Women Giving Birth at Home Without Midwives - ABC News

I was quite pleased with this article, actually.

Women Giving Birth at Home Without Midwives

Women taking back control of birth by having 'freebirth' babies at home without medical help

By JEFF BARNARD Associated Press Writer
ASHLAND, Ore. November 19, 2009 (AP)
The Associated Press
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This photo taken Nov. 11, 2009 shows Jennifer Margulis and husband James di Properzio gazing at... Expand
This photo taken Nov. 11, 2009 shows Jennifer Margulis and husband James di Properzio gazing at their newest daughter, Leone Francesca, at their home in Ashland, Ore. When Margulis went into labor, there was no rushing to the hospital, no midwife, no EMTs called to a taxi cab. Just Margulis and her husband, home alone, giving birth. Nationwide, 90 percent of births still take place in hospitals with doctors, but it appears an increasing number of women are having what is becoming known as a free birth without trained medical help. (AP Photo/Jeff Barnard) Collapse
When Jennifer Margulis went into labor with her fourth child, she sent her husband off to take the kids to school, then waited at home for her body to do what she felt confident it had evolved over millions of years to do on its own.
There was no rushing to the hospital, no midwife, no EMTs. Just Jennifer and her husband, home alone, giving birth.
"I think a lot of people think a woman who would want to have an unassisted birth would be a little bit crazy," said Margulis, who holds a Ph.D. in literature, and is a contributing editor for Mothering Magazine. "I think I may have had that reaction as well. I am definitely not a crazy person. I am a very educated, thoughtful and caring person. I am not a person who takes a lot of unnecessary risks. The whole point is it is not risky if you do your homework."
Nationwide, 90 percent of births still take place in hospitals with doctors attending, said Oregon State University medical anthropologist and midwife Melissa Cheney. Another 8 to 10 percent are with midwives in hospitals or birthing centers. And 1 to 2 percent are at home.
The numbers of at-home births that are unattended are impossible to track, Cheney said.
But Internet traffic and books on the subject indicate more women are choosing to take control with what is becoming known as freebirth because they are concerned about the United States' dismal record of maternity care and skyrocketing rate of Cesarean births, now at nearly 32 percent of all births, Cheney said.
"I don't think they are just crazy," said Cheney. "I think they are trying to find a way to work around a system they see as very problematic."
Though the United States spends more money on childbirth than any other nation, it has one of the world's worst records for infant mortality and maternal mortality, said Cheney. The infant mortality rate is nearly 7 infant deaths per 1,000 live births, according to the Centers for Disease Control and Prevention, ranking the U.S. 30th in the world in 2005.
"The U.S. is really the butt of lots of international public health jokes," Cheney said. "`What a waste of money,' is usually the punchline."
This photo taken Nov. 11, 2009 shows Jennifer Margulis, center, husband James di Properzio,... Expand
This photo taken Nov. 11, 2009 shows Jennifer Margulis, center, husband James di Properzio, right,and daughter Hesperus, left, posing with the newest baby girl in the family, Leone Francesca. Margulis, a freelance writer, decided to have her fourth child at home without the help of a doctor or midwife. There are signs more women are choosing to do this, like Margulis, because they want a more private and intimate birth. (AP Photo/Jeff Barnard) Collapse
Dr. Erin Tracy, an obstetrician and gynecologist at Massachusetts General Hospital in Boston and assistant professor at Harvard medical School, said most women can give birth alone without any problem, but there are still small numbers — as high as 10 percent — who will run into complications, often without warning.
"What worries me is that very often women who have absolutely no risk factors develop an emergency complication," she said. "I can't imagine how you can possibly recognize that yourself, particularly if you have no medical training. Sometimes you have only minutes to intervene."
Tracy said the increase in C-sections appears driven by the high rate of obesity in America, more births of twins and triplets, more women asking for them, as well as the fear of lawsuits. The high infant mortality rate is related to the high number of premature births that can survive for a time.
"None of these make it, I think, a wise choice to have a delivery in a setting where no one has any training," she said.
Margulis' decision to have her child without medical help evolved.
She had a bad experience with her first birth in a hospital, and her second birth, which was with a midwife at home. A midwife also assisted with the third, but this midwife had half of her own 10 children unassisted, and was an inspiration for the idea. Margulis began interviewing midwives for her fourth birth, but as she learned more about doing it herself, she became convinced she could.
"I felt like when I read other peoples' stories, I felt like those were the most amazing women in the world and they were all so much stronger than I am," she said. "It wasn't true. In no way am I special or amazing. It's that if we let our bodies do what they evolved to do, what they know how to do, then any woman can have a safe unassisted home birth."
Jennifer Block, author of the book, "Pushed," said while it is impossible to track the numbers of women doing unassisted childbirth, they are highly educated, committed, motivated, and frustrated with mainstream medicine.
"That should give us pause," she said. "We are failing in some way. Women should be able to be in control and still have trained support with them. Emergencies do happen. I can't imagine trying to resuscitate my own infant, or if I had a hemorrhage."
Margulis said she lied to her mother, University of Massachusetts Amherst evolutionist Lynn Margulis, a member of the National Academy of Sciences, about having a midwife present. Lynn Margulis said she's nonetheless proud of her daughter.
"I'm delighted. Her father and I used to say, when people asked how may kids do you have, we used to say, `We have a daughter and a half,'" she said.
Laura Shanley, a leading advocate for freebirth, had her first child in 1978 without a doctor or midwife at home. She and her husband were inspired by the book "Childbirth Without Fear," by the late British obstetrician Grantly Dick-Read, widely regarded as the father of the natural childbirth movement. She went on to have all five of her children that way. One died of a congenital heart defect soon after birth, she said.
Shanley later wrote her own book and established a Web site called Bornfree!
"It didn't make sense to me that the thing that assures the continuation of the race would be this horrendous experience," she said.
Margulis' husband James Di Properzio was not convinced at first. He was worried about the few births that do not go smoothly.
"I wanted to know what the contingency was, and how we were going to know when to go to the contingency," he said. Being a short drive from the hospital and having a midwife standing by to call helped, he said.

Jennifer went into labor the night before, and in the morning told di Properzio to take the kids, Hesperus, Athena and Etani, to school. When he came back, she got into the shower, where she stayed under a stream of warm water until she felt the urge to push. De Properzio helped her into the bedroom, where she gave birth to a healthy girl — Leone Francesca — who di Properzio caught.


August Carnival of Breastfeeding: Prepared for Life

Welcome to August's Carnival of Breastfeeding! This month our posts are on the World Breastfeeding Week themes "Prepared for Life" and "Breastfeeding in Emergencies." Be sure to check out the posts from our other Carnival participants linked at the end of this one.

I'm not entirely sure I'm doing this right but I've come across so many posts in response to this that I was inspired to write, too.  So,here goes!


Stop and Smell the Baby: Prepared for Life

By the time my first was a few weeks old I could make a great case for breastfeeding based on the benefits to the baby alone.  I was completely unprepared, though, for how it would change my life.  There is something almost magical about the way nursing a baby makes a mother feel.  The very first time I looked into my daughter's eyes, it took my breath away.  She was so...sentient, so aware and so uniquely HER, right from the beginning.  The first time she latched on and took sustenance from me, the hormonal rushes combined with intense pride about knocked me out of the bed! I chose to breastfeed before knowing anything about nursing, though.  I chose it because it was FREE and natural.  Therefore, it made loads more sense to me than the alternatives.  I was to discover, though, that it is so, SO much more than just a free meal.  I learned SO much in the first year about the benefits of breastfeeding for my baby but I was completely innocent of how much breastfeeding would change ME and prepare me for life.

You see, breastfeeding is natural, yes.  For some of us, it's even easy (has always been for me, though I realize that for many, it's most definitely NOT).  But it comes at great personal sacrifice.  I know, I know, that's not trendy.  Trendy moms juggle a career and a family and find a way to make it work: and my hat's off to them.  But breastfeeding requires a great deal of personal investment.  It's TIME CONSUMING.  Yes, much easier than lugging bottles and checking water temperatures and measuring and sterilizing, to be sure.  But you can't take your boob off, prop it up with a pillow for the baby and go back to doing dishes.  Nope.  You cant take your breasts off and hand them and the baby to a friend and finish cooking dinner, either.  Nope.  If the baby is hungry, everything stops so she can eat.  If the baby hurts herself and needs comfort, you sit down, wip it out and give comfort!  If the baby is sick you thank God, the universe or whomever you thank that breastmilk, at least, stays down when nothing else will...and so do you, on the couch, for the entire day/night until bub feels better.   Nursing our babies forces us to literally give of ourselves.  It's as if nature has built in a platform for forming that connection from day one.  I'm not suggesting that women who bottle feed do not give of themselves.  I've known plenty of fantastic, selfless, bottlefeeding mothers.  I just have to wonder, though, if it was harder for them.  I suppose this is the sort of thing that varies from woman to woman anyway, we are all so different.  But for me, at least, breastfeeding my babies has underlined everything else.  It's like a srpingboard that vaults me into other areas of self-giving that help prepare my children for life. 

Nursing my children has taught me patience (trust me, when you've been interrupted during a growth spurt for what feels like the 400th time that hour for a quick nibble, you learn patience).  It's taught me humility (I mean, come on, when one is wearing a 40G you learn humility when the baby isn't particularly interested in who you are flashing when nursing at Walmart).  
Out of all the things I've learned, though, I think one of the most profound is to STOP...and smell the baby.  This has been particularly true since my 2nd daughter was born, as I'm sure any mother of more than one can attest to.  I just get SO busy, so stressed about this and that which needs to be done. Then,  that call, those eyes and that forced rest.  So, sure,  the laundry is only half folded and taking over my kitchen table and perhaps child #1 is over there "helping" in an entirely unhelpful way while I'm nursing the baby but STILL, I'm forced to sit down, take a few deep breaths and look my little one in the face and spend just a few minutes with JUST her.  If nothing else, I've learned to let go a little and relax.  RELAX. 

If I'm able to relax, to let rigidity give way to routine, to allow my children to impose upon MY plans a bit, I'm a better mother.  I'm also far less stressed out.  This not only prepares my children for a life that's actually happy (you know, without a stressed out, spastic headcase for a mom) it molds and shapes me into a better persn in general.  Breastfeeding my children has been a door that has opened up onto a new outlook of life for me.  I have learned (and continue to learn) how to truly serve.  I've learned how to love with my whole being.  I've learned that it's OK if the priority is my children and not having the Better Homes and Gardens thing DOWN.  I've learned to stop and smell the baby.  And really, what could possibly be more wonderful?  

Check out the other participants in this month's Carnival.

Motherwear Breastfeeding Blog: Breastfeeding in Emergencies
Hobo Mama: Prepared for Life: Breastfeeding in local and global crises
Zen Mommy: How breastfeeding has shaped my toddler's view of breasts
Pure Mothers: Marketing away real milk
Chronicles of a Nursing Mom: Tips for consistent & long-term breastfeeding success
Cave Mother: Three moments that make me thankful I breastfeed
Blactating: Breastfeeding news and views from a mom of color: Infant feeding and disasters



This deserves to be spread around

As many of you have heard, ACOG and the AMA have really stepped in it, both writing reccomendations to introduce legislation making out of hospital birth illegal.  (For more information, try here, , and here , . 

Rixa's blog is a very good place to get a good overview of what is going on :

Anyway, this was written by an OB/GYN (Dr. Fischbein)  who is also a member of ACOG, regarding their recent statement.  I seriously want to kiss this man.  Please read this! 

Douglas H. Kirkpatrick, MD
The American College of Obstetricians and Gynecologists
PO Box 96920
Washington, DC 20090-2188

Dear Sir:
I am a practicing OB/ GYN in southern California and Fellow of ACOG and recently was informed by midwife colleagues of your recommendation and encouragement for the AMA to lobby Congress for a law banning out of hospital birth. Funny that I had to hear of this decision from outside sources and was never approached by my college to see how I or my local colleagues felt about it. I have grave concerns regarding my organization taking such a stand. I think we are all agreed that ACOG has a statement regarding patients' rights to informed consent and informed refusal. Yet, it seems with every decision our organization moves further away from that basic tenet. ACOG's little "guideline" paper on VBAC in 2004 where the word readily was changed to immediately has had the chilling effect of doing away with VBAC options at hundreds if not more hospitals. Not due to patient safety, or the ideal of giving true informed consent but really, let's be honest, to fear of litigation. I have seen how patients have become counseled by obstetricians at facilities where VBAC has been banned. They are clearly given a skewed view of the risks of VBAC but rarely told of the risks of multiple surgeries. If you think this is untrue you are, sadly, out of touch with real clinical medicine.

As to out of hospital birthing, please give me the courtesy of an explanation as to the data you used and the process by which an organization which is supposed to represent me came to this conclusion. Any statement saying that it is as simple as patient safety and that one-size fits all hospital birth under the "obstetric model" of practice should be applied to all patients is, putting it nicely, not really in line with what best serves all our patients. In many instances, hospitals are not safe, certainly not nurturing and have a far worse track record for disasters than home birth. Even when emergency help is nearby this is true. The focus of all of us in medicine should be on reigning in trial lawyers and tort reform and lobbying Congress for that. The best interest of the college members and the patients we serve would be for my organization to spend its time and energy on something that has true benefit. Removing choices from well-informed patients and caring doctors and midwives is wholly un-American.

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Article in Baltimore's "City Paper"

Home Made
Inside Baltimore's Home-Birth Underground

Michelle Gienow

By Michelle Gienow

Like any 8-day-old baby, Jimmy Gaffney spends most of his time either nursing or sleeping. Peacefully alternating between the two while cradled in his mother's arms in the family's sun-dappled Hamilton backyard, the robust newborn looks like a promotional photograph for parenthood. And yet, so far as the state and city of his birth are concerned, this baby does not officially exist.

He was born at home, in May, with only his mother and father, Alana and Matt Gaffney, in attendance (his two excited siblings, who had slept through most of the five-hour labor that culminated in his 4 a.m. birth, came in just as their father was placing the freshly born baby on his mother's chest). The family is in no rush to notify the authorities about Jimmy's birth; they have been taking it easy for the past week, sticking close to home and bonding with the new addition while Alana recovers. A call to register his birth with the Baltimore City Health Department will summon a visit from a home nurse, and the Gaffneys are not quite ready for outsiders, particularly bureaucrats asking a lot of questions about a process they regard as utterly natural--and completely private.

Although they have health insurance that would have paid for a hospital delivery, Alana and Matt managed Jimmy's birth entirely on their own; Alana even administered her own prenatal care. Neither is a doctor; she is trained as a nurse and Matt is a wildlife biologist, so there is a certain amount of medical/scientific experience between them, but it's hardly the job experience most people look for when hiring a birth attendant. In fact, 99 percent of women in the United States give birth in a hospital; the remaining one percent of births include all births outside the hospital, including accidental births (as in, say, the back seat of a taxi).

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Government-Supervised Parenting

Posted by: admin on June 24th, 2008

Part I of an In-depth Look at Article 18 of the UN Convention on the Rights of the Child

During our series on the UN Convention on the Rights of the Child, most of the articles we have considered have focused on the relationship between the state and the child. Article 18 is therefore unique in its emphasis on the responsibilities of parents, and the supervised relationship that these parents have with the state.

Article 18 is also one of the more complex articles in the Convention, divided into three sections that address distinct facets of the relationship between parents and the state. This week, we will focus on the first section, which says that “States Parties shall use their best efforts to ensure recognition of the principle that both parents have common responsibilities for the upbringing and development of the child,” and that parents are primarily responsible for their children. As parents, “the best interests of the child will be their basic concern.”

The danger of Article 18 is that it places an enforceable responsibility upon parents to make child-rearing decisions based on the “best interests of the child,” subjecting parental decisions to second-guessing at the discretion of government agents.

Obligations on Parents?

Article 18 stands out because it affects not only the relationship between the UN and the nation that ratifies the Convention, but also the relationship between private individuals and their government: a relationship that is usually changed through legislation at a local level. In fact, the UN’s Implementation Handbook for the CRC explains that “when article 18 was being drafted, the delegate from the United States of America commented that it was rather strange to set down responsibilities for private individuals, since the Convention could only be binding on ratifying governments.”

But instead of paying heed to this objection, the drafters of the CRC rejected it, making the Convention enforceable against private individuals and requiring that “parental rights be translated into principles of parental responsibilities.” The Handbook itself notes that if the actions of parents could be shown to impair the child’s physical, psychological, or intellectual development, “the parents” – not the state – “can be found to be failing in their responsibilities.” (emphasis added).

The end result is parental involvement under state supervision. According to Chris Revaz, Article 18 “recognizes that parents and legal guardians have the primary responsibility for the upbringing and development of the child, with the best interest of the child as their basic concern,” but also invests in the state “a secondary responsibility to provide appropriate assistance to parents and legal guardians in meeting their responsibilities.” Roger Levesque opines that such supervision attempts to “regulate the relationship between child and state,” essentially relegating the role of parental and familial involvement to a position of “secondary importance.”

Enforcing the “Best Interest” Standard

As a previous e-mail in our series has already discussed, the “best interests of the child” is a significant theme in the Convention, providing “decision and policy makers with the authority to substitute their own decisions for either the child’s or the parents’.”

The inevitable result, according to Levesque, is that “by placing the burden on the State to take affirmative steps toward ensuring the fulfillment of children’s rights, the Convention assumes responsibility and invokes the State as the ensurer and protector of rights.” This point is echoed by Law Professor Bruce Hafen, who warns that the Convention’s emphasis on the “best interests of the child” creates “an arguably new standard for state intervention in intact families.” According to Hafen, legal authors in Australia have already suggested that “under the CRC, parental childrearing rights are ’subject to external scrutiny’ and ‘may be overridden’ when ‘the parents are not acting in the best interests of the child.’”

Hafen warns that this conclusion – though inapposite to America’s cultural and legal heritage – is “consistent with the CRC’s apparent intent to place children and parents on the same plane as co-autonomous persons in their relationship with the state.” This is a far cry from America’s legal heritage, which has long held that parents have a fundamental right to oversee the upbringing and education of their children, free from government control. Article 18 makes it plain, however, that under the Convention, it is the state that is ultimately responsible for the fate of its children, and has authority to supervise its parents.

Please forward this message onto your friends and urge them to sign the Petition to Protect Parental Rights.


UN Convention on the Rights of the Child

Cris Revaz, “An Introduction to the U.N. Convention on the Rights of the Child,” in The U.N. Convention on the Rights of the Child: An Analysis of Treaty Provisions and Implications on U.S. Ratification (2006): 10-11.

Roger Levesque, International Children’s Rights Grow Up: Implications for American Jurisprudence and Domestic Policy (1994): 214.

Bruce and Jonathan Hafen, Abandoning Children to their Autonomy (1996): 461-462, 464.

United Nations Children’s Fund, Implementation Handbook for the Convention on the Rights of the Child (2002): 245-246, 46, 246.

  • Current Mood
    cynical cynical

This gets it's own entry because it's so beautiful

These Last Few Hours

It is important to me
that I spend a part
of the next few hours
here alone with you
in the darkness.

You and I will never be
this close again.
Soon you will be
a tiny person
all on your own.
No longer the kicking,
demanding bulge in my body
that I have grown to love so much.

I pray that you will be safely guided
on your journey to my arms
and I ask for the strength, courage and
the power of birthing, to open my body and mind for you

And ever so gently us

as one will become two.

Author unknown

A Bit of Morning Humor

How many forum members does it takes to change a light bulb?

1 to change the light bulb and to post that the light bulb has been
14 to share similar experiences of changing light bulbs and how the
light bulb could have been changed differently
7 to caution about the dangers of changing light bulbs
1 to move it to the Lighting section
2 to argue then move it to the Electricals section
7 to point out spelling/grammar errors in posts about changing light
5 to flame the spell checkers
3 to correct spelling/grammar flames
6 to argue over whether it's "lightbulb" or "light bulb" ... another 6
condemn those 6 as stupid
2 industry professionals to inform the group that the proper term is
15 know-it-alls who claim they were in the industry, and that "light
bulb" is perfectly correct
19 to post that this forum is not about light bulbs and to please take
this discussion to a lightbulb forum
11 to defend the posting to this forum saying that we all use light
bulbs and therefore the posts are relevant to this forum
36 to debate which method of changing light bulbs is superior, where
to buy the best light bulbs, what brand of light bulbs work best for this
technique and what brands are faulty
7 to post URL's where one can see examples of different light bulbs
4 to post that the URL's were posted incorrectly and then post the
corrected URL's
3 to post about links they found from the URL's that are relevant to
this group which makes light bulbs relevant to this group
13 to link all posts to date, quote them in their entirety including  all headers
and signatures, and add "Me too"
5 to post to the group that they will no longer post because they
cannot handle the light bulb controversy
4 to say "didn't we go through this already a short time ago?"
13 to say "do a Google search on light bulbs before posting questions
about light bulbs" 1 forum lurker to respond to the original post 6 months from now and start it
all over again.
  • Current Mood
    amused amused
  • Tags

This kind of selflessness is just beautiful

May 19, 2008
Milk of human kindness
PERSONAL CONTRIBUTION: Ms Jiang Xiaojuan is helping to nurse eight babies affected by the quake.
A CHINESE policewoman is contributing to the country's massive earthquake relief effort in a very personal way - by breast-feeding eight babies.

A newspaper in Chengdu, the capital of quake-hit Sichuan province, yesterday devoted a special page to 29-year-old Jiang Xiaojuan, calling her a 'hero' while Web users hailed her as 'the most beautiful mother' in the world.

Ms Jiang, from the quake-ravaged town of Jiangyou, has just had a child herself, the Western Daily reported. She is breast-feeding the children of three women who have been left homeless by the quake and are too traumatised to nurse, as well as five orphans, the report said.

One mother, Ms Chen Tanghua, 36, said she has been unable to breast-feed her six-month-old son. He had been crying from hunger until Ms Jiang offered to breast-feed him.

The babies who lost their parents have been put in an orphanage which does not have powdered milk, the newspaper reported. It said Ms Jiang brushed off a reporter's questions about her deed by saying: 'All mothers love children. Nursing a few babies is no big deal.'



Fantastic Article


Pelvises I Have Known and Loved

by Gloria Lemay

© 2003 Midwifery Today, Inc. All rights reserved.

[Editor's note: This article first appeared in Midwifery Today Issue 50, Summer 1999 and is also available online in Spanish.]

What if there were no pelvis? What if it were as insignificant to how a child is born as how big the nose is on the mother's face? After twenty years of watching birth, this is what I have come to. Pelvises open at three stretch points—the symphisis pubis and the two sacroiliac joints. These points are full of relaxin hormones—the pelvis literally begins falling apart at about thirty-four weeks of pregnancy. In addition to this mobile, loose, stretchy pelvis, nature has given human beings the added bonus of having a moldable, pliable, shrinkable baby head. Like a steamer tray for a cooking pot has folding plates that adjust it to any size pot, so do these four overlapping plates that form the infant's skull adjust to fit the mother's body.

Every woman who is alive today is the result of millions of years of natural selection. Today's women are the end result of evolution. We are the ones with the bones that made it all the way here. With the exception of those born in the last thirty years, we almost all go back through our maternal lineage generation after generation having smooth, normal vaginal births. Prior to thirty years ago, major problems in large groups were always attributable to maternal malnutrition (starvation) or sepsis in hospitals.

Twenty years ago, physicians were known to tell women that the reason they had a cesarean was that the child's head was just too big for the size of the pelvis. The trouble began when these same women would stay at home for their next child's birth and give birth to a bigger baby through that same pelvis. This became very embarrassing, and it curtailed this reason being put forward for doing cesareans. What replaced this reason was the post-cesarean statement: "Well, it's a good thing we did the cesarean because the cord was twice around the baby's neck." This is what I've heard a lot of in the past ten years. Doctors must come up with a very good reason for every operation because the family will have such a dreadful time with the new baby and mother when they get home that, without a convincing reason, the fathers would be on the warpath. Just imagine if the doctor said honestly, "Well, Joe, this was one of those times when we jumped the gun—there was actually not a thing wrong with either your baby or your wife. I'm sorry she'll have a six week recovery to go through for nothing." We do know that at least 15 percent of cesareans are unnecessary but the parents are never told. There is a conspiracy among hospital staff to keep this information from families for obvious reasons.

In a similar vein, I find it interesting that in 1999, doctors now advocate discontinuing the use of the electronic fetal monitor. This is something natural birth advocates have campaigned hard for and have not been able to accomplish in the past twenty years. The natural-types were concerned about possible harm to the baby from the Doppler ultrasound radiation as well as discomfort for the mother from the two tight belts around her belly. Now in l999, the doctors have joined the campaign to rid maternity wards of these expensive pieces of technology. Why, you ask. Because it has just dawned on the doctors that the very strip of paper recording fetal heart tones that they thought proved how careful and conscientious they were, and which they thought was their protection, has actually been their worst enemy in a court of law. A good lawyer can take any piece of "evidence" and find an expert to interpret it to his own ends. After a baby dies or is damaged, the hindsight people come in and go over these strips, and the doctors are left with huge legal settlements to make. What the literature indicates now is that when a nurse with a stethoscope listens to the "real" heartbeat through a fetoscope (not the bounced back and recorded beat shown on a monitor read-out) the cesarean rate goes down by 50 percent with no adverse effects on fetal mortality rates.

Of course, I am in favour of the abolition of electronic fetal monitoring but it would be far more uplifting if this was being done for some sort of health improvement and not just more ways to cover butt in court.

Now let's get back to pelvises I have known and loved. When I was a keen beginner midwife, I took many workshops in which I measured pelvises of my classmates. Bi-spinous diameters, sacral promontories, narrow arches—all very important and serious. Gynecoid, android, anthropoid and the dreaded platypelloid all had to be measured, assessed and agonized over. I worried that babies would get "hung up" on spikes and bone spurs that could, according to the folklore, appear out of nowhere. Then one day I heard the head of obstetrics at our local hospital say, "The best pelvimeter is the baby's head." In other words, a head passing through the pelvis would tell you more about the size of it than all the calipers and X-rays in the world. He did not advocate taking pelvic measurements at all. Of course, doing pelvimetry in early pregnancy before the hormones have started relaxing the pelvis is ridiculous.

One of the midwife "tricks" that we were taught was to ask the mother's shoe size. If the mother wore size five or more shoes, the theory went that her pelvis would be ample. Well, 98 percent of women take over size five shoes so this was a good theory that gave me confidence in women's bodies for a number of years. Then I had a client who came to me at eight months pregnant seeking a home waterbirth. She had, up till that time, been under the care of a hospital nurse-midwifery practise. She was Greek and loved doing gymnastics. Her eighteen-year-old body glowed with good health, and I felt lucky to have her in my practise until I asked the shoe size question. She took size two shoes. She had to buy her shoes in Chinatown to get them small enough—oh dear. I thought briefly of refreshing my rusting pelvimetry skills, but then I reconsidered. I would not lay this small pelvis trip on her. I would be vigilant at her birth and act if the birth seemed obstructed in an unusual way, but I would not make it a self-fulfilling prophecy. She gave birth to a seven-pound girl and only pushed about twelve times. She gave birth in a water tub sitting on the lap of her young lover and the scene reminded me of "Blue Lagoon" with Brooke Shields—it was so sexy. So that pelvis ended the shoe size theory forever.

Another pelvis that came my way a few years ago stands out in my mind. This young woman had had a cesarean for her first childbirth experience. She had been induced, and it sounded like the usual cascade of interventions. When she was being stitched up after the surgery her husband said to her, "Never mind, Carol, next baby you can have vaginally." The surgeon made the comment back to him, "Not unless she has a two pound baby." When I met her she was having mild, early birth sensations. Her doula had called me to consult on her birth. She really had a strangely shaped body. She was only about five feet, one inch tall, and most of that was legs. Her pregnant belly looked huge because it just went forward—she had very little space between the crest of her hip and her rib cage. Luckily her own mother was present in the house when I first arrived there. I took her into the kitchen and asked her about her own birth experiences. She had had her first baby vaginally. With her second, there had been a malpresentation and she had undergone a cesarean. Since the grandmother had the same body-type as her daughter, I was heartened by the fact that at least she had had one baby vaginally. Again, this woman dilated in the water tub. It was a planned hospital birth, so at advanced dilation they moved to the hospital. She was pushing when she got there and proceeded to birth a seven-pound girl. She used a squatting bar and was thrilled with her completely spontaneous birth experience. I asked her to write to the surgeon who had made the remark that she couldn't birth a baby over two pounds and let him know that this unscientific, unkind remark had caused her much unneeded worry.

Another group of pelvises that inspire me are those of the pygmy women of Africa. I have an article in my files by an anthropologist who reports that these women have a height of four feet, on average. The average weight of their infants is eight pounds! In relative terms, this is like a woman five feet six giving birth to a fourteen-pound baby. The custom in their villages is that the woman stays alone in her hut for birth until her membranes rupture. At that time, she strolls through the village and finds her midwives. The midwives and the woman hold hands and sing as they walk down to the river. At the edge of the river is a flat, well-worn rock on which all the babies are born. The two midwives squat at the mother's side while she pushes her baby out. One midwife scoops up river water to splash on the newborn to stimulate the first breath. After the placenta is birthed the other midwife finds a narrow place in the cord and chews it to separate the infant. Then, the three walk back to join the people. This article has been a teaching and inspiration for me.

That's the bottom line on pelvises—they don't exist in real midwifery. Any baby can slide through any pelvis with a powerful uterus pistoning down on him/her.

Gloria Lemay is a private birth attendant in Vancouver, B.C., Canada.