PushLinks

http://thefeministbreeder.com/breaking-news-acog-admits-what-we-already-knew/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+thefeministbreeder%2FMXNm+%28TheFeministBreeder%29

Gina Crosley-Corcoran - In a long overdue press release, the American Congress of Obstetrics and Gynecologists finally steps forward to revise the old guidelines that had once caused so many hospitals and doctors to “ban” VBAC.  In a revision released today, The ACOG now states,

“a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans…”

Hallelujah!  It’s about time! But they didn’t come to this decision on their own.  Back in March, the National Institutes of Health held a conference on Vaginal Birth After Cesarean – a conference that I attended, wrote about, and ...

http://www.scienceandsensibility.org/?p=1349

Amy Romano - A lot has been said about the new meta-analysis of home birth. (Here is an excellent summary from Jennifer Block.) Canadian physician Michael Klein has been widely quoted as saying that the meta-analysis, a potentially valuable statistical tool, was performed poorly because the researchers included studies using discredited methodology, as well as studies that are decades old. “Garbage in, garbage out.” I totally agree with this assessment. I also take issue with the fact that the researchers did not display the standard “forest plot” that customarily accompanies a meta-analysis to illustrate how the relative magnitude of observed differences in the individual studies and the pooled analysis. And I’m perplexed by the use of a fixed-effects model for the analysis of neonatal death. But I want to take a step back and ask a larger question - is meta-analysis even appropriate for the study of home birth? ...

http://www.theunnecesarean.com/blog/2010/7/9/new-study-identifies-need-to-distinguish-planned-from-unplan.html

By Jill—Unnecesarean - The authors of a new study in the July 2010 issue of Obstetrics and Gynecology found that in order for a successful analysis of home birth to be conducted in the United States, a distinction needs to be made between planned and unplanned home births. This study, titled Characteristics of Planned and Unplanned Home Births in 19 States, by Eugene Declercq, PhD, Marian F. MacDorman, PhD, Fay Menacker, DrPH, CPNP, and Naomi Stotland, MD has not received any media coverage, while another home birth study scheduled to be published in the American Journal of Obstetrics and Gynecology in September 2010 has generated international attention. ...

http://blogs.babble.com/strollerderby/2010/06/18/obs-and-midwives-battle-for-nycs-births/

Sierra - Obstetricians don’t like competition. This week in New York, the American Congress of Obstetricians and Gynecologists came out swinging against a bill that would have made it easier for women to choose home birth. Having a home birth isn’t illegal in New York, but the legal hoops the state requires midwives to jump through make it all but unavailable to many Big Apple mamas. Rather than regulate midwifery directly, the state requires midwives to have written “practice agreements” with obstetricians at nearby hospitals. The obstetrician has to agree to take over care of the midwives patients should an emergency occur. The state legislature moved to do away with the “written agreement” rule this week, and was met with strong opposition from OBs. The move has special urgency for New York City midwives. The city has only 13 home birth midwives, and 7 of them are currently not allowed to attend births since the hospital where they had their practice agreements closed last month....

http://networkedblogs.com/4ykWZ

Asheya - When you think about childbirth, what springs instantly to your mind? If you live in North America, the most likely answer is something to do with pain. Everyone knows, labour hurts. When we think about pain in labour we often think about things like epidurals and morphine, which many women decide to use before they even go into labour, and some women aren't sure about but decide to use after they are in labour. I want to talk about epidurals and morphine and their risks in another post, so stay tuned for that! Before we even talk about how to cope with pain or manage pain, whether in a natural (physiological) way or with medication, I think it's important to first talk about the pain itself. Remarkably, very little research has been done into the purpose of pain in labour. You would think that because nearly every mother experiences pain in labour that some thought would have gone into identifying the reasons for the pain, before trying to figure out first of all whether intervening in that pain is actually a good thing, and second of all, how to intervene to provide the most benefit to the mother and baby, the least (or no) harm to the mother and baby, and still accomplish the purpose of the pain....

http://womenslawproject.wordpress.com/2010/04/29/cesarean-sections-in-the-news-are-women-fully-informed/

Women's Law Project Blog - Delivery by cesarean section is a hot topic these days.  In recent months newspapers have reported that the rate of c-sections in the U.S. has reached an all-time high; that the federal government has issued new guidelines to encourage vaginal birth after c-section (VBAC); and that health care reform has targeted unfair insurer practices, including the treatment of c-sections as pre-existing conditions.  All of these stories make one wonder, do women understand what they are getting into when they undergo a c-section? The consequences are far-ranging, and unfortunately, will likely remain until 2014, when most of the health insurance reforms curbing unfair insurer practices go into effect. ...

http://www.newyorkinjuries.com/blog/?p=20181

Legal Blog - A March, 2010, Data Brief of the National Center for Health Statistics (“NCHS”) reported that nearly a third of cesarean sections in New York state may be performed unnecessarily, and a report released by Public Citizen this past Wednesday found that Long Island has among the state’s highest rates of caesarean sections. The rapid rise in cesarean sections is due to the procedures being performed on women who had never had one before, as well as to a sharp decline in the rate of women who undergo a vaginal birth after a previous cesarean (VBAC). The Public Citizen report analyzes the rates of c-section by counties and hospitals in New York, and sets forth suggestions for expecting parents to try to avoid an unnecessary c-section. ...

http://birthingbeautifulideas.com/?p=1628

BirthingBeautifulIdeas - Remember way back in mid-March when I returned from the NIH Consensus Development Conference on VBAC with a heapload of inspiration and energy to transform maternity care and access to VBAC in the United StatesI haven’t written much about my goals since then, but this doesn’t mean that the momentum I carried home from the NIH has fizzled out in the , passing weeks. Quite the contrary, in fact. It’s just that I’ve been doing a lot of “behind the scenes” work.  (It should come as no surprise that my goals will take some hefty organizational efforts!) And as it stands right now, it looks like the first of my goals to materialize will be the “NIH VBAC Statement Primer”–a proverbial “how-to” guide to help consumers use the  statement to their advantage....

http://abortiongang.org/2010/04/reproductive-justice-a-new-home-for-birthing-rights/

Abortion Gang - Every time it comes up I always get the same reaction. Why? The curious point is that there is a strong division, perhaps even animosity, between birthing rights and reproductive rights. Many people in the birthing rights movement are anti-choice, some quite sternly so. This is continually surprising to folks inside and outside of reproductive justice, and as I ponder why this divide came to be I think a great deal of it stems from the beginnings of the women’s movement. Going back as far as Susan B. Anthony, who is cited again and again for her anti-choice stance, we see that even at Seneca Falls, over a hundred years before Roe v. Wade, there was division over abortion. ...

http://birthingbeautifulideas.com/?p=1592

BirthingBeautifulIdeas - Today I am excited to share with my readers a birth story from one of my doula clients! It’s a special story–one that I often recount to other pregnant women, doulas, and birth advocates. (Before going on, I should note that all of the births that I have attended are special and near and dear to my heart, and every single woman whose birth I have attended has demonstrated the most humbling and awe-inspiring strength.  Birthing women are amazing.  Birth is amazing.  Period.) ...

http://www.opposingviews.com/i/women-have-right-to-complain-about-mistreatment-during-birth

Unnecesarean - ICAN has posted a list of things you can do to complain about your mistreatment during a birth. It’s helpful and necessary, but also a little discouraging.  Affecting hospital policy and practice from the outside is still a hard slog, and lawsuits for unnecessary c-section are difficult and expensive to bring. At the moment all we can do is file complaints, educate others, and push for legal reform. The most effective wedge right now seems to be pushing for wider access to midwifery and/or birth centers, because while you can’t tell doctors or hospitals what to do, you can shake things up by introducing medical practitioners like midwives who challenge them by providing better and more satisfactory care. ...

http://seasonsoflifebirthcenter.blogspot.com/2010/04/four-birth-centers-open-in-four-months.html

Four birth centers opened their doors in the past four months, with another two centers scheduled to open over the summer in Virginia, Minnesota, Montana and Missouri. The six show the wide diversity among birth centers, with privately owned businesses and non-profit organizations, with centers run by certified nurse midwives [CPMs] and centers run by certified professional midwives [CNMs]). But all centers have an unwavering commitment to the Midwives Model of Care. ...

http://abortiongang.org/2010/04/on-abortion-rights-and-vbac/

KushielsMoon - I learned something new today! (An important part of daily life.) One of the lovely members of Abortioneers explained to me over Twitter that the scars from a c-section can be reason to deny a woman an abortion. I had never even thought of this. I knew of women being denied a vaginal birth because of their risk of uterine rupture, but I had never considered women being denied an abortion because of previous c-section(s). It shouldn’t have surprised me, of course. 60% of women who abort already have at least one child, which means they’ve already given birth at least once. And with a c-section rate at somewhere around 32% or more, depending upon the state, it makes perfect sense that many women wishing to obtain an abortion would have had c-sections. This past week, when I haven’t been worrying about real life, I’ve been trying to think of a way that the birthing activists and abortion rights activists could be brought together, to fight together for reproductive justice. Could this be it? ...

http://www.sydneymidwife.com.au/2010/03/florida-agency-set-to-ban-vbac-in-states-birth-centers/

Melissa Maimann - Florida’s Agency for Health Care Administration is expected to permanently ban Vaginal Birth after Cesarean (VBAC) in the state’s birth centers. In response, BirthGirlz, a national nonprofit based in Florida, is mounting a legal challenge, arguing that the ban is beyond the scope of the state health agency’s role. The ban aims to close the loop on what is already a stringent policy on VBACs in Florida. To have a non-surgical birth after a C-section, women are compelled to go to hospitals that permit it (which are not accessible throughout the state), or, if a physician signs off on the procedure, they can have one at home with the guidance of a licensed midwife. VBACs currently don’t occur in Florida birthing centers because of what is being a called a “de facto ban” due to outdated language in the state regulations. The language, which will be updated this week, will turn the ban from de facto to explicit—making VBACs illegal in all of Florida licensed birthing facilities. ...

http://www.blazzering.com/2010/03/vbac-rates-are-low-but-are-obstetricians-to-blame/

Kenneth Lin, MD - My daughter, who turns two years old in June, is becoming something of a medical rarity. This isn’t because she is showing signs of a late-developing handicap or extraordinary ability for her age – it’s because she came into the world as a vaginal birth after Cesarean section (VBAC), delivered by a certified nurse midwife. Although more than three-quarters of women who choose a trial of labor over a repeat Cesarean section successfully deliver vaginally, studies showing slightly elevated risks of rupture or infection of the uterus with VBAC, pressure from insurance companies concerned about lawsuits, and restrictive medical guidelines discourage most women from even trying. ...

http://margotmagowan.wordpress.com/2010/03/26/c-sections-reach-all-time-high-in-u-s/

Margotmagowan - The New York Times is reporting that Caesarian births, the most common operations in American hospitals, have reached an all time high in this country. A major reason for the increase is that many doctors and hospitals are now discouraging or even refusing to perform VBACs (vaginal births after c-section.) ...

http://www.thedailybeast.com/blogs-and-stories/2010-03-24/why-are-so-many-moms-dying/

Danielle Friedman - New reports reveal an alarming rise in the number of mothers dying during childbirth. From C-sections to the obesity epidemic, Danielle Friedman investigates what’s causing the problem. After more than a decade leading outdoor expeditions across the mountains of Montana and Utah, Karen Sclafani prepared to face a new challenge: pregnancy and parenthood. Vibrant and fit, the 37-year-old vegan had originally planned for a natural delivery. A few days before her due date in February 2004, however, she was diagnosed with preeclampsia—a type of pregnancy-induced hypertension—and checked into a hospital near her home in southwest Montana, where nurses gave her medicine to control her blood pressure and induce delivery. After only four hours of labor, Sclafani delivered a healthy baby girl. Over the next day, however, her condition took a horrific turn. When she didn’t deliver her placenta, her doctors performed surgery to remove it; shortly after, her heart stopped beating. Doctors realized she had suffered a hemorrhage, and despite their efforts to save her, two days later Sclafani was dead. ...

http://www.healthbeatblog.com/2010/03/overtreating-birth-csection-rates-hit-an-alltime-high-of-32.html

Maggie Mahar - The figures are alarming: The cesarean rate in this country has increased 50% since 1996; hitting an all-time high of 32% of all deliveries. What could possibly be fueling this dramatic rise in surgery? The latest figures come from a report released yesterday by the National Center for Health Statistics and have added more fire to an already simmering debate over the increased use of cesarean sections. Cesarean deliveries carry greater risks for mothers and newborns; require longer recovery times and incur hospital costs that are almost double those for a vaginal delivery, according to the report. ...

http://www.rhrealitycheck.org/blog/2010/03/24/expanded-support-midwifery-serviceswinwin-health-reform

Jodi Jacobson - Yesterday we provided a broad-brush overview of the implications for women of the health reform bill signed into law yesterday by President Obama. At the time, it was not yet clear which elements of the original House bill favorable to expansion of midwifery services provided by certified nurse-midwives had survived and been incorporated into the Senate bill ultimately passed by the House this weekend. As an update to our original article--and because midwifery services have been a long-neglected and in fact marginalized aspect of health care for women--here is an overview of how the bill addresses midwifery provided by certified nurse-midwives and expands the conditions under which nurse-midwives may provide broader health care services. ...

http://www.npr.org/blogs/health/2010/03/cesarean_births_hit_new_high_i.html

Brenda Wilson - Nearly one-third of all births in the United States are by cesarean section, according to data just out from the Centers for Disease Control and Prevention. Cesareans steadily rose in the last decade, after declining in the early 1990s. C-sections then held for a few years up to 1998, when they accounted for 21 percent of all deliveries. Since then, though, cesareans have increased each year, rising to 1.4 million in 2007, or 32 percent of all deliveries, the highest proportion on record. Rates of cesareans in recent years have increased for women, regardless of race, age or location in the U.S. The analysis comes from the CDC's National Center for Health Statistics. ...

http://www.rhrealitycheck.org/blog/2010/03/16/pregnant-women-informed-refusal

Rebecca A. Spence - Last week, a firestorm erupted in the birth and reproductive justice advocacy world over a statement generated by the NIH Vaginal Birth After Cesarean (VBAC) Consensus Development panel implying that in some circumstances a pregnant woman cannot refuse cesarean surgery. (Audio files can be found here, videocast here and commentary here, here, and here). Panelist Laurence McCullough, the chair in Medical Ethics and Health Policy at Baylor University College of Medicine, spoke for the panel during the public comment session and in a press briefing, taking the position that a physician has an independent obligation to protect a fetus, which, it is claimed, is not dispensed by a laboring woman’s refusal to consent. The panelists’ comments indicated that a conclusion regarding the ethical question was beyond their scope, yet stated to the press and to the audience that the body of law and ethics that protects the right to refuse surgery was not written for, and may not include pregnant patients. ...

http://www.rhrealitycheck.org/blog/2010/03/10/stupak-vbac-womens-reproductive-choices-bargaining-chips

Rebecca A. Spence - Wednesday ended the National Institutes of Health (NIH) Consensus Development Conference on Vaginal Birth After Cesarean (VBAC). In anticipation of the event, Courtroom Mama, an attorney and reproductive justice advocate, has written a powerful call to action on the travesty of hospital VBAC bans.  Henci Goer, author of “The Thinking Woman’s Guide to a Better Birth,” argues that the conference must remind clinicians  of their ethical and professional obligation to treat all women planning a VBAC, because “VBAC is a right, not a preference, a right, let me add, not abrogated by the clinician’s opinion of its wisdom.” ...

http://www.huffingtonpost.com/2010/03/11/panel-women-need-chance-t_n_495171.html#

Lauran Neergaard - Too many pregnant women who want to avoid a repeat cesarean delivery are being denied the chance, concludes a government panel that urged doctors to rethink litigation-spurred policies that have swung the pendulum back toward the days of "once a C-section, always a C-section." Fifteen years ago, nearly 3 in 10 women who had a first C-section were able to deliver their next baby vaginally, a trend called VBAC for "vaginal birth after cesarean." Now that rate has dropped to 1 in 10, in part because a third of hospitals and half of physicians ban women from attempting VBAC, a panel of specialists convened by the National Institutes of Health said Wednesday. ...

http://www.rhrealitycheck.org/blog/2010/03/10/vaginal-birth-after-cesarean-panel-pregnant-women-have-full-decision-making-power

Amie Newman - Unquestionably, the accessibility and safety of VBACs or vaginal birth after cesarean section has become an issue of controversy for pregnant women and birth activists. It's an issue taken up by reproductive justice advocates who see the connection between choices in childbirth and the choice to continue with a pregnancy or not. Over the last decade VBACs have become increasingly less accessible with fewer clinicians and facilities willing to provide them, despite and with little regard for pregnant women's desire to have a vaginal birth after a cesarean. ...

http://courtroommama.com/2010/03/06/why-is-vbac-a-vital-option/

Courtroom Mama - You see, I trust women.  I’m not fooled by people who diminish women’s choices and the process by which they make them by saying that they make their choices out of vanity, convenience, or hedonism. I believe in women to make the right decisions for themselves and for their families. Sure, we get it wrong sometimes, but I also trust women to know the risks and own their mistakes. ...

http://www.rhrealitycheck.org/blog/2010/02/25/mississippi-midwives-under-attack

Amie Newman - A bill to criminalize Certified Professional Midwifery (CPM) in Mississippi was defeated today, according to reports, thanks to a groundswell of opposition led by the grassroots advocacy organization The Big Push for Midwives. Had it been passed, HB 695 would have limited the practice of midwifery to Certified Nurse Midwives (CNMs), stating that "any person who is not a certified nurse midwife who engages in the practice of midwifery shall be subject to criminal penalties." The bill also stipulated that the practice of midwifery would be overseen by the Board of Nursing, something Katie Prown, Campaign Manager of the Big Push for Midwives, saw as an "inherent conflict of interest." ...

http://www.ourbodiesourblog.org/blog/2010/03/mississippi-senate-drops-bill-outlawing-cpms

According to reports, the Mississippi bill that would make non-nurse midwives illegal in the state is dead after “a barrage of calls and e-mails on lawmakers, urging them to kill the bill” from advocates for midwifery and home birth. We mentioned the bill in a post last week, after it passed the House and was referred to the state Senate’s Public Health and Welfare committee. Committee chair Hob Bryan has now indicated that he will not bring the bill up for a vote, saying that “This is something there’s a good bit of concern about. Several people in the committee said they had gotten calls to oppose it.” The Big Push for Midwives, mentioned in the story, led the campaign to mobilize against this bill and issued action alerts last week encouraging midwifery supporters  to contact their State Senators regarding the bill. Campaign manager Katherine Prown explained that their opposition was not opposition to regulation of midwifery, but to the limitation of midwifery practice solely to CNMs (who typically do not provide home birth support). ...

http://inthesetimes.com/working/entry/5610/the_labor_of_labor_gets_a_fresh_look/

Michelle Chen - Mention “childbirth” to the average American woman and you'll likely evoke a reaction somewhere between terror and elation, conjuring images of harshly lit emergency rooms, cold white sheets, syringes—a mess of pain and joy sprawled before a team of antiseptic doctors. But there was a time when bringing a baby into the world, while by no means easy, was a little more... personal. Today, traditional natural birthing practices survive through the work of midwives, who bring a human touch to an increasingly mechanized health care system. More than a vocation, midwifery embodies a physical and emotional communion in childbirth—an experience that modern medicine has scrubbed away in the “medicalization” of obstetrics. ...

http://www.rhrealitycheck.org/blog/2010/02/22/wyoming-legalize-midwifery

Amie Newman - Wyoming may soon become the 27th state in the United States to legalize the practice of midwifery. A bill to allow Certified Professional Midwives (CPMs) to attend and facilitate homebirths and to practice a particular scope of care as described in the bill has received "initial approval" in the Senate and has a strong supporter in the House. Certified Nurse Midwives (CNMs) are licensed in Wyoming and are allowed to practice the full scope of midwifery care and work in hospitals, private practices and birth centers. They are regulated by the Board of Nursing in that state as is the case in most states. CNMs are authorized to practice in all 50 states. ...

http://www.huffingtonpost.com/pamela-paul/childbirth-without-choice_b_168652.html

Pamela Paul - It would seem perfectly natural that a woman could give birth naturally if she wants to. Guess what? She can't. An increasing number of hospitals in this country are refusing to offer women the option of delivering the way nature intended, if she had a cesarean section the first time around (and guess what -- chances are she has because the 31% of all births are now C-sections -- up 50% in 10 years). I wrote an article in this week's issue of Time magazine called "The Trouble With Repeat Cesareans" on the subject of women's diminishing patient's rights. I won't repeat the story here, since you can link to it here, but will give some of the back story for those who want more. ...

http://www.rhrealitycheck.org/blog/2010/01/22/choice-also-means-choices-birth

"This post is part of our "What Does Choice Mean to You?" series commemorating the 37th anniversary of Roe v. Wade."

Steff Hedenkamp - In the beginning, there is birth, I  always say. And strangely, to me anyway, Choices In Birth is sort of the new girl on the sexuality and reproduction block. Or at least the one who keeps trying to move in but finds her key getting lost, or broken off in the door anyway. Who is she, this Choices in Birth? Smart, educated. She might choose Door No. 1 with midwives and out-of-hospital birth, or she might choose Door No. 2 with obstetricians and conventional birth options in hospital settings. But that's her Gemini way I suppose. Such vim! Such duality! Such affinity with Monty Hall! ...

http://www.huffingtonpost.com/christiane-northrup/c-section-or-natural-birt_b_323422.html

Christiane Northrup, MD - The times have truly changed. According to the newly released The Shriver Report: A Woman's Nation Changes Everything, women now make up half the work force for the first time in written history! This means that our voices and skills are impacting all areas of society more than ever before. The Shriver Report also found that for both men and women, health is their number one priority! Since women make the vast majority of healthcare decisions in their families--and have the buying power to do it--we women are in a very powerful position to influence the future of healthcare in America. Nowhere is this more critical than in the area of pregnancy and birth. ...

http://www.feministing.com/archives/018132.html

From the Lake Powell Chronicle:

Joy Szabo, 32, said she is upset with Page Hospital's general ruling in June prohibiting vaginal births after cesareans (VBAC). The mother of three children, she has given birth to all of her children at Page Hospital, the only hospital in the immediate area. A placenta eruption caused her to have an emergency cesarean delivering her second child, but the hospital allowed her third child to be delivered naturally two years ago. Now pregnant with her fourth child, she is being forced to have a cesarean due to lack of hospital staffing.

The International Cesarean Awareness Network reports that over 31% of US births are now by cesarean section, although a 5% to 10% rate is best for mothers and babies. The extra cost is well over $2.5 billion per year. Szabo has argued for her point-of-view--that the method of delivery is a birthing woman's right to choose--at a board of directors meeting and has met twice with Chief Executive Officer Sandy Haryasz, who claims that the choice is strictly economic (not enough physicians). So far, there's no progress. ...

http://www.rhrealitycheck.org/blog/2009/09/11/nbc-today-shows-homebirth-scare-segment

"The Perils of Home Births" screams the title of the segment at the bottom of the screen in a Today show attempt to cover the realities of homebirth in the United States. ...

http://blogs.babble.com/strollerderby/2009/09/14/the-perils-of-bad-reporting-on-home-birth/

Just when you think we’ve gone beyond safety issues with regard to homebirth — what with the findings in this study and, more recently, this one, among others — the Today show goes and airs “The Perils of Home Birth,” a seven-minute segment so poorly reported, so one-sided and salacious, that instead of feeling defensive and outraged — I laughed. Out loud. Alone! ...

http://wmcblog.livejournal.com/5639.html

Some of you may be aware of the "Big Push for Midwives" campaign that is on-going. Yesterday, this article came out, talking about how physicians are continuing their anti-midwives smear campaign to the airwaves. ...

http://www.theunnecesarean.com/blog/2009/9/13/hedonistic-obstetrics-medical-spas-ready-for-your-pap-n-wax.html

The Today Show aired a segment about home birth on September 11, 2009, called “The Perils of Midwifery.” Journalist Peter Alexander leads into the segment by asking, “Is avoiding the clinical nature of a hospital birth worth the risk when complications arise?” Halfway through the clip, Erin Tracy, the delegate from the American College of Obstetricians and Gynecologists who who authored the anti-midwifery AMA resolutions last June, provided her answer to Alexander’s question. ...

http://enjoybirth.wordpress.com/2009/09/12/acog-fear-and-litigation-motivation/

It is interesting that on the same day ACOG (via help from NBC) tries to use fear to motivate moms to birth in hospitals they admit that fear of litigation motivates them to make decisions, rather than evidence based choices. ...

http://keyboardrevolutionary.blogspot.com/2009/09/iridescent-tile-makes-all-difference.html

I started this post a few weeks ago, but it got shuffled to the backburner and forgotten...which actually works out well for me, because now I can tie it in with the Today Show's recent expose on "The Perils of Midwifery." Several bloggers have already posted about this article , which is one of those things that you just have to laugh about, because otherwise you'll cry. Here's a few choice excerpts: ...

http://radicaldoula.com/2009/09/12/acog-is-making-me-nauseous/
Ugh. That’s how I feel everytime I get another press release from the Big Push for Midwives, or see another blog post from a doula or midwifery blog about what ACOG–the American College of Obstetrics and Gynecology is up to. Just ugh. The latest: a totally biased segment on the Today show. To be honest, I couldn’t bring myself to watch it. If you want to see for yourself, it’s here. ...

http://realityrounds.com/2009/09/11/the-perils-of-midwifery-reality-rounds-calls-a-code-bullshit-on-the-today-show/

Oh my, Oh my.  My husband actually alerted me to a Today Show investigation (cue scary music) airing this morning while I was getting the kiddos ready for school.   I was flabbergasted, but not surprised by the one-sided, scare tactics of this investigative report (cue scary music)….The Perils of Midwifery (cue scary music….are you scared yet!). ...

http://www.theunnecesarean.com/blog/2009/9/11/acog-releases-survey-results-ob-gyns-ultimately-hurt-patient.html

In an honest yet damning press release today, ACOG released survey data that revealed that the changes OB-GYNs feel forced to make to their practices due to their fear of being sued ultimately hurt patients. ...

http://www.ourbodiesourblog.org/blog/2009/09/acogs-home-birth-survey
Earlier this week, the American College of Obstetricians and Gynecologists posted a survey, Complications Related to Home Delivery, at its website. The survey, designed for OB/GYNs, has raised the hackles of home birth and midwifery advocates, who question the intent of the survey and limitations inherent in the design. ...

http://www.huffingtonpost.com/louise-marie-roth/acog-up-to-dirty-tricks_b_274372.html
A recent press release details some of the lengths that the American College of Obstetricians and Gynecologists (ACOG) is willing to go to preserve its near-monopoly over maternity care in the United States. In an effort to deter growing numbers of women from seeking out-of-hospital maternity care, ACOG urged its members to submit anecdotal, anonymous "data" (i.e. horror stories) about women who planned out-of-hospital births. This represents an effort to develop an unscientific case against out-of-hospital birth. ...

http://wellroundedmama.blogspot.com/2009/09/patients-best-interests-not-anymore.html
Check out Rixa's recent interview with Dr. Stuart Fischbein, a VBAC- and breech-supportive doctor in California who is in trouble with his hospital for supporting Vaginal Birth After Cesarean (VBAC) and vaginal breech births. It's an interesting summary of the sad state of birth in hospitals these days.....ruled not by the patient's best interests, but by the hospital's best interests, along with doctor convenience, insurance rules, ease of staffing, and fear of litigation. ...

http://blogcritics.org/politics/article/embracing-health-care-cost-controls-my/

Radioactive words: cost containment and rationing. The reality however is that we should all be embracing a strong counter force to the expanding menu of health care options and services that the medical industrial complex is trying to sell us. A lot of what passes for health care in the United States is cosmetic and elective, not to mention unproven and actually guinea pig medicine. As a formerly well-insured American, my life is littered with examples. I will describe just one of each of the above as I am sure each and every well insured individual can, if honest or more importantly well informed and educated, find that they are also the beneficiaries of this largesse. ...

http://www.examiner.com/x-233-Denver-Parenting-Examiner~y2009m8d31-Doctors-okay-liquids-in-labor-woman-imprisioned-for-disobeying-doctors-orders

Last week The American College of Obstetricians and Gynecologists(ACOG) magnanimously decided to "allow" laboring women to take clear liquids during labor, instead of limiting them to ice chips and IV fluids. Women are still, of course, not "allowed" to have anything solid, because of the risk of aspiration if the labor ends in an emergency C-section with general anesthesia. Left unexplained is why every woman has to suffer to address a situation that few women end up in (an alarming number of labors end in C-sections, well over half in many hospitals, but most of them are done under spinal anesthetics) -- after all, most people don't avoid eating for twelve hours before they drive somewhere just in case they are in an accident and need emergency surgery. Also not explained is why denying sustenance to women engaged in long and grueling labors is better than addressing the issue of aspiration when it actually becomes a problem, i.e., when a crash C-section is about to happen. After all, people undergo emergency surgery all the time with food in their stomachs (see the snark above), so there has to be some sort of protocol. ...

http://enjoybirth.wordpress.com/2009/08/28/response-to-acog-homebirth-survey/

A fellow doula, Tabaré Depaep, J.D., Esq., CLD (CAPPA), wrote up this response and said that I could share it with the world!: As most of you already know, ACOG (American College of Obstetricians and Gynecologists) is collecting data on elective home deliveries, even if there were no adverse outcomes (see their data collection form at http://www.acog.org/survey/hdComplications.cfm).  Here is my tongue-in-cheek response (I am a lawyer and a doula):*

*Complications Related to Hospital Delivery* -- We at Doulable Birth are concerned that high rates of elective hospital delivery have resulted in an increased complication and morbidity rate. Reports from clients indicate that doulas are being called in to try and prevent these emergencies, and in some instances doulas and doula organizations have even suggested legal proceedings against the hospitals and doctors that seem unable or unwilling to learn from and address the deficiencies of their practices. To attempt to determine the extent of the problem, a registry of these cases will be maintained by Doulable Birth on a year-by-year basis. ...

http://www.huffingtonpost.com/grant-cardone/natural-home-childbirth-a_b_268869.html
My wife and I just gave birth to our first child in the comfort of our home and participated in one of the great miracles of life. The benefits of doing this at home was there were no alarming strangers in hospital garb telling us what to do, no blazing color codes coming over the PA system, no push or rush to have nature's process sped up, my wife was not confined to one bed in one position, no hospital food and no one pushed the drugs to increase contractions or epidurals to manage the pain. It was an amazing drug-free and stress-free experience that allowed my wife and me to be actively involved in the birthing process, not just patients along for the ride. ...

http://www.theunnecesarean.com/blog/2009/8/25/the-big-push-for-midwives-acog-wants-to-keep-women-hungry-in.html
[Shameless self-promotion going on here, we know ...]  I hate copying and pasting entire press releases, boilerplate and all, but this one is full of great quotes and writing a new post wouldn’t do it justice. It’s from The Big Push for Midwives, so please go there, click around and read liberally. ...

http://www.momlogic.com/2009/08/vbac_or_cesarean.php
<!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal    {mso-style-parent:"";    margin:0in;    margin-bottom:.0001pt;    mso-pagination:widow-orphan;    font-size:12.0pt;    font-family:"Times New Roman";    mso-fareast-font-family:"Times New Roman";} @page Section1    {size:8.5in 11.0in;    margin:1.0in 1.25in 1.0in 1.25in;    mso-header-margin:.5in;    mso-footer-margin:.5in;    mso-paper-source:0;} div.Section1    {page:Section1;} --> More than one million babies are born by Cesarean section in the U.S. each year. If you are a mom who had one, but who wants to try a vaginal delivery next, you may be out of luck. A VBAC, or Vaginal Birth After Cesarean, is when a mother delivers her baby vaginally after having previously delivered a baby via c-section. The VBAC rate has dropped significantly in the past ten years, and is becoming increasingly difficult to obtain. Here's why: ...

http://dooce.com/2009/08/04/labor-story-part-three

So. The end of the story. I'm not sure how to even begin this, and there's a part of me that wants to go: there once was a lady who got pregnant and then 40 weeks later there was a baby. The End. Except, then my monitor would be covered in tomatoes and trash and whatever you can find to throw at me, maybe a handful of pebbles or a brick, something substantial to cause a lot of pain, because you've been patiently waiting for this part of the story. But WHAT IF THERE ISN'T AN END TO THIS STORY? What if one of the rumors I read somewhere was true? THAT I MADE IT ALL UP. THAT MY BELLY WAS A PROSTHETIC AND MARLO IS A ROBOT.  Note: turns out robots have stinky poo. WHO KNEW. ...

http://phdoula.blogspot.com/2009/08/jennifer-block-on-whos-winning-home.html
New article from Jennifer Block on Who's Winning the Home Birth Debate. It's a step beyond the usual "Hey, home birth might be safe" or "Some people say home birth is safe" articles and into "If research has shown that home birth is safe, why is there still so much opposition?" She writes: ...

http://dooce.com/2009/07/27/labor-story-part-two
Five years ago when I was experiencing postpartum depression with Leta I was actively seeing a therapist to try and talk my way up and out and through the darkness. This therapist is by far the best one I've ever seen, and I've recommended her to almost everyone I know. Have a hangnail? GO SEE THIS THERAPIST. She's just totally no nonsense, out with it now, and will tell you exactly what you need to hear even if you don't want to hear it. I cannot count the times she has rolled her eyes, shaken her head and said, "Well, Heather, if that wasn't the stupidest thing you've ever done. Is it me, or do you just get dumber?" ...

http://www.huffingtonpost.com/louise-marie-roth/is-a-woman-in-labor-a-per_b_242307.html
Yet another ruling is providing legal support for the false belief that obstetricians are infallible and stripping pregnant women of basic civil rights that are then accorded to other individuals. In the case, New Jersey Division of Youth and Family Services v. V.M. and B.G., the New Jersey appellate court found that V.M. and B.G. had abused and neglected their child, based on the fact that the mother, V.M., refused to consent to a cesarean section and behaved erratically while in labor. The mother gave birth vaginally without incident, and the baby was "in good medical condition." Then she was never returned to her parents, and the judge in the case approved a plan to terminate their parental rights and give custody of the child to foster parents. What, beyond the obvious, is wrong with this picture? ...

http://www.rhrealitycheck.org/blog/2009/07/19/not-in-our-name-midwifery-turf-battle

It hasn't been an easy road for Certified Professional Midwifery thus far. Certified Professional Midwives (CPMs) are fighting, across the country, simply not to be considered criminals; more than that, CPMs are looking for federal recognition of their vocation, and for acknowledgement that midwifery is actually a tonic for much of what ails pregnancy and childbirth care in the United States. So it is that campaigns like The Big Push for Midwives and MAMA (Midwives and Mothers In Action) are pushing amibitious agendas. In the case of these two campaigns, under health care reform, their current fight is for federal recognition of CPMs. In concert with a host of advocacy and professional organizations including the Midwifery Education Accreditation Council, the Midwives Alliance of North America, the International Center for Traditional Childbearing and others, these campaigns are working the halls of Congress and the streets of America to expand access to safe care during childbirth, through midwifery and out-of-hospital birth options. ...

http://dooce.com/2009/07/13/labor-story-part-one
I have sat down to write this post so many times and abandoned the effort because I didn't know if I was going to be able to summon the words to describe what a sacred and spiritual experience labor was for me this time around. Yes. Sacred and spiritual. Words you never thought you'd hear from someone who can talk about breakfast cereal and hemorrhoids in the same sentence with the hemorrhoids being the part that didn't make you throw up. ...

http://www.rhrealitycheck.org/blog/2009/07/13/rh-reality-check-interviews-melissa-cheyney-midwife
Birth is a big part of Melissa Cheyney’s life – especially right now. As a new mother, having given birth in May of this year to a beautiful girl, as well as a practicing midwife and homebirth advocate, Cheyney has devoted much of her life to bringing new life into this world. In fact, the weekend after we conducted this email interview, Cheyney attended her first birth as a midwife since her daughter’s arrival. But it is her work as a professor of medical anthropology and reproductive biology at Oregon State University that recently caught my eye. ...

http://keyboardrevolutionary.blogspot.com/2009/07/just-when-id-thought-id-heard-it-all.html
"Pit to distress." How have I not heard about this? Apparently it's quite en vogue in many hospitals these days. Googling the term brings up a number of pages discussing the practice, which entails administering the highest possible dosage of Pitocin in order to deliberately distress the fetus, so a C-section can be performed. Yes folks, you read that right. All that Pit is not to coerce mom's body into birthing ASAP so they can turn that moneymaking bed over, but to purposefully squeeze all the oxygen out of her baby so they can put on a concerned face and say, "Oh dear, looks like we're heading to the OR!" ...

http://www.theunnecesarean.com/blog/2009/7/6/pit-to-distress-your-ticket-to-an-emergency-cesarean.html

... I imagine that all of us who have openly questioned the practices of obstetricians in the U.S. have been hit with the same backlash. We must be selfish, irrational and motivated by our own personal satisfaction. We’ve been indoctrinated into a subculture of natural birth zealots and want to force pain on other women or just feel mighty and superior. We fetishize vaginal birth and attach magical powers to a so-called natural entrance to the world. Nah. It’s stuff like “pit to distress” that made me run for the nearest freestanding birth center. If I had to do it all over again, I’d stay home. ...

http://www.dailykos.com/story/2009/6/18/743851/-Is-the-American-Medical-Association-Still-Relevant
Barack Obama met the AMA last Monday at its Annual Meeting in Chicago. He received everything from applause to boos to cautious comments of support afterward.  But in a time where its membership is at best only 20-30% of American doctors, does the AMA really matter? ...

http://www.rhrealitycheck.org/blog/2009/05/07/making-my-birth-my-choice-a-reality-for-all-women
Join Feministing blogger, radical doula, and RH Reality Check writer Miriam Perez and JayVon Muhammad, certified professional midwife and Steff Hedenkamp with The Big Push for Midwives campaign, on Thursday, May 14th for a fascinating, in depth discussion about the reality of access to homebirth in the United States for all women! Ask your questions of or share your experiences with out-of-hospital birthing, midwifery and doula services for all women regardless of income level. Replay the livechat anytime.

http://independentchildbirth.wordpress.com/2009/05/10/celebrate-womens-real-birth-wisdom/
The more a midwife speaks to a mother and spends quality time with her, the more likely a mother is to open up and reveal more of her daily routines and habits that can affect her pregnancy and birth. For example, the midwife will ask a mother the most basic yet critical questions like what is she eating and follow up with nutritional counseling, a topic in which the midwife owns expertise. She'll ask her what is occurring in her life today, yesterday, expecting for tomorrow. A mother's every day peace and stress contributes to her body's sense of well-being and reaching the point where mother and her body believe it is time now to give birth safely and securely. ...

http://www.rhrealitycheck.org/blog/2009/05/07/barriers-home-birth-fall-washington-state
Nationally, only a small portion of women give birth outside of hospitals (around 1%) and very few of those women are low-income. In a recent piece for RH Reality Check, The Cost of Being Born at Home, I painted a grim picture of the options afforded to low-income women around the country who are considering out-of-hospital birth. Few out-of-hospital childbirth providers are registered with Medicaid. Cost and physical space available at women's homes are also significant prohibiting factors. And lack of knowledge of the practice, as well as lack of targeting from media and advocacy promoting home birth (such as the pro-home birth film The Business of Being Born), impact low-income women's decisions about where to birth. ...

http://homebirthishealthy.blogspot.com/2009/04/what-if-buzz-on-social-networks.html
What if I go into labor, and the hospital is full of flu patients? What if hospitals become overrun with contagious carriers of a deadly virus? Who has the specialized portable equipment and knows how to help women give birth safely without all the risky drugs that most American hospital staffs rely on? ...

http://ecochildsplay.com/2009/04/17/home-birthing-is-gasp-safe/
Those crazy Europeans. They think that–gaffaw–home birthing is safe! Haven’t they heard about home birth activist Janet Fraser and her very personal tragedy? You know the story: an unassisted childbirth ended with her baby’s death, for reasons that have not yet been determined. And now some are calling for her head, while others are criticizing at home births in general (though not the same as freebirthing). ...

http://www.unnecesarean.com/blog/2009/4/15/bruce-flamm-some-say-c-sections-are-more-cost-effective.html
"Some people in the medical community actually think it will be cheaper to increase the C-section rate. It sounds crazy, because the surgery stay is longer, but when you figure in the cost of going through labor and the 1-to-1 of nurses and patients, the difference is not quite as obvious." -Dr. Bruce L. Flamm, an obstetrician with Kaiser Permanente in Riverside, CA and a spokesman for the American College of Obstetricians and Gynecologists (ACOG) ...

http://keyboardrevolutionary.blogspot.com/2009/04/when-life-gives-you-lemons.html
VA Governor Jim Kaine signed HB 2163 this week, which if you may remember from a few months ago was a bill proposed by my very own delegate that will tighten midwifery legislation by demanding that midwives provide their clients with "evidence-based information," in particular regarding homebirths, and ESPECIALLY regarding twin, breech, or VBAC homebirths. ...

http://nursingbirth.wordpress.com/2009/03/11/the-scope-of-practice-for-midwifery-in-america-or-why-physicians-are-shaking-in-their-boots/
I recently read an article published on amednews.com (a publication of the American Medical Association) entitled Scope of practice expansions fuel legal battles by Amy Lynn Sorrel. The article reports on the increasing number of physicians and professional medical associations bringing forth court cases against state boards of health on what they refer to as "scope of practice expansions" by a growing number of health care professionals. Two examples of this phenomenon that are highlighted in the article include the right of nurse anesthetists to provide interventional pain management services to their patients and the right of certified professional midwives to practice independently (as was passed in the State of Missouri in 2007). If you have 10 minutes, the article is pretty short can be found at the link above. ...

www.babble.com.au/2009/02/13/society-doesnt-support-home-birth-or-does-it/
As the economy continues into the toilet, there seems to be a growing push to consider increasing the use of midwives (both hospital and home birth, nurse-midwives and certified professional midwives) as a way to cut down health care costs. Of course, it’s being met with a predictable backlash from doctors screaming about how dangerous home birth is. ...

www.banned-from-baby-showers.blogspot.com/2009/01/why-would-you-choose-homebirth.html
I have a friend I went to college with that I have recently reconnected with through Facebook. He and his wife are pregnant with their 3rd baby. I told him about our last two babies being born at home and I just wanted to share some of our dialogue: ...

http://well.blogs.nytimes.com/2008/11/12/having-baby-at-home/?ref=garden

A friend recently stumped me with a health-related trivia question. Who was the first president to be born in a hospital? The answer, posted below, left me thinking about what a relatively new phenomenon hospital births really are. My colleague Julie Scelfo explores the issue further in today’s Home section, finding that the home birth appears to be making a surprising comeback. ...

www.ourbodiesourblog.org/blog/2008/07/american_medical_association_apology_sparks_d.php

Last week, as mentioned in the Double Dose, the American Medical Association apologized for more than a century of racial inequality within the organization. The apology provided a teaching moment of sorts for Chicago Tribune columnist Dawn Turner Trice, who maintains an online forum on race. White readers, she notes, frequently write in to ask why blacks create their own groups, such as the National Association for the Advancement of Colored People, along with black colleges, sororities, etc. After all, if the word “white” were in the title, wouldn’t those groups be considered racist?

http://www.theunnecesarean.com/blog/2010/4/10/the-virtue-of-complaining.html

ICAN has posted a list of things you can do to complain about your mistreatment during a birth. It’s helpful and necessary, but also a little discouraging.  Affecting hospital policy and practice from the outside is still a hard slog, and lawsuits for unnecessary c-section are difficult and expensive to bring. At the moment all we can do is file complaints, educate others, and push for legal reform. The most effective wedge right now seems to be pushing for wider access to midwifery and/or birth centers, because while you can’t tell doctors or hospitals what to do, you can shake things up by introducing medical practitioners like midwives who challenge them by providing better and more satisfactory care. On that note, you can contribute to groups like the M.A.M.A. Campaign (full disclosure: I do some volunteer work for them, and ICAN too) and the Big Push for Midwives as another way of fighting back. ...

http://www.ourbodiesourblog.org/blog/2009/09/needs-a-title-today-show

Last week, the Today Show aired a segment initially titled “The Perils of Midwifery,” which despite the title was not about occupational hazards for midwives (ha), or even about midwifery in general, but about home birth specifically. Although it has since been recaptioned “The Perils of Home Birth” on the NBC website, the original titling as aired to many viewers can still be seen on various websites, including Hulu. ...