March 20, 2009

Panel examines midwifery’s rise and business of birth in U.S.

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Rena Diem, left, and Charmaine Jackson spend time with six-month-old Ahanu Fasani at last week’s presenation and discussion about birthing methods available in the United States. Ahanu came to the event with his mother, Bohdana Fasani. (photo by Joe Howell)

Panel examines midwifery’s rise and business of birth in U.S.

Physicians, certified nurse-midwives, parents and community members came together at a presentation called “The Business of Birthing in the United States” to discuss whether births are a natural life process or a medical emergency.

The answer makes a big difference in the number of medical interventions and assistance needed in delivering healthy babies.

Brian Heuser, a Vanderbilt University lecturer in international education and public policy, and Marie Martin, assistant director of the Global Education Office, organized the panel discussion to open up lines of communication about childbirth — something they experienced firsthand during the recent birth of their son Gabriel.

“We gather tonight to have an important dialogue about the birthing industry in the United States and how it has, in our opinion, at times failed to uphold its social contract with women and families. We also gather to advocate on behalf of increasing birthing options available to women in this country,” Heuser said in his opening remarks.

Soheyl Asadsangabi, R.N., C.N.M., a member of the nurse-midwife faculty practice at West End Women's Health Center, delivered Gabriel. She said nurse-midwives are known for developing relationships with their patients and for their hands-off approach to delivery.

“It's an art of educating people … of providing the option of choices and deciding for themselves,” she said. “The patients love the fact that they can have control of their pregnancy and eventually their labor and delivery.”

According to Mavis Schorn, Ph.D., C.N.M., director of Nurse-Midwifery at Vanderbilt University School of Nursing, certified nurse-midwives attended 23 percent of all births at Vanderbilt in 2008. In Tennessee as a whole, they attend about 7 percent of births.

Martin said she only heard about midwifery recently through friends, and was drawn to it for many reasons.

“What really resonated for me was the concept of birth as a natural process, something that wasn't a disease but actually a healthy thing for a woman to experience, and midwifery was mother- and child-centered,” Martin said.

The presentation also included a screening of the movie “The Business of Being Born.”
It presented the idea that many mothers are increasingly afraid that physicians will push unnecessary medical interventions on them just to make money or turn the beds over more quickly — a notion refuted by Bruce Beyer, M.D., assistant professor of Obstetrics and Gynecology at Vanderbilt Medical Center and preceptor for VUSN’s Nurse-Midwifery Program.

“I don't think everybody is just looking at a mother as a dollar sign,” he said. “What I think the goal should be is to provide people with the safety net of medical care and technology without pushing that technology on them when they don't need it.”

“I feel that the midwife practice does an outstanding job at delivering care. I'm proud to work with them, and I feel pretty aligned with their philosophy when they care for patients. It's a collaborative process, and we reach decisions on interventions together.”

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