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5/12/00
From the "Midwives-to-be" email list:
Message: 4
Date: Fri, 12 May 2000 12:38:02 -0500
From: "Beth Roberts/AUS/Lotus" <[email protected]>
Subject: Re: To Dawn, Stacy, Joy,Listmates-Please read!
(Ed. note: A nurse wrote to the list extolling the virtues of medical interventions which caused many responses on the email list. This is one of them)Ok, ok, I had to bite. My mother works in medical malpractice (she is an adjuster) and I am, shall we say, a little bit familiar with this attitude .
Gail wrote:
"many of you are not in the medical
profession, so you can't understand the reasoning for certain procedures."
I certainly hope that the medical profession uses a type of reasoning and logic that is accessible to others, rather than something that can only be comprehensible when the letters "MD" or "RN" are added to your name. I do know that many of these procedures are a CYA thing for the doctor and hospital, though. I don't have to have any letters after my name at all to understand that kind of reasoning.
"First, I have had moms who insisted on having the baby in bed with them, then fell asleep and the baby literally fell off the bed and hit the floor!"
Are you advocating that this never be allowed, then? I agree there are risks to having a baby in bed, but they can be minimized. How about better-designed hospital beds, with full-length side rails that a baby can't get stuck in? Rather than forbidding it, why not make it safer to cosleep in the hospital, so that the many benefits to mother and baby can be preserved?
"Vitamin K injection is an absolute necessity as a baby is born with not even minimal ability to clot it's blood."
My understanding is that it *helps* the baby clot blood better, which is very important to protect babies who have hemolytic disease of the newborn (which certainly does not affect EVERY baby, by any means). Are you stating that without vitamin K, every baby would bleed to death at the slightest pin prick? If you have some evidence, I would be glad to hear it, but this sounds like total bunk.
"Erythromycin eye ointment is to prevent a horrendous infection from all the bacteria in the vagina that can and has caused loss of vision for life."
Yes, erythromycin protects against gonorrhea-induced blindness in the baby. But rather than testing mothers to see if they have gonorrhea, everyone is treated. If the mother's not infected with anything, then the baby doesn't require erythromycin.
"I have read medical malpractice charts of babies left brain amaged from a Beta Strep infection."
And I have read medical malpractice charts of:
- a patient who was given pepto-bismol accidentially into their heart catheter (instead of the stomach tube).
- a man who hurt his back playing volleyball and was paralyzed for life starting shortly after he walked into the emergency room.
- a four-year-old girl who presented with a fever, was sent home, and died the next day of septic shock.
- a man with an injured ankle who died from septic shock (no break in his skin was ever found).
When you read medical malpractice charts, you are looking at the tiniest percentage of cases where something goes horribly wrong. Sometimes there is
clearly someone at fault - negligence, neglect, a mistake. Other times, it's just a freak occurrence that no one could have seen coming. This DOES NOT mean that you treat EVERY case as though it might end up as one of those 1 in 10 million bad outcomes. Even if you tried to keep everyone in the hospital at the slightest hint of danger, you'd end up hurting them through iatrogenic causes or nosocomial infections. Not to mention the considerable cost.
Mothers should be informed of the risks and allowed to choose accordingly. For instance, the evidence has shown that home birth is safer than hospital birth for low risk moms. Sometimes babies die, and sometimes mothers die, even in the hospital with every technological gadget available. And for many others, they are injured in the hospital (psychologically as well as physically) when they would have been better off at home. Let the person who pays the largest share of the consequences make the choice.
"A baby is born with no ability to fight infection!"
None? Zero? Zilch? I'd really like to see what evidence you have for this statement. This would be interesting, since formula offers NO help at all for the child's immune system -- a formula-fed baby would be dead with the first bacteria or virus that hit them (unless you figured out what was going on soon enough and gave effective antibiotics or antiviral agents). So withholding breastmilk would be even more dangerous than it already is.
"Although breast is best, there is nothing wrong with a little formula"
Blatantly, horribly incorrect. You really should educate yourself better about the risks of formula. Look at the AAP's recommendation statement - there are many, many references listed there for the myriad problems
formula-fed babies are prey to. Talk to any reputable IBCLC about what sort of damage can occur to a breastfeeding relationship due to early introduction of formula. (to start with: complete change of gut flora
making it easier for bacteria to invade, exposure to large amounts of cow's milk protein or soy protein (can trigger allergies, cause bleeding in the gut), baby is not spending as much time at the breast to receive immune
factors and stimulate mother's milk supply, and much more)
"have never seen a nipple confused baby in my entire career!"
How old are the babies when they leave your care? A few days? Sometimes babies can seem to be feeding well at this stage, when in reality they are just "hanging out" at the breast, or can be damaging their mothers' nipples trying to suck like they do on the bottle. You may not have seen one of these babies, but they sure do exist. I urge you to familiarize yourself
further with a good lactation text. The book I'm reading now, Dr. Jack Newman's Guide to Breastfeeding, has a great deal of excellent information on this very topic.
"Until the mother's milk comes
in (day 2-3 depending on if it's her first or second baby), 1/2 oz of colostrum just isn't going to cut it every 2 hours."
First of all, unless you're doing pre- and post-feed weights, how do you know exactly how much colostrum the baby is getting? If the baby achieves a truly good latch and is alert enough to breastfeed energetically and well, the baby may well be getting quite a bit more colostrum than you suspect. It is crucial to make sure the baby is breastfeeding WELL, not just mouthing the nipple. Also, why are you so certain that the way our bodies are designed is BROKEN? How did we ever survive if colostrum wasn't sufficient to keep a baby alive? (and it certainly is, barring rare abnormal circumstances where the mother's milk does not come in normally and in reasonable time)
"fetal monitors have drastically cut the incidence of brain damage and cerebral palsy, as a low heart rate can be picked up and acted upon much faster."
Would you please provide us with a reference for the above information? I am aware that there are multiple studies showing that this is not the case. They found equivalent outcomes for intermittent auscultation vs. continuous monitoring.
"all of you did not go through 9 months of pregnancy to end up with a dead or injured baby-certainly not me."
True, and no one can ever guarantee you a healthy baby, or that you will even survive childbirth. Certainly not a hospital! Birth is most often a normal event that is not a crisis. If something goes seriously wrong,
certainly it's a good idea to get the best help available, typically in a hospital. But this is certainly not necessary for the majority of births to mothers without prenatally-identifiable complications.
"So, next time you give birth, please understand that there are policies and procedures to protect you and your baby, and I promise you that you will be thankful for modern medicine!"
I understand the intent of these procedures, and I also understand that often they are not necessary (this varies with the individual procedure under discussion, of course), and that often there are other less invasive
ways of ensuring the optimal health of mother and baby. I do not object to them when they *are* necessary. Mothers should be free to choose them if
they wish, after being informed of the risks, costs, and benefits, and NOT coerced by well-meaning HCP's who try to make them feel as though they will damage their children if they refuse.
I would add that I have read many stories of women who have had both hospital births and home births, and by a clear and overwhelming majority, they have enjoyed the home births more. Those who had unnecessary interventions in the hospital were certainly not "thankful for modern medicine".
I am glad that the midwifery model of care is alive and well, but I don't see it existing much in the hospital environment.
No offense, ma'am, but I would NOT choose you to be my practitioner, with your attitude as shown by your posting.
-Beth in Austin, TX
Aspiring doula, maybe a midwife someday. Definitely want a home birth for baby #2, whenever that is.
more.....
The only other statement made by a nurse that I've ever heard that was worse than this one was "We get these women who read everything they can while they are pregnant, and then think they actually know something."
This statement was made to me by my SIL, who is a NICU/newborn nurse, during a conversation that started out with her saying "Do you know how hard it is to teach a woman to breastfeed if you've never done it
before?"
more...
First of all I want to say that I bet you have seen some pretty bad things in your 26 year career. I'm sure those things have built up a certain level of fear and caution. I am glad that you are on this list because I feel you
will learn a lot. I'm not going to criticize the things that you posted but I hope to educate you just a little bit.
I do want to respond to your statement, "I have had moms who insisted on having the baby in bed with them, then fell asleep and the baby literally fell off the bed and hit the floor!" I don't doubt that, accidents happen. I however, probably like you, have seen physicians drop babies during the delivery. I attended a birth in March with a CNM in a local hospital where the baby slide face first right into the catch pan. I have observed nurses washing babies in the nursery and banging their heads on the faucet or bumping them into the wall. In December I had a homebirth transport that
ended in a cesarean. The physician cut the baby during the operation. Let's just face it. Accidents happen!
" ...Since home birth and direct entry midwifery are perfectly safe options, (a majority of) State legislatures have concluded that it is the right of each woman and her family to choose such options. State laws must guarantee families the freedom to choose home birth by recognizing the type of midwifery which focuses principally on out-of-hospital birth, direct entry midwifery."
"State legislatures are also concerned with guaranteeing an open marketplace and fair competition, including in health care services. To exclude direct entry midwives from practice is to allow a scientifically unjustified monopoly of doctors and nurse midwives... "
-Marsden Wagner, to the Va.JCHC, 1998"Dr. DeLee, who introduced forceps and episiotomy
around the turn of the century, stated just before he died that if he had his whole life to live over he would do home births and nothing else, realizing that the majority of his work was probably going to do bad instead of good."
-Mayer Eisenstein, MD in Safe Alternatives in Childbirth
A Forum for people interested in learning more about the Art of Midwifery and how to become a Midwife.
Go To the ASPIRING MIDWIVES page (in development) or go directly to the Forum:
Pictures
Articles
I Wish They Were All Like This
- by Sandi BlankenshipThe Safety of Homebirth
-by Yvonne Lapp CrynsSiblings at the Homebirth Scene
- by Yvonne Lapp CrynsMidwives and Homebirth
- by Yvonne Lapp CrynsSelecting a Midwife
- by Yvonne Lapp CrynsThe Advantages of a Water Birth
- by Heather SotnickHomebirth Grandmother
-by Beverley Viljakainen
The Butterfly and the Episiotomy
A man found a cocoon of a butterfly. A a small opening appeared, and he watched the butterfly struggle to force it's body through that little hole.
It seemed to stop making any progress. It appeared
as if it had gotten as far as it could and could go no farther.
The man helped the butterfly; he took scissors and snipped off the remaining bit of the cocoon. The
butterfly then emerged easily. But it had a swollen body and small, shriveled wings.
The man expected that, at any moment, the wings would enlarge and expand to be able to support the body, which would contract in time.
It didn't. The butterfly spent the rest of it's life
crawling around with a swollen body and shriveled wings. It never was able to fly.
What the man did not understand was that the restricting cocoon and the struggle required for the butterfly to to get through the tiny opening were God's
way of forcing fluid from the body of the butterfly into it's wings so it would be ready for flight once it achieved freedom from the cocoon.- author unknown (please contact if you know the author)
Sometimes struggles are exactly what we need in our life. If God allowed us to go our way without obstacles, it would cripple us. We would not be as strong as we could have been. And we could never fly.
Personal Birth StoriesColleen Anne Britton
* With pictures!Matthew's Birth
Very nice webpage and story about a homebirth.
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* With pictures!Griffin's Birth
Website with full story and chock full of pictures.
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* With pictures!Please submit your personal homebirth stories via EMAIL for inclusion here. Please keep your story to one page in length or less.
We are sold out of this book,
but the author is about to release
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[email protected] for futher information.
by Lora-Lee McCrackenGloria Lemay is a well-known midwife in Canada. This interview was conducted by Lora-Lee McCracken. Q&A with Gloria LemayFollowing is an excerpt from Rape of the Twentieth Century. This material is protected by the Copyright Laws of the U.S.A. All rights are reserved. If you would like to reprint this article let us know via email.
Gloria Lemay is the only non-registered birth attendant in the province of British Columbia still serving parturient women; all others have been terrorized out of practice by a monopolizing, litigious,
government-sanctioned midwifery cartel. Ms. Lemay has been in service for over twenty years, and is currently the most popular midwife in B.C.
Q- Why did you become a midwife?A- Because having my first homebirth was a life-changing experience for me.Up until that time I had worked in fields primarily involving men; and when I gave birth to my daughter, I really claimed my womanhood- it changed my direction completely into wanting to work with women.
Q- What does birth mean to you?A- it's one of the few opportunities we have in life for transformation. The suck of life is that people can change- that change will happen over time. We come to believe that because there is a lot of common agreement around it; and transformation is expected to happen in a predictable time-frame. Yet in birth, a transformation happens outside of time- outside of time and space. It's not something you can repeat or do again; it's actually a change
of substance. I was transformed in my births, and creating room for other people to experience that is really important to me.
Q- Sometimes you call yourself a "private birth attendant". Why don't you like to be called "midwife" anymore?A- Legally managed and sanctioned midwifery tends to become invisible in the
system very quickly. Working outside the system is what I do, and I am not attached to calling myself a midwife- it's a lovely word to my ears, but my definition of the word seems to be quite different from the legislators in my province: to them, "obstetrical nursing" is equatable with "midwifery".
Q- What qualities make a good midwife?A- Patience number one. And an ability to be in true service- to put yourself aside and see what is really needed in the other person. Love in the heart... It helps to be smart. One should be able to stay calm, and be reliable in the face of emergency.
Q- What is the role of modern medicine in childbirth?A- Mostly, to get the hell out of it. In a small percentage of cases, modern
medicine can make a life-saving difference. But the harm that doctors have inflicted on the women of North America for no reason is like a holocaust. A good analogy would be if you sent your kids to the local swimming pool on ten different days in the summer. If your child was given complete CPR, oxygen, and a drug injection on nine out of the ten days he went there because the Lifeguard "thought" he was drowning, and he wasn't, you'd get pretty upset. The fact that normal, healthy young women walk into the hospital to have a baby, and 90% of them came out looking like they've had major trauma, is ridiculous.
Q-Do you feel a backlash happening against the homebirth movement?A- I actually think that there's less as we approach the year 2000. We've gotten to a point where alternatives- and practices that have endured over time- are becoming increasingly accepted. Did you know that twenty-five percent of people buy organic food? When an idea reaches critical mass, what was the idea of a few people suddenly becomes everybody's idea. The day is coming quickly when the women who have been persecuted as midwives will be rewarded for their perseverance with very busy practices.
Q- What is your single greatest fear regarding childbirth?A- My natural fear is having a baby death, because of the pain that the parents go through. That fear keeps me smart, prepared, and keeps me working
preventatively, so parents have the best chance possible of having a live
baby. I also fear that one of my clients will have a cesarean section- or a forceps delivery- or any of the other interventions that I hate.
Q- How many women should be getting cesarean sections?A- No more than three percent.
Q- Why aren't you a registered midwife?A- I believe in joining and giving my membership to organizations whose
actions reflect my own beliefs regarding their actions and stated philosophies. The British Columbia College of Midwives is not an organization to which I'd give my name or my money. They see new midwives as a threat to their monopoly of the homebirth market- I was not welcomed or supported as a new midwife, to say the least.
Q- Is there anything positive in the medical model of birth?A- There are a lot of positive things about it, and if midwives are smart, they'd take all the positives, duplicate them, and compete strongly on the things that are not positive. Taking things like clean fingernails,
reliability (there's always someone there when women show up at the birth
captivity center), making sure there's enough oxygen in the oxygen tank, always having lots of sterile gauze- there are certain things that are useful, and conscious, that doctors and nurses do that midwives can, and should, duplicate. On the other hand, we can compete very strongly with doctors and nurses because midwives can do all those things easily, plus offer preventative measures, womanly wisdom, and our own experience in
giving birth. We can also offer a lot of tricks of the trade that doctors don't know about- plus a gentler approach.
Q- What is the role of men in childbirth?A- To protect the women.
Q-What is your most important job as a birth attendant?A- To create a safe environment for the mother and baby.
Q- What bothers you most about TV's portrayal of childbirth?A- In order to sell commercial space, whatever's being presented has to have
a dramatic element. Birth in real life is not dramatic- it is sacred, moving, alive and earthy- but it's not something that would make a dramatic screenplay. Birth has to be warped a bit to make it saleable to commercial interests. Unfortunately, people get their general perceptions of birth,
police work and legal matters- and their perceptions of those who work within these professions- through what they see on TV. Midwives, police officers and lawyers will tell you that the every day work of their businesses is nothing at all like what is seen on TV- but people never
believe it.Q- What questions do you hear most from families, and how do you respond to them?
A- Mostly- "How can we avoid being involved with the medical system in any
way?" They want to avoid transfer to the hospital, having a Doppler used to detect fetal heart tones ultrasonically, diabetes screenings... Most people who come to see me are referred by friends- so they've already heard all about me. They already know that I'm out of the system. In the course of prenatal visits, we get to know each other, trust each other and understand
each other's vulnerabilities. This all pays dividends at the birth because everyone has only one focus- the highest good of mother and baby.
Q- What should midwives do in society to help heal birth?A- What I concentrate on is one birth at a time, with excellence in my practice. One woman tells another, and soon a hundred people have heard the birth story. Each birth creates a ripple effect in the community- it's amazing the effect that a normal birth has on people.
Q- What roles should midwives have- aside from attending birth- in the
community?A- Classically, midwives have been the wise women who looked out for their
communities: they were the women to whom you would go to get help with
burying your grandparents; the women who would come with hot meals for the
family when the husbands have been ill; they were mature women who never
gossiped or betrayed confidences. They furthered wise action and harmony in
their communities, and in turn, their communities took care of and honored
the midwives. A midwife's role should be to promote harmony.
Q- How would a woman go about becoming a midwife?
A- The way I did it twenty years ago was best for me. For four years I immersed myself in reading, eating and breathing birth. We formed different midwifery study groups, and I began teaching prenatal classes. I did a lot of hospital labor support, and was helped by friends who were doctors and nurse-midwives. I learned a lot from them. I also learned a lot about what NOT to do at a birth... Some of these births were such gruesome rapes I
shudder to think of them now. I know there are obstetricians who hate women
and are just plain evil in their disregard. I really wanted to keep women away from medicine as much as I could- so I learned how do things like injections and suturing myself. Also, a midwife needs to know many things to be good at her job. She should learn all she can about all aspects of life- she needs to know about religion, government, history, economics, auto mechanics, linguistics, geography, psychology, matters of the law, physiology, crisis management- she will have to have a wide repertoire of knowledge regarding all aspects of women's lives.
Q- Could you briefly describe your legal battles?A- In 1985 my partner and I attended a homebirth in Vancouver where a baby
died. We were charged with criminal negligence causing death to the baby,
criminal negligence causing bodily harm to the mother, and four counts of practicing medicine without a license. What ensued was a six-year odyssey of appearing before the courts in British Columbia and Ontario- ultimately culminating in an appearance before the Supreme Court of Canada. We were finally acquitted of all charges in 1991. At that time I returned to my midwifery practice (I wasn't practising at all between 1985-91). In 1994 I
had a baby in my practice who died at three days old; and there was a seven
day Coroner's Inquest into his death- which resulted in a finding of "accidental death". There was a lot of negative publicity and again, once it blew over, I returned to my practice.Q- What positive result came from your Supreme Court case?
A- Our goal was for it to be the last time midwives faced the criminal justice system in Canada, and for our trial to be the end of all midwifery trials in Canada. There has not been a criminal arrest of a midwife since.
Q- What is the climate for you inside hospitals when you need to take women in?
A- It varies- sometimes extremely hostile, sometimes extremely cooperative-
it seems to depend on the mood of the hospital staff. I've learned not to
take it personally.
Q- Do doctors really believe they do right by women by interfering with childbirth?A- I think they're resigned to birth as it appears to them inside the confines of a hospital. They get resigned to what they see every day, and believe that what they see is how birth is supposed to be. I really feel that doctors don't have a clue about what to do or how to help birthing
women- then they blame women for "needing" interventions. They blame the
women for the terrible statistics. They've been taught how to do things- and have never questioned the wisdom of what they've been taught.
Q- Why do midwives in hospitals remain silent regarding alarming
intervention rates?A- I think they're resigned to playing politics.
Q- Do some women- such as non-English speaking or minority- suffer more in hospital births than others?A- I think that in Canadian hospitals some women are used as teaching patients more than others, so interns can learn procedures. These women often have no idea what's going on, either to them or around them. They also have an unrealistic idea that modern technology is always better than the simpler, more natural ways in their own countries. I think it would make a difference to these women if there were labor support people of their own
language or descent in hospitals to help them. Young and uneducated women
are taken advantage of too. Two Burnaby midwives were running a program for
teaching teenage mothers about nutrition in pregnancy; they soon got a huge number of young women coming to them for counseling. They would channel
these young mothers for their regular prenatal care to doctors who never did
episiotomies- that is, to gentle women doctors. Soon, other doctors could
feel the pinch in their practices- and were forced to develop kinder approaches as well. Hit them where it counts to make change- in the wallet.
Q- What are the most important things a pregnant woman can do to ensure the
health of her baby?A- Eat a good diet. Muster all the social support she can around her. There
have been studies that have shown that these are the only two things really
make a difference.
Q- What are the two greatest advantages of homebirth?A- No one will lose your baby, and so far no one has had a cesarean section
at home.
Q- Can you think of any disadvantages?A- Your midwife has to wash the sheets- there's no paid cleanup staff.
Q- Do breathing exercises really help in preparation for childbirth?A- Breathing exercises worked for me personally. I love to have some familiar tools when going into scary or unknown situations- learning how to breathe was valuable for me going into my own births. Some women don't care about them, though. Every woman has unique wants and needs, and midwives should listen, and put their own judgments aside. If women say they would like to be taught breathing exercises, then they should be taught. That goes for anything else as well. Midwives need to address women as individuals-
they need to address individual needs.
Q- What do you find most rewarding about being a midwife?A- Feeling like I make a difference- knowing that I make a difference.
Q- If you could tell all the obstetricians in the world one thing, what would it be?A- That birth needs to be undisturbed.
Q- What would you like written on your gravestone?A- "Gloria Lemay- MIDWIFE & MOTHER... She spoke up for babies".
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