“They’re so negative, OMG!”

Bambi (a home birth loss mother) replies to NCBers who care more about tone of voice than giving women accurate information about their childbirth decisions.

Momofmanyfeet

I have two and a half months, or 73 days, before my daughter’s birthday. 4 weeks after her birth/death is when everything came crashing down around me. Everyone and everything I trusted, GONE. Why??? This photo here. Image

This led me on the path that I am on. This was the first indicator that my daughter died a very preventable death. This is why Brenda freaked out and tried every manipulation tactic in her arsenal. This is why I have spent all this time being attacked, harassed, stalked, and threatened by people within the community. All because I have chosen to not let my baby die in vain. Many women like me, they’re bullied into silence. They’re not allowed to speak up or else. Do people really not get what this is like for any of us??

I got to see an email sent out about Dr Amy and those of…

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This is Me

a safe place to talk about birth trauma (physical or mental)

peaceoutofpieces

I am a woman.  I am a daughter.  I am a sister.  I am an educated individual.  I am a wife.  I am a mother.  I am an advocate.  I am me.

I am me.  But, does everyone know the real me?  Sometimes I feel as though I keep a major part of my life locked away, accessible to only those who I know will not judge nor stigmatize.  Since the obstetric trauma, in March 2008, I feel as though I have compartmentalized pieces of myself.  In starting my blog, in August 2011, I became an advocate.  Though largely anonymous, my blog seeks to expose people to the very real ramifications of birth trauma, both emotional and physical.  My journey in blogging led me to becoming a Patient Ambassador for Medtronic Interstim therapy, and a facilitator for our local bowel disorders support group.  These two endeavors allow me…

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Debunking the Business of Being Born: Part 7

This is part 7 in my series on The Business of Being Born. The other parts can be found here. Descriptions or quotes from the movie will be in bold, and my commentary will be in normal text.

Bad Company’s “feel like makin’ love” plays

Footage of hippies dancing, presumably from the 1960s, is shown

Patricia Burkhardt, proffessor at NYU’s midwifery program says says “Historically, the home birth movement grew apace again after it was basically cut out from under the midwives at the turn of the century. During the hippie era, when there were communes, and the communes mimicked, in many ways, immigration communities. They mimic, you know, extended families, and so midwives were reborn, in a sense, during that era. “

I have always had a lot of interest in communes and other non-conventional communities. I’ve read about more than I could count. One thing I know for sure is that each commune I have read about was very different from others and it is difficult to generalize about them in any meaningful way. Some are religious, some are not. Some are vegan, others are not. Some are polyamarous, some are not.  Some are violent other not. Every difference you could imagine existed in these societies.

The movie shows a lot of happy hippies while the midwives speak in an attempt to (once again) associate the pro-midwife speakers with positive imagery. Once you recognize that technique in the movie it becomes quite grating to watch it, because you know exactly what to expect in terms of imagery based on if the person speaking is pro or anti home birth.

Ina May Gaskin says “We wanted the choices. We didn’t want somebody else making the rules. That didn’t understand us, that thought we were machines instead of people with feelings. ‘Cause we knew that feelings affected birth.

The last line here is something that the movie glosses over, which is curious because ‘feelings affect birth’ is a major part of Natural Child Birth and home birth philosophically.  A film maker with integrity would delve deeply into core tenants of NCB and explore if they have merit or not.

There is no real evidence that feelings affect birth- it is hard to measure feelings outside of self reporting.  I cannot find any research about feelings during labor and their impact on outcome. It is important to base childbirth choices on good information, for instance lets say that Ina May is right and feelings do affect child birth. How much of an affect is there? What outcomes do maternal feelings influence? Is it more or less than the affect on outcomes that birthing out of hospital is associated with? Again, critical questions are not asked in this movie, and it does a disservice to women who believe this film is educational.

More hippy footage and “feel like makin’ love” soundtrack

An anthropologist from earlier in the movie says “That was part of what sparked the natural childbirth movement, was a reaction against the abuses of the scopolamine era, the twilight sleep era, because some people realized the only way to get away from that was to get out of the hospital altogether.”

This is one theory about where NCB came from. Another is explained here, basically it explains that the origins of the natural childbirth movement can be found in stalinist russia. There was a lack of pain medication for laboring women so the government told women that there was merit to foregoing pain relief. The same dynamic can be found with midwives- they cannot provide pain relief that is as effective as hospitals, It is hard to say with any authority which one of these is the true origin of NCB (it may be a mix of the two theories, or neither). However the belief out necessity dynamic is absolutely present in home birth situations because midwives have very limited options for pain relief compared to OBGYNs in a hospital setting.

This portion of the film tries very hard to make it seem like the NCB movement, as a political movement, is about the rights of laboring women. From what I can tell, based on the political actions endorsed by midwives, it is a movement to let midwives operate without accountability or adequate training. Midwives and NCB advocates will fight hard to prevent a midwife from being held accountable for a death. They will fight hard to prevent any educational or licensing requirements for midwives. If anyone is aware of a political campaign by NCB or midwives that does not fall into one of those two categories, please let me know. I have literally never seen it. What a political movement represents is better understood through its own actions than its stated aims- virtually no one is willing to broadcast shocking aspects of a groups political ideology to the uninitiated.

She continues “Just as we were getting someplace, technology caught up to us again. The electronic fetal monitor got introduced into hospitals starting in 1970, and by the end of the 70s it was pervasive in hospital birth.”

creepy music and footage of 1970s hospital births are shown 

“And the cesarean rate in that decade went from 4% to 23%”

No word on what the perinatal mortality rate was at the beginning and end of the 70s. I decided to look into it myself. According to the CDC:

From 1970 to 1979, neonatal mortality plummeted 41%

If you look at the table the CDC provides, neonatal, perinatal, and infant mortality all fell significantly during that time period. It is completely irresponsible to fail to report this information while decrying the use of the technology that facilitated the drop in death rates, because its a totally obvious question that should have been asked and answered during the film.

Footage of a younger Ina May Gaskin is shown. She says 

“See, when I started, only 5% of women in the US had cesarean. Ten years passed, and it was up to about one woman in four. I couldn’t believe it. And we didn’t, in our group, didn’t need the first cesarean until birth number 187. So we were going the other way from the rest of the country. And we were doing that safely. So that told me something about the pelvis of the American woman, its just quite fine, thank you very much. And we didn’t have another c-section until birth 324.”

There is absolutely no word about the outcomes of these births except for c-section. Absolutely NONE. That is very difficult for me to understand, because there are many other outcomes to consider, such as birth injuries, debilitating tears, pelvic floor damage, disability (for either infants or mothers), PPH, and of course death. We are not given the numbers to examine if Ina May’s practices were producing an extremely low c-section result ‘safely’. Even if she had done it safely, three hundred or so births are not adequate as a sample size to determine if their practices at the farm were optimal or not.

Text appears on the screen that reads “since 1996 the cesarean section rate in the U.S. has risen 46%

In 2005 it was one out of every three births “

news footage of reporters discussing high c-section rates in America are spliced together

This is a pretty blatant argument from tradition- they are making it seem as though newer protocols are bad just because they differ from the past. The only other reason that the audience has been given to worry about the c-section rate so far is that it isn’t a vaginal birth. They have not demonstrated any benefit of one form of birth over the other yet, but we are supposed to be shocked about the rates.

Dr Marsden Wagner says “As we all know, The cesarean section rate in this country is going up, up, up. Why? What is really, really underneath this? Cesarean is extremely doctor-friendly, because of instead of having a woman in labor for an average of 12 hours, 7 days a week, It’s 20 minutes, and “I’ll be home for dinner”. 

Once again, we are made to believe that midwives never behave poorly because of the inconvenience of looking after a laboring woman. There is no evidence for that, and I do actually know of two cases that ended in death because midwives couldn’t be bothered to look after their patients. My midwives were eager to get me out of their birth center when I was in labor too.  Midwives are once again shown as the answer to a problem when they are equally as capable of being unethical. I am sure there are bad doctors out there that do this, but to claim that it is industry wide practice so that OBGYNs can go home earlier would require a lot more evidence than the film offers.

The difference, as far as I can tell, is that if you have an unethical OBGYN you can end up with procedures done against your will or without your permission, a c-section, and extremely rarely a preventable death.  Deaths or injuries caused by unethical OBGYNs can be reasonably sued for in a malpractice case. A doctor can lose his or her ability to practice based on their actions. If you have an unethical home birth midwife you can end up with procedures done againt your will or without your permission, birthing unassisted, preventable death or injury at a much higher rate than physicians. You can not readily sue them in malpractice court, and if you sue it is hard to collect. You cannot prevent them from simply moving to another state and setting up shop again.

These are big differences that women deserve to know about, but the film leaves them out because it does not fit the film maker’s beliefs about birth.

Stay tuned for part 8.

For first time mothers who want a Natural Child Birth

Dear first time mom who wants NCB,

I used to be one of you. I tried very, very hard to have a natural childbirth in a free standing birth center. I would have chosen home birth if my house did not have so many negative memories attached to it (although that is another post for another day). I tried.

I cannot overstate how much I felt like a failure rolling down the hall at the hospital in a wheelchair to the L&D unit. It was the place I desperately did not want to be. I had a great doula with me, but the midwives I trusted with my labor had abused me, and so I declined to have any of them accompany me to the hospital.  I knew I was going to have to give birth with strangers, and I dreaded a fight with them over what I would consent to or not.

I won’t lie to you- it was an awful experience. A procedure was done without my permission. My trust in any medical professional was shattered. I still haven’t gone to an OB or a midwife since my baby’s birth, despite the fact that I had surgery and was told to follow up with someone. Some nights I worry that I will have cervical or ovarian cancer and not find out until its too late. The fear of that is outweighed by the fear of being violated again.

I learned the hard way that people are not always what they say they are. I learned the hard way that it didn’t matter if it was a midwife or a doctor, I couldn’t control what anyone decided to do to me during my labor. I felt especially upset because I believed that I had avoided a lot of problems by picking midwives, that they would respect me and my wishes. I felt bad for having chose to have a baby, that I was too weak or stupid to properly care for my child. I felt that the way things went during my labor was proof that I shouldn’t have even tried in the first place, that my judgment must be terrible to have ended up like I did.

I had to make my decision about care providers without a lot of crucial information, because it there was so little data about first time mothers in home birth. Most women in the NCB movement had a traumatic or less than ideal birth in the hospital and decided to home birth after that. I searched endlessly for anecdotes from first time mothers who home birthed, and found very few reassuring stories. What I didn’t know was that in other countries first time mom status was enough to consider a patient high risk. There isn’t a way to know if some kind of issue inherent to an individual will arise in a mother until it happens. Most of the time the occurrence of a complication in the first birth is an indication of a problem in the subsequent births. I still want to know the rate of transfer for home birth midwives with first time mothers ONLY, I know it is usually about 10% over all, but I am willing to bet that first time mothers have a disproportionately high rate of transfer.

What I want first time mothers to know most of all is this: You can’t control your birth. You can roll the dice and choose a birth provider that brags a certain percentage for certain things, but there is no way to know if it will be you or not. Anyone who has played D&D or any other table top RPG knows that sometimes you strike out, even with a 90% skill. 10% happens, and its not because you did anything wrong. Its just life. If you had a c-section or an instrumental delivery or an epidural you did not fail at anything.  It literally means nothing about you as a human being if you had a c section vs a vaginal birth- you can force it to be meaningful, and therefore you also have the power to decide it isn’t worth worrying about.   Having a vaginal birth or a c-section isn’t inherent in anyones character- how much meaning could it really have outside of one constructed by culture?

I don’t think there is anything wrong with wanting a specific experience in childbirth. I don’t think there is anything wrong with being disappointed when it turns out differently. I am not someone who will complain that women who tried for NCB and ended up with something else are selfish or ungrateful, because I know that isn’t what its about.  No one needs permission for their feelings or their hopes- they just are, and should be accepted. What I do think is wrong is women blaming themselves for something that they don’t have the power to change.  I don’t think women blaming themselves are wrong, I think the people who perpetuate a culture that blames women are wrong.  This means that home birth midwives are wrong- they perpetuate a culture of sexism where mothers are at fault for virtually anything that happens during a birth, and where women who have the ‘right’ child birth experience get bragging rights and support for something that happened by luck instead of skill.  I remember ruminating over my c-section, wondering at what critical point I fucked up and made the small odds of having a primary c-section become a certainty. I’m reminded now of the aftermath of sexual abuse, where victims wonder what they did to “make” the other person hurt them, all of us search for absurd ways to make it our fault.  Women cannot control the outcome of giving birth any more than we can control the actions of other people. We can say “no” to people or interventions, but it guarantees nothing.  Women should not be made to blame themselves for any of it. Picking up the pieces, working through what happened and moving on takes a lot of strength. Energy should not be wasted on self hatred during something so difficult.

Take care!

-An ex home birther

Calling out a negligent Midwife

Here is a revealing exchange between a midwife (Brenda Ann Scarpino Newport) who is responsible for a preventable death and the grieving mother. It seems to me like the midwife is trying to convince herself as much as the mom that nothing could have been done to save the baby, despite what the medical examiners said. The gaslighting and guilt tripping placed on the mom is familiar to me because of my experience in reporting abuse by a midwife to a birth center. It seems like this is standard operating procedure for midwives who screw up. I would be amazed if I saw one who took responsibility, apologized, and stopped practicing. The mother is a brave woman who fights on behalf of her daughter to make sure she did not die in vain. Please follow and support her blog if you want insights from a loss mother about NCB and out of hospital births.

Momofmanyfeet

What can you do when your child dies due to a midwife’s negligence?

Let’s see, we attempted to consult a lawyer only to have nobody want to help because midwives don’t carry insurance.
The police wanted to charge her with Negligent Homicide, but the detective refused to go on a “witch hunt”.
The midwife review board did nothing but give us shit. Funny enough, they also have sat idly by while multiple babies die under her care.
A reporter was going to help us but after an interview, we never heard from him again.

After much thought I am going to publicly share the emails and as much info as I can dig up.

Email 1

There is alot of mis-truths on this. A Baby born at 37 weeks is not pre-mature by anyones standards, not even the medical community. Respitory distress is a common label for any reason the…

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