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Your Delivery, Your Choice

Mar 14, 2014

RT
Stage· 348 messages
Mar 14, 2014

Is banning home births the next wave of reproductive control?nMother and Peace Corp alumna Rebecca Westbrook is joining me to discuss the trend of gov't intrusion into the delivery room. Rebecca's work w/midwives lead her to value both their work & a woman's bodily autonomy. She, in fact, chose to use a midwife when she delivered.nCheck out Robin Marty's piece on pending AZ legislation http://ow.ly/tPK5S & join us for this important discussion!

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Katie Klabusich · 1:00 AM

Hi, everyone! Thanks for coming to "Your Delivery, Your Choice” with my friend and fellow resident tawker Rebecca Westbrook Toker!
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Katie Klabusich · 1:01 AM

(she's driving in and will be like two minutes late, so I'll stall with the intro)
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Katie Klabusich · 1:01 AM

Real quick, if you’re new to Tawkers, Rebecca and I will be chatting on the left. And if you’re signed in (it only takes two minutes to set up a profile!),
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Katie Klabusich · 1:01 AM

you can add comments/questions on the right. Interrupt any time with questions!
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Katie Klabusich · 1:01 AM

★ Spotlighted from Robin Maynard

“hiya, jordan!”

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Katie Klabusich · 1:01 AM

★ Spotlighted from Robin Maynard

“hello Katie”

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Katie Klabusich · 1:01 AM

★ Spotlighted from Jordan Birnbaum

“Robinsky!”

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Katie Klabusich · 1:01 AM

We can spotlight comments to toss them into our conversation for everyone to see, so be sure to “thumbs-up” anything you want us to respond to! (That also makes it easier for us to see them.)
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Katie Klabusich · 1:02 AM

Most of my readers/followers know me as someone who fiercely advocates for reproductive healthcare access.
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Katie Klabusich · 1:03 AM

So when Rebecca came to me and said it isn't just whether or when women give birth, but HOW they give birth that's under attack on this country, I said "Let's chat about it!"
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Rebecca Westbrook Toker · 1:03 AM

Ah! Okay! I'm here! With Chocolate!
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Katie Klabusich · 1:03 AM

Hooray! Thanks for joining me tonight, Rebecca!
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Katie Klabusich · 1:03 AM

★ Spotlighted from Robin Maynard

“hello Rebecca”

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Rebecca Westbrook Toker · 1:04 AM

It's quite an honor. I have to tell you, Katie, i admire your work and your words SO MUCH!
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Katie Klabusich · 1:04 AM

<blushing>
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Katie Klabusich · 1:04 AM

The mandatory ultrasound bills sweeping the country (still, btw) have gotten pretty famous. But they aren’t the only legislative attempt to control our reproductive healthcare and choices.
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Katie Klabusich · 1:04 AM

★ Spotlighted from Avital Norman Nathman

“So excited for this tawk!”

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Rebecca Westbrook Toker · 1:04 AM

Me, too, Avital!
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Katie Klabusich · 1:04 AM

Hooray, the woman who literally wrote the book on mothering is with us. Thanks for coming, Avital!
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Katie Klabusich · 1:05 AM

Arizona is trying to essentially outlaw midwifery. Hospital births for everyone no matter what! Why is this awful, Rebecca?
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Rebecca Westbrook Toker · 1:05 AM

This is awful for the same reason that banning of all abortions everywhere is awful.
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Rebecca Westbrook Toker · 1:06 AM

It takes choice and personal soverignity away from women.
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Katie Klabusich · 1:06 AM

Word. It definitely seems to be an extension of the "sex police" under the guise of "caring about the health of the woman."
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Katie Klabusich · 1:06 AM

★ Spotlighted from Avital Norman Nathman

“Thanks for hosting this chat, Katie. prenatal/maternal care sometimes get left to the wayside when discussing repro justice. So it's always great to see it highlighted.”

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Rebecca Westbrook Toker · 1:06 AM

It puts A MAN, or A DOCTOR, or SOME LAWS in charge of what a woman can do in regard to her body and her baby.
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Rebecca Westbrook Toker · 1:07 AM

Pretty unacceptable in the 21st century.
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Katie Klabusich · 1:07 AM

You'd certainly think so...
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Katie Klabusich · 1:07 AM

For some background, tell folks why this particular aspect of reproductive justice is so important to you and how you became passionate about it.
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Rebecca Westbrook Toker · 1:08 AM

Well, when I went into the Peace Corps, i went as a Youth Development volunteer, because I'm a teacher
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Rebecca Westbrook Toker · 1:08 AM

But, i wound up working mostly with public health issues.
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Rebecca Westbrook Toker · 1:08 AM

I wrote dental hygiene curriculum, translated for med brigades
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Katie Klabusich · 1:09 AM

(I feel like we may have to do another chat on that experience!)
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Rebecca Westbrook Toker · 1:09 AM

and my Grandma sent me a copy of What to Expect When You're Expecting in Spanish
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Rebecca Westbrook Toker · 1:09 AM

so i started giving "charlas" on maternal health and nutrition to pregnant women.
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Rebecca Westbrook Toker · 1:09 AM

And then i started coming to the monthly midwife meetings
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Rebecca Westbrook Toker · 1:10 AM

And then i got really interested in midwifery. ;)
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Katie Klabusich · 1:10 AM

Most people in this country would assume that our advice is an upgrade for other countries & are shocked to find out where we rank in infant/maternal mortality.
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Katie Klabusich · 1:10 AM

There's an assumption that our hospital method is superior to the midwifery/etc of other countries.
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Rebecca Westbrook Toker · 1:10 AM

Dude, that's totally true.
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Rebecca Westbrook Toker · 1:10 AM

And I was guilty of all of those assumptions.
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Katie Klabusich · 1:11 AM

★ Spotlighted from kelly mackin

“OK, then all I have to say is humans being giving birth naturally for many MANY years before hospitals and doctors. Do we need them?”

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Rebecca Westbrook Toker · 1:11 AM

I became a Health Program Pseudo-Volunteer, so i was getting training from them, learning the rhetoric, learning to tell the midwives to send everyone to the hospital...
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Rebecca Westbrook Toker · 1:11 AM

but then i shut my mouth and started listening.
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Katie Klabusich · 1:11 AM

Kelly -- definitely in some case; just like we need C-sections as an option in some cases. But we're all "WE CAN SO WE MUST" with a lot of medical "care" round here.
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Katie Klabusich · 1:11 AM

★ Spotlighted from Robin Maynard

“i needed a doc. too little for my babies to get out. yes, i gave it a heckuva a try first.”

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Katie Klabusich · 1:11 AM

Amazing how that works!
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Katie Klabusich · 1:12 AM

Shutting your mouth to listen is not something we as a people are trained to do either. ;)
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Rebecca Westbrook Toker · 1:12 AM

The hospital system was in no way equipped to deal with the women's needs, and most of the women couldn't even get transportation TO the hospital/afford the hospital stay.
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Rebecca Westbrook Toker · 1:12 AM

Hahaha.
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Katie Klabusich · 1:12 AM

★ Spotlighted from Feminist Lady

“After interning with an OB I was shocked at how little control pregnant people are allowed in their healthcare. The hospital births I've seen have been nothing short of violent.”

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Rebecca Westbrook Toker · 1:12 AM

And I saw that the midwife model of care was much more intimate, much more women-centered, and JUST AS SKILLED.
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Katie Klabusich · 1:12 AM

@FL -- yeah, a lot of people choose home birth for the tranquility of the experience. (despite the obvi pain)
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Katie Klabusich · 1:12 AM

Talk a little about the skill aspect.
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Rebecca Westbrook Toker · 1:13 AM

"Why aren't they working TOGETHER?" was the first question I asked.
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Rebecca Westbrook Toker · 1:13 AM

Midwives are extremely skilled.
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Rebecca Westbrook Toker · 1:13 AM

In Honduras, the trade is handed down in family lines_
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Katie Klabusich · 1:13 AM

★ Spotlighted from Avital Norman Nathman

“midwifery model of care = patient-centric model of care”

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Rebecca Westbrook Toker · 1:13 AM

mother to daughter, aunt to neice...
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Rebecca Westbrook Toker · 1:13 AM

YES, Avital!
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Katie Klabusich · 1:13 AM

Avital -- that's an interesting aspect and I'd expect the family tradition adds to that.
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Katie Klabusich · 1:14 AM

It's a trade and a calling.
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Rebecca Westbrook Toker · 1:14 AM

So the women have experiences in all kinds of births from a very young age.
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Katie Klabusich · 1:14 AM

★ Spotlighted from Feminist Lady

“I was completely traumatized out of ever giving birth. How can we try to discuss this with OBs who don't want to listen?”

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Katie Klabusich · 1:14 AM

I'll let Rebecca (and maybe Avital) handle that W from @FL. How do you discuss birthing method/options with your OBGN?
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Katie Klabusich · 1:15 AM

They may have been great with primary care issues, but rigid on the options for giving birth.
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Katie Klabusich · 1:15 AM

(Q not W -- thanks, autocorrect)
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Rebecca Westbrook Toker · 1:15 AM

Yes, it's a trade and a calling, and something that you get a lot of insight into from having your own babies, which is why, in my opinion, male doctors will never be as good a female caregivers in regard to labor/delivery/OB/prenatal/post-natal.
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Rebecca Westbrook Toker · 1:15 AM

There, I've said it!
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Katie Klabusich · 1:15 AM

★ Spotlighted from Avital Norman Nathman

“I suggest reading up as much as you can on not only the birth process, but the birth industry and use that knowledge when talking with your provider”

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Rebecca Westbrook Toker · 1:16 AM

Honestly, after my first and ONLY OB appointment, i refused to go back!
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Katie Klabusich · 1:16 AM

Ha! I'd assume that there's also a background in listening to patients and being open to avenues that require referral. Not all docs are great about referring patients to someone else.
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Rebecca Westbrook Toker · 1:16 AM

Thank goodness I was older (28), and had done my research and had my experiences, or his bullying and outright LYING about stats would have thrown me for a loop!
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Rebecca Westbrook Toker · 1:17 AM

★ Spotlighted from Avital Norman Nathman

“A regular obgyn will see a pregnant patient for a cumulative 2 hours over the course of her pregnancy before birth. 2 HOURS. That's beyond inadequate.”

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Katie Klabusich · 1:17 AM

★ Spotlighted from Feminist Lady

“To be more clear: how can I bring up with the OB I intern with that the way he and his colleagues (male and female) handle birth is inappropriate? I'm just a student, none of them want to listen to me.”

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Rebecca Westbrook Toker · 1:17 AM

Avital, that is right on the nose!
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Katie Klabusich · 1:17 AM

★ Spotlighted from Avital Norman Nathman

“By regular obgyn I mean an obgyn who practices traditional care”

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Katie Klabusich · 1:17 AM

Holy shitballz. TWO HOURS?
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Katie Klabusich · 1:18 AM

Then why did I spend so much time in the waiting room at my OB for early morning ultrasounds to get done. :P
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Rebecca Westbrook Toker · 1:18 AM

Feminist lady, you are awesome! I have no idea how to bring it up to them. I have had so much trouble with egocentric medical professionals that I just don't truck with them anymore. Any audience suggstions?
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Katie Klabusich · 1:18 AM

(J/k my doc was great and handled a lot of high risk pregnancies and care.)
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Katie Klabusich · 1:18 AM

★ Spotlighted from Suzy Sunshine

“I had one birth at a hospital. I had one homebirth that was doctor attended and one homebirth that was attended by a "lay" midwife ~ and that was my biggest baby and best birth”

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Katie Klabusich · 1:18 AM

★ Spotlighted from Avital Norman Nathman

“Right? It's absurd. You have a lot of visits, but they're 5-10 min max of quality 1 on 1 time. How is that enough to discuss anything remotely close to good care?”

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Rebecca Westbrook Toker · 1:18 AM

The midwife model of care is so very different.
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Rebecca Westbrook Toker · 1:18 AM

No one pokes your junk unless you give them permission.
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Rebecca Westbrook Toker · 1:19 AM

The OB couldn't wait to get my feet up in the stirrups.
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Rebecca Westbrook Toker · 1:19 AM

The first time my midwife ever handled anything was when i came in dilated to 7 cm.
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Katie Klabusich · 1:19 AM

★ Spotlighted from Suzy Sunshine

“That was 22 years ago and they have been trying to make lay midwives illegal since then”

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Katie Klabusich · 1:19 AM

★ Spotlighted from Avital Norman Nathman

“@FL - that is hard. What about bringing up recent studies talking about positive benefits of midwifery model of care? Maybe get a discussion going?”

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Katie Klabusich · 1:19 AM

★ Spotlighted from Robin Maynard

“assembly line reproductive care.. the new normal.”

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Rebecca Westbrook Toker · 1:20 AM

BAM!, Robin!
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Rebecca Westbrook Toker · 1:20 AM

It's nuts!
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Katie Klabusich · 1:20 AM

When I was figuring out what questions to ask of a new GP, I talked to Dr. Torres on twitter, actually. (@LeahNTorres) She's fantastic & gave me good questions to use as a screening process.
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Katie Klabusich · 1:20 AM

★ Spotlighted from Avital Norman Nathman

“But beyond that, there's a sense of agency and empowerment for teh patient in a midwifery model of care.”

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Rebecca Westbrook Toker · 1:20 AM

That's great, Katie!
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Katie Klabusich · 1:20 AM

★ Spotlighted from Feminist Lady

“Thank you! And exactly! OBs seem so eager to poke around in your vag-and the worst part is they feel entitled to it!”

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Katie Klabusich · 1:20 AM

I feel like a lot of people need new OBs
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Rebecca Westbrook Toker · 1:21 AM

There are also resources online. You can print out pages, or whatever - but it is important to go in armed with your requirements and remember that YOU are hiring HIM/HER!
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Katie Klabusich · 1:21 AM

★ Spotlighted from Avital Norman Nathman

“(and I should probably disclose that I'm currently working on a project with the Yale School of Public Health re: taking evidence based research to create curriculum for a group style prenatal education program, so I'm biased to - you know - good”

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Katie Klabusich · 1:21 AM

★ Spotlighted from Avital Norman Nathman

“prenatal research”

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Katie Klabusich · 1:22 AM

That's definitely something people forget. Go and interview the doc.
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Katie Klabusich · 1:22 AM

Or midwife.
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Rebecca Westbrook Toker · 1:22 AM

Avital, you are a hero!!!!
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Katie Klabusich · 1:22 AM

Whoever is handling your care.
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Rebecca Westbrook Toker · 1:22 AM

Exactly.
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Rebecca Westbrook Toker · 1:22 AM

When i met my midwife, I KNEW she was the one.
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Katie Klabusich · 1:22 AM

Kids, hold on to your hats -- Avital's project is badass. And she's coming back to tawk about it. #AssumptiveComments
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Rebecca Westbrook Toker · 1:22 AM

And I think that's important.
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Katie Klabusich · 1:22 AM

★ Spotlighted from Suzy Sunshine

“But even if you go in to see your doctor with a list of questions and a lengthy birthing plan, doctors will just do what is easiest for them!!”

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Rebecca Westbrook Toker · 1:22 AM

Suzy, holy moly, that is true!
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Katie Klabusich · 1:22 AM

★ Spotlighted from Avital Norman Nathman

“Thanks, Rebecca. I just get very passionate about this topic!”

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Katie Klabusich · 1:23 AM

Avital/Rebecca do you have good online resources for people who need a starting point or list of what to ask?
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Rebecca Westbrook Toker · 1:23 AM

It's so very scary that stepping foot inside a hospital takes your risk for cesarian up to about 34%.
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Rebecca Westbrook Toker · 1:23 AM

Hold on, katie, I can find something.
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Katie Klabusich · 1:23 AM

★ Spotlighted from Avital Norman Nathman

“It continues to amaze me that we spend the most $$ on maternal healthcare in this country, but have one of the worst maternal mortality rates within industrialized nations. :/”

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Katie Klabusich · 1:24 AM

Avital, that's true about almost all of our healthcare.
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Katie Klabusich · 1:24 AM

We think if it costs a fortune, it must be the best.
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Katie Klabusich · 1:24 AM

★ Spotlighted from Avital Norman Nathman

“I would suggest reading Pushed by Jennifer Block or watching the Business of Being Born”

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Katie Klabusich · 1:24 AM

★ Spotlighted from Suzy Sunshine

“Exactly Rebecca!! I know absolutely NO ONE who has had a vagina birth in all of 2013-2014”

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Katie Klabusich · 1:24 AM

★ Spotlighted from Feminist Lady

“Rebecca, I have a question: I've heard stories of women being abused in labor by HB MW (not as common as w/OBs obvi). What are some resources for those women? It seems like everyone just wants to throw blame on her for hiring a MW instead of an OB.”

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Rebecca Westbrook Toker · 1:24 AM

http://www.yogadenvercolorado.com/pregnancy_birth_postpartum_resources/doctor_midwife_interview.php
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Katie Klabusich · 1:24 AM

am I the only guy here?
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Katie Klabusich · 1:24 AM

If you are, we welcome you, Rick. :]
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Katie Klabusich · 1:24 AM

will there be snacks?
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Katie Klabusich · 1:25 AM

Apparently I have cookies. <cough> (Facebook joke for my followers)
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Rebecca Westbrook Toker · 1:25 AM

Try this! It's LENGTHY, but it's basically what my childbirth educator gave to me when I thought I might still get a backup OB.
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Rebecca Westbrook Toker · 1:25 AM

http://www.yogadenvercolorado.com/pregnancy_birth_postpartum_resources/doctor_midwife_interview.php
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Katie Klabusich · 1:25 AM

hi Katie and Rebecca
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Rebecca Westbrook Toker · 1:25 AM

hey, Rick! So glad to see you!
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Katie Klabusich · 1:26 AM

So the thing that brought the midwife banning to my attention was Robin Marty's piece on proposed legislation in AZ: http://www.care2.com/causes/banning-home-births-the-next-wave-of-reproductive-control.html#ixzz2tm7BbHj5
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Rebecca Westbrook Toker · 1:26 AM

Yes.
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Rebecca Westbrook Toker · 1:26 AM

Gotta love AZ.
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Katie Klabusich · 1:26 AM

Basically, they want to force people to go to hospitals no matter what.
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Rebecca Westbrook Toker · 1:26 AM

*sigh.
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Katie Klabusich · 1:26 AM

Word.
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Katie Klabusich · 1:26 AM

Is this part of the Americans United for Life push of legislation, or is this just a bizarre offshoot of paternalistic legislating?
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Katie Klabusich · 1:27 AM

★ Spotlighted from Feminist Lady

“How would they enforce this?”

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Rebecca Westbrook Toker · 1:27 AM

Well, there are problems inherent in the assumption that the hospital is the best place to be while in labor or delivery.
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Katie Klabusich · 1:27 AM

@FL THANK YOU. Ugh. Sex/bedroom police.
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Rebecca Westbrook Toker · 1:27 AM

But let me make something clear: Doctors DO NOT in fact deliver babies. Women do.
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Katie Klabusich · 1:27 AM

That's an excellent point.
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Katie Klabusich · 1:27 AM

For a couple millennia, in fact.
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Rebecca Westbrook Toker · 1:27 AM

We seem to have forgotten that.
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Katie Klabusich · 1:27 AM

★ Spotlighted from Suzy Sunshine

“Well Texas and Arizon have a large number of Mexican women walking over the border in labor. My midwife did her training in El Paso and had many patients like this”

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Rebecca Westbrook Toker · 1:28 AM

hospitals are where people die
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Katie Klabusich · 1:28 AM

★ Spotlighted from Avital Norman Nathman

“Great point, Rebecca”

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Katie Klabusich · 1:28 AM

★ Spotlighted from Suzy Sunshine

“And many women globally have safer births without the "assistance" by a physician”

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Rebecca Westbrook Toker · 1:29 AM

Well, Suzy, I can see that. but that seems like an ass-backward way to attack the problem. Regulate ALL women because some women come into the country to deliver citizens.
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Katie Klabusich · 1:29 AM

Yeah, we were saying that earlier, Suzy. Americans think we have the best brand of healthcare and the best practices. Our maternal/infant mortality rates are embarrassing.
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Katie Klabusich · 1:29 AM

★ Spotlighted from Suzy Sunshine

“Also doctors are taught to think of pathology and birth is not a pathological condition”

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Rebecca Westbrook Toker · 1:29 AM

BAM, Suzy!
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Rebecca Westbrook Toker · 1:29 AM

Birth is not an emergency!
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Rebecca Westbrook Toker · 1:29 AM

But, an OB is a surgeon. And, if you have a hammer, everything looks like a nail!
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Katie Klabusich · 1:30 AM

Suzy brings up an interesting answer to my earlier question of who was behind the legislative push to outlaw midwifery. It has an anti-immigrant feel to it.
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Rebecca Westbrook Toker · 1:30 AM

That is not to say that there are not situations in which there are risks posed to the fetus and/or the mother.
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Katie Klabusich · 1:30 AM

Perhaps it's more racist than sexist. <sigh>
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Rebecca Westbrook Toker · 1:30 AM

Well, anti-immigrant mentality seems to cozy up to anti-woman mentality.
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Katie Klabusich · 1:31 AM

Oh, for sure. There's plenty of cross over in the Venn diagram...
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Rebecca Westbrook Toker · 1:31 AM

And, honestly, the whole pushback against midwifery has been anti-immigrant and anti-woman.
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Katie Klabusich · 1:31 AM

★ Spotlighted from Kassy Brazier

“I may be wrong, but statistically speaking, aren't most women who choose to give birth at home or at a birthing center with a midwife, educated women?”

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Katie Klabusich · 1:31 AM

imagine that, educated women
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Rebecca Westbrook Toker · 1:31 AM

Way back since the 40s, when it started.
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Katie Klabusich · 1:31 AM

What was the public claim about in the 40's? Safety?
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Rebecca Westbrook Toker · 1:32 AM

Kassy, taht is absolutely true! Their stats are incredible, too! VERY low c-sections rate, low infant-maternal morbidity, low infections, higher breastfeeding success...
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Rebecca Westbrook Toker · 1:32 AM

The public claim in the late 40s was part of the post-war "Better Living Through Science" push.
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Rebecca Westbrook Toker · 1:33 AM

Doctors are better.
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Rebecca Westbrook Toker · 1:33 AM

Science is better.
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Rebecca Westbrook Toker · 1:33 AM

These immigrant grannies are not who should be in charge!
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Katie Klabusich · 1:33 AM

Huh. That last stat seems to make the most sense. It would obviously be easier to learn breast feeding techniques at home than in a hospital. Or maybe that's just me and my not liking to be stared at in a clinic setting talking...
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Rebecca Westbrook Toker · 1:34 AM

And so we ushered in an era of horrible smear campaigns with propaganda to the effect that an old immigrant hag was going to kill your baby with her dirty hands.
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Rebecca Westbrook Toker · 1:34 AM

It was ruthless!
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Katie Klabusich · 1:34 AM

★ Spotlighted from Suzy Sunshine

“There was a big push in the late 70s and early 80s to support homebirths.”

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Rebecca Westbrook Toker · 1:34 AM

NO ONE likes to be stared at in the clinic!
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Katie Klabusich · 1:34 AM

Did that dissipate as part of a "hippie" counterculture thing?
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Katie Klabusich · 1:34 AM

Meaning, the perception that that's what it was.
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Rebecca Westbrook Toker · 1:34 AM

Have you seen taht Monty Python sketch about the Machine That GOes BING?
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Rebecca Westbrook Toker · 1:35 AM

Yes, katie, it did.
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Katie Klabusich · 1:35 AM

No....I feel a need to google coming on.
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Rebecca Westbrook Toker · 1:35 AM

In the 50s, everyone was going to live better through science.
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Katie Klabusich · 1:35 AM

Sure. And I'm a big science girl; but that means looking at the facts. #duh
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Katie Klabusich · 1:35 AM

★ Spotlighted from Suzy Sunshine

“I know both my parents and in-laws (who had their babies in the 50s) were just dying to "I told you so" me for having homebirths. People do think you are a happie or crazy”

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Rebecca Westbrook Toker · 1:35 AM

Rich women, women who weren't "trash" went to the clean hospital to have "twighlight births" and fed their babies formula.
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Katie Klabusich · 1:35 AM

★ Spotlighted from Kassy Brazier

“It just seems that these legislators are getting bad info in regards to the level of care given by midwives. Maybe some hospital lobbyists are behind the push for this, too.”

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Rebecca Westbrook Toker · 1:36 AM

And so the push-back came in the 70s when those children then wanted ot birth NATURALLY, not CHEMICALLY.
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Katie Klabusich · 1:36 AM

Kassy -- a lot of it really is controlling women and immigrant bodies. If you aren't where they can see you, they can't control you.
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Rebecca Westbrook Toker · 1:36 AM

That's where Ina May Gaskin came from (she IS THE MIDWIFE)
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Katie Klabusich · 1:36 AM

★ Spotlighted from Suzy Sunshine

“These legislators are getting BAD info on EVERYTHING related to women and their bodies and choices!!”

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Katie Klabusich · 1:37 AM

That's because they listen to extreme right-wing/fundamentalist/fringe lobby groups like AUL.
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Katie Klabusich · 1:37 AM

★ Spotlighted from Suzy Sunshine

“Ina May Gaskin's book is fabulous!!!”

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Rebecca Westbrook Toker · 1:37 AM

Can I clarify something? I'd like to make the point that everyone has the same access to the same advances and information: midwives can do everything doctors can EXCEPT surgery and write prescriptions.
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Rebecca Westbrook Toker · 1:37 AM

Stats show better outcomes for midwife-assisted births.
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Katie Klabusich · 1:38 AM

This is a good sidebar. Especially for those of us w/o kids.
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Rebecca Westbrook Toker · 1:38 AM

Of course hospitals are threatened.
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Katie Klabusich · 1:38 AM

So what are the duties of a midwife?
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Katie Klabusich · 1:38 AM

(Pardon the midwifery 101)
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Rebecca Westbrook Toker · 1:38 AM

A midwife does the same prenatal screenings that a doctors does: bloodwork, health history, etc.
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Rebecca Westbrook Toker · 1:39 AM

They are more selective - they want you in good health.
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Rebecca Westbrook Toker · 1:39 AM

They work a lot on diet, stress reduction,and exercise so that your outcome will be better.
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Katie Klabusich · 1:39 AM

★ Spotlighted from Avital Norman Nathman

“I see a midwife for my yearly check ups. I haven't seen an ob before I gave birth. My midwife works w/a collective associated w/local hospital”

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Katie Klabusich · 1:39 AM

★ Spotlighted from Kassy Brazier

“I'd venture to say midwives do it better! I used a midwife for my son's birth and she did everything possible to make sure it was the outcome that I wanted.”

KK

Katie Klabusich · 1:39 AM

I had no idea.
KK

Katie Klabusich · 1:40 AM

This is SO interesting.
RT

Rebecca Westbrook Toker · 1:40 AM

The keep the same appoinment schedule: once a month for the first trimester, then every other week, then once a week.
KK

Katie Klabusich · 1:40 AM

★ Spotlighted from Suzy Sunshine

“My midwife did everything a doctor might. She did all my pre-natal visits and came and checked on me (I was nearly 2 weeks late with my daughter and find me a doctor that would let that go!!) and she hung out with me during low labor and fed my kids”

RT

Rebecca Westbrook Toker · 1:40 AM

BUT, a midwife appoinment is more like sitting down to tea with a friend.
RT

Rebecca Westbrook Toker · 1:40 AM

It's a nice, hour-ish long chat.
RT

Rebecca Westbrook Toker · 1:40 AM

My husband came.
RT

Rebecca Westbrook Toker · 1:40 AM

I invited friends sometimes.
RT

Rebecca Westbrook Toker · 1:40 AM

I even gave permission for all the interns to be involved.
RT

Rebecca Westbrook Toker · 1:41 AM

So it was fun lady-group time.
KK

Katie Klabusich · 1:41 AM

★ Spotlighted from Suzy Sunshine

“And gave me a perfect birth of a 10 pound girl without needing a stitch on a twice sewn up perenium”

KK

Katie Klabusich · 1:41 AM

★ Spotlighted from Feminist Lady

“Even the CNM I've worked with was very birth negative, very pro-mom shaming.”

RT

Rebecca Westbrook Toker · 1:41 AM

And when I was worried or stressed, they TOOK THE TIME to talk me through it.
KK

Katie Klabusich · 1:41 AM

that's pretty awesome
RT

Rebecca Westbrook Toker · 1:41 AM

AND, there were SO MANY CHOICES offered to me!
RT

Rebecca Westbrook Toker · 1:41 AM

I could have sonograms if i wanted.
KK

Katie Klabusich · 1:41 AM

So what is it they CAN'T do? And I don't mean b/c of dumb laws. I mean they traditionally see certain things as outside their scope.
RT

Rebecca Westbrook Toker · 1:42 AM

I could have the extra screenings if I wanted them.
KK

Katie Klabusich · 1:42 AM

★ Spotlighted from Suzy Sunshine

“My midwife let my 3 year old son poke his sister and listen to her heart beat with the fetal-scope.. A midwife is really more like a friend!!”

RT

Rebecca Westbrook Toker · 1:42 AM

i could have whatever swabs for things that might be transmissible to the baby if I wanted them.
RT

Rebecca Westbrook Toker · 1:42 AM

Midwives are not OBs.
RT

Rebecca Westbrook Toker · 1:42 AM

They don't do c-sections.
KK

Katie Klabusich · 1:42 AM

★ Spotlighted from Suzy Sunshine

“They cannot do surgery or prescribe medication”

RT

Rebecca Westbrook Toker · 1:42 AM

They CAN do episiotomies.
RT

Rebecca Westbrook Toker · 1:43 AM

They do infant CPR if necessary.
KK

Katie Klabusich · 1:43 AM

So would having a general practitioner be all you need as backup for the meds/hospital options?
RT

Rebecca Westbrook Toker · 1:43 AM

They can do regular first aid/CPR.
RT

Rebecca Westbrook Toker · 1:43 AM

They can suture.
KK

Katie Klabusich · 1:43 AM

★ Spotlighted from Suzy Sunshine

“And they view birth as a holistic life passage”

KK

Katie Klabusich · 1:43 AM

★ Spotlighted from Kassy Brazier

“About a month before he was born he was in the breech position. Instead of saying we would need a c-section, she told me to go swimming and to flip in the water to get him to move. I did it (probably looked ridiculous, too at 9 mo pregs) ”

RT

Rebecca Westbrook Toker · 1:43 AM

You don't NEED a general practitioner as a backup.
RT

Rebecca Westbrook Toker · 1:43 AM

it's nice to have, but hard to get.
RT

Rebecca Westbrook Toker · 1:44 AM

Docotrs and midwives don't typically have good partnerships.
KK

Katie Klabusich · 1:44 AM

I have a lot of issues, so I pretty much have to have one. (Referrals to other docs b/c insurance, etc.)
KK

Katie Klabusich · 1:44 AM

★ Spotlighted from Suzy Sunshine

“A general practitioner will not do births because of the high cost of malpractice insurance”

RT

Rebecca Westbrook Toker · 1:44 AM

There are some places where there are great relationships, but nationally there's a lot of animosity.
KK

Katie Klabusich · 1:44 AM

So if there's an issue during a home birth, does the midwife just accompany you to the hospital and see you through the delivery?
KK

Katie Klabusich · 1:44 AM

★ Spotlighted from Suzy Sunshine

“Alot of the decisions doctors make in "birthing rooms" have to do with lawbooks”

RT

Rebecca Westbrook Toker · 1:44 AM

Yeah, Katie, and many people like to have the assurance of the backup plan.
RT

Rebecca Westbrook Toker · 1:44 AM

Most people want to have a backup OB.
KK

Katie Klabusich · 1:45 AM

★ Spotlighted from Avital Norman Nathman

“When I was pregnant (way back when), my midwife (CNM) allowed me to skip the awful glucose test in lieu of me tracking my blood sugar for a week and discussing the results with her. The fact that we could discuss my choice for 1/2hr? amazing.”

RT

Rebecca Westbrook Toker · 1:45 AM

But that's EVEN HARDER than finding a backup general practitioner.
KK

Katie Klabusich · 1:45 AM

★ Spotlighted from Kassy Brazier

“Yes, she does”

KK

Katie Klabusich · 1:45 AM

I found a GP with an OBGYN background.
KK

Katie Klabusich · 1:45 AM

I had to look for her.
RT

Rebecca Westbrook Toker · 1:45 AM

Katie, taht's a good question.
KK

Katie Klabusich · 1:45 AM

(Thanks, Angie's List!)
RT

Rebecca Westbrook Toker · 1:45 AM

Yes, there will be a transfer.
RT

Rebecca Westbrook Toker · 1:45 AM

In the best of all possible worlds, the midwife would stay with you.
RT

Rebecca Westbrook Toker · 1:45 AM

Often, though, she is shunted aside.
RT

Rebecca Westbrook Toker · 1:46 AM

There's a lot of abuse for midwives and also for women who choose midwives and then have transfers.
KK

Katie Klabusich · 1:46 AM

So how do you get to the hospital? I'm just picturing a logistical nightmare from home to OR.
RT

Rebecca Westbrook Toker · 1:46 AM

Many ER doctors will look at the midwife and say to colleagues that the mother had no prenatal care.
KK

Katie Klabusich · 1:46 AM

★ Spotlighted from Avital Norman Nathman

“Around here, almost all of the homebirth midwives have great relationships with local hospitals and are allowed to accompany if need be. But we live in a rather progressive area.”

RT

Rebecca Westbrook Toker · 1:46 AM

It is a nightmare. It's an ambulance.
KK

Katie Klabusich · 1:47 AM

So, ambulance and the ER doc then makes the call from there?
RT

Rebecca Westbrook Toker · 1:47 AM

Moving in a vehicle in labor is a nightmare!
RT

Rebecca Westbrook Toker · 1:47 AM

:D
KK

Katie Klabusich · 1:47 AM

★ Spotlighted from Suzy Sunshine

“I know of a couple doctors that did homebirths. They would send their nurse midwife to the home earlier and then the doc would come later. Those medical practitioner could transfer to the hospital if necessary”

RT

Rebecca Westbrook Toker · 1:47 AM

Yes.
KK

Katie Klabusich · 1:47 AM

Suzy -- that sounds like an awesome best of both worlds.
RT

Rebecca Westbrook Toker · 1:47 AM

And those things DO happen!\
KK

Katie Klabusich · 1:47 AM

I didn't enjoy the cab home from the colposcopy. I can't even imagine.
RT

Rebecca Westbrook Toker · 1:47 AM

And that's what we should psh for!
KK

Katie Klabusich · 1:47 AM

More integrated medicine!
RT

Rebecca Westbrook Toker · 1:47 AM

THAT is the answer, is RESPECT!
KK

Katie Klabusich · 1:47 AM

Why choose! Everybody in!
KK

Katie Klabusich · 1:47 AM

lol
KK

Katie Klabusich · 1:47 AM

Look at that. We solved medicine.
KK

Katie Klabusich · 1:48 AM

In like 45 minutes.
RT

Rebecca Westbrook Toker · 1:48 AM

Hhahahaha!
RT

Rebecca Westbrook Toker · 1:48 AM

Now, we just gotta get the doctors on-board...
RT

Rebecca Westbrook Toker · 1:48 AM

Midwives want good partnerships.
KK

Katie Klabusich · 1:48 AM

★ Spotlighted from Suzy Sunshine

“Midwives around here will refer a woman to a medical doctor if they suspect any medical complications or problems”

RT

Rebecca Westbrook Toker · 1:48 AM

Women should want good partnerships - it ensures the free-flow of information and CHOICES.
RT

Rebecca Westbrook Toker · 1:49 AM

Yes.
RT

Rebecca Westbrook Toker · 1:49 AM

Midwives do not typically borrow trouble.
KK

Katie Klabusich · 1:49 AM

★ Spotlighted from Avital Norman Nathman

“Same here, Suzy”

KK

Katie Klabusich · 1:49 AM

★ Spotlighted from Suzy Sunshine

“It's very hard for doctors to practice non-consensus medicine ~ and sadly other doctors do not support these heretical ideas like homebirth.”

RT

Rebecca Westbrook Toker · 1:49 AM

They send women to doctors if they suspect anything is out of their scope.
RT

Rebecca Westbrook Toker · 1:49 AM

That's very sadly true, Suzy!
KK

Katie Klabusich · 1:49 AM

★ Spotlighted from Avital Norman Nathman

“I think there's also a need, however, to talk about who has access to this type of care”

KK

Katie Klabusich · 1:50 AM

★ Spotlighted from Suzy Sunshine

“No midwife want trouble. I believe they are more tuned into their patients and even more careful than doctors.”

RT

Rebecca Westbrook Toker · 1:50 AM

★ Spotlighted from Avital Norman Nathman

“Especially related to costs. Many insurance companies will only cover certain doctors, etc... and homebirths can be $$$”

RT

Rebecca Westbrook Toker · 1:50 AM

VERY true, Avital.
RT

Rebecca Westbrook Toker · 1:50 AM

Insurance has already decided who they'll cover. :/
RT

Rebecca Westbrook Toker · 1:50 AM

That limits a lot of people.
KK

Katie Klabusich · 1:50 AM

Is there any way around that
KK

Katie Klabusich · 1:50 AM

?
RT

Rebecca Westbrook Toker · 1:51 AM

I know several people who say, "I WOULD have had a home birth/midwife/doula - IF my insurance would have covered it!"
RT

Rebecca Westbrook Toker · 1:51 AM

I paid out of pocket.
KK

Katie Klabusich · 1:51 AM

★ Spotlighted from Avital Norman Nathman

“It's hard”

RT

Rebecca Westbrook Toker · 1:51 AM

It depends on the state and what the regulations are.
KK

Katie Klabusich · 1:51 AM

★ Spotlighted from Suzy Sunshine

“Well my insurance did not cover my doctor attended birth and my midwife was more cost effective and I really got my money's worth. But back in the day I had to pre-pay for my births upfront”

KK

Katie Klabusich · 1:51 AM

I think a lot of people don't understand the kind of bills they're going to get from a hospital birth. You insurance doesn't cover everything.
RT

Rebecca Westbrook Toker · 1:51 AM

Some states permit nurse/midwife births.
RT

Rebecca Westbrook Toker · 1:51 AM

That's true!
KK

Katie Klabusich · 1:52 AM

★ Spotlighted from Avital Norman Nathman

“I can give you an example. A large clinic is a big, urban, low-income, high-density city has an induction rate of 99.9%”

KK

Katie Klabusich · 1:52 AM

★ Spotlighted from Avital Norman Nathman

“their c-sec rate is over 80%”

RT

Rebecca Westbrook Toker · 1:52 AM

A typical hospital birth averages $13,000+.
RT

Rebecca Westbrook Toker · 1:52 AM

I paid my midwife $4,000.
RT

Rebecca Westbrook Toker · 1:52 AM

Ooooh, Avital, now you're getting to the heart of the matter!
RT

Rebecca Westbrook Toker · 1:52 AM

Who is profiting?
KK

Katie Klabusich · 1:53 AM

★ Spotlighted from Avital Norman Nathman

“who are the patients? usually at-risk populations who could more than benefit from a much better model of care :/”

KK

Katie Klabusich · 1:53 AM

★ Spotlighted from Suzy Sunshine

“And if a doctor does a C-section they have done everything "in their power" to save the baby!! What a scam.”

KK

Katie Klabusich · 1:53 AM

★ Spotlighted from Avital Norman Nathman

“(this is a sample city where our project is piloting. I SO hope it changes the stats)”

RT

Rebecca Westbrook Toker · 1:53 AM

Most hospitals get 60% of their revenue from the birth/labor ward...
KK

Katie Klabusich · 1:53 AM

★ Spotlighted from Avital Norman Nathman

“And there's such manipulation. 99.9% induction rate? b/c patients get frightened into making sure "their" obgyn is at the delivery so they schedule”

RT

Rebecca Westbrook Toker · 1:54 AM

So...
KK

Katie Klabusich · 1:54 AM

WOW
RT

Rebecca Westbrook Toker · 1:54 AM

there's a lot of motivation to offer lots of "services" and to keep those beds full!
KK

Katie Klabusich · 1:54 AM

60 PERCENT?
RT

Rebecca Westbrook Toker · 1:54 AM

Or more.
RT

Rebecca Westbrook Toker · 1:54 AM

So...
KK

Katie Klabusich · 1:54 AM

★ Spotlighted from Suzy Sunshine

“Hospitals are FOR PROFIT!! And the more procedures the more expensive”

RT

Rebecca Westbrook Toker · 1:55 AM

Induction usually starts the "cascade of interventions"
KK

Katie Klabusich · 1:55 AM

I think I was just stunned into silence.
RT

Rebecca Westbrook Toker · 1:55 AM

otherwise known as the money hemmorage.
KK

Katie Klabusich · 1:55 AM

I just...
KK

Katie Klabusich · 1:55 AM

I can't....
RT

Rebecca Westbrook Toker · 1:55 AM

AND, frankly,
KK

Katie Klabusich · 1:55 AM

★ Spotlighted from Suzy Sunshine

“And once a woman is induced she has lost control of her labor”

KK

Katie Klabusich · 1:56 AM

★ Spotlighted from Avital Norman Nathman

“and then think of all those post-op days you can now charge for!”

RT

Rebecca Westbrook Toker · 1:56 AM

an institution that gives several times the necessary and recommended dose of a synthetic hormone should be FINED, not paid.
RT

Rebecca Westbrook Toker · 1:56 AM

What I'm referring to is the routine use of pitocin to start labor.
RT

Rebecca Westbrook Toker · 1:56 AM

Pitocin is a synthetic hormone.
RT

Rebecca Westbrook Toker · 1:56 AM

it produces contractions,
KK

Katie Klabusich · 1:56 AM

★ Spotlighted from Suzy Sunshine

“That would be a great policy rebecca!!”

RT

Rebecca Westbrook Toker · 1:57 AM

but the contractions are LONG, HARD, and MORE PAINFUL than natural contractions.
RT

Rebecca Westbrook Toker · 1:57 AM

Most hospitals START a woman on a drip of pitocin that is several times the recommended dose.
KK

Katie Klabusich · 1:57 AM

Bah! I can't believe we're running out of time. Does anyone (I see the readers/silent tawkers out there!) have questions for Rebecca before we have to close out>>
RT

Rebecca Westbrook Toker · 1:57 AM

★ Spotlighted from Suzy Sunshine

“It produces unnatural contractions without a rest in between ~ there is no ebb and flow any longer”

KK

Katie Klabusich · 1:58 AM

Obvi, Suzy, SPEED
RT

Rebecca Westbrook Toker · 1:58 AM

Well, and it mashes the baby around a lot. When the fetal heart rate rises and the oxygen levels drop, then it's almost c-section time!
KK

Katie Klabusich · 1:59 AM

★ Spotlighted from Robin Maynard

“run them thru the mill as quickly as possible. pretty disgusting.”

KK

Katie Klabusich · 1:59 AM

★ Spotlighted from Suzy Sunshine

“Speed and then the desired profits are almost guaranteed”

RT

Rebecca Westbrook Toker · 1:59 AM

BUT, if we didn't squeeze the poor little thing's head so hard, it might just make it out by iteself...
RT

Rebecca Westbrook Toker · 1:59 AM

★ Spotlighted from Suzy Sunshine

“I hope you can create dynamic changes Avita!!!”

KK

Katie Klabusich · 1:59 AM

THANK YOU so much to everyone who came out and chatted. Go bug Avital on twitter (@themamafesto) and tell her I want to bring her on to talk about the new project when it's up.
KK

Katie Klabusich · 1:59 AM

And check out Rebecca's upcoming tawks!
RT

Rebecca Westbrook Toker · 2:00 AM

Thanks for being here, ladies!
KK

Katie Klabusich · 2:00 AM

You can follow me at @Katie_Speak and find my writing/media spots at katiespeak.com
KK

Katie Klabusich · 2:00 AM

Rebecca, thank you SO much! I learned a bunch!
KK

Katie Klabusich · 2:00 AM

★ Spotlighted from Robin Maynard

“very interesting tawk. thank you all!”

KK

Katie Klabusich · 2:00 AM

★ Spotlighted from Suzy Sunshine

“thank you!!”

RT

Rebecca Westbrook Toker · 2:00 AM

Katie, thanks for having me here! You keep fighting and stay safe, Lady!
KK

Katie Klabusich · 2:01 AM

Always. <3
RT

Rebecca Westbrook Toker · 2:30 AM

★ Spotlighted from Avital Norman Nathman

“Thanks all (sorry, got distracted!). Thanks so much for this conversation Katie & Rebecca!”

RT

Rebecca Westbrook Toker · 2:30 AM

Extra Resource Article: http://cfmidwifery.org/Resources/item.aspx?ID=32