Then and Now

Last week Elisabeth Bing, the 'Mother of Lamaze' died at age 100. Reading this article about her in the New York Times, I was inspired by her tireless advocacy for birthing women and families.

She was instrumental in educating an entire generation of women about childbirth. 

The history of childbirth, the way knowledge was lost and gained over time is fascinating to me. As part of our archival work for the film I purchased the book, Principles and Practice of Obstetrics by Joseph DeLee. Published in 1918 DeLee is considered to be the father of modern obstetrics.

I was looking through the book the other day when my six year old son took note of the image of a baby being delivered by forceps. "That doesn't look very nice for the baby," he said. "Why are they doing that?" 

His question prompted a brief  history of medicine and women's rights.

We've come a long way since Elisabeth started her work in the '60's, but there is still much further to go. Understanding the history of childbirth is important as we look for a way forward. 

If you want to see a beautiful historical section in the film, support here or buy a T-shirt before Thursday May 21st. Proceeds will go toward purchasing archival rights. 

If you haven't watched old educational films about childbirth, or if you're feeling discouraged about the current state of things, check this one out. Labor and Childbirth (1950).

Maryland and Midwife vs. Midwife

This week Maryland become the latest state to license Direct Entry Midwives (DEMs), allowing them to attend home and birth center birth. This leaves 21 states that do not. I read this article about the bill and couldn’t help but get sucked into the comments.

Claudia Booker (Right) a CPM and attorney in Virginia was involved in the push to legalize CPMs in Maryland. Pictured here at the Home Birth Summit, she and attorneys Tara Gaston (Left) and Hermine Hayes-Klein (Center) talked to the Why Not Home? crew about some of the legal challenges to home birth midwives and mothers in the US. Photo Credit: Erin Wrightsman

The biggest criticism of Certified Professional Midwives and DEMs is that their education and training is not rigorous enough. “Midwives in Europe are more like Certified Nurse Midwives,” you’ll often hear. I won't get into the more vitriolic comments.

As a Family Nurse Practitioner, trained in university settings, working in hospitals and outpatient clinics, this other kind of midwife, the CPM or Direct Entry Midwife was mysterious and poorly understood.

Until I really got into this project, I knew very little about the requirements or training. My colleagues would say the same.

Over the past year I’ve come to understand much more about this qualification thanks to women like Ellie Daniels and many others at the Home Birth Summit and in my community.

Still I’m struggling with how to lay out the differences in a way that's simple enough for anyone to understand. I don't want to get bogged down and bore viewers with the layers of nuance and complexity, but I do want to be fair and accurate.

Thankfully women like Tanashia Huff and the staff at the Florida School for Traditional Midwifery showed me what the CPM training at FSTM looks like. This will certainly help viewers understand the education of CPMs. Still, many CPMs have less than the 3 year training program offered through FSTM. That doesn’t mean they aren’t good midwives, it just means their training was different, and I think that’s important for consumers to understand.

I’m curious to hear from other home birth moms, what did you know about your midwife’s training and experience when you chose her to attend your birth? What was important for you in choosing your midwife?

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Oh, and you have less than a week left to order T-shirts! 

If we meet our goal of 215 shirts it will allow us to purchase some great archival footage to add to this film. If you love archival footage and would rather just donate and not get a T-shirt click here. 

Images of Support

I met with the motion graphics artist a couple of weeks ago. We reviewed our list of animations together and sketched out some ideas. When we got to the end, he asked what I had in mind for the closing credits.

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Photo Credit Erin Wrightsman

During our Kickstarter campaign, the $125 backer reward was one of your own images included in the film. We're working on a treatment of these images that conveys a feeling of broad and diverse support for women and families making informed choices about their birth.

Images that convey the kind of respect, trust, support, and love that every woman deserves during her pregnancy and birth.

I want the closing credits to feel like a chorus of supporters adding their voice through an image.

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Photo Credit Erin Wrightsman

If you have an image you would like to share and you didn't get in on the Kickstarter reward, between now and Mother's Day when you donate $125 you can add your image* and support finishing funds. You'll also get a digital download of the film for personal use once it's finished. 

Donate

If you've been following our progress, you know post production is going to take longer and cost more than we initially hoped. We've applied for some grants, but so far nothing has materialized. We have a rough cut we feel good about, but there's still a lot of work before we have a locked picture. 

Our strongest support continues to be from the community of birth workers, women, and families with some connection to home birth.

If you are passionate about this work, please donate today and add your voice and your image of support. If you are already a supporter, please share with your network. The window closes on this offer Sunday May 10th. 

Thank you! 

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*We will send electronic release forms once we have set the resolution and aspect ratio guidelines. You must have permission from everyone in the picture as well as the right to share the image with Why Not Home? We can't wait to see what you send us!

Cheers to Community

One year ago, I was looking for a pregnant person to meet me at the hospital for some filming. It was coming down to the wire and I hadn't found a willing volunteer.

At the time my friend Paige Green was pregnant with her second child and planning a home birth. As a photographer, she knows what it's like to ask for volunteers and stand-ins, so she agreed to help me out. Her only request was that we avoid any head shots if possible. 

Paige saved me again several weeks later. She was nearly 40 weeks pregnant by then and we got the call at 2AM that Grace was in labor. It was time to film the first birth! 

We had rented a camera and equipment, but the extra batteries hadn't yet arrived. Kelly headed out with the one battery we had while Erin and I tried to get up the courage to wake up our photographer friends who shoot Canon at 3AM and ask to borrow batteries.

We knocked on two other doors before we went to Paige's. Her dog woke the whole house up, and she graciously loaned us the batteries we needed. I promised to repay the favor in any way I could. 

A couple of months ago she called in the favor. She had a shoot for Gloria Ferrer coming up and needed someone to stand on a bench and hold balloons, would I do it? 

This is what happened to that photo.

Family and friends have had a great time sharing the news that one of their own appeared in Glamour magazine. For me, the attention is a little odd.

I've done many things in my life that I'm proud of, but for this I literally stood on a bench and held balloons and smiled.

It was fun and the attention is flattering, but it's not exactly my crowning achievement. 

What I am proud of is that I'm part of a community that helps each other out. We are pursuing our art, our passion, our work, our dreams and we're doing it together. That's something worth toasting. 

Letting Go

The past 2 weeks have been hard. After a great day at the med school I was optimistic that our rough cut was just around the corner--then we got stuck. Things kind of went off track.

Today was the self-imposed deadline and the third and final act is still unresolved.

We've tried the last few scenes several different ways and haven't figured it out yet.

Victoria, the editor, goes back to her full time job soon. She extended her leave already and the editing budget is spent. There are so many unknowns.

Cutting the film apart has been harder than I thought it would be. Having an experienced editor who can see the project with fresh eyes has made a tremendous difference. Still, it's hard to accept that some of the elements and events we captured or characters we filmed just won't make it into the final cut.

So much time, energy, and money went into the travel, the shooting, the editing. It's hard to let go of the pieces.

I'm trying to be gentle with myself in this process. Of course things won't always go as expected, but when it's finally finished, it will be even better than I imagined it would be.

Thanks for joining me and supporting me in the process. We will get there.

In the meantime, I'm choosing to take this as yet another opportunity to learn to hold softly and let go of what isn't working.  

Sneak Peek

Two days ago I had the opportunity to talk to a class of first year medical students about home birth. As part of the class, I showed them a 25 minute clip from the beginning of the film. It was the first time anyone outside our core team has had a look at what we've been working on.

I captured this response from one of the students and wanted to share it. Please forgive the lack of editing, we're spending energy on editing the film--this was just for fun. 

He was responding to something Robyn, the OB/GYN in the film says about birth not being just a medical event, but a family event, a social event, and a personal transformation. He wasn't the only one that responded this way.

Many had never thought about home birth at all and were curious and open. I had them write down their views of home birth prior to the film and discussion, then asked them how their ideas had changed at the end. 

Another student had this to say, "This film was one of the most well made I have seen and I loved the view from a variety of medical professionals. I'm starting to accept home birth as an option and may be leaning toward it myself."

I hope that many more medical schools and nursing schools can use this film as a teaching tool.

It's still a long way from finished, but watching the rough cut with them confirmed that we're on the right track and this is a project worth all the time and energy we're putting into it. 

Welcome to My Workspace

Yes. This is where I work. 

I live in a 2 bedroom 1 bath house with my husband and two kids. I have a desk in the amorphous extra room/playroom that used to be a one car garage, but it's covered with FedEx envelopes, postcards I still need to send out from the Kickstarter, legos, felt, and "a bunch of other crap," my husband would say (he's decidedly neater than I am).

I rarely work there for obvious reasons.  The desk I most often use is a small wooden stand a childhood friend's dad made for me as a wedding gift. Over the years it has been a night stand, a side table, and an anchor for play tents. It's current incarnation however, is my desk. 

This all came up tonight because we actually need a shot of me doing some research on my computer to help cover some narration. 

It shouldn't be a big deal. Logistically it's easy. It's just me and someone behind the camera, but when I think about people seeing where I work I cringe. 

I even considered using a friend's home office to avoid the whole scene. It's fine to film other people's reality, but not mine. 

I talked to Erin about it tonight and getting more comfortable with the idea. 

This is real. This is me. I am a working mom with a passion project trying to squeeze everything I can out of the time and space I have. What says that better than a MacBook on a 12X15" glorified TV tray--and of course laundry.

As a quick update we have an assembled first and second act and it looks like we're on track to have a rough cut by the end of March!

Sign up for updates by using the connect tab above and like us on facebook. Thanks!

What I Didn't Know

“The lifelong accumulated experiences of racial discrimination by African American women constitute an independent risk factor for preterm delivery.”

Does this surprise you? It did me. This was the conclusion of a 2004 study on very low birthweight in African American Infants.

Of course I learned in nursing school that African American women and infants had worse outcomes than their white counterparts. I had been taught that this was a function of largely (if not exclusively) socioeconomic factors or social determinants of health. 

Image courtesy of Claudia Booker, CPM.

Sherry Payne set me straight. I met Sherry at the MANA conference last fall. Sherry, has a Masters in Nursing, is a certified lactation consultant, nursing educator, doula, and is studying to be a midwife. She is also a co-founder of Uzazi Villiage and the mother of nine. Sherry knows something about the experience of birth in the African American community and she isn't shy about educating you if you don't.

I went to the talk she presented titled, What You Don't Know Hurts Us: Racism, White Privilege and Perinatal Health Inequities. (You can click here to purchase an audio recording of the session.) 

It was there that I first heard about the idea that the accumulated stress resulting from racial discrimination itself was a factor in the disparities we see in African-American babies and mothers. 

Not surprisingly, racial discrimination is affecting more than just birth outcomes. PBS did a documentary series called Unnatural Causes all about how inequalities are affecting population health. Episode 2 focuses specifically on perinatal outcomes, When the Bough Breaks.

If you still think the disparities are socioeconomic, here are two important facts. Black women with a college education have higher rates of infant death than white women with a high school diploma and that recent immigrants from Africa have infant mortality rates that more closely match their white counterparts. Clearly socioeconomic and racial differences alone do not account for the disparity. 

Organizations like Black Women Birthing Justice, Mamatoto Villiage, Uzazi Villiage, and others are innovating ways to support women and families of color. Still, I am painfully aware that as long as Black women encounter even subtle racism in their every day lives the disparities we see in maternal and infant death rates will persist. 

A dynamic group of Black women in Oakland, CA. These doulas and advocates are committed to birthing justice in their community. 

So what does this mean for me? As Sherry recently told me, "Racism doesn't just land on Black women from the air." How are my unexamined biases and actions or inaction contributing to the current systemic inequalities?

I'm not an expert when it comes to racial reconciliation, but there are a few things I've done as a result of these conversations.

One is to examine my implicit biases.  We all have them. Take the test if you think you don't. If I am aware of mine, I'm more likely to be able to consciously challenge them and change my behavior. 

Another is to seek out communities of color who are working to reduce disparities and become involved. I'm not talking about taking over or inserting myself where I am not needed or wanted, but listening and supporting, becoming an ally. 

In her essay, White Privilege and Male Privilege: A Personal Account of Coming to See Correspondences Through Work in Women's Studies, Peggy McIntosh puts it this way:

“If we raise our daily consciousness on the perquisites of being light-skinned. What will we do with such knowledge? As we know from watching men, it is an open question whether we will choose to use unearned advantage, and whether we will use any of our arbitrarily awarded power to try to reconstruct power systems on a broader base.”

As a woman, I find this correspondence useful. As a white woman I can promote racial equality the same way I expect men to promote gender equality.

I love the way midwives (mostly white women) have rallied to support the #blacklivesmatter campaign. At first I didn't see the connection, but then it became so clear. Racism and inequality affects everything.

Before black babies are born their mothers carry the stress of generations of racism and discrimination in their bodies. Too often babies suffer as a result.

If you care about these issues, sign up and support the work of Jennie Joseph and the National Perinatal Task Force. I'm planning to visit next month and to some shooting for the film. More about that here. 

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Thanks for staying with me. I know this stuff can feel overwhelming. If that's where you are, then here are a few simple steps. 

Today, in honor of Martin Luther King Jr. I invite you to examine your own biases. Challenge those biases, then seek out communities of color working for change and listen. 

Talk to your friends. Engage in the conversation. It's not fair to leave all the work to men and women of color.

We are all connected. When one community suffers we all suffer, but together we can make the world a safer place for every man, woman, and child, regardless of the color of their skin. 

Thanks to Claudia Booker for sharing this beautiful image!

Special thanks to all the Black women who have shared their experience with me and who have taught me things I didn't know, especially Claudia Booker, Jennie Joseph, and Sherry Payne. 

Where are the Women of Color?

It's been a recurring question. I've spent months thinking about how to incorporate more diversity in a meaningful way and looking for the right person or people to do it. Today, I think I've found them.

Tanashia Huff is Labor and Delivery nurse, doula, and mother of 3. Her first 2 daughters were born in the hospital, and her youngest was born at home. She's also studying to be a Certified Professional Midwife. The only catch is that she's in Florida.

The good news is there's someone else in Florida I've been wanting to catch up with--Jennie Joseph. I wrote about meeting her at the Home Birth Summit here. She's making herself and her clinic open to us. We just have to get there. Florida is a long way from northern California. I thought I was done traveling. This trip wasn't in the budget, but it keeps coming back to me. This trip needs to happen. 

To make it happen I need to raise another $2,950 to cover the travel and shooting costs. If you think this is part of the story worth telling please click here to support. If you would like to make a  tax deductible, you can donate through IDA when you click here.

The first 20 people who make a donation of $60 or more get a canvas tote with the screen printed hand drawn illustration from Marla Pedersen, "Home Sweet Home." Please click the button now to support if you haven't already. I need to make my travel plans this week. Our editor is working hard and I don't want to hold her up waiting for footage. Thank you for supporting!

Gnome for the Holidays

This fall was so full of work and travel for the Why Not Home? team. I'm pretty sure I speak for everyone when I say we're feeling happy to be home for the holidays. 

Last week we spent 26 hours in Denver on our last shoot of the year. The family we spent the day with had this lovely little guy on their porch.

Sunday night, I copied over our footage to a new drive and sent it off to our editor in New York. It should arrive there the day after Christmas. 

This project has had many seasons and transitions already, but sending off the hard drive that night felt BIG. It's exciting to think about how the project will grow and change over the next 6 months.

Earlier this week on our Facebook page we asked followers what top 3 issues or questions they would like to see addressed in this film. If you'd like to weigh-in you still have time. Click here facebook.com/whynothome. The responses so far have confirmed we're on the right track. 

For the next few days I'll be taking a break and celebrating this magical time of year with my family before starting the edit in January.

Merry Christmas! It's good to be home.

Generations of Change

Today is my mom's birthday. Thinking about her made me think about the generations of women in my family and the different choices we have made at different times in history in different cultural contexts. 

Grandma and Grandpa's 60th Anniversary

Mom was born in the 50's in a small hospital in central Missouri. The second of 3 children, she was Grandma's biggest baby (9lb 12oz) and the easiest to deliver according to Grandma. She and Grandpa drove about 30 miles to the nearest hospital when she was in labor. She gave birth to my mom 3 hours later. At that time they didn't allow dad's to be in the delivery room. They didn't even want Grandpa to wait outside the door. He was told to stay in the waiting room on the other floor.

Once my mom was born, they stayed in the hospital another 4 or 5 days. That's just what you did then. This was also a time when most babies in the US were "bottle-fed" (Grandma's phrase), so she bottle-fed her babies too (the formula recommended at the time was a home made mixture of condensed milk and Karo syurp). The information available to her didn't suggest any reason to do otherwise, and again, it was the cultural norm. 

When my mom gave birth to me 24 years later, there had been major cultural changes in terms of breastfeeding. My mom breastfeed both me and my brother for over a year (despite her mother-in-law's protests).

By this time hospitals had also changed their policies about fathers' involvement at delivery. I was breech and failed an external version. The OB told my mom that her pelvis was too small to accommodate my head and she would need to have a c-section. My dad was in the operating room and still talks about how amazing it was to see Mom's uterus. 

When I think about these two stories, only a generation apart it reminds me of 2 things:

1. Things change.

Grandpa was kept out of the delivery room and my dad was welcomed into the operating room at my birth. Grandma bottle-fed her kids because that's what people did. New information was available to my mom and she made a different choice.

2. It's all OK.

I'm not saying that condensed milk and Karo syrup is as good as the breast milk I got as a baby, or that I didn't miss out on some beneficial bacteria because I wasn't colonized in the birth canal, or that Mom's recovery from her c-section was just as easy as Grandma's vaginal birth. But all things considered, we're fine. Mom doesn't have diabetes. I don't have asthma or attachment issues. They did the best they could with the information they had in their cultural and historical context. Just like me.

I don't mean to sound flip about it, we're still learning about the complex interplay between environmental, genetic, and epigenetic factors in health and illness. But as a mom, when I was back at work and struggling to pump enough milk for my baby, it was reassuring for me to remember that my mom was raised on condensed milk and Karo syrup, and she turned out just fine. Better than fine. She's pretty amazing actually. Happy Birthday Mom! 

Kickstarter Nostalgia and Thanksgiving

One month ago today our Kickstarter campaign closed. We officially reached our goal. That day marked the end of a marathon 40 day effort by so many. I still haven't fully recovered. 

Tonight I talked to a friend in DC who has been a major advocate through the entire process. We hadn't talked since the day our backers put us over the line. It was fun to hear about those last days from her perspective, on the other coast, watching with friends and supporters I've never met.

All across the country and all over the world people came together in such an amazing way. At some point it just had this momentum. I had never experienced anything quite like it.

I hope I don't come off sounding nostalgic. I'm not exaggerating when I say it was one of the hardest things I've ever done. To keep going. Keep pushing. Keep asking. Keep hoping. I wouldn't want to do it again, but it feels so good that we did it. 

Today there is still more work to be done. Rewards are coming in and going out. Shooting schedules are coming together. I'm writing more and refining the story structure, but tonight I am just feeling thankful.

Tonight I want to stop and celebrate the amazing work that so many of you did during that 40 day campaign.

Thank you to to those who e-mailed your friends and family, who shared my relentless posting on Facebook, and who represented us at farmer's markets and baby expos.

Thanks to those who pestered their celebrity friends, who came to our events, and didn't stop believing our big goal was possible.

Thanks especially to the people who made my family dinner, who picked up my kids from school when I was traveling, and who gave me an extra hug when I needed it. 

All of these actions, big and small, have left their mark on this project. Your confidence and support continue to pick me up on the days when I am overwhelmed by the amount of work still to come. 

Thank you. Thank you. Thank you.

The Only Man in the Room: Home Birth Dad

So far the voices here and in the trailer have been those of only women. Today we get another perspective. Tim Talbott, a home birth dad, shares his experience at the birth of his daughter. Enjoy!

When my wife was pregnant with our first daughter, she was absolutely certain that her ideal vision would be to give birth at home. She had been born at home, had attended several home births as a doula, and related to childbirth as being a natural and healthy experience for mothers and babies. In her experience, hospitals weren't a necessity for births, unless medical complications were to arise which required their expertise.

At that time I was fairly neutral on the decision. I was born in a hospital and was raised with the mainstream, conventional relationship to birth. One that assumed babies were born in the hospital. Nearly 99% of births in the US happen there.

At the same time, my grandmother had been born in 1900, and I knew that my mom and all of her siblings had been born at home, which to me seemed like a reasonable thing to do.  Somewhere along the line as a child, I even remember learning that Jimmy Carter was the first US President to be born in a hospital, which at the time made me realize that hospital births must be a fairly new phenomenon.

In all honesty, I hadn't really given much thought as to where children were born until it personally related to me. Looking back, given my wife’s strong certainty and confidence that home birth would be the most desirable option for her, coupled with my neutrality on the matter, I can see that although I hadn't formulated the exact thought in my mind, somewhere in my psyche I had related to the decision of childbirth location with the question, "Why not give birth at home?"

During the pregnancy, we connected with an exceptional home birth midwife and support team.  Up until the final weeks of pregnancy, we utilized our health insurance by also doing concurrent care through the medical system. We made a clearly defined hospital back-up plan, in case any complications arose. 

Being pragmatic people, my wife and I aligned in becoming very clear that our optimal intention was to give birth at home, but neither of us would have hesitated for a second to go to the hospital, if that was what was needed to ensure the health and safety of her and our baby girl.

After I had several months to transition into my new role of birth partner, my wife was put on bed rest for the last weeks of pregnancy, so it became my sole duty to gather all of the necessary items that would be needed for a birth at home. Successfully completing this task gave me a deep sense of purpose and duty, which left me feeling empowered and very excited for the arrival of our child.

And then the big day arrived, and with a tremendous amount of power, strength, beauty, fierceness, light and grace, my wife labored our daughter into the world.

For me, witnessing the metamorphous that my wife went through in growing and birthing our daughter, and getting to be the only man present at the birth (with five women and our daughter), was unlike anything I had ever experienced before. I had the sense of having been invited into a very sacred circle of The Feminine Power of Creation.

Through that experience of supporting my wife and catching our child as she entered into the world, I felt like more of a man than I had before. To be able to do this in the safety, security and love of the bubble we created at our home, was a gift that cannot be put into words.

Though my daughter’s birth was an exceptional experience, and the one we had hoped for, I can see clearly that home birth is not for everyone, nor does it always end up being the best option for everyone who originally plans on birthing at home.

The key is for the birthing mother to be in the environment where she feels the most safe and confident, and where she'll receive the optimal support she needs to birth her baby in the most healthy and positive way for her. Within that framework, I believe that home birth should be a viable option that is fully supported for a birthing mother if that is her choice. 

The reality of the current birth system in the US is that it is a luxury to be able to consider having a home birth.  It's not cheap to give birth at home (or anywhere for that matter). With the exception of PPO insurance, most insurance providers will not cover the costs of home birth. We were lucky enough to be in a position to pool the resources together to choose this option, but it wasn’t easy and I can see that not everyone is fortunate enough to be able to make that choice. 

It also takes a strong resolve in our culture to make the decision to birth at home and to follow through with it. Making a counter cultural decision like that can feel like swimming upstream against the prevailing winds. This needs to change.

We as a society need to take a reasonable and discerning look at the current state of our profit-driven medical system, rethink our relationship to pregnancy, birth and birth environment, and work to create a more integrated system that utilizes the strengths of the midwifery and medical models in complementary ways. Both the process of birth and the outcome have meaning and consequence. 

As my wife, daughter and I now prepare for the arrival of our second daughter in the coming weeks, I feel a sense of deep gratitude to get to be a man with the opportunity to play an integral role in another birth experience.

I have great hopes that in the future more and more birthing mothers and their partners will have the opportunity to consider home birth as an option, within a US society that fully supports this choice. I hope that more and more men, women and children will get the opportunity to experience empowered childbirth, wherever and however it takes place.  

To Life!

Tim Talbott, MA, lives in Petaluma, California with his wife, Brooke, and (almost) two daughters. He is an up-and-coming singer/songwriter (known as Micha’El), and is currently working on an album called, 'Protect the Land,' which will be launched in 2015.  For his day jobs, he works at a San Rafael based financial planning firm, he markets and sells the eco-friendly cat toy he invented, and offers spiritual counseling to modern men through his project, “Man, Spirited.” For more information on Tim’s work, check out www.manspirited.com, greencattoy.com and https://www.facebook.com/pages/MichaEl/1627233910835318