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"Some people were like, 'Ooh, gross,'" Geoffrey says. "To be honest, I was like, 'This is kind of odd.' But I felt like my job was to be like, whatever is going to make her feel better." And it did. "It tastes amazing!" Indra says.

The next day, when Flame visited to check on them, Indra was fired up; her interest in midwifery had been piqued in a personal way, and she was hungry for more information. So she immediately began reading a book by French doctor and natural birth proponent Michel Odent. Other books followed, including Baby Catcher: Chronicles of a Modern Midwife and Immaculate Deception, a 1975 book that was key to midwifery's '70s resurgence. Together, Indra and Flame pondered why more lesbians weren't choosing home birth, and they wrote an article for the monthly magazine Weird Sisters West. "Where are all the dykes?" it asked.

"Just in writing that article and those moments after birth, I was like, I'm not just going to be the average client that goes away," Indra says. "I'm going to be an advocate, actually. That was just the beginning."

Indra Lusero is putting her law degree to work for midwives.
anthony camera
Indra Lusero is putting her law degree to work for midwives.
Indra Lusero in a family photo, shortly after giving birth to Eliot Indigo.
anthony camera
Indra Lusero in a family photo, shortly after giving birth to Eliot Indigo.

******

The midwife population in Colorado is tiny: There are 54 registered direct-entry midwives, according to a DORA report prepared in October, though the CMA now puts that number at 67. In 2009, direct-entry midwives delivered 637 babies, which was about 1 percent of the babies born in Colorado. That number has grown; in 1994, the first full year after midwifery was legalized, midwives delivered 253 babies.

The state also requires midwives to track how many babies in their care die during pregnancy or soon after they're born. In 1994, it was two. In 2008, the most recent year for which statistics are available, it was seven, up from five in both of the previous two years. That's a lower rate than with hospital births, partly because midwives can only attend low-risk births.

A DORA report from 2000 also contains statistics on infant health (while the 2010 report does not). On average, it says, babies born to midwives in Colorado had healthier birth weights, and better heart rates, respiration, reflexes and muscle tone.

But things can still go wrong. In 2009, DORA statistics show that ninety women attempting home births were transferred to the hospital during labor and thirteen babies born at home were transferred within 24 hours. Sue Townsend, a neonatologist at Memorial Hospital in Colorado Springs, says that in December, it so happened that the hospital saw two transferred babies: one with pneumonia and another with a tear in its lung. Both problems are common, she says, but it's safer to experience them in the hospital.

"If you're in the hospital, you have the ultrasound machine. Or you can do an emergency C-section," says Townsend, who is the immediate past president of the Colorado chapter of the American Academy of Pediatrics. "Many physicians and certified nurse-midwives are trained to recognize the risks."

So are midwives, say midwifery advocates. To practice in Colorado, they must graduate from a midwifery school or its equivalent and complete a year-long apprenticeship, as well as pass a national exam. In addition to becoming skilled in prenatal care, delivery and newborn health, they must know how to use equipment such as catheters and suturing tools, evaluate lab records, give a shot, treat blood loss after a delivery, administer oxygen and activate an emergency backup plan. "I always feel like doctors don't understand that midwives are educated," says Boulder midwife Elizabeth Moore, who served as the regional representative to the Midwives Alliance of North America for several years. "If they could understand that, I think things would be better. They just assume the stereotype — that we're just hippies in the alley. It seems like it's just this territorial thing, like you're bad and we're good."

That quarrel has been at the heart of the legislature's two previous sunset reviews of the midwifery law, in 1996 and 2001, and it's already playing a role in this year's review.

A sunset review works like this: DORA talks to all interested parties, including doctors and midwives, and prepares a report with recommendations for changes to the law. A legislative committee then holds a hearing, in which stakeholders testify and push for amendments, which are voted on by lawmakers in that committee. Legislative bill-drafters use the report and amendments to write a bill, which is subject to more hearings. Lawmakers eventually vote on whether to renew the law and which changes, if any, are made.

This time around, several of the DORA recommendations are familiar. Among them is granting midwives "limited prescriptive authority" to obtain and administer certain drugs to mothers and babies: Rhogam for pregnant women whose blood is Rh-negative, a condition that can be dangerous if their babies are Rh-positive; vitamin K shots to combat vitamin-K deficiency, which can lead to bleeding disorders in infants; anti-hemorrhagic drugs for mothers who bleed uncontrollably after delivery. All three conditions are treatable, and midwives must learn in the course of their training when and how to administer the appropriate drugs. But the law prohibits them from doing so. In the 26 other states where midwifery is regulated, all but three allow midwives to administer at least one of the drugs.

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27 comments
Dlmakamartha
Dlmakamartha

Women and babies suffer at the hands of doctors and nurses way more than midwives....unnecessary interventions leading to major abdominal surgery.....I am so sorry for every mother/family that has suffered at the hands of any provider....but it is no reason to throw the baby out with the bath water! Tragedies happen in all stages of pregnancy and delivery and the right people need to be held responsible. But it's not a good reason to ban all midwifery or to issue a blanket statement that women should only have their babies in the hospital. Do you research people and make an informed choice for you and your baby....instead of following blindly like sheep.

I've had a baby in the hospital and one at home....I will forever have the rest of my children at one....

Liz
Liz

I have suffered tremendous injuries from a Colorado DEM. They aren't required any formal education. My midwife is currently under investigation for negligence. She tried to offer someone else's prescription to induce my labor because I was post due. She was gravely uneducated in GBS protocol. She wanted to "sterilize" her instruments in a baking pan in my oven. She tried to "PowerBirth" me without my consent (I wasn't dilated completely when she told me to start pushing.) She forcibly broke my water with her finger. She yelled at me to push every ten seconds, that I was wasting my contractions, wasn't working hard enough, didn't want my baby enough. She kept saying she could see the head, but I didn't feel it. After 3 hours of pushing, I was weak. She put oxygen on me because I was going to pass out, but she forgot to turn it on and left me alone in my room. When I transferred to the hospital, she did not take me to the hospital in our emergency plan, but to a hospital farther away because she had a "better relationship with them." She refused to transfer my medical records to the on call OB. I was so swollen from pushing before being dilated that it took over a half an hour, two L&D nurses, and many, many tries to even insert a catheter. The "head" she saw was a blood clot that had formed on my bladder- I was only 6 cm dilated. "Oh, she must have undilated when we got to the hospital," was her response to the OB. After my csection, my surgeon said he had to literally pick my bladder up and put it back where it belonged, I was pushing so hard before complete dilation. My child almost died from her incompetence. He had to be recuisitated at birth. I suffered uterine trauma, a severe prolapse, and I'll be lucky to sustain another pregnancy. My body will never be able to vaginally birth a baby. Dare to call me an "uninformed skeptic?"

LindaRosaRN
LindaRosaRN

Families who have been injured by midwife care are beginning to tell their stories at "Hurt by Homebirth" (http://hurtbyhomebirth.blogspo.... These are horrific stories of gross incompetence resulting in needless deaths and injuries.

On this site, note "Zen's Story" about a Colorado "direct-entry midwife" (DEM) who apparently couldn't tell the difference between a blood clot and crowning of the infant's head (and had a woman pushing for three hours when her cervix was only partially dilated). This DEM also prescribed garlic as vaginal suppositories for Group B Strep infections, etc.

I urge families who have been injured by DEMs to come to the Capitol in Denver on Tuesday, April 19th to speak to the House Judiciary Committee (hearing starts 1:30pm in Room 107) on SB-088, a bill that seeks to expand the midwives' scope of practice.

"Regulation" of midwives has done nothing to protect the public, but only dupe the public that DEMs have the State's blessing to provide what is really alarmingly substandard care.

If you have suffered a loss or injury at the hands of a Colorado direct-entry midwife, please contact me: contact*at*childrenintherapy*dot*org

john
john

Grace S and other closed-minded, uninformed skeptics, please check out the documentary, and website, The Business of Being Born.

Grace S
Grace S

It just AMAZES me that people can be so self-absorbed and egotistical that they would take ANY risk with the birth of their baby, as if it's all about *them* and not their baby. And now these unprofessional midwives want to be able to "play doctor" by using medications and suturing in people's homes!? Why don't they just become OBGYN doctorsi if they REALLY want to help moms deliver their babies? It BOGGLES the mind!

Njcronk
Njcronk

Grace, I think you have never been at a midwifery birth. If you had, you would see the huge difference in quality of care -- by midwives. Here is my story. I've had both. A birth with a midwife and a birth with OBs. I would pick the midwife birth every time if I could.

http://www.huffingtonpost.com/...

Westword W. Westword
Westword W. Westword

If you would like your comment considered for our Letters to the Editor section, please e-mail me with your name and town (we don't print e-mail addresses)at patricia.calhoun@westword.com.

Leanna14369
Leanna14369

I pray for you and your family and hope this all happens in the best way. I want a midwife, so good luck!!

Karen Robinson, CPM, RM
Karen Robinson, CPM, RM

Because of the way the Department of Regulatory Agencies has collected information regarding homebirths in Colorado, information about perinatal demises is sketchy at best. Some midwives report first trimester miscarriages as perinatal deaths. DORA does not collect details on the surveys midwives complete, so we have no way to know what happened with the demises that have been reported. The Colorado Department of Vital Records also tracks homebirths and their reported demise rate for planned homebirth is less than 3 per 1000--which is what one would expect in the low risk population direct-entry midwives serve.

Karen Robinson, CPM, RMPresidentColorado Midwives Association

LindaRosaRN
LindaRosaRN

About that 3 deaths per 1000 births. Shame on Ms. Robinson for presenting this very misleading statistic.

I called Vital Statistics. The Colorado Department of Health Environment has data on direct-entry midwives for 2007-2009: For midwives, the department does not collect data on deaths for the usual perinatal period (i.e. week 20 of pregnancy through 28 days after birth), but only deaths in the neonate period (i.e. first 28 days of life). Then only deaths that occur at home go on the midwives' record. Any distressed infants transferred to a hospital and die there (or are declared dead there) are not added to midwives' kill rate.

And actually, infant deaths with low risk pregnancies should be more like 1 death per 1,000 births. An obstetrician may only see one such death in his whole career.

DORA's data also under-reports midwife-related deaths in a number of ways.

So much for midwives being "experts at normal deliveries." As someone said, "That's like being a pilot who is an expert at flying in good weather."

Linda Rosa, RN
Linda Rosa, RN

Ms Robinson's statement does not seem to jive with the data provided by DORA:

http://www.dora.state.co.us/mi...

Where are those first trimester miscarriages of which you speak? I presume the demises are here, reported as required by Colorado law of register midwives.

Regarding the statistics by the Colorado Department of Vital Records: that rate must be largely for unassisted-by-midwife, spontaneous births. But DORA's data clearly shows that having a registered midwife assist at a home birth puts the death rate over three times that amount (11.3 deaths per 1,000 births).

And look at the huge number of transfers to hospital care. Presumably those are emergencies where lives and staving off injury are dependent on STAT care.

What is sketchy is the number and type of injuries suffered by newborns who survive home deliveries. DORA should be collecting that data as well.

I also note on websites of Colorado midwives that they generally state that home birth is "safe" and even imply that it is safer than hospital care. That is misleading the public.

I agree that adults should be allowed to risk their own fool necks, but putting infants at needless risk is another matter. Seriously, what is more important: having the best possible outcome for an infant or having a pasta party with friends after a delivery?

2AlbertaA
2AlbertaA

32 yrs ago, my daughter had a home birth with a midwife, nurse studying midwifery and a physician who approved of such and me holding a mirror so she could watch...important since I had been given that choice when she was born. It was wonderfull and within an hour we all sat around the table and ate lasagnia and toasted the great experience and new grandchild. Since then Ive had five grands waterbirths and a greatgrandson by 32 yr old gd.All have been happy and no problem events. New mexico and Colorado are with it....from a believer.

Linda Rosa, RN
Linda Rosa, RN

One thing more...

When things go wrong with lay midwives and home births, there is now a new website for families to tell their tragic stories:

Hurt by Homebirthhttp://hurtbyhomebirth.blogspo...

These heart-rending accounts are a far cry from the hot-tub-poetry-drumming-birth-as-theater sort of event described in this Westword article.

Linda Rosa, RN
Linda Rosa, RN

What I don't see in the Sunset Review or this Westword article is a comparison of death rates -- the bottom line on issue of direct-entry midwives.

The incidence of death of newborns at the hands of direct-entry midwives is appalling high in Colorado, and climbing. The last figures put it at 11.3 deaths per 1000 births. That is DOUBLE the rate of the rest of the state. Also consider that the direct-entry midwives are not involved in high-risk pregnancies, premature births, etc.

For more info, see comments by Amy Tuteur, MD:http://skepticalob.blogspot.co...

Linda Rosa, RNLoveland, CO

Bbcatcher
Bbcatcher

Linda, I am trying to research these statistics. Can you give me your source for this number, as I've not been able to verify it? Thanks,Janelle Komorowski, CNMGreeley CO

Guest
Guest

Seriously, you're quoting Dr. Amy??? The woman actually believes the Wax Paper is good science!

inkintheveins
inkintheveins

I heard Indra speak during the Senate hearing and she was absolutely amazing. I spoke too, but got too choked up a couple of times talking about how important home birth is for those of us who choose it. Here is the written version of my testimony: http://www.facebook.com/note.p...

Guest
Guest

"Home birth has long been a controversial issue. Doctors and nurses say it's unnecessarily risky, and they criticize the midwives who deliver babies at home as amateur and insufficiently trained." ------- How absurd! Women have been giving birth how long compared to the "Medical Profession" which has been established how long?

A great book on this is - Witches, Midwives, and Nurses, A History of Women Healers by Barbara Ehrenreich and Deirdre English- original publishing 1973 Feminist Press. It is only 48 pages and well researched and referenced.

Marvelousbobchestnut
Marvelousbobchestnut

The baby on the cover doesn't have nipples or a belly button. Is this because of anti-obscenity laws?

 
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