A Quiet Place

| by Peggy O’Mara, Editor and Publisher

In 1973 I was living in southern New Mexico, pregnant with my first child and looking for a midwife. I didn’t know how to find one, so I went to a local obstetrician for prenatal care, all the while still hoping to find a midwife.

A woman my husband worked with had been a midwife in England, and two of my friends, who lived 200 miles away, were planning to become midwives. I called the New Mexico Department of Health, only to find that the state no longer licensed midwives.

My friends and I all wanted to have homebirths, but there were no midwives where we lived. We were awestruck by 
The Birth Book, the first book to publish graphic, step-by-step photos of birth for the layman, and were reassured by the National Association of Parents and Professionals for Safe Alternatives in Childbirth (NAPSAC), an organization that held conferences on and published evidence about the safety of homebirth. Having a do-it-yourself mentality and trying to live lives of self-sufficiency, we naturally began to birth our babies ourselves.

Six months before our own first baby was born, my husband and I saw our friend Stephanie birth her son, Aram, at her home. We later helped to deliver the babies of three friends. I love birth, and was on my way to becoming a midwife, starting out, as had so many women before me, by helping a friend or neighbor. As Shafia Monroe, president of the International Center for Traditional Childbearing (ICTC), says, “Every woman 
is a potential midwife waiting to be born.”

As it turned out, while I loved helping the laboring mom, I was afraid of catching the baby. My husband always did that. Nor could I figure out how to be a midwife while being the mother of my own babies. In short, my life went in other directions.

Many of my contemporaries entered midwifery in a similar fashion and actually went on to become midwives. Elizabeth Gilmore, who cofounded the Northern New Mexico Birth Center and the Midwifery Education Accreditation Council (MEAC), and created the National College of Midwifery, began by helping her friends deliver their own babies on Martha’s Vineyard. Gilmore was instrumental in preserving and improving New Mexico’s licensure of midwives in the late 1970s, but when I interviewed her and her midwife partners in the early ’80s, they knew nothing about the legal status of midwifery in other states; they were too busy developing their own practices.

Supporting midwifery was part of the original mission of Mothering. I realized that, for midwifery to grow, we had to know what one another was doing, which legal strategies were working, which licensure processes were most effective. Parents and midwives alike needed to know the legal status of midwifery.

In 1981 we compiled our first edition of Midwifery and the Law, at first a special section in the magazine and then a small book. I remember how fellow editor Pacia Sallomi and I pored over the distinctions between the legal statuses of midwives in different states until we had distilled them down to a concise taxonomy. We published this book from 1981 to 1988, until the newly formed Midwives Alliance of North America (MANA) and other advocacy groups took over the task of identifying the legal status of midwives; they still use the taxonomy we created.

In 1982, sociologist Barbara Katz Rothman wrote her seminal work, In Labor: Women and Power in the Birthplace, in which she contrasts the midwifery and medical models of care. She put the yearning for midwifery care felt by so many of us within a context of human rights.

While that larger context of human rights may come as a surprise to those of us in the US, accustomed as we are to inferior care, it is not lost on Amnesty International. Their March 2010 report, Deadly Delivery: The Maternal Health Care Crisis in the USA, trains a spotlight on the US crisis in maternal health care. According to the report, a total of 1.7 million women a year—one-third of all pregnant women in the US—suffer from pregnancy-related complications. At greatest risk are minorities, Native Americans, immigrants, non-English speakers, and those living in poverty. “Good maternal care should not be considered a luxury available only to those who can access the best hospitals and the best doctors,” said Larry Cox, executive director of Amnesty International USA. “Women should not die in the richest country on earth from preventable complications and emergencies.”

According to the Centers for Disease Control and Prevention (CDC), US infant mortality failed to improve from 2000 to 2005. This plateau represents the first time since the 1950s that US infant mortality has seen no improvement. Even though the US spends more on health care than any other country in the world, we are ranked 33rd in the world in infant mortality. A baby born in Cuba, Slovenia, the Czech Republic, or South Korea has a greater chance of surviving the first year of life than a baby born in the US. In fact, a baby born in Singapore is twice as likely as a US baby to survive that first year.

The rate of infant mortality among non-Hispanic black women is 2.4 times what it is among non-Hispanic white women. One of the chief contributing factors to infant mortality is premature birth. In 2005, 36.5 percent of all infant deaths in the US were due to preterm-related causes; among the non-Hispanic black community, nearly half (46 percent) of infant deaths were related to prematurity.

Maternal mortality, too, is on the rise in the US, as it is elsewhere. In a joint statement, the World Health Organization (WHO), UNICEF, and other groups called maternal mortality the “largest health inequity in the world.” Ninety-nine percent of women who die in childbirth do so in the developing world, and 50 percent of those deaths occur in Africa. The WHO estimates that we need 350,000 more midwives to meet this global crisis. According to the International Confederation of Midwives, there are currently some 250,000 licensed midwives worldwide, and only 13,000 in sub-Saharan Africa.

We also need more midwives in the US, where each year approximately 10,000 midwives attend just 10 percent of births—about 430,000. If midwives attended 75 percent of US births, as they do in New Zealand—a country with a 12 percent lower rate of infant mortality than the US—we would need 75,000 more midwives.

The ICTC has a fast-track training program for midwives, but many more midwives are needed, especially from the African American community—evidence suggests that women of color birth best when attended by midwives of color. In fact, one of the criteria for a mother-friendly birth established by the Mother Friendly Childbirth Initiative is what is called culturally competent care: “that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion.”

Eleanor Hinton-Hoytt, president of the Black Women’s Health Imperative, and other presenters recounted to attendees of the Seventh International Black Midwives and Healers Conference (held in Long Beach, California, on October 8–10, 2010) that it is commonplace for pregnant black women to experience racism in hospitals and doctors’ offices. These women report routine instances of white doctors who do not touch them or look them in the eye.

The ICTC conducted a pilot study in which 300 black women were asked about their care during pregnancy. Ninety percent of the women in the study reported being left alone during birth, and none was offered a doula. The ICTC intends to follow up the pilot study with a national survey.

While we have great affection for midwives, we may not fully realize how important their model of care is in the saving of actual lives. In 2007, the Journal of Perinatal Education (Vol. 16, Supplement 1, Winter 2007) published an extensive review of the research into maternity care done by the Coalition to Improve Maternity Services (CIMS) Expert Work Group.

The group found that the use of midwives is associated with:

• •    longer prenatal visits
  •    more education and counseling during prenatal visits
  •    fewer hospital admissions
  •    less need for analgesia and/or epidural anesthesia
  •    increased use of alternative pain-relief methods
  •    more freedom of movement during labor
  •    more intake of food and drink during labor
  •    decreased instances of rupture of the membranes 
(amniotomy)
  •    fewer IVs
  •    less electronic fetal monitoring
  •    fewer inductions and augmentations of labor
  •    fewer injuries of the perineum
  •    fewer episiotomies
  •    fewer rectal tears
  •    more intact perinea
  •    fewer cesarean sections
  •    more vaginal births after cesarean (VBACs)
  •    fewer preterm or low-birth-weight babies
  •    more infants exclusively breastfeeding at two to four months after birth

The key to improving US maternity care is to provide midwifery care for all normal pregnancies. On July 21, 2010, Representative Lucille Roybal-Allard (D-CA) introduced House legislation for a sweeping reform of maternity care. The Maximizing Optimal Maternity Care Services for the 21st Century Act (HR 5807) authorizes a public-awareness campaign about evidence-based maternity practices, expands federal research into these practices, and authorizes data collection to pinpoint those most in need of maternity-care providers.

According to a press release from Roybal-Allard’s office regarding the MOMS bill, as it has become known, “Finally, the measure puts in place a concerted effort to create a more culturally diverse and interdisciplinary maternity care workforce. It establishes loan repayment programs for providers in maternity care shortage areas. It authorizes grant programs for maternity professional organizations to recruit and retain minority providers. It also calls for the development of core curricula across maternity professional disciplines to better ensure that providers are better trained and able to inform patients about all of their maternity care options.”

In addition to federal aid, it needs to be easier for women to become midwives. Currently, one of the most exciting models for midwifery training is at the community-college level. An exemplary model of midwifery education is Southwest Tech, in Fennimore, Wisconsin, where one can earn an associate degree in direct-entry midwifery that combines classroom instruction with apprenticeship. The program is accessible because it offers tuition assistance, affordable housing, and liaison with preceptors. And it can be replicated at other colleges.

If you’re interested in being a midwife, know that there is no type of professional more needed at this time. Here are some helpful resources for getting started:

Resources:

• FAQs for aspiring midwives: Midwifery Education Accreditation Council
• Information about Certified Professional Midwives: National Association of Certified Professional Midwives
• Information about Certified Midwives and Certified Nurse-Midwives: American College of Nurse-Midwives,
• Find a midwifery preceptor: see Citizens for Midwifery’s list of state midwifery organizations

| by Peggy O’Mara, Editor and Publisher

This is the talk I gave at the International Chiropractic Pediatric Association (ICPA) Family Wellness conference on October 21, 2010.

When I attended the National Vaccine 
Information Center (NVIC) conference here in 2009, 
I was struck by the vitality of many of the attendees, and I began to realize that among the most vital were the chiropractors.

Vitality is a very personal expression, but I do think we all know what it looks like and feels like. When ICPA’s Jeanne Ohm asked me to speak at the conference, I thought I would talk about vitality in the context of family wellness; like all parents, I want to protect and enhance the vitality of my family.

Vitality has to do not only with demeanor, though it is reflected there, but also with our innate ability to grow, to thrive, and to heal ourselves. Having confidence in this innate ability in our children, and trusting ourselves as parents to make decisions that enhance that vitality, are perhaps our biggest challenges as new parents.

Society tells us to dominate our child’s body, to suppress its symptoms with drugs, and to artificially augment its immune system. Those of us who believe in the capacity of the body to repair itself must resist this model of domination, which does not enhance family wellness. In fact, domination of any kind cannot be the norm in a healthy family.

This is a conference about family wellness in the context of conscious choice. Conscious choice implies that we have both the right and the responsibility to decide what is appropriate for our own families, and that doing so leads us down the path of an authentic life. Becoming an authentic, original parent means basing our decisions on observations of our own, unique child and on our personal vision of our family, rather than on the current fashion or what other parents are doing. This vision becomes our ethic of parenting.

Here are some questions you might want to ask to foster the development of your own ethic of parenting:

• What do you believe about children in general, and about your own child in particular?
• Do you believe that your child has a legitimate reason for his or her behavior, even when you don’t understand or agree with it?
• What do you believe about yourself as a parent?
• Do you think that you are the expert, or are the experts outside of you?
• What does leading an authentic life mean to you?

When we examine our actions, we sometimes find that they are incongruous with our beliefs. Our words and actions may reflect unconscious cultural or personal beliefs that we want to bring into awareness. At first, we may act automatically and parent as we ourselves were parented, only to find, upon reflection and through experience, that there are other ways. Gradually, we become ourselves. As Rollo May said, “The opposite of courage in our society is not cowardice, it is conformity.”

Conformity does not serve children. They are not conformists. They are idiosyncratic, original. We must dive deeply into ourselves for them and actively examine our beliefs—even be willing to change our mind.

Who is the child? What do you believe about the nature of the child? Do you believe that your child is inherently good, inherently bad, or a blank slate? Do you believe that your child is the product of heredity or of environment? Does your child feel as you do? Does your child understand things as you do?

What do you believe about the world? Do you believe that we live in a benign universe? Do you trust others? Do you trust yourself? Are you tolerant of your child’s innate timetable and legitimate biological needs?

Once you’ve asked yourself these and other questions, challenged your beliefs, and possibly changed your mind, you will have to find the courage to act on your new beliefs. Finding the courage to act on these beliefs, especially if they are controversial, can be more difficult than discovering what you believe in the first place. You must remain steadfast with yourself. You must not abandon yourself to please others. This may mean straining relationships with family. It may mean finding new friends. It may even cause differences of opinion between you and your partner.

This is healthy. This is normal. Everyone has a right to her or his opinion, but only you can choose for your own family. It is the job of each new generation to finish the unfinished business of the past, and often that means doing things differently. Only you have the authority for your family.

Fortunately, courage is self-generating. The more you face difficult situations, the braver you become. Here are some things that will help you to sustain your courage:

Practice self-appreciation. This is helpful every day, and essential when making difficult decisions. Be gentle on yourself. Don’t turn against yourself in tough times. Don’t listen to negative self-talk. Mentally rehearse difficult future situations and imagine yourself as being successful in them. Expect things to work out.

Learn to navigate tough times. In tough 
times, contemplation, meditation, and just sitting and staring off into space can all help. Allow fun and pleasure into your life, regardless of what you face emotionally. Build a social network of like-minded friends. To keep perspective during tough times, ask yourself two key questions:

• What am I looking forward to?
• What am I grateful for?

Understand how change happens. Change is a process. If you decide that you’d like to find more time for family meals, or want to stop yelling at your kids, or are interested in learning about homebirth, just give yourself some time. Only about 20 percent of people are prepared to change their habits; just by contemplating change, you are already a nonconformist, already courageous. What people often don’t realize about personal change is that it doesn’t happen overnight, but in stages. First, we have to contemplate the problem. Then we must imagine what changing the situation will require. Next, we mentally prepare ourselves to take the new action. Finally, we act.

Then, if the change is to be lasting, we must maintain the new behavior. And with any new behavior, there will be lapses into old behavior. While you’re learning how to live more naturally, for example, you may buy fast food, then severely reprimand yourself. This is a mistake. It’s how you talk to yourself about lapses, not the lapses themselves, that can lead you back to old habits. Don’t blame yourself as if it were a catastrophe. Just pick up where you left off and start over, keeping the big picture in mind. And remember to reward yourself for your successes. For example, reward yourself for laying off junk food for a month by taking time to relax, getting a new book, or having a healthy lunch with a friend. Congratulate yourself on having met your own goals.

In addition to self-care, it is also important to find friends you are compatible with and whose values you share, and to avoid people who model the behavior you want to avoid, or who offer you depression, despair, or disrespect.

Einstein once said, “The field is the sole governing agency of the particle.” What this means is that we are logically and irrevocably influenced by the field we are in. If we are around people who use a certain kind of slang, we will use that kind of slang. 
If we see women with big purses, we will want a big purse. If we have ice cream in the freezer, we will eat it. If, on the other hand, we are at a retreat where everyone eats healthy food, we will eat that. We are animals, and we mimic what we see others doing.

Community is so important that some people have formed intentional communities; others live in cohousing developments where families live in close proximity to one another, share meals, and have group social events. A friend told me that her house had recently been sold to two families, who would share the house.

One of the most popular articles ever to appear in Mothering is “Finding Your Tribe,” by Teresa Pitman, published in the September–October 2000 issue. It’s the story of a young mom who spends days with her friend. They cook together, clean together, help each other with their children. 
On the Mothering.com discussion forums, we have very popular Finding Your Tribe threads of forum members who regularly get together in real time.

We come to conferences like this to see each other, to be inspired and energized by a community of like-minded people. It’s important to look for community, but we don’t really have to worry about finding it. It finds us. We attract it. We find it where we are. We go deeper with people we already know: neighbors, coworkers, the parents of our children’s friends.

We need community. Visualize what it feels like to feel part of a community. Describe it to yourself. What is one community you want to know more about? What is one step you could take toward that community? Break it down into small steps, then take just that first step.

We live in an age in which the individual has seemed to be more important than the collective. Our current economic challenges underline precisely the opposite, but these times are just a reminder of what has always been true: Regardless of what era we live in, we need community. There is nothing wrong with us if we can’t go it alone. We’re not supposed to.

Community is important because we are profoundly influenced by those around us. We are influenced by their dress, their language, their moods. Positive thoughts, positive intentions, and positive words all contribute to our vitality and to the vitality of others. We certainly can’t believe in our own inherent vitality or that of our child if we are in a bad mood. It seems, then, that optimism is a job requirement, both for parents and for anyone who wants to maintain vitality.

As you enjoy the conference over the next few days, don’t look for a dogma. Notice your experience. Observe what excites you, what inspires you, what makes your pulse quicken and your blood boil. Follow those things. Trust your impulses. Remember that vitality is ultimately about the unfolding of your own uniqueness. It is about the fact that you are an original.

I will leave you with a quote from the legendary dancer and choreographer Martha Graham:

“There is a vitality, a life-force, an energy, a quickening, that is translated through you into action and because there is only one of you in all of time, this expression is unique. And, if you block it, it will never exist through any other medium and be lost. The world will not have it. It is not your business to determine how good it is nor how valuable nor how it compares with other expressions. It is your business to keep it yours clearly and directly, to keep the channel open. You have to keep open and aware directly to the urges that motivate you. Keep the channel open.”

| by Peggy O’Mara, Editor and Publisher

“The unexamined life is not worth living.” This saying of the Greek philosopher Socrates inspires me to lead an examined life as a parent. Socrates observed the world around him in order to learn, through thought and discussion, how to make it a better place. He was found guilty of corrupting the minds of the youth of Athens, whom he encouraged to challenge the accepted beliefs of the time and to think for themselves.

Do parents today think for themselves? We are called “helicopter parents”—hovering, overly attached—if we set healthy boundaries and limits on our children’s experience, and yet only a minority of parents do so. In the latest report from the Kaiser Family Foundation, more than 2,000 children aged 8 to 18 were asked whether or not they were subject to any rules regarding media use. Only 26 percent reported having some rules that were regularly enforced.

As parents who try to bring consciousness to family life, we are in a minority. As readers of this magazine, we are also in a minority. Eighty-four percent of us have a college degree, and 32 percent have a graduate degree. In contrast, just 27 percent of the 
US population has graduated from college.

Forty-six percent of our readers had a midwife present at their children’s birth, which is five times the national average of 8 percent; and 30 percent gave birth at home, 30 times the national average of 1 percent. And when it comes to breastfeeding, we’re off the charts: 96 percent of Mothering subscribers breastfeed; of those, 41 percent nurse for one to two years, and 32 percent for three to four years. Nationally, only 22.7 percent of babies are still breastfeeding at one year.

In short, Mothering readers are definitely part of a culture distinct from the dominant one in the US, and, as such, we should take the recommendations of that culture with a grain of salt. Like Socrates, we may appear to be heretical for questioning the dominant parenting practices of our times, for challenging authority, for making individual and sometimes controversial decisions regarding the welfare of our families—but sometimes we must.

Soon after my first baby was born, in 1974, my husband designed and built a small, wooden addition to attach to our bed so that our baby could sleep beside us and we could have more room. This practical solution helped facilitate breastfeeding, and we liked keeping our baby close all through the night.

In those days, my husband and I said that we had a family bed, a term coined by Tine Thevenin in her classic book, The Family Bed. This practice was not particularly controversial at the time, as it was of interest only to the minority of women, 32.2 percent, who were then breastfeeding. For us, it was simply a good idea that helped us to be more successful at nursing; we talked with one another about how to make the family bed more comfortable, but seldom questioned its safety.

Today the family bed has become controversial, its vocabulary complicated and clinical. There is no longer talk of the family bed, but only of cosleeping and bedsharing, two terms that, not long ago, were used interchangeably. This fall you may see press releases from the Juvenile Products Manufacturing Association (JPMA) designating September as Baby Safety Month, and exhorting parents to put their babies to sleep only in cribs approved by the Consumer Product Safety Commission (CPSC). Further, the JPMA, along with the CPSC, will caution you against putting your baby to sleep in an adult bed.

I imagine that, if I were a new parent today, I would be frightened by these messages, but my own experience tells me that bedsharing with my baby is perfectly safe. Nor am I convinced by a trade organization that represents crib manufacturers or a government agency that regulates those cribs. These entities are experts on products, and can understandably recommend only something that is a product; they are not experts on sleep, and certainly not on cosleeping or bedsharing.

For an expert on cosleeping, I always turn to James McKenna, PhD, Edmund P. Joyce Chair in Anthropology at the University of Notre Dame, and director of the Mother-Baby Behavioral Sleep Laboratory, where he and his team observe mothers and babies bedsharing. According to McKenna and fellow researcher Thomas McDade, “mother-infant co-sleeping represents the most biologically appropriate sleeping arrangement for humans and is both ancient and ubiquitous simply because breast feeding is not possible, nor easily managed, without it.”

McKenna and McDade also shed light on some of the myths involving cosleeping: “Most USA and other western infants die from [Sudden Infant Death Syndrome] or from fatal accidents during solitary sleep outside the supervision of a committed adult. Moreover, the overwhelming number of suspected accidental overlays or fatal accidents occur not within breast feeding–bed sharing communities but in urban poverty, where multiple independent SIDS risk ‘factors’ converge and bottle feeding rather than breast feeding predominates.”

I thought carefully about risk factors when, in the 1970s and ’80s, I chose to birth three of my babies at home. Two of these homebirths were attended by a doctor, and the third by a midwife. I live in New Mexico, where midwives now attend 32 percent of births, and where one in every ten births takes place at home.

Homebirth, however, remains outside the experience of most US physicians, so it is no surprise that, in 2008, the American Congress of Obstetricians and Gynecologists (ACOG) reiterated its long-standing opposition to homebirth. While ACOG pays lip service to informed consent for pregnant women in its “Statement on Home Births,” the organization “does not support programs that advocate for, or individuals who provide, home births.” In addition, ACOG supports care only by nurse-midwives, not licensed midwives, even though states such as New Mexico have safely and 
successfully licensed midwives for 30 years.

ACOG’s “Statement on Home Births” is also disrespectful of birthing moms because it suggests that mothers make childbirth decisions “dictated or influenced by what’s fashionable, trendy, or the latest cause célèbre.” Further, the statement suggests that mothers would be selfish to “place the process of giving birth over the goal of having a healthy baby.”

This suggestion—that homebirth is a selfish choice—is further reinforced by a study published online in June by the American Journal of Obstetrics & Gynecology, “Maternal and Newborn Outcomes in Planned Home Birth vs. Planned Hospital Births: A Metaanalysis,” which concludes: “Less medical intervention during planned home birth is associated 
with a tripling of the neonatal mortality rate.”

A metaanalysis is a study that looks at many other studies; this one looked at studies as far back as 1950, something the American College of Nurse Midwives (ACNM) questions: “[W]e are puzzled by the authors’ inclusion of older studies and studies that have been discredited because they did not sufficiently distinguish between planned and unplanned home births—a critical factor in predicting outcomes. Also troubling is that several recent credible studies of home birth were excluded for no apparent reason.” The ACNM goes on to say, “Of the largest studies included in this metaanalysis, only three . . . clearly distinguish between planned and unplanned home births. These three studies—which comprise 93% of the women included in the metaanalysis—found no significant differences in perinatal outcomes.” Citing the international body of evidence that has found no significant difference in infant mortality between planned home and planned hospital births, the ACNM cautions “against over-interpretation of these findings.”

It’s important to note that the publication of the study cited above coincided with efforts in New York and Massachusetts to pass legislation granting autonomous practice to all licensed midwives working in all settings. While it’s common for one profession to challenge a competing profession, it’s up to us to differentiate between objective scientific fact and public relations.

While ACOG has remained firm in its opposition to homebirth, how do we respond when another influential organization, the American Academy of Pediatrics (AAP), appears to change theirs?

In 1971, 1975, and 1983, in updated editions of its policy statements on circumcision, the AAP concluded that there are no medical indications for routine circumcisions of newborn males. In 1989, the revised AAP statement concluded that circumcision has “potential medical benefits and advantages as well as disadvantages and risks.” In 2005, the AAP reiterated their 1989 position, saying that “Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.” Further, they remanded the decision to the parents: “In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child’s current well-being, parents should determine what is in the best interest of the child.”

With my own sons, both born before 1983, it was easy for me to make a decision. The AAP told me that circumcision was not medically necessary, and neither my husband nor any of his brothers had been circumcised.

Coming to a decision may not be as easy for parents today, who may have heard about recent studies suggesting that circumcision protects against AIDS. They may not know that the methodology of these studies has been questioned, or that circumcision has never been shown to protect against sexually transmitted diseases.

Despite the apparent ambivalence of their statements, the AAP does not recommend circumcision. In fact, no national or international medical association recommends routine infant circumcision. The US is alone in the world in circumcising the majority of baby boys: 56 percent in 2008.

These three examples of important parenting decisions—infant sleep, place of birth, and circumcision—require us to do more than follow the leaders. Even when we are confused by contradictory opinions and vested interests, we must remember that the responsibility lies with us. When it comes to making decisions that may impact our child’s entire life, we can’t afford to rely on changing customs, or be distracted by political rhetoric.

We are left, then, with just a few constants: our observations of our child, our trust in ourselves, consultations with experts, the scientific evidence, and our own common sense. These things are enough. And it helps if we’re already comfortable with being part of a minority.

| by Peggy O’Mara, Editor and Publisher

Last fall, my oldest daughter went to college. And she came back. I didn’t know—I thought that maybe, at 18, they grew up and left home. No. It ain’t over yet. This has turned out to be one of my most profound mothering experiences. As with my daughter’s birth, her college experience turned me around 180 degrees, so that everything looked quite different and I felt, as I did after her birth, that 
no one had really told me what to expect.

When we prepared for college, we did all the right things. My daughter took the college entrance tests and pored over books listing numerous college choices. I went to college meetings at her high school, waded through financial-aid options, and made lists of college supplies. In effect, I got the boiling water and cord clamps ready, yet forgot to talk about the pain. We spoke a great deal about the practical details and little about the potential emotional realities. Fortunately, this time around, we’re a family that has learned how to talk about the pain and how to handle the unexpected.

My daughter chose a large college because she had attended a small, private high school. She chose a college town she liked that is less than 500 miles from home, and where we have old family friends. She chose a college that has a lot of different course offerings. And although none of her friends planned to go there, she visited the campus beforehand and liked it. She made a good choice.

The reality of life away from home turned out to be very different from the widely accepted fantasy of college as fun. The reality was a large institution with many of a large institution’s pitfalls. We place our vulnerable young adults in a new situation that carries heavy personal, societal, and financial expectations of success. To support them in this new and important venture, we pull the rug out from under their personal lives. They leave family and friends—their existing support network—to live with someone they’ve never met, in a room so small that furniture must be stacked. The room has one window that looks out onto a roof. The bathroom is down the hall. They eat in a cafeteria.

For young people who want to leave their present situations, who are highly motivated to learn or pursue a career, or who are of a different temperament, such experiences may not be sacrifices. At other schools, they may not be sacrifices. However, for those who value aesthetic and emotional experience, large-college personal life may be too impersonal. I am surprised that colleges and universities remain so unaware of how important the personal dimension is, and how impersonal campus life still can be.

At her first dorm meeting, my daughter was given a piece of candy, a condom, and a black whistle. The whistle was in case of threatened rape, and stiff penalties were attached to irresponsible whistle blowing. It was rumored that a student whose roommate commits suicide receives all A’s for that semester. Amid the innuendos suggesting serious emotional experiences, very little acknowledgment was given to the day-to-day coping with these new situations. Parents were cautioned to take a hard line when they received “the call” from their child, asking to come home.

The profundity of it all came in contemplating this hard line. Unlike the period following my daughter’s birth, this time I had the memory of my own college experience, and knew how much my own responses to her would echo the choices I had made as a young adult. While I encouraged her to give herself time to adjust, the line did not turn out to be mine to hold.

For one thing, I have the habit of trusting my daughter and her perception of her own experience. She knew when she wanted to walk, to talk, to wean, to read, to go to school. Her choices so far have been just fine. I have had no reason to distrust her experience—and neither has she. Once my daughter had decided she did not want to stay at this college at this moment, she had no ambivalence, no second thoughts, no looking back. She simply knew her own mind.

She had no guilt, either. Once she’d made sure that I would receive a tuition and housing refund, she was free of concerns. Having never been lonely, she could make no sense of unnecessary loneliness. Her large classes did not cause her to complain; what she could not endure was the abrupt loss of a family and social life that had been working well for her.

Due to her ability to know so clearly what she wanted and my ability to trust her feelings, even though they were not in my plans, my entire life fell into place in a different way. If it really is true that someone can be trusted to understand her own experiences, make her own choices, and take responsibility for her own decisions, then it must be possible to fashion very unique lives for ourselves—lives that are truly handmade, rather than imitations of society’s shifting standards 
of behavior.

My daughter made all of the times I had toughed it out the sadnesses they really were, rather than the necessities I had believed them to be. Her decision made my whole body relax, as I no longer had to be ever alert to the “right” way. Her clarity demonstrated that it is possible to raise children who know and trust their inner experience, who have not been lied to, who are not neurotic.

There is a name for what my daughter is doing. It’s called taking a year off. When I went to college, there was no adult education to speak of, and women who didn’t go right to college from high school usually didn’t go to college at all. That is no longer so. My daughter is seriously examining the college options right in her own backyard, with the knowledge that she can return to a larger school when she’s ready to specialize.

Surprisingly, many of her former classmates are choosing similar paths. Several boys went to a university nearby so that they could be together and close to home. Others have come home. Some would like to. A few are traveling. And many are adjusting to college just fine.

Like birth, college requires us to prepare as best we can, knowing that we must also be able to respond to the unexpected. Curious that it should be unexpected. In our family we value personal timetables, connection, cooperation, and support for one another. We share difficult emotions and hard times. In our family, how someone feels is very important. Our quality of life is very important to all of us. And so it is with my daughter and her classmates. They have broken 
the mold of “ivy league” expectations and recognized, at a young age, that life is not only about going after something, it is also about the getting there. These 
students are insisting on getting there 
in a style to which they have become accustomed.

In October 2009, Barbara Loe Fisher awarded me the Courage in Journalism Award of the National Vaccine Information Center (NVIC). The award certificate reads: “. . . for her vision and journalistic integrity in defending a mother’s right to raise her children in the holistic health tradition.” When Barbara presented me with the award, she added, “for her dedication to improving the health and well-being of mothers and children; for her honest, accurate, and insightful coverage of the vaccine-safety and informed-consent debate; for her leadership in empowering young mothers to make educated, independent health decisions for their children.”

The following is an edited, abridged version of the opening talk I gave at the NVIC conference in Washington, DC, where the award was presented. For the original speech in its entirety, go to my blog, http://mothering.com/peggyomara/
2009/10, where I also talk about other speeches from the conference.

As new parents, we believe that society will take care of us, has our best interests at heart, and will protect us. I want new parents to believe this, but health-care policy in the US is focused on eradicating rather than preventing disease. It is fear-based, interventionist, and compromised by economic considerations. At this time in history, assuming that society will protect you can be a dangerous belief.

It was new parents who, in 1976, founded Mothering in the mountains of southern Colorado. We were natural-living pioneers who had gone “back to the land.” Many of us tried to grow our own food, can fruits and vegetables, keep chickens and goats, and heat with wood. This was a time when one could find children’s cotton pajamas only at a secondhand store—newer pajamas for children were required, by law, to be made with flame retardants that were later found to be toxic. There were no natural personal-care products, and no packaged herbal teas or organic produce in grocery stores. Natural-living pioneers preferred to use peppermint oil or willow bark instead of aspirin for a headache, and were particularly cautious about the use of antibiotics. We often chose not to circumcise our male infants, and usually breastfed. When vaccinations were suggested for our babies, we had questions.

Mothering magazine was born out of these and other questions that natural parents had in the mid-1970s. Then as well as now, one of the most popular topics in the letters to the editor section was that of vaccination. In 1980, we published our first full-length article on the subject: Roxanne Bank’s “A Mother Researches Immunization.”

When we began covering the issue of vaccination in Mothering, we were asking legitimate questions raised by the community of natural-living pioneers. I never thought the issue would become of such wide concern, though I did anticipate its political significance when I subtitled our first anthology of reprinted articles on this subject The Issue of Our Times.

But that was before Congressman Dan Burton’s (R-IN) hearings of the late 1990s and early 2000s. That was before 1997, when the EPA set a reference dose for mercury in biologics. That was before July 1999, when the American Academy of Pediatrics (AAP) and the US Public Health Service called for the elimination of mercury from childhood vaccines.

It is concern for children that is at the root of the new health journalism. The new health journalists are participant observers reporting on their own lives. Some have medical backgrounds that help them in their search to find out what’s wrong with their children; others become scientists along the way.

When we publish articles about vaccines and autism, grateful mothers call me, in tears, and tell me that they now have something they can show to their relatives, to all the people who doubt them or who think they’re crazy. I know that these mothers are not crazy. I know they are telling the truth, because by the time a mother has reached the conclusion that her child has autism because of vaccines, she has considered and thrown out every other possible explanation. She did not want to come to this conclusion—she has dragged herself to it, kicking and screaming. If a mother has decided that vaccines caused her child’s symptoms of autism, then there is no question but that she is right—because she so badly wants to be wrong.

The mother always knows.

It is these heartbroken mothers and fathers who have gotten on the Web and told each other what is going on, compared symptoms, and put the pieces together. It is their experience that challenges the status quo.

Since 1980, Mothering has published hundreds of articles and letters about vaccines. In the early days of the magazine, this content was about reconciling vaccines with a natural-living philosophy. By the mid-1990s, it had become evident to me that parents were feeling oppressed on all sides. A mom sat in my office, weeping as she told me that she had no idea what her point of view was regarding vaccines. She felt pressured by her family to vaccinate, and pressured by her health practitioner not to.

When, in 1999, the AAP called for the elimination of mercury from vaccines, everyone took notice. It was also in the late 1990s that we began to hear in earnest from the community of families whose children’s autism was caused by vaccines, and to publish their stories. We were the first magazine to publish articles on hopeful treatments for children with vaccine-induced autism.

With 140,000 members, our discussion community on Mothering.com is the largest one for parents on the World Wide Web. Our vaccine forum has 24,000 threads and 263,000 posts. Before the Internet, there was no way for so many like-minded people to so easily exchange information about an issue. Unlike industrial media, which require special skills, special equipment, and considerable financial resources, digital media require no special knowledge or equipment, are immediate, and can be quickly updated.

In the leading textbook about the Internet, The Wealth of Networks: How Social Production Transforms Markets and Freedom (Yale University Press, 2006), author Yochai Benkler writes, “It seems passé today to speak of ‘the Internet revolution.’ . . . But it should not be. The change brought about by the networked information environment is deep. . . . It goes to the very foundations of how liberal markets and liberal democracies have coevolved for almost two centuries.” According to Benkler, we are shifting from a mass-
mediated public sphere to a networked public sphere. 
“I suggest,” he says, “that the networked public sphere enables many more individuals to communicate their observations and their viewpoints to many others, and to do so in a way that cannot be controlled by media owners and is not as easily corruptible by money as were the mass media.”

No better example of this exists than the proliferation of vaccine information on the Internet. It takes me hours now to do the research that, before the Internet, used to take weeks. Because of the networked nature of the Web, when an important observation is made within the online vaccine community, it is quickly picked up by other sites, and then by bigger sites. Before you know it, it’s on The Huffington Post, and then there’s an interview on Larry King Live. According to Christopher Harper, co-director of Temple University’s Multimedia Urban Reporting Lab, “Until recently, only a small number of people owned a news organization. Today, digital tools have empowered many people to own a news organization.”

Barbara Loe Fisher asked me if I have suffered for challenging the status quo. My job as a mother is to challenge the status quo. If I am lucky enough to have a child who is perfect and one of a kind, it is not my job to make my child be like everyone else. It is not my job to follow the current fashions, but to forge my own way, to develop my own personal ethic of parenting. As a journalist, my job is the same: to challenge the status quo. It’s not the media giants that need protection. It is the common man. As the journalist Finley Peter Dunne said a century ago, “the job of the newspaper is to comfort the afflicted and to afflict the comfortable.”

Because I own Mothering and am both its editor and publisher, I don’t have to answer to anyone, and seldom have to negotiate my point of view among my staff. But Mothering has suffered financially for our advocacy and our standards. Independent magazines are not the norm in the US. Most, if not all, of our competitors are owned by companies that publish multiple titles and therefore enjoy greater economies of scale. They are often driven by advertising, and seldom have a strong point of view.

We don’t take advantage of the ad dollars spent in other parenting magazines by formula companies and pharmaceutical manufacturers because we don’t accept ads for those products. In the magazine industry today, such a policy is almost unheard of. Our mission at Mothering magazine and Mothering.com is not to sell products to parents, though we hope that the products we do advertise are useful. Our mission is to help parents make informed choices.

The current trend toward patients’ rights, informed consent, and the new health journalism is about “we, the people.” We—all of you—have brought the issue of vaccine safety to center stage in the US, and it is only a matter of time before the new health journalism becomes the status quo. Don’t be deceived by the backlash—the last gasp of tyranny is always the loudest.