Thursday, March 12, 2009

Helping and Preventing Birth Trauma

We are pleased to announce the Solace for Mothers Friends and Advocates Online Community which provides a forum for those who support mothers who have experienced birth trauma, have been impacted by witnessing birth trauma, or want to connect with others to advocate for gentler birth practices.

Solace for Mothers is committed to providing resources and support to professionals and loved ones supporting women through the difficult emotions following a disappointing, hurtful, or violating birth experience. Spouses, family, and friends of mothers who have experienced traumatic births are offered a space to find information, support, and resources through participation in the Friends and Advocates Forum. Birth attendants are also provided with the opportunity to process their own emotions in response to births they have attended. Birth professionals and birth advocates are provided a space to discuss the causes of birth trauma, how policies and programs can be enacted to prevent trauma from occurring to childbearing mothers, and methods of treatment when trauma has occurred.

The Solace for Mothers Friends and Advocates Online Community welcomes birth activists, mothers, families, and professionals, all of whom are stakeholders in providing healthy, safe, and empowering births that enable families to successfully transition to parenthood. Users of the online community are invited to contemplate and discuss the current state of birth and what evidence based practices best support childbearing women, their babies and families. Advocates who are interested in becoming involved in organized efforts to promote these practices are encouraged to participate and share their thoughts.

The Friends and Advocates Online Community can be entered from The forum is made public for browsing and registration is required to post and respond to topics. To view the online community, go to:

Mothers are welcome to participate in the Friends and Advocates role but they are invited to register and participate in the Online Community for Healing Birth Trauma ( which provides peer support to women who have had traumatic childbearing experiences. Birth professionals, family members, and friends please respect the privacy of the Community for Healing Birth Trauma and register only for the Friends and Advocates Community.

If you have something to say regarding childbirth and want to be a part of a larger conversation, please join us. We are interested to read your stories, thoughts, hopes and goals for the future! Please also feel free to pass this invitation on to organizations and individuals who would be interested in the topics of birth trauma and improving maternity care.


Sharon Storton, Founder of Solace for Mothers, Inc.
Jenne Alderks, Creator and Moderator of Online Communities
Jennifer Zimmerman, Creator and Moderator of Online Communities

Monday, March 9, 2009

If I were to birth in my hometown

I recently started entertaining the thought of birthing my baby in my hometown of Stockton, CA. Many of my friends are still living there and beginning to have babies, so I've learned a little bit about the birth climate there. All of my friends there have had hospital births, which is not too surprising. I have been disappointed by the number of primary cesareans that my friends have experienced. I took that to be an indicator that the hospitals in Stockton aren't incredibly supportive of physiological birth.

A quick search showed me that there are no homebirth midwives working in the city of Stockton, and no out of hospital birthing centers. The nearest birthing center is 50 miles away in Fair Oaks, with two more in San Francisco and Oakland, respectively. The nearest homebirth midwives are 40 miles away in the Sacramento area.

I decided to look at the websites for the two main hospitals in the city of Stockton: Dameron (where I was born 24 years ago) and St. Joseph's. I was not encouraged with my options when I read this:
The baby's father or support person may visit from 7 a.m. to 10 p.m.
Only two people, in addition to the support person, may visit at one time.
Children under age 12 are not allowed in the department. Exception - after delivery, brothers and sisters of the newborn, accompanied by an adult, are welcome during regular visiting hours. Short visits are best for your children.
Visitors must not have fever, cold, cold sores, diarrhea, vomiting, rash or skin sores. Those who have been exposed to illnesses such as chickenpox or measles may not visit.
Labor and Delivery:

One additional person, other than the support person, may be present during labor and delivery. We ask that all other visitors wait in the visitor's lounge, (not the hallway).
Only the support person may accompany the expectant mom for a Cesarean delivery.

For a more detailed description of their practices, see their PDF entitled "Welcome to Life--Guide to Pregnancy, Birth and Postpartum."

Dameron's information was a little more encouraging:
The Alex and Faye Spanos Start of Life Center
This holistic focus is reflected in our Start of Life Center. A generous gift from Alex and Faye Spanos, the Start of Life Center operates on the concept of "Family Centered Care," where birth is treated as a total family experience. From the time an expectant mother experiences her first labor symptoms and arrives at the hospital, through the actual delivery of her child, she receives total maternity care without ever having to leave the pleasant and comfortable environment of her home-style birthing room.

The Labor and Delivery Department is staffed by highly trained Registered Nurses sensitive to both the emotional and medical needs of pregnancies and birth situations.

Based on the experiences of my friends and my own interpretation of available materials, I'd probably choose Dameron over St. Joseph's if I needed a hospital, but I'm so opposed to a planned hospital birth that I'd be more likely (if I lived there) to find a homebirth midwife outside the city. This investigation has not encouraged me to change my plan in the slightest. I feel that the state of Washington provides me with more choices and access to better care than I could get in the Stockton area.

So the plan goes forward that both of our first children will be able to claim Washington as their state of birth. Once the new baby and I are fit to travel (no sooner than 1 week postpartum), we'll be driving down to spend the summer in Stockton while my husband does his summer research on the California coast.

More general information on birth choices in the Stockton area is that St. Joseph's has an all out ban on VBACs while Dameron does allow VBACS, although a statement refusing the C-section must be signed. That leads me to believe that women are strongly encouraged to consent to an elective repeat cesarean. It appears the hospital staff is rather persuasive since in the county, 96.5% of women have a repeat cesarean(source: March of Dimes Peristats for San Joaquin County, CA).

Reporting on CIMS

I came away from the 2009 CIMS Forum feeling like the take home message was the same as we all know: the maternity care system is messing up women and children. It was interesting to me to find out what different people are doing in different places.

I went to one presentation that discussed violations of the Mother-Friendly Childbirth Initiative as violence against women. The researchers (from Canada) qualitatively analyzed women's experiences (using interviews) that showed how women felt victimized by their maternity care. The researchers put together a really cool little chart that helps to illustrate it and I'm planning on filling one out with events from my own birth experience. I am just gratified that it is being framed in those words--that violations of informed consent are violent acts being perpetrated against women. I hope that the awareness becomes more accepted. I felt that their presentation and Solace for Mothers presentation worked well together, because they made the case for us that birth professionals are causing trauma and then we were able to follow up with the message "this is the outcome for women who experience that trauma and this is how we can help."

There was talk at the conference that the powerpoints from many of the presentations will be available on the CIMS website at some point, including the one I participated in for Solace for Mothers.

I also finally attended the Birth Survey marketing training and I realized that since I helped edit the training manual and powerpoint presentation that I pretty much knew all of it. But I did meet Nasima and Elan (the co-chairs of the Birth Survey Project) and it was really good to be able to meet them in person and visit a little bit. Here is a run-dowm of some of the Birth Survey results that Nasima unveiled: The sample of people who are responded so far is a little more educated that the national average, but not shockingly so. The most typical time for women to complete the survey is actually 9-15 months postpartum so marketing ambassadors are now being told to target pediatricians offices (and they will be more like to post the info than OBs because peditricians aren't going to be as threatened by the results). Probably most surprising is that the birth outcomes are pretty inline with the national data: the C-section rate isn't too far off, the percentage of hospital births, etc. Nasima did find that the questions regarding if you would recommend a provider, if a provider answered questions well and were respectful were highly correlated to whether a woman ranked that provider positively or negatively. So it appears that those questions are good indicators of overall quality and if women are saying they had a good experience.

Henci Goer gave a really good presentation on interpretting the research. She pointed out that a lot of birth activists are citing "Evidence Based Care" as the answer to the maternity care problems (think of the new report that came out a couple of months ago). I saw alot of that too but it must be realized that a lot of research is inherently flawed, that some researchers mess with their data, others draw conclusions not supported by their data, etc. Its stuff that I already knew, as a researcher, but may not be known by those who don't have the background in research. I think its a good thing to get the word out about.

For most of the conference, I was just making due since I had Willem with me. One day I couldn't find any childcare for him so he ended up attending the sessions with me. He did great and didn't appear to be a disruption to anyone but I didn't get as much out of it as I would have if he had been able to stay home. I'm not complaining though because it was still a very good experience. I'm happy to have learned what I did, and met the people that I did.

At one point, the different CIMS committees did overviews of their work and I'm kind of drawn toward working with the Informed Consent Committee. Coming up in the Winter 2009 issue Journal of Perinatal Education will be an article compiled by that team called "Informed Decision Making in Maternity Care." Another article with Maddy Oden as the lead author will be published in the May issue. Solace for Mothers is working on a tool that would be available for expecting mothers to use when choosing their maternity care provider. It may be an advantagous partnernship for CIMS and Solace to work together.

Tuesday, March 3, 2009

Going to CIMS

This weekend, I'll be attending the CIMS (Coalition for Improving Maternity Services) Forum in San Diego. Sharon Storton from Solace for Mothers will be speaking on the services that Solace provides mothers who have experienced traumatic birth and how the utilization of the CIMS Mother Friendly Initiative can prevent birth trauma from occurring. Other speakers will be Henci Goer and Phyllis Klaus. I'll also be able to attend the CIMS Marketing Ambassadors Training which I haven't been able to participate in yet. When I get back, I should have some good information on how to promote the Birth Survey in Washington state. This is my first birth conference and I'm very happy to be able to attend. I'll summarize and report upon my return!