Strollerderby : home birth

Creepy Old Japanese Pregnant Dolls (with Attached Creepy Fetus Dolls!)

Cole Gamble — Tue, 02 Jun 2009 17:00:00 GMT

Apparently used to teach 19th century Japanese midwives, these pregnant dolls not only included placenta and stretch marks, but also interchangeable fetuses of different stages. At least, I hope that's what they were used for. It's kind of weird for a novelty item.

Crocheted Doll Gives Birth

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YouTube Helps Man Deliver Baby

Jen Chaney — Sun, 03 May 2009 18:06:00 GMT

YouTube: It sucks hours away from our lives by allowing us to watch complete episodes of "T.J. Hooker" and annoying videos about a kid named Fred. But evidently it also is (indrectly) responsible for bringing new life into the world.

After watching some how-to videos on YouTube, a British engineer named Marc Stephens delivered his son last month when his wife quickly went into labor. As the BBC reports, Stephens's wife, Jo, reported some discomfort one evening, which prompted her husband to Google "how to deliver a baby." He watched a few videos, just in case. When Jo woke up in the middle of the night already in labor and found that no midwives were available to perform the home birth the couple had planned, Stephens was able to put his recently acquired medical expertise to use. He calmly delivered a healthy 5 lb., 5 oz. baby boy named Gabriel, the fourth addition to the Stephens family.

This is obviously a very happy story (and, possibly, awesome fodder for a future YouTube ad campaign). But a few of the stories that reported this news actually made me laugh out loud, simply because some of the quotes from the Stephens family are so hilarious. Some highlights:

From the BBC: "I Googled how to deliver a baby, watched a few videos and basically swotted up."

Also from the BBC: "This is our fourth child now and while for our first I spent most of the time at my wife's head, now I'm not afraid to go down to the business end."

Then there's this punchline, delivered by Jo Stephens to The Guardian: "I was quite relaxed. I have to say, out of all my four labours, that was the one I enjoyed the most. Marc is one of those people who can put his hand to anything."

Put his hand to anything? You got that right, sister.

Anyway, we here at Strollerderby wish the Stephens family congratulations. And we also offer this link to a YouTube video as a public service to anyone who thinks he or she may have to deliver a baby sometime in the near future. The video delivery takes place in a taxi cab. And (obviously) it involves a fake mommy and a doll baby. But if it worked for Stephens, maybe it can work for you, too.

Homebirthing Advocate's Baby Dies During Homebirth

Brett Singer — Mon, 13 Apr 2009 12:00:00 GMT

Janet Fraser is a big advocate for homebirth. She is described as "one of the principals behind the homebirth organization Joyous Birth," and goes so far as to call C-sections and episiotomies "birthrape." "I don't care if you don't like the word or the idea," she writes in an article on the site. "Survivors are angry and we are starting to talk about it."

Sadly, Ms. Fraser lost her baby during a recent homebirth. One site says that she had been in labor for "several days" at her Australian home. The Age had published an interview with Fraser a week before, in which she stated that she planned to deliver "the baby at home without an attending midwife," prompting The Australian College of Midwives to say that she "recklessly" promotes "free-birthing," which is where the mother gives birth alone, according to London's Daily Mail. (If that's not a good description of free-birthing, let me know and I'll update this article.)

The Age reports that police are investigating the newborn child's death. At press time authorities were unsure if the baby died after delivery or was stillborn; in the latter case, there is no autopsy.

It's tremendously sad when this happens of course, no matter where the birth occurs. It never occurred to my wife and I to have a homebirth, but of course millions of people do it and everything turns out fine. Medpie offers some statistics that are alarming, such as one study that found "an infant mortality rate of 2.2 per thousand for home births and 0.7 per thousand for hospital births in Sweden." They interpret these numbers as saying that "having a home birth resulted in a preventable death of the infant in one out of every 666 cases," which they call "not a reassuring number." But again, I'm not trying to say that homebirthing is automatically a bad idea. It's a choice, one that should be taken very seriously.

The real problem with Fraser's views isn't the views themselves but the way she expresses them. She's clearly angry, and may have reason to be. But as with those who are strong proponents of breastfeeding, it's better to advocate rather than attack anyone that may do things differently than you do. C-sections are sometimes medically necessary. Is that a "birthrape"? The rest of the site appears to be equally high in volume, such as this page about C-sections which makes the claim "The fact is that surgery is a suboptimal way to be born and that most surgeries are not for evidence based reasons," (emphasis not added), and advises mothers to "Put your anger where it belongs - with your surgeon." Because yelling at your doctor is an excellent way to get better healthcare.

With the obvious tragedy of what happened to Ms. Fraser's baby, it seems uncouth to really go after her with the same level of vituperativeness that she displays on the Joyous Birth site. And one sad event does not mean that every homebirth is a bad idea. But it seems fair to take a moment to suggest that the best course of action, when lives are at stake, is to take a deep cleansing breath and consider all of your options, rather than act out of anger or any sort of revolutionary zeal.

Source: medpie.com, others

Image from here

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And Deliver Us by Google

JeanneSager — Thu, 02 Apr 2009 16:34:00 GMT

For all you people who scoff at the power of Google University, I present the story of Jordan and Natalie Peck and their newborn baby girl

The Pecks live in Hendrum, Minnesota, right in the center of the bad flooding that's been making the news lately. So when the heavily pregnant Natalie went into labor, Jordan knew there was no way he could drive her to the hospital - and there was no way their midwife was getting to them.

So he did what any American who wants to know something did - he powered up Google and read up online on how to deliver a baby.

And then he did. The Pecks welcomed a healthy little girl named Margaret into their lives - and into their home - which they soon left because of the rising water. They are now staying with friends, unsure when they can move back into their home. But Jordan joked that he knows what it's like to be the guy told to just follow the instructions.

"This was one of those cases where I was going to follow the instructions to the T," he said. If you're one of those people who doesn't mind brushing up on knowledge (no need for waders - you can still be ready for the floods!) check out eHow - they've got it all . . . down to the T.

Image: KSTP TV

Are You a Good Candidate for Hospital Birth?

Miriam Axel-Lute — Wed, 11 Mar 2009 18:30:00 GMT

It's always nice—and often informative—to try a little role reversal to reveal unstated assumptions. So I have to admit I'm tickled by the concept of Gloria Lemay's post "Are You a Good Candidate for Hospital Birth?", a checklist that includes items such as:

Must not be scared of needles.
Must not be claustrophobic or uncomfortable in confined spaces.
Must be able to go for long periods of time without eating or drinking.
Must be happy to share a bathroom with others.
Must enjoy sleeping on a mattress covered with plastic.
Must accept the possibility of contracting antibiotic-resistant infections.

Any given one won't apply to every hospital birth, it's true. (If I were writing it, I would have adapted things a bit, such as saying "Must accept a high likelihood that your written birth plan will be ignored" rather than "Must accept your written birth plan will be ignored," for example.) But that's really no different that the way many people phrase things like when asking you if you really want an out-of-hospital birth.

So while I wouldn't use it as is in a childbirth education class, I'm happy to see a little offense as the best defense, especially when doctors are pushing back on attempts to expand midwife care.

Hat-tip: Citizens for Midwifery. Photo by la_cola_de_mi_perro.

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South Dakotans Don't Support Home Birth. Or Do They?

Miriam Axel-Lute — Wed, 11 Feb 2009 22:00:00 GMT

As the economy continues into the toilet, there seems to be a growing push to consider increasing the use of midwives (both hospital and home birth, nurse-midwives and certified professional midwives) as a way to cut down health care costs.

Of course, it's being met with a predictable backlash from doctors screaming about how dangerous home birth is.

In South Dakota, this time around, the doctors won and the house rejected a bill to allow certified professional midwives (the only credential that requires experience in out-of-hospital births) to attend home births. In South Dakota, as in many other states, certified nurse midwives can attend home births if they work with a doctor who approves it—but no doctor will approve it, effectively making the option nonexistant.

But no matter. No one really wants the option anyway. From the AP story: "South Dakota had more than 12,000 live births in 2007, and only 26 of those babies were born at home, said Doneen Hollingsworth, state Health Department secretary. Only 19 of those were intended to be home births, which indicates home births are not supported by most South Dakotans, she said."

Or, um, that you've made it illegal for the people who want to attend home births to attend them? If people who wanted a home birth were willing to do it alone they wouldn't feel the need for this bill would they? (And they do.)

(Not to mention that at least some of the other seven probably lied about whether their home births were planned to protect midwives working underground.)

Photo by dizznbonn.

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TV Producer Seeking Urban Home Birth to Film

Miriam Axel-Lute — Mon, 29 Dec 2008 21:28:00 GMT

Producer Zach Marion is looking for someone planning have a home birth and due in January or early February to add to the birth stories in an upcoming Discovery Health Network show promoting midwifery and home birth.

Since the two already on board involve organic coffee growers in Hawaii and a couple planning to erect a "birth teepee" in Utah, he suggests that maybe a more urban birth setting would round out the trio.

Unsure about having a film crew at your birth? (I hope, frankly, that you are at least a little unsure.) Marion knows strangers can be disruptive but says in filming dozens of births for "House of Babies," he and his crew have become practiced at fading into the background and becoming "a fly on the wall." Not to mention blurring out the bits network TV doesn't want to show in high-def.

So if you're due at the right time and want to do your part for home birth awareness (especially, say I, if you are not the "stereotypical" home birth mom), give Marion a ring. It'll mean dad won't need to worry about the camcorder.

Photo by mil8, via Flickr.

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Today Show Says: Doulas Get in the Way

Miriam Axel-Lute — Mon, 24 Nov 2008 18:30:00 GMT

Despite having been exceedingly happy with my own home birth, I know birth location is a very personal choice. When I have friends who are planning to give birth in a hospital, I don't go home-birth evangelical on them. I just have three words: "Get a doula."

A doula, or labor assistant, is a trained birth attendant, but not a medical professional. Their role is to provide support for the laboring woman—reassurance, massage, etc.—and her partner, and also to be a patient advocate when needed, not inserting their own opinions, but understanding what the parents want to happen under certain circumstances and sticking up for it. How many OBs read birth plans these days? Breastfeeding, circumcision, pain relief . . . In these days of understaffed hospitals, it's good have someone keeping track of you, your needs, and your decisions.

The extra, consistent support makes a difference. In fact as far back as the 1970s, all sorts of clinical studies show that the presence of a doula reduces complications and c-section rates and improves mothers' feelings about the birth outcomes. Sounds perfect, doesn't it? A nice middle ground in the birth-location fight, a win-win situation? DONA International, a group that trains doulas, was hopeful that that was the message that a recent Today Show segment on doulas would spread.

They, and many others who have used doulas, were dismayed to find that instead a huge amount of the segment was devoted to a doctor who wanted to emphasize how doulas get in the way, inserting their own (non-doctorly!) opinions, and arguing with doctors. Her hospital has actually banned them. I have to wonder if they had any hard numbers on birth outcomes that contradicted the larger clinical studies, or whether they just don't like being challenged.

If it had just been her inclusion that was the problem with the segment, I would have disappointed but understood that it was coming from the twisted meaning of "balance" that operates in journalism these days (i.e., "We must find one extreme opposing viewpoint, even if it's a lie or represents only 2 people out of the whole world"). But the host and resident expert were also astoundingly snotty and condescending throughout, full of smug phrases like "buyer beware" (You know, unlike choosing an OB) and "this is a luxury for most women" (You know, unlike an increased risk of major abdominal surgery, which is just fine) and "Make sure they know they're not there to get in the way."

Yes, doulas are not medical professionals and shouldn't be trying to act as such. But as this stunning article points out, unfortunately, laboring women often need someone adovcating for them, and it shouldn't always fall on the partner.

Interestingly, the text article on the Today Show's site is very different in tone and content, and much more positive.

DONA hasn't issued an official response yet, but it's planning one. Its supporters are, not surprisingly, already asking people to write in and complain.

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If You're Not Birthing at Home, You're Irritated With Women Who Do

Madeline Holler — Fri, 14 Nov 2008 18:02:00 GMT

Seems like you can't swing a freshly born placenta without hitting another story on home birth these days. Take this recent one in the New York Times about the growing number of women who are planning home births around NYC.

The article is especially notable to me for a couple of reasons: none of the couples say they wanted a home birth for spiritual/religious/back-to-nature reasons, or because hospitals won't let them burn sage and snack on placenta in the L&D room.

Not that I think those reasons are ridiculous (OK, I do), but because those stereotypes have such a prominent place in home birth talk and assume characteristics and beliefs about women who, like me, choose to give birth at home.

So I get a little defensive, then, when I read posts like this one from Jezebel's Tracie. She says you'll have one of two reactions to the Times piece: you'll like it or you'll hate it. If you hated it, it's because you find "unconventional" births gross. If you liked it, it's because you think the article was yet another celebration of the miracle of life.

Really? Just one or the other?

Tracie also warns the story is graphic (it's totally not. In fact, what's shocking is how all these laboring women are photographed fully clothed). She even enlarges the picture of a laboring woman's sister who is, in Tracie's words, horrified by "watching her sister's vagina go whoosh." Honestly, the chick just looks a little tired (the labor was a long one). Plus -- and I feel awkward tutoring a writer for Jezebel (Jezebel!) on lady parts -- vaginas don't go "whoosh" in birth (granted, it's a damn shame they don't!).

Tracie's and many of the commenters' other big problem with NYC apartment dwellers giving birth at home is the noise factor for neighbors, which the article brings up. Thing is, noise didn't wind up being a factor for any of them, and it's not so surprising.

Listen, people. A 40-hour labor does not entail 40 hours of screaming. In fact, a 40-hour labor more likely entails 39.75 hours of sitting in the tub, peeing on the toilet, light conversation, off and on contracting -- and then a final 15 minutes of grunting or growling, maaaaaaaybe a scream (in 15-second intervals every, what, one or two minutes?).

You probably hear more sustained moans and groans from the couple getting it on on the other side of the wall. Just saying.

But I don't blame Tracie and all the commenters, etc., because really, who even knows about how minimally messy, un-noisy, un-dangerous birth can be? Unless you've seen a birth or talked to women who have had low-key hospital or home births, all you've got is Hollywood and there, well, there you have to have screaming and profuse sweating and swearing and "I'm hacking off your balls"-ing and lots and lots of blood. For laughs, you know, and drama.

Still, what I find so baffling is that women whose trade is writing about women stuff, calling out hate on women-haters, professing a love of women who think their bodies are just fine, women who take on the man (or at least ignore him,), etc., just shut down when it comes to birthing outside the medical model. Why is home birth -- or even unmedicated birth -- of all things, such an assinine plan and seeming threat to the way other women live and have babies?

Finally, a pet peeve: terms "water birth" and "home birth" used interchangeably. Look, the inflatable tubs that Tracie (and, OK, the article) kind of obsess over? Just think of those as the epidural, which is, in fact, how they're used -- to ease the pain of labor (sounds ridiculous but works pretty well). An actual water birth happens when the baby is pushed out in the tub (or when you're swimmig with dolphins -- WTF?), not when you've only labored in water.

PS: The point of the article (and the original point of my post) was that lots of home birth families are wildly educated, non-spiritual, meat-eating lawyers, bankers, bloggers and writers -- professionals who aren't scared of birth and/or just want to stay out of hospitals and away from hospital protocols that just don't make sense. But looks like that doesn't come through so much in the article, which, again let me add, is so not graphic.

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Photo: NYTimes

The Doctors Does Fair and Balanced

Miriam Axel-Lute — Wed, 17 Sep 2008 14:36:00 GMT

So perhaps you expected Dr. Phil to be fear mongering about home birth, but how about The Doctors? Their home birth show featured an undecided couple, an OB, and Dr. Sears, who supports home births. It was supposed to be an open dialogue. Guess who got to speak for 95 percent of the time? OB Dr. Lisa Masterson (pictured, who, apparently often provides sex advice on Dr. Phil. Oh well).

On the shows' forums, viewers are ripping into the show for not having a midwife participate. Wendy Gordon, a certified professional midwife from Portland, Oregon, also spells out all of their astounding inaccuracies, complete with footnotes, and suggests that the producers and the OB read the latest Listening to Mothers survey to find out what their experiences really are. Another midwife blogger suggests wryly, "Have Dr. Masterson call me. I'll tell her how to avoid a 10-15% shoulder dystocia rate."

This has got me wondering, though, is home birth getting so much negative publicity specifically because Ricci Lake and all the other folks questioning the U.S. medical model of birth actually have OBs scared? Are they worried about the competition? Is this the big backlash before a big breakthrough?

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What Does It Mean for Midwives, or Home Birth, to Be Illegal?

Miriam Axel-Lute — Thu, 11 Sep 2008 17:50:00 GMT

With the recent conviction of two Florida women for practicing "illegal midwifery" in a case where the mother died, I think it's worth sorting out exactly what is or isn't legal about home births and midwifery in this country.

First, it's not illegal to have a home birth, as Madeline Holler explained recently in her Babble story on her home birth. It's just often illegal to attend one acting as a medical professional (the question of whether the women convicted were acting as midwives was central to the case above).

In terms of the midwives, the first question that comes to most people's minds is that of licensing. There are two major midwifery credentials: the certified nurse midwife (CNM) and certified professional midwife (CPM). Both involve both written exams, proof of skills mastery, and clinical experience under supervision. CNMs also get a full nursing degree. CNMs are widely accepted throughout the country (though not nearly as widely as in other countries) and routinely see women for pre- and post-natal care and attend low-risk births in hospitals and birthing centers. CPMs are recognized and regulated in 24 states. Only CPMs are required to have experience in out-of-hospital birth settings, so they are more likely to be the ones attending home births. (As far as I can tell, the women convicted in the Florida case had no certification at all and it seems like their religious convictions may have kept them from seeking help as soon as they should have.)

Then there's the question about the legality of attending a birth at home even if you have the proper training. Many (if not all?) states require that a midwife wishing to offer home births be working in the practice of an OB that agrees to provide backup. Often this is what makes legal home births de facto unavailable—doctors are afraid for their malpractice premiums (or of the competition) and none in a given region will let home birth midwives join their practices. For a long time that was true up here in upstate New York.

Then there are those trained midwives who prefer to stay under the radar even where there are doctors who would work with them because the limits on what they can do as midwives (no breech deliveries, no delivery past 41 weeks, etc.) are so restrictive.

The potential effects of all this on home birth midwives—and therefore the availability of home birth for most of us who wouldn't want to go unattended—is pretty scary.

Brett Singer asked in his post about the Florida convictions a couple days ago whether someone could be prosecuted for an illegal home birth even if nothing goes wrong. Sadly the answer is yes. There is a case in Connecticut like that right now. The midwives responsibly transported the mother to the hopsital when a need arose, and it all went fine, but the ticked off doctor who received her filed a complaint. (This is why many home birth midwives have underground back-up relationships with friendly doctors who just can't afford to work with them openly.) You can just imagine what happens in the courts in those rare cases when something unavoidable does go wrong in a home birth, despite proper precautions.

And cases like the one in Florida certainly don't help any. Sigh.

Photo by freckle'sphotos.

Australia Looks to Midwives to Handle Baby Boom

Miriam Axel-Lute — Thu, 11 Sep 2008 14:00:00 GMT

Apparently birth rates are booming down under, and to handle the demand, Australia's federal government is looking to expand midwifery care, giving licensed midwives more access to insurance, prescribing rights, and ability to get paid through public health subsidies even if they aren't working directly under a doctor's supervision. The goals of the review will also include "how to cut medical interventions such as caesarean sections and forceps deliveries. Alternative birth options will also be examined, including the possibility for more home births."

Australian OBs aren't thrilled, but it seems that in a country that has a "chief nurse and midwifery officer," who is leading the overhaul, that they don't have quite as much power as they do stateside.

Photo by salimfadhley.

Tell Dr. Phil About Your Home Birth—If You Dare

Miriam Axel-Lute — Wed, 10 Sep 2008 12:55:00 GMT

Dr. Phil is seeking home birth stories. But not just any home birth stories. He wants just the bad ones—the ones you regret, the ones that made you have your next kid in the hospital.

I'm sure those exist somewhere. I'm sure it is partly just who I know that the only parents I've heard of regretting their choice of birth location are people who went to hospitals (which is not to say that everyone who chooses a hospital regrets it certainly).

And Dr. Phil has a right to focus his shows how he wants. If I were doing a show on home birth myself, I don't think I'd go out of my way to find one that had been a disaster.

Nonetheless, it's awfully hard to look at the questions he's asking and not fear that the show will be a massive fear-mongering misconception fest, which is a definite problem as home birth keeps facing legal challenges. You can almost hear the condescension dripping:

"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?

Did you have your second child the traditional way in a hospital?"

I suspect that I'm not the only mother whose reasons for to giving birth at home were a damn sight more numerous and complex than just wanting a "soothing experience" (though, frankly, feeling safe and calm is not just a perk—it can make labor a lot shorter). In fact, pne of my reasons was that our (trained, experienced, prepared for emergencies) midwives understood that birth usually doesn't go as planned and can't really be controlled. OBs and hospitals tend to forget that and are all too ready to make extreme interventions not because something is dangerous, but just because it's inconveinent or unexpected. For me, since my kid had unexpectedly turned breech the night before, being at home meant the difference between a trouble-free, quick delivery and an unnecessary c-section.

There are a number of midwifery and doula groups, as well as individuals, encouraging women to bombard Dr. Phil with positive home birth stories. I sent him mine, but I'm not sure how how much good it'll do. Sounds like his mind is made up. I think the suggestion someone made to pester Oprah to do a show of positive home birth stories (and, I would add, include real home-birth midwives talking about how they bring oxygen and know how to do sutures and do transport to the hospital when warranted) might have a greater effect in the long run. Or am I giving up on the good doctor too easily?

Photo, "Prepared," by freckle'sphotos.

Two women found guilty of illegal midwifery

Brett Singer — Sat, 06 Sep 2008 21:00:00 GMT

This is a serious issue, but I have to say that the term "illegal midwifery" sounds like something out of a bad Shakespeare parody.

Now that I've gotten that out of the way, here's the story:

"Tonya McGlade was found guilty of Attempting Midwifery Without a License. Linda McGlade was found guilty of Principal to Practice Midwifery Without a License.

"Prosecutors say the women helped Linda McGlade's other daughter-in-law deliver her baby boy. She died of internal bleeding two days after giving birth back in 2004."

In other words, they attempted to deliver a baby without having a license to do so. Sadly, the mother died; the baby survived. This site has a lot more detail if you're interested (fair warning: it's very sad).

What I'm wondering is, just how prevalent is this practice? If someone decides to give birth at home without a trained person present (midwife, doctor, nurse, whatever) and nothing goes wrong, would they be prosecuted as well? Judging by what I've seen on Babble, home births are far more common than I realized. If I had to guess, I would say that a large percentage of these births are against the law. And something else: isn't the problem that the patient died and received poor treatment, rather than the midwife's lack of license? I mean, you can get a midwife license online. (CORRECTION: according to a commenter, that web site only offers the coursework; to get licensed you have to complete your training under supervision.)

Image/source: mysuncoast.com

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Only 43% of British Moms Offered Home Birth! Outrage!

Miriam Axel-Lute — Fri, 05 Sep 2008 20:55:00 GMT

Here in the states, we know things are a little different across the pond. British nannies have a certain something, their weather lacks a certain something, and there's that whole royalty business.

But sometimes we forget just how deep the differences can go. Take maternity care. In fact, in order to avoid a rose-colored-glasses look, take what bugs Brits about their maternity care, as described in a government-sponsored survey, and reported under headlines like "Maternity Nightmares!"

The top concerns, according to one TV station that has done a recent follow up, are:

"43% of women were not offered a home birth
23% said they were underfed in hospital
36% were not offered antenatal classes
18% said toilets and bathrooms on wards were not clean"

Well now. Certainly dirty bathrooms and not feeding new mothers enough is unacceptable. Sounds like there's some serious funding and staffing issues at NHS.

But to American eyes that top item feels a little like hearing someone complaining about the freshness and flavor of their food while you're starving. Natural childbirth and midwifery advocates here would be doing a ~~little~~ major happy dance if anywhere near 57 percent of pregnant American women were offered a home birth. (Or, you know, even if fully trained home birth midwives were no longer treated as criminals.)

Even though the survey found only about 3 percent of British moms actually did give birth at home, even the mainstream British media clearly thinks having the choice presented to everyone is important. How strangely refreshing. Perhaps the AMA (which is trying to make home birth illegal) is overdue for a British invasion.

BirthChoice logo used with permission.

Is Home Birth a Civil Right?

Hannah Tennant-Moore — Sat, 09 Aug 2008 19:00:00 GMT

Most people agree that where and how to give birth is a personal choice. But what if your choice is one that many doctors feel is dangerous for you and your baby?

A resurgence in the home birthing movement has doctors and midwives grappling with this question, and Babble’s own Ada Calhoun has researched the heck out of the issue for Time.

Women who opt for home births argue that this method allows them more control over their birthing experience, making it unlikely that they will undergo interventions, such as C-sections or episiotomies, that they don’t feel are necessary. Midwives only assist at home births for low risk patients, and are trained not only to deal with emergencies themselves—often in the exact same way an obstetric nurse would—but they also know when it’s necessary to bring a patient to the hospital as quickly as possible.

But many doctors argue that the best medical care can only be accessed in the hospital—period. The American Medical Association is urging lawmakers to restrict the home birthing movement, in part by making it more difficult for direct-entry midwives (who don’t have nursing degrees) to get licensed.

Currently, only 1 percent of U.S. births occur in the home. So midwife Joan Bryson seems justified in defending home birth’s safety in these terms: “We [the U.S.] rank 42nd in the world in live births, and we spend more money than anyone else. You can’t blame it on home birth.”

My personal experience makes me naturally inclined to side with Bryson. Both my sister and I were born at home with a midwife, and my parents describe the experience in near ecstatic terms (honestly, their extreme enthusiasm when recounting my mother's 12-hour labor can be a bit disconcerting). Also, my older sister never exhibited the jealousy and sense of displacement that many older children feel after the birth of a sibling. I believe this was in part because she was present in the house while my mother was in labor, and was able to see my mother and me almost as soon as I was born. There was no sense that her mother had disappeared, and then returned carrying the reason for her disappearance.

It goes without saying that giving birth at home is not for everyone—but neither is giving birth at a hospital. Competent midwives should not be subject to prosecution for allowing women to opt out of a traditional hospital birthing experience.

Photo: Time

Would You Let a Midwife Perform Your C-Section?

Madeline Holler — Wed, 16 Jul 2008 18:14:00 GMT

Well, would you? What if she had trained for four years as a midwife and performed more than 100 c-sections under the eye of an actual surgeon? Still no?

Well, maybe me too. I don't know. But! I have the good fortune of not ...

being desperately poor and living in rural Mozambique, where there are but 18 OBs for the entire country (yes, the entire country and its 19 million inhabitants!). Because in that case, I'd say I'm allllll for it.

Last night, PBS's Wide Angle (the summer version of Frontline) aired a documentary about one woman who trained in this innovative program and, OK, sure, I'd let her have a whack at me. She was kind, totally cool under pressure and knew her stuff. You can watch a preview here and also a short take on midwives in the U.S. Or read more about Mozambique and its tragically high maternal and infant mortality numbers.

Of course, midwifery supporters such as myself have to approach the topic if midwives performing surgery with some caution. Having had a midwife-attended home birth in a state that had yet to legalize professional midwives, I know that doctors and lawmakers opposed to midwifery often scare people away from the idea of legalizing the profession by saying "they'll start performing c-sections!" or "now they'll do abortions!" So it bears pointing out that in Mozambique, training low-level healthcare workers in surgery (not just the midwives are picking up the scalpel) is a response to a severe shortage of doctors in the country. It's the best they can do for now.

Oh, and it's working!

Czech Law Forces Pregnant Teens Out of School

Newborn Son Brings Dead Dad Back to Life

My Big Fat American Pregnancy

Photo: PBS.org/Wide Angle

Ohh, Baby - Orgasmic Birth Video

Brett Singer — Mon, 07 Jul 2008 14:00:00 GMT

Some things go great together. Chocolate and peanut butter. Milk and cookies. Childbirth and orgasms.

What, you disagree? You think that it's unbelievably weird to be thinking about sex while your child is being born? What are you, a stiff?

There's a scene in Edward Albee's play "The Goat or Who is Sylvia?" (which is about a man who -- SPOILER ALERT -- cheats on his wife with a goat) when the father (who is having an affair with a goat) is comforting his son and talking about becoming sexually aroused at a certain inappropriate time (when a baby is bouncing on your lap). His friend enters and overhears the conversation, saying, "Is there anything that doesn't turn you people on?"

That's what I thought of when I saw this video. What possible good can come from reaching orgasm while you give birth? Why does it have to be either insanely painful or insanely pleasurable? Why not something in between?

If somebody wants to give birth outside of a hospital, that's their business. (Unless they want to do it RIGHT outside a hospital, on the street. That seems like a bad idea.) Madeline Holler just wrote a terrific essay on home births. But why does it need to be a sexual experience? And before you say, "Don't knock it 'til you've tried it," let me be the first to tell you that trying it isn't an issue, because it'll never happen.

Here's the video. You tell me what the creepy factor is. For me, on a scale of one to ten, this is an eleven. But maybe I'm just uptight.

The U.S. of A: Fertility Capital of the World

Home Delivery Only for Pizza?

Tyra Learns to Breast Feed

Attack of the Strippers

Watermelon the same as Viagra – maybe

Let This Woman Give You A (birth) Orgasm

Come Again? Orgasmic Childbirth?

911 Operator Talks Couple Through Home Birth

Amy S.F. Lutz — Thu, 29 May 2008 18:32:00 GMT

Is it just me, or have 911 operators been getting a bad rap lately? Callers have been kept on hold, kids in crisis have been accused of making up stories, help hasn't arrived in time. But Janet Jones, from Sarasota County, Florida, may have just redeemed 911 operators everywhere with the calm and capable way she talked Andrew and Dina Layne through an unplanned home birth.

Dina Layne was 37 weeks pregnant when her water broke. She had her husband call 911 for an ambulance, but the baby started to crown before the paramedics arrived. Although Jones, who has been a 911 operator for more than two years, had never handled a situation like this, she gave Andrew detailed instructions, including directing him to position Dina on the bed with her head raised, telling him to make sure his wife took deep breaths during contractions, and instructing him to support the baby's head and shoulders as it emerged. After baby Trevor was born, Jones walked Andrew through the process of tying off the umbilical cord with a shoelace.

You can listen to the entire 911 call here. My favorite part? When you can hear the happy tears in Jones' voice after the successful birth.

Let This Woman Give You A (birth) Orgasm

Cole Gamble — Thu, 06 Mar 2008 16:00:00 GMT

One Tennessee midwife is touting her “orgasmic births” or, if you prefer, births with a happy ending. Fellow blogger Kelly has written about the birth orgasm phenomenon here. Now this midwife is selling the baby "O".

Everybody knows you’re not supposed to enjoy giving birth. Now you say orgasming and birth are synonymous? Hmmm. Next time my wife says I’m not being sensually attentive enough I’ll just get her pregnant. Could you hear the rimshot after that one? Here’s another: I once had a girlfriend who said that lots of foreplay gave her multiple births, but I’m pretty sure she faked most of them.

So, birth orgasms, yeah! No longer do you have to hide how powerfully sexy you feel as another human being is clawing it's way out of you. But hold on ladies, read the fine print. At the end of the article the midwife admits the term “orgasmic birth” is not so much a guarantee as a marketing ploy. Some "orgasmic" results might only be metaphorical. Selling products with the promise of unadulterated orgasming isn’t new. Worked for Herbal Essences shampoo and, I don’t know, tube socks? Really, though, read Kelly's original post. A woman suggests you help your sexual pleasure during birth along by making out with your husband. So when you're water breaks, you'd better break out the Binaca because you're in for eight to twelve hours of hot and heavy french kissing.

Photo: www.msnbc.com

Are Hospitals Bad for Babies?

Karen Murphy — Sun, 03 Feb 2008 18:27:00 GMT

About the last thing you'd want to hear when planning an upcoming birth is that the place you're going to give birth in? The hospital? May be one of the worst places for your baby. Yikes.

But a new (small) study looked at 388 babies born in a teaching hospital in the south of France during most of 2005. Of those 388 babies, 116 were affected by a total of 267 "incidents", defined as anything compromising the safety of the baby. That's almost 30%! And here's why:

Most of the incidents involved babies who had low birth weight, were in the hospital for an extended time, or had an IV line or breathing tube or were on a mechanical ventilator. In short, these were the babies who were subject to more handling by hospital personnel, and therefore were at greater risk for "incidents." (yes, that word bothers me) In addition, these are the babies who already may be somewhat compromised, in a weakened state, etc, and so are more susceptible to problems and "incidents." Plus, this was a teaching hospital, which implies that there's a level of learning involved (and therefore, possibly, a greater risk for mistakes).

But a large number of the "incidents" involved medications, dosing errors, etc. And it's admitted that pediatric medicine has a long way to go with newborns, who seem to be a science all their own and can't be treated, necessarily, as older babies are.

And, it's fairly common knowledge now that anybody spending time in a hospital these days is at greater risk for developing infection. (Did I hear that a little handwashing could help with this?)

So here's the bottom line, in my opinion:

Babies who need medical intervention do belong in hospitals, but it's a double-edged sword. Babies who are healthy (and everybody else) should stay out of hospitals (home birth, anyone?) beyond the necessary.

Oh, and medical science has a long way to go.

Photo: www.mcmasterchildrenshospital.ca

Christina Aguilera Has Baby--And Jennifer Block Preaches C-Sections

Kelly Mills — Sat, 12 Jan 2008 13:57:00 GMT

Yesterday was the date the mags and rags told us one Christina to the Aguilera had her baby, possibly by scheduled cesarean section. Jennifer Block wrote our fair lady an open letter on HuffPo before the blessed event, opening with the statement that it is every woman's choice how she does her birth. Buuuut c-sections are so much more dangerous for mom and baby, have a longer recovery time, and are more painful. She notes that if Xtina is going non-hoo hoo birth for cosmetic reasons, she should know about the belly skin overhang that is the aftermath of the "C". Block tells Xtina that since she has all the money and resources at her disposal, perhaps she could consider a home birth, an option not even available to most women. She stops short at mentioning the possibility a vaginal birth can make you orgasm. And now I'm actually feeling bad for Xtina.

See, I get why people don't want births to be so medicalized, and I do believe home births should be legal and I'm fully supportive of however anyone wants to get the little bundle to emerge. But damn, leaving aside the fact that we have no real idea what Xtina did, if she wanted or needed a c-section, then I say leave her the hell alone. I mean, if she had some medical reason for the "C" would anyone decent then launch into the litany of how much more dangerous it is than vaginal birth? Naw, the assumption is that she's doing to avoid birth pain (as reported) or for vanity or convenience. Well, so what? It's her life, her baby. Just because she's famous, doesn't mean she has to be earth mama for us all, resources at her disposal or not. I have to tell you that at times, some folks in the natural home birth camp bug the hell out of me with all the preaching. For some people birth is better at home, and for others, an epidural and a doc are a better fit, and for still others, a c-section is going to be the way to go, and even an imperative. I guess I think it doesn't matter as much how the babies come out, and more that everyone gets support and non-judge-y love.

Unassisted Birth -- Help Me Out

Madeline Holler — Wed, 09 Jan 2008 22:46:00 GMT

When I read stories about women who opt to give birth at home allllll by themselves -- no help from a midwife or a doctor or a staff of nurses -- I think to myself, "can you blame them?" I know, I know, a lot of you are thinking these people are just trying to be heroes or adhere to some kind of radical hippie code that shuns any relationship with established authority. Or you think they're narcissistic idiots who put their own childbirth dreams above the health and safety of an innocent child. Homebirth moms get that kind of talk too.

But I think all that's wrong. Quite wrong.

Pregnant women in the U.S. are in this totally weird position where our reproductive rights are, on both ends of the conception and pregnancy chronology, narrowing quickly. State judges, with the eventual help of the Supreme Court, are shrinking options on the early end of the spectrum. Doctors, hospital administrators, and insurance companies and legislatures (who make midwifery a crime) are taking away choices at the latter end.

Let's focus on the latter:

More than one third of all childbirth in the U.S. results in surgery -- a c-section. Some are, of course, necessary (but, like, 10 percent). A tiny percentage are the "too posh to push" variety and not indicated, but allowed (and hey, it's your choice, I won't stand in your way.). More are the "once-a-c-section-always-a-c-section," variety and then the rest, a significant number, could probably have been avoided all together.

It's the last two that, I think, push women to go the DIY route. In loads of hospitals all over the country, VBACs have been banned. Doctors and midwives are not allowed to do these vaginal births after ceseareans because of some studies that say there is an increased chance for uterine rupture in VBACs. Which may or may not be true, but that chance of which they speak is actually quite small. So what do you do? Avoid the hospital.

And avoidable c-sections? There a loads of ways to decrease one's risk of being pushed to have a c-section, but many can't be done in the hospital. Get in a tub, move around, stay off IV fluids, don't get hooked up to continuous fetal monitors, blah, blah, blah. They were in the birth plan! But the pressure! Look at what the quoted doctor has to say:

"What women need to appreciate is that the few hours of labor are the most dangerous time during the entire lifetime of the soon-to-be-born child," said Dr. Frank Chervenak, Chairman of Obstetrics and Gynecology at New York Presbyterian/Weill Cornell. "Because of this, I would argue ... all soon-to-be born children have a right to access immediate Caesarean delivery, and women who are denying this right are irresponsible."

So what do you do in your next pregnancy? That's right. Avoid the hospital and that attitude toward pregnancy and childbirth.

What about the child? Well there are risks to childbirth and those risks play out in different ways in each of the settings a woman might want to give birth in. Don't think women and babies don't die after childbirth in hospitals, which is NOT saying death in the hospital is certain and likely. Just like it's not certain and likely at home or unassisted.

What I'm trying to say is that women/patients/clients want what they want. Because there are so many possibilities. So many ways to do it right. So few ways that make it wrong (smoking crack comes to mind -- but who am I to judge?) Yet hospitals, midwives and doctors only allow for (without battles) a certain range of them. And that's fine for them and their jobs. But not fine for some women. So some women opt for birthing centers with midwives or doctors, or homebirth with midwives or (the few remaining homebirth) doctors. And some women opt to go it alone.

Unassisted birth is not for me, but like I said, who can blame them?

PS: Is it me or is that a fake belly on the woman in the picture? Just asking ...

Photo: ABC News

Kids in the Delivery Room: Yes or No?

Karen Murphy — Tue, 01 Jan 2008 15:56:00 GMT

Birth. Such an intense experience, sometimes. Mine were, anyway, all four of them. And in the last three, there were older siblings to think about, and they were one of the many things I obsessed over in the weeks preceding the birth: what to do with the kids??

I ran across this "Ask Amy" column in the Chicago Tribune this morning, where someone was being encouraged to watch her friend's kid in the labor room during birth, and it all came rushing back to me: all the worrying about arrangements for my older kids during an event that no one (except maybe the baby, who wasn't telling) knew when would happen. Contingencies for every possible permutation of labor had to be considered. Truly, this was an obsession for me. It probably would have been easier if I just let the older kids be at the birth. But...I just couldn't. Could you?

Yeah, yeah, people have home births all the time. I almost had one until I freaked about about it at the last minute (and it turned out the baby needed medical attention anyway, so it was a good thing after all), and I have tons of friends who had beautiful gentle home births with their older kids present and attentive, a warm and welcoming experience for the whole family.

But...I still can't get past the difficulty I had about the intensity of the experience, and how my older kids would have taken that. Yes, I know it's a natural process, part of life yada yada yada, but what kid wants to see his mom semi-naked, screaming, grimacing and maybe even pooping during birth of the baby sister/brother that the kid is ambivalent about anyway? Do kids really want to see this stuff?

What about you? Did you have your older kids present for the birth of your younger ones? Either way, if you had it to do again would you change your mind? (Here's some comments from parents on a UK homebirth group)

Photo: storchenwige.com

http://www.chicagotribune.com/features/columnists/advice/chi-0101askamyjan01,1,2144580.column

Babies Are Expensive, Hospital Edition

Karen Murphy — Mon, 29 Oct 2007 11:32:00 GMT

I'm pretty sure that none of us are having babies in order to make money (are we? if you are, I'm not sure I want to know you), counting on future income or whatever. In fact, most of us accept the fact that kids are pretty much a loss financially. A pretty big one, too. And the cash drain begins before they are even born! (Isn't parenting fun?) So why it's news that babies cost money, I'm not sure, but here it is:

Babies cost money. Oh yeah, we covered that. Having a hospital birth? The average cost for that in the U.S. is $7600, including prenatal care. Not that it's all out of your pocket. Your average expense is only about 8% of that if you're privately insured.

Interestingly, the cost for women on Medicaid to give birth is less than that for women who have private medical insurance, though the prenatal care expense is about the same. Hmm. (Can you say, "There's something wrong with this picture?" And on Medicaid, the average out-of-pocket expense is only 1% of the total cost. Hmm again.

Care to draw some conclusions from this information? Here we go:

1. Blah blah blah U.S. healthcare system.

2. Blah blah blah gouging by U.S. health insurance companies.

3. Home birth blah blah blah.

There. Are we all clear on that?