The 2019 Birth Conference in Romania

excerpts from my talk in July in Romania

Since the 1990s, C-sections have more than tripled globally. C-sections now outnumber vaginal deliveries in parts of southeast Europe, Latin America and China. Even in poor countries, the rates can be extremely high. For example, in Bangladesh, less than 60 percent of births occur at a clinic, but when they do, about 65 percent of them are C-sections.

Such high rates are due mainly to an increase of elective C-sections, says the vice president of global programs at March of Dimes, a U.S. maternal and child health organization. "The procedure is done when it is not really necessary or indicated," she says. The rates can be even higher in private clinics. For example, in Brazil, 95 percent of births in private clinics are now C-sections.

For a mom, an elected C-section can raise the chance of death by at least 60 percent, and in some circumstances as much as 700 percent, several studies have reported. And it increases a woman's risk of life-threatening complications during childbirth. The risks rises even further in subsequent deliveries. 

That said, the last birth I attended only 7 months ago started out quite uneventful. The mother ate only organic food. She practiced yoga. She was in great shape, determined to have a natural birth. After laboring for 30 hours without medication, we realized that everything that could go wrong was going wrong. A rare sepsis infection was causing untold havoc internally, where we couldn't detect it--until then. Finally Anadi had a C-section. Had she been in her home country of Ethiopia and not in the U.S. I am sure we would have lost them both.

So what's driving the global rise of C-sections?

It's likely three factors working together: financial, legal and technical, says Holly Kennedy, a professor of midwifery at the Yale School of Nursing. She says, "As an obstetrician told me ... 'You're going to pay me more [to do a C-section], you're not going to sue me and I'll be done in a hour.'" 

I am convinced that the root cause of the problem originates with the fact that these 3rd world countries are enamored with what they perceive as superior medical care as seen and taught in the United States. America is not actually leading the world in health care. Here are some sobering facts:

The U.S. is a worse place for newborns than 68 other countries, including Egypt, Turkey and Peru, according to a report released last month by Save the Children. A million babies die every year globally on the same day they were born, including more than 11,000 American newborns. Cuba is doing better, much better.

America is 48th on the list of the safest countries for mothers to deliver in. Maternal death is greater in the U.S. than in Cuba, Hungary, Chili, Mexico, and Slovakia. America does not have this all figured out. 

So why am I here? 

First of all, my hope is that you don't look to the U.S. as a role model for going forward in the future. Birth has become big business at the expense of mothers, babies and families. To top it off, the current situation is affecting even those who claim to be pursuing more natural methods and family-centered birth.

A trained home birth midwife in Minnesota where I come from charges from $6,000 and up (that is about €5,339.) In New York city prices are even higher. Those fees are not paid or reimbursed by insurance companies. A doula cannot be hired for under $600 or €537 per birth in Minnesota. The usual rate is $1,000 or €896s. Middle and lower class families can no longer afford such luxuries. 

Birth is not a business. It is an honor to be called to do this work. It is a vocation, I believe. It doesn't matter what tools you have in your medical bag if you cannot bring love, compassion, humility and respect to each woman you serve.

That said, my hope is that you don't make the same mistakes that other countries have made as they go forward seeking answers for themselves. We have much to learn from these mistakes but we also have examples of what does work and why, and how.

How many of you have heard of Ina May Gaskin? She led the resurgence of midwifery in the U.S. and later in much of Europe during the 1970s. Year after year, decade after decade she and midwives like her, learned, often by trial and error, often from friendly doctors, and also by listening to women and their families. This was uncharted territory. They had to be brave, they had to be daring. They understood the huge responsibility this work carried and, I assure you, they went into it trembling. Prayer, humility and respect counted as much as education and knowledge. There is no easy fix here. I cannot teach you what it has taken me, or Ina May or Carolyn Flint or others years and years to learn, but we are all behind you. 

I do not presume to know all the political or logistical issues that face you here in Eastern Europe,  so I won't even try. I can only guess, so I will not assume to tell you what you need to do. But I will listen to your concerns and tell you everything I know. I won't have all the answers, but I might be able to tell you where to get the answers you seek. I don't have more lectures planned. I am hoping we can use what time we have to talk together.

So who am I, anyway?

I am a retired licensed midwife. I also trained as a doula, a lactation consultant, taught neonatal resuscitation, and a whole bunch of other certifications, but first I am a woman, a mother and a grandma, hoping to bring what I have learned to other women. I will share absolutely everything I know; it was freely given to me and I must pass it on to the next generation. I have never charged for my work or time. Occasionally an insurance company saw fit to pay me. Others offered what they could. 

I have 5 grown children, 8 grandchildren so far, and a wonderful husband who has put up with so much over the years. Ina May was with me when I had my twins 37 years ago. No one in Minnesota would agree to even let me try to deliver them naturally, even though I agreed to have them in a hospital, so we went to Tennessee to her midwifery school to have them. It was my children who actually wrote the rules at home as teenagers: They decided that we would have no more talk of bodily fluids at the dinner table from then on. I had assumed everyone wanted to hear all the details of the most recent birth when I got home. 

When I lost all but 30% of my hearing about 6 years ago, I had to retire. I could no longer hear well enough to attend births. I began writing my memories of the past 30 years, all true stories. I found an editor and a publisher and all of a sudden now I am writing books and giving seminars. 

 Left: The English version

I have written 3 books on birth so far. I am currently looking for a new publisher. My original publisher died quite unexpectedly last year. My first book is here in Romania to purchase during the conference. I am hoping the sequel will also be available to you soon, and my book on bonding soon after that.

To contact me write: ssskimchee@gmail.com

Stay tuned for more!

The Romanian translation here below:

And a HUGE thanks to all who made this possible!!!