Birth Services

23/10/2025

Yes!

12/10/2025

From Dr Rachel Reed: "this musing, I want to suggest an alternative focus: supporting spontaneous, uncomplicated labour and vaginal birth. First, AIWH statistics that give us some clues about the underlying cause of c-sections and potential remedies:
• Giving birth vaginally was significantly more likely to happen when labour began spontaneously. Only 15.3% of women who had a spontaneous labour had a c-section, compared with 23.6% who had an induction (further evidence that the ARRIVE Trial does not apply to the Australian context).
• 80.8% of first-time mothers with a singleton, cephalic baby who went into spontaneous labour had a vaginal birth (though this figure includes instrumental births, which accounted for 19.5% of all first-time mothers).
• More first-time mothers had their labour induced (39.7%) than went into spontaneous labour (39.3%).
• 20% of first-time mothers had a planned c-section with no labour.
• The most common reason for a c-section was a 'previous c-section'.
• Only 21.8% of women who had a previous c-section had a spontaneous labour with their next baby, compared to 71.2% who had a repeat c-section with no labour. 6.9% had their next labour induced (reflecting the risks of induction for VBAC).
• There is no information about what % of women had a repeat c-section after planning a VBAC. My hunch is that a lot of women planning VBACs ended up being labelled 'high risk' at the end of their pregnancy due to the ever-expanding list of reasons (age, BMI, big baby, small baby, term gestation, etc., etc.). And because induction is risky with VBAC, a repeat c-section is recommended.

In summary, the first birth appears to be the key, because most c-sections are performed on women who have already had one.

Women who went into spontaneous labour had the lowest rates of c-section. Increasing the rates of vaginal birth for first-time mothers AND supporting more women to have a VBAC are the most critical factors in reducing the overall c-section rate.

We need to focus on what we want, not on what we don't want. Instead of pressuring maternity services to simply reduce c-section rates, I'd like to see reporting that tracks improvements in the rates of spontaneous labour and non-instrumental vaginal birth. By shifting our attention here, c-section rates will reduce as a side effect.

Here are the statistics I'd like to see governments, organisations and institutions reporting, to truly reflect the effectiveness of maternity services in supporting physiology:
Statistic 1:
The percentage of first-time mothers who:
• Go into spontaneous labour (without any induction methods, including membrane sweeping)
• Labour without augmentation (no ARM or syntocinon)
• Give birth vaginally without instruments or an episiotomy
• Remain physically well throughout (no complications such as a PPH)
• Have a healthy, well baby
AND
• Rate their birth care as supportive and respectful.

Statistic 2:
The percentage of women planning a VBAC in early pregnancy who:
• Go into spontaneous labour (without any induction methods, including membrane sweeping)
• Labour without augmentation (no ARM or syntocinon)
• Give birth vaginally without instruments or an episiotomy
• Remain physically well throughout (no complications such as a PPH)
• Have a healthy, well baby
AND
• Rate their birth care as supportive and respectful.
If we shift our reporting lens towards supporting spontaneous, uncomplicated birth and respectful care, we will see the rates of c-section decline to levels where they reduce harm rather than cause it."

19/07/2025

https://www.instagram.com/p/DMQv7gzxyFF/?img_index=2&igsh=a2JycmE1OGJ3MjRn

30/06/2025

I taught one of the Massachusetts Midwives Alliance midwifery classes on Saturday.
The class was about what might come up in the 3rd trimester.
A student asked why it was so common for birthing folks to get UTIs after birth. I hypothesized it might be due to dehydration or being catheterized during labor.
But check out this latest study!
And the reel commentor talking about post-birth genito-urinary symptoms similar to folks going through menopause - thin tissue, painful penetration, UTIs!
The more you know!

30/06/2025

"DearJoyce, we are so grateful that we were fortunate enough to have you attend the home birth of our son! Thank you so much for everything you did throughout my labor and his birth. The way you tiptoed around with such a respect for M and me being in a peaceful space throughout my labor, offering support at the perfect time, and taking the photos! I will cherish the photos you took forever. ❤ Thank you so much for those. I will never forget how you made me avocado toast and fed it to me in bed while I snuggled L on my chest right after he was born-absolute heaven! Thank you for all your hard work. You are truly so appreciated. ❤ Love, L & M

28/05/2025

11/04/2025

Practicing and keeping our suturing and IV skills up to date.

24/03/2025

Did your post birth instructions include:

- no stairs, no housework, no driving for a week.

- someone should bring breakfast, lunch and dinner and 2 snacks, cut up, to you in bed for a week.

07/02/2025

"Cerebral palsy is still the most common motor disability in childhood, and it’s now widely understood that the disability is more likely to be caused by prenatal factors prior than factors during labor anyway. In fact, not once since its rapid adoption has it been shown to improve the health of babies in any measurable way (Apgar score, rates of brain damage, NICU admissions, or death). The data hasn’t changed since those first few studies in the late 1970s: the only thing fetal monitoring has ever been shown to do is increase the cesarean birth rate which, since its introduction, has soared from 5% to 32%. It’s nothing more than a talisman, a relic, an amulet. And yet it continues to be used as a matter of course, despite the fact that the obstetric community knows this and has published damning study after damning study.⁷"

"What has been studied is the management of birth. We have pulled the cart before the horse — starting from what we do to birth rather than how birth itself behaves — and then we treat birth according to that logic. We limit what’s possible because we have never bothered to meaningfully investigate it. I don’t mean this as an indictment of obstetrics generally (well, not entirely anyway). But I do think we need to intervene in the idea that it is in any way “objective,” “rational,” “scientific,” or “advanced,” — or more importantly that it reflects any kind of truth. It does not. It is simply another belief system, not as unlike the belief system that I discussed among tradition Thai and Malay midwives in a prior newsletter as it would have us believe. Obstetrics is simply another culturally constructed and reproduced belief system, and a lot of its evidence is fragile. When we start to unravel some of the way obstetrics makes meaning about birth we begin to collapse the distinctions between what is commonly thought of as “modern medicine” and “tradition,” of “science” and “folk wisdom,” of “rational” and “irrational” practices around birth. "

Robina from Small Things Growing smallthingsgrowing@substack.com

29/08/2024

ACNM Region 1 Conference: Strengthening Midwifery Through Advocacy, Leadership, and Knowledge

Holyoke, MA US September 20, 2024 to September 21, 2024

Register Now!
Click on the "Program" tab to view the outline of the day

Date & Location:
Friday, September 20, 2024 & Saturday, September 21, 2024
8:30-5:00pm
Baystate Health Education Center, 361 Whitney Avenue, Holyoke, MA

Hybrid course: In-Person and Zoom

ACNM Sponsored Evening Gala
Black Birch Vineyard
108 Straits Road
North Hatfield, MA
Click here to register for the ACNM sponsored Evening Gala

Goal: The goal of this educational activity is to expand high quality reproductive health care though the lifespan with emphasis on the healthcare needs of marginalized populations and enhance leadership competencies to align interprofessional workgroups in working toward improved health outcomes and decreased disparities.

Jointly Provided by: Baystate Department of OB/GYN Division of Midwifery, American College of Nurse-Midwives (ACNM) Region I, Massachusetts Affiliate of ACNM, & Baystate Continuing Interprofessional Education

Target Audience: This course was designed for Midwives, student midwives, nurses, doulas, nurse practitioners, physicians assistants, physicians providing Ob/Gyn and midwifery care in New England, Puerto Rico, and NY State.

Date & Location: Friday, September 20, 2024 & Saturday, September 21, 20248:30-5:00pmBaystate Health Education Center, 361 Whitney Avenue, Holyoke, MA

21/09/2022

21/09/2022

In 2015 Jack Markell signed HB70 into law giving homebirth midwives licensure. 7 years later, The State of Delaware is the largest payer of birth services between State employees and Medicaid by a huge measure but srefuses to cover homebirth services. Why did the governor sign a bill into law knowing that the benefit would remain out of reach to all but a few? Why do our legislators talk about wanting to reduce health disparities but keep the most obvious intervention, allowing those being harmed by the medical industrial complex birth in a place of safety, in the care of a competent community midwife out of our reach?

Want to join me in making a difference? I'm raising money to benefit Ubunt… Michelle Drew needs your support for Black Midwives and Doulas for Black Families