The site crashed a while back and nothing restored properly. I’m working on it. If you want to help build YOUR state resources, I have 10-12 links I need on each state. Feel free to email me: director at birthaction.org or contact me on Facebook!
I have had some fantastic help from a few sources and much of the website content is being restored. I’m so relieved! I can’t always retrieve comments left in the past but the site itself is here!
In a discussion this morning, I came to the thought that every time I hear birth workers talk about lack of options, something bugs me.
Oh yeah, it’s that it’s our fault to begin with. Ours. Not “hers” or “The OBs” or the “Midwife Down the Street”s fault.
It’s my fault. I am taking responsibility for my pieces in it.
If you are a CNM in a birth center who turns away VBACs “because”
If you are a licensed midwife who turns away breech mothers “because”
If you a mom who gives into induction “because”
If you are currently a woman on this planet who has a pap smear every year just “because”
If you are a woman who let someone take your baby to another room after birth just “because”
If you are a doctor who induces women because of fear
If you believe not doing VBAC protects you from the natural consequences of being a pregnancy-related practitioner
If you are a doctor who does cesareans for breech rather than discussing risks and allowing the woman to decide…
yes, YOU bear responsibility in this.
So what are you going to do about it? When are you going to start taking responsibility for not changing it?
I saw this recently and felt it was worth posting. If you have concerns about your midwife using O2 or if you feel your baby has other issues resulting from hospital or homebirth use of O2, this may help you to understand why those concerns may be valid:
His accent can be a bit heavy: Dr Sola on Neonatal Dangers of Too Much Oxygen via PatientSafetyMovemnt on YouTube
“The issue that we have all been taught this for decades and that medical schools still haven’t changed the teaching. Because hyperoxia is as bad as hypoxia and that’s where we got involved. So I can tell you that hyperoxia can lead to all sorts of mental disabilities, associated. Associated 3 minutes of oxygen, pure oxygen in delivery room has been associated in 2 large studies, one from Sweden, and the other one from the United States, with cancer in childhood. Oxygen changes our genome, oxygen in excess. DNA, endocrine function, interestingly enough, cardiac function is decreased by too much oxygen. (Editor: Unidentified syndrome At :45), cerebral palsy, has been associated with too much oxygen. And actually, some people say that actually what we have done with our hands (he reaches out and turns his wrist like turning a knob), people talk about out of our hands, and has been studied, possibly inappropriately in animal studies or even in baby studies, is not the problem there was with hypoxia but is the treatment that we give, increase perfusion and give much more oxygen to all the system. “
and please take the time to go watch his entire commentary on the panel, it’s worth watching:
And in light of the recent changes back toward appropriate physiological cord closure, we need to remember that a baby’s perfusion initially is from the placenta, through the cord and that when they are born, compromising THIS “scuba tank” of oxygenated blood by cutting the cord in a baby who is DESIGNED for lower oxygen levels in the first few minutes and is transitioning to room air which is NOT 100% oxygen, is leaving that little diver without air.
In honor of Pregnancy and Infant Loss Remembrance Day, October 15:
Surviving Loss: Defining Your Triggers
A deeply bereaved friend of mine is describing on her blog how losing her son has changed her very existence. She, along with so many other mothers, experience loss. Reading their pain causes your eyes to well with tears. You cannot imagine, you hug your children a little tighter. You can glimpse for a moment what your life would be like if your living children suddenly weren’t, if your little person in your arms was suddenly gone or if the life inside you never becomes that laughing child you dream of. The ache terrifies you and you shut that off into a space far away.
Or, you live with the acknowledgement of that ache. Of knowing that little life for so little time. Of feeling that loss. The cloud passes your eyes and shadows your soul and for a moment, you are lost inside of yourself, remembering.
This post is for you.
In watching Samantha talk about Bram, I realized that so many of us don’t talk about loss in a real way or tell people how we really feel. We walk around protecting them from the truth because the truth would rip us apart and leave us simply screaming and rending our hair and rejecting our loss while keening on a sidewalk in some public place because we cannot take this One.More.Minute.Give.Them.Back! Because every little thing seems to be a trigger for some and so many things are a comfort for others, I wanted to say this:
Define your triggers. Tell people. Not just “don’t ever say this to a mother” but “these are things I cannot take right now in my grief.” It should be passed out at the services, posted on your facebook, dropped on your blog, imo. Let people know “THIS” hurts me.
It can be a short list, a long list, a paragraph or 2 words or a sentence. But let people know because they need to know. Not just for you, but for them. One day, they will stand here in this space of loss and knowing that it’s safe to say, safe to hear “I can’t talk about that right now, I can’t do that right now. Tell me XYZ” really helps Telling me XYZ simply hurts.” As simple as “Please don’t tell me God has a plan. Please feel free to say you are sorry for our loss. Please feel free to stand nearby and love me. Please feel free to bring food. Please clean the house and the bathrooms. Please don’t tell me you are doing it.” or as complicated as a full page of phrases that drive you crazy right now. You can always change your mind later, it’s okay, you are in mourning and grieving changes every day.
Defining your triggers also might give you space to help sort through some of your own emotions as well. There are so many complexities to grief and sometimes, we have to listen to them in order to let go or make changes in how we do things to protect ourselves for a little while. If noises, sounds, smells, locations set off deep grieving, it may give you the chance to really sit down and think of ways to avoid them until you are ready to come back and deal with them in small ways, little by little.
Grief is not something you get over but defining these things might help you and those you love to move past moments that hurt without need.
In honor of National Pregnancy and Infant Loss Week, I wanted to share that I recently wrote for the medical records from the pregnancies I lost, asking for the blood test results and ultrasound reports. I decided that I wanted the tangible evidence of those losses. There is often no way to mourn someone without pictures, without a story, without other records. We have only the hopes and dreams for those babies to carry forward, knowing that when we are gone, they are gone, because they only lived within us.
Tell your stories, write your dreams down, record your babies dates. Leave tangible evidence that feels appropriate to you so that future generations might know of these lives that have spent such a short time here with us.
As birth happens, as a part of the greater part of the continuum that is life, death will occur. It will find us. It will always be a part of things.
Take pictures. keep a lock of hair, have a ceremony, celebrate the birthday, share the names, share the love. Find ways to hold in your heart the beauty of your little one.
For years, I have been told that I am too passionate, too aggressive, to much a defender of women’s choices in birth. I am told that I am for mothers and babies above all occupations and that I defend their rights to choice and autonomy. The midwives often are angered by my words towards them and obstetricians may not know my name but many women have used my words to change their care.
I believe in choice. I believe in autonomy in birth. I believe in the intelligence of women to make informed choices with discernment for information. I believe they are adults who can and should make their own decisions. I’m so conservative, my car leans a little right.
And I believe in accountability. Accountability for women, accountability for consequences and responsibilities. I believe in accountability for care providers.
Accountability, not retribution.
My recent post about Rowan Bailey has sparked some lively defense of women in various places without actually addressing what I said at all, which is the point, after all. A baby died and therefore, someone must suffer as much as the mother did in losing her child. Isn’t this the basis of ALL maternity care actions in the US right now? Fear of litigation and lawsuits?
When a physician is a part of a birth where a mother loses her baby, immediately, the hospital goes into action. There is a review. Legal is called. Everyone goes over it with a fine tooth comb and there are settlements, things are “done” to protect the hospital and the doctor involved. The review is done to determine whether or not the physician is at fault or is at risk of being SEEN as at fault. If it goes to lawyers and possible litigation, settlements are once again made and the records sealed. No District Attorney or State Attorney shows up to accuse anyone of murder. There are even systems in place with “expert” witnesses whose sole job is to defend the status quo of health care in the US despite our knowledge that it’s non-evidence and non-standard of health-care and despite the rising maternal morbidity and mortality rates. They get the lawsuits settled, the lawyers get their money, the physicians go back to work. There is very little decision making on the part of the parents and the mother is treated like a mindless idiot who had no knowledge that she had choices to make or that she could have declined care. In fact, much is made of how she was actually told she couldn’t make other decisions or that her doctor or hospital will drop her care, treat her badly or that they should have done “more” to prevent whatever occurred. It’s treated by the state as a personal contract dispute between a woman and her physician and her lawyer almost always wins. This is why physicians treat women and babies defensively, btw, this fear of the malpractice lawsuit/settlement/rates being raised/losing their practice via exorbitant cost.
When a midwife attends a birth wherein a baby dies, she is investigated by the state and/or prosecuted. She has given the mother informed consent, she has allowed the mother time to consider, she has not taken control of the mother and “made” her do anything, not coerced her or forced her…if she’s a even halfway decent midwife and yes, I’m aware there are many out there who are now following the above “medical model” of midwifery and being more like physicians in how they care for women. In doing so, she becomes responsible to only one person, the mother. And so, when something goes wrong, instead of discussions of accountability and review of the process by those who are knowledgeable in normal birth and sympathetic to the mother’s loss, the state steps in, still assuming that this woman has no ability to have made decisions for herself and that she is simply a hapless victim in all of this and that by virtue of the fact that a midwife is not an obstetrician, she is wholly and 100% at fault for simply not being in a hospital. There is no accountability and no justice for the mother or for the midwife, this is treated like a public health crisis wherein we should all be protected by rogue midwives who are a threat to every woman.
Rowan’s case highlights that this doesn’t work as a system. Rowan had choices to make, she made them. As did the mother. And a baby died. There is accountability to be had here, on both sides, and lessons to be learned.
I believe in accountability and I feel that Rowan did not walk into the situation blind. She knew the repercussions of helping to serve mothers in a state antagonistic to normal midwifery and personal accountability in birth. Accountability comes from having appropriate charges match appropriate actions. Murder in this case would have to be the willful, deliberate and premeditated act of killing a baby. If you want to hold Rowan accountable for decisions she made, that is up to state law. If you want to hold her accountable for bad decisions she made, that is up to state law as well. As we well know, laws change as people think more about appropriate ways to handle situations. I think the above example of a physician’s responsibility in a baby death and the difference for ANY OTHER MATERNITY SERVICE PROVIDER who is outside of a hospital highlights that we are not trying to exact accountability, safety or responsibility in accusing midwives of murder. It’s retribution for being outside the approved system of obstetrical care. Support holding people accountable. Support changing laws if that’s what is applicable here. Don’t support arbitrary and retributory actions in the guise of a legal system. In the end, it hurts mothers who make choices outside the system, just as much as it hurts midwives who make choices outside the system.
North Carolina’s statute on murder:
§ 14-17. Murder in the first and second degree defined; punishment.
A murder which shall be perpetrated by means of poison, lying in wait, imprisonment, starving, torture, or by any other kind of willful, deliberate, and premeditated killing, or which shall be committed in the perpetration or attempted perpetration of any arson, rape or a sex offense, robbery, kidnapping, burglary, or other felony committed or attempted with the use of a deadly weapon shall be deemed to be murder in the first degree, a Class A felony, and any person who commits such murder shall be punished with death or imprisonment in the State’s prison for life without parole as the court shall determine pursuant to G.S. 15A-2000, except that any such person who was under 17 years of age at the time of the murder shall be punished with imprisonment in the State’s prison for life without parole. Provided, however, any person under the age of 17 who commits murder in the first degree while serving a prison sentence imposed for a prior murder or while on escape from a prison sentence imposed for a prior murder shall be punished with death or imprisonment in the State’s prison for life without parole as the court shall determine pursuant to G.S. 15A-2000. All other kinds of murder, including that which shall be proximately caused by the unlawful distribution of opium or any synthetic or natural salt, compound, derivative, or preparation of opium, or cocaine or other substance described in G.S. 90-90(1)d., when the ingestion of such substance causes the death of the user, shall be deemed murder in the second degree, and any person who commits such murder shall be punished as a Class B2 felon. (1893, cc. 85, 281; Rev., s. 3631; C.S., s. 4200; 1949, c. 299, s. 1; 1973, c. 1201, s. 1; 1977, c. 406, s. 1; 1979, c. 682, s. 6; 1979, c. 760, s. 5; 1979, 2nd Sess., c. 1251, ss. 1, 2; 1981, c. 662, s. 1; 1987, c. 693; 1989, c. 694; 1993, c. 539, s. 112; 1994, Ex. Sess., c. 21, s. 1; c. 22, s. 4; c. 24, s. 14(c); 1997-456, s. 27.)
By Shannon Mitchell
Today I had a conversation that left me cold.
We all know the story of the midwives, the ones who have been arrested, who are being investigated, who had a bad outcome and now the state has noticed or the parents are upset. It happens. It’s inevitable. All midwives will eventually face this moment in some form.
This conversation today was different. I had to openly discard my humanity and step out of the thought box that allows me to feel protected.
It goes beyond “it could never happen to me”. It goes beyond, “there must have been more to the story.” It goes beyond “well, what was really going on in that situation. And I know that it goes beyond our good intentions that we meant to send money or we don’t have enough to help or even why should I help someone I distrust.
The reality is that if Rowan Bailey is found guilty of murder in North Carolina, then a precedent will be set that a death in a midwife attended birth was found to be WILLFUL murder of a baby.
Don’t talk to me about “But she wasn’t legal” because we all know that midwives hedge their bets on legal. They all do some small thing that is maybe crossing a line or helping someone they shouldn’t “legally” because frankly, the legal system is full of discrimination against healthy women and we all know it.
Don’t talk to me about the ramifications of fetal personhood because it’s clouding the issue here. Dwell on your thoughts of the evils of the issue after we’ve fought this case.
If you don’t send money to Rowan’s defense, if you don’t travel to show a tour de force that midwifery attendance at a birth is not willful murder, if you don’t react in some way to this case that goes beyond sitting on a couch and speculating, then don’t be surprised when it’s you and you are alone and ostracized, no matter your intentions on legal, no matter your intentions or vocation or grace.
Because one day it will be and you had better hope that as you are looking into that mourning woman’s grieving and confused eyes and try to help her to comprehend her loss that there isn’t some DA behind her who is willing to call you a murderer.
Rowan may indeed be guilty of any number of things in this life. Her life, her intentions, her training, her abilities will all be drawn into question.
That doesn’t make her guilty of murder.
Murder is premeditation, it’s intent to kill, it’s intentional destruction of human life and that is NOT what happened here.
Get off your collective asses, get your ostrich heads out of your sandbox where you feel protected and realize the ramifications of this on all midwives.
And do something to help.
And if after reading this, you still don’t think it applies to YOU or you can’t overcome your vicious distrust of the “what really happened”…I want you to stand in front of your child, your husband or your grandchild or the kids at your church or your mother or your father. Pick any person you respect and admire and slowly say the words out loud “They are charging me with deliberately murdering a baby”. Let that roll off your tongue. Let it seep into your soul. And realize that this is what they are doing to another human being.
If you are a midwife, you have lost the right to be apathetic.
I have so much I want to say about the Trust Birth Conference in Sydney, Australia but before I do…I want one post to reflect the reality of homebirth, homebirth bias and the damage that medical care and obstetrical control has done to motherhood and birthing.
Since I heard these words, my brain has spun. I hear it over and over and it rings with me and there is a level of heartbreak over it that I do not know how to respond to. If you want the truth about our “system”, here it is…
If you have a baby in a hospital and it dies before or after birth, pictures will be taken, the staff will try to treat you well, it’s obviously a foregone “this had to happen” thing wherein you will be given resources, even if they are sometimes stilted and ignorant. People will try to understand. They will try to comfort you or look on you in your mourning with sadness and an inability to say the right thing.
If your baby dies at a homebirth, in almost all circumstances, you will be blamed.
People will look at you and sometimes even tell you that you killed your baby.
And your baby’s body will become evidence.
When you are done reading this blog post and you are mad at me because either you need to change your verbiage, you think I’m too into semantics or you just don’t agree with me, I challenge you to go read five dictionary entries on the word “empower” and then think about who uses the word and how it’s used in common contexts.
Empower first began to pop up in circles of people who wanted others to do something differently. It’s a paternalistic connotation meaning “I’m smarter than you, so I’mma gonna give you some of this” and really, it’s a negative connotation. Over the last several years, I’ve begun to strip it from my vocabulary for several reasons but first, let’s just look at the word:
verb (used with object)
1. to give power or authority to; authorize, especially by legal or official means: I empowered my agent to make the deal for me. The local ordinance empowers the board of health to close unsanitary restaurants.
2. to enable or permit: Wealth empowered him to live a comfortable life.
World English Dictionary:
1. to give or delegate power or authority to; authorize
2. to give ability to; enable or permit
So let’s use that in a birthy sentence. The obstetrician gave power or authority to the VBAC mom. The midwife authorized the mom to have a vbac. The doula permitted the client to vbac. Yeah, not quite that same feeling, is it?
Empower is passive for the woman. It means that someone out there is not acting and you are giving them permission to act. So, this is the exact opposite of what we want to convey as birth workers and care providers. We want active women. We want..dare I say it…POWERFUL women. Yes, POWERFUL. Not empowered. Women who have power and know it, not power that is given to them from the outside to work with like some sort of permission.
When you empower someone, you give them the legal right to act on your behalf. A woman empowers her midwfe, not the other way around. A woman empowers her OB to act on her behalf and make medical decisions. When a woman refers to herself as “empowered” she means that someone else gave that to her. No, not the slightest bit. She had the power all along, but much like Dorothy in the Wizard of Oz, she had to choose to use it. She had to find the internal strength. I can support women while they are doing that, finding that strength. I can be their sister, their support, I can help them find information but they must choose to access it, to activate it, to step into their own power.
And I’ll leave you with one last thought.
What if empowered is just one more way we use words to say that women really are kind of weak and indecisive and uneducated and we should enlighten them? What if we use this word about poor women? black women? other women of color? At some point, don’t you get the feeling you are acting for someone when you listen to how the word is used?
No. No empowerment here. I don’t empower anyone.
She is powerful because she IS. Powerful. Amazing. Strong. ACTIVE.
Sometimes, the universe conspires against you.
I was on my cell, waiting on my son this morning, when something came to me that I really wanted to write.
I know a lot of people are out there working hard on this whole “Improving Birth” thing and I hope that their efforts are fruitful for them but I’m a student of words and if the words “Improving” and “Empowering” didn’t bug me enough before, they bug me even more in this constant barrage of belief in evidence-based everything being the answer to maternity care problems. I may not like the language, but I’m going to the rally. We need to stand together and stop asking for permission and I hate that we are somehow begging providers to PLEASE be nice to women and give good care, pretty please? I was thinking about writing a blog post about that and I’m sure I will but this morning, I thought (and consequently wrote) this:
For the record, I am not asking your permission for better health care, evidence for what you would like me to do and respectful treatment.. I’m telling you that I will not accept less and that I am willing to walk out of your office. -my dream
Facebook has a sense of humor, so it posted it onto the VBAC Facts Community rather than on my wall. Gotta love wonky mobile apps, but perhaps it was meant to be, right? Who else needs this message more than women who are in all likelihood, often coming to find a path between “can I” and “I’m going to” and “is it safe? and “is it possible?” So, I think kharma might have been with me there.
But imagine my surprise when I realized that it was also August 28th. The “I Have A Dream” speech. I make my children listen to this every year, on several different days of the year. There is a greater purpose than race relations there, there is a desire to look past division and find action that produces change, a belief in the higher purpose of human beings and an ability to rise above the things we are taught by society and reach a freedom with each other.
And I realized that truly, kharma was playing with me.
I have a dream for women, I stated it.
That they will respect themselves enough to take responsibility for their births and their babies.
That they will be strong in the face of adversity.
That they will stand together when others use laws to refuse them access to their care of choice.
That they will realize that together, they are strong and capable.
And that if all else fails,
Refuse to give in to what you know is inhumane.
Stop trying to make other people do the right thing.
Stop trying to prove that you are doing the right thing.
Just do it.
Show peace, show love