Denise Howell

Blogger and mom Denise Howell, of Bag and Baggage fame, has been fired. And she writes about it so graciously and insightfully.

Ms. Howell is widely credited with coining the term "blawg", a fact for which I and my three blogs are eternally grateful.

P.S. There is no Wiktionary entry for "blawg", and no definition on Wikipedia, either as its own entry or on the "blog" page. Someone want to take care of that?

50 Ways to Protest a VBAC Denial

Barbara Stratton (voted one of the United States' top 30 women's health activists of 2005 by the National Women's Health Network) has a great piece up at Midwifery Today titled 50 Ways to Protest a VBAC Denial:

In 1999, the American College of Obstetrics and Gynecology (ACOG) issued new, restrictive guidelines for physicians and hospitals that handle vaginal birth after cesarean (VBAC). At first small, rural hospitals stopped offering VBAC; then larger, metropolitan ones followed suit. Now over 300 hospitals in our country no longer allow women to choose their method of birth.

Some of her suggestions include the usual; contacting local media, writing your legislator, organizing a protest, etc.; but she has the following legal suggestions:

3. File a complaint with your state medical board against the physician. Again, if the hospital where he/she has privileges meets the ACOG guidelines, then use the standard of care argument. Also point out that your physician is violating your right to refuse treatment. For more information on these rights, see the essay created by Katie Prown based on her research of the illegality of VBAC bans, at www.birthpolicy.org/primer.html.

Katie also covers how denying a patient the right to refuse treatment violates ACOG's own ethics guidelines. Throw that in, too!

In situations where you were literally forced into surgery, use the blue pages of the telephone book to contact your state's attorney general and pursue criminal assault and battery charges against the physician.

4. File a complaint with your state agency that regulates hospitals. In Maryland, this is the Office of Hospital Quality Assurance (comes under of Department of Mental Health and Hygiene). They have an official complaint process for consumers. Again, use the ACOG standard of care argument if your hospital meets the VBAC guidelines and include that you are being denied your right to refusal of treatment. Then, pull a copy of your hospital's patient bill of rights (found on many hospital Web pages) and see if the ban is a direct violation of their own document! In Maryland, all hospitals are required to have a bill of rights.

She later explains:

7. Find a lawyer who will help you sue your banning hospital. Make sure you give him or her the link to Katie's essay because most lawyers don't seem to know the ins and outs of the patient rights issue. Tell them about the violation of standard of care if that pertains. To find a lawyer, write to your state chapter of the ACLU or contact your local law school and ask for someone who deals with health law. Try your state's bar association for referrals as well. In a case from Massachusetts a woman was awarded $1.5 million for the post traumatic stress disorder and medical complications resulting from her coerced cesarean.(Meador v. Stahler and Gheridian (Middlesex Superior Court C.A. No. 88-6450, Mass. 1993)) Many lawyers won't know about that case until you tell them.

Interesting. Any takers?

National Advocates for Pregnant Women

The National Advocates for Pregnant Women (NAPW) website (whose stand on some issues I don't happen to agree with) has a blog which, among other things, tracks the arrests of pregnant women (for instance, women who allegedly used drugs while pregnant and are charged with child endangerment). Another one of their issues of note is coerced or court-ordered c-sections and childbirth interventions.

While of course no one thinks it is a good idea for pregnant women to use illegal drugs, it is quite ironic that society and the medical profession frown on drug use, legal or illegal, during pregnancy, but once labor starts we encourage the use, sometimes without informed consent, of all kinds of drugs which have not been proven safe for the unborn baby.

Spokane, Washington, CPS Case Update

Hawthor the Cow Goddess gives an update on the CPS story I blogged about in April.

Inmate Shackling

As promised, Wisconsin's Department of Corrections is "close" to finalizing a policy on shackling of pregnant inmates during labor.

Lactivism, Nurse-ins, and Victoria's Secret

At last count, 39 states (and a few cities) have enacted legislation protecting the right of mothers to breastfeed in public. Usually this legislation exempts breastfeeding from public indecency laws, with language stating that a woman has the right to breastfeed "anywhere she is legally allowed to be" or something similar. Federal legislation on the topic ensures the right to breastfeed on federal property. None of the legislation, to my knowledge, has any "teeth"; that is, there is no fine (so far) or remedy in tort for a mother who has wrongfully been asked to move, cover up, or stop breastfeeding (but see Scotland, which levies a fine).
One could argue that there is an inherent right to breastfeed in public without legislation, but that is beside the point.

Lactivists, however, have developed their own disincentive for businesses who give nursing moms a hard time: the Nurse-In. Basically, it works like this: You own a business. One of your employees asks a customer to stop breastfeeding in your place of business, otherwise open to the public. Or cover up. Or go to the restroom to nurse. Either on their own whim, or at the request of another customer. Regardless of how the situation is resolved, mom goes back home, and complains of the incident on her blog, on her email and discussion groups, at her La Leche League meeting, etc. And the news will spread like wildfire. Promom will start a letter writing campaign. The incident will be discussed to death on Mothering Magazine's discussion forums. Hawthor the Cow Goddess will write a cartoon about you. Your business will be on the evening news.

If you act quickly, offer an apology, and promise to change your company policy and educate your employees on the law, you may be able to avoid the Nurse-In. Maybe not. What will happen is that on a given day, at a given hour, anywhere from two to a hundred women with nursing infants (and some without) will come to your establishment and nurse their babies. If, by the time of the Nurse-In, you have apologized and made nice, the lactivists will eat at your restaurant, shop in your store, and be friendly. If you are stupid enough to still profess to be in the right by this point, they will stand on the sidewalk, or across the street, carry signs, and eat at your competitor's restaurant.

On June 21st and 22nd, there were two separate incidents (in Boston, MA and Burlington, WI) where women who were shopping at Victoria's Secrets were asked to use a public restroom instead of a changing room or nursing in the store. In case you miss the high irony of the situation, here are some quotes from the Blogging Baby article:

[S]he had been asked "to nurse in the restroom because the sight of her breasts might offend a customer."

Imagine, Victoria's Secret customers offended by the sight of breasts!

When she refused to nurse in the bathroom, she was told that "it was unsanitary for her to nurse in the dressing room because people change in them."

And restrooms are more sanitary?

If this had been the first such incident for Victoria's Secret, it might have been forgivable, but sadly it is not. After you get some bad press on this once, you think you'd get the word out to your managers and employees. Also, Victoria's Secret does not carry nursing bras (although I do own two of their bras and manage to nurse in them quite comfortably), even though sexy fashionable nursing wear is quite hot right now.

Anyhow, these two women started a nationwide protest - yesterday at 1:00 pm Nurse-Ins were taking place at VSs across the US. (I tried to blog about this two days ago but ran out of time. If you wanted to go and were depending on me to give you the heads up, you need to get out more often). They were met with varying degrees of response from the VS employees, from complete ignorance of the Nurse-In, to a pleasant "yes, we have been told to expect you" welcome. A couple minor run-ins with mall security, but no arrests as far as I know. Also clear from the post-Nurse-In debriefing; the problem with scheduling these things is, sometimes babies just don't want to nurse at 1pm on a Saturday in the middle of a mall. It's hard to have a protest when half your participants don't feel like participating.

I hope, by the tone of this post, I don't seem unsympathetic to, or critical of, the Nurse-In as a form of social protest. I actually think it is quite effective and might have joined had my domestic schedule been otherwise. But I am looking at it from the point of view of the business owner, for whom it is a major, yet very avoidable, public relations fiasco. On the other hand, as they say, there is no such thing as bad press.

I have two pet peeves, one for each side. I hate it when businesses say "our company policy permits nursing in our store." I want to scream when I hear that. In a state where breastfeeding in public is permitted by law, it is not up to the business to "permit" or "forbid" breastfeeding on their premesis. They can be welcoming or not, educate their employees or not, but it is not up to them to "allow" it.

On the other side, almost all of the articles about the Nurse-In will quote someone saying something like "you see more in their magazines and store windows than you do when a mother nurses". While technically that is true, and I am in no way defending Victoria's Secret's (and popular culture in general's) abhorent lack of modesty, it is all about nipples. In our society, you can show all of the breast but that. Any any woman who claims that all of the nipple is in the baby's mouth while breastfeeding in public is either lying, or has unusually small nipples (or a baby with an unusually large mouth) . Ok, sorry to be so blunt, and please don't leave me nasty comments, but it's the truth.

Here are a few links, and I'll update with some of the better news items as they trickle in:

Breastfeeding Moms Blast Victoria's Secret in Nationwide Protests
Victoria's Dirty Little Secret
Reluctant Lactivist
CITIZEN-TIMES.com: Breastfeeding mothers to stage protest at Asheville Mall
Fox 42 Nebraska
Huntsville Times


**Update 7/05/2006**

The Cleveland Plain Dealer published a truly sensational and bizarre article:

Lactation and lacy lingerie were the subjects of a national nurse-in Saturday as breast-feeding mothers across the country let their kids chug-a-lug in front of Victoria's Secret stores.

Fifteen mothers armed with hungry babies gathered on the sidewalk outside the Crocker Park Victoria's Secret store in Westlake where scantily clad mannequins seemed delighted by the peaceful, half-hour demonstration.

"It's kind of ironic that Victoria's Secret, which plasters breasts everywhere, is offended at seeing breasts used for their intended purpose," said Anna Mauser-Martinez, who organized the local nurse-in and volunteered that she happened to be wearing a pair of Victoria's Secret underwear.
...
Back on the sidewalk, the mothers caught Aaron Bonk's eye. A juggler and stilt walker, he towered over them on 4-foot stilts. "Oh," Bonk said, sounding surprised. "You're nursing right here? Good!"

Looking up from her suckling child, Amy Klomfas said, "It'd be fun to breast-feed on stilts" - a notion that Bonk advised against.

Amish Farmer Busted In Sting Operation

Amish farmer says milk law opposes beliefs

**Update 7/12/2006: Judge rules against farmer in raw milk case

Funny eBbay Auction

I love a well-written eBay auction description:

Some people might ask what good a 14" Apple iBook with no hard drive and a faulty motherboard is.

Those people lack imagination.

Those are the kind of people who wouldn't buy a car that lacked an engine. They'd forsake a book without pages. They'd probably toss out a perfectly good non-definition TV.

I'm not selling to those people.

I'm selling to the kind of person who wants a 14" Apple iBook with no hard drive and a faulty motherboard. The kind of person who thinks differently.

I think this guy could probably sell anything.

Midwifery Legal Update - Wisconsin

Helen Dentice entered a not guilty plea on Friday to practicing medicine without a license.

She is not charged with practicing midwifery without a license? How odd, since she was clearly holding herself out to be a midwife, not a doctor. Although prosecutors may believe her actions meet the legal definition of "practicing medicine", I would think that the "practicing midwifery" charge would be easier to prove. My guess (without looking it up) is that one is a misdemeanor and the other a felony. But why not charge both? Even though Wisconsin recently legalized CPMs, Ms. Dentice, if I understand correctly, is not one.

Midwifery Legal Update - Florida & Indiana

In Florida this week, Linda McGlade and her daughter-in-law Tanya McGlade were sentenced to 2 1/2 years in prison after being found guilty of practicing midwifery without a license. The charges stem from the 2004 childbirth death of another daughter-in-law, Mara McGlade. The Florida case is a bit bizarre, because Florida licenses direct-entry midwives:

The defendants said they never claimed to be midwives, a profession regulated by the state. They said they merely attended an unassisted home birth, which is legal.

But Circuit Judge Edward Nicholas noted that they checked the heart rate of the fetus, delivered oxygen to the mother and examined the placenta.

(link:"Women sentenced for unlicensed midwifery")

In Indiana, Jennifer Williams, CPM, pled guilty on Wednesday to a charge of practicing midwifery without a license ("Ind. midwife pleads guilty in infant death"). As part of the plea deal, the charges of practicing medicine without a license were dropped. No charges were brought in connection with the death of the baby. Ms. Williams' case gained national notoriety after she was featured in a New York Times article ("Prosecution of Midwife Casts Light on Home Births"). In May, she brought suit against the Attorney General of Indiana, requesting that the state clarify the definition of midwifery. Indiana regulates nurse-midwifery, but has no statute regarding the practice of direct-entry midwifery.

From Ms. Williams' press release:

I am a Certified Professional Midwife which means that I am a fully trained and fully educated midwife and credentialed through the North American Registry of Midwives. There are two types of certified midwives in Indiana, and elsewhere in the United States - Certified Nurse Midwives and Certified Professional Midwives. In many other states across the country Certified Professional Midwives practice legally, with the sanction of the state. CPMs in these states are able to accept insurance and Medicaid reimbursement and interact fully with the medical establishment. Indiana chooses to prosecute these same CPMs with felony charges, instead of utilizing CPMs in the maternal child- health care system, which desperately needs support and re-enforcement.

Prosecuting CPMs is a short-sighted waste of money, time and effort. CPMs are not criminals or felons. They are well-trained professionals who practice with the highest of standards, who pass academic and clinical skills board exams, and undergo peer review and continuing education, just as any other health care professional does. Indiana should be incorporating these midwives into the health care system, rather than prosecuting them.

Midwifery supporters in Indiana have been trying for years to pass legislation legalizing and regulating direct-entry midwifery, but have been blocked by Sen. Patricia Miller, a nurse and the chair of the Senate Public Health Committee ("Desperate midwives: Sen. Miller continues to block legislation").

News links:
State questions legality of midwifery
Trying to boost at-home births
Midwives fight to practice in Indiana

Blogs:
Kemplog - Midwives vs. State and Midwife Takes Plea
**Updated 6/17/06 to add: Legal Status of Unlicensed Midwives in Indiana
Belly Tales - Homebirth Prosecution
Chai There - Calling my elected official
5 Dollars - Midwife charged in Edinburgh case

Parents Fight Over Son's Circumcision

Groups opposed to circumcision are watching the case of an 8-year-old suburban Chicago boy whose divorced parents are fighting in court over whether he should have the procedure.

The child's mother wants him circumcised to prevent recurring, painful inflammation she says he's experienced during the past year. But the father says the boy is healthy and circumcision, which removes the foreskin of the penis, is an unnecessary medical procedure that could cause him long-term physical and psychological harm.

There are religious issues, too:

Tracy Rizzo, the mother's attorney, said religion, not medicine, is the father's concern. Rizzo said the father disagrees with circumcision because he resents the fact that his ex-wife has remarried a Jewish man. The mother lives with her new husband, her son and her husband's son from a previous relationship in Northbrook.

The father, an Arlington Heights resident, denies he's concerned about the religion of his ex-wife's husband.

The mother testified Wednesday that she wanted the boy circumcised when he was a newborn, but her then-husband refused. She quoted him as saying at the time: "There is no way my son is going to be circumcised. He is not a Jew."

But the judge would not allow Alan Toback, an attorney for the father, to ask the new husband, who also testified Wednesday, if he is circumcised.

"We're not going there," the judge said.

Yeah, me neither.

(link)

Rethinking the VBAC Ban

Frederick Memorial Hospital in Pensylvania institued a VBAC ban in 2004, but is rethinking its policy, according to the Frederick News-Post:

Dr. Chen [head of the obstetrics and gynecology department] believes the decision to perform a VBAC should be between the physician and patient upon evaluating a woman's individual risk for complications. Depending on the circumstances of a woman's previous Caesarean(s), the risks from VBAC are different for each person, he said.

The main reason FMH doctors stopped performing VBACs is because of rapidly increasing medical malpractice rates.

"Hospitals don't want to say that. That's the only reason," he said.

Another choice quote:

Rebecca Mack of Frederick recently delivered her son at home because she did not want to have a C-section for her second child.

Her first child was delivered via Caesarean at Shady Grove Adventist Hospital. She said her experience at Shady Grove was unpleasant, and she did not want to go to the Rockville hospital to have her second child, despite the opportunity to have a VBAC there.

"I felt that if they had given me a chance to relax and rest my body for awhile ... I could've gotten through it," she said. "I'm still bitter."

Update: Placenta Found At Wellesley College

Placenta mystery solved: Mom, baby found safe, no charges filed

Apparently, I was right.

And the Boston Herald is just as facinated with placentas as I am.

Parkland Hospital & Immigration (of the Illegal variety)

The Dallas Morning News this week featured Parkland hospital, which boasts the nation's second-busiest maternity unit, in relation to the immigration debate (link):

Since Parkland opened in 1895, it has served Dallas' indigent population, which often includes uninsured minority and immigrant residents.

A recent patient survey indicated that 70 percent of the women who gave birth at Parkland in the first three months of 2006 were illegal immigrants, hospital officials said.

These Hispanic women had been having their babies at Parkland without much attention until the recent debate over illegal immigration. Critics have questioned the ease with which illegal immigrants are delivering their babies at U.S. hospitals – at taxpayers' expense.

Placenta Found At Wellesley College

Possible Placenta Found At Wellesley College

Oh, darn. Guess I shouldn't have drained the birth tub out into the arboretum.

No, seriously, this is not funny because if someone is going to just toss a placenta somewhere (as opposed to, say, a ziplock bag in the freezer), they could have easily tossed the baby out too. Which is I'm sure what the police are thinking.

Pro Wrestling & Pregnancy

Missouri's Office of Athletics has a relative new rule that, in conjunction with the licensing of contact sports such as boxing and wrestling, female athletes must take monthly pregnancy tests in order to compete. Wrestler Julie Utley will have none of it.

This is wrong on so many levels.

Midwifery Legal Update - Wisconsin

A Waukesha County judge has banned midwife Helen Dentice from performing any duties as a midwife. She is accused of practicing medicine without a license. (link)

Breastfeeding Lesislative Update - Kansas

Kansas has not only passed a new law insuring the right of moms to breastfeed in public breastfed babies to be fed wherever they are, but has gone one step further by distributing cards explaining the law:

To help educate the public about the law, the Kansas Department of Health and Environment (KDHE) and La Leche League of Kansas produced a breastfeeding informational card called Loving Support Makes Breastfeeding Work. The card was designed for nursing mothers to carry with them and share with the public or businesses that do not understand their right to breastfeed. The card has the law printed on it as well as additional information about breastfeeding.

Such cards have been carried by breastfeeding advocates for years, but never, to my knowlege, has the government partnered with LLL to produce and distribue the cards.

Overwhelmed

Yes, that's how I feel. There is so much to blog about and so little time. Recently I discovered that I had over 250 links saved as drafts that I had never posted to this blog. I'm a bit of a perfectionist; I want to write something clever, or important, or summarize everything in one post, or look up all possible relevant links, or ...

So I'm going to take a hint from Glenn Reynolds and just post links with only brief explanations or quotes. That's all I'm good for right now.

Italian MP Wins Breastfeeding Battle

"Italian Parliament member Donatella Poretti won installation of a nursery allowing her to safely breastfeed her 3-month-old while at work."

(link)

More Things You Don't Want to Hear Your 5-Year Old Say

"Mommy, when is your tummy going to go back to normal?"

Sorry, champ, this is the "new normal".

Midwifery Miscellaneous

Former Vermont midwife Roberta Devers-Scott has a new attorney for her state Supreme Court appeal - civil rights lawyer Michael Sussman. (link)

The Guardian (which "Covers Prince Edward Island Like the Dew") reports on an effort to regulate midwivery in that part of Canada (link). Some choice quotes:

The Birth Options Research Network (BORN) was established in 2003 by a handful of women to explore birthing options for women in Prince Edward Island.
...
Kerstin Martin, president of the Canadian Association of Midwives, is helping to draft midwifery legislation for Nova Scotia. Currently, the Yukon and all Atlantic provinces are the only jurisdictions in Canada that don’t have regulated midwifery.
...
BORN is also keen to meet with policy makers, politicians and hospital administration to continue to express the concerns of birthing women in P.E.I.

Martin, who has tended to more than 1,000 births, said there needs to be a perception of a need for midwifery to gain support in the province.

“This group BORN is certainly going to do everything it can with that,’’ she said.

“I think they need to really listen to the women of this Island and the communities. What are the women’s experiences of maternity care as it is delivered right now and look at whether women themselves want something different.

“And, of course, women can’t ask for things that they don’t know about.’’

And sorry I haven't done a complete legislative roundup, but Missouri's bill to authorize/legislate direct-entry midwifery,HB 974, did not pass. (link).

Childbirth-related Organizations

Three organizations of interest, which I have recently become aware of:

The Foundation for the Advancement of Midwifery is "a 501 (c)(3) non-profit organization dedicated to the midwifery model of care as the quality health care option for women and families." Their mission is:

To improve the health status of women, babies and families by increasing awareness of and access to the midwifery model of care. This mission is accomplished through the funding of education, research and public policy initiatives.

WECAN is Women Educating Cytotec Awareness Nationwide:

WECAN'S MISSION: To inform and educate the public regarding the adverse effects of using Cytotec "off-label" to induce labor.

WECAN is demanding that women be fully informed before Cytotec is administered for induction.

This weekend WECAN held a rally in Washington, DC, timed to conincde with ACOG's annual conference. Speakers included Ina May Gaskin and Marsden Wagner.

And the US Birth Practices Committee (USBPC) has been formed:

The mission of the multidisciplinary group is to encourage, conduct, evaluate and disseminate research related to the best practices in birth care for childbearing women and their families in the United States and its territories. The USBPC is composed of prominent individuals and representatives of many American organizations with interest in the health of women and families.

The first act of the USBPC was to endorse the Mother-friendly Childbirth Initiative.

International Midwives' Day

Today is International Midwives' Day. Call you midwife and thank her! Or you can send her an e-card here.

Links of interest:

MANA's IMD page.

New Zealand midwives want equal pay.

The website for the Australian College of Midwives says this year's theme is "The world needs midwives, now more than ever".

Nebraska's governor has made an official proclaimaion. Idaho too. Interesting, since direct-entry midwifery in both states is unregulated.

Will add more links later if I see some good articles.

Nice thought, but no thanks

From the Associated Press, Lawmakers consider free admission to shows for breast-fed infants:

Rhode Island legislators are considering a bill that would allow mothers who are breastfeeding their infants to bring those children to the theater and other live performances for free.

House lawmakers at the General Assembly approved a bill Thursday to permit free admission to shows for children under 1 year old if they are being breastfed by their mothers. The Senate has yet to approve it.

Who comes up with this stuff? Listen, you are not going to find anyone more pro-breastfeeding legislation than me. But did these guys fail Legislation Writing 101?

Most attractions - movies, zoos, etc. - do not charge for babies, and often not for children under 2 if they are lap children. If they are not taking up an extra seat, and not really partaking of the entertainment, they shouldn't have to pay. But I don't see the point of anyone legislating this. The free market tends to take care of this quite well - if you make me pay for my baby to take a nap in his stroller in your museum, I'm just not going to be giving you my money, and neither will any other parent with good sense. And to do it in such a way as to specifically reference breastfeeding. I mean, are you going to have to prove it? How would that work?

All babies - not just breastfed ones - need to be close to their mommies. Perhaps bottlefed babies even more so, since there is no biologically mandated closeness to foster the attachment. I'm not saying you shouldn't ever leave baby with a sitter and some EBM and go out for a few hours; I'm just saying that as a society, we should think of the mother-infant pair as one entity rather than two.