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Whole Mothering Center
Southeast Texas Maternal Resources

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March 10-14, 2008

How "The Business of Being Born" Affected Me
by Heather Thomas

When I first learned that Ricki Lake was making a documentary film about birth in America, I was kind of
surprised and, I admit, a little startled. After all, she's a talk show host, and most of Hollywood is notorious
for being fake and covered in glitz and glam. Anything as messy and "natural" as birthing seems out of place
when it you're talking about celebrities, especially when one takes into consideration the number of female
celebrities who are "too posh to push" and schedule their elective c-sections as soon as they find out that
they're pregnant. I basically brushed the whole thing off. I jokingly applied the term "semi-crunchy" to
myself with regard to mothering style, and figured that I'd have nothing in common with someone "like
that". Then, I started hearing bits and pieces about the content of the film and I realized that she may really
have something to say that was worth hearing.

When I first sat down to watch the film, it was in a room with 5 other women and 11 children (yes, eleven)
running in and out of the room. It took us 4 hours to watch an 87 minute film! Somehow, as I was preparing
for the Whole Mothering Center's screening of the film, I managed to get four pages of things that were
noteworthy to me. Facts and figures, comments, different perspectives - things I just hadn't bothered to
look up or heard before. I was amazed at some of the numbers!

One of the most significant points to me was how bad our maternity care has gotten in the century since
midwives did most of the care for pregnant women. "Of the seven countries with 400,000 births per year,
the US ranks LAST" when it comes to maternal health. Our country, the leader of the industrialized world,
has the highest maternal death rate among industrialized nations and the 2nd worst newborn death rate.
Comparing our maternal health care with countries where midwives still attend 70-80% of all births and
you see much better outcomes!

Why? How does such a thing happen? How could we, as women and mothers, have LET this happen?

One of the main reasons I feel we are now facing such a medical crisis state in maternal health is a lack of
education. We have allowed ourselves to become complacent, letting the doctor take care of things, and
trusting that the doctor or facility always has our best interest at heart. We have also allowed a culture of
birth fear to color our perceptions of what giving birth is and can be. Television shows rarely feature a
natural birth, and rare is it that you will find an obstetrical student who has ever even seen a
non-medicated, natural human birth. More often than not, the doctor is painted as a knight in shining
armour who swoops in with his epidural and saves the screaming mother from her pain and rescues the
baby from certain death.

The reality is that much of the time, 'pain' of childbirth would have been significantly reduced had the
mother been encouraged to be an active participant in labor by getting out of the bed and moving freely.
The epidural that blocked mother's pain contributed to a longer labor and to the baby's distress, and the
c-section that was painted as the saviour of yet another mother/baby pair most likely was caused by the
practices and policies we all 'expect' because those are the things we have been cleverly trained to see as
'normal'.

The biggest impact on me has been a renewed determination to ensure that women are informed. Not just
of the benefits, but also a real look at the risks and drawbacks of surgical birth. I am also more committed to
helping women locate and support midwives in the area. Beaumont currently offers midwifery prenatal
care, but no midwives are able to deliver in either of the Beaumont hospitals at this time. I am very
interested in helping create a community of women in Southeast Texas who demand midwifery care be
accessible locally. I am eager to see the changes we women can make when we set our minds towards a
task. I look forward to being with my clients, my friends, my future daughters-in-law and my nieces when
they give birth, and know that they are confident in their body's ability to give birth naturally, that they
know their options, rights and are both informed and confident in their ability to make the best decisions for
their bodies and their babies.
And I hope that you will be, too.

March 24-27 2008

What Makes a "Qualified" Care Provider?
By Heather Thomas

There are a wide variety of qualifications that I personally look for in a care provider. First among them are
personality, their interest in me and what things are important to me during the course of our visit, personal
views, education, wisdom and experience.

Recently, the topic of "experience" has been called into question. Is experience alone enough to call yourself
"qualified" to offer care or support to another person? I think that depends, in part, on what each individual
person deems necessary in order to feel supported. It also depends on what the care provider feels is her
responsibility to provide her clients. For conversations sake, let's limit this to the medical and related fields
surrounding the pregnant and new mother, shall we?

For some women, seeing "OB/GYN" behind a doctor's name is the ultimate in "qualified". Another may require
"CNM" following her midwife's name in order to feel that her care provider is qualified. Still another woman
may rely not so much on the official certifications, but on the recommendation of her close friends or family
members, and so may choose a lay midwife to attend her birth. Still other mothers eschew traditional care
providers altogether and choose to rely on their own previous experience and education to see them through
their birthing experience.

All of these views and preferences have value.

Still another area of care for the pregnant woman and family is in doula services. Though not new in theory or
practice, doulas are relatively new to this area. Many women aren't familiar with the term "doula". If you're
not, a doula as usually defined today means a professional labor support person who works with the expectant
mother and her family to help her achieve the birth she wants. A postpartum doula provides care to the new
family and often helps with breastfeeding and light housekeeping - both are sort of a "mother to the new
mother" role. This type of service becomes more and more important in today's cultures where women live far
from their own mothers or other relatives and few companies have adequate paternal leave policies.

So back to the topic at hand - we were talking about "qualifications". Many doulas are certified through
nationally (and internationally) recognized programs. Two of the largest and most recognized associations are
Doulas of North America (DONA), Childbirth and Postpartum Professional Association (CAPPA). Both these
and other certifying bodies have extensive requirements, including educational workshops, childbirth
education, reading and writing portions, a review of one's own birthing processes and some also require
breastfeeding education as well.

Many care providers are called into service positions that care for expectant and new mothers because of
their own experiences. Either things went swimmingly and they are eager to help other mothers have the
same type of experience, or there was something that didn't go as they had planned and their mission has
become to help other mothers avoid the same kinds of situations and outcomes. Both pathways call dedicated
and caring women. There is no doubt that certification has a certain level of expected education or
experience, and to many, those letters instill confidence that the care provider has at least a minimum of
education, experience and skill. But the flip side of that is that every class has a "smart kid" and a
"not-so-smart kid". There's really no way of telling which end of the spectrum your provider falls at. A certified
care provider of any type may have done only the bare minimum to pass the certification exam or process,
but have virtually no other experience!

Please don't think that I discount certification - if I didn't think it was important, then I wouldn't be working
towards my own certifications as a doula, childbirth educator and IBCLC. As I said, many women are "called"
to these types of professions because of their own experiences. I am one such woman, and in between raising
my two children, I completed La Leche League International's Leader Accreditation training in 2003 and
completed a Breastfeeding Educator's course in 2005 because I felt that the additional training afforded by
these agencies would enhance my skills and knowledge . I continue to work with numerous mothers, both in
person and over the phone to provide breastfeeding support, and spend time with many of those women in
their homes acting as an uncertified postpartum doula. My time with them has no less value because I am not
yet certified as a postpartum doula, rather, I feel that this experience enhances my training.

My point is that we shouldn't allow ourselves to be blinded by the certification and miss that an equally
qualified but uncertified care provider may be more compatible with our personal ideals or philosophies. Each
individual mother and couple must find the care providers that meet their needs, whatever they are. In that
capacity, Whole Mothering Center is completely dedicated to providing resources t women and families in
Southeast Texas. It is my goal, if I personally cannot hep you, to help you find someone who can.