How did it go? What did you learn? You know, the skinny...Or shall I say the swell?!

How did it go? What did you learn? You know, the skinny...Or shall I say the swell?!

Yeah! What she said!!

Bethanie, Jennifer, myself from the soon to be unit at Ochsner, Carrie from EKL, several CNMs from Lafayette, and several from New Orleans, attended this meeting. Direct entry midwives included Cathy, Emmy, Linnie and Sherri (sorry if I missed any one else). The Birth Helps group was well represented, as were the nurses from Ochsner. The above groups networked well. A few nurses from Woman's Hospital were also there (sorry, I don't know their names.}

Cultural Anthropologist - Robbie Davis-Floyd PhD - spoke twice. The morning session was titled Birth as an American Rite of Passage. She showed how birth in the US has changed from mother centered to physician centered. This was interesting. It also demonstrated that, even within the medical community, we are moving beyond this model of care. As a clinician I know the benefits of "mother centered" care, and I know that we love accomplishing that kind of care. I also know that the majority of pregnant mom's (at least in Baton Rouge) are not aware of the benefits of this and accept, no expect, a medical model of care. The Louisiana Natural Birth group does a great job of professing the benefits... how could this group outreach to the community???

Dr. Davis-Floyd's afternoon speech was basically how other countries do so much better than the US in care of the pregnant family. Frankly, I was expecting something more like a study of our particular population in Louisiana, our particular problems and suggested solutions for them.

Other speakers discussed breastfeeding and infant mortality in Louisiana. Again, we know we need to change what is but how do we do it???? When I try, I am being opposed by mom, grandmom, aunts, family and friends of the patient......

There was a panel discussion about how CNMs, homebirth midwives and birth center midwives affected the care of women. This was "preaching to the choir." WE know the effect... again how do we spread the word?

Food was good, company was great, but many questions were left unanswered.

Thanks for posting. I am trying to find enough time to write down my thoughs and what I learned. Right now my son is begging for computer time....


I agree Davis-Floyd's message was either preaching to the choir or to those that can only do so much. By that I just mean that there is only so much change a nurse can make, working in the confines of hospital policy and the OBs belief system.

I agree there was no solutions being spelled out in her second talk but instead she gave us mulitple examples of what works. I don't feel it is Davis-Floyd"s place to give us a solution but rather to give us the tools and information we need to move forward creating a solution that works in our climate. You are right that the consumers first have to be aware of what is NOT working and want what will work. This job can only partially be done by the HCP, by the time a women is pregnant there is only so much you can do to change her perspective. Not to say there is not a lot that can still be done. The HCPs do have the most power right now to iniate change. We have to start at the top of the heirachy, when changes in perception occur there it will trickle all the way down. At the same time more has to be done to educate our women and change their veiw of birth and motherhood long BEFORE they are pregnant. I think the LNB and other groups like BirthHelp have a good vice for getting something going on this. Community outreach is a very good direction for us to go.

Okay so now I must give into the pleading...he is being so sweet. But I will get on later and try to post my review of the PNB and what has so inspired me about Davis-Floyd's message.

Kathy, I would love to hear from the others that attended, nurses and CNM's especially. Can you please help to encourage them to give thier feedback here.

Wow. Sounds cool, but also like continuation and real world solutions need to be dreamed up, implemented, etc. No more honing the verbiage that discusses the problem. Time to come up with ideas that are workable and cheap.

Thanks!

Davis-Floyd is amazing. I discovered her long before I thought about having babies. Her ideas are applicable to women in many stages of life.

Perhaps another meetup to "knowledge share" (my husband's IT term) and brainstorm?

Amy

I'm trying to get a write-up done for you for granola rouge, Amy, if you want it! But it will probably be later this week.

Overall, I thought the conference was interesting, inspiring, and disturbing all at the same time---I was especially compelled by the presentations on infant mortality and breastfeeding in Louisiana. We have a lot of work to do in our communities. What struck me most was how much bigger these issues are: this is about poverty, education, nutrition, and poor health in general. Maternal/baby health is typically a good indicator of the overall health of a community, and we are at the very bottom. Definitely some big-idea brainstorming is in order...

I dont' think there is one clear cut answer to how do we fix the problems in our maternity system. It is too multi faceted to have one group/person/organization responisible for iniating change. I think progress is already being made and we just need to keep moving forward. I think we need to come at this problem from many different angles; women need to be educated, doctors need to practice evidence based care, hospitals need to do away with policies that hinder the birth process, support groups need to be more accessible, midwives need to be more accessible, doulas need to be more accessible, women need to be the focus, birth professionals need to co-exist and allow the women autonomy to make her own choices about her care. The last one to me is the most important, as in it would make the most overall difference.

One important message I took away from the talk on Birth Models that Work is that one consistant factor is the autonomy the women share, they are responsible for their care. This personal responsibility is what is lacking from our maternity system. Women are encouraged to give up their autonomy and place thier lives and the lives of their babies in the hands of doctors, nurses, and hopsitals. Utilizing technology to manage their safety. So it is not surprising that when something does go wrong these women feel no personal responsibility for what has happened and look immediately to the nurses, doctors, hospitals, or technology (or lack there of in some cases) to blame. This blame game is essentially what has turned out health care system into such a nightmare. Decisions are no longer being made to protect women and babies but rather to cover asses.

Kathy is right. The reason for our pathetic numbers won't be changed by home births, b/c the problem is not due to this type of mom or her birth. The problem as we know it is access to care issues, poverty and access to food issues, and pure ignorance. Now, assuming we could get this model in place in La., here is how it might look.

http://www.jenniejose...

If you have not seen it......JJ is IMPRESSIVE......as far as I know, she does not even do the birth, but using the Medicaid $$ that they are allowed to collect in Fl, they run a clinic in which the access, ignorance and food issues, as well as the self-responsibility factor are addressed. I want to do this. I am willing to do it. How can we implement it?

I did enjoy the conf., and of course, there is that choir thing. But I would like to get with La. Mat and Ch Health to sponsor something like it for bigwigs and present this JJ model to them........anybody ready?

ready willing and able!!

I agree the solutions have to start before the birth...solutions to the problems with birth will come when women are educated, doctors aren't scared, and there is accessibility for ALL women to make choices that fit thier familiies.

Oh, wow! Rarely have we addressed birth as a poverty/education issue. Now we're talkin'...It's not about home birth versus hospital birth. This goes way more basic than that...Talking birth environment and all things Ina Mae and Mothering Magazine is like frosting on a cake that is already, apparently, quite out of reach for many, am I right?

A