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Archive for the ‘birth advocacy’ Category

Today we visited the local clinic here and got my pregnancy booklet done and released into our hands. All in one visit– this is the second time we’ve done this at our clinic here in Ivankov, since I am propisen (like registered but more permanent) here in our village house.

This booklet is given to all pregnant women when they do prenatal care here, and it has all their test results and pregnancy info (I’ll post a photo later). Around week 34-35-36, the booklet is given to the woman for her to take to her local birth house where she has her baby (at least, this is how it is in Kiev; in villages where there’s only one birth house, I’m not sure if they give it to the woman or not.)

Because we birth at home, we need this booklet to show the pediatrician who comes to our house after the birth– mostly to prove that I was pregnant (we also sometimes show the placenta as proof). Then the pediatrician gives us the next paper we need to get the birth certificate from the local ZAKs (govt office that registers local marriages, deaths, births).

The doctor is very smiley and pleasant. Except when she needs to say to me a few times that home birth is dangerous and am I not afraid…? She later explains that she needs to say these things because she gets in trouble with her “higher ups” because she couldn’t talk me out of our homebirth plans. They use an outdated tool of pelvic measurements to measure my pelvis, ask for my blood type, measure fundal growth, and decide a due date.

Here are some photos of the waiting area in the hallway:

This big sign has a poem on it about "mama"

This big sign has a poem on it about “mama”

the doctor's door over/behind Vitaliy's head

the doctor’s door over/behind Vitaliy’s head

blue poster about how using a condom is "love"

blue poster about how using a condom is “love”

more informational posters

more informational posters

So I got my fourth due date today … My earliest due date is Aug 23, then Sept 1 or 2, then Sept 8, then Sept 15.

Ha.

I guess we’ll see which one is correct.

She says I have a big-looking stomach just because my muscles get stretched out from pregnancies, but the baby is not that big. And s/he is head down for the moment. But there’s so much room in there, the baby can move pretty freely.

Vitaliy writes the refusal of all tests and signs it for their files. We can get tests done at a private clinic if we want, we’re just refusing the government-required testing.

All in all, a lovely visit.

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I accomplished one of my goals for midwifery studies, a goal I can only fulfill in the States, and that was attending a Midwifery Skills Lab (MSL) put on by my school.

I actually hosted the event, which was only possible because of my lovely, hospitable church and its amazing members. Not to mention my awesome family who perceived we were in need and took over all childcare and meal prep!!!

Skills we learned and practiced: taking fetal heart tones, palpating, giving IM injections and taking blood, internal exams, how to “massage” (or touch) the uterus in case of blood clots or hemorrhage, how to do nipple stim, taking BP, determining blood type on Eldon cards … much more. And this hands-off, birth-trusting midwife gave us honest ideas about how rare doing any of these things is.

We discussed: informed consent, transport, taking notes during birth (yes/no, what), creating forms for parents, working alegally or illegally or being licensed. … and much more.

We formed relationships as students and midwives and talked about: family relationships, being non-egoist in the birth world, finishing our curriculum … and more.

Now I need to take my handouts and notes apart and file them appropriately, and add some to my Birth Notebook Client Education Notebook.

Overall, it was awesome. On a personal level, …. I had stopped all birth work (doula, childbirth ed, etc.) because I was so disturbed by how undisturbed and even cold I was becoming toward hospital birth routine practices, giving up emotional attachment to clients b/c it hurt too much to watch their birth choices, integrating all these responsibilities with family life, etc. And some of our discussions gave me ideas how to get past this and re-invent my involvement in birth so I can be personally and “professionally” (as if those are two different things!) satisfied with how I’m serving people. (More to come in that area later.)

So, if you are a midwifery student, I highly recommend Ancient Art Midwifery Institutes’ Midwifery Skills Labs.

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The two political/legal battles we need to be fighting are:

  1. The right of the people to choose their own health care (be it chiropractic, midwifery, craniosacral therapy, a naturopath, homeopathic, or an allopathic MD)
  2. The right of practitioners to offer and practice their skills without threat of arrest for “practicing medicine.”

I will weave a discussion of these two points in with further examination of licensure flaws.

Licensing works on the presumption that the state is trying to serve the public by protecting them from harmful practitioners through licensing.

But what really happens, and what has happened to the American public, is that the state suppresses their choices. The state suppresses your choices.

I will give you one example of this: We all know there is “no cure” for Hepatitis C.

But did you know that this is only true in the allopathic system of medicine? The statement should read: “Allopathic medicine has no cure for Hepatitis C.”

Did you know that there actually are cures for Hep C? It’s just that you are being stopped from knowing about them and having access to them. Why? Because the allopathic system (the American Medical Association) “owns,” by law, the right to “practice medicine,” and they don’t offer the cures. And they want you to have knowledge about and access to only their pitiful drug options.

So … Has the state protected you through the licensing system? … Or have they killed you?

Are the licensing laws working to protect you? Or are they harming you by suppressing other practitioners’ freedom to practice certain health arts and your right to freely choose them without fear of your practitioner being arrested and charged for helping you?

This is not just about midwifery. It encompasses midwifery, especially the true, non-allopathic-based practice of midwifery.

“If the midwifery movement is lured by the apparent short term benefits of licensing, it will, in the long run, sacrifice its independence, its identity, an creativity, and people’s freedom of choice” (Solares, Compulsory Hospitalization, vol. 2, p. 400)

In the late 1800s, [Dr. Benjamin] Rush’s fears came true when the exclusive licensing of one system of healing—allopathy—established State Medicine. … State control in either religion or medicine leads to intolerable abuses of our basic human rights. It is a fundamental human right to make decisions about what is right for your body and soul, and to be free from the interference of self-interested, competitive groups, especially in religion and its historical cousin, the healing arts. (Solares, p. 403)

So, our goals ought to be (Solares, 403-404):

  • “A constitutional amendment extending the Bill of Rights to include ‘freedom of choice in health care.’” “… the government has no business licensing any kind of healing art.”
  • Rewriting practice of medicine laws—i.e., narrowing down the legal definition of “practice of medicine”

Let’s talk about the legal definition of “practice of medicine.”

Solares cites an early medical practice act (MPA) definition of “medical practice” to be people who use drugs, performed surgery, or claimed to be doctors. … Great.

Today? Here’s a more current definition Solares cites; Medical practice is [emphases by this blog’s author]

Any person who practices … any system or mode of treating the sick or afflicted, or who diagnoses, treats, operates for, or prescribes for any ailment, blemish, deformity, disease, disfigurement, disorder, injury or other mental or physical condition [includes pregnancy in most/many states] of any person…

I thought of this definition of practicing medicine as I put olive oil drops in my daughter’s earaching ear. It’s truly a strangle-hold on your freedom and mine. And if I call an experienced mom, or even my sister, and ask about my daughter’s symptoms and possible treatments, she could be arrested for answering my questions? For diagnosing, treating … ??? Hello????

Solares points out: “Consequently almost any act relating to health or pathology could be interpreted as violating the medical practice act. More particularly, there is a substantial danger that any movement or method which challenges orthodox standards will be selectively suppressed” (p. 404) … Remember what I said about Hep C cures? … Selectively suppressed.

So stop and think. See what is happening already as midwifery becomes licensed. What have they given up? Compromised? “Selectively suppressed”? In order to practice legally?

It’s disgraceful. As a mom, if I used a licensed midwife, my health care options are limited to the midwife’s licensure laws. It has very little to do with my personal health and well-being. Her hopefully skillful hands are tied when she ought to be free to practice her art to my benefit.

Is this really the system we want midwifery crushed and deformed into? Over time, that’s what will happen. It’s what is already happening.

So to recap: One of our battles that Solares spells out is that we need to write laws that redefine “medical practice” as being limited to allopathic practice (i.e., using drugs and surgery to treat pathology, calling oneself a medical doctor).

So there’s one good, political battle for you to invest your time, energy, reputation into. A much better battle than mandatory licensure, for sure.

And second, don’t forget that Bill of Rights amendment—freedom of choice in health care.

You see? They go together. In order for us to have freedom of choice, practitioners must have freedom to practice without fear of arrest for breaking “practice of medicine” laws.

And yes, protect consumers through fraud and criminal assault laws, but don’t limit their choices by mandatory licensure.

🙂 More, more, more to come!

Midwifery will succeed only if we see that the attainment of freedom of choice is synonymous with our survival. ~Allen Star Solares

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we enjoy supporting each other!

we enjoy supporting each other!

And we love supporting expecting families 🙂

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Continuity of Care: This is a major minus here in Ukraine.

A pregnant woman goes to see OB/GYNs in her local clinic for prenatal care.

The doctors in the birth houses she usually sees for the first/only time during her birth.

One exception I know of is if she arranges/pays a particular doctor to be at her birth, she might go to see him/her the last 3-4 weeks of pregnancy, depending on how that particular doctor makes arrangements.

Basically all the birth doctors know is what’s written in the woman’s prenatal care booklet which they hopefully look over when she comes to the birth house for her birth.

Speaking of prenatal care, it’s nothing like a one-stop shop/private doctor’s office. It requires going to all different offices, etc., in the local clinic to get all the various tests done at various hours of operation.

And if you do a urine test, it’s BYOC (Bring/Buy Your Own Container). Most of the supplies the woman needs to supply herself.

Out in our village, I saw a doctor there one time in order to register the birth and get the prenatal care form we needed (in order to get the forms after the birth to then get the birth certificate after a home birth). It was a very interesting experience. I had my pelvis measured, an already antiquated practice in most places. They used this tool below. It was very simply done as I lay on my back. I have never heard or seen this done in Kiev, however. So maybe it was just a village thing?

Image

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One aspect of Ukrainian culture and birth that I really like is the normalcy of un-pain-relieved birth. I mean birth without pain relief drugs (like epidurals, etc). Women here, while yes, they do consider birth painful generally, they don’t view it as impossibly so.

I say this based on my own culture in the U.S. I think that quite a few American women have the assumption that birth is impossibly painful, that there is no way for one to live through the experience of un-pain-relieved birth. I don’t say this in a judgmental way; just as observation. I think many American women sincerely think it’s impossible for herself to birth without pain relief. That is the cultural message passed along.

Ukrainian women generally start with the assumption that they can/will birth without pain relief, for various reasons (money, desire, etc). When I was pregnant with my first child, I was over at my friend’s house (we lived in a village at that time), and she had two kids. We were chatting about birth, and I mentioned the pain of labor, and she just smiled and said I would do just fine. … I like that women in a culture can pass that normalcy on to each other.

And I would like to insert a thought from Carla Hartley, the director of my midwifery school. Basically, if you’ve had a natural birth, “you’re nothing special.” In the sense that most of the world’s women birth without pain relief. It is the norm; it’s not heroic or a special achievement.

♥      ♥      ♥      ♥

Next, I would like to comment about finances and the economy of birth here.

Birth houses are government facilities. Opening a private birth house would be next to impossible without enormous sums of money and a lot of uncertainty about if, even then, the government would allow/approve it. It’s been done once so far.

So, being an ob/gyn is a government job, not a private one. Just like being a policeman or working in the local government buildings. And in Ukraine, probably in all post-Communist countries, the pay is laughable. In Kiev, this site says the average monthly cost of living is $1,728. That’s a really thrifty budget for Kiev, especially if you rent an apartment for $1000 or more.

Doctors in Kiev (like other govt workers) are paid a salary of $100/month. In order to actually live, they have to be “paid” by average citizens for their services. 

I used to have a bad view of doctors and other govt workers who angled for personal money gifts. I don’t really anymore. The government is unjust.  I dislike that treatment is based on this, and as a Christian, I hope I would be able to treat everyone well and without discrimination. But what means “well”? 

When our daughter had her appendix out a few months back, the anesthesiologist took Vitaliy aside and said that it would be nice if Vitaliy would pay him $100 for doing the operation anesthesia, but it wasn’t necessary–just what we could afford would be OK. So Vitaliy paid him and also thanked the surgeon/doctor for $100. And we noticed that the entire stay, Vitaliy (who had to live in the hospital to take care of daughter) was given his own bed to sleep in, for example, when other parents had to sleep on the same bed as their child.

So, what is considered normal? What is a doable normal for the conditions in which these medical personnel work?

Personally, I see the advantages of this system. When people want to arrange ahead of time for their births and pay a particular doctor to attend them, they can bargain with one person who can be pretty flexible. They don’t have to bargain with an entire institution, for example, that pays the doctor. You have bargaining power because you are paying the doctor personally from your pocket to his.

So, economically, you can have a “free” birth, although you are expected to buy and bring with you a list of birthing supplies (kind of like home birthers do). Or you can opt to pay a pre-arranged sum to the doctor of your choice, or you can “thank” the doctors/medical personnel that are on shift when you arrive (or afterwards) to leverage some nicer treatment, etc.

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I enrolled in AAMI Advanced Midwifery Studies in late Sept 2010. While I’m at it, I want to say that I am more than pleased with this course. I am just thrilled. It inspires me more and more with how much I have to learn and how much I am learning. I also appreciate their FaceBook pages where students and midwives have discussions about various questions that come up. Their conference phone calls are also unbelievable–Gail Hart, Gloria Lemay, Joy Jones, Kristi Zittle, etc. So many fabulous ways to learn!

Midwifery Past: 2011 

Before stating my midwifery study goals for 2012, I’d like to review what I’ve accomplished in 2011.

  • Submitted Phase 3 (Phases 1-3 are introductory phases before starting the actual curriculum; they require a lot of work)

Once Phase 3 work was accepted, I started with Phase 4, the main curriculum. It has 6 sections. I made a submission each quarter of the year.

  • First submission: all of section 1 (mostly terminology definitions, workbook, roots/prefixes/suffixes, etc.) I also submitted 2 Section Two assignments (watching videos, listening to past conference lectures).

 

This submission made the Honor Roll! I’m amazed.

  • Second submission: Section 2–4 assignments: an article abstract, a textbook overview, assignments from Goer’s Obstetric Myths vs. Research Realites, 2 book reviews, and a book critique.

  • Then, this final quarter, I submitted Section 3A–two assignments from a list of choices; my childbirth educator/doula training and the Placenta Intensive Study Module. (I was hoping to submit 3B also, but the Placenta ISM was a doozy!!!!)

Other things I accomplished in 2011: set up my Section 5 files (50+ midwifery topics), started collecting AEU points (haven’t turned them in yet), listened to several conference calls, attended 4 births as a doula, and attended informal breastfeeding classes with a brilliant IBCLC counselor.

Midwifery future: 2012

Today I sat down and mapped submission goals for each quarter of this year. Not sure I will meet them all and they may be revamped, but here’s the plan for now:

  • Quarter 1: submit assignment 4A (read Holistic Midwifery 1, questions/answers, notes) and 20 assignments from Section 6. (So far, I’m almost on page 500 of Hol Mid 1 and almost at 100 of 175 questions. And I’m hoping to go through Section 6 and see what I can work on. And several Section 6 assignments are done.)
  • Quarter 2: submit 3B.2 (Midwifery Skills book and assignments) and 20 assignments from Section 6.
  • Quarter 3: submit 4B and second annual report
  • Quarter 4: submit 5 Section 5 files.

I’m also evaluating how I sense myself evolving as a student, and I feel like I’m still in the absorbtion stage rather than in the output/teaching stage. I’m also still learning what resources I have for learning. Once I hit Sections 5 and 6, then I want to move into more of the educating-others mode. Right now, I’m amazed at how much I have to learn!

So that’s my midwifery studies past and future!

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