in healthcare delivery, so imagine my surprise at getting inspiration from a somewhat lascivious TV show. Oh well, I'll take my inspiration wherever I can find it.
I actually caught myself daydreaming about turning one of my training rooms in my office into a birth space! (Let's see, shove those manikins to one side, suspend a rope from the ceiling, throw around some beanbags, install surround sound and voila!) I'd call it my 'birth observatory' since I'd employ a hands off approach. Just stop by, hang out, and birth a baby.
Birth can be so much more simplified. I always thought hospital birth was such a HUGE production. Such a simple process taken to an extreme of regimentation and regulation. I'd like to lead a movement to 'declutter' birth. I'll have t-shirts that say BIRTH SLOW : ) or 'Squat and Deliver' and go on cable access shows to demonstrate a step by step process for braiding your own birth rope or write a pamphlet on 101 uses for a placenta. Women everywhere will demand 'Uncluttered Births' that are void of hidden trays and cabinets of medicinals, or hordes of staff that appear at precisely the moment your perineum starts to bulge. In 'Uncluts' (as they will come to be known) there will be no hierarchy and everyone will be called by their first name- the only one who 'delivers' the baby is the mom. The birth plan will be the supreme document, not consent forms. In fact, the caregivers will have to sign the mother's consent form to be present at her birth.
See what one little episode of a TV show has started. I'll be dreaming this stuff all night...

Wednesday, November 14, 2007

Reader Love

Beloved Readers,
Thank you for your outpouring of support for the upcoming book. I love that so many of you have emailed or left blog messages stating your desire to be a part of the reading group. However- I have decided I will not let anyone who already knows me be in the group. Sorry, I just think I'd get more objective feedback from those who haven't actually met me yet. I might be wrong about this, but I'm going with my gut on this one. However if my local friends could send me names of potential couples for my homebirth workshop in January, I'd be very grateful- I only have one couple so far. Fishing for speaking engagements is going very well- I have applied to several national and regional conferences this week. I'll post them on my website as I get confirmation. My goal is one speaking gig a month. I'd also appreciate any heads up on any conferences any of you might know about that might be appropriate for me. I found a website called Lact Speak that lists lactation speakers for hire. This was such a cool website, and so user friendly. I plan to sign up for it. I looked for a similar website for birth speakers and didn't find one. The Lact Speak site was so simple, I toyed with the idea of starting one myself. Birth Speak anyone? Your warm encouragement and well wishes spur me on- I'm indebted to you all.

Monday, November 12, 2007

Mothering Magazine

I've been meaning to write this post for a while now. While at the LLL conference a couple of weeks ago, I picked up a complementary copy of this month's Mothering Magazine. Folks, this is an EXCELLENT edition. I read it from cover to cover and loved every story. The features included, "Cesarean Birth in a Culture of Fear," "Homebirth in Holland," and "The Legacy of Black Midwives," and also a story on the benefits of extended breastfeeding! I loved reading this issue.

In writing about cesareans, Wendy Ponte, may not know it, but she has the fine makings of a book outline here. Her article was so well written, thorough, and knowledgeable. She quotes all the right folks and draws all the right conclusions and makes a very rational argument for lowering the rate of cesareans, while at the same time showing why they may continue to go up. Pregnant women should be reading articles like this one in the doc's or midwife's waiting room.

Birth in Holland took me back to The Netherlands. This American mama, married to a Dutchman and living in the city of Utrecht, writes about her homebirth there and how vivid the contrast is when birth is truly seen as normal. Part of my enjoyment of this story, is the teller's view of Dutch culture juxtoposed to American. She also writes of Utrecht, a city I walked the streets of when I visited The Netherlands several years ago while attending a Midwifery Today conference. Its ancient cobblestone streets still beckon me back. I loved how she writes that no one ever gave her a pregnancy test. When she presented herself as pregnant- eveyone just believed her! From there the story flows forward with little tidbits of delight all along the way... especially as she makes comparisons with her first birth in America (you know, that place with the best healthcare in the world...)

Black Midwives is about Miss Shafia Monroe, and her organization (The International Center of Traditional Childbearing). I've had the pleasure of meeting her and presenting at her annual conference a couple of years ago. She is a true pioneer and she was in fact, honored at this year's MANA conference. She was not in attendance due to a family emergency, but her husband and several of her staff were there. The article was a nice overview of the organization's and Shafia's accomplishments.

So if you have access, you might want to pick up a copy. When you finish reading it, perhaps you can just happen to leave it in a OB waiting room.

Book Update

Dear Readers,
I'm happy to report good progress on the book and have two requests of you:
1) I'm looking to recruit a focus group to pre-review the finished manuscript and give gut-wrentchingly honest feedback. (I will most likely move ahead with self-publishing- I have an editor, I'm looking for feedback on content.) You do not have to be in my physical vicinity. I will email it out. You have to commit to reading it and giving your feedback. You'll also have to be willing to sign a confidentiality agreement. Just respond to this post if you are interested. The manuscripts will go out after Christmas, and the focus groups (facilitated by someone other than me) will be held (via email/yahoo group) in mid January. I'm looking for about 20-25 folks regionally, nationally, and internationally.
2) I'm looking for homebirth couples due next Spring and Summer to test my workshops on. These folks DO need to be in the Greater Kansas City vicinity or be willing to travel to my locale (I have access to very low cost accommodations). The weekend long workshop will be free and held in January (date tba). I will take 4-6 couples. Using my book as the text, the workshop will prepare them for a homebirth. This test workshop will require extensive feedback as well. I also plan a test workshop for doulas and childbirth educators on homebirth preparation, but I have enough local folks to use for that one.
Thanks everyone for your feedback and responsiveness. I know I've been like a cat hiding her kittens about the book, but I've felt an intense need to write in isolation. I'm just about ready to come out of hiding.

Friday, November 09, 2007

Missouri Update or Show Me the Midwives

I thought I'd send along an update for those who may not have heard what became of the Missouri Bill to legalize midwifery. The short version is this (taken from the Friends of Missouri Midwives newsletter that just landed in my mail.) The bill was shot down before it took affect at the end of August. A bunch of medical organizations (including ACOG) sued to have the addition to the insurance bill ruled as unconstitutional. They won. Now there is an appeal to the Missouri Supreme Court underway to overturn the ruling. Its an exciting saga... stay tuned.

Read the article in its entirety at

Ready for a controversial question? (Of course you are, why else would you be reading this blog?)

Will making midwives legal really fix what ails us as a state? I just followed the link Dawn sent for a local mother's online forum. The discussion was on the best place in town to give birth, and to hear all the women chime in about their wonderful hospital births gives me pause. Women don't know what a good birth is. Having legal midwives may increase options, but what if those midwives are forced to deliver up the same old, same old that women get now. Lots of folks assume legalization is a good thing, and I suppose in some ways it is. But what drove me from the ranks of aspiring midwife was looking around and seeing midwives who were doing the very things they became midwives not to do. Look, I'm not knocking midwives, I love midwives. I just believe wholeheartedly that we live in a culture that is devoted to making midwives into mini-docs. Our culture does not even begin to appreciate the solutions that midwives have to offer. They want to police and legislate them into servants of the status quo. I want REAL options. I want NEW ideas. I want birth on MY OWN terms. The best conversations I've heard this year have been about unassisted birth. I want a revolution. I want transformation. What will it take to see real change?

Thursday, November 08, 2007

Conference Recap

I have been remiss in that I have not written about the three conferences I recently attended, so here is my recap of each:

MANA 2007, Clearwater Beach Florida

I have to say that I did and I didn't attend this conference. Though I was a registered attendant, I did not attend any other sessions. I wanted to, I was just too focused on my own presentation, and technical difficulties kept me from getting beyond my own concerns. I even missed a plenary session that was the buzz of the conference. The topic was racism among midwives and apparently there was some pretty cathartic conversation that went on- but I missed it. My roomates (3 midwife students from the same Florida school) and I had very long and heated discussions into the night on this topic which was in its own way interesting if not productive. My roomates included a Haitian-American (she spoke bitterly of the racism she experienced from African-Americans), an international student from Switzerland (she came to the US for homebirth experience!!!!), and a Caucasian American, and of course me, a Midwestern. middle-aged, black woman. On the topic of racism in midwifery, I can only say that in my corner of the world, I was enthusiastically welcomed and encouraged on my midwifery journey. There were some who expressed disappointment when I changed courses. To this day, there are no midwives of color in my community (or even in my state to my knowledge). Midwives of color remain as rare as hen's teeth.

My session turned out better than I could have hoped. We had a rousing discussion on the ACOG (American College of Obstetrics and Gynecology) statement on homebirth. Oddly, it can no longer be found on their website. I talked about when this statement was published last October, it so enraged me, that I wrote this session and proposed it to MANA. Since the statement is a year old now, we talked about its long term impact to the politics of birth. We also looked at organizational responses to the statement when it came out- that I pre-printed for my audience. We then brainstormed on our own responses to the statement, both as individuals and within our own organizations and communities. This was where things got good. We sited as problems, a lack of scientific evidence that out of hospital birth was unsafe, a lack of scientific evidence that hospital birth was safe, how out of hospital birth collaboration among caregivers was discouraged, how the statement denied an inclusion of all stakeholders, and the socio-economic impact of the statement. We sited as solutions models for clinician collaboration, grass roots action, policy and political change, advocacy models, and pushing for change within the insurance industry. There was also talk of starting an organization or organizations just to address the problems this statement has created or perpetuated. I was so proud of the nurses and midwives in my session. For sure I was preaching to the choir, there were no dissenting voices- but that's why I gave this talk at MANA to fire up the troops. I remain in dialog with a couple of the midwives about starting an organization or two. I see a need for an advocacy organization devoted to out of hospital birth in order to provide resources to women seeking options and create solidarity for out of hospital providers.

KC Doula Conference, Kansas City KS

This conference was a real treat- again I didn't really attend any of it, but my part, but what I did attend was excellent. I participated in a panel the ran the entire morning. The information was so good and of such high quality. The panel included experts speaking on the birth experiences of: deaf women, Latino women, African-American women (that was me), Somali women, and Korean/Chinese women. Each panel speaker gave an intriguing look into the birth customs of her culture (or the culture she served). My favorite was the speaker on deaf culture. I had never thought about birth from the perspective of someone who cannot hear before. The doulas here always put on a good conference and this year's was no exception. The CNMs put on an annual conference as well, but it tends to get more and more medicalized. Perhaps I'll throw my hat into the ring for next year and propose a session on homebirth and scandalize the community!

La Leche League, Missouri Conference- Columbia MO

This was by far the best of the three conferences for me. For one, I didn't present, that helps. I did have a booth pedaling my speaking wares, but I was rarely at it. I mostly perused the workshops and for the most part liked what I heard. I definitely need to submit a proposal for this conference. There was lots of talk around the edges about the impact of birth on breastfeeding, but for me this needs to be a direct hit- successful breastfeeding begins in labor. My biggest treat was hearing Dia Micheals and Diane Wiessinger. These ladies are real pros when it comes to lactation presentations and they did not disappoint. Diane was particularly inspiring on her talk about the importance of mother to mother support groups. Dia was intriguing when she talked about lactation models of other mammals (lactation = childhood, when animals stop nursing its because their young a ready to go out on their own- very interesting). My favorite session was by a local hospital chaplain on the grieving process and supporting families during an infant loss. This session was sooo good and practical. Childbearing loss has long been a clinical interest of mine and I learned lots of new things during this session.

So that's my recap. In the next day or two, I'll have pictures to post. Its been a busy Fall and now I need to get started planning speaking engagements for next year.

Sunday, October 28, 2007

Reprinted from The Kansas City Star

Dawn, a loyal reader and responder wrote this essay that appeared in our local paper. I wanted to share it with the rest of you. Thank you Dawn.

Respect, not callousness, for at-risk babies
Special to The Star
“The name is Jillian Faith,” my husband said, letting me know we had a girl. I was handed my tiny baby as the nurse proclaimed, “She’s beautiful, perfect.”
Five months earlier I was not certain I’d hear “perfect.” My prenatal blood screen results showed a risk of Trisomy 18.
Fear sent me online where I learned an extra 18th chromosome would likely give her a malformed brain and failing organ systems. More than 90 percent of babies with Trisomy 18 die within one year.
After two ultrasounds, she looked healthy, but there were no guarantees. I wanted an amniocentesis test just in case. I’d plan a Cesarean section to see the baby alive or for care after birth.
The perinatologist said he would do amnio only to pressure me to avoid heroic measures for “that type of child.” I realized that if Trisomy 18 was verified, my baby’s life could be valued less by others. I chose not to undergo the test, but I still worried.
I found myself in a support group for families whose babies are affected by Trisomy 18. I learned that parents with a prenatal diagnosis could expect to be treated in one of two ways: with coldness or compassion. Many stories touched my heart, but two in particular show the difference a doctor can make.
Christian was diagnosed with Trisomy 18 by amnio. The parents were immediately encouraged to terminate after an initial ultrasound.
After the diagnosis they were denied any further tests. The family was told they were “choosing when not if” their baby would die and were informed that “doctors don’t help babies with Trisomy 18, because they are incompatible with life.”
Early on, Christian’s parents were instructed to call when the baby stopped moving in the womb. Week after week, Christian kept moving.
He was alive when measurements showed too much amniotic fluid. He was alive when the induction began and when he was in breech position. Christian’s parents wanted a C-section in hopes of seeing their seventh child born alive but were denied monitoring or a C-section during labor.
Christian was stillborn with a cord tightly wrapped around his neck. The death certificate lists Trisomy 18 as the cause. Christian’s mother carries grief from the loss of her child and anxiety from the medical care. She believes that her son may have been born alive if he had been monitored during childbirth and blames herself for not demanding a C-section.
A different case was Teodora’s. She was also diagnosed with Trisomy 18 at mid-pregnancy. She was her parents’ first child. They decided to carry her to term.
Teodora’s mother visited two doctors before finding Michael Berman, an obstetrician and Yale University professor. Teodora was monitored closely in pregnancy, and born at 39½ weeks by C-section. She lived for more than two hours.
The medical staff went a long way to help the parents honor their daughter in life and in death.
Here is an excerpt from a letter read by Berman at the memorial service for Teodora. His words speak about the respect for Teodora’s life despite her supposed “poor quality of life.”
“As physicians it is the greatest professional privilege to participate in the care of a pregnancy and the birth of a child. Yet the bar is raised when the child dies. As elation turns to grief, and joy to sorrow; when in a brief moment the expected becomes the unexpected, this privilege becomes sacred. For we are first to see and touch her, we inscribe her image indelibly in our minds, and her death, in paradox, does not sear our bonds of caring but rather seals them.”
I think Berman picked the better way. His actions showed his value of a child’s life, even in death.
Dawn Meisenheimer Lewis, a former teacher, lives in Gardner with her husband and six children. To reach Midwest Voices columnists, send e-mail to

Sage Femme Birth Center

Something wonderful has been going on right under my nose, and I missed it. Sage Femme Birthcenter, in Kansas City Kansas is an absolute jewel. The doula conference I recently spoke at took place at Sage Femme. Though I've known about the birthcenter since before it opened, I've never visited there before. What a fabulous place. I'm a longtime admirer of the CNM who runs it and listened to her speak of her dream, years before it manifested. As I toured the birthcenter over the conference lunch break, I had an almost out-of-body experience. It hit me that I should be promoting this place. My kinswomen should be birthing there. My friends (okay friends kids) should be birthing there. I think I've just changed where I get my well-woman care. We do have another local solution to hospital birth.
Sage Femme.

A New Epiphany

MANA, as always, has rejuvinated me. I also spoke two days ago at our annual Doula conference on the African-American experience of birth. That was awesome! I sat on a panel with others who spoke about Latina, Chinese, Somali, Indian (from India) and Deaf women's experience of birth. It was sooo informative. Conferences like this also bring out all the local activists whom I enjoy hobnobbing with. One local midwife, had a showing of Ricki Lake's film- even though I just saw it in Florida, I hated to miss this viewing (I had to teach a CPR class) because I wanted to hear women's reaction to it. I'm grateful to be surrounded by such an active and thriving community of birth activists, not everyone has that.

On to that epiphany...
It has finally settled into my soul, what this book is about and why I'm writing it. For the past year, I've struggled to write not knowing my direction. After the past two weeks, I'm sure. I now know who this book is for and what it is about. I've even come up with a finally suitable title. I've written my query letter to find an agent. I'm told I should send out about 100 querys to find 10-20 agents interested in reading my manuscript in hopes of getting 1-2 interested agents. Well, I'm ready. I've had worse odds than that before. However, should I not find an agent and publisher at the end of this process, I'm equally ready and willing to self-publish.

The 15 minute excerpt that the Brits sent me was excellent. Now I understand the difference between a home movie and a documentary. I can't wait to see what a one-two hour long version might look like. (watch out Ricki Lake) Thanks to Larry and Lucy for fed-exing it across the pond in time for MANA.

What's next? I'm scouting out my next speaking gig, but I'll be attending the Missouri LLL conference next weekend to see some stellar speakers like Dia Micheals. I'll use the time to pick up tips and ideas on my own speaking career. The following weekend, I'm heading to the Holy Land, the retreat center owned by my hermitess nun friend. I'm waaaayyyy overdue for some R&R. I'll hang out in her teepee and have some time of solitude and meditation. I need to reflect on all that has transpired this Fall and how my life is changing. I'll regroup and be ready for Spring engagements. I also hope to return to Mexico in January to do the San Miguel Walk. My goal for finishing my book is December, I'm keeping my fingers crossed...

Saturday, October 20, 2007

In The Belly of the Whale

I just had a chance to watch the second half of Ricki Lake's 'The Business of Being Born' My roomies and I were late getting back from the restaurant but I'm glad I snuck in to catch the last half anyway. Being here at MANA this weekend is really intensifying my desire to advocate for women. They need to know the truth. It's my job to tell them. But I'm just a modern-day Jonah running from the task I've been given to do. Finishing this book will not be easy, but it will be a labor of love. Things have just gone from bad to worse. I've got to do SOMETHING to stem the tide of runaway inductions, and cesareans, and epidurals, and pitocin, and cytotec, and on, and on, and on. This is not good for women. It is not good for babies. Something has got to give. Women are dying. NICUs are filled with babies made to be born too soon. Women need to know the risks associated with hospital and medicalized birth. Its time for me to head on over to Nineveh...

It Is Done

I have now completed my session at MANA. I thought it went very well. I built in lots of discussion and the midwives were eager to express what was on their minds and in their hearts.
I was even able to show my video excerpt. Lucy and Larry did a phenomenal job on editing. It was quite powerful to watch and I am inspired to really get the book finished. I will take courage and tell my story. I'm so grateful to be here, amongst these men and women. Everytime I come to MANA, it renews my faith. My three roomates are all young midwife students. I love my conversations with them. I've also met a Dear Reader who introduced herself to me. It has been such a blessing to be able to come, one I'm very grateful for. I'll write more later. Right now, I'm off to the Red Tent for some time of quiet reflection and afterwards its dinner at a local seafood restaurant-fresh seafood in the midwest is very expensive so I'm looking forward to having it while I'm here in Florida.

The Big Day

I'm here in Clearwater Florida, just across the bay from Tampa. Its lovely and warm and rainy here. A nice change from the much cooler Midwest. I love being at MANA. This conference always has such a lovely feel to it- the midwives give off good energy. I'm putting the finishing touches to my powerpoint and adding to my list of AV needs. I'm hoping to show the 17 minute video Lucy and Larry fed-exed from London. So far I've haven't seen it but I'm hoping to get some good help here to get it up and going. I've been praying and meditating to give my audience a worthwhile experience. I want it to be powerful and inspiring for them. I'm really looking forward to doing the presentation in about 3 hours. Thanks, Dear Readers for all your well-wishes.

Friday, October 19, 2007

Ready or Not...

Josiah turned one last week and it seems fitting that to mark the occasion, I'm headed to the MANA (Midwives Alliance of North America) conference in Clearwater Florida to speak about his birth experience. It is a privilege to do so, but I am nervous about how I will do. Keep me in your thoughts- I'll write later about the conference, which I'm sure will be wonderful.

Thursday, October 04, 2007

I Must Be Dreaming...

Been drop dead busy of late. I'm preparing my presentation for the Midwives Alliance of North American (MANA) conference- remember, if you'll be there, come say hi. This month is also Josiah's first birthday (can you believe it???) He's been such a fussy little spider monkey these days with teething and all. I'll post some pictures soon. I also have another presentation on birth a week after the MANA one on 'The African-American Experience of Birth" (I have no clue what to talk about for that one!) . I'm teaching my first NRP course tomorrow and don't feel prepared AT ALL. This month is also my wedding anniversary so I'll have to think of something special to do for my darling husband. In the mean time my business is busy, busy, busy. I need to sit, catch my breath, and think about birth and what messages I want to relay about it. I changed my website to focus on holistic birth and birth practices. I've been studying the websites of other speakers/presenters to get ideas. Bear with me Dear Readers. I've got lots to say, just no time to say it! On the other hand, I'm starting to live the life of my dreams...

Sunday, September 23, 2007

A Night to Remember

I was blessed to enjoy a lovely day for my 45th birthday party. I covered the tables with lavender cloths and yellow folded napkins. I placed a flower bulb wrapped in tuille and tied with a matching bow as a favor above each napkin. The florist created lavish floral arrangements in purple and yellow for each table. The weather was flawless, warm, but not hot, and very little wind. The garden was in full bloom and the harpist was positioned in one corner. Her melodious tunes greeted guest as they arrived. There were lanterns and tiki torches and luminaries to give light to the evenings festivities. The buffet line was set up under the carraige port. We served beef brisket, fried chicken, macaroni and cheese, greens (mustard, collard, and turnip) and dinner rolls. For dessert there was peach cobbler and yellow cake. There was an area in the back of the garden under an archway where I read my poetry to an attentive audience. A gift of sorts to my Dear Readers, one of my poems:

The Old Folks Usta Say

God, I still miss her
The way she used to preface her verbiage
With the phrase " you know, the old folks usta say"

As if that confirmed the veracity of the matter
Old folks too long dead to be disputed
Neither can they be confirmed by fact
- that odd propensity of the living

She could always conjure up the borrowed wisdom
Of omnipotent knowing
Gifted by the 'old folks' as witnesses
To the vast folly of humanity

Now settled comfortably
She takes her rightful place among them
And whispers in my ear
The priceless gift
Of an opportune quote

Tuesday, September 18, 2007

I'm Gonna Party Like It's My Birthday...

Cause it is! Yes, its my 45th birthday and I feel fabulous! It started with a call from my mother- she calls me every year at the time I was born! When she called this time I was snuggling my own baby- what a blessing. I can't imagine my life without this little guy. Later I had a 90 minute massage, then a great workout. My husband (and baby) took me to lunch at Garozzo's one of my favorite Italian eateries. I had a few hours in the office working then a nice dinner at home with my family. It has been a lovely, sunny hot then rainy day. My annual birthday celebration will be Saturday. I've planned a garden party at the home of friends who have a great garden. My mother is catering the dinner, and I've hired a harpist to perform. We'll cap the evening the way all my birthday parties end, with a reading of my poetry. In lieu of gifts guests can donate to one of my favorite non-profits that I volunteer for. The theme of my party is "Bloom Where You Are Planted" and each guest will recieve a flower bulb to plant as a favor.

Sunday, September 16, 2007

MANA from Heaven

Great news! My proposal has been accepted and I will be presenting at this year's MANA conference (Midwife Alliance of North America) in Clearwater Florida on October 20th. If any of you Dear Readers will be there, please come up and say hello. It would be a real treat to meet some of you in person. My presentation is titled, "A Response to ACOG: A Labor and Delivery Nurse's Choice for Homebirth" Now to start creating that powerpoint...

If White Folks Sneeze, Black Folks Already Have The Cold

I attended a facinating talk the other night. A local retired dentist, Brian Palmer has set about the last 20 years to devote himself to researching the tie between breastfeeding and oral health. I have heard him present before, but this time his message seemed more refined and succinct. It was really exciting to listen to him explain the relationship between breastfeeding and SIDs, breastfeeding and sleep apnea, breastfeeding and speech impairment, breastfeeding and bed wetting, breastfeeding and ADHD, even breastfeeding and beauty (!) I couldn't help but get excited. This information should be known, and bless his heart, he's working to get it out there. Dr Palmer is a pioneer, and I feel so fortunate to have him right here in my own back yard. What was most impressed upon me, once again, is that issues that impact our culture as a whole, can really have exponential impact on the black community. Black women need to breastfeed. Its as simple as that. We have so much more at stake. Our folks suffer in disproportionate amounts from the above-mentioned maladies (more SIDs, more ADHD, more speech impediments, more asthma and sleep apnea) and therefore need the intervention of breastfeeding more. Why aren't healthcare providers saying this to women of color? Why aren't researchers saying it to healthcare providers? Well I'm going to say it. African-American woman need to choose breastfeeding (and low tech birth, but thats another essay) to impact long standing chronic conditions that impair the health and vitality of our children. (We also need to change other habits, but thats another blog also.) Black women need to be strongly encouraged to breastfeed and told exactly why. How about a government funded campaign for that?

Sunday, September 09, 2007

And Now, A Word From Our Sponsors

Anonymous said...
So, what's the goal for women here? (please note this is not a sarcastic tone at all and a genuine question) I am a woman and birther, and have been heavily "OB'd." Rare hospital births? Saving OB's and hospital births for only critical cases and everyone using midwives? Educating women to make better choices? Getting medical professionals to listen to women and actually give them true informed consent and reducing unneccesary intervention? I'm just see.

Dear Anon,
I'm so glad you asked this question. It forced me into several days of hard thinking about how I would summerize my philosophy. MAJOR DISCLAIMER: I only speak for myself. These are not the thoughts of any movement or group but simply my own. This is also a reveal of my (only thinly veiled) identity. For those who want to know "what the goal for women is" according to 'moi' follow this link to my business website at and all will be known.

Friday, August 31, 2007

Fishing for Babies

Check out the story of this Birth I found on the internet! Breech delivery so easy, a shrimp boat captain can do it! But apparently a highly skilled OB can't- too much liability. Now that OBs are leaving obstetrics in droves (at least here in Missouri) for other career choices, perhaps they can add shrimping to the list, along with GYN only or cosmetic surgery.

Thursday, August 30, 2007

Death By Cesarean

This article appeared in my local paper, The Kansas City Star, last Saturday. Read it and weep. This is where the out of control cesarean rate is taking us. Oh well, look at the bright side. When enough women die the medical establishment will stop looking at cesareans are 'cure alls.'

Posted on Sat, Aug. 25, 2007
Experts: U.S. childbirth deaths on rise
By MIKE STOBBEAP Medical Writer
U.S. women are dying from childbirth at the highest rate in decades, new government figures show. Though the risk of death is very small, experts believe increasing maternal obesity and a jump in Caesarean sections are partly to blame.
Some numbers crunchers note that a change in how such deaths are reported also may be a factor.
"Those of us who look at this a lot say it's probably a little bit of both," said Dr. Jeffrey King, an obstetrician who led a recent New York state review of maternal deaths.
The U.S. maternal mortality rate rose to 13 deaths per 100,000 live births in 2004, according to statistics released this week by the National Center for Health Statistics.
The rate was 12 per 100,000 live births in 2003 - the first time the maternal death rate rose above 10 since 1977.
To be sure, death from childbirth remains fairly rare in the United States. The death of infants is much more common - the nation's infant mortality rate was 679 per 100,000 live births in 2004.
Maternal deaths were a much more common tragedy long ago. Nearly one in every 100 live births resulted in a mother's death as recently as 90 years ago.
But the fact that maternal deaths are rising at all these days is shocking, said Tim Davis, a Virginia man whose wife Elizabeth died after childbirth in 2000.
"The hardest thing to understand is how in this day and age, in a modern hospital with doctors and nurses, that somebody can just die like that," he said.
Some health statisticians note the total number of maternal deaths - still fewer than 600 each year - is small. It's so small that 50 to 100 extra deaths could raise the rate, said Donna Hoyert, a health scientist with the National Center for Health Statistics. The rate is the number of deaths per 100,000 live births.
In 2003, there was a change in death certificate questions in the nation's most populous state, California, as well as Montana and Idaho. That may have resulted in more deaths being linked to childbirth - enough push up the 2003 rate, Hoyert said.
Some researchers point to the rising C-section rate, now 29 percent of all births - far higher than what public health experts say is appropriate. Like other surgeries, Caesareans come with risks related to anesthesia, infections and blood clots.
"There's an inherent risk to C-sections," said Dr. Elliott Main, who co-chairs a panel reviewing obstetrics care in California. "As you do thousands and thousands of them, there's going to be a price."
Excessive bleeding is one of the leading causes of pregnancy-related death, and women with several previous C-sections are at especially high risk, according to a review of maternal deaths in New York. Blood vessel blockages and infections are among the other leading causes.
Experts also say obesity may be a factor. Heavier women are more prone to diabetes and other complications, and they may have excess tissue and larger babies that make a vaginal delivery more problematic. That can lead to more C-sections. "It becomes this sort of snowball effect," said King, who is now medical director of maternal-fetal medicine at Riverside Methodist Hospital in Columbus, Ohio.
The age of mothers could be a factor, too. More women are giving birth in their late 30s and 40s, when complications risks are greater.
Other characteristics of the maternal mortality rate include:
-Race: Studies have found that the maternal death rate in black women is at least three times greater than is it is for whites. Black women are more susceptible to complications like high blood pressure and are more likely to get inadequate prenatal care.
-Quality of care: Three different studies indicate at least 40 percent of maternal deaths could have been prevented.
Sometimes, there is no clear explanation for a woman's death.
Valerie Scythes, a 35-year-old elementary schoolteacher, died in March at a hospital in New Jersey - the state with the highest Caesarean section rate. She had had a C-section, as did another teacher at the same school who died after giving birth at the same hospital two weeks later.
However, Scythes died of a blocked blood vessel and the other woman died from bleeding, said John Baldante, a Philadelphia attorney investigating the death for Scythes' family.
"I'm not sure there was any connection between the two deaths," Baldante said.
Also mysterious was the death of Tim Davis' 37-year-old wife, Elizabeth, who died a day after a vaginal delivery at a Danville, Va., hospital in September 2000.
She had a heart attack after a massive blood loss, Davis said. It's not clearly known what caused the heavy bleeding. There was no autopsy, he said, a decision he now regrets.
Two previous births had gone well.
"Nothing led us to believe anything was wrong with this pregnancy. She was like a picture of health," he continued, noting she had been a YMCA fitness instructor.
A lawsuit against the hospital ended in a settlement. Davis also sued the obstetrician, but a jury ruled in the doctor's favor.
The child born that day, Ethan, starts second grade next week. "He's a happy kid," Davis said. "He's just never had a mom."
© 2007 Kansas City Star and wire service sources. All Rights Reserved.

Sunday, August 26, 2007

Sick and Tired of being Sick and Tired

I'm bitter about birth. It's true. I am. I'm sick of hearing about healthy young women going under the knife for no good reason. I'm sick of docs telling women that their babies are too big, or their pelvises are too small, or what the fuck ever. I'm tired of hearing women say they can't give birth without an epidural. I'm tired of docs scheduling inductions and women eagerly and gullibly going along with it because they are 'tired of being pregnant'. I'm sick and tired of those same inductions leading to cesareans that wouldn't have happened if the induction had not happened. I'm tired of women blaming themselves for things the healthcare system causes. I'm tired of medwives. I'm tired of burnt out women-hating, baby-hating doctors who need to get out of obstetrics. I'm tired of wimpy, whiny women who want no responsibility for their births, tired of women deluded enough to believe everything their doctors tell them. I don't want to bear witness to someone else's shitty birth. I don't want to see that look in her eyes, sick and desperately afraid of something being wrong with her baby if she doesn't do what THEY tell her. I don't want to watch a woman thank her doctor after he or she just fucked up royally but made themselves look like the hero. I'm tired, just plain old sick and tired of all the bullshit.

Tuesday, August 21, 2007

Home Funeral Photos

Not to be morbid, or belabor a point, but since I had such wonderful responses to the posts on my friend's recent passing and his "green funeral" I thought some pictures might inspire some to really plan ahead or begin to share with loved ones about their own desires for death and burial (or cremation). There's a photo of Kathy and her grandbaby saying goodby, friends sealing the casket, Lee's sons and friends transporting him to the crematorium and a good photo of the casket itself, handcrafted as a final gift from a friend. I took these photos from Lee's website that he set up to keep friends and family informed of his condition. The site itself has been wonderfully comforting. Folks left messages for Lee, and then his family, by the hundreds. When Lee was well enough, he journaled, then later Kathy took over for him, giving updates every 2-3 days. Now the site is inundated with condolensces to Kathy and her children. Their family has done a wonderful thing not only in modeling how death can be done with dignity, but in sharing the whole process with others in a very transparent way. If you haven't done so, write out your Will and Living Will too, or just write you wishes down and put them in your desk drawer. Have you been meaning to get life insurance (stay at home moms need it too)but haven't yet ? Talk to your loved ones about what you would want done in the event of your death or debilitating illness. Do you feel strongly about donating your organs? Have you told anyone in your family how you feel? We won't all get the chance Lee did to plan the details over several years. Talk to your family about it now.

Sunday, August 19, 2007

I've Been Tagged!

I got tagged by Housefairy. You go girl- this child can write. Click on over to Breast and Belly and check out her post, A Nurse's Guide to Managing Failure.

Here are the rules for being tagged:
RULES - Post rules before giving the facts - Players start with eight random facts/habits about themselves - People who are tagged need to write their own blog about their eight things and post these rules - At the end of the your blog you need to tag six people and list their names - Leave them a comment on their blog, telling them they have been tagged and not to forget to read your blog.

You asked for it, you got it: eight things about me you probably didn't need to know:
  1. I'm tall (for a girl) and love it. I tower over most women and half the men I know even though I'm only 5'7'' I like the feeling of taking up space in the world.
  2. I have a fetish for the tops of bald men's heads. It started when my husband decided to shave his head after his hair started to thin. Now, every time I walk by a guy sitting down with a smooth bald head, I'm tempted to bend down and kiss it. (Fortunately my husband lets me kiss his smooth shaven head as much as I want!)
  3. I speak competitively. For the past 3 years I've entered speech contests hosted by Toastmasters International. I've even won some competitions.
  4. I'm a cat lover. I haven't been without a pet cat since the age of 20.
  5. My favorite show on TV is "60 Minutes." I try never to miss it.
  6. I'm a compulsive journaler. I have boxes and boxes of old journals I've kept since I was 18. I usually have 2-3 going at a time. I don't know if I should put it in my Will to destroy them upon my death, or let my kids have at it.
  7. I throw myself a birthday party every year! People plan on it all year round. I include reading the poetry I've written the preceding year.
  8. I'm secretly writing a naughty romance novel. Shhhhh, don't tell anyone.

Now that you know all my dirty little secrets, I'm tagging Mimi, Mountain, Monkey Momma, One Hot Mama, Red Spiral, and Molly.

India Arie - I Am Not My Hair: Remix, Closed Captioned

Check this out- I love this video by Akon and India Arie. It expresses perfectly what I'm trying to say. I am not my hair, or my skin, (or my fat!) I am the soul that lives within! (Double click on the image to see the video)

Busting Out

A seed has taken root in my heart. I won't reveal it all here and now, but I have learned that dreams manifest quicker if you share them with others. I am sharing this one with you. One of the things I have found that I do really well is write curriculum. I have written many continuing education programs over the years and presented them to specialized audiences. Something I've wanted to write for many years but always managed to talk myself out of, is a curriculum for 1) homebirth doulas and 2) homebirth couples. Maybe talking myself out of it, was a manifestation of my diminished esteem, or perhaps the timing was not right, but I am writing them now. A guide for doulas on how to help at a homebirth (Red Spiral wrote recently that she felt she didn't have a role in homebirth but felt very needed in hospital birth- I found that interesting since I specialized in homebirth when I was a doula and of course my own homebirth doula- Nadah, was amazing) and a guide for parents planning a homebirth. I'm really excited about creating these educational guides.
On another note, I decided to grow out my hair and have it twisted. (Now I know all my poor caucasian readers won't have a clue as to what I'm talking about), but just trust me on this one, it will look good- eventually. I'm becoming concerned about my apprearance. It's time to loose all this damn baby weight. I taught a CPR class with a client for the past 3 years. He hires my firm to come train his school districts's coaches. When I saw him last year he weighed a little over 300 pounds, when I saw him again this year, he weighed half that. He told me he did it by bicycling. He was too fat to jog (his words) and even walking was hard on his joints but he found bicycling (and ammending his diet) worked just right for him. It was really an impressive testimony. I want that kind of testimony! I want to be 45, fit and fabulous (not white girl skinny : ) but curvaceous and bodacious with a big booty (and natural twisted hair). I want to be my own kind of beautiful. Fuck whatever current fashion trends prevail. I'm only concerned that my outside me expresses the vivacious inside me. I'm not the type to obsess about my appearance, even with the weight I know I'm pretty, but damn it, my body's going to seed. I've got to get fit, I'm even considering a return to a vegetarian diet. Right now, I've got a bicycle collecting dust in the garage to confront. Today, Dear Readers, be beautiful your own way...

Saturday, August 18, 2007

Appeal to the Supreme Court

I added a new blog to my list today, "Molly Reads." This avid reader, (a woman after my own heart) reads and reviews birth related books for her blog. What a great service- thanks Molly! As an avid reader myself, I keep a stack of books on my bureau, (and one in my purse for spur of the moment reading) that I am constantly devouring. Right now I'm finishing up, "The 21 Irrefutable Qualities of a Leader" by John Maxwell, an absolute must read for anyone in a leadership position or who wants to be.
I got news of an update on the Missouri battle for legality here on our borders. There has been much buzz about it throughout Kansas and Missouri in the birth community. Though the initial legal battle was lost, there is intent to carry the case to the supreme court. Here is an article from the Friends of Missouri Midwives website:

Midwives supporters to appeal injunction on new Missouri
Midwifery Law to Missouri Supreme Court
(JEFFERSON CITY, MO.) – Missouri midwifery supporters say the injunction barring the new midwifery law is disappointing, but that it’s not the end of the story. The coalition of four nonprofit midwifery organizations has determined it will appeal to the Missouri Supreme Court based on the fairly well-stated position of that court that they do not make the laws, and that the Missouri Legislature does, enabling “wide latitude” in what laws are passed and how.
“If a law has been passed by both chambers and signed by the Governor, it indicates a pretty solid process, and the Missouri Supreme Court has a lot of respect for that,” said Mary Ueland of the Missouri Midwives Association. “We feel very optimistic about the likelihood of the Court upholding the midwifery provision,” she stated, referencing the Missouri Supreme Court’s three most recent rulings on these kinds of constitutional challenges, in which the court has upheld what the Missouri Legislature has passed.
“Frankly though, the larger issue here is why the Missouri State Medical Association is talking with the American Medical Association to raise more money to fight this law,” Ueland asked. “Why is it that they fail to see the midwifery provision of HB 818 is indeed related to the underlying health insurance bill, when we know the Missouri Supreme Court has already ruled that health insurance and health services are closely related and interdependent on the other.”
Ueland isn’t the only one who questions the seeming stranglehold that organized doctor’s groups in Missouri seem to want to put around the Midwives Model of Care and the profession of being a Certified Professional Midwife, a career that is legal and regulated in 24 states, and that is Medicaid recognizes as eligible for reimbursement in nine states.
President of Friends of Missouri Midwives, Laurel Smith, says efforts to thwart midwifery on these weak “unconstitutional” grounds obscure the larger issue that organized doctor groups are fearful of the imagined impact midwifery will have on their financial bottom lines and thus try to strike down any attempt to create midwifery policy.
“We must remember what got us to this point: the filibustering of Sen. Chuck Graham and Sen. Yvonne Wilson of a Missouri midwifery bill that had majority support for passage,” Smith said. “Sen. John Loudon tried another way to bring the Midwives Model of Care to Missouri so families can have access to maternity care that is safe, respectful, family centered, health promoting, and cost effective, and now the doctor’s groups are coming at it a different way.”
Dr. Elizabeth Allemann, MD is one of the intervenors in the case to support Certified Professional Midwives in Missouri and said that despite the documented evidence proving up the Midwives Model of Care, it generally causes great fear and alarm in the organized medical groups. “What is interesting to me is that we seek not to take anything away from doctors, but to work very closely with them, as is the case in other industrialized nations to a significant extent. We seek to expand access to healthcare services, which is exactly what decriminalizing midwifery does.”
Dr. Allemann says it is clear they will continue on to the Supreme Court. “We will continue to shine light on the creation of a healthcare system in Missouri that includes Certified Professional Midwives, which ultimately is good for mothers and babies. While I understand the organized doctors’ groups are not limited in the amount of money they will spend to continue to fight about this issue, honestly, my concern is more about the women in our state who cannot even afford prenatal care due to skyrocketing costs.”
She said she hopes she can help facilitate a time when the state’s medical and midwife communities will be able to be work together. “We will stand shoulder to shoulder to do the very best for women and babies in Missouri,” she said.

Friday, August 17, 2007

Putting the Dead to Rest

Thanks to everyone who responded to my two posts on the dying process. I'm comforted to know that these posts touched so many of you. On a final note, Lee's memorial service was grand. Lee was an avid writer and journaler and some of his writing were read at the funeral. I was priviledged to be asked to read one of his poems. Three of Lee's adult sons and several pastors of our church spoke about Lee's life and character. We all should have such testimonies of love and stregnth at our passings. Attending a service like that certainly gives you a renewed perspective on what your life should be about. I found myself wondering what people will say about me at my funeral and about how the choices I make today (and everyday) will influence what they say. What about each of you, Dear Readers? How would you like to be remembered by those you love?

Sunday, August 12, 2007

Sitting Up With The Dead

Sitting bedside in death is not unlike sitting bedside in birth. I went last night to sit with my friend Kathy after her husband Lee passed away. There he lay in their bedroom in his lovely pine box coffin that had been lovingly fashioned by a family friend, and packed in dry ice to preserve the body. Their dream of a "green funeral" was in all its glory. The formal memorial service will take place in a few days, but their home has seen much traffic of visitors coming and going. We sat for 3 hours into the night beside his coffin, laughing, crying, telling old stories and new ones alike. While Kathy shared the details of his actual passing, I thought of more ways the dying process is like the birthing process.
Like birth, death is messy- social decorum prevents me from going into detail, but the dying process can be a very messy one.
Like birth, death is noisy- as Kathy described Lee's 'death rattle' she seemed to be struck by how loud it was. The dying person can become quite 'vocal' though not verbal.
A need for orchestrated control- Lee's 'death plan' included all aspects of home death and a green funeral. He planned it all down to the detail, and Kathy carried it out for him.
The weight of the unknown- When will death come? (When will this baby get here?) Will he be in pain? ( Will it hurt?) Will he suffer? (Will I be able to handle the pain?) Will his death be a peaceful one? (Will my baby be healthy?)
Corporate social rituals to mark the occasion- Wakes, Visitations, Funerals vs Baby Showers, Blessingways and Baptisms
The intrusion of medical intervention for a process that basically happens on its own- for a brutal look at how bizarre our death customs really are, read Jessica Mitford's, "The American Way of Death." I believe the dying should be made comfortable with palliative care but not in prolonging the dying process.
The outrageous and unprecedented cost- I was struck by how simple and inexpensive Lee's passage was made. (That's not why they did it the way they did) Lee looked so at peace in his simple pine box without the heavy make up I'm used to seeing on dead people, just simply his dead self without embellishment.
Fancy doodads that add nothing but expense-Think state of the art 'baby warmers', when mamma's belly will do just fine. (Did you know just one those things can cost hundreds of thousands of dollars??) Looking at Lee's tidy pine box reminded me of this whole issue of 'sealed caskets' that's all the rage in the funeral industry (and remember, it is a money making industry). Metal, sealed caskets are absurd. We were meant to be put in the ground to dry rot- and the vermin facilitate that process (sorry there is no nicer way to describe it). Sealed caskets turn the body to mush and dramatically increase decomposition time, instead of the natural process that's supposed to occur.
Artificial Timetables- Medical interventions prolong the dying process while medical interventions work to shorten birth- either way, an artificial socio-medical construct changes the natural process. Most folks have no idea how hard the medical system works to keep dying people alive while conversely, an artificial timeline is placed on birth to speed it up without scientific evidence that either is warranted
Tampered Input- In birth women are denied simple food and water to see them through the arduous journey of birth- they must do the hardest work of their physical lives without calories or adequate hydration (crazy!) In death, the dying are force fed and IV hydrated in defiance of the natural dehydration of death. The unwillingness of the dying to take in food and water is part of the body's shutting down process. When Lee decided to stop eating and drinking, the hospice nurse told Kathy that he could live 2 weeks without food and up to a week without water. It was accepted as a part of the process of dying.
I could go on, but I think I've made my point. I remembered in the olden days folks would display the casket on the dining room table and sitting up with the dead was a common practice. For the last two nights Kathy has pulled a mattress into the bedroom to sleep alongside her husband's casket (the room being emptied of furniture to make room for the coffin and to accommodate visitors). It was such a blessing to sit with her as I did and share in her sorrow (to the extent that one can). Tomorrow when she wakes, it will be to say goodbye to his physical shell for the last time. Her sons will help take the casket to the crematorium.

Midwife for the Living

I read this post from Sage Femme and had to post it for my readers. It is a beautifully written essay on why I think hospital birth is so fucked up, and I refuse to do it. Read it and the accompanying post she links to called "If you buy the hospital ticket, you go for the hospital ride" This post by Navelgazing Midwife changed my mind about trying to change hospital birth and instead putting my energy behind promoting homebirth as a viable, reasonable and safe option.

Midwife for the Dying

My friend Lee will die soon. He has struggled off and on with cancer for the past 3 years. He is my age. His family has been on the death watch for two days. Most folks don't realize how hard it is for the body to die. When his soul does leave his body, I will help his wife Kathy prepare his body. Lee has chosen to die at home. Together, he and his wife Kathy elected to have a home funeral. His body will be available for viewing at his home after he passes. He will then be cremated and a memorial service held at our church. I love that he has chosen a death, like his life, outside of conventions. (After homebirth, homeschooling, and home business, home death somewhat completes that philosophical cycle.) They even set up a website where he and his wife have journaled his dying process. Its a wonderful tool for communication. Along with journaled updates on how he is doing, folks can leave him messages, post pictures, and even videos. (The site has wonderful videos of a recent wedding of one of their sons- they had the wedding at Lee and Kathy's house and Lee was able to attend in a wheelchair, with a portable oxygen tank.) I'm so glad they elected to be public with this death- our culture is far too mysterious, hiding it away and shrouding it in fear.
The title for today's post is apt, because for me there are glaring similarities between the act of dying and the act of being born. How can that be? It is the same doorway, all are passing through, some coming in, and others going out. On either side of that doorway, helpers are needed. The midwives who guide the passage in, and the midwives who guide the passage out. Both are a holy service for those gifted to bestow it.
Birth requires a great work of labor, but so does death. Unless a person dies instantly such as a traumatic car crash or gun shot wound, the body struggles toward death. The body wants to live, it wants to be in homeostasis (balance) because thats what it knows to do. Death is foreign to the body and the shutting down process is long and arduous, much like utero emergence is foreign to the fetus, and a long arduous, mysterious journey. Ask anyone who ever sat bedside at death. Like labor, it can seem to go on forever.
Death requires the same tender mercies rendered for birth. Respect and dignity are paramount for both. Quiet, sometimes solitude are called for. There is a gathering of family and those who are close. Meals are brought, memories are shared, there is communal rejoicing/sorrowing.
I will miss Lee. Strangest for me will be Kathy without her Lee. They have always been a strong, bonded couple. He was her knight in shining armour. It seems especially cruel for her to be without him, headed into their empty nest years when they would have enjoyed each other's company freely with the kids all married or away at college. Unfortunately, we have little say over our coming and going on this earth. We only have say over what we do with our time while we are here.
Lee used his time well.

Friday, August 10, 2007

Update on Josiah

Can you believe, Josiah is 10 months old? He is crawling everywhere, pulls himself up and 'walks' while holding on to the furniture. This week his two lower front teeth finally popped through. We thought he'd never get teeth! And I'm not ashamed to say- he's as cute as can be. He has fine straight brown hair and looks so much like his daddy. He has soft cafe au lait colored skin and is long and lean. He loves to munch on crackers, and if we open a peach or plum with a couple of bites, he can grab it with both hands and suck down the soft inside flesh. It is so difficult to believe that a year ago he wasn't even here, and now he is the center of our lives. We all love this baby so much. He has truly changed our family for the better. Last night, his 13 year old sister heard him yelp because he almost fell off our bed. My husband and I were both on the bed reading, and he ventured too close to the edge, but I grabbed him before he fell off. He cried anyway from fright. Big sister comes running in yells at us for being neglectful, and whisks him away to her room. I yelled after her, asking how she managed to survive this long with such neglectful parenting? My husband and I had a good laugh, and I thought, that baby just brings out the protector in everyone. We all want him to be well and happy and have his every need met. I'm so grateful we have that baby- so grateful to be his conduit for coming int0 the world.

Monday, August 06, 2007

First Timer's Remorse

"but thanks for addressing the frustrating, sometimes infuriatingly helpless feeling that is talking to a primip about homebirth!!! Arg! "

This comment from Housefairy got me to thinking (a dangerous pasttime I know). Most folks, even those who might agree with most of what I have to say and read this blog, have no idea how permeated with fear the hospital is. The fear of birth is literally paralyzing. The fear keeps the docs (and midwives and nurses, et al...) from acting on a woman's best behalf- heck the fear keeps the docs from even knowing what is best for her, because all they can see is their own liability. This is why its so difficult for moms (especially first timers) to fathom their doctors not having their best interest at heart. They cannot fathom the fear that these people operate under. The way they see it, each birth is a lawsuit (or at least catastrophe) waiting to happen. They don't have the luxury of viewing each woman and her baby as a unique unit. They can't afford to care about the supremacy of her birth experience. All they know is they gotta have a live baby and live mamma at the end of it all, and if they can accomplish that without losing a whole lot of sleep, so much the better. Fear negates the value of hand holding, fear eliminates autonomy and individuality. Control is the antidote to the pervasive fear that inhabits the birth room today. Controlling every aspect of the outcome is the only way to choke down the fear and operate through it. I almost feel sorry for the poor bastards- almost. Then I remember, that the price they gladly pay for peace of mind and comfort, comes at the expense of a woman and her baby.

Sunday, August 05, 2007

Blogorgy (blog-orgy)

Spent all Sunday morning reading and replying to blogs and was late for church. (Forgive me, Lord- but we spend lots of time together- I have to steal snippets of time for blogging- nonetheless Sunday morning is yours) Found some great new (to me) blogs and possibly some new friends. Am I becoming one of those weirdos who has more virtual friends than actual??? Maybe. I'm so grateful for the blogosphere- for so long I thought I was alone or maybe just isolated. Its nice to have a voice- and time for listening to the voices of others.

Saturday, August 04, 2007

Midwives, Doulas, and Lactation Consultants

It is done. Our World Breastfeeding Week Health Fair is over. It went really well. I was so proud of my Breastfeeding Committee. We worked hard and pulled off a wonderful event. In the end folks did come through. We had enough vendors, enough presenters, enough food, enough door prizes, even enough participants. The city newspaper sent a reporter and photographer. The mayor sent a representative and a proclamation. A lovely time was had by all. I met a local midwife named Cheryl. She was quite fascinating. She takes the CPM test next week. One of my committee members, Valtra just took the IBLC exam. When she passes, she will be the very first African-American lactation consultant in our city. She has done a mighty work, toiling with inner-city poor women (mostly black) who will most likely not encounter anyone else more devoted to their breastfeeding success. As a lactation consultant she'll be able to do even more. Please say a prayer or send a good thought to Cheryl and Valtra. We need more like them.

Friday, August 03, 2007

Ripe for the Picking

Yesterday, I had a young pregnant labor and delivery nurse in my CPR class. She happened to work at a hospital I used to work at. So naturally, after class we struck up a conversation about mutual friends and eventually childbirth. She was having her first baby and mentioned that she was using a midwife. Of course I talked about my homebirths and why I made that choice. She gave the typical argument of what if something goes wrong. I countered with my usual, its the interventions that makes things go wrong. Having worked in California, she did concede that we tend to be a lot more heavy-handed on management of labor here. (for international readers- the US tends to be more conservative in the middle and more progressive on either coast) I don't know how much I convinced her but I hope I gave her some things to think about. She really is a thinker, but its hard not to get sucked into the world of doom and gloom birth when you are mired in it daily- that's why I had to get out, it was changing my view of birth. My hope for her is that all goes well, but that these issues become more passionate for her after she experiences birth for herself. I always did notice a change in L&D nurses after they had thier first babies.

Thursday, August 02, 2007

Sisterhood Soliloquy

We had dinner last night with our best couple friends, whom we don't see nearly enough anymore since we changed churches. While our younger kids ran around their massive yard (all the teens left to go to youth group at the church), we sat around the grill drinking iced Chai teas and arguing about Islam and immigration, I thought about how incredibly important these people are to me. How our 25 years of friendship, (the husband and I went to college together, our spouses came into the picture later) has embedded and taken root in my heart.

On another level, the same thing has happened to me with birth. I didn't know I would feel so passionate about it. It took root and has never waned. Anonymous got me to thinking. She (or he) wrote:
"First, I want to say that your boy Josiah is just about as beautiful a baby as I have ever seen, But being upset by "Knocked Up?" C'mon, lighten up, it's a movie and a pretty funny one at that!"
But a movie scene did upset me. I can't lighten up! I can't watch movies of bad births, or hear conversations about bad births without it affecting me. Sometimes I wish I didn't feel so passionately. Sometimes it feels like a burden I wish I could relieve myself of. Any of you reading this who share this passion will understand what I mean. Folks who just think birth is about how you have a baby just don't get it. I am consumed by this issue. I'm not writing a book, the book is using me as a vehicle to get written. Things will change, I'm certain of that, if only because they always do. Societal mores constantly shift and the young girls of today will wonder why so many of their mothers opted for cesarean or phamaceutically mediated birth. In fact, I see inklings of a shift in beliefs about birth already. I just want to be sure I'm a part of that shift. Perhaps ladies (and gents), things have become so off kilter, partially so we can have a role in setting it to rights. Each of us in our own little part of the world fighting diligently for the kind of birth we believe in, is making a difference. I'm so grateful to know I am not alone, that our sisterhood (which includes the men who get it) is strong and enduring, and that change will eventually come.

Monday, July 30, 2007

MO Legal Woes

Dear Readers,
I promised an update on the Missouri Midwifery Law. I pulled this update off the Friends of Missouri Midwives website- a legal battle of true David and Goliath proportions.

News from Missouri Midwifery Supporters
CONTACT: Mary Ueland (417) 543-4258,
FOR IMMEDIATE RELEASE: Tuesday, July 31, 2007
Missouri home-birth families, supporters combine legal efforts to preserve and protect the new Missouri Midwifery Law
(JEFFERSON CITY, MO.) – Supporters of the new Missouri Midwifery Law have joined with the Missouri Attorney General’s Office to shine a light on the importance of family healthcare choices and to legally defend the ability of Certified Professional Midwives (CPMs) to provide prenatal, birth and postpartum care in the state of Missouri.
These combined legal efforts to preserve and protect the new Missouri Midwifery Law come in direct response to the Missouri State Medical Association’s (MSMA) ongoing, well-financed challenge to the new law. A temporary estraining order was granted to MSMA on July 3. The restraining order is in effect until the preliminary injunction hearing that is scheduled for 9 a.m. Thursday, Aug. 2, at the Cole County Courthouse, 301 E High St., Jefferson City, Mo.
Judge Patricia Joyce will hear testimony from organized medicine’s MSMA, which is trying to prevent the new law from taking effect on Aug. 28 as originally intended. The Judge will also hear from newly admitted-to-the-case homebirth defendants and midwifery supporters, as well as from the Missouri Attorney General’s Office.�
One of the newly listed supporters is Dr. Elizabeth Allemann, MD, with the Columbia Community Birth Center. “It is a frustration that Missouri has taken so long to recognize the skills and expertise of CPM’s, when the science is so clear about the safety and high quality of the care they provide,” she said.
In support of the new law and to voice opposition to any injunction of it, as well as to increase attention to the safety of the midwifery model of care, midwifery supporters have organized a rally for Thursday. The rally is co-sponsored by the Friends of Missouri Midwives, Missouri Midwives Association, Show-Me Freedom in Healthcare, and Free the Midwives.
In addition to the rally, the candid and eye-opening documentary, "The Business of Being Born," will be shown Thursday as well. Thanks to the generous donation by the film’s director Abby Epstein and producer Ricki Lake, the film will be shown for a one-time screening prior to the documentary’s official theatrical release this fall. In the film, Epstein and Lake explore and question the way American women have babies. Surprising facts regarding the historical and current practices of the child birthing industry interweave with stories of couples who decide to give birth on their own terms. The yet-to-be-released documentary was screened in New York at the Tribeca Film Festival this spring.
In a statement of support, Lake said, “I sincerely hope that Missouri lawmakers do not deny parents a basic human right by restricting how their children can come into the world. I also hope that Missouri lawmakers recognize midwifery as a serious, social-service profession that deserves licensing, public support and admiration.”

Sunday, July 29, 2007

New and Improved

Check out my spiffy new template (okay, it looks just like my old template, but it is updated!) I was finally able to add my links of all my favorite blogs. Please be sure and check them out if you haven't already. If you like homebirth diaries, you'll love some of these others. Some of my most favorite medi-blogs have gone off line. Blogs like Flea, and FP Mama, I still miss dearly. There was a big stink in the blog world not long ago when Flea had actual legal trouble about his blog. He was in the midst of a malpractice suit when it was discovered he had a blog and wrote about his case on it. He got into big trouble and medi-blogs started to disappear like crazy. Of course the issue is confidentiality. A lot of clinicians share client birth stories, and that can be a point of contention. The rule is (I think) that you have to get the person's permission to write about them or obscure the facts so that they are unrecognizable. Here, I mostly tell my own stories (mostly) and my own opinions, but it has made even me wary about how I tell someone else's story. I always try to cite the source when I quote someone else's material (I don't want to plagerize either). Anyway enjoy the reads, these ladies are terrific (Flea was my only boy blog!)

Saturday, July 28, 2007

Lost Battle in the VBAC Wars

There's an interesting conversation going on over at Sisterhood Six. I thought my dear readers might want to pop over and take a look. An OB doc is asking, what is the mysterious allure of homebirth? Boy did she get some responses. (I left 3 of my own.) There are also a few comments from folks detailing why they would never choose homebirth. I truly don't mind that women choose hospital birth- I mind that they don't know what they are choosing when they do. One of the stories that I put in my book is the one about a woman who had a c/section on her second baby, she then went on to have two VBACs. When she came in to have her fifth baby, unbeknownst to her, her OB group had changed to a no-VBAC policy during her pregnancy. Instead of informing the woman that this policy was hard and fast, her doc told her she would "see what she could do" to get her of VBAC. Of course when the time came, her particular doc was nowhere around, and the partner that was present would not entertain ANY conversation about a VBAC, even when the woman implored, "but I've had two VBACs already!" I watched the spirit go out of that woman as she at first ranted and cried, then gave a lound sigh, dropped her shoulders and quietly submited to the operation. I wanted her to keep on ranting. I wanted her to fire her doctor. But doctors are considered sacrosanct, even asshole ones. It takes a woman of great courage, who is fully informed of her rights, and is willing to stand up for them, to overcome the pressures that are brought to bear in the delivery room. (no pun intended) This is what I want women to know about hospital birth.

Thursday, July 26, 2007

Putting the SOB into OB

My husband and I went on a date last night to see the movie, "Knocked Up." I thought it would be funny and sweet. It was kinda. (I actually liked the movie "Waitress" much better with a similar theme.) I later realized upon reflection that the birth scenes left a really bad taste in my mouth. Actually, upon reflection, I hated those scenes. While I was watching them, I had an out of body experience and was right back in my labor and delivery nurse role. I hated that OB in the movie, the actor's portrayal of a self-centered arrogant SOB was so on target (forgive me, any OB readers!). His performance really did remind me of about 80% of the docs I worked with. (As a nurse, I began to believe that OBs as a group didn't really like women and that they became OBs as a socially sanctioned way to torture them.) It did remind me of all the medical abuse I witnessed and assisted in. I feel so grateful to be out of that vocation (sorry all my L&D nurse readers!) That's why I can't attend anymore (hospital) births- I can't stand witness to the abuse anymore. Even if I attend just as a 'friend' I'm still totally intuned to all the fine nuances that go on around me. I know when the nurse is afraid of the doctor, or when the doctor thinks the mom is a nutjob. I know when the mom is being bullshitted with big fancy words, to manipulate her behavior. I just can't stand to bear witness to it anymore. Birth is no longer a beautiful act of nature for me- its an opportunity to watch a woman be debassed, manipulated, and dishonored. I can't even watch a fake birth anymore.

Wednesday, July 25, 2007

BWI- Breastfeeding While Ignorant

World Breastfeeding Week is almost once more upon us. My Breastfeeding Committee is hard at work on a breastfeeding health fair that a local community clinic will host. I'm sad to report that we didn't get all the usual support and assist that we usually do with these events because this year's event is being held in a Black neighborhood. Even though I knew this would happen, I'm still disappointed. The lactation consultant on our committee had a terrible time getting other LCs to sign up to do educational seminars because they didn't want to go into THAT neighborhood (the one I just happened to grow up in). The really sad irony is that the neighborhood underwent major restoration several years ago from an influx of city dollars and is beautiful with restored parks and boulevards. The clinic itself is a showpiece with a new building and sculptured grounds. I hate fighting battles within battles. Everyone agrees that the rates of breastfeeding for African-Americans suck, but this is what you get when you try to engage folks in the problem. Last year we brought an AA breastfeeding advocate to town to speak to folks about the situation of low breastfeeding rates. But I guess her message has already been forgotten.