On the Radar, 11/15/08

The weekend is an excellent time to catch up on the latest news. Here are some things rolling around the internet that piqued my interest.

I had to edit my post to include the latest cartoon by Hathor the Cow Goddess.  This one really resonates with me in a funny and sick way.  It’s so true . . . except that I never made it out of the hospital bed, unless you count changing beds to be wheeled into surgery . . .  If wishes were horses, I’d have followed my instincts and not left my house that night.  We were fine until the midwife broke my water. <sigh>

AMA Scope of Practice Initiative Advances – I get so focused on what ACOG and the AMA is trying to do to childbirth, that I forget the far reaching affects of their actions. This post was written by the American Optometric Association. I think it’s a good one to study to get another perspective on expanding SOPP. Plus, it makes me thing that we need to forge ties with other “secondary level” practitioners, hire our own marketing teams, and put together a real professional campaign against the AMA.

Can you give yourself a few minutes every day for the next 15 days to practice relaxation and yoga? I’ve been thinking about this a lot lately, especially since I’ve started reading Living Buddha, Living Christ by Thich Nhat Hanh. One of my students let me borrow it. While I’m at it, let me share one wonderful thing I’ve read from the book thus far:

Peace is all around us – in the world and in nature – and within us – in our bodies and our spirits. once we learn to touch this peace, we will be healed and transformed. (23-24)

It’s so hard for me to recognize peace around me, and, in a way, to embrace the healing and transformation that is promised by embracing peace. I keep being led to practicing mindfulness, peace, meditation, yoga, being present, but I keep resisting it. How about you? And will you also take mamascoffeetime’s challenge to practice yoga? If you have a little one at home, try the Animal Adventure!

I found a petition, “Practicing midwives Should Be Licensed and Carry Insurance.” I sighed in sadness and exasperation when I read it. It really stinks that this family lost their baby in this manner, but shouldn’t they have been aware through the interview process if their midwife was licensed and if she carried insurance? I’m not trying to point fingers back at this family, but these are such basic questions. For some homebirthers, it’s important that their midwives carry the proper credentials. Others recognize that midwives don’t always care about formal recognition for what they do. They help babies and their families at one of the most critical and beautiful times in their lives. A piece of paper doesn’t mean that they’re a good or bad midwife any more than a medical degree ensures that you have a good doctor. And to require midwives to carry insurance is to ask them (and us) to continue to support a system that is completely FUBAR! Anyone who has suffered from major medical problems – even if they have “good” insurance – can attest to that.

Choices in Childbirth Statement Encourages Options and Evidence in Maternity Care. What a concept, eh? Options for women and their babies? EVIDENCE when it comes to maternity care?? Here’s a taste, but please do read the whole thing! I wonder if ACOG or the AMA will respond?

The statement also calls for evidence-based practices in maternity care, and for the American College of Obstetricians and Gynecologists and the American Medical Association “to strike those resolutions that deny childbearing women the autonomy and rights that medical professionals, educators, and women’s health advocates have historically endorsed.”

A wonderful post at BlogHer, It’s lonely out here: planning for a natural childbirth. Some great comments too!

CfM Grassroots Network: MEAC Needs Our Help! What they really need is our $$.

And last but not least . . . a new website and blog to which I will subscribe: The Unnecessarian which I found via CfM and Birth, Interrupted. Read the latest blog entry and you’ll see that they’re already holding the medical community’s feet to the fire.

Recent Interesting Reads

Not that I’m voting Republican, but I am curious to know anything about Sarah Palin.  Who is this woman and how did she secure the VP slot on the Republican ticket?  Here are my guesses: (1) She’s such a nobody that when McCain loses, no Republican with a political future would be sacrificed and (2) Should McCain/Palin pull out a win, they have Alaskan Oil in their pockets.  But I digress – read this post at Jezebel about Sarah Palin’s brand of feminism.  I don’t mean to be polemic, and well, when you hear it enough times, it ceases to be polemic and looks more like the down-low on shadiness.

Researchers from the University of Connecticut released a study which looked at the relationship between cesarean rates and malpractice rates.

“When I compared the malpractice rates to cesarean delivery rates prior to 1999, both were declining at a similar rate,” says Spencer. From 1999 to 2005, however, both were increasing. “I can’t say one led to the other or visa versa,” he says, but he speculates that rising medical malpractice rates are driving up cesarean delivery rates.  “With our data, we cannot prove a causation but only suggest an association.”

An insightful read from the UK, especially:

“Since the 1970s, the medicalisation of childbirth has been a hot topic for obstetricians, midwives and feminists. There exists in maternity services a clear division between the interventionists, typically headed by the obstetricians, and those, such as midwives, who favour a low-intervention approach. Caught in the middle are the women giving birth. Those who opt for high-tech hospital births are condemned for giving in to unnatural patriarchal models of healthcare and betraying the sisterhood. Those who eschew medical and technological assistance are deemed irresponsible and reckless. They can’t win.”

No, we can’t seem to win, especially those of us who have already been cut once.  To put our babies through a “trial of labor” is considered irresponsible and reckless at best by a growing majority of care providers and the general public.

And finally, I’ve never liked Dr. Phil.  I’ve watched enough of him on TV at various times in his career to know that he has nothing new to add to my knowledge base.  I find him to be a subversive character – wish I could remember the exact moment I decided that, but it was many years back and had something to do with him blaming a wife (in front of her husband) for their marital distress.  I don’t know who was at fault, but Phil pinned the whole thing on the wife and was using this icky patronizing tone.  Ick.

I digress.

Over at Inspired Mama I came across this post – Dr. Phil is asking for homebirth disaster stories.  <sigh>  I’m reproducing it below so you don’t HAVE to click on the link unless you want to go to the horse’s ass, I mean, mouth.  (Keep in mind that when you click active links it raises their “rating” in search engines.  Click at your own risk.)

DO YOU REGRET HAVING A HOMEBIRTH?
Did you have a child at your home?

Did you want to have a soothing experience where you were in control and could bond with your child?

Did it not go the way you planned?

Do you regret having a home birth?

Do you regret using a midwife instead of going to a hospital?

Did you have your second child the traditional way in a hospital?

If you or someone you know regrets having a home birth please tell us your story below.

Be sure to be specific and include details!

Here’s an idea – instead I recommend flooding the Dr. Phil show with letters about how wonderful homebirth can be, how difficult VBACs can be to achieve within a hospital environment, and how the current maternity system ruins natural childbirth.

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“Black Market Birth” – Request for Your Stories

A friend of mine in ICAN is working on a very important project.  She will be making a presentation to the American Public Health Association (APHA) in October:  “VBAC Beyond Borders.”   One thing that she asked us to share is her need for stories regarding “Black Market Births.”  She writes:

Specifically, I am looking for birth stories of women who delivered in hospitals with VBAC “Bans” in place.   I am also very interested in stories of homebirth where VBAC itself was explicitly illegal.  At some point, I will be looking at HBAC in states where midwifery is unregulated or “alegal,”  but at this time am most interested in births where homebirth midwifery is regulated, but VBAC is outside the practice regulations or scope of practice.

Please send your stories and questions to ICANMidlandssc *at* gmail *dot* com.

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Homebirth Featured by Christian Science Monitor

What a great story about Diane Goslin, a Christian midwife in Pennsylvania.  If you haven’t read this article, I highly recommend it!

“The [issue of] the medicalization of childbirth has been around for a long time, now,” says Arthur Caplan director of the Center for Bioethics at the University of Pennsylvania. “There will always be [people like] the Amish, who want no technology” on one end of a continuum, and those who will refuse to have a baby “if they can’t deliver at University of Pennsylvania” on the other. He argues that the home-vs.-hospital argument should be removed from the ideological push and pull, and instead be driven by safety data specific to the woman‘s age and risk factors as well as the availability of emergency backup care.
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Upcoming Interview

In about an hour I will be interviewed for a local news station regarding Montana’s cesarean rate.  I don’t know much more than that.  The reporter has a young child.  The reporter is supposed to be meeting with a local hospital official.  Other than that, who knows what her focus will be.  In anticipation of this interview, I decided to review some things that I have read and wrote regarding cesarean rates.

With regard to rates, it is important to consider that the US cesarean rate (2006, preliminary) is 31.1%.  The rate has increased by 50% since 1996.  The rate recommended by the World Health Organization is 10-15%.  Once the cesarean rate exceeds 15%, the risks (statistically speaking) outweigh the benefits.  The Montana cesarean rate (2006, preliminary) is 28%, nearly a 3% increase from the year prior.  According to a source at the local hospital, our local rate is around 31%.  I was told that only 16 VBACs took place in 2006 at my hospital.  (A local CNM questioned the accuracy of the VBAC figure, suggesting that VBACs were under-reported.)

I can list many contributing factors to the continued increase in the cesarean rate:

  • Medico-legal concerns on the part of doctors, hospitals, and insurance providers (it’s HUGE, actually)
  • “So and so had a cesarean . . .”
  • Hollywood stars having elective cesareans
  • Young and underpriviledged mothers are more at risk for cesarean surgery
  • An unchecked trust in care providers – most women do not seek second opinions when it comes to maternity services
  • Sensationalization of birth – Baby Story and OR Live come to mind
  • Society – our view of birth has changed; the culture of fear has spread to childbirth
  • Cesareans ARE more safe now than they ever have been

Of course I’ll direct the reporter to resources such as:

  • ICAN
  • The Mother-Friendly Childbirth Initiative
  • Childbirth Connection
  • Conscious Woman

April: Cesarean Awareness Month

Cesarean Awareness Month (CAM) is an internationally recognized awareness month which sheds light on the impact of cesarean surgery on mothers, babies, and families worldwide.  Cesarean birth is major abdominal surgery for women with serious health risks to weigh for both moms and babies.  Cesareans may be safer now than they ever have been, but this surgery is being conducted more frequently than is prudent or safe.  The acceptable rate established by the World Health Organization (WHO) is 10-15% – what is your community’s cesarean rate?

The blogosphere is atwitter about Cesarean Awareness Month.  Here are some posts I found today that deal directly with CAM:

  • Instinctual Birth’s post
  • No Womb Pod’s post
  • Strain Station’s post
  • Cesarean Awareness’s post
  • CT Birth Experience’s post
  • She Got Hips’s post
  • CT Doula’s post

If you have blogged about Cesarean Awareness Month and don’t appear on my list, please leave a comment so we can read your post.

To learn more about cesarean awareness, support, and education, visit the Internation Cesarean Awareness Network (ICAN) website and/or look for a chapter in your area.  Another great resource to consult when weighing the benefits and risks of intervention in chilbirth is Childbirth Connection.  Also, I recommend looking at and considering the Mother-Friendly Childbirth Initiative.

How do you plan to honor Cesarean Awareness Month?  How can you let people know that natural birth is an important issue for you and for them?  I promise that there is some way, no matter how small it may seem, that you can have a positive impact on your birth community.  Even wearing a cesarean awareness ribbon several days this month will help.  If you need ideas, feel free to ask.