The Midwives and Mothers in Action (MAMA) Campaign

The Midwives and Mothers in Action (MAMA) Campaign is launched!

The MAMA campaign is a collaborative effort by the National Association of Certified Professional Midwives (NACPM), Midwives Alliance of North America (MANA), Citizens for Midwifery (CfM), International Center for Traditional Childbearing (ICTC), North American Registry of Midwives (NARM), and the Midwifery Education Accreditation Council (MEAC).

This partnership is now at work to gain federal recognition of Certified Professional Midwives so that women and families will have increased access to quality, affordable maternity care in the settings of their choice. Sign up below to receive news and action alerts. We will be sending out information about the ways that you can take action for CPMs. Please consider endorsing the campaign, making a donation, and sharing your birth story on our site.

Federal recognition that enables Certified Professional Midwives to be Medicaid providers would:

  • Increase the number of safe, qualified, affordable maternity care providers
  • Eliminate current discriminatory policies that prevent low-income women on Medicaid from access to CPM services in their communities
  • Save money and add no extra costs: women on Medicaid who choose an out-of-hospital birth with a Certified Professional Midwife would incur lower costs for Medicaid than if they had used a physician in a hospital

Increased access to Certified Professional Midwives (CPMs) can address the goals of health care reform:

  • Ensure quality care for every American – CPMs provide evidence-based, prevention-oriented and health-promoting care, with more babies that are healthy, full weight and full term, and much lower rates of cesarean section and medical interventions.

  • Reduce costs – The reduction in interventions, unnecessary cesarean sections, and the associated increased health status of mothers and babies under the care of CPMs would lead to a cost savings to the US health care system.
  • Guarantee choice – If CPMs are included in Medicaid reimbursement or a federal insurance program, CPMs and out-of- hospital birth would be available to all women, not just those who can afford to pay out-of-pocket.

Maternity Care & Health Care Reform:
Access, Quality & Costs

Maternity care must be given priority if health care reform is to succeed:

  • 4.3 million American women give birth each year
  • 23% of all hospital discharges are related to childbearing
  • Cesarean section is the most common operating room procedure in the U.S.
  • Charges associated with pregnancy, delivery and newborn care are the most costly hospital condition for both Medicaid and private insurers
  • The U.S. ranks behind most industrialized countries in basic indicators such as maternal and neonatal mortality

    Midwives are the key to increasing access to effective maternity care:

  • The American Public Health Association and the World Health Organization recommend midwives as the primary maternity care providers for the majority of women
  • Nations with the lowest infant mortality employ midwives as the primary maternity care providers for the majority of women
  • Mounting evidence supports the value and cost-savings potential of midwifery care
  • CPMs are trained skilled credentialed attendants for out-of-hospital births
  • Birth centers and planned home birth have been shown to be safe for low-risk women, with demonstrated potential to significantly reduce costs to the system
  • CPMs are currently licensed in 25 states and own approximately half of the birth centers in the U.S.

The Milbank Report “Evidence-Based Maternity Care: What It Is and What It Can Achieve”

Key Findings : Midwives provide high-quality, cost-effective care – access to nationally credentialed midwives should be increased

  • Policy Recommendation: “Foster broad access to safe, effective maternity care by setting adequate Medicaid and Medicare reimbursement rates for certified nurse-midwives (CNM), certified midwives (CM), and certified professional midwives”(CPM). (p. 70)
  • “The low CPM study rates of intervention are benchmarks for what the majority of childbearing women and babies who are in good health might achieve.” (p. 29)
  • “Projected cost savings from shifting to a system of care with midwives as primary care givers for most U.S. birthing women are considerable”. (p. 63)

View the Milbank Report and Childbirth Connection's Summary

Federal action is needed now to support on-going state efforts to increase access to quality maternity care and reduce costs:

  • Reimburse and/or employ CPMs in publicly subsidized health care plans and services, including, but not limited to, Medicaid and Medicare, the Federal Employee Health Benefits Plan, the National Health Service Corps, and the Indian Health Service
  • Establish equitable reimbursement rates within applicable federal legislation
  • Mandate reimbursement for birth centers
  • Expand federal resources to educate more midwives
  • Implement guidelines for evidence-based practice and cost-effective care in federal health care reform initiatives

To view resources and references for the statements above click HERE.

The Importance of Baby's Position During Labor

By Misha Safranski

With the cesarean rate now over 30% and climbing in the United States, many of those unnecessary according to the World Heath Organization, it is vital for women to be informed about ways to reduce their risk of cesarean section as well as difficult and/or instrumental vaginal delivery. There are many aspects to this complex issue, one of the major ones being the position of baby at delivery.

When a mother is delivered by cesarean, often it is blamed on "CPD" - cephalopelvic disproportion or dystocia. What is more often the case is that the baby is misaligned in a number of possible ways; asynclitic - baby's head is tilted slightly to one side, posterior - the baby is facing forward in the womb with his/her back to the mother's spine, occipital transverse - baby facing to the side while trying to enter the pelvis, and rarely face-presentation - baby's head is flexed with the face pointing down toward the vaginal opening.

Obstetricians have lost the art of palpation, which allows the care provider to assess the baby's position during late pregnancy and labor. Mothers can, and should, learn to do this themselves by studying books like Optimal Foetal Positioning by Jean Sutton and Pauline Scott, and websites such as Spinningbabies.

This will help the mother identify a malposition and attempt to correct it by specific positioning exercises. Chiropractic care can also be very useful, both for malpositioning and general pregnancy aches. If you seek out chiropractic care, try to find a practitioner who knows how to perform the Webster Technique - a maneuver that can help open the pelvis so that the baby can align properly. A Webster chiropractor can be found by searching the ICPA website.

There are also steps a mother can take to prevent a well-positioned baby from getting into a bad position during labor, or to maximize baby's chances of turning if she or he is still badly positioned when labor starts.

Avoid epidural anesthesia. Being flat on the back encourages a baby to stay, or turn, posterior, as well as keeps mom's pelvis in a restricted position which doesn't allow it to open as fully as possible. It also numbs the mother's sensations which can prevent her from being able to tell if she needs to adjust her own position to help baby along.

Stay mobile. Mobility allows mom to do things such as lunges, knee-chest, hands and knees and squatting, all of which can assist in getting a baby well aligned.

Do not allow AROM (artificial rupture of membranes). This is perhaps the most important thing a mother can do. AROM robs the baby of the cushion of water, which can be a great help in allowing baby to get into position for birth. If baby is already malpositioned, AROM can jam him or her into the pelvis in a way that prevents any further adjustment. AROM is not necessary; research shows it does not significantly shorten the length of labor and in fact increases the risk of cesarean delivery. AROM also puts mom on the clock, most hospitals "require" that she deliver within 24 hrs. due to the perceived risk of infection (which is raised, for the most part, because of excessive vaginal exams).

Knowledge is power. Most obstetricians and even some midwives do not tell mothers about the importance of baby's position in the womb. Be informed, and you will greatly increase your chance for a safe, satisfying birth experience.

References: Amniotomy for shortening spontaneous labour. Obstet Gynecol. 2008 Jan;111(1):204-5.

La Leche League Statement on Vitamin D & Breastfeeding

The great thing about Vitamin D is that it is free and readily available most times of the year, in most places via natural sunlight. Just 10 minutes a day of direct sunlight, 3 times a week, or 20 minutes of direct sunlight, once a week, provides a baby and child's body with all the Vit D necessary. It is more easily and readily used (and more natural) than pill-form supplements.

This statement highlights the fact that as long as Mom has all the Vit D she needs, her baby gets plenty from her milk. No additional supplements are needed. It is the perfect feeding design! So get out and enjoy a little sunlight now and then...and let your baby do the same on occasion as well.

It should be noted that it is best to not wash all your skin (or baby's) with soap too often - Vit D needs to absorb via the skin and daily scrubs interfere with this. Many doctors specializing in immunity and nutrition recommend a "pits and bits" soap wash for adults and occasionally for baby (as well as hands, of course). All over daily washes are not needed, and may actually deter from health and natural immunity building.

According to the Vitamin D Council:

The single most important fact anyone needs to know about vitamin D is how much nature supplies if we behave naturally, i.e., go into the sun. Humans make at least 10,000 units of vitamin D within 30 minutes of full body exposure to the sun.

Fear of the fatal form of skin cancer, malignant melanoma, keeps many people out of the sun. The problem with the theory is that the incidence of melanoma continues to increase dramatically although many people have been completely avoiding the sun for years. We are not saying sunburns are safe, they are not. We are saying that brief, full-body sun exposure is a much smarter thing to do than suffering from vitamin D deficiency.

For more info on the topic:

An article on safe sun exposure (pdf)

Physician and lactation expert, Dr. Jack Newman's, information on breastfeeding and vitamins.

Book: The Healing Sun: Sunlight and Health in the 21st Century

Pregnant women not getting enough Vit D (it is best to take prenatal vitamins for 3 months prior to conception, during pregnancy, and after for the duration of time you are breastfeeding)


La Leche League International encourages all mothers to recognize the importance of vitamin D to the health of their children. Recent research shows that due to current lifestyles, breastfeeding mothers may not have enough vitamin D in their own bodies to pass to their infants through breastmilk.

In October 2008, the American Academy of Pediatrics recommended that infants receive 400 IU a day of vitamin D, beginning in the first few days of life. Children who do not receive enough vitamin D are at risk for rickets and increased risk for infections, autoimmune diseases, cancer, diabetes, and osteoporosis.

Vitamin D is mainly acquired through exposure to sunlight and secondarily through food. Research shows that the adoption of indoor lifestyles and the use of sunscreen have seriously depleted vitamin D in most women. The ability to acquire adequate amounts of vitamin D through sunlight depends on skin color and geographic location.

Dark-skinned people can require up to six times the amount of sunlight as light-skinned people. People living near the equator can obtain vitamin D for 12 months of the year while those living in northern and southern climates may only absorb vitamin D for six or fewer months of the year.

For many years, La Leche League International has offered the research-based recommendation that exclusively breastfed babies received all the vitamin D necessary through mother’s milk. Health care professionals now have a better understanding of the function of vitamin D and the amounts required, and the newest research shows this is only true when mothers themselves have enough vitamin D. Statistics indicate that a large percentage of women do not have adequate amounts of vitamin D in their bodies.

La Leche League International acknowledges that breastfeeding mothers who have adequate amounts of vitamin D in their bodies can successfully provide enough vitamin D to their children through breastmilk. It is recommended that pregnant and nursing mothers obtain adequate vitamin D or supplement as necessary. Health care providers may recommend that women who are unsure of their vitamin D status undergo a simple blood test before choosing not to supplement.

Parents or health care providers who want more information on rickets, vitamin D in human milk, or other information on breastfeeding issues visit: La Leche League International

Born in late winter, Sophie, a few days old, sunbathing in an *open* window (direct sunlight), as Vitamin D cannot be produced in the body from sun rays which are filtered through glass/windows.


Take Your Whole Baby Home

10 Reasons to Bring Your Whole Baby Home
adapted from Intact America
photo by Danelle Frisbie
  1. Because there is no medical reason for "routine" circumcision of baby boys. No professional medical association in the United States or the entire world recommends routine neonatal circumcision. The American Medical Association calls it "non-therapeutic." At no time in its 75 years has the American Academy of Pediatrics ever recommended infant circumcision. The World Health Organization also stands against the practice.
  2. Because the foreskin is not a birth defect. The foreskin is a normal, sensitive, functional part of the body. In infant boys, the foreskin is attached to the head of the penis (glans) and protects it from urine, feces, and irritation; it also protects the urinary opening, keeping contaminants from entering the sterile urinary tract. Throughout life, the foreskin keeps the glans moist and protects it from injury. The foreskin also has an important role in sexual pleasure, due to its specialized, erogenous nerve endings and its natural gliding and lubricating functions.
  3. Because you wouldn't circumcise your baby girl. In the United States, girls of all ages are protected by federal and state laws from genital surgery to which they do not consent, whether practiced in medical or non-medical settings, and regardless of the religious or cultural preferences of their parents. There is no ethical rationale for distinguishing between female and male genital alteration. The prepuce organ is made of the same nerves, blood vessels, membranes, and tissues on both boys and girls. If it is wrong to remove part of a baby girl's healthy genitals, then it is wrong to do the same to those of a baby boy.
  4. Because your baby does not want to be circumcised. Circumcision painfully and permanently alters a baby boy's genitals, removing healthy, protective, functional tissue from the penis and exposing the child to unnecessary pain and medical risks – all for no medical benefit. What do you think your baby boy would say if he could tell you? Of course, no baby boy can consent for himself, and parents cannot ethically consent to surgery on behalf of a child unless the child's health or life is at risk.
  5. Because removing part of a baby's penis is painful, risky and harmful. Babies are sensitive to pain, just like older children and adults. Many circumcisions in the United States are performed with no pain control at all. But even when pain control is employed, the analgesics used for circumcision can only decrease pain; they do not eliminate it. As with any surgery, complications – even including death – do often occur with circumcision. Infection and abnormal bleeding are the most common complications. Other complications include removal of too much skin, loss of part or all of the penis, life-threatening infection, and urinary problems. All circumcisions result in the loss of the foreskin and its functions, and a penile scar.
  6. Because times and attitudes have changed. Today, nearly half of all baby boys in the United States leave the hospital intact. The circumcision rate in the U.S. was 50% in 2008 (and much lower on the East & West Coasts), down from 65% in 1981. More and more parents today keep their sons intact.
  7. Because most medically advanced nations do not circumcise baby boys. People in Europe, Asia and Latin America are often appalled to hear that American doctors and hospitals routinely remove part of a boy's penis shortly after birth. Approximately 85% of the men in the world are not circumcised and remain intact throughout their lives.
  8. Because caring for and cleaning the foreskin is easy. A natural, intact penis requires no special care. Gently wash the genital area with warm water while bathing. That's it. Later, when the foreskin can be retracted (something that often does not occur until adolescence), a boy can be taught to pull back his foreskin to wash his penis. The boy should be the first person to retract his foreskin, since forcible retraction by anyone else results in pain and injury.
  9. Because circumcision does not prevent HIV or other diseases. Despite common misinformation, studies show no link between circumcision and sexually transmitted disease (STD) prevention. Over the years, the claims that circumcision prevents various diseases have repeatedly been proven to be exaggerated or outright fabrications. Most men in the United States are circumcised, but our STD rates are higher than those in countries where circumcision is rare; it is obvious that circumcision does not protect against STDs.
  10. Because children should be protected from permanent bodily alteration inflicted on them without their consent in the name of culture, religion, profit, or parental preference. Under accepted bioethical principles, parents can consent to surgery on behalf of a child only if it is necessary to protect that child's life or health. "Routine" circumcision fails this simple ethics test because it painfully and permanently removes a normal and healthy part of a boy's penis, does not protect the child’s life or health, and in fact creates new risks. Medically unnecessary surgery to alter a baby’s penis is no more justified than removing a finger or any other healthy body part.

Bebé Glotón: The Breastfeeding Doll

Photo of the Bebe Gloton doll inside its product box.

Some people like the idea - a baby doll who eats as normal human babies eat - at the breast. And yet, it comes with a pacifier?! (A long-known deterrent to a healthy breastfeeding relationship, especially in the early months). Many La Leche League leaders are not too sure it is such a good thing. After all, we can just give our sons and daughters 'regular' dolls and they can nurse them any way they wish. Do we really need the "glurp glurp" sound effects and the pretty petaled bra? Yet, some also feel it is a fun way to imagine you are nursing a real baby. And this encouragement - this life-like imitation of Mom - may just serve to normalize human milk for human babies. Something that could put a small crack in our hardcore nipplephobic state in North America.

So, what do you think?

Bye-Bye Bottles: The Breastfeeding Dolls are Here!

Bebé Glotón is a baby doll made by Berjuan, a toy maker in Spain, for the express purpose of promoting breastfeeding. The idea is to impress upon youngsters that breastfeeding is the natural, normal way to feed a human baby. I would hope they already see Mom nursing (not to mention aunts, relatives, strangers at the park, etc) but maybe my wishful thinking of a ubiquitously breastfeeding-friendly world is not yet reality.

Children can wear the colorful bra-like top adorned with small flowers over their chest. When the doll is placed at the flowers, s/he makes a nursing motion and suckling sound.

The doll is available as either a girl or boy infant (both intact of course).

Bebé Glotón (which translates as 'Baby Glutton' or, in more common American English slang, the little 'Piggy Baby') sells for 44 Euro or about $65 U.S. dollars. Although you will be hard pressed to find one here at this time, unless you are ready to search online and pay international shipping fees.

See Bebé Glotón in action:

Click here for more video news on the release of Bebé Glotón in Spain.

Two photos showing the flowery nursing bra being tied on a girl and then the girl pretend nursing her baby doll.

Circumcision - Information for Circumcised Fathers Making the Decision for Their Son

A colleague asked me to put together a short list of resources for circumcised men who were thinking about whether or not to keep their own sons intact. Unfortunately, because of the massive misinformation abounding in the 1970s and 80s on the issue, a lot of today's fathers were cut at birth. Fortunately, however, parents today are starting to really dig into the medical literature and research this topic before they subject their own baby boys to the same genital cutting that was done to "Dear Ol' Dad." A LOT is taken away from a boy (and future man) when he is cut at birth. And most fathers deeply desire to give their sons the very best -- even MORE than they had themselves. So here are some resources for circumcised fathers to tap into when beginning this exploration for the sake of their son. is a site specifically for men who were circumcised at birth but are considering keeping their boys intact.

Here is an appeal to new (circumcised) fathers to give their sons all that was taken from them:

This man, Derek - aka "Natural Papa" - was cut at birth. His first son was born in the hospital and was cut "to be like him" before he knew any better. He said it was the most horrible thing to witness (he was by his son's side through the whole ordeal) and after this experience, he learned about the procedure, the prepuce organ, and what the surgery had robbed his son (and himself) of. His next son was kept intact, and if he has any more boys, they too, will be intact. His story is especially good for other fathers who maybe cut their first son, but are now expecting another. Just because it was done to one boy, it does NOT need to be repeated. Derek sometimes blogs about it:

This is a video clip in which Greg Hartley spoke on this very topic in D.C. this year. Greg (and his son) are also willing to exchange email and talk with new dads on this issue and their experience (drop me a message and I will get you his contact info):

Parents discuss the circumcision process and why they regret they did not know ahead of time in this piece, "Considering Circumcision? Why I'm An Intactivist, Will Not Circ Again & Wish My Boy Was Whole"

This site has good tips for fathers (and mothers) who are new to the whole intact-penis thing... as well as addressing some of the common misconceptions out there (that little boys 'squirt' or spray -- this tends to only be the case with cut boys; that the foreskin must retract and be cleaned - NO!; teasing; father-son 'matching'; etc.):

Circumcision & Prepuce (Foreskin) Information Part 1 -

Circumcision & Prepuce Information Part 2 -

This is a hypothetical conversation between parents (father circumcised) and their young, intact boy after he was teased at school. I genuinely do not think that teasing is as much an issue today (or, that soon it will be REVERSED - that cut boys will be the ones teased) because the rates of U.S. baby boys left intact vs. cut at birth are 50/50 nationwide and 75/25 (3/4 kept intact) on the coasts. As more parents educate themselves prior to birth, as accurate medical information is shared, as doctors speak out, and as fewer insurance companies cover the procedure, we are seeing the numbers change quickly. Kids also tease each other about anything that can be found - hair, eyes, glasses, shoes - girls with small breasts get teased (should we give 14-yr-olds breast enlargements?) girls with large breasts get teased (should they have reductions in junior high?). The possibility of teasing is certainly not a reason to permanently amputate healthy, essential body organs from babies. All this aside, here is an 'old' example of a conversation that may be had...

Protect Your Son - A Father & Doctor/Expert in the Prepuce (Foreskin) and Circumcision speaks:

Many video clips from an assortment of fathers (and others) tell their stories and take on circumcision:

Penn & Teller take on the topic of circumcision in a recent episode of their show (if you have not watched Penn & Teller before, know that there is 'adult' content and language used):
Part One:
Part Two:
Part Three:


This is the statement and story of a (circumcised) Christian father with 6 sons who turned to the Bible and medical literature when questioning whether or not to repeat the cutting with his own boys. He found there to be no medical, social, or Christian reason to cut, and they all remain intact. It may be a good story for other Christian (circumcised) fathers.

Circumcision and Christian parents:

Circumcision and Christianity: A Call to Christian Action:

Circumcision Within Christianity (a parent's story):

What the Bible Says About Circumcision:

A video documenting various places in the Bible where circumcision is discussed:

*In the video listed below ("CUT") circumcision among Christians (or, rather, the absence of circumcision among Christians throughout human history until it was started in the United States in an effort to curtail masturbation) is discussed.

Especially for Catholic Men -


The video "CUT: Slicing Through the Myths of Circumcision" is an excellent examination by a Jewish man who was circumcised himself, but made a different decision for his son after researching for this film. Video Website:
Abridged Version of "CUT":

A Jewish Doctor & Father speaks:

"My Son, The Little Jew with a Foreskin":

Judaism & Circumcision

Jewish Circumcision Resource Center:

Many Jewish fathers today are electing to have a Brit Shalom in place of cutting their son. For more information, and to talk with other Jewish men making this choice for their sons, see:


My friend - Dr. Joel Wells - (circumcised at birth, did not cut his sons in the early 70s when everyone else was still 'doing it') would be happy to talk with/exchange experience with anyone - I can give you his email/phone privately if you like. Joe has also taught at the University level and conducted research in human sexuality for 30+ years, so he has heard all the questions and has oodles of good (accurate!) answers. My husband is willing to talk/exchange email on this as it was a decision he made just 10 months ago. There may be other men reading this who have gone through the same experience who would be willing to talk to a new dad as well? (drop me a note, or leave a comment below if you are one willing to do so)

Additional Helpful Sites for more information: - a site especially for physicians and others in the medical field>raising.htm - discusses ways that male circumcision hurts women & women's sexual health as well as adult men [site has graphic images] - for men who were cut at birth - legal representation for men cut against their will at birth - for men who were cut at birth

"Each time a man stands up for an ideal, or the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope." -Robert F. Kennedy

Video: The Circumcision Decision

Avoiding the Cobra Pose

Circumcision: Echoes in the Body
By Jeane Rhodes, Ph.D.

Recently, I completed a doctoral research project in which I investigated the possible link between the way children do selected yoga postures for the first time and their individual birth experiences. The body language of 22 children, five to nine years old, was carefully videotaped and analyzed. To learn about the children's birth experiences I interviewed the parents. After analysis of the data, I was able to identify specific elements in the performance of the yoga postures that could be perceived as clues to the child's prenatal and birth experience.

In the course of this research, I made an unexpected observation related to male circumcision. It can only be considered preliminary at this point, as the study was not designed to focus on this issue, and, had it not been so evident in this small sample, I probably would not have noticed it. Asking about circumcision had not been on my original list of questions for the interview with parents. Fortunately, the first father inter-viewed mentioned it, so I included a question about circumcision for all of the boys in the study.

What I observed was that the seven boys in the study who had been circumcised did not place their hips on the floor when doing an abdominal-lying-arch posture (the "cobra" pose for those of you familiar with yoga postures). In contrast, the two boys in the study who had not been circumcised did it easily.

When I mentioned this observation to a colleague who is a body-worker, she said she had noticed that her clients who had been circumcised were much more rigid in the pelvic area than those who had not been circumcised. If this very preliminary observation is confirmed, it would be coherent with a recent finding on the long-term effect of circumcision on pain tolerance. A team at the Hospital for Sick Children in Toronto, Ontario (1995) studied the pain responses of children having routine vaccinations four to six months after birth. They discovered that boys circumcised as infants had higher behavioral pain scores and cried longer.

Email Dr. Rhodes for more information at:



Related Posts with Thumbnails