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Birth Network advocates for Santa Cruz moms PDF Print E-mail
Written by Suki Wessling   

The Birth Network of Santa Cruz was born of two parents.


First, the Coalition for Improving Maternity Services launched its landmark consensus document, The Mother-Friendly Childbirth Initiative (MFCI), which laid out straightforward, evidence-based best practices for childbirth.


Second, Sally-Christine Rodgers had a baby. As an educated, mature woman, a writer whose husband had founded West Marine, she had resources that many parents don’t have. Yet she had trouble getting information.


Rodgers offered a grant to build an organization with the goal of connecting parents and birth practitioners, based on the recommendations of the MFCI.


“Birth Network of Santa Cruz County became the first nonprofit to organize around the MFCI after it was ratified,” remembers Laura Maxson, a founder and Executive Director of the Birth Network. “The Coalition for Improving Maternity Services was really excited to see somebody take their document and actually use it to form an organization.”


Many Santa Cruz residents know how lucky we are to live in a community that supports a variety of birth choices. The Birth Network offers bi-monthly ‘Meet the Doulas’ meetings for expectant parents and networking events for professionals. Next year, they are bringing back their ‘Bellies, Birth, and Babies Expo’ which connects expectant parents with care providers and offers evidence-based information about childbirth options.


“We’re blessed to be in a community that has many resources for pregnant women and postpartum,” says Kymm Ann Wallin, who has been a doula for over 20 years and is now working on her master’s degree in Nurse-Midwifery. “Local midwives have worked hard to make changes in our hospitals.”


The three options for hospital birth in our county are Dominican, Sutter, and Watsonville Community. Unlike the old days of “knock out the mom then whisk the baby off to the nursery,” these hospitals offer such evidence-based practices as skin-to-skin contact between mother and baby directly after birth, encouragement of breastfeeding, and natural (unmedicated) childbirth.


But despite the fact that all three hospitals call their units “birth centers,” none sign onto the evidence-based practices laid out in the MFCI.

Why evidence-based?

This phrase comes up often in tense discussions about birth, where life-and-death decisions may need to be made for both the mother and the child. These decisions that affect the family unit are made within entities that have to base their decision-making also on the perspectives of doctors, institutions, and governments.

Local practitioners outside of the hospital system are careful to call all three birth units “hospitals” in order to clarify the distinction. Although supportive of Sutter’s emphasis on mother- and baby-friendly practices, they use Sutter as an example of the difference between a “birth center,” where decisions are made based on the best scientific evidence available in the interests of mother and child, and “hospitals,” whose protocols may go against this evidence.


“Sutter is a hospital,” Wallin explains. “They have the same doctors who work at Dominican and Sutter, the same protocols and practices, some of which aren’t evidence-based. The nurses are awesome there, very conscientious about women’s choices. But it doesn’t change the fact that the doctors have to practice standard obstetrics that are not evidence-based.”


The ways in which hospitals’ choices can go against evidence-based medicine is illuminated by the ongoing argument over VBAC—vaginal birth after caesarian.

According to the journal STAT, “In the United States, about one in three births happen by C-section, a rate that has risen dramatically over the past few decades, from 5 percent in 1970 and 20 percent in 1996.” The rate in our county for 2015 was 30%. These high rates result in an unusually high maternal mortality rate across the country.


C-section rates continue to rise despite evidence that vaginal birth is always safer for a woman except in situations where the risks of vaginal birth outweigh the risks of abdominal surgery. This is even true for VBAC, which is statistically as safe for the mother as typical vaginal delivery. But due to a complex web of concerns—from legal departments, insurance companies, doctors, and expectant parents who are unfamiliar with their options—VBAC is seen as “risky” by hospitals and thus once a woman has gone through one C-section, she is often sent immediately to C-section for subsequent births.


Dr. Alexandra Klikoff is ending her tenure as the last of a vanishing breed—an independent obstetrician. She has served women of Santa Cruz and Monterey counties for 19 years, and is closing her practice to move to Kaiser in Santa Clara. She minces no words when explaining how difficult it is for OBs to follow evidence-based best practices.


“If I were to attend home birth I would lose my malpractice insurance and then lose

my hospital privileges,” she explains.


She points out that a seemingly insignificant change in legal wording—a surgeon should be ‘immediately available’ for women who are attempting VBAC—has led hospitals to be wary of VBACs.


“’Readily available’ has come to be defined as 30 minutes between identifying the problem and getting an obstetrician,” Dr. Klikoff explains. “Coming from home, you could have 30 minutes. ‘Immediately available’ means something shorter, meaning that you should be in the hospital.”


Furthermore, she says, hospitals saw that there was no financial incentive.

“They didn’t want [obstetricians] to sit in the hospital while the woman has 12 to 24 hours of labor,” she says, “and they decided not to offer VBAC.”


Practitioners in our local community are careful about how they express their frustrations at the state of birth practices here—because they all work together and know that they chose their professions with the best intentions. But childbirth, a natural process, differs from almost all other medical needs we see a doctor for.


Wallin describes this difference in terms of the functions of OBs versus midwives.

“Obstetricians are surgeons—midwives are not,” she explains. “If the woman goes out of the range of normal, it makes a lot of sense for her to be in the care of a surgeon. But if the birth is normal, why does she need that? Midwives are trained to treat normal birth.”


It is the Birth Network’s mission to “support parents and care providers by providing information, education, and advocacy for Mother-Friendly childbirth.”


“People are getting their information in little bits and segments on social media,” explains Maxson, who says that instead, education about birth options needs to be a conversation separate from insurance, hospital regulations, and Medi-Cal. “So much about what you might want with your birth comes from knowing what those options might be, and having the time and the inclination to really explore those options.”


Dr. Klikoff says that expectant mothers should think of their birth team as a crew going on an unpredictable sea voyage.


“It’s like going for a sail on the bay. You get out there and the weather is the weather. You’re going to depend on your ship and your crew. Maybe you won’t get where you thought where you were going.


“Birth is like that. It’s a force of nature.”


For more information: Watch in 2017 for the next Bellies, Birth, and Babies Expo at http://www.birthnet.org/ or follow the Birth Network on Facebook.


Sidebar :

Full Moon Birth Center: Almost there!

Santa Cruz, a county that has long been supportive of mother-friendly childbirth, has not had a freestanding birth center since 1970. Local midwife Sunshine Tomlin and a group of dedicated supporters are working to change that. They already have a location, less than ten minutes from Dominican, and practitioners ranging from doulas to acupuncturists. Daytime services are available. But they need funds to be able to bring the center fully into operation, including a city permit that costs $2300. At the center, parents will be able to access midwifery care throughout pregnancy and postpartum, and also have an option for midwife-attended birth free of hospital interventions.


To learn more and donate, visit https://www.gofundme.com/fullmoonbirthing. Find event information, including October’s art show, on Facebook.


Suki Wessling is a local writer and the mother of two children. Her most recent book is Hanna, Homeschooler, a chapter book. Read more at www.SukiWessling.com.

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