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Posts from the ‘Midwifery’ Category

18
Apr

Cesarean Awareness Month: Day 18

I’ve done it. We’ve all done it. We’ve read the story online about some mother that we know had a completely unnecessary cesarean. Just reading the story, as some doctor forced her body to open, stretching her cervix or inducing for dates and not indication, as the vbac “fails”, we cringe. We wonder how she didn’t see the signs. We can’t help but think about the story, we can’t help but be angry for her, hurt for her, sad for her. Why is this happening to her? How we do we stop it as a society if we can’t help one another be supported? How do we protect ourselves and our daughters, from this insanity?
These emotions flood us.
So what I’m about to say is important.
SHUT UP.
Not long-term, not forever. You don’t have to stop warning women, stop talking to them, not using your voice as much as you can.
But in this moment. With this mom.
This postpartum, just had a baby, mom.
She is not in that space. She is not processing the bigger picture.
She is in her own place, needing empathy, hope, and lots of loving on her and her baby.
She needs to recover from surgery, she needs to meet her newborn and learn to know them, she needs to take some time as she wraps her head around what has happened to her.
I did this not long ago. I had to stop, apologize and get out of the conversation because I had wronged the mother involved. She should NEVER have had to deal with my angry outburst towards her doctor at 3-4 days out.

What I should have done was this:
-Congratulate her on her baby
-Told her how cute her baby was
-Told her I wished her recovery and peace and healing
-Reminded her that when she was ready to process her experience or ask questions, whether it was in 2 weeks or 2 years, I am here for her to listen to her and help her walk that path.
-When she chooses to talk, ask questions and listen and help her come to her own answers, not provide them for her but holding her accountable to her own journey.

Remember
-To every thing there is a season, and a time to every purpose under heaven-

‪#‎cesareanawarenessmonth‬ Day 18

17
Apr

Cesarean Awareness Month Day 17

“Once a Cesarean, Always a Cesarean” never rings more true than when referring to a child’s birth. Even though a mother may later go on to have a vaginal birth or future healthy pregnancies, there is no way to step back into our footsteps in the snow and change that day in surgery. Sometimes, coping lasts a lifetime but there are critical moments in recovery in the first year that moms have to weave through and often, they are alone and unsupported. Most of the time, those close to them don’t even realize the impact of their words or actions, thinking they are sharing the moments with the new mother. On baby’s first birthday, many well-intentioned friends and family fail to see what is in front of them: a mother in mourning being forced into celebration.

A mom may ask herself if she’s even normal, because she feels so despondent or unwilling to plan birthday parties. She may throw herself into planning the biggest celebration possible, hoping it will drown all the pain out. The reality is, she often sees this is as the first anniversary of trauma. While not all cesarean moms view it this way, it’s important to understand how a mom could wind up in this emotional dilemma of baby’s birth vs mother’s birth experience.

Research shows that women remember their birth experiences for the rest of their lives. These stories impact not just today but the rest of their lives. A mother goes into labor and gives birth, remembering much of it while wrapped in the heightened sensations of labor. She remembers specific smells, looks, people’s faces and attitudes and words. As she goes into labor or is induced, she is often afraid of the unknown or even the known if this is not her first labor. She walks into the hospital and deals with strangers she is forced to trust at the most vulnerable time of her life. In some cases, she doesn’t really like her care provider or her nurses. Then, as labor continues, something changes and she labors longer and harder and suddenly, a cesarean. This isn’t what she prepared for, this is surgery. She is drugged, she is strapped down, and she is often throwing up. Sometimes, she is not even conscious, depending on the circumstances. Unable to help herself, she watches the ceiling as her body is cut open and her baby is taken away. Often, the obstetricians and nurses discuss their day or other clients or even football games. This event that was hers and personal becomes distracted and impersonal. Her baby is born and she gets a glimpse before having the baby removed, wrapped, and only a face and then gone to the nursery. There is no physical contact to solidify this bond between mother and child. There is no orgasm of love and completion in each other’s arms that is so tactile and important for every being. She is left alone with the staff, cleaned up and moved to recovery.

At this point, her husband or partner goes with the baby. They share joy, “Look at his hair! His fingers, his toes!” They call family and tell of joy in the new little person. His size, his weight, his features. They take cell phone pictures and post on Facebook or blogs. They are building a vision of love.

A year later, they share this vision. They talk over and over about the day he was born or the first moments they saw her. They are overwhelmed by the joy of that moment and they relish in it. “I was the first person to hold her!” a grandmother remembers. As they share these moments, the mother remembers, “Everyone held her but me. And when I finally got to hold her, it hurt so badly, I could barely move. “ They pass around pictures of baby’s first few moments, none of which include the mom except one, with an upside down baby’s face, wrapped tightly in a blanket, next to her head while she feebly smiles. She thinks to herself that even in that moment, she didn’t get to hold her baby or touch, skin to skin and feel the baby newness.

This is the reality of the first birthday. These flashbacks and moments where only the mother , and she alone, remembers and recovers her own experience. So how can someone help a mother in this situation? How can you, help yourself? Here are some tips on recovering at that first birthday:

Listen.

The new mother needs you to hear her side of the story.

Talk.

If you are the new mom, talk about the birth. Find someone you can share this with and just talk. Many women turn to online support at this time just to be able to get it out and share with other moms who get it.

Accept.

It’s not only ok but normal to wonder things like, “Is this baby really mine?” or “I don’t feel like her mom, I didn’t give birth.” Many moms have asked themselves these questions. Accept for yourself that your child and you have moved past that day, even if you were not unaffected by it. The feelings surrounding the birth do not have to stop you from loving your child, bonding with them and helping you both to grow.

Feel.

You have every right to feel however you want to feel. You do NOT have to dwell on feeling grateful that your child is alive or that your birth occurred the way it did. You have the right to feel questioning of the outcome and ungrateful for the way things happened.

Express.

Talk, paint, feel, write letters to the providers about your care. Write out your birth story in the way you wanted it to occur. Cry if you need to. Have a day for yourself, treating yourself well and celebrating your motherhood while allowing yourself the freedom to see the day as a multitude of different occasions that happened to different people at the same time.

Ignore.

You can ignore a child’s first birthday. The subtle way to do this is simple: Move the date. Make the party on a day that has nothing to do with the actual birth. Celebrate a half-birthday instead. You can still use a 1 candle at 1.5! You can have a small thing at home with just a cake and you and baby, celebrating together and being special in a way you were denied the first time.

All in all, treat this as if it were YOUR day. This is not simply a birthday, deserving of a Blue’s Clues cake smooshed by a happy baby. It is also the anniversary of a transition in your life that you deserve to memorialize in whatever way best suits your personal needs.

Would you like to share your story or ideas for surviving the first birthday?
http://birthaftercesarean.com/surviving-the-first-birthday-after-a-cesarean/

#cesareanawarenessmonth Day 17

28
Jan

“High” is not a Clinical Diagnosis.

For the record, neither is “normal” or “low” and what the heck does “low normal” mean anyway?

Test results should never be given to mothers as “high” or “you failed the test” or “your numbers are low”. If numbers like this are given to you, here are some questions to ask:

1. What were my actual numbers?
2. What do you consider the range of normal? **
3. Why do these numbers concern you?
4. What is the chance of a false positive/negative or false reading?
5. Is there somewhere I can go to learn more about this?
6. I’d like to do more research before treating this, can you tell me what my options are in the meantime?

**THIS can be very important. One doctor might have an utterly different range of normal from another or one lab might use a different range of normal from another. There is also a serious concern arising with many mothers that a mother may be experiencing symptoms or testing that is abnormal for her even though the tests results show normal. Or that an individual’s normal may be a testing abnormal.
Example: A 15 year old active athlete or dancer might have a pulse rate in the 40s and a bp of 102/49. A heart rate of 72 and a bp of 120/80 might be a sign of serious illness. Same for a marathon runner or an individual with naturally low blood pressure. You should always know YOUR normal numbers when you aren’t ill, if possible.

And in regards to urine tests or other tests where a comparison is done vs. a color on a stick, you can put the little stick in the box, go out of the bathroom and stick your head into the diagnostic room and say “I’d like to see the comparison, please” or tell the nurse “I’d like to see the comparison, please, the stick and the bottle you are comparing it to. Thank you.”

14
Jan

Florida Hospital Violates Women’s Rights

Petition to get North Florida Regional Medical Center to give women back their rights

I ask you to sign this petition if you want, but please, contact the hospital involved. Send letters, emails, phone calls. PLEASE. The women of Gainesville and the surrounding counties deserve the care they were getting without having to give up their rights to support. This is in violation of Federal law as well as Florida State Statute. There is no legitimate reason for this policy and frankly, NFRMC and HCA should be ashamed as it’s clearly a power grab over women and their support.

I think the people in this world that do the most harm are the ones who sign up for these kinds of  regulations or laws based on good intentions. Laws are not there to grant freedoms. Laws are there to set limits. Regulations in this instance are there to set limits based on what the hospital wants, not on anything else, JUST on who they can control and put that control in place. They don’t want doulas not hired by them, who are not on board with their policies. This is the entire reason that doulas exist. To support women to have the births that they want, sometimes while not agreeing with hospital policy. They are there to be the woman’s advocate FIRST. Allowing this policy to continue means that doulas have given up their basic freedoms and rights as well as the woman’s right to hire who she will or have who she will as support.

It’s important to remember that this past year, doulas were helping women and supporting them and now, only one doula is ‘registered’ and supporting women and therefore, the hospital is sending her referrals. Unless we change this NOW, more doulas will be inclined to agree to this registration process simply from a financial standpoint and keep in mind, these are not hospital employees, but visitors who are non-medical in nature. They are being asked for invasive medical information and being required to violate their own privacy, even if they do as little as ONE birth a year at this hospital. Even more importantly, women have power. They can refuse to give in to this. If doulas stood up for themselves and said, “No, we have rights, our mothers have rights” then the women know that they can get support, and that they will have to exercise their power. Signing up for registration to save women to keep from having to do that is just one more way we act as if women need saving from birth. They don’t.

Please help change this NOW.
http://www.change.org/petitions/north-florida-regional-medical-center-respect-the-right-of-mothers-to-choose-who-may-visit-them-during-childbirth

28
Dec

The Evidence is In: The Evidence isn’t Working.

I am always reminded at the oddest times that the biggest enemies women have are themselves. Midwives pitted against midwives. Women pitted against other birthing women. Personal choices and autonomy are lost in the fight of defensive women who feel they must protect their own choices.

In the 20th century, midwives were reduced to isolated pockets of education and experience then a resurgence occurred because women wanted to have home births, not because they wanted medical care providers at their births.
They walked away from medical care and into their bedrooms, supported by other women.

Then the rise in midwifery caused midwives to walk away from women in order to establish themselves as a profession. They compromised women’s authority at their births and autonomy for their choices in order to rise to what they assumed would be professional acceptance. It has yet to happen. They chose licensure over women’s autonomy and fought for that cause instead of women’s rights to give birth. It became about their right to a profession and their right to access to specific women under very refined guidelines. Since then, they’ve been steadily decreasing the control women have over their own births at home.

Now, I see a variety of movements occurring rapidly and the same issues over and over, with individual organizations rising and falling that keep trying to talk about evidence-based birth.

The reality is that the US birthing community that includes and is controlled by hospital-based obstetricians has never been about safety and never been about evidence. In order for us to continue the pretense that somehow, birth is safer in hospitals, we would have to ignore the vast majority of women who are walking out of those facilities with significant morbidity, emotional and physical trauma. We would have to ignore the headlines of women asking why they can’t find providers who won’t induce or demand cesarean sections. We would have to ignore the women seeking postpartum depression and PTSD care for the after-effects of their hospital births. We would have to ignore the impacts on breastfeeding of these events. And the disgusting reality is that we are ignoring those impacts. Daily.

So why are we choosing to ignore so much? Is it our allure for the preemies that are saved by unique measures? The mass media “we will promote whatever sells on any given day so you don’t get the real picture of either side”? Government agency-driven healthcare through Medicaid that has to be rigid in order to determine payments and “equal” care? Are we just not wanting to believe that an OB can threaten a woman with CPS and/or forced cesareans? Or are we busy telling other women “I did it/I needed a cesarean/What if something goes WRONG?” that we don’t stop to assess our fears and simply apply across the board that, despite evidence to the contrary, anyone who doesn’t birth in a hospital isn’t like “us”?

Or is the truth much uglier?
That women feel helpless and powerless because of exactly what CAN happen.
When a woman is told “if you try to have a normal birth, we will put you in a helicopter and make you go somewhere else” or
-“You have to show up for a cesarean” or
-“you can’t have a VBAC in our hospital, we will put you on the sidewalk if you attempt it”
-What about “if you try to have a VBA3C, we will call CPS to take your newborn”?

WHO THE HELL DO WE TURN TO?

Who do you call when your doctor can do that to you?
Their medical associations shrug.
The Department of Health considers this STANDARD OF CARE.
The NIH repeated during a 2010 conference, over and over, “We can’t make the obstetricians do anything.”

Ask any woman on the street who is 40 weeks and she will tell you: “My doctor won’t LET me go to 41 weeks”
“I had to have…an induction, a cesarean, a….”
“My doctor said they would drop me if I didn’t do XYZ”

And WHO is protecting her rights? No one.

If an ob says you must, you must. If a law created to employ midwives says you must, you must. If they both act out of fear, you have to submit. Their best interest is higher than yours. Always.

And if you don’t believe me, wait until it happens to someone you know. Wait until you are sitting holding the hand of a crying woman at 36 weeks whose doctor just told her “schedule or leave my care” without any reason.

So instead, we have women across the country once again fleeing midwifery care which is bound by obstetrical vision, they are fleeing hospitals where this kind of intimidation, fear and maltreatment is normal. They are choosing unassisted births. They are learning what they need to in order to give birth by themselves with their families. And many of the midwives they relied on are turning on them for making these choices.

Other women are writing their doctors and midwives. They are sending notes and requesting evidence-based care. They are coercing their doctors into better care via social media. They are trying to fight this but always with the knowledge that it’s at the WHIM of the doctor or hospital that they will be treated well.
Women are being abused and as a society, we not only tolerate it, we’ve institutionalized it and we punish women if they go against it and anything bad happens. We are brutal and nasty and post things like “see, her baby died” and the obstetrical trade union society CELEBRATES someone who does this kind of disgusting abuse for a living and rewards them with attention. If she’s lucky (and normal, as almost all birth goes pretty well if left alone) then we tell her how lucky she is and how someone we know almost DIED giving birth, never realizing we’re simply adding to the evidence pile that perhaps those elective inductions that lead to almost dying and emergency cesareans just perhaps aren’t warranted. And then so many women have families who were born into this system who are happy to tell us we are killing our babies if we go against, not evidence-based care, no…but obstetrical opinion or midwifery law.

We think that by acting like professionals, by writing those letters, we can appeal to the intellectual, that educated doctor fellow that spent all those years in school and will surely understand the evidence and will then allow “evidence” to rule and ethically allow women to participate in their care. We are convinced that it is somehow a lack of knowledge on the part of obstetricians rather than this institutionalized willful ignorance and bad legislative policies being coupled with a complete lack of oversight and consumer choice.

And so tonight, I got an email saying that because I help women, I am being “watched”. Let’s address that. How do I help women?

-By telling them they CAN give birth.
-By telling them to educate THEMSELVES.
-By telling them that a midwife’s protocol is not necessarily YOUR plan.
-By telling them they are ADULTS. AUTONOMOUS ADULTS.
-By telling women that they have the right as human beings to determine their own health care, their own beliefs, their own tolerance for risk and their own decision-making skills.

Women can use obstetricians and midwives as services and still be respected as adults with intelligence, capable of understanding. They can refuse specific parts of care. They can ask for others. They have the right and the obligation to their children to vote with their feet if the kind of abuse mentioned above is how they are treated.

STOP LICENSING MIDWIVES BASED ON OBSTETRICAL OPINIONS and STOP TOLERATING OBSTETRICAL VIOLENCE.

START ENUMERATING THE RIGHTS OF PREGNANT WOMEN TO GIVE BIRTH WITH WHOM THEY CHOOSE, WHERE THEY CHOOSE

9
Oct

In Defense of Midwifery

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.

 

http://www.indiegogo.com/projects/rowan-bailey-s-legal-fund