Think Global, Birth Local

(editorial from the new issue of The Birth Project Issue VI Spring 2008)

This spring ACOG (American College of Obstetrics and Gynocology) released their updated statement on home birth (reprinted on pg. 12), generally reiterating that they oppose homebirth as well as individuals and organizations who offer or support such options for women and families. We have a few great articles responding to this ACOG statement. This statement is not supported by much of the research; in contrast, research shows that homebirth and freestanding birth centers are statistically safe and actually produce better outcomes overall.

Also this spring many meetings were held by home birth midwives and those who support them discussing The Big Push for Midwives (see pg. 26 for web link), debating the future of midwifery in the United States. Check out their website for more information about the issues around the legislating midwives. Some are in favor of this movement towards “legalization” and some are against it. There are members of the “medical” community opposed to anything that would support homebirth options but also within the homebirth community some see legislation not as progress but as restriction on their practice and how they are able to serve women and families.

What most people don’t realize is that in some states the right to ma
ke the decision to birth at home and birth centers have been taken away from women and families. As seen on Good Morning America on January 2008 unassisted homebirth is something that women are turning to when they cannot find a midwife to attend to them at home. Some also make the decision to have an unassisted homebirth in areas where midwives are available for personal or sometimes financial reasons since homebirth care is usually paid out of pocket. Like other women’s reproductive rights issues, we need to ask: should it be a case of choice, availability and safety? One would think...

On the internet many bloggers are also discussing/debating these hot birth topics and more. There is a buzz of something going on. We are talking about it too, here in The Birth Project.

Most think or assume that birth and birth culture is fine and dandy (more or less outside of the fear of pain that the majority of women have). Many times I end up having conversations about birth with expecting parents, in either doula consultations or in my childbirth education class, friends and family, or even sometimes strangers (although I don’t go out of my way to get on this topic with strangers, it just sometimes comes up). I can see it in their faces that they are realizing that birth, birth culture, birthing decisions, and birth politics are not fine and dandy. They are complicated, multi-layered, politically charged shades of gray, with the eye of the storm - mothers, babies and their families, usually unaware of the huge conflict spinning around them. There are issues- health care issues, human rights issues, women’s rights issues, safety issues, ethical issues, legal issues, psychological issues, emotional issues, physical issues, even environmental issues.
One of the many books on my reading list this spring is actually not about birth. It is
Animal, Vegetable, Miracle by Barbara Kingsolver. It makes a ”passionate case for putting the kitchen back at the center of family life and diversified farms at the center of the American diet”. This book speaks to the idea of eating local and seasonal to, among other things, reduce one’s carbon footprint. So what do agricultural sustainability, and carbon footprints have to do with birth politics you ask?

It is all about how we live and think. Like sustainable agriculture, birth is about business. If we eat more local and seasonal it causes economical issues for the businesses (corporate farms, trucking, packaging, etc.) and employees of those businesses that grow and transport food all over the world. On the flip side local farmers, markets, dairies etc. would be more supported. If more women birth at home or in birth centers a large portion of hospital revenue will take a economical hit along with the companies that make and distribute much of the equipment used at hospital births as well as the income of the doctors that do deliveries in the hospitals. Again on the flip side community midwives would be supported and if the demand were higher for these birth settings momentum could be made for insurance coverage and more accessibility for all who seek alternative birth options, potentially reducing insurance premiums. The waste byproduct from the equipment and apparati at hospital births is many times that of home and birth centers. So again, it is also an environmental issue - reducing the human carbon footprint.

On this beautiful spring-y day (finally!) I ask you to open your mind to the big picture. Think big and also with empathy for the whole picture on both sides. The only way we can hope to move forward is to work together (see the well written open letter to ACOG on page 13). I also ask you to incorporate this kind of thinking to other aspects of your life - how you eat, if you recycle, speak of politics, how you parent, and so on.

Act with thought and empathy for all.

We are dedicating this issue to midwives since May 5th is National Midwife Day. If you have had a midwife in your life and feel so inclined, send her a letter of appreciation this May. It is hard, amazing work that these women take on ~ send them some love to help get through that next sleepless night. The month of May is also International Doula month so send them warm fuzzies too.


in respone to ACOG's anti-homebirth statement.... PASS IT ON AND SUPPORT YOUR LOCAL MIDWIVES!

RESPONSE from The Big Push for Midwives Campaign

CONTACT: Steff Hedenkamp, (816) 506-4630, RedQuill@kc.

FOR IMMEDIATE RELEASE: Thursday, February 7, 2008

ACOG: Out of Touch with Needs of Childbearing Families

Trade Union claims out-of-hospital birth is “trendy;”
tries to play the “bad mother” card

(February 7, 2008) The American College of Obstetricians and Gynecologists (ACOG), a trade union representing the financial and professional interests of obstetricians, has issued the latest in a series of statements condemning families who choose home birth and calling on policy makers to deny them access to Certified Professional Midwives. CPMs are trained as experts in out-of-hospital delivery and as specialists in risk assessment and preventative care.

“It will certainly come as news to the Amish and other groups in this country who have long chosen home birth that they’re simply being ‘trendy’ or ‘fashionable,’” said Katie Prown, PhD, Campaign Manager of The Big Push for Midwives 2008. “The fact is, families deliver their babies at home for a variety of very valid reasons, either because they’re exercising their religious freedom, following their cultural traditions or because of financial need. These families deserve access to safe, quality and affordable maternity care, just like everyone else.”

Besides referring to home birth as a fashionable “trend” and a “cause célèbre” that families choose out of ignorance, ACOG’s latest statement adds insult to injury by claiming that women delivering outside of the hospital are bad mothers who value the childbirth “experience” over the safety of their babies.

“ACOG has it backwards,” said Steff Hedenkamp, Communications Coordinator of The Big Push and the mother of two children born at home. “I delivered my babies with a trained, skilled professional midwife because I wanted the safest out-of-hospital care possible. If every state were to follow ACOG’s recommendations and outlaw CPMs, families who choose home birth will be left with no care providers at all. I think we can all agree that this is an irresponsible policy that puts mothers and babies at risk.”

The Big Push for Midwives calls on ACOG to abandon these outdated policies and work with CPMs to reduce the cesarean rate and to take meaningful steps towards reducing racial and ethnic disparities in birth outcomes in all regions of the United States. CPMs play a critical role in both cesarean prevention and in the reduction of low-birth weight and pre-term births, the two most preventable causes of neonatal mortality.

Moreover, their training as specialists in out-of-hospital maternity care qualifies CPMs as essential first-responders during disasters in which hospitals become inaccessible or unsafe for laboring mothers. In addition, CPMs work to ensure that all babies born outside of the hospital undergo state-mandated newborn screenings and are provided with legal and secure birth certificates.

Currently, Certified Nurse-Midwives, who work predominantly in hospital settings, are licensed and regulated in all 50 states, while Certified Professional Midwives, who work in out-of-hospital settings, are licensed and regulated in 24 states, with legislation pending in an additional 20 states.

The Big Push for Midwives is a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia andPuerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care.

Media inquiries should be directed to Steff Hedenkamp (816) 506-4630,RedQuill@kc.


i am so heated by this that i am almost in tears. i really thought we were beyond this.

but it did say that the makers of a prostaglandin compound funded the study, and would be helping fund the next one, along with NIH.


Triggered by the title of the last post I thought I would share with you the definition of Prodromal.

pro·drome (prō'drōm') pronunciation
n., pl. -dromes or -dro·ma·ta (-drō'mə-tə).

An early symptom indicating the onset of an attack or a disease.

Oh my goodness. I find it so fascinating the words used for normal parts of birth. Prodromal labor, or false labor, both really inappropriate names for the start and stop warm up of the body getting ready for birth. The purist in me thinks it is so silly for this to have a label at all.

Prodromal Printing

We have been trying to get this issue printed for the past couple of days but in the beautiful world of technology their are glitches. Today hopefully we will be able to get it done. Then it is in the mail and off to all our wonderful subscribers.

This issue is a bit more experimental on some topics but we hope you are able to look at it with an open mind. There are so many sides of birth and different ways to get there. Also, with our philosophy of birth being wholistic, the adjustment after birth is very important but rarely talked about.

We really hope you like this issue and makes you think and take action. Get the word out- tell your friends about us. Send them to our website. SEND US YOUR SUBMISSIONS. Send us your love letters or hate mail. We want to hear from you and what you think about what we are talking about.