Radical Doula

My blog post regarding the death of Dr. George Tiller caught the eye of Miriam Perez, an editor at Feministing. Miriam is also a doula and women's health activist who chronicles her work at Radical Doula.

Miriam interviewed me via email regarding my work as a doula, and I'm flattered to be featured by her work. Thank you, Miriam!

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A Tale of Two Birth Centers: Massachusetts and New Hampshire

I belong to a really wonderful and supportive e-network of doulas in Massachusetts. The members provide a wealth of information and a depth of experience from which I am lucky to be learning. Just this week, one of the doulas wrote that she was compiling a list of Birth Centers in Massachusetts and nearby New Hampshire.

A list of Birth Centers in Massachusetts is not hard to compile, as there are all of two, and they are not without their controversies. The Cambridge Birth Center has a high transfer rate to Cambridge Hospital, and The North Shore Birth Center, in order to avoid closure, will comply with remote external fetal monitoring by OB's at the North Shore Hospital on the campus.

But then there's New Hampshire, with its 5 birth centers: The Birth Cottage, The Monadnock Birth Center, The Coastal Family Birth Retreat, The Concord Birth and Wellness Center, and The Longmeadow Farm and Birthing Home. All safe, non-medical, home-like environments that offer the CHOICE to birth at their center or at home! They are all owned and run by midwives, mostly licensed NH midwives and one or two Nurse-Midwives. Each of the websites has legislative updates on the status of midwifery, insurance, and homebirth in New Hampshire. One web site states it so plainly: Almost all insurance plans now cover out-of-hospital birth services with a NH Certified Midwife. It's a sentence that almost strikes me as funny, since it is so far from Massachusetts truth.


As a proponent for choices in childbirth, I have alway philosophically maintained that the 2 Birth Centers we have here in MA offer a middle-of-the-road choice between homebirth and hospital births. But when I hear what is happening just over the border (the MA/NH border, not the US/Canadian border!), I do worry about some of the ways Massachusetts Birth Centers are forced to operate if they are to be in existence at all. Tomorrow, the MA Joint Committee will hear Senate Bill 847, which creates a Massachusetts Board of Midwifery, which would make the practice of midwifery similar to New Hampshire's. Until that bill is passed, the 2 birth centers we do have - operating under the heavy thumb of their affiliated hospitals -- will struggle to maintain choices for pregnant women in Massachusetts.

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Mind-over-matter, Butt-over-head

Last week, my client due next was found to have a breech baby. Determined to birth vaginally and without medication, she spent the better part of the next week lying down with her hips higher than her head, visualizing her baby spinning, and visiting an acupuncturist and a chiropractor trained in the Webster technique. She went in this week (36 weeks) for an external version, which many women describe as painful, pressured, and ultimately unsuccessful.

She said her OB kneaded her belly, gave a little push, then shrugged. "All set," she said.

"That's it?" asked my client.

Her OB nodded. "Baby's vertex."

Victory! A successful, easy version! I have to think that all the work my client did made it easier for the OB to spin the baby.

And now back to birth-planning...

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Doulas, How Do You Practice Self-Care?

When I meet with new moms either in private counseling sessions or support groups, I am a compassionate listener -- but I will be a harpy nag about one thing: self-care. It could be 15 minutes of reading People Magazine while the baby naps or keeping a jar of luxurious foot cream by the bedside table - whatever it is, I require them to care for themselves in some small way.

I've just returned from a birth, the first one I've attended since my extended pregnancy and maternity leave. It was a beautiful, satisfying birth for all involved, and I'm trying to decide what to do for myself today as a treat.

So, doulas, in the aftermath of a birth, when you've given nurturing care for hours, what do you like to do to care for yourselves? Please share, so that more doulas can take good care of themselves!

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Support Midwifery in Massachusetts!

Massachusetts Senate Bill 847 will be heard at the State House on July 28. This bill, as it similarly does in 26 other states, protects midwives and their practice, as well as the women who choose to give birth with them and receive other well-woman care from them.

Right now, Nurse-Midwives are under the supervision of MD's, and this bill would give nurse-midwives the ability to practice collaboratively with MD's. Nurse-midwives are the only midwives who can legally attend births in Massachusetts.

Additionally, this bill will allow Massachusetts to license Professional Midwives, who are stringently licensed in 26 other states. Professional Midwives go through rigorous training and education in order to care for healthy, uncomplicated pregnant and laboring women in out-of-hospital settings, such as birth centers and private homes.

This bill will regulate the practices of both types of midwives so that they practice a standard of care that is SAFE.

Please get involved! Perhaps you received care from a midwife - at home, in a hospital, or at a birth center -- and can attest to the quality of the midwifery model of care. Maybe you, personally, would not choose care from a midwife or to have your baby in any place but a hospital, but you DO believe that the only way to ensure quality health care for women is through a variety of evidence-based care, dispensed by a variety of highly-skilled professionals. All women can support this bill, because it is NOT about natural birth vs. epidural, homebirth vs. hospital birth, or one woman being stronger/better/smarter/more concerned about her baby than another woman.

This bill is about mothers and babies being born safely.

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Massachusetts Friends of Midwives asks: "If you can join us at the State House for the hearing, please do! Babies andsmall children are welcome participants on visits to MA Senators and Repsand are welcome in the Gallery during the hearing. Please use your judgment,however, as the day can be long (we will not know when during the day wewill be testifying). While we would love to have as many families as possible, we also realizethat sitting still for a couple of hours may not be in everyone's skill sets--adults included! For more information and updates, please check out the MFOM blog(www.mfom.org) . Thanks so much for everyone's ongoing support!"

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A Bumper Sticker (or a few of them!) is Worth a Thousand Words

Here's a photo that my brother-in-law took while vacationing in Philadelphia over the weekend. When I saw it, I jumped up and down, clapping my hands.

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Don't Push The River...It Flows By Itself

A beautiful blog post by Lindsay, who poetically describes how she discovered her own strength and the "vastness of her spirit."

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Who Needs a Doula?

Thanks, Kathy Peterson, for a concise and articulate explanation of one the doula's many roles -- advocacy.

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Birth Story, Take II

In my line of work, I hear or read birth stories -- a lot of them. It's no secret that the birth of my last child was a whirl-wind: abruption, extremely precipitous labor, a baby feared to be in cardiac crisis. My birth story is about a blissful intention that turned into a potential medical emergency, the kind of emergency that makes those fearful of out-of-hospital births feel smug. So when I hear or read the beautiful birth stories, a part of me still hurts. My birth story is full of disappointment and fear and politics: OB vs. midwife, blood, numb shock, the image of my non-breathing, seconds-old baby being shaken so vigorously that I, too, lost my own breath.

This week, at the Mass Friends of Midwives Birth Circle, a pregnant woman shared her fear about a repeat c-section. A midwife in the circle gave her wise advice. "Re-envision this birth," she said, "And imagine it as something beyond avoiding another c-section. Let that past experience go, and allow this birth to be all that it might be."

And taking the advice meant for someone else, I want to re-envision my birth story and see what's bautiful. The story that shows my faith in birth and in my body. The one where I can feel the muscles of labor, and I command all other muscles to surrender to their activity. The one where I'm rocking and swaying, working with my body to move my baby down through my pelvis. The one where the sounds of my breath and voice -- formally trained from years of singing and yoga --are the soundtrack to my daughter's beginning. The one where I push two times, knowing that with the third one, I will do it, I will push past the resistence and not feel it break, but instead give way to a whole other person. And the one where my daughter latched right on to my breast and expertly nursed herself to beautiful pinkness.

Yes, that birth story. That's mine. That's the one.

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