Category Archives: Hospital birth

WISE WOMAN WAY OF BIRTH DOULA TRAININGS (2025)

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The Next Scheduled Course begins on
Saturday, January 18, 2025 at 10:00 a.m. (Pacific Time)
Cost: $675 (Canadian)

taught by Gloria Lemay

Jessica Austin, with a Doula client.

Jessica Austin, with a Doula client.

This course will give you the skills to assist women giving birth at home or in hospital. Doula services are in demand. There is a pre-reading requirement. Please email waterbirthinwoman@gmail.com for further information and to register for the course.

The course will be on Zoom and assignments and tests will be on Google Classroom.
12 Classes 2 and a half hours long. .

Course One in 2025: Saturday mornings (Pacific)

Successful students will receive Wise Woman Way of Birth Doula Training certification.

OVERVIEW OF COURSE CONTENT
Class 1: Introductions, birth “politics” and Language
Class 2: Preventing Problems before the Birth: Nutrition. Prenatal Screening
Class 3: Types of “support” in birth: Midwife, Dr, Obstetrician, Doula — what are the differences? Comparison of home and hospital choices. Assisting your client in making a clear Birth Plan for the chosen place of birth.
Class 4: Anatomy and fetal positions, introduce the concept of “pain” and normalizing birth sensations through knowing the anatomy. Introduction to the concept of breech and twins as variations of Fetal positions.
Class 5: Medical Birth Phases and the “real” phases of birth and how to recognize them.
Class 6: Breastfeeding and early days postpartum and newborn care / Doula Role in these.
Class 7: Common Interventions and the Intervention Cascade. (Fetal monitoring, ultrasound, epidurals, Caesarean, vacuum, forceps, etc.)
Class 8: Preventing Birth Derailment in common scenarios and special situations: Induction for Postdates, augmenting a “slow” birth, a diagnosis of Low or High Amniotic Fluid Levels, Meconium, premature release of the membranes, vaginal birth after cesarean (VBAC).
Class 9: “Informed Choice”: what it *really* means and how to use it as a tool for your client vs a tool for enabling the institutional model of birth, more work on creating a Birth Plan with a client
Class 10: Business Basics: Finances, record keeping, professional practices, client confidentiality, and effective advertising. Structuring a plan for working with clients from interview through to completion.
Class 11: Comfort Measures, supporting Long Births, Helpful things to say, Water Birth.
Class 12: Staying calm when the baby comes: Miscarriage, Abortion, and Stillbirth. How to support people through the hard things in birth work.

Added on May 22, 2024 From Gloria, I am training a great group of women to be birth doulas currently. It’s quite amazing to see them creating alliances and support structures from taking an online course. One of them voiced in the classroom that she thought the class would be about rubbing backs and saying comforting words to birthing women. Instead of that, we have to prepare the students for the “sysem” and how to navigate it to protect their clients from harm. This is my response to her: Quote: “Gloria Lemay May 19”
Oh, I wish so much that we could teach a nice course on how you should all be team players, think positive, reframe every terrible experience into a good memory for your client, be liked, be appreciated and live happily within a specific “scope” of practice. There are courses that try to “sell” that model of being a doula. We’re a little different. We name “Obstetric Violence” , “Medical Rape” and “Birth Trauma”. The numbers don’t lie. When 40% of our sisters, cousins, aunts, friends and associates are having their bellies cut open with a knife and their babies being dragged out drugged and dazed, we just can’t “sell” a denial of the facts. Medical birth is assaulting women.
All of your comments above are so important. Thank you for taking the time to read/watch the materials. I know they are disturbing. We need every one of you in the birth advocate business. It is scary and intimidating at times. That’s okay. You’re going to learn and experience things that will help you be better consumers of medical care to protect yourself and your family. You’re going to have moments of such pride and accomplishment when you know you’ve made a difference. You’re going to have times when you want to quit and get a nice job at a supermarket—-don’t do it! The secret agenda I have for each and every one of you is that eventually you’ll all be the woman in your community who is the “Go To, Birth Woman”. People do recognize courage and persistence.”
Contact Gloria Lemay at waterbirthinwoman@gmail.com

A Doula’s Experience with Breech

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After a birth, it helps to get a perspective on what could have/ should have/ might have been different in order to learn and grow. Every birth story is different. Gloria

A DOULA WRITES:
The family had a super healthy (first) pregnancy, with opportunities
galore; access to acupuncture, chiropractics, yoga, watsu, massage,
walking, biking, good rest and healthy food (they are both vegan and
eat really well). They chose not to have any ultra sounds and had
her first internal exam at 40 weeks, at her request. She was quite
anxious about having internal exams, learned that it is possible to go
through pregnancy and birth without any fingers up her vagina and
decided that would be best for her. She asked for the exam at 40 weeks
because she felt it would be better to have a ‘practice’ exam in a non
labour situation to see what it would be like just in case she wanted
to have one in labour.

Throughout her pregnancy her various health care professionals
palpated her belly and were sure the head was down. I don’t touch
bellies, I just pay attention to how women are carrying and moving and
what they are saying, and it seemed like a vertex presentation to me
as well. At 39 weeks, her chiropractor and her midwives noticed a
difference, but figured maybe the head was engaged. On her due date
she had an appointment with one of her midwives, who is quite new to
midwifery and she basically freaked out from feeling what she thought
were hands presenting and told the family they must go for an ultra
sound the following morning at 8am. The family was left quite worried.
I asked what she felt about the baby’s position. She said she had been
feeling flutters down below, and figured it was simply mild
contractions. I also asked if she was feeling pressure up in her ribs,
or if she was pushing down on her belly in discomfort, and she said
she had been feeling that way all week. I told her not to worry and
offered to join her for the ultra sound in the am.

Later that night I received a call that labour had started, she had
been contracting since her midwife appointment, but thought it was due
to the internal exam. The contractions were building, so she called
the midwives and they told her to go straight to the hospital for an
ultra sound and one of the midwives would meet them there. The ultra
sound indicated baby was breech and the OB on call was one of the only
in the city who was open to vaginal breech births, although he clearly
stated he was not interested in any marathons and she would have 6
hours to labour (no pressure!) The midwife assured them he was good at
what he does, but he was known to have no bedside manner. That was
pretty clear, but they didn’t care.

At this point their midwife said they could go home to grab their
stuff and take a pause. She was well aware that this was a total game
change from their water birth at home plan, so taking a moment at home
seemed an important part of their birth experience. They called to
let me know the baby was in fact in a breech presentation and that
they were heading home to get their stuff. I was pleasantly surprised
they were encouraged to go home, and told them to keep me posted and
take their time. I said I would meet them back at the hospital when
they returned.

We met at the hospital at 9:45. The midwife did a very gentle and slow
internal exam and found her cervix was 4 cm and stretchy. They had her
on the monitors after that. I asked if she could be on hands and
knees, but they couldn’t get the heart rate as clear, so that was
ruled out. She was laying on her side and after 10 minutes on the
monitor we heard major dips in the heart rate over and over, tried
getting her on her other side and baby was still dipping quite a bit.
The midwife was concerned of a cord prolapse, so the nurse came in and
did a very different internal exam, got right in there fast and
vigorously and felt bulging membranes and what she thought was a cord.
Suddenly two nurses had their hands inside of her, it was terrible.
They said they were trying to push the baby up off of the cord.
breech presentations

You can imagine how intense this was for the mother to be. The room
filled with nurses and it was announced that she would have an
emergency cesarean birth. They wouldn’t let her partner go with her,
this was also terrible. The midwife wouldn’t take no for an answer and
got her scrubs on to accompany her. I stayed with her partner. He was
a mess. We found the only nurse on the floor and asked if she could
keep us updated and I asked if there was any way her partner could go
in. They were waiting for the doctor to come (this whole time with the
nurses hands inside of her…) the doctor would do one more check to
make sure the cesarean was necessary. The nurse grabbed scrubs for the father
and he got changed, but just as he was going to go in the doctor
arrived.

I later found out instead of determining whether a cesarean was
necessary, he yelled at the midwife for having let them go home. One
of the nurses spoke up and suggested they instead focus on the task
at hand and he determined the cord was not presenting, but a foot was,
and her cervix was 8cm dilated. They went ahead and gave her general
and she heard the OB yelling at her midwife as she went under. Her
partner and I waited in the hallway, he made a comment that being the
dad waiting in the hallway while his baby was born felt like we time
warped to the 1950’s.

Baby was born at 10:45pm and dad held him for the first time in the
hallway at 11:10 pm. Apgars 8 & 9, and he was 5lbs 11 oz.

Mom and baby were moved to the recovery room and dad right away took
off his shirt and gave baby skin to skin cuddles until mom was ready.
At 12:45am the nurse said baby’s sugar was low and suggested formula
or glucose water. I asked mom if she was ready to try breastfeeding or
if she wanted me to get on the phone and call her friend who had
offered expressed breast milk if they needed. The nurses were outraged at this
suggestion, said they couldn’t allow it and so she did her best to
try breastfeeding. An hour later they did the sugar test again and it
was way up. The midwife and nurse were both in disbelief (the sugar
level raised from 1.9 to 3.7 in one hour!) The midwife commented how
interesting it was that they had no trouble believing the low number.
I told them it must have been the skin to skin contact with mom and
some colostrum that did the trick. Once they were settled and resting, I
drove home with their placenta and made them some quick prints and a
smoothie. They were happy to have had some of their birth wishes
granted.

Today the family is doing quite well. They are breastfeeding, resting,
eating well, have lots of support and are processing their unexpected birth
experience a little bit each day.

QUESTIONS:
– Could we have avoided those low decels if she could have been up on
her hands and knees?
– What happened when that nurse felt bulging membranes? Did she cause the membranes to release?
Or is it possible to feel a prolapsed cord through the bag?
– Could a baby with apgars 8 & 9 have been in such distress moments
before? (or was it that they were worried baby couldn’t handle two
more centimeters as well as pushing?)
– Was this the only way it could have happened? In general it felt to
me like everything happened as it had to, except those few questions
above that leave me feeling a bit curious.

I have never attended a cesarean birth (I have been a doula for four years).

Any way in which we can learn together from this story would be great.
Comments and feedback are very welcome.

Ruby

Gloria’s thoughts

    Dear Ruby, It’s getting to be hopeless to have a primip give birth vaginally to a breech.
    You must be traumatized/grieving about all this. Thank goodness you were able to give them some measure of getting their wishes met.:

    When the adrenalin gets going at a breech birth, they basically find reasons to head to the surgical setting. The cord wasn’t causing problems so, in hindsight, the heart tones were fine.

    Don’t know what the nurse doing the exam was intending but I would hope she was being careful NOT to rupture that membrane with a breech. Did she break the water bag? You would have seen amniotic fluid with clear poop coming out of the woman’s vulva after that exam if the membranes released.FOOTLING BREECH

    As far as diagnosing a prolapsed cord through the membranes with a footling breech, it might be possible because the bag is thin but it’s highly unlikely and, we know in this case (again, good hindsight), it wasn’t there.

    Apgars of 8 and 9 indicate a healthy, well grown term baby (again, golden hindsight). We do know that monitoring increases the risk of cesareans without any evidence that it is helpful in improving health.

    From what that dr with no bedside manner said, the woman wasn’t going to be given much of a chance to give birth vaginally. Since she hadn’t had previous uterine surgery, it would have been nice if someone with the skill to do a cephalic version had been there when she was first at the hospital. The baby presenting by the feet is the easiest to turn, especially if the baby is small and it’s early in the birth process. To be fair, a first birth with feet presenting is not a good vaginal birth risk to take. Luckily it is a rare situation to have so the numbers should be very low.
    footbreech

    If the caregiver is palpating bellies and listening with a fetoscope (instead of doppler) in the prenatal period, the caregiver should be picking up when it’s breech at 36 weeks gestation (if in doubt, the woman can have a one-swipe quickie ultrasound to double-check). At that point, if it’s discovered, there’s time/space to get baby turned to head down. As I said, a footling breech is easiest to get turned. Frank breech is a more optimal position for safe vaginal birth of breech but not for turning baby to cephalic. Querying rib pain, listening in the 4 quadrants with a regular fetoscope (and finding the true fetal heartbeat low in the pregnant belly) and observing the shape of the pregnant belly are your best tools for early diagnosis.
    Thanks for being there for this family. Gloria

“An Unnecessary Cut”, 20 min video on Hospital VBAC

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This video is timely and a valuable resource for birth workers. It’s a good length (20 mins) and it addresses that large number of women who are not ready for a home birth for a VBAC. It’s also a very good promotion for hiring a doula. Chileshe Nkonde-Price, a cardiologist at the University of Pennsylvania, wants to avoid an unnecessary Cesarean. This is the last week of her pregnancy. Enjoy and tell me what you think of it. Gloria

An Unnecessary Cut? How the C-section Became America’s Most Common Major Surgery – The New Yorker

Producer: Sky Dylan-Robbins

New Thinking in OBGYN

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Want to see the future in OBGYN? Just keep reading my blog. This morning’s email (2014) contained a newsletter that updates obstetricians on the latest trends. Some of which I wrote about in 2009 and 2011. Now, if we could just get these ideas into practice.

OBGYN Clinical Updates/ July 23, 2014 Analysis Questions Use of Antibiotics for Group B Strep During Labor
Do prophylactic antibiotics for group B strep do more harm than good? The practice of giving prophylactic antibiotics to women in labor who are positive for group B Streptococcus was based on studies with poor methodology, an analysis finds.
Gloria’s blog Sept 2011: https://wisewomanwayofbirth.com/group-b-strep-what-you-need-to-know/

OBGYN Clinical Updates/ July 23, 2014: Medicare Costs for Screening Mammos Have Soared: New Strategies Needed
Spending on screening mammography has increased 44% ($296 million) in 8 years, without a corresponding increased benefit of earlier detection of breast cancer. Analysts suggest this spending increase is unsustainable, and new screening strategies are needed.
Gloria’s blog 2009: https://wisewomanwayofbirth.com/seven-ways-to-reduce-unnecessary-medical-costs-right-now/

OBGYN Clinical updates/ July 23, 2014 POLL
Is the Pelvic Exam Important?
New recommendations against routine pelvic exams in adult women with no symptoms have been issued by the American College of Physicians. Many women will be happy to hear this. As a provider, are you?
Gloria’s blog 2009: https://wisewomanwayofbirth.com/7-tips-for-creating-a-calm-joyous-homebirth/

Just say "no" to stripping membranes.

Just say “no” to stripping membranes.

Added to post April 10, 2015
AROM (Artificial Rupture of the Membranes) October 30, 2007
Vital Signs
Childbirth: Purposely Breaking Water Does Not Speed Delivery By NICHOLAS BAKALAR

http://www.nytimes.com/2007/10/30/health/research/30chil.html?_r=1&ref=health&pagewanted=print&oref=slogin

A large review of studies suggests that a common procedure in labor, intentionally breaking the water, has no effect in reducing the labor time or assuring the baby’s health.

The procedure, sometimes called amniotomy, involves rupturing the amniotic membranes to speed contractions. The procedure has been in use for at least
250 years, although its popularity has varied.

The researchers reviewed 14 randomized controlled trials involving almost
5,000 women and found little evidence for any benefits. Amniotomy did not shorten the length of labor, decrease the need for the labor-stimulating drug oxytocin, decrease pain, reduce the number of instrument-aided births or lead to serious maternal injury or death.

The report, published Oct. 17 in The Cochrane Reviews, did find that the procedure might be associated with an increase in Caesarean sections and a reduced risk of a lower reading on the Apgar scale, which rates the baby’s condition at birth. But neither finding was statistically significant.

“We advise women whose labors are progressing normally to request their waters be left intact,” said the lead author, Dr. Rebecca Smyth, a research associate at the University of Liverpool. “There is no evidence that leaving the waters intact causes any problems, and there is not sufficient evidence to suggest any benefit to either themselves or their baby.”

Cytotec (misoprostol) injuries or death? Medical records needed.

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Hyper Stimulation of the Uterus cuts off Oxygen to fetus.

Hyper Stimulation of the Uterus cuts off Oxygen to fetus.

    From Jette Aaroe Clausen

I am engaged in the public discussion on induction of labor and misoprostol in Denmark. I and a colleague, Eva Rydahl, have addressed the Health committee in the Danish parliament. They have not banned cytotec but they have announced that they will do more monitoring of this and they issued a new circular making it mandatory for midwives and doctors to report side effects to off-label medication.

Eva and I strive to learn more about hyper stimulation and the way cytotec works. To do so we need patient records. We will of course treat them in confidence and not reveal any names. We will be grateful if we can be allowed to read any medical notes from patients (or their families) who have had adverse reactions to Cytotec (misoprostol). Fetal monitor tracings are especially useful to us. My colleague, Eva Rydahl (who is also on facebook), will also be happy to correspond with families. My e-mail address is jecl@phmetropol.dk I work at the Danish midwifery education in Copenhagen. I am an Assoc Prof of Midwifery and a researcher. Jette Aaroe Clausen, May 21, 2014

$70 million Birth Injury Case – Largest Arbitration Award in U.S. History (Cytotec Brain Injury)

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David Woodruff, Attorney
Posted on 07 May 2012.

LAW WEEK COLORADO

David Woodruff took home Case of the Year honors at last week’s Colorado Trial Lawyers Association Spring Dinner for a birth injury case stretching nearly five years.

“We are fighters for those who can’t fight,” Woodruff told the crowd as he accepted the award.

The partner at Hillyard Wallberg Kudla & Sloane in July helped obtain a $70 million arbitration award against the company which owned both the hospital the family of Abigael Blasco went to and the health maintenance organization covering the family. Nurses at the hospital, per instructions from the HMO, administered Blasco’s mother (Rebecca Blasco) an ulcer medication to induce labor despite warnings from the government and the manufacturer itself against this off-label use.

The medication, which cost more than $100 less than the approved labor-inducing medication, had been indicated in too-forceful contractions during labor, which compromises blood flow to the fetus.

The company provided Woodruff with differing fetal heart tracing reports from the day of the delivery. Comparing the different versions, he was able to show that Abigael had suffered a lack of oxygen during labor, which led to developmental issues for the 12-year-old.

Rebecca and Abigael Blasco with David Woodruff

Rebecca and Abigael Blasco with David Woodruff

Fighting for those who can’t fight seemed a theme of the night. Michael Rosenberg, shareholder at Roberts Levin Rosenberg, one of the two other nominees for case of the year, said of his case helping an accident victim, “If you have to fight for 11 years, then you do it.”

Robert F. Kennedy Jr., the night’s keynote speaker, was seen outside the ballroom pacing the hallways going over what he would later say. Stopped to chat, Kennedy called trial lawyers “my people.”
“These are the most important people to democracy,” he said. “They’re fighting for justice.”
Source: Law Week Online
http://www.lawweekonline.com/2012/05/david-woodruff-wins-case-of-the-year/

Birth Injury Case – Largest Arbitration Award in U.S. History
David Scott Woodruff
Case Conclusion Date:July 6, 2011
Practice Area:Medical Malpractice
Outcome:$70 million award, the largest in U.S. history
Description: Case involved a baby born at an HMO hospital in Los Angeles, CA. Mother was given improper dose of misoprostil (Cytotec) and Pitocin, and suffered uterine hyperstimulation, causing fetal asphyxia and severe brain injury. Child is now 11 years old and has severe mental and physical disabilities. Case was tried to a judge/Arbitrator in Orange County, CA.

Source: http://www.avvo.com/attorneys/80237-co-david-woodruff-1412913/legal_cases/72634

Youtube video of a lawyer, Mike Papantonio, talking about the methods of Pfizer (now the owners of Searle) who make Cytotec:
“Ian Read, who is the CEO of Pfizer. . . you talk about a bottom feeder of CEOs, it’s him.” (paraphrased)

High Cesarean rates: all talk, no action

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If we look at childbirth from the point of view of a game, the success or failure would be measured by the cesarean rate. When there is a 30% or higher rate of cesarean for first time mothers, there can be no excuse. . . those people playing the game are losing and losing badly. When there can be no denying that something is terribly wrong, what happens? The players get together and try to figure out what can be done to get a winning outcome. This has been done before by medical people with good results when action resulted. Unfortunately for women, it seems to be impossible to maintain positive results once the initial action plan is withdrawn. See my post.

There have been many statements, pledges, admonitions, expressions of concern, etc in the past 10 years about the impact on women’s health of all these major abdominal surgeries. See:
Cesareans Are Seriously Harming Women

Now we have a new statement put out by a team of people who are duly concerned in the USA. It mirrors other team reports. How many teams have to be gathered and how many over-educated people have to produce reports before a concerted program is instituted to stop the cesarean butchery of women in North America? We need action and we need it fast. Gloria Lemay, Feb. 12, 2014

______________________________________________________________

Experts Identify Key to Reducing Cesarean Delivery Rate
News | February 05, 2014 | Pregnancy and Birth
By OBGYN.net Staff

Continued education on reducing unnecessary cesarean deliveries must include particular attention to preventing the first cesarean delivery, as well as tapping into the clinician’s ability to modify and mitigate factors that often contribute to the cesarean, leading experts suggested.

The article in which these suggestions are published is based on a workshop aimed at preventing first cesarean delivery.1 The workshop was a joint effort of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Society for Maternal-Fetal Medicine, and the American College of Obstetricians and Gynecologists.

“Given the risks associated with the initial cesarean and its implications in subsequent pregnancies, the most effective approach to reducing overall morbidities related to cesarean delivery is to avoid the first cesarean,” said George R. Saade, MD, of the division of maternal-fetal medicine, department of obstetrics and gynecology, University of Texas Medical Branch, Galveston and chair of the Society for Maternal-Fetal Medicine’s health policy committee. “The implications of a cesarean rate of 30% or more—since approximately 1 in 3 pregnancies are delivered by cesarean—have significant effects on the medical system as well as on the health of women and children. It is essential to embrace this concern and provide guidance on strategies to lower the primary cesarean rate.”

In 1995, the total rate of cesarean deliveries was 20.8%, and the rate of primary cesarean deliveries was 15.5%.2 The rise in the rate of cesarean delivery compared with these 1995 rates is due in part to an increase in the frequency of primary cesareans, the authors noted, but it is also because attempts at labor after cesarean have declined.

Workshop participants developed a set of guidelines for preventing first cesarean delivery. They included the appropriate ways to identify failed induction, arrest of labor progress, and non-reassuring fetal status. Adequate time for normal latent and active phases of the first stage, and for the second stage, should be allowed, as long as the maternal and fetal conditions permit, they noted. The experts also determined that the adequate time for each stage appears to be longer than traditionally thought.

Other key points included:

Accepting operative vaginal delivery as a birth method when indicated. Given its declining use, training and experience in operative vaginal delivery must be facilitated and encouraged.
Counseling pregnant women about the effect of cesarean delivery on future reproductive health.
If cesarean deliveries are conducted for non-medical indications, the gestational age should be at least 39 weeks and the cervix should be favorable, especially in the nulliparous patient.

The complete study is available here.
References

1. Spong CY, Berghella V, Wenstrom KD, et al. Preventing the first cesarean delivery: summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists workshop. Accessed January 31, 2013. Available here.

2. Curtin SC, Kozak LJ. Cesarean delivery rates in 1995 continue to decline in the United States. Birth. 1997;24:194-196.

Source http://www.obgyn.net/news/experts-identify-key-reducing-cesarean-delivery-rate?cid=newsletter#sthash.UuS7x6rD.dpuf
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INDUCTION: Reasons you won’t believe

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These are reasons for inducing the birth process that have appeared in hospital documents:

From the physicians:

“Patient lives in Mexico”
“PTL” needing cervical ripening
“Physician Distress”
“Patient lives far away”
“Worrisome weather”
“She has a note from her husband” (he stated he understood all the risks and promised not to sue if there was a bad outcome)
The patient wants to fit in her prom dress
impending macrosomia
Approaching post dates
“Avoid unlucky birthday on the Chinese calendar”
“placental lakes”
“MOP”
Because the baby is sitting right there.
History of rapid labor ……. (this was for a first time mother)
Multip with history of rapid deliveries…for cytotec induction…
“her husband’s team is playing in town and he (professional athlete) wants to be at the delivery”.

Don't let them induce you

From the patients who want to
schedule their own inductions:
“My doctor scritched my membranes and told me to call you”
“Fireballs in my uterus” and “Fireballs in my Eucharist”
” I am here for “instruction” for labor”
“my doctor is going to indulge me next week”

Birth in North America circa 1975

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I just saw this photo on Flickr and it reminded me of what it was like when I was looking for a gentle birth in 1976. Thank heaven I found a midwife to attend me at home. Gloria

Woman Who Has Just Given Birth in the Delivery Room of Loretto Hospital in New Ulm, Minnesota...

Woman Who Has Just Given Birth in the Delivery Room of Loretto Hospital in New Ulm, Minnesota…

Original Caption: Woman Who Has Just Given Birth in the Delivery Room of Loretto Hospital in New Ulm, Minnesota. Her Husband, Who Observed the Birth, Holds His Wife’s Head as She Turns to Gaze at Her Newborn Child. There Are Two Hospitals in the Town, Union Which Is Non-Denominational and Loretto Which Is Catholic. They Have Divided Their Services to Specialize and Give More Efficient Service New Ulm Is a County Seat Trading Center of 13,000 in a Farming Area in South Central Minnesota.

U.S. National Archives’ Local Identifier: 412-DA-15716

Photographer: Phillips, Kathy

College of Midwives of B.C.

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Parents, grandparents, children and birth rights activists picketed the College of Midwives offices on Nov. 28, 2012. The College of Midwives conducts secret investigations and flagging operations to undermine the alternative birth workers in the province. By sending negative press releases and spreading half-truths and innuendo, they attempt to claim a monopoly on who shall attend births in the province.

Choice of birth attendant is a woman's right

From the film “Freedom for Birth”: — “One of the home birth mothers supported by Ms Gereb (Agnes Gereb, Hungarian midwife) decided to take a stand.
When pregnant with her second child, Anna Ternovsky took her country (Hungary) to the European Court of Human Rights and won a landmark case that has major implications for childbirth around the world.

Toni Harman, one of the filmmakers says, “the “Ternovsky vs Hungary” ruling at the European Court of Human Rights in 2010 means that,. . . now in Europe, every birthing woman has the legal right to decide where and how she gives birth. . .

. . .And across the world. . ., it means that if a woman feels like her Human Rights are being violated because her birth choices are not being fully supported, she could use the power of the law to protect those rights. With the release of “Freedom For Birth”, we hope millions of women become aware of their legal rights and so our film has the potential to spark a revolution in maternity care across the world. In fact, we are calling this the Mothers’ Revolution.”

Added on June 17 2013: EUROPEAN COURT OF HUMAN RIGHTS Fact Sheet
Under Article 37 § 1(c)of the Convention
Home Birth
Ternovsky v. Hungary
(no.67545/09)
14.12.2010
The applicant complained about being denied the opportunity to give birth at home, arguing that midwives or other health professionals were effectively dissuaded by law from assisting her, because they risked being prosecuted.
(There had recently been at least one such prosecution.)
The Court found that the applicant was in effect not free to choose to give birth at home because of the permanent threat of prosecution faced by health professionals and the absence of specific and comprehensive legislation on the subject, in violation of Article 8
Right to respect for private and family life.
Source: http://www.echr.coe.int/Documents/FS_Reproductive_ENG.pdf

ADDED June 2017: A case involving a member of the College of Midwives of B.C.
MEGAN DOLSKI
VANCOUVER — The Globe and Mail
Published Sunday, Aug. 14, 2016 8:22PM EDT
Last updated Sunday, Aug. 14, 2016 8:24PM EDT

The mother of a boy who was born with severely debilitating brain injuries on Vancouver Island has settled a lawsuit against her midwife and local health authority for more than $3-million, as well as annual payments that could add millions of dollars to the cost of the case.

The annual $400,000 payments outlined in the settlement are rare, but a legal expert says if they become more common they could add an unpredictable liability to the B.C. government’s finances.

Cabe Crossman was born in December, 2011, at the Cowichan District Hospital in Duncan, located about 60 kilometres northwest of Victoria. Due to injuries suffered during the delivery, he now has severe cerebral palsy and intellectual impairment, and will require extensive care for the rest of his life.

His mother, Sarah Corrin, sued her midwife, Selina Boily, the Vancouver Island Health Authority and two unidentified nurses alleging the care she received, first from the midwife and then at the hospital, was negligent. She alleged that her labour and delivery was not properly monitored, assessed or responded to. The defendants admitted liability and a B.C. Supreme Court judge approved a settlement earlier this month.

The boy’s life expectancy could be anywhere from 12 to 30 years, according to the court ruling, meaning the final cost to the provincial government could be well over $10-million. In addition to ultimately being responsible for the health authority, the province also sponsors the Midwives Protection Program, an insurance plan unique to B.C. across the country.

The program provides midwives with legal expenses and covers claims against them alleging negligence while practising, if they pay an annual fee of $1,800 per year.

A separate liability insurance program for midwives is also used in Ontario, Saskatchewan, Manitoba and Nova Scotia. It was not immediately clear about the situation in other provinces.

The Midwives Association of B.C. says the cost of malpractice insurance was halved in 2007 by the Ministry of Health “due to the excellent record that midwives currently hold in relation to large claims,” and reduced again in 2014.

As of this year, midwives in B.C. are required to also hold commercial general liability insurance, which they can get through the insurance provider of their choice

Paul McGivern, a lawyer with Pacific Medical Law who specializes in medical malpractice and infant injury cases, said that over the past decade he has seen a trend in which settlements for obstetric cases in British Columbia have been going up – not in quantity, but in dollar value.

Mr. McGivern, who was not involved in the Corrin family’s lawsuit, has worked on many cases that have involved $3-million claims or more.

“Part of it is that the cost of care is going up. Part of it is that counsel are presenting much more sophisticated analysis of the cost of care – the evidence is getting better as to how much things cost,” he said.

However, Mr. McGivern said incremental payments in the agreement, without insurance backing, is unusual.

“It is very difficult to predict what your ongoing financial obligations are going to be,” he said.

“If you have one case or two cases, you can manage that. If you’ve got 100, 200 or 500 of those cases that build up over time, your finances can become incredibly difficult to manage and predict.”

A recurring payment in a case such as this “is not unprecedented,” said Barbara Webster-Evans, the lawyer who represented Ms. Corrin. “But it’s probably rare.”

Ms. Webster-Evans said the family requested privacy and that agreements are in place that prevent her from discussing the case in detail.

“Any of these cases when they occur are tragedies for the child as well as the family,” she said.
Source: https://www.theglobeandmail.com/news/british-columbia/vancouver-island-mother-wins-3-million-suit-against-midwife/article31403354/

Added July 11, 2017

B.C. College of Midwives demands ‘death midwives’ stop using title
College says midwife title is protected by law; death midwife says her use of it completely different
By Liam Britten, CBC News Posted: Jul 05, 2016 8:51 PM PT Last Updated: Jul 05, 2016 8:51 PM PT

Death midwife Pashta MaryMoon (far right) instructs others on a live model, how to properly wash and care for a dead body at home. The College of Midwives of British Columbia says the title “midwife” is protected by law and has sent a cease and desist letter to MaryMoon’s organization ordering them to stop using it. (Canadian Integrative Network for Death Education and Alternatives)
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The College of Midwives of British Columbia is demanding a group of “death midwives” stop using the term “midwife” when referring to their services.
The Canadian Integrative Network for Death Education and Alternatives is an organization that represents and provides awareness about “death midwives” — people who help a dying person and their loved ones with alternative funeral arrangements, often at home.
CINDEA’s webpage says they use the term “midwife” to “honour and parallel the role of a birth midwife,” but College of Midwives registrar and executive director Louise Aerts says the term is reserved under the Health Professions Act and CINDEA’s use is breaking the law.
“There can be a misperception from the public when a title is being used inappropriately,” she said.
“Part of the idea is to provide a sense to the public of what it means to be a registered health professional, and they know when those terms are being used, that there is a regulatory body overseeing the education and practices and standards of that profession.”
Even though death midwives have the “death” modifier before their title, Aerts says the potential is there for confusion.
“The public could conceive that they have the same level of training, the same level of oversight of their practice as do registrants of the college,” she said.
As a result, the college sent CINDEA a cease and desist letter this week to prevent them from using the term “midwife.”
• Death midwives offer a ‘more authentic’ funeral experience
• B.C. home funeral workshops teach loved ones to care for corpses
• Midwives call for better education and funding
Doubts about confusion
Aerts says she hadn’t heard of CINDEA until the CBC profiled the work of founder Pashta MaryMoon for a radio series.
MaryMoon says the term “death midwife” has been used for over a decade by people like herself, and she isn’t sure why it has become an issue now.
“We’re not talking about being a midwife for pregnant women,” she said. “People who are dealing with the death of a person have no confusion about what kind of midwife we are. So I don’t really see why that’s an issue.”

Pashta MaryMoon, seen here practising on a live model, says using the term “death midwife” has “nothing to do with being equally credible as birth midwives.” (Canadian Integrative Network for Death Education and Alternatives)
MaryMoon questions whether the College has the legal standing to stop death midwives from using the title, but admits CINDEA has no legal representation.
She also says CINDEA’s use of the title is not about claiming the legitimacy of midwifery.
“What we’re doing is reclaiming the ancient word and the ancient practice. It has nothing to do with being equally credible as birth midwives,” she said.
“It has to do with bringing back the original practice of caring for your own dead and the people who would support the families to do that, who were the midwives.”
MaryMoon said on Tuesday she wasn’t sure what CINDEA’s next steps would be besides consulting other group members and similar practitioners in the United States.

View story online (with photos) here:
http://www.cbc.ca/news/canada/british-columbia/college-of-midwives-death-midwives-1.3666406