Dear Nate and healthcare meeting participants,

I’m sorry I didn’t get around to writing this email sooner.  My 18 month old has been teething and she missed her mommy this morning.  We had some much needed family time this afternoon!

I am so grateful for your participation in the meeting we had today.  So many good and earnest people came together to honestly share their experiences with the failures of the for-profit healthcare system.  I am especially grateful to the members of the MAMA Campaign, who shared their vision for lowering costs and improving outcomes in maternity care by increasing access to Certified Professional Midwives, and the supporters of MomsRising who spoke so eloquently to the ways in which women in particular are disenfranchised by the broken healthcare system.  When we take time off to care for our children, we either pay a huge part of our family income to get access to healthcare or we lose our insurance and gamble the financial health of our families on whether or not we get sick.  We spoke with one voice about the importance of reform and our support for government provided universal healthcare.  Many of us even expressed our willingness to pay more taxes to provide funds for
this important undertaking. 

I want to thank each and every person who shared their personal stories in the hopes that someone else’s life would be improved if they spoke out.  And, Nate, I want to thank you for listening and joining in and taking our words and ideas to share with the Senator. God bless you all for taking the time to work for a better America. 

Sincerely,

Alison Cole Duren-Sutherland

We all know I love Rachel Maddow.  I cheesily sent her an email today.  As the only mainstream news person who really paid attention when Dr Tiller was shot, I thought maybe she would think about covering the role of midwifery in the health care debate.  <Sigh>  A girl can dream..

Rachel,

I've worked in abortion care for six years now, and I want to thank you so much for your unflinching coverage of the murder of Kansas abortion provider and Christian grandfather George Tiller.  There weren't really any other places in the media where I felt like someone care about the experience of clinic workers in the wake of such terrible violence.  Thanks for "getting it" in a way that even my own partner, who is pro-choice because he knows it's none of his business, did not. 

I am also really grateful for your coverage of health care reform.  These days at the abortion clinic, I'm doing the health insurance billing, and this perspective on the health care system has made me a somewhat obsessive advocate for health care reform.  Profit-driven insurance companies need to be reigned in.  Only in the health care arena does the consumer not know what they will be responsible for paying until long after they have been provided with services, because insurance companies are not bound by the information they give to patients and doctor's offices about what will be covered. 

The real reason I am writing to you right now, though, is because I think you might be able to "get it" on another issue that is sometimes invisible to the mainstream media, probably because, like abortion, it is a women's health issue.  But it is also a health care reform issue, a public health issue, and a deficit reduction issue:  midwifery care and out of hospital birth.

The US has abysmal maternal and infant mortality rates, while spending huge amounts of money on high-tech maternity care, most of which came into use before it's benefits had been rigorously demonstrated.  Health care reform needs evidence-based birth care.  Science is now beginning to back up leaving birth alone, and when women give birth with minimal intervention, the cost-savings is huge.  That is why Certified Professional Midwives need to be a part of health care reform.  If CPMs were federally recognized as eligible for reimbursement by Medicaid, poor women would have increased access to safe, evidence-based, low-cost care.  In the midst of all the corporate advocacy happening in Washington, women from the MAMA Campaign and The Big Push for Midwives are trying to get the voices of women and families heard.  I am writing to ask you to cover the movement for the full range of reproductive justice in health care reform.  

The bottom line is that we need to reduce health care costs, or health care reform just won't work.  Women who choose to prevent pregnancy when they are not prepared to be parents save money for their insurer (the state in the case of a public plan).  Women who do not wish to be pregnant but are will save their insurer money by choosing abortion.  Women who are carrying a pregnancy to term and wish to seek midwifery care in an out of hospital setting will save their insurer money because interventions will be reduced.  Any reasonable insurer, while not mandating a woman to do any of these things, will provide her the coverage to do these things if she so chooses.  By honoring a woman's own wisdom about her reproductive choices, insurers win as does the dignity of the woman, who is given every opportunity to control her reproductive destiny. 

I am a huge fan and love listening to your show on my computer at work.  Thanks for what you do. 

Sincerely,

Alison Cole Duren-Sutheralnd

In becoming a mother, I fell in many ways like I have fulfilled a destiny.  Whether it was taught to me by my culture, or whether I had an innate desire within me, I have always wanted to be a mother.  I conceptualize God as mother, giving birth to all things from Her body.  The Mother is an feminine archetype, and birth is her rite of passage.  I am musing more and more these days on what it means to mother, mother well, mother on our own terms, release the way we were mothered to become our own embodiment of Mother.  I am studying to be a midwife, the guide for women on their own journey into motherhood, and my own daughter is growing.

I believe in the equality of all people.  But I am also very strongly woman-identified, as a women's reproductive health worker and myself a mother of a daughter, and a woman raised in a house by mother and grandmother.  In my activism, I suppose part of me feels that men, so long the privileged sex, can take care of themselves; to make equality, we need to make things better off for women, so long subjugated around the world, even into the 21st century.  And I know that what is good for women is good for societies, as mothers are responsible for raising the citizens.  My work for women, my passion for women's issues is human rights work. 

However, my woman-focus can serve to alienate men, even my dear feminist male partner.  It's a bummer, and something I need to focus on correcting.  The other day, he reminded me that our home-birth wasn't only beneficial to me and Ramona, but also to him, and that my birth work is not only about women, but people, families.  It is absolutely true.  But full control of our bodies is something that white men take for granted and women & people of color must fight for; and men can choose not to participate in the realities of pregnancy, birth, and parenting but women cannot.  So, I fight for women.

Jamie said that he thinks this is a change in me, being so woman-identified.  I still care about humanity as a whole.  But my work in this life is with pregnant women, and as my learning progresses,  I am seeing everyday more clearly how all my work comes together.  I also know that I could not do this work, I could not support women (and families) without some balance in my life; Jamie's masculinity helps to bring balance into my life.  His support and love have been absolutely necessary for me to progress on my journey toward midwifery and women's health advocacy.  I am so grateful for him, and the family that we have made together.  He is the partner that I need to do this work. 

Abortion, contraception, VBAC and homebirth are not currently illegal in the US, though all may be difficult to access, especially for poor women.  But there are those on every side who would choose to legislate away women's bodily autonomy -- the AMA would like to outlaw homebirth, and those who would like abortion to be illegal (and thus illicit and dangerous) proudly call themselves "pro-life".  Thank God I gave birth to a daughter in country where women have reproductive rights allowing us to give birth in the manner of our choosing.  Thank God we have the legal right to choose to end unwanted pregnancies and give birth in our homes to wanted children.  I pray that I will some day live in a country where poor women can have access to subsidized homebirth midwifery and abortion care. 

I am so grateful to have been able to make it out to the organic farm to pick chard and blackberries.  The chard I froze, the berries I made into canned jam for Solstice gifts.  Now, I have apples and pears cooking down into fruit butter on the stove, which I picked from the orchard on the land where my father lives.  Participating in the journey of food from farm to kitchen and then to a friend or into my own body is satisfying and meaningful for me.  It connects me to the bigger cycles, to the wheel of the year, which just turned to autumn with the Equinox last week.  Certainly, I feel the wheel turn this year.  Ramona is saying "mama" and "dada," the first harvest of all the language she has heard and the love we have given her these past seven months.  I am reaping the fruits of the seeds we have sown, figuratively and literally, as big changes come down the pike for our little family. 

I am so grateful to have found a job back with my old employer in a new part-time position with flexible hours to allow for mothering and eventually midwifery apprenticeship.  Jamie and I will now spend just about equal time away from home doing paid work, and equal time at home with the babe.  When I told a friend about this, he gave me kudos for putting my gender equity money where my mouth was, but that's not why I wanted to do this.  Jamie's been miserable at work, and although being an at-home parent is no cake-walk, we both love spending time with Ramona, and I think part of Jamie's unhappiness has been missing his time with her.  We'll both have the joy of coming home to her after a day at work, along with the joy of waking up in the morning with a whole day filled with her ahead of us.  And the added bonus of saying fuck you to traditional gender roles. 

I am so grateful that I Jamie and I love mothering my daughter, but I'm shocked by the way my mothering is policed.  At my 10 year high-school reunion, another woman with a baby approached me and gushed, "Don't you just LOVE being a mom?"  Pushing the stroller with the sleeping baby in it the other day, lost in thought, a stranger said to me, "Smile when you do that, that's the joy of your life."  And I do, and it is, but what did they know about it?  As a woman, I'm supposed to be Joyfully consumed by my baby, and otherwise happily vacant.   Jamie, however, is not really supposed to be as absorbed with Ramona, but plagued by a general anxiety about financially supporting us.  He isn't expected to smile.  And then there are the people who are shocked to hear that she's a girl, just because she isn't wearing a dress or pink or ruffles.  There are people that expect us to introduce formula, have her sleep in her crib, follow the CDC vaccination schedule, put her in day care, and on and on.  I'm glad that we're strong enough to figure out what works for us as parents without paying attention to what everyone else thinks our parenting ought to look like. 

I am troubled by Sarah Palin and the furor surrounding her, and yet I'm going to contribute to it by writing this post.  As a midwife, I'm supposed to keep my politics to myself, but as a midwife I have a hard time not speaking out against anyone who would deny women autonomy over their own bodies.  It is a fact that the push for fetal  "personhood" and fetal rights which trump those of the pregnant woman has lead to hospitals getting court orders to perform cesareans on unconsenting women who wish to birth outside the hospital or simply wait to give birth in their bodies' own time (see National Advocates for Pregnant Women for more on this scary phenomenon).  People who want freedom to birth in their own way need to think twice before supporting politicians who want the law to respect the rights of fertilized eggs more than the rights of grown women.  Women need to be trusted to know what's best for their families.  Sarah Palin and her daughter have both made choices about their childbearing that need to be respected.  Women who choose homebirth make choices about their childbearing that need to be respected.  And women who choose abortion are also making valid choices that deserve to be respected.  I have seen women with disabled children choose abortion so that they can continue to provide full-time care to the special-needs child they already have.  It takes more than an antiabortion stance to support special-needs families.  It takes government-subsidized healthcare, childcare, sick and family leave.  I don't agree with Ms Palin's assertion that we necessarily need to reduce the number of abortions in this country, unless she's talking about reducing the number of unplanned pregnancies.  Shaming women into bearing children they do not want and cannot afford while denying them the education to prevent unwanted pregnancy is not valid goal, and that is all that Sarah Palin has to offer if she advocates both abstinence-only sex education and reduing the number of abortions.  But I am more deeply troubled by the way in which Sarah Palin and her daughter are being used by the old boys of the Republican party.  They knew her daughter was pregnant, that she had a disabled child, and they picked her to showcase these ways in which she did her woman duty and chose "life" (note that she had the choice).  They have allowed her to speak freely a total of once so far, and in that interview with Charlie Gibson she was less conversant than most of the people I know on foreign policy.  But she is the Republican's ticket onto the cover of People  magazine, and so what is between her ears is less important than her uterus.  And they can use her femaleness to call foul on any reasonable criticism of her as a candidate.  It will be a tragedy if her nomination leads to the defeat of candidates who pledge to help mothers and families with programs like paid family leave and equal pay for equal work. 

I got an email newsletter from a local parenting publication, the whole purpose of which was to promote "Heelarious," makers of baby's first high-heels.  Yes, that's right.  High-heeled shoes for baby.  Don't believe me?  Here's the link.  Sure, these shoes are soft, they don't impede baby's attempts at standing (supposedly), and they don't have the square-peg-in-round-hole fit of most women's dress shoes, but sheesh!  High heels are ridiculous things for grown women to wear, let alone tiny babies.  I want to encourage my daughter to wear clothes that are comfortable for her body, and putting her in high-heel look-alikes before she can walk seems counter to this notion.  How many of the back pains we see in pregnant women would be alleviated if only these women eschewed high heels during pregnancy?  I fired off an email telling the publication I thought there promotion was in poor taste, but I guess I should expect this sort of thing in a world where my child is assumed to be male if she's not conspicuously dressed in frilly pink crap. 

Maybe my sense of humor has been dulled by my daily struggle to transcend the heteronormativity of my family's current existence -- I am desperately trying not to become a housewife, and to figure out how my partner can have an equal role in parenting while working 40 hours a week to support us.  When daddy's around, I want him to be as present, as in-tune to her needs as I am, and he simply doesn't have enough opportunity to, nor can he provide for her needs in the same way I can (what with the breastfeeding).  For the most part, my days with Ramona are pure joy.  But in the past four months, I've been away from her for only about ten hours total, and it's enough to make me feel sometimes like THE parent rather than part of a team.  I am at the last frontier of gender equity, trying desperately to reconcile the separate-but-equal nature of parental equality in these early days of our parenthood, trying to believe in a time when our equality will be more equal.  I know it's coming, and that one day I'll mourn the loss of the intense connection I have now with my baby girl.  But for now, I need to get out more, and when I do, I'll be wearing sensible shoes.

I don't often read Time magazine, but a few articles lately have caught my attention, and not in a good way. "Choosy moms choose caesareans" (found here) perpetuates the myth of the "maternal choice" caesarean. While the article's authors were able to find a lady who truly sprung for elective abdominal surgery to deliver her baby, such women are the exception rather than the rule. The only survey to actually ask women if they chose c-section (the Listening to Mothers survey, found here) found that many women in fact felt pressured by their doctors to undergo the surgery.  I firmly believe that a woman's informed choices around pregnancy and birth should be honored. I bet, though, that this woman's wasn't told that her risk of dying was quadrupled by choosing surgical over vaginal birth for her baby, and I bet no one discussed with her the epidemic of physician-caused prematurity that has risen along with the c-section rate (reported by the New York Times here.  Nonetheless, I'm glad the woman featured in the article had her birth choices respected by her care provider.  But, should she decide she wants a vaginal birth for her second baby, she'll likely see the tables turn.  In spite of the fact that there is evidence that VBAC is safer for moms and babies than repeat surgery, most likely this woman would be unable to find a provider who would respect her choice to VBAC. If she lived in my home state of Washington, there's be one hospital in Seattle she could go to, or she could find a midwife practicing off the radar, risking her own neck to offer women the choice to VBAC in a very hostile climate.  So, Time Magazine, where's the article supporting women's choices to birth vaginally?

I guess they were too busy writing the article undermining women's choices to terminate a pregnancy.  "Study Links Abortion and Preemies" (found here) has quite a title, but they're already backpedaling by the second sentence.  The data is from 1959 to 1966.  Roe v. Wade?  1973.  So, yes, folks, if we're talking about data from a time where abortions were illegal (and we include miscarriages as "abortions," which the study also does) then, yes, we've got a study that links abortion and premature births.  Please note:  this study does not demonstrate a link between safe, legal abortion performed by a  trained health care provider and ANYTHING.  "Women  need to be informed about these risks," says the researcher who  penned the study.  But the truth is, as Time points out, this study doesn't really say anything about  risks to women who choose abortion today.  Grr.