Tuesday, March 9, 2010

Great Blog Interview

The blog may be a little slow over the next few weeks as I get organized for a big spring cleaning and get started out in the garden. But I just have to share a great interview post over at Progressive Pioneer: MamaViews: Donna of Banned From Baby Showers. Here's a teaser:
"My focus as a natural childbirth educator is to reach the mainstream and help them understand that this is not about being “crunchy” or alternative. It's simply about doing what we, as women, are made to do. Our bodies are amazing, and to numb the experience of childbirth is a shame. We avoid drugs throughout the pregnancy and load up in labor. It doesn't make sense. 'Mainstream.' 'Alternative.' 'Crunchy.' How about just 'Woman.'"
Good stuff, eh?

Have you come across any particularly interesting interviews or blog posts lately? Share in the comments!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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Wednesday, February 24, 2010

A Week of Links: Personal Experience

Rixa, at Stand and Deliver, recently asked women to share their epidural stories. She wrote, "When I was a PhD student, I was chatting with an acquaintance about pregnancy and birth. She had four children. She said something that was really hard for me to wrap my mind around. 'I just love it when I go into labor and get an epidural,' she said. 'I feel so empowered!'" Rixa goes on to wonder why "women have such different reactions to certain choices or life experiences", noting how potentially divisive women's reactions to others' choices can be.

At last count, there were 45 comments, with women discussing their personal experiences with epidurals. I found it very, very interesting.

Also interesting is the At Your Cervix post, "Some self loathing, some guilt, and a whole lot of venting". Here's an intro:
"Yes, hospitals, medicine and nursing care can save lives. However, ever notice the trickle down effect of us *causing* some of the problems in the first place?

I have been guilty of thinking far too medically as a nurse on L&D. I feel guilt for being that medicalized thinking nurse. I'm not talking about truly sick people, I'm talking about normal labor and births."
More post, coming up. Have you read anything interesting online that's been birth/pregnancy-related? Please share in the comments!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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Monday, February 22, 2010

A Week of Links: News

I've read some great posts lately, and I want to share several of them with you. First, the news items:

From the Motherwear blog, Study: Common antidepressants can delay milk coming in. According to the study, women who were taking an SSRI drug like Prozac, Zoloft, or Paxil had a median onset of lactation difference of about 17 hours - 69.1 vs. 85.8. This is especially important given that milk is termed "officially" delayed if it takes more than 72 hours to come in.

Of course all this is not to say that mothers taking an SSRI drug should not breastfeed! Just that they should be aware that it may take a bit longer for their milk to come in, and that this longer length of time is normal for women taking an SSRI drug. Ideally, they would also be aware of the problematic sequence of events mentioned in the post, and take steps to prevent longer-term challenges:
"delayed milk "coming in" can have some serious consequences, especially if it isn't managed well. The drill goes something like this: delayed onset of mature milk leads to higher than normal weight loss in the baby, which leads to supplementation, which can lead to compromising of the milk supply and/or nipple preferencing if the supplementation isn't done carefully. It can also increase the risk of jaundice.
Talking to a local lactation consultant, a La Leche League leader, and/or doing some reading ahead of time are all suggestions I would make to moms who want to prepare for this potential challenge.

And, from a link from Woman to Woman Childbirth Education blog, a blog post from the San Diego Birth Network on Cervical Scar Tissue – A Big Issue That No One Is Talking About. This is an incredibly valuable post for professionals who work with women during pregnancy and childbirth, as well as for women themselves who may have scar tissue on their cervix, from cryo surgery or other surgeries.
The midwife proceeds to explain to my sister that she is going to try and massage the cervix and break the scar up. With some discomfort for my sister, she went from a finger tip dilated to 3 cms in a matter of minutes. An hour later she was 4 cms and an hour after that my nephew was born. Once the scar tissue had completely released, she flew to 10 cms.

As you can imagine, I asked that Midwife a ton of questions. I wanted to know all I could about this scar tissue stuff. Besides “massaging”, what can you do before hand? She shared her knowledge with me. Told me that HPV is so very common and more and more women are having these standard procedures done, but are never informed that it most likely will leave scar tissue. Although less common, this includes women who have ever had a D & C after a miscarriage or abortion.

Once I was armed with the knowledge, my successful VBAC rate shot up as did my vaginal birth rate in general. I would ask the question and if the answer was yes, I would tell them what I knew."
There is more useful information on the blog post, so I highly recommend clicking on the link and reading the whole post!

More links tomorrow!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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Sunday, February 21, 2010

Give Aways!

The Motherwear Blog just had an incredible give-away week. It's not too late to add your comment and be entered into the contests. Wonderful books and cds, gift certificates and more!

Also, if you're looking for nursing clothes, I highly suggest you check out their clearance sale. I can't tell you how many wonderful items I've gotten from these sales for incredible prices. Some, I still wear now - a long black skirt, and pj shorts, for example.

And, from Progressive Pioneer, a blog I recently discovered: Giveaway: The Sitting Tree. Beautiful, beautiful!

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Saturday, February 20, 2010

Mamas & Muffins: Baby Food

Last Monday was the Mamas & Muffins group, so I got to snuggle some sweet little babies and we all talked about baby food. If you couldn't make it, here's some of the information we discussed:

… there’s no rush …

Frank Greer, M.D., FAAP, member of the American Academy of Pediatrics' (AAP) Committee on Nutrition, says breastmilk is the optimal choice of nutrition for your baby for the first 12 months.

“The AAP Section on Breastfeeding, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, Academy of Breastfeeding Medicine, WHO, United Nations Children's Fund, and many other health organizations recommend exclusive breastfeeding for the first 6 months of life.”


… it’s a go …

Signs baby may be ready for solid food include:

  • baby sits upright
  • baby has lost tongue-thrust reflex
  • baby watches people eating & imitates
  • baby can pinch-grasp smaller objects
  • baby may have doubled(ish) birth weight
  • baby may be teething

    There is no definitive sign, I don't think. I used the examples of my children. I started them both with solid food at about 5.5 months, when they could both sit up, they seemed interested, and could swallow tiny spoonfuls of food. Madelyn was still a few pounds off from doubling her birth weight, but she was teething. Owen was still months from getting teeth, but had long since doubled his birth weight.

    In my opinion, the best way is to be guided by baby. If baby likes the food you offer, has no trouble swallowing it, and is happy at mealtimes, than it sounds like she's ready!


    … first foods …

    first: bananas, pears, unsweetened applesauce, avocado, sweet potatoes, rice cereal, peaches

    and then: yogurt, egg yolk, oatmeal, finely chopped chicken, beans, cheese, cheerios, baby biscuits

    I love the list of food suggestions in the Sears' Baby Book

    I also mentioned to the Mamas about the BRAT & anti-BRAT foods, because I learned this the hard way. Madelyn wouldn't take rice cereal, so this wasn't a problem for her, but after I'd been feeding Owen solids for a month or so (applesauce, bananas, a bit of rice cereal), he became wicked constipated. Poor bubby. I hadn't heard of the BRAT diet, that people sometimes eat if they're recovering from a stomach bug or something else that may have caused diarrhea. Basically, it's Bananas, Rice, Applesauce, and Toast - which all have binding-up properties. Turns out I was feeding a lot of those foods to Owen. Then someone (thankfully!) told me that P fruits tend to have the opposite effect, loosening things up: pears, peaches, plums, prunes. All of these are good first foods for babies too, so it became a matter of simply adjusting amounts depending on the desired effect. I'd mix pears and applesauce, or peaches and banana, for example.


    ... make your own…

    Making your own baby food can be easy. Roast vegetables like sweet potatoes or winter squash. Peel and use fruits like bananas, pears, and avocados. Mash with a fork, or food process. Scrape into ice cube trays; freeze; remove from the trays and store in freezer bags. Thaw the cubes in the refrigerator, or warm in the microwave. Check temperature and texture and feed to baby. Or if you want some real excitement, hand baby the spoon!

    It really is that simple.

    Once the baby was just a bit bigger, I'd spend an hour every few weeks - roast a few sweet potatoes; poach some skinless chicken breast; briefly cook a few peaches in a pot of boiling water (X the skin before you put them on so it slips off easily) and then puree it to the texture I wanted in the food processor. Put in the ice cube trays and I had baby meals for several weeks. Add to that the things I fork-mashed (banana, pear, avocado) or made to order (egg yolk) and some plain yogurt, and we were pretty much all set.

    One of the other nice things about making your own baby food (beyond knowing exactly what's in it!) is that you can feed your baby more local foods, and foods that are in season. When Owen was a baby I got a huge box of peaches, in season, and pureed/froze them until he was ready for them. When we picked apples, I froze plain applesauce for him. I know that isn't a huge motivator for some people (and he had plenty of non-local bananas and avocados!), but it was something I felt good about.


    … resources …

    The Z Recs Guide publishes information about harmful chemicals in common baby products.

    Also, a post I wrote about toxins in children's toys and products.

    All about Baby-Led Solids

    Foods to avoid, and why

    KidSafe Seafood

    Baby Safe feeder

    The Baby Book by William Sears, MD and Martha Sears, RN

    Super Baby Food by Ruth Yaron

    Feel free to leave any of your favorite baby feeding tips, recipes, links, cookbooks etc. in the comments!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Monday, February 8, 2010

    Date Night

    At Your Cervix is one of my favorite birth blogs. It's written by a registered nurse who currently works on a L&D unit at a large teaching hospital. She's also in-training to become a midwife. Very interesting stuff, from a perspective that I won't have from personal experience.

    She was recently invited to guest blog on another blog, and wrote "How to Take Charge of Your Labor and Delivery". Two things that she wrote in this post really stand out for me:
    "Dads: what can you do to help Mom? Go to childbirth classes together. Consider it a date night before the baby arrives."
    What a lovely idea! If a couple decides to do four classes with me, that's four date nights. Maybe they'll go out to eat afterwards, depending on time and finances. Or maybe they'll go for a nice long walk and talk. All of a sudden, what may have seemed a bit like a chore-commitment is a springboard for a really nice day together!

    Also:

    Why do people date? To get to know each other! And getting to know each other's ideas and preferences and fears around labor and birth is such an important part of the process.

    Do dates cost money, at least some of the time? Yes. And so do birth classes. But for the cost of a night on the town, with a nice dinner and movie, a couple could attend birth classes that teach them life-long skills... classes that help them during an exciting and sometimes challenging time of life as individuals and as a couple... they get to explore, with each other, their ideas and dreams around meeting the life they created.

    Dates sometimes take some planning, and some setting-aside-of-time during hectic daily life. So do birth classes. But is a date worth it? Yes. And so are birth classes!

    Why?

    Well, that's the other thing about At Your Cervix's guest post. She wrote, "Planning ahead and knowing what you might expect are important to your labor and delivery experience" followed by questions about the routine management of labor in most hospitals: fetal monitoring for how long? getting out of bed? IVs? Etc.

    Of course it's important for moms & partners to know what the routine is at the birth place they chose. It's not good to think your date is to an elegant restaurant and then the car stops at McDonalds! But before women can choose where they want to give birth, they need to know their options! In order to know what we want, we need information.

    Which takes me back to childbirth classes... independent childbirth classes to be specific.

    If you're in the Central Maine area, and are having a baby - let's set up some date nights! They may be the most life-changing, important dates you ever go on.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Wednesday, February 3, 2010

    Make Your Own Baby Sling

    For those of you interested in making your own baby slings, I have two links to free patterns!

    Here's a tutorial offering step-by-step directions and pictures on how to make a ring sling, like the Maya Wrap.

    And here's how to make a pouch, kind of like a Kangeroo Kozy Pouch. I found this link through Progressive Pioneer's post on making a pouch for her new baby.

    Happy Sewing!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Tuesday, January 26, 2010

    More on Eating, Drinking and Labor

    This is just a quick post to highlight an article in today's New York Times Health section (by the way, I love getting this free, weekly, via email). The article is called, "In Labor, a Snack or a Sip?", and in it, an obstetrician is quoted giving the same example situation I give in my classes:
    '“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.'
    I wonder if more people need emergency general anesthetic after a car accident or during a Cesarean birth?

    I imagine this article in the Times was prompted by the recent Cochrane review of the seven-decades-long ban on eating and drinking in labor enforced by many (but not all) hospitals. The review, Restricting Oral Fluid Intake and Food Intake During Labour is available online.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Sunday, January 24, 2010

    Wow! Links.

    I love reading birth blogs. And I love the fact that I can share my favorite entries written by informed, compassionate birth professionals with you. Here are some great ones that I've read lately...

    Navelgazing Midwife has had some fantastic photo posts lately. "Labor: A Visual Guide" explains some of the signposts Barbara uses to assess where a woman is in her birth journey.

    So many of the mamas I work with ask about eating and drinking during labor. Kathy, a fellow independent childbirth educator, offers a terrific evidence-based post on this topic, "No Justification for NPO".

    She also wrote a hard-to-read but oh-so-important post on circumcision. When a family I'm working with wants to talk about their plans to circumcise their son, I always ask, "Who is going to go with him for this procedure?". The responses are often telling: no one wants to go. When that happens, I hope that gives the family room to think through putting their infant through a procedure they don't even want to watch! There are some graphic pictures in this post, but I think it's an important one, "Circumcision Guidelines". I didn't watch the linked videos and so cannot comment on those.

    Finally, Gloria Lemay has had some great blog posts lately too. Even though the H1N1/swine flu has gotten much less hype lately, I think her tips on staying flu-free are excellent ones throughout a winter pregnancy. You can read them at "Gloria Lemay's Regimen for a Flu-free Pregnancy". And her post, "The Slow Birth" movement may make some women who wish for short labors reconsider...

    Have you read any excellent blog posts lately that you'd like to share? Or written a really good one? Leave a link in the comments!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Thursday, January 21, 2010

    "Why Choose a Midwife?" Video

    I saw this video on Gloria Lemay's blog. I think it's a terrific overview of the many reasons why women choose hospital or homebirth midwives. It was put together by volunteers from Our Bodies Ourselves and the Massachusetts Friends of Midwives.



    Of course it's critical to remember that there are some OBs and family docs who practice evidence-based, woman-centered care and that there are some midwives who practice as "med"wives. That's why it's so important to get to know your care provider!

    But for people who are just beginning to investigate the possibilities of midwifery care, or those who are curious, this video is a great introduction.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Sunday, January 17, 2010

    Status Quo: Not Good Enough

    As usual, I enjoyed Peggy O'Mara's article in the most recent Mothering magazine, "The New Health Journalism: Challenging the Status Quo". What stood out to me most was this part, "Barbara Loe Fisher asked me if I have suffered for challenging the status quo. My job as a mother is to challenge the status quo . . . It is not my job to follow the current fashions, but to forge my own way, to develop my own personal ethic of parenting."

    The status quo (defined by dictionary.com as "the existing state or condition") is not good enough. Just yesterday I got an email link to an msnbc news article, "C-section rates around globe at 'epidemic' levels", which makes a perfect Exhibit A.
    "In the U.S., where C-sections are at an all-time high of 31 percent, the surgery is often performed on older expectant mothers, during multiple births or simply because patients request it or doctors fear malpractice lawsuits. A government panel warned against elective C-sections in 2006.

    “The relative safety of the operation leads people to think it’s as safe as vaginal birth,” said Dr. A. Metin Gulmezoglu, who co-authored the Asia report. “That’s unlikely to be the case.”

    Women undergoing C-sections that are not medically necessary are more likely to die or be admitted into intensive care units, require blood transfusions or encounter complications that lead to hysterectomies, the WHO study found."
    This example fits Peggy O'Mara's warning perfectly. She explains that,
    "As new parents, we believe that society will take care of us, has our best interests at heart, and will protect us. I want new parents to believe this, but health-care policy in the US is focused on eradicating rather than preventing disease. It is fear-based, interventionist, and compromised by economic considerations. At this time in history, assuming that society will protect you can be a dangerous belief."
    Personally, I do not want new parents to believe this. I want it to be true; but until it IS true, I wish opened eyes and hearts for all of us, so we can make the best choices possible for our families' health.

    Do you believe it is a mother's (or parent's) job to challenge the status quo? How have you challenged the status quo? What sources do you use to make your best informed choices for your families' health?

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    Friday, January 15, 2010

    Mamas & Muffins Group Coming Up: Monday, 1/18

    We're meeting in Winthrop (15 min from Augusta; around ~30 min from Waterville and Lewiston/Auburn) this Monday, January 18th. Free, fun, with food!

    This group's topic is baby-wearing, with demos of a Maya Wrap (ring sling), a Moby Wrap, and a fleece snap sling. Come visit & try them out.

    Pregnant moms welcome too!

    For time, directions and more information, go to http://www.birthingyourbaby.com/postpartum.html.

    We'll be meeting regularly, first and third Mondays of the month. Hope to see you there!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Tuesday, September 29, 2009

    You Have a Choice - Video

    I've seen this circulating through various birth-related blogs. I first saw it on Gloria Lemay's blog. Since it clearly fits in with my last few blog entries, I thought I'd post it here too in case you haven't already seen it.

    You Have a Choice (A Short Birth Documentary) from Goodrich Creative on Vimeo.



    It turns out, apparently, that my (unintentional) theme for September was centered on asking questions & making choices. I have some posts brewing on postpartum life and parenting, so look for them in October!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Sunday, September 20, 2009

    Fall Classes & New Mamas Group

    I'm currently scheduling group and private classes for this fall and early next year - moms with due dates from October thru January! Classes are held in Winthrop, which is about half an hour from Waterville and the Lewiston/Auburn area, and fifteen minutes from Augusta.

    For more information, feel free to email me or visit Independent Childbirth Classes for Central Maine.

    Read below for some of the benefits of attending Birthing Your Baby classes!*

    CLASSES THROUGH MONMOUTH/WINTHROP ADULT EDUCATION
    Preconception & Early Pregnancy Class
    An introduction to pregnancy, with activities and discussion on nutrition, exercise, and self-care for a healthy, comfortable pregnancy as well as tips on choosing a care provider and putting together a supportive birth team. Enrollment is limited to women and their partners who are trying to conceive, or who are less than twenty weeks pregnant.

    Thursday, September 24th, 6-9pm
    Winthrop Middle School Library
    Fee: $20/couple

    To register, contact the Winthrop Adult Learning Center from 8-2:30 Monday thru Thursday at 377-2265 or Friday 8-10am.
    Coping Strategies for Labor and Birth
    Introduces a wide variety of coping strategies for labor and birth, including breathing, relaxation, massage, visualization, position change, and water therapy. Some practice time and a short video will help you start thinking about which strategies might work best for you. This class will also be helpful for the birth partner, providing lots of concrete ideas of how to be supportive during labor and birth. Enrollment is limited to women who are in their second or third trimester. Participants are encouraged to bring a support person.

    Monday, November 9th, 6-9pm
    Winthrop Middle School Library
    Fee: $20/couple

    To register, contact the Winthrop Adult Learning Center from 8-2:30 Monday thru Thursday at 377-2265 or Friday 8-10am.

    MAMAS AND MUFFINS: NEW MOMS GROUP!
    I invite all mamas and their "little muffins" ;-) to drop in anytime from 9 to 10am, have a muffin and some tea, and enjoy chatting with other new moms. From 10am to 11, there will be time for women to share their experiences, ask questions & get support. Free and open to all new mamas and their pre-crawling babies.

    Groups will be held on the 1st and 3rd Mondays of each month, from 9-11am at the Winthrop United Methodist Church (58 Main Street in Winthrop), upstairs in the nursery. Use the side Wonder Awhile Nursery School entrance. Signs will be posted. Although the WUMC graciously hosts the group, the group itself is not connected with the church and is secular.

    September 21st, 2009
    October 5th & 19th, 2009
    November 2nd & 16th, 2009
    December 7th & 21st, 2009

    *Wondering about the benefits of Birthing Your Baby classes?
    Birthing Your Baby classes are centered in a deep belief in a woman’s ability to give birth… that birth can be an empowering, transforming experience in a woman’s life…that birth is an essentially safe process for baby and mother. The philosophy that drives these classes also inspires confidence and joy in the birth process and in your new lives as parents.

    Birthing Your Baby classes are independent. I am not required to teach from a rigid curriculum that only “approves” of certain kinds of birth. This is your birth…your baby!! I will provide up-to-date, evidence-based information and then you can make your best decisions for a healthy and satisfying birth experience, whether it’s an all-natural home birth or a hospital birth with a planned epidural. We will also discuss and practice helpful communication skills so you can maintain an open dialogue with your careproviders.

    I believe small classes work best, so there will never be more than five couples in a class. Small classes allow for more student interaction, for more discussion, and for the class content to be personalized to address each student’s particular needs. Private classes are also available.

    I offer a variety of classes – group classes that last four to six weeks, as well as private classes. We discuss everything from how you’re all feeling that particular week and addressing any questions that have come up, to self-care during pregnancy, prenatal testing, nutrition, and exercise, to the emotional and physical aspects of labor, comfort measures, birth positions, and communicating with your caregivers, to the transitions of post-partum life, new baby care, breastfeeding and a lot more – the time seems to fly by… you’ll be talking, writing, laughing, drawing, moving around (a lot!), viewing videos, discovering sensations, and practicing, practicing, practicing!

    Birthing Your Baby classes are consumer-oriented. In other words, I am not “prepping” you for the policies and routines for any particular birth place or caregiver. As Dr. Sears writes in The Birth Book, “some hospital-based educators, constrained by their own hospital’s birthing policies, prepare parents to more to be compliant patients than to be informed consumers” (53). Instead, Birthing Your Baby classes will teach you (and give you lots of time to practice) a variety of coping skills, relaxation techniques, and positions for labor and birth. Labor is impossible to predict, so the more tricks you can pull out of your bag, the better prepared you will be!

    In addition to the individualized class attention, I provide (free) unlimited telephone and email consultation. Any time (pregnancy, birth, post-partum) you have questions or concerns, I welcome your call or email. I can research a topic… offer emotional support and affirmation… or simply listen.

    I have a well-stocked pregnancy, childbirth, and parenting “lending library” that includes books, magazines, and videos that I encourage you to borrow from at any time. I have read all of these selections and can help you find ones which address the topics that interest you.

    Birthing Your Baby classes encourage you to be open to the possibilities of birth. I will help you create a birth “plan”, but we will also talk about what the “next best thing” is if everything doesn’t go according to plan. Studies have shown that women who feel like they coped well and were active in making decisions about their care had the most satisfying birth experiences. Regardless of your plans for birth, whether this is your first birth or your third, Birthing Your Baby can provide the information and hands-on practice time to enhance your birth experience.
    If you have questions about any of these classes or events, please email me or give me a call at 512-2627!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Friday, September 18, 2009

    Circumcision Information

    I'm always on the lookout for information on circumcision that I would be comfortable passing on to parents. I think these .pdf documents offer useful information in a neutral, nonthreatening tone. If you work with pregnant women or are pregnant yourself and trying to come to a decision about circumcising, these documents might be helpful.

    Infant Circumcision: Some Considerations
    10 Reasons Not to Circumcise Your Baby Boy
    Myths & Facts About Circumcision
    Flawed African Circumcision Trials & US Circumcision Debate

    Any other good resources out there on circumcision that you'd like to share? Leave a note!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Saturday, September 12, 2009

    Why Ask Questions: Part II

    I just watched a YouTube video on Nicole's blog Bellies & Babies. The post was about midwifery support videos on YouTube. But one of the videos in support of Australian midwives stood out to me as highlighting, again, the importance of asking questions. If you watch it, you may see why:



    I'm going to assume that all these babies and mamas in this video were healthy after the birth. But what an enormous difference in their (mamas and babies) experiences. Sometimes medications or procedures are truly necessary... but sometimes they are a consequence of choices and decisions made earlier or they are agreed to when a mother/family has not been given all the information, has been coerced or bullied or rushed.

    So, again: Ask questions. Own your power.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Wednesday, September 9, 2009

    Rights

    Rixa at Stand and Deliver wrote a short but powerful post yesterday about "Iron in my Soul" that I encourage you to go read. I think the "iron in my soul" feeling is the same feeling that my sister & I talk about when we say something/someone brought out the "Mama Bear" in us. You know how you don't want to get between a mama bear & her cubs... we've all heard about the lengths a mama bear will go to if she believes her cubs are threatened.

    If you're wondering about a woman's rights are during the childbirth year, I encourage you to download a free copy of The Rights of the Childbearing Woman. Being informed is so important, and I hand out this document to every woman I work with. In some ways, it goes back to what Diana Korte and Roberta Scaer, authors of A Good Birth, A Safe Birth, said: “If you don’t know your options, you don’t have any.”

    But. We parents are powerful - we have iron in our souls. We have a Mama Bear ready to be unleashed. A parent's intuition and the strength to act on the small voice that whispers (or shouts!) "something is wrong, something is wrong" is the most important, in my opinion.

    Being informed and confident in one's intuition is an extremely powerful combination!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Tuesday, September 8, 2009

    Why Ask Questions?

    I've read several blog posts lately that highlight the importance of asking questions in very dramatic (and uncomfortable: reader beware) ways.

    Birth Trauma
    Navalgazing Midwife wrote "Just because it's the standard of care* doesn't mean it's ethical" which lists and lists and lists some of the abusive things done and said to birthing women. She writes, "How can people NOT believe women would consider their experiences traumatic and abusive"??

    Ask questions well ahead of time about the standard of care used by your doctor/midwife and birth place. Their answers and attitudes will help help you assess the likelihood that you may be on the receiving end of treatment like that listed by Navalgazing Midwife.

    Lest you say, this could not happen to me, not here... let me offer you two examples in this local area:
    "You have to have an IV or your baby could DIE!"

    The details in this situation are that the woman (who took my birth classes) was asking about IVs because needles made her very nervous, and she was hoping to avoid one. She was also planning an unmedicated childbirth. This hostile (and untrue) response prompted her to change care providers. She ultimately had an unmedicated birth without an IV - a gorgeous, healthy baby girl - in a different birth place, with a different care provider.

    "The anesthesiologist is leaving. If you want an epidural, you need to have it now."

    Said to a friend of mine (who didn't take my classes) whose water had broken before contractions began. She went to the hospital, where she was admitted, and was waiting for contractions. Because she felt pressured, and didn't want to cause a scene, she had the epidural before she ever felt one contraction.
    There is not any 100% guarantee against birth trauma. There are certain things you can do to avoid it though. Here are a few:

  • Ask questions.
  • Think carefully about where you are planning to birth and with whom.**
  • Educate yourself.
  • Have continuous support with you at the birth (partner, friend, relative, doula).

    I think there are certain uncontrollable/less-controllable factors that come into play as well. Mostly I believe we "make our own luck", but I do think there is a certain amount of luck involved too. I'll use my birth stories as an example.

    When I was pregnant with my first child, I did everything I could think of to educate myself, and to work towards having a relatively smooth, trauma-free, unmedicated birth. Which, thankfully, happened. But looking back on it, I realized that I had left one big variable open - care provider. I had established a wonderful relationship with my OB. She was in a practice with three other OBs. It didn't really dawn on me that I only had a 25% chance of birthing with her. I had not met two of the other OBs in the practice because, as a teacher, I could only schedule appointments after school, and these two OBs didn't have appointments after 3pm. The other OB I met I was not happy with - he measured this, checked that, said "any questions" without looking at me or sitting down, and strode briskly out of the room.

    It turned out that the doctor who attended my daughter's birth was neither of the OBs who I had met - though I am very happy and thankful to say that she was fantastic. Very supportive and friendly. She ended up helping me off the bed where my pushing wasn't very productive and onto a birth stool on the floor. She and the nurses sat cross-legged on the floor surrounding me, with the blue drapes all around me. I was like a birthing island in an ocean of blue. I gave birth as the sun rose, surrounded by these wonderful supportive women, one of whom remarked, "This is lovely! It's like a slumber party!!" I'll never forget that. At the time, it didn't feel much like a slumber party, but looking back I understand why she said that - it was the energy in the room. And that's where the luck came in - what do you want to bet that the birth energy would have been very, very different if the OB whom I had met and not liked attended the birth?

    I realized how lucky I was after the birth. For my son's birth three years later, I wanted to be sure I didn't leave care provider so much to chance. I chose to birth with two midwives, so I would know for sure that the person who attended my birth matched my preferences for standard of care and philosophy.

    Technology
    I believe that in this country at least, there will always be some new technology (machine that goes "ping" for you Monty Python fans) awaiting some women when they give birth in a hospital. Think forceps, earlier in the 20th century, or continuous electronic fetal monitoring. There is nothing inherently wrong with technology, certainly there are times when a Cesarean birth, or using a vacuum extractor or a dose of Pitocin, is what has become necessary for a healthy baby and mother. But! Technology used most of the time, for most births, low and high risk? Maybe not something all women want during their birth...

    Which is why it's so important to ask questions. Things like this lurk on our birth horizon.

    While you're at Nursing Birth's blog, take the time to check out her "Don't Let This Happen to You! The Injustice in Maternity Care" series. Scroll all the way down to start at the beginning. I think this series could highly motivate someone to ask questions, lots of questions!

    *What is "standard of care"? Standard of care is the typical, common (standard) care that is usually provided by a doctor/midwife/hospital. Various pressures (legal and financial and bureaucratic and staffing) as well as training, philosophy, routines at the birth place, peer pressure and current trends all impact the standard of care offered by a particular doctor/midwife. It is very much part of the time and place in which a woman births. For example, some hospitals have a Cesarean birth rate of 50% while some homebirth midwives have a Cesarean birth rate of less than 5% - with similar outcomes for mom and baby. Clearly the standard of care offered would be very different.

    **There are some that say "you bought the ticket, you go for the ride". Which is usually true. For example, if a woman gives birth at a hospital with a high Cesarean rate, she should not be surprised if she has a Cesarean. It would be like going to McDonalds and expecting a luxurious, five-course, chef-prepared dinner. Not going to happen.


    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Sunday, September 6, 2009

    Ask Questions!



    Not sure what to ask?

    That could be a sign of a problem. Why? Most women have preferences when it comes to their birth experience - or they would if they knew some of their options ahead of time. The most important information needs to be obtained long before baby's birth day: when mom is choosing where to have her baby, and with whom.

    To find out more about your choices, do some reading, talk to an independent childbirth educator (one not affiliated with a hospital), talk to local women about their birth experiences, listening for a birth story that is like the one you want, watch some birth films (not necessarily birth tv).

    Then ask questions - respectfully, clearly, firmly. Specific questions that are not simply answered with a yes or a no. Ask follow-up why & how questions - how many ...? how come...? why not...? If questions seem to make your care provider angry or defensive, take these signs seriously. If your appointments don't last long enough for your care provider to answer your questions, or he/she doesn't take the time to answer thoroughly, take this seriously too.

    Asking questions is not rude, nor does it imply that you do not trust your care provider. A respectful care provider who takes you and your birth seriously will encourage you to ask questions and will be happy to answer them. Getting answers helps you evaluate your options, to be sure that the standard care provided by your doctor/midwife/birthplace is the type of care you prefer to receive. Asking questions and getting answers is one sign of a responsible parent, a responsibility that most of us take seriously from the first positive pregnancy test.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Saturday, August 22, 2009

    What Not to Say to a Pregnant Woman

    Rebirth Nurse is hosting a the second Rebirth Carnival about "what not to say to a pregnant or laboring woman". There have already been some excellent posts on this topic on other blogs I follow, and I'll be sure to put a link to the carnival once it's published so you can read them too, if you haven't happened by yet.

    Since I was venting this story to my mom just last week - more than four years after it happened (again and again), clearly it made an impression on me. I found it infuriating at the time, and it still rankles now.

    A little backstory: this only happened when I was pregnant the second time, after my 20-week ultrasound. My first child was a little girl, who was 2 while I was pregnant - she has the appearance of being a very girl-y girl since she wore lots of dresses and hairbows etc. At the ultrasound, I learned that my second child was a boy, so I could finally answer the first question my friends, acquaintances and strangers usually asked: "Do you know what you're having?"

    "Yes! A little boy!" I would say.

    I cannot tell you how many people then went on & on about how wonderful it was that I would have one child of each gender. And some went even further, "Oh, Daddy must be so happy to have a son!" And way too many people ended with a comment along the mind-boggling lines of this: "So now you can be done! One child of each - that's enough!"

    Um, what? Assuming much are we?

    Knowing that these people meant well, I said very little about how rude I found these comments. First, because of Assumption #1:
    Everyone wants children of both genders.
    Is this true in many cases? Surely. But it is it true always? Surely not. For a variety of very personal reasons, from medical to family history, some people may have a preference for one gender or the other.

    Some people may in fact be offended that someone would assume that they somehow are experiencing more joy because a child is a boy and not a girl. I would have been overjoyed to have another girl. On some level, I was in fact hoping to have another girl, since I knew we were probably only having two children, and another girl meant my daughter would have a sister. And while I love my two brothers very much, there is no doubt I have much stronger relationships with my sisters. And I experienced a bit of trepidation around having a boy because of personal history. This is not to suggest that I wasn't overjoyed to have a son: I was very, very happy. And I love him very, very much. Because he's my child. Not because he's my son.

    By the way, the people who simply commented: "Oh, one of each!" and made no value judgement were fine, in my book. It's the ones who went on & on about how great it was I was pregnant with a boy who I found irritating.

    Assumption #2 may be even bigger, and more offensive to some people, the final comment that some people tacked on:
    "Two children are enough."
    Well, it turns out that two children are enough. For my family. But some people want three children, or four, or more. I come from a family of five children and have heard many, many comments about it directed to my mother, including:

  • What a lovely Catholic family! [We're not Catholic.]
  • Are all those YOURS???
  • Aren't you busy!!!
  • You do know what causes this, right? [wink wink]

    and I'm sure many, many comments she could add. She didn't appreciate them, I know that much!

    It's true that, in America in general, as well as in the area where I live, many families do have two children - that's definitely the norm. But I have a bunch of friends who have three children, and know plenty of families with more. I would never presume to suggest to someone that I knew how many children they were planning/hoping to have in their family!

  • So this isn't an exhaustive list, you'll have to go check out Rebirth Nurse's carnival for more no-no's! If you've heard some good ones, feel free to add them in the comments. It's unbelievable what some people find to be topics of appropriate conversation when they're talking to a pregnant woman!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Friday, August 21, 2009

    Commencement: Copyright 2009

    I just finished a very enjoyable book, called Commencement, about the experience of four young women at Smith College and their "commencement" of life outside of Smith. I especially enjoyed it, I think, because I lived in Western Massachusetts at the time the novel was set in, and it was interesting to read about a place I passed on a regular basis.

    There were a few things I didn't like about this book though. First, there was what felt to me like a big plot stretch to include lots of information about girls and very young women being forced into prostitution. It's not that this issue wasn't related to other issues explored in the book, around freedom and feminism and the choices women make, or aren't able to make and why... it's more that the plot felt driven by it in a way that didn't feel realistic.

    What really annoyed me, though, was this scene, when one of the four central characters, Sally, is in the hospital giving birth:
    "'Sally, we're having a little trouble getting the baby's shoulders out,' the doctor said. 'We're going to have to do a small episiotomy.'

    'How small?' she said.

    'Small,' the doctor said. 'I promise. Seven stitches, max.'

    Stitches? Celia reminded herself to get on the waiting list for a couple of Romanian orphans as soon as she got home.

    'No,' Sally said, shaking her head. 'I don't want it done.'

    Celia was about to speak up, about to say that these damn people needed to listen to Sally, and really, hadn't the poor girl been through enough without slicing her open?

    'Babe,' Jake said gently [Jake's her husband & the baby's father]. 'I know you didn't want one, but it will heal so much better than a jagged tear.'

    Bree's eyes nearly popped out of her head.

    The doctor grinned. 'I see Daddy here has been reading What to Expect When You're Expecting. He's right, I'm afraid.'

    'Oh okay,' Sally said. 'Just get this thing out of me.' She put her head back, resigned.
    Okay, maybe this scene infuriated me. I'll admit it.

    I don't know where to start. The fact that the doctor promises the number of stitches it will take to close the episiotomy? How would he know?? Especially since from all the research I've seen many of the worst kinds of tears happen more frequently after an episiotomy.

    In case you're wondering, this is what the very mainstream Babycenter.com says about perineal tears:
    "A third-degree laceration is a tear in the vaginal tissue, perineal skin, and perineal muscles that extends into the anal sphincter (the muscle that surrounds your anus). A fourth-degree tear goes through the anal sphincter and the tissue underneath it." . . . and that "It's possible to tear even if you have an episiotomy. In fact, an episiotomy may raise your risk of getting more severe tears."
    And here's a bit of what Henci Goer writes in Obstetric Myths Versus Research Realities about episiotomies, "The major argument for episiotomy is that it protects the perineum from injury, a protection accomplished by slicing through perineal skin, connective tissue, and muscle. Obstetricians presume spontaneous tears do worse damage, but now that researchers have finally done some studies, every one has found that deep tears are almost exclusively extensions of episiotomies. This makes sense, because as anyone who has tried to tear cloth [or paper] knows, intact material is extremely resistant until you snip it. Then it rips easily" (276).

    I do that demo in class, with paper. When we talk about circumcision, almost always the dads turn a bit green. The episiotomy demo has the same effect on the moms.

    This is an excerpt from Chapter 32 of A Guide to Effective Care in Pregnancy and Childbirth:
    Although episiotomy has become one of the most commonly performed surgical procedures in the world, it was introduced without strong scientific procedures of its effectiveness. The suggested beneficial effects of episiotomy are: a reduction in the likelihood of third-degree tears; preservation of the pelvic floor and perineal muscle leading to improved sexual function and a reduced risk of fecal and/or urinary incontinence; reduced risk of shoulder dystocia; easier repair and better healing of a straight, clean incision rather than a laceration . . . On the other hand, a number of adverse effects of episiotomy have been suggested. These include: the cutting of, or extension into, the anal sphincter or rectum; unsatisfactory anatomic results such as skin tags, asymmetry, or excessive narrowing of the introitus; vaginal prolapse; rectovaginal or anal fistulas; increased blood loss and hematoma; pain and edema; infection and dehiscence; and sexual dysfunction.

    Liberal use of an operation with the risks described above could only be justified by evidence that such use confers worthwhile benefits. There is no evidence to support the postulated benefits of liberal use of episiotomy. Controlled trials show that restricted use of episiotomy results in less risk of posterior perineal trauma, less need for suturing perineal trauma, fewer healing complications, and no differences in the risk of severe vaginal or perineal trauma..." (295)
    Then, the fact that, in a book with a 2009 copyright date, full of thoughtful examination of women's independence and women's choices the author writes, with no evidence of criticism the passage quoted above... this passage that feels like the baby's dad and the doctor pull a paternalistic act of "reassuring" the "ignorant", "hysterical" laboring woman, with LIES, makes me feel a little crazed!

    Where is the critique? Where is the "speak truth to power"?? Where is the sense of outrage???

    Instead we get "She put her head back, resigned." We get one observer whose eyes nearly pop out of her head and another who is so traumatized and horrified that she wants to adopt children instead of give birth. We get What to Expect When You're Expecting.

    There are 29 holds on this book from the Maine library system. People, probably mostly women, are reading it. And on the whole, it's a good book. Which makes the above passage all the more insulting, in my opinion. And all the more damaging.

    What would possess an otherwise well-informed, sensitive, thoughtful author to write it? Any ideas?

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Wednesday, August 19, 2009

    New Birth Stories

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    Tuesday, August 18, 2009

    Classes, Moms Group & More!

    And... I'm back! We've had a wonderful summer in many ways, with terrific company, fun times at the ocean and out on the boat, and a few precious lazy days. Must work in more lazy days for next year! And respectfully request more sun - that was sorely lacking this year, but we surely did take advantage of what we got, going to the ocean and lake beaches, whenever there was a sunny and hot (or even warm-ish!) day. Like today in fact, and yesterday! Now I'm getting ready to enjoy fall, and another school year with the children, who are attending 3-day a week nursery school and homeschooling. Fun times!

    MAMAS AND MUFFINS: NEW MOMS GROUP!
    I've changed times and format for the moms group... and it has a new name: Mamas and Muffins. It's still free, of course, and open to all new mamas and their pre-crawling babies. I invite all mamas and their "little muffins" ;-) to drop in anytime from 9 to 10am, have a muffin and some tea, and enjoy chatting with other new moms. From 10am to 11, there will be time for women to share their experiences, ask questions & get support.

    Groups will be held on the 1st and 3rd Mondays of each month, from 9-11am at the Winthrop United Methodist Church (58 Main Street in Winthrop), upstairs in the nursery. Use the side Wonder Awhile Nursery School entrance. Signs will be posted.

    September 21st, 2009
    October 5th & 19th, 2009
    November 2nd & 16th, 2009
    December 7th & 21st, 2009

    BIRTHING YOUR BABY CLASSES
    I am scheduling group and private classes for this fall. If you're expecting your baby in October, November, December, or January, give me a call at 512-2627 or email me!

    CLASSES THROUGH MONMOUTH/WINTHROP ADULT EDUCATION
    Preconception & Early Pregnancy Class

    An introduction to pregnancy, with activities and discussion on nutrition, exercise, and self-care for a healthy, comfortable pregnancy as well as tips on choosing a care provider and putting together a supportive birth team. Enrollment is limited to women and their partners who are trying to conceive, or who are less than twenty weeks pregnant.

    Thursday, September 24th, 6-9pm
    Winthrop Middle School Library
    Fee: $20/couple

    To register, contact the Winthrop Adult Learning Center from 8-2:30 Monday thru Thursday at 377-2265 or Friday 8-10am.

    Coping Strategies for Labor and Birth

    Introduces a wide variety of coping strategies for labor and birth, including breathing, relaxation, massage, visualization, position change, and water therapy. Some practice time and a short video will help you start thinking about which strategies might work best for you. This class will also be helpful for the birth partner, providing lots of concrete ideas of how to be supportive during labor and birth. Enrollment is limited to women who are in their second or third trimester. Participants are encouraged to bring a support person.

    Monday, November 9th, 6-9pm
    Winthrop Middle School Library
    Fee: $20/couple

    To register, contact the Winthrop Adult Learning Center from 8-2:30 Monday thru Thursday at 377-2265 or Friday 8-10am.

    UPCOMING!
    I am very excited to be working on a Pregnancy Wellness Fair - if you support women during the childbearing year (pregnancy, birth, postpartum) and are looking for ways to share your expertise, please contact me! I am especially interested in connecting more women with "outside the doctor's office" services with benefits that may not be well-known, like chiropractic care, massage therapy, accupuncture, doulas, and more. If you're pregnant, or trying to conceive, check back for more details!

    I am also planning a film screening or two for the fall & winter months!


    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Sunday, May 10, 2009

    Happy Mother's Day

    Happy Mother's Day!

    Here's another way to celebrate: go on a cyber-journey... beginning at "Celebrate Women's Real Birth Wisdom"!

    Wishing you all peace and strength and joy, mothers and mothers-to-be.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    New Mothers Support Circle

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    Saturday, May 9, 2009

    International Birth Wisdom Week

    There's a story I want to share for International Birth Wisdom Week, but I can't remember where I read it, or when*. The story comes from an African culture, and it tells how the women think about the birth process: Birth is like crossing a river on a log. You need to get across the river on that log, and no one can else can do it for you - it's your journey. People on the shore you left behind cheer you on with encouraging words, and people on the far shore will be waiting to greet you. Someone even follows beside you to guide you and support you with her words and presence. Though you are not alone, birth is work only you can do.

    This story has always stuck in my mind, as a pregnant and laboring woman, and then as a childbirth educator - because its truth resonates with me, and also because it is so different from how birth is perceived in American popular culture. So many times birth is talked about (and lived) as something that is done to a birthing woman, not as something that she does.

    I don't mean that in order to experience "real" birth, all women need to have unmedicated vaginal births. In my opinion, the difference is about agency: when it is the laboring woman who is exerting her own power to birth safely and with strength and wisdom, she owns her birth, whatever happens. She is unlikely to be haunted with "if only I had known" because she knows that she did the best she could with the situation she was living in that moment.

    Whenever I think about birth wisdom, I think about this quote, which is all over the natural birth world: “Birth is not only about making babies. Birth is about making mothers ~ strong, competent, capable mothers who trust themselves and know their inner strength.” Barbara Katz Rothman articulates why it is so important that birth is honored as a beginning, not as "just" an end, "to get the baby out safely".

    I also think of this other popular birth quote by Laura Stavoe Harm: “We have a secret in our culture, and it's not that birth is painful. It's that women are strong.” I feel sad when I read this, because, too often, women's strength is a secret.
    Birth is painful!!! Get an epidural as soon as possible!! Birth is scary! Birth is an emergency! Just be happy you have a healthy baby!!
    This is the subtext of so many stories, in the media, and among women. I was sitting at my daughter's dance class the other day, and some of the other moms were talking about their births: thank God for my epidural! ... I don't know how/why anyone would give birth without one! ... It was miserable until I got my epidural... My epidural didn't work, but at least I had one [?!!?]. Another mom and I were silent. What could I possibly say about my wonderful natural births that would not seem judgemental or holier than thou? Thankfully someone directly asked the other silent woman about her birth, and she voiced her joy at giving birth naturally.

    I'm grateful for every opportunity to empower pregnant women and their partners to make informed choices, to take personal responsibility, to understand that birth is the beginning of their journey as mothers. I want to join that chorus of people on either side of the river, in hopes that it will swell and swell, getting louder and louder, until "women are strong" is not a whisper, a secret that some of us carry in our hearts and share with our daughters, but a shout, a proclamation, and a promise: WOMEN ARE STRONG.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    New Mothers Support Circle

    *If you know where I might have read this story, please leave a comment!

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    Friday, May 8, 2009

    Exciting Birth Cyber Event!

    Spreading the word:

    Join Independent Childbirth in a birth community cyber event next week!

    All you have to do is blog about birth wisdom whether it's refuting an obstetrical myth or sharing a birth story of a woman who experienced spontaneous birth outside 'textbook' birth (i.e. a posterior birth, cesarean prevention, VBAC, twins, international birth voices are of great need, etc.). In your post link back to the independent childbirth blog post on birth wisdom (it will be on the site tomorrow).

    When you complete your post send us a link to it to view it for inclusion in the IC blog post. In addition, if you visit those posts that are listed on the IC blog post and leave comments on a couple that inspire you to comment we'll send you a 'button' for your blog that you may wish to include on your blog.

    Many of us have readers who follow our blogs but may not be aware of other blogs that also have great information to share. Together we are an awesome resource is what the IC birth wisdom cyber event is about. The birth community is global yet we, what we know, are/is all available wherever a mother resides.

    If you are interested in joining the event please email us offlist at births @ comcast dot net. Please feel free to forward this email to other birth groups.

    Thank you in advance for sharing what you know and inspiring mothers in your neighborhood and "ours."

    Dale
    www.independentchildbirth.wordpress.com
    www.independentchildbirth.com

    I'll have my International Birth Week post up tomorrow! Happy reading!!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    New Mothers Support Circle

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    Thursday, April 30, 2009

    April is Cesarean Awareness Month

    I'm slow on this one, but while it's still April, I want to acknowledge Cesarean Awareness Month. You can read anywhere that the cesarean birth rate in the United States is climbing each year - both because the rate of primary cesarean births is rising, and because the rate of VBACs (vaginal birth after cesarean) is falling. As of 2007, an average of one out of three babies are born surgically. The Centers for Disease Control (CDC) reports that in 2007, 31.8% of women birthed by cesarean in the United States.

    There is support for women who are recovering from a cesarean birth, including ICAN chapters in many states. If you live in Maine where there is currently no chapter listed, you can still request support. There are also online communities that support women recovering from traumatic birth (cesarean or vaginal), like Solace for Mothers.

    In my opinion, one of the most troubling effects of cesarean birth is that it can severely limit women's options for future births. In Maine, there are only a handful of hospitals that "permit" VBACs. In central Maine, the only hospitals I know that do VBACs are CMMC in Lewiston and Maine General in Waterville. Nationally, VBACs are only permitted in about half of hospitals, and frequently only under certain specific conditions or with select care providers who are willing to attend them. Is this information that is offered to women as part of informed consent, especially in the many non-emergent situations like "failure to progress" or "you have a big baby"?

    You can read about the lack of choice in Time Magazine, "The Trouble with Repeat Cesareans" and Pamela Paul's follow-up article in the Huffington Post, "Childbirth Without Choice".

    You can read about why the rate of VBAC is so low at The Well-Rounded Mama.

    Also, you can click on the Cesarean label below this post to read more blog entries on Cesarean birth.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    New Mothers Support Circle

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    Saturday, April 25, 2009

    Birth: Assuming Control

    The word assume has several meanings - three that I want to highlight here:
    Assume can mean to take for granted or without proof; suppose. Clearly, this is the definition the well-known quip "assume makes an ass out of u and me" comes from.

    Assume can also mean to take upon oneself; undertake, as in assuming responsibility for a task.

    And, assume can mean to appropriate; seize; usurp - when a dictator assumes power, for example.
    What does this have to do with birth? I was enjoying Anna Quindlen's back-page opinion article a few weeks ago in Newsweek, Dollars and Sense, when that phrase popped out at me and has been stuck in my head ever since. She was discussing how few of us understand the complexities of our financial world,
    "the great unspoken issue behind the tanking of the market, the mess in subprime mortgages and the bailout bill is that Americans don't understand the basics of the economy. Faced with financial instruments increasingly arcane and complex and financial institutions increasingly faceless and vast, most outsourced knowledge and responsibility to those they assumed were ethical and responsible. The banker, the broker, the rating agencies: they would look out for us."
    As I read this article, I was struck by how this whole article could also apply to birth. And towards the end of the article, she wrote
    "Americans have given up understanding much of what passes for daily life . . . But there's also a precedent for assuming control, even of complex issues. Look at the way many Americans deal with health care today compared with a generation ago. Once doctors, like financial managers, were seen as keepers of a mysterious flame and patients as people who should simply do what they were told. Today many more patients think of themselves as partners and work hard to educate themselves about their health and their ailments before having surgery or taking medications."
    Is this true, do you think: have American women "assumed control" of birth?

    Unfortunately, I see and hear and read many, many more stories about women assuming (first definition) that they have control and many, many more stories about doctors and medwives assuming control (last definition). If I could make only one wish for my clients, it would be for them to assume control (second definition): not to assume that they can control birth, but that they would assume responsibility for making the choices that are right for themselves and their babies, with caring, responsive doctors and midwives to help them.

    I want to share a blog with you that I think is absolutely amazing, called Nursing Birth. It's written by a labor & delivery nurse, and she's started a series called "Don't Let This Happen to You" because, as she says, "Throughout my time as a labor and delivery nurse at a large urban hospital in the Northeast, I have mentally tallied up a list of patients and circumstances that make me go “WHAT!?! Are you SERIOUS!? Oh come ON!”

    Women need to read these stories and take them seriously. Just like any other aspect of life, don't just assume you're in control: assume control. What does that mean? Learn about birth and think about your options. Interview care providers and visit hospitals and birth centers. Find a good fit. If you find yourself in a situation that is not a good fit, make changes! Find support. Take classes (email me if you're in Maine!). Reflect, discuss, learn, practice what you've learned. Rehearse. Discuss some more. Assume control!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    New Mothers Support Circle

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    Monday, April 20, 2009

    Birth Video Contest

    Birth Documentary Contest: $1,000 First Prize

    Birth Matters Virginia is soliciting 4-7 minute educational videos about birth in the hopes of reducing the incidence of medically unnecessary c-sections, infant and maternal morbidity, and skyrocketing health care costs. The first-place winner will receive a prize of $1,000. Second place $500 and an "honorable mention" prize of $100will also be awarded. The deadline for entering the contest is Mother's Day, May 10, 2009.

    Guest judges include: Ricki Lake and Abby Epstein, acclaimed producers of the Business of Being Born and Sarah J. Buckley., MD, international birth expert and author of Gentle Birth, Gentle Mothering. Ricki, Abby, and Sarah will join a consumer-based panel of judges who will be evaluating the tone, educational content, creativity and more. You don't have to be a professional to enter and you don't have to be from Virginia. We'd love to get videos from mothers, fathers, filmmakers, film students, birth advocates, and anyone else who is interested in birth or film or wants to win $1000.

    Birth Matters Virginia advocates "evidence-based" maternity care, which simply means using the best available research on the safety and effectiveness of specific practices to help guide maternity care decisions and to facilitate optimal outcomes in mothers and newborns. There are a lot of ways to approach that topic and lots of opinions on what that means, and we're looking forward to the variety of entries.

    For rules, how to enter, or to sign up for updates, please visit http://www.birthmattersva.org/videocontest.html.

    You can also join our Facebook group to get updates about the contest and exchange ideas with other participants at
    http://www.facebook.com/group.php?gid=73753459808.

    And if you have questions, email Sarah at Richmond@birthmattersva.org.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    New Mothers Support Circle

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    Saturday, April 18, 2009

    The Birth Survey in Maine!

    Did you know that The Birth Survey now has information about Maine??! The survey results are searchable by doctor/midwife and hospital/birth center/homebirth. The best way to find information for our state is to type in your zip code, and select the distance in miles you are able to travel.

    Currently, there are only a few reviews for some of our local hospitals and some of our local doctors and midwives. Of course the information is still very well worth looking at! But how awesome would it be if it were even more complete?!! If you've had a baby in the past three years, and would like to help expecting families make an informed decision about the care they choose, consider sharing your experience! The survey only takes about thirty minutes to complete and is completely anonymous.

    I would particularly encourage anyone who has birthed at our state's only independent, free-standing birth center (The Birth House), or with a homebirth midwife to share their experience, because there aren't any reviews yet, and I know there have been some fantastic experiences!

    I would also particularly encourage anyone who has had care that they were not happy with to complete a survey. I think the tendency can sometimes be to "not make trouble" or take some of the blame for a negative experience on ourselves, and therefore decide not to share the experience... but I think it's crucial for as many women as possible to complete surveys, whether it's to recommend a care provider or location, or to express dissatisfaction with a care provider or location.

    "Our goal is to give women a mechanism that can be used to share information about maternity care practices in their community while at the same time providing practitioners and institutions feedback for quality of care improvement efforts."

    "We are dedicated to improving maternity care for all women. We will do this by 1) creating a higher level of transparency in maternity care so that women will be better able to make informed decisions about where and with whom to birth and 2) providing practitioners and hospitals with information that will aid in evaluating and improving quality of care."

    Objective 1
    Annually obtain maternity care intervention rates on an institutional level for all fifty states.

    Objective 2
    Collect feedback about women’s birth experiences using an online, ongoing survey, The Birth Survey.

    Objective 3
    Present official hospital intervention rates, results of The Birth Survey, and information about the MFCI in an on-line format.

    Objective 4
    Increase public awareness of differences among maternity care providers and facilities and increase recognition of the MFCI as the gold standard for maternity care.


    I am so excited by this project, and the difference it could make for birthing mothers and their new babies! I urge you to participate by either spreading the news, or completing a survey!!

    I'll leave you with this inspiring thought from Christiane Northrup:
    "Imagine what might happen if the majority of women emerged from their labor beds with a renewed sense of the strength and power of their bodies and their capacity for ecstasy through giving birth. When enough women realize that birth is a time of great opportunity to get in touch with their true power, and then they are willing to assume responsibility for this, we will reclaim the power of birth and help move technology where it belongs--in the service of birthing women, not as their master."
    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    New Mothers Support Circle

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    Wednesday, April 8, 2009

    Links!

    Thought I'd share:

    If you live in central Maine, there's a great guide to low-cost or free (mostly free) places to be active, courtesy of Healthy Communities. There are trails, parks & playgrounds, schools, and local resources listed for Augusta, Chelsea, Farmingdale, Fayette, Gardiner, West Gardiner, Hallowell, Litchfield, Manchester, Mount Vernon, Pittston, Randolph, Readfield, Richmond, Wayne, Windsor, and Winthrop. Places to be Active

    The April Peaceful Birth Project newsletter asks
    "How are women making these fundamental choices? In a technology worshiping environment where can women find the information and support they need to make knowledge-based choices?

    How can that first cesarean be prevented?"
    And then goes on to provide some great resources to help families start answering those questions.

    Nicole at Bellies and Babies wrote a post this past week called "Vagina Anyone?" that made me laugh and squirm at the same time ("ta-ta"?!!), and goes back to the post I wrote recently re: the impact of language.

    The Motherwear Breastfeeding Blog reviewed Your Best Birth, which I immediately put on my Amazon wishlist.

    Kathy at Woman to Woman Childbirth Education wrote "Nothing by Mouth?" - a clear look at the history of "it's not safe to eat or drink during labor" rule and then links and explanations re: whether this standard routine is evidence-based (short answer: it's not!). Here's more on this topic by Rixa, at Stand and Deliver, "Eating and Drinking during Labor".

    And finally, the juiciest for last, Navelgazing Midwife on "Freebirthing", the recent show on Discovery Channel.

    Enjoy!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    New Mothers Support Circle

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    Saturday, April 4, 2009

    Normal Childbirth?

    I've read lots of articles and blog posts and email conversations surrounding the many perceptions and definitions of "normal" childbirth and "natural" childbirth. One thing I've learned is that these definitions are extremely fluid and subjective. One person may define natural childbirth as any birth that is vaginal, others believe that a natural childbirth is one without any medical procedures or medications. What is defined as a procedure can even by tricky - while most of us would agree that artificially rupturing membranes is a procedure, what about a vaginal exam?

    Personally, I would define my first child's birth as natural, even though my membranes were ruptured (with my consent) when I got to 10cm and they were bulging, and I had some electronic fetal monitoring. Because I had nothing attached to me (IV, catheter, epidural) and no medication, that fits my personal definition of a natural birth.

    What's the big deal about this anyway? Well, as a former high school English teacher, I am a person who appreciates unambiguous language - I like it when people intentionally use the right word for something. In fact, this drives my husband crazy sometimes because he'll come home and use the word flu to describe just about anything going around his office. This word sets off a chain of (annoying, if you ask him) question: a stomach flu? the real flu? how long did it last? was there a fever? etc. Any cold with a fever or vomiting episode fits his definition of flu, but mine is much more narrow. What I want to know is what he might have been exposed to, and what symptoms I should be on the lookout for in the children, and his definition doesn't help me figure that out!

    Back to childbirth - does it matter if someone discussing a natural birth means that she didn't have a cesarean, and is basically using the word natural because she doesn't want to say the word vaginal in regular conversation?

    The word normal is even more slippery, because its definition is shaped so much by what is normal in any given culture or sub-culture. Normal could mean a very medicalized birth, with IV, epidural, catheter and prone pushing or it could be a homebirth with a midwife attending as a "guardian" who supports the mother and checks on the baby, but who does not do anything medical in nature beyond checking baby's heart tones and examining the placenta and the mother afterward for tears.

    I started thinking about these definitions because of a question I read in the Midwifery Today newsletter:
    "If the general public continues to be indoctrinated into medicalized birth, how can we expect women to stand up and fight against the marginalization of freestanding birth centers and midwifery in this country?"

    — Colleen Bak
    Indoctrination is a serious word. This question (or call to arms!) is all about definition, to me. If the definition of natural birth encompasses physiological birth and birth that is medicalized with procedures and medications that may or may not be evidence-based, it becomes very, very hard for people to understand and appreciate the benefits of physiological birth to mother and baby, as well as making that type of birth seem even more unusual than it is. A big part of why I offer independent childbirth classes (and write this blog) is because these are my ways of making a difference: they're my small way to fight against the indoctrination that pervades birth as portrayed on mainstream television and in movies, on TLC's Baby Story, and in some books and classes about birth.

    [And yes, I threw another birth category into that paragraph: physiological. What is physiological birth? Dictionary.com defines physiological as "characteristic of or appropriate to an organism's healthy or normal functioning". I like Dr. Kotaska's explanation, from Jennifer Block's book Pushed, “An unmedicated birth in an environment where a woman feels comfortable, where she’s adequately supported, where she has a degree of privacy that allows her brain and her uterus to do the dance that we understand very poorly called labor, is physiological birth.”]

    Before I eat lunch I want to wrap this up with a few more links. Lamaze International offers its defining qualities of normal birth with these six care practices. By normal, they mean normal physiologically, not culturally.

    And I want to point you to the free online sample of the excellent journal, Birth, where they've posted the articles from current issue (March 2009). The article that directly applies to this post is the editorial, "What is Normal Childbirth and Do We Need More Statements About It?", where you can read more about the words normal, natural, and physiological as they relate to birth. I'll leave you with a quote from the editorial,
    "Clearly, 'normal’ has a different meaning in different countries. The dominant cultural definition and experience of childbirth in North America and elsewhere are widely recognized to be medical and technological in both philosophy and practice (3,5), and as evidenced from the medical inclusion criteria for ‘normal birth’ listed in the British and Canadian statements (1,4). As long as birthing systems continue to evolve in this direction, definition of ‘normal’ will evolve to keep up. Provider and consumer groups will have to continue to make their voices heard in support of natural childbirth and, hopefully, a more normal ‘normal childbirth.’"
    And that's my addition to what I hope will swell to a growing chorus of women who support a more normal "normal childbirth".

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    New Mothers Support Circle

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