Having a professional lobbyist helping to keep midwifery legal and accessible for home birthing families is essential. Without a lobbyist, midwives run the risk of being legislated out of practice. Midwives do not have the deep pockets that those in the medical establishment have. Please consider a donation to help keep midwifery available for home birthing families. Pledge your donation using the link above today!
Please use this link to Donate to the MMA Lobbyist Fund.
Columbia Area Midwives is pleased to invite you to free screening of the latest home birth documentary movie: “Why Not Home? The Surprising Choices of Doctors and Nurses.”
This is a family friendly event and snacks will be provided.
Thank you to Erica Kroll of Nona Birth Education and Counseling for hosting this event.
Date: November 17th, 2016
Time: 7:00 pm to 9:00pm
Location: Nona Birth Education and Counseling
1204 Rogers St. Columbia, MO 65201
After the film, we will have time for Q & A and discussion.
Why Not Home? tells the stories of doctors, nurses, and midwives who have attended hundreds of hospital births, yet chose to have their children at home. How did these women with inside knowledge of hospital based birth evaluate the evidence and make their decisions? Through the experiences of these women, both at home and in the hospital, we gain unique insights into risk, safety, and the
experience of childbirth in America.
Here is a link to the film’s website: http://www.whynothome.com/
Please share this invitation widely, RSVP on the Why Not Home Facebook event page, and bring a friend!
We look forward to seeing you!
This month's blog post comes from midwife Dawn Finney and can also be viewed at her website Birthroot Midwifery.
Granted, I am biased, but in no particular order, here are five things I think are particularly wonderful about home births and midwifery care.
Supporting women in labor with whatever kind of support they desire
If a woman desires complete silence with no moving around while she is having a contraction, or if she asks me to kneel on her lower back while she is on all fours because she wants that much counter pressure during a contraction—she gets it.
I love adapting and supporting a laboring woman in whatever way she discovers she needs, whether it is hands on, hands off, praying, singing, silence, or verbal encouragement.
Witnessing women being forces of nature
That’s how I describe it. The raw power of labor and birth are simply magnificent. I am in awe of every woman dealing with contraction after contraction in her own unique rhythm as she builds in power to push her baby into the world. Even if things don’t go as expected and we have to transport to hospital, these women have given 150% by this time and handle the change in plans with such strength and stamina. Women are simply amazing.
Birthing positions and places: One size doesn’t fit all!
Standing, sitting on a birth stool, squatting, laying down, side-lying, hands and knees, on the stairs, in the tub, in the bathroom, in the living room, in the bedroom, outside! These are positions and places women have given birth. What will work best for you? I don’t know, let’s find out! Instead of being maneuvered into the typical “sit-on-your-sacrum-feet-in-stirrups” position that is mainly for the doctor’s benefit; at a home birth, a woman is encouraged try out many different positions for second stage. Some positions really do work better than others for bringing a baby down and out so when the woman’s work of birth is supported, rather than a doctor’s convenience, births go more smoothly for mother and baby.
Welcoming babies with care and respect
As the newest member of the human species, making the transition from watery environment to air-breather-land dweller in a matter of mere minutes, a new baby deserves some respect! For a normally adapting baby, the typical routine procedures like suctioning out the airway, immediate cutting of the cord, and separation from the mother quickly after the birth are unnecessary. I love that babies get the loving care that keeps them with their mothers in home births.
Family togetherness and support during the postpartum time
I have witnessed so many wonderful moments of older siblings meeting their newest family member for the first time--the gentle fascination for tiny hands, soft skin, and fuzzy hair! When this happens in the loving familiarity of the home and not the strange environment of the hospital, I believe it helps children adapt better. Because midwives give postpartum care in the home in the days to come, the older children continue to witness and sometimes “help” with these visits. Newborn babies are fascinating and I love answering question children have –most commonly about the newborn’s umbilical stump!
There are many more things I love about midwifery care and home birth, but I will keep to five things for now. What did you love about your midwifery care and/or home birth?
Written by Sarah Davis CPM
Most mothers eventually ask the midwife - “What happens if I have a false alarm? What if I think labor is happening, I call you and you come out, and then my labor goes away?” Nobody wants to be the client who calls her birth team out and then becomes the “watched pot.” The answer to the question about false alarms is simple: if labor quits, mother and baby are doing well, and there isn’t any reason for us to encourage labor (like a broken bag of waters), then we go home!
This scenario happens more frequently than you might think, and it truly doesn’t bother midwives. We would always rather you call if you think you are in labor than wait until it’s too late for us to arrive before the baby. This summer I had several false alarms, one that included a lovely walk with Kim on a not-too-hot afternoon, and a pleasant visit to a bookstore, but my favorite false alarm story happened a number of years ago.
June of 2008 was very, very busy. Some May clients ended up having their babies in June, some July clients did the same, and June had plenty of due dates, too. It was a hot, but otherwise very nice month in the middle of the country - not too humid, and enough rain to keep my garden growing well (which was handy, because I had no time to water it!).
One of my clients, “Mary,” was having her 7th baby. An Amish woman, she lived in a community about 45 minutes away from me, along with the majority of my clients. This was her first homebirth, and she asked several times about when to call me about labor. We talked it through - she had managed to get to the hospital *before* the baby’s arrival 6 times previously, so it was clear that she recognized active labor when it happened, but with at least two of her children, she had arrived at the hospital only to have her contractions stop. In both cases, the OB staff had induced her labor to start up again, as she was already admitted to the hospital, and it would have been a hardship to go back and forth a number of times.
One of the issues that Amish families deal with when staying at a hospital outside of their community is transportation. Most families hire a driver, who is simply an English (non-Amish) person with a vehicle who acts as a taxi, to drive them to places they otherwise couldn’t go. This isn’t a hard thing to set up if you are planning a trip to a regional center for the day - you know ahead of time which day you want to go, you invite your sisters or neighbors to go along, and everybody can get their special shopping and appointments done and split the fare. But if you are in labor and need a ride to the hospital RIGHT NOW, it can be hard to get a driver! Drivers are well aware that sometimes babies come more quickly than expected, perhaps in the 45 minutes between your house and the hospital. And drivers like to schedule trips ahead of time, and your favorite driver might just not be available when your labor begins. These were good reasons for my client to have her labors induced, but there was also the cost of a taxi, which could be $100 or more for each trip back and forth from the hospital.
But Mary didn’t like to be induced, and this was one of the reasons she wanted to have this baby at home. She was also looking forward to having postpartum visits at her house, but she was especially looking forward to not being stuck in a hospital with no contractions.
Mary’s due date was right in the middle of June. The first two weeks of the month were full of other client’s labors and babies, and Mary warmed up for labor, with bouts of mild contractions every couple of days. The night before her due date, her husband called me at 2:30 in the morning.
“Mary says ‘this is it’ - she was awake for a little while before she got me up to call you, and these look like the real thing.” I told Mary’s husband that I was on the way, and dashed off into the night. Driving at night to a birth is always a little bit surreal; I usually have the road to myself, and I am WIDE awake, anticipating a labor and birth. I ate my snack (I always have a snack packed) while I drove, and enjoyed the cool night air coming in the windows.
When I pulled into Mary’s driveway at 3:20, I could see the lamp lit in the living room. Her husband met me at the door, and helped me carry my equipment into the house. I checked Mary’s vitals and listened to her baby’s heartbeat - all normal. I unpacked some equipment and settled into a rocker to observe Mary’s labor. She leaned over the counter in her nightgown, breathing quietly through contractions about 4 minutes apart. Despite the cool night temperatures, her face was a little sweaty. Her labor looked active, and seemed to have progressed since her husband had called me.
I rocked and pretended to read an Amish family periodical while quietly observing. Mary’s husband read a German-language Amish newsletter, dozing in his recliner. Mary walked slowly around the living room and kitchen between contractions, stopping to lean on the counter and breath deeply with every contraction.
Thirty minutes later I listened to Mary’s baby again - he or she sounded fine. I settled back into the rocker and timed a few contractions. Hmmm…6 minutes, then 8 between contractions. Mary went to the bathroom, then settled into her own recliner when she returned. Twelve minutes went by before another contraction, and soon Mary was snoozing along with her husband. My eyes closed, too, and an hour went by. Mary and I opened our eyes at the same time, and she smiled, a little embarrassed.
“Well, I really thought this day was going to start with a baby, but I don’t seem to be having contractions anymore. Dawn will be here soon.”
“This happens pretty frequently,” I assured her, “it’s not a problem at all - why don’t you go to bed and get another hour of sleep? I’ll sleep out here, and if labor hasn’t picked up again by breakfast time, I’ll head home.”
Mary slept from 5-6 a.m. in her own bed. I claimed the couch, and Mary’s husband slept on in the recliner.
At 6 a.m., Mary came out to the living room in her day dress. She told me that she was determined to “be grateful for this day, even if my labor isn’t ready to start.” We discussed the need to call ASAP if labor seemed to kick in again, as she had almost certainly done some dilating overnight, and she was feeling lots of pressure. I listened to the baby one more time, gratefully accepted a cup of coffee and a fried-egg sandwich, and headed off home. The road was just beginning to fill with commuters as I arrived home at 7a.m. I was a little tired, but it was a beautiful day, and my belly was full.
That evening, a different mother called me at 10 p.m. She had her baby at 2 a.m., and I got home at 5 a.m. I slept in until noon. No word from Mary. The afternoon was full of laundry and supper preparation, and my family went to bed early. At 2:30 in the morning, Mary’s husband called me.
“Mary says labor has come back, and it really feels strong. She didn’t want to call, but then she had a couple of hard ones and we both thought you’d better come.” I grabbed my snack and my bags and headed out. The evening was just as pleasant and cool as the first time, and the scene at Mary’s house was just about identical, except that her husband was in the rocker. Mary’s baby’s heart rate was normal, her vitals were normal, and she was having close, strong contractions. I quietly timed a few, and they were 4 minutes apart, and lasting more than one minute. Thirty minutes later when I went to listen to the baby again, contractions were 5, then 6, then 8 minutes apart. Hmmm…
Thirty minutes later Mary was sleeping in her recliner, and I was one the couch. Mary’s husband woke up and headed for his bed.
At 6 a.m., Mary woke up with a start, and gave me a very sheepish look.
“I’m so sorry, I really, really thought that I was far into labor this time. I was even a little afraid that you wouldn’t make it before the baby.”
“I truly don’t mind, Mary - this isn’t that unusual, and you and your baby are doing fine. Just don’t wait to call me the next time labor begins because you’re worried it will go away!”
Mary made me a cup of coffee and a fried egg sandwich and I headed home, arriving at 7 a.m.
That afternoon, another mother began labor, and had her baby at 10 p.m. that evening. I headed home and went immediately to sleep, fully anticipating a call from Mary. I woke the next morning and checked the phone, to make sure I hadn’t missed a call, and I hadn’t.
The day passed with a trip to the library and the grocery store, and choir practice that evening. It was pretty hot, and I was glad for the sun to go down and a breeze to cool off the house.
At 2:30 in the morning, Mary’s husband called me.
“I just hate to call you, after the last two times, but if I didn’t call now, I just don’t know when I would call at all. Mary’s up and about with contractions, and they are strong. She was trying not to wake me up, but she couldn’t stay still in the bed, and now she’s pacing around the kitchen.”
“I’m glad you called,” I replied, “I’ll be on my way.”
The scene was very familiar at Mary’s house Mary and her baby were doing well, labor seemed to be well-established, and Mary was determined to have a baby! She was walking briskly up and down the living room between contractions, and even went up and down the cellar stairs several times to encourage labor progression. Mary’s husband was back to his recliner. But despite all the walking, labor slowed and stopped by 4:30 a.m., just like the previous nights. Mary and I slept until 6, then got up and talked the situation through over a fried-egg sandwich and coffee. Mary was starting to feel frustrated and a little silly - how could these contractions feel so convincing and yet peter out? I asked if she would like a cervical check, or wanted to try any gentle methods to encourage labor to keep going. After some thought, she said that she didn’t. She had hated having her water broken previously, and didn’t think there was any point in checking her cervix if she wasn’t having any contractions anyway. She was sure (and I agreed) that it had done some opening already, but without contractions, she wasn’t going to get very far. As it was my regular prenatal visit day, I did my regular check-up: urinalysis, blood pressure and pulse, listening to the baby’s heartbeat, checking the baby’s position, measuring fundal height, and talking to the mother about everything from swelling to heartburn and digestion. All was well, and Mary’s baby was in a great position: LOA, back on Mary’s left, towards the front of the belly, with head very low in the pelvis (engaged) and central. Baby was moving very well. I headed off for a full day of visiting clients. I arrived back home at suppertime and was glad to get everyone to bed early.
I slept all night - no babies!
The next day, I enjoyed meeting up with other families at the park, and caught up on some yard work. That evening, like clockwork, Mary’s husband called at 2:30 a.m.
“I don’t know what to say, except that it seems to be time.”
“I’m on the way.”
This time was different as Mary’s 2 yr old woke up about the time I arrived. Mary’s husband tried to help her go back to sleep while Mary labored, but by 4 a.m., he needed some help. The little girl was teething and had been sleeping poorly, and really wanted her mom. Mary went in to snuggle her daughter, and when I peeked into the room 30 minutes later, I found them both asleep in the tiny child’s bed.
Being quite familiar with the couch, I got comfortable until the sun came up and my stomach growled for a fried-egg sandwich. Mary was tired and decidedly grouchy (what mother wouldn’t be???). She cried a little.
“I just don’t think I’ll ever have this baby! I know all my other babies came eventually, but I just can’t believe this! It’s ridiculous, and I’m so sorry that you've come here four times now with no baby.”
“I truly don’t mind, Mary, and you and your baby are doing well, so I don’t see that there’s anything we need to do differently unless you’d like to try something to encourage labor.”
“No, I really don’t want to do that. I know if I can be patient this baby will come, I’m just having a really hard time staying patient.”
I left after breakfast, with Mary determined to go about her day. She had decided to invite her elderly neighbor for supper in hopes that it would keep her mind off the lack of labor.
That night, I woke up to a call from Mary’s husband at 3 a.m.
“It’s time, again,” he said dryly.
“I’m on the way.”
I snacked and listened to the radio on the way down, wondering what would happen, and if Mary would change her mind about encouraging labor. At home we don’t use pitocin or other oxytocic medications to induce labor, but we do have some tricks. Of course, they won’t really start labor if labor isn’t pretty close anyway, but a mother having her 7th baby, with lots of contractions softening and opening her cervix, usually isn’t that hard to encourage!
I arrived at 4:20 a.m., noting the light in the living room window. I didn’t see Mary or her husband inside as I struggled with the door, so I quietly let myself in.
“Mary?” I called, quietly.
Mary’s husband stuck his head out of the bathroom door.
“We’re in here! I can’t get her off the toilet!”
This sounded promising! I grabbed gloves, a doppler (for listening to babies in utero), and some towels from the shelf as I dashed into the bathroom, just in time to hear Mary push. I darted over to her, pulling on gloves, and noted her perineum bulging. With the passing of the contraction, I was able to maneuver my doppler under her belly and listen to her baby - he or she was chugging right along.
“I’m definitely having this baby today!” Mary huffed, as she caught her breath. I had to agree.
Two more pushes with the next contraction, and Mary was snuggling her baby daughter in her arms, smiling and crooning to the baby. Mary’s husband was looking a little shocked. As he told me later, Mary’s labor had proceeded in the same way as the other nights, with the difference that Mary wouldn’t let her husband call me until 3 a.m., when he announced that he was calling me no matter what she said. Contractions continued like all the other nights until about 10 minutes before I arrived, when Mary’s water broke while she was sitting on the toilet. With the next contraction, they both knew the baby was very close, and Mary’s husband began to get very, very nervous that I wouldn’t arrive before the baby. When he expressed this to Mary, she let him know that while she would prefer that I get there first, she certainly wasn’t going to try and delay the birth of the baby just because I wasn’t there yet! Luckily, I made it with five minutes to spare.
After Mary delivered her placenta, I walked her back to her bedroom. She nursed her baby in bed and nibbled on some cookies. In between checking on Mary and the new baby, I cleaned up after the birth and charted. Mary’s husband cuddled his wife and baby, and smiled with relief. Eventually, Mary was ready to urinate and take a shower. She was VERY happy to finally put on her postpartum nightgown, which had been waiting for her in her box of birth supplies for weeks. I weighed and measured the new baby and did my normal newborn exam. Mother and baby were both well.
At 6:30 a.m., I packed up my supplies and did a final assessment of mother and baby: both doing just fine, and getting ready for a nap. I headed to the kitchen and made fried-egg sandwiches for everybody. Mary laughed when I brought her her sandwich in bed.
“I thought I would just keep making these for you forever! I do like them for breakfast, but I think I’m going to like this sandwich even better than normal, because I didn’t make it.”
Tips for protecting your baby from environmental toxins during pregnancy
A child’s most critical development occurs while in the womb. This is a time when a mother must take proactive steps against harmful toxins. The first step is being aware of where they exist and how to avoid them. Follow these tips for a healthier
Food and food preparation:
Fish is some of the healthiest food you can eat but it’s important to choose wisely and ALWAYS cook your fish. Avoid King mackerel, Marlin, Shark, Swordfish, Tilefish, Tuna, Striped wild bass, Alewife, Bluefish, Sturgeon or weakfish. Choose fish lower in mercury like Wild salmon, Sardines, Atlantic herring, Dungeness crab, Pacific cod, Tilapia, Catfish, Clams, Mussels, Shrimp and Pacific oysters. Most farm raised fish contains high levels of PCB’s.
Eat organic food as much as possible, especially when choosing foods found to be most contaminated with pesticides: peaches, apples, bell peppers, celery, nectarines, strawberries, cherries, pears, grapes, spinach, lettuce and potatoes. These are known as the dirty dozen.
Remember to carefully wash all fruits and veggies.
Avoid canned foods as much as possible. The lining in cans leaches bisphenol A (BPA) it is an endocrine disruptor that can lead to high blood sugar and hormonal imbalances. There are some organic brands that are BPA-free but you must check the label to be sure.
Choose organic animal products. Chemicals and toxins accumulate in fat tissue, therefore your meat and dairy products are best when labeled organic. Animal fats are part of a healthy pregnancy diet so look for organic products when possible.
Avoid raw meat, fish and milk products, they may contain a bacteria called listeria which is potentially very harmful to you and your baby during pregnancy. Check labels on soft cheeses to make sure it does not contain raw milk.
Check the CDC’s website for complete listeria safety guidelines.
Drink filtered water in glass or stainless steel containers. Have at least 64oz of clean water daily. Your urine should always be clear and very light in color. Water helps flush toxins from the body.
When reheating food in a microwave use glass or ceramic containers in order to avoid leaching plastic into your food.
Avoid non-stick or teflon-coated cookware which may release toxic compounds into food. Choose stainless steel, glass, cast iron or ceramic cookware.
Avoid microwave popcorn. The inside of the bags are coated with toxic chemicals that can leach into the popcorn.
Fast food containers are often lined with teflon chemicals and should be avoided.
Clean with hot soapy water after handling raw meat and eggs. Keep these things cold until ready to use and refrigerate leftovers promptly to avoid food poisoning.
Choose fragrance free personal care products and consider giving up perfumes, nail polish, and hair dye which may contain toxic chemicals which are absorbed through the skin.
Choose cosmetics and personal care products from companies that are committed to safer, non-toxic products.
Avoid antibacterial soaps which over time can lead to germs that are harder to kill. Plain soap and very warm water are effective cleaning agents.
Avoid bug killers, weed killers, and other pesticides in the home and garden. Focus on preventative techniques and learn about non-toxic pest control.
Try green cleaning agents like liquid soap, baking soda and vinegar or look for green brands like seventh generation.
Leave shoes at the front door. Toxic waste travels into your home on the bottom of your shoes.
If you must paint (most families expecting a new baby want to!) consider using low VOC wall paints and opening windows for good ventilation. Consider leaving your home for several days for major painting jobs and all oil based painting projects.
If you live in a home built before 1978 in may contain lead paint. Do not attempt to remove lead paint yourself and avoid old paint chips and the soil around the perimeter of the home which could be contaminated with lead paint dust.
Make sure your older home does not have old lead pipes which could contaminate your water.
Compiled by Kim James, CPM 2016
Perhaps you waited in line for your ticket at the Ragtag showing of "Why Not Home" on Mother's Day only to be turned away, as I was, due to the room being at capacity. We were certainly happy that the film was well attended but felt badly for those of you who were not able to get in. Well! We are happy to announce another free showing coming up soon! Please come to this showing--especially if you missed the first one. Snacks will be provided and there will be time for discussion after the film.
Presented by Mid-Missouri Chapter of Missouri Midwives Association:
"Why Not Home? The Surprising Birth Choices of Doctors and Nurses"
Location: Daniel Boone Regional Library
100 W. Broadway, Columbia Missouri 65203
Room: Friends' Room, First Floor
Date: Tuesday, July 26, 2016
Here is the website for the movie: "Why Not Home?"
Written by Dawn Finney, CPM
When it comes to hospital birth in the USA, we have many wonderful technological advancements that can do a great deal of good when it comes to keeping mothers and babies healthy and safe. After a birth, hospital postpartum care makes sure mothers and babies make normal transitions in this important time, that the needed newborn tests are done, and by the time a swaddled bundle is placed in the mother’s arms as she makes her way to the car to go home, all is well.
However, this is just the beginning of life with a new baby, and the beginning of a mother’s continued healing and adjustment after the momentous act of giving birth. There may be other children at home and a partner that needs to get back to work all too soon.
The new baby gets follow up appointments, of course: well-baby check ups and weigh-ins if necessary. However, mothers are not seen again until the six-week postpartum visit unless there is a problem.
What if that problem was preventable with some post partum visits for the mother? What if there was someone coming to visit the mother and new baby to help with things like breastfeeding, or checking on uterine and perineal healing? What if someone came to her home to ask how she is feeling and offer remedies for postpartum blues? And what if there was someone to assist the new mother to get extra help, community support, or a referral to another care provider so a small problem can get solved before it turns into a bigger one?
Our institutionally-based maternal and newborn health care system does many good things, but postpartum care is not one of them. It leaves mothers to fend for themselves in what is, in American culture, an often isolating experience.
There is a solution, though. Certified Professional Midwives know that birth is really the beginning of everything. Good postpartum care is essential to the healthy continuum of a woman’s childbearing cycle.
What does this look like? Midwives come to the home to comprehensively assess the mother and baby’s well-being at regular visits. Midwives help with breastfeeding as much as needed. Midwives get late-night phone calls from clients asking for help and then go to the home to help. What physician or nurse is going to do that?
You can’t get better or more responsive postpartum care than with a midwife. In a medical system that undervalues this important area of health care, Columbia Area Midwives fills this gap. We are happy to let everyone know that we offer a package of postpartum care services (home visits and much more!) that can be contracted by those who are having hospital births. We also offer postpartum doula services. Please check the Our Services web page for more information. Mothers and babies deserve midwives!
On Mother's Day, Sunday May 8th, Columbia Area Midwives are hosting a free screening of the new documentary movie "Why Not Home? The Surprising Birth Choices of Doctors and Nurses" at 7:00 pm at Ragtag Cinema (10 Hitt Street, Columbia Missouri.)
Why Not Home? tells the stories of doctors, nurses, and midwives who have attended hundreds of hospital births, yet chose to have their children at home. How did these women with inside knowledge of birth evaluate the evidence and make their decisions? Through the experiences of these women, both at home and in the hospital, we gain unique insights into risk, safety, and the experience of childbirth in America.
We will have midwives as well as some local hospital care providers who chose to give birth at home at the screening to briefly share their stories and answer questions during the Q&A after the film.
Click here to View the film's trailer
Cookie Day is scheduled for Tuesday, February 9th, 2016 at the Capitol in Jefferson City, Missouri. It is sponsored by Friends of Missouri Midwives. Please visit the event page for cookie day on Facebook. Scroll down and view the posts--there you will find instructions about how cookie day works, and the when and wheres. You can also order lunch with the group--scroll until you find the post about lunch ordering! Thank you for your support and we hope to see you there.
Cookie Day Event Page
For clients of Columbia Area Midwives who need screening for their newborns, the next date of screening is Oct. 16. There is no cost. Please contact Kim James to reserve your spot.