Sunday, October 31, 2010

Lack of Support for Birth Trauma in the United States

There is a huge misfortune occurring to women and babies in this society. Birth trauma is greatly misunderstood and rarely believed to be a problem. Other countries such as England and Australia have well organized groups to help combat and heal from this real problem. Too often women who have suffered a traumatic birth are told to "just move on", to "get over it" to "take accountability for their choices", that "they have a healthy baby so what is the big deal". This is demeaning to women and our culture as a whole. How a woman and baby experiences birth is trans formative for their family and society as a whole. I have no doubt that if more births were gentle and peaceful the family unit would be as well.

After my own traumatic birth(see took so much work and healing to come to a place where I felt like I could parent and welcome another child (see
My experiences were transformative. The healing was powerful. I feel the need to help other women come to a place of peace and healing regarding their own births.

I have several plans in motion and encourage my sisters in birth to consider taking similar strides in their communities and practice.
*I have started a local support group for birth trauma.

*I am attending a series of trainings over the next three years to become a practitioner of Somatic Experiencing (see as a way to help even more women and other people dealing with trauma in their lives.

*I am also involved in the rebuilding of a internationally well known childbirth education organization to add a birth trauma prevention and healing component to their instructor training.

*I also make it my life goal to respect the women that I work with and if trauma does occur, because sometimes it does regardless of how careful we are, that their feelings will be taken seriously and resources provided for healing.

I encourage practitioners and those working on healing trauma to also visit and support this organization.

Monday, October 25, 2010

Birth survey

Posted by Tatiana

I'm conducting a survey for some research I'm doing about a baby's physiological and psychological experience of childbirth.  If you've vaginally birthed a full term baby, please take a few moments to take the survey. And even more importantly, whether you've birthed a babe or not, please pass this along where mamas might see it and participate.

I'm interested in as diverse a response as is possible (on the internet.)


Your Baby's Birth - A Short Survey

Monday, October 18, 2010

Midwifery and Public Health: A Sisterhood

Posted by Katy
There is an old fable told in the Public Health world that has been on my mind this week:

The villagers of Downstream lived peacefully by the river until one day, many years ago, a single man was found floating in the river. Good people, the villagers jumped to their feet, dragged the body from the river and were able to save the man. After the first bodies, many turned up in the river and quickly the rescuing mission became the primary work of many of the villagers. The villagers grew better at rescuing the bodies, swifter and wiser, and the village was very proud of their work. Despite their prowess at life saving, the number of people drowning in the river continued to increase until the villagers were not able to keep up and the numbers of dead bodies began to pile up. The villagers worked harder, learned more, trained more rescuers, put more resources into rescuing, but higher still the bodies piled. Until, one day the granddaughter of a wise old woman finally took the time to listen to her grandmother and began to hike upstream. The other villagers shook their heads at her and told her that people were dying while she chose not to help. It pained her to do nothing as the bodies floated by, but she was faithful to the wise woman and continued her journey until she reached the village of Upstream.

Monday, October 11, 2010

Female Circumscision

posted by Katy
During undergrad at Berkeley, I came across the topic of female circumcision (also called female genital cutting, female genital mutilation, FGC, or FGM) fairly frequently. The subject came up in Public Health classes, in Medical Anthropology, in Development Studies, and in classes my friends were taking about gender and race. It seemed to be everyone's favorite example of ways that culture and power effect health. I often got the strangest of looks if I pointed out the motifs of the Heart of Darkness story playing out as we discussed female circumcision, despite the fact that this was a very popular concept in other conversations. The key sources used in discussing female circumcision were white, American, faith-based organizations who were set to "save" African women from the horrors of female circumcision. Berkeley's much loved cultural relativity was not considered applicable to families, mostly women, who chose to have their daughters circumcised. The voice of women who were assumed rather than elicited. Needless to say, female circumcision did not seem like something I would ever experience in the US, it seemed like an "African Problem".

I was surprised to discover that the first patient I did a pelvic exam for was circumcised. She was not a meek woman who had no voice, the character suggested by Berkeley academics. She was strong and angry about pain during sex, which was the reason she had come to the clinic. The pain was not from circumcision however, but rather from an endometrial infection, presumably contracted from a colposcopy. She did not mention the circumcision and the midwife I was studying with also did not. The next day, though, I worked with a midwife who is currently doing ethnographic research on circumcised women in New York (this is one reason I love midwives!). We served another circumcised patient and the midwife responded in perfectly "I can see you've been cut, when was that done? Where? Have you had any problems with it? Do you have any questions or concerns?". She answered with validation and empowerment, opened the door for the woman to discuss the circumcision in a setting that was affirming and non-judgmental, or not as her choice may be. This was a moment where theory was biased while practice in the real world lived up to the opportunity to be honest, human, and completely present to serve a woman's needs.

People often ask me "Girl, what are you doing in New York?", often with about that much attitude-- usually I don't have an answer. "Its just the way the wind blew." Slowly though, I'm piecing together reasons and one of them is the diversity of patients. Having the opportunity to work with women who were circumcised is an opportunity to broaden my understanding of the experiences of womanhood and what it means to serve women. This is why I came to New York and why I chose a CNM program.

Sunday, October 10, 2010


Posted by Tatiana

I had my first midwifery dream last night. I remember a fleeting feeling of being with a friend. And then being on the ready below her squatting body. I watched her swell and felt an impulse to apply counter pressure, but I held back and that baby came smoothly out with her pushes. I caught its slippery body in my nervous and elated hands. The whole dream was probably just one minute long, but what a delicious minute.

I hope I don't catch most of the babies I attend. That's a pleasure I'd like to leave for the mamas and the papas.

A nice little glimmer, too, that in my dream mind, at least, I could set aside the urge to intervene unnecessarily. That dream mama didn't need my hands pushing on her.

Wednesday, October 6, 2010

How Many Hours to Become a Midwife?

Posted by DyAnna

I came to my midwifery journey in a round about basis. I can't say that I always knew I would be a midwife but my life experiences have definitely helped bring me to this place. I looked into becoming a Certified Nurse Midwife briefly while on I was on the nursing track. After the birth of my second in 2005 I looked at different distance education options including Midwifery College of Utah and National College of Midwifery. My midwife for my second offered to be my preceptor if I went with a school she was familiar with. I also looked into finishing my nursing degree and then doing my CNM through Frontier School of Midwifery. In the end we moved away and I resolved myself not to do midwifery or other birth work. We moved to an area that had no CNM's or licensed midwives that did home births. I was very grossly misinformed regarding the education it took to become a traditional midwife and thought I would never want to train with any of the midwives locally.

I took a little over a year off. Few people even knew I had ever been involved with birth work and it was a much needed break. After the difficult birth of my third I knew that in order to be sure that quality midwifery care was offered in the area I would need to help by providing it myself so my midwifery journey began. I attended a few births of mutual friends with a local midwife I had been friends with for a few years. We hit it off and before I knew it I had transitioned from assistant to apprentice.

I still struggled (and still do) about whether or not I needed a more traditional school. In the end it came down to a few things. 1- I had already done the traditional college route and done it well graduating with and A- average and learned and retained very little compared to the amount of time spent. 2- Money. We already have so much student loan debt for my husbands law degree that the thought of spending more money on my school for a career that wasn't a huge money maker just wasn't possible for my family. 3- I wanted to be able to tailor what I learned and avoid the busy work. So far I think I am holding my own with a curriculum I established on my own and tailored to my needs.

So this is how it has broken down give or take. For the last 2 1/2 years of my life I have spent time studying individually, studying and discussing with my preceptor, teaching childbirth classes, attending doula birth, attending prenatals, births, and postpartum visits, doing skills classes, attending workshops. In the end of my apprenticeship assuming another 18 months the break down will likely look like this.

Time spent studying individually, reading, writting protocols etc.
8 hrs a week x 208 weeks =1664 hours

Time spent doing prenatals and postpartum visits
6 hrs a week x 208 = 1248 hours

Time spent in skills class (suturing practice, exams, etc.)
5 hrs a month x 48 months = 240 hours

Discussion, review and study with my preceptor
2 hrs a week x 208 = 416 hours

Birth attendance
2 births a month at an average of 8 hours per birth x 48 months = 768 hours

Additional workshops
24 hours total

Childbirth classes and doula births
3 series a year at 18 hours per series plus another 20 hours a year doing doula births x 4 years =296

Total: 4,656 hours of study and instruction

NARM the national midwifery association that provides the test for your Certified Professional Midwife required a minimum of 1350 hours.
I think I've got it covered.

Grandmother's at Birth

Posted by DyAnna
Having your mother attend your birth seems like a relatively benign thing. Wrong, really, really wrong. Your mother's influence at your birth is so powerful both for the good and the bad that can come from it. It seems like it would be a natural part of human nature. Years ago before we all lived in large cities most of us lived in extended family groups. Your mother would be at your birth as well and many other births in the family. It was a normal part of every day life. Fast forward many years when fear and women's rights meet with a vengeance. As women were requiring to be seen as full citizens of the USA, meaning we get the right to vote, we also rebel against Eve. Who was she to doom women of all time to painful child birth? Liberated women have a right to pain free childbirth. Enter anesthesia for childbirth. Mothers were removed from being at their daughters births in almost a single generation as their roles were taken by nurses, doctors, ether and stirrups. Fast forward a few more years. Woops we made a mistake and women still want their mothers at the births of their babies. Let's let them back in the room. Sounds like a perfect solution the joy of choice in childbirth, natural or medicated, with your mother by your side. Unfortunately it is more often than not like a train wreck. But it is not the grandmothers fault. For the past 80 years nothing but fear and distain has surrounded childbirth. So when you explain you want an unmedicated birth, to have your baby underwater and maybe even have your baby—gasp—at home what is a grandmother to do. Unfortunately most of the time it is panic. She was never encouraged to listen to her own instincts and intuition in her births or often even with her parenting. How can she be expected to support you while you do the same?
I most often see three different types of grandmothers when it comes to their daughters or daughters in law giving birth at home.

First- grandmothers who want nothing to do with the experience. They don't want to know or hear anything about birth. From the midwives approach these ones are easy to deal with unless the mother has a burning desire to have her mother there. Then it gets more difficult as the pregnant mom feels abandoned because her mother doesn't want to be involved in her life changing event.

Second- grandmothers who want to be there and are super supportive. These are often women who a- either had amazing empowering births that they can't wait to share with their families or b-had completely unfulfilling births and want to see and experience how different and normal birth can be. These women are often wonderful helpers to have at a birth IF and I do mean IF their daughters want them there and they can follow directions and respect boundaries. If they are not welcome and can't respect boundaries it is a recipe for disaster.

Third-grandmothers who want to be there because they want to protect their daughters. Unfortunately my mother falls into this category. She wants to help me and protect me from anything that could possibly go wrong with my birth. They often bring fear, distrust and belittlement into the birth experience. Not only making it frustrating and difficult for the mother to manage but potentially dangerous as well.

All of these situations have the potential for disaster or success. So much of it has to do with the pregnant woman talking to her mother about her wishes for her birth and her mother's role there, the pregnant woman discussing her mother's role at her birth with her midwife, and a hopefully uncomplicated labor. If any of these three things don't occur, aren't clear or go astray there is likely to be hurt and frustrated feelings.

As midwives we walk a fine line between support emotionally and support physically and with grandmothers it is easy for this line to get fuzzy. I highly encourage all pregnant mothers who are considering having their mothers at their birth to truly consider what both you and your mother have to gain from the experience. Now it may seem that I am calloused against grandmothers being in attendance and this is not entirely true. It can be a wonderful and bonding experience for the whole family, however often this is not the case. We are a different generation and we screwed up long ago removing our mothers and other support women from our places of birth and now we are reaping the consequences. It will take patience and careful navigating to mesh the natural and seamless beauty of a woman in labor supported by her mother with the thoughts of the world regarding normal birth.<