Friday, January 30, 2009

Are Certified Professional Midwives properly trained?

The statistics for Certified Professional Midwives, CPMs, are excellent in comparison to Certified Nurse Midwives, CNMs, who also have superior statistics. And all midwives have excellent statistics compared to physicians when each profession helps low risk women.

Direct entry midwives prepare for a test by either apprenticeship or by a nationally recognized college. Before qualifying for the CPM test, aspiring midwives attend births learning hands on skills and then, when they have attained the necessary skills, give continuous care to ten families through pregnancy, labor, birth and the full postpartum period.

The outcomes of CPMs are so impressive that Canada has revamped its maternity services to include CPMs not only for increasing the numbers of homebirths but also giving CPMs hospital privileges. Britain has increased midwife births also following the British Medical Journal's CPM2000 report. The American Medical Association may have missed the news. They have a paper which purposely attacks midwifery as a celebrity fad. Medical advocates, in our country, on the other hand, address the growing interest in CPMs by suggesting CPMs be brought into the current system with university training, licensing, and oversite by nurses or physicians.

If CPMs are already achieving excellence with the inexpensive training they currently receive, why increase their training? Why fix what is not broken?

Rather, our maternity system overall seems to be broken. Induction rates, cesarean rates and prematurity rates are increasing, and relatedly. Nurse Midwife practices are too often closed by hospital administrators urging high volume, low touch prenatal care. Physicians hands are tied by the profit margin.

So, why bring in the midwives who are already giving the best of care into a system that isn't working for the health professions that are held in it? Let them break free.

Let our nurses and doctors discover the joy of walking beside a woman who is making life style choices that will improve her and her baby's health in pregnancy, birth and for weeks afterwards, even years, as she is more likely to have prolonged breastfeeding. We aren't getting better birth outcomes in the insurance driven system. We get better health when health providers are autonomous.


Monday, January 26, 2009

The ethics of intuition

Clare and I were talking today at Kat Man Do on Grand in St. Paul (eat there, its spicy and delicious!).
When a mother calls me to help with her birth, I occasionally get a premonition of how it will go. Not in detail, but enough. It might be a split second view or a strong feeling as if it were the moment after birth. My sister says its the Holy Spirit. My paternal Grandmother, I heard, was like this, too.

The point isn't that it happens, but rather, what is the purpose of it, what should I do?
What should I do when I get the feeling that the mother won't be having a home birth? Or won't have an easy birth, or maybe will have a cesarean. What do I do at a home visit when I walk through the house and "can't see" the birth there? Twice this absence of "seeing" or "feeling" the birth in the home was preceded by cesareans, and several times, by transfers. I hadn't been tracking it because I felt a sense that I should be more positive.
Is it important to only say yes when I "feel" the tinkle of fairy dust?
Shortly into that initial conversation I start connecting to the mother's dream and her heart and want to walk that walk beside her, very often. So does it matter where the birth is at?

Clare says its not about where the birth ends up, but its about walking with the mother.
What is the ethics of saying, I'm not sure that your birth will end up as you see it, but I'm willing to walk that walk with you... I couldn't see myself telling a sincere woman, well, you're not having a homebirth so are you sure you want to work with me and pay for a homebirth midwife?
Wouldn't she think I was nuts? Am I sure I really know each time? Isn't there a reason for Hope?

Wednesday, January 21, 2009

March 9th March

Better Birth. Lower Cost.
Join the Minnesota Better Birth Coalition Facebook group.

We'll be marching to our state Capitol by noon on Monday, March 9th, 2009 with signs and strollers and slings. Several birth, postpartum, and early parenting groups are united for bringing about cost saving legislation that will improve birth outcomes for mothers and babies.
We propose to do this by increasing access to evidence-based (study proven) avenues such as continuous doula care and homebirth midwifery. Increasing access means that when parents pay for insurance that they are actaully able to get their costs covered by their insurance. It also means that since a third of all Minnesota births are paid for by state funds (taxes) that, if elegible parents want a homebirth, they can have their homebirth paid for just as they would have their hospital birth paid for. Discrimination between providers must end. The quality of our births and lives depend on equal access to appropriate birth care.

Tuesday, January 20, 2009

My comadres are at the Riverview watching the inauguration on the big theater screen. My comadres are my two midwife partners, Emme Corbeil, CPM and Clare Welter, CNM.
Emme took this photo of the full house at Riverview.

I'm home working on a new and upcoming website, (not on line yet), and waiting for a baby to decide to come, hopefully today. I'd think he'd want to come on inauguration day.

Since we don't have cable, I will have to catch history on the rerun. Crazy, huh? I'm patient; more patient to see the highlights of Obama's swearing in than for this baby, at this point...

Friday, January 2, 2009

Happy New Year with Orgasmic Birth!

20/20 started the New Year right with Debra Pascali Bonaro presenting Orgasmic Birth. I hope the benefits to the nation are as great as they have been locally since Debra was here on Sept. 25, 08 to present her film at the Riverview Theater to a very nearly full house.

Congratulations to 20/20 for getting it right, and congratulations for Debra for getting the attention and respect of such a top venue!

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.