Guest Post: The Midwife as a Storyteller and Teacher by Patricia Harman

Oct18

The use of old-fashioned narrative to influence, and inform patients about health practices

As an author of memoirs, historical fiction and children’s literature, I am a storyteller, but I’m also a nurse-midwife, and I use storytelling as one of my primary teaching tools.

Storytelling is uniquely human. Anthropologists have argued that storytelling is pre-verbal, that pictographs on the inside of caves are in fact stories. Form the earliest days humankind has used narrative to record history, to entertain, to convey experience and to transfer information.

To convey information in narrative form is something no other species can do. It’s an evolutionary advantage and allows each individual to harbor more information than personal experience would allow.

Using stories to teach patients is not unique to midwives. All good providers use stories to illustrate how individuals can make better health choices.

We all know that many patients are non-traditional learners and even those in higher education love a good story. Research and statistics are boring for most people and easy to forget . Many patients, even if given a handout drop it in the trash as they leave our office. They don’t have time to read it or are non-readers.

On the other hand, if I tell a tale, in an amusing way, about a young woman who refused to take her birth control pills because she was worried they would make her fat…and now she’s pregnant…that’s a cautionary tale and brings a smile and a knowing nod from the fifteen-year-old here to discuss birth control: That’s not going to happen to her!

Using self-disclosure about your own life can humanize a professional relationship and help patients be more honest with you about their lives. For example, I might say with a smile, that I’ve gone to Weight Watchers for so long I could teach the class, even though I’ve never reached goal weight. The patient and I share a good laugh and now she feels comfortable telling me she can’t stand to look in the mirror, has tried four different TV diets and is terribly discouraged. A door for real communication has opened. She no longer feels alone and she knows she has me as a non-judgmental advocate.

Stories can accomplish what no other form of communication can do; they can get through to hearts with a message. I might tell a very stressed-out college student, sitting on the end of the exam table, about a patient of mine who had two jobs and was studying nursing full time. Last year she started getting a series of illnesses. Next thing she knew, she flunked two courses, lost her boyfriend and had a motor vehicle accident. The moral is clear: don’t take on more than is humanly possible. And the tale is more likely to induce lifestyle change than a lecture.

All health care providers, surgeons, nurses, physical therapists, family doctors or midwives must be teachers. If you missed that part in school, it’s not too late. With humor and love we can become part of the human story that will bring health and hope to our patients.

For the past twenty years, Patricia Harman has been a nurse-midwife on the faculty of The Ohio State University, Case Western Reserve University and most recently West Virginia University. In 1998 she went into private practice with her husband, Tom, an OB/Gyn, in Morgantown, West Virginia. Here they devoted their lives to caring for women and bringing babies into the world in a gentle way. Patricia Harman still lives with her husband, Thomas Harman, in Morgantown, West Virginia. She recently retired from her thirty-five years of midwifery so she could write more books for people like you!

My past reviews of Patsy’s books:

Past blog posts on the subject of story power:

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Talk Books: Lost on Hope Island

Sep28

Patricia Harman is an experienced midwife, beginning as a community midwife in the 1960’s and then becoming a CNM and maintaining a busy practice with her obstetrician husband Tom. Her memories about midwifery practice are some of my all-time favorite midwifery memoirs. She has a delightful gift with sharing stories, wisdom, and creating what feels like a true relationship with the reader. Now, she has put her attention into a new project: fiction for middle-grade children. Her first child’s novel, Lost on Hope Island: The Amazing Tale of the Little Goat Midwives, tells the story of two siblings, Trillium and Jacob (ages 12 and 8) who are shipwrecked on a small island in the Pacific Ocean and separated from their parents.

Lost on Hope Island is set in the modern day, it is not a Swiss Family Robinson reboot. On the island, the children must learn how to survive with only each other, and the goats the inhabit the island for company. They make some surprising (and convenient!) discoveries left behind by previous homesteaders on the island that help them survive and they develop close relationships with their goat friends. After the traumatic death of one baby goat, they learn how to help the nanny goats on the island give birth to their kids when they encounter difficulties (specifying that their mother and grandmothers are midwives and they know that if a mother isn’t have any trouble, it is best to keep your hands off and leave her alone!). This tale is not a fantastical or “glitzy” children’s read, nor does it shy away from complicated and difficult topics, instead it opens the door to real questions about relationships and feelings and how to draw on one’s own strength when you think you can’t go on. It is unusual to find a middle grade children’s book about realistic people in unusual, but not fantasy, circumstances. The book is illustrated with charming little hand-drawn pictures of the goats and the island’s adventures.

I read Lost on Hope Island out loud to my kids at bedtime over the course of a few weeks. My kids are ages 2, 5, 10, and 13. The older boys groaned a bit about reading it and found the goat-birth scenes to be a bit “icky,” but after they settled into the rhythm and pacing of the story, they listened with rapt attention and we often mentioned the story at other points during the day. My five-year-old daughter loved the book and it taught my nearly two-year-old son how to both say “midwives” (in a truly adorable fashion…he would get the book and bring it to me saying, “mid-wiiiifes”) and also “bey-aa” like the goats in the story.

If you are looking for a family read aloud, this adventure story with a birth-worker twist, is the book for you!

Past reviews of Patricia’s other books:

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Disclaimer: I received a complimentary copy of this book for review purposes.

Crossposted at Brigid’s Grove.

Talk Books: The Last Midwife

Oct5

A baby’s first cry was the sound of angels’ songs. No matter how long and difficult the labor, no matter how the mother moaned from the pain and the tearing, praying and cursing, Gracy knew joy at the sight of the baby’s body pushing into the world, felt exhilaration as she caught the tiny living creature and held the soft, wet flesh in her hands a moment longer than was necessary. And she passed that sense of wonder on to the mother, exclaiming over the fingers and toes as tiny as birds’ claws, the eyelashes thin as a thread, the button of a nose.

It was not the money or the gold dust or the barter items that sent Gracy over icy trails, that drew her out of sleep-warm quilts at midnight to face cold and howling blizzards. She went where she was called because she knew a woman needed her, because new life waited for her…

The Last Midwife is a historical mystery novel set in gold rush country, a Colorado mining town in the 19th century. Gracy Brookens is the last midwife in the community, aging and creaky, but taking long treks into deep country to continue to serve women, despite the presence of a new, modern doctor in town. Unfortunately, a baby is murdered and Gracy is accused of the crime. Mixed with birth stories, personal trauma and the witnessing of intense family suffering, the baby’s murder case comes to trial and Gracy must face the chance of imprisonment as well as rejection and betrayal from some of the women she has loyally served. The mystery of who really killed the baby runs through the book along with several other intertwined subplots that are like mini-mysteries of their own.

While the twist ending left me a little disappointed, The Last Midwife was a realistic, interesting, engaging, suspenseful, well-developed, and creative read that doulas, midwives, and childbirth educators will particularly enjoy.

Talk Books: Touching Bellies, Touching Lives

Aug20

Every so often I end up reading a book that is nothing like I was expecting and yet is totally amazing. Touching Bellies, Touching Lives is one of those books. Subtitled “Midwives of Southern Mexico Tell Their Stories,” I was expecting a collection of birth stories from Mexican midwives. While there are birth stories, and everyone knows that I love birth stories, this book is so much more than a birth story collection. It is a personal pilgrimage, a preservation of the legacy of midwives, an examination of cultural birth practices, and a sobering first-hand account of the declining culture of traditional midwifery in Mexico. Many people may have the misconception that in Mexico or other South American cultures, midwifery is commonplace and maybe even flourishing. In Touching Bellies, we come to understand that Western medical practices are encroaching at a steady pace and that many midwives are elderly, retiring, and not being replaced. A steady theme runs throughout of women going to midwives for “belly massage,” but going to “modern” facilities to have their babies (unfortunately, they’ve imported some U.S. 1950’s-style practices in terms of birth position, birthing alone with no husbands allowed, and being treated dismissively in labor. This is along with a cesarean rate over 40% and up to 70% much in some cities).

The author, Judy Gabriel, takes multiple trips to Mexico on her quest to document the lives and stories of Mexican midwives (most of whom are age 65 and many of whom do not live to see the end of the book). She photographs the midwives and, with some hurdles with language barriers, listens to their stories–asking about the first birth they attended as well as any births that were problematic for them. She returns to them bearing hearing aids, dresses, and photos of family members from the United States. She travels through rough terrain and to distant villages on her quest to listen and learn from these midwives. I was completely absorbed by Judy’s dedication to her mission and her personal insights and life lessons as she travels and learns.

The “belly massage” practice for which Touching Bellies gains its title was endlessly fascinating to me (and to Judy, the author) with midwives regularly helping position the baby, release tight muscles, and ease aches and pains through a gentle process of abdominal massage and fetal manipulation. This aspect of midwifery care was so pervasive that when Judy would ask in a village where the midwives are, many people would not understand and say that they don’t know what she is talking about. When she asks for the woman who massages the bellies of pregnant women, everyone knows where to tell her to go.

In this quote, a 75-year-old midwife tells the story of helping a woman who is in premature labor. The doctors have tried to stop her contractions without avail and now say she must have a cesarean and the baby will most likely die:

“…The mother-in-law said, ‘This woman knows more than you doctors. You may have gone to the university, but, excuse me, for you doctors it is always puro cuchillo, puro cuchillo [just knives, just knives]. Leave the midwife to work in peace, and you’ll see what can be done without knives.’

So I did my work. I rocked the girl in a rebozo and massaged her belly, moving the baby up. The contractions stopped.

The doctors asked, ‘How did you do that?’

I said, ‘You were standing right there watching. I did it in front of you. I’m not hiding anything. You saw me rock her; you saw me massage her.’

‘Is that all you had to do?” they asked.

I said, ‘Yes, that’s all I had to do. What else would I have to do?’

(The baby survived and was born at full-term six weeks later.)

The dedicated care for women, in touching their bellies, touches their lives. Almost all of the midwives in the book have access to nurturing touch and almost no other resources available and yet almost all of them report never losing a baby or a mother in childbirth.

I absolutely loved reading Touching Bellies, Touching Lives. It is an extremely interesting, thought-provoking, and thoroughly fascinating journey. The information about the gradual decline and near-extinction of midwifery in Mexico is sobering, but the book does end on a hopeful note.

You can read more about the book here as well as see some of the interesting documentary-style photographs of the midwives from the book (one of the points of Judy’s travels was to photograph the midwives and share pictures of their families in the U.S. with them and vice versa). The book itself is available via Amazon.

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Disclosure: I received a complimentary copy of this book for review purposes.

Tuesday Tidbits: International Day of the Midwife

May5

Today is International Day of the Midwife and I find myself reflecting on the many midwives I have known and the incredibly diversity and gifts of the women who join this profession. In addition to the midwives I had for prenatal and postpartum care for each of my births, I’ve been privileged to know many midwives on the state and national level through our shared interest in maternity care activism and birth rights. With my first baby, I had prenatal and birth care with a family practice physician and a CPM. The CPM was gray-haired, pretty, soft-spoken and wryly witty and pretty much exactly what you picture a stereotypical midwife looking like! My prenatal care with this team was excellent, birth care so-so (I didn’t need much), but my postpartum care left a lot to be desired and I felt very cast adrift after the birth. I became very embroiled with midwifery activism and birth work after this birth and as a result my experiences with all subsequent midwives has been an interesting blend of collegial + consumer. My first birth was the only one for which I was consumer only. Though I’m not a midwife myself, my subsequent experiences all involved being a sister birthworker AND client, rather than solely a client. This has both benefits and disadvantages.

My midwife with my second baby was amazing. I loved her so much and I have felt a gap in every pregnancy following that I was not able to have her as a midwife again. She was gentle and caring and passionate and inspiring and wonderful. Cute and upbeat, full-figured, and intelligent, she had a soft and reassuring presence and gave wonderful hugs! We became good friends and she was a very important part of my life. My prenatal care and birth care with her was excellent. She was also helpful with postpartum care, but I don’t think I “allowed” her to be as helpful as she could have been because I couldn’t allow myself to be as vulnerable and needy as I actually felt.

When I was pregnant with my third baby, my much-loved midwife had moved away and found myself at a loss for who to choose for pregnancy and birth care. This baby died early in my second trimester and I found myself calling on the sisterhood of midwives for help when I desperately needed it. From the very busy midwife who talked to me kindly and patiently when I was freaking out over a retained placenta, to the Mennonite midwife who helped me from the road as she was driving to another state and connected me to yet another midwife several hours away who drove in to town to meet and help me when I was very scared and alone, it was during this experience that I realized very viscerally how much we need midwives in our lives. When I was pregnant again, I decided to choose the Mennonite midwife for my prenatal care and immediate postpartum care. She is a very capable and determined and intelligent midwife, but I felt an unbridgeable gap between us spiritually speaking and so was never able to fully connect with her emotionally. She embodied the gray-haired, no-nonsense “granny midwife” archetype. She provided great prenatal care and was very respectful of my wish for immediate postpartum care, but an unassisted birth. Postpartum follow-up care was limited due to snowstorms.

With my last baby, I felt a powerful need to feel taken care of again. I really needed to have some set aside time, space, and energy that was just focused on me and my baby. I knew that I needed a midwife! While I could have used the same midwife as with the baby before, this time it was important to me to develop the emotional connection I had with my second midwife—I needed a midwife with whom I could feel “safe” with all of me, instead of feeling like I had to hide my goddess sculptures when she came over! 😉 It took some work, but I was able to find that. With this experience, I came to accept that the blur between colleague-consumer is my reality and I will never re-capture the feeling of being client only and being completely focused on in that respect, because I’m simply not just a client only. That’s okay. This midwife has long brown hair, wears lots of skirts and had the hippie-ish midwife feel I was craving. She is funny and talkative and connected to the roots of what midwifery is all about. I was safe with her in the way I needed. I really appreciated the midwife’s prenatal care (and the opportunity to focus on my pregnancy and baby), her respect of my wish for immediate postpartum care rather than birth care, and her postpartum follow-up care. I felt like this midwife offered the most complete postpartum care of all of my birth experiences.

I’ve mentioned before that the only vaginal exam I had during six pregnancies was at ten centimeters dilated when I went to the birth center to push out my baby (I also had to have one for a manual clot extraction following his birth and one for help removing the placenta after my miscarriage-birth of my third baby). This is totally cool with me. Somehow I’ve managed to labor and birth four full-term babies without ever knowing how dilated I am in labor! So, I loved reading this article about the pointlessness of vaginal exams in labor and the cultural attachment, even in midwifery circles, to cervix-focused childbirth:

“…There is also reluctance to change hospital policies, underpinned by a need to maintain cultural norms. The Cochrane review on the use of partograms on the one hand states that they cannot be recommended for use during ‘standard labour care’, and on the other hand states: “Given the fact that the partogram is currently in widespread use and generally accepted, it appears reasonable, until stronger evidence is available, that partogram use should be locally determined.” Once again, an intervention implemented without evidence requires ‘strong’ evidence before it is removed. The reality is that we are unlikely to get what is considered ‘strong evidence’ (ie. randomised controlled trials) due to research ethics and the culture of maternity systems. Guidelines for care in labour continue to advocate ‘4 hourly VEs’ and reference each other rather than any actual research to support this (NICE, Queensland Health). Interesting whilst Queensland Health guidelines recommend 4 hourly VEs, their parent information leaflet states: “While a VE can provide information about how a woman has progressed so far in labour, it cannot predict how much longer you will be in labour…” and that there are “…other factors such as the strength, duration and length of contractions as well as a woman’s behaviour and wellbeing that can indicate progress in labour”. Which begs the question ‘why bother doing a VE’?

The cervical-centric discourse is so embedded that it is evident everywhere. Despite telling women to ‘trust themselves’ and ‘listen to their body’, midwives define women’s labours in centimetres “She’s not in labour, she’s only 2cm dilated”. We do this despite having many experiences of cervixes misleading us ie. being only 2cm and suddenly a baby appears, or being 9cm and no baby for hours. Women’s birth stories are often peppered with cervical measurements “I was 8cm by the time I got to the hospital”. Even women choosing birth outside of the mainstream maternity system are not immune to the cervical-centric discourse. Regardless of previous knowledge and beliefs, once in labour women often revert to cultural norms (Machin & Scamell 1997). Women want to know their labour is progressing and there is a deep subconscious belief that the cervix can provide the answer. Most of the VEs I have carried out in recent years have been at the insistence of labouring women – women who know that their cervix is not a good indicator of ‘where they are at’ but still need that number. One woman even said “I know it doesn’t mean anything but I want you to do it”. Of course, her cervix was still fat and obvious (I didn’t estimate dilatation)… her baby was born within an hour…”

Vaginal examinations: a symptom of a cervical-centric birth culture | MidwifeThinking

I also read this article about the now late, great midwife and activist, Sheila Kitzinger and how she connected her birthwork to feminism (as do I). I despise the article’s title, but it is still worth a read!

…In the Seventies, I was viewed as a radical for saying that birth was being depersonalised and treated as if it were a pathological event, rather than a normal life process.

To my surprise, it wasn’t just obstetricians who dismissed what I had to say. I also found myself in conflict with feminists, who saw birth in very simplistic terms.

Why? Because they claimed it was every woman’s right to give birth painlessly.

An article in Spare Rib, the radical campaigning feminist magazine, went further.

Without any evidence, the authors asserted: ‘Undoubtedly, hospitals, with all their faults, are the safest places in which to give birth. For this reason, we think we should press for improvements in hospitals rather than support a move to more home confinements.’

I was appalled at how my sister-feminists could fail to support woman-centred birth. Polly Toynbee, writing in The Guardian, was particularly virulent, dismissing me as a lentil-eating earth goddess…

via Sheila Kitzinger on why feminists HATE natural childbirth and why it’s harmful | Daily Mail Online.

Lentil-eating earth goddesses unite! Unlike Kitzinger’s experiences with the distance between some expressions of feminism and birth-care, I find that many midwives, whether explicitly or implicitly, understand the deep connection between midwifery care, birth activism, and feminism.

“Midwifery work is feminist work. That is to say, midwives recognize that women’s health care has been subordinated to men’s care by a historically male, physician-dominated medical industry. Midwifery values woman-centered care and puts mothers’ needs first. Though not all midwives embrace the word feminism (the term admittedly carries some baggage), I maintain that providing midwifery care is an expression of feminism’s core values (that women are people who have intrinsic rights).

–Jon Lasser, in Diversity & Social Justice in Maternity Care as an Ethical Concern, Midwifery Today, issue 100, Winter 2011/2012

via Midwifery & Feminism | Talk Birth

Perhaps this is because midwives care so deeply about mothers and feminists might actually make the best mothers…

…As a mother who works extensively with other mothers, I appreciated Caron’s acknowledgement that raising children is a feminist act with potential to create change as well. “Another strategy for change is through raising children to be just and caring people. A media image portrays feminists as being against motherhood—but in fact, feminists make the best mothers. They raise children aware of themselves and the world, of options and values, of what justice means and how to work toward it, and how to be self-critical and self-respecting” (p. 203-204). Caron also explains that “in a just society, women would be free to make whatever decisions they needed to, for however long they needed to, in relation to political action in the public and the private sphere. All people would participate in the decision-making, and women would be supported in their decisions rather than, as sometimes happens, made to feel guilty for not doing enough or not valued for what they do.”

via Thesis Tidbits: Feminism, Midwifery, and Motherhood | Talk Birth.

Happy International Day of the Midwife! Thank you for bearing witness to our journeys and for holding the space for the continually unfolding spiral of life.

“…As we ready ourselves to accept new life into our hands,
Let us be reminded of our place in the dance of creation.
Let us be protectors of courage.
Let us be observers of beauty.
Let us be guardians of the passage.
Let us be witnesses to the unfolding…”

—Cathy Moore (in Sisters Singing)

via National Midwifery Week! | Talk Birth.

In addition to midwives, we’re also celebrating mothers all week this week! First on our lineup of activities is our gift to you: our first ever coupon code for $5 off purchases over $15. Use code: MOTHER.

We’ve also got a giveaway upcoming, two new product launches, a new Facebook group, and two class announcements! Stay tuned…

Author Interview: Sally Hepworth

Feb10

At the end of last year, I reviewed a preview copy of an awesome new novel about midwives: The Secrets of Midwives.

Secrets of Midwives, the

The Secrets of Midwives is released for sale today and I’m excited to share an interview with the author, Sally Hepworth.

A Conversation with Sally Hepworth…

Q 1. How did you come to write the book?

Sally Hepworth and Family

There is a saying among writers “Write the book you want to read.” That’s what I did. Being the mother of young children (and pregnant while I wrote book), I was finding myself drawn to novels such as The Birth House by Ami McKay and Midwives by Chris Bohjalian. I have always thought there was a certain magic to midwifery—for a while, after I left high school, I even considered becoming a midwife. So, when it came time to start a novel, there was no choice to make.

I researched for months before I wrote a word. While I knew I was going to write about midwives, I had no idea what the actual story would be. I had a suspicion it would involve a mother and a daughter—particularly when I found out I was carrying a daughter—but it wasn’t until I read some fascinating stories about midwifery in the 1940s and 50s that Floss’s character (a grandmother) was born.

For me, the best plots start with a question, and the question I landed on for this book was: “Why would a woman hide the identity of her baby’s father?” I like books that have a big upheaval really early on—a “call to action” for the readers—so I knew that by the end of the first chapter, the reader would find out that Neva was pregnant, and that she wouldn’t reveal the identity of the father. At first, I didn’t know why she was hiding it, and I didn’t know who the father was, but as I wrote, I started to figure it out.

But when all is said and done, THE SECRETS OF MIDWIVES is a book about family. What makes a mother, what binds family together, and the role of biology.

In writing this book, I found answers to a whole lot of questions I never knew I had. And I suspect it is no coincidence that this book took me nine months to write.

In effect, in 2012, I gave birth to two babies.

Q 2. In the novel there are many differing opinions about the “right” way to give birth, even among the midwives. Why did you choose to include this in the book?

In my experience, there still exists a lot of debate over the “right” way to give birth so I thought it was important for authenticity to include this in the book. Also, the idea of “right” and “wrong” tied in with the novel’s theme: family. Unfortunately, there is still a commonly held belief that there is a “right” and “wrong” kind of family. Or at least a “good” and a “better” type. But these days, there are so many different kinds of families—blended, adoptive, single-parent, same-sex parents, communities of singles. Of course, there are a lot of (strong) opinions on this too! To me, this was all rich fodder for a novel.

As I started researching for this book, I read a lovely line in a book that said childbirth was a woman’s first battle as a mother, and it was this battle that made her a warrior, capable of protecting her child. I found this fascinating, but also troubling. If birth makes a mother a warrior, where did it leave adoptive parents? Step parents? Fathers?

It was also troubling on a personal level. My son had been born naturally and my daughter was due to be born by scheduled C-section. I had a sense that it didn’t matter how the baby was born, that the birth had no continued bearing on the relationship between mother and child, but the more I read about the transformative quality of natural birth, the more I wondered.

In writing this book, and in giving birth to my daughter by C-section, I was able to find answers to my questions. I have more respect for natural birth and midwifery now than I ever did, and I think a woman’s ability to provide everything her child needs through pregnancy and birth (and beyond!) is astonishing—even magical. And the idea of a home birth, I’ll admit, holds a certain appeal for me now that it hadn’t before. But I finally determined that there is no “right” way to give birth, because there is no “wrong” way. You don’t become a warrior because of the way you give birth. You become a warrior because of the depth of the love you feel for your child.

And while labor may be the first battle you’ll fight for your child, compared to the battles that still lie ahead? Even the most arduous birth is a walk in the park.

Q 3. What research did you do?

As I prepared to write this novel, I read everything I could get my hands on about midwifery—novels, memoirs, non-fiction books—and I watched every piece of footage that showed high-risk deliveries that YouTube had available. I subscribed to online communities and forums where I was able to ask questions about midwifery and birth and I touched base with several home-birth midwives and midwives alliance groups. I also have an aunt who is a midwife who was able to make suggestions and verify things for me.

Being pregnant, I also had easy access to my obstetrician for questions. It became common for my prenatal check-ups to consist of a quick blood pressure check, followed by twenty minutes of question time about my novel. In the hospital after having my daughter, I had a fantastic midwife who shared many stories with me about unusual or memorable births. I was stunned by the level of skill and expertise that was required, and the host of things to be prepared for during labor. But what I remember most about our conversations is her awe and respect for mothers in labor, and I attempted to weave this awe into all three of my POV characters, particularly Neva.

Q 4. What are some of the weird and wonderful facts you’ve learned about midwifery and birth during your research?

In the past, midwives were known to secretly harbor unwed mothers, perform abortions, baptize babies, and serve as pediatricians for the first year of the baby’s birth.
May Babies Are The Heaviest: Babies born in May are, on average, 200 grams heavier than any other month.
Centuries ago the midwife would catch the baby in her apron!
In the US, midwifery is only licensed or regulated in 21 states. In most states licensed midwives are not required to have any practice agreement with a doctor.

Q 5. One of your protagonists has issues with her mother. Did you draw on personal experience for this?

Actually, my mother and I have a very close—verging on boring—relationship. Though we are quite different (she is private and conservative like Neva, and I am like Grace—pushy and talkative and loud) conflict between us is rare. So I wasn’t able to draw on that relationship from a dysfunctional perspective. That said, I was able to identify with loving someone who is very different (not just my mother, but also my husband and my son), and learning how to love them the way they need you to. Above all, the key is respecting the person for who they are, and always looking for the good they can offer.

Q 6. How can readers get in touch with you and support your work?

I am very active on Facebook, Instagram and Twitter. I have also started spending more time on Goodreads. My website www.sallyhepworthauthor.com is the place to go for book information, upcoming events and my bio.

Thanks for listening (reading)!

Sally x

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Disclosure: I received a complimentary copy of the book for review purposes.

Talk Books: The Secrets of Midwives

Nov10

“By the time the baby boy spilled into my arms, I knew. Women were warriors. And I wanted to be part of it.” –Neva Bradley

(character in The Secrets of Midwives by Sally Hepworth)

While feeling somewhat pre-laborish in the last days of pregnancy, I stayed up way too late devouring a review copy of the new novel The Secrets of Midwives by Sally Hepworth. I got it in the mail in the afternoon and by 1:30 a.m. that night, I’d finished the whole thing! In the past, I’ve been heard to remark that I can think of few things better than a novel about a midwife. Well…how about a novel about three midwives? That’s right, The Secrets of Midwives interlaces the three stories and pivotal life journeys of three midwives, who happen to be grandmother, mother, and pregnant daughter. Each midwife has a different personality and style of practice. In an intriguing style that kept me turning pages, the chapters are split between the viewpoints of each, allowing for multiple perspectives on the same relationship and personal issues.

Floss, the grandmother/mother, is retired from midwifery, but her chapters alternate between her early experiences as a midwife in the UK and her current life as a natural childbirth instructor. Neva, the daughter/granddaughter, is a hospital birth-center based CNM who is hiding her unexpected pregnancy with her own first child. Grace, the mother/daughter, is a CNM who attends homebirths.

The Secrets of Midwives contains elements of a romance story and elements of a mystery story. It blends the three women’s midwifery journeys in a creative, engaging way, including exploring the complex quality of mother-daughter relationships and communication vs. secret-keeping therein. It is serious enough to keep the pages turning, but not so “heavy” as to be depressing. There is a subplot in which the homebirth midwife is investigated by the state nursing board for possible malpractice and it felt relevant and contemporary to the fears and risks faced by midwives around the country. And, while reading as a pregnant woman myself, I appreciated that in this novel, with one pivotal exception, there are no scary births with bad outcomes—I find that high drama births resulting in maternal or infant death are a common feature of midwifery novels that often makes them somewhat iffy reads for pregnant women!

“That superhuman feeling people describe? It has nothing to do with the way the baby comes out. It’s about what happens to the mother. You become superhuman. You’ll grow extra hands and legs to look after your baby. You’ll definitely grow an extra heart for all the love you’ll feel.” –Neva Bradley

(in The Secrets of Midwives)

THE SECRETS OF MIDWIVES by Sally Hepworth

Find the author on Facebook here and her website here.

Published by St. Martin’s Press

On sale February 10, 2015

ISBN-13: 978-1-250-05189-9 | $25.99

—

Disclosure: I was provided with a complimentary copy of the book for review purposes.

National Midwifery Week!

Oct8

Lots of events in October! I just found out that National Midwifery Week is October 5-11 (same as Babywearing Week). It is finals week for me (I teach on an 8 week session schedule) and so I don’t have time for a lot of things other than grading, but I did pluck some delicious quotes out of past blog posts…

“It’s hard to describe if you’ve never been there, but to watch a woman access her full power as a woman to give birth is awe-inspiring, and I never get tired of being witness to it. It’s an honor to watch that transformation take place.”

~ Julie Bates, CNM

“There is no ‘normal’ birth–each is individual and nonconforming. Childbirth opens an extraordinary spectrum of physical, emotional, and spiritual growth opportunities that is nothing less than extraordinary, which women should be supported in freely exploring. The Midwife must guard parameters of safety, yes, but she should also encourage women to play their edges, experience deep currents of emotion, discover their own ways of transformation, and chart new creative territory.”

–Elizabeth Davis

“Midwifery asks us to truly become at home with ourselves, with nature, and with women. Birth takes us out of our external experiences, our linear timing of progress, and our everyday rituals. In contrast, birth time is measured in a circular movement like the seasons. There are rhythms and patterns. If we let birth unfold with spontaneity and attuned to nature, we will end up appreciating the nature of our souls as well.”

–Mary Sommers (More than a Midwife)

To me, midwife means: loves women. I wrote about this idea in a past post:

I know the traditional root of the word midwife is “with woman” some sources say “wise woman”, but I’d like to offer another. When I was pregnant with my second son, I had a wonderful midwife and we spent many hours together talking about birth and midwifery. During one conversation she said to me, “you can’t be a midwife unless you love women.” This struck me profoundly—a midwife must love women…

via Midwife means “loves women”… | Talk Birth.

To acknowledge midwifery week and the profound gift of service offered by midwives to so many women, we also set up a special discount code in our etsy shop. It is our best one ever: 20% off a purchase of $12 or more (expires October 12). This could be the perfect opportunity to find a special gift for your midwife! To receive the discount use midwifeweek2014 for the 20% on $12+ (Remember, this week only we also have one for International Babywearing Week: babywearing2014 for 15% off any purchase.)

We’ve been working on improving our colors for our birth art sculptures recently and are finally getting some really nice results! We also have new pigments ordered so we can do even more colors soon.

Tuesday Tidbits: Human Rights and Birth

Jul22

“It takes force, mighty force, to restrain an instinctual animal in the moment of performing a bodily function, especially birth. Have we successfully used intellectual fear to overpower the instinctual fear of a birthing human, so she will now submit to actions that otherwise would make her bite and kick and run for the hills?”

–Sister Morningstar (in Midwifery Today)

When I end my introduction to human services class and then again when I begin my social policy class, I ask my students to consider the above: What would happen if everyone cared? What would happen if our first reaction was compassion? What would happen if we focused on what matters? What would happen if we assumed everyone had inherent worth and value and deserves humane care and compassion?

I have said for a long time that women’s rights in birth represent a human rights issue, so I was very interested to receive word of a Human Rights in Childbirth campaign:

Women do not lose their basic human rights once they become pregnant. And yet, across the globe, women’s human rights are compromised and violated around childbirth. Examinations, interventions and procedures that pose risks to both mothers and their babies are routinely performed without informed consent, or through coerced compliance via threats or fear. When women come out of childbirth with post-partum PTSD from disrespect, abuse, or obstetric violence, the goal of a “healthy mother and healthy baby” has not been met.

via Home | Human Rights in Childbirth.

Childbirth IS a women’s rights issue and a reproductive issue:

Childbirth is a women’s rights issue and a reproductive justice issue. The United States maternity system is one of the costliest in the developed world, yet our birth outcomes compare poorly to those of other industrialized nations. Among industrialized countries, we consistently rank last or second to last in perinatal and maternal mortality rates. Moreover, birth is depicted in mainstream media with fear, medical intervention, and crisis…

via Business of Being Born: Classroom Edition | Talk Birth.

But, childbirth is also, quite simply, a human issue:

This is the whole point—women’s rights aren’t about “taking” rights from anyone else OR about demanding “special treatment,” they are important for a HUMANE WORLD for all people. I think it is hilariously awful that “women’s rights” are considered a political issue and that there is a section about “women’s rights” in the “opposing viewpoints” database for my social policy class. As long as women’s rights are considered a political issue or as something about which an opposing viewpoint can be held, rather than as self-evident, we are in continued, desperate need of revolution.

via Women’s Power & Self-Authority | Talk Birth.

Human rights in childbirth include access to the provider of one’s own free choice, so on a related note check out this set of consumer-oriented materials about the midwives model of care offered by collaborative effort of several midwifery organizations and endorsed by several others:

“Normal Healthy Childbirth for Women & Families: What You Need to Know” clearly explains and advocates the benefits of normal, physiologic birth for the average health care consumer. This helpful tool was created from a 2012 consensus statement developed by ACNM, the Midwives Alliance of North America, and the National Association of Certified Professional Midwives.

via OMOT Normal Birth Document Feature Page.

The below quote may seem obvious to birth advocates, but it is revolutionary in terms of health care. When Citizens for Midwifery shared this quote, they noted that, “One the KEY findings of the Lancet Special Series on Midwifery affirms the importance of women and their families participating in planning of health care.” For more from this special series on midwifery, go here: TheLancet.com.

And, in case we get so caught up in theorizing about appropriate care that we forget the lived experiences of the women who need it, read this tough, sobering article about why “going in pushing” does not a VBAC birth plan make:

Karen’s story is not uncommon and nor is the advice she was given about “going in pushing” but when we tell women they can not be cut unless they consent are we telling the truth? Whilst it’s true that legally the hospital can not physically force you into an operating theatre without your consent, they are not afraid to gain consent using underhand methods…

via Go In Pushing – It’s not a VBAC Birth Plan – Whole Woman.

And, of course, some relevant quotes to remember:

“If women lose the right to say where and how they birth their children, then they will have lost something that is as dear to life as breathing.” –Ami McKay

“Mothers need to know that their care and their choices won’t be compromised by birth politics.” – Jennifer Rosenberg

via As dear as breathing… | Talk Birth.

Is there anything that can be done, or are we facing an insurmountable struggle? I think we can remember that our “small stone” birth activism does matter:

While reading the book The Mother Trip by Ariel Gore, I came across this quote from civil rights activist Alice Walker: “It has become a common feeling, I believe, as we have watched our heroes failing over the years, that our own small stone of activism, which might not seem to measure up to the rugged boulders of heroism we have so admired, is a paltry offering toward the building of an edifice of hope. Many who believe this choose to withhold their offerings out of shame. This is the tragedy of our world.” Ariel adds her own thoughts to this: “Remember: as women, as mothers, we cannot not work. Put aside your ideas that your work should be something different or grander than it is. In each area of your life—in work, art, child-rearing, gardening, friendships, politics, love, and spirituality—do what you can do. That’s enough. Your small stone is enough.”

These quotes caused me to reflect on the myriad methods of “small stone” birth activism that can be engaged in as a passionate birth activist mother embroiled in a season of her life in which the needs of her own young family take precedence over “changing the world”…

via Small Stone Birth Activism | Talk Birth.

And, on a fun note, you might enjoy this lovely homebirth treasury on etsy: Home Birth by Kayleigh on Etsy. 🙂

“Thousands of women today have had their babies born under modern humanitarian conditions–they are the first to disclaim any knowledge of the beauties of childbirth…” –Grantly Dick Read, Childbirth without Fear

“I am not free while any woman is unfree, even when her shackles are very different from my own.” –Audre Lorde

“Humanizing birth means understanding that the woman giving birth is a human being, not a machine and not just a container for making babies. Showing women—half of all people—that they are inferior and inadequate by taking away their power to give birth is a tragedy for all society.” –Marsden Wagner

Tuesday Tidbits: Pregnant Woman

Jun10

I’ve got a whole collection of thoughts rolling around and wanting to be shared! Tonight is my teaching night, however, so I have to boil it down.

First of all, I’m 20 weeks pregnant already! I can hardly believe it, though I also feel as if I’ve been pregnant for a “long time” too. I remain in a state of being both constantly aware of being pregnant and constantly in something like disbelief or “denial.” I feel surprised when I see myself in the mirror and in my head I still feel distanced from the idea of being pregnant and the identity of Pregnant Woman. It still feels somehow “far away,” like that chapter of my life is still closed for me mentally.

This picture was taken at the St. Louis Renaissance Festival on Sunday, one day before 20 weeks. I wasn’t sure my pretty Holy Clothing dress would actually still fit, but it did!

One of the reasons I decided to hire a midwife for this pregnancy was because I feel like I need to bring it back into the front of my mind and to give time and attention to this experience. I need some time to focus on being pregnant and on my new baby and have interaction with someone who cares about exactly that. I need someone to pay attention to me as Pregnant Woman and to care about me in that way that midwives do so well.

I finally added a couple of items to my Amazon wish list for new baby boy as well. I’m intrigued by this Nesting Days carrier and also by the new Ergobaby Four Position 360 Baby Carrier.

(Yes, I do still have Alaina’s Ergo, but apparently I think maybe each baby needs its own new baby carrier!)

With regard to Pregnant Woman, I took the leap and signed up for the online Sacred Pregnancy retreat training in August. I’ve thought about it several times and now feels like the right time for me—I hope to benefit from it both personally and professionally.

Signing up for this training represents another moment of Leonie Dawson‘s #AmazingYear workbook 100 Things list, ftw. I had it on my list as a tentative, but it has now become a reality.

Speaking of the Amazing Year workbook, I’m gearing up to give two presentations at the La Leche League of Missouri Conference coming up this week. I’m doing a session on the amazing year and my first continuing education eligible session on active birth/pelvic mobility. I’ve been working hard on preparing for both sessions as well as getting all of our booth stuff ready, since we’ll be having a Brigid’s Grove booth at the conference too. (Mark will be working at it while I attend sessions.) My LLL Group also has a sales table in the boutique for which I am providing most of the items and we also got silent auction donations ready over the weekend.

Back to the Renaissance Festival where some dear friends were working as pirates, I received this lovely surprise birthday gift.

It is perfect for my Red Tent plans for August!

Speaking of the Red Tent, I enjoyed watching this video again today and thinking about my plans and wishes for this event:

And, surfacing from celebration and shifting to the pain women experience as part of the childbearing year, I appreciated two powerful articles this morning. The first was about a backlash to the backlash with regard to traumatic birth:

If we want to reduce the prevalence of traumatic birth experiences, we’re going to have to confront some common expectations, narratives, and perceptions around childbirth to help shape women’s beliefs and emotionally prepare them for the realities of childbirth. Childbirth is often glamorized as a spiritual journey, but physically, it is called labor for a reason. Sure, it can be a transcendent experience for many women, but it can also be a challenging ordeal involving blood, sweat, and tears, among other bodily fluids. Without adding any other stressful or complicating circumstances, childbirth already has all the necessary ingredients to be bewildering, frightening, and emotionally exhausting. And yet, because of the subjective nature of experience, two mothers can have the same events happen during birth, and one can emerge merely rattled while the other emerges with PTSD.

A good place to start with recalibrating beliefs and expectations of childbirth is with the image of an ideal birth with little pain, no complications or medical interventions, dim lights, and soft music. It’s a lovely and inspiring conception of birth, but we should also acknowledge that absolute perfection is rarely a reality. Most births don’t have complications but some do, and it is unfortunate when women feel they or their births are failures for failing to meet their preconceived notions of success. Women should strive for a birth that is manageable and meaningful, but without a sense of entitlement that it must be fast, painless, and stoic. Holding unrealistic expectations of childbirth can set women up for disappointment…

via Recalibrating Our Expectations of Childbirth | Cara Paiuk.

(Just a note that the conclusion of this otherwise powerful piece felt a little forced and a little too close to “at least you have a healthy baby” for my taste.)

And, then there was this essay about a cesarean picture on Facebook that was reported as “violent”:

This is motherhood. Raw and uncut. Refuse to be silent, show up and stand out, rip off the covers and be seen. This is the motherhood behind closed doors. This is the warriors path and these women are foot soldiers on the battlefield to make miracles and bring fragile lives onto this Earthen soil. Don’t let anyone tell you your birth wasn’t beautiful, that that your moment of utter transcendence wasn’t real. Never believe for a moment that you, too, did not emerge a butterfly…

via A Slightly Twisted Fairy Tale » The warrior with a scar.

The cesarean post reminded me of some of my own previous posts about Cesarean Courage. And, the piece about recalibrating childbirth reminded me of these two articles, the first about the strength found in our most shadowy “what’s ifs” and darkest places:

I’ve also come to realize that despite the many amazing and wonderful, profound and magical things about birth, the experience of giving birth is very likely to take some kind of toll on a woman—whether her body, mind, or emotions. There is usually some type of “price” to be paid for each and every birth and sometimes the price is very high. This is, I guess, what qualifies, birth as such an intense, initiatory rite for women. It is most definitely a transformative event and transformation does not usually come without some degree of challenge. Something to be triumphed over or overcome, but something that also leaves permanent marks. Sometimes those marks are literal and sometimes they are emotional and sometimes they are truly beautiful, but we all earn some of them, somewhere along the line. And, I also think that by glossing over the marks, the figurative or literal scars birth can leave on us, and talking about only the positive side we can deny or hide the full impact of our journeys. What if it was okay to share our scars with each other? Not in a fear-mongering or “horror story” manner, but in honesty, depth, and truth—what if we let other women see the full range of our courage?

via What If…She’s Stronger than She Knows… | Talk Birth.

And, the second about the many possibilities for birth regret:

I’ve come to realize that just as each woman has moments of triumph in birth, almost every woman, even those with the most blissful birth stories to share, have birth regrets of some kind of another. And, we may often look at subsequent births as an opportunity to “fix” whatever it was that went “wrong” with the birth that came before it. While it may seem to some that most mother swap “horror stories” more often than tales of exhilaration, I’ve noticed that those who are particularly passionate about birth, may withhold or hurry past their own birth regret moments, perhaps out of a desire not to tarnish the blissful birth image, a desire not to lose crunchy points, or a desire not to contribute to the climate of doubt already potently swirling around pregnant women…

via Birth Regrets? | Talk Birth.

Last night, I enjoyed looking at photos from a very interesting art exhibit called Mama that explores birth as a creative process…

The artist has a beautiful etsy shop as well in which she sells her “mamamore” sculptures:

I’m currently looking into ways to reproduce some of my own sculptures, so that I can make them more readily available to women without burning myself out in the process. Here is a photo of a recent batch that mostly headed to Canada for a shop there, with a few extras that went on etsy (and a few are prototypes for possible casting in resin).