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.

Warrior Storyteller

I gave my speech about my grandmother yesterday. It was well received and I move on to the next round. She passed away quietly later that afternoon. She was 90 years old. I am so glad I will be able to honor her memory with this speech, and hopefully later with more writings as well. I made all my writing deadlines finishing my articles. I still have one article left to write this week on the loss of the birth center. I've had a terrible time tracking down the administrator to interview her for the article. I may have to write it without her input. I love the daily discipline of writing (there's my journal, my blog, my blank book I keep in my purse for jotting down thoughts and ideas, there's my poetry, my books, articles, essays and speeches written for the enjoyment or illiteration of others). I find it quite refreshing. Today I give thanks to the written word, and my grandmother who taught me the fine art of telling a story.