The Final Day of Testimony in Shaheeda Pierce's Breech Homebirth Trial
The Washington Court is Adjourned for a Breastfeeding Mama!!
The final day of testimony in Shaheeda Pierce's trial took place on Thursday 3rd November. The day seemed to go very well for Shaheeda's case. There were several inspiring moments during the day's proceedings, including one particularly poignant instance during the testimony of "Upel" Hsieh Yu Chin, the client whose breech birth Shaheeda attended. As Upel was speaking, her daughter, the breech baby who is now a healthy, vibrant 2½ year old, ran up to her and wanted to nurse. Upel said, "My daughter needs to feed now." The judge responded, "Oh! I am up with that breastfeeding stuff!" and proceeded to share with the court that his daughter was now happily nursing his grandchild. Then he ADJOURNED THE COURT! He offered Upel a separate room where she could nurse her daughter peacefully, asking if she thought 10 minutes would be enough, or if she felt she would need more time!
There were several eloquent and passionate witnesses for Shaheeda's defense throughout the day. Jordan van Voast, the father of the child whose birth sparked this trial, continued his testimony from the previous day:
Jordan has a Master's degree in Psychology and Oriental Medicine, and he is a practicing acupuncturist. During his testimony, he described the research he and his wife did to prepare for the birth of their baby. "I became a student of midwifery, studying everything I could find... I started studying as soon as I found out my wife was pregnant." When they learned their baby was breech, they took a tour of the hospital and spoke to many doctors, all of whom said that the only option for a breech baby was a cesarean birth. This was unacceptable to Jordan and his wife. "It's a major surgery with inherent risks for mothers, and potential health issues for the lungs of the baby... We preferred to have a birth as natural as possible. My wife was born at home. All of her ancestors were born at home, and she was the 7th child of 7 born at home."
He spoke of his and his wife's Buddhist beliefs. For ethical, religious, and moral reasons, an unnecessary surgical birth simply didn't fit with their world view. Jordan contacted Ina Mae Gaskin, who sent him a list of doctors in the area who were willing to attend vaginal breech deliveries. He contacted every one of them, but found that they either were no longer practicing, or they were not attending breeches. Running out of options, he turned to the midwives in Washington state. They found one midwife who said that a "vaginal breech birth is an option, but you'd have to find someone who has those skills. She contacted Ms. Pierce, for which I am very grateful. We called her immediately and made an appointment to meet her... immediately we felt a deep, spiritual connection and sense of trust. We felt very welcomed... "
Jordan continued to talk about Shaheeda's care for them, and the ways they tried to get the baby to turn. "I'm pretty sure she said vaginal breech birth is a variation of normal... but if there's an opportunity to turn the baby, then that would be good... She made some recommendations of some things that may encourage the baby to turn: continue acupuncture and moxa to the Bladder 67 point. Several studies in China show 88% success rate in using moxa to turn fetuses. Shaheeda suggested Webster's technique. We made appointments with a chiropractor in Greenlake for 4 sessions... lying on slant board, playing peaceful music down low by birth canal, communicating with baby about turning... We had been taught how to listen to the baby's heart rate and to notice how the baby was moving, and I am an acupuncturist so I am used to taking pulses as part of my work. We had also taken a full series of prenatal and birth classes...
"The Supreme Court has ruled that a woman can (choose to) have an abortion. Can't a woman also choose to give birth?"
In the days after I posted the first story on Shaheeda's case, there was an outpouring of support and well-wishes from mother's, midwives, and women's rights advocates throughout the area. Thank you so much for your hopes and prayers. It means so much to Shaheeda, and to midwives, apprentices, and students everywhere!
There were also a few words of caution from various corners. I'd like to take a minute to address these concerns. I want it to be 100% clear that Upel and her husband were completely aware of their situation, of ALL the inherent risks of vaginal breech birth AND cesarean section. There was absolutely no question that they gave their fully informed consent at every step of this process. Some of the responses to the original post suggested that Upel might not have truly understood the terminology used by Shaheeda. Please note that Upel is fully fluent in THREE languages. She and her husband spent many weeks reading everything they could find, in English and Chinese, on homebirth and the particulars of breech presentations. As Upel herself stated: "I studied English since age 10 in Taiwan... and studied Tibetan language in India... studied in Buddhist University for 10 years... was a Buddhist nun for 7 years in India. Special words may be difficult (in English), so then we use this language machine (At this point, she pulls out pocket translator and explains it translates from Mandarin Chinese to English and from English to Mandarin Chinese). Simple words are okay. Jordan helps explain the forms we sign." It was they who sought Shaheeda out, because she was the ONLY person who was willing to offer them any other possibility besides surgery.
As Upel said, "I don't want to go to hospital (for breech birth). We tried very hard to find a midwife to help us with the home birth. When I talked to Shaheeda the first time, I had just one question: Can she help me? After talking (with Shaheeda), I know that she can help me. Shaheeda never tricked me about anything. I decided EVERYTHING! When I decided we (would) go to hospital, Shaheeda helped us by calling the doctor there. We were feeling sad (to go to hospital). We cried. Really home is very warm and a comfort to me."
Among the other witnesses who testified on behalf of Ms. Pierce were Linda Marks and Leslie Gesner, two Washington state midwives; Betty-Ann Daviss, co-author of a major study on the benefits of homebirth published in the British Medical Journal; and Ida Darragh, director of testing for NARM.
Leslie Gesner testified on the content of the Practical Skills Guide for Midwives, by Weaver and Evans, in which "breech births are listed under general skills. Under general skills simulation, the book gives you step-by-step instructions, equipment, and procedures." She read the steps listed in the book, and said that this is one of the recommended books to study before taking the NARM exam, which is the day-long exam required for a Washington state midwifery license. Linda also pointed out that as midwives, "We encourage babies to rotate (to a head-down position), but we trust that the babies may know something that we don't... "
Betty-Ann Daviss spoke of the study she co-authored, entitled 'Out comes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America,' BMJ 2005;330:1416 (18 June). The study is the first large-scale study of homebirth, and has given statistical and evidence-based credence to what we have always known to be true: Homebirth is a viable and safe option for low-risk pregnancies. She also spoke of the inconsistencies and methodological problems in another study, the 'Term Breech Trial,' which many OBs have used to argue in favor of surgical birth. "I received a call from one of the obstetricians who said, "Think of what we have been telling women for these last two years... think of what we have done to our patients- exposing them to the dangers of cesarean section!""
Ida Darragh, is the director of testing for NARM. NARM is the North American Registry of Midwives. They are responsible for writing and administering the examination that Washington state uses to license midwives. "There's nothing in our testing that would indicate an expectation for them (the midwives) not to use the skills they were tested on. Every CPM should know how to assist at a breech birth... " She spoke about the job analysis that was sent to hundreds of midwives around the world, asking for input on what topics to include in the exam. "For knowledge of management of breech birth, (the importance) rating was 6.56 out of 7 on the 2001 job analysis survey. This is considered a core skill for all CPMs."
Kendra Pitzler, the manager of the Washington Midwifery Department was subpoenaed to testify, apparently against her will, as an adverse witness. She said, "I don't think there's ever been a discussion as to whether it's outside the scope of practice (for a midwife to attend an out-of-hospital breech birth). There are no Rules (in Washington for midwives) defining "significant deviation from normal" (as mentioned in Washington statute, for when a midwife would consult a physician).
In his final rebuttal, Dr. Petty, the prosecution's "expert" witness, said such things as:
● "The woman (Upel) should not have been allowed to get up and move around during labour."
● "Midwives would always be doing very frequent pelvic exams during labour, and she (Shaheeda) should definitely have been doing them in this case."
● When questioned about midwives' tendency to not do internal exams, especially after the waters have broken, due to increased risk of infection and adding stress and discomfort to the mother, Petty said, "Oh, no. Midwives and OBs do that exactly alike!!
A final point to note is that, as the prosecution's primary witness, Dr. Petty, was paid $175 per hour, for five 7-hour days. You do the math... No- let me help you. That's $6125. He was paid by the Assistant DA's office. Yup, that's right. $6125 of Washington taxpayer's hard-earned money, to persecute a woman who did not break any laws or do anything wrong! And that's just what they paid to ONE WITNESS. So far, Shaheeda's legal expenses are well over $31,000. The cost of this and other investigations has basically bankrupted the Midwifery Department in Washington, which is required by law to have ALL of its costs born by the midwives. So, not only does Shaheeda have to cover her own legal expenses, she is required to shoulder the responsibility for the prosecution's expenses as well!
In the end, the final days of testimony went really well. While it still too early to tell for sure what the outcome of this trial will be, things seem positive for Shaheeda's defense. There are a few more days left in which objections may be made against anything that was brought up in the trial. And then we wait... The judge will have 30-60 days to make his decision. But he may not take that long. I will post again with news of the verdict as soon as it is available.
Throughout the trial, the judge was very respectful to Shaheeda and her fellow midwives. He seemed open to, and interested in, the non-conventional model of care that midwives adhere to. He said that in the course of his research for this trial, he had read Ann Frye's entire section on Breech Birth in her comprehensive textbook Holistic Midwifery, as well as watching Ina Mae Gaskin's video series. He said that the trial "opened his eyes to childbirth in a way I never knew before."
Ida Darragh said it just right. The reason women seek out midwives; the difference between home and hospital; the fatal flaw of the medical model of actively managing birth; the one thing that OBs and emergency rooms will never quite be able to understand... When asked if she was familiar with the term 'Spiritual Midwifery,' she replied, "Of course, all births are spiritual."
Please keep up the correspondence, and show your support of Shaheeda to those officials who are involved in creating midwifery legislation. Follow his link for addresses to write to: www.shaheedapierce.com/pages/contact.html
If you want to help out with Shaheeda's mounting legal costs, please feel free to mail your non-tax-deductible donations to:
Shaheeda Pierce, LM, CPM
10307 SW Cemetery Rd
Vashon Island, WA 98070
Or send by PayPal to firstname.lastname@example.org
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