take that, lame study on home birth dangers!

Home birth has been in the media a lot lately due to a recent study saying that although home birth is safe for low-risk moms, babies born at home had a 3x greater mortality rate. But how did they get that number? The American College of Nurse-Midwives' (ACNM response is great at picking apart the findings...bottom-line, it was a poorly done compilation.

In part, ACNM president, Holly Powell Kennedy, CNM, PhD, FACNM, FAAN, says the study is flawed because,

They included studies that did not distinguish between planned and unplanned home births. For example, if you had planned a hospital birth, but your labor progressed so quickly that you gave birth before you even made it to the hospital, then you wouldn’t have had a skilled attendant or necessary resources present.

In contrast, a planned home birth means that the woman and her health care provider have determined she is healthy, at low risk for complications, and has the necessary resources in place for a safe birth. By combining the two types of home births, the findings are limited.

Second, a meta-analysis is a way of combining the results of many studies. But in this case, there seems to be no clear reason as to which studies they included versus those they excluded. In fact, they actually did not include the best and by far largest study that's been done—which did not find a higher neonatal mortality rate.

Welcome Lilianna Sarah

Born Monday, 7/12/10 at 11:06pm, 7lbs even and 19' long.

You heard about the scheduled induction and decided to head out on your own - and when you did, man did you fly...so much so that I had to help the doctor catch you! Your momma was a rock star and your daddy rock solid ...enjoy the pictures of her examining you herself, complete with stethoscope and him cutting the cord - priceless. You are blessed with a wonderful family: auntie, uncles, grandparents and big dog brother, Whiskey Bob, who helped doula you throughout labor.

Welcome to the world, Lilianna!

sling it good!

be sure to watch until the end!

Happy Internal Activist Day

Happy Independence Day!

I went to yoga this morning and the talk at the start of class was about freedom and what that means. It so perfectly meshed with the choices we make around birth and life. Apologies for the ramble that is to come...I'm choosing (ha!) not to edit very much because that is my right! ;-)

I think we mostly think of that "Yahoo! I'm free!! School's out for summer!!" kind of feeling when we think about freedom. Other times we feel a lack of freedom and might say, "I'd love to, but my hands are tied". These can both be valid, but you never really have one without the other...with freedom comes responsibility. If we are free to choose, then we acknowledge that we are in charge at least of the things we are choosing. We always have freedoms if we choose to see them and take them on, even if those freedoms are small. Like in yoga, creating alignment in life, birth, death - it's a choice.

Many times we create the construct for ourselves that we have no choice because to do otherwise means that we have to take action. If someone is 39 weeks pregnant and knows deep down that she is not on the same page as her care provider, she might say she has no option but to hope for the best. Not true (unless she allows it to be). She might not have every choice - not all other providers will want to take her on, or maybe her insurance limits her choices, she could go into labor before switching. BUT, she does have a choice whether to continue in the relationship that is not working for her without entertaining her other options. She can try on other care providers for size...in fact, she might learn that the care provider she wanted to leave now may feel like the best choice after all...and then she CHOOSES to stay with an open heart, rather then stay because she feels she has no other option. That's powerful.

But I get it...feeling like someone else is in charge and calling the shots is appealing on a certain level. My mom is very ill and part of me just wants to sit back and let others tell us what to do...what is the best course of action, what will be easiest. I do get it on a deep level. And yet, I hope that I will find the courage to proceed with awareness, even if it is frightening or overwhelming. I know I have options, freedoms...and that they come with a price.

Ultimately, freedom is a good thing. So even if your only bit of freedom (it feels like) is to take three deep and relaxing breaths right at this moment, choose to do so, knowing that you are doing what you can. My yoga teacher would call this "internal activism" (I think! - I may be totally misinterpreting...) .
Happy Independence Day.
Happy Internal Activist Day too.

seeking doula in Portland, ME

This is for a friend of a client...due around 8/18...

fleeting

I always loved feeling my babies kick and wiggle when I was pregnant.
I often tell women in labor, as a reminder to check in with their babies, to pay attention...before long, that baby will be on the outside and those delicious internal movements once felt will be only a memory.

Welcome Ross Edward III

Born 6/15/10 (Flag Day +1) at 7:39pm, weighing 7lbs 3oz
Named for your proud papa & grandpa.
Worth the very long wait...12 years, 41 weeks and about 25 hours.
You looked right into your momma's eyes as she sang to you. You are so very wanted and loved already by your wonderful parents and fur sibling.
It was an honor to be there when you finally joined us.
By the way, I've never met a baby who calmly flirts moments after birth!
Happy birth day!

Welcome, Juliette!

I never cease to be awed by the strength of women, including your mom, Juliette! You were born at 6:30 this morning, a wonderful all-natural VBAC, cheered on by your ever-calm dad. A relatively quick and very intense labor followed by some long hours of pushing, but out you came, delicate and beautiful, 7lb 15oz. Congratulations to your parents and your big brother, J.

Happy birthday!

welcome Hunter Michael!

Born yesterday, 6/2/10, with a head of curly hair and weighing a lovely, if surprising, 9lbs 13oz!

After weeks of contractions, yesterday was the day and you, handsome boy, were born into a family so very full of love, partnership, kindness and strength - it was such a pleasure to witness your parents over the last months and then the final hours leading up to your birth!

SOS: Save Home Birth in NY!

(DoulaMomma says:
Passing this along - even if it doesn't impact you personally, please consider making your voice heard as someone who cares about preserving options for all birthing women - if it can happen in NY, it can happen in your state too...pass this info along on your blogs, Facebook etc. too please)

ACTION ALERT:

Save Home Birth in New York

We need your help!

At midnight tomorrow, April 30th, the majority of New York City's home birth midwives will no longer be able to practice legally. Unless immediate action is taken by the Governor and the NYS Department of Health the women that these midwives serve will be denied access to a home birth with their chosen provider and these providers will no longer be able to practice legally in NYS.

YOU MUST ACT NOWto save the home birth option for New York Women:

Call:

• 311
• Wendy Saunders, Executive Deputy Commissioner for the NY State Department of Health, appointed by Governor Paterson. 518-474-8390
• Larry Mokhiber, he Secretary of the Board of Midwifery(518-474-3817, extension 130)

And say....

With the closing of St. Vincent's Hospital, half of the licensed, highly trained home birth midwives serving NYC have lost their Written Practice Agreement (WPA). St Vincent's was the only Hospital in the city supportive of a woman's right to choose a home birth and willing to sign a WPA. In the weeks since it's announced closure, these midwives have reached out to hospitals and obstetricians all across the city looking for support, with no success. Please help us to save the homebirth option in New York.

People can also email the Governor at http://www.state.ny.us/governor/contact/GovernorContactForm.php.

We are in our final hours! Please forward this email and help us flood 311 and the Governor's office with calls supporting home birth.

And while you're at it, please sign our petitionsupporting the Midwifery Modernization Act which will remove the WPA from the midwifery law effectively removing this barrier to accessing midwifery care.

http://www.ipetitions.com/petition/midwifery/

See NYSALM's fact sheet about what the Midwifery Modernization Act Means for You.

Snippet of Motherhood

Two from my oldest (12.5 going on 25)...gotta write this stuff down or I'll never remember:

this morning I asked him if he wanted eggs - he needed a good breakfast before a big test...his reply?

"How will eating chicken fetuses impact my test performance, Mamacita?"

and over the weekend I heard him and his friend talking while eating breakfast and watching TV:

my kid: "Oh yeah - that's my show, son!"
friend: "what is this?"
my kid: "Twelve Angry Men, yo!"
friend: "good stuff, excellent entertainment"

sometimes, not knowing is better

I watch The Biggest Loser & really like Jillian, one of the trainers. But I have to say that it's probably easier to like a public figure if you don't know much about them. Take this quote for instance,

"I'm going to adopt. I can't handle doing that to my body,"

I suppose if that's the way she feels, it's for the best that she doesn't get pregnant. And I think it's great that she feels drawn to create her family through adoption.

BUT it makes me feel uncomfortable that someone who is in the public eye for inspiring women to be strong and feel good about their bodies is putting this idea out there. I understand she had a weight issue as a teen, but so did a lot of us (sometimes way beyond our teen years!) and yet we put it aside. So what do you think - am I being too tough?

so bad/so good

I'm going through a breakup. With Diet Coke. We can still be friends & see each other sometimes, maybe out in public, but no more living together.

We've been together for a LONG time, sometimes in a really unhealthy way, spending way too much time together and to the exclusion of healthier beverage choices. Diet Coke, for me, is like that bad-boy boyfriend. The one who is super hot but just not good for you. You know in your head you should move on, but that tingle in the back of your throat, that satisfying sound when you pop open a can (I always tap it with my nails first, don't know why) - it's hard to give up. And European Coca-Cola Lite - amazing (must be the accent!). Being from the south, where we like our drinks cold, DC is the way I've often started my day - I know, I know - try not to think less of me.

I was set up today by my new friend Heather with Zevia (made with stevia)...solid marriage material I suppose, though a bit like Tab (with whom I had only a brief fling)...but I don't know if it will be the same. Gotta try to preserve the brain cells I have left though, so it looks like it's me a Steve, I mean Zevia. Or maybe I'll just drink more coffee.

snippet of motherhood

Spring is in the air & so are allergies - our pediatrician has suggested Claritin, though we don't generally use it. Today my youngest, who JUST turned six, said

I think I need some of that "kids' clarinet", Mom - I'm really sneezing a lot

spring fever

Today was glorious weather and so I did the big garden clean up...cutting back the old & dead, raking out the leftover leaves from fall, stacking up all the branches and rounding up all stray soccer balls. Had to step around the muddy areas after snow melt from back-to-back blizzards & the wettest March ever or something. It's love/hate - kind of drudge work that is strangely satisfying. I'm a homebody.

But a homebody who loves to travel & dream of the unknown, the road not taken. I know a couple of people moving to California and I'm finding myself a bit envious - seems like an adventure to start fresh - like a pioneer heading west - but truly I don't want to move. I like being here.

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.