The biggest mommy blogger talks about natural birth

July 30, 2009

Thanks to Bethany for giving me a heads up about this. Dooce, probably the biggest mommy blogger on the internet, recently wrote about her birth story. Her humor is pretty awesome, and I think her experience is probably pretty common. You can read the first segment here.

Up until about the 30th week of my pregnancy I hadn’t given labor much thought, only that I was going to ask for the epidural two days before contractions started. I’m not kidding, that was the extent of my birth plan. There was no need to experience any of the pain, I thought, especially since I had been through this before and I remember thinking that the pain was so awful that it was going to kill me. Give me the epidural and any other pain relief, maybe throw in a couple dozen shots of bourbon, oh and how about you just put me under general anesthesia and wake me up two days later. I’m not good with pain. I tend to complain and holler and call people regrettable things. It’s like the Hulk, only he’s on his period.

I was also under the impression, having never really researched the subject whatsoever, that any woman who would opt for a homebirth was not only COMPLETELY OUT OF HER MIND but also not interested in the safety of her unborn child. I mean, there’s a reason that infant and maternal mortality rates are so much better than a hundred years ago, right? HOSPITALS. And MEDICINE. And smart people we call DOCTORS. Yes, women routinely used to go out into the field by themselves and give birth without any assistance, and many of them routinely did not return BECAUSE THEY DIED.

But then out of no where the publishers of Ricki Lake and Abby Epstein’s book Your Best Birth sent me a copy, just like the publishers of many books send me copies of other books all the time. Internet, I have rooms full of books that publishers have sent me. ROOMS FULL. And I was just about to toss this onto the mountainous pile of ones I’d eventually drop off at Goodwill when, I don’t know, I flipped through a few pages and gave a full minute to one or two paragraphs. And those two paragraphs happened to be ones that really pissed me off. So much so that I read them aloud to Jon and said something like GOD, THOSE HIPPIES! or I BET THEY SMELL LIKE PATCHOULI!

You know, something totally open-minded.

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Radical Doula: Maria Dolorico

July 29, 2009

maria_radicaldoulaAnother awesome Radical Doula I want to highlight, Maria Dolorico, who is a doula in Boston. You can learn more about Maria at her website and her blog.

What made you become a doula?

I was an unlikely doula. I had no appreciation for birth as anything but a medical experience. My father is a retired anesthesiologist; growing up, if his chair was empty at the dinner table, it’s because he was giving an epidural. Anticipating the birth of my first child, I remember knowing I wanted an epidural, even saying, “There’s nothing natural about that kind of pain!”

Everything was going according to plan in my labor, and because of the epidural I felt the intense, but not quite painful pressure of the contractions. But then something amazing happened in second stage (pushing) – I felt myself giving birth. In my mind, I had never seen myself as anything but passive while laboring, yet with each contraction, I got behind each one and pushed my daughter further and further into the world. Between each contraction I was meditating, exquisitely focused on gathering my breath and my strength. Her birth was glorious, victorious, and I was heroic. I remember being a little sheepish as I told the birth story again and again, because it seemed to me that I was the only person on earth to have ever given birth before.

After her birth, I spent countless hours thinking up ways to get back into the delivery room. I thought about becoming a nurse, but had no interest in nursing outside of labor and delivery. Somewhere in this search, I heard the word “doula” for the first time, and I assumed that I could never be one because I didn’t see myself as an advocate for natural birth.

With my background and previous career as a mental health clinician, I began to work as a post-partum doula, finding clients who really benefited from not just my knowledge of infant care but from the intimate counseling and companionship I provided. The friend of a client asked me to be her birth doula because she “got such a good feeling” from me, and I vehemently declined. But she persisted, and serendipitously there was a birth doula workshop within a few weeks of her due date. I attended, bristling every time there was disparaging subtext about women who chose epidurals, yet I was excited finally to have a reason to be in the birth room. I knew in my heart that my doula practice would not be motivated by helping women have a natural birth, but by helping women find resources within themselves, at depths they never even imagined, in order to give birth in a way that was meaningful to them.
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More Radical Doula twitter action!

July 28, 2009

So for those of you on Twitter, I just set up the radicaldoula twitter account. It’s set up to automatically post new blogs from here, so if you want a feed of Radical Doula posts directly to your twitter you can follow radicaldoula here. If you want posts and commentary from me (about all sorts of things) you can follow me, miriamzperez, here.

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Cute CPM video from MAMA campaign

July 27, 2009

There’s even some diversity! Yay.

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Midwifery infighting

July 24, 2009

I was really upset to see the news that the American College of Nurse Midwives (ACNM) had come out against the Certified Professional Midwives (CPMs) attempts at getting recognized in the health care reform process. You can read the ACNM letter to their members here.

It all just makes me sad, reading this letter, wishing I understood exactly why those dialogues between the CPM groups and the CNM groups broke down. If your read this letter in response to ACNM’s actions, Geradine Simkins, CNM, MSN, MANA Board President explains that it was actually just one phone call where ACNM refused to concede anything.

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.

I’m a big fan of CPMs, and while I think CNMs have done a lot to bring the midwifery model of care to the hospital setting, women need more options. I like that there is a midwifery model out there that doesn’t start with nursing school, or rotations in the labor and delivery wards of hospitals. I like that some midwives are just trained to do home births, or birth center births. We need that, just like we need OBs to do c-sections (when necessary) and CNMs to do births in hospital.

ACNMs main issue with CPMs seems to be the fact that apprenticeship model’s of education are recognized alongside traditional brick and mortar education. I don’t want to throw apprenticeship out the window. I want it to be a valid way of learning. This is how midwifery started! These are our roots. We can’t abandon them completely. They’ve served us.

Why can’t we all just get along?

Well, because everyone has their own professional interests in mind.

I can’t pretend I understand what is behind ACNM’s opposition to CPMs.

Maybe ACNM is afraid of their reputation. Maybe they are afraid if these other midwives get acknowledged as providers by the federal government, it will tarnish the name of midwives. Maybe they are afraid of losing business to a new group of midwives. I don’t really know, but it’s just typical for those on the margins to end up fighting each other over little scraps when the big players (doctors) end up with all the power and gains.

I know not all CNMs are supportive of this decision by ACNM. Read this letter from a group of CNMs, even in leadership of other organizations, for a great breakdown of why this was a terrible move on the part of ACNM, why it’s wrong, bad for midwifery and ignores the evidence (does this sound familiar?).

Sigh.

You can sign this petition in response to ACNMs campaign.

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Inspiring birth story from reader

July 13, 2009

A reader also named Miriam sent me a lovely email with her birth stories, and agreed to let me share them here. It’s always lovely to me to hear from parents who had second birth experiences that fulfilled their dreams and expectations. Enjoy!

Hello Miriam-

I wanted to thank you for all your wonderful posts about reproductive freedom.  While I’ve always been pro-choice, until I had children myself, I didn’t think of it has having anything to do with birth choices.

My first child was born in the hospital four years ago and it was horrific. It was the classic medically unnecessary c-section after a tidal wave of interventions that I was unprepared to deal with.  I’d wanted as natural a birth as possible and I was basically denied and undermined in every way in working towards this goal. I was never really given informed consent about the Pictocin they put me on right away, even though I was already in labor. As you can imagine, one thing lead to another and another until I had a c-section. The really truly stupid thing about it was that the reason they officially gave “failure to progress” was based on the fact that some 7 different people had checked my dilation and everyone had a different number, 4, 8, 3, 5… it was crazy!

After that, we had four months of breastfeeding misery…which did have a happy ending, we were successful with breastfeeding and my son weaned a little bit after he turned three.

I now think that so many women have postpartum depression because they internalize and blame themselves for painful birth experiences. We are made to feel like failures, were the system is what failed. I didn’t get depressed at all, as it happens. I got wicked insane angry. It took a couple of years of talking to people, doing a lot of reading and such but I finally put all the pieces of the puzzle together and figured out what really happened to me and my baby and why.

Seven weeks ago I had my second child, a girl, at home. It was the exact opposite of my hospital birth experience. It was wonderful, peaceful and loving. (and I got to eat!) My midwife supported me and took the time to listen to me and discuss options. It was so different from being told what to do without any discussion!  We had a birth pool, which felt amazing. And in the end, I have to say, it wasn’t as painful as everyone seems to think childbirth is. Maybe because we get scared and have mentally been indoctrinated to think that child birth is super painful and everyone absolutely needs to have drugs? I don’t know. The recovery was a cake-walk compared to the recovery from the c-section and we haven’t had any problems whatsoever with breastfeeding.

Anyway, sorry for the long rambling message. Your posts about being pro-choice and the homebirth/midwife movement were a part of my mental space as I got ready for this birth and it meant a lot to me. Thank you.

Sincerely,

Miriam

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What’s the connection between health care reform and midwifery care?

July 8, 2009

My first article is up at The American Prospect, about Certified Professional Midwives and health care reform. I talked to some amazing advocates in reporting for the piece, including Michelle Bartlett, an Idaho midwife who helped push through licensing legislation in her state.

Michelle Bartlett is not the typical Washington high-stakes health-care player. She’s probably not on the radar of anyone in Congress or the Obama administration. Bartlett is a midwife in Idaho, but in the last few years, she’s been trying her hand at lobbying. This came after a night spent in jail for using medication during a home birth she attended in 2000. Bartlett was the second midwife to be charged for this type of practice in Idaho, and thanks to her efforts, she will be the last in her state. “I’ve done a lot of hard things in my life, and giving birth was one of them,” Bartlett says. “But giving birth to a law was really hard.”

On April 1, Gov. C.L. “Butch” Otter of Idaho signed legislation allowing certified professional midwives (CPMs) like Bartlett to administer medication during births. Unlike certified nurse midwives who are able to practice in all 50 states and generally work in hospital settings alongside obstetricians, midwives like Bartlett are referred to as “direct entry” midwives, and practice exclusively outside of hospitals, mostly in homes or birth centers. These CPMs spend three to five years training and meet the standards for certification set by the North American Registry of Midwives.

…

State licensing fights may be the first step for these midwives, but it’s not their last. Now they’re turning their attention to the federal health-care reform debate, and a look at the maternity-related health-care costs quickly explains why. Childbirth is among the top five causes for hospitalization, and the No. 1 cause for women. According to Childbirth Connection, Cesarean section is the most common operating-room procedure, and in 2009 the C-section rate hit an all-time high according to the Centers for Disease Control and Prevention, at 31.8 percent of all births. These rates account, in part, for the increasing cost of maternity care in the U.S. Maternal and newborn charges totaled $86 billion in 2006, 45 percent of which was paid for by Medicaid. The federal government is already footing a huge portion of the U.S.’ maternity-care bill, and these midwives think they can help reduce costs significantly, and not just for low-income women.

Check out the rest of the article here.

If you want to join the advocacy efforts mentioned in the article, check out The Big Push for Midwives and The MAMA Campaign.

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Radical doula on Twitter

July 7, 2009

I joined the Twitter-mania a few months ago. I find it to be a great way to learn about breaking news and share links with other like-minded people.

You can follow me at http://twitter.com/miriamzperez

If you’re on twitter, send me a message!

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Great article on the practice of shackling incarcerated women

July 6, 2009

Anna Clark has a great piece up at RH Reality Check about the practice of shackling incarcerated women. She delves into both the realities of the practice (horrific) and the amazing activist response that has arisen to organize against this practice (and has been successful!). Here is an excerpt:

The 2008 federal policy against shackling cued renewed hope among advocates for the humane treatment of incarcerated women. Beyond lawsuits and advocacy with individual departments, legislative campaigns to restrict shackling are finding unprecedented success-after years of falling on deaf ears.

New Mexico is the most recent state to bar shackling through a bill signed by Governor Bill Richardson this spring. New York and Texas currently have bills backed by legislative support that await the word of their governors before they become law. “For us, it’s not enough to change regulations (on shackling in particular prisons),” Saada Saar said. “To do this campaign through the legislature gives us a way to respond to violations of the policy. Through state statutes, mothers’ rights are better protected.”

“A lot of states do have corrections policies that restrict shackling, but (the policies) aren’t commonly known or understood,” Sussman said. “A law allows us to go to court; it makes it hard for others to say they didn’t know (that shackling is restricted).

“We have a strong case in Illinois because of the law there, for example. We need to bring cases to ensure enforcement,” Sussman added. “It’s a dual strategy.”

It’s a strategy that inspires diverse support. Broad coalitions are signing on to legislative and legal campaigns to transform the experience of giving birth in prisons, jails, and detention centers.

Among those backing the New York Anti-Shackling Bill are women’s health advocates, prison rights organizations, medical and public health groups, and “even fellowships and ministries that aren’t our frequent allies,” Sussman said.

Read the rest here and more from Anna Clark here.

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