What Will This Home Birth Summit Look Like?

The upcoming Home Birth Summit, supported by funding from the Transforming Birth Fund, is raising numerous questions in my mind, and for numerous others, such as: 

  • How are the agreed-upon ‘stakeholders’ being represented?  How are consumers, in particular, being chosen?
  • What percentage of invited participants have direct experience with home birth?  In my opinion, a representation of 1/3 HB midwives, 1/3 CNMs, and 1/3 OBs would not be an appropriate proportion from the practitioner group.
  • Why exactly is the American College of Nurse-Midwives interested in the issue of homebirth considering that very few actually attend home births?
  • Given the above question, I’d like to know if the home birth midwifery organizations (NARM, MANA) submitted a grant application?
  • How will the outcomes make home birth more accessible and more safe?  Will an outcome be that hospital systems and serving on-call OBs will be more respectful toward homebirth transfers?  Will OBs begin offering back-up services to homebirth midwives?  What might that look like?
  • What are the potential positive outcomes of this summit?
  • What are the potential negative outcomes of this summit, especially considering that the need for this summit originated outside of homebirth midwifery?

With permission, I share the following e-mail from retired homebirth midwife, Linda Bennett:

Are you invited? Who is going?

I have concerns about this “Summit”. I want to encourage communication with invited participants the same way I have encouraged communication with our elected representatives. These participants have been appointed to represent the interests of mothers, families, and, coordinated by a midwifery group, I also assume the interests of midwives. I have every hope this will be the case. My long experience with some of the groups that have been invited raises some doubt.

The “Home Birth Summit”, scheduled for some time and some place in the Fall of 2011, is being coordinated by the organization called “Future Search”. The ACNM originated and identified a need to hold this “Summit”.

The American College of Midwives has many CNM members who actively support families and mothers who want a low-tech physiologic labor and birth in the hospital, in birthing centers and at home. CNMs have demonstrated over and over the value of personalized physiologic management that dramatically reduces unnecessary major surgery while improving outcomes. Their work continues to be overlooked, ignored and impeded by Obstetric professionals in overt and subtle ways. If this summit was only held with these particular participants I would have little concern for the outcome.

Unfortunately the ACNM also has very vocal and politically active members who oppose home birth and/or non-nurse midwifery on local and national levels. Here in Oregon we have the “Home Birth Safety” committee organized by L&D nurses and CNMs in Portland at OHSU for instance. Nothing they have done has improved home birth safety in Oregon, rather their actions have polarized the birthing community and has caused even more mothers to consider unassisted home birth for their VBAC attempts after multiple cesareans.

It should not surprise the ACNM and Future Search organizers that home birth families, midwives with home birth practices, and long-standing Birth Activist groups and individuals feel uncertainty about the outcome of a “Summit” top-heavy with groups who have a history of opposition to maternal choice as well as to the independent practice of midwifery.

We have a vested interest in this “Summit” as its pronouncements will be used against maternal choice at every possible opportunity. Statements made in any documents released as a result of this “Summit” will be entered into testimony for or against legislation affecting mothers, families, home birth and midwives across the USA.

Amy Tuteur is an example of a vociferous emotionally-charged tea-party-esque commentator on the subject of home birth. She is not an expert on home birth. She has never been to one. In order to be allowed to deliver another baby in the hospital she would be required to re-train. If she is in any shape or form part of this “Summit” then it will be obvious that it will not represent the interests of mothers, families or address the real concerns of home birth.

Is Lynn Paltrow invited? Her work with NAPW has been as one of the most effective advocates for mothers in the USA in the tradition of  Doris Haire.

The reality is that home birth exists in the form it is currently functioning in the USA because of what it offers mothers and families AND because of what hospital-based ACOG-controlled maternity care does not.

Please communicate to individuals carefully selected for participation in this “Home Birth Summit”. They have been selected to represent you.

Future Search
4700 Wissahickon Ave, Suite 126
Philadelphia PA 19144
800-951-6333 or 215-951-0328
fsn@futuresearch.net

Here are additional links you might find interesting:

Day 2 Pt 1 Impactful ICAN Conference Tweets

The working subtitle of this post is . . . you can lead an OB to the table, but can you keep him/her from cutting??

some rights reserved - thetorpedodog @ Flickr

Here are some of my favorite tweets from the Saturday morning sessions.  (And as I look at the 300+ conference tweets paused in twitterfall this morning, the day after, I realize there may not be a part 2 . . . kind of like History of the World!)

Disclaimer: Since I collated these posts from a public feed reader, I have not asked permission to repost them.  OPs may request their tweets be removed and are welcomed to clarify their tweets in the comments section.)

Regarding breech:

BirthingKristen “Women should have the right, the support, and the resources to choose their own set of risks.” #vaginalbreech #ICAN2011
I do believe this, but gee, it’s hard to achieve especially when you involve birth attendants, regulations, insurance, hospitals, even birth centers, etc.  I’m afraid to say that the fact is that women will never fully have the right to choose their own set of risks unless they birth on their own.

DeepSouthDoula Vaginal breech birth is in our reach but it’s up to the parents to make it happen. Like the parents who walked out 1 hour prior. #ICAN2011
Again, somewhat idealistic.  In my case, I knew I’d be trying to fight my provider’s malpractice insurance . . . me . . . alone.  I’m not saying there aren’t things we can’t and shouldn’t do, but realistically many, if not most, families are not going to fight the system one hour before giving birth.  And they shouldn’t be made to feel like failures because they didn’t fight this overwhelming machine.

ShannonMitchell GT: breech birth is a part of the traditions midwifery #ican2011 #breech
Yes it is.  Isn’t it a shame that it’s often not in the current scope of practice for traditional midwifery?

DoulaMari: “Mama loves you enough to have you at home even though you were breech!” #ican2011
This just hurts my feelings.  I know the statement had nothing to do with me or my choice to consent to a CBAC for double footling breech twins and that it’s excerpted from an emotionally powerful experience, but it still cuts like a knife.  Actually, it feels like a repetitive cut to the same wound that refuses to heal.

drpoppyBHRT When docs tell midwives, “you can’t do that” is it really because THEY can’t do that? #vaginalbreech #normalbirthignorance #ICAN2011
Nice.  Yes, I think a lot of the time it does mean that.  They haven’t been trained to trust the body’s wisdom; they’ve been trained to search for pathology and treat that pathology.  Even the NIH VBAC consensus report indicates that younger doctors may be more resistant to VBACs because they were trained during a time when VBAC was (is) so highly contentious.

heathertom Tully: the question may be Is the attendant safe? #ICAN2011 #vaginalbreech
Absolutely.  I personally would be more afraid to show up at the hospital pushing out a breech baby if I didn’t know that the doctor on the receiving end was experienced with breech.  In fact, I’m of the opinion that in my community it may be irresponsible to show up at my hospital with a vaginal breech.  It hasn’t been part of the local practice – obstetrics or midwifery – for more than 10 years.

poderyparto Breech: 80% no intervention needed at all, 20% need maneuvering. #CAM2011 #ICAN2011
In other words . . . HANDS OFF THE BREECH!

drpoppyBHRT OBs in Germany and Israel are working to unite midwives and OBs to increase vaginal breech birth. I love that! #kneechest #ICAN2011
This is wonderful to know.  We should be pointing to these case studies every chance we get.  This will help us as we advocate for evidence-based care.

Other awesome tweets: (before I fell off the wagon)

drpoppyBHRT: Midwives told to stop doing #VBACs, they responded “when you stop doing cesareans.” Gail Tully #ICAN2011
AWE.SOME.

MamaBear1326 Why am I lucky enough to live where I achieved a vba2c and some people dont have that option #breaksmyheart #ican2011
Many women don’t feel they have the option to birth their babies.  This is so sad.  The fact is that women have fundamental rights.  No one can force you to consent to a surgery.  And even ACOG’s 2005 committee opinion supports protecting these rights:

Efforts to use the legal system to protect the fetus by constraining pregnant women’s decision making or punishing them erode a woman’s basic rights to privacy and bodily integrity and are not justified.”  (via birthaftercesarean)

Unnecesarean Dr. Poppy Daniels: “Women who really want a vaginal birth can go to extremes to get it.” (No kidding) #ICAN2011
And we will.

ICANofAtlanta How many ob-gyns have not read the latest ACOG practice bulletin on VBAC, not to mention the NIH consensus? #ican2011 #hcsm @drpoppybhrt
. . . and won’t acknowledge that local practice should change to reflect the bulletin and NIH findings.  This is why I’m sending letters to all local OBs.  I’m done with their fear mongering and lies.

RobinPregnancy T-shirt spotted: Keep your politics out of my vagina on @shannonmitchell #ican2011
Nearly snorted my coffee when I read this.  And I want one.

mollytoba I keep hearing about better integration of midwifery and OBGYN care. Who is actually doing this? Any successful models? #ICAN2011
Someone did respond to this, but I can’t find the tweet.  She mentioned some place in LA (which I can’t remember if refers to Louisiana or Los Angeles!).  But that was the only ‘successful model’ response I read.

DeepSouthDoula Exploring birth trauma in mamas AND with birth professionals. What we witness can be traumatic for us too. #ICAN2011
I may have to dedicate a post to this.  Birth professionals who experience trauma need to be treated!!!  Please refrain from bringing your trauma into future births.

babydickey “I’m not a uterus walking into an operating room.” I’m a pregnant woman with a family. #ICAN2011
<le sigh>

blairlovesjason Glad @drpoppybhrt discusses the harm in shows like Deliver Me, A Baby Story, etc. Means a lot coming from a professional. #ican2011
Totally!  I didn’t know any better and was watching these shows in 2004 when I was pregnant with DD1.  It made me afraid of the cesarean, but it didn’t do anything to help me (or encourage) me to prevent it.  It was like watching a car wreck in progress, over and over and over again.  Dammit, and then I wrecked my ‘car.’

ShannonMitchell Acnm says they are working on revised vbac statement addressing “immediately available” #birthaction #ican2011
Very good news.  The ACNM needs to step up and not hide behind ‘big brother.’

babydickey Midwives Alliance of North America (MANA) has a c-section rate of 5.03%. YEA! #ICAN2011
I trust this to be true, but it would be so helpful if MANA would release the data.  People want to see it.  I want to see it.  MANA hold plenty of statistics that to my knowledge are not publicly accessible.  It’s a shame.

mollytoba Ida Darreagh of NARM: the safest place for a woman to give birth is where she feels strong, supported and capable. #ICAN2011
Absolutely.  This is why I try to be super careful when talking with mamas who have different ideas about where to birth.  Everyone should feel safe giving birth.  It doesn’t ensure a perfect outcome, but it’s still important to respect one another’s decisions.

DeepSouthDoula Don’t feed the trolls! Seriously not worth it. As @unmarketing says – you are not the jackass whisperer. #ICAN2011 AND seeKJtweet Ok who said Beetlejuice? #ICAN2011
Oh my.  There is a persistent non-practicing OB with too much time on her hands who just hates natural birth advocacy.  She has quite a cult following.  I used to go to her blogs thinking there was something possibly to learn there . . . but it’s just so polemic that I realized I was wasting my time and scaring myself in the process.

RobinPregnancy Every state needs to look at the safe transport bill for home births. #ican2011
And where do I go to find that?  Over to Google.  Searched [“home birth” “safe transport” legislation] which didn’t come up with much.  But I did find that a bill is working its way through the Illinois General Assembly.  Have a look!  I found this as a result of reading this action alert from the Chicago-area homebirth meet-up group.