The Blue Cotton Gown

My favorite book this week was the midwifery memoir The Blue Cotton Gown. The author is a CNM who practices with her OB-GYN husband (a women's health practice, not births). It was really sad in parts--lots of stories about clients' lives and some of them were pretty complicated. I wrote a full review on CfM.

I've also been reading old issues of the International Journal of Childbirth Education. I wrote a post with some quotes about that at ICEA.

I got the BirthWorks journal this week as well and was surprised to find my Our Bodies, Ourselves: Pregnancy & Birth review published in it. I'd forgotten about sending it to them!

This is a really insubstantial post, but it is all I can manage today (and possibly until next week!)

14

Labor of Love

Last week I finished a review copy of Cara Muhlhahn's brand new midwifery memoir, Labor of Love. Cara is the CNM who was featured in The Business of Being Born. I'm not going to write a whole lot about the book here, because I'm reviewing it for CfM News. It was a fast-paced read and very different than Lady's Hands, Lion's Heart, the other midwife's memoir I recently finished. It was interesting to read this one on the heels of the other one and I wonder if I would have enjoyed it more as a "stand alone" rather as an immediately-following read.

This book was different in that it was much more autobiographical than most other books in this genre--there were lots of details about her personal life and family (details which were nearly absent in books like Baby Catcher) and much less birth stories than you'd expect (the birth stories were not very detailed). In general, it was more a well-rounded picture of her life, her path to midwifery, her thoughts about her career, her work experiences, and so forth than I expected, but less "birthy" than I expected. Overall, it was an interesting and engaging read and I recommend it--especially to aspiring midwives. I think it is more relevant to them than to childbirth educators or other general birth activists.

Quite a few years ago, I was doing a lot of soul-searching about my life purpose. One of the things that bothered me was wanting my role in life/my life purpose to be transcendent of time and space (i.e. not "I'm meant to be a Really Specific Title only relevant in the 21st century"--like an ipod programmer or something like that!). So, a quote jumped out at me from this book:

"But something deep within me insisted on finding some kind of work that would be relevant throughout time, from life in caves through life in outer space. I didn't know yet that I wanted to be a midwife. I just knew that one of the criteria for my career was that it did not permit built-in obsolescence."

I thought I was the only one who thought of careers in these terms! I swear, I used to lament to my husband, "But, what would my purpose in life have been if I was a cavewoman?!" (This was before I had any children--mothering is certainly relevant across time and space and cavewomen!)

Recent Activities

I've had a nice and busy week and wanted to post a quick update about what I've been up to. My article Satisfaction with Birth, just came out in the fall issue of the International Journal of Childbirth Education (ICEA). At four pages, it is the longest professional article I've had published and I'm proud of it. :) The Journal has been redesigned and has a fresh, glossy new look for this issue and it is fun to be in the first edition with this new style! The whole publication looks really great. It also has some great content and I read the whole thing cover-to-cover right away. Particularly good was an article by Sheila Kitzinger about PTSD called "Screaming Inside: A Normal Response to Abnormal Stress" that was pretty powerful. (Also, I am excited to have my own article in the same issue with an article by such a talented woman!)

Yesterday, I finished making a mei tai baby carrier with my Mindful Mothers group. We had SO much fun!I shared a while ago about how making things for yourself is so empowering and this was another example of that--I did this myself! Yay me! :-D Of course Z is rather too big for carrier like this anymore, so now I'll have to have another baby to put in it...

Mindful Mothers originally started as a chapter of a national organization and I was a co-leader for it. As I've been faced recently with making hard choices about what to keep doing and what to let go of, I handed over the group to two wonderful and talented women who have reworked it into an independent group called Mindful Mothers. It is now going strong under its new leadership and new independence and I feel I made the right decision in stepping down. They've been doing awesome things like this mei tai party! (We all brought our sewing machines and worked together on two separate evenings making the mei tais--as well as eating delicious potluck dinner and doing lots of chatting!)

Finally, last night I finished reading an excellent book called Lady's Hands, Lion's Heart. It is a midwife's memoir and covers 13 years of devoted practice. Lots of great birth stories, as well as being an interesting personal journey and the journey of midwifery as a profession in NH. I strongly recommend it to anyone who is interested in birth, particularly aspiring midwives. I reviewed it for the forthcoming issue of CfM News and posted a little more about it on the CfM blog.

Birth Book

This week I also finished reading my brand new copy of the 1970's classic, Birth Book by Raven Lang. I've blogged about this book several times on the CfM blog, so I won't say too much more about it here. I also reviewed it for the spring issue of CfM News. Overall, I enjoyed it, though the slang terms for women's genitalia throughout made me uncomfortable--I'm a pretty "proper" type and linguistically conservative!

Birth Book was originally published in 1972--first book of the sort, even before the better known Spiritual Midwifery. It has recently been reprinted on a very limited basis and is being sold by Citizens for Midwifery. I wanted to share one quote from the introduction of the book that felt relevant to me when thinking about midwifery in Missouri:

“Birth has not only reached the absurdity of having to be relearned, it also has the absurdity of becoming a criminal offense if we are to go ahead with our ideals and do things the way we desire. And so, because of the system, midwifery as practiced in this book is against the law. It has become political. We didn’t make it that way. For us it is a beautiful, personal, spiritual, sexual experience. And for us to have that, we become criminals.”

The highlight of this book are the tons of beautiful black and white photos. Lots of photos of women birthing on their hands and knees which you don't see that often.

Midwifery Today Prenatal Yoga Article

In August, Midwifery Today accepted an article I wrote about prenatal yoga. I was incredibly excited about it then, but I didn't tell many people just in case they never actually published it (I didn't even tell my parents until October!). Then, last week the issue finally came in the mail with my article published in it--Incorporating Prenatal Yoga into Childbirth Education Classes. Woo hoo! I was re-delighted anew and now I'm telling all kinds of people and hoping I don't sound insufferably braggy about it. This feels like a lifetime goal (of sorts) realized. If anyone had told me last year that I would have an article published in Midwifery Today I wouldn't have believed them (too "big league" for me!). I'm getting a lot of mileage out of this, since every time I think about it I get a little thrill of excitement and disbelief. The article is placed right next to one by Michel Odent, so I've been joking about how we just overlap SO much, people confuse our work ALL the time (LOL!). They published the photo I submitted with it in the middle of the article, which was a nice layout (my mom took the photo of me when I was pregnant with L in 2003. The pose is called Proud (Birth) Warrior). There is a little synopsis of the article on the current issue page of MT's website.

I have so many more ideas for articles and essays ALL of the time. It is a constant flow of them. I wish I had more time to actually *write* them. Sometimes the most I get down is just the prospective title. Oh well. I have all the time I need (right?!). The idea for this prenatal yoga article actually came to me several months before I actually wrote it. It floated around my head for a while germinating and then refining and then one morning I woke up and said, "bring me my notebook!" and the whole thing came out basically fully formed onto the pages while Z and L were still sleeping. This helps me see how "writing in my head" is actually real writing and real work--even though I'm not actually putting pen to paper or fingers to keyboard, something is being created that can be born when the time is right. I hope the next article that happened like this is also published soon...I'll keep you posted, of course ;-)

Publication Station

Last Saturday, I received a lot of fun stuff in the mail. The first was a big box of Compleat Mother issues. They published my Singapore birth essay on the first page! :-) It also had a really extensive article about the midwifery legislation struggles in Missouri with lots of pictures. The fall issue of the FoMM newsletter also arrived (I'm the editor of this and write an article each issue based on the "question of the quarter"--the winter issue's Q of the Q is, "did you have a doula present at your birth(s)?" and/or "did your birth experiences inspire you to become a doula?"). I was really happy with this issue. My mother wrote a really beautiful essay for it about empty nesting (my youngest sister just left home this summer) and another grandmother submitted a wonderful (and very long) poem about the homebirth of her granddaughter.

Finally, my first issue as editor of CfM News also arrived! This issue had two film reviews that I wrote--The Business of Being Born and Birth As We Know It--a book review of The Official Lamaze Guide and then my article about Domestic Violence and Pregnancy. So, it was a fun ego-boost to get all of this stuff and see my name in print over and over again all at once! ;-)

New websites!

I recently finished a new website specifically for my birth classes. Before, they were kind of buried in my regular website. Though it isn't totally done, I already prefer having this new one! Yesterday I taught my first class that was specifically for a homebirth couple and that was really nice--it was so nice to be able to skip past a lot of the "defensive childbirth" type stuff I feel like I need to cover in my regular classes in order to help couples have a realistic view.

I also just started working on the Citizens for Midwifery blog. I'm hoping it will become a consumer birth issues blog and I plan to post questions for discussion/consideration and so forth. I want it to be opinion and commentary based more than news based, though some news will be sprinkled in there as well. Right now, there are only a few posts. I'm going to start making regular updates to it on Saturdays (Fridays are my usual day for this one, but I'm "cheating" a little today to post a few quick updates (instead of reviews).

Pushed

This week I was delighted to finally read Pushed by Jennifer Block. This book is seriously GOOD! Wow! Lots of weighty, meaty information, scathing critiques, astute observations, and clever commentary. She has plenty of scientific backup for her claims and the book is written in an engaging, fast paced style that skillfully weaves facts into descriptive commentary and personal, illuminating interviews. I checked this book out of the library, but after seeing all of the data contained within--she's pulled together vast quantities of data about effectiveness of "routine" practices, etc. and made it accessible to the average reader--I knew I had to put it at the top of my Amazon wish list.

Pushed is a thorough critique of obstetrics as an industry and how women and babies are being HURT by the systems ostensibly in place to "protect" them. Especially thought provoking is her descriptive exploration of the cesarean epidemic. She points out on one occasion when discussing the whole uterine rupture straw man used to deny women VBACs, that people must prefer "controlled uterine rupture" (i.e. cesarean). Later, in a separate section regarding blood loss during birth, she mentions that average loss is 300-500 mil and over 500 is considered a hemorrhage. She then notes that during a cesarean the average loss is 1000 mil. Reading that, I thought so essentially with a cesarean you have a 100% chance of a uterine rupture AND a 100% chance of a hemorrhage. Wow! No wonder they are common ::sob:: :-(

The information about blood loss wasn't new to me, but I did learn something I hadn't known before--300-500 mil of blood is approximately 8-9 menstrual periods worth. Isn't the female body thoroughly awesome?!

Some assorted thoughts & quotes:

Re: EFM (external fetal monitoring): "For the natural childbirth movement, the emergence of the monitor was unfortunate timing. Just as activists were urging women to get up and birth, hospitals reined them back down in bed and strapped them, both physically & psychologically, to a machine that falsely promised a safe birth."

Quoting a midwife re: unassisted birth: "'That's not why you're hiring a midwife. You're hiring a midwife because you want her there for complications' Some of Linda's clients are such believers in birth that they toy with the idea of going unassisted. To this, Linda is fond of telling the story of a birth she attended where the baby had its umbilical cord wrapped around its neck three times and need resuscitation. 'You never know when you're going to have a problem,' she says. 'It's like playing Russian roulette.'"

This paragraph made me really sad and also frustrated and annoyed. Frustrated because those kinds of scare-tactic comments and implied "you must not really love your baby" subtext is EXACTLY the same as the conventional medical system's attitude toward homebirth. The midwife quoted seemed totally oblivious that her remarks are virtually identical to the things OBs say say about homebirth and are just as demeaning and restrictive to women as the anti-homebirth sentiments are. Makes me think of the Trust Birth Initiative's point:

"Being afraid to support a woman’s choice of UC is the same convoluted, illogical thinking
if we are talking about trusting BIRTH. If we say we trust birth, but only
IF________then we are saying we trust the place or the personnel more
than we trust birth. So then our trust for birth is totally dependent on so many
conditions that are totally outside our control. And once again we are saying that birth is
dangerous UNLESS___________. And we are back right where we started."

So, which is it, do you honor, respect, and trust birth or not?!

Okay, brief rant aside and another quote. This one while the author was observing a home water birth:

"It is at this point that I begin to fathom what supporting normal birth really entails. Linda is on her knees, sleeves pushed up, gloved hand in a soiled kiddy pool up to her bare elbow, gleaning diarrhea wisps with a spaghetti strainer by flashlight. I try to imagine a doctor doing this work and have great difficulty. This is not medicine. This is birth. It is messy, backbreaking, humble work."

During the conclusion of the book after a discussion about the NAPW and whether childbirth is a reproductive right or not:

"To her [a doctor who thinks it is not], it is a medical issue, one that may need reform, but one that belongs under the purview of physicians. 'To my mind, I'm all for people having a pleasant and safe birth experience,' she says. 'But my highest priority would be for them to have a safe birth experience.' But what's considered safe is political. What's safe changes. Thirty years ago obstetricians said VBAC was dangerous. Then they said it was safe. Now they've gone back to saying it's dangerous. ACOG says out-of-hospital birth isn't safe, but the research has consistently suggested that for women with normal, uncomplicated pregnancies it is not just safe, but safer, because those women are far more likely to have a normal, spontaneous vaginal birth and far less likely to experience harmful, unnecessary interventions...."

"...The goal is to have a healthy baby. 'This phrase is used over and over and over to shut down women's requests,' she [Erica Lyon] says. 'The context needs to be that the goal is a healthy mom. Because mothers never make decisions without thinking about that healthy baby. And to suggest otherwise is insulting and degrading and disrespectful'...What's best for women is best for babies. and what's best for women and babies is minimally invasive births that are physically, emotionally, and socially supported. This is not the kind of experience that most women have. In the age of evidence based medicine, women need to know that standard American maternity care is not primarily driven by their health and well-being or by the health and well-being of their babies. Care is constrained and determined by liability and financial considerations, by a provider's licensing regulations and malpractice insurer. The evidence often has nothing to do with it."

This the TRUTH and I hope women hear it.

The only critique I have of this book is one I echo from several other reviews. The book fires you up and has a lot of passion and energy, but provides no outlet or ideas for where to channel that energy. There is no "resources" section, no suggestion to join Citizens for Midwifery or your state midwifery advocates, no list of birth-positive organizations who are working diligently for birth change in our culture, etc.

Midwifery Today

I was so pleased to to receive and read the autumn issue of Midwifery Today. I love this publication very much! :-) There was an article by Michel Odent called The Function of Joy in Pregnancy and I loved one of his conclusions therein:

"Prenatal care of the future will be guided by a [this rule]: "Eat sardines, be happy...and sing!"

(Sardines for the omega-three fatty acids in which many of us are deficient.)

There was also a lengthy article about uterine rupture and I appreciated the following observation (when considering the blanket recommendation of a repeat cesarean to avoid rutpure):

"At this point, wouldn't limiting the use of synthetic oxytocics and analgesia--and cesareans, of course--seem reasonable, so that fewer mothers and babies are exposed to fewer risks during the current labor and birth as well as in future pregnancies and births?"

Yes, doesn't it make more sense to focus on reducing the cesarean rates and the interventions that contribute to it, rather than focus on instilling fear of "rupture" in the many women who have experienced a prior (possibly unnecessary) cesarean? Not to mention that Pitocin use increases a woman's risk of uterine rupture whether or not she has had a prior cesarean (it also contributes to her likelihood that she'll end up as one of the statistics)--Pitocin use is epidemic in the US. It is bizarre that the interest of hospitals and doctors is focused on denying VBAC "because you might rupture" instead of reducing the use of chemical "enhancements" to the birth process.

Also in this issue I learned of the existence of an organization I was unfamiliar with before: The Association of Independent Childbirth Educators. I joined :-)

This week I got a postcard from Dancing for Birth in St. Louis. Anyway, I am NOT a dancer (not that I've tried to be, so I guess I really don't know. But, I think this would be like me going to a "singing for birth" workshop--singing is NOT my forte and it would be a joke to go to a workshop like that), but I got this fantasy all built up about how I would become a Dancing for Birth instructor and pregnant women would flock to these classes even though I struggle to attract them to my regular classes. I do think I have a point there--my regular classes compete with the "free" hospital class whereas a dance or yoga class would not and might reel people in, because of the "fun" element. So, M kind of gently pointed out that this probably isn't the training for me, but I keep thinking about it anyway...

Two hours of prenatal care?

A while ago I got Lamaze's email newsletter regarding "Research Summaries for Normal Birth." One summary is of a study regarding group prenatal care. In the summary, it states in passing, "In the settings where the trial took place, traditional prenatal visits lasted about 10-15 minutes each for a total of 2 hours of prenatal care over the course of a woman's pregnancy. The group care model, on the other hand, yielded about 20 hours of prenatal care over the course of the pregnancy."

Wow! Two *whole* hours of prenatal care during a woman's pregnancy? I'm so impressed! And, I daresay that this is likely a generous estimate. I know very few women who actually see their OB for a whole 15 minutes during a prenatal visit. Anyway, this quote made me realize how truly absurd it is when people say to unassisted birthers--"But what about prenatal care?!" like you are totally endangering the life of your baby without it or as if you could not possibly manage to get through pregnancy without it. I know there has been some research studies indicating better outcomes for women who have prenatal care, but I seriously question whether or not 2 hours out of 40 weeks can actually matter very much in the scope of things. That is pathetic! I forgot who said or where I read that prenatal care is what happens between prenatal visits--prenatal care is what a woman does throughout her pregnancy, not a 10 minute visit and fundal height measurement (was it you who told me that, Shauna, or did I read it in a Midwifery Today or in Laura Shanley's book or somewhere else...)

So, that is the UC perspective in me--how could 2 hours really make any kind of difference and that question people ask about prenatal care is such a twisted joke really. The midwifery perspective in me says, don't we value women and babies enough to spend more than 2 hours out of 40 weeks with them? Don't we value them enough to spend even more than the 20 hours referenced above out of 40 weeks one-on-one with them? Women deserve more than two hours of targeted attention during their pregnancies! (Not to "save" their babies, but to show them how important and how valued they are!)

The aspect of midwifery care that I most valued from my midwife was the time she spent with me--that is what I wanted from her, not fundal height or heart tones or blood pressure (I can do all of those things myself, big deal. But someone to listen to me and to care about my pregnancy and to care about my thoughts and views about birth? That was priceless to me!) I estimate that she spent probably 30+ hours with me during my pregnancy. Then, 5 minutes during the birth. What actually mattered in my life? Those 30 hours, not those 5 minutes (I could have done that myself too, just like I can find and listen to my own baby's heartbeat.) Also, she spent probably 12 hours postpartum with me. That was also of great personal value to me. What OB spends 12 hours--or really ANY TIME AT ALL--with women postpartum? (other than maybe spending some time on stitching, but that is a whole other rant...)

Leaven

Late last month I got and read the fall issue of LEAVEN, LLL's journal for Leaders. I was excited to have an essay of mine published in this issue. It was about an experience I had in the post office nearly 2 years ago now in which an older woman noticed my LLL logo necklace and shared her positive experience with LLL that had happened 32 years ago (as of the very beginning of 2006).

I was particularly excited about this publication, because they asked me if they could publish it. Everything else that I've ever had published anywhere, was something I sent in--this was a first for me to have someone to request permission from me for publication instead!

I also got a recent newsletter from the UMR Psychology Dept. and there was an alumni update in it (in a blue box, no less, LOL!) saying that Z was born at home and also that I'm the FoMM newsletter editor. I sent birth announcements to the Mizzou alumni magazine and to the UMR alumni magazine after he was born saying that he was born at home and they both printed my "born at home" phrasing. I figure why not spread the words "homebirth" or "midwifery" to people who might not ever think about it otherwise! It is a tiny method of birth activism.

Who Made the Lamb?

Let me begin by saying, I do not really understand why this book was called Who Made the Lamb? Ah, well. Maybe such things are not for me to know. The subtitle is "A Journal of Childbirth" and it was written in the 60's by Charlotte Painter. This book was given away by a fellow midwifery advocate at the recent Retreat, which is how I came to have and read it (I finished it on Monday). I'm also confused why the back of the book claims that the book is an "exploration of natural childbirth," when the author actually has a scheduled cesarean after only minimal and halfhearted attempts to learn about natural childbirth (such as a taking a hospital class in which she quickly realizes that the instructor is really only preparing them to be "good girls" and follow their doctors' orders--classes of the type that I refer to as "hospital obedience classes").

A thoroughly still true and unfortunate truth quoted therein: "Tom [her husband] laughed at this idealism. 'You don't understand,' he said, 'Pregnancy is not regarded as a process of creation. It's a disease of the uterus.'"

How true this is--a disease of the uterus. This is absolutely how the medical system continues to view pregnancy (and birth is the excavation of the disease. This reminds me of our "friendly" neighborhood doctor testifying at the Capitol against the midwifery bill that pregnancy can be viewed as a foreign object in the body and therefore "babies are like tumors that need to be removed").

Letter to the Editor

This is a letter to the editor that I wrote regarding the midwifery situation in Missouri and my friends and I sent to several newspapers. It was published in at least two--the Rolla Daily News and the Salem News.
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Why would a normal, healthy American woman want to travel to Singapore to have her baby? Because, according to the CIA, her baby is almost three times less likely to die in Singapore than in the U.S (www.cia.gov/library). Yes, according to the Central Intelligence Agency of our own federal government (who doesn’t have a specific interest in pregnancy, birth, or midwifery), our country comes in number FORTY-THREE when it comes to infant mortality. This is in spite of the fact that Singapore:

· Doesn’t have better technology.

· Doesn’t spend as much per capita on pregnancy and childbirth.

· Doesn’t have better doctors or hospitals.

What Singapore and the other countries who rank in the top five (Sweden, Hong Kong, Japan & Iceland), do is:

• Utilize more midwives.
• Follow the midwifery model of care as standard practice.
• Integrate midwives into the healthcare network.
• Have more out-of-hospital births.
• Have better birth outcomes for babies.

The recent lawsuit against the state of Missouri by the Missouri State Medical Association in regard to the midwifery legislation passed in May claims to advocate on behalf of women’s health and safety during childbirth and yet their determination to declare Missouri midwives criminals is in direct opposition to the recommendations of both the World Health Organization (WHO) and the American Public Health Association (APHA). The recommendations of these well respected organizations include midwives as the principal providers of care for pregnant women and increased access to out-of-hospital maternity care services.

Yes, we chose homebirth in order to have empowering and triumphant birth experiences. We also chose homebirth because we care about the health and safety of our babies. By choosing homebirth and midwifery care, we protected our babies from hospital acquired infections (the fourth largest killer in the United States, causing as many deaths as AIDS, breast cancer, and auto accidents combined. Centers for Disease Control, www.cdc.gov). We also protected our babies and ourselves from a myriad of other routinely performed hospital interventions that are contraindicated by medical research to be safe or effective for mothers and babies.

Let’s face it, for the Missouri State Medical Association this is about politics and big business. Their expressed concern about our access to midwifery care is not about the safety of mothers and babies.

So, why don’t we just move to Singapore? Because we love the United States and the many freedoms it proudly holds strong. America is the home of the free and was built on the tenants of personal freedom. Families in Missouri should be free to choose midwives, to have their babies in their homes if they desire, and to have access to safe, respectful maternity care services. We love our country and our wonderful state and we believe that Missouri can do better for the wonderful mothers and beautiful babies who are born and live here.

More about midwifery in Missouri....

A fellow midwifery advocate, Jessica, shared some interesting insights recently about the MSMA's lawsuit and I wanted to quote them here as she makes some very interesting and thoughtful points:

"The hypocrisy involved in the Missouri State Medical Association's (and partner physician groups) lawsuit against the people of Missouri is truly mind boggling.

Between its initial introduction and the final passage HB818 nearly doubled in size and while all elements pertained to health care and/or making health care more financially accessible - the midwifery provision was far from the only part of the bill that didn't deal with insurance directly.

Let's look at an example from the final summary:

http://www.house.mo.gov/bills071/bilsum/truly/sHB818T.htm

DELINQUENT MEDICAL BILLS

Currently, state agencies are allowed to submit an agency debt to
the Department of Revenue in order to set off the debt by the
person's tax refund. The bill establishes a process for
hospitals and other health care providers to intercept a person's
tax refund or lottery winnings.

Hmmmm.... I don't see anything in the above about Relating to Health Insurance. But wait - that provision will allow the members of the MSMA and the other groups involved in the suite to garnish the funds of Missouri citizens without having to go through the standard judicial oversight required of all of other business. Guess since it isn't a "danger" to patients (or would that be MSMA pocket book?) we don't have to worry about its constitutionality?

As the new law is written it allows *only* Certified Professional Midwives to care for paranatal women as independent practitioners. Practitioners who are CPM certified have undergone a rigorous training process followed by both a clinical and written exam. They are the only birth professionals specifically trained to attend birthing women in an out-of-hospital setting - something virtually no doctor has experience in doing.

Additionally, nothing about the new law prevents the state of Missouri from establishing a licensing board similar to the boards that govern all other allopathic and complimentary care providers in this state. In fact, that was exactly what the midwifery supporters had been attempting to do (and had majority support to do in both Chambers) but where unable to accomplish due to the filibuster maintained by one Senator Chuck Graham, recipient of the Missouri Academy of Family Physicians 2007 MAFP Legislative Award. You'll recognize the MAFP as co-Plaintiffs on the MSMA lawsuit.

If I was a doctor in the state of Missouri I'd be hanging my head in shame at the sophomoric stunts and juvenile tantrums of my trade union. Perhaps their colleagues in Kansas, Nebraska, Arkansas or any of the other 37 states where non-Nurse midwives legally take clients can demonstrate that doctors can indeed continue to practice when women are granted the right to choose their own health care providers."

At Home Motherhood

This week I read At Home Motherhood. It had been on my wish list at Amazon for a while and got down to like $1, so I bought it. It is really late on this, my appointed blog day, & so I'm going to have to leave it at that. It was a good book & offered me some good insights/food for thought. It wasn't what I expected really--I think I was looking for something that was going to say, "cut back on your other interests & make the kids your mission," but this book was very supportive of at home mothers pursuing their passions & actually made me feel much better about all the stuff I squeeze in around the edges--like it is important to my full development as a woman :-) I'd marked a bunch of pages, but don't have time to transcribe them now.

One evening I was putting some books away--deciding what belongs in my to-read-someday-but-probably-not-very-soon-and-maybe-never box and what belongs on my to-read-next bookshelf--and I accidentally started reading The Nanny Diaries. I've read it before, but it was several years ago. So, before I knew it, it was after 2:00 a.m. and the book was finished (I started it at like 11:30). This is why I don't read fiction very often--because I will not get enough sleep and will be all glassy-eyed from excessive book consumption without a break for food or water ;-)

This week I also read the summer issue of Midwifery Today. There was an interesting article in it about "life as an apprentice." Reinforced that it is not the path for me during this season of my life. I don't know how people manage it! There was also a good article about using media to educate about birth. I'd like to use this blog for more birth education/advocacy than I currently do. Another good article was "reflections on the end of my career." Lots to think about--I think it is good for people just starting out to read/hear the reflections of those who are closing that chapter of their lives.

Midwifery in Missouri

I'm deviating from my usual reading-materials-only format to post briefly about the midwifery legislation situation in Missouri. The MSMA has filed a lawsuit with the state in an effort to get the midwifery provision overturned (declared unconstitutional). Birth is a business in the US and this lawsuit makes that abundantly clear. The MSMA is joking if they think their lawsuit has anything to do with safety for mothers and babies.

The Governor of Missouri has come out in support of our legislation. I shared my thoughts on a politics blog as follows:

"I am politically liberal & have not been a special fan of Gov. Blunt. However, I'm so encouraged to see that he is "hearing" the voices of the people on this issue and not just the voice of big business--lets face it, for the MSMA this is NOT about the safety of mothers and babies. It is about politics, power, and money, nothing else. There are relatively few families in Missouri who would even consider homebirth with a midwife. It does not make any sense to restrict their choices in this way, particularly because in many other states families DO have the choice of midwifery care (and it is even covered by Medicaid in several states). There is not a single study that shows homebirth and midwifery to be any less safe than hospital birth, indeed, there is ample evidence that hospital births carry significant health risks for both babies and mothers. It is time to place the burden of proof on the medical profession--can they prove that hospital birth with an OB is actually safe? Studies so far indicate that maternal and infant mortality and morbidity rates are 2 to SIX times higher for hospital births with OB care."

For an exploration of this issue from a consumer rights perspective, check out Susan Hodges excellent and informative article: Mother-Friendly Childbirth Is A Consumer Issue

This issue cuts across partisan lines--ALL women deserve access to midwifery care, not just pro-life women or pro-choice women. We cannot be divided by political party lines--midwives are good for women and babies. Period.

Recent magazine reads...

I also recently finished reading several magazines--the May/June issue of New Beginnings from LLLI. I was reflecting on how much this magazine meant to me in my early months of mothering. It was the most supportive and validating "voice" out there! It still is an excellent magazine, but it really touched me when I needed it (now, I need it less, but still enjoy it when it comes). I was also pleased to have one of my responses to one of the Mother's Situations published in this issue--even if it is fairly small, I do so love a publication credit! :) This one was about "From Mother Mode to Lover Mode" and they took that title for the article from the body of my response (uncredited), which I thought was fun :)

I also read two issues of Ode magazine. I enjoy it usually, but I'm thinking it might clutter up my "simple" life a bit to try to keep up with it--it usually ends up in a stack of to-read stuff, instead of being devoured right away like many of my other subscriptions. That's why I had two issues to read at once (plus, today I found another one that I'd packed to read at Craft Camp in April and never read or unpacked!)

I also read Brain, Child. Now THIS, I devour. Literally. (well, I guess not literally, but you know what I mean). I often use food-related words to describe how I read. I gobble, I devour, I consume, I swallow, I drink, I eat up, I guzzle, I gorge on the printed word. I really do feel like I take it into myself, so maybe food words are apt descriptors. Anyway, I DEVOUR Brain, Child. I love it. I would probably keep my subscription to it above all others, even Mothering magazine (gasp!). I love how many ideas it brings together under one "roof," I love how it makes me think and consider and to laugh and to, occasionally, cry. It is so, so good. I read it cover to cover in a matter of seconds (well, hours) and then pine for it for the next three months...

Today, I just read the newsletter of the Missouri Midwives Association as well. Legalization of midwifery barely squeaked by this session (OMG! I can hardly believe that it is true! CPMs are technically legal in MO beginning in August. Yay!), so that was the main focus of this issue.

Baby Catcher

Earlier this week I finished reading another one of my birthday books, Baby Catcher: Chronicles of a Modern Midwife. It was fast paced and engaging and overall I enjoyed it (really, I couldn't put it down!). I have a couple of criticisms though: the book seemed very self-centered. Each birth story was all about Peggy (the midwife and author) and what SHE was doing, thinking, feeling. I realize that she is the person writing the book and that her experiences are valuable, but there was an "I'm the real star of this show" vibe that I didn't care for. There was also an overall "drama" portrayal of births--lots of "dashing in and skidding into place to save the day" type of stories (makes for an exciting book, I guess!). Finally, my HUGE pet peeve. She exclusively refers catching babies as "deliveries"--the books probably has over 1000 uses of the term. "I delivered her" or "I delivered the placenta" or "one of the mothers I delivered" or "I performed the delivery" and so on and so on. It grated on my nerves so badly. I'm surprised she could have "missed" that the term "delivery" is so dismissive of the birthing woman. (The whole babies are born, pizzas are delivered thing--where has she been recently?) It is such a passive and disempowering term (and, it also turns the focus to the midwife instead of the woman herself). Where was the, "the woman gave birth to..." or "then she gently birthed the head" language, or, at the very least, "I CAUGHT her baby." No, it is delivery, delivery, delivery all the time. The roots of the phrase are even distasteful--the whole "delivering the woman from her biblically ordained suffering" thing. Even her concluding statement reads as follows: "Those who are supportive of midwives, home birth, and a woman's right to choose how, where, and by whom she will be delivered, are hopeful that this is the wave of the future." Women are active, powerful, birth givers! Women give Birth, Peggy, they are NOT delivered!

That said, the book was well written and fast paced and I'd still recommend it to others. The author was really committed to her profession and served a lot of women in a skillful way. Oh, one more criticism, there virtually no discussion of the author's own family and how she integrated her busy practice with her family. I was curious about it throughout the book.

Recent Reads

I've read a number of things recently that I haven't blogged about (many while I was sick) and I'm going to quickly "catch up" with them here all under one post:

At our Craft Camp at the end of April, I finally finished reading Having Your Baby with a Nurse Midwife. I got it at the JC book sale and it was a little old, but really quite good. I wish CNM's were more available, because I think they really have the potential to bring midwifery to the masses ("normal" people aren't going to flock to homebirth any time soon, I don't think, and CNMs have the potential to interject some humanity into the hospital birth machine). I have always been much more drawn to direct entry midwifery and my heart lies with homebirth, but reading books like this helps me remember that CNMs have a very valuable role to play as well (they can also attend homebirths...sometimes...but I'm posting here about the majority that attend only in hospitals).

I also read the spring issue of Citizens for Midwifery News and the spring issue of International Doula (DONA's publication). Much as I love and support other childbirth organizations, I find the International Doula to be the most high quality of all the organizations' publications. They really do a nice job with this journal!

I really enjoyed reading Let the Baby Drive by Lu Hanessian as well. I had the opportunity to buy some copies wholesale a few months ago and I bought 15 or so, but hadn't read it myself until now. I donated a copy to my LLL Group's library (I was so excited to find something on the "approved" list that I could buy in bulk like this!). I hope a lot of mothers are able to read it and enjoy her perspective as I did. I had a bunch of pages marked to share quotes from, but I'll have to do that some other day. Suffice to say, I strongly recommend this book! I have a copy set aside for our new HMN chapter's library as well.

One of the birthday books I finished was The Mother Trip, by Ariel Gore. She is a compelling and engaging writer. I don't connect with everything she has to say, but that is what makes the world go round! I'm also uptight and prudish and so I get turned off sometimes by the language that she uses and in this book, by an essay about her trip to the city for a book tour without her kid and how she sort of slipped back into "party mode" (as I said, uptight, and I don't really appreciate or respect the whole "partying" mentality--like it is a desirable thing to be all impaired?).

In one essay she shares a meaningful quote from Alice Walker: "It has become a common feeling, I believe, as we have watched our heroes failing over the years, that our own small stone of activism, which might not seem to measure up to the rugged boulders of heroism we have so admired, is a paltry offering toward the building of an edifice of hope. Many who believe this choose to withhold their offerings out of shame. This is the tragedy of our world." Ariel adds her own thoughts to this: "Remember: as women, as mothers, we cannot not work. Put aside your ideas that your work should be something different or grander than it is. In each area of your life--in work, art, child-rearing, gardening, friendships, politics, love, and spirituality--do what you can do. That's enough. Your small stone is enough."

This afternoon I got and read the spring issue of Forum, Mothers & More's quarterly publication. I guess they've changed their tagline to be "Making Connections. Making a Difference." I love this part of their mission: "the caregiving work that mothers do is real work, with real social and economic value." I wish that was posted on billboards all over the country and I wish that state and federal governments GOT it!

The Birth House

On Thursday, I stayed up too late finishing The Birth House. While it kept me turning pages and was an interesting story, I was left feeling a little disappointed. It wasn't really what I expecting, I guess (most notably, there was not as much content about birth or midwifery). Also, I didn't necessarily click with the "literary scrapbook" style--it seemed a little "dramatic" and improbable at times or otherwise disjointed. The author's style reminded me of Catherine Cookson--lots of downtrodden women, rape, abuse, etc. The story was set during WWI, but I kept feeling like it was earlier--like 1850 and so my mental images of the women were "off" a little--i.e. some of the women got their hair bobbed and I was thinking, "hey, aren't they wearing bonnets on the prairie?" That wasn't the author's fault though! Some of the characters form a women's group called the "Occasional Knitters Society" and I really enjoyed the sections about that group--it was a strong core of women that pulled together to support each other.

Of course, I was reminded of our current efforts in MO to legalize midwifery, in the book's portrayal of the doctor arriving nearby and building a "safe, clean maternity home" with "pain free childbirth" and encouraging all of the women to stop receiving midwifery care ("not safe" or "hygienic"). Ugh! Sounds all too familiar! The main character, Dora, apprentices as a midwife with the elderly Bay midwife in her small community in Nova Scotia. However, as I referenced earlier, Dora only ends up attending like 5 births in the book (382 pages). The rest of it is about other elements of her life, her marriage, etc. While this isn't *bad*, it just wasn't what I was expecting from a book called The Birth House and the jacket copy that leads one to believe that it is a book about a birth house (save one, the only births that actually take place in the house happen in the epilogue or in foreshadowing, but no detail/story).