We Are Pregnant!

We are pregnant! We have been gestating some super exciting ideas. You know how sometimes where you are pregnant you want to go into a hibernation mode, curl up, limit your contact with the outside world? Sometimes you even neglect your beloved friends? This is what we have done, and we apologize. Now we have some second trimester energy and are ready to let you in on some of our news. We can’t tell you about our baby. We still need to keep that secret, sacred, creative space; however we want to invite you to our birth! We hope you will join us in San Francisco, CA at the BirthKeeper Summit June 27-29!

This blog post originally appeared on our Birth Activist Collective website to read the rest of this post and more exciting updates please subscribe to our new blog!

 birthkeeper

What will we be doing at the Birth Activist Retreat?

This blog was originally published on BirthActivist.org.  To see the original post and more excellent activist content click here.

The purpose of the Birth Activist Retreat is to lay the groundwork for a full scale birth revolution.  Our primary emphasis will be action, how can we actively engage in change as individuals and as a collective movement.  This is not a time for passively sitting and absorbing information; it is a chance for birth activists from everywhere to meet face to face and get to work. The retreat sessions will generally fall into one of four categories: inspiring addresses, workshops where activists can learn useful skills, moderated working groups, and opportunities to connect with other activists.

During the inspiring addresses accomplished activists such as Suzanne Arms, Dawn Thompson, Cristen Pascucci, Karen Brody, and Michal Klau-Stevens will speak to the group as a whole.  They will be sharing actions that have already made a difference and their visions for the IMG_4635best way our movement can effectively engage the system.  Gina Crosley-Corcoran (aka The Feminist Breeder), Kate Donahue (Truth About Birth in Social Media)  and January Harshe (Birth Without Fear) make up our panel on Social Media.  These lovely ladies will share their secrets to success and help us to outline a powerful on-line campaign that will continue to grow the number of folks engaged in changing the culture of birth.  The Birth Activist Skill Workshops will teach the skills every Birth Activist needs to know to be effective.

The moderated working groups are where we will really get down to the nitty gritty planning details.  They are also the most open ended type of  session.  Anyone can volunteer to moderate a group, and people will be able to participate in multiple groups.  The groups will focus on specific projects or ideas that need to be developed.  The moderator will propose the project and initiate the discussion.  The project could be something concrete such as creating a public service announcement that will air during midwifery week.  At the retreat the PSA could be written and a plan for recording and distributing the announcement could be put into place. The group would continue working beyond the weekend retreat to accomplish their goal.  Or the group could focus on an idea or something more general such as: how and what do we begin to teach young girls about IMG_4718birth? The potential for these groups is unlimited.  If you have an idea for a group you would like to moderate please email anna@wheresmymidwife.org.  We will share these working group ideas so that folks can get excited about them before the retreat, then at the retreat they can sign up and get to work!

As a group we will discuss activities such as the National Rally for change that can happen as a coordinated effort.  Two other events we will present are 1) flash mob/guerrilla theater  of the “My Body Rocks” scene from Karen Brody’s play “Birth;” 2) a film festival that promotes the Mother Friendly Childbirth Initiative to be produced and coordinated by BirthNetwork National.  If you have a national event that is ready to be put into action email anna@wheresmymidwife.org and we will include you in this part of the program.  Everyone who attends the retreat will have all the information they need to implement these events in their community.  We will use the working groups to come up with coordinated actions that will part of the core events presented at the 2014 retreat.  Coordinated actions can cast a huge national spotlight on our cause.

Online communities dominate our current social worlds.  These virtual networks have tremendous power for activism, however there is still a need for face to face meetings.  The retreat will provide many opportunities for networking and building our activist community.   We will share our meals and we will be collaborating  and connecting during all the sessions.  Before the retreat officially starts and after it officially ends there will be time set aside for National Leaders to connect.  Who is a National Leader?  Anyone who is already working on a national level or anyone with the ideas, energy, and desire to be involved in that way!

IMG_4728The Birth Activist Retreat is a unique opportunity for people who are passionate about maternity care to come together and engage in the developing birth revolution.  As Dawn Thompson said the retreat “is about digging in, hard-core planning, and really working together to create lasting change in maternity care.”  You do not want to miss this crucial weekend. We look forward to seeing you there, July 26-28 in Salt Lake City, Utah.  Click here to register now!

Transitions can be painful

changeAs we prepare for the 2nd Annual Birth Activist Retreat in July, we see that our focus as birth activists is being pulled in a new direction. “Where’s My Midwife?” has been an incredible platform for us to raise awareness about the issues facing midwives and the families who choose to be attended by them. We have created a tool-kit for folks who are dealing with threats to their midwifery practices, which contains all kinds of useful information about organizing your community, dealing with the media and building your birth community. By the end of June, we will have the tool-kit online and ready to roll.

The tool-kit will also be available at the Birth Activist Collective website, our latest endeavor. You can read more about our newest baby here. Although access to midwifery care is still extremely important to us, we believe that increasing the number of midwives practicing is an impossibility until we address the folks who currently have control of the system. And in order to be effective in changing the climate of maternity care in our country, we feel called to focus on uniting all of the birth activists.

Over the summer, we will be transitioning to the Birth Activist Collective website. “Where’s My Midwife?” will remain as a resource and will continue to work locally to assist NCFOM. Anna and I will also continue to be available as consultants on midwifery issues, but we ask you to join us at our new website as we further develop the work we started at last year’s Birth Activist Retreat.  So, go ‘like’ our page on Facebook and find out how you can get involved with the Birth Revolution!

Birth Activists Unite!!

Anna and I have been busy creating our new website – the Birth Activist Collective!  Below is a blog post explaining what we hope to accomplish with our latest endeavor.  Please ‘like’ our new Facebook page and follow the new blog for lots of new action items and activist content!

Power through unitySo, what exactly is the Birth Activist Collective?  Our vision for the Collective is to bring together all of the brilliant people who are out there, on the ground, making a difference for moms and babies in their communities.  We would like to serve as a hub where folks can exchange ideas and inspire one another.  Working to improve maternity care can feel quite isolating.  We have certainly felt like the lone crazy ladies in our community!  The retreat last year proved to us that there are countless others who feel the same way we do – the time for talk is over.  We already know that the current system is broken, that women and babies are dying and suffering as a result of greed, ego, and inertia.  The time for action is here.

We love what we see happening at Human Rights in Childbirth!  We love the focus and drive of ImprovingBirth.org!  We love how BirthNetwork National has built strong birth communities across the U.S.!  We love the energy of the Birth Revolution Facebook group that formed after the Midwifery Today Conference!  We agree with the folks at Birth Revolution that we need to begin modeling our movement after other successful social movements, like the Arab Spring and the Civil Rights Movement.  Our vision for this year’s Birth Activist Retreat is to come out on the other side united and fully equipped with an action plan for engaging the ‘medical-industrial complex’ as well as the public.

Our primary guiding principle is being supportive of one another.  In order for this movement to be successful, we all have to join forces.  We are all on the same team working towards a common goal.  We need to work together.  We will have differences in methods.  Some of us are more radical than others.  Some of us are negotiating very delicate terrain.  Some of us can be outspoken, others will need to operate as secret agents. This is ok.  We all have a part to play and we need to support one another to be most effective.  We need our differences because the problems we face are complex and the solutions will be multifaceted.  Our hope with the website is that we will expose activists to each other’s amazing work and amplify our collective voice.

We are currently working to build the resource section on our website.  We encourage you to post links to your blogs and favorite birth-y websites so that we can add them to our list.  And if your organization has done something that improved the climate for birthing mamas in your community, we want to hear about it!  We invite you to submit a blog post that can be shared with the Collective.  Please share our Facebook page and website with your activist friends!  Together we have the power to transform maternity care.

love-n-feistiness,

Anna and Kirsti

Second Annual Birth Activist Retreat

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!

History Lesson

Background: There are three general categories of midwives: Certified Nurse Midwives, who train in a medical program as nurses and then obtain a master’s degree in midwifery; certified professional midwives, who train and apprentice according to national standards set by the North American Registry of Midwives; and “direct-entry” midwives, who train by lengthy apprenticeships and hands-on, peer-based, self-education.

1983 – Midwives seek legal accountability from state

Legislation is passed allowing Certified Nurse Midwives to attend home birth in North Carolina, with their permitting contingent on obtaining the signature of a physician who agrees to “supervise” them.

Although a state study finds home birth to be a safe option that should be legal, no physicians will agree to supply the signature required for a CNM to attend births at home.  Thus, there is still no legal provider option for families who choose out-of-hospital birth.

The direct-entry midwives hire a lobbyist and work hard to establish a permitting/licensure system that will make them legal and accountable to the state.  Their efforts are largely stymied by a single state senator who is also a doctor.  (Senator Purcell retired in 2013.)

1991 to 1995 – development of the CPM credential

2007 – Consumers step in

Consumer group North Carolina Friends of Midwives (NCFOM) takes over legislative efforts from the organization that represents Certified Professional Midwives in the state, the North Carolina Midwives Alliance (NCMA).

Throughout 2007 and 2008, the General Assembly forms a study committee to investigate whether or not the state will license Certified Professional Midwives.  After testimony from both sides, the committee finds in favor of licensing and, in 2009, charges the Midwifery Joint Committee (MJC)—the board that issues permits to CNMs—with figuring out a pathway to licensure for Certified Professional Midwives.  Midwives are, unfortunately, disproportionately represented on a committee that is made up of two Certified Nurse Midwives and another eight folks from the Board of Medicine and Board of Nursing.

[Side Note/Tangent:  Also in August of 2009, two Certified Nurse Midwives were fired from a private practice here in Wilmington leaving 80 pregnant women without their care provider of choice.  The local families asked NCFOM to write a letter to the hospital asking for a meeting.  The hospital was unresponsive, so we protested outside the hospital (every day, M thru F from noon to one) for a month until they agreed to meet with us.  That was when I became aware of the climate in our state for Nurse Midwives, and when we first asked the midwives to work together on licensure.]

After a series of monthly meetings at the MJC, the medical folks on the committee point to the language of the state study, which says the MJC “may” find a methodology to license Certified Professional Midwives.  Because of the word “may,” the MJC chooses not to interpret the state’s study as a directive, and decides that they also “may not” find a methodology to license Certified Professional Midwives.  A vote from the board on whether to continue the discussion yields “No” votes from everyone but the two midwives.

February 2011

A Certified Professional Midwife is arrested and charged with practicing midwifery without a license, and with providing prenatal care in a second case.

March 2011

The largest rally regarding midwifery issues that has ever taken place in the United States is at the North Carolina General Assembly, when 650 people come to demonstrate their support of licensing Certified Professional Midwives.  At that time, NCFOM has two bills in limbo—both of which end up languishing in Health Committee in both chambers.

February 2012

A direct-entry midwife and her doula are arrested and charged with practicing midwifery without a license.  Charges are eventually dropped.

Summer 2012

A series of bad outcomes comes to the attention of the Midwifery Joint Committee (involving direct-entry midwife Rowan Bailey in July, and a Certified Professional Midwife and two Certified Nurse Midwives around the same time).  A cease and desist order is filed against both Rowan and the Certified Professional Midwife.

During testimony by one of the Certified Nurse Midwives, she mentions that the obstetrician who signed her permit to practice is also providing supervision for approximately eleven other Certified Nurse Midwives serving families across the state.  This obstetrician is called into a closed-door session before the Board of Medicine, immediately after which he notifies each of the eleven midwives that he will no longer serve as their supervising physician.

This leaves hundreds of families planning legal, professionally assisted home births with no care and very few options.  There are not enough practicing Certified Professional Midwives, whose numbers have been thinned by fear of arrest, to attend all of these births.

The MJC issues a temporary 75-day license to the Certified Nurse Midwives to cover the gap in physician supervision, but most are unable to find a doctor willing to buck the establishment and allow them legal status.  Today, only four Certified Nurse Midwife home birth practices are left in the state.

Around the same time, the NCFOM tries to get their bills moving out of the Health Committee.  This is when they are shown a copy of a letter from the Medical Society to its members looking for “tragic transport stories” (that is, home births that ended with deaths in a hospital of either mother or baby) to share with legislators.  WMM? publishes the letter on its website, leading, ultimately, to a meeting with the Medical Society.

In that meeting, WMM? is told in response to the question, “What are these families supposed to do without their midwives?” that they should “Go to the hospital.”  The doctors also express surprise that women are seeking alternatives to birth in the hospital as a direct result of their experiences in the hospital—pressure or coercion into unwanted interventions and high incidences of c-sections that may have been preventable.  One doctor comments, “Women feel pressured in the hospital?  I thought women chose home birth because they wanted to be in control; they had control issues.”

Fall 2012

A Certified Nurse Midwife in Wilmington is assisting a woman at home and makes a prudent and appropriate call to 911 for assistance transporting the woman to a hospital for an emergency procedure.  Police arrive before the ambulance.  This leads us to believe that the North Carolina district attorneys have been instructed to send police to any call to EMS regarding birth at home.

Today:  The War on Mothers

It’s our feeling that the strategic decision was made not to arrest any more Certified Professional Midwives after the huge public outcry following the arrest of the CPM in February 2011.  Instead, a year-long campaign was launched to pick off home birth midwives one by one by issuing a series of cease and desist orders.

If Rowan had not been charged with murder, surely, the next midwife arrested would have been charged with something equally as damning.  The arrest and criminalization of “a” Rowan has been a long time coming.

But we’re not going to take this assault on families lying down.

It’s the basic right of a woman to decide where she wants to give birth, and with whom.  That includes birth outside of the medical monopoly.  It’s time we addressed the fact that the corporations making money off the business of birth in North Carolina are the ones dictating our policy and law, and doing their best to eliminate the competition.

humanrightsMeanwhile, our hospitals—where 94% of women give birth—are delivering us care that has placed our state 47th in the nation for mothers dying in childbirth.  We believe it is time we addressed the REAL problem in birth in North Carolina: the system that prompts almost daily reports of unsafe and outdated medical care and violations of women’s dignity and legal rights.

Please continue sending your hospital stories to us.  We are planning to print them and place them in a notebook to be delivered to the Medical establishment sometime in the next couple of weeks, as a part of a public awareness campaign.  We will be asking them to sit down, again, and discuss how we can all work together to improve the climate for birthing families in our state.

Stay tuned for more information about our upcoming events. . .

Wide Awake

We need hospital stories.  If you had great experience or if you had a bad experience in the hospital, if you had an awakening about the ‘safety’ of hospitals, we want to hear from you.  Whether you are a birthing mama, a daddy, a doula, a nurse, we need your perspective.  E-mail us at hospitalstories@wheresmymidwife.org, and please do not include names.

North Carolina seems to be the most hostile state for folks who wish to seek an alternative to hospital based physicians for maternity care.  With no path to licensure for CPMs, physician signature requirements for CNMs and a murder charge hanging over the heads of anyone who dares to practice home birth, I think we win the “most hostile state” award.  So maybe this awful environment gives those of us in NC a unique perspective on what’s wrong with maternity care in our country, and motivates us to try harder to find solutions.  It certainly has made me want to have face-to-face meetings with folks in power, to try and have a real conversation about the problems we are all a part of creating.  In 2009, when the midwives at a private practice in town were fired quite suddenly, we immediately called the head of the Women and Children’s Center here in Wilmington.  We asked her for the name of the head of the Department of OB/GYN so that we could write him a letter asking for a meeting.  She refused to give us the name!  Why?  He’s just a person, like us.  He’s capable of talking and listening to others, having a thoughtful conversation, right?  Over time, we discovered that the ‘hospital’ policies governing labor and delivery are actually written by the physicians themselves – the members of the Department of OB/GYN. The policies, which are not always based on evidence, are put in place by the physicians to protect them and the hospital from law suits.

Last summer, we sat down with the powers that be at the NC Medical Society to explain why we want licensed CPMs in our state.  They listened and nodded at the appropriate times, but when we asked how they planned to protect families choosing to give birth at home, they replied, “Go to the hospital.”  In March, we sat down with hospital administrators at Outer Banks Hospital and explained why over 400 people in their community had signed a petition asking for access to midwifery care.  They told us that they could not afford to hire midwives, because they were a small hospital and did not have the resources.  Understandable.  But when we explained that women are unhappy with the care they are receiving in their hospital, the physician at the table said that he believed that there were a ‘handful of angry women’ in the community.  He also said those women were probably the type of people who were not going to be happy with any type of care they received and that they had simply decided not to like him.  He then went on to say they probably ‘hated all men.’  During the meeting, Dallas Bassola (board member of ImprovingBirth.org and the local rally coordinator) made such an incredible point  – whenever a mother tells her a story about being coerced or mistreated in labor, Dallas tells the woman that she must tell the care provider how she feels so that he or she can become aware of their behavior and work to change it.  But most of the women she has spoken with say things like, “Oh, but he’s so sweet and my son plays soccer with his son” or “But we go to the same church and it would just be awkward” or “I’m friends with his wife and it would ruin the relationship.”  And the cycle of fear and intimidation continues, and many of the providers are completely unaware that there is a problem.

And herein lies the problem.  We have two groups of people who seem to be afraid of each other.  Physicians view every pregnant woman as a possible law suit, a potential accident waiting to happen. Then you have women who have been conditioned to be ‘nice,’ to not speak out when something upsets them because they might hurt someone else’s feelings.  And the vast majority of women in this country also fear birth.  Ninety-six percent of women go to hospitals because they believe that hospitals are the safest place to have their babies.

So, how do we begin to really have an honest conversation about how to do the work that needs to be done to put women back at the center of their care?  To build a system that works for women, not a system that is made to protect providers and hospitals?  

We must tell our stories so that the we can begin healing and moving forward.  What is happening in our country in hospitals needs to be brought to the light.  For too long, the media has perpetuated the myth that home is dangerous and hospital is safe.  Let’s really examine just how ‘safe’ it is to give birth in the hospital.  [Before we get angry comments about 'hospital-bashing' or 'doctor-bashing,' I invite you to read an old post called, "Time Out for Bad Behavior."  We are not, nor have we ever been, bashing anyone.  We simply believe that we must address bad behavior in order for it to stop.]

I invite you to contact us at Where’s My Midwife? to share your hospital story.  If you had great experience or if you had a bad experience in the hospital, if you had an awakening about the ‘safety’ of hospitals, we want to hear from you.  Whether you are a birthing mama, a daddy, a doula, a nurse, we need your perspective.  E-mail us at hospitalstories@wheresmymidwife.org, and please do not include names.

***Please indicate in your e-mail if you would be willing to tell your story on camera.  We intend to set up a YouTube Channel for this project.  Below is an example of a woman telling her compare and contrast story – she had both a hospital birth with a physician and one with a midwife: