I don’t get to go to births much anymore. My midwifery practice closed in July. Our consulting doctors merged with another group and in the merger were forced to stop accepting our referrals and collaborating on VBACs. As a result of that we had to forfeit our hospital privileges. We would have continued offering only home birth services but one of our three midwives left to join another practice with 9-5 hours and we couldn’t recruit another midwife to replace her. As much satisfaction as the work brings, home birth is hard and the pay isn’t great. That’s because insurance reimbursement is a joke. It doesn’t cover things that are fundamental to our work, like home visits for mother-baby check-ups or having a skilled birth assistant present. And if we spend hours supporting a woman in labor, use our well-honed assessment skills to diagnose a complication, and facilitate a timely transfer of care so a baby can be safely delivered? We probably won’t get paid a dime if the doctor performs the delivery.
So it was really nice to come across this video last week. It’s not going to fix any of the problems I just mentioned. But it’s powerful. And important. And I just love it.
It’s about doulas - women whose profession is to support mothers in the work of birthing their children. Woman-to-woman support is such a simple way to make maternity care better, safer, and more satisfying. It’s so clear from these pictures that putting the mother at the center of our work keeps birth healthy and safe. And the statistics tell the rest of the story. Birth is healthier and safer when the mother is supported.
Am I naïve to think that if more people saw images of birth in which the woman is supported and cared for, they might start asking for this kind of care? One popular home birth video on YouTube has had over 3 million views in two years. That’s many, many times the number of people who actually had home births in North America in that time. I can only interpret this to mean that women are yearning to see birth the way it’s meant to be seen. I don’t know how long they can watch it happen on YouTube and compare that with how it happens in most real delivery rooms and tolerate the discrepancy. Could YouTube be the thing that changes birth culture?
I posed a bold question on my Facebook page the other day. (My high school friends probably tire of my birth politics). I said, "It feels like it’s been the week of egregious human rights abuses against childbearing women. Is it in the air? Or is social media just finally exposing the stuff that’s been going on forever?" The consensus was that the internet is catching up with some of the garbage that’s been quietly happening behind hospital curtains. And that there’s plenty more to expose.
Nothing has ever changed in maternity care without women rising up and demanding change. But what’s different today is the astounding pace with which information and stories are being shared and the limitless community women can tap into. I think we may be nearing a tipping point. This could get interesting…
(For more on the evidence basis for continuous support in labor, read Lamaze’s Healthy Birth Practice Paper.)





| November 4th, 2009 at 8:16 am
I am so sorry about your midwifery practice closing. That was one of the many reasons I switched from midwifery to medical school. I didn’t want to have to search for resistant physician back up. If I went to medical school, I could be that back up.
I hope the more people hear about other people’s good experiences and outcomes with supported, physiologically normal labor and delivery. The horror stories about birth seem to have the good press agent. I hope the good stories get more popular.
I laughed when I read the part about your Facebook activism. I wonder sometimes about what people think when I write about birth (or other political topics). But, hey, I’d rather read that from you than what kind of sandwich you had for lunch!
| November 4th, 2009 at 9:52 am
I have been presenting at birth conferences for the last year, saying exactly that. Nothing will change in the birth world unless women themselves step up and demand it, and the best tool they have for seeing what the possibilities are, is social media.