News
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6/19/2024
There is a bill filed in the MA legislature (H.4566) that would license the 30 MA home birth midwives. The licensure bill was filed not because there is anything wrong with MA home birth midwifery. The bill was filed, I think, because our society thinks that getting licensed by the state is a good thing.
There is no benefit to being licensed. Licensing MA home birth midwives will restrict access to MA home birth midwives, create rules and regulations about which birthing people can hire a MA licensed home birth midwife and does not compel Mass Health or any insurance company to cover the cost of home birth midwifery.
Here's how it is being spun:
“We owe huge thanks to champions and advocates from ACNM, Bay State Birth Coalition, Repro Equity Now, the Massachusetts Hospital Association and the Department of Public Health for fighting for language that supports independent, autonomous midwifery. “ Notice the home birth midwives of Massachusetts, the trade organization for MA home birth midwives - Massachusetts Midwives Alliance - are not on the list of champions and advocates.
“The language reported out of the review committee protects US MERA and Bridge qualified CPMs” – the language of the bill bans apprentice “PEP” qualified CPMs.
“it mandates a CPM majority in the Board that will create regulations and review complaints” – there will be ob/gyns on a home birth midwifery board; a midwifery board that is charged with creating rules and regulations about women's bodies.
“The language is also free from any restrictions against VBAC, twins, etc.” – because the new midwifery board is charged with rules and regulations around VBAC, twins, etc.
“includes the proposed (MA) Licensed Midwife cadre as core providers” – birthing folks will be restricted to only hire state-approved MA licensed midwife to attend their MA home birth. Birthing folks who hire “other” midwives will set “other” midwives up for prosecution: https://longreads.com/2020/03/10/criminalization-of-the-american-midwife/
Aaannnddd, of course, once we start colonizing and criminalizing “other” midwives through licensing, a MA state house Rep has added another component that continues to make licensure of home birth midwifery a colonization and criminalization exercise: “we have also learned that opponents are pushing hard to include a malpractice insurance requirement in the Bill”.
Stop colonizing and criminalizing home birth midwifery.
Stop legislating birthing people’s bodies.
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From the Milk Making Minutes podcast:
“Sometimes all we need is to be heard when going through a major event like a pregnancy. It is one of the most formative events of a woman's life because of everything that goes on inside and outside of her.
“However, what happens if you lose your voice when you really need it. Even the most outspoken people can lose their voice in crucial moments because of the magnitude of the event of giving birth. This can continue throughout postpartum and have a massive effect on your physical and mental health.
“Our guest on today's episode experienced losing her ability to advocate for herself and her first born at birth. Resulting in a traumatic first experience with her child which carried on afterwards during breastfeeding.
“Joyce Kimball from central Massachusetts, mother of two now grown adults, and midwife, takes us into her memories and accounts her experiences dealing with lack of information on breastfeeding, having to go back to work too early, and what she is now able to put a name to, postpartum psychosis.
“Joyce dealt with many hardships during her first pregnancy, but did whatever she could to mitigate these issues in her second pregnancy which led her down the road to becoming a midwife to help other women so they won't have to go through what she had to.
“Tune in to hear a vulnerable story that could potentially help you or someone you know going through a difficult postpartum period.“
Topics discussed in this episode:
- How Joyce left her corporate job and became a midwife
- Joyce's birthing experience with her first child
- How Joyce was unable to voice her needs during her births
- The feeling of loss when there is no immediate skin to skin
- The uncomfortable breastfeeding experience with Joyce's first child
- The lack of sleep causing hallucinations
- How finding a breastfeeding group saved Joyce's life
- Joyce's experience with intrusive thoughts
- Joyce's introduction to homebirth midwifery
- How Joyce found her voice again during her second birth and breastfeeding experience
- Joyce's advice to her younger self
- The transition to doula
- How Joyce terminated breastfeeding with her second child
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Motherhood, Midwifery, and Home Birth with Joyce Kimball, from the Be Loud About What Matters podcast
1 hour 23 minutes
Posted Mar 2, 2022 at 8:00 am.
Show Notes
Joyce Kimball has been the Owner and Primary Midwife of Joyce Kimball Birth Services, a full-service childbearing-year care service started in 2000. Prior to Birth Services, Joyce spent 15 years working in Human Resources for Massachusetts corporations. After the home birth of her second child, she completed the apprenticeship process to certify and practice as a Certified Professional Midwife. Joyce holds an MBA, a Certificate in Midwifery, an Associate’s Degree in Nursing and a Registered Nurse’s license.
Joyce practices as a homebirth midwife, childbirth educator, birth counselor, and belly caster. She is active in the Massachusetts birth community - answering many questions on the MassDoula email list, connecting families with appropriate childbearing-year services, serving in various capacities with the MA trade organization - Massachusetts Midwives Alliance, precepting student midwives, nurses, and doulas, and talking with anyone and everyone about birth, supporting birth choice and reproductive justice. When she is not doing birth work, she’s listening to podcasts, at the gym or spending time with her family and friends eating, talking, listening, dancing, laughing, sharing and eating dark chocolate.
Resources:
maternal mortality rates:
- "Maternal Mortality in the United States," from Obstetrics and Gynecology
- Maternal mortality rates worldwide in 2019, by country
mother + baby health:
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I’m not sure where to begin.
I have full permission from RZ to share anything and everything.
Here goes.
RZ is an anesthesiologist. And she was raped and assaulted during the birth of her 4th baby.
R reported the “incident of obstetrical violence, including negligence and assault” to the Medical Board.
R's complaint included that her care and care providers were:
“Rude, confrontational, unprofessional, not supportive, very tense, unpleasant, escalated to physical violence, restrained and assaulted, baby violently pulled out of me, pushed flat on my back, told to pull her down on the bed and grab her feet, dragged, feet lifted, shoved a drape under me, unable to move, backside was lifting off the bed, could barely breathe, being forced into an extremely crunched position, hands inside me, extremely painful, unexpected, did not ask my permission or speak to me about inserting their hands inside my vagina, my legs were aggressively pushed towards me, continued to put their hands inside me, asked to be able to put my feet down – Dr. N would not allow my feet to be put down, continually forced into this position against my will, even as I repeatedly stated I wanted to be on my side, unable to move, people were holding onto each legs in the air, violently manipulating my baby’s head, my husband and I continued to plead with the (care providers) without success, (threatened) - “I don’t want to vacuum you”, documentation is false. I felt dismay and disbelief, bitter disappointment, horrible experience to be physically restrained and painfully assaulted during childbirth. Recovery has been extremely challenging, unnecessary violent force exerted on unborn baby’s head, in shock, great difficulty sleeping, depressed mood, anxiety, severe pain, hip and back instability for 2 months.”
Dr. Z responded to RZ's complaint:
“I’m sorry that Dr. Z didn’t have the birth experience she was envisioning, I believe the management of her labor and delivery was appropriate and within the standard of care. Given her high risk status (R had a cesarean section for her first baby, then vaginal births of her second and third babies) and the ongoing difficulty monitoring due to her desire to keep moving, I noted her resistance to monitoring in my note. I strongly disagree with the patient’s characterization of her labor and delivery….she was not effectively pushing and was not making sufficient progress in that position. I did not want to delay the delivery because we were not effectively monitoring her and she was at high risk for uterine rupture.”
“There was nothing traumatic about the delivery of the baby and she was certainly not “held down” as she suggests in her Complaint. It was not appropriate to allow her to labor on her hands and knees or her left side – as she was not pushing effectively in those positions and it was important to deliver as soon as possible.”
“the patient was pushing by 21:52 and was delivered at 21:55” (3 freaking minutes!!)
“I was able to facilitate her delivery with natural interventions, including massage of the perineum. I was aware that this was not the position she was hoping to deliver in; however, in my clinical judgement, it was the best, most effective way to deliver.”
“the patient has characterized me as rude, confrontational and unprofessional. I take exception with this characterization and I believe that I always poke to the patient in a calm and professional manner. Unfortunately, I was not able to allow Dr. Z to dictate the manner of delivery, and this clearly was an issue for her. All of my clinical management decisions were to facilitate the safe, appropriate and proper manner for her delivery.”
“while I am certainly sorry that this patient feels she did not have the delivery experience she was hoping for, I believe the care I provided was appropriate and within standard of care. She had a vison of her labor experience; however, that vision did not contemplate what was necessary for the safety and well-being of the baby.”
“our department is an interventional high-risk labor and delivery unit. Accordingly, we utilize standard interventions in the management and delivery of our patients. This patient chose to deliver without pain medication. She managed labor pain well; but, certainly her pain in active labor may have impacted her perception of her delivery. I can assure you that she was not “assaulted,” nor was she subjected to “physical force.”
“As you can see, the patient’s allegations of “unprofessional care and lack of communication during the labor and birth” was unsubstantiated (by the DPH). The DPH investigator found our actions to be “consistent with prudent medical/nursing obstetric practice to monitor the health of the mother and baby”. They found there was no “abuse”. The DPH went on to find that the obstetric care met the standard of care with regard to managing a delivery. The DPH indicated that given the patient’s past obstetric history, and her high risk status and risk for uterine rupture, the management was appropriate.”
“I’m sorry that Dr. Z did not have the birth experience she had hoped; however, I am happy to report that she safely delivered a healthy baby…the well-being of the mother and baby motivated my clinical decision making. While I try to accommodate a patient’s birth plan whenever possible, this patient’s history of previous cesarean delivery and potential for uterine rupture mandated the mode of delivery management utilized in her care.”
The response from Dr. N to RZ’s complaint to the medical board is the same thing birthing folks get told every day:
- I’m sorry you feel that way.
- Your experience is wrong.
- I work at a high-risk hospital and this is standard obstetrical care here.
- My clinical judgement that rape and assault is necessary trumps your requests for body autonomy.
- You are not allowed to birth the way you want, you birth the way I want.
- You brought it on yourself by wanting to move around and by not getting an epidural.
- Other powerful people who were not at the birth believe that my abuse was warranted and expected in standard obstetrical care.
- At least you have a healthy baby.
Every.damn.day this happens to birthing folks all across this country. My heart is broken.