Continuing Education

To her faithful readers, friends, and clients -

Hi there, this is a letter from a friend of Cole's. She was my doula a number of years ago and she is now on her way to becoming a midwife. As she continues this journey, she has a number of opportunities to continue her education and keep her skills up to date. There are two opportunities that she would like to be able to take advantage of in 2016, but I also know it is virtually impossible with the cost of midwifery training. And that's why I'm writing this letter.

Cole has said, in conversation, that she would love to go to the Association of Texas Midwives Conference this year. This conference will be an evening and two full days of lectures and hands-on learning for the midwife and midwife student, specific to the state of Texas. The dates are May 5, 6, and 7, 2016. The total cost for the Conference is $420 for a double occupancy room.

The other continuing education opportunity that she has is the Farm Midwife Assistant Workshop. The Midwife Assistant workshop that she would like to attend is either August workshop dates: Aug. 7-13 or Aug. 28-Sept. 3. The 6-day workshop is very intensive and integrative. This workshop will fulfill many of the requirements of her midwifery module training through Via Vita School of Midwifery. The total cost for the workshop is $1,345. This includes her meals and her materials. She already has the book and a place to stay.

If you think that you can help fund her in any way, simply click on the PayPal button on the side bar that says "Want to Help A Midwife Apprentice?" with the amount you would like to donate and a note in the donation 'for the ATM conference' or 'Assistant Workshop'. If she doesn't raise the entire amount for the ones denoted, she'll refund it.

So, if you've ever wanted to help give back to your community, this is a tangible way to do so. To see more about her, or to read about her vision as a birth worker, check out her website, http://www.houstondoulas.org/ .

Sincerely,

A. Gentry

Rose of Jericho - Symbol and Midwife Medicine

I happened upon this older article from Baraka Birth today. It's beauty was worth sharing.

"Labor begins, and the midwife places a small dry twiggy rosette in a bowl of warm water near the mother. Labor continues, the mother gently perspires, her cervix is softening and opening, and as it does, the ball of twigs begins to soften and expand into a woody flower. She takes a sip of the medicinal water, and, breathing deeply, she watches as the ball fully blossoms. Soon enough, she’s ready to push… 

The Flower of Maryam (Anastatica hierochuntica) is a small shrub collected across North Africa, Saudi Arabia, Iran, and Pakistan, and among its most popular medicinal uses is its application for childbirth. Whether its medicinal properties encourage dilation, or if it’s a powerful visualization tool for mothers, traditional midwives have used the Flower of Maryam with their laboring mothers for hundreds of years. A quick glance at its names (below) suggests its religious significance: it is referred to as the “leaf of Maryam” (mother of Jesus), the “hand of Fatima” (daughter of the Prophet), as well as simply “daughter of the Prophet,” and “resurrection plant.” It is referenced in the Bible in II Kings 19:34-36 and in Psalms 83:13, “make them like tumbleweed,” here referring to the dried twiggy balls of Anastatica that disperse in the wind, scattering its seeds."

- Baraka Birth 

According to birth workers and women in the Middle East, the Flower of Maryam (or Flower of Jericho) is a medicinal plant used during childbirth for women in labor. It is steeped as a tea by the midwife, and then taken as birth becomes imminent. 

Rose of Jericho from Sean Steininger on Vimeo.

This powerful image is ingrained into women of every culture regarding birth, every culture but Western culture. This opening, unfolding, spiraling full and wide - unveiling - it's universal. In addition, the tea itself is full of calcium, magnesium, potassium, iron, and alkaloids. 

I found it also interesting that the dried plant looks very much like the vessels of a placenta and umbilical cord. Nature is amazing, isn't it? 

To purchase one for yourself, see here. 

B.I.R.T.H. Fair 2014

Every year, Houston birth workers, education professionals, infant and young child professionals, and parents converge in one location to share information and support with their community. Picture this: hundereds of women, their partners, and their nurslings milling about. There are fashion shows, children's craft and learning areas, keynote speakers, workshops, movie screenings, and educational booths for everything from midwives and doulas to baby wearing and homeschool co-ops. 

Every year, the Houston Doula Co-Op and Sage Beginnings (me) are there. Every year, we speak to our community during the workshops. Every year, we meet hundreds of amazing women and their families - will you be one of them?  

Join us for our 13th annual BIRTH Fair as we celebrate natural parenting and pregnancy. Get the latest information about vaccines, birthing options, breastfeeding, babywearing, VBACs, and more! We will have overstuffed goody bags for our guests, activities for children. Birth Fair will be held on October 4th from 11 a.m. to 4 p.m. at the United Way Center on 50 Waugh Drive. Check us out on Facebook (www.facebook.com/houbirth) for our latest giveaways, or visit www.houbirth.org or call 832-499-6029 for more information. This event is free and open to all ages.

Two Way Street

If you read my blog much, I'm sure you have seen at least some of these stories circulating:

• Who's the Boss
• Doula's And Don'ts
• 5 Lies My LC Told Me

And so many more that I just don't have the heart to link... what two things do these tell me?

One, I cannot stress enough - it is so important to choose the right provider and birth/postpartum team. Interview, fire, hire, question, become your own advocate and conscientious consumer. It is your responsibility to choose the best option for your needs and desires.

And two, our system is broken - birth workers need to remember whom we work for. Mamas can only make the best choice with the options they have available to them - it is our responsibility to provide ethical services within our scope of practice.

'Nuff said.

End rant.

12 Days of Christmas - Midwife Style

Lyrics:

On the first day of Christmas my midwife gave to me, a bag of red raspberry leaf tea
On the second day of Christmas my midwife gave to me, 2 doula choices
On the third day of Christmas my midwife gave to me, 3 birthing videos
On the fourth day of Christmas my midwife gave to me, 4 supplements
On the fifth day of Christmas my midwife gave to me, 5 gold ring slings
On the sixth day of Christmas my midwife gave to me, 6 hours of hip squeeze
On the seventh day of Christmas my midwife gave to me, 7 ways to breastfeed
On the eighth day of Christmas my midwife gave to me, 8 lbs of baby
On the ninth day of Christmas my midwife gave to me, 9 months of care
On the tenth day of Christmas my midwife gave to me, 10 centimeters
On the eleventh day of Christmas my midwife gave to me, 11 ways to push
On the twelfth day of Christmas my midwife gave to me, 12 herbal baths

Caveat Emptor

Caveat Emptor - a principle in commerce: the buyer assumes the risk. Latin for, Let the buyer beware. A warning that notifies a buyer that the goods he or she is buying are "as is," or subject to all defects. When a sale is subject to this warning the purchaser assumes the risk that the product might be either defective or unsuitable to his or her needs. The basic premise that the buyer buys at his/her own risk and therefore should examine and test a product himself/herself for obvious defects and imperfections.

Let the buyer beware, for (s)he assumes all risk. During your childbearing years, it is so acutely important to understand this concept.

There are a set of 'rules' and expectations that every birthing place has in place. These outline how your
place of birth expects you to behave and what they expect you to consent to. Of course, you can decline any set of policies, protocols, or expectations/interventions, but at what cost? Your provider can (and many do) 'make you pay' for bucking their authority and rules.

If you want low lights, candles, a water birth, hand-held dopplers for monitoring intermittently, and a birth team that speaks in hushed tones and helps you birth in any position you want, you probably shouldn't attempt to achieve that in a florescent-lit hospital, where they have only showers, a strict policy against water birth, no dopplers on the floor, and an OB and nurse who see 'a handful' of natural births in any given year.

 Likewise, if your provider uses such terminology as "I don't normally let my patients...", "I don't do ____", or "I don't work with doulas", guess what? They are not looking out for your best interests, they are looking out for themselves and their policies to be upheld. This is saying nothing of their personality, only of their practices.

I have spoken to many women whose providers state that, in order to continue in their care, they must consent to certain tests or procedures. Again, this is not informed consent, this is coercion. Buyer beware - if they cannot respect your autonomy to make decisions for your own healthcare during pregnancy, how can you hope/believe that they will when you are in as vulnerable state as labor and birth?

Buyer beware - understand the policies and protocols of your place of birth and your provider prior to purchasing their package of goods.

How to Interview a Midwife

May people ask me "what questions do I ask when interviewing a midwife?". Although that is a great question, and we will definitely cover that, another component to interviewing is asking yourself "what type of person do I want watching me tromp around naked and then squat in front of her grunting out baby and possibly more?"

Laugh if you want, but it's true. Make sure that you take time to consider what type of midwife you want for that type of a time. 

Perhaps you want a matronly woman, perhaps one to sit in the corner knitting in the rocking chair while you power around, or lounge in the candle lit bathtub. Who knows, she may even have a silver hair or two.

Perhaps you want a young and upbeat midwife in colorful skirts and piercings who makes you grin from ear to ear and can talk about the latest trends with while you hula through contractions.

Perhaps you envision her smelling like patchouli, intoning with you and rocking with you as you lean against her shoulder, brushing her dreadlocks aside. She takes your pace in stride. 

And perhaps you see her with clear, sharp eyes, and a cooler-than-a-cucumber attitude who charts diligently, gently directs you and keeps the rhythm of your labor and your clinical care to-the-clock.

Whatever you envision, keep that vision in the forefront of your mind as you start the interviewing process.

When you do begin interviewing midwives, try your hardest to interview more than one, and in person, so you can see her mannerisms and hear her voice. Can you see this person moving through your birthing space? Can you hear this voice making suggestions to you or talking you through the most intense part of the journey?

And then the questions to consider asking her. This is a small compilation of some of the information that will help you to make a decision on if you feel she is qualified to attend your birthing time:

Training and Skills:

• How, when, and where did you receive your midwifery education 
• How much experience do you have in the birth profession?
• Is your certification in CPR and neonatal resuscitation up to date?
• What is your rate of transport? cesarean? Episiotomies?
• Do you participate in regular peer reviews?
• Do you have midwife or OB backup?
• What emergency equipment and medications/herbs do you bring to the delivery?
• Do you recommend any herbs or supplements to help with pregnancy, labor, birth, postpartum, and breastfeeding?
• What is your personal style and/or procedure for pregnancy, labor, and birth?
• Do you consider yourself hands-on or hands-off? Why?
• Do you have references? 

Prenatal Care:

• What does prenatal care look like?
• What are your expectations of clients during pregnancy?
• Can you recommend or will you loan to us books, videos, internet sites, etc. to help us prepare for homebirth?
• Do you recommend that my partner and I take a childbirth education class or attend pregnancy discussion groups?
• Do you work alone or with a partner/backup?
• Do you test for Group B strep? If so, how is it treated?

Labor and Birth:

• How far past the official due date will you allow me to go? What happens if I pass that point?
  
• During labor, when should I call you?
  
• What supplies do I need to get for the birth?
  
• Do you have a tub the clients can use?
  
• How many women do you have that are due 2 weeks on either side of my due date?
• What is your plan if someone else is in labor when I am?
• What is some of the equipment you bring to a birth?
• What methods do you suggest to alleviate labor discomfort?
• When will you come to me? About what point in labor?
• How much time do you spend with a laboring mother?
  
• What has your experience been with doulas at labors?
  
• Do you bring an assistant or encourage an extra set of hands (like a doula) be there?
• What do you do if the baby is presenting breech? How about a surprise twin?
• How long are you comfortable waiting on a mom whose water has broken as long as she is not showing signs of infection?
• To what hospital do you transport if this becomes necessary? Who will go with me?
• Do you have a doctor that you work with who will take care of me if a transport becomes necessary?
• What makes a hospital transfer necessary?
• If I am 10cm dilated but don’t feel the urge to push, what would your response be?
• Do you put limitations on how long I push as long as baby and I are ok?

Postpartum:

• Do you give eye ointment/vitamin K shot to baby?
  
• How would you control postpartum hemorrhaging?
• Can the cord be allowed to pulse before cutting? What if we want to consider lotus birth or waiting until the placenta is birthed to cut? 
• What are your thoughts on cord burning in lieu of cord cutting?
• Can we give the baby time to breastfeed right upon birth before disturbing it to clean/weigh and so on?
  
• Will we be given the chance to be a part of the newborn exams?
  
• What do you do if I tear? Can you stitch me or does an MD have to?
  
• How often will you make postpartum visits?
  
• Are the postpartum visits in my home or at your office?
• What do you do with the placenta?

There are a great many more things you can ask a midwife at an interview, the list goes on and on, but this will give you a pretty good starting point. What kind of midwife resonates with you? What questions are not on that list that you would ask?

Birthing From Love

Birthing From Love

DECLARATION

We find ourselves in a time where the culture of childbirth is at a crossroads. It’s time to choose which path we will take.

AND SO....
We choose the path that empowers, supports, and advocates for childbirth to be grounded in love.
We are loyal to the path that allows women to be empowered by birth and not traumatized by it.

AND SO WE KNOW...
the time has come to dissolve the ideology that has brought us to the point where women live in fear of the birthing process and under the tyranny of scathing judgment about how they bring their children into the world. This oppression of judgment has kept us from seeing the truth about ourselves. We are in this together.

It doesn’t matter where a woman chooses to give birth: in a hospital, a warm water tub, or a sacred hut in the Himalayas—it is time for us to embrace a woman’s choice to birth where she wants to birth.

It is time for us to support women in taking control of their birthing experiences—not the rigid, inflexible control that springs from fear, but the wise, empowered control that’s rooted in love. With that control, giving birth becomes an act of joy, of self-discovery, and of profound self-expression.


AND SO WE DECLARE....
Birth, more than any other experience, has the potential to transform the world. It is time that we support women in experiencing birth as a peaceful, positive, and powerful event.

Birth has the potential to be the most powerful driving force on the planet. The healing of birth will surely change the world.

We must reframe the way we conceptualize birth. We must share this wisdom with the world.

Birth is something to be embraced—not controlled.

Birth is something to be welcomed—not dreaded.

Birth is something to be loved—not feared.

AND SO WE CALL...
To those who know that our world is deeply influenced by the way we bring our children into the world.

To those who are ready for audacious steps towards changing the culture of birth.

To those who are ready to dedicate themselves to all the women of birth who feel like they’ve lost their way to the hurt, the fear, the judgment, the shame, the blame, the trauma.

To those who know we are stronger together.

AND SO WE UNITE...
Although we cannot control the choices of those around us, we have faith that the pursuit of Birthing From Love is a noble, meaningful, and powerful one.

And for the support of this declaration, we pledge to each other our time, passion, energy, and wisdom.

For the love of birth.

Heart and Hands

I just finished reading the new, 5th edition of Heart & Hands, a classic for midwives and midwives-in-training. And might I say, it is beautiful!

I have long been a fan of this book, but the updates are long overdue and I am happy to have this one for my library.

The revised edition includes new, breathtaking photographs and educational illustrations, updated resources for parents (a big bonus), and an international list of midwifery schools - another huge bonus!

The newly revised edition also features a strong focus on physiologic, “hands-off” birth, with updates on breech assisting, fetal effects of ultrasound, screening for preeclampsia and diabetes, Group B-strep treatments, postdates pregnancy, VBAC (including longterm effects on mother and baby), diagnosis of and recovery from trauma, and postpartum depression. The new cover and updated photographs will appeal to parents, and for midwives, updated forms include a “Mother’s Confidential Worksheet” on abuse issues. Sections on electronic charting and state-of-the-art informed choice have been added, as well as an international list of schools and expanded resource list for parents.

As Chrstiane Northrup, MD, states:

"The wisdom of this work is as old as time."

This book will never get old, but with the updated information, it is now ready for the next generation of midwives and midwives-in-training.

If you have never read the book, you really should go get a copy. The chapters include:

• The Midwife: a Profile
• Prenatal Care - all about how to care for a women during prenatal appointments
• Problems in Pregnancy - variations and problems, emotional and physical variations/problems that may be encountered, and both information on how to holistically and medically care for these variations and problems.
• Assisting At Birth - straight forward, what labor looks like for a midwife, how she can assist a woman during her birthing time, and expectations and responsibilities/roles.
• Complications in Labor - just as it states, what can make a butter birth into a complicated labor/birth, and how to help resolve or work through those issues.
• Postpartum Care - what postpartum care looks like for a midwife, how she can assist a woman during her lying-in period, and how to help when problems/variations arise.
• Becoming a Midwife - information on laws and regulations, paths of midwifery training, etc..
• The Midwife's Practice - figuring out what demographics, hurdles, equipment, standards and laws, etc... that a midwife should know when setting up her practice
• The Long Run - how parents can support their local midwives
• Appendices: including forms for the budding and seasoned midwife, information on resources, MANA core competencies and standards, midwifery programs, HIPPA guidelines, midwife's kit, and parent's supply list, to name a few.

I encourage you, if you have the book already, upgrade to the new one, it is beautifully 'remastered' and completely updated. If you have never read Heart & Hands, now is a great time to do so!

Tis The Season

I love Christmas. I love the snow (which we don't get here in TX), building snow forts in the dazzling night sky, the scent of the pine tree, the roaring fire, the baking and cooking, the family and friends visiting, the warm cups of joy clutched in cold fists... I love it all. Except one thing: when I'm asked to make a Christmas list for myself.

Maybe it's my nature, maybe I feel shy about saying 'I want' something, maybe its

because I am happy with all of the above, that gifts are an afterthought... whatever the reason, I am inevitably asked to send out a gift list for myself after the kids have sent out theirs.

For that reason, and in case you are considering giving your midwife, doula, or childbirth educator a gift this season, consider this doula's "open Christmas list".

If you are shopping for a childbirth educator, I can tell you that, unless she works through a hospital, CBE work doesn't make a lot of money. She has expenses and some of her items are either consumable/perishable or will wear out over time.

• Budget Friendly - a gift card to her favorite bookstore for her latest wishlist book. Or a copy of the Business of Being Born
• Moderate Cost - A knitted uterus is a great choice, especially for newer childbirth educators.
• No Expense too Great - a flip chart of childbirth graphics. This is an awesome one that I am personally in love with.

If you are shopping for a doula, I can suggest items that will help her to be the best that she can be for the future women that she attends. Although the number one most precious and perfect gift you can give her is word-of-mouth advertising and referrals, there are other, more tangible, gifts that will help her on her way.

• Budget Friendly - a necklace to inspire her, or a set of childbirth education booklets for her and her clients would be perfect.
• Moderate Cost - the hypnodoula packet would give her excellent continued education and help her expand her bag of tools, or a homeopathy starter kit, or, if she is newer and wants a wonderful educational item, a Rebozo and DVD is a great idea.
• No Expense too Great - if she is interested in becoming a placenta encapsulationist, a dehydrator would get her on her way nicely, and a birth stool would go wonderfully with any doula to any birth.

Midwives are a little more difficult, unless you know specifically what she doesn't have that she would like or needs.

• Budget Friendly - if you know her assistant or any of her peers, ask them what her favorite restaurant is, a giftcard is a great way to tell her how much you appreciate her, as is buying a second of any book in her lending library (in the event one is not returned).
• Moderate - Again, jewelry is always appreciated, as is a copy of any DVD in her lending library, or a hand-painted (placenta) bowl. 
• No Expense Too Great - a shrine is a beautiful piece of artwork to add to her office, or an antique for her collection.

 And finally, if you really don't mind the cost, a wonderful gift to any midwife, doula, or childbirth educator is to gift her services to someone who cannot afford them. This allows the birthworker to give back, in turn.

Other items that all doulas, midwives, and CBE educators can always use are gift cards to bookstores or gift certificates to places like Doula Shop and Birth with Love.

In fact, we like to recycle, and places such as Ebay have resale and items at great prices.

So, if you are thinking of giving a gift to your birthworker this season, consider some of the ideas above. And have a Merry Christmas!

Boardwalks and Home Births

I met you on the boardwalk, a beautifully bronzed burst of sunshine adorned with sparkles, bright yellow, and black flowers that flowed around your barely rounded belly. Your tangled mass of thick, wavy, auburn hair reached down toward your elbows and your smile was as brilliant white as the sun-bleached wicker chairs dotting the deck.

A square jaw jutted forward as you pressed your face toward the wind as you laughed gently at something that was said between your lover and you. Your partner lovingly wrapped his hands around you from behind, caressing your abdomen, before dashing off into the crowd.

I edged closer.

"My, are you ever beautiful! I love a pregnant woman, so full of life!"

You blushed darker bronze and murmured a thanks while outlining the contours of your baby with your palms.

I introduced myself and told you my calling. Instantly, your eyes began to sparkle and dance like the sunlight on the nearby cresting waves, "Oooh! I wanted to have a home birth so badly!" you exclaimed.

"What's holding you back?"

"My partner/I thought it was too risky", "I will definitely look into it further for future pregnancies, but, with my first and because I don't know what to expect, I think the hospital is a better choice", "It seems a little too hippy for me", "My partner is not comfortable with it", "my doctor is just fine and its only one day, right?".

You named your reasons, and I listened quietly, offering only a gentle nod of encouragement to continue. When you had exhausted all of your worries, you looked at me anxiously, apologetically. Your partner appeared as if a mirage and wrapped his sheltering arms around you, moving you away from me and further down the boardwalk.

I grasped your hand in goodbye, pressing my card, and this blog address, into your palm. "I wish you all the luck in the world. You are an amazingly beautiful, strong woman who is doing a good work to bring this beautiful life into the world!"

And you were gone.

I hope you have found your way here. Because I had so much I wanted to tell you!

A midwife and a doctor view birth so much differently! There is a wonderful source of information on what to ask your care provider to find out if they are truly Mother-Friendly, and I invite you to read it here.


Additionally, here is a pretty concise outline of the differences between a midwife and a medical model of care.

Midwives Model of Care	Medical Model of Care
Definition:	Definition:
• Birth is a social event, a normal part of a woman's life. • Birth is the work of the woman and her family. • The woman is a person experiencing a life-transforming event.	• Childbirth is a potentially pathological process. • Birth is the work of doctors, nurses, midwives and other experts. • The woman is a patient.
Definition:	Definition:
• Home or other familiar surroundings. • Informal system of care.	• Hospital, unfamiliar territory to the woman • Bueaucratic, hierarchical system of care
Definition:	Definition:
• See birth as a holistic process • Shared decision-making between caregivers and birthing woman • No class distinction between birthing women and caregivers • Equal relationship • Information shared with an attitude of personal caring. • Longer, more in-depth prenatal visits • Often strong emotional support • Familiar language and imagery used • Awareness of spiritual significance of birth • Believes in integrity of birth, uses technology if appropriate and proven	• Trained to focus on the medical aspects of birth • "Professional" care that is authoritarian • Often a class distinction between obstetrician and patients • Dominant-subordinate relationship • Information about health, disease and degree of risk not shared with the patient adequately. • Brief, depersonalized care • Little emotional support • Use of medical language • Spiritual aspects of birth are ignored or treated as embarrassing • Values technology, often without proof that it improves birth outcome

No matter how natural of a birth you have in a hospital setting, it will never even come close to a home birth. Home births are different on so many different levels than simple surroundings.

"My partner/I thought it was too risky"
There have been many studies throughout the years that have found that home birth is as safe, if not safer, for healthy, low-risk women, as hospital birth. Most recently, a Canadian study has shown these same findings, once again. Home birth midwives will, very often, carry oxygen, and all carry homeopathics as well as are trained in lifesaving CPR and first-aid.

Home birth midwives are experts in normal, natural childbirth. Because they are experts in normal pregnancy and birth, they will see deviations from normal and natural pregnancy and labor/birth early on, be able to assess these variations, and take immediate and early precautionary measures to ensure your safety... this is part of the reason why home birth is so safe.

If your midwife were to see something that did not match normal and natural, she would be able to attempt to get you back to normal and natural before it became an emergency and, if she couldn't, she would be able to transfer you to appropriate care. Home births have come a long way from ripping up bedsheets and boiling water.

"I will definitely look into it further for future pregnancies, but, with my first and because I don't know what to expect, I think the hospital is a better choice"
This particular reason is like a punch to the midsection. There is a large body of women who choose home birth for their second birth because they had a horrible experience with their hospital birth. If you are considering a home birth, your first birth is a great birth to start with - you cannot go back and redo your first birth, and that first birth can impact your options, emotional health and wellbeing, and even fertility of future pregnancies/births.

Some women, by the end of their labor, believe that their doctor/hospital has saved them from a bad outcome, when, in actuality, the hospital or doctor (procedure that they performed) caused the risks that they ended up needing to save you from. But, the perception that is given is that a woman is so thankful that they were in the hospital and are glad that they didn't have a home birth because they 'needed' this or that intervention.

Other women end up with unnecessary cesareans and find it hard to find a homebirth midwife or hospital based doctor who will take her on for a vaginal birth with subsequent pregnancies and births. I am sure you have heard the saying 'there is no time like the present'.

Bottom line, THIS pregnancy and birth is the best one to pursue a home birth for.

"It seems a little too hippy for me"
The wonderful thing about midwifery going mainstream in the last 20 years is that you have all types of midwives now practicing. There are more traditional midwives, as well as more modern midwives. This allows for families to find the right type of midwife to fit their families needs.

I know midwives who wear hemp, bohemian skirts, have dread locks, drink herbal teas, eat a vegan diet, and choose a more natural lifestyle.

I also know midwives who wear high heels, highlight their hair, like cabernet sauvignon and sushi, and have a more urban feel.

And most of the midwives I know fall somewhere in-between. The stereotypical 70's midwife is not the only option anymore, but the continuity of care, the midwifery model, will remain constant no matter whom you choose.

"My partner is not comfortable with it"
Not all partners are men, and not all partners fit this stereotype, but the majority of male partners are not comfortable with home birth at first. They usually don't research and read as much and tend to follow the paternal medical suit more readily.

That said, if you can simply get your partner to go to an initial interview/consultation with a home birth midwife and present it as an opportunity for your partner to ask whatever questions they might have of the midwife, this can, oftentimes, dispel fear, uncertainty, and incorrect stereotypes and assumptions that they might have about home birth and midwives. Oftentimes, just one consultation is all it takes to get a partner to start seriously considering a home birth.

Here and here are two different examples of the types of interview questions you might ask at an initial consult.

And finally, when it comes down to it, although it is always best to have both of you in agreement over your birth options, it is your birth and body, ultimately, it should be your comfort level and decision on where and with whom to birth.

"My doctor is just fine and its only one day, right?"
I know lots of good doctors, I know some 'just fine' docs, and many bad doctors. Not bad at what they do, but bad at taking care of a woman and babies needs and holistic health.

There are doctors who have great bedside personalities, but who are not good doctors. There are doctors who make you feel 'taken care of', but don't shoot straight with you about your options... or disguise your options as necessities so that you don't have true options. And there are doctors who, when you are at your most vulnerable (labor and birth) will 'not allow you' so many things previously promised. It is necessary to more than LIKE your doctor... you must trust him/her with your holistic health and life, and that of your unborn baby. If you don't, you really truly should look for another care provider.

And let's not forget that the average first time labor is around 16 hours. This is average. Some women labor for a few days, some for a few minutes. Beyond the actual laboring time, your birth experience will last with you for much, MUCH longer.. in fact, your whole life. So, if you think it is 'just one day', think again.

My heartfelt desire is for you to remember this moment, which will stick with you for the rest of your life, with joy, trust, love, and fondness. Please make sure that you can trust your care provider for that.

As Dr. Biter said in a recent interview,

They don't even know the difference between natural birth and a vaginal birth. They think that, just because a baby is born out of a vagina that that is a natural birth.

But a natural birth is an unmedicated birth, a birth that is honored, where women and their partners are respected, and where that little buddy comes into this world in a solemn sacred moment. That's what a natural birth is!

There are additional great resources out there that will help you to work through other scenarios that you might encounter to help you make the best choice for you and, hopefully, feel secure in choosing a home birth for your first, beautiful, birthing time.

And finally, just for you, Sunshine Mama, some inspiration!

Immediate Breathing At Birth

Jenna, this one is for you.

I was recently at a birth where baby didn't pink up and start yollering right away. Now, someone who has been at a great number of births can start to tell when it is normal flaccidity that will ebb with a little attention and patience and when baby needs a little help starting up.

But, one of the main concerns I have is how this is managed at the hospital...

This babe was quite shell shocked from a rather severe case of shoulder dystocia and a little tired from the hard work he and mama had done. He was born with no tone, bad color, and no breathing. He was one of those babies that needed a little help. Doc gave him 40 seconds to become responsive and, with vigorous rubbing, sole thumping, and mama and daddy calling him earth bound, pronounced him 'needing more work' and clamped and cut the cord, whisked him away to a nearby table, and continued what they were already doing previously on mama's tummy.

Only now, his oxygen line was gone.

In this study, it is shown, in part, how the presence of oxygen, as well as decreased blood flow in the umbilical cord, help to stimulate a babies first breathe. The downside is, if you are worried about baby showing stimulated response, independent breathing, and coming 'earth side', WHY THE HECK WOULD YOU CUT OFF THEIR ONLY SOURCE OF OXYGEN in hopes that they will start respiration? It is exasperating an already possibly problematic situation.

They rubbed him down... coulda continued to do that while he was still attached. They thumped his heels... coulda continued doing that while he was still attached. They ran the oxygen under his nose... coulda done that while he was still attached.

As it was, he took his first breath, independently, about a minute and 45 seconds after he was born... 45 seconds after he was deprived of his oxygen source. seconds from being intubated. They were literally prepping the line to intubate him when he took his first shaky breath. He began crying lustily and everyone cheered, me included... but they could have avoided that emergently necessary first breath by leaving him attached. The placenta detached 30 minutes later.

I have seen homebirths where baby was born equally shell shocked and the midwife was equally diligent at getting babies first breath initiated... while leaving the cord intact. The difference is that one babe will have to be 'bagged' when the placenta detaches or umbilical cord stops pulsing (generally within 2-5 minutes) vs. baby having to be bagged within 1-2 minutes postpartum. Giving baby that extra cushion can be the difference between an 'emergency' and the emergent first breath.

Most homebirth midwives carry oxygen, the same as hospitals, but usually let nature, and baby, determine when they need to intervene, not before, which reduces risk by default.

.. sigh, I was planning on posting the birthstory of Tres this evening, but this is what you got instead. I have it written down on pen and paper (I know, what is that) and promise to get it up by week ending. I know Mama M and Daddy M are getting anxious to see it, and the pictures - BREATHTAKING (no pun intended).

Friendly Emails from Midwives and Codes of Ethics

Hi Nicole,

My name is ****, I am a CNM at ******. We are an independent Midwifery Clinic and deliver at ******. Dr. Judd has backed this clinic for years. And everything you're reading is true, he uses tons of Forceps and I was shocked as well and don't always agree with it, but what I can tell you he is very safe. I've never seen forceps used where a Dr. can actually keep the perineum intact while doing it. The nice thing is, He lets us be more natural with our patients and only helps us when we absolutely need him. I agree it is shocking to see the sign in his office, he just prefers these patients see a Midwife. What people need to know is that he is safe, and he has the lowest C-section rate I have ever seen in an MD. If you need his percentage I can get you that. I think it is important that people know he is safe. Of course, I prefer Midwives and I imagine you do too. Spread the word for Midwifery. If you have any more questions, let me know.

I received this nice email in response to my previous post (shared by permission). I am looking forward to seeing the percentages from my newly acquired midwife-friend and enjoy that we can have this dialogue.

On another note, I have been active in a BirthWorkers workshop that is held monthly. We are instructed by a CPM as childbirth professionals who either ARE or WILL BE pursuing midwifery in the near future. The last meetings were on Code of Ethics... The next series of meetings will be on anatomy and physiology. As we were working on Codes of Ethics, I did a little research and pulled up both MANA and ACOGs CoEs...

It is interesting if you read them as a comparison.

MANA
ACOG

Happy reading!

Pain in Labor - a Midwife's View Under Fire

I hadn't heard about Midwife Dr. Denis Walsh until I was looking up current childbirth news this morning (one of the sad byproducts of working M-F; I can only 'research' on the weekends).

And what I see is astounding and saddening.

He has submitted a work to Evidence Based Midwifery that discusses the topic of pain in labor and it's purpose. You can read an article on it here, another here, and another on it here.

I applaud him. He, as far as I can see, has not written anything malicious or inaccurate. He talks about the usefulness of feeling labor, the chemicals released as a result, establishing a good labor pattern, aids in stronger infant-maternal bonding, and generally has a natural purpose in the process.

Nothing that has not been mentioned already in other articles like this and this. He even states that sometimes epidurals are useful, but of course, one of the articles above states that his comments make women who fall short of a 'normal birth' feel stigmatized.

The rest of the articles are followed up with statements such as "I dare him to say that to a woman in labor", "When he pushes a baby out of HIS body, maybe we'll give a damn what he has to say!", and more, much more. Defensive, aren't we? Do a google search for his article and you will find him slammed from all angles (or see Rixa's post for additional links to more articles on him) - it's a free for all!

Think of it: he's a man (sets him up for attacks from prideful, defensive, or angry women), he's a midwife (which sets him up for attacks from the main-stream medical community), and he's a male midwife (which even sets him up for failure in many natural childbirth communities).

It amazed me to see that this poor man has been strung up like a pinata from both the Obstetrical community as well as feminists. Even some fellow midwives didn't spare the firing squad. And you know what, all of this hubbub and no one actually has his submission piece yet!

Which is why I was relieved to see this blog post.

Denis Walsh is not the slimy pig-man who’s out to demonize women who choose pain relief, as the Daily Mail (or the BBC, for that matter) would have us believe. He’s a midwife who wants midwives to act as advocates for women: to put the needs of the labouring woman on the map, rather than letting the midwive’s own needs as professionals or the the baby’s (purported) needs push all mention of the woman’s well-being out the window. I, for one, am very thankful I’ve read his work in preparation for the birth of my second child.

I applaud his yet-to-be published piece and cannot wait to read it! From what I can see on the news now, he advocates alternative pain management options to better healthier, safer health care options for women in labor - evidence based health care. What shame is there in that? None. Shame on the nay-sayers instead!

*** Additional linkies here and here.

Careers in Maternal-Child Health

Childbirth Professionals - Please visit here to help with an online survey for others seeking professions in the childbirth field.

Tribute to Supporting Women of Childbearing Years

Medicas y Medicos - a Healing Tradition

I could sit at her feet and listen for days!



(can you tell where I am surfing today?)

Interview With a Home Birth Midwfe

This is a great series of 7 videos on Youtube of an interview with a midwife on the basics of home birth.

Introduction to a Midwife


Why Birth At Home Is Safer


Before The Birth


The Birth


After the Birth


Parental Responsibility


If Complications Arise


Go positive education!

Communication

I talk a lot on here about what is wrong in obstetrical care, but what about YOUR responsibility as a consumer?

Your doctor or midwife has a responsibility to give you factual information, practice unbiased and evidence-based medicine, and to treat you as a whole woman, not simply a patient.

Likewise, though, as a patient, it is your responsibility to be open and honest with your care provider. Withholding your feelings, beliefs, desires, and fears breeds distrust on both sides. You need to be able to speak up about your choices regarding your health care, even if you and your care provider do not see eye to eye on some issues. (see here for a good example).

The relationship that you have with your care provider is not THEIR sole responsibility - it is a two way street. If you are fully open and honest with them and don't feel it is reciprocated, if you feel they have ulterior motives beyond your health in making decisions regarding your pregnancy, labor, and birth, or if you do not make a good team (yes, you TWO are a team) after doing your part, then it is time to look for another care giver.

Until you fulfill your responsibilities, though, you are as much faulted as they. For your surfing pleasure, please take a look at the links below:

• What Type of Care Giver Fits Your Beliefs
  
• 10 Questions for Your Practitioner in Pregnancy
• How to Choose a Doctor or Midwife
  
• 10 Questions to Ask Before You Have a Baby
  
• Switching Doctors in Pregnancy
• When Interviewing Doulas

Marsden Wagner

"In [European] countries, obstetricians serve as specialists. They are essential members of the maternity care team, but they play a role only in the 10 to 15 percent of cases where there are serious complications. Most women have babies without ever setting eyes on a doctor.

In the United States, the numbers are reversed. Obstetricians "attend" 90% of births and have a great deal of control, essentially a monopoly, over the maternity care system. Obstetricians are taught to view birth in a medical framework rather than to understand it as a natural process. In a medical model, pregnancy and birth are an illness that requires diagnoses and treatment. It is an obstetrician's job to figure out what is wrong (diagnoses) and do something about it (treatment) - even though, with childbirth, the right thing in most cases is to do nothing.

To put it another way, having an obstetrical surgeon manage a normal birth is like having a pediatric surgeon babysit a normal two-year-old. Both will find medical solutions to normal situations -- drugs to stimulate normal labor and narcotics for a fussy toddler. Its a paradigm that doesn't work."

Marsden Wagner