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Depressed about U.S. Birth Culture

post #1 of 21
Thread Starter 
I am so upset and discouraged by the state of maternal and infant care and the increasing pressure to once again reduce women's birth options in the United States. Just a few recent indicators:

- the closure of the excellent midwifery practice at Georgetown University Hospital in DC, a birth center in Boston, the loss of hospital priviledges to the Seattle birthcenter and homebirth midwives that appeared in the PBS documentary Born in the USA, the closure of the University of Utah birth center (several years back)... I'm sure the list goes on and on...

- the increasing difficulty and expense of obtaining malpractice insurance for home-birth midwives not to mention poor health insurance coverage for the same

- completely unethical "statements" by ACOG and pressure many women get to have interventions they absolutely do not need, and active hospital and cultural discouragement of breastfeeding

- the supposed "murder" case against the mother in Utah who did not consent to a C-sec soon enough to "save" both of her twins...

Can anyone help me feel any less depressed about the apparent renewed attempt to eradicate midwifery in the United States?
post #2 of 21
Thread Starter 

Here's a news link

About Georgetown laying off their midwives:

post #3 of 21
I agree, but I for one am so happy that homebirth midwives do not need malpractice insurance. It's malpractice insurance, and the culture of litigation in our culture, that has created some horrific policies around birth. (Well, it's one of the main reasons...)

I love the fact that I do not have to answer to a malpractice insurance company telling me what I have to do, or when I have to do it.

I wish more homebirth midwives had autonomy. I realize that in my state, I am very, very lucky.

It is sad about CNMs and how so many of them are losing MD back-up and support.

I am seeing a resurgence in people choosing midwifery care and more natural birth. Natural birth is often difficult in the hospital, but I see women fighting for what they want.

I believe that the internet has been a HUGE benefit to women and babies in regards to birth. I think we will see a shift after it gets much worse. I hold alot of hope that things are changing. I trust that women will stop letting others have control over their bodies and healthcare.

Times have changed in the last five years already. I hold great hope!
post #4 of 21
Very sad. Unfortunately, I am hearing more and more stories like this. The wonderful birth center on my island just closed last year, after only being open for one year.

Suzanne Arms spoke at a conference I attended last weekend and told of a hospital that fired its CNMs with no warning. One day armed gaurds just came in to escort them off the premisis. One was with a laboring woman and one was even attending a birth. Unfortunately, they don't seem to be organizing, they are probably afraid of never being able to work again.

However, I have a friend in nursing school. She is very medically-oriented. This week she observed two births. She said one was with an OB and the other with a CNM. She told me the difference was like night and day. I asked which she preferred, and she said "THe midwife, defintly, thats why I am telling you this story." She said her bedside manner was so much better, she liked how the lights were low and everything was gentle. In the OB-attended birth it was very "managed", it was clearly painful (induced) and she said watching the epidural was the worst. It took 3 tries and she then couldn't feel to push, so my friend and another student had to hold the woman's legs. If she feels like this many of the other students probably do to. Also my friend was one to sing the praises of epidurals (despite never having a baby) and the entire medical field, so maybe attitudes are changing. I just hope it isn't too late.
post #5 of 21
add Elizabeth Seton Birthing Center in NYC to the list of closures.

It is all very depressing. I know many women, myself included, who had birth center birth with midwives in attendance. Without a birth center option, it would force many women to choose between hospital births with OBs and home births with midwives. Some women are not comfortable with these 2 options and thus the free-standing birth center was the perfect solution!

ldsmama, thank you for posting on this very important issue. It may take a heavily coordinated grass roots effort to reopen the birth centers and protect a woman's right to birth options....

P.S. It was my midwife who was featured in the PBS documentary you mentioned. What can we do to encourage our birthing practitioners not to give up?!
post #6 of 21
Hi Everyone,

Sigh. Yuk...such sad news all around.

What I don't understand is why malpractice insurance is so high for midwives. I keep hearing, although I don't have any hard data, that midwives are sued less often because they encourage their clients to do their own research, participate in decision making and own their choices. The cases I have heard about where a midwife ended up with legal trouble, it was the state prosecuting while the parents supported the midwife. Those cases shouldn't figure into malpractice rates because they involve midwives attending homebirths in alegal or illegal states.

Anyone have more data? Also, are there any good organized efforts to support midwives and birth centers?

post #7 of 21
I am a doula and feel just the same way. I was living in Manassas ( i saw you are forom n.va.) and now live in PA, where the birth climate is just as, if not more crappy. I am going to nursing school to then go on to get a cnm degree but sometimes i get so frustrated i just think I should stop with the rn degree and work in say, orthopedics or something else completely not birth related. I read something in midwifery today that talked about the high burn out rate among midwives- i can understand why.
post #8 of 21
Thread Starter 
Thanks for your thoughts, all.

There are several non-profit, consumer-based midwifery support groups. Midwifery Options for Mothers (MOM) is one. Citizens for Midwifery is another. They seem to be more localized, based on what is going on in each state or locality. The net is a great way to find them.

But does anyone know of a more national or global effort (consumer oriented) beyond the education efforts of Lamaze, BirthWorks, Bradley, ALACE, and ICEA? (I'm a CBE.)

Other orgs that can be helpful in midwifery advocacy are birthing circles. They're kind of like LLL for birth. Groups that get together once a month or quarterly to discuss birth options, and provide support and information about birth options in a non-judgmental way. There is a birthing circle in Maryland (the closest I know of). Also one in the Seattle area I believe... I don't know where else. Kinda a new trend I think.

There is also the Motherhood Quilt project that you can find online.
post #9 of 21
For birth supportive resources, check out the Seattle Midwifery School website... lots of great info. Also, I rec'v their midwifery and doula e-newsletter if anyone is interested in getting it, you can sign up to receive it on their website.

post #10 of 21
May is International Doula Month and May 5 is International Midwives Day... perhaps there are activities/events in different geographic areas to celebrate....
post #11 of 21
Thread Starter 
Murder charges were dropped. Melissa plead guilty to two charges of child endangerment and admitted to cocaine use so will enter drug treatment as part of her sentence. Well, one better than it could have been outcome. Though still never should have been charged w murder in the first place.
post #12 of 21
When I gave birth to my DD 3.5 yrs ago, I was 6 mos shy of age 40. I got my prenatal care from a wonderful practice of midwives and ended up w/the best of them at my DD's birth. I was one of the last ones to receive care from there before they disbanded. Many other women had to finish their prenatal care elsewhere, but I can't imagine where I would have gone. I refused all prenatal testing (including the glucola drink) and they were very supportive of my decisions. Although I gave birth at a hospital, I had a wonderful, natural and unmed birth, thanks to my midwife and doula. My midwife was willing to let me birth on the floor and was fabulous guiding me through my contractions--I didn't even tear. I would never had had such a wonderful pg/birth experience with an OB doc.
post #13 of 21
Thread Starter 
Just heard word that a birth center in Baltimore is closing as well.

Can someone give me a quick course in activism 101??? What can I possibly do about this?
post #14 of 21
Citizens for Midwifery - Learn, Connect, Take Action

I joined their grassworks e-mail loop. It's activist oriented. I encourage all of you to join if you haven't already.

Does anyone know of other similar groups?
post #15 of 21
Thread Starter 
Thank you Tanya!!! I think I'll start keeping a list of birth center and midwifery practice closures on my own website, too.
post #16 of 21
*sigh* yes....

Also Pennsylvania Hospital (Phila) just announced plan to close their Birthing Suite this summer. That is, the CEO announced he will no longer fund the birthing suite's nurses' salaries.... so the mw's can't exactly continue without $ for their nurses.

I wanted to also mention the Coalition to Improve Maternity Services (CIMS ). Great avenue for advocacy!

post #17 of 21
I'm often hearing of OBs deciding they are tired of paying malpractice premiums and choosing to be only gyn's. So maybe the reverse is also happening...soon, there could be no more OBs and women would have nothing else but direct entry midwives, and after the birth would wonder what all the fuss was about...
post #18 of 21
I am actually very hopeful about US birth culture. With all the concern about the spiraling costs of health care, somebody somewhere is going to wise up and realize that midwifery care would save a whole lot of money.
post #19 of 21
I'm frustrated, too. Knowing myself pretty darned well, I think what I'd most like (as far as birthing options go) is a CNM (or other midwife) at a birthing center. But I didn't have a birthing center close by when I had ds, and heck, I don't know if there even are any in the state where I currently live. And there are no more CNMs in my town (I guess none of the OBs are willing to serve as back-ups???). It doesn't seem like there's a range of choices at all.
post #20 of 21
Thread Starter 
Actually, rising professional liability insurance is affecting midwives, too. And the new insurance carrier for the American College of Nurse Midwives does not cover home birth. What kind of statement is ACNM making with a decision like that?!
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