INTERVIEW WITH Dr. BEN TOANE By Gudrun von Selzam previously published in Birth Issues Fall 1999
Gudrun von Selzam : When did you start being involved in home births, and how did your colleagues react ?
Dr. Ben Toane : I started doing home births in April 1978. I recognized that I would need the assistance of midwives to monitor the progress of labour. Several midwives who worked in city hospital case rooms helped me until the late summer/early fall of 1978 when I made contact with Noreen Walker who was present for the birth of my first daughter, Carey, on October 3, 1978. Soon after, Sandy Pullin returned from working as a nurse in Whitecourt to join our home birth team. The atmosphere was extremely charged in those early days as the College of Physicians and Surgeons discovered that I was involved in home birth and made it clear that in the event of any civil litigations by patients, I would find no support from the College for my position. The early books from NAPSAC (National Association of Parents and Professionals for Safe Alternatives in Childbirth) were a source of inspiration and guidance for me. In the absence of any medical support for my position in Alberta and indeed Canada, these gave me support for my position that providing a safe alternative at home was indeed legitimate.
Gudrun : You organized the first meeting of people concerned with child Birth Issues over 20 years ago. What were the motivating factors – the hopes and concerns at that time?
Ben : I soon realized that a large part of the success of a safe home birth program would be to involve the consumer, that is the parents, in organizing themselves. This involved the active participation of parents to express their needs for particular birth experiences, to provide mutual support for each other in the face of a lot of public opposition to what they wanted, and to start the political lobbying of hospitals and licensing authorities for physicians and nurse midwives. I felt that a good way to carry this out would be to form a local chapter of NAPSAC in Edmonton. This would use the umbrella of an already established organization, which was gaining credibility through its conferences on alternative child birth practices and publications available to convince the powers that be that there was some objective verification going on. So, in 1979 I drafted a letter introducing these ideas and sent it to all my patients , past and present, who had expressed an interest in home birth and other alternative child Birth Issues, and to their friends, inviting them to a founding meeting for an association of consumers and professionals. This took place at the home of Ray Rasmussen and Sandra Dowie, with close to one hundred people attending. After a few introductory comments about my hopes and concerns, I turned things over to the meeting itself to establish the origins of the organization, which later formally joined NAPSAC as the Association for Safe Alternativse in Childbirth for Edmonton. The hope was to provide some protection for the professionals from conservative and hostile professional groups such as the College.
Gudrun : When and why did you stop attending home births ?
Ben : I continued to be involved with attending home births until the end of 1980. Sandy and Noreen would attend the labouring women at home and I would come closer to the delivery. Very soon the midwives proved their expertise and I was left to be present as needed for medical back-up, should complications occur. It was very much a team approach with all members of the team providing equal input into decision making. In those early days the biggest thing that I provided was a legal umbrella so that the midwives could function and learn their craft. As home births became more frequent and more public, the College of Physicians and Surgeons flexed its muscles by making it more difficult for physicians to legally involve themselves in home births. They passed a ruling which by the end of 1980 forbade physicians to attend home births unless they had active hospital privileges. I had lost my courtesy privileges at a local hospital because of my involvement in home births. So, in essence, it was a way of trying to stop home births without outright banning physician involvement. There was probably about half a dozen births towards the end of 1980 where I sat in a car outside the door waiting for the birth to occur should I be needed in an emergency situation. In early 1981, despite a comprehensive presentation of research to the College, it saw fit to outright ban physician involvement.
Gudrun : How do you feel physicians can make a difference in the way pregnancy and childbirth is handled these days ?
Ben : Physicians can make a huge difference in the way in which pregnancies and childbirths are delivered. The most important thing they can do it to acknowledge to the pregnant woman and her partner that pregnancy and childbirth are first and foremost normal, natural events which in all likelihood will proceed safely and without complication. I believe that a physician should do everything possible to reaffirm the woman’s ability to birth normally and naturally. He or she can do this by their attitudes and conduct throughout the pregnancy to support what the pregnant couple is doing to educate themselves and prepare themselves physically, emotionally, and intellectually for their birth experience. He/she can do so throughout the labour process by patiently watching the natural process unfold and only intervening if absolutely necessary. Physicians can also involve the patient along every step of the way by educating them and informing them about their options and their ownership of their birth process. The physician has to realize that although he/she may have hundreds of deliveries throughout their career, most parents may have just a few such experiences. These experiences, if made meaningful by their active participation and their taking personal responsibility, will set them on the pathway to more affective and loving parenting.
Gudrun : Please share some of your memories related to ASAC and the childbirth movement with us.
Ben : Probably one of the fondest memories is the actual founding meeting of ASAC in Edmonton. This was the coming together of a passionate group of people in a time of great change and unfolding options here in this city. My compliments are to those early women and their partners who had the courage to stand up for what they really wanted and put their money where their mouths were, so to speak, by forming an organization and doing all the hard work necessary to make their views known. The other very memorable moments were at an ASAC conference in 1981 held at Grant MacEwan College, which was very well organized and involved leading representatives of various options in natural childbirth from the city and from the United States. Physicians and nurses from all over the province were invited and I believe the conference was a real pioneering event in the history of alternative childbirth here in this city. Also memorable were the ASAC sponsored visits by Dr. Robert Mendelson and Shiela Kitzinger to Edmonton. These were two of the individuals who added their genius to this movement. I remember when Dr. Mendelson presented obstetrical rounds at the University Hospital to an extremely hostile reception. As a Chicago-born physician he was completely unperturbed by this response. A very irate obstetrical resident shouted at him from the back of the room stating that he would be responsible for the death of any baby who dies at home in the province. The resident demanded the references to the statements made in Dr. Mendelson’s books: Male Practice, Confessions of a Medical Heretic. Dr. Mendelson clamly told him that all the references where held by his lawyer in a safe in Chicago and that if the resident wanted the resources he could look them up himself. After all, Dr. Mendelson had to do so. He took great delight in translating the name of Dr. Roy LeRiche, a controversial registrar of the College of Physicians and Surgeons in Edmonton, saying, “Only in Alberta would the registrar have the name The Rich King”. It must be added, however, that really we can credit Dr. LeRiche with the establishment of midwifery as a profession in this province, because he single handedly convinced physicians to prohibit their colleagues from attending home births in this province, thereby leaving the door open for the venerable profession of midwifery to find its rightful place.
Dr. Ben Toane is a family physician in Edmonton, Alberta, who has been a long-standing supporter of midwifery and home births. 30 years ago he initiated a meeting that brought together a huge group of people who later founded the Association for Safe Alternatives in Childbirth (ASAC). He practiced with midwives Noreen Walker and Sandy Pullin.
Gudrun von Selzam home birthed 3 children including twins. She is currently working as the Nursery school teacher for the Waldorf Education Society of Edmonton. She has been a member of ASAC since 1992, and a past editor of Birth Issues Magazine.