Languages correction

I said before that Open Arms has doulas that can serve women in six different languages - I reported that incorrectly.

Our doulas speak SEVEN languages:

English
French
Spanish
Portugese
Somali
Arabic
Japanese

Amnesty International again: "Maternal health is a human right"

Just received this from our Executive Director, Sheila Capestany:

Please read this. While Open Arms is working hard to ensure that women get the support they need before, during and in the weeks following the birth of their babies, we all have to start looking at systemic change in this country.

Amnesty International - Take Action Now (2 things we can do right now to combat preventable maternal deaths)

And, on top of the appalling lack of care cited by Amnesty International, the 2008 Report on Injury and Violence Prevention for Maternal and Child Health states "homicide is a leading cause of death in pregnant and postpartum women in the United States." A leading cause of death for pregnant women in the United States is PEOPLE KILLING THEM. This is profoundly unacceptable and deeply offends our humanity.

Quote for the Day

"If we hope to create a non-violent world where respect and kindness replace fear and hatred, we must begin with how we treat each other at the beginning of life. For that is where our deepest patterns are set. From these roots grow fear and alienation - or love and trust."

-Suzanne Arms

Ah ha - here's the NIH report we've been waiting for!

Thanks to Julia G. for posting this on Facebook - the NIH did indeed conclude after their conference that VBAC's were "reasonably safe" and should be more available.

The Seattle Times covered it, but they buried it in the middle of a news story.

Natural birth can follow Caesarean (it's the second headline in the article so scroll down)

Here are more details from the NIH press release that came out yesterday just after the conference ended.

Panel Questions "VBAC Bans," Advocates Expanded Delivery Options for Women

They say in the press release:

The panel will hold a press telebriefing to discuss their findings (...) Audio playback will be available shortly after conclusion of the telebriefing, by calling 1-888-632-8973 (U.S.) or 201-499-0429 (International) and entering replay code 56036507.

Anyone want to listen to the playback and report back?

You can also look at the NIH panel statement NIH Consensus Development Conference on Vaginal Birth After Cesarean: New Insights.

From the conclusions section, I noticed this:

Information, including risk assessment, should be shared with the woman at a level and pace that she can understand. When both TOL and ERCD are medically equivalent options, a shared decisionmaking process should be adopted and, whenever possible, the woman’s preference should be honored.

What I like about this is the statement that a women's preference should be honored. There are plenty of stories like this and then there's the risk of a court order requiring a c-section, so I'm glad to see the NIH take the stand that women indeed can and should have input and the final decision on how to birth.

However, I don't think this will change anything overnight. It remains to be seen how doctors will interpret "medically equivalent options" and whether the legal ramifications (in terms of lawsuits) for not doing c-sections will remain barriers to women's choice. But it's a step in the right direction.

I'll end this with these words from the NIH panel statement:

We are concerned that medico-legal considerations add to, as well as exacerbate, these barriers. Policymakers, providers, and other stakeholders must collaborate in the development and implementation of appropriate strategies to mitigate the chilling effect of the medico-legal environment on access to care.

Bilingual doulas

Did you know that Open Arms is able to serve women in six different languages?

The news is ablaze with c-section information

I find this wave of news stories on reducing the number c-sections very interesting. These two came out today on MSNBC.

Video: Experts find natural delivery safe after c-sections

and

Women need chance to avoid 2nd C-section

I wonder if all this news coverage is indicative of some sort of change on the horizon? Is it a coincidence that the National Institute of Health (NIH) is holding a conference this week on VBACs? Maybe some new policy is going to come out of that.

I've never seen so much coverage on c-sections as has been coming out this week.

An example of another way to do it - musings on birth

I saw this article in the New York Times this week:

NYT: Lessons at Indian Hospital About Births

The article shows how rising costs don't have to be part of maternal healthcare:

As Washington debates health care, this small hospital in a dusty desert town on an Indian reservation, showing its age and struggling to make ends meet, somehow manages to outperform richer, more prestigious institutions when it comes to keeping Caesarean rates down, which saves money and is better for many mothers and infants.

What if this could be a model for other hospitals providing maternity care?

Tuba City will not be on the agenda, but its hospital, with about 500 births a year, could probably teach the rest of the country a few things about obstetrical care. But matching its success would require sweeping, fundamental changes in medical practice, like allowing midwives to handle more deliveries and removing the profit motive for performing surgery.

Changes in malpractice insurance would also help, so that obstetricians would feel less pressure to perform Caesareans. (The hospital and doctors in Tuba City are insured by the federal government, and therefore insurance companies cannot threaten to increase their premiums or withdraw coverage if they allow vaginal births after Caesarean.) Patients, too, would have to adjust their attitudes about birth and medical care during pregnancy and labor.

Read the article - it's interesting. Yes, many obstetricians seem intrigued by the idea, but admit that it's going to require changes. You can't do the kind of obstetrical medicine that we're doing today and have this kind of outcome.

But why do we have the obstetrical care that we have today? Isn't it a cycle - birth appears dangerous, so patients want safety, which creates new ways of controlling the situation, which now turns out to be less safe?

What I wonder is, what do women want here? What has our culture taught women about labor and birth that makes us want all the interventions? Safety? Responsibility? Choice? What does that mean, exactly, and do we as women in this culture begin to understand what our real choices are?

I don't think we do, overall, and so I'm glad to see these articles continue to come out and help frame the discussion for women and families so that we can become educated about what the possibilities are and maybe, just maybe, things will shift enough so that changes are possible.

In the article, midwives describe having whole families come into the delivery room to be present for births. Then, when some of the younger girls become mothers themselves, they've seen births already and it is familiar, not scary.

Just like death, birth in our culture has moved out of the ordinary into the private and extraordinary - even secret. These events - two of the most sacred of our lives - are now locked away behind a closed hospital door. No wonder people are scared. We hear stories and whispers, but we've never seen it until it's our turn to go. We starkly face the unknown. Therefore, we fear. We want it over with as quickly and therefore safely as possible (because in our conventional wisdom, the shorter the labor, the safer the baby and mom...), numb us please so we don't have to feel anything, and if something goes wrong, it's a doctor's fault and we sue.

There has to be a balance. What goes around, comes around. The wheel turns. The pendulum swings. Fashion moves on. We're back where we started.

It interests me to see the flood of articles on the newswire on this topic lately.

Do you think this discussion would be as lively now if it weren't for health care reform and cost discussions? I wonder...