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AGENDA welcomes letters. Please send your commenís, opinions, and criticisms to: AGENDA Editor, 220 S. Main Sí., AnnArbor, MI 48104. This is the 90s! I am acerüfied Nurse-Midwife, an Ann Arborite, and a long time reader of AGENDA. I actively support home birth and traditional midwifery in this community. I recently read the JulyAugust issue and would like to respond to a few points in the article, "Midwifery: Helping Homebirths Happen" which were unclear, incomplete, or erroneous. It is truc that "nurse-midwives have been trained as nurses," but to say "and then have taken extra training in birthing" is incomplete and misleading. Nurse-midwifery education is 14-24 months in duration (depending on the program) and includes reproductive anatomy and physiology.nutrition counseling and education, care of the normal newborn through six weeks of age, breastfeeding promotion, care of the nonpregnant woman from menarche through menopause, and facilitation of normal, healthy pregnancy and birth as well as detection, management, and referral of complications throughout the childbearing year. The curriculum is based on the midwifery model, NOT the medical model, and stresses empowerment of the woman and the family to reach their optimum levelof wellnessutilizing a feminist approach to delivering care. I work in inner city Detroit with a population of women who have very limited resources and are vulnerable to many stressors during pregnancy. These include, but are not limited to, battering in pregnancy, crack addiction, syphilis (a 900% increase in Detroit in the past five years), poor nutrition, severe anemia, cigarette smoking, social isolation, extremely early child-bearing (12-13 years old), and toxic exposure, to name just a few. Our Midwifery service attends approximately 1700 births a year (with 20 Certified Nurse Midwives). We have an 8% C-section rate. 85% of the births we attend occur in a private birth room with family and friends in attendance. I have cut three episiotomies in the past year. All three were for severe fetal distress. I provide prenatal care at the Detroit Health Department clinics and the Scott Regional Correctional Facility (Women's Prison) in Plymouth. The health of the women we care for is improved because we help them take respoasibility for themselves and their pregnancies. They are well-informed about their bodies and have our constant support prenatally, during labor and birth, and in the postpartum period. This is hardly the "medical model." Granted, there are some nurse-midwives that wish they were doctors, either consciously or sub-consciously, and that is a terrible shame. There are also lay midwives that do not have the "thorough hands-on training" thatour Ann Arbor lay and traditional midwives have. Consumers of health care deserve to get unbiased information from your publication. They sure don't gct it anywhere else in town. Don't you think that most readers of AGENDA are aware of home birth as an option in this arca? How about some reporting on the politics of home birth, the threatened status of lay midwifery in the state, home birth as a reproductiva choice issue, the politics of medicine and insurance controlling home birth as an option, or what activists can and must do to keep home birth safe and legal? Come on you guys - this is the 90" s. Get off your "hipperthan-thou" podium and help readers really become aware of the government and the power elite' s successful attempt to control women's bodies and their private decisions.


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