When Tim Armstrong, CEO of AOL, cited the cost of “distressed babies” as the reason for cutting 401K benefits to AOL employees, he created a media storm by blaming sick babies for poor corporate governance.  Armstrong cited the million dollar costs of caring for two premature babies as the reason for needing to change employee benefits, essentially outing the private health information of a few of its workers (possibly against HIPPA regulations). He put the mother of one of those babies in a position of defending her daughter’s life and honor, and their family’s sizeable use of the benefits package they pay for through AOL’s employee insurance program.

It is much easier to blame babies and the women who bear them than it is to shine a light on selfish corporate leadership and our bloated, inefficient, for-profit medical system that often works on the rationale of doing procedures “because it can” instead of establishing criteria for action “because it should or should not.”  Extreme incidences such as this mask the underlying problems inherent in our “can do” medical system’s approach to caring for those who are ill, and hold a special lens for viewing maternity care.

I have not yet in the media coverage of this story seen a reference to the question of whether or not a “micro-preemie,” born barely at the age of viability, should undergo extensive lifesaving measures.  Some would call the procedures necessary to keep a five-month fetus alive outside of the womb “heroic measures,” but others could call those procedures “torture.”  Numerous needle sticks in veins that are so small they are barely visible to the eye, tubes in the nostrils and down the throat for months on end, electrodes and monitors attached all over the body, kept in a plastic box to maintain body temperature because the baby is unable to do that on its own, attached to a ventilator because it cannot breathe on its own, fed through a tube threaded through its nostril and down into its belly into an underdeveloped gastric system which is at high risk for painful and deadly infection, being so fragile that it cannot be held or touched for months are just some of the “heroic” measures that micro-preemies endure.

In addition to the efforts made to save the fetus, the mother often undergoes a cesarean section; a major abdominal surgery that puts her at risk for complications and infections and can jeopardize her health in future pregnancies.

Furthermore, the micro-preemies that survive into early childhood often suffer from ongoing health problems, learning disabilities, and behavioral problems.  Sometimes these problems are relatively minor and children grow to become healthy, productive adults.  Sometimes though, these children do not fare as well and demand constant, high-level care throughout their lives.  There is no crystal ball to tell the future and know which outcome will occur.

It is truly a miracle of modern science that a baby can be born so early and survive, but the doctors who make the decisions in the Neonatal Intensive Care Unit are not the same doctors who continue to treat the life-long illnesses and deficits from which micro-preemies often suffer, and they are not the doctors guiding the mothers through future pregnancies where they are denied Vaginal Births After Cesareans (VBACs) or suffer complications from the previous cesarean.  Previous cesarean has been linked to infertility, and by using surgical means to attempt to save a fetus with a 1 in 3 chance of survival, doctors put in jeopardy the very thing the parents may desperately want if their premature baby dies – a chance for another baby.  Pushing the envelope of viability is really a grand experiment on human subjects that sometimes seems to focus more on whether or not the doctors and medical teams can create miracles of life in the moment, but doesn’t take a long view of what those lives might look like in the days, months, or years ahead.

A surgeon’s tool is surgery, so it is the prescribed course of action for many who are confronted with illness and seek help through our current medical system.  There are numerous unnecessary and unhelpful surgeries performed every year to provide “healing” from heart disease and back problems, as well as other maladies.  Based on our doctors’ advice, we are optimistic to a fault, believing we can prolong life and cheat death without truly understanding the odds in each healthcare situation, believing we will be the one with the winning lottery ticket and consoling ourselves when failure occurs that “at least we did everything possible to save a life.”  What this system denies is the possibility of a more compassionate acceptance of fate, and tragic though it may be, there can be such a thing as a good death.

Maternity care is particularly vulnerable to over-action and heroic measures because birth, by its very nature, is the entryway into life.  Our modern system of obstetrics in the United States uses numerous interventions and takes every precaution to ensure a healthy baby which, ironically, leads to the highest death rates of mothers and babies of any country in the industrialized world.  Countries that treat birth as a normal, healthy process intervene less and get better outcomes.  Often, the families that are receiving this over-medicalized care are not even given enough information to make care decisions based on informed consent, nor are they given true choice in the medical setting.  Blaming the women, and without question, blaming the babies for costly care is the epitome of shit rolling downhill.

All this care, optimism, and desire to cheat death – this attitude of “life at any cost” does cost us dearly.  Our inability to grapple with these issues ends up being very expensive, and truly does lead to “million dollar babies.”  I don’t have the answers for many of the questions these dilemmas raise.  What I might choose in a life or death situation would be very different from what you would choose, I am sure. There are no simple solutions.  It seems to me though, if doctors want to advance medical science through human experimentation the subjects should be fully informed and not have to pay for it, and if we truly believe as a society in “life at any cost,” that should extend to everyone and we shouldn’t gripe about it when it comes time to actually pay.

If AOL had planned for the rising costs associated with the rollout of the Affordable Care Act, which strives to provide everyone in our country with access to healthcare so they too might have a chance to cheat death, it would not have made the news.  If AOL leadership had respect for and appreciation of its employees to the point of reducing management’s salaries in favor of buffering these unusual and short-term costs of healthcare and retirement for its workers, it probably would not have made the news.  If it made an effort to improve the healthcare system in our country to one that is evidence-based, efficient and affordable, that probably would not have made the news either.  That bad behavior gets highlighted instead of examples of how to move equitable, affordable, high-quality healthcare forward for our country; that makes me “distressed.”

 

Michal Klau-Stevens is The Birth Lady.  She is a Lamaze Certified Childbirth Educator and expert on citizen childbirth issues.  Her website is TheBIrthLady.INFO.

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Publishing and publicity seminar photo

The pressure was on now.  She rose to speak, in a roomful of 50 strangers.  This was just the practice; the true test would come tomorrow when she actually would meet with ten professionals in the publishing field.  She would have three minutes to convince them that her book would be worth a second, more in-depth look to see if they could sell it to a publisher and the public.

The lives of women and children depend on her being able spread to a wide audience the words of her mission:  to change the maternity care system to one that supports the needs of mothers and babies.

Her hand shook as she took the microphone and she tried to modulate her voice to sound confident, yet relaxed and friendly.  She took a deep breath and began,

“Hello, my name is Michal Klau-Stevens.  I am the President Emeritus of BirthNetwork National, a nonprofit with fifty chapters around the country, and I am an expert on citizen maternity care issues.  The book I am writing is a business book geared towards anyone in business or government working on healthcare reform and corporate financing of healthcare.  It is called “Million Dollar Babies: Controlling the Billion Dollar Business Costs of Maternity to Save Money and Lives.

Businesses pay for almost half the births in this country for a system that is costly and leads to some of the worst outcomes in the industrialized world.  Obamacare is forcing coverage of maternity now, healthcare is bankrupting our country, and everyone is looking for solutions.  The midwifery model of care is the billion dollar answer, and nobody is talking about it.

The reason I think this book will sell is because I am a leader in the movement to promote evidence-based maternity care and with my position, public speaking skills, and connections to national midwifery and birth related organizations I can reach at least half a million people in the birth community with my message, and I’m actively reaching out to the business community now too.

How does this sound to you?”

She looked up to the stage, where her guru, the seminar leader, was standing illuminated in the spotlight.  “Very good,” he said.  People in the room were applauding.  Relief flooded into her body.  At least now she knew she was on the playing field, not outside the ballpark.  So much was riding on this day.

The next day she rose early, unable to sleep from the nervous excitement about the experience which lay ahead.  She dressed in her best businesslike clothes, so different from the jeans and crocs that are her usual uniform as a work-from-home pregnancy coach and birth advocate.  As she walked into the room full of people all jostling for the attention of the eight agents, one editor, and one hybrid publisher, she released her intention out to the universe.  “Just do your best,” she whispered to herself.

In speed-dating form, she met with agent after agent.  She had one minute to give her pitch, then two minutes to answer questions, give clarification, ask for and receive advice from experts in their field.  Her first pitch, with her number one pick to publish her book, was less than thrilled with what she had to offer.  “Maybe if you had a person in business or government writing with you it might work, but it’s not really our kind of book now.”  A disappointment, to be sure, but she picked up her head and moved on.

Meeting after meeting she offered her pitch to the agents.  Some of them felt that the market isn’t big enough, or her platform isn’t big enough, or they didn’t understand why she is writing a business book on a subject that only affects pregnant women.  Sometimes her pitch was right on the mark, and other times, when she varied it to appeal to something the agent had said earlier in the day, it lost its punch or she wandered away from key points.  Every interaction was a chance to learn something new about how to improve, to gain experience to be able to do this well.

Some of the agents understood right away what she was talking about, and saw potential in the market for a book with a new take on serious problem that our whole country is grappling with right now.  Those meetings buzzed with energy.

In the end, she finished the day with three agents interested in reading her full book proposal to learn more about her work.  It doesn’t mean the book will be published, but it is another step along the road in the right direction.

By evening, she felt the day had been a success.  She hadn’t caught the big fish she dreamed about, but she wasn’t walking away empty-handed either.  She had connected with people and was moving forward towards her goal of publishing a book in service to her mission.  Over the course of the seminar, people had approached her to say they felt she is doing important work and she should continue to try to get her book published.

She realized that this is the work of an activist; serving her mission by taking action, stretching her boundaries, and taking personal risks.  Speaking her truth, believing it will resonate with some, and accepting it will not resonate with all.  Hoping that others who hear her message will want to share it.  She showed up and did her best.

proposal pic on laptop

It has been my dream for the past four years to write a book that will activate American corporations to support evidence-based maternity care for healthy pregnancy, birth and breastfeeding.  Next month I am pitching my book proposal to a number of literary agents to see if any are interested in working with me to get my dream book published.  A big factor in whether they will see the proposal as a viable project is my “platform;” my ability to promote my book through existing relationships that I have with organizations and people in order to sell copies of the book.  I’m reaching out now to see what my platform actually looks like.

I often picture myself as a lone mother/activist working out of my kitchen in my sweaty workout clothes after a morning walk or run, no make-up on and munching on rice cakes while writing blog posts, answering emails, and participating in conference calls for BirthNetwork National and other organizations.  I write and talk about my ideas for maternity care and citizen involvement in transforming birth practices and I send them out into the ether of cyberspace.  Occasionally, I put on my fancy clothes and connect with other birth advocates at conferences, such as the CIMS Annual Forum and the Birth Activist Retreats, but those are oases in deserts of time spent working alone.  When I speak with other activists about the nature of our work, I often counsel, “Carry water, chop wood.  Do the daily work that needs to be done, and eventually the village will be built.”  Well, for the past eight years I have been carrying water and chopping wood, daily performing the tasks to speak out about the need for a maternity care system that supports the needs of mothers and babies to have healthy safe births.  Today I am picking my head up, and looking around to see how my village is coming along.

Inspired by Childbirth Connection’s “Blueprint for Action,” I want to address American corporations as stakeholders in maternity care who have the financial resources and clout to transform maternity care in this age of medical reform.  The book I am proposing is primarily geared towards Human Resources and Benefits managers and corporate financial executives, healthcare and medical industry managers, and government workers focused on healthcare.  It will also be of interest to birth professionals who promote evidence-based care.  It will outline the billions of dollars of costs savings and the positive impact on employee productivity and wellness of promoting evidence-based maternity care practices and family friendly programs in their businesses and in their communities.  To make the business case for promoting evidence-based care the book will utilize the abundant evidence that has been investigated, compiled, and published by organizations such as Childbirth Connection, CIMS, and Lamaze, as well as the individual authors, filmmakers, and bloggers who are part of our birth community.  It will shine a light on corporate programs that work and the resources that are already available in some communities such as birth centers, midwives, and birth networks and include many nonprofit organizations such as BirthNetwork National, ImprovingBirth, ICAN, Holistic Moms Network, La Leche League, Breastfeeding USA, and others.  It will also tell the stories of working mothers and fathers and how they are affected by corporate approaches to family needs.  The idea is to activate corporate awareness and spending to promote practices that achieve better outcomes because American businesses can save billions of dollars by doing so.  Hopefully, the fact that lives can saved will add to the appeal.

You can help me achieve my dream of writing this book and seeing it published by being a part of my platform.  Are you part of an organization that would invite me to speak about these ideas or my book at an event?  Does your organization have a publication, blog, newsletter or other outlet that would publish a book review, article by me, or post on the topic?  Would you post on your social media pages about the book when it is released?  Would you consider bulk purchasing copies of the book to distribute as gifts or incentives to your members or event attendees?  Are you a blogger who would publish a guest post by me or would write a book review or post?  Would you promote the book to your list? If you and I are friends on Facebook or LinkedIn would you share a post with your friends?

Let me know!  While your response would not be considered a formal contract or binding in any way, it would give me and the agents I will be speaking with an idea of the reach that I have going into the project.  Please leave a comment here on the blog or send me an email at Michal@thebirthlady.info and tell me what you or your organization might be willing to do to help me as I promote the book.  Tell me a little bit about your interest in the project, your organization, and your work.  Please include the size of the organization or the size of your readership, followers, or list, as that will be a key piece of information for the agents to know.

I’m excited and nervous to see what my village looks like and who visits it!  Your responses will let me know if my platform is a small life raft or the deck of ship that will sail me towards my dream of writing my book and seeing it published.  Either way, I will be blessed by connecting with others in service of my life mission.  Thank you for all of your support!

 

When businesses offer healthcare packages as benefits to their employees, they take on the responsibility of having a direct impact on the health and well-being of their employees through the programs they offer.  There will be lots of changes to our healthcare system in the coming years as more aspects of the Affordable Care Act come online, yet as long as corporations continue to offer employee healthcare as a benefit, they have an influence on the quality of care and how it is delivered.  As stakeholders in the healthcare system, businesses have a responsibility and a financial imperative to ensure that the healthcare access they offer through their insurance programs is going to lead to high-quality care with the healthiest outcomes at the lowest cost.  To do this, they may have to use their best business tools and skills to engage unlikely corporate partners in the healthcare field.

My husband’s company offers us several healthcare plans to choose from as part of his corporate benefits package.  We choose the plan that best suits our needs, but even that statement is somewhat laughable based on the choices that are made available to us.  In the decade that he has worked for this company, our costs of participating in this benefits package have more than doubled, while our coverage has diminished.  We went from paying $400 out-of-pocket for our first birth to over $1400 for our third, and they were six years apart.  (The first birth was with an epidural, and the second two were totally unmedicated, yet cost more than twice as much – crazy, right?)  Costs of childbirth education and a doula were not covered, yet both services have been shown to improve outcomes and reduce costs.  I had low-intervention births because I prepared in advance and demanded it from hospital staff, not because that type of care was freely offered.  The nearest birth center is an hour and a half away, and homebirth is not covered by our insurance.  Of course, to go outside of this system and pay for maternity care without insurance is even worse.  A relative who did that got slapped with a $10,000 hospital bill that will take years for her to pay off.  We are forced into expensive, poor quality care partially because that is what our employers provide to us as our choice.

The insurance company that manages these benefits is making record profits, but my husband’s company is certainly not getting a great deal from this arrangement, as it is paying more for the service, giving less to its employees, and paying for the poor outcomes both in healthcare bills and lower employee productivity.  The hospitals that provide care in the community where my husband’s corporation is located deliver non-evidence-based services that have a direct impact on the corporation’s bottom line.  Participation in this system contributes to infant and maternal mortality rates that are some of the worst in the industrialized world, and are putting a huge financial strain on our country’s economy.  At what point does it become fair to say that corporations, as major stakeholders in healthcare, have a responsibility to force change within the insurance, hospital, pharmaceutical, and medical industries because they have the resources and the clout to do it in a way that nonprofits and individuals can’t?  I think the time is now.

This means that, for an example, my husband’s employer would have to invest time and money into learning about optimal maternity care.  A good place to start is with Childbirth Connection’s report “2020 Vision for a High-Quality, High-Value Maternity Care System.” Next, they would work with insurance companies to develop benefits packages which offer high-quality, high-value care.  I’m sure there is an insurance company out there that would be happy to work with a Fortune 50 company to develop an innovative maternity care package that provides high-quality, evidence-based care at reasonable costs, with good profit margins because it utilizes lower-cost practitioners.  His company could go to the hospitals that serve its employees and work with them to institute midwifery programs, redesign labor rooms to be more conducive to low-intervention birth, and provide training for nurses, midwives, and doctors on collaborative, evidence-based care practices.  It could send its lobbyists to advocate for change in payment for healthcare and tort reform, as well as laws that limit the powers of the hospital, pharmaceutical, and medical industries to influence research and the practice of non-allopathic care while increasing access to midwives and birth centers through legislation.  Also, his employer could support community-based resources such as birth networks, independent birth centers, and nonprofits that provide information and services to expectant and new families, and steer employees towards healthier options through education and improved access.

Through the tools and skills of negotiation, leveraging business relationships, utilization of resources, and government and community engagement, corporations can play a major part in quickly changing the quality of our maternity care system.  It is in their best interest to do so, and it is their responsibility to do so.  As long as corporations continue to take on the role of healthcare payers, it is reasonable for society to expect a high level of corporate engagement in ensuring the system they are paying for produces good outcomes at reasonable cost.

We know our maternity care system is broken, and there are many steps that will need to be taken to fix it.  Our regulatory, legal, and compensation systems will need reform.  We need to change our education system so that we have enough midwives and doctors coming through the learning pipeline to manage all the births that take place every year in our country.  We need to ensure that the information these students are learning about birth is accurate, evidence-based, and clinically appropriate.  Research must be unbiased and include qualitative evidence so that the psychological and emotional aspects of birth are understood as well as the physical aspects.  Women must have physical and financial access to normal, physiologic birth in hospitals, birth centers, and at home, which means that midwives and birth centers must be legal and accessible in every state.  In order for these changes to happen, the infrastructure our current system will have to undergo drastic changes that will reduce the number of hospital beds and displace obstetricians, who are surgical specialists.  It is not enough for advocates of maternity care reform to demand change; we must also work together with the existing systems to find creative, workable solutions which focus on having healthy women and babies as the primary result.

Evidence shows that midwifery care outside of the hospital setting provides comparable outcomes for babies and improved outcomes for mothers at much lower cost than hospital birth.  That is causing competition to grow with doctors, Certified Nurse Midwives, and hospitals, many of which are educational institutions, on one side and Certified Professional Midwives and independent birth centers on the other.  From a fiscal point of view, this is a David vs. Goliath fight.  Billions of dollars flow through the hospitals systems, while birth centers are small, independent businesses.  According to Salary.com, Obstetricians are paid a median income of $251,374, while Certified Nurse Midwives are paid $92,115, and SimplyHired.com puts the annual salary for Certified Professional Midwives at $50,000.  “Big Birth” is trying to eliminate its smaller competitors to maintain market share, even while the evidence and financials support the benefits of utilizing less costly practitioners.

Viewed through a lens of improving outcomes though, opportunities exist that might satisfy both sides.  Reducing malpractice cost is a primary concern, because that is what is driving the maternity care system currently.  Obstetricians can pay between $85,000 and $200,000 for malpractice insurance.  Rising payouts for non-economic damages and punitive damages drive the malpractice rates to dizzying levels.  The problem is that sick babies are expensive to care for, and even when doctors and hospitals are not at fault for poor outcomes, they have the deep pockets to cover the costs of ongoing care.  Many years ago, Suzanne Arms, an advocate for maternity care reform, suggested creating a superfund that would be used to support children born with birth defects, genetic illnesses, and other poor outcomes that are not due to negligence but are financially overwhelming to parents.  Having an option to care for sick children that is not tied to the legal system would go far in reducing the pressure on doctors and hospitals to provide perfect results in an imperfect world.  Implementing such a plan today would break the stranglehold that risk management has over giving appropriate care to pregnant women.

Furthermore, a common practice now is for hospitals to build new wings to accommodate more labor and delivery beds that accommodate patients who have Cesareans.  This creates the revolving problem of having more beds, so they need to be filled to pay for them.  Why not purchase or rent nearby existing buildings that could be converted into freestanding birth centers to accommodate the low-risk birthing women?  This would free the in-hospital beds for the small percentage of women who truly need to have surgical births, while offering the more appropriate level and style of care that most birthing women need.  These “flex spaces” would allow for changes in the needs of the community in terms of numbers of beds as populations ebb and flow.  More out-of-hospital births that are still connected with learning institutions would provide more opportunities for medical and midwifery students to learn about and research normal, physiologic birth in a way that they are not able to do now in hospitals.  Also, they would provide more access to safe, appropriate, cost-effective care to birthing women.  These freestanding birth centers that employ a mix of obstetricians, CNMs and CPMs would be models for collaborative care.

We know that money is major factor that drives decision-making, but outcomes must also be at the top of our list of priorities.  Right now, our outcomes are terrible – in fact, they are some of the worst in the industrialized world.  It is time that all the elements in the system work cooperatively to take steps to change this broken system.  There will be mid-points where compromise will be necessary on all sides, and the groups with less money and fewer, less influential voices must be allowed an equal seat at the table.  There are many bright, motivated people working to improve care for birthing women and babies, and there are many opportunities to employ creative solutions to the vexing problems within our maternity care system.

I returned yesterday from the Where’s My Midwife?’s 2nd Annual Birth Activist Retreat, which took place at the beautiful Snowbird Resort outside of Salt Lake City, Utah.  Of course, the beautiful surroundings took a back seat to the high-level strategizing and learning that was taking place in the conference center as around 40 birth activists gathered to advance the citizens’ movement to improve maternity care in the United States.

The group included leaders and members of organizations, such as BirthNetwork National, ImprovingBirth.Org, Where’s My Midwife?, BOLD, MEAC, Empowering Birth Awareness Week, Uzazi Village, Birthing the Future, and more.  Bloggers from the sites The Feminist Breeder, Plus-Size Mommy Memoirs, Portland MamaBaby, Human Rights in Childbirth, and Evidence Based Birth were in attendance.  Others in the group were birth workers and independent activists who want to participate in collective action.

The speakers were top-notch, hitting on a number of important topics. Major themes that ran through the speeches and through conversations included:

  • The violence and trauma that we experience as part of our maternity care system today, and how it is now being viewed as a violation of human rights
  • Finding areas of unity within our diverse network of organizations, missions, and beliefs
  • The need to increase the racial and cultural diversity of the movement for greater understanding within our network, and greater impact on our cause
  • Learning tools and frameworks to work efficiently and maximize our impact
  • Monetizing the movement, and birth work in general, to “step into our worth,” and recognize the value of the work we do so that others will recognize it too

Every person in the room had stories of abuse that they had either personally experienced or had witnessed in maternity care settings.  They ran from blatant failure to provide informed consent, to disregarding the wishes of laboring women, to physical assaults such as cutting episiotomies without consent, using a vacuum extractor on a baby without consent, and performing cesarean surgery without consent.

What does that look like?  Picture in your mind, a doctor saying that his on-call time is almost over so it’s time to get this birth done and over with, while a woman is being wheeled into an operating room, screaming that she can push the baby out and she does not consent to surgery.  While the doctor is in the hallway trying to convince the husband to consent to the surgery, the woman pushes the baby out onto the bed while she is in the operating room with the anesthesiologist.  The woman is traumatized and suffers PTSD, the husband is traumatized by being powerless to protect his wife and by missing the birth of his child, the doula is traumatized by witnessing the abuse and being powerless to stop it, and the doctors, nurses, and hospital staff are affected by working in a system that fosters this type of behavior.

This is a true story.  It is not the first time any of us had heard a story like it.  In fact, each of us in the room had participated in stories like it, and had helped our fellow birth workers process through similar events.  We know that every woman giving birth can fall prey to this type of abuse while engaging with the current maternity care system because it happens daily in hospitals and caregiver’s offices around the country.  Almost every speaker at the Retreat started her or his speech with a story about violence in childbirth and the need to protect the empowering nature of birth as being the catalyst for our work.  For many of us in the room, the fire of our activism was ignited because of these experiences.  These abuses simply cannot continue, and we feel compelled to do everything in our power to stop them.

To change our maternity care system, activists are developing programs and events to raise awareness and empower action.  Uzazi Village serves low-income women in the urban core in Kansas City by teaching and providing services to support healthy birth, breastfeeding, and parenting and will act as a model for such villages in cities across the country.  Rallies to Improve Birth will happen on Labor Day in over 150 cities along with movie screening and performances of the play “Birth.” Empowering Birth Awareness Week offers activists the opportunity to focus and unite during one week in September to amplify their messages.  Activists can utilize BOLD classes to enhance skills to affect change.  Women and birth workers can download printouts about the evidence basis of common birth interventions at Evidence Based Birth.  Lawyers who have a passion for issues surrounding birth can get active through Human Rights In Childbirth.  BirthNetwork National focuses on community organizing through growing chapters where all the stakeholders involved can come together to problem-solve, and the activities of many of these other activists in the network of the greater birth movement can be done through those local community groups.

Being an activist is challenging, isolating work.  We all felt renewed by coming together and “refilling our activist cups.”  That renewal allows us to move forward with our important work.

Learn about these organizations and activities and participate!

The organizers of this amazing event put their personal finances on the line to make it happen, and it did not break even.  Please consider making a donation to help defray the costs so they can make sure there will be a 3rd Annual Birth Activist Retreat next year!

This Friday I will be traveling to participate in The Second Annual Birth Activist Retreat, Friday, July 26- Sunday, July 28, 2013 at Snowbird Resort near Salt Lake City, Utah.

 

I will be speaking on Sunday about “Adopting a Network Mind-Set to Become a Force for Good,” utilizing concepts from the book Forces for Good: Six Practices of High-Impact Nonprofits by Leslie R. Crutchfield and Heather McLeod Grant to show how the individuals and organizations involved in the birth community can use proven methods to work together to grow a movement to improve birth in America.  We are implementing many of these concepts in our leadership of BirthNetwork National as we work to harness the power of our network, and we are working outside of our network to increase impact throughout the whole birth community.  These concepts are powerful tools for your activist toolkit that can transform the way you go about working with others to change maternity care.

 

Joining me as speakers are Suzanne Arms from Birthing the FutureDawn Thompson and  Cristen Pascucci from Improving BirthKaren Brody from BOLD, Gina Crosley-Corcoran from The Feminist BreederJanuary Harshe from Birth Without Fear,  Kate DonahueDavid Paxon and Kirsti Kreutzer and Anna Van Wagoner form Where’s My Midwife?, alongside birth activists from all over North America!

 

Where’s My Midwife? says, “The retreat is a time for activists to come together, inspire one another and get to work on affecting change in their own communities and the nation at large. We will plan nationally coordinated actions and build skills that every birth activist needs. We will share success stories and you will have opportunities to receive feedback on your own unique local birth issues as you network with other activists.”

I hope you will join us, either in person or via live-streaming, at this event geared for birth activists.  Being an activist can be frustrating, isolating hard work.  There is very little that is more exciting and fulfilling than coming together with like-minded people who “fill your cup” and inspire you to keep moving forward to achieve your goals.

For more information or to register for the retreat go to www.wheresmymidwife.org.

Do you remember the uproar that created the dolphin-safe tuna movement?  People discovered that fishermen, with nets trawling the ocean searching for tuna, captured and killed whole pods of dolphins.  Nets, as big as two kilometers long and two hundred feet deep, were used to encircle schools of tuna.  Once the tuna were surrounded in the net, the bottom was pulled tight, and the catch was hauled onto the boat.  The practice is still continued today, with about 60% of tuna being caught by this method.  It turns out many different species of marine life are caught in those giant nets.  It is called “bycatch.”  It is the unintended consequence of the business of industrial tuna fishing, and it kills hundreds of thousands of non-targeted sea animals, including endangered sea turtles, sharks, barracuda, and a number of other species.

Every time I read about the anti-abortion legislation being passed in states around our country I think about the dolphins and other majestic creatures that die in those giant nets as bycatch.  I think about them because to me they represent the collateral damage of a sweeping, indiscriminate practice that is wasteful and damaging, and that is how I see this legislation.

If the reproductive rights movement was viewed on a spectrum, one end would be those fighting for access to birth control and abortion, and at the other end would be those of us who are demanding access to optimal maternity care for women so they can have their babies in a safe and healthy way.  As an advocate for healthy birth, I am at the forefront of a movement that involves reproductive rights, and I fight for women who have made the decision to follow through with their pregnancies.

I have experienced the unintended consequences of anti-abortion legislation, including limited access to healthcare and polarized community.  The birth-related organization I work for decided to remove the tagline, “It’s your birth.  Know your options,”   that we used for marketing because I and several other chapter leaders reported being confronted at events on several occasions by angry people who thought the word “options” referred to abortion.  How many women did not approach our booths to get information about healthy birth and breastfeeding because they mistook our mission?  A woman I know who desperately wanted another child had to wait to miscarry a pregnancy that was not viable (no heartbeat was detected) because she was in a place that did not allow “abortions” and they would not do a D&C.

The whole idea of “personhood” seems to put the needs of fetus before the needs of the already living, breathing mother.  Both anti-abortion and personhood legislation seem to make it acceptable to view the mother as simply a vessel for growing life; an incubator that has no need for healthcare, human rights, personal autonomy, or bodily integrity.  Every woman who is denied a VBAC (vaginal birth after cesarean) because the risks to the baby may be slightly greater than a repeat cesarean, regardless of the fact that cesarean surgery exposes the mother to serious risk, is affected by this attitude.  Women who live in places where women are denied homebirth with a qualified birth attendant are victims of the same philosophy.  A friend of mine who moved to North Carolina had to go through the “underground railroad,” sending carefully coded emails and having furtive phone conversations to find a homebirth midwife who would attend her.  She felt a homebirth was a safer choice for her than a hospital birth because of all the unnecessary interventions to which she would be subjected in the name of ensuring a “healthy baby,” even at the sacrifice of her own health.  And heaven help the women who attempt a home birth but need to transfer to a hospital and are seen as criminals and undergo investigations by child protective services or are arrested for child endangerment.

Women have been carried out of their homes in shackles while in labor and forced to undergo cesarean surgeries.  This video by the National Advocates for Pregnant Women describes incidents where pregnant women, some of whom are anti-abortion, were denied their rights in order to protect the rights of the fetuses they were carrying.  While this video focuses on personhood legislation, what we are seeing with much of the current anti-abortion legislation which is closing down clinics is that women will have less access to all kinds of healthcare, including well woman exams, cancer screenings, and STD and HIV screening.

The other type of anti-abortion legislation that has unintended consequences for women who want to be pregnant involves mandatory ultrasound.  I have already heard stories of women who have found out that their babies suffered from genetic defects that are incompatible with life or who died in utero who had to endure mandatory vaginal ultrasounds before undergoing medically necessary abortions.  How much more pain and grief must these women suffer?

These laws being enacted are just like those giant fishing nets, catching their target but also capturing women who are pregnant and have very different needs than those of the women the laws seek to thwart.  Yet, women’s reproductive health runs along the full spectrum, and all women need individualized care.  Each woman has a different story, different needs, different circumstances, and different health concerns.  Women need to make these healthcare decisions with their doctors and have access to the full package of reproductive healthcare in order to remain healthy.  Legislation is too broad and general to adequately answer women’s healthcare needs when it comes to pregnancy.  It is wasteful and damaging, and produces too much bycatch in the form of personal pain and suffering for individual women and societal damage because so many women are unintentionally caught up in the sweeping net.

One step that pregnant women can take towards making sure their care provider is familiar with the latest evidence-based maternity practices is to give their doctor or midwife a copy of the book “Optimal Care in Childbirth,” by Henci Goer and Amy Romano.  Every maternity care provider should read this book, and keep it handy as a reference.  Women might want to keep a copy for themselves too.  Giving this book to your doctor or midwife sends a strong message that you value and expect to receive evidence-based maternity care and that you are savvy enough and motivated enough to seek out the evidence basis of their practice.

This book is not an easy read, nor is it intended as a reference for expectant women.  Instead of “what to expect…” this book is full of detailed scientific evidence about the care birthing women should be given and uses the physiologic, or the normal natural physical process of birth as the basis of care.  Authored by a medical writer and acknowledged expert in evidence-based maternity care and a research expert/midwife, “Optimal Care in Childbirth” gives thorough analyses of current medical maternity practices and the evidence that supports or refutes their use.  It also provides strategies for optimal care and mini-reviews of the evidence, and leaves no stone unturned with respect to the scientific basis for cesarean surgery, induction of labor, augmentation of labor, positioning for labor and birth, care after birth, newborn practices, and more.

I have heard doctors and midwives complain that it is hard to keep up with the research because they are so busy delivering babies.  I have also seen that “silos” exist, where doctors only read journals in their specialty, and miss out on the research that is conducted in related fields, such as midwifery, nursing, and childbirth education.  This book captures research from many sources and packages it in a manner that is portable and easy to share with others.  The mini-reviews provide quick reference points for decision-making in non-emergency situations.

The book costs $50, and by giving it as a gift to your doctor or midwife the message it sends is priceless:  receiving evidence-based maternity care matters to you and you are willing to invest your time and your money in order to get it.

Do they already have a copy?  Suggest they re-gift it to another doctor or midwife in the practice, or to the nurse’s station on the labor and delivery floor of the hospital, or to a nurse, or a hospital administrator, or…

 

Goer, H. and Romano, A. (2012). Opimal Care In Childbirth:  The Case For a Physiologic Approach. Seattle, WA: Classic Day Publishing.

Available on Amazon.com

This is an unsolicited review and I receive no compensation for posting it.