Thursday, December 17, 2009

A great website

I just found this great website!

Are you using the right type of healthcare provider for your pregnancy? Take this quiz and find out!

http://www.delivermybaby.org/

Wednesday, November 18, 2009

Shoulder Dystocia

I'm sure most of you have heard of Shoulder Dystocia, but does anyone know much about it, or how it's resolved?

From Wikipedia:
Shoulder dystocia is a specific case of dystocia whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below the pubic symphysis, or requires significant manipulation to pass below the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head. In shoulder dystocia, it is the chin that presses against the walls of the perineum


So, the most common way I've seen this handled in the hospital is by using the McRoberts Manuver, which just means pulling your knees all the way back to your ears... followed by suprapubic pressure. The technique is effective in about 42% of cases. Although McRoberts maneuver and suprapubic pressure are generally safe, it is possible to cause maternal injury by performing them.

Personally, I would like to see more of the Gaskin maneuver, named after Certified Professional Midwife, Ina May Gaskin, which involves moving the mother to an all fours position with the back arched, widening the pelvic outlet. I partially understand why it isn't... most women in the hospital have an epidural, and most likely it is heavy enough that quickly moving to an all fours position is nearly impossible.

BUT, for those mothers that can assume this position, the results are good.

One study found:
The most significant observations of the study were the negative findings. No still births or neonatal deaths were reported. Not a single infant suffered Erb palsy, either transient or permanent, and no newborns experienced seizures, hemorrhage, hypoxic-ischemic encephalopathy, cerebral palsy, or fractured clavicle. No patients required any tocolytic medication during labor. No vaginal, cervical, or uterine lacerations occurred. No women required transfusions. And no cases of postpartum, ileus or pulmonary embolus were reported. Overall, the maternal complication associated with the use of the “Gaskin Maneuver” was 1.2 percent (one case of postpartum hemorrhage, transfusion not required), and the neonatal complication rate was 4.9 percent. . . None of these patients required any additional maneuvers. . . Not only was the Gaskin Maneuver instrumental in relieving shoulder impact in every instance, it is also a non-invasive procedure requiring only a change of maternal position.” The average time needed to assume the position and complete the delivery was 2-3 minutes, with the longest reported interval being 6 minutes.

Saturday, November 14, 2009

Cheap Websites?

This is a completely unrelated post, but...

I'm offering to do basic, but nice websites for a great price!

Prices will range from $50 for a basic website with no more than 5 pages, up to $100 for more complicated designs.

You are responsible for securing your domain name and choosing a hosting plan. I will provide your finished website in a zipped folder, which you can upload to your site.

Samples:

www.wiregrassdoulaservices.com
www.aplacetorenew.com

Thursday, November 5, 2009

Just for FUN...

Jill at the Unnecesarean is having a contest! So, just for fun, I thought I'd throw in an entry.

Sunday, November 1, 2009

When VBAC, meets CBAC...


VBAC = Vaginal Birth after Cesarean
HBAC = Home Birth after Cesarean
WBAC = Water Birth after Cesarean
CBAC = Cesarean Birth after Cesarean


For every woman there is an end to pregnancy. Yes, even for those women who's OB's told them they really would stay pregnant forever if they didn't do X, Y or Z. It's an exciting time, anxiously awaiting the impending birth of their new baby.

But, for a VBAC mom, the end of a pregnancy can be bittersweet. There is endless preparation, reading, praying, hoping and dreaming of the long awaited birth. Will they be able to accomplish this? Are they really broken?

If it ends in another cesarean, what is left of that mom? Peace? Emptiness? Gratitude? Pain? Just another scar?

The nationwide VBAC success rate is around 20 percent. But, if you look more closely, you will find better odds. A VBAC mom who is under the care of a practitioner who regards VBAC as no riskier than any other delivery and chooses to deliver in a setting that does not consider VBAC women "high risk,", her success rate is more like 75-90 percent.

So, what does a VBAC turned CBAC mom do?
- Recognize, honor and accept the feelings of loss or sadness if they are present.
- Share your story and feelings with other CBAC mom's.
- Above all, love yourself and your baby.
- Get help if you need it.

Tuesday, October 20, 2009

Unfortunate



Well, this is the newest update in the BIRTH WORLD.

So, here is my 2 cents on the photo....

It's disgusting, and irritating. The fact that they are so out of touch with birth that they can't even spell "doula" or use the correct term for a birth plan shows that they just "decided" to do this and didn't base it on anything, let alone consider the welfare of their patients.

I also would like to know what they plan on doing if one of their patients shows up in labor, and is using The Bradley Method? I'm assuming they have heard of the Emergency Medical Treatment and Active Labor Act.

EMTALA requires hospital emergency departments (EDs) to provide any individual coming to their premises with a medical screening exam (MSE) to determine if an emergency condition or active pregnancy labor is present. If so, the hospital must supply either stabilization prior to transferring the patient or a certification (signed by the physician) that the transfer is appropriate and meets certain conditions.


Are they planning on refusing to accept the woman as a patient and pass them off to some other on call OB?

Honestly, it's GREAT that they have this posted on their wall. Pregnant women know upfront what they are getting themselves into with this practice and can feel free to run the other direction if necessary.

Someone who called the actual office for more information got this:

"I called this clinic and spoke personally to the receptionist, manager, and then doctor. The receptionist and manager were concerned over the fact that I informed them that "doula" was misspelled, and that "birth contracts" were actually birth plans. The doctor was rude and told me that he HATED doulas and didn't care what I thought and didn't care about evidence-based maternity research."


Well, if that isn't a place to end this post, I don't know what is.

Monday, October 19, 2009

Angie's List




Mainstream attention to poor OB decisions, yes.

Friday, October 16, 2009

Myth vs. Reality: Episiotomy

I'm not going to do anything in the way of my own writing, since this basically speaks for itself. You can't always believe your doctor.


Myth: A nice clean cut is better than a jagged tear.

Reality: "Like any surgical procedure, episiotomy carries a number of risks: excessive blood loss, haematoma formation, and infection. . . . There is no evidence . . . that routine episiotomy reduces the risk of severe perineal trauma, improves perineal healing, prevents fetal trauma or reduces the risk of urinary stress incontinence." Sleep, Roberts, and Chalmers 1989

Summary of Significant Points, from Henci Goer's Book, Obstetric Myths vs. Research Realities

>Episiotomies do not prevent tears into or through the anal sphincter or vaginal tears. In fact, deep tears almost never occur in the absence of an episiotomy.

>Even when properly repaired, tears of the anal sphincter may cause chronic problems with coital pain and gas or fecal incontinence later in life. In addition, anal injury predisposes to rectovaginal fistulas.

>If a woman does not have an episiotomy, she is likely to have a small tear, but with rare exceptions the tear will be, at worst, no worse than an episiotomy.

>Episiotomies do not prevent relaxation of the pelvic floor musculature. Therefore, they do not prevent urinary incontinence or improve sexual satisfaction.

>Episiotomies are not easier to repair than tears.

>Episiotomies do not heal better than tears.

>Episiotomies are not less painful than tears. They may cause prolonged problems with pain, especially pain during intercourse.

>Episiotomies do not prevent birth injuries or fetal brain damage.

>Episiotomies increase blood loss.

>As with any other surgical procedure, episiotomies may lead to infection, including fatal infections.

>Epidurals increase the need for episiotomy. They also increase the probability of instrumental delivery. Instrumental delivery increases both the odds of episiotomy and deep tears.

>The lithotomy position increases the need for episiotomy, probably because the perineum is tightly stretched.

>The birth attendant's philosophy, technique, skill, and experience are the major determinants of perineal outcome.

>Some techniques for reducing perineal trauma that have been evaluated and found effective are: prenatal perineal massage, slow delivery of the head, supporting the perineum, keeping the head flexed, delivering the shoulders one at a time, and doing instrumental deliveries without episiotomy. (Others, such as perineal massage during labor or hot compresses have yet to be studied.)

>Independent of specifically contracting the pelvic floor muscles (Kegels), a regular exercise program strengthens the pelvic floor.

Monday, September 28, 2009

Dothan Meeting - Why Midwives?


Join the Wiregrass Birth Network in Dothan for a discussion on the importance of CPM's in the maternal health circle of care providers with Shannon Burdeshaw, ALMA President.

The Alabama Midwives Alliance (ALMA) is the professional midwifery organization for out-of-hospital midwives in Alabama.

ALMA is gearing up for a heck of a year here in Alabama. We are trying to educate a new lobbyist, talking with legislators again and rallying the troops for fundraising initiatives.

ABC and ALMA are working feverishly to legalize Certified Professional Midwifery and increase access to care in YOUR state.

For more information, visit these websites:
www.alabamamidwivesalliance.org
www.alabamabirthcoalition.org

Thursday, October 29, 2009
10:00am - 12:00pm

Episcopal Church of the Nativity
205 Holly Lane
Dothan, Alabama


Contact us at: wiregrassbirthnetwork@gmail.com
Visit us on the web at: www.wiregrassbirthnetwork.webs.com

Ft. Rucker Meeting - Why Midwives?


Join the Wiregrass Birth Network in Ft. Rucker for a discussion on the importance of CPM's in the maternal health circle of care providers with Shannon Burdeshaw, ALMA President.

The Alabama Midwives Alliance (ALMA) is the professional midwifery organization for out-of-hospital midwives in Alabama.

ALMA is gearing up for a heck of a year here in Alabama. We are trying to educate a new lobbyist, talking with legislators again and rallying the troops for fundraising initiatives.

ABC and ALMA are working feverishly to legalize Certified Professional Midwifery and increase access to care in YOUR state.

For more information, visit these websites:
www.alabamamidwivesalliance.org
www.alabamabirthcoalition.org

Tuesday, October 27, 2009
10:00am - 12:00pm
Allen Heights Neighborhood Center, Fort Rucker, AL


Contact us at: wiregrassbirthnetwork@gmail.com
Visit us on the web at: www.wiregrassbirthnetwork.webs.com

Wednesday, September 23, 2009

Oligohydramnios



Oligo-wha-huh?

Oligohydramnios is the condition of having too little amniotic fluid.

What causes it?

Birth defects – Problems with the development of the kidneys or urinary tract which could cause little urine production, leading to low levels of amniotic fluid.

Placental problems – If the placenta is not providing enough blood and nutrients to the baby, then the baby may stop recycling fluid.

Leaking or rupture of membranes – This may be a gush of fluid or a slow constant trickle of fluid. This is due to a tear in the membrane. Premature rupture of membranes (PROM) can also result in low amniotic fluid levels.

Post Date Pregnancy - A post date pregnancy (one that goes over 42 weeks) can have low levels of amniotic fluid, which could be a result of declining placental function.

Maternal Complications - Factors such as maternal dehydration, hypertension, preeclampsia, diabetes, and chronic hypoxia can have an effect on amniotic fluid levels.

Ok, so now for the real post - Should you be induced because your doctor performs an ultrasound and says you have low fluid? Hmmmm..

It depends (as usual). How low is low? An AFI (amniotic fluid index) that is less than 5-6 = oligohydramnios, but...

On the other hand, a low AFI (oligohydramnios) at or near term may be an indication for delivery, either by induction or C-section. If there were to turn out to be a normal amount of fluid with rupture of membranes during an induction, then the low AFI that prompted the induction was either temporary or wrong. - http://www.gynob.com/biopamfl.htm


Notice the word temporary.

Notice the word wrong.

Some interesting information:

It is important for parents to know that this is likely an inaccurate assessment. What the ultrasound technician is doing could be compared to viewing an adult in a see-through plexiglass bathtub from below the tub. In such a scenario, it would be difficult to assess how much water is in the tub above the body that is resting on the bottom of the tub. You might be able to get an idea of the water volume by measuring how much water was showing below the elbows and around the knees, but if the elbows were down at the bottom of the tub, too, you might think there was very little water. This is what the technician is trying to do in late pregnancy—find pockets of amniotic fluid in little spaces around the relatively large body of an 8 lb. baby who is stuffed tightly into an organ that is about the size of a watermelon (the uterus). If most of the amniotic fluid is near the side of the uterus closest to the woman’s spine, it can not be seen or measured. - Gloria Lemay's Blog


Now, how do you know whether is a true case of "Oligo" or not? Well, there are several things that should be taken into account.

What gestation is your pregnancy?

If you are post dates, is the fluid "low" because the baby is big and the assessment is wrong? How do you tell? Why not get some IV fluids and then get another ultrasound? If you were borderline low, is it back into a normal range now? Maybe you could go home and drink drink drink and come back in the morning for another ultrasound?

Is the baby in any distress? Are you doing kick counts and getting 10 movements in an hour?

What if you are only 38 weeks and your AFI is showing 1? Way too low. And induction is probably very necessary.

So, here's the point. If your doctor says, "Your fluid is low, we need to induce.", don't blink blindly and say, "ok". Ask some questions.

What is my AFI?
Did you do a Biophysical Profile, and what are the results?
Can I get some fluids (IV, etc.) and retest?

Can low fluid be dangerous? Of course! And for that reason you should always pay attention to any diagnosis you are given. Oligohydramnios is more dangerous in the 2nd trimester. It is sometimes associated with other dangerous pregnancy complications. True low fluid in post dates pregnancies is associated with labor complications.

The problem is that it is very often hard to determine "oligo" with certainty.

As usual, be an active participant in your pregnancy and birth. There is nothing wrong with asking questions, even if you decide to take your doctors recommendations.


**Blog Post included in the Lamaze Healthy Birth Practice Blog Carnival**
COOL!

Wednesday, September 16, 2009

Red Tent Event

Tuesday, September 15, 2009

A Birth Story

I attended this birth as their doula on Monday. It was a wonderful experience with a room full of love.

Friday, September 11, 2009

Fort Rucker Meeting


Join us for the first Fort Rucker Meeting!!

We will show the movie, The Business of Being Born, with open discussion of the movie to follow. Refreshments will be provided. Babies-in-arms welcome.

10am-12pm at the Allen Heights Neighborhood Center (corner of Christian and Artillery Road).

Contact Amy or Ashley for more information at wiregrassbirthnetwork@gmail.com.

Remember


We Remember September 11, 2001.

The Eleventh Of September
Written by Roger J. Robicheau ©2002

We mourn their loss this day this year
Those now with God, no danger near

So many loved ones left do stand
Confronting loss throughout our land

My heart goes out to those who do
No one can fathom what they view

I firmly pray for peace of mind
Dear God please help each one to find

And to our soldiers now at war
God guide above, at sea, on shore

They are the best, I have no doubt
Our country’s pride, complete, devout

The finest force you’ll ever see
All freedom grown through liberty

One final thought comes clear to me
For what must live in infamy

Absolutely - We’ll Remember
The Eleventh - Of September

Wednesday, September 9, 2009

The Worst Idea Since Routine Continuous Monitoring


I really couldn't say this any better myself, so I'll just refer you directly to the blog post:

The WORST Idea Since Routine Continuous Fetal Monitoring for Low Risk Mothers

Well I have a message for both Trig Medical and Barnev, LABORING WOMEN DO NOT NEED ANY MORE THINGS SHOVED UP THIER VAGINA!!!! And furthermore, CLIPING ANYTHING TO A WOMAN’S CERVIX OR SCREWING ANYTHING INTO A BABY’S HEAD DOES NOT COUNT AS “NON-INVASIVE”!!! LABORING WOMEN AND BABIES ARE NOT ROBOTS THAT DON’T FEEL ANY PAIN OR DISCOMFORT!!!! RESEARCH HAS SHOWN TIME AND TIME AGAIN THAT LESS IS MORE WHEN IT COMES TO LABOR FOR HEALTHY MOMS AND BABIES!!! CONTINUITY OF CARE IS MUCH MORE EFFECTIVE, LESS PAINFUL, LESS INVASIVE THAN ANY “COMPUTERIZED FINGER.”

Saturday, September 5, 2009

Cesarean

Ladies - don't underestimate the cost of a cesarean; on your body, your mind and your baby.



Do your research NOW - http://ican-online.org/

Walk for Midwives


MORE INFORMATION ON SPECIFICS COMING SOON - BUT HERE IS SOME GENERAL INFORMATION!

On October 3, we’ll be joining citizens in communities across the state to help raise funds and awareness as we work for greater access to midwives and better maternity care in Alabama. 

The Walk for Midwives is part of the Alabama Birth Coalition’s campaign to raise $55,000 to support our vital public policy and educational work. A nonprofit, all-volunteer, grassroots organization, the Alabama Birth Coalition relies on the generous support of our sponsors and individual donors to make this work possible.

Get Ready to Walk!

Here’s what you need to do:

Pre-register by September 17 to let us know you’re coming and guarantee your free t-shirt size. Just fill out the registration form and mail it with your donation to Alabama Birth Coalition, PO Box 121, Montevallo, AL 35115. Or you can make a secure donation online via PayPal on our website at alabamabirthcoalition.org and email your registration info to alabamabirth@gmail.com.

Can’t pre-register? That’s okay! You can also register after September 17 all the way up until the day of the Walk. Those registering after September 17 will receive free t-shirts based on availability.

Invite your loved ones to walk with you. This will be a fun, casual event, suitable for all ages, so bring the family with you!

Ask your friends, family, co-workers, and neighbors to sponsor you in the Walk! Just fill out the Sponsor form and bring it along with cash or check donations to the Walk. Your sponsors can also donate online at our website, alabamabirthcoalition.org. Every gift makes a huge difference for our work.

And did you hear? A generous donor has offered up to $25,000 in matching funds for donations to the Walk for Midwives! That means every dollar you and your sponsors give will be matched, dollar for dollar!

To receive a registration form, please email me at apmotz@comcast.net.

Friday, September 4, 2009

New Lamaze Site


Lamaze has updated their site: http://www.lamaze.org/

PLUS... their Care Practices have been updated! They represent "evidence-based care," which is the gold standard for maternity care worldwide...

#1 Let Labor Begin on Its Own
#2 Walk, Move Around, and Change Positions Throughout Labor
#3 Bring a Loved One, Friend, or Doula for Continuous Support
#4 Avoid Interventions That Are Not Medically Necessary
#5 Avoid Giving Birth on the Back and Follow the Body’s Urges to Push
#6 Keep Mother and Baby Together – It’s Best for Mother, Baby, and Breastfeeding

Check out more here: http://www.lamaze.org/ChildbirthProfessionals/ResourcesforProfessionals/CarePracticePapers/tabid/90/Default.aspx

Tuesday, September 1, 2009

The Safety Of Planned Home Birth With Registered Midwife


I found yet another article today about the SAFETY of homebirth... http://www.medicalnewstoday.com/articles/162421.php

The risk of infant death following planned home birth attended by a registered midwife does not differ from that of a planned hospital birth, found a study published in CMAJ (Canadian Medical Association Journal).


While reading through some of the study - this immediately stood out at me:

The rate of perinatal death per 1000 births was 0.35 in the group of planned home births. The rate in the group of planned hospital births was 0.57 among women attended by a midwife and 0.64 among those attended by a physician.

It also found that babies benefited from homebirth:

Newborns in the home-birth group were less likely than those in the midwife-attended hospital-birth group to require resuscitation at birth or oxygen therapy beyond 24 hours. They were also less likely to have meconium aspiration.

Another great point found that those who planned a home birth were significantly less likely to have a third- or fourth-degree perineal tear. I'm going to go out on a limb here and assume this has something to do with the rate of epidurals and episiotomies in hospitals.

To sum up...

Women who planned a home birth had a significantly lower risk of obstetric interventions and adverse outcomes, including augmentation of labour, electronic fetal monitoring, epidural analgesia, assisted vaginal delivery, cesarean section, hemorrhage, and infection.


Need anyone say more? I didn't think so.

Friday, August 28, 2009

Woo-Hoo! Hooray for fruit juice without pulp!


Recommendations Relax On Liquid Intake During Labor

Women in labor may be allowed to quench their thirst with more than just the standard allowance of ice chips, according to a new Committee Opinion released today from The American College of Obstetricians and Gynecologists (ACOG) and published in the September issue of Obstetrics & Gynecology. Although the guidelines on prohibiting solid food while in labor or before scheduled cesarean surgery remain the same, ACOG says that women with uncomplicated labor, as well as uncomplicated patients undergoing a planned cesarean, may drink modest amounts of clear liquids during labor if they wish.


Um... wow. Thanks!

From what I can gather, the risks of aspiration are only a problem when general anesthesia is used (3.5-13% of cesareans), and the technique has improved. I've searched for a study that shows an actual number or percentage of patients who do end up aspirating during a surgery, and I can't find anything. I'm thinking it's NOT at epidemic proportions...

It is honestly ridiculous to deprive every laboring woman of food! Labor is often long and it requires quite a bit of energy.

Obstetrics, yet again, is being practiced via a "one size fits all" mentality. Women with a high risk of needing a cesarean (ie women with known placental problems or other serious medical problems) should be monitored more carefully, but low risk women should not be automatically relegated to this bizarre list of approved beverages.

Ugh.

Sunday, August 23, 2009

This is WRONG on so many levels....


I am shocked... well maybe I'm not... but I am infuriated. This is wrong on so many levels...

Bedtime Feedings - Enfamil

Your baby needs a proper amount of sleep to keep her healthy and happy. That's why we created new Enfamil RestFull, the formula specially designed to naturally encourage a good night's sleep.

* A natural way to help keep your baby feeling satisfied.
* Thickens gently in baby's tummy and digests slowly.


Fact #1: Newborns need to be fed every two to four hours - and sometimes more.

Fact #2: For a new baby, a five-hour stretch is a full night.

Fact #3: One of the suspected deficits involved in some SIDS deaths is the apparent inability of the infant to arouse to re-initiate breathing during a prolonged breathing pause.

Fact #4: Breastmilk (babies preferred diet) digests within 90 minutes.

We need to, as a culture, understand that babies waking often during the night is NORMAL and HEALTHY! As a friend of mine said... "This product is trying to improve upon nature." SORRY! I think nature got it right.

I encourage you to contact Enfamil and let them know your concerns.

Saturday, August 22, 2009

Parents ‘Last Good Bye’ Saved Their Baby’s Life

I can't take credit for this post, but I thought I'd copy it in it's entirety.
(Read the Original Article here.)


It was to be the one and only cuddle Carolyn Isbister would have with her tiny, premature daughter.

Rachael had been born minutes before - weighing a mere 20oz - and had only minutes to live. Her heart was beating once every ten seconds and she was not breathing.

As doctors gave up, Miss Isbister lifted her baby out of her hospital blanket and placed her on her chest.

Life-saver: The mother's hug that kickstarted Rachael's heart


She said: "I didn't want her to die being cold. So I lifted her out of her blanket and put her against my skin to warm her up. Her feet were so cold.

"It was the only cuddle I was going to have with her, so I wanted to remember the moment." Then something remarkable happened. The warmth of her mother's skin kickstarted Rachael's heart into beating properly, which allowed her to take little breaths of her own.

Miss Isbister said: "We couldn't believe it - and neither could the doctors. She let out a tiny cry.

Doing well: Carolyn Isbister at home with Rachael


"The doctors came in and said there was still no hope - but I wasn't letting go of her. We had her blessed by the hospital chaplain, and waited for her to slip away.

"But she still hung on. And then amazingly the pink colour began to return to her cheeks.

"She literally was turning from grey to pink before our eyes, and she began to warm up too."

Four months later, Rachael was allowed home weighing 8lb - the same as a newborn baby - and she has a healthy appetite.

Miss Isbister, a 36-year- old chemist from West Lothian, said: "Rachael has been such a little fighter - it is a miracle that she is here at all. When she was born the doctors told us that she would die within 20 minutes. But that one precious cuddle saved her life. I'll never forget it."

Miss Isbister and her partner David Elliott, 35, an electronics engineer, were thrilled when she became pregnant.

At the 20-week scan at the Edinburgh Royal Infirmary, doctors told them she was carrying a girl and they decided to name her Rachael.

But at 24 weeks a womb infection led to premature labour.

Miss Isbister, who also has two children Samuel, 10, and Kirsten, eight, from a previous marriage, said: "We were terrified we were going to lose her. I had suffered three miscarriages before, so we didn't think there was much hope." When Rachael was born she was grey and lifeless.

"The doctor just took one look at her and said no," said Miss Isbister.

"They didn't even try to help her with her breathing as they said it would just prolong her dying. Everyone just gave up on her."

Ian Laing, a consultant neonatologist at the hospital, said: "All the signs were that the little one was not going to make it and we took the decision to let mum have a cuddle as it was all we could do.

"Two hours later the wee thing was crying. This is indeed a miracle baby and I have seen nothing like it in my 27 years of practice. I have not the slightest doubt that mother's love saved her daughter."

Rachael was moved on to a ventilator where she continued to make steady progress.

Miss Isbister said: "The doctors said that she had proved she was a fighter and that she now deserved some intensive care as there was some hope.

"She had done it all on her own - without any medical intervention or drugs.

"She had clung on to life - and it was all because of that cuddle. It had warmed up her body enough for her to start fighting." Because Rachel had suffered from a lack of oxygen doctors said there was a high risk of damage to her brain. But a scan showed no evidence of any problems.

As the days passed, Rachael began to gain in strength and put on weight. She had laser treatment to save her sight because the blood vessels had not had a chance to develop properly in the womb. And she also had six blood transfusions.

"We couldn't believe that she was doing so well," her mother said.

"Her heart rate and breathing would suddenly sometimes drop without warning, but she just got stronger and stronger."

After five weeks she was taken off a ventilator and Miss Isbister was able to breastfeed her.

Then, after four months, the couple were allowed to take her home - a day they thought they would never see.

Miss Isbister said: "She is doing so well. When we finally brought her home, the doctors told us that she was a remarkable little girl.

"And most of all, she just loves her cuddles. She will sleep for hours, just curled into my chest.

"It was that first cuddle which saved her life - and I'm just so glad I trusted my instinct and picked her up when I did.

"Otherwise she wouldn't be here today."

Tuesday, August 18, 2009

Preterm Birth = Low Progesterone?


An exploratory study to be published in BJOG: An International Journal of Obstetrics and Gynaecology, has shown that women going into early preterm labour (before 34 weeks gestation) have low-levels of progesterone in their saliva as early as 24 weeks, and that moreover, these levels fail to rise during pregnancy in the normal way.


Read more here: http://www.medicalnewstoday.com/articles/158505.php

Monday, August 10, 2009

Mortality Rates

As you can see, the United States' infant mortality rates have risen over the past 40 years:


The CIA World Factbook shows that for 2009, the United States is ranked 46th in the World, with 6.26 deaths per 1,000 live births. See the complete list here.

With all the "advancements" and gadgets we have to monitor and "protect" pregnant women and their newborns, shouldn't we be in the top 5?

Saturday, August 8, 2009

In the spirit of breastfeeding...

Breastfeeding in Bronze


Daniel Edwards' (remember the nude Britney Spears giving birth on a bear skin rug?) latest work, 'Landmark For Breastfeeding,' depicts Angelina Jolie nursing her two babies in the football hold.

I think it's wonderful that we are bringing attention to breastfeeding. That it is a beautiful and normal event in motherhood, but... I can't decide how a really feel about this statue. I am torn between the weirdness of it, and the absolute beauty of the work.

"I totally support shifting societal standards to make breastfeeding anywhere, any time totally cool," writes Celebitchy blogger. "I'm even okay with public art celebrating breast feeding. But to use Angelina's image for it? Just seems weird. Then again, they are raising awareness more with this than with a sculpture of just some random woman breastfeeding. So... well done?"


Now, as for the whole "but it's Angelina Jolie" thing - I honestly don't think it looks a lot like her anyway, but that is maybe beside the point.

I think I'm just going to resign myself to this:

It looks a bit robotic and mechanical, and maybe even a little weird, but I hope the message gets out there regardless.

The sculpture will debut in Norman, Oklahoma in the second week of September, as part of World Breastfeeding Week.

Friday, August 7, 2009

WHY?


Ok, so it's been a few days since I posted. I've been tired and unable to think of a topic to post on.

I attended a birth on Monday that was a bit emotionally exhausting. Mom, Dad and baby are wonderful, and they did wonderful, but I find myself so demoralized just thinking about the birth itself.

Why do OB's think that they need to put down a woman's body to the woman while she is in labor? It is especially irritating when they do it after said woman has received an epidural because she just can't take anymore of the ridiculously and unnecessarily painful contractions caused by pitocin. And you know, "You could have never done this without an epidural. Don't you see how hard pushing is? Can you imagine how much pain you would be in without it?" Well, duh... maybe if you'd left her alone to go into labor naturally, she wouldn't have needed the epidural. Bah!

Being a doula is wonderful. I get to be a part of one of the most empowering and life changing experiences in a woman's life. The birth of her baby. I can't describe to you the feeling of seeing a brand new life enter into the world, and to see a mother born.

But sometimes, being a doula is hard, emotionally. It is hard to sit and listen to doctors or nurses tell women that their bodies are broken, when I know they aren't. It is hard to see a woman lose her voice, instead of find it, when she is about to go through one of the most important changes in her life. When she is no longer only responsible for herself, but for the life of another.

Birth is beautiful. It is amazing. It is hard. It is rewarding, in the most unimaginable way.

"There is power that comes to women when they give birth. They don't ask for it, it simply invades them. Accumulates like clouds on the horizon and passes through, carrying the child with it."
-Sheryl Feldman

Thursday, July 30, 2009

Group B Strep Positive = Antibiotics During Labor... Evidence Based?


This review finds that giving antibiotics is not supported by conclusive evidence. The review identified four trials involving 852 GBS positive women. Three trials, which were around 20 years old, compared ampicillin or penicillin to no treatment and found no clear differences in newborn deaths although the occurrence of early GBS infection in the newborn was reduced with antibiotics. "Intrapartum antibiotics for known maternal Group B streptococcal colonization"


Anyone that has been pregnant knows that at around 35-36 weeks gestation, your OB tests you to find out of you are "GBS+" or Group B Strep positive. This involves a swab of the vagina and usually the rectum and it is sent off for analysis and culture. If the results show that you are GBS+, antibiotics are required during labor to keep the baby from contracting the infection.... or will they?

A new study by the Cochrane Reviews shows that giving antibiotics made no clear difference in the instance of GBS infections.

So, yet again, ACOG and its members are practicing medicine that is not evidence based. At the very least, I would like to see OB's using antibiotics on a case by case basis.

There are symptoms that can indicate that you are at a higher risk of delivering a baby with GBS...

* Labor or rupture of membranes before 37 weeks
* Rupture of membranes 18 hours or more before delivery
* Fever during labor
* A urinary tract infection as a result of GBS during your pregnancy
* A previous baby with GBS disease

Shouldn't we be looking more at these risk factors and treating mindfully, rather then assuming that yet another one-size fits all way of practicing is best?

Looking for some alternative treatment options? http://www.givingbirthnaturally.com/group-b-streptococcus.html

Wednesday, July 29, 2009

The Experience of Birth

Tuesday, July 28, 2009

Wiregrass Birth Network


The Wiregrass Birth Network is a non-profit organization committed to helping women and families have a safe & fulfilling pregnancy and birth experience.

Our goal is to empower women in their roles as health care consumers. We promote an awareness of evidence-based care and informed decision making through advocacy, education and support.

Visit the new site at: http://wiregrassbirthnetwork.webs.com/

Saturday, July 25, 2009

Pregnant Woman = Doormat?


So, I've been reading a lot of articles and stories lately about women who have been treated badly during labor and birth.

Here are just a few:

Skol v. Pierce Update: Doctor Fined and Placed on Probation

New Jersey Cesarean Refusal Case: The "System" is Schizophrenic

Since when did pregnant women become doormats? No one, especially a woman in labor, deserves to be treated like this.

This all has me thinking.

A pregnant woman, like any other competent adult, has certain basic rights. She has the right (for any or no reason) to decline medical treatment. This has long been recognized by the common law in the United States, Canada, England and Australia. (from Childbirth and the law; By John A. Seymour)


It amazes me that in this country you can actually choose to have an abortion, yet you (obviously) can't choose to refuse a cesarean. And while I don't want to open a can of worms in regards to abortion, we need to sort out some facts.

An abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a fetus/embryo, resulting in or caused by its death. (from Wikipedia)


So, an abortion ends in the death of the fetus (or embryo as the case may be), and it is a deliberate act. And if we take into consideration that there are a few doctors in this country that still do LATE term abortions, we can factually say that some abortions are performed on viable fetuses. So, we are legally allowed to cause death deliberately to a potentially viable baby, but we are not allowed to refuse a cesarean (even when fetal distress is the reason given for it).

Abortion = Deliberate Death = OK
Cesarean Refusal = Possible Death = Not OK

Now, I am not advocating for women to refuse cesareans if their baby is in true distress. And I think that most women are smart enough and brave enough to admit that cesareans are a wonderful live-saving tool and a benefit when used judiciously. But to tell a woman that she must sacrifice her bodily integrity to potentially save the fetus's life seems out of line.

Lets talk a bit about fetal monitoring for a moment.

Results were the same in all four studies: more electronically monitored women ended up...with Cesarean deliveries. Cesarean section rates ranged between 63% and 314% higher for electronically monitored women than manually monitored women. There was no improvement in perinatal outcome for the babies delivered by Cesarean section. The principal "reasons" alleged for these surgical deliveries--fetal distress and cephalopelvic disproportion (disproportion of head to pelvis)--cannot be proved or disproved. The real reasons, according to these studies, are attending physicians' impatience and nervousness. (Brackbill et al. 1984:10)


Ok, so according to 4 studies, the diagnosis of fetal distress via electronic fetal monitors which led to an implied life-saving cesarean, showed NO better outcome.

Forgive me, I am failing to see why a pregnant woman's autonomy should be violated...

Friday, July 24, 2009

VBAC


What is a VBAC? Simply put, it is a vaginal birth after cesarean. I talk to a lot of pregnant women. Most of the mother's I speak with who have had previous c-sections will express some interest in a VBAC, but won't follow through. This is unfortunate, because the risks associated with VBAC's are less than those of elective repeat c-sections.

And yes, I did say elective repeat c-sections. This is what they are... elective. You don't have to have one.

Risks to the baby from elective cesarean section:

* Babies delivered by elective cesarean have an increased risk of neonatal respiratory distress syndrome (RDS), a life-threatening condition,3-7 and other respiratory problems that may require NICU care.
* Babies delivered by elective cesarean have a five-fold increase in persistent pulmonary hypertension (PPH) over those born vaginally.6
* Babies delivered by elective cesarean are at increased risk of iatrogenic (physician-caused) prematurity, usually related to failure to conform to protocols for determining gestational age prior to delivery, or errors in estimating weeks of gestation even with the use of clinical data.7,8 Prematurity can have life-long effects on health and well-being, and even mild to moderate preterm births have serious health consequences.9
* Babies delivered by elective cesarean are cut by the surgeon’s scalpel from two to six percent of the time.10 Researchers believe these risks to be under reported.

Risks to the mother from elective cesarean section:

* Up to 30% of women who have a cesarean acquire a postpartum infection. Infections are the most common maternal complication after cesarean section and account for substantial postnatal morbidity and prolonged hospital stay.11
* Other serious complications for women undergoing cesarean include massive hemorrhage,12 transfusions,13 ureter injury,14 injury to bowels,15 and incisional endometriosis.16,17
* Women who undergo cesarean report much lower levels of health and well-being at seven weeks postpartum than women who have vaginal births.18
* Women who undergo cesarean section have twice the risk of rehospitalization for reasons such as infection, gallbladder disease, surgical wound complications, cardiopulmonary conditions, thromboembolic conditions, and appendicitis. Rehospitalization has a negative social and financial effect on the family.19
* Women who undergo cesarean section report less satisfaction than women having vaginal births.20,21
* Women undergoing cesarean are at increased risk of hysterectomy in both the current and future pregnancies.22,23
* The maternal death rate is twice as high for elective cesarean as for vaginal birth.24
* In subsequent pregnancies, women with a prior cesarean have higher rates of serious placental abnormalities which endanger the life and health of the baby and the mother.25-27 Women are rarely told that a cesarean places future babies at higher risk.
* After cesarean section, women face higher rates of secondary infertility as well as higher rates of miscarriage and ectopic pregnancy.28,29

References:
1 Harer WB Jr. Patient choice cesarean. ACOG Clinical Rev 2000; 5(2).
2 Greene MF. Vaginal delivery after cesarean section - Is the risk acceptable? N Engl J Med 2001; 345(1): 54-5.
3 Bowers SK, MacDonald HM, Shapiro ED. Prevention of iatrogenic neonatal respiratory distress syndrome: Elective repeat cesarean section and spontaneous labor. Am J Obstet Gynecol 1982;143(2):186-9.
4 Morrison JJ, Rennie JM, Milton PJ. Neonatal respiratory morbidity and mode of delivery at term: Influence of timing of elective caesarean section. Br J Obstet Gynaecol 1995; 102:101-6.
5 Hales KA, Morgan MA, Thurnau GR. Influence of labor and route of delivery on the frequency of respiratory morbidity in term neonates. Int J Gynaecol Obstet 1993; 43(1):35-40.
6 Levine EM, Ghai V, Barton JJ, Strom CM. Mode of delivery and risk of respiratory diseases in newborns. Obstet Gynecol 2001;97(3):439-42.
7 Parilla BV, Dooley SL, Jansen RD, and Socol ML. Iatrogenic respiratory distress syndrome following elective repeat cesarean delivery. Obstet Gynecol 1993; 81(3):392-5.
8 Hook, B et al. Neonatal morbidity after elective repeat cesarean section and trial of labor. Pediatrics 1997; 100(3):348-53.
9 Kramer MS, Demissie K, Yang H, Platt RW, Sauve R, Liston R. The contribution of mild and moderate preterm birth to infant mortality. Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System. J Amer Med Assoc 2000; 284(7):843-9.
10 Smith JF, Hernandez C, Wax JR. Fetal laceration injury at cesarean delivery. Obstet Gynecol 1997; 90(3): 344-6.
11 Henderson EJ & Love EJ. Incidence of hospital-acquired infections associated with cesarean section. J Hosp Infect 1995; 29: 245-255.
12 van Ham MA, van Dongen PW & Mulder J. Maternal consequences of caesarean section. A retrospective study of intra-operative and postoperative maternal complications of caesarean section during a 10-year period. Eur J Obstet Gynecol Reprod Biol 1997; 74: 1-6.
13 Naef RW III, Washburne JF, Martin RW et al. Hemorrhage associated with cesarean delivery: When is transfusion needed? J Perinatol 1995; 15: 32-35.
14 Eisenkop SM, Richman R, Platt LD & Paul RH. Urinary tract injury during cesarean section. Obstet Gynecol 1982; 60: 591-596.
15 Davis JD. Management of injuries to the urinary and gastrointestinal tract during cesarean section. Obstet Gynecol Clin North Am 1999; 26: 469-480.
16 Wolf Y, Haddad R, Werbin N, Skornick Y, Kaplan O. Endometriosis in abdominal scars: A diagnostic pitfall. Am Surg 1996; 62(12):1042-4.
17 Wolf GC, Singh KB. Cesarean scar endometriosis: A review. Obstet Gynecol Surv 1989; 44(2):89-95.
18 Lydon-Rochelle MT, Holt VL, Martin DP. Delivery method and self-reported postpartum general health status among primiparous women. Paediatr Perinat Epidemiol. 2001 Jul;15(3):241-2.
19 Lydon-Rochelle M, Holt VL, Martin DP, Easterling TR. Association between method of delivery and maternal rehospitalization. J Amer Med Assoc 2000; 283(18):2411-2416.
20 Fawcett J, Pollio N & Tully A. Women’s perceptions of cesarean and vaginal delivery: Another look. Res Nurs Health 1992; 15: 439-446.
21 Waldenstroem U. Experience of labor and birth in 1111 women. J Psychosom Res 1999;47: 471-482.
22 Stanco LM, Schrimmer DB, Paul RH, Mishell DR Jr. Emergency peripartum hysterectomy and associated risk factors. Am J Obstet Gynecol 1993; 168(3 Pt 1):879-83.
23 Bakshi S, Meyer BA. Indications for and outcomes of emergency peripartum hysterectomy. A five-year review. J Reprod Med 2000; 45(9):733-7.
24 Bewley S. Maternal mortality and mode of delivery. Lancet 1999; 354: 776.
25 Zaideh, SM et al. Placenta praevia and accreta: Analysis of a two-year experience. Gynecol Obstet Invest 1998; 46(2):96-8.
26 Ananth, CV et al. The association of placenta previa with history of cesarean delivery and abortion: A meta-analysis. Am J Obstet Gynecol 1997; 177(5):1071-78.
27 Miller DA, Chollet JA & Goodwin TM. Clinical risk factors for placenta previa-placenta accreta. Am J Obstet Gynecol 1997; 177: 210-214.
28 Hemminki, E and Merilainen, J. Long-term effects of cesarean sections: Ectopic pregnancies and placental problems. Am J Obstet Gynecol 1996; 174(5):1569-74.
29 Hall MH, Campbell DM, Fraser C & Lemon J. Mode of delivery and future fertility. Brit J Obstet Gynecol 1989; 96: 1297-1303.

© International Cesarean Awareness Network, Inc. All Rights Reserved.


The most serious risk of a VBAC is a uterine rupture. While this often sounds catastrophic, that is not always the case. Most uterine ruptures occur without symptoms and do not cause problems for the mother or baby. This mild type is usually only noticed when surgery is required for other reasons.

Researchers have shown that women attempting a VBAC and who have undergone a trial of labor have a 1.6 per thousand chance of uterine rupture or 0.16%.

A recent study, The Vermont/New Hampshire VBAC Project, reported that the overall risk of infant death from a VBAC attempt is 6 per 10,000 compared to 3 per 10,000 planned cesarean births.

The rate of uterine rupture rises when labor is induced with oxytocin, prostaglandin preparations, or misoprostol (Cytotec).

Women interested in attempting a VBAC should learn as much as possible about labor, childbirth, cesareans, informed consent and VBAC pros and cons. I also recommend looking into support groups like ICAN and getting the support of a doula or other support person with professional childbirth experience.

A VBAC can be a very emotionally charged and challenging event. But it is often an empowering and healing one as well.

Tuesday, July 21, 2009

Inductions


Ok, so I'm posting about inductions, again. Yes, I'm irritated about them, again. So, here are my lists.

Reasons to induce:
  • Preeclampsia (or worsening preeclampsia/HELLP)
  • Eclampsia (life threatening, usually means a c-section)
  • Chronic high blood pressure that is difficult to keep under control or is affecting the baby's growth
  • Intrauterine growth restriction
  • Gestational diabetes - induction can be indicated at 40 weeks for this, to prevent complications related to the diabetes (risk for stillbirth goes up, blood glucose out of control)
  • Mom has an illness or medical condition that continuing the pregnancy would make the condition worse, or could endanger mother or baby's health.
  • Very low amniotic fluid levels (below 6) - usually confirmed by a 2nd ultrasound -- first ultrasound could have been wrong.
  • Fetal distress or health concerns for the baby based on prenatal screenings (NSTs, biophysical profiles)
  • Post dates (beyond 42+ weeks)
  • Amniotic sac has ruptured but labor hasn't started within 24-48 hours.
NOT Reasons to Induce:
  • Large for gestational age
  • Maternal discomfort
  • Hypothyroidism
  • History of short labors
  • Live more than 30 minutes from the hospital
  • Family will be in town
  • Want to pick the birth date
  • Edema
  • Tired of being pregnant
  • Husband in the military
  • Patient convenience
  • Doctor convenience
  • One or two days past your due date

About one out of every five pregnant women in the U.S. has their labor induced, according to the CDC. You can't honestly tell me that 1 in 5 women have the above medical indications for induction.
“It's really become an epidemic,” said Dr. Mildred Ramirez, an author of the American College of Obstetricians and Gynecologists guidelines and professor of ob-gyn at the University of Texas Medical School at Houston.

The overall induction rate doubled from 1999 to 2006.

Ladies!!! Wait it out. Be firm.

The Birth Survey


If you've given birth in the past 3 years, please take this survey!!!

www.thebirthsurvey.com

The purpose of The Birth Survey is to provide women with a venue to give feedback about their birth experiences with specific doctors, midwives, hospitals and birth centers, and to make this feedback available on this website as searchable reports. These reports currently include overall ratings but will over time expand to include detailed feedback. These searchable reports will be a resource to help other women and families to make more informed choices when choosing maternity care providers and birth settings and provide practitioners and institutions with feedback for quality of care improvement efforts.

Monday, July 20, 2009

Boring

So, I've been trying to decide what to blog about this evening. The kids are in bed, I have the house to myself and I've been searching the internet for some new piece of interesting information for an hour now. So far... nothing has hit me.

So maybe I'll just blog some random thoughts...

1. Every pregnant woman should read the book "Pushed" by Jennifer Block. It is a wonderful collection of information. Read it. Pass it on.

2. My daughter had a hard evening. She refused to take a nap this afternoon and by the time we arrived home around 6pm she was a mess. The screaming and crying ensued and I finally ended up giving her soup for dinner and sending her to bed at 7:30pm. She didn't even complain much. She was tired.

3. Cole has been an angel about sleeping since we got home from Jamaica. He has slept through the night since we got home. This morning I woke up to him standing next to my bed with his arms up. He wanted to nurse. So I changed him, and put him in bed with us and we snuggled and slept a bit longer. I'm going to miss these days.

4. I love my babies, even when they are horrible and run around car dealerships and stores and scream and don't listen and whine and cry and talk back. I still love them... even when I want to rip out my hair.

Ok, well, now I'm even more exhausted, so I'm going to bed.. early. YUM.

Wednesday, July 8, 2009

Pit to Distress


While I feel very lucky that all the births I've attended thus far have been induction and pitocin free, I know there will come a day when a client faces pitocin.

With all the birthy information that I read about or talk about on a daily basis, I have not heard of this. Honestly (and unfortunately), I am NOT surprised. The fact that there is even a need to inform women of this, disgusts me.

"Pit to Distress": Your Ticket to an "Emergency" Cesarean?

“Pit to distress.” How have I not heard about this? Apparently it’s quite en vogue in many hospitals these days. Googling the term brings up a number of pages discussing the practice, which entails administering the highest possible dosage of Pitocin in order to deliberately distress the fetus, so a C-section can be performed.

Yes folks, you read that right. All that Pit is not to coerce mom’s body into birthing ASAP so they can turn that moneymaking bed over, but to purposefully squeeze all the oxygen out of her baby so they can put on a concerned face and say, “Oh dear, looks like we’re heading to the OR!”


Ok, so here is my advice.

First, read the blog entry from Jill at Unnecesarean (above).

Next, read my blog on Labor Induction.

Next, don't induce unless it is medically necessary.

Finally, do some research on pit protocols and ask your doctor and hospital what their policy is. Do they jive? Does it sound like too much? Will they agree to a lower or slower pit induction?

If not... RUN.

Shame on OB's that practice this way.

Tuesday, July 7, 2009

Welcome Baby!

My client due 7/20 had her baby this morning. I'm so glad I got to attend this birth!

She was great. Very calm, very in control. She called me yesterday afternoon to check in after her OB appt and let me know that she was 3cm/100%/btw 0 & +1. WOW! She told me her back was hurting her a lot. I had a nervous feeling, but told her to try some pelvic rocks and hands & knees.

She called me back a few hours later around 6:30pm to ask if she was having contractions. From her description, I confirmed that she was probably in early labor and told her to go rest, take a bath, relax and to call me back in 2 hours to let me know if things had changed.

She called again at about 7pm, to say she was bleeding. She felt like it was a lot of bright red blood, so I told her to call her doctor and ask what he thought she should do. He wanted her to come and get it check out, just to make sure there wasn't a problem. She has a 45min drive to the hospital. I told her I would meet her at there.

I arrived at about 8pm. She was checked at 8:15pm and was 4cm/100%/0. The blood was just bloody show, although a lot of it. She was admitted and we were in a room around 9pm and her antibiotics were started (GBS+).

Around 10pm, her contractions were about 3 minutes apart, and long (double peaking). I got her in the tub and it spaced her contractions out a bit and they weren't as long, and she said she felt a lot better there. After about 30 minutes, she got out and back to the bed to lay down.

At 12am on 7/7, she was checked again and was 5cm, her contractions were long again (90+ seconds) and about 2 minutes apart. Around 2am she went to the bathroom and said she heard a pop and thought her water had broken. She laid back down on the bed and was immediately shaking and showing signs of transition. After saying she was feeling some pressure and grunting, she was checked and was 8cm.

The nurse left us alone (again) and we talked her out of giving up. Several times I looked up at the door wondering why no one was in here checking in. After several contractions of uncontrollable pushing during contractions, I paged the nurse to come. A different nurse comes in and I tell her that she is pushing a lot with each contraction. It's been about 20 minutes since she was last checked. She tells me she will tell her nurse, but not to push (as if I can hold her baby in or stop her). We work to get her to breathe out and that works a lot to keep her from pushing. Finally (at 3am) the nurse comes in and I give her a look... you know the she is ready to have a baby look, and she checks her (she's complete, duh!) and she calls the doctor, and tells her not to push (hah!). I tell her to blow out again, but I don't try and stop her from pushing. She's complete and whether he makes it or not, wasn't that important.

OB comes in and asks how things are going. Watches her push a couple times and leaves. (This doc is kind of funny, he's sort of a interventionist, but he tries to be hands off) At about 3:30pm, she has moved the baby down to almost crowning and doc comes back in. The baby is born at 3:41am.

He is a cutie! Congratulations to the new mom and dad!

Thursday, July 2, 2009

Sleep with your baby!


Ok! So how often have you heard this:

"Is your baby sleeping through the night yet?"


It is often (and unfortunately) the first question people ask a new parent.

The truth is that most babies do not sleep through the night, yet it is a myth that is perpetuated from generation to generation.


Ladies! It is ok! There is no reason for your baby to be sleeping through the night! The fact that they are not, shows that they are developing just as they should. They are bonding. They are attaching. They need you at night, just like they need you during the day.

Parents who are frustrated with frequent waking or who are sleep deprived may be tempted to try sleep training techniques that recommend letting a baby cry in an effort to "teach" him to "self-soothe". New research suggests that these techniques can have detrimental physiological effects on the baby by increasing the stress hormone cortisol in the brain, with potential long term effects to emotional regulation, sleep patterns and behavior. An infant is not neurologically or developmentally capable of calming or soothing himself to sleep in a way that is healthy. The part of the brain that helps with self-soothing isn't well developed until the child is two and a half to three years of age. Until that time, a child depends on his parents to help him calm down and learn to regulate his intense feelings.


Notice the bold that I added. Bet you didn't think about the neurological aspects of sleeping through the night!

The Case Against Solitary Sleep

It's important to note that infant solitary sleep is a relatively new practice that has evolved in the western world only within the last 100 years. Recently, there have been efforts by various medical and professional organizations to discourage parents from sleeping with their children for fear that it contributes to an increase in Sudden Infant Death Syndrome (SIDS). However, new research demonstrates that co-sleeping, when practiced by informed parents, can be safe and beneficial. In fact, many cultures where parents routinely sleep with their children report some of the lowest SIDS rates. In some of these cultures SIDS is non-existent.


In closing! Sleep with your baby! If you aren't comfortable with the baby in your bed, try a side-car arrangement or a bassinet next to your bed. If nothing else, keep the baby in your room! It will help your baby, and it will help you. If you have to get up in the middle of the night with your little one, at least you don't have to walk across the house in a haze.

Happy sleeping!

Ref: http://www.attachmentparenting.org/principles/night.php

Wednesday, July 1, 2009

Special Offers!

Ok, so I've got some special deals running right now. The economy being what it is, I thought I would try to offer what I could.

Check them out here!

Push Summit 2009 in Birmingham!


Push Summit 2009 in Birmingham!

The Big Push for Midwives, is holding “Push Summit 2009” in Birmingham from July 12-14. The nation’s best and brightest midwifery advocates will be convening to discuss state- and national-level strategies for licensure of Certified Professional Midwives.

The summit is expected to draw national media attention.

If you want to be more involved in our state’s licensing effort, this will be an informative event. You may register here.

Please note that they are offering a discounted rate for students who wish to attend.

2009/2010 Maternity Care Excellence Awards


HealthGrades recognized 145 hospitals with a 2009/2010 Maternity Care Excellence AwardTM. This places these hospitals among the top 10% of all hospitals nationwide for maternity care.

These best-performing hospitals consistently outperformed all other hospitals for maternal complication indicators as well as the weight-stratified neonatal mortality indicator (the number of newborns who died while in the hospital, examined by birth weight). Because of these vast quality differences, women should take care to research quality prior to choosing the hospital where they will deliver their baby.


Unfortunately, not a single hospital in Alabama received an award. In fact, the closest hospital that received the award is in Gainsville, FL, 240 miles away from Dothan. North Florida Regional Medical Center

AND... I am not incredibly happy with this study for its cesarean rates....

C-section rates average approximately 32% among the 19 states studied.


Obviously, a much lower c-section rate would be beneficial.

For a complete list of the hospitals, click here.

Saturday, June 27, 2009

Labor Rooms Around The Country

The Brooklyn Hospital Center
Brooklyn, NY



Mount Nittany Medical Center
State College, PA



Medical Center of Lewisville
Lewisville, TX



Simi Valley Hospital
Simi Valley, CA



Cedar Park Regional Medical Center
Cedar Park, TX



Reston Hospital Center
Reston, VA

Saturday, June 13, 2009

Babies R Us

So, the healthy mommy, healthy baby event was a bit of a bust, but I did have the opportunity to meet a few pregnant ladies, so it was well worth it!

I had quite a busy day afterward though. Some friends came over with their kids and we had a small birthday party for one of them. Such fun! The kids played all day and I had ZERO problems getting either one to bed.

I feel great... except that the house is a but messy now, but oh well... tomorrow is Sunday and I can take care of it then. Right now I have a Saturday evening alone to relax and unwind... at least until Cole wakes up... although, he didn't nap this afternoon, only around 10am.... hmmm, maybe he'll sleep for a while!

Friday, June 12, 2009

Frustration

It's really easy to come by lately...

Frustrated because I'm a mom... the kids don't always go to bed peacefully, they throw tantrums, they're whiny or hungry or sleepy or all of the above...

Frustrated because I'm a wife... to someone in law enforcement, and all that comes with it.. the long hours, the weird schedules, the fear and worry, the grumpy mornings from lack of sleep and because the kids are screaming...

Frustrated because I have a job and a business, despite already being a mother and wife.

Frustrated because it's often hard to find money to pay all the bills, not to mention all those random bills that show up when you least need them too.

Frustrated because life is just frustrating... because when you had no responsibility, "life" looked so exciting and easy. Welcome to the real world.

Despite all that frustration, I still love being a mother, a wife, a worker, a business owner, a doula, a birthy woman, an advocate.... I just wish there was a bit more money (hahaha)!!!!

Thursday, June 11, 2009

The evenings happenings...

This evening was full of lively adventures! There was outside play, followed by homemade lasagna...



Yum! And of course, the aftermath of such a meal...



Such fun! And if you are Sophia, you are now driving around the garage...



And finally, after awaking from the lasagna coma, a lovely bath...



Night night!

Wednesday, June 10, 2009

Childbirth Intensive

A 3-hour intensive class on the ins and outs of labor and delivery! We'll talk about the process of labor, the risks and benefits of getting an epidural or going all natural and the real reasons for c-sections. And we'll be a peek at a birth shown in the film, The Business of Being Born.

Saturday, June 20, 2009 from 10:00am to 1:00pm

The class is for couples or moms-to-be, place to be announced.

For more information or to register, please contact Ashley by phone (334/726-9267) or email (apmotz@comcast.net).

Price: $40.00

Babies R Us - Healthy Mommy, Healthy Baby

Come join me at Babies R Us in Dothan on Saturday, June 13th from 9:30am-11:30am. There is a Plan & Scan Baby Registry event happening, along with 3 other local businesses related to pregnancy or babies to get great information from!

See you there!

Thursday, May 28, 2009

OB Consent

So, in being the huge birth junkie that I am, I am a member of several email groups. Today, while reading through some posts, I came across this little jewel...

A Different Kind of Consent Form

Did you know that OB's love to pull out those long and horribly written consent forms when you want to use your rights as a citizen to respectfully decline a treatment, even when that treatment might be worse than declining it in the first place?

It really gives you a lot to think about. While this may not apply to every woman, it often applies to far more than is acceptable.

Don't be a sheep! It is your body, and your baby... and your birth. Do your homework! Read some good books with real research in them. Here are a few...

Think about what your doctor says to you. Does it make sense? Is it logical? Ask questions. Remember, you hired them to be your birth attendant... you are not at their mercy.

Tuesday, May 26, 2009

Running out of TIME!

Childbirth Intensive!

A 3-hour intensive class on the ins and outs of labor and delivery! We'll talk about the process of labor, the risks and benefits of getting an epidural or going all natural and the real reasons for c-sections. And we'll be a peek at a birth shown in the film, The Business of Being Born.

Saturday, June 6, 2009 from 10:00am to 1:00pm

The class is for couples or moms-to-be, place to be announced.

For more information or to register, please contact Ashley by phone (334/726-9267) or email (apmotz@comcast.net).

Price: $40.00

Easy as A B C...

http://www.alabamabirthcoalition.org/

Check out the Alabama Birth Coalition! Get involved... it is YOUR right to birth!

Saturday, May 16, 2009

Labor Induction

One of the most common things that I hear among pregnant women is regarding induction. My insides cringe when I hear "I was induced"...

As our society has slowly placed more and more emphasis on the "due date", we have forgotten that babies don't keep a calendar with them in your womb. Each baby is unique. It grows at it's own pace. And frankly, it should be allowed to pick its OWN birthday. Why? Because it is safer. Safer for your baby, and safer for you.

Babies that are induced before they are ready can have trouble breathing, staying warm and breastfeeding, and they often need special hospital care after birth. In fact, we are seeing a large increase in preterm births, mostly due to the fact that we are inducing and sectioning babies way before they are ready.

It's isn't devoid of risk for mothers either. Research shows that first-time moms who are induced are twice as likely to have a cesarean as one whose labor starts on its own.

Actually, I've only scratched the surface here. The other risks involved are being confined to your bed, IV fluids, continuous fetal monitoring and denial of food and drink. These often lead to epidurals, because induced labors are significantly more painful. Epidurals lead to catheters and internal monitors. They can even lead to an assisted delivery with a vacuum or forceps. AND as mentioned above, inductions often lead to a cesarean, usually for fetal distress or stalled labors. Oh, and did I mention that sometimes an induction just doesn't work at all?

My advice to any pregnant woman... skip the elective induction. No matter how miserable you think you are, no matter how many times your well meaning friends call and ask if you've had the baby yet, no matter how tempting it is to schedule when you are going to meet your baby... be strong, for yourself, for your baby and for your birth.

Thursday, May 7, 2009

Fresh Bread

Freshly baked bread is a wonderful thing. My daughter and I made some today and it was wonderful, or as Sophie says "Yummy!"

Monday, May 4, 2009

Childbirth Intensive

A 3-hour intensive class on the ins and outs of labor and delivery! We'll talk about the process of labor, the risks and benefits of getting an epidural or going all natural and the real reasons for c-sections. And we'll be a peek at a birth shown in the film, The Business of Being Born.

Saturday, June 6, 2009 from 10:00am to 1:00pm

The class is for couples or moms-to-be, place to be announced.

For more information or to register, please contact Ashley by phone (334/726-9267) or email (apmotz@comcast.net).

Price: $40.00

Sunday, May 3, 2009

Babypalooza

I had a booth at Babypalooza yesterday. I think it was a success! There were so many women and babies there, I ran out of brochures and flyers within the first 2 hours!

Thanks to everyone who stopped by and said hello. I met a lot of great new people and saw a ton of beautiful pregnant bellies!

I hope to hear from some of those ladies soon!

Congratulations to anyone that won a prize. That stroller and car seat was amazing!

Wednesday, April 22, 2009

A "birthy" quote for inspiration!

"There is power that comes to women when they give birth. They don't ask for it, it simply invades them. Accumulates like clouds on the horizon and passes through, carrying the child with it."

-Sheryl Feldman

Wednesday, April 15, 2009

Tea Party

Are you attending a TEA party today???

If you're in Dothan, it's from 5:00pm - 7:00pm at the Federal Courthouse on Troy Street, Downtown Dothan. SEE YOU THERE!!

If you can't attend, show your support by honking your car horn 3 times at noon!

DON'T TREAD ON ME!

Thursday, April 9, 2009

Just not a hamburger... please!

So, here is some great justification for not starving yourself during labor! Just do yourself a favor, NOT A HAMBURGER! You'll thank me later.

Eating During Labour Has No Effect On Delivery

Eating during labour does not affect delivery, according to a study published on bmj.com. It also has no effect on the duration of labour, the need for assisted delivery (forceps or vacuum extraction), or caesarean rates.


Read the full article at: http://www.medicalnewstoday.com/articles/143640.php

Wednesday, April 8, 2009

You're a "Crick in the Neck"

So, I woke up this morning with a crick in my neck. I spent the whole day trying not to turn my head the wrong way. So, I decided to look up some info about "cricks", so you won't suffer as much as I have today!

About 75% of "cricks in the neck" are due to a muscle spasm. If you wake up with a crick in the neck, try at home therapies like ice and/or heat and massage. But it's important to go easy on the area in the first few days at least, to avoid making it worse.

Remedy #1: Take a hot towel (or rice sock) and wrap it around your neck for 20 minutes. Take it off and then very slowly move your neck around, up and down and back and forth, but don't "stretch". Then use an ice pack for 20 minutes. Slowly move your neck again. Rest for 20 minutes. Do this every hour until you start to feel better.

Another interesting tidbit is that most cricks are a long time coming. It has been building up for some time and no matter how you slept last night, the crick was coming, like it or not.

Remedy #2: Put lotion on your neck and have someone roll a rolling pin up and down the large muscles along your neck. If you don't have a rolling pin, you can use use a round smooth plastic bottle or such.

Don't stretch your neck! This can irritate and even make worse a crick in the neck. It's fine to slowly move your head (within normal range of motion), but don't stretch the muscles!

If you are still hurting after relaxation, rest and remedies.... head to the chiropractor!

Good luck! I'm off to try to relieve some pain.

Wednesday, March 25, 2009

My Birth Story, Cole Henry

My 2nd Birth...

I woke up around 5am on 2/19/08 with easy contractions, but they were different than the previous weeks. I basically continued on with my day as normal. Contractions were all over the place (which happened with me last time).

My mom came over and cleaned my house (way cool). Around 12pm I got irritated about being in the house and we went and ate lunch at Ruby Tuesday.

When we got home, I cleaned some more and wandered around. Around 4pm I was getting really irritated about where I was in labor, and that I was bored in the house. So, I got everyone together and we took a quick (2 min) trip to my doctor's office to get a "progress report". Once I got there, my contractions started getting worse. He checked me and I was 6cm and 90% effaced. Told me to head on over to the hospital.

We ran home for a few last minute things and went in. My doctor called over to L&D and got me THE BEST nurse there. She has actually looked into opening her own birthing center (but the interest still isn't here). She did all doppler monitoring like I wanted and when they wanted one strip she just held the monitor on me herself for 20 minutes.

Anyway, about 8:45pm I started feeling a lot of pressure all of a sudden and made my husband go get the nurse (she had stepped out for a minute). There was a lot of scurrying about trying to find a doctor. Mine wasn't there yet and the on-call was heading into c-section. My nurse was trying to find a midwife from downstairs while putting on gloves to possibly catch the baby. The on-call walked in (because apparently someone thought I was only at 30 weeks gestation), but stayed anyway to catch.

Pushing was QUICK! His shoulders got stuck for a second or two, but pulling my legs/knees back was enough to free them, no biggie. I felt a big pop when his shoulders came out. Baby was born at 9:06pm. He was 8lbs 5oz and 21inches long (HUGE, more than a pound bigger than my last, who was 6 days past her edd). I had a tiny tiny tear that wasn't really on my perineum and didn't need any attention.

I had a lot of bleeding (again) with this birth AND my water never broke and they had to tear it off the baby.

This was such an easy birth!