Increased C/S, Increased Complications

Interesting report from the National Partnership for Women and Families on a new study finding that the increase in C-Section deliveries coincides with increase in complications during birth.

Citizens for Midwifery Meeting in Rolla, MO!

This year, Citizens for Midwifery will hold its annual meeting in Rolla, MO and any and all interested birth activists are welcome to join us!

FoMM/MMA's very own Mary Ueland and Debbie Smithey have been nominated to receive the annual Susan Hodges award for excellence in consumer activism and that will be given during the public portion of the annual meeting.

This year our Annual Membership Meeting, including the election of members of the Board of Directors, will be held in Rolla, Missouri, on Saturday, November 8, 2008, from 1-2 pm, followed by a Gathering with other birth activists in the area from 2-4pm. The CfM Board members will be meeting in person throughout the weekend.

Location: These meetings will be held at Baymont Inn and Suites, 1801 Martin Springs Drive in Rolla, Missouri. Hotel phone: 573-364-7000.

Our Annual Meeting affords us the chance to review the past year and look ahead to the coming years – your questions and ideas are important! This is a great opportunity to meet with and talk to CfM’s Board of Directors in person. And of course we’ll count the ballots for the election of Board Members for the next year

Following the Annual Membership Meeting, a Birth Activist Gathering will bring together CfM members with Friends of Missouri Midwives and anyone else who is interested, including other consumer activists, midwives, and other birth professionals. CfM will give a brief presentation about our current work and projects, including our response to the AMA Resolution, an open discussion about "what’s next in MO" and how CfM can help, and how we can work together to sustain birth advocacy. This event is free and light refreshments will be served.

Please RSVP to molly@cfmidwifery.org if you plan to attend the meetings. CfM’s Board of Directors looks forward to hearing from many of you, and even seeing some of you in November!

Please pass this message along to other interested persons or organizations (including activists in our neighboring states of IL and KS, if you have contacts there).

Mark your calendars! I hope to see you there.

Postpartum Reading List

As a follow-up to the presentation I gave at the FoMM retreat about "Planning for Postpartum," this is my list of suggested postpartum reading (for my annotated list, see here):

Suggested Reading—Postpartum

After the Baby’s Birth, by Robin Lim

Mother Nurture: A Mother’s Guide to Health in Body, Mind, & Intimate Relationships, by Rick & Jan Hanson

The Year After Childbirth, by Sheila Kitzinger

The Post-Pregnancy Handbook, by Sylvia Brown

Mothering the New Mother, by Sally Placksin

What Mothers Do: Especially When it Looks Like its Nothing, by Naomi Stadlen

Postpartum Memoirs:

Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood, by Naomi Wolf

Operating Instructions, by Anne Lamott

Let the Baby Drive: Navigating the Road of New Motherhood, by Lu Hanessian

Callie’s Tally: An Accounting of Baby’s First Year, [or, What My Daughter Owes Me], by Betsy Howie

The 2008 FoMM Family Retreat

Over 90 friends of Missouri Midwives enjoyed a weekend together at Pin Oak Camp in the Lake of the Ozarks State Park Sept. 12-14.  It was a terrific time!

Friday night, we had a bountiful potluck dinner and lots of time to visit with old and new friends.  And there were S'mores!  The campground had a great firepit encircled by benches and logs for sitting and visiting.  The fire was a highlight of the weekend, especially for the kids, and we managed to get by with very few burns.

Saturday was full of insightful sessions, a productive business meeting, lovely crafting.  We even managed to stay on track with our schedule so that we had quite a bit of free time!  

Our sessions on Saturday included Fathers and Home Birth (where the guys actually talked about birth... don't tell!); Mothers (with kids) and Midwives (crafting!); Planning for Postpartum; Preparing for a Hospital Birth; and Celebrating Birth with Exercise, Yoga, and Dance.

The weather on Saturday, though a bit muggy, was a wonderful change from the expected rain.  It did not begin to rain until Saturday night, and on Sunday morning most of us were thankful for our sweatshirts! 

In our business meetings, we passed 7 (Seven!) proposals and killed one (following a helpful discussion).  We also held elections.  Our new president is Samanda R., vice-president is Jen K., Secretary is Allison D., and Treasurer is Jessica K.  There has been tremendous growth in Friends of Missouri Midwives over the past year, and we are eagerly looking forward to the future.

Many thanks are deserved for bringing this weekend together - Samanda and David, who did an amazing job of pulling everything together; Brian, who cooked us terrific meals; Kolbi, who waited for the parks folks on Sunday afternoon; the presenters of various sessions; and all of the attendees, who pitched in and made everything work!

Here are some pictures from the weekend.  If you have some you would like to share, email them to admin@friendsofmomidwives.org, and they will be uploaded to the Picasa page.

If you attended the retreat, please add your thoughts in the Comments section.

Looking forward to next year already!

The Birth Survey is Here!

Well, the moment we have been waiting for has arrived. The Birth Survey project has launched nationwide. This is an exciting moment!

Here are all the details and information about how you can help from the CIMS Grassroots Advocates Committee:

The Birth Survey Now Available Nationwide!

For years, consumers have enthusiastically shared online reviews of movies, restaurants, products and services, but readily available information about maternity care providers and birth settings was nearly unattainable--but no longer. The Birth Survey is now available to all women in the US who have given birth in the last three years. Women can now give consumer reviews of doctors, midwives, hospitals, and birth centers, learn about the choices and birth experiences of others, and view data on hospital and birth center standard practices and intervention rates.

Thank you to all the tireless volunteers who have worked so hard since 2006 to make this project a reality. And thank you to all our new project ambassadors and friends who are helping to make the Transparency in Maternity Care Project: The Birth Survey a reality.

To help spread the word about The Birth Survey, please:

• Send E-mails out to your contacts encouraging them to take thesurvey (e-mail text provided at end of this message). Suggested language is provided below. An automated “Invite a Friend” email tool can be accessed here. Invite your friends with a personalized message!
• Post the downloadable web banners and buttons to The Birth Survey on your personal or organizational websites. Download these here.
• Add a link to The Birth Survey Project in your email signature and on your website.
• Distribute postcards inviting women to take The Birth Survey. These cards can be downloaded here and printed as needed or preprinted cards can be ordered from CIMS here. Preprinted materials are currently being printed and will be mailed out in about two weeks.
• Send Press Releases to local press outlets. Press releases will be sent out nationally on Monday morning 8/18. A pdf press release that can be used for distribution by anyone will be available here on Monday. We encourage those of you who have been trained as a Marketing Ambassador and have signed a MOU to request a customizable press release by e-mailing admin@thebirthsurvey.com. We will provide these ambassadors with a customizable press release in which their personal contact information can be added if they plan to act as a local press contact.
  

Thank you all for your support of this project. If you have questions please e-mail admin@thebirthsurvey.com.

Language for Distribution Below:

Longer Project Description for Distribution:

For years, consumers have enthusiastically shared online reviews of movies, restaurants, products and services, but readily available information about maternity care services was nearly unattainable—but no longer. The Coalition for Improving Maternity Services (CIMS) has developed www.TheBirthSurvey.com, a consumer feedback website where women provide information about the maternity care they received from specific doctors, midwives, hospitals, and birth centers. Families choosing where and with whom to birth can utilize this consumer feedback, along with data on hospital and birth center standard practices and intervention rates, to make more informed health care choices.

Have You Given Birth in the Last Three Years?

If so, take The Birth Survey and provide feedback on your doctor, midwife, birth center or hospital at www.TheBirthSurvey.com.

Help Spread the Word About The Birth Survey!

Forward this e-mail and download buttons, banners, and promo cards at www.thebirthsurvey.com. Are you interested in helping to get the word out about The Birth Survey in your community or working to obtain official facility level intervention rates? To get involved, contact us at info@thebirthsurvey.com.

Support this non-profit project by the Coalition for Improving Maternity Services (CIMS) by donating or becoming a member here and sign up for e-cims newsletter here.

For information visit www.thebirthsurvey.com or email info@thebirthsurvey.com.

Short Email Template for distribution:

Hi!

I found this great site, check out www.thebirthsurvey.com

The Birth Survey works by asking birthing women nationwide to provide feedback about their doctor, midwife, hospital, birth center or homebirth service. Responses are made available online free to other women who are deciding where and with whom to birth.

The Birth Survey is…

• FREE
• Available to women who have given birth in the US in the last three years
• Accessible online 24/7 at www.thebirthsurvey.com

Take the Birth Survey and provide feedback on your maternity care experience at www.thebirthsurvey.com. Help women in your community or around the US find quality providers and birth settings that are compatible with their needs and philosophies.

Help spread the word about The Birth Survey! Forward this e-mail and download buttons, banners, and promo cards at www.thebirthsurvey.com.

Support this non-profit project by the Coalition for Improving Maternity Services (CIMS) by donating or becoming a member at http://www.motherfriendly.org/online_contribution.php and sign up for e-cims newsletter at http://www.motherfriendly.org/e-cims.php

A Celebration of Legal Midwives in Missouri!

July 12, 2008 ~ St. James, Missouri

According to the Missouri Supreme Court, Certified Professional Midwives became legal to practice in Missouri on July 4, 2008.

It's a long story, beginning with a little word, "tocology" and ending with a historic Missouri Supreme Court decision that overturned a lower court's ruling. The Missouri Supreme Court stated that the physicians associations who sued the State over the new midwifery law (passed in 2007) had no right to be in court over this in the first place. So, the injunction that they had placed against the midwifery law in August of 2007 was thrown out, and the law stood as passed.

And Certified Professional Midwives became legal to practice in Missouri on the day we celebrate in honor of FREEDOM!

Since most people already had 4th of July plans, we had to postpone our statewide celebration a bit. (Actually, the St. Charles and St. Louis Friends of Missouri Midwives area chapters held celebrations the day the court ruling was handed down - June 24 - and a few days later at their usual monthly meetings.)

Our statewide celebration was planned rather last minute and the Nisbett's graciously offered their spacious home near Rolla.
Here are a few pictures from the Saturday afternoon party (July 12).

The Nisbett's have a dream yard for children...

Their house is really kid-friendly (and fun) as well.
All the kids had a blast!

Jesse and Emily (who take care of all of the accounting and web up-keep for Free the Midwives!) were at the party showing off their new little girl - Ellie.

Senator Mike Gibbons (President Pro Tem of the Missouri Senate)
showed up while we were eating lunch.
Here he is, chatting with folks in the kitchen.

After visiting for awhile and joining us for dessert, Senator Gibbons spoke to our group, congratulating us on the recent court ruling allowing professional midwives to practice freely and reminiscing about several funny incidents that happened at the Capitol, involving "the midwives." He said that every grassroots effort that he has seen in his 16 years as a legislator pales in comparison to the one that the midwives have put on at the Capitol.
Eventually he had to head off and hit the campaign trail again (for his Attorney General race).

Collene agreed to be MC for our afternoon program, which was mostly informal story-telling by those who had been involved in trying to legalize midwives in Missouri over the last thirty-some years.

Dr. David Stewart, Ph.D, and his wife, Lee, joined us for the day and spoke first. They told their story of having their first baby at home in Rolla without a midwife or a doctor in the 1960's, because there was no one to attend a homebirth at the time. They have been working to allow access to Missouri midwives and homebirth since 1967. David Stewart has written many books on the subject and is the founder of NAPSAC International (International Association of Parents and Professional for Safe Alternatives in Childbirth).

Keith and Kim Nisbett came next in the history as they moved to Missouri in the late 1980's and were shocked to find that they couldn't open the Yellow Pages and find a midwife. Keith told the story of writing up the first midwifery bill with their illegal midwife in their bedroom and taking it to the Capitol where he learned the legislative process over the next few years as the bill passed the House of Representatives many times. It was always blocked by a filibuster in the Senate, till families eventually burnt out and went home for a few years.

Margaret spoke next about Friends of Missouri Midwives organizing in the 1990's and deciding that a foundation of public education was necessary before success would ever be secured at the Capitol. (She's speaking way in the back in a white shirt in this picture.)

Then it was Debbie and Mary's turn to tell the story of how tocology really happened behind the scenes the day it was passed in the Senate.
Right in the middle of telling the tocology story, much to our surprise, we looked up and saw Senator Chris Koster (also a candidate for Attorney General, and a friend of ours at the Capitol) walk in! He took a seat and listened intently to all of the details that most of the legislators were never privy to hear about.
(Above, Chris Koster and Jonathan Smith listening.)

Then Collene told a touching story about the 2008 legislative session. She talked about how she was walking around the Capitol on one of the very last days, knowing that Senate Leadership was killing our bill behind the scenes.
She said that in desperation, she finally went into the little coffee room near the chamber and shut the door. She told us all how she had knelt down on the floor by the ice machine and cried out to God, "Why does this have to be so long and so hard and so painful? Why does our bill never pass? I've been coming to this place for 20 years and, God, you know how much I HATE it! I don't ever want to come back! Why can't our bill just pass?!"

She said that she stopped and thought about it before she said it, but then she ended her prayer with, "But I will come back if I must."

Then she recounted the last agonizing day of session and the feelings she had as she left the Capitol, tears stinging her eyes when, once again, our bill hadn't passed... not because it wasn't a good bill, not because it didn't have majority support or any other good reason. But simply because it was all about a few men who wanted to ensure their campaign donations in an election year. She had gone home and cried and wondered why things were so unjust.

And then she nearly brought the whole roomful to tears when she said, "And now I see why God didn't let that bill pass and gave us something better instead. Now I'm so happy that I didn't get what I asked for when I was crying in the little coffee room. Justice was served, and better than I could have imagined or asked for."

Afterwards, Senator Koster (above, speaking) added his own funny stories about "midwives in the Capitol".

... And then we posed for pictures!
Mary, Senator Koster, Debbie

Lastly, we all took a big group picture, and people began to head for home, feeling extremely thankful that midwifery had become legal in Missouri in a way that was far beyond anything we had ever imagined or hoped for. We also went away, realizing the gravity of the situation and the need for us to guard our new-found freedom vigilantly.

President's Editorial - Response from MANA President to Res. 205

President’s Editorial
July 11, 2008

Midwives Alliance of North America
611 Pennsylvania Avenue SE # 1700
Washington, DC
20003-4303

Contact:
Geradine Simkins
president@mana.org
888-923-MANA (6262)
info@mana.org
http://www.mana.org

Doctors Ignore Evidence,
AMA Seeks to Deny Women Choices in Childbirth

One wonders what process the American Medical Association (AMA) House of Delegates used to determine that “Resolution 205 on Home Deliveries” was a prudent and reasonable proposal to adopt. AMA Resolution 205 attempts to outlaw a woman’s choice to birth at home or in a freestanding birth center by calling for legislation to establish hospitals and hospital-based birth centers as the safest place for labor, delivery and postpartum recovery. Further, Resolution 205 seeks to establish that hospital-based midwives who work under the control of physicians are the only safe midwifery practitioners.

The Midwives Alliance of North America, which has represented the profession of midwifery since 1982 and whose members are specialists in homebirth, finds AMA’s Resolution 205 to be arrogant, patronizing and self-serving. We have three major objections to Resolution 2005. First, Resolution 205 patently ignores the vast body of scientific evidence that has documented homebirth to be a safe, cost-effective and satisfying option for women who prefer this alternative to hospital birth. Second, AMA Resolution 205 is seriously out-of-step with the ethical concept of patient autonomy in health care (encompassing both informed consent and informed refusal), which has gained widespread acceptance in the medical community. And third, Resolution 205 distracts from other critical issues in maternity care to which healthcare professionals should be giving substantial attention, including increasing access to care, improving perinatal outcomes, reducing health disparities and fostering client satisfaction. AMA Resolution 205 is anti-homebirth, anti-midwife, anti-choice and is unsupported by scientific evidence.

Why is the American Medical Association not asking the real questions instead of trying to debunk existing research evidence on the safety and efficacy of homebirth and attempting to corner the market on maternity care? For example, why are midwife-attended births far more likely to have fewer interventions, fewer postpartum infections, more successful breastfeeding rates, healthy infant weight gain and result in more satisfied, empowered mothers ready to embrace their newborns and parenting experiences? Why are so many women across the nation left emotionally traumatized by their childbirth experiences in hospitals and consequently why do rates of postpartum depression, anxiety and post-traumatic stress continue to escalate?

It is ironic that the AMA should have a quarrel with a known safe birth option such as homebirth at the same time when the epidemic rise in coerced or elective cesarean sections puts healthy mothers and infants at greater risk than normal vaginal birth and causes excess strain on the limited resources of our healthcare system. The rate of cesarean sections in the United States is unacceptable—one in three pregnancies end in major abdominal surgery—and the decline in availability of vaginal birth after cesarean (VBAC) is deplorable. It is unethical to expect that women and infants should continue to bear the brunt of increasing medical malpractice risks by over-treating them with obstetric technologies such as c-sections while denying them safe evidence-based options such as VBAC. It is past time that the AMA in collusion against homebirth with the American College of Obstetricians and Gynecologists (ACOG) realizes that women and their partners are choosing to labor and deliver at home and in freestanding birth centers to avoid ethically unsupported obstetric interventions.

Modern medical ethics have evolved to embrace autonomy—patient choices and patient rights—over medical recommendations based on paternalism or physician preference. In almost all areas of modern medicine, except obstetrics, the locus of control rests firmly with the client or patient and not with the medical provider. It is a commonly held principle that it is not appropriate to force medical treatment upon clients or patients against their will, including medications, blood transfusions, chemotherapy or even life-saving surgeries. Informed consent has appropriately become the gold standard in healthcare decision-making. Why then do the AMA and ACOG believe that they can promote legislative efforts to deny women choices in maternity care providers and childbirth settings? In the 21st century this concept is outdated and absurd.

The AMA and its members might consider using their considerable energy, intelligence and resources to focus on promoting the health and well-being of mothers and babies and devote less time to limiting women’s access to midwifery services. All maternity care providers should band together to reduce the unacceptably high rates of maternal and infant mortality and morbidity in the United States, increase access to maternity care for all women, reduce unnecessary cesarean sections, encourage vaginal birth and VBACs for healthy women, reduce health disparities of women and infants in minority populations, and promote increased breastfeeding. These challenging but attainable goals would improve the health of mothers and babies far more impressively than reducing the rates of homebirth.

The Midwives Alliance joins the other individuals and organizations, including individual AMA and ACOG members, who have grave concerns about the AMA taking the stand articulated in Resolution 205, and calls for the AMA to abandon this resolution. Midwives everywhere honor and respect the numerous friendly physicians with whom we already partner and look to the day when midwives and obstetricians will consistently work collaboratively to support women’s choices in childbirth and provide the best possible and most appropriate range of services for every situation.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
References

1. K.C. Johnson, B.A. Daviss, Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America, British Medical Journal 2005; 330: 1416 (18 June).
2. Royal College of Obstetricians and Gynaecologists and Royal College of Midwives Joint Statement No. 2, April 2007. See http://www.rcog.org.uk/index.asp?PageID=2023
3. Wiegers TA, Keirse MJ, Van der Zee J, Berghs GA. Outcome of planned home birth and planned hospital births in low risk pregnancies: prospective study in midwifery practices in the Netherlands. BMJ 1996; 313:1309–13.
4. Olsen O. Meta-analysis of the safety of the home birth. Birth 1997; 24:4–13.
5. Ogden J, Shaw A, Zander L. Deciding on a home birth: help and hindrances. Br J Midwifery 1997;5:212–15.
6. Canadian Institute for Health Research Giving Birth in Canada:
Regional Trends From 2001-2002 to 2005-2006.
http://secure.cihi.ca/cihiweb/en/downloads/Childbirth_AiB_FINAL_E.pdf
7. CMAJ Maternal mortality and severe morbidity associated with low-risk
planned Cesarean delivery versus planned vaginal delivery at term
http://www.cmaj.ca/cgi/reprint/176/4/455.pdf
8. Listening to Mothers II Report (2006.) Childbirth Connections,
http://www.childbirthconnection.org/article