Another study with positive results concerning planned home birth with a professional midwife published in the Canadian Medical Association Journal.

Here is the Abstract:

Background: Studies of planned home births attended by registered midwives have been limited by incomplete data, nonrepresentative sampling, inadequate statistical power and the inability to exclude unplanned home births. We compared the outcomes of planned home births attended by midwives with those of planned hospital births attended by midwives or physicians.

Methods: We included all planned home births attended by registered midwives from Jan. 1, 2000, to Dec. 31, 2004, in British Columbia, Canada (n = 2889), and all planned hospital births meeting the eligibility requirements for home birth that were attended by the same cohort of midwives (n = 4752). We also included a matched sample of physician-attended planned hospital births (n = 5331). The primary outcome measure was perinatal mortality; secondary outcomes were obstetric interventions and adverse maternal and neonatal outcomes.

Results: The rate of perinatal death per 1000 births was 0.35 (95% confidence interval [CI] 0.00–1.03) in the group of planned home births; the rate in the group of planned hospital births was 0.57 (95% CI 0.00–1.43) among women attended by a midwife and 0.64 (95% CI 0.00–1.56) among those attended by a physician. Wo men in the planned home-birth group were significantly less likely than those who planned a midwife-attended hospital birth to have obstetric interventions (e.g., electronic fetal monitoring, relative risk [RR] 0.32, 95% CI 0.29–0.36; assisted vaginal delivery, RR 0.41, 95% 0.33–0.52) or adverse maternal outcomes (e.g., third- or fourth-degree perineal tear, RR 0.41, 95% CI 0.28–0.59; postpartum hemorrhage, RR 0.62, 95% CI 0.49–0.77). The findings were similar in the comparison with physician-assisted hospital births. Newborns in the home-birth group were less likely than those in the midwife- attended hospital-birth group to require resuscitation at birth (RR 0.23, 95% CI 0.14–0.37) or oxygen therapy beyond 24 hours (RR 0.37, 95% CI 0.24–0.59). The findings were similar in the comparison with newborns in the physician-assisted hospital births; in addition, newborns in the home-birth group were less likely to have meconium aspiration (RR 0.45, 95% CI 0.21–0.93) and more likely to Abstract be admitted to hospital or readmitted if born in hospital (RR 1.39, 95% CI 1.09–1.85).

Interpretation: Planned home birth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician.

Published online ahead of print August 31, 2009
CMAJ 10.1503/cmaj.081869
© 2009 Canadian Medical Association or its licensors

Click here for the pdf of the entire text.

Cookie Day at the Capitol - 2009!

Midwife supporters started showing up bright and early laden with boxes, baskets, crates, backpacks, and even wheeled luggage crammed full of hundreds and hundreds of packages of cookies! We lost count of just how many home baked cookies were delivered on Cookie Day, but our estimate puts it around 800 packages, or 400 dozen cookies!

Jen Keifer, FoMM VP, arrived with a wagon load of cookies and children.
Her homeborn baby, David (above) appears ready to go charm the legislators!

By 1 pm, most people had visited dozens of offices with their children and cookies and were happy to sit and listen to special speakers at our rally in celebration of legal CPMs. Many people were especially excited to hear Jennifer Block from Brooklyn, New York and many brought copies of her book, "Pushed" to be autographed afterwards. A number of legislators and various lobbyists showed up to hear her as well.
Above, Halley Watson, Legislative Chair, welcomes everyone and thanks them for coming to celebrate with us.

After receiving an emotional standing ovation from a rotunda full of homebirth parents, children, and their midwives, Senator Loudon spoke about his motivation for legalizing Certified Professional Midwives. He added, "You wouldn't believe all the people I've met through this! I have so many Facebook friends because of this issue!"

Samanda Rossi, President of Friends of Missouri Midwives, surprised Mary and Debbie by coming to the front to recognize them for their years of service and present them with beautiful bouquets, thanking them for all that they have sacrificed over the past four years to make midwives legal in Missouri.

"In their time as unpaid, volunteer lobbyists, they [Debbie and Mary] gave up a great deal for the betterment of families in Missouri and the midwives who serve them. And they did without complaint or of asking for much beyond our presence at the Capitol. They dug deep into their pockets to pay for gas and meager dinners of canned beans and donated food.... After dinner, sleep was scarce and work hours were long as they strategized and planned for the daylight hours ahead...
The intensity and selflessness of Mary and Debbie's work may never be fully understood or appreciated. But the magnitute of their work will resonate each time a midwife takes her CPM exam, each time a mother-to-be locates a legal midwife to assist her patiently and lovingly through pregnancy, and each time a baby utters it's first sounds of greeting upon birth in the great state of Missouri." - Samanda Rossi

The crowd in the rotunda, listening to Debbie tell the story of how her midwife was arrested two weeks before her due date, leaving her with nothing to do but have her baby at home alone or go to the hospital. Debbie spoke of how that experience led her to spend years of her life working to make midwives legal for every other pregnant woman in Missouri.

Debbie Smithey, Jennifer Block, Mary Ueland, Sarah Greek listen to Elizabeth Allemann, MD. "We've hunted midwives down and thrown them in prison for 50 years in Missouri," she said. "Now, we've decided that they shouldn't be criminalized. But what should Missouri do with them now? I suggest that we integrate them into our maternity care system!"

Halley Watson, Debbie Smithey, Mary Ueland, Sarah Greek - the "old" lobbyists and the "new" midwifery lobbyists!

All together with their heroes - Senator John and Dr. Gina Loudon!

Sarah and Mary discuss the Supreme Court ruling with Steve Walsh, reporter for the MissouriNet news service at the Capitol.

An interview for KWMU news. Homebirth slideshow playing in the background.

After the rally, we spent some time in a basement hearing room with
Jennifer Block, discussing the state of our modern maternity care system
and how to reach women with information and options.

Members of Friends of Missouri Midwives and Missouri Midwives Association leadership went to dinner with Jennifer Block at Panera bread to continue our conversation. We are so grateful to Jennifer Block, author of "Pushed: The Painful Truth About Modern Maternity Care" for taking time out of her busy schedule to speak at our rally, and for coming to spend Cookie Day promoting midwives at the Missouri Capitol! Thank you, Jennifer!

And lastly, a picture of Sarah Greek and Halley Watson, the new faces of midwifery seen at the Capitol every day in place of Debbie and Mary's continual presence. Their job is to make sure that Certified Professional Midwives STAY legal!

Thank you so much Halley and Sarah!

Midwifery Memoirs

I recently finished reading and reviewing a great new midwifery memoir, The Blue Cotton Gown by Patsy Harman. This book was written by a CNM who no longer attends births, so it was about the rest of midwifery--the well woman care side. It was very good.

A few months ago, I also read the very excellent Lady's Hands, Lion's Heart, another midwifery memoir (this one had lots of births and also lots of drama!). I really loved it. Very good.

In short order, I also read Labor of Love, by the CNM who was shadowed in the film The Business of Being Born.

If you get the opportunity to read any of these books, I think you'll enjoy them!

Increased C/S, Increased Complications

Interesting report from the National Partnership for Women and Families on a new study finding that the increase in C-Section deliveries coincides with increase in complications during birth.

Citizens for Midwifery Meeting in Rolla, MO!

This year, Citizens for Midwifery will hold its annual meeting in Rolla, MO and any and all interested birth activists are welcome to join us!

FoMM/MMA's very own Mary Ueland and Debbie Smithey have been nominated to receive the annual Susan Hodges award for excellence in consumer activism and that will be given during the public portion of the annual meeting.

This year our Annual Membership Meeting, including the election of members of the Board of Directors, will be held in Rolla, Missouri, on Saturday, November 8, 2008, from 1-2 pm, followed by a Gathering with other birth activists in the area from 2-4pm. The CfM Board members will be meeting in person throughout the weekend.

Location: These meetings will be held at Baymont Inn and Suites, 1801 Martin Springs Drive in Rolla, Missouri. Hotel phone: 573-364-7000.

Our Annual Meeting affords us the chance to review the past year and look ahead to the coming years – your questions and ideas are important! This is a great opportunity to meet with and talk to CfM’s Board of Directors in person. And of course we’ll count the ballots for the election of Board Members for the next year

Following the Annual Membership Meeting, a Birth Activist Gathering will bring together CfM members with Friends of Missouri Midwives and anyone else who is interested, including other consumer activists, midwives, and other birth professionals. CfM will give a brief presentation about our current work and projects, including our response to the AMA Resolution, an open discussion about "what’s next in MO" and how CfM can help, and how we can work together to sustain birth advocacy. This event is free and light refreshments will be served.

Please RSVP to molly@cfmidwifery.org if you plan to attend the meetings. CfM’s Board of Directors looks forward to hearing from many of you, and even seeing some of you in November!

Please pass this message along to other interested persons or organizations (including activists in our neighboring states of IL and KS, if you have contacts there).

Mark your calendars! I hope to see you there.

Postpartum Reading List

As a follow-up to the presentation I gave at the FoMM retreat about "Planning for Postpartum," this is my list of suggested postpartum reading (for my annotated list, see here):

Suggested Reading—Postpartum

After the Baby’s Birth, by Robin Lim

Mother Nurture: A Mother’s Guide to Health in Body, Mind, & Intimate Relationships, by Rick & Jan Hanson

The Year After Childbirth, by Sheila Kitzinger

The Post-Pregnancy Handbook, by Sylvia Brown

Mothering the New Mother, by Sally Placksin

What Mothers Do: Especially When it Looks Like its Nothing, by Naomi Stadlen

Postpartum Memoirs:

Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood, by Naomi Wolf

Operating Instructions, by Anne Lamott

Let the Baby Drive: Navigating the Road of New Motherhood, by Lu Hanessian

Callie’s Tally: An Accounting of Baby’s First Year, [or, What My Daughter Owes Me], by Betsy Howie

The 2008 FoMM Family Retreat

Over 90 friends of Missouri Midwives enjoyed a weekend together at Pin Oak Camp in the Lake of the Ozarks State Park Sept. 12-14.  It was a terrific time!

Friday night, we had a bountiful potluck dinner and lots of time to visit with old and new friends.  And there were S'mores!  The campground had a great firepit encircled by benches and logs for sitting and visiting.  The fire was a highlight of the weekend, especially for the kids, and we managed to get by with very few burns.

Saturday was full of insightful sessions, a productive business meeting, lovely crafting.  We even managed to stay on track with our schedule so that we had quite a bit of free time!  

Our sessions on Saturday included Fathers and Home Birth (where the guys actually talked about birth... don't tell!); Mothers (with kids) and Midwives (crafting!); Planning for Postpartum; Preparing for a Hospital Birth; and Celebrating Birth with Exercise, Yoga, and Dance.

The weather on Saturday, though a bit muggy, was a wonderful change from the expected rain.  It did not begin to rain until Saturday night, and on Sunday morning most of us were thankful for our sweatshirts! 

In our business meetings, we passed 7 (Seven!) proposals and killed one (following a helpful discussion).  We also held elections.  Our new president is Samanda R., vice-president is Jen K., Secretary is Allison D., and Treasurer is Jessica K.  There has been tremendous growth in Friends of Missouri Midwives over the past year, and we are eagerly looking forward to the future.

Many thanks are deserved for bringing this weekend together - Samanda and David, who did an amazing job of pulling everything together; Brian, who cooked us terrific meals; Kolbi, who waited for the parks folks on Sunday afternoon; the presenters of various sessions; and all of the attendees, who pitched in and made everything work!

Here are some pictures from the weekend.  If you have some you would like to share, email them to admin@friendsofmomidwives.org, and they will be uploaded to the Picasa page.

If you attended the retreat, please add your thoughts in the Comments section.

Looking forward to next year already!