|March 30, 2011|
Volume 13, Issue 7
|Midwifery Today E-News|
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Attend one or both days of the two-day Traditional Midwifery Skills pre-conference class at our conference in Bad Wildbad, Germany, this October!. You’ll learn from teachers such as Elizabeth Davis, Carol Gautschi, Ina May Gaskin and Gail Hart. Topics covered include Essentials for a Normal Birth, Preventing Complications with Prenatal Care, Labor and Birth Complications, Holistic Complete Exam, Helping the Slow-starting Baby and Suturing Overview.
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In This Week’s Issue:
Quote of the Week
Childbirth isn’t something that is done to you, or for you; it is something you do yourself. Women give birth. Doctors, hospitals and nurses don’t.
— Lester Dessez Hazell
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The Art of Midwifery
Drinking seaweed tea after birth is a Korean tradition. My mother, an RN, saw friends of a newly delivered Korean mom bringing her this iron-rich tea, which she drank along with orange juice. My mother remarked on the wisdom of increasing iron absorption with vitamin C. The new mom had not realized the scientific justification for her great tradition.
— Lisa Noguchi
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Our First 24 Hours in Amish Country
We, Eneyda and I, just did a venue check for Midwifery Today’s East Coast conference in Harrisburg, Pennsylvania (we found a lovely hotel and have already started brainstorming for an exciting program), and our first 24 hours proved busy and exciting.
Diane Goslin, with whom we were staying, picked us up from the airport and we headed straight to the birth of an Amish woman having her 13th baby. She and her husband gave their permission for us to attend the birth and the baby was born a few hours after we arrived. We all went to work attending this lovely couple, and the extra hands were needed. Eneyda told me later that her phone had died and she needed to recharge it, so she took it in the house with her. No electricity! Amish births are lovely in their gas-lit ambience.
We arrived at Diane’s around 3 am and got a little sleep, though we were almost too thrilled to sleep. There is always something so very, very special about new life entering the world! The privilege we have in our work was renewed within our hearts. In the morning, after a quick breakfast, we had the continued privilege of helping out with clinic. Diane and her experienced student had around 40 women to see. Most of the clients on that day were Amish. It is amazing how much work the women go through just to get to the clinic, coming in with drivers whom they have to pay or with horse and buggy, if they live close enough. Our morning was busy and I learned so much from these amazing women, both the midwives and the women we were seeing. After a very busy morning, we sat down to a lovely lunch the midwives had fixed for us. A very busy afternoon was rewarded with dessert, at nearly 7 pm.
The way Diane cares for this lovely population and her “English” clients, as well, is quite the opposite of birth abuse. It reminded me quite clearly how birth should be, in contrast to what it is for 98% of our country’s motherbabies. The rest of the world is just as bad, or worse. The hospital system has become more and more oppressive and interventive. We must watch that as midwives we don’t become part of the problem. We must hold ourselves to a higher standard. We must not forget that we are protectors of normal birth, realizing that these are difficult times we live in. Though we often have the privilege of becoming good friends with the women we attend, we must always put motherbaby first and remember that we are guests in their homes and in their lives. We work in service and it is important to remember whom we are serving— motherbaby and God.
— Jan Tritten, mother of Midwifery Today
Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.
Jan on Twitter: twitter.com/jantritten
ResearchThe Link between Prenatal Conditions and Violence
Research has repeatedly demonstrated a link between prenatal conditions and behavioral problems in adolescence. Maternal substance abuse, poor nutrition and depression during pregnancy, along with birth complications, can leave adolescents at increased risk for criminal behavior and violence.
A 2009 study found that “babies with birth complications are more likely to develop externalizing behavior problems at age 11.” Earlier studies, including one conducted in 1997, indicate that birth complications such as “forceps extraction, breech delivery, umbilical cord prolapse, preeclampsia at the time of delivery, and long birth duration” are linked to maternal rejection and subsequent criminal behavior.
Researchers suggest that early investment in public health programs like nutritional education and additional screening of pregnant woman could help to reduce the overall rates of societal violence.
Modwives, Medwives and Abuse
Editor’s Note: For this edition of E-News, we bring you an original, first-run article written by award-winning author and midwife Nancy Wainer. You can read more from Wainer in the Summer 2011 issue of Midwifery Today.
Recently, a woman, who had changed her mind and decided to have a homebirth called me. When she’d told one of the midwives in a hospital practice that she wanted a completely natural birth, the response was, “Well, you know, we aren’t really very open to that option around here.” Another woman remarked that the first thing her midwife asked when she entered the hospital in early labor was, “Are you planning on doing an epidural when it’s appropriate?” And yet another said she thought she’d be sent home as she was only three centimeters; instead, the midwife said, “We could break your water and give you Pitocin.”
The stories are endless. Maryanne, who thought she was coping very well in labor, was told there was “no point in being miserable” and that drugs were available when she wanted them. "If you stall out,” she was told, “we can talk about a c-section.” When asked, a midwife told Laura there were no detrimental effects of an epidural to either mother or baby—what midfoolery and how very sad. Drug pushers aren’t just out on the streets. Jennifer, pregnant for the fourth time, told me that she was very disappointed when the waterbirth tub was unavailable for all three of her hospital labors. Her hospital midwife had recently confided in her that the tub wasn’t really ever used—it was just advertised to get women to come to their practice.
The hundreds of comments I hear each month from disenfranchised, traumatized women all over the country are all the same—they feel betrayed. These women thought that by choosing midwives, they would be getting a much different experience than by choosing OBs. But the inductions keep happening, the Pit keeps dripping, the ultrasounds are done more often and earlier. There is little or no time for nutritional counseling, but plenty of time to give the mother a sickeningly sweet bad-for-her-baby drink and test for “gestational diabetes.”
A while back, I heard the term medwife. Lately, I hear it often from women who have contacted me; they explain that they want a “real midwife” and not someone who mimics the behavior of the OBs they have left in search of a better experience. I began using the term mobwife but you can easily see why that term doesn’t work! A mobwife sounds like someone who is married to someone in the mafia, so I use the terms medwife and modwife interchangeably.
Medwives, or modwives—so-called modern midwives who model their practices after obstetricians—have women wait anywhere from 20 minutes to an hour for a prenatal appointment, only to see them for a few minutes. Modwives have little genuine attachment to the women they see and may even have to look on a chart to find a woman’s name. After all, time is money and they see one woman after another. In addition, they may not see any particular woman at any other prenatal appointment, have only about a 10 percent chance of being at the birth, and may not even see her postpartum—or ever again.
Modwives leave when their shifts are over and expect women to risk “pot luck” in terms of a care attendant. They do not understand that, as mammals, women’s bodies react to strangers at birth. They often cannot find, or use, a fetoscope, and rely on ultrasound to ascertain the position of the baby; assessing position early and interceding naturally can often make a difference between birthing normally or a cesarean. I interviewed the chief research and design engineer who developed ultrasound machines. He said he wouldn’t want his own pregnant daughter or granddaughter having scans because of safety concerns—especially in the first trimester. Modwives cut cords quickly (and still don’t understand that continually checking a cord to see if it has stopped pulsing causes it to spasm and stop prematurely, and that stem cells belong in babies not in banks!) and think that vigilant testing, vitamin K shots, eye goop and a myriad of other procedures that have become routine for healthy women and babies are necessary. They often lack the patience to wait for a woman’s body to go into labor and frighten women into compliance; remember: it is only a “guess time” not a “due” date, and anxiety doesn’t help a woman or her baby. They influence women’s decisions through intimidation—how vulnerable pregnant women are! The spiritual-sexual-wholistic nature of birth is all but ignored. They operate from a medical, fear-based approach to birth, and are indoctrinated by (and into) such a system. I wonder why hospital midwives are not required to attend at least 20 homebirths to see what true natural birth looks like; they could then model the births they attend after these births and save the technology for the situations when it is truly needed.
Some birth center midwives tell me that they thought they could change things from the inside but find that they have their hands tied. They say that they end up doing things they never thought they would (refusing to attend twins or VBAC mothers, as examples) and not doing things they were certain they would (waiting once the woman’s water has released instead of inducing her within hours; permitting a woman to eat when she is hungry). One birth center midwife said, “I admit it: it’s too scary not to do it their way and I can’t afford to lose this job. Even if I lose a baby, if I’ve done it their way, I’m protected— well, sort of.”
A labor and delivery nurse who is now a homebirth midwife writes, “The problem…is that women birthing in hospitals are given excuses by their doctors, nurses and hospital midwives that are used to justify what has happened to the woman and to make it seem like all the actions the medical staff took simply ‘had’ to be done in order to ‘save’ the mom or baby. I have never, ever, ever heard an OB/GYN, nurse or midwife in the hospital apologize for the way a birth occurred if it was traumatic…. There is such a heightened fear of lawsuits that it removes the humanity from the person. [Women] are informed as to why all the torture and abuse was ‘needed’…” She says that women swallow what they are told and use it as ammo against women who want natural births or homebirths: “But what if this happens to you, it happened to me and my doctor told me I had to have a c-section because the baby’s heartbeat went down so low, or blah blah blah.”
Women are told that everything that is being done to them is totally safe. If so, why then do they have to be monitored when these “safe” practices are engaged? We all know that monitors aren’t that accurate and that the c-section rate rises dramatically with their use—with no improvement in infant outcome. Women are tethered by tubes and belts that rob them of mobility and independence. Women are still starved in labor. Ice chips? Puh-leeze! Misinformation drips like Pitocin; we all know that many of these practices are based on faulty research, research done by those who will benefit from the interventions—and which will be found to be outdated (although continued to be used) within a short period of time. The insurance companies and doctors are in bed together—cesareans fund new sections for hospitals.
Although there are times when hospitals and doctors are necessary and very much appreciated, I continue to be contacted by hundreds of thousands of women all over the country who’ve had miserable, traumatic births and been left to pick up the pieces. They were pushed into cesareans that they now know were preventable, or ended up with vaginal deliveries that made them wish maybe they had been sectioned—how sad. I remember Jeanine Parvati Baker’s statement that so many women have “near birth experiences.”
I lit a candle last night for the traumatized women who have been unnecessarily cut and have become additional casualties of this culture’s disgusting birth practices. I lit another for the ones who were on operating tables at that very moment. Tonight I will light one for the babies who are taken away from their mothers and abused, American obstetrics-style.
I understand—and know—a few wonderful hospital midwives who are doing the very best given the constraints they feel. It appears, however, as if the entire system has to be changed—dramatically. We must educate the entire population—this is a human rights issue and a situation that could change the entire health care system in ways that would benefit everyone, not just pregnant women. As it has been said time and time again: If we want to heal the planet, one of the places we must start is at birth.
— Nancy Wainer, CPM, co-founded the first cesarean awareness organization in the world and coined the term VBAC. Her first book won the award for the Best Book in the Field of Health and Medicine by the American Library Association. She was recently selected as a “Living Treasure” by Mothering Magazine. Her work is being archived at the Schlesinger Library (Harvard University). Visit her Web site at www.birthdaymidwifery.com.
Web Site Update
Read these article excerpts from the brand-new issue of Midwifery Today, Spring 2011:
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Question of the Week Responses
Q: How do you define abuse when it comes to pregnancy and birth?
— E-News Editorial Staff
A: As defined by thefreedictionary.com:
I have seen all of this occur during births. The definition of abuse does not change just because a woman is in labour. For example, if you would not allow a stranger on the street to come up and stick a needle in you without telling you who they are, what’s in the needle, or why you are being stuck with it, then why the hell would you allow this behaviour from a doctor, midwife, or nurse?
In the first instance, you would certainly try to stop them and would sue them for assault. Likewise, if a stranger walked up to you and asked you to take off your pants and spread your legs, how many women would do it? But move the woman and the stranger into a doctor’s office or hospital (I would hope not a birthing centre or homebirth) and put a white coat on the stranger and most women would comply. In the first case, it would be sexual abuse but in the second, it is allowed and even expected.
— Anna Grace Christine
Q: What role does creative expression play in the births you attend?
— E-News Editorial Staff
A: My background is in the creative arts—I went to art school and set up my own design gallery/shop before I was drawn to midwifery. At the time I felt these two interests were entirely separate; however, my work with women and their families during childbearing has increasingly drawn me back to the arts, both personally and professionally.
A colleague and I are presently organising a day of “Exploring Childbirth through Art.” The inspiration for this event developed from the fact that conception, pregnancy and birth is the ultimate form of creative expression. The intention is for women and their families, as well as maternity services staff, to create small pieces of visual art/poetry, which can then be collated into a large collective artwork reflective of the community. This artwork will be displayed in our hospital for all to enjoy and hopefully be inspired by.
As art is an excellent way of communicating and exploring one’s fears and feelings in a non-verbal context, we hope that this event will develop into a programme incorporating creativity and the arts into our mainstream parent education groups, and as a tool for discussing birth choices and therapeutic recovery from pregnancy loss or trauma.
— Lucy Martin
Responses to any Question of the Week may be sent to E-News at any time. Write to email@example.com. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.
Birth Wisdom from the Web
Editor’s Note: From the pages of Facebook to our favorite blogs, news bits and videos, this new E-News column brings you the best bits from the birth-related Web.
Al Jazeera will run an eight-part series on birth in March and April. The network goes around the globe as it examines the vastly different circumstances women face in labor and what activists are doing to improve maternal health in their local communities. Watch video from the series at:
Australian homebirth advocate Lisa Barrett says more in a paragraph about breech than you will get in a whole chapter on it any textbook. The photos are amazing!
The Beautiful Cervix Project aims to empower women by sharing pictures of cervixes and other women’s health resources.
If you’d like to share a bit of wisdom from the Web, please send a link and a 2–3 sentence review of its contents to firstname.lastname@example.org.
Think about It
Technological obstetrics makes the assumption that more knowledge is better, but, like Eve’s apple, the knowledge that we gain through prenatal diagnosis can cast us from our pregnant paradise, with major and long-lasting sequellae for mother, baby and family.
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