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!

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!

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!

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!

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

Violence in Midwifery Part 2: Obstetric Violence

Posted by Katy Bones

Midwives deal with violence on a regular basis. Whether its violence experienced by the women we serve, violence within systems of health care, violence against women by providers, or violence within the community of midwives, violence should be looked at continuously in an attempt to understand it, cope with it, and curb it.

“Obstetric violence” is a legal term defined by the Venezuelan government that has been talked about a lot in the birth community since Dr. Perez D’Gregorio published an editorial describing the Venezuelan laws on obstetric violence in the Dec. 2010 issue of the International Journal of Gynecology and Obstetrics. There are several links to some wonderful blogs and articles at the end of this entry that describe the particulars of the legislation in Venezuela. These laws emphasize the role of individual providers in perpetuating and engaging in violence by holding individuals responsible for their actions. D’Gregorio also recognizes the importance of health care systems in contributing to or preventing violence. He notes the importance of training, specifically in regards to upright deliveries, in supporting the autonomy of women and in respecting the natural process of childbirth. Additionally, he recognizes the limitations of individual providers in resource-poor settings where “environmental” reasons necessitate separating the mother and baby shortly postpartum. In itself, the idea that laws can change violent practices points to the importance of system changes as well as individual changes in eliminating practices that undermine the ability of women to get both the best care and the care of their choosing.

As I begin the intrapartum clinicals in January, I feel grateful to have this opportunity to examine obstetric violence with clarity and intentionality before starting to guide women through labor and birth. The very specific acts delineated by the Venezuelan laws offer explicit components of care that must be handled with knowledge and deep respect for the woman. Specifically, I recognize the importance of learning to help women give birth vertically, a skill that I haven’t yet learned or been well familiarized with. I also intend to maintain consciousness of the ways that I am learning to be a midwife, to avoid violence and to gain trust in the process of childbirth that allows me to serve women in the best ways possible.

Salon.com on Obstetric Violence

Babble.com
The Unnecesarean

Orgasmicbirth.com on Obstetric Violence

Violence in Midwifery Part I: Intimate Partner Violence

Posted by Katy

Midwives deal with violence on a regular basis. Whether its violence experienced by the women we serve, violence within systems of health care, violence against women by providers, or violence within the community of midwives, violence should be looked at continuously in an attempt to understand it, cope with it, and curb it.

I’ve been seeing a patient in antepartum clinic that has a very interesting story suggestive of intimate partner violence (IPV). IPV is both affected by pregnancy and affects the course and outcomes of pregnancy. While the statistics of prevalence are fairly unknown, about 14% of pregnant women in the US experience IPV. IPV in pregnancy is associated with low weight gain, substance abuse, premature labor and birth, persistent STIs, anemia, vaginal bleeding, and complications associated with physical trauma. IPV is an important and relevant topic for midwives to be familiar with in order to best care for women. Intimate partner violence is challenging to fit into the process of diagnosis and management which makes midwives (and all providers) shirk away from the issue rather than dealing with it appropriately. This case study served as an important opportunity for me to become more competent in screening for and supporting women experiencing IPV.

This woman, let’s call her Josefina, came to the inner city hospital clinic where I’m doing clinicals for prenatal care. The first time I saw her she had bruises on her face that she said were from play fighting with her partner. She had been testing positive for chlamydia since the beginning of her pregnancy and had already been treated once. She said that her partner had not been treated and that they were still having sex without condoms, despite previous counseling on the importance of using condoms or abstinence to prevent reinfection. She withdrew with questioning about her social situation or the sexual relationship with her partner, and would not answer questions.

Midwifery education survey

Posted by Tatiana

Daphne Singingtree is conducting some research about the experience of student midwives and precepting midwives. Take a little time to take the appropriate survey.

2010 Clinical Education Survey - Students

2010 Clinical Education Survey - Midwives

Cheers!

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.