Have you bought your copy of Robbie Davis-Floyd's most recent book, Birth Models That Work?If not, do so now! Robbie needs to sell 250 more books in order to get the contract for Volume II: Birth Models on the Cutting Edge.
Birth Models That Work is a phenomenal collection of articles describing maternity systems around the globe that foster excellent birth outcomes through the midwifery model of care. It is a must read for anyone wanting to improve their maternity system. Personally, I found this book refreshing and hopeful, and I can't wait for Volume II!
I thought that I would share with all of you my paper that I wrote for my monitrice/midwife's assistant certification course. My assignment was to read Witches, Midwives & Nurses: A History of Women Healersby Barbara Ehrenreich & Deirdre English and write a paper on a particular point of interest. I have always been fascinated with the events that led to the establishment of the American maternity medical system, so I took this opportunity to research the history of birth more thoroughly and organize my thoughts into this paper. If this topic also interests you, I would love to hear your feedback!
Reading Witches, Midwives & Nurses peaked my curiosity about how our modern American maternity system was established, comparative to more humanistic models in other parts of the world. What happened to our culture that enabled the development of the majority of births being “produced” in a hospital setting under the primary care of obstetricians? To explore this question further, I read three other books: Lying-In: A History of Childbirth in America by Richard W. & Dorothy C. Wertz, Brought to Bed: Child-bearing in America, 1750-1950by Judith Walzer Leavitt, and Birth as an American Rite of Passage by Robbie Davis-Floyd. I came to realize that there were multiple cultural, political and scientific threads that converged from the middle of the nineteenth century through the twentieth century, facilitating the development of America’s modern maternity system.
What were the cultural events and beliefs that fueled this system and enabled it to become institutionalized into our culture?
The American culture was based on the Protestant idea of man’s power over nature. This also led to an acceptance of man-made science dealing with the powerful natural experiences and replacing the ancient wisdom and magic of pregnancy and birth. This entire transformation of pregnancy and birth needed to be culturally controlled and standard obstetrical procedures filled this need for society.
The strong definition of sex roles at the turn of the century reinforced a male dominated culture when mostly men were becoming doctors.
The feminist movement focused on women becoming doctors instead of the right of humanistic care for women.
Americans became more mobile, which led to women leaving their support networks and this left doctors to fill the gap. The mobility of society also broke up the networks that supported midwifery. This lack of support enabled the doctors to easily make women feel fearful that they were weak and susceptible to disease and eager for their aid.
Strong American class distinctions allowed for the upper & middle class to feel as if they were getting better care through the new specialized doctor that used technology. There was a belief that doctors made birth “less dreadful.” This left the lower classes to still receive midwifery care and as a whole midwifery care started to be looked down upon. Multiple women’s magazines, groups and advocates of women’s health supported and advertised this new and improved specialty.
During the nineteenth century, ailments became fashionable in the upper class. Women at this time were expected to be weaker than men. Both of these fueled the new idea that a pregnant woman was sick and needed to be managed by a male doctor.
This new “American” way to have a baby fueled the desire for second generation immigrant families to Americanize themselves by going to an obstetrician and having their baby in the hospital.
During and after the industrial revolution,the idea of going to the hospital to be “processed” in a factory was the new way to produce things. Also, the machine is now replacing the organism as the way the world is organized, and this created an idea of our bodies working as a machine that can essentially be controlled. Culturally there was a distancing taking place from birth being a human experience and women becoming passively dependent on medicine. This was also the time where the power of the institution over the individual was being developed.
Women began to want a break from their “confinement” of pregnancy and the hospital took them away from their dreaded housework and obligations.
During this time women’s identification as a woman and mother was taken away which erased the woman’s power over the process and obliterated their own birthing traditions.
These choices from generations past declared the choices for each subsequent generation. Women’s choice to have more doctors made less midwives; their choice to have more hospitals meant less home births. Now multiple generations later, the choices of childbirth are limited.
What were the political events surrounding the development of our modern maternity system?
Once created, the medical profession grew rapidly, making doctors more accessible.
The development of the nursing profession created more nurses than midwives. This fit with the cultural establishment of the hierarchy within a medical establishment and fueled the patriarchy of American society.
The feminist movement focused on integrating women into a male dominated profession rather than attacking the male dominated medical profession.
The establishment of medical schools and certifying doctors forced midwives to legitimize their knowledge while possibly losing the essence of being a wise woman.
Corporate patronage and support of the new, larger medical schools eliminated the smaller midwifery schools for women and minorities.
Doctors were not being trained alongside midwives which created a loss of shared knowledge and competition between the two.
Centralizing care and institutionalizing medicine brought doctors power and prestige.
The rise in lawsuits and malpractice insurance became deterrents against physicians to humanize and personalize American medicine. This led to the establishment of standardization in the maternity system.
What were the scientific developments that stimulated the American maternity system we have today?
The lure of technology, which began with the development of forceps, was strong in a society where technology was a sign of progress.
The discovery of bacteria and the Germ Theory created a mystique of medical science. Since the knowledge was coveted by the medical profession, they gained the superior knowledge that women no longer owned.
Modern science allowed society to grow rapidly alongside the medical profession.
The development and use of pain relieving medicines created the lure of a pain free birth that you could only get in the hospital with a physician in attendance.
The fear of puerperal fever, syphilis, gonorrhea, and other transmittable diseases created the “cleansing” of women in the hospital and the inherent idea that women are diseased and need doctors to cleanse and manage them.
The development of automobiles enabled rural women to receive urban hospital care.
As doctors learned about scientific causes of ailments, they started to lose interest in the behavioral and environmental causes of diseases and birth traumas. This was the start of practitioners treating the disease instead of counseling the woman.
The discovery of the Germ Theory also created a frenzy of cleanliness around the home and birth was viewed as dirty, so going to the sterile hospital was appealing.
Stemming from Greek Aristotelian traditions, the male body became the prototype of a perfect machine, while the female was defective and needed to be manipulated by man. This also fit well into the Protestant belief of woman being less than man.
The convergence of these culture, political and scientific beliefs and events have brought us to the system that is in place today. It is unfortunate that we are now bound by a dehumanizing maternity system. I am hopeful that midwives will continue to pass down the sacred wise woman knowledge of birth and that we will all educate women and let them demand to be cared for in a humane and safe way, making access to midwifery care a human right among all classes.
Some of my posts have been really deep lately, so I thought I would lighten it up a little bit! The following is a post that MODG posted on her blog: http://www.modgblog.com/ Thanks, MODG, for officially declaring that myself and all of my doula sisters are now officially FAIRIES!
The hippies know something that the rest of us don’t. Well since I am falling somewhere in between hippie and gossip girl, I’m going to ruin the hippie code and tell you what they have going on. I hope they don’t kick me out of the club. I was pretty close when I wore the 4 inch heels to see the midwife last week. She was having NONE of that.
Ok, hippie secret. So they figured out a way to do something that I have been trying to find a way to do my whole life. And not only are they doing it, they got their husbands on board to pay for it.
THEY HIRE PERSONAL ASSISTANTS DURING PREGNANCY AND BIRTH!!!! NOT KIDDING.
So here’s how they did it. They were like, you know what? My husband is a lame tard and I don’t trust him at all to do the stuff I need when I give birth and I may squeeze his head off with the forceps. I am going to hire a personal assistant who does whatever I say and who is a baby birth expert and I’m going to call it something hippie sounding like “Doula” so they get confused and just go along with it.
SO SMART HIPPIES!
You hire a doula when you get preg and they are there for you throughout the whole pregnancy with secret tips and tricks to make you feel better and will give you massages and will bring you secret herbs from their magic gardens and are basically birth geniuses. And they work for YOU, not the hospital, not your husband. So they do what you say.
So you best believe I jumped on that shit immediately. B was pretty much on board because he faints if the tampon doesn’t flush in the toilet. So he can play brickbreaker on his blackberry while me and the doula work it all out.
MODG, eat this flower and your baby will float delicately out of your vagina. OK fairy whatever you say.
Here was my criteria in hiring a doula:
1) She has to be pretty but not prettier than me.
2) She has to have a lot of secret magic. Like stuff that I don’t know about involving aromatherapy, herbs, spells and ESPECIALLY know how to make my vagina stay in one piece when I deliver this 23lb baby.
3) She has to think I’m funny.
4) She has to have really long hippie hair.
And would you believe that I found her? I did. I did. I DID. And not only does she meet all of my criteria, I THINK that she may be a fairy (!!!!) I know. She is tinier than me with super white skin and looong black hair and wore a little blue fairy dress. In our interview I was like, Fairy…do you have secret tricks and can you please detail them for me? She’s like, yes I do but I can’t tell you now. SUPER SECRET TRICKS!!! Obviously she was hired.
So my fairy has already been at my beck and call via email. I’m betting she regrets this arrangement already. And when Plankton wants to show his hairy face, she’ll come to my house and then follow me to the birth center and make sure everyone does what I want when I want, like a good personal fairy assistant. She also comes for a few visits to our house to do secret stuff.
Also she is a birth photographer as a bonus. I’m going to have a strict no pink parts policy. But I do enjoy a photo shoot. And I KNOW you’ll on be on me for pictures like the second Plankton pops out with his laptop in hand.
So, my recommendation ladies is if you EVER have the chance to hire a personal assistant/fairy, DO IT. Pregnant or not. Husbands are easy to convince of this stuff.
If you have detailed doula questions, I recommend asking my virtual doula Zdub. She would be my actual doula if she didn’t live in Colorado. But she scores 300 hippie points for living there.
First of all, I want to say "thank you" to Sarah and Sally for the positive feedback and getting me motivated to post again :) I have so many birthing thoughts swirling around in my head that I want to share, so I will start with the most positive...
I have started studying for my midwife's assistant/monitrice certification through Birth Arts International, and my first assignment is studying the history of midwives and birth assistants. I LOVE IT!! First of all, I have a great excuse to get more books and read for hours on end, but mostly I love learning how our present birthing society was created. The hopeful part is that we haven't been entrenched in this highly medical model of care for very long and now there are some really strong signs that our birthing culture is waking up and noticing that there may be a better way for women to give birth and for babies to come into this world.
Let's all applaud ACOG for declaring that VBACs should be an option for women and celebrate the fall in circumcision rates to 33%!! Hopefully, this is just the beginning. I am imagining an ideal birthing culture in the next 100 years where women have a choice in where and who attends her birth and midwives and doctors will all be working together to provide optimum care for pregnant mamas.
In order for this to happen (& preferably sooner), we all need to educate ourselves on the facts of our birthing culture and how it can be improved and, most importantly, TALK ABOUT IT & SPREAD THE WORD!! There is no need for our sisters and babies to struggle through a time that should be so beautiful!
Here are the books that I am reading: Witches, Midwives & Nurses by Barbara Ehrenreich & Deirdre English
I am consistently amazed at how this beautiful Universe works. I love the little (and big) messages that are given to show me "the way." Yesterday, I had a great friend tell me that my last blog post inspired her to "speak up" and call 3-1-1 to report two dogs left in a hot car with the windows rolled up. This makes me think about all of the wonderful changes that are going to be made when we all support and act with loving-kindness.
I have also been trying to sort through my feelings about activism and how to do it without aggression and anger fueling my agenda, because anger and aggression just don't "feel right." So, here is the message I received today from Pema Chodron's book, When Things Fall Apart: Heart Advice for Difficult Times...
When we hold on to our opinions with aggression,
no matter how valid our cause, we are simply adding
more aggression to the planet, and violence and pain increase.
Cultivating nonaggression is cultivating peace.
How perfect is that! I have a sense of peace this morning that I will and am making a difference in the birthing world. I will ask for the patience to help me maintain my nonaggression and subdue the feeling of immediacy that begets agendas and anger while overshadowing the essential aspects of clarity of mind, and openness.
I am excited to continue my journey and witness the beauty and empowerment of women experiencing the wonder of conception, pregnancy, birth and mothering.
Much love, peace and gratitude to all of you that share the path of loving-kindness!
I read a quote today: "Speak your mind, even if your voice shakes." So, here I am...speaking, and if you could hear me or see me...I am shaking. I am shaking because changes to our maternity system need to happen NOW! I was also inspired by something else I read the other day...set your goal to be like someone you admire. Today is the day that I am going to start speaking up, speaking from my heart so that I can start to make changes like all of those women that I admire so much. After I rattled off my passions and goals to my dad today, he asked me, "So, you are going to be a shaker?" Yes, Dad, I am going to be a mover & shaker. I am going to continue researching and start talking and writing louder, because my whispers aren't helping moms and babies and families. I am committed to help other women find their voices, so that they can speak what their hearts are telling them and assist them in breaking through the cultural ideology surrounding birth in the US. I will make mistakes along the way, and I invite you to point them out to me, so that I can learn from them. This is the only way to invoke a transformation that will save and improve lives. Today, I vow to speak my mind, even if my voice shakes. Do you?
I was honored to attend the birth of a beautiful baby boy just recently. Because he died at 40 weeks gestation, I am still processing through this birth. I am going through all of the emotions and nurturing them as they arrive. Hopefully, I can express my thoughts soon, so that my words will be helpful to anyone who may be confronted with the death of a baby. Until then, much peace and gratitude to all transformed by this sweet baby and to all of those who have assisted me through this process.
Not to mention observing the home-learning of our two children, taking care of numerous pets, being a loving wife, enjoying friends & sometimes cleaning the house!!!
Early Sunday morning, Debra called me with two simple words, “Come on!” This was my cue to meet her at my first homebirth as a midwife’s apprentice. I was so excited, but apprehensive. I was excited to be attending a home birth but apprehensive about the discoveries I would make... “Do I agree with Debra’s birth philosophies? Would we work well together? Would I feel comfortable being in the midwife role?”
I learned so much in the early morning hours of March 28th. I learned that I was on the right path. I learned that I was where I was meant to be. For the few previous months, I had been following my intuition and walking through the many doors of opportunities. These opportunities lead me here, to this beautiful birth and I was grateful.
I fell more in love with Debra during this birth, and this birth confirmed our connection and ability to work together. It also confirmed my ability to be in the role as a midwife. Maybe one day, I will share with the mom how special her birth was to me. Maybe one day, I will share with you the story of my first “catch.” Now how amazing is that?
I met Robin Lim at the CIMS forum a couple of weeks ago. This woman is amazing! She is so full of love and doing a great service from her heart. She is a midwife with 3 birthing centers in Bali, Aceh and Haiti. Her website (http://www.bumisehatbali.org/) has field notes from Haiti and a list of supplies that each birthing center is in need of.
One of her daughters also attended the conference and showed a screening of her new movie dedicated to the work her mother has done. This documentary is amazing!
It is women like these that give me the inspiration to follow my heart and make a positive impact on our world. They are a great testimony to the power of love!
I copied this important article from San Diego Birth Resource Network’s blog. I will now also ask all of my client’s about any history of cervical operations or procedures. Coincidently, I just read about cervical scar tissue in Elizabeth Davis’s Heart & Hands: A Midwife’s Guide to Pregnancy & Childbirth. It is nice to know that there is a pretty simple fix for this scenario, too. Heart & Hands recommends massaging the cervix (the mom can do this herself) with evening primrose oil twice daily for several minutes (this is contraindicated for any woman with a history of premature labor until she is at least 37 weeks). This can also be done in early labor, in case it is prolonged. The evening primrose massage will soften tissues and break up adhesions, preparing the cervix for dilation. Here is yet another way to treat our bodies gently!
Cervical Scar Tissue – A Big Issue That No One Is Talking About.
by Doula
In my first year of being a birth doula, I had this client. She desperately wanted a VBAC (vaginal birth after c-section). She told me how in her first birth that she was in labor for hours. Waters broken, Pitocin, epidural, tubes and wires coming from every direction. During her extremely long ordeal the only change to her cervix was the effacement (the thinning of the cervix). Her cervix never opened at all. I assumed at the time that this was because her baby was just not ready to come out. This time could and would be different. She would wait for labor to start. We would stay at home and labor where she was comfortable. When the day came, that is exactly what she did. Her labor seemed to be moving right along. When we got to the hospital I expected they would tell her that she was 4-5 cms. Instead what we got was, 100% effaced but only a finger tip dilated. I think I may have even gasped out loud. I immediately started beating myself up in my head. How could I have read her labor so wrong? 6 more hours would pass with her, her husband and I working hard. Moving from the birth ball to the shower and I swear every inch of that hospital room in between. After 6 hours, still a finger tip dilated. Obviously there is something wrong with her cervix, but what. No one seemed to know. Not the two different nurses that we had the pleasure of getting to know or the doctor who we saw just once when he was coming to explain that she would be having yet another c-section. This is one of those moments in my career that I really wish I knew then what I know now.
I have never stopped thinking of her. There has always been this part of me that wanted to call her and say “I know what it is now, can you have another baby so we can fix it?” I just know this would not make her feel any better. Instead, I keep her close to me whenever I ask the question now during each and every prenatal visit, “Have you ever had any procedures done to your cervix?” Every single birth professional that is assisting clients should be asking this question.
Look, I’m not a scientist, researcher, doctor and anything else that would know how to study this stuff. What I am is a doula that has had the pleasure of attending over 100 births. I know that the client I mentioned above was not the only one who had a c-section because of scar tissue during my earlier days. I can look back and think of all the clients that seemed to be in transition (7-10 cms) but when checked were still only 4cm. Stuck there for hours and hours. Then wondering for days after their c-section if there was something I could have done differently to help.
A New Day!
The day that changed my life as a doula forever, my very own sister was having a baby. She was having her second baby. I told her how great it would be and it would be so much faster than her first. When she started having surges just a few days before her due date, we were excited. I went to her home (3 hrs away) and stayed the whole weekend. She had surges off and on all weekend but nothing really steady. I went home after three days and decided that maybe my being there was freaking her out. For the next week, she had surges every day. I kept telling her it was going to be great. All this work would get her cervix open slowly and gently. Then she visited her midwife. She was just a finger tip dilated. I chalk this up to my sister being a big drama queen. All the surges have been Braxton Hicks! The next weekend comes and I find myself making the drive because this time her water broke. Now we know this baby is coming. She has mild labor, 7 minutes apart for 16 hours. Nothing is changing. I suggest we head in. Something is just not right. We get to the hospital and a different midwife she has never met comes to check her. 100% effaced but only a finger tip dilated. What?! Are you kidding me?! Then the words that changed my life. “Have you even had any procedures done to your cervix?” My sister says “yes, I had cryo surgery done a couple of years ago to remove pre cancer cells”. Midwife “ok well that makes sense, you have scar tissue on your cervix, and I can feel it.” Huh? Scar tissue on the cervix? Why had I never heard of this? My client from before comes rushing back to my head. Of course! The midwife proceeds to explain to my sister that she is going to try and massage the cervix and break the scar up. With some discomfort for my sister, she went from a finger tip dilated to 3 cms in a matter of minutes. An hour later she was 4 cms and an hour after that my nephew was born. Once the scar tissue had completely released, she flew to 10 cms.
As you can imagine, I asked that Midwife a ton of questions. I wanted to know all I could about this scar tissue stuff. Besides “massaging”, what can you do before hand? She shared her knowledge with me. Told me that HPV is so very common and more and more women are having these standard procedures done, but are never informed that it most likely will leave scar tissue. Although less common, this includes women who have ever had a D & C after a miscarriage or abortion.
Once I was armed with the knowledge, my successful VBAC rate shot up as did my vaginal birth rate in general. I would ask the question and if the answer was yes, I would tell them what I knew. I would suggest that they mention it to their doctor so that if anything came up during labor, would he or she be willing to massage the cervix. Also I learned from that Midwife that evening primrose oil taken orally and vaginally would help break up the scar tissue before labor. (Orally taken the entire pregnancy and vaginally each night only after 36 weeks).
Since this very important day 3 1/2 years ago, I know I have prevented c-sections. Several times in the hospital I have asked the doctor to please, when he is checking mama to feel for scar tissue. Almost every time the doctor has said “oh yeah, I feel some sort of knot here” or some other variation of that statement. This then leads to a question of; can you try and rub it out?
Why Doctors aren’t talking about this is beyond me. I honestly think they don’t know that it is an issue. I don’t believe it is something they are being taught in medical school. We all need to start talking about it because unless women are being asked the question, they just don’t know.
The current US Health Care System is failing babies and families before, during and after birth. At this critical moment when the US government is re-envisioning our health care system, we are seizing the opportunity to make a 10-12 minute video not only to point out the flaws in the way we care for babies and families, but also to identify the keys to improved care. Our infant mortality ranking is 42nd on the world stage which means 41 countries have better statistics. This places us right in the middle of the following countries: Guam, Cuba, Croatia and Belarus, with over double the infant deaths compared to the top 10 countries of the world. (CIA World Factbook).
Our astronomically high African American infant mortality rate at 16 deaths per 1,000 is similar to countries such as Malaysia and the West Bank. Not only are babies dying needlessly, but the ones who survive this failing system are also often adversely affected by unnecessary procedures and separation from mother and family. Our intent with this video is to encourage policy makers to consider a health care system that holds prevention of these calamities as a high priority. The midwifery model of care for healthy low-risk women is a simple solution which addresses many of these issues simultaneously.
We are advocating for a health care system in which it will be standard procedure for mothers and babies to thrive and not merely survive through birth and early life. The midwifery model of care will save our health care system millions of dollars each year.
Photo Credits:
Creative Commons Photos
Palestinian woman from the Gaza Strip is giving birth to quadruplets in a cesarean surgery in an Israel Hospital Edi Isreal
Cesarean team Bob J Galindo
Cesarean Eduardo Marquetti
Epidural Rave Dave
Fetus Lunar Caustic
DSCN 6000 Vesna Roganovic
First bottle feeding Jason Morrison
Esto Somos Nosotros Quique
Takahata HS 10 F a r e w e l l
Photo by Alejandra Sarmiento from the book Beautiful! Images of Health, Joy and Vitality in Pregnancy and Birth by Jennie Joseph (2007) reprinted with kind permission of Jennie Joseph.
Premature babies Photos by Raylene Phillips MD
Film footage:
What Babies Want
Vintage Film footage:
Labor and Childbirth 1950 Prelinger Archives Produced by Medical Arts Productions Public Domain
Reducing Infant Mortality has a creative commons copyright for sharing and attribution
The Experts in the film:
Marti Glenn, PhD, Founder and President, Santa Barbara Graduate Institute.
Geeta Maker-Clark, MD, Family Physician, Maternal Child Health, Prenatal Yoga Instructor, Magnolia Family Medical Clinic, Ventura County Medical Center.
Bruce Smith, MD, MPH, Medical Officer, County of San Bernadino Department of Public Health, Maternal, Child and Adolescent Health Section.
Sarah Buckley, MD, Dip Obst, Author: Gentle Birth, Gentle Mothering: A Doctors Guide to Natural Childbirth and Gentle Early Parenting Choices.
Chauntelle Williams-Parker, Mother, Lactation Specialist, WIC Program (Federally Funded, Women, Infants and Children Program).
Jennie Joseph, LM, CPM, Executive Director: Commonsense Childbirth, Inc., Founder of "The JJ Way' Maternal Child Healthcare System.
Monica Matos, Founder Ten Moons Rising Holistic Family Education, Birth Educator and Activist, Doula: Author: articles include, Reclaiming the Wisdom and Power of Birth, Women Disregarded in Maternity Care, The Amazing Motherbaby Connection, The Power of Healing Early Trauma.
Phyllis Klaus, MFT, LMSW, Author: books include, The Doula Book, Bonding, Your Amazing Newborn, a video, The Amazing Talents of the Newborn,and When Survivors Give Birth: Understanding and Healing the Effects of Child Sexual Abuse on Childbearing Women.
Marsden Wagner, MD, Perinatologist, 15 years Director, Women's and Children's Health, World Health Organization (responsible for Women's and Children's Health in 45 industrialized countries),131 scientific papers, 20 book chapters, 14 scientific books published in English, German, French, Spanish, Russian, Italian, Japanese, Chinese, Swedish, Hebrew and Danish.
Paula Ingalls, BA, Lecturer, Author: In Search of My Mind and Soul: Birth Traumas and Beyond.
Bryan Oshiro, MD, Medical Director, Perinatal Institute, Loma Linda University Children’s Hospital.
Stuart Fischbein, MD, FACOG, Internship and Residency at Cedars-Sinai Medical Center in Los Angeles, Certified by the American Board of Obstetrics and Gynecology. Expertise includes high-risk OB, ultrasound and infertility. Advisory Board: The Baby Center. Co-Author: Fearless Pregnancy, Wisdom & Reassurance from a Doctor, a Midwife and a Mom.
Raylene Phillips, MD, MA, IBCLC, Preterm Infant Developmental Specialist and Neonatology Fellow. Loma Linda University Children's Hospital.
Due to the length and pointed focus of this short film not everyone interviewed could make it into the final version. Our gratitude to all the distinguished experts who lent their wisdom, suggestions and words to our understanding of the issues of Infant Mortality and creating Healthy Babies.
Michel Odent, MD, Obstetrician and researcher. Medical studies at Paris University. Author of more than 50 scientific papers. Author of 12 books published in 22 languages including: The Farmer and the Obstetrician,The Cesarean, The Scientification of Love, The Functions of the Orgasms: The Highways to Transcendence.
Thomas Verny, MD, Psychiatrist, internationally recognized author who has written 7 books and published 44 scientific papers on topics relating to prenatal and early postnatal environment on personality development. His book, The Secret Life ofthe Unborn Child, has become an international bestseller published in 27 countries. Founder, the Association of Pre and Peri-natal Psychology and Health.
Marshall Klaus, MD, Neonatologist , Professor Emeritus of Pediatrics, University of California, San Francisco, Author: books include, Care of the High-Risk Neonate, The Doula Book, Bonding, Your Amazing Newborn,and co–editor for 10 years ofThe Neonatal/Perinatal Yearbook.
David Chamberlain, PhD, Author: The Mind of Your Newborn Baby.
Karen Strange, Midwife and Clinical Director, Maternidad La Luz Midwifery School on the US/Mexico border in Texas, Neonatal Resuscitation Instructor: newbornbreath.
Robbie Davis-Floyd, PhD, Senior Researcher Fellow, Dept of Anthropology, U of Texas, Austin, Author- books include: Birth in Four Cultures, Birth an American Rite of Passage, mainstreaming Midwives, From Doctor to Healer – The Transformative Journey.
Yeshi Neumann, CNM, MA, MPH,practiced midwifery in diverse settings, from high-risk obstetrics in an urban hospital to working with traditional midwives in Nicaragua, Guatemala, Mexico and Tibet. She created Homestyle Midwifery at St. Luke’s Hospital in San Francisco, CA in 2000.
Arisika Razak, BSW, RN, MPH (Masters in Public Health), CNM, Director of the Women’s Spirituality M.A. and PhD. Programs in Philosophy and Religion at the California Institute of Integral Studies. She was worked for over thirty years in women’s health, spiritual dance and nurse-midwifery.
Paul Fleiss, MD, Masters in Public Health. Pediatrician in private practice, Hollywood, California.
Maria Iorillo, LM, CPM, Wisewoman Childbirth Traditions, Vice President, Midwives Alliance of North America (MANA), Board of Directors California Association of Midwives (CAM).
Rupert Linder,MD, President of JSPPM, OB-GYN, Psychotherapist.
Wendy Anne McCarty, PhD, RN, Founding Chair & Faculty, Prenatal & Perinatal Psychology Program, Santa Barbara Graduate Institute. Author, Welcoming Consciousness: Supporting Babies' Wholeness from the Beginning of Life–An Integrated Model of Early Development (2009). Co-founder, BEBA, a non-profit clinic for babies and families to early trauma. International presenter, educator, consultant and practitioner specializing in optimizing human potential from the beginning of life. Guest editor, Journal of Prenatal and Perinatal Psychology and Health.
Tara Blasco, PhD, RCST, Therapist BEBA Family Clinic.
Micheline Charpie, MD, PhD, MA, MT, LCAT, Newborn Intensive Care, Roosevelt Hospital, New York City.
Brent Babcock,DC, Author: My Twin Vanished: Did Yours?
Barbara Findeisen, MFT, PhD, President of the Association of Pre and Peri-natal Psychology and Health.
Charlotte Peterson, PhD, Director Oregon Network of Infant Mental Health, Infant Mortality Task Force of Lane County Oregon.
Corey Colwel-Lipson, MA, LMFT, ATR-BC.
William Emerson, PhD, Author: Healing Birth Trauma in Children.
Debra Bonaro-Pascali, LCCE, CD (DONA), Director-Producer of the film: Orgasmic Birth.
Carrie Contey, PhD, Co-Author: CALMS, A Guide to Soothing Your Baby.
Julie Gerland, Chief Administrative Officer UN Representative for OMAEP, (The World Association for Prenatal Education Associations) an NGO in Special Consultative Status with the Economic and Social Council of the United Nations.
Simon House, MA, Parish Priest, Author: The Unborn ChildandGenerating Healthy Brains.
Mia Kalef, DC, Director of Emerging Families Clinic, Author: The Secret Life of Babies.
Guiditta Tornetta, Doula, Founder: Joy in Birthing.
Dave Paxton, RCST, MBA, Clinical Social Worker.
Dorothy Mandall, MA, PhD, Consultant for autistic and developmentally delayed children.
Wendy McCord, PhD, Psychotherapist.
Myrna Martin, MN, RCC, RCST, President of Kutenai Institute of Integral Therapies, Director of Nelson and Area Mental Health Services. Author: Birth and Attachment: how to totally support your baby from here on.
Michael Trout, MA, Licensed Clinical Professional Counselor specializing in Infant and Maternal Health.
Laura Uplinger
Giselle Whitwell, BA, MA, Board Certified Music Therapist, MT-BC.
Marilyn Milos, RN, Executive Director National Organization of Circumcision Information.
Judith Prager, PhD, Consultant, Verbal First Aid, Author: THE WORST IS OVER: What to Say When Every Moment Counts and Journey to Alternity, Transformational Healing through Stories and Metaphors.
This is an excellent video of a couple and their journey on deciding to have a home birth.
I wanted to post this video mainly to enforce that having a home birth is a safe option. Many women do not even know that they have a CHOICE on where they want to give birth. I also think a certain stigma surrounds home births and videos like these are steps toward more women having empowered and beautiful births.
Who is this beautiful lady? This is my new mentor! Her name is Debra Day and she is wonderful! We met in a hospital bathroom while we were both giving labor support to clients practically next door to each other. I had her and her daughter (who lives right down the street from me) over for tea last week to talk more about becoming a midwife and all of the cards fell into place.
I am now working with her two days per week. She works independently and with another midwife in town, Mary Barnett. Debra provides labor support, prenatal and postpartum care and attends home births.
I am still in awe that I am studying to become a Certified Professional Midwife to assist women in their home births!
Check out their websites and look forward to many more adventures on my new journey.
Childbirth Connection is a wonderful organization that is dedicated to improving maternity care. Here is what they have to say about informed consent & refusal:
Who is responsible for making informed maternity decisions?
When pregnant, giving birth, and after birth, women are responsible for making informed
decisions for themselves and on behalf of their babies. They have the legal right to give
"informed consent" or "informed refusal." Most women report a high degree of interest in
knowing what a proposed maternity intervention would involve, alternatives (including no
action), and potential benefits and harms of the different choices. Maternity professionals are responsible for providing scientifically supported care and for carrying out established legal processes for informed consent. Legally, "patient viewpoint standards" are in effect in many or most states. This means that clinicians must tell those in their care about the possible benefits and harms that a reasonable person in that situation would want to know to make an informed decision. Much time and effort are required to meet these legal and ethical standards for informed consent. Women need full and accurate information about labor and birth decision points and interventions well before labor to be able to pursue the care of their choice and make informed decisions around the time of birth.
Why is women's involvement in maternity care decisions important?
The decisions women make and the maternity care they receive can have lasting effects on
the health and well-being of their baby, themselves, and their family. It is always important to understand whether there is a clear, well-supported rationale for any procedure, drug, test or treatment that is being considered. In many care settings, some practices are used freely and even routinely, whether or not the mother or baby have shown a clear need. Although these practices may be of value to women or babies in certain situations, they may be unnecessary for most. They may be disruptive, be uncomfortable, cause more serious side effects, and lead to the use of other interventions. For these reasons, interventions should not be used routinely or unnecessarily.
What are important factors for informed maternity decision making?
For a woman, making informed decisions means learning and thinking about the best
information available on maternity care, and then deciding what's right for herself and her
baby. Key questions include:
• What are the possible choices?
• What does the best available research tell us about beneficial and harmful effects of each of these choices?
• What are her own needs and preferences and those of her partner (if she has one)?
• What choices are available and supported in her care setting and through her caregivers?
• If she wants an option that will not or may not be available, would she consider switching to a care setting or caregiver that does offer the preferred care? It is not possible to know ahead of time exactly what a woman's labor experience will be like. Being as informed as possible in advance can help women deal wisely with any new decisions that may arise at the time. It is important for a woman to learn about options, get answers to her questions and think about her preferences well before labor begins. It is also important that her partner or other support people are aware of her wishes and prepared to speak on her behalf if the need arises.
What does it mean to give "informed consent?"
Informed consent is not a form or a signature. It is a process between a woman and her
caregivers to help her decide what will and will not be done to her and her body. In the case of maternity care, informed consent also gives a woman the authority to decide about care that affects her baby. The purpose of informed consent is to respect her right to self-determination. It empowers her with the authority to decide what options are in her best interest and the best interest of her baby. Her rights to autonomy, to the truth (as best as it can be known at the time), and to keep her and her children safe and free of harm are very basic human rights.
What are women's legal rights to "Informed Consent" and "Informed Refusal?"
Whenever a medical procedure, drug, test, or other treatment is offered to a woman, she has the legal right to "informed consent." This means that her doctor, midwife or nurse is
responsible for explaining:
• why this type of care is being offered
• what it would involve
• the harms and benefits that are associated with this type of care
• alternatives to this care, and their respective harms and benefits, including the possibility of doing nothing and simply waiting longer.
A woman has a right to clear and full explanations about her care and answers to any and all
questions about her care. She also has the right to request and receive a copy of her medical
records and to get a second opinion. Then, by law, she has the right to decide whether to accept the care that is offered. If she disagrees with her caregiver and decides not to accept care that is offered, she has a right to this "informed refusal." And, even if she signed a form agreeing to a particular type of care, she has the right to change her mind. Although these are well-established legal rights, they have been challenged in a few recent cases. It can be difficult to carry out the informed consent process in busy health care settings. Yet, a woman and her caregiver should set aside the time to discuss these issues in advance whenever possible, and again when it is time to make a decision. It is crucial that women do not learn about procedures and options for the first time while in labor and facing important decisions. At that time, it may be too late to get all questions answered, weigh options, and pursue specific preferences.
What are some tips to help women explore these issues with their doctor or midwife?
Women can make a list of questions before each visit, and jot down the answers. They may
wish to bring their partner or someone else who is close along to listen to what is said. This is not the time to be shy; nothing is off limits.
While talking with caregivers, women can say:
• I don't understand.
• Please explain this to me.
• What could happen to me or my baby if I do that? Or if I don't?
• What are my other options?
• Please show me the research to support what you're recommending.
• Where can I get more information?
• I have some information I'd like to share with you.
• I'm uncomfortable with what you are recommending.
• I'm not ready to make a decision yet.
• I'm thinking about getting a second opinion.
Any question that a woman has is worth asking. When answers are not clear, women should
ask again until they understand.
What happens if a woman and her caregiver disagree?
Caregivers have rights, too. They have the right to agree or disagree to provide care that a
woman may request. For example, if a woman requests a cesarean and has no medical need
for this procedure, her caregiver has the right to refuse to do the surgery. Increasingly, fear of lawsuits is leading caregivers and hospitals to refuse to provide some types of care that would be a good and reasonable choice for many women, such as vaginal birth after cesarean (VBAC). Forcing healthy pregnant women with a previous cesarean to have major surgery against their wishes seriously compromises the quality of maternity care. Major liability system reforms are needed to improve this situation.
These issues speak to how important it is to have a good collaborative relationship that
includes open communication, mutual respect, and shared points of view. A woman who takes care to find a doctor or midwife who respects her needs, values and goals can help avoid conflict down the road.
