Category Archives: Midwifery

The homebirth witch hunts have finally hit home. Please support Marlene Bergman, RM.

When I read stories about midwives being prosecuted, I cringe in sympathy and frustration–but there’s always a little piece of my mind that’s skeptical, wondering if maybe the midwife really did do something irresponsible.

Marlene Bergman measures my fundal height at 38 weeks and 2 days, back in 2008.

But recently, the reality of the homebirth witch hunts hit home.  A midwife that I know, love, and trust is being hung out to dry–and she really didn’t do anything irresponsible.

I’ve known for a while that the wonderful Marlene Bergman, RM, was being investigated by her local hospital in Gunnison, Colorado, two hours from where I live.  But I didn’t know that the investigation had become so serious that her career, her practice, and her family’s livelihood are all at stake.

Marlene was finishing up her direct-entry apprenticeship with my midwife, Bill Dwelley, RM, as I prepared for the birth of my daughter in 2008.  She attended all of my prenatal visits, and helped me believe everything would be ok as early labor set in two weeks before my estimated due date.  And now, four years later, I’m studying under the same midwife who she apprenticed with, and Marlene’s enjoying a successful homebirth practice–and enduring a completely unnecessary and inappropriate investigation of her practice.

When she was caring for me during my pregnancy, Marlene and I felt a sweet little kinship with each other, the kind where you know you would have easily become friends if you didn’t live a couple hundred miles apart and both have extremely demanding lives.  I really, really enjoy Marlene.  And I trust her.

So it breaks my heart to see that her situation with the Gunnison Valley Hospital has become so tense that she’s asking for public financial support to pay for the TWO attorneys that she’s been forced to hire.

I’ll be making a donation to her account today, and sending her a note of support.  Please read her “Open Letter to the Midwifery Community” below, and if you take away from it that she is enduring a terribly unnecessary challenge, then please offer your support, too.

An Open Letter to the Midwifery Community:

My name is Marlene Bergman. I am in my third year of practice as a Registered Midwife in the state of Continue reading

Ibu Robin Lim Brings Midwifery to the Forefront (and wins $300k) as CNN’s Hero of the Year 2011

When I met Ibu Robin Lim last year, she was promoting the documentary Guerrilla Midwife and selling t-shirts to fundraise for her Yayasan Bumi Sehat midwifery clinics in Bali.  Today, she’s basking in the glow of having just been named CNN’s 2011 Hero of the Year.

When I met Ibu Robin Lim last year, she was promoting her new film and selling t-shirts as a fundraiser. Yesterday she was named CNN's 2011 Hero of the Year. I should've bought a t-shirt!

This award isn’t just a gracious nod to all of her hard work.  Rather, it has the potential to move midwifery care forward exponentially, both here in the US, in Bali, and internationally.  It has the potential to skyrocket Ibu Robin and Bumi Sehat’s goals from being ambitious, to being met.

For a few days, everyone who logs onto CNN.com or watches CNN News will know who she is, what she does, and why.  Media consumers will have the concept of gentle birth brought right into their daily lives, whether or not they’re pregnant or involved in mother-baby care at all.

And aside from the massive media attention and the momentum that this could create, there’s also the $300,000 grant that comes along with the award.  That will help, too.

Congratulations to Ibu Robin Lim, the Yayasan Bumi Sehat community, and every family who will ever benefit from this work and this award.

We Are Not All Women: Midwives, Doulas & the Gender of Birth Work

Tucked inside the new issue of SQUAT Birth Journal #5 is my latest article “We Are Not All Women:  Midwives, Doulas & the Gender of Birth Work.”  The article shares the experiences of a transgender midwifery student, and a male midwife who’s been practicing for 30+ years.

The article attempts to challenge our assumptions about the gender identities of birth workers, and to explore the estrogen-rich environment that is the birth world.

Here’s an excerpt from my interview with Kennedy Rollins,* a transgender midwifery student:

“Considering his experience of feeling alienated in the birth community, Kennedy wonders what effect his gender identity will have on his ability to serve birthing families.  “As someone who really wants to prioritize being accessible to people, and being able to be a competent care provider, how am I potentially restricting myself by transitioning?”

There will undoubtedly be families who are not interested in having a transgendered midwife as their care provider.  “I know that I would reach more people if I appeared to be female,” Kennedy admits.  But at the same time, there are also birthing families who embrace gender diversity as an element of the vibrant world around us, or who are themselves gender-non-conforming.  For these families, Kennedy and the handful of other publicly transgender doulas, midwives, and student midwives may be the ideal care providers.”

* A pseudonym has been used in this article to protect the privacy of the person being interviewed.

71% C-Section Rate at Hospital in Miami

When I spoke with Barbara Harper last week, she casually mentioned that one hospital in Miami-Dade County has a 73% overall caesaerean rate.  Uhmm, excuse me?

71% of Births are C-Sections at Kendall Regional Medical Center in Miami - Photo by Grendellion

I’m originally from Miami, and my partner and I flirt with the idea of moving our family back there one day.  So when I imagine being pregnant again, back home in the tropical circus that is South Florida, I keep getting a visual image of 73% flashing across my daydreams.  So I called Kendall Regional Medical Center.

The first nurse I spoke with was sincerely confused by my question about their caesarean rate.  She tried to explain to me what a c-section was, and eventually referred me to another nurse.

This second nurse explained that the hospital doesn’t actually have a caesarean rate, but rather the individual doctors do.  Absurd.  She also made sure to point out that, “Anywhere you go in Miami is going to be a high c-section rate.”  Awesome.

After persisting a bit about the hospital’s percentage of c-sections, nurse #2 admitted, “We know our doctors here who are quick to cut, and some who aren’t.”  She stated that some care providers at the hospital have individual rates of 5%, whereas some are 20%.  While I appreciated her effort to give me an answer, it didn’t jive at all with Barbara Harper’s mention of 73% or The Unnecessarean‘s published 2008 statistic of 71%. Continue reading

FDA Returns Birth Pools, Warns ‘We’ll be back’

The seized birthing tubs have now theoretically been returned to their owners, but this fight is far from over.  Barbara Harper, author of Gentle Birth Choices and founder of Waterbirth International, outlined the situation to me this morning.

Is this birth tub a piece of medical equipment? Photo by BirtherSage

Two of the four major U.S. distributors of birth tubs have recently received warning letters from the FDA, thus halting their sales and shipments.  A shipping container of birth tubs was temporarily held at U.S. Customs in Portland, OR earlier this week, and underwent FDA inspection before being released to the distributors.

But Barbara says the FDA made it clear that even though the distributors were allowed to take their shipments to their own warehouses, the FDA is still in control of the property.  She says their attitude was, ‘We own it.  You can’t sell it, you can’t ship it.’  They came in, inspected and counted the birth tubs, and left with a ‘We’ll be back.’

An Attack on Birth Choices?

The public response to this story seems to have been either along the lines of ‘This is one more battle in the government’s war on water birth and birth choices in general,’ or ‘The FDA is just doing their jobs trying to protect birthing women from harm.’  Perhaps the reality is somewhere in the middle.

“If there is an effort to take away water birth,” Barbara explains, “We have to enlist the hospital midwives and obstetricians.  It’s not just about home birth,” since many hospitals are allowing water births these days, with some even using portable, inflatable birthing tubs such as the ones seized in this FDA fiasco.

If this situation truly turns out to be about eliminating water birth as a choice for pregnant women, Barbara adds, “How long do you think it’s going to be before they put yellow caution tape on every hospital bathtub?” Continue reading

Birth Pools Seized by FDA in Portland, OR

According to Barbara Harper, author of Gentle Birth Choices and founder of Waterbirth International, the FDA has seized a shipping container of AquaBorn birthing pools at a dock in Portland, Oregon, and have ordered agents to “inspect and destroy.”

“They claim they are unregistered medical equipment, but they are not providing a way or means to get them registered. In other words, if the medical authorities can’t stop waterbirth, then just have the FDA take away the birth pools,” she explains in a lengthy discussion that began yesterday.

While birth pools are imported to Canada under the category “paddling pools” and some are imported here in the U.S. under the category “sitz baths,” they have no legal standing as medical equipment at this time.

Is this birth tub a piece of medical equipment?

But why would they?  They are often purchased or rented for personal use in private homes.  Barbara’s conversation with an FDA official may shed some light on this as a clash of perspectives.  She explains that she was told, “Pregnancy is an illness and birth is a medical event. Therefore, a pool that a woman gives birth in should be classified as medical equipment.”   So what about our toilets, our bathtubs, our showers?  Kiddie pools, horse troughs, hot tubs?  Oh, and what about the fact that pregnancy is *not* an illness?

What the FDA Wants

Martha Blackmore Althouse, owner and manager of Waterbirth Solutions in Beaverton, Oregon, has been interacting with attorneys and the FDA on the issue.  She explains:

The FDA is requiring a 510(k) – PreMarket Authorization – to be turned in for each Inflatable Birth Pool. The problem is that there is no Pre-existing Medical Device – “Predicate” – already approved by the FDA. Hence, potential of years of clinical trials and legal fees that can cost up to a million or more. Continue reading

Birth Story: A Home Birth at the Hospital

Susannah and her husband spent months planning & preparing for a homebirth. they hired a homebirth midwife, hired me as their doula, took natural childbirth classes, ordered a birth kit, and got their house ready for the birth and the baby. then, in her third trimester, the almighty dollar sign reared its ugly head, and they realized that their homebirth would be financially impossible.

if they went to the hospital to give birth, Susannah’s health insurance would pay all of the $10,000+ bill, whereas a homebirth would be less expensive ($3,000) but they’d have to pay the entire bill themselves.  Susannah grieved the loss of her fantasy homebirth, but had to quickly move on and embrace a new fantasy of the perfect hospital birth with homebirth-style care.

when her baby’s birth-day finally came, Susannah’s fantasy came true.  she labored beautifully at home late into the night, until transition, often the most difficult part of labor. most women rush themselves frantically to the hospital long before this advanced stage of labor, but instead Susannah and her mother and i sat quietly in the darkness of her home, massaging and reassuring and hydrating and timing, for hours as her body prepared her to meet her baby.

it was beautiful to watch her disappear inside her mind with each surge of pressure & pain, and then re-awaken to our voices as the contraction passed.  Susannah’s mother held her tightly, loving being needed, and Susannah loving being cared for.  we created a quiet, calm, and safe space for the mother inside Susannah to begin to emerge, and we waited. Continue reading