Sunday, February 21, 2010

Give Aways!

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

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

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

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Wednesday, February 3, 2010

Make Your Own Baby Sling

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

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

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

Happy Sewing!

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

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Sunday, January 24, 2010

Wow! Links.

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

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

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

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

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

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

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

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Friday, September 18, 2009

Circumcision Information

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

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

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

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

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Sunday, March 15, 2009

Essentials?

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

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

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

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

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

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Tuesday, March 3, 2009

Preserving Memories

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

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

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

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

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

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

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

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

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Monday, February 16, 2009

Safer Bottle Feeding

I've already written about safety & children's products in several times, with lots of links in my Pregnancy Awareness Month: Week Three - Nutrition & Green Living and Toxins in Children's Toys and Products posts.

The third Z Report on BPA was available last September, and full of very useful information re: BPA (bisphenol A) in children's feeding products, especially bottles & sippy cups. I hadn't noticed their wallet-sized card before - it lists BPA-free bottles, sippys, pacifiers, and tableware. What a fantastic resource!

So I'm revisiting this because I just read an email with a link to this website, EWG's Guide to Infant Formula and Baby Bottles: Guide to Baby-Safe Bottles & Formula, which discusses how to make bottle-feeding as safe as possible. There's a one-page poster pdf and an executive summary that explains the findings regarding BPA in formula packaging. Explore the site for additional information, BPA in Formula -- How Harmful? as well as ways to Take Action!

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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Thursday, February 12, 2009

It's a Boy!

I have two children - a girl and a boy. My daughter was born first, and I was so excited to have a little girl: dresses, braids, someone who might notice new earrings. It's not that I didn't want to have a little boy, too... it's just that I was hoping, in my heart of hearts, to have a little girl first.

There was another reason, too: circumcision. I read & thought and thought & read about pregnancy and birth... and then I discussed, discussed, discussed choices I had for birth with my partner, my care provider, my family & friends. I didn't know what I thought about circumcision, beyond the gut feeling that I didn't want to do anything that would hurt my newly born child. My husband didn't know what to think either, other than he had been circumcised, so it seemed to him that it would be an okay choice to make for our son. But! Since Madelyn is a girl, we didn't have to hash it out, and I could focus on learning about birth and breastfeeding. Thus, in addition to my joy of having my little girl, I was also relieved.

Well, when I got pregnant again, it was with my son Owen. I already had learned a lot about birth and postpartum, and was ready to tackle investigating circumcision and the process of explaining my uneasiness to my husband. I had always said - hey, I don't have a penis, this is a decision I'll defer to him on. But when it came down to the fact that he favored circumcision, I realized I couldn't just go with the flow on this one after all (hardly surprising - me not going with the flow!).

So I asked him - please look at some of the research I've done, and then make an educated, informed decision, like we've tried to do all along regarding medical care and parenting choices. Reluctantly, he agreed. I did some research, shared it with him, and did the best I could to give him the space to make his decision.

I wish that I could have shared this excellent website, It's a Boy, with him then - it's factual, non-confrontational, not full of upsetting pictures or biased propaganda one way or the other, and answers the most common questions about circumcision.

Another good resource is this video, The Prepuce, on the Doctors Opposing Circumcision website. It is a clinical take on this issue instead of an emotional one.

I've listened to a lot of clients confront this issue - some couples have been in agreement, others not; some have decided to keep their sons intact and others have decided to circumcise. In fact, one of the dads in a class I taught about a year ago, blogged about the decision process: Circumcision Decision to Circumcision - The Decision to Circumcision - The Final Post - be sure to read the comments, too! So, I try to answer questions and point families to unbiased, understandable information, and then I let it go.

I'm so happy to have this new website to add to my list of resources!

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

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Wednesday, January 21, 2009

Lecithin, Plugged Ducts & Mastitis

I had not heard of lecithin until today, in the Midwifery Today e-newsletter, where they featured this information about it:
Lecithin is present in many of the foods we eat, but it is most concentrated in foods that are high in cholesterol and fats. Organ meats, red meats and eggs are the most concentrated sources of dietary lecithin. With the current trend of reducing cardiovascular disease and improving overall health quality, many breastfeeding women lean toward low-calorie, low-cholesterol diets. People are limiting their consumption of organ meats and eggs, thus limiting their intake of lecithin (USDA 1979 and 1992). This reduction most likely results in an inadequate dietary intake of lecithin.

The diet of the average American today also has less lecithin than that of the previous generation because purified and refined foods comprise the bulk of their diet. With the current demand for highly processed foods, refined sugars and hydrogenated fats, consumption of lecithin is further decreased, possibly even to the point where consumption of foods containing lecithin is at suboptimal levels for health.

The average pregnant and breastfeeding woman eating the Standard American Diet (SAD), which is high in saturated fats, is not able to naturally produce enough lecithin to assist with the emulsification of fats in her blood stream and carry out milk duct cleanup.

Scientists tell us that the body, without dietary sources, is not able to synthesize an adequate supply of lecithin. Lecithin is produced in the liver, and small amounts are present in foods such as brewer's yeast, grains, legumes, fish and wheat germ. People who eat the SAD, elderly people, breastfeeding women, infants, children and those who would like to improve memory, strengthen nerve growth and decrease buildup of fatty deposits in liver, heart and brain would benefit from supplemental lecithin.

The best form of supplemental lecithin is the granular form. Avoiding liquid lecithin, usually found in gel capsules, is advisable. It is primarily designed for commercial use as an emulsifier in food, cosmetics, paints and so on. It is a bad-tasting, sticky material and consists of about 37% oil and only 60% phosphatides. This combination would add to the high dietary fat content that lecithin has to clean up in the body. Capsules are a high-calorie, low-potency supplement, but if a pregnant or breastfeeding woman cannot find granulated lecithin locally or has difficulty adapting to sprinkling granules on her food, taking lecithin in capsule form is far better than not taking it at all.


— Cheryl Renfree Scott
Excerpted from "Lecithin: It Isn't Just for Plugged Milk Ducts and Mastitis Anymore," Midwifery Today, Issue 76
I thought it was particularly interesting in relation to plugged ducts and mastitis. Kellymom also has a page about plugged ducts and lecithin, Lecithin treatment for recurrent plugged ducts.

Plugged ducts can be very uncomfortable and can lead to mastitis. Kellymom has some excellent general information on plugged ducts and mastitis: Plugged Ducts and Mastitis.

These are the recommendations I share with my clients on how to avoid plugged ducts & mastitis:

** Do not wear bras that are too tight.

** Do not wear underwire bras.

** Take care of yourself: get some rest, and eat nutritious food.

** Breastfeed frequently, making sure to empty both breasts over the course of several feeding sessions.

** Pay attention to how you sleep – avoid compressing breast tissue overnight.

** Make sure to feed baby from both breasts during the night, too. Sometimes it’s easier to favor one breast if baby is sleeping with you.

When I had mastitis (thankfully, only once) from a plugged duct, what helped me the most was hot showers and really hot compresses over the blockage and feeding my son from that side first, when he was hungriest. The trick that I didn’t hear about until later: point the baby’s chin toward the blockage (try different positions as necessary), as that tends to direct the most efficient pressure at the plugged duct.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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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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Monday, November 10, 2008

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

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Friday, October 17, 2008

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

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Sunday, October 12, 2008

NY Times Health Update Links

I receive the weekly Health Update e-newsletter from the New York Times. There have been several interesting articles lately:

Fan in Room Seems to Cut Infants' Cut Infants Risk of Crib Death (SIDS)
"Dr. Li said the use of fans should not replace other sleeping strategies for lowering SIDS, like removing soft bedding and putting babies on their back. He noted that the gains shown in the study were an average for the whole group, including for babies whose care did not meet the guidelines. Still, even if a baby had a safe sleeping environment, the risk of SIDS was lowered by about 16 percent for those who had a fan in the room, although the trend was not statistically significant.

“If parents wanted to do more to reduce the baby’s SIDS risk,” he said, “they can add a fan.”"


More links to safe sleeping information and SIDS prevention:

An interesting article on SIDS and bed-sharing and breastfeeding.

Dr. James McKenna offers a complete guide to bed-sharing on the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame website, including sections on guidelines, advantages, long-term effects

Safe Sleeping with Your Baby provides recent information on sleep-sharing from attachment parenting gurus, the Drs. Sears.

Safe Sleeping tips from Drs. Sears for all babies, those co-sleeping or sleeping in a crib.


Advances in Testing for Down Syndrome Rely on Mother's Blood
"For three decades, scientists have been trying to develop a noninvasive prenatal test for Down syndrome that would replace amniocentesis, which can cause miscarriages.

Now, scientists using powerful genetic techniques are closing in on that goal with tests that require only a blood sample from the pregnant woman."


Acetaminophen in Babies Tied to Asthma Risk
"The use of acetaminophen in the first year of life is associated with an increased risk for asthma, eczema and allergic runny nose later in childhood, a New Zealand study reports. Acetaminophen is sold in the United States under the brand name Tylenol and as an ingredient in many other pain relievers."

Ack!!!!!!!!! Not that I medicated my kids all the time, but they were both intense teethers - swollen bloody gums, lots of crying, at night especially... I guess a lot of that was after 12 months, but my daughter started teething at 4 months, so I know she got some.


And from last week: You're Sick. Now What? Knowledge is Power. Not all of this applies, certainly, because pregnancy and birth are not illnesses. An interesting perspective. Here's an excerpt:
"“I don’t think people have a choice — it’s mandatory,” said Dr. Marisa Weiss, a breast oncologist in Pennsylvania who founded the Web site breastcancer.org. “The time you have with your doctor is getting progressively shorter, yet there’s so much more to talk about. You have to prepare for this important meeting.”"


If you want to sign up for the free newsletter, go to the NYTimes Member Center and sign up, indicating which newsletters you want.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Saturday, October 11, 2008

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

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Friday, October 10, 2008

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

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Great Blog Posts

I've been reading some great blogs lately, and wanted to list the posts I've enjoyed/learned from the most. In no particular order:

The Profit of Pain Relief and All About Due Dates: Do Due Dates Mean Your Baby is Due? on Bellies and Babies

We Birth the Way We Live on Birth Change

Conscious Cesarean Birth on Making Birth Safe in the U.S.

This blog post includes a link to the full text of an amazing article, "The Natural Cesarean: A Woman-Centred Technique"
Abstract: Although much effort has gone into promoting early skin-to-skin contact and parental involvement at vaginal birth, caesarean birth remains entrenched in surgical and resuscitative rituals, which delay parental contact, impair maternal satisfaction and reduce breastfeeding. We describe a 'natural' approach that mimics the situation at vaginal birth by allowing (i) the parents to watch the birth of their child as active participants (ii) slow delivery with physiological autoresuscitation and (iii) the baby to be transferred directly onto the mother's chest for early skin-to-skin. Studies are required into methods of reforming caesarean section, the most common operation worldwide.

An FYI post on Breastfeeding and Codeine on the Motherwear blog

Where Have All the Flowers Gone on Real Women, Real Options, Real Birth discusses this article - "Doctor Won’t Make The Cut: Feeling Pressure from Hospital for More C-sections, She Leaves".

And from the same blog, Behind the Numbers: Surgical Birth in the USA.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Friday, October 3, 2008

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

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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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Wednesday, September 24, 2008

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

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Friday, September 19, 2008

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

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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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Tuesday, September 9, 2008

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

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Wednesday, September 3, 2008

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.

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Friday, August 22, 2008

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 provider, or are CNMs (certified nurse midwife) and CPMs (certified professional midwife) safe options too?

First, I want to share a quote by Harriette Hartigan (midwife/photographer) that is commonly heard in the birthing community, "Birth is as safe as life gets". I wonder what the context of this quote originally was... to me, it suggests several important ideas:
  • Birth is a part of life. This is easy to forget when, in our culture, birth is so removed from life - usually taking place in the hospital, with only the birthing mother, her partner and maybe a female friend or relative. Very, very few of the pregnant mamas who take my classes have ever seen a real birth - human or animal. Contrast that experience with the one pictured below, where you can see birth really is a part of life:



  • While birth is safe, there are no guarantees. And that, I think, is the hardest thing. We've all heard horror stories, and I feel no need to put additional details in people's heads. Thankfully, in our country, most births conclude with a healthy mother and healthy baby (not that there isn't room for improvement!). But there are times, so sadly, when despite careful attention to mother and baby, something goes wrong. Sometimes with a warning, sometimes not. Even sometimes when the mother has had excellent prenatal care, an uncomplicated pregnancy, and highly qualified, experienced birth attendants. As sad as that is - it's life. People die. The struggle is to avoid medicalizing the experience of so many motherbabies in the name of preventing one or two deaths. Because doing that - continuous fetal monitoring, or not laboring at all and giving birth via a cesarean at 39 weeks - actually carries many, many more risks for mothers and babies, as well as the health of their future children. The struggle is to avoid lawsuits where something bad happens despite excellent care. This tendency has had the unfortunate effect of justifying doctors who practice defensive medicine: monitoring continuously for the paper trail, and the many cesareans that happen "just in case", because doctors know they will be sued over the cesarean they didn't do, not the one they did.

  • Choices we make can make birth safer. I wear my seat belt, and buckle my kids into booster seats. We wear life jackets. We get consistent check-ups by experienced, well-trained care providers. We eat lots of fruits and vegetables and whole grains etc. & etc. & etc. My husband and I make choices for ourselves, and for our children, that - to the best of our knowledge - enhance and protect our healthy bodies. Women can make choices for their birth experience that enhance and protect their bodies and their babies.

    One last point - while I wear a seat belt, I do still drive a car. I know that accidents happen, but that doesn't change my decision to drive on a daily basis. While I try to minimize the chance that something catastrophic happens while we're in the car, I understand that driving safely, while I'm not too tired, in a safe vehicle that gets routine maintenance, doesn't completely protect me. There are things that happen where no blame can be assigned - they just happen.
  • I believe birth is very similar to driving a car. Safe most of the time, even when people don't make the best choices; safest, but not perfectly safe, when they do. So, back to the original questions: where, and with whom, is it safe to give birth?

    Book after book that I've read reassures that quality care in a well-prepared home or quality birth center is as safe if not safer than a hospital birth attended by a doctor. Here are some excerpts that I found particularly helpful:

    From the Sears' Birth Book on birth center births, "In 1989 the New England Journal of Medicine reported a study of nearly twelve thousand women admitted for labor and delivery to eight-four free-standing birth centers in the United States. The study concluded that birth centers offer a safe and acceptable alternative to hospital births for low-risk women. The cesarean-section rate for the women in the study was 4.4 percent, far below the national average. There were no maternal deaths, and the neonatal death rate was well below average" (Sears 42). To find a birth center near you (as well as lots of other great information), check out American Association of Birth Centers . For questions to ask and things to think about, visit Childbirth Connections "Tips and Tools for Choosing a Place of Birth" page.

    While discussing homebirth, the Sears' write: "In 1900 fewer than 5 percent of births took place in hospitals. This increased to 75 percent by 1936, and by 1970 approximately 99 percent of mothers delivered in hospitals. But is this progress? Illustrating the differing perceptions of home birthing are these two mothers discussing their birth choices: 'You are brave to have a home birth,' said a concerned mother. 'You are brave to have a hospital birth,' replied the other" (43). They go on to discuss the safety of home births this way, "both sides of statistics to support their view. The people in white coats boast that the chances of a mother dying in childbirth was much higher in 1935 than in 1980, and that this is the result of technology available only in the hospital. Home-birth supporters argue that there is no reason to believe that there is a cause-and-effect relationship between birth in the hospital and lower mortality rates. Today's women have better access to prenatal care and more is known about safe birthing. Antibiotics are available to treat infections, and most aspects of health are better now than they used to be. Hospitals actually have higher mortality rates than home births, in part because mothers with the highest risk of life-threatening medical problems deliver in hospitals. Statistics that show poor outcomes in home births are equally misleading since these studies lump all out-of-hospital births together, whether they're planned, properly attended home births or involve foolhardy couples with no prenatal care doing it on their own [or happen by accident, at home or en route, mom has the baby earlier than anticipated]" (46).

    The more recently published book, Having a Baby Naturally, comes to similar conclusions. O'Mara asks "Which birth environment is safest? Surprisingly, home births, birthing in birthing centers, and hospital births are equally safe. Recent studies show definitively that there is no improvement in outcome, for mother or baby, in hospital births as compared to those that happen at home or in a birthing center . . . in fact, there is an indication that outcome is actually slightly better in low-risk births out of the hospital" (34). She goes on to explain that "home births, and births in birthing centers, have enjoyed a recent renaissance in the United States. However, there is still a lingering societal question about the safety of such births, and most women continue to go to the maternity ward of the hospital where their caregiver practices. Choosing to do something different may take real courage, as friends and relatives may be particularly concerned about the safety of your choice" (35).

    There is a great website that offers answers to many of the "What if" questions friends and family might ask. It does have some loud music that accompanies it, but if it bothers you, just mute it.

    The Home Birth Reference Site has some terrific information too, on the safety of homebirth, as well as home birth stories, reasons why people homebirth, how to plan a homebirth, more answers to "what if?" questions and other useful information. The North Carolina Homebirth website provides additional information on why homebirth, how to plan and prepare, and more birth stories.

    A few additional links include:
  • Citizens for Midwifery document comparing WHO recommendations, CIMS suggestions, and the reality of birth in the US as of 2004.

  • An article by Pam England (Birthing From Within), "No Place Like Home".

  • Childbirth Connections offers excellent information about the different care provider options, as well as information on questions to ask yourself in making a choice, and questions to ask during the interview process.
  • Finally, I want to mention that 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).

    There is something many (but not all) of these other countries have in common: universal access to prenatal care, and more support and use of midwives and out-of-hospital births.

    Marsden Wagner's book Born in the USA offers some interesting critiques and comparisons of care in the US vs. care in other developed countries. He writes, "Whenever I discuss home birth with obstetricians in the United Sates, I need only ask, 'What about the Netherlands?' to see their faces fall. The Netherlands has a long tradition of planned home birth. As recently as thirty years ago, half of all births in the Netherlands were planned home births. The percentage fell to one-third in the 1980s, but the rate has been climbing for the last ten years and is now more than one-third - 36 percent. The Dutch do not have significantly more women and babies dying around the time of birth than other Western European countries, and they have lower mortality rates than the United States does" (144).

    Later he also discuss birth in Denmark: "Denmark also guarantees a choice of place of birth to all Danish families. Like every other highly industrialized country except the United States, Denmark also has a national health care system. In Denmark, midwives attend all low-risk births either in the hospital or in the family's home . . . The home birth rate varies within Denmark (it is around 10 percent of all births in some districts), and Denmark's mortality rates for birthing women and newborn babies are among the lowest in the world" (193).

    Wagner also explains that "In some areas of Western Europe and Scandinavia, a low-risk pregnant woman can choose a small group of midwives who share a practice. The woman will usually get to know all of the midwives during prenatal visits over the course of her pregnancy, and when she goes into labor, one of them will come to the home or hospital and assist for the entire time, even if the labor is thirty-six hours long. This allows the woman to receive one-on-one continuous care with a known midwife - so this scientifically proven ideal scenario is not pie in the sky, but quite feasible. All those countries in Western Europe and Scandinavia where midwives handle prenatal and birth care for low-risk women exclusively have lower mortality rates for birthing women and their babies than the United States does" (198).

    He goes on to use a few more examples - "a resurgence of birth houses in Japan began [after the Americans left post-World War II], and more and more midwives are leaving hospital practice to work as community midwives in birth houses. This Japanese experience confirms what we have seen in the United States, that in the end, attempts to eradicate midwifery are not successful. In every society, there will always be midwives working to maintain women's freedom to control their own reproductive lives, and there will always be women who will avail themselves of midwifery services" (199).

    And, "In New Zealand, the maternity system is similar to Scandinavia's, but a woman having a low-risk pregnancy can choose either a midwife or a family physician to provide her prenatal and birth care" (Wagner 199).

    Each of these countries have significantly better outcomes for babies: New Zealand (4.99/1000), Netherlands (4.81/1000), Denmark (4.40/1000), Japan (ranked third, at 2.80/1000), and Sweden (ranked second, at 2.75/1000).

    Another famous champion of birth, Barbara Katz-Rothman, explains that "Birth is not only about making babies. Birth is about making mothers - strong, competent, capable mothers who trust themselves and know their inner strength." Safety concerns should not limit women's options for where they give birth, and with whom. Women should be able to choose the options that feel safest to them - hospital or birth center or homebirth, obstetrician, family physician, or midwife. All care providers should encourage women to trust themselves, to participate in decision-making, and treat each birthing motherbaby as individuals. Your baby has only one birth experience; you will probably only have one or a few birth experiences - and each one is an amazing opportunity for growth and joy.

    There's a quote in Our Bodies, Ourselves For the New Century that I share with my clients: “When women go to caregivers for checkups, they should walk out from every visit feeling ten feet tall. Every site of care and style of care, no matter who gives it, ought not only give surveillance but should educate and empower, should enhance every woman’s feeling of ability to do what she’s doing well” (451). That sums it up beautifully for me, and I hope this blog entry helps you explore the options for care that surround you so that you enjoy education and empowerment on your journey to motherhood.

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine

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