Reversal of position!

It seems the AAP has heard the public outcries to their revision of policy in regards to infant female genital mutilation. It has reversed this policy back to the original one of nonsupport.

To quote Dr. Judith S. Palfrey, president of the academy:

“We’re saying don’t do it. Do everything that you can to support that family in this tough time, but don’t be pulled into the procedure.”

Dare we hope that they will continue to NOT endorse male genital mutilation?

Our boys deserve to be protected just as much as our girls.

Let's just stop cutting our babies

I recall talking once with an Intact America rep at a midwifery conference and he was very happy to hear that I was interested in getting some literature to hand out to my clients. He told me that many of the midwives he had talked to at the conference said that, while they supported his orgainzation's aim, they didn't feel it was their place to bring up the topic of circumcistion with their pregnant clients; that is wasn't their place to discuss it.

In my experience, education is of the utmost importance on this topic. I have seen countless families who originally planned, without question, to circumcise their baby boy, but then once they learned more and because informed, they instead kept their boy intact. Indeed, more and more families in the United States are keeping their boys intact. In my region of the country, around 70% of baby boys are now left intact. Even still, 30% of boys being cut is too high.

I bring up the topic prenatally with my clients, if they know they are having a boy and if they don't know the sex of their baby. It is sometimes an anxiety-filled conversation, but its an important one. I myself am the mother of 2 intact boys and married to an intact man (as are the majority of men in South America, where my husband was born).

Quoted directly from the National Organization of Circumcision Information Resource Center website, here are the basics on male circumcision:

No national or international medical association recommends routine circumcision.

Only the USA circumcises the majority of newborn boys without medical or religious reason.

Medicalized circumcision began during the 1800s to prevent masturbation, which was believed to cause disease.

Today's parents are learning that the foreskin is a normal, protective, functioning organ.

Today's parents realize circumcision harms and has unnecessary risks.

Circumcision denies a male's right to genital integrity and choice for his own body.

This brings me to the recent news that the American Academy of Pediatrics revised their policy on female genital mutilation (now called 'cutting'). I believe that this move is likely related to the fact that they (along with the CDC) are currently reviewing their policy on infant male genital mutilation (aka circumcision), exploring whether or not they are going to continue to NOT endorse circumcision. If I am correct in my connecting the two, I am fully expecting the policy of infant male genital mutilation to be reversed. (I hope I am wrong.)

When I originally heard the news of the AAP and CDC reconsidering recommending circumcision and now backtracking on their original opposition to all female mutilation, I felt such shock and disgust. How about we just stop cutting our babies? No, really! Sharp objects belong nowhere near genitals of babies and children, in my opinion.

Marilyn Milos, director of NOCIRC, recently sent the AAP this letter in reply to their policy revision on female genital mutilation, which ElementalMom so wisely blogged about.

CNN recently published a good article on the topic of female genital mutilation. A Somali film director and activist, Soraya Mire, counsels genital mutilation survivors and families who want to have their daughters cut:

She sleeps with her cell phone tucked under her pillow, so she can answer at all hours.

"You don't have a right to do this to your children," Mire tells the immigrant community. "You are continuing the abuse."

Fatima Mohamed, a Somali immigrant and activist, was herself cut and says of her own daughter:

Her 11-year-old daughter is too young to comprehend genital cutting, Mohamed says. Instead, they discuss her daughter's dreams to become a pediatrician. Perhaps in a few years, Mohamed will tell her the truth.

"I would never do it to my daughter," she said. "I don't want it. This has nothing to do with religion or culture. I believe nobody should control my child."

Really, this applies to both sexes.

On the topic of Jewish male circumcision, have you seen the documentary CUT? It's worth a watch!


This is something that affects all of us. Our babies are born perfect, whether they have labia and a clitoris, or a penis and scrotum between their legs. How about we just don't cut our babies?

Clarification

Because I think there may be some confusion from my last blog entry, I wanted to clarify something.

The rule changes that are being proposed will not make breech, twins, VBACs and postdates 'illegal' or absolute risk factors for licensed midwives. They will still be 'allowed' to attend them out of hospital.

But, they are creating stringent criteria in each of those categories, proposing to dictate under what terms a VBAC, breech, twin, postdate birth would be considered safe enough to stay home (with a licensed midwife).

For example, if the baby is breech, is must be frank breech with an estimated fetal weight less than __gms. Or....once you hit 41 weeks, you must have a weekly biophysical profile and get a score of __ or better to continue with a homebirth. (AGAIN, THIS IS JUST AN EXAMPLE OF SOME OF WHAT I HAVE HEARD BEING PROPOSED. ITS STILL ALL IN PROCESS).

Oregon's current rules dictating what is an absolute risk factor for out of hospital birth with a licensed midwife are very BROAD with lots of grey area. They were originally written this way on purpose.

It should be up to each mother and each midwife individually to decide if they are comfortable proceeding with an out of hospital birth, not up to the licensing board. I think that the informed choice process is critical in this issue.

So, when writing those letters, please remember they are not (at this point) discussing making VBACs, twins, breeches, and postdates illegal...but are trying to put restrictions and set in stone guidelines around them. (Not good for birthing women!)

Come to the meetings if you can!!!

To all Oregon mothers!

(eta: See my post on clarification of this issue here)

We need EVERYONE in Oregon to write letters in support of keeping birth choices open for birthing families!

The Board of Direct Entry Midwifery is currently reevaluating our current rules and regulations, reconsidering what should be considered an 'absolute risk factor' and what should risk women out of the care of an licensed midwife/out-of-hospital birth. This is taking choice out of the consumer's (YOU) hands and they need to hear from you!

The things that they are focusing on are:

POSTDATES
TWINS
VBACs
BREECH

There are board meetings being held on each of these topics (some of which the dates have already passed). Upcoming meetings can be found here and are as follows:

June 2, 2010, 9am , topic: BREECH and TWINS
ODVA Auditorium, 700 Summer Street NE, First Floor, Salem, OR

June 16, 2010, 9am , topic: VBAC and POSTDATES
ODVA Auditorium, 700 Summer Street NE, First Floor, Salem, OR

August 5, 2010, 9am , topic: TBA
Rhoades Conference Room, 700 Summer Street NE, Third Floor

August 12, 2010, 9am , topic: TBA
Rhoades Conference Room, 700 Summer Street NE, Third Floor

These meetings are open to the public, but there won't be time for public comment. (Because why would they want public comment when they are working on rules to protect the public, right? ). Even so, your presence is needed! Please attend, and show your support for birthing choices in Oregon. (when you sign in, you can write "Support Birth Freedom!" or something similar). You don't have to stay for the entire meeting, and you don't have to be there right when it starts. Even if you can only come for one hour, please do!

Since there are no times for public comment, we need to FLOOD their mailboxes with letters in support of women having the choice to choose where and how they give birth. Email letters to samie.patnode@state.or.us or snail mail to Oregon Health Licensing Agency (OHLA), Attn. Samie Patnode, 700 Summer St. NE, Suite 320, Salem, Oregon 97301-1287

Speaking as a birthing woman, I am highly insulted the the state is trying to tell me what is safe and what is not safe when I give birth. A mother is of course still be able to stay home alone if her midwife has to risk her out and discontinue care, but no woman should choose unassisted birth because she is backed into a corner!!

Many of you are aware of the lovely law in Oregon that allows midwives to be unlicensed if they choose. However, our voluntary licensure law is ALSO at risk. While there are many who are under the false assumption that licensed midwifery is safer midwifery, this couldn't be further from the truth. What mandatory licensing does is LIMIT choice for families.

More than ever before, we need the state of Oregon to hear from the consumer of midwifery care (birthing families...YOU!!!) that you won't stand for your choices being limited and restricted!! Please write and come to the meetings!!

To summarize, here are the main points that your letters should include:

• keep our rules and protocols as they are!
• allow women to choose for themselves once they have been given informed choice! (women are smart enough!)
  
• support voluntary licensure!
  

If you have never had a breech baby, or aren't planning a VBAC, or never go past your due date, or have unassisted births and don't utilize midwives, please don't think that this won't affect you. It does. It will have far reaching effects for all women planning out-of-hospital births. Please act. Please make your voice heard and pass the word on!

The human being behind the midwife

There are births that stay with us forever. All births that I have attended have moved me, changed me, shaped me to be the midwife and person that I am today. But there are some births that stay at the forefront of my consciousness for a long, long time.

I am not a confrontational person. I don't mind standing up for myself, or speaking up when I need to. But, I really like peace between people and have always struggled with my 'need to please' everyone. When I was in school, I would have rather skipped class than show up to class with my homework incomplete. Oh, the shame! Truth be told, having this blog is one of my attempts to thicken my skin just a bit, as when you are writing on the Internet, it is utterly impossible to please everyone.

I am forever grateful to every learning experience life throws at me. Midwifery is an incredible journey and ego-tamer.

Thank you to all of the families who have allowed me to serve them, and continue to allow me to serve them.

In peace.

The Arrival of Sierra Journey

My client has graciously allowed me to share her daughter's birth story here. A beautiful story of the birth of a beautiful baby!

In her words....

~~~~~~~~~~~~~~~~

Our Journey

It was on Beltane, May day, your due date. I was never a believer of "due dates" and whenever people asked when you were due, I told them springtime.

Yet, you came earthside on such a beautiful, warm day. The trees were just starting to blossom with little buds. I could feel the twinge of labor coming on, slowly and lightly. I told my dear partner, Jesse, that it was time, and we drove to a friend's farm.

When we arrived, I was just in the mood to take a slow amble around the farm. We walked on a tiny dirt path through the tall grass to a little pond surrounded by huge trees and flowers. The contractions slowed down. I guess the rocking sensation of walking relaxed you. We slept outside on the grass under a tree for most of the afternoon.

I woke up with the urge to go take a warm bath. Jesse and I got into the bathtub and I felt so relaxed...and then the contractions started rushing in with gusto. Blood was coming out in little bits. Jesse told the midwives that things were really progressing. They got on their way, and we filled up the big blue birthing tub outside on the grass. I absolutely loved the smell of fresh grass and watched two little spring robins play around.

The rushes became stronger and stronger. Soon, I lost nearly all my sense of control and just let go. I let the sounds inside of me out. I moved around madly with every pang of contraction. Our midwives came outside to check on your heartbeat once in every while. They were completely silent and stayed inside most of the time. It was starting to get dark and cold outside. I asked my midwife when she came outside, "When will I know how or when to push?" She smiled and said that my body would do it for me, and that you and I would work together.

Not very long after that, I decided to head into the bathroom with Jesse. I took a few sips of water, and with three ABSOLUTELY overwhelming contractions, I yelled and felt like I was about to throw up. I felt like I was being turned inside out. There was absolutely no holding back. You came so FAST. I was standing up. Jesse could see the intact water bag come out first, your head twisting out. The bag broke and you slid right out, in your father's hands.

Jesse immediately gave you to me. You quickly raised your arm towards me, your fingers spread out, touching my heart.

And then I realized that your birth was unhindered and beautiful. The way women in so many cultures have done it for centuries. I felt so empowered, strong.

And the rain immediately started pouring outside.

Why "Radical"?

My husband has said before that he doesn't understand why I would identify myself as 'radical'. He thinks it has a negative connotation. And, maybe it does in many situations. Honestly, I was originally inspired to pick the name 'Radical Midwife' for my blog by the amazing Radical Midwives Association in the UK.

But, there is more. I cannot tell you how often I feel on the fringes of the 'norm' in midwifery. Sometimes it is almost as if I live in a bubble, where I assume at least most midwives not only practice evidence based midwifery, but also know what 'trust birth' means and act on it. Well, if I live in a bubble, it is popped on a regular basis every time I venture out on the Internet or start talking about birth and midwifery with other students or practicing midwives.

The opportunity to reconsider the name of this blog arose recently when I opened a twitter account to begin twittering. I had to choose a user name. After some thinking, i went with 'radicalmidwife'. The obvious reason being that it matches the name of my blog, so people who know me by my blog will recognize me. However, this also compelled me to re-consider the word 'radical', to be sure its still how I want to identify myself (it is).

So I looked up the definition of 'radical':

From the Merriam Webster dictionary:

Etymology: Middle English, from Late Latin radicalis, from Latin radic-, radix root

Date: 14th century

1 : of, relating to, or proceeding from a root: as a (1) : of or growing from the root of a plant (2) : growing from the base of a stem, from a rootlike stem, or from a stem that does not rise above the ground b : of, relating to, or constituting a linguistic root c : of or relating to a mathematical root d : designed to remove the root of a disease or all diseased and potentially diseased tissue
2 : of or relating to the origin : fundamental
3 a : marked by a considerable departure from the usual or traditional : extreme b : tending or disposed to make extreme changes in existing views, habits, conditions, or institutions c : of, relating to, or constituting a political group associated with views, practices, and policies of extreme change d : advocating extreme measures to retain or restore a political state of affairs
4 slang : excellent, cool

First off, I love that the word relates back the the Latin form of 'root'. I am constantly thinking about what is midwifery, at its root, and how to get midwifery back to its roots. The 1st definition doesn't really apply...I'm not referring to plants, or linguistics, or mathematics, or eradicating diseases. The 2nd definition listed above fits nicely, though, and of course I can't deny that I love the 4th definition.

3 a and b are more interesting to ponder:

3 a : marked by a considerable departure from the usual or traditional : extreme b : tending or disposed to make extreme changes in existing views, habits, conditions, or institutions

Midwifery is one of the oldest professions / occupations in human history. Yet, I feel we are at a cross-roads on many levels. "Traditional" midwifery or "modern" midwifery? And, what do they even mean? Do they mean the same to everyone? I'm not going to get into this right now; that's another blog post that I promise I will write.

I still really feel like 'Radical Midwife' is a fitting description of myself.