Hello dear friends,

And Happy Two-Days-After- April-Fools’-Day!

A few people did not realize that my message about “retirement” was an April Fools’ joke, and now I feel badly, partly because I misled some of you, but also because it’s been a very long time since I have been as hopeful about the direction of maternity care as I am today. This is no time for me to retire! Perhaps this photo should replace my April Fool’s Day photo. It was taken a few weeks ago in Mexico, where I was invited (by Elena Carillo, a dedicated childbirth educator and doula trainer in Mexico) to speak at Anahuac University’s 20th Anniversary Celebration of their Lamaze/ DONA Training Programs. It was such fun! Mexican activists are striving as we are in the US to establish MotherBaby-centered maternity care.

Why am I so hopeful? Among other things, the new ACOG (American College of Obstetrics and Gynecology) consensus statement on safely preventing primary cesareans is a forceful condemnation of contemporary American maternity care. According to ACOG, practically everything that comprises typical obstetric management is unsound or wrong. The document condemns the etiologies for the majority of cesareans: failure to progress (in both first and second stages); macrosomia (big baby); and non-reassuring (or, to use their new term, “indeterminate”) fetal heart tracings. Labor support in the form of a doula is actively promoted.
Let’s rejoice, but with a measure of realism. Let’s see how many years it takes before the recommendations become widely accepted. I also am concerned that, if and when followed, these recommendations will present added challenges to childbearing women and those who care for them.

I’m planning to present a Webinar on the impact of the ACOG Consensus Statement on women, their partners, and their nurses, doulas, and childbirth educators on May 14, through Simkin Center at Bastyr University. I’ll share the link to register next week.

With high hopes, but realistic expectations,