Midwifery an antidote to the lack of OBGYNs in Iowa

The Daily Iowan published a story in which Monica Brasile, a FOIM founder and steering committee member, argues that licensing homebirth midwives can provide much needed well-woman and pregnancy and childbirth care for women in rural counties lacking OBGYNs. Read the full article here.

UI women-studies graduate student Monica Brasile said that because of the lack of care in rural areas, Iowa should begin to license midwives to give women another recognized health-care option.

"A lot of women don't realize the other options for birth and prenatal care," said Brasile, who is part of the organization Friends of Iowa Midwives. "When you are in a rural area with no proximity to a hospital, midwifery is a good option to provide care for these women at home."

Letter from a Homebirth Father

My husband Brian wrote this letter to our legislator this month. Feel free to use it as an example of the way a homebirth supporter who ISN'T a Mom can appeal to lawmakers!

My name is Brian Whitehead and I am writing today to discuss my experience with homebirth.

Nine moths ago my wife gave birth to our daughter Robin in our home with a midwife and two doulas. The experience was - as anyone who has had a baby knows - grueling, difficult and exhausting, but by chosing to undergo this life-changing event at home I was able to be an integral part of my wife's labor and our daughter's birth. I have talked to other fathers who had the misfortune of having traditional hospitals births with their wives and it is my opinion that homebirthing is the superior option.

Our birth was overseen by a trained, competent professional. It was safe and inexpensive. It allowed us to have this rare and special event transpire in the comfort and familiarity of our own home.

I am relatively new to Iowa, having moved here four years ago to get my MA from the University of Iowa. As someone who plans on spending my future and raising a family in this state, I cannot remain silent while this practice is still - inexplicably - not fully protected by law.

Please consider my experience when making legislative decisions in the future.

Brian Whitehead

Central Iowa Chapter Meeting

The first official meeting of the Central IA chapter of FOIM is coming up! Join us this Sunday (11/23) at the Westown Pkwy Panera in West Des Moines from 4pm-6pm.

Our aim at this meeting is to get the central IA chapter off the ground, create an opportunity for central and eastern IA folks to meet each other, generate ideas for networking and events, and identify some coordinators for the chapter. Everyone is welcome!

General Mtg Reminder -- Nov 15!

Don't forget our meeting this Saturday, Nov 15, at Birth, Baby & Beyond in Cedar Rapids. 3:30 pm. Be there!

NYT article on homebirth, plus statement on Choices in Childbirth

Hello friends! The New York Times published a wonderful story about the recent increase in homebirth in the NYC area. Overall the article does a great job highlighting the reasons more and more women are making the choice to have their babies at home. Every woman deserves access to homebirth!

The Our Bodies, Ourselves blog recently announced the Statement on Choices in Childbirth, a statement endorsed by physicians, midwives, and women's health advocates who are "concerned about preserving safe choices in childbirth that respect the diversity of women’s needs." They specifically urge health care reformers to protect and ensure women's access to VBACs and access to hospital-based midwifery care, in addition to licensing CPMs across the country. Read the entire statement here. If you are a physician, midwife, or health care advocate interested in endorsing the statement, follow the link on the statement's main page to do so.

Despite ACOG and the AMA's attempts, it's clear that women are increasingly demanding access to midwifery and all its benefits. It's just a matter of time!

November Letter Writing Challenge: Write for CHANGE!

Dear Friends,
As snow begins to fall in Iowa I think back to last winter when I was enormously pregnant, carefully making my way down icy sidewalks to Presidential primary events, and then caucusing for the first time about 10 weeks before my daughter's homebirth. Robin was with me when I saw John Edwards, Joe Biden, and Barack Obama speak in Iowa, and she was with me to see Obama elected president this week.

No matter who you caucused or voted for, I think we can all agree on a change that needs to happen for women in our state and in our country: they need full access to a model of care that respects and honors their bodies and births, and that will come through licensure of professional midwives. This is a great time to send a letter on the theme of CHANGE to our local, state, and national representatives urging them to implement midwifery and homebirth into the future of our healthcare system.

President-elect Barack Obama has created a website devoted to citizens' ideas about change and we encourage you to send a letter to him, as well as your local represenatives and our state representatives, arguing for midwifery as a part of your vision for change.

Barb at the Navelgazing Midwife has created a wonderful letter that we encourage you to use, edit, adapt, etc and send send send. A highlight from the letter:

Because I wholeheartedly support your desire to overhaul medical insurance availability…

Because I believe that home birth is a viable and safe option for women in the United States…

Because the mechanism for licensing non-nurse midwifery exists in this country through the North American Registry of Midwives…

Because studies increasingly demonstrate that non-nurse midwives are a safe option for women having normal pregnancies…

Because studies prove a midwife’s presence maintains low cesarean rates and saves an enormous amount of money when normal pregnant women utilize midwives instead of obstetricians…

Because non-nurse midwives are paid the least of all obstetric care providers even as they provide comprehensive quality care…

Because requiring Medicaid to include paying non-nurse midwives would save our country millions, if not billions, of dollars as women having normal pregnancies use the most cost effective care provider…

I hereby ask that non-nurse midwifery become a prominent part of your developing health plan.

To reward your efforts, you will receive a FREE FOIM BUMPER STICKER for every letter you send! Email Lauren at laurendoula@yahoo.com to let me know what you wrote (if you'd like to share) and who you sent a letter to and you will receive a free sticker. HELLO! THAT IS AWESOME. YES WE CAN!

Lauren
clerk

Des Moines Women Have to Travel For VBACs

Check out this article about Des Moines women having to travel to Iowa City for access to VBACs (vaginal birth after cesarean, shown to be perfectly safe and beneficial for most women who've had a previous cesarean birth). These women are seeking the care of nurse midwives at the UIHC.

A quotation:
"Ericson says if V-Bac was more commonplace, the state could probably cut its rate of Cesarean surgery in half. She says at least a dozen studies point to the dangers of Cesarean surgery, which carries twice the risk of injury and death for both mother and baby."

ATTENTION CENTRAL IOWANS!

You're invited to the organizational meeting of the Central Iowa chapter of Friends of Iowa Midwives!

We'll be meeting this Saturday, Nov. 8th, at Almost Home Birth Center, 2708 Grand Ave. in Des Moines at 3:30. Thanks to Carey Ann Ryan for hosting us!

RSVP to Monica (monica-brasile@uiowa.edu). Learn more.

October Action Alert Newsletter

Sorry for the lapse in FOIM Friday this week. We should be back next week.

Go here to view our October Action Alert newsletter.

FOIM Friday (on a Saturday again, sorry!)

This week, FOIM member Bel sent me a link to an article her husband, Ven Batista, wrote about being a homebirth Dad. Bel and Ven had their second daughter in a homebirth in London. The article features 7 reasons that homebirth is great for Daddies/partners. Check it out!

Video about homebirth dads

On Mothering.com this week, I noticed there was an ad for a new film about the experience of homebirthing fathers. I can't wait to see this!

http://www.homebirthdads.com/

FOIM Friday 1 day late: Robin's birth

Every Friday, we will feature member-submitted stories and photos about their homebirth experiences. Today, we feature images from the birth of my daughter (Lauren Whitehead, FOIM clerk) last February. Labor was 21 hours, start to finish, and I was fortunate to have two doulas, a midwife and midwife's apprentice, and of course my amazing husband, Brian, in attendance. Robin was born in water in our living room around 1 am on Feb 24th. We agree that having a homebirth was the best decision we've ever made for our family. Being in the comfort of my home, without the constraints of a clinically imposed timeline or monitoring, allowed me to completely surrender to my birth experience. Although it took me a loooong time to start dilating, once my water broke labor went very quickly. I think that in a clinical setting there may have been unnecessary concern about "failure to progress" when it was just the normal, slow lead-up to transition and pushing that many first-time mothers experience during an unhindered natural birth. We loved waking up at home with our daughter the very next morning, and eating my Mom's homemade spaghetti sauce as our post-birth first meal, neither of which could have happened in a clinical birth setting. We will definitely have our future babies at home!









And a recent photo of Robin at 8 months old!

FOIM Friday!

Every Friday, we will feature member-submitted stories and photos about their homebirth experiences. This week, Janelle sent this picture of a beautiful moment following her daughter's birth and the joyous email her husband sent to friends and families.


Last night Janelle birthed our baby – Baby Ella, a genuine Georgia love angel. I’m looking at her and her mama right now. They’re gazing into one another’s eyes as Ella - Eleanor Beatrice Railey - drifts in and out of sleep. Mother and child. Ella’s swaddled, mother’s
relieved, coffee’s percolating in the next room, and our coyote, Stella, is licking her paws.
“Yesterday was a long, hard day,” Janelle just said to me, “If there were drugs (for pain) nearby, I would’ve taken them. I’m glad we were at home.” Her labor started at 3 a.m. yesterday morning and lasted 19 hours and 59 minutes. (That’s about average,
according to our midwife, Debbie, whose “performance” yesterday was masterful, motherly, improvisational, and, in a word, expert.) Time bended and flopped in on itself, though, as it is wont to do during these major life events. The clock played tricks on us, cause one
minute we’re getting up a 3 a.m., starting to stir, and phoning the midwife. Next minute I’m out in our front yard, under the stars, getting a quick breather before we head into the home stretch and Janelle’s in our bedroom, breathing deep like a soft, fierce war-woman through formidable contractions that swelled in major upsurges and reverberated throughout her
abdomen and entire body.

Janelle did fine. We both did fine. Janelle, though, was amazing. An adult life devoted largely to psycho-spiritual pursuits and yogic asana practice paid off in huge amounts yesterday. No drugs. No episiotemy. Minimal, all-natural interventions (just juice, water, food, homeopathics, one chiropractic adjustment by Dr. Randy, and the constant emotional/physical support of our two attentive doulas, Amy and Christie, who perfectly and unerringly embodied the highest ideals of that noble feminine role yesterday.). It was just the kind of birth we wanted for baby Ella – couldn’t have been better. A straight-up, non-institutional, folk-birth, a home birth - solid! Though difficult and exhausting, the
day unfolded itself just as it should have. In moments of anxiety, Janelle & I drew close. In moments of expansion and space, we laughed, told jokes, made hilarious surreal and/or inappropriate remarks, cried, felt the love, and often just rested up because a new
set of waves/contractions lay in wait. Big waves, Hawaii-style, the kind that boggle the mind when you seem them swell against the horizon. Janelle surfed these waves and we listened to Patti Smith, Bob Dylan, and Neko Case on the hi-fi. That helped. Rocking – musically or in chairs - helps. Having a midwife, doulas, and a chiropractor/brother nearby who all know
what they’re doing - and what Mama & Papa are all about – helps considerably, too…

What can I say? Before long, there was a head, a body…a baby! Ella was born at 10:16 p.m. on June 7, 2007. She’s 22 inches long, 6 lbs., 6 oz., and has Janelle’s brow, my mouth, and her own lovely blue eyes. She’s got black hair and is curious, expressive, responsive, and, by all accounts, seems to feel pretty well at home on the planet Earth, despite a long, hard
day for herself yesterday as well. (When she came out of the birth canal, her forearm was placed above her head, which made the labor slow and considerably more
difficult - hence the 19 hr. 59 min.-long labor.) She’s doing well, though. We’re all doing well.

After Ella’s birth, Janelle and I feasted on eggs, milk, cornmeal fritters, and vegetables. Ella in her mama’s arms, we spent the night fading in and out of the transom of wakefulness. It is now morning. The population of Athens, Ga. has increased by one. Soon, you’ll all be getting to know Little Ella in your own ways. Until then get on the horn and spread the word.

Thanks Janelle, Jonathan, and Ella!

FOIM in Iowa Source

Here's a great article about FOIM in Iowa Source. Check it out!

Some highlights:

Clodi-Whitehead said she and her husband interviewed four midwives before choosing to work with McCormick-Deol. “I really wanted the quality of prenatal care that midwives offered,” she said, noting that her appointments generally lasted an hour versus a typical 12-minute prenatal visit with an obstetrician. “I wanted to know who was going to be there for the birth.”

McCormick-Deol is one of two or three CNMs in Iowa who attends home births. Her calendar is booked through the year with women who want to have their babies at home.

She asserts that safety is of utmost importance. “All patients get an initial baseline of blood work done to assess health,” McCormick-Deol said. “The standard tests offered in pregnancy are available to my clients as well, but they may choose to opt out of them. As long as they’re making an informed decision and they’re aware of what the consequence might be, they’re absolutely allowed to do that.”

Clodi-Whitehead gave birth to her daughter, Robin, eight months ago and was thrilled that the experience was free of complications. She didn’t have to leave the comfort of her home, was surrounded by close friends and family and didn’t undergo any interventions. “It was exactly what I wanted,” she said. “A totally natural home birth.”

FOIM at Iowa Women's Music Festival!!

A birth film for fathers

Here's a preview of an upcoming film that focuses on the disempowerment of fathers in modern (hospital) birth.



ALSO, come to the Iowa Women's Music Festival in City Park, Iowa City, and see the FOIM table! Cute babies will be there, too.

Come to the August meeting and picnic!

We've rescheduled our summer picnic to coincide with the August general meeting of FOIM. This is a great opportunity to meet and greet new members and see old friends. Please view the evite below and rsvp using their website. Hope to see you there!!

View the FOIM August Meeting/Picnic Invitation!

Details:
Aug 16th at Creekside Park in Iowa City
1:00 General Meeting
2:00-4:00 Picnic -- bring a side dish to share, we'll provide the rest. Please let Lauren (laurendoula@yahoo.com) or Monica (monica-brasile@uiowa.edu) know if you are interested in volunteering for misc. duties.

MANA response to AMA Resolution

President's Editorial
July 11, 2008

Midwives Alliance of North America
611 Pennsylvania Avenue SE # 1700
Washington , DC
20003-4303

Contact:
Geradine Simkins
president@mana.org
888-923-MANA (6262)
info@mana.org
http://www.mana.org


Doctors Ignore Evidence, AMA Seeks to Deny Women Choices in Childbirth

One wonders what process the American Medical Association (AMA) House
of Delegates used to determine that "Resolution 205 on Home
Deliveries" was a prudent and reasonable proposal to adopt. AMA
Resolution 205 attempts to outlaw a woman's choice to birth at home
or in a freestanding birth center by calling for legislation to
establish hospitals and hospital-based birth centers as the safest
place for labor, delivery and postpartum recovery. Further,
Resolution 205 seeks to establish that hospital-based midwives who
work under the control of physicians are the only safe midwifery
practitioners.

The Midwives Alliance of North America, which has represented the
profession of midwifery since 1982 and whose members are specialists
in homebirth, finds AMA's Resolution 205 to be arrogant, patronizing
and self-serving. We have three major objections to Resolution 2005.
First, Resolution 205 patently ignores the vast body of scientific
evidence that has documented homebirth to be a safe, cost-effective
and satisfying option for women who prefer this alternative to
hospital birth. Second, AMA Resolution 205 is seriously out-of-step
with the ethical concept of patient autonomy in health care
(encompassing both informed consent and informed refusal), which has
gained widespread acceptance in the medical community. And third,
Resolution 205 distracts from other critical issues in maternity care
to which healthcare professionals should be giving substantial
attention, including increasing access to care, improving perinatal
outcomes, reducing health disparities and fostering client
satisfaction. AMA Resolution 205 is anti-homebirth, anti-midwife,
anti-choice and is unsupported by scientific evidence.

Why is the American Medical Association not asking the real questions
instead of trying to debunk existing research evidence on the safety
and efficacy of homebirth and attempting to corner the market on
maternity care? For example, why are midwife-attended births far more
likely to have fewer interventions, fewer postpartum infections, more
successful breastfeeding rates, healthy infant weight gain and result
in more satisfied, empowered mothers ready to embrace their newborns
and parenting experiences? Why are so many women across the nation
left emotionally traumatized by their childbirth experiences in
hospitals and consequently why do rates of postpartum depression,
anxiety and post-traumatic stress continue to escalate?

It is ironic that the AMA should have a quarrel with a known safe
birth option such as homebirth at the same time when the epidemic
rise in coerced or elective cesarean sections puts healthy mothers
and infants at greater risk than normal vaginal birth and causes
excess strain on the limited resources of our healthcare system. The
rate of cesarean sections in the United States is unacceptable�one in
three pregnancies end in major abdominal surgery�and the decline in
availability of vaginal birth after cesarean (VBAC) is deplorable. It
is unethical to expect that women and infants should continue to bear
the brunt of increasing medical malpractice risks by over-treating
them with obstetric technologies such as c-sections while denying
them safe evidence-based options such as VBAC. It is past time that
the AMA in collusion against homebirth with the American College of
Obstetricians and Gynecologists (ACOG) realizes that women and their
partners are choosing to labor and deliver at home and in
freestanding birth centers to avoid ethically unsupported obstetric
interventions.

Modern medical ethics have evolved to embrace autonomy�patient
choices and patient rights�over medical recommendations based on
paternalism or physician preference. In almost all areas of modern
medicine, except obstetrics, the locus of control rests firmly with
the client or patient and not with the medical provider. It is a
commonly held principle that it is not appropriate to force medical
treatment upon clients or patients against their will, including
medications, blood transfusions, chemotherapy or even life-saving
surgeries. Informed consent has appropriately become the gold
standard in healthcare decision-making. Why then do the AMA and ACOG
believe that they can promote legislative efforts to deny women
choices in maternity care providers and childbirth settings? In the
21st century this concept is outdated and absurd.

The AMA and its members might consider using their considerable
energy, intelligence and resources to focus on promoting the health
and well-being of mothers and babies and devote less time to limiting
women's access to midwifery services. All maternity care providers
should band together to reduce the unacceptably high rates of
maternal and infant mortality and morbidity in the United States,
increase access to maternity care for all women, reduce unnecessary
cesarean sections, encourage vaginal birth and VBACs for healthy
women, reduce health disparities of women and infants in minority
populations, and promote increased breastfeeding. These challenging
but attainable goals would improve the health of mothers and babies
far more impressively than reducing the rates of homebirth.

The Midwives Alliance joins the other individuals and organizations,
including individual AMA and ACOG members, who have grave concerns
about the AMA taking the stand articulated in Resolution 205, and
calls for the AMA to abandon this resolution. Midwives everywhere
honor and respect the numerous friendly physicians with whom we
already partner and look to the day when midwives and obstetricians
will consistently work collaboratively to support women's choices in
childbirth and provide the best possible and most appropriate range
of services for every situation.


References

1. K.C. Johnson, B.A. Daviss, Outcomes of Planned Home Births with
Certified Professional Midwives: Large Prospective Study in North
America , British Medical Journal 2005; 330: 1416 (18 June).

2. Royal College of Obstetricians and Gynaecologists and Royal College
of Midwives Joint Statement No. 2, April 2007. See
http://www.rcog.org.uk/index.asp?PageID=2023

3. Wiegers TA, Keirse MJ, Van der Zee J, Berghs GA. Outcome of planned
home birth and planned hospital births in low risk pregnancies:
prospective study in midwifery practices in the Netherlands . BMJ
1996; 313:1309�13.

4. Olsen O. Meta-analysis of the safety of the home birth. Birth 1997;
24:4:13.

5. Ogden J, Shaw A, Zander L. Deciding on a home birth: help and
hindrances. Br J Midwifery 1997;5:212�15.

6. Canadian Institute for Health Research Giving Birth in Canada :
Regional Trends From 2001-2002 to 2005-2006.
http://secure.cihi.ca/cihiweb/en/downloads/Childbirth_AiB_FINAL_E.pdf

7. CMAJ Maternal mortality and severe morbidity associated
with low-risk planned Cesarean delivery versus planned vaginal
delivery at term. http://www.cmaj.ca/cgi/reprint/176/4/455.pdf

8. Listening to Mothers II Report (2006.) Childbirth Connections,
http://www.childbirthconnection.org/article

Benefit Dinner at The Red Avocado

POTLUCK CANCELED - Two other events

With the bad weather predicted for tomorrow, we have decided to cancel the Mothers and Midwives Picnic and reschedule for sometime later in the summer.

In sunnier news, The Red Avocado in Iowa City is again graciously hosting a benefit night for Friends of Iowa Midwives on Wed. May 28, starting at 5:30. The last event was such a great time - please come out and join us for good food in support of a good cause!

Also, tune in to Iowa Public Radio on Sunday: a four minute radio feature on the midwife movement in Iowa will air on WSUI AM 910 this Sunday, May 11 (Mother's Day), at 7:34 and 9:34 a.m.

Mothers and Midwives Picnic

In honor of Mother's Day and International Midwives Day (both in May),
FOIM is hosting a Mothers and Midwives picnic on Saturday, May 10 from
1:00-4:00 in Iowa City at City Park, shelter 12.

Please bring the whole family and a dish to share! This will be a
great opportunity to gather with friends old and new, enjoy the spring
weather, and spread the word about midwifery and birth options.

Everyone is welcome!

Article on obesity and c/s rates

This great article over at Our Bodies Our Blog discusses the ways that the midwifery model of care can better serve plus-sized women and help reduce their sky high rates of c-section. Check it out!

FOIM on the Radio

Today, April 2, from 12:15-1:00 on KRUI, 89.7 fm in Iowa City. We will be talking about midwifery in Iowa with the host of Vox Uncommon. Tune in!

Video about homebirth and midwifery in Iowa

A few UI film students made this great video about homebirth and midwifery in Iowa featuring a FOIM meeting, myself, and Monica Brasile.

I gave birth to my daughter at home on Feb 24th and it was fantastic, I'm happy to say!!

More great press from Iowa City...

Here's an op-ed in the Press Citizen advocating for licensure! Awesome!

Kathy's Iowa City Clinic in the news

There was a great article today in the Press-Citizen featuring Kathy Deol and the clinic she's opened in Iowa City with chiropractor Angela Ballew. More good press for birthing options!

Homebirth and childbirth ed in the news!

FOIM member Kara Seaton and her husband were featured on the local news this week speaking about their Bradley childbirth classes and their choice to homebirth with their second baby. Check it out!

Segment One

Segment Two

Steering Committee Poll Results

Below are the results from the 2 steering committee polls we put forth on the group listserv earlier this month. Thanks for your outstanding participation in the voting! We now have an elected Steering Committee and an established protocol for meetings.

Your new clerk, Lauren!

Question

Resolved: to establish the Steering Committee as described in in the Friends of Iowa Midwives Steering Committee Proposal and to elect the following members to the following positions: Co-chairs - Ashley Miller, Monica Brasile, Jonathan Hansen
Clerk - Lauren Whitehead
Treasurer - Jenn Bowen

Responses

Choices	Votes	%
Yes	21	100

Question

Resolved: to change the meeting structure of FOIM to reflect the policies outlined in the Steering Committee Proposal, namely to hold General Membership meetings quarterly (4 times/year) and Steering Committee meetings monthly (12 times/year). Steering Committee meetings will always be open to any FOIM member.

Responses

Choices	Votes	%
Yes	17	94
No	1	5

FOIM Family on KWWL!

From FOIM member Kara, who gave birth to a beautiful little boy a few weeks ago at home with a midwife:

KWWL (news channel 7 in eastern Iowa) is airing a special on Marcus and I next Tuesday, February 19. I believe they will be running a preview on the 6:00pm news and the actual
story on the 10:00pm news.

The reporter interviewed us about natural birth, the Bradley Method classes we teach, and also about the *awesome* homebirth we had last week. They also took some footage of the current Bradley class we are teaching. I'm unsure what spin the final story will actually take since they took so much footage, but am excited to be getting some press on birth options in eastern Iowa! Check it out :-)

Steering Committee Elections!

Dear Friends,

Our first order of business for the new year will be to nominate and then elect a Steering Committee for our group. Please head to the files section on our yahoo group's homepage to read the proposal, nominate someone, and then vote in our election next week!

If you aren't a member of the mailing list -- JOIN UP!

New Year Meeting and Potluck!

Our first meeting of 2008 will be a New Year's potluck at Melanie's house in Wilton this Sunday, Jan 13, at 2:00. Email Lauren at laurendoula@yahoo.com for directions and to add items to the agenda.