Category: Midwifery

Married to the Midwife

newborn-bwThis article from Mothering Magazine can be found here: http://mothering.com/pregnancy-birth/married-to-the-midwife

By Tom Smith
Web Exclusive

Sharon’s alarm buzzes, and I wait for her to turn it off. Finally I roll over, mumbling that it’s her alarm, and would she please turn it off-only to find myself talking to an empty bed. I groan, remembering the 2 a.m. phone call and thinking of the harried morning ahead.

When they call, she goes. It doesn’t matter what time it is, it doesn’t matter where in the movie you are or who’s over for dinner. Out the door she goes, and woe to the man who tries to stop her. I did, once. We were having a fight and she got the phone call. It wasn’t fair, I said. I stamped my foot. I cried. She just got madder and madder. She asked me if I wanted to call the woman and tell her to go ahead and have the baby herself. For a moment I hated the woman having the baby, but I also began to realize that for Sharon, a laboring mother always takes first priority.

I’ve heard midwives say, sometimes jokingly, sometimes with fierceness, that there is no profession quite like it. I agree, and would add that there is nothing quite like being married to a midwife. I hate what she does and I love what she does. I find it annoying and I find it exciting. Someone once told me that the divorce rate is high among homebirth midwives. I thought, “Are you kidding? What with the low pay and the bad hours and throw in the risk of prosecution in our state, what man wouldn’t want a midwife for a spouse?”

Am I angry? Sometimes. Do I want her to do something else? No way. How can I, when she comes home at 4 a.m. with tears in her eyes and tells me the story of a mother who was so afraid because her last baby had died in utero at 6 months, and how the grief and pain and joy combined as the 9 lb. baby burst into the world? She loves her work and she loves her women. She makes so many hard choices. I don’t want to make her choose between her work and me. Besides, I’d probably lose.

When our daughter, Hannah, whines and asks why her mother has to go out again tomorrow, Sharon says simply, “It’s my work, it’s what I do.” That’s true, but it is also her calling and her passion. It’s what she does to make a difference in the world. She is a lioness when she says, “Women need to have a choice about where they have their babies.” I admire her greatly at that moment–and then the phone rings. I listen as she explains about the importance of eating to feed the baby. She waves her hand as she talks, cutting to shreds the myth of minimal weight gain during pregnancy. She says, “For God’s sake, if you’re hungry, eat! Eat lots of protein. Sure, four eggs with hot sauce is fine. We want fat, happy babies.” She hangs up, and the phone rings again.

One day Hannah answered the phone, and then called Sharon, who retreated into the bedroom. I asked my daughter who it was. She said she didn’t know, but it sounded like a midwife. I thought, “Oh yes, I know what you mean. The friendly but businesslike tone, the willingness to talk to children and the sound of sisterhood coming over the lines, ‘I need to talk to your mother about something.’” As Sharon shuts the door to the bedroom I hear her say, “We use comfrey and rosemary in our sitz bath for postpartum moms and find…”

The homebirth midwives I know soak up knowledge like hungry sponges. I envy Sharon’s single-minded drive for information, whether found in a medical bulletin or in the herbal lore that is passed around orally. She eagerly collects birth stories and medical texts, experiential knowledge and book knowledge. These women have to know their stuff, because they walk a pretty narrow line–especially in Indiana. Homebirth midwifery is not exactly illegal here, but neither is it licensed.

Sometimes I feel like I’m living with an emotional roller coaster. Most of the births are uneventful, and Sharon returns home exhausted and satisfied. But sometimes when she gets home her face is filled with pain and she begins, “We had to transport…” A story of loss begins, and I go down with her into the anguish. Often the stories are not easy to listen to: the agonizing decision as it becomes increasingly clear that this birth is not going to happen in the home, the cold sterility of the ER room, the gruffness and sometimes outright hostility of the doctors who don’t have much contact with midwives. And through it all, the grief, because often, though not always, a transport means a cesarean. The midwife goes along, assisting the woman’s partner, suggesting options at the hospital. The cord of sisterhood remains intact even in this environment, so different from the quiet security and warmth of a home.

I confess that Sharon’s profession frightens me at times. She works so close to the window between life and death. She assists in the pouring forth of life into the world, and sometimes it’s a dangerous place to stand.

I talk about it as if I’m actually there, but I’m just a small part of the supporting cast. I’m a listener. I wonder at the beauty and the pain, at the toughness and vulnerability of women, and yet I stand outside. I learn the names of the birthing women and hear their birth stories, but never meet most of them.

I often think that I’m married to someone on the Wise Woman path. But Sharon is not an archetype; she’s a real woman who deals in blood and pain and bulging bellies and the epiphany of new life. She is a guardian of the birth time, and when that times comes, there nothing to do but let her go. The phone rings and she’s gone.

Tom Smith divides his time between writing, homeschooling his two children, Ben and Hannah, and working at the local library. He lives in Lafayette, Indiana, where he is still married to the midwife after 14 years.

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New York midwives lose right to deliver babies at home

Newborn baby after a home birth The below story can be found here: http://www.guardian.co.uk/lifeandstyle/2010/may/14/home-births-new-york-midwives

As residents of the world’s consumer capital, New Yorkers can have anything delivered to their door at any time. They can have their hair cut in the living room, have champagne and caviar rushed to them on a whim, enjoy a shiatsu massage in their own bed or invite a clairvoyant to predict their future from Tarot cards laid out on the kitchen table.

But there is one thing that is currently unavailable for delivery to those who live in this most can-do of metropolises. Women can not legally give birth at home in the presence of a trained and experienced midwife.

This city of more than 8 million people, with its reputation for being at the cutting-edge of modern urban living, now lacks a single midwife legally permitted to help women have a baby in their own homes. “It’s pretty shocking that in a city where you can get anything any hour of the day a person cannot give birth at home with a trained practitioner,” said Elan McAllister, president of the New York-based Choices in Childbirth.

The collapse of New York’s legal home birth midwifery services has come as a result of the closure two weeks ago of one of the most progressive hospitals in the city, St Vincent’s in Manhattan. When the bankrupt hospital shut its doors on 30 April the midwives suddenly found themselves without any backing or support.

There are 13 midwives who practise home births in New York, and under a system introduced in 1992 they are all obliged under state law to be approved by a hospital or obstetrician, on top of their professional training.

St Vincent’s was prepared to underwrite their services, but most other doctors and institutions are not, and they now find themselves without the paperwork they need to work lawfully.

Miriam Schwarzschild, one of the 13, is now in the invidious position of either abandoning her clients or operating illegally. “Apparently by taking a woman’s blood pressure I am committing an illegal act,” she said. She has no doubts about what she will do: she will stand by the six to eight women she helps in labour every month, law be damned. She said she intends to “fly under the radar”, but is anxious about what would happen should she be reported to the state authorities. “At any time a nurse or doctor could report me, and once that happens they could go after my licence and shut me down.”

Jitters are spreading among the tiny community of home birth midwives. The rumour has circulated that one of them has already been shopped to the authorities by an obstetrician at a hospital where she transferred one of her clients in need of medical attention.

The crisis of home birth in New York city is an extreme example of a pattern found across America. Fewer than 1% of babies are born at home in the US, and in New York that figure is as low as 0.48% — about 600 babies every year out of 125,000. That compares with a rate of about 30% in the Netherlands.

In much of Europe, midwives play the lead role in assisting most low-risk and healthy women to give birth, handing over to a specialist doctor or surgeon only when conditions demand. In the US, that relationship is reversed.

Obstetricians, who are trained to focus on interventionist methods and often have never even witnessed a natural birth, are in charge of about 92% of all cases. As a body, they are fiercely resistant both to midwives – who under the private medical system in America are their competitors – and to women choosing to remain at home.

In 2008 the American Congress of Obstetricians and Gynaecologists put out a statement effectively instructing its members to have nothing to do with the “trendy” fashion towards home births. Yet despite Acog’s stance, and despite the fact that the US spends more money onpregnancy and childbirth-related hospital costs than any other type of hospital care ($86bn a year), the country has the unfortunate distinction of having one of the highest rates of maternal mortality in the industrialised world. Its rate stands at 16.7 maternal deaths per 100,000 live births, compared with 7.6% in the Netherlands and 3.9% in Italy. Britain’s rate is 8.2%.

On top of that, about one in three pregnancies in the US end in a caesarean section — a product, critics say, of the highly interventionist approach that includes frequent induced labours and epidurals. Amnesty International recently dubbed the US record on childbirth as a whole a “human rights crisis”.

Knowledge of these statistics, and of what is now happening to New York midwives, makes Julie Jacobowitz-Kelly see red. She is one of Schwarzschild’s clients and is preparing to give birth to her first child, a boy she and her partner have already named Benjamin, whose due date fell today.

She said the current illegal status of the home birth midwives was “a travesty, it’s absolutely ridiculous. It angers me that experienced midwives like Miriam are in jeopardy.”

That is a view shared by some senior New York politicians, including Scott Stringer, Manhattan borough president. “There are 600 women who are going to give birth in the next year who want midwives with them at home, and to take away their rights and choices is so backwards it’s embarrassing,” he said.

Midwifery organisations are scrambling to persuade other hospitals to take over St Vincent’s role by signing the so-called “written practice agreements” the midwives need to be legal. So far 75 hospitals have been approached; not one has replied.

Meanwhile, a bill is sitting before the New York state assembly that would scrap the system of practice agreements and allow the midwives to offer their services free of the control of obstetricians. But the bill may not be put to a vote at all this year.

“At the end of the day, hospitals are for sick people, and I’m not sick,” said Jacobowitz-Kelly. “I’m going through one of the most natural processes women can go through, so why do it anywhere other than the most natural setting — my home.”

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The Best Textbook Dedication I’ve Ever Seen

To my sister Healers
 Witches
Wise Women

Midwives

Who for hundreds of years
Were burned
and tortured
and died
by the millions 
as your children looked on

To those who locked arms and walked into the sea
Rather than submit to the inquisitor’s torments.

For the wisdom that went with you
Mostly unwritten, but never forgotten.

For all you knew and shared
The care you gave
And the courage it took
To continue in the face of truly
Overwhelming odds,

For your strength; a source of continuing inspiration,

To you, dear sisters,

I dedicate this book. 

                                         – Anne Frye

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Keep Homebirth Legal in Australia

Australia is very close to making homebirth illegal by refusing to provide insurance to homebirth midwives. As a result, private practice midwives will be unable to register, therefore making it illegal for them to attend homebirths in Australia.

As an aspiring midwife and a former Australian resident, this issue is close to my heart. I urge everyone to sign this petition to protect a woman’s right to birth in her home: http://www.homebirthaustralia.org/sites/sign-petition-save-private-midwifery

For those of you in Canberra where I used to live, there is a rally in September, please attend if you can. Writing to your Senate members and asking them to support homebirth would be great. As Sarah Buckley says, “the most effective action right now….is to hold up this legislation in the senate and require that this doesn’t impact the availability of homebirth before they let it through. You can email senator.williams@aph.gov.au and senator.sue.”

Here is a sweet video response to the Australian governments actions that explains in more detail what is happening in Australia:

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A Midwife and Her Patience

I read this somewhere about midwives patience when attending birth:
Midwives have skilled hands and know how to sit on them.
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Midwife Whales

Midwife whales are female whales that accompany a pregnant whale throughout her pregnancy, birth and three months postpartum. The midwife whale is present with the mom in a way that is nurturing, allowing mom to do exactly what she needs to do to have her baby in peace. The midwife whale looks on protectively and only intervenes when necessary.

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International Day of the Midwife – May 5

International Day of the Midwife

The below info is from the Midwives Alliance of North America (MANA), which was established in 1982 as a professional organization for all midwives. The group recognizes and honors the diversity of educational backgrounds and practice styles within the profession. MANA’s goal is yo unify and strengthen the profession of midwifery, therby improving the quality of health care for women, babies and communities.


Today is International Midwifery Day! Hug your midwife today and enjoy the following read from MANA!!!


Midwife numbers must be expanded to achieve Millennium Development Goals 4, 5 and 6 by 2015 350,000 more midwives are needed!

The UN Millennium Development Goals Report 2008 states: The high risk of dying in pregnancy or childbirth continues unabated in sub-Saharan Africa and Southern Asia … little progress has been made in saving mothers’ lives. Over 60% of women in these areas of the world still do not have skilled care during childbirth.

This report notes better progress for all of the MDG goals, apart from MDG5!2 Yet all the goals are linked: until
poverty and hunger are reduced, until diseases such as HIV and malaria are controlled, until there is more
equality between men and women, until every child completes primary education, until all women have access
to reproductive healthcare – then mothers and babies will continue to die.

Midwives are key healthcare providers in achieving MDG!5: Improving Maternal Health. That is the clear message coming from the WHO, UNFPA, UNICEF and the World Bank: the four UN agencies that have recently united to pledge increased support to countries with the highest maternal mortality rates.

They identified mortality in pregnancy and childbirth as the “highest health inequity in the world with over 99% of
deaths occurring in the developing world”. They committed to work with governments and civil society organizations to address the “urgent need for skilled health workers, particularly midwives”.

Midwives provide skilled newborn care to achieve MDG 4: Reduce Child Mortality Every year in sub-Saharan Africa and South Asia more than 1 million infants die within their first 24 hours of life due to lack of adequate health services, including midwifery care. The midwives of the world understand that every childbearing woman deserves to give birth within a safe and supported environment for herself and her baby. Skilled midwifery care includes emergency care for both mothers and their newborns.

Midwives are essential to achieve MDG 6: Combat HIV/AIDS, Malaria and Other Diseases Thousands of pregnant women and hundreds of thousands of newborns die each year due to preventable disease. Throughout sub-Saharan Africa governments have recognized the primary role of midwives inreducing these devastating deaths. As essential frontline workers, midwives provide vaccines to newborns and children; they identify, counsel and treat pregnant women with HIV and AIDS, thus preventing mother-to-child transmission of HIV; they also provide anti-malarial drugs and bed nets to vulnerable pregnant women and their children, saving lives and promoting health.

The achievement of MDGs 4, 5 and 6 requires a global commitment to grow a strong, well educated midwifery workforce within functioning health service delivery systems.

The sense of urgency to achieve MDGs 4, 5 and 6 in the next six years is increasing daily. The ICM and the
midwives of the world are committed to working with global partners to achieve these goals. The Confederation
has grown to 91 member associations with 250,000 midwives in over 80 countries and has recently partnered
with the UNFPA to strengthen midwifery education, regulation and associations in 40 low income countries. The ICM has also joined the White Ribbon Alliance (WRA) and Sarah Brown’s Maternal Mortality Campaign to
increase public awareness and apply political pressure on the G8 and G20 to make maternal and newborn
health a global priority. The ICM recognizes that health delivery systems must be strengthened and the
midwifery workforce must be increased to stop the needless deaths of millions of women and their newborns
who will die in the next six years if immediate action is not taken now.

The world needs midwives now more than ever!

For more information contact ICM President Bridget Lynch or ICM Secretary General Agneta Bridges at +31 70
3060520 or e-mail a.bridges@internationalmidwives.org.
1. The World Health Report: Make every mother and child count. World Health Organization, 2005.
2. The Millennium Development Goals Report 2008. New York, USA: UN, 2008
3. MDG 5 Target: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio. UN, 2000.
4. Accelerating efforts to save the lives of women and newborns. WHO/UNFPA/UNICEF/World Bank. Joint statement: Sept. 2008.
5. MDG 4 Target: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate. UN.

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Midwifery Today Conference

Just got back from my only day at the Midwifery Conference in Eugene, Oregon today. There were very bright and precious gems of insight I gained from being there, but I am left wondering where are the critical thinkers? Where are the midwives who are looking at what we are all doing and questioning the directions we are headed and the right steps?

I understand that midwives need to support each other and that, as a community, midwifery needs to insulate itself from the medical model of childbirth. I understand that some of us can be arrested in their state if they have to transport a mother to a hospital. And I understand that we need to celebrate what we do and how we do it. Cheerleading is great – at times.
But I left the conference only hearing one person, Michel Odent (who I am totally in love with), ask such questions. He proposed that men all together, male doctors, husbands and fathers should be banned from the birth room. This stems from the fact that Midwifery is woman’s work and men are under pressure in this situation and their stress hormones are contagious to the birthing mom (among other factors).
Interesting point he brings up. I would love to ask him if he could re frame that to try to educate men to understand the birth process and recreate a supportive environment for the mom? But I want to talk more about this later.
What I’m really feeling is this very uncomfortable notion that we, as a midwifery community, are living in a bit of a vacuum and only asking questions that are politically correct. Which is partially hilarious when you think about it considering Midwifery has been pushed to the fringes of all that is acceptable.
Michel Odent is holding a conference next year in the Canary Islands (I think) that is bringing people who normally wouldn’t interact with each other (you know, the guy who invented this really great way of doing a C-section and Ina May) to really question each other and talk about the things that no one seems to be talking about. That’s my kind of conference. 
At any rate, I’m sure I’ll have more insights after I’m able to process it a bit more. What I do know is that being there today got me fired up to begin my studies and interview for apprenticeships. It also left me feeling very confident and comfortable about the path I’m choosing to pursue Midwifery…I know now, with out a doubt, that a traditional academic classroom is not for me. I need to be able to more freely challenge what I’m learning and have many different avenues of exploration.
Today also showed me that I have never been as passionate about anything in my life as I am about childbirth and for that I am so grateful.
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Woman Shaman’s – Book Review

If you’re looking for a solid book on the history of woman shamans who were Midwives and Healers, The Woman in the Shaman’s Body is a great start. This book is all about reclaiming the feminine in religion and medicine, as the author Barbara Tedlock puts it.

Barbara makes a case that women, not men, are the oldest shamans and it’s incorrect skeletal analysis and a history of archeology being a mostly male vocation that has led to misconceptions of the true history of healing around the world.
The book takes the reader on a journey throughout ancient cultures and modern villages where shamans, like midwifery, is a strongly feminine specialty. She also shares traditional practices of ancient people, like the Huichol tribe’s practice of having the husband of a laboring woman’s first child squat in the rafters with ropes attached to his testicles. As the woman goes into labor, she tugs on the tethers allowing her husband to share in her painful experience of childbirth. (To quote my husband, “That tribe is probably no longer.”)
Below is a song from a shaman chanted while she was in an hallucinogenic trance. The first verse was recited in a feminine voice, the second verse was spoken in a stronger and more powerful masculine-sounding voice:

Woman who waits am I
Woman who divines am I
Woman of justice am I
Woman of law am I
Woman of the Southern Cross am I
Woman of the first star am I.
For I go up into the sky.

Lawyer woman am I.
Woman of transactions am I.
Mexican woman am I.
Woman like a clock am I.
Woman like an eagle am I.
Woman like an opossum am I.
Woman like a hunting dog am I.
Woman like a wolf am I.
I’ll show my power!
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