The Battle with AZDHS

Justice. Respect for all peoples. Women’s rights. These are issues that have always mattered to me. I have fought for them. I have sacrificed for them. And I will continue to do so until I have no breath.

The story…

Feb 2014, one year ago I attended the birth of a young, healthy, educated, and very strong woman. It was her first baby and this mama worked long and hard to hold her wee one. Just after noon she triumphantly pushed out her baby in a birth tub in her own bedroom. A baby’s cry, shouts of joy and blood. Who knew this normal happy homebirth would lead to a legal battle and a courtroom.

A little background…

In the state of Arizona midwives are licensed under the state department of health – AZDHS. They house our rules and regulate our scope and practice. For the most part our rules and regulations are not unreasonable. However, there are still many places within our rules that are antiquated, inappropriate, harmful and not the current standard of care despite the most recent rule changes. To read our full set of rules – Title_09/9-16.htm#pgfid

The two rules I want to highlight in this story provide a perfect example of how the department of health and their interpretations of our rules make it nearly impossible to do our job safely. R9-16-111 Prohibited Practice; Transfer of Care
B. A midwife shall not accept for midwifery services or CONTINUE MIDWIFERY SERVICES for a client who has or develops any of the following:

25. A postpartum hemorrhage of greater than 500ml in the current pregnancy

First, continuing midwifery services. When something comes up that is on the list of prohibited practice we are to transfer care immediately. As stated by AZDHS – when EMS arrives, the midwife is to walk out the front door, never to have contact with the woman again – (their interpretation of transfer of care). A midwife who has been with a family, caring for a mother and her baby for 9 months is suppose to relinquish care to a less trained, under qualified healthcare worker that is not as skilled in handling out of hospital births and complications. This abandonment of care is unethical, costly to every tax payer, wastes resources that could be better spent else where.

Second, a hemorrhage. 500ml in nearly all medical literature is a normal amount of bleeding after birth. Most literature does not consider a hemorrhage until 750-1000ml of blood. Yet at 500ml midwives have to transfer care to EMS and ultimately the hospital.

So lets go back to our story and read the rest of what happened…

As joy and celebration were happening over this beautiful birth, I noticed a normal gush of blood, then a little bit more. I asked the mama to get out of the pool so I could monitor more closely. Several minutes later the placenta followed as normal. As per our practice and dictated by our rules we watched this mama closely to make sure her bleeding was under control and uterus firm, which it was until an hour after birth. This healthy strong mama released more than

500 ml of blood which our rules state we need to transfer care to a hospital. This mother, being a naturopath, extremely body conscious and capable in making her own health decisions firmly told me she would not go into a hospital upon discussing what my rules dictate. Her bleeding ceased, she was completely stable and yet according to AZDHS rules and interpretation would require me to transport to a hospital.

What was I to do? Go against medical ethics? Go against federal case law? Call EMS against her wishes? Waste precious times and resources of our EMS on a healthy stable person? Have 5-10 firefighters come tromping though her beautiful homebirth to find a completely stable healthy mama that will refuse to go to the hospital?

I respected her choice to not have EMS activated and invade her home only to turn them away. I stayed, as I believe any good and moral midwife would do. I continued care for this new mom through 6 weeks and I do not regret a moment of it.

AZDHS regulation is required to file a report for every client. I filled out this report honestly and openly documenting the accurate blood loss of over 500 ml. I know was turning myself in to a very hostile department of health that would potentially pursue this legally. I had several reasons for full disclosure. I don’t want to hide. I am a damn good midwife, who gives fantastic and SAFE care to all of my clients. I should not have to lie about it. I should be able to document accurately with out fear. I want the department and the world to know exactly what we are doing in order to have accurate accounts. If I did not report this accurately it sends the message that the department’s rules are good and can be followed. There are some rules that put us all in compromising positions and should be changed! I am a justice fighter. I am not afraid of bullies. So I stood strong behind the care I gave knowing it would probably land me in a courtroom, which it eventually did.

April would start my battle. My first email from the department requesting my records was 4/24/2014. I submitted my records immediately. Apparently AZDHS misplaced the first set of records, so the department requested records again on 5/23/2014.

On July 2, 2014 I was served papers of a notice of intent to suspend my license for one year. AZDHS Intent to Suspend Midwifery License for One Year Court date was set for Aug 8. I did not respond, only waited for my Aug 8 hearing.

Sidenote, most of you know midwives are midwives because it is a calling. We are by no means rich, and most of us barely make enough to get by without a partner contributing. That being said, I could not afford a lawyer. I was very confident in standing behind my midwifery care but trembling at the legal system and the games I didn’t know the rules for the impending process. As Aug 8 came closer I was coming to terms with the fact I am fighting the department of health. That is a big and powerful entity and ultimately they do control my license. I very well could lose it for a whole year. Heavy thought, being I am my only provider.

On Aug 4 I got notice that they were postponing my trial to give me time to “negotiate.” As per the history with the department, most midwives negotiate outside the courtroom for a lower penalty. I wanted a formal hearing with an objective view to make a judgement on the midwifery care I provided because I gave the best possible care according to national and international standards. I was not willing to negotiate about something in which I did nothing wrong. So the new court date was set for Sept 16 and I continued to wait.

On Sept 16 I showed up ready to battle confidently. For the next 4 hours I witnessed an administrative law judge question again and again the department’s ridiculous rules and thought processes or lack there of. This judge GOT IT! I didn’t have to do anything, that is how bad some of our rules are. It is evident to all, including our justice system. Since I was self represented, the judge helped me through the legal game. I was not prepared to back up any of my arguments so she left my case open in order to give me time to submit further evidence. It was such a victory for Homebirth and Midwives!

My hearing was kept open for 30 days. I immediately found a lawyer willing to help me write something pro bono. It was eloquent and perfect. I was grateful. We submitted it Oct 13. Wendi’s Final Argument
AZDHS had 2 weeks to respond. On Oct 27 they submitted a uneducated, unfounded rebuttal. AZDHS Final Argument

The judge then had 30 days to make a judgement which put us at Nov 27. When Thanksgiving came and went and the Monday following I still heard nothing from the judge, I called. I was informed the recommendation was to be sent directly to the department and once they make a final decision I could see the judges response. That due date was Dec 15.

Let me take a moment to talk about the waiting game. I believe midwives are the very best at this trait called patience. That really is our job in a nutshell. But the last four months of 2014 were among the most excruciating! In Sept I really started to look at this whole thing as a battle I was ready to fight even if it meant loosing my license for a season. It was worth it to me. This battle was costly. In the event that the department would win and I loose my license for a year, I started to reign back on accepting clients. I looked at it as a sabbatical, a much needed one at that. By the time Nov rolled around I was delivering my “last baby” in anticipation to the impending judgement. I came to peace about stepping away from midwifery and tried to find the good in the situation. In the process, I had to sell my house because I just could not afford payments anymore and I took a job at a restaurant to pay my living expenses. I almost had to file bankruptcy. It was a rough winter, but again, still worth the ultimate fight.

On Dec 15 the final judgement came from AZDHS. AZDHS Final Verdict I also got my hands on the judges recommendation. Judge Lang’s Recommendation to AZDHS
I am not going to give much attention to AZDHS’s judgement because it was ridiculous. They reduced my punishment from one year suspension to one month suspension and 40 hours of CEUs and two years of probation. If the dept really thought I did something wrong and the dept really thought they were in the right and the dept is really going to disregard a judge’s recommendation, then why the compromise?

What I do want to focus on, and give major props to, is the judges recommendation. IT WAS AMAZING!!!! Judge Lang’s Recommendation to AZDHS PLEASE READ IT! It is fantastic. She outlines so clearly all the craziness of our rules. She blames the department completely for putting me and all midwives in this predicament. It is a great read especially for you midwives!

My response to the department was as follows:

To whom it may concern:
I received the judge’s recommendation and AZDHS’s final verdict. Though I do not agree, nor understand the departments blatant disregard for the judge’s recommendation, I will comply to the terms as stated by the department:

“Suspension for a period of no less than 30 days and no more than six months beginning on the effective date of the orders herein. if appellant completes 40 hours of continuing education units that are pre-approved by the department and that are consistent with AAC R9 – 16–105, suspension of more than 30 days will be lifted by the department. The 40 hours of department pre-approved continuing education units must include continuing education units related to emergency measures and procedures.”

I need to know from the department EXACTLY what CEU’s are pre-approved by the department. I need to know the specific PROCESS you want me to follow for pre-approval. I need this information ASAP. I also need to know the firm deadline for the CEU’s to be completed.
As pointed out clearly by Judge Lang, “AZDHS knows that it’s own rules and lack of guidance have put the midwife in this position…AZDHS has known about the potential problem posed by the rules for years and yet has failed to arrive at a solution itself.” I would hope the department will address this sooner rather than later.

I served my one month. I did my 40 hours CEUs. My licenses was reinstated as of January 27. In stepping back from my practice for a brief time I realized a couple of things-
I AM A MIDWIFE. In every sense of that statement, I can not deny it or run away from it. It is who I am and I am SO glad to be back. So all the rumors of me hanging my hat for good can stop. I am back. I am a midwife.

THERE IS STILL A BATTLE. We press on. There is a lot of work to do. Women still need to have their right to autonomy and midwives still need to be protected. Midwives’ rules need to be fixed!! There is a lot we can do legally, but it will take a lot of time and money. I am in it for the long haul. Are you?
For the next steps of involvement –
For updates and continued action items, keep checking
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When was your last Well Woman Exam?

Did you know that licensed midwives do “well woman” exams? Did you know that licensed midwives do kick-ass, amazing “well woman” exams?
We do. And today was just another confirmation that we do fantastic “well woman” care!

Sometimes I like to pretend I am not a healthcare worker, certainly not a midwife and just be a woman. I made my “well woman” appointment with a GYN office hosting several doctors and a CNM just to check out what other offices do, see if I am missing anything or can improve on anything. I met with the CNM who was lovely in every way, a true gem, yet she is stuck in a very broken system. This highly skilled, extremely educate woman could only spend 10 minutes with me. 10 min to connect to our new relationship, make me feel at ease, touch on my medical history, mush my boobs around, stick a speculum in my yoni, and give me a script for a mammogram. WHOA! How did we do all that in 10 min? She did the best she could with the time given.
It just made me all the more grateful and proud of the “well woman” care I, and all licensed midwives, give.

We have a fundamental belief that women are amazing, worthy of love, respect and time. Everything we do flows from that belief.
We schedule an hour for all “well woman” exams.
We spend A LOT of time talking, especially if this is the first time we have met. It is super important to us, not only health history, but current lifestyle. We want to know not just the physical but emotional, sexual, psychological, and spiritual side of a woman.
We talk about all the different tests and procedures to decide together what things actually are appropriate for her.
We do A LOT of education. From breast to yoni, contraception to STD’s.
We encourage women to take an active role in their bodies and healthcare.
We don’t just do a PAP. We offer STD testing, blood work, ultrasounds/mammograms.
We take our time especially with the women who have experienced trauma. We realize this can be an empowering experience instead of re-traumatizing situation.

In our office many tears fall because women feel safe to release, they have found ears to listen. In our office there is laughter as we share common experiences about our crazy bodies. In our office women have seen their own cervixes for the first time. In our office we live and love and learn together. It is for all of these reasons and so much more why we love the freedom midwifery offers every woman.

Call us for an amazing “well woman” exam today!

Red Lentil Soup with Lime and Spinach Recipe

To all who may as yet be unaware:                                

FALL IS HERE!!  Temperature is irrelevant!

Get that colorful cardigan out and begin celebrating the autumnal weather which is so quickly approaching.

Now that the leaves are starting to turn, it’s time to make some festive soups.  Here is a delicious recipe I found for Red Lentil Soup with Lime and Spinach:

Start to Finish: 50 min

Prep: 15 min

Cook: 35 min


2 cups split red lentils (or yellow split peas), picked over and rinsed several times

1 tablespoon turmeric

2 tablespoons butter, divided

1 tablespoon salt

1 large onion, finely diced

2 teaspoons ground cumin

1 teaspoon ground mustard

1 bunch chopped cilantro

Juice of 3 limes, or to taste

1 bunch of fresh spinach, chopped

4 to 6 tablespoons plain yogurt, strained (you could also use plain greek style yogurt)


Place lentils in a soup pot with 2 1/2 quarts water, turmeric, 1 tablespoon butter and salt. Bring to a boil; lower heat and simmer, covered, until lentils are soft, about 20 minutes. Puree in a blender or food processor.

Cook onion in remaining 1 tablespoon butter with cumin and mustard over low heat until soft, about 15 minutes. Stir occasionally. Add cilantro and cook for 1 minute. Add onion mixture to soup and season with lime juice.

Just before serving, add spinach to soup and cook just until it wilts. Top with a swirl of yogurt!

Let us know how you like it, and share your favorite Fall recipes for pregnancy.

Don’t forget to send us your birth story or spread the word to be entered to win a prize!

With love,


Every Woman Could Use A Wife

In the Britannica World Language Dictionary (1956) the definition of Wife is a woman joined to a man in lawful wedlockWhen you look up the word Midwife it says, a woman who assists at childbirthIn my opinion, neither of these definitions are accurate. It doesn’t capture the essence or expected tasks that being a wife means. A wife is a partner, a confidante, a lover, a spiritualist, an interior designer, a therapist, a culinary expert, a psychiatrist, a nutritionist, a doctor, a peer mediator …. I could go on. When the role of wife is defined in rudimentary terms the woman’s power, respect, and significance is lost. These terms put women at a disadvantage both mentally and physically in today’s society.

Women are now afraid of their strength and their own bodies.  When I thought about having a child I always assumed it would be in the hospital, on drugs, ending with a cesarean section. Discovering the world of midwifery I can’t believe I ever accepted this as my only option. Having a child is something my body does naturally. I’m not sick, so why go to a place that only deals with illness? Won’t they treat my labor as an illness instead of a miracle? Reading Spiritual Midwifery by Ina May Gaskin opened my world up to new possibilities. It made me realize that midwifery got a bum rap and it started with how it was defined.

I was trying to think of a new term for Midwife. Since my imagination is pretty wild sometimes, I thought about how Midwife and Midlife Crisis sound sort of similar. What if we defined the word Midlife Wife? How would that go? What could that show?

I think it’s safe to say that Midlife Crisis is when you reach a point in life where you look back on where you came from, where you are, and where you’re going. At times, this causes extreme reactions with some individuals and they do things so they can feel new, transition, and change their world. They want to feel alive. Midlife, describes the time in which this transition occurs for people. Doesn’t having a baby take up a good chunk of the middle of your life? Aren’t you in transition when you choose to have children? Doesn’t that mean constant change? If the word Wife was defined as a support, a friend, a project manager, a cleaning woman, a teacher, a counselor, a healer … then as a woman, wouldn’t you want a wife to help you through one of the most significant moments of the middle of your life?

I don’t know about you but that blew my mind! A Midlife Wife is there to nurture a fellow female so she can blossom and serve her true biological purpose. Childbirth is a miracle, a blessing, and a right of passage. It makes us one with the universe. As the universe creates life, so do you. It is a spiritual journey that only we can do. They say man rules the world, well ladies, we make it! You tell me which has the true power. Who would you prefer helping you? Face it ladies, childbirth is a big deal and every woman could use a Midlife Wife. There will always be a reason to appreciate the nurturing hand of a female that understands.

Don’t forget to send us your birth story or spread the word to be entered to win a prize!

Peace and Blessings,

Old Earth

Be in the know about the Ocotillo

Ocotillo is one of my beloved desert plants. So you can imagine how pleasantly surprised I was on my hike to find all the rain caused this amazing healer to explode with life! These pictures do not do justice to the beauty these plants exude.



A couple of interesting facts about Ocotillo –

The leaves are delicious and super nutritious! Especially when they first burst out of the limbs. The mineral content of a couple leaves is huge! I like to nibble on them as I hike or harvest a handful for my salad.

The inside bark of the limbs can be harvested to aid in poor circulation especially in the pelvic region. Symptoms of pre-menstrual congestion, bloating, prostrate enlargement can all benefit from Ocotillo. It is also great for urinary tract support and to aid our bodies in fighting urinary tract infections (UTI).

The red-orange glowing flowers that light the tops are powerful energy medicine. The flower essence of the Ocotillo gives insight into and acceptance of our emotions without feeling victimized by them. It is soothing, calming, and grounding especially in emotionally charged events. Ocotillo flower essence also helps us in our inability to express emotions or to understand one’s feelings.

I made a fresh batch of the flower essence and it is available in the FATS office.

Enjoy these picture and then go for a hike and enjoy this exquisite plant!

For more info visit – Desert Bloom Herbs

Much love ~ Wendi

Don’t forget to send us your birth story or spread the word to be entered to win a prize!