Birth in the Natural State

Our Blog Has Moved

2011-03-01T17:36:00.000-08:00

BirthNetwork NWA has a brand new website design, which includes a new home for our blog! For recent and future content, please visit us at birthnetworknwa.org/blog.

Be sure to let us know what you think of the new site!

NWA Hospitals Adopt New VBAC Policies

2011-02-17T14:13:00.000-08:00

Our blog has moved! You can find the content of this post at our new home here.

For Profit Hospitals Are Performing More C-Sections

2010-09-23T06:18:00.000-07:00

An interesting new study has found that "for-profit hospitals in California are performing cesarean sections at higher rates than nonprofit hospitals.

A database compiled from state birthing records revealed that, all factors considered, women are at least 17 percent more likely to have a cesarean section at a for-profit hospital than at one that operates as a non-profit. A surgical birth can bring in twice the revenue of a vaginal delivery.

In addition, some hospitals appear to be performing more C-sections for non-medical reasons – including an individual doctor’s level of patience and the staffing schedules in maternity wards, according to interviews with health professionals."

Research has told us for some time now that your chance of ending up with a C-section has a lot to do with which doctor and hospital you choose. Yet women continue to choose their doctor based on who their insurance covers, and unfortunately, (and I hear this often) which hospital has the biggest, prettiest birthing suites. In fact, that's what the hospitals in NW Arkansas seem to promote most of all. A large sign on I-540 stood for some time marketing an area hospital as "the Beverly Hills of Birthing Centers." Really? Well, I hear they do a lot of surgery in Beverly Hills.

If you are really interested in the best birth for you and your baby, do your research. Not all doctors and hospitals are created equal. Ask what the c-section rate is when you are deciding where to go, then compare. You owe it to yourself. I have a pretty good feeling that California isn't the only place where money is made on unnecessary c-sections.

Siblings at Births

2010-05-14T08:39:00.000-07:00

Our blog has moved! You can find the content of this post at our new home here.

Living It Green Expo

2009-09-15T20:05:00.000-07:00

Here are a few pictures from our booth at the Living It Green Expo, held September 11-15 at the Pinnacle Hills Promenade. We wish we had kept track of how many women we spoke with, but I am convinced that we reached as many as 200 women. We had a great time and met some amazing women!

One lady we met was a yoga instructor who told us about her amazing birth experience. At 9 cm she got an epidural and shortly thereafter learned that her baby was transverse (lying sideways instead of head down). Despite the fact that she had an epidural, and without the aid of a doula or midwife, she was able to get on her hands and knees to use yoga positions to turn her baby, thereby avoiding a c-section. Amazing! It's always great to get out into the community and talk to moms. You never know what stories you are going to hear!

KNWA Morning Show Highlights Pampered Mama Giveaway

2009-09-15T20:00:00.000-07:00

Check out the interview we did with KNWA Today on the Pampered Mama Giveaway and the Birth Survey. I always come away from these interviews realizing that my nervousness results in important points being left out. I wish that I had emphasized that The Birth Survey isn't just for hospitals and doctors. You can take the survey if you had a home birth or birth center birth with a midwife. I also forgot to mention our Pickles and Ice Cream meetings. Well, hopefully people will find everything when they come to our website. We've already had an increase in hits this month since we started promoting the Pampered Mama Giveaway!

All This Hard Work Calls For A Little Pampering

2009-08-31T06:39:00.000-07:00

Yesterday my husband and I were having a conversation about the nature of advocacy work. We both are very passionate about our causes. If you come to our house, don't be surprised if you hear something about birth, politics, or both. What we have found lately, however, is that sometimes, the negative aspects of our work can tend to "overwhelm our systems" and instead of feeling fulfilled and refreshed by our work, we feel frustrated, angry, and defeated by an opposition more powerful, more well funded, and more irrational. Three qualities that make an enemy hard to defeat.

For instance, you may remember seeing us on the news in April protesting the bans on VBAC in NW Arkansas hospitals. We stood outside of every hospital in NW Arkansas with signs declaring our support of a woman's right to choose the course of her own maternity care. We wrote letters to the hospitals and met with administrations of some of them. The news cameras were there. People driving by honked in support and took pictures of us holding our signs and our babies at the same time. We felt powerful. We felt like we were making a difference.

Well, the outcome, unfortunately, was the exact opposite of what we wanted. The four hospitals in the NW Arkansas metro area, who are usually in competition with one another, joined hands in a show of solidarity, issuing a joint statement affirming their united committment to continue to ban VBAC. In fact, those who had been known to be more "merciful" in their approach, tightened the ban and placed their doctors under strict orders to turn women away who requested support for a VBAC.

Needless to say, I personally spent the summer feeling pretty defeated. I "took a break" from all things birth and tried to focus on the needs of my family. After all, birth work is only one part of my life. Luckily, thanks to some amazing co-leaders, we regrouped. We decided that protesting isn't the only way we can help women, and we decided to focus our efforts on some things more basic: namely

Creating a cohesive birth community where members are supportive of each other and where mothers who need direction during their pregnancy and birth can find resources and support.
Serving our professional members who have endorsed the MFCI.
Reaching out to women "beyond the choir" in our community.
Promoting the Birth Survey in our area so that women have a robust resource for comparing the quality of maternity care providers and the services they offer.

We hope you will stay tuned, because starting tomorrow, September 1st, we have some exciting programs and opportunities for you. Like our "Pampered Mama Giveaway." Click on our homepage to find out how you can win a prize package full of ways to help you relax and enjoy life after birth. Massages, dinner for two, entertainment, spa services, carpet cleaning, a mama-baby photo session, and more! It's all there. And we think you deserve it. Mothering is hard work, after all--as is every really important work.

Hmm. . . after the last year, maybe I need a little pampering.

"Heads Up!" Study on Breech Pregnancy and Birth

2009-07-06T12:05:00.000-07:00

Most women in NW Arkansas are not aware that if their baby is breech, they do have options. However, the key to avoiding an elective (or mandated) cesarean is early awareness. Does your care provider ever palpate (or feel) your belly to determine the position of a baby? (Hint, most OB's don't do this anymore.) Does she recommend positioning exercises you can do to help the baby turn heads down? If she doesn't you may not find out that your baby is breech until it's too late, and the baby is too big to turn with these exercises. An external version is also an option, but this can be painful, requires medication to relax the uterus, and is only successful about half of the time. I've had several clients who ended up with elective cesareans.

If you have experienced a breech pregnancy and/or birth (vaginal or cesarean), please take a moment to fill out this new survey "Heads Up! Study on Breech Pregnancy and Birth." Breech research is often aimed towards health care providers and tends to focus on health outcomes for mom and baby. Their research explores women’s experiences and feelings about carrying a breech baby; their decision-making process when discovering that their baby was breech; their care providers' recommendations and protocols for breech birth; and the birth options
available to them, from vaginal breech birth to elective cesarean section. The results will be presented at the International Breech Conference in Ottawa, Canada.

Who can participate:

All North American women who have had breech pregnancies or births are invited participate in an essay-response survey, which takes approximately 15-30 minutes to complete. They are interested in participants who had breech
pregnancies (breech babies who turned head-down before birth). They would also like to hear from women who have given birth to breech babies, whether vaginally or by cesarean section; with midwives, physicians, or unassisted; at home, in a birth center or in a hospital. They welcome input from both singleton and multiple (twin, triplet, etc) breech pregnancies and births.

How to Participate:

To take the survey, please visit the Breech Pregnancy and Birth Survey.

About the Researchers:

Dr. Rixa Freeze has a PhD in American Studies and focuses on childbirth and maternity care. She blogs at Stand and Deliver.

Julie Searcy is a PhD candidate at Indiana University with interest in the cultural discourse around birth.

Questions:

Please contact the researchers at breechbirth.study@gmail.com.

Call to Action on Breastfeeding!

2009-04-14T06:25:00.000-07:00

Don't delay in letting your comments be heard! From the US Breastfeeding Committee:

We are seeking comments from individuals and organizations about breastfeeding in the United States. We welcome your suggestions about policies, activities, or other initiatives to protect, promote, and support breastfeeding that need to be considered for inclusion in our national action plan for the next decade. We are especially interested in new ideas that will increase equity in breastfeeding rates among all racial, ethnic, and socioeconomic groups. Ideas should build on programs and policies that are recognized to be effective or evidence-based. In addition, we welcome suggestions to adopt, expand, implement, research, or improve existing strategies.

Visit this link to submit your comments (deadline is May 31, 2009):
http://www.blsmeetings.net/owh_call_to_action_on_breastfeeding/index.cfm

April: Cesarean Awareness Month

2009-04-01T14:09:00.000-07:00

This month be sure to view the BirthNetworkNWA calendar of events for opportunities to support Cesarean/VBAC awareness.

Among the activities:

Cesarean Awareness Month Reception, the 11th
Washington Regional Medical Center March, the 17th
Northwest Medical Center Protest, the 24th
Willow Creek Protest, May 1st
Mercy Protest, May 8th

For more information about VBACs in Arkansas, please visit BringBackVBAC.org.

Going BOLD

2008-09-04T10:14:00.000-07:00

BirthNetworkNWA provides a unique opportunity for women in the area to come forward, share their birth stories and enjoy theatrical birth experiences through all the offerings associated with our BOLD Red Tents and the play "Birth" by former Arkansan Karen Brody.

Tell Your BOLD Birth Story under The BOLD Red Tent!

BE BOLD and join in the global movement "Birth On Labor Day" as women around the world gather during the month of September to inspire their communities to create childbirth choices that work for mothers.

When and Where:

Saturday, Sep 13th at the Fayetteville Farmer's Market from 7 a.m. to 1 p.m.

and

Saturday, Sep 20th at the Bentonville Farmer's Market from 7 a.m. to 1 p.m.

What:

1. Tell your birth story! - Stories have the power to reach into our hearts and minds, impart truths, and transform lives. Share your knowledge, wisdom and birth experiences with other women under the red tent.

2. Buy your tickets to a production of Karen Brody's play "Birth", debuting at Fayetteville's Teatro Scarpino on Friday, September 19th. (Tickets available online or at the Fayetteville Red Tent)

3. Henna Body Art - Bring your pregnant belly (or your beautiful non-pregnant body) and experience the beautiful, nurturing art of henna painting. Choose a design that expresses your unique personality as well as the universality of womanhood and motherhood.

4. Learn about Free Local Birth Resources - Get connected with representatives from BirthNetwork NWA, La Leche League, the International Cesarean Awareness Network (ICAN), and DONA International (a doula organization) about how we can support you throughout pregnancy, birth, and beyond.

5. Win Great Prizes! - Enter your name in a drawing to win some great prizes from the following businesses

And we don't want you to miss the

local performance of a play by Karen Brody

"Birth"

Friday, September 19th, 2008

Teatro Scarpino in Fayetteville.

Birth is part of the BOLD (Birth On Labor Day) Movement. Every September, Birth is performed in cities around the world, uniting women's voices calling for change in a maternity-care system that is broken--

For example:

One in three women in America give birth by undergoing major abdominal surgery.
In Northwest Arkansas, vaginal birth after cesarean (VBAC) is banned in most hospitals.
In our area, few women have access to professional nurse-midwifery care in a hospital and there are no freestanding birth centers.
The American Medical Association just adopted a resolution that would seek to ban homebirth in every state.

But there is a movement to promote a model of care that is evidence-based and centered on mothers and babies. It's called "Mother-Friendly" Maternity Care. BirthNetwork NWA promotes this model of care through education, advocacy, and support. Please join with BirthNetwork NWA and BOLD to raise money, raise awareness, and raise the energy of a movement that will empower women take charge of their births and give them options that work.

Tickets are on sale now. Click here to access ticket sales through BirthNetwork's "Events" page. Please don't wait, because we do expect a "sell-out" of the play. Even if you can't come, please consider becoming a consumer member of BirthNetwork NWA. Your name and your voice as a consumer means something, and we must have broad consumer support to encourage doctors and legislators to listen.

As we make strides to improve our state's maternity care system, making it more mother-friendly, we want everyone to know we value our mothers and our children. This is just another step we are taking . . . one of the first of many to come.

The Birth Survey is up and running!

2008-08-29T18:37:00.001-07:00

Last night I stayed up until 1:30 a.m. taking The Birth Survey, a new online survey where women can share information and reviews of their maternity care providers. I was amazed at the depth and breadth of the survey. It took me about 30 minutes to complete, but I felt that it was time very well spent--especially if other women can gain insight from my experiences and choose a care provider who was as wonderful as mine was.

For years, consumers have enthusiastically shared online reviews of movies, restaurants, products and services, but it has been nearly impossible to find such information about maternity care providers and birth settings . No longer! As part of the Transparency in Maternity Care Project, CIMS developed The Birth Survey as an online resource for sharing consumer reviews of doctors, midwives, hospitals, and birth centers, learning about the choices and birth experiences of others, and viewing data on hospital and birth center standard practices and intervention rates. The Birth Survey is now accessible online nationwide in the United States.

Help spread the word about The Birth Survey!

Send e-mails to your contacts encouraging them to take the survey, or learn about the project, through the "Invite a Friend" email tool.
Post web banners and buttons to The Birth Survey on your personal or organizational websites, or link to www.TheBirthSurvey.com in your email signature and on your website.

Distribute postcards inviting women to take The Birth Survey. Download the cards or order preprinted cards.

Final Numbers on VBAC Bans in Arkansas

2008-05-16T06:38:00.000-07:00

Final Numbers on VBAC Bans in Arkansas! Local moms polled 44 hospitals that have Labor and Delivery Units and almost half of them ALLOW VBAC. You can access more information on the ICAN website at www.ican-online.org by selecting the Advocacy Link. Then search ICAN’s Hospital VBAC Policy Database by state or zip code to find out if your local hospital bans VBACs or not.

Barbara Stratton, a national VBAC activist who reversed several bans, has opened up a national yahoo group for people actively working on reversing bans across the nation. VBACtivist@yahoogroups.com. This is a great place for people to share ideas and strategy with people all over the country. She only wants people to join who are actively working on reversing bans. If you are interested please join the group. There are already several women from Arkansas on the group talking about ideas for activism, including legislation.

Official Proclomation: April is Cesarean Awareness Month in Arkansas

2008-04-23T21:49:00.000-07:00

Fayetteville Mayor Dan Coody presented the chapter leaders of the International Cesarean Awareness Network (ICAN) and of Birth Network of NWA with a proclamation declaring April Cesarean Awareness Month in Fayetteville. (see picture attached courtesy of ICAN of NWA).

Arkansas Governor Mike Beebe also issued a proclamation declaring April Cesarean Awareness Month in Arkansas which will be read and presented to ICAN and Birth Network by State Representative Sue Madison at a reception in recognition of National Cesarean Awareness Month, Monday April 28th at 1:00pm at the Fayetteville Public Library, Walker Room. The public is invited to attend.

ICAN of NWA and Birth Network are two groups working to raise awareness in the community to prevent unnecessary cesareans and promote VBAC, normal birth after c-section, a practice that is currently banned at ALL NWA hospitals but is offered at hospitals in neighboring communities like Berryville, Ft. Smith, Siloam Springs and Little Rock.

1 in 3 babies born in NWA is delivered by c-section, a number that is well over the recommendations of the Arkansas Board of Health, the US Dept. of Health and the World Health Organization.

BirthNetwork Living It Green

2008-04-06T07:54:00.000-07:00

BirthNetwork of NW Arkansas was featured Friday evening on KNWA. We met the reporters at the new Mercy Hospital in Rogers where we set up a birth pool in preparation for a local woman's upcoming water birth. (A "dry" run, you might say.) We were glad that we were able to get media coverage right before the Living It Green Expo at Pinnacle Hills Promenade this weekend. Come see us Sunday if you haven't yet!

See the segment here!

BirthNetwork NWA Speaks Out on the VBAC Ban

2008-02-26T21:56:00.000-08:00

BirthNetwork was featured tonight on our local CBS Affiliate. Our monthly Parent Topic Nights feature various topics surrounding pregnancy, childbirth and breastfeeding. Tonight's topic was entitled "The Truth About Cesarean Section and VBAC."

Bring Back VBAC to NWA!

2008-02-16T13:21:00.000-08:00

Here's another great development for normal, mother-friendly birth in Northwest Arkansas. A local mother has created a website dedicated to bringing VBAC back to our area as a viable and available option for women who have had a previous cesarean section.

Please check out www.bringbackvbac.org and speak out on the forum and blog dedicated to the specific issues surrounding VBAC bans in our local hospitals. Get involved! Send the link to all of your friends who have had a previous cesarean, and even those who haven't. We are all impacted when hospital and insurance company policies undermine the rights of birthing women.

www.bringbackvbac.org links

The Big Push Campaign-petitions, letters, direct mail, press releases, advertising, more details to come......
Get the Facts- read it for yourself. Links to groups, sites& articles concerning VBAC.
Get Connected- sign up to get newsletter & update e-mails concerning VBAC.
Speak Up- forum to discuss the VBAC issue, share advice,coordinate with other groups, and trade ideas.
Speak Out- "It Happened to Me" themed blog. Share your C-section/VBAC stories. Show how VBAC (or lack of)effects real women's lives. Tell your story & read stories from other women in our community.
Suggestion Box- What do you think? Have suggestions, ideas, good links? Let us know. Everyone's input is needed.
Help Out- Find out what groups are working on the VBAC issue in our area and how you can help. Sign up- email help@bringbackvbac.org

ICAN has arrived to NW Arkansas!

2008-02-15T22:12:00.000-08:00

The International Cesarean Awareness Network, Inc. (ICAN) is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC). Visit our research based website, http://www.ican-online.net/

Join us on the 3rd Wednesday of each month at 7:00PM for educational and support meetings at The Jones Center For Families, 922 East Emma Ave. Springdale, AR. Room #221. Scroll down to review our 2008 meeting schedule.Lap babies are welcome. Free childcare is available on site. Call Kid Plus at 756-8090 ext. 118 for reservations. For more information about our meetings, to subscribe or volunteer, contact alyNWAican@hotmail.comor call Aly at 479-251-8446 or Angela at (479) 443-2337.

Please consider becoming a subscriber to ICAN! Without support from our subscriber base, ICAN could not continue its efforts towards improving maternal-child health internationally and in our local community!

Volunteers are needed and appreciated!

2008 Meeting Schedule

Mar: Current VBAC Climate in NW Arkansas
Apr: *Open Forum
May: Choosing A Caregiver
Jun: Open Forum

Jul: Increase Potential For Normal Birthing
Aug: Open Forum

Sep: Uterine Dependability
Oct: Open Forum

Nov: Creating a Positive Birth Environment

Dec: Open Forum

* Open Forum nights provide a safe environment for sharing birth experiences, healing and questions.

Terra Tots Grand Opening and the "Round Up" Fundraiser

2008-02-09T16:22:00.000-08:00

I just got back from the Terra Tots Grand Opening Sale! The place was literally packed while I was there. My congratulations to the owners, Bernice and Brian Hembree. The store is warm, cute, and exudes a feeling of living life in awareness and peace with the earth. I know, it sounds granola, but my husband and I got the feeling while we were there that eco-friendly is also very chic. Hey, we've made the decision to make the leap to cloth diapering!

Besides being good to the environment, Bernice and Brian are all about being good to their community as well. Watch this clip as Bernice describes the Terra Tots "Round Up" Fundraiser. Until the end of March, proceeds from this program will benefit BirthNetwork of Northwest Arkansas. Make sure you pay a visit to this remarkable little store!

Business of Being Born

2008-02-05T21:52:00.000-08:00

Well, all of the receipts and thank you notes have been sent out, and I think life may get back down to normal after a very successful opening event for the BirthNetwork of Northwest Arkansas, a benefit screening of "The Business of Being Born." Click on the movie above to see a slide show of pictures from the event.

We would like to express our heartfelt appreciation to our local sponsors, Birthroot Midwifery, Café of Life Chiropractic Wellness Center, and Advocating Birth made the majority of our marketing, printing, and hosting of guests possible. Additionally we received 35 silent auction items from 26 birth or parenting-related businesses, which brought just over $1,000 in donations for our Transparency Project initiative.

We are proud to report that 248 people attended the screening, including many expectant parents and birth professionals. Before the screening, we held a VIP reception where we were able to make some great contacts with consumers and professionals enthusiastic about improving the awareness and availability of mother-friendly maternity care in Northwest Arkansas.

We were proud to host an excellent panel of local birth experts, which included doulas, midwives, childbirth educators, a family practice doctor, labor and delivery nurses, and parents who had experienced many kinds of birth, from homebirth to cesarean to VBAC. The panel did an excellent job of discussing the current state of maternity care in Northwest Arkansas.

We have received many notes of praise, gratitude, and enthusiasm about the evening and about our upcoming initiatives, including the Transparency Project and our series of free Parent Topic Nights. It is evident to us that there are many, many people here in Northwest Arkansas who care deeply about the way babies (and mothers) are born.

AHRQ and Ad Council Encourage Patients To Ask Questions...

2008-01-08T21:52:00.001-08:00

Now this is more like it. Transparency in health care is a growing issue, and according the the Agency for Healthcare Research and Quality, "Medical errors cause tens of thousands of deaths each year. Clinicians, the Government, and many other groups are working hard to improve health care quality, but improving health care quality is a team effort. You can improve your care and the care of your loved ones by taking an active role in your health care. Ask questions. Understand your condition. Evaluate your options."

Check out www.ahrq.gov to find a list of 10 questions to ask your doctor. And while you are at it, check out "Having a Baby? Ten Questions to Ask" by the Coalition for Improving Maternity Services (authors of the Mother Friendly Childbirth Initiative). www.motherfriendly.org

Hopefully, this message will translate to the often overlooked area of maternity care. I have a feeling that we will have the greatest impact on our community as we empower one consumer at a time to take responsibility for the quality of their own maternity care.

You Wouldn't Eat Here

2007-11-04T18:43:00.000-08:00

A friend of mine posted this wonderful ad from Austrailia on her blog. Enjoy!

DONA Doula Training a Success!

2007-10-27T20:02:00.001-07:00

I just arrived home from a wonderful DONA International Doula Training, taught by DONA International President Debbie Young. It was held at Birthroot Midwifery, a beautiful birth clinic in Fayetteville. A group of 13 women from around Northwest Arkansas, and from as far away as Tulsa, OK attended the 3-day training that will prepare them to complete their certification or recertify as birth doulas. Attendees learned skills such as comfort techniques for labor, the emotional stages of labor, prenatal and postpartum support, communication techniques, marketing of services, and care of women with special needs. The training culminated in a surprisingly accurate simulation of a birth, where all of the trainees were able to practice their new skills on "Britney," a teen mom in labor (played by trainer Debbie Young).

What a wonderful opportunity to mingle with women who want to care for other women! There was a lot of talent, wisdom, heart in this group. I'm convinced they will make a real difference for many women in our area.

In order to finish their certification, new doulas must provide labor support to three mothers and receive positive evaluations from each. If you are looking for a doula, or know someone who would like one, please have them email me (douladay@gmail.com) and I'll be happy to connect them with one of the doulas-in-training.

(1) Sara Milford (2) Renee Johnson (3) Janessa Craig

(4) Carie Means, Sara Milford, Amber Fisk, Debbie (5) Sara Visser and Carrie Staten (6) Meredith Ek

(7) Renee Johnson and Nancy Davis (8) Kathy Taylor (9) Nicole Sheppard

Other participants not pictured: Anna Sturges and Elizabeth Day

Sesame Street - Buffy Nurses Cody

2007-10-18T09:35:00.001-07:00

Chapter Co-leader, childbirth educator, and student midwife Carie Means found this sweet vintage Sesame Street video that shows breastfeeding in a very positive light. Thanks Carie!

Woman in Residence

2007-10-18T09:20:00.000-07:00

Kay Smith, a local childbirth educator and leader in the NWA birth community sent me this beautiful excerpt. . .

"Here is an excerpt from Dr. Michelle Harrison's book Woman in Residence. She is a family doctor who did residency training in OB/GYN. This book describes her experiences as a resident. Wouldn’t it be wonderful if all OBs adopted this point of view?"

Kay Smith

“Imagine dancers on a stage. Once, doing a pirouette, a woman sustained a cervical fracture as a result of a fall; she is now paralyzed. We try to make the stage safer, to have the dancers better prepared. But can a dancer wear a collar around her neck, just in case she falls? The presence of the collar will inhibit her free motion. We cannot say to her, “This will be entirely natural except for the brace on your neck, just in case.” It cannot be “as if” it is not there, because we know that creative movement and creative expression cannot exist with those constraints. The dancer cannot dance with the brace on.

In the same way, the birthing woman cannot “dance” with a brace on. The straps around her abdomen, the wires coming from her vagina, change her birth.The birthing woman plays in an orchestra of her body, her soul, her baby, her loved ones, her past and her future. And we do not know who leads the orchestra.

Doctors cannot lead the orchestra, because they are not within the process. Unable to hear the music, trained only in modalities of power and control, they can only interfere with the music being played.What should they be able to do? They should stand ready to help the player in trouble to get back into rhythm. Instead, they take over. Instead of supporting the mother, they say, “Okay, you have failed. It’s our piece now.”

How do you get a 30 percent Cesarean rate? You orchestrate it. You write a piece in which the third movement is a Cesarean, then build the first two with that in mind. You write in a different language; you write in terms of centimeters of dilation, external fetal monitor, internal fetal monitor, pH, scalp electrodes, Cesarean birth experience, arrest of labor, protracted labor, fetal distress, episiotomy, prolapse, cephalopelvic disproportion, ultrasound waves, amniocentesis, “premium baby,” post-mature (when the baby stays too long in the uterus), “maternal environment” (formerly known as mother). Those are the words, the notes, while the piece is played to the rhythm of fear."

Here is another excerpt:

“Often I don’t like the women I've delivered. I don’t like them for their submissiveness. When I make rounds in the morning I ask, “When are you going home?” They answer, “I don’t know when my doctor will let me.” They have let themselves be imprisoned. For me, the submissiveness of one woman becomes my own, as though we were all one organism. . . . I used to have fantasies at Doctor’s Hospital about women in a state of revolution. I saw them getting up out of their beds and refusing the knife, refusing to be tied down, refusing to submit—whether they are in childbirth or when they were forty and having a hysterectomy for a uterus no longer considered useful. Women’s health care will not improve until women reject the present system and begin instead to develop less destructive means of creating and maintaining a state of wellness.”