breech

i've yet to attend a breech birth and after reading Rixa's writings from the conference i am motivated to find some practitioners to work with to train in this skill. 

so much to learn. 

i need to bury my head in oxorn. 

here is a link to her writings on each of the sessions. so indebted to her for this. 

Stand and Deliver: Synopsis of the Heads Up! Breech Birth Conference

my life as a jellyfish

this is me becoming a jellyfish. after birth four of five this thanksgiving. 

i haven't written in so long. not sure why. mostly i've been so exhausted and i guess focused on domestic life when not at clinic or births. also been watching too many programs on my computer. good excuses for baths and scotch and chocolate. 

i haven't counted my births recently. but i was at 18 or so like a month ago since i started here and must be up to 30. who knows. 

i've also been busy trying to figure out my life. we have been busy trying to figure out the next phase of our life. with the bridging programs in limbo we are looking at our options of staying in the US. staying in Washington. what that might look like and how that may be possible. i wish movement of people was as easy and free flowing as goods and ideas. 

one day at a time. 

i am a *student* midwife

panic

this unsettling feeling has been setting in the past few weeks. i haven't really wanted to acknowledge it. but maybe i should just give it a voice and then move on past it.

i'm terrified to be a midwife.

i'm terrified of the responsibility.

the obligation.

not having enough knowledge. not having the answers.

not being able to communicate effectively.

terrified that i don't know where i will practice. i mean. i don't even know what country or continent i will be living in ten months from now. 

terrified that if we do go back to canada that i won't get into the bridging program. that i won't be able to get licensed in canada and all of this was for naught. 

terrified that i won't be a good midwife. 

i think that i  am getting too comfortable in the role of the assistant. i think i am damn good at that. i'm terrified to move to the next level. 

OK. i said. those thoughts can move on now.

as you were. 

wednesdays are for suturing

practicing my knots tonight and labial tears.

sitting side by side with love watching movies and working. my choice. Chasing Amy. His choice. Anvil.

flood gates are open. feeling electrified.

started with the new practice and the babies are coming. 

this is the "last phase" of my midwifery training. last in that this should be my final placement, but i'm well aware the learning never stops. 

i'm beginning a new adventure. husband by my side. in a new city. with new midwives. in a new environment. 

a high volume urban birth centre----a wee bit of a change from the semi-rural low-volume home birth practices i've been with for the last year. and a hell of a lot different than the practice i began my training with. where my foundation of understanding birth was grounded. 

_______

nine births in 18 days. really it probably was in less time than that. maybe two weeks.

one of those chubby babies slid into my hands. well actually she had double nuchal hands, one of which was wrapped in her cord. she kinda burst into the world with some flare. 

it has been an experience attending women in birth that i have met only once prenatally. 

definitely a change. 

it has been good though. my birth attending skills feel solid. learning a new environment has been smoother than i had anticipated. this past weekend i was thrown back into the primary student role for the first time with these midwives. there wasn't really an option. the babies kept coming. two primips within fours hours of each other. the joys of birth centre birthing. 

fucking powerful births. excuse the language. but seriously both these women rocked my world. 

i keep getting taught new things at every birth. lately it has all been from the mothers...well not exactly. i'm loving working with multiple midwives. midwives with diverse backgrounds that have tricks up their sleeves. 

but the mothers. the mothers have been fantastic teachers. so many of them becoming mothers for the first time. changing them. altering their reality. being part of that. observing that. supporting that....

is there anything better?

west seattle

i'm waiting for the heat to start bringing these babies.

but i'm thankful they have been gentle. We finally found a place to live. Tomorrow g and I are signing the lease on our very first home together.

After ten years.

Currently we are camped out in a midwife friend's house in west Seattle. I'm on call for the birth centre. Second student call. This I'm so content with right now. Having three other students starting a new practice is brilliant and is making this transition much smoother.

I need to relax though. I'm losing my shit through all this change.

I haven't posted too much if at all about it but seven weeks ago I married the love of my life. My soulmate. My partner in nefarious times.

I'm so excited about our life together. What it will bring. Curious of how this will challenge me after living independently so many years.

This next ten months.

Living with g in Seattle.
My final midwifery placement at a high volume birth centre.
Starting new. From nothing. From love.

72. the language of birth.

on monday i was called to my 72nd birth. not all of these have been home births. some have been transports, but were successful vaginal births. others ended in c/s. only one or two were somewhat emergent. one because of bad FHTs that happened after we were in the hospital - 7 mins from decision to incision. the second was a surprise breech. still transported by car, but because she was a primip there wasn't a doc willing to let her attempt a vaginal birth. 

but that's not what this is about. on monday i attended my 72nd birth and i'm entering into primary care under supervision. 

what i'm learning from this is the language of birth. finding within myself the authenticity of guiding a women through her experience as and if she needs it. 

i have been having discussions about the visceral versus the intellectual understanding of birth. number 72 was a primip, but she was also an experienced midwife who had her mind blown from the power and the intensity of her birth. she had a visceral experience of which she had deep intellectual knowledge about. 

i know with time i will develop my own language. one that is authentic to me and not seeming like rehearsed lines from a midwifery handbook. 

being with woman is one thing, but actually guiding a woman through her experience is another and i don't think you can actually learn this other than doing it. being in that primary role. 

one of my special challenges in life is my ability to communicate. verbally. clearly. concisely. effectively. 

developing this ability, this language of birth will be awkward. and probably one of the most informative and growing experiences of my midwifery education. 

an internationally trained midwives worst nightmare

so i decided i needed to check into the MMBP program as i periodically do wondering how son i could apply... and i found the above message. 

what the fuck!?

what is canada doing? how are they going to meet the needs and demand for midwives? 

sorry. freaking out right now. 

does anyone know more about this?

hey men. don't rape women.

i love this post. it is a great follow-up to a recent article, "Don't Rape:" Part I".

with all the shit that has been going off in the US as of late, it is clear that the liberties of women and in turn american society are under threat. 

does the government really understand the repercussions of legislating women's reproductive rights? the media has already labelled a young college woman as a slut because she was fighting to keep her access to birth control. implying in many people's minds that maybe she deserves to be raped if you know, she wants to go out and be a sexually active woman.

i wish i could articulate the fear that is building in me from what i hear in the media, what is being put forth by legislators, and what some of the population believe. the only saving grace is republican woman taking a stand against their lesser halves. 

i suppose this tangent is off topic to the poster, but i think it's also fundamental to the point of it's message. where are the men in the discussion about reproductive rights? what is their responsibility and what is society imbuing in young men and women today?  

CPM symposium newslwetter

http://archive.constantcontact.com/fs013/1101776730575/archive/1110281271316.html

cancer, death, and moving forward

alright. it's been about a month since i last wrote anything. 

this last month. well last 5 weeks have been challenging to say the least. 

to start out with. saying publicly for the first time. my mother has cancer. shit fuck motherfucker (excuse the profanities, but i think they are justified). 

i found out a few weeks ago while i was at school. needless to say. i can't really remember that session. the diagnoses. she has colon cancer. so i guess if you are going to have cancer it's one of the ones you want, right? apparently it's been growing now for 3-4years. not sure how they actually know that, but well this is what has been told to me. so again, it's slow growing. non-invasive right? this is a good thing. my mantra. 

she is having surgery the end of the month. allegedly having 12" of her colon removed. it's fucking killing me. so much conflict. on call for about five births. i'm going home. when. i think i've finally figured that out. after the surgery though. better not fucking die during surgery. seriously. anxiety. morbid? maybe. but when you are dealing with the mortality of someone in your family, particularly your mother. it's hard not to be.

this has pretty much consumed me for the last two weeks. which also included a stint in new york visiting old loves and returning home to move. ack.

so death. you may be thinking i was referring to my mother, but no. i haven't mentioned this. i haven't written about this other than a vague post last month. 

on march 12 i attended the birth of a beautiful boy that was born quietly into this world. his mother is writing her story about her feelings on dealing with the loss in a way that i can't imagine touching on.  

this has been one of the most powerful experiences of my life, not just midwifery life, but so far. i hadn't ever contemplated the notion of attending a stillbirth. i don't know why. it was nothing i was prepared for. 

march 8th i got out of the dentist and had a call from my midwife saying that she was meeting one of our clients at a colleagues office to check for heart tones, after the mother had reported feeling decreased fetal movements. 

i drove as quickly as i could over, but they were leaving. they hadn't found heart tones and were on the way to the hospital for an u/s to confirm that baby was no longer with us. i could use phrases like "we went to confirm the fetal demise" but like some medical terminology we use in midwifery, it is not something i feel comfortable with. this situation was not something i felt comfortable with. but what was i to do? 

when we got to the hospital the parents already had the u/s. we all just sat there and cried. the next five days are somewhat of a blur. working with two midwives means off call doesn't really happen. regardless of what is going on. i kept getting called to births. i was in and out of the hospital and between births for five days. little sleep, little to eat, so much emotion.

it's hard to let something like a baby's death not affect you when you are attending other births. i think i did OK, outwardly. but i know on the inside when one mother in particular was having a tough go of a labour she thought would be "easy", i felt resentment inside of me. thinking...if she only knew. she should be grateful, she should relish the fact that her baby is alive. i know that is horrible. but i also think it is normal, as meanwhile this beautiful family was in the midst of an induction that just kept going.

for five days this family sat with this stillness as copious amounts of drugs and attempts were made to stimulate her body into labour. finally on the fifth morning the time had come. i had just gotten home from a birth about four hours before the phone rang.

i laid in bed for about a half hour before getting up. i called the director of my school. i needed some guidance. i was not equipped to counsel a family though something like this. i was reassured that if anything it was my presence. my midwife had also said the same thing. 

as i got up and got ready i had no idea what was about to transpire, what to expect. there was no way of preparing myself. i merely put one foot in front of the other. 

when i got to the hospital they were waiting for the doc to come in and check her. she had been on an epidural all night long labouring and was complete. 

i don't even know how to articulate the rest. as she birthed we were all by her side. the strongest i have ever seen a woman. even through tears. all of us tears. conner david was born breech and placed on his mothers chest. he was wrapped in a blanket and we could see his perfect tiny hands and feet. after the placenta was delivered conner was taken by his dad into the next room to be bathed and dressed. 

we spent the rest of the morning sitting together, in conner's presence. a professional photographer came in, as well as his older sisters and grandfather. i spent most of the time with the girls. talking to them. sitting with them. occupying them. i think i may have needed them more than they needed me. though i know it was appreciated, but caring for them. 

it is heartbreaking to think back on. but as the weeks have passed, sleep has gotten easier and remembering not as triggering. 

for weeks afterwards i couldn't sleep. that first night i had taken a sleeping pill and drank a bottle of wine. sure, not the picture of clean living, but i needed to sleep. i needed to dull the pain. 

life doesn't stop. i'm not sure how much i have processed everything and now with the news about my mother....i just want to scream and hide. i'm struggling not falling back into depression. i prone to it. the sunny days have helped. i've laid in the grass feeling the warmth of the sun bathe me. seeing babies and mothers and friends help. i moved in with my midwife for the summer and being around her family i think is good for me. despite the energy of a 2, 7 and 10 year old. i feel love. i feel family. 

time moves forward. 

Day 2: midwives as primary maternity care providers and inter-professional collaborative care

yesterday was intense. it was a long day and we had powerful discussions, the day culminating in the language of racism that exists in "white neo-midwifery".

i'll talk about this concept later as it is a big topic. one that is distinct from what i see as the intention of this conference. but one that is important in order to address the disparity in maternal and neonatal mortality rates in the united states.

a discussion that leads to more questions than perhaps answers. 

--------

i attended two break away sessions yesterday.

take away message from both:

"the right care at the right time in the right place by the right people"

the question is - what does this look like and how do we get there?

in the two sessions, the first on midwives as primary maternity care providers, the second, collaborative care. 

Amy Romano discussed what a primary maternity care provider is and the concept of a maternity care home. These concepts are the outcomes of the 2020 Visioning and the Blueprint for Action.

some interesting distinctions that she made, which we can see happening in other countries, is the difference between midwifery care and midwife-led care. it is this concept that midwives need not necessarily be limited to low-risk women, but that midwives work with women, in a collaborative relationship with other healthcare provider to meet the individual needs of pregnant women. the midwife essentially coordinates a woman's care. 

this can work in conjunction with the concept of a maternity care home (which i discovered was not necessarily a discrete physical place - though it could be). 

Elements and features of maternity care home

-        primary maternity care providers assigned to each women

-        individualized care planning guided by

o      standardized risk screening

o      evidence-based guidelines

-        linkages with community resources

o      behavioural health services

o      mental health services

o      parenting services

-        preventative care

-        access to self-care information, reseources, and tools

-        accessto a higher level of care, as needed

-        shared decision making and clinical decision support

-        coordination of care

-        performance measurement and reporting, continuous quality imporovemnt

-        new payment models, eg. bundled payment, pay for performance (including “patient experince”)

-        community outreach to foster access to care

-        newborn care and breastfeeding support/promotion

the second part of implementing a system like this is by facilitating effective inter-professional collaborative care.

this is huge. 

Debbie Jessup talked about the MOM's for the 21st century act - HR2141 (122th)/HR5807 (111th), a large component of which involved the development of a core curriculum that is essential to providing high quality maternity care. one with a public health focus, incorporated cultural sensitivities, supports physiologic birth, and includes an interdisciplinary curriculum. 

emerging from the homebirth summit, statement six addresses the idea of interdisciplinary education. 

"effective communication and collaboration across all disciplines caring for mothers and babies are essential for optimal outcomes across all settings. to achieve this, we believe that all health profession students and practitioner who are involved in maternity and newborn care must learn about each others disciplines and about maternity can health care in all settings."

Practical application of inter-professional education (IPE) in maternity care

-  focus on expanded understanding of roles, responsibilities, skills and training or maternity care providers

-    focus on expanded understanding and appreciation for varied birth settings

-    focus on promoting more integrated approaches to supporting women across all birth settings both in selecting sites for care and in movine from one care setting to another as needed/desired

Lisa Kane Low, CNM involved in the interdisciplinary education workgroup made an important argument that the cross training can and should begin between CPM's and CNM's. that we should be welcoming each other into our practices and spaces. learning from each other, gaining knowledge from each others expertise. 

-----

so were does this leave us?

Day 3 - today we focus on where we want to go.

i have a lot more to say about the discussions from yesterday, and this is where i want to focus my attention. what i see as important in addressing the maternity care disparity in this country. 

we will see what emerges. 

Day 1: Setting the Stage

millennium development goals, blueprint for action, government initiatives - strong start, AOC's, innovative awards. but how do midwives access these? how do CPM's access these? 

there has been an increase in homebirth --> amongst white, non-hispanic women. 40% of maternity care covered by medicaid. in 26 states midwifery is legal. in 14 states medicaid covers midwives. where do we go?

do midwives want to be primary maternity care providers?

what does this mean? how does this look? what does it imply?

education: skills in health promotion, public health, collaboration....

individual responsibilities of midwives to foster these relationships at a local level. don't stop fighting just because midwifery is legal. a system that requires mother to go between midwife --> family practice doc --> specialist is inefficient.

women will be lost, particularly if we are trying to mitigate the disparity that exists. 

do we as white midwives feel guilty because of the colour of our skin? most women don't seek healthcare providers. most women only see healthcare providers during their pregnancy. 

what tools do we as midwives have to meet the needs of these women?

are we turning our backs on them? do we even see these women and their needs?

do we want to be primary maternity care providers or do we want to be midwives (continuing to serve the same women we have been serving)?

i thank the midwives that came before me, that fought for the white, non-hispanic women to have the options that they do. but it's time to move forward. we need to reframe the discussion around midwifery care away from homebirth and refocus it on to what is important. serving women during their pregnancies - not only white women, but all women. 

sure birth can be a spiritual journey, but today is that what is important? when women and baby's are dying, what is important?

the above may not actually be a summary of all that came out of yesterday, but the above is how i've processed it. where i see the discussion.

lobby day

the beginning of the 2012 NACPM Symposium started with a bunch of midwives occupying capitol hill.

there were about 45 of us crowded into a small room at the health policy source office this morning, being prepped for our meetings with senators and congressmen, advocating for the mission of the MAMA campaign and HR 1054.

the bill, if passed would include CPM's in the list of providers that would be reimbursed by medicaid for out of hospital midwifery services. right now there are only about 14 of the 24 odd states where midwives are licensed that receive medicaid reimbursements.

our WA state contingent was strong, about fourteen. much of the information that we provided the representatives comes from data collected from our home state (yes, yes. i'm not from washington, but for all intensive purposes, why not).

over the next four days we will be filled with information, my aim is to try and blog throughout.

i should be proud. there are only a handful of students that are present at this symposium. i'm amongst some pretty powerful midwives and the energy is high.

numb

little one. you left too early. 

creating business plan for school is causing me to think about the future.

this semester i have two professional issues classes: business and responsibilities. lab work. pharmacology. well-woman. skills IV. plus a few seminars. and my independent research class. 

creating a business plan for school is causing me to think about the future.

this is stressing me out. 

i was so focused on staying in the present for so long because the future, what i am going to do, where i am going to go is so up in the air. i have no singular attachment. i feel as though i have no home, but know i could make one anywhere.

i left myself open to options. to be free to see where life took me. 

i'm contemplating staying in WA. this, with having to write a business plan for school is forcing me to analyze what this actually would look like, how it could be feasible. choosing a state that has no clear route for licensing midwives trained outside of their approved schools (N=1). with midwives currently waiting with their applications, piled with others, for any sort of due process.

it will take years for me to get licensed in WA after i finish school. there are groups out there that are trying to work on a way to get midwives licensed in the state, midwives trained outside the all holy bastyr/SMS system. there are two groups. philosophically opposed with each other vying for the same purpose. 

hopefully it will be sorted out by the time i finish school. how long would such a bureaucratic process take to sort out?

this is all being counterproductive to my practice of staying in the present. this is having an unhealthy side effect. 

choosing to immigrate to another country isn't an easy process. particularly when i would be giving up socialised health care. but it's worth it, right? it's good. 

tending the fire

i'm overcome with awe lately by the women around me. not just the women, but my community. near and far. the inspiration is overwhelming.

i'm too excited to work. i just want to explore and learn from those around me. 

this is not just procrastination. 

i want to tend to the basics in life, like making sourdough and building fires. as etherial as it may seem i want to learn from the earth, from my kin. my chosen family is abundant and amazing. 

i want to build relationships. i want to tend to the one i have with an amazing man who has so much to give. but we are struggling with the realities of life. with burdens from our past. with conflicts of the future.

none of it is easy.

i want to tend the fire.

i don't want to lay in bed with the blanket over my head. ignoring the shit around me. i have so much work to do right now and it looks like i'm going to be moving...again. this instability is getting to me. i want to remain in my little cabin. i don't want to move. i wish money was not an object. 

my last quarter of school is herbs and homeopathy. so after this next session i can justifiably throw myself into the earth. learn the alchemy of the elements. i have my books and i have my teachers. many teachers. women that excite me. that make me want to jump up and down. to scream and shout. i don't care that they are far away. there knowledge is rich and deep and penetrating.

i want to surround myself with the knowledge gained by a thousand women. passed on from the ancestors, delivered to their descendants. 

there is so much power and beauty out there to be known. i want to emerge myself in it all.   

the sounds of birth

probably one of the most uneasy and self-conscious parts of birth is a woman's concern around the noises she is bound to make in labour.

the sweet songs that she moans as she rocks back and forth, going deeper within herself. hypnotizing herself. the vibrations activating her moola banda. stimulating her pelvis. preparing it for the work to come. 

this is the unquantifiable aspect of birth. beautiful. powerful. awe inspiring. 

i was at a birth the other night. i met the woman in labour for the first time. not an ideal situation. i'm good at integrating into the birth space. not being intrusive. even if the first time i am meeting her is while i'm sinking my hand into her birth tub to listen to heart tones. 

over the course of the evening i began to support her more intensely in her labour. her back ached with each contraction, suggesting a posterior baby. sitting at 8cm for a few hours also suggestive. i asked her if she wanted to get out of the tub and sit on the toilet for awhile. her contractions surged. as i pressed on her back she began moving with each contraction, leaning on me. finding her rhythm. we moaned a low primal moan together. taking deep yogic breaths in between. 

i was humbled by her words telling me that i was helping her, that i had calmed her, that she was figuring out where to go because of my presence. i wasn't doing anything. counter pressure. a few words. relax your toes. sink into your bottom. let your body work. 

the other midwife joined us in the bathroom, the mother now on hands and knees, draping her upper body over a birth ball. she was surrendering herself to her intensifying labour. she found herself surrounded by her women. 

the power of this is unmistakable. sometimes that is all a woman needs. to be surrounded by other women. light touches, soft words. but the presence. it's that union. walking that right of passage with those of your kind. 

i haven't given birth. i haven't walked that path. but i have watched and learned as many women have. i have been there as mothers have emerged for the first time. i have been there as mothers five, six times over have rocked those babies out their bodies with knowledge and power. 

all births fierce.

the moans, the squeals, singing, screams, the howls. 

the innumerable sounds of birth.

the power of women.  


i don't think i will ever stop being amazed.

a midwife for every woman.

it's been one month since i've written. i should have been. it's been busy and exciting and satisfying. 

in my last post i wrote about the CPM symposium. 

well i'm going!

there was a scholarship offered. i applied. i was granted the award. so next month, i'm headed to D.C. 

this is such an interesting discussion that i have been having with midwives. i'm working with and have worked with midwives on either side of the divide. the divide being: should midwives be primary healthcare providers? or maybe the question is: are midwives primary healthcare providers? 

lay, traditional, modern, med. all terms applied to midwives. terms that seem to initiate hostility, drawing lines in the sand and determining the way they practice.

not really. all hold true to the tenants of the midwifery model of care. really! regardless if you agree with how each side practices, it seems each will argue the other is practicing irresponsibly. one says midwifery is lost, the other questions the quality of care provided. it's not as black and white as that. it's not that simple. and midwives do embrace each other. i'm not saying they don't. just trying defining the sides as simply as possible. like it or not. 

washington is such an interesting place to observe all of this. i love my midwives, all of them, all three of them. i love them for their diversity, for what they offer, for their views on things, for what i can learn from them.

---

i am an eighties baby. i grew up in a very different world than midwives that began their practice before i was born. midwives that are self-taught, that were called to serve the women and families in their communities because there were no other options. out of need. whether spiritual or practical. 

understanding the context in which these midwives emerged, in which they practice is important. their skepticism of modern medical standards should not be dismissed. we need them to challenge what many so readily accept. a model in which us younger generations are a product of.

we live in a world of evidence-based practice, but so much of what midwives do will never be proven by science. there is no money it, there is no standardization. it's specific, intuitive, regional based, anecdotal. 

midwives trained in the old ways, so to speak, have knowledge of herbs, of homeopathics, the effects of nutrition. they use this knowledge in practice. they believe that observing a women is as important, if not more important as diagnosing a woman with a disorder through a medically-based test. 

this is not always copacetic to the thinking and practice of today. but that doesn't mean it should be thrown out. 

the question is, can you throw out an evidence-based, but not perfect test, for intuition? can we dismiss a standard-of-care that we have agreed to offer in order to practice legally, because we don't agree with it?  is that informed-choice? is it safe? what effect does it have on the judgement of the profession in a national/international context?

i'm not judging, i'm observing. understanding. questioning. trying to merge both sides. traditional midwifery does not need to be at odds with midwives embracing a role as healthcare providers. 

i strongly believe that there is a midwife for every woman. and that the decision to be a midwife is a political decision. it may not have been thirty years ago (or maybe it was even more so), but today, with midwifery emerging as a prominent profession that is becoming recognised as a safe, cost-effective and high-quality means of maternity care, practicing outside of this so called standard-of-care may put the entire profession at risk.

i haven't even touched on midwives as primary healthcare providers and how that fits into the picture.  i'm not sure if the issue is a moot point. what will happen to midwives that refuse to play nice with the "system"? 

this is all percolating in my brain.   

oh this brings up so many topics. the right to homebirth, the rights of birthing mothers, the rights of midwives, access to midwives.  

CPM Symposium and the voice of future midwives

so i've been talking for awhile now about the place midwives should take in public health. in canada, the U.K. and many other countries around the world midwives play an integral role in women's health beyond maternity care. 

i'll be writing more on this in the next few months, but in the meantime check out the Future Midwives Alliance. 

as student midwives we have to decide how we envision our future roles in public health. we also must recognise the role in public health we play today. we have a unique place in woman's life that goes beyond bettering reproductive health for mothers and babies, beyond creating a sacred space for which women can birth. 

we are moving into a position where we have a responsibility to function as a bridge for the public and other health care providers to increase the over all health of women and in turn our communities. this may not be a role that everyone wants to embrace, but it is a role that we all must support. 

take a look at the actions aimed at the upcoming CPM symposium in washington this coming march. 

although the intentions of the symposium are admirable, they are neglecting to include the voices of future midwives, those of us who will be supporting, working with in and moving these ambitions forward. the future midwives alliance is trying to get student representation present at the symposium so that our voices are heard. 

if i weren't going to be on call, and if my wonderful midwife wasn't going to be there, lobbying on the steps capital hill, i'd be there...someone has to be here for our mothers! leave it to the student midwives. thankfully there are two of us!

i encourage all student midwives out there to take a look at these websites, think about where you see yourself, and ask yourself what are your limitations to practice? 

is it possible for midwives to be primary health care providers? should we be?

Below is what CPM symposium aims to achieve:

Our Intended Outcomes

• a fresh, strengthened sense of ourselves as valuable and primary care providers and midwifery educators in the U.S.
• a dynamic new community of CPMs and educators where many more voices are engaged in creating the maternity care system of the future
• a mutually-held appreciation of the essential roles of education and professional association in strengthening the profession of CPMs
• a clear sense of being equipped to act to achieve our goals
• a deep appreciation of our past, our present situation, and an open thinking about where we can go from here
• a renewed vision and concrete next steps for effectively carrying forward the profession
• a variety of vehicles for engaging CPMs and educators beyond the scope of this event

We ask ourselves: What will success for the profession look like if....

• ...CPMs are fully established as primary maternity care providers in the U.S.? 
• ...the CPM workforce reflects the racial and cultural diversity in the U.S. population?
• ...CPMs serve underserved and vulnerable populations?
• ...CPMs serve childbearing women in all settings?
• ...educators and students have the resources necessary to prepare the CPM workforce of the future?
• ...CPMs achieve Federal recognition: for midwives, schools, educators, preceptors and students?
• ...CPMs are fully reimbursed for the range of services and care they provide by all private and public plans?
• ...CPMs attend 5% of U.S. births in the next ten years?
• ...CPMs schools and preceptors teach to evidence-based maternity care?
• ...CPMs fulfill their potential to improve outcomes for women and babies and reduce disparities in the U.S.?
• ...there are adequate educational opportunities to educate enough CPMs to fill the need for midwives?

Resolution Request

so as one of my resolutions, i want to send things, postcards and letters in the mail.


if you would like to take part in this, be a recipient. send me your address. 


i'm compiling a list. 

four days of yoga

so one of my resolutions was to yoga.

what does that mean?

for the last four days i have gone to my mat (actually i don't have a mat, just practicing on the carpet). 

i haven't had a dedicated yoga practice in somewhere in the range of three years. seriously.

my body hurts. i have chronic lower back pain. i look at my body and i see how it has changed 

i'm tired. i'm bitter. have battled depression. i'm judgmental. i'm insecure. i'm self-deprecating to the point where i am limiting my opportunities.  

i'm not that horrible. i've made it through my blue period. that at least i've done. 

i'm putting my worst foot forward.

but it's a truth.

it's part of me.

and it's time to turn that around.

strengthen my core, heal my back. 

lengthen and strengthen my muscles and stop the aches and pains. 

tone and shed excess fat and feel better about myself.

i love my curves. but there is a difference between curves and puckering. 

2012 is a new year.

it has started with heightened motivation and inspiration. 

2011 ended with a plague lifting and a load of changes that has brought about a clean slate. 

i'm challenging myself. committing to myself. my teacher once said. everyday step onto your mat. even if you do nothing. step on to your mat. 

so i have stepped onto my mat. and for four days i have lengthened and strengthened and moved my body in ways i haven't consistently for so long. and it feels so good. 

four days of yoga and counting. 

resolutions

• don't take life so seriously
• hike more
• take more pictures
• smile more
• listen to more music
• take days off
• send letters and postcards the old fashion way
• let myself be loved, unconditionally and in the moment, regardless for how long it may last
• yoga
• take a class, workshop or join some group
• stop being so self-depricating
• write more
• communicate more
• site by the water
• read books that i don't have to, but that i want to
• sew something
• knit something

Midwives. More than Baby Catchers.

Below is the introduction to the paper that I am writing for school. 


Would love to hear ideas, opinions, thoughts on this topic. Are you interested? Do you find this relevant? Do you as midwives and student midwives place yourself or desire to place yourself within the context or role of public health provider? 

What role do midwives play in public health?

The role of midwives within overall healthcare is seen to vary across nations. In some countries, UK and Canada, midwives are integrated into the overall maternity care system. In the UK for instance, midwives are the state mandated care providers for all normal healthy low risk women, the place of birthplace is irrelevant to the choice of care provider. In the US, midwifery varies from being fully integrated (CNM’s and CPM’s in some states) to unregulated and in some states the practice of midwifery is illegal. 

Midwives, if placed within the context of public health are in a unique position to screen women for psycho-social, and disease and illness risk factors, in addition to providing prenatal care. Pregnancy is a period of a woman’s life in which she will seek out the routine care of a primary health provider. Midwives have the unique opportunity to help women at a most critical period in their life.

The following is a historical review of the evolution of women’s health framed in the context of public health promotion. Through this review we will see how public policy has become shaped by the understanding women’s health is shaped by the biological determinants of a women’s biological. Understanding the specific demands that are placed on a woman, both physical and socially will help improve the health of women and in return the overall health of a population. Health professionals and policy makers, must focus their efforts in culturally appropriate ways in order to significantly improve upon the integration of preventative care in health promotion.

Through investigating the role of midwives in public health, I aim to show that even in the US, midwives are actively filling an integral role in maternity care and to differing degrees, general well woman care. The aim is to legitimize the place of midwives within a healthcare system, both in the eyes of the midwives themselves, but as well by other healthcare professionals and the community at large.

I seek to frame the context of this discussion in the ambitions set forth in the Ottawa Charter presented at the First International Conference on Health Promotion (1986), which first defined public health and initiated a platform for countries to implement public health. In addition, there will be a brief discussion of the numerous reports and bills that have come out in recent years including the Millennium Development Goals, the Global Strategy for Women’s and Children’s Health, the State of the World’s Midwifery Report, the Affordable Care Act and more recently the agreements set forth in the Home Birth Consensus Summit that took place in Oct. 2011, It is my goal with this discussion to illustrate what is being done and has been achieved, while identifying areas of requiring further improvement.