Judging Right and Wrong?

Great changes are happening to midwifery and women's birth choices in Australia. The government has passed legislation that on the one hand gives more autonomy and a wider scope of practice to midwives working in the public health system and on the other hand, restricts the services able to be offered by midwives in private practice. More women will be able to have their babies at home as more public hospital homebirth services are being offered. However women will have less ability to choose their own midwife. In accessing publicly funded services, women will have to, in the main, take 'pot luck' with their midwives. Women who have 'criteria' also known as risk factors will be denied a choice of birth venue, even though many of the risk factors are poor predictors of outcomes. With good midwifery care, these women birth  well.

I have had an email from someone recently who is absolutely distraught because her local hospital staff are bullying her into having another caesarean. The maddening thing is that the woman has given birth normally both before and after the caesarean birth. The hospital where the woman lives has a 'once a caesarean always a caesarean' policy and does not take into account the individual and her circumstances . The woman is unable to pay a private midwife and any other options are non existent.

Just yesterday, a woman who was booked to have a homebirth with a publicly funded service, was explaining to some midwifery students how she found out that her allocated midwife was off when she went into labour. She rang the phone number and got a midwife on the other end who she felt was not the least bit interested in her. The woman told the students how uncomfortable she felt and how she had to ring someone in charge and get another midwife allocated to care for her. She was finally allocated two midwives she felt good with. Once that arrangement was settled, she was able to focus on her baby and her labour. She went on to have a her baby at home.

I've found the various perspectives on the current changes polarised and distressing for many people. I can understand the distress. Change is always challenging. Many people feel we are losing too much. I believe that we have to stay focused on what we want and how we want maternity services to be. Focusing on the problem only adds energy to the problem. Looking clearly at what is going on and then choosing our path and taking action is a much better way.

I truly want everything - I want women led maternity services.  I want women and their babies to be safe and given the care they want so that their physiology works well and their safety is optimised. I want publicly funded birthing services, including venue of choice to be freely available.  I want midwives in private practice able to work to the full scope of their practice. I want 'no fault' compensation for women and their families when babies have problems as they occasionally do regardless of birth venue.  I want women, midwives and doctors to work together and with other health care providers as needed for any particular woman's circumstances.  I believe we can achieve these changes.

Imagine my delight when I found this email newsletter in my inbox from a wonderful man, Charlie Badenhop, this evening talking about right and wrong. Charlie is a fourth degree black belt and certified instructor of Aikido in Japan, and a certified trainer in NLP and Ericksonian Hypnosis. He is also a long term practitioner of various forms of bodywork, Self-relations therapy, the Japanese healing arts of sei tai and seiki jutsu, and Yoga.

I have found Charlie well worth listening to as he always has something interesting and appropriate to say. As I read the newsletter, I thought how pertinent Charlie's writing is to our circumstances. I wrote to Charlie and asked if I could share the newsletter. He readily agreed and to my surprise, told me that at one stage he had thought about becoming a midwife but ended up in Japan instead.

Enjoy!  If you like what Charlie has to say, you can subscribe to his newsletters down the bottom of the blog post.

"Pure Heart, Simple Mind"(tm) is the Seishindo newsletter written and edited by Charlie Badenhop (c).

Punishment, and the concept of "right or wrong"

"A lot of the best learning I received as an Aikido student came when we were outside of the dojo with sensei. We could be having a cup of coffee, or occasionally having a drink, and at some point it would become clear sensei had a message to deliver.

Once we were sitting in a coffee shop waiting for a train in the countryside.
Seemingly out of nowhere, sensei said, "I think there are many people in the world who act in a confrontational manner, and thus I wish more people understood the Aikido principle of non-dissension."

"Instead of spending so much time and so many human lives quarreling over who is right and who is wrong, I think the world would be a better place if we spent more time exploring how both sides are both right and wrong."


Myself, and the other two students sat there and said very little, knowing sensei was just beginning to get warmed up.

"You see," sensei said, "In Aikido we learn to refrain from engaging in confrontation, but that does not mean we shy away from protecting ourselves. It always intrigues me when new students attend a class and ask, ‘How can Aikido really be a martial art if you don't attack or retaliate against your opponents.' By this time the three of you have heard my reply many times over. In Aikido we have no attack form because we have no desire or intention to harm our adversaries. Instead we strive to bring hostilities to a conclusion that is respectful of all involved."

"If my opponent has never harmed me, never struck me, never hurt me, then why would I want to hurt or punish him? Do I want to punish him simply because he has thought about hurting me, or because he has made a weak effort that was easily rebuffed? You see, even in a court of law, you can't charge someone with murder simply because they thought about murdering someone. Attempted murder and actual murder are two very different crimes. When I am relaxed, aware, and fully present in the moment, then my adversary will have little opportunity to successfully attack me. Since he hasn't hurt me, since he hasn't truly threatened me, I have little desire to punish him in any way. His own thoughts, and the negative results he achieves in the world will be punishment enough."

"Related to punishing someone, is the idea of someone or something being either right or wrong. In Aikido, we learn to refrain from believing one path, or one way of thinking, is inherently superior to another. We also learn to refrain from engaging in thinking that any one point of view is the opposite of others."

"When we think in terms of opposites and disagree with someone else's opinion, we begin to oppose the other person's point of view. And this is exactly the kind of thinking that leads to resisting, combat, antagonism, and an overall disrespect for our perceived adversary."

"In Aikido, we do not attack, but we also do not concede or give up. In every day life the same can be true. Without attacking the viewpoint of others, without conceding or giving up our own viewpoint, we can still maintain ourselves, and continue to act in a way that is consistent with our beliefs."

"Keep that in mind," sensei said as he looked across the table. "More than once I've heard you arguing with other students, trying to prove your viewpoint was more correct than theirs. When you act like that, not only will you fail to convince them that you are right, and they are wrong, you'll also wind up losing them as friends and allies."

"Pure Heart, Simple Mind"(tm) is the Seishindo newsletter written and edited by Charlie Badenhop (c). All rights reserved. Click if you would like to subscribe.

Distracted parenting: Hang up and see your baby - The Boston Globe

Claudia Gold, a paediatrician in Great Barrington, wrote in the Boston Globe today:

"RECENTLY I was on vacation sitting by a pool. I noticed a father with his infant daughter who looked to be about 3 months old. Perched on a table in her car seat, she sat kicking and smiling. Her father faced her, but was talking on his cellphone. He distractedly shook the rattle hanging in front of her as he spoke in an animated way with the person on the other end of the line"

Her article continues to talk about how the baby develops her/his sense of self by the way the mother looks at her/him and interacts on a moment to moment basis. Dr Gold cautions that parents are perhaps not aware of the critical importance of the first few months and the vital importance of attending to and engaging with the baby to optimise the way the brain develops and the infant forms her/his sense of self. Fathers are taking more and more of the primary caretaking role of newborns and infants. A recent article in the New York Times outlined the way that social norms are changing as fathers become more engaged in parenting. Gold discusses the role of oxytocin in the way that mothers are preoccupied with their babies. Perhaps males are disadvantaged in this biological aspect? As feminists in the 70's, one of our catch cries was that 'biology is not destiny' but perhaps we were and are wrong not to pay attention to biological factors and instead of seeing these physiological realities as 'biological determinism' we could reframe the way that hormones and other communication molecules behave as 'biological intelligence'.

Mothers behaviour and orientation to their babies displays what D.W. Winnicott called 'primary maternal preoccupation'. Mothers are meant to be fixated on their babies, attending to their facial expressions; responding and reacting to them. In the past, women were told that babies are such 'time wasters'; that sitting staring at a baby was of no value, however, neuroscience has proven the value of primary maternal preoccupation and those hours of staring, awestruck at the wonder of one's own baby. From the beginning, a baby's brain wires itself, connecting and associating neurons to other neurons in response to environmental cues and emotional experiences. These neuronal associations form patterns of connection that from the earliest days form a mental map for security, enabling an infant to feel safe (or not) in the presence of her/his primary care giver. This primary relationship sets the stage for the child's future relationships and how the child perceives the world. As an infant feels more and more secure in her/his attachment to her/his primary care giver, she/he is able to then turn outward to the world and start engaging with the people and events in his/her wider environment. In those early days, the mother's face provides a mirror which allows the infant to see him/herself and form a sense of self that reflects that image. When mothers are fully engaged, smiling, encouraging, reflecting joy in being, the infant emerges emotionally resilient. Research has shown that mothers with flat affect produce withdrawn, less communicative infants.

Walking through any postnatal unit or going to any home where a new mother and baby reside, you see the ubiquitous cell phone in residence, either next to the woman's ear or being pounded by her flashing finger tips as she dashes off messages to cyberspace. Is it possible that primary maternal preoccupation has, in many instances, been diverted to the cell phone. What message and brain patterning do you think the little ones are getting? What do you think Mary Ainsworth and John Bowlby would make of this phenomenon?

Life, birth and death: The horror of poverty

This video from Time, on Maternal Mortality in Sierra Leone, the story of Mamma - one woman's journey from pregnancy to death is a heart wrenching portrayal of what is happening to too many women in
impoverished circumstances.

The Time photo montage shows a photo of young woman with a glazed, far away look on her face, intravenous therapy in her hand, lying on a trolley bed, a baby on a chair beside her.  The photo's caption says:

"Birthing Room
Forced to marry at age 14, Mamma Sessay first gave birth when she was 15. Three years later, at the age of 18, she gave birth to the first of a pair of twins near her village, but when the contractions ceased for the second child, she traveled by canoe and ambulance to the Magburaka Government Hospital, where she waits, in the photo above, to deliver".

Read more at Time Photos: Maternal Mortality in Sierra Leone

The video of Mamma Sessay's life and death experience is recorded and reproduced here:

Video: Maternal Mortality in Sierra Leone

Poverty and the associated lack of clean water, sanitation, good food, contraception, respect for women, education, family planning, antenatal care, being married too young, having babies too early - the list goes on and on, is the real problem. The other real problem is social apathy and feelings of helplessness about women's lot in disadvantaged situations. Labour and birth are peak and demanding activities. Women do best when they are well nourished, well hydrated, informed, have good midwifery care during pregnancy, labour and postnatal period, are having babies when they want to, have been well prepared for labour and birth, are able to labour and birth with loved ones around and able to access good medical care if and when required.

The article in Time, called The perils of pregnancy is horrific, but the emphasis is wrong. The emphasis should be on the perils of poverty.


Why are our governments spending our hard earned tax dollars on war for oil, when we could spend our money on making life better for our brothers and sisters across the world. With a different way of looking at world affairs we could save the lives of women like Mamma.

There are some good signs. According to Dr Margaret Chan, Director-General of the World Health Organisation, in her opening address on behalf of eight organizations at the Women Deliver 2010 Ministers Forum Washington, DC, USA  on the 7th June 2010

"Domestic resources and donor funds are making a real difference to the lives of millions. The number of children dying before reaching their fifth birthday has been falling for several years. We are now seeing early signs of progress in reducing the number of women dying in pregnancy and child birth, in addition to the achievements in HIV, TB and malaria".

and added

"This progress is most welcome, but is fragile, uneven, inequitable and inadequate. Far too many women and children continue to die needlessly"

calling for a world wide, coordinated effort and finances, including:

"government leadership of inclusive partnerships at country and global levels to design, implement and monitor the commitments and promises of all stakeholders".

Letter writing and political activism required. 

What do you think?

Safe Bed Sharing

This montage is beautifully done by Kathleen Kendall Tackett, also known as Uppity Science Chick
Kathleen has written books on breastfeeding, Postnatal depression, and inviting serenity into your home.

The photos in the montage are delightful, soft, heartwarming. Wouldn't you love to have been one of these babies?  Good to see the Dads in the photos as well as the Mothers.   The messsage is clear and powerful. Well done Kathleen.  Please give Kathleen feedback, she would like to know what you think about this mini video.

Make an on-line slideshow at www.OneTrueMedia.com

Further to the 'ritual nick' - Effective Intactivism

I've been reading more about the circumcision debate and happened upon a couple of very good blog posts on a site called Peaceful Parenting in my net travels.

The following quote was from a post was about the purpose of the prepuce . The article is well worth reading as it contains a thorough and thought provoking run down on the astonishing functions of that little bit of 'useless' and 'unnecessary' skin on a penis. The prepuce is rightly defined as an organ by two human sexuality experts. A full description of the myriad purposes of the prepuce are on the Peaceful Parenting blog post, but the following information really stood out for me

"A circumcised male, or his partner, for that matter, can never know the intimacy of the normal penis and the ability of the foreskin to open and glide up and down the shaft. An entire dimension of sexuality has been lost to both the male and his sexual partner"... Intact males can be more tender, gentle, relaxed, and loving during sex because the slightest and subtlest gesture or motion evokes deeply satisfying sensations. Circumcised males have to work harder just to feel sensations. This is an unhealthy situation for both the male and his partner".

I know that female circumcision is popular amongst some groups because cutting out her clitoris diminishes a woman's enjoyment of the sexual act, not to mention any sexual feelings and therefore functions to keep women 'faithful' - and under control! I don't think that as a culture, we truly understand the way that male circumcision interferes with male sexuality to the degree that it does. Circumcised men often laugh when that suggestion is made, because sex is just fine for them. The reality is of course, that they don't know what they haven't got. If circumcised males have to work harder, thrust harder and for longer just to feel sensations and get that level of stimulation required to orgasm because the sensory nerves on the head of their penis have been traumatised AND they lack the sensory nerves of the prepuce, that level of activity would be normal for them. The leap to thinking about what that level of activity actually means for their partners is then an easy one to make. Our cultural practice of male circumcision is actually blunting the sexual pleasure of couples, not just the head of the penis's feelings.

Coupled with that reality, the fact that circumcision leads to trauma and even death for some boys is explored in another post by Peaceful Parenting's Danelle Frisbe.

Intactivism is gaining ground as social media takes up the case for keeping both girls and boys intact. The latest post on Peaceful Parenting is excellent, explaining why we need to focus on solutions and in this case it is keeping children safe by keeping them intact. Aubrey Taylor a social activist, explains that negative emotions are understandable when we really think about what circumcision means and how human rights are being violated by the practice. However, people don't respond to negativity and anger - such reaction tends to invoke resistence and opposition.  Aubrey talks about Effective Intactivism which involves getting our language and feelings 'right' and coming with clear vision of how we want the situation to be.

Effective Intactivism involves education, compassion, love, persistence and patience.

Power and Agency in Childbirth: Women’s relationships with obstetricians.

Trust, Power and Agency in Childbirth: Women’s relationships with obstetricians.

This great article by Monica Campo, a feminist sociologist and scholar, needs to be shared. Monica is doing her PhD at La Trobe University, in Victoria, and this article is part of her work for her PhD. The article is published online at Outskirts: Feminism along the Edge. Monica explains the content of this article this way:

"This paper has a twofold argument: that women participating in this study enter into a relationship of trust with their obstetrician based both on their class positioning and their belief and entrenchment within the hegemonic biomedical model of birth; and that their confidence and trust in their own ability to birth without medical expertise is subtly eroded in the medical encounter as well as through cultural fears surrounding birth. I use this evidence to make a wider claim regarding the limits of choice and agency within the obstetric encounter. Women in medical systems of maternity care are not ‘passive dupes’ of obstetric hegemony but their autonomy is nonetheless constrained by their relationship with their obstetrician and an increasing normalisation of medical birth".

The Ritual Nick

What's the ritual nick?   A ceremonial pinprick or 'nick' in a young girl's clitoris.

Female circumcision otherwise known as female genital mutilation, has been illegal in the US and other countries, including Australia for some time. 'Intactivists' have been positioning male circumcision as male genital mutilation and campaigning to make male circumcision illegal too. In Dakar, on the west coast of the African continent, lawmakers from 27 African countries, together with envoys from the African Union and United Nations came together in early May 2010 to create a resolution which clearly bans female genital mutilation as a violation of human rights.

"The African Union's envoy Yetunda Teriba stressed that the West had a role to play in combating genital mutilations".

Just as the African nations are moving to ban the practice of FGM, the American Academy of Paediatricians recently  suggested a 'ritual nick' may be a good idea for girls from other countries to stop them being taken overseas for more severe forms of 'cutting'. What a confusing message to send!  That suggestion created a wave of criticism and caused the backdown of the AAP on this idea.


And now the clever country is getting in on the act. Our Australian doctors are considering this as a way  of dealing with female genital mutilation! What are RANZCOG thinking?  Obviously they are not thinking.

The 'ritual nick' is being called a 'modified' form of genital mutilation. Now that's a perfect example of a 'minifism' '

'Minifisms' is a word coined by Lawler (1991) describing behaviours which minimise the significance or severity of problems.

and get this:

"But experts are divided on whether to allow the practice, given that in some cultures it is used to remove the sexual feelings of women".

I'm speechless with that remark. I'd love to know which experts and experts on what exactly? 

Intactivists have considered the 'ritual nick' suggestion as a way to defuse and take attention from the growing call to have male circumcision made illegal.

This link is to the Intactivists page, where you will find recent media on the AAP moves and counter moves on 'the ritual nick'.


Marilyn Milos, a long time campaigner for the ending of circumcision said

"Circumcision is where sex and violence meet for the first time."

What do you think of that statement?

and finally, I refer you to Jeannine Parvati Baker's piece quoting Marilyn Milo's comment.

http://birthpsychology.com/violence/baker.html

What are your thoughts on all of this?


Reference:
Lawler, J. (1991). Behind the screens: Nursing, somology and the problem of the body. United Kingdom:
Churchill Livingstone

BBC News - Post-natal depression in fathers 'often undiagnosed'

Modern day pressures on men have escalated in the last couple of decades as men seek to find relevance in a world that is rapidly changing their role in society and the family.

At last researchers are turning their attention to men's experiences of birth and early parenting. Researchers from the Eastern Virginia Medical School team looked at 43 studies involving 28,004 parents from 16 different countries. The countries included the UK and the US. In a news item in the BBC news, the researchers were quoted as saying:

"One in 10 new fathers may have the baby blues, US researchers believe - based on their trawl of medical literature. While this rate is lower than in new mothers, it is more than currently recognised, they told the Journal of the American Medical Association. Lack of sleep and new responsibilities, or supporting a wife with post-natal depression can be triggers, they say".

Childbearing and early parenting are stressful experiences.  New roles, new experiences and general unfamiliarity with babies provide a catalogue of changes that both women and men are having to deal with and integrate. A new reality for many along with smaller family sizes and the nuclear family phenomenon is that a vast majority of young parents have never even held a baby before they hold their own. Many men are inadequately prepared for being present at the birth of their baby and parenting.

BBC News Article

Midwives have a real role in including fathers-to-be in their work with childbearing women. Many men feel left out and sidelined during antenatal visits and during the birth process. Feedback from women on their experiences of midwifery student follow through often contain comments about how the student included their partner. The women always say how grateful they are that their partner was included and made to feel important by the student. The fact that the women feel a need to comment on this aspect of the student's involvement in their childbearing experience indicates to me that partners are not generally included in the care given by midwives and doctors.

Midwives and other health professionals have to recognise that childbearing is an emotional experience for men too. Working with women across the continuum of childbearing is enhanced when their partners are included in the woman centred focus of the midwife. Respect, kindness, inclusion and relationship building are core attributes of midwifery practice and set the foundation for women's feelings of being well cared for and valued during their experience of maternity care. Engaging fathers in the same way obviously has implications for how men emerge from their experience of maternity care too.

John Heron (born 1928) , a wonderful man who pioneered a participatory research method called cooperative inquiry, provided (for me) the first clear understanding about the importance of emotions in human interactions and wellbeing. John Heron identified three core emotional needs:

1. To love and be loved
2. To choose and be chosen
3. To understand and be understood

Heron said when these core emotional needs were not met, people develop defense mechanisms. Defense mechanisms are often counter productive to optimal relationships; optimal interactions on both cellular and social levels and overall mental and physical health and wellbeing.

If midwives and other health practitioners make a clear goal to ensure the emotional needs of women and their partners are met in their work with them through the childbearing year and beyond, many of the ills that plague new parents may be 'headed off at the pass'.

BBC News - Post-natal depression in fathers 'often undiagnosed'

Why midwives and women have to stay upbeat about birth: The wisdom of herds: How social mood moves the world - 19 May 2010 - New Scientist

In the latest New Scientist (19th May 2010), an article by John Casti, Senior Research Scholar and a futurist (castiwien@cs.com) based at the International Institute for Applied Systems Analysis in Laxenburg, Austria who is developing early-warning indicators for extreme events in society, informs us that

"No collective human activities or actions, such as globalisation or, for that matter, trends in popular culture such as fashions in films, books or haute couture, can be understood without recognising that it is how a group or population sees the future that shapes events. Feelings, not rational calculations, are what matter. To see what our world might be like tomorrow, next year or next decade, we need to spend time and money investigating "social mood". Put simply, the mood of a group - an institution, state, continent or even the world - is how that group, as a group, feels about the future".

How would we, as a group of people who care about what happens to women and babies during the childbearing year, be described as feeling about the future?

Are we optimistic or pessimistic? "

According to John Casti, how we feel and how we see the future, does much to create it. In the Selfish Gene, British scientist, Richard Dawkins coined the word 'meme' as a concept to enable discussion about these collective social, cultural moods/orientations and behaviours as evolutionary principles in explaining the spread of ideas and cultural phenomena.

What's our meme? What do we want it to be?

Casti's essay is based on his new book Mood Matters: From rising skirt lengths to the collapse of world powers.

The wisdom of herds: How social mood moves the world - 19 May 2010 - New Scientist

Where's the Placenta in Birth Films?

The placenta is an ignored organ in birth films. 


The following film is beautiful, but the cord is cut early and there is no placenta! I can't help but wonder why.



The way the woman gives birth so calmly and consciously in this video is a delight.  I love the way the tank enables the family, the midwife and the doctor to see what is happening without interfering or interrupting the woman's 'flow'. I also love the way the woman uses her hands to birth her baby's head and how she engages with the baby when the baby's head is born.  This woman was obviously well prepared for the birth of her baby.

BUT - where is the placenta???

The birth of the placenta is missing from most videos.  The fact that the placenta is missing from birth videos sends the wrong and incomplete message about birth.  Giving birth to the placenta is the third stage of labour. The third and fourth stage of labour, during which time the woman adjusts psychologically, physiologically and spiritually to the birth of the baby, are vitally important parts of the birth process. This period is a 'peak experience' time; one where women get surges of the 'love' hormone oxytocin if the environmental conditions are optimal. These surges in oxytocin are essential for optimal psychophysiological functioning for bonding with the baby, contraction of the woman's uterus, haemostasis and the initiation of lactation. 

The placenta is an awesome organ and needs to be given due respect and acknowledgment for the mighty role it plays in the beginning of life.

Many cultures have the Tree of Life symbol which is said to be a metaphor for the placenta; artworks across millenia demonstrate this potent recognition of the placenta's role in the life of a fetus and baby.  Not only is the symbolism missing in modern life, even the placenta itself is written out of the mainstream artform - that of videos.

Ignoring or dismissing the placenta comes at a cost.  Women don't know they have a placenta to birth; if they do know, they don't know the magnificence of it. What that means is they think birth is over when the baby is born. Unfortunately, thinking birth is over sends the wrong message to the neural networks and hormonal system.  Safe birth requires conscious engagement in the process.

A key lesson of modern neuroscience is that a change in the focus of our attention changes our brain firing patterns and changes the neurochemicals associated with the firing pattern. The practical application of this lesson is that our physiology responds to our thinking. The thought that birth is over when a woman doesn't realise that the birth of the placenta requires attention, especially when the feeling of relief is profound and/or the woman is disturbed/distracted from her baby and birth process can result in a blocking of the release of oxytocin.  A drop in the level of oxytocin can  predispose the woman to excessive blood loss because her uterus doesn't get the chemical messages it needs to contract well and seal off the placental site. The attentional network that I suggest is optimal in birthing the placenta and keeping safe in third and fourth stage of labour is the attentional neural network associated with fascination. When a woman is fascinated with her baby, she is safe and her physiology works as it ought. Disrupting, distracting or in any other way interrupting the fascinating network bodes trouble. Midwives have a duty of care to ensure the birth environment is conducive to women's fascination with their babies being enhanced and potentiated; a key aspect of midwifery guardianship. .

I've written a theoretical paper, with my colleague, Professor of Midwifery, Dr Kathleen Fahy,  on midwifery guardianship in the third stage of labour. You can access the abstract here. 

We also conducted a cohort study which showed that women who had active management of third stage were 7-8 times more likely to experience excessive blood loss in third and fourth stages of labour than women who were well prepared and, together with their families and midwives, had a mindful approach to the birth of the placenta.

The answer is: let's talk up the placenta, make sure women know that third and fourth stages are an integral and important part of labour and include the birth of the placenta as an integral part of any film about birth.
 
On this Mother's Day,  the recognition that knowledge is power and education about the placenta is lifesaving and helping women to stay safe in childbirth is a good thing to think about!

What you don't say can hurt you!

The vital importance of speaking up and saying how you feel to your health and wellbeing is demonstrated in a post by this young woman, Fiona Hollis.

You can visit Fiona’s website and read more about her journey here: http://www.iloveraw.co.uk/

The post was part of an email newsletter I found in my in-box this morning from The Raw Divas, one of my favourite health and wellness sites.

The Raw Divas are entertaining and informative and I always enjoy their take on life and food. Their articles are often enlightening and I have fun with their recipes. Their approach suits my interests and understanding because my move to a vegetarian way of life, as a result of being employed as a nurse in an abattoir in the early 70's, has lead to an increasing interest in the power of food, especially raw food, to function as medicine for all sorts of ailments.


Fiona writes:

"My name is Fiona, and I wanted to share with you how raw greens have helped transform my health. January was my one year anniversary of healthy thyroid function. Woohooo!

In December 2008, I was diagnosed with hyperthyroidism. To my horror, I was told by my GP that surgery would probably be needed to remove 3/4 of my thyroid gland, leaving me dependent on medication for the rest of my life. This didn’t feel like a road I wanted to go down at all".

Having a baby had been life transforming for Fiona. Her birthing experience caused her to think differently about life and health. Fiona now believes that:

"... all illness or dis-ease is caused by energy blockages within our bodies where emotions get trapped and repressed. I have not always thought this way - but since having my son my eyes have opened to the magical possibilities that are open to us if we dare to believe and see for ourselves"

She explained her belief that our bodies are able to heal themselves when they are working properly and how she:

"... knew deep down the goiter in my neck was blocked expression - clearly affecting my throat chakra. There was a key issue that had been bubbling to the surface of my mind for the last few months and the fear of expressing it to those around me was too great. I denied the need to confront it. The ‘thing’ I least wanted to say - had now backed me into a corner and was testing how much I was willing to stay in denial.

I now had no choice - and I could feel it in every painful cell. The emotions surrounding this admission were HUGE. The waves of shame, self-hatred, and despair I experienced as I spoke my truth was clearly what I had been avoiding. The day after I spoke my truth my goiter went down & I started my healing - and believe me it was the biggest thing that’s ever happened to me".

According to Fiona, her remarkable healing and overnight reduction in her goitre occurred when she 'spoke her truth' and dealt with difficulties that she had been suppressing.

Fiona's experience resonates with what happens for childbearing women having one to one midwifery care. Anyone who observes the results of one to one midwifery care for childbearing women will find that among that cohort of women, more births are normal, more women and babies are well and breastfeeding successfully, there are less occasions of preterm labour and birth, pre-eclampsia and gestational diabetes compared to what happens for women who access the standard, run of the mill maternity 'care'.   

Midwives who work in a genuine continuity, one to one, relationship based model of care provide a safe place and develop a relationship of trust with the woman within which the pregnant woman can feel heard and respected and able to discuss concerns, fears and troubles. Putting words to troublesome feelings enables emotional release. The role of unrelieved and unexpressed stress on inflammatory processes and the involvement of inflammatory processes in the aetiology of disease is becoming more widely recognised.

As stress is expressed and released, health and wellbeing go up.

Awareness is so crucial to living a full, healthy and happy life. The importance of paying attention and acknowledging how you feel cannot be overemphasised. Midwives have a real role in supporting women to become aware of and express their feelings. Asking 'how are you today' in a meaningful way and waiting for a genuine answer, being present and acknowledging any discomfort for the woman, enables her to feel heard and cared about - the ultimate stress reduction exercise.

Not saying how you feel, as Fiona's experience demonstrates, can be toxic to the bodymind.

Another important point to note in Fiona's remarkable story is that she also embraced a nutritional approach to improving her health and used raw food to suppress thyroxine release.

Happy International Midwives Day!

Happy International Midwives Day! 

All over the world, midwives and women, their partners and anyone who cares about how women are cared for during childbirth,  are celebrating midwifery today, the International Day of the Midwife. 


The 24 Hour Virtual International Day of the Midwife is an online event aimed at bringing midwives together from all over the world. The event is being facilitated by Sarah Stewart and Deborah Davis. For more info: click this link here

Remember to come and enjoy the different sessions. You can find the program here. 


A gallery of photos of Global mothers, midwives and nurses can be found here

Talking about the importance of baby's birth experiences at the Mother of all rallies, PH Canberra 2009

I happened upon this video when I was searching for some information on Google! What a rally that was. I was interviewed at the rally for the upcoming film 'Face of Birth' and this is the result of that interview:



There are other snippets of the film in the making on the site.

Carolyn Hastie - Mother of all rallies, PH Canberra 2009

The Cardiotocograph test: Absurd at best?

When I did my midwifery training in the 70's, the Cardiff Infusion pump was used to induce labour. The women were placed flat on their backs and monitored with a cardiotocograph machine. The cardiotocograph machine recorded an approximation of the fetal heart rate with an ultrasound transducer. There was also a capacity to record the uterine activity, but the uterine activity was actually monitored by the Cardiff pump machine. Women had their amniotic sac membrane broken with an instrument called a amnihook. A thin plastic tube with a pressure monitoring device was inserted into the woman's uterus through the cervix and into the sac next to the baby. The pressure monitoring device was hooked up to a machine called a Cardiff pump. The pump also provided a syntocinon (a synthetic hormone designed to induce labour) infusion into the woman's blood stream via a cannula in a vein in her arm. The rate of the infusion was set according to the pressure of the uterine contractions. The theory was that the rate of infusion of syntocinon would be governed to deliver the right amount of uterine stimulating drug and no more.

Of course there were problems with that process!

The Cardiff infusion pump has been phased out because of all the problems, but the cardiotocograph lives on, despite evidence that it is not reliable, overly useful, accurate nor does it enable women freedom of movement, known to provide the best opportunity to birth well and have optimal oxygenation of the woman and her baby.

The cardiotocograph machine has become the constant in the standard birth room and has taken the place of the midwife in the role of being 'with woman'.

An insightful honest account of the uselessness of cardiotocograph monitoring of labouring women is provided in the link below.

Test leads to needless C-sections | Philadelphia Inquirer | 04/26/2010

What's known is that the rampant use of cardiotocographs has increased the caesarean section rate with no benefit.

Dr Alex Friedman, a Fellow of Maternal-Fetal Medicine at the Hospital of the University of Pennsylvania said: 

"A 2006 analysis by the British Cochrane Collaboration, evaluating all available research, found that fetal heart monitoring failed to reduce perinatal mortality - the risk of a baby's dying late in pregnancy, during birth, or shortly after birth - and increased cesarean section rates and forceps deliveries, compared with listening to a baby's heart rate intermittently".

Steven Clark and Gary Hankins, two prominent obstetricians said

"A test leading to an unnecessary major abdominal operation in more than 99.5 percent of cases should be regarded by the medical community as absurd at best," they wrote in the American Journal of Obstetrics and Gynecology. "Electronic fetal heart rate monitoring has probably done more harm than good."

and The Doctors' Channel has an excellent video explaining that C-Sections, necessary or not increase maternal morbidity and mortality.

So why are they still done so mindlessly?

The answer is best summed up by this comment:

"Why do doctors cling to continuous fetal heart monitoring? An obstetrician will most likely point to the fear of being sued, but the complete answer is more complex. Our medical culture prizes technology and tests, even if they don't work and can cause harm".

Breastfeeding helps build healthy bones

Nutrition is a key ingredient in health and wellness for every individual. Even before conception, the mother's nutritional state influences her baby's genetic and physical makeup, plus long term health and wellbeing.

Osteoporosis is a crippling and painful disease that afflicts some people as they age.

A wide variety of high impact exercise during the teenage years plus good nutrition including calcium and Vitamin D is known to set in place stable bone mass and provide a healthy bone structure for life. Weight bearing and resistance exercise, including netball, basketball, tennis, swimming and sprinting in the teenage years, means reduced risk of osteoporosis in the later years. Peak bone mass for girls is laid down by 16 years of age for girls and 20 years of age for young men.

Telegraph.co.uk

A new study by Stahl and colleagues have found that calcium intake in the neonatal period may be critical for life long bone health.

Stahl et al took two groups of newborn piglets and fed one group calcium enriched diet and the other group were fed calcium deficient diet during their first 18 days of life. The piglets were subjected to frequent blood sampling and daily weighing. At the end of the study, samples were collected from the bone marrows, livers, kidneys and small intestines of the animals. The strength and bone density of their hind legs was also tested.

Calcium deficient piglets were compromised in their bone density and strength. Many of the mesenchymal stem cells that eventually become bone forming cells were found to have been programmed to become fat cells. Reduced numbers of bone forming osteoblasts in early life means a reduced ability to repair and grow bones throughout life. The researchers conclude that lack of calcium in the neonatal period leads to programmed mesenchymal stem cells, predisposing the individual to having bones that are less mineralised and contain more fat. In this way, Stahl suggests, osteoporosis can be seen as a paediatric disease with later onset, rather than a disease of old age.

Irrespective of what I think about this study on piglets, who are very intelligent and sensitively aware animals, I was intrigued that Stahl and his colleagues didn't also add a control group of breastfed piglets to the study. Breastmilk, also known as 'white blood' because of its alive, blood like nature and inability to be manufactured, is known to contain bio-available calcium amongst the nutrient mix. I would have thought to include breastfeeding and breastmilk to have been a foundational, sensible thing for a scientific endeavor aiming to find a reason and a cure for disease.

However, I found the following written in the article:

Stahl and his colleagues have a long-standing interest in understanding how much calcium babies need in order to optimize bone density and strength when they get older. Not only is this a worthy academic question, but it has special relevance to the infant food industry which currently fortifies most baby formulas with calcium at levels substantially above those found in breastmilk - considered the "gold standard" for infant nutrition. This differential level of fortification has been based largely on older studies suggesting that breastmilk's calcium is substantially more usable than that in baby formulas. However, more recent research has challenged this dogma, and Dr. Stahl and his group are committed to helping determine what is best in this regard.

I italicized and bolded the words in the quoted text above.

You will notice several things about this quoted piece.

1. The infant food industry would seem to be behind this study from what is written above. No wonder that a breastfeeding control group was not included!
2. the words 'gold standard' are in inverted commas leading the reader to subliminally appraise the term negatively
3. The word 'dogma' is used to degrade the idea that breastmilk is the gold standard for infant nutrition.
4. Dr Stahl and his group are committed to helping determine what is best in this regard! Yet Dr Stahl does not include breastmilk in his study!!!

I know this study was about pigs, but I smell a rat!

Who pays Dr Stahl and who funded this research???

No matter what Stahl's objective or who funded the research, the study is actually useful for promoting breastfeeding as it shows how important good calcium intake is in early life and breastmilk provides that along with all the baby needs for optimal nutrition. Now we know breastfeeding protects the individual from osteoporosis and builds bones that can last a lifetime with the right input of exercise and good nutrition in adolescence.  Thank you Dr Stahl and colleagues.



Study suggests a much earlier onset for bone problems

Flu vaccination ban goes national after fever, convulsions in children

More than 60 children around WA have had adverse reactions to the flu vaccine, Fluvax. This vaccine contains three different flu components, including swine flu. If a child has already been exposed to swine flu, experts suggest that some children may be reacting badly to receiving a second exposure. Reactions have included febrile convulsions leaving one child in a critical condition. Doctors have been advised by the department of health to stop giving the vaccine to children under five years of age.

Photo from WA News 23rd April 2010

The official response to the adverse reactions has been remarkably slow.

Chris Thompson reported in WA News that

"WA's chief public health officer Tarun Weeramanthri has defended the response time in closing down the state's juvenile flu vaccine program amid revelations that children were presenting with convulsions more than two weeks ago".

The ABC said on Friday, 23rd April, 2010, that authorities in SA and Queensland have also acknowledged a number of adverse reactions to the vaccine in young children. The AMA have agreed with the ban on Fluvax to young children, however they caution parents not to lose confidence in immunisation.

In the ABC news story on Friday, Professor Peter Collignon, from the Australian National University, whose expertise is in infectious diseases, voiced concern about wide scale vaccination with Fluvax. Professory Collignon doesn't think that we have enough data to roll out a population wide vaccination program because it might cause more harm that good.

I'm wondering if the delayed reaction to the widespread reaction to the Fluvax is the result of an inability to truly perceive what was happening because the phenomenon is so outside the belief system that has been created about vaccination.

While the authorities claim they were monitoring the situation, the reality appears otherwise. They appear to have been rationalising.

The pro- vaccination lobby has been virulent in the way that open debate and discussion about the value of vaccination has been squashed until now. Dissent has been forbidden, thought patterns about vaccination have been dictated. I was told at an immunisation nurses' update session to leave the room if I didn't agree with newborn babies being given Hep B immunisation. I was seeking honest, open discussion and information. I was told "you have to believe!!" in very strong tones. Well, I don't agree to 'just believe' I want to keep my thinking open, curious and able to critique events if and when they occur.

The cult like behaviour that accompanies the pro-vaccination stance reminds me of fundamentalism.

Fundamentalism in any context is dangerous. Slavish following of 'science' is no different to slavish following of 'religion'. Slavishness removes the ability to discern, debate and think clearly.

The delayed response to the childrens' vaccine reactions can be seen as a symptom of a fundamentalist, non thinking bio-behavioural state.

The Term Breech Trial and Catholic Priests paedophilia are both examples of slavishness; also recognised as cult like behaviour - (no independent thinking encouraged or allowed) with dreadful sequelae that continues to reverberate.

Programming the future

My friend came back from England yesterday.  I picked up her daughter in the early hours and we drove to the airport together to meet her mum. Her daughter is in year 12. Studying is her major activity. The sunrise was stunning. Intensely pink and orange light filled the sky over Sydney as we made our way towards the airport. We chatted about her studies and what she hoped to do in the future. I was impressed with her clarity and vision.

Next week, as part of her family and children studies, all her group are being given a 'baby' to take home. The students all have to pretend it is a real baby and do all the things that mothers do when they have a new baby.  As many new mothers have never even held  a baby until they give birth to their own, this initiative is an effective way to help address that deficit in embodied knowledge.

I asked about feeding the baby. "oh, I have to give it a bottle and make up the formula" was the answer.

The conversation that followed explored the damaging message that this very creative and innovative exercise was unwittingly sending about how babies are fed.

The well intentioned, but ill advised, baby care education promotes bottle feeding as 'normal'. Young girls get that message early, for example, when given a baby doll complete with bottle as a gift for their birthday or Christmas. Have you noticed how those dolls all have bottles?

I went to the NSW Department of Education's website and looked up the curriculum for the "Exploring Early Childhood" program. 

The syllabus is very comprehensive.

Infant feeding, including a thorough section on breastfeeding is there, but no mention about how these subjects are taught. The practical application of knowledge to behaviour by providing a baby model for each student to take care of and feed is excellent. However, teachers need to ensure that students are able to 'breastfeed' the 'baby' as a matter of course.

Then young adults will get the right message: that breastfeeding is 'normal'.

As we pulled into the airport car park, my friend's daughter said she was grateful for the conversation, because she 'hadn't thought of it like that'. 

Neither would she.

Why would she? 

People don't know something until they know there is something to know!  When all society's clues and subliminal messages point to bottle feeding as 'normal', for a counter truth to have traction, you need other experiences or input, perhaps from a breastfeeding aunt, friend, neighbour or mother to enable you to think differently to the crowd, to be able to challenge the 'status quo'.

 La Leche Materna

After the event is a terrible time to learn the truth about what you can do to give your baby the optimal start in life. 

Birth Control Drugs: Female Sexual Castration?

When I opened my inbox this morning, I found an email from Gail J. Dahl discussing birth control drugs and the way they act to sexually castrate women. This information is food for thought and something every woman should think about when she is considering her fertility and contraception. I decided when I was very young and the 'pill' was new that I was not interested in taking it. Other methods such as I used to manage my fertility are outlined at the end of Gail's explanation. I also chose to embrace the 'croning' and changes that come with menopause as the idea of HRT does not and did not appeal to me.  Reading Gail's words have made me glad that I did listen to my inner self on this one! 

Gail J. Dahl is a childbirth researcher, award winning and national bestselling author. She is the founder and Executive Director of the Canadian Childbirth Association. Dahl has received many awards, including  "The YWCA Woman of Distinction Award", "The Woman of Vision Award" and "The Great Women of the 21st Century Award" for her contributions toward women's health and education.  

Gail has written two great books  Pregnancy & Childbirth Secrets and Pregnancy and Childbirth Tips

Her websites are:

http://web.mac.com/pregnancysecrets

http://www.youtube.com/gaildahl
 

 Here is Gail's email to me, reproduced with her permission.

Secrets - Female Sexual Castration - Birth Control Drugs

Shortly after our last e-newsletter on the health dangers of the newest birth control pills, I had the opportunity to speak at length with Jody McLaughlin, who has now logged in over thirty years in the birth industry. It was wonderful to hear of her observations of women over the past thirty years. In our conversation, Judy called the birth control pill, "female castration", and she said it was causing a generation of our young women to be dumbed down intellectually, emotionally and sexually. I agree, this is exactly what is happening to our young women.

Since we began taking the birth control pill, we no longer have young women protesting or advocating for change. University rallies rarely last for more than a few hours. Colleges and universities know that they can easily double tuition fees and have little backlash to deal with. Wars, started and never ended because women have lost their ability to speak up, or so few are willing to. Chemical castration causes one to lose their drive and ambition in life, something that has been known for centuries. 

The pill did not provide women with freedom, instead it has muffled us and stripped us of our female sexuality and sensuality. Stealing the best out of us, our drive and ambition. I believe the pill has become a prison for the modern young woman. All doors out of this chemical prison are locked or just lead more deeply within, each room providing different formats of the same female castrating drugs.

Some our young men are complaining that today's young women have nothing to say past gossip, display little ambition, they are difficult to arouse and quite frankly, boring in bed. That is how a young woman would behave after her sex drive was chemically removed. And because the pill takes away our keen sense of scent, women are choosing the wrong partners when they are on birth control and realize this too late, once they stop the pill and their ability to smell increases. The young women then complain that now their guy smells different. Liking the scent of your partner, sweaty or clean, is what draws us sexually to our partners.  Young women are also losing their drive and ambition just at the moment that they need everything at their command to complete their higher education and begin their new career.

Taking the pill at a too young age, before the age of 25, can leave a legacy of infertility in later years. Undiscovered sexually transmitted diseases along with too early and long term use of chemical birth control is the foundation of the tremendous rise in infertility we are seeing in our North American society today. Young women taking some of the new birth control dugs are finding their period goes away and either doesn't come back for years or perhaps not at all, stealing their fertility and their future. 

Additional physical complaints from chemical birth control include depression, mood swings, frequent headaches, bloating, lack of energy, weight gain, lung clots, pancreatitis, risk of heart attacks, strokes, pulmonary embolism, deep vein thrombosis, gallbladder complications and other life-threatening health problems. Don't believe that today's birth control pills are "safer" than they were when we were growing up, they are much, much more dangerous today. Does a bright young woman you know exhibit feelings of hopeless, lack of energy, depression, lack of desire to get ahead, cloudy thinking and mood swings? Is she mostly "down" instead of "up"? These are the young women also at risk for numerous addictions used in order to attempt to chemically feel better. 

Looking back I can see that I started the pill at a too young age. At that time you were on the pill whether you were actually having sex or not. If there was any sexual activity it was certainly sporadic and rarely occurred more than a few times a year. I was continually going on and off the pill and having my prescription changed to another drug due to the multitude of side effects I was experiencing. I finally gave up using all chemical birth control and began to study my personal fertility cycle and and use barrier methods during fertility only. This difference in my ability to move forward in my career and my ability to get things done increased tremendously after I stopped taking the pill. Depression lifted and life just began to look differently allowing me to take great strides forward in my life. 

Still chemical birth control free and have been since the birth of my daughter. Now, I can see what was happening to me in my twenties and why. I much prefer my sexuality intact and will not be doing anything to stop my cycles. I am happy to have my cycle to the very, very, last, last day. I recently spoke with a sexual health expert and now I understand the importance of my cycles for maintaining my optimum health as a woman. This expert had forecast long before the tremendous damage that could occur when a woman's cycle is stopped or altered chemically. 

Our daughters should not be graduating school without completing a program in Science or Health on tracking her own personal fertility cycle. The recent book, "Cycle Savvy" and "Taking Charge of Your Fertility" by Toni Weschler are excellent guides for young women for understanding their own personal body cycle and fertility pattern. Every young woman of the age of fourteen was given this book as a gift in Chicago a few years ago, what a wonderful gift to receive, free control of your fertility for the balance of their life. 

Whether you are in the public or private school system, take a moment today or tomorrow and ask your school district if they will add a Fertility Planning module to the Sexual Health programing in your area. This only takes a short email to the Superintendent of your local school system. Ask them to add Fertility Awareness Programming to their Grade 9 Science or Health Classes.  Sometimes a suggestion is all that is needed to get the ball rolling. Pick up the telephone or click on the internet and send a quick email to the leader of the school system for your city. Our young women will not have any alternatives unless we teach them. This just takes a few minutes and could have tremendously positive results for the young women in your city or town, wherever you are.  I just wrote in myself to the head of our school system in my city. It took approximately 4 minutes to locate the top boss, write a one paragraph letter and attach the following recent article and email it. If ten women happened to write in at the same time, with the same suggestion, I would imagine the school system would need to pay attention. 

The pharmaceutical companies and the physicians are not presenting birth control with the correct statistics and side effects. The statistics for birth control are skewed, only showing the stats from using the product correctly which they state, most don't. The chemicals are providing no more than a 50/50 proposition of working, the side effects are not clearly noted. No mention is made of the sexual castration leading to a woman's suppressed sexual desire, decreased drive, decreased ambition, decreased mood and energy, increased weight gain, along with the real and serious life threatening possibilities of physical damage to her body. 

I understand that mom's have enough to worry about today with young daughters, but it is really worth it to take away your daughter's drive, ambition and ability to choose a partner at the most critical time of her life, for the sake of "peace of mind"?

Many thanks to everyone who sends in their comments and thanks also to those who let me know they passed this important article along to a daughter, granddaughter, friend, family member or physician. We need to think of better alternatives to pass on to our daughters to ensure the generational line continues in our own families and that our daughter's are in optimal health.  Best wishes, Gail J. Dahl

Your Fertility Awareness and Charting References:

"Cycle Savvy" by Toni Weschler:  http://cyclesavvy.com/

"Taking Charge of Your Fertility" by Toni Weschler : http://www.tcoyf.com/

"The Garden of Fertility" by Katie Singer : http://www.gardenoffertility.com/

"Justisse Fertility Awareness for Women":  http://www.justisse.com/default.htm

Free Online Guidebook at:  "Justisse Fertility Awareness"  http://www.justisse.com/eBook/

Free Fertility Charts at: http://www.gardenoffertility.com/fertilitycharts.shtml

Each one of these authors has created an excellent website to go along with their books and all have great free information. It only takes a few hours to learn how to work the fertility system and a few minutes daily to track your own personal fertility pattern. Some women track their ovulation and use it to schedule important business meetings and projects. 

Ovulation is a high energy and highly creative time for all women. An excellent time to write a song, paint and do some innovative thinking about life. Tracking the ebb and flow of your body's cycle can also assist you in monitoring your personal health throughout your years of fertility.  A free and drug-free way to have full control of your fertility throughout your life. Best, G

Need More Convincing on the Castration Part?

The birth control drugs being sold to your daughters, relatives and female friends is the same drug used for male sexual castration. This drug creates the same personal devastating effects such as of loss of sexual desire, loss of drive and ambition, deep depression, excessive weight gain, emotional turmoil, sexual confusion, isolating behavior and other serious mental, emotional and physical side effects. These drugs are usually reserved for sexual deviants and transexuals.  I was unaware of the depth of damage chemical birth control can do to women. I had an idea from watching what the drugs did to my own body, I am amazed now at how the effects are so all encompassing with the potential for devastating results. The type of drug used for male chemical castration is the foundation for the new types of birth control sold under the names of Yaz, Yazmin and the birth control shot Depo-Provera, any chemical that attempts to stop, re-program or delay a woman's cycle. All chemical birth control has the potential to have the same castrating effect on a woman as it does on men

Midwifery Legislation Update from Maternity Coalition

Update from Maternity Coalition about Health Care Legislation.

The Senate passed the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 on Tuesday 16 March. This legislation should give Australian women greater access to affordable, continuity of care with a known midwife.

It marks the beginning of a new era of maternity care for Australia’s maternity consumers. It is a huge achievement; and thanks to the work of generations of women and to you.

In recent months, much of our focus in the birth community has been on the aspects of the maternity reforms we are unhappy with including the collaborative arrangement and the threat to births at home. But we should remember that this legislation is a giant step forward in the right direction to woman-centred maternity care.

What this means

We don’t know how it will all work in practice yet as Health Minister Roxon still needs to make decisions on a number of things including definitions for ‘eligible midwife’ and ‘collaborative arrangement’ and details around Medicare and prescribing are still not finalised.

But what we do know is that:
• Consumers, from November 2010, will be able to choose (in theory) their own midwife for their pregnancy, birth care in a hospital and post-natal care. How intrapartum care in hospital will work still needs to be sorted with visiting/admitting rights. This care will be more affordable as they can get Medicare rebates for it. This has the potential of increasing the numbers of Australian women who can access continuity of care with a known midwife from less than 5% to a New Zealand figure of around 80% or higher.
• Midwives will have access to
o Medical Benefits Scheme
o Pharmaceutical Benefits Scheme
o Professional Indemnity Insurance (excluding birth at home) and the Government will also pay any insurance claims that exceed $1 million. Note: The need for a collaborative arrangement to be in place before a midwife could access this indemnity was dropped in the Bills.

What MC is doing?
MC is working hard. We have:
• representatives at all working groups of the Department of Health and Ageing involved in implementing these reforms.
• given evidence at two Senate enquiries.
• attended consultations and made submissions to provide the consumer perspective on maternity issues.
• engaged in strategic conversations with other stakeholders.

MC and a range of midwifery and nursing organisations have agreed on a consensus for collaborative arrangements and took this proposal to the Minister’s office. We’re feeling optimistic about this. Senator Joe Ludwig (ALP) clearly stated in the Senate it was not the Government’s intention in the legislation to give one professional group control over another. We need to keep the Government accountable to this.

What about homebirth?
There is nothing in the Bills for homebirth – the Bills neither support nor outlaw homebirth. However Health Minister Roxon has made it clear that she intends women to be able to continue to access midwifery care for homebirths. To hear it straight from the Minister, see this video:
http://www.youtube.com/watch?v=iK_Vt18eq0s

MC, along with the Australian College of Midwives, has developed an alternative proposal for the Quality and Safety Framework midwives will need to work to in order to qualify for the two year exemption from professional indemnity insurance. As the whole purpose of this exemption was to secure women’s access to homebirth care, MC expects an outcome which will work.

We have asked that this framework be finalised by 1 April 2010 giving women and midwives 3 months in which to make plans. The final version of the framework will be released in the next few days. Look to the website for a link to it shortly.


MC’s perspective of an ideal outcome for homebirth (in terms of what’s going on at the moment) is that midwives providing homebirth care will be:
• registered as a midwife and able to practice
• exempt from professional indemnity insurance for the first two years of national registration (from July 2010)
• working in much the same way they do now.

Some homebirth midwives might also choose to become an ‘eligible midwife’ with access to MBS and PBS. In which case they will need to have a collaborative arrangement in place so that their clients can receive Medicare rebates for their pregnancy and post-natal care.


What you can do right now?

• The National Health and Medical Research Council has released its draft ‘Guidance on Collaborative Maternity Care’. This is a very important document. They are asking for feedback on this document and want it by Friday 27 April. For more information go here: http://www.nhmrc.gov.au/guidelines/consult/consultations/ngcmc.htm. When you read it, ask yourself how these arrangements would work for you as a consumer. SEND YOUR COMMENTS TO l.metcalfe@tpg.com.au for incorporation into a response to the NHMRC.

• If you haven’t written/visited your Federal MP for awhile, get back in touch and tell him/her that birth and birth care really matter to women and families, and we expect governments to take responsibility for the quality of care and choices available to women [how do you see this yourself?]. Remind them that they need to find a long-term solution for indemnity for midwives providing homebirth by June 2012 and that the clock is ticking.

• Keep up your membership to Maternity Coalition and other consumer and midwifery groups. In numbers we have strength. Without you, we are nothing. To renew your membership with MC and find out when and where the next meeting is close to you, go to our website www.maternitycoalition.org.au



Lisa Metcalfe
President Maternity Coalition
Em: president@maternitycoalition.org.au
Web: www.maternitycoalition.org.au

Optimal Environmental Conditions for Childbearing

The shocking deaths within the last six months of two child brides from the Yemmen ,one from sexual intercourse related haemorrhage five days after her forced marriage and one from childbirth, provide a graphic and tragic illustration of the disastrous circumstances that can accompany female reproductive lives. Their stories are testimony to the difficulties that girls and women face in living their lives in ways that are empowered and valued.

Thinking about these young girls and their lack of choices, driven by culture,  religion, standard of education, political will and misogyny, led me to consider what is the optimal environment for childbearing?

Optimal Environmental Conditions For Childbearing

In an optimal social environment, childbearing women, babies and children are highly valued in ways that are quite tangible. The vital contribution that mothers and babies make to society is recognised as fundamental to the health and wellbeing and indeed the future of society. The needs of mothers and babies needs are at the heart of government policies and social considerations. The society as a whole expects every workplace to be family friendly and therefore it is the norm. To be considered family friendly, a workplace has on-site childcare, flexible working hours and breastfeeding facilities as a matter of course. Breastfeeding is a normal, accepted part of childbearing. Breastfeeding in public is normal and there are easily accessible facilities in every large department store, recreational and public utility for breastfeeding women and their babies. All children are educated at school about child development, contraception, maternity care, pregnancy, birth and breastfeeding. In our optimal social environment, women have true choice about pregnancy. If a woman chooses to stay childless, that is accepted as a valid choice. Women are not pressured in any way by the media or their social network. Women have access to the contraceptive that suits their needs. There is general agreement that no women should have to bear a child that is unwanted. There is an appreciation that an unwanted pregnancy creates unacceptably high levels of suffering for the woman and for the individual who is born unwanted. Women’s self determination is valued and encouraged. Every pregnant woman is in a stable and loving relationship and has at least five people that she knows, love and support her in emotional and in practical ways. 

Every woman who wants to become pregnant is financially secure. She is at her best nutritionally, physically and emotionally with the help of free and easily accessible holistic pre-conceptual health care. A visit to the pre-conceptual health centre is a normal thing to do for a couple planning a pregnancy. At these centres, couples build on their knowledge gained from their school education and learn more about prenatal and infant development. The role of nutrition, stress management and exercise in optimising the prenatal environment for their future pregnancy is explored. A conscious approach to conception, pregnancy, birth and childrearing is treasured. Couples go to courses about relationships and parenting to ensure they are well equipped to provide a loving environment for their own growth and development as partners and parents. Families are encouraged to be supportive of one another as family friendly practices are part of the educational process in schools and work places.

There are women centred health services in neighbourhood centres where pregnant women can access relationship based midwifery care and an integrated perinatal service. The integrated perinatal service includes midwives, doctors, social workers, psychologists, mental health nurses, psychiatrists, dieticians, early childhood nurses and paediatricians. According to the individual woman’s needs, members of the health care service work with the women as an integral part of the team. Women can choose to give birth at these centres or at home. If there is some condition requiring close medical attention and care in labour, the woman can birth at the tertiary referral centre with her midwife and other team members support. 

The woman and her partner are supported by their midwife and a home help person for up to six weeks after their baby is born.

Of course the optimal environment for childbearing that I have described can be seen as a 'pipe dream' a fanciful idea that is unattainable. I suggest that for our species to become all it can be, humanity needs to look seriously at how women and children are treated in this world.  We will only fulfill our potential if we start taking  proper care of women and children and ensuring there is an optimal environment for childbearing.  The plight of young girls in the Yemmen is a blight upon humanity.  However, the Yemmen is not the only place where being female is a liability.

Everyone needs to take responsibility for the position of females in society.  Everyone has to do their bit to improve the social structure. Nothing changes until we change.