MIDWIFERY IN CANADA, THE MESS WE’RE IN

Many people are confused about why Canadian birth attendants are prosecuted for the most minor actions. . . . calling herself a “midwife”, doing a vaginal examination at a woman’s request or with permission, advising a woman about how to eat for her unborn baby, etc.

Let me tell you how we got into the mess we’re in. Yes, it is a mess. Hundreds of thousands of dollars spent on legal actions, clients left upset and confused, hospital workers unclear about the legalities in their area, each province of Canada having a different wording in their Act, midwives mistrusting doulas and each other. It’s a climate of fear and turmoil that isn’t getting better after more than 20 years of legislating midwifery. (Ontario regulated in 1993, B.C. followed in 1998)

The first problem is that legislators tried to make laws to cover a life event that is natural and one that a woman can do all by herself, if she chooses. Birth is a normal life process. We don’t usually legislate who can be with an adult when they are in their own home. What can you make illegal about a woman having a baby and choosing someone to be with her? Well, you can make it illegal for that someone to charge money for being there. That doesn’t really fit with a concern for the well-being of the woman/baby. If a birth attendant is really wealthy can they go to help birthing women with no fear of the law? If the pregnant woman wants to donate money to her helper’s children, is that illegal? You can see it gets very tangled. The laws have been twisted and turned to try to make them less ridiculous as time goes by but no province has succeeded in coming up with wording that makes common sense.

Then, the law makers thought, “okay let’s make it illegal to do clinical acts like vaginal exams, injections, blood tests, etc.” Trouble with that is a) it is almost impossible to police these activities when they happen in a private home and, b) women allow their partners to perform vaginal exams all the time. Many massage therapists do pelvic therapy with vaginal exams, naturopaths, nurses, etc. so how does it help to say that one particular group cannot do vaginal exams? So, by saying that only a member of a midwifery disciplinary body may do a pelvic exam, things get almost laughable. Since any 16 year old boy can figure out how to do it, it’s hardly an act that needs 4 years of training. Many lay people have to give injections to their children/loved ones, learning how to draw blood takes about 2 hours, all these things are done by a myriad of workers in the community. It is grasping at straws to make these minor clinical acts a basis for a prosecution.
FirstNationsMW

The original intention of seeking licensure started with midwives wanting to be paid under the National Medical insurance plan and to be protected from prosecution/persecution from the giant medical monopoly. That intent backfired right away due to the medical profession. Instead of embracing the midwives as colleagues, they began advising the clients of registered midwives to sue their midwife. There have been lawsuits against registered midwives here in B.C. where millions of dollars have been paid out to families. If a child has any type of neurological damage, the family physician advises the parents that “ the money won’t come out of your midwife’s pocket. That’s why they carry insurance. The insurance is there and you don’t know if your child will need special care that’s not covered by the National Medical insurance plan when he/she gets older. You’d better sue now.” Of course, they would never say that if the care provider was a physician. You can guess what happened then. The insurance rates for midwives right across the country went through the roof. Different provinces have different schemes for covering the midwives but the bottom line is that the government really doesn’t want more midwives because each midwife has to be subsidized for about $30,000 per year in order to provide insurance for her practice. If the midwives had to pay it all, they would be out of business immediately. The government also doesn’t want to give them a raise which leads to a great deal of bitterness on the part of the registered midwives.

Registered midwives are between a rock and a hard spot. They want to follow their dream and have happy, contented clients BUT they rely on the physicians to give them hospital privileges and, if they don’t toe the line of what the doctors wish them to do, they can lose those privileges or even lose their registration.

So, when you’re wondering what’s going on with registered-midwife-generated court cases to pound unregistered birth attendants out of business in Canada, this is some of the background. Because the numbers of registered midwives is low AND the midwives are so limited by the medical profession, there exists an alternative birth attendant market. There are a number of women throughout the country who still go out to help at home births without a blessing from the medical profession/government. They simply don’t want to work in that space between the rock and the hard spot.

Preparing for a Home Birth

Home Birth Supply List

Please let me know well in advance if you are unable to find any item on the list. Collect all supplies and place them into a box. Place the box in an easily accessible place. Please tell the midwives where the supplies are kept when they arrive for the birth.

 24 flat incontinent pads to use under Mom’s bottom (22” x 24”)
 1 box of 4”x4” gauze squares
 2 boxes of Super Kotex pads (overnight)
 1 box or bag of salt (cheap, for stained linens)
 1 450 ml bottle of Hydrogen Peroxide (for removing stains from carpets, etc.)
 1 small bottle of bleach or Sudsy Ammonia
 1 100 ml bottle of Witch Hazel
 1 sealed small bottle of Olive Oil for perineal massage, baby’s bum
 1 bag of “pure” cotton balls
 2 large green garbage bags
 2 Plastic sheets (shower curtain liners work)
 1 flashlight with extra batteries
 1 plug-in room heater (if needed)
 1 hot water bottle
 1 nail brush
 1 tea strainer
 Womanly Art of Breastfeeding (book)

Nice Extras:
Bath pillow, candles, ice cubes, popsicles, plant mister, music, camera/film, tapes, thermometer, massage cream, heating pad, small Fleet Enema (if you get constipated a lot in pregnancy), reusable cotton menstrual pads.

Preparing Your Home:
Make up 5 casserole dishes to get you through the first days after birth and freeze them. Put a plastic sheet on your bed in the last week of pregnancy in case your waters break. Dust and clean the bedroom. Clean the toilet and bathtub. Clear off the top of a chest of drawers or other surface for us to put our instruments on. Make arrangements to have your pets out of the house during the birth.

Sterile Linens:
 6 face cloths
 6 bath towels
 2 bed sheets
 2 cotton cloth diapers
 6 receiving (flannel) blankets for baby
 1 undershirt and nightie/sleeper for baby

Put clean linens in HOT dryer for one half hour. During the last 10 minutes throw in 3 brown paper grocery bags and heat them through. When dryer finishes, fold the hot linens with clean hands and put them in hot bags. Seal them with staples or tape and label the outside. Store in a dry place. You do not need to use your best linens…clean is our main concern.

Electrolyte Balanced Drink (Labour-Ade):
1/3 cup lemon juice
1/3 cup honey or maple syrup
1/4 tsp salt
1 crushed calcium tablet (or 1/4 tsp calcium powder)
enough water to make 1 quart

Mix all ingredients together- use warm water to help dissolve the honey and calcium, and then chill. You can also make ice cubes. Buy enough ingredients to make 4 quarts. This is a delicious drink for after the birth as well. *After the baby is born you can add 1/4 tsp. cream of tartar to this drink to assist with peeing after the birth.

Podcast available for download

I had a great time being interviewed by Alain Desaulniers, DC, recently. Enjoy this podcast. Love, Gloria

Thanks so much for sharing about your AWESOME birth story and for your willingness to share so openly and authentically. I hope that millions are transformed through your words and message! I look forward to connecting with you soon! You rock!
I would be honoured if you would share with your circle of influence!

Your Show’s link:
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Dr. Alain Desaulniers

Family Chiropractor, Everyday Revolutions Podcast Host, Educator, Keynote Speaker everydayrevs

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6 Point Recipe for Making New Parenthood as Difficult as Possible

4 Days old and the milk is in. Continuous skin to skin in bed with mother.

4 Days old and the milk is in. Continuous skin to skin in bed with mother.

1. Start with giving the birthing woman antibiotics in high doses so that the baby develops candida (thrush) and colic. Then mix in a lot of stitches, either to repair the perineum or the lower belly/uterus.

2. Separate the mother and newborn. Make the mother walk a long distance (with her stitched body) to be able to see/feed her newborn.

3. Teach her that the best (and only) way to feed her baby is to sit upright in a chair

4. Discourage sleeping together as a family. Don’t let her know that lying down to nurse will enable her (and her partner) to get much more sleep.

5. Tell her that the baby is not getting enough milk and don’t give her the tools to increase her supply.

6. Scare her into thinking that her instincts about caring for her baby are not to be trusted and that she should listen to professionals for all things to do with her baby’s health.

Checking Your Own Cervix

How to Check Your Own Cervix- “it’s not rocket science”

“I think it’s a good and empowering thing for a woman to check her own cervix for dilation. This is not rocket science, and you hardly need a medical degree or years of training to do it. Your vagina is a lot like your nose- other people may do harm if they put fingers or instruments up there but you have a greater sensitivity and will not do yourself any harm. Clean your hands well and make sure your fingernails are trimmed and rounded.

“The best way to do it when hugely pregnant is to sit on the toilet with one foot on the floor and one up on the seat of the toilet (or if that yoga is too difficult, put one foot up on the bathtub or a stool with your knee bent).

toilet Put two fingers in and go back towards your bum. The cervix in a pregnant woman feels like your lips puckered up into a kiss. On a non-pregnant woman it feels like the end of your nose. When it is dilating, one finger slips into the middle of the cervix easily (just like you could slide your finger into your mouth easily if you are puckered up for a kiss). As the dilation progresses the inside of that hole becomes more like a taught elastic band and by 5 cms dilated (5 fingerwidths) it is a perfect rubbery circle like one of those Mason jar rings that you use for canning, and about that thick.

“What’s in the centre of that opening space is the membranes (bag of waters) that are covering the baby’s head and feel like a latex balloon filled with water. If you push on them a bit you’ll feel the baby’s head like a hard ball (as in baseball). If the waters have released you’ll feel the babe’s head directly.

“It is time for women to take back ownership of their bodies.”
-Gloria Lemay, Vancouver, BC

http://www.gentlebirth.org/archives/birth.html#Self-Checking

    Update

One birthing woman who checked her own cervix described it like this: “I could feel my bag of water bulging down and then later the baby’s head once the waters broke- so cool.”
“How did I do it? I just reached up in all the way to the back and felt. It’s sort of awkward/difficult to reach but if you are familiar with what your cervix normally feels like, sort of like the tip of your nose, it gets shorter and stretchy. I felt it at like maybe 2 cm, about 6, which is when I could feel the bag, and then when it was time for baby to come. When the contractions were getting super intense I pushed a bit and that was enough to break my waters. Babe came shortly after.”
(shared with permission) 2014

Polycythemia and the natural emergence of the placenta

I have only encountered it once in my career (over 1300 births plus lots of prenatal class parents, 35 years in the birth biz). The baby with polycythemia I worked with was very ill with it, she was hospitalized on Day 2 of life and had some blood removed which improved her condition right away. She remained in hospital for about 7 days. She had Down syndrome and polycythemia can be part of the presentation with Down. A very good friend who is also a doula has a daughter with Down Syndrome and her story is almost exactly the same as the baby girl in my practice i.e. polycythemia after a gentle homebirth which was treated well in hospital. Both these baby girls were discharged from hospital much faster than the medical professionals involved expected.

I am a believer in leaving the birth of the placenta for a full 30 minutes (or longer). If the placenta births before 30 minutes, it is rare, and it means that the mother pushed it out without any advice from me. In my work, the cord is clamped and cut only after the placenta is out. With the one exception of the girl with Down Syndrome, I do not see cases of polycythemia, jaundice or any of the other dire predictions that the medical profession warns about with leaving the cord to pulse until it stops naturally. Fear of polycythemia is no justification for continuing on with amputating the placenta prematurely. Waiting only two or three minutes to clamp the cord is still an assault on the baby.

Couple cutting cord after birth of placenta

Couple cutting cord after birth of placenta


Remember, scissors, hemostats and cord clamps have only been invented for a short time in human history. Before that, people waited till the placenta came out naturally before doing anything about the umbilical cord. When the baby is adjusting to life with the cord intact, the blood goes back and forth through the two arteries and one vein in the cord. . . it isn’t just going in to the baby from the placenta, it’s coming out, too, in correct balance for that baby’s anatomy. The placenta was trusted to sustain the well being of the baby in every way for nine months, I am certain that it’s okay to let it keep performing that function for another 30 minutes.

(This is a comment from Facebook that I made in response to a query about cord clamping. The women who birth at home are not induced, not medicated and receive no routine injection of pitocin after the birth. They are healthy women with full term babies, for the most part.) Gloria Lemay

The Herbal Bath

This is something I have had in my files for many years. I’m posting it for those who are interested. The only time I have prepared all these herbs, we had them “cooking” while the woman was in the birth process. She didn’t like the smell so we had to interrupt the process, take the big pot outside and get the house cleared of the smell. So, lesson learned, don’t do this during the birth. I’m not in agreement about the idea of getting a woman into a bath to stop excessive bleeding or the idea of opening the labia and swooshing bath water into a post partum vulva. Actually, there are lots of ideas in here that I don’t go along with but I thought you might like to read this handout from around 1985.

I’m sorry I don’t know the source of this to credit the author. Gloria Lemay

Beginning of the quote:

THE HERBAL BATH
This bath mixture should be prepared, strained and put together in a large container ready for the bath. Remember, this bath is also used as treatment for heavy bleeding, and must be ready for immediate use if necessary. A quart or two of strong shepherd’s purse and extra comfrey (fresh if possible) should be set aside for internal use and for adding to the bath if needed.

¼ C sea salt
1 ounce Uva Ursi
1-2 ounces Comfrey
½ – 1 ounce Shepherd’s Purse
1 large bulb fresh garlic

Have ready for emergency use:
2 quarts strong shepherd’s purse tea
2 quarts strong comfrey (fresh if possible)
1 qt. alum root tea, or alum crystals

Simmer the tea and let set for some time before straining. Simmer the tea leaves again to get their full benefit. If you have garden fresh comfrey, do not simmer—use raw. Whiz it in the blender, strain and add to the tea mixture in a large container. Whiz the fresh garlic, add this and the sea salt to the mixture. Cover, label and set aside. Add to the warm bath water when needed.

This herbal bath is highly recommended for every woman following childbirth. There is absolutely no danger of introducing an infection, if the baths are done correctly. The garlic and sea salt make the bath solution aseptic. Uva Ursi is a specific for healing a woman’s reproductive organs. Comfrey contains alantoin, a cell proliferant, which causes the edges of wounds to grow together. It is very healing and soothing. Shepherd’s purse is excellent for preventing and controlling excessive bleeding.

The bath should be taken shortly after the birth. If the placenta has not been expelled, and you would like to get in the bath, you may do so. When you feel a contraction coming on –squat over a bowl and push it out.

A warm bath to soothe after the birth.

A warm bath to soothe after the birth.


The water should be comfortably warm, but not hot. The water should be about hip level. Lie back, spread your legs and swoosh the healing waters up inside the birth canal. Thirty minutes should be the minimum time in the bath. You will find the bath very soothing, relaxing and rejuvenating.
The baby should be put in this bath with you. The herb bath will start the healing process of the cord stump, and it may drop off as early as 3 days. In this bath, your baby will become mellow, and may even smile. He will unfold, stretch and float in the lovely weightless, warmness of the water. It’s wonderful to watch his pure joy at finding something so familiar and enjoyable in this new world. Caress and speak softly to him. He will love this communication, and will respond by total eye contact and facial expressions. When the infant is taken out of the bath, he should be patted dry, not rubbed. Dress him in soft, warm things. Put him to bed with you and let him cuddle up next to your warm body.

End of quoted material.

Letter from Jenny (Homebirth after 2 cesareans)

My dear sweet Gloria,

A year ago today at 4:45 a.m. I gave birth. I have treasured that moment every day. I know it is really Rowan’s birthday. But it’s my birthday too. I feel like that was the day I was born as a woman. Whole, powerful, beautiful, healed.

As you know my other births left me with scars. Scars on my body and scars on my soul. This birth healed me. I am not broken, I am whole. I am not helpless, I am powerful. I am not less than a woman, I am beautiful. I am healed.

Thank you, Gloria, for being there for me. I will never forget the first time you put your hands on my large belly. I could feel love through your touch. For me and for my baby. Visits with you were relaxed; you spent so much time with me. You told me so many stories. Stories to make me laugh, give me courage and impart knowledge. You challenged me to dream of this birth. To really think in detail how I wanted it to be. And I had the birth I dreamed of! What a gift.

Thank you, Gloria, for your quiet confident presence during my labour.
You gave me my space and that’s exactly what I wanted. You gave me quiet encouragement as I pushed, and through the fog I heard your words and they helped me. You reminded me to get ready to catch my baby; you knew how much I wanted that! And you left us to get acquainted with her as you went to get me some tea. What a peaceful birth. I still remember her looking at me with those eyes. Nothing is like that first look a newborn takes at the world around, and I got to see it!

Thank you Gloria for being who you are. You are a woman to be reckoned with! You supported me and my desire to have an amazing birth. And it has changed me.

Happy 1st birthday, Rowan. Happy birth day to me, too. Thank you, Gloria!
Love,
Jenny
PS. My placenta is still in my freezer waiting to be planted under a Rowan tree when we have our own place 😀