Category Archives: politics

It’s MINE! Shared decision-making and evidence-based practice in childbirth

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This is a brief, but interesting interview with Maureen Corry, MPH, Executive Director of Childbirth Connection on the subject of shared decision making.

Right off the bat, Corry mentions exactly what came to mind for me when I was confronted with the term “shared decision making”. She says,

…we’ve heard some concerns from women that shared decision making means giving up some control of decision making to the care provider – essentially a move away from informed consent and refusal. Because of the history of childbirth in the United States, and many troubling practices that still happen today, childbearing women are justified in being concerned about their rights.

Continue reading →

Why Doula?

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“Do you have any children of your own?”

This is a question that sometimes comes up when I talk about my work, whether I’m talking with a potential client or just chatting with someone at a party. Sometimes, when I respond with, “no, not yet.” and a smile, I’m met with a puzzled look. On a few occasions, the puzzled person has come right out and asked me, “so, why did you become a doula then?”

In honour of International Women’s Day today I thought I’d take a stab at answering that question. Continue reading →

Don’t Believe the Hype

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This article from The Wall Street Journal provides some great historical information that connects meaningfully with my previous post (Home)Birth is Safe.

The author, Nathaniel Johnson notes that,

In 1923, Mary Breckinridge started the Frontier Nursing Service in rural Appalachia….Within a decade, the astonishing impact of that care was apparent. The women the Frontier Nursing Service cared for, who were desperately poor and usually gave birth at home, were 10 times less likely to die in childbirth than the average American at the time. The nation as a whole wouldn’t catch up until the 1950s, after the widespread acceptance of antiseptic and the discovery of antibiotics.

Given that antiseptic practices and the use of antibiotics are available and in use in midwife-attended home births today, it makes sense that, as Sheila Kitzinger has argued, it is not a high level of medicalization that makes birth safer – it is overall health: access to good pre-conception, prenatal and postpartum healthcare, good quality nutrition, access to clean water and access to skilled birth attendants. This has been borne out the world over, regardless of whether women are typically birthing at home or in hospitals. Access to medical interventions for the few women who actually need them is important, which is why midwives are thoroughly trained to detect possible complications before they become problematic and why they only support home births for women who are not at risk. Obstetricians are trained to deal with problems when they arise, but midwives are far more likely to be able to prevent them in the first place. Continue reading →

You Can’t Beat Mother Nature

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I’m always excited to read about good hard science that reveals more about the awesome power of women’s and babies’ bodies. Check out this article about the hundreds of different bacterial microorganisms that have been identified in breast milk through DNA sequencing.

In addition to the further confirmation that a mother’s milk can’t be duplicated in its richness and complexity, this article also lends support for minimizing interventions in labour where possible:

The type of labour also affects the microbiome within the breast milk: that of mothers who underwent a planned caesarean is different and not as rich in microorganisms as that of mothers who had a vaginal birth. However, when the caesarean is unplanned (intrapartum), milk composition is very similar to that of mothers who have a vaginal birth.

These results suggest that the hormonal state of the mother at the time of labour also plays a role: “The lack of signals of physiological stress, as well as hormonal signals specific to labour, could influence the microbial composition and diversity of breast milk,” state the authors.

Our bodies truly are amazing.

Take Action!

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jordyn_contract

Since April 1, 2011, 25 000 babies have been caught by midwives in Ontario. Since then, the midwives of this province have been working without a contract. Today is the Social Media Day of Action. Email the Minister of Health and Long-Term Care, tweet #backtothetable and urge @DebMatthews to restart negotiations with @OntarioMidwives! For more information and ideas on how to make an impact today, visit http://www.ontariomidwives.ca/support/backtothetable

Freedom For Birth – FREE Screening

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On Thursday, September 20th, 2012 there will be hundreds of screenings worldwide of the new documentary Freedom For Birth. Twyla Kowalenko, a local mother and passionate birth advocate and I will be screening the film at the Centre for Social Innovation, Annex at 7pm (more details on location below) as part of the global premiere. Continue reading →

Birth at the Movies!

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I have been absolutely terrible about posting lately – things have been super busy with lots of births, teaching, speaking engagements, event planning and Community Animation at the Centre for Social Innovation. All good things, but I miss having more time to write and share with all of you out there. Hopefully I will have more time soon!

In the meantime…I’m feeling pretty excited about the number of films coming out on the subject of birth these days. I think that the idea of birth as an opportunity for empowerment and birthing rights as a human rights issue are really starting to edge towards the mainstream (have you told someone about doulas today?!) and that these films are a sign of that movement. I thought I’d link to some trailers and things for those of you out there interested in checking out the latest and greatest in birth cinema. Continue reading →

Your Birth Choices: Yours and Yours Alone

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Just finished reading this great post on epidural rates in BC as compared to other provinces. I really like this blogger’s take on the issue, which, in a nutshell, is that as long as the women who want epidurals are able to access them, it doesn’t matter whether you choose a natural childbirth or a medicated one. What does matter (and what people should be concerned about) is that you are supported. It’s so important that women feel informed and respected in their decision-making and I’m saddened by the amount of judgement that flies around whenever any birthing mama states what she has decided to work towards for her birth. Women who choose homebirths are accused of being selfish and ignorant (despite the fact that we know that homebirth is safe or safer for most women in Ontario), women who choose to learn the sex of their baby prenatally are accused of being gender-biased, women who decline ultrasounds are accused of being ignorant “hippies”, women who choose epidurals are accused of being wimps or dupes who bend to the whims of their authoritarian caregivers. Enough! These are all individual, personal choices that different people make for a wide variety of reasons and none of them are anyone’s business but the birthing woman’s and, in some cases, her partner’s (though I would argue that the choice to medicate for pain or not lies solely with the woman in labour).

All the guilt that is heaped on moms for making their choices (and it really does seem like you’re damned if you do and damned if you don’t, doesn’t it?) leads to this bizarre impression that there is a wide gulf between natural birth moms and epidural-choosing moms. Not only is that gulf a complete fiction, but it is a harmful fiction. It leads people to believe things like “only women who want natural births need doulas”, which is just plain crazy. Every birthing woman deserves unconditional, continuous, one-on-one comfort and support; every birthing woman deserves a doula.

Sure, I believe passionately in the power of natural birth – I know that women’s bodies were designed to do this work and that those who wish to experience it should have the right to try without being chastised, mocked or frightened (and that if they are given that right, they are much more likely to succeed). But just because I believe that you can do it, doesn’t mean that I think that you ought to do it. That is the clincher. If you hire me to do be your doula I will make it my top priority to ensure that you are knowledgeable and confident and that you feel supported and cared for in whatever choices you make, even if they bear no resemblance to the choices I would make for myself.

It’s your body, your birth, your baby, your choice.

Related: http://offbeatmama.com/2012/03/doula-at-hospital-birth

It’s OK To Admit You’re Uncomfortable

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This is a great little post on the beauty and benefits of nursing toddlers. Following up on the controversial Time magazine cover, this article provides an excellent overview of why some moms choose to let their babies self-wean, and why we shouldn’t judge them for it. Breastfeeding duration is a personal choice and it’s nobody’s business but your own one way or the other. I hate to think that we may be letting fabricated or sensationalized notions of “mommy wars” get in the way of advocating for real support for real moms who are making individual choices based on what’s best for them, their babies and existing evidence. Ensuring that all women have access to the resources they need in order to make informed decisions and then making sure that they are supported in those decisions (whatever they may be) by their healthcare practitioners, their partners, their families, their employers and their peers is fundamental. You don’t have to approve of everyone else’s choices, it’s ok to admit it when something makes you uncomfortable. Everyone feels that way about something, sooner or later. Just because something makes you feel uncomfortable though, that doesn’t make it wrong, it just makes it wrong for you.

While writing this, I got a little stuck on how I wanted to wrap up. I popped over to another tab to read an interview with Jamie Lynn Grumet, the woman on theTime cover in question, and her final statement expresses exactly what I wanted to say, so I’m going to let her do it for me:

“There seems to be a war going on between conventional parenting and attachment parenting, and that’s what I want to avoid. I want everyone to be encouraging. We’re not on opposing teams. We all need to be encouraging to each other, and I don’t think we’re doing a very good job at that.”

Related: The Real Breastfeeding Scandal