Tuesday, February 22, 2011

Why we chose home-birth, and why midwives and access to care are important...

We have 3 beautiful children, and one more on the way... we are loving parents who make the best choices we can for our kids, from the foods they eat, to sitting rear-facing in the car as long as possible, to the people we allow around the kids. There is nothing that we wouldn't do for our children, and each choice we make is something that we weigh and research, and are informed about.

One choice that Carl and I have made for our third birth, and have made for this fourth child, is the choice to homebirth. With Canyon, we had what in NC is considered unassisted birth because we did not use an OB. We had 2 "uncertified" midwives attend our birth, and we even had our child in a hot-tub in the middle of the living room, at HOME. Most of our family and friends thought we were insane, making a dangerous choice, and didn't understand. After getting facts in the forms of numbers, and safety statistics from all over the world, most understood our choice. But what most don't know and don't understand is what lead us to make this choice, and to KNOW that for us, it is the safest and best choice.

In 2003, Carl and I were expecting our first child, Rory. We were beyond excited, and all I knew was that I wanted to have a "natural" birth, to breastfeed, and to have a healthy baby. As my due date approached, I switched from the OBs in my practice to the nurse midwife, and was happy and comfortable with that choice. On Dec. 30th I went to my weekly appointment, where I was pushed by one of the OBs in the practice to schedule an induction, even though I was just at 40 weeks or so. She proceeded to do a cervical exam, which was very painful. Turns out, she stripped my membranes, and didn't tell me that she was doing it. A few hours later, I found myself "peeing" in my undies, over and over. It wasn't a lot, but it was constant. I called the midwife, she suggested seeing if my water was broken, so we headed off to the hospital, even though I was not having contractions. It turns out, the OB had broken my bag of water, and I had a leak. I was admitted to the hospital about 11pm/12am and my midwife (who was in the hospital with her husband at the time) told us to rest, and relax; I was 2cm, and had lots of time. As the hours past, my contractions started, and the first contractions were more intense then we had anticipated. At 4am, I sent Carl to get the nurse. I was vomiting, shaking, pushing, and hurting. The nurse comes in, does NOT do an exam, and tells me that I am overreacting, still only 2 cm, and this is just normal. At this point, I can't handle it, ask for an epidural, and abandon my plans for a natural birth. Afterall, if I have another 12+ hours of this, I need something... They put the IV in my hand, put the large needle in my back, and as the Anesthesiologist is about to give me the meds, the nurse yells out "Don't give it to her! Don't push!!" and runs to the hall to grab the first OB she sees. I had crowned, was pushing, and had the baby moments later. She didn't listen to me, or realize the obvious cues that I was in transition and ready to have a baby. We just assumed things had moved so fast, that this couldn't be the norm and it was no big deal that both Carl and I had been ignored.

A short while later, Carl and I decided to have another baby. We had moved to Asheville, NC and decided to go with a highly rated local practice because I had some odd blood issues. I used the same birth plan with Arden as I had with Canyon, although I did decline the quad screen over and over. The office was taking so much blood each week to track my issues, that I didn't know, but they ran the quad screen anyway without my permission. At 36 weeks, I gave the doctor my birthplan. This particular appointment was interesting because I was seeing the only OB in the practice that I hadn't met yet. When she read my birth plan she started yelling at me. Literally yelling. Over what, me not wanting an heploc or IV unless I needed it. I don't like needles, they limit my movement, and make me uncomfortable. No one had issues with birth #1 with my choice, and I was blindsided. I was told how many women hemorrhage, and how women die b/c there are not anistiologists on call 24-7 to administer IVs, etc. I went home, scared, and did some research with the CDC. Not only did the OB lie to me, but she was bullying me. I was not happy. I went back the next day, armed with stats, only one out of HUNDREDS of thousands of women in my status levels hemorrhaged, and our hospital does have the staff to place a central line if needed... I was promptly fired from the practice. At 36 almost 37 weeks, I had no prenatal care. I was able to get into the hospital practice, (mostly b/c they can't refuse you) and never got to see the OBs who deliver. At 41weeks and 6 days I went into labor around 10am. At 9pm or so I went to the hospital with contractions 2 minutes long and 5 minutes apart. I was told that I was not in labor, and needed to go home. Carl and I had been told that this is common, and decided to go downstairs, walk, eat, etc. At 11:30 I went back, and was told again, to go home and go to bed, that I was not in labor. At 12:30 we called back again (after having stayed in town b/c we were afraid of having the baby at home) and were told "not to bother coming in, she isn't in labor, I told you to go home and take a bath". So we did. As soon as I ran the tub, I got out, and told Carl we needed to go back, that the baby was coming. I couldn't walk, was feeling a lot of pressure, and had a difficult time riding in the car. So it is now about 3am and we are heading back. When Carl called to let them know we were coming, he was yelled at, and he responded with "I am not ASKING you if we can come, I am TELLING you we are coming back to have a baby". When we arrived, they saw us in a private room so that we didn't make a scene in the triage area. I refused to leave. Over the next 20 minutes we argued and finally pissed the OB off to the point she told us we had an hour, and we were either being induced or going home. I had the nurse fill the tub, and got in. I remember her telling Carl I wasn't in labor because I wasn't in pain, and was sleeping. She left the room, and I told Carl I needed to go to the bathroom, and then push. The nurse came back in, told me I didn't need to push, that I was (again) 2cm and she laughed. Carl yelled at this point "LAST TIME SHE SAID THIS WE HAD A BABY IN MINUTES, SOMEONE NEEDS TO LISTEN TO HER!!!". The nurse called the OB back, who proceeds to roll her eyes, tell me that my water wasn't broken, I didn't need to push and wasn't in labor. She turned, walked out of the room, and I delivered the baby on my own in the tub as Carl hit her as she walked out. Arden was taken from us for almost 45 minutes, and I was treated like crap by the OB and the rest of the staff. It was a horrible experience.None of my after care plans for the baby were followed, we were begging to get him back, but because I had #1 birthed in the tub and #2 birthed without monitoring, the wouldn't give him to me. No one listened to me, watched me, or even acknowledged me... which placed both me and my baby in danger.

A year later when we found out we were pregnant again, I had a panic attack over what to do. I couldn't go back to the hospital. I could barely drive past it without getting upset and crying. I knew that going there was not an option at all. I was lucky that my local support group consisted of moms who had homebirths and connections in the "underground" birthing network here in NC. Carl, well, he was less then thrilled and not very accepting of my birth choice... We decided to meet with some midwives, and decide after that. The first midwives we met, ended up being the only ones we met with. They were wonderful, and exactly what I wanted and needed. Both were Lay Midwives, one was taking her skills tests as a CPM as a choice, but that didn't matter to us. These women were so calming and wonderful, that by the time that they left, Carl was 100% on board and couldn't imagine going back to the hospital again.

At 41weeks and 6 days I went into labor again. It was perfect. Everything was calm, we were surrounded by family and friends, and there was no stress. Carl and I went for a walk, ate what we wanted, held each other, and played with our kids... a few hours in, I decided to get into the tub, and start pushing. Canyon was born moments later, into a perfect peaceful home, underwater, right into my arms. It was one of the most healing things that we could have imagined.

We made the choice for that birth because we knew that someone would be with me, the whole time, and would listen to us. The midwives were wonderful, cared for us, came back each day for a few weeks, and were wonderful.

These two women risk everything to be who they are, and to do what they do. They can be arrested and risk their homes, children, livelihoods being taken from them. Why? They were more competent, more caring, and more devoted then the OBs and nurses at my previous two births. While it is legal for us to use the midwives, it is illegal for them to practice in NC, while it is legal in all of our surrounding states.

We will be having a homebirth again this time, with different attendants (not because of an issue with the midwives, but because my blood issues have gotten worse and need more monitoring). There was never any doubt that this would be our choice again. Carl and I plan on another waterbirth, in our bedroom, with Rory and Arden in attendance. Canyon too if he is awake.

Now, you are probably wondering why I am telling you about this, well, I got this email last night, and am furious; this is a horrible slippery slope, and puts moms in NC in danger. Please read this, and take action. Call the legislators, do something! Without access to trained and competent care, more and more moms will make the decision to have births without attendants, with c-section happy OBs, and with an uncaring hospital staff, all of which put everyone -mom, baby, and family- at risk. Laws and arrests like this are systematically taking away the rights and safety of the mothers. Please join NCFOM, and if you can, join in the action.****

Dear Friends,

We all were hoping today would not happen. We were hoping we would pass our legislation this session and prevent this. Well, we haven't yet and it has happened.

Our beloved Amy Medwin, CPM has been arrested. They are closing their practice.

Many women now have a problem. What will they now do?

Below is our press release to get out in front of the media with our message. We are formulating our near term plan to both

Protect and support Amy
Use this to our advantage to pass legislation.

Please prepare yourself for dramatic action. We will head up to Jones St. Wednesday, March 2nd to make it crystal clear to the legislators that this ain't right. If we can't turn this around, we will open the door to other prosecutions.

Amy is healing with people who care very deeply for her and trying to figure out where she stands. I will keep you posted. I can assure everyone that we will step up for Amy.

Get mad folks. Get angry. Nurture your outrage and cultivate it for useful purpose. We must turn this around, Friends. Stay tuned.



Russ Fawcett
Vice President
North Carolina Friends of Midwives

RALEIGH, NC – On February 19, a Certified Professional Midwife who would be licensed and regulated in neighboring states was arrested for performing the duties for which she is trained. Charged with practicing midwifery without a license, her practice is in jeopardy. Should it close, dozens of pregnant women will face a crisis of care. “Our focus is on the mothers,” says a fellow Certified Professional Midwife. “This is an unfortunate day for mothers in North Carolina.” It is also an unfortunate day for the taxpayers of North Carolina, as they face the potential for a huge bill as the case winds its way through the criminal courts.

Unlike the laws in Virginia, Tennessee, South Carolina, and Florida, North Carolina law denies childbearing women access to legally practicing Certified Professional Midwives, who are specially trained as experts in the provision of out-of-hospital maternity care. Because North Carolina does not license CPMs, they remain open to criminal prosecution for unlicensed health care practice, despite the fact that they are the primary care providers for women all across the United States who deliver their babies in private homes and freestanding birth centers.

CPMs are legally recognized in 27 states, but North Carolina is one of a handful of states that explicitly prohibit their practice. The arrest of one of the state’s most experienced and well-respected CPMs has sent shockwaves throughout the home birth community, leaving pregnant women across the state wondering if their midwife will be next.

“Using the police and the criminal courts to investigate and discipline health care providers is the most costly, inefficient, and ineffective form of professional regulation possible,” said Katie Prown, PhD, Campaign Manager of The Big Push for Midwives Campaign. “If this proceeds to trial the taxpayers of North Carolina are looking at hundreds of thousands—if not millions—of dollars wasted, when a simple case review is all that is indicated.”

Despite a groundswell of grassroots support from across the state, the North Carolina General Assembly has repeatedly declined to pass legislation to license and regulate CPMs, thanks to entrenched opposition from the North Carolina Medical Society.

“It is time we stop rolling over to the bullies and special interests, manage our house the right way, and let democracy and common sense prevail,” said Russ Fawcett, Vice President of the North Carolina Friends of Midwives. “In this economy we simply cannot afford to waste resources on prosecuting midwives when we have a simple, cost-effective solution at hand—enacting legislation to license and regulate CPMs, just like our neighbors have done.”

North Carolina Friends of Midwives is a grassroots organization of advocates dedicated to promoting, supporting, and protecting access to midwifery care in North Carolina.

North Carolina Friends of Midwives - www.ncfom.org - Copyright 2011.