Bowing out

Hey, y'all. I'm going to be totally unsatisfying and leave my intended future posts dangling unfinished as I bow out from this endeavor which is much more like trying to perpetuate myself as a solo blogger than I was imagining, and that's not what I'm looking to do.

What I really want to do is collaborate. So I'll still be tripping around the blogosphere and perhaps occasionally offering a post in other settings (maybe even here if this blog stays around) and if you're working on stuff and are interested in bringing me on as a collaborator, hit me up by emailing me via the link on blogger.

Will the NARMs new preceptor guidelines actually reduce the number of potential CPMs in the US?

My midwifery journey is not that different than many others. I birthed all four of my children with midwives, two CNM’s, a CPM and a traditional midwife. After completing all of my pre-nursing requirements, graduating with a Bachelors of Science degree in psychology, working as a Certified Nursing Assistant and working for five years as a doula and childbirth educator I began my apprenticeship with a traditional midwife. She had had a whirlwind apprenticeship that ended with her spending 5 weeks working at a birth center in the Philippines and returning home to a full practice as her preceptor moved out of the state while she was gone. About a year later I began my apprenticeship with her. She was a great preceptor. Matching my skill level where I was while continuing to stretch my thoughts and learning by working out situations both intellectually and hands on as they evolved in the births I attended with her. She encouraged my didactic education spending numerous hours studying and reviewing information, protocols, and reports written in my personal study. I quickly stepped into the primary under supervision role. We worked together like a well oiled machine. After about three years I had completed all of the required numbers in order to apply to sit for the NARM through the PEP process. I was surprised to discover that all of the forms and paperwork had changed since I had originally printed them in 2008. I was also surprised to find that they were putting restrictions on who would qualify as a preceptor.
Preceptor guidelines are as shown from the NARM.org website “ A preceptor for a NARM Entry-Level PEP applicant must be credentialed as a Certified Professional Midwife (CPM), Certified Nurse Midwife (CNM), or Licensed Midwife. Preceptors must also have an additional three years of experience or 50 births, including 10 continuity of care births beyond the primary birth experience requirements for CPM certification.
Preceptors who do not meet the above requirements must be approved by NARM before signatures will be accepted on CPM Applications. Exceptions will be considered only for midwives who meet the experience requirements but do not yet hold the required credentials.
No new preceptor exceptions will be accepted after January 1, 2012.”
My main preceptor applied for an exception as did another midwife that I occasionally attended births with. My main preceptor was denied as a NARM preceptor. She had met the experience requirements concerning the number of births but was about a year short of being on her own long enough and had no goal of acquiring the CPM credentials. My second preceptor, a midwife with 25 years of experience and an intention of applying for the CPM credential in the next year was approved. There is only one CPM with in a 200 mile radius of where I live and practice and she was a personal midwife of mine that ended in a very traumatic birth. Apprenticing with her was not an option for me. So where did that leave me on my personal journey?
When I contacted NARM about the denial they replied that “ACTUALLY, NARM HAS BEEN PLANNING TO REQUIRE THAT ALL NEW CPMs BE TRAINED BY CPMs SINCE THE BEGINNING OF THE CERTIFICATION PROCESS. IT IS FOR EDUCATIONAL QUALITY ASSURANCE. THIS IS THE FIRST STEP TOWARD THAT GOAL...THAT IS WHY THEY CREATED THE PRECEPTOR EXCEPTION. WE ENCOURAGE
EVERY MIDWIFE TO BECOME A CPM.”
They have a goal of only CPM’s being able to act as preceptors for students wishing to take the NARM? I was flabbergasted. What about areas such as my own where the CPM credential is not valued? What about areas where midwifery isn’t legal? Can they really put such restrictions on who can sit for the NARM exam? I thought the whole purpose was to increase the accessibility to midwives nation wide by having a national standard?
When I voiced my concerns about the limited access that traditionally trained midwives (who do not apprentice with CPM’s) will have in attempting to sit for the NARM I was encouraged to look at out of state options such as a high volume birth center in order to get “my numbers”. I then questioned NARM about the possible complications of taking midwifery training and experience away from the obvious need in my community to train as a birth center midwife when my goal was to work in the home setting. I also questioned my families needs not being met by me leaving them to “get numbers” at an out of state or country clinical setting.
This was the response I received “IT TAKES MANY MIDWIVES 3-5 YEARS OR LONGER, DEPENDING ON MANY LIFE INTERVENTIONS, TO COMPLETE THEIR EDUCATION. I ENCOURAGE YOU TO KEEP PLUGGING AWAY AT IT. IT ALSO SOUNDS LIKE YOU HAVE A FAMILY THAT NEEDS YOU, AND SOMETIMES THAT IS THE PRIORITY AND MIDWIFERY EDUCATION TAKES A LITTLE LONGER. I GUESS THE OLD ADAGE THAT "PATIENCE IS A VIRTUE" IS APPLICABLE, BUT MORE THAN THAT IT IS A CRITICAL LIFE LESSON FOR A MIDWIFETO LEARN.”
When I addressed that almost all of the midwives in my community didn’t find value in the CPM credential so my potential NARM approved preceptors were essentially non existent I was told that
“IT IS A PROBLEM THAT WE ARE AWARE OF. HOWEVER, IT REALLY IS A COMMUNITY PROBLEM AND NOT SOMETHING THAT NARM HAS ANY CONTROL OVER.”
Really? . Here I was trying to bring midwifery and the CPM credential to an area that found little value in it and they were trying to tell me I wasn’t being patient and that I needed to put my family first and work on my priorities. I had more than completed all of the requirements laid out by NARM for the PEP process but the new stipulations of only allowing CPM’s to act as preceptors changes the entire dynamic of the PEP process for the traditionally trained midwife. Also the lack or responsibility from NARM for the affect it has on communities was disheartening. So that leads to the ultimate question, will NARM’s new preceptor guidelines actually lead to fewer CPM’s? I believe the answer is YES, and I may just end up being one of them.

Notes from a day-long lecture with Michel Odent - Part 1

Long promised notes from the lecture I attended with Michel Odent at the Midwifery Today conference in Eugene, Oregon back in April. Text that is offset are roughly paraphrased quotes, scrawled as I heard them spoken. The rest is a summarization in my words.

Make sure you turn on the French accent in your brain for full effect.

On becoming radical

It is time to stop being politically correct and to talk about the situation as it is. Nice terms like "turning point" are not relevant. To accurately discuss what is happening in natural birth, we need words like "abyss" or "trap."

He was really emphatic about this - that he was at a point in the discourse when trying to be appropriate or accessible was no longer important, that we can't look for shifts or movements, that we have to speak radically because the reality of birth today is radical. And he's talking about home and birth center settings, too.

On pitocin

Pitocin drips are the most common intrevention. Almost no births take place (in the Western world) without some amount of synthetic oxytocin. A birth is considered to be normal and natural despite a continuous drip of pitocin through the labor. You'll see it ignored as a factor in research, and certainly in the medical culture. We have no idea of the long term implications of giving synthetic oxytocin to, practically speaking, all birthing mothers.

The number women who birth without the hormone of love approaches zero.

Coming soon: Part 2, On three recent studies questioning home birth safety, and why they're right.

"Women are indispensable," and other nuggets from Cleverbot

So I just finished listening to the latest RadioLab episode about artificial intelligence, and decided to take Cleverbot (AI you can chat with) out for a spin on some of my favorite topics. It doesn't seem to process more than the immediate line of conversation to come up with a response, so they're sort of wonderful one-liners. Here are my favorite exchanges:

Me: How should women give birth?
Cleverbot: For every person, human or robot, the answer is different.

Me: What do you think about women who give birth at home?
Cleverbot: Women are indispensable.

Me: Do you think the rate of cesarean births is a problem?
Cleverbot: Only when I'm sober and you?

Me: Do you have a uterus?
Cleverbot: Yes.
Me: What do you do with your uterus?
Cleverbot: Talk, play, hang out.

Me: Should midwives be allowed to practice?
Cleverbot: You really should. You guys would be great for each other.

Me: How should women give birth?
Cleverbot: You should trust me.
(Typical technocrat..)

And finally...

Me: How can we address the disparities in access to midwifery care?
Cleverbot: Love bridges all gaps. We will find a way.

My only editing of the exchanges was to change "User" to "Me" so that it would be easier for our readers here to quickly track what's what, and to capitalize the "I" in "Only when I'm sober" because.. I just couldn't help myself.

Feel free to try your luck with Cleverbot and post any good ones in the comments!

Student midwives - Be heard!

The Future Midwives Coalition we heard about a few months ago has taken shape and also joined with MAMA's Student Section. They've created an anonymous and comprehensive survey for aspiring, student, new, seasoned and retired midwives of all ilks to share their experiences, opinions, and ideas. And on the whole gamut.. apprenticeships, education, inclusiveness, specific programs, etc.

"We specifically encourage people from marginalized communities to share their experiences so that we can create documents that serve all future midwives, in a truly inclusive way," they write.

The responses will be painstakingly used to draft a "Bill of Rights" which will hopefully help to shape a more sound, diverse, and feasible future for incoming midwives.

So go fill out the survey!

Resources for dads

"...a unique father-to-father, community-based workshop that inspires and equips men of different economic levels, ages and cultures to become confidently engaged with their infants, support their mates and personally navigate their transformation into dads."


I put a "..." instead of the name of the thing, because the name just grates on my nerves. Seriously? But here it is, the above blurb is describing: Boot Camp for New Dads. And if you can get past the militaristic drumbeat in the background, the video on the main page is sweet in a confused-new-dads-sharing-their-feelings sort of way.

I was surprised that they even have BCND in my town. As much great mama-centered stuff as I've heard about, the most I've encountered for new dads is that some childbirth educators will set aside a portion of time for new-dad related conversation. But mostly its a flying blind thing, and it seems really valuable that new fathers have some extra support. Obviously same-sex partners and "unconventional" participants in burgeoning parenthood would have that same need. I've most appreciated the modeling of some midwives of bringing the partner (if there is one) on board during prenatal care and addressing their needs (articulated, or equally importantly, not articulated) with care and the benefit of much experience. Not all midwives tune into that.

It has also been intriguing to realize that postpartum depression is increasingly being recognized among men (not to mention the impact on them of PPD in their partners). For a little more on that check out Postpartum Dads Project. I think we'll all be wise to remember to check in with partners when serving moms and babies.

And for both of these great resources, a hat tip to MedEd PPD who have a wonderful series of free Postpartum Depression modules that I plan on going through this summer. Anyone want to join me and make it a study buddy party?

I'm in sprinting distance of having completed my first year back in college since I had kids, and look forward to cashing in on some of those promises I've made about posts to this blog once my end-of-term schoolwork wraps up.

The Baby Project on NPR

Putting it out there for those of you plugged in with a lot of pregnant mamas:

"This summer, NPR is looking for expectant mothers to be part of a special project where we document that final month leading to delivery.

If your due date is mid-July and you'd like to be considered for our Baby Project, please fill out the form below.

We're looking for the most compelling stories to feature, so please describe what makes your family, pregnancy or delivery plan interesting or unique."

The Baby Project

Gloria Lemay's Classes

I start my official midwifery training tomorrow at Midwives College of Utah, but this past Thursday, I started a series of online classes taught through WizIQ by renowned Canadian midwife Gloria Lemay. This course was on postpartum hemorrhage and we learned so many great tips, plus had the chance to ask questions and learn from Gloria's many years of experience. The best part about the classes is that you can have as many people as you want per computer, so if you got a group together, they can be quite inexpensive. Gloria is so generous with her time and knowledge, and I took pages of notes on tips and tricks she's picked up from the years she's attended births and the research she has done. The classes only last an hour every Thursday night, and they cover very specific topics. Next week, for example, is all about meconium staining.

It is important to me to learn directly from other midwives, and I think we must treasure the living resources we have available to us. Not everyone can make it to Vancouver to meet Gloria, or afford travel expenses and childcare to attend a conference where such luminaries might be, but this online learning is an excellent way to learn from the masters.

Have any of you ever taken these classes with Gloria? I highly recommend them!

White Ribbon Alliance - Stories of Midwives

Check it out:

http://www.whiteribbonalliance.org/storiesofmidwives/

HIPPA for Midwirery 101

Made another addition to the Free Resources for Midwifery Study list:

HIPAA for Midwifery 101 is a straightforward guide to privacy regulations in the US written by a CPM.

Birth Story Listener

A friend of mine on Twitter has been livetweeting the ICAN conference, and one of her tweets quoted Pam England (of Birthing from Within fame) as saying her profession is Birth Story Listener. Not having been at the conference, I don't know the context of this quote, but I think it's a sentiment we can all relate to as birth workers.

For me, the idea of being a Birth Story Listener is not just about tuning into my clients and holding the space for them as they process their previous and recent births, but about doing this for all women. Whenever someone finds out that I am a doula and student midwife, I inevitably hear their birth story. This is one of the parts of my job I love the most, even when I have to bite my tongue as they recount things like, "My baby was too big at 38 weeks, so I had to have a c-section" or "I just wasn't progressing once I got to the hospital, so I had to be on Pit." Often they ask me questions about their experience, and I realize they've never been given the opportunity to truly process their births. I don't think this is something OBs regularly do. Once I was in one of my PhD classes and during the break, I'd gotten a call from a client that her OB had stripped her membranes during her appointment with the hopes that she would go into labor before the OB had to leave for vacation that weekend. I was so excited because this was my first client, and I was telling my classmates that I would likely attend my first birth that night! Before I knew it, eight women were telling me their birth stories, almost simultaneously, just lovely detail after detail pouring out of them, all piling up around me and surrounding me with happy birth thoughts.

The most important part of being a Birth Story Listener is to avoid judgement. I will gently correct certain statements made, like "well, it's not possible to have a breech baby vaginally," with something like "Actually, that's not true, it's just that few people are taught the skills to help deliver a breech presentation" or, "Pitocin does speed up contractions, but it also makes them more unmanageable." I never ever say, "That was a bad decision" or "Your OB lied to you," (unless this is an idea they introduced and which seems obvious--often I encounter women who are looking for someone to validate their feelings of being lied to and cheated out of their ideal birth). It's also common to have women ask me if, based on what they've told me, I think they could have gone natural. I try to offer affirmation and validation of their feelings and thank them for sharing with me.

It is a gift to be able to hear a birth story, and not everyone can listen and receive such stories in a supportive manner. One of our jobs as midwives or doulas or birthworkers of any kind is to hold the space for women to safely process their births. I have heard from friends who had planned homebirths and had to transfer that their midwives never followed up and went through the birth story with them. It can be embarrassing or uncomfortable when things don't go according to plan, but this is all the more reason to process what happened, both for you and the client. We are the keepers of birth stories, and we can learn so much from each one.

Wax study might be onto something

Ugh, I can't help myself. Despite the heap of schoolwork before me - grown even larger by four days of conference attendance - I can't help but keep dwelling on some of what I heard over the weekend. What really rocked the boat for me and was outside of what I would have expected to hear at a midwifery conference (I mean - Huge maternal and infant mortality: big, bad problem, Midwifery model of care: good, appropriate solution - that's pretty predictable and formulaic, right?) was what Michel Odent said about the recent research about neonatal mortality and other indicators of birth outcomes that has made home and hospital vaginal birth appear more dangerous for mothers and babies. It wasn't "Those studies are shoddy." It was, "They're right, I would have expected as much, and here's how we're doing harm even in home births."

Since Science & Sensibility posted about the Wax study again yesterday, I had to comment:

I got to hear Michel Odent speaking about this study last week and was really fascinated to hear his take. Rather than criticizing the study methodology, he said that its results as well as a couple of others of the last 6 months (Netherlands and China) indicate that birth is becoming more difficult in all settings. He suggests that we have a gross misunderstanding of the needs of a laboring woman across the board, even in natural childbirth circles. I’ll be writing more about this in the coming weeks because it is possible that we are largely turning a blind eye to a lot of widely accepted and in fact celebrated and endorsed practices even in the most natural and low-intervention approaches that may not actually be physiologically sound.

That being said, I’d be delighted to see this study retracted or taken down as inflammatory or unsound – but if there IS a kernel of truth in it, I think we’re wise to look directly and honestly at the implications.

I made a few corrections over the actual comment I left where I made a bunch of mistakes - my fingers are thundering through this today so I can get to "real" work. If you see any typos or mistakes, please give me a heads up.

I had no idea, until this weekend, that midwives are widely ignoring a number of the less convenient and conventional (midwifery-wise) criticisms Odent makes about very common and very accepted interventions (or as we like to think of them, practices.) That dude is way more fringe than most midwives, makes some very specific and potentially revolutionary observations, and we're not listening.

To give you a teaser... Is it possible, despite all our advocacy for allowing women to have food and water freely in hospitals, that they don't actually need food and water in labor, and that we are actually making their labors more difficult, prolonged, and unnatural by insisting that they do? 

More to come, more to come.

Update: Forum for Creation of National Coalition of Student Midwives (or whatever)

There is now a forum up for discussing the formation of this new Coalition of Student Midwives or whatever it is going to be called for those who want to participate in midwifing it, so to speak. It is here:

http://wearefuturemidwives.ning.com/

From the inaguaral post by Jeramie Peacock of SQUAT Birth Journal:

"The group (council/coalition/federation/ whatever) as I understand it enters into existence consciously leaving behind any sort of descriptive term (nurse, lay, license, direct-entry) before the word midwife as this division does not necessarily serve the next/future generation of midwives... All of the issues the group will explore in my opinion must be inclusive. We need to acknowledge issues such as barriers to midwifery for women of color/ lower economic brackets, issues of gender/ birth work, culturally appropriate care and training, etc. These issues are equally relevant in my mind to the creation of a Student's Bill of rights (one of the things discussed in the MT session in Eugene)."

Fetal Pigs

This week in my anatomy lab we had the opportunity to dissect fetal pigs. Dissection is something that I love, in another life, or maybe later in this one, I will be a surgeon. The inner workings of the body are fascinating.


OF COURSE there were many in the class who spent a lot of time sympathizing over the "poor baby pigs" and "but they are so cute", "it is just so cruel", refusing to take advantage of the opportunity to dirty their hands inside a body cavity.


On my way home, as I was rethinking the discoveries of the dissection (most amazing was seeing how the venous system of the umbilical cord ties into the venous system of the rest of the body) I flashed on an article a friend had shared with me earlier in the week, a report of a study on Maternal and Infant Mortality. An excerpt from the article reads:    

                 "Some 1,000 women and 2,000 babies died every day from easily preventable birth  complications…" (Emphasis is mine)


The article is focused on the fact that more midwives worldwide would serve to reduce the number of deaths that are being seen in impoverished nations; My heart focused on fetal pigs. Would the people in my class who were shocked and outraged at the loss of animal life have taken a moment of pause if they knew that during the 2 hour period we were in lab, approximately 83 human babies and 42 human mothers died because they lacked access to good food, clean water and a midwife? Here we were, in our charmed and privileged little world despairing because some baby pigs were euthanized in the name of science while families around the world were mourning the loss of their women and children. In my mind, the only reason to weep for those fetal pigs was thinking that, had one of them grown to butchering weight, a family somewhere in the world (maybe in our own back yard) might have been able to feed their children.


How lucky are we that we can slaughter our food source in the name of science to train the next generation of supposed "care" providers? (Cynicism is mine) How out of touch with reality are we to lament the perceived "senseless" death of ANIMALS while our brothers and sisters are losing their lives because they don't have food, water or access to rudimentary healthcare? I am the person in the corner talking to my little piggy, thanking its' spirit for the sacrifice it made, thanking the universe for the opportunity to better understand the intricacies of anatomy so that I can be the best care provider possible. I know that not everybody can see things this way. I know not everyone will cry through the article and feel deeply the unfairness of the world. I do, and I am thankful that I can feel that compassion and know that it will drive me to be the absolute best that I can be as a midwife, as a care provider, as a citizen of the world. I am thankful too that the squeamish and outraged people in my class have a measure of compassion in them as well, I just feel like it could be better placed.


I have been on the path of Midwifery long enough to realize that there will always be a struggle. A struggle for respect, a struggle for access, a struggle to maintain boundaries, a struggle to maintain marriages and care for kids while upholding our commitment to our mamas, babies and families. I have not yet been in the position to have to struggle for food, for water, for medicines for my mamas. I haven't had to watch a single one of them decide between eating enough to maintain a pregnancy or feeding her living children. I haven't watched a woman slip away as the blood slowly drains from her once lithe and dancing body because her placenta crawled through her uterus in search of sustenance. I have never handed a dead baby into a mother's arms or a newly motherless infant to its father. These things are happening EVERY DAY, more than once, 1,000 and 2,000 times a day and our sister midwives are out there struggling to stem the tide, to cheat Death of just one.


I am apprehensive. The numbers say that as I mature in my practice and as I see more mamas, I will experience these things first hand; Dead mamas, dead babies. Nobody likes to talk about this. Death of people in your care can mean death of your practice, of your spirit, of your career, especially if you are a homebirth provider in the Unites States because the cultural " we" takes it for granted that the beauty and miracle of birth and life is forever entwined with the miracle and beauty of death. I know that I am fortunate to be learning midwifery in an environment where normal, low risk pregnancy IS the norm and the safety net of medical technology is rarely far away. I have the luxury of serving a population of women who are willing to take responsibility for their own care, have clean water, access to a diverse range of fresh foods (if only they will choose to take advantage of it!!!) and the freedom to choose to give birth outside of the medical system should they so desire it.


I have to wonder, as I continue to pursue midwifery, how will I handle the realities? How will they shape me? Am I brave enough, mature enough, still flexible enough to attend births where there are far fewer guarantees of a good outcome? Will this kind of experience help or hinder me as a midwife? The answers will come and in the meantime, I am grateful to those Midwives who are serving the underserved populations, staring death in the face and yet able to celebrate those moments when life triumphs. Only the Universe knows if I will join their ranks. For the time being, I will continue my studies, attempt to maintain compassion and stay open to the possibilities.



My name is Annie, I am privileged to be a student of midwifery in the United State and I am thankful for fetal pigs.

Coming Soon: a National Coalition of Student Midwives

I could easily write two dozen posts processing and responding to what I heard at the "Gentle Birth is a Human Rights Issue" conference of Midwifery Today. Unfortunately, though it would be really useful for me personally and possibly useful for other folks if I did that, I likely won't be able to spare that kind of time for a while.

I will pass along this bit of news, however, because it is oh-so-relevant and plus very cutting edge! I'm sure we'll all be hearing more about this, but one of the things that came out of this conference was the push to start a National Coalition for/of Student Midwives (don't quote me on the name, it may morph as it takes shape but that's what was being tossed around this weekend) which will draft a Bill of Rights for student midwives and act as a protective body that holds proctors and educational programs to a standard that respects the rights of student/apprentice midwives.

Many students experience various forms of abuse at the hands of their preceptors and as of now have no way to raise their hand for help without putting themselves in an even worse position with their preceptors. This new body will provide protection and anonymity for those students, as well as a clear set of standards and rights.

I'm curious to hear what more comes of it and will share any information as it comes my way. This national coalition is the inspiration of Elizabeth Davis in response to the reports she has heard from many students and their expressed inability to stand up for themselves without putting themselves in the line of further fire.

call for submissions--outlaw midwives zine vol 3

call for submissions

focusing on pregnancy, birth, post partum, baby and breastfeeding

for and by: mothers, friends and allies of mothers, doulas, midwives, birthworkers, childbirth educators, childbirth advocates,

intention: to create a zine for pregnancy, birth, and the first year of motherhood centering the lives of working class, marginalized mothers and birthworkers.

submit: photos, drawings, visual art
poems, essays, fiction and non-fiction
tips, suggestions, lists of resources

check out the outlaw midwives manifesta and website: http://outlawmidwife.wordpress.com/

outlaw midwives: creating revolutionary communities of love

some suggestions for topics on which you can submit…but these are just suggestions…

suggestions for those trying to conceive. and for not conceiving. stories of conception, abortions and miscarriage.

what are the social, economic, legal consequences and limitations for marginalized mothers to make choices about how, when and where they will give birth.

tips for the first, second, third trimester. relationship with doctors, clinic, midwives, family, friends, etc.

how do our ideas of gender and sexuality influence how we view childbearing, midwifery, and parenting?

Your take on reproductive justice?

how do we resist the high infant and mortality rates?

what are the ways that community could support the childbearing year, mothers and families?

how have you navigated through the systems of welfare, protective child services, hospitals, etc?

reflect on the state of midwifery today. what do you see as the positives and negatives? how has legalization and licensing affected mothers and families access to care?

what would you want to tell a soon to be mother about pregnancy, birth, and early motherhood? or write a letter to your pre-mother or pre-pregnant self about what you should expect. what didnt you expect to happen/learn/experience in pregnancy, birth, the baby year? write a letter to you daughter and/or son about what you learned/want to pass on about pregnancy, birth, baby year.

what was your personal experience/story of birth? pregnancy, the baby year?
what did you learn/are you learning from the baby year?

what do you wish someone had told you about early motherhood and/or being a birth worker?
what do you wish you could have said to someone, but didnt?
what is your vision/ideal of how pregnancy, birth, baby year could be?

what family/traditional wisdom did you receive about pregnancy, birth, breastfeeding? what practical tips do you have for working poor mothers?

breastfeeding vs. bottle. what are the social, biological and economic influences and consequences of the choice to breastfeed or bottle feed?

what to do with the placenta? placenta art, consumption, burials?

why did you become a birth worker? what has been the highlights of the experience? what have been the difficulties?

what does ‘outlaw midwife’ mean to you?

keep it simple

deadline may 15

send submissions to maiamedicine at gmail dot com

you can read previous volumes of outlaw midwives zine

volume 1

volume 2

i just got back from the desert

--i will always be a student midwife. always be learning. to me that is essential to being an outlaw midwife. and the folks i learn the most from about birth and childbearing are the mamas. talking to them. listening to their stories of childbearing. everyone's story is different, takes unexpected twists and turns.

--at births, i imagine myself to be the hum in the background. reassuring. riding the waves up and down with the mama.

--for me being a midwife is more than knowing the physiology of childbearing. it is knowing how to stop pregnancy, if desired. this is why i created the lilith plan.

--here in egypt, where i live, local traditional midwives often do the female and male circumcision as well. as gloria lemay pointed out to me a couple of years ago, the cutting of another genitals without that person's consent is a violation of their bodily autonomy. so as an outlaw midwife here, i tell folks, i dont do circumcision and i see no reason for it to be done to a child. if that child when they grow up wants to have circumcision they will have every right to do so on their own body.

--i was in sinai egypt last week and i kept thinking about what are the bedouin traditions of childbearing. i dont know yet. what does it mean to give birth in a desert traveling culture? and how the mountains themselves are pregnant earth.

Flag me down at Midwifery Today!

For those of you who happen to be attending the Midwifery Today conference this week in Eugene, please feel free to flag me down and introduce yourself! I'm afraid I don't have great current photos available of myself but this will have to do...

I probably won't be reading a mirror-image copy of Бульдог и Таксик with baby chew marks on it, and my hair looks kind of different, but that's pretty much my face.. so, you know, look for it and say hi! It would be delightful to meet some readers in real life, and if you're thinking about becoming a contributor all the better - I can woo you with my charm. (I'm totally not charming!) But you know, with everything so digitized and distancing it's a breath of air to have a little of that human connection.

I have to admit that I already have a tight knot in my stomach about the logistics of my children's needs balanced out against not wanting to miss such great and charismatic folks that do such important work and who are here for such a brief window.

I'm signed up for some interesting talks and workshops, but I'm most curious to hear what the main conference talks will discuss with the conference tag line topic of "Gentle Birth Is a Human Rights Issue." I do hope to hear the disparities in access to midwifery care getting some air time.

Introducing Myself

I will start my midwifery program in May at Midwives College of Utah, a program I chose for its distance learning and flexibility, as well as the fact that I live in Salt Lake, where direct entry midwifery is expressly legal and licensing is optional. Utah is not the place I ever thought I'd end up, being a lesbian from the Midwest, but I came here to get my PhD in Literature & Creative Writing, studying & teaching poetry (my day job, as I like to joke), and the university's program is in the top five in the nation. Fortunately I've fallen in love with the place and its natural beauty and I hope to stay here for awhile. 

My road to birthwork seems at once direct and circuitous. I have always loved babies, pregnancy, and birth, but it never occurred to me that could be a career. When I was little, I used to play doctor with my stuffed animals and dolls, but the only thing that ever happened was they gave birth. I told my mother I wanted to be a doctor, and she said, "No, you don't! You want to be a teacher and a writer." She was correct, I did. But now that I look back on that, I obviously wanted to be a midwife, I just didn't know such a job existed! I was the older sister and the oldest cousin, and worked regularly as a babysitter for several families in my teens. I was never happier than when I was surrounded by children. I went off to college and then became a high school English teacher for awhile before going back to grad school for my MFA and now my PhD. But I missed having children in my life. One night I was out with some friends and one woman confided in me that she and her husband were trying to conceive. I discovered a few years ago that I am infertile, and, anyway, I am single and not in a position to parent right now. But I went home from an evening of talking about babies and I felt this primal ache. I loved school and writing, but something very deep was missing from my life. That is when I decided to become a doula. 

I trained and certified through DONA and have had the pleasure to assist at several births. It fulfills me in a way my academic life never has. I love knowing so much about the process, and I found I was quite good at helping parents through the process of labor. My knack for school helped me remember all I read, and my maternal instincts and babysitter skills kicked in when it came to sensing what a woman needed from me in labor. All the clients I worked with wanted natural vaginal deliveries, but chose to deliver at a hospital, and I became so frustrated as time and again the OBs would swoop in and disregard a mother's plan. After a particularly frustrating encounter with an OB who lied to my client, telling her that purple pushing was the only way it was possible to get the baby out when my client was begging to be allowed to breathe and push at will and grunt, after the OB told me doulas only make things difficult for doctors, I thought for awhile that maybe I should give it up. It was so frustrating feeling so powerless, but after a few months of taking a break, I missed it so much. I felt like I wasn't fulfilling my calling. I decided that what I really wanted was more involvement, not less. I wanted to be the one in charge, I wanted more power so that I could give that power back to the person in labor, where it belongs, so that she can tune in to her body and her instincts and birth the way she wants. 

I am training to be a direct-entry midwife and I hope to specialize in home births. I look forward to sharing my journey with you!

Interesting New Comment

I wanted to quickly call attention to an interesting new comment on an old post "The Art and Joy of Pelvic Exams". The comment describes a developing technology that seems to assist with pelvic exams. I'm really interested to hear what people have to say about the possibility of using some sort of video probe to visualize the cervix rather than performing a vaginal exam. Would something be lost if we stopped doing pelvic exams or if we changed them in such a significant way? What do we have to gain and would

Calling new contributors

The trouble with a collaborative blog of student midwives is that you have a collaborative blog of people who don't really have time to write very often, who may prefer to roll up their sleeves and get into the mess of life, and who may - just possibly - have their heads in the clouds on occasion.

So, erm, are there any more of you out there?

For me the beauty of a collaboration is that in the collision of different and sometimes disparate perspectives, we are all enriched. So whether you favor hospital, birth center or home birth, whether you believe in regulation or in outlaw midwifery, whether you believe in active management or active hand-sitting - you are invited. You can cozy into the collective without worrying about self-promotion, or having to shoulder the burden of producing content alone, or having to stand stark and naked with the exposure an unpopular opinion (you might still be naked, but you won't the stark when you're with peers.) I find that comforting, anyway. Plus I'm tired of the me-me-me of the internet. I want to move the discourse forward, be enriched, and bring something useful to the table - not just create another popularity-craving cyber-identity. Neither the world nor my ego needs that!

(Are you sold yet?)

So, consider yourself invited. Join the conversation, and may we all be changed and improved in the process. Contact Katy - bones206@gmail.com - if you're interested!

I don't have a punchline

There is just this: an unplanned unassisted (but planned home birth) to a mother who, when her baby grew limp and breathless moments after her birth had the resuscitation training to calmly position her, breathe into her mouth, and repeat until her little arms curled up, she sputtered, and she cried. (Watch.) When I first watched the baby's arms grow limp, even though I anticipated it, having read the word "resuscitation" in Rixa's post, I panicked. My own baby was nursing to sleep as I watched this and I startled harshly enough that he pulled back, opened his eyes and looked at me, surprised. As I watched the baby grow dangly, I said to the screen, "No, no."

That was the first pit of the last 20 minutes, that full-body rejection of the sight of an unbreathing baby. (Qualifier: I am a mom with a still-young baby and some unresolved junk around his birth - I know I have no business bringing all of that to anyone's birth, and I am not attending births. But I'm allowed to watch youtube.)

And then, as I watched the aftermath, mama settling into the tub, baby squirming in the normal fashion, the bustling attendant arriving and then being asked to leave, and the new baby girl seeming fine, I filled with joyful exuberance. That this one precious, tender, incredibly sensitive new little person could be born needing help and receiving that help from her mother in the warm safety of a tub is a transcendently beautiful departure of what neonatal resuscitation normally looks like. Nothing jarring, nothing painful or invasive, nothing panicked, nothing even as upset as my own response watching on a screen so many miles away. No, just family, breath appropriately applied, and the rolling of time into life here among us other breathing people. I felt buoyant and celebratory.

But now I'm sad again. Because this exemplifies what Adrienne Rich said. I believe every baby is that tender, soft, new, sensitive and deserving of such gentleness. Especially when it needs extra help. But in our world, such gentleness is not a universal right but a privilege that becomes available based on the constraints of social, cultural and demographic factors, including educational privilege and a willingness to make a choice that our culture largely regards as reckless. That is an awful lot to ask of people, who are social, dynamic beings in constant relationship and flux with the people around us, carrying with us the vestiges of that sense that certainly we can't know everything about this world, so mightn't it be wise to defer to authority?

I love Rixa's bold and unapologetic grasp on her responsibility for the choices she makes for her family. I'm so glad for her, and for that sweet baby girl who may have had the world's most tender resuscitation. I'm so glad for my own children's relatively peaceful births, and for the so many that are held in that remarkably rare spirit of reverence and respect in this slowly growing trend of gentle birthing.

But it is a bittersweet gladness, indeed, when I let myself broaden the lens to the larger world.

I wish I could summarize it all with... "And here is our clear answer."

But where? Where is our clear answer? I don't live in a world that has any of those. Not really, anyway. We like to assume the stance of certainty and conviction, but not one answer seems to stand firm against the onslaught of every possible experience, every possible shred of information, and every possible circumstance. And as much as I don't like to leave a bit of writing dangling with this feeling of conflicted joy-sad-ambiguity, it's what I have. There is no punchline.

"When culture trumps law"

Quite an image for reproductive justice in all its forms.

Click to see:

Zina Saunders illustration

Is the natural birth movement too narrow?

"A movement narrowly concerned with pregnancy and birth, which does not ask questions and demand answers about the lives of children and the priorities of government; a movement in which individual families rely on consumerism and educational privilege to supply their own children with good nutrition, schooling, health care, can, while perceiving itself as progressive or alternative, exist only as a minor contradiction within a society most of whose children grow up in poverty and which places its highest priority on the technology of war."

-- Adrienne Rich

Blowing open science

Posted by Tatiana

An update: I'm now in school full time plodding along, hopefully, towards a Master's Degree in Public Health. (First, I'm working on finishing up a BS.) Midwifery is still in my heart and in my future, but the confluence of the trials of learning and practicing midwifery with very young chilluns PLUS the opportunity for excellent funding to finish school has me eagerly accepting this chance. I see the research and policy making that a Public Health degree allows to be on excellent and friendly terms with the kind of direct-entry hands-off socially-conscious midwifery I plan on stepping into in a few years time.

All of this means that I am in a mountain of schoolwork and enjoying the grace of a little extra help with the kiddos this weekend to catch up. I LOVE statistics (which I think boads well for my research goals), and find I have a sharper and more critical eye for all of school than I ever had before (thanks, year of self-educating!) I'm a glutton for all of it. I can feel my toolbox filling with some wickedly useful skills to take on some of the nonsense ostensibly founded on science that we are all contending with every day.

Cheerio and wish me the best.

Edit: In retrospect, that's kind of an odd title I picked for this post. I guess I titled it "Blowing open science" because I just felt some walls of reverence crumble within myself that I hadn't even noticed before. Science is couched in this social world with all of its sneaky little unconscious ideals and motives, and I'm just a little less wooed with the illusion of it's supposed objectivity.

I know we try to deconstruct science in the blogosphere a lot, so that's not original. But I think that because we often use other science to disprove whatever science we're trying to deconstruct, it reinforces the notion that somewhere out there is that "real real" science, and if we just use it against that "not exactly real" science we'll come out on top. Spinning in the sand. And don't get me wrong, I love science and will continue to use it. Just with a little less mystical awe, is all.