In today's wonderful world of technology, we have an amazing invention known as Facebook! This website can be a hindrance, or a hazard. Recently, I joined a Facebook page known as "Fed Up With Natural Childbirth". I honestly hate the name of that page, but agree with 90% of what is said there and what the page stands for. In my opinion, a much better name for the group that would give better representation of what the group is all about would be, "Fed Up With The Natural Childbirth Movement". What is boils down to, is weeding out the whole "trust birth" mentality and focusing on what we can do to bring safe, adequate maternity care for all women - especially those who choose CPMs or DEMs. Several have voiced their concern that I am now "anti natural birth" because the noticed I was a member of this group. This is simply not the case at all. The group stands for safe maternity care. They realize that birth is not always flowers and butterflies and that interventions can and do save lives. Many of the ladies there have had natural births attended by an OB, CNM, and some even by a CPM. A name, is only a name and nothing more.
I agree with a wise woman who said "I respect birth, not trust it". Birth is unpredictable - you can not simply blindly trust it! I feel it would be a good thing for me to go over what I do and do not stand for at this point in my life, as it may help many understand where I am coming from.
I do:
* Support out of hospital birth for truly low risk women, attended by a CNM, and within close proximity to a hospital.
* Support natural child birth! I believe a birth with zero interventions is a wonderful, healthy thing!! I also fully support a women who desires pain relief during her labor. Please don't think because I joined the above mentioned group that I am "anti natural childbirth" and think all women should have epidurals, internal monitoring, and cesareans.
I do not:
* Support homebirth with a CPM or DEM at this time. Until there are higher educational requirements, better standards, better regulations, and insurance requirements - the only truly safe homebirth is that with a certified nurse midwife.
* Think all women should have natural births to somehow "prove themselves". I also do not think all women should have cesarean sections!
The bottom line is that I support a woman's choice regarding her birth. Whether that be a natural birth, or a birth plan that includes an epidural as soon as possible! Whether she plans to circumcise and vaccinate her child, or not vaccinate and leave him intact. Whether she plans to breastfeed, or bottle feed. These choices are very personal and it is not my place to judge another woman's choice.
One of the main "purposes" of the "Fed Up With Natural Childbirth" group, is to make it known that you don't have to breastfeed, or have a natural birth, or even have a vaginal birth to be a woman, or to love your child! The spreading of misinformation and dangerous facts by the NCB movement is appalling, and the "Fed Up" group is working to end that. Scratch beneath the surface. Look past the name and understand what this amazing group of women are trying to accomplish! You might just be surprised!
21 comments:
Well-written, well-said. I strongly admire those who can step back from what they've previously thought and look at the other side of the picture. I hope you continue with your training, with your writing, and with your advocacy of safe, responsible birth, Amber.
Amber, this is excellent and and you've articulated exactly how I feel as well!
Thank you both.
Very nice post. I've subscribed to your blog. :-)
I went through a similar transformation of heart after traveling in the developing world. I still believe in the importance of supporting a woman's desire for physiological birth... but I also recognize the naivety of the "trust birth" mentality. If natural childbirth were the answer for EVERY woman, our global infant and maternal mortality statistics wouldn't be as abysmal as they are (as the vast, vast majority of women in the developing world have "natural" childbirths).
The turning point for me was recognizing that if I wanted to be radically, absolutely, totally WITH WOMEN, I needed to meet women where they ARE, not where I wish they'd be. If that means being in a hospital, educating her regarding the risks of an induction at 37 weeks for "psychosocial reasons," that's just as valid, necessary, and important as being with a woman who "gets it" in her home.
I hope the universe blesses me with the opportunity to work in both spheres.
~Temporarily anonymous
(p.s. I'm emailing you now to introduce myself :-)
I couldn't have said it better, myself! Well written, Amber!!
I agree with your concerns about there being no universal objective measure of non-CNM midwives. Are you saying though that this makes all births with CPMs and DEMs inherently unsafe or are you saying that out-of-hospital births with them should not be blanketly endorsed?
Amber, you rock! You have written beautifully the reasons that exactly mirror my own in wanting to become a midwife, as well as how fed up you are with the movement of natural childbirth. I was a member of the group, but when a friend told me he saw a post I had made there, I got embarrassed reaaaalll quickly and left it (shamefully...). One day I will rejoin, because I think it is a wonderful place to have sane, logical, and educated discussions about maternity care in this country.
ps. I discovered your blog via a post from the NGM.
I hope you continue along with your journey to midwifery with the same passion you express in your posts!
This is awesome!! I know the name of group puts people off, but they would really benefit to look beneath the name. So many of us pour our hearts and souls into fighting the misinformation and judgement day in and day out. People don't realize that.
Love this post. I have blogrolled you at Oregon Homebirth Reality Check.
This is a helpful explanation for the purpose of that group. After having a traumatizing hospital birth (traumatizing bc of how the staff belittled and degraded me) I chose to pursue a home birth for baby #2. My pregnancy and delivery were healthy. I was a little frustrated with the NCB community bc it was so difficult to find credible, hard science information about risks and outcomes. As we consider baby #3 and decide whether we'll do a home or hospital birth, I find myself frustrated with the animosity from both sides. I've spent lots of time hearing the venom that the "trust birth" crowd spews at the medical community. But i've also read the same spirit of mistrust and venom in the Facebook group you mentioned.
There is obviously much at stake, and deep seated emotion on both sides of he debate. Women need answers and concrete information, but what I've found when searching in both camps is a lot of bickering and anecdotes. Where are women to look for credible information regarding the outcomes of home AND hospital births?
Amber - I really want to congratulate you on your change of heart regarding your educational path and the acceptance that you have much to learn. It takes a TON of courage to make that change so public. You are a great example of courage, humility and empathy. I truly wish you well on your journey.
I understand what your describing, but I feel this group does nothing but use fear mongering tactics on women. The Trust Birth movement is exactly what you said "Respecting birth" and a woman's body. If you have attended a Trust Birth meeting then you understand. I am very disappointed to hear that you feel the only truly safe birth is with a CNM or DEM and NOT a CPM. I have a wonderful CPM that I gave birth with and will use with my next due soon. From my standpoint (and I think yours too) the safest place for a woman to birth is where she feels the safest. I'm sorry, but I don't support Fed Up With Natural Childbirth. If an advocacy group truly wants to make a difference in women's health and birth they should work to change a maternity care system that doesn't practice evidence based medicine NOT blame CPMs. Truly, we need to bridge the gap but I'm disappointed to see you supporting this group. Maybe there should be a group called "Bridging the Gap" or something.... I don't know.
Amber, you have hit it right on the nose with this one!
I do have to ask what someone else asked, though: Do you absolutely not endorse CPMs at all, now, regardless of their track records, or do you just not support blanketing them all as one?
The reason I ask is because I know two CPMs who are incredibly knowledgeable and good at what they do; one has practiced for decades and caught well over a thousand babies, and they have reasonable transfer rates - though they don't transfer at the drop of a hat, either. Even though I am training to be a CNM, I absolutely trust these two and have delivered and will continue to deliver my babies with them. It just seems a shame to lambast all CPMs in general, you know?
Another question: you say you support a mother's decision - but say she is a low risk woman who chooses to birth far away from a hospital? What about women of certain religions who choose to birth at home and don't have access to a CNM? Would you
The reason I'd like to hear what you think is because I'm trying to figure out my own position on these matters, and the only way I can really do that is by hearing a lot of viewpoints on both sides from people I respect. :-)So I hope to get an answer! Thanks!
"temp anonymous" - Wonderful comment. You make excellent points and very, very valid statements!! Thank you.
Lyndsay - Thank you :)
Grace - At this point, I'm definitely saying that I do not think birthing with a CPM or DEM should be endorsed at all - under any circumstance. That isn't a decision that I take lightly, and I battle with myself over it still because I *KNOW* beyond a shadow of a doubt there are educated, competent traditional midwives out there! The issue however, is that the gross negligence and under-education, and incompetency of so, so, so many other traditional midwives overshadows that. Again, the problem is that there is no way to tell the good from the bad. There are no standards (regarding licensing, certification, education, practice standards, ect...) for all CPMs/DEMs. It varies so widely and it causes problems. Until that is changed, I cannot endorse CPM or DEM attended births.
Emily - Thank you so much for the kind words!
Bambi - I couldn't agree with you more! The name really puts people off.... Perhaps a much better name is "Fed Up With The NBC Movement"....
Astraea - Thank you so much for the kind words and for blogrolling!
I wanted to come back and see what other comments were written and also b/c I had a few more thoughts myself....
I wonder how you can change something by leaving it behind... I pose the question: Wouldn't you have a greater impact becoming a CPM (a good, proficient one) and then trying to change the system from within? I look at it like this: I live in a town with low breastfeeding rates, how will I ever create the change I want to see if I up and leave?
Also, It's important to point out that even WITH the highest demands of certification you will still have many negligent practitioners, it's common in the medical profession as well as every other field. I totally agree that improvements can be made (they can be made everywhere), but once again the FB page creates us vs. them mentality and I just can't support it. Also.....I know the page HATES the Trust Birth mentality, but I don't understand why??? They say you have to respect birth not trust it. To me, how can you have trust without respect, that's what trust is ALL about. (Think about interpersonal relationships? Respect = Trust) Okay, I'm stepping down now. But I've read your blog for a few months and just wanted to pick that brain of yours more. I do love your personal position and openness along with kindness. Also, I watch the drama with the NGM unfold and though that you handled yourself with the utmost professionalism and I can see your willingness to learn. I love that you don't 'dig your heels' in so to speak, but seek out what is true!
Kitty - Can you give me some insight as to why you believe the group is "fear mongering", because I don't see that. Perhaps I am overlooking something though! What gives you this impression? And no, I do not at all feel the safest place for a women to give birth is where she feels is safest. A mother carrying a baby postdates, GBS+, mild blood pressure issues may believe with every fiber of her being that the safest place for her to give birth is at her home or a birth center, but this is certianly not the case. "Feelings" have very little to do with where the safest place to birth is. There is a massive problem with the education and standards of CPMs. I'm sorry to hear that you are saddend by my feelings on this, but my feelings stand firm. I can not endorse homebirth with a CPM until the standards are brought up to par.
You said - "I wonder how you can change something by leaving it behind... I pose the question: Wouldn't you have a greater impact becoming a CPM (a good, proficient one) and then trying to change the system from within?"
Most definitely not. I have no desire to be a part of an entity that is recognized by so many (and myself!) as a group of midwives who are horribly under-educated, un-regulated, many un-licensed, and responsible for the three-fold increase of neonatal death. I do not desire to be associated with that at all.
Regarding the issue with "Trust Birth". So many "trust birth" advocates claim that everything is simply a variation of normal. Breech? Variation of normal! Increased blood pressure? Variation of normal! Cord around the neck x3? Variation of normal! Mom is bleeding horribly? Varition of normal! Mom has been in active labor for 4 days now? Some people just take longer - a varition of nromal! Unfortunately - so many of these things are NOT normal! They put much emphasis on the fact that a woman can simply "wish away" a problem. That she just needs to let go of her fears and trust her baby, trust her body, and trust birth. I see it over, and over, and over! A woman posts on a group saying she is 41+6 and her OB/MW is pushing for an induction. On a classic NCB page, most of the responses are things such as: Baby will come when baby is read, the fruit will fall when ripe, do not induce, inductions are horrible, inductions lead to cesareans, trust your body to know when it is time, trust your baby to know when it is time, ect... It is clear in black and white the increase in stillbirth in postdates women, however that is never mentioned! Only typical 'trust birth' jargon.
That is what I cannot support regarding the trust birth movement. I trust that my body is designed to birth a baby, but does it always happen?? NOPE! Some women NEED cesareans! Some women simply cannot birth a baby vaginally. You do have women whose babies simply will not fit, or have a misshapen pelvis. It does happen, but the NCB community refuses to acknowledge that so often and simply tells a mom to trust birth. If a mom ends up with a cesarean section it is because she didn't trust herself or her baby enough. She is made to feel inferior. That is just wrong.
This is why I feel birth should be respected, not fully trust.
Anonymous - I can understand your frustration with the inability to find 'real 'information as far as homebirth, midwives, ect.. I can possibly see where you could find 'venom' in the group (I'd call it more of a strong feeling, not venom exactly) but not mistrust. Perhaps you can shed light on what you mean by that? As far as where you can look for concrete evidence - your state health board and/or licensing board is required to have all information for all nurses, OBs, anesthesiologists, ect. It will give you information regarding if they've ever had any issues such as malpractice, or if there are any open cases or investigations now. The CDC Wonder tool is also great because you can look at specific statistics on outcomes at the hospital by state, as well as comparing it to other thing such as out of hospital birth. You can also compare outcomes by care providers. As far as finding hard evidence on traditional midwives, that is a tough thing due to the fact that many states do not recognize traditional midwives and therefore there is no governing agency/licensing board. In states where CPMs are licensed, you can call the state board and perhaps request information regarding a certain midwife. I hope that helps a little.
Dea - thank you for your kind words.
mrsnichols - I think I pretty much covered your question regarding my endorsement (or lack thereof) of all CPMs.
I completely do see where you are coming from and as I've said over and over I often find myself dealing with an internal battle over this because I know beyond a shadow of a doubt there are wonderful, competent midwives. Unfortunately though - there is no way to tell the good from the bad, and until there is, I cannot endorse birthing with a traditional midwife.
You bring a very interesting question to the table regarding homebirth and various religions or people (I'm assuming you are predominately talking about the Amish). That is something that only briefly crossed my mind when discussing the homebirth community among the Amish with another student midwife. Again, a hard battled. Religious beliefs are sacred and so personal and we should always respect that. But at the same time, each and every woman deserves safe, adequate maternity care and we cannot at this time absolutely guarantee that with a traditional midwife. I'm conflicted on this as well. I'm sorry I do not have a more concrete answer!
The fear mongering is there. I don't know how else to point it out if you don't blatantly see it.
What's the three-fold increase? I haven't seen this study, but would really like to. Could you share a link? Unless, it's the one Dr. Amy compiled, I've seen/read that and she didn't take into account unplanned homebirths so I don't think it's really accurate. As far as I know, there hasn't been a really good published research study done on homebirth in the US.
"A mother carrying a baby postdates, GBS+, mild blood pressure issues may believe with every fiber of her being that the safest place for her to give birth is at her home or a birth center, but this is certianly not the case."
All of those issues you stated ARE variations of a normal birth that needs intervention! Natural birth and intervention are not enemies of each other. The natural birth community I'm involved with must be a different kind, b/c women educate themselves and think very critically about while also understanding their own deepest fears. They know when to get help or a second opinion. I had 3 health care providers for my second birth (my 1st birth at home) I felt like I had the best care ever and I really want to point out that it was because I had medical and natural care. I was able to bridge that gap and I just think that the group does more to widen the gap rather than bridge it.
I also think that you shouldn't judge a community based on what's online. There are so many women giving birth at home or naturally in the hospital that are not part of an online network. I can think of 5 friends off the top of my head like this and I live in a small community. So while you feel the natural childbirth 'community' online may be bogus, there are natural birth communities IN REAL LIFE that (to me) do not represent what's online.
"If a mom ends up with a cesarean section it is because she didn't trust herself or her baby enough. She is made to feel inferior. That is just wrong."
I agree... to a certain extent. We should be advocates and supporter of one another. For sure. NO ONES feelings should be discounted. Usually if a mother was 'made' to feel that way it was already there somewhere. That's why it's so touchy. If she feels that way from something online then there is a deep underlying regret/hurt somewhere. She needs so seek actual support and counseling. Not go online to find it. She may feel regretful, out of control, scared, sad, or guilty with how things went but usually when a mother says to me that "so and so made her feel inferior" I just know that it means she is sad and hurting and still processing what happened. Every mother feels that way at some point and time whether it's about birth or another issue. It's not that someone "made" us feel that way, it's just that it's a natural way to deal with things when they may not have gone how we expected.
I have so much more going on in my mind that I want to express, but am not that eloquent with it. It's scary and interesting to me to see you make this shift. But at the same time I think we are all on the same page. The bottom line is that a woman can choose what she wants that is her right and her BIG responsibility. It's also clear that the current US maternity care system does not practice evidence based medicine and hasn't for a long time. There needs to be changes across the board.
I have to bow out now as I am leaving town to head back home and then I start school with my kids. I will check back when I can....
This is how I felt for a long time, but haven't really been able to put it into words.
Great post, def following you for more updates!
-Courtney @ http://mybrowneyedgirl.blogspot.com
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