Tuesday, February 23, 2010

Mississippi Midwives - Help Needed!

Reprinted from my blog-friend Kathy, regarding upcoming legislation (already passed by Missouri Representatives) that would ban CPM midwives from practicing in the state of Mississippi:


"I was shocked to find out today that HB 695 which would amend current Mississippi state law to restrict the practice of midwifery to only Certified Nurse Midwives (CNMs) has passed the House and is in the Senate. This is a historic and unwelcome revision of long-standing Mississippi law which has always allowed for the free practice of midwifery.

"There are only about 25 CNMs in the state (as of 2008), and most serve the lower third of the state. This leaves the rest of us without the benefit of a legal home-birth attendant. Tennessee, Louisiana and Arkansas allow for CPMs (Certified Professional Midwives), and some may even allow for non-certified or "lay" midwives to legally practice (as current Mississippi law does). When I was pregnant with my son, now three years old, I was unable to find a local Mississippi midwife close enough to attend my birth, so chose a CPM from Tennessee. If this bill becomes a law, I fear that that option will no longer be available. What then? My choices will be limited to an unassisted birth or giving birth in a hospital.

"A midwife is a safeguard of normal birth -- monitoring the mother throughout pregnancy, just like a doctor (only better), and monitoring the mother and baby throughout labor. In most hospitals, this one-on-one labor care is nonexistent, replaced by machines monitoring the mother and baby, with nurses checking in only rarely. Sure, it's more cost-effective since there can be a higher patient-to-nurse ratio, but it's not better! With the close "with woman" care that homebirth midwives can give mothers, they can pick up on indications that labor may not be progressing normally, and take steps to put it back on track at home, or make an appropriate and timely transfer to the hospital.

"Without homebirth midwives, women such as myself will be forced to give birth at home without a midwife in attendance, or to give birth in substandard conditions in a hospital. There are no baby-friendly hospitals in Mississippi. Our fair state consistently ranks at the bottom of most health criteria, including breastfeeding (see also this link). Home-birth is very "baby friendly" -- what we need is more encouragement for women to have home birth, not less! This is just one of many benefits to babies of home birth. Among the many benefits to mothers are a much lower rate of interventions, including C-sections, epidurals, inductions, augmentations, episiotomies and vacuum- or forceps-assisted births.

"Home birth is not for everyone. Many women would not choose it if they could; and some who want to give birth at home have risk factors that cause them not to be good candidates for a home birth, so give birth at a hospital. Yet most women are low-risk, and about 90% of women who plan on giving birth at home do so (and only a very small minority of the 10% who transfer to hospitals do so in an emergency; most are calm, routine transfers for pain medication or labor augmentation).

"CNMs are wonderful -- I had one during my first pregnancy (I lived in Illinois then). CPMs are likewise wonderful -- I had one during my second pregnancy. As far as practice style went, there was no difference. The main difference between CNMs and CPMs is that CNMs are Registered Nurses who go on to complete midwifery training -- training which is very similar if not identical to the midwifery training that CPMs complete.

"With midwives already in short supply, changing the law to an even more restrictive one will be counterproductive. If you care about home birth, midwifery, the right of mothers to choose where and with whom to give birth, or just plain don't like government interference, please contact State Senators and urge them to vote against this legislation! And for good measure, contact Representatives and express your disappointment that this bill passed.

"Thank you."


You can see her blog entry (the above is Facebook) here.


Here is the letter from the Big Push for Midwives (I'm too tired to link up the links, so you'll have to cut and paste:

Dear All,

Here is an emergency message from the Big Push Campaign about an
anti-midwife bill in Mississippi. Please contact everyone you know in
Mississippi and pass this on to them. Not just midwives --
relatives, friends, childbirth educators, doulas, former clients,
email friends, groups you belong to who may have members in
Mississippi -- everyone in Mississippi or who may have contacts

PLEASE urge them to take action NOW!!

If any of you know any midwives in MS, please pass their contact
information on to Katie Prown, Campaign Manager for The Big Push for
Midwives, at kprown@prodigy.net

Katie's message provides links and buttons, so you don't have to look
these names and numbers up. PHONE CALLS are what count to
legislators, not email, not snail mail. CALL THEM to register your
opposition to this terrible, dangerous bill:

Mississippi House Bill 695, which would OUTLAW Certified Professional
Midwives and deny women access to their care, needs to be stopped

If you live in or have midwifery or doula clients in Mississippi,
start making calls and sending emails to your STATE SENATORS ONLY and
forward this to anyone you know who lives in the state (calls can be
made to home and office numbers both).

Mississippi residents can find out who their State Senator is here:


It is particularly important that members of the Senate Public Health
committee (listed below) hear from their constituents, telling them to
vote NO on HB 695 and that you do NOT support making Certified
Professional Midwives, who are specially trained to deliver babies in
out-of-hospital settings illegal.

The bill, which includes stiff penalties for ANY midwife practicing
who is not a nurse-midwife and which repeals the current exemption
that midwives have from Mississippi’s medical practice act, has
already sailed through the Mississippi House, so urgent action is
needed TODAY.



Take a moment to send an email or make a call... This is a super-important issue that will involve an entire state (not to mention national ramifications). Here is some contact information:

Hob Bryan,
Chair (It is especially urgent that Senator Bryan hear from his
constituents—please spread the word to anyone you know who lives in
District 7 to start making calls)
District 7 - Itawamba, Lee, Monroe

Contact Information:
Room: 212 D
P. O. Box 1018
Jackson, MS 39215
P. O. Box 75
Amory, MS 38821
(662)256-9989 (H)
(662)256-9601 (W)

Bob M. Dearing
District 37 - Adams, Amite, Franklin, Pike

Contact Information:
Room: 215 B
P. O. Box 1018
Jackson, MS 39215
305 Melrose-Motebello Parkway
Natchez, MS 39120
(601)442-0486 (H)
(601)446-7651 (W)
(601)446-7651 (F)

Hillman Terome Frazier
District 27 - Hinds

Contact Information:
Room: 213 E
P. O. Box 1018
Jackson, MS 39215

2066 Queensroad Avenue
Jackson, MS 39213
(601)982-1871 (H)
(601)359-5957 (F)

John Horhn
District 26 - Hinds, Madison

Contact Information:
Room: 212 B
P. O. Box 1018
Jackson, MS 39215

P.O. Box 2030
Jackson, MS 39225
(601)362-1045 (H)
(601)362-4285 (W)


Cindy Hyde-Smith
District 39 - Lawrence, Lincoln, Simpson

Contact Information:
Room: 405 B
P. O. Box 1018
Jackson, MS 39215

400 Cattle Trail, N. W.
Brookhaven, MS 39601
(601)835-3322 (H)


Kenneth Wayne Jones
District 21 - Attala, Holmes, Madison, Yazoo

Contact Information:
P. O. Box 1018
Jackson, MS 39215

232 Boyd Street
Canton, MS 39046
(601)859-3438 (H)
(601)859-8844 (W)


Willie Simmons
District 13 - Bolivar, Humphreys, Sunflower

Contact Information:
Room: 213 A
P. O. Box 1018
Jackson, MS 39215

P. O. Box 297
Cleveland, MS 39732
(662)846-7433 (W)

Bennie L. Turner
District 16 - Clay, Lowndes, Noxubee, Oktibbeha

Contact Information:
Room: 404 C
P. O. Box 1018
Jackson, MS 39215

P. O. Drawer 1500
West Point, MS 39773
(662)494-5061 (H)
(662)494-6611 (W)


Friday, February 19, 2010

Wednesday, February 17, 2010

HBA3C Story

One of my doulas, Nikki, is a HBA3C mama (that is, she had a homebirth after three cesareans - could also be written as a VBA3C, or vaginal birth after three cesareans). Her midwife has written out Nikki's VBA3C birth story - check it out!

A True Story of Triumph

Very neat stuff, especially in a world where doctors are pushing for repeat elective cesareans after only one cesarean (which is what got Nikki two more cesareans after her first).

Nikki is an amazing woman and a top-notch doula and childbirth educator here in the valley... it was fun to read her story at last!

Monday, February 8, 2010

The Sacred Cow of Modern Pregnancy Care: Routine Cervical Exams

I've been meaning to write on this topic for so long that, as usual, someone else got there before me! Thankfully she did a top-notch job, so check it out!

Cervical Exams: Who Needs Them?

(If you haven't subscribed to her blog yet, do! It's been great so far, and Stephanie is a superb midwife and wonderful thinker. She has great stuff to say.)

Anyhow, back to the topic - routine cervical exams.

Cervical exams are so much a part of routine pregnancy management nowadays that women don't really think to question them. I know that I didn't. When we were on our way to our first visit with our midwife, I remember telling my husband that I was sure our midwife would do a vaginal exam along with the visit. Why? Because "that's just what you do."

(Not that I have anything against needed vaginal exams. I remember telling my mother when I was a young teen that I would gladly die of cancer rather than submit to a vaginal exam, but when that time rolled around I didn't find it that big of a deal - when needed, that is.)

After that first visit (no vaginal exam), my pregnancy progressed (to my utmost surprise) without any vaginal exams whatsoever. When I finally broached the subject with my midwife, she gave the surprising response: "It doesn't serve any purpose or tell me anything worth knowing, so I don't do them unless there is a reason to do so." Wow! What a world-changing statement! Talk about shooting down sacred cows!

During labor, it was the same thing - my midwife told me that she would do vaginal exams only if something appeared to be amiss or if I particularly requested it. When I was in active labor, I repeatedly asked "Are we almost done yet?" and she would reply "You'll be done soon, but if you want numbers then I'll have to check. Do you want me to check?" And I would think about it and decide that I would not be able to handle things emotionally if the news was "bad," so I refused the checks (thank goodness!). During that first labor, I had only one check. During my next labor with our last-born, I had no checks whatsoever, bringing my grand total of pregnancy/labor checks to one.

Cervical checks during the last weeks of pregnancy do not serve any good purpose (a ripe cervix does not necessarily portend either a fast labor or an impending labor), and I believe that routine cervical checks during labor can be actively harmful. Why?

(1) If the membranes have ruptured, cervical checks increase the likelihood of infection.

(2) They put the mother "on the clock" if she is birthing in-hospital.

(3) They are uncomfortable (read: excruciating, if done during a contraction), disturb a mother's concentration (which is vitally important), require (usually) a prone position, and can be embarrassing/humiliating when done by strangers or in front of strangers.

(4) They are unnecessary - a good care provider can tell if labor is progressing by using external signs. Here are some signs that labor is progressing: vomiting, confusion, loss of modesty, inability to talk, "I can't do this anymore" statements, the "birth smell", disorientation, change in vocalizations, etc.

(5) Most of all - they are a major source of discouragement, i.e. "What do you MEAN I've been laboring for X hours and I'm only at 3 cm?????" I can't count the number of times that I've read some variation of the following: "I wanted to know how far I had gotten, so I asked the nurse to check me and I couldn't believe I was only at X centimeters, so I got the epidural because I couldn't take it anymore." Listen - labor is HARD. Very hard. It is vital not to invite discouragement during this intense process. If I had been told "2 centimeters" or something like that when I was in that much pain, I don't know if I could have taken it. If I had been birthing in-hospital, I definitely couldn't have kept going. But being told repeatedly - "You are doing fine, your labor is going well, and you are doing a great job" - WITHOUT a number being attached to that - was incredibly heartening and was one of the only things that enabled me to make it through. In fact, it was so helpful NOT to know my dilation that I wrote it into my second birth plan - "If you need to check me, please do NOT tell me my dilation unless it is medically necessary that I should know." I really think that women would do better in labor if cervical checks were reserved for times when it became obvious that something was wrong, rather than just being a part of routine labor management.

Anyhow, I could keep writing for ages, but I will just say - read the article! Stephanie has said it all so beautifully, and I whole-heartedly agree with everything she wrote. Read it, love it, send it to every pregnant woman you know.

(As usual, this is really an issue of mother-preference. Some mamas love cervical checks and want to know every inch of progress, from pre-labor to birth - they find it energizing. If that's the case, great! But it shouldn't be forced upon women, and I definitely question its use as a routine part of pregnancy/birth care.)

Saturday, February 6, 2010

Birth Story with Pictures - Lovely

This is one of the sweetest birth stories I've read:

Nella Cordelia: A Birth Story

A great and honest telling of the entrance into the world of a very precious and special little one. What a blessing that this mama has taken the time to share her story with the world.

As a side note, this is some of the best photography I've ever seen in a birth story!

Definitely take the time to read this one!

Thanks to Dou-la-la for posting this!

Wednesday, February 3, 2010

Interview with a Doula

Check this out! This is one of my amazing, wonderful, superb doulas, Rose Day:

A Hand to Hold Through Labor and Birth

A brief snippet:

“I come as soon as the mom wants me, whether that’s at home with early contractions or at the hospital,” says Rose Day, a birth doula and doula trainer for Nurturing Hearts Birth Services (azdoulas.com). “After the birth, lots of moms say they couldn’t have done it without me. I don’t believe that. They could. But the feeling of having been supported, of having someone there to take care of you and make sure you have what you want makes all the difference in a birth experience.”

"Studies show that constant support from a doula increases the mom’s chances of having a natural birth, but doulas are trained to provide support for any type of birth situation, including a scheduled Cesarean.

“Many times I work as much with dad or grandma as I do mom,” says Day. “I have different roles at every birth. It’s nice for dad because if I’m there he doesn’t have to worry about remembering everything from the childbirth class or feeling responsible for what’s going on when he’s never been through it before.”

Doulas a wonderful things to have, and Rose is one of the best. If you're in the area, give her a call! If you're not in the area, get someone else - but don't birth without one! Doulas are amazing women, and birth is so much better with their help!!

Another Hyperemesis Story

Cross-posted from my hyperemesis (severe morning sickness) blog:

Check out this mother's hyperemesis story!

Hyperemesis Gravidarum (HG): A Pregnancy Disease About Which Little is Understood

Hurray for correct grammar, LOL!!

At this time, I only know of four HG blogs in existence, though there are probably more. Lots of mamas have their HG-stories or blog-records of their HG-pregnancies on their personal blogs - like this story - but these stories are a lot harder to find, though they are much more plentiful.

It's always good to get HG stories out there!

Tuesday, February 2, 2010

VBAC in Local News!

This is more on the story of Joy Szabo (who, being threatened with a court-ordered cesarean in her home-town hospital, temporarily moved here to Phoenix for a VBAC), and I thought it was pretty cool that I knew two of the people in the newscast! Sally Stevens, Joy's doula and leader of our local ICAN chapter, and my OB Dr. Brass-Jones, are both interviewed here:

Joy Szabo Interview

I actually had no idea that Dr. Brass was Joy's OB - what a fun connection, and what a neat thing for Dr. Brass!

Monday, February 1, 2010

New HG Blog: This is Awesome!

Cross-posted from my morning sickness blog:

Okay, folks! Announcing the newest Hyperemesis Gravidarum (HG) blog!! This is really awesome!

Baby, You're Making Me Sick!

You can read her HG story, read about the various remedies she tried, and even see a video of her PICC line being put in (having an extremely weak stomach, I lasted about 10 seconds into the video).

It's so awesome to have another HG blog out there! Thank you!

Nursing in Public, Episode I: The Church Nursing Room

Okay, I'll have to admit it. I don't get it. What's up?

Here's the situation: Our church has a nursing room, directly off the sanctuary, where mamas can go to nurse infants. It's entirely enclosed, no windows, darkened, with a TV screen of the pastor speaking. There's even a sign that says "Since this room is for women and infants, no men are allowed in this room." Thus, we have a private, low-light, women-and-babies-only nursing situation.

But what do I find?

I find that women, even in these circumstances, take the time to elaborately cover themselves with nursing covers before they are willing to nurse. Baby is screaming, mama is stressed - but they won't nurse until they've swathed themselves in the heavy folds of their nursing covers.

What gives?

I mean, seriously! It's ALL WOMEN. There are no men present, and not even any children. (Not that I'd object to that, but some would.) So WHY? Do they think other women are going to be grossed out by their breast-feeding? ("I'm sitting here breastfeeding my baby, but if I see another baby nursing I'll puke!") Are they that modest that they can't show one inch of skin to nurse a baby?

I find it puzzling. All the more so because, statistically, I know that most of these women are hospital-birthers, meaning that they have undergone demeaning and immodest procedures and situations that I would never wish on anyone - such as nudity before multiple complete strangers, vaginal exams by multiple complete strangers, birth in the lithotomy position before complete strangers.... and yet they cannot possibly nurse in front of other women without being completely covered. Can I say that this is a little strange?

I'm not an "in-your-face" nurser, but I don't cover myself completely. It's an unnecessary pain in the neck! But I find myself worrying and feeling self-conscious about nursing normally when surrounded by nursing-cover moms. "Are they thinking I'm weird? Are they grossed out by the sight of me breastfeeding? Are they going to talk about me when I leave?" All my insecurities come out in the nursing room.

This past week I finally saw one woman nurse who only partially covered herself with a blanket. I could have kissed her in gratitude - I felt an immediate sisterhood. :)

Weird stuff.... Thoughts, anyone?