How to Build a Birth Network

by Cynthia Yula and Katie Heffelfinger

© 2000 Midwifery Today, Inc. All rights reserved.

[Editor's note: This article first appeared in Midwifery Today Issue 56, Winter 2000.]

This article is a blueprint for a grassroots movement—a program of birth activism that can be set up in any community to stimulate better birth practices, political activism, and media savvy for the birth community. Two successful birth networks—one in Nashville, Tennessee, and the other in Philadelphia, Pennsylvania—were started by the writers of this article. The program we developed can augment collaborative marketing efforts for birth professionals and create pockets of activism to promote birth change and the midwifery model of care.

We believe that women in our culture need to be educated toward a much healthier attitude about what normal is, what our bodies can do, and what powers we possess. We all know that some women make uninformed choices, can't feel connected to their bodies, and buy into mainstream attitudes. By uniting into a birth network, women can choose to birth with the professional they feel close to, in the setting they are most comfortable with. We know the revolution starts with the consumer. By correcting the myths surrounding birth and educating families about the choices that are available to them, we make a leap toward better birth.

This article guides you step-by-step into building a network of birth activists. Each step builds on the activity that precedes it, so you can take one "baby step" at a time: 1) contact other childbirth activists; 2) coordinate your efforts; 3) inform the public; and 4) cultivate special projects. A birth network can be as formal or informal as you wish it to be. Whatever you do with the information we've provided here, realize that the clear goal is a great birth experience for every woman.

If preserving your sisters' dignity and building confidence in natural birth is important to you; if a good experience from preconception to menopause appeals to you; you might be a birth change agent. If you were ever told that you were a leader; if you know that you can't help but try to stop injustice; you might be a birth change agent…

Step 1: Contact other childbirth activists

Goal

Introduce other birth change agents to your city's birth network, raise their awareness of the benefits and options available within a midwifery model of care, and encourage them to include a midwifery model in their own classes and practice.

Process

Write or call the local midwives, doulas, independent childbirth educators and others interested in childbirth, and invite them to join the birth network now growing in their community:

• Explain how businesses informed by this model can benefit from group networking and media coordination.
• Offer to e-mail them literature such as the Citizens for Midwifery's "Midwifery Model of Care" pamphlets or Coalition for Improving Maternity Services' (CIMS) Mother-Friendly™ Childbirth Initiative (MFCI), the latter of which might be used to develop the philosophical base for the network and can act as an organizational starting point.
• Ask them whether there's any educational literature they would consider essential to the newly forming movement.

Make a follow-up call a week or two later. If you provided them with literature at their request, ask them whether they've had a chance to go over the information, and whether they think it might be useful either for the birth network or for use in their classes. The exchanges of insight that this might spark are what will constitute the birth network's very first breath of life outside of the womb! If you tracked down the literature they referred you to, thank them and let them know that you'd like to bring it to the group's first meeting for discussion.

Let them know when and where the first meeting will be held, and invite them to bring their insights and their love for better birth.

At your first meeting you may want to make an opening statement, to help everyone get oriented and inspire them to participate. As an example, here's a version of the opening statement we made at the Philadelphia Birth Network's first meeting:

We are all very different types of people. Our lifestyles are different. Our needs are different. Our personal philosophies range from one end of the spectrum to the other. We all have different comfort zones. We all need a network of services to keep our lives running the way we are accustomed. Birth and pregnancy have always been a personal experience heavily influenced by cultural norms. Today we have many choices that are encouraged by our culture. Some women want pain medications while others want a more natural experience of everything about the birth. Some women find comfort in a hospital setting while others prefer to stay at home for their birth.

The goal of the Philadelphia Birth Network is to refer professionals who will be truly supportive of pregnant families' choices, and to encourage families to make healthy choices. Whatever your vision is of your birth and pregnancy, we are here to listen, support and encourage. A mom knows best her level of comfort, physically and emotionally. As a team of midwives, doulas, physicians, massage therapists, and body workers, we are united to provide services and education to pregnant families.

Our city, defined by an influx of new cultures and traditions, is growing up! As it does, the flavors of families will undoubtedly broaden. We must embrace diversity. No matter what the vision of the mother is, we must do our best to accommodate her requests by matching the family to the provider.

The first meeting is also a time to draft a mission statement and to determine how thebirth network will be organized. We address these subjects in the next section.

Step 2: Coordinate your efforts

Goal

Inform, educate, and build community. Specifically, bring a diverse group of childbirth activists together to educate the community about the midwifery model of care, and to demonstrate how businesses inspired by this model can benefit from group networking and media coordination.

Process

Build relationships over the phone and in face-to-face groups. Determine responsible persons for setting up media and networking contacts within the community. Make arrangements to form committees and to develop a responsible team of activists.

• Encourage communication within childbirth groups and with individuals.
• Find out what the needs are within the community and develop task forces to solve problems within the community. Need statistics? Go gather them!
• Coordinate get-togethers to facilitate conversation.
• Develop common long-term goals.

The key to success is teamwork! Local and regional birth change agents need to work together to arrange for the most time- and cost-effective use of resources to facilitate change. Here are a few ideas:

• Market individual ideas as group ideas, to dilute the workload, increase the client base and pool community contacts.
• Foster strength within the birth community through shared activities and events.
• Form a task force to make presentations at a hospital or other settings in need of change.
• Compile a comprehensive contact list of parenting organizations and professional groups with a mission similar to yours: include name, address, phone, e-mail address (the most cost-effective means of contact!), Web site, birthday (a nicety), and professional alliance. Don't overlook health-care professionals, hospitals and clinics, out-groups, and birth centers.
• Coordinate referrals. Use a computer, and some kind of database that can be searched. (Outlook allows you to input information that can be queried, but there are many more databases on the market that work just as well, if not better.) If a mom calls and wants a midwife who will come to her homebirth, you'll then be able to search for "homebirth, midwife" and give her a quick referral to the homebirth midwives available to her. Having a searchable database makes life way easier for anyone who's answering the phones. Those without computers are just a printout away from having a current, paper database.
• Develop an electronic newsletter, and send it to group members as well as to clients, contacts, and other interested parties in the birth community.
• Get CIMS designation for the hospital and medical practices in the community.

Organization

When you're ready to schedule your meetings, call everyone. Twice! Ask for phone numbers of their childbirth friends; call them. Twice-once to connect with them and spark enthusiasm about the birth network, and a second time to invite them to the meeting they'll be looking forward to after your first call.

At your very first community meeting, determine:

• The mission statement: Why are we here? Look to your community to see what it needs. Consider what draws you together, as well as what graces you with diversity.
• Interim officers: Secretary (possibly the most important role) and president (or coordinator), at minimum. If possible, a media representative, treasurer, and an events coordinator would be helpful.
• Degree of parliamentary procedures and by-laws: It's often easier to let a committee decide on a reasonable response to a controversial issue. As the community evolves, however, different needs will be perceived. A strong, large group will need strong procedures. A fluid, evolving group will need less procedure and more room. There might not be a need to have by-laws and procedures in place until three to five months into the group's evolution.
• Dues: Is this a dues paying organization, and if so, will there be benefits? What need is there in the community? In the past, The Greater Philadelphia Network asked for $35 a year. The Nashville Birth network asked members to choose between active and regular membership.

Regular members paid $42 per year, and received promotion of their birth service without having to perform any duties for the organization. Active members paid only $29 per year, but were obliged to answer incoming calls to a message-linked voice mailbox on a rotation basis. (Active members acted as liaisons between the public and the birth network, and encouraged callers interested in their birth services to interview at least three other professionals besides themselves.)

Our membership money was enough to generate a Baby Expo in Philadelphia and a Baby Fair in Nashville!

Handling the money

• We asked members of our birth network to make checks out to the treasurer's name. Since you are at the grassroots level you don't need to be concerned with reporting the money made. (Check with your local authorities about any possible loopholes.) Since the network reinvests its money into the marketing of the network you won't see a profit, and the network is a "marketing collaborative" as opposed to a non-profit.
• Members should be informed that the money paid to the network for membership or donation will go directly into the marketing of the network, and therefore indirectly into their own birth services. The profit end will come from the thriving of your own birth business, as your services are demanded by the droves of families who will find out about you through the network's marketing efforts.

As you create a structure that suits your group's temperament, try to plan around the following pitfalls:

• One person gets an idea and cannot carry it through. Make sure that committees have the support they need, especially when dealing with the community-at-large in the name of the group. If you find that you are lagging, don't be afraid to ask for help. Everyone is counting on everyone else to carry out the plans. If you need help, call your coordinator and explain your need.
• One person is taking on too many responsibilities. Volunteering takes time; overworked folks need help from others. Ask everyone to be "real" with the time that they are able to give.

Look for someone with the ability to delegate, and use him or her! As a leader, don't hog leadership; rather, optimize on the strong leadership abilities of the women around you. The leader's primary responsibility should be delegating and implementing, coordinating and making it happen.

Keep in mind

• Poor communication kills. The secretary must be able to disseminate info very well without taking over.
• No backbiting. Especially the leadership! You must learn to hold your tongue before hurting people's feelings or making a major social faux pas. When facts are scarce keep it to yourself. Nothing nice to say—keep it to yourself. The goal is unity.
• Ideas need funding. Every proposal should include some ideas to help fund it, right at the brainstorming session. This is the most effective use of your time and energy.
• Attendance drops. Meeting attendance will fall off—it naturally happens! The strong people left will be doing most of the work; the occasional member can fill in where s/he can. It really only takes a small group of five to 10 to lead the rest, and a small group of leaders ensures smoother interaction. Here are ideas to stimulate the group:
  • Find ways to excite folks into coming to the gathering.
  • Plan a series of events/goals on a timeline—work toward them.
  • Offer special speakers, incentives and door prizes.
  • Assign special jobs: "you bring donuts next time."
  • Make Each Person Feel Special-you can do this by giving them jobs that you know they will enjoy and do well with.
  • Plan for a babysitter to come to watch the kids while you are holding the meetings. (Everyone can chip in a few dollars to pay the sitter.)
• If meeting attendance falls to a level where only one or two other people come, re-think the group. This is not a failure! What can those who are left do?
  • Evaluate reasons why people might have given up, such as personality, inexperience, unknown factors, or just plain giving up.
  • Do something that makes them want to come, like bringing in a good speaker.
  • Don't fret. Links will be made and connections forged. Allow that to happen. Once you give a birth network life, you have to let it make new choices, like a growing child.
  • Wait a few months and try again; shift the targeted location; try to rally new leadership.

You might avoid many of these pitfalls, if you nurture community spirit from the beginning. Here are a few ways of bringing a diverse group of childbirth activists closer together:

• Communication. With one or two positive communications a week, folks feel looked after, you know-loved! Call or send loving reminders to folks who haven't attended lately; encourage everyone to bring a new friend; and be sure to compliment the forward movement or exceptional idea of one of your members, including new moms. (Remember: new moms are most likely to join your network and promote the excellence of the care that you have given!)
• E-mail is easiest, fastest, and most inexpensive. Set up a format that includes a set of notes from the last meeting, an agenda for the next one, and a call for new ideas.
• If you must, snail mail-but it is costly and slow. Make sure that your dues can cover the costs, and send your mailings out well in advance of when they need to reach people.
• Social support. Regular get-togethers like potlucks and "Kawfee Klatches" allow members to relax with each other and build friendships and trust. (Such gatherings should not replace the regular meetings, however, since they tend to be less economically stimulating than the more structured, formal meetings.)
• Common interests. To nurture bonds among group members, you might unite around La Leche League participation, or form groups around a common interest in church, politics, exercise, a particular hobby, or homebirth.
• Economic support and development. Brainstorm together over low cost advertisements and projects more easily done in a group. A few examples: setting up a referral line or group phone, creating an online newsletter to inform the public about the services offered by members of the birth network, getting a doula group set up at the local hospital, and other special projects mentioned in the fourth and last step of this article.

Step 3: Inform the public

Goal

Use regional and local media avenues to let the public know about the midwifery model of care, and about the wonderful services and events your birth network provides to the community.

Process

Pick up your phone book. Use your town's network of outreach capabilities to reach the public. The media is especially powerful, when it's used ethically and for the purpose of education. Television and radio have the potential to alert many people at once about issues critical to their health and well being.

Seek a place in:

• TV health segments
• Newspaper "help available" sections
• Radio "top personality" programs
• Association journals and monthly newsletters
• Free local informative publications for expectant parents

Story concepts

News is information. News is what is significant, interesting or unusual to the readers who subscribe to the community's paper. The news editor, in turn, measures midwifery-related information on how much it will interest the community. To tap this interest, focus on the human-interest story, and have your tasks ready to go along with the national news. (Timing is everything!)

• Pick a "real world' family to introduce to the community. Offer to provide the names of local couples who decided to have homebirths-if you have their permission, and if this is prudent in your area.
• Have the local Citizens for Midwifery group provide a contact person who is a homebirth mother as well as an activist and birth change agent-someone who is able to present a clear view of the benefits of the midwifery model of care versus the medical model of care.
• Rally local people around a new clinical study, e.g., breastfeeding is best, episiotomies are not necessary. Use science to put across your mission.
• Emphasize national speakers at a conference coming to your town.

Plan radio- and television-worthy events that celebrate the midwifery model of care. You might organize a baby fair at a local college, for example. Be sure to network with other organizations in the birth community.

• Three to four months ahead of the event, send out a bulk electronic mailing to these organizations. (Use the contact list you compiled in Step 1.) See if they will post information on their respective bulletin boards.
• Make a phone call to each organization's contact person. This task calls for strength in numbers: be careful not to place any one person in the position of having to cold-call 50 organizations. If each birth change agent takes just a few names s/he is most familiar with, this task will be very easy.
• After initial contact, send a letter/e-mail explaining the event and (if appropriate) how you would like them on board. Include enclosures/attachments and let them know what you'd like them to do with the information. For example: "please post in your office," "please announce at your February and March meetings," or "please announce in your upcoming newsletter." Invite them to attend future meetings of your group, if it seems appropriate.
• Keep your e-mail (or snail mail) letter simple; in one page include the "what, where, when, why, how, and how much" of the event in concise language.
• You may decide that a generic letter would work well for sending fliers to hospitals for posting. The customized letter, however, enables a more personal connection. Try to find some connection, no matter how small, so that you are connecting in more than one way.
• Personally call key people. When following up with a phone call:
  • Speak to an actual person rather than a machine. Get a contact person so you can reiterate information on a machine, but be sure to call back.
  • Ask the contact person if there is any way s/he can publicize the event for you.
  • Be prepared to send additional fliers, letters and information by fax immediately following the call.
  • Ask for additional contacts to follow up with.
• About a month apart, call your contacts to ask if they want more fliers to hand out or post. Also ask contacts if they have any events that you could come to and announce your event at.
• Don't forget parent activists. Distribute your flyers to Planned Parenthood, maternity stores, ob-gyn offices, children's museums, natural food stores, libraries, and anywhere there are big pregnant bellies en masse.

Create a press release about your event, and send it out to the local and regional media.

• If you are writing a press release, be sure it has an angle. Example: a notable person is scheduled to talk about the midwifery model of care. As you write the press release, you should ask yourself: "what would readers want to know about the upcoming program?"
• Bear in mind that the reader is busy, and wants a concise report of the "who, what, when, why, where, and how" of this event.
• Remember that newspapers are generally short on space.

While you cannot control what the media airs or prints, you can educate the public on the clinical breakthroughs and benefits of the midwifery model of care. The birth change agent has a social responsibility to inform and report on this effective method of care, one that has saved lives that may otherwise have been lost or impaired due to the medical model's view of childbirth.

Midwifery's alternative and potentially preferred model of care for the pregnant woman is a forward-thinking topic for your community to explore. Please know that what you are doing is of local, national, and even global importance!

Step 4: Cultivate special projects

The group now has a network in place, media contacts have been established, and the group can mobilize the network and media as needed to move certain areas forward. Follow-up and tenacity will be the keys to the birth network's continued evolution.

The group should begin working on other projects and connections at this time. These projects, based on the group's evolving needs and concerns, will be what keeps it all going. Projects might include:

• Getting a doula group set up at a local hospital.
• Running a referral line, group phone number for perinatal services.
• Publishing a newsletter to tell the public about your birth network's services. (You could supplement membership dues with advertisements, to pay for production and distribution.)
• Planning another baby fair or expo, in conjunction with local stores and colleges.
• Celebrating the midwifery model with some other newsworthy event.

We leave you with a Taoist image…Like the rippling effect of a droplet of water, each move you make has an effect on the whole universe!

Cynthia Yula is a doula and a student midwife.

Katie Heffelfinger is a mother of three and soon-to-be a traditional midwife.

More information:

To connect with Citizens for Midwifery:
  Web site: www.cfmidwifery.org
  E-mail: info@cfmidwifery.org
  Postal: P.O. Box 82227, Athens GA 30608-2227
  Phone: 1-888-CfM-4880

To connect with Coalition for Improving Maternity Services (CIMS):
  Web site: www.motherfriendly.org
  E-mail: info@motherfriendly.org
  Postal: CIMS National Office, P.O. Box 2346, Ponte Vedra Beach, FL 32004

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