Where is this all coming from?

Many of my recent posts were prompted by a thought process that Rixa started me on when she posted a blog about doulas making a difference in the birth outcomes of women. She expressed her reservations that doulas may unintentionally support the status quo in our maternity care system.

This is my response to her post, and what started me on thinking about what an "organized effort" to promote change in the maternity care system would look like.

On August 20, at 9:58 pm I wrote:

In the last few months, I've been having a crisis of faith in doulas which has kept me away from going through the certification process.

From a first time mom who then came into the birth community, I learned that doulas tend to represent themselves as advocates and spokespeople for laboring women. But then the same doulas turn around and change the definition of advocate into something that doesn't mean what is being heard when a pregnant couple hears "advocate."

I also know that I am one of those mothers who found a doula as a no confidence vote in the hosptial. And while I avoided the cesarean, my plan backfired when I experienced PTSD after being forced repeatedly to find my voice in order to speak up for myself like Jen said. I did that and it was like trying to stave off a freight train that was trying to barrel down on me. And Jen is right, it is the responsibility of DOULAS (not mothers!) to correct the misconception that they aren't there to be advocates or spokespeople.

In addition to all of that, I do believe that doulas are contributing to the status quo of what is happening to women during birth. I see them spending more time trying to make women "more educated" when all that ends up happening is that those women go into the situation that is stacked against them. Doulas should be mounting organized efforts against hospitals and maternity care providers that change the face of birth in hospitals so in time it will become what we know is the true face of birth is supposed to be.

I see the efforts to make those changes being kept separate from the work of doula-ing. I've heard doulas say "when I'm older, I'll take on the system but now I'm going to focus on the individual family." While I understand where they are coming from, I strongly think that most doulas have the responsibility to do both: care for their individual familes and take on the system. As they do that work, women will join them.

This is also a time to say that when I do see doula efforts to take on the system, it is very disjointed and in little pockets. While that is the way grassroots changes come about, its important to connect those pockets and getting them to work together. It is that organized effort that is needed now.

To see the posts I've written aspects of what an organized effort would look like go to:
Birth "Think-Tank"
Legal Rights to Informed Consent in Birth
Framing Birth As Public Health, Reproductive Rights Social Issue
Speaking of Frames

Stay tune as my vision and ideas coalesce themselves, and how the organizations that I volunteer for (The Coalition for Improving Maternity Services and Solace for Mothers) fit into that vision.

Framing Birth As Public Health, Reproductive Rights Social Issue

In a previous post, I shared the legal connection between informed consent and birthing choices. Sara Ainsworth in the Seattle PI article, framed women's birthing choices as legal issues relating to reproductive rights, patient's rights, as well as the public health concerns stemming from the risks of Cesarean births.

Framing is a process of developing communications that change the way that people think about social issues. People tend to have existing intellectualized constructs that provides their interpretations of events and issues. Sometime those dominant frames are called "pictures in our heads," "mental shortcuts." (Source: Frameworks Institute)

Effective framing, combined with field building can bring out social change where coalitions of social policy advocates work together to effectively communicate about their issue.

I learned about framing policy issues in my graduate coursework from this summer. For that purpose, my cohort members and I worked on framing early childhood education as a social issue. However, my involvement in the birth community has led me to change my focus to framing birth issues as social issues that need policy changes that benefit infants, mothers and families, instead of the current system where its the obstetricians and insurance companies who benefit.

The dialouge about social frames has gotten started and the Northwest Women's Law Center has joined it. Who else will?

Will a think-tank (a policy, research and advocacy organization) ever be formed for birth issues? What type of effort is needed to accomplish the desired changes?

As one can tell, I'm not content to sit at my computer and bemoan all that is wrong with childbirth in the United States, as Rixa says.

Birth "Think-Tank"

The Tatia Oden French Memorial Foundation is currently partnering with doulas and childbirth researchers and birth activists in forming a birth "Think Tank". The purpose of the Think Tank is to gather information, perspectives and solutions to the state of childbirth in the US, which now focuses on the "medical" model of childbirth. We hope to change the direction of birthing in the US and bring it closer to its natural state. Understanding HOW childbirth evolved to where we are now .... and the educating women regarding natural childbirth. If you would like to join us please contact us at momoden@sbcglobal.net

I found this today on Tatia Oden French Foundation website. Through the course of my graduate students, I had begun to wonder if the birth activist community needed a think tank to further the work of improving maternity services through research, advocacy and policy.

For those unfamiliar with what a think tank actually does, here is the definition from wikipedia: "A think tank (also called a policy institute) is an organization, institute, corporation, or group that conducts research and engages in advocacy in areas such as social policy, political strategy, economy, science or technology issues, industrial or business policies, or military advice."

I am most familiar with think tanks relating to issues regarding early care and education (since that is what my graduate degree is in) but as I've been transitioning from preschool issues to birth issues, I've realized the birth community can benefit from the coordinate efforts of a think tank created for the purposes of correcting what is wrong with the way birth is treated today.

This blog post is a call to other researchers and activists to consider what your role can be in assisting in the organization and efforts a birth think tank. As I find out more information, I will post.

Ban the Bags (cont)

In the newest issue of Mothering magazine, an article added more information on the history of "Ban the Bags" a movement that would restrict hospitals, and infant formula makers from distributing free samples of formula to new mothers. The reason for this ban is because research has shown that women who are given free samples of formula are less likely to continue breastfeeding as long as recommended (2 years by the World Health Organization, and at least one year and longer by the American Academy of Pediatrics). Women use formula feed their babies spend on average $2,000 on formula in the first year, whereas breastfeeding is free. Obviously the formula companies have a financial incentive to get as many mothers as possible to breastfeed, and through hospital giving out free samples, "mothers will assume that the brand [of formula] is sanctioned by the health care provider and safe to use."

The sour note to the article was learning about the history of the Ban the Bags bill from the Massachusetts state legislature. It appears that former presidential candidate Mitt Romney gave into the temptation of letting special interests and money get in the way of promoting what is healthy for infants and mothers.

He then defended his actions by saying that not giving women formula when they left the hospital with their new babies interferes with a woman's "choice" to feed their baby in whatever way they view as appropriate. What an awful argument! A woman has the choice to go to the store and buy formula if she chooses to formula feed her baby. Nothing is stopping her! She's going to have to feed her baby, so if she's not using the milk produced by her breasts, then she needs to go to the store. Simple enough solution to protecting a woman's choice.

If Romney wants to argue that hospitals are not offering equal time to the various methods of infant feeding, then we can say that hospitals need to become objective when it comes to issues relating to infant feeding. If this were to happen, hospitals would not be allowed to advocate or assist mothers in establishing the breastfeeding relationship. Hospitals would either need to remain mum on the topic or provide information (but information, only!) on the benefits, disadvantages and risks of both breastfeeding and infant formula. In this way, mothers would be given knowledge and then the opportunity to make the choice for themselves.

Unfortunately (rather, fortunately), the public health arena realizes the risks to the overall health of our society that comes from not advocating breastfeeding. Research has shown that breastfeeding is the optimal way to feed infants, so much so that hospitals across the country are employing specially trained professionals known as Lactation Consultants who counsel women and often provide around the clock assistance to women who have questions and concerns with breastfeeding. Women, of course, have the freedom to choose to employ the LC's assistance or to go to formula. Not providing bags of formula doesn't interfere with choice: just with the finanical incentives of hospitals, formula manufactures and now we see, politician who are courting the big business constituency.

MomsRising to Enact Paid Family Leave

I just took a minute to contact the leading candidates for President using the link below and I hope you will too. Breastfeeding takes eight to ten hours per day, and mothers need paid family leave in order to give their babies a healthy start. Join me in telling the candidates for President to support and prioritize paid family leave.

To send a quick and easy email to the candidates, just go to: Email the candidates

Thank you!

For more information read this message from Nannette of MomsRising below:

Dear MomsRising member,

Did you know it takes eight to ten hours per day to breastfeed a newborn?[1]

As a mother of four, I can attest that I spent many long hours breastfeeding, especially in my children's first weeks of life. So, the question of paid family leave is personal for me. How can a mother be successful in those early make-or-break days if she's working long hours, feeling pressured to get back to work quickly, or wondering how to make ends meet if she doesn't return fast because she has no paid time off?

The Presidential candidates talk about bringing new ideas and leadership to this country. Some of them even have plans in place to enact paid family leave, but none of those promises will become policy unless the candidates know that moms are paying attention -- and what we want is action.

Tell the leading Presidential candidates that moms in America need paid family leave.

Email the Candidates

According to a new study just released by the U.S. Census Bureau [2], 49% of American mothers cobble together some sort of paid leave following childbirth by using a combination of sick days, vacation days, disability leave, and employer-provided maternity leave. A full 51% of new mothers lack any paid leave-so some take unpaid leave, some quit, some even lose their jobs.

Tomorrow, Saturday, March 8, is International Women's Day. A joint Harvard and McGill University study of over 170 countries found that the U.S. is one of only four countries that doesn't have any paid leave for new mothers.[3] This is a national disgrace.

The next president has a chance to right this wrong. But we need to get on their radar now, while they are courting the "mom" vote. Send an email to the leading Presidential candidates asking them, upon taking office, to make it a priority to pass national paid family leave.

Please pass along this email to other moms, dads, and grandparents who want to see a more family-friendly America. We appreciate it and so do our babies!

[1] The Womanly Art of Breastfeeding, by the La Leche League, contains a treasure trove of advice for new moms.

[2] U.S. Census Bureau, Maternity Leave and Employment Patterns: 1961-2003 Maternity Leave and Employment Patterns

[3] For example, mothers in France get 10 weeks and mothers in Germany get 14 weeks of fully paid leave. See: Paid Leave in 5 countries. See also: "The Work, Family, and Equity Index: How Does the U.S. Measure Up," by Jody Heyman, Allison Earle, and Jeffrey Hayes. How the US Measures Up; and "More Moms Take Paid Leave," by Cheryl Wetzstein, The Washington Times, February 26, 2008. Moms Take Paid Leave