Saturday, December 26, 2009

My First Induction

I experienced my first Pitocin induction this week. My client’s water broke four days before her due date, and she wasn’t having any contraction. So after much debate and a second opinion from a midwife, she agreed to being induced. I was expecting the worst, but the entire birthing experience went really well. The nurses started her off very slowly and her body kicked in so that she didn’t need a lot of Pitocin. The only negative effect of the induction was having the contractions so close together and active labor lasting longer. The mom gave birth after 19 hours of labor and never got an epidural or had any interventions. I was honored to be a part of their birthing experience and grateful for the experience of a necessary induction.

Thursday, December 17, 2009

You are a Midwife...

Midwife’s Sign in Ancient China

"You are a midwife. You are assisting at someone else's birth. Do good without show or fuss. Facilitate what is happening rather than what you think ought to be happening. If you must, take the lead. Lead so that the mother is helped, yet still free and in charge. When the babe is born the mother will rightly say, 'We did it ourselves.'"

Lao Tzu, in Tao Te Ching

Monday, December 14, 2009

Cesarean vs. VBAC: A Dramatic Difference

Cesarean vs. VBAC: A Dramatic Difference from Alexandra Orchard on Vimeo.

Watch how a baby is born by cesarean section and see the dramatic difference of what both the mother and baby experience in a home water birth after cesarean.

Thursday, December 10, 2009

My kids and I went to the cinema today and watched a movie, One Peace at a Time. In a society of greed, power, fear and war, it was so refreshing to spend some time listening to stories of hope and empowerment in the world. One organization that was highlighted in the movie was CARE. One woman in the movie from CARE had a shirt on that said, “I am powerful.” HAVING to get one of these shirts, I found their website and became instantly engrossed. This is a description of the organization from their website:

“CARE is a leading humanitarian organization fighting global poverty. We place special focus on working alongside poor women because, equipped with the proper resources, women have the power to help whole families and entire communities escape poverty. Women are at the heart of CARE's community-based efforts to improve basic education, prevent the spread of HIV, increase access to clean water and sanitation, expand economic opportunity and protect natural resources. CARE also delivers emergency aid to survivors of war and natural disasters, and helps people rebuild their lives.”

I believe that we all want to help out our brothers & sisters to make this world we live in even better. We just have to use our hearts to pick a cause and start taking steps. Right now, I am helping women become empowered by their birth experience and giving children a more peaceful entrance into the world. This is just the beginning for me.

Wednesday, December 9, 2009

Kristen's Birth Story

Here is a great birth story from one of my clients:

Birth Story, Part I

In bullet point form, because the challenge of composing coherent sentences is more than I feel like attempting at the moment:

Started having contractions early in the morning on Saturday November 28th, sometime around 6am.

Told Mark I was having contractions at around 9am, via text message from the bedroom, so I wouldn’t have to get jumped on in the process by Alexander. Contractions were light at this stage, and were coming every 10-15 mins or so.

Sent Alexander and Rosie off to play with Auntie Katie and Uncle Marcus around noon.

Then not a lot else happened for a while, so I had a bath and tried to get some rest because I was expecting a long day ahead of me.

When Mark helped me out of bed after my rest, I felt a small gush of fluid between my legs. Not very dramatic. Did my waters break? Did I pee myself? Hmm.

Decided to walk up to Katie’s house to get some fresh air and sunshine and move around. About 100m out from the house, felt another gush of fluid. This time I was certain that it was not a bladder control issue.

Called my doula, who didn’t reply. (I actually still have not heard from my original supposed doula. I am rather worried something may have happened to her or her family over Thanksgiving?)

Called my backup doula, Erica, who suggested Mark and I go out and continue on our little walk to see if that gets things moving.

Walked around the block, running into several neighbours who seem…concerned that I was out and about. Visited with Katie while Alexander was napping. The outing did provoke a few more contractions, but still nothing serious.

Went back to the house. Contractions continued all evening on and off, with varying intensity.

Watched some television – a few episodes of “Coupling” – from the comfort of my couch.

Every time I got up, there was a small gush of fluid, which I soaked up with an old towel between my legs. I know. Nice.

My mood turned more serious around 7pm, and although contractions were still not that intense, they were coming regularly at 6 minutes apart, and I was getting concerned about the fluid leakage. We spoke to Erica, our doula, and after some deliberation, Mark and I decided to head in to the hospital.

We got to the hospital and checked in around 8pm. I lay down on the bed and as soon as I did, contractions more or less stopped. Pah.

The nurse checked me and pronounced me to be around 2.5cm dilated and 70% effaced, with my bag of membranes still intact. In other words, pretty much the same as at my previous doc appointment. PAH.

Erica encouraged us to walk the halls to see if that would help move things along. We walked loops around the Labor and Delivery floor for the next hour. Erica had me walk through my contractions, which was challenging, but possible. Labour definitely picked up while I was actively walking.

We stopped back at the room around 9.30pm to check in with our nurse. I lay down again on the bed, and once again, contractions dissipated when I stopped moving. I felt a little discouraged. It was late, I was getting tired and feeling hungry and it really looked like we were in for a looooong night. I was silently berating myself for coming in to the hospital too early.

While we waited for the nurse to come by, Mark, Erica and I discussed possible options for what we would like to happen next. We agreed that if possible, we would like to be discharged from the hospital and head home for the night to recoup. Erica prepared me for the possibility that the doc may not want us to leave, since it seemed possible that I had a tear or leak somewhere that was producing the little gushes of fluid.

The nurse came back, checked me again and announced no additional progress. We said we would like to head home for the night and our nurse agreed to check with the doctor. The nurse tested my pad for amniotic fluid and it came back negative (not sure how, but yay!), so we were dismissed with doctor’s permission for me to head home, take an Ambien (sleep aid) and try to rest up before a later attempt.

We left the hospital, came home, had a quick bite to eat and I popped an Ambien and went to bed. The truly amazing thing is that I slept! I actually slept from around 11.30pm until around 6am! I woke up a few times through the night with contractions, but nothing dramatic.

When I woke up at 6am, contractions had picked up. I stayed in bed for another hour or so, timing contractions which were coming around 6 minutes apart, but with stronger intensity than the previous day. After the previous evening’s events, I was determined not to go into hospital until I really knew I was making progress. So I slowly and methodically worked my way through brushing my teeth, washing my face and then I had a bath. Contractions really picked up in the bath, and I could tell that Mark was getting concerned about getting me back to the hospital. He tried to shepherd me through getting dressed, but I was determined to go slow.

We got into the car at around 8.15am and called Erica and my doctor to let them know we were headed back to the hospital. Mark dropped me off at the entrance and went off to park the car. I huffed and puffed my way through a few contractions in the lobby area, attracting the attention of a passing nurse, who seemed very concerned and wanted to get me into a wheelchair. I declined, explaining to her in my firm, I’m-in-labour-matter-of-fact way that “No. I’m fine. I’m just having a baby.”

Check-in was a lot more challenging this time. I didn’t want to hang around and chat. Mark could tell and he dealt with me and the check-in person.

Erica met us at the check-in station and we headed to our room. I was kind of dreading being checked by the nurse again for progress. What if nothing had changed from the night before?

Our nurse (different one from previous evening) checked me and pronounced me to be 7cm dilated and 80% effaced. YAY! Finally, some progress!

To be continued….

Birth Story, Part II

Continued from Part I….

Once it was clear that baby was indeed on her way, it was time to go through the process of checking on the baby with the external fetal monitors. This process of being in active labour and needing to lie down on the bed whilst being monitored was something I had been dreading. I lay down on my side and the nurse attached the monitors. I stayed in that position for a little while, but not the full 20 minutes requested, opting instead to move to sitting on the ball with the monitors still attached. From my point of view, this was a good thing. I felt a lot less anxious about pain management once I got out of the bed.

I’m not sure how long it took, but after a while, the nurse seemed satisfied with the data gathered about the baby’s heartrate and whatnot, and we took the external monitors off. Whew. Free at last.

All this while, Erica and Mark worked with me to make me as comfortable as possible. Mark stayed close by and applied counter pressure to my back during contractions. Erica put cool wash cloths on my neck and placed peppermint aromatherapy oils nearby to help with nausea. Every so often I was aware that there was music playing softly in the background. I specifically remember listening to “Blackbird” at some point, and for whatever reason that song has stayed with me, floating around my brain.

At some point, I went into the bathroom to use the toilet. While I was in there, the doctor who was on call came in to check on me. I thought I had met all the doctors at my OBGYN’s practice, but I didn’t know this doctor. So, I’m inside the toilet, with the door closed when the doctor, who I have never met, comes into the room. The very first words I hear come out of her mouth are something to the effect of “Has her water broken yet? No? Ok, well we can rupture the membranes to help move things along faster.”. Immediately, alarm bells started ringing in my head. This was not what I had in mind! I finished up in the bathroom and shuffled out to meet my doctor. I decided to introduce myself. “Hi. I’m Kristen. We haven’t met before.” I don’t remember exactly what was said from here, but between me, Mark and Erica, we made it clear that I was progressing just fine and no artificial rupturing of anything would be required at this point in time. To which the doctor replied “Oh. Well, I guess they’ll rupture at some point.”. She guesses? GUESSES? Pah. [Also, I'm pretty sure the doc was wearing some sort of perfume. If I had to guess, it was something Estee Lauder - either Beautiful or Pleasures. It may have been pretty faint, but I could still smell it. It made me feel nauseous. Ick.]

I laboured for a while longer, mostly sitting on the ball, bent over the bed with my head on a pillow. I began feeling increasingly nauseous and DANG those contraction hurt. I started asking for an epidural. Mark and Erica talked calmly to me, explaining that in all likelihood I was going through transition and this was the worst part and soon it would be time to push and so on. And I wanted to believe them. But I was flat out terrified of having to lie on my back for delivery without any pain management in place. So I persisted with my request for an epidural.

At some point around this time, a new nurse started working with us. Our previous nurse had been called in to assist with another birth in a neighbouring room. Although I liked the first nurse – she was supportive and upbeat – I was kind of glad when she left….because she was so supportive and upbeat. Apparently I prefer silence when I’m concentrating during labour. New nurse was a lot more quiet.

An IV was placed to get the necessary fluids into me as required by the docs before the epidural could be administered. Then the anasthesiologist showed up and asked me to get into bed and lie on my side, so he could do his thing. I got onto the bed and lay down, only to promptly get up onto my hands and knees in preparation for an oncoming contraction. I figured I would deal with that contraction first before laying down, since I knew it would hurt more once I was on my side in bed. But the contraction just went on and on and on, and after a while, the anasthesiologist helpfully informed me that if I would just lie down, he could administer the epidural, and my pain would go away. I snapped my head up, and said “Yeah. I get that.” and finally succumbed to laying on my side.

HOLY MOTHER OF ALL THINGS PAINFUL. Is there anything worse than having mega-contractions whilst laying down in a bed and trying to stay still so that someone can stick an enormously long needle into your spine? I THINK NOT.

And then it was done, and the pain eased and I waited for the fog to lift. Which it did….sort of…except that my next set of contractions made me want to PUSH. My body knew what it wanted to do, and it just did it. The pushing motion broke my water and suddenly there was a full on gush of warmth. I told the nurse, Mark and Erica the news. “Uh. I want to push. And my water broke.” The nurse peered beneath the sheet that was draped over my lower body and asked “How long did you push with your first child?”. “Not long.”, I answered. The nurse promptly disappeared from my field of view and called in the doctor and delivery team. Meanwhile, Erica started to prepare the bed for push time, lifting the stirrups out for placement. As she was doing so, the nurse told her not to put the stirrups up yet and that we needed to wait until I was ready to push since the combination of the epidural and having my legs up in the stirrups for an extended period of time was a paralysis risk. As all this was going, the doctor arrived, checked me and asked the nurse to put the stirrups up, because I was ready to push. HA.

All this while, I could still feel the contractions and I could still wiggle my own toes. The epidural had taken most of the pain away, but I still had sensation in my lower body. The first proper push attempt felt very different than it had with Alexander’s birth. I could feel what I was doing. And it was quite hurty. Meanwhile, the doctor started messing with my delivery zone, presumably to help prepare for the upcoming stretchathon. YOWCH. I snapped my head up and shouted at her “HEY! WHAT ARE YOU DOING DOWN THERE!”. She looked up and caught my eye momentarily before answering brusquely “Trying to make sure you don’t tear. It’s looking tight. Did you have an episiotomy with your first birth?”. “No, I did not!”, I replied. And in my head I was screaming “AND I DON’T WANT ONE THIS TIME, THANK YOU VERY MUCH.” but I kept that gem to myself.

Fortunately, after about 20 or 25 minutes of working hard with the pushing, the baby appeared without any further drama, and the next thing I knew, she was there in all her glory, wailing and wriggling on my chest. For all the doctor’s doom and gloom, the baby was delivered with only very minor tearing and I did not need any stitches. So YAY for that.

Oh, just remembered one more thing – when the baby arrived, the doctor announced “Congratulations! It’s a boy!” and I was all “What? A boy? Really?” while doc quickly corrected herself “It’s a girl! Sorry! A girl!”.

Suzanna Mary was born at 11.51am on Sunday November 29th, a mere ~3 hours after we arrived at the hospital that morning. Not a bad, eh? She is beautiful and perfect and nurses like an absolute champ. We could not be more thrilled.

Part III to follow soon – a short round up of what happened once Suzanna arrived and some general reflections on her birth.

Birth Story, Part III

Continued from Part I and Part II

A few notes from after the birth:

Unlike when Alexander was born, with Suzanna, all the weighing and measuring and bathing etc were done in the delivery room, so she was never out of sight. This meant that Mark, Suzanna and I were never split up. That was nice.

Since the epidural never really took hold of me, I was able to get up and walk to the bathroom by myself shortly after delivery. That was really nice.

Did I mention that I didn’t need any stitches? That was really super nice.

Katie and Marc came to visit us in the delivery room and helped us to move and settled into the new room.

When everything that needed to be taken care of was completed in the delivery room, we were moved en masse across to the Nesting rooms. It was very close by. On our way to the new room, we passed by the same nurse I had talked to in the lobby area upon my arrival that day. The one who tried to get me into a wheelchair. I recognised her and said “Hey! I had my baby!”. She laughed and said “Well done! That didn’t take long!”.

Once we were installed in the new room, it was still only early afternoon, so we had plenty of time for my parents, Alexander and Lennie to come and visit us. They brought us lunch from Uno. Mmm.

We tackled a small mountain of paperwork that afternoon. Whew.

Mark made sure Suzanna and I were settled in and happy, and then he was able to go out for dinner with Alexander and my parents, which was nice for Alexander. Mark came back to visit Suzanna and I at the hospital after dinner and brought us a few things from home, then he went home again to try to get some real sleep.

Real sleep is hard to come by in a hospital. There are all sorts of people who need to come and poke at you at all hours of the day and night. And if they weren’t prodding at me, then they needed to check on Suzanna. So even though Suzanna was a perfect angel, and even though I was crazy tired, I still didn’t manage to get much sleep.

Thus, when morning rolled around, my goal for the day was to get us dismissed from the hospital. There are a lot of items that need to be dealt with in order to gain approval to leave! We visited with Suzanna’s doctor, my doctor, Suzanna did a hearing test and had some blood work done, I had a tetanus shot and we filled in yet more paperwork. Alexander and Heather came to visit around lunch time, and then Billie came by to visit us after she finished work, and was able to help us to get packed up to leave.

Finally, we got the all-clear to leave around 5pm. We secured Suzanna into her car seat and trundled down to the car with our belongings. Once we were all loaded into the car, Mark drove carefully up Mopac in the thick of Monday evening rush hour traffic, in the freezing cold rain.

My labour and Suzanna’s birth were so very different from Alexander’s arrival in so many ways. I don’t know why I was expecting them to be more similar, but it seems that whether consciously or unconsciously, I was expecting events to unfold in a similar manner and timeframe, and it kind of threw me for a loop when things didn’t play out the same way. In retrospect it seems absurd that I should have even considered that the birth of my very different children should be in any way the same.

One final note on the topic of Suzanna’s arrival that I don’t think I’ve mentioned up until now – she was born on her actual due date! For whatever reason, I had got it stuck in my brain that Suzanna was due on November 28th. But the doctors and nurses all confirmed that the official due date in my medical file was November 29th! So there you go. Suzanna was exactly on time.

Tuesday, December 8, 2009

Support is...

Support Is..


It is Listening…

Not judging and telling your own story.

Support is not offering advice…

It is offering a handkerchief, a touch, a hug…caring.

We are here to help women discover what they are feeling…

Not to make the feelings go away.

We are here to help a woman identify her options…

Not to tell her which options to choose.

We are here to discuss steps with a woman…

Not to take the steps for her.

We are here to help a woman discover her own strength…

Not to rescue her and leave her still vulnerable.

We are here to help a woman discover that she can help herself…

Not to take that responsibility for her.

We are here to help a woman learn to choose…

Not to make unnecessary for her to make difficult decisions.


Monday, December 7, 2009

Plaque for Every Birth Room

I attended a doula workshop on VBAC this weekend. This excerpt from Dutch professor of obstetrics G. Kloosterman really made sense to me:

Spontaneous labour in a normal woman is an event marked by a number of processes so complicated and so perfectly attuned to each other that any interference will only detract from the optimal character. The only thing required from the bystanders is that they show respect for this awe-inspiring process by complying with the first rule of medicine--nil nocere [Do no harm].

I personally believe that Western obstetrics could learn something from the Netherlands’ model of care since they have one of the highest percentages of home births and one of the lowest percentages of C-section rates and perinatal and maternal mortality in the world.

Thursday, October 8, 2009


The National Organization of Circumcision Information Resource Centers has posted a very informative video on their website ( I highly recommend watching it if you are wanting more information about circumcision of boys. They state the following on their site:

What you need to know...

  • 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.
  • Beautiful VBAC Story

    My Journey to a VBAC from Lindsey Meehleis on Vimeo.

    Thursday, August 13, 2009

    Birth #5

    I attended my 5th birth last week. This was my last birth for certification through Birth Arts International.

    The mom visited with her doctor on Tuesday and wasn't dilated at all. Then she calls me on Friday morning at 1:30 to say that she is having regular contractions. She calls me back at 3:30 am to say that she wants me to come over. On the way to her house, her husband calls to say that they are going to the hospital and to meet them there. We walk around the hospital parking lot for about 1.5 hours until she wants to be admitted where they find her at 9 cm!! She delivers a beautiful baby girl 3 hours later!!

    Did I mention that is was my first VBAC, too? Gotta love it!

    Friday, July 24, 2009

    Thursday, July 23, 2009

    My 3rd & 4th Births!

    The third birth I attended was another special was my first vaginal birth!  This first time mom arrived at the hospital 7 cm dilated and gave birth 5.5 hours later!  It was a very "easy" birth for me which was good because just 6 days later, I attend birth #4!



    I know that I am not the only doula who feels this way...

    Between births, sometimes I get the feeling of amazement that couples pay me to attend their births. It is such an honor for me to help couples through their birthing experience that I sometimes forget what a blessing it is for the couple to have someone present who is compassionate, knowledgeable and consistently advocating for their ideal birth.

    I received a thank-you note today from a family that brought tears to my eyes:

    Dear Erica,
    I cannot thank you enough for the service you have provided since my husband and I decided to have you as our doula. Your passion for what you do, your knowledge and skills, and the calmness of your personality all contribute to the excellent job you performed, especially on the day when our baby was ready to come out and meet us. Thank you for being there for me, my husband and our baby. Having you as a wonderful part of this beautiful birth experience will be something for us to cherish for the rest of our lives.
    May God bless you and your family abundantly!

    This thank you letter is not only for me. It is for all of the doulas out there that forget what an important job we are doing. It is to remind us all that our services provide not only a lifetime of positive memories for families but also our compassion for beautiful births ripples through the community in so ways.

    Saturday, July 18, 2009

    Response to ACNM's stand on CPM's

    This is Simkins' letter in response to ACNM's letter to their members and Congress stating that they do not support federal recognition of CPMs.

    TO: Open Letter to the ACNM Board of Directors and Executive Director

    FROM: Geradine Simkins, CNM, MSN, MANA Board President

    RE: ACNM Opposition to Federal Recognition for the CPM

    DATE: July 17, 2009

    I am a CNM and a member of the ACNM and I say very emphatically-not in my name! I do not support your recent decision to publicly and aggressively oppose the efforts of a broad-based coalition of six national midwifery and consumer organizations seeking federal recognition of the Certified Professional midwife. Your position, to me, is indefensible.

    Lack of Evidence

    For an organization of professionals that values evidence, I find it inexcusable that you have chosen an action that the evidence does not support.

    * There is no evidence to support your claim that the majority of CPMs are not properly qualified to practice.

    * There is no evidence to support the position that CPMs in general have poorer outcomes than CNMs or CMs.

    * There is no evidence to support the position that CPMs trained though apprenticeship and evaluated for certification through the Portfolio Evaluation Process (PEP) of NARM have different outcomes than CPMs trained in MEAC-accredited schools.

    * And there is no evidence to support the notion that a midwife with a Master’s Degree has better outcomes than one without that level of higher education.

    The evidence we do have on the CPM credential indicates that the midwives holding this credential are performing well, have good outcomes, and are saving money in maternity care costs. The growing number of women choosing CPMs suggests that women value the care provided by CPMs. If future research should demonstrate the PEP process is unsafe or not cost-effective, then that would be the time to reassess and restructure the process.

    Differing Values

    We, as midwives, have values that underpin our professional practice. We cherish and honor those values. You have stated that your board made its decision because ACNM strongly values formal standardized education, and opposes federal recognition of CPMs who have not gone through an accredited program. I can accept that you strongly value standardized education. However, I strongly value multiple routes of midwifery education for a variety of reasons.

    There is something important, powerful and valuable in a training process in which the student midwife or apprentice is educated in a one-on-one relationship with a preceptor and her clients in the community, as opposed to the tertiary setting where student midwives do not follow women throughout the childbearing year, and may never experience continuity of care or individualized care. In addition, by preserving multiple routes of entry into the profession, we are able to educate more midwives. We need more midwives! If health care reforms were to produce an adoption of the midwifery model of care as the gold standard this year, we could not possible supply “a midwife for every mother.”

    Impact of Taking a Stand

    By publicly and actively opposing federal recognition of CPMs as Medicaid providers, in addition to taking a stand about formal education, you are also taking a stand (willingly or inadvertently) for decreased access to midwifery care, for diminished choice for women to choose their maternity care providers and place of birth, and for restricted access to the profession. Is it worth it to sacrifice several things you value, just so you can take a stand for one thing you value? Is it possible for you as an organization to value something, but also realize that it is not the only valid way? Is it possible for you to respect the diversity of pathways to midwifery that the CPM represents? Standing aside on a potentially divisive issue does not require the ACNM to sacrifice any of its standards. It simply requires the ACNM to respect the standards of another part of the profession of midwifery.

    Disingenuous Claims

    It is disingenuous of ACNM to state in its Special Alert to ACNM Members on July 15, 2009, “ACNM’s decision to oppose this initiative followed unsuccessful attempts by ACNM and MAMA Campaign leaders to reach a compromise that both organizations could support…” There was no formal process or interaction, no negotiations, and no attempt at collaboration between ACNM leaders and MAMA Campaign leaders. There was one phone conversation in which the ACNM representative stated there was only one concession they would accept: federal recognition only for gradates of MEAC-accredited programs; this is not a compromise. The MAMA Campaign, of course, is promoting all CPMs to receive federal recognition as Medicaid providers, not just some CPMs.

    Furthermore, it is disingenuous to suggest the World Health Organization (WHO) document sets a standard that has been embraced around the world. In fact, the WHO developed global standards for midwifery education without the input of the International Confederation of Midwives (ICM), an international partner of the WHO. The majority of members of the task force that developed the standards were not even midwives. There was not widespread input regarding the document nor targeted input by midwives. In response to this oversight, the ICM passed a resolution at the June 2008 Council meeting in Glasgow Scotland (I was there!) to develop global midwifery standards. A task force has since been convened and all member organizations (which includes MANA and ACNM) will be able to give input to the standards developed by the ICM. Generally, when the ICM develops a document that might supplant an existing WHO document (as was the case in the international definition of a midwife), the ICM document is eventually incorporated by the larger international community. This will be a long process and any new document will not be ratified by ICM until the next Council meeting in 2011.

    Lack of Vision

    What offends me most-as a CNM, an ACNM member, a member of the MANA/ACNM Liaison Committee, and the President of the Midwives Alliance-is the lack of vision this decision represents.

    Why not embrace diversity and support innovation? Why not bring the turf wars to an end? Why not unite under the banner of midwifery and the values that we share in common? Why not set aside our differences and recognize that we are all midwives? Why not recognize that the work we do is more important than the credentials we hold? Why not support one another within the profession, because diversity is our strength not our weakness?

    What We Do Matters

    The healthcare debate has been in progress in Washington DC for over a decade, but never before has the possibility of real change been as promising as it is now. Now is the time when we may have a real opportunity to effect unprecedented changes in maternal and child health care that will have long-lasting affects for mothers, infants, families and communities. Women deserve high quality maternity care, affordable care, and equal access to care. Women deserve options in maternity care providers and in their place of birth. Vulnerable and underserved women deserve to have disparities in health care outcomes eliminated, and they deserve to have barriers removed that limit services, providers and reimbursement for maternity care.

    Expanding the pool of qualified Medicaid providers to include CPMs will help address the plight of so many women around the country who receive poor quality maternity care or do not have access to care at all. We need to lower the cesarean rate and increase VBACs. We need to lower infant and maternal mortality and morbidity rates in the U.S. We need to offer women the opportunity to believe in their bodies again and to give birth powerfully and in their own time. We need to welcome babies gently into the world. We need to give the experiences of pregnancy and birth back to families. We need to support women to breastfeed and help shelter the process of maternal-infant bonding. These are the real issues. These are the things we deeply value. Midwives are the solution that can address each of these vital issues. All midwives and midwifery organizations united, together, working toward these common goals, could produce these kinds of improvements in maternity care. We do not have to think together; but we must pull together!

    In Conclusion

    I repeat to you-not in my name. As an ACNM member, I will not comply with your requested action; I will actively oppose it and encourage others to do join me in doing so. Your position on CPMs does not represent what I value, what I hope for, and what I work untold hours to achieve. I have written this letter at the urging of the fourteen members of the MANA Board of Directors. Seven of the Board members are CPMs, four are CNMs, one is a CPM/CNM, one is a CM, and one is a DEM. They represent a true cross-section of the midwives in practice in this nation. We stand for diversity, tolerance, and unity among midwives and within the profession of midwifery. We advocate and work for a midwife for every mother, in every village, city, tribe, and community in this country and across the globe.


    Geradine Simkins-CNM, MSN, President

    MANA Board of Directors

    Maria Iorillo-CPM, 1st Vice President

    Christy Tashjian-CPM, 2nd Vice President

    Angy Nixon-CNM, MSN, Secretary

    Audra Phillips-CPM, Treasurer

    Pam Dyer Stewart-CPM, Region 1

    Regina Willette-CM, Region 2

    Tamara Taitt-DEM, PhDc Region 3

    Sherry DeVries-CPM, CNM Region 4

    Elizabeth Moore-CPM, Region 5

    Colleen Donovan-Batson-CNM, Region 6

    Dinah Waranch-CNM, Region 9

    Friday, July 17, 2009

    With America being the leading country in over using technology during pregnancy and birth, it is nice to know that there are some politicians in America that still value the health of women and children and listen to the overwhelming statistics that state ultrasounds alter cell development and should only be used for medical diagnosis.  This is definitely a step in the right direction.  Read the article here (,0,2341415.story)

    Tuesday, July 7, 2009

    Early Labor Anticipation

    There is something magical about early labor.  You know that there will be a beautiful baby born very soon.  You know that a family will enjoy one of the most memorable moments of their life.  It is almost like your own early labor anticipation.  You have time and energy to think about the magnificence of birth with a certain uncertainty of what lies ahead.  I begin to feel the adrenaline run through my veins, so I take deep cleansing breaths to calm the excitement of being part one of the most amazing times of life...birth.

    Thursday, July 2, 2009

    Birth Video Junkie

    So, I have become a birth video junkie :-)  I have spent many hours browsing all of the births on YouTube.  A few weeks ago I found Bastian's Birth.  There are 9 ten minute videos that take you through a good portion of a woman's beautiful unassisted birth.  It shows a lot of active labor and pushing and made a lasting impression on me.  Tell me what you think...

    My 2nd Birth!

    I attended my second birth on April 30th.  One of my best friends from middle and high school gave birth to a sweet baby girl, Tess.  I was honored to be a part of such a special day!


    So, when I was pregnant and raising my kids, I have always just followed my heart on what works best for our family...home births, co-sleeping, attachment parenting, homeschooling, etc.

    Now that I am working with many different families, I am confronted with numerous questions on the multiple debatable topics around birthing and children (vaccinations, circumcisions, etc.)  There is a certain challenge to presenting information in a non-biased and honest way without pushing my personal opinions on them.  Yesterday, a mom that I am working with mentioned how a pediatrician does not support co-sleeping because of the high numbers of deaths that it causes every year.  He stated that there are around 100 deaths from co-sleeping each year in Texas alone!

    So, I became curious about this statistic and started poking around the internet and asking questions.  It turns out that the American Pediatric Association and Consumer Product Safety Commission state that co-sleeping is not safe.  Well, this does not mean too much to me, but got me digging further.  I started receiving lots of input from co-sleeping adovocates and some anti co-sleeping supporters.  Needless to say, I was getting very confused.  I finally received a link to the 2008 DSHS Texas State Child Fatality Review(  This is a super comprehensive report of all the 2006 deaths of everyone under the age of 17.  From this report, there are two sections of greatest importance as related to deaths from co-sleeping.  The first one is on pages 47-48.  It states that there were 83 SIDS related deaths in 2006 of children one year old and younger.  38.8% of these deaths happened in an adult bed and 32.8% happened in a crib (these were the highest percentages with bassinette being the next highest at 10.4%).  This amounts to 26 SIDS deaths happened in an adult bed. Hmmmm....this still doesn't say if the child was co-sleeping in the adult bed.  Another interesting statistic is on page 57.  This chart shows the percentages of asphysxia infant deaths due to suffocation by sleeping place.  An overwhelming 60% of the 38 deaths happened in an adult bed (22 deaths)!   So, the total amount of infant deaths in 2006 in Texas in an adult bed is about 48.  This still doesn't state if an adult was sleeping with the child or not.  It also doesn't explain that if the parent was sleeping in the bed if the adult was intoxicated or on drugs.

    Now every coin has two sides and there are multiple studies showing the benefits to co-sleeping.  Dr. McKenna has done extensive research into co-sleeping.  You can read all about his findings here:
    Also, Mothering Magazine has multiple articles on the benefits of co-sleeping (  Just some of the benefits listed are the baby sleeping better, the baby not crying as much, closer bonding, etc.  There are also numerous articles supporting the idea that co-sleeping is safer than crib sleeping.  All of the co-sleeping advocates reinforce the importance of co-sleeping safely (not being intoxicated, not having lots of bedding, etc.)

    So, here is my not so scientific personal conclusion...I KNOW that co-sleeping can be safe.  After all, our kids slept with us until they were 6 years old and they didn't suffocate.  We were very mindful about sleeping with the kids, especially when they were infants.  We didn't ever cover their heads, I always protected them with my arm and they didn't sleep on the edge of the bed.  I never even considered the fact that they could die while sleeping with us.  I only knew that it felt right.  Did they benefit from sleeping with us?  I believe they did.  I think that it reinforced the bonding that we shared during the day and it allowed them to sleep better.

    So, how do I present this information to the parents that I am working with now?  I consistently tell them to do what is best for their family, be mindful of propoganda and FOLLOW THEIR HEARTS!

    Good night!

    Monday, May 11, 2009

    The Caesarean

    So, after 2 births and 2 Caesareans, I have become very curious about the theories revolving around the causes of caesareans.  I was pleased to read a book by Michel Odent called The Caesarean.   I really enjoyed Odent's writing that stepped over "politically correct" boundaries numerous times, in order stay authentic to his beliefs and observations.  He mainly states that a woman needs privacy and NO neocortex stimulation for the birthing process to be most successful.

    Since reading this book I have modified my role as a professional birth supporter to incorporate more of my own authentic, non-judgmental, mother-type nurturing.  I feel like women giving birth need to feel safe and nurtured, in order to relax and let their bodies' natural function progress without intervention.  After attending two relatively traumatic births, I started feeling like I should be doing more.  When in reality, I am doing exactly what I should be and could almost do less "persuading."  "Persuading" the mom that she is doing a good job and "persuading" her body to do more.  I honestly trust in the women's ability to find her unique coping strategies during birth.  I trust that her body will do what it needs to do to birth a child.  I trust that the baby is doing what he/she needs to do to be born.

    Sunday, April 26, 2009

    Breast Crawl

    I love to see videos of births from other countries.

    Circumcision Movie

    This is an interesting movie about circumcision...

    Sunday, April 12, 2009

    My First Baby

    Here is a picture of my first baby born under my watch...

    Wednesday, March 25, 2009

    My Personal Artist

    I know you can't help noticing the beautiful painting at the top of this blog.  It is by an up and coming Swedish artist, Sofie Trigo Wagner.  The original painting was done 3 years ago, and after I showed interest in buying the painting, Sofie decided to repaint it for me.  She sends me updates of the painting as she works on it.  The most recent update is at the top of the page.  I can't wait to get my hands on the original!
      You can see more of Sofie's work here:
    This was the original painting done 3 years ago

    Monday, March 16, 2009

    I (She) Did It!

      I attended my first birth a couple of days ago!  I will post the full story once I get permission from the new parents.  I can tell you that I spent about 22 hours with them and it was wonderful!  I learned so much, and I felt like I did a good job in supporting both of them through one of the most amazing experiences in their lives.  I can now honestly say that I have found another calling in my life.  I will hopefully be assisting women during birth for many years to come.  I feel a deep gratitude for this couple inviting me into their lives and initiating my new career.  I am also very grateful to my friend, Shelley, for giving me the opportunity to attend her childbirth education classes at the hospital that this couple delivered at and all of the super helpful advice she has given me.  
      I have gained a lot of perspective after attending a hospital birth (I had two homebirths myself). I now see the benefits of having a competent medical staff to assist in the delivery of a child. Even though it may take a little bit more leg work, a woman can have a beautiful, nurturing, and empowering experience in a hospital.  I know my new mama did and so did I!

    Wednesday, March 11, 2009

    My 1st Birth...almost

    So, I'm waiting for my first mama to enter into active labor.  She had early contractions, then they conveniently stopped so that she could finish up her work before taking her maternity leave tomorrow!  I talked to her again at 9pm.  She had been having consistent contractions for about 4 hours, but not real strong.  She is so cute and trying not to get too excited.  She said, "Well, I think he will be here by St. Patrick's Day."  Uh, yeah! 
    I am also trying not to get super excited.  My in-laws arriving from Pennsylvania will be a nice distraction for this evening.
    Hopefully, I will have a nice birth story to post tomorrow!

    Sunday, March 8, 2009

    A Shock and Call for Change

     I just left a childbirth education class held at a local hospital by a local doula and friend.  It was a 2 day class and very informative.  After the class, the teacher let me thumb through the evaluations left my the attending couples.  Two of the questions were:  "How did you feel about labor and delivery before the class?" and "How do you feel about labor and delivery after the class?"  The majority of participants used words like "anxious," "scared," "worried," and "afraid" to describe how they felt before the class.  This was really shocking to me.  Where are they getting these feelings from?  Is it because the majority of televised fake births on t.v. look scary?  Are the majority of people describing their births as scary and painful?  I understand that this class was a very small sample of expecting parents, but I wonder if the feelings of anxiety about birth are common.  
      How can we as a society transform this perception of labor and delivery to an image of beauty and serenity?
      Some of the responses to the second question, "How do you feel about labor and delivery after the class?" were "better," "excited," and "less scared."  So, obviously a little bit of education can relieve a lot of fears.  But what about all of those couples that did not sign up for an elective childbirth education class?  I do believe that we should all start expressing our views that birth is a beautiful, NATURAL process in life that can be enjoyed.  Let's empower all of those pregnant couples out there!!  Let's tell them, "Have Fun!" and "Enjoy" when going off to labor, after all it is a ride that they can only take a few times in their lives.

    Thursday, March 5, 2009

    A Doula Story

    I started my morning watching this movie about a doula from West Chicago that works with pregnant teens.  It was beautifully done and very moving.  At one point, I was actually crying out loud (I have NEVER done that during a movie).  It fills me with so much hope that there are people out there like Loretha who are making a huge difference in empowering women to use their voices, reach their dreams, and be loving mothers.