Friday, January 25, 2008

womanly furniture

Not sure how much longer this Craigslist ad will stay up, but I had to share this with all you birth junkies:

For Sale - beautiful pink "vagina couch" that I made in art school and no longer have space for. The couch is large: measures 5' 3" long, 3' 3" wide at the middle, and stands 2' 3" tall (and is heavy like a couch). The pics are from my portfolio and are several years old; as a result, the couch has some scuffmarks and stains around the bottom from being moved, but otherwise is in excellent shape. A professional upholsterer helped me build the couch, so it is also functional and durable as a piece of furniture. The couch must be picked up in Mendocino, a 3-hour drive north of SF. I am asking for $600 and a loving home! Call Willow at [deleted] or reply to posting.

It's a vulva couch... (I have to say that calling things 'vagina' when it's clearly a vulva is a pet peeve, but that's just me. Eve Ensler? You hear me??)

A good friend of mine sent it to me, thinking that THIS would have been the perfect new couch for my office.

Edited to add:

Here is the entire link on Craigslist. I'm uploading the pics from it and adding it to this entry in case the link goes bad.

Just how do you sit in it? Like you'd expect to sit in a vulva!

Thursday, January 24, 2008

Sign of the times

I hope you can tolerate more celebrity news from me!

Jessica Alba, who is currently pregnant, recently told the press in an interview:

"It had to do with breastfeeding, which is the only thing I'm paranoid about, more than giving birth."

Read the entire article and watch the video clip here

We live in a culture that is set up for so many breastfeeding moms to fail. It's no wonder that women naturally believe that breastfeeding is hard and not something that they can do.

Don't even get me started on the weight gain comments - or the fact that a superstar is receiving free gifts from a network. Couldn't those gifts go to a more needy recipient?

I hope she finds solid informed support for her breastfeeding experience. I am pleased to hear that she's at least considering it. Even a week of colostrum/milk to a new baby is better than none at all.

Monday, January 21, 2008

a new blog!

I'm always searching for new blogs that cover healthcare issues for women and children (if you would like to share more, including your own, please do!). I recently found this blog of a midwife and midwifery educator in New Zealand: Carolyn's Blog.

It's a rich, full blog. Enjoy!

...want to add something here. I read a lot of blogs every day. I have about 30 blogs in my Google Reader that I scan and devour in my off time (ha!), typically on my Blackberry while waiting in line somewhere or while nursing the babe. Since the Blackberry offers slow processing I am unable to comment on most entries without it taking forever and losing my train of thought (ADD?). I used to have a list of blogs that I read on my sidebar and didn't carry it over into the new format - simply because I feel weird about listing so many blogs with the risk of forgetting one or five important reads. Which blog do I list first? If they link to me should I automatically link to them?

Ah, the new paths we are pioneering in blogland.

Friday, January 18, 2008

Prenatal Testing

Modern science says that to know everything is to empower. The vast majority of the time, this is very true. I certainly feel empowered when I have complete exposure of facts and truth. The issue I have with standard prenatal testing is the myth that somehow each test that is done will ensure a healthy baby or point out any issues with a baby with special needs. The myth that each procedure (the biggest offenders - the Alphafetoprotein screen and ultrasound - which are not diagnostic, just screens) offers an accurate diagnosis of any issue - and if it's not apparent with these tests then your baby must be ok.

Current evidence shows us that the Alphafetoprotein test, routine ultrasound and the glucose tolerance test all have rather large errors in assisting with an accurate diagnosis. Still, for some reason, these tests are treated as if they are going to make sure your baby is healthy without any discussion regarding false results. If we're really looking at empowering women with knowledge the accuracy rate, along with what the test is screening for and what the path is if an abnormal result is found, should be discussed prior to the test. And women should always have the option of refusing any testing.

We all live very different lives. While some families would choose to terminate a pregnancy based on prenatal testing, other families will not change the course of their pregnancy based on the results. Knowing that for some women the information gained is beneficial, we must also look at what standardized testing can do to many other women (the majority) that are given ominous news regarding what turns out to be a healthy baby.

We cannot ignore the impact of even five weeks of thinking your baby has Down Syndrome, only to find out through an amniocentesis (complete with its own risks) that your baby does not. The emotional impact of that course is huge - even if the woman desired prenatal testing. My issue isn't with the testing alone, but the inability of the medical model to offer full disclosure about testing and it's accuracy. Or how, aside from terminating the pregnancy, there are few if any 'treatments' prenatally for these disorders.

Mothers must choose for themselves what testing they want and why. If the test results will not dictate termination of the pregnancy, care must be taken to discuss how an emotional attachment to the pregnancy/baby will be severed or enhanced with an adverse result. Some people talk about 'getting prepared' while families of special needs babies will tell you that there is no amount of information that can truly prepare you for what you will experience with a birth or a termination of a pregnancy. Those same families can also attest to an emotional detachment that occurs when, knowing the information/status of your baby, you decide to continue the pregnancy.

Prenatal testing involves a family's faith. Each woman, each family must decide for themselves if the accuracy/risks/benefits warrant these tests. For what it's worth, each of my clients receive full informed choice about Chorionic Villus Sampling, Amniocentesis, Ultrasound, AFP Screening, the Glucose Tolerance Test, Group Beta Strep Testing, etc. I've supported - and will continue to support - clients who choose prenatal testing as well as those who painfully choose to end their pregnancy because of test results.

On an emotional levels, we have to consider this: When a provider's office calls with a high positive reading from an AFP screen, does the woman hear anything but "your baby has Down Syndrome"? If she had been educated about the accuracy rates, including the rate of false positives, perhaps she could be more clear in her thinking about the possibility that her baby will NOT have Down Syndrome. In fact, by the time an inconclusive ultrasound comes back after such a call followed by an amniocentesis and the time waiting for results, many women are well into their 22nd or 23rd week of pregnancy.

Here are some great quotes and links for further review on just how standardized, blind (meaning women either don't know what they're being tested for and/or aren't told about the accuracy of the test) prenatal testing impacts us as a culture:

The MSAFP screens for the level of AFP in maternal blood—it is not a diagnostic test.. It is easy to administer and most women choose to accept it. However, research by Carole H. Browner at UCLA Department of Psychiatry and Biobehavioral Sciences, has show that women who ‘choose’ are not always informed about what this test is for and the implications of a positive result, or that it has a high (upwards of 80%) false positive rate. The result is that many women who are otherwise experiencing normal, healthy pregnancies are faced with a positive MSAFP. These women are counseled to consider amniocentesis for a diagnosis.

The readings by Hubbard, Browner and Press and Kaplan all capture the eugenic implications of these prenatal tests in different ways. Browner and Press show how the information provided by the state of California is worded so as to emphasize the "reassurance" provided by the test, and not the fact that so far we have no therapy for the conditions identified by the tests, only termination of the pregnancy. Further work by Browner, Rapp and others have shown that genetic counseling is not as value neutral as we might think. And, as we saw from last week, not all women who desire genetic testing have access to the tests.


These experimental forms of genetic screening are clearly controversial. But even the most common forms of prenatal testing are open to dispute. Despite the matter-of-fact manner in which physicians offer the tests to their patients, their safety has never been scientifically established. Ultrasound, for example, which doctors present as a thoroughly uncontroversial procedure, is still being contested within the medical literature. A classic example of a "creeping technology," ultrasound in pregnancy has never been subjected to a large-scale randomized controlled trial to assess either its safety or usefulness.

The use of AFP tests has a peculiarly nonmedical history. Both ACOG and the American Academy of Pediatrics urged the FDA not to approve early release of AFP test kits in the late 1970s. They noted that in order to detect enough cases of open spina bifida and anencephaly the tests would necessarily have a high false-positive rate-about fifty false positives for every true positive. They recommended that the FDA make its release contingent on laboratories’ ability to coordinate follow-up tests to weed out false positives, a crucial concern in a test parents may rely on in deciding whether to continue a pregnancy. But when the FDA went ahead and approved the marketing of the kits without these restrictions, ACOG’s legal department promptly issued a liability "alert" to its members, urging all obstetricians to offer the procedure to their patients. This, it said, should place the doctor in the "best possible defense position" in the event of a birth defect.


It is also important to realize that most women take these tests without fully considering all of the implications of the test. Most women think of these as a simple blood test, a cursory part of prenatal care. They don't consider that intimately wrapped up in the question of prenatal testing is the moral dilemma of abortion and the thorny issue of eugenics. Barbara Katz Rothman points out:

The history of prenatal diagnosis has roots in the eugenics movement...part of its history has been an attempt to control the gates of life: to decide who is, and who is not, fit to make a contribution to the gene pool.

Katz Rothman is by no means arguing against the use of prenatal testing; she actually presents a number of compelling reasons to consider it. Her writing is a fair and balanced look at the intricacies and difficulties of this issue. But she has found through extensive interviewing of parents involved in such testing that most of them were simply unprepared to confront the scope of the types of decisions presented by prenatal testing, and that choosing such testing often changed the way a woman experienced pregnancy in subtle ways.


The emotional effects of these prenatal tests have not been well studied. This means you need to take responsibility for figuring this out for yourself and for your family.

One of the most obvious effects of all of this testing is that it serves to "medicalize" your pregnancy. Trying to turn a healthy pregnancy into a medical experience can cause unnecessary worry and a tendency to avoid bonding too soon with the developing baby until it is "certain" that everything is okay. Going through these tests can make it easy to forget that birth is a normal process and does not need to be frightening. And remember-none of these tests is foolproof.

In fact, being forced to worry about conditions that ultimately work themselves out (like early diagnosis of placenta previa, for example, picked up in a routine ultrasound) can have negative effects. It is hard to shake off the anxiety of wondering whether everything is okay. Waiting two weeks for the result of an amniocentesis can be very stressful, even if you have every reason to believe that you and your baby are healthy.

Parents who are especially jittery, and think they might feel better after having these tests, need to consider this information even more carefully. You might think that prenatal tests will provide you with a sense of security, but unless there is a true indication of high risk, these tests can be misleading. You can find security by discussing your concerns with your healthcare provider, who will take the time to listen and explain, and by talking with your partner, doula, or friend.

Many women have testing done even though they have no intention of terminating an abnormal pregnancy. This is often because of pressure from family and friends to "find out" if everything is OK, even though these tests offer no guarantees. It can take great courage to say no under pressure. Remember that having prenatal tests done just to appease your family or partner will have consequences for only you. You must carefully think through each step of this decision, and review the possible consequences of prenatal tests, before you decide if they are right for you.


Reading that I recommend to every woman interested in how prenatal testing impacts women and impacts what we perceive as a 'better outcome' in maternal/fetal health include:

Expecting Trouble: The Myth of Preantal Care in America by Thomas Strong, MD

The Tentative Pregnancy by Barbara Katz Rothman

Which Tests for My Unborn Baby? by De Crespigny and Dredge

Informed choice and full disclosure should be the standard in maternity care. We also owe it to women to have an understanding about the impact of prenatal testing on the feelings towards their pregnancy, towards their baby and the choices made along the way.

Wednesday, January 16, 2008

Link time!

I wanted to create a list of some of my favorite blogs and websites. Hopefully some will inspire you!

Jennifer Block's blog (author of Pushed)

The True Face of Birth

Tina Cassidy's blog (author of Birth: The Surprising History of How We Are Born)

Hathor the Cow Goddess

Radical Midwife (in the making)
- the title is misleading. There is no 'in the making' - this is my wonderful apprentice/assistant and she came to my practice already a radical midwife! She was, and still remains to be, an inspiration to me

The Human Pacifier

The Lactivist

Jennifer Tipton's blog

Now for some non-birth-related links: - inspires me to no end!

Curiosity Shoppe

Fred Flare

Craft Zine

Miranda July

The Blow

K Records
(Tender Forever is my new favorite find!)

Tuesday, January 15, 2008

"Technological obstetrics makes the assumption that more knowledge is better, but, like Eve's apple, the knowledge that we gain through prenatal diagnosis can cast us from our pregnant paradise, with major and long-lasting sequellae for mother, baby and family."

— Sarah Buckley

Sunday, January 13, 2008


Both babies that were expected in December-January have been born. Both boys. There could be more to add about either birth and postpartum, but I haven't gotten around to asking for permission to share.

Working hard to keep up with all the demands of life. You know how it is - we all know how it is. Having the computer in the basement has limited my online time - but I am working on getting some childcare a couple days a week to help move everything forward.

Can I just tell you how grateful I am for the clients I have? It's hard to feel too stressed when you enjoy seeing and working for all of them!

Monday, January 7, 2008

Please help Waterbirth International....

Please help Barbara Harper keep waterbirth alive

Waterbirth International may close doors. Here is a note from Barbara Harper of Waterbirth International

Barbara Harper wrote:

I cannot yet imagine a world without the voice and work of Waterbirth International - we get calls and emails every day from women who need help convincing one hospital or another to let them labor or birth in water. If we die - a big part of the movement dies. Waterbirth has shown us all that women know how to give birth and babies know how to be born. Waterbirth gave us "hands-off", sit back and let the baby out. I see waterbirth mentioned on Blogs every single day, not to mention Baby Story on the TV. I took Waterbirth International to ACOG two years in a row - and was the ONLY booth showing birth films to obstetricians and especially to student physicians. There were tears, laughter and outrage - just the thing to stir up those young crop of doctors.

I am finally realizing a life's dream. But now I am faced with letting this dream go. Perhaps I have done enough. Perhaps it is time to quit.

About 18 years ago, maybe it was longer, when Mothering Magazine was facing bankruptcy Peggy did a heartfelt plea asking their readers to consider ordering a Life-time subscription. I think the subscriptions were $1000 or $1200, I can't remember now. I do remember that I couldn't imagine not reading my Mothering. So, I bought two and gave one to my obstetrician's office.

How can you help us stay open to take the next phone call? - to convince the next obstetrician to incorporate waterbirth into his/her practice - to work with the nurse midwives to install pools in their facilities? To educate an entire hospital on the benefits of allowing women freedom of movement in the water. How much is it worth to see waterbirth become the norm in the US, like it is in the UK? I think we only need a few more years to make that happen. Do women really want waterbirth to be an available choice in every hospital? I think so.

Can you help us by getting the word out on blogs and lists? I had to let go of all of the staff except one person to process orders. Miraculously, we made payroll today, but we can't hang on much longer. We need a miracle.

If I need to call every single waterbirth parent personally, I will. I don't want 25 years of work to end over a measly $200,000. The work that we have done the last few years has been phenomenal. How God arranged for me to teach in hospitals and medical schools around the planet - Taiwan, Venezuela, Turkey, Mexico, Canada, Holland, Portugal, China, Trinidad, Croatia - I'll never figure that out. I laugh out loud sometimes when I get up in front of an audience of physicians in a medical school
overseas - who all want to hear about waterbirth and the incorporation of Gentle Birth practices and principles into their routines.

Think about what you can do and call me if you want to chat or if you have some great ideas on how we can quickly move into the black and keep waterbirth alive and thriving.

We need your help. Barbara Harper needs your help. The waterbirth/gentle birth movement needs your help.

Barbara Harper, RN, CLD, CCE
Waterbirth International
503-673-0026 -office (out of US or in Portland)
800-641-2229 - toll free
503-710-7975 - cell phone

We LOVE helping women get into Hot Water!!
And have been doing it for 24 years!!

Trust Birth Conference

Can you spare three days to challenge yourself, rejuvenate yourself, learn more than you imagined, and walk away with a new approach to birth, life and your own journey?

The Trust Birth conference
includes some of the most powerful voices in unhindered birth:

Sarah Buckley, MD
Michel Odent, MD
John Stevenson, MD
Henci Goer
Gloria Lemay
Gail Hart
Hathor the Cow Goddess
Laura Shanley
Rixa Freeze
Mindy Goorchenko

I have been to midwifery conferences that essentially feature the same speakers, the same messages, the same level of enthusiasm. The Trust Birth Conference has created within me new emotions about a conference: hope, faith, excitement, awe, joy and peace.

This is a conference that really walks the talk: there is no hiding the truth, no "birth is safe, yes, BUT...." - these are people who honor the truth in birth, even when that requires recognition of when birth moves outside of normal.

I don't know that I've ever been this excited about a birth-related conference. I'm thrilled to meet all these people - and the people attending. I'm ready to be surrounded with others who can teach me and who will stand with me for the rights of women and children everywhere!

Please, please join us. I am speaking on a panel titled "Transitioning to Trust Birth Midwifery", giving a talk on "More of Them; Less of Me!" (basically my journey from being anxious about birth to learning how trusting the process - and parents - has empowered me personally), and a talk on "Hands Off the Perineum!".

I know that, despite my biases and strong beliefs, I will be hugely challenged at this conference. It's what I want, what I need. It's what we all need.

Are you ready for it?