Wednesday, July 30, 2008

Vertical Birth

Here is the Vertical Birth video recommended by Debra Pascali-Bonaro from her Orgasmic Birth blog. Make sure you read Mariana's blog. Mariana Bazo was the photographer for Vertical Birth. Wow.

Sunday, July 27, 2008

Orgasmic Birth showing in Minneapolis!

Birth Activists have banded together to bring Debra Pascali-Bonaro's Orgasmic Birth film here to Minnesota, Thursday, September 25, 2008. The full length film will show one night only at the historic Riverview Theater.

This post announces our new local website,

Buy your tickets online. They just may sell out. Business of Being Born sold out before both viewings in the Twin Cities. Don't be left out. Debra is presenting her film, and answering questions afterwards.

Tickets are sold online before the day of the film. If any seats are still available, they will be available at the door of the theater at 6:30, Thursday evening, 9-25-08.

Two other events are scheduled, a Thursday afternoon class with Debra and a Friday morning power brunch with Debra and community leaders. Tickets to those events will be offered soon. Plus, the Minnesota DONA group (DONA doulas) are having their annual picnic meeting the afternoon before the film.

Tuesday, July 15, 2008

Midwife in Mozambique

PBS aired a compelling story about midwives learning to do cesarean surgery to fill the shortage of doctors in rural Mozambique.

The young midwife featured is shown conducting a couple of repeat cesareans. One for a placental abruption for which uncontrolled bleeding leads to a hysterectomy. Another mother is given a repeat cesarean and she is clearly unhappy about. The supervising doctor/teacher tells the midwife to be kind to the mother, give her special treatment, that way when she is pregnant again she will come to the hospital at 8 months and they can schedule her next cesarean. The implication is to avoid a ruptured uterus. He wants her to have the opportunity for more children in a culture where 2 children are not considered enough.
Yet, when he leaves her to do the surgery to attend to other patients, the midwife is shown deciding for herself - while the mother sleeps under anesthesia - to sterilize the mother.

Whew. Interviewing the midwife later, it is clear that she doesn't have up to date information about the safety of vaginal birth after cesarean (VBAC). Also, it is clear that she really thinks she did this woman and her family a favor. She talks about missing her mother who died when she was 20.

Going to the PBS website, a short video shows American Certified Nurse Midwives working in the hospital environment. One midwife asks a woman, in for her first prenatal exam, if she wants a vaginal birth this time. The mother says she certainly does, she doesn't want a cesarean again.

What we work hard to gain or to hold on to here is already being eradicated as the physiology of birth is bypassed to spread obstetrics. It makes sense to take advantage of the African midwives' intelligence and add another life saving skill to her abilities. But what a loss to never teach a midwife midwifery.

Another risk of cesarean surgery

A 26-yr old woman was 8-weeks pregnant and experiencing some light bleeding. Her previous birth was by cesarean section. When an ultrasound was done to see the cause of her bleeding the technician could find no baby in her womb. Instead, the baby was developing in the separating edges of her cesarean scar!

I wonder what the conversation was like that lead to her agreement to have a hysterectomy and loose both her baby and her uterus. The medical notes were shared on Medscape Today, an excellent medical educational site by WebMD.

It is beyond sad that medical notes are written without reflecting the emotional journey of the patient. Here is an excerpt of the notes.
  • Sonographic evaluation revealed an empty uterine cavity and endocervical canal, but a gestational sac was seen in the myometrium anteriorly and at the level of the uterine isthmus. The gestational sac bulged anteriorly and was separated from the bladder by only a 7-mm layer of myometrium.
  • Our patient desired no future fertility and hysterectomy was selected to treat her cesarean delivery scar pregnancy (CDSP). Intraoperatively, a bulge at the level of the isthmus was noted anteriorly. The bladder was dissected from the lower anterior uterus, and the CDSP was seen distinctly. Hysterectomy was completed without complication. The patient's recovery was uneventful.
It sounds like the young mother was game for the hysterectomy. But the truth behind the statement is that she simply agreed to the surgery. What could she do? What options could she be offered? To continue the pregnancy and see if by some miracle she and the baby survived? The sac wasn't in the tube. But it seems unlikely the baby could go to term. Few women would have continued this pregnancy.

Still, I can't believe her thoughts when she woke the next day was that getting over this was "uneventful."

My thoughts are with her. And with our nation and world as the rising cesarean tide claims more and more lives, wombs, and hopes, as well as cumulative years of well being from the women of the world.

Sunday, July 13, 2008

Ricki and Jennifer Block the AMA

Isn't it great how things line up sometimes? First, Betty-Anne Daviss and Ken Johnson lead the CPM 2000 statistical collection. The British Medical Journal published the good news. Canada and Britain took the results seriously and began improving their maternity care policies immediately. (Even though Canada has the best infant survival rate in the Americas. That's how you have good outcomes.) Then, Ricki Lake makes her cathartic and timely film, The Business of Being Born.
And now we have Debra Pascali-Bonaro's Orgasmic Birth film. The crème for the top, you might say.

Whereas, Canada, the UK and many European countries respond to evidence with action, the US seems to wait for media attention. Suddenly, what has been being done behind closed doors is exposed--and so are the tempers!

The American Medical Association raises its hoary head and roars against humble midwives who expose the truth only by the simplicity of quality care.

Hey, if Cuba can beat US infant survival rate with 10 times less spending on average medical expenses per citizen, there should be no further surprise that independent, low-tech, high-touch midwives help parents with brilliant birth outcomes.

First, we wonder what's wrong with maternity services here. And suddenly we find the physician's power club racing to suppress the competition. No competition; no pressure to improve. Business, as usual.

Not so usual, however. There was a day when the family doctor or rising obstetrician would not induce a woman unless there was clear harm in waiting. Surgery was for life saving, not profit margins.

The March of Dimes sounds the alarm against the new epidemic of late preterm births and the resulting rise in infant death in the first year of life because of this. Is anyone listening?

For doctors, induction and scheduled cesarean are a strategy against malpractice premiums and litigation costs. For parents, interventions without immediate need can bring unforseen sorrow. Maternal death is more common now in the US than it was in the 1970s. Cytotec and rising cesarean surgeries being two leading reasons.

Home birth in Minnesota and the US occur in only .5 percent of the 4 million births a year in this country. The AMA is right to fear this tiny splinter peeling from their fortress wall. With media coverage, intelligent women
are starting to notice.

You can sign Citizens for Midwives' petition to the AMA to block their efforts against women's rights and scientific evidence.

Changing the Earth by supporting Birth

Mothers bring forth life; medical corporations do not. Birth can be simple, powerful and loving. Fetal positioning, natural birthing and practical help for normal birth.