a perfect storm - two babies born

It NEVER happens - except when it does. It seems like it's about every 3 or 4 years or so that two clients are in labor at once...I'm pretty sure it takes years off my life when I go through this. Luckily, my amazing friend & colleague, Gayle, had my back (and my client's, literally!)

so,
Two Babies, in Two States, in One Day!
(and not even one missed night of sleep - go figure!)

Early this morning I headed into NYC and by the afternoon, I got to witness the birth of Eliza May...a beauty, 6lb 3oz and "sunny side up"! This was extra special because I was at the birth of her big brother just 16 months ago...and the proud papa is a friend from high school. Congrats to L & W, blessings on your healthy babies - here's to two under two!

and then I raced back to NJ at the start of rush hour (fortunately the traffic gods were with me!) and joined my lovely clients at an already-in-progress labor...so we were then parents, two doulas, a midwife and a nurse. But wow - this daddy did such a super job that it was a pleasure to watch...not to mention the momma, who was amazing too! Welcome, Eliot Cooper, 6lb 8oz & amazingly handsome, who charged into the world with an arm leading the way!

Congrats to all the grandparents who were there to welcome their new grandbabies at both these births!

welcome Liana!

A March surprise since we weren't expecting you until April...but everyone is so happy you are here & perfect at 6lbs. Your momma made it look easy even though she worked so hard and your dad was calm and cool. By the way, thanks for listening to your momma and not coming at night - everyone was well rested and there was no rushing home from work in the city for you dad!
Have fun with your big sister - she's so ready to finally meet you (once she's finished with her "adventure")!
Welcome to this world, baby Liana!

way cool stuff

I get so jazzed when I pick up something new! Via Facebook I came across this post on how to check cervical dilation without an internal exam. Some of the information I knew already, but a few suggestions were new to me...like this:

...Think about the shape of the uterus. Before labor, the muscle of the uterus is thick evenly around all sides, above, below, behind. As the cervix starts thinning and dilating, all that muscle has to go somewhere – it bunches up at that top. The top of the uterus thickens dramatically the more the cervix opens. During a contraction, at the beginning of labor, check how many fingers you can fit between the fundus (top of your bump) and the bra line – you will be able to fit 5 fingers. As the top of the fundus rises higher during labor, you will fit fewer and fewer fingers. When you can fit 3 fingers, I usually tell mothers they can think about going into hospital as they will find they are around 5cm dilated. At 1 finger, you are fully dilated. (Awesome, huh!)...

check out the whole post/list HERE

I'll for sure be trying this out and encouraging my ladies to give it a go also.

high-touch birth

Lessons at Indian Hospital About Births

...In Tuba City last year, 32 percent of women with prior Caesareans had vaginal births. Its overall Caesarean rate has been low — 13.5 percent, less than half the national rate of 31.8 percent in 2007 (the latest year with figures available). This is despite the fact that more women here have diabetes and high blood pressure, which usually result in higher Caesarean rates...

How do they do it? Check out the entire NY Times article here.

I read this makes-you-shake-your-head-because-it-can-be-so-simple article after coming home from a birth at a hospital five minutes from my home where MANY doctors (whole practices) don't take call on weekends. Period. So there is a very good chance the doctor you stayed at this hospital for will not even be there, won't even know you're in labor. When you get there, get ready to sit in an office not unlike that of a car dealership, where copies will be made of your driver's license and insurance card before you can go to triage. Where you stay in bed if your water is broken. Use a bedpan, 'cause you're not getting out of bed to pee. Be ready to have "concerned" conversations over the birth ball you brought. A hospital where the Friedman Curve is king. Where there isn't even a pantry room because nothing but ice chips is permitted, so why would you need a fridge or microwave or electric tea kettle. Where one can feel truly lucky if not among the 49.3% of birthing women who have a cesarean at this hospital.

There are hospitals within spitting distance where the level of care is as good (better, in my opinion) but people don't have to put up with this way of doing birth. Yet many people still flock to this institution. I don't know why and will continue to offer information on alternatives and then meet them where ever they are, trusting that they know what feels best for them. But in my heart, I'll likely wish we were someplace else...maybe Tuba City.

OK - rant over.

Welcome, baby Madeline!

What a smart girl - you figured out how to turn (from posterior) completely in order to be born after only a very short time of pushing by your amazing mom.
6lb 4oz and 18" long...you're a petite girl, like your mommy & like you kitty sister, Katie. Katie was a fantastic cat doula, so protective and intuitive, by the way!
Congrats to you and your lovely mom & dad...happy birthday, little one.

Snippet of Motherhood

Today my 12 year old came home from school saying that his math teacher was discussing math rays, which led to discussion of space, life in alternate universes & various religions...he said, "he blew my mind - it's BLOWN - in a good way!"

Glorious VBAC...welcome Riley!

Every birth is special (and I have been remiss with a few announcements lately...) but some are just awe-inspiring & majestic!
Today I had the pleasure of bearing witness to the all natural VBAC of a healthy baby girl, Riley. She weighed 11lb 15oz (!) and was 22.5" long.

Riley, your momma worked so hard to have the best possible chance at this VBAC (including crossing state lines to have you in NJ)...I am so humbled to meet and serve women this strong and tenacious, supported by partners like your daddy every step of the way. Many blessings for a life filled with everything good - happy birth day!

Gimme Shelter

Help needed for pregnant & birthing women in Haiti, c/o midwife Robin Lim's organization, bumi sehat haiti. Something tangible we can do to help!
Please share...

Dear All: We are holding a tent drive for
our pregnant and birthing Mothers who are
living in rubble and need a dry shelter.
In order to make the ship that is leaving
New Orleans we need these tents shipped to
the to locations below within the next week.
We are looking for tents of all sizes that
are water proof and have a rain shield
protection. In addition, if possible include
a tarp to go with these tents for additional
rain protection. We will shrink wrap and put
these tents on a palate to get to Jacmel
via boat.

Locations to ship tents:

West Coast:Penny Tyrrell
c/o Bumi Sehat Haiti-Tent Drive 93 North Polk
Eugene, OR 97402

East Coast: Andre Gillis
c/o Bumi Sheat Haiti-Tent Drive
417 North Front Street
Philadelphia, PA 19123

Midwest people please mail to the East Coast.
Please share this information with as many
people as you know and provide them the
shipping information.
Thank you for your support. This drive
will continue well beyond the week time
frame so continue to send tents as they
become available.

Thank you, Heather Maurer
Director of LogisticsBumi Sehat Haiti

Doulas go to Washington

Are you a doula & free on March 11th? If so, what about a road trip?

HealthConnect One and members of its National Community-based Doula Network are heading to Washington, DC to advocate for continued funding for community-based doula programs in the FY11 federal budget.

There will be a National Doula Network reception at the DC Birth Center on Wednesday evening March 10th, and Doula Lobby Day activities on Capitol Hill, Thursday March 11th.

"HealthConnect One has reserved a block of rooms for overnight stay on Wednesday March 10th at the DoubleTree Washington, 1515 Rhode Island Ave. NW. Please call the hotel directly to make a reservation at 1-800-492-5195. When you call to book your room, please state that you are part of the HealthConnect One Network meeting, in order to take advantage of our $175/night room rate (including breakfast). The deadline for the room block rate is February 15th. You will need to provide a valid credit card number upon booking.

We will begin the Lobby Day activities by attending Senator Richard J. Durbin's constituent coffee on Thursday morning (8:30am-9:30am). We encourage you to schedule visits with your congressional delegation from 10am-noon. HealthConnect One will then host a lunch de-brief session from 1pm-4pm at the DoubleTree Washington following our morning visits on Capitol Hill.

Please let us know by Thursday, February 11, 2010 if you are able to attend!

We can assist you with making appointments with your U.S. Senators' and Representative's offices to request a visit (with your elected official or their health legislative assistant). Further information on Doula Funding talking points will also be provided when you register.

We hope that you will be able to join us for these Lobby Day activities, and that your organization can support your travel expenses. HealthConnect One has a small budget to support travel costs, so if you would like to join us, but your organization is unable to cover travel costs, please contact Mac Grambauer at mac@lmcalpine.com.

For those of you who cannot come with us to Washington, we suggest that you call your elected officials in Washington on March 10 and 11, and ask for their support to continue the funding for community-based doula programs in the FY11 budget.

snippet of motherhood

We got stood up for the last big snowstorm - only a mere dusting. There has not been a snow day all year - just the one delayed opening. So this morning I asked my middle son, age 9, if he was planning to wear his pajamas inside out and backwards tonight to help increase the chances of a snow day. His reply:

"Nope - it doesn't work. It's not magic - either it snows or it doesn't."

Jaded much? Where's that sense of childhood wonder??

Birth Trauma

Photo and video editing at www.OneTrueMedia.com

There are women who experience all the things shown in this montage and do not feel trauma - bless you!...but there are many who do carry this trauma with them into motherhood. Many times women are told just to be grateful that they have a healthy baby, end of story. But if your joy is tempered with anger or sadness, please find someone to tell. Process your feelings so that you can move beyond them. Just like labor, these feelings might be intense or messy or not what you expected, but there you are and the only way beyond is through. Be gentle with yourself, go at your own pace, knowing that there are people who care and can help. Solace For Mothers is one such resource.

snippet of motherhood

car conversation with oldest this morning, a delayed school opening because of snow:

me: I wish school started two hours late every day

kid: me too. You should talk to B about it.

me: who is "B"

kid: um, our president?!

me: so you guys are on a first letter basis, then?

kid: yup.

(lest you think it's all chill conversation...in background is youngest kid saying - "yeah - maybe then you wouldn't freak out every morning" and me saying to him, "well, maybe, but only if you put your shoes & coat on when I ask, don't forget you backpack again & stop fighting about who took someone's socks...")

We gotta fight for our right to...

Passing along this message - I'll be calling - will you?

LADIES of the UNITED STATES of AMERICA!
WHY WAIT for REFORM THAT MIGHT NOT COME?!
What do you think would happen in every woman in the United States who has any type of maternity coverage called their health care insurer to tell them:
PLEASE CALL YOUR HEALTHCARE INSURER ON FRIDAY, FEBRUARY 5TH. CALL EARLY IN ...THE DAY!


"I WANT SAFE BIRTHING CHOICES FOR HAVING MY BABY OUTSIDE OF HOSPITAL WITH A CERTIFIED PROFESSIONAL MIDWIFE -- AT HOME OR AT A BIRTH CENTER.

WHEN IS YOUR COMPANY GOING TO COVER MY MATERNITY EXPENSES WHERE I WANT TO GIVE BIRTH?"
"I AM PLANNING TO HAVE A BABY NEXT YEAR (OR WHENEVER!) AND I WANT THIS COVERAGE -- SO I'M CALLING YOU & MY EMPLOYER AND MY STATE INSURANCE COMMISSIONER THIS WEEK TO ASK THIS SAME QUESTION & I NEED AN ANSWER BY [ DATE ].

"
What if these insurers were SIMPLY BLASTED with phone calls, faxes, emails, and other contacts? What do you think their response would be?
I don't know -- if we kept it up for about 1 week -- we might actually demonstrate to these huge companies that what women need is important and they need to listen to us! AND it might make Congress sit up & take notice.
And it wouldn't hurt to call your employer's HR department -- remember THEY are the purchasers of these policies -- and be sure that Licensed Midwives, Certified Professional Midwives, and birth outside hospital is covered in ALL STATES.
Don't wait for Congress to MAYBE do this -- DO IT NOW!
"Who ya gonna call?!" -- Always ask for a Case Manager over OB services! NEVER speak to the first person who answer the phone! They are trained to say, "No, that's not covered," or "I don't know."
THEN get the name & direct phone number of the person with whom you spoke.
Let's get it together Ladies -- and DEMONSTRATE OUR BUYING POWER!

"Comparison Shopping has never been more important!'

Joyce Moxley Thomas, MHA, CPM/LM, HCHICertified Professional Midwife/LM239Certified Hypnobabies InstructorCertified Perinatal Massage Therapist
Executive DirectorAmazing Babies Midwifery Education13768 Roswell Ave. #209Chino, CA 91710909-591-2924www.Amazing-Babies.com
AquaNatal Birth Center13768 Roswell Ave. #209Chino, CA 91710909-591-2924www.AquaNatalBirthCenter.com

winter in NJ

a haiku for today:

whiteout for breakfast
sunshine and blue skies for lunch
what will dinner bring?

follow up: eating & drinking in labor

Today I received a comment from a reader questioning a statement I'd made in an earlier post on new information regarding the ban on eating and drinking in labor. I thought the comment posed a great question worthy of follow up, so thanks Molly.

In my post, I said:

Many hospitals have been advising all laboring women to not eat or drink during labor in case they need emergency surgery with general anesthesia. But isn't that kind of like advising everyone to skip breakfast in case they get hit by a bus?

Molly's comment:

Are the chances of having an emergency C-section really comparable to getting hit by a bus? I've definitely heard of more C-sections than I have bus accidents in the past...

My reply:

Sure, Molly - the chances of having a labor culminate in a cesarean are, possibly, higher than having a random accident (edited to add: I'm guessing here - a less lazy/busy person might add some statistics - chime in if ya got 'em!). However, I think it's VERY important to differentiate between unplanned cesareans and true emergency cesareans. Many woman will call their unplanned cesareans "emergency" when in fact they were actually unplanned and while there was perhaps not an easy-breezy pace, there was likely time for regional anesthesia. I have, luckily, been a part of only one true emergency cesarean in about 400 births.
As I said, the chances of needing energy for labor is 100%...and not having sufficient energy can actually lead to unnecessary cesareans if the laboring woman is unable to carry on or her labor stalls and augmentation of that labor leads to fetal distress. Avoidable cesareans (major abdominal surgeries) pose risks to moms and babies. So the extremely small risk posed by eating in labor is, in my opinion, worth it.
Coincidentally, an OB from a respected hospital in Boston recently quoted in the NY Times used a very similar example and line of reasoning to my bus idea, so I'm comfortable with my statement. I'll post this in a blog entry & try to find the NY Times article too. Thanks for your important question.

best,
Kim

And that NY Times article can be found here if you would like to read the whole thing - there is a good discussion of what all the fuss is about, concern-wise - it is serious, and it's very, very rare. The quote I mentioned:

“My own view of this has always been that you could say one shouldn’t eat or drink anything before getting into a car on the same basis, because you could be in an automobile accident and you might require general anesthesia,” said Dr. Marcie Richardson, an obstetrician and gynecologist at Harvard Vanguard Medical Associates in Boston, who was not connected to the new study.

got milk?

Jan-25-2010
Urgent Call for Human Milk Donations for Haiti Infants
Salem-News.com

Donor milk provides unique protection for fragile preterm infants, mothers who are willing to donate human milk should contact their regional Mothers’ Milk Bank.


(PORTLAND, Ore.) - The Human Milk Banking Association of North America (HMBANA), United States Breastfeeding Committee (USBC), International Lactation Consultant Association/United States Lactation Consultant Association (ILCA/USLCA), and La Leche League International (LLLI) are jointly issuing an urgent call for human milk donations for premature infants in Haiti, as well as sick and premature infants in the United States.

This week the first shipment of human milk from mothers in the United States will be shipped to the U.S. Navy Ship “Comfort” stationed outside Haiti. “Comfort” is currently set up with a neonatal intensive care unit and medical personnel to provide urgent care to victims of the earthquake.

An International Board Certified Lactation Consultant stationed at the U.S. Navy base in Bethesda, MD is assisting with providing breast pump equipment and supplies to the “Comfort.” Dr. Erika Beard-Irvine, pediatric neonatologist, is on board the “Comfort” to coordinate distribution of the milk to infants in need. HMBANA, USBC, ILCA/USLCA, and LLL are responding to requests to provide milk for both premature infants and at-risk mothers who have recently delivered babies on board the U.S.N.S. Comfort, but an urgent need exists for additional donations.

At the current time, the infrastructure to deliver human milk on land to Haiti infants has not yet been established. As soon as that infrastructure is in place, additional donations will be provided to older infants.

Mothers who are willing to donate human milk should contact their regional Mothers’ Milk Bank of HMBANA. A list of regional milk banks is available at the HMBANA website at www.hmbana.org.

Currently milk banks are already low on donor milk. New milk donations will be used for both Haiti victims as well as to replenish donor supplies to continue to serve sick and premature infants in the U.S. Donor milk provides unique protection for fragile preterm infants.

Financial donations are also strongly encouraged to allow HMBANA, a nonprofit organization, to continue serving infants in need.

UNICEF, the World Health Organization, the Emergency Nutrition Network, and medical professionals all recommend that breastfeeding and human milk be used for infants in disasters or emergencies. Human milk is life-saving due to its disease prevention properties. It is safe, clean, and does not depend on water which is often unavailable or contaminated in an emergency.

Relief workers, health care providers, and other volunteers are urged to provide support for breastfeeding mothers to enable them to continue breastfeeding, and to assist pregnant and postpartum women in initiating and sustaining breastfeeding.

For more information, contact HMBANA at 408-998-4550 or hmbana.org. Additional information can be provided from the United States Breastfeeding Committee at 202-367-1132 (usbreastfeeding.org), ILCA/USLCA at 1-800-452-2478 (www.ilca.org or www.uslca.org), or La Leche League at 847-519-7730 (llli.org).

Hike for Haiti

We had fun starting our day yesterday with this beautiful hike, enjoying the nature and people of our community...while raising some bucks for people who so need it.

sachidananda

I just came from a wonderful yoga mini-retreat - just two and a half hours, but very thought provoking (and hard work!), part of a bigger weekend workshop. And all I had to do was go a few blocks from my house and join in. It was an Anusara workshop organized by South Mountain Yoga & facilitated by Ross Rayburn. And it's happening again tomorrow afternoon - there is still some room if you're local & interested! (Maybe you can score a new Ganesh tshirt too)

The thought behind the day was the trinity (he used a fancier word, which I've already forgotten)...he used, in part, the backdrop of Sachindananda, which is part of the Anusara invocation (above).
Sachidananda is a combination of three words:
Sat = existence, truth, real.
Chit = consciousness
Ananda = bliss.
He suggested that in yoga we must first surrender, then reign it in and consider the boundaries before we can once again and more fully surrender. We spent time in each posture playing with the idea that you can't really fly or surrender or get to the bliss with out finding the tension and working with it, fine-tuning it, moving beyond it to a place you wouldn't have gotten to without first acknowledging it. So often we just go to the fullest expression of something, because we can, out of habit or because it's easier than really engaging...like in Uttanasana (standing forward bend) if we make touching the floor the main goal, and flop down there without making sure that our shoulders are engaged, pulling back even as we reach forward.

Like many things, this got me thinking about, what else?, birth. How many times have I told someone in labor to "just surrender" - JUST! Maybe I need to be mindful of the negotiation that must take place between the tension & surrender, allowing a woman to be contained by her body, feeling safe, before surrendering a little and then contained again, and then a deeper surrender. Like when a baby is being born and he turtles back and forth until ready to emerge under the pubic bone and out. Like when it's kinder to a mother's body if she can stay in the place of tension as she stretches, even as she wants to maybe blast out that baby, but allows herself to negotiate the passage, tempering the holding with releasing.

Balance requires choice and mindfulness, but then we get to melt more fully.

blog for choice day

Unlike me, some people are not falling down on the job today - check out Radical Doula's post, "How About We Call It Blog For Justice Day?"

hmm - it's as if they are using their brains!

Many hospitals have been advising all laboring women to not eat or drink during labor in case they need emergency surgery with general anesthesia. But isn't that kind of like advising everyone to skip breakfast in case they get hit by a bus? There's a 100% chance that women will need energy for labor...

Well, finally a well-respected organization is calling BS on this (read the full article here) for low risk women:

NEW YORK (Reuters Health) - There is no reason why pregnant women at low risk for complications during delivery should be denied fluids and food during labor, a new Cochrane research review concludes.

..."Women should be free to eat and drink in labor, or not, as they wish," the authors of the review wrote in the Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research....

...Standard hospital policy for many decades has been to allow only tiny sips of water or ice chips for pregnant women in labor if they were thirsty. Why? It was feared, and some studies in the 1940s showed, that if a woman needed to undergo general anesthesia for a cesarean delivery, she might inhale regurgitated liquids or food particles that could lead to pneumonia and other lung damage.

But anesthesia practices have changed and improved since the 1940s, with more use of regional anesthesia and safer general anesthesia...

...And recently, attitudes on food and drink during labor have begun to relax. Last September, the American College of Obstetricians and Gynecologists (ACOG) released a "Committee Opinion" advising doctors that women with a normal, uncomplicated labor may drink modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks. They fell short of saying food was okay, however, advising that women should avoid fluids with solid particles, such as soup...

...Singata and colleagues systematically reviewed five studies involving more than 3100 pregnant that looked at the evidence for restricting food and drink in women who were considered unlikely to need anesthesia. One study looked at complete restriction versus giving women the freedom to eat and drink at will; two studies looked at water only versus giving women specific fluids and foods and two studies looked at water only versus giving women carbohydrate drinks.

The evidence showed no benefits or harms of restricting foods and fluids during labor in women at low risk of needing anesthesia.

...Singata and colleagues acknowledge that many women may not feel like eating or drinking during labor. However, research has shown that some women find the food and drink restriction unpleasant. Poor nutritional balance may be also associated with longer and more painful labors. Drinking clear liquids in limited quantities has been found to bring comfort to women in labor and does not increase labor complications.