UCAN Birth Meeting on Wednesday, December 3rd at 7 p.m.

December 1, 2008

We’ll meet from 7 – 9 p.m. We will be discussing options for birth location and care provider (doctors, midwives, etc.). Bring a food item to share. Women who desire to give or receive support and information regarding unmedicated, natural childbirth options are invited to attend UCAN Birth support group meetings. Please make arrangements for older children. Nursing babies are always welcome.

More info is here:

http://www.birthnaturally.org/ucanbirth.htm

Please RSVP through the above link.

Well it’s about time!

October 9, 2008

I know I’ve been away for awhile. I’ve been enjoying my new baby! ๐Ÿ™‚ An article put out by Consumer Reports favors low-tech birth, which I think is fantastic and long overdue. Here it is:

Back to Basics for Safer Childbirth

Be sure to check out their Maternity Care Quiz as well!

She’s here! My fourth home water Hypnobabies birth.

July 18, 2008

Pics and a full story are posted here:

Clara’s Birth

Another great Hypnobabies birth! (video)

April 1, 2008

This is Michael’s home birth with her son, Willem. Notice how she laughs! Warning: There is nudity (which you might expect in a birth video, but I’m just warning you in case you weren’t expecting that).

Update on Midwifery Legislation

March 13, 2008

Utah’s legislative session ended on March 5th at midnight. At a House Health and Human Services Committee meeting I attended the previous week, the seventh substitute version of SB 93 was introduced as a compromise bill between the Licensed Direct-Entry Midwives and the Utah Medical Association. It’s very frustrating that we (birthing women) would have to compromise at all, given that the current law is working and preserves our freedoms. The powerful medical lobby that is the Utah Medical Association forced us to do so.

So, what did we lose?

The two biggest losses are vaginal breech and twins. This would only be an issue if a woman is using a Licensed Direct-Entry Midwife. The bill mandates transfer, with no possibility of signing a waiver, if it’s determined that a woman is carrying a baby in a breech presentation or twins unless birth is “imminent”. In fact, it goes so far as to say that the midwife must terminate care and call 9-1-1, regardless of whether or not a woman wants this to happen. That’s what bothers me the most–women are being treated as if they are too stupid to make their own health care decisions.

Legally, since this bill does not affect unlicensed midwives, a woman could choose to transfer care to an unlicensed home birth midwife rather than a hospital care provider. I’m upset that a woman would be forced to make a choice between two potentially unsatisfactory care providers. I know that I have reasons for choosing a licensed midwife and I would feel very put out if I found myself in a situation where my only options to continue with my preferred option of home birth would be to choose a care provider that I’m not wholly comfortable with or an unassisted birth (no care provider).

Did we gain anything?

The midwives went on the record during the committee meeting to say that they will not bring forth any legislation regarding this issue until 2011, which is when the original midwifery bill was going to come up again in order to review the statistics for Licensed Direct-Entry Midwives.

The Utah Medical Association didn’t explicitly say they would not bring new legislation. They side-stepped the issue, even though a committee member asked twice about it. The Utah Medical Association representative said “It is not our intention” to run another bill, which is a nice political euphemism for “it’s possible that we might”. @@ I don’t think they’d have much political traction if they did try to run another bill next session.

We kept VBACs, with restrictions. VBAC mamas now have to have an ultrasound to determine placental placement. VBAC mamas can only have as many as two previous c-sections if they want to use a licensed midwife. Again, unlicensed midwives are not affected by this bill so they could still take VBAC mamas who have had more than two c-sections, if appropriate in a particular woman’s situation.

There was a bit of a stir over whether or not this bill passed legally. There were discrepancies between the clock the senate was using and the official time. The official time stamp for seventh substitute SB 93 is marked as 14 seconds past midnight, which means it technically is too late and should be dead. It has gone to enrolling (which is where passed bills go), so it looks like the powers that be ruled to let it stand.

Thank you to all of you who worked to preserve birth freedoms in Utah! We’re not done, yet, and will need to participate in the new rules process to let everyone know that we care about retaining our rights to give birth the way we prefer.

Utah Medical Association is trying to eliminate home birth again.

February 8, 2008

The witch hunt continues. Really, this is nothing new, but it is always frustrating. Marsden Wagner, world-renowned perinatologist (ie. “high risk” pregnancy doctor), is a vocal supporter of home birth as a safe option for most women. He’s also well aware of what he calls the global witch hunt against midwives. Obstetricians and other hospital care providers (such as certified nurse-midwives , nurses, and family practice doctors) have long waged a war against out-of-hospital midwives. Their battle cry is “Safety! We must protect women and babies from dangerous, unskilled midwives!” Their motive, however, is actually a combination of money and power. From Marsden Wagner’s “The Global Witch Hunt“:

“The witch-hunt is part of a global struggle for control of maternity systems and there are several key issues, one of which is economic. An obstetrician in private practise in Des Moines, USA, told me that he and the other obstetricians in that city were determined to close down the only alternative birth centre, staffed by midwives, because “it is stealing our patients” (Shortly after this remark, the only doctor in the city willing to back up the alternative birth centre retired and, since no other doctor would provide such support, the centre had to close.)… However, in the face of increasingly limited economic resources, governments and insurance companies are becoming more and more concerned with the waste associated with high-technology, high-intervention obstetrics. It is much more difficult for obstetricians to defend this expensive type of practice when midwives and a few doctors are meanwhile showing that a much less expensive type of maternity care is equally safe. The witch-hunt is an attempt to display lack of safety among the competitors.”

And:

“A second issue is the control of maternity services. Until recently, government regulations in most countries have given medical doctors a monopoly in providing health services.”

You see, if these self-proclaimed logical scientists actually looked at the data on planned, midwife-attended home birth they’d realize that they have absolutely no grounds to charge midwives as being unsafe care providers.

Conclusions Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.”Johnson, K. and Betty0Anne Daviss, “Outcomes of planned home births with certified professional midwives: large prospective study in North America“, British Medical Journal

In his article, “Fish Can’t See Water”, Marsden Wagner says:

“Showing women—half of all people—that they are inferior and inadequate by taking away their power to give birth is a tragedy for all society. On the other hand, respecting the woman as an important and valuable human being and making certain that the womanโ€™s experience while giving birth is fulfilling and empowering is not just a nice extra, it is absolutely essential as it makes the woman strong and therefore makes society strong” (“Fish Can’t See Water“).

So what’s happening in Utah? Well, in 2005 the Utah State Legislature passed the Direct-Entry Midwife Act. This law expressly legalized non-nurse midwifery as a distinct profession with its own unique rules of practice. Prior to the passage of the law, the Utah Medical Association (UMA) formally dropped their opposition after some compromises were made to the bill as did the state’s Certified Nurse-Midwife organization. Utah’s Direct-Entry Midwife law is a wonderful piece of legislation that strikes the delicate balance between Licensure is voluntary. Those midwives who wish to carry certain emergency medications must license in order to do so. As is standard procedure, there was a rules hearing process during which the Licensed Direct-Entry Midwife board defined a Utah LDEM’s scope of practice.

Three direct-entry midwives, one certified nurse-midwife (CNM), one member of the public, one naturopathic doctor, and one obstetrician were appointed to this board. Throughout the rules process there were rules hearings (during which the UMA voiced objections) and there were working meetings (during which public input was considered). The Utah Medical Association (UMA) did not choose to attend any of the work meetings and the obstetrician never came to any of the meetings, either. Now the UMA has brought foth its second legislative attempt to re-write the circumstances under which a direct-entry midwife (licensed or not) can practice. They introduced a bill last year (2007) that did not pass, but was rather sent to an interim committee for further study. The interim committee did not choose to study it because the bill is wholly unnecessary given the excellent outcomes for Licensed Direct-Entry Midwives (2006, 2007).

This year’s version (SB 93) includes a myriad of restrictions that would exclude a woman from the care of a direct-entry midwife. Some of the exclusions are valid (HIV positive women, premature babies, etc.). Most of them, however, are not. In fact, over 90% of the women who currently choose the care of a direct-entry midwife would no longer be able to do so. I personally “risk out” multiple times.

Among this year’s outrageous guidelines that would cause a woman to be labeled too high risk to give birth at home with a midwife are the following:

  • pulmonary disease (asthma is a pulmonary disease), line 117
  • Group B streptococcus colonization or infection disease (this can be treated safely at home), lines 118 and 119
  • hematological disorder (anemia is a hematological disorder–this can be treated), line 121
  • hypertension (but it doesn’t say what constitutes “high” blood pressure), line 122
  • a family history of a serious genetic disorder that may affect the current pregnancy (whether or not it actually does affect the current pregnancy seems to be irrelevant), line 124
  • a history of neonatal infection, line 125 (One of my newborn’s caught Strep A from my husband who had strep throat at the time of her birth. That’s a “neonatal infection” since she got it as a newborn, yet it had nothing whatsoever to do with where, how, or with whom she was born and is very unlikely to repeat with future babies.)
  • a history of cerclage or incompetent cervix (even if the current pregnancy reaches 37 weeks), line 125
  • a history of an infant below 2,500 grams (5 lbs. 8 oz.) or above 4,500 grams (9 lbs. 14 oz.), lines 125-126 (So if a woman had twins who were small, she would be prevented from having home births with any future babies and any woman who birthed a large baby with no trouble would be forced to go to a hospital.)
  • a history a preterm singleton birth of 36 weeks or less (even if the current pregnancy lasts until 37 weeks), line 126
  • a history of a postpartum hemorrhage requiring transfusion (no matter what the circumstances of the hemorrhage were, no matter that it may not be likely to repeat–what if her doctor decided to manually extract her placenta, causing a massive hemorrhage?), lines 126-127
  • a history of three or more consecutive miscarriages (again, whether or not the current pregnancy lasts until 37 weeks), line 127
  • a miscarriage after 14 weeks, line 128 (What if she got in a car accident? What if her current pregnancy goes to term?)
  • a stillborn, line 128 (What if she experienced complications from common medical interventions? What if it was because the baby had a genetic disorder incompatible with life? What if her current pregnancy is unlikely to be threatened by the previous circumstances? What if the woman would still prefer to give birth at home?)
  • a prior myomectomy, hysterotomy, or c-section, line 129 (So no more vaginal births after cesareans (VBACs). They’re nearly impossible to get in hospitals around here. Home birth was really the least restrictive option. For most women, VBAC poses only slightly more risk to the mother and baby than a vaginal birth without a prior c-section. C-sections carry very significant risks and it should be left to the mother to decide which risks she’s most comfortable assuming. It’s important to note that all of the VBACs attended by Utah Licensed Direct-Entry Midwives have had favorable outcomes.)
  • any condition, disease, or illness that would disqualify a certified nurse midwife, licensed under Chapter 44a, Nurse Midwife Practice Act, from delivering a child (amended), lines 132-133 (Certified Nurse Midwives must practice under the supervision of an obstetrician. The OB gives them permission (or not) to attend certain pregnancies and births. I don’t know of any OBs in the state who would give a CNM permission to attend a home birth. If interpreted this way, this clause automatically prevents direct-entry midwives from attending anyone!)

If any woman manages to qualify under the above restrictions, she’d then be subject to further “screening”. Mandatory consultation with a licensed health care provider is required upon:

  • a threatened miscarriage or miscarriage after 14 weeks, line 202 (Some women may be reassured by a doctor consultation, other women, knowing that there is nothing a doctor could do, may prefer to just wait things out. Under this law, a woman would have no choice.)
  • vaginal bleeding after 13 weeks of gestation, line 203 (Again, some women may want a visit, others may not. What’s particularly difficult is the fact that most doctors would be absolutely hostile and rude toward any woman who was or is planning a home birth.)
  • discovery of maternal age as of the estimated day of conception of more than 35 years, lines 205-206 (Good heavens! You’re over age 35? You’re going to kill your baby!)
  • assorted other conditions that still leave a woman no choice in her own health care decisions

Mandatory transfer of patient care before the onset of labor to a physician licensed under Chapter 67, Utah Medical Practice Act, or Chapter 68, Utah Osteopathic Medical Practice Act, is required, upon evidence of:

  • multiple gestations, line 226 (This one really steams me. When you look at home born twins vs. hospital born twins you find a very drastic difference in treatment and outcomes! Home born twins are commonly born at term–many even go a full 40 weeks or longer! Home born twins are generally larger–some are even 8 or 9 lbs. each! Home born twins are born vaginally. Hospital born twins are commonly born prematurely. Sometimes this happens spontaneously, other times mothers are induced or c-sectioned early, often without a clear medical indication. This results in premature babies that could have been born as healthy full-term infants. Hospital born twins are usually much smaller as well, and suffer the complications small and early babies are subject to. Given this information, I would not at all feel comfortable giving birth in a hospital with twins unless they came prematurely on their own.)
  • known or suspected Group B streptococcus colonization or infection, line 227 (Suspected? Suspected?! That’s every single woman on the planet! This line here is another that would eliminate every woman! Also, group B strep during pregnancy and birth can be safely monitored and treated at home.)
  • intrauterine growth restriction, which includes a fundal height that measures more than three centimeters less than the weeks of gestation, lines 228-229 (This restriction does not allow for variations in a mother’s shape or how she carries her babies. I’ve measured more than 3 cm small and gone on to give birth to a baby over 7 lbs. Closer monitoring may be indicated, but mandatory transfer is certainly not!)
  • suspected macrosomia, which includes a fundal height measuring more than three centimeters greater than the weeks of gestation, lines 232-233 (Again, this doesn’t factor in a mother’s shape.)

Mandatory transfer of care during labor and an immediate transfer in the manner specifically set forth in Subsection (4)(a), (b), or (c) is required upon evidence of:

  • a membrane rupture of more than 18 hours, line 239 (There is an increased risk of infection after a woman’s water has broken. However, if precautions are taken to reduce the risk–no vaginal exams, for one–and a woman is monitored to make sure she doesn’t exhibit signs of infection such as a fever, there is no logical reason why to give her a time limit of any sort. If mother and baby are both doing well, there is no reason to intervene. A mandatory transfer would place this mother in a germ-ridden hospital environment where care providers are inclined to perform multiple, infection-introducing vaginal exams and recommend significantly risky induction medications or cesarean surgery. That’s not safer than staying home when there’s no problem.)
  • breech or other inappropriate fetal presence, line 241 (One can only guess at what’s meant by “inappropriate fetal presence”, but vaginal breech when attended by an experienced attendant for a screened population is at least as safe as cesarean birth. A mandatory transfer for a breech baby would mean major abdominal surgery for the mother, whether or not she finds the risks of a c-section preferable to the risks of a vaginal breech birth. Of course, this c-section would then forevermore prevent her from having a home birth with a future baby.)
  • failure to deliver after three hours of pushing, line 246 (Time limits and birth should have nothing to do with each other. Birth takes as long as it takes. This length of pushing is unusual, but if a woman wants to keep going and she and her baby are both fine, then she should keep on pushing!)

And there you have it. I have purposely left out conditions that would appropriately be transfered. The situations I have included are the ones that may indicate closer monitoring but should not automatically risk a woman out of receiving care from a direct-entry midwife.

If you would like to help and you live in Utah, please join the Utah Friends of Midwives yahoo group for information on how you can help. We need hospital birthers, too!

Singing birthing mama who used Hypnobabies

January 16, 2008

She did the Hypnobabies home study course and chose to sing during her birthing waves prior to giving birth to her 10-lb. son at home. Lovely!

Two spots for Jan. 4th Hypnobabies class!

December 28, 2007

This is a 6-week course meeting on Friday nights. Visit my website to find out more details about Hypnobabies childbirth education. To enroll, please contact me. In order to have time to listen to your first CD before the class begins, please contact me as early as possible! ๐Ÿ™‚

All spots are now filled in my January/February class. I do have openings in series starting February and later.

New Hypnobabies Doula Training!

December 21, 2007

I will be holding a training for doulas who would like to know how to help their hypnosis for childbirth students. While the main focus will be on Hypnobabies moms, I also have experience with HypnoBirthing (the Mongan) method and general recommendations for moms using hypnosis of any sort. The training will be held:

Saturday, April 12th, from 9:30 a.m. – 5:00 p.m. in Provo, UT.

More details can be found here.

New Birth Stories Pages and Last Night’s UCAN Birth Meeting.

December 14, 2007

I’ll keep a few inspirational stories collected here on this blog. You can access them by visiting this page (or by using the Pages links to the right).

Last night’s UCAN Birth meeting was well-attended as well as very inspirational and uplifting. One of the women shared her three beautiful unassisted home birth stories. Her faith in birth is incredible. She also brought her mother, who has also had unassisted births after having c-sections with earlier babies. Another woman shared the story of her midwife-attended home birth. Both of the women who shared their personal birth stories talked about joy and laughter as being part of their birth experiences, which is awesome!

We also watched the video of Psalm & Zoya (unassisted home birth of twins). The birthing mother’s calm and confidence is lovely. It was wonderful to witness the birth of twins, born past 40 weeks, with one weighing over 7 lbs. and the second twin weighing over 8! That’s incredibly rare in a culture where twin births are treated as highly complicated and dangerous and few twin pregnancies go to term. While prematurity is a concern with twins, even women who manage to carry their babies into their ninth month are often manipulated by their doctors into inducing or having a c-section as early as 36 weeks. Of the small group of home born twins I’ve learned about, most are average size (7 lbs.+) and are born near their due dates. It is my firm belief that if mother and babies are healthy and well, it’s safest to allow nature to simply take its course.

The overall message of last night’s meeting was: Birth happens. We just need to get out of the way and let it unfold the way it was designed to.