The “Big” Walk-In is Happening Now!

The "Big Walk-In"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?

Get it done!

Soooooooo, yeah. . .our friends at the NC Medical Society have stopped returning phone calls and are not responding to e-mail.  Apparently, one meeting was enough for them.  I keep thinking about an exchange with Haywood Brown at our last meeting.  We said, “If you don’t want to license CPMs, what is your plan for helping to make home birth safe for the families who chose it?”  He replied, “Go to the hospital.”  Uh, you’re not getting it.  Families will continue to chose home birth (and they are doing so in increasing numbers), lets license the women who are already serving our state and integrate them into the health care system.  It’s working all over the country, it can work here.

I was under the impression that Mr. Brown was in the minority at that meeting.  I felt that the rest of the attendees were genuinely interested in beginning a discussion about how to make home birth safe in our state.  I can see now I was wrong.  This is truly heartbreaking to me.  The physicians in North Carolina have determined that protecting their Scope of Practice is more important than doing what’s right for the consumers they are supposed to be serving.  Which is why we will be demonstrating our disappointment outside of their offices tomorrow in Raleigh!

I sat down this weekend with Lisa Fawcett, CPM and lobbyist for NCFOM.  We had a nice long chat about the history of NCFOM’s efforts to license Certified Professional Midwives in our state.  This is the first installment of “Couch Talk,” with more episodes to follow.  We need everyone now, more than ever, to get this job done.  See y’all in Raleigh!

It’s all about ME!

I am feeling a bit nostalgic today because tonight is the beginning of the Fourth Annual WILD Festival.  Four years ago, I was a brand new birth advocate.  I had just given birth to my second daughter at home with a CPM who was unlicensed in my state, and was more determined than ever to change maternity care for the better!  When my second child was born, I was amazed at how my work load had suddenly doubled, but my husband’s stayed the same.  WHA???  Mothers needed to be recognized for all they do for their families and communities!  I envisioned a weeklong celebration for moms to come out and cut loose at night – a night of comedy, an outdoor concert and “Birth” by Karen Brody.  And during the day, come together at the local YWCA to discuss issues that we all faced – getting dad more involved, balancing family and work, remembering to take care of yourself.  Somehow, we pulled it off!  But right in the middle of planning this fun-fest, two Certified Nurse Midwives were fired, sending our community into crisis mode.  Oye.

It amazes me that while we were working to bring women together to celebrate being mothers, we ended up coming together for more upsetting reasons.  This idea of bringing women together has long been a weird obsession for me.  I am the oldest of four girls, and I am super close with all of three of them.  But in my twenties, I was one of those women who had more guy friends as a result of being the victim of bullying by other girls in middle school.  You know the story – there have been countless books written on the subject (Queen Bees and Wannabes, Odd Girl Out, Reviving Ophelia, etc.).  Why was it that so many women were so nasty to each other?  I longed for a sense of community with women like the one I had grown up with, the closeness I had with my sisters.  So, when I met my midwife and saw that she was going out into the world on a regular basis to serve women, I was blown away.  And all along, she was putting her entire family and livelihood in jeopardy as a result of having no license.  Here was a shining example of women supporting women!  We need more of this!  So began my personal quest for more Wise Women – women who understand that we need to be coming together, not constantly tearing each other down.

Unfortunately, I also grew up a consumate good-girl-people-pleaser who was told that any emotion other than happy was unacceptable.  So when I became a birth advocate, I liked the fact that I had found an acceptable way to be angry about something.  Here was a system that was mistreating, some would even say abusing women.  Damn right I was angry!  And when the hospital/physician’s decided to ignore our request for a meeting after the CNMs were fired, we went out in the streets to let the world know that we were not going to be abused and ignored anymore.  Quite suddenly, we were getting requests from all over the country to come tell our story.  My outrage was being encouraged.  Kind of.

On the one hand, I was being invited to speak out about the fact that midwives were being mistreated, oppressed, and so were the women.  But I was also being sent a very different message from the same community – your ‘truth-telling’ is making it uncomfortable for those of us trying to keep our heads down and make a difference.  I was hearing the same thing I had been told as a little girl – no one will listen to you if you’re angry.  What a load of poo!  How is anything going to change if we don’t point out when people are behaving badly?  But no one wants to admit their behavior may be hurtful to others.   It’s the same reason my kids tell me I’m mean when I point out that they cannot hit each other.

Four years later, after my first foray into public displays of outrage, I am ready to move in a different direction.  At times, it feels as if all of my efforts have amounted to very little locally – the midwives in our community are behaving more outrageously toward each other than before; our local organization grew and then shrunk in numbers; we are still getting reports of women being mistreated by providers (including the midwives, yall!).  But, I have made some incredible connections in other parts of the country.  Places where the midwives WORK TOGETHER!  Places where physicians speak highly of other providers!  Places where women are able to give birth in the setting of their choice, with the provider of their choice, at their own pace.  Places where the providers celebrate their differences and remember that it’s NOT ABOUT THEM.  IT’S ABOUT THE WOMEN!

Holy crap!  Birth is working in other parts of this country.  What happens if we begin shining a huge, happy spotlight on those places?!  Won’t women and providers say, “Hey. If they can do it, why can’t we?”  So, I am working on a video project with the American Association of Birth Centers Foundation to grow more birth centers:

I am serving on the board of BirthNetwork National, an organization working in communities all over the country to bring professionals and consumers together to promote the Mother Friendly Childbirth Initiative.  And I am working on a program aimed at teaching young girls about birth and the amazing power of their bodies.

“Where’s My Midwife?” will continue to be a resource for folks who want to learn about how to protect their access to midwives in their community.  We are in the process of taking all the knowledge that we have accumulated in our efforts to increase access to midwifery care and organizing it into a tool-kit that others can use.  Having this tool-kit will enable us to help more people in a more efficient way.  But I am ready to focus my time and energy on growing more healthy communities.  As a dear friend keeps telling me, “You can only lead the willing.”

Improving Birth National Rally for Change Reaches Millions

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!

Communities Across the U.S. Rally to Improve Birth

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!

Support your Sisters

This morning, I was reminded of another reason I considered quitting this whole activist thing.  A local CNM commented on my last blog post regarding our meeting with the NC OB/GYN Society:

Hi Kirsti!!!! THANKS FOR ALL YOU ARE DOING!!!!!! Is it possible to include homebirth nurse midwives in the planning stages? I appreciate all Rob and Russ and Lisa are doing-please don’t misunderstand. I just know homebirth needs support from all providers and this is another perfect opportunity for professional midwives and nurse midwives to work together.

I could not agree more.  When the CNMs in NC lost their physician back-up, WMM? immediately began blogging about it, contacting the press and organizing public events to raise awareness of the crisis facing home birth families.  The leadership of NCFOM attended a Midwifery Joint Committee meeting to testify in favor of the emergency extension of the home birth CNM’s permit to practice.  And WMM? wrote a letter to the Board of Directors of NCACNM expressing our desire for the leadership from all parties to sit down and figure out a way to work together to increase access to midwives in all settings:


After we sent this letter, the home birth CNMs and their families formed a separate Facebook group and stopped communicating with us.  Shortly there after, we received a formal response from the president of the NC chapter of ACNM reiterating their inability to support licensure of CPMs, effectively giving us the brush off.  Apparently, they did not need or want our help until they found out we had had a meeting with the physicians.

From the beginning, WMM? has consistently asked the midwives in our state and in our country to stand together.  We have always honored our mission to increase access to ALL midwives in ALL settings because in countries with best outcomes, midwives are the primary maternity care providers.  Time and again, the physicians and CNMs I have spoken with point to educational requirements as a reason for not supporting CPMs.  But in all of the years since the CPM credential was created, no state has ever reversed their decision to offer licenses to CPMs.  In fact, Washington state is now calling for more CPMs to be licensed because the increasing number of families choosing home birth are saving the state millions of dollars.

But aside from all of that, what troubles me the most is the idea that physicians and Nurse Midwives get to decide whether or not families have access to midwives trained to attend women at home.  This speaks to the heart of the problem in maternity care – women are judged by their providers to be too stupid to make decisions about their own health.  We couldn’t possibly be smart enough to decide for ourselves which provider is right for us, so the physicians and midwives will save us from all that trouble by limiting our options to the ones they feel are best.  And which settings are best.  And which procedures are best (VBACs, water birth, etc.).

But I digress. . .to answer the question from the beginning of this post, ‘yes.’ As we expressed to your organization back in June, we would love for all interested parties to sit down and discuss how to make maternity care better for the families of North Carolina.

I wanted to quit and then we sat down and talked like adults!

Yesterday, both past and current presidents of the NC OB/GYN Society sat down (at our request!) with representatives from “Where’s My Midwife?” and the North Carolina Friends of Midwives to begin a dialogue about making the environment safer for families who choose home birth in North Carolina!  We drove to Raleigh, gathered in their board room and talked like actual grown ups.  They listened, asked questions and expressed concerns.  We addressed their concerns and shared our personal stories about why this issue is important to us, and gently explained that we were not going away.

I cannot express to you how much this one meeting filled me with hope.  Eight people (six of them OBs) came to the meeting to have a conversation!  Honestly, before yesterday, I had been thinking about quitting this whole birth activist thing.  The retreat was mind-blowing – it was so nice to meet others who are as fired up as I am about truly making change happen in maternity care!  But after it was over, I got a bit overwhelmed at the task at hand. We realized that trying to get folks to work locally AND nationally was a huge undertaking.

Then, I saw this video and the awful comments posted underneath:

Here was a group of ladies who had tried to talk to their local physicians and hospital about being displeased with the type of care they had received.  When going through the appropriate channels did not work, they decided to take to the streets to raise awareness and put public pressure on the folks who had mistreated them to address their concerns. . .sound familiar?  The comments from the nurse who worked in the hospital were pretty typical, “no one is going to want talk to you if you stick with these methods.”

Then what are we going to do?  When trying to ‘do the right thing’ gets us no where, we must stand up and say “Enough!”  The whole reason nothing has changed thus far, is that the women who do speak out about being treated badly are then shamed or dismissed for telling the truth.  And, in my experience, women are far more likely to be the ones doing the shaming.  When I saw the same kind of discouraging language going on over at the Improving Birth Facebook page, I sincerely wanted to quit.  How are we ever going to come together to make things better if we keep tearing each other down?

And then, one little meeting changed everything.  If we can get a meeting with the NC OB/GYN Society to discuss home birth, anything is possible!  So, come on folks, let’s put aside the judgement about how the message is being delivered and keep telling the truth about birth.  Women and babies deserve to be treated better than they are, and we all need to work together to make that happen.