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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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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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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Thursday, February 4, 2010

Free Photography Sessions

I received an inquiry from a young woman who is a photography student at USM. She is interested in doing a photographic study on birth and is looking for a woman (or more than one) to photograph before, during, and after giving birth.

She writes:
"In return for the photography I will supply the mother with all of the photographs on a CD and at least ten 8x10 prints of favorite images. I would like to do at least one pregnancy session, one infant (or infant and mother) session, and a session during the actual delivery and birth. I am interested in starting as soon as possible with someone due as soon as this month, but I do believe (if I can find the right people) that this could be a long term project so I am open to any woman at any point in their pregnancy."
If you, or someone you know, may be interested, get in touch with her via email.

One reason I'm passing this information along is that I really wish I had more photos of myself during my pregnancies and of me and the new baby shortly after birth. And having someone along to photography frees up dad/partner to support the mama instead of snapping pictures!

Here's a bit more information about the project:
"At the moment this is just a class project that will only be shared with related people. But I am hoping that this could turn into a larger, more long-term project that may have a wider audience. At that point I would consult with the mothers and get their permission before showing any work in a public or online setting. My aim is to photograph the birth in a unobtrusive but realistic manner. Meaning that I would like to capture everything that comes with the birthing process but will not knock over your significant other to get a shot. I am very laid back and open to many options and am looking to work with woman and families who feel the same."
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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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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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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    Tuesday, August 25, 2009

    What Not To Say Blog - Rebirth Carnival

    Rebirth Nurse's "What Not to Say" carnival is here! I highly encourage you to head over and read the entries - they're fabulous!

    Meanwhile I'll be eeking out one of the last bits of summer here in Maine, down at the lake. After a humid and rainy weekend thanks to Hurricane Bill (we even had a tornado warning!), we're very happy to dry out a bit.

    Hope the sun and a warm breeze is finding you, too.

    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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    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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    Friday, June 12, 2009

    Summer Vacation

    Summer has started for our family, after a whirlwind of spring recitals and performances. Homeschool and nursery school are over, and the children and I are traveling for most of June, so I expect I won't be blogging much for another month or so. I'll be back in a bit... I've got a bunch of ideas swirling around, so I know I won't be able to keep quiet for long!

    I also want to mention that the postpartum support group, New Moms Support Circle is taking a break for the summer. Look for fall meeting dates to be published sometime in August.

    I am continuing to teach and schedule classes for this summer and fall, so email me if you'd like to set up a time to meet or join a class. I will be able to check me email and voicemail while I'm away, and I'll get back in touch with you.

    Until then, here's a gorgeous poem I received in a Mothering email.

    Ripening

    As the baby, from seed to worldly entrance ripens
    So does the mother's consciousness mature through revelations
    of life's beginnings-
    During this, their growing season.

    Out of man and woman's union springs the fruit-
    A child swelling 'neath a woman's belly,
    And the Madonna-ripening fruit of womanhood.

    Joining forces, father and mother weed out their fears,
    To clear the ground and prepare the way for the day of harvesting.

    On that day, they reap as they sow, the fruits of their labor.


    -- Author Unknown

    There's so much to love in this poem, I had to share it with you!

    Hope your summer is off to a wonderful start!

    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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    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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    Monday, April 6, 2009

    Scheduling Spring & Summer Birth Classes!

    I'm currently scheduling group and private classes for this spring and summer - moms with due dates from May to September! 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 on for some of the benefits of attending 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.

    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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    Friday, April 3, 2009

    Preparing for Birth: "What If?" Can Be Motivating

    The most recent Midwifery Today e-newsletter has a quote that ties in well to yesterday's post re: what do childbirth educators teach anyway? and re: how some of the most important work a woman does to birth her baby happens before the birth.
    "When we are aware of potential risk factors or when mothers express extreme anxiety we can take steps to remedy the situation and facilitate a smooth birth. Our actions will depend on the particular situation, but often just identifying the source of worry and getting it out into the open may be all that is needed to prevent related problems from arising in labor. Ultimately we want to empower moms to use the resources and address the problems before labor begins."

    — Heidi Nielson Sylvester
    Excerpted from "Psychological and Emotional Dystocia," Midwifery Today, Issue 81
    The above quote resonates so well with me because I've seen so many a-ha moments come from the activities we do in class around worrying. After we talk about the purpose of worrying, I encourage families to come up with a "worry list". I suggest they use the "what if" questions that linger in the back (and front!) of their minds as motivation to prepare during birth. One of my favorite activities we do together is the Birthing From Within "taming your birth tiger" visualization. I sometimes see a dramatic shift following this activity: moms and dads relax their shoulders and jaws and leave the class looking like a weight has literally been lifted away. I would love to be a fly on the dashboard of the car sometimes, to hear what conversations are sparked from this exercise.

    These discussions in class pave the way for couples to communicate concerns and preferences together, as well as with their care providers and other birth support people. Framing worry as a motivator instead of something to be suppressed and avoided totally changes a lot of people's perceptions and helps them feel more directed and in-control.

    For example, one of the my first clients turned out to be very, very afraid of and worried about needles, especially having an IV. I think she felt a little silly about this, but getting it out in the open seemed to be a relief. So we talked about ways needles and IVs in labor - why they are used and how they might be avoided. I strongly encouraged her to talk to her care provider about the routine care she provided during labor so she could be prepared ahead of time. Turns out this OB was very uncomfortable with anything less than a routine IV, and told the mom I was working with that she might die or her baby might die without one. Instead of frightening this mom, the OB's comment made her very angry, and motivated her to change care providers entirely, to a midwife who practiced at a different hospital. She went on to have a very satisfying (and safe) birth experience - without an IV!

    While we spend a lot of time on the birth process, and coping strategies, as well as discussing common procedures and medications, one thing that makes my classes different from the standard prenatal class is the focus on preparation that can be done now, while pregnant - whether it's nutrition, or exercise, or communicating, or reflection.

    Preparing for birth and parenting starts, in my opinion, during pregnancy - and it goes far beyond getting the baby's room ready and installing a car seat! To read more, click on the What If post I wrote a few months ago.

    I'm curious - what did you do (or are doing now) to prepare for your baby's birth? Was there anything you wished you had done?

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

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    Thursday, April 2, 2009

    Reply Turned Post: What DO Childbirth Educators Teach??

    I've been thoroughly enjoying the posts over at Mom's Tinfoil Hat, and the whole idea of "reply turned post" seems to fit my response to this very interesting post from RedRN, "On Childbirth Education", which I highly recommend clicking over to read and respond to.

    This is my response:

    "Interesting post! It strikes me how "in the middle" nurses sometimes are, and impresses me all the more when I read about the patient advocating you and others like you do over & over.

    One of the things I tell clients (and write in my blog - see the sidebar on popular posts) over & over again is that the prep work done before the birth is extremely important. The mom needs to think about how she wants the birth to go (a set of educated preferences, not demands) and then do the work she can ahead of time to set herself up well: get support from partner and/or friend/family and/or doula; choose a careprovider who is a good match; choose a birth place that's a good match etc. & etc. And then keep reflecting and communicating.

    One thing I've noticed about teaching anything (I've taught high school, Sunday School, and birth classes) is that a teacher can say one thing, and there are as many interpretations of that thing as there are students. People tend to hear, in general I think, what makes sense to them, what fits in with their perceptions and experiences. So what you're seeing may or may not accurately reflect the information presented in a class.

    People do zone out - so few people contact me in enough time, with enough time, to do shorter classes over more weeks. Families usually choose two or four session classes of three or four hours each. Those are *full* classes, and it's hard to pay attention and process everything. Edited here to add that with breaks, and food, and a balance of activities, brainstorming, groupwork, movies and presentations I think families in my classes have a better shot at staying fully engaged!

    And I think you hit on something else important to keep in mind - there are some care providers who *say* one thing and then do another, or are misleadingly ambiguous, especially if asked vague questions with no follow-up. Add that to the fact that many women get care from a practice and may or may not see all the care providers to discuss each partners' routine management ahead of time... I really encourage and role-play with families ahead of time how to ask questions during their appointments, and how to follow-up to get the information they're looking for."

    A few more things I've thought of after I posted the reply:

    ** Some hospitals do allow doppler monitoring instead of electronic fetal monitoring. Other than a five minute test-strip when I first arrived, my son's heart rate was only tracked via doppler. I did discuss this ahead of time with my midwife, to be sure that doppler monitoring was possible.

    ** That some hospitals still don't allow moms to eat and/or drink during labor astounds me, given how many studies have shown that this is not evidence-based care. And like I tell clients: we're not advised to avoid eating or drinking before getting in the car, just in case there's an accident and we'll need anesthesia, are we? We're not given an IV just in case, either.

    ** I also continue to be amazed at how "railroaded" some families are during labor, like the scenario mentioned in the original blog post, with Dr. Ass. It's amazing to me that care providers act that way and it's amazing that women and their partners accept it. I understand that there will always be sub-par performers in any profession, and I understand that labor/birth is a very vulnerable time for women, and when providers pull out the "dead baby" card it would be very, very hard to be non-compliant.

    So, if you didn't - go read the original post and leave a reply!

    Or, to get more information about Birthing Your Baby classes, visit my Class Information page!

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

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    Sunday, March 15, 2009

    Essentials?

    I've really been enjoying a series of posts at Eco Child's Play, a website the supports and promotes "Green Parenting for Non-toxic, Healthy Homes".

    The latest post in this series is Baby Essentials That Aren't: Baby Food, by Heather Dunham. Other "essentials" discussed in previous posts include the crib, the bucket carseat, the stroller, diapers, tub, and brain boosters.

    I thought these articles were fascinating and well-written, and they included lots of resources to learn more. This series is a great antidote to all the commercialism that swirls around pregnancy and postpartum parenting.

    It's a crazy week here this week and I've been up many, many times the past two nights with a dog who is having digestive issues and needs to go outside every hour or two. Good times. So, this is going to be a week of link posts! Hope you enjoy!

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

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    Saturday, March 7, 2009

    Diddos for Kiddos Consignment Sale - May 2009

    For all of you Diddos for Kiddos fans - here is the spring information:

    The spring sale is at the St. Paul Center (136 State Street) in Augusta. The sale dates are Saturday, May 2nd, from 8am to 6pm and Sunday, May 3rd, from 8am to 4pm. The Sunday sale is half-price on all items.

    There is also a consignor sale on Friday, May 1st. For more information on consigning, or about the sale, click on this link to the pdf brochure.

    On a personal note, I've been consigning at this sale for years. Not to make money, because most of my kids' stuff is handed down to my sister & her children. I consign just to get to the presale! And it is so worth it. I never come home with the same ratio clothes/toys - sometimes one kid gets way more than the other. But it works out perfectly for me to get some of their spring/summer clothes and birthday presents (May & June birthdays) at the Spring sale, and some of their fall/winter clothes and Christmas presents at the Fall sale.

    I also make it a "girls night out" and go with a friend - each consignor gets an extra ticket to the sale - so we go to the sale and then out to dinner.

    Maybe I'll see you there...

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

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    Tuesday, March 3, 2009

    Preserving Memories

    I've admitted before that I wish I'd been more faithful in keeping a pregnancy journal with thoughts and especially photographs from my two pregnancies. Once I started a family blog, and made a commitment to keeping it up-to-date for our long-distance family members, I've done a lot better. And someday (when we have more money!), I have a system I want to implement with binders and photo pages and the photos I've stored in Snapfish. It turns out that, although I bought and was given a bunch of scrapbook supplies, I'm not really a scrapbooker. And that's okay, right? Right.

    Anyway, I've come across some really cool ideas lately that appeal to me even though I'm not a scrapbooker, and I want to be sure to pass them on to you. These are the kind of easy projects I wish I had done:

    Scrapbooking Your Belly Shots and Scrapbooking Baby's First 12 Months, both from Adventures in Diapering.

    If you want video inspiration, here is a video from Mothering Media, showing how one mom turned her pregnant belly into a work of art.

    If you are a scrapbooker, here is the site for our local scrapbooking guru, Cheryl Freye. I especially want to highlight the FREE Baby & Toddler Webinarscoming up over the next two weeks - what a fantastic opportunity to learn more about preserving your memories.

    And finally, a professional archivist's take on digital storage, in case you, like me, are holding on to cd's full of photos. Because as Cheryl wrote in her email, "You'll never reminisce over your zip drive .......albums make the memory."

    If you have want to share any of your ideas on how to preserve memories, leave a comment!

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

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    Friday, January 30, 2009

    Stay at Home!

    Even though we thoroughly discuss the benefits of staying at home in labor during birth classes, I would say at least half of the families I talk to after their babies are born make a comment about how either the mom or the dad wanted to leave for the hospital early and had to be talked down.

    This isn't surprising, really. There's trained help at the hospital or birth center. It seems to make sense to get there sooner than later: mom can "get comfortable" in her birth space, right? meet up with her doctor or midwife, yes? there will be nurses who can provide some labor support... the car ride will be easier to handle in early labor etc. & etc.

    Plus - and I think this is the biggest one - sometimes there is a little blood in early labor, and that, frankly, freaks some people out.

    Who mom chooses to attend the birth, where she plans to birth (hospital, birth center, or at home! then you really could stay at home!!), the support she has, and how well she's communicated her preferences ahead of time all play into the mix as well. But even in the best scenarios, it turns out there are some good reasons to stay home through early labor and into the beginning of active labor.

    Let's take a second look at those reasonable-sounding rationales for high-tailing it to the hospital, like they do in the movies:

    First: the doctors, nurses and midwives are trained, yes. But mostly what nurses and doctors are trained in is managing labor, and looking for problems. Care providers who trust the process, are women-centered, and make few "routine" decisions (as in, routine IV; routine continuous monitoring, etc) are more likely to let mom labor without any inteference. Otherwise, as I've heard it described, "you get on the train and you go for the ride". In other words, once mom gets to the hospital, she's on the hospital ride, more or less. Usually, a shorter ride is easier on mom and baby.

    Second: if "getting comfortable" means getting hooked up to an IV and continuous monitoring, then yes, by all means: go to the hospital and "get comfortable"! If your idea of comfort is wearing your own clothes and eating when you want and not answering questions about your pain level and lying in your own comfy bed or petting your cat or dog or taking a stroll in your garden and enjoying the sunshine: well, then, stay home for a little while longer.

    Third: Most doctors come in when mom is ready to start pushing or give birth, though they might be in/out to check mom too. Midwives may be present for more of labor, or they may not - depends on the midwife and/or her schedule.

    Fourth: Most nurses are there to check on mom - ask questions and assess progress, but do not rub backs, hold hands, or make lots of suggestions re: comfort techniques. I think most nurses would like to do more of this, but the realities of understaffing and charting makes this less a part of their job than they would like.

    Fifth: the car ride... yes, that one's valid! But weighed against all the others above, plus what's below... mom may decide it's worth the extra discomfort in the car, after all.

    According to the Lamaze 34 week e-newsletter, when mom gets to the hospital actually affects her likelihood for birthing vaginally vs. via surgery:
    "Can we safely lower the cesarean surgery rate simply by admitting women to the hospital later in labor? Research conducted on more than 40,000 births in California suggests strongly that the answer is yes. The research team compared the cesarean rates in low-risk, first-time mothers in 20 different hospitals. They calculated the number of women in each hospital who were admitted before they reached 3 cm dilation. After taking various other factors into account, they found that hospitals that admitted many women before 3 cm dilation tended to have very high cesarean surgery rates, while those who didn't admit many women before 3 cm tended to have low cesarean surgery rates. The babies born in the high-cesarean rate hospitals were no healthier than those born in the low-cesarean rate hospitals."
    Source: Main, E. K., Moore, D., Barrell, B., Schimmel, L. D., Altman, R. J., Abrahams, C., et al. (2006). Is there a useful cesarean birth measure? Assessment of the nulliparous term singleton vertex cesarean birth rate as a tool for obstetric quality improvement. American Journal of Obstetrics & Gynecology, 194, 1644-1652.

    Also, don't be afraid to be wrong. Maybe you think this is it, pack up, load up, get to the birth place and discover the contractions have stopped and progress is not being made, and/or you're 3 cm or less dilated. As long as you & the baby are doing fine, think about going home. You can always come back! And hey, me - the trained childbirth educator, second-time mom - I didn't get it right and did the whole rigamarole of calling husband home from work, MIL to stay with my daughter, pack up, load up, drive forty minutes to the hospital thing to find out: my contractions had stopped and I was not. dilated. at all. A little bit of squatting and walking to be sure I couldn't get the contractions to come back (after all they'd been five minutes apart for four hours) and then some crying, and I went home. Owen did come out eventually, short easy labor, yes, but two days later.

    Finally, do keep in mind that there are good reasons to leave for the hospital before the 4:1:1 suggestion I make to clients (contractions four minutes apart, lasting a minute, for one hour)... for example, a snowstorm; or living further from the place of birth; history of fast labor, or labor progressing quickly. Or, if mom feels like something isn't right, has a lot of bleeding, or a lot of pain between contractions, then it's time to head out right away.

    I like how Dr. Sears puts it in The Birth Book: "For most mothers the best odds for a safe and satisfying birth come with laboring at home as long as possible. Presenting yourself at the hospital too early may give you a case of performance anxiety. Soon after check-in the clock starts ticking and the pressure to progress begins. Early arrival opens the door for questionable interventions that may shake your confidence and slow your progress. Also, you're no longer queen in your castle, but a 'patient' in someone else's domain. The house rules are not yours" (214).

    So: don't let "bloody show" scare you to the hospital. It's a good sign - the capillaries (small blood vessels) in the cervix are breaking as the cervix thins and opens. Labor has started, or will start soon: but be patient and hang out at homoe a little longer, as queen of your castle.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine

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    Sunday, January 25, 2009

    What Shocks Us

    It's interesting to me how different people can be, and how this difference is reflected in our perspectives or attitudes. For example, I avoid watching the very common CSI-type shows because it seems to me that almost every show has has a plot line and/or images of violence against women or children.

    When I see or hear blood, screaming etc. on the television, I cannot help but think of myself or my sisters/mother/friends or our children in this specific situation. Watching too much of this type of television would undoubtedly make me paranoid!

    But! I can watch any graphic woman-centered childbirth video without upset, even while snacking or eating my lunch. Full-on crowning shot? No problem. Triumphant birth howls? Sure. Deliriously happy mama embracing her blood-streaked, vernix-covered baby for the first time on her bare skin? Terrific! Yes, I may get a little teary, but those images are beautiful to me. However, from what I hear casually, as well as from friends and family, most people in this culture would be much more uncomfortable and/or shocked by this type of video versus the graphically violent images on CSI-type shows. Interesting, isn't it?

    I got the chance to watch 20/20's "Extreme Motherhood" show when it aired, January 2nd. My first thought was that it seemed bizarre to combine orgasmic birth, women who nurse their children beyond infancy and babyhood, and women who birth at home with midwives (which for some reason 20/20 labeled as "unassisted") with the much more rare women who mother the uber-realistic (creepily realistic, to me) baby dolls called Reborns, and who are "serial" surrogate mothers.

    Anyway, clearly all of these topics were supposed to be "extreme" or shocking!! in some way.

    Let's look at the whole "orgasmic" childbirth thing. Here is the 20/20 clip: Orgasmic Birth, it's about seven minutes long. There are two things in this clip that, in my opinion, might seem shocking.

    The first is simply connecting the idea of an orgasm (sex) to the idea of childbirth (a baby). You just don't hear those two words together very often, I don't think, especially on network television.

    The second one is the idea that childbirth could be "orgasmic". But really: it's the same body parts... the same hormones... and childbirth is a direct result of having sex. Is it really such an extreme position to take that childbirth could be pleasurable instead of painful? Because that's what the clip is really suggesting, I think. "To actually experience an orgasmic, or pleasurable birth, Northrup [Dr. Christiane Northrup] says it's important for women to lose their fear and their inhibitions." A mother interviewed for the show explained, "I hope women watching and men watching don't feel that what we're saying is, every woman should have an orgasmic birth," she said. "Our message is that women can journey through labor and birth in all different ways. And there are a lot more options out there, to make this a positive and pleasurable experience." It seems to me to be more of a media-type attention-grabbing trick to stretch the label of pleasurable to orgasmic (though I do not doubt at all that orgasmic birth happens!).

    Why the idea of childbirth as pleasurable is shocking is because the vast majority of American women labor under conditions that would make it almost impossible to experience pleasurable sensations during labor and birth. Many are tied to a bed via an IV, continuous fetal monitoring, an epidural, and a catheter. The epidural numbs them to the sensations of birth: can you imagine if it was the norm for virgin young women to be given an epidural during their first sexual experience because it might hurt? Add any number of other factors, including a lack of exposure to labor/birth as normal, fears from watching the many emergency-birth shows on tv, lack of support, threat of cesarean, time limits etc. & etc. Contrast these scenarios with the births discussed on 20/20 - they're day and night, and, in my opinion, go a long way to explaining why many women feel pain and fear and the few who labor unmedicated, with support, upright and moving, with water - with true woman-centered care, may experience pleasure during their births.

    What's shocking to me is that so many women labor and birth the hard way.

    Or how about this for shocking?

    "Best Practices in Maternity Care Not Widely Used in the United States"
    WASHINGTON (January 7, 2009)— Despite best evidence, health care providers continue to perform routine procedures during labor and birth that often are unnecessary and can have harmful results for mothers and babies. The Centers for Disease Control’s (CDC) most recent release of birth statistics reveals that the rate of cesarean surgery, for example, is on the rise to 31.1% of all births—50% greater than data from 1996. This information comes on the heels of The Milbank Report’s Evidence-Based Maternity Care, which confirms that beneficial, evidence-based maternity care practices are underused in the U.S. health care system.

    Research indicates that routinely used procedures, such as continuous electronic fetal monitoring, labor induction for low-risk women and cesarean surgery, have not improved health outcomes for women and, in fact, can cause harm. In contrast, care practices that support a healthy labor and birth are unavailable to or underused with the majority of women in the United States.

    Beneficial care practices outlined by Evidence-Based Maternity Care, a report produced by a collaboration of Childbirth Connection, the Reforming States Group and the Milbank Memorial Fund, could have a positive impact on the quality of maternity care if widely implemented throughout the United States. Suggested practices include to:

    Let labor begin on its own.
    Walk, move around, and change positions throughout labor.
    Bring a loved one, friend, or doula to support you
    Avoid interventions that are not medically necessary
    Choose the most comfortable position to give birth and follow your body’s urges to push
    Keep your baby with you – it's best for you, your baby and breastfeeding.

    Lamaze International has developed six care practice papers that are supported by research studies and represent “gold-standard” maternity care. When adopted, these care practices have a profound effect—instilling confidence in the mother, and facilitating a natural process that results in an active, healthy baby. Each one of the Lamaze care practices is cited in the Evidence-Based Maternity Care report as being underused in the U.S. maternity care system.

    Debra Bingham, MS, RN, DrPH(c), Chair of the Lamaze International Institute for Normal Birth says, “As with any drug, we need to be sure that women and their babies receive the right dose of medical interventions. In the United States we are giving too high a dose of cesarean sections and other medical interventions which are causing harm to women and their babies. Yet there are many countries where life saving medical interventions are under dosed which can also cause harm. Every woman and her baby needs and deserves the right dose of medical interventions during childbirth.”

    The research is clear, when medically necessary, interventions, such as cesarean surgery, can be lifesaving procedures for both mother and baby, and worth the risks involved. However, in recent years, the rate of cesarean surgeries cause more risks than benefits for mothers and babies. Cesarean surgery is a major abdominal surgery, and carries both short-term risks, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as percreta and accreta, which can lead to excessive bleeding, bladder injury, a hysterectomy, and maternal death. Cesarean surgery also increases harm to babies including women giving birth prior to full brain development, breathing problems, surgical injury and difficulties with breastfeeding.
    Read more about Lamaze's Six Care Practices that Support Normal Birth here.

    To read other reviews of 20/20's "Extreme Motherhood" show, visit Kathy's blog article at Woman to Woman Childbirth Education or the Navelgazing Midwife's commentary.

    Or read this short review, "Orgasmic Birth: The Natural Reality Behind the Hype", which offers a gem of a quote from Debra Pascalli-Bonaro, the filmmaker of Orgasmic Birth: the idea that orgasmic birth "sounds strange in our culture because we're used to seeing birth dealt with on an illness model, rather than a wellness model. Birth is part of a woman's sexual life."

    More to be shocked about coming soon.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine

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