Midwifery; a David and Goliath Tale

The story of midwifery in America is a classic power struggle for women’s rights, respect and choice; a tale of the clash of women’s culture and values with the male dominated spheres of science, medicine and finance. It is an ugly story laced with racism and class war fare. This struggle continues to walk the halls of political power and sits in insurance industry board rooms today.
It began as the eighteenth century was drawing to a close and the science of medicine was on the rise. Men for the first time began to move deeply into the privacy of the birth room, a place that in most cultures around the world is traditionally populated almost exclusively by women. This slow and determined encroachment into what had previously always been a woman’s world began the battle.

Before men became involved American midwives had always held a place of respect within their communities. Their skill at helping women during the birth process was of vital importance to all in the community. Women were encouraged to stay mobile as long as possible during the birth, the pain of the process was recognized but not believed to be insurmountable, the passage of time was noted but there were no standardized graphs labors had to abide by, and women utilized up-right physiologically sound positions for pushing a baby out.


When male doctors took over this all changed. Pain relieving drugs were used as an inducement to have doctors attend women’s births. These medications changed the balance of power forever; stripping the woman’s innate abilities. She became an object to practice medicine upon; someone who needed her baby delivered to her like a pizza instead of using her own physical power to bring her baby forth. Soon untested scientific “theories” blended with necessities created by using pain medications and women were routinely being cut and babies were being pulled out with forceps.

As the prestige of the medical profession rose, so did their power. In the end it came down to dollars and cents. In order to corner the market doctors began a campaign to stamp out midwifery. First they created a belief that birth was a medical event which could only be safe if attended by a physician. Doctors traveled in the upper circles of society. They convinced bankers, lawyers and other prominent society men to avail themselves of the best that the science of modern medicine could offer for their wives by using a physician. Men controlled the medical schools and women were not allowed to attend so female care providers slowly began to die out. In the early twentieth century not satisfied yet, they convinced the government to begin a propaganda campaign slandering midwives as dirty, illiterate, and ignorant. Eventually only poor women or newly arrived immigrants were still turning to midwives for care.


Meanwhile another huge shift in health care in our country was taking place. Hospitals were on the rise, with their bureaucracies, standardizations, schedules and sanitization of birth. Women were told it was best when labor began to leave their homes, where they had some control, and travel to a hospital, where they had no control. Hospitals lead to the immediate separation of the newborn from its mother and scheduled feedings. These disruptions in the process along with the drugs created babies who could not suck effectively, needing to be force fed from bottles. Soon the women of America thought their bodies were so defective they couldn’t even breastfeed their own children. Meanwhile the practice of midwifery was outlawed in most states.


But it’s hard to hold good women down. It is hard to stop women from answering the call to serve women; especially women in need. In the 1920’s nurses began to step forward to get additional training in the skills required to help low income women, the rural and urban poor. These were women who couldn’t pay doctors and hospitals, therefore providing them care did not threaten the medical establishment’s monopoly. They eventually founded specialized nurse midwifery schools and associations. From this branch was born the certified nurse midwife. In the 1960’s couples living on communes had turned their backs on many forms of the “establishment”. These female rebels began to birth their babies at home with the help of other women in their communities. The daring women who answered this call eventually became highly trained homebirth midwives. It took courage to be a midwife, to practice midwifery without a license. Not only could you lose everything, your home and your practice, you could be thrown in jail. In our county one traditional midwife was brought up on charges and convicted in 1982. Over time this branch of midwifery also adopted standards for training, created associations and worked hard to become legal once again. In California the legal battle culminated in 1993 in the creation of a system to license out of hospital midwives but it took 4 more years for the first group of midwives to be licensed by the state medical board.


All midwives are still fighting for the right to work as autonomous, respected members of the birth provider community. Whether they are CNMs who have made the choice to work in a doctor’s practice under his supervision because even if they could find a company willing to cover them medical malpractice insurance is prohibitive, or the LMs who can’t get insurance company’s to reimburse their clients for basic care the struggle continues. The California Medical Board is currently reviewing whether to change the language in the regulations governing LMs to allow them to order the life saving medications and tools they need to attend birthing women. And so the struggle continues.


This year on May 5th, the International Day of the Midwife, the women and their families who have been cared for so well for so many years by our community’s midwives will gather in Mission Plaza to honor 41 courageous, tireless, and caring professional women. The Birth & Baby Resource Network along with the co-sponsors of this year’s Birth & Baby Fair wish to invite you to join us at 10:30 for this historic event in the annuls of San Luis Obispo women’s rights.


Participate in BBRN’s on-line Midwifery Project at: www.bbrn.org.
Learn More about the History of Midwifery:
A Midwife’s Tale; Martha Ballard her Diary by Laurel Thatcher Ulrich
Motherwit; an Alabama Midwife’s Story by Onnie Lee Logan
Listen to Me Good; the Life Story of an Alabama Midwife by Margaret Charles Smith
Birth Matters; a Midwife’s Manifesta by Ina May Gaskin
A Short History of Midwifery: from Midwife Info an independent internet resource 
I am a Midwife, a movie trailer by the Midwives Alliance of North America
Fiction with Midwifery themes:
The Midwife's Apprentice by Karen Cushman
The Red Tent by Anita Diamant
Midwives by Chris Bohjalian

A Midwife's Story by Penny Armstrong and Sheryl Feldman

Homebirth & Saving the Earth: a Natural Fit

Many women who birth outside of a hospital setting are changed by that experience for the rest of their lives. It begins in pregnancy as they educate themselves about the choices they are making surrounding birth. In discussions with their midwife, a subtle paradigm shift happens which puts the pregnant woman in charge. A good midwife guides them to see that they need to look beyond what the medical institutions have presented as ‘truth’, and find their own. During a natural, unmedicated, and uninduced birth a woman must listen to her own rhythms of contraction and expansion and learn to work in harmony with them. She taps into a power within herself that until now has been hidden from her. It is an awe-inspiring power that deeply connects the woman to generations of women from the past and the future. From that time on, she knows this power lies within her and she can rely on it. The confidence this brings helps her to look at the world with new eyes. She may make new choices, such as deciding to have her baby sleep in bed with her and her partner even though her best friend says it is dangerous. She may simply feel more able to stick with a choice she already made, such as breastfeeding, even though the first several weeks are rough going.

So how does this help the earth? Well, first there are her choices surrounding parenting in the first weeks and months of her baby’s life, such as sleeping with the baby. Co-sleeping means no trees were cut down to build a cradle or toxic chemicals used to build a crib. On top of that, no fuel was spent to ship it to a store and then get it to your home. No energy was used to run the factory or store. No lights were used at home while putting the crib together.

Breastfeeding, though natural, can be challenging at first. Midwives traditionally promote breastfeeding and are an ongoing resource for nursing education and support. The impacts it can make on our environment are varied. First, it requires no excess packaging, processing, or shipping. There are no bottles to buy, transport, wash, and eventually throw away. This is a huge energy savings, plus there is no damage to our environment from the making and disposal of plastics or glass. Because breastmilk is nutritionally superior to formula, it grows stronger, healthier people who are less likely to need pharmaceuticals or mercury-laden fillings. The fats contained within breastmilk spur more brain growth than formula. We need smarter kids to help us out of the environmental dilemma we are in. On top of all that, exclusive breast-feeding prevents more births than all other forms of contraception combined, which helps slow our ever-climbing population explosion.

Empowered birth creates an empowered woman who has confidence in her physical and psychological abilities. A woman who knows she is capable and has the strength to follow through on those out-of-the-norm decisions, such as cloth diapering. Let’s face it: cloth diapering is a bit more work than disposables, but the small amount of effort required is easy compared to filling up our landfills.

Home birth creates a mother who listens to her own innate intuition. She can listen to herself as a guide instead of relying on ‘authorities’. She will make her own best choices for the survival of her children, even if that means making different choices than mainstream America. She might decide not to fill a prescription for antibiotics which end up in our water supply and create super bugs, and instead rely on rest and mommy love to get her baby through a cold.

Then there are the less obvious connections. A positive birth experience imparts to the couple confidence in parenting to the couple. It creates a solid foundation and unites them in their parenting journey. Midwives often encourage the couple to explore the components of Attachment Parenting, such as baby wearing, responsive parenting, and immediate bonding after birth. This style of parenting creates confident kids with a different world outlook. They tend to think about what the group needs, instead of feeling they would be better off looking out for themselves because no one else will.”

Who knows where a woman’s new-found sense of accomplishment will take her? Perhaps she will decide to roll up her sleeves and plant an organic garden, saving her kids from pesticides and lessening the world’s fuel consumption, or decide to take on the local water board when she finds out there are unsafe levels of chemicals in the tap water her family drinks. Maybe she will confront her local school board on buying more local organic fruits and vegetables for the lunch program. Perhaps she will start her own recycled kids’ clothing store, or get active with her local Earth Day committee. Perhaps she will sponsor a local kids’ sustainable community garden. These are just a few of the things I have seen local mothers do. The power and energy a positive out-of-hospital birth unleashes is tremendous. The possible choices of what to do with that power are endless. The positive effects that might bring for our planet are immeasurable. As a doula, one thing I have learned is to never underestimate the power of a mother!

What’s a Parent to Do?

The American Academy of Pediatrics latest guidelines on car seat safety recently hit the news. Are you confused about which seat in your car to use, which direction to have it face and when your child can safely come out of a car seat? What about air bags? When should you move your child from full on car seat to booster seat? What about safely using seat belts with older kids and a host of other questions? The San Luis Obispo County Child Injury Prevention Coalition will be teaming up with the Birth & Baby Fair this year to answer all your questions about the new guidelines and state laws regarding car seat safety. There will be 10 certified car seat technicians on hand to check car seats for proper installation, broken parts and recalls in the parking lot next to the Historical Museum on Broad St. in SLO. The Coalition is happy to provide this service free to the community. San Luis Obispo Police Officer John Caudill, a member of the Coalition, says much of what he does is education because car seats constantly change, as well as the laws about them. This is an important year to get your questions answered Caudill clarifies because, “although these new guidelines are only recommendations they are very significant and we support the changes. They go over and above current laws in California. They aren’t the law yet but we will be lobbying the state to change California law.”

Vehicle accidents are the leading cause of death and injuries for children because they aren’t properly restrained in car seats. This led to a nation wide campaign to educate parents. Officer Caudill who attended a week long series of classes to become certified said, “The guidelines are rigid because of the little ones we are keeping safe.” Typically eighty to ninety percent of the seats checked have some sort of problem, usually misuse by parents; anywhere from just installing it too loosely to actual broken parts. Caudill explained, “We’re not going to be writing tickets. We don’t want to cite parents. We want to help fix things so they leave safer than they came.”

Bring your car and seat on Saturday May 7 from 10 to 3 or make an appointment during the Fair for a check to be done at a later date.

Experience Watsu

There is nothing more earthbound than a heavily pregnant woman. Waking or sleeping, she feels more and more weighed down as she slowly plods through the last weeks of pregnancy; her belly swollen with baby and amniotic fluid.

Now imagine the same woman stepping into a pool of warm water and floating, weightless. Her eyes are closed as light and shadows play across her eyelids. Her ears are submerged, so only muffled sounds can be heard. She is cradled in the supportive arms of another, who gently rocks her to and fro to the rhythm of her own breathing. The baby floats submerged within her womb in the warm, dark amniotic water, gently cradled within the mother’s pelvic bones. They are one, together, weightless and free. Their energy flows freely and all tension about the impending birth drifts away. The mother-to-be achieves a deep level of peaceful relaxation, entering an altered state; bliss. This is a state through which the journey of natural birth is much more possible. Floating somewhere between dreaming and wakefulness the mother-to-be feels her body gently letting go, stretching, lengthening, opening and releasing.

This is water massage, a unique form of bodywork also known as water shiatsu or Watsu. Invented in 1980 by Harold Dull, it combines elements of massage, joint mobilization, shiatsu, muscle stretching and dance. Its therapeutic benefits are for everyone and can bring new life into long neglected muscles, joints and ligaments.

As a birth professional I have witnessed the amazing benefits specifically for pregnant women. They go beyond relieving the typical aches and pains of carrying a baby to term. Watsu combines the deep breathing of the Bradley method, the trance state of Hybnobirthing and the gentle stretching of prenatal yoga within the weightlessness of water. Requiring no intellectual effort on the mother’s part water massage frees both her body and mind to prepare to birth confidently. As a doula, I have held many women in my arms during labor, so I find Harold Dull’s goal particularly poignant; “a world where everybody holds and floats each other in their arms.”

To experience this amazing technique connect with kinesiotherapist Kay Heaton:
544-4280. kay@clubk-aquaticintegration.com

To see prenatal Watsu for yourself visit: http://www.youtube.com/watch?v=vpDrmfNz98k

Health-care legislation increases birth options: Women covered by Medicaid are insured for delivery at birth centers as well as hospitals

Publised in the SLO New Times April 14, 2010
Picked up by the American Association of Birth Centers for their web site.

BY JENNIFER STOVER

A provision in the new legislation for health care gives women more latitude to decide where, how, and with what kind of professional they will give birth, and may lead to a birth center finally being established in San Luis Obispo.

Most Americans don’t know that 42 percent of all births in the United States are paid through Medicaid reimbursement. Thanks to the passage of the health-care bill, women so insured will have a choice of how they spend that money. Section 2301 includes full Medicaid reimbursement for free-standing birth centers, certified nurse midwives working in hospitals or birth centers, and certified professional midwives (CPMs) working in birth centers. Women can continue to choose a hospital birth with a doctor or midwife, but now they can choose to birth at a licensed out-of-hospital birth center attended by midwives instead.

The average cost of a birth-center birth is approximately one-fifth of a doctor-attended hospital delivery, a huge potential savings to Medicaid: Consider that the typical hospital birth costs approximately $20,000 and the cost can climb to $60,000 for a cesarean birth. Not all women will want to birth naturally without pain medication in birth centers. Not all women are appropriate candidates for birthing with midwives in birth centers. But if only 5 percent of the 4.3 million women in this country who give birth annually choose this option, it would mean millions of dollars saved each year.

For 28 years, local women have been asking now-retired Certified Nurse Midwife Linda Seeley why we don’t have this option. She explained, “A lot of women don’t want to have their babies at home, but also don’t want to be in a hospital. A birth center is usually located close to a hospital but not in a hospital.” After General Hospital closed, Seeley was part of San Luis Obispo General Hospital Foundation’s attempt to start up a birth center. She continued, “A center is more intimate, the women themselves are more in control of what happens. There is more satisfaction and lower stress. It is well known that the lower the stress, the better the outcomes.”

We have no out-of-hospital birth centers in the county. Atascadero midwife Edana Hall, CPM, who is licensed by the California Medical Board, said she is “cautiously optimistic this could lead to the opening of a birth center in San Luis.”

Tiffany Dietrich, a naturopathic doctor and midwife who recently moved to San Luis Obispo, explained that in the greater Seattle area where she recently practiced there are two birth centers. The fact that Medicaid in Washington State already paid for out-of-hospital birth-center births is part of what made that possible.

“When Medicaid pays for something, eventually the insurance companies also begin to pay,” Dietrich said. “It’s a good time to open a community birth center here. Our culture is changing. Out-of-hospital births are on the rise due to media exposure, such as The Business of Being Born, the documentary by Ricki Lake.
“What is happening in Washington State shows that birth centers are a successful model of care for women and babies—as well as financially—for the birth center and Medicaid,” she added.

Jessica Elliott relocated from Morro Bay to Oregon, where Medicaid and insurance companies already pay for out-of-hospital births. She echoed Dietrich: “There are currently three birth centers located in the Portland area where CPMs attend births.”
Elliott, a participant in an intensive clinical training for midwifery at the Andaluz Waterbirth Center, continued, “We do anywhere from 20 to 30 births a month, but demand is growing. The center recently had to hire two new midwives to keep up.”

Last June, a panel of local professionals who work with children and birthing women met with Congresswoman Lois Capps’ district representative, Betsy Umhofer, to present information about the merits of midwifery and out-of-hospital births. She listened to us carefully and relayed our information to Capps, who, as vice chairman of the Health Committee, was in Washington, D.C., working on the legislation that just passed.

After the signing ceremony, Congresswoman Capps issued this statement about this important section of the health-care bill: “I know that bringing a new life into the world can be the most profound moment of a woman’s life. And I am proud that this new legislation will afford women more choices regarding the setting in which this momentous occasion can occur. One of the many important provisions in the new health-care reform legislation is the increased access to care in a variety of settings, including for women who choose to obtain prenatal care and deliver their babies in freestanding birth centers. I was proud to support this provision that assures these centers Medicaid reimbursement for providing this important service in promoting women’s health.”

Jennifer Stover, the president of Birth and Baby Resource Network in San Luis Obispo, is a childbirth educator and doula.

Send comments via the editor at econnolly@newtimesslo.com.

The Day President Obama Signed the Health Care Bill

Published in the SLO Tribune on Friday March 26, 2010

Hidden in the thousands of pages of the Health Care Bill that President Obama signed into law were some items very few people were aware of that will effect women all across the country. They target issues concerning maternity care and they have the power to change our beliefs about where, how and with whom women should be giving birth in our country.

Did you know forty-two % of all births in the U.S. are paid for through Medicaid reimbursement? Now women will have a choice of how they use that money. They can continue to choose to birth in a hospital with a doctor but they can also choose to have a Certified Nurse Midwife attend them in a hospital, or they could attend them at an out of hospital birth center. Another option is to have a Certified Professional Midwife attend them at an out of hospital birth center. This doesn’t just represent more freedom for women to choose the birth the want it also represents a huge cost savings to the Medicaid budget. The average hospital birth with a doctor attending costs approximately $20,000. It skyrockets to $60,000 for a cesarean section birth. With our national cesarean section rate climbing every day this is a serious chunk of change. On the other hand the average cost for a birth center birth is approximately ¼ of that or $5000. Not all women should be birthing in birth centers with midwives but if just 5% of women choose this option it will mean millions of dollars a year saved.

Did you know until today they was no widespread standardized assessment of the maternity care being offered in this country? Statistics relating to the benefits and risks of current practices in use today, such as, induction of labor, medication to speed labor, or drugs for pain relief were not being kept in a national database. Over time this data base will yield important information for women and their care providers. Helping them base their care on informed choices.

Did you know women were being denied health care coverage because they had given birth by cesarean section? This was being labeled a pre-existing condition which ruled them out of further care. On top of that the current stance of the American College of Obstetricians and Gynecologists about vaginal birth after cesarean section makes it impossible for many women in the U.S. to do anything except have a repeat cesarean section for all future births. Until today women were faced with the choice of letting their insurance company limit the size of their family or pay about $60,000 per child.

Did you know until today your insurance company could deny you care simply because you were pregnant? Stopping this practice has the potential of effecting millions of women and babies. Guaranteeing access to quality maternity care impacts not just this generation but the next as well.

Thank you to Representative Capps for working to pass this important legislation for women and babies. When asked about this piece of the bill she said, "I know that bringing a new life into the world can be the most profound moment in a woman’s life. And I am proud that this new legislation will afford women more choices regarding the setting in which this momentous occasion can occur. One of the many important provisions in the new health reform legislation is the increased access to care in a variety of settings, including for women who choose to obtain prenatal care and deliver their babies in freestanding birth centers. I was proud to support this provision that assures these centers Medicaid reimbursement for providing this important service in promoting women’s health."

A Sign on a Door

“Because the Physicians at Aspen Women’s Center care about the quality of their patient’s deliveries and are very concerned about the welfare and health of your unborn child, we will not participate in a “Birth Contract”, a Doula Assisted, or Bradley Method delivery. For those patients who are interested in such methods, please notify the nurse so we may arrange transfer of your care.”

A photo of this sign has been posted on the internet and has created a stir in the pro-natural birth community. Wow! So here is a hospital being completely upfront with their beliefs: natural childbirth is less safe, laboring moms and dads do not have the right to make their own choices during the birth process regarding the safety of their babies, and they can not bring into the process any outside professionals who do believe in the safety of natural birth. As a doula I am both shocked and glad they are being this straight forward. Many hospitals and medical professionals share these same beliefs but they are not so open about it. The women in Aspen who take a tour of this facility before they make a choice about where to birth their babies can decide for themselves if the philosophy of birth expressed here is a good match for them. Luckily I was able to find one other hospital in the Provo Utah area where the Aspen Women’s Center is located so women do have a choice.

At the root of this sign are two men, Dr. Robert Bradley and Dr. Fernand Lamaze but to understand why a sign like this would end up hanging on a door in a maternity ward it is helpful to look at a little history. Perhaps one of the worst times for birthing women in this country occurred during the era when doctors stopped going to their patients and medicine became more centralized. Driven by the discovery of germs to be feared and a culture that was turning away from individualization and toward efficiency, hospital protocols turned birth from a family event into the business of birth. Culturally women were trained to acquiesce to male authority figures and so they passively allowed the process of birthing babies to be taken over, fathers were excluded, rigid hospital routines were followed and male doctors dominated the scene.

Then the Sixties arrived and with it the women’s movement, hippies and the protest era. Into this powerful mix walked Dr. Bradley and Dr. Lamaze to spearhead the “natural” birth movement here and abroad. Although their “methods” differed they both believed two things; the sensations of birth can be handled without pain medication and a husband’s help is vitally important to the process. Through their books and training of out of hospital birth educators they changed maternity care in this country by creating consumers, moms and dads, who demanded changes. Fathers went from being completely excluded and made to sit anxiously waiting in a separate room to being required to be an active participant at their child’s birth. Women showed doctors it was possible to experience labor without being rescued by pain medication; birthing in up right positions became possible and labor beds which convert into a variety of positions were adopted. Babies who weren’t drugged in labor could latch-on and nurse immediately after birth and did not need bottles and formula; La Leche League and the breastfeeding movement began. Now hospitals have lactation consultants on staff. Women who had not received medications and/or surgery could immediately begin to care for their infants and rooming-in became the norm; only infants who need special care go to our local nurseries now so they look like ghost towns. None of these changes were begun from within the system they came about through consumer demand on the system, although all along the way nurses, certified nurse midwives and a few doctors listened to their clients and ultimately were the ones to bring about change within the system.

Here are some of the changes I have seen in San Luis Obispo in the twenty years since I became a doula. When I was pregnant with my son there were two hospitals to choose from in San Luis; General Hospital which was known for being more pro-natural birth and Sierra Vista which had just gone through a dramatic physical renovation to create less “hospitally” looking rooms where a mom could stay throughout her time in the hospital. You had two choices of care providers who supported a natural birth, Dr. Lickness or the Certified Nurse Midwives working for Dr. Johnson and Dr. Richards. Kathleen Huggins had published her “Nursing Mother’s Companion” and begun the Breastfeeding Warm Line which dramatically increased our county’s breastfeeding rate. Did you want to try to birth vaginally after a cesarean? Talk to Dr. Clutter; eventually all the doctors in town would “allow” a woman to try for a V-BAC. At General Hospital the nurses worked hard to achieve the World Health Organizations “Baby Friendly” status and later with the help of the nurse midwives, Linda Seeley, Midday Johnson, and Lisa Winnick, and Dr. Spalding they began doing water births. At French hospital the nurses have worked with the anesthesiologists to find a level of medication which will give adequate pain control and leave the mom able to be more of an active participant during pushing. Sierra Vista increased the level of care they could provide seriously ill newborns so moms and babies can stay together in the county instead of being flown to bigger hospitals. Many beliefs about standard safety procedures have changed too, such as, when I had my son I was continuously on the baby heart monitor but now even the American College Of Obstetricians and Gynecologists agree that fifteen minutes out of every hour is adequate for picking up a baby who’s in trouble. Doulas became more common in the county and I personally felt more accepted as part of an over all team working to achieve the most positive births possible for my clients. Each of these changes and many others started small, one doctor saying yes or nurse saying I’ve never seen that done before but if it’s what you want. . .

None of these changes happened without push back from the established system. The stakes are high. The business of birth is big money. The fear of litigation is all too real. My birth class clients have had doctors throw their birth plans across the room. I sat in a doctor’s office and heard him tell my doula client that “natural” birth was all very well but it wasn’t optimal. Both our hospitals currently refuse to “allow” women to birth in water. Now because of space issues dads aren’t always able to stay with moms and babies after their births at our hospitals. I listened to a birth professional tell a group of women that Bradley classes teach women not to trust their care provider but I believe it is a birth educator’s responsibility to teach women to trust themselves and to trust birth and it is the care provider’s responsibility to foster a trusting relationship with their client. Sierra Vista asks doulas to sign a paper agreeing to do little else than bring ice chips and hold a woman’s hand. These days many women don’t want to actually feel birth, our society is too accustomed to medicating our pain away. Add to that our culture’s obsession with scheduling our lives and we get inductions and planned cesareans. Meanwhile our hospitals’ cesarean section rates are climbing as is our premature birth rate as too many babies are being “scheduled” to be born too early.

So this sign on a hospital’s maternity ward door doesn’t surprise me but it does sadden me to see that the things women and their partners, nurses, doctors and midwives have worked so hard to achieve in moving birth in our country toward a more humane, family centered experience grounded in the belief that women are created with the power in them to birth their babies is being eroded.

Jennifer Stover
Labor of Love Childbirth Preparation & Doula Services
www.slolaboroflovedoula.blogspot.com

Making a Baby Shower Special

Over the years as a doula I have been invited to many baby showers. Some have been traditional American showers with silly games, arrival date gambling pools, gifts and cake. Some have been more alternative or spiritual based Blessing Ways with ritual foot washing, adornment of the woman or couple, and blessings for the new life coming. Here are some of my favorite ideas.


Gifts are wonderful and are gratefully received. Most first time parents depend on their shower to help outfit the baby and the “nursery”, but to create a memorable shower material gifts should not be what a shower is all about. Equally important as these gifts is offering our collective wisdom on birth, parenting, and promises of future support to see them through the challenges ahead which will touch her heart and make her feel buoyed up by love and caring.


Here are some ways to create an atmosphere that allows the party goers to feel free to share their thoughts and feelings. Remember to bring a way to record all these wonderful gifts so the parents can listen to them whenever they need to feel your love and caring. I think audio is best because it is less intrusive.

For the Birth
Every first time mom feels a bit apprehensive when faced with the unknown quality of labor. No matter how many classes she has attended, or practicing relaxation she has done she has never labored and can’t really understand what labor is like until she has been through it and out the other side. Knowing people who care about her are holding her in their thoughts as labor approaches will surround her with positive & peaceful thoughts calming her anxieties.


Have all the party guests sit in a circle with the expectant mom, or expectant couple as part of the ring. Give the new mom a skein of yarn to hold. She keeps the string end and passes the rest of the skein to the guest sitting next to her. That guest wraps a loop of yarn loosely over their wrist and says some words of wisdom about labor and birth. She passes the yarn to the next person and they loop their wrist and share their feelings. This is repeated all the way around the circle finishing with the dad and finally he connects to the mom creating an unbroken tie. Now the new mom shares her feelings. Finally scissors are passed to cut the yarn between the guests. The guests are asked to continue to wear or keep this “bracelet” with them as a reminder of the love they all share for this new life and to keep the couple in their hearts in the coming days until mom and baby have passed safely through labor.


A similar ceremony can be done with candles. Pass out candles to everyone in the circle. Start by lighting the candle of the guest next to the new mom who uses that time to share her feelings. Her flame should light the next guest’s candle and so on around the circle finally lighting the new mom’s candle. Ask that each guest take their candle home and relight it each day to hold the coming labor in their hearts.

For Parenting
New parents really only need two things, physical help to get through the first draining weeks and confidence in their own ability to parent. Here are some easy ways to rally the troops to help during the first week. Create a dinner calendar. You can’t use dates because you don’t know when the baby will arrive. Instead mark the calendar first night home, second night, etc. Ask people to please sign up for a dinner and to put their phone number down. Everyone should make enough for at least two nights and bring it in a dish that can be frozen. From two weeks of dinners the couple will actually get four weeks. Once the baby arrives home you will need to call each guest and give them their dinner date.


Create a jobs list: laundry, grocery shopping, mowing the lawn, baby sitting etc. Cut the list into strips with one job on each strip. Have one less job than players. Play any elimination game, such as, Musical Chairs. Each person eliminated must draw from the jobs bag. The winner gets to choose the job they want from among the all the jobs already handed out and then the big job swap can begin!


Initially confidence comes from knowing other people see the strengths the new parents bring to this difficult task, as well as, knowing there is lots of parenting wisdom out there for them to tap into when they aren’t sure what to do. Here are three ways to encourage guests to open up and share.


Ask all the guests to bring an item that can be strung. It is a good idea to give them an idea for the diameter of the hole, i.e. strung onto string, or thread or cord. These items should symbolize something they would like to impart to the new parents about parenting. Not every guest will be a parent but remind them they have all been parented. Sit in a circle and pass a bowl from person to person. Each guest should hold up their object and share what it represents before placing it in the bowl. After all the items are collected give the mom the bowl and something to string all the items. As she strings them one by one she has an opportunity to respond to all the positive energy coming her way.


Here is a wonderful activity if you have a quilter as a resource. Buy white muslin and different colors of fabric paint. You might want the paint colors to match the nursery color scheme. Before the guests arrive wash and dry the muslin and securely tape it down onto a large piece of plywood. Lay the plywood on a table or over some sawhorses. Use fabric tape to divide the cloth into squares. As guests arrive ask them to please paint their thoughts and good wishes on a square. After everyone has had an opportunity to paint, gather everyone around the table and have each guest explain their square. Later your quilter will decide how best to turn the art into a quilt to hang in the baby’s room. Don’t know a quilter? Alternatively this could be done as a less permanent piece of wall art by using a roll of butcher paper. Bring a way to “mount” the finished piece when you are done.


Do you need help pulling off either the craft side or ceremonial side of the event? Get help from The Sisterhood of the Traveling Pots! This is a wonderful local business that specializes in making personal events memorable and from the heart through the medium of candle creation. They help people tap into their childlike creative side which allows them to feel safe expressing their hopes and dreams for the baby and new parents. They will talk to you about creating a ceremony unique to your new parents and their guests. Let the Sisterhood help you truly honor and bless the miracle of this birth. Contact them at www.thesisterhoodofthetravelingpots.com.


Showers are an important tradition. A time to honor the new family about to be born and recognize the power of the transformative process they are entering. Shower them with gifts. Shower them with friendship. Shower them with support. Shower them with love.

Jennifer Stover
Doula & Childbirth Educator
www.slolaboroflovedoula.blogspot.com

Informed Consent

Recently I missed a birth. I am a doula. I help guide women and their partners during pregnancy, labor and birth. I had been hired by a woman pregnant with her second child to insure that this time she would be informed of any procedures or options by the nurses and doctors during her birth so that she could make her own choices. This time, she wanted to be listened to and respected during the birth process.

But this birth, as often happens, had its own story to write. Her labor came so fast and furious there was barely time to get to one of our local hospitals before the baby zoomed into the world. I was left “doula-ing” via speaker phone as I raced down the road. I heard the baby’s first cry as I exited the freeway in Templeton five minutes from the hospital.

When I walked into their room, Mom and Dad were ecstatic as the doctor quietly finished sewing a minor tear and moved on to another woman in labor down the hall. The baby looked great. Mom looked great. Then I noticed she had an I.V. of medication running into her. I asked my mom what it was. She said it was her saline lock. I said no you are hooked up to an I.V. of medication. We looked at the nurse who calmly told us it was Pitocin and that it was standard protocol at the hospital for all moms. I was shocked. My mom looked shocked. Where was the informed consent?

When did it become OK to administer a drug to someone without getting their permission? This was not an emergency when fast action has to be taken. This patient wasn’t unconscious, delirious or out of her head. She was simply having a baby. Actually she had just had her baby. She was elated, alert and aware. She was completely capable of rationally saying yes or no to a medication given as a routine at a hospital.

The nurse became concerned and offered to unhook her from the drug, but half the bag was already in her system so my client chose to allow it to finish. Would she have said yes or no if asked, “Do you want us to give you medicine that can stop any excess bleeding that might occur?” We will never know because she was never granted that right.

In a study done in 1969 Hershey and Bushkoff came to the conclusion informed consent means, “the patient has the right to know the nature of, the risks and benefits of, and the alternatives to a proposed treatment or procedure.” The United States Court of Appeals ruled in Canterbury v. Spence in 1972 that it is a fundamental concept in American jurisprudence that “every human being of adult years and sound mind has a right to determine what shall be done with his own body.” This right has been supported both federally and on a state level. Further, the American College of Obstetricians and Gynecologists first publicly acknowledged the pregnant patient’s right to informed consent in 1974. This was followed by the International Childbirth Education Association publishing “The Pregnant Patient’s Bill of Rights” in 1975. So how can it be that 35 years later birthing women, such as my client, are routinely given medications or have procedures performed on them without even telling them it is happening let alone giving actual informed consent?

Jennifer Stover
Labor of Love Birth Education and Support
jjmstover@sbcglobal.net

Women's Press Article: Birth & Baby Resource Network

There is an organization of tireless volunteers working in our community who, like those in many other “women’s” organizations, receive little recognition or fanfare as they strive to educate, support and empower young women starting families. What drives these women’s passion to reach out and share their wisdom about pregnancy, birth and early parenting? Why do they feel it is necessary to continue to struggle against the tide of our current culture?

In 1992 a group of women interested in becoming midwifery assistants and doulas met at a workshop. They shared a common goal: to make women’s birth experiences better, less medicalized and more woman-centered; more self-empowered. This meeting sparked an organization that has changed names, changed members, and changed locations over the years but has never changed its core beliefs that pregnancy and birth are normal, healthy processes that women are uniquely equipped to perform, and that women should have access to quality evidence-based care wherever they choose to birth; hospital, home or freestanding birth centers. They believe that an educated woman will make her own best choices for herself and her family and that these choices should not be made for her or taken away from her. This group is the Birth & Baby Resource Network or BBRN.

As in many other “women’s” groups, there is a coming and going of members as women try to balance the needs of their families, their lives, their work and their passions. It is always a blend of birth professionals, such as birth educators and doulas, and women young and old who were touched deeply by a birth experience and wish to reach out to others. Some had a beautiful, positive birth which touched them profoundly as women and mothers and they wish to help other women achieve the same. Some had births that left deep wounds on their female psyche from which they are still recovering and hope to spare other women. Some have never experienced giving birth but are drawn to the process as a calling; a deep, abiding woman-to-woman, sister-to-sister experience in our core.

As in many other areas of our female lives, these women are coming to see our current set of cultural beliefs about birth as being a fraud perpetrated on women by the male- dominated world of medicine and litigation. Women are drawn into the system by offers to take away their pain and promises of perceived safety. No one tells them about the risks inherent in the system or gives them an honest choice. No one really shares how empowering birth can be for a woman. This is a pivotal rite of passage for a woman and should not be directed by outside interests, such as the threat of a lawsuit, or someone else’s personal time schedule. Birth can’t be quantified, regulated, put on a timeline or boxed into someone else’s preconceived notion of how women should birth. Every woman is unique, and so are her births.

If you are interested in learning more about birth in our community or becoming a member of the Birth & Baby Resource Network visit them in Mission Plaza at their annual Birth & Baby Fair Saturday May 9 or on the BBRN website at www.bbrn.org.

Jennifer Stover
Birth Educator & Doula
Founding member & Current President of BBRN