Have you had a baby within the last 3 years? If so, please take The Birth Survey. It is an online survey meant to provide information and transparency about maternity care providers and birth locations. Click on the above link, then click on “Take our Survey.” It is a lengthy survey, so be sure to give yourself some time to take it and/or save it and come back to it when you can.
Join FOIM on Saturday Feb 14 to write a handwritten letter to your lawmakers in Iowa, asking them to support direct-entry midwives. You can learn more about this event HERE. FOIM will provide paper, envelopes, and postage – you provide the handwriting! There will be events in both Des Moines and Iowa City. (Des Moines is at the Urbandale Public Library 10-12.)
Alright, all you midwifery supporters, this post is for you.
Friends of Iowa Midwives is a statewide grassroots organization working to:
* Promote access to midwifery and out-of-hospital birth in Iowa
* Protect the rights of Iowa women to choose their place of birth and birth attendant
* Provide education about childbirth options
* Create supportive community for birthing women and families
Their current legislative campaign aims to license Certified Professional Midwives in Iowa so that families who choose out-of-hospital birth can have access to safe maternity care with legal midwives.
Many families in Iowa believe that Iowa is sort of “a-legal” when it comes to CPMs. They are not recognized by the state, but they are not outright forbidden. Many midwives, and many consumers, have been content to leave it this way. (I am one of them.) But then Melanie Moore was brought up on charges of Practicing Medicine Without A License. (Her prosecution was not brought on by any negative incidents, by the way.)
And, to some people, that changes things.
I will admit to still being on the fence about this goal of licensure. In many states, licensure of CPMs has led to a significant decrease in the options available to certain high-risk women: those with twins, those wanting a VBAC, and those with breech babies. These are women who are close to my heart and I don’t want to do anything that would make their lives even tougher!
However, it all depends on the language in the bill and whether FOIM is willing to compromise on the language that would protect these women, as well. A few ladies from ICAN are involved with FOIM to help protect the interests of these women, which is reassuring.
If this is an issue that interests you, that you’re passionate about, or that you just want to keep current on, please head over to the FOIM website, Yahoo Group, or Facebook page. Volunteer if you’re able!
Filed under: Birth
Des Moines, IA – In Iowa, roughly one-third of all babies are born through Cesarean surgery. Experts say that number could be reduced if doctors would allow women to have a vaginal birth after they’ve had C-sections. More and more expectant mothers are traveling to University of Iowa Hospital and Clinics in Iowa City to give birth, because no other facilities will do a vaginal birth after C-section, also called a “V-Bac.”
Dana Ericson is a Certified Nurse Midwife in Des Moines who says the latest guidelines require doctors to be present during labor. As a result, most hospitals have opted out of providing that care.
“They don’t want to be sitting on the labor and delivery unit waiting, and they also cannot figure out a way to get paid for that waiting period.”
The article goes on from there.
This is just sad. We live in Des Moines! Not Podunk City. But yet many women have had to travel to Iowa City, Kansas City, or other locations in order to attempt a VBAC, because so few doctors here will even consider VBAC. Those that do often have long lists of reasons to refuse a VBAC at the last minute – baby’s too small, baby’s too big, you’re past 41 weeks, etc.
Article Submitted by Dr. Heather Yost from Yost Family Chiropractic
A breech birth (aka “breech presentation”) refers to the position of the baby in the uterus. These babies will be delivered buttocks first instead of the normal head down (vertex) position. The risk of breech presentation is small, with research showing approximately 4% of full-term (38-42 weeks) pregnancies being breech.
In the 1990’s, some breech babies were still delivered naturally. Beginning in 2003, almost all hospitals declared a halt to delivering breech babies vaginally and began using c-section 100% of the time. But what about the woman who doesn’t want a c-section? Is this the only way?
Chiropractic care, using the Webster Technique, may help prevent a c-section. This is a technique where specific chiropractic adjustments allow for balance in the pregnant woman’s pelvis and reduce unnecessary stress to her uterus and supporting ligaments. This makes it easier for a breech baby to turn naturally.
The Journal of Manipulative and Physiological Therapeutics reported, in the July/August 2002 issue, an 82% success rate of babies turning vertex (head down) when doctors of chiropractic used the Webster Technique.
Currently, the International Chiropractic Pediatric Association recommends that women receive chiropractic care throughout pregnancy to create pelvic balance and optimize the room a baby has for development throughout pregnancy. Breech presentation may be avoided altogether, resulting in easier and safer deliveries for both the mother and baby.
For more information, contact Dr. Heather at Yost Family Chiropractic. 278-YOST. Or visit us at www.YostFamilyChiropractic.com
Information submitted by Dr. Heather Yost, DC, FICPA, Webster-Certified.
Compiled using information from the following sources:
International Chiropractic Pediatric Association, http://www.icpa4kids.org/
American Pregnancy Association, htt;://www.americanpregnancy.org/
Journal of Manipulative and Physiological Therapeutics, Volume 25, July/August 2002.
Breech birth – Wikipedia, htt://en.wikipedia.org/wiki/Breech_birth
Block, Jennifer. Pushed. MA: Da Capo Press, 2007
note from the editor (Sarah):
During my recent pregnancy, my head-down baby turned Frank breech (butt down, legs and head up). There was no physical reason, and I had been under chiropractic care the entire pregnancy (with Dr. Heather). My own research showed me that breech delivery is really quite safe if you are with a skilled care provider who has experience with breech. Problem? There are very few providers with breech experience these days. Those who are skilled at breech often will not do it. In Des Moines, I found one OB who would “consider” taking me as a patient and one OB who would not make me have a C/S if I showed up at the hospital in labor with a breech and refused to consent to surgery. This man was experienced and skilled at breech, and comfortable handling a breech delivery, but would not take me as a patient knowingly planning a vaginal breech delivery. Phone calls to providers – OBs and midwives – across the state and into neighboring states turned up only one OB who would take me as a patient planning a vaginal breech delivery. This was an OB in Omaha.
It is SO important for women to educate themselves about their options and not accept No for an answer unless it’s what YOU want. In the case of a breech, it’s not enough to refuse surgery. You need to make sure you’re being safe – a care provider who doesn’t know what they’re doing can really cause a bad outcome with a breech.
I know the Webster Technique is among the most proven ways to turn a breech naturally. Acupuncture is another well-studied option. Neither choice will do any damage in any way – there are no risks. There are also no guarantees – I was one of those women for whom neither technique did the trick. We ended up doing an external version (which IS risky) and went on to have a wonderful homebirth with a head-down baby.
Filed under: Birth
As you know, the state of Iowa was charging me with practicing medicine without a license, a felony. My court date was set for August 20 but on August 17 the state made an offer, which I accepted.
Here is a break down:
The good: No jail! If I follow the rules of my probation for one year all charges against me will be expunged. The charge was considered a “serious misdemeanor.”
The bad: One year probation, $315 in fines, $100 court costs and $300 probationfee (so far). Not bad fees, but they are compounded by my inability to earn aliving. An added surprise was 25 hours community service (not a part of theoriginal deal). I will look at it as an opportunity to expand my horizons andwork toward empowering women through birth.
The ugly: I was forced to sign a plea of guilty to practicing medicine without a license. I feel nauseous to even write this. You know and I know that midwifery is NOT the practice of medicine and I will yell it from the rooftops forever!
Please forgive me for signing those papers. If you had seen my family when they made the offer – the looks on their faces – you would surely understand. A friend who has been through it herself counseled “THEY have all the power; you are a mere speck. A flea on the back of the elephant. You can fight them and destroy your life because it will take herculean stamina and financial resources AND you will undoubtedly lose.”
I hope women will continue to choose homebirths, lay midwives will attend them and apprentices will wait in line to assist at these incredible events! Please decriminalize midwifery in Iowa! Or at least recognize the Certified Professional Midwife.
What does my future hold? Time will tell. I continue attending births as a certified doula. I dream of combining my love of dance and women to teach some pregnancy belly dance classes. Thank you so very much for all your support. I and my family have been humbled. You are all awesome.
Please never give up!
~ Melanie Moore
Simul-posting at all my blogs.
Central Iowans have an opportunity next month to see an awesome film about childbirth in America – The Business of Being Born is a movie about the business of childbirth in this country. In the film, actress and former talk show host Ricki Lake and filmmaker Abby Epstein draw on their personal experiences in exploring The Business of Being Born.
This 85-minute long documentary follows clients of NY midwife Cara Muhlhahn as they consider their birth choices. The film includes interviews with well-known advocates for physiological birth including: Dr. Michel Odent, an OB/GYN and author of The Caesarean; Susan Hodges, President of Citizens for Midwifery; and Dr. Robbie Davis-Floyd, PhD in Medical Anthropology and author of Birth as an American Rite of Passage.
The Business of Being Born debuted in April 2007 at the Tribeca (NY) Film Festival, receiving a standing ovation, and will have a very limited release in 11 large cities. You can bet Des Moines is not one of those cities. BUT! You can catch a sneak preview hosted by ICAN of Central Iowa.
Schedule for the evening
6:00 PM: Doors open for a meet and greet and book signing with Jennifer Block author of Pushed. (Books will be available for sale–cash or check only–for $20)
7:00 PM: “The Business of Being Born”
8:30 PM: Comments and Question and Answer session with Ms. Block
Advanced tickets will be $8 each (two for $15). To order tickets in advance:
Click HERE for a mail-in form (paying by check, money order or cash).
Or click HERE to order online (paying by credit card or Paypal).
Or you can purchase tickets from me.
All orders have a will-call pick up option or may be mailed to you.
Tickets at the door the night of the show will be $10 each.
For more details
Please visit the following sites for more information on the movie “The Business of Being Born” and the author Jennifer Block:
This was quite good. Catherine decided, between pregnancies, to write a book on midwifery, so devoted a year to following some midwives around and documenting her observations. Hospital-based midwives, homebirth midwives, lay midwives, certified nurse-midwives, midwives of all types and personalities. During the course of her research, she got pregnant, and she weaves in the story of her own pregnancy and birth with the stories of the women she’s observing.
The most interesting part of the book for me was how Ms Taylor herself changed over the course of her year of research. She started out very pro-hospital birth. A midwife in a hospital working under a doctor is the best of both worlds, she thought. (And I know many who share this opinion.) But by the end of the book, she’s decided to have her own baby at home, in the water, with two CNMs onhand, and seems convinced that, for women who are comfortable at home, it’s the best place for a normal delivery. The book’s purpose is not to convince anyone of anything, but rather to give some insight into the world of midwifery, the variety of midwives out there, how they are similar to and different from one another and from OBs, the different settings in which they practice, and their differing beliefs about how birth should progress.
It’s a very easy read, written in a leisurely narrative. I finished it off in just over one day.
I marked a few particularly interesting (to me) passages.
1) Ms. Taylor has just asked one of the hospital midwives about the increased use of epidurals. After commenting on a few other things, the midwife says “I think increased epidural use might have something to do with the fact that we don’t think that we should have pain in this modern world. Most of the women we see don’t generally challenge themselves physically. They are sedentary, and they aren’t familiar with physical pain. But I think a lot of it is that we’re all so stressed out that we just can’t handle any more pain. It’s funny, at a time when there are so many conveniences, why are we all so stressed out?” Then later, she comments, “The increase in analgesia and anesthesia use may be related to our own pain as midwives as careivers. It would be interesting to do a study that tried to see if epidural use was in part because we, and the nurses too, don’t want to deal with mothers’ pain. I’m not proud of this, but it’s true. When you’re with a laboring woman, sometimes it is hard to bear her pain. And we see so much, volume-wise. It gets to you. So now, with epidurals, we don’t have to bear their pain.” (p59)
2) Ms. Taylor is now talking to a homebirth midwife, who says, “The moms come out with these stories like ‘Oh, my birth was so great. They let me walk around.’ And I mean who’s in charge here? Look at where the power is in that sentence. ‘They let me use the bathroom.’ ‘They let me hold my baby.’ But to the women, that was a wondeful birth experience, because in their last one maybe they got cut with no one asking her permission, or they weren’t allowed out of bed, or they had to be catheterized, or their baby was taken away immediately. For me, it’s hard. I know in one part of my heart that that’s progress, but I’m also kind of sickened by how little progress that is, and I’m sad that women put up with it.”
3) Ms. Taylor is at this point visiting at a women’s clinic in Taos, NM. (which was interesting since I finished this book the day before heading to Taos myself!) The midwife in charge at the clinic has fought tirelessly for years to improve the birthing woman’s experience in her community, and she has made progress, but it’s been difficult. In a twist on the usual, her midwifery clinic has recently hired two OBs to work for them. (Normally, of course, doctors hire midwifes to work under them.) Her name is Elizabeth. “Elizabeth insists that, as a nation, we need to be asking some basic, logical questions. ‘Why don’t we care that mothers and babies are dying at greater rates in the United States than in so many other places? If we know that outcome-based care does reduce maternal and infant mortality, can we talk about why we refuse to go there? Do we care about mothers and babies?’
“Elizabeth is confident that change will come, slowly but surely, through education, saying that it isn’t a matter of opinion vs science, but of making the data known. ‘I mean, obviously, the science isn’t improving across the board,’ she says. ‘In 1989, our maternal mortality rate in the United States was around 8 deaths per 100,000; it has actually risen to 10 per 100,000! Some people would argue that we’re counting it better, but in any case, we haven’t improved. Not only have we not improved, but nobody’s objecting. Maybe they don’t know. Maybe they don’t know that, statistically, you should have your baby in Japan or Spain if you want a better outcome.’”
I really liked this book, but it does have one major hole in it – there is hardly any mention of certified nurse midwives who practice independently at hospitals and in homes. Ms. Taylor follows CNMs who work for hospitals and HMOs, and she follows lay midwives who work independently. But there is no mention of CNMs who work independently, beyond Elizabeth and her clinic in Taos. Maybe Des Moines is unique in this aspect, that we can choose among CNMs who are employed by a hospital, CNMs who work independently and do primarily homebirth, CNMs who work independently and do primarily hospital birth, and lay midwives who do only home birth. We have a wealth of choices here, when you stop to think about it. (The only thing we don’t have, that they do have in the book, is lay midwifes who are acknowledged by the state and allowed to practice legally.)
If you want to get a copy of this book, our local chapter of ICAN is selling it as a fundraiser.
Another good book, an easy read, written in a gentle narrative format and very short chapters. And another story of a woman’s transition from preferring birth in a hospital setting to seeing birth as normal and uneventful and perfectly suited to a home setting. Penny Armstrong completed her midwifery training in Scotland and worked there for a while before coming back to the US and completing a training program here to obtain her US credentials. After looking down at homebirth for a number of years, one day a call came to the hospital where she worked that a rural doctor wanted to hire a midwife for his clinic. On a whim, she took the job, which involved helping the largely Amish population of the rural Lancaster County, PA deliver their babies at home.
The book is largely just what the title suggests – the story of one midwife, and also of the women whose babies she delivers. It also provides wonderful insight into the world of the Amish as Ms. Armstrong slowly adapts to their ways and comes to admire and respect the Amish people with whom she works.
One of my favorite passages in the book has really nothing to do with birth. Ms. Armstrong is explaining about how the Amish think about technology. (Her story will then relate to a situation that arose with the birth of one of her clients.) She says “Most of all, an Amishman wants to protect his faith, keep his family close, keep his ways, keep humble before God, be a steward of the land, and make a living. If ne needs a technology to allow him to continue, then maybe, he’ll say, taking a long time to decide – debating the matter with his brethren – maybe he’ll use it; but if it gets in the way of faith, family, and stewardship, then he’ll stop thinking about it.”
We could all stand to put technology in that light, I think.
Filed under: Birth
I hate inductions. Hate them. Inductions are the root of childbirth gone wrong in
It has been proven that getting induced increases your chances of ending up with a c/section by 50%! And I don’t believe doctors really need to think too hard for any reason to give any women a c/section. I have heard of dozens of reasons to be induced and very few are truly legitimate.
Among those not-so-legitimate reasons to get induced are: You are overdue, the baby is too big, the baby is too small, you are too fat, you are too skinny, you are going on a vacation, I (the doctor) am going on vacation, it’s too close to a holiday, your mother-in-law is here to babysit now, your husband is on leave, my (the doctor’s) kid has a dance recital, your baby isn’t moving enough, your baby is moving too much, you look ready, you look tired, you look impatient….
If your doctor tells you any of these types of things, or enthusiastically agrees to induce you if you mention one, it’s time to run. LOOK FOR A NEW CAREPROVIDER.
Remember, that it’s OK to not agree to be induced and it’s OK to question why your careprovider wants you to be induced. The careprovider is employed by you, not vice versa. This is your body and your baby. Your baby/body doesn’t have a little timer on it and even if it did, it’s not going to ding that it’s ready the second you hit your magical/all knowing due date. Some pregnancies take 37 weeks to thoroughly cook the baby…some take 43 weeks (some more, especially if it’s your first baby)! Research shows the average first pregnancy (if left to run it’s own course) averages 8 days longer than “the due date”. Everyone is different.
Your body knows when the baby is done and ready to come out….very very few women remain pregnant all of their lives. Those babies come out, it’s just a matter of when and how.
Induced births tend to be longer, harder and more painful (three things a pg woman does NOT need) than a labor that occurs naturally. And, like I previously mentioned, tend to end in c/sections more often.
Unfortunately, for us, this is where a doctor’s magic bag of excuses often comes in. Your baby MIGHT have been in distress (and needed an emergency c/section), but would it had been in distress had it not been given pitocin to make contractions stronger than what it could bear (and then an epidural…and then more pitocin, etc)?
Yes, you may have pushed and pushed and pushed in every position known to man and that baby wouldn’t come out…but, was this because your pelvis is “too small” or was that because the induction didn’t allow that baby to get in the right position and then a good old epidural on top of it caused that baby to get stuck?
Yes, you may have labored for 18 hrs and still didn’t get past a 3cm but…was this a case of “failure to progress” or were you strapped in bed, not allowed to move around, stuck in the arms w/ a jillion different things, watched by 18 nurses, three doctors and two residents?
Yes, you may have had a fever/infection, but would this have occurred anyway or was this because you had had at least 23 introducing new-bacteria-with-every-prod vaginal exams in the last 12 hours?
Inductions are the first of the slippery slopes leading to a c/section. What starts as an “innocent” breaking of water/little pitocin drip, leads to more pitocin, an epidural, more pit, another epidural, the inablity to get out of bed, an impatient doctor, an exhausted mother and a baby in distress. If you don’t want a c/s (and you don’t, topic of another blog), then don’t get induced.