Thursday, December 27, 2007
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
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
Sunday, December 02, 2007
I got an email from a reader in my area looking for a certified nurse midwife to do a homebirth.
"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
- Around Christmas vacation time, I will send out via email, the confidentiality agreements to sign.
- When they are returned, I will email 3 consecutive book chapters to each volunteer reader along with the evaluation tool.
- 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
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
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
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.
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
Read the article in its entirety at www.friendsofmomidwives.org
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
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
Respect, not callousness, for at-risk babies
By DAWN MEISENHEIMER LEWIS
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 email@example.com.
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
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.
Friday, October 19, 2007
Thursday, October 04, 2007
Sunday, September 23, 2007
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
Sunday, September 16, 2007
Sunday, September 09, 2007
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 asking...to see.
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 www.perinatalresourcellc.com and all will be known.
Friday, August 31, 2007
Thursday, August 30, 2007
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. http://www.kansascity.com
Sunday, August 26, 2007
Tuesday, August 21, 2007
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
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:
- 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.
- 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!)
- I speak competitively. For the past 3 years I've entered speech contests hosted by Toastmasters International. I've even won some competitions.
- I'm a cat lover. I haven't been without a pet cat since the age of 20.
- My favorite show on TV is "60 Minutes." I try never to miss it.
- 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.
- 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.
- I'm secretly writing a naughty romance novel. Shhhhh, don't tell anyone.
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)
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
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
Sunday, August 12, 2007
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.
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
Monday, August 06, 2007
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
Saturday, August 04, 2007
Friday, August 03, 2007
Thursday, August 02, 2007
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
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, firstname.lastname@example.org
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.”