AT HOME IN MAINE - Fogler Library, University of Maine
Transcription
AT HOME IN MAINE - Fogler Library, University of Maine
AT HOME IN MAINE: A DOCUMENTARY FILM SERIES AND WEB RESOURCE ABOUT MAINE'S HOMEBIRTH AND MIDWIFERY COMMUNITY By Nicolle Littrell BA State University of New York, Buffalo, 1991 A PROJECT Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Arts (in Liberal Studies) The Graduate School The University of Maine August, 2011 Advisory Committee: Laura Lindenfeld, Associate Professor of Communication & Journalism and the Margaret Chase Smith Policy Center, Advisor Mazie Hough, Associate Director of Women's Studies Bill Kuykendall, Associate Professor of New Media Kristin Langellier, Professor of Communication and Journalism AT HOME IN MAINE: A DOCUMENTARY FILM SERIES AND WEB RESOURCE ABOUT MAINE'S HOMEBIRTH AND MIDWIFERY COMMUNITY By Nicolle Littrell Project Advisor: Dr. Laura Lindenfeld An Abstract of the Project Presented in Partial Fulfillment of the Requirements for the Degree of Master of Arts (in Liberal Studies) August, 2011 Childbirth is a contested site of public, professional and academic debate and discourse. This begins with a woman's body and her right to choose to give birth. Once a woman has chosen to give birth, the focus of the debate shifts to her baby, the practitioner attending the birth, that is, the doctor or midwife—or the choice to have an unassisted birth-and the actual location of the birth. "At Home in Maine [AHIM]" is a documentary film series and web resource that addresses an underrepresented area of discourse about Maine: contemporary homebirth and midwifery culture. Homebirth and midwifery care are often historicized in scholarly discourses, as seen in "A Midwife's Tale (Ulrich, 1991)," concerning the life and career of 18th century midwife Martha Moore Ballard. Homebirth has also been marginalized in the mainstream, though that may be changing with the recent release of a CDC report stating that in the United States, homebirth is on the rise (McDorman, Declercq and Matthews, 2011). Homebirth and midwifery care is also an underrepresented area in feminist discourse. AHIM frames this subject as part of the domain of choices in childbirth, and therefore, should be a significant area of feminist inquiry. Through the visual record and the genre of documentary film, AHIM shows that homebirth—and normal, natural, childbirth—happens. With the online distribution format, the project provides an accessible informational and educational resource for women and their partners regarding choices in childbirth. Central research questions of this project are: What does homebirth in Maine look like? Who are the people, and what are the practices, philosophies and politics that constitute Maine's homebirth culture? How is this domain significant for women--and an important area of inquiry for feminist discourse? Over the course of four years, using community-based feminist models, this investigator documented eight homebirths, representing seven different families, five different midwifery practices, six towns and five regions in Maine, as well as recorded other pertinent events in the homebirth community. Timing makes this project especially distinctive with the investigator's documentation of a group of Maine midwives' pursuit of title licensure in 2008. The bill for licensure did not pass; however, an unprecedented new law, "Chapter 669" was enacted, which decriminalized Certified Professional Midwives' [CPMs] use of a short list of medications at birth. The results of the AHIM project are a film series of ten authentic portraits of homebirth in Maine and a website, which provides an online distribution platform for the films: <http://mainehomebirth.wordpress.com/> In concept, output and distribution this project is one-of-a-kind. As of this publication, there are no other known discourses on Maine's contemporary homebirth and midwifery culture, nor are there any media products such as AHIM: an online film series about homebirth and midwifery care. AT HOME IN MAINE: A DOCUMENTARY FILM SERIES AND WEB RESOURCE ABOUT MAINE'S HOMEBIRTH AND MIDWIFERY COMMUNITY By Nicolle Littrell Project Advisor: Dr. Laura Lindenfeld A Lay Abstract of the Project Presented in Partial Fulfillment of the Requirements for the Degree of Master of Arts (in Liberal Studies) August, 2011 Courtesy of Nicolle Littrell 2011 KEYWORDS: At Home in Maine, Contemporary Homebirth in Maine, Midwifery Care in Maine, Certified Professional Midwives, Homebirth Midwives, Licensure of Midwives, Homebirth films, Homebirth Videos, Homebirth Film Series, Childbirth Films, Websites about Homebirth, Natural Birth Movement on the Internet "At Home in Maine [AHIM]" is a documentary film series and web resource that addresses an underrepresented area of discourse about Maine: contemporary homebirth and midwifery culture. Homebirth and midwifery care are often historicized in scholarly discourses, as seen in "A Midwife's Tale (Ulrich, 1991)," concerning the life and career of 18th century midwife Martha Moore Ballard. Homebirth has also been marginalized in the mainstream, though that may be changing with the recent release of a CDC report stating that in the United States, homebirth is on the rise (McDorman, Declercq and Matthews, 2011). Homebirth and midwifery care is also an underrepresented area in feminist discourse. AHIM frames this subject as part of the domain of choices in childbirth, and therefore, should be a significant area of feminist inquiry. Through the visual record and the genre of documentary film, AHIM shows that homebirth—and normal, natural, childbirth—happens. With the online distribution format, this project provides an accessible informational and educational resource for women and their partners regarding choices in childbirth. Central research questions of this project are: What does homebirth in Maine look like? Who are the people-and what are the practices, philosophies and politics-that constitute Maine's homebirth culture? How is this domain significant for women-and an important area of inquiry for feminist discourse? Over the course of four years, using community-based feminist models, this investigator documented eight homebirths, representing seven different families, five different midwifery practices, six towns and five regions in Maine, as well as recorded other pertinent events in the homebirth community. Timing makes this project especially distinctive with the investigator's documentation of a group of Maine midwives' pursuit of title licensure in 2008. The bill for licensure did not pass; however, an unprecedented new law, "Chapter 669" was enacted, which decriminalized Certified Professional Midwives' [CPMs] use of a short list of medications at birth. The results of the AHIM project are a film series of ten authentic portraits of homebirth in Maine and a website, which provides an online distribution platform for the films: <http://mainehomebirth.wordpress.com/> In concept, output and distribution this project is one-of-a-kind. As of this publication, there are no other known discourses on Maine's contemporary homebirth and midwifery culture, nor are there any media products such as AHIM: an online film series about homebirth and midwifery care. DEDICATION For my Mother, who started the whole thing. For my son, who led me to this. For the many teachers and supporters along the way. But most of all, for the women— who shared so much and trusted so much. Without them, this project would not have been possible. iv ACKNOWLEDGMENTS To my MALS committee members for their ongoing support and assistance: Dr. Laura Lindenfeld, Bill Kuykendall, Dr. Mazie Hough and Dr. Kristin Langellier. And to James Clark for assistance reading this manuscript, editing suggestions and for feedback regarding several of the films in the AHIM series. Thank you. v TABLE OF CONTENTS DEDICATION iv ACKNOWLEDGMENTS v LIST OF FIGURES x INTRODUCTION 1 CHAPTER 1: MY PARENTS WERE NOT HIPPIES 2 CHAPTER 2: PSYCHEDELIC BABY 3 CHAPTER 3: BIRTH AS WE KNOW IT OR BORN IN THE USA 5 CHAPTER 4: SHIFT 7 CHAPTER 5: AT HOME IN MONTVILLE, MAINE 10 CHAPTER 6: CONCEPTION 17 CHAPTER 7: A FRAMEWORK. MASTER'S OF ARTS IN LIBERAL STUDIES AT THE UNIVERSITY OF MAINE 19 Method: Film as Proof. 19 Program of Study 20 CHAPTER 8: I FILM MY FIRST BIRTH 22 CHAPTER 9: MAINE MIDWIVES PURSUE LICENSURE 25 Are you With Us or Against Us? 26 Turf Wars 27 Fact Sheet 28 vi CHAPTER 10: THE BUSINESS OF BEING BORN 30 Documentary Film 31 At Home in Maine, The Film 32 Maine Politics 33 CHAPTER 11: FALL 2008 34 Harvest 34 CHAPTER 12: BIRTH, FEMINISM AND "VAGINAL POLITICS" 36 ROAR 36 Advanced Feminist Theory 37 At Home in Maine, Part III 38 Memories and Insertions 39 CHAPTER 13: AT HOME IN NORTHEAST HARBOR, MAINE Why Don't You Become a Midwife? 42 44 CHAPTER 14: ONLINE VIDEO-SHARING OR THE START OF MY LOVE AFFAIR WITH FREEWARE 46 CHAPTER 15: SHIFT 48 CHAPTER 16: AT HOME IN WALDO COUNTY 50 Melinda 50 Gretchen 51 Lament 51 vii CHAPTER 17: THE NATURAL BIRTH MOVEMENT AND THE INTERNET 53 The Camden International Film Festival CHAPTER 18: AT HOME IN MAINE, THE WEBSITE 56 58 Independent Studies 58 Dream 59 CHAPTER 19: OUTSIDE THE FRAME 61 Cutting Room Floor or "Omission Montage" 63 What Made the Cut 63 CHAPTER 20: DIVERSITY, LIMITATIONS AND ACCESS 64 Racial Diversity and the "Subculture of White Women" 65 "Subculture of White Women?" 66 Other Limitations: Proximity 68 Location 68 Midwifery Education 70 Lament 72 CHAPTER 21: SPRING 2011. BIRTH MATTERS 73 At Home in Waldo, Maine 73 Maine Coalition for Choices in Childbirth 74 CHAPTER 22: OPPORTUNITIES AND THE DIY FILMMAKER 77 Audience 78 Cyber Connections 78 Kickstarter 79 viii Mothering.com 79 Public Screenings 80 Independence Day 81 CHAPTER 23: CONCLUSION 82 REFERENCES 85 APPENDIX A: AT HOME IN MAINE PROJECT DOCUMENTS 90 APPENDIX B: AT HOME IN MAINE SERIES FILMDESCRIPTIONS 102 APPENDIX C: AT HOME IN MAINE WEBSITE ADDRESS AND SCREEN SHOTS 114 BIOGRAPHY OF THE AUTHOR 124 ix LIST OF FIGURES Figure C.1. Historical Context of Homebirth in the US; At Home in Maine Project Description and Goals 115 Figure C.2. Project Investigator's Personal Experience with Homebirth; At Home in Maine Project Origins 116 Figure C.3. Overview of Homebirth Films 117 Figure C.4. Overview of Maine's Certified Professional Midwives 118 Figure C.5. Invitation for Viewers to Share Personal Homebirth Stories 119 Figure C.6. Overview of Different Resources Pertaining to Homebirth 120 Figure C.l. Example of Two Posts on the News/Blog Page 121 Figure C.8. Listing of Different Ways to Support the At Home in Maine Project 122 Figure C.9. Information about Filming Births as a Service for Consumers 123 x INTRODUCTION How do I write about a project that has spanned over four years, involved dozens of participants, countless hours, shifts and insights and is the substance of a graduate career? A body of work that represents seven families, eight births, over half of Maine's twenty-five midwives, six towns and five regions of Maine? A creative product that is comprised of eleven films, a website and (yes, of course) a Facebook page? A project that is my own living breathing expression of "the personal is political." In documentary, the "montage" (or "assembly") is a careful arrangement of images, or "fragments," when juxtaposed with each other, create new meaning. "Insight replaces recognition, new possibilities suggest themselves, alternatives come to light." Bill Nichols, Representing Reality: Issues and Concepts in Documentary (p 132). Through a narrative montage representing key events, insights, shifts, limitations and opportunities pertaining to this project, I will attempt to articulate the evolution and meaning of "At Home in Maine," framing it as a product of personal, political and cultural significance. It all begins with a story of a birth. The story of my birth. * * 1 * CHAPTER 1: MY PARENTS WERE NOT HIPPIES I was born on August 22, 1969 at 10:43am in a hospital in Warsaw, New York. My parents had finished their sophomore year of college at the State University of New York, Geneseo. Psych majors; barely twenty years old. They had not gone to Woodstock. I had been due on the last day of the festival and the doctor thought it best they stay put. My parents weren't love children, either; though I had been conceived out of wedlock, during Thanksgiving break. And my Father had "experimented" with certain substances. Learning of the pregnancy, my grandparents, steeped in the moral dogma of their religions, were properly shocked. A priest counseled my mother and father to have an abortion. My Mother had a fast labor for a first birth. She was shaved, given an enema, a spinal epidural and a deep-cut episiotomy. This is all she remembers, except that she never felt the same "down there." Had pain during sex. Later, some incontinence issues. Scars. My Mother never thought to question her experience. She didn't know that in the late 1960's and early 70's, all around her in different parts of the US, from California to Maine, a revolution was happening. Women were starting to help other women have babies again. And they were doing it at home. They were learning how to midwife, reclaiming the old wisdom. My parents were not hippies. •k * 2 ic CHAPTER 2: PSYCHEDELIC BABY "I felt higher than I ever had in my life. It was such a heavy spiritual experience, and so much fun. In between rushes I'd laugh at how telepathic it was. " Carol, Spiritual Midwifery (p. 80) June 2004. I am two months pregnant and a friend of a friend has given me the book, "Spiritual Midwifery" by Ina May Gaskin. Written in 1970, it is a compilation of birth stories, as well as a do-it-yourself midwifery manual. Gaskin, one of the original "hippie" midwives, was called to the profession through assisting friends with their births. The first birth she attended was on a bus, in a parking lot, during a cross-country road trip she and her husband Stephen embarked on with a group of friends. Gaskin, her husband and this group would found "The Farm," an intentional community in rural Tennessee. The stories for Spiritual Midwifery were culled from the many birth experiences of Farm residents and visitors. The book delights me. It's written in an accessible style with liberal hippie flourishes. Words like "psychedelic," "telepathic" and "rushes" to describe birth not only make me laugh but move my wanna-be hippie soul. More than this: I am captivated by the beauty, power and naturalness of birth presented and women helping other women. I devour the stories, even the ones representing "bad outcomes (this book written at a time before this phrase was even coined)." And then there are the photos. Graphic images of women giving birth—before, during and after-pervade the book. The image quality, circa 1970, is not great, yet I am enthralled. The book, like midwifery itself, was initially passed on from woman to woman. Now it is available at Borders. "Spiritual Midwifery" is a kind of 3 phenomenon and "Ina May" (as she is affectionately known), the supreme goddess of birth. It is the bible of the Natural Birth movement, a tome representative of the reemergence of homebirth midwifery in the United States. * * 4 * CHAPTER 3: BIRTH AS WE KNOW IT OR BORN IN THE USA "What the hell is wrong with this picture?" Carol Leonard, Lady's Hands, Lion's Heart: A Midwife's Saga (p. 17) Despite the Natural Birth Movement, my Mother's medicalized birth was de rigor in 1969. Midwife Carol Leonard, in her book, "Ladies Hands, Lions Heart" (Bad Beaver Press, 2009) describes a similar experience when she gave birth to her son in 1975. Only she was strapped down. I reach down to soothe the fiery skin around my child's emerging head. Dr. Easey sees me do this. He flips out. Totally and irrationally. He is irate that I have the audacity to touch myself in front of him. He slaps my hand away. He shouts that I have contaminated his sterile field. Godammit! He gives orders for me to be restrained, for my hands to be strapped down. He continues ranting as though I am a disgusting, wild beast. The nurse ties my hands securely with leather handcuffs that are built into the table; they look like the wrist restraints found on electric chairs. I watch as Dr. Easey cuts a huge midline episiotomy in my vagina. Milan's head is born (p. 19). Midwives came to their professions this way, too, from oppression. Rising from the ashes of their own nightmarish births. In the late seventies my Aunt, my Mother's sister, had similar experiences with both of her sons' births. Incidentally, my Aunt was born at home, by "accident" in 1951. By the 1950's, with the advent of the field of obstetrics—and an effective smear campaign against midwives-most women were having their babies in the hospital (Ehrenreich and English, 1993; Gaskin, 2011). Not much has changed. Approximately 99% of women give birth in a hospital (National Center for Health Statistics, 2010). It's just that now about 23% are induced, over 32% of them are having Cesarean sections and several women are dying every day from birth-related 5 complications, including C-sections (National Center for Health Statistics, 2010; National Center for Health Statistics, 2010; National Center for Disease Control, 2010, California Pregnancy-Associated Mortality Review, 2011, respectively). In May of 2011, Amnesty International releases a new report, "Deadly Delivery: The Maternal Health Care Crisis in the US" indicating that the US now holds the distinction of ranking the worst among developed nations in regards to maternal mortality. And the babies are dying, too. The United States spends the most on maternity care in the world and has some of the worst results. What the hell is wrong with this picture? •k it 6 * CHAPTER 4: SHIFT I am six months pregnant. I have transferred from a hospital birth with a Certified Nurse Midwife [CNM] to a homebirth with two Certified Professional Midwives [CPMs], the practitioners who specialize in out-of-hospital birth. They live a mile down the road from my partner "O" and I in Montville, Maine. Donna and Ellie came to their profession through each of their own experiences of having unassisted births with their first babies. Though I liked my CNM and felt she was surely competent, the hospital setting and almost perfunctory feeling of my prenatal care just didn't feel.. .right. I remember sitting in the office waiting room, reading magazines like "Parenting" and "Fit Pregnancy," taking in the industrial carpeting, the receptionist, the white walls and thinking, This just isn't me. Prenatal visits, though pleasant enough, were short. When I expressed concern about certain particulars, I was given a proverbial "pat, pat" and comforted with, "You'll either have a vaginal birth or C-section, dear." I was asked to sign voluminous paperwork consenting to hospital policies, releasing the institution from all responsibility. In contrast, prenatal visits with my homebirth midwives last two hours. They are filled with laughter~and plenty of time to talk and dish. We discuss O's and my backgrounds, our births, our relationship; our sex life. My concerns. When I ask them if I need to do anything to prepare for the birth, like take a hypno-birthing class, they just look at me and say, "Your body knows how to birth your baby." I sign a consent form underscoring my responsibility in making the choice to have a 7 homebirth and receive professional midwifery care. I don't really understand what this means until much later, after I have become a Mother. We have lively discussions about the state of birth in the US. The high rate of intervention. Medicalized birth. Women and babies being underserved by the mainstream maternity system. I feel something fermenting me. Fanning the fire, Ellie turns me on to more politically-minded works like medical anthropologist Robbie Davis-Floyd's "Birth as an American Rite of Passage (University of California Press, 1993)." Davis-Floyd frames medical birth as a cultural ritual into which both women and medical practitioners are inculcated. It was in this book that the term "technocracy" was coined in relation to medicalized birth, to describe US culture deigning technology as God. Though presented through a fairly dense methodological framework, the message comes through loud and clear: women in the US are brainwashed by culture into believing that they can't give birth, that doctors know best and that the hospital is the safest place to give birth. Women are giving away their power. I think about my high school friends, the ones that had babies in their early-mid twenties, during the time Davis-Floyd conducted the research. Her findings are representative of their experiences. The author includes data from her study-set about women who have chosen homebirths with midwives. This creates a foil that more than subtly suggests this kind of birth may be a saner, safer choice for women. It takes me months to read the book; I don't finish it until long after my son had been born. When I do, I have a better understanding of the underpinnings of medicalized childbirth, the medical maternity complex, the disparity in paradigms 8 between the medical and "natural" models of birth--and the recognition that most women in the US did not have the kind of birth experience I had. * * 9 * CHAPTER 5: AT HOME IN MONTVTLLE, MAINE "It wasn't an illness; it wasn't something that needed to be numbed. It needed to be experienced. " Ricki Lake, from "The Business of Being Born " December 27, 2004. At thirty-six and half weeks pregnant, I wake up after a particularly rough night of sleep with the words to the song, "In the jungle, the mighty jungle, the lion sleeps tonight" playing in my head. I'd been up to pee about ten times that night, with abundant tossing and turning. We'd had some "weather" the night before. New snow blanketed the ground and bitterly cold temperatures pressed in, despite the bright sun. O was taking the day off from work and planning on going into town for some provisions. We live in a small 1790's farmhouse on a dirt road in rural Montville. As I sat down to eat my breakfast, a bowl of cereal, I feel a "squirt" down below. That was weird. When I get up another squirt. I tell O about it. He offers that maybe I have peed my pants? It had happened, you know, once or twice during this pregnancy. I assure him that this is not what is happening. This is different. I call my midwife, Donna and tell her about the squirts. She says it sounds possible my membranes have ruptured. "Don't put anything in there" she tells me; doing so could run the risk of infection. She tells me to put on a pad, check the color and call her back. O leaves for town. I look at the film schedule at Railroad Square Cinema in Waterville thinking I might check out a film that day, one of my favorite pregnancy pastimes. 10 The color on the pad is a soft brownish-pink.. .kind of pretty, actually. I call Donna back and report this. She says, "I'll be down in a few minutes." I ask, "Does this mean I can't go to the movies this afternoon?" She responds, "You might want to check in with yourself about that." Donna arrives a short while later. As she steps through the door, I tell her I think I'm going to be sick. She brings me a bowl and I throw up in it. She regards me. "I think you're going to have your baby tonight." My response: "No way." She tells me she's going to go back to the house to get some supplies. There are things to do, namely set up the birth tub, as I am planning a waterbirth. Donna asks when O will be back. I tell her I have no idea but will give him a call and find out. I call O and leave a voicemail message telling him that Donna thinks that I might be in labor and when will he be home? It is three and half weeks before my due date. My baby is due around January 22nd, not two days after Christmas; supposed to be an Aquarius, not a Capricorn. I start washing baby clothes. They are still in packages, on hangers from the baby shower my Mother held for me at Thanksgiving. I talk to my belly. "Are you sure you want to be born now?" In response, my labor starts cranking up. It's about 2:30 pm. The contractions get to a point where I can't just sit; I need to move into other positions to work with the energy. Damn, this is intense! I start to understand why women ask for pain relief. It's not that it hurts but that it's the most intense physical sensation I have ever experienced. 11 I realize I am at a crossroads. I can go down the road of fighting the intensity and experience it as "pain" or I can let go and let it happen to me; its just energy, after all. It becomes a choice. There is a tree outside our bedroom window with a big hole in the middle. During my pregnancy, I have named it the "cervix tree," though the opening is much larger than ten centimeters. Ten cm seems so big! But the hole on the tree is bigger. I meditate on it. My mantra: you can do this.. ..open up.. .open up.. .you can do this. Donna returns and starts setting things up for the birth. The birthing tub will be right next to the Christmas tree; my favorite gift that year. I am fairly oblivious to her ministrations. She asks again, "When will O be home?" Ellie is far away in Massachusetts, on the road chauffeuring her mother home after the holidays. Christ, they weren't even on call for me, yet. O arrives home and starts helping Donna with set-up. I hear blurbs of conversation concerning having enough hot water and will the old wood floor hold the birth tub? Though doubtless many babies have been born in this home before, none in one these new fangled contraptions. Earlier in the pregnancy, after I transfer care from a CNM at Blue Hill Hospital to Donna and Ellie and a homebirth in Montville, O and I tell them where we live. They chuckle and say, "Oh yeah, the baby house." They have assisted two other families there with homebirths. I wonder how many other babies have been born there? Is this house some kind of baby portal? 12 At some point Donna leaves again to get more supplies. It's just O and me. My feet are so freaking cold! It becomes my point of focus~and a major distraction. It's as if all the heat in my body has rushed to my womb, leaving my extremities frozen. I ask O to start a shower for me—I've got to heat up my damned feet! I step into the shower without pulling off my long johns—they are about my knees. The shower feels good, the water steaming down on my body. Standing and laboring. My labor likes this; likes standing, likes the water. More of my mucous plug releases-onto my long johns. At this point, I turn into Martha Stewart and give O explicit directions on stain removal. I get out of the shower and labor on all fours on the bathroom rug. More blood and mucous. Martha Stewart pipes up again. O laughs and says, "We'll get a new rug!" Donna has returned. At around 6:30 pm she does a cervical check. "You're seven cm." "No way," I say. I guess I'm still not convinced this is really happening. She tells me I can get in the birthing tub at any time. Birthing tub? I forgot all about that! Like the shower, but even better, submerging into the birthing tub has a deeply relaxing effect. The contractions feel more manageable, softer. The water is warm, almost hot. I settle in. I move around, letting my body tell me where it wants to go, how it wants to labor. I try different positions—back up against the tub, on my knees and hanging over the side ... At around 7 pm, Heather arrives, another midwife, who in Ellie's absence steps in to back-up Donna. Midwives like to work in pairs. My mama bear instinct bristles at the influx of new energy in the room. Heather eases into the circle with respect and professionalism; warm compresses on my back, making sure I stay 13 hydrated and a nurse's attention to detail. And later, after the birth, a mean turkey soup and magical comfrey salve. The mood changes. I go deeper into labor-land. The feeling becomes almost hallucinatory. Sacred. The only light.. .illumination from the Christmas tree and the waning full moon beaming through the frosted windowpanes. The only sounds, my moans and roars, urges I could never suppress. Donna breathing beside me ... holding the space ... just right. The woodstove nearly red with heat. The room starts to feel like a Temple and me, a goddess. Am I really making those sounds? Kali? How could I not? Isis? I'm feeling pushy; my vocalizations indicate this. Donna would like to do another vaginal exam, asks me if that would be ok and would I mind sitting on the birthing stool, which is a modified wooden toilet seat, for better access. I do and it feels good. She checks me. "There's no cervix left, it's all baby." "No way," I say. Wait.. .I'vegone through transition? D laughs and nods. Wasn't I supposed to feel like I was splitting apart? A moment poised between life and death—like so many of the women described in the stories I read? I ask the question that untold numbers of first-time mothers ask at this point, "Does that mean I can push?" Yes. ..ifyou feel like pushing. I do. I stay seated on the birth stool. It feels good to have something to bear down on. My body goes on autopilot and my vocalizations work in tandem with my physiology to move my baby (or is it a bowling ball?!) down my vaginal canal. It feels like nothing is happening. I say this. Donna laughs, "Oh, the baby's coming down alright. You 14 can feel the head." I opt out of this. I'm reminded from all my reading during pregnancy that it can be this way—the baby's descent, followed by what seems like an inching up back towards the womb. O has asked several times if he can come in the tub. "Not yet" I have told him. Realizing the birth is probably getting close, that maybe this is, in fact, happening, I allow him to join me. The pushing doesn't really even feel like work. I sense that it's somehow about me staying out of the way. I am on the birthing stool, with my back against the side of the tub. O is poised between my legs, like a catcher for a baseball team. The water is so hot. Then the "ring of fire." Owww and ... owww ...! Now that hurts!! But not for very long. That final push, the one I thought would never come and my baby emerging out of me. And then, magic. His body half in me and half out in the water. His father supports his head. He grabs one of my hands and Donna's. He looks up through the water. What does he see? The Christmas tree lights? The full moon? A moment, just a moment, held fast, then he slides out of me and into his father's hands. 9:15pm. No more than seven hours of labor start to finish. His father starts to cry and say, "Thank you ... thank you for my son." He brings him over to me. I am in shock. A human being has just come out of my body. It is too much to comprehend.. .or articulate. But, yes, he is a boy and wide awake, but apparently, not breathing. His heart rate goes from 140 to 40. The midwives spring into action, placing an oxygen mask on him. Heather gives him a homeopathic remedy. We are encouraged to rub him and talk to him. It is the longest minute of my life. He starts breathing, as if understanding that it's ok to do 15 that now. Later, I find out that this is fairly common with water babies. They are lazy to breathe out of the womb. O gives him to me. He is at my chest. I position myself to breastfeed him. He nuzzles and licks my nipple a bit, sort of latches on. We start talking about names. "So, do you think he's a Rufus?" I say. "No, he's a Leo," O responds, another name we discussed, in the event that he was a girl. With a tug from Donna, my placenta is born. We stay in the tub for over an hour, gazing at our baby. After we get out, there is food, magical tea and Leo's first exam. Calls are made to the immediate family. My father is the first on my side to know, then O's. Stitches are considered and then the idea discarded, given that I only had minor labial tears. I am very glad about this; on all counts. Leo is dressed, the midwives clean up, we make decisions about what standard newborn treatments we should consent to-or not? Leo's footprint on a homemade "birth certificate"; the real one gets filed in a week or so at the Montville town office. Donna impresses upon us how warm we need to keep the room. This is a drafty old farmhouse, after all, and it is zero outside. The moon is crystalline and bright. We move our bed into the living room, right in front of the woodstove. The midwives finish their work and leave about 11pm. It's just me and O and Leo. O fluffs the nest and stocks the fire. I hold our son, still in shock. We go to bed, Leo nestled between us. A family is born. And I a Mother. •k * 16 -k CHAPTER 6: CONCEPTION "I felt I had discovered a new religion. In a way, it was like I was reborn. " Me, from my MALS program application essay The idea for a film about birth bore directly out of my own homebirth experience and my "conscientization (Freire, 1968)," meaning a growing knowledge and awareness, including a developing political sensibility regarding the state of birth in the US. Simply put: my homebirth experience radicalized my thinking and politicized the way I saw my body, women and the world. The original concept would be a feature-length documentary film comparing home and hospital birth. Hospital birth would be used as a foil to show how homebirth and professional midwifery care could be a better choice for women-that this was a viable option. With a camera I had received as a Mother's Day present in May of 2005,1 kicked off the project by interviewing my former care provider, the CNM from Blue Hill. Her responses to my questions were careful, guarded. She did not dash the medical maternity system to pieces, as I had hoped. I allowed her to interview me. The question that resonated the most: Weren't you afraid to have a homebirth? •k it * November 2004. O and I take a Birthing from Within (England and Horowitz, 1998) childbirth preparation class (inspired by the book of the same name), held at the office of our midwives and led by two doulas, women who provide education and labor support to birthing women. It is the perfect class for creative types, hopes and fears addressed through touchy-feely conversation, meditation, visualization and 17 creating birth art. We practice dealing with pain (ice cube on the wrist) and birthing positions. My own fears are directly addressed in a way that helped to dissipate them, though some still lingered. What if the baby dies? Through conversation, information and creative expression, I come to terms with them. When asked to portray how I see myself in labor, I paint an image of "the cervix tree" in my front yard, branches open-wide, roots nourished by subterranean water, a full moon in the background, an owl perched on a branch. An owl? I later find out that in Irish lore, an owl near a pregnant woman bodes a fast and easy labor. there was no time to be afraid. No, I wasn 't afraid. •k ~k 18 My labor was so fast CHAPTER 7: A FRAMEWORK. MASTER'S OF ARTS IN LIBERAL STUDIES PROGRAM AT THE UNIVERSITY OF MAINE September 2006. I enter into the Masters of Arts in Liberal Studies [MALS] program at the University of Maine. With no money or equipment, I decide Academia is the best arena to produce my film about birth—to access resources, be a part of a network and create a framework for the project. Leo is twenty-two months old, still breastfeeding. The winter prior, I completed an introductory editing class and have gained some basic skills. I decide my lead concentration will be "New Media;" it's the closest connection to film I can muster, despite the debates. I would later change my focus to a "specialization" (changed from "concentration") in Women's Studies. The concept for my film had shifted. It would now be a featurelength film exclusively about homebirth. Homebirth in Maine. Write what you know. Method: Film as Proof I am a filmmaker. I am compelled by images; arresting moments that breathe fire into me. Moments that can be connected to create a story; singular moments that tell a story in themselves. Film is proof-that things happen. That birth happens. That homebirth happens. That normal, natural, vaginal birth happens. As we see all too frequently, in the mainstream, birth is usually either misrepresented with (the usual) high drama~or obscured. There are too many examples, take your pick. Of course, there was "Dharma and Greg" and "Northern Exposure" and "Dr. Quinn Medicine Woman." Thank you Hollywood for these. People have forgotten what normal natural birth looks like, let alone homebirth. I want to remind them. About what is possible. 19 Program of Study My courses in my MALS program become important avenues for shaping my project. I develop a methodology; learn what "methodology" even is. I reconstitute my definition of "feminism," dehydrated from the usual negative associations. I gain a working understanding of how the two can go hand in hand. In "Feminist Research Methodology" I learn about research and colonization, feeling sound in my choice to produce a project that takes place in my own backyard and concerns a community in which I am a "native." I gain a deeper understanding of "participatory" and "consent." Through the University Internal Review Process (IRB), I develop my own project consent and release forms (see Appendix A). In the course "A Midwife's Tale," through the patient daily record of the life of Martha Moore Ballard (and Laurel Ulrich's nuanced analysis in the book of the same name; Ulrich, 1991) I gain a historical purview of midwifery in the United States. Ballard's "daily-ness" documents a pivotal shift in how birth is done in the US, marking the entrance of male doctors into birth, leveraged by the privilege of class. The advent of the field of obstetrics. The rise and fall of midwifery in the US and Maine's own rich heritage. I seethe inside discovering the age-old struggle between the medical community and midwives and come to understand that if anything can be counted on (besides death and taxes) it's the medical community's efforts to wipe midwives out every few centuries, or decades-from "Malleus Maleficarum (Kramer and Sprenger, I486)" to the more recent "Wax Paper (Wax, K., etal., 2010)." I learn about women's networks; systems of commerce comfort and support. 20 Later, I will attend two Midwives Alliance of North America (MANA) conferences and experience the sisterhood firsthand. I will meet and interview Robbie Davis-Floyd, Carol Leonard, Sister Angela, Elizabeth Davis, Ricki Lake, Abby Epstein and Ina May. I will create a film, a "herstory" about the organization: <http://www.vimeo.com/3130025> * * 21 * CHAPTER 8: I FILM MY FIRST BIRTH September 6, 2007. At 6 am I receive a call from Casey. She thinks she is in labor. Holly, the midwife who has referred me to this mother is already there. Given that I have about a two-hour drive (from Ellsworth to Auburn), I am urged to get on the road. Casey is a stay-at-home mother with two boys. Her husband Jason is a high school science teacher. Her first birth was planned to take place at a birth center in Alaska, where she and Jason lived for several years. She ended up having a Csection. She tells me that, to this day, she questions its necessity. She had a "home" birth with her second child at a friend's house in New Hampshire. For her third child, she is planning on giving birth in the house the couple has recently purchased on a quiet neighborhood street in Auburn, Maine. Casey's labor slows after my arrival. Holly knowingly nods towards Casey's two young sons, who are quite energetic. She says it's pretty typical for labor to be hijacked by the needs of young children. The boys and her husband Jason vacate the house to attend a birthday party. It's just Casey, Holly and I~and Bridget the dog. Intimate conversation about birth unfolds. Casey reflects on this pregnancy, its sensations, comparing this one with her other experiences. Holly listens and offers quiet reassuring counsel. We talk about how birth is portrayed in mainstream; water breaking like a dam, always a crisis. We decide that given the long hike back to Ellsworth, I will stay the night. Casey's birth seems imminent. 22 I make dinner for Casey and Jason, adding an extra dose of cayenne pepper to the squash casserole to help reclaim the attention of her labor (a tip gleaned from Alabama "Granny Midwife" Onnie Lee Ogan, as described in "Motherwit"; Clark, 1991). At midnight, I wake up to activity on the second floor. Jason comes downstairs saying that Casey's labor has started again and is intensifying; it's here to stay this time. I ask him when it is ok to enter their bedroom, where the birth will take place, and start filming? Jason is pretty easy-going about it all, responding that I could go in anytime and just allow for some periodic interludes of privacy. Casey labors in the birthing tub. The room is dark, illuminated by only a single bulb in their closet (where I ensconce myself to film—the best seat in the house) and a digital clock. I am transfixed by Casey's beauty and power—and the connection between her and Jason, who is patient with and supportive of his wife. They've done this before. The feeling is intimate, even sensual. Holly is always close at hand, staying connected and responsive to Casey's needs but also keeping a respectful distance. Casey's labor moves steadily along until her two boys wake up. She explains to Attigan, her youngest son, what is happening. He is curious and excited. A friend arrives and brings them to her house. Casey's labor resumes-full speed ahead. She is working hard but not feeling pushy. After an exam, Holly determines that Casey's water bag is still intact. This is making it hard to feel like pushing. She invites Casey to labor on the birth stool. I move closer into the inner circle of the birth. Lots of close-ups. After working hard for quite some time Casey becomes faint. The midwives supply her with oxygen, hydration and confidence. Your baby's head is right there. 23 I am awed by the professionalism of the care and support they provide this birthing Mother. An hour or two after sunrise their baby is born. I weep, unable to contain the feelings I'm experiencing. I have just witnessed a miracle. They name him "Phineus," then later, "Rain," though the birth happened on a beautiful sunny early fall day. I drink tea with the midwives while they complete charting the birth. I am in awe. I feel like I have lost my virginity, like I am a now a part of something much bigger than words can express. On my way home later that morning, I feel radiantly alive, despite being woefully sleep deprived. I have filmed my first birth. I will film seven more. Casey refers me to Aubrie, a friend of hers who is having a homebirth, who lives right around the corner. I film her birth a month later, arriving twenty minutes before baby Oden is born in the birth tub. The network of commerce, comfort and support. My project had begun. k k 24 -k CHAPTER 9: MAINE MIDWIVES PURSUE LICENSURE "One ofthe reasons I make films is to find out what my own attitude is towards the material that is the subject of the film. "Fredrick Wiseman (Renov, 1993) May 2007. In fact, my project began several months earlier, when I documented a public hearing held by the Business Research and Economic Development [BRED] committee concerning a new bill to license Maine's CPM's. My midwife Ellie, a leader in this campaign, has kept me abreast of this burgeoning movement. A group of CPM's had mobilized and formed a "special interest" group-the Maine Association of Certified Professional Midwives [MACPM]—and were pursuing title licensure (LD 1827, 123rd Maine State Licensure, 2008). Not all the midwives wanted this. You can't license respect... from the medical community--the obstetricians, gynecologists and pediatricians who oppose the bill. But the midwives in opposition to licensure promise not to stand in the way. The sisterhood. This local campaign reflected a national trend. In 2007, twenty-four states had direct-entry midwifery licensure programs <http.www.mana.org>. In Maine, homebirth midwifery is not considered the practice of medicine; anyone can be a midwife. It is "alegal," meaning it is unregulated and practitioners are unlicensed. Much of MACPM's strategy was based around rhetoric; licensure would make homebirth "safer" and "promote greater access to care." However, underlying this was an undercurrent of establishing more credibility and visibility. In 2005 CPMs had participated in a national study, "CPM 2000 Study" with the findings being that for "low-risk" women, home or "out-of-hospital" birth (meaning birth centers) with professional midwives was at least as safe-or safer-than hospital birth 25 (Johnson and Davis, 2005). With this significant recognition and midwifery groups in other states also pursuing licensure, MACPM felt it was time to "have a seat at the table" in regards to receiving the imprimatur of the State for their profession; to become more "mainstream." Robbie Davis-Floyd and Barbara Johnson (and other contributors) describe this movement in "Mainstreaming Midwives (Routledge, 2006)." Timing distinguished my project. Not only are there no other works about Maine's contemporary homebirth and midwifery community, with the pursuit of licensure, there was an opportunity to record an important moment in time. I ended up documenting the process almost in its entirety, through to the bill's outcome; the defeat of the majority report in the Senate, the passage of the "Minority Report" and the corresponding enactment of an unprecedented new law, "Chapter 669 (LD 2253, 123rd Maine State Licensure, 2008)," which legalized CPM's use of a short list of medications at births. Nowhere else in the US are unlicensed birth professionals legalized to carry medications. Are You With Us or Against Us? Publicly, I advertise that I am neither for nor against licensure. Neutral. This creates tension with some of the midwives. From being immersed in the issue I can see the relevance of both sides. I maintain my stance to maintain access. Inwardly, I'm not so sure. As a woman, I cannot fathom the concept of sacrificing our choices around birth in the name of licensure, as so many state programs already have. Licensure can mean losing choices such as Vaginal Birth After Cesarean [VBAC], twins and breech births at home. Don't we have the right 26 to decide what is best for our babies and ourselves? Home may be the only location where women can have these kinds of births. In hospitals, the standard protocol for breech births is a C-section, despite the research (Society of Obstetricians and Gynecologists Canada, 2009). And what about licensure programs that criminalize other midwives? Midwives who are don't have a license become illegal. The ledger steadily grows with names of midwives who, though educated, credentialed and hired by their clients, are charged with illegal practice in states that legalize only certain midwives (see Medwin, 2011; Carr, 2011; Lester, 2011). CPM's replicating what CNM's have done replicating the doctors. Is it possible to have anything but such power struggles-within calcified institutional structures and the obsession with the credential? Turf Wars Doctors vs. midwives. Midwives vs. midwives. CNM's vs. CPM's. CPM's vs. "Traditional" Midwives. Lay Midwives; a dirty word. Disillusionment. * * * While filming at the State House, there is no doubt whose camp I'm in: the midwives'. My mantra: I support homebirth, midwives and women. I maintain a respectful distance from the "other side," making sure they see where I stand; with the women. While lobbying, Jill talks and laughs with one of the doctors, the figurehead of the opposition. I like to keep my enemies close. In the State House, I see only one portrait of a woman gracing the halls filled with images of "the Great Man." Somebody's wife. 27 Fact Sheet Project Name At Home in Maine Objective To help make visible the people, practices, philosophies and politics that constitute Maine's homebirth and midwifery culture. Participants Homebirth families. Women. Mothers. Women. Fathers. Women. Children. Women. Midwives. Women. Doctors. Women. Legislators. Women. Lobbyists. Women. Interviews Questions: Why did you choose to have a homebirth? Why did you become a midwife? How do you feel about homebirth? About licensure? About women? Pam, a midwife from Harrington: "Yeah, I mean I'm a homebirth midwife because of what happened to me with the birth of my first child, because it was a radical change, a radical transformation for me.. .and I totally fell for women." Jill, the "matriarch" of Maine' homebirth midwives: "I think women need to change the structures of government." Beth, the former President of the Maine State Senate: "Democracy takes time." Gordon, the lobbyist for the Maine Medical Association: "Legislation is not about science. Legislation is the art of politics." 28 Jay, an obstetrician in Farmington and the president of the Maine Chapter of the American College (now Congress) of Obstetricians and Gynecologists [ACOG]: "We're not against women's choices, weren't just against homebirth." * * 29 * CHAPTER 10: THE BUSINESS OF BEING BORN "We Struck a Cord." Ricki Lake (from MANA!) Fall 2007. For my "Media History" course term project, I am asked to analyze a media product and consider its historical context and significance, its emergence within a specific point in history. I compare two films about birth "Knocked Up (Universal Pictures, 2007)" and a new documentary, "The Business of Being Born (Barranca Productions, 2007)." An unlikely pairing; the first directed by a Hollywood director and the second, by the celebrity talk show host and actress Ricki Lake. I compare and contrast how birth is portrayed in each film. "The Business of Being Born" is an expose' about the "broken" maternity system in the United States. Lake had a hospital birth with her first child and a homebirth with her second. The filmmakers frame the medical industry as a forprofit system, driven by financial gains, liability suits and maximizing convenience for doctors over the optimum care for women and babies. Through eye-opening sequences, the film presents not only astonishing sequences presenting the vagaries of medicalized birth, but shows how many women believe this is the way birth is supposed to be. The testimonies of leading birth experts, like Ina May, Michel Odent, Marsden Wagner MD and Christine Northrup MD are threaded throughout the film, juxtaposed against scenes of medical birth. This content is juxtaposed with the alternative—homebirth, birth center birth, working with midwives—framed without a doubt as the better choice. Yet, the film's conclusion is ambiguous at best, concluding with the emergency C-section of the film's director, Abbey Epstein; an odd punctuation. 30 By way of contrast, "Knocked Up" features the unplanned pregnancy and highly medicalized birth experience of Alison Scott, played by Katherine Heigel. During the birth scene, the obstetrician derides Alison's natural "birth plan;" later, he yells at and berates the birthing mother. At another point, several of the characters revile Alison's birthing vagina-including Alison herself. In my paper, I make the claim that though "Knocked Up" indulges in contorting birth and framing it as a crisis (pretty standard Hollywood fare) some of the values imbued in the film are unfortunately an all too true representation of how US culture views birth. And women. And vaginas. I watch each film a dozen times; until I'm punch drunk. Documentary Film In the online course, "Introduction to Documentary Filmmaking" I put a name to the style I so gravitate to in my filmmaking. Observational. Witnessing, listening with the camera. Cinema Verite'. Direct Cinema. Frederick Wiseman. The Maysles Brothers. Where are the women? Poetic. Renard. Les Blank. Reflexive. Ross McElwee. Where are the women? The foundation of the class is a survey of the history and development of documentary films. In the course conference, another student and I ask, But where are the films by women? We've screened only two, including "Triumph of the Will" by Leni Riefenstahl (1935); the rest, works of the great man. The professor does not respond well. February 2008. The Business of Being Born is officially released. In the spring, the American Medical Association [AMA] issues "Resolution 205" (AMA, 2008) calling out Ricki Lake, denouncing her as responsible for making homebirth 31 "trendy." AMA restates their position that they are in opposition of homebirth and make the claim they will push for state legislation in the US mandating that births must occur in a hospital or birth center (attached to a hospital). Outrage ensues in the Natural Birth community. A wave of related films about the state of birth floods the landscape; at the crest, "Orgasmic Birth (2008)." 20/20 does a segment about this film. There is also "Birth as We Know It (2006)," "Le Premiere Cri (2007)," "Birth Day (2008)," "Born in America (2009)," "My Body, My Baby, My Birth (2009)," "Laboring Under an Illusion (2009)" and "Guerilla Midwife (2010)." At Home in Maine, The Film For my term project in "Intro to Documentary Film" I create my first documentary film. It is called "At Home in Maine [AHIM]." Why did I choose this title? Much is imbued in this simple and direct phrase. Though not directly indicating homebirth, I feel this title cleverly suggests the imagery and the feeling I am trying to convey with this project. In the film, I start with Casey's birth story and juxtapose it with sequences from the public hearing about licensure. The birth story is the heart of the piece; this will become standard practice for all forthcoming films. I integrate other footage, including coverage of a workshop for midwifery students about traditional midwifery with Ellie and interviews and activity from several fundraising events my midwives hosted. In essence, I surround homebirth with the institution and confluences of change. Does homebirth belong in the hands of the State? With 50% of midwives coming through institution-based education (Midwifery 32 Education Accreditation Council) does traditional midwifery even exist anymore? The film later becomes "At Home in Maine, Part I." Maine Politics I enroll in "Maine Politics and Policy" in the summer semester of 2008. Given my subject matter, I figure it is rather important to learn more about the workings of lawmaking and governance in Maine. I want to understand the process I have documented. I trust there is much I can glean from the faculty, who come from the Political Science and Public Policy departments; the lead faculty wrote a book on this subject, which is the course textbook. For my term project, I create "Legislating Maine's Midwives: People, Politics and Policy (this later becomes "At Home in Maine, Part II)." I pick up where "At Home in Maine, Part I" left off with the continuation of the legislative process for the licensure campaign; presenting more committee hearings, floor debates and bureaucratic influences and conclude the narrative with the bill's overwhelming passage in the House. It's far from being the end of the story. * * 33 * CHAPTER 11: FALL 2008 Harvest Midwives of Maine Meeting. I film a meeting of Midwives of Maine (MOM), the original professional group for midwives in this state. Most of the members are older midwives and were in opposition to licensure. The focus of this meeting is the new legislation, Chapter 669, in lieu of licensure, the law that decriminalized their use of a short list of meds at birth, including Oxytocin, an anti-hemorrhagic, local aesthesia for suturing and Vitamin K eye ointment. The midwives were already carrying all of these, as required by their CPM credential. Chapter 669 did not include a provision for Rhogam, an antidote for Mothers who do not carry the antibody for RH + babies (a potentially dangerous condition) or Methergine, another anti-hemorrhagic, more powerful than Oxytocin. The doctors vetoed this drug as well, even though the midwives carry this. They smuggle it over state lines. I feel especially privileged that I have been allowed to document this meeting. Despite the presence of my camera, the midwives talk freely about their concern for the new legislation—and how they will conspire together to deal with this new mandate, which has strict protocols about how meds are obtained. They now must purchase these through a pharmacist and in large amounts, not very practical for midwives that on average do about 12-20 births per year. Cindy, a CNM with a lapsed credential asks, "What's coming down the pike? What happens if licensure becomes mandatory? Then what next, malpractice insurance? This and that and these regulations.. .and the squelching and stifling of what we have already. It's seems like a poor trade-off to me (excerpted from "At Home in Maine, Part III")." I 34 can't believe the midwives are letting me film this discussion. It's like they want someone to hear this. A witness. Common Ground Fair. Marching in and filming a parade of people dressed like vegetables. A circle dance. Breastfeeding Moms everywhere. Filming Jill doing a presentation to the public about Chapter 669. Informed choice. Hanging out with the midwives at their table in the "Health and Healing" tent. Five years earlier and five months pregnant, at this same place I weep as Ellie, my future midwife, spoke a ballad to homebirth. I ask, "But without insurance, how can someone afford this?" A Mother with babe in arms responds, "After my experience with a hospital birth, I knew I couldn't afford not to have a homebirth." After, I tremble as I approach Ellie, "I think I need to meet with you." I have officially been pushed over the edge. •k * 35 ~k CHAPTER 12: BIRTH, FEMINISM AND "VAGINAL POLITICS" "The right to a positive and safe birth is just as important as the right to choose whether or not to have a child." Ina May Gaskin, from "Birth Matters (p. 7)" "A feminine text cannot fail to be more than subversive. It is volcanic; as it is written it brings about an upheaval of the old property crust, carrier of masculine investments; there's no other way. " Cixous,from "The Laugh of the Medusa (p. 357)" ROAR January 2009. I submit a short film for a video installation at Bates College, focused on "social justice," in celebration of Martin Luther King Day. The film's title: "ROAR: mother, midwives, legislators: birth, authority and the politics of change." I juxtapose Casey's birth with interview clips from two midwives and two legislators. It is meant to be experimental and unabashedly "feminist." What do I mean by "feminist?" In the most traditional sense, the film is about women, for women and produced by a woman concerning a significant domain of oppression for women: birth. I kick off the piece with the midwife Jill stating: "Women have always been more connected to the Earth. They are just naturally by being women.. .they have a direct conduit to God. God's energy moves through them.. .creation.. .they are a part of creation. And men are not. They plant the seed but they don't actually have to do with growing a baby, birthing a baby.. .the creation of new life. That conflict is probably at the root of the male establishment. It's another effort to try and connect with that creative power, which women just naturally have by being who they are (ROAR, 2009)." 36 I'm pulling no punches here. Women's voice—in birth and politics—is an important metaphor, as well as authority. Central questions: Who has the authority in birth? Who should? At Bates, ROAR is looped on a monitor with other short films focused on the theme of "Critique." Casey and I huddle together around the screen and watch the film with headphones on. It is my first public showing for a film from this project. Advanced Feminist Theory I enroll in this course in the spring of 2009. I had attempted to take it the year before with different faculty. During that first meeting, as we introduced ourselves I got the feeling I was in decidedly mixed company in regards to my position that birth and motherhood needed to be significant areas of feminist inquiry. Most of the other students were vehemently "childfree" and appeared not to share either my viewpoint or interest in including works on the course-reading list about this domain. I dropped out of the class. A year later, I enrolled once again. It becomes my second experience with critical feminist theory. I finally delve into works by Wollstonecraft, de Beauvoir and Cixous, among others. It is fascinating to navigate the tension between de Beauvoir and her philosophies concerning the oppression of female reproductive biology and the liberating proclamations of Cixous that pregnancy and birth is something to be enjoyed, even exalted: We are not going to refuse, if it should strike our fancy, the unsurpassed pleasures of pregnancy which have actually been always exaggerated or conjured away—or cursed—in the classic texts (Medusa, p. 359). 37 For my term project, using tools developed in this course I conduct an analysis, a "close reading" of the latest film I have produced, "At Home in Maine, Part III." In that text, I expound on my methodology, the theoretical underpinnings of my research and filmmaking practice, framing it as "feminist:" Methodologically speaking, I regard the project itself as feminist, not just in content and aim but also in regards to research methods used and modes of production. I have utilized community-based feminist models with regards to researcher/participant relationships; consentbased, participatory relationships between project participants and myself, the researcher/producer characterize this model. This has ranged from participant's involvement in forming research/interview questions, a relaxed, open-ended interview style, to participants being engaged in the editing process, including having "final say" about including footage that features them. Radically speaking, I also see this project as feminist in its visual focus on "positive" imagery of women's bodies, as well as featuring their voices. I see this film as contributing to discourse on vaginal politics. For the most part, women's bodies—the vagina in particular—in the dominant mainstream media have been framed as and acted upon as a site of pornography, problems, crisis and shame; hidden from view except as a sexual object or in the case of commercial feminine hygiene, a site in need of purification. An important undercurrent then, of "At Home in Maine" is about making visible women, their bodies, their vaginas (and their voices) engaged in acts of empowerment in birth. At Home in Maine, Part HI April 2009. I am a presenter for the 2009 WIC Lunch Series. I have created a film for this purpose, "At Home in Maine (which later becomes "At Home in Maine, Part III")." It picks up where the last film left off, moving into the floor debate in the 38 Senate through the bill for licensure's defeat there. The Maine State Senate, as Jill says, are "the thirty-five people that make the laws in Maine." I juxtapose footage of the political activity with the third homebirth I filmed, with Valerie in Orland. "Val" bled heavily after this birth, as she had with her first birth, in the hospital, and again later with her third birth (which I also filmed). Her midwife, Andrea, gives her the two different anti-hemorrhagics she carries, one legal and one not, when the homeopathic remedy doesn't work. Even with this, Valerie's bleeding persists. She also feels faint. She is transported to the hospital only to be released forty-five minutes later with no complications. Before I release the film, I screen it for Val and Andrea, a standard practice with all the birth films I produce, and ask them if they are ok if I include coverage of Val's hemorrhage. I had shut off the camera for most of this period and even pitched in to help out. I feel it is important to document this somehow. It is a situation I haven't encountered before. Between an ongoing hostile climate with homebirth midwives and doctors and the new law regarding the meds, I am concerned. Including this material could pose risks to Andrea and her practice. Both Val and Andrea's respond: Of course we're ok. We have nothing to hide. Words I will here again and again from midwives and Mothers. Just to be sure, I interview Valerie and ask her to speak on camera about her experience postpartum. I integrate this, too, into the sequence. Is it too contrived? Memories and Insertions The opening shot of "At Home in Maine, Part III" is an image of the house in Montville where I gave birth. Several years after my birth, I return to the home and 39 shoot a winter exterior of the house. Outside of my own memory, my homebirth was not recorded. The introduction to the film is a montage of clips from the Common Ground Fair. I cannot separate my birth from that fabled fall festival. In the montage I actively choose to call attention to stereotypes associated with homebirth. Hippies doing their hippie thing... One of the midwives is concerned. We discuss this. I rationalize the material as ok given that in the film, I have juxtaposed a "regular" Maine family with all this hippie stuff. I want to see the reaction it will incite. Will the audience pick up on my selectivity and arrangement? With the opening shot of the Montville house, I have inserted myself in this film, however subtly. It is an ongoing question—should I be doing this? Do I locate myself as the filmmaker-and if so, how? The current trends in documentary move in the direction of reflexivity, calling attention to film as a constructed product, a selective and biased point of view. However, for me, it never feels quite right to indicate my location directly, so more impressionistic insertions feel like a better choice. Later, I return to "At Home in Maine, Part I" and add excerpts of me sharing my birth story in the film's beginning. In forthcoming pieces, I will call attention in the narrative to my location as filmmaker with subtle, creative clues: sounds of my laughter in the background, an audible "mmm hmm" in response to a participant's testimony, a participant looking directly at the camera and saying "hi" to me, my shadow, sounds of my weeping. The screening is a full house. Certain sequences, including the revealing MOM meeting, attract particular interest. In the post-screening discussion a CNM 40 questions Andrea about her use of homeopathy in regards to Val's bleeding. It reads more like an interrogation. I recognize this woman as faculty from the "Midwife's Tale" course. I remember having heated debates with her about the credibility of CPM's vs. CNM's and the licensure campaign. She had said to me, "I became a midwife because of women like you." Women like me? "What am I?" I ask defensively. She tells me it has something to do with my independence and my faith and idealism about birth and midwives. It was a compliment. Andrea responds to the CNM with confidence but later admits to feeling ill at ease with what was clearly a line of questioning. The hierarchy. The presumption that CNM's have more authority than CPM's. Should she have revealed what remedy she used with Val? Witch hunt. •k k 41 k CHAPTER 13: AT HOME IN NORTHEAST HARBOR, MAINE Bumper Sticker: Midwives Help People Out January 2010. I film Tammy's birth, with midwives Julie and Chris in Northeast Harbor. It is my first birth with this midwifery team. The family's house is huge~the master bedroom where the birth takes place is bigger than my whole apartment. Tammy and the midwives laugh hysterically at a book of jokes about homeschooling, which Tammy practices with her two other children. My laughter is recorded, as well (I keep it in the final cut). I am inspired by this birth in new ways, experiment with my coverage; record a lot of imagery around the home. Tammy's mother is at the birth and I am moved to tears watching her support her daughter through a long and difficult labor. At one point, Julie shuts off the light in the bedroom to give Tammy some rest. The faux fireplace crackles, the only light in the room. It is just us women breathing together, sleeping. For a few minutes, I doze off, too. The moon is full in Cancer. After I arrive home the next day, I fall into a deep sleep. When I wake up, I am bleeding. For the first time in my life, my period has come twice in a month. Early menopause? Women's weird hormonal mojo, my boyfriend intones. The film I craft from this birth is initially entitled "At Home in Maine, IV" but later is renamed "At Home in Northeast Harbor, Maine." It marks the beginning of an important conceptual shift: it is the first film in the AHIM project that focuses exclusively on the preparation and experience of the birth event, as opposed to integrating political activity. Stylistically, I have worked at developing a more poetic feel for this piece, integrating imagery liberally that describes the exterior 42 and interior environment. To texturize the narrative. To frame birth as art. I will use this approach in all forthcoming films. Later that year, Tammy writes a letter of support for a grant application I'm submitting to the "Transforming Birth Fund": The most transforming events of my life were the birth of my three children. I was fortunate enough to have crossed paths with Nicolle Littrell at the beginning of my pregnancy with my third child, Oakley. At the time, I did not realize the impact the documentary would have on other women and myself. Women approach me frequently and tell me how moved they were when they saw the documentary. Most of these women, I had never met before. Some women have told me, they cried after watching this documentary. Sometimes, I am baffled by their response. These women do not know me. How could they have such a strong reaction to the birth of my son? Then, I remember the impact of the few births I was fortunate enough to watch on film. Until, I had viewed a home birth video, I had never seen an honest representation of birth, that was not tainted by Hollywood sensationalism. Some of the documentaries Nicolle filmed prior to my son's birth, were so real, at times, it was difficult to watch. The honest sounds, the timeframe in which the birth took place, which was excellently displayed throughout her documentaries. Those births silently led and guided me through my birth. Knowing other women felt scared, yelled, shrieked, and felt discouraged were comforting to me when those obstacles fell in my path during birth. After the hospital birth of my first son, I felt I had done a horrible job, and was not good at "having babies". Through education from homebirth midwives, literature, and viewing "real" births, I made peace with myself knowing what an incredible and strong woman I actually was during birth. I wish every woman could have this knowledge. I wish every woman could have an opportunity, I was blessed with to share their birth with others and encourage and strengthen other women. 43 On a personal level, Nicolle's presence at Oakley's birth was peaceful. After meeting her, inviting her into our birth was easy. Her conviction and love for her work comes through during the prenatal visits and birth. Not once, did I wish she was not there. Her gentle spirit was a welcome addition to the women surrounding me. After a night of no sleep, she tirelessly continued to film with only words of thankfulness to us after the birth. This has been an amazing journey for me. Sharing my experience with other women has been one of the greater experiences of my life. I believe Nicole is doing important work. Through knowledge, fear is abolished. May Nicolle continue on her quest to inform and inspire women (dated September 22, 2010). This becomes an unspoken benefit of the project, one that I never could have divined when I first conceived AHIM, one that is not listed in the "Benefits to Participants" section of my Internal Review Board [IRB] consent form: that the films could benefit the women themselves, improving how they see themselves and their bodies. Helping them to see how beautiful, powerful and strong they really are. Why Don't You Become a Midwife? It is a question I'm asked all the time. Sometimes I want to more than anything. My fantasies are rich and deep around this. But I have a small child and I'm a single parent. Limited resources. Many of the midwives came to the profession this way, too, through the fire of being a single mother. Oppression. Feeling disempowered. Helping women with their births, being around that power and strength is good medicine. Because there are those that believe that birth is the seat of women's power. Without liberation in birth, women will remain under the thumb of patriarchy. Yes, the patriarchy. It is still real. The realm of birth provides but one salient looking glass to reflect ongoing oppression and abuse. Yes, abuse. 44 I consult with my midwife friends; yes, many are friends now. Several say I would make a great midwife, one says she'd love to work with me; another whom I have filmed several births with playfully refers to me as her "apprentice." After watching two midwives pull and untwist a baby from his mother like a stuck cork, after having only a handful of experiences driving home like a zombie as opposed to many, after being at a birth for over twenty-four hours and feeling like I've abandoned my son, I decide I don't want that responsibility. Not now. And babies die, as well. They die at hospitals, too, but the price midwives pay is far greater when this happens than with doctors. Most midwives practice without liability insurance, being far too expensive for most to acquire. No, I'm a storyteller. I know that now. I can contribute to the movement this way. Be a part of the change. •k k 45 k CHAPTER 14: ONLINE VIDEO-SHARING PLATFORMS OR THE START OF MY LOVE AFFAIR WITH FREEWARE Spring 2009. Through other filmmakers, I discover online video sharing platforms. In addition to You Tube, there is also "Blip TV" and "Vimeo," which are geared towards the independent filmmaker. With its user-friendly interface and good quality video streaming capabilities, Vimeo becomes my platform of choice. I upload films I have completed to date, including "ROAR" and "At Home in Maine, Parts I, II and III". I post "ROAR" on my rarely used Facebook page. Numerous compliments and virtual pats on the back ensue. Then the film is removed. Three times. Reported as including "graphic or obscene" content. I wonder which one of my "friends" (or friends of friends--or friends of friends of friends) ratted. I start a "Cause" on Facebook "Support Images of Natural Childbirth and Breastfeeding on Facebook." To date, the cause has nearly 6,000 supporters: <http://www.causes.com/causes/223739>. Though I am the administrator, these numbers have accrued without any particular effort on my part. While no money has been raised, a wealth of photos, stories and declarations about holding space for natural birth on Facebook fill the "wall" of the Cause. I begin the practice of uploading footage of births on these platforms, assigning a password for privacy and using these venues as a tool to share content with participants, and later, faculty to review various cuts of my films. I feel very sophisticated working this way, very high-tech, even if it takes forever and a day to 46 render, export and compress the project files out of my editing software-and then another forever and a day to upload the files. It doesn't matter; anyone can see my films. Suddenly, I have an audience. May 2009. I create a short film for "Birth Matters," a short video contest sponsored by the Virginia Midwives Association. They are taking a creative (and budget-conscious) approach to generating fresh content to promote Natural Birth and midwifery care. I craft a shorter version of Val's birth story, sculpt it down to the required submission length of seven minutes, add some evocative music and name it, "At Home with Mother-Friendly Birth <http://voutu.be/PEtRVRwmkhO> (this later becomes "At Home in Orland")." The submissions must be uploaded to You Tube. I create a channel there, expanding my presence on the Internet to three video-sharing platforms (and that Facebook page). A few days after I post the video, Val reports to me there have been several thousand views. She's keeping dibs. I don't win the contest. A year later, there are 60,000 views. Last check, 100,433 (July 13, 2011). * * 47 * CHAPTER 15: SHIFT April 2010. I am freaking out. I am hoping to graduate soon and have not completed the feature-length documentary film about homebirth and midwifery care in Maine I set out to do. Instead, I have produced seven "short" films exploring the subject. I am feeling restless. This project does not seem like it wants to be one film. There are too many issues, too much ground to cover to adequately represent "homebirth in Maine." I want to make the great American film about homebirth, but don't know how to synthesize all the issues at hand. I'm concerned the political stuff will overshadow the significance of the birth event. And then there's the Internet. I have distributed several of my films on my video-sharing platforms and my new Facebook page and am attracting an audience. I submitted two of my AHIM films to the Camden Film Festival; neither was selected. Is theatrical distribution the way to go here—or can I self-distribute online? I consult with my advisors Laura and Bill, who encourage me to go in this direction. As soon as I make this decision, I am asked to film four more births. I shift to the idea of a series of films, a body of work representative of homebirth in Maine, with an emphasis on the birth story, the birth experience. I move in the direction that feels right-away from the weightiness and complexity of the "politics"-- though how can homebirth ever be anything but political? I am relieved at a respite from posturing around licensure. 48 Incidentally, as I ground myself in this shift, there is in fact, not much activity happening on the political front anyway; MACPM is focusing on "public education" and "building relationships." Attuning to this rhythm feels in sync with the organic approach I have been experimenting with in this project. I will continue my MALS program for one more year and complete four more films and a trailer for the series. k k 49 k CHAPTER 16: AT HOME IN WALDO COUNTY "It was a cake walk." Melinda, age 42, speaking about her 40 + hour labor April 2010. I film two "new" births in April—Melinda in Waldo and Gretchen in Morrill. Both of these hamlets are a stone's throw from my home in Belfast; I breathe a sigh of relief at the prospect of a short commute. It is the first birth experience for each of these women. They are "primups." I have never filmed a first birth before, only "multi-tips (second, third, etc. babies)." I feel like I've hit the jackpot. Melinda Melinda is 42 years old, which is significant, given the hype around the "geriatric uterus" and the risks of giving birth after age 35, let alone having a homebirth. Melinda's active labor lasts about twenty hours. I'm there for the whole thing: from her baby emerging from her womb in the mid-afternoon, filming the midwife deftly suctioning aspirated meconium (baby's first fecal matter) from the baby's lungs, to sharing a celebratory toast of "Dark and Stormies" with the family. I sculpt a forty-five minute film from over seven hours of birth footage. I also integrate coverage of this family's day-to-day life, their lifestyle of farming, homeschooling and entrepreneurship. This marks another shift with this project, where the narrative becomes a more holistic representation of lifestyle and values. The birth story is always at the heart, but crafting the narrative this way gives it more texture, more points of recognition and access. 50 Gretchen Gretchen is the first woman who approaches me to film her birth~and the first woman that ends not being comfortable with the camera. I am surprised, she is such a performer, but I respect her boundaries. My mantra (supplied by a doula friend): Meet women where they are. I film much of the early stages of labor but this is interrupted when Gretchen and her husband Danny retreat to the privacy of their bedroom for the last few hours of the birth. Taking an ambiguous cue from Danny--and recognizing those pushy sounding vocalizations I enter the bedroom. I'm not entirely sure if this is ok. I film the last push, as Gretchen's baby emerges out of her womb and into the water in the birth tub, the midwife sweeping him up and settling him into his Mother's arms. To complicate matters, I'm working with an older borrowed camera and the image quality is not so great. After the birth, Gretchen tells me she wished I had been in the room to document more of the birth; that I had pushed more. She is worried there is not enough coverage to craft a story. I assure her that there is and am surprised at Gretchen's presumption that I would dash my ethical principals to pieces to "get the shot." I realize I'm not Michael Moore. Lament I wish I had my own camera. I borrow equipment for the At Home in Maine project from the Collaborative Media Lab (CML) at the University. Most of the time I feel charmed, getting what I want and when I need it, but this involves pushing the 51 boundaries a lot too, to make that happen. I feel lucky that a filmmaker manages the CML. But sometimes I don't get the right camera or don't get it when I need it and that compromises the quality of my footage. * * 52 * CHAPTER 17: THE NATURAL BIRTH MOVEMENT AND THE INTERNET Interview question: How did you find your midwife? Response: The Internet. A recent Google search of "Natural Birth" yields 17,000,000 results; a search of "Homebirth" 2,050,000. Natural Birth has moved to the Internet. Blogs, websites and discussion boards proliferate and a Movement is born. Then there are all those home videos of births on "You Tube." It's a phenomenon. Where else can women go? Not to many of their doctors or OB's who tell them their baby is too big, or something is wrong with their physiology, they will need a C-section, or they can't have a VBAC, they will need another C-section or that homebirth is unsafe and midwives are hacks; they will need a C-section. There are lots books of course, the most popular, "What to Expect When You're Expecting (Murkoff, 2008; 4th Edition)"--which I like to refer to as "What to Be Afraid of When You're Expecting"~and a few films (some even available on Netflix) and the midwives, of course, in some communities and doulas where women can learn and talk about their choices. But where can women really talk about birth? Share their stories? Their resources? Their wisdom? The Internet, blogging and Facebook become potent thoroughfares for the Natural Birth Movement, filling a seemingly gaping hole. In Martha Moore Ballard's day, women found comfort around life's transitions in their home-based circles of family and friends. Though there may be a few networks today that resemble those in Ballard's time, culture in the Millennium looks nothing like it did in the late 1700's. Yet, women find the support they need, establishing their own 53 networks of support, regardless of the era. And the Internet has become the prime venue of connection and communication for women in the Millennium around birth. Today, women can create a blog, share their birth story and their views about everything pertaining to birth—in a matter of minutes-and attract an audience almost as quickly. They can upload their homespun birth video to You Tube; post links on their blogs. They can connect with women from every area imaginable in the birth community: "C-section Moms," "Homebirth Moms," "VBAC Moms," "Moms Who Have Had a Baby Die," "Extended Breastfeeding Moms;" the list is endless. And it's not just about Moms, there's also "Homebirth Dads," "Dads for Attachment Parenting," "Dads Against Circumcision," etc. New communities—and communities within communities-are seemingly created daily. Most midwives have websites, as do all the professional midwifery organizations, the birth education, advocacy and support groups. Correspondingly, groups that oppose homebirth and midwives also have a strong online presence. "Dr. Amy," with a reputation in the Natural Birth community as the "wicked witch" of the Anti-Homebirth/Anti-Midwife Movement has several, including, "The Skeptical OB" <http://skepticalob.blogspot.com/>. Note the gravestone on the webpage (as of July 7, 2011). This is an oft-conjured image generated by these groups when speaking about homebirth. The images of gravestones and the dead mother/dead baby card were leveraged in the Maine State Senate as a strategy to kill the bill for licensure. Go to any old cemetery in Maine and what will you see? Died in childbirth (I'm unable to 54 actually locate any of these). In her several decades of practice, Martha Moore Ballard never loses one mother (Ulrich, 1991). Yes, mothers and babies died then in greater frequency in childbirth, but how much is spoken about puerperal fever and that doctors dirty hands spread this, causing untold numbers of maternal deaths (Ehrenreich and English, 1993). Once, I engage in cyber-sparring with Dr. Amy and her supporters. The sheer hostility and polemical posturing take me off guard and I retreat, feeling like I've pulled a narrow escape from a scene right out of the "Twilight Zone." And everyone has a Facebook page. On this venue, news and information is shared with lighting speed; like never before. In May of this year, USA today reports on the findings of a group of Centers for Disease Control [CDC] researchers that homebirth increased in the US by 20% between 2004-2008 (MacDorman, Declercq and Matthews, 2011). In a blink of an eye, it is simultaneously posted on thousands of Facebook pages. What impact will social networking have on women educating themselves about pregnancy and birth? What impact will it have on their choices? I ruminate on what the findings will be for 2008 and beyond. April 2011. Cyber diva "The Feminist Breeder" broadcasts her homebirth via live web cam. Over 1,800 viewers follow this day and half long event, hanging on her every contraction, even long through the night, responding with continuous cheerleader-like posts <http://thefeministbreeder.com/tfbs-live-homebirth-blogevent/>. Has the online Natural Birth Movement become a penultimate expression of the personal is political? It's about information-sharing, access and yes, privilege, 55 too. As long as you have a computer, are literate and know how to blog (and/or create a profile for posting comments) you, too, can participate in the Movement. The Camden International Film Festival In the fall of 2009 and again in 2010 I enroll in the Camden International Film Festival [CIFF] course. On the whole, it is a rewarding experience. There are no other classes at U Maine that offer such a unique and stimulating opportunity to immerse myself in my medium. My experiences with this class are both inspiring.. .and sobering. I come to a realization that my AHIM films will most likely never see the light of the projection screen at an event like this-especially when hip twenty-something childfree men are the programmers; emphasis on hip. Though I'm a bit of a glamour-puss and love the razzle-dazzle of a good film festival, which CIFF most certainly is, I consider ideologies of access around who gets to see these kinds of films. And privilege. As a student with a VIP pass (who has paid $1300 for the honor) I regard the long lines of "regular" ticket holders and ruminate on how festivals like this replicate and perpetuate capitalistic structures of hierarchy and privilege-not unlike the medical maternity complex and powers structures between birth professionals. Filmmakers pay for the privilege to submit their film and only a select few are actually chosen. The club. Much of this has to do with the subject matter—what themes the programmer considers significant at that point and time—and of course, the quality of the message. In the several years that I have attended CIFF, I have not seen a film that deals substantively with the two most significant transitions in the 56 life of human beings—birth and death. On the whole, our culture is still uneasy with these domains. In panel discussions and Q & A's with the filmmakers, I call attention to the Internet, inquiring if this venue is opening up modes of distribution for independent filmmakers. In both years, the response from industry experts is always the same: No. The Internet is more so an avenue of promotion for filmmakers. Not distribution. I wonder if this reasoning applies to the niche of birth films. I feel that familiar ferment. Something tells me the playing field is changing. And maybe I can be a part of it. •k * 57 1e CHAPTER 18: AT HOME IN MAINE, THE WEBSITE Bill turns me on to "Wordpress," to create an online distribution platform for At Home in Maine. Its template-based "freeware" and heavies like "National Geographic" are using it. Drag and drop website building. I drag and drop myself a site in the early part of summer 2010. The blog name: "At Home in Maine: Homebirth films, resources and community" and address <http: / /mainehomebirth.wordpress.com/ >. It takes me about a week of focused work. There are pages devoted to the films, a blog space for "News" relevant to the homebirth community, a comprehensive listing of homebirth midwifery practices in Maine, a page for users to share their own homebirth stories and a listing of print, media and web resources. And, of course, I've made space for the occasional (healthy) dose of proselytizing; it is a blog, after all. I feel like a magician. I wonder why in hell did I take that web design class the previous summer? A folder on my computer stuffed with dormant pages. In contrast, my AHIM website is live immediately. My films can be seen by anyone, anywhere in the world. Independent Studies My vision is clear now. Like a break in labor, I settle into this new space. The films will be a series and will be distributed online. Much of this, like other aspects of life, is about timing. I feel I am in sync with something. I move where the energy is and for me, right now, it's about creating birth stories, not the great American documentary film about homebirth. Maybe someday.. .1 certainly have enough material. 58 I utilize several "Topics in Media Production" courses to complete four more films and a trailer for the AHIM series. There are limited academic venues that allow for this kind of focused creative production-these kinds of courses (as well as Master's Thesis credits) become key to realizing my vision with At Home in Maine. By December of 2010, there are nine films comprising the series. January 2011. A few days after I post my two latest films, "At Home in Waldo" and "At Home in Orland, Maine (#2)," I check my statistics on Vimeo and find that the AHIM films have been viewed 1,500 times that week; not exactly viral, but far from being insignificant. A scan of my "Geo-stats" reveals that AHIM has attracted a global audience. Viewers in countries as far-flung as Russia, Iraq and Japan are watching my films. And even after the Tsunami hits in Japan, they still watch the films. No matter where you are in the world, apparently there is no place like home. Dream I am in Sicily, the land of my grandmother's family, producing films about homebirth. I'm drawn to cultures like this that place a precedence on tradition, though the cultural climate around birth there is similar to Maine; homebirth and midwifery care are available however not well-integrated into the system of maternity care. I am in France, Greece, Egypt, England, Australia.. .working with families and midwives in these countries creating more films about homebirth. More diversity. More universality. I dream of developing a Meta online platform that expands the portrait of homebirth I've created with AHIM to present a cross-cultural tapestry. Is there a "brand" in the making? At Home in ... the World? 59 I look into the possibility of a Fulbright scholarship to power this dream. Later, I discover a new project, "One World Birth" <http://www.oneworldbirth.com/>, the concept of two British filmmakers to create a "living breathing documentary," a meta-platform presenting birth stories (in all locations—home, hospital, etc.) from around the world, plus a feature-length documentary film to boot. Clearly, I am not the only one with wildly ambitious ideas. k k 60 k CHAPTER 19: OUTSIDE OF THE FRAME A whole separate manuscript could be written about the material I chose not to include in films in the AHIM series—and on what films I chose not to make. As I have already noted, I made an active choice not to feature medicalized births. This eliminates the convention of juxtaposing polemics, in this case, home and hospital birth—as rhetorical strategy to persuade the superiority of one mode over another and is possibly a limitation with this project. However, medicalized birth gets a lot of "play" in US culture and I felt sure in my decision to focus on homebirths exclusively, bringing this choice more into view. Throughout the early contractions of this project I explored the idea of integrating stories of "bad outcomes," code in the birth world for when a baby dies (or is seriously injured as a result of birth). I'd only known of a few families where this had happened—and only one of these families blamed the midwives. The other two had homebirths where their baby had either died in utero at thirty-one weeks (stillborn) or a few days after the birth (from anencephaly). Each family held the midwives blameless, as is often the case. When midwives are persecuted, it is generally not by their clients but rather, the medical community. Despite my interest in creating a nuanced perspective regarding homebirth by including a few "bad outcome" stories, the project seemed resistant to go in this direction. Or I was. I recognized that there were enough negative stories out there about "train wreck" homebirths. With this decision, I re-grounded myself in my agenda that this project would present only positive experiences of homebirth; of the many variations of normal, natural, vaginal birth. Biased, perhaps, but necessary. 61 Related to this are the events I did not have access to. In the spring and summer of 2009 several "bad outcomes" concerning homebirth were reviewed by the "Maine Child Death and Serious Injury Review Panel," facilitated by the Department of Human Health Services [DHHS]. When a baby dies at a homebirth it is now reported to the state (by medical personnel) and reviewed by this group, which is comprised of a panel of medical professionals, State bureaucrats, law enforcement officers and forensic specialists. Given that infant deaths that occur in hospitals are not subject to the investigations of this committee, this can be interpreted as a read on the State's position on homebirth and midwives. Though I had originally been contacted by a representative of this panel to screen one of my films at this meeting the request was rescinded. And despite my own request, as a scholar of this domain to be present at this meeting, I was denied. I was told the meeting and the resulting findings were "not discoverable" for the public. Who then, were they for? Similar to hospital-based doctors, the midwives have their own protocol for reviewing bad outcomes—peer review. Though I have had an interest, I have never filmed one of these meetings. I have never asked to. I have known not to. Though I regard myself as a card-carrying member of "the Club," there is a recognition that some areas of homebirth must remain out of view; because of the at times hostile climate that midwives in Maine practice in; because of persistent cultural fears and denial around death; because of the cultural precedence placed on the lawsuit. At present, showing midwives talking about "bad outcomes" carries far too much risk. It is an area that is off-limits and remains out of the frame. 62 Because of the possibility of a bad outcome, I have suspected that some midwives, despite their support of this project (as well as the potential interest of their clients) do not want their midwifery practices documented-though this has never been directly articulated. With a bad outcome there is the potential for their practices to be on full view~and judged—and possible consequences around this. For example, if a midwife was prosecuted. In the current climate they practice in, which many midwives regard as "hostile" to midwives and homebirth, it would seem some midwives feel far too vulnerable to participate in the project this way. Cutting Room Floor or "Omission Montage" A couple talking about their political positions as "Constitutionalists." A crucifix, prominently placed during an interview. A baby spewing out meconium his head is born. Mothers pooping during labor. Mothers talking about pooping during labor. A Mother screaming "Get it out of me. Get it out!" A midwife lancing a water bag. A woman's buttocks (at her request). A woman rambling on about medicinal herbs (as per request of the participant). A vaginal exam during a prenatal (as per request of the midwife). A Mother looking seriously worked over after a long labor. A Mother yelling "Get it out, get it out!" Hours and hours of labor. What Made the Cut Naked bodies. Nipple stimulation. Intimate contact between the birthing couple. Sensuality. Body fluids. Blood. Mucous. Meconium. Rectums. Vaginas. Breasts. Buttocks. Grimacing faces. Babies' heads crowning. Tears. Pleasure. Yells. Moans. Screams. Laughter. Expletives. Homeopathics. Allopathies. Support. Love. Hours and hours of labor. 63 CHAPTER 20: DIVERSITY, LIMITATIONS AND ACCESS Bumper sticker: Homebirth Happens Educated. Middle-class. White. Women. This is the standard profile of my project participants. Yet, diversity has been an important consideration for me with AHIM, as a strategy to show that homebirth happens—with a variety of people, practitioners and in different localities. With such a singular demographic how then can diversity be expressed with this project? I started by considering who my audience was, which I envisioned as being someone like myself: an educated, middle-class white woman-and possibly "on the fence" about homebirth. The idea is that viewers see the diversity of families who are choosing homebirths (with a similar socio-economic status) and perhaps recognize themselves in some of these portraits, or at least find familiarity, in an attempt to reify the normalcy of homebirth. With this, the primary means of expressing diversity in this project has been through the "faces," personalities and lifestyles of the participants and the different midwives and locations in Maine that are represented. Diversity around who "should" be having a homebirth has been an important consideration of this project. Age and body type of the participants have been leveraged in some cases to challenge limiting mainstream assumptions about what women should have homebirths—and also the variation of what is "normal" when it comes to birth. I have filmed a birth with a forty-two year old first-time mother ("At Home in Waldo, Maine") and a birth with an overweight woman who was presenting with early signs of preeclampsia ("At Home in Winthrop, Maine"); both 64 were births that are representative of "high risk" "conditions" and would presume to occur in the hospital. In the films, each of these births is meant to demonstrate the many variations of "normal," as well as the difference in philosophy and practice in how midwives manage these kinds of births over medical mainstream models. Racial Diversity and the "Subculture of White Women" There has been no significant racial diversity with this project; all participants have been Caucasian. On one hand, this has something to do with the fact that Maine's population is predominantly made up of this demographic (US Census Bureau, 2010). This also has much to do with the profile of women who are choosing homebirths. My findings with the AHIM project indicate that the woman who has a homebirth in Maine is largely representative of the rest of the US; white, educated and middle-class, as the CDC study referenced earlier indicates (McDorman, Declercq and Matthews, 2011). However, I originally envisioned that this project would represent more racial diversity. At a certain point, I challenged this idea: why was it important for me to represent this~so I could be "inclusive"-having the token black, Native American, Asian, etc. family represented in this project? In fact, the lack of representation around racial diversity in this project calls attention to a more significant issue pertaining to homebirth: who has access to this choice? Race and class are significant considerations here. The fact that mostly middle-upper class white women are having homebirths connects not only to who has access to this kind of care but also connects to historical patterns concerning birth trends being dictated by the middle and upper classes. As noted previously regarding "A Midwife's Tale (Ulrich, 1991)," 65 in the late 18th century we begin to see the trend of upper-class women choosing doctors over midwives to assist with their births~and about a century later, the move from birthing at home to the hospital. The middle and poorer classes eventually follow suit, replicating these patterns. It should be noted that the hegemony of the medical model of maternity care in the US trickles down not only through class and race in this country but also impacts birth practices in other cultures. Though significant, this is not a major area of inquiry in regards to the AHIM project, which centers on local and national discourses around homebirth and midwifery care. Access to information about choices in childbirth, including homebirth is also connected to race and socio-economic standing. Community-based family planning clinics, which often serve a racially diverse demographic, as well as economically disadvantaged women, generally presume birth will occur in a hospital; information about other options such as homebirth and midwives is not readily available in such locations, nor is out-of-hospital birth (birth center and homebirth) covered by Medicaid (including Mainecare) at this time. "Subculture of White Women?" The CDC report concerning the 20% increase in homebirth in the US cites the "subculture of white women" as responsible for this growth. What does this mean? "Subculture" can easily be read as "hippie" or "New Age"—and has been interpreted this way by some. Doubtless, these are marginalizing associations. I interpret the researchers' identification of "subculture" differently, however, connecting it to the phenomenon of the vibrant online Natural Birth Movement, 66 which, as described earlier, could most certainly be identified also as subculture. It has been my experience, based on the identity of bloggers and leaders in various birth educational and advocacy groups in large part (though not exclusively) educated white women are, in fact, powering this movement. As noted earlier, my own findings with the AHIM project indicate that this is the demographic that is choosing (and/or has the most access to) homebirth. Formal education is implicated in this subculture; this group is regarded as being educated about their choices in childbirth, including homebirth. However, this is not always the case. Another recent study (Klein, M.C., etal., 2011) indicates a woman's high degree of education is no guarantee that she will know much about pregnancy and birth, namely the risks and benefits of various interventions and procedures pertaining to birth. A midwife framed it to me this way once, "Women don't know what they don't know." Despite the proliferation of information available about choices in childbirth, deference to authority persists as a dominant cultural value (Davis-Floyd, 1993). This may be more so the case when considering relationships between disadvantaged women and their practitioners—and potential power imbalances. Regardless of socio-economic status, the study indicates that women often are surprisingly uneducated about their choices in childbirth. Despite my original interest in presenting racial and socio-economic diversity with this project, I am ultimately satisfied that in fact AHIM is representative of the population that is most accessing homebirths currently. 67 Other Limitations: Proximity Proximity has at times been a limitation with this project. There were several births that I was unable to film because of distance—the family lived too far away and my own resources were too limited for it to be realistic to film these births. This past winter I missed filming one birth because the mother went into labor a week before her due date and my phone was shut off-thinking that I was not "on call" for the birth. I missed another during the same time period because the midwife was called late by the family and correspondingly, called me too late to be at the birth; both of these births were an hour away. Ultimately, I filmed eight births representing eight families-exceeding my original goal of four-and worked with over half of Maine's twenty-four CPMs. Location Location is undoubtedly central to a project entitled "At Home in Maine." This project concerns a practice, a community and a culture in a particular locality. Both homebirth in Maine (and Maine itself) conjure certain associations in the public imagination. As AHIM project participant Representative Bernie Aoette has said, "Homebirth is as natural to Maine as a woodstove.. .or a rocker in front of the fire (excerpted from "At Home in Maine, Part III")." From my experience interviewing participants for this project some of these associations have been historical, anachronistic, something to do with Maine's "independent" spirit and of course, those "hippie back-to-the-landers." The AHIM project focuses on the contemporary landscape of homebirth in Maine, a sense of place-how homebirth "fits" here, as well as other features that 68 make the culture distinctive; the fact that homebirth midwifery is unlicensed and unregulated as one example. Yet, homebirth in Maine is also representative of national trends; about 1-1.5% of Maine's population has homebirths, similar to the national statistics. And as noted earlier in regards to the new CDC report, the profile of a woman having a homebirth in Maine fits the national profile. Naturally, the "home" is a significant image in this project. I have chosen to focus on the physical relevance of the home over metaphorical or symbolic implications, though to be sure, meanings could be extracted here, too. Exteriors and interiors of homes are shown in AHIM films to provide both a feel for the families that live in them and also to establish the "normalcy" of homebirth; it does not happen in the woods or behind barns, but in homes that look and feel familiar to viewers. A classic clapboard farmhouse~or a ranch with vinyl siding; the family next door could be having a homebirth. Seven towns and five regions of the state are represented in this project. Though homebirths are happening in all parts of the state, certain areas, such as the mid-coast region appear to be a hub of more activity. My own community of Belfast has a thriving homebirth culture-with two professional midwifery practices located in the downtown area. Informal calculations by one midwife here suggest about 2040% of all births in this area are planned homebirths (personal conversation, 2011). Even with my interest in doing so, representing all regions of Maine was not possible with this project. Much of this has to do with how I located my project participants, which was facilitated through networks of midwives and homebirth families—and personal resources. Though I informed all of Maine's twenty-five 69 CPM's about the project, only a few of these connections actually produced participants. Other participants came from referrals from women whose births I filmed--and my own canvassing (that is, approaching pregnant women directly myself). It became easier to maintain relationships with midwives that had practices close to where I live—or ones with whom I had already worked with. In fact, I worked with several of the midwives twice: Sarah from Tophsam, Andrea (with her client Val) of Old Town and Chris, based out of Belfast. I have suspected that some midwives, despite their support of this project, as well as the potential interest of their clients, do not want their midwifery practices documented—and for a variety of reasons—though this has never been directly articulated. The potential of a "bad outcome," their practices coming in to view and the potential consequences of this make this vulnerable area I have managed to work with these midwives in other ways—such as interviews, filming political activity, meetings, etc. Midwifery Education With AHIM, I had intended to include a film about the education of homebirth midwives in Maine. CPM's are "direct-entry" midwives, meaning that unlike CNMs, where midwives must be credentialed first as a nurse (American College of Nurse Midwives), prospective CPMs may enter their training and education with only a high school degree (National Association of Registered Midwives). Midwives may receive their education through apprenticeship or institution-based education models. Though there is a didactic component, in an apprenticeship, a midwife works directly in a community with a preceptor midwife. 70 Students in institution-based education also work with preceptors. Many of the midwifery practices in Maine accommodate student midwives working with either model. In regards to institution-based education, Maine has one of ten direct-entry midwifery schools in the US-Birth wise, in Bridgton, Maine. Though the apprenticeship model is the route through which many of the older midwives in Maine came to their profession, more and more women are choosing the institutionbased route; the current statistics are around 50% (Midwifery Education Accreditation Council). Creating a film about midwifery education in Maine had its limitations. Early in the project I had filmed some material at Birthwise, however, the camera I was using was not functioning properly and the footage was degraded; it was ultimately not usable. What it really came down to, however, was money and time. I didn't have enough of either to produce a separate film about midwifery education. Though I had ongoing access to Birthwise-and several midwifery students working with the apprenticeship model~I simply did not have the personal resources to produce a film focused exclusively on this subject. Even with this midwifery education is represented in several of the AHIM films: "At Home in Maine, Part I" features a workshop on "traditional midwifery" with Ellie and a group of Birthwise midwifery students and "At Home in Waldo, Maine" calls attention to one of the film participants who is working with the apprenticeship model. Given the importance of this issue—both in terms of how midwifery education is changing as well as a strategy to show the viability and professionalism of midwives—one of the 71 long-term goals of this project is to realize this vision and produce a film focused on midwifery education in Maine. Lament March 2011. I'm graduating soon and wish I had more money. To sustain this project. To continue this work. To generate income. Outside of garnering a U Maine summer research scholarship in 2007, the entire project has been funded outof-pocket with student loans, which, of course, I have to pay back. Several grants proposals have been submitted~to no avail. I'm guessing that films about homebirth and midwifery are not high on the list of funding priorities for most foundations these days. And the rare one or two organizations that believe all of this matters, that are dedicated to transforming birth in the US, are swamped with proposals-from every corner of the birth advocacy, policy change and education movement. I'd like to place a monetary value on the AHIM film series, perhaps create a revenue stream. Is that appropriate? I feel some inner tension around the idea of selling or renting my films. The project was conceived as an educational resource for the community. Should it continue to be free, as it has within the context of my graduate program? Will placing a price on my films restrict access? Would anyone even pay to watch or buy these films? k k 72 k CHAPTER 21: SPRING 2011. BIRTH MATTERS At Home in Waldo, Maine I screen "At Home in Waldo, Maine" at the Belfast Free Library. It is a packed house. I have received some great press for this event, with an article about my work, "Filmmaker makes documentary series about homebirth" printed in the Lifestyle Section of the Bangor Daily News (Curtis, 2011). The audience is a mix of birth junkies, families with young children, middle-aged "childfree" couples, knitting moms, elders and the film's participants. Friends. Familiar faces. I am certain that more than a few are there because I am a hometown girl—and curiosity about what I've been up to all these years. It is the first community screening I have done with this project in several years. But there are many new faces I don't know, and this pleases me. After resolving the usual technical difficulties, the lights are finally dimmed and my film begins. There is laughter. Tears. Gasps. Silence. After the screening, Ellie, whose midwifery practice is featured in "At Home in Waldo," reads an excerpt from Ina May Gaskin's new book "Birth Matters (Seven Stories Press, 2011)." It is the preface by Ani Defranco, who had a homebirth several years ago: What happens when eons of feminine wisdom are buried under the shifting sands of important men and their machines? What happens when women lose control over the fundamental processes of their lives? What would happen if instead, women were encouraged to believe in themselves, their bodies, and their instincts? What if there were an atmosphere of respect and deference to mothers, in which women were empowered to access their inner strength and wisdom, as well as the wisdom of eons of women who have come before them? What if society acknowledged all the ways in which Birth Matters (pp xi-xii)? 73 The room is silent for a few long moments. Then the questions, the discussion, my favorite part begins. A nurse who had her children in the nineties talks about her positive experiences with hospital birth. Ellie remarks that things have changed a lot since then, referencing the dramatic increase in rate of interventions in medicalized birth. A woman who has had a C-section asks more about the Midwifery Model of Care, not knowing that midwives were even an option for her birth. A father-to-be remarks that it is women who should be deciding what happens with their bodies. More questions and comments follow; it appears it could go on all night. However, it's getting late and Brenda, the library staff hosting this event has to pull the plug. Later, a toast at a local pub with Melinda, Jerry and the midwives.. .without a doubt, the event has been a complete success. Maine Coalition for Choices in Childbirth I yearn to do something more. With my experience. With the information and knowledge I have gleaned. With my passion. For birth. For women. There is so much work to do. I decide I want to get organized—to start a consumer group focused on choices in childbirth. I share the idea with several friends who respond enthusiastically, enlisting their support. We form the "Maine Coalition for Choices in Childbirth [MCCC]." Though still in start-up MCCC's mission is to improve access to information about choices in childbirth for women in Maine, thereby improving access to these choices-with the goal of improving birth outcomes for women and babies in Maine. 74 Our maiden voyage is a table at the University of Maine's Women's Health Fair. Lots of women drop by to talk about birth and eat our homemade cookies. I am shocked once more at how many women do not know about their choices in childbirth. "You mean I can have a midwife in the hospital?" Yes. "A doula?" Yes. "People in Maine are still having homebirths?" Yes. "Is it safe?" Yes. We hear several accounts of the all too familiar birth nightmare, with women resigned: "But at least I have a healthy baby." We nod affirmatively. Meet women where they are. The visitors linger on the poster board presenting a collage of images of women giving birth at home. Of women being supported in their choices. A few days later MCCC's platform moves to Eastern Maine Medical Center's [EMCC] annual "Birth Fair." The doulas are astonished that the nurse who organized the event has allowed MCCC to participate in this event. In the field, EMCC is not known for it's favorable view of homebirth and midwives (though there have been several individual exceptions from time to time). It took several years and lots of hard work establishing relationships for the doulas to be insinuated at EMCC-and included in this event. The "Birth Fair" takes place in a hospital, after all, and is centered on birth in that location. The belly of the beast or an opportunity? The nurse who organizes the event confides in me that she had a homebirth with her son and that now he and his pregnant girlfriend are considering this option. An opening. In arenas like this I realize that "Choices" incites a far more receptive response than "Homebirth." Perhaps this is a more gentler, accessible way of advancing "the Cause." 75 At this fair, a student midwife and I pass out information about choices. We point out books about birth we have on display. We hand out business cards for midwifery practices and doula services. I pass out AHIM postcards. We talk to a near continuous stream of women and their partners about their choices in childbirth, about doula care, homebirth and midwives. We hear more horror stories. Stories of women being denied VBACs, being told their physiology is not adequate—or told they're "too fat" to have a natural childbirth-being told again and again that they can't do it. Some of the women share with us that they are interested in homebirths-and the reasons why this is not possible. Money. Their partner doesn't support this. Health issues. Their insurance doesn't cover it. Fear of pain. There is so much work to do. •k -k 76 * CHAPTER 22: OPPORTUNITIES AND THE DIY FILMMAKER June 2011. It's finally happening. "Video on Demand" services catering to the "Do it yourself [DIY]" filmmaker are cropping up. This proves that the Internet is no longer strictly a venue for promotion and marketing independent film but a viable outlet for distribution and commerce. Costly theatrical runs and exclusive distribution deals are no longer necessary to garner an audience and see a return on your film. Independent film distribution is undergoing the process of democratization. And the Internet has made this possible. "DIY" filmmaking has become a "brand" in the film industry—a practice, an identity, a Movement~and a market. Though distribution platforms such as "iTunes" have been around for years, it is difficult for the average independent filmmaker to access this venue and secure distribution deals with a company like this. Selling DVD's on your website is another option, but DVD duplication and product fulfillment are costly. And DVD's are dying. Word on the street is that Netflix will be phasing out DVD distribution of their rentals and moving exclusively to digital distribution. As a major trendsetter in the film distribution industry when Netflix makes this move, DVDs will most likely be wiped out—just like earlier formats such as Beta and VHS were. The new online distribution platform companies take a cut off each sale transaction; no upfront investment from the filmmaker is required. Films are embedded on the filmmaker's website; viewers can rent or purchase directly from the there. Previously, in my exploration of this, I have uncovered services that offer 77 rental (or pay-per-view) solutions only; however, given my market, which includes birth educators and doulas, I need to offer my audience the option to either rent or buy my films. It becomes about access—for the professional groups utilizing the films as an educational tool and for the independent consumer who want to learn about homebirth. Through "Filmmaker Magazine (Rosen, 2011)," I discover two new services that allow me to do both: "Film DIY" <http://www.filmdiy.com/index.php> and "Indie Playa" <http://www.indieplaya.com/Main.do>. There is no other way to describe how I feel about these new resources except empowered. And hopeful. Being a fully functioning DIY filmmaker is feeling far more in reach. Audience Women in their childbearing years and their partners. Midwives. Student midwives. Birth educators. Doulas. Women/Gender/Cultural Studies Programs. Medical professionals. Insurance company stakeholders. Legislators. Birth junkies. Cyber Connections Throughout 2012 I steadily made connections with other bloggers in the Natural Birth/Homebirth/Midwifery community. My site is cross-linked to numerous other related sites, including popular blogs such as Ricki Lake's, "My Best Birth" <http://www.mvbestbirth.com/> and "Midwife Thinking" <http://midwifethinking.com/videos/>. I am the "featured filmmaker" on a site that is garnering a lot of attention, "Where's My Midwife" <http: / / www. wheresmvmidwife. org / >. Many of these connections come from Facebook. This platform proves to be a dynamite source of promotion, connection 78 and now, with the Film DIY "App," a means of distribution. I will be able to rent and sell AHIM films off of my AHIM fan page. I post liberally and "friend" shamelessly, making new connections; harvesting daily crops from the birth world. Kickstarter Like film distribution, through the Internet, fundraising is also undergoing a revolution. Platforms like "Kickstarter" allow for creative producers to use "crowdfunding", based on a social networking model to reach a global audience to raise funds for their project. I am positively spellbound by this opportunity and am readying myself to launch a Kickstarter campaign. I want to continue to add to the AHIM series. More films = more representations of homebirth and midwifery care in Maine = more education and "normalcy" around this choice. The only catch: the campaign must raise the entire funding goal~or none of the funds may be kept. My goal: $10,000. Recently, Ricki Lake and Abby Epstein launched a Kickstarter campaign to raise funds for "More Business of Being Born." On July 8, 2011 they reached their goal of $100,000 (see <http: / / www. kickstarter. com/projects /211982196/ more-business-of-being-bornricki-lake-and-abby-ep?ref=live>). Mothering.com In May, International Midwifery Month, I discover that "Mothering.com" has featured midwives as the theme of their current issue. Following the trends and motivated by the constrained economy, Mothering moved from a print publication to a "web business" at the start of 2011 (O'Mara, 2011). On the home page, they have posted articles and videos focused on midwives; from my connections with the 79 Midwives Alliance I know many of the women featured. I contact the web editor and ask if they would have an interest in featuring AHIM. The response is an overwhelming "yes." This is great news! Mothering.com is a popular source for all things Natural Birth/Parenting. Given the huge subscriber-base and viewer-ship of this publication, this could be big. Public Screenings Over the next few months, film from AHIM will be screened in Brunswick, again in Belfast, Bridgton and Camden. Though my prime mode of distribution is online, there is no substitute for community-based events like this to attract public interest and raise awareness about the project. Of course there is no guarantee with any of these opportunities. I could lose my audience once the film series is monetized (I have been told by those "in the know" that I can expect my viewers to drop by two-thirds). I may not reach my funding goal on Kickstarter. I may draw only a modest audience to my screening. And DIY filmmaking surely has its limitations. "Freeware" and social networking platforms are empowering but not without bugs and kinks. I am fond of my AHIM Wordpress website but want to upgrade it, sweetening and polishing the interface and incorporating more e-commerce functionality. Recently, I discovered "Square Space" <http://www.squarespace.com/>. a new template-based webbuilding platform that appears to have all I'm looking for, not to mention the ability to create dreamy-looking websites. DIY takes time, which is a resource. It would be much easier to hire a web designer to create a new site. If I had the money. I 80 embrace both the opportunities and the challenges that come with DIY. I am learning so much. Independence Day July 2011. The Bangor Daily News publishes the article, "Independent Down East mom gives birth at home on Fourth of July" about a woman in East Machias that has a homebirth and will be raising her child as a single parent (Mack, 2011). I swell with admiration and pride-for the mother and her decision to parent on her own (and allow this to be broadcast in this state-wide paper), for the midwives Pam and Suzanne, each of whom I have worked with in my project and for the Bangor Daily News for covering this story and calling attention to two seeming unrelated issues that in fact are. As a "homebirther" and single Mother I happen to know a few things about both. * * 81 -k CHAPTER 23: CONCLUSION "Timing is everything. " William Shakespeare, from "Julius Caesar" It is undoubtedly a fertile moment in time to be producing a film series about homebirth and midwifery care. I have underscored how timing makes this project distinctive—both in regards to MA CPM's pursuit of licensure and the fact that this is the only work I am aware of that concerns contemporary homebirth culture in Maine. Also of significance is the fact that there is also no other media project that resembles this; a film series about homebirth distributed online. Timing is also significant in other ways: birth films breaking into the mainstream (as well as CPMs), the emergence of the Internet as a significant venue for the Natural Birth Movement-presenting a significant channel for the dissemination of information, new technologies popping up almost daily to support the distribution of content online and correspondingly, the phenomenon of the Internet becoming a prime venue for media consumption. Then a spate of positive coverage in the mainstream media about homebirth (The New York Times, 2011; CNN, 2010; Time, 2011) with the most significant being the recent CDC report about the 20% increase in homebirths in the US. This report is repurposed and published in dozens of publications, the most recent being from the "Associated Press <http://www.huffingtonpost.com/2011 /07/05/homebirths-up-bv-20 n 890547.html>." 82 It would seem the United States is more interested in homebirth than ever. In ways not entirely measurable at this point, AHIM is a part of that movement, a campaign that seeks to bring homebirth into view and increase access to information about this choice. A movement that at its core is about transforming how the US sees and does birth. In many ways, I feel glad at my decision to extend my MALS program and delay my graduation until the summer of 2011. Could I have predicted the various confluences that have occurred to position this project to be significant—if only in humble ways? Each year I have been a student has provided another opportunity to hone and develop this concept, expand the body of work and grow as a scholar and independent creative producer. And film more births. I am grateful for this. For the guidance I have received along the way, the lessons I have learned and for the opportunity to move this project in the direction it wanted to go. When I started my program in 2006, could I ever have imagined that AHIM would look as it does now? I don't think so! But most of all, I am grateful for the opportunity to be present at and film births. And to the families and midwives that believe in this project enough, believe in women enough to allow me to join their inner circle and document this significant life event. Every time I do so I feel like pinching myself at my good fortune. I witness miracles. And I feel glad at the timing for women. The Internet and the slew of positive media coverage have provided women with an opportunity to learn more about their choices in childbirth, including homebirth and midwifery care. Blogs, websites and 83 Facebook pages dedicated to Natural Birth have become a powerful means of education, info sharing, support--—and a political act. This is happening through the story. It always has. Women have shared in the story of birth since the beginning of time. And with birth largely out of view in our culture-that is, normal, natural, vaginal birth-birth stories, and the recording of them, are more important than ever. Stories of empowerment, challenge, transformation and change. My own homebirth story is why I make films about homebirth; why I will continue to do so. I want to keep presenting the power, strength and sacredness that I experienced with my own birth; to preserve and persist that story through presenting stories of other women who have shared this experience. To show what is possible. To show, in the words of Pam, the midwife from Harrington, Maine "That women, in fact, can give birth." To show that birth matters. For we are all born. That's where the story begins. Fin 84 REFERENCES Articles AP Wire (2011, May 20). Home births Up by 20%, driven by Natural Birth Subculture. USA Today. Retrieved July 12, 2011, from http: / /yourlife.usatoday.com/parentingfamily/pregnancy/story/2011/05/Home-births-up-20-driven-by-naturalbirth-subculture/47353398/1 Belkin, L (2011, January 4). Debating Home Birth. The New York Times. Retrieved July 12, 2011, from http://parenting.blogs.nytimes.com/2011/01/04/debating-home-birth/ Block, J (2011, May 25). Midwife Q & A: Are We Having Our Babies All Wrong? TIME. 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Malleus Maleficarum. Germany. 86 Murkoff, H (1984). What to Expect When You're Expecting (4th ed.). New York: Workman Publishing Company, Inc. Nichols, B. (1992). Representing Reality: Issues and Concepts in Documentary Film. Bloomington: Indiana University Press. Renov, M. (1993). Theorizing Documentary. New York: Routledge. Shakespeare, W. (1599). Julius Caesar. England. Kramer, H., & Sprenger, J. (1486). Malleus Maleficarum. Germany. Ulrich, L. T. (1991). A Midwife's Tale. New York: Vintage. Films Apatow, J. (Director). (2008). Knocked Up [DVD], Buonaugurio, S. (Producer and Director). (2008). Born in America. Bernhardt, D. (Director). (2010). Guerrilla Midwife [DVD]. Skwatta Camp Productions. de Maistre, G. (Director). (2006). LePremiere Cri [Pirated DVD], Buena Vista. Elson, V. (Producer). (2009). Laboring Under An Illusion. Iarillo, M. (Producer and Director). (2008). It's My Body, My Baby, My Birth [DVD], San Francisco: Wisewoman Childbirth Traditions. Lake, R. (Producer) & Epstein, A. (Director). (2008). The Business of Being Born. New York: Barranca Productions. Riefenstahl, L. (Director). (1935). Triumph of the Will. Germany: Leni RiefenstahlProduktion. Pascali-Bonaro, D. (Producer and Director). (2008). Orgasmic Birth. Sunken Treasures LLC. Tonetti-Vladimirova, E. (Producer and Director). (2006). Birth as We Know It. [DVD], 87 Reports Johnson, K. C. & Davis, BA (2005). Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America. British Medical Journal 330; 1416. Menacker, F., & Hamilton, B., (2010). Recent Trends in Cesarean Delivery in the United States. NCHS Data Brief, 35. Deadly Delivery: The Maternal Health Care Crisis in the US; One Year Update Spring 2011. New York: Amnesty International. Klein, M.C., Kaczorowski, J., Hearps, S. J. C., Tomkinson, J., Baradaran, N., Hall, W. A. (2011). Birth Technology and Maternal Roles in Birth: Knowledge and Attitudes of Canadian Women Approaching Childbirth for the First Time. Journal Obstetricians Gynecologists Canada, 33 (6), 598-608 Kotaska, A., Menticoglou, S., & Gagnon, R. (2009). Vaginal Delivery of Breech Presentation. SOGS Practice Guideline, 226. Martin, J. A., Kirmeyer, S., Osterman, M., & Shepherd, R. (2009). Born a Bit Too Early: Recent Trends in Late Preterm Births. Centers for Disease Control and Prevention National Center Health Statistics Data Brief, 24. Martin, J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Matthews, T.J., Osterman, J.K. (2010). Births: Final Data for 2008. Centers for Disease Control and Prevention National Vital Statistics Reports, 59 (1). MacDorman, M. F., Declercq, E., & Matthews, T. J. (2011). United States Homebirths Increase 20 Percent 2004-2008. Birth, doi: 10.1111/). 1523536X.2011.00481.x Wax, J., Lucas, F. L., Lamont, M., Pinette, M. G., Cartin, A., & Blackstone, J. (2010). Maternal and newborn outcomes in planned home birth vs planned hospital births; a metaanalysis. American Journal of Obstetrics and Gynecology, 203, 243.el-243.e8. State & County QuickFacts re. Maine. U.S. Census Bureau. Retrieved July 12, 2011, from http://quickfacts.census.gov/qfd/states/23000.html 88 Television Dharma and Greg (1997-2002). San Francisco: ABC. Dr. Quinn, Medicine Woman (1993-1998). CBS. Northern Exposure (1990-1995). Universal TV. Twilight Zone (1959-1964). CBS. Miscellaneous Resolve: 205. American Medical Association House of Delegates. Published June 17, 2008. HP 1616-LD 2253, Item I, 123rd Maine State Legislature. An Act to License Certified Professional Midwives (2008). Chapter 669. HP1616-LD 2253, 123rd Maine State Legislature. An Act to Provide Access to Certain Medications to Certified Midwives (2008). Retrieved July 12, 2011, from http://www.mainelegislature.org/ros/LOM/loml23rd/123sl/public669.asp State of Maine v. Sally Morrison. Criminal Court Docket No. CR-96-27, Superior Court of Maine, Sagadahoc County, 1997 89 APPENDIX A: AT HOME IN MAINE PROJECT DOCUMENTS Appendix A includes samples of forms that were sent to participants. 90 Participant Info Sheet At Home in Maine (AHIM) Participant Info Sheet Contact Info Name: Address: Phone(s): E-mail: Personal Info (optional, but helpful for this project!) Age/Birthday/Location of Birth: Occupation: Business Name/Address/Phone/Website: Number of years residing in Maine: If not from Maine, where did you relocate from: Education: Interests: Spouse or partner's name and occupation: Number of children and location of their births? How did you hear about this project? 91 Consent Form CONSENT FORM FOR THE AT HOME IN MAINE RESEARCH PROJECT You are invited to participate in research for At Home in Maine, a project about midwifery and homebirth conducted by University of Maine graduate student and filmmaker, Nicolle Littrell. The purpose of this project is to create a documentary film series about homebirth in Maine, making visible the people, practices, philosophies and politics of the home birth culture/community. The series will be composed of interviews from and/or observations of midwives, student midwives, homebirth families, the medical community, legislators and lobbyists, as well as pertinent events and activity in the homebirth community. This film series will be used for educational purposes. Its primary purpose is that it is the Masters Project for Nicolle's Masters Program. The films will be organized into a website that will be used as an educational resource for people in Maine, and other localities, to learn about homebirth. Upon completion of this project, Nicolle will present her work to her Masters Program committee. The website will be available to the public; there will also be several public screenings throughout the state to screen films and raise awareness about this project. Nicolle will retain the website and the film pieces as part of her portfolio. What will you be asked to do? If you choose to participate, you will be asked questions about midwifery and homebirth that will be documented in on-camera interview. This footage will be used to create a film. Examples of questions include: What is a midwife? Why did you choose to become a midwife? Why did you choose a home birth? How would you describe a "good birth?" How do you think licensure of midwives might affect midwifery practice; home birth and Maine's economy? With your consent, some of your professional and personal activities may also be documented. This could include day-to-day activity at your home or office; this may also include documenting the homebirth you are participating in. Length of interviews may be as brief as 5 or 10 minutes or up to an hour or more, depending on your interest and availability. During the editing of the film, you will be invited to participate in a screening of the "rough cut" of the film, where you will have the opportunity to offer your feedback. 92 Participation of Minors If you have children and they are interested in participating in this project, with your consent and under your supervision, I invite the opportunity to include their important perspective about the homebirth experience. Examples of interview questions I would ask minors include: Where are babies born in Maine? What was it tike for you to be at your little sister/brother's homebirth? Can you describe the experience? What do homebirth and midwives mean to you? Risks: • Except for your time, there are no risks to you from participating in this research. Benefits: • Your documentation will be a part of scholarship on contemporary homebirth practices in Maine. • Your participation will contribute to the creation of a unique film series that will help to raise awareness and educate Maine's families about the choice to have a homebirth. • Your personal experiences, stories and views about midwifery and homebirth will be documented and upon request, available for your own personal use. Upon request, you will receive a copy of film pieces you have participated in. • You will be invited to a participant-oriented screening of the film series, as well as forthcoming public screenings and presentations. Confidentiality Documentation for this research will occur through on-camera interviews that will be used to create a film. If you do not wish to be documented on-camera, but would still like to participate in the project, then you may choose to be interviewed off-camera, using audio equipment only. Nicolle will maintain video, audio and written documentation, as well as the completed film at her home office "in perpetuity." Your original documentation, as well as your personal information will not be released without your permission. 93 Voluntary Participation is voluntary, without compensation. If you choose to take part in this project, you may stop at any time during the process. In this case, if your interview was documented, you may choose to retain the video/audio tape that was used or upon request, this data will be destroyed. You may also skip any interview questions you do not wish to answer. Contact Information If you have any questions about this project, please contact Nicolle: Nicolle Littrell 207-323-3932/nicolle.littrell@umit.maine.edu 28 Bayview Street Belfast, ME 04915 You may also contact Nicolle's faculty advisor: Laura Lindenfeld Assistant Professor, Department of Communication and Journalism 207-581-1843/laura.lindenfeld@umit.maine.edu 5724 Dunn Hall, Room 432 University of Maine Orono, ME 04469 If you have any questions about your rights as a research participant, please contact: Gayle Jones, Assistant to the University of Maine's Protection of Human Subjects Review Board, at 581-1498 (or e-mail: qavle.iones@umit.maine.edu^ Your signature below indicates that you have read and understand the above information. You will receive a copy of this form. Thank you for your interest in this project. Signature Date Parent/Guardian Signature for Participants who are Minors Your signature below indicates your consent for your child to participate in this project. Parent or Guardian Signature Date 94 Release Form At Home in Maine Release Form Participant's name: Program Name: At Home in Maine (Working Title) Production Dates: May 2007-June 2011 I authorize Nicolle Littrell to document and edit into the Program described above my name, likeness, image, voice, interview, and/or performance. Nicolle may use all or parts of the program. Nicolle shall own all right, title, and interest in and to the program, including the documentation, to be used and disposed of without limitation, as Nicolle shall in her sole discretion determine. Participant's signature: Date: Address: Phone: Addition for Minors I represent that I am the parent and/or guardian of the minor who has signed above or is the participant in the program. I agree that we will both be bound by this agreement. Parent/Guardian's signature: Date: You will receive a copy of this form. 95 Sample Interview Questions Interview Guide for At Home in Maine Sample Questions for: Midwives • Where are babies born in Maine? • What is your personal philosophy about birth ? • How would you describe a "good birth?" • Where were you born? If you have children, where were they born? Can you describe your birth experience? • What is your occupation ? • What is a midwife? Can you describe the different kinds of midwives that are part of the midwifery community? What is the educational background and scope of practice for each kind of midwife? Can you describe the "midwifery model of care?" Is this model of care consistent for each of the different kinds of midwives? • In your view, which kind of midwife most resembles Maine's most famous midwifef Martha Ballard~and why? • Why did you choose to become a midwife? How did you come to the profession? Where did you receive your education and training? Can you share your thoughts on the different kinds of education and training available—formal education at a midwifery school\ apprenticeship or as in the case of direct entry midwives—no formal education, training or certification? What are the benefits and limitations of each? How have these options impacted the practice of midwifery? • How would you describe your lifestyle? What do you value in your life? Would you say that your occupation as a midwife is in sync with your values/lifestyle? • What are the professional organizations of the midwifery community—in Maine and nationally? Do you participate in any of these organizations? How do these organizations serve the midwifery community? The public? 96 How long have you been a resident of Maine? What brought you to Maine? Where is your practice located? How long have you been in practice? Can you describe the services you provide? What kind of clientele do you serve? What is the cost of your services? Do you allow for bartering as a means of payment for your services? How does the cost of a homebirth compare to a hospital birth? How do you advertise your practice? What methods or outlets have you found to be the most effective? In general, what is it like being a midwife in Maine? What are some of the benefits? The challenges? What is the history of midwifery in the state of Maine? How has the practice changed over time? Has your practice changed at all over time and if so, how? In addition to location, how is birth with a midwife different than giving birth with a doctor in a hospital? What are the benefits? The challenges? Do you work with a back-up physician(s)? How would you describe your relationship with this person? What is your transfer rate? What is your successful homebirth rate? What are your rates for maternal and infant deaths? What are your views on death in regards to birth? What is your relationship with Maine's insurance companies? What are the policies? Do you or your clients receive reimbursement for your midwifery services? Are policies changing? What would influence policy change? What is your view on the cultural evolution in the mainstream of birth from the home to the hospital? What factors have contributed to this evolution? Is this position changing in any way? In your view, how do childbirth practices and policies impact society? What do these practices and policies "say" about our society—about Maine, in particular? What roles/significance do midwives and homebirth play? What is the future of birth? 97 • How do you feel licensure of Maine's CPMS will impact, a.) the practice of midwifery, b.) choices for families who choose home birth, c.) Maine's economy? • Is there anything you would like to add that you feel is important for people to know about the homebirth culture in Maine? Doctors/Medical Professionals • Where are babies born in Maine? • Why did you choose to become a doctor? Where did you receive your education and training? Can you describe the medical model/standard of care? How long have you been a resident of Maine? • What is a midwife? Can you describe the different kinds of midwives that are part of the midwifery community and their scope of practice? Are you familiar with the "midwifery model of care." • What is your personal or professional experience of or connection to midwifery and home birth? • In addition to location, how is birth with a doctor in a hospital different than giving birth with a midwife at home? What are the benefits? The challenges? What is your view on cultural evolution of birth from the home to the hospital? What factors have contributed to this evolution? What is the future of birth? • Where were you born? If you have children, where were they born? Can you describe your birth experience? • Where are babies born in Maine? • What are your views about pregnancy and childbirth ? • How would you describe a "good birth?" • How would you describe your lifestyle? • What do you value in your life? • How do you feel licensure of Maine's CPMS will impact, a.) the practice of midwifery, b.) choices for families who choose home birth, c.) Maine's economy? 98 Legislators • Where are babies born in Maine? • Why did you choose to become a legislator? Can you describe your professional role and responsibilities? Where did you receive your education and training? What district in Maine do you serve? How long have you been a resident of Maine? • What is your personal experience of or connection to midwifery and home birth? Are you familiar with the midwives in your district? • Is it clear to you who the different types of midwives are and their different scopes of practice or do you find this confusing? • Where were you born? If you have children, where were they born? Can you describe your birth experience? • What are your views about pregnancy and childbirth? • How would you describe a "good birth?" • How would you describe your lifestyle? • What do you value in your life? • What is your view on cultural evolution of birth from the home to the hospital? What factors have contributed to this evolution? What is the future of birth? • How do you feel licensure of Maine's CPMS will impact, a.) the practice of midwifery, b.) choices for families who choose home birth, c.) Maine's economy? • Why did you choose (or not choose) to sponsor this bill? What do you think the outcome might be? Homebirth Families • Where are babies born in Maine? • Can you describe your personal and professional background? Where were you born? How long have you been a resident of Maine? 99 • What are your views about pregnancy and childbirth ? • How would you describe a "good birth?" • How would you describe your lifestyle? • What do you value in your life? • Why did you choose a home birth? How did you choose your midwife? How did you find her? • Can you describe your birth experience? What were the benefits of choosing homebirth? The challenges? • What are your views about pregnancy and childbirth ? • How would you describe a "good birth?" • How would you describe your lifestyle? • What do you value in your life? • What is your view on the cultural evolution of birth from the home to the hospital? What factors have contributed to this evolution? What is the future of birth? • How do you feel licensure of Maine's CPMS will impact, a.) the practice of midwifery, b.) choices for families who choose home birth, c.) Maine's economy? For Minors (under 18) • Where are babies born in Maine? • Where were you born? • What was it like for you to be at your little sister's/brother's homebirth? Can you describe your experience? What did you like about it? What didn't you like about it? • What does homebirth mean to you? • What do you like about living in Maine? Not like about it? 100 Recruitment Flyer Would you like to participate in a film project about midwifery and home birth in Maine? I'm a graduate student at the University of Maine, filmmaker and homebirth Mom. I'm seeking participants for my masters project, which is a documentary film about the midwifery and homebirth culture in Maine. The working title of the project is called: At Home in Maine. I am exploring the question: What does homebirth and midwifery look like in the state of Maine? Who are the people? What are the practices? The philosophies? The politics? Your participation could include anything from on-camera interviews where you will be asked questions about your relationship to homebirth and midwifery, to actually filming your homebirth. Benefits: • Your documentation will contribute to scholarship on contemporary home birth practices in Maine. • Your participation will contribute to the creation of a film that will help to raise awareness and educate Maine's families about the choice of homebirth. • Your personal experiences, stories and views about midwifery and home birth will be documented, available for your own personal use. Upon request, you will receive a copy of the completed film. If you are interested in participating in this project, please contact: Nicolle Littrell/207-323-3932/nicolle.littrell(aumit.maine.edu Thank you for your consideration! 101 APPENDIX B: AT HOME IN MAINE SERIES FILM DESCRIPTIONS Appendix B includes descriptions of all eleven films that comprise the At Home in Maine film series. 102 At Home in Maine, Part I (2008) This film presents an introduction to Maine's contemporary homebirth and midwifery culture, making visible some of the people, practices, philosophies and politics that constitute the culture. Politics is an important emphasis in this piece; in 2007, a group of Maine's Certified Professional Midwives (CPMs) pursued a bill for title licensure. CPMs are the professionals trained in out-of-hospital births; in Maine, CPMs are the midwives that mainly attend homebirths. The film documents the early stages of the legislative process of the licensure bill where two important questions emerge: * Should Maine's homebirth midwives be licensed? * Is the practice of homebirth midwifery a public safety issue? Intercut with stunning footage of a homebirth, "part 1" aims to present both a vivid modern portrait of the state's homebirth and midwifery culture and to address important present-day issues this culture is facing. Running time: 63 minutes 103 At Home in Maine, Part II Legislating Homebirth Midwives in Maine: People, Politics and Policy (2008) I'm just a bill, yes, I'm only a bill.. .(Schoolhouse Rocks) This film presents a narrative of the "life" of LD 2253 (formerly LD 1827), "An Act to License Certified Professional Midwives." In 2007, a group of Certified Professional Midwives (CPMs) formed a special interest group, Maine Association of Certified Professional Midwives (MACPM) with the aim of pursuing title licensure in the state of Maine. The film focuses on some of the key players in the legislative effort, including the bill's proponents, MACPM, the bill's sponsors in the legislature and lobbyists representing MACPM. Opposition to the bill, namely, the Maine Medical Association (MMA) and the ensuing tensions arising between the proponents and opponents is also a focal point of this piece. The narrative begins in early 2008, when the bill came back into the committee it first emerged from, the Joint Standing Committee on Business, Research and Economic Development (BRED). From proponent lobbying at the State House and committee meetings though participant interviews and House floor debates, this film reveals the significance of the bill to license CPMs, making visible the people, the politics and the policy of the legislative process. Running time: 70 minutes 104 At Home in Maine, Part m (2009) This film is the third in a series of films focusing on political activity in Maine's homebirth community, in particular, movement around licensing Maine's Certified Professional Midwives. The film looks at post-enactment activity and views around CH.669, a law passed in 2008 that legalizes Maine's Certified Professional Midwives (CPMs) to use of a short list of medications at homebirths (such as the anti-hemorrhagic Oxytocin). Through recounting this event, diverse views around homebirth, licensure of midwives and CH.669 are presented. Midwives, legislators, medical professionals and homebirth consumers comment on and critique this unprecedented legislation. The narrative is centered around a homebirth story, an Orland couple's choice to stay at home for the birth of their second child, attended by a CPM. Running time: 45 minutes 105 ROAR (2009) "ROAR" is a video meditation on the state of birth, who "owns" or has authority over it and a call for change. The female voice is at the center; ranging from the public to the private, ROAR features several Maine women, including homebirth midwives, legislators and a woman giving birth at home. Contextual background: In 2008, Maine's Certified Professional Midwives (CPMS) pursued a bill for voluntary licensure. CPMS are the professionals trained to attend out-of-hospital births and are generally recognized as attending most planned homebirths in Maine. The bill for licensure was defeated; however, a controversial law was enacted that legalized CPMS' use of a short list of medications at birth. Culled from interviews with the women about this event, ROAR aims to get at the core of the debate, namely, the politics of birth-in particular, the choice to have a planned homebirth-and the persisting cultural fears and tensions surrounding this domain. Woman and her body, difference between men and women, "turf wars", birth as the matrix of women's power & authority and cultural/community support of women (or lack there of) are thematic concerns. At its root, ROAR calls into question the relationship between these touchstones and the very health of our culture and society. Ideas are arranged and collided in a narrative that positions the female voice as a powerful agent of change and transformation. Running time: 14 minutes 106 At Home in Auburn, Maine (2009) (originally "Birth at Home") Features the home waterbirth experience of Aubrie and Jim with their second child in Auburn, Maine. The couple reflects on their choice to have a homebirth and discuss philosophies and values around birth, pain and fear in the US. Running time: 6 minutes 107 At Home in Morrill, Maine (2011) "At Home in Morrill, Maine" presents the homebirth story of Gretchen and Danny, a couple living in a small rural community near Belfast, Maine. Both Gretchen and Danny have careers in "sustainability." Gretchen is a holistic health counselor and nutritionist and danny is a solar energy specialist/contractor and co-proprietor (along with his dad, chuck) of sundog solar store in Searsport, Maine. Gretchen connects her choice to have a homebirth with her family heritage and her upbringing, emphasizing deep and abiding connections to nature and the outdoors. This birth story highlights the love and connection between the expectant couple-how pregnancy and birth can be sensual and sexual-and also an intensely private experience. Gretchen and Danny were assisted by certified professional midwife Chris Yentes of First Fight Community Midwives and Gina Forbes, student midwife, doula and childbirth educator. Gretchen's mother, "Mo" and her sister, Holly were also key sources of support for this birthing mother. This story extends beyond the homebirth to the couple's wedding ceremony (deemed "Lovefest") showing the circle of love and support that surround Gretchen and Danny as they make their transition into their new life as parents of Yukon. Running time: 45 minutes 108 At Home in Northeast Harbor, Maine (2010) This film features a Northeast Harbor, Maine couple's choice to have a homebirth with their third child attended by two Certified Professional Midwives; they also had a homebirth with their second child with the same midwifery team. Crafted around footage of the birth, a pre-natal visit and personal interviews, the film provides an in-depth look at this family's homebirth experience. Key themes of this film are: the normalcy and naturalness of birth, the safety of homebirth, the Midwifery Model of Care and labor support, mother's intuition about her body and her baby's position, personal healing and transformation around a previous birth experience through the homebirth event and birth as a joyous and intimate family event. Running time: 36 minutes 109 At Home in Orland, Maine (2008) (originally "At Home with Mother-Friendly Birth") The film features a condensed narrative of Valerie's beautiful homebirth with a professional midwife and doula. This birth is also featured in another one of my films, At Home in Maine, Part III. This is the 7-minute version! 110 At Home in Orland, Maine (#2) (2010) This birth features the second homebirth experience for Valerie Bates and her husband, Todd Cotier. Valerie and Todd are both from Maine. Todd is a mechanic and Valerie, a stay-at-home Mom (for now!). They have three children, Austin, Cooper and Penelope. Family is an important centerpiece of their life. Val and Todd had a homebirth with their second child, Cooper, in November of 2008, which is featured in two other films in the At Home in Maine series: "At Home in Orland" and "At Home in Maine, Part III." With both homebirths, Valerie and Todd were assisted by Andrea Mietkiewicz, CPM and Evelyn Conrad, CD of Clear Light Holistic Midwives of Old Town, Maine. Valerie is almost two weeks "overdue" when she and Todd meet with Andrea for a prenatal visit at Andrea's home/office. The film presents a natural holistic model for how this midwifery practice addresses their client's concerns, focusing on the "mind-body" connection. Several days after this visit, Valerie has a very fast labor and births her daughter Penelope in the birth tub! Though Valerie's birth with Penelope is normal, Valerie begins to bleed heavily post-partum. The film shows how midwives are trained to address these situations. Running time: 20 minutes 111 At Home in Waldo, Maine (2010) "At Home in Waldo, Maine" presents the homebirth experience of the Weavers-Melinda, Jerry, Ravi and Gideon-a family living in midcoast Maine. The film observes Melinda's approaching delivery in context of the Weaver's daily activities and documents the pre-natal planning and support the family receives from their professional midwives. The Weavers are (semi) homesteaders, home/internet-based entrepreneurs, homeschoolers-and rock and rollers (their band is Odlaw and their song, "Learn to Love" is featured in this film)! This 46-minute film is both an intimate document of their experience and an exploration into the relationship between how we live and how we birth. 112 At Home in Winthrop, Maine (2011) Joyful. Ripe. Intense. Real. It's the start of summer, on the eve of the solstice. "At Home in Winthrop, Maine" opens up possibilities of how rich-and raucous-birth at home can be. Jenn is supported by her professional midwifery team, her husband James and a circle of friends and raconteurs who revel in her beauty, strength and indefatigable spirit. When a woman is supported this way, when she has this kind of confidence and strength of body and soul, birth becomes not just a celebration of life, but a work of art. Jenn is a mainly stay-at-home mother to her young daughter Sarah, who was born at a birth center in Maine. She works at a local bookshop part-time and is co-owner of "Potato," a cooperative store offering Maine-produced goods. James is a social worker. The family lives in a small bedroom community about 10 miles outside of Augusta, Maine, sharing their home with Jenn's mother, Connie. The family was assisted by certified professional midwives (and naturopathic doctors) Sarah Ackerly ND, CPM and Josie Skavdahl ND, CPM of Northern Sun Family Healthcare in Topsham, Maine and also, Krystel Viehmann, student midwife. The couple is well vested in their community. Jenn participates in various town organizations, including the green committee. James is a loving father and supportive husband who likes to rock climb. Their garden gets bigger every year. They say they're on a "five year plan" to stay in Maine, with the deadline up in November, but it doesn't appear they're leaving any time soon. Their roots grow deeper every day in the community where their son Robbie was born. Running time: 45 minutes 113 APPENDIX C: AT HOME IN MAINE WEBSITE ADDRESS AND SCREEN SHOTS Appendix C contains Figures C.l through C.9 and presents the website address of the At Home in Maine website and screen shots for a selection of pages on the website. 114 www.mainehomebirth.wordpress.com Figure C.1 Historical Context of Homebirth in the US; At Home in Maine Project Description and Goals At Home in Maine: homebirth films, resources and community Home Homebirth in Maine. Who are the people who are choosing homebirths? The midwives that attend homebirths? Wliat are the practices, the philosophies and the politics of homebirth in Maine? IVhat dues humebirth in .Maine look like? Historically, birth was seen and experienced by women and their families regularly. Up until the first part of the 20th century. must births took place at home and were attended by midwives. Birth was a regular "every day" event; people had a picture of it. Today, most people in the United States liave no idea what normal, natural, vaginal birth looks like, let alone homebirth. Why it this? Highly mcdicalizcd birth, the continued distortion of birth by the mainstream media, political posturing by the medical maternity community and lack of access to information about choices in childbirth. 115 Figure C.2 Project Investigator's Personal Experience with Homebirth; At Home in Maine Project Origins at home in maine In December of 2004, I had a homebirth with my son Leo in Montville. Maine. It was a powerful, life changing transformative experience. Through my birth experience and the support of the professional midwives who attended me, I developed a faith in myself and birth that I had never known before. It changed not only my relationship with myself but how I saw the world. Through reading, storytelling and the media. I also became acutely aware that my birth experience was not the one most women in the United Slates had. As 1 learned more about the mainstream maternity NtooU Li!» and tar Leo Jfe <9 »M system, I came to know lliat it was under serving women and their children. The US ranks 29' in the world for infant mortality and 34U1 for maternal mortality. In March, the Center for Disease Control reported the national rate of Cesarean Section at almost in 2007. following a trend of a steady increase in this procedure. Prior to the birtli of inv son, I liad been working as a filmmaker and educator for ten years: after my homebirth experience. I knew I wanted to create a film tliat would help educate women and their partners about the choice to have a homebirth: that would challenge marginalizing perceptions about this choice and perhaps, be a part of a reproductive justice movement aimed al creating change. The project was first conceived as producing one "conventional" documentary film about homebirth in Maine. However, as 1 delved deeper into the project. I saw that one film would simply not adequately represent the diversity of the people choosing homebirth. the midwives attending these families and the different issues surrounding homebirth. Over three years lime, I had produced six short films about homebirth in Maine. With this realization. I shifted the project vision to building on and adding to this body of work and organizing and distributing the films as an educational/advocacy/community building website/web channel. 116 Figure C.3 Overview of Homebirth Films homebirth stories These five films focus on the homebirth event, the Midwifery Model of Care and relationships-between women and their midwives-and family interactions. Each film film takes an observational approach to presenting an authentic experience of homebirth. Some of the films also include testimonial from women and their partners about why they chose to have a homebirth. As a series, these films show the diversity of people who are choosing homebirths in Maine, the different midwives who serve these families and different regions in Maine where homebirths are happening (hint: everywhere). All films contain graphic (and beautiful) images of childbirth (click the to view film) 117 Figure C.4 Overview of Maine's Certified Professional Midwives Homebirth Midwives In Maine, the birth professionals who mainly serve women at homebirths are Certifed Professional Midwives (CPMs). Certified Professional Midwives are direct-entry midwives educated and trained through both apprenticeship and institution based models and are certified nationally by the North American Registry of Midwives. Maine has 24 Certified Professional Midw ives with practices located in most regions of tile state: North. Central. South, Midcoast and Downcast. Midwives may serve regions outside of where they are loculed. Maine's CPMs have two professional organizations: Midwiv es of Maine (MOM) and Maine Association of Certified Professional Midwives (MACPM). Maine's CPMs are also active in national organizations such as the Midwives Alliance of North America (MANA), the National Association of Certified Professional Midwives (NACPM). the Midwifery Education and Accreditation Council (MEAC). as well as the •MAMA Campaign. For a listing of Maine homebirth midwifery practices, click llic links to the regions listed above or access through the Homebirth Midwives tab on this page's menu. The Midwives of Maine website also offers a detailed directory. If you are a professional homebirth midwife practicing in Maine and would like to be included in this directory, please click here for contact info. 118 Figure C.5 Invitation for Viewers to Share Personal Homebirth Stories Community Be a part of creating community around homebirth in Maine. Share your h o m e b i r t h video, storv or other media and/or participate in discussions about homebirth. You can also access these links to these pages under the "Community" menu tab. Or you can go to the At Home in Maine's Facebook pane and share there! share your homebirth Contribute to building Maine's homebirth community by sharing y o u r own homebirth video...or written story, photos, artwork—music? There are several ways to share your birth story. In the "Reply" field below: * If you have an account/channel with an online video platform, copy and paste the embed code for your video-be sure to include a brief description of your film-and post. If your videos are not online you can set up an account/channel with blip.tv. vimeo. uoutube or other online viewing platforms. ' Copy, paste and post a URL link to your video, photo alburn, bloft a n d / o r music file. • Copy, paste and post text of your birth story. 119 Figure C.6 Overview of Different Resources Pertaining to Homebirth in maine Midwives a n d W o m e n Tile best resource in Maine to learn about homebirth are the homebirth midwives who serve women and their families and also, women who have chosen homebirths. One way to connect is on this site, which provides a community space to connect with others interested in homebirth and to exchange information and ideas. Many of Maine's homebirth midwives offer workshops, presentations and/or childbirth education classes pertaining to natural birth and homebirtli throughout the year. See News for upcoming events in Maine's homebirth community. Click here for a listing of Maine's homebirth midwives or visit the Midwives of Maine website (MOM). The Maine Association of Certified Professional Midwives (MACPM) is also an excellent resource for education and information about homebirth in Maine. Both of tlrese organizations have a presence at the Common Ground Fair, which happens September 24. 25 and 26 uf this year in Unity, Maine. Each year. Maine's homebirtli midwives offer presentations and workshops about homebirtli. See tire Common Ground Fair website for a complete program listing. Ilumebirth supplies In Maine, ifyou are having a homebirth. your midwife will provide you with a "birth kit" listing all inventory of the supplies you will need for your homebirtli. Ifyou are interested in having a watcrbirlh, you can order this item from your midwife. You can also order supplies for your homebirth through a Maine based company. Everything Birth. media resources Media can change the way we look at the world-and be an incredible awareness-building and educational resource. Click links to listings for film*, print pertaining to homebirth and/or choices in childbirth. Also see News for posts about homebirth in the media and upcoming events in Maine's homebirth community. S h a r e this: Etke »'•»« 0 Edit 120 Figure C.7 Example of Two Posts on the News/Blog Page Premiere Screening of At Home in Winthrop BRUNSWICK. MAINE. It is the eve of solstice. Julie 2010. Jenn and James Currier stand on a quite neighborhood street engaged in what appears to be a slow, swaying dance. In fact, Jenn is having a contraction: labor is the rhythm she moves to. Later that evening, in the dining room of her home, she will give birth to her son Robbie in a birth tub supported by her husband, her mother, her doula and her professional midwives, Sarah Ackerly ND. CPM and Josie Skavdahl ND. CPM of Northern Sun Family I Icailhearc and Birth Center. This story is presented in a new documentary film, "At Home i:: Wmtlirou. Maine" by Belfast. Maine based filmmaker Nicotic UU.-ell and will have it's premiere screening at the Frontier Caft on Wednesday, July 27th from 6:30 8pm. A discussion with Liltrell. tile Curriers, Ackerly and Skavdahl will follow the screening. Admission is by suggested donation: S5 for individuals and S10 for families. The film is part of "At Home in Maine", a film series and educational resource about the choice to have a homebirth and receive professional midwifery' care in Maine. To learn more about At Home ill Maine visit: www.tnainehomebirth.wordurcss.coir', Page Too homebirth in the bangor daily news (again) Click here to read a ureal article about a machias woman's choice to have a homebirth-and to be a single parent. kudos to the bangor daily news for covering both! the underlying issue of support for women's choices in each of these areas are completely interrelated. it is so wonderful thai homebirth is getting so much positive press these days, women are learning about their choices, getting educated and empowered to have the kind of birth they want for themselves and their babies-and to parent in the way they choose, as more women do this, they will be less subject to the obvious posturing of some medical groups who do not support homebirth-and therefore do not support women's choices. as more women exercise their rights around birth and receive more support for their choices, it is my hope that outcomes for mama, baby and families will improve. congrats anna! welcome eamon! 121 Figure C.8 Listing of Different Ways to Support the At Home in Maine Project At Home in Maine: homebirth films, resources and community S u p p o r t this Project Buy At Home in Maine films on DVD Donate S to sustain the Al Home in Maine project Schedule a screening of At Home in Maine 122 Figure C.9 Information about Filming Births as a Service for Consumers Film Your Birth Would you like your birth filmed? A birth film provides a precious keepsake of this important family e v e n t Nicolle will film births in all settings-whether it be at home, in the hospital or at a birth center. As a professional filmmaker who is experienced in this realm, Nicolle will document your birth with care, sensitivity and respect. Interested? Contact Nicolle for more info about packages and rates: wmninthemoon@gmail.com 2 Responses to A i ^ i Film Your Birth L a u r a A r m s t r o n u says: March 23.2011 «t 7:15 pmlEditl Please tell me how I can obtain a copy of your At Home birthing films -1 would love to share these with my clients and may not always be able to access your site and links. Are they available on DVD? Thank you, 123 BIOGRAPHY OF THE AUTHOR Nicolle was born in Warsaw, NY on August 22, 1969. She studied Theater and English Literature at The State University of New York at Buffalo, earning a BA with Honors in 1991. After graduating, Nicolle moved to New York City to pursue an acting career, performing in theater, independent film and broadcast TV. It was in NYC where Nicolle began her creative work in filmmaking, which started with completing several courses in film production at New York University. In 1997-1999 she assisted Mary Lea Bandy, the Chief Curator of the Department of Film and Video at the Museum of Modern Art. For five years, Nicolle also co-owed and operated a home-delivery organic produce service. In 1999 Nicolle moved to mid-coast Maine. From 1999-2000 she worked as a teaching assistant, instructor and departmental manager at the Maine Media Workshops. In 2003, she directed, produced and premiered her first short film, TRAP, which screened throughout Maine. With the homebirth of her son, Leo, in Montville, Maine, Nicolle transitioned into producing documentary films. Her current project is "At Home in Maine" about Maine's homebirth and midwifery community, helping to making visible the people, practices, policies and philosophies that constitute the culture. As a scholar and filmmaker, Nicolle's major area of inquiry is contemporary homebirth and midwifery culture, in particular, women's personal experience of this reproductive choice, kinship between women and their midwives, as well as examination of socio-political impacts and influences on this choice. 124 Nicolle has presented and performed her creative work in a variety of venues in Maine and New York State. She has taught filmmaking, theater, storytelling and other genres of creative production to children and adults in Maine's schools and art festivals and has been awarded numerous grants for her creative work. Nicolle lives in Belfast with her six-year old son, Leo. Nicolle is a candidate for the Masters of Arts degree in Liberal Studies, with a specialization in Women's Studies, from The University of Maine in August, 2011. 125