Birth Services

Joyce Kimball, CPM

Motherhood, Midwifery, and Home Birth with Joyce Kimball

1 hour 23 minutes Posted Mar 2, 2022 at 8:00 am.

https://podbay.fm/p/healthy-balanced-birth-and-beyond-podcast/e/1646226000

SHOW NOTES

Joyce Kimball has been the Owner and Primary Midwife of Joyce Kimball Birth Services, a full-service childbearing-year care service started in 2000. Prior to Birth Services, Joyce spent 15 years working in Human Resources for Massachusetts corporations. After the home birth of her second child, she completed the apprenticeship process to certify and practice as a Certified Professional Midwife. Joyce holds an MBA, a Certificate in Midwifery, an Associate’s Degree in Nursing and a Registered Nurse’s license.

Joyce practices as a homebirth midwife, birth doula, childbirth educator, birth counselor, and belly caster. She is active in the Massachusetts birth community - answering many questions on the MassDoula email list, connecting families with appropriate childbearing-year services, serving in various capacities with the MA trade organization - Massachusetts Midwives Alliance, precepting student midwives, nurses, and doulas, and talking with anyone and everyone about birth, supporting birth choice and reproductive justice. When she is not doing birth work, she’s listening to podcasts, at the gym or spending time with her family and friends eating, talking, listening, dancing, laughing, sharing and eating dark chocolate.

Connect with Joyce:

https://birthservices.net/

Resources:

La Leche League: https://www.llli.org/

maternal mortality rates:

mother + baby health:

I’m not sure where to begin. 

I have full permission from RZ to share anything and everything.

Here goes.

RZ is an anesthesiologist. And she was raped and assaulted during the birth of her 4th baby.

R reported the “incident of obstetrical violence, including negligence and assault” to the Medical Board.

R's complaint included that her care and care providers were:

“Rude, confrontational, unprofessional, not supportive, very tense, unpleasant, escalated to physical violence, restrained and assaulted, baby violently pulled out of me, pushed flat on my back, told to pull her down on the bed and grab her feet, dragged, feet lifted, shoved a drape under me, unable to move, backside was lifting off the bed, could barely breathe, being forced into an extremely crunched position, hands inside me, extremely painful, unexpected, did not ask my permission or speak to me about inserting their hands inside my vagina, my legs were aggressively pushed towards me, continued to put their hands inside me, asked to be able to put my feet down – Dr. N would not allow my feet to be put down, continually forced into this position against my will, even as I repeatedly stated I wanted to be on my side, unable to move, people were holding onto each legs in the air, violently manipulating my baby’s head, my husband and I continued to plead with the (care providers) without success, (threatened) - “I don’t want to vacuum you”, documentation is false. I felt dismay and disbelief, bitter disappointment, horrible experience to be physically restrained and painfully assaulted during childbirth. Recovery has been extremely challenging, unnecessary violent force exerted on unborn baby’s head, in shock, great difficulty sleeping, depressed mood, anxiety, severe pain, hip and back instability for 2 months.”

Dr. Z responded to RZ's complaint:

“I’m sorry that Dr. Z didn’t have the birth experience she was envisioning, I believe the management of her labor and delivery was appropriate and within the standard of care. Given her high risk status (R had a cesarean section for her first baby, then vaginal births of her second and third babies) and the ongoing difficulty monitoring due to her desire to keep moving, I noted her resistance to monitoring in my note. I strongly disagree with the patient’s characterization of her labor and delivery….she was not effectively pushing and was not making sufficient progress in that position. I did not want to delay the delivery because we were not effectively monitoring her and she was at high risk for uterine rupture.”

“There was nothing traumatic about the delivery of the baby and she was certainly not “held down” as she suggests in her Complaint. It was not appropriate to allow her to labor on her hands and knees or her left side – as she was not pushing effectively in those positions and it was important to deliver as soon as possible.”

“the patient was pushing by 21:52 and was delivered at 21:55” (3 freaking minutes!!)

“I was able to facilitate her delivery with natural interventions, including massage of the perineum. I was aware that this was not the position she was hoping to deliver in; however, in my clinical judgement, it was the best, most effective way to deliver.”

“the patient has characterized me as rude, confrontational and unprofessional. I take exception with this characterization and I believe that I always poke to the patient in a calm and professional manner. Unfortunately, I was not able to allow Dr. Z to dictate the manner of delivery, and this clearly was an issue for her. All of my clinical management decisions were to facilitate the safe, appropriate and proper manner for her delivery.”

“while I am certainly sorry that this patient feels she did not have the delivery experience she was hoping for, I believe the care I provided was appropriate and within standard of care. She had a vison of her labor experience; however, that vision did not contemplate what was necessary for the safety and well-being of the baby.”

“our department is an interventional high-risk labor and delivery unit. Accordingly, we utilize standard interventions in the management and delivery of our patients. This patient chose to deliver without pain medication. She managed labor pain well; but, certainly her pain in active labor may have impacted her perception of her delivery. I can assure you that she was not “assaulted,” nor was she subjected to “physical force.”

“As you can see, the patient’s allegations of “unprofessional care and lack of communication during the labor and birth” was unsubstantiated (by the DPH). The DPH investigator found our actions to be “consistent with prudent medical/nursing obstetric practice to monitor the health of the mother and baby”. They found there was no “abuse”. The DPH went on to find that the obstetric care met the standard of care with regard to managing a delivery. The DPH indicated that given the patient’s past obstetric history, and her high risk status and risk for uterine rupture, the management was appropriate.”

“I’m sorry that Dr. Z did not have the birth experience she had hoped; however, I am happy to report that she safely delivered a healthy baby…the well-being of the mother and baby motivated my clinical decision making. While I try to accommodate a patient’s birth plan whenever possible, this patient’s history of previous cesarean delivery and potential for uterine rupture mandated the mode of delivery management utilized in her care.”

The response from Dr. N to RZ’s complaint to the medical board is the same thing birthing folks get told every day:

  • I’m sorry you feel that way.
  • Your experience is wrong.
  • I work at a high-risk hospital and this is standard obstetrical care here.
  • My clinical judgement that rape and assault is necessary trumps your requests for body autonomy.
  • You are not allowed to birth the way you want, you birth the way I want.
  • You brought it on yourself by wanting to move around and by not getting an epidural.
  • Other powerful people who were not at the birth believe that my abuse was warranted and expected in standard obstetrical care.
  • At least you have a healthy baby.

Every.damn.day this happens to birthing folks all across this country. My heart is broken.