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Monthly Archives: July 2013

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!

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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.