Baby Catcher

I have been meaning to blog about this book since I finished reading it what seems like forever ago.  Here I am now, almost through Ina May's Birth Matters, and I haven't shared my thoughts on this book.

Put simply, it's magnificent. Basically, it is the story of one midwife's career--from hospital nurse to CNM attending home births and back into the hospital as a staff midwife.  What drew her into private practice was a realization that, in the hospital at the time she was a nurse (in the 1970s), birth was often treated as pathological until proven otherwise.  The stories she related of women being knocked out, tied down, and having all manner of things done to them without their consent were pretty horrific.  It's kind of hard to believe these kinds of things took place in hospitals in our country not so long ago.

One quote from early in the book, before Peggy opened her private practice, which really resonated with me, is "Women's bodies have near-perfect knowledge of childbirth; it's when their brains get involved that things can go wrong."  On that note, I ordered the EFT Manual recommended to me by J in the hopes that I can really get out of my head and release any fears I may have before T's birth, so that during my next labor, I can really shut my brain off and just let my body do its work.

Anyhow, I digress.  The meat of the book is spent sharing stories of clients and their births during her home birth practice.  Peggy is such an excellent writer--you feel like you get to know the women she talks about as intimately as she does.  I loved reading the stories of their births--they were so very different in how they labored, and it was nice to see how different women coped with the intensity of labor.  Some were funny, some complained, some were fascinated at what was going on in their bodies, and on and on.  Her client base ranged from those that had alternative lifestyles to the ordinary, every day woman.  All of the births were as individual as the women themselves, and there was always a sense of excitement and joy in her relation of their stories.  And a great deal of humor, which I loved--one of the reasons I love K so much is her ability to make me laugh, which I really value.

I was actually really saddened when I read of how her private practice closed, after being unable to renew her malpractice insurance as the result of being sued by a woman whose baby was damaged--not even a home birth client of hers, but a woman she had agreed to be a labor coach for until she transported to the hospital.  A woman who had been advised by her doctor to get to the hospital early in labor as he felt the baby needed careful monitoring.  However, this woman had her own ideas, it appears, and really wanted to birth her way, despite the warnings.  Due to an unfortunate set of events, this woman's baby suffered catastrophic brain damage as a result of a prolapsed cord.  Despite the fact that nothing Peggy did or didn't do would have changed the end result**, she was sued and forced to settle for a large sum of money, after which she could not retain malpractice insurance.  As an attorney, this part of the book really fascinated me.  I understand there are certain groups of people who feel that midwives should have to maintain malpractice insurance.  Here in Texas, CPMs are not required to carry malpractice insurance, and I personally, am just fine with that.  If they were forced to pay premiums on insurance, many of them could not afford to remain in practice--or they would have to charge so much for births that many women could not afford them.  And, in my opinion, choosing a home birth means accepting a certain amount of responsibility for whatever the outcome may be.  Yes, your baby could die or be damaged--very unlikely, but your baby could.  I think it would do home birthing women a great disservice to impose requirements on many competent, professional midwives that would force them out of practice.  And if we impose these kinds of requirements on home birth midwives, we run the risk of turning home birth into something potentially as litigious as hospital birth.  So many of the practices in hospitals are done out of fear of being sued, not necessarily what is in the best interest of mom and baby--precisely why some women are drawn to home birthing in the first place.  If we start imposing the kinds of requirements on midwives that would force them to operate more from a CYA standpoint, we run the real risk of losing any semblance of normal birth in any setting in the United States.  We also would run the risk of forcing women to choose between unassisted childbirth or having an attendant whose primary motivation may be ensuring they are not sued at the end of the day.  I would really hate to see what that would do to birth in this country.

After her practice closed, Peggy took a position as a staff midwife at a hospital, and it was actually really, really sad to see how different birth was there.  I am not ashamed to say I got a little misty eyed at all that she, and all her potential home birthing clients, lost.

Peggy includes an Epilogue on the situation of birth in the United States at the end of the book, and I agree with much of her sentiment.  In addition, she includes some Appendices--one is just a short list of advice and things she's learned throughout her career, another is a list of supplies for the home birth midwife, there is a recipe for caramels (mmmmm), as well as statistics on the safety of midwives, and on and on.

Overall, this book was excellent--easy to read, and at the same time, extremely thought provoking.  A definite must read.


**As an aside, the paramedics in this story reminded me of the ones who transported me to the hospital during E's birth.  They weren't rude like the ones in the book, but they were definitely moving sooooooo slowly, as if nothing were emergent.  Luckily, nothing was, but if I had been ruptured, we would have been in a world of hurt.