STORY FROM A STRAGGLER

STORY FROM A STRAGGLER

This story was told to me by a young man who came, on his own, to a birth film night that I hosted in Vancouver, BC. It was strange to have a 19-ish year old man in a room full of women. He said he had come because he saw the event advertised in a local paper and he thought it might be important in his future to know about birth. After the films ended, people milled about for a while chatting but, then, everyone dispersed except for him. He seemed to be loitering around. I wasn’t afraid to be alone in a building with him—he had such a pleasant way of being. As I packed up my gear and replaced things in the room, he said “Gloria, I’ve stayed behind because I want to tell you a story.” I was all ears. This is the story that the straggler recounted that night.

“My mother was born at home in Berlin, Germany. In Germany, it’s different from here. When someone has an apartment they stay in it their whole lives and sometimes pass it down through generations. It’s not like here where people move around a lot. In the old days, when my grandmother felt it was time to give birth, she would knock on her bedroom wall and that was a signal for her neighbor to come over and assist her with the birth. My grandmother did the same for her neighbor when the roles were reversed. So, my mother was born in my grandmother’s bed. Family Bed They were very close mother and daughter but my mother ended up falling in love with a Canadian and moved to Canada after she was married. She would take every vacation opportunity to fly back to Germany and be with my grandmother.

One day we got the news that grandmother had cancer and was dying. The doctors gave her six months to live. My mother took a leave of absence from her work and flew to Germany to be with her mother through this passage. The night that my grandmother died, my mother was holding my grandmother in her arms in the same bed and bedroom that my mother had been born in.”

That young man’s story has stayed with me. I’m so glad he came to my event and that he felt it was important to share with me. The more I ponder on this story, the more I think about him and I wonder if he has had children of his own. I think that, because he was the son and grandson of those two women, is why I felt so safe with him. Love Gloria
p.s. thanks for your encouragement to tell these stories, Babz Covington and Carla Hartley. I love you both so much. Please share your stories, too.

LITTLE THINGS MEAN A LOT

Quote

I wanted to write this story down because it is one I can’t forget.

I was walking back to my car after a late night downtown meeting and I was accompanied by Peter and Molly, old friends. Molly was someone I really admired and she had two young children. As we were walking along together, Molly said: “Gloria, I don’t think I’ve ever told you what an incredible difference you made to me.” My ears perked right up, I love to be acknowledged, but I couldn’t remember anything special that I had done for Molly.

She said, “Remember that day we bumped into each other on the street when I was hugely pregnant with Caroline, my second daughter? We hadn’t seen much of each other during my pregnancy and I was working with two registered midwives and planning a homebirth.End of Pregnancy

My mother had come out from Eastern Canada to help the family at the end of my pregnancy and it seemed to be taking forever for the baby to come. I was worried that my mom might be really scared to see me birthing and I had a feeling she didn’t like the idea that, this time, I would have the baby at home. I didn’t even want to talk to her about the idea I had of having a waterbirth. Everything else about the birth was going smoothly but I had this nagging fear about my mom’s reactions. Well, Gloria, you listened to everything I said and then you said “Oh, do you know what? I have the most amazing video of waterbirth that you just have to watch. Everyone who sees it has a lovely smooth birth, you’re going to love it”. (The video was Barbara Harper’s “Birth Into Being”). You went to your car trunk and presented me with the vhs tape. I took it home and we watched it that evening. My mom watched it with us and said at the end “Why don’t you get one of those water tubs and do it that way, Molly!” All my worries were gone and the next morning my birth process started. The birth was everything we wanted. Afterwards my Mom said “Honey, that is the most beautiful thing that has ever happened in my whole life. I’m so glad I came out to Vancouver and got here on time to be present to the miracle.”
My Mom returned home to Eastern Canada. She was a widow and she liked to live in her own home alone. A few months after Caroline was born, we got the terrible news that my mother had taken a fall down a flight of stairs and she died. The grief was terrible. Amidst all the grieving I had this sense of peace that my Mom had been present to a miracle and that we had shared a profound experience. I don’t know if it would have unfolded that way if you hadn’t run to your car and lent us that video.”

 Only two remain undilated.


Only two remain undilated.

Molly (not her real name) only told me this story when the baby in this story was about 12 years old. You never know what the ripples in the pond of your actions might be. Love Gloria

CHARGES AGAINST BIRTH ATTENDANT, LISA KUSCH

Lisa Kusch Case in Saskatchewan, Canada

When a birth worker is charged with an offense in Canada, she receives legal advice not to discuss the case and not to speak with the clients involved. This makes things very difficult because she must raise funds to cover expensive legal bills and she can’t campaign on her own because of these restrictions.
I have asked for facts from different sources and submit the following information for those who are helping with the funding and care about my friend, Lisa Kusch.

Lisa in 2015

Lisa in 2015


In October 2016 Lisa was charged, as follows:
“It is alleged that between the 29th day of October 2014 and the 29th day of November, 2014 in Saskatoon Saskatchewan, Lisa Kusch “ DID ENGAGE IN THE BUSINESS OR PRACTICE OF MIDWIFERY, WHILE UNAUTHORIZED TO DO SO, CONTARY TO SECTION 23(2) OF THE MIDWIFERY ACT” (see below for the wording of that section of the Act).
That’s it. There are no specific details of what Lisa did or did not do. It seems to me that this is an overly broad and vague accusation. The document with the allegation was accompanied by emailed complaints filed by the birthing woman and the attendant at the birth (a doula/friend of the woman who accompanied her when she transported to the hospital).

Some of the information I have gathered which is to the best of my knowledge:
1. Lisa was not present when the baby was born.
2. Lisa is not a Registered Midwife and doesn’t represent herself as a Registered Midwife. That has been agreed upon by all parties and she is not accused or charged for this.
3. The woman was having her first baby and transferred to hospital for pain management. I am told that the baby was delivered by non-emergency c-section, at the mother’s request. The medical reason given was failure to progress.
4. Mother and baby were discharged from hospital on a normal schedule.
5. Lisa is accused in the complaints of causing poor outcomes and delayed recovery, due to excess blood loss during the surgery.

If Lisa is found guilty of a summary offense the result will be a fine of up to $4000. This is not a criminal case and it is not a civil case. The burden of proof is on the Crown to prove that the defendant practiced unauthorized practices according to the Midwifery Act of Saskatchewan. If one reads the applicable section of the act quoted in the charge above, it is vague in its definitions.
This case will set a precedent as it is the first in Saskatchewan and will have national implications.
The trial date is now set for October 24, 2017.

Start of Section 23 (2) No person shall engage in the business or practice of performing any of the authorizedpractices described in subsection (1) with respect to another individual unless:
(a) the person is a member who is authorized by his or her license to perform
that practice;
(b) the person is authorized pursuant to another Act to perform that practice;
or
(c) the activity is one of daily living and is performed by the individual or by
a person on the individual’s behalf. (end of section)

I submit the above to help people see the bones of this complaint and action against Lisa Kusch. Thanks for reading. I will update/edit as more info comes to light. Gloria Lemay, July 12, 2017

Some people have asked if they can send money for Lisa’s fund by bank transfer so I’ve set up a separate email and bank account for that purpose. The email address is lisakuschfund@gmail.com I’ll post periodic messages on the GoFundMe page about the total that comes in via bank transfer.
Lisa Kusch

The GoFundMe page to donate to the legal fund is at https://www.gofundme.com/lisakusch

Rest in peace, Mayer Eisenstein, M.D.

Dec. 25, 2014 It is with great sadness that I share the news with you that a truly special man has died. Dr. Eisenstein was a home birth doctor who has been such a great friend to midwives and birthing families. He has helped to educate on the dangers of vaccines. He will be sorely missed. This message is from his son.

Mayer Eisenstein, M. D., Extraordinary Man.

Mayer Eisenstein, M. D., Extraordinary Man.

Bringer of Light

The name Mayer means “bringer of light” in Hebrew. What an appropriate name this is for my father. Just like the miracle of Chanukah where the lights did not go out, my father’s light did not go out. It was passed on to his children, his grandchildren, his partners, and all who knew him. They will be sure to keep his light burning strong. He was always a beacon for the causes he championed such as, vaccines and religious choice, minimal intervention, minimal pharmaceuticals, and supplemental use. His philosophy will continue in our endeavors as he would want.

As many may have heard, my family has had the ultimate loss. Monday morning we lost our patriarch, Mayer Eisenstein, MD, JD, MPH. He was the greatest Husband, Father, Grandfather, Son, Physician, and Attorney. In essence, there was nothing in which he did not excel. If Dad wanted to do something, not only did he accomplish it; but it would be completed in record time with accolades, awards, and incredible respect from his peers. Even in the field of medicine where you would expect him to have “enemies”, it was the very rare exception. More often than not, there was nothing but respect, praise, and gratitude for his expressing an opinion that many agreed with but did not have the courage to utter. This is a terrible loss for the entire community.

Everyone knew him as the physician who gave you all he had. He made sure every patient he saw felt that they were his number one patient, period, because at that moment they were. He might not have remembered your name, but he could recite every aspect of your medical history by seeing your face. Countless times we could be somewhere, and a person would walk up to him and say, “You delivered my daughter fifteen years ago.” Within a minute he would recite, “Wait, it was snowing in October, you had a short labor followed by a mini birthday party.” The feelings of exuberance were as much for him as was for the patient. No physician ever gave as much of themselves to their practice. In the course of practice, his organization delivered over 15,000 children and took care of 20,000 families. With his study in medicine these families got the benefit of Minimal Cesarean Section, No Autism, No Asthma, No Juvenile Diabetes, and a greatly reduced incidence of infection and sickness. One time, in a record’s review, the reviewing physician said, “Eisenstein, you are just lucky.” To which his superior said, “Would you rather us have unlucky Doctors?” Call it luck; you came to this practice and you stayed healthy.

As much as he gave to his patients, he gave to his family even more. In my early childhood, it was standard practice for us to take two cars where ever we went. Dad would regularly be called away to assist a woman giving birth all hours of the day, rain or shine. This never stopped him from being with us. Many times he would come home in the middle of the night not ready to go to sleep. If I were the least bit up, he would come by me saying, “Let’s go out a little bit.” It was always the same. We would go to 7-11 and play some pinball for an hour. He always told my mother, “Stop worrying about what time it is. Spending time with my children is more important than worrying about school. My children will be successful period!” He left this world with six children. All with advanced degrees: four with doctorates, an attorney, two nurse practitioners, two veterinarians, and the youngest person to ever complete all levels of the actuarial examinations. There is no arguing about his success in raising his children and making them all great.

As his oldest son, I can go on with examples, stories, and the like. To me, he was my father, mentor, best friend, partner, and classmate (we went to law school together, which is a story in and of itself). He was involved in every facet of our lives. Since he was involved in every aspect of our lives, in the practice and in everything else, he gave me and my sister the tools we need to carry his message forward.

With this great tragedy in all of our lives we will still be here serving his practice and extended practice with the philosophy he cultivated over the FORTY PLUS years he was in practice.

Jeremy B Eisenstein Esq.

Paul M. Fleiss, M.D., M.P.T.

In Loving Memory
Paul M. Fleiss, MD, MPT
Sept. 18, 1933 to July 19, 2014

Paul Fleiss 1933 - 2014

Paul Fleiss 1933 – 2014

Dr. Fleiss was a father of 6 children and a much-loved and respected Pediatrician for 50 years in the Los Angeles, CA area.
He spoke up for babies and was a voice of reason about the importance of breastfeeding, attachment parenting and keeping boys intact. He genuinely loved babies and wanted them to have the best health possible. In 1997, Dr. Fleiss wrote an article for Mothering Magazine called “The Case Against Circumcision”. Peggy O’Mara, the founder of the magazine adopted that title for the forum on her website on the subject of ending circumcision. Peggy would not permit any discussion that endorsed male genital cutting and the name of the forum was self-explanatory. To read Dr. Fleiss’ article go to this reprint. http://www.mothersagainstcirc.org/fleiss.html

I met Dr. Fleiss when we both attended the International Symposium for Genital Integrity in Seattle, Washington; August 24–26, 2006. I was thrilled to meet him and be able to thank him for all his efforts to make life better and healthier for children.

Dr. Paul Fleiss, Gloria Lemay, Gillian Longley, Jenn Beaman and other intactivists in Seattle.

Dr. Paul Fleiss, Gloria Lemay, Gillian Longley, Jenn Beaman and other intactivists in Seattle.

Carla Hartley of Ancient Art Midwifery Institute brought us together again at a Trust Birth Conference in 2008 in California. I will remember him as a warm and happy man who made a big difference in the lives of those who were fortunate enough to read his books/articles, meet him professionally or use his services. He provided leadership to many physicians who have joined him in urging the abolition of male genital mutilation.

Jay Gordon, M.D. wrote about his memories of training with Paul Fleiss at http://drjaygordon.com/in-the-news/paul-fleiss-md-1933-2014.html

I offer deepest condolences to the family and close friends of Paul Fleiss. This fine man will be remembered with love and appreciation by doulas, midwives, lactation consultants, nurses and parents who will benefit from his work for a long time into the future. Gloria Lemay, Vancouver, BC Canada

Memorial Service for Marsden Wagner

What: Memorial service for Marsden Wagner
When: Saturday, May 24th, 2014 at 1330 hrs., or 1:30 p.m.
Where: Harmony Grove Church at Lockeford Cemetery, just outside Lockeford, California ( see link to Google maps )
Who is invited: everyone

https://maps.google.dk/maps?q=Lockeford,+CA,+United+States&hl=en&ll=38.176469,-121.15448&spn=0.041765,0.077162&sll=55.869147,11.228027&sspn=3.816204,9.876709&oq=lockeford,+ca&hnear=Lockeford,+San+Joaquin+County,+California,+United+States&t=m&z=14

From Dana, Marsden’s son:

“Because my father was a very informal person, the memorial will be intimate and informal also, and everyone is invited to get up and say a few words, or tell an anecdote about my Dad….we will read some words sent in by those who cul not make it …..afterward, we can walk into the beautiful historic cemetery and hold a short ceremony by his gravestone, which will be in place, and his ashes interred by then… There is lodging nearby, and some of us may go into Lockeford for coffee later, we’ll play it by ear… Please, everyone, family included, I haven’t got that many email addresses, so could you all contact everyone you know and forward this message, please? Put it on Facebook and everyone’s invited…. I, Dana, can be contacted 24/7 here in California at 805 886-8277, I can possibly help with lodging…. Lastly, anyone possessing photos or other memorabilia about Mardy, please bring it with you, or send it to me at: 17 Ocean Front Ln. Cayucos, CA 93430 USA There will be things to look at, perhaps some of his favorite music too, and the church was built in 1860, so come one, come all, let us celebrate this special man in a special setting, the Wagner/Hansen family graveyard. Love, Dana”

Marsden Wagner and his son, Dana

Marsden Wagner and his son, Dana

Marsden Wagner, MD, remembered

Author of "Pursuing The Birth Machine". 1994

Author of “Pursuing The Birth Machine”. 1994

Update on May 4, 2014. From Marsden’s son, Dana regarding a memorial celebration: “Thank you for your kind words, my Dad was a very special guy, and I hope we can do him a little bit of honor on the 24th of May, a Saturday, in a little town East of Sacramento called Lockford, where the old family grave is located, at the foot of the Sierra Nevada mountains….
I don’t have any times finalized as yet, but I will be writing an invitation to the whole world to attend a very informal memorial, as my father was a very informal kind of guy….put the word out, it’ll be nice, and absolutely everyone is welcome! There will be music, etc, and everyone can get up and say a word too….
Let’s all celebrate Mardy….I’ll write you soon, with details, best regards, Dana
p.s. here’s a few photos of my Dad’s beloved California, we got some rain, so it’s green at last!!”

This letter was shared on Facebook by Christal Bratton. Thank you, Christal! I’ll update here as details become available, Gloria

Marsden Wagner was my friend and teacher. I first met him when he testified in my (and Mary Sullivan’s) defense in a court case in British Columbia in 1986. When we asked him to testify, he requested that we send him our notes and chart from the case. He, then, took those notes to a physician and a midwife in Europe, where he lived at the time, and asked them to review our paperwork. He didn’t tell them that the baby had died of an unforeseen complication, shoulder dystocia, right at the end of the birth process. The notes ended minutes before the complication. Both of his chosen practitioners said to him “We would not criticize what the midwives have done from these notes.” That was when he became part of our defense team.

In the years following, he and I had many reunions at midwifery conferences. We ended up on the same plane going to one conference and I remember telling him how much I admired him and how important his work was. He replied, “Gloria, you and all the women who actually go to the births, are the ones that I admire. You keep me going and I stand in awe of you.” I was so touched by that acknowledgement. Another time, at a conference he said something that has helped me through many tough places in my career. He said “I’m only in this movement because it’s a parade that I can dance in. If you can’t enjoy this work, don’t do it.” He wasn’t passionate about birth in a suffering way. . . he loved babies and he wanted to move obstetrics in an intelligent direction that would serve all of humanity, and he had fun with the journey.

I share this article from the Lancet with the young midwives of today. A lot of what Marsden contributed is in books and journals and might not be easily found on the internet. This is a historical perspective on a dark period of persecution of midwives that continues to this day. I want to keep his perspective alive for future generations. Thank you for your life of service, dear Marsden, Gloria Lemay

Marsden died in April 2014 at the age of 84.

Marsden died in April 2014 at the age of 84.

Reprinted from ‘The Lancet’ – Vol 346 (1995): 1020-1022
A global witch-hunt

Marsden Wagner

5 years ago a midwife working in the University hospital in Uppsala, Sweden, told the chief of obstetrics that she was going to assist occasionally at home births. Although he was angry, he could not stop her since home births attended by a midwife are not unlawful. Nevertheless, the pressure from the hospital doctors became so unpleasant that, after a while, she felt she had no option other than to resign from her hospital post. Her independent practice flourished, although she was unable to get any local doctor to back her up or even give her occasional advice. She was denied hospital privileges and was unable to follow labouring women to hospital if the planned home birth needed transfer. She had no perinatal deaths and encountered no problems with the families she served. Yet, in 1994, the chief of obstetrics asked the local government authority to investigate her practice.

There is a global witch-hunt in progress – the investigation of health professionals in many countries to accuse them of dangerous maternity practices. This witch-hunt is part of a global struggle for control of maternity services, the key underlying issues being money, power, sex, and choice. The investigation often leads to a public court, a medical review board, or a health insurance review board. Over the past 10 years I have been asked to consult, and in some instances testify, in twenty cases in ten countries – a very small proportion of the actual cases. In the USA alone: “Though no one knows how many out-of-hospital midwives have actually been charged, we have reports of legal altercations involving more than 145 out-of-hospital midwives in 36 states” (1)

Whilst the profession of the accused in my twenty cases includes obstetrics (Austria, Italy, UK), general practice (Australia, New Zealand), and midwifery (Canada, France, Germany, Italy, Sweden, UK, USA), the striking thing is that, of the accused, 70% were midwives and 85% were women.

Bringing a health professional before a court of review board is the last and most extreme sanction for professional deviances. In the cases I am familiar with, other sanctions have included loss of hospital privileges (Australia, Canada, France, Italy, Sweden, USA), refusal of insurance companies to provide malpractice insurance (USA), and refusal of insurance companies or governments to reimburse certain practices such as home births or alternative birth centres (Australia, New Zealand, Germany, USA).

In the twenty cases, all of the accused have one thing in common; at least some of their practice is not mainstream. In other words, what they do is not what the local doctors in authority most commonly do. For example, of the twenty accused, fifteen practised home births, three practised in alternative birth centres, and two were doctors in hospital practice. All of the midwives were in independent practice. Orthodox maternity care providers are seldom brought to review boards but, in the USA and Britain, over 70% of obstetricians have been sued one or more times by parents. Unorthodox providers are rarely sued by parents but are now being brought to review boards or public courts by the medical establishment.

Irrespective of the country, certain methods are commonly used by the obstetric establishment to accrue evidence against the accused. For example, in most cases, the doctors notify the legal authorities only after a perinatal death. One death, even if not preventable and not the result of any mistake, suddenly negates years of impeccable statistics. This is in stark contrast to what happens when an orthodox doctor is involved in a perinatal death in the hospital – there may be a hospital review committee meeting behind closed doors but it will not come to the attention of the public or legal authorities. After 25 years of successful practice, an obstetrician in Rome who favours the Leboyer approach had a perinatal death. She was immediately sued after other doctors told the family that the death was due to the “soft” methods used at birth. 10 years ago midwifery was illegal in Canada but the obstetricians knew there were a few midwives managing home births. The medical establishment waited until there was a death during a home birth in Toronto, and then immediately went to the provincial prosecutor claiming it was a preventable death. The midwife who assisted at the home birth was taken to court.

Another ploy is to scrutinise obstetric patients records connected with the accused looking for possible mistakes. This method was used against doctors in London, Vienna, and Melbourne. With midwives, a common method is to accuse them of practising medicine without a license. Sometimes local law-enforcement officers (police) will arrest the accused individuals, search their records, cause them to spend money on legal assistance, and then just before the court date, drop the charges. Such a strategy creates fear in all those in that community who might deviate from orthodox practice.

Once the case is brought before a court or review board, other methods are commonly adopted. Threats may be used to pressure local doctors who are perceived to be sympathetic to the accused so they will be too afraid to testify. A local doctor in the Toronto case mentioned above informed me that he was told he would lose his hospital privileges if he testified on behalf of the accused midwife. Because the defence lawyer in this case could not find a local doctor to testify, the lawyer turned to me because I am a physician and perinatal scientist with many years experience as a specialist in maternity services in the World Health Organisation.

The local professor of obstetrics usually testifies for the prosecution, and the testimony is based on what the professor believes to be acceptable practice rather than on the scientific evidence. Attempts are made by the prosecution to prevent outside experts from testifying. For example, a judge in a court in Vienna would not allow me to testify because I was a “foreigner”, and in Sicily a judge would not allow me in the courtroom except when I gave testimony for the defence, although a local professor of obstetrics, who testified for the prosecution was allowed in the courtroom at all times. Moreover, tribunals, especially if they are medical or insurance review boards, usually try to forbid the public or media from being present. In London in the 1980s. Mrs. Wendy Savage, an obstetrician, caused an enormous upheaval when she demanded – ultimately successfully – a public hearing. (2)

The results of these cases have been mixed. The circumstances of the trial affect the chances that the accused will win the case. The accused who comes before a public court with a jury has the greatest chance of winning. The chances are progressively less with a public court with a judge, then a medical review board open to the public and the media, and finally a closed medical review board. If the accused is allowed to bring in experts to testify, including those from other countries, the chances of winning are higher. If the case has media coverage and the accused has visible media support, again there is a better chance of winning, as was the case with Mrs. Savage and the California and Toronto midwives.

If the accused loses, that often means losing the possibility, at least temporarily, of continuing to practise. Apart from the great personal losses entailed there is an impact on the health professionals. Midwives in that country feel threatened in their independent practise rightly fearing loss of medical backup and/or hospital privileges. Doctors are afraid to support midwives or to go along with the wishes of their patients when the requests are outside mainstream policy – eg, water births. Women in that community therefore lose the freedom to choose among a broader set of options for giving birth.

Conversely, investigation of independent midwives and unorthodox doctors, with a possible board hearing or court case, can sometimes have the opposite effect, leading to solidarity among midwives and between midwives and unorthodox doctors, and women, irrespective of whether the accused wins or loses. The trial of the midwife in Toronto began with a process which resulted in the eventual legislation of midwifery in the province of Ontario. Similarly, the case of Mrs. Savage in London brought about a re-examination of the medical review board system. In a case I was involved with in California, the state board of medical quality assurance recruited the local police to assist them in organising an entrapment operation, arrested a breastfeeding midwife, took her infant away, and threw her in jail because a local obstetrician accused her of practising medicine without a license. In another case, as reported by Korte,’ “In 1994, the 13-year-old daughter of a California midwife was kept on the floor at gunpoint while law enforcement personnel searched for evidence of a midwifery practise. Such harassment and many trials of midwives in California eventually led to new state legislation strengthening midwifery.”

Nevertheless, there is no apparent slowing of the global witch-hunt. In the 1980s, the German society of Obstetrics and Gynaecology demanded that their government abolish the law requiring the presence of midwives at all births, and in 1990 the same society wrote to their national government demanding that home births be outlawed. This plea failed and the society has now turned to Lander (state) governments with the same demands. In 1994, there were attempts in France to forbid independent midwives from entering the hospital when a home birth patient had to be transferred. Last year also saw the first attempt in Sweden to bring an independent midwife to tribunal.

The witch-hunt is part of a global struggle for control of maternity systems and there are several key issues, one of which is economic. An obstetrician in private practise in Des Moines, USA, told me that he and the other obstetricians in that city were determined to close down the only alternative birth centre, staffed by midwives, because “it is stealing our patients” (Shortly after this remark, the only doctor in the city willing to back up the alternative birth centre retired and, since no other doctor would provide such support, the centre had to close.) As birthrates fall, the competition for pregnant patients increases, especially in countries largely reliant on private medical care; and as more and more countries move towards pluralistic health care systems with private practice, maternity care becomes more competitive. However, in the face of increasingly limited economic resources, governments and insurance companies are becoming more and more concerned with the waste associated with high-technology, high-intervention obstetrics. It is much more difficult for obstetricians to defend this expensive type of practice when midwives and a few doctors are meanwhile showing that a much less expensive type of maternity care is equally safe. The witch-hunt is an attempt to display lack of safety among the competitors.

A second issue is the control of maternity services. Until recently, government regulations in most countries have given medical doctors a monopoly in providing health services. Medical licensure represents “a social tolerance for a monopoly in return for a promise of social benefit in the form of competent and dedicated medical care”.'(3) But this monopoly can easily be abused, especially behind closed doors. The issue becomes one of peer control versus accountability to the public. In medical board reviews of professional behaviour, if the medical profession can make secret judgments on the accused, the doctors have absolute control of their monopoly, and there is the possibility of abusing the system for professional gain.

On the other hand, in a public court in which a judge makes the final decision, there is a danger that the judge, as part of power elite in the community, will be more influenced by another member of the same elite-the local professor- than by a midwife or even by outside scientific opinion. From my experience in the courtrooms in Sicily and Vancouver, where the judge made all decisions, the judge and the local professor of obstetrics testifying for the prosecution in both places made no attempt to hide that they knew each other well and that they shared their annoyance that the defence had brought in a foreign expert. But if the public court uses a jury to make the final decision, there is a greater possibility that the midwife or outsider will be listened to. There is a great difference between unorthodox doctors and midwives being judged by orthodox doctors and judges or being judge by the public – and that is why it is so important to have a medical review board open to the public.

Fortunately the pendulum is swinging, at least in some places, with the coming of quality assurance systems that include public accountability of health care and health care professionals. Maternity services are in the forefront of the controversy over peer control and public accountability because birth, like death, is a deeply personal social and family event and does not fit the doctors disease model. So today the medical monopoly of maternity services is coming into question and the witch-hunt is one means of reasserting the orthodox doctor’s control

Choice and freedom for health care consumers are at issue here. In the USA and UK, consumers of health care have been asserting themselves for some time. The health consumer movement is slowly coming to continental Europe but it is still almost non-existent in central and eastern Europe. This lack of freedom of consumer choice is illustrated by a statement in an article about home birth, published in 1994 in a German journal of obstetrics and gynaecology: “It remains to be tested in law whether the infant has legal claims, independent of the mother, to the best possible standard of safety in obstetrics.” (4)The claim is made that the obstetrician must protect the best interest of the fetus by overriding any woman’s choice not approved by orthodox obstetricians. As pluralistic health care systems increase in Europe, so will consumer choice; the witch-hunt is one way of limiting that freedom of choice.

Choice and freedom for healthcare providers are also at stake here. There is considerable peer pressure to conform because deviations may threaten the legitimacy of supremacy of a standard of practice based on opinion rather than evidence. It is no coincidence that 90% of the accused in my sample were involved in homebirth or alternative birth centres. It is important to distinguish between the quality assurance function and the witch-hunt function so that the courts are not inappropriately used for professional gain. When making that distinction in a particular case, think about who might gain from a successful prosecution; is the evidence brought against the accused scientifically based ?

Whilst tribunals may have a declared function to weed out true incompetence and protect the public in the cases I describe the real function was to punish deviant professional behaviour that could threaten the income, practise style, prestige, and power of mainstream doctors.

For example, the time and effort spent recently by the California state board of medical quality assurance trying to prosecute independent midwives might have been better spent pursuing incompetent doctors. A recent review of state medical boards in the USA showed that most states have a long way to go before “they are even beginning to seriously protect their residents from doctors who are incompetent, sexually abuse patients, or otherwise have serious problems that interfere with delivering high-quality medical care in a compassionate way” (5)

Another issue is the two-hundred-year-old struggle of doctors to control midwifery. It is no coincidence that 70% of the accused in my sample are midwives, all in independent practice where they are not under the immediate control of doctors. Fear of being investigated by authorities is a strong deterrent to independent midwives.

Solutions begin with increasing the public’s awareness of the witch-hunt and its basis in political not medical issues. As quality assurance systems develop in health care, public accountability must be built in. There should be no closed doors in health policy making, in health service delivery, or when the behaviour of health professionals is being judged. The evaluation of professional behaviour must be based on deviations from practice based on scientific evidence rather than on deviations from peer-controlled opinions of what constitutes good practice.


References

1. Korte D. Midwives on trial. Mothering 1995 (fall issue); 21-25.
2. Savage W. A Savage enquiry, London: Virago, 1986.
3. Jonson Q. Waiting for the doctor. N Engl J Med 1983, 308; 1531-34.
4. Berg D, Suss J. Die erhohte Mortalitat in der Hausgeburtshilfe. Geburtsh u Frauenheik 1994; 5: 131-38.
5. Wolfe S. News and notes. Ob Gyn News June 1, 1994.
Two Candles on my Altar

Marsden’s daughter, Karen, shared this about her Dad:

28 April My father, Marsden Grigg Wagner, died peacefully yesterday in hospital in West Virginia. He had an amazing life and did more and helped more people than most of us could ever dream of. I will remember him as warm and caring and loving and charming and brilliant and musical. He loved me very much and we had lots of great times together. I am lucky to have so many good memories of him.

Oh Canada

Mulidzas-CurtisWilsonflag_n

I saw this piece of Canadian First Nations Art on Facebook and thought to myself, “Hmmmm, I love it and I also know a woman who has a flag manufacturing business. I should get them together.” I didn’t hear a thing about it after that and, today, I was tagged in a post on FB announcing that the flag is being produced. I am so pleased. . . what a wonderful age we live in where it’s so simple to network people who do excellent work.

Here’s what the artist said:
Mulidzas-Curtis Wilson (facebook account name)

Gila Kasla-Greetings,

It has been a long time coming…but I would like to announce that my rendition of the Canadian Flag is finally going to be produced into an actual flag that can be hung and flown. I have been working with The Flag Shop based in Vancouver and they will be producing the design on a flag that measures 27″ x 54″. The flag will be screen printed on 200 denier nylon. It will be finished with rope and toggle in the sleeve, which is the standard way flags are finished in Canada.

These flags will be available at the beginning of March through their website and also through their 13 stores across Canada (Vancouver and 12 others). They offer shipping all over the world. These flags will be sold for $79.95 and I am posting this to get an idea of who would be interested in ordering a flag. If you or someone you know is interested in purchasing a flag, would you please send me a private message? Email info@curtiswilson.ca

Gila Kasla-Thank you

If you know someone who orders flags for civic functions, please have them consider this one. Let’s get some publicity going for this project, too.

Hungarian midwife in jail

Hungarian OB/Midwife, Agnes Gereb, has been incarcerated for attending home births. This is a powerful piece speaking to her cause and is a call-to-action over the Dark Age-style health policies still alive today. One of my favourite quotes in the video: “Psychiatry and obstetrics are two of the most insane fields within the world of medicine.” The video features Psychotherapist, Andrew Feldmar, Please watch it and pass it on.

What can we do to obtain the release of Agnes (Agi) Gereb?

1. Contact politicians, media and relevant agencies in your country to
protest against the events in Hungary, and to insist that they contact the
Hungarian government directly to express their disapproval.

2. Contact the Hungarian embassy in your country. In particular, if any of
you are in a position to organise a protest demonstration outside the
Hungarian embassy in your country, we would be pleased to know of this and
to help you in this task.

3. Send a letter of protest to and of the following people:

• Ministry of Health in Hungary (Dr. Miklos Szocska, Ministry
of Health, Social and Family Affairs, Budapest 1051, Arany Janos Utca
6-8, Hungary)

• Ministry of Justice in Hungary (Dr. Forgacs Imre Jozsef,
Ministry of Justice and Law Enforcement, Igazsagugyi és Rendeszeti
Miniszterium, 1363 Budapest, Pf. 54., Hungary).

• Prime Minister of Hungary (Viktor Orban, 1054 Budapest,
Hungary, Szechenyi rakpart 19). fidesz@fidesz.hu

• *János Martonyi Minister of Foreign Affairs *kozkapcsolat@kum.hu

*• **Tibor Navracsics*, Minister of Public Administration and Justice

1357 Budapest Pf.2 lakossag@kim.gov.hu**

• *Office of Parliament,** *Committee on Human Rights,
Minorities, Civil and Religious Matters. 1358 Budapest, Széchenyi rkp.
19. emb@parlament.hu

• *Sándor Pintér, Minister of the Interior* 1903 Budapest Pf.:
314 ugyfelszolgalat@bm.gov.hu

• *Dr. Tamás Kovács, State Prosecutor* State Prosecutor’s Office

1372 Budapest, Pf. 438. lu@mku.hu

• *Budapest** Courts* 1363 Bp. Pf. 16 Fax: +361-354-6066

• *Hungarian National Press Service* 1016 Budapest, Naphegy tér
8.mti@mti.hu

4. Send a postcard with words of support to Dr. Agnes Gereb in prison
at Fovarosi Buntetes Vegrehajtasi Intezet., 1055 Budapest, Nagy Ignac
u. 5-11, Hungary

5. Join the Free Gereb Agnes page on Facebook
http://www.facebook.com/profile.php?id=1132929673

6. Sign the petition for birth choices in Hungary:
http://www.petitiononline.com/szul2010/petition.html

7. Donate money towards Dr. Gereb’s legal expenses:

Születésház Egyesület

CIB Bank

10700567-65588927-52000001

IBAN: HU54-1070-0567-6558-8927-5200-0001

8. Spread the word! Inform your friends about this campaign.

Dec 21, 2010 update

Agnes has been released home on “house arrest”. This was on Facebook from Ina May Gaskin:

Here’s what Ina May has on her FB page: On December 20th, Agnes’ birthday, the Ministry of Natural Resources and its Department of Health held a press conference and publicly announced the birth of the new regulations regarding out of hosp…ital deliveries. There are some severe r…estrictions, like no previous C-sections, but we are hoping that this is just a start. The government promised to build birth centers in the countryside so that women can benefit from midwife assisted out of hospital births there
as well until many more home birth midwives will be trained.

Now we’d like to see all charges dropped against her and the other 4 midwives who have been charged with “reckless endangerment.” International pressure clearly helped.

INSPIRATION

Inspiration:
Definition:
1.
a. Stimulation of the mind or emotions to a high level of feeling or activity.
b. The condition of being so stimulated.
2. An agency, such as a person or work of art, that moves the intellect or emotions or prompts action or invention.
3. Something, such as a sudden creative act or idea, that is inspired.
4. The quality of inspiring or exalting: a painting full of inspiration.
5. Divine guidance or influence exerted directly on the mind and soul of humankind.
6. The act of drawing in, especially the inhalation of air into the lungs.

This morning I saw this comment on my friend’s Facebook page:
“. . . In the years after my midwife’s trial and our persecution, even though I had to run away and bleed, knowing Gloria was still out there, holding the place of women, at times kept me breathing and hopeful that all was not lost. I appreciate you both so much.

When I read these words, I marveled that I had not even known about this woman’s troubles. I live on a different continent from her. And, yet, somehow something I did gave her strength in her difficult time. What grace it is to know that my courage made a difference for someone else.

I then started thinking about from where my inspiration comes. One source is the many, many inspiring stories that were told to me as a child. “Daniel in the Lions Den” was what came to mind when I was being driven to prison in 2002 and I had such peace knowing that, like Daniel, I was a good person and that, if I just kept on being decent, everything would be fine.

When I was on trial from 1985 to 1986 for being a midwife involved in a baby death at a home birth, I had an extraordinary partner in adversity who gave me inspiration in the darkest hours. Rick Hansen is a man from Vancouver (where I live) B.C., Canada who has a spinal cord injury. He set out in his wheelchair at the same time as our trial started. He was going to wheel across 4 continents and across the Great Wall of China to bring attention to spinal cord research and raise funds. Many locals said he wouldn’t succeed. He was under funded and many put him down because they thought it was a stunt and a copycat of Terry Fox’s Run for Cancer which had happened in Canada earlier. The whole country had fallen in love with Terry Fox and didn’t want a new hero to emerge, it seemed.

Rick, who was 27 years old at the time, set out anyway and, as he persevered, others caught the spirit of what he was doing and public support built month by month. Our stories were side by side in the newspaper for a long time and I thought about him in a wheelchair going 85 kms per day and it gave me the strength to go down to the Court House and face the criminal justice system and the medical/pharma giant even though I was terrified.

When he returned to Vancouver in 1987, there was a huge “Welcome Home, Rick” celebration held at a large shopping centre in our city. At the time, I was still appealing my conviction and I was working as a nanny. The day he returned, I told the children I looked after that we had to go to the shopping centre and welcome this man home. I had to park a long way away from the event and I found a shopping cart and loaded the 3 kids into it. They had to stand together and hold on and they really didn’t like it much. It didn’t matter. I told them, “we are going to see a hero and this is very important.” It WAS very important. This man had carried me through a very hard time.

I saw him one time on a ferry and I really wanted to go over and hug him but I talked myself out of it. He was with his family and I didn’t want to disturb them. I regret that now.

From where does your inspiration come? Do you know for sure that there will always be something or someone there to give you strength if you look for it?