A New Beginning

Homebirth Diaries will shortly be put to rest, so that The LaborPayne Epistles may emerge. Please follow me to my new blog.

A Return to Love

Here is what we need to do:

One: Love our bodies as they are.
Short ones, tall ones, fat ones, sleek ones, flabby ones, toned ones- it doesn't matter. We must first make friends with our own bodies. Our culture teaches us to loathe our bodies no matter how they look- we can never quite measure up. That is why we need to stop right now and choose to love our bodies no matter what they look like. I choose to love my chocolate brown skin, my full lips, my gray-speckled hair. I love it all. I find no fault with it. I groom it and dress it up and endeavor to look my best everyday. While I do have a goal to lose weight, I don't give myself negative messages. I make good food choices and work out almost every day. I know if I keep this up, I will lose weight, but I don't care about looking good tomorrow. I care about looking good today. So I buy nice things that flatter my physique as it is today. I must confess I have a great sense of style and I do get compliments almost daily on my appearance- despite the fact that I do not fit the standard of beauty in our culture. To the unobservant eye, I'm an overweight, old, black lady. Yes, I am those things, but to my own eyes, I am also beautiful. I believe that I am- so I project that view out onto the world from the inside of me. Hell, I'm downright sexy. A few rolls of fat can't stop the sexiness from oozing out through my pores. I believe with all my being that I am beautiful, therefore others believe it too. (There is a great lesson here. We cannot convince others of that which we ourselves do not believe .) How do you start to love yourself? Perhaps you have been bombarded all your life with messages that you are inadequate and do not measure up. Start there. Change those messages (at least the ones that come from inside you). Whenever you start to criticize your body, stop and change the words, even if you don't quite believe them yet. Say to yourself, "I accept my body." "I love my body." "I am grateful to my body." Women who do not love their bodies, do not believe in their bodies ability to birth. So let's start there. Love your body.
(You might also read 'A New Earth' by Eckart Tolle)


Two: Recognize that our bodies are not us.
They are the shell we travel this life in. While it is important to love your body, it is equally important not to mistake it for being you. You are a triune being, composed of body, mind, and spirit. Your spirit will live on, your body will age and die. It is all too easy to get caught up in the life of the body. Especially if you are a mom and have little ones at home. But please recognize, dear ones, that you are more, so much more, than today's laundry list of chores and meetings, and doings, and havings. Take time to honor your mind (read a good thinking book, or practice daily phrases of that language you always wanted to learn!) and to honor spirit (light a candle during daily quiet time, make time for prayer, or meditation, or if those kinds of activities don't suit you, dance wildly to music you love and that speaks to your soul, howl at a full moon!) You want a life of balance- well you don't get it by being mired in the body. Get out of the body if only a few minutes a day and pamper the mind and the spirit. You know what makes birth such an amazing experience? It doesn't just happen in the body, it happens to our minds and spirits as well. All the great landmark events of human experience do. We just get distracted with the physicality of birth, yet it is a tremendous mental/spiritual event as well. Make a plan today to honor all aspects of your amazing being- body, mind, and spirit.
(To emphasize these principles, it might be helpful to read Victoria Moran's 'Creating a Charmed Life')

Return to love, dear ones. Do not give in to our culture's condemnation or perversion of the feminine form. We must learn to love ourselves, and then loving birth will come to us.

Birth Prophecy

For most of my life, I believed I was non-orgasmic. That is, I did not achieve orgasm during intercourse or as a result of intercourse, but only through masturbation. For a long time, this was an issue of great concern to myself and my husband. I read many books over the years, tried many 'techniques' all with the same disappointing result. But we persisted with both faith and creativity and some years ago now, we quite abruptly stumbled upon not 'the right technique' but the flood gate. Once we discovered, through trial and error, what triggers worked for me, we were delighted to find, that not only was I capable of achieving orgasm, but it was only the beginning of new found heights of responsiveness that I had never before even dreamed of. It appears foolish to me now, to think that I or any other woman could be labeled 'non-orgasmic.' The female body (indeed the human body) has amazing capabilities that because of our limiting beliefs and paralyzing fears lie mostly untapped and unknown. The same can be said for birth. We do not know what the body is capable of. We do not know because of the fears others seek to instill or because of false beliefs we choose to embrace. We think the issue is medicated birth vs natural birth, doctor vs midwife, or assisted vs unassisted. But I tell you this, the true lesson is love vs fear, control vs power, knowledge vs wisdom. We can cling to modern medicine to separate us from our own bodies, to relieve ourselves of any responsibility for our births, but the power to birth is within us still. We must fight to reclaim it - knowing it is already ours.

These sling back pumps were made for walking...

I should clarify. I'm selling my business to my son. He has worked alongside me for two years now, learning the ropes. He is eager to take it over, and 'take it to the next level'. I confess, there's lots of potential for the business, and I know he'll do well with it. Something is happening to me. This business has been my baby, yet I knew in an instant I must sell it in order to grow and move forward. I'm not hesitant, nor even grieving. I'm just eager to get on to the next thing and give it my undivided attention. Today at school, I'll have a panel of postpartum moms, and then the pregs. I'm excited for today and the activities I have planned for my students. I'm also planning my next class and lining up speakers and planning exercises. My goal is to write 3 pages a day and to keep looking for speaking opportunities. I have decided to attend a spiritual retreat called Grace Adventure. It is a huge commitment that will take me away from my family for four weekends over the next 3 months. But I have internal work to do- I can't move forward until it gets done, and I'm chomping at the bit to move forward. I already have someone else to teach my students while I'm away. I will also be applying to NYU for a fellowship in nursing leadership. If I'm accepted, I'll be in NY six times in six months next year. One of my CPR students told me about this and I've been waiting all year to apply. I won't be speaking at AAP in Boston because it's too close to MANA but I did receive an award from them for best abstract (that was pretty cool, it came with a cash prize). It's good to wake up every morning eager to put my feet on the floor.

Fire Sale

I'm selling my business. I want to free up time to pursue my master's. I really wanted to own my own business. In four years I've grown a successful business- I've done it. Now it's time to move on. I really want to teach. I really want to write. I really want to speak. I'm giving myself permission to follow my bliss- which means, I'm selling my business. I don't know what the future holds, but I'm opening my arms wide to embrace it.

Offerings Upon the Alter

I have returned from retreat- no new hairdo perhaps, but a new attitude. Every internal belief and mental construct has been challenged. I feel like humpty dumpty- shattered to pieces and in dire need of reconstruction. Yet I am at peace and full of hope and the clarity continues to come to me...

At the retreat, Morningstar had a reconsecration on Sunday night. It was a beautiful ceremony. She renewed her vows as a hermitess nun. One the the things that Morningstar is gifted at is creating ceremony. (She created one for me two years ago when I was pregnant) Folks come to her needing a ritual of celebration or mourning or whatever and she creates it for them at the Holy Land. (She makes alters like most folks bake a dozen cookies or fill a vase with flowers. I've decided to come home and make my own household alter- been wanting to do it for years) Morningstar literally created an outdoor church, hanging banners from her small forest of trees, setting up several alters, and tables for feasting afterwards. Her priest came to consecrate her(he was quite a sight in his long flowing white robes and white hair and beard- he looked like Saint Francis of Assisi in his church of the woods). About 50 people came bearing food and gifts and loving intentions including many of Morningstar's family and a small army of children she midwifed. Morningstar incorporated many of her native Cherokee elements into the ceremony. When she could not find an order that fit her beliefs and culture- she started her own- an order devoted to simple and sacred living. Ten years later she remains an order of one- with a worldwide community of supporters.

It occurred to me watching the ceremony play out, that Morningstar created something where there was once nothing. (her hermitage, her order, her priestesshood, her community) Surely this is what God wants of each of us. To join in and become a part of the creative process for good wherever we are, and where the capacity to perform our soul's work doesn't exist- to create it. This is my task in the work of birth.

Dangerous Mind

Okay, yesterday I did something totally out of character. I was reading my book, minding my own business, when out of the blue (seemingly) I had a thought that I should go to the Holy Land (no, not that Holy Land). My hermitess nun's retreat center in central Missouri- she calls it the Holy Land. This thought came into my brain about 1:32. At 3:06, I was packed and on the road to Lake of the Ozarks. I left kids and husband for 3 days of silence and solitude. I didn't plan it, I just got up and went. I paid the mortgage, made dinner, arranged my kid a ride to soccer, gased up the van, called my husband at work to tell him what was up, and then I left on a 3 hour drive. I've never done anything like this, not sure why I did it now. But I felt an urgent need to get away from my life for a little while and process things. The Holy Land is beautiful. It's a little meadow nestled in between foothills on all sides (you can't make a cell phone call from there). Sr. Morningstar has many scultures and well tended gardens, along with her cottage, the retreat cottage and a small chapel. Folks also camp out in the meadow, or stay in the teepee, that's been erected on the land. Except for Morningstar and her dog, I am alone on the land. I read, write, pray, meditate, do chores I'm given (Morningstar says work can be done as a meditative practice- she tells me to imagine my old self being transformed as the wooden bench is transformed as I clean and oil it- I bet she learned that from Mr. Meyagi- 'Daniel son, wax on, wax off, wax on, wax off...') and gaze in wonder at the beauty all around me. I am in silence but it is not quiet. The sounds are constant, but not like city noise. In the relative quiet, I can hear my own voice. Not sure if this is an epiphany or descent into madness -it's sometimes difficult to tell the difference. My heart feels at peace, but my mind is all ablaze. Mostly I'm here to experience God(ness) and re-create my life and refine my mission. Tall order for 3 days in the sticks... I kinda feel like Moses ascending into the mountain wilderness. We'll see if I emerge in 3 days with an ethereal glow and a spiffy new hairdo (if Charlton Heston can get one, why can't I?)

Conversations With Myself

I've been reading 'Conversations With God.' Stole it from my 17 year old- he wants it back, but I must finish it. So intriguing, so conflicted. I want to believe it- it makes so much sense to my way of thinking, yet it conflicts with everything I've ever been told is true. It's a spiritual dilemma in the making- I feel my middle giving way. One of the by-products of reading this book, is that my work as a birth advocate seems complete in light of it. I used to think, oh I'm just a birth advocate, it's not like finding a cure for cancer or brokering peace in the Middle East, but its my little contribution to the world. I even used to think my vocation was not 'spiritual enough.' After reading (only half of) CWG, I see what I do in a much larger context. I already knew birth work was what I was born to do- I just didn't see it as being essential to the world- I didn't see my presence as being essential to the world. Now everything is being shot to shit and I'm forced to delve deeper... to answer questions I don't know if I should be asking...

Calling All Pregs...

Well not all pregs, only those between 6 and 9 months- in the Kansas City area. I need 4 pregnant ladies to volunteer for my upcoming nursing class on Aug. 25th. The students will measure and feel bellies for fetal positions. It will take about an hour of your time. Please contact me at laborpayne@yahoo.com if you are interested.

As if I don't have enough to do...

Yesterday, I got an email from the doula list serve that said the doc and midwife will resume seeing patients on Wed. I suppose this is a victory, but I still have'nt got the whole story-which is why I delay in relating it. I'll try to go straight to the source for some input.

I heard through the grapevine Dr. Phil is asking for input for a show on homebirth. I sent an email- don't expect anything to come of it. (I like the good doc, but I do think he's biased and runs his own agenda. That could spell trouble for the person supporting the view he's opposed to- since he's not shy about bullying and berating.)

Check out this article from Time magazine on homebirth. I like that the topic is getting press. It lays out the pros and cons without drawing any conclusions and mentions the epic battle here in Missouri.

Just got the news this week- I'll be speaking at MANA (Midwives Alliance of North America), on the topic of healthcare blogs no less! I'll have to spend some time getting back on the circuit and finding some new birth blogs to cite. If you know of some you really like, let me know please. MANA will be in Traverse City Michigan (beautiful place!) in October. I attended a MANA there many years ago and loved it. The resort served cherries in every meal (thats what they are known for there) and I stole a quiet moment to walk the shores of Lake Michigan. I took my baby with me, who is now 14. Ironically, I was interviewed for a video production on homebirth at this conference when I attended in 1993, and it will be premiered at this year's conference (yes, it took fourteen years to complete- so I'm doing well going on year two of my production!). The producer, Sage Femme has amazingly kept in touch with me all this time (we see each other at MANAs) and has been an enthusiastic supporter of my work. I'll let you know when the video is out. I use her video, "My Baby, My Body, My Birth" to teach my nursing students. Last year was my first time to present at MANA. I'm looking forward to doing so again. I may be presenting at this year's AAP conference (American Academy of Pediatrics) as well on the topic of 'lactation in the African-American community'. Its in Boston near the same time as MANA so I don't know if I can work it out- but I have been invited.

I've officially applied to the master's program at the same nursing school I did my undergrad. I could finish my masters in nursing education in 1 year. (I already have a million hours from changing my major twice already- first CNM, then healthcare administration- so all I need it the educator specific courses). I'm excited to think I'll be finishing my masters soon. I'm more activist than academic, so I don't know how any employer will interpret my 'extracurricular activities'. It will probably be like L&D nursing- I'll probably lose a lot of jobs! But it makes for good storytelling!

Birth Activism 101

So here's what happened. I got an email a couple of days ago off the doula list serve that a local DO and her partner CNM had their privileges suspended at a local hospital. This is a group that is highly regarded and recommended in the community. The were the first doctor midwife and midwife for this particular hospital. I don't know the circumstances for the suspension (the community is abuzz with speculation) but no one really knows because they are not supposed to speak about it. This action is not based on a consumer complaint (these women are well loved and respected). A local homebirth midwife called a letter writing campaign to support them and hopefully get their privileges reinstated. We did the letter writing thing last night, about 25 moms and a couple of dads got together at our local birthing center (which just recently reopened) and wrote all these nice letters. The homebirth midwife and I will deliver them to the hospital this morning, as the big meeting with the DO and CNM is tonight- of course its a closed meeting.

This makes me so angry. Another CNM under attack by her own facility. I've seen so many CNMs in this city tiptoeing through practice in order not to upset the apple cart. Sometimes even being sabotaged by their own success. Physicians complain if their practices grow too big or too fast. Babies born in a squat on the floor instead of on the bed, well we can't have that. The list goes on and on. Those few practitioners who doggedly try to make changes in the hospital setting have to constantly watch their backs for things like this. Even their labor nurses will rat them out if they deviate from 'the norm.' Its difficult to be an agent for change, whether you are on the inside or the outside. My challenge right now is to keep the bigger picture in mind- it's not just about these two practitioners, its about all the women they serve. All the women due right now, who will have to be delivered by 'the physician on call' if they go into labor this week, or find a new care provider at term. This is untenable. This is unethical. Women deserve better than this.

So I'll put a smile on my face, be nice, and deliver the letters, and hope they get read, and responded to. If not, we may have to kick things up a notch...

World Breastfeeding Week

As promised my (edited) letter to the editor in my local paper. Going for the Gold

My so called academic life...

Now that my class is over, and I have some time to reflect (two whole days before my second summer class starts) I'm amazed at how quickly I've become attached to this teaching thing. I'm also itching to get back to my writing. I need to get back to work on my homebirth book and I'm rethinking and tweaking the breastfeeding book. I plan on starting work on my masters again in September. I'm seriously thinking of changing from Nurse Executive Practice to Nurse Educator. I can see myself doing this. I can see it as a better jumping off place for my writing. Wow, I didn't think a part time gig would change me so much. I'm amazed that there is this much change in me. I feel so focused and sharpened, like I know what I want, and how to go get it. I've decided to continue teaching part time, finish my masters (about 2 years) and get out my books and documentary. More than enough to keep me busy over the next 2-3 years. I think I've accidently stumbled upon my life.

Living my life like it's golden...

It's time to send my little darlings out into the world... Not my kids, my students! I finish up with this OB class for RNs on Friday and start OB for LPNs next Monday. I am dead dog tired but with a smile on my face. I hope I've given my students food for thought when it comes to women and birth and breastfeeding. One of their final assignments is to write a short essay on what the class meant to them. I'll ask their permission to post some of their responses on the blog. There are some terrific future nurses in this bunch and I'm so proud to have been a part of their education.

World Breastfeeding Week is upon us! (Aug. 1-7) I just emailed my customary annual letter to the editor about it this morning. They usually print it. I'll post a link to it if it goes up. Life is a mad rush of creating a 100 question final for my OB students, getting ready for our Sat WBW event (I got the mayor's wife to come speak- she used to be a doula, and some food donations from some catering friends of mine), and getting my kiddos ready for school. We have eye appointments, haircuts, clothing shopping, school physicals and shots, and instuments to get into playing condition (blow the summer dust off of them). If I live through this week- you'll hear back from me!

Leaving Las Vegas

I haven't written about Las Vegas yet- so here it is. I spoke to a small but enthusiastic audience about maternal-infant care after a disaster. The audience were institutional, municipal, state, and federal emergency management planners. I talked to them about the special needs of pregnant, laboring, and lactating women, before, during, and after a disaster. I knew this was information that probably didn't even come onto the radar screen for most of these folks. I spent a large portion of my time on the importance of lactation during a disaster. They seemed particularly enthralled with the concept of 'giving birth in place'- not a planned homebirth exactly, but giving birth wherever a woman happens to be by necessity (think Katrina- hospital not functioning or can't get to it). The ACNM website has lots of info on it: http://www.midwife.org/. The folks I spoke to have to plan for every possibility as well as contingency plans. They have to designate possible shelters and were intrigued by the idea that women might be giving birth or breastfeeding in their shelters- oops didn't think to plan for such a thing. It was very satisfying to give this presentation. There were emergency planners there from as far away as Delaware. I'm glad I could give them new information, and I learned a lot from them as well. Las Vegas was- interesting. My mother and visited the strip twice. We walked through several of the hotel/casinos. We didn't gamble- all those slot machines with the lights blinking and and pinging sounds were kind of headache inducing. Each hotel has it's own personality- some were cheesy/quasi-sleezy, others were more elegant than I ever would have imagined. We ate meals in lush surroundings, and enjoyed a lovely afternoon respite on the most elegant hotel veranda in the presence of a waterfall and lush wooded area (all transplanted to make you forget you were in a desert- it worked). Nice trip, but I was glad to get back home- to my family, and my students. I didn't like leaving them in the hands of another instructor. My kids on the other hand, were in the hands of my DH and MIL so I knew they were fine-- I just missed seeing them.

Sorry for my long hiatus. I've become enmeshed in this new venture of teaching nursing. I love it, I absolutely love it. Slowly but surely I'm clearing my schedule to accommodate this grand experiment. I really thought this was just a part time gig for extra money. I didn't think about it being an opportunity to convert 13 people to midwifery care, or opening 13 people's eyes to birth inequities, or change 13 minds about the delivery of healthcare to birthing women. I've gotten to teach OB nursing exactly the way I would want to teach it. We have visited both the navelgazer's blog and the baby catcher's blog. They sat in raptured awe as my friend Mary told us about her experience being foster mother to an HIV positive child, we thrilled to the stories of my midwife as she told of her struggles and challenges in trying to practice her trade. I watched them giggle as they tried to steady themselves on the birthball the way the doula had showed them. I thrilled to hear their comments about what they saw and heard in clinicals- I knew I had gotten to them before they were enculturated into 'normal hospital birth.' I love watching their minds change right before my eyes. I taught them about the seven types of childbearing loss and watched their eyes grow big as they realized that they had experienced their own losses, but no one had called it that. We've discussed maternal and infant mortality, healthcare in third world systems, unorthodox family structures, healthcare policy and the impact of politics. (Now to be fair, we've also learned how to read a fetal monitor strip, how to assign apgars and difference between a first degree and fourth degree tear- you know the textbook stuff. ) I've tried to focus my skill building on good communication, and critical thinking, two skills indispensable to nurses. I don't think I've ever done anything so difficult that I loved so much.

Living La Vida Loco

Yes, Dear Reader
You have been abandoned. Between my new teaching gig and getting ready for Las Vegas on Monday, I have not had a spare moment to write. I really like teaching, but as I assign my first grades, I'm seeing the down side. I've been using the Navelgazer's blog to teach them about midwifery. Writing curriculum has consumed me. On top of all that, my business is booming. I'll have to see if really have the intestinal fortitude for success. My mother is going with me to LV. I'm looking forward to 3 days with her. I have to return early because I have classes to teach, but it will be nice to get away if I can refrain from worrying about my nursing students, and my baby, and my business, and my clients, and my husband, and... (okay, maybe it won't be so nice- but collecting a check for speaking will be. I'll be talking about maternal/child health during a disaster. Did I mention I haven't finished my powerpoint...

Legal in Missouri

Article from my local paper:

Missouri law delivers good news to midwives
By JASON NOBLE
The Star’s Jefferson City correspondent
JEFFERSON CITY Missouri midwives, who for decades risked prison time to deliver babies in their clients’ homes, can now do their work openly and without fear of prosecution.
The state Supreme Court on Tuesday reversed a lower court ruling and upheld a 2007 law allowing midwifery in the state. Missouri was one of about 10 states that didn’t allow the practice unless the midwives were certified nurse-midwives — registered nurses who worked with a doctor.
“This is a victory for Missouri families,” said Anita Woods, a certified professional midwife from Leavenworth, Kan. “This has been a hard-fought battle for something that Missouri families have deserved for decades.”
The law allows midwives who have earned certification through a nationally accredited organization to practice in the state. Previously, midwifery was a class C felony and carried a seven-year prison term.
The exception was the certified nurse-midwives who usually deliver babies in hospitals. They could do home deliveries, but only if they had a collaborative agreement with a doctor. The majority of Missouri doctors don’t agree to that arrangement, according to the Missouri Midwives Association.
Midwives and their advocates cheered the 5-2 decision, while doctors groups mulled their options for a challenge.
The law in question, which allows certified midwives to provide prenatal, delivery and post partum services, was slipped into a larger bill concerning health insurance in the waning days of the 2007 legislative session. Gov. Matt Blunt signed it into law before most people realized it was included.
Once it was discovered, several state physicians’ groups sued to block it, arguing that doctors could be held legally liable for cooperating with midwives who lack professional licenses.
In August, the Cole County Circuit Court ruled in their favor, throwing out the midwifery language on constitutional grounds.
The state constitution limits each bill passed by the legislature to a single subject that is clearly expressed in its title. Including the midwifery language in the larger health insurance bill violated that law, the circuit court said.
The Supreme Court took up the case earlier this year. The opinion handed down on Tuesday reverses the lower court, ruling that the physicians’ groups lack the legal standing to sue. Without proper standing, the court ruled it could not consider the facts of the case.
Judge William Ray Price Jr. issued a dissenting opinion, in which he said the doctors did have standing and agreed with the lower court’s constitutional interpretation.
Lawyers for the doctors’ groups are deciding how to proceed, said Jeff Howell, general counsel for the Missouri State Medical Association.
Price’s dissent clearly shows the doctors’ arguments were legitimate, he said, if only they had the right to argue them.
“I really think we were denied our day in court,” Howell said.
The doctors’ groups have 15 days to apply for a rehearing.
Sen. John Loudon, the St. Louis County Republican who originally slipped the midwifery language into the 2007 bill, said the decision — even if appealed — marked an opportunity for further discussion between doctors and advocates of midwifery.
Before the ruling, doctors refused to negotiate on the matter, believing they had the upper hand, Loudon said. Now things are different.
“At this point, the table is level, and it’s time for everybody to sit down and negotiate a bill we all can live with,” he said. “That’s always been my desire.”
Some midwifery advocates, however, interpreted the decision as a firm scolding for the health care industry.
“The real significance for both Missouri and nationally is that this tells big medicine — or organized medicine — that it has no legal right to speak for the consumer,” said Debbie Pulley, director of public education and advocacy for the North American Registry of Midwives.
Midwives and their supporters have waited for this day for decades, said Mary Ueland, the grassroots coordinator for Friends of Missouri Midwives.
There aren’t a lot of certified midwives in Missouri now, although with their services legal, Ueland said midwives from across the country could soon make their way to Missouri.
“I’ve heard from a number of midwives in other states that grew up here and got training elsewhere…,” she said. “I think there’s a lot of people across state lines waiting to come back to their home state if they can only practice.”
Home births account for between 1 and 2 percent of all births, although the numbers vary greatly from place to place, Pulley said. There are more than 1,400 certified midwives nationwide. Numbers specific to Missouri are harder to come by because midwives cannot advertise their services openly.
Woods, the Kansas midwife, said the ruling brought the state into line with the rest of the country.
About 40 other states, including nearby Kansas, Nebraska and Oklahoma allow midwives to practice.
“In Arizona, New Mexico and Washington State, you can open the yellow pages and find a page and a half of midwives,” Woods said. “I’m so happy Missouri has stepped into the 21st century where that’s possible for the average Missouri family.”

Petition

There is a petition to support homebirth has been started in response to AMA and ACOG. You can sign it here.

Must Read

You must read Navelgazing Midwife's post on her response to the updated ACOG statement against homebirth. It's a marvelous read. She lays out 11 suggestions for MDs for wooing women back to hospital birth. I love her suggestions. It also made me realize that if OBs are fighting this hard, they must see homebirth as a real threat (not to public safety as they claim, but to their political status). The victory in Missouri also reminds me that Goliath doesn't win every battle. Am I feeling the beginnings of a shift in attitude about birth that I've long waited for, or is it just last night's burrito testing my intestinal fortitude?

It's a Wrap

According to Families for Missouri Midwives, the MO Supreme Court overturned the ruling yesterday that outlawed the new midwifery law- so CPMs are now legal in Missouri! I can scarcely believe it. This has been such a long time coming- more than 20 years in the making. Go to FOMM to read the details. This is a huge victory for the families of Missouri and for MO midwives. The Supreme Court found that AMA (American Medical Association) had no standing in the case and set aside their appeal that blocked the new law. Wow. How this will all play out, I have no idea, but this decision is huge. You can also read about it at Big Push. Now the real work begins: how will CPMs be regulated, and by whom?

AMA - WTF?

Okay, so I grieved for all of three days. The rest of this time I've been prepping for my summer job- teaching OB/Peds nursing at a local college. This should be an adventure. I'm also finishing my powerpoint for next month's presentation on Maternal Child Health During a Disaster. I'm looking forward to visiting Las Vegas, but I'll be stressing about my students since school will have started. Anyone hear what the AMA (American Medical Association) is up to in regards to homebirth? I would love to see some documentation on this if anyone has some links.

Flying from the nest...

We are having some great dialog on pay scales for midwives. I especially appreciated Molly's point. Consumers are mostly shielded from the true cost of healthcare by third party payers, so when something comes out of pocket (like homebirth fees) it feels like a lot more than it really is. I'll chime in a bit more later in case there are other comments. Right now I'm having a sad week because my 20 year old has left the nest. He caught a plane yesterday to Washington DC to do his summer internship. When he returns in August he will be attending college about 2 hours away. I miss him terribly already. His siblings are expressing their grief by moving into his old room already (he's only been gone 24 hours!). Let me lick my maternal wounds and I'll be back shortly.

Calling all midwives...

A commentor has got me thinking. She mentioned how midwives are compensated less than physicians, which got me thinking- should this be so? What parameters are used by midwives (of all types) to set their fees. Is it years of education, years of experience, the going rate for your community? The reason I ask is because I get the impression that doulas, midwives, childbirth educators and the like are expected to get less than 'market value' for their services.
So Dear Readers, who fall into these categories, don't leave me to my ignorant guessing. How do you feel about clients asking you to reduce your fees or even asking you to serve them for no fee at all? What criteria do you use to set your fees. Do you feel that you get fair compensation for the work you do? Midwives, should you be making less than your physician collegues? (I once saw a 60 minutes segment where nurse practitioners made a compelling case for charging the exact SAME fees as physicians.) Do you feel your service is valued by the community you serve and is that value reflected in the fees you recieve? (What about that good 'ol Americanism, 'you get what you pay for' where a higher value is assigned to a higher price tag?) Do you feel yours is a spiritual calling and therefore don't feel right taking money for it at all? I would love to hear your thoughts on this topic. Then perhaps I'll chime in from a nurse's perspective, but for now, the floor is yours.

I'm Baaaack...

The conference went swell. My presentation was well attended and well recieved. I love doing this (the horrors of flight notwithstanding) and look forward to my next speaking gig in Las Vegas in July. My mother wants to go with me, which will be great. She'll get a kick out of watching me speak, and I'll have someone to film me. (I need some footage for my website.) I got some good feedback after my talk and look forward to seeing my evals for the session. Doing this presentation, and collecting a check for it, makes we want to do it more and more. I tweeked my website since I've been back, and have read two books on building a consulting business. I would love for my speaking to branch into consulting. Meanwhile, back at the ranch, my human baby was cared for just fine, and my business baby also did fine as well. I have to give my son his props- he held down the fort just fine. (Although I confess, I called home twice while I was away, but I called about the business about 3 times a day.) I also had it impressed upon me that I need to finish a book- any book, for the sake of needed promotion.

I'ma leaving on a jet plane...

Headed to Minneapolis this morning- still over my head in overdue reports and articles. I guess I'll be using my travel time to write. I am anxious leaving my baby- not the human one- my husband is excellent with him. I mean my business. I'm leaving it in the hands of my oldest son. I have a total of 5 classes going on while I'm away and have done everything in my power to make sure they go off without a hitch. But I'm still nervous. I don't want my clients to be let down in any way in my absence. I know things will probably go just fine- its just so hard to delegate and let go. I checked the itinerary of the conference. There are about 1200 attendees, I should get about 200 in my breakout session. Send good thoughts my way, that I will positively influence my listeners. It would also be nice if I got more speaking gigs out of this one!

Texas- Its a whole other controversy

Check out this link to Controversies in Childbirth. This looks like a terrific conference and they are still requesting speakers! What controversial topic should I take on? Unassissted birth? Health disparities in birth? How birth practices sabotage successful breastfeeding? Homebirth for grandmultips? Why I turned my back on hospital L&D nursing? Ah, so many subjects, so little time. Unfortunately with an article due and getting ready to leave town, I'll have little time to devote to daydreaming, but I do intend to submit an idea.

Put Your Money Where Your Breast Is

I got some excellent feedback from the LCs last night. Its interesting that my very first official speaking gig for pay (besides the one I did in San Francisco last February) is talking to WIC about breastfeeding. I'll be addressing admin not the rank and file, so my presentation is to those who can facilitate change, yet this will be a delicate balancing act. Some have told me I'll be preaching to the choir, but others have said its a great venue for making converts. I'm sure both statements are true. Its a balancing act, because I don't want to offend them on the formula issue because I want them to hear what I'm saying about lactation. So I included a slide of what I think they are doing right. The suggestions are a little radical- like having an LC in every clinic (LCs are expensive) but as good as peer counselors are, they do not represent professional support. I'm also suggesting that all peer counselors be trained as breastfeeding educators (also expensive). But I have no choice - if we want to make an impact on breastfeeding rates, we have to be willing to invest in those outcomes. The taxpayer is getting a much better return on investment if breastfeeding rates go up, and formula feeding goes down. Past a certain tipping point, there will begin to be a savings.

Breast Conversion

Tonight I give a preview of my breastfeeding presentation to the local lactation consultant group. I look forward to finally visiting their meeting, even more so to give my presentation and get feedback. Our local LCs are the foot soldiers. They labor tirelessly often stretched between hospitals. I hope to gather feedback from them about what LCs have to offer in a WIC office setting. This is one of my suggestions for WIC in my presentation- that they have an LC in every office. I also suggest that WIC offices be converted to breastfeeding clinics. I'm sure that suggestion will go over like a ton of bricks. Then I suggest that they delay offering formula vouchers until six weeks postnatal. That should have them booing me off the stage and throwing tomatoes. Its very difficult to convert someone from bottle-think to breast-think. I'm hoping an evening of hanging out with LCs will be refreshing for my soul and good preparation for next week.

Battle for the Breast

Last night, I attended a meeting for the healthcare foundation board that I sit on. This group has many wonderful pans in the fire, but last night, a proposal was made to start a new initiative dealing with cultural competency. Now before I started researching my breastfeeding presentation, I thought cultural competency was a noble enough goal- now I think it's absolutely essential to making a dent in health disparities. My look at research showed me how minority interaction with the healthcare community can be unproductive and downright punitive without the principles of cultural competency in place. There is a direct link between health disparities or health outcomes and cultural competence. That is why I'm so excited about this new 3 year initiative to fund the exploration of training for safety net clinics. I hope to have an active role in this, even though my term is up next year. What I found, while not directly looking for it, was that black women were less likely to be talked to about breastfeeding from their healthcare provider during prenatal care, were less likely to get follow up support when complications arose, and were less likely to have access to mother to mother community-based support. Failure to initiate or continue lactation has a direct impact on infant health- more so in the black community where health disparities already put black infants at more risk. What I found overall is that the infants most likely to benefit healthwise from breastfeeding, were the least likely to get it. My buddy Charlene has already warned me that I'd have to overcome WIC complacency in my presentation, that "they messed 'em up at the hospital, so what can we do about it now?" attitude. However WIC does see folks prenatally too! I'm gleaning my list of over 55 barriers. I want to shock folks out of their complacency, but not overwhelm them. I want them to see that black women don't just 'prefer the bottle' as some research suggests, but that they have overwhelming odds against them in the fight for successful breastfeeding. More to come on that subject.

Blog Eulogy

I'm so sorry to have to be writing this, but this is a farewell send off to Mama Midwife Madness, a blog I've enjoyed since I discovered blogging 2 years ago. Mama Midwife joins others in a long line of wonderful blogs that have removed themselves off line. Flea, FPMama, Minority Midwife and others, gone, all gone. They become like friends, a glimpse into the world of likeminded others... and when they go, they are missed. Some leave the blogosphere entirely, some just go private. Mama Midwife went private and has graciously invited me to continue reading, but I know the sadness of losing a blog, often without warning and usually because something really bad has happened. Unfortunately Mama Midwife was the victim of blog bullying which can be very scary and very damaging. This all echos my presentation a few weeks back, when I wrote that blogs can have their dark side. Just as you can use blogs to build a reputation, they can backfire when used to call your credentials into account. It makes me wonder what kinds of things can be said about me to make me want to stop blogging. It's hard to imagine such words. One of the reasons I 'divested' myself of affiliations (ie., quit working at hospitals) was to be able to write and speak freely. I use my real identity precisely because I don't have to 'hide out' or worry about 'getting caught'. I don't expect everyone who reads this blog to agree with me, but I do expect respect and common courtesy, which I'm happy to report, so far- I've always recieved. I do try to be objective and listen to dissenting voices. No one is 100% correct nor 100% incorrect so there is something to be learned from everyone. Having said that, I do have a political agenda- I'm not just blogging to blow off steam. I consider blogging a tool in my arsenal for cultural change. It's sobering to think that any of us can be driven off line by the hurtful words of others. Farewell Mama Midwife- the blogosphere will be a lonelier place without you.

Knocking Down Barriers

I've been hard at work trying to finish my powerpoint for the WIC conference in a couple of weeks. (WIC is a government run food program for low income women and children who are nutritionally at risk- the program supplies them with supplemental nutritious foods to round out their diets) The research has been very thought provoking. I've learned so much more about the barriers that have to be overcome for some women to breastfeed. Its amazing. It seems that the babies who would most benefit from being breastfed are the least likely to be. How sad. I hope to have many, many opportunities to give this presentation. From the research, I identified 55 barriers divided into 9 categories ( political, cultural, social, economic, institutional, behavioral, environmental, educational, and relational). I came up with a list of recommendations that cover every level of human intereaction from governmental interventions to community-based, to one-on-one in the workplace. I have still have mixed feelings about this organization. They are an arm of the government, and the largest purchaser of formula. On the other hand they are under federal mandate to increase breastfeeding rates. However, one of the research articles I came across identified being a WIC mom as a factor for being least likely to breastfeed! At least 2 research articles found WIC interventions to boost breastfeeding to be weak or ineffective (though there were other articles that promoted the stregnth of other interventions). In other words, there is much work to be done. This organization has access to the women who need to increase their breastfeeding rates- so this is the organization to join forces with. The idea is to come up with interventions that really work- interventions that truly change peoples beliefs and behaviors. I don't believe that governments lead cultural change, they can only facilitate and encourage that change. Consumers lead cultural change. My desire is to draw consumers to claim and embrace breastfeeding as their own.

Between a Rock and a Hard Place

The Missouri midwifery bill is having a final go at it. This legislative session is about to come to an end, and there's just enough time to get a vote in the state senate. I wish my sister Missourians well. We've gotten to this point many times in the past. So many folks work so hard to get a bill this far. Folks who move here from other states are always amazed at how repressive things are here. Kansas law keeps non nurse midwives allegal, while Missouri law has them out and out illegal. Its a felony offense to practice midwifery (unless you are a CNM) and midwives here have been prosecuted. The fear of prosecution keeps midwifery underground for the most part. You kinda have to know someone who knows someone. All this cloak and dagger mystique keeps options out of the reach of most women. Some women prefer a CNM to care for them- but good luck finding one who does homebirth. Punitive malpractice insurance companies practically guarantee that needed physician back up and collaboration will be unavailable. Women don't have true choices in the hospital setting. Political tyranny limits their choices outside of the hospital. What are women to do?

Decidedly Undecided

I'm reflecting on life as I sit at the computer and watch my toddler feed his oatmeal to the dog. I heard a terrific speaker, Dr. Mom, at a luncheon earlier this week talk about life balance. How when we take something on, we should let something else go so that we don't get overloaded. I know that my life needs an overhaul to support my weight loss goals. While I don't know yet what I'll decide- its nice to have choices. It's good to be in the decision making role. I'm happily muching on an apple bran muffin and glass of water (I've given up drinking milk), and thinking about how this relates to birth. How much of her decision making role does a woman give up when she enters the hospital to birth. Yes, healthcare providers expect you to make decisions- the ones they want you to. Woe to those who desire something contrary to standard protocol. But if you can't say no, does your yes really have much value?

Back to Birth

I met with a fresh, young, lovely couple last week about being their doula. I don't think they will (or should) select me, because I have an out of town speaking engagement one week before their due date. I have to confess a slight anxiousness about returning to birth. I don't know if its too soon, or if I just have to jump in and do it. I do feel the need to work through my issues before I attend anyone's birth. I want to help birthing women, but I'm still struggling with what exactly that looks like

Conjugating Verbosity

This is a photo of Josiah and I 'womanning' our booth at the Debi Bocar breastfeeding conference a couple of weeks ago. Jo is flirting with a pretty lady (or begging for her food) I can't remember which. He engages in both activities shamelessly and often. You'll notice me on the other hand studiously examing some undoubtedly important research document pertaining to some critical issue, or is it a People magazine article about the state of Britney's upper thigh cellulite? Oh well, at least I'm reading.

Blogger Beware

Today, I'll be doing my presentation on healthcare blogging- so this message is for the audience of my presentation. Blogging is great for sharing information, consensus building, or just blowing off steam, but beware, it is not without risks. Blogging can have unintended consequences. It can cause misunderstandings, hurt feelings, fights, and even litigation. You should always follow the bloggers code of conduct when blogging and always be aware that you never know who is reading your blog. It's okay to share your opinions, even if others don't agree, but you should be wary of personal attacks. Words don't always come across in print, they way they would in speech. Happy blogging.

Myths of the Black Breast

So much flowing through my mind as I review research for the breastfeeding book and upcoming presentations. I give a presentation tomorrow on the impact of blogging on healthcare! I'm quite excited about it and learned a lot as I researched the subject. Sadly my research on breastfeeding is drawing me to conclusions that no one wants to hear about. Unfortunately the most powerful barriers to breastfeeding for black women can be traced back to institutionalized racism and how that racism impacts healthcare disparities, access to care, care provider and healthcare consumer interactions, cultural perceptions, competence and ability, and on and on and on. It's really quite depressing and quite shocking- even for me. These are not the answers (to the question, why don't black women breastfeed) that I expected to find. But everytime I turn a corner, there it is smacking me in the face. On a brighter note, Valtra and I decided on the framework of our book (it won't be a how-to) and look forward to crafting our query to our selected publishing houses.

One Flew Out of the Cukoo's Nest

I took my 19 year old down to visit his college yesterday. He'll be attending Pittsburg State University in Pittsburg KS (don't even try finding it on a map). He has an internship in DC this summer first and will start at Pitt State this Fall. Before the intership, he has to get through graduation at the Jr. College he attends. A busy year for this kiddo. He is steadfast, earnest, and very thorough. So far he has payed for college all on his own, with his savings and earnings. He scrupulously accounts for every penny (he didn't get that from me). He researched colleges for months and chose one that offered his major and minor but was most economical. He studiously informed us that Pitt State would be less expensive than going to the state college here in our town and living at home. But honestly, I think it will do him good to go away to school anyway. I've been giving him some cooking lessons and reviewing the finer points of ironing. (He'll need to wear suits and button down shirts while in DC.) I'll miss this kid- he's really been the easiest one of the bunch. He's a 'walk the chalk' kind of person who wouldn't dream of breaking a rule (he doesn't get that from me either). Honestly it just seems like yesterday my husband and I were taking turns cuddling him in our arms (he was such a pretty baby) and now he's taller than both of us! He is quiet, handsome, and serious about his academics and will do well at his new school. I worry about him socially just a little. An introvert by nature (like both his parents) he is still warm and friendly toward people. He is very active in the church youth group and quite popular and a leader. But he's grown up with all those kids- its been a very insulated environment. Also, he's never dated- just group events with the church kids. (No we didn't forbid it, nor did we encourage it, he just never showed an interest.) He's a very devout person- I don't think he'll go crazy once he's out of his element, but I want to be prepared if he does start 'experimenting.' He's a good kid, but he's not perfect. I just want to be supportive of the man he is trying to become.

Drowning in a Think Tank

I was thinking about Monkey Mama's response to the Birth Abuse post. I also perused her blog, which I recommend http://babymonkeymomma.blogspot.com/. In thinking about this for weeks now, I've bruised my brain trying to come up with a way to communicate with first timers. I think I may have come up with something. Instead of scary cautionary tales- why not give them a new standard to shoot for? Instead of a list of dos and don'ts, how about a list goals to aim for achieving? (I didn't promise this was Nobel Prize level thinking) Why not encourage women with a new paradigm of birth and then send them out into the world with an objective list that care providers and hospitals and birth centers need to measure up to? I've contacted a friend who is a banker, to get guidance on setting up a non-prof. I'd be happy to hear from others.

Green Around the Gills

I've been writing a lot lately. Mostly changing "Homebirth Handbook" into " Green Birth" Honest to God, I haven't changed any content, just the layout and made some additions. The impact on my own life has been somewhat amusing. Let's see, we already changed over to the funny lightbulbs and started recycling. I'm really yearning for the vegan diet (I think dairy is keeping me fat) and I'm trying those green cleaning products. I'm actively experimenting with waste reduction. I once spent the weekend with a family of five that produced almost no trash. This must have been 10 or 12 years ago, but I never forgot it. They lived in the country and had goats. They purchased their food in bulk from a coop and stored things in glass jars. (I recently joined a food co-op too!) The only disposible item I saw them use was toilet paper (brown and recycled). They used hankies instead of tissue, and cloth napkins instead of paper. I have observed that the bulk of our trash is food packaging. Fast food and grocery store food is really over packaged. My immediate goal is a FAST FOOD FAST. Which means that I need to start cooking again. (I purposely stopped cooking some years ago) Now I make a weekly menu calendar for the fridge and plan ahead what to cook and where to purchase food. Because I have 5 kids that get sack lunches everyday, I'm not really sure how to cut that trash. Sandwiches have to bagged, granola bars, chips, etc. come in individual packaging that make life so much simpler. I did cut out juice boxes, explaining to my kids that its mostly empty calories and they'd be better off drinking water anyway. I've slowly weaned them off American 'cheese' and processed 'lunch meat' to real cheddar and deli meats. (They hardly notice the difference but it makes me feel better.) I also started shopping regularly at Sam's Club (I used to go about twice a year, now I go almost every week). Some of their stuff is over packaged to but I can buy in bulk which makes sense for our family of eight. My husband balked about the increase in food bill, but I just passed it off as a consequence of have almost 4 teenagers in the house. I live near a wonderful health food store (Whole Foods) but it is expensive. I try things out from the store, and then purchase them in bulk from the coop. I'm having a love affair with my crock pot. I like throwing in the ingredients in the morning and coming home to good smells and a cooked meal in the evening. Besides fitting in daily excercise, returning to daily cooking has been the biggest lifestyle change toward a healthier, greener life.

Bunny Hop

Hopping around on crutches today. Pulled a ligament in my foot the first day of a new free weight class. (pathetic!) Now I can't even do my early morning walk I enjoy so much- bummer. The good news is I can still hobble over to my CEO Roundtable and my writer's group this morning. I love both those groups. In the roundtable I meet with other women business owners- what a dynamic group. At the writer's group, I hobnob with some really talented writers. I'm taking my article for show and tell. I also officially joined the doula group yesterday as a homebirth doula (or should I say Greenbirth Doula!). Busy day, busy week, but I plan to use every spare moment to write.

Born Green

Its official. I'm initiating a website. Join me if you'd like. I've tried all weekend to purchase a domain but keep running into technical difficulties. I'm also trying to decide if I'm going to start a second blog, or simply change the name of this one. Input welcome.

Green Birth

I'm back- after a 3 day head cold induced coma, just coherent enough to blog. My son Airick won the seat on the local school board : ) I was disqualified from the speech competition for my paperwork not being in on time : ( And somewhere in the midst of my awake/asleep/dream state, I envisioned a movement. A massive uprising of men and women who said enough is enough. Things cannot go on the way they are, the way we treat birth must change. Our values in birth must be consistent with our values for living. This movement needed a name, a banner. Something common to the times- that immediately conjured up images of a new approach to birth. Something that would make a catchy domain name and an easy to remember web address. Something they'd talk about on CNN and pick up on at Associated Press. Something that would run rampant through the mommy-blogs as well as the medi-blogs. Something like-minded folks could rally around. A social cause, a consumer movement, a healthcare protest, an Ina Mae- load up the busses, we're headed for Tennessee, honest-to-goodness birth epiphany, THE LIKES OF WHICH THE WORLD HAS NEVER SEEN.

Or maybe that's just the headcold medicine talking.

Cytotec Kills

Here is a link to a story about cytotec http://www.consciouswoman.org/2008/04/01/conscious-woman-of-the-month-april-2008/
I was scared shitless every time I had to administer this drug to a woman. Of course, the women were clueless (think thier docs told them the risks- don't bet on it), but I knew exactly what the risks were. The cytotec pill was cut into pieces and placed in the woman's vagina or rectum where it dissolved and caused contractions. Unlike pitocin (and I never thought I'd be complimenting pit) that we could shut off instantaneously through the IV if a problem occured, there was nothing we could really do about a dissolved pill in someone's pussy if things went bad. (We could try running sterile water up her rectum or vagina to flush it out but that was a long shot.) When I complained to my nursing supervisors about my discomfort with practices like these, I was told I had no say over how doctors practiced. If they were doing something illegal or unethical, yes, but I could not complain (well, I could, but no one was bound to listen) if I disagreed with their practice protocals.. For instance, I couldn't complain about a doctor breaking a patient's water when they were dilated to 2 (even though I knew this could lead to an unneccessary cesarean.) In fact I was told by the higher ups (whose office I was called into from time to time) that defensive practice was defensible. They actually wanted the docs to be heavy-handed to protect the hospital from liability!
Anyway, take a good look around the Conscious Woman website. I'll be doing a program with them this Fall on the topic of infant mortality and lactation. It's a really cool set up. You access programs via conference call and computer. It's actually a very intimate setting to interact with world class speakers. It's a cheaper way to get ceus than traveling to a conference but you get the same caliber of speaker.

Cover Girl

Finally, it's up on the web! Read my April article, 'Delivered, Safe and Sound.' http://www.kcwellnessmagazine.com/kc_wellness_magazine_april_2008_006.htm
This was a scary article for me to submit, because I could catch a lot of flak but now that it is done, I'm proud of what I wrote. - Oh, and check me out, I'm on the cover! Enjoy.
PS: Some folks are having trouble with the way the pages load: you must click NEXT in the left hand column to see the next page. My article is about 4 pages.

Birth Abuse

I've been reading on the blogs lately some entries about 'birth rape.' http://www.birthactivist.com/node/226 and http://www.thefword.org.uk/features/2008/03/not_a_happy_bir
Birth rape seems to define an emotionally and or physically traumatic birth that leaves the mother feeling violated and traumatized. As someone who worked briefly as a sexual assault nurse, I hestitate to use the word rape out of deference to what happened to the women I saw, and prefer abuse instead. At the same time I'm not trying to belittle what birth-abused women have experienced. I've experienced it myself. But even worse- I have been an abuser. That is much harder to live with. That is one reason I feel so strongly about not returning to hospital nursing. It is to be perpetually torn. On one hand it is beat into your head that you must be the patient's advocate in the healthcare system. On the other hand, you are to be allies with your healthcare colleagues and there is an unspoken 'code' that you do not betray them- you protect them, and they will protect you, presumably from the patient. This was a line I could not walk. I abused patients at the doctor's will. I abused doctors in every conceivable underhanded sneaky way I could to make myself feel better about being coerced into abusing patients. After some time, I came to despise both camps because I could not do right by either. I cannot have a healthy relationship with birthing women or my physician colleagues in a hospital setting. The power is too unbalanced and I must pick a side. Sweetly coerce the patient into things she doesn't want done, or face down the ire of the doctor- and I did face down the ire. I was yelled at, cursed at, had things thrown at me, written up, complained about, asked to be replaced by another nurse. I also tried to empower women to fight for themselves. Once when a mother of six came in to deliver, she was stunned to find out she would be getting a cesarean because she had one with her second birth and her physician group had just banned vbacs. Now HER physician had promised her a vbac, but of course HER physician was no where to be found when she came in to deliver. When I was alone with her, I took a major risk by telling her she did not have to have the cesarean, she could ask for a different doctor. But later when the doctor reentered the room to get her decision, she simply resigned herself to it- even though she had initially been very angry about it. This story exemplifies birth abuse in all its glory- and yes I helped to cut her open without a medical provocation- just on account of a fear-based policy (litigation fear at that). I remember being angry with everyone that night, the patient, the doctor who promised something she couldn't deliver, the doctor who cut her, and myself. I cannot divorce hospital birth from birth abuse. It happens every day in a million mundane ways- here where I used to practice it is nearly ubiquitous.

Human Milk for Human Babies- Duh

Okay, I've put off writing about it for a couple of days, but if anyone happened to be listening to National Public Radio on April 1st, you may have heard a segment about a new breastfeeding study (http://www.npr.org/templates/player/mediaPlayer.html?action=1&t=1&islist=false&id=89271759&m=89271722). It's about 3 minutes long so you can listen for yourselves. The study, being reviewed by NPR's pediatrician, ultimately discounts some benefits of breastfeeding, such as bonding and increased cognitive acuity. It does support some benefits such as gastrointestinal protection. I haven't looked at the actual study, which is still ongoing. But what ultimately alarmed me is not the study findings, so much as the physician response to it. His final words were that he had always assumed the humans knew how to make the best milk for their babies, over cows and soy plants, but now he's not so sure??? Is he kidding? It takes one unfinished study (from Belarus, no less, a country whose child health has been so compromised by nuclear fallout that they send their kids to the US to be exposed to clean air, clean water, and healthy food not grown in contaminated fields!http://www.projectrestoration.org/) to make him question whether or not humans make better milk for humans than cows do? I hope his views do not represent typical pediatrician thinking. I was very heartened recently by the presence of so many pediatricians at the US Breastfeeding Committee conference in January, in Washington DC, though here in the midwest I have not found very robust support from that quarter.

airick leonard west for kcmo school board

My son Airick is running for the local school board. I couldn't resist running his video ad. If you are in the KCMO School District, don't forget to vote April 8th!

How to make a Bee Gee turn over in his grave

Big shake up in the world of CPR yesterday. In case you haven't heard the news, the American Heart Association announced yesterday that it's backing compression only CPR for sudden cardiac arrest in adults. Why do I care? For those who don't know, my 'day job' is running a CPR training business. Unfortunately I can't make a living bitching on blogs about birth and breastfeeding- so I just save that for my spare time activity. When I'm being gainfully employed I roam about the city teaching people how to save lives. I got an email from the powers that be telling me to start teaching the new way- NOW. I'm still trying to wrap my brain around the new changes and rushing to read the research so I know what to tell my trainers. Apparently the new data is so compelling (in number of lives saved by the new technique) that AHA couldn't wait until 2010 to make the change (they usually implement new changes every 5 years after their big research conference) . The last big change of 30 compressions, 2 breaths took place in 2005. So starting today, here it is folks:

For adults only do compressions (pushing hard and fast in the middle of the chest, between the nipples with both hands one on top of another, about 2 inches deep into the chest). Do the compressions at the rate of 100 per minute until help arrives. How fast is 100 per minute? Sing the BeeGees song "Ha, ha, ha, ha, staying alive, staying alive, ha, ha, ha, ha, staying alive, staying alive" The cadence of this song is 100 beats per minute. Simply push to the rhythm of the song. And don't stop until help arrives. (You did have someone call 911 didn't you???)

Children and infants, and adults who have drowned or suffered a drug overdose should still get 30 compressions and 2 breaths.

Crazy 'bout my baby...

I'm hanging out at home with Josiah and just thinking how nice it is to have a baby. Of course he's a toddler now. He's a cutie with brown curly hair and chocolate colored eyes. I realized what a happy happy boy he is, when he came down with an upper respiratory infection (URI) and he was fussy nonstop for 3 days. The virus passed and then he was back to his natural joyful self. He runs around from activity to activity, from sibling to sibling and from parent to parent. The world is just of feast of pleasurable activity for him. It would have been awful to have missed having this baby. I stop at no attempt to keep him out of mortal danger, cutting grapes in half, plugging up oh so attractive outlets, swooping down to pluck quarters out of his hands as they aim for his mouth, or stopping his 16 year brother from dangling him upside down by one foot. I probably save his life a hundred times a day. He rewards me with the sweetest 6 toothed grin. He has added much love and joy to our lives- not to mention his weight in poop and drool. Thanks Lord- nice call.

Pardon Our Construction...

I've been making some changes- to my life that is. I've been rearranging a few things. For starters, my extra weight is starting to negatively impact my life- so it has to go. I'm working in time for two things: exercise and writing. I've made my bedtime earlier (my evenings are woefully unproductive anyway) so I can get up earlier to walk. I've also found a gym near my office where I can do a midday workout. I'm taking Wednesday afternoons off to devote to writing. I can't let my life potential be sabotaged by ill health or disorganization. There is so much I want to do.
I have two article due out tomorrow. I'll post a link when they go online.
I met with Miss Valtra yesterday to discuss our book. We are stuck on whether our audience should be professionals or consumers. This one is tough. I was stuck on this same question with the homebirth book for nearly a year! But there is no point in picking up a pen until this crucial question is answered. We went back and forth for two hours discussing the pros and cons of each focus. Professionals need resources to assist them in encouraging their clients to breastfeed, but they can also act as gatekeepers to keep knowledge from clients. If we write a consumer book that appeals directly to women- women can access the knowledge for themselves. Valtra voiced frustration that one of her clients told her she went to a hospital breastfeeding course, and when she became excited and asked the lactation consultant what it took to become a lactation consultant, she was not given a direct answer. Valtra was furious. I know her frustration. There aren't enough nurses of color either. Part of the purpose of the book could be to inspire women of color to enter our professions because our needs aren't being met by professionals who fail in understanding what we need and how to encourage us (even when their intentions are good). Lord knows I saw plenty of providers whose intentions weren't good. "Those women don't breastfeed, so why invest the time?" sort of thinking. I'm not bitter about this, I'm just struggling. On one hand I want to write a book for my co-workers in the trenches to assist them with their clients, on the other hand, I want to write a book that pregnant and breastfeeding moms can pull off the library shelf and read for themselves and empower themselves. Everything flows from that choice. Even the title will be different depending on what audience we are writing to. This is not a how to book- this will be a book imploring the audience to consider the high stakes of black women not breastfeeding, medically, socially, politically, etc. We can't even choose a publisher until we know the slant of the book, professional resource literature or consumer guide? Any thoughts Dear Readers?

Bibliomania

Forebearance,
Dear Reader I beg of you- but I must confess, I spent my Easter weekend creating an outline for my grandmother's book. I've been gathering notes, stories and recipes for the past two years and now that she is gone, I feel very anxious to get started. The working title for the book will be: Midwife, Holy Woman, Warrior: Three Generations of African-American Life and Food
The book will include my grandmother's, mother's, and my own recipes and stories. Sort of a memoir/cookbook. I don't even know where to begin to find a publisher for this project. But I know I can always self publish. My second book: Chocolate Milk: The Impact of Lactation on the African-American Community has several identified publishers that Valtra and I are writing the query for. We completed our outline and have started researching our chapters. I suddenly feel less anxious about The Homebirth Handbook and I'm preparing it for query as well. I've decided to set aside Wednesday afternoons as my writing/research day. I'm planning a trip to my mother's/grandmother's hometown to research a little more geneology. Even with nine living aunts and uncles, I'm not getting a full sense of my grandmother's life and times. We also have several branches of family still living there so I can interview them as well. This project feels huge and holy- but somehow the times seems just right.

Have Pen, Will Scribble

That writer's group was great. It was full of local writers I had actually read before. Most of the women were former reporters looking to break into the national freelance market. There were a couple of book authors also. I learned a lot and was warmly embraced. I set a new goal (actually its an old goal I'm pulling out the closet and dusting off). I'd like to sell an article to one of the big national women's magazines, like Redbook or LHJ-and I'd like to sell an article to a popular African-American women's magazine like Essense or Body and Soul. These mags hits national markets and I'd love to bring some birth issues into public discourse. I just have to come up with a palatable pitch. I'm glad I've been writing articles all along. I have a body of work to point to to show my writing ability and expertise. With the encouragement and practical tips I recieved, I think I'm ready to write for the big markets.

Madwoman or Genius- the world may never know...

I took second place at the speech competition. So, unless number 1 forfeits or can't make it, I drop out here. I'm still keeping my fingers crossed though. I've decided on some publishers to query for my book, and I'm meeting with Valtra regularly to work on our book. The writer's group that I've been want to join meets tomorrow morning. This week my goal is to get those three proposals sent in. I love making writing a part of my daily routine, the books, the blog, my journaling... and guess what I write just for fun? Romances. I have chapters and excerpts all over the place that I jot down in momentary bursts of creativity in several blank books that I keep around just for that reason. I think in print. I have dozens of [formerly] blank books that I jot down thoughts, ideas, stories, poems, plans, goals, objectives, to do lists. They are right brain and left brain writings all jumbled together. Maybe that's my problem. I love writing, but I can't decide if I'm a pragmatist or a dreamer. I once told my friend Scott that I must be perfect because I use my right and left brain equally. He countered, that no, I was probably just schizophrenic. Just my lot, to have the kind of genious only serotonin re-uptake can cure...

Of This, You Can Be Sure

Recently, someone considering a homebirth asked me, if indirectly, for assurances. Of course I can give none. The person had been inflicted by horror stories that made them rethink their course of action. Well, I got horror stories too. I've seen illegal shit, immoral shit, unethical shit, and shit that was plain just wrong. You don't know how far a person will go when they think their liscencsure and livelihood are in jepardy. They will do anything to cover their asses, anything. Of that, you can be sure. My assurance in choosing a homebirth, if any, was that I would be in control of my environment, and I would choose my caregiver. If the shit did hit the fan, I'd be the determiner of which shit- mother nature shit, or iatrogenic shit. And nothing I saw during my years on L&D gave me any confidence in medical 'management' of normal childbirth. I just saw a lot of shit hitting a lot of fans.

Talking the Talk

It's official. I just booked my second paid speaking gig for the year (my goal is 12). I'll be speaking in Las Vegas this summer on the topic of Maternal-Child Health during a Disaster. I'm so excited about this topic. I actually get to mix my safety and emergency preparedness knowledge with maternal child health knowledge. Plus it will be my first time to see Las Vegas. I don't participate in gaming but it will fun to see the sights and sounds. I have three deadlines coming up to write proposals for Fall conferences, and have 3 that I've turned in and am keeping my fingers crossed for. The one in Las Vegas called me- I didn't submit a proposal to them. They got my name from the conference planners I presented for last February in San Francisco. I didn't expect to be getting word of mouth clients so soon.
My speech contest is this Saturday. I'm sprucing up my speech to re-present it. I'd really like to win this and go on to the next level. Last year, I attended the speech competition at the highest local level to cheer on a sister competitor. Those speakers were so good, each one was better than the one before. I've got bring my A game if I want to compete on that level.
And since I'm bored and don't have enough to do, I changed my website again. I've been studying other speaker websites for tips. My new Toastmaster's group has been wonderfully supportive and I look forward to visiting that new writer's group next week. I've also set a goal to starting fishing around my manuscript to publishers and see what kind of bites I get.

Too Posh to Push or Too Scared to Squat

I taught a lovely little infant CPR class last night for parents at a local baby store. All the expectant parents come out to learn the skills in preparation for newborn care. When I introduce myself, I talk about my experience with childbirth and I mention my homebirths and passion for breastfeeding. One very pregnant mom lingered after class to clarify that all nine of my births had been 'natural.' "You didn't have a cesarean or anything?" she asked. "Oh no, nothing like that" I answered. We chatted for just a moment. She remained amazed that I could have so many births without a cesarean. So this is what we've come to. I find this all very sad. Women have been socialized in the last 30 years to believe they cannot birth. I want to do my part to convince them that they can.

A Kinder Gentler Laborpayne

All the best parts of this blog this weekend were in the comments so I hope you are reading those. After a night of tossing and turning over this, I had to ask myself, who is my audience? I came to the conclusion that my targeted audience are people who feel about birth the way I do. This blog probably is NOT geared toward making converts. That's why its called HOMEBIRTH diaries, why I'm writing a book about HOMEBIRTH, and why I want to be a doula only for HOMEBIRTHS. (I don't want to be on a hospital maternity unit, I don't want to see, hear, smell, or feel that kind of birth again) It's why I didn't strike up a conversation with that young mom at church. I'm too far gone to deal with first-timers. I can't help but scare the shit out of them. That's also why I focus a lot of my efforts at professionals, even though I believe true change will come with consumer uprising. Even so, Anonymous two is right, I need to dial back the hostilities, and put more compassion into my passion. I hope birthing women find this blog helpful, I really do. But in the end, I'm writing for the AMEN corner, not the unconverted masses.

ACOG Update

ACOG has expanded and updated its statement regarding homebirth. I did a conference presentation around the previous statement last Fall at MANA (Midwives Alliance of North America). I am re-printing the new statement and the comments of RIXA from her blog where she makes some very good comments.

Revised ACOG Statement:

ACOG Statement on Home Births
Washington, DC -- The American College of Obstetricians and Gynecologists (ACOG) reiterates its long-standing opposition to home births. While childbirth is a normal physiologic process that most women experience without problems, monitoring of both the woman and the fetus during labor and delivery in a hospital or accredited birthing center is essential because complications can arise with little or no warning even among women with low-risk pregnancies.
ACOG acknowledges a woman's right to make informed decisions regarding her delivery and to have a choice in choosing her health care provider, but ACOG does not support programs that advocate for, or individuals who provide, home births. Nor does ACOG support the provision of care by midwives who are not certified by the American College of Nurse-Midwives (ACNM) or the American Midwifery Certification Board (AMCB).
Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre. Despite the rosy picture painted by home birth advocates, a seemingly normal labor and delivery can quickly become life-threatening for both the mother and baby. Attempting a vaginal birth after cesarean (VBAC) at home is especially dangerous because if the uterus ruptures during labor, both the mother and baby face an emergency situation with potentially catastrophic consequences, including death. Unless a woman is in a hospital, an accredited freestanding birthing center, or a birthing center within a hospital complex, with physicians ready to intervene quickly if necessary, she puts herself and her baby's health and life at unnecessary risk.
Advocates cite the high US cesarean rate as one justification for promoting home births. The cesarean delivery rate has concerned ACOG for the past several decades and ACOG remains committed to reducing it, but there is no scientific way to recommend an 'ideal' national cesarean rate as a target goal. In 2000, ACOG issued its Task Force Report Evaluation of Cesarean Delivery to assist physicians and institutions in assessing and reducing, if necessary, their cesarean delivery rates. Multiple factors are responsible for the current cesarean rate, but emerging contributors include maternal choice and the rising tide of high-risk pregnancies due to maternal age, overweight, obesity and diabetes.
The availability of an obstetrician-gynecologist to provide expertise and intervention in an emergency during labor and/or delivery may be life-saving for the mother or newborn and lower the likelihood of a bad outcome. ACOG believes that the safest setting for labor, delivery, and the immediate postpartum period is in the hospital, or a birthing center within a hospital complex, that meets the standards jointly outlined by the American Academy of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers.
It should be emphasized that studies comparing the safety and outcome of births in hospitals with those occurring in other settings in the US are limited and have not been scientifically rigorous. Moreover, lay or other midwives attending to home births are unable to perform live-saving emergency cesarean deliveries and other surgical and medical procedures that would best safeguard the mother and child.
ACOG encourages all pregnant women to get prenatal care and to make a birth plan. The main goal should be a healthy and safe outcome for both mother and baby. Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby. For women who choose a midwife to help deliver their baby, it is critical that they choose only ACNM-certified or AMCB-certified midwives that collaborate with a physician to deliver their baby in a hospital, hospital-based birthing center, or properly accredited freestanding birth center.
# # #
The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.

Read blogger RIXA's great response. Scroll down to find it.

Shut Your Humble Pie Hole II

I have not been pleased by my arrogant tone in my writing of late. I came across this little blurb on a post of navelgazing midwife:
Women just don’t know that they didn’t need that cesarean. It’s my duty to make them feel like crap about their birth experience, not allow them to discover on their own if a cesarean was warranted. It’s important to discount a woman’s birth story even if I wasn’t there, don’t have her records, don’t know HER truth
Of course Navelgazer is being tongue-in-cheek here, but her words give me pause. I respect her wisdom and her truth and I feel myself slipping into kind of an abyss. I am not savior of the world, (not even the birth world), I am NOT a midwife, only a homebirth advocate, and a FORMER L&D nurse (not even a very good one- I was too busy trying to sabotage technology to learn to use it as an effective tool). My religious training tells me that pride precedes a fall, if that's so I should be landing on my ass right about now. My apologies to the doulas, my apologies to the young mom mentioned in the previous entry (and my apologies to the two moms I called dumbasses two years ago in a post for having inductions together so they could be roommates.) My job is not to judge, and I cannot teach from a place of ignorance. Please forgive me Dear Readers. I will try to do better.

Women Should Educate Themselves

Hey Original Anonymous,
I found this great essay that makes a wonderful follow up to what has been written lately (by me and others). Check out the birth activist entry titled, "Women Need to Educate Themselves." The writer makes some great points. After reading this, I thought I should clarify my previous entry by saying that women have power, en masse. All alone they are kinda screwed. This is a long entry but well worth the read.

Holding Court

I attended the local CNM conference last night to view Ricki Lake's film. What a powerful evening. The film was powerful, but what came afterwards was even better. After the film, they had a panel that included three CNMs, one MD, and a homebirth consumer. The homebirth consumer spoke very eloquently on why she chose homebirhth. What I found surprising were the responses of the professional members of the panel. The MD, who practices alongside CNMs, said basically that doctors are demonized (my word, not hers) and that they shouldn't be because they don't have all the power. I agree with her to a degree. Docs are bullied on everyside, the insurance companies tell them how to practice, the hospitals close them in, their patients come with birth plans, yada, yada, yada. I really do understand the pressures that come to bear on physicians. On top of everything else, they always have to be on red alert for that lawsuit coming down the pike. However, they have fallen into a mode of practice that shifts the burden from them to the patient. I have to say, they've taken the easier route, they haven't really fought for women. As for the CNMs- I'm moved by their plight. I get that they are between a rock and a hard place. CNMs have it worse than physicians. They have to appease their physician collegues, while trying to maintain some resemblance of the midwifery model of care, often in environments that are hostile to their presence. But even in the hallowed halls of midwifery, some have chosen to go along with the status quo to keep the peace, be seen as an equal, whatever, but the net result is the same- women lose options, and are subjected to unneccessary medicalized treatment that puts them and their babies at risk. A few step out and do homebirths, fewer still keep fighting for change within institutions. Look I get all this, I really do, I've seen it all up close and personal. Hospital-based midwives have to fight hard for their little piece of the pond with the big sharks always hovering waiting for them to fuck up. I'm grateful to the hospital-based CNMs- I just don't think it's enough. Women need more options. All these people keep saying they don't have the power, but dammit somebody's got it! The docs don't think they have it, the midwife doesn't think she has it, the L&D nurse sure doesn't think she has it, and the doula doesn't think she has it either. Now each may have a share (some bigger than others) but ultimately WOMEN possess the greatest share of power. BIRTHING WOMEN HAVE THE POWER. It's just that they often don't know they have it, and are easily tricked into giving it away. That's the premise upon which I build my mission. I want another social movement powered by birthing women. Women can vote with their feet and their pocketbooks by not settling for status quo medical treatment. Then things will change because the market responds to consumer demands. If women stood up and demanded the births they wanted, all their allies would 'come out of the closet' and lend some power to the equation. As things are now, women have given up birth, they fear it too much to fight for it. Fear is a powerful catalyst. Most people think the antithisis of love is hate. It isn't, it's fear. Where fear rules, love cannot abide. American women need a love affair with their bodies that puts them at peace with birth. One midwife got it right when she said we need to start with teaching young girls. Most American girls are socialized to disdain their bodies instead of being in awe of them. Birth becomes a betrayal, an affirmation that their bodies don't work right.

The words of Morningstar keeps echoing in my ears "All the midwives' daughters are having cesareans..." (Hell, even the young midwives themselves are getting inductions and cesareans- I say this without blame or malice, just stating an observation.)

They problem is systemic, so the solution will have to be also.

We have so much work to do.

The Clean Up Woman Strikes Again

I wonder if you know this person's circumstances. I wonder how she would feel about your anger toward her. Do you know that she's naive, uneducated, or ignorant? She might be. But what purpose does your anger toward her serve? Wouldn't your energy be better spent encouraging women in your church with information and resources, and then LETTING THEM PRAYERFULLY DECIDE without your attack? I understand that your blog is a place to vent, but your published foul mouthed rage toward others is not welcomed by your targets. It does no good. Not in your church. Not to the world wide web.You may just be pationate about a really important topic, but your approach alienates those who don't know what you know. Or, they know, but make choices you don't approve of anyway. Division in a church, unless it's to address sin, should be seriouly looked at (and avoided). It distracts from peoples relationship the Lord.

I'd like to address this person point by point. First of all, I am not angry at the young mom. Far from it. That would be like blaming the victim. I really don't see how anyone could get that message out of what I wrote. I was making a commentary on how in 26 years (the length of time I've been in my church) I have seen the attitudes toward birth evolve to match that of the greater culture- this from a church that was totally counter-culture in its fundamentalism. What I was expressing was frustration, not anger. Now of course the writer is correct, maybe, just maybe HER induction really is medically warranted. If so, so be it. However that would be out of the ordinary. I did not say that she was naive, uneducated, or ingorant, but that she was probably skittish, a quality common in first time moms that makes them vunerable to physician's suggestions- and most physicians cannot resist the urge to try to get a mom to go for an induction. Its unethical, but its also quickly becoming the norm. Again, my anger is focused at the medical establishment not the poor women who fall victim to it. It is not my intent to attack her (that would be futile) but to change the culture of birth (also futile, but at least noble).

As for being foul-mouthed- guilty as charged. (I know some find it offensive, but I choose not to change. I invite my pastors to read my blog, knowing they won't be happy about my swearing, but still hoping they'll see the value of my message.)

As for my blog being a place to vent, I hope to God it' more than that. I have been known to do a totally self-indulgent blog from time to time (see Pissed Warrior) and I try not to do many of those. I honestly want this to be a vehicle for my message that I honestly believe the world needs to hear. I'm passionate, because this is my life mission and purpose. I want to be successful at fulfilling it. Beating up on moms won't fulfill that purpose and frankly, is not worthy of me.

You are correct on this point, I should have been giving her encouragement and information. I blew it, and wasted the opportunity. For that I have true regret.

Far be it for me to distract anyone from their relationship with their Lord. But religious argument won't stop me from doing what I believe I must.

And finally whatever I write, I have the guts to write it under my own name. Thank you for your thoughts, Anonymous.

The Clean Up Woman

I just recieved an email from a nice lady at my church asking for meals for the young couple about to have a baby. Meals were requested starting Sunday- wait a minute- how do they know the baby will be born by Sunday??? Can you say INDUCTION boys and girls? I can't believe this shit is happening in my own church. How did we lose birth in one generation??? How can this be happening in MY church- a church started by hippie college students in the 70s? During the 80s everyone in my church was doing homebirth and breastfeeding. Half the women were lay midwives. We even had folks doing unassisted births back before it was trendy. Now their daughters get inductions (or as I call them, pre-cesareans). Part of me wants to talk to her- but of course I can't just call her up- I don't know her that well. Plus she's a first timer- you know how skitish they are. It's too late, I've missed my chance. I hope to God she doesn't end up with a cesarean. I'm so sick of seeing young healthy first time mothers end up scarred (literally and figuratively). In case no one has noticed, we're back to 'once a cesarean, always a cesarean'. With VBACs falling out of fashion, good luck finding an OB who will do one. CNMs are often restricted from them as well. I submitted my article this week about the dangers of hospital birth. The editor actually thanked me (I thought she wouldn't run it). It will be published in May- I'll provide a link when it comes out. I also emailed a homebirth mama who just moved to this area and was trying to find the 'homebirth community'. Thank God for this blog- at least I have an outlet for some of my angst. I'm headed to the CNM conference tonight. They'll be showing the Ricki Lake film with a discussion afterwards. It's my self-appointed job to go point out to them that they aren't supporting homebirth in great enough numbers and why things need to change. It's a dirty job- but somebody's got to do it. Oy vey.