Work-N-Progress: A Better Form of Social Activism ~ Six Degrees of Separation
Extraordinary Street Art ~ graffiti on public retaining wall incorporated into this compelling pair of eyes, with the foliage on the top of the wall framing her face with what looks like green hair.
Editor’s Contemporary Note — the large size of the text is so far an unsolved mystery — nothing I’ve done has fixed the problem, so I’m looking for reliable and affordable tech support. In the meantime, we are all stuck with this too-big font!
I apologize to anyone who is reading this unfinished draft. At the moment, it is more like “brainstorming”.
However, this “work-n-progress’ does nail down some very interesting ideas, and is a useful stepping stone to the (eventually) finish the post.
Come back again in a couple of weeks. Right now is a busy time in our birth practice with 3 babies due in the next four weeks, so it may take a while to finished this essay.
Dear Long-Time Friends and Best New Acquaintances ^O^
I hope this letter/email/blog post finds you and your loved ones well and happy. Each of you is one of a very small handful of my friends and professional acquaintances — people that I have a long and strong connection with, or if we have only recently met, someone’s who has talents that are uniquely suited to a new area of political activism that I have been developing over the last few months.
Being a midwife during the 2020-21 Covide pandemic
The focus of this activity is to promote the normalization of childbirth practice for healthy women with normal pregnancies and to stop the ever-escalating, unnecessary and potentially dangerous (always expensive!) medicalization of normal childbirth in this same population of healthy women. However, this new perspective for activism can also be used to good purpose in almost every arena of modern life.
I describe this as a variation of “six degrees of separation”. This is an observation that an individual can get in touch (either personally or in an exchange of information) with persons they aren’t already acquainted with in the equivalent of 6 steps, usually as phone calls. As a former ER nurse, I was often had to track down the vacationing parents of an ER patient that wasn’t yet 21 and we need parental permission to treat. I usually accomplished the job in less than 6 phone calls.
When it comes effective activism without exploiting precious human resources, what is needed is a way to connect people with specific abilities to a particular need in a timely fashion. Each of us is quite naturally the hub of a web that connects to other talented people or otherwise useful resources. Most of us, myself included, have not made use of these opportunities because there was no organized structure for utilizing such talent and no one else to coordinate with on a particular topic. All by ourselves, our time, talents, creative ideas and energies are too limited to make much headway.
But this alternative model of political activism creates both structure and coordinated effort that at the personal level is satisfying and effective without being burdensome. I’m describing unrushed activity that uses the unique talents of each of you as individuals, is both respectful and conservative of your time and energies, and occurs in the comfort of your own home, at your own pace.
I hope each of you will consider the possibility of being such a ‘resource’ – both in regard to your own unique talents and to the functional gift as the hub of a web of your own “six degrees of separation” resources.
As long as you have access to phone, a computer, and internet service, it also won’t cost you anything and no, its not a pyramid scheme. I am not marketing anything (multi-level or otherwise) or in any other way ‘pitching’ an economic scheme of any kind.
A bit of background about me and birth politics
As most of you know, I have been a professional health care provider for my entire adult life, working as a nurse in the Labor & Delivery unit and as an ER nurse and now as a professional midwife.
But my experience as student nurse in a still racially segregated hospital — what I called the ‘Dark Ages of the Deep South” — convinced me that the obstetric system in American was both dysfunction and in many ways barbaric.
In our segregated institution, there were two seperate wards for maternity patients, depending on whether the mother-to-be was white or black. White women were admitted the L&D unit on 5 North, which black moms were just admitted to “women’s only” ward on 1 South in the hospital’s basement, between the hospital’s busy kitchen and its big busy laundry and just a few feet away from the morgue.
The kind of care you received as a laboring woman was totally dependant on skin color.
All White 5 North — All interventions, all the time!
If you were white, you had no choice but to have your labor taken over by a system massive intervention in all normal labors and births of healthy women. This began by isolating them from their families in the “No Admittance – Hospital Personnel Only ” labor ward on 5 North, where all labor patient were immediately and repeatedly medicated with Twilight Sleep drugs — narcotics and amnesic and hallucinogenic drug scopolamine. When labor patients started to push, they were moved by stretcher to the ‘delivery room’, which was an operating room specially outfitted for the surgical procedures of “delivery”.
So-called “normal childbirth” conducted as a series of surgical procedures from 1910 to the 1980s
After the heavily medicated and semi-conscious labor patient was taken to the delivery room by stretcher, she was moved to an operating room table outfitted with large leather wrist restraints and obstetrical stirrups. After the nurees moved her on to the OR table, her wrists were clamped to her side by the leather restraints and her leg were put up in stirrups and likewise strapped into place with large leather restraints.
Then the nurse anesthetist strapped a black anesthetic mask over the mother’s face and began by rendering the mother unconscious under general anesthesia. When I was an L&D nurse in the 1970s ether and chloroform, which were both highly explosive, had been replaced by cyclopropane, which was safer, as it was less explosive and less likely to cause liver damage. However, the anesthesia, in combination with the repeated injections of narcotics given to the mother ever 2 or three hours during labor, routinely resulted in respiratory depression in newborn babies.
during the m followed by the doctor or OB resident cutting a “generous” episiotomy, followed by inserting the forceps blades up into the mother’ vagina and around the head of her baby.
Then the OB gave instruction to the L&D nurse (i.e. my job!) to stand on a 12″ foot stool and push has hard as i could on the top of the mother’s uterus to forge the baby deeping into the pelvis so it would be easier for the doctor to extract the baby with forceps. Then the doctor manually removed the placenta by reaching his hand into the other vaginia and up into her uterus in order to pell the placenta from the uterine wall and pull it out in his hand.
The ‘finishing touch” was to suture the episiotomy, including the infamous “husband stitch”. This was the result of an appocraful story in which obstetricians recounted a complaint by some husband somewhere. The story was that husband came to see his wife’s OB some months after the birth of their first baby and complained that “Ever since she had the baby, having sex with her is like walking into a warm room”.
Black Labor Patients admitted to 1 South — an intervention-free zone and hands-off normal childbirth
Our black mothers-to-be were admitted to a 4-bed ward. This was not a special “maternity” unit, just other black women hospitalized for a variety of non-contagious medical conditions. After being shown to their bed, give a hospital gown and admittance temp and blood pressure taken, black labor patient were instructed to notify the nurse when they stated to push and then were left to their own devices.
Often one or more of the other women patients would give these new labor patients tips on how best to cope with the pain of labor. This advise started by cautioning the laboring woman not to lying down in bed, but instead that she walk and move around between contraction. During the contraction, her roommates encouraged her to hold on the bar at the end of her bed and let her body sink down into a semi-squat. When she began to feel pelvic pressure, they told her it was best to sit on the toilet for while, to keep her bladder empty (more room for the baby) and in case she she needed to poop. When she needed to push with each and every contraction, one of the women in the ward would notify the nurse.
Within a few minutes one of the nurses would bring a stretcher to the room, have about-to-be new mom move over and lay down. Then the nurse throw a sheet over her and head for the elevator that traversed the physical and political distance between 1 South and the hospital’s only delivery rooms which were five floor above on 5 North.
However, most of these moms were having a 2nd, 3rd, 4th, 5th, or even 15th baby. By the time these labor patients started to push and had been moved by stretcher to the elevator, the race with the stork was lost! Sometime between the closing of the elevator door on 1 South and before it opened on 5 North, that one last big pushed resulted in the baby’s spontaneous birth in the elevator.
As a student nurses i was an observer to several of these “happy occasions” as the RN “caught” the baby and simply handed it up to the unmedicated and fully conscious mother. Since there were no narcotics drugs in the baby’s system (narcotics given to the mother depress respirations in newborns) her baby took its first breath and started to cry and it’s new mom proclaimed “look what i did”, why isn’t s/her pretty!
Normal childbirth as it occurred naturally in women whose labors and births were NOT subjected to obstetrical interventions — amnesic drug, general anesthesia, episiotomies, fundal pressure by nurses and forceps deliveries by OBs — was of course a study in what happens when childbirth services for healthy women with normal term pregnancies (70 to 85%) and regardless of skin color are provided with supportive rather than interventive care.
Click the link below to read my personal “Time Traveler’s Perspective on Normal Childbirth“, published in the journal BIRTH in September 2011
BIRTH-PracPerspective_MyArticle_Sept11_2011
since graduating from nursing school in 1960’s, most of my time and talents as a political and social activist have focused on trying to normalize childbirth practices.
In 1964 I became a mother myself and since then have been even more committed to seeing that the right of self-determination in regard to normal childbirth in healthy, mentally competent adult women was not merely respected but was accepted as the standard of care with legal obligations of maternity care providers — doctors, nurses, hospital administrators and state licensing agencies — to respect.
After working unsuccessfully for more than a decade as an L&D nurse to correct the many excesses of hospital obstetrics, I left nursing as a profession. I wanted to ‘walk my talk’, that is, to exemplify the safety and social benefits of a physiologically-based model of care for healthy women by being on the front lines myself as a community-based midwife.
The basic purpose of maternity care is to protect and preserve the health of already healthy women. The basic goal is a cost-effective model that is able to preserve health and effectively prevent or successfully treat complications during pregnancy and childbirth. Mastery in normal childbirth services for healthy women with normal pregnancies means bringing about a good outcome without introducing any unnecessary harm or unproductive expense.
The ideal maternity care system seeks out the point of balance where the skillful use of physiological management and adroit use of necessary medical interventions provides the best outcome with the fewest number of medical/surgical procedures and least expense to the health care system. Ultimately, all maternity care is judged by its results — the number of mothers and babies who graduate from its ministration as healthy, or healthier, than when they started.
In my mind, the ultimate goal has always been a model of maternity care for healthy women that integrated the scientific principles of physiological management with best advances in obstetrical medicine to create a single, evidence-based standard for all healthy women with normal pregnancies.
In this scientific evidence-based model, obstetric interventions are reserved for those with complications or if requested by the mother.
Having scientifically identified ‘standard care’ characteristics, this model of ‘best practices’ would apply to all birth settings and be used universally by all categories of birth attendants when providing care to healthy women.
In such an evidence-based model, the individual management of pregnancy and child- birth would be determined by the health status of the childbearing woman and her unborn baby, in conjunction with the mother’s stated preferences, rather than the occupational status of the care provider (physician or midwife).
In practical and political terms, the cultural controversy over childbirth practices should not pit physicians and midwives against each other or pit obstetricians against family practice physicians. No healthy child- bearing woman should ever be forced to choose between a midwife and a physician-obstetrician or between a home and hospital birth to have a physiologically managed normal birth.
Over that considerable span of time I saw and experienced many dramatic advances in medical science, new trends in how health care was provided and paid for, and in particular, the political configurations that determined which patients did and didn’t get taken care of and how (particularly childbirth practices) that care was provided or withheld. As someone with a lot of “up and close personal’ experience, I have lots of opinions about this important area of modern life. At elevating the public discourse in the area of health and in the rehabilitation of maternity care for healthy women.
@@@@ unedited below – June 23, 2016 @@@@
Participatory Democracy & Grass-roots Social Activism: Ideas for using people and technology in new and better ways
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Ideas for integrating people with professional expertise and extensive life experience as an ‘expert resource’ for authors who want to use fiction (i.e. books, films, television, etc.) as a medium for scientific information and education on various topics, but especially the normalizing of normal childbirth in healthy women.
Education in this sense refers to a general understanding of scientific principals as well as correcting wrong ideas & harmful assumptions. It that regard, this form of fact-based fictions also provides an opportunity to raise social consciousness relative to controversial topics.
@ Fact-based fiction as medium for science education and “six degrees of separation” as a complementary source of uniquely relevant information from
@ Before I marry these two strange ideas to make one big whole, let me explain each one by itself and then we’ll them back together.
@ First is fact-based fiction as medium for science education as part of an entertaining story by adding either ‘hot’ and ‘cold’ topics that usually are not a part of the public discourse
@I would like to see if we could get people already proven to have a certain talent or influence to together to work on a project in their area of expertise or loosely on big picture ideas that have the potential to move the conversation forward to a 21st century model of physiologically-based maternity care for healthy women.
@ While this can appeal to any type of audience, a particularly appropriate target audience are stories written for the young-adult age group (late teens, early 20s). This can address any interesting science topic, as well correcting specific wrong & harmful assumption and raising the general social consciousness of various issues (for example racial, ethnic and religious prejudice in the context of one’s family, schoolmates,and neighborhood
@ – that is, personally connecting up authors and screen-writers the profession expertize and life-experience of people with unique personal stories.
@ Six degrees of Separation — connecting the profession expertize and life-experience of people with unique personal stories into a people-powered grid the areas of fiction writing, investigative journalism, Hollywood and indie film makings, television, etc.
@@@ Other related ideas that bundle with this untapped pool of “unsung “experts” is idea I have been developing for an “off-Broadway” version of TED Talks — video presentations in areas of expertise (what I describe as “TeddyTalks”) for those of us who would benefit from the wonders of video-editing technology (ex. retakes, out-takes and ways to perfect a less-than-perfect first take performance.
@@@@ Last but not least I also an interesting in developing of a computer-based video teaching program relative to the biological principles of normal childbirth. Obviously an online computer generated video program allows you to make mistakes w/o anyone dying.
Students get to practice making decisions and finding out what happens when they make their best guess. It the ideal way to teach any healthcare discipline, in that it is effective, inexpensive and safe. (more about this later in this post).
@ into a people-powered grid the areas of fiction writing, investigative journalism, Hollywood and indie film makings, television, etc.
@ Brief part of the story – backstory, flash-backs, or short contemporary scenes from a few pages to an on-going thread intertwined in a fiction story of any kind – can interlaced into books, Hollywood and Indie films, TV sitcoms and dramatic series, mini-series.
@ A published example of this is Young-Adults author Kate McGovern. Her novel “RULES FOR 50/50 CHANCES” is about a 17½ year-old high school senior whose mother is a carrier for the Huntington’s disease gene and has recently become symptomatic. At the age of 18, her daughter will have to decide whether she wants to take a genetic test for HD, knowing there’s a 50-50 chance it will be positive.
@ If she decides to test and looses this coin-toss, it means living the rest of her life knowing that she will literally follow in her mother’s footstep into increasing dementia by the age of 40 or so. If she doesn’t test, she and her loved ones will have to live different, but also difficult set of issues and problems. The format of a novel provides an extremely useful for exploring the science of HD, and the sociology and psychology of dealing with HD up-close and personal. (U can read more @ http://www.kate-mcgovern.com/#hello-there)
@@ My own personal and professional goals for fact-based fiction is to tell the last and most important UNTOLD story of the 20th century: How normal childbirth got trapped on the wrong side of history in America. Beginning in 1910, a perfect storm of unrelated issues turned healthy childbearing women in the US into the patients of a surgical specialty and normal childbirth into a surgical procedure. The result was the most profound and far-reaching change in childbirth practices in the history of the human species. This perspective, and the policies they engendered, continues to underpin the obstetrical model of care as applied to healthy women today.
@@ A Downton Abby type series/Call the Midwife to be produced in the UK
@@ Ask the midwife, an on-going series of 3 to 10 minute YouTube video dealing with all kinds of issues relative to normal physiological childbirth the controversy between Ob medicine, mfry and physiologically normal child birth etc.
@@@@ Game theory – actually what I would call a computer-based video teaching program that allowed not only information about the biology-physiology and other technical aspects of caring for women having a normal childbirth but also the ability to develop and practice using one clinical judgments. Obviously an online computer generated video program allows you to make mistakes w/o anyone dying.
Students get to practice making decisions and finding out what happens when they make their best guess. It the ideal way to teach any healthcare discipline, in that it is effective, inexpensive and safe.
@@@ Last but not least is the idea of Teddy Talks. Teddy Talks are like Ted Talks, only on topics that are much less global. Anyone can do a Teddy Talk about topics that are of limited interest or only pertinent to a special group of people.
Also it’s something that you can yourself decide to do, rather than waiting for the Ted talk people to invite you to prove to present. It also means that you get to use notes, do a takeover and use the wonders of video editing. That means that you can take delete bad parts and rearrange the order in which ideas are presented. It’s really much more user-friendly than TED Talks and it’s much more achievable then waiting to get invited to do a Ted talk.
@@ I would like to see if we could get people already proven to have a certain talent, or influence to together to work on a project in their area of expertise or loosely on big picture ideas that have the potential to move the conversation forward to a 21st century model of physiologically-based maternity care for healthy women.
@@ What we are doing now (food fights in the NYT with Amy Tuteur et al are not working and frankly, can’t work. Pitched battles between two opposing side do not provide a suitable opportunity to inform people in ways that really make a real difference.
@@ As I and other midwives are found of saying “More of what isn’t working won’t work either. So let’s skip what doesn’t work and do the things that would work to change the public perception of normal birth from an obstetrical emergency to something that’s part of normal life. We want the next generation of childbearing women to NOT expect a surgical delivery unless there’s an actual present tense medical problem for which that is the appropriate solution.
========= parking lot for unfinished ideas/sentences, etc =============
@@ I want to harness the idea of fact-based fiction, and
@@ as an aspect of scientific education and raised consciousness of the public about childbirth practices and to appropriately portray midwives and midwifery as an important and historically honorable profession
@@ as known characters in the fiction story deal with pregnancy and a physiologically-managed (i.e. not medicalized) normal labor and birth in an OOH setting, and what happens to the new mother and baby in the first hours after the birth.
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People identified as possibly interested and to contact later on:
Angie Thieriot, founder, Planetree Hospitals; Don Creevy, MD, retired obstetrician, Myra Gerson-Gilfix, JD, Dr. Selva (midwife-friendly obstetrician, Santa Cruz, CA), Shelly Girard, LM, normal birth activist, Henci Goer, researcher and published author several books on normal childbirth, Muna Bastir, mother and birth activist, Katy Reckdahl, investigative reporter, New Orleans area, Kate McGovern, author “50-50 Chance”; Lidia Yuknavitch, author; Professor Dues {Great Courses’ The Art of Conflict Management}
