License my Midwife: CPM Licensure Passes House, Proceeds to Senate Health Committee

Image by Toby Blackwood

The Indiana House passed the midwifery licensure bill (HB1135) yesterday evening 63 to 32 with broad support from both parties.

During the discussion of the bill, a number of representatives, both Democrat and Republican, male and female, spoke eloquently, persuasively and compassionately in support of the bill. Notably, two representatives were born at home! Several spoke on behalf of their Amish constituency – Indiana has the 3rd largest Amish population in the U.S., a fact alone, which begs for CPM licensure.

Many spoke in favor of choice. A woman’s right to choose where and how she gives birth.

Unlike their colleagues who spoke in opposition to the bill, they recognized the expertise and skill of the CPM credential.

It was encouraging to see our midwives held in high esteem by a majority of legislators in our state who chose to support this bill and vote yes.

What comes next?

The bill now moves to the Senate Health Committee for a hearing with testimony. If approved by the committee, it will proceed to the full Senate for a vote. This legislation, if it becomes law, will license Certified Professional Midwives (CPMs). It will safeguard mothers and families who choose to birth at home by preventing untrained, lay midwives from legally practicing in the state.

For Indiana residents who support CPM licensure – now is the time to contact members of the Senate Health Committee.

Find your state senator. If they sit on the Senate Health Committee (see below), contact them to voice your support for the bill and ask them to vote yes. Let them know you are their constituent. Be brief, friendly and polite. You do not need to have had a homebirth to support this bill. If you support the choice of Indiana mothers and families to birth at home and their safe, legal access to CPMs, please contact your senator today.

Finally, join the Facebook group Indiana Push for Midwives to find out what you can do to help support this grassroots movement.

Members of the Senate Health Committee:
Senator Patricia Miller (Senate District 32), Chair
Senator Jean Breaux (SD 34), R.M.M.
Senator Ed Charbonneau (SD 5) R.M.
Senator Frank Mrvan (SD 1)
Senator Vaneta Becker (SD 50)
Senator Mark Stoops (SD 40)
Senator Rod Bray (SD 37)
Senator Greg Taylor (SD 33)
Senator Ron Grooms (SD 46)
Senator Jean Leising (SD 42)
Senator Pete Miller (SD 24)
Senator Ryan Mishler (SD 9)

Email your Senator using the following scheme: s#@in.gov, where # is replaced by their senate district number.

Amateur Paleontologists

Ezra hatching a T-Rex

Why are dinosaurs so fascinating to children, but not adults? This was a question posed to me by a friend who did not understand their appeal. I had no answer. I thought everyone was interested in learning more about these mysterious Mesozoic animals. Sure, it’s likely they became distracted by other interests and obligations, but once a little boy reminds them, they once again begin to dream about the earth a hundred million years ago.

Like most kids his age, Ezra went through a dinosaur phase. His obsession with dinosaurs reawakened my own curiosity. I discovered that Paleontologists’ thoughts on these extinct creatures have changed dramatically since I was Ezra’s age. I had a lot to learn, and Ezra was my first teacher. Our lessons began by learning the names and features of many of the vast number of identified dinosaur species. I’m sure Ezra could name more dinosaurs than 96% of the population (99.9% of the population if you remove paleontologists and preschool age boys). Since I remember only learning about T-Rex, Stegosaurus, Brontosaurus, Triceratops, and Pterodactyl (two of which are not even the correct genus names!), he taught me more dinosaur species than I had previously known. At 2 1/2 he would correct my identification, “Dad, that is a Brachiosaurus not an Apatosaurus,” or pronunciation.  I would struggle, “it’s a Stygim…something.” Ezra would patiently reply, “a Stygimolochs, Dad.”

Ezra’s interest in dinosaurs has tapered off at the moment, while mine has continued to increase.  One of my favorite sources for dino-related information is science writer Brian Switek. Switek did a wonderful job summarizing current dinosaur research and highlighting dinosaur spottings in pop culture on his Smithsonian Magazine blog Dinosaur Tracking. Unfortunately, Dinosaur Tracking is now extinct, but you can still read Switek’s writing, though it is not exclusively about dinosaurs, at his new National  Geographic blog Laelaps.

Our Week

License My Midwife

Image by Toby Blackwood

Eighteen months ago, I wrote a brief post about pending legislation in the Indiana House to license Certified Professional Midwives (CPMs). That bill passed the House Health Committee and was killed when it didn't come up for a full vote.

The legislation has been introduced again this year, and this year's bill, HB1135, has passed the House Health Committee and will be voted on this coming Monday, February 25.

The Indiana Midwives Association has been working for 20 years to promote and pass this legislation in Indiana. It is currently illegal for CPMs to practice and attend home births. Indeed, a CPM was arrested last year and is awaiting trial for attending a birth with a healthy outcome for both the mother and her baby.

HB1135 will legalize the practice of CPMs in the state of Indiana, the only birth professionals in the state who attend home births. Importantly, the licensure and regulation of CPMs will protect Indiana mothers and families choosing to birth at home by establishing standards of care, requiring collaborative relationships with physicians and tracking outcomes for home births, among other things.

CPMs are not lay midwives. They have multiple years of comprehensive academic and clinical experience, must pass national exams from their certifying agency, NARM, and must complete continuing education. CPMs are currently licensed or otherwise recognized in 27 states and are qualified Medicaid providers in twelve. Numerous scientific studies have attested to the safety and efficacy of home birth for low-risk pregnancies.

Every year, about 1000 women in Indiana give birth at home. Home birth in Indiana will continue, and the Indiana legislature needs to ensure that these women and families have legal and safe access to certified and licensed midwives.

A CPM provided all of my prenatal care and attended Ezra's birth. She was a highly skilled, knowledgeable and caring professional. We spent a considerable amount of time researching the safety of home birth before choosing to birth at home. For a more personal look at our decision to birth at home read Amanda’s post, Reflections on Midwifery, or Garry’s post, A Homebirth Dad.

This bill is important to us and we consider it morally unacceptable for the State to fail to recognize CPMs.

If you are a resident of Indiana who supports home birth, join the Facebook group Indiana Push for Midwives to learn what you can do to help support this legislation.

And from now through Monday, find your state representative and contact them to let them know you support this legislation.

Broken Bones

In October, I fell down a few stairs in a parking garage breaking my right ankle. This was my second major bone fracture. The first happened when I was six. I fell from a playground’s unusually high, monkey bars and broke my wrist a few weeks before I started first-grade. I clearly remember the timing because as the doctor covered my arm with a plaster cast he let me know that my summer filled with swimming and physical play had come to a premature end. The restrictions continued into the first few weeks at my new school. While my classmates ran and bonded during recess, I had to sit in the grass by myself. Later that same year I missed our biggest field trip because I had chicken pox. My poor health was leading to a life as a social outcast.

Thirty years later, my broken bone did not have as big an impact on my social life. It did put a temporary hold on our Sunday hikes with friends, but the cold winter would have slowed those down anyways. Regardless, a sudden change in your physical abilities is inconvenient. My initial reaction to the loud popping noise, intense pain and swelling in my ankle was denial. I continued walking on it while chanting, “it’s not broken, it’s not broken.” My mind is not stronger than my body, but my injured body did allow me to learn a few lessons about myself, my body and Ezra.

First, be more calm. I am clumsy, but this time falling down a flight of stairs was not from lack of grace. It was from impatience, annoyance, and panic resulting from miscommunication. Amanda and I did not connect after work, and I was unsure if Ezra was going to be picked-up from daycare in time. If I had defaulted to a more rational reaction than frustration and anger I would have realized why Amanda did not meet me at our normal spot. I also would not have frantically changed path mid-run, mid-flight of stairs in the parking garage when I realized my mistake. Instead, I would have calmly walked to the spot where we actually parked the car several blocks from the garage. Being in a bad state of mind was 90% of the cause of my injury. The other 10% was probably from not owning a cell phone like a normal person.

Second, bodies are amazing and each one is different. When the doctor sat me down (or since my foot was broken I was probably already sitting) to tell me the bad news, she began to explain that part of the bone in my foot broke off causing a tendon to detach. I immediately began to panic (my lesson about calmness had yet to sink in). How was having surgery going to affect work, taking care of Ezra, camping the following week, ... ? She then said it should heal on its own without any help. I would just need to wear a walking cast to keep it immobilized for 6 weeks.

My foot basically produced additional bone in the damaged area to reconnect the tendon and pull it back into place. Once the tendon was secured the additional bone would smooth and remold itself back into its original shape. At least that is my understanding and simplification of what happened, but my take away was mostly amazement at how the body can, to some extent, self-repair so effectively. If only my house and car could do the same.

I also had to have several weeks of physical therapy to help regain mobility in my ankle. After wearing the walking cast for six weeks, my ankle was weak and frozen in place. I could not move it up or down or left or right. My feet are pretty flexible, and my therapist and I have worked really hard to get back to what is normal for me. I am still not quite there yet. I am sure most everyone has fantasized about what it would be like to temporarily switch bodies with someone else. What would it feel like to be in the body of someone taller, more athletic, or of the opposite sex? After this experience, I now realize how off-putting that experience would be. I am so used to how my body works that not being able to pick up a sock on the floor with my toes feels like I am inhabiting an alien form. I’m sure this pales in comparison to how a woman must feel during pregnancy.

Finally, Ezra does not view me as superhuman. When a coworker saw my cast, one of her first questions was how Ezra reacted to my breaking my foot. She said that her father breaking his wrist when she was a preschooler was a significant moment in her childhood. She had previously not realized her father could be hurt. To her he was godlike: immortal and infallible. I think Ezra’s and my relationship is more grounded than that. In fact, he didn’t even seem that surprised that I would fall and break my ankle. I hope and believe Ezra realizes I am very human. I am not perfect. I make mistakes. Every once in awhile I fall down stairs. He also knows that sometimes I might need help.  For weeks after my injury he insisted on “carrying” me down the stairs “so you don’t fall again.”

Our Week

Celebrating Valentine's Day

We have started a ritual of lighting candles with dinner. It creates a nice ambience, and Ezra looks forward to it and will remind us if we've forgotten to light them. This tradition, as cozy as it sounds, really started out of necessity. It would be nice to think it was a deliberate attempt to incorporate a new ritual around food, but no. Our overhead lights are burned out, and in the dead of winter our house was too dark even with the wall sconces on. We can’t replace the bulbs in our overhead lights without renting a 12-foot ladder, something we can’t do without help. (We have very high ceilings – guests, please, do not look at our ceiling fans ever as I am sure they are growing things).

Since we are burning candles in our candelabrum every evening, it's practically impossible not to get some wax on the table. Thus, it follows that, every evening (literally, every evening), Garry will make a comment about how we need a candle snuffer. Okay, good, I can do this! For Valentine's Day I got him this candle snuffer,

Nothing says "I love you" like a slightly deranged, big-toothed, ceramic rabbit whose butt puts out fires. It’s even holding a heart! It's PERFECT.

This gift may solidify my reputation as the worst gift-giver ever.

When Garry and I were a couple, we didn’t pay much attention to Valentine’s Day. Now that we’re a family of three, we’ve taken care to observe holidays, including ones that we didn’t care for before. Routine is important for children, and while Ezra doesn’t quite yet grasp the length of a year, he fondly talks about past annual holidays like Halloween, Christmas, birthdays, and now Valentine’s Day. Soon he will associate these days with specific seasons and know they are important days that happen once a year. For now, he believes they can happen at any moment. In the car today, he mentioned “maybe, we can go to Grandma Sandy’s for Christmas next week.”

To celebrate Valentine’s Day, we made crepes, both savory and sweet, and opened small gifts. Over dinner we talked about Ezra’s valentine exchange at school and about our love for each other.

Garry’s candle snuffer is quickly becoming the closing part of our dinner routine. Last night Ezra instructed, “Rabbit, dinner is done. Put out the candles with your bottom now.”  I’m honestly really happy with this candles snuffer, and I hope Garry is too. I ordered it from Barry Gregg Clayworks and there are lots of cute little ceramics in his Etsy shop.

I hope all of you enjoyed your Valentine’s Day. What are some of your traditions for this holiday? Are there routines and rituals you enjoy with your loved ones?

Happy Valentine's Day

 Hope you have a  

♡ filled Valentine's Day!  

Winter Drink: Maple Leaf Cocktail

At the start of the New Year, we filled a small notebook with things we wanted to do in 2013. One suggestion was to find a signature drink to mark each season. We thought this would be a nice way of noting the passage of time, celebrating seasonal flavors, and pretending our house was an upscale restaurant.

The idea of a seasonal drink started last summer. Amanda and I declared the shandy our summer drink and kept our church stocked with San Pellegrino Limonata and either a good pilsner or hefeweizen. The shandy* is a simple concoction of light beer mixed with carbonated lemonade, and this refreshing drink was perfect for one of the hottest, driest summers on record. It helped to make our un-airconditioned house more tolerable, but by September we were ready to move on to another drink.

This winter we have been drinking a maple leaf cocktail. We usually drink bourbon straight or with ice, but were intrigued by this recipe that brings together sweet, salty and sour flavors. It is delicious, and does a great job keeping us warm on a snowy evening.

As winter comes to an end we have begun our search for our spring inspired drink. Let us know if you have a favorite beverage (with our without alcohol) that is suited for the rainy days of March, April and May.

*the shandy has 100 different names including shandygaff, panaché, kivelthä, bicicletta, or radler which vary from country (or region) and by the types of beer or mixer

Our Week

A snapshot from our week ...

His indelible imprint

When Ezra was an infant, I spent a lot of time in our rocking chair breastfeeding, and to pass the time, I would try to memorize his imprint in my arms. I would pay attention to the size of his body next to mine, the shape of his back as it curved into my chest, the weight of his small frame on my belly. I mentally traced the features of his face and torso, his arms and legs, his hands and feet, his fingers and toes. I wanted to remember every detail vividly. I knew it was an impossible task, that I would never quite succeed, but I repeated the exercise over and over during his infancy and toddlerhood.

Tonight, Ezra woke from sleep and when it was clear from his cries he needed help going back to sleep, I went upstairs and found him sitting in bed, groggy. I normally sit in the rocking chair beside his bed and pat his back until he falls asleep again or I will lie down next to him, but tonight I brought him into the rocking chair with me. As the motion of the rocking chair quieted him back to sleep, I repeated the exercise I hadn’t done in so long.

His torso fills my arms, his legs spill over my lap, and his face and limbs are leaner. He’s no longer a baby. I know the change has come gradually, but in this moment it feels sudden. My heart is aching the loss. I have been acutely feeling his growth over the last three months. He started preschool, weaned, and potty trained, and every aspect of his infancy is only a memory. My mind hasn’t fully grasped this new imprint and the outlines of his infant frame are blurred.

I cried for my loss, and I cried for my failure. I don’t remember his smell, I only remember it was intoxicating. I can’t recall the physical touch of his infant fingers and toes with my fingers, the grasp of his hand in my own. They are only reassuring traces in my mind. 

While the physical details of Ezra’s infancy that I tried so hard to memorize are elusive, the emotional imprint of that exercise is etched in my mind precisely. Remembering how much time we spent together breastfeeding, physically close and emotionally bonding has left an indelible mark on me. He is stitched into the fibers of my heart and the fabric of my soul, and it has no undoing.

A Cute Child's Apron, A Birthday Gift

Check out my first sewing project this year! I made an apron as a birthday gift for Ezra’s BFF – the wee girl at Sagetribe who loves to cook. I wanted to make her something cute, as well as functional, and voilà …

I think it’s pretty cute!

It was really nice to sew something and this apron was fun and fairly simple to construct. I am, for the most part, really happy with it. I felt a bit rusty since I haven’t sewn anything in quite a while, and I’m using a sewing machine that I’m still not very familiar with. Also, to my great frustration, I didn’t find my good sewing scissors until after I had finished it. I do like the construction of the bib and ties, and I’m totally in love with the binding on the gathered pockets, so here are some more photos (I don’t get tired of looking at them so I’ll share).

This was a good project for myself after such a long hiatus from sewing. The process of creating something from scratch as a gift for a dear girl was also a great gift to myself.

What We’re Reading: 2012 Summary

The Frog and Toad books by Arnold Lobel are one of our family’s favorite series. Each chapter is a standalone story of a day, sometimes two, in the life of Frog and Toad. Their days are not terribly exciting. They wait for the mail, get ice cream, do chores, make lists of things to do, or try to not eat more cookies. Though their days may sound mundane, Frog and Toad are content in their simple life because their days are shared with their best friend, and we are always happy to spend part of our day with Frog and Toad.

Animal Music by Harriet Ziefert holds our household’s record for “most checked-out library book.” The library’s single copy of Animal Music is either at our house or sitting on the library’s shelf waiting for Ezra to check it out again on his next visit. I keep expecting the library to tell us to just keep it. This would make Ezra very happy, and I’m not sure any other library patron would notice its absence – which is a shame because it’s a great book. Divided into two sections, the first half of the book focuses on the lion’s marching band and the instruments and animal musicians that form the band. The second half shows the animal musicians and the instruments that compose the sheep’s dance band.

In the Night Kitchen by Maurice Sendak is one of the most often banned books, but is only removed from our shelf to read over and over again. Ezra, who often helps us bake, is fascinated with the main character’s, Mickey’s, dream of a surreal, late-night adventure with three bakers as they prepare breads and cakes for the next day. Like Mickey and the bakers, Ezra chants, “Milk in the batter! Milk in the batter! Stir it! Scrape it! Make it! Bake it!” whenever he helps make bread, muffins or scones. Like Mickey, he is often naked while doing so.

Nudity (which is the cause of In the Night Kitchen's troubles) has not led to our banning Ezra from our kitchen. 

Ezra’s daycare introduced us to Olivia, the hyperactive, creative and opinionated pig, in the series of books by Ian Falconer. We even met her at an event at the public library. I was surprised by how quiet she is in person. At home, our favorite books in the series are Olivia Helps with Christmas and Olivia . . . and the Missing Toy.

Go, Dog. Go! by P.D. Eastman was Ezra’s very favorite book for months. By chance, our local theatre company’s, Cardinal Stage’s, summer production for children was a musical version the book. Ezra carried brochures for the show around for weeks. Handing them out. Telling everyone that would listen that he was going to see Go, Dog. Go!, and they should too. He should have received a commission on tickets sold. I was less excited and more intrigued. Go, Dog. Go! lacks a plot, is repetitive and random, and I was curious how the book could sustain a one hour show. The show ended up being awesome. I’m glad I listened to Ezra’s recommendation.

Ezra holding his playbill waiting for the show to begin.

The Giving Tree by Shel Silverstein is another of Ezra’s favorite books to check out from the library. He calls the book the “Tree that loves the boy.” I enjoy most of Silverstein’s poems and songs, but The Giving Tree, as children's literature, makes me feel a little uncomfortable. The female tree keeps giving more and more of herself to the boy (later, a man) she loves because his happiness makes her happy. “But not really.” By the end, nothing is left of her except a stump.

What else have we been reading? Check-out more "What we're reading" posts:

The Wonderful Wizard of Oz
Books about the Body: Flip-Flap Body Book; Quest to Digest; Where Willy Went
The Gruffalo
Books about Buses

Knut: The Baby Polar Bear

Moo, Baa, La La La
Peek a Who
Manhood for Amateurs

Sex and death, part two: tough conversations

When Ezra was five months old I wrote a blog post titled Sex and Death. I imagined future conversations Ezra and I would have on these complex and emotional topics, and what I would find difficult versus easy to discuss. Three years later, I am still anxiously waiting for these talks to begin. 

My anxiousness is not from dread, but anticipation. I am eager to hear Ezra’s thoughts, questions, and misconceptions about these essential aspects of life. I look forward to learning what sparks his curiosity, guiding his understanding, and hopefully creating a safe place for him to come as his questions become more complicated, more personal and possibly more embarrassing.

I realize the importance in allowing Ezra to initiate these conversations. His curiosity is a great gauge for what he is developmentally capable of understanding, but I feel a little impatient. I had assumed that by now we would have already had a few minor talks about the subject many parents dread most: where babies come from.

Amanda and I are not too guarded when talking about reproduction, and while Ezra and I are playing I will, unintentionally, say something that makes me think, “hmmm, this is going to lead to an interesting question.”

For example, when we are talking about animals, often dinosaurs, we sometimes list features that distinguish mammals. One, mammals have hair. Two, infant mammals nurse. Three, mammals (with a few odd exceptions- weirdo monotremes) do not hatch from eggs, but grow inside their mommies. I remind him that he is also a mammal. I then wait for an inevitable, “how did I get inside my mom?” question, but so far nothing.

His interest in reproduction will probably increase with both age and when it has more impact on his life. Later this year Ezra is going to become a cousin for the first time. I assume his inquisitiveness will expand along side his aunt's belly. 

I have always been more nervous to discuss death with Ezra than sex. Fortunately, Ezra’s curiosity about death is not much stronger than it is about sex so the topic rarely comes up.  A degree in philosophy is probably not in his future. 

The one time Ezra did have questions about death was last year when our cat, Stella, passed away. I still regret how poorly prepared I was to answered his questions. I was so vague about what had happened to Stella and why Amanda and I were sad that I added to his confusion. I even avoided using the words dead or death to explain her absence. I knew I was being unfair to him by not explaining what had happened better, but I was at a loss to know where to draw the line between adequate answer and too much information. The emotions of losing our pet made the conversation even more difficult. So, I have hoped for a chance to start that conversation over.

A few weeks ago we had a second opportunity to talk to Ezra about death. This time he was the one reluctant to have the conversation. Buttercup the class pet at Ezra’s preschool died at the ripe old age of eight. I had no idea that the life expectancy for guinea pigs was so long. Mine were never so lucky, and provided my parents with plenty of opportunities to talk to me about death. Though we acknowledged the passing of Buttercup, Ezra was not that interested in talking about it, and we did not push him. After a few days, I did bring up Buttercup. The conversation was short.

“Are you and your friends sad about Buttercup no longer being in your class,” I asked.

“No.”

“Do you understand what happened to Buttercup?”

“Yes, she’s dead. We put her in a hole in the ground,” he explained in a matter of fact tone, and then changed the subject.

I don’t think he was avoiding talking about it because it was upsetting. At this moment in his life, he is learning to navigating his relationships and interactions between himself and his friends at school. He is preoccupied with his own difficult conversations that do not involve me, and death is not something that dwells in his thoughts for long. I am grateful that is the case. I also realized that the simple explanations I had avoided when discussing Stella, that she had died and was gone, was all that he was seeking.

At three years and four months old, Ezra and I are only just beginning to have "big talks." Not all of the conversations have been successful in helping Ezra to better understand the world, but have been wonderful at teaching me that these "big talks" begin as nothing more than small conversations.