Women’s Space

The Midwives Alliance of North America (MANA) Statement of Values and Ethics, a historic document of the women’s movement which cites to radical feminists/lesbian separatists Mary Daly, Sonia Johnson and Sarah Lucia Hoaglund, sets forth the rights of pregnant and birthing mothers as follows:

I. Woman as an Individual with Unique Value and Worth:

A. We value women and their creative, life-affirming and life-giving powers which find expressions in a diversity of ways.
B. We value a woman’s right to make choices regarding all aspects of her life.

II. Mother and Baby as Whole:

A. We value the oneness of the pregnant mother and her unborn child - an inseparable and interdependent whole.
B. We value the birth experience as a rite of passage; the sentient and sensitive nature of the newborn; and the right of each baby to be born in a caring and loving manner, without separation from mother and family.
C. We value the integrity of a woman’s body to be totally supported in their efforts to achieve a natural, spontaneous vaginal birth.
D. We value the breastfeeding relationship as the ideal way of nourishing and nurturing the newborn.

III. The Nature of Birth:

A. We value the essential mystery of birth.
B. We value pregnancy and birth as natural processes that technology will never supplant.
C. We value the integrity of life’s experiences; the physical, emotional, mental, psychological and spiritual components of a process are inseparable.
D. We value pregnancy and birth as personal, intimate, internal, sexual and social events to be shared in the environment and with the attendants a woman chooses.
E. We value the learning experiences of life and birth.
F. We value pregnancy and birth as processes which have lifelong impact on a woman’s self esteem, her health, her ability to nurture, and her personal growth.

IV. The Art of Midwifery:

A. We value our right to practice the art of midwifery. We value our work as an ancient vocation of women which has existed as long as humans have lived on earth.
B. We value expertise which incorporates academic knowledge, clinical skill, intuitive judgment and spiritual awareness.
C. We value all forms of midwifery education and acknowledge the ongoing wisdom of apprenticeship as the original model for training midwives.
D. We value the all of nurturing the intrinsic normalcy of birth and recognize that each woman and baby have parameters of well-being unique unto themselves.
E. We value the empowerment of women in all aspects of life and particularly as that strength is realized during pregnancy, birth and thereafter. We value the art of encouraging the open expression of that strength so women can birth unhindered and confident in their abilities and in our support.
F. We value skills which support a complicated pregnancy or birth to move toward a sate of greater well-being or to be brought to the most healing conclusion possible. We value the art of letting go.
G. We value the acceptance of death as a possible outcome of birth. We value our focus as supporting life rather than avoiding death.
H. We value standing for what we believe in the face of social and political oppression.

V. Woman as mother:

A. We value a mother’s intuitive knowledge of herself and her baby before, during and after birth.
B. We value a woman’s innate ability to nurture her pregnancy and birth her baby; the power and beauty of her body as it grows and the awesome strength summoned in labor.
C. We value the mother as the only direct care provider for her unborn child.
D. We value supporting women in a non-judgmental way, whatever their state of physical, emotional, social or spiritual health. We value the broadening of available resources whenever possible so that the desired goals of health, happiness and personal growth are realized according to their needs and perceptions.
E. We value the right of each woman to choose a care giver appropriate to her needs and compatible with her belief systems.
F. We value pregnancy and birth as rites of passage integral to a woman’s evolution into mothering.
G. We value the potential of partners, family and community to support women in all aspects of birth and mothering.

The entire document is worth reading.  Since the earliest days  of the women’s movement, women have been fighting for our right to birth our babies in our own way.  For as long a time, patriarchal, allopathic medicine has attempted, in every conceivable way, to assert, establish and maintain control over our bodies and our lives.  It has consistently attempted, often successfully, to establish policies and procedures, rules and regulations, which forbid home birth, birth with midwives, and unassisted birth.  It has attempted, often successfully, to lobby for legislation which would prevent insurance companies from paying for midwife-attended home birth.  It has bullied, ostracized, slandered and harassed M.D.s who have stood in support of home birth, midwifery and the rights of birthing women to determine how and where we will give birth.   It has supported and endorsed the criminalizing of motherhood, has reported women to law enforcement agencies because they refused c-sections, resulting in women being arrested for “murder”, and has supported arresting pregnant women because they have or are suspected of having drug problems.

And they are at it again.

Via Mothering Magazine, though Jeyoani first spotted the news on the Feminist Peace Network:

Ricki Lake Defends Women’s Right to Choose Homebirth

The Business of Being Born (BOBB) is causing a stir in the medical community. The American College of Obstetricians and Gynecologists (ACOG) is so concerned about Ricki’s message that they plan to introduce a resolution to the American Medical Association (AMA) to create legislation in support of hospital births, suggesting that they are the only safe place for a woman to give birth.

As the BOBB team explains in a recent press release, Medical News Today recently reported that “about 8.2% of infants born in the US in 2005 had low birth weights, the highest percentage since 1968.” American infant mortality rates continue to be high enough to put us in 30th place in the world. Twenty-two percent of pregnancies are induced, and in only four years, the maternal mortality rate has risen above 10 per 100,000. “To us,” say the BOBB team, “these seem like the troubling trends, not homebirth.”

It appears that the BOBB Team has become a threat to the multibillion-dollar birth business, so much so that medical associations are willing to disregard women’s voices and compromise their rights to choose where they give birth.

Above is the trailer for Ricki Lake’s “Business of Being Born,” the movie that has ACOG up in arms.  If you are unfamiliar with the issues around the Big Business that is pregnancy and birth in the U.S., it is well worth watching, both the Youtube clip and the movie itself.

This is an outrage!  Despite the comparative affluence of the United States and its state-of-the-art medical schools and hospitals, our infant mortality rate compares with Croatia, Lithuania and Taiwan and, at 28th among nations ranked, is far behind other industrialized nations such as Sweden, France, Japan and Germany.  The reasons offered for this abysmal state of affairs include a rise in premature births and premature deliveries.  And why this “rise?  By and large because of doctors’  coercive interventions and surgical procedures to include untimely and unnecessary induction of labor and c-sections.

I am a home birthing mother.  I delivered my first home-birthed baby in my own bed in 1989, the next in 1991, the next in the back seat of our car in 1995,  and the last in the peace and calm of my own bed in the country in 1998.  Doctors would never have agreed that I was a good candidate for home birth when I first decided to birth at home. For one thing, my first home birth was my 8th birth, making me a “grande multipara” and supposedly “high risk” for that reason alone.  Some doctors would have found me to be high risk because of my age, if not in 1987, when I had my first home birth at 35, certainly in 1998, when I bore my 11th child at age 46.  But I knew I was healthy, my midwives knew I was healthy, I had never had difficulties birthing and my births were spectacularly successful and wonderful, including the one that took place in the car.

Lisa over at Home Birth:  A Midwife Mutiny, who is a midwife, recently did a really great analysis of a study of infant deaths in hospital versus home births in the United States.  Here are some of her findings:

Home Births

Medical Attendant	Deaths	Births	(*1) Deaths per 1K	(*2) Deaths per 1K
Certified Nurse Midwife (CNM)	14	18,151	-	0.77
Doctor of Medicine (MD)	16	4,929	-	3.25
Doctor of Osteopathy (DO)	3	1,022	-	2.94
Other	58	14,348	4.04	4.04
Other Midwife	33	25,427	1.3	1.3
Unknown	5	660	-	7.58
Total	129	64,537	2	2

Hospital Births

Medical Attendant	Deaths	Births	(*1) Deaths per 1K	(*2) Deaths per 1K
Certified Nurse Midwife (CNM)	266	547,371	0.49	0.49
Doctor of Medicine (MD)	5,493	6,103,677	0.90	0.90
Doctor of Osteopathy (DO)	283	316,010	0.90	0.90
Other	14	19,134	-	0.73
Other Midwife	3	8,023	-	0.37
Unknown	9	13,197	-	0.68
Total	6,067	7,007,412	0.87	0.87

What follows is what is of most interest.  It is an analysis of the cause of the deaths in the hospital vs. the home:

ICD-10 Codes	Hospital		Home
	No	%	No	%
A00-B99 (Certain infectious and parasitic diseases)	40	0.7	0	0.0
C00-D48 (Neoplasms)	24	0.4	0	0.0
D50-D89 (Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism)	15	0.2	0	0.0
E00-E88 (Endocrine, nutritional and metabolic diseases)	67	1.1	0	0.0
G00-G98 (Diseases of the nervous system)	68	1.1	0	0.0
I00-I99 (Diseases of the circulatory system)	149	2.5	1	0.8
J00-J98 (Diseases of the respiratory system)	31	0.5	2	1.6
K00-K92 (Diseases of the digestive system)	63	1.0	2	1.6
L00-L98 (Diseases of the skin and subcutaneous tissue)	2	0.0	0	0.0
M00-M99 (Diseases of the musculoskeletal system and connective tissue)	5	0.1	0	0.0
N00-N98 (Diseases of the genitourinary system)	14	0.2	1	0.8
P00-P96 (Certain conditions originating in the perinatal period)	1675	27.6	46	35.7
Q00-Q99 (Congenital malformations, deformations and chromosomal abnormalities)	3144	51.8	44	34.1
R00-R99 (Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified)	570	9.4	9	7.0
V01-Y89 (External causes of morbidity and mortality)	199	3.3	23	17.8
Total	6067	100	129	100

Lisa says:  “The most notable figure here is the “V01-Y89 (External Causes)” category for homebirths, which is essentially deaths from assault (drowning, suffocation, etc). It makes up a shocking 18% of all homebirth deaths. Certainly worthy of closer examination don’t you think?

When we reveal the Medical Attendant for these births we discover that 15 of the 23 were in the “Other” category – freebirth. I think it’s reasonable to assume that these were unwanted children from an unplanned pregnancy. Hardly a valid reason to conclude that homebirth is dangerous for wanted children from a planned pregnancy.

If we adjust for this anomaly, the “% of deaths” in all the other categories will slightly increase and we get a disparity in the “P00-P96” category. Ahh, this is where all those risky breech births and other notorious homebirth disasters are hiding. You’re going to be disappointed again. 15 of the 46 deaths are attributed to (Birth asphyxia, unspecified). We can probably conclude that this is a result of the Medical Attendant (if there was one) failing to have equipment or the knowledge of how to use it. The remainder are a mix of reasons, similar to those at a hospital, but not one prominent example of dangerous practice. All the same let’s take a quick look at who we can pin the blame on”:

Medical Attendant	Deaths	Births
Certified Nurse Midwife (CNM)	5	18151
Doctor of Medicine (MD)	10	4929
Doctor of Osteopathy (DO)	1	1022
Other	17	14348
Other Midwife	11	25427
Unknown or not stated	2	660
Total	46	64537

Lisa: “Oh dear, not what you were expecting? As you can see, it’s the usual culprits!

“Finally, take a look back at some of the other causes of neonatal deaths. The biggest single cause is congenital abnormalities. These do not make birth risky or dangerous, it is simply how nature works and unless we want doctors and geneticists playing god, we have to accept them. Some people are born with particularly strong hearts and muscles that make them powerful athletes, whilst others are born with hearts so weak that they cannot even support life. Abnormalities are both a curse and a blessing, but it is how nature helps us adapt and improve.”

Lisa makes these additional excellent points:

As has been shown many times before, and is supported by countries like the UK, it is just as safe for a woman with a normal pregnancy to birth with a qualified midwife at home as it is to birth in a hospital. It is also worth remembering the many benefits of a homebirth versus a hospital birth that do not form part of the preceding statistics.

• You won’t get your baby stolen or mixed up with another.
• You or your baby will not be exposed to the many dangerous pathogens that exists in a hospital environment.
• You won’t receive unnecessary major surgery and subsequently suffer from possibly fatal and non-fatal complications.
• You retain control and are not obliged or encouraged to comply with hospital policy such as immunisation/injections that may have health implications further down the track.

One thing she doesn’t mention as a safety factor for home birthing mothers:  they won’t be raped or sexually assaulted by obstetricians!

You know, not so long ago, preservation and defense of woman-centered home birth and of midwives were important to feminists, including radical feminists.  It’s stunning how effective the backlash has been in erasing this particular chapter of the feminist movement, with the result that feminists regularly defend the intrusions and invasions of patriarchal medicine, many of them forced on the bodies of women or accepted by women because they have not been educated or informed as to the risks, dangers, and especially, the alternatives.  I will post updates and will let everyone know if there are specific actions we can take as ACOG launches this newest attack on women.  

MANA
Black Midwives
Sheila Kitzinger
Ina May Gaskin and the Farm Midwives

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