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Home birth Activist from the Czech Republic Meets US Midwifery Stars - October 2013

As a Community Solution Program leader, I am here in the US for a four month fellowship at the American College of Nurse-Midwives. We are 56 leaders from all over the world, place in many different places in US. I am here to explore out-of-hospital births. In the Czech Republic I have been working for several years to achieve a systemic change in Czech obstetrics. The situation there is not very good for women or midwives. Out-of-hospital births are illegal for midwives to attend. In most of the hospitals, there are violated human rights (episiotomy without permition, intervention without permition, separation of mother and baby, and so one). Free choice and informed consent are still rare occurrences. 

One of the reasons I came to the US is to explore the differences in the maternity care in different states and different settings. As I am placed at the headquarters of ACNM, I am based in D.C. I have wonderful community mentors, Mairi Rothman and Erin Fulham, two homebirth midwives in Maryland. I am learning so much about their experiences with home births and their experiences with the regulatory system in Maryland. They are introducing me to their friends and to the families they serve. It is great. 

During the first two months I have been introduced to so many great midwives who are really enriching my stay. At the end of August I visited Ruth Lubic at her Developing Families Center in D.C. She is such a wonderful woman, wise old lady full of energy and joy. She told me a lot about her life’s work and it seems like she may be one of the most influential women in the US providing out-of-hospital midwifery care. She also told me about Kitty Ernst and "her" American Association of Birth Centers. I already knew they were having an annual meeting at the end of September. I was excited, and wondering how I could attend since I had already missed the deadline for scholarship and my sources are so limited.

Ruth looked me and said: "We should call Kitty, maybe she can do something", like she knew my thoughts. And then she just picked up the phone and called her! Kitty was nice and friendly, but a bit surprised to talk to me without knowing anything about me. We stayed in touch through mail and finally Kitty just offered to sponsor my conference fee by her self. That was so nice and helpful for me and I was just touched. One week before I went to Minneapolis, I got an email from another nice lady, inviting me also to the Gala dinner provided during the conference, I was honored.

On Wednesday 25th of September I went to Minneapolis. I got such a good luck and I can stay with another great leader Fatima from Indonesia, in enjoyable house. On Thursday there were already planed the dinner for all CSP leaders in Minneapolis with Jessica Lane. Great to see all five leaders and Angela also visiting together again.

Then, the next day, the conference started. Debra Pascali-Bonaro, a wonderful doula and birth activist promoting orgasmic birth, gave the welcome speech. She spoke about human rights in childbirth, and their crucial role in today’s birth situation all over the world. So true and so touching. Then there were so many interesting lectures, sometimes two of them in the same time. 
I really enjoyed skeptic point of view presented by Nathanael Johnson, journalist from California, I even bought his book All Natural. The panel discussion about Birth centers and transports to the hospitals was really stimulating. Closing words from Dawn Thompson, founder of Improovingbirth.org gave us hope, that in the time of social media we have chance to make change happened faster.

Friday evening I went on a tour of the Minneapolis births centers: Health Foundations Family Health & Birth CenterMorning Star Women’s Health & Birth CenterMinnesota Birth Center. It was awesome to see how the birth centers are growing and prospering. The interior was so beautiful and warm, and I couldn’t help but think about how nice it would be to give birth at one of them. At the same time, I began to wonder how long it would be before birth centers will be possible in the Czech Republic.

We are on the good path, but far, far away. We are still struggling to gain women the right to choose midwifery care during pregnancy and birth, to have one care provider who can take care of women and their babies. To just have the type of care, which was proofed as the safest and has the best outcomes.

            

The US maternity care system is not easy and perfect. Definitely not, but still there is the possibility for most of the women to choose. If I am looking around me in the conference I see, that I am one of the youngest here, so probably I have to be patient.

On Saturday, the second day of the conference, I already knew some midwives from the birth centers tour yesterday and I was encouraged to start my interviews. The first midwife I approached was Kiersten Figurski, a certified professional midwife from New Mexico. She was so open and friendly. She described the system of care in New Mexico as really working well. They are homebirths midwives having also births center in really rural area. The home births are not anything strange there, they are traditional there. They also have wonderful collaboration with obstetricians at the neighboring hospital, because they are used to them. Her story makes me believe that change is possible. 

During the rest of the lunch break I found Kitty Ernst siting alone at a table in the exhibit hall. I grabbed my chance and asked her for an interview. She agreed, and started to tell me her story. I suddenly felt the power of her experience and wisdom, which we are lucking so much in nowadays fast, super modern, technological culture adoring youths and development. I felt she knows what she is talking about. True midwifery care is simple, honest, safe, and wise, serving women to empower them in their ability to give birth. The modern medical approach to birth is control, power and fear. This cannot work well. The biggest obstacle she sees in US maternity care is luck of working system. “Instead of building one, everybody is fighting each other. But it is about the mother”.

After the interview with Kitty, I felt so encourage and empowered. I also understand what she means by being a midwife to midwives. Building safe and supportive space in the maternity care system is needed for midwives. This role is crucially needed also in the Czech Republic and this is an important discovery for me. At the end of our talk, she took me to the table for Frontier University and gave me a T-shirt and book Best Practices in Midwifery. I am really blessed by meeting such women. 

I continued to interview more midwives and I was enriched every time. Saturday concluded with the great gala dinner, which is also a big auction to raise funds for the AABC Foundation. Here I feel little bit lost. I couldn't come to the conference if Kitty is not supporting my fee, so I am not in the position to give money. I feel kind of said and useless, but on the other hand it gives me motivation to work hard with what I just got from this wonderful company of women, midwives, birth activists.

This experience also made me think more about the money and how big difference they could make. I also realized, that there is huge gap between US and the Czech Republic in this case, even though we are part of EU and we are mostly counted as developed country. But in this matter we are not. You can see it explicitly in the case of the ICM conference, which is taking place next June in Prague. One of the main ideas of that conference is to support midwives from Eastern Europe, because the situation of midwifery there is still quite poor. But, the entrance fee is 600 euros, which is more then one months salary for standard midwife. It is also not translated to Czech, so not many midwives have the real access to ICM, specifically there are just 28 Czech people who applied for the conference and 130 from US. So there is still a big difference.But the money is hopefully not everything. I feel that we still have so many things to do in the Czech Republic to make the change possible. What I learned in AABC conference is that motivation, hard work, believing in women and supporting midwives is really crucial and we have to be strong and overcome all the obstacles.

There was one more surprise at the end of the evening - the gift of $500 000 to the AABC Foundation from the Lubics. Wow. Now, I understand that I am meeting the Stars of US Midwifery. I am happy and enriched. Thank you Kitty Ernst and Ruth Lubic, once again. You inspire me.

Zora Javorská


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