Mothering Webinar (Free!) on Natural Toys

Let's Play!: Mothering's A to Z Guide to Natural Toys is a free webinar offered by Mothering, on Tuesday, December 2nd 3-4pm EST. This is their description:

"The holidays are here. Given today's economy and the demand for toxic-free toys, parents are on the lookout for affordable, natural toys. Let Mothering help you choose the safest, highest quality gifts that won't break the bank.

Mothering's own product reviewer, Candace Walsh, will help you find toys under $20 and answer the question "When is 'Made in China' OK?"

Also, green expert Mindy Pennybacker will discuss toxin-free toy options for your kids.

And mama crafter Amber Dusick will take the scariness out of scroll saw wooden toy making and discuss natural paint options."

The other Mothering webinar I participated in was excellent, and I imagine this one will be very helpful too!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Toxins in Children's Toys and Products

Most every summer we go visit my husband's best friend's mom (quite the introduction, yes?) at her annual beach rental in Friendship, ME. She is the Director of Outreach on things environmental for an Ivy League school. About four years ago, she saw me heat up my kid's fish sticks on a plastic plate in the microwave and went up one side of me and down the other: "plastics! heat! YOUR KID!!" I had no idea there was anything wrong with this habit. But let me tell you, that was the last time I've heated up my kids' food in plasic! I thanked her then for the heads-up, but now, with everything that's come out since about BPA and children's products, I'm especially grateful.

TOXIC WHAT???
If you're wondering what I'm talking about, or want to know more than you do now, here are three helpful links that explain the potential hazards of common toxins in our children's environment, including BPA in plastic:

Plastic Exposure in Childhood - Is There Evidence of Exposure?

Toxic Toys on PBS

Controversy Over Safety of Plastics and Kids Health

Mothering Magazine also has a great article on this topic: Out of the Mouths of Babes.


BPA-FREE
If you're wondering where you can find BPA-free feeding products for your baby, here are two websites that might be helpful:

Choosing glass or BPA-free plastic baby bottles

Z Report on BPA in Children's Feeding Products offers more information on what bottles, pacifiers, and tableware are BPA-Free.

As more and more companies are becoming aware that "BPA-free" on the label will attract consumers, there will be more BPA-free choices and clear labeling.


CHOOSING TOYS
With the holiday season coming up, here are a few of the websites listed in "The Long Goodbye to Toxic Toys" from the Nov/Dec 2008 Mothering Magazine, a great article by Mindy Pennybacker.

Tips on Toy Safety

Search Toys for Toxins (by brand, type, search)

Toys Without Detected Toxins of Concern

Toys with Highest Levels of Toxins


RECALL INFORMATION
US Consumer Product Safety Commission Recalls and Product Safety News lists recalls by month and year.


CHOOSING BATHING & INFANT CARE PRODUCTS
TIPS Unlimited Baby Skincare Awards include product descriptions for safer baby wash, shampoo, bum cream, lotion, toothpaste and more.

Hope this information is helpful!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Prenatal Nutrition: Iron

The sources that I read consistently suggest a goal of about 30mg per day of iron for pregnant women. This is a lot of iron for most women, and it can be a challenge to get that much iron through food. Iron is one of the nutritional needs that many pregnant women do not meet through diet, which is why prenatal supplements can be so helpful.

What does iron do?

The Family Nutrition Book, an excellent resource by Dr. William Sears and his wife Martha Sears, an R.N., explains why iron is critical to health:

"Iron is necessary to make hemoglobin, the substance that carries oxygen through your blood to all the cells in your body. Hemoglobin is what makes red blood cells red. With insufficient iron, and therefore not enough hemoglobin, red blood cells become small and pale and don't carry enough oxygen. You may have heard the expression, 'tired blood.' This refers to blood that is low in iron and that can't carry enough oxygen to vital organs and muscles. 'Tired blood' results in a tired body.

Iron is needed not only for blood but also for brains. Neurotransmitters, the neurochemicals that carry messages from one nerve to another, require sufficient iron to function properly. A person with an iron deficiency may have a tired mind as well as a tired body" (Sears 58).

During pregnancy, a woman's blood volume increases by 40%, so additional iron is essential to maintain good health and energy levels. It is also important for the creation of the baby’s red blood cells. In Having a Baby, Naturally, Peggy O'Mara states that the health benefits of "getting enough iron during pregnancy may also reduce the risk of premature delivery and low birth weight" (26).

Elizabeth Somer's book Nutrition for a Healthy Pregnancy explains the additional need for iron during pregnancy in even more detail, "The iron costs of pregnancy are high. More than 246mg of iron is stockpiled in the baby's tissue prior to delivery, and another 134mg is taken up by the placenta, and about 290mg is used to expand the volume of the mother's blood. That equates to about 2.4mg a day during pregnancy just to cover the iron costs of pregnancy. In addition, 1.0mg or more is needed to maintain the mother's normal body processes. Since you absorb only about 10 percent of dietary intake (although iron absorption increases as much as 50 percent during pregnancy in some women), you must consume about 30 to 60mg or more of iron daily to ensure optimal iron status" (84).

What are the symptoms of iron deficiency?

According to The Family Nutrition Book, the following are possible signs of iron-deficiency anemia:

paleness (especially in the face, palms and nail beds)
weakness
fatigue
shortness of breath
irritability
difficulty concentrating
increased susceptibility to infections
intolerance of cold temperatures
constipation
brittle, thin, spoon-shaped nails (63).

What food sources are good sources of iron?

Beef (4oz): 3.5mg
Ground beef (4oz): 2.5mg
Chicken (4oz): 1.6mg (dark meat) to 1.0mg (white meat)
Turkey (4oz): 2.5 (dark meat) to 1.6 (white meat)
Potato with skin: 2.5mg
Beans (1/2C): 2.0mg
Lentils (4oz): 3.0mg
Barley (4oz): 2.0mg
Sweet Potatoes (4oz): 1.7mg
Pumpkin seeds (1oz): 4.0mg
Cream of Wheat (4oz): 5.0mg
1/2C cooked spinach: 3mg
1C dry roasted mixed nuts: 5.0mg
1 egg: .7mg
Quinoa (grain): 9.0mg
Dried Fruit (1/4C): 2.0mg
Iron-fortified breakfast cereal: check your favorite brands

Peggy O'Mara writes that "You need 27mg of iron in your daily diet. You can get enough of it by consuming:

1/2C of cream of wheat (fortified) or 2 servings of beef, turkey, or clams or 1 cup of lentils and

1 cup of lima or kidney beans or black-eyed peas or 1/2C of prune juice, and

1 wedge of watermelon or 12 dried apricot halves or 1T of blackstrap molasses or 2 eggs, and

1 cup of cooked spinach or 2 cups of cooked kale or 4 oysters and

2 slices of whole wheat bread or 1/2C of tofu or 1 chicken leg" (26).

That equals out to some interesting food combinations, in my opinion, but it gives an idea of some iron-rich food sources and combinations. This is one way I can imagine including these selections in a day:

Breakfast: Cream of wheat cereal and 6 apricot halves
Snack: Wedge of watermelon
Lunch: Sandwich on two slices of whole wheat bread
Snack: Prune juice (?? but then I don't like beans)
Dinner: Omelet of quiche with eggs and spinach

There, that sounds more appetizing.

How can I maximize iron absorption?

"Eating food rich in vitamin C along with plant sources of iron helps to unbind phytates and the oxalic acid and increase iron absorption. Vitamin C can double the amount of iron absorbed from a food. Meat, poultry, and fish also enhance the absorption of iron from plant sources . . . Meat can double the amount of iron absorbed from veggies. The best partners for getting the maximum amount of iron out of food are meat and foods high in vitamin C eaten together at the same meal" (Sears 59).

Here are some suggestions of food combinations to maximize iron absorption listed in the Sears book: spaghetti with meat and tomato sauce; meat and potatoes; chicken fajitas with broccoli, sweet peppers and tomatoes; fresh fruit, iron-fortified cereal.

Nutrition for a Healthy Pregnancy offers this helpful information, "Iron intake involves a balance between iron promoters and iron inhibitors, and entails more than just eating iron-rich foods. Here are a few ways to maximize your promoters to guarantee you get the most from your diet:

1. Always consume a vitamin C-rich food with every meal, such as orange juice, a tossed salad, broccoli, more most fruits. Vitamin C improves the absorption of iron and counteracts some of the inhibitors in foods, such as phytates in whole grains and tannins in tea and coffee.

2. Consuming small amount of red meat, such as extra-lean beef, with large amounts of iron-rich plants, such as split pea and ham soup, increases the absorption of the plant iron.

3. Cook in cast-iron skillets. The iron leaches out of the pot into the food, raising the iron content of the meal.

4. Select iron-fortified foods.

5. Drink tea and coffee between meals. Tannins in these beverages (even if they are decaf) reduce iron absorption by up to 80 percent if consumed with food.

6. Take iron supplements on an empty stomach to improve absorption [as long as this doesn't cause nausea!]" (85).

Additional suggestions I can think of:
Potato with skin, chopped broccoli, and a little chopped ham (or bacon)
Beef-barley stew
Mashed sweet potatoes with a little orange juice and honey
Cream of Wheat cereal with chopped almonds and chopped dried fruit
Breakfast cereal and a glass of orange juice
Breakfast cereal, nuts, and dried fruit trail mix
Quinoa hot cereal for breakfast with chopped dried fruits
Qunioa pilaf
Chili with ground beef and tomatoes

It's important to remember that iron from animal ("heme" iron) sources is absorbed much higher amounts than iron from plant sources ("non-heme" iron). Heme iron is absorbed at a rate of 15-35% whereas non-heme iron is absorbed at a rate of only 2-20%. Dr. Sears reminds us that "the percentage of iron listed on the package label is certainly not the amount of iron that gets into your bloodstream. This is especially true of iron-fortified cereals, in which only 4 to 10 percent of the iron listed actually gets absorbed. The amount of iron absorbed from any food depends on the type of iron in the food, the body's need for iron, and the company of other foods eaten at the same meal" (65).

Peggy O'Mara writes recommends concentrating on "dark green leafy vegetables such as spinach and kale. Also eat plenty of whole grains, seaweed, soy products and fortified cereals" if you follow a vegetarian diet (26).

Finally, "The following foods hinder iron absorption: tea and coffee; high fiber foods such as bran; soy proteins; antacid medicines; milk or dairy products consumed with a meal" (Sears 60).

What about iron supplements?

Because adequate iron intake is critical for mother and baby during pregnancy, and because it is higher than what many women are able to consume through food alone, some women find that they need to take an iron supplement. I have heard good things (anecdotally) about Floradix, which is available at many health food stores and on Amazon, where you can check out their reviews, too. Here's what The Motherwear blog had to say about Floradix, Help for the Weary.

O'Mara does caution: "Most prenatal vitamins will provide the amount of iron necessary for expecting women. It is very important, however, to check with your health care provider before taking any additional supplements because too much of it can be toxic. Also keep in mind that some women will experience more constipation with increased iron supplementation" (26).

If anyone has any experience with overcoming anemia or any iron-rich recipes, please leave a comment!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

All Women Should Be Offered Midwife-led Care

This is a truly groundbreaking study: Midwife-led versus other models of care for childbearing women!

Background
Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led and other models of care.

Objectives
To compare midwife-led models of care with other models of care for childbearing women and their infants.

Main results
We included 11trials (12,276 women). Women who had midwife-led models of care were less likely to experience antenatal hospitalisation, risk ratio (RR) 0.90, 95% confidence interval (CI) 0.81 to 0.99), the use of regional analgesia (RR 0.81, 95% CI 0.73 to 0.91), episiotomy (RR 0.82, 95% CI 0.77 to 0.88), and instrumental delivery (RR 0.86, 95% CI 0.78 to 0.96) and were more likely to experience no intrapartum analgesia/anaesthesia (RR 1.16, 95% CI 1.05 to 1.29), spontaneous vaginal birth (RR 1.04, 95% CI 1.02 to 1.06), to feel in control during labour and childbirth (RR 1.74, 95% CI 1.32 to 2.30), attendance at birth by a known midwife (RR 7.84, 95% CI 4.15 to 14.81) and initiate breastfeeding (RR 1.35, 95% CI 1.03 to 1.76). In addition, women who were randomised to receive midwife-led care were less likely to experience fetal loss before 24 weeks' gestation (RR 0.79, 95% CI 0.65 to 0.97), and their babies were more likely to have a shorter length of hospital stay (mean difference -2.00, 95% CI -2.15 to -1.85). There were no statistically significant differences between groups for overall fetal loss/neonatal death (RR 0.83, 95% CI 0.70 to 1.00), or fetal loss/neonatal death of at least 24 weeks (RR 1.01, 95% CI 0.67 to 1.53).

Authors' conclusions
All women should be offered midwife-led models of care and women should be encouraged to ask for this option.

Plain language summary
Midwife-led care confers benefits for pregnant women and their babies and is recommended.

In many parts of the world, midwives are the primary providers of care for childbearing women. Elsewhere it may be medical doctors or family physicians who have the main responsibility for care, or the responsibility may be shared. The underpinning philosophy of midwife-led care is normality and being cared for by a known and trusted midwife during labour. There is an emphasis on the natural ability of women to experience birth with minimum intervention. Some models of midwife-led care provide a service through a team of midwives sharing a caseload, often called 'team' midwifery. Another model is 'caseload midwifery', where the aim is to offer greater continuity of caregiver throughout the episode of care. Caseload midwifery aims to ensure that the woman receives all her care from one midwife or her/his practice partner. By contrast, medical-led models of care are where an obstetrician or family physician is primarily responsible for care. In shared-care models, responsibility is shared between different healthcare professionals.

The review of midwife-led care covered midwives providing care antenatally, during labour and postnatally. This was compared with models of medical-led care and shared care, and identified 11 trials, involving 12,276 women. Midwife-led care was associated with several benefits for mothers and babies, and had no identified adverse effects. The main benefits were a reduced risk of losing a baby before 24 weeks. Also during labour, there was a reduced use of regional analgesia, with fewer episiotomies or instrumental births. Midwife-led care also increased the woman's chance of being cared for in labour by a midwife she had got to know. It also increased the chance of a spontaneous vaginal birth and initiation of breastfeeding. In addition, midwife-led care led to more women feeling they were in control during labour. There was no difference in risk of a mother losing her baby after 24 weeks. The review concluded that all women should be offered midwife-led models of care.

Hatem M, Sandall J, Devane D, Soltani H, Gates S. Midwife-led versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub2.

Finding a Midwife in Maine

There are many midwives currently working with families here in central Maine, both CNMs (Certified Nurse Midwives) who attend births in hospitals, and CPMs (Certified Professional Midwives0 who attend births at home. There is also one independent, free-standing birth center in Maine, staffed by midwives: The Birth House, in Bridgton.

Waterville Women's Care
Rights at Maine General, Waterville Campus
Waterville
877-7477

Central Maine Medical Center OB/GYN
Rights at CMMC
Lewiston
795-5770

Women's Health Associates
Rights at St. Mary's Hospital
Lewiston
777-4300

The Women's Center
Rights at Miles Memorial Hospital
Damariscotta
563-4700

Mid Coast Medical Group
Rights at Mid Coast Hospital
[This group appears to include several offices at different locations with different phone numbers.]
Brunswick
729-4996

Cathy Heffernan, CNM
Winthrop Family Practice
Rights at Maine General, Augusta Campus
Winthrop
377-2111

Heather Stamler, CPM
Vassalboro
873-5225

Midcoast Midwifery
Christine Yentes, CPM
Monroe
525-7740

Morning Star Midwifery
Donna Broderick, CPM
322-6464
Ellie Daniels, CPM
338-0708
Belfast

Mother Bloom Midwifery
Anna Fernandez, Traditional Homebirth Midwife
Blue Hill
326-4373

The Pregnancy Support Center
Jan Willson
Lewiston
777-3776

Northern Sun Family Health Care
Sarah Ackerly, ND, CPM Topsham
798-3993

Birch Moon Midwifery
Holly Arrends, CPM
Bath
522-6043

Casco Bay Midwifery
Schyla St. Laurent, CPM
Falmouth
797-7463

Open Circle Midwifery Services
Robin Doolittle, CPM
Deirdre Sulka/Meister, CPM
Greater Portland
838-2157

Sacopee Valley Birth Services
Brenda Surabian, CPM and
Lindsay Johnston, CPM
Parsonsfield
329-2111

To search for more midwives in Maine, go to the Midwives of Maine website or the Find a Midwife section of the American College of Nurse-Midwives website.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

How to Choose a Prenatal Vitamin

Many women take prenatal vitamins during their pregnancy. Some expectant moms take store brand vitamins, others get a prescription from their care provider for a specific brand. Since taking a prenatal vitamin is such a common aspect of pregnancy, I thought I'd spend the next few "Nutrition Wednesday" posts on it. This post will be an overview - and then each week I'll highlight a few common vitamins/minerals contained in the vitamin: what each does for mom and baby; common dosages; what foods contain this nutrient etc.

Interestingly, as I checked in several pregnancy and prenatal nutrition books, I found that there was not a consensus on prenatal vitamins: several books went so far as to explain that if mother's diet is excellent, prenatal vitamins are unnecessary. Most of the my sources, however, did suggest using prenatal vitamins almost as insurance:

The Harvard Medical Guide to Healthy Eating During Pregnancy has a helpful chapter called "Dietary Supplements - What's Good and What's Not". In this chapter, the author explains that

"Most physicians recommend taking a prenatal vitamin to ensure that pregnant women are not deficient in nutrients. This is an important point, because the goal of taking a vitamin is not to 'boost' the levels of any one nutrient to excess but to bring abnormally low levels of nutrients to a normal level. A reputable supplement with the right amount of vitamins and minerals can serve as a safety net in case the foods you eat fail to supply a critical nutrient that your baby needs, or if nausea and vomiting are preventing you from eating a balanced diet" (92).

and

Peggy O'Mara writes in Having a Baby, Naturally :

"Taking a prenatal vitamin can help ensure adequate vitamin levels, although it should not be used as a substitute for a good diet. Experiment with the best time of day to take your supplement, because taking it on an empty stomach may contribute to nausea. Taking it with a meal is usually best" (11).

Okay, so that's why many doctors and midwives recommend taking prenatal vitamins... now, which one to take? Here are some guidelines:

First, take a prenatal supplement, meant specifically for pregnant or breastfeeding (lactating) women. Prenatal vitamins have been modified to correspond with pregnant women's needs, and will work better than a traditional multivitamin.

The Harvard Medical School Guide to Healthy Eating During Pregnancy offers these additional considerations:

"It is safest to choose a supplement from a large, reputable manufacturer at a retail pharmacy, because these companies will be under higher scrutiny to provide a safe product than small companies that sell products over the Internet or in smaller stores. Choose a formula specifically designed for pregnant women, and check to see that it provides the level of vitamins and minerals that you need. You can ask your doctor to recommend an over-the-counter vitamin or to prescribe one through your pharmacy. Some people may also choose not to take a multivitamin, instead preferring individual supplements of the nutrients they need most. In this case, it's important to make sure you are getting the right dose, because individual-nutrient supplements are often sold as doses above the recommended daily dose" (93).

According to this same book, here is a list of Dietary Reference Intakes During Pregnancy, for women 19 years old or older:

Calcium: 1000mg
Phosphorous: 700mg
Magnesium: 350mg
Vitamin A: 770mcg (2,560IU)
Vitamin D: 5mcg (200IU)
Flouride: 3mg
Thiamin: 1.4mg
Riboflavin: 1.4mg
Niacin: 18mg
Vitamin B6: 1.9mg
Folate: 600mcg
Vitamin B12: 2.6mcg
Panthothenic acid: 6mg
Biotin: 30 mcg
Choline: 450mg
Vitamin C: 85mg
Vitamin E: 15IU
Iron: 27mg
Zinc: 11mg
Copper: 1000mcg
Selenium: 60mcg
Iodine: 220mcg

Elizabeth Somer writes in Nutrition for a Healthy Pregnancy that

"the secret to supplementation is to do it sensibly. Choose a multiple vitamin and mineral that supplies at least 400mcg of folic acid and approximately 100-200 percent of the Daily Value for all other nutrients. If you don't consume daily at least two calcium-rich foods, such as nonfat milk and fortified soy milk, and lots of magnesium-rich whole grains, wheat germ, and legumes, then consider supplementing your multiple with extra calcium (500mg) and magnesium (250mg) since no one-pill multiple contains enough of these two minerals. In addition, you will need additional iron if blood or tissue iron levels are low" (10).

Here is Mothering's response to "I'm looking for a really good prenatal vitamin and wondered what your suggestions would be."

I have used DaVinci Laboratory's Ultimate Prenatal Vitamins for 20 years with excellent results. It is in a base of herbs so consult with your midwife or doctor about your own health needs in this area. Some vitamin shops carry this product although it was formerly for professional use only. Ask your doctor to order it for you if you cannot find it locally visit their website at www.davincilabs.com Wishing you a beautiful pregnancy and birth experience.

So there are a few caveats about prenatal vitamins:

1. Don't assume all prenatal supplements (or supplements in general) are safe.

The author of the Harvard Medical School Guide to Healthy Eating During Pregnancy cautions that "dietary supplements are regulated differently from either food or medications. The responsibility for ensuring a supplement's safety lies with the manufacturer, not an overseeing agency such as the FDA . . . supplements that contain the same ingredient have been found to vary widely in quality and content. This doesn't mean that all supplements are dangerous; most reputable companies know that ensuring a safe, consistent product is in their best interest. But you can't assume that everything sold on your pharmacy's shelves [or online!!] has been tested for quality and safety" (92).

For example, you might want to check out a vitamin on this list before you buy it: Survey Data on Lead in Women's and Children's Vitamins. I was shocked to notice a significant overlap between health food store vitamins and the vitamins on the list for the highest lead content.

2. Prenatal vitamins sometimes cause nausea in pregnant women, especially in the first trimester. If your prenatal vitamins make you nauseous or add to your morning sickness, consider switching brands or - what I've found anecdotally to help the most women - take them at night after dinner rather than in the morning on an empty or nearly empty stomach. The Midwifery Today e-newsletter had an article about this common problem just recently: Nausea and Prenatal Vitamins

3. While taking prenatal vitamins can be "insurance" against a nutritional deficit, it's critically important to eat a balanced, healthy diet during pregnancy. Our bodies absorb nutrients much better from food than from vitamins, and many times the combinations involved in foods or traditional recipes combine together to work better in our bodies. Also, there are lots of important phytochemicals in fruits, vegetables and whole grains that are not available (yet?) in prenatal supplements.

Several of the books mention iron, calcium, and folic acid as three nutrients in prenatal vitamins that are particularly important, because many pre-pregnant and pregnant women do not get adequate amounts of these nutrients through the foods they eat. We'll start with those next week. In the meantime, these are the books I used to compile this information, and would recommend reading as additional resources:

The Pregnancy Book, by William Sears, MD and Martha Sears, RN
The Harvard Medical School Guide to Healthy Eating During Pregnancy, by W. Allan Walker, MD
Nutrition for a Healthy Pregnancy, by Elizabeth Somer, MA, RD
Having a Baby Naturally, by Peggy O'Mara

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Stretch Marks, Round Ligament Pain, and Nausea, Oh My!

Several links to some excellent information on a trio that concerns many pregnant women...

Round Ligament Pain, in the Lamaze Week 19 e-newsletter:

"Baby’s first movements may not be the only sensation in your belly these days. If you notice a sharp pain or pulling sensation on one side of your lower belly when you twist, bend or reach, you may be experiencing round ligament pain. The round ligaments, just a couple of centimeters long when you begin pregnancy, stretch like rubber bands to many times their pre-pregnant size as your uterus grows.

Round ligament pain is usually brief – coming on suddenly and subsiding over a few minutes. If you experience round ligament pain often, think of it as your body telling you to move a little slower. Get in the habit of supporting your belly with your hands when you get up from sitting or when you bend, twist, cough, or sneeze. You might even consider using a maternity belt to support your belly—you can find one at most maternity retailers. Try a warm compress on your lower belly if the pain doesn’t go away right away. And take heart in knowing that round ligament pain is usually short-lived. By next month, your body will be used to the stretching, and these sudden shocks of pain should be a thing of the past.

Of course, if you have any concern that your pain is something more serious, or if you are experiencing other symptoms, such as a fever or vaginal discharge, consult your care provider."

I've noticed that many women seem to talk about round ligament pain the most during weeks 20-24; I've theorized that many babies go through a growth spurt around that time, so moms sometimes feel the ligaments stretching in a painful way.

I liked this blog entry about common pains during pregnancy, from Healthy Mother Wellness & Care.

Finally, the Midwifery Today e-newsletter has two interesting articles - one connecting prenatal vitamins and vomiting/nausea also known as morning sickness and one with a recipe for make-your-own belly butter and other herbal remedies for stretch marks.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

USA Today Article on High-tech Interventions

High-tech Interventions Deliver Huge Childbirth Bill

I am so pleased to see this article in a mainstream newspaper! I do wonder about the title though... I would love to have seen something about how the costs don't produce healthier mothers and babies - that piece, to me, is the real story.

Here are two excerpts:

"Childbirth is the leading reason for hospitalization in the USA and one of the top reasons for outpatient visits, yet much maternity care consists of high-tech procedures that lack scientific evidence of benefit for most women, a report says today.

U.S. hospital charges for maternal and newborn care jumped from $79 billion in 2005 to $86 billion in 2006, the authors write. More than $2.5 billion a year is spent on unnecessary C-sections, which now represent nearly a third of all deliveries. [The language in this sentence is unclear to me: it makes it sound like ALL of the Cesareans are unnecessary; clearly there are times when a Cesarean birth is appropriate use of technology. Maybe the "which now represent" refers to C-sections in general, not unnecessary ones in particular? Anyway...]

Reducing expensive techniques such as C-sections and increasing low-cost approaches such as childbirth assistants called doulas would improve mothers' and babies' health while cutting costs, the authors say.

. . .

"The University of Wisconsin's Douglas Laube, a former president of the American College of Obstetricians and Gynecologists, blames "very significant external forces" for the overuse of expensive technologies in maternity care.

"I don't like to admit it, but there are economic incentives" for doctors and hospitals to use the procedures, says Laube, who reviewed the new report before its release.

For example, some doctors might get bonuses for performing more labor inductions, which adds costs and increases the risk of C-sections, which, in turn, increase hospital profits because they require longer stays.

In addition, some doctors order unnecessary tests and procedures to protect against malpractice suits, Laube says."

It's important to remember that these higher prices DO NOT equal better care. The United States is not the standard-bearer for safety for mothers and babies. Using 2008 statistics, the United States (6.3/1000) currently ranks BEHIND the following countries for infant mortality rates: South Korea (5.94/1000), Cuba, Isle of Man, Italy, Taiwan, San Marino, Greece, Monaco, Ireland, Canada, Jersey, New Zealand, United Kingdom, Gibraltar, Portugal, Netherlands, Luxembourg, Guernsey, Liechtenstein, Australia, Belgium, Austria, Denmark, Slovenia, Macau, Isreal, Spain, Switzerland, Andorra, Germany, Czech Republic, Malta, Norway, Anguilla, Finland, France, Iceland, Hong Kong, Japan, Sweden, and Singapore (2.3/1000).

If you are interested in reading the report, it is available in pdf format, and a print copy can be obtained for free by emailing your contact information.

Milbank Report: Evidence-based Maternity Care

"What are top implications for policy makers, childbearing women and maternity professionals?"

Policymakers can play an important role in improving quality, health outcomes and resource use by addressing barriers to evidence-based maternity care. Recommendations for addressing barriers in the new report (PDF) fall in four areas: measuring performance and leveraging results, fixing perverse financial incentives, educating the key groups, and filling priority research gaps.

Childbearing women need to understand that maternity care that is routinely available often is not in the best interest of themselves and their babies. Pregnant women have the right and responsibility to become informed and make wise choices — for example, their choice of caregiver, birth setting and specific procedures, drugs and tests. Becoming informed and taking responsibility can be a big task — and can have very big pay-offs.

Health professionals need to recognize that usual ways of practicing frequently do not reflect the best evidence about safe, effective maternity care. The field of pregnancy and childbirth care ushered in the era of evidence-based practice: many hundreds of currently underutilized systematic reviews point the way to improved maternity practice and outcomes. The Evidence-Based Maternity Care report (PDF) identifies dozens of reviews that are relevant to care of a large segment of the maternal-newborn population. Engaging with the unparalleled move for health care quality and patient safety can improve professional performance and satisfaction and reduce risk of liability.

I am so excited to read this report and be able to include this information in my classes!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Keeping a Journal during Pregnancy

There are a few things I really wish now that I had done during my two pregnancies and births. The first one is that I wish we'd taken more pictures of me/baby during pregnancy, labor, and right after the birth. I do have a few for each child, but looking back I really wish I had more.

The other thing is that I wish I'd kept a journal. Not necessarily a formal one; I do have one partially filled out in a sweet book my sisters gave me when I told them my husband & I would be trying to conceive. I treasure that book, but now I also wish I had more of a day to day or week to week informal record.

In fact I started off well during my first pregnancy, but that only lasted a few weeks; here's a few of the entries:

October 13: Your first Maine hike – “The Roost” near Gilead, Maine. We had perfect weather: beautiful blue skies and peak fall color. I had a difficult time hauling us up the mountain.

October 16: I had my first real dream about the baby: we were at the doctors having an ultrasound done & the baby was very clearly a boy!

October 17: Our first trip to the doctor’s to get blood drawn. It was strange to stare down at the paper and see, under diagnosis, “pregnancy”!

There are tons of online journal websites, some baby-oriented and others not. And there are lots of blank books, and baby "fill in the blank" journals at bookstores.

Here are a few additional resources:

The beautiful Birthing From Within Keepsake Journal.

In the September e-newsletter, Birthing From Within's founder, Pam England, discusses the three kinds of knowing as "primordial knowing", "modern knowing", and "knowing thyself" - this is a terrific article, and also a good starting place for considering why/how journaling can be a helpful part of birth preparation.

The Week Fifteen Lamaze e-newsletter also discusses journaling, "Focusing on your thoughts and daydreaming about motherhood can be a great way to slow down and relax. Even if you don’t think of yourself as a writer, journaling can help make your feelings, thoughts and concerns clearer to you. Furthermore, spending time thinking about your growing baby starts the important bonding process even before your baby is born." This article also includes some journal writing prompts.

I've never gotten into the whole scissors/layout/stickers thing, but this scrapbooking website has some good suggestions for a pregnancy scrapbook or journal.

More good ideas here.

Here is a link to Wondertime magazine's journal prompts for young children.

And this is an intersting blog post "Journaling Can Provoke an Oxytocin Response".

Finally, if you want to read other people's journals, you can look online at pregnancy blogs, or go book shopping. A few of my favorite books are Having Faith, by Sandra Steingraber, The Blue Jay's Dance, by Louise Erdrich, and Operating Instructions, by Anne Lamott.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Links & Other Goodies

From Midwifery Today's September e-newsletter:

"What makes pain intolerable to women is fear. What takes the fear away is knowledge, relaxation and focus. Yes, when these things are incorporated, there will still be pain but it will not be intolerable. Remember, you are hearing this from a certified wimp."

— Gloria Lemay


From the Sears' September e-newsletter: 10 Balanced Breakfasts - good for prenatal/postpartum moms and their table-food eating children!


Free Co-sleeping Webinar on Mothering, featuring James McKenna, Lysa Parker, Barbara Nicholson and Paul Fleiss. Excellent information on the physiological reasons to co-sleep, explanations of co-sleeping benefits for baby and mom, and a lot more.


Some blog entries I've enjoyed lately:

Amazing New Research from AJOG, on Making Birth Safe in the US.

Well, bloglines isn't working for me right now... I guess there will be a long list next Friday!!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Maine's Biggest Baby Shower

Inland Hospital, in Waterville, ME is hosting MAINE'S BIGGEST BABY SHOWER, on Saturday, October 4th, from 9-11:30am. There are lots of informative, helpful exhibits, as well as food, gifts, and games. For more information, email inlandhospital@emh.org or call 861-3392. See the schedule.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Local Eating during Pregnancy: Part One

I'm finishing up the excellent book Animal, Vegetable, Miracle: A Year of Food Life, by Barbara Kingsolver, who is one of my favorite authors. And I'm finishing up my year of garden work: picking my winter squash and orange pumpkins, the last peppers and eggplant, and putting cold frames over the less-hardy greens. Three days of rainy weather approaching has made the task more urgent - I don't want my peppers and winter squash to get moldy! During the rain, I think we'll be inside peeling apples from our local orchard for applesauce and husking/blanching/freezing corn from a farm just up the road.

There are many advantages to buying & eating more foods locally and seasonally. Some help others most directly, but certainly affect us in the long-term: economic benefits for the local area and local farmers; less dependence on gasoline to bring the food to you; small farms often farm more sustainably and/or organically (even if they don't go through the process to be certified organic). There are other benefits that are just for the local eater her/himself: eating food that was grown for taste, not portability/storage (YUM!) as well as the additional nutrition offered by eating locally and seasonally.

For many women, pregnancy is a time when they are more motivated to learn about nutrition, and to make food choices based on what they learn. It's also a time when there is a more obvious link to other mothers - mothers past, animal mothers, our mothers, future mothers. One of my favorite books to read during pregnancy was a memoir-ish book called Having Faith: An Ecologist's Journey to Motherhood. The author, Sandra Steingraber, discusses her journey month-by-month through pregnancy, giving each chapter a moon name, from "Old Moon" to "Harvest Moon". She writes in the preface that "When I became pregnant at the age of thirty-eight, I realized, with amazement, that I myself had become a habitat. My womb was an inland ocean with a population of one" (ix).

So, in honor of the coming harvest, and for all of you mamas growing your babies in the "inland ocean", here are a few recipes I'll be using to take advantage of this beautiful (and delicious!) season...

KALE

This recipe, Dino Kale Saute, is my favorite ways to use kale - everyone I've made it for as always loved it. Kale is an excellent source of Vitamin C, Vitamin A, and Vitamin K and has calcium and protein in it (!!).

Dino Kale Saute

12 ounces dinosaur kale or regular kale, cut or torn into 1- to 2-inch pieces (about 12 cups)
2 tablespoons olive oil
1/4 cup soft sourdough or French loaf bread crumbs
1/8 teaspoon pepper
1 teaspoon white wine Worcestershire sauce
Lemon wedges (optional)

1. Rinse kale leaves thoroughly under cold running water. Drain well; set aside.

2. In a small skillet heat 2 teaspoons of the oil. Cook bread crumbs in the hot oil for 1 to 2 minutes or until browned. Season with pepper; set aside.

3. In a large, nonstick skillet heat the remaining 4 teaspoons oil. Add kale. Cook the kale, covered, for 1 minute. Uncover. Cook and stir for 1 minute more or until just wilted. Transfer kale to serving dish. Drizzle with Worcestershire sauce. Sprinkle with the browned bread crumbs. Squeeze lemon wedges over all. Makes 4 servings.

Nutrition Facts
Servings Per Recipe 4 servings
Calories 89, Total Fat (g) 5, Saturated Fat (g) 1, Cholesterol (mg) 0, Sodium (mg) 53, Carbohydrate (g) 9, Fiber (g) 4, Protein (g) 3, Vitamin C (DV%) 94, Calcium (DV%) 8, Iron (DV%) 8, Percent Daily Values are based on a 2,000 calorie diet


APPLES

Apples are delicious this time of year and there are so many kinds to choose from. Apples have some Vitamin C and are a good source of fiber.

Rustic Apple Sauce

Ingredients
4 cups cubed peeled Braeburn or Pink Lady apple
4 cups cubed peeled Granny Smith apple
1/2 cup packed brown sugar
2 teaspoons grated lemon rind
3 tablespoons fresh lemon juice
1 teaspoon ground cinnamon
1 teaspoon vanilla extract
Dash of salt
2 tablespoons crème fraîche (or full-fat yogurt or sour cream)
Preparation

Combine first 8 ingredients in a Dutch oven over medium heat. Cook 25 minutes or until apples are tender, stirring occasionally.

Remove from heat; mash to desired consistency with a fork or potato masher. Stir in crème fraîche. Serve warm or chilled.

Nutritional Information
Calories:140 (12% from fat)
Fat:1.8g (sat 1g,mono 0.5g,poly 0.2g) Protein:0.3g Carbohydrate:32.5g Fiber:2.3g
Cholesterol:3mg Iron:0.5mg Sodium:30mg Calcium:31mg

One of my favorite recipes comes from the mother of my best friend growing up. It's not really a recipe, actually: chop up an apple and a small handful of walnuts; add a couple of spoonfuls of ricotta cheese and a sprinkle of cinnamon. Yum!


PEARS

Pears are also in season in the fall. They have some Vitamin C and are a very good source of fiber.

Pear Clafouti

Cooking spray
1 teaspoon all-purpose flour
2 cups cubed peeled pear
3/4 cup all-purpose flour
1/4 teaspoon salt
1/8 teaspoon nutmeg
2 cups 1% low-fat milk, divided
3 large eggs, lightly beaten
1/2 cup sugar
1/2 teaspoon vanilla extract
Preparation

Preheat oven to 375°.

Coat a 10-inch deep-dish pie plate with cooking spray, and dust plate with 1 teaspoon flour. Arrange the pear cubes in the bottom of prepared dish, and set aside.

Combine 3/4 cup flour, salt, and nutmeg in a bowl. Gradually add 1 cup milk, stirring with a whisk until well-blended. Add 1 cup milk, eggs, sugar, and vanilla extract, stirring until smooth. Pour batter over pear cubes. Bake mixture at 375° for 35 minutes or until set.

Nutritional Information
Calories:230 (15% from fat)
Fat:3.9g (sat 1.3g,mono 1g,poly 0.5g) Protein:7.7g Carbohydrate:41.1g Fiber:1.8g
Cholesterol:113mg Iron:1.3mg Sodium:171mg Calcium:121mg


PEARS & APPLES

I think pears and apples are both excellent addition to spinach or lettuce salads. A salad with spinach or mixed greens, apples or pears, a sprinkle of sunflower seeds and some chopped cooked chicken or hard-boiled egg is an excellent lunch or dinner. Paul Newman's raspberry walnut salad dressing is a good one to try on this type of salad if you don't want to make your own balsamic vinaigrette. A sprinkle of (pastuerized!) blue cheese or goat cheese, or cheddar, can be nice too.

Pears and apples are also good served with this dip:

Cottage Cheese and Apple Snacks

1 cup low-fat cottage cheese
2 tablespoons peanut butter
1/4 teaspoon ground cinnamon or apple pie spice
1 to 2 teaspoons skim milk
3 medium apples or pears, cored and sliced

For dip, in blender container or food processor bowl place the cottage cheese, peanut butter, and cinnamon or apple pie spice. Cover and blend or process until smooth. If necessary, stir in enough milk to make dip of desired consistency.

Serve the dip immediately or cover and chill it for up to 24 hours. Serve dip with the apple or pear slices. Makes 6 (2-tablespoon) servings.

Nutrition Facts
Calories 106, Total Fat (g) 4, Cholesterol (mg) 3, Sodium (mg) 178, Carbohydrate (g) 13, Protein (g) 7, Percent Daily Values are based on a 2,000 calorie diet

Next week, I'll include more seasonal recipes for spinach, winter squash, pumpkin and more.

In the meantime, to learn more about eating locally, I recommend Kingsolver's book (of course) - as well as the Animal, Vegetable, Miracle website, which offers tons of online resources to learn more about the benefits of eating locally/seasonally and how to incorporate more seasonal/local food into your diet. There is also information on how to find local foods, and the recipes from her book (which I can't wait to try!).

For us Mainers, I also recommend the Get Real Get Maine website, which has searches for specific food items, listed by county; pick your own farms; farmers markets; CSAs (community sustained agriculture farms that sell "shares" of their produce) and more.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

The Other Side of the Glass

I watched a very, very powerful film trailer, called The Other Side of the Glass, the other day and I want to invite you to view it too. You can also view it directly from Janel's (the film's writer/producer) blog, along with information on how to purchase the extended trailer and her story of making the film so far. I just purchased the extended trailer myself & can't wait to view it - and offer it as a resource for my clients.

This trailer is about dads and moms and babies: how babies are thinking, feeling creatures from the time of birth (and before), and as such, deserve dignity and respect during the birthing process; how dads can be guardians of the birth space, for mom and baby; how birth is now and how it could be.

I've noticed that families who are expecting their first baby sometimes have a certain attitude about experiences they see or hear that challenge the decisions they're making for their baby's birth: this _____________ won't happen to me. It happens to other people, but it won't happen to me because ___________________.

**I** won't be one of the women who have a cesarean for failure-to-progress (the reason for 40% of primary cesareans).

**MY baby** will stay with me for skin-to-skin bonding after the birth (according to the Listening to Mothers II report, 39% left their mother's arms during the first hour for "routine, non-urgent care").

**MY hospital/doctor/midwife** will treat me like an individual, offering care specific to my body, my baby and my birth.

Turns out that many caregivers and hospitals have certain routines (routine IV, routine continuous electronic fetal monitoring, routine epidural), and they have varying degrees of willingness to deviate from that routine. According to the Listening to Mothers II report, "Each of the following interventions was experienced by most mothers: continuous electronic fetal monitoring, one or more vaginal exams, intravenous drip, epidural or spinal analgesia, and urinary catheter."

There are certainly doctors, midwives, and hospitals who encourage women to participate in their care, and who treat women and their babies as individuals, with respect and dignity and patience. But, unfortunately, not all do. Even if you personally like your provider, or he/she is "terrific" accoring to your friends, or if he/she is the closest, or has rights at the newly remodeled hospital birth center: none of these things guarantee that dignity, respect, patience and/or treatment as an individual. According to the Listening to Mothers Survey II, 26% of women chose a care provider on family/friend recommendation; 26% for its nearby location; 47% because of their insurance plan. Only 18% chose a care provider because (s)he was a good match with the mother's philosophy.

I encourage (implore?) moms and their partners to remove any blinders and truly investigate whether or not the provider/birth place that they've chosen truly fits their needs. Ask challenging questions! Ask yourself, each other, your care provider(s), your hospital/birth center. Assuming (hoping?) that it won't be you, or your partner, or your baby has nothing like the impact of asking questions, communicating preferences, doing the research, and making informed decisions. Nothing guarantees a perfect birth experience, but doing this kind of work ahead of time has obvious advantages for moms, dads, and babies!

Wondering where to get started? I wrote two posts that directly address these issues, both full of book and website recommendations that might help: "Pregnancy and Birth: What Are My Choices" and "Choosing a Care Provider and Birth Place".

Other resources to check out, especially for partners: book review on Don't Just Stand There, and one of the best books for moms & their partners: Penny Simkin's The Birth Partner. Pam England's book Birthing From Within also has some good suggestions specifically for dads and birth support people, as well as some thoughtful & practical information for dads on her website.

Good luck on the journey!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Bonding after Cesarean Birth in the News

I read Tara Parker-Pope's most recent blog entry in the Health section of the New York Times, "Delivery Method Affects Brain Response to Baby's Cry" last week and I've been thinking about it ever since.

Pope opens with some personal experience, explaining that her feelings of "being numb" and "uninvolved" with her daughter's Cesarean birth surprised her, and that "When I finally heard a baby cry, it took a minute for me to realize that the sound belonged to my own baby."

She goes on to summarize the study:

"That’s why I was particularly interested to read of new research showing that the method of delivery seems to influence how a mother’s brain responds to the cries of her own baby. The brains of women who have natural childbirth appear to be more responsive to the cries of their own babies, compared to the brains of women who have C-section births . . . The study, published in The Journal of Child Psychology and Psychiatry, found that the cry of a woman’s own baby triggered significant responses in several parts of the brain related to sensory processing, empathy, arousal, motivation, reward and habit-regulation"

(I'm going to interrupt myself here to say that I hate it when people euphemize "vaginal birth" with "natural birth" - is the word vagina that threatening? because to me, and to lots of other people, natural birth is not the same as, or interchangeable with, vaginal birth. A vaginal birth could have been induced with cytotec (to soften the cervix) and pitocin (to stimulate contractions); the amniotic membranes could have been artificially ruptured; the mother could have been hooked up to an IV (with the Pitocin drip) and an epidural and a catheter; baby could be removed with a vacuum extractor. Does all this result in a vaginal birth? Yes, certainly! But is that a "natural" birth?? I'm not sure how all those medications and procedures equal "natural", even in the loosest sense of the word. And when doctors and/or scientists, and those who report their findings, start choosing not to distinguish between the two, that's when we're in real trouble - see VBAC link below...).

Anyway! Here are two links to a summary of the study: "Maternal brain response to own baby-cry is affected by cesarean section delivery". I like this summary because it reports that this study was done on a sample size of (only!!) TWELVE women - six who "delivered vaginally" and six who elected for a Cesarean birth; and "Natural childbirth makes mothers more responsive to own baby-cry", which I think summarizes the study in easier to understand language, though they do make that pesky trick of making "vaginal" into "natural" in their title (!!).

Another blogger, who writes about oxytocin (the "hormone of luuuuuvv" is what I call it in class), has this blog entry about the study.

Reading that study made me think back to something that I read (or heard?) about monkeys who reject their babies born by Cesarean. After a little searching, I found out that the reknowned French obstetrician has a very interesting website called WombEcology. In one terrific article, "In-labor Physiolocial Reference", he reminds us that humans are mammals, and that we give birth as mammals. He describes the handicaps that are special to human mothers giving birth, and how we can help minimize them. It's really a terrific article - much better than the title makes it sound - go read it!

One thing he highlights in the article is that:

"Physiologists constantly refer to what they learn from non-human mammals. This leads to keep in mind the main differences between human beings and other species. One of the main differences is that the effects of a disturbed birth process on maternal behaviour are much more evident at an individual level among non-human mammals . . .

Today caesareans are common in veterinary medicine, particularly among dogs. This is possible as long as human beings compensate for a frequently inadequate maternal behaviour, assist the process of nursing and provide, if necessary, commercial canine milk replacers. The effects of a caesarean on the maternal behaviour of primates are well documented, because several species of monkeys are used as laboratory animals. This is the case of the ‘crab-eating macaques’ and the rhesus monkeys.(3) In these species the mothers do not take care of their baby after a caesarean; laboratory personnel must spread vaginal secretions on the baby’s body in order to try to induce the mother’s interest for her newborn.

We don’t need to multiply the examples of animal experiments and observations by veterinarians and primate-using scientists to convince anyone that a caesarean – or just the anaesthesia that is necessary for the operation – can dramatically alter the maternal behaviour of mammals in general. In this regard humans are special. Millions of women all over the world have taken care of their baby after a caesarean birth or simply an epidural birth or a ‘twilight sleep birth’.

We know why the behaviour of humans is more complex and more difficult to interpret than the behaviour of other mammals, including primates.(4) Human beings have developed sophisticated ways to communicate. They speak. They create cultures. Their behaviour is less directly influenced by their hormonal balance and more directly by the cultural milieu. When a woman knows that she is expecting a baby, she can anticipate displaying some maternal behaviour. This does not mean that we cannot learn from non-human mammals. The spectacular and immediate behavioural responses of animals indicate the questions we should raise about ourselves."

The reason I include this excerpt is because I think that for some women, feelings of distance, or not feeling immediately "bonded" to her baby, become one more thing that she feels guilt or shame about. I think it's critical to realize that bonding happens over time, and that we as humans can overcome a less-than-optimal beginning. I think the truth - that feelings of distance can be a part of some women's postpartum experience - gets covered up, which can make women feel alone and also make it very hard to find resources for help.

If we realized, accepted, and publicized as part of informed consent that epidural anesthesia and/or Cesarean birth can have a physiological impact on bonding and post-partum blues/depression, women could make more informed decisions about their care and could prepare in one of the many ways (extra support, more skin-to-skin contact with baby, and massage come immediately to mind) that are shown to promote bonding and lessen post-partum blues.

If any of this gets you wondering about choices for VBAC (vaginal birth after cesarean), or the safety of VBAC, I came across a great article on the Midwifery Today website, Homebirth after Cesarean: The Myth and the Reality (see also if you're interested in how equating vaginal birth with natural birth as affected hospital policies on VBACs).

You can also visit the Online Resources section of my site for links to VBAC.com and ICAN (International Cesarean Awareness Network), as well as lots of links to postpartum depression and support sites.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Be BOLD: Birth Performances in Gardiner, ME

Karen Brody's play, Birth, will be performed at the Johnson Hall Performing Arts Center (280 Water Street) in Gardiner, Maine on Friday, September 26th at 7pm and Sunday, September 28th at 2pm. The Friday performance will feature a "talk back" discussion with area healthcare providers and birth experts. Tickets are $10, and are available at the door or by emailing BOLDinMaine@yahoo.com.

All profits are to benefit Birthroots of Maine.

About the play, from the BOLD website, www.boldaction.org

"Birth is a play based on over one hundred interviews Karen Brody conducted with mothers across America who gave birth between 2000-2004. It tells the true stories of 8 women painting a portrait of how low-risk, educated women are giving birth in America today . . . Moving between first-person monologues, some dialogue, and the voices these women heard on the day they gave birth, Birth confronts, what City Lights Theater Company has called, "The naked truth about childbirth in America."

"BOLD is an exciting, uplifting, and empowering answer to our nation's childbirth crisis. I support this movement with every fiber of my being" Christine Northrup, MD, author of Mother-Daughter Wisdom, The Wisdom of Menopause and Women's Bodies, Women's Wisdom

Playwright Karen Brody's blog.

More about BOLD, from the BOLD website, www.boldaction.org, below. The website has a great list of links and books, lots more about BOLD and Birth, as well as information on how you can contribute by organizing an event or through a financial donation.

"What is BOLD’s approach?"

"BOLD's approach to our mission is based on similar "theatre for social change" models (V-Day, The Innocence Project). Every September (and during the month of other Labour Day around the world) we support communities to organize a BOLD production of Karen Brody's critically acclaimed play, Birth, and a BOLD Talkback, take the play to a college campus to educate students about maternity care, or organize a BOLD Red Tent. The goal of each event is to engage communities in a discussion about how to improve their local maternity care issues. BOLD puts mothers at the center of solving their maternity care problems. At BOLD we ask mothers: what kind of childbirth conditions do you want? What do you deserve?"

"What does the BOLD acronym stand for?"

"Our acronym stands for Birth On Labor Day (BOLD). In 2006, BOLD's first year, over forty performances of Karen Brody's critically acclaimed play, Birth, were performed throughout the world over four days during the American Labor Day weekend. Since then BOLD has expanded to include events at other times beyond Labor Day weekend."

"Why BOLD?"

"Playwright Karen Brody wanted to find a way to honor mothers’ birth experiences, get communities talking about their local birthing issues, and raise money for organizations and small groups who are working to make maternity care mother-friendly. “One woman dies every minute throughout the world from a pregnancy or childbirth-related cause,” says Brody, “As a writer I wondered, why are we not telling this story? And as an activist I wondered, how can we tell this story in a way that will make a difference, that will shift the model of maternity care for women to the mother’s needs?”

I plan to go to the Friday performance - it's been on my "to do" list for a couple of years, but the dates have never worked out. I'm really, really excited to go!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Diddos for Kiddos - Consignment Sale in Central Maine

Diddos for Kiddos is coming up! Diddos is an awesome consignment sale (clothes, baby supplies, toys) in Augusta, Maine. There are new dates - Saturday, October 11th, from 8am to 6pm and Sunday, October 12th, from 8am to 4pm. Here's a pdf with all the information you'll need if you want to come to buy, or find out how to sell.

I've been doing this for years (buying and selling), and while it can get a little crazy, it's a lot of fun. The timing is great too - one sale in the fall (winter clothing, and holiday presents) and one in the spring (summer clothes, and presents for my kids' May & June birthdays).

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

Resource Round-up

We camped up at Cobscook Bay State Park, visited the Windsor Fair, went apple picking and started school in the past ten days - whew! So, finally, here's a list of resources from my reading in the past two weeks:

The Lamaze weekly newsletter
Excellent, as usual, with information on how to handle unsolicited advice (my personal favorite response: "I'll keep that in mind..." prefaced with "oh..." or "thank you!" depending on the brand of advice & its delivery). Their breastfeeding expert had some very helpful tips in her answer to this common question: "Is there anything I can do to make sure I will have a good experience breastfeeding?"

Last week's newsletter had a chart that provided a summary of nutritional information - specific nutrients, why they're important, and what foods are good sources.


Hilarious Blog
Jeremy Adam Smith wrote a blog entry for the Mothering website that just cracked me up, called "I am a Porn Star".


New Products at Target!
I just read that Target has started carrying Bum Genius 3.0. I called to request information on stores here in Maine - it sounds like Topsham and Augusta have them on their computer but none in the store or ordered; Bangor might be having a shipment come in soon. To get information about locations near you, call the corporate customer service at 1-800-440-0680 and ask for stores in your area carrying these specific DPI (item #s):

wetbag (found by searching for “wet bag”): 030 00 2235
reuseable diapers: 030 00 2126

I also read somewhere (the new Mothering magazine?) that Target is carrying California Baby products - my local Target has them in stock, which I'm very excited about. We love the bubble bath, especially!


Homebirth Dads Video
The most recent Mothering magazine also included information about a film called Homebirth Dads. That's definitely going to make it into my birth class lending library, the next time I buy videos.


Long-term Effects of Pitocin Study
A really interesting study on Pitocin, on The True Face of Birth blog.

The Relationship between Artificial Oxytocin (Pitocin) Use at Birth for Labor Induction or Augmentation and the Psychosocial Functioning of Three-year-olds

The focus of my dissertation research study was, as you can see by the above title, an exploration of whether there is any relationship between the use of Pitocin (artificial oxytocin) to start or speed up labor, and the way children born with its use function individually and in their relationships when they are three years old...

The following is a summary of the findings that were statistically significant.

1. Receiving Pitocin resulted in more negative recollections of labor and delivery, suggesting that mothers who received it had a more challenging experience than those who didn’t. However, there was a similar finding for the use of epidural anesthesia and for pain medication, both of which tend either to precede or follow the use of Pitocin.

2. Mothers who received Pitocin spent less time with their babies in the first hour after delivery, and were less likely to feed their babies exclusively at the breast in the first six months. In other words, babies who were born without Pitocin were more likely to be fed exclusively at the breast in the first six months than those born with Pitocin

3. Two factors distinguished children born with Pitocin from those born without Pitocin.

The first was called “Assertiveness”, which describes a socially appropriate way that babies and children communicate their need for help and comfort when they are feeling uncomfortable or unsafe. Typically, crying, using facial expressions and physical gestures, and later, verbalizing their thoughts and feelings, elicits helpful responses from parents, who try to identify and meet the need the baby or child is expressing. However, babies born with Pitocin, whose mothers reported having had a more challenging time during labor and delivery, appear to have a higher need to be assertive because they seem to experience more discomfort, but are apparently less effective in asserting their needs and getting them met when they feel unsafe or uncomfortable.

The second factor was called “Need to Control Environment” and this summarizes what seems to be a higher level of discomfort or insecurity, particularly in response to “outside-in” influences (e.g., reacting to food with digestive problems or being picky eaters; problems coping with other people’s timing and structure, refusing help from others) and increased or exaggerated efforts to control their environment, resulting in behaviors that may be more challenging to their mothers/family. There appears to be some continuity of effects between infancy and age three: for example, children who were described as picky eaters, or as having digestive problems at three, were likely to have been colicky, fussy babies. Interestingly, the hormone oxytocin is very involved in the digestive process: it plays a role in the production of digestive enzymes and as we enjoy our meal, in a positive feedback loop, we produce more oxytocin.

It may be that a process described as “hormonal imprinting,” identified in a considerable number of animal studies since the 1970s, is the mechanism that accounts for these differences between children exposed to Pitocin and those who were not. Using Pitocin to initiate labor may “flood” the available oxytocin receptors in mother and baby, apparently affecting children’s internal comfort levels and how they interact with others, although how this takes place in the babies has not yet been studied. Since both mother and baby receive Pitocin during labor and delivery, it is as yet unclear to what degree each contributes to challenges in their mutual relationship.

Claire L. Winstone, Ph.D.
Santa Barbara Graduate Institute July 2008

Protecting Infants and Children from Toxic Exposure: Cribs
"Friends of the Earth has found that commonly used baby and children’s products, and upholstered household furniture contain dangerous levels of toxic chemicals called halogenated fire retardants.

56% of all infant carriers, 44% of all car seats, 40% of all strollers and 19% of all portable cribs were found to have high levels of halogenated fire retardants."

There is also a link to "Safe Baby Products" - ones without halogenated fire retardents - at the bottom of the page.


Who Co-Sleeps?
Turns out, lots of people! Take this co-sleeping survey to add your voice, or view the results. Over 8,000 people have taken this survey!


Body & Soul Soothers - Links to articles on Mothering.com.


Is there lead in your prenatal vitamin?
I was shocked at the number of children's vitamins and prenatal vitamins that contain lead... Here's a website with additional information, including particular vitamins and how much lead they contain.

Questioning Safety: Hospital, Birth Center, and Homebirth

Where is it safe to birth your baby? Is the hospital the safest option? The only safe option? Are planned homebirths safe? Is it safer to have an OB/GYN (obstetrician, who is a doctor) as a care