Cross Post about Business of Being Born

I just LOVE the True Face of Birth blog.  There’s always a gem of a post there that makes me smile, or think, or cry.  I’m not a huge fan of regurgitating other bloggers’ posts, but I’d at least like to draw a few things out of a particular post that really spoke to me.  My comments are sprinkled throughout.

A family practice doctor was in the audience of a “BOBB” screening.  She sent an e-mail to Rixa sharing her thoughts on the movie:

I loved that the births were shown to unfold in their own time and that the mamas looked free to move on their own and birthed upright. I love that upright birth center birth where the mama is so joyous right after.

I cried at every one of those births. Don’t know what was up with that! My little dd even kept asking me if I was okay. (I cry a fair amount of the time at actual births, though, too–you’d think I’d get over it.) I think if people watched this movie and the only thing they took away was visions of women pushing their babies out standing, squatting, in the water, whatever, that would at least be a start. [bold emphasis mine]

I was disappointed in the ending. I don’t think they explained enough what was happening, and I was disappointed that the final interview blew off any benefits of homebirth and implied that it’s all nice if you can have it, but thank God we had this cesarean and saved my baby. I actually think in her particular case transferring for a breech, growth-restricted baby was probably a good idea–but there had to have been a better way to wrap up that movie than Abby saying “Oh well, at least I got a healthy baby” you know?

I wish they’d wrapped up with some kind of activism information–like talking about CIMS, or ICAN. Here’s where you can start to change the world kind of info.  [Thanks for the plug, Doc!!!]

It was also discouraging, though, to hear how people struggle to get the birth they want. I am pretty disappointed in this whole VBAC thing, and disappointed especially that so many “low-risk” providers are just giving up VBACs and verbalizing that it’s just too bad, so sad for the women involved, but nothing we can do.  [You and me both.  I feel abandoned and betrayed by the medical community at large.]

I actually think all of medicine needs to be reworked.[emphasis mine] Something I was trying to say, and may not have got it out coherently at the panel discusson, is that having doctors in charge of medical care and responsible for the outcomes doesn’t benefit anybody.  [Whoa!  Again, this is coming from a DOCTOR.  Wow!!  I wonder how many other practitioners feel like that.]

I’m not sure how to make a change in modern obstetrics, but I think one factor is that women have to refuse to accept paternalistic, condescending care. I don’t care what kind of choices women make, but they need to insist on accurate information and fully informed decision making.OBs need to get out of the business of normal maternity care. We have put normal care into the hands of folks trained in the abnormal.   [I couldn’t agree more.  I wish obstetrics would accept its mandate as a surgical specialty.  Practitioners trained in normal birth need to attend and assist low-risk moms, and that includes low-risk VBAC.]

I am so inspired by this care provider’s perspective.  It gives me hope at a time when it is easy to despair given the challenges ahead for me in terms of maintaining a pregnancy and making L&D choices that will be best for me and my family.

Blessings to Rixa for her post and to this marvelous doctor.

Please visit Rixa’s blog and read the entire post!

Danger Will Robinson

I read this over at Birth Matters:

the American Medical Association formed a group called the Scope of Practice Partnership (SOPP), whose mission is to launch investigations of unlicensed “midlevel providers” and to support initiatives to fight legislation expanding the current scope of practice for licensed “midlevel providers”.

Doesn’t the AMA have anything better to do?  Like schedule unnecessary procedures and fight law suits?

 Watch out for AWHONN.  Here’s another group of medical folks looks like mostly duped L&D nurses) that just must not be busy enough.  This group is trying to stir up trouble for direct entry midwives, stating that they aren’t educated enough to perform their services.  Here’s an excerpt from their Fall newsletter:

AWHONN strongly supports the practice of midwifery by a Certified
Nurse Midwife (CNM), who is a registered nurse with an advanced
degree and broad range of training in areas including pharmacology,
and formal collaborates with other health care professionals as an
expectation of their licensure to provide safe, holistic care.

Certified Professional (Lay) Midwives (CPMs), in contrast, have a
far more limited apprenticeship and are not required to have
relevant college degree, pharmacology training, or collaborative
practice agreement with an obstetrician or hospital in case of
complications.

Far more limited apprenticeship?  Could you be more specific please?  What I know about midwifery apprenticeship is that they have to observe and then participate in (as an apprentice) a large number of births before they are allowed to practice alone.  This is regulated state by state.

Relevant college degree?  And what is that?  In this day and age a bachelor’s degree is only a vehicle to get you somewhere else.  A bachelor degree is not something to measure proficiency in ANYTHING by.  I have a BS in Psychology and certainly wasn’t qualified to practice or conduct scholarly research at the end of my program.  And I don’t have a bachelor’s degree in music though that is my field of specialization.  I happen to be a damned good singer and teacher in spite of my lack of a degree that is not considered terminal in my field.

Collaborative practice agreements?  What a joke.  I had a PA tell me recently that her OBs were no longer able to provide back-up service for homebirth.  I’m sure it boils down to liability/malpractice.  So, this group is fudging that part of the argument.

I am surprised that AWHONN is turning its back on homebirth.  They were evidently founders in the Coalition for Improving Maternity Services (CIMS).  According to the CIMS website:

In its first five years, the work of the coalition has focused on the creation and implementation of the evidence-based Mother-Friendly Childbirth Initiative (MFCI), which provides guidelines for identifying and designating “mother-friendly” birth sites including hospitals, birth centers and home-birth services.

So what’s different now in 2007?  Anyone else smell something stinky?

TRAITORS!