Safety in Numbers

Working to bring awareness to our broken maternity care system can feel quite lonely.  When we produced the play “Birth” by Karen Brody back in 2007, we had a strong group of doulas helping, and a close-knit home birth community to fill the seats.  Ultimately, aside from the professionals who agreed to participate in the talk back panel discussion after the play, it felt a bit like preaching to the choir.  But we plugged along, undeterred because we so passionately believed that nothing would improve if we weren’t talking about it.  So, we held a screening of “Business of Being Born,” we hosted Jennifer Block to discuss her book Pushed, we hosted a screening of “Pregnant in America”and we created Women In Labor Daze, a week long celebration of motherhood which culminated in another weekend of the play “Birth.”  But all along, we wondered if our message was being received by the folks who most needed to hear it – the providers and the women who were afraid of birth.

When a large midwifery practice in our community was abruptly shut down we organized a daily protest at the hospital.  After we had been protesting outside the hospital for a couple of weeks, I arrived first one day and pulled my poster board sign out of the van and stood on the sidewalk waiting for others to show up.  A guy in a red pick-up truck drove by and shouted, “GET A JOB, BITCH!!!” out his window.  Wow.  At the time, I thought, “It’s true, I don’t have a job.  I just stay home with my kids.  I’m just a mom. . .but I want this to be my job!”  How was anything going to change unless women made it our job to change the current culture around childbirth?  So we decided that we would!  We recognized that after most women have their first baby, they are so overwhelmed with the transition to motherhood, they don’t necessarily have time to reflect on their birth experience much less set out to try to change the system.  But we knew there were others like us out there – there were communities all over the world producing the play, “Birth,” the film “Business of Being Born” was being screened everywhere.  What if we could somehow coordinate our efforts?  Form a national campaign to raise awareness?  Start networking with other activists and find out about where other folks have affected change in their communities so that we can replicate those things in our own communities.

And that’s where you come in, birth activist!  We need you.  We want to know what you have been up to.  If you are available June 22 – 24, join us at the Farm for our Birth Activist Retreat.  If you have already been accepted to the retreat, look for an invitation this week to join our private facebook group where we will begin brainstorming ways to actively engage the public about pregnancy and birth.  And if you cannot make it in June, but want to be a part of the discussion, sign up to be on our mailing list and we will invite you to join the discussion on facebook.

It may feel lonely being the one lady holding up a sign, talking about transforming maternity care.  But you are not alone – there’s safety in numbers.  Join us.

Bad Behavior, Part 2

Last year, I wrote a post called, “Time Out for Bad Behavior” which was supposed to be the first in a series.  And then it didn’t really pan out that way.  I’ll be honest here – I have a hard time writing about these issues.  I was raised in a household that used the dreaded phrase ‘be a good girl’  which has taken quite some time to get over.  If I got angry or upset, I was told, “quit yer cryin’.”  Also, it was made quite clear that no one wanted to see a woman get angry because then everyone would think you were (God forbid) a bitch.  But now I have daughters, and if I don’t talk about the problems I see with our maternity care system, they will have to get pregnant and give birth under the same messed up conditions that I did.  So, I have to talk about it!  I have met folks in the birth-y world who very strongly believe that we ought to just keep it positive and plug along, don’t talk about the problems, don’t be negative.  And that’s exactly why nothing is changing. That’s more of the same ‘be a good girl’ thinking that keeps us stuck.  How can anything improve if we don’t talk honestly about what is not working?  Being almost 40, I have been given the gift of time and wisdom, and I’ve come to realize that it really doesn’t matter what other people think of me, what matters is what I think of me.  And I have also realized that not talking about it makes me feel miserable, makes me feel like I am part of the problem.  So, let’s talk about providers in the hospital setting. . .

I recently had a conversation with a physician (we’ll call him Dr. X) who had quit obstetrics and opened a birth center.  Yay!  He also said that while he was practicing obstetrics, his c-section rate was only 5% – again, Yay!  But, he then shared the fact that he had colleagues who had c-section rates close to 50% – boo.  And Dr. X claimed he understood why – huh?  Dr. X said he was recently named in a lawsuit from a birth that happened years ago because the child was diagnosed with ADHD and the family was claiming birth trauma was to blame.  He said that if it wasn’t for such a ‘litigious society,’ physicians would not feel so much pressure to perform cesareans.  WHA?!  I get it – doctors who get sued have to deal with really high insurance rates, and might even get sued personally.  That really sucks.  But the key word here is MIGHT.  They might NOT get sued.  And if it is perfectly acceptable for a physician to perform defensive medicine in order to protect his own livelihood, why don’t we talk about the countless women whose livelihoods MIGHT be impacted by an unnecessary cesarean?  Why is this physician’s livelihood/lifestyle more important than the women he serves?  What of all of the women who end up with physical issues stemming from surgery that last a lifetime?  Is a physician’s life more important because we value doctors more than we value women?

And another thing – why aren’t the providers taking some responsibility for the ‘litigious society’ that they helped create?  If you are going to claim that the hospital is the safest place to have a baby, to claim that you have all of these fancy machines designed to prevent anything from going wrong, then you better have a good explanation when things inevitably do go wrong.  Essentially, women are being told, “Trust me.  Just lie back and let us take care of everything for you.”  If you ask a woman to give up her power to you, she is participating in your version of birth where the woman is just a vessel and your only goal is to take a live baby out of her.  But somewhere along the line, she is going to realize that what happens to her in birth is going to stay with her forever.  And you lied to her – you told her to trust you and that everything would be okay if she does exactly what she is told.  If she is a ‘good girl.’  So of course she is going to be upset when she does what she is told and something horrible happens.  In her mind, you were doing everything TO her, so it is your responsibility, not hers.  Of course you’re going to get sued!  You promised she wouldn’t have to participate in her own birth, that you would do all the work.

But there are no guarantees in birth.  No matter how many fancy machines you have, injury and death are always a possible outcome.  And no matter how much you might want to control birth to prevent a bad outcome, it is never really the care provider’s work to have control over.  It’s that woman’s labor, and the work needs to be HER work.  It took us a long time to forget this important fact, and it’s going to take a lot of work to help women and the people who care for them to remember and act accordingly.  So, let’s start talking about it.

Rally in Hawai’i – by Summer-Lee Faria

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!

Is this thing on???

Hello, birth workers.  I’m talking to you – midwives, doulas, activists, advocates, physicians, nurses, bloggers, hospital administrators – anyone and everyone who can see what a mess our maternity care system is in.  I want to congratulate all of you for working to make birth better for mommies and babies, and to ask if you are ready to ‘kick it up a notch’?  For over a year now, I have been using the word ‘revolution,’ and calling on all of us to unite and begin actively engaging those who hold positions of power to effect change where it is needed (Let’s get it started in here, Time out for Bad Behavior, and Who Ya Gonna Call?).

Over the Christmas break, I read a post over at the Unnecessarean about ‘pit to distress.’  I had heard of this practice, but did not realize how pervasive it is.  As the post points out, pit to distress (giving a mother high amounts of pitocin in order to send a baby into distress) was occurring in our country at such high rates, the act found its way into nursing text books.  I was so angry after reading this post, I couldn’t sleep for weeks.  I wanted to blog about it, but every time I sat down to write, I became afraid of my anger.  How could this be happening in our country?  How could people who had taken an oath to ‘do no harm’ be putting women and babies in danger for their own convenience?  And what of the people who were carrying out the orders, knowing what the implications were for their patients?  The post was written three years ago – is this practice still going on?  And when will it stop?  As a wise physician once said to me, “We [the physicians] are comfortable with the way things are. Nothing is going to change until the women ask for something different.”

We at WMM? have been emboldened by our successes. Twice now, when mommies and midwives have stood together and demanded change, the folks who have the power to affect change have listened. We believe the time for action is now. Let’s stop talking about how bad things are and do something. Let’s come together, gather our allies, learn from the people who have improved maternity care in their communities and lay the groundwork for a full-scale birth revolution! Join the national grassroots movement to change maternity care.

WMM? invites you to spend a weekend at the Farm in Tennessee, collaborating and brainstorming, coming up with activities that can be carried out in any community at any time for little to no money. These activities will raise public awareness about our broken maternity care system, and draw attention to the methods that are producing better results for mothers and babies. We need to put public pressure on the people, organizations and businesses in positions of power and hold them accountable for improving outcomes.

If you are ready to take the next step, join us June 22nd through the 24th at our first annual Birth Activists Retreat. For more information, e-mail us at info@wheresmymidwife.org.

And remember, “Well-behaved women seldom make history.” – Laurel Thatcher Ulrich

Put Your Big Girl Panties On

Do you all remember my t-shirt slogans from months and months past… or is it years?  I’ve come up with another slogan: “Put your Big Girl Panties On.” Let me back track. A year ago, I started writing a series for the Where’s My Midwife? blog. My series was about potential slogans for t-shirts. I came up with “Don’t Hate Me Because I Had a Beautiful Birth” (one of our most popular blog entries ever—thanks readers!) When I wrote that blog, I was feeling positive and upbeat. Then personal tragedy hit.

My sister, Elena, had been diagnosed with a highly metastatic form of cancer only a month after our midwives were fired from a local practice. If my sister could (and was!) battling, and seemed to be kicking cancer’s ass, well, I would battle right along with her. While I would continue to fight against the injustices that I witnessed daily in my community, not only about access to midwives, but also to woman-centered care locally and nationwide, I would try to spend as much time with my sister as possible.

About a year after Elena’s diagnosis, she lost her battle, and she suddenly passed away.  I was with her as she took those last difficult breaths. There were moments that I thought as I slept next to her on the hard cot in her hospital room, and as I kept certain forces at bay (unwelcomed visitors, etc.) that this was actually the culmination of my work as a doula. I will always hold those moments with my sister close, as difficult and painful as they were.

This was the second year that we experienced the holidays without my sister. It was harder this year for me than last year. Last week I sat across from my friend and midwife, Suzanne, one of the two midwives who was dismissed from our local practice. As I wept, wailed, and screamed (unfortunately my grief has recently manifested as anger towards people who I dearly love), Suzanne gently suggested that I contact a therapist. She chose her words carefully, “Sylvia, I want you to consider if you might benefit from medication, therapy, or both.” It is one of the things that I appreciate about the way that midwives practice. They are at their core “with woman,” and they are trained to care for the total person. I appreciate that Suzanne recommended that I seek help not only as my friend, but also as a health care practitioner.

The last two years were for me the intersection of a personal fight (dealing with my sister’s illness and death) and of a more public battle (increasing access to midwives.) It’s been a tough couple of years. For me “put your big girl panties on” has meant that I got up every day and not only take care of myself and of my children, but it has also meant that I continued to work to make change in my community and beyond. As we become “big girls,”(i.e. women) we face major life changes and tragedies. “Putting my girl panties on” means that I need to prepare myself mentally and physically for this next stage in my life. I am facing life without my big sister, and I am also squarely in the middle of middle age. (Did you know, by the way, that midwives provide continuity of care throughout women’s lives?) I have made an appointment with a therapist to help me navigate these unchartered waters. Thank you, Suzanne, midwife and friend, for reminding me that it’s necessary to take care of this aspect of my health.

So, I leave you with this. When I say, “put your big girl panties on” I mean that we all have our personal and public battles to fight. For me it’s one of the mantras that have helped me through the past couple of years. Join me in putting ‘em on and in fighting your own fight: whatever this may be.

Happy New Year!

The New Year is a time to reflect back on the past and to step forward into the future with clear intentions. Here are some of our new year reflections:
In 2011 we test drove a sweet little idea called Pregnant Mayhem. This was an opportunity for mommies everywhere to hit the streets and demand better maternity care using theatre, public art, flash mobs, megaphones, protests, whatever it takes to get the word out about our broken system and the beautiful ways it could be better. The original idea was to have something simple and provocative every month. This something would take place all over the country.
Our initial action took place around Labor Day to coincide with the 5th anniversary of Karen Brody’s International movement –  “Birth” On Labor Day.  It consisted of four women in four different cities giving birth in public spaces, a conference, a street fair, a tourist destination and a parking lot. Of course we didn’t force any real babies to spend their first moments of life as a public spectacle. These women were all performing a scene from Karen Brody’s play “Birth”. In 2012 we want to further develop this idea of taking our birth activism to the streets. We want to reach more people in more places with bigger and more profound happenings. It is time for birth activists to stop talking amongst ourselves and to get the message out to where it can make the most impact.
Also in September of last year, Where’s My Midwife? planted roots in Canada with the birth of the Ontario chapter.  Maria Radonicich relocated from Wilmington with her family only to find that a local midwifery practice, in Orangeville, Ontario, needed help.  Maria told the locals about the success we had in Wilmington when mamas demanded change.
Soon, local families were painting car windows and marching for midwives, all in the hopes that the local hospital – Headwaters Health Care Centre – would see the community demand for midwifery care and grant privileges to the Midwives of Headwater Hills’ entire practice.
The new chapter saw one midwife granted privileges in November (bringing the practice total to 3 with privileges at HHCC) and are awaiting approval of a fourth midwife’s privileges. In the coming months we anticipate seeing the Midwives of Headwater Hills catching babies at Headwaters Health Care Centre again.  We will be working on establishing non-profit status in Ontario and researching what town to head to next.  We will continue reaching out to communities who have lost their midwives or seen their ability to practice be crippled by unfair laws and policies.  We are ready to stand with communities across the U.S. and Ontario and help them develop an individualized plan to set things straight. If you need more midwives in your community give us a call!
And, finally, one of our favorite projects in 2011 was a short film titled “Midwives’ Diner”.  This year look for more short films promoting midwives and the amazing care that they provide. We love making films and will continue to use them as our megaphone.
We are looking forward to a year full of positive, creative, engaging action. We hope your 2012 is full of all good things. Happy New Year!

Thoughts While Driving

Those of you who follow us on Facebook , know that Where’s My Midwife? has been busy giving birth and participating in other BOLD activities. There is much happening, and it is very cool and exciting, but I will let the lovely and talented Kirsti and Anna share those stories.

For now, I wanted to tell you about a very odd experience I had a couple of weeks ago. I went to see my midwife, and when I left, I was sad. I know, I know. You are thinking, “Honey, you ain’t the first person to be sad. Let me tell you about a SAD trip to see a health care professional!” And you’re right. You are totally right.

What seemed so unusual, at least to me, was the reason for my sadness. I was there for a routine checkup. Yes, every woman’s favorite – the annual exam. All was well, and as I was leaving everyone, from the lovely nurse who asked me about all my other kids at each visit during my last pregnancy to the ladies at the front desk who were simply kind enough to treat me as a person and not a number, said, “Bye! See you next year!” Really? I have to go a year without seeing this people? I’m going to miss them. And that doesn’t even include my midwife. Love her! She is amazing! That is all I can say.

But it struck me as I was driving home, who is their right mind is sad about not spending time with the people who poke and prod at their most sensitive parts? A woman seeing a midwife, that’s who.

BOLD is turning 5 and Where’s My Midwife? will be a guest of honor at the birthday party!

What is BOLD you ask? BOLD (“Birth” On Labor Day) is a global movement to make maternity care mother-friendly. Folks all over the world sign up to perform a play called “Birth” by Karen Brody over Labor Day weekend.  Ms. Brody conducted hundreds of interviews with women about their birth experiences, and condensed them into seven interwoven monologues that paint a vivid picture of birth in our country.  People all over the world are coming together to laugh and cry, to be entertained and educated, to discuss how to improve maternity care and to raise money for organizations doing the work.

The women in the play could be your best friend, sister, neighbor or coworker and their stories reflect the reality of giving birth today. There is ecstasy, pain, disappointment, rejoicing, and poop!

BOLD has been happening for 5 years and to celebrate they are honoring 5 people or organizations that have made creative contributions to improving childbirth choices for mothers in the last 5 years. Where’s My Midwife? was chosen alongside:

We are very excited and honored to be included in such an amazing group of creative activists! We hope that you will join us in New York City.   Before you list all the reasons why spending Labor Day in NYC is impractical visit: www.GetBoldAboutBirth.com.   The play and birthday celebration are being broadcast for free via the internet. All you have to do is sign up. You can even bake a cake and invite all your friends over to watch the play and celebrate with you!

Summer Madness and our Anniversary!

After a busy spring of blogging, we have been oddly silent for the past couple of months.  For that, we apologize.  We know you enjoy reading our rambling (some of you even admit it in emails – and muchas gracias for the love!), and we love sharing with you. 

Last spring we went through a bit of a restructuring, and I emerged as the primary blogger.  Little did the rest of the group know, that beneath my exterior of overachieving auditor and mommy of four, I am a slacker.  This summer I have totally failed to share the latest and greatest WMM? news with you.  But while I have been busy eating bonbons and drinking margaritas (oh how I wish!), the rest of the group has been busy.  Some of the things that have gone on since Memorial Day:

 

So now that we are updated, we are going to work on posting regularly so you can keep up with all our fun and madness – whether you like it or not!

P.S. – It has officially been two years since we found out that our beloved midwives had been fired.  In case you missed it, or want to remember why we are still so fired up, here is our birth story:

“Where’s My Midwife?” from Kirsti Kreutzer on Vimeo.

 

 

Congratulations, Missi!

 

The lovely and talented Missi Willmarth was awarded the 2011 Kitty Ernst Award at the 56th Annual ACNM Meeting and Expo in San Antonio, TX last week!  We could not be happier for Missi, one of our biggest supporters.  She is the lovely midwife who ran a half marathon last October to raise money for WMM?  Ms. Willmarth is the coordinator for the University of Cincinnati’s nurse-midwifery and women’s health nurse practitioner’s program where she teaches and coordinates the fully on-line Master’s program!

Congratulations, Missi!  YOU ROCK!