"Pit to Distress"

There's lots of blogging buzz at the moment that "Pit to Distress" - that's PITOCIN, the common drug given to women who get induced or are told by the hospital their labor needs to speed up (Pitocin gets the uterus to contract faster), and the DISTRESS meaning doctors are giving orders for nurses to up the Pitocin on mothers until the mother/baby go into distress and then the mother can be told "We have a problem and we're going to need to do a C-section."

Is this criminal? Well, if it isn't it should be.

Do I wish I had never heard about this? Yes, but unfortunately this is not my first knowledge of "Pit to Distress" orders. When I wrote my play and was doing research 2 Labor and Delivery nurses told me about this practice. Neither would go on the record for me so I decided not to put it in the play.

Did I know it was more common practice than the two hospitals where these nurses worked? No. But you bet I suspected it's more widespread than 2 hospitals. That's why I quickly finished writing my play and tried to do my part to warn women that, I'm sorry, the hospital does not have your best interest at heart. I know people don't want to hear this - especially a pregnant woman - but it's the unfortunate truth. Sure there are better hospitals and some fabulous OBs and midwives. Some women do have wonderful birth experiences in hospitals. But the bottom line in hospitals is money. And c-sections are money and lower the risk of lawsuits. It's that heartless.

I noticed one blogger mentioned that Dr Marsden Wagner told women in his book "Born in the USA" that this term is being used. I've always been shocked that his book got so little press. We all embraced Jennifer Block's book "Pushed" - which is fabulous - but in turn we discarded one of the most right-on people writing about maternity care. Dr Wagner has seen maternity care first hand and is a physician who has not been afraid to blow the whistle. I encourage everyone to embrace his book. It's unfortunately the honest truth. Yes, a cold shower and not the literary prose of Jennifer Block's book, but it's the truth and everyone needs to hear it and rise up, be BOLD and stop these criminal practices in maternity care.

Here are some links of people weighing in on this:

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

http://phdoula.blogspot.com/2009/07/pit-to-distress-around-birth-blogs.html

And a passionate You Tube video by a mom on this:

http://www.youtube.com/watch?v=cRpseY2aiwM

Winners of Birth Video contest!

Birth Matters of Virginia just announced the winners of their childbirth video contest with judges comments. Check them out!


FIRST PRIZE, $1000
Prevent Cesarean Surgery, Ragan Cohen (California):
http://www.youtube.com/watch?v=EZy0JPtubiQ

----“Such great myth-busting and important information for all women, I loved your use of natural scenes. I'd love to see this video getting lots of airplay in the public arena.” –Dr. Sarah Buckley, MD
----“The directness and statistics worked well together…” –Ricki Lake and Abby Epstein
----“Very well done.” “One of my favorites. Talk about evidenced-based care; this really motivates someone to take action.” “This really puts it out there. Cesareans aren’t pretty.” “This was so emotional for me. The film does an excellent job questioning the idea that c-sections are easy, normal, and no big deal.” --from the BMV Judging Panel

SECOND PRIZE, $500
The Nature of Natural Birth, Laura Alvarez (Wisconsin):
http://www.youtube.com/watch?v=OrIPtVEjVnc

----“Very sweet birth video - and of course we love the song and used it in the Business of Being Born!”—Ricki Lake and Abby Epstein
----“Gorgous photos of homebirth, nicely balanced with information. Well done!”—Dr. Sarah Buckley, MD
----“Amazing editing. Very professional. This film isn’t afraid to show birth as it really is.” “Lovely. Powerful. Very sweet.” “I think the whole room was tearing up by the end of this one!” “So sweet and beautifully done.” --from the BMV Judging Panel


HONORABLE MENTION, $100
Misconception, Becky Carey (Virginia):
http://www.youtube.com/watch?v=vxRmVciXy-g

----“Incorporated an excellent variety of people, lovely to have original music and real women's distilled wisdom, Great work!”—Dr. Sarah Buckley, MD
----“Very well done, nice mix between informative and emotional.”—Ricki Lake and Abby Epstein
----“Great editing. Good, casual, conversational tone. Catches a particular angle on the conversation surrounding the normalcy of birth.” “I just loved this one!” --from the BMV Judging Panel

and check out their other finalists at http://birthmattersva.org/videocontest.html

Canada encourages vaginal breech births!

In another shocking move to mothers in America, this month Canada's obstetric community issued a statement that they are going to start encouraging OBs to not automatically deliver breech babies via c-section. Once again, American mothers and others who live in a country where their obstetric association is virtually a trade union for obstetricians are floored by this statement. Over and over again so many mothers have been told it's too risky to do vaginal breech births and therefore these women have been offered no other choice than to have a c-section. But wait, now a large group of OBs is telling us many breech babies can be delivered vaginally?

Yes, it's a jungle out there mothers. But you've got to weed through and find the truth.

Now the only problem with Canada's statement is finding OBs who are qualified to deliver breech babies vaginally. Unfortunately, as a New Yorker piece in 2006 by MD Atul Gawande pointed out so eloquently, the art of obstetrics is being lost because doctors only know how to do c-sections for any slightly abnormal birth presentation. Also, as I had reaffirmed recently when hearing Dr. Abraham Verghese speak, patients are now not people but i-patients, which further removed the personal out of medicine and for childbirth this is especially costly in terms of deliveries that require personal attention.

Hmmm...

Okay, here's the article on Canada: click here

Here are a couple of my favorite quotes from the piece:

The SOGC (Canadian equivalent of ACOG...the American Obstetricians and Gyns) believes that if a woman is well-prepared during pregnancy, she has the innate ability to deliver vaginally.

- YES!

“There's the idea out there in the public sometimes that having a C-section today with modern anesthesia and modern hospitals is as safe as having a normal childbirth, but we don't think so,” said Dr. Lalonde.

- YES!

One more thing I want to point out. While SOGC is issuing statements supporting women to deliver vaginally and questioning c-sections, in American ACOG has recently been pouring money into making sure no woman has access to CPM (certified professional midwifery) care and cannot deliver any place other than a hospital or hospital sanctioned birth center. How can this obstetrical witch hunt against midwifery still be allowed to exist in 2009?

For an antedote to ACOGs position, join the new MAMA campaign and to help make CPMs federally recognized in the United States. http://www.mamacampaign.org/

Reversing the Elective C-section trend in UK

Interesting piece in UK's Guardian newspaper about encouraging OBs to get moms to have VBACs! (vaginal births after cesareans). Wow...after reading this piece it's crystal clear why VBAC is not encouraged in the United States. One word: Money.


'I felt totally out of control'

Many women who have an emergency caesarean are so shocked that they demand an elective section next time. Joanna Moorhead hears how hospitals are trying to reverse this trend


Like most mothers, Anna Sabba hoped for a straightforward delivery when she went into labour with her first child. But 20 hours later, exhausted and with the baby still not born, doctors decided to do an emergency section. Sabba, 32, remembers only the fear: "It was really scary - I was shaking so much. I felt totally out of control, I'd not had any time to mentally prepare myself for this, and suddenly I was about to be cut open."

So when she found herself pregnant again, two years on, she decided to play safe. "I thought I'd ask for an elective section - that way, at least I'd know what to expect," says Sabba, who lives in Manchester. But her consultant in Manchester, Louise Byrd, had other ideas.

This month, several primary care trusts announced that they would be offering cash incentives to hospitals in a bid to reduce the number of surgical deliveries - and the frontline targets are women like Sabba, who have already had one caesarean and opt for another in their next pregnancy.

Central Manchester University Hospitals NHS Foundation Trust has had a policy for some time under which obstetricians are expected to at least question a woman's decision to go for a repeat caesarean if there is no clear medical reason. Reducing the number would, they argue, spare thousands of women from the trauma of a major operation they may not actually need. "Everyone should have a thorough explanation of the pros and cons," says consultant obstetrician Phil Bullen of the Manchester trust.

When labour goes relatively smoothly, there are psychological and emotional advantages to vaginal birth, says Byrd. "A normal delivery can be a wonderful experience, with benefits not only for the woman but for her child," she says. "Women need to be reminded of this. It can seem an 'easy option' to simply agree to elective surgery - but it's vital that we, as medical practitioners, take the opportunity to discuss a woman's choice and see how we might work together to encourage her to aim for a vaginal delivery. Choice is important - but it must be informed."

The problem for doctors is that they may persuade a woman to go for a vaginal delivery, only for the situation to change during labour and for a caesarean section to become inevitable anyway. Rachael Keith, 32, who lives in Cheshire, found herself in precisely this situation when she gave birth five months ago to her second child Dylan. She had had an emergency section with her daughter Matilda two years ago, and wanted to have a planned section second time around, but was talked out of it by her consultant. "I explained I didn't want a second horrific experience - they had to get Matilda out so quickly I had to have a general anaesthetic, which was awful. I thought by planning it I'd be far more in control, and would be able to anticipate what was going to happen, which would make it all a lot easier to handle.

"But the obstetrician seemed to be thinking only about her statistics, and she did everything she could to dissuade me." Keith tried for a vaginal birth but in the event her labour failed to progress, and she ended up with another emergency caesarean.

"I feel my instincts were right: I should have been allowed to elect for a section," says Keith. "I'd be the first to agree that hospitals should be reducing the caesarean rate, but not by railroading women and refusing to hear their point of view."

According to the latest figures, and despite previous attempts to reduce them, caesarean sections are still on the increase - up from 24.3% to 24.6% in 2007-2008. And while emergency sections account for about half of all operations, the other 50% are pre-planned.

For NHS managers, there is clearly a financial incentive to reducing the amount of surgery - caesareans cost on average around £2,700, compared with around £1,400 for a vaginal birth, not to mention the bill for extra days in hospital afterwards. But there is safety as well as cost at stake - giving birth in an industrialised nation like the UK is a very safe process but all the same, giving birth by caesarean is more dangerous than giving birth vaginally. A report in the British Medical Journal said a caesarean raised fourfold the risk of serious complications including haemorrhage, infection and uterine rupture.

Targeting second-time-around mothers in a bid to reduce caesareans has its critics - some argue that health bosses should take a long, hard look at the procedures that lead to the high number of first-time-around emergency sections, since there's a growing body of evidence that suggests many of these could be avoided by better support in labour, and by the sort of one-to-one care that many maternity units struggle to provide.

But things worked out well for Sabba: Connie, now 10 months, was born after a normal labour. "Dr Byrd was great - she didn't just say 'Don't' when I said I wanted a section. She realised that what I needed was confidence, and she helped me gain that confidence. She told me the baby was in a good position, and that there was every chance I could deliver normally this time around. Towards the end of my pregnancy, she saw me every few days. She talked me through all my worries, which helped enormously."

The outcome couldn't have been better, says Sabba. "I've never had a sense of triumph like it. The skin-to-skin contact right after the birth was amazing - completely different from after my caesarean, when the baby was wrapped in a towel and just shown to me. Also, after Connie, the recovery was so much easier which was a real help, since I was looking after a baby and a toddler at the same time.

"Psychologically, I feel Connie's birth has made me stronger. I'm less scared about things."

MAMA campaign launches...and needs you to write Congress

Listen up Americans: healthcare reform is happening and if you want women to have access to all midwives please get involved with the new MAMA Campaign (Midwives and Mothers in Action). Their mission is simple: to make sure CPMs (certified professional midwives) get federal recognition so that women and families will have increased access to quality maternity care in the setting of their choice.

What's needed right now is to FLOOD the US Congress with letters asking for CPMs to be included in the current healthcare reform bills. Below is a recent email from MAMA on how to get involved in their letter writing campaign.

From MAMA...

A. Greetings, mothers, midwives and supporters of maternity care choices!

We need all your energy and enthusiasm for our ambitious policy goals on behalf of pregnant women across the nation and the Certified Professional Midwives who can provide services to them. This is the MOMENT for action!

Just last week, the Midwives and Mothers in Action (MAMA) Campaign organized twenty midwives and consumers to visit their Congress members in Washington DC and tell them about midwifery care. This lobbying push is a vital part of the MAMA Campaign mission to increase all women's access to midwives and to quality, affordable maternity care by achieving federal recognition of Certified Professional Midwives (CPMs).

The MAMA Campaign was established by a coalition of six key national midwifery and consumer organizations.

Our immediate goal is to get an amendment into the health care bills currently moving through Congress to mandate federal Medicaid coverage for CPM services. Health care reform is at a pivotal point and we have an unprecedented opportunity to inform Congressional members about the skilled, high quality maternity care provided by CPMs and the cost savings CPMs can achieve. Congressional members are particularly interested in what their constituents are thinking.

So now we need your help …
• Please join the effort to send an outpouring of personal letters to U.S. Senators and Representatives to their local district offices this week. We've learned this is the best way to get their attention on fast-moving urgent policy issues.

• Please read further to see a sample letter you can use, and tips for writing. Your role in the MAMA Campaign is so important. Now is your chance to stand up and be counted!

Thank you for your support!


B. Writing Your Congress Members – Suggestions & Instructions

THANK YOU! Contacting your U.S. Senators and Representatives is important! Please mail your letters to their local district offices.
You'll find a sample letter below these instructions; use or adapt this language for your own personalized letter to your members of Congress. If you have any questions or need assistance please contact Evelyn deFrees, Campaign Manager (info@mamacampaign.org).

Eight points to remember when writing your own letter:

1. Ask: Please be sure to include the specific "ask," underlined in the first and final paragraphs of the sample letter (the "ask" is what you want your Senator or Representative to do).

2. Information: The second paragraph is an important part of the message. Feel free to use other words in paragraphs 3 and 4 to explain why Certified Professional Midwives should be added as Medicaid providers. See handout "Midwives and Mothers in Action: Improve Maternity Care Quality by Expanding Patient Choice"

3. Your story: A sentence or two about your "story" personalizes the letter; describe a birth or birth provider experience you or a family member or friend has had, or why you are passionate about this issue.

4. NOTE: Please ALWAYS write out "Certified Professional Midwife"; do NOT use "CPM" by itself (which is frequently misinterpreted with the more familiar "CNM").

5. CPM Facts: If you want to write about the CPM credential and/or education, please use the CPM FAQ sheet – please stick to that exact language, which has been carefully developed for this purpose.

6. Format: Neat, hand-written letters are the most effective – it shows that someone cared enough about the issue to take their time to personally sit down and write to their congress member. Typed, printed and signed letters are next best. Make sure your name and address with zipcode are on your letters as well as the envelope.

7. District Offices: Please send letters to your U.S. Senator and/or Representative's local district/state office (mail to their Washington office would take several weeks to get to them). For addresses: Visit www.house.gov and www.senate.gov ; once on these homepages, click on the search tool in the upper corners of the pages to find your own U.S. Senator or Representatives, and their websites and addresses for district offices.

8. Tell us you've taken action: Please send us a copy of your letter so we can track what policy-makers are hearing from constituents like you about the urgent need for federal recognition of Certified Professional Midwives. Please send a copy to info@mamacampaign.org or to MAMA Campaign c/o NACPM, 243 Banning Road, Putney VT 05346

C. SAMPLE LETTER for CONGRESS MEMBERS

[Date]
The Honorable [Full Name]
[Street Address]
[City], [State] [Zip]


Dear [Senator/Representative Last Name]:

Congress is now debating comprehensive health reform legislation. I urge you to ensure that the maternity care needs of millions of women and their families are addressed by your support for adding Certified Professional Midwives (CPMs)--who are licensed by their states--to the list of Medicaid-eligible providers recognized at the federal level. Health care reform must address the problems and high costs of maternity care in the U.S and ensure safe, qualified maternity care providers for all pregnant women.

Safe high-quality care: Today in many states across the country women seek safe, high-quality, health-promoting maternity care provided by Certified Professional Midwives who provide excellent childbirth outcomes with a fraction of the medical interventions (including cesarean section). I received my prenatal care and delivered my baby with the assistance of a Certified Professional Midwife and believe all women in our state and country should have this safe, cost-effective choice regardless of their income level.

Cost Effective: Pregnant women on Medicaid deserve access to the full range of maternity care providers including Certified Professional Midwives. The choice of Certified Professional Midwives is often restricted to those with private insurance coverage or the capacity to pay out-of-pocket. Adding Certified Professional Midwives to the Medicaid list would start reducing health care costs immediately.

Choice at lower cost: Childbirth is the number one reason for hospitalization in the US, accounting for $86 billion in annual expenditures in 2006. Much of that spending is driven by costly, overused and unnecessary interventions. Certified Professional Midwives can help Congress deliver on the basic goals of health care reform: preserving a patient's choice of health care provider while simultaneously improving quality and outcomes, at lower cost. Expanding Medicaid coverage to include services provided by Certified Professional Midwives is the equitable thing to do. The tremendous cost and quality advantages make it sound public policy.

Please support this important change to the law governing Medicaid so that Certified Professional Midwives who are licensed by their states are added to the list of Medicaid-eligible providers recognized at the federal level. Thank you for your time.


Sincerely,

[Your name]
[Address]
[Phone number]


Please visit the Midwives and Mothers in Action Campaign at www.mamacampaign.org

Giving "Birth" in Little Rock - article

I thought this was a nice piece about the play and BOLD movement written after the Little Rock, Arkansas performances in May. (just wish she didn't call the play, "Birth: The Play" - that's not the name of the play!!!).

http://www.communityarts.net/readingroom/archivefiles/2009/06/giving_birth_in.php

Amazing BOLD happenings today!

I love this movement - truly international! Today I'm sending lots of BOLD wishes to BOLD Paris and BOLD Gainesville. BOLD Paris will be taking 80 audience members down the Seine in Paris performing the play (hey, maybe Michelle will be there??!!)...and BOLD Gainesville is performing in a 400+ theater to medical students and professionals at a large teaching hospital in Gainesville. You go BOLD Warriors!

(By the way, saw this piece "Flordia ranks second in the nation for c-sections" today. Yes, that's why we need to be BOLD!!!!!)

My Son's Birth Story - 10 years later

My oldest son turned 10 this past weekend. I can't believe I gave birth one decade ago! I thought this was a wonderful moment to share with you his birth story. I'm so used to listening to other people's birth stories and rarely seem to share mine. So let me tell you about Jacob's birth - 10 years ago. The day I became a mother.

Jacob's Birth Story

“Tim…I’m wet,” I said as I sat up in bed at one in the morning on June 6, 1999...about an hour after we went to bed.

“What?” he said sleepily.

“ I think my water broke.”

We spent about ten minutes discussing if my water broke, looking at a few pregnancy books for reference and then I got up to go to the bathroom and about two gallons of water started gushing out of my vagina. Yep, my water definitely broke. Tim called the midwives as I walked to the toilet in case there was more coming.

“Is there any discharge?” Mary, who had just returned from a twelve-hour birth, asked.

“Yes,” I said. “Just a little and it’s brown.”

“Okay, no problem,” she said. “Do you think you need us?”

Sitting on the toilet I thought: don’t be a wimp, Karen. You know you’re not going to have this baby in a hour. Let the midwives sleep. But then I flashed to the Japanese women in our childbirth class who two weeks earlier didn’t ask the midwives to come right away and ended up having the baby in her shower delivered by her West African husband.

“We can be there just sleeping on your couch if you feel better having us close,” Mary said, her words unlocking what I wanted to say.

“Yes, I want you to come.”

By four in the morning Mary and Ida showed up, told us to get some sleep, and then they we all fell asleep, Mary and Ida on our living room couches. I must say I was a little disappointed. I had hoped when they arrived that they’d check my dilation giving me an indication of where I was in labor. I wasn’t having any contractions, but still I thought I must be dilating.

“We don’t want to check a woman much when her water has broke because it could invite infection,” Ida said in such a sweet voice I that I tried not to show my disappointment.

By ten in the morning I began to get a tightening sensation in my body that felt like a contraction and they came every five minutes, which Mary said was encouraging. Tim had made a loaf of bread and Mary, Ida and now Stacey and their apprentice Jennifer joined us on our outside deck eating hot buttered bread, the temperature outside already a balmy eighty-five degrees.

“I wonder when it will be clear I’m progressing,” I said to them all.

“Oh, you’ll know!” Mary shouted. “You won’t be here talking eating bread with us – that’s for sure!”

We all laughed.

“Relax, Karen,” Mary said. “Your body knows how to birth this baby. Your job is to allow it to do what it's meant to do.”

As the hours progressed so did my labor, the contractions now four minutes apart and much longer in length. Except for Tim – who has such great feminine energy it didn’t matter that he was present – I felt like my house had become a women-only club where I was the honored guest. Anything I wanted I could have – a cup of tea, a back rub, laughter. The midwives were there to fan my flames, help me on my path, and feed me grapes if I desired. The feminine juice in my house was cooking, so much so I wanted to bottle the vibe for all my girlfriends.

By noon Mary was right - the contractions got worse and I stopped talking. I threw up the banana I ate and began slowly walking in circles around our living room with Tim and our black Labrador, Kali chanting “I feel great!” which definitely wasn’t how I felt but I thought it was better than shouting, “This sucks!” which was also right up there in my mind. Every time I’d have a contraction I’d stop walking, burp, lean against Tim feeling like a piece of concrete was trying to make its way out of my body, and shout, “I feel great!” as the contraction beat into me. After the minute-long pounding ended I’d continue walking and shouting, “I feel great!” with varying degrees of humor, sarcasm and feminist determination.

Thirty minutes later I asked Ida to check my dilation. Laying on my bed I prayed I was ten centimeters and ready to push. I’d even take eight.

“You’re a really solid four centimeters,” Ida said with a smile.

Four? Now I knew why, besides the infection issue, she hadn’t checked me before. There’s nothing worse than to feel like a piece of concrete is banging around in your belly and be told it may be in there for a lot longer.

“Why don’t you get into the pool,” Jennifer suggested.

“Yes!” I replied. I had completely forgot about the Toys R Us twenty dollar pool we purchased for just this moment.

Getting into a pool of water when you’re one hundred and eighty pounds isn’t easy I found out, but with the help of Mary, Ida, Stacey and Jennifer I entered the water, and exhaled. A monster size contraction immediately hit.

“Holy shit!” I screamed. “That hurt like hell!”

“Excellent!” Ida said like a cheerleading coach. “That’s exactly how it’s suppose to feel!”

That’s exactly the way it’s supposed to feel? I’m in pain and that okay? I moved around in the water trying to get comfortable, but mostly during that first contraction I squeezed Tim’s hand so tightly he asked me to let go which was the best thing that could have happened. In the warm water, floating on my own, nobody touching me, I felt like I was back on the mountain in Tannersville where I spent a year in my 20s by myself writing, snow coming down, losing control…and it was okay. With each contraction after that Jennifer prompted me to chant, “Open…” and while my renditions of “Open” vacillated from a slow and even pitched “Oooopen” to a choppier, panicky “Open! Open! Open!” fifteen minutes later my body was leading the dance, my mind surrendering to the real boss.

“I want to push!” I scream.

Mary and Ida looked at each other and decided to wait a few more contractions to check me, but with the next contraction I screamed again, “I need to push!” so they checked me.

“You’re about eight and a half centimeter!” Ida says.

“If you want to give birth in the pool we’re going to have to put some cooler water in it,” Mary says looking over at Tim, who engineered the system to get water to our pool.

“No! I don’t want cold water!” I shouted.

“Then before your next contraction you’re going have to get out of the pool!” Mary forcefully said.

If I thought lowering my one hundred and eighty pound body into the water was tough, getting up – and quickly – felt like an Olympic event.

“One, two, three!” they all shouted Tim holding one hand, Mary the other, everyone else pushing on my butt. A few seconds later I was out of the water – and freezing. With my shower just a few feet from the pool I begged to go into it for warmth.

“That’ll work for a few contractions, Karen,” Mary said looking at the tiny shower. “But when that baby’s comin’ you’re gonna have to give us more space than that to catch it!”

“Okay!” I said.

Two contractions later- around one-thirty in the afternoon - they lead me out of the shower, found I was ten centimeters dilated and asked me where I wanted to push.

“In my bedroom!” I told them.

I was convinced at this point the baby would be out in twenty minutes. I had been doing creative visualization exercises imagining the baby slipping out of me which I thought would translate into a short pushing stage.

By three-fifteen, nearly two hours later, I felt like a mental patient on a level three psych ward. I had tried pushing on all fours, leaning against the bed, laying on my back in bed feet down, laying on my back in bed feet up and none of it was moving that baby down and out. I finally got on a bar that helps you squat, Tim sitting on a birthing ball behind me, and that felt right but still when I’d get a contraction to push the baby wasn’t moving.

“Push down into your perineum,” Ida said, squatted in front of me.

This made no sense to me. I thought I was pushing down there. Feeling desperate I asked Ida to do a really icky thing.

“Can you put your finger inside me so I know where to push?”

Ida gently pressed her finger inside my perineum. Bingo - a target.

“I can do it!” I shouted.

“You can do it!” Everyone in the room shouted back.

“I can do it!’ I grunted louder.

“You can do it!”they cheered.

“I CAN DO IT!”

This championship fight-like atmosphere went on for ten more minutes with me shouting, “I can do it!” and everyone agreeing with me. Not bad…five people in my house with total reverence, respect and love for the sacred feminine act I was about to do. While I was chanting I began to imagine all my female ancestors who had given birth before me surrounding me, cheering me on. That’s when I knew I had it in me to push that baby out, that the gateway to life was about to open. After two more “I can do it!” chants I felt the baby’s head move through my perineum, and with it a sensation that felt like someone had lit a match on my vagina.

“Aaaaaaah! It burns! It burns!” I shouted.

“Yes! Great!” Ida shouted back.

“Ooooouuuuu!” I barked again and again and again until Jacob flew out of me into Ida’s hands.

I was so blissed out on endorphins – a natural pain reducing hormone that gets released when you’re pushing – that if I knew they sold it at a drug store I’d have bought a standing order every year as holiday presents. My body knew it had achieve something great. I laughed, I danced, I cheered. It was my moment of magic.

“You looked like you were having fun at the end Karen!” Mary laughed.

“I was,” I said.

BOLD Paris...cruising down the Seine!

BOLD Paris just sent me this lovely photo of their performance last month. And this month they'll be doing a performance cruising down the Seine and interviewing audience members after the show on the barge.

They're also performing at a women's festival in Normandy in September!

Check out their website here. (even if you don't read French, it's worth a look!)

Nearly Bleeding to Death from a C-Section

Oh my, this is a brave blog post by a male nurse in Chicago:

http://mannursediaries.blogspot.com/2009/05/nearly-bleeding-to-death-from-cesarean.html

Using Solar Power to Improve Maternity Care

The maternity care situation for mothers in developing countries has so many needs it's hard to know where to begin. Well, one obstetrician knew where to start: getting light to maternity care facilities using solar power. The Organization is called WE CARE Solar (Women's Emergency Communication and Reliable Electricity).

I just love hearing about creative ways to help mothers and babies! You've got to watch their video about it!

http://gallery.me.com/adinfinitumtv#100294/We%20Care%20Solar%20Promo2%20480x360&bgcolor=black

(click on "We Care Solar" then click on their movie)

Action Alert on healthcare reform: Let's set a record!

Below is The Big Push for Midwives' appeal to send the Obama administration your ideas for health reform. It's simple - I just did it - and you can too! It must be done this week so don't delay!

Let's set a record! NEW action alert!

As many of you may know, the White House issued a call this week asking citizens from across the country to send emails about what they would like to see in health care reform. Not long afterwards, the server accepting the emails crashed.

Why? Because it got flooded with emails about the President’s birth certificate!

Now the press is reporting about it, just as they did when grassroots organizers for the legalization of marijuana set the record for the most number of emails sent during the transition—a mere 6000. We can top that!

It turns out there is another, lesser-known online form for submitting comments about health care reform. Let’s use it!

If we top 6000 emails—and I know we can—we will set a new record and get the White House’s attention on how strong support for out-of-hospital maternity care and Certified Professional Midwives is.

So please go to the following link and fill out the form with a short, simple message about why you want all women, including those on Medicaid, to have access to out-of-hospital maternity care and Certified Professional Midwives who are specially trained to provide it.

http://www.healthreform.gov/communityreports/comments.html

Pick one or two points to include in your own words: And always use the title, Certified Professional Midwives, spelled out.

* Certified Professional Midwives are specially trained as experts in out-of-hospital maternity care and deliver babies in private homes and in freestanding birth centers.



* Research consistently shows that low-risk women planning to deliver their babies at home under the care of Certified Professional Midwives experience outcomes equal to low-risk women who deliver in the hospital, but with far fewer costly and preventable interventions, including a five-fold decrease in cesarean section.

* Babies delivered under the care of Certified Professional Midwives have significantly reduced rates of prematurity and low-birth weight, two of the leading contributing factors to racial and ethnic disparities in birth outcomes and to the costs associated with long-term care.

* David Anderson, Professor of Economics at Center College with a specialization in the costs of out-of-hospital maternity care, calculates that increasing use of Certified Professional Midwives and of out-of-hospital maternity care by less than 10% would result in savings of $9.1 billion annually, while actually improving outcomes.

* The state of Washington reports a savings of $3.1 million dollars over a period of two years to the state Medicaid system when women experiencing healthy, low-risk pregnancies give birth with licensed midwives instead of in the hospital.

* The recent Milbank Report conservatively estimates savings of $2.5 billion dollars a year if the cesarean surgery rate is brought down to 15% in the U.S.

* Certified Professional Midwives are the only providers specially trained in out-of-hospital birth in the event that hospitals become unsafe for healthy pregnant women during a disaster.


Thank you to everyone who is reaching out—it only takes a few minutes but it is so very helpful. We are making amazing progress in DC and now is not the time to let up! So please forward this to family and friends who can help,
and thank you for doing your part to get Certified Professional Midwives and out-of-hospital maternity care included in health care reform.

ATTENTION MIDWIVES! Yes, we are shouting at you! Please send this action alert with a personal appeal to your networks of clients—it only takes a few minutes, and people are especially motivated to act when they get a personal request from their midwife.

STATE GROUPS! Please be sure to post this alert to your state lists!

Katherine Prown, PhD | Campaign Manager |
http://www.facebook.com/l/;TheBigPushForMidwives.org |
http://www.facebook.com/l/;414.550.8025 | JOIN US on Facebook! | SIGN UP
for PushAlerts

BOLD Bermuda!

BOLD Bermuda had 2 performances this past weekend that I heard went really well. "Birth celebrity" Barbara Harper performed in them too!

She sent me the photos above.

Despite Promise, Better Maternal Care Is Unrealized

Great piece in Women's E-news. Just read this short excerpt:

"The Women Deliver Initiative, which works to promote action on maternal and newborn health, estimates that 1 in 8 women die in childbirth in Afghanistan.

In the United States it's 1 in 4,800; in Sweden it's 1 in 20,000."

Can the US really still call itself a Superpower?!! This is shameful in a wealthy country.

Click here to read the entire piece.

New DVD: How the Media Influences Birth Choices

Finally, Vicki Elson's DVD is out on how the media influences our beliefs when it comes to childbirth. I can't wait to see it!

Click here to view a clip.

One-Act version of the play now available!

In April a One-Act version of my play premiered at the Arkansas Literary Festival to rave audience reviews. Now the One-Act is available to perform!

My vision in writing a One Act version of "Birth" was to make the play more accessible to people who know little about childbirth like students or the average consumers/pregnant couples. The One-Act gives people a taste of what childbirth is like today for low risk mothers. It's approximately 50 minutes. This allows for a lengthy and engaged discussion afterwards!

If you are interested in performing the play you can do it as part of BOLD or license the play directly from me. Email me for details at: Karen@boldaction.org.

I've already received BOLD requests to possibly perform the One Act as a student social justice project at a University in Canada...and to mothers at Babies R Us stores in Houston.

I just love the BOLD spirit!

(photo: BOLD London, Ontario, Canada, 2008)

My interview with KUAR in Little Rock

Here's an interview I did with Ann Nicolson, the host of KUAR's Arts Scene:

http://stream.publicbroadcasting.net/production/mp3/kuar/local-kuar-838354.mp3

Congratulations to BOLD Organizer Michal Klau-Stevens!

Check out this wonderful piece of BOLD Organizer Michal Klau-Steven's birth advocacy work in Connecticut! Michal produced BOLD performances from 2006-2008 (and who knows, maybe 2009?!).

http://www.jewishledger.com/articles/2009/05/07/news/on_the_cover/news02.prt

BOLD Gainesville rocks the high schoolers!

I'm rarely speechless, but I was after reading this feedback from BOLD Gainesville's recent performance of the play in front of over a hundred high school students and BOLD Red Tent with teenage girls and mothers.

BOLD Gainesville's organizer, Heddy Vernon shares:

BOLD Gainesville had an amazing experience bringing the message of BOLD and the stories of BIRTH to a local high school on Monday, May 18th. Loften High School is home to the ACCEPT program which focuses on pregnant teens and teen mothers, supporting them as they continue their education. Loften is the only high school in the area with an on-campus daycare for use by the students. The daycare is provided free of charge and cares for the children from the beginning to the end of a full school day. Loften is proud to have a very high breastfeeding rate and girls are called out of class to nurse their babies.

Girls from PACE were also invited to the performance. PACE is a community-based, gender-responsive prevention, diversion and early intervention program serving girls, ages 12-17. It is nationally recognized for helping girls find success in school, with their families and in their communities by integrating education, counseling, training and advocacy.

We had approximately 130 Loften students and 20 girls from PACE in our audience. The program ran in the morning for about an hour and a half. The audience laughed, shouted back at the treatment of some of the characters, and chanted MY BODY ROCKS throughout the play. They were engaged and moved. We were all moved too by the reactions of the audience. The air truly felt electric in that room.

After the performance, we had a local pediatrician and two childbirth professionals for our talkback panel. Students wrote down questions on index cards that ranged from 'What do they cut during an episiotomy?' to 'Can you really give birth in water?'. At one point someone said the way for a man's body to rock is to be supportive of his partner in birth and parenting and a number of young men in the audience stood up and applauded.

We held a private red tent for the girls from the ACCEPT and PACE programs. Lunch was provided and they were given the space to process and share their feelings on the play and their own birth experiences. It was a special bonding experience for both the girls and the cast. We were able to share our birth stories too and support one another with our experiences and thoughts. It was an energizing (and exhausting) day that reinforced in all of us the reason why we are part of this movement. It was powerful and beautiful!

And finally, some feedback from Liz Purdue, Director of ACCEPT:

"WOW!!!! What an incredible experience! My students are still talking about it! Thanks so much to you, the other cast members and the Red Tent coordinators for an outstanding event. I had so many positive comments from the ACCEPT girls, especially. They were touched that you made them feel so special."


For more info on BOLD Gainesville check them out here.

Purple pushing: reconsider!

Boy was I happy to read this:

Reconsideration of 'purple pushing' urged

Lisa Miller, the midwife they quote, is a labor and delivery nurse, turned midwife, and is also a lawyer. Wow! What a winning combination for these times!

BOLD Winnipeg, Paris, and Little Rock

In addition to BOLD Gainesville's performance for high schoolers (which I heard went REALLY well!) lots of BOLDness has been happening this month:

Winnipeg! (pictured above) Packed 160 people into their performance and had a dynamic talkback building communication between an OB and Birth Center.

Paris! Rocked a full house this month and plans to "rent a little theater on a barge, floating on the river La Seine that go through Paris" in June. Oooo la, la!

And tonight is my "hometown" Little Rock's first of two performances. Click here to check out the PSA they're running in Little Rock to promote the performances.

I'm so proud of all these BOLD women! Wish I could make it to all of the performances!

Home Birth Story - in pictures

I had to share this!

click here to read this hysterical comic about a woman's homebirth.

BOLD Gainesville: performance for high schoolers

In honor of BOLD Gainesville's (Florida) performance this week at a local high school in Gainesville, I'm wearing my BOLD Gainesville t-shirt today!

BOLD Gainesville are presenting the play to a program called ACCEPT where they take in pregnant teens and have onsite daycare and pull the girls out of class to nurse. They have pre-natel and parenting classes at the school. After the play and talkback they are catering a lunch for the girls who are in the ACCEPT program and having a more intimate BOLD Red Tent.

Rock on, BOLD Gainesville!

Sudan: Maternity Care Needs Our Attention too!

Yes, all women need our attention when it comes to maternity care. Not just American mothers.

Here's an interesting piece from Suden on biking for safer childbirth:

http://www.irinnews.org/Report.aspx?ReportId=83727

Childbirth Connection: How Maternity Care Can Be Overhauled

Love this!


May 18, 2009

Maternity Care, A Major Segment of Health Industry, Must Be Overhauled
For Health Care Reform to Succeed, Says Childbirth Connection

New York NY – As competing interests work out the particulars of health care reform, a leading national advocate for families and the women who give birth to over 4.3 million babies each year reminds the nation that rapid gains in the quality, value and cost of maternity care are achievable.

“It’s crystal clear: Let’s start providing maternity care that is proven to be the best,” said Maureen Corry, Executive Director of Childbirth Connection, a not-for-profit advocating evidence-based maternity care (www.childbirthconnection.org). “Then, women and babies will get higher quality care with better results, and the savings from following best practices can be put toward providing health care to all."

Maternity care is a major segment of health care:
-- 85% of women give birth. Childbirth is the number one reason for being hospitalized: 23% of those discharged from the hospital are childbearing women or newborns.
- Maternal and newborn charges are the runaway leader in hospital charges: $86 billion in 2006, $39 billion of which was shouldered by Medicaid. Childbirth accounts for six of the fifteen most common hospital procedures. Cesarean section is the most common operating room procedure.
-- The cost of childbirth is borne by employers and private insurers who pay for 49% of all births, and taxpayers and Medicaid programs who pay for 43% of births.

Costly childbirth procedures that entail risk are overused and wasteful, while proven ones that are generally safer and cheaper are underutilized:
-- Per capita health expenditures in the U.S. far exceed those of all other nations, but our performance lags distantly behind other developed nations on quality indicators including low birthweight, c-section and maternal death rates.
-- While the vast majority of childbearing women and their babies are healthy and at low risk, the current style of maternity care is procedure-intensive, costly and entails unnecessary risk. For example, induction and routine repeat c-section often contribute to preterm birth and expose women and babies to harm while offering little or no benefit. These and other common interventions: are associated with risk of harm to woman and baby; are experienced by a large and growing number of childbearing women; and result in wasted health care spending.
-- While the economic stimulus bill has over a billion dollars slated for research on the comparative effectiveness of different medical treatments, a wealth of systematic reviews (well over 2,000 summarizing high quality research evidence on specific maternity care topics) is already available to guide maternity care practice. But this valuable knowledge is grossly underutilized in the U.S.
-- A recent Milbank Memorial Fund report, Evidence-Based Maternity Care: What It Is and What It Can Achieve, shows that much of the care women receive is not consistent with the best evidence. It also outlines practices that have better results and are less technology- and procedure-intensive (e.g., continuous human support during labor). A Los Angeles Times op-ed (12-24-08) about this report concludes: "The Obama administration could save the country billions by overhauling the American way of birth."

“Consumers, legislators and health care stakeholders agree that access needs to be broadened, quality and value improved, and costs reduced. All of these goals are achievable for maternity care today by simply putting into practice what we already know,” said Corry.

What women want is often not what they get:
A national Harris Interactive survey of over 1,500 mothers shows that: About half of those with a previous c-section were interested in the option of vaginal birth after cesarean (VBAC), but 57% were denied this option due to caregiver or hospital unwillingness; 17% who were induced say they felt pressured to do so by their caregiver, as did 25% of women who had cesareans; and, 73% of women had an episiotomy (a cut, rarely needed, to enlarge the opening of the vagina) reported that they had no choice in the matter.

“It’s time to replace provider and institutional centered care with patient-centered, evidence-based care that meets the individual needs, values, and preferences of women, babies and families. Better informed, shared decision making between patients and providers is essential to quality improvement,” said Corry.

Childbirth Connection’s 8 Steps to Reform Maternity Care:
-- Ensure access to quality, affordable health care to all women. Stop insurers from excluding pregnancy as a pre-existing condition and using past birth experiences (e.g., c-section) to justify ineligibility or higher charges.
-- Use maternity care practices proven to be best for women and babies.
-- Move to a primary maternity care model by, for example, employing more midwives and family physicians and expanding access to freestanding birth centers. Most childbearing women and babies are healthy and at low risk. Primary maternity care supports innate capacities for birthing, breastfeeding and attachment, avoids overuse, and gives priority to prevention and wellness.
-- Measure and publicly report the performance of maternity care providers and facilities, and use results to improve care.
-- Reform payment policy to stop rewarding procedure-heavy maternity care that is unnecessary for most women and babies, through such mechanisms as bundled risk-adjusted payment for an entire episode of pregnancy.
-- Medicaid, who pays for more than 43% of U.S. births, should initiate demonstration projects to test key strategies for maternity care quality improvement.
-- Engage and educate consumers to help them make informed maternity care decisions including use of decision-aids based on comparative effectiveness research.
-- Improve maternity health professions education and maternity care guidelines to enhance primary maternity care skills and knowledge to support innate capacities of mothers and newborns.

About Childbirth Connection
Founded in 1918, Childbirth Connection is a not-for-profit organization working to improve the quality of maternity care through research, education, advocacy and policy. As a voice for the needs and interests of over 4.3 million women who give birth annually, Childbirth Connection uses best research evidence and the results of its periodic national Listening to Mothers surveys to inform policy, practice, education and research.

# # #

LA Times article on Health Reform: Now what?

Kudos to The LA Times for pointing out in a piece last Sunday (Childbirth: Can the U.S. Improve?)what every birth activist and pregnant mother who felt she had a raw deal by the medical community knows: childbirth has got to change.

Please, mothers, if you're not going to listen to me or to your local birth activist then listen to Dr. Elliot Main, chief of obstetrics for Sutter Health, a Northern California hospital chain who was quoted in the WSJ piece saying:

"Cesarean birth ends up being a profit center in hospitals, so there's not a lot of incentive to reduce them."

Let me repeat that:

"Cesarean birth ends up being a profit center in hospitals, so there's not a lot of incentive to reduce them."

Yes, women, your bodies are not being respected and it's time to rise up and say something about it!

When is the US government going to finally address this billion dollar industry that abuses women's bodies? Just look at the economics: an incredible amount of money would be saved if low risk women were attended to by midwives. Why is the US so behind on this? Yep, you guessed it. Because money can be made off of women's pregnant bodies.

Please, everyone, wake up! Be BOLD! Get involved with healthcare reform. Obama is saying it's a priority, everyone's talking about it. Now they need to show women the money. Not the money that's being wasted on healthcare, the money that needs to be invested in saving women from abusive human rights violations all in the name of the almighty dollar.

Okay, done.

Visit:

1. The Big Push for Midwives click here
2. Childbirth Connections Millbank Report referred to in the WSJ piece.

Big Push for Midwives on Capitol Hill

Wow, I'm super excited that the Big Push for Midwives is having a briefing for congress on how out-of-hospital maternity care reduces costs and improves outcomes. It's all happening this week on Thursday May 21. (I sure wish I wasn't dropping my kids off at school when it was happening...I'd love to be there!)

Right now you can: contact your congress member and tell them to be there! Click here for info on how to do it.

PushMedia Alert From The Big Push for Midwives Campaign
CONTACT: Steff Hedenkamp, (816) 506-4630, Steff@TheBigPushForMidwives.org
FOR IMMEDIATE RELEASE: Monday, May 18, 2009


Congress Invited to Attend Issue Briefing on Maternity Care and the Role of Out-of-Hospital Birth in Reducing Costs, Improving Outcomes

Expert Panel to Address the Need to Include Services of Certified Professional Midwives in Health Care Reform

WHAT:
Members of Congress have been invited to learn more about how increasing access to out-of-hospital maternity care provided by Certified Professional Midwives (CPMs) plays a critical role in lowering costs and improving outcomes as we reform our health care system.

WHY:
The current unsustainable model of U.S. maternity care delivers inferior results at premium costs. High rates of cesarean surgery are driving up costs without improving birth outcomes. Escalating rates of preterm and low birth weight deliveries are fueling high rates of infant mortality, and racial and ethnic disparities in birth outcomes, as well as increasing the long-term costs associated with maternity care.

WHO:
Kenneth C. Johnson, PhD, Senior Epidemiologist/ Research Scientist, Evidence and Risk Assessment Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ontario, Canada

David A. Anderson, PhD, Paul G. Blazer Professor of Economics, Dept. of Economics, Centre College, Danville, KY

Betty-Anne Daviss, M.A., R.M., Research Midwife and Adjunct Professor, Pauline Jewett School of Women’s Studies, Carleton University Ottawa, Ontario, Canada

Eileen Nehme, MPH, Mother of two girls born out-of-hospital: six-year-old Iris and three-year-old Nora, Austin, TX

The Big Push for Midwives Campaign supports grassroots activists across the country as they build winning, state-level advocacy campaigns towards successful regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia, and Puerto Rico, as well as educates national policymakers about the reduced costs and improved outcomes associated with out-of-hospital maternity care.

WHERE:
Sewall-Belmont House, 144 Constitution Avenue, NE, Washington, D.C.

WHEN:
Between 8 and 9 a.m. on Thursday, May 21. Coffee and refreshments will be served.

#####

The Birth Survey - reviews are out!

The Birth Survey Now Offers Access to Reviews of Local Maternity Care Providers and Facilities!

Click here to read reviews in your area.

Sign a petition to support all midwives

With the legislative season coming in the United States defining who should be recognized as a midwife is also heating up. Have a read and please sign the petition to support all midwives as care providers. Women need a range of birth options and midwives!

Dear Friends-

A recently revised Position Statement from the American College of Nurse
Midwives (ACNM) seeks to limit recognition of midwifery providers to those who
have received their training through government accredited programs. The North
American Registry of Midwives (NARM) oversees the credentialing of midwives who
have received their training through time honored and evidenced based systems
that emphasize clinical competency over all other criteria (Certified
Professional Midwives-CPMs).

NARM has posted an online petition in an effort to organize our voices and
convince the ACNM to reconsider its position on apprentice trained midwives.
This letter seeks to unite US Midwifery under the common goal of providing women
with access to the provider and setting of their choice for birth.

There are many great opportunities mounting to move midwifery forward on both
the state and national level. We must stand together as a community of midwives
if we are going to have a real voice for change in maternity care. Whether you
are a CPM, CNM, a midwifery consumer, advocate, or none of the above, please go
to :
http://www.thepetitionsite.com/1/support-evidenced-based-midwifery-education to
read more details about this issue and sign the petition to make your voice
heard.

Respectfully,

The NARM Board of Directors

Superpower BS

I just read on the Momsrising website that:

The U.S is one of only 4 countries that doesn't offer paid leave to new mothers -- the others are Papua New Guinea, Swaziland, and Lesotho.

Oh my, I knew things were bad but this is pathetic. Shameful, really. And the stories Momsrising posts from mothers is just heartbreaking to read.

And we call ourselves a Superpower?

Flu Pandemics and Certified Professional Midwives (CPMs)

Something to definitely think about given the numbers with Swine Flu rising.

But, honestly, training more CPM's just makes sense on many more levels (for low risk women it's super mother-friendly and it's ALOT cheaper!!!).

Read below!

FOR IMMEDIATE RELEASE: Tuesday, April 28, 2009

Flu Cases Raise Concern About Shortage of Midwives With Expertise in Out-of-Hospital Birth

Advocates Call on State and Federal Policy Makers to Prioritize Maternal and Infant Safety



WASHINGTON, D.C. (April 28, 2009)—Maternal and infant health advocates are calling on policy makers to take action to ensure that there are enough Certified Professional Midwives (CPMs), who are trained as experts in out-of-hospital delivery, to meet the needs of pregnant women in the event that a flu pandemic makes hospitals unsafe settings for the provision of maternity care.



“Hospitals filled to capacity with flu patients are unsafe and inaccessible places for healthy women to deliver their babies,” said Colette Bernhard, Vice President of Illinois Families for Midwifery. “Fewer than 3 percent of nurse-midwives have undergone the additional training needed to establish out-of-hospital practices, while legal and reimbursement barriers at the state and federal level prevent far too many Certified Professional Midwives, who already have the necessary training and equipment, to utilize their services to the fullest. Given the very real possibility of a flu pandemic, the need to fully incorporate CPMs into our health care system could not be more urgent.”



Certified Nurse-Midwives (CNMs), who are trained to practice in hospital settings, are legally authorized by all 50 states and are federally mandated Medicaid providers. CPMs are the only professional midwives in the United States whose educational and credentialing process requires them to develop the specialized skills necessary to safely deliver babies in private homes and in freestanding birth centers. However, CPMs are legally authorized to practice in just over half the states and are eligible for Medicaid reimbursement in fewer than a dozen states.



Recognizing the need for more midwives with expertise in out-of-hospital maternity care and risk assessment, as well as the ability to safely triage laboring women during a disaster, advocates called on state and federal policy makers to take immediate steps to safeguard maternal and infant health in preparation for a possible flu pandemic.



“First, all states need to get on board and license CPMs to practice legally,” said Russ Fawcett of The National Birth Policy Coalition. “But it is every bit as critical that our federal policy makers require Homeland Security to include CPMs—who function as mobile primary care facilities for pregnant women—in disaster planning at local, regional, and national levels and as eligible providers for the National Health Service Corps.”



In the wake of Hurricane Katrina, members of the White Ribbon Alliance for Safe Motherhood formed the National Working Group for Women and Infant Needs in Emergencies in the United States, and the group’s April 2007 report includes CPMs among those who can educate and train home-based delivery skills to institution-based birth providers.



The Big Push for Midwives is the first initiative of the National Birth Policy Coalition (NBPC), whose mission is to promote the autonomous practice of Certified Professional Midwives and Certified Nurse-Midwives and to ensure the availability of safe, evidence-based care during pregnancy, labor, birth, and postpartum. The Big Push is a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care.



Through its work with state-level advocates, the Big Push is helping to build a new model of U.S. maternity care built on expanding access to out-of-hospital maternity care and CPMs, who provide affordable, quality, community-based care that is proven to reduce costly and preventable interventions as well as the rate of low-birth weight and premature births. Media inquiries: Steff Hedenkamp (816) 506-4630, steff@thebigpushformidwives.org.

###

New BOLD T-shirts!

Support BOLD and raise awareness about healthcare reform with BOLD's new "Obama Needs a BOLD Birth Plan" t-shirts!

In addition to these new shirts we also have lots of BOLD notecards with dramatic images from BOLD performances for sale!

Click HERE to view BOLD merchandise.

Activity May Decrease Length of Labor

It's almost a no brainer, but nice to see the New York Times is reporting on it:

http://www.nytimes.com/2009/04/21/health/research/21baby.html?_r=1&em

Nominate a Women's Health Hero!

Time is running out to nominate a "Women's Health Hero" in the Our Bodies Ourselves contest. Deadline is May 1.

There are so many women's health champions out there and many of you reading this blog know them! Nominate them now! Click here.

bed commercial in Barcelona - a must-see!

Well,I've never seen a commercial like this before! It's a commercial for a company that sells beds in Barcelona.

I'd love to know who thought up this ad!!

http://www.youtube.com/watch?v=yrDfPHJ28dE&feature=related

Little Rock photos

Here are some photos with the cast, and after the play at a reception with all four women (three midwives and their apprentice) who were at the births of my 2 boys!, and out to dinner later that night with three midwives, two doulas, a Labor and Delivery nurse, a friend and a brave husband!

Little Rock ROCKS!

Little Rock ROCKS!!!! My new one-act version of the play debuted at the Arkansas Literary Festival on the 19th, with a jam-packed audience and a crowd whose laughter and tears just kept flowing.

Thank you Little Rock!

So many incredible people made it all happen – too many to mention by name – but I do want to give a shout-out to Ida Darragh (whose home I stayed at and who founded the Arkansas Childbirth Institute that sponsored my trip to Little Rock), Verda Davenport Booher(who produced a fabulous event AND acted in the play!), and Stacy Pendergraft (who directed the play, acted in it and really got what I want the play to convey).

And a shout-out to Mary Alexander because of all the birth goodness in Little Rock that grows out of her that she’s too modest to talk about. (I love you, Mary!)

As you can imagine I see the play a lot, but as I told the crowd of people after the play this time seeing the play was different. This time it felt like I was coming home, surrounded by so many good friends cheering me and the play on.

And the actors were just fabulous - and so was the dynamic talkback. I was deeply moved when a 10 year old girl asked me a question (the first question after the play from a young girl!). She asked:

“Do any women really shout ‘My Body Rocks!’ when they are giving birth?”

They sure do! This girl was amazed to hear that the character Amanda in the play, who chanted “My body rocks!” in the play, really did say those words in real life at her birth. And that while every woman may not chant those exact words there are women who shout out “My body rocks” using different words and in different languages. MY BODY ROCKS language is out there! And we need it to spread.

I’m so pleased this young girl of ten now knows this is possible.

What a weekend.
(If you live anywhere near Little Rock go to their May 21 and 22 performances!!!)

My Little Rock midwives

This weekend in Little Rock I've been doing alot of reflecting on my 2 birth experiences with my midwives here - now nearly 10 years ago.

There's a line in the play when Jillian attends a beautiful home birth and afterwards she comments:

I want what SHE got!

Well, this weekend I keep thinking:

I want all women to have what I got.

Mary Alexander, Ida Darragh and Stacey Blackburn provided me with all the juice, passion, and trust for me to have the birth I wanted. Their recipe was simple: lots of talking and getting to know who I was, a calm, laid-back belief that birth is normal and that I could do it, and always being available for neurotic moments before and after the birth!

I was recently interviewed by a radio show host who had her baby in the hospital and she commented quite extensively on how after she had her baby she was sent home and her postpartum period was horrible, filled with breastfeeding challenges and very lonely. This got me thinking about the women who birth with midwives, and especially at home. Postpartum IS part of the midwife's scope of practice. In home births there are always visits made to the woman's home, sometimes - like me - up to 6 weeks postpartum!

On Friday night my midwife Mary (really,my surrogate mother here in Little Rock) reminded me after my second birth she slept over my house (for nothing!) to help me with our second baby. Midwife heroes like this exist all over the world. So why do so many people still not take midwifery seriously? Would you rather be sent home alone after your baby or visited by a qualified maternity care provider? To me it's a no brainer.

Well, I"m off to the first performance in Little Rock of my play this afternoon and I can't wait! Finally, I'm back home.

To learn more about my Little Rock midwives check out their website here. And be sure to click on the slide shows of some incredible home births (you'll see Mary too!). They're just beautiful!

Little Rock, the play, and Dr. Baldwin

I'm in Little Rock for the play this weekend at the Arkansas Literary Festival... and what a fun evening I had last night! Went out with a crew of BOLD women putting the production together here in Little Rock including my 2 midwives, the director and producer.

And what did we talk about? Birth of course! Not just the play, but like most people who are passionate about childbirth we told just a few birth stories! And I was updated on the birthing scene here. Midwives have actually been legal and liscesed since 1983 so midwifery is out in the open, but it's still a struggle to get the local community to take home birth seriously. There are no hospital based midwives in Little Rock, or birthcenters, so if you want a midwife it has to be at home.

I found out a frightening statistic that one of their local hospitals has an (unpublished) 60% cesarean rate!

Deep breath...

But I also heard a few gems, like a local obstetrician who has backed up the home birth midwives for years but due to a change in his insurance (that makes him sign off that he is not in anyway assisting home births!) he can no longer back up the midwives (and in Arkansas midwives can only take women who have an official back up OB). BUT...this BOLD obstetrician told the midwives he so wants to support what they do that they can call him on his cell if they have to transport and he will meet them at the hospital. I love hearing about these heroic acts to help birthing women!

But politics of chidbirth aside, last night something even more special happened after our meal as we were leaving. Sitting at a corner table at the restaurant was Dr. Baldwin, the BOLD obstetrician who backed up my home births in Little Rock nearly 10 years ago. Dr. Baldwin is a hero if ever there was one. I even used a line he said to me in my play. He's the OB in the play who says:

I've learned more about childbirth from birthing women then from medical school.

I remember how profoundly that affected me when I was first pregnant. For an OB to say he trusted me, he knew my body knows how to give birth and as long as I followed my intuition in most low risk cases all will go well...that had a huge impact on me!

Last night, as I serentipidously bumped into Dr. Baldwin, I thought how life always gives us what we need. I was lucky and got his pearls of wisdom before I gave birth, but we all are given these pearls in different manifestation. The challenge is for us to be listening, paying attention, to them.

Visit the Little Rock production's website! http://birthinlittlerock.webs.com/#

weighing in on the new home birth study - where's the United States?

The Daily Telegraph in the UK also covered the new home birth study:

http://www.telegraph.co.uk/health/healthnews/5153546/Boost-home-births-call-as-research-shows-they-are-safe.html

Why are the US papers not weighing in on this? Hmmm...

Home birth safe? Yes!

The BBC - not a major US paper - reports today on a new major study from The Netherlands that shows home birth with a midwife is safe.

Come on, United States, the evidence is in front of our faces! Let's use the evidence to reform maternity care and save money. Forget the interests of our Obstetric "trade union" - the American College of Obstetricians and Gyns - and insurance companies. Home birth just makes sense.


Here's the BBC piece:

Home births 'as safe as hospital'

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands - which has a high rate of home births - found no difference in death rates of either mothers or babies in 530,000 births.

Home births have long been debated amid concerns about their safety.

UK obstetricians welcomed the study - published in the journal BJOG - but said it may not apply universally.

The number of mothers giving birth at home in the UK has been rising since it dipped to a low in 1988. Of all births in England and Wales in 2006, 2.7% took place at home, the most recent figures from the Office for National Statistics showed.

The research was carried out in the Netherlands after figures showed the country had one of the highest rates in Europe of babies dying during or just after birth.

It was suggested that home births could be a factor, as Dutch women are able and encouraged to choose this option. One third do so.

But a comparison of "low-risk" women who planned to give birth at home with those who planned to give birth in hospital with a midwife found no difference in death or serious illness among either baby or mother.

"We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife," said Professor Simone Buitendijk of the TNO Institute for Applied Scientific Research.

"These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth."

Hospital transfer

Low-risk women in the study were those who had no known complications - such as a baby in breech or one with a congenital abnormality, or a previous caesarean section.

Nearly a third of women who planned and started their labours at home ended up being transferred as complications arose - including for instance an abnormal fetal heart rate, or if the mother required more effective pain relief in the form of an epidural.
“ The NHS is simply not set up to meet the potential demand for home births ”
Louise Silverton Royal College of Midwives

But even when she needed to be transferred to the care of a doctor in a hospital, the risk to her or her baby was no higher than if she had started out her labour under the care of a midwife in hospital.

The researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

While stressing the study was the most comprehensive yet into the safety of home births, they also acknowledged some caveats.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background - the risk of complications is higher in both these groups.

The study did not compare the relative safety of home births against low-risk women who opted for doctor rather than midwife-led care. This is to be the subject of a future investigation.

Home option

But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.
“ Women need to be counselled on the unexpected emergencies which can arise during labour and can only be managed in a maternity hospital ”
RCOG

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was "a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

"However, to begin providing more home births there has to be a seismic shift in the way maternity services are organised. The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital.

"There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies."

The Royal College of Obstetricians and Gynaecologists (RCOG) said it supported home births "in cases of low-risk pregnancies provided the appropriate infrastructures and resources are present to support such a system.

But it added: "Women need to be counselled on the unexpected emergencies - such as cord prolapse, fetal heart rate abnormalities, undiagnosed breech, prolonged labour and postpartum haemorrhage - which can arise during labour and can only be managed in a maternity hospital.

"Such emergencies would always require the transfer of women by ambulance to the hospital as extra medical support is only present in hospital settings and would not be available to them when they deliver at home."

The Department of Health said that giving more mothers-to-be the opportunity to choose to give birth at home was one of its priority targets for 2009/10.

A spokesman said: "All Strategic Health Authorities (SHAs) have set out plans for implementing Maternity Matters to provide high-quality, safe maternity care for women and their babies."

Playwright conceived Birth, hearing ‘voices of the mothers’

Here's the piece about me, BOLD and the play in the Arkansas Democrat Gazette today.

Not surprisingly, he got a few things wrong, like that one of BOLD's major tenets is to just support low risk pregnancies doing homebirths with midwives. No, I said, we support low-risk women going to midwives who practice the midwifery model of care - whether that be in the home, hospital, or a birth center.

I also spent alot of time talking to him about how if Obama really wants to save money and reform health care he MUST consider training and using more midwifery care for low risk pregnancies. But I don't see that mentioned in the article!

Anyhow...it's nice to be back in Arkansas - it was a fabulous place to live.


Playwright conceived Birth, hearing ‘voices of the mothers’
BY ERIC E. HARRISON ARKANSAS DEMOCRAT-GAZETTE

Karen Brody gave birth to two sons while living in Little Rock just before and just after the turn of the century.

Her experience helped her to eventually also give birth to a play.

Brody’s play, Birth, has drawn comparisons to The Vagina Monologues for its portrayal of women’s birth stories in their own voices and for the grass-roots movement that is moving the message from community to community one performance at a time.

A local cast of actresses will put on a staged reading of the play (in a slightly abridged 45-minute version) at 3 p.m. Sunday in the third-floor meeting room of the Cox Building, 120 Commerce St., next to the Central Arkansas Library System’s Main Library in Little Rock.

The cast includes Angie Gilbert, Monica Clark-Robinson, Paige Renolds, Stephanie Ong, Verda Davenport-Booher and director Stacy Pendergraft.

The reading is part of the Arkansas Literary Festival, in conjunction with the Arkansas Childbirth Institute. The play includes adult language.

Brody will speak and sign copies of the play after the reading.

A fully staged version is on tap for May 21-22 at the University of Arkansas at Little Rock.
HOME DELIVERIES

Brody found out she was pregnant shortly after moving to Arkansas in 1998 when her husband, Tim Ogborn, who works in international development, got a job with Heifer International.

She had her first son, Jacob, in 1999 and her second, Aden, in 2001. Both deliveries were at home with the help of midwives from Birth Works, a home-birth service.

“I didn’t expect to fi nd groovy home-birth midwives in Little Rock,” Brody says. “I felt instinctively that I didn’t want to have my babies in a hospital.”

Hospitals are where sick people go, sometimes to die (“My father passed away in a hospital and I was there,” she says) and Brody is a firm - one might even say fervent- believer that pregnancy is not an illness.

Brody, a freelance author, is the founder of Birth on Labor Day (BOLD), a global arts-based, theater-for-social-change movement that inspires communities around the world to create childbirth choices that work for mothers. Brody notes that neither Birth nor BOLD necessarily promotes any particular option, but that women should be able to choose how they want to deliver their children.

One of the movement’s tenets is that in most low-risk pregnancies, babies can be delivered safely at home with a certified professional midwife.

Complicating Brody’s second pregnancy was a case of amebic dysentery. “We thought it was morning sickness for six months,” she recalls. “It was a pretty rare amoeba. I thought it might risk me out of home birth.”
SECOND BIRTH

Once she had been diagnosed and partially treated for the condition, however, “my second birth was actually easier than my first.”

Her home births led her to consider writing about women’s birth experiences. There are plenty of books and plenty of statistics, but “I was interested in bringing women’s voices out,” she says. “I didn’t see any voices of the mothers.”

Just before she moved from Little Rock to Washington in 2003, she started interviewing women about their experiences. “I spent a good year doing that,” she says. After gathering more than 100 stories, “I realized, ‘Now I have to do something with this.’”

She decided it would speak better if she put it into play form.

“I realized that if I wrote what I was hearing as a book, no one would read it.”

She says she has always loved theater - as a child in New York, her mother took her to plays - but had never written a play before, and was surprised to discover she had a talent for writing dialogue.

The play features the stories of eight women who discuss their birth experiences, ranging from positive to frightening. A positive case is “Amanda,” who delivers a son in a hospital but without drugs with her husband and doula (from the ancient Greek, meaning “a woman who serves,” a doula provides physical, emotional and informational support to the mother before, during and just after birth) nearby. A less positive story is told by “Lisa,” who ended up having a Caesarean section without her full consent.

Brody worked on the script with a Washington-area playwriting group, and was surprised to discover that her colleagues didn’t believe the stories were true.
WHERE’S THE DOCTOR?

For example, “Most women don’t realize that the doctor doesn’t show up until the pushing starts.

“It stirred me to finish it once I saw the impact.”

A first staged reading in 2004 drew 75 people into a black-box space at George Washington University that had only 40 seats. “They all felt the energy and the passion,” the playwright recalls with a touch of pride.

The play had its official premiere in 2005. An early 2006 performance caught the attention of Dr. Christiane Northrup, a fellow of the American College of Obstetricians and Gynecologists, who made the first comparison to Eve Ensler’s Vagina Monologues. Northrup also wrote the foreword to the book version of the play, which AuthorHouse published in paperback in 2008.

The play sparked the founding of BOLD - Labor Day 2006 was the kickoff - with the goal of raising childbirth awareness and providing education to as many as 10,000 people a year. On and around Labor Day 2008, the play had more than 100 performances around the United States.

For more information about Birth and BOLD, visit the Web site,
www.boldaction.org

Little Rock, here I come....

I'm off to the Arkansas Literary Festival this weekend in Little Rock, the place where I gave birth to my two sons. I can't wait to see so many special friends...and the midwives who rocked my births. My weekend is jam-packed!

A piece came out about me and the play in today's Arkansas Democrat Gazette. ("Playwright conceived Birth, hearing ‘voices of the mothers’")

I'll be speaking after a 45-minute version of the play this weekend, but the play will be performed in its entirety in May. Click here to check out their website for details!

Make a documentary about childbirth!

Time is running out to enter an Birth Matters Virginia's exciting short film contest! Below is more details:


Birth Documentary Contest: $1,000 First Prize

Birth Matters Virginia is soliciting 4-7 minute educational videos about birth in the hopes of reducing the incidence of medically unnecessary c-sections, infant and maternal morbidity, and skyrocketing health care costs. The first-place winner will receive a prize of $1,000. Second place $500 and an "honorable mention" prize of $100 will also be awarded. The deadline for entering the contest is Mother's Day, May 10, 2009.

Guest judges include: Ricki Lake and Abby Epstein, acclaimed producers of the Business of Being Born and Sarah J. Buckley., MD, international birth expert and author of Gentle Birth, Gentle Mothering. Ricki, Abby, and Sarah will join a consumer-based panel of judges who will be evaluating the tone, educational content, creativity and more. You don't have to be a professional to enter and you don't have to be from Virginia. We'd love to get videos from mothers, fathers, filmmakers, film students, birth advocates, and anyone else who is interested in birth or film or wants to win $1000.

Birth Matters Virginia advocates "evidence-based" maternity care, which simply means using the best available research on the safety and effectiveness of specific practices to help guide maternity care decisions and to facilitate optimal outcomes in mothers and newborns. There are a lot of ways to approach that topic and lots of opinions on what that means, and we're looking forward to the variety of entries.

For rules, how to enter, or to sign up for updates, please visit http://www.birthmattersva.org/videocontest.html
You can also join our Facebook group to get updates about the contest and exchange ideas with other participants at
http://www.facebook.com/group.php?gid=73753459808
And if you have questions, email Sarah at Richmond@birthmattersva.org

URGENT: Contact Washington to PUSH for Midwives

From: The Big Push for Midwives

Urgent Request for Action!

WASHINGTON Must Hear Direct From Grassroots America

Folks, I have some urgent news to report. PushScouts who have attended White House town-hall health care meetings across the country with policy wonks and DC insiders have all returned with the same message:

Federal health care reform is moving fast and *the window of opportunity for including Certified Professional Midwives is rapidly closing.* Bills are being drafted now and any providers who aren't on "the list" by September
will be left behind.

The time to act is now.

*We need each and every Pusher* to schedule an in-district meeting with their member of Congress and two Senators today. Both chambers are in recess, and members are in their home districts until April 19th. This is a
*golden opportunity* to begin educating our federal representatives about CPMs and to make sure all of us are doing everything we can to *make sure that CPMs are included in the final reform package*.

Scheduling a meeting is easy, but many other groups are competing for face-time and the available *slots are filling up fast.* So please follow the instructions below and *call* your federal delegation today!

*Midwives, please forward this important information to your clients,* past and present, and ask them to schedule a visit with their federal representatives. Also, it's important that CPMs represent their profession at the federal level, so please *pick one or two clients you would like to accompany you to a visit* and ask them to join you.

Attached you will find a two-page FAQ that includes each of the messages your representatives need to hear. You can also download it from the PushSite at
http://www.thebigpushformidwives.org/attachments/pages/WASHINGTON+-+Health+Reform+Must+Include+Access+to+CPMs+4-8-09.pdf

All you need to do in the next week is *1)* pick one or two of your favorite points to talk briefly about, *2)* record any questions they may have that you are unable to answer to pass along for follow-up, *3) *leave the FAQ
sheet with their staff and *4)* report back to other Pushers about your meeting!

Because there is strength in numbers, we ask you to recruit one or two supportive allies to go to the meeting with you: community leaders, local clergy, physicians, nurses or other providers, a neighbor or member of your
family. It is important that our members of the Senate and Congress understand that *access to CPMs is important to Americans from all walks of life,* not just to those of us who choose this model of care or are CPMs ourselves.

*SCHEDULING AN IN-DISTRICT MEETING IS AS EASY AS A-B-C: *

All you need to do is identify your U.S. representative and two U.S. senators and contact them!

A. Use this link to determine your full zip code, which is your ZIP+four code: http://zip4.usps.com/zip4/welcome.jsp

B. Use this link and type in your ZIP+four code to determine your U.S. representative: http://www.house.gov/zip/ZIP2Rep.html

C. Use this link to determine your two U.S. senators:
http://www.senate.gov/general/contact_information/senators_cfm.cfm?OrderBy=state%26Sort=ASC

Please make the call today! *We have 10 days* until their April recess is over.

Below is a list of tips and pointers to help you plan a smooth and easy visit with your federal representatives. Remember, they work *for you*!

*Tips for Visiting Your Members of Congress in Their District Offices*

§ When you call to make the appointment, be sure to *mention that you are a constituent*, where you live and that you would like to briefly discuss the importance of including Certified Professional Midwives, who are specialists in out-of-hospital birth, in federal health reform.

It may take more than one call to get an appointment. Don't be shy about calling more than once!

§ Meeting with the staff person in charge of health care is every bit as effective as meeting with your member of Congress. Don't be discouraged if your representative can't meet with you—convincing staff that your issue is worthwhile is *a huge step forward* in getting your representative to support you.

§ Take a look at your representatives' web pages and get some background on their issues of interest or any legislation they support that you do, too.

§ *Recruit at least one other person in your community to join you*, but appoint one lead spokesperson for the meeting.

§ Be sure to wear business-casual clothes—no jeans or t-shirts, please!

§ Be considerate of their time. Make sure you keep track of your time and articulate your position without running over your allotted time.

§ After you have briefly made one or two points about the importance of including CPMs in federal health care reform, *ask if they have any questions*.

§ If you don't know the answer to a question, tell them you will pass it along to *The Big Push for Midwives Steering Committee
* for follow up.

§ After you've answered any questions, *ask them if they have a position on CPMs and out-of-hospital birth.* Offer to provide them with more information if they haven't yet taken a position.

§ Even if they are non-committal, *ask them for advice about what you can do to get CPMs included in federal health care reform.* Legislators and staff appreciate being asked to share their expertise and insight about
the legislative process with constituents.

§ It is appropriate to take notes about any questions they may want follow up or about advice they are offering. Save notes on the rest of the discussion for after your meeting.

§ Be sure to leave staff with your contact information and make sure you have theirs.

And of course, please don't forget to thank everyone for their time!

*The Final Push*

After you leave, sit down and conduct a brief review with others at the meeting. Assign someone to take notes and write down any key information or questions such as the legislator/staff's position, questions they have, objections they raised and any advice they offered.

Write legislators and staff after the visit to thank them for their time. Remind them of anything they may have agreed to do and send any additional information they may have requested.

*Report back to The Push Team*!* *Please forward notes and questions to Steff at Steff@TheBigPushForMidwives.org and share your experience, thoughts and tips with others at The Big Push for Midwives Facebook Discussion board http://www.facebook.com/group.php?gid=25544608578&ref=ts

Don't be shy about staying in touch with legislators and staff with alerts or other relevant news or information about CPMs. Effective advocacy at the legislative level is all about relationships—it's important to start building them now with your federal representatives and their staff.

DC Birth Center

I visited the DC Birth Center last week...located in one of the poorest areas of Washington, DC (northeast, wards 5 and 6). Wow...what a vision that's been realized by Ruth Lubik, an octogenarian who founded the center.

Actually, the birthing area is just one part of an integrated model of care for women and babies in the community that includes everything from pregnancy, birth and postpartum (and I'm not talking about postpartum care as in the first 2-3 weeks...the center really addresses daycare issues for mothers and gets the toddlers involved with planting gardens to connect to teaching about eating healthy foods).

Another thing I loved about the center is that the community has a large say in how it is run. This is such a strong model for community development and recognizes how important it is for women to have ownership of their care.

Before I left several of the midwives said they may be interested in organizing a BOLD Red Tent. I will definitely be involved if this happens!

I also think Michelle Obama needs to get herself over there!

The gliding chair above is one of the very cool ways the birth center offers women to give birth (the bottom comes out and the woman can birth the baby right there!).

DC Birth Center...you ROCK!

Review of BIRTH

Just spotted this review of the book version of my play in the award-winning book review website: myshelf.com.

It comes in waves it seems, every twenty years or so, a period of revolt followed by a period of acquiescence. But it seems in the area of natural birthing a little of the gain is retained each time. Still, over the past twenty years or so, natural birthing has been increasingly suppressed by the medical community. Somehow normal childbirth became risky, requiring medical intervention. Obstetricians pushed Caesarean sections to the point that today more than one-third of all births are C-sections.

Now, in the 21st century, Karen Brody’s play, Birth, has fomented another revolt; one that recognizes and honors the intrinsic wisdom of women’s bodies throughout the birth process.

Birth is not a statistical review of studies conducted by scientific researchers. Rather, the play was drawn from numerous interviews Brody held with birth mothers. It is a play of experiences, eight women relating their birth stories. "There are too many... mothers who are injured from their birth experiences," Brody says. "While I never set out to write a play that was against the medical community, my one commitment when I wrote the play was to tell the truth. It became difficult to tell the truth... and not find at the end a negative picture was being painted of the medical establishment."

Birth is not merely a play; it is a phenomenon with the force to change business-as-usual within the medical community. The point clearly made is: Birthing should be woman-centered; normal birth is a joyful experience to be embraced. This powerful, epiphany-inducing play is being performed all over the world to packed houses.

The well-crafted play is beautiful in its simplicity, itself a motif of the exquisite simplicity of natural birth. The play’s unobtrusive framework acts as a setting for the jewel-like experiences of the eight women characters. That this is Karen Brody’s first play is astonishing. That its message is so exceedingly welcome, less so. Brody’s insightful work is excruciatingly unbiased, a work of refreshing honesty and clarity. I urge you to read it; see it; embrace it.

A great day for midwives - and pregnant women - in Idaho

The Big Push for Midwives just issued the press release below. Waa-hoo!


Idaho Pushes Midwife Movement to the Tipping Point
Physician and Midwife Groups Forge Unprecedented Alliance as Idaho Becomes the 26th State to Pass Legislation to Legalizing Certified Professional Midwives

BOISE, ID (April 1, 2009)—Governor C.L. “Butch” Otter signed into law today a bill to license and regulate Certified Professional Midwives, making Idaho the 26th state to legally authorize them to provide out-of-hospital maternity care. In a notable reversal of longstanding anti-midwife policies, medical groups worked together with legislators, midwives, and advocates to reach consensus on a law that provides for independent practice, mutual collaboration, and the rights of parents to choose where and how their babies are born.

“This is a great day for midwives and home birth advocates all across the country,” said Kyndal May of Idahoans for Midwives. “We truly have reached the tipping point, breaking through the medical lobby’s longstanding opposition and developing a legislative consensus model that other states are looking to follow.”

Certified Nurse-Midwives (CNMs), who practice primarily in hospital settings, are legally authorized in all 50 states, while Certified Professional Midwives (CPMs), who specialize in out-of-hospital birth, until today were legally authorized to practice in just half the states. Representatives from The Big Push for Midwives Campaign noted that Idaho typifies recent legislative trends across the country, as a growing number of states come closer to passing CPM legislation.

“We’re seeing unprecedented advances this legislative season,” said Katie Prown, Campaign Manager of The Big Push for Midwives. “For the first time, physician groups are coming to the table and negotiating in good faith, and bills that had long been stalled in previously antagonistic committees are suddenly starting to move.” States that have recently seen significant legislative advances include South Dakota, Indiana, Illinois, Iowa, North Carolina, and Alabama. Idaho joins Missouri and Maine as among the most recent states to legally authorize CPMs to provide maternity care.

“It’s clear that organized medicine has finally realized that, between current economic trends and the drive for healthcare reform, the demand for access to CPMs and out-of-hospital maternity care is only going to grow,” said Susan M. Jenkins, Legal Counsel for the Big Push. “It simply makes good sense to pass laws that provide for regulatory oversight, transparency, and accountability, all of which are necessary to ensure safe practice.”


Thousands of people from across the nation watched the Senate floor vote on live video from the Idaho statehouse last week, cheering on their fellow midwife advocates on Facebook, Twitter, and email groups. “It’s very exciting to be part of a growing national movement,” said Michelle Bartlett, CPM, Legislative Liaison for the Idaho Midwifery Council. “I’m humbled to hear from so many advocates in other states who are looking to us as a model for how to work with every stakeholder to craft CPM legislation that addresses the needs and concerns of all of us who care about the health and safety of mothers and babies.”


Idaho is a priority of The Big Push for Midwives Campaign, a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care. Through its work with state-level advocates, the Big Push is helping to forge a new model of U.S. maternity care built on expanding access to out-of-hospital maternity care and CPMs, who provide affordable, quality, community-based care that is proven to reduce costly and preventable interventions as well as the rate of low-birth weight and premature births.

Extreme Birth

Just finished reading a piece in New York Magazine about midwife Cara Muhlhahn (of "The Business of Being Born" fame). It was a frustrating piece to get through mostly because to take one midwife and scrutinize her pros and cons distorts the midwifery model of care and throws the label "scary midwife" on all midwives.

The reality is you can find "dirt" on almost every maternity care provider. Even my beloved midwives who were at my births in Arkansas had negative comments made about them by mothers who would never use them again. And just last week I googled my long-term gynecologist and found 2 people who thought she was a monster and 2 others who felt there was no better practitioner in the world. Go figure. But dirt seems to always be what matters to sell magazines and newspapers.

The unfortunate, senseless consequence of a piece like this will be that more low-risk women will be scared to do a home birth and run to give birth in hospitals with 30% c-section rates. That makes no sense.

Well, at least the title made sense: Extreme Birth. Yes, the birthing scenarios told in this piece were extreme. Remember that mothers!

April Fools

Received this today from Citizens for Midwifery, a consumer advocacy group promoting the midwives model of care. Oh how I wish it wasn't April Fools Day!

Citizens for Midwifery is pleased to report that, with an extra bit of effort, we have achieved all of our organization's stated aims over the course of the last two months. The following goals have been met:

--All women now have equal access to high-quality care that follows the Midwives Model of Care, and, due to recent federal legislation, all maternity care is fully subsidized and/or covered by insurance, and the government has launched a comprehensive effort to encourage lower-cost out-of-hospital and non-medicalized birth.

--All midwifery licensing is now federally recognized, and the government's recent reports on the vast benefits of midwifery care are encouraging more and more women to seek out midwifery services.

--Due to the above, new Cesarean rates are starting to come in, and the percentage is down to about 15% of all births.

--Also due to the above, new Epidural rates are starting to come in, and the percentage is down to about 20% of all births.

--All American hospitals have recently adopted the Mother-Friendly Childbirth Initiative and have replaced standard L&D wards with 90%+ birthing rooms fully equipped with tubs, birthing stools, and free doula services.

--Due to the new across-the-board Baby-Friendly Hospital standards that have come out of the Mother-Friendly Childbirth Initiative, 95% of all American women are now breastfeeding for at least a year.

--The World Health Organization is now promoting the American model of maternity and midwifery care, what with its excellent outcomes and evidence-based policies, as the gold standard in the world.

In light of all of this, Citizens for Midwifery has decided to disband its board, but only after we use our remaining funds for one last annual board meeting at an all-inclusive Caribbean resort.

Happy April 1st, everyone! May it one day not be such a joke!

If you don't know this woman you should

If you want transformation, if you want a good birth experience, this woman is for you.

Okay, yes, she's earthy-crunchy-hippie looking, but get over it. I encourage everyone, and especially pregnant women, to get to know more about Gurmukh Kaur Khalsa.

Here's a short interview she did that gives so much food for thought you can put down all the birth books and just pay attention to her sage advice:

http://www.youtube.com/watch?v=4NwVAFkiqsk


I love her point to "leave your mind and go to your heart." When I was a doula this is exactly what my gut told me to tell pregnant women. Too many times we're birthing from our heads - all the birth statistics, all the warnings, all the fear fed to us by media stereotypes of childbirth as an emergency. But what if we birthed from our hearts, not our mind? Gurmukh's thinking is simple and radical. Try it!

Listen to me talk about BOLD on KPFK this Weds

I'll be talking about BOLD and the play this Wednesday, April 1 at 4.30pm EST/1.30pm PST on The Aware Show on KPFK. You can listen to it streamed live online at www.kpfk.org.

Mamapolooza rocks!

BOLD organizer Mamu Rangel is bringing the play and a BOLD red tent next month to Mamapolooza in New York City. Joy Rose, founder of Mamapolooza, had her four babies with a midwife and really gets the childbirth crisis we're facing in America and how much childbirth is an opportunity for women to experience personal transformation.

Mamu, Joy - and Mamapolooza - you ROCK!

check out Brain, Child magazine

This month's edition of Brain, Child magazine (who calls itself a magazine for "thinking mothers"!) mentions the play and the BOLD movement in a short piece called "Birth pangs." I'm not sure I really got the point of the piece, but it was nice to be mentioned alongside other important childbirth work like Thin Air's radio documentaries on childbirth and postpartum.

Why My Son Admires Me

My son recently had to pick a person he admires in his life and write a few sentences why he admires them. I was honored that he picked me and a bit shocked (given our discipline interactions lately!).

Not surprisingly, he knows alot about childbirth and knows being an advocate for mothers and babies is a large part of who I am. So I expected some mention of my play, my work with BOLD, or something related to childbirth. But no, instead he saw other attributes in me that I had missed:

I admire my mom because she has awesome typewriting skills.

Hmmm...I never thought about that.

And I admire my mom because she plays basketball with me.

Ah yes, I thought, these are the important things in life. Thank you, Jacob, for reminding me!

Birth stats from CDC 2007

The Center for Disease Control (CDC) just officially announced the birth statistics for 2007 (check the full report out at: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_12.pdf).

The cesarean rate in the United States is now officially up to 31.8%. This is shameful.

I know Obama has alot on his plate, but don't you think how we bring children into this world and the complete health of mothers should be high up there?!

A quote for pregnant women, their partners, family and friends

"And the time came when the risk to remain tight in a bud was more painful than the risk it took to blossom."

- Anais Nin

Birth Autopsy

My cousin had her second baby last Friday night. She always expected to have natural births, her best friend is an acupuncturist, she's does spring detoxes, takes herbal supplements, does chakra dancing, lives in San Francisco, and doesn't have a television in her house. She has birth warrior stamped all over her. Yet on Friday she gave birth to her second C-section baby.

Last night I found myself thinking: what went wrong? It's so easy to blame, blame, blame. But I don't want to do that. Instead, I thought, I want to do a birth autopsy.

When I started thinking about what I know about her birth experiences it wasn't much. Maybe it's because I wrote a play on childbirth, or maybe it's just the normal mode for moms who have upsetting birth experiences, but both my cousin and I seemed to have never talked about the details of her births. Partly I know it's distance and years growing up with a significant age difference (she's 7 years younger than me).

Sure, I know some things: For her first birth she started out in a birthing center with midwives. In fact, I remember her pregnancy period very well, we spoke often on the phone, and she was pretty set on doing a hypnosis course (which worried me because while I've seen it help alot of women, I actually think the idea of taking the pain away from labor is not an empowering approach to labor...finding visualizations to stay calm, yes, but not eliminate the pain). She also read just about every natural childbirth book out there, which I thought was great until the week before the pregnancy when she still had her head in about a dozen books. I remember telling her on the phone: throw the books out! Now is the time to get OUT of your head and INTO your body!

I'm not sure if she put down the books, but a week or so before her due date her midwives saw a "potential problem" (I never found out what) so she was brought in for induction at the birth center but I think quickly risked out of the midwifery care and went to the Labor and Delivery floor at the hospital ("Thank goodness she was at a hospital!" my aunt told me later on the phone, like a scene from ER). Low risk woman, just induced, now on the L&D floor and yes...you know what's coming...the doctors were "concerned about the baby"...so she had a C-section.

Fast-forward five years and she's living in San Francisco, you think the progressive capital of the United States, but she can only find two places who will let her try to have a VBAC (vaginal birth after cesarean). And one, she tells me, says they do VBAC but she has heard from most women that this virtually never happens. So she chooses the other - no, the ONLY VBAC-friendly doctor she can find - and a week past her due date goes for a routine check of the baby and they say they see a "potential problem" and want her to go get checked at the local hospital, never preparing her that of course once she gets checked at the local hospital there is relatively no chance she will be "allowed" to leave (without feeling like a "bad girl" and just leaving).

So she is checked in, unprepared, not in labor and says she still wants to try for a vaginal birth. They give her something to gently induce her (knowing that one big reason VBAC can be dangerous is uterine rupture caused by the medical interventions to induce!) and she begins to go into labor (note: she has an upper respiratory infection so she's coughing alot and not feeling great) but a few hours later labor completely stops ("Can you believe it? Just suddenly!" my aunt tells me on the phone and I say, "Oh" but what I want to say is "What the fuck do you think a woman's body is going to do when she's thrown into a hospital, she's sick and her body has not indicated she or the baby is ready?"). An hour or so later, feeling tired from all her coughing and I'm sure knowing she had a VERY uphill battle to get the birth she wanted she decided to go for her second major abdominal surgery.

My birth warrior cousin had two C-sections.

And, another birth warrior, her step-sister also had two disappointing birth experiences.

When I ask the question what went wrong all I can think of is this:

Our culture failed them. The maternity care system - that so resembles our ailing culture - wasn't there for them. Perhaps we could say my cousin should not have tried to get what wasn't on the menu at the hospital, but should have gone for a home birth. And yes, in this climate this is where birth warriors must go (and to free- standing birth centers). But we also have to take a deep look at the culture we live in that treats pregnancy as illness and has a body of obstetricians and gynecologists (ACOG) that resembles a trade union, not an advocate for women's maternal health.

There are thousands and thousands of birth warrior mamas out there who know they are birth mamas - and millions who don't. We must make sure women begin to notice the "birth mama" in them and then once they do we must give them safe, intimate places to experiences normal birth. For the sake of birth, and for the sake of humanity.

Another BOLD baby!

I've been meaning to post this for a while. Meet Julie Lambert's sweet baby Kate! Julie, BOLD's 2007 Organizer in Chicago, gave birth to Kate in December at home. It was Julie's first HVBAC. YAY! A belated congratulations Julie...you ROCK!

I am always given what I need

Well, I'm finally out of bed after the worst cold/flu/whatever-you-want-to-call-it of my adult life. Over 104 degree fever for 3 of the past 5 days.

As I was laying in bed, the first time in 10 years (since the birth of my first son) that I laid in bed for three days straight, I started thinking alot about all the good this sickness has brought me. Besides the obvious that it got me out of "doing mode" which every mother of young kids is in, it provided an opportunity for my body to release emotions, toxins, etc that had been stored up and gave me the opportunity for transformation.

I came to this realization on day two of my illness. By day three, feeling quite spiritually superior and thinking my awareness was the transformation itself I was a little pissed off that I wasn't over my fever. Aaah, transformation is not that simple. Still with 104 fever and at this point very weak I decided to very slowly and grumpily (is that a word?!!) make my way to my meditation cushion, ring a Tibetan bell, and pick a "goddess card." The card read:

I am always given exactly what I need.

Hmmm...I had had 104 fever for 3 days and my son's 8th birthday was the next day. Was this what I needed?

Yes. Exactly.

And that's when I started thinking about Jillian's lines in my play Birth - "I finally walked through all my birth baggage." Jillian finally had an awareness of what went wrong in her first two births and this was very powerful for her, but she finally got that awareness without action wasn't going to create transformation. Once she got that awareness plus action equals transformation that's when she began to transform.

awareness + action = TRANSFORMATION

For me my transformation last week began once I started writing in my journal again. This was something that was deeply missing from my life that I hadn't honored in over two years due to my busy family life and constant moving. For two days I wrote in my journal, sharing my feels and drawing my feelings as well, and each of those nights I sweat as though I had taken a shower, allowing the toxins to leave my body and the fever to end.

There are so many parallels to a positive childbirth experience. We lead busy lives and yet when we're pregnant we need to create sacred space in our lives to stop, increase our awareness of our pregnancy and tune in to the childbirth choices available and then take action to make your best birth possible. That's when transformation takes place. A good birth experience, and an empowered life.

Sure, it's a journey, a process, it's not easy and often we are faced with a breaking point before we're brave enough to go through it (for me it was having a high fever for 3 days). But don't wait for your childbirth experience and then transform. Commit to transformation - walking through your birth baggage - today.

Imagine what would childbirth experiences for low-risk mothers be like if women walked through their birth baggage before giving birth. What if a rich inner feminine life was every woman's goal (committing to journaling, a women's support group, an empowering childbirth class)? What would our birth choices look like then?

Listen to me on the radio!

Want to listen to me speak about BOLD, the play and childbirth today in America? This morning I was on "Strategies for Living" radio show...it will be broadcast nationally next month, but you can listen to the podcast now online at:

http://www.strategiesforliving.com/podcast.php?p=1929

Enjoy!

Mothers Day Every Day

The White Ribbon Alliance, a super-cool coalition of groups committed to improving maternity for mothers worldwide, just launched a campaign called Mothers Day Every Day that calls for greater U.S. leadership to accelerate progress toward safe and healthy pregnancy and childbirth for all.

And they also have a "sister" campaign in the United Kingdom called Million Mums who are trying to get a million moms to donate 1 UK pound so they have a million pounds of money to go to help prevent women from dying needlessly in childbirth.

You ROCK White Ribbon Alliance!

Childbirth for teenage mothers

Today I've been looking at BOLD 2009 applications for the BOLD red tents. Wow...these organizers ROCK!

The BOLD Red Tent in Atlanta, Georgia just sent us some fun photos from their red tent (see the one above!). And I was just reading about the BOLD Red Tent in Calgary and their plans in May to do two BOLD red tents with teenage pregnant mothers at Elizabeth House, a home for pregnant and parenting young mothers in crisis. BOLD Red Tent Calgary's organizer, Michelle Haywood, gave us some insight into what childbirth is like for teenage mothers at Elizabeth House:

Birth to a teenage mother is not seen as a right of passage – it’s seen as a sentence for the crime she committed of becoming pregnant. This is wrong and heartbreaking on many levels. This mentality permeates her pregnancy and poisons the birth environment, the fear is great and the mother-child bond is compromised.

She also pointed out:

Speaking generally of the population we serve – there seems to be a lot of fear, pressure and ignorance. When the mother is a child herself, she tends to be treated as though she does not have the same rights an adult woman is given during pregnancy and childbirth. She remains misinformed and misunderstood.

I wanted to share Michelle's feedback with you because while my play just addressed low-risk mothers who were college-educated there are SO many mothers giving birth who need a spotlight shown on them...and teenage mothers are definitely one.

My step sister (a teenage mother who is now 30) is doing a documentary through photos and possibly film on teenage mothers. It's important work. If you are a teenage mother or work with teenage mothers and want to participate contact her - judith.weinberg@gmail.com

Women are not chicks

My oldest son is almost ten and lately I've been thinking how much he provides me with reflection and insight into how women are viewed by society. He recently learned (from television, I admit!) that sometimes girls are referred to as "chicks." This gave him, and me, great reason for pause.

"Why are girls called chicks, Mommy?" he asked me as we drove to school this week.

The answer, I thought, is long but I launched anyway into a history lesson of the sub-standard treatment of women, the glass ceiling, the derogatory labels that have been attached to women for centuries...and then suddenly my son interrupted:

"Is this why pregnant mothers are not treated with respect when they give birth?"

Well, yes!

"They're treated like chicks!," he joked. "Here chick, chick, chick! Do what I say chick, chick, chick! I'm your master...chick, chick, chick!"

Hmmm...I think he's on to something. Perhaps shifting childbirth towards a more mother-friendly system will only come once we start abandoning the negative stereotypes we have layed on women for years: when we can watch the Superbowl and stop seeing "dumb blonds" and women held up only for their sexuality, when I can go to see movies like The Pink Panther 2 and it doesn't teach my two boys that women are "less than," and when girls can open up major magazines and not see unrealistic pictures of perfect. How can we expect women to be treated with honor and respect in childbirth when women are depicted so poorly in our culture? I see it through my boys eyes every day, believing women are equal until the images and words tell them otherwise.

I want a t-shirt "Women are NOT chicks!" Make that two more - for my boys.

(by the way, I was once give a great coloring book called "Girls are not chicks." Check it out! http://www.girlsnotchicks.com/index.html )

Obama needs a birth plan

I know Obama has alot on his plate these days, and Daschle is out for Secretary of Health and Human Servives, but I've been thinking alot about the mounting press finally exposing the troubled US maternity care system and specifically Jennifer Block's December piece in the LA Times ("Midwives Deliver") that makes a beautiful case for how training more midwives to deliver low-risk births is economically smart for the United States (not to mention the emotional benefits to women).

So today I want to do a shout-out to President Obama to get a birth plan! Yes, the Lilly Ledbetter fair-pay act will help women in the workplace (hallelujah!), but what about the 4 million women every year who give birth in the United States? Don't they deserve a plan that's going to get the maternity care system to start making economic and societal sense?

Obama needs a birth plan.

Time Magazine rocks!

I'm thinking the journalist who wrote the Time Magazine piece that just came out today - "The Trouble with Repeat Cesareans" - has got to be a mother either denied a VBAC or faced denial and then went to great measures to get a VBAC. Why? Because her piece is dead-on right about today's VBAC crisis.

How did she managed to get an OB on record to say the following on the reasons doctors encourage pregnant women to have cesareans:

"It's a numbers thing," says Dr. Shelley Binkley, an ob-gyn in private practice in Colorado Springs who stopped offering VBACs in 2003. "You don't get sued for doing a C-section. You get sued for not doing a C-section."

Ain't that the truth!

And I loved this point as well:

Some doctors, however, argue that any facility ill equipped for VBACs shouldn't do labor and delivery at all. "How can a hospital say it can handle an emergency C-section due to fetal distress yet not be able to do a VBAC?" asks Dr. Mark Landon, a maternal-fetal-medicine specialist at the Ohio State University Medical Center and lead investigator of the NIH's largest prospective VBAC study.

Haven't I heard Henci Goer, author of "The Thinking Woman's Guide to a Better Birth", saying this for YEARS?!!

Another great message in the piece that women have to start thinking about is: how good major abdominal surgery is on their bodies 2 or 3 times? If there's going to be informed consent (which we all know there's not in most places) then we must tell pregnant women these risks! I've heard too many women telling their birth stories at BOLD Red Tents saying their doctor told them he doesn't do VBAC and having another c-section is "no big deal." Hmmm...I beg to differ.

It seems we've scared pregnant women into the operation room. How sick is that?

Women shouldn't just be standing up we need to be SHOUTING!

Can humanity survive the safe cesarean?

I read this today and wanted to share it with you. At the end of Ricki Lake's film, The Business of Being Born, obstetrician Michel Odent wonders if women stop giving birth naturally and the cocktail of love hormones released during natural birth ceases what will happen to our capacity to love as a society? It's an interesting question. Below Odent continues sharing his thoughts on this...

Today, we understand that to have a baby, a woman - like any other mammal - has been programmed to release a cocktail of love hormones. Today the number of women who actually "give birth" to babies and placentas thanks to this hormonal release is ever-decreasing. First, because many women give by birth by cesarean. Second, most of those who give birth vaginally receive pharmacological interventions. Unfortunately substitutes block the release of the natural hormones and do not create the same behavioural benefits. We have to wonder what will happen, in terms of civilization, if this trend continues in future generations. Can humanity survive the safe cesarean?

~ Michel Odent, MD
Excerpted from "The Future of Obstetric Technology," Midwifery Today, Issue 85

Curing versus healing

I attended an interesting talk yesterday by Abraham Verghese. Verghese is a brilliant writer, but he's also a doctor and this is why I went to see him speak last night.

He spoke quite a bit about his position at Stanford University's medical school...it's quite unique and some might say, radical. His job is to encourage third year medical students to stop thinking of patients as "ipatients" - interacting with them primarily by looking at their test results on a computer - and instead get to their bedside, sit with them, take lengthy oral histories. This, he says, is when true healing can occur.

I saw so many parallels to what he was saying as it relates to maternity care today. The "ipatient" generation is a significant problem: pregnant mothers in labor are monitored in the hallways of hospitals, everyone standing around looking at their numbers on the computer, and few people are going in to deeply interact with these women. As a result of medicine's obsession with technology, Verghese points out,the art of medicine is being lost and it's to the detriment of the patient. In the case of maternity care, mothers are treated based on their numbers, not on their detailed physical and spiritual (emotional) history. This, Verghese stresses, results in inaccurate treatment and even worse, while the patient may be cured (ie, the baby being delivered is healthy and the mother is alive) true healing has not occurred (ie, perhaps the mother is physically or emotionally injured by the experience).

I'm thrilled to see Verghese gets it and isn't afraid to take his medical colleagues to task on this subject. But when are the majority of doctors going to get it? When is ACOG (the Association of Obstetricians and Gynecologists) going to get it? When are they going to put true healing first?

Make a short film about birth!

Calling all muses!

Enter a contest intended to educate women about the choices they have during pregnancy and childbirth. Birth Matters Virginia (an organization that works to promote an evidence-based model of maternity care) is inviting mothers, fathers, filmmakers, film students, birth advocates, and others to create a 4-7 minute educational video about birth. The first-place winner will receive a cash prize of $1000. Second place $500 and an "honorable mention" prize of $100 will also be awarded. The deadline for entering the contest is Mother's Day, May 10, 2009.

For rules and to see how to enter, please visit http://www.birthmattersva.org/videocontest.html

You can also join our Facebook group (whether or not you intend to make a video) to get updates about the contest and exchange ideas with other participants at
http://www.facebook.com/group.php?gid=73753459808#/group.php?sid=e146cf29ff029d1148a6a465af742146&gid=73753459808

There goal is to get as many people to enter as possible so that YouTube is inundated with videos about mother- and baby-friendly pregnancy and birth care so that more people are educated about their options.

Now that's BOLD!!!!

Octuplets versuses midwifery

I've been searching for coverage of the AP story on "home birth advocates pressing for a pro-midwife campaign" and only found one major news outlet MSNBC covered it so far. Meanwhile a mother of 6 gives birth to octuplets recently and every news station has covered every angle of this story. (If I see Dr. Sanjay Gupta on CNN interviewed one more time on this subject I'm going flip out!).

Do we need to throw in the word "orgasmic" for people to cover a serious childbirth story? (and we already found out where that got us -- see my comments on the 20/20 piece about "orgasmic birth").

The lack of coverage on a serious childbirth subject - one that could radically reform health care to a cheaper, saner, more compassionate place for pregnant mothers - speaks volumes of how women and childbirth are viewed in our society.

Maybe if news organizations covered childbirth more responsibly people will stop giving women "push" presents and demanding that women get better maternity care.

What news story is going to improve more American lives - getting people to think about reforming maternity care or getting people to see show after show about a woman who gave birth to 8 children? When are news organizations going to start being responsible?

Okay, I'm a little grouchy today. Perhaps it's because my son told me the groundhog saw his shadow...6 more weeks of cold winter weather!!!

Rock on, Erykah Badu

Erykah Badu just gave birth at home in Brooklyn, New York and blogged about it.

Keep speaking out celebrities!

Home-birth advocates press pro-midwife campaign

This just hit the AP wires today. Let's hear it for The Big Push for Midwives! You ROCK!

http://www.google.com/hostednews/ap/article/ALeqM5i8fJ2C7TgNkq8F70slj14c7HwR1QD960CNDG2

I'm off to feed my kids

BOLD Red Tent - Paris

Our BOLD organizer in Paris, France sent me a link to a YouTube presentation of their BOLD Red Tent last year. Check it out!

http://fr.youtube.com/watch?v=grzeLsrjc4Q

C-Sections to Blame for Childbirth Complicatons

Need more evidence that choosing a C-Section could be dangerous for your health? Several newspapers this week have reported a study published in the new issue of Obstetrics & Gynecology linking the upward swing in the number of Cesarean sections performed in the United States to rising rates of serious complications in women giving birth.

"By examining hospital discharges nationwide, a team of researchers found that rates of kidney failure, respiratory distress syndrome, shock and ventilator use associated with childbirth climbed more than 20 percent from 1998-99 to 2004-05, while rates for pulmonary embolism and blood transfusions rose 50percent and 92 percent, respectively...Researchers said more frequent delivery by C-section--a major surgery--seemed to explain or contribute to the increases."

Think it's time we stop bashing birth advocates for trying to raise awareness about the dangers of C-sections? How about holding those pushing unnecessary C-sections accountable for their actions?

Sure, everyone has a right to choose what birth they want, but with women being denied VBACs (vaginal birth after cesareans) at so many hospitals in the United States and few understanding the risks of C-sections (and that entering most hospitals today moms have a 1 in 3 chance they'll have a C-section) we have to ask ourselves does choice really exist for the majority of pregnant women?

Studies like these need to be a wake up call to hospital administrators, doctors and those who work for insurance companies deciding coverage for pregnant women. Is the dollar above pregnant women's health?

Childbirth, Choices, Fears

As we head into Inauguration Weekend here in the United States I have been thinking alot about how fear fuels so much of how our society acts and how fear leads us to make poor choices, clouding our instincts.

This week I had tea with a girlfriend, the mother of two boys 4 and 9,who shared with me her health saga. For the past year she has struggled with a wide range of debilitating symptoms including fatigue but more recently disturbing vision problems (several months ago she went for over 24 hours with blurry vision, more recently letters in words seem to disappear). She has seen several doctors and no one seems to know what's wrong or think much of it. Meanwhile, every day she struggles with her health. As she spoke I wondered why she has not seen a health care provider outside the traditional medical model of care - these days acupuncturists and chiropractors seem almost mainstream medicine! - but the response I got was this: "my husband doesn't believe in that kind of stuff."

Oh boy, I thought, I've heard that line before. That's the classic line so many mothers told me when I wrote my play of why they did not make the choice to have a a midwife or a doula.

I'm often surprised when people don't get that there's a childbirth crisis because there clearly a health care crisis in America (if you've seen Michael Moore's film SICKO you know what I mean). But the deeper issue in all of this seems to be fear and how people make choices entrenched in the culture of fear.

How is it possible that a mother is unable to see and can barely get out of bed in the morning and she's not going to see an acupuncturist, chiropractor, energy healer and every other care provider who can provide a different model of care from the one that is clearly not helping her?

Why do we have so much faith in fear, but little faith in ourselves?

As Americans head into Inauguration Weekend, with the promise of hope upon us, my hope is that fear can begin to take a backseat to hope, that women can access their true selves once again and reclaim their innate sisterhood - in childbirth and life.

Once childbirth choices are no longer made from a place of fear the revolution will have begun.

Birth stats finally out

Official 2006 statistics in the United States for childbirth are out. Cesarean rate is officially 31.1%. But remember, these are 2006 STATISTICS. It's now 2009. I'm wondering how long it's going to take before we see 2007! Hmmm...

Check it out: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf

Happy BIRTH-day

to my youngest son...and me! Eight years ago I gave birth at home to a beautiful little boy at 3.34am on January 12th. Wow, how time flies!

Tonight we went out for Indian food for my son's birthday - his favorite food (see photo above!). After I got home my husband and I watched his birth on video as we do every year on his birthday. But this year I gave a chuckle that we went for Indian food, remembering that eight years ago on the night I gave birth to him my husband, myself and our oldest son went out for Indian food. It all made sense!

Washington Post doesn't get it

Well, I had high hopes yesterday when I saw the front-page piece in the Washington Post titled, "Early Repeat C-Sections Increase Risks, Study Finds." Finally, a study was on the front page informing women that having a repeat C-section increases risks to their babies especially if the section is done before 39 weeks. These are new findings in the recent New England Journal of Medicine.

But no...the article completely missed the point when it comes to mothers and their birth choices. First off, how can you mention repeat c-sections and not at the very LEAST mention the volatile VBAC (vaginal birth after cesarean) issue? The Washington Post explains the reasons for the rise in repeat cesareans as a "subject of intense debate" (right!) but then goes on to list some of the reasons and never mentions that ACOG (American College of Obstetricians and Gynecologists) issued guidelines several years ago on repeat cesareans that have resulted in many hospitals denying women who have had one cesarean the right to try to have a vaginal birth for their next birth. So the Washington Post's simple statement, "once a mother has a C-section, she is much more likely to deliver subsequent children the same way" is misleading at best. The more accurate way of putting it would be, "once a woman has a C-section, she is typically not allowed or strongly encouraged to have another C-section despite evidence that does not support this."

Here's my point: to even mention a study about repeat C-sections we have to tell the truth and face the fact that women in America are not given the option to do anything but another C-section. So the statistic given in this article that "13,258 (C-sections) were clearly elective" is wrong. If your hospital or doctor doesn't allow VBAC for women who are low risk and meet the standards to have a VBAC that's NOT an elective C-section to me. That's a human rights abuse on women.

If this wasn't bad enough the Washington Post goes on to tell us this study can help women make decisions about timing their C-sections. WAIT! Maybe this study should also make us reflect on whether ACOG and others are putting low risk women and their babies in physical danger by denying them VBAC? Sure, some women need C-sections, I get it - but many women do not and this needs to be addressed. The risks of C-sections, and especially repeat C-sections, are so clear that to encourage women to have them smells like a human rights abuse to me.

Okay, and finally, the piece of course had to end on the "birth as illness" note. The real kicker which was predictable but sad to read was the quote at the end of the piece from a doctor who warns women, "how many babies may have died waiting to get to 39 weeks." Come on...stop scaring women (and their friends and family). If you make a statement like that give us some evidence and especially give us some evidence of in how many low risk pregnancies babies died waiting to get to 39 weeks." Put women's interests first, not the medical community.

Beam me up to Planet Normal Birth - right now!

BOLD 2009 registration starts January 15th

Here's the plug: want a groovy way to raise awareness about childbirth and make it better for mothers? Organize a BOLD event! Registration begins January 15th. Request an application to do a Performance or Red Tent.

Yes you CAN!

20/20 on childbirth - ugh!

Well, I don't know about you, but I was disappointed when I watched 20/20's show on childbirth on Friday, January 2. First of all, it was called EXTREME MOTHERHOOD. Now I get that most women aren't having orgasmic births and home birth is also rare, but calling it "EXTREME"? And then sandwiching between these two segments a truly extreme story about women who buys dolls and mother them instead of real babies? Come on...

And that's not all. Could the correspondents who did the childbirth pieces on Orgasmic Birth and Home birth be any more judgmental in their tone of voices? I was appalled at how biased these correspondents were. Yes, filmmaker Debra Pascali-Bonaro and Ricki Lake made some fabulous points, but when right after they make those points the 20/20 correspondent puts down their points I felt like I was watching a tabloid entertainment show.

And finally (yes, the hair on my back really rose with this next point!) the home birth piece was completely, utterly misleading. They interspersed Laura Shanley, a well-respected pioneer in the unassisted birth community, with Ricki Lake who was not talking about unassisted birth at all. I nearly fell off my couch when Elizabeth Vargas talked about women who decide to have their babies at home with no medical care provider present and then proceeded to talk about home birth without making the CRUCIAL distinction that home births are attended by medical care providers while unassisted home births are not. I might have thought I was crazy and misheard something if it wasn't for my mother calling me at the end of the segment and she too felt it was totally misleading and made home birth sound even more extreme than it is.

I hope someone out there who didn't know about childbirth walked away thinking they might want a home birth or an orgasmic birth, but quite honestly 20/20's take would have had me running from these experiences...and my mother most definitely wouldn't be in my court.

What a way to start off the new year.

Midwives Corps?

Okay, one more comment about Jennifer Block's piece in today's LA Times. I LOVE her idea of Obama's administration setting up a Midwives Corps to recruit and train midwives! And I love it not just because 20 years ago I was a Peace Corps volunteer, I love it because we need a birth-friendly culture in this country (not to mention the world!) and more midwives equals more birth friendliness. That's the bottom line.

The evidence is there to prove midwives make economic and societal sense. Let's make it a reality!

Click here to suggest Obama set up a Midwives Corps. Reference Jannifer Block's article. I know it's Christmas Eve, but this is one present that can't wait!

Number one reason people are admitted to hospital

Childbirth is the number one reason people are admitted to the hospital in the United States, Jennifer Block points out in an Op-Ed piece in today's Los Angeles Times. And childbirth costs the U.S. far more than any other health condition. Her conclusion? "America needs better birth care, and midwives can deliver it."

Kudos to Block for boldly making the case that one of the best places health care reform under President Obama can start is at the beginning - birth. I couldn't agree more.

"The joint Milbank report conservatively estimates savings of $2.5 billion a year if the caesarean rate were brought down to 15%," Block states.

$2.5 BILLION???

What are you waiting for Obama and Daschle?

Let's flood Obama's office with this suggestion to get more midwives assisting low risk deliveries!

Click here to do it!

Teaching a Wake Up Pregnancy course

"Wake up" is something I want to say alot around pregnant women, but often I find it too rude so instead I say "it's important to become an advocate for yourself." I've been thinking alot about this lately, about what it's going to take to get mothers to think critically about their birth experiences before their births.

I wrote my play hoping it would get pregnant women (and their family and friends) to wake up about the state of childbirth in America. But lately I find myself thinking of how to use the play in other ways. I've often dreamt of teaching a group of pregnant women a childbirth class right off the pages of my play. An 8 week "wake up" course where we watch one story in my play per week (or read it aloud) and then methodically go through each woman's story looking at what choices she had, didn't have, how she could have made better choices or what she did right and how to use that insight in a woman's birth experience. The goal would be BOLD...for every woman in the course would go on to have a "my body rocks" birth.

We've got to find new, creative ways to educate pregnant women.

On a week when we're winding down the year and dreaming of 2009 this is my dream - make childbirth education fun...use a play to get women to "wake up" and have a terrific birth.

"Shut up, close your mouth and push"

Unfortunately it wasn't shocking to read in yesterday's Chicago Tribune the story of a mother being told by her doctor when giving birth to, "Shut up, close your mouth and push." That's why I wrote my play. I've heard some incredibly rude words said to pregnant women while pregnant and giving birth. This isn't doctor bashing, this is telling the truth. We do it all the time in BOLD Red Tents, but this time a mother has decided to file a lawsuit claiming abuse.

Let me tell you - this mother is not alone. Sandy in my play had incredibly abusive things said to her (the play doesn't even use everything because it just seemed so unbelievable that any woman would be spoken to that way). After Sandy's birth she joined a listserv and happened to mention how she was treated at this hospital and 14 other women immediately emailed her to also share their abuse stories. Most of it was verbal abuse, like this Chicago woman. So they formed a group and wrote the hospital a letter and eventually got a meeting with a senior person who listened to them, but it was obvious nothing would change. They found a lawyer and considered a class action suit against the hospital, but the lawyer said verbal/emotional abuse is hard to prove. He was quite blunt: it would take a mother or baby getting physically injured to make a viable lawsuit...not just 14 mothers who were verbally abused on one of the most important days of their lives. So these 14 mothers backed down, they went back to their homes, many of them joined the International Cesarean Awareness Network group and they processed their abuse silently, without most of their friends, family and our society knowing.

Something is wrong with the fictitious picture of childbirth most people have today.

In too many cases mom is returning from the hospital NOT okay emotionally and sometimes it does stem from emotional abuse at the birth that even she is not able to identify.

This reminds me of a line from the play, shouted by Sandy to her labor and delivery nurses at the end of her birth:

YOU'RE IN THE HAPPY PLACE IN THE HOSPITAL, THE MATERNITY WARD! WHY ARE YOU NOT HAPPY?!!!

While I'm furious when I hear a laboring woman has been told "Shut up, close your mouth and push" I also feel compassion for all sides. There's something deeply wrong with maternity care when any care provider shouts words like this. Why are they not happy?

URGENT: Invite Tom Daschle to Missouri!

The Big Push For Midwives is on it again. This is urgent - as in you need to write a letter by tomorrow, December 17! Obama's new Health and Human Servives Secretary, Tom Daschle, wants to attend Health Care Reform Meetings. Make sure he hears about the Midwives Model of Care and how it benefits low risk mothers!

Read on...

PUSH ALERT Dec. 2008

Greetings Pushers!

This mission, should you choose to accept it, could help push the pile in a big way for the new Midwives Model of Care paradigm.

This past week, we learned that new HHS Secretary Sen. Tom Daschle is graciously open to attending one or more Health Care Reform Community Meetings (http://change.gov/newsroom/entry/daschle_asks_americans_to_help_reform_health_care/) as outlined at Change.gov. The window of opportunity for him to attend is for meetings held in homes and neighborhoods between Dec. 15 and 31.

Initially, there was a thought to organize as many community meetings in as many homes and neighborhoods as possible during this timeframe ... "Imagine it! 1,490 people emailing in from every state in the nation to share about 1,490 different community meetings all about the Midwives Model of Care!!" ...

And then the magnitude of even requesting that undertaking hit us, and we sat still a bit longer. "Okay, well then imagine we have 1,490 people emailing in from every state in the nation to share about *just one singular* community meeting all about the Midwives Model of Care!! ...Many voices. One Message. Meet. Us. Here."

Ah, yes. This sounds like fun.

Where to have it? NYC? DC?? .... Naw, the Heartland!

And so we are planning a meeting, and our great hope is that Sen. Daschle can join us. Our "Maternity Care Community Discussion in the Heartland," is planned for 2 p.m. on Sat. Dec. 20. We have reached out to him, as well as U.S. Sen. Claire McCaskill and U.S. Rep. Emanuel Cleaver, and their key staff as well, and have received early positive word from Sen. McCaskill's office. We expect to receive confirmation from the Congressman's office very soon. We are also reaching out to key state and local legislators here in the Lee's Summit area. Many other hands are making light work as we scramble to put this event together by next Saturday!!!!

NOW is the time for your urgent mission. (You can do it from any place with Internet access in the whole wide world, and Please Do As Soon As Possible!!).

PLEASE HELP US REACH OUR GOAL OF 1,490 SIGN-UPS ABOUT THE HEARTLAND MEETING BY WEDNESDAY, DEC. 17:

1) Please go to link about the Health Care Reform Community Meetings
(http://change.gov/newsroom/entry/daschle_asks_americans_to_help_reform_health_care ) and read more about Daschle's ear to the rail during this next two weeks.

2) Click the "sign-up here" link (http://change.gov/page/s/hcdiscussion)

3) Cut and Paste the following information into the text fields and click "Submit Form"

4) Forward this message to 5, 50 or 500 of your closest friends and ask them to repeat steps 1 through 4.

5) Do a little happy jig BECAUSE YOU PUSH IT REAL GOOD! (and hey, if you can get yourself to Lee's Summit this Saturday, we can do another one together!)

Note: After completing the form, you will receive nearly instant email from the Obama-Biden Transition Project thanking you for signing up as a "Lead Moderator" with links to download Moderator and Participant Guides. These guides are not specific to maternity care reform but focus on larger health care reform issues.
================================
You’ll find boxes on the form to fill in as follows:

EMAIL: *
Insert your email address

FIRST NAME: *
Insert your first name

LAST NAME: *
Insert your last name

ZIP / POSTAL CODE: *
Insert your Zip / Postal Code


EVENT ADDRESS

STREET ADDRESS: *
509 SE Miller Street

CITY: *
Lees Summit

STATE: *
Missouri

ZIP: *
64063

DATE AND TIME OF EVENT: *
Saturday, Dec. 20 at 2 p.m.

PLEASE DESCRIBE YOUR EVENT: *
Missouri Senator Claire McCaskill and Congressman Emanuel Cleaver and their health policy staff have been invited to join us for our “Maternity Care Community Discussion in the Heartland.” The community meeting will convene at a home in Lee’s Summit to discuss one critical aspect of health care where reform is desperately needed: the current U.S. maternity care crisis.

WHAT ARE THE MAJOR AREAS YOU WANT TO DISCUSS?: *
Our conversation will address Missouri's recent failing grade on the March of Dimes 2008 Premature Birth Report Card. Missouri ranks 34th in the nation with a 13.3% preterm birth rate.

We will also discuss the cost impacts of our current maternity care system. As the national organization Childbirth Connection reports, childbirth is the leading reason for admission to U.S. hospitals, and hospitalization is the most costly health care component. Combined hospital charges for birthing women and newborns ($75,187,000,000 in 2004) far exceed charges for any other condition. In 2004, fully 27% of hospital charges to Medicaid and 16% of charges to private insurance were for birthing women and newborns, the most expensive conditions for both payers. The burden on public budgets, taxpayers and employers is considerable.

On the national scale, a recent American Journal of Obstetrics and Gynecology report stated that “Despite spending more of our gross domestic product on health care than any other industrialized country, the United States currently ranks 17th in the world in perinatal mortality rate, outcomes that, according to the World Health Organization, are largely due to obstetric causes.”

As Michael McGuire, CEO of UnitedHealthcare, a health-care insurance carrier, wrote recently: “Obviously, reducing the number of premature babies increases the number of healthy babies. Not so obvious or widely known, however, is the corresponding decrease in medical costs associated with having fewer premature births.”

Finally, our meeting discussion will touch on expanding access to the Midwives Model of Care, an evidence-based maternity care model that provides mothers with not only medical support, but education, emotional support, psychological support and social support, a lot of the things proven to result in healthy birth. The Midwives Model of Care has been proven to reduce the number of c-sections and birth trauma experienced by laboring women.

A recent Washington State study, using conservative cost estimates, estimates that the state’s licensed midwives program, over two years, resulted in recoveries from Medicaid Fee for Service (FFS) alone at more than $473,000. Cost savings to the health care system (public and private insurance) is estimated at $2.7 million.

These estimates demonstrate that even the most modest favorable effect on lowering the csection rates associated with licensed midwives leads to substantial savings to the health care system, as well as lower medical risk and cost to families. What if Missouri implements such a program? How much can we save? What if ALL states implement such a program? Specific to upcoming federal legislation, what if birth centers, where many midwives practice, were added as official mandated Medicaid providers? How much can we save then? Both in financial and human costs.

WHY SHOULD THE HEALTH POLICY TEAM SEND SENATOR DASCHLE TO YOUR EVENT?: *

As a recent piece in the Boston Globe notes, health care reform “has focused intensely on two key questions: How much would reform cost and how many people would be covered? It also must address the critical issue of why the United States has such poor health outcomes despite all the money we spend.”

The first step in maternity care reform centers on recognizing that our problems go beyond the secondary issue of insurance coverage and access to care. As the Globe states, “This is not just about who gets care, but about how they’re cared for. Expanding access to a system that doesn’t work won’t change our embarrassing rankings.” Our community, our state, our nation, must immediately shift its ingrained belief “that more medical intervention, regardless of cost, is bettereven when the evidence doesn’t support such a claim.”

We must improve our maternity model, as demanded by the urgent problems with maternal and infant health, excess bad outcomes (premature, very low birth weight babies), and the infant mortality gap between the races that has been widening in recent years. In 2007, new numbers from the Missouri Department of Health and Senior Services showed the state’s infant death rate for African-Americans live births was more than 2.7 times the white rate. In addition, Missouri c-sections have increased by 68 percent since 1997, reaching a record high of 30.9 percent of all births.

Senator Daschle should come to the Heartland and hear the strengthening voices of mothers and families. He should sit with us as we discuss the urgency of the maternity care crisis and how the integration of the Midwives Model of Care into our states’ health care systems plays a pivotal role in improving maternal and infant health.

Senator Daschle, please join us.

================================
If you wish to include other stats that you have from your state in addition to the Missouri stats, please do so.

And again, thank you so much for forwarding this message on (and on and on) to any others who might accept this PushMission too!!

We truly appreciate your support for the Big Push for Midwives Campaign. Together, we are working toward our vision of quality maternity care across a continuum of birth settings and provided by licensed and certified birth attendants. We are envisioning a new model for the delivery of U.S. maternity care at the local and regional levels at the heart of which is the Midwives Model of Care, based on the fact that pregnancy and birth are normal life processes.

Steff Hedenkamp
Home birth mom of two
Communications Coordinator, The Big Push for Midwives Campaign
redquill@kc.rr.com
816-506-4630
Lee's Summit, Missouri

BOLD movement can't hold back tidal wave

BOLD 2009: Lansing, Michigan (notice the first girl acting in a BOLD production!!!)


In 2009 the BOLD movement is expecting to grow given the ripe childbirth issues that are swelling these days! Starting January 15, 2009 our performances can be produced year-round. We just couldn't hold back the tidal wave of mothers who want to bring change in childbirth to their communities.

We already have an exciting number of communities ready to be BOLD – from multiple locations in France and Austria to a traveling cast throughout the boroughs in New York City starting in Harlem and our BOLD organizer in Maui Robin Garisson just reporting she got a grant to bring the play and BOLD movement to Maui again with a local Hawaiian flavor.

I’m juiced, and so are so many others, to keep this movement alive, fresh and preparing women to get ready for what’s possible in childbirth.

Dear Santa: BOLD's 2009 holiday wish list!

Here's BOLD's 2009 wish list!!! (even in a bad economy, mothers gotta wish!)

We have three priorities this year:

- finding sponsors so we can begin to pay our small, passionate staff of volunteers

- building and engaging our supporters base,

- and challenging our new BOLD organizers to start “pushing outside the choir,” raising more awareness among the unaware to create a permanent paradigm shift in childbirth.

Sponsors are critical for our survival, supporters are our muscle power, and people who never even considered childbirth as a women’s rights issue or pleasurable birth options are exactly who need to “get it” in order for an attitude shift to take place.

Here's what you can do:


* Send BOLD a holiday gift of $25 or more. Do it to honor your mother, sister, friend's birth. Click here(note:we're listed as "Birth on Labor Day")

* Want to be a sponsor of BOLD or know a great sponsor we should contact. Tell us! Email info@boldaction.org.

* A movement needs people - help us build our base of supporters. If you have a mailing list of people - or just a list of friends of relatives - you think would be interested in being a part of the BOLD movement email us that list and we'll include them in our next newsletter (note: they can always unsubscribe!). Email us your list at info@boldaction.org.

* Be BOLD and consider organizing a BOLD event in your community for people who are not aware of what's going on in your birth community. For BOLD Performances and Talkbacks email: performance@boldaction.org. For BOLD Red tents email: redtent@boldaction.org.

* Got a copy of Dreamweaver? We need it! Email us at info@boldaction.org.

*Want to organize a fundraiser for BOLD? (host a screening of Orgasmic Birth or The Business of Being Born!). Contact us at info@boldaction.org.

Well, that's it! Thank you for making our wish list come true!

Interview with me on Healthylife.net

Oops... I was on a radio show Friday and couldn't post to listen live because my internet was out until today(due to a nasty ice storm!). You can check out an archived version:

http://www.ecstreams.com/HealthyLife/wma/hyp1212_wma.asx

Warning: It's an hour-long show! But it was great fun...we covered alot of important issues about childbirth today.

Orgasms when you're giving birth?

Not surprisingly, the word "orgasm" has ignited a fire in Americans' bellies this week - thanks to a brave filmmaker, Debra Pascali-Bonaro, who decided to make a documentary about women who had orgasmic birth experiences.

I'm thrilled Pascali-Bonaro's film, Orgasmic Birth, is getting press, but let's not jump too high about the orgasm reference. Sure, some women do have orgasms and people like Dr. Sarah Buckley are fabulous at explaining the science behind how this could happen, but an "orgasmic birth" doesn't mean every woman is going to have an orgasm. I think it's more accurate to say it's about pleasure...women enjoying their birth experiences, having an ecstatic moment when giving birth, rather than a literal orgasm.

I hope this film is covered for it's boldness in telling women that they can have a baby and it can be a pleasurable experience. Not pain-free necessarily. Some of the best things in life come from hard work and a great attitude.

Sounds like a recipe for an orgasmic birth to me!

Check out Lisa's Belkin's blog on the NY Times website. It currently has over 500 comments on this topic! To weigh in go to:

http://parenting.blogs.nytimes.com/2008/12/11/orgasms-during-childbirth/

and then check our her follow-up:

http://parenting.blogs.nytimes.com/2008/12/12/some-thoughts-from-tamra-larter/

Bolivian women stay home to have their babies

Oh my...more and more Bolivian woman, recognizing how much the hospital environment prevents them from having empowering births, are staying home to have their babies.

http://www.womensenews.org/article.cfm/dyn/aid/3839/context/cover/

When are American women going to wake up to this understanding? I'm not talking about a hospital versus home birth debate - childbirth is not a competition - I'm talking about understanding that to have a fabulous birth experience you have to choose a birthing environment where "fabulous" is on the menu. Once more women follow our Bolivian sisters in taking back childbirth that's when the childbirth horror stories are going to finally stop.

Nelson Mandela and childbirth?

Last night I was reading a book and came across this quote from Nelson Mandela:

Our deepest fear is not that we are inadequate.
Our deepest fear is that we are powerful beyond measure.
It is our light, not our darkness, that frightens us.

How does this relate to childbirth? Just think...most women today think their deepest fear in childbirth is that their bodies' are inadequate to give birth...that they can't do it. As one woman who I interviewed before I wrote my play told me she thought it was gross the idea of a baby coming out of her ("I'm not an Earth Mama," she told me). Ironically, as Mandela points out, this is not our deepest fear when it comes to childbirth. I think women's deepest fear is that they are "powerful beyond measure."

And women are. Powerful.

When we claim our power we raise the stakes. When a woman is pregnant and claims her power fear is not part of her equation. She knows she can give birth. She knows, as Amanda in my play says, her "body rocks." So she surrounds herself with people who trust birth, believe it's normal, gets a midwife if she's low risk...at the birth the lights are dim, soothing music is playing, she is allowed to get up, sit down, dance, sing...do her thing...and she does, she does it beautifully, safely, and when the baby is out the baby is put immediately on her body...skin to skin...for bonding, for the love hormones...all because she embraced her power.

Sounds wonderful, right? Then why is claiming this power so scary for women today?

BOLD mentioned in 20/20 online piece

This Friday's 20/20 piece is being preceded by an online article "Labor Orgasms Called 'Best Kept Secret'" and BOLD is mentioned!

Check it out: http://abcnews.go.com/Health/story?id=6120045&page=1

Waa-hoo!

Memo to Beyonce: Your Body Rocks!

It's definitely time for Beyonce to channel her Sasha Fierce. In this month's Elle she says what terrifies her most is childbirth. And if you read the majority of blog entries after her piece alot of other women agree with her.

Memo to Beyonce: Your Body Rocks! Sasha Fierce knows how to have a "my body rocks" birth...and you can too.

Beyonce (and several women who posted on the blog after the piece) mentioned being at a "friend, sister, cousin's" birth and being traumatized from it. I guarantee you they did not attend a homebirth or probably a midwife-assisted birth at a birth center. They saw a woman giving birth in a typical hospital today - which can be traumatizing (a woman laying flat on her back being told when to push isn't an empowering picture). That's why we have to be BOLD and look for birthing options that assist us to have "my body rocks" births.

Beyonce, I know you can do it. You ROCK!

Skylar is 4 months!

I attended the birth of my friends' baby, Skylar Dawn Sullivan, and while the arrival of Skylar was filled with joy, her mother - Kathy - was not so joyful at what she went through at the hospital to give birth (see my "Think About It" posting in July describing her birth story).

Well, the good news is that Skylar is now 4 months, bright-eyed, happy, giggly and Kathy - who for many nights called me in that manic "how am I going to breastfeed this baby?" stage any mother knows who found it hard to breastfeed - is now exclusively breastfeeding Skylar and has created a special bond with her despite her rough birth story.

As I watched Kathy feeding Skylar I thought of how insistent we were with the hospital staff that she breastfeed in the recovery room, how they let me and her doula into the Recovery room to help Kathy who didn't have a clue what to do and was drugged out, and how when I told the hospital lactation consultant that Kathy breastfed immediately in the recovery room - when the baby was fully alert and eager to feed - she said this was a huge victory as it almost never happens at that hospital. And that made me think: instead of focusing on what went wrong on the day Skylar was born, why not focus on what went right?

Pain-Free Birth?

This came across my desk today, from Midwifery Today, and thought I'd share it.


Inevitably, in discussions about unassisted or natural birth, the topic of pain-free birth rolls around. When it does, I wonder if striving for a "pain-free birth" doesn't inadvertently miss the potential beauty of natural birth itself. I don't believe birth is meant to be pain-free, in fact, I believe it's far more than that! I believe, and have experienced, birth to be downright ecstatically, blissfully pleasurable.

"Pain-free" doesn't even come close to describing that experience. That's like calling a high sexual union with your mate "pain-free," or the most breathtaking sunset you've ever seen "ugly-free." I think that as long as we're focusing on getting rid of or avoiding pain, we're focusing on the wrong area and we're completely missing the point.

There's also the idea that birth is painful but simultaneously pleasurable. Which is it? I just can't buy into the whole "no pain, no gain" paradigm, or the description of the "joy pain," or sacrificing to experience joy. How is pain joyful? How is joy painful? Given the opportunity and knowing it was natural and healthy, wouldn't we all forgo the pain each and every time? I think the folks who believe that no woman should have to suffer through childbirth have the right root but, through fear and ignorance (and perhaps greed, in the case of the pharmaceutical industry), have climbed up the wrong tree.

I don't deny at all that these things get very mixed up in our cultural conditioning, and most of us have confused and enmeshed the two. Most of us, unfortunately, have instances in our upbringing and lives where pleasure and hurt were closely connected and became entwined. For some people this goes as far as masochism, where no pleasure can be experienced unless there is pain (or a lot of intense therapy).

But is this natural? Does this happen in nature when there is no interference? Would undomesticated animals raised in a natural environment really endure a painful situation willingly because they also somehow convinced themselves it was pleasurable? I wonder.

Prolonged pain is, in my opinion, a sign of blocked energy, whether physical, emotional, environmental or other. I don't deny at all that pain arises (and denial is just a symptom of another kind of pain I think). I understand that there are millions of women for whom birth is extraordinarily difficult and painful, and I don't discount or question the reality of their experience. I'm not talking about denying feelings or striving obsessively for some ideal and judging ourselves if it is not reached. Both physical and emotional pain is still a regular, even frequent, companion on my life journey, especially in those areas where I am still learning what my natural expression is or where I am reluctant to make certain changes. But I no longer believe that this pain is inherently necessary or natural, as in "birth (or menses) is painful," or "burns/cuts hurt while they heal," or "teething hurts" or "rejection is devastating."

~ Ingrid Bauer
Excerpted from "Birth as Sheer Pleasure," Midwifery Today, Issue 68

Yes, I'm a Vassar Girl

I don't talk about my years at Vassar too much - my Freshman year I was told I didn't write well and needed to go into a class to improve my writing if I wanted to take a Vassar English class (which I never took!). But click here for a short a piece on me, the play and BOLD.

Thanks Vassar!

Negative or Truth?

I get an overwhelming amount of praise about the play, but with any important, political piece of art I also get people who don't praise the play. The biggest complaint seems to be that "this play is too negative."

It's interesting how this comment has affected me differently from year to year. When I first wrote the play I hardly felt phased by this comment at talkbacks after the play. My response was always a consistent: well, the truth is that maternity care is not working for many mothers, it's in crisis and that it's impossible to write a play showing the maternity care system in a positive light when there are so many c-section mothers, so many women being denied VBACs, so many mothers who STILL are given episiotomies without their consent.

Lately, though, I've felt a different response to the critique that the play is too negative. My first inkling is to agree...it IS negative and feel bad about that. Maybe it's all the rosy new films like Orgasmic Birth and Business of Being Born - who responsibly mention the childbirth crisis, but focus more on the tiny percentage of women having ecstatic, positive birth experiences - that has made me feel a bit guilty lately for writing a play that shows just how horrible our birth crisis is, that shows just how easy it is for women today to feel coerced into birth options that they do not want, to scream "No!" and not be listened to. I guess lately I've been feeling like, yes, this play can be tough to watch, and feeling bad about that. Like perhaps I should have protected people from this bad news by matching every tough hospital birth with an orgasmic home birth.

So, yes, I've been swimming in negativity guilt...for showing the play to 300 University of Florida students in a Human Sexuality class this Fall and getting an overwhelming number of comments saying they thought the play was unfair to the medical system, to doctors and they were now scared to give birth.

Hmmm...lots of food for thought...and then...

And then I watched a few talkbacks from BOLD 2008 performances last night...like the one in Columbia, South Carolina where a man in the audience commented how negative the play was - that it was skewed to just attack hospitals, etc - and then the BOLD organizer in South Carolina, Barbara, spoke up and said perhaps the play is skewed but she had just been a doula at 10 births at hospitals with really good reputations and she'd say 7 out of the 10 women she was with had at least one incident where they were treated incredibly disrespectfully by staff or physicians so, she said, "perhaps this play is skewed and perhaps that skew is the reality for alot of women giving birth today."

Cue: ton of bricks on my head.

And then a lawyer for the National Advocates for Pregnant Women went on and asked: "I'm wondering how many women in the audience thought these stories were exaggerated? Unfortunately they're not."

So it's back to the truth for me. That's why I wrote this play. That's why I'm BOLD!

BOLD Statements

Just got some photos from BOLD Duluth's 2008 performance of my play. Before their performance they asked their community to donate whatever they could to their event and with their donation write a "BOLD Statement" about childbirth. Above are a few of those statements...they filled the entryway of their performance that night with them!

Tell Obama What Kind of Maternity Care YOU want!

Susan Hodges, superstar grassroots organizer and director of Citizens for Midwifery, recently sent out an appeal to all Americans to make our voices heard on maternity care to President-Elect Obama!

Obama can't change what he doesn't know...let's tell him the truth about maternity care...from the mothers.

It's time for the problems and solutions about maternity care that mothers know to Trickle UP!

Here's what to do:

Read about Obama’s proposals for health care at:

http://www.barackobama.com/issues/healthcare

Click on the paragraph under "Present Your Ideas." This will take you to an online form you can use to offer your ideas on health care to the new administration.

Susan Hodges urges:

You can urge the administration to support increased access to midwives and to take a look at the Midwives Model of Care page on CfM's website (http://www.cfmidwifery.org/mmoc). Issues that could be brought up: The need for accountability for outcomes and costs in maternity care; the need for transparency so women can find out accurate information about the practices of maternity care providers; the need to address disparities in access to care and effectiveness of care. A policy for evidence-based practices in maternity care, including the Midwives Model of Care, would help to address these issues. We also encourage you to suggest that the new administration implement the recommendations of Childbirth Connection's Evidence-Based Maternity Care: What It Is and What It Can Accomplish." (http://www.childbirthconnection.org/article.asp?ck=10575) This will bring this comprehensive policy report to their attention.

The more the campaign hears from us about the problems in maternity care and the SOLUTIONS, the better!

Come on, Lisa Belkin...

Of course I should have seen it coming. The New York Times does a nice piece on home birth (okay, it was in the "light news" Home Section)and then another New York Times reporter uses a colleague's birth story to slam home birth and scare women into running to a hospital. That's what Family Life reporter Lisa Belkin did this week in her Motherload column (A Near-Death Birthing Story). She allowed a colleague's unfortunate birth story to be an example why women should not give birth at home.

Come on, Lisa.

I got the feeling that she, like many people, think home birth midwives show up to people's birth with a couple of wash cloths. In the case of this woman's birth story, who was discovered to be pre-eclampsic when she arrived at the hospital (which is a serious condition that makes her high risk) it's very clear to everyone who has had the pleasure of using a well-trained home birth midwife that this would have been diagnosed immediately at home and the midwife would have transported her to the hospital (with plenty of time - in the article the woman who gave birth says the hospital let her labor until 6 centimeters...a clear indication that a midwife who discovered her condition had plenty of time to get the woman to the hospital without threatening her life).

I can appreciate and sympathize deeply with a low risk woman who develops pre-eclampsia at the end of her pregnancy, but let's not use this story to deter people from using qualified midwives. That's irresponsible to women. Especially when there is such a high rate of cesarean and other interventions on low risk woman who do not need these interventions.Trained midwives are not sitting around a woman's house baking bread and boiling water - they are taking blood pressure, fetal heart tones, and they know women who are pre-eclampsic should not be giving birth at home.

Thankfully, the blog entries that followed the piece included several people who pointed this out, including this one:

There are always near-death horror stories that are dredged up to scare people away from home births. I am sorry for Catherine’s ordeal, but I want to point out (as someone who worked on a documentary about home birth) that midwives who practice home deliveries are very good at spotting trouble before it becomes an emergency and transferring women to hospital when needed. It is the expertise of these midwives that makes home birth safe. Catherine, her husband and her mother in the car didn’t know she was in danger, but this does not in any way correlate to what might have transpired if she had planned a home birth and was under the care of a trained midwife.

And, finally, at my own privileged Manhattan childbirth class, which was absolutely focused on natural birth, the instructors were clear again and again that we are not ever in control of our birth. In fact, successful birth necessitates letting go of the idea of control. You can have an idea of what you would like to happen, and it is good to think ahead about options, but when it comes down to it, your plans may be completely worthless.


If you want to add your voice to this piece click here.

PS: I should add that I normally love Lisa Belkin's well-written, perceptive pieces in the Times...which made this even harder for me to read!

Today Show on doulas

It's always nice to see doulas get mentioned, especially on national television, but this morning's Today Show piece was disappointing. I'm just wondering if Dr. Nancy Snyderman could look a little less interested in this topic? Her piece was "balanced" in the good and evil sense (good doula, really bad doula), but let's face it most subjects fall closer to the middle.

I thought it was irresponsible for her to interview a doctor in Reston, Virginia who has banned doulas from their hospital because they feel doulas get in the way from allowing women to make "the right decision" (TRANSLATION: The decision the hospital thinks is best) because many times women are facing medical emergencies (Yes, almost always due to medical interventions). A good investigative journalist would have to point out the disasterous medical statistics of most hospitals: over 30% c-section rates, etc and that this alone would suggest hospitals may not have women's best interests in mind in their labor and delivery rooms.

Also, as Ms. Snyderman hinted, if women did not hire a doula most are left to labor alone until they are pushing. Is that ideal for women?

I completely agree when anyone is considering taking on a care provider you must look at their credentials and ideally get firsthand feedback on them (this includes when a woman looks for an OB or midwife too), but when Ms. Snyderman suggested people contact their doctors about what doula they should use I have to stop and say to women: just remember, if you are going to a doctor that supports the kind of birth you want then this makes sense, but if you are going to a doctor who has a high cesarean rate and you want a natural birth then you better think twice before you take the doula that doctor recommends. I've unfortunately heard this story too many times: mom seeing a doctor who doesn't completely agree with how she wants to birth her baby, she hires a doula recommended by the doctor practice thinking this doula will be the key to her getting the birth she wants and then the disappointment that the birth she gets is what 90 percent of the doctor's patients have been getting.

The moral of this story: get educated women! Positive childbirth options are out there! Choices in Childbirth in New York City has done alot to promote safe, gentle birthing options through their Guide to a Healthy Birth. Check it out! (click here to get the guide)

3:52am

I woke up this morning greeted by my 2 sons and my mother (hubby is away for work) singing Happy Birthday to me. At 3:52am 42 years ago I was born. I hadn't thought about how special it would be to see my mother's face on my birthday...she always feels bad that she can't remember much about my birth other then being happy I was a girl and that I didn't have a cone head like my brother did....yet as I lay there in bed this morning (at 6am!) and stared into my mothers eyes I had a viceral experience of the first moment I met her at Englewood Hospital in New Jersey 42 years ago. We both may be older, but her loving eyes looked just the same.

I know presents will be opened tonight (my youngest son has been busy gluing and taping something that seems monstrous in size!) but in many ways I feel like I already got my birthday present for the day...mom.

Birth Activists Save Birth Center!

What great news - grassroots birth activists in Massachusetts have helped to save the North Shore Birthing Center! Hospital officials who made the decision to shelve plans to close the birth center noted in today's Boston Globe that the intense grassroots campaign to save the birth center "did not go unnoticed."

YES! Congratulations to all the families who marched and wrote letters and stood strong for positive birth choices for women. You ROCK!

Check out today's Boston Globe article: click here

BOLD Red Tent Kelowna, Canada on You Tube

Sometimes I'm left speechless and this contribution from the BOLD Red Tent in Kelowna, Canada did just that:

http://www.youtube.com/watch?v=4GtjDvjXdMo

Check out The New York Times

Check it out!

http://www.nytimes.com/2008/11/13/garden/13birth.html?_r=3&pagewanted=1&ref=garden&oref=slogin&oref=slogin

Yesterday's piece in the New York times on home birth had me dancing around my kitchen after I took my kids to school. Sure, it pointed out that ACOG (American College of Obstetricians and Gynecologists) is so against home birth they even recently convinced the American Medical Association to join them in the witch hunt. But thankfully this reporter had the sense to also cite that over in the UK their equivalent association of OBs said for low risk women home birth is beneficial.

It seems American women are slowly waking up to this reality despite ACOG's attempt to scare women into thinking it's common for low-risk pregnant women to suddenly become high-risk. Sure it is...in a hospital setting where a low-risk woman is given interventions. It happens every day. But when you don't intervene with drugs this is rare.

The only thing this article forgot to mention is that along with Ricki Lake's fabulous film there has also been a BOLD movement of activists doing my play for three years, over thirty BOLD Red Tents around the world this year gathering women to tell their birth stories, and these BOLD events have raised lots of money for grassroots birth networks and other needed services that expand birth choices to all women! (BOLD has raised over $100,000 for its beneficiaries since 2006. Oh, and let's not forget the film "Orgasmic Birth" showings around the world this year! There's alot that has contributed to swinging the childbirth pendulum and I'm proud of everyone who is out there contributing to raising awareness.

Also check out the slideshow from the New York Times' piece:

http://www.nytimes.com/slideshow/2008/11/13/garden/20081113-BIRTH_index.html

Get BOLD: Save a Birth Center!

A passionate and growing group of birth activists (including BOLD's 2007 Boston organizer Cathleen Barstow!) are furiously organizing to save the North Shore Birth Center in Massachusetts. There is a very serious move to stop all births at the birth center which would greatly restrict mother-friendly birthing options for women in that area.

This is a great opportunity to be BOLD for the women of this area!

THEY NEED YOU TO ACT NOW!

On November 18, 2008, the Board of Trustees of the Northeast Health Corporation will consider a proposal to no longer allow women to labor or birth at the Birth Center.

Will you take a moment to write a letter in support of the birth center? Click here.

And if you live in the area or know someone who does attend their rally on November 18th. They already sense the numbers at the rally will be high.

It's just incredible to me that with such strong research supporting birth centers and midwives this could happen. When's common sense going to surface?

If you're in to Facebook here's their link on Facebook:

http://www.facebook.com/group.php?gid=33650813774

The Power of Women Gathering

I receive alot of photos from BOLD locations, but last week I popped in the photos from BOLD Austin's BOLD Red Tent this year and I got to thinking about the power of women gathering...so many women gathering in BOLD Red Tents around the world...and how even when the numbers are only five or six this act of gathering bonds us, puts out the intention that women want childbirth to be the best it can be, women want to support all sisters through this journey, and women know that great change can come from small gatherings.

In swahili they say "pole pole" - slowly. Change is coming.

Rock on, BOLD Red Tents!

Yes We Can

Well, America spoke last night. As a community organizer, a mother, a writer...and a childbirth advocate...what I heard loud and clear were the words: Yes We Can.

Here are a few post-election day "Yes We Can's" from me...

Yes We Can find ways of bringing a hospital obstetrician and a home birth midwife together, agreeing to come to the table open-hearted, to agree to disagree but know that the common goal is increasing the number of (emotionally and physically) healthy mothers and babies.

Yes We Can say to our children that we will work hard to give all women access to safe birth choices so that when they become adults those choices will be available and considered normal.

Yes We Can envision a world where women in developing countries don't have to have a baby under a tree in their village with no qualified labor and delivery attendant or supplies available, where the women are given free care and treated humanely.

Yes We Can show the next generation of women and men that women's pregnant bodies ROCK so that they look for birth choices that pick them up.

Yes We Can build a movement of people who use every peaceful, nonviolent method to BOLDly tell our representatives that now is the time to make maternity care work for mothers, now is the time to treat women with respect in the labor and delivery rooms, now is the time to not just use the technology of saving lives but to use compassionate words with women having a baby so that compassion can spread into everything we do and are.

Yes We Can be BOLD.

Yes We Can!!!!!

This is why I'm BOLD

Got this email in my inbox this morning. Now this is why I"m BOLD (I've taken out the name of the hospital)...


My name is Julia. I am thirteen years old. I am not nor have been pregnant yet but I just wanted to tell you how much your program inspired me. I have heard of such hospital "horrors" as the things that some of the women were saying in the tents (the BOLD Red Tents). My own mother went through such during my own birth.

My mother gave birth to both my sister and I at XXX Hospital. XXX Hospital is a College and students were learning there so a student was giving my mother epideral. The student had tried six times to give my mother the epideral, failing to do so each time. After my father had been removed from the room by hospital security because he was demanding for a real doctor to continue, a doctor finally did come in and give my mom the epideral.

I'm sure that this is mild compared to some of the stories you've been told but I believe that no mother should be treated this way or any other way during the birth of their child. Isn't birth supposed to be a happy time for a family?


Thankyou for being such an inspirational program and just being a program!

Sincerely,

Julia

Choice

I just received an email from a very special nun I know in Tanzania. She is originally a midwife by training and has worked with poor women throughout Africa for over forty years...from assisting women having babies in refugee camps in Ethiopia to working in government hospitals with poor African women. She's really seen it all. So I thought it was interesting when she wrote this to me after reading the just-released book version of my play and the BOLD movement:

"I got the book/play as I was leaving for retreat and read it and so did all the Jesuits at the Retreat Centre; some (Americans) were aware of "Vagina........." and thought that they would love to see the play so I guess you will have to come to East Africa. One of them - an elderly NE man said : this is so interesting to read of as (in Africa) we hear so much of childbirth where women are "under trees, have no doctors etc" but these were women with choice ....but in fact with NO choice really."

YES...he got it! We think of poor women in Africa with no birth choices (and this is true - the risk of a woman dying in pregnancy in a developing country is 1 in 48)...but how could women in the "land of choice" (America!) in many communities have NO choice? (how could a woman in Chicago not be able to legally go to a home birth midwife???!!! or get a VBAC - vaginal birth after cesarean - in the hospital?)

Just a little Halloween food-for-thought!

Wanna buy the book version of the play signed by me? Email BOLD at info@boldaction.org.

Boo-hoo...no 20/20 tonight

20/20 has re-scheduled their segment on Orgasmic Birth for tonight. Probably better as much of the constituency it needs to reach are out trick or treating tonight!

Check out www.orgasmicbirth.com for when it will be rescheduled.

Orgasmic Birth on 20/20!

Set your DVR's! (it's Halloween night so for those of us who have young children you're going to need to tape it!)

Debra Pascali Bonaro's inspirational film, Orgasmic Birth, is going to be featured in a segment on ABC's 20/20 next Friday, October 31st.

Debra has put her heart, soul, and over 25 years of doula/childbirth experience into making this film a reality (she even mortgaged her home to help fund it) so let's tune in and support the film. It's an uplifting picture of what childbirth could be for every woman if we start embracing the concept of pleasure in our society.

Haven't a clue what an orgasmic birth is? It's the "waa-hoo" that the character Jillian in my play shouts at the end of the play...it's a woman giving birth on her terms in a room filled with love and trust in her and the process of giving birth...it's a euphoric state that women can achieve (and sometimes even an orgasm) when the same hormones that come out when we have sex are released from the act of giving birth (check out Dr. Sarah Buckley on this one...I love her work!).

Waa-hoo!!!

Debra, you ROCK!

New report underscores the critical need for Mother-Friendly Care

Childbirth Connection is blazing a trail when it comes to standing up for pregnant mothers. They just keep coming out with more and more well-researched data that shows the importance of mother-friendly maternity care.

Their most recent report - The Evidence-based Maternity Care report - takes stock of the U.S. maternity care system, identifies many opportunities for improving the quality, outcomes, and value of maternity care, and presents policy recommendations. This landmark report was developed through a collaboration among Childbirth Connection, the Reforming States Group, and the Milbank Memorial Fund.

Check out these new articles covering this report and its implications for making childbirth more mother-friendly:

- "Maternity-care failings can be remedied with cost-saving fixes," USA Today, Oct. 8, 2008.

- "Study: High-tech interventions deliver huge childbirth bill," USA Today, Oct. 8, 2008.

- "Back to basics for safer childbirth," Consumer Reports, Oct. 2008.

- "Quiz: Maternity care, beware," Consumer Reports, Oct. 2008.

Going through the photos...

Photos from BOLD 2008 Performances are just pouring in these days. I thought I'd share a few with you from Charlotte, North Carolina, Cincinnati, Ohio and Gainsville, Flordia.

So many BOLD people made these events happen. And they all ROCK!

The Warren Report - interview with me

When I was in Seattle last month I was interviewed by Warren Etheridge, a media critic and founder of The Warren Report. This interview was actually videotaped and will be shown as part of a video podcast on birthing in the future, but for now you can listen to an audio of the interview. I think it's a great overview of what the play and BOLD is, who I am and what's happening in childbirth today.

Check it out:


http://cdn2.libsyn.com/thewarrenreport/TheWarrenReportKarenBrodyBirth.mp3?nvb=20081015153445&nva=20081016153445&t=0f75094fb43d79e2aaccd

Waking up

Well, September felt like a wild college party that went on for days...sleepless nights, too many "donuts," and the hangover effect one gets from a really good night out. Suddenly it's October (MID October!) and I'm just waking up. Did nearly 100 performances of my play really happen in September? Did I just see the final version of the German script for an Austrian production of the play in my inbox? Is it possible that I'm not the only one suffering a hangover from BOLD 2008...but so are dozens of BOLD organizers who for the past couple of months also slept little, ate poorly and feel like they'll be back to normal in about a year or two.

A BOLD Organizer shared in August that her hair was falling out. By September so was mine.

But who said giving voices to the stories of mothers having babies was going to be easy? Who said standing up for what is right, just and fair -- that all pregnant women matter, all mothers deserve to have safe and groovy birth choices - was going to be a walk in the park?

Okay, yes the economy is hurting, which means the Arts is really hurting as people hunker down on expenses, but guess what? They came. Women, men, grandmothers, grandfathers came out in September to the BOLD performances despite a bad economy, despite Presidential debate nights, and despite the beginning of the school year that wipes energy out of even the most enthusiastic parent. They came. Sold out performances in Cincinnati, pack houses in San Francisco, and Hartford, Connecticut had to turn people away...there just were no more seats. That's not to say some locations didn't sell out, whether it was from lack of publicity or whatever forces were in place.

I always believe that the people who need to see this play will see it.

And let me not forget to mention the BOLD Red Tents. Wow...communities are approaching us from all over the world to do BOLD Red Tents. On my wish list for the coming year is getting the BOLD Red Tents to be more than just a one-day gathering of women. How about an on-going community? Women connected...gathering, supporting one another throughout their lives...in childbirth...childcare...sickness. This is a vision I'd like to make happen.

I guess I truly am waking up this morning. And it feels good!!!!

Birth centers need you NOW

Oh boy...please let's not lose the option of birth centers!!! This is serious...please take action NOW! Check out the American Association of Birth Centers' (AABC) breaking news:

AABC Legislative Alert: Payment Crisis Looming - Action Needed Immediately

We must get our message about the payment crisis out to Congress immediately and we need everyone to help!

Over the past few years, CMS (the federal agency that runs Medicaid/Medicare) has begun disallowing federal matching funds for state Medicaid payments for freestanding birth centers services. Birth centers have been recognized by CMS (and earlier, by HCFA) as a Medicaid provider type in State Medicaid Plans since 1987. Recently, however, CMS has disallowed such payment by several state Medicaid Agencies, including Alaska, South Carolina, Texas, and Washington State, claiming that it lacks clear statutory authority and direction to do so. CMS has directed its regional offices to stop federal payments to any state for birth center services.

This is not a Medicaid crisis but a payment crisis for birth centers. Historically all payers follow the lead of Medicaid. If Medicaid stops paying the birth center facility fee so will other insurers. We remind you of what happened to the chiropractors in the 1990s. They spent millions to reinstate their coverage.

For information on how to take action click here:
http://www.birthcenters.org/news/breaking-news/?id=75

A BOLD night in Tacoma, Washington

I had a blast last night attending the performance of the Puget Sound BOLD cast's 5th performance this month - in Tacoma, Washington. What a show! I loved so many elements of how it was directed (bright lights for hospital scenes, dim lights when a woman felt safe)...and the actors were just wonderful.

Tacoma has so many wonderful birthing option for women (strong hospital options, a birth center, and home birth midwives) it almost felt like I was on another planet!!! I loved hearing how well, in general, the midwifery and obstetric community works together. Yet, even in this community, a woman stood up and she said she had the perception that midwives were women "who are hippies" and not until her third birth did she understand more about midwifery care, that they are not just for hippies who want to deliver their babies on a bus, and that for low risk women they are a great, mother-friendly, SAFE option that makes sense.

I encouraged everyone to check out The Big Push for Midwives campaign because, quite simply, many communities don't have birth options like Planet Tacoma, midwives have been marginalized and under sometimes widespread suspect (and legal persecution) in their communities...and this needs to stop now. People need to wake up that midwifery care is really the only way communities are going to flourish...it saves money, mothers have higher birth satisfaction....midwifery care for low risk women just makes sense.

Tonight I'll see this cast again in Olympia, Washington. And then...go HOME! I love being BOLD...but I also can't wait to go home and BOLDly sleep! (as a mother of a 2nd and 4th grader this is at least somewhat possible on weekends now!)

Meeting the very BOLD Penny Simkin

I flew out to Seattle yesterday to attend two BOLD performances this weekend out here, but today I had the privilege of having lunch with Penny Simkin. Penny's really a living legend in the childbirth field. I've wanted to meet her for quite a while because I just love her books and what she's all about which is very clearly to be on this earth to assist women in having powerful births.

So I asked Penny at lunch today what she thought pregnant women needed to know that would help them have a powerful birth experience and she turned around and said: "They need to know that their bodies rock." We smiled. Penny knows all about the character Amanda in my play who passionately chants "My Body Rocks!" with the audience throughout her labor because she was asked to play that character at one of BOLD Seattle's performances last year. What a moment in BOLD history.

If you haven't seen the play the "My Body Rocks" spirit can best be described as an attitude that birth is normal, that you completely trust the birth process and your body to birth a baby.

Here's to Penny's words: that all women know their bodies ROCK!

PS: If you're out in Seattle this weekend come to the performances! Visit www.boldinseattle.com for ticket information.

(Who's in the photo: that's Lynn Hughes, BOLD Seattle organizer, me and Penny Simkin (wearing her "Got Doula?" shirt!)

A BOLD time in Philly

I went down to Philadelphia this weekend to see their BOLD performance of the play. What a great cast, director and BOLD organizer Audrey McDonnell! (there we are above having a laugh as we shout "My Body Rocks!" - and the other photo is of me, Audrey and Cathy Daub, President of BirthWorks). The performance benefited BirthWorks International.

The talkback really engaged the audience in the themes of the play...I loved it! Questions bounced around from how can we get this play to more diverse populations (teenagers, college students) to who the play was appropriate for (would the disturbing picture of birth today be too frightening for teenagers to see?). All of this was on my mind too, so it was great to discuss it with the audience.

An OB was part of the panel and from the start he made it clear that in his practice he encouraged women to give birth at 39 weeks by what he called "compassionate induction" because, according to the study he quoted, this is when induction is most successful. Well...this is obviously quite controversial...but this OB has SINGLE DIGIT c-section rates so it did seem important to listen to his reasoning. But as I said at the talkback I think the bigger question women have to ask is: can all women get "compassionate inductions" in hospitals today (with OB's who have single digit c-sectiojn rates)? And is it right to be intervening with nature?

Some food for thought!

Congratulations BOLD Philadelphia...for a wonderful performance and a passionate talkback! That's what BOLD is all about.

Oh, and I couldn't resist getting a picture with two very BOLD men at the performance...my husband Tim (on my left) and Audrey's husband Patrick (on my right) They weren't the only men there Saturday night, but they were outfitted with their gear supporting women being at the center of their births (Patrick's shirt said on the back: HER Body Rocks!) Here's to all the BOLD men!

Be BOLD for mothers in the Czech Republic

All women are sisters. Today childbirth in the Czech Republic is unsafe for mothers and our sister there need our help. Read more below and PLEASE sign the petition!

Karen


Dear friends,

Even today, after almost 20 years of democracy, the maternity care in the Czech Republic fails to provide suitable alternatives for all mothers and babies: birth is considered unsafe outside large hospitals, birthing women have to comply with unnecessary routine interventions and are often separated from their babies after birth, and independent midwifery is suppressed by state authorities.

A number of organizations supporting normal births (parents, midwives and doulas) wants to initiate important changes by starting a dialogue with the Ministry and other authorities. We have gained a significant support from within our country, but we need an international support as well. Please help to support our claim by signing our petition - your voice is important!

Go to : http://www.normalniporod.cz/english.asp

Many thanks,

Dagmar Suchá,
UNIPA, Prague

A birth film for fathers

Finally, a film for fathers...to empower them and show them how to protect their babies.

The Other Side of the Glass is coming out next year. Check out the trailer on YouTube:

http://www.youtube.com/watch?v=wVf4rzam0Xo

Controversies in Childbirth

Just found out this morning that our BOLD director (and former producer) in Austin has been invited to do a performance of the play in Fort Worth, Texas in March 2009 at the Controversies in Childbirth conference.

YESSS!

The conference is bringing together the entire birth community - OBs, Midwives, Nurses, Doulas, etc - to address the crisis in the US maternity care system.

This is a historic conference...debating and discussing the evidence, economics, perceptions and politics of childbirth.

And now, through the play and the BOLD movement, mothers voices will be added to the table.

Waaaa-hooo!

"Natalie"

I heard from "Natalie" today...not the real Natalie whom the character in the play is based(she is due to have her third baby this Spring!)...but one of the hundreds of women who played the character "Natalie" in a BOLD production of the play (Earth Lande, from BOLD San Francisco plays "Natalie" in top photo above). She laughed that the photo of her in the BOLD Chicago performance of the play last year, with her legs stretched apart (bottom photo above), had made it into many newspaper articles. She also wrote the following:

Before I did the show, I was literally terrified of childbirth--and I feel incredibly lucky to have had this artistic experience which has taught me so much about the choices I will have when I one day decide to become a mother. Now, I can barely WAIT for the day when I get to have this experience. In addition, I now feel a certain responsiblity to women to help reveal to them some of the hidden truths about childbirth in America. I start a lot of conversations with "Oh? You're pregnant?...Welllll...I was in this play called Birth..." I am positive that you have touched so many lives by telling these womens' stories. Thank you for being Bold!


No...thank YOU! Thank you to the hundreds of Natalies', Jillians', Amandas', Beths', Vanessas', Sandys', Janets', and Lisas' who have brought more than just their characters to life...You have helped ignite a movement.

Check out BOLD Chicago's journey last year in a photo tribute: click here

When Things Fall Apart

My uncle died last week and the funeral was Wednesday the same day my husband got a new job that requires us to move and my son started his new school for kids with dyslexia that this Saturday we had to tell him he's leaving. So this weekend I decided to pick up the appropriately-titled-for-this-moment-in-my-life book called, "When Things Fall Apart" by my new favorite author Pema Chodron.

Bingo - not only have I felt uplifted by her words, reminding me at this time that "thoughts, emotions, moods and memories come and go" I also kept reading it thinking about the birthing climate today - that in many communities it is falling apart...and it's so easy to take a morbid, depressing attitude towards it all. It's so easy to sink into the depths of asking: how are we going to find the joy in childbirth again? How are we going to rise above how challenging it is to be dedicated to supporting pregnant mothers when what most pregnant mothers are doing is walking into a hospital and getting hooked up to machines for no medically sound reason?

Deep breath...

Here's what Pema would say: develop compassion right alongside seeing clearly. Lighten up and cheer up instead of being miserably down about childbirth today. "Otherwise," she says, "All that happens is that we all cut everybody else down, and we also cut ourselves down." Yes.

While my "falling apart" week last week wasn't enjoyable, I am thankful that I came out knowing this:

that personally honesty (yes, the week was miserable) needs kindness, humor and goodheartedness. And that in childbirth today we need to be honest about the crisis, about the birth trauma, but we also need to be kind and compassionate as we move forward.

As Pema says, "That's the beginning of growing up."

Dr. Phil - Shame on you

I've been meaning to mention this for a while. Dr. Phil has decided to jump in the ring on home birth. Not surprisingly, he's looking for sensational home birth stories to present to his viewers - not the truth.

Come on Dr. Phil...do your research. There's a childbirth crisis in America - one in three women are having c-sections...birth trauma due to childbirth is now even acknowledged in well-respected newspapers like the Wall Street Journal. Why are you doing a show bashing home birth and midwives?

Here are the questions he asked:

- 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.


Ironically, the exact opposite is true about home birth experiences. A very small percent regret having a home birth. In fact, if we took Dr. Phil's questions and replaced "hospital birth" it would make more sense...

- Do you regret having a HOSPITAL BIRTH?

- Do you regret using AN OBSTETRICIAN instead of GIVING BIRTH UNINTERRUPTED AT HOME?

- Did you have your second child USING A MIDWIFE?

Now THAT makes sense!

If you want to make some noise to Dr. Phil email him here: http://www.drphil.com/plugger/respond/?plugID=12524

BOLD Nashville - breaking down walls in middle Tennessee

Every year since BOLD started back in 2006 I'm blown away by the people in communities who bring a BOLD event to their hometown. And I'm heartened each time I get feedback from a BOLD organizer that the play had ripples of impact on their community.

BOLD Nashville this year is definitely a strong example of the BOLD spirit out there in 2008, PUSHING for better childbirth choices for mothers, PUSHING for community awareness of local maternity care issues, PUSHING for people to be BOLD and make maternity care the best it can be for every woman.

BOLD Nashiville's organizer and director, Nicole Deelah, shares feedback from her BOLD journey to bring the play to Nashville:

It was amazing. I cannot quite put into words how wonderful it was.

From the hardships to the blessings, it was such a labor of love, a work of the heart.

Finding our venue proved to be one of the hardest obstacles - as my location tends to be VERY political and hostile when in regards to anything 'birth' oriented. Finally, we found a small studio theater that was run by a man who was over 50, single, no children. I had no hope that this man would want to support our vision. I didn't pull any punches after having so many experiences with hard-sells that were later reniged on when 'certain key individuals' in our community encouraged them NOT to host this play. I told him the play was controversial, he would most likely be encouraged NOT to help us, and that I needed a yes that would remain a yes, or a no - but nothing in
between. He jumped at the opportunity to help.

Consequentially, two weeks before opening night, he was able to be at the birth of his niece, a homebirth - his first birth ever. He 'now got it' what we were trying to accomplish.

1 month from production, he let me know that the owner of the building (not him) had said he HAD to have SOME upfront financing for our use of this venue. He named a price. It was not in our upfront budget. Miraculously, within 24 hours, a sponsor came forward for EXACTLY that amount.

Then, we had one role which we continuously could not keep filled. We found our "Natalie" 2 weeks before production!

Opening night and every production afterward was amazingly nerve-racking, humbly empowering, and awe-inspiring. I had the privilege of looking out over the audience every night and watching women with beautifully ripe bellies; their chins would quiver with passionate emotion, their eyes would grow in anxious expectation, and
their hands would roam, independent of thought, their bountiful wombs. Mothers comforted their babes at their breasts and nodded in understanding and compassion at the triumphs, trials, and journeys of the women on the stage.

Beautiful irony, amazingly healing journeys, and poignantly painful sifting through "birth baggage" marked every heart and mind of the cast and crew of "Birth". A staunchly anti-establishment lesbian woman befriended an outspoken conservative Christian pastor. An avid home birther became great confidants with a strongly opinionated medically-minded mother. And the walls just kept falling down.

We saw two women who were both a part of the birthing profession in our area break down their differences and sit, together, on our talk-back panel - surprising each other and those in the audience when they found they were in agreement on most all subjects discussed.

We watched a husband beg forgiveness of his wife for not understanding her need to have her mom at the birth of their last baby - he hadn't'allowed it'. But now he understood.

And we saw a family, whose generational differences had previously alienated one young woman because of her birthing choices, surround her in support before leaving the doors.

Powerful.

You would not believe the responses I have gotten from this project (after the performance). In fact, let me share some of them with you:

"I always felt guilty that I secretly felt RAPED by my episiotomy. I asked my doctor not to do one, but she did it anyway. And I didn't even know until after my baby girl was born. Only afterward, when she started stitching me up, laughing about a 'honeymoon stitch' she would put in for my partners benefit, and refusing me local pain medication because I 'couldn't feel it because [you] had an epidural."

"I never knew that epidurals could make a babies heart rate fall. You know, I'm 3 months pregnant and no one knows. I didn't want to tell anyone because I am not ready to resign myself to another cesarean. I didn't know I COULD have a vaginal birth if I wanted. I was told my pelvis is too small to accommodate ANY sized baby. My doctor told me that any baby who I tried to push out myself would be squeezed to death... I never was willing to consider the 'coincidence' that his heart beat was fine until I got my epidural. And my doctor made me feel like I was the one who was broken - my body - not their medicines and policies"

"You can have homebirths in Tennessee? I didn't know that! Can I have some names? I would LOVE to have a waterbirth. I want what Jillian got [big smile]".

"You have no idea what it means to me that I have been given PERMISSION to be angry about my cesarean. I felt like a bad mom for feeling like a 'healthy baby was not enough'."


I cannot tell you how hard, overwhelming, frightening, frustrating, stressful.... BEAUTIFUL, REWARDING, HUMBLING, AWE-INSPIRING, SWEET,and CHERISHING this process has been.

I cannot wait to do it all again, I look forward to it in the way that all things of worth are looked forward to - with a healthy perspective on the hard work that accompanies a rewarding process that demands your heart, mind, and body.... and the personal fulfillment we all experience when we complete the task! We did it!

I like the sound of that... WE did it... We DID it! """


Check out a tribute to the BOLD Nashville performance on UTube:

http://www.youtube.com/watch?v=bKvoIJ3a1t0

Thinking of our BOLD Sisters in Houston...

BOLD Houston's performances were supposed to be this weekend, but with hurricane Ike hitting the coast of Texas they've had to reschedule for next weekend. BOLD Houston Organizer Pat Jones shares:

althought it seems like our "labor" is sure having some complications - we are persevering - never give up until it is done - just like labor - the cast is strong, powerful, dedicated, enthusiastic, willing, and have worked hard to make this "baby" come out!

Stay safe, BOLD Sisters...we'll be thinking of you.

Oxytocin - yes!

Since most of my family doesn't believe anything unless there's a study or an article written in the major mainstream press here's something from the BBC to pass along to all those people who might think you're nuts for planning a natural birth.


http://news.bbc.co.uk/2/hi/health/7594282.stm


Yes, oxytocin is what you want ladies...it's the love hormone...the hormone that all physiologists, doctors and midwives know is essential during the birth process and lactation. If you have a natural birth, you get it.

When I read Dr. Michel Odent's "The Scientification of Love" I was sold on oxytocin after the introduction. It's not just about the power of this love hormone at birth - it's about the long term advantages to getting this hormone at birth. The impact on our culture, if we all experienced love at birth, would be tremendous.

Want to know more? Dr. Sarah Buckley writes passionately and medically sound articles on this topic. Here's a good article to start with:

http://www.sarahjbuckley.com/articles/ecstatic-birth.htm

BOLD Nebraska

The BOLD Organizer in Nebraska - Holly - just sent this photo of the cast. They'll travel all around the state this month being BOLD.

Now that ROCKS!

Yes, I'm a mother and I'm BOLD

My youngest son started his first day of school yesterday. Here he is leaving for school...happy and bright-eyed.

As I dropped him off he said to me, "Mommy, are you going home to help mommies bodies rock?"

Yes, I said with a smile. I sure am.

Why we need to be BOLD

Well, we're number two - number two, that is on the American Obstetricians and Gynecologists' (ACOG) legislative agenda to completely deny women the right to choose their maternity care providers and birth settings.

I don't know about you, but I smell a witch hunt.

When I was at BOLD San Francisco's talkback after my play last weekend a question was asked whether birth advocates should be afraid of a backlash from the medical establishment given the popularity of my play and all the new films out there that are educating women to take back their births. My response? Absolutely not! I consider it a compliment that a play and a couple of new honest and powerful films can shake ACOG to their core this much. It just encourages me (and I hope others) to KEEP GOING! It's when people speak out, rise up, that lasting change happens.

Below is a press release from The Big Push For Midwives about this. You might want to have a glass of wine nearby!



Number Two With a Bullet

Critical Women’s Health Issues Neglected as Physician Group Yet Again Sets its Sites on Midwives

WASHINGTON, D.C. (September 1, 2008)—In the newest phase of its ongoing effort to deny women the right to choose their maternity care providers and birth settings, the American College of Obstetricians and Gynecologists (ACOG) has announced that eliminating access to midwives who specialize in out-of-hospital birth is now the second most important issue on its state legislative agenda. This move puts restricting access to trained midwives ahead of such critical issues as contraceptive equity, ensuring access to emergency contraception, and the prevention and treatment of perinatal HIV/AIDS.



“ACOG claims to be an advocate of women’s health and choice, but when it comes to the right to choose to deliver your baby in the privacy of your own home with a Certified Professional Midwife (CPM) who is specifically trained to provide the safest care possible, ACOG’s paternalistic colors bleed through,” said Susan M. Jenkins, Legal Counsel for the Big Push for Midwives Campaign. “It is astonishing that an organization that purports to be a champion of women’s healthcare would put a petty turf battle that affects less than one percent of the nation’s childbearing women ahead of pressing issues that have an impact on nearly every woman in this country. If this is not dereliction of duty, I can’t imagine what is.”



In recent years, ACOG has led a well-financed campaign to fight legislative reforms that would license and regulate CPMs and has now teamed up with the American Medical Association (AMA) to promote legislation that would prevent families from choosing to give birth at home. Despite these joint efforts, the groups have not been successful in defeating the groundswell of grassroots activism in support of full access to a comprehensive range of maternity care options that meet the needs of all families.


“Wisconsin is a good example of what ACOG and the AMA are up against,” said Jane Crawford Peterson, CPM, Advocacy Trainer for The Big Push. “Our bipartisan grassroots coalition of everyday people from across the state managed to defeat the most powerful and well-financed special interest groups in Wisconsin, all on an expenses-only budget of $3000 during a legislative session in which $47 million was spent on lobbying. When you try to deny women the fundamental and very personal right to choose where and how to give birth, they will get organized and they will let their elected officials know that restrictions on those rights cannot stand.”



Noting these successes, ACOG has recently launched its own grassroots organizing effort, calling on member physicians to recruit their patients to participate in its “Who Will Deliver My Baby?” medical liability reform campaign.



“ACOG itself admits that we’re facing a critical shortage of maternity care providers,” said Steff Hedenkamp, Communications Coordinator for the Big Push. “They certainly realize that medical liability reform is nothing more than a band aid and that increasing access to midwives and birth settings is critical to fixing our maternity care system and ensuring that rural, low-income and uninsured women don’t fall through the cracks. Midwives represent an essential growth segment of the U.S. pool of maternity care providers, but instead of putting the healthcare needs of women first, ACOG would rather devote its considerable lobbying budget to a last-ditch attempt to protect its own bottom line. This is not a happy Labor Day for our nation’s mothers and babies.”

BOLD San Francisco on YouTube

My good friend put together photos from the BOLD San Francisco performance and posted them on YouTube to music. Check it out! (if it's in standard mode you're going to have to click on "Click on High Quality" to view it better).

http://www.youtube.com/watch?v=u0fW7szaZ4E

After a capacity benefit performance at the 350 seat Brava Theatre these BOLD women are headed to perform and have a talkback with an all-teenager audience tomorrow night in San Francisco and then the next week perform for the clients at the Homeless Prenatal Project.

Waa-hoo!

Give birth BOLDly!

Before I left San Francisco yesterday I was on ABC's "View from the Bay." Check it out:

http://abclocal.go.com/kgo/story?section=view_from_the_bay/parenting_babies&id=6366339

Happy LABOR day!

What a Labor day weekend...It's 9.30pm here in San Francisco and I spent the day recovering from a wonderful evening last night watching the BOLD San Francisco cast perform at the Brava Theatre.

I will write more and post photos soon - I promise! For now, here's a photo of me with the cast last night before the show.

Cincinatti, San Francisco, Flagstaff, Gainsville, Omaha, Phoenix...

BOLD kicks off this weekend in all of these cities!!

I thought I'd share with you a letter I wrote this week to the BOLD 2008 communities.

As Labor Day approaches I am getting yet again that BOLD feeling in my hands, feet and stomach. It's not always comfortable – actually some days I feel like I want it to go away, that groundless feeling of going into the unknown – and then suddenly I realize why I'm doing this BOLD work, why I'm feeding my kids too much pizza this summer, not listening to my husband when he's talking to me because I'm in "BOLD mode. It's because of a dream. (And how appropriate to dream this week, the 45th anniversary of Dr. Martin Luther King Jr's "I Have a Dream Speech").

After I gave birth to my son in 1999 I couldn't believe the number of mothers – low risk like me and educated – who had bad birth
experiences. Not just bad – I'm talking traumatic. It made no sense to me. The character Lisa in the play was a woman I met through a
playgroup friend who had just moved to Little Rock with her husband
and young son back in 2001. Lisa was quiet and reserved around the
playgroup moms at first, her eyes tired and dark. Every day I'd see
her and we'd talk about mom things and I discovered how funny and
confident she was, but deep down I could see her sadness and knew she had a story to tell. We became friends for two years and only as she was leaving Little Rock with her family one evening at her farewell party she had heard I was interviewing mothers about their birth stories and she cornered me in a room and said, "I need to talk with you." She didn't want to do it in person so several months later I called her on the phone and she told me her birth story…she wept, I wept; she said she was still so angry and didn't know if she'd have another baby and I understood. I understood – after I had interviewed 118 new mothers – that she is not alone. And that in order for maternity care to change we had to start telling the birth stories of mothers to tell the truth about childbirth.

My dream was that all people would know this truth and get so fired
up – not angry but inspired – to make childbirth center around the
woman, not the insurance companies or drug companies or hospitals.
Birth today is a justice issue, human rights issue, women's rights
issue…whatever you want to call it. And you are all a part of it. A
part of my dream – now our dream. And I thank you. I thank you for
being BOLD, for doing something that puts you, your kids and your
families over the edge for a few months this year because you know
deep down that it's right. It's a dream we must make happen.

On the eve of over 100 BOLD performances next month I encourage all of you to take a deep breath, remember the dream and then go for it – for mothers, babies and future generations.

The time is now to be BOLD.

Warmly,
Karen

I hope you'll come dream with us!!

Mein Körper ROCKT!