Wednesday, December 31, 2008
A Quick Note
As the new year starts, I find myself quite unexpectedly expecting! That's right, baby #3 has made him or herself known. I am going to be tracking the beginning of my pregnancy journey on my other blog (my hyperemesis blog), as that may (or hopefully, may not be) more applicable. As things progress, I'm not sure what to do - whether to split my pregnancy entries between these two blogs or keep my journey on one blog only. The latter is probably more sensible, but I don't know which blog to choose! Ah well, a decision for another day. Wish me luck!
New Article by Jennifer Block
A Yahoo! group to which I belong just posted this article by Jennifer Block. It is really great! Jennifer knows her stuff. Check it out!
Midwives Deliver
If you haven't read Jennifer's book, "Pushed: The Painful Truth About Childbirth and Modern Maternity Care," you're missing out! Go get a copy today. It's an eye-opener if there ever was one.
Midwives Deliver
If you haven't read Jennifer's book, "Pushed: The Painful Truth About Childbirth and Modern Maternity Care," you're missing out! Go get a copy today. It's an eye-opener if there ever was one.
Thursday, December 25, 2008
Merry Christmas
A very merry Christmas to each and every one of you! As we celebrate the birth of the Savior (the homebirth of all homebirths!!... or perhaps the home-away-from-home or cave-away-from-home birth), I wish everyone a fun and safe day of celebration and a wonderful start to the coming year.
This blog looks like it will have to stay dormant for at least a couple more weeks, as our house is still not move-in-able (not to mention that I've been too busy to pack), so house things will continue to engross my time for at least the next month. Rest assured, this blog is not dead! It will be up and running in no time (I hope!).
Merry Christmas!
This blog looks like it will have to stay dormant for at least a couple more weeks, as our house is still not move-in-able (not to mention that I've been too busy to pack), so house things will continue to engross my time for at least the next month. Rest assured, this blog is not dead! It will be up and running in no time (I hope!).
Merry Christmas!
Thursday, November 20, 2008
Notes on Life
This is a cross-post from my other blog, "The Whining Puker"....
Just a quick note!
We got our house last week, and my parents have come out to AZ to help us get it livable - so my blogging time is apt to be very little over the next month or so - not to mention the fact that we're probably going back to dial-up after our move, so it may be reduced permanently! I don't know - we'll see. But I wanted to write a quick note to explain that this blog is not dead - it's just going to be on a bit of a sabbatical.
I'm learning a lot working on the house. Growing up, I groused so much about helping with home-improvement projects (which I do not enjoy) that my parents let me off the hook - with the result that until now, I have done nothing more home-improvement-wise than hang a picture! Seriously! This week I have been ridiculously proud of myself for learning to remove doorknobs!! LOL Hopefully a preview of more to come, for I am absurdly ignorant.
Our house is lovely, but it does have some serious issues due to severe neglect. Its previous owners didn't beat it to a pulp, like some other houses we saw, but they neglected it so badly that they might as well have. There are literally masses of cobwebs hanging from the ceiling!! And there are things like water damage from neglected leaks, corrosion from mineral build-up gone mad and not taken care of, appliances that have to be trashed because they weren't cleaned in so long that they're no longer redeemable, etc. But I'm learning a lot! And DS is having a blast having a larger space to roam and a bit yard to play in.
So that's about all! I'll try to check back in periodically. Love to all!!
Diana
Just a quick note!
We got our house last week, and my parents have come out to AZ to help us get it livable - so my blogging time is apt to be very little over the next month or so - not to mention the fact that we're probably going back to dial-up after our move, so it may be reduced permanently! I don't know - we'll see. But I wanted to write a quick note to explain that this blog is not dead - it's just going to be on a bit of a sabbatical.
I'm learning a lot working on the house. Growing up, I groused so much about helping with home-improvement projects (which I do not enjoy) that my parents let me off the hook - with the result that until now, I have done nothing more home-improvement-wise than hang a picture! Seriously! This week I have been ridiculously proud of myself for learning to remove doorknobs!! LOL Hopefully a preview of more to come, for I am absurdly ignorant.
Our house is lovely, but it does have some serious issues due to severe neglect. Its previous owners didn't beat it to a pulp, like some other houses we saw, but they neglected it so badly that they might as well have. There are literally masses of cobwebs hanging from the ceiling!! And there are things like water damage from neglected leaks, corrosion from mineral build-up gone mad and not taken care of, appliances that have to be trashed because they weren't cleaned in so long that they're no longer redeemable, etc. But I'm learning a lot! And DS is having a blast having a larger space to roam and a bit yard to play in.
So that's about all! I'll try to check back in periodically. Love to all!!
Diana
Thursday, November 13, 2008
Book Review: "Infertility for Dummies"
"Infertility for Dummies"
Sharon Perkins, RN, and Jackie Meyers-Thompson
2007, 362 pages
Before reading this, I should warn you that it is written from my strongly pro-life position. Okay, you've been warned.
I decided to pick up a basic book on infertility simply because so many of my friends are dealing with this. In fact, out of the six young married couples in our church with whom we hang out, four have dealt or are dealing with infertility. I didn't want to leave such a widespread issue out of my reading, so I picked up this book. I'm definitely going to read more books on the subject to develop my understanding further.
I wasn't that crazy about this book, both informationally and ethically. I'll deal with those issues in a minute. First, what I liked:
Like all the dummies books, this book is clear, concise, humorous, well-organized and easily accessible. The language and the explanations were clear, and I learned a lot (though the hormonal interchanges of the fertility cycle are still largely beyond me!). I think that this would be a good reference book (it's really easy to find specific information that you might need at a time) and as a basic primer.
The two things I didn't like: information problems and ethics.
Starting with the book's information:
I can't speak to the later chapters, because I was reading much of this information for the first time. However, though I am not overly conversant with reproductive technologies and the ins and outs of infertility, I am fairly knowledgeable about basic female fertility and especially natural family planning. When I was reading these sections, I kept finding errors - lots of them, some tiny, some not so tiny. But that made me wonder just how accurate the following chapters were. Now, don't get me wrong. Most of these errors were really tiny and wouldn't make a big difference to the reader. But they are errors that wouldn't be written by a truly knowledgeable author and which shouldn't have made it to print. Here are a few examples:
Text: "The cervix... keeps the baby from falling out of the uterus when you're pregnant because it's a tight, muscle-like tissue." (p. 23)
Correction: The cervix is not muscle-like, it IS a muscle (being part of the uterus, which is a muscle).
Text: ""But the most consistent thing about your menstrual cycle should be that ovulation occurs 14 days before your period begins. So if your cycles are 28 days, you ovulate on day 14. But if your cycles are short, say 25 days, you're actually ovulating on day 11..." (p. 29)
Correction: This was a big one. In fact, I can't believe they included this simplistic of an explanation of female fertility, because it is vastly misleading. While the average fertile luteal phase is assumed to be 14, it can range anywhere from 10 to 16 days (some docs say 12 is the lower limit, but many babies have been carried to term with mums who have 10/11 day luteal phases). Thus, timing sex to be just before [average period length - 14 days] is extremely inaccurate and misleading. The authors do acknowledge different luteal phase lengths, but in their directions on "how to get pregnant," they just tell you to subtract 14 from your average cycle length to get your ovulation date.
Text: In reference to charting: "Look for a subtle drop in temperature, followed by a sustained rise in temperature.... at least 0.5 degrees" (p. 70)
Correction: #1 - It's 0.4 degrees, not 0.5 degrees; #2 - They completely ignore the fact that many women "stair-step" with their temperatures - you may see your temperature rise gradually to the high temperature level rather than just one big jump. #3 - They also fail to tell anything of the official natural family planning rules, such as "3 over 6," etc. It's not so much that it's wrong as that it's incomplete. #4 - Not every woman gets the "pre-ovulation dip;" in fact, most don't. Thus to depend on the dip as a predictor of ovulation is not a reliable method.
Enough on that.... I will just say that these little errors made me slightly distrustful of the book's reliability.
Onto ethics...
This is a hard subject, because it really depends on your beliefs. I am dissatisfied with the book's ethics because of my pro-life and Christian beliefs, but you, gentle reader, may not be. So read on, and make of it what you will.
Basically, my position: I believe that a new life begins at the moment of conception. In other words, Sperm + Egg = Baby. This is regardless of whether the embryo is one cell or ten or a hundred or a hundred million - I believe that it is a unique individual, created by God. Thus, to "discard embryos" is, to me, the same thing as an abortion. This is not a popular view, but it is my honest belief.
IVF (in-vitro fertilization), thus, is rife with ethical dilemmas for those of us who believe this way, because "extra embryos" are generally part of the process. Many couples try to transfer all of their embryos, but usually this is impossible, as the number of embryos is usually far greater than the average woman's ability to bear children. Some couples purposely try to ensure that a small number of embryos is created so that they will have the ability to transfer all of them. A very small number put their extra embryos up for adoption (or, in a less formal process them, "donate" them - since the state regards embryos as property rather than persons, the legal adoption process is optional and therefore generally used only by parents who want to respect the personhood of their babies). However, most extra embryos are eventually discarded. As I believe that embryos are babies, and not "genetic material for making babies," the practice of embryo disposal is ethically unacceptable.
There is also the issue of pre-implantation genetic diagnosis, in which embryos are tested for gender and genetic conditions - those with characteristics the parents want are kept, those with unfavorable or unwanted characteristics (wrong gender, genetic conditions) are discarded. Ethically, this is the same thing as an aborting a baby with health defects. (Not to mention that embryos are often injured in the process of testing them, with some data showing that these babies have a higher incidence of birth defects, possibly resulting from the testing itself.)
Thus, for me, there are many deep, deep problems with the reproductive technologies industry. However, this book is completely dismissive of these issues. Besides stating that "there are ethical issues under debate with such-and-such procedure" or "some people have problems with this," they are somewhat contemptuously dismissive of all ethical considerations. The book is filled with statements such as the following: "Many people with frozen embryos would like to see something positive done with embryos that they donate for research, and would rather have them used for stem cell development than just be destroyed." (p. 324) Furthermore, in referring to embryos, the authors refuse to call them more than "potential life," which is an easy way to dismiss the personhood of embryos.
Lastly, here is one corker that made me really angry, and also made me wonder if the authors have the emotional maturity to be even writing a book, let alone one on infertility. In the chapter on adoption, there is one teensy-weensy section on adopting special-needs kiddos, and the main jist of the section is to discourage adoptive parents from doing so. Let's hear this choice morsel from the authors:
"Sometimes, people are tempted to adopt special-needs children because they're more easily available. Other couples are drawn by a picture of a child... Sharon (one of the authors) remembers thinking seriously about adopting a child with handicaps while her family was waiting for their referral... every one of the pictures appealed to her. However, she realized that her family wasn't really emotionally prepared to handle a child with serious problems. Although it's easy to be caught up emotionally in the idea of raising a special-needs child, look realistically at your lifestyle and personalities before making a decision." (pp. 312-313)
In other words, "Stop and get ahold of yourself before you do something stupd."
*Sigh.*
Do I recommend this book? It gets a "whatever" kind of rating. The information is okay, the ethics are (in my opinion) absolutely deplorable. Next time, I'm going to look for a book with a conscience.
Sharon Perkins, RN, and Jackie Meyers-Thompson
2007, 362 pages
Before reading this, I should warn you that it is written from my strongly pro-life position. Okay, you've been warned.
I decided to pick up a basic book on infertility simply because so many of my friends are dealing with this. In fact, out of the six young married couples in our church with whom we hang out, four have dealt or are dealing with infertility. I didn't want to leave such a widespread issue out of my reading, so I picked up this book. I'm definitely going to read more books on the subject to develop my understanding further.
I wasn't that crazy about this book, both informationally and ethically. I'll deal with those issues in a minute. First, what I liked:
Like all the dummies books, this book is clear, concise, humorous, well-organized and easily accessible. The language and the explanations were clear, and I learned a lot (though the hormonal interchanges of the fertility cycle are still largely beyond me!). I think that this would be a good reference book (it's really easy to find specific information that you might need at a time) and as a basic primer.
The two things I didn't like: information problems and ethics.
Starting with the book's information:
I can't speak to the later chapters, because I was reading much of this information for the first time. However, though I am not overly conversant with reproductive technologies and the ins and outs of infertility, I am fairly knowledgeable about basic female fertility and especially natural family planning. When I was reading these sections, I kept finding errors - lots of them, some tiny, some not so tiny. But that made me wonder just how accurate the following chapters were. Now, don't get me wrong. Most of these errors were really tiny and wouldn't make a big difference to the reader. But they are errors that wouldn't be written by a truly knowledgeable author and which shouldn't have made it to print. Here are a few examples:
Text: "The cervix... keeps the baby from falling out of the uterus when you're pregnant because it's a tight, muscle-like tissue." (p. 23)
Correction: The cervix is not muscle-like, it IS a muscle (being part of the uterus, which is a muscle).
Text: ""But the most consistent thing about your menstrual cycle should be that ovulation occurs 14 days before your period begins. So if your cycles are 28 days, you ovulate on day 14. But if your cycles are short, say 25 days, you're actually ovulating on day 11..." (p. 29)
Correction: This was a big one. In fact, I can't believe they included this simplistic of an explanation of female fertility, because it is vastly misleading. While the average fertile luteal phase is assumed to be 14, it can range anywhere from 10 to 16 days (some docs say 12 is the lower limit, but many babies have been carried to term with mums who have 10/11 day luteal phases). Thus, timing sex to be just before [average period length - 14 days] is extremely inaccurate and misleading. The authors do acknowledge different luteal phase lengths, but in their directions on "how to get pregnant," they just tell you to subtract 14 from your average cycle length to get your ovulation date.
Text: In reference to charting: "Look for a subtle drop in temperature, followed by a sustained rise in temperature.... at least 0.5 degrees" (p. 70)
Correction: #1 - It's 0.4 degrees, not 0.5 degrees; #2 - They completely ignore the fact that many women "stair-step" with their temperatures - you may see your temperature rise gradually to the high temperature level rather than just one big jump. #3 - They also fail to tell anything of the official natural family planning rules, such as "3 over 6," etc. It's not so much that it's wrong as that it's incomplete. #4 - Not every woman gets the "pre-ovulation dip;" in fact, most don't. Thus to depend on the dip as a predictor of ovulation is not a reliable method.
Enough on that.... I will just say that these little errors made me slightly distrustful of the book's reliability.
Onto ethics...
This is a hard subject, because it really depends on your beliefs. I am dissatisfied with the book's ethics because of my pro-life and Christian beliefs, but you, gentle reader, may not be. So read on, and make of it what you will.
Basically, my position: I believe that a new life begins at the moment of conception. In other words, Sperm + Egg = Baby. This is regardless of whether the embryo is one cell or ten or a hundred or a hundred million - I believe that it is a unique individual, created by God. Thus, to "discard embryos" is, to me, the same thing as an abortion. This is not a popular view, but it is my honest belief.
IVF (in-vitro fertilization), thus, is rife with ethical dilemmas for those of us who believe this way, because "extra embryos" are generally part of the process. Many couples try to transfer all of their embryos, but usually this is impossible, as the number of embryos is usually far greater than the average woman's ability to bear children. Some couples purposely try to ensure that a small number of embryos is created so that they will have the ability to transfer all of them. A very small number put their extra embryos up for adoption (or, in a less formal process them, "donate" them - since the state regards embryos as property rather than persons, the legal adoption process is optional and therefore generally used only by parents who want to respect the personhood of their babies). However, most extra embryos are eventually discarded. As I believe that embryos are babies, and not "genetic material for making babies," the practice of embryo disposal is ethically unacceptable.
There is also the issue of pre-implantation genetic diagnosis, in which embryos are tested for gender and genetic conditions - those with characteristics the parents want are kept, those with unfavorable or unwanted characteristics (wrong gender, genetic conditions) are discarded. Ethically, this is the same thing as an aborting a baby with health defects. (Not to mention that embryos are often injured in the process of testing them, with some data showing that these babies have a higher incidence of birth defects, possibly resulting from the testing itself.)
Thus, for me, there are many deep, deep problems with the reproductive technologies industry. However, this book is completely dismissive of these issues. Besides stating that "there are ethical issues under debate with such-and-such procedure" or "some people have problems with this," they are somewhat contemptuously dismissive of all ethical considerations. The book is filled with statements such as the following: "Many people with frozen embryos would like to see something positive done with embryos that they donate for research, and would rather have them used for stem cell development than just be destroyed." (p. 324) Furthermore, in referring to embryos, the authors refuse to call them more than "potential life," which is an easy way to dismiss the personhood of embryos.
Lastly, here is one corker that made me really angry, and also made me wonder if the authors have the emotional maturity to be even writing a book, let alone one on infertility. In the chapter on adoption, there is one teensy-weensy section on adopting special-needs kiddos, and the main jist of the section is to discourage adoptive parents from doing so. Let's hear this choice morsel from the authors:
"Sometimes, people are tempted to adopt special-needs children because they're more easily available. Other couples are drawn by a picture of a child... Sharon (one of the authors) remembers thinking seriously about adopting a child with handicaps while her family was waiting for their referral... every one of the pictures appealed to her. However, she realized that her family wasn't really emotionally prepared to handle a child with serious problems. Although it's easy to be caught up emotionally in the idea of raising a special-needs child, look realistically at your lifestyle and personalities before making a decision." (pp. 312-313)
In other words, "Stop and get ahold of yourself before you do something stupd."
*Sigh.*
Do I recommend this book? It gets a "whatever" kind of rating. The information is okay, the ethics are (in my opinion) absolutely deplorable. Next time, I'm going to look for a book with a conscience.
Wednesday, November 12, 2008
Book Review: "The Natural Pregnancy Book" by Aviva Jill Romm
"The Natural Pregnancy Book"
Aviva Jill Romm
2003, 318 pages
This is going to be another short book review, because I loved this book and have nothing to criticize! This book easily goes down as one of my all-time favorites and merits a place on my "buy soon" list.
I have read several other Romm books and loved them all, so I was expecting great things from this book - and I was right! This is truly an excellent book.
Part II of the book, "Common Concerns during Pregnancy," is an alphabetical compendium of the various complications and concerns that occur during pregnancy (morning sickness, heartburn, etc.), with Romm's recommendations and comments on each. This section is excellent. She gives general/dietary recommendations and also herbal recommendations (complete with dosage instructions and lots of herbal formulas), and they look absolutely fabulous in terms of usefulness and thoroughness. I wouldn't want to go through another pregnancy without this book.
Part I of the book covers many of the usual pregnancy topics (prenatal care, nutrition, baby's development, exercise, physical changes, preparing for birth, etc.), but with a twist - not only is Romm in favor of natural birth and midwifery care, but she also has incredible respect for women's bodies, women's birthing rights, women's spirituality, the sacredness of birth, and women's wisdom. Rather than saying, "Do whatever the doctor says," (as oh-so-many pregnancy books do), Romm says, "Educate yourself. Listen to your body. Listen to your baby. Your body knows how to do this, so trust yourself." In today's fear-mongering birth world, where pregnant mothers are treated like time bombs waiting to go off, this book is extremely refreshing. Romm works consistently to bolster and build a mother's confidence in herself and her abilities, and that is a great asset of this book.
Romm also has a great understanding of the understanding of the birth experience as a pivotal event in a woman's life - the fact that birth is truly a rite of passage for a woman. Most pregnancy books, and Western culture in general, dismiss the importance of the birth experience to women. Most view birth as "something really unpleasant that you endure in order to get a baby." After the birth, culture will dote on the baby but give little to no attention to the woman who has experienced a unique and earth-shattering transformation in her rite of passage to motherhood, and who also deserves honor and attention. (Although I believe that motherhood begins with conception, there is something especially transformative about birth in terms of the "becoming" process.)
I experienced this above-mentioned phenomenon very much with my birth experience. After my birth I wanted to shout from the rooftops how proud I was of myself and my abilities, and how I had experienced this amazing transformation, and I could have told my birth story to every passerby who came within ear's reach. However, I found that in general, all eyes were on the baby. (In fact, one of the times I was asked about my birth, I had to go into the back room to nurse the baby and came out just in time to hear my husband finishing up telling my birth story! What a bummer!!!)
Romm really focuses on the importance of the birth experience and gives great examples of how to honor your experience - and for others, how to honor the mother and make her birth the acknowledged rite of passage that it should be.
I love how Romm describes communicating with unborn children as something that can and should be done, and as something that is possible. As a Westerner, I tended to think of my baby as someone who was unreachable, on another planet, etc. - i.e. "I know you're there, and we'll talk when you get here." She emphasizes the importance of prenatal communication and giving love to pre-birth babies, and I really love that.
I also love how life-affirming Romm is. Something that can absolutely drive me up a wall is a pregnancy book that refers to the baby as a "fetus." While "fetus" does literally mean "unborn child," it is used (consciously or unconsciously) to dehumanize the infant, to make it seem less than human (this is especially true when talking of abortion, when the baby is dehumanized further into "fetal tissue" or "products of conception"). Romm consistently refers to the unborn child as a "baby," something that I try to do as well, and I love that. Here's a quote from her:
"From the onset, this was my child, not an embryo or a fetus with potential defects or a pregnancy with potential complications, but my child. I truly believe that it is partially this attitude that has nurtured health in each child. But had one of my babies not been perfectly healthy, that baby would still have felt loved and accepted from the beginning.
"Later in this book you will find a discussion of the various prenatal diagnostic tests that are commonly offered to pregnant women. There are times when these tests are medically warranted; however, routine use of such testing can prevent a woman from developing and trusting her connection with her baby. The real connection between a mother and her baby exists before the connection that is fostered by seeing the baby on a screen, knowing whether the baby is a boy or a girl, or hearing the baby's hearbeat by electronic amplification."
(Romm, 2003:20)
I love that.
This book has a great emphasis on natural health, herbal treatments and non-invasive methods for handling pregnancy concerns. It is a great compendium of wisdom and knowledge.
I highly recommend this book to all new mothers. If I get pregnant before I manage to get my hands on a copy, my fingers will be marching straight to Amazon to order it! Highly, highly recommended.
Aviva Jill Romm
2003, 318 pages
This is going to be another short book review, because I loved this book and have nothing to criticize! This book easily goes down as one of my all-time favorites and merits a place on my "buy soon" list.
I have read several other Romm books and loved them all, so I was expecting great things from this book - and I was right! This is truly an excellent book.
Part II of the book, "Common Concerns during Pregnancy," is an alphabetical compendium of the various complications and concerns that occur during pregnancy (morning sickness, heartburn, etc.), with Romm's recommendations and comments on each. This section is excellent. She gives general/dietary recommendations and also herbal recommendations (complete with dosage instructions and lots of herbal formulas), and they look absolutely fabulous in terms of usefulness and thoroughness. I wouldn't want to go through another pregnancy without this book.
Part I of the book covers many of the usual pregnancy topics (prenatal care, nutrition, baby's development, exercise, physical changes, preparing for birth, etc.), but with a twist - not only is Romm in favor of natural birth and midwifery care, but she also has incredible respect for women's bodies, women's birthing rights, women's spirituality, the sacredness of birth, and women's wisdom. Rather than saying, "Do whatever the doctor says," (as oh-so-many pregnancy books do), Romm says, "Educate yourself. Listen to your body. Listen to your baby. Your body knows how to do this, so trust yourself." In today's fear-mongering birth world, where pregnant mothers are treated like time bombs waiting to go off, this book is extremely refreshing. Romm works consistently to bolster and build a mother's confidence in herself and her abilities, and that is a great asset of this book.
Romm also has a great understanding of the understanding of the birth experience as a pivotal event in a woman's life - the fact that birth is truly a rite of passage for a woman. Most pregnancy books, and Western culture in general, dismiss the importance of the birth experience to women. Most view birth as "something really unpleasant that you endure in order to get a baby." After the birth, culture will dote on the baby but give little to no attention to the woman who has experienced a unique and earth-shattering transformation in her rite of passage to motherhood, and who also deserves honor and attention. (Although I believe that motherhood begins with conception, there is something especially transformative about birth in terms of the "becoming" process.)
I experienced this above-mentioned phenomenon very much with my birth experience. After my birth I wanted to shout from the rooftops how proud I was of myself and my abilities, and how I had experienced this amazing transformation, and I could have told my birth story to every passerby who came within ear's reach. However, I found that in general, all eyes were on the baby. (In fact, one of the times I was asked about my birth, I had to go into the back room to nurse the baby and came out just in time to hear my husband finishing up telling my birth story! What a bummer!!!)
Romm really focuses on the importance of the birth experience and gives great examples of how to honor your experience - and for others, how to honor the mother and make her birth the acknowledged rite of passage that it should be.
I love how Romm describes communicating with unborn children as something that can and should be done, and as something that is possible. As a Westerner, I tended to think of my baby as someone who was unreachable, on another planet, etc. - i.e. "I know you're there, and we'll talk when you get here." She emphasizes the importance of prenatal communication and giving love to pre-birth babies, and I really love that.
I also love how life-affirming Romm is. Something that can absolutely drive me up a wall is a pregnancy book that refers to the baby as a "fetus." While "fetus" does literally mean "unborn child," it is used (consciously or unconsciously) to dehumanize the infant, to make it seem less than human (this is especially true when talking of abortion, when the baby is dehumanized further into "fetal tissue" or "products of conception"). Romm consistently refers to the unborn child as a "baby," something that I try to do as well, and I love that. Here's a quote from her:
"From the onset, this was my child, not an embryo or a fetus with potential defects or a pregnancy with potential complications, but my child. I truly believe that it is partially this attitude that has nurtured health in each child. But had one of my babies not been perfectly healthy, that baby would still have felt loved and accepted from the beginning.
"Later in this book you will find a discussion of the various prenatal diagnostic tests that are commonly offered to pregnant women. There are times when these tests are medically warranted; however, routine use of such testing can prevent a woman from developing and trusting her connection with her baby. The real connection between a mother and her baby exists before the connection that is fostered by seeing the baby on a screen, knowing whether the baby is a boy or a girl, or hearing the baby's hearbeat by electronic amplification."
(Romm, 2003:20)
I love that.
This book has a great emphasis on natural health, herbal treatments and non-invasive methods for handling pregnancy concerns. It is a great compendium of wisdom and knowledge.
I highly recommend this book to all new mothers. If I get pregnant before I manage to get my hands on a copy, my fingers will be marching straight to Amazon to order it! Highly, highly recommended.
Tuesday, November 11, 2008
Book Review: "Our Bodies, Ourselves: Pregnancy and Birth"
"Our Bodies, Ourselves: Pregnancy and Birth"
Boston Women's Health Book Collective
2008, 370 pages
I'm on a roll! That stack of to-be-reviewed pregnancy/birth books on my dresser WILL decrease, if I have to review one book a day!!!
Having gotten the notice from my library that I can't renew my loan of "Our Bodies, Ourselves" for the fifth time (I don't know why!!!), this book has now moved to the forefront, as it has to be back at the library today.
I have found, rather surprisingly, that the best books get the shortest reviews from me. Why? Well, what's there to say? "I loved it - I loved it - I loved it!" Bad books get longer reviews because of all the anger I need to vent after reading them (See "From Here to Maternity" book review, for example).
With that in mind, I don't have an overwhelming amount to say about this book other than - I LOVED IT!!! It gets the highest review from me. It is a book of almost unequaled excellence, absolutely thorough in its coverage of pregnancy/birth issues, and utterly and completely evidence-based. Basically, if you are pregnant or interested in pregnancy/birth, this book is a must-have. It's definitely going on my "want" list.
Looking through the book, I remember again why I loved this book - it's just SO thorough! Anything and everything to do with pregnancy, birth, baby and postpartum is covered.
The book is supportive of natural birth while remaining balanced - it is not fanatically anti-hospital or anti-homebirth. I'd say that it would be a good book for anyone, regardless of whether one is planning a hospital or home birth.
I have two complaints about this book:
#1 - This book is supportive of all women's choices, which in my opinion is great as far as birthing options go. But as a Christian and thus someone who affirms the sanctity of human life, I am NOT okay with a mother's decision to have her in-utero baby killed because it is not perfectly healthy. This book is supportive of that decision, and I found the chapter covering that to be heart-rending. Basically, the book's attitude is "Decide to keep your non-perfect baby? Great! Decide to kill your non-perfect baby? Great!" I believe that this is irresponsible and unethical. After skipping ahead to read that chapter (which I usually do with all books, to catch the moral and ethical tone of the book), I was so sickened and saddened by the book's support for the killing of non-perfect babies that I almost didn't finish the book. I'm glad I did, because the book on the whole is excellent. But the authors need to seriously rethink their ethics on the issue of abortion. What does it say about a society which gladly sanctions the killing of all less-than-healthy babies?
#2 - After addressing the issue of the multiple social issues facing pregnant and postpartum mothers (the birth situation, single parent epidemic, etc.), the authors present their idea of what should be done to remedy the situation. I found myself disagreeing sharply with most of this chapter. Their ideas, which are mostly political in nature, involve massive governmental programs and welfare assistance, and seem to be somewhat socialist in nature. I think that we could do women a big favor not by focusing on increased governmental control and involvement in family life, but by focusing on moral reform. Having a society in which men marry women before making babies and stay married to them for life will do a lot more for women and children than funneling governmental funding into social programs to try to fix the irreparable harm done to mothers, children and families by fatherless homes or dysfunctional families.
I don't mean to get off too much on politics, but the final chapter was fairly irritating. I'll stop now, though, before I turn this into a political blog.
Barring the above two issues, I loved this book and recommend it strongly to all.
Boston Women's Health Book Collective
2008, 370 pages
I'm on a roll! That stack of to-be-reviewed pregnancy/birth books on my dresser WILL decrease, if I have to review one book a day!!!
Having gotten the notice from my library that I can't renew my loan of "Our Bodies, Ourselves" for the fifth time (I don't know why!!!), this book has now moved to the forefront, as it has to be back at the library today.
I have found, rather surprisingly, that the best books get the shortest reviews from me. Why? Well, what's there to say? "I loved it - I loved it - I loved it!" Bad books get longer reviews because of all the anger I need to vent after reading them (See "From Here to Maternity" book review, for example).
With that in mind, I don't have an overwhelming amount to say about this book other than - I LOVED IT!!! It gets the highest review from me. It is a book of almost unequaled excellence, absolutely thorough in its coverage of pregnancy/birth issues, and utterly and completely evidence-based. Basically, if you are pregnant or interested in pregnancy/birth, this book is a must-have. It's definitely going on my "want" list.
Looking through the book, I remember again why I loved this book - it's just SO thorough! Anything and everything to do with pregnancy, birth, baby and postpartum is covered.
The book is supportive of natural birth while remaining balanced - it is not fanatically anti-hospital or anti-homebirth. I'd say that it would be a good book for anyone, regardless of whether one is planning a hospital or home birth.
I have two complaints about this book:
#1 - This book is supportive of all women's choices, which in my opinion is great as far as birthing options go. But as a Christian and thus someone who affirms the sanctity of human life, I am NOT okay with a mother's decision to have her in-utero baby killed because it is not perfectly healthy. This book is supportive of that decision, and I found the chapter covering that to be heart-rending. Basically, the book's attitude is "Decide to keep your non-perfect baby? Great! Decide to kill your non-perfect baby? Great!" I believe that this is irresponsible and unethical. After skipping ahead to read that chapter (which I usually do with all books, to catch the moral and ethical tone of the book), I was so sickened and saddened by the book's support for the killing of non-perfect babies that I almost didn't finish the book. I'm glad I did, because the book on the whole is excellent. But the authors need to seriously rethink their ethics on the issue of abortion. What does it say about a society which gladly sanctions the killing of all less-than-healthy babies?
#2 - After addressing the issue of the multiple social issues facing pregnant and postpartum mothers (the birth situation, single parent epidemic, etc.), the authors present their idea of what should be done to remedy the situation. I found myself disagreeing sharply with most of this chapter. Their ideas, which are mostly political in nature, involve massive governmental programs and welfare assistance, and seem to be somewhat socialist in nature. I think that we could do women a big favor not by focusing on increased governmental control and involvement in family life, but by focusing on moral reform. Having a society in which men marry women before making babies and stay married to them for life will do a lot more for women and children than funneling governmental funding into social programs to try to fix the irreparable harm done to mothers, children and families by fatherless homes or dysfunctional families.
I don't mean to get off too much on politics, but the final chapter was fairly irritating. I'll stop now, though, before I turn this into a political blog.
Barring the above two issues, I loved this book and recommend it strongly to all.
Monday, November 10, 2008
Book Review: "Wise Woman Herbal for the Childbearing Year"
"Wise Woman Herbal for the Childbearing Year"
Susan S. Weed
1985, 196 pages
I have been reading madly lately, trying to get through all of my books that I've injudiciously over-borrowed, while at the same time procrastinating on writing book reviews, with the end result that many of the books I've borrowed have been returned long-since, while the reviews have remained unwritten. I am going to try, over the next few weeks, to catch up with book reviews so that I can move on to more books and other writings. I want to focus on Arizona birth resources for Arizona mothers soon, and I can't get to any of that until I get these reviews done!
"Wise Woman Herbal for the Childbearing Year" is one book which had to be returned to the library almost a month ago, but it is still sitting in front of me. Why? Because it was one of those books which are so excellent that possession of them becomes an immediate and obsessive need! So when hubby said, "Hon, I need a book to put on this Amazon order to get to the free shipping amount," I knew which book to order!
This book is a keeper. It is so much of a keeper that I can't even tell you how much I liked it! Suffice it to say that I will recommend it unreservedly to all and sundry I meet. It is truly excellent.
I have been getting into amateur herbalism lately, and finding reliable information about herbs in pregnancy literature can be downright frustrating. For example, a pregnancy book (even a naturally-minded one!) might say, "For morning sickness, take dandelion." Well, great. Do you mean fresh herb, dried herb, tea, infusion, decoction, fresh herb tincture, dried herb tincture, oil, salve, or compress? How often should I take it? What strength? How should I take it? How much at a time? This book is one of the few books that explicitly gives dosage directions. For example, "Ten to twenty drops of Witch Hazel tincture under the tongue can be used repeatedly to control bleeding until the placenta is delivered." (p. 71) It's terrific!!
The book is arranged in chapters by time period (pre-conception, pregnancy, labor/birth, postpartum, baby), with a great chapter on making your own herbal products and several helpful appendices. Within the chapter, various complaints and conditions (hemorrhage, cramps, etc.) are listed alphabetically for easy access.
Another thing I love about this book is that for each condition, there is a section on "prevention" as well as a section on "what to do if you have this condition." That is just terrific! I love to be proactive. For example, with my delivery I had horrendous after-pains, something which is supposed to be negligible or non-existent for primips. Since they generally increase in intensity with each pregnancy, I know that I can expect them with any future pregnancies, and now I have the preventative advice of this book to help me prevent afterpains with pre-birth herbs. Hurray!!
There is one chapter in this book which I found very disappointing, but I won't elaborate further. On the whole, this book receives my complete applause and approval.
When I told my midwife that I was reading this book, she told me that she keeps multiple copies both at her home and at her office because it is so vital to her practice.
This book is indispensable, and I love it! Highly recommended.
Susan S. Weed
1985, 196 pages
I have been reading madly lately, trying to get through all of my books that I've injudiciously over-borrowed, while at the same time procrastinating on writing book reviews, with the end result that many of the books I've borrowed have been returned long-since, while the reviews have remained unwritten. I am going to try, over the next few weeks, to catch up with book reviews so that I can move on to more books and other writings. I want to focus on Arizona birth resources for Arizona mothers soon, and I can't get to any of that until I get these reviews done!
"Wise Woman Herbal for the Childbearing Year" is one book which had to be returned to the library almost a month ago, but it is still sitting in front of me. Why? Because it was one of those books which are so excellent that possession of them becomes an immediate and obsessive need! So when hubby said, "Hon, I need a book to put on this Amazon order to get to the free shipping amount," I knew which book to order!
This book is a keeper. It is so much of a keeper that I can't even tell you how much I liked it! Suffice it to say that I will recommend it unreservedly to all and sundry I meet. It is truly excellent.
I have been getting into amateur herbalism lately, and finding reliable information about herbs in pregnancy literature can be downright frustrating. For example, a pregnancy book (even a naturally-minded one!) might say, "For morning sickness, take dandelion." Well, great. Do you mean fresh herb, dried herb, tea, infusion, decoction, fresh herb tincture, dried herb tincture, oil, salve, or compress? How often should I take it? What strength? How should I take it? How much at a time? This book is one of the few books that explicitly gives dosage directions. For example, "Ten to twenty drops of Witch Hazel tincture under the tongue can be used repeatedly to control bleeding until the placenta is delivered." (p. 71) It's terrific!!
The book is arranged in chapters by time period (pre-conception, pregnancy, labor/birth, postpartum, baby), with a great chapter on making your own herbal products and several helpful appendices. Within the chapter, various complaints and conditions (hemorrhage, cramps, etc.) are listed alphabetically for easy access.
Another thing I love about this book is that for each condition, there is a section on "prevention" as well as a section on "what to do if you have this condition." That is just terrific! I love to be proactive. For example, with my delivery I had horrendous after-pains, something which is supposed to be negligible or non-existent for primips. Since they generally increase in intensity with each pregnancy, I know that I can expect them with any future pregnancies, and now I have the preventative advice of this book to help me prevent afterpains with pre-birth herbs. Hurray!!
There is one chapter in this book which I found very disappointing, but I won't elaborate further. On the whole, this book receives my complete applause and approval.
When I told my midwife that I was reading this book, she told me that she keeps multiple copies both at her home and at her office because it is so vital to her practice.
This book is indispensable, and I love it! Highly recommended.
Friday, October 24, 2008
"A Brief History of Midwifery in America," or, "Why on Earth Are There So Many Kinds of Midwives?"
I've been wanting to write an article on this subject for a long time, but didn't have time to do the research - and then I found a book which had done that research for me! Thus, most of the information for this article is taken from "Mainstreaming Midwives: The Politics of Change," edited by Robbie Davis-Floyd and Christine Barbara Johnson. I will be reviewing this book (in glowing terms!) very soon as well, but I wanted to write this article as soon as I could, as I need to return the book to my midwife on Sunday. So here goes!
Midwives are still, for the most part, America's best-kept secret in terms of health-care practitioners. When I was in Border's last year buying a copy of Elizabeth Davis' "Heart and Hands," the clerk said, "Do midwives even still exist? You're kidding!" Yes, Virginia, there really are midwives! Alive and thriving (and growing!) but unfortunately still attending only about 1% of all births.
However, for those of us who do know about midwives, the sheer number of midwife "titles" can be overwhelming and confusing - certified nurse midwife, certified midwife, certified professional midwife, lay midwife, licensed midwife - and more!
The purpose of this article will be to briefly (and incompletely, I'm afraid) examine the history of American midwifery and throw some light onto the differentiations between types of American midwives.
The history of American midwifery is a long and conflicted story which has unfortunately not always been a positive one. The story of midwives in the early part of the 20th century was marked by persecution and witch-hunts (still going on, unfortunately), and in the latter part of the century was marked with internal strife and divisions which led to midwives oftentimes fighting amongst themselves over ideological differences rather than uniting as a common front.
To begin....
In 1900, only 1% of births took place in hospitals. By 2000, those numbers had reversed, with only 1% of births taking place at home. How and why did this change occur? It occurred because a decision was made by the medical profession that birth was profitable and midwives, therefore, needed to go. A massive propaganda campaign was launched against midwives, with midwives portrayed as dirty, ignorant, old-fashioned, archaic, disease-carrying crones who were unsafe care-givers and who were practicing medicine illegally. This campaign was especially effective with immigrant mothers, who wanted to forsake everything having to do with the Old World and become as "American" as possible - and being "American" soon came to mean having a male obstetrician delivering one's babies in a hospital (and giving formula, etc.).
Unlike European midwives, who were well-organized in trade unions and professional organizations and were able to protect themselves and their profession, American midwives were not well-organized, or even organized at all. They were isolated, working within their own ethnic groups, with little to no communication with other midwives, and had no professional organizations. To put it vulgarly, they were sitting ducks who went down with one shot - they were not able to resist the combined efforts of the government and the medical establishment who were bent on eradicating them.
Of course, lay homebirth midwives never completely disappeared - but their numbers were greatly reduced and they were forced to practice underground.
Midwives who wished to continue practicing legally made a monumental decision, one that affects American midwifery to this day - they decided to unite with the respected position of nursing. Thus, in 1925 Mary Breckenridge formed the first organization uniting nursing and midwifery, the Frontier Nursing Service, bringing midwifery care to the Appalachian poor, and the profession of nurse-midwifery (eventually producing the certified nurse-midwife) was born.
In 1930 a second nurse-midwifery institution was opened - the Lobenstine Clinic in New York City, later home of the nation's first nurse-midwifery program. This clinic met the needs of poor, inner-city women and was staffed by nurse-midwives.
Initial efforts of nurse-midwives met with success. There was a notable lack of opposition from obstetricians because of the clientele that the midwives were serving - most obstetricians did not want the "down and dirty" jobs of providing care to the poorest-of-the-poor or to mothers in extreme rural districts. Midwifery survived by meeting needs no one else wanted to meet, and by finding a niche for itself there. Nurse-midwives also survived by proving their worth with excellent statistical results and by finding small numbers of physicians sympathetic to their cause who would support them and work with them.
Thus, nurse-midwifery gained a foot-hold in American maternity care, but growth for the profession was extremely slow. Additionally, many of America's nurse-midwives were lost to the system in that they decided to pursue careers overseas in missions work or left the nurse-midwifery profession altogether and worked in health-related fields.
Also, at this time nurse-midwifery was not synonymous with hospital birth, as it often is today - many nurse-midwives attended home births or worked in maternity centers. Thus hospital births were attended primarily by obstetricians.
In 1929, six nurse-midwives from the Frontier Nursing Service formed the American Association of Nurse-Midwives. This was not a professional organization, but an attempt to focus on providing better maternity care for women and babies.
However, the lack of a true professional organization for the nurse-midwives was soon felt. Unable to find a good niche for themselves in other health-care professional organizations, nurse midwives in 1955 formed the American College of Nurse Midwives (ACNM), still extant today. Their initial goals were to develop educational standards, sponsor research and participate in the International Confederation of Midwives. The formative purpose of the ACNM was to promote and protect the profession of nurse-midwifery, and in doing so it was an enormous step forward for midwifery.
At the same time, the baby boom was occurring, and city hospitals were overwhelmed with the sheer number of birthing mothers. To reduce costs and meet staffing needs, hospitals began to hire large numbers of nurse-midwives, and thus the transition of nurse-midwifery into a hospital-based instition began - and has really never reversed. Nurse-midwives now overwhelmingly work in hospitals and attend hospital births.
There were several positives to this shift into hospital-based work. Nurse-midwives were now able to serve more women, able to increase their knowledge-base by serving cases with complications (which in homebirths would have been risked out to hospital care, as they are today), able to better serve the needs of the poor, and also able to more firmly establish themselves in the maternity system. Because of the shift into hospital-based work, more nurse-midwifery schools opened and there was steady employment for larger numbers of nurse-midwives.
However, there was also a negative side to the shift into hospitals. Primarily this was seen in nurse-midwives' loss of autonomy and increasing subordination to doctors. Rather than always being independent practitioners in charge of women's health-care, nurse-midwives were now subordinate to the doctor in charge, and in many cases became nothing more than glorified obstetrical nurses (something that holds true today).
In-hospital conflicts for nurse-midwives have never disappeared. Although nurse-midwives are still entrenched in the hospital system, they are still often treated as nurses and are under the authority of physicians. Additionally, because of intervention-heavy hospital protocols, they are often forced to practice against the midwifery model of care, resulting in births that are midwife-atended but still heavy on unnecessary and dehumanizing interventions. Also, the training and hospital work of nurse-midwives can unfortunately produce midwives who are more obstetrically-minded than midwifery minded (called "med-wives") who are no longer practicing according to midwifery standards but have conformed in both thought and behavior to the model of mainstream birth as a medical event. Thus, although nurse-midwives are able to provide hospital midwifery birth services to women who want hospital births (which is the majority of modern American women), their practice and sometimes their beliefs can be negatively altered by their chosen place of practice.
For nurse midwives, the shift to hospital-based work was so complete that in 1973 the ACNM published a statement against homebirth, saying that the hospital was:
"the preferred site for childbirth because of the distinct advantageto the physical wefare of mother and infant" (ACNM 1973, quoted in Rooks 1997:67, quoted in Davis-Floyd 2006:36)
(This statement was retracted in 1980.)
During the 1960's and 1970's the profession of nurse-midwifery made great strides. Although in 1963 there were only forty nurse-midwives practicing in the United States, the ACNM was making great strides in terms of developing the profession of nurse-midwifery. In 1965 the ACNM developed their accreditation process, and by 1970 it was administering national certification and accreditation for all nurse-midwifery programs. In 1978 the ACNM defined the core competencies for nurse midwifery (core competencies are "the fundamental knowledge, skills, and behaviors that are the expected outcomes of..... education", p. 38) and by 1980 there were nineteen nurse-midwifery education programs, with nurse-midwifery legal and protected in 41 states. Nurse-midwives attended approximately 1% of all American births.
***
And now we examine the other side of the coin: We will examine the story of the lay midwife, also called the direct-entry midwife (DEM) who is not a trained nurse and who often learned her trade by apprenticeship.
In the 1960's and 1970's there was a reactionist movement (mixed together with the countercultural and feminist movements) against the extreme medicalization and often brutalization of birth in American hospitals. At the time women were isolated from family during birth, physically restrained, and forcibly anaesthetized during the birth process. Both mothers and babies suffered from the drugs used on them, breastfeeding was discouraged, and babies were isolated in newborn nurseries.
"From the 1930's to the 1970's scopolamine was heavily employed. A psychedelic amnesiac that was supposed to take away memory, this drug often did not render women unconscious during birth, but rather made them wild. They were strapped down with lamb's wool bands (which did not leave marks on thier arms) and often left alone to scream until the baby finally came; many women were subsequently haunted by spotty nightmarish memories. Technological interventions such as forceps and episiotomies became increasingly common as humanistic care for birthing women became increasingly rare." (p. 38)
Some mothers, helped by certified nurse-midwives, tried to change and improve hospital birth for the better. Benefits gained during this time included getting fathers into the delivery room, permitting mothers to labor without being restrained and the promotion of conscious birth and breastfeeding. However, change was limited and slow.
Frustrated with slow change, women within this movement began to give birth at home. Since there were oftentimes no midwives to attend them, these women became each other's midwives - attending births of friends and families and slowly building their knowledge-base by experience and self-teaching. They became the first generation of the resurgence of the lay midwife. As time went by lay midwifery grew in numbers and knowledge, formed relationships and began producing literature, such as Ina May Gaskin's "Spiritual Midwifery."
Lay midwifery was not well-received by nurse-midwifery. To put it succinctly, "They're destroying everything we've worked for!" Nurse midwives stood for credibility, professionalism, standards of care, medical orientation, protocols, etc. Lay midwifery stood for women's rights and natural birth and was often hippie-ish and spiritual in nature (especially in the early days), making nurse-midwives fear for the credibility of midwifery professionalism. Thus began a conflict between schools of thought in American midwifery which has never been completely healed, and which has often caused deep and bitter resentment and divide between the two camps. (In fact, the divide and the conflict has often been so deep and problematic that American midwifery has been used by other nations, Canada in particular, as a model of how not to do midwifery.)
In 1981, Sister Angela Murdaugh, then-president of the ACNM, met with a group of lay midwives and, in a controversial move, urged them to organize and create principles of practice by which lay midwifery could be organized and made more professionals. Sister Angela received a great deal of opposition from within her own ranks in the ACNM - many nurse-midwives felt that lay midwives should either be discouraged from practicing altogether or encouraged to become nurse-midwives and join the ACNM. However, Sister Angela's courageous move gave impetus to the lay midwifery movement and started wheels turning for the organization of lay midwifery. However, the two professions remained separate and did not in any way unite. Although the ACNM had in 1980 made a counter-statement now supporting homebirth, the ACNM did not open to lay midwifery until 1994 - by which time lay midwifery was already well organized on its own and did not need the ACNM's help.
And so the stage was set for one of the biggest accomplishments for lay midwifery in America - the formation of the Midwives Alliance of North America (MANA), a coalition formed by lay midwives and some sympathetic nurse-midwives. There was no nursing requirement for membership, as nursing was seen by nurse-midwives to be detrimental to the practice of true midwifery, the two having completely different philosophies and knowledge-bases.
"As these original lay midwives became more sophisticated in their understanding of the details of medical training an dpractice, they saw quite clearly that what they were seeing at homebirths often did not reflect what they were reading about and seeing in hospital birth. Understanding that they were developing a different knowledge system, over time they sought to develop educational methods and programs that would perpetuate that systyem, and to avoid incorporation into the more medicalized nurse-midwifery approach." (Anne Fry, quoted on p. 43)
MANA and lay midwifery thrived despite ill-wishes of the medical and nurse-midwifery community and despite active persecution law enforcement. Occasionally supportive CNM's joined MANA as well (MANA valued inclusivity and welcomed nurse-midwives).
However, MANA was not then an official professional organization because, at the time, it had no ability to enforce its core competencies as educational requirements, and thus was open to the accusation of illegitimacy as an professional organization.
In the late eighties and early nineties, meetings called the Carnegie Meetings were held between MANA and the ACNM to try to create much-needed unity. While each deemed that their core competencies were equivalent, the philosophical divide between the two was too great to achieve unity.
One of the most deeply divisive issues at hand was that of apprenticeship. ACNM holds that apprenticeship is an invalid and incomplete method of training, and that only a university degree can validly qualify a midwife. MANA holds that apprenticeship is a valid route to midwifery training, and furthermore, that it is an essential method that preserves the midwifery model of care, and additionally, that university training in a traditional setting can be destructive to the formation of holistically-minded midwives.
(Speaking as a woman who was cared for by apprenticeship-trained midwives, I wholeheartedly agree with MANA's position and view apprenticeship as vital and essential to midwifery education. I now would not want to be under the care of a midwife trained any other way. - Author)
In 1991 MANA created the Midwifery Education Accreditation Counsel (MEAC) which was recognized by the US Department of Education in 2001, comparable to the ACNM's Department of Accreditation (DOA) which was recognized by the Department of Education in 1982. Thus MANA was well on its way to becoming more "professional." MANA recognized the need for a mechanism to prove the competency of its midwives. Most lay midwives had already dropped the term "lay midwife" for the term "direct-entry midwife" (DEM), by which they meant apprenticeship-trained or non-university-trained midwives. Thus, by 1994, MANA's daughter organization the North American Registry of Midwives (NARM) had developed into a testing and certifying agency and had developed the Certified Professional Midwife (CPM) credential, a credential that recognized formal training, self-training, apprenticeship training and portfolio work for credentialing as well as designing the NARM written and practical exam for licensing.
"CPM certification is competency based; where a midwife gains her knowledge, skills, and experience is not th eissue - the fact that she has them is what counts." (p. 53)
At the same time, certified nurse-midwives were reexamining their self-identity. Many wished to break with nursing, for some of the following reasons: (1) they were tired of being treated as glorified nurses, (2) they desired autonomy from doctors and state nursing boards, (3) Physicians Assistants had started attending births, and (4) the realization that only some nursing knowledge is needed for midwifery. Nurse-midwives thus created the Certified Midwife (CM) credential, a certification that maintains the tradition and philosophy of nurse-midwifery without the nursing requirement. Nurse-midwives refer to the CM as their direct-entry midwife, creating some confusion as to what a DEM really is.
In summary, America has two basic types of midwives:
Type #1: Nurse Midwife
Includes: Certified Nurse-Midwife, Certified Midwife
Professional Organization: ACNM (American College of Nurse Midwives)
Accreditation Organization: DOA (Department of Accreditation)
Location of Practice: Mostly hospital, occasionally birth centers and home
Type #2: Lay or Direct-Entry Midwife (DEM)
Includes: Lay Midwife, Licensed/Unlicensed Midwife, Certified Professional Midwife
Professional Organization: MANA (Midwives Alliance of North America)
Accreditation Organization: MEAC (Midwifery Education Accreditation Counsel)
Location of Practice: Home (may not practice in-hospital in America)
A few other notes:
The legality of homebirth DEM's differs greatly from state to state. In about ten states (poor pitiable places) lay midwives' work is 100% illegal, and midwives must work underground. In other states it is "a-legal" - neither legal nor illegal, but midwives maintain a tenuous position of being open to prosecution in cases of poor neonatal or maternal outcomes. In other states (such as Arizona, hurray!) midwives are legal and may practice openly, though they still deal with backward attitudes in hospitals and from doctors.
Midwives' legal scope of practice varies widely by state as well. For example, homebirth midwives may deliver twins in California, but not in Arizona; they may deliver VBAC babies in Utah, but not in Arizona.
Additionally, some states allow midwives to practice while unlicensed, such as Utah and Oregon (Arizona doesn't).
I'd like to look at a few other terms:
"granny midwife" - a term for an elderly female midwife, usually black, who served her ethnic community, generally in the deep south. These women were effectively put out of business by the health departments.
"plain midwife" - a midwife, usually unlicensed and unregistered, who works (often unpaid) among her religious or ethnic community. Examples are Amish & Mennonite midwives, and midwives who serve Mormon communities and Christian Scientist communities
"renegade midwife" - there are a couple of different types here:
(!) a midwife who practices without sufficient training and is dangerous to the community - few and far between, but it does happen. These are not licensed midwives, but unlicensed lay midwives who branch out on their own when they should still be studying or learning under apprenticeship
(2) a midwife who practices outside the legal scope of practice for her region but is generally considered responsible by the midwifery community. For example, a midwife might attend VBAC homebirths, which are considered safe by midwives (VBAC's are generally only risky when labor-augmenting drugs are used) but are often illegal by state licensure laws
(3) a midwife who attends women at home in risky situations, such as triplets, etc. These women can be risk-takers but are often valued by the community as midwives who keep options open for birthing women. (I, for example, support a woman's right to birth how she wishes, even if a hospital birth is medically indicated. But midwives who don't want to endanger their licensing or ability to practice are often reluctant to take on such mothers, even though they support mothers' rights. This type of renegade midwife ensures that mothers retain their rights even when other homebirth midwives have to turn them away. - Author) However, they can give the midwifery community a bad name.
Midwifery in America is a constantly growing, changing, evolving profession, and one which I am glad that I now know of! I love midwives and am so happy to have several among my close acquaintance.
***
That's about it! If you see any omissions or errors, please contact me, as I want the above to be as accurate as possible.
***
Postscript on January 5th, 2009:
The Mommy Blawger sent in the following comments, which I wanted to add below, as they're both very pertinent points which I should have included in the article:
"I will make just one or two additions. First, since the rise of the CPM credential, the term "lay midwife" has taken on an almost pejorative meaning, and is almost exclusively used (at least by midwives) to refer to women without any formal midwifery training or credential.
"Second, many (including myself) believe that there is no such thing as an "alegal" state. Either a state recognizes/permits/regulates direct-entry midwifery, or it doesn't. In a state where midwifery is not "authorized", even if there is no statute specifically prohibiting DEMs, a midwife runs the risk of being charged with practicing medicine or nurse-midwifery without a license, or a number of related offenses. You can see that in states such as Pennsylvania, which was formerly described as "alegal", it took only one bad outcome for the powers-that-be to start actively prosecuting midwives.
"Your readers may be interested in this resource for more on the legal status of midwifery:
http://fromcallingtocourtroom.net/
Midwives are still, for the most part, America's best-kept secret in terms of health-care practitioners. When I was in Border's last year buying a copy of Elizabeth Davis' "Heart and Hands," the clerk said, "Do midwives even still exist? You're kidding!" Yes, Virginia, there really are midwives! Alive and thriving (and growing!) but unfortunately still attending only about 1% of all births.
However, for those of us who do know about midwives, the sheer number of midwife "titles" can be overwhelming and confusing - certified nurse midwife, certified midwife, certified professional midwife, lay midwife, licensed midwife - and more!
The purpose of this article will be to briefly (and incompletely, I'm afraid) examine the history of American midwifery and throw some light onto the differentiations between types of American midwives.
The history of American midwifery is a long and conflicted story which has unfortunately not always been a positive one. The story of midwives in the early part of the 20th century was marked by persecution and witch-hunts (still going on, unfortunately), and in the latter part of the century was marked with internal strife and divisions which led to midwives oftentimes fighting amongst themselves over ideological differences rather than uniting as a common front.
To begin....
In 1900, only 1% of births took place in hospitals. By 2000, those numbers had reversed, with only 1% of births taking place at home. How and why did this change occur? It occurred because a decision was made by the medical profession that birth was profitable and midwives, therefore, needed to go. A massive propaganda campaign was launched against midwives, with midwives portrayed as dirty, ignorant, old-fashioned, archaic, disease-carrying crones who were unsafe care-givers and who were practicing medicine illegally. This campaign was especially effective with immigrant mothers, who wanted to forsake everything having to do with the Old World and become as "American" as possible - and being "American" soon came to mean having a male obstetrician delivering one's babies in a hospital (and giving formula, etc.).
Unlike European midwives, who were well-organized in trade unions and professional organizations and were able to protect themselves and their profession, American midwives were not well-organized, or even organized at all. They were isolated, working within their own ethnic groups, with little to no communication with other midwives, and had no professional organizations. To put it vulgarly, they were sitting ducks who went down with one shot - they were not able to resist the combined efforts of the government and the medical establishment who were bent on eradicating them.
Of course, lay homebirth midwives never completely disappeared - but their numbers were greatly reduced and they were forced to practice underground.
Midwives who wished to continue practicing legally made a monumental decision, one that affects American midwifery to this day - they decided to unite with the respected position of nursing. Thus, in 1925 Mary Breckenridge formed the first organization uniting nursing and midwifery, the Frontier Nursing Service, bringing midwifery care to the Appalachian poor, and the profession of nurse-midwifery (eventually producing the certified nurse-midwife) was born.
In 1930 a second nurse-midwifery institution was opened - the Lobenstine Clinic in New York City, later home of the nation's first nurse-midwifery program. This clinic met the needs of poor, inner-city women and was staffed by nurse-midwives.
Initial efforts of nurse-midwives met with success. There was a notable lack of opposition from obstetricians because of the clientele that the midwives were serving - most obstetricians did not want the "down and dirty" jobs of providing care to the poorest-of-the-poor or to mothers in extreme rural districts. Midwifery survived by meeting needs no one else wanted to meet, and by finding a niche for itself there. Nurse-midwives also survived by proving their worth with excellent statistical results and by finding small numbers of physicians sympathetic to their cause who would support them and work with them.
Thus, nurse-midwifery gained a foot-hold in American maternity care, but growth for the profession was extremely slow. Additionally, many of America's nurse-midwives were lost to the system in that they decided to pursue careers overseas in missions work or left the nurse-midwifery profession altogether and worked in health-related fields.
Also, at this time nurse-midwifery was not synonymous with hospital birth, as it often is today - many nurse-midwives attended home births or worked in maternity centers. Thus hospital births were attended primarily by obstetricians.
In 1929, six nurse-midwives from the Frontier Nursing Service formed the American Association of Nurse-Midwives. This was not a professional organization, but an attempt to focus on providing better maternity care for women and babies.
However, the lack of a true professional organization for the nurse-midwives was soon felt. Unable to find a good niche for themselves in other health-care professional organizations, nurse midwives in 1955 formed the American College of Nurse Midwives (ACNM), still extant today. Their initial goals were to develop educational standards, sponsor research and participate in the International Confederation of Midwives. The formative purpose of the ACNM was to promote and protect the profession of nurse-midwifery, and in doing so it was an enormous step forward for midwifery.
At the same time, the baby boom was occurring, and city hospitals were overwhelmed with the sheer number of birthing mothers. To reduce costs and meet staffing needs, hospitals began to hire large numbers of nurse-midwives, and thus the transition of nurse-midwifery into a hospital-based instition began - and has really never reversed. Nurse-midwives now overwhelmingly work in hospitals and attend hospital births.
There were several positives to this shift into hospital-based work. Nurse-midwives were now able to serve more women, able to increase their knowledge-base by serving cases with complications (which in homebirths would have been risked out to hospital care, as they are today), able to better serve the needs of the poor, and also able to more firmly establish themselves in the maternity system. Because of the shift into hospital-based work, more nurse-midwifery schools opened and there was steady employment for larger numbers of nurse-midwives.
However, there was also a negative side to the shift into hospitals. Primarily this was seen in nurse-midwives' loss of autonomy and increasing subordination to doctors. Rather than always being independent practitioners in charge of women's health-care, nurse-midwives were now subordinate to the doctor in charge, and in many cases became nothing more than glorified obstetrical nurses (something that holds true today).
In-hospital conflicts for nurse-midwives have never disappeared. Although nurse-midwives are still entrenched in the hospital system, they are still often treated as nurses and are under the authority of physicians. Additionally, because of intervention-heavy hospital protocols, they are often forced to practice against the midwifery model of care, resulting in births that are midwife-atended but still heavy on unnecessary and dehumanizing interventions. Also, the training and hospital work of nurse-midwives can unfortunately produce midwives who are more obstetrically-minded than midwifery minded (called "med-wives") who are no longer practicing according to midwifery standards but have conformed in both thought and behavior to the model of mainstream birth as a medical event. Thus, although nurse-midwives are able to provide hospital midwifery birth services to women who want hospital births (which is the majority of modern American women), their practice and sometimes their beliefs can be negatively altered by their chosen place of practice.
For nurse midwives, the shift to hospital-based work was so complete that in 1973 the ACNM published a statement against homebirth, saying that the hospital was:
"the preferred site for childbirth because of the distinct advantageto the physical wefare of mother and infant" (ACNM 1973, quoted in Rooks 1997:67, quoted in Davis-Floyd 2006:36)
(This statement was retracted in 1980.)
During the 1960's and 1970's the profession of nurse-midwifery made great strides. Although in 1963 there were only forty nurse-midwives practicing in the United States, the ACNM was making great strides in terms of developing the profession of nurse-midwifery. In 1965 the ACNM developed their accreditation process, and by 1970 it was administering national certification and accreditation for all nurse-midwifery programs. In 1978 the ACNM defined the core competencies for nurse midwifery (core competencies are "the fundamental knowledge, skills, and behaviors that are the expected outcomes of..... education", p. 38) and by 1980 there were nineteen nurse-midwifery education programs, with nurse-midwifery legal and protected in 41 states. Nurse-midwives attended approximately 1% of all American births.
***
And now we examine the other side of the coin: We will examine the story of the lay midwife, also called the direct-entry midwife (DEM) who is not a trained nurse and who often learned her trade by apprenticeship.
In the 1960's and 1970's there was a reactionist movement (mixed together with the countercultural and feminist movements) against the extreme medicalization and often brutalization of birth in American hospitals. At the time women were isolated from family during birth, physically restrained, and forcibly anaesthetized during the birth process. Both mothers and babies suffered from the drugs used on them, breastfeeding was discouraged, and babies were isolated in newborn nurseries.
"From the 1930's to the 1970's scopolamine was heavily employed. A psychedelic amnesiac that was supposed to take away memory, this drug often did not render women unconscious during birth, but rather made them wild. They were strapped down with lamb's wool bands (which did not leave marks on thier arms) and often left alone to scream until the baby finally came; many women were subsequently haunted by spotty nightmarish memories. Technological interventions such as forceps and episiotomies became increasingly common as humanistic care for birthing women became increasingly rare." (p. 38)
Some mothers, helped by certified nurse-midwives, tried to change and improve hospital birth for the better. Benefits gained during this time included getting fathers into the delivery room, permitting mothers to labor without being restrained and the promotion of conscious birth and breastfeeding. However, change was limited and slow.
Frustrated with slow change, women within this movement began to give birth at home. Since there were oftentimes no midwives to attend them, these women became each other's midwives - attending births of friends and families and slowly building their knowledge-base by experience and self-teaching. They became the first generation of the resurgence of the lay midwife. As time went by lay midwifery grew in numbers and knowledge, formed relationships and began producing literature, such as Ina May Gaskin's "Spiritual Midwifery."
Lay midwifery was not well-received by nurse-midwifery. To put it succinctly, "They're destroying everything we've worked for!" Nurse midwives stood for credibility, professionalism, standards of care, medical orientation, protocols, etc. Lay midwifery stood for women's rights and natural birth and was often hippie-ish and spiritual in nature (especially in the early days), making nurse-midwives fear for the credibility of midwifery professionalism. Thus began a conflict between schools of thought in American midwifery which has never been completely healed, and which has often caused deep and bitter resentment and divide between the two camps. (In fact, the divide and the conflict has often been so deep and problematic that American midwifery has been used by other nations, Canada in particular, as a model of how not to do midwifery.)
In 1981, Sister Angela Murdaugh, then-president of the ACNM, met with a group of lay midwives and, in a controversial move, urged them to organize and create principles of practice by which lay midwifery could be organized and made more professionals. Sister Angela received a great deal of opposition from within her own ranks in the ACNM - many nurse-midwives felt that lay midwives should either be discouraged from practicing altogether or encouraged to become nurse-midwives and join the ACNM. However, Sister Angela's courageous move gave impetus to the lay midwifery movement and started wheels turning for the organization of lay midwifery. However, the two professions remained separate and did not in any way unite. Although the ACNM had in 1980 made a counter-statement now supporting homebirth, the ACNM did not open to lay midwifery until 1994 - by which time lay midwifery was already well organized on its own and did not need the ACNM's help.
And so the stage was set for one of the biggest accomplishments for lay midwifery in America - the formation of the Midwives Alliance of North America (MANA), a coalition formed by lay midwives and some sympathetic nurse-midwives. There was no nursing requirement for membership, as nursing was seen by nurse-midwives to be detrimental to the practice of true midwifery, the two having completely different philosophies and knowledge-bases.
"As these original lay midwives became more sophisticated in their understanding of the details of medical training an dpractice, they saw quite clearly that what they were seeing at homebirths often did not reflect what they were reading about and seeing in hospital birth. Understanding that they were developing a different knowledge system, over time they sought to develop educational methods and programs that would perpetuate that systyem, and to avoid incorporation into the more medicalized nurse-midwifery approach." (Anne Fry, quoted on p. 43)
MANA and lay midwifery thrived despite ill-wishes of the medical and nurse-midwifery community and despite active persecution law enforcement. Occasionally supportive CNM's joined MANA as well (MANA valued inclusivity and welcomed nurse-midwives).
However, MANA was not then an official professional organization because, at the time, it had no ability to enforce its core competencies as educational requirements, and thus was open to the accusation of illegitimacy as an professional organization.
In the late eighties and early nineties, meetings called the Carnegie Meetings were held between MANA and the ACNM to try to create much-needed unity. While each deemed that their core competencies were equivalent, the philosophical divide between the two was too great to achieve unity.
One of the most deeply divisive issues at hand was that of apprenticeship. ACNM holds that apprenticeship is an invalid and incomplete method of training, and that only a university degree can validly qualify a midwife. MANA holds that apprenticeship is a valid route to midwifery training, and furthermore, that it is an essential method that preserves the midwifery model of care, and additionally, that university training in a traditional setting can be destructive to the formation of holistically-minded midwives.
(Speaking as a woman who was cared for by apprenticeship-trained midwives, I wholeheartedly agree with MANA's position and view apprenticeship as vital and essential to midwifery education. I now would not want to be under the care of a midwife trained any other way. - Author)
In 1991 MANA created the Midwifery Education Accreditation Counsel (MEAC) which was recognized by the US Department of Education in 2001, comparable to the ACNM's Department of Accreditation (DOA) which was recognized by the Department of Education in 1982. Thus MANA was well on its way to becoming more "professional." MANA recognized the need for a mechanism to prove the competency of its midwives. Most lay midwives had already dropped the term "lay midwife" for the term "direct-entry midwife" (DEM), by which they meant apprenticeship-trained or non-university-trained midwives. Thus, by 1994, MANA's daughter organization the North American Registry of Midwives (NARM) had developed into a testing and certifying agency and had developed the Certified Professional Midwife (CPM) credential, a credential that recognized formal training, self-training, apprenticeship training and portfolio work for credentialing as well as designing the NARM written and practical exam for licensing.
"CPM certification is competency based; where a midwife gains her knowledge, skills, and experience is not th eissue - the fact that she has them is what counts." (p. 53)
At the same time, certified nurse-midwives were reexamining their self-identity. Many wished to break with nursing, for some of the following reasons: (1) they were tired of being treated as glorified nurses, (2) they desired autonomy from doctors and state nursing boards, (3) Physicians Assistants had started attending births, and (4) the realization that only some nursing knowledge is needed for midwifery. Nurse-midwives thus created the Certified Midwife (CM) credential, a certification that maintains the tradition and philosophy of nurse-midwifery without the nursing requirement. Nurse-midwives refer to the CM as their direct-entry midwife, creating some confusion as to what a DEM really is.
In summary, America has two basic types of midwives:
Type #1: Nurse Midwife
Includes: Certified Nurse-Midwife, Certified Midwife
Professional Organization: ACNM (American College of Nurse Midwives)
Accreditation Organization: DOA (Department of Accreditation)
Location of Practice: Mostly hospital, occasionally birth centers and home
Type #2: Lay or Direct-Entry Midwife (DEM)
Includes: Lay Midwife, Licensed/Unlicensed Midwife, Certified Professional Midwife
Professional Organization: MANA (Midwives Alliance of North America)
Accreditation Organization: MEAC (Midwifery Education Accreditation Counsel)
Location of Practice: Home (may not practice in-hospital in America)
A few other notes:
The legality of homebirth DEM's differs greatly from state to state. In about ten states (poor pitiable places) lay midwives' work is 100% illegal, and midwives must work underground. In other states it is "a-legal" - neither legal nor illegal, but midwives maintain a tenuous position of being open to prosecution in cases of poor neonatal or maternal outcomes. In other states (such as Arizona, hurray!) midwives are legal and may practice openly, though they still deal with backward attitudes in hospitals and from doctors.
Midwives' legal scope of practice varies widely by state as well. For example, homebirth midwives may deliver twins in California, but not in Arizona; they may deliver VBAC babies in Utah, but not in Arizona.
Additionally, some states allow midwives to practice while unlicensed, such as Utah and Oregon (Arizona doesn't).
I'd like to look at a few other terms:
"granny midwife" - a term for an elderly female midwife, usually black, who served her ethnic community, generally in the deep south. These women were effectively put out of business by the health departments.
"plain midwife" - a midwife, usually unlicensed and unregistered, who works (often unpaid) among her religious or ethnic community. Examples are Amish & Mennonite midwives, and midwives who serve Mormon communities and Christian Scientist communities
"renegade midwife" - there are a couple of different types here:
(!) a midwife who practices without sufficient training and is dangerous to the community - few and far between, but it does happen. These are not licensed midwives, but unlicensed lay midwives who branch out on their own when they should still be studying or learning under apprenticeship
(2) a midwife who practices outside the legal scope of practice for her region but is generally considered responsible by the midwifery community. For example, a midwife might attend VBAC homebirths, which are considered safe by midwives (VBAC's are generally only risky when labor-augmenting drugs are used) but are often illegal by state licensure laws
(3) a midwife who attends women at home in risky situations, such as triplets, etc. These women can be risk-takers but are often valued by the community as midwives who keep options open for birthing women. (I, for example, support a woman's right to birth how she wishes, even if a hospital birth is medically indicated. But midwives who don't want to endanger their licensing or ability to practice are often reluctant to take on such mothers, even though they support mothers' rights. This type of renegade midwife ensures that mothers retain their rights even when other homebirth midwives have to turn them away. - Author) However, they can give the midwifery community a bad name.
Midwifery in America is a constantly growing, changing, evolving profession, and one which I am glad that I now know of! I love midwives and am so happy to have several among my close acquaintance.
***
That's about it! If you see any omissions or errors, please contact me, as I want the above to be as accurate as possible.
***
Postscript on January 5th, 2009:
The Mommy Blawger sent in the following comments, which I wanted to add below, as they're both very pertinent points which I should have included in the article:
"I will make just one or two additions. First, since the rise of the CPM credential, the term "lay midwife" has taken on an almost pejorative meaning, and is almost exclusively used (at least by midwives) to refer to women without any formal midwifery training or credential.
"Second, many (including myself) believe that there is no such thing as an "alegal" state. Either a state recognizes/permits/regulates direct-entry midwifery, or it doesn't. In a state where midwifery is not "authorized", even if there is no statute specifically prohibiting DEMs, a midwife runs the risk of being charged with practicing medicine or nurse-midwifery without a license, or a number of related offenses. You can see that in states such as Pennsylvania, which was formerly described as "alegal", it took only one bad outcome for the powers-that-be to start actively prosecuting midwives.
"Your readers may be interested in this resource for more on the legal status of midwifery:
http://fromcallingtocourtroom.net/
Wednesday, October 22, 2008
Mainstream Birth: It's Not Just the Docs
Today I was sitting in a public place (researching midwifery, oddly enough) and happened to overhear a somewhat saddening conversation between two women, one of whom was pregnant. I'm going to try to piece it together here for you, with details obscured... I'm not guaranteeing accuracy, as this is from memory, but you'll get the gist.
Woman (not pg): So, when's your due date?
Pregnant Mother: {mentions date}
Woman: Well, my last couple of babies were cesareans. We had my last one two weeks early so his birthday wouldn't be too close to Christmas.
Pregnant Mother: Oh, that's cool!
Woman: Yeah, I mean, when their birthdays are on Christmas, they don't get the special treatment that everyone else gets. My {mentions relative} has two kids who were born just before Thanksgiving and just after Christmas, and they never get real birthday parties. And I'm thinking, "Gee, couldn't you have planned better than that?" Those poor kids!
Pregnant Mother: That's a good idea. I'll keep it in mind.
My goodness! Scheduled prematurity so your child can have "real birthday parties"???? Is this what we're coming to? What ever happened to letting a baby come when he is ready?
As much as we vilify ACOG (and they definitely deserve some vilification), we must, as women, take responsibility for the birth situation as well. Unethical birth practices only exist because we submit to them and sometimes actively encourage them by willing participation and willing ignorance. If we refused to participate, hospitals and doctors would follow suit.
Food for thought!
Woman (not pg): So, when's your due date?
Pregnant Mother: {mentions date}
Woman: Well, my last couple of babies were cesareans. We had my last one two weeks early so his birthday wouldn't be too close to Christmas.
Pregnant Mother: Oh, that's cool!
Woman: Yeah, I mean, when their birthdays are on Christmas, they don't get the special treatment that everyone else gets. My {mentions relative} has two kids who were born just before Thanksgiving and just after Christmas, and they never get real birthday parties. And I'm thinking, "Gee, couldn't you have planned better than that?" Those poor kids!
Pregnant Mother: That's a good idea. I'll keep it in mind.
My goodness! Scheduled prematurity so your child can have "real birthday parties"???? Is this what we're coming to? What ever happened to letting a baby come when he is ready?
As much as we vilify ACOG (and they definitely deserve some vilification), we must, as women, take responsibility for the birth situation as well. Unethical birth practices only exist because we submit to them and sometimes actively encourage them by willing participation and willing ignorance. If we refused to participate, hospitals and doctors would follow suit.
Food for thought!
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