The New York Times published an article this week about the decline in use of midwives. Here is a link to the article, you will have to register with the NYT to read it, or you can use the login and password: hipmama, hipmama.

The article focuses on New York and the recent closure of the Elizabeth Seton Birth Center, but the rising costs of insurance that is pushing midwives out of business is applicable all over the United States.

Pro-choice mamas, families and friends! You are invited to join the Mamas for Choice delegation at the April 25, 2004 March on Washington for abortion rights! This historic event will demonstrate that despite the efforts of the current administration, we are prepared to fight for our reproductive freedom.

Mamas, kids, partners and friends are welcome, and we would like to join up as many mamas and mama groups as possible, to march together and represent all mothers who support each woman's right to choose for each pregnancy, without explanation or apology.

Please email dorie at mamagathering dot com to march with the Mamas for Choice, and check out www.marchforwomen.org for general information.

If you are not able to attend, consider making a small donation to your local Planned Parenthood affiliate or March co-sponsor, to help provide a scholarship for a member of your community to attend.

The Cesarean epidemic has reached a new apex that calls for urgent action supporting women's rights to make personal health care decisions. At a recent talk by Henci Goer, author of The Thinking Women's Guide to a Better Birth, she spoke of the rising Cesarean rates in the United States, which are creeping up from one in four women to one in every three women recieving a Cesarean delivery. The World Health Organization reports that there is no justification for a developed country to have a Cesarean rate higher than 10-15%, and both hospital-based and homebirth midwives have Cesarean rates of less than 7-10%.

Medically justified reasons for a Cesarean delivery are placenta previa, placental abruption, umbilical prolapse, or a shoulder presentation. The majority of Ceserean births in hospitals are due to non-medically justified situations that could be assisted through vaginal delivery with appropriate skill, time, patience, and knowledge. Twin delivery, VBAC, slow progress, breech baby, fetal distress, and a suspected big baby (macrosomia) are commonly used reasons in the medical community justifying Cesarean section, yet these reasons do not neccessarily justify a Cesarean, with all the complications that major abdominal surgery bears.

In the United States, the last few years have seen major changes in hospital protocals with many hospitals refusing to attempt VBAC delivery and discharging obstetricians who do, and refusing transfers from midwives who support VBACs. The Cesarean rate is rising and the consequences for woman who refuse are growing. This week a new mother in Utah has been charged with murder for refusing a Cesarean delivery of her twins as recommended by the hospital, and one child was born stillborn. The implications of this case are meaningful in how much right women have to make their own health care decisions in pregnancy.

This case will have powerful far-reaching effects on abortion, midwifery care, insurance, and whether or not women recieve prenatal care or medical care during pregnancy. Not to mention the midwifery bill that is currently pending in the Utah legislature. Will women be prosecuted in the future for taking herbs that her doctor did not prescribe, or smoking during pregnancy? What about the implications for labor support doulas and childbirth educators who advocate informed choice during the childbearing year? The largest issue is that the media and general public are not educated on birth options, implications of Cesearean, and pregnancy and birth in general.

More information for the consumer: Internation Cesarean Awareness Network and VBAC Information