Lesbian-friendly care providers in RI/MA

[hilbean88]

Hi, a lesbian couple that I am friends with recently got pregnant using IUI and is looking into their options for birth. They are currently seeing an OB affiliated with Charlton and they love her, but are worried that they may not be able to get the natural birth that they desire. They have put together a birth plan and a list of questions that they would like to use to interview their current provider as well as any other prospective providers. They are looking at midwives, including homebirth midwives, though they aren't 100% sure that they would like a homebirth. (I'm partial to homebirth given my Feb 20, 2009 HBAC which was absolutely AMAZING!!!)

Does anyone have any experience with Charlton?

Does anyone know of any providers/places that are particularly lesbian-friendly? Or particularly UN-friendly that they should avoid??

Thanks!!!

[Paige, CPM]

Congrats to your friends (and to you too, for your hbac)!

OK, I say this in every post on the subject as I am all about people having a humane, compassionate and empowering experience during their prenatal, birth and post partum care. I may be a hb midwife but I really wish this was offered in every birth setting, but, by and large, in hospitals, it is sadly not. Charlton is no exception with their high c/s rate. It is all about liability based protocols being in place at the hospital and also provider training and beliefs, and the truth is you or I may be the nicest person but as an ob provider we may not have the training to be able to trust in a woman's body. Compound that with the fact that even if you love one or two of the people in the office you go to for your care there may be two others you do not like and you never know who you will end up with at birth. So, personally, I am blessed to know that there are a couple of good hospital providers (excellent stats, highly personal care, belief in our bodies abilities to give birth, etc) in our region. Mary Mumford Haily, CNM at Memorial (you can read other threads about her here) and Louise Bastarache, CNM (you can read about her here too) at Tobey in Wareham. HB midwives, as you know, another awesome option with excellent stats. If they are interested in exploring all their options they may want to watch the Business of Being Born, check the homebirth section here at MDC, and read Pushed by Jennifer Block are good places to start...then book a free consult with one or more of us (massmidwives.org, also I am in New Bedford, which may be close to them) to ask the really detailed questions...this will be helpful in making a fully informed choice. There's another video...It's My Body, My Baby, My Birth that talks about homebirth and what it involves from the midwife's and clients' perspective. I have these videos/books too, if they would like to borrow any of them, just have them contact me ([e-mail]).

Good luck to your friends and all their parenting decisions!

[FtMPapa]

I can't help with specifics, but I can share that one the first families in my little circle to have kids is a two-mom lesbian family and their hospital tour convinced them that home birth was how they wanted to proceed.

Basically, they ran SMACK into the heterocentrism of the hospital, from the nurse saying "And this chair pulls out to a bed where the dad sleeps" and non-pregnant mom saying "Or the other other mother." And then they get to the next thing in the tour "And this is where the kitchen and lounge is where the dads like to hang out sometimes." And the mom said "Or the mother." You get the picture.

I would encourage them to do their hospital tour now rather than later, it's the post-partum staff that are going to make the difference, and that has nothing to do with the OB or the midwife attending in hospital, because ze isn't going to be around after the birth, or at least, not much in the case of midwives.

[hilbean88]

Thanks, Paige! I have them watching The Business of Being Born on netflix this week I'm also trying to get them to read Henci Goer's The Thinking Woman's Guide to a Better Birth. I think they were pretty closed off to a homebirth, since she had an ectopic pregnancy and thought this meant that she was high risk and should be in the hospital, but I think I have since opened their minds a bit. Actually, the pregnant mother told me today that they are leaning towards a homebirth, but want to fully interview their current OB and hospital based midwives, too, before making their decision. I've done my best to educate them and I think they've come up with a good set of questions to really find out the kind of care they will be getting. And from what they've been learning, they're beginning to think that they won't be able to get the birth they want in a hospital. But they are still exploring all the options and doing research, which is good, they should be well-read and comfortable that they are making hte right decision for them. Anyway, I know that they are also worried about the attitude of a HB midwife towards them. I guess they've had good experiences thus far with Charlton...and somewhere (I think their website?) she read that "79% of births at Charlton are vaginal." I believe the website also uses "Fathers/Significant Others/Partners" throughout, which also makes them feel better.

I will let them know about the other movie that you recommended, Paige, and that you are willing to loan it to them. You actually helped me find Sue Smith and I interviewed Mary Mumford-Haley (who I REALLY liked as well, but ultimately decided that homebirth was the way for me to go) because of you! Thank you for being on these forums and doing all that you do to help every woman get the birth experience that she deserves!!

[hilbean88]

Thanks, FtMPapa! I will definitely pass on the suggestion to do their hospital tour very early! Their current experience with the hospital is lab work and the ER and what they've read on the website. Good luck with your pregnancy! I think my friends are due around the same time as you =)

[Paige, CPM]

Thank you for your kind words, hilbean88.

As far as homebirth midwives go most of us a pretty progressive bunch, when I went to midwifery school about half of my class were bisexual or lesbian, that is a pretty heavy percentage. I think the midwifery model of care is very attractive to many of us because it has a strong feminist angle...it is the way all women and families should be treated. I know traditionally midwives have been associated with religious movements but today it is very much a mixed bag. Here in MA however there are just a couple of more religious homebirth midwives. I would be happy to pass along that info...not to badmouth at all, but just to save everyone time.

As far as hospital stats go, they are a general guideline, the best thing that anyone can do is to find out each persons c/s, episiotomy, epidural rates in the practice...this will give the best indicator of how it may go at birth, who really supports low c/s and natural birth. I have to say also that it is not about 'natural' birth per say, but about getting a woman, if she wants an epi as far along as possible and keeping it intervention free. So like as natural as possible, which most ob practitioners do not know how to facilitate, sadly...just not in the training, imagination...

Here is the 'latest' Birth Data for MA hospitals (2007) http://www.mass.gov/?pageID=eohhs2te...s&csid=Eeohhs2

Charlton is listed as having a 33.7 % cesarean rate. Pretty dismal. According to WHO standards it should be 10-15%, NO EXCUSES...Charlton is not a tertiary care facility dealing with the really difficult cases.

To give you an idea, which you may already have, Tobey has the best stats in MA at 17.1% cesarean rate. I believe Louise has an 8% c/s rate, one of her backups a 10% rate. I am not sure about the other two practitioners there but they seem to be more typical care providers so this would account for somewhat of the statistical rise to 17.1%. Let me say that the other two docs, although from what I understand, are more conservative, did take excellent care of me when I had my son with Louise and them 3 years ago. I know a lot of it had to do with Louise's mediation...she was there with them through the entire process...7 days, 3 inductions and finally a vaginal birth. That is the kind of service you just can not find in most facilities. And I am sure she did not get paid, because the insurance companies will not pay two providers...

Homebirth midwives have the lowest rates (as we deal only with pretty healthy clients, but still ours are outstanding). It is because we are free to practice medical evidence based care and have been taught many tricks for helping labor and postition, psychology that are not taught in medical school today...plus no shift change, patience, etc... My c/s rate of 3% is not uncommon.

I know you know this stuff hilbean88, perhaps you should share this thread with your friends... Take care!

[FtMPapa]

Somewhat OT, but to build on what Paige is saying, take the stats with a grain of salt.

I realized after my appointment with a nurse at a local hospital that has excellent stats that one of the reasons their stats are so good is because they're basically a small satellite for the bigger hospital owned by the same corporation, so they are extremely likely to transfer people to the bigger hospital, thus keeping their numbers low, while the big hospital's numbers are much, much higher (because they have the only NICU around here, and because they get all the high risk folks, and because of all the transfers, plus the socioeconomic factors, etc).

So it turns out that my local hospital where the numbers aren't as good is possibly a better or equivalent choice because they're a bigger hospital and their threshold to transfer to The Big (owned by a different coporation) Hospital is a lot higher.

It makes sense to look at individual providers, too. My local hospital has both a birth center and an OB ward, but the numbers get lumped together for stats.

The numbers from any homebirth midwife are going to be better, but again, part of that is the type of client and that high risk folk are going to get tracked out early.

FYI, a previous ectopic, once this pregnancy is known to be intra-uterine, which they should know by now, doesn't make this one any higher risk.

[sparkjen]

I just want to add my 2 cents here for an alternative to homebirth for your friends to consider: Birthing Centers tend to be places where staff are more likely to be open to different types of families. We had a wonderful experience at the Birth Center at Cooley Dickinson hospital 16 months ago, where my partner gave birth to our son. And now that we live in Boston and I'm pregnant, we're having a very nice, welcoming experience so far at the Cambridge Birth Center which is associated with Cambridge Hospital. I think in general midwives, CPMs or CNMs, are going to be a lot more open to lesbian families than your run of the mill OB... however, in MA, anyway, where we're coming up on 6 years of legal same sex marriage, I think they'll find more and more openminded professionals in most areas.

[KnittingTigers]

We are a queer family who gave birth in Rhode Island with Mary Mumford Haley at Memorial. Mary is great, and I recommend her without hesitation. That said, I second what Papa said about the heterocentrism of hospitals. Memorial is certainly no exception.

If I were to do it again, I'd have a homebirth, because I found the hospital very stressful. Being queer was part of that, but only part. I think hospitals are just stressful places, especially when you're in labor. However, one thing that helped me relax is that no one at Memorial pushed anything on me, meds-wise. Honestly, people trying to put an IV in my arm would have stressed me out far more than someone asking, "So who's the dad?" But, that's me. For other people, it may be exactly the opposite.

So I guess what I'm saying is, your friends may have to figure out what their priorities are, and go from there. No one at Memorial was hostile or unfriendly at all; they were just a little clueless. I was willing to take that over a place that was more queer-savvy but less likely to let me have the natural birth I wanted.

If you want to put your friends in touch with me, send me a PM and I'll give you my email address.

Good luck!

[FtMPapa]

Originally Posted by sparkjen

however, in MA, anyway, where we're coming up on 6 years of legal same sex marriage, I think they'll find more and more openminded professionals in most areas.

This is true, we do live in a very liberal part of the country. But speaking as someone who was refused health care by a fertility clinic because of my gender/sexual orientation (a little of both) in the past six months, I can tell you that it still happens.

It happens in overt ways, like what happened to me, and it happens in subtle ways.

And it only takes one bigot to ruin your healthcare. I don't mean ruin the experience of giving birth with a "who's the dad" comment or a "but you're the real mother" or something like that, I mean someone who can't see you as a real person and makes medical decisions that put you at risk of complications because of hir bigotry.

[joyrises]

And I would throw in my two cents and say, find a doula who is queer-friendly! As important as it is to to choose a facilty and midwife or OB who's truly accepting of your family and supportive of you birth plans- the reality is that a great deal of your labor time in hospital will be spent w/out the MW or OB present. Having a queer-positive doula is a great buffer from any insensitive comments or assumptions that might come along.

[elismum1908]

I had my son while living in Western MA and could not have been happier with the Holyoke midwives and Holyoke Hospital. The nurses were awesome and a lesbian midwife attended my son's birth.

Since then I have moved and am seeing Louise in Wareham for this pregnancy. She and her staff have been very supportive and friendly. DW and I toured Tobey Hospital and the staff was welcoming and didn't seem to bat an eyelash at us being a lesbian couple.

ETA: I agree, about getting a queer friendly doula. I can't imagine birthing in a hospital without a doula (hetero or queer, doulas are awesome!).

[Amberoxy]

I think I heard at the last playgroup I went to that MMH's practice is now doing home births...