Radical Midwife

yep

2011-04-29T14:48:00.000-07:00

Lately, I've been asked a lot by prospective student midwives and classes of high school students to share about the hardest part of being a midwife.

I usually will laugh and say it's the lack of sleep that goes along with birth work. But honestly, I don't really mind missing sleep. In the moment, it can be hard to have been physically awake for more than 24 plus hours, but we make do.

I've been really pondering this question internally, though: What is the hardest part of being a midwife (for me)?

I've come to the conclusion that it is the never ending questioning that I do of myself, or my actions, of how things play out.

There are a handful of births that haunt me, that I constantly turn over and over in my head, thinking about them from different angles, wondering why things happened the way they did. This has got to be the hardest thing. I've attended a couple of births which I have thought about daily for what seems like months, and then the memory slowly fades from my daily thoughts, and then when a random occurrence brings up the memory, it feels as if a scab has been pulled from my skin and my emotions are raw all over again.

(I want to make it clear that these handful of births had good outcomes...healthy mother, healthy baby. Some were transports, some were homebirths.)

Being a midwife has taught me so many things that have nothing to do with birth or babies. It has been an amazing journey. I suspect that many midwives begin their journey with their ego leading the way. There are many other professions where this is probably the case, but in midwifery, I run across it often. I know that for me, personally, being involved in birth and midwifery has taught me (and I am still learning!) big huge lessons about the ego.

Where are the mothers?

2011-01-16T15:05:00.000-08:00

I live in a city with a hospital that has roughly 3,500 births every year.

Their cesarean rate is very hard to find (as are most hospitals'), but based upon information from some of the doctors and nurses that work there, it is estimated to be around 50% (some say closer to 60%). The rate is, in part, this high because the hospital doesn't "allow" VBACs. So, the many first-time mothers whose labor inductions fail (induction rate is very high in my area) or whose labor is taking too long that end up having a cesarean...with future babies, they are told that they must have a repeat cesarean. I have met many mothers in my city that have had 4 and 5 cesareans. It is criminal.

There is a hospital about 20 minutes away that allows providers to attend VBAC, though not every provider does.

Where are the mothers? I am a little surprised to see how very, very few women seek out the services of a midwife for an out of hospital VBAC. I would expect there would be such a demand that we would be needing more and more midwives to accommodate the demand. But, there isn't.

Of course, not every mother will decide that an HBAC is the right choice for her. But, it makes me wonder...where are the mothers? Ar they signing up for repeat cesareans? Are their doctors telling them that, although their hospital doesn't 'allow' VBACs, even the National Institute of Health came to the conclusion that a VBAC is a perfectly safe option and that perhaps they should look into different birth options? I seriously doubt that.

There are approximately 50-60 homebirths each year in my county. It would make me so happy to see that number sky-rocket in the coming years.

Pet peeve

2011-01-16T14:48:00.000-08:00

I need to clear something up.

I notice all of the time on message boards, news articles, or among conversations in person, that many people are under the assumption that DEM (direct entry midwife, a midwife who has not entered midwifery through a nursing degree first) and CPM (certified professional midwife, a term created by NARM) are synonymous. When asking about midwives or referring to midwives, it sounds like you now have two choices in the US: Certified Nurse-Midwife and Certified Professional Midwife. This is not true. CNM and CPM are not the only options, and DEM is not the same as CPM. (Though most CPMs are indeed DEMs, the reverse is not true).

All of these letters make things confusing.

A midwife can be a midwife without being a CPM. There are many, many fabulous and highly expereinced midwives in our country whose title is 'Midwife', not CPM or CNM or CM. And there are currently wonderful student midwives in this country who are apprenticing with a homebirth midwife who have no plans whatsoever to become certified. We need to stop expecting some certifying body to determine who is a midwife.

Please, please, please, people...stop referring to ALL non-CNM midwives as "CPMs". This is simply not true and it does a huge disservice to midwifery.

EC the second time around

2010-11-30T14:29:00.000-08:00

The following is my own experience with EC. There are many great website explaining the why's and how's of EC, and I will include links to some at the end of my post. I am not attempting to teach people how to practice EC with this post, but I simply want to share my own experience with it here.

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

With my first son, we practiced elimination communication (EC) from about 3 months old onwards. We used cloth diapers when we went out until about 7 months old, and from then on, we just took him potty wherever we were and stopped putting him in diapers. He was reliably dry (or would wake to potty) from about 7 months onwards, as well. We had carpeted floors at the time (for those wondering).

I wasn't sure how I was going to approach diapering with my second baby. I knew we'd use cloth diapers, and I knew I'd be taking him potty sometimes..I just wasn't sure how I'd manage doing EC full time this time around, since I not only had an another child to care for, but I knew I'd be taking my baby with me to births and appointments for a good part of his first year.

So, my second boy was born. Within the first few days, I started putting him on his potty for bowel movements. It seemed to help him calm down and he was less gassy. (I recall this as well from my first son.) He was still almost always in a diaper, usually a prefold held on with a snappy. I didn't put covers on his diapers when we were home, because I wanted to know right away when his diaper was wet, so I could promptly change it. I would also always talk to him about his pee "Oh, did you just pee? OK, I'll get you a clean diaper. You can pee in the potty, too. That might be nicer for you."

My second son sitting on his potty, 5 months old.

When he was with my during prenatal appointments or births, I always had a diaper and cover on him (or an all-in-one diaper), and wasn't able to pay much attention to his pottying. I'd just try to check frequently to see if he'd peed yet (maybe every 30-60 minutes when he was awake) and then change his diaper. Yes, I went through MANY diapers this way. But, I think it was key in helping him to not get used to the feeling of ignoring that function of his body or the feeling of a wet diaper.

When we were home, I began to let him be diaper free more and more. I found that we 'caught' more pees this way, and it felt like much less work to wipe up a 'missed' pee than to put his diaper on, take it off to offer the potty then put it back on. I also noticed that when he was diaper free, he seemed to empty his bladder more fully. When he would pee in his diaper, it was as if he'd pee a little, then 10 minutes later a little more, etc. When we took him potty and he peed, he wouldn't need to pee again for maybe 30 minutes. The interval between pees has increased as he has grown. (For example, he is now 17 months, and sometimes goes 3-4 hours without needing to pee).

He was in diapers MUCH more than his older brother was during his first year, partly because he was with me at work and partly because I don't feel like I was able to pick up on his cues as well as I could with my older son. In fact, I'd even say that I feel like he wasn't doing any cues for a long while. I mostly relied upon my own intuition that he needed to pee.

In the car, he was in diapers, and around 12 months old or so, I started just setting a diaper in his carseat and then setting him in his car seat. That way, it was there in case he peed, but it wasn't attached to him. If we drover more than 30 minutes or so, he'd usually end up peeing. We also had these nifty waterproof pads in his seat that I really like. In the last month or so, I've stopped putting a diaper in his seat, as he is so reliably dry now. My normal routine when we are driving somewhere is to take him potty just before putting him in his seat, and he usually pees. Then I pull his pants up and sit him in his seat with no diaper.

In the baby carrier, I place him with just pants, not diaper. When he was younger, I would sometimes place a folded prefold between he and I when he was in the carrier, just in case. However, he normally lets me know he has to pee by sort of squeezing his legs when he is in the carrier.

For bowel movements, he has much more reliably let me know since the beginning. The sign that he gives me now is so hard to explain. I can actually even hear it in his step if he is running to me from another room to tell me he has to poop. It is so interesting to see how I have learned that cue so well.

At night, we have been sleeping with him diaper free since about 4 months old. It was just easier to keep his diaper off and take him potty than changing his diaper. I keep a little potty (or two) by the bed on the floor, and have gotten to know his nighttime elimination habits. He normally won't pee until he has nursed when he wakes in the middle of the night. When he starts to sort of move around and not able to focus on nursing anymore, I know he needs to pee. When he empties his bladder in his potty, I know he won't need to pee for a few more hours, so we sleep deeply in peace. And, now that he is 17 months, he usually only needs to pee once in the night (even though he wakes to nurse 2-5 times during the night), and occasionally, he won't pee at all and will hold it all night. We he wakes in the morning or from naps, the first thing we do is take him pee. He will then pee almost all of the time. I do keep a large over sized waterproof pad that I made underneath the sheet in out part of bed, just to help protect the bed. I also have 2 smaller waterproof pads that I place a prefold on top of and then lay that underneath him. When he was younger, I would regularly miss pees every few nights, and this was a nice and easy way to keep the bed clean. Now it rarely gets used. Nighttimes are actually pretty easy. This is no doubt due to the fact that babies don't pee when sleeping deeply. They will always rouse to pee (though it may seem that they are sleeping...they are likely just in a light sleep cycle). They also tend to produce less urine at night, thanks to the antidiruetic hormone.

The aspect that I love about EC so much is the simplicity. It feels so normal and seamless to me. There is no 'potty training' time, it just sort of morphs into a baby/toddler who knows what their body is doing. I don't think it is the "best" way to approach diapering and pottying, but it is certainly a real option and one that some people will really come to enjoy. However, I do acknowledge that the vast majority of people in our culture do not want to fuss with taking their baby potty.

I hope from this post you gleamed a small insight into what it is like to EC. It might sound like a lot of work, and indeed, there have been times where I feel crazy for doing this, and I wish I could just stick a diaper on my baby and not think about it for a few hours. But, those feelings of exasperation are short-lived, and I truly love the connection that EC'ing has given me with my babies as they have grown.

I always tell people that I don't view EC as easier or harder than traditional diapering potty training. I figure that it may really be about the same amount of work overall, but simply expended in a different manner.

I could talk and write so much about EC. However, I already feel like this post is a bit scattered, so I will stop here. Maybe I will write more another day.

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

Here are some links if you would like to learn more about EC:

Diaper Free Baby groups

The EC Store

What is EC?

What is EC? (a different article)

Diaper Free! The Gentle Wisdom of Natural Hygiene

Born Potty Trained

Visions of Breastfeeding

2010-08-05T08:23:00.000-07:00

I wrote this post back in August during World Breastfeeding Week and am finally getting a chance to post it.

Some reminders to the pediatricians, perinatologists, and other care providers who may have forgotten (or never learned otherwise):

Breastmilk DOES have everything all of the vitamins and nutrients that babies need. Really, they don't need vitamin drops made by a huge artificial baby milk company given to them daily. (Since Vitamin D is the 'hot button' on this topic, read this page if you want more info.)
The amount that you express, by hand or with a pump, is NOT reflective of how much your baby gets when nursing, nor of your milk supply as a whole.
Babies don't know how to read a clock. Please follow babies' signs and signals for as to when and how often to breastfeed. (Imagine someone telling you that you may not eat as it hasn't been X number of hours yet, even though your body is telling you that you are hungry.)
Co-sleeping is SAFE and one of the best ways to promote breastfeeding in the early weeks. Please don't tell parents to simply not co-sleep, telling them they will kill their baby. Instead, please teach parents how to co-sleep safely. Sleeping snuggled in bed with baby happily nursing at the breast is far safer than an exhausted mother sitting in her arm chair nursing her baby, trying desperately to not drift off to sleep.)
Nipple shield s can be a useful tool when used judiciously. They are not a band-aid fix for sore nipples, baby not latching or not latching well, or every breastfeeding mother. Yes, nipple shields can save the breastfeeding relationship, but 99% of the times when I encounter them, they were unnecessary and cause problems.
Babies do not all gain at the same rate. Read this, please! An excerpt:
Many rules about weight gain are taken from observations of growth of formula feeding babies. They do not necessarily apply to breastfeeding babies. A slow start may be compensated for later by fixing the breastfeeding. Growth charts are guidelines only.
Six months of age isn't a magic number. Babies don't suddenly begin needing solids at six months old. Many babies aren't interested in solids until they are 8-9 months old, and sometimes not until they are 12 months old. That is ok. Breastmilk is enough to meet the nutritional needs of a healthy baby for the first 12 months (and sometimes beyond).
Rice cereal is not necessary. In fact, 'baby food' (the sort you buy in cans) is not necessary. Please, tell parents to skip the processed food (mainly, boxed rice cereal) and offer their baby real food when they are ready for solids. Fruit, vegetables, beans, meat, whole grains. The sort of iron that is in frortified baby cereals is nasty junk, nothing near as effective or good for your baby as the iron that is in breastmilk.
Please visit Dr. Jack Newman's site. He is an amazing resource, and you can even email him directly with clinical questions.

I leave you with a quote from Dr. Grantly Dick-Read

A newborn baby has only three demands. They are warmth in the arms of its mother, food from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three.

Reversal of position!

2010-05-27T09:59:00.001-07:00

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

2010-05-22T15:48:00.000-07:00

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

2010-05-21T23:29:00.000-07:00

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!

2010-05-19T11:52:00.000-07:00

(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

2010-05-19T00:09:00.000-07:00

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

2010-05-11T09:41:00.000-07:00

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"?

2010-05-08T11:25:00.000-07:00

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.

Standing up for homebirth

2010-04-22T13:36:00.000-07:00

This video was posted back in August,2009, but I just came across it. In light of what is brewing here in Oregon (which I will discuss more in a separate post), it makes me wish we had a representative who would stand up for homebirth and mothers' rights like Mr. Andrew Laming does here.

To learn more about what is happening with midwifery/homebirth in Australia, here and here you go.

My newest son's birth story

2010-04-06T00:18:00.001-07:00

Long overdue, here finally is the story of my second son's birth.

Julian Hugo, born July 10, 2009, weighing 9lb, 11oz.

~~~

July 9, we went out to eat at River's favorite thai restaurant. My due date was July 13, and I wasn't feeling like anything was going to happen anytime soon.

I finally laid down to bed around 11:30 that night, and turned out the lights. I felt a contraction that felt strong, and so i glanced at the clock: 11:42pm. A few minutes later, I felt another one, then as it eased off, it felt like I had peed myself. It was just a tiny trickle of fluid, but I jumped out of bed to go into the bathroom to see what was going on. With the light on, I wiped and saw specks of white: vernix! Before I knew it, another contraction started, my 3rd one, and it was really intense!

I got up to tell Walter what had happened, and he muttered something about wanting to get at least an hour of sleep, as he was thinking it was going to be another long labor like it was with our first son. I was fine with that at that moment and went back to sit on the toilet. My contractions were coming every 3-4 minutes right away, and I was pooping like mad, as my body started clearing everything out. Within a few contractions, I was needing to vocalize loudly with each contraction. I knew soon that I did indeed want to call my friends over. This was something that I had considered while pregnant, and I had even sent the three of them an email explaining that if I called them when I started labor, that they were to enter through our side door, not talk to me, and go quietly to another room. They were to also do nothing to me unless I specifically asked. (they are all midwives).

So, i called them. I think i texted P first, then texted A, then called T. When I was talking to T, I had to put the phone down and moan loudly through a couple of contractions. About 20 minutes had passed since my first contraction.

Then my noises woke up River, who was crying. He has a tendency to vomit when he cries hard, and as he was crying in confusion at having just woken up and odd things happening, that's just what he did. So, Walter was occupied with calming him down and cleaning up the mess, and I felt I had made the right decision to call my friends over, as I wasn't sure if Walter would be able to work on getting the pool filled. But, River soon calmed down and Walter got the pool going. I think he was a bit upset about not getting any sleep, as he was still thinking the birth was many hours away. :)

As soon as there was some water in the pool, I got in. At some point, Walter said that they were all there, and I told him to tell them to come over to me. i really needed to talk to them, to complain and tell them how much it hurt.

I want to discuss the pain for a moment here. Let me say that i was in labor with my first son, who is now 6 years old, for a day and a half, and had intense back labor. I never felt anything down in the front of my belly, it was all in my back. I was hoping to not have a repeat of that this time around, and indeed, I didn't have one back-pain twinge. However, the pain of the contractions this time around were just above my pubic bone, and it was like nothing I'd ever felt before! The only way I got through each one was to moan/yell. My son, I learned later, had said that i sounded like an elephant. Those contractions HURT! But between contractions, I felt no pain whatsoever, which was very different from the constant dull back pain during my first labor.

So, i was there in my living room, in the birth pool, with my husband somewhere close by, my son playing in the other room with P, and T and A sitting near me as well. I felt so angry about how much it hurt, and the fact that the water wasn't helping the pain at all. I kept telling them how much it hurt, how they were crazy to have more babies, etc. At one point I remember thinking that I couldn't be a midwife anymore, because how could I tell women to go through with this when it sucked so much! haha! Of course, at that moment, i also thought I had hours more of laboring to go. P made a comment, I think, about how it wouldn't be long and that I'd be meeting my baby before sunrise. I scoffed at that, sure there was no way. At some point, i asked one of them to check me. I could feel my baby's head and some cervix, but couldn't reach well enough to know how dilated i was. The midwife in me knows that dilation means nothing. But, it felt important to me to know that i was close, whatever that really means. They asked me if I was sure I really wanted to be checked, asked if I just wanted them to talk me out off it, asked what i wanted from the exam. I snapped that, yes, I wanted it, and that I wanted them to tell me I was nearly complete and not 4 centimeters or similar. I found out later that there was a silent argument in the hallway about who would do it, as they knew I wasn't happy and didn't want to have to be the one to tell me what i may not want to hear. In the end, T checked me, and I could tell in the way she looked that I wouldn't like the news. I was 6 centimeters, which was so disappointing!

I'm a little fuzzy on time, but I think this was around 2 hours after my first contraction. At some point, my body started to bear down involuntarily. After the first time it happened, I remember yelling out that I wasn't pushing! (even though I obviously was, I was still convinced it would be hours more and I didn't want them to think that I was pushing already.) He was born at 3:03 am, after 3 or 4 pushes, into my own hands in the water, with my older son and husband looking on. About 3 hours and 20 minutes of labor in all. It was amazing!

The placenta took a while to come and was finally born while I sat on the birth stool. We did a lotus birth, meaning we didn't cut the cord. It fell off on its own when Julian was 3 days old.

What I've been up to lately...

2010-04-01T16:21:00.001-07:00

Pure love!

The Birth of Benjamin

2010-01-20T23:45:00.000-08:00

(What follows is the birth story of sweet Benjamin Timothy as told by his mama, reposted here with permission. He was born at home on January 5, 2010, weighing 8 lb 8 oz)

My birth with this baby started 4 yrs ago with the birth of my first. After 10 days of prodromal labor, Cameron was born on a cold day in February at 42 weeks. I went to the hospital in sheer desperation for sleep b/c of the constant contractions. At that point, I didn't care about the baby any more. They tried to break my water but only got a little leak. He was born 6 hrs later. I wanted something different with my next baby.

Elijah was born two years later, in May, after an AROM induction at 42 weeks with an experienced midwife at home. While it was a homebirth, I had kind of been relegated to the bedroom for most of labor and was not very active during labor. Overall, better than the hospital, but still, something was missing.

I consciously know when Benjamin was conceived. I told my husband that I would get pregnant that night. We were in Salem, Oregon, looking forward to a move, scoping things out and excited about our future as a family. I confirmed pregnancy 2 weeks later.

We moved and Bret couldn't find a job so I worked 6 months part time at a local hospital as a registrar to support us. I was tired all the time, the boys were missing me, but Bret still didn't have a job so I didn't have a choice.

I found a midwife as soon as I moved up here. Lennon was comfortable to talk to and I felt free to want the birth I hadn't had yet. She was very willing/capable to handle more difficult births, if they arose. I was nervous both about the possibility of 42 weeks again and also that Elijah & Cameron had been breech until 37 weeks.

Two months before my due date, Bret got a very part-time on call job. Two weeks before my due date, he got a full-time job with benefits. God's timing is impeccable. I stopped working a week before my due date b/c of intense contractions that kept me up all night. I had to call in sick to my two last shifts and felt really bad about that.

Family came for the holidays, I thought Monster would come then b/c of some major labor type activity. But no. Family left. My due date passed and I started to doubt my ability to go into labor. I had emotional breakdowns. I ate brownies. I ate extra sharp yellow cheddar cheese, the only thing I've ever craved in a pregnancy. I got swap packages ready. The boys were wearing me out with Bret's 12 hr work shifts so I was ready for baby to come.

Monday, Jan 4th, Bret came home from work and I asked if I could go do some errands sans boys. I was highly irritable and pubic symphysis dysfunction had just set in painfully making it hard to be a good mommy. So, I went out, fed the horse, went to a store to buy some puzzles for Cameron, toys for Eli and chocolate for me. Stopped by the grocery store for prescription meds and some herbal cough syrup for Eli. Got in the car and suddenly peed all over myself. It was very embarrassing b/c I never had any sort of incontinence. I kept peeing and couldn't figure out why.

It suddenly hit me as I drove into our parking lot, that my membranes could have possibly ruptured. So, I crossed my legs, waddled upstairs and told Bret to go get the bags from the car. Soaked my first pair of pants. Called Lennon and she said it could be just a small leak but to keep her updated.

Ate dinner, had some of the regular old contractions I'd had for weeks. More leaking, definitely was not pee. The boys were tired so I put them to bed at 6:30 instead of the normal 8:30. Both went down fairly well and I noticed contractions picking up to about 5-7 min apart and not too strong.

Called Lennon to update her. Updated some of my friends online who were eagerly waiting to hear about baby. Went to sleep from 10:30-midnight and stronger contrax woke me.

Got up, went in living room for a while and then Elijah woke up and wandered out. He apparently thought it was morning. I laid him in bed, he was dry coughing a lot so gave him some cough syrup. He did NOT want to sleep, kept singing to himself, sitting up and smiling at me. The contractions were getting stronger and I was having to blow through them a little. He loved that and would blow back.

I NEEDED him to sleep so I could get up and call Lennon. I couldn't leave him to get Bret if he was awake 'cause we'd start it ALL over again. So I laid there...for 2.5 hrs, trying to move with contractions and blow quietly. Finally, he was asleep. I jumped up, checked the clock and contrax were 2-3 min apart. Called Lennon, asked her to come right away (she's an hour away) and woke up Bret to go into the boys' bedroom.

Finally, I could start labor. I paced and rocked almost the whole labor, swaying. The contractions were getting strong in my back and hips. Lennon and Angie (midwife apprentice) arrived at 3:40 or so, walking in without knocking and I smiled at them and said I was glad they were there, that things were getting painful and I was tired of being alone. I don't think they had any idea how far I was b/c I was smiling, lighthearted. We had agreed earlier in the week not to do any vag checks unnecessarily so there was no picture of how far along I was in that sense.

I felt like there was a stall when they arrived though, that I sensed an intrusion for a while and needed to regain my composure and start going back into my little dark quiet space. I asked them if we could just have the blue cafe lights on in the living room with minimal lighting and they were fine with that.

Even with them there, I was alone in my labor, sometimes sitting on my knees rocking to all fours, sometimes just standing swaying. My noises turned from low moans to horse lips and a few "ow"s when things would sting a little. My midwife kept telling me softly, "You're making this look easy. You're doing great."

In between contrax, I wanted to throw up. I knew that sometimes that opens you up and I felt like throwing up, but I couldn't make myself do it. With my gallstone issues, throwing up has always meant there was something wrong with me and for some reason, the mental block was there that this was NOT wrong and I shouldn't do it.

Transition came and went quickly. I remember a few things I said, something like, "How did I ever do this twice already? What if he never comes out? How do I make this go away?" At one point, I started crying and frantically reaching out for a hand, meeting Angie's. My eyes were closed. I've always handled pain w/ eyes closed. I cried and was scared a few times but knew that I was safe.

And then, I started whispering, "Down, down, baby, come out. It's time. I don't want to do this anymore. I don't like it. It hurts. Come down now." I have no idea if I was whispering, but it seemed quiet to me and I kept saying that during the next 2 or 3 contractions.

I realized suddenly that I had to push. Someone woke up Bret and he came out as I grunted my first push. I was draped over the little exercise ball and rolled back and forth to push. I remember being relieved that it was almost over. I remember a little fear at the change in pain as he came down. There were a few pushes and he came out in a ball of screaming baby. They helped me sit back and put my bewildered but quieted son in my arms. I soaked him into my soul.

It was less than two hours from Lennon arriving and baby meeting the world. I'm really glad I was able to labor that much on my own.

That was the birth at 5:22 am. It was quiet, dark and sweet.

Lennon and Angie left a while later, after cleaning up. I reclined on the couch sleeping and DH went back to fend off the early waking boys. When they came out at 8, they walked in quietly and then Cameron said, "Mommy, you had the baby!" Cameron wanted to kiss him and kiss him. Eli just smiled and patted his hand and head and kept nodding. Later, Cameron gave me the most perfect example of how I've tried so hard to raise him. He said, "Mommy, you did a REALLY good job. He looks so cute from being born. That was a lot of hard work." What an affirmation from an almost 4 yr old!

I was so empowered by this birth. It was what I wanted. It was the birth I'd been searching for since my first pregnancy. I had imagined birthing in the quietness of night, in the light of the blue bulbs strung along the wall, in the quiet and surrounded by people that believed in me.

I was dumped on with a lot of responsibility in my first post-partum days, unable to get the help I needed to rest. When I have been overwhelmed, I have clung to the sweet dark peace I felt after Benjamin came to me that early morning. While my body has been tired, my mind clearly greets that memory and gives me strength to just get through one more minute, one more hour, one more day.

Unscrupulous

2009-10-23T11:56:00.000-07:00

I am currently pumping milk once a day for donation for a sick adopted baby girl. I was nearly out of breastmilk freezer bags, so when I was at the grocery store yesterday, I picked some up. The grocery store is a large chain store, with one of those coupon machines that spit out coupons for you when you check out based upon what you purchased.

Imagine my surprise when I glanced at the coupons the cashier handed me, and one was for infant formula. Great, I thought. I suppose it must have been because they can tell I have a baby, since I was buying breastmilk freezer bags.

When I looked closer at the coupon, though, I couldn't suppress a disgusted laugh at what was written upon the coupon. It has a picture of a cute baby along with a picture of the formula which they were advertising (which I will not name, so as to not give them free advertising). The words read:

"Thinking of supplementing your breastfed baby? Consider X brand, our closest formula to breastmilk. Clinically proven to benefit infants in all three areas: growth, brain and eye, and immune system development."

So, not only were they targeting me because I had purchased a baby item, but they were banking on me, as a breastfeeding mother. You know, because I might not have enough milk, or maybe I don't like nursing in public or want to have a break from the task of nursing my beautiful boy..... right. And, you know, it is pretty close to breastmilk....its almost the same thing! Right???

Oh, it all just makes my blood boil.

It really makes me feel ill. I don't know how those who work in marketing for the formula industry sleep at night.

The birth of Sean Sylph

2009-10-19T23:19:00.000-07:00

My dear client (and friend!) Lee has given me persmission to share her birth story of her sweet stillborn son, Sean Sylph.

*********

Late in the afternoon on September 10th, at 33 weeks of pregnancy, we found out that baby Sean was no longer alive. The morning of Friday, September 11th, after a difficult night, I told my midwives that I was ready to no longer be pregnant and I wanted to go ahead with the birth (we were originally planning for Saturday morning).

After a morning spent with my parents and Jake, we went home and prepared. I set up an altar and Mike and I made sure the house was ready, then I rested for awhile while Jake took a nap. At 3pm, my parents came and picked Jake up. My midwives, Lennon and Angie, arrived.

First Mike and I performed a smudging ceremony to cleanse ourselves and our space.

Then we went upstairs to get started. I was very pleased to find that I was already 6 centimeters dilated, and then Lennon broke the bag of waters. I went and sat in the bathtub to let the water flow out, and eventually filled the tub with some warm water for comfort. About 15 minutes after breaking the waters, I had my first contraction. The contractions were very mild at first, and slowly built up in intensity, frequency, and duration. I stayed in the bathtub for quite awhile, keeping myself upright to help things move along more quickly. Mike sat in the bathroom with me, and my midwives were in the bedroom next door, ready to check on me whenever I called. I had a candle brought up and lit and put in the corner of the bathtub for something to focus on.

Suddenly things changed and I found I could no longer be in the bathtub. I was immediately so hot and dizzy that I broke out into a sweat (it was 90 that day!) and practically ran to the bedroom where I got on my hands and knees on the bed and threw up into a bucket, except only water came out. This was probably transition! I started feeling a little better after that but the contractions were incredibly intense and close together at this point. I just kept myself as comfortable as I could on the bed with pillows to help prop me up to stay upright. Contractions continued to come and go, and I sipped cool water in between and breathed through each one.

Soon I moved to the edge of the bed and sat through a few contractions to ease the pressure on my knees. I asked for the birth stool, which the midwives brought up and set up for me. It felt great to sit on. After a few more contractions, I had a contraction where I let out a long, low, primal moan that surprised me but felt really good. The midwives immediately came into the bedroom and began setting up for the birth. Pushing was slow, with long resting times in between contractions. The baby soon crowned, but wasn't born until about 40 minutes later.

Sean was finally born at 5:40. Mike was the one who caught him and cut the cord. He was put down in front of me and I gently caressed his face and examined his body, toes, and fingers. This was so hard to do. I could see for myself that his body was not normal, his face hadn't developed properly, but he was still my baby that I had loved and carried inside me for 7 and a half months.

I was given the time and space to just look at Sean and be with him. I sat back on the bed, exhausted, and waited for the placenta to come. It took awhile, just like with Jake's birth. When it finally did come out (easily), the midwives found that it hadn't developed quite normally, either. During this time Mike sat with Sean and held him and connected with his spirit.

After the quick, 2 hour labor and birth, I was able to then sit back on my bed and rest. Sean weighed in at 7 pounds, 3 ounces! Mike and I sat with Sean and just held the peace for awhile, contemplating it all.

When we were ready, at about 8:30pm the guy from the funeral home came, and Mike took Sean down to the car and laid him inside. I watched from the upstairs window and then cried as the car drove away.

My parents brought Jake back, and Mike and I hugged our boy tight.

(The middle name: a sylph is a sky spirit, seen in the form of particularly-shaped cloud wisps.)

*********

Thank you, Lee and Mike. Thank you for allowing me to be with you during such a sacred, beautiful and sad event.

The veil

2009-09-16T21:51:00.000-07:00

It is a sobering fact that birth and death are closely related. Flip sides of the same coin. Thankfully, birth and death are usually spaced far apart in one's life.

Not always, though.

This month, two of my dear clients have lost their babies, much too soon. Both babies passed from their bodies within 9-10 days of each other. The first in the 26th week of pregnancy, the second in the 33rd week or pregnancy. Otherwise known as intrauterine fetal demise. I don't like that term, though. It sounds much too cold to describe something that deserves all the compassion we can muster.

As a midwife, this felt like a bad dream. Could this really be true? I felt like my heart had been riped out.

The days and weeks that followed have been a time that I can only describe with one word: humbling. I have been in utter awe at the strength of each of these women, in birthing their babies and subsequently saying goodbye to them, and each of these families, in grieving and doing the hard work of moving forward and healing. These babies were/are both dearly loved and very much wanted.

I cannot describe in words how these two babies have touched my life and my work. They will never be forgotten, and will be loved and remembered. Though their time with us was much too short, the gifts each baby gave to all of us whose lives they touched are many.

He's here!

2009-08-03T19:20:00.001-07:00

(and, I'm here still, too. :)

Our newest family member, Julian, made his way earthside on July 10, 2009. It was a fast and intense birth. I was a bit shell-shocked for a few days, but looking back, it was such a wonderful birth! He was a big boy, weighing in at 9lb 11oz (my first baby weighed 6lb 6oz).

Midwifery in Australia

2009-04-01T14:00:00.000-07:00

I have seen very little talk in the midwifery community in the states about what is happening to midwifery down under in Australia. Personally, I would be totally in the dark if it weren't for the wonderful Lisa Barrett and her incredible blog.

I urge everyone to click here and either watch the video or read the transcript.

It is just deplorable what the government is doing, not just to midwifery but also, and most importantly, to women and families.

Public Perceptions of Breastfeeding

2009-02-13T15:32:00.000-08:00

I did not write this, but it was too fabulous to not pass on. (I'm not sure of the original author, but whomever you are, thank you!!!)

Society is so sexualized that they have forgotten what God created
our breasts for in the first place. They throw hissy fits over
breastfeeding in public and expect us to feed our babies in dirty,
stinky bathrooms. So I ask you to judge for yourself, which breasts are
truly offensive here? And I understand some of you won't think ANY of
them are offensive. But I am making a point by showing how ridiculous
it is that society looks upon scantily clad women in sexy ads as ok,
even GREAT, but providing important nourishment and nutrients to your
child in public by breastfeeding is offensive, distasteful, disgusting,
whatever. Give me your feedback. :)

Wait... well, this is a bad example. Let's try again...

Hmmm... just a minute. Surely i can find better ones than these...

Eh... still not racy enough. I'll check one more time.

That's better. LOOK AT THAT! I see about an inch of boob! Totally disgusting.

Ugh! Look at that indecency!! She must be from some third-world country to be exposed like that!!

Now that's just... There's no words to describe how inappropriate that is. Something needs to be done!!

Now
this takes the cake!! How dare they actually put such a disgusting
image on the cover of a magazine where teenage boys might see it. This
simply must be disposed of ASAP via a shredder, before teenage boys
learn what boobs are really for!!

This just makes me want to vomit!

...but why stop at breastfeeding women? There are boobs
everywhere. Beware! If you thought the above photos were offensive, you
WILL DEFINITELY be offended by the photos below.

Not this one though. This was in plain view on newsstands and in mailboxes in 19 countries worldwide!

Not this one either. This one actually won an award!

Oh, and i guess this ones fine too, since everyone knows you can't sell jeans without someone being topless.

or beer, for that matter!

or sunglasses...

or movie tickets...

or CDs...

...you
know what? Maybe I'm crazy, but i think that someone mixed up some
photos here. The first batch are offensive, but the second batch are
just fine and dandy???

people who live in glass bras:

shouldn't throw stones:

Which message is healthier?

Breastfeeding which is medically approved to give HUMANS the best start in life. . . or

Images that promote STD's, unattainable beauty standards, sexual promiscuity, plastic surgery, and just plain TRUE indecency?

Which would you rather your daughter live up to?

Ifyou think women have the right to breastfeed their children no matter
where they are, please re-post this. The least you can do is help some
children get the best nutrition they can get. Breastfed babies have
lower instances of obesity, asthma, allergies, certain childhood
diseases, learning disabilities, and other health problems. For each
woman who feels like she shouldn't be breastfeeding right where she is,
there is an innocent baby who is losing out. Don't be responsible for
any child's health problems. support breastfed babies and their right
to eat in public like the rest of us.

Absence explained

2008-12-18T21:56:00.000-08:00

I am in the midst of first trimester fun! We are expecting our second baby to arrive sometime this summer!!!

I haven't been on the computer much at all, although I have thought of many things I'd like to blog about.

Hopefully January will be a better blogging month for me. :-)

Security

2008-10-23T07:47:00.000-07:00

Go check out another excellent post by the amazing Gloria Lemay, if you haven't seen it already!!

Living Exposed

I live under no false assumption that by being certified and licensed, I am 'protected'. Codswallop. Midwives need to let go of the assumption that if they always follow their protocols to the 'T' and keep up their license, they will never be liable to prosecution. As Gloria says:

"There is no safety to be had in birth work. No amount of butt covering will avoid the fact that you’re not perfect. If you do something, you will be attacked and, if you don’t do anything, you will be attacked. If you have a certificate, someone will want to take it away from you and if you aren’t certified people will make that wrong."

Can't we just have Gloria cloned and distributed throughout the world, so that we can all have some of her sanity and wisdom in our community? :p

Birth Stools

2008-10-12T22:17:00.000-07:00

Ok, ok, I know that I'm a neglectful blogger. I really do promise to have more interesting, fun and insightful posts in the near future! Including one all about the maternity system in Peru. Ahem...

Starting up a practice is hard work, though! I'm spending most of my days writing client handouts. Oh, and shopping for supplies....which isn't really hard work at all, but quiet fun. I'm having a hard time deciding which birth stool to purchase. I want one that doesn't inhibit the sacrum, which is harder to find than you'd think. Here are the ones I fancy so far:

Wooden birth stool
DeBy birth stool
and if money were no factor,
the Birth Mate stool

I need to decide soon. I've personally given birth on the wooden version, and I like it well enough. But, I'm intrigued by the DeBy. I've heard both positive and negative feedback from mothers who've birthed on it.

What???

2008-10-12T22:13:00.000-07:00

Has everyone heard about what Poland's health minister is proposing?

New mother and child department in Poland draws protest

Regardless of your views on abortion rights, this is a direct violation of women's right to privacy. Frightening!

News

2008-08-11T17:35:00.000-07:00

Although I attempt to keep my identity anonymous on this blog, I want to share some personal midwifery-related news and thoughts.

I recently finished my apprenticeship. My last birth alongside my preceptor was August 4. A sweet waterbirth of a beautiful baby boy. I will be taking the NARM written exam in 3 days time. Keep me in your thoughts. I would love to pass it and not worry about it any longer!

It is a very bittersweet time of transition at the moment. I am so excited to finally be starting out on my own, something I have dreamed about for 8 years now! But, every time I think about no longer attending births with my former preceptor, I get weepy. It's a hard thing, moving on.

Another footing breech homebirth

2008-08-06T15:35:00.000-07:00

Attended by independent midwives in the UK. Enjoy!

Peru's ploy to end homebirth

2008-07-17T08:17:00.000-07:00

Peru embraces vertical birth to save lives

Some choice quotes:

"Condori said she did not want to take any chances and that hiking through the mountains was a safer bet than having her baby at home."

"The hope of the program is to cut high rates of maternal mortality by encouraging poor, mostly indigenous Peruvian women to place themselves under the care of professionals."

There were some good things in the article, even if the overall tone is to emphasize that these women are dieing because they are home. Like I was happy to see this:

"Peru's health ministry has said vertical birthing positions can be healthier for women by reducing pressure on the uterus and large blood vessels that can affect the amount of oxygen going to the baby. Standing or sitting during childbirth also tends to reduce labor and delivery time, according to the health ministry, and allows the mother to watch the birth better than if she were lying down."

"The practice of women giving birth on their backs is done for the convenience of doctors, not women, say supporters of Andean birthing methods."

Peru has a recent history of trying to rid itself of traditional rural parteras. I have corresponded with a German homebirth midwife who lives in Cusco, and it is rather hostile there for midwives according to her.

This article makes me feel so frustrated. Yes, Peru's maternal mortality rate is devastatingly too high: 185 women die per 100,000 births. But, is the move to hospital or clinic births the answer?

In my opinion: NO.

Why not start a national program to educate existing midwives in how to treat and handle shock and allow them to carry lifesaving anti-hemorrhagic medications? Why not start a national program to CREATE more midwives who will serve these women in their homes, and ensure they are adequately nourished prenatally? I have read many times that many rural Andean Peruvian women give birth with just their family present, and if there is a problem, they then send their husband out to fetch the midwife.

It has been shown again and again that it isn't the fact of being HOME that increases the maternal mortality rate. It is the undernourishment and poverty of women, and the lack of access to skilled attendants when they are need of them.

Does it really make sense to have a woman hiking 5 hours in labor to reach a clinic to birth? I will be shocked if this support of vertical birth is going to start bringing women in droves to birth in the clinics. Women in many cases can't leave their homes, especially if they have other young children.

My family is planning a vacation to Peru in a few months, and I am hoping to meet the German midwife and talk about this topic more with her.

Unassisted footling breech birth

2008-07-12T10:15:00.000-07:00

Here is a photo series of a beautiful surprise footling breech unassisted birth. How beautiful!

Tis the season

2008-04-04T12:16:00.000-07:00

I apologize for my absence. I know I had made a commitment to blogging again. But, as so often happens, life gets in the way. I am in the midst of some major personal life changes. I won't go into details about it all here, because it isn't remotely related to birth. :-)

As a consequence, I have little room in my mind to ponder midwifery related subjects. When things have settled some, and my mind is calmer, I promise to be back in full force.

Thank you!

Birth Trust

2008-03-24T22:09:00.000-07:00

I had no idea it had been so many days since my last post. This past week has been a fuzz. We attended 3 births in 6 days, all with their own unique excitment. I won't go into details here, as the birth stories aren't mine to tell.

But, let me just say this:

I don't trust birth naively. I know that things can 'go wrong' in all birth settings, with all birth attendants, and with no birth attendant, and that there are two very precious lives involved in birth, both equally important. I have seen things during births that would cause some midwives and student midwives to quit for good. But, I have not waivered in my belief that BIRTH WORKS. And, I am always critically looking at another key question: how can I guarantee that "X" complication would have occurred no matter what? (I can't). What role do I have, as a midwife, to causing the situation at hand? (And, I don't mean any obvious cause....but what about the simple presence of us midwives?). I wish I could explain in more detail these births I have attended in this last month. It was a blessing that I had just attended The Trust Birth Conference 2 weeks earlier.

Homebirth Montage

2008-03-17T21:31:00.001-07:00

I know this has been out on the net for a few months now, but it is so wonderful, I just have to put it up here:

baby girl

2008-03-16T20:52:00.000-07:00

Yesterday I was awoken at 7am with a call that a 3rd time mom was in early labor. We were there by 8:30. It was a sweet birth, the couple really spent lots of loving time together while the rest of the family was in another part of the house (including us). She labored absolutly silent, and when we suddenly heard her low moaning with pushing, we knew it was almost baby time! Her baby was born while in a supported squat with her husband beind her and her 2 daughters (2 and 6) looking on. Sweet and healthy baby! We finished the day off with 2 postpartum visits for clients who have 2 week old babies. All was well. After a 12 hour day, R was sure glad to see me, but had a fun day with his dad and brother.

I need to make some time in the next few days for studying. I have all of these thoughts and ideas swimming around in my head that I want to research more. It is so great to finally be having real hands-on training. I realize now how much of a hands-on learner I am. Everything is visual for me. To hear something, it just goes in one ear and out the other. But, to see it done (or better yet, to do it myself) is so much better!! I am excited that my preceptor really just throws me into things and has me do things I have never done (like listening to fetal heart tones during labor). That is the best way for me to learn, I think.

(Originally posted April, 2006)

Birth

2008-03-16T20:51:00.000-07:00

Well, as suspected the mom that was ready to go any day had her baby early yesterday morning! She had a sweet, sweet baby girl. The strength and perseverance of this mama really touched me. After about 5 hours of pushing at home, and discovering hematoma on the baby's head, mom was ok with transferring and we hoped that perhaps the CNM at the local country hospital (20 minutes away) would have some ideas. Instead, when we arrived, they just preped her for a c-sect. They didn't even want to check her vaginally. Her baby sounded great, very healthy. Baby girl was born at about 2:30am via cesarean section. She was posterior and asynclitic. They had to reach up and push her up vaginally a bit, she was so wedged in there, and there were bruises on her back from the doctors trying to lift her out of the uterus. Apparently, the incision tore down into her cervix from their efforts to pull the baby out. Baby was very healthy and the mom was in her room with her baby very soon.

The hospital was very respectful, very welcoming to all of us. They have 'rooming in' and encourage breastfeeding (they got the baby latched on within 1 hour!).

I am sad to see such a conclusion to her birth, but I don't believe in accidents. For some reason, this was the path of this baby and mama. This mama's strength and beauty is awe-inspiring!

I have been busy reading lots and lots about Optimal Foetal Positioning. I feel like we tried everything we could to get her baby to turn into a better position. But, the way that it unfolded was the way it was to happen (proven by the fact that it DID happen that way). Still, I want to learn as much as I can about OFP. Heck, I could have used the information during my pregnancy/labor to help make it a smoother experience (or, so I like to think). But, my little guy came out to this world exactly as he needed to. There are no accidents, imo.

(Originally posted April, 2006)

Limbic imprinting

2008-03-16T20:50:00.000-07:00

I saw a new birth video last night called Birth As We Know It. It is similar to the Birth Into Being Russian waterbirth video in that they showed some similar footage of babies being born in the water and in the Black Sea. But, this movie goes much more into depth on the social implications for birthing consciously. They talk a lot about limbic imprinting and healing our own birth trauma.

It really shook me up. I was born via forceps (that left a mark at birth) and then separated from my mother for 4 hours. I was born in Louisiana, and at the time at that hospital, it was still standard procedure to take the baby to the nursery for 24 hours (the nurses at the hospital were trying to talk my mom out of nursing me!!!). Well, the reason I was separated for only 4 hours was because that was how long it took for my mom to get ahold of someone who would be willing to override the hospital rules and allow me back with my mother. I was born in a smaller town, and my dad ran the local newspaper, so he knew "people". My mom finally got the mayor on the phone and demanded that her daughter be given back to her. She then proceeded to check us out "against medical advice". And, she breastfeed me for just over 2 years!

But, this movie made some connections for me. I realized plain and simple WHY my family has always called me "cold", "distant", "hard-hearted", and very selective of who I let get close to me. My most basic trust in life was betrayed. It makes me so sad inside to even think about it. :(

The good thing is that I don't think that there is any hurt that is permanent...we CAN heal and grow. R's birth was a big part of this, as well as being able to give him what I wanted so badly (as in, not being separated from my mom). But, I still have a long road ahead of me to open up those wounds and let heal afresh.

It is so simple, really. Just give your babies what they want...what they NEED!!!! They need our arms, our voice, our breasts. They need to be born with respect, wherever their birth location is. They are whole and complete humans at birth (And before!) and they deserve to be treated as such.

Our planet's future just may depend on it, in my opinion...

(Originally posted April, 2006)

Welcome, Baby!

2008-03-16T20:48:00.000-07:00

Last night, a beautiful baby boy was born! I had the honor of being present and serving the mother however she needed me to. It was my first birth as the "assistant midwife". It was just great. Woman's strength is awe inspiring, everytime! It was her 3rd baby, 2nd born at home. She is Russian, and I thought how fitting it was that my first birth that I attend on my path to midwifery is with a Russian family (I have always felt like Russia is my 'motherland' and have always dreamed of returning and living there).

R. did really, really well with me gone!! I left him during his nap in the middle of the day, and returned around midnight, and he had just gone to sleep. He struggled a little with falling asleep without nursing, but it went just fine. I am so thrilled!!! Yipee!!!!

We have one first-time mom due "anyday" and that is it for April due dates (though there are some early May dates, and those could birth early, of course).

I had such a hard time really sleeping last night, I was too excited. I was very tired, but my mind was just jumping up and down all night, the excitement was too much!!

I am at peace.

(Originally posted in April, 2006)

Babies, babies and more babies!

2008-03-16T20:47:00.001-07:00

I am officially 'on-call' starting today. There are 4 women due any day now. One mama is close to 42 weeks, and is anxious to have her baby out, but doesn't want to do any interventions to get labor started (yay for her!!). Another mama has very iffy dates. Originally, she thought she was due i December (she was nursing, and hadn't had her period return yet when she got pregnant). Well, she is till pregnant, and it looks like she was due sometime last week, so she will have her baby very soon too.

I am very excited about all these babies that are going to make their appearances soon! My preceptor says that they were all waiting for me to get settled so I could be there. :)

It is a wonderful northwest day outside. Pouring rain one minute to sunny skies the next. I love it!

(Originally posted in April, 2006)
As soon as R. wakes up from his nap, we are going to head out to the store to buy me a watch. I haven't owned a watch in who knows how many years!! But, I need to have one on me during births and prenatals. I still haven't figured out what sort of bag I am going to use for all of my prenatal/birth supplies, but I can take my time to find the right one. I wish I was more crafty with the sewing machine, so I could just make my own!! I am still tempted to try. We will see!

I cast on for a pair of socks for myself, and a soaker for a friend of mine who is due in June with her first baby. Her mother blessing is in 2 weeks, so I hope I can finish it in time! The socks will take me a while I think, they are on size 1 needles, but there is no rush. I enjoy the creation process of just making them.

I like our new city ok. We are adjusting to it, anyhow. I feel rather lonely, no one up here for me to talk to really, but I know that will change in time. I attended our local Stitch'n'Bitch the other night, and that was great to get out of the house for a little while and meet some new people. But, it always takes me a while to warm up to people to make real friends with them. I have always been that way. I think that to some people I may appear cold and distant, but it is really just me being self-conscious. It used to be much worse when I was younger, so I seem to be growing stronger in that regard as I grow.

i know, i know...

2008-03-16T20:43:00.000-07:00

cool blogs have pictures and people that regular post! So, I am not there yet. I just can't carve out the time lately. That's ok, not that anybody reads this anyways, it is really just for my own release.

Not much going on lately. I went to my first birth since my son was born a few weeks ago. Just an awesome beautiful waterbirth!!!! God, out bodies just rock! It was good to see how well my son did with me being gone, too. He just turned two, and while to wasn't totally smooth, it went WAY better than I thought it would. Whew!! This fall I shall begin apprenticing full time with a fairly busy midwife, so he is just going to get better at being away from me. Wow, he got big so fast!

I had often thought about becoming a CBE or a doula....but I just don't think I could do either very effectively. I find it very hard to support women who have a perfectly healthy pregnancy and choose to walk into the hospital to give birth. Don't get me wrong, I acknowledge that there is a time and place for hospitals and OBs, but I seriously don't think more than 5% of births need them. Maybe even less. But, in this country, it is less than 5% who have homebirths, while the majority of the 95% remaining births take place in hospitals. I think this is criminal. And, firstly, we need to start with the next generation to change things. I acknowledge that come women do feel safer giving birth in the hospital, but they weren't born feeling that way...it is our culture who has taught them to feel that way. Most teenage girls are terrified of the whole process of birth. No wonder they are convinced they want the epidural long before they are even in labor!

Ok, I feel like I am going off on a tangent. sorry.

I feel so frustrated when I hear moms sharing their martyr birth stories, or about how their baby almost died, thank GOD they weren't at home! ......

So, something that I am reading more and more about is the use of oxygen in resuscitation of newborns. Very interesting stuff! There isn't really any research that shows that 100% oxygen is better than room air for resuscitation and in fact, some research to show that 100% oxygen can actually cause DAMAGE!!!! This is just mind-blowing to me! I just heard an old conference tape by Dr. John Stevenson. He has NEVER carried oxygen equipment with him to homebirths, he doesn't think it is necessary. Huh! I know some midwives who would NEVER attend a birth without it!

I used to think that the midwifery community was all fuzzy and warm and supportive of one another....but the more I become involved in it, the more I see that there are people who are VERY different from others and often tension between them that is so very palpable. Like this oxygen topic...talk about some strong opinions! But, to me, it does just make sense that room air would be best, esp considering how tiny the babies organs are, and how toxic oxygen can be when the tissues are OVERLY saturated.

Once again, our bodies just simply ROCK!

(Originally posted in Feb, 2006)

you know it's bad when...

2008-03-16T20:41:00.000-07:00

Geez, it is pathetic that I almost always can easily predict what will happen to friends and friends of friends that give birth in hospitals these days...I am (very sadly) wrong very infrequently. Same old story...labor wasn't going fast enough (or hadn't started soon and she is "over-due"), then the pit., then a good chance of an epidural, then the ominous c-sect...or sometimes, you can throw in the scary FHTs a while after the Pit is given, and then the doctors ("Thanks GOD we were in the hospital!!") do the emergency section. I wish I was wrong. I wish that each time a woman went into the hospital, she emerged whole and uncut (physically and emotionally). And, I know that some do. But, it seems to be more and more uncommon. Oh, it just makes me want to cry....

And here I am wanting to start doula'ing hospital births. I have always said that wasn't for me, that I would just come home from most births outraged and so, so sad. But, something in me wants to see what I can do to help. I don't know. If it is the right thing, I know it shall unfold in time.

(Originally posted in December, 2005)

Birth Talk

2008-03-16T20:40:00.000-07:00

So, I had this thought the other day. So many people, including myself, seem to assume that homebirth midwives are "protecting" birth and women. But, I am coming to realize more and more that birth survives and happens many times IN SPITE of some midwives. I never thought I would say this, but that is where I am at right now. I keep hearing of more and more stories where the midwife (in a homebirth, btw), is yelling "PUSH! PUSH! PUSH!", telling the woman where, when and how to push, and generally NOT respecting women's intution. It is almost as if there are some midwives who just give lip service to trusting birth, and deep down, they still feel the need to control birth.

I am not midwife bashing. I love midwifery. I am a student midwife myself. I am just seeing more and more exactly what kind of midwife I want to be, and realizing more and more that there are many more differences between midwifes other than CPM, CNM, DEM, etc, etc..... Thank goddess that I had P. at my birth. She is the kind of midwife that I aspire to be. She truly understands what birth is and can be if left alone. I pray for guidance as I walk down my path to midwifery to keep my heart open and to be honest with myself and confront my fears head on.

Old posts

2008-03-16T20:39:00.000-07:00

I am moving my personal blog to a different server, so I wanted to re-post here the entries that pertain to midwifery. Enjoy!

2008

2008-03-16T19:52:00.000-07:00

Now that the Trust Birth Conference is over and I have gotten back into the swing of day to day life, I need to get things back on track. Only about 3.5 months left of my time as an apprentice; plans to graduate midwifery school by the end of this year; taking my NARM exam August 20; figuring out where I fit in my community as a newly-winged midwife. As a testament that I am interested in more than just midwifery, I am planning on enrolling in my local community college in the fall to begin a Russian language class. I am almost as excited about this as I am about the prospect of passing the NARM. In preparation, I bought a bunch of these flash cards today. I had a set of them when I lived in Russia as a high school exchange student, and they were fabulous. I did at one time speak quite a bit of Russian, almost to the point of fluency. I am hoping these classes and flash cards help to dig out of my memory the language that must be in the depths of my brain somewhere, and offer me a chance to learn proper Russian grammar.

I hope to use this blog to expand upon my thoughts on various midwifery subjects that I am studying for school assignments. Knowing that I want to keep this blog alive and well will help to motivate me to keep working on my assignments to meet my final goal: GRADUATION. Sounds simple enough, but I have been working at this (off and on) since 2001.

2008.

one more time

2008-03-15T20:59:00.000-07:00

The Trust Birth Conference.....it was incredible! The entire event was like a dream for me!

The highlights for me:

The awards dinner was so great. I especially loved Dr. Odent's presentation on breaking the dis-empowering vocabulary of birth. I strained my ears the best I could to catch every precious word he said.
Meeting so many wonderful people, especially those I have "known" online for many years.
Meeting the wonderful Gloria Lemay. In more ways than I can count, she is my hero and role model!
Meeting and speaking with so many other amazing speakers: Jody McLaughlin of Compleat Mother magazine, Dr. Sarah Buckley, Laura Shanley, Karen Strange, Rixa Freeze, Gail Hart, and many others too numerous to mention.
Rachel Correa's beautiful presentation about her first born daughter during the opening session.

and honestly, that list is a very abbreviated about a seriously life-changing trip!

The conference has inspired me to keep this blog going. I know I haven't been consistently writing. But, I plan on changing that. You will have to bear with me, as eloquent prose isn't my strong point. But, I will do my best to breath new life into this here blog.

Starting today.

My excuse

2008-02-26T19:07:00.000-08:00

I think so often about this blog, and sometimes, even about things I would love to post about. But, it is the same way with friends I haven't talked to in months: I think about them and want to call, but in that moment, I'm not free to gab away on the phone, so I put off calling until later, and then forget. So it is here with my blog.

I really do see a time when I will be able to be more devoted to keeping up with things here. I'm not sure when that will be, but definitely not for a few more weeks.

And, here is my big news that prompted me to come and post today.....

I finished my NARM PEP application tonight!!! Whew! All I have to do is get to the notary in the next day or two, and go get a passport photo of myself to send in along with it.

The sense of relief is enormous! Though, I know the next thing I will be worrying about once I get confirmation from NARM that my application was accepted will be the skills and written exams. But, for today, this week...all is well. :)

I'll be taking my exam August 20. It seems like eons away right now, but I know that it will be here in no time at all. I mean, we are just days away from March! That's shocking enough to me.

***
In the world of birth, we have been busy with prenatals, but our last birth was in early January. We have 6 mamas who could have their babies anytime now, though 5 of them could wait a few more weeks. From this point on through the summer, we have plenty of births to keep very busy.

***
I leave next week to The Trust Birth Conference. I can't really even say what I am most excited about. I sort of feel like even if all of the sessions were cancelled, it would still be wonderful: just getting to hang around with everyone attending and spend hours and hours chatting away about pregnancy and birth. But, the sessions are going to be pretty awesome, too, of course. I still feel giddy about it all.

Help save Waterbirth International!!!

2008-01-08T21:36:00.000-08:00

Please pass the word on to anyone you know who may be willing to help.....

*****************
Waterbirth International may close doors. Here is a note from Barbara Harper of Waterbirth International

Barbara Harper wrote:.

I cannot yet imagine a world without the voice and work of Waterbirth
International - we get calls and emails every day from women who need help
convincing one hospital or another to let them labor or birth in water. If
we die - a big part of the movement dies. Waterbirth has shown us all that
women know how to give birth and babies know how to be born. Waterbirth
gave us "hands-off", sit back and let the baby out. I see waterbirth
mentioned on Blogs every single day, not to mention Baby Story on the TV. I
took Waterbirth International to ACOG two years in a row - and was the ONLY
booth showing birth films to obstetricians and especially to student
physicians. There were tears, laughter and outrage - just the thing to stir
up those young crop of doctors. I am finally realizing a life's dream.

But now I am faced with letting this dream go. Perhaps I have done enough.
Perhaps it is time to quit.

About 18 years ago, maybe it was longer, when Mothering Magazine was facing
bankruptcy Peggy did a heartfelt plea asking their readers to consider
ordering a Life-time subscription. I think the subscriptions were $1000 or
$1200, I can't remember now. I do remember that I couldn't imagine not
reading my Mothering. So, I bought two and gave one to my obstetrician's
office.

How can you help us stay open to take the next phone call? - to convince the
next obstetrician to incorporate waterbirth into his/her practice - to work
with the nurse midwives to install pools in their facilities? To educate an
entire hospital on the benefits of allowing women freedom of movement in the
water. How much is it worth to see waterbirth become the norm in the US,
like it is in the UK? I think we only need a few more years to make that
happen. Do women really want waterbirth to be an available choice in every
hospital? I think so.

Can you help us by getting the word out on blogs and lists? I had to let go
of all of the staff except one person to process orders. Miraculously, we
made payroll today, but we can't hang on much longer. We need a miracle.

If I need to call every single waterbirth parent personally, I will. I
don't want 25 years of work to end over a measly $200,000.

The work that we have done the last few years has been phenomenal. How God
arranged for me to teach in hospitals and medical schools around the planet
- Taiwan, Venezuela, Turkey, Mexico, Canada, Holland, Portugal, China,
Trinidad, Croatia - I'll never figure that out. I laugh out loud sometimes
when I get up in front of an audience of physicians in a medical school
overseas - who all want to hear about waterbirth and the incorporation of
Gentle Birth practices and principles into their routines.

Think about what you can do and call me if you want to chat or if you have
some great ideas on how we can quickly move into the black and keep
waterbirth alive and thriving.

We need your help. Barbara Harper needs your help. The waterbirth/gentle
birth movement needs your help.

Blessings,
Barbara
Barbara Harper, RN, CLD, CCE
Founder/Director
Waterbirth International
www.waterbirth.org
503-673-0026 -office (out of US or in Portland)
800-641-2229 - toll free
503-710-7975 - cell phone

We LOVE helping women get into Hot Water!!
And have been doing it for 24 years!!

******************

Homebirth Increasing in the UK!

2008-01-01T11:35:00.000-08:00

http://www.nct.org.uk/media/pressrelease?prid=108

New National Statistics: Big increase in home births across UK<

Date: Friday, 14 December 2007

New National Statistics: Big increase in home births across UK

The National Childbirth Trust (NCT) welcomes the significant rise in the number of women in the UK giving birth at home, according to official new data provided by by the Office of National Statistics, The General Register Office for Scotland and the Northern Ireland Statistics and Research Agency and analysed by BirthChoiceUK (available at www.BirthChoiceUK.com).

Across the UK in 2006, 18,953 of all births (741,952) took place at home, compared with 17,277 in 2005. This is an encouraging rise of 9.7% overall, but still only represents 2.5% of all UK births.

The biggest increase - more than 10% - has been in England, where 16,923 women had a home birth.

Scotland shows the second highest rise in the number of home births (762) with an increase of 9.2%. Wales has fallen behind with the smallest increase in home births (1177) - 0.9% - despite having the fastest growing home birth rate in the UK for 2005.

Mary Newburn, Head of Policy Research, NCT, said; "It's very pleasing to see that home birth rates are on the increase, allowing women and their partners greater choice. However, many women around the UK still find it difficult to access a home birth. There is a lack of balanced information available to enable them to make an informed choice about where to have their baby. Low midwifery staffing levels mean that too often the option of a home birth is either not being offered or services end up being withdrawn at short notice."

Local administrative areas with highest and lowest home birth rates include:-

Highest	Lowest
West Somerset (England) - 14.2%	Middlesbrough (England) - 0.4% Blyth Valley (England) - 0.4%
East Lothian (Scotland) - 4.8%	Renfrewshire (Scotland) - 0.3% East Renfrewshire (Scotland) - 0.3%
Powys (Wales) - 10.7%	Conwy (Wales) - 0.9%

Government policy, as set out in Maternity Matters in England and the NICE Intrapartum Care Guideline, published by the Department of Health state that 'women should be offered the choice of planning birth at home, in a midwifery-led unit or a consultant-led unit.'

Mary Newburn continues;

"If the Government's choice guarantee for England is to be implemented by the end of 2009, considerable work must be done to increase access to home birth. We also welcome Keeping Childbirth Natural and Dynamic (KCND) in Scotland and the target for a 10% home birth rate in Wales as home birth initiatives."

At Your Cervix

2007-12-12T13:29:00.000-08:00

Everyone, go check out the trailer for this new documentary.....

http://www.atyourcervixmovie.com/multimedia.html

An Iranian Waterbirth

2007-11-07T00:19:00.000-08:00

If you haven't yet, go read Andrea Robertson's account of the recent Iranian waterbirth.

Reading stuff like this makes me really feel like there IS hope for birth.

Amniotomy

2007-11-05T21:02:00.000-08:00

The latest from the Cochrane Review.

Breaking The Waters During Labor No Longer Recommended

17 Oct 2007

"We do not recommend that amniotomy, also known as breaking the waters, should be used routinely as part of standard labour management and care" says Cochrane Researcher Rebecca Smyth, after completing a systematic review of relevant research studies. "Women should be informed that it doesn't shorten the first or second stage of labour, it doesn't affect the woman's satisfaction with her childbirth experience, and doesn't result in the child being in better condition immediately after birth."

This Cochrane Systematic Review found that breaking the waters may be associated with a slightly (non-significantly) higher rate of Caesarean section. Breaking the waters may cause changes in the baby's heart rate.

The aim of breaking the waters is to speed up and strengthen contractions, with the intention of shortening labour. The membranes are punctured using a long handled hook, and it is thought that hormones in the amniotic fluid that flows out will stimulate contractions. In some centres, it is performed as a routine part of care for all women in labour -- in others it is used only for women with a clinical need to have their waters broken.

Ms Smyth came to these conclusions after she and colleagues had identified 14 relevant studies that involved almost 5,000 women. The overall quality of the studies was variable, making it difficult for the group to give firm recommendations about the use of amniotomy. There is a need for further research in this area.

"Our evidence suggesting this lack of effect should be discussed with women in the antenatal period," says Smyth.

----------------------------
Article adapted by Medical News Today from original press release.

A totally rockin' breastfeeding article!!

2007-10-22T18:59:00.000-07:00

Dr. Jack Newman and Edith Kernerman talk about breastfeeding and answer mothers' questions here.

A little long, but well worth the read. There were some really choice quotes from Dr. Newman in here!

Dr. John

2007-10-18T15:53:00.000-07:00

If you have never read any of Dr. John Stevenson's writing, then here is a gem to start with.

Enjoy!!

Re-evaluating

2007-10-07T10:41:00.000-07:00

I have been spending the last few days really considering what I want this blog to become.

I have such a hard-to-beat inclination to talk about what other midwives do/don't do in a critical way, mainly due to my own struggle to come to grips with the reality of maternity care, midwives included.

But, I don't want this blog to be about my judgement (that is what it is, essentially) of others. I want this blog to be about my own journey as a midwife and my own ideas. More "I" statements than "they" statements. LOL!

Often I feel compelled to post here about various topics because of an encounter with someone or something that I am in disagreement with. So, I will have to carefully check my tendencies to rant on and on about such things because I have been feeling like there is enough out there on the net and in books that bashes what others are doing. I want my blog to approach birth and midwifery from a positive light, spoken more from my heart and mind.

birth magazines

2007-10-03T23:39:00.000-07:00

I'm not sure if Midwifery Today has changed, or if it is my perspective that has changed, but I can no longer devour each new edition that comes out and be left feeling excited and content.

I still love Midwifery Today, of course, and have great respect for their publication and recognize them as the great resource that they are. But lately, almost every article I read in each new edition makes me cringe at some point.

I know I have said it before, but it feels like the more I read other midwives' work or talk with other midwives, the more it has become glaringly obvious how far on the fringe I am in regards to my approach to birth.

I am tired of hearing midwives say that they trust birth and that birth is a normal and natural process, when they turn right around and start trying to convince everyone about how their interventions to 'help' the situation was natural because it only involved their hands (not a knife) and how midwives are needed to save birth, and so on. If birth works so well, then why do some midwives consider it dangerous to give birth with no trained professional?

I have to say....what is up with all of the bed births? Seriously! I'm not just talking about the birth pictures always featured on the inside back cover (which are almost always in bed, with lots of hands on the baby's crowning head and perineum), but about the birth stories themselves. I know that there are women who truly do choose to give birth laying down, and that is fine by me, but I am positive that they are in the very small minority. I think that more often than not, the bed becomes the chosen birth place because it is never presented to the woman as the least ideal place for giving birth (physiologically speaking). Though, again, I don't think that the birth pictures are a reflection of Midwifery Today's philosophy, but probably they print whichever pictures are received, and most of what they receive are bed births.

I am still a devoted reader of Midwifery Today, and I have been wanting to write an article to submit, as I don't think it is productive if all I do is complain about the situation. I have been brain-storming all night about which topic I should write about. Really, my issue I suppose lies more with the reality that I am facing: that the majority of midwives out there from what I can tell approach midwifery and birth very differently than I do. This is something that I am having a hard time coming to grips with, I suppose.

Elephant Suckling

2007-10-03T12:28:00.000-07:00

"Elephant milk looks rather thin and watery but it is very nourishing and babies put on weight at a rate of 22-44 lb per month. They tend to suckle little and often."

From Eyewitness Books: Elepahant

Our mammal sisters have so much to teach us.

Perineums

2007-10-03T00:03:00.000-07:00

Everyone has heard a story of a birth where the perineum was "tight" and just wouldn't stretch to allow the head to be fully born, and the midwife (or doctor) just had to either cut an episiotomy (it makes me wince to even consider) or massage it back around the baby's head.

Does this make biological sense? This makes as much sense as saying that a baby won't breath properly if not suctioned. ???? Um, no.

Any perineum that hasn't been mutilated by FGM will stretch as needed to birth a baby. Perhaps those women who have these so called 'tight' perineums need to be given more privacy, perineums unobserved, to give birth.

Sort of how our vaginas are soft and open up to our lover's touch but tense up when a stranger inserts a speculum.

conference fun

2007-10-02T21:10:00.000-07:00

I really love going to conferences. Meeting new people, catching up with old friends, hearing speakers on hopefully amazing topics. It just makes me happy.

I am lucky enough to live within a reasonable driving distance of the Gentle Birth World Congress conference which happened this last weekend. Though I only registered for the neonatal resuscitation training during a pre-conference session, I ended up spending Thursday through Sunday there, just hanging out, talking with people, walking around the free baby expo, and seeing the (free) birth and breastfeeding videos. I drove lots and lots of miles to make it happen, but it was fun and totally worth it! I say that even though I didn't actually attend any of the conference sessions. lol!

It just makes me even more excited about the Trust Birth Conference happenings!

breastfeeding again

2007-09-07T19:33:00.000-07:00

I am just blown away. Seriously! What is up with the pervasive amount of mis-information about breastfeeding???? Even from alternative health care practitioners......

In the last few days, I have talked with 2 different moms.

First mom's baby is about a month old. At 2 weeks old, she took her baby to the 'breastfeeding clinic' class that takes place twice a week at our local hospital. The lactation consultants there (called lactation specialists on their website, so probably not IBCLCs) determined that because she didn't gain much after nursing (leisurely) for 20 minutes, that the mother's supply was inadequate. Baby was fine otherwise, good output (wet/poopy diapers) thriving in all other aspects, not loosing weight, etc. They sent her home with formula (!!), a nipple shield (not surprising) and a SNS (which they didn't show her how to use at all). When I hear crap like this, I just want to throw up. Oh my. :( She had never tried the SNS because she had no idea how to use it. Of course, she could have gone back and asked for help, but why the hell would you give a mom (who you believe to have a low supply) a SNS without showing her HOW to use it????

This breastfeeding clinic consists of stripping baby down, weighing baby, nursing baby, then weighing baby. Then being told that you either have enough milk or don't. Total nonsense. That coupled with their love of handing out nipple shields like there is no tomorrow, and, I admit it, I have a very strong dislike of the class.

The second mom has a week old baby, and was having horrible sore nipples. Her midwife suggested giving her nipples a rest for a few days, and just pump or hand express milk and gave her a syringe feeder to feed her baby. Then, at a week, when it was apparent that the baby wasn't gaining, and was still loosing weight, she suggested she supplement with goat's milk. :( I can't be the only one who sees problems with this advice. It's the latch! It's the latch!! A poor latch will of course cause sore nipples. It will also lead to the baby not getting as much milk, and, because the breasts aren't being effectively drained, to a low milk supply. Which is where the mom is at now. Her supply is low, her baby is still losing weight. :( While I understand that you want to give mom a break from the horrible pain of sore nipples, stopping nursing is a very poor solution. It too will more often than not lead to low supply. Fixing the latch is the best solution for both mom and baby.

She took her baby in to see a naturopath doctor (who also happens to attend homebirths) and he told her that because she never experienced any physical breast changes (tenderness, growth, etc.) during pregnancy, she would never make enough milk. He suggested that it was perhaps because she had a lot of stress going on in her life during her pregnancy. What the....???? There have been studies that have shown that prenatal breast changes are NOT associated with milk supply at all. And, the bit about stress? In my opinion, a large number of women have a lot of stress during pregnancy. It seems that so much transitions and life changes suddenly occur when a woman is pregnant: moving, job changes, financial worries, and so on. If stress caused us to not make milk that easily, low milk supply would be a true problem for numerous women. Well, I guess low milk supply IS a common breastfeeding problem, but that is because of a whole other set of reasons (scheduled feedings, supplementing, poor latch, etc.).

It feels like there are so many factors that really undermine breastfeeding in our culture. Can I at least have hope that it won't last forever? Because I do, I really do.

Birth Philosophy

2007-09-06T00:38:00.001-07:00

I have been spending lots of free time looking at all different midwives' websites while preparing to start creating my own website. What has struck me more than anything is the similarity of all of the 'philosophies'. I know from experience that many (most?) people assume that a midwife is a midwife is a midwife. Of course, that is not the case at all. But, when you ask midwives about their birth philosophies, they almost all include some talk about birth being natural, birth working best left alone, their role is to support the woman/family, about promoting calm/gentle birth, etc.

You will never see a midwife say that she believes birth works, but only if she does "X" (perineal support/massage, vaginal exams, hat on baby right after birth, test your glucose levels prenatally, and so on).

So, when pondering about how I can word my own philosophy on birth, I am struck with the fact that I am just restating the same old lines. However, the more that I read/hear/talk with other midwives, the more I feel very much like the odd ball. How can there be this disconnect?

Practice Philosophy

2007-08-25T21:37:00.000-07:00

My practice philosophy has been on my mind lots lately. Not just my general, overall philosophy, because I feel very sure of that. I support women in their informed choices, birth unfolds best left alone, and essentially, I do want to be what is termed a 'hands-off' midwife.

But, I have been thinking more and more about the lovely details. Different situations, how I would react in various circumstances. How much nutritional counseling do I want to offer? Which pregnancy/birth/breastfeeding books do I want to give to all clients? How will I approach clients who have failed to hold up their agreed upon payments? Will I use a doppler prenatally if clients choose it?

I need to start writing all of this down. It is, of course, one of my assignments for school (to create a thorough Principles of Practice), but I would want to do it anyways. Getting computer time for it seems so scare. I have been considering hand writing it all, and then typing it up later.

Another thing I have really been wanting to get started is a website. There is no rush, as I am not taking clients of my own for a little while still, but it is something that gets me all excited! The main thing holding me back is the fact that I must choose a domain name. I have a very hard time with such things. It is right up there with the name of my future practice. I have NO idea. I am hoping that the right name will just 'appear'. Maybe the universe will send it to me in my dreams. I can dream, right?

Baby girl born unassisted

2007-08-25T21:34:00.000-07:00

I got word today that the sweet couple for whom we were on call as back-up for their UC had their baby girl early this morning. :) So very sweet. I knew it would go perfectly and they wouldn't need us.

Apprentices

2007-08-22T23:34:00.000-07:00

It feels more and more like so many midwives do not show fair amounts of respect to their apprentices. I hear more and more of apprentices who are made to the grunt work, asked to do all sorts of things (not midwifery related), and aren't paid.

I don't mean to say that it is unreasonable for apprentices to do ALL aspects of midwifery, including the grunt work; of course, she should do her best to help the midwives as much as is reasonable and to experience all the work involved in being a midwife. But it often seems like the apprentice is treated with little regard.

I understand, too, that not all midwives can afford to pay their apprentices, and that the midwives are offering a huge amount of learning to the apprentice. But, there does come a point where the apprentice is quite valuable to the midwife, not just a bystander watching to learn. At this point, it does seem only fair to give the apprentice some sort of pay, even if it is $20 per birth. It isn't so much about the money as it is the act.

I feel extremely blessed to be working with a midwife who respects and values me as much as I respect and value her. She does pay me a very generous amount to assist her at births, more now that I am acting as the primary midwife during prenatal and antenatal care. For this, I am grateful beyond words. Because of my experience, I fully intend to do the same for my future apprentices.

I am just tired of hearing about midwives who are asked (more often, expected!) to organize the midwife's (personal) files, run (personal) errands for her. Midwives and apprentices both have so much value and ought to have mutual respect and admiration.

Aunt Orlene

2007-08-17T09:42:00.000-07:00

Granny midwife Orlean Puckett.

I just cannot even fathom losing 24 of my own babies.

nipple shield fun

2007-08-15T21:54:00.000-07:00

Our local hospital has a breastfeeding class twice a week, consisting of everyone undressing their babies, weighing their babies, nursing their babies, then weighing the babies again. This is to make sure they 'have enough milk'. The lactation consultants (most of whom are IBCLCs) seem to hand out nipple shields like there is no tomorrow.

These 2 facts make somewhat despise the this 'class'. I have yet to see a mom go there and come away with helpful, sane information. It really just makes me want to pull my hair out in frustration! It makes it even harder when clients go there for help, without ever calling us to tell us they are having problems, even after repeatedly telling them to PLEASE call us if they need anything.

Back to nipple shields. I am sure that there are some rare cases where they can be a true blessing, but they are so hugely overused and, in my opinion, really are a danger to the success of breastfeeding. I have emailed with Dr. Jack Newman regarding nipple shields in the past, and here is some of what he had to say:

"No, a nipple shield is not better than a bottle. With the bottle, the milk supply is maintained and the chances of getting the baby to latch on are good. With the nipple shield the milk supply decreases, and that makes it more difficult to get the baby to latch on. I am appalled by the wide spread use of nipple shields by anyone, but particularly lactation consultants."

Dr. Newman totally rocks.

I just wish them shields weren't handed out like candy everywhere. :(

a decision

2007-08-15T00:37:00.000-07:00

I am feeling like I probably won't be telling birth stories here. It feels too personal to me, like they aren't really mine to be telling, and even if I think this is an anonymous blog....on the internet, do we really have anonymity? :) I will probably include snipits about out of the ordinary events that may come up at births from a midwifery perspective, though.

But, it should be full of my musings and whatever it is that I am learning about at the moment.

Fun!

Trust Birth Conference

2007-08-14T16:23:00.000-07:00

I'm SO excited about the upcoming Trust Birth Conference.......

Sarah Buckley, Michel Odent, Gloria Lemay, Rixa Freeze, Pamela Hines-Powell, Gail Hart, and many more!!!

Yay!!!

March 7-9, 2008 in Redondo Beach, California.

Come and join us!

While you are at it, take a look at the Trust Birth site itself. ;)

Bump.

2007-08-13T22:20:00.000-07:00

Ok, with only a little over 6 months of a lapse, I am back. :)

I have been feeling the need practice my eloquence these days when it comes to birth, as well as have some spare moments for clarifying for myself what precisely is my philosophy about birth. So, I think that the best way for me to do that is to pick up writing once again and start babbling away. Here we go, one more time.

new year

2006-12-31T01:31:00.000-08:00

2006 was a big year in my life.

We moved (again), my son is not a baby anymore (almost 3) and talks a mile a minute, my dss is now an unschooling teenager, and my dh (essentially) works from home now.

And, I got an apprenticeship.

It felt like I had been waiting for this my whole like...even though I didn't even know midwives existed outside of history books until I was 19. I have been apprenticing now 9 months. Some times I have to focus really hard on my daily tasks at hand because my head is constantly spinning with all of the things that I am learning and pondering all of the time.

I have had the honor at assisting at 16 births as an apprentice. Until I began this journey 9 months ago, I had only been present at 4 births (2 homebirths, one of which was a UC, and 2 hospital births)...and then of course my own son's birth at home nearly 3 years ago.

Today my preceptor talked to me about my acting as primary midwife soon. We have many, many births coming up this winter, spring and summer. This is just such an exciting time in my life.

(Am I selfish to hope that one of our upcoming clients has a breech baby and sticks with her choice to homebirth??? LOL!)

2007

My big news for 2007 is that I am getting serious about graduating from my school. I am likening it to me being in grad school full time. I am going to be BUSY...but by choice! All of the work that I have left to do just feels like it would be SO relevant to what I am doing now, so I want to get on it. I don't think that I will feel *ready* to be a midwife on my own until I am graduated or very near graduating, simply because I know what I have left to learn is vital to my practice as a midwife.

So, even though I just began blogging again, I don't think I will be posting often. Of course, when we have a birth, I will do my best to come and post and write my thoughts about it. Or, whenever any other issue that I feel needs to be talked about comes up. But, for the most part, I will be hitting the books. ;)

There have been no births for almost a month, and no clients due until the beginning of February. I am really excited for all of our clients who are coming upon their 'due' date. Birth is just so awesome!!

Feeling out my own way

2006-12-14T23:37:00.000-08:00

I went and saw a mama (Z) today for her 1 week postpartum visit. I went and did the visit solo (without my preceptor).

The last time we saw her was 5 days ago at the 3 day visit. At that visit, we asked how nursing was going, and Z said it was going fine. This was her 4th baby, and has nursed all of her kids. He looked sleepy, but not out of the range of normal for a 3 day old baby. Near the end of the visit, Z said that everything was going great, she just wanted to make sure he was nursing enough. We asked how often he nurses.

Every 8 hours.

We asked about how many times had he nursed since birth.

6 times.

OMG!!!!! It was all we could do to contain our shock.

We told her to offer her breast to him at least every 2 hours, or more often if he wants it.

I think what was/is happening is that because he just sleeps and doesn't cry to nurse, Z just lets him sleep because she is pretty overwhelmed by her 3 other young kids. Sometimes I think demanding, fussy babies are better off, esp when they have lots of older siblings. So, we left her with instructions to nurse him often, to wake him up at least every 2 hours to nurse if he is sleeping. Z said she would.

So, today I go and see her. She says baby is still sleeping lots, but now waking up every 4 hours or so, and she nurses him then. I asked how many times in a 24 hour period is he nursing. She says 6 times. How many wet diapers? 4 really soaked ones, but she said probably more because she isn't changing him as often as she could/should. (So, if this is true, in my head I am stretching her wet diaper count to 5). Then we weigh him. We expect babies to loose some weight in the 1st few days, and we like to see them gain their birth weight back by 2 weeks. This little guy was 7 lbs, 1 oz at birth. Today, at one week, he is 6 lbs, 6 oz. That is slightly over a 10% loss. Pretty borderline.

Now, what I wanted to tell Z was this: 'please, please wake him up in the daytime at least every 2 hours and try to get him to nurse, and when you do nurse him, when he is 'done' on one side, offer him the other breast. This is so important because it ensures he is getting enough milk and to ensure you have a full milk supply.'

What I told her was that at this age, baby should be nursing at least 8-12 times in a 24 hour period. But, if she felt like he was getting enough, and he keeps wetting 5-6 diapers (disposable, and she said they always had poop in them) in a 24 hour period, maybe that is fine for him. After all, all babies are different.

So... WHY didn't I say what I felt? 2 things. 1st, this is a 4th time mom. She has done this before. I don't want to undermine her own mother instinct about her own baby. I know she is a caring mother (though overwhelmed with not much help). She said she really feels like he is getting enough milk. And, we did already tell her this 5 days previous...and we made it clear how important it is, too. 2nd, this isn't my client. I know it sounds silly (at least, to me it does!) but I have a hard time being assertive and sure of myself with clients knowing that they didn't hire me and that I don't want to say something that might contraindicate something that my preceptor might say.

This in no way is the result of my preceptor's sentiments. She strongly encourages me to do solo care and be the person her clients come to with questions. It is my own sensitivity.

I really need to work on trusting in myself and my thoughts. I need to be more assertive about what I believe is best (while still respecting the client's own wishes).

I volunteered to go out and visit Z again in a few days to weigh baby again (to make sure he is back on the way to gaining) and to really talk to her more about getting him to the breast more often. I feel pretty guilty about not being clearer to her today about how very important it is for her to be nursing him much more often...for both the baby's sake and for establishing a good milk supply. I know all of this, and I let my insecurities get in the way of this mama and baby's breastfeeding relationship.

Fresh start

2006-12-13T00:40:00.000-08:00

After a long break in blogging, I am ready to jump right back in.

Wheeeeeeeeeeeeeeeee................