Friday, March 27, 2015

Mothers, study groups and being called

I meet an old friend and midwife in the store.   Our midwifery careers began in much the same way.  We were young moms who had births that in our heart of hearts did not feel "right."   We went on, after these births, to be moms and work and go to school but inside we knew we could birth differently.  We did not have the right words to say this or even had anyone much to say it to.  This feeling lived within us.  Perhaps we tried to shrug it off.   To say that's jus how birth is but inside we knew that wasn't true. We knew we had a strength, an inner voice and a power that was not allowed to   be heard.   We knew we had been silenced.  We had, of course, been silence many times before and had learned to still that voice; to not be who we were meant to be, to compromise our truest selves. We had watched our mothers and the women in our communities.   That we breastfed and fought for a natural childbirth against all odds- wasn't that enough.

But when we got pregnant again we knew that the voice would not be quiet.  Perhaps because it was in the hearts of own all over the country and because there were generations of women all over the world there minor hearts to encourage and protect us.  And so we began to look- quietly and alone and found a book and had a conversation and had our first home births and then joined study groups and took correspondence courses and dared to listen to that voice that called upon us to sing a song for women and mothers; the one inside of us that was waiting to be heard.

When we were young, with breastfeeding toddlers at home, we took a week long workshop on midwifery and slept in a tent in a backyard.  We laughed all night long.  We had no idea where this would take us or who we would be but we followed a small,still voice and tried to learn as best we could.  There were no schools in Portland.  We had study groups  and read what we could and began to attend births.  It was an avocation.   I don't think we thought of it as a profession.  It was our life as we saw and felt and dreamed it.  It was us waiting to be born, even as we held the hands of women giving birth.

This is how many, many woman became a midwife.   There was a river.  We put our toes in the water and then could not turn back.

A Letter from Dr Ed Hoffman- Smith on Oregon's Birth Story. Thank you so much for everything

Hi Sarah,

I just found your email. Sorry bout that. If you could find Michael
Ancharski (now in Hawaii) or John Dye (at the Southwest College of
Naturopathic Medicine), they would be able to add stuff. (Kathy
Naughton, ND also did births with Dr. Hedges, and Katherine Downey was
in my class along with Michael and John.) John and Michael trained with
two people in LA. One was Dr. Nail Ettinghausen. He was a licensed
"Drugless Practitioner". Really old school licensing. He wrote a couple
of books, one was "Childbirth at its Best". His methods were pretty much
exactly what we were taught. He even did a very nice video on delivering
breeches (that saved our bacon early in my career). He typically worked
with midwives who did the labor sitting and Dr. Ettinghausen would show
up later and deliver the baby. He was much beloved, but at the end was
getting hassled by the legal structure in California. Shortly after he
stopped doing births he spoke at a conference mainly of ND's in
Portland. Just after explaining to the audience about his retirement -
he seemed to want everybody to know that he was not retiring because of
legal pressure - he collapsed and died right while he was speaking. It
seemed like he was dead when he hit the floor. He might be considered
the leader in the field of home birth in our profession, but Dr. Babnick
might dispute that. Dr. B no doubt trained more doctors, but didn't
write a book. They really used the same methods, but Dr. B never used
midwives to my knowledge.

There was also a MD who did homebirths in the LA area, but I don't know
anything about him. Dr. Ancharski also trained with him.

Dr. Babnick spoke Russian and he helped the Russian community. I guess
he was Russian Orthodox. He lost the sight in one eye early in his life
due to an accident. He was very proud of being a champion weight lifter.
He would sometimes put force on the iliac crests to widen the lower
pelvis during the pushing stage. During birth classes, he taught
exercises, like duck walks and squatting to help open the pelvis, and he
advocated aerobic exercise, particularly walking, that is now well
proven to help labor. During labor, he would sometimes have the laboring
mother climb stairs when her pelvis was particularly challenged. He
would often successfully deliver babies after a first baby was CPD. He
did do VBAC's. He was a believer in various breathing techniques -
typically Lamaze - to help women in labor. He would invite women back to
birth class to tell their story. He would sometime say, "Now is there
anything else I could have told you that would have helped you?" The
answer was usually, "No". He was a big believer in having women at
births to help the laboring woman. He was famous for his technique of
having the woman climb onto his birth chair for the second stage. The
chair was on a sturdy folding table that Dr. B would bring to the birth.
That set up gave a very good exposure for various techniques - like the
iliac crest pressure or supported squat - for difficult second stages. I
myself did these and other techniques, but I designed my own birth chair
that was much more comfortable than Dr. B's, and it sat on the floor -
easier for the laboring woman but not for the birth team.

He had a very good record of success. My wife Elena says he had an angel
on his shoulder. She did a birth with him where the baby came out growth
retarded/genetic defect, and he was able to transport the baby alive to
the hospital where it subsequently died. In retrospect, he should have
recognized that the baby was abnormally small, but all in all, it worked
out well and showed that he had skill in CPR.

Finally, Dr. B was committed to training. Some would criticise him for
bring three students to births. I personally think it could be too much,
and the pregnant women also sometimes would quietly complain. But there
it is - his commitment to training and promoting home birth.

I remember my first birth with Dr. B. He slept in a chair (he advised
that we catch our sleep when we could) then checked dilatation every two
hours. Each student then would do the check after him. A laboring women
naturally would prefer not to have a series of 4 internal checks
periodically during their labor, but most respected the goal of training
and loved Dr. B for his generous heart. At one point in the labor he
happily announced for our benefit that this was a perfectly normal
average first labor.

I hope this fills out some of the info about our early teachers. Dr.
Hedges was two years ahead of me, so he could give you more info.


Ed Hofmann-Smith

On 2/17/15 11:14 AM, Sarah Taylor wrote:
Hi Alan and Ed,

So here I am, trying to put together the pieces of Oregon's home birth 
history. I realized that the younger midwives did not know it all and 
what a grand story it was and so I am trying to capture it. We are 
having a panel and display night on May 5th at 6:00 at the Central 
Lutheran Church. We are also going to thank doctors like you two.

In the man time, I am trying to put the story together and realize 
that DC/ND's were most likely the main ones attending home births 
before they trained a core group of midwives and ND students who in 
turn trained more and so on down the line.

I remember Dr Babnick but could find little at NCNM about him.
What do you all recall? Were their others? Did he share what his 
training was and who taught him? What stories do you recall? What 
other ND's did he train? Was he the main source of that teaching at 
the time?

He seems to have worked in northeast Portland; Hollywood area and his 
wife's memorial was at St Stephen's in SE so perhaps Catholic. Did 
you get the sense that a particular group used him?

Do you have any idea when DC's stopped doing births an when the DC/ND 
degree stopped?

In addition to the panel I am trying to encourage people to write down 
any small stories or pieces of history for anon informal journal. We 
are including ND's, Midwives and CNM's. Any homebirth practitioners.

Do you have any direction you think I should go? Ed, do you have a 
link of the ND Ob group email if they have one?

Of course, with any history collecting there is the question of 
importance. Is this useful to collect before its too late. I know 
that we mostly failed to capture the stories of the last midwives who 
practiced before the 1970's. Everyone was so sad but now we are about 
to do it again. I guess its easy to not think the current story is of 
value. One thing I am fascinate with is the connecting moments 
between the old time ND's and the new generations of 1970's- 1980's 
homebirth practicioners.

Love and appreciate you guys for all you did. Lets capture some 
story together.


Thursday, March 19, 2015

People's Clinic's and Communes

The renaissance of midwives in Oregon and the United States emerged from many places; a reaction to the war in SE Asia,  the women's movement and a desire to create a new and kinder world.  There was a powerful view that corporations had caused all the death in SE Asia and the numbing effect of an American Dream that was inequitable and unfair.   It was a time of a peaceful revolution.  Everywhere small groups of people were deciding to take back their communities.  Many things that exist today, stemmed from this movement to take control by  building peaceful, cooperative communities.

People started food buying clubs, food co-ops, daycare centers, free schools and free clinics.   Doctors, nurses, EMT's, herbalist and community health workers got together in small spaces and offered free healthcare.

Such places emerged in Oregon, both in the city and in remote communities that had minimal access to health care.  One such clinic was the Takilma Clinic near Cave Junction.  The community that started the Takilma's People Clinic also started schools, Natural Resource Organizations and much more. They devoted themselves to making a healthy, peaceful world for themselves and the people around them.  People left the city to start a new way of growing food, making decisions and raising families.

Having their babies at home, training midwives grew out of this.   There was the Deadwood People's Clinic near Eugene and the Birth Center in Portland.  There was The Farm in Tennessee.  This was a time of minimal health insurance or medical assistance.  People's clinics and the midwives who worked in them, became the answer to many a pregnant woman who lacked the resources to pay hospital and doctor fees.   It was two things; it was cheap or free and the midwives were willing to spend lots of time with a pregnant woman and her family.   Midwives of this time, in Oregon history, threw themselves into the practice and art of catching babies with love and a belief that a new world order was emerging.  Clinics run by the people and for the people were one of those values.

Fast forward to 2015, and the free or people's clinics have largely been incorporated into state and federally funded clinics.  There is Oregon Health Plan,  The Affordable Care Act, Medicaid.   The few "free" clinics in Portland are mostly for the homeless or drug effected and often have large boards and are non-profits with substantial budgets.

For many years, I offered free prenatal care in Portland.  First at a mother-baby Head Start and then in my own clinic.   It was always pretty low key; one time a week of free prenatal care.  I also almost always lived in some form of community.   It is a little hard to reflect tenths time.  I talk with a neighbor who says he spent an afternoon at Woodstock and how it changed his life because everyone shared.   I look down.  It seemed like everything almost always became corporate and always turned into making lots of money; not just a simple living.

I remember Ina Mae saying that birth was spiritual and so you could not confuse birth with making money.   I don't know what she thinks now.  This was in the 1970's when we got together and taught each other and people opened free clinics and traded a birth for eggs and carpentry and a piece of art.

It was a unique and special time in Oregon's history and midwives, delivering babies at home, were a part of it.

I think sometimes, I feel tricked. Like I was this hippie midwife and was on this track of peace and community and then I woke up and it was not quite there anymore.   That somehow I had gotten too busy or too tried or spread too thin.   Or that there was a river and we were just one small part of that and that change is inevitable and its all good.   Practically, I could see that midwifery could not stay as it was in the 70's and 80's and yet as I read about the People's Clinic, I am filled with a longing.

For more about Takilma and the People's Clinic you might read, Takilma Tales by Susan Fahrnkopf.

Sunday, March 15, 2015

North from the Texas-Mexico Border

North from the Mexico-Texas Border

In August, when school was about to begin again and everyone was happy to just sit an enjoy the last long days of summer, I met Hope.   We were sitting at a picnic watching children play.  I was still revering from a mosquito borne illness caught in Haiti and so was full of a concentrated effort to breathe through the lingering pain.

I had known Hope's daughter for over 15 years but had never met her mother.  e talked about our lives; as educators and mine as a midwife.  She then told me of her mother an dyer grandmother; of aunties and friends who were healers and midwives.

She had made the long journey to Santiam, each summer, where her family camped in tents and worked the fields.  At sumer's end, they returned to Texas.  They did this for many years and then one year her father died and they just stayed in Oregon.

Yesterday, I went to Hope's birthday/ retirement party.  Her daughter said it might be a good place to get the women to talk about midwives and birth in the migrant camps in the 50's.   I enjoy the drive to Woodburn and find the housing complex where so many of the family lives; three generations in avocado green wood apartments.  We gather in a party room where there are decorations and food and a scattering of family and friends.  I had known Maria all these years and her family had come to so many parties and meals at my house and we had gone to her house many times but this was different.  I could see it was women who were older now; in bright make up and good clothes who sat  at tables and served warm tortillas with beans and were both festive and stoic.

I was not sure that I should sit there at there tables and ask them about midwives.   It was a long time ago. Their children were born at the Silverton or Salem Hospitals.  There were no more midwives; in Texas and Mexico maybe but not in Oregon.

One woman tells me there mother delivered many babies, on both sides of the border. For white people too.  She had promised to come and deliver her babies at home in Oregon but hehe died right before the birth.  I can see this was hard on her.   She said her mother told her never scream. "If you scream, the baby won't get enough air and will die."   She tells me that her mother never let women scream and no one, mother or baby, ever died.

Hope says she cannot remember.  A cousins says the old midwife had a book of remedies she kept but when she died and they wen town there someone had stolen it and they feel badly about that.  Her daughter, Hope's mother, knew a lot of herbal remedies and lived in Woodburn but she died too.

I am trying too hard.   "So, you came up here and lived in tents and had your babies int he hospital."

The cousin says well probably not because I deal with birth certificates and even white people of a certain age were born at home.  It says so on the birth certificate. Everyone shrugs.

At the playground, in August, Hope remembered being a girl in the camps.  She remembered playing and watching the children and babies being born there in he camps.   I tell myself this is her party.  Her sister says, "Everyone had to work in the fields.  That's all."

Hope is my age.   She was born on the Texas border. Her grandmother was her midwife and then they came and stayed in Oregon each summer and one summer they never returned; to Mexico, to Texas and to her grandmother.  She has kids, a divorce, grandkids and a pension form working as a bi-lingual teachers-aide.   She wants to dance, go to the casino and hold grand babies.   Life with her midwife/ grandmother is a long, long, long time ago.  They are sorry the book she wrote was stolen.  They wish someone caed about the story of her grandmother.  That the younger generation cared.   We sing, take photos and cut the cake and then I drive throughout the dusk to Portland.

In the 1970's and 1980's, the same Mexico-Texas boxer became a place for midwives who wanted to be taught traditional midwifery to learn.  I drive through El Paso where the midwifery school once was and there are walls and border control trucks everywhere.  It is no place for a midwife to walk across the border; back and forth to deliver babies with no regard to nation or language or skin color.

Monday, March 9, 2015

Birth and the Women's Movement

Two forces, so opposite, came into play, when we consider the influence of feminism on childbirth.  During the suffrage movement, women advocated for pain free childbirth and welcomed not only birth control but also any new technology that made it less painful.   They pushed for hospital births, drug them and drag them out systems.   The wealthier women, with more formal education, pushed for twilight sleep and even created twilight societies.

Fast forward twenty to thirty years and the women's movement demanded  participation in their own healthcare.  Our Bodies Ourselves was written in the late 60's and becomes popular in the 70's.  Women learned to do their own gyn exams and with that, begin to teach themselves childbirth.  They no longer want to lie on their back, strapped down with no control.   Much of the natural and later home or birth center movement came from these early feminists who wanted to take back control of their bodies.

Many of the early home birth study groups emerged from the early feminists health centers.  Portland's first midwifery school and Birth Center was an out growth of the Feminist Women's Health Collective.  For many years, the two walked hand in hand.

May 5th - Stories of Oregon's midwives


This journey does not seem difficult when I take it on. I am simply trying to invite doctors and midwives who were part of the home birth movement in the 1970's and 1980's to an event on May 5th; to tell their stories, see old friends and have a good time.

It is not simple.  We have scattered and many are no longer in practice.  People got wounded along the way or felt that they lost their voice.   I try to listen and am amazed at what I do not know.   After so much struggle, many have moved on to other careers and interests.

I am also trying to write a timeline of important events.  I try to grasp the forces at play in the 1970's and how they impacted birth and what the response was and how it all shifted and changed and what has come out of all those back woods births in the middle of  the night in free clinics and communes and urban homesteads.  What do I hold in my heart still and how does it lead me still?

If you read this and have a story to tell come on May 5th to the Central Lutheran Church.  Bring photos and important items.  We'll open the doors at 6:00 and start story telling at 7:00.  Please pass the word on.

In April, I am going to a remote community in the Philipines.  My daughter in law is from the Philipines and I am supporting her friends organization.  I know they will all teach me so much even as I try to offer something in exchange.   I consider what it means to be a community of midwives the world around s I collect these Oregon stories.

Thursday, March 5, 2015

The fire never went out; tending the coals of natural, home births.

I am listening to a midwife share her perspective.

She wants everyone  to understand  that there were always people doing home births and that it never went  away.   Family practice doctors and chiropractors continued to attend women at home and worked closely with midwives during the 1940's and 1950's and 1960's when most births began to take place in hospitals.  

It is like a campfire, early in the morning.  There are still glowing embers and coals.   It only needs someone to blow on it and add some more fuel and it will burn again.

Doctors and midwives, seemingly, working together, delivered babies at home, in Oregon, long before the re- emergence of midwives in the 1970's.   When women looked for an alternative to a "drug em and drag em out birth"  they found the remaining home birth doctors and midwives.    They found old text books,  doctors and midwives trained in other countries and began to work together to learn how to deliver babies without intervention and with the people they needed by their side.

It must have been amazing for the old family docs,  to watch all these people breathe new life into home birth.   Amazing but also, in all the fuss, they were soon forgotten.  

The doctors and midwives, who had been working together for so many years, separated and there were nurse midwives and doctors and lay midwives.  There were families having their babies on their own, after reading a book.   And then there were hospitals, that giving into consumer pressure, decorated birth rooms to look like a home and allowed natural childbirth.

When I announced to my parents, that I was having my baby at home, they protested.  Then, my grandmother looked sternly at them and said, "And where do you think you two were born?"  It was that close.  My parents born at home and then my children born at home.  

When the women in the 1970's decided to become midwives, they found people who had tended the fire in the cold, lean years of home birth.  It was sometimes hard but they were there all along.

This is what this wise midwife of the 1970's wants everyone to know.  The fire never went out.

Tuesday, March 3, 2015

Peter Bours and the Forest Grove Birth Cabins

During the 1970's and 1980's, Peter Bours and his wife, Joan delivered babies at home and in small birthing cabins on their farm in Forest Grove.   This is an article fro the New York Times.  I am sharing the part about his home and birth center practice.

Peter Bours, too, was drawn by the uncomplicated beauty of the place. He bought a piece of farmland and an old frame house outside town in 1974 and went into practice. By this time, Dr. Bours was once again single. ''If I weren't such a social traditionalist,'' he says in wry reflection, ''I wouldn't have married so many times.'' And within a few years, he did it again, marrying his nurse, Joan Moss.
Together, they built a family practice based on delivering babies - often, in that era, to couples who wanted their children born at home or in one of the birthing cabins that Dr. Bours fashioned from outbuildings on his property. It was an effort to take obstetrical medicine out of cold, institutional hospital delivery rooms and return it to the home - and it fit with the ideas he had developed during the war years, the search for a redefinition of personal and social relationships.
Few doctors in the area were offering that kind of care. ''So we had a lot of highly educated 30- to 40-year-olds in Portland coming out to have their babies with us,'' Dr. Bours says. For his wife, it was an idyllic time. ''In one year,'' she recalls, ''we did 350 deliveries, and that was in just 365 days. I remember thinking, 'I have the most wonderful job in the world.' '' In time, the couple had their own children, a daughter, Heidi, and a son, William Alsop Bours V. Peter Bours had his own style. He wore loose shirts and comfortable pants and knockaround shoes, almost never a coat and tie. His patients called him by his first name. And he kept his rates low, paying himself less than $50,000 a year, sinking the rest of his income into the new clinic which he built in town, next to the community hospital.
Says the Rev. Richard E. Osburn, pastor of the United Church of Christ, whose congregation supports the right to abortion, ''A lot of people considered Peter a strange duck. Different.'' When the town police would stop Dr. Bours for speeding on the way to a delivery, recalls the minister, a former chaplain of the police force, the doctor would inform them that he would meet them the next morning if they wanted to give him a ticket, but that at the moment he was in a rush. ''I know that a lot of the officers think of Peter as thinking he's above things,'' the minister says.

Dr. Bours's practice flourished. His new office and patient rooms were bright and cheerful, crammed with snapshots of pink new babies and their beaming parents. And at the top of the building he hung a bell, to ring out the news of birth.