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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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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Tuesday, September 29, 2009

You Have a Choice - Video

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

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



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

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

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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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Friday, August 21, 2009

Commencement: Copyright 2009

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

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

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

'How small?' she said.

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

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

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

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

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

Bree's eyes nearly popped out of her head.

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

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

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

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

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

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

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

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

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

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

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

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

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Friday, May 8, 2009

Exciting Birth Cyber Event!

Spreading the word:

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

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

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

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

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

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

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

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

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

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Monday, April 20, 2009

Birth Video Contest

Birth Documentary Contest: $1,000 First Prize

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

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

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

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

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

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

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

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Saturday, April 18, 2009

The Birth Survey in Maine!

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

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

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

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

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

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

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

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

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

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


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

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

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Wednesday, April 8, 2009

Links!

Thought I'd share:

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

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

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

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

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

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

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

Enjoy!

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

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Thursday, March 5, 2009

Qualifications

I posted the "You Get Your Hair Done by a Doctor?" Sweet Surprise advertisement yesterday, soliciting comments.

Kathy, of Woman to Woman Childbirth Education, commented
"Y'know, I read something recently that said something along the lines of HFCS and sugar being "nearly identical" or "almost chemically identical." Hmm, well, oxytocin and Pitocin are exactly identical... but one crosses into the brain and makes the mother feel good and has benefits for the baby, while the other just makes her uterus contract and slams her baby. So, maybe they're not as "identical" as they thought, hmm? :-)".
I hadn't even thought of that! But I do think it's a very interesting thought, and it does connect the ad with birth... which was what I thought about the first time I saw it. It totally raised my hackles because it shows a woman elevating her doctor as the only credible expert. The way I read the ad, it simultaneously elevates the doctor, puts down the hairdresser, and attempts to make the woman who considered her hairdresser's opinion seem foolish.

I realize that it is no small thing to go through the education and training necessary to become a medical doctor. This eduction, training, and practice should certainly lend weight to a doctor's opinion. However, I also believe that good information is usually available to all intelligent people who take the time to seek and evaluate it. Even if they're "just" hairdressers... or everyday moms... or construction workers etc. & etc. I truly resent the insinuation that the hairdresser has nothing of value to add to the conversation.

Especially because the advertisement was created by Sweet Surprise, according to their website titled "High Fructose Corn Syrup Health and Diet Facts". Facts according to whom?? Facts according to the Corn Refiner's Association, that's who:
"The Corn Refiners Association (CRA) is the national trade association representing the corn refining (wet milling) industry of the United States. CRA and its predecessors have served this important segment of American agribusiness since 1913. Corn refiners manufacture sweeteners, ethanol, starch, bioproducts, corn oil, and feed products from corn components such as starch, oil, protein, and fiber."
Not that they might have a stake in it, or anything...

And those are the thoughts I applied in my head to birth: don't devalue the laywoman who has made it her business to learn about birth, just because she doesn't have a medical degree; and don't underestimate the strength with which people will fight to keep their power, and the dollars that come with it.

In case you were expecting this post to actually be about high fructose corn syrup, here is a sampling of the interesting links I found:

The Murky World of High Fructose Corn Syrup explains the process of making high fructose corn syrup, as well as how the production of high fructose corn syrup fits into the big picture of big farm and food conglomerates:
"The development of the HFCS process came at an opportune time for corn growers. Refinements of the partial hydrogenation process had made it possible to get better shortenings and margarines out of soybeans than corn. HFCS took up the slack as demand for corn oil margarine declined. Lysine, an amino acid, can be produced from the corn residue after the glucose is removed. This is the modus operandi of the food conglomerates--break down commodities into their basic components and then put them back together again as processed food."
Here's what the Mayo Clinic says about HFCS, including that
"research has yielded conflicting results about the effects of high-fructose corn syrup. For example, various early studies showed an association between increased consumption of sweetened beverages (many of which contained high-fructose corn syrup) and obesity. But recent research — some of which is supported by the beverage industry — suggests that high-fructose corn syrup isn't intrinsically less healthy than other sweeteners, nor is it the root cause of obesity."
Maybe you've heard about mercury in high fructose corn syrup? You can read more information on Web MD, including a list of the 17 products that tested positive for mercury.

The Washington Post also reported on mercury and HFCS, in "Study Finds High-Fructose Corn Syrup Contains Mercury." Here is part of that article which I found interesting,
"HFCS has replaced sugar as the sweetener in many beverages and foods such as breads, cereals, breakfast bars, lunch meats, yogurts, soups and condiments. On average, Americans consume about 12 teaspoons per day of HFCS, but teens and other high consumers can take in 80 percent more HFCS than average."
Okay, that just grosses me out: there's HFCS in lunch meat?? The article goes on,
"Mercury is toxic in all its forms. Given how much high-fructose corn syrup is consumed by children, it could be a significant additional source of mercury never before considered. We are calling for immediate changes by industry and the [U.S. Food and Drug Administration] to help stop this avoidable mercury contamination of the food supply," the Institute for Agriculture and Trade Policy's Dr. David Wallinga, a co-author of both studies, said in a prepared statement."
About a year ago, the Washington Post published a very informative article about the impact of HFCS on health - the health of our planet, "High-Fructose Corn Syrup: Not So Sweet for the Planet."

Apparently I'm not the only one insulted by the "Sweet Surprise" advertisements. Marion Nestle, author of the Food Polictics blog, writes that
"OK, so lots of people think HFCS is the new trans-fat. It isn’t, but is insulting your intelligence an effective way to deal with that concern? It’s hard to know what on the website is most offensive: the videos of dumb people being condescended to by friends who think they know better (and what’s up with the race and gender combinations?), the slogans (“HFCS has no artificial ingredients and is the same as table sugar”), the quiz questions (“which of the following sweeteners is considered a natural food ingredient: HFCS, honey, sugar, or all of the above”), or the take home message: “As registered dietitians recommend, keep enjoying the foods you love, just do it in moderation.”"
Nestle continues:
"Let’s agree that HFCS has an enormous public relations problem and is widely misunderstood. Biochemically, it is about the same as table sugar (both have about the same amount of fructose and calories), but it is in everything and Americans eat a lot of it—nearly 60 pounds per capita in 2006, just a bit less than pounds of table sugar. HFCS is not a poison, but eating less of any kind of sugar is a good idea these days and anything that promotes eating more is not."
"Ad Wars: Is High-Fructose Corn Syrup Really Good for You?" was published in Time Magazine, and brings up what I believe is one of the most important points.
"The commercials claim that just like sugar, high-fructose corn syrup isn't unhealthy when consumed in moderation. But it's hard to know exactly how much of it we're actually consuming because it shows up in so many unexpected foods. "It was in my children's vitamins!" said Elise Mackin. Because high-fructose corn syrup extends the shelf life of foods, and farm subsidies make it cheaper than sugar, it's added to a staggering range of items, including fruity yogurts, cereals, crackers, ketchup and bread — and in most foods marketed to children. So, unless you're making a concerted effort to avoid it, it's pretty difficult to consume high-fructose corn syrup in moderation. "We did a consumers survey," says Doug Radi of Boulder, Colo., based Rudi's Organic Breads, "and less than 25% of them realized that high-fructose corn syrup is commonly used in bread.""
Yes, bread! For the past thirteen years or so that I've been buying my own bread, I've almost always chosen whole-grain breads - partially for taste, and partially for nutrition. A while back, I realized that seeing "made with whole grains" wasn't a good indication of nutrition, because bread that was mostly processed flour could still be labeled that way. So I got all vigilant about it, and only bought breads that listed a whole grain flour first, or that were labeled as 100% whole grains. Country Kitchen, which is a local company, made one of the best-tasting, most-affordable 100% whole wheat breads, so I had been buying that for years. Then the whole HFCS thing came up. And that's when I threw in the towel and became my own bread baker.

That's right: I make two loaves every week and half or so, and I get to know exactly what's in it. I have a thirty-year old stand mixer that makes it easy - takes about fifteen minutes to make the dough and then only a few more minutes to punch it down, shape it, and slide it into the oven. I've even learned to cut the thin & straight slices!

If you're interested in becoming your own bread baker, here are a few homemade bread recipes that are easy and nutritious. They're the ones I make over & over again...

Light Wheat Bread
from The Bread Baker’s Apprentice

2 1/2 cups (11.25 oz) unbleached high-gluten or bread flour
1 1/2 cups (6.75 oz.) whole-wheat flour
1 1/2 tablespoons (.75 oz.) granulated sugar or honey
1 1/2 teaspoons (.38 oz.) salt
3 tablespoons (1 oz.) powdered milk*
1 1/2 teaspoons (.17 oz.) instant yeast
2 tablespoons (1 oz.) unsalted butter, at room temperature
1 1/4 cups (10 oz.) water, at room temperature

1. Stir together the high-gluten flour, whole-wheat flour, sugar (if using), salt, powdered milk, and yeast in a 4-quart mixing bowl (or in the bowl of an electric mixer). Add the shortening, honey (if using), and water. Stir (or mix on low speed with the paddle attachment) until the ingredients form a ball. If there is still flour in the bottom of the bowl, dribble in additional water. The dough should feel soft and supple. It is better for it to be a little too soft that to be too stiff and tough.

2. Sprinkle high-gluten or whole-wheat flour on the counter, and transfer the dough to the counter, and begin kneading (or mix on medium speed with the dough hook). Add more flour if needed to make a firm, supple dough that is slightly tacky but not sticky. Kneading should take about 10 minutes (6 minutes by machine). The dough should pass the windowpane test and register 77 to 81 degrees F. Lightly oil a large bowl and transfer the dough to the bowl, rolling it around to coat it with oil. Cover the bowl with plastic wrap.

3. Ferment at room temperature for 1 1/2 to 2 hours, or until the dough doubles in size.

4. Remove the dough from the bowl and press it by hand into a rectangle about 3/4 inch thick, 6 inches wide, and 8 to 10 inches long. Form it into a loaf by working from the short side of the dough, rolling up the length of the dough one section at a time, pinching the crease with each rotation to strengthen the surface tension. It will spread wider as you roll it. Pinch the final seam closed with the back edge of your hand or with your thumbs. Place the loaf in a lightly oiled 8 1/2 by 4 1/2 inch bread pan; the ends of the loaf should touch the ends of the pan to ensure an even rise. Mist the top with spray oil and loosely cover with plastic wrap.

5. Proof at room temperature for approximately 60 to 90 minutes, or until the dough crests above the lip of the pan.

6. Preheat the oven to 350 degrees F with the oven rack on the middle shelf.

7. Place the bread pan on a sheet pan and bake for 30 minutes. Rotate the pan 180 degrees for even baking and continue baking for 15 to 30 minutes, depending on the oven. The finished loaf should register 190 degrees F in the center, be golden brown on the top and the sides, and sound hollow when thumped on the bottom.

8. When the bread is finished baking, remove it immediately from the loaf pan and cool it on a rack for at least 1 hour, preferably 2 hours (yeah, good luck with that), before slicing or serving.

Makes one 2-lb. loaf

My Mom's NO-KNEAD OATMEAL BREAD

2pkgs (or equivalent) active dry yeast
1 1/2 C boiling water
1C quick cooking oats (I use regular oats)
1/2C molasses
1/3C butter
1T salt
6 1/4C white flour (I do 3C whole wheat; 3C-ish white)
2 slightly beaten eggs

Soften yeast in 1/2C warm water. In a large bowl, combine the 1.5C boiling water, the oats, molasses, butter and salt; cool to lukewarm. Stir in 2C of the flour; add eggs; beat well. Stir in the softened yeast; beat well.

Add remaining flour, 2C at a time, mixing vigorously after each addition, to make moderately stiff dough. Beat vigorously til smooth, about 10 minutes. Grease top lightly. Cover tightly; place in refrigerator at least 2 hrs or overnight.

Turn out on well-floured surface; shape into 2laves. Place in 8.5 x 4.5" loaf pans. Cover; let rise in warm place until double 1-2hrs. Bake at 375 for about 40 minutes.

Makes 2 loaves

And Whole Wheat Bread with Wheat Germ and Rye
from Cook's Illustrated - The New Best Recipe Cookbook

2 1/3 cups warm water (about 110 degrees)
1 1/2 tablespoons instant yeast
1/4 cup honey
4 tablespoons unsalted butter, melted
2 1/2 teaspoons salt
1/4 C rye flour
1/2 cup toasted wheat germ
3 cups whole-wheat flour
2 3/4 C unbleached all-purpose flour, plus more for dusting the work surface

1. In the bowl of a standing mixer, mix the water, yeast, honey, butter, and salt with a spatula mix in the rye flour, wheat germ, and 1 cup each of the whole-wheat and all-purpose flours.

2. Add the remaining whole-wheat and all- purpose flours, attach the dough hook, and knead at low speed until the dough is smooth and elastic, about 8 minutes. Transfer the dough to a lightly floured work surface. Knead just long enough to make sure that the dough is soft and smooth, about 30 seconds.

Note on hand kneading: Mixing the water, yeast, honey, butter, salt, rye flour, and wheat germ in a large mixing bowl. Mix 2 3/4 cups of the whole- wheat flour and the all-purpose flour in a separate bowl, reserving 1/4 cup of the whole-wheat flour. Add 4 cups of the flour mixture to the wet ingredients; beat with a wooden spoon 5 minutes. Beat in another 1 1/2 cups of the flour mixture to make a thick dough. Turn the dough onto a work surface that has been sprinkled with some of the reserved flour. Knead, adding only as much of the remaining flour as necessary to form a soft, elastic dough, about 5 minutes. Continue with step 3.

3. Place the dough in a very lightly oiled large bowl; cover with plastic wrap. Let rise in a warm, draft-free area until the dough has doubled in volume, about 1 hour.

4. Heat the oven to 375 degrees. Gently press down the dough and divide into two equal pieces. Gently press each piece into a rectangle, about 1 inch thick and no longer than 9 inches. With a long side of the dough facing you, roll the dough firmly into a cylinder, pressing down to make sure that the dough sticks to itself. Turn the dough seam-side up and pinch it closed. Place each cylinder of dough in a greased 9 by 5-inch loaf pan, seam-side down and pressing the dough gently so it touches all four sides of the pan. Cover the shaped dough; let rise until almost doubled in volume, to 30 minutes.

5. Bake until an instant thermometer inserted at an angle from the shot end just above the pan rim reads 205 degrees, 35 to 45 minutes. Transfer the bread immediately from the baking pans to wire racks; cool to room temperature.

Makes two loaves.

Do you have a favorite bread recipe? A story about reading the label & seeing HFCS listed in an unlikely-seeming food? An advertisement that aggravates you? Leave a comment & add to the conversation...

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

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Sunday, February 22, 2009

More on Midwifery and Gender

Well, we're two down (the little guy & I are both through the stomach bug) and two to go here and the suspense is high: are we through with Pukefest the Third, or is this day of non-sickness only an intermission? So, while I have the chance:

Interestingly, the comments and emails I've received on this blog and the family blog where I cross-posted the Private Practice entries have all been about gender and midwifery, not about the indignation I personally felt when seeing a "midwife" provide the kind of care Dell offered the laboring woman.

The gender issue seems a little like sleight of hand to me - here look: a male midwife!! Ignore the fact that Dell is not practicing actual midwifery. Since we've been in an ongoing old-school Star Wars movie marathon, the other comparison that comes to mind is the Jedi Mind Trick: we're post-gender here at Private Practice, look at sexy sensitive Dell delivering this baby!! Ignore the fact that Dell is performing a risky procedure without informed consent!

Let me clarify my feelings on the gender issue. I think men should be able to become midwives or ob/gyn doctors, just like women should be able to become midwives or ob/gyn doctors. Like I said previously, I wonder about the market for a male midwife. I think there is a significant overlap of "women who seek midwifery care because they perceive it to be more woman-centered" with "women who want a female care provider because they perceive her to be more woman-centered" (picture a Venn diagram here, if you would) and therefore, I would be curious as to how many women who fall into both of these categories might actively choose a male midwife. This is hard to debate because at least here in the United States, there are very, very few male midwives.

There's a much more important sleight of hand that women need to be aware of when they choose a care provider: the tendency to make assumptions about a care provider because she is a woman or he is a man OR because one is a midwife and one is a doctor. Get to know your provider! Neither gender nor training & credentials guarantee certain philosophies or care practices. If you can't get to know your provider, because you're seeing so many different partners in a practice or because (s)he doesn't bother to sit down during your appointments, that gives you some very valuable information.

Some men, as OBs, family practice doctors, or midwives provide excellent, evidence-based, woman-centered care. The country doctor in Lady's Hand, Lion's Heart (my review), Navelgazing Midwife's Dr. Wonderful, and Michel Odent come immediately to mind.

On the other hand, some women, as OBs, family practice doctors, or midwives, do not provide woman-centered care, instead relying on routines that are not evidence-based and can even be degrading.

Is it more shocking when a woman provides care like this? I don't know if it should be, but I've definitely heard, in tones of betrayal and disappointment, "well... I thought because she was a woman she'd __________________________." or "I thought because she was a midwife she'd __________________________."

A care provider's gender or training does not automatically guarantees a certain kind of care. There are certainly trends that midwifery care and OB care follow, but there are certainly midwives who tend to practice more from a medical model and OBs who tend to practice more from a midwifery model. Personally, I think gender offers even less certainty than training and credentials. Does this make me suspicious, or only a careful consumer?

How did you decide on a care provider? How much did the credential as midwife or OB or family practice doctor come into play? How much did gender matter to you? Did your care meet your expectations?

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

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Tuesday, February 17, 2009

Private Practice: "Acceptance"

I don't watch much television - for the most part, I'd much rather read. Especially because it seems like so much on tv is crime drama, and watching shows that feature violence against women & children just doesn't feel like entertainment for me - more like fodder for anxiety & nightmares. So! There are a few things I watch, like American Idol... The Office... 24... And Private Practice: I like the characters, the drama, and school or medical dramas have always been my favorites (I still miss Boston Public and Everwood). Does anyone else watch it?

I'm wondering because the show two weeks ago, "Acceptance", just about made me do my crazy-shriek and wake up the kids when I watched it. We had it on tape, and I thought: now this, THIS *#$&($#, would be perfect to show in my classes when I talk about informed consent looks like - or doesn't look like. And I planned to blog about it. But then we taped over it. And I didn't want to blog it without a transcript because I started thinking, well, maybe it wasn't as bad as I thought.

Then I taught an early pregnancy class through our local continuing education department (if you're local, look for this class in the Monmouth/Winthrop continuing ed course offerings) and both of the families who attended had seen this show, and brought up the vacuum extractor. And that got me thinking again about how this show might seem to someone who was watching it as strictly entertainment, without the critical-thinking part of their brain on high alert. I know I don't watch most tv ready to jump up & down with the crazy-shriek of "how could they do that??" primed.

Then I thought of looking on the ABC page to see if they have free past episodes, and they do! So I could type out a transcript of this tiny scene, just to make sure it was as bad as I thought: it's four minutes into the episode, which can be viewed here.

The characters are:
Dell (the office manager/midwife-in-training),
Addison (neonatal surgeon/OB)
Laboring mom
Worried dad

The scene is in the Private Practice birthing room.
Dell & Addison are in scrubs.
Mom & Dad are in scrubs with hair coverings.
Mom is covered in blue drapes so she & Dad can’t see anything.
Mom is flat on her back, hooked up to fetal monitor.

4:00

Mom: “AAHHHGGGG!!”
Dad: “Why is it taking so long?”

Dell (hushed voice to Addison): “She’s still at +2”

Dad: “What does that mean?”

Addison: “It means that labor is not progressing and the baby has variable decels. We’re going to need to perform an assisted delivery to help guide the baby out. It’s VEEEERRRY safe. Dell would you prep the vacuum extractor please.”

Mom: “The vacuum WHAT?”

Dad: “It’s going to be fine honey.”

Dell (whispered aside to Addison: “I’ve never done one of these!”

Addison (aside to Dell): “It’s okay. I’ll guide you through it. ‘Kay. Place the cuff directly on the vertex. Good.”

Addison (to parents): “Now Maggie, when I tell you, I need you to push as hard as you can and while you push we will take the baby out. Okay?”

Mom gives a nod with scared look on her face.

Addison: “Okay.”

Addison: “Ready… and push!”

Mom: “AARRRRGGH!!!!”

Addison: “That’s great, Maggie. The baby’s crowning.”

Mom: “Take it out take it out take it out.”

Mom: “AAGH.”

Crying.

Dell: “It’s a girl. A baby girl.”

Addison: “Congratulations!”

Dell (aside to Addison): “Discoloration on her head?”

Addison (aside to Dell): “Hematoma. Happens sometimes with vacuum delivery.”

Dell (aside to Addison): “Her apgar is low.”

Addison (aside to Dell): “Dell. Don’t worry. It’s fine. You did great.”
Anybody else see huge red flags?

In case you want to read a summary of the whole show, here's a link to a Yahoo summary. Here are the most relevant parts of the summary, for my purposes:
Dell and Addison are continuing the delivery. The father wants to know what's taking so long, and Addison tells him the labor's not progressing (still at "plus-2") and that the baby has "variable D cells," [sic - decels, or declerations in fetal heart rate] so they are going to have to help guide the baby out through assisted delivery. She instructs Dell to get the vacuum extractor, a term that freaks the mom out -- as it would any sane woman. Dell has never used one of these, but Addison has him do it anyway. It basically looks like Dell is holding onto a hose and pulling it out of the woman, which I guess is what's happening, but the other end of the hose is attached to the baby's head. The baby's out before we know it, and Dell's freaking out about the shape of the baby's head. Um, seriously? Has he never seen a newborn baby, because I am no expert, but I have seen several of them with crazy head shapes. That's because heads are too big to fit through a hole that size [!!!!] so they get misshapen. Addison tells him it's normal to have a head like that with a vacuum delivery, but he's still worried. She tells him not to. He worries some more.

. . .

Dell comes in to Violet's office and sits next to her on the couch . . . He tells her he thinks he might be a pretty good midwife, and she says she thinks he is. It's a really sweet moment, and I'm glad Dell got it, even if his story seemed sort of insignificant otherwise.
I'll post more tonight or tomorrow. We're off to the children's museum to watch a presentation on "scales and tales" and then to a friend's house for some sledding.

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

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Friday, February 13, 2009

Birth Video/Documentary Contest!

Announcing a birth video/documentary contest! $1000 prize!
From Birth Matters Virginia : Birth Matters Virginia (an organization that works to promote an evidence-based model of maternity care) is soliciting 4-7 minute educational videos about birth. The first-place winner will receive a cash prize of $1000. Second place $500 and an "honorable mention" prize of $100 will also be awarded. The deadline for entering the contest is Mother's Day, May 10, 2009.

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

As the national rate of c-sections surpasses 30% and the U.S. ranks 41st in terms of maternal mortality, it is more important than ever for women and their partners to be educated about the options they have during pregnancy and birth. Birth Matters Virginia advocates "evidence-based" maternity care, which simply means using the best available research on the safety and effectiveness of specific practices to help guide maternity care decisions and to facilitate optimal outcomes in mothers and newborns.

There are a lot of ways to approach that topic, and we're looking forward to the variety of entries.

For rules and to see how to enter, please visit http://www.birthmattersva.org/videocontest.html

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

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

Even if you don't plan to make a video or submit an entry, please pass this email on to everyone you can think of, post it on your blog, your Facebook page, Twitter, whatever you can think of! The more people submit videos, the more will be out there on YouTube and we could use all the help we can get spreading the word.
If anyone wants to leave a link to their favorite online video(es), I'd love to see them! Or leave a link to the birth video you're submitting to this contest. I think it's so important to expand the vision of safe birth choices. Films can be a very powerful medium to use to show that birth choices include more than the "infotainment" found on TLC's birth dramas!!

An aside: the name of this group, Birth Matters Virginia, reminds me of the famous letter to the editor, "Yes, Virginia, there is a Santa Claus". In my head, I couldn't help but reading the organization's name as "Yes! Birth DOES matter, Virginia". Anyway, what a fantastic opportunity to spread the word!!

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

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Tuesday, February 10, 2009

Lady's Hands, Lion's Heart

Every once in a while I begin reading a book and think to myself, "Self: You are going to be really sad when this is done. Pace yourself. As much as you want to read & read & read it, savor it instead."

I knew after the first few pages of Lady's Hands, Lion's Heart: A Midwife's Saga that I would love it. And I did: the birth stories, of course, and also the inspiration of Carol Leonard's life... how hard she worked to make a difference, and how much she learned and loved along the way.

There are so many people to whom I would recommend this book, starting with my sister, since she is trying to figure out how to pursue her own dreams of entering midwifery. Also: Anyone who is interested in birth stories. Anyone who enjoys memoirs. Anyone interested in excellent writing that is hilarious, poignant, fascinating, thought-provoking. Anyone who is curious about the difference one person can make. Anyone who works with mothers and babies during the birth year. It's a fast, delicious read that really tests the reader's ability to slow down & savor it.

I will definitely be adding Lady's Hands, Lion's Heart to my childbirth education library the next time I made updates, and buying it for my sister. It's available to borrow through the Maine inter-library loan system (now that I've finally returned it ;-). To buy it, go online to Bad Beaver Publishing. Amazon.com also has it, and that's where I will probably be on the lookout for used copies.

Here's an excerpt from a review by Pamela Victor,
"Lady’s Hands, Lion’s Heart has it all. It’s part memoir, part American history, part textbook, part spiritual journey, part love story. Carol Leonard relays her life story as a midwife, a mother, a wife and a health care activist from 1975 (the year her son was born) to 1987 (the year of her deepest, darkest time.) The yarn that winds seamlessly thorough this book is the moment of birth. As a midwife who has delivered hundreds of babies, Carol Leonard tells the best birth stories! By their very nature, birth stories are the ultimate adventure tales, full of fraught emotion and drama that would make any Hollywood producer envious. Danger, romance, mystery, comedy and sometimes, sadly, tragedy – Leonard’s stories will keep you turning the pages with anticipation."
There's also a review from Citizens of Midwifery on the Bad Beaver Publishing website and all nine reviews on amazon.com were five stars. Also, don't miss the sample story on the order page - just click on any of the links to the book to read it!

Lady's Hands, Lion's Heart: A Midwife's Saga
by Carol Leonard
published by Bad Beaver Publishing in 2008.

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

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Friday, February 6, 2009

Prenatal Vitamin & Iron Supplements Recalled

Well, in case the link to Survey Data on Lead in Women and Children's Vitamins in my How to Choose a Prenatal Vitamin post wasn't disturbing enough...

I just read in a Raising Maine post by Gooddogz that some prenatal vitamins were just recalled by the FDA. But of course you knew that already, right?? Because of all the press coverage that information has already received. Not.

Here's the list:

Prescription Iron Supplement Products:

Chromagen® Caplet
Chromagen® FA Caplet
Chromagen® Forte Caplet
Encora® Capsule
Niferex® Gold Tablet
Niferex® 150 Forte Capsule
Repliva 21/7® Tablet

Prescription Prenatal Vitamin Products:

PreCare® Chewable Tablet
PreCare® Conceive Tablet
PreCare Premier® Tablet
PremesisRx® Tablet
PrimaCare® Capsule/Tablet
PrimaCare® Advantage™ Capsule/Tablet
PrimaCare® ONE Capsule

courtesy of this press release: Voluntary Nationwide Recall Of Prescription Prenatal and Iron Supplements .

And there's more!

Prescription Prenatal Vitamin Products:

Advanced NatalCare® Tablets
Advanced-RF NatalCare® Tablets
Cal-Nate™ Tablets
CareNatal™ DHA Tablets
ComBgen Tablets
ComBiRx™Tablets
NataCaps Capsules
NatalCare Gloss Tablets
NatalCare PIC Tablets
NatalCare PIC Forte Tablets
NatalCare Plus Tablets
NatalCare Rx Tablets
NatalCare Three Tablets
NataTab FA Tablets
NataTab RX Tablets
NutriNate® Chewable Tablets
NutriSpire™ Tablets
Prenatal MR 90 FE Tablets
Prenatal MTR w/Selinium Tablets
Prenatal Rx 1 Tablets
Prenatal Z, Advanced Formula Tablets
Ultra NatalCare Tablets

Prescription Iron Supplement Products:

Anemagen Caplets
Anemagen Forte Caplets
Conison™ Capsules
Fe-Tinic™ 150 Forte Capsules

from this press release: Voluntary Nationwide Recall Of Prescription Prenatal and Iron Supplements .

For more of my blog posts on vitamins and supplements, click on the nutrition tag below.

Feel free to pass this information on in whatever way makes sense to you!

Oh, and I'm writing this amid stacks of seed catalogs and lists of seeds. While I can't grow my own vitamins, it's recalls and information like this that makes me feel so lucky to be able to feed my family from my garden!

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

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Thursday, February 5, 2009

Postpartum Links: Listening and Healing

More postpartum posts to follow, once I'm post-whirlwind-trip-to-Boston and have caught up around here! Until then:

The Power of Listening

I love this quote in the recent Midwivery Today E-newsletter on communication, from Dr. Rachel Remen:
"The most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention.... A loving silence often has far more power to heal and to connect than the most well-intentioned words."
Obviously this relates to all times of our lives, but I think it is especially pertinant during labor and birth. Just listening to a mom talking about how much labor hurts is validating: she may not be asking someone to "fix" it - she just needs someone to hear her. There's a terrific segment on this excellent video, which I highly recommend (and keep in my lending library!): Gentle Birth Choices. And "We Ain't Broke, Don't Fix Us" is a great blog entry on this topic.

Listening during the postpartum period can also be incredibly valuable. I recently read about a study re: the power of listening for postpartum moms, on a RaisingMaine blog . For more information, read "Peer Phone Calls Prevent Postpartum Depression in at-Risk Mothers". The article explains that,
"Phone calls from volunteer mothers who overcame postpartum depression prevent depressive symptoms in at-risk mothers, a Canadian study shows.

"Mothers who received this support were at half the risk of depressive symptoms 12 weeks after delivery," says study leader Cindy-Lee Dennis, PhD, Canada research chair in perinatal community health at the University of Toronto.

It's the first big study to show that postpartum depression can be prevented without intensive home care, Dennis says.

The study included 701 women at risk of postpartum depression. Half got standard postnatal care and half got peer support. With standard care, 25% of the mothers had significant depressive symptoms 12 weeks after delivery. About half as many women who got peer support -- 14% -- had such symptoms."
Another place to listen and be listened to, and that offers peer support, is the New Mothers Support Circle I'm hosting here in Winthrop, on 2nd and 4th Thursdays - this month we're getting together on February 12th and February 27th.

Perineal Healing

Another Midwifery Today E-newsletter that fits with entry focuses on Postpartum Perineal Healing, with some great tips from Elizabeth Davis:
"Physicians commonly have women return for a checkup at six weeks postpartum to assess the healing of the perineum and to make recommendations for contraception, as appropriate. But most women are told little or nothing about how to care for the perineum in the interim, or how to watch for warning signals of infection like swelling or inflammation. Pain is an important signal of problems too, but it may go unnoticed if a woman is taking painkillers during the first few days, the most critical time for healing.

I suggest that women use ice packs for 24 hours to reduce swelling, and then switch to sitz baths several times daily using hot water with selected herbs. Nothing speeds healing faster than heat, and soaking is far superior to topical application as it more deeply stimulates circulation. Fresh ginger is a good addition to the solution; it helps relieve the itching that often occurs as stitches dissolve and the skin heals.

Here is how I recommend women take a sitz bath: Grate a 3- to 4-inch piece of ginger root into a large pot of water; simmer twenty minutes; strain and divide into two portions. Save one for later in the day, and dilute the first with water in a sitz bath. After soaking for twenty minutes, thoroughly dry the perineum and expose to air or sunlight for another 10 minutes before putting on a fresh pad (or use a hair dryer to speed the process). If the perineum feels at all sticky, use aloe vera gel to dry and soothe the tissues. Avoid vitamin E or other oil-based ointments until the skin is healed over, as these tend to keep edges from closing."
The Mother-Hero

For dessert, read this thought-provoking article from Birthing From Within's Pam England, "Mother-Hero on the Hudson".

We are strong! Listen, and be listened to.

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

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Sunday, February 1, 2009

Postpartum Life: True or False?

In honor of the new postpartum support group I'm facilitating, the New Mother's Support Circle, I'm going to be doing a series of posts on postpartum life.

Here's how the media portrays postpartum life: glowing new mom (who is also clean, thin, wearing clean clothes, relaxed, and looking not-exhausted) holding peacefully sleeping (and also clean! wearing white!!) newborn.



I'm not saying that it's not a gorgeous picture - it is. And there may be some moments like that during the babymoon. But this picture, also beautiful, is a whole lot more realistic:



What's the harm in fantasizing about exhibit A? I love this quote from Jennifer Louden's Pregnant Woman's Comfort Book, and think it sums up a lot about why the postpartum period can be a hard one for many women:
"It is the lack of permission to feel conflicted, inadequate, sad, angry, bored, or irritable as well as grateful, rapturous, tingling with life, and intoxicated with love that makes the postpartum period unnecessarily difficult and lonely".
So for what it's worth: here's permission - and encouragement! - to come share what's wonderful as well as what's really hard with other new moms this Thursday!

And if you can't join us in person, leave a comment! What's been one of the most beautiful moments during your babymoon period? What's been one of the most challenging?

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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Sunday, January 11, 2009

Cesarean Births: Too Early?

A USA Today article, "Elective C-sections performed too early 36% of the time", reporting on a recent study published in the New England Journal of Medicine, begins with this startling information:
"More than a third of elective C-sections are performed too early, increasing newborns' risk of respiratory distress and other problems, researchers report today."
Full-term is now defined as 37-41 weeks (used to be full-term was considered 38-42 weeks), and although the American College of Obstetricians and Gynecologists (ACOG) recommend that elective cesareans are performed no earlier than 39 weeks gestation, the study results found that 36% of the time, ceseareans are performed before 39 weeks.

Highlights from the article include this statement about the difference between baby-initiated labor and induced labor/cesarean birth:
"At 37 weeks, babies are considered fullterm, but there's a difference between those delivered vaginally and by elective C-section, says coauthor John Thorp, professor of obstetrics and gynecology at the University of North Carolina, Chapel Hill. "We would not worry about a 37 1/2-week baby born vaginally with the onset of labor," Thorp says. In that case, 'there is some signal from a baby to his mother that says, "I'm ready …"'".
People mature - physically and emotionally - at very different rates. Think of the range for puberty... some girls start menstruating at age nine, and others at fourteen. Both situations are within the normal range, and indicate that particular body's readiness for puberty. I was one of the fourteen year olds; my body was no where near puberty or womanhood at age nine. Of course, we can't induce menstruation on young girls - who would want to?

But ask a woman when she's nine months pregnant if, uninformed of any risks, she might want to birth her baby a few weeks early. She just might be inclined to jump at the chance to meet her baby and end the last, frequently uncomfortable, stage of pregnancy.

What are the risks? Well, the USA Today article explains that
"Overall, about 10% of the babies at birth had at least one of these problems: respiratory distress, low blood sugar, infection or need for a respirator or intensive care. Those born at 37 weeks were twice as likely and those born at 38 weeks 50% more likely to have a problem than those at 39."
Are most women informed about these risks when their cesarean birth is scheduled? I doubt it.

Also, note that this article discusses "elective" cesarean births. Just to clarify, so this post does not add to the myth that many women are choosing elective cesarean births, the vast, vast majority of "elective" cesarean births are not a mother's first choice. In the Listening to Mothers II study, only one mother in 1500 indicated that a cesarean was her personal birth choice while many others (25%) indicated that they felt pressure from their care providers to "choose" a cesarean. Read Childbirth Connections interesting article, "Why the National U.S. C-Section Rate is Rising" for more information.

What's the best way to minimize the risk of performing a cesarean birth too early? If possible, don't schedule it! Wait until labor begins, and then go to the hospital for the cesarean birth. In many "elective" cesarean births, this method should be without additional risks: for a twin birth, or a breech birth, or birth after a previous cesarean (though for all of these situations, a trained care provider can frequently have just as safe or safer outcomes with a vaginal birth). There are, of course, other situations when this "contractions before cesarean" method would not be safe, for example, if the placenta covers part or all of the cervix (placenta previa).

Does waiting until labor sound inconveniant? There could certainly be inconveniances with this strategy, of waiting for labor to begin and then going in for surgery: the inconveniance of waiting; the inconveniance of not knowing when labor will start; the possible discomfort/inconveniance of going into labor; inconveniance for the doctor's schedule. But balance those inconveniances with the increased risk of a NICU stay... short- or long-term medical problems... the emotional roller coaster... the larger possibility of immediate and prolonged separation.

Add future safety to the list too: ICAN reports that women who went into labor on their own before a Cesarean birth were less likely have a uterine rupture during a subsequent VBAC. The study, published in Obstetrics and Gynecology found that
"Women with a history of either spontaneous labor or vaginal birth had one rupture for every 460 deliveries, compared with one rupture in 95 among women without this history who also required induction for their trial of labor."
For more information about the risks of Cesarean births versus the risks of vaginal births, as well as several links on this topic, visit one of my earlier posts: "In the News: Where is Birth Going & Who is Taking it There?" Additional, very complete and scholarly information is available on ICAN's webpage "Fighting the VBAC-Lash: Critiquing Current Research".

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Friday, December 12, 2008

Ignorance Meets Knowledge: Extended Breastfeeding

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Wednesday, November 12, 2008

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

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Friday, November 7, 2008

Three Great Movies

Homebirth/Waterbirth of Judah Darwin

Just beautiful!



Seen on Woman to Woman Childbirth Education, accompanied by a thoughtful post on What Does Natural Birth Sound Like?


Women Talk about Natural Birth

From the Real Women, Real Birth, Real Options blog:




Painless Childbirth Trailer

Trailer introducing Painless Childbirth by Giuditta Tornetta



I don't agree with everything in this trailer - I personally don't agree with implicitly or explicitly promising a woman a painless childbirth - but it's a beautiful trailer and offers a very interesting perspective. I'm excited to read the book.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Friday, September 26, 2008

Nursing Is Normal Media Project

This slide show of nursing mothers is beautiful - brought tears to my eyes. Babies and young children nursing in a variety of settings - some on Mama's lap, others in baby carriers; mothers of various sizes and ages, too.

The slideshow, by Kathy O'Brien, is currently being presented on the Mothering website, which introduces it this way:
"The NIN Project is a photographic display of nursing moms in public settings. We believe the more often something is seen, the more accepted it becomes. These mothers have posed in various public settings to help other mothers feel comfortable nursing in public. Nursing is normal."
NIN Slide Show

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Saturday, September 13, 2008

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

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