Today on Science & Sensibility, I congratulate the Cochrane Collaboration on their 20 year anniversary and remind Lamaze International members that full access to this gold standard of evidence-based research. To read the whole post and learn how you can use the Cochrane Library for finding out current best practice, check out my post; Happy 20th Anniversary to the Cochrane Collaboration.
This blog is a bit stagnant as I have been appointed to the Community Manager position at Lamaze International’s Science & Sensibility blog. Come on over to see what I am writing about!
Well, here I sit, in my own favorite chair, in my own living room, with my laptop balanced on my legs, and the sound of jet engines slowly fading from my ears! What a trip!
I am just back from the Lamaze International Conference in Orlando, Florida. Two days doing Disney “things” with my kids, (and trust me, two days was about 1 1/2 too many for all of us, but that is another story!) then on to the Conference.
The conference was held in the Coronado Springs Resort, in Disney. This place doubles as a million football fields all strung together! It is HUGE! HUGE! Like, if you leave something in the exhibit hall and are now in a breakout session in another room, and want to “run” back to get it, count on 20 minutes! Seriously, but enough griping!
I got to meet so many people that I have only heard about and read their material! Robin Weiss, who writes both pregnancy.about.com and many books as well as blogs over at The Birth Activist. I met Rixa Freeze, who received the Safe and Healthy Birth Media Award in recognition and appreciation of her engagement of new media and reaching childbearing women with critical messages about safe and healthy birth practices/ Her blog is on my blogroll, Stand and Deliver I met the blogger responsible for the great blog Mom’s Tinfoil Hat, who is in med school to become an OBGYN!. I looked for, but couldn’t find Amy Romano, who does the Lamaze Science and Sensibility blog. I also couldn’t find the blogger Reality Rounds, another one I love! I got to give a hug to Katy Rawlins from Idaho, who was presented the Safe and Healthy Birth Advocate Award in recognition of her promotion of safe and healthy birth and its contribution to childbearing women and their families. I got to meet Debbie Amis, who was was presented the Elisabeth Bing award in appreciation of her continued efforts to train and mentor new Lamaze childbirth educators. She also has a great blog that I love.
I got to clap really loud for my dear friend Teri Shilling who was presented the Lamaze International Award in recognition of her significant contribution to expanding the reach of Lamaze childbirth education around the world. I also met Barbara Hotelling, Ann Tumblin, Pat Predmore, Marilyn Hildreth, Ann Israel, and the list can go on and on, I probably left out many others, such a crowd of women (and a very few men!) who know that birth matters and how babies and women are treated during pregnancy and birth is important.
Another high of the conference was that I was a speaker! My session was “Working Your Magic!” The Educator’s Role in Reducing the Fear of Pain.” I had a blast and the session was received very well by the almost 90 participants! The attendees got to rock and roll during a realistic labor simulation with lots of ice! just like my clients and students do!
So many more things to say, but my head is spinning from lack of sleep! We got up at 1 AM Seattle time, in order to catch our very early plane out of Orlando!
I am renewed, encouraged, excited and proud to be a childbirth educator, doula and doula trainer! I know that what I do matters and I look forward to growing my business and improving my skills from all that I have learned this past week at the conference!
I am so excited that I have been invited to joined my friend, Teri Shilling, as a “Passioneer,” with Passion for Birth. I am training under Teri to become a Lamaze trainer of Childbirth Educators. My first assignment is to help Teri with an upcoming Seattle Passion for Birth training in November! I can’t wait. I think that what Teri does just rocks! She is creative, accurate, up to date on all the new research and presents material in an absolutely engaging and memorable way!
These are all the skills I strive to have as a childbirth educator and I am delighted to be able to learn from the master! I have found my students get so much more out of my class, when I add in the tips and techniques that Teri so aptly demonstrates.
If you have ever considered becoming a childbirth educator, here is a great chance to learn some fantastic skills, learn about the Lamaze Childbirth Educator certification process and be absolutely amazed at how fun teaching childbirth classes could be. The three day class is scheduled for November 16-18th and the training site is right on Puget Sound in Seattle. Right on the water!! One could throw a placenta right into the water, if you wanted! Beautiful views of the Olympics, sounds of gulls and sea lions and the smell of the salt air! And a Passion for Birth!!!! Won’t you consider joining Teri and I at this engaging, fun filled training? For more information and to register, check out Teri’s seminar information page on her website. See you there!
The week of September 21-28, 2009 is International Babywearing Week! Thank you to my friend Teri Shilling at Passion for Birth for bringing this to my attention and sharing some great resources!
I LOVED wearing my babies. Well, confession… my first daughter rode in a sling or other baby carrier occasionally and then a backpack frequently when she got older!. But, by the time I had my second daughter, I needed my hands free to hold my older child’s hand or push a shopping cart or carry things or….and I turned to a classic ring sling for my babywearing needs. My good friend Natalie Steiner gave me some quick lessons and I realized all I had done wrong the first time. Now, I was hooked!
I ordered a custom made sling in fabric I chose, along with a smaller matching sling for my older daughter to carry her babies in too! I was so excited and I am pleased to say that my younger daughter settled comfortably into her sling three days after birth, and neither of us ever looked back! I chose to leave the infant car seat carrier in the car, and get into the habit of taking my daughter out of the car and into the sling every time we went anywhere. No dragging that heavy, clunky, back-breaking carseat anywhere, no need to place it on the floor near all the dirt and grime and feet of the “outside world,” no need to fear all the hacking, coughing old ladies at Ballard Market who wanted to come up and touch my baby riding in her carseat on the top of my shopping cart! Oh no! My daughter was snuggled on my chest, usually fast asleep, or sometimes even nursing…safe next to my heart!
I wore out that lovely custom sling and two more additional slings (including one I made from an Elizabeth Lee Designs pattern) until they were threadbare from, from constant 18-hour/day use! The sling went on my body when I got dressed and came off when I went to bed…sounds extreme, but it worked for my family. I took my daughter to Europe for 3 weeks when she was 15 months old, with only a ring sling for carrying her and it was great!
One of my favorite parts of being a doula is meeting with my clients and their new baby for the first postpartum visit sometime between day 3-5. We cover all the important stuff like breastfeeding and mom’s recovery, but I always make sure to save some time to get their new little one into a baby carrier, (I bring a few of my own, in case one isn’t handy!)
It is especially heartwarming to see the partners so proudly wear their baby, and realize how easy, convenient and soothing it can be for both baby and parent! Way better than the teddy bear we practiced with at the prenatal visit!
If you are expecting, consider wearing your baby! It is good for your baby, good for the parents and the way it has been done for all time! If you are an experienced babywearer, comment to this post and let us know what type of carrier you like best and why, and how we can source them (weblink) and I will add that information to my resource page!
Enjoy this short but wonderful video on babywearing and celebrate International Babywearing Week by keeping your baby kiss-ably close in your arms, in a baby carrier!
More info on babywearing can be found at Babywearing International
When I am teaching childbirth classes and doula trainings, I “sing the praises” of singing or toning in labor! When a woman opens her throat and her mouth and vocalizes, sings, chants, tones or hums during labor, it helps to keep her bottom and perineum loose and relaxed. Ina May Gaskin, the famous midwife and author of several books, including my favorite “Ina May’s Guide to Childbirth,” says in her books; “loose lips, loose perineum.” I believe that whole-heartedly.
I just came across a new favorite video of a woman singing her way through transition (8-10 cm) and wanted to post it here, along with an older favorite as well! I often show these in class and everyone clearly sees the power of the song!
Watch these two clips and enjoy the power of birth as the women sing their birth song! And if a birth is in your future, consider adding song to your labor toolbox.
(and as a side note, I once had a very talented voice professional as a client, and prenatally, I suspected that vocalizing would be one of the things that would work for her as a coping technique in labor. Reality: during her unmedicated birth, there was no toning or singing! But she did state repeatedly in a very loud, vocal manner, “My ass is gonna explode,” as she powered through a very intense transition! Such a unique birth song!)
This week, The American College of Obstetricians and Gynecologists (ACOG) released “updated” recommendations for eating and drinking in labor. Recommendations Relax on Liquid Intake During Labor is the title of their newest Committee Opinion, and I fear it is already hopelessly outdated before the ink is even dry on the page!
The newest recommendations “allow” women to consume “modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks.” While this is certainly a big improvement from the “ICE CHIPS ONLY” policy that has been around forever, it hardly seems like the kind of nourishment one would want a laboring mama to be limited to, when she is doing the magnificant, powerful, hard work of birthing a baby!
I could go on and on about how this “new” policy makes no sense, alas, another blogger has already done a much better job than I ever could! Head over to The Family Way Publications Blog and read how a person has more of a chance of being struck by lightening TWICE in one year, than they do in dying from aspiration in labor!
There, you can also follow links to studies examining the true risks of eating and drinking in labor, find out that the American Society of Anesthesiologists (ASA) announced more than 11 years ago, that women should be allowed clear liquids in labor, and read how the American College of Nurse-Midwives (ACNM) recommends counseling women on the rare risk of complications from eating in labor, and encourages laboring moms to make a decision from a place of informed choice!
As a doula who has attended more than 130 births and a childbirth educator who has listened to probably 500 birth stories over the years at all those birth class reunions, I have always been impressed with the wisdom of women and their bodies to know when it made sense to eat and drink in labor and when they needed to cut back!
The fact is, women who are working crazy hard to have their baby, are just not asking for a cheeseburger between contractions! And, if they are, my bet is they have a ways to go before baby is earthside, and we would all benefit from making sure that she is eating and drinking to appetite and thirst.
Women who are denied adequate calories, energy and sustenance during birth often end up with longer labors, less energy and stamina as the hours drag on, and increase the risk of unwanted complications and interventions…all because they are running out of “steam” on their ice chip diet!
I encourage my clients to eat easy to digest foods (grapes, nut butters, eggs, yogurt, toast, melon, pasta, brown rice, yummy soup, strawberries, bananas…you get the idea), good quality proteins and carbs and plenty of good liquids like Recharge (a natural gator-ade product with no corn syrup or strange artificial colors), Emergen-C and my favorite, Bolthouse Perfectly Protein drink, (my fave flavor is Vanilla Chai) throughout labor, as long as they can, and to drink at least diluted juice till birth, even when they can’t eat anymore, just so they have calories going in!
I have seen eating and drinking in labor make all the difference in how the birth goes! And I have seen how quickly women fade and lose necessary energy and strength when denied nourishment! (1000ml of Lactated Ringers on your IV pole is not an adequate replacement for good quality food and drink!) If you are having a hospital birth, I encourage a dialogue with your doctor or midwife about both their philosophy around women eating in labor, as well as the policies of the birth center or hospital. Listen carefully and make your own choices about what you and your body need during your labor and birth! I deeply believe that women know what is best for themselves and their babies!
And if you have a minute, share your favorite labor/birth food and drink ideas and stories from a client or your own birth! Post your comments here!
PS: Don’t forget that partner also needs good fuel to get him/her through too! Remember that!
The United States of America, world’s largest, (financially!) most powerful country, land of opportunity, the home of the “American Dream” takes their place in line behind 48**other countries when it comes to infant mortality. Infant Mortality is defined as the death of an infant under the age of 1 year per one thousand live births. 48 other countries, including Slovenia, Cuba, and Cyprus have better infant mortality rates than the USA!
Why? We must ask why! And we must demand better from our medical system, from our government, from our social systems! Frankly, I think this situation is disgraceful!
We deserve better, our mothers and babies deserve better! Debbie Takikawa is the woman behind the project and the film, and she encourages all of us to do the following:
Send this videolink to your legislator!
Write your legislator!
Support the midwifery model of care for low risk women!
Share this on your facebook page, blog about it, Twitter!
Check out Debbie’s website and learn more. Only working together, can we as a country climb out of the big hole we are in and better out position on this very important list! Our babies depend upon us!
**Source: Population Reference Bureau
I was so pleased to read today that the State of Washington is taking away any financial incentive for medical providers who do Cesarean surgeries covered by Medicaid. Almost half the births in Washington are covered by Medicaid and paid for by taxpayers dollars. Now, doctors and hospitals will receive the same payment for an uncomplicated Cesarean surgery as they would for a complicated vaginal birth.
To read a wonderful analysis of the new legislation, check out Carolyn McConnell’s article in CrossCut: Take away the incentives for too many c-sections
Maybe the State of Washington can lead the way in reducing the rate of Cesarean sections, saving more than 10,000 women a year from undergoing unnecessary surgical births and supporting the availability of VBACs in our hospitals, and dare I say, even our birth centers too! While we are at it, let’s make midwifery care available to all low risk women, and send our high risk mamas to the OBs! But hey, that’s a post for another day! A girl can dream, can’t she???
I was reading one of the many birth blogs I follow, and came across this wonderful HBAC (Home Birth After Cesarean) birth story about a strong woman who worked very hard to have the birth she wanted second time around! I encourage you to head over to Women in Charge and read about this great birth! But the part that struck me most of all, that I will immediately add to my toolbox when I work with any birthing woman is the following:
My mantra was that I be yoga’s corpse pose in between contractions. It worked. I slept. I had prepared by meditating on a chart given by my hypnotherapist of a typical hour of active labor – a 1.5 minute contraction divided into three equal parts is, 30-seconds rise, 30-seconds peak, 30-seconds fall. Being 3 minutes apart, as contractions usually are in this stage, means that in one hour, there is 15 minutes of contractions, only 5 of which are peak, leaving 45 minutes of absolute nothing – REST.
When you do the math, it really works out to 7 minutes/hour of peak contractions, but hey, the birthing woman was in laborland! I just love this image! ONLY SEVEN MINUTES OF PEAK CONTRACTION SENSATIONS IN AN HOUR! We can do that. right? Seven minutes of hard peaky contractions in an hour! You bet, with support, and trust and patience, a birthing woman can do this for an hour, and another and even another, if need be!
I can’t wait to share this mental image at my next prenatal meeting with clients! Maybe I even bring some colored pencils and paper to our prenatal, and we draw a wonderful pie chart or other representation of the seven peak minutes of contractions that occur in an hour of labor!
I will let you know how it is received. And I would love to hear your favorite visualization tip that works well for your clients. Share with me and let me learn!
Birth Matters Virginia announces the winners of their recent video contest, and first place goes to “Prevent Cesarean Surgery,” chosen from more than 40 outstanding video submissions! Ragan Cohen from California submitted this stunning production that is at times hard to watch, but contains a very important message! With the United States approaching a 32% cesarean rate, highest C/S rate ever, and some hospitals (in Florida) with stats that indicate 70% of their babies are born by cesarean, women need to stand up, educate themselves, and be an educated consumer of their maternity care! Enough is enough! Women take back your births! Thank you Ragan for this great effort at turning the tide! And thanks to all the people who submitted videos for the contest, I have enjoyed watching most of them! What a resource for all of us!
All of the submissions are worth watching, particularly those that took top honors! Watch, learn and share with those who are finding their way in our rocky maternity system! Do what you can to help more women achieve their birth right and birth their babies free from routine interventions and unnecessary surgeries. Support our midwives who are doing what they can to support normal birth! We can make a difference, one birth at a time.
I read a great blog post today by a Certified Nurse Midwife about the usefulness (or actually, the possible emotional harm!) of vaginal exams prior to the beginning of labor. I think this is a great read and good information to take to heart, and have at times said exactly the same words to both clients and class participants. I already posted this over at the ICAN Seattle blog, ( I am the co-leader of the Seattle Chapter) but felt it was so good, I needed to get it up on my own blog too!
The question I always ask is this…. ‘Will the information gained from THIS vaginal exam change what we are going to do today?’ In your present situation, unless you are considering being induced a vaginal exam is irrelevant. What do I mean irrelevant…it does not change what we are going to do TODAY and things can literally change overnight. Because of this, I encourage you to avoid all vaginal exams until you think you are in labor and are having a labor check or you are preparing for an induction. I encourage you to let go of your current cervical change expectations and focus on getting your mind ready for labor and motherhood. You can go from closed to delivered overnight. It will happen. Don’t start to doubt and don’t start to worry. Your body and your baby know the perfect time to move to birth.
Recently I had a student in a class come to me during a break and ask me if spotting, crampiness and some contractions were normal at 33 weeks. I told her that those symptoms might be a reason to check in with her Health Care Provider, as they might want to rule out pre-term labor. She went on to tell me that she had had an appointment the day before, where a vaginal exam was done, that was fairly painful.
Ever since then, she had been feeling some contractions and cramps. When asked why the exam was done, she could not tell me, other than her HCP suggested it. I honestly did not know what to say, and wondered to myself if this woman was going to be birthing a 33 weeker because some things got stirred up when they should have left things alone. I did encourage her to check in with the provider, and am pleased to report that after another day, things settled down and she has not yet gone into labor!
Skip over to read this entire blog post by It’s Your Birth Right; Skip This Routine and think about keeping YOUR pants on if you are not in labor!
I am writing this letter to you, my clients, to thank you! Thank you for showing me strength, grace, power and absolute fortitude during the labor and birth of your beautiful daughter. I was honored to witness this fundamental power during your recent birth! It has changed me forever.
I remember when we met to discuss working together at the birth of your baby. You shared your fears, your concerns and your doubts. Tears were shed. As I got to know you, I listened as you expressed your thoughts and self doubts about your own strength. So many things to worry about, so many unknowns.
As you neared the end of your pregnancy, so many deadlines and obstacles arose that required you to prove that you and your baby were doing well. As your due date came and went, you wondered why you were still pregnant, yet you knew that your baby would choose the date of her birth. Balancing doubt and belief became a daily struggle, and you still forged on, waking up each morning, surprised that you were still pregnant. Acceptance and peace settled slowly, and you found your rhythm to wait for your daughter.
And then, labor started. Contractions regular and intense, starting as midnight drew near, needing to breathe through them and pay attention….this continued, throughout the night, with little sleep, during the day and onwards through a second night. Exhaustion was huge and the question about why things were not progressing? and still you soldiered on! Another day and evening, and then a spontaneous release of water after 48 hours, and things kicked into high gear. Active labor started and you never looked back! Strong contractions dilated your cervix and you found your groove. You got down to the hard work of birthing your baby, without complaint, without question, so calm, so intent and so intentional! The questioning, uncertain woman who expressed doubts during pregnancy was nowhere to be found. In her place, a strong, powerful woman, loose, fluid and laboring. Internal and composed. Accepting and strong.
And when things were at their most intense, you looked inside and found strength to advocate for yourself and your daughter. During the most vulnerable, most intense, final hours, you were composed and grounded! I listened and watched as you found your voice, in a way that few women do, ever in their life, never mind at 9 cm in labor! I was and continue to be in awe of your actions and thoughts and your conversations with your health care providers, speaking your mind and your intent. You are woman who can do anything! I hope that as you reflect back on this experience, you recognize how powerful and capable you are! Your daughter should grow up knowing what a strong, capable woman her mother is, and how lucky she is to have you as her mom.
Thank you for letting me support you and watch you in all your glory, as you brought forth your daughter! I am in awe of your power! Thank you!
I am so excited about the news that The Transparency in Maternity Care Project: The Birth Survey results are now available to everyone! You can search this dynamic database for information on all the providers (OB, CNM, LM, Family Practice) and birth locations specific for your area! You can read how women who have given birth in the past three years at these locations and with these providers rate their satisfaction in many categories! And you too, can rate your provider or birth location as well, sharing the information on your own personal experience. This is just so powerful, that I am giddy with excitement! Consumer information and ratings on maternity care by provider and location is a long time coming. Now, women and their families expecting a baby can make provider and facility selections based on knowledge and information that is current and reported by other consumers with recent experience with those providers and facilities!
Information available includes:
The consumer reviews just launched include:
- Overall ratings and recommendations for birth facilities and care providers
- A seven-item set of questions on providers’ interpersonal and communication skills
- Facility intervention rates
- Information on finding good care.
- A national average of ratings is also displayed to provide comparison with individual ratings.
If you looking for a provider or birth location go here, and click on connect to check out the survey results.
And if you have given birth in the past three years, take a few minutes to share your experience here, by clicking on the share link, so that others may benefit from your recent birth experience.
I think this is really big, and maybe the beginning of change, women sharing information so that others can make informed choice! A huge thanks have to go out to The Coalition for Improving Maternity Services (CIMS) for making this possible. Check out their fantastic website just jam packed with important information for expectant families!
Being a birth doula involves waiting. Waiting for babies! Babies who come in their own sweet time! Babies who have their own secret, internal clock that we mere mortals can only hope to understand! Here I sit. On call! I am usually on call. I am on call for most of the year, probably 48 out of 52 weeks. What that means is that at any time of day, or night, I can expect a phone call from a client telling me she needs me. Or telling me she doesn’t need me, but just wants to update me. Come now. Come later. What that means is that my phone is always on and always close. What that means is that I need to always be sure to get enough sleep, go to bed at a decent time, so that I can be ready for a 1 AM phone call. I am waiting now. A woman will be asking me to join her soon! This I know, as she is now admitted to a local hospital for an induction after spontaneous rupture of membranes in the pre-dawn hours of yesterday! And no labor, as of yet, so a push to get things rolling. Hopefully, a gentle push.
Since the news of yesterday’s events, I have been on “high alert.” High alert, I suppose is more alert than normal, of which I already am always on alert. Is that possible? With every action, with every errand, with every event of my day, I calculate, “What do I need to do, in case I get the call NOW!” Sometimes, this can be exhausting. Very exhausting. Emotionally draining. For the doula and also for her family. Thankfully, I have been doing this for more than 6 years, and my family rolls with the punches well. But, the waiting doesn’t get easier. Not for me, not for the pregnant mama and her family, and not for my own family. Yet, the thrill of the call, the rush to join a laboring woman, the chance to help and witness women trust in their bodies and their babies, to participate in that age old labor dance, that brings a new baby earthside! There is nothing like it! Nothing! And I suppose, that is why many birth professionals do it. Over and Over!
And still I wait. Restless, unable to complete anything, drifting from task to task, unable to really focus, while I wait. So many things still undone, yet I can accomplish almost nothing. Should I go for a walk on this lovely day? Make a yummy casserole for my family to eat this evening, as surely I will be gone? Will I??? Will I be gone? Rest? Nap, in case tonight is a night of no sleep?? Sometimes denial is a good state of mind. Be ready, really ready and then forget about it! Just forget about it! That works for a while, but now as I sit, and wait, I reassure myself that this baby will come like all the others, in its own sweet time! I remind myself of this a million times! And so, it goes. Wait with me, and help me by sharing your own stories of waiting, for babies, for something else? What was your experience like?
As for me, I will go and put together a new, tasty mac and cheese casserole from the Splendid Table’s newest cookbook! And leave it in the fridge, as I suspect my family will be enjoying it this evening without me. Or will they?
Share your stories of waiting for babies with us! Post a comment!
I was just reading the current edition of the Breastfeeding Coalition of Washington’s newsletter and was thrilled to read about a great breastfeeding resource for childbirth educators, doulas and lactation consultants and couldn’t wait to share! Imagine, all the breastfeeding resources, research, tips, suggestions, care practices and breastfeeding links you could ever want, conveniently located on your iPhone or smart phone!
The Massachusetts Breastfeeding Coalition has developed and provided for free, an iPhone or Palm OS application called Breastfeeding Management, a reference for supporting breastfeeding mothers! Did I mention this was free! What a bounty of information! I have already installed it on my iPhone and am amazed at the wealth of resources I now have handy for those postpartum visits with new moms! Go check it out, install it yourself and see how helpful it can be. I always say that I think breastfeeding is the next big challenge after birth, and women can use all the support and help they can to make sure the breastfeeding relationship starts out strong and stays that way! Do your part to help with this handy tool right in your pocket!
And while you are at it, did you know that there is an international symbol for breastfeeding that states “Breastfeeding welcomed here!” The purpose of an international symbol for breastfeeding is to increase public awareness of breastfeeding, to provide an alternative to the use of a baby bottle image to designate baby friendly areas in public, and to mark breastfeeding friendly facilities. The winning image was designed by Matt Daigle of Sioux Falls, South Dakota. Matt is a stay-at-home dad, freelance graphic designer, and cartoonist. Matt and his wife Kay are the parents of one-year-old son Hayden.
The breastfeeding symbol is available copyright free. Matt has signed it over to the Public Domain. You can download a variety of formats of the International Breastfeeding Symbol here. Think about downloading it and posting it on your website, printing it out and hanging it in your classroom, on your car bumper, in your clinic or office, the storefront window of your business, anywhere you feel it is important to say “Breastfeeding Moms Rock!”
I received a call from my doula student last night, updating me on her clients! I am ever so pleased to report that this woman gave birth non-induced and non-medicated and non-intervened with to a happy, healthy baby on Saturday!
And now for for the rest of the story…the doula met up with them the evening before the scheduled induction, and was really present for their discussion and decision-making process. The doula shared The Problems and Hazards of Induction CIMS information sheet from her doula training manual. Using her wonderful, reflective listening skills, she heard the mom say that she wanted to go into labor on her own, that she did not want to be induced and felt like she might want to switch doctors, but who would “want” her, as she was past her due date. As the parents talked, they realized that they would not go in the next day for the induction and would wait for labor to start on it’s own.
The morning of the now-cancelled induction, the mom started having some contractions! It started to look more and more like active labor. Amazing how removing emotional issues can be freeing for some women and tip them into labor. Alas, the evening saw things slow down and peter out. The parents went to bed and woke up Friday morning with no sign of any labor at all. Discussions with the doula involved re-affirming that her body and her baby knew what to do and that her baby will pick it’s due date and be born when it is ready. Friday night, labor started again, and this time, kept on going, a late night trip to the hospital, several hours in the tub and a wonderful baby landed earthside! Mom gave birth in an upright position, unmedicated and oh so powerful! The doula reports that the parents are thrilled with the experience, so thankful for the support and listening ear of their doula, who helped them to clarify what was important to them.
I was proud of this new doula, and told her so! I am glad that she sought out my help when she felt she needed it, glad she was there for her client and supportive of the couple as they found their way. And oh so happy this mom got to have a wonderful, empowering birth on her own terms.
I am so lucky to have the opportunity to teach birth doulas as part of the faculty of the Simkin School for Allied Birth Professions at Seattle Midwifery School. I know I can help one family at a time as a birth doula, but I get the shivers when I think of how many families the doulas I have trained can go on to empower! I always tell my doula students, that if they ever need to bounce ideas off someone, or find themselves “stuck” and need some help, they can call me 24/7. I am always happy to help! I remember what it was like when I was starting out and was grateful for my experienced doula sisters who made themselves available to me. And now in turn, I can do the same! The circle of life continues!
I have always shared with both my doula clients and my childbirth students that less is more when it comes to baby hygiene products, and bathing your newborn and infant. Reality is, little babes do not get all that dirty, (it’s not like they are crawling through the mud or anything! and what is wrong with mud anyway?) and their skin is ever so sensitive. I have always stated that just plain water is the ONLY product that babies need on their skin and in their hair and on their bottom on a regular basis. And, too much bathing can be drying on their tender newborn skin. If parents feel the need to bathe with a product, the purest, most simple product available is the best, without artificial dyes, without fragrance, free of petroleum products, free of preservatives. Simple is better, plain water is best. Today I read in the Washington Post, that more than half the baby shampoo, lotion and other infant care products analyzed by a health advocacy group were found to contain trace amounts of two chemicals that are believed to cause cancer. Wow! Probable Carcinogens Found in Baby Toiletries will open your eyes to the truth around less is more when it comes to using such products on your gentle newborn.Additionally, I encourage my clients to look into the benefits of delaying the first bath for their newborn. For homebirthers, this is not usually an issue, no one ever seems to be in a rush to bathe the baby, and sometimes many days pass before it moves to the top of the list. In a hospital setting, there is often great pressure by care providers to get the baby bathed, especially if the new family is being moved to a postpartum room elsewhere on the unit. It always seems as if there is a big, master checklist of things that HAVE to happen before the family relocates, and bathing is often right up there. When the bath occurs in the first few hours, mom is not quite physically able to participate as she is still regaining her footing after birthing a human being. The baby will have nursed and settled down, only to be disturbed by this “necessary” activity. Often it is the nurse or nursing assistant who does the bath, with the proud partner standing by and taking pictures, and mama across the room, in the bed, resting. How much nicer if the first bath could be in the arms of a parent, shared bathing in the big, large bathtub, safe in the arms and on the chest of those who love them most. Even better, if this happens at home, after discharge. Over the years, I have heard so many discussions from providers on why the baby needs to be bathed asap, including…”We will have to handle your baby with gloves, until it is bathed…” which I personally think is a good thing in the hospital anyway, bath or no! Also…”We consider your baby a biohazard and will have to post something on the door to your room warning people of this…” which I also think is a good thing, keeps the riffraff out!
My intuition is backed up by the research! Check out this study: Host defense proteins in vernix caseosa and amniotic fluid This study questions the routine use of some newborn procedures. Early bathing of the baby removes vernix, which contains antimicrobial proteins that are active against group B. streptococcus and E. coli. Delaying the bath and keeping the newborn together with his or her mother until breastfeeding is established may prevent some cases of devastating infections caused by these bacteria. The fact that preterm babies tend to have more vernix than babies born at or after 40 weeks might mean that healthy, stable preterm babies derive even greater benefit from staying with their mothers during the immediate newborn period.
Finally, this study illustrates how the normal physiology of pregnancy and fetal development is part of a continuum that extends beyond birth to the newborn period. The place for a newborn is right on his/her mama’s chest, skin to skin, for as long as possible. And letting that vernix work it’s way into the baby’s skin is just added protection from the “big bad outside” that the newborn is becoming familiar with.
Keeping the diaper area clean and dry, washing the baby’s hands and face with warm water several times a day, and the occasional bath safe in the arms of a parent, with just water is all your kidlet needs to get off to a healthy start!
Helping to get the word about about a valuable resource for women who have experienced birth trauma!
“We are pleased to announce the Solace for Mothers Friends and Advocates Online Community which provides a forum for those who support mothers who have experienced birth trauma, have been impacted by witnessing birth trauma, or want to connect with others to advocate for gentler birth practices.
Solace for Mothers is committed to providing resources and support to professionals and loved ones supporting women through the difficult emotions following a disappointing, hurtful, or violating birth experience. Spouses, family, and friends of mothers who have experienced traumatic births are offered a space to find information, support, and resources through participation in the Friends and Advocates Forum. Birth attendants are also provided with the opportunity to process their own emotions in response to births they have attended. Birth professionals and birth advocates are provided a space to discuss the causes of birth trauma, how policies and programs can be enacted to prevent trauma from occurring to childbearing mothers, and methods of treatment when trauma has occurred.
The Solace for Mothers Friends and Advocates Online Community welcomes birth activists, mothers, families, and professionals, all of whom are stakeholders in providing healthy, safe, and empowering births that enable families to successfully transition to parenthood. Users of the online community are invited to contemplate and discuss the current state of birth and what evidence based practices best support childbearing women, their babies and families. Advocates who are interested in becoming involved in organized efforts to promote these practices are encouraged to participate and share their thoughts.
The Friends and Advocates Online Community can be entered from this site on the Solace website . The forum is made public for browsing and registration is required to post and respond to topics. To view the online community, go to the forum section
Mothers are welcome to participate in the Friends and Advocates role but they are invited to register and participate in the Online Community for Healing Birth Trauma which provides peer support to women who have had traumatic childbearing experiences. Birth professionals, family members, and friends please respect the privacy of the Community for Healing Birth Trauma and register only for the Friends and Advocates Community.
If you have something to say regarding childbirth and want to be a part of a larger conversation, please join us. We are interested to read your stories, thoughts, hopes and goals for the future! Please also feel free to pass this invitation on to organizations and individuals who would be interested in the topics of birth trauma and improving maternity care.
Sharon Storton, Founder of Solace for Mothers, Inc.
Jenne Alderks, Creator and Moderator of Online Communities
Jennifer Zimmerman, Creator and Moderator of Online Communities”
I had a newer doula call me yesterday for some advice. She had been in a recent doula training class at Seattle Midwifery School and wanted to talk over a current client situation. Her client was less than a week overdue with her second child and her first baby was a vaginal birth with no complications. Her doctor told her that she needed to be induced, sooner rather than later! Like…tomorrow! And when this client inquired as to why, the reasons provided by this surgeon were: 1) most women are done being pregnant by now and just want their bodies back, 2) the baby is only getting bigger and bigger every day, and pretty soon your baby’s head will not be able to fit through your pelvis. Remember, this is a mama who has a “proven” pelvis, meaning that a baby has already found it’s way out through this very same pelvis, that now is getting more and more unable to birth her second baby by the minute! When the client asked about waiting a few more days, the doctor replied that the client could only be induced on days that the doctor was on call, even though this is one practitioner in a large, well established practice with doctors on call 24/7 for the unlikely event that a labor actually starts on it’s own.
Since this multip’s (woman who has already birthed at least one baby) cervix was already dilated and effaced, the method of induction would be pitocin or if the client preferred, they could rupture her membranes. No discussion of the benefits or risks or alternatives of any of these interventions, no discussion of the evidence based research that supports the appropriateness (or not) of these interventions, nor any reason that indicates this induction is based on a valid medical reason.
The parents were confused, scared and nervous. Maybe the obstetrician was right, maybe it was best to induce the next day! They asked for more time to discuss this privately and told the OB they would call with more questions. They called their doula, using her as a resource to help them make this decision. And the doula called me. The more I listened to the comments allegedly made by the doctor, (and I do realize I was receiving this information second-hand!) the more I could feel myself shake my head in disbelief. How is this behavior ethical? Even The American College of Obstetricians and Gynecologists, (a professional organization, mind you, not a research institution) in their own literature and patient pamphlets states what is a valid medical reason for induction! And “wanting your body back” is not on the list! No evidence of improved outcomes following induction of labour for non-diabetic women who are thought to be carrying large babies has been found that warrants an induction for macrosomia in this case.
What is up? Where is the information about informed choice, benefits and risks? Where is the truth? A great resource for anyone facing an induction for non-medically supported reasons (and even for the medically supported ones!) can use the Coalition for Improving Maternity Care Problems and Hazards of Induction as a great guide. CIMS Problems and Hazards of Induction Fact Sheet
An extremely valuable resource was published this fall by some powerhouse organizations, including Childbirth Connections that I think should be required reading for all women of childbearing age, particularly, the pregnant ones: Evidenced Based Maternity Care: What It Is and What It Can Achieve You can read a pdf on-line, or you can order copies for free! What a fantastic resource. If you are a doula, childbirth educator, or other birth professional, consider ordering some for your practice to share with clients!
As for the woman mentioned in the original paragraph, at last report, she has been in early labor since this morning, all on her own and with the support of her partner and doula, waiting for things to pick up! Maybe it was that beautiful full moon over Seattle that “induced” her baby to come! May this baby arrive safely earthside before the moon sets again!
Another stellar post by The Well-Rounded Mama! A History of VBACs and Cesareans in the USA
How this mama finds the time to put all this together and shares her information so freely simply amazes me. I encourage you all to read this well written post, and follow the her links, and you will be amazed at the total lack of evidence based medical practices being applied to women who have birthed by Cesarean and are seeking a different journey this time! Thank you Well-Rounded Mama, for being so well-rounded!
I just received a heads up that the Northwest Mothers Milk Bank is now open for business and can receive donated breastmilk! Their donor depot is located in Newberg, OR. They are intently looking to open other donor depots in the Northwest, so I expect that we may see one closer to Seattle soon! At this time, they are still getting set up to have milk available for babies in need here in the Northwest. Until that happens, the donor milk will be shipped to their partner, Mothers Milk Bank of Colorado. There was a great article in The Oregonian about this wonderful news that highlighted a premature baby who greatly benefited from donor milk!
I think this is such a great thing, women who have an abundance of milk can share the excess and babies in need can benefit from the absolute best food for them! Northwest Mothers Milk Bank is also working hard to get insurance companies to cover the cost of donated breastmilk, after all, it is just as lifesaving as medication!
Over the years, I have informally helped clients of mine exchange milk, when a mama needed some extra and other women had a surplus! And I was so awed and appreciative that the women I support are so giving and unselfish with something that they work so hard to produce! I look forward to being able to refer clients to the Northwest Mothers Milk Bank in the future, both as a place to donate extra and a supply for those who need it!
If you are a mama with extra breastmilk, consider contacting the Northwest Mothers Milk Bank and letting them know you have breastmilk to share. And update us here, about the process, so others can be inspired to do the same. It takes a village, I always say, and I am proud to be a part of mine!
My current hospital-based childbirth series has been a lot of fun. The 10 couples in the class are engaged, participatory and very funny. I am enjoying this group! Wednesday, I was teaching and before we started talking about pain medications, I asked the class if they thought childbirth “had to hurt?” One guy raised his hand and said, “Of course it hurts, there is a baby ripping and tearing through your vagina!”
The class collectively inhaled sharply, and there was silence. “What???,” he inquired, “I thought it was okay to say vagina in this class?” I held in my laugh, and politely informed him, “It was the ripping and tearing part that got us!” We went on to have a great talk about the power and purpose of pain! I love my job!
Yesterday I had a reunion celebrating the births of a recent childbirth class series. This group of parents was a totally fun group to have in class, engaged, asking questions, having lively discussions and forming a community amongst themselves as the weeks progressed. Sometimes I think the most important thing I can offer expectant families is this sense of community! They formed a google group at the end of class, shared birth stories and pictures, made some pizza dates and met for coffee, before and after the babies arrived! By the time I met all the babies at the reunion, they had gotten together several times and shared advice and wisdom as they learned along with their newborns.
I was so happy to hear the birth stories (these women are strong!) and was so proud at how confidently they moved in the world of the new parent, and so willingly shared their tips and tricks with each other.
It takes a village, and these families were creating it right in front of my eyes! Plans are underway for more meetings in the future, and a slew of emails went back and forth today with more things to share.
Events like this remind me how much I love my job!
I read an absolutely fantastic post from one of my favorite bloggers, and I believe she has hit the nail right on the head! The loss of VBAC options for women changed significantly in 1999 when ACOG issued a new guideline stating that a surgeon and anesthesiologist both needed to be IMMEDIATELY available in hospital, if a woman was to “safely” VBAC. Since then, our options are shrinking, hospitals are banning VBACs with increasing frequency, OB practices are refusing to accept VBAC patients and women are being herded down a one-way street, with tall barriers on both sides, right into the OR for their scheduled repeat cesarean.
I encourage you to hustle over right now to The Well-Rounded Mama and read this post. I could not have said it better myself! Thank you Well-Rounded Mama, for being so thorough!