Guest guest Posted June 13, 2003 Report Share Posted June 13, 2003 http://www.voiceofwomen.com/midwife.html The State vs. Midwives A Battle for Body and Soul by Carolyne Pion Karen Hunter, a Maryland midwife, was delivering a thirteen pound baby boy on December 19, 1994. Things began well, but anticipation turned to grief when a life-threatening complication arose and the baby went into cardiac arrest. Every expectant parent's worst nightmare was realized when the infant died. Karen Hunter was arrested. When a baby dies in the hospital--and, despite the promise of technical wizardry, babies and mothers do die--the doctor is not arrested. In this case, though, the baby's parents--an Air Force sergeant and her husband--did not hold Hunter responsible. The State did. The fundamental issue here--the very marrow from which our choices about life and death are conceived--is a world view which mandates that we, human beings, are systems able to be standardized and collectively acted upon. And the root assumption of our medical model--that technological births are the only safe births--is the offspring of this worldview; the mantra of man as machine, as chanted by Science and Rationalism, our holiest gods. Gods who have subsumed and declared blasphemous the many and insistent rebellions proffered by our bodies and souls. With the arrest of Hunter and two other midwives practicing in Maryland in the last year, it appears that the state is engaging in a modern day witch hunt, a persecution of those who do not mirror and reinforce state-mandated beliefs, regardless of their truth or efficacy. But these midwives are only scapegoats for a cultural delusion that technology can fix everything, the modern equivalent of a two dimensional--the world is flat--understanding of life. Tightening the institutional grip on the wombs of women and dragging them into hospitals won't save every mother, nor every child. It never has and never will. But it does deny us our humanity, our completeness--the acknowledgment that we are immeasurably more than the sum of our anatomical parts--just as the flatworlders denied that the earth was round. The irony of the situation is that most midwives are well-practiced, well-prepared, well supplied, and just as capable of delivering babies as well as obstetricians. The Catch-22 is that although they have the statistics to prove this, they cannot even step forward to defend themselves without risking self-incrimination and possible arrest. Hunter was the primary midwife at 128 births, and attended 140 births altogether. Of the 128 births at which she served as primary midwife, only 5 were ever transferred to a hospital, and 127 of them had successful outcomes. Her ability to labor and deliver birthing mothers is exemplary. As tragic as the death of this baby was, his chances of survival in a hospital--where hospital mortality rates for shoulder dystocia (the underlying birth problem) range from 21 to 290 deaths per 1,000 births and morbidity rates range from 16-48%--were probably not any better. Medical abstracts also report that the most important factor associated with fetal death is a birth weight over 3,499 grams, or 7.71 pounds. In our culture today, about 98% of women give birth in hospitals, where approximately 90% of them receive some type of birth intervention. Approximately one in four mothers end up with cesarean sections which, in and of itself, carries two to four times the risk of maternal death. Only a handful of women decide to birth at home, and in states where lay midwifery is legal and statistics are kept, their outcomes are as good or better than those of obstetricians. But being as good or better is apparently not enough for the American College of Obstetricians and Gynecologists (ACOG), who have mandated compulsory hospitalization of all births. Although it is not technically illegal to have a homebirth, the states of Virginia, Maryland, and the District of Columbia have made lay midwifery illegal. And, in most cases, nurse midwives cannot get insurance or a doctor back-up, as required by their protocols. So what's a mother to do? Throw in the towel, accept the " birth as disease " paradigm, check into a hospital, and run the risk of a half dozen interventions or so while enjoying the lovely confines of an institutionalized setting, as well as the added benefit of germ-ridden corridors? Remember Woody Allen's movie Sleeper, a Brave New World spoof where a 1980s man awakens from freeze-dried sleep to a world where everything, even one's most personal experiences, are state-sanctioned? Robotic and insipid, the inhabitants of this land are so disembodied they drug themselves into a state of feeling simulation, and climb into machines called " orgasmatrons " in order to have sex. Living beside these humanoids are the renegades who thrive in nature and live more genuine, albeit more dangerous, lives. Midwives and homebirth mothers are among our renegades, calling us into feeling-life and out of technological coma. One real-life renegade is Catherine Falknor of Chevy Chase, Maryland. A mild-mannered, self-described model patient, Falknor ended up walking out of a hospital at five or six o'clock one Sunday morning, in labor. She had been told that after dawn she could not eat anymore, and that she was likely to be given a drug called pitocin if her labor didn't start to pick up. Having taken birthing classes (where, if she learned nothing else, she learned what to watch out for in the hospital), she realized she was about to lose control of one of the most important experiences in her life. Fortuitously, a highly recommended midwife was available to talk with her, coach her, and eventually deliver her baby. On Wednesday, three days after she'd left the hospital, her healthy son was born. Her second and third children were born at home as well. Had she not left the hospital, believes Falknor, her first child would have been born by cesarean. " For my first birth I needed a lot of physical and emotional support. My midwife was tremendous. She brought me from one point to the next seamlessly. It is phenomenal, incredible, that someone can be so attuned, " say Falknor. " I felt I really broke through, I was so empowered, " and, she laughs, " I used my birth experiences as a paradigm for getting a very difficult Master's degree. " By turning a potential nightmare into a personal breakthrough, Falknor was able to experience a powerful rite of passage. By acknowledging our totality we nurture the bodymindspirit, cosmically empowering ourselves beyond any arithmetic formula for a " happy " life, or a " safe " birth. What is safety, really? How did we get to the point in Western society where experiences such as Falknor's are technically illegal and unsafe; where technology is both the piper and the tune, and a medical model which can actually be injurious to women is not only acceptable, but ideal? Have we as a culture gone, like Alice, through a looking glass, where everything is its mirror image and the degree to which a practice is inimical to life is directly proportional to its usage--but everyone agrees to agree that the opposite is true? Technological intervention in birth is not good. We know that. Statistics tell us that. The Centers for Disease Prevention stated that in 1993 alone doctors performed 349,000 unnecessary cesareans at a cost of more than $1 billion, many of them based on the inaccurate readings of fetal monitors. Is anybody investigating how many of these mothers may have died from complications due to these unnecessary cesareans, or how many mothers and babies suffered other forms of morbidity directly related to these surgeries? The efficacy of fetal monitors, of lithotomy (feet in stirrups) birthing positions, and even epidurals have been roundly questioned and condemned, but to little avail. It's not that technology is bad, per se. Technology is neutral; it's the overuse and dependence on technology which is harmful. It's the fact that not just the person who really needs the interventions is given them, it's that almost everybody is given them; which really, is the failure of Western medicine overall. Why did it take so long for diet and exercise to be properly acknowledged as preventions for cancer and heart disease, for instance? Because we were too busy playing with our technology to concentrate on prevention. Technology is both the boon and the bane of modern existence. Used correctly, it's miraculous; used indiscriminately, it's a cure that's worse than the disease! " Physicians have a very skewed view of homebirth, because the only time they ever see one is when something goes wrong, " says Lynn McDonald, a certified nurse-midwife (CNM) who practiced at the Baltimore Birth Center before moving to New Jersey. " And although most cases come out beautifully, it's understandable that doctors just don't realize how wonderful homebirths are, how really rare serious complications are. " " There's a set of risks that go along with being in the hospital, and a set of risks that go along with being at home, " continues McDonald. A nurse-midwife, with her feet in both worlds and the ability to professionally analyze both sets of risks as she calls them, McDonald chose a homebirth. Why? " I wanted freedom and emotional comfort; I wanted to be able to have there who I wanted. I wanted to be able to do whatever--walk around naked, take a shower, dance-- without anybody judging me, " said McDonald. " Most of all, I wanted to be able to look at the birth process as a whole, especially when it came to any important decisions, and not be limited to arbitrary protocols. " And why did McDonald, a nurse-midwife, choose a lay-midwife to attend her birth? " I definitely had an advantage being able to evaluate my midwife. I knew she was very knowledgeable, and I trusted her ability to help me make decisions, " says McDonald. Education is the key stumbling block for lay midwives. In our culture it is assumed that because most lay midwives follow an apprenticeship model, learning from another midwife or even a sympathetic doctor, they are automatically inferior to those doctors or nurses who have learned in formalized settings. Homebirth statistics simply do not bear this out. And some of today's lay midwives actually do attend excellent midwifery schools in states where lay midwifery is legal. " Whether it's someone from Harvard, a granny midwife, or anyone in-between, it shouldn't really matter how they are trained, " says McDonald. " The bottom line is do they know what they're doing? " To assist midwives in asserting their competency, The Midwives Alliance of North America (MANA), a national association of lay and nurse-midwives, has developed a skills assessment examination, to evaluate the midwifery skills of lay and/or nurse-midwives. The MANA exam is a good measure of skills, and very similar to the American College of Nurse Midwives (ACNM) exam, says McDonald, who took both. The ACNM exam is administered upon graduation from nursing school, whereas the MANA exam is available through national registration. Karen Hunter also took and passed this exam. What no one measures, however, is the intuitive guidance one woman--especially an experienced midwife--can give another, the seamless coaching Falknor so aptly described. Historically, as birth became a more measurable and quantifiable procedure, the concept of quality of experience diminished and where woman to woman contact once flourished, human to machine contact took its place. No longer a sacred process, our medical model usurped the role of the creator, creating a reality which mandates that machine-managed births are superior, and mother is a patient. But who does this version of reality serve? The mother, who lies in a supine birthing position strapped to a fetal monitor, her legs numb from epidurals given her for the pain and discomfort she might have alleviated had she been allowed a warm bath or shower-- or been given the psychological and emotional support many birthing woman need--her bladder hooked to a catheter, her arm to an IV? Statistics reveal that, thanks to these interventions, cesarean section rates rose from 3-5% in 1970 to 25% or more today, indicating that birth is much less safe when this medical model is employed. Cultural anthropologist Robbie Davis-Floyd has looked at how ingeniously insidious and powerful our technological mindset really is. Taking a powerfully female phenomenon--birth--and shaping it to reinforce rather than contradict the medical technological birth model was quite a challenge says Davis-Floyd. Birth had to be made to at least appear to conform to not dispute the basic tenets of the medical world view. Standardizing each woman's experience, say Davis-Floyd, solved the paradox. " From this perspective, " says Davis-Floyd, " routinely used obstetrical procedures, such as electronic fetal monitoring, episiotomies, the lithotomy position, and even cesarean section, emerge as rational ritual responses to the conflicts between reality as American society has constructed it and the physiological realities of birth. " So what we're actually experiencing, as American women, isn't necessarily the safest mode of giving birth--there are many other models and statistics which dispute that--but the one most analogous to the culture we live in. Rituals reinforce the beliefs of the prevailing value system; it is not their efficacy, but their repeated reinforcement which legitimizes them. Being one of the most technologically advanced societies in the West, it follows that because we view the universe as mechanistic, we view the body as a mere extension of this same mechanistic system. So it's not ironic that the procedures used to " improve " birth create the very problems they seek to prevent. It is simply a self-fulfilling prophecy! The need for women to be purified, sanitized, and finally mechanized began long before Descartes thought us into our mechanistic conundrum four-hundred years ago. The negative connotation associated with woman's connection to nature--through menstruation and birth--dates back to biblical times, when Western man first pitted himself against nature, and sought God as an ally. With the advent of Augustine and the doctrine of Original Sin, in approximately 300 C.E. (common era), God, with a little help from man, also pitted himself against woman, casting her into patriarchal hell. This solidified the battle lines, placing woman squarely in the camp with the base, the dark , the evil, with nature and it's natural extension the body; whereas man became more clearly aligned with the good, the rational and spiritual (the two weren't mutually exclusive yet), with God, and Heaven. When Descartes floated into the cosmic soup in the 1600s, a kind of dismembered brain--Cogito ergo sum--man simply thought, therefore he was. Woman still cleaned, cooked, worked in the fields, fornicated, and gave birth--therefore she was. And by that time, thanks to Augustine, man had already decided to think for women, the need for this having been incontrovertibly documented in the Malleus Maleficarum (1486), a witch hunting manual which stated that " When a woman thinks alone, she thinks evil. " Cultural norms create reality. History has proven to us that reality is only as real as the culture which creates it empowers it to be. Reality, then, is a flexible by-product of the customs of the society which creates it; just ask an Aborigine, a tribal person from the rainforest, or a Hindu firewalker what reality is. Sometimes, we also know that what's real really isn't, like the story about the emperor and his new suit of clothes. In this case the emperor is the medical birth model, and the clothes he isn't wearing are all the technical gadgetry he depends on. Ina May Gaskin, a Tennessee midwife, has been trying to tell the emperor about his clothes for a long time now. A pre-eminent expert on homebirth, lay midwifery, and birth presentations, Gaskin has been to midwifery what Florence Nightingale was to nursing. Her combination of non-intervention, intuition, insight, research, and dedication have placed her in the forefront of practicing midwives internationally. Her best-selling book, Spiritual Midwifery (1976), expanded the boundaries of birth for millions of women. Through 20 plus years of study, 1,900 births, and worldwide travel and research, Gaskin has dedicated herself to the search for the best ways to deliver babies, however they present themselves. One of the most difficult presentations imaginable--and the one which presented itself to Karen Hunter that December day--is shoulder dystocia, when the head is born but the shoulders are literally stuck. Gaskin believes that when it comes to shoulder dystocia, homebirth may be even safer than a hospital birth. By comparing two recently published articles on how to handle shoulder dystocia, we can see why. Writing in Obstetrics and Gynecology, Vol. 82, No. 5 , November, 1993, James O'Leary, M.D. advocates the use of the Zavanelli maneuver for dealing with shoulder dystocia presentations. The Zavanelli maneuver basically involves pushing the baby's head (remember the head is out and the shoulders are stuck) back into the birth canal, after which you anaesthetize the mother and extract the child by cesarean. In the 59 cases O'Leary was able to collect data on--the maneuver is still exceedingly rare--the results were mixed. Although no mothers died, 2 mothers (3%) had emergency hysterectomies, 5% had torn lower uterine ligaments, and 10% had symphysiotomies, where the ligament between the frontal pubic bones is slit to enhance delivery. The babies fared less well. Of 59 babies, there were two deaths (3%), there were 4 infant seizures (7%), of which two babies (3%) suffered permanent damage, 17 babies experienced Erb's palsy, and of these, 5 (8%) suffered permanent damage. APGAR scores--tests administered right after birth to ascertain a baby's condition--were very, very low. O'Leary is enthusiastic about this technique, which gives you an idea how serious a complication this is, even in a hospital. Perhaps it is viable as a last ditch attempt to save a child, and perhaps there are better techniques. Interestingly enough, Gaskin's method of choice, putting a mother on her hands and knees (a crawling position) when faced with shoulder dystocia is not used by obstetricians, but family practitioners seem very open to it. In the Journal of Family Practice, Vol. 32, No 6, 1991, in an article written by Anna L. Meenan, M.D., Ina May Gaskin, M.A., Pamela Hunt, and Charles A. Ball, M.D., the method is touted as highly successful. The article gives several case reports, as well as examining the 35 shoulder dystocia births which took place at The Farm Midwifery Center in Tennessee; 32 of which were delivered by the hands/knees method Gaskin learned in the mountains of Guatemala from indigenous midwives. All of the hands/knees births were successful, with no injury to mother or baby, good APGAR scores, and obviously no anesthesia, as it would be hard to get a woman whose legs were numb up onto her knees. There is no way to absolutely compare any shoulder dystocia statistics because every birth, like every woman and infant, is completely unique, but it would seem that obstetricians (OBs) would do well to learn and utilize this simple, yet highly successful maneuver, particularly before trying anything as unusual, invasive, and dangerous as the Zavanelli Maneuver. Although new to Western culture, the hands/knees maneuver is actually a very old one, cited in Labor Among Primitive People (1883) by George Engelmann. It is impossible to know how many resourceful ideas were lost as various battles for dominion over healthcare raged throughout history, but one insightful book has recovered at least some of the names and activities of woman healers from prehistoric times to the present. Woman As Healer, (1990), by Jeanne Achterberg, examines woman as lifegiver and healer, beginning with the archetype of the Great Mother, which existed for 20,000 years. Since her overthrow by patriarchal culture, there were many women who stood out as model healers--and the models they embodied were very similar to the models held dear by women today. The legend of the Greek Asclepius, and the gifts of his daughters, Hygeia and Panacea, is a case in point. They lived around 900 BCE (before common era), and were a pinnacle in medical history, says Achterberg. It is to them, in fact, that the Hippocratic Oath, the ethical code of honor taken by physicians, is recited. Hygeia represented prevention, sanitation, nutrition, and general prescriptions for healthy living as primary medical tools, and her sister, Panacea, represented the cure for ills. How sophisticated Hygeia's roots in healing are, when compared with some of the barbaric practices associated with the Western medical model and its dependency on interventions, such as surgery and medication, notes Achterberg. Hildegard of Bingen (1098-1179), a physician, mystic, and abbess, is singled out by Achterberg as " the most profound scientist of her time. " Hildegard's work was ignored by generations of scholars who preferred to champion the less insightful " fathers " of science--Bacon, Aquinas, and Magnus, among others, whose dogmas " fueled the hue and cry against women. " While we cannot, within the scope of this article, chronicle the holocaust against women--the witch hunts--which took place in Europe in the 15th-16th centuries, we can note that women skilled in the healing arts, medicine, herbs and midwifery, were prime targets. Those women who competed with the rising male medical profession, and lived alone (that is, without a man), were particularly at risk. The manner of torture and death these women endured is beyond any rational explanation. Because the accusers of witches were eligible to inherit from her estate, as were her torturers and judges, it is no surprise that wealthy women were the first to go. The Catholic church seems to have been the single largest beneficiary of this witch craze. Some feminist historians believe that many of those accused may have been practicing a form of goddess worship which their skills were inherently part and parcel of. Childbirth has long been portrayed as the scourge of womankind. This may be traced back to several factors, including the theme of pain in childbirth as punishment for Eve's sins--Adam gets off scott-free, but that's another story. What also should be given consideration is the paucity of birth control options available to women, who, resigned to birth after birth, and--after four, five, eight births or more--did not necessarily look forward to the next one with joyful anticipation. Yet another factor in any historical analysis is the fact that history is written by and for the winners, reinforcing their own value systems again and again. The medicalized version of the body as mechanism, of birth as illness and its subsequent fear-based decision-making process has clearly won out over any pre-dualistic bodymindspirit belief system. The subsequent version of reality, which separates the sacred from the rational and the physical, is internalized in our culture at the deepest psycho-spiritual-emotional level, and has resulted in the self-perpetuating technocratic approach to reality we embrace today. That women did die in childbirth was clearly a factor of poverty, nutrition, and urban growth. As more and more people lived closer and closer together without the benefits of sanitation and with minimal standards of personal hygiene (at least in the West), death and disease flourished. Women were more likely to die due to the perpetual state of germ warfare than because of difficulties inherent in the birthing process. Presumably, those who were poor, sick, and ill-fed succumbed to death; the physical demands of pregnancy and childbirth were more a catalyst for, than a direct cause of, their inevitable fate. Though things were gloomy in urban Europe, particularly England, they were less gloomy in the colonies. This is recounted in A Midwives Tale: The Life of Martha Ballard Based On Her Diary 1785-1812, written by a midwife and healer who practiced in New England in the 1700s. Ballard had excellent birth statistics, and reported delivering breech and multiple births as a normal process. Clearly, it seems, when factors of disease and poor nutrition were minimized, the actual physical process of giving birth put very few women at risk. And for awhile, the birthing process escaped the notice of male doctors, but as Ballard's diaries reflect, they were becoming more and more interested in this lucrative market. How many other " Martha Ballards " lived and delivered babies, we'll never know. It was mere chance that her diaries were discovered and printed, earning a Pulitzer Prize for historian Laurel Thatcher Ulrich. Most of the evidence for efficacious woman to woman birth assistance lies buried with all the other Marthas who delivered our forbears. As the 18th century converged with the Victorian era, corsets alone were probably responsible for a good deal of the pain in childbirth. The Victorian practice of wearing corsets permanently deformed many women's ribcages, not to mention what it must have done to their organs. Although the corset could obviously not be worn during the latter stages of pregnancy, damage and infection could have already taken their toll. Victorian culture, says Lying-In: A History of Childbirth in America (1989) by Richard and Dorothy Wertz, also developed the issue of pain as the chief concern of childbirth. " Many doctors described birth pain as one of the worst agonies known to them, greater than the terrible agonies of soldiers in the Civil War, " says Lying-In. No wonder women were frightened out of their minds! This, of course, insured the necessity for doctors, and the need to palliate this terrible pain. To underline just how controversial this issue of pain must have become, none other than feminist foremother Elizabeth Cady Stanton wrote on the subject. A mother of seven, Stanton wrote that having always attended to her health, and having never worn unhealthful garments, she suffered very little with her births. With the birth of her last child, Stanton said she decided it was unnecessary for her to suffer at all and " the child was born without a particle of pain. " In the case of the medical community versus Stanton, there is no doubt who won. The issue of pain became firmly entrenched in subsequent birth cosmology, and even today is one of the chief birth fears many women harbor. Ironically, the greatest pain in childbirth was probably caused by the interventions of the doctors. According to Lying-In, in 1879, the president of the newly formed American Gynecological Society suggested that doctors consider using forceps to expedite delivery, rather than standing by the anguished, laboring woman and crooning to themselves that meddlesome midwifery was bad. What's wrong with this picture--doctors exploiting women they've pumped up into terror over birth pain they've never even felt themselves, complaining that midwifery was meddlesome? Evidence indicates that repairs to the bladder, uterus, and other female parts from misplaced forceps and other implements, were far more painful, and less fixable, than labor ever was. But once medicine got its teeth into birth interventions, causing no doubt far more deaths than good, it's been like a pit bull with its jaws dug into a succulent morsel--and determined to keep it that way. So, by 1900-1920, a marked transformation from home to hospital occurred. By this time the paradigm of birth as disease was ingrained, and " normal " deliveries were thought to be few and far between. One formidable physician, Dr. Joseph DeLee of Chicago, insisted that episiotomies and forceps be made routine in all deliveries. In a skillful through-the-looking-glass maneuver, DeLee " maintained that only a small minority of women escaped damage and many babies were killed or damaged by the direct action of the natural process itself. " By the 1930s, such practices were standard fare. No wonder women needed anesthesia. In the late 1950s, the hospital dream birth was exposed as nightmare in none other then the Ladies Home Journal. Sparked by a letter from an obstetrical nurse which demanded the investigation of " cruelty in maternity wards, " a deluge of horror stories poured from the pens of mistreated mothers. Women complained of sadistic practices, of being left in rooms for hours at a time without so much as a drop of water, of being tied and trussed to the delivery tables like " trapped animals, " and of a system which protected the guilty at the expense of the pregnant. A woman whose husband was a veterinarian wrote in to say that " even animal maternity cases are treated with a little more grace than is accorded human mothers. " While Hollywood handed out 3-D glasses, and Rock Hudson and Doris Day fantasies played out on the silver screen, reality emerged from the collective unconscious and shapeshifted into a profoundly different animal--the 60s. And groves of flower children sprouted from the seeds of our discontent. The arrival of flower power set the stage for women to recultivate their own power, and implicit in this flowering was the reclamation of ourbodies and ourselves. Midwives, who had been almost stamped out of existence by the predominant medical model, made a comeback. Fathers, who legend has it awaited their progeny on bar stools, only emerging to pass out cigars in the aftermath, became key figures in the birth drama--transformed from non-player to coach. As late as 1975, couples had to argue to be allowed into the obstetrical theater, where there was still no room for daddy. Although we take Dad's presence in the delivery room for granted today, it was a cultural abnormality only a few short decades ago.The 70s saw a rise in birth options and a lessening of the authoritarian claim of doctors exerted over mothers. Lay midwives (those who learn through apprenticeship) and nurse-midwives (those who learn in nursing school), gained a wider degree of enthusiasm and acceptance. Midwives also gained the acceptance of middle and upper-middle class women, whose experiences, as recounted by word of mouth accounts and numerous written " birth story " digests, presented a loving, nurturing birth attendant in stark contrast to the caricatures of filthy, backward midwives promulgated by doctors in the early 1900s. And this reality paradigm was supported by European models where, according to World Health Organization statistics, every single country in Europe with perinatal and infant mortality rates lower than the United States uses midwives as the principal and only birth attendant for at least 70% of all births. The United States, despite having the most interventions, has one of the highest infant mortality rates in the Western world. But even as births seemed to grow more humanistic, with invasive and outlandish prepping rituals such as the shaving of pubic hair, the strapping down of arms and legs, and the forcing of enemas, were displaced, other equally frightening and potentially more dangerous procedures took their place. One reality merged into another, and birth interventions multiplied, creating a new norm, a new measure of reality. " One intervention leads to another, " says Michele Fletcher of Northern Virginia, a casualty of medicalized childbirth. Fletcher's first birth was by cesarean attributed to Cephalo-Pelvic Disorder (CPD). The doctors told Fletcher she wasn't big enough to deliver her baby. Though CPD is the most common excuse for performing a cesarean, its true incidence is very, very rare. Fletcher was forced--by the threat of a court order--to have her next child by cesarean as well. Ironically, her mother, who worked for the Virginia court system, happened to be there when the call came in from the hospital demanding that Fletcher's unborn child be made a ward of the court if she refused a cesarean. Her mother, of course, had no idea that the recalcitrant mother described over the phone was her own daughter! In her third pregnancy, Fletcher chose a nurse-midwife and was able, despite interference from doctors, to deliver her baby vaginally. For her fourth and fifth births, Fletcher chose to have a lay midwife at home, where she finally achieved the birth experiences she'd been longing for. Interestingly enough, the babies Fletcher delivered vaginally were larger than the babies she delivered by cesarean--you know, the ones which couldn't fit through her pelvis. Fletcher believes her inability to progress in the hospital was directly attributable to fear. Joseph Chilton Pearce, noted author and lecturer (Magical Child, The Crack in the Cosmic Egg) agrees. " At the first sign of interference or intervention, something that's liable to threaten them, nature designs the mammalian limbic structures of the brain to stop the birth process. The mother waits until the coast is clear, or moves to another place to give birth where it's safer. That's our mammalian, genetically-encoded heritage, " says Pearce, in a 1993 interview in Spectrum News Magazine. " What happens to our women in hospitals? Every intervention conceivable. Birth becomes a long, torturous, risky, painful ordeal. So what do the males do? They pump all sorts of chemicals into the pain, they pump chemicals in to induce birth, which has been stopped by their very interventions, " says Pearce. He expounds on his concepts of violence, intelligence, and the birth process in his latest book Evolution's End: Claiming the Potential of Our Intelligence (1992). When she was finally able to birth at home, says Fletcher, her births were simple and fast. She felt secure and empowered, at home in her body, herself. And during that process, the emotional scars from her previous births finally healed. For Fletcher, as for many women, the birth experience is a chrysalis for a merging of the spiritual, the physical and the rational; a gateway to the sacred. It is through our experience that we are transformed. Although our culture has objectified the sacred, turning it into a chalice, a cross, a vestment, and now a fetal monitor--such objects are merely symbols of what exists only on the experiential level. It is through our experience of the sacred that we are transformed. And what is this transformation but the bodymindspirit's recognition of its homecoming, of finding what's always been there, the grandmother of all déja vu experiences, the clicking together of the ruby slippers. There's no place like home. Though our culture has embalmed our experience of the sacred, rendering it lifeless, the state has institutionalized this mummification, and television has homogenized it; the ability to go home, to embody the sacred, endures. Now the question is: will homebirth remain an option for those who see it as a pathway, or will a handful of bureaucrats and insurance companies succeed in contriving metaphor or simile as life itself? If we don't take responsibility for consecrating our own life, confirming our authenticity, we'll be given the Hallmark card version instead. D.H. Lawrence, over 100 years ago, understood the illness of our souls, the angst of our separation, and the numbness from which a profound desire to heal calls us home. HealingI am not a mechanism, an assembly of various sections. And it is not because the mechanism is working wrongly, that I am ill. I am ill because of wounds to the soul, to the deep emotional self and the wounds to the soul take a long, long time, only time can help and patience, and a certain difficult repentance, long, difficult repentance, realization of life's mistakes, and the freeing oneself from the endless repetition of the mistake which mankind at large has chosen to sanctify. Each and every birth is a call to embody life's potential. Living only in the mind is, in essence, living one-third of a life. By acknowledging and revering the totality of our being, our bodymindspirit, we can awaken from the deep mechanistic slumber which has numbed us--from birth until death--for far too long. Honoring as birthright a woman's creation of her own birth space, her hallowed ground, is but a beginning. Recognizing our own sanctification of science and rationalism as gods, rather than tools, is another step. Creating a brave new world which consecrates humanity, not machinery, will bring rewards well beyond our systems of measure. Carolyne Pion is a freelance writer, mother, and acupuncture student living in Takoma Park, Maryland. She birthed her two children at home. How You Can Help: Maryland Friends of Midwives is coordinating efforts in Maryland and welcome any assistance. They are asking women to: A. Make A Donation. Maryland Friends of Midwives desperately needs money both for legal defense costs and to work to enact fair midwifery legislation. B. Lend a Hand. Volunteers are needed to serve on the legislative, fundraising, public relations, and administrative committees. C. Write Letters. Let your legislators and the media know you support home birth and/or midwives. Send Maryland Friends of Midwives a copy of your letter. State Legislators: to find out the names, phone numbers, and addresses of the state legislators from your district call the Annapolis General Assembly Information: 1-800-492-7122. Newspapers: Baltimore Sun, 501 N. Calvert St. Baltimore, MD 21278, 1-800-829-8000. Washington Post: 1-800-627-1150 Or your local paper. Also answer any published letters with rebuttal or support. What Do I Write? The most effective letters are personal, handwritten or typed, and to the point. Write why you support home birth and/or midwives. Talk about: cost-effectiveness, control, safety, less intervention; parents must have the right to choose the manner of, cost of, and setting for their children's birth; you support the recognition and legalization of MANA-recognized midwives. Legislation must include midwives recognized by both MANA (Midwives Alliance of North America) and ACNM (American College of Nurse-Midwives). Write exactly what action you want them to take and ask them to support this legislation. Follow up with a phone call. Remember that they are folks from your community and educate them in a friendly way by sharing your experiences and views, send them photocopies of articles. Check back with them periodically to remind them about the issue. (They have to keep track of numerous bills, and part of the job of citizens is to remind elected officials about issues important to you.) That's how people make things happen! If you would like, send a donation made payable to Maryland Friends of Midwives. See address below. Benefits for Midwives: June 10 Friends of Midwives Benefit Dance at St. Johns United Methodist Church, in Baltimore, $10. Featuring Nada Brahma and others. Join us for an evening of music, great fun, and networking to support the midwives of this region! More info to follow or Liz Allen call 410-747-3352. Community Resources: Maryland Friends of Midwives, 410-876-0551, 153 E. Main St., Westminster, MD 21157, contact Sandra Loats. Chesapeake Midwifery Guild, 3619 Chadwick Ct., Pasadena, MD 21122, 410-360-0751, contact Debra Mackall. Cesarean Awareness Network (ICAN) has local chapters for education, support, info following cesarean section, to avoid c-section, or plan a vaginal birth after c-section (VBAC). Referral service. Baltimore: 410-467-4586. North VA: 703-451-6649. MD/DC: 301-460-0220 Waterbirths are available both in-home and in-hospital. For more information contact Ellyn MacKay, RN, 410-560-1873. She is the east coast coordinator for Waterbirth International. Tub rentals and classes available. Babystart Birth Services is a holistic support service for new families during the birth process. Gail Flory, RN is a birth therapist, birth assistant, breasftfeeding consultant and director for Babystart, 410-267-9492. Birthworks offers a preparation for pregnancy and childbirth class. Toics include conscious consumerism and VBAC. Bonnie Cowan, certified instructor, 301-460-0220. Find well woman and OB services in our directory under Midwifery & Birth Services. Top of Page / Article Index Gettingwell- / Vitamins, Herbs, Aminos, etc. To , e-mail to: Gettingwell- Or, go to our group site: Gettingwell Free online calendar with sync to Outlook. Quote Link to comment Share on other sites More sharing options...
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