Posts Tagged ‘birth’

May 23rd, 2010

Was Biter Blackballed?

It certainly seems like it!  For all of you that do not know who Dr. Biter is, or has not been following the story of the California OB/GYN who was suspended with no explanation in recent weeks can read more about it here, thanks to Dou-La-La one of my fav bloggers.

So basically on Friday, we all got the word that Dr. Biter had been re-instated after weeks of daily protests outside of this hospital. The excitement through the birth community that had rallies around him was loud, and quick. Unfortunately it was immediately followed by the announcement that Dr. Biter had “willingly” given up his privileges to practice medicine at this hospital.  Of course at this point there is still no explanation as to why this has taken place, but it is no surprise to most of us really involved in the natural childbirth community.

With no word from the Biter camp, and a brief statement from the hospital, it leaves a lot to the imagination. Certainly tons of speculation, but this is also alarming on several levels. The fact that there are tons of pregnant women who are not left without the provider of their choice is the first and most important issue. These women went to Dr. Biter because of his thoughts on birth, the way he practices, and the fact that he had the lowest cesarean section rate.

This was no small community that was upset. This was lots of mothers, fathers, and even children delivered by the doctor who rallied around him.

The hospital seems to be where all fingers are being pointed here. The other L&D staff, mainly Obstetricians that simply wanted nothing to do with someone who did not practice the way they did, or did not like the way he handled birth. Understandable on some levels because good OB/Gyn’s are certainly hard to come by, especially the ones who really look at birth as something more than a medical procedure, or something they need to do before heading home for their dinner at 5:00pm.

Unfortunately for us, we may never know exactly what happened. But it certainly has shown the natural childbirth community, what happens when a OB/Gyn stands up to “the man” to fight back for something they believe in. My thoughts are with Dr. Biter, and his family, the families of all the babies he has delivered, and the pregnant women who are now left without a provider for their birth.

It is a very sad state of affairs for birth in our country. 

May 20th, 2010

There are good OB’s

A lot of people tend to think I am some kind of man hating, anti-ob/gyn, crunchy nut. Which in reality couldn’t be farther from the truth. With my first pregnancy I had a female OB/GYN, who was tolerable at first, but in the end I jokingly called her The Wicked Witch. As mean as it sounds, it was a pretty accurate depiction on her, as well as her personality. The only thing she was missing was a wort on the end of her pointy nose.

Needless to say, most of you who read here know I had a horrible experience and switched to midwife care for my second child. In the end, I needed a second cesarean section, so I was with the on call OB/GYN and the OB/GYN resident who was on call. Female on call, and male resident.  I have always had a thing about male OB’s… was just kind of off to me. A man, who wants to do that for a living kind of makes me wonder.

But really, back to the point of my post.
Many in the natural childbirth community give off the impression that all OB/GYN’s are evil, Midwives are far superior, and we should set out in an angry mob with pitch forks and torches to run them all out of the country. While there are some OB’s out there like that (coughDramyinsaneinternettrollcough) not all of them are evil, and in the case of some situations, they are fully needed.

Enter Keith. My resident who took amazingly good care of me when I was not only in surgery, but during my 4 day stay at the hospital I gave birth at. I coughed, he offered me a cough suppressant (coughing after a c-section is NO walk in the park), he helped me walk to the bathroom, he was caring, warm, welcoming, informative, helpful, and everything a truly good OB should really be.

I have sang his praises since I was discharged on May 20th, 2009. Well a couple days ago, right before Benjamin’s first birthday, I found Keith on facebook. Just so happens that he is facebook friends with one of my midwives. Haha!  (Who thought that Doctors actually used facebook!  OH! That’s right, they cause internet drama!)  So of course I sent him a random message knowing he would have no idea who I was, what my story involved, or why the heck I would even take the time to message him… I was wrong!

I guess I made such an impression on the L&D staff with my labor, they all remembered me. I thanked him for being an example of what ALL OB’s should be, and we are now super cool facebook friends!

Moral of the story, when there is a time and place for an OB/GYN, there are some great ones out there. We just need to weed out the bad ones.

May 10th, 2010

Natural Labor Induction

Towards the end of pregnancy, many women are really uncomfortable and ready to get pregnancy over with. I experienced this with my first pregnancy which was long, rough, and I was in and out of the hospital multiple times.  I ended up with an induction after being encouraged to because of all the complications. Looking back, I wish I had tried more natural ways of encouraging myself into labor rather than forcing my baby to enter the world before he was ready.

Although some of these methods may be helpful, in many cases if your baby is not ready, nothing is going to work to get them out. You could stand on your head and chant some ritualistic melody and in the end, you still may be pregnant.

But I wanted to share so labor encouragement methods, and some of the old wives tales you can find that insist they will cause labor.

The full moon - Although many insist that a full moon helps to encourage labor, some still despite this old wives tale.
Driving down a bumpy road – In most cases taking a quick cruise down a long bumpy road, or even going off roading will probably only upset your stomach instead of encouraging your little one to join you.
Physical Activity – Walking, jogging, Yoga, or any other kind of physically activity may help to encourage labor, but no one really knows if it will actually put you into labor.
Spicy Food – Eating spicy food is another wives tale we hear often. But in most women, it just gives them an upset stomach. LOL
Sexual Intercourse – This is one we have all heard before, while we may not be too fond of it, I am sure most of our partners are! There are many conflicting reports that say it helps, and doesn’t help. The conflicting reports suggest it may be the seamen, or even the oxytocin that is released during an orgasm.
Castor Oil – Depending on how brave you are, some say drinking caster oil may jump start your labor. For others they say it will only land you with an upset stomach and diarrhea. Try this one as your own risk!  LOL
Herbs – Herbs have been used for centuries by midwives to induce labor. Because these herbs are very dangerous when not used properly, it is suggested they are ONLY used under the strict watch of a medical professional. Some of these herbs include Blue Cohosh, Black Cohosh, caulophyllum, and Evening primrose oil. On the lighter side of herbs, Red Raspberry Leaf Tea is something recommended before and after labor as it helps to tone the uterus.
Nipple Stimulation – Nipple stimulation is known as an old form of labor induction that midwives have used for ages. The stimulation to the nipple can help cause contractions from the release of oxytocin into the body.

A lot of these are hit or miss. They may or may not work, but many women feel the need to try anything in hopes of avoiding a medical induction with drugs like pitocin, or even cytotec (which is not FDA approved for use in pregnant women).

Be sure to talk to your provider about any methods to induce labor, and be sure to research the effects of medical induction.

May 8th, 2010

Positions You Should Be Birthing In (Part 2)

With my last post, I had a couple people commenting about positions I left out. I should have put the intent to continue the list of positions in a second post at the top of my post, instead of at the end. The other day I left off at Squatting, and I plan to pick back up with Side lying today.

To check out the first post of birthing positions, check the link out.

Side-Lying

Pros :

• The side lying position helps to increase the oxygen to the baby.
• It is also a great position for resting.
• It is a position in which you can use an epidural with.
• Side-lying can be very helpful in mothers who have increased blood pressure.
• It can help to make your contractions much more effective.
• The position offers good access to the perineus
• It lowers your change of tearing or needing an episiotomy.
• Easier to relax between contractions during the second stage of labor.
• Your partner can assist in your birth experience by holding your legs or supporting your legs.

Cons :

• It may be hard for your health-care provider to access fetal heart tones.
• You have feel too passive to push while in this position.
• You will have no help from gravity.
• If you do not have anyone to help by holding your legs, you will have to support them on your own.

Leaning or Kneeling Forward with Support :

Pros :

• This position helps to shift the baby if needed.
• Helps to use gravity.
• Less strain on your arms, and wrists by supporting yourself.
• A birth ball often helps in this position.
• Contractions are often less painful, but more helpful and productive in your labor.
• Helps greatly if you are experiencing back labor. (Believe me, I know!  I had it with my second child)
• Baby will be well aligned with your pelvis.
• Position is more restful than standing positions.
• Provides less strain for your arms and wrists.
• Easier for your partner to help relieve back pain, and help to support.

Cons :

• May be hard for your health-care provider to help with the birth.

Knees to Chest :

Pros :

• This position is helpful to those experiencing back labor.
• Helps to assist with the rotation of the baby, if it is needed.
• Helps to take the pressure off of hemorroids.
• Can be helpful if fetal heart tones are low.
• Good delivery position for a large baby.
• A great position to help preventing tearing or an episiotomy.

Cons :

• Hard for your support team to maintain eye contact with you in this position.
• This position may make it hard for you do see what is going on yourself.

The above video, provided by Gurgle shows why and how some of these positions are helpful to laboring mothers. Getting off of your back is very important during labor.

To look back on my childbirth education Journey thus far check out these posts :

My Journey to Becoming a Certified Childbirth Educator
Passion For Birth Training
Holy Expensive Books
Working on my Journey into Childbirth Education
Labor Day!  The Stages of Labor
Lamaze Isn’t Just About Breathing
Positions You Should be Birthing In

May 5th, 2010

International Day of the Midwife

Today is the International Day of the Midwife, as well as Cinco De Mayo, but I totally think the Midwife one is way more important.

To celebrate this, I wanted to put together a list of some of my favorite blog posts about midwives, blogs that midwives themselves write, and overall celebrate midwives because they are such an amazingly important part of out maternity care system today.

The Midwife Difference – One of my own posts about the difference of care I experienced between pre natal care under an OB/GYN and a Midwife for my second pregnancy. Incomparable!
Science & Sensibility – Amy Romano a local CNM to my area, and amazing birth advocate, researcher, and educator writes awesomely amazing posts weekly.
The Feminist Breeder & Friends Radio Show – Today, Gina AKA The Feminist Breeder is going to host her radio show focused around midwives with Amy Romano, Mary Murry, and Amie Newman.
Home Birth in Connecticut – An interview with a local Connecticut CPM that attends births at home.
My reaction to The Business of Being Born – I think this was the turning point that really got me involved in the childbirth community.
Gloria Lemay – A Canadian Midwife who I enjoy reading about. She has some great posts you will probably love too!

What are your favorite midwives posts and posters?

May 4th, 2010

Positions You Should be Birthing In

In my reading yesterday, I came across The World Organization Practices that Promote Healthy Birth, and the one practice in that list that stood out to me the most was : “Women should not give birth on their back”.  Something that high profile professionals like Michael Odent, Ina May Gaskin, and Marsden Wagner have been saying for decades, yet the practice of putting a woman on her back for birth has not changed.

Another part of this is that movement is instrumental in labor.  Staying in bed, on your back is not going to help labor progress or make labor manageable for most women.

Our whole pregnancies we are told to stay off of our backs, not sleep on our back for fear of harming the baby, or compressing blood flow to the baby, but the first thing they do when you check into the hospital is put you on your back. Doesn’t seem like a common sense thing to do. Unfortunately for women this is the most convenient position for your provider to deliver your baby in, and that is why it was been implemented.

So I wanted to talk about a couple alternative birthing positions, and their pros and cons.

Standing Supported Squatting :

Pros :

• This position helps to realign your pelvis which will increase it by up to 15 %.
• This position allows you to be supported by your standing or sitting partner, the wall, or a squatting bar allowing you several options.
• Standing supported squatting allows your body to take advantage of gravity.
• This may assist, or help your urge to push during the second stage of labor.
• Standing supported squatting helps make the contractions less painful, and more productive to your labor process.
• The movement and positions you can get into with this position will help cause changes in your pelvic joints which will in turn help your baby to come down into the birth canal easier.

Cons :

• This position requires the help of a strong partner.
• May become a tiring position for both you and your partner.

Sitting on the Toilet :

Pros :

• Sitting on the toilet during labor will help to relax your perineum.
• This position like the one above also utilizes gravity.
• You get used to an open-leg position and the pelvis pressure that comes with it.

Cons :

• The pressure from the toilet seat itself may be uncomfortable.

Sitting Position :

Pros :

• This position is good for helping Mom to rest.
• Like the other positions, this will help with the use of gravity.
• The sitting position can be used with continuous electronic fetal monitoring in mothers who have a need for that type of monitoring/intervention.

Cons :

• This position for laboring or birth may not be an option if you suffer from high blood pressure.

Squatting Position :

Pros :

• Squatting helps to encourage rapid descent by the baby.
• Again, like above, this position encourages the use of gravity in birth.
• Your thighs will help to keep the baby aligned.
• Descent is encouraged by the position.
• Squatting may increase the rotation of your baby.
• The Squatting position is helpful for fetal circulation.
• This allows freedom to shift your weight to stay comfortable without much movement.
• Requires less bearing down effort for giving birth.
• Squatting may increase your pelvis diameter by as much as 2 full centimeters.
• Squatting allows for extended perineal access.

Cons :

• This position can often be tiring.
• May be hard for you to assist in the birth yourself if you have the desire to.
• Sometimes hard for health-care providers to hear fetal heart tones.

Those are my first couple positions I plan to cover in the next week or so. I don’t want to make the post too long, or bombard you with too much information at once.

I am really enjoying the chance to share all I am learning my my journey to become a childbirth educator through my blog!  If you are a childbirth educator, or just interested, check out our Childbirth Educator party on Twitter tonight!  10pm EST and it will be under the hashtag #CBEParty   I hope you come join in!

May 1st, 2010

All About Doulas Survey

Here we go again right?  I have teamed up with The Healthy Baby Network once again to tackle a great survey on the use of doulas. This is along the same line as our Post Cesarean Feelings Survey, and will run for the next month or so in hopes of getting a good response as our previous survey got.

With this second survey, we are hoping to understand the reasons of why some women do, or do not use a doula for their births, and tackle some of the misconceptions about doulas.

One thing I have noticed over the years is many people think doulas are actual medical professionals, and use the statement of “midwife OR doula” when talking about someone to catch their baby, specifically those uninformed on home birth, or alternative natural birthing options.

All About Doulas

Some of the other information we would like to collect regards the amount of support women who did have a doula for their birth received, their satisfaction level, the feelings of spouses and partners regarding a doula being present for birth, and even popular misconceptions about doulas.

I know a lot of my readers are doulas, and heavily involved in the birth community, so I would greatly appreciate it if you could pass this along to your clients, friends, colleagues, and maybe even post it on your facebook fan page (if you have one of course)

The more women we get to take this, the better as it will give us a more accurate collection of experiences.

April 28th, 2010

Labor Day! The Stages of Labor

During my journey to becoming a Lamaze childbirth educator, there are so many things I would like to document and share through the information and learning processes on my blog. I hope that others enjoy the information as I work through it and share what I feel so be some of the most important pieces of key information.

Today I am going to touch on the different Stages of Labor. Many who are active in the childbirth community may already be familiar with these, but what I have noticed through my work with pregnant women, and what is being shown in studies, run of the mill pregnant women are not familiar with most of the information provided in childbirth education courses. Stages of labor happen to be one of these.

Prodomal Labor

What is going on?

• The cervix is beginning to thin out, and soften, and move forward. During this process it also may start to open.
• The baby will settle into the pelvis.
• You may start to notice some contractions, but will remain irregular, slightly noticeable, and will not form a pattern.
• The contractions may be noticeable or identified as a pain in the lower stomach, or back.
• Normally this phase can last anywhere from a couple hours, to days.

This is your bodies way to gear up for the marathon of labor it will be running shortly.

What Helps?

• Don’t worry or over think what you are going through. You will not miss labor, and you will certainly know when you are in labor!
• Be patient!  Having confidence that your body truly knows what to do is key.
• Take care of yourself. Sleep, eat, stay active, and overall be healthy (but you should be doing that through your entire pregnancy to begin with)
• Be sure to only surround yourself with supportive and positive people. You only want those around who will make you feel not only safe, but comfortable.

Early Labor (Latent Phase)

Whats going on?

• Your cervix will start to dilating to about 3-4 centimeters, and the cervix continues to thin.
• Labor can tend to be slow, but most prefer to call it gradual. On average, the latent phase of labor makes up two-thirds of the total labor time in most mothers.
• Over time contractions will become longer, stronger, and more intense.
• Contractions will become more regular, and start to form a pattern.
• Contractions can be described as 5 minutes apart, and 25 to 45 seconds in length.
• You may have pinkish discharge that can be normally called a show that will increase as labor progresses.

What Helps?

• Be calm, relax, and don’t get too excited or worked up that labor has finally started.
• Alternate staying active with relaxation. A great example is chores, or taking walk, followed by taking a shower, and including snacks, and lots of fluids.
• Keep your environment pleasant and positive. Visitors or people who will not carry out this kind of environment should be asked to leave, or change their tune.
• Work on positive activities, you can do some light work in the new babies room, listen to music or even watch a favorite tv show.
• Stay at home as long as you can. Most women find that home is the most comfortable option for laboring in a positive environment.
• When contractions start to become more intense, or unbearable, be sure to have your support team helping you, and supporting you in the activities around the house.
• Use relaxation, as well as breathing to work through your contractions.

Active Labor

Whats going on?

• Contractions will become longer as well as stronger, and become about 3 minutes apart, and last about a minute at a time.
• Women in active labor will start to become very focused on their labor.
• During this phase which lasts between 2 to 6 hours on average, the cervix will completely efface, and dilate to 8 centimeters.

What Helps?

• Listen to your body!  It is meant to give birth to babies and now has you really rockin’ and rollin’ towards birth.
• Do something to stay active during contractions, walk, talk, breathe, or just move around, and take the time in between contractions to rest.
• Create a peaceful, and relaxed environment as your surroundings will impact your labor, and harsh feelings, comments, or actions can halt your labor.
• Personalize your surroundings. Use your own music, clothes, and comforts of home (especially in a hospital setting)
• Changing positions will help you stay more active and comfortable, and will also help you to progress.

Transition

Whats going on?

• The cervix will finish effacing and dilating.
• Contractions are powerful, efficient, and close together.
• Phase usually lasts about less than an hour.
• Some women will feel very sick to their stomach, or actually vomit during transition.
• Women may feel wreckless or increasingly emotional and irritable.

What Helps?

• Focus on your contractions, one at a time to help from getting overwhelmed with your experience. There is a lot going on, focus on the most important part, your contractions.
• Continue to focus on your breathing as well as visualization techniques.
• Those who are providing labor support should be giving you their undivided attention to help you through your contractions. Massage, talking you through, encouragement and praise.
• Continue to use your time between contractions for rest and to relax. The time spacing may be much smaller, but it is still very important.

Second Stage (Pushing)

Whats going on?

• Your body will now shift from dilating and effacing to pushing.
• The baby will make its way down through the pelvis and birth canal.
• This phase can last anywhere from 15 minutes to several hours.
• Some women may not feel the urge right away after full dilation, many will feel the urge to start to “bear down”. This urge will continue to get stronger as the baby descends.
• Many women will feel as though their head has been “cleared” and they have a renewed energy for pushing.
• Just before your baby will be born, many women will feel a burning , stinging, stretching at the open of the vagina. Many call this the famous “ring of fire” but not all experience it.
• The babies head will emerge, and it will turn to one side to allow the shoulders to pass through, and the rest of the baby will slip right out.

What Helps?

• Follow your instinct. Women normally feel the strongest urge to push at the peak of a contraction, follow what your body feels like it needs to do, or wants to do through the contractions.
• It may help some women to be vocal, but loud high pitched sounds will only use up all of your energy and breathe. Low, deep noises and moans are most helpful.
• Those supporting you in your labor should remain as quiet as possible, or provide low or quiet support and encouragement.
• Let go of any tension you may feel in your perineum. Applying a warm compress may help.
• If progress is slow, changing positions can be very helpful. The most efficient positions to push in tend to be squatting, laying on your side, or hands and knees. (The lithotomy position, or flat on your back with your legs in the air decreases the opening of your pelvis.)
• Rest in between contractions.

Third Stage (Recovery)

Whats going on?

• Your baby should be placed on your abdomen, and quickly dried.
• You will probably experience a boat load of feelings, excitement, joy, happiness, awe, and relief that it is finally over!
• The cord will be cut and the placenta will be delivered normally within 30 minutes.
• Many women get after pains of “the shakes” after birth.
• Cold compresses are often applied to the perineum to ease your discomfort as well as help with the swelling.

What Helps?

• Touch, caress, and cuddle your new little baby without time restrictions. (If there is no medical needs for mother and baby separation).
• Skin-to-skin contact with your baby is your best option.
• All routine infant procedures can be done without removing your baby from your side. Request that all measuring, weighing, and other procedures be delayed for the first few hours.
• Offering your baby the breast during this time will increase the likelihood of a successful breastfeeding relationship, and will also help to decrease the bleeding, and tightening of the uterus.

Lots of information, in a long post.
I hope you all enjoy and find it as educational and helpful as I do!

April 24th, 2010

Lamaze Isn’t Just About Breathing!

Working towards becoming a Childbirth Educator through Lamaze I have noticed one thing.  Everyone still thinks Lamaze is about all about breathing! I must admit, before I became familiar with modern day Lamaze, I would have thought the same exact things because of all the movies that still depict Lamaze as a woman in a taxi cab on the way to the hospital “whoooooo whooooooo heeeeeeeee”

In the 1950′s a man by the name of Fernand Lamaze, a French Obstetrician developed a method of breathing and relaxation to help women in labor, and coping with the pain of childbirth. Over the next decades Lamaze evolved into what it is today and has turned far away from the original breathing focused birth technique.  During this time, Lamaze has really changed from a method for giving birth to a philosophy that helps to educate women on what birth can and should be, while giving them confidence on birthing the way our bodies are intended to.

The Lamaze Philosophy of Birth includes :

• Birth is normal, natural, and healthy.
• The experience of birth profoundly affects women and their families.
• Women’s inner wisdom guides them through birth.
• Women’s confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth.
• Women have the right to give birth free from routine medical interventions.
• Birth can safely take place in homes, birth centers, and hospitals.
• Childbirth education empowers women to make informed choices in healthcare, to assume responsibility for their health, and trust their inner wisdom.

That is a far cry from teaching women how to pant through birth through strange breathing techniques.

A great resource for learning more about birth and childbirth education is the Lamaze Magazine. There is a lot of great information on moving during labor to help with pain relief, and enhance your birth experience.

The words birth and experience are used a lot in the subject of childbirth education. Many feel as though the experience for mother and baby are not important as long as the end result is a healthy baby.  More and more modern day studies are showing this to be more and more inaccurate, as there are an increasing number of birth trauma cases that go hand in hand with the rising number of surgical births, and birth experiences that have a lot of medical interventions.

I look forward to discussing more, the more I learn in my journey to becoming a childbirth educator.
This should be a fun 6 months!

April 22nd, 2010

Post Cesarean Feelings Survey – Question #6

Continuing to unveil the results of the World Wide Post Cesarean Feelings Survey that I recently worked on with Theresa from Health Baby Network, I wanted to move on to question number 6 which was “Did you feel like you were in control or your care and respected through out the process?”

Like every other question on this survey, we saw complete extremes on each side of the question, and very few moderate or middle of  the road answers. 312 women left a comment with their answer for this question, which left me with 14 pages of information, experiences, and comments that could be a trigger for anyone with any sort of a birth trauma. So I truly caution those same people from reading further.

Our of the 851 women who answered this question :
37.4% or 318 women felt like they were in control of their experience, and respected.
35.3% or 300 women felt like they were somewhat in control of their experience, and/or respected.
31.4% or 267 women felt like they were not in control of their experience, and were not respected.

When I discussed some of the comments these women left, Theresa said to me “Man, some nasty treatment” which is horribly sad for any woman who has been subjected to such treatment. It took me nearly 2 weeks to get through these comments and write this post because of the extreme nature of some of it.

So on to the comments.

“They treated me like a number. Like a ticking clock. They seemed to be prepping the OR behind my back, and every request, from ice to squat bar was ignored and almost sneered at.”

“No one treated me harshly at any time, my requests were carried out without protest, good lactation help”

“No respect, no compassion. At the mention of a c-section I started sobbing and the OB just stared at me stone-faced.”

“Dr. came into the room only a couple times the entire day, told me what was going to be done (never asked) she even laughed when she saw me sitting on the birth ball”

“Doctors are experts. I was OK with them being in control.”

“I am disappointed that no one ever explained the risks of c/s to me, especially to subsequent pregnancies, but I do feel like my OB would have respected my choices/opinions had I known better and refused c/s”

“The doctors were very respectful, explaining every step & making sure I understood why & what was going on.”

“I was constantly told what I needed in an effort to wear me down so that I would agree to their demands. I was forced to have my legs open in front of many strangers. I cried and nobody batted an eyelid. I wasn’t important. Childbirth is supposed to be a sensual, sexual, and most significant event in a woman’s and her child’s life which is certainly not acknowledged by the hospital system. I would say that I was sexually abused while in the hospital bed – another doctor (this time male) came and put his fingers into my vagina and the hospital midwife looked on with a smirk on her face that said ” You’re lucky to have such a good looking doctor like that up you”

“my membranes were ruptured without my consent, the OB did an episiotomy without my consent, the midwife was rude and confrontational, students were invited into the delivery room for the birth without my consent, i was left to hemorrhage until i came close to death, and so many more instances of poor care.”

“I felt in control of everything and I was able to explain my desires/wants”

“My first c-section – No. I felt like scare tactics were used to get me to induce w/o medical reason (“every day past your due date your baby has a higher chance of dying”), and then after 13 hours of labor, progressing nicely, I was told I had to have a c-section because my baby’s heart rate was very concerning. Yet, it took nearly 1.5 hours from decision to incision. Doesn’t seem very emergent to me.
Later, when I requested my records, I found that it listed my c-section as ELECTIVE. I still think I was coerced into a c-section because the doctor felt my labor was taking too long, it was the night before Thanksgiving, and she wanted to go home. After the surgery, they told me I couldn’t be with my baby and she HAD to go to the nursery. I didn’t see her for two hours and no one would call the nursery to find out if she was okay. I laid in a hospital bed, unable to move, terrified for my baby who was FINE (the nursery was understaffed). No one seemed to care how I felt or how upset I was. My second c-section was much better supported – however, I firmly believe that was because I demanded it of my caregivers. I knew everything I could know about VBACs and repeat c-sections
and refused to let myself be treated as poorly as I was the first time.”

I feel as though some of these comments are very telling as to the way maternity care works today, and the way that women view their providers, especially the comment above that a woman was happy her Doctor was in control because they are the professionals show us how much faith and trust women are putting into their providers. Good, bad or middle of the road outcome way too much faith and trust is being placed blindly in providers today.

Women need to build relationships with their provider, and build trust, it is not something that we should just automatically be giving because we picked Dr. X to deliver our baby, or provide us with prenatal care.

April 13th, 2010

The Doula Difference

My first piece of advice to a new mother interested in birthing in the hospital is, GET A DOULA!  With my first child I thought I would be able to go into the hospital with the wishes for a completely natural birth and get what I wanted, and what I had expected from birth. I was wrong.

Just as my experiences which greatly differed under OB/GYN care, and Midwife care in my post The Midwife Difference, I had greatly different experiences without a doula for my first, and with a doula for my second. If I knew what I did about hospital birth today, I would have requested money for a doula rather than baby gifts, and essentially a bunch of stuff that we would barely use for our oldest.

One of the major concerns over doula’s is the cost. Insurance rarely covers it, though they should because it lowers the costs of birth in a hospital by reducing the need or request for pain medication, epidurals, and even reduces the risk of a forcep assisted or vacuum assisted delivery. But cost being the biggest issue, many women opt to skip on a doula and use their husband or partner in this type of support capacity. I know, because I did it!  And if anyone knows my husband, half way into my labor, we found him sleeping in one of the most uncomfortable looking positions. Yes, that is him to the right, sleeping on the floor with a tipped chair as a pillow while I was hooked up to pitocin. Had I had a doula, I would have probably skipped the pitocin, and the hospital, and especially the Obstetric practice I ended up with!  Come time for my second child, especially given that my birth was going to be a VBAC attempt, I knew how important it was to have a doula no matter how much it may have cost our family. And it was worth it! The support I got from my doula was unlike anything my husband, or hospital staff could have ever provided me with. I knew this because I had already been through it one time, and I vowed I wouldn’t do it again under those circumstances.

But there are ways around the costs of doulas. Believe it or nor there are a lot of doulas out there. Training, well educated, attending births for decades, all kinds. And they are willing to work with you, especially if the only factor is money!  If you contact local doula organizations such as DONA, or CAPPA they can point you in the direction of women who are still becoming certified and many of them would be willing to attend a birth for free, or seriously discounted rate to obtain their birth hours needed for certifications. Then there are the doulas who have been attending birth for decades willing to work on a sliding scale, payment plan, or make alternative arrangements such as bartering. Heck, some midwives even barter for services. Makes me glad I married a handy husband! (LOL!)

But what exactly is a doula?

Well, a birth doula according to DONA :

• Recognizes birth as a key experience the mother will remember all her life
• Understands the physiology of birth and the emotional needs of a woman in labor
• Assists the woman in preparing for and carrying out her plans for birth
• Stays with the woman throughout the labor
• Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
• Facilitates communication between the laboring woman, her partner and her clinical care providers
• Perceives her role as nurturing and protecting the woman’s memory of the birth experience
• Allows the woman’s partner to participate at his/her comfort level

A birth doula certified by DONA International is designated by the initials CD(DONA).

A postpartum doula is described as :

• Offers education, companionship and nonjudgmental support during the postpartum fourth trimester
• Assists with newborn care, family adjustment, meal preparation and light household tidying
• Offers evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents and makes appropriate referrals when necessary

A postpartum doula certified by DONA International is designated by the initials PCD(DONA).

Where did the word Doula come from?  Seems like a funny word right? Why couldn’t they just use the word birth attendant, or support person,  or something less exotic. The word doula comes from an ancient Greek word that means mothers servant or woman who serves.

Where can you find a doula?  Lots of places!
DONA International – Doulas of North America
CAPPA – Childbirth and Postpartum Professional Association
Doula Network
Find a Doula
How to Find a Doula from ehow.com

Take a couple minutes to watch the short clip above, in June the full film will be released and I can’t wait to see it as a whole. I am sure there is going to be a lot of awesome clips that really show the great need, and benefit of having a doula.

What are the benefits of having a doula?  There are a lot!

Numerous clinical studies have found that a doula’s presence at birth

• tends to result in shorter labors with fewer complications
• reduces negative feelings about one’s childbirth experience
• reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
• reduces the mother’s request for pain medication and/or epidurals

Research shows parents who receive support can:

• Feel more secure and cared for
• Are more successful in adapting to new family dynamics
• Have greater success with breastfeeding
• Have greater self-confidence
• Have less postpartum depression
• Have lower incidence of abuse

Thank you to DONA International for the amazing resources above provided on their website.

I hope some of the mothers, especially first time mothers will take a couple minutes to really seriously consider having a doula for their birth.

April 13th, 2010

Dr. Stuart Fischbein on the Momotics Radio Show

This coming Wednesday evening for the continued celebration of Cesarean Awareness Month, I am going to have a special hour long radio show with California OB/GYN Dr. Stuart Fischbein discussing VBAC, Cesarean Sections, and maternity care in the United States.

I am hoping that some of my readers will take some time not only to call in to the show this week, but submit questions by commenting on this post, or e-mailing them to me directly at Danielle.Elwood@gmail.com .

If you are not familiar with Dr. Fischbein you can check out his blog

Now, ladies!  Go to work!

April 10th, 2010

You Have A Choice in How You Give Birth!

“You Have a Choice” // A Short Birth Documentary from Mark Mroz on Vimeo.

In our society today, women often believe that if your provider tells you something not only is it best for you, but it is also your only real option. Because of this type of thinking in pregnancy and birth today, we are seeing women having increasingly negative birth experiences. Recently while working on the Post Cesarean Feelings Survey, I have noticed really how much of a problem it is in our society.

Childbearing women have rights, and choices.

According to the Childbirth Connecticut brochure I liked above, your rights include :

1) Every woman has the right to healthcare before, during, and after pregnancy and childbirth.
2) Every woman and infant has the right to receive care that is consistent with current scientific evidence about benefits and risks. Practices that have been found to be safe and beneficial should be used when indicated. Harmful, ineffective, or unnecessary practices should be avoided. Unproven interventions should be used only in the context of research to evaluate their effects.
3) Every woman has the right to choose a midwife of a physician as her maternity care provider. Both caregivers skilled in normal childbearing and caregivers skilled in complications are needed to ensure quality care for all.
4) Every woman has the right to choose her birth setting from the full range of safe options available in her community, on the basis of complete, objective information about the benefits, risks and costs of these options.
5) Every woman has the right to received all or most of her maternity care from a single caregiver or a small group of caregivers within whom she can establish a relationship. Every woman has the right to leave her maternity caregiver and select another if she becomes dissatisfied with her care.
6) Every woman has the right to information about the professional identity and qualifications of those involved with her care, and to known when those involved are trainees.
7) Every woman has the right to communicate with caregivers and receive all care in privacy, which may involved excluding nonessential personnel. She also has the right to have all personal information treated according to all standards of confidentiality.
8 Every woman has the right to receive maternity care that identifies and addresses social and behavioral factors that affect her health and that of her baby. She should receive information to her her take the best care of herself and her baby and have access to social services and behavioral change programs that could contribute to their health.
9) Every woman has the right to full and clear information about benefits, risks, and costs of the procedures, drugs, tests, and treatments offered to her, and of all other reasonable options, including no intervention. She should receive this information about all interventions that are likely to be offered during labor and birth well before the onset of labor.
10) Every woman has the right to accept or refuse procedures, drugs, tests, and treatments, and to have her choices honored. She has the right to change her mind.
11) Every woman has the right to be informed if her caregivers wish to enroll her or her infant in a research study. She should received full information about all known and possible benefits and risks of participation, and she has the right to decide whether to participate free from coercion and without negative consequences.
12) Every woman has the right to unrestricted access to all available records about her pregnancy, labor, birth, postpartum course and infant; to obtain a full copy of these records and to received help in understanding them if necessary.
13) Every woman has the right to receive maternity care that is appropriate to her cultural and religious background, and to receive information in a language which she can understand.
14) Every woman has the right to have family members and friends of her choice present during all aspects of maternity care.
15) Every woman has the right to receive continuous social, emotional, and physical support during labor and birth from a caregiver who has been trained in labor support.
16) Every woman has the right to receive full advance information about the risks and benefits of all reasonably available methods for relieving pain during labor and birth, including methods that do not require the use of drugs. She has the right to choose which methods will be used and to change her mind at any time.
17) Every woman has the right to freedom of movement during labor, unencumbered by tubes, wires or other apparatus. She also has the right to give birth in the position of her choice.
18) Every woman has the right to virtually uninterrupted contact with her newborn from the moment of birth, as long as she and her baby are healthy and do not need care that requires separation.
19) Every woman has the right to receive complete information about the benefits of breastfeeding well in advance of labor, to refuse supplemental bottles and other actions that interfere with breastfeeding, and to have access to skilled lactation support for as long as she chooses to breastfeed.
20) Every woman has the right to decided collaboratively with caregivers when she and her baby will leave the birth site for home, based on their conditions, and circumstances.

Being armed with the knowledge that we as women are human beings, with rights that heavily stand in our favor is the most important thing we need to know and be familiar with in the current climate birth is in today!