Why is the US ranked 50th in the world in maternal mortality and 37th in infant mortality?  Why are one third of pregnancies ending in major surgery?  If you are reading this blog post, you are very likely on the front lines, working to improve the way women give birth in your community as a doula or childbirth educator or nurse or midwife.  You may even see women being mistreated or disrespected and feel powerless to do something to stop it.  If you feel like we do, that the time for talk is over, that it is time for a full scale birth revolution, join us in Utah at the Second Annual Birth Activist Retreat Friday, July 26 – Sunday, July 28.  We need action now!

Last year, 75 folks from 29 states and 2 countries gathered at the Farm in Tennessee to get organized.  We heard from folks who had actively engaged the ‘system’  in their own communities and affected change.  We formed working groups and connected with other folks who were passionate about transforming maternity care in this country.  This year’s retreat will continue the work we started last year.

The Birth Activist Retreat is not your typical conference where folks sit around passively consuming information.  We will be working as a group planning actions that will make a difference:  Nationally coordinated events, such as the Rally to Improve Birth; local events that can transform communities; and individual actions that will raise awareness about the challenges we face. There will be workshops where Birth Activists can build the skills they need to make a difference. There will be many opportunities to network with other activists, share inspiring ideas and receive feedback on the unique issues facing your community.

Join Suzanne Arms, Karen Brody, Dawn Thompson, Michal Klau-Stevens, and other birth activists from all over the country who are working everyday to make birth better.  Together we have the power to transform maternity care!  Space is limited register now!

I have been having practice contractions forever, at least my whole last trimester. As my guess date approaches– tomorrow!– they have been increasing in intensity and frequency. I have even had a few that have made me think, “humm, will tonight be the night!?” Last night seemed to be one of those nights, so I called my dear midwife in the early evening just to give her an update. I knew I wasn’t in labor, but the slowly increasing activity seemed worth noting. She replied with an offer to come to my house just to check me.

Now I am someone with a history of shorter labors. My last one was about three hours; and only half of that time was I really sure that it was the real thing. So having someone who is willing to drive all the way to my home in the evening just to give me a bit of extra information and reassurance, is deeply comforting. This is part of the magic of midwifery care. For me this aspect of truly personalized care is what is most important.

Stay tuned my next blog will probably have a baby in it, maybe tonight will be the night!

You may be wondering what is this? Where are people walking and why? The “Big” Walk-In is the first in a campaign of three events sponsored by Improving Birth, The “Big” Walk-In, The “Big” Write-In and The “Big” Call-in. These events are Big because they are happening everywhere at the same time, however they could also be described as small because they are all simple things one person can do without very much time or effort. Thousands of “small” actions are building something “Big”.

Here are the details! The purpose of this event is simple: to raise awareness about evidence-based maternity care. To participate all you need to do is register at Improving Birth, print their friendly letter and evidence-based care fact sheet, and take them to the maternity-care provider of your choice. This could be the OB office who cared for you throughout your pregnancy or just the maternity-care office closest to your house. You could simply deliver the letter and information about evidence-based care or you could also include a personalized thank you note and a box of chocolates. You could go quietly on your lunch break or you could invite all your friends and deliver a whole bunch of letters at once. Whatever you choose, you are participating in something “Big”.

One letter may or may not make much difference, but if one practice were to receive ten letters they would pause and think. If they receive one hundred letters they will see that there is a demand for change. In addition to the positive effect your letter may have, you will have the satisfaction that comes with speaking out for the rights of mom’s and babies in your community. Are you ready to walk in?

Salt Lake City, Utah; Photo by Cara Baker

Did you hear the shouts for change? Do feel the ripples spreading out all over the U.S.A? This Labor Day almost 10,000 people participated in an Improving Birth National Rally for Change! Nearly 10,000 people used their physical presence to demand evidence based maternity care by standing together all on the same morning. We can only attempt to measure the impact of this historic event.

Salt Lake City, Utah; Photo by Earthside Birth Photography

Most rallies got some media attention. Improving Birth lists 68 different news stories on their website. That means countless numbers of people, who probably have no idea about birth politics or why birth even matters, got a taste for the change brewing in maternity care. Then there is Facebook, the National Improving Birth page reached 89,586 people in the week of the rally. The largest local page, San Antonio, TX reached 67,571. The modest page I administer for Salt Lake City, UT reached 10,571 people in the same week. The average reach of the 17 pages I have numbers for was 10,884 people, if you multiply this by the 110 rallies nationwide 1,197,318 were exposed to Improving Birth through Facebook in one week. I think my head would explode if I try to expand that number to the many weeks we have been promoting the rallies. There is also website traffic to measure and the people who drove or walked by a rally while it was in progress. We had a massive reach. Our ripples will be going out into the world for a long time!

Birth Salt Lake City, Utah; Photo by Vilo Photo

However, all of those numbers do not come close to showing us what it was like to be at a rally. As I have browsed hundreds of pictures from rallies all over the place, there is one clear thread. People are having fun. They are connecting with others in their communities, and their faces show the joy and satisfaction that come along with doing something they know is making a difference. There are children holding signs and playing with balloons. There are men and women standing side by side, many of them with a small child in their arms or attached to their bodies. People are cheering and chanting. People passing in cars are waving and honking. At our rally in Utah an elderly couple was passing by in their car. They slowed way down to read each sign, smiled and even stopped to talk to some of the rally participants. These types of interactions were a highlight for people everywhere.

Salt Lake City, Utah; Photo by Earthside Birth Photography

According to another number cruncher: since we had 75 people at last year’s rally and 9400 this year, the growth was 12533%. So, if we continue on the same growth rate, we can expect 1,178,133.33 people at next year’s rally. Imagine all the connections we will make, all the people we will influence, and all the relationships we will foster with our local hospitals as we demand change. The revolution is happening, and it is going to be fun!

Change is brewing. Revolution is in the air. This coming Labor Day women and men in over 100 communities across the U.S. are coming together to demand that hospitals increase their practice of evidence based maternity care, as part of the Improving Birth National Rally for Change. Most of these rallies will take place in front of a local hospital. However there are some unique locations such as the Democratic National Convention in Charlotte, NC and the headquarters of the American Medical Association in Chicago, IL.

The founder of Improving Birth, Dawn Thompson, participated in our First Annual Birth Activist Retreat. At the retreat we decided that this event would be the first of many coordinated actions we would promote and organize as a collective of birth activists. When people all over the country stand together and speak in unison the message can not be ignored. There is power in unity. We can change maternity care. This rally is the first step.

Every hospital that is being honored as a rally site has received a friendly letter introducing Improving Birth and encouraging them to make concrete changes that will improve the care they provide. Most of the hospitals were chosen for their high cesarean rates. The rallies will let the hospitals know that the families they serve are ready for change. We are ready to be their partners in making this change happen. We will not give up!

Where’s My Midwife? Is proud to be a National Sponsor of this event. We hope you will attend a rally near you. This truly is the beginning of a full scale birth revolution! Don’t miss your opportunity to be part of history!

The First Annual Birth Activist Retreat occurred June 22-24 at The Farm in Tennessee, this was an inspiring and transformative experience for all who attended!   Remember when we talked about finding Safety in Numbers?  Well, after meeting 75 activists from 29 states and two countries at the retreat, we’re feeling unstoppable!  We laid the groundwork for a full scale Birth Revolution.  The first event will be National Rally for Change this coming Labor Day  to raise awareness about the skyrocketing Cesarean Section and elective induction rates.

For a taste of what it was like to be at the retreat, check out our little video:

Where’s My Midwife? will continue as a separate organization. We are currently working on a toolkit that can be sent to communities who have experienced a loss in midwifery services. This toolkit will enable these communities to hit the ground running and organize their masses in effecting change and educating the public.

The question “Where’s my midwife?” has suddenly become very personal for me. I am pregnant! My estimated due date is 12/12/12, wouldn’t that be an awesome birthday!?! We will be a family of five! So now that I have somewhat adjusted to all that excitement and caught my breath, I need to find a midwife! My last baby was born at home in North Carolina with the most wonderful CPM. Now I am living in Salt Lake City, Utah. The two states could not be more different as far as midwifery options go.

The state of North Carolina does not license CPMs, even though it is perfectly legal to have your baby at home, it is not legal for your midwife to be there supporting you.  And CNMs are required to have a physician’s signature to obtain a license, so only a handful of them practice home birth in the entire state!  These restrictions limit the number of midwives who will work in NC.  In Wilmington, where I lived, there were three CNMs practicing in hospital and one CPM practicing home birth.  We really wanted a home birth, as our first child was born at home in Boston.  But choosing the CPM meant that, throughout my entire pregnancy, I had to live with the very real possibility that my midwife may get arrested or be forced to quit working.  It was her loving support that turned me into a birth activist!  How could health care that was so personal, so wonderful NOT be an option? 

Now in Utah I can have a midwife that is licensed and doesn’t have to break any laws to help me out! I don’t have to press my ear to the underground to find someone. Oooo maybe I can even have one that is covered by my insurance and not pay for my entire birth out-of-pocket, wouldn’t that be neat!

So I went was my insurance company website. First I searched for “home birth midwife”, but alas that was not a recognized term. When I did I search for “Salt Lake City” and “midwife” I got 68 matches! Wow, surely some of these ladies will do a home birth, right? After further internet exploration I found that there is only one midwife, Rebecca Williams, a CNM, who is considered to be “in network” by my insurance. When I went to her website I saw that she is already booked through January! Yikes, I guess I am not on the ball enough to have the option of maximum insurance coverage. Oh well, going out of network opens things way up. I am not sure how many home birth midwives there in my area, my guess is more than ten.

My next step was to get recommendations from folks I knew in the birth community. From their advice and a little more help from Google I set up three consultations and interviewed five midwives. I love that I have options here, I get to choose! All five midwives were wonderful to meet with and highly skilled. I would trust them all with the details of pregnancy and birth. That makes choosing actually rather tricky. They all answered my questions perfectly, no red flags, five fabulous midwives.

My first consultation was with a pair of CPMs, Melissa Mayo and Heidi Sylvester.  One is licensed, and one is unlicensed. In Utah an unlicensed midwife is not illegal, so not everyone chooses to license. The benefits of licensure include being able to carry certain medications, such as things that would slow a postpartum hemorrhage. Some of the draw backs to licensure are being banned from attending breech and twin births. So midwives choose what works best for them.  If the licensed and unlicensed work together theoretically you have the best of both worlds.

The second pair I met with run a birth center and also attend births at home. The duo consists of Becky McInnis, a CNM, and Adrienne Trahnstrom, a CPM. They use the centering model for their prenatal appointments, all of that peaked my interest. With the birth center they also have the capacity to do ultrasounds and other clinical tasks at their offices and a CNM can prescribe medications. They had a lot of resources.

My last appointment was with Cathy Larson, the midwife I ended up choosing. She is licensed CPM with a solo practice. We met at her home office, but all of my other appointments will be at my home. I love not driving! In the end my decision was based on geography and temperament. Simply put, I thought her style would best serve my needs. I feel so fortunate now to have access to so many high quality midwives. I didn’t even meet with half of the midwives in my community! What are the birth options like where you are?  I would love to hear from you!

Guest blogger, Summer-Lee Faria, has agreed to keep us posted on what’s going on with the midwives in her home state of Hawai’i.  Here is her first report:

For the Midwives at the North Hawai`i Community Hospital Rally

A friend of mine and I hear about this rally on Hawai`i island to protest the proposal to cut staff from 3 full time CNMs, 1 per diem CNM, and 3 OBs down to
1 CNM and 2 Ob’s. Last year the hospital had 680 births, and they want to cut it down to 300. According to news sources, they claim the Medicaid reimbursements slow processing is partly to blame and that the hospital lost about 1 million dollars last year.

We fly from O`ahu to Hawai`i the morning of the rally, the desire to save any midwives threatened to be let go from any hospital in the state gets us going. The North Hawai`i Community Hospital has been the gem of the island since integrating midwifery care into their system, with parents/pregnant women driving sometimes hundreds of miles just to get the ‘women-centered’ care they desire that can be covered by their insurance.

There were about 2 dozen women, men and children gathered on the lawn, the
sun was shining and the wind was blowing the chilly air; typical Waimea weather. When we arrive, the signs saying, “Where’s My Midwife” and “More Midwives Not Less” are greeted with tons of honks, waves and “shakas” from passersby.  A few motorists stopped in the parking lot to ask what was going on and 2 media crews came and did interviews. There were laughs and talks about each others families going on the hour or so we were there waving our signs of support.

After our visit with our sisters there, we got inspired to start a rally on O`ahu at the State Capitol this Thursday, to show support for the midwives at NHCH, raise awareness that the Midwives Model of Care is essential to women’s well being and should only be increased and never decreased.

Stay tuned for an update from our sisters in Hawai’i!