tag:blogger.com,1999:blog-43863695369759429352024-02-06T20:11:53.815-08:00Birthkeeper Midwifery ServicesAffordable Midwifery Care in Southern UtahBirthkeeperMidwiferyhttp://www.blogger.com/profile/17905162180422319691noreply@blogger.comBlogger23125tag:blogger.com,1999:blog-4386369536975942935.post-49921853679608512352015-05-06T13:06:00.001-07:002015-05-06T13:44:57.965-07:00DRMC Unveils 'Simply Birth Suite' for Low Risk Mothers <div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVxuGqfSC1N37ghAP2eMaRsfinVEyVRlHMs8WEayppiQmsV6tJMMomqmxhE-iN_u84AGMtXuIIOHo_43cYNFHt7mguF2XoeBVlq1yOh2zj0Wz3ZJBOTxrt0H47E46meqhug6d9qsMM1Ks/s1600/Simply-Birth-Suite-1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVxuGqfSC1N37ghAP2eMaRsfinVEyVRlHMs8WEayppiQmsV6tJMMomqmxhE-iN_u84AGMtXuIIOHo_43cYNFHt7mguF2XoeBVlq1yOh2zj0Wz3ZJBOTxrt0H47E46meqhug6d9qsMM1Ks/s1600/Simply-Birth-Suite-1.jpg" height="240" width="320" /></a></div>
<br />
<br />
Last week Dixie Regional Medical Center unveiled it's new 'Simply Birth Suite' for "no to low risk women". Women in the community have been excited about this new option, but there seems to be several misconceptions that I'd like to make people aware of.<br />
<br />
First, the 'Simply Birth Suite", is a mere addition of two beautiful rooms inside of the hospital. Yes, they are stunning. Gone is the small, uncomfortable, adjustable bed and replaced with a queen sized bed. The rooms are large, and offer a beautiful tub in which you can labor. You may or may not notice the absence of the infant warmer, and may notice the addition of comfortable chairs and a more inviting atmosphere than the regular rooms.<br />
<br />
But what are the medical differences from the regular rooms, and the similarities to home birth? Not much, I'm afraid.<br />
<br />
You may decline to have an IV. You do not need to be continually monitored, beyond an initial 20 minute monitoring session when you are first admitted. You will be monitored via intermittent doppler. You may use different pushing positions, based on the discretion of your care provider. Baby will be with you, rather than taken to a warmer.<br />
<br />
But that's really where the differences end.<br />
<br />
You will need to submit an application. Your past and current medical history will be reviewed before you are either accepted or rejected. You are required to take a hypnobirthing class if you have not given birth without medication before. You are required to have dedicated support for your whole stay. You are still in the hospital, which has policies and procedures that must be followed if any (even minor) blip comes up. You will not be admitted to stay until you are at least 5cm (which is not a bad thing - just be aware). You will be unable to use one of the two rooms if they are full when you go into labor.<br />
<br />
You are still not allowed to birth in the water.<br />
<br />
Did I also mention that it's the same doctors and nurses who will be attending you? This seems to be the biggest confusion. Women have asked me if I will now be able to attend at the hospital. The answer is no. It is the same doctors and the same midwife (Katie Gubler - whom I have heard is fabulous!) who will be attending women, and the same nurses.<br />
<br />
Women planning a VBAC are not allowed to utilize the birth suite rooms, even though they are <i>inside</i> of the hospital. Statistically, there is a 0.3-0.7% risk of uterine rupture with a vaginal birth after one prior cesarean, and less than 2% for up to four prior cesareans. This is less than the risk of cord prolapse and the need for immediate cesarean in any other woman. But, women planning a VBAC are not allowed.<br />
<br />
I am awaiting news on how the actual delivery process goes. At DRMC, the routine protocol is lithotomy (on back/mostly reclined, knees pulled back) and directed pushing during each contraction while the nurse sweeps in and stretches the inside of the vaginal opening (which is unnecessary and often causes swelling). Does this still occur within the 'birthing suite' rooms? Is the newborn exam done on the bed with mom? Is mom allowed to really EAT while in labor, and not just ice or jello? I'm unsure. I will update if I ever learn the answers to these questions.<br />
<br />
While these are wonderful steps taken by DRMC to offer women an additional option, it is not "just like home birth" as claimed. Especially when those who attend you have very likely never attended a home birth before. I would be curious to know how many have even witnessed a truly (and purposeful) physiological birth without any interference during, or after. Obstetricians are trained surgeons who follow their own and the hospital's set of guidelines and protocols ... and we know from ACOG's own admission that only 1/3 of current obstetric protocol is based on empirical evidence.<br />
<br />
Ask in depth questions before making a decision about where to birth - whether hospital or home. Ask what kind of philosophy your potential care provider has regarding birth. Is it normal? Natural? An emergency waiting to happen? Do they facilitate physiologic birth? Do they encourage autonomy and choice for the birthing mother? Do they follow evidence-based protocols? Are they up-to-date with research?BirthkeeperMidwiferyhttp://www.blogger.com/profile/17905162180422319691noreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-11797147803749713132015-05-06T11:43:00.000-07:002015-05-06T13:33:07.745-07:00Vaginal Birth After Cesarean (VBAC) <span style="font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="font-family: inherit;">It hit me just how long it has been since I have kept up-to-date with posting in this blog. I do apologize! I am still in practice in Southern Utah, and my clients keep me busy! </span><br />
<span style="font-family: inherit;"><br />
We just wrapped up Cesarean Awareness Month last week. In case you don't follow me on Facebook, here are my posts to bring about awareness regarding both cesarean section and vaginal birth after cesarean: </span><br />
<span style="font-family: inherit;"><br />
</span><br />
<blockquote class="tr_bq">
<span style="background-color: white; color: #141823; font-family: inherit; line-height: 19.3199996948242px;">Did you know that approximately 1 in every 3 women in America who walk into the hospital to give birth, walk out healing from major abdominal surgery?</span></blockquote>
<span style="font-family: inherit;"><span style="background-color: white; color: #141823; line-height: 19.3199996948242px;"><br /></span>
<span style="background-color: white; color: #141823; line-height: 19.3199996948242px;"><br /></span>
</span><br />
<blockquote class="tr_bq" style="background-color: white; color: #141823; line-height: 19.3199996948242px; margin-bottom: 6px;">
<span style="font-family: inherit;">Did you know that a cesarean for "big baby" is actually not a valid medical reason, and is advised against by the American College of Obstetrics and Gynecology, based on empirical research?<br />Did you know that according to research, most complications during labor that lead to a cesarean are iatrogenic (physician or procedure caused)? This includes cord prolapse, cesarean for nuchal cord (cord around the neck), fetal distress, hemorrhage, and more<span style="color: #141823;"><span style="line-height: 19.3199996948242px;"><br /></span></span></span></blockquote>
<span style="background-color: white; color: #141823; font-family: inherit; line-height: 19.3199996948242px;">.</span><br />
<div>
<div>
<span style="color: #141823;"><span style="font-family: inherit; line-height: 19.3199996948242px;"><br /></span></span></div>
<div>
<blockquote class="tr_bq" style="background-color: white; color: #141823; line-height: 19.3199996948242px; margin-bottom: 6px;">
<span style="font-family: inherit;">Did you know that not only is Vaginal Birth After Cesarean (VBAC) possible, but that it's statistically low risk? The main concern with a VBAC is uterine rupture, which has a likelihood of 0.3-0.7%. This means that you are 99.3-99.7% likely to NOT rupture.<br />Being in a birth setting which is conducive to complete support and facilitation of VBAC is the most important aspect, beyond researching the ins and outs of it all. Unfortunately, many care providers and hospitals have policies and procedures which reduce your likelihood of a successful VBAC. Not because it can't be done, but because of the "rules" that often come with VBAC. Sadly, many care providers are not up to date with research in this area, and have restrictive rules surrounding VBAC labor.</span></blockquote>
</div>
<div>
<div style="background-color: white; color: #141823; display: inline; line-height: 19.3199996948242px; margin-top: 6px;">
<span style="font-family: inherit;"><br /></span></div>
</div>
<div>
<span style="color: #141823;"><span style="font-family: inherit; line-height: 19.3199996948242px;"><br /></span></span></div>
<div>
<div class="_5pbx userContent" data-ft="{"tn":"K"}" style="line-height: 1.38; overflow: hidden;">
<blockquote class="tr_bq" style="margin-bottom: 6px;">
<span style="font-family: inherit;">Did you know that a VBAC after more than one cesarean is not only possible, but still considered relatively low risk? I have attended women who have had 2 cesareans, and have a current client who has had 3.<br />The largest research conducted on vaginal birth after multiple cesareans showed a uterine rupture rate of between 1-1.7%. The American College of Obstetrics and Gynecology position statement on VBAMC say that women who have had 2 cesareans with low-transverse incisions should not be discouraged from planning a vaginal birth.</span></blockquote>
</div>
<div class="_5pbx userContent" data-ft="{"tn":"K"}" style="line-height: 1.38; overflow: hidden;">
<div style="display: inline; margin-top: 6px;">
<span style="font-family: inherit;"><br /></span></div>
</div>
<div>
</div>
<span style="font-family: inherit;"><span style="background-color: white; color: #141823; line-height: 19.3199996948242px;"><br /></span>
</span><br />
<blockquote class="tr_bq" style="margin-bottom: 6px;">
<span style="font-family: inherit;">Did you know that your chances for a successful VBAC lie with the rules your care provider might have for VBAC labor/birth, rather than your inherent ability to give birth vaginally?<br />Restrictive (and non-evidence based) rules such as scoring "well" on a trial of labor success scoresheet (where they take into consideration your age, weight, reason for previous cesarean, whether you've had a vaginal birth, etc), going into labor prior to 40 weeks, needing to dilate at the rate<span class="text_exposed_show" style="display: inline;">of approximately 1cm per hour, consistent monitoring, epidural (some require this), and the type of closure you had during your last cesarean.</span>The American College of Obstetrics and Gynecology does not limit their recommendations for encouraging VBAC in women with 1-2 prior cesareans to these things, yet Obstetricians and Midwives (even home birth midwives!) restrict to these things. Make sure you know your care provider's beliefs about VBAC, and what rules they may have in labor and birth. How do they feel about VBAC? Are they hesitant, worried, even afraid? Do they know what the research says about VBAC risk and benefit? Find someone who knows these things thoroughly, and who is experienced and comfortable with VBAC.</span></blockquote>
<div class="text_exposed_show" style="background-color: white; color: #141823; display: inline; line-height: 19.3199996948242px;">
<span style="font-family: inherit;"><br />
<div style="margin-bottom: 6px;">
<br /></div>
<blockquote class="tr_bq" style="line-height: 19.3199996948242px; margin-bottom: 6px;">
Did you know that not being dilated or effaced by your due date is NOT an indication that you are not likely to have a successful VBAC? Though this is often said as a stipulation to "allow" (gotta stop allowing people to "allow" you in birth, ladies!) you to have a trial of labor, it is not evidence based. Dilation only tells you what your cervix is doing at that moment. That's it. Normal gestation length (38-42 weeks) applies to VBAC moms as well, and some may need longer.<br />
Waiting does not increase your risk of rupture.</blockquote>
</span></div>
<span style="background-color: white; color: #141823; font-family: helvetica, arial, 'lucida grande', sans-serif; font-size: 14px; line-height: 19.3199996948242px;"><br /></span>
<span style="background-color: white; color: #141823; font-family: helvetica, arial, 'lucida grande', sans-serif; font-size: 14px; line-height: 19.3199996948242px;">Christine Fiscer is a Traditional Midwife in Southern Utah who has been entrenched in VBAC research for over ten years. She has been attending VBAC and VBAmC (vaginal birth after multiple cesareans) at home for eight years. </span></div>
</div>
BirthkeeperMidwiferyhttp://www.blogger.com/profile/17905162180422319691noreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-8195683069360934982012-12-15T10:11:00.000-08:002012-12-15T10:11:00.644-08:00Midwife Arrested in CA After 22 Years of Faithful ServiceBy now some of you may have already seen the story of Brenda Capps, a Traditional and Christian Domiciliary Midwife who was arrested in CA last month. She has served families there for 22 years, and has a better safety record than just about any physician that I have ever known of (even when you break it down to only low-risk women!). She was not arrested because a mom or baby died. She was not arrested because a family reported her. She was arrested after being named in another case, even though she had nothing to do with said case.<br /><br />There are many who are shaking their heads, saying that she knew better and should have just been licensed. Many more disagree with this sentiment. You see, Brenda has served the women in California that other, Licensed Midwives, would not and/or could not. She has served the women who have found themselves carrying twins or a breech baby that would not turn. She has served the women who have had multiple cesareans.<br /><br />She served me. She was my Midwife, seven years ago. After every other single Midwife had turned me down due to multiple factors, she believed in my body's ability, and wasn't bound by state regulations that were put together by Physicians. Without Brenda, I would have ended up in the operating room again. She believed in me and supported me through the birth of my posterior, 10lb 10oz baby girl. My triumphant HBAC.<br /><br />There is a desperate need for Midwives who serve families, and not the state. We need more, not less of women like Brenda.<br /><br />Technically, Brenda didn't even do anything wrong according to the law. According to the Licensed Midwife Practice Act of 1993 (CA), it is only unlawful to represent oneself as a Licensed Midwife when one is not. Brenda NEVER did this. Each and every one of the families she served knew with full disclosure, from Brenda, that she was not licensed. Each family signed her religious exemption clause. Families chose Brenda BECAUSE of her status, not in spite of it.<br /><br />Even if you don't fully agree with what Brenda has done over 22 years, can't you agree that the rights of women to choose their birth attendants (even if that means no one at all!) are at stake here? If you do, please sign a petition that was put together on behalf of Brenda, and women's rights. We are hoping to see the petition hit over 2,000 signatures. We want the medical board to know that women and men are SPEAKING UP about their choices being limited to what the Medical Board thinks is appropriate.<br /><br />Please sign it. Share it. This is such a vital issue.<br /><br />
<div style="text-align: center;">
<span style="font-size: large;"><a href="http://www.change.org/petitions/california-medical-board-drop-the-case-against-brenda-capps-a-traditional-midwife-4">Petition to the Medical Board</a></span></div>
BirthkeeperMidwiferyhttp://www.blogger.com/profile/17905162180422319691noreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-24347698252443893462012-04-18T10:52:00.000-07:002012-04-18T10:52:20.228-07:00Cesarean Awareness MonthI am so late with this, but I am hoping to keep in mind that late is better than never, right?<br />
<br />
April is Cesarean Awareness Month. Did you know that? Have you come up with any ways to help spread awareness? If so, please list them! I'd love more ideas for next year. This year I got caught up with clients, school, and exams to do the legwork ahead of time. I am hoping to still put together a VBAC Q&A community event, but I am waiting to hear back from contacts about location. I'll keep you all updated!<br />
<br />
No onto some of the things that I have posted on Facebook so far. I was thinking of doing them individually, but I decided to just list them all in this one post in case I don't get back here before April is over. ;)<br />
<br />
________________________________________________________________________<br />
<br />
<span style="background-color: #eeeeee;"><span style="color: #333333; font-size: 13px; line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i>Did you know that our current national Cesarean Rate is 32.9%? That means that roughly 1 out of every 3 women who walk into a hospital to give birth, walk out recovering from major abdominal surgery. The World Health Organization, the Coalition for Improving Maternity Services, and other health organizations recommend a safe cesarean rate NO HIGHER than 10-15%, which means that approximately 1/2 - 2/3 of the cesareans done are unnecessary or were avoidable.</i></span></span> </span><br />
<span style="background-color: #eeeeee; color: #333333; font-size: 13px; line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><br />
</i></span></span><br />
<span style="background-color: #eeeeee; color: #333333; font-size: 13px; line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><a href="http://www.nytimes.com/2010/03/24/health/24birth.html">Concerns Over Rising Cesarean Rates</a></i></span></span><br />
<br />
<div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-family: Georgia, 'Times New Roman', serif; font-size: x-small;"><br />
</span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-family: Georgia, 'Times New Roman', serif; font-size: x-small;">________________________________________________________________________</span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-family: Georgia, 'Times New Roman', serif; font-size: x-small;"><br />
</span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span style="color: #333333; font-size: 13px;">Cesarean Awareness Month Fact: </span><br style="color: #333333; font-size: 13px;" /><br style="color: #333333; font-size: 13px;" /><span style="color: #333333; font-size: 13px;">Did you know that your OB is NOT supposed to recommend induction of labor for a baby who "seems to be large" at term? This is not only NOT evidence based, but it also leads to higher rates of cesarean section. Baby's weight plateaus at term, with adding only ounces per week. Half a pound or so is *not* going to make a difference between a birthable baby, and a baby who is "too big" for your pelvis. Fat squishes, and baby's skeletal size does not increase at term.</span><br style="color: #333333; font-size: 13px;" /><br style="color: #333333; font-size: 13px;" /><span style="color: #333333; font-size: 13px;">From ACOG: "Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes." </span></i></span> </span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span style="background-color: #eeeeee; color: #333333; font-size: 13px;"><br />
</span></i></span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span style="background-color: #eeeeee; color: #333333; font-size: 13px;"><a href="http://www.aafp.org/afp/2001/0701/p169.html">ACOG's Recommendation for Suspected Macrosomia</a></span></i></span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i style="background-color: #eeeeee;"><br />
</i></span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i style="background-color: #eeeeee;">_______________________________________________________</i></span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i style="background-color: #eeeeee;"><br />
</i></span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee;"><span style="color: #333333; font-size: 13px;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i>Did you know that in 2006 it was found that a cesarean delivery comes with a 3x higher risk of newborn death, than a vaginal delivery? The rates were found: .62 per 1000 deaths among vaginal births versus 1.77 per 1000 infant deaths among cesarean babies.</i></span></span></span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-size: 13px;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><br />
</i></span></span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-size: 13px;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><a href="http://voices.yahoo.com/cdc-says-cesarean-triples-neonatal-death-risk-3877056.html?cat=25">Cesarean Triples Neonatal Death Risk</a></i></span></span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-size: 13px;"><span style="font-family: Georgia, 'Times New Roman', serif;"><br />
</span></span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-size: 13px;"><span style="font-family: Georgia, 'Times New Roman', serif;">________________________________________________________________________</span></span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-size: 13px;"><span style="font-family: Georgia, 'Times New Roman', serif;"><br />
</span></span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee;"><span style="color: #333333; font-family: Georgia, 'Times New Roman', serif; font-size: x-small;"><i>Did you know that a VBAC is possible, even after THREE Cesareans? </i></span> </span></div><div class="separator" style="clear: both; text-align: center;"><span style="background-color: #eeeeee;"><br />
</span></div><div class="separator" style="clear: both; text-align: center;"><span style="background-color: #eeeeee;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/X1uEJdKvGM8?feature=player_embedded' frameborder='0'></iframe></span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-family: Georgia, 'Times New Roman', serif; font-size: x-small;"><br />
________________________________________________________________________</span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee; color: #333333; font-family: Georgia, 'Times New Roman', serif; font-size: x-small;"><br />
</span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span style="color: #333333; font-size: 13px;">Did you know that the majority of women who were diagnosed with CPD (Pelvis too small for baby) had other things going on, and that true CPD is extremely rare and occurs mainly when you've had a pelvic injury, or have had rickets?</span><br style="color: #333333; font-size: 13px;" /><br style="color: #333333; font-size: 13px;" /><span style="color: #333333; font-size: 13px;">Inductio</span><span class="text_exposed_show" style="color: #333333; display: inline; font-size: 13px;">n of labor, malpositioned baby, epidural, forced pushing, and pushing on your back (which decreases pelvic size by up to 20%) all increase the risk of "baby not fitting" - or baby not being allowed to come as he would without these interventions. Almost never does a woman *actually* have a pelvis that is too small to birth her babies ... and many moms with a label of "CPD" have gone on to not only give birth vaginally, but a good number of them have given birth to *larger* babies. ;) </span></i></span> </span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span class="text_exposed_show" style="background-color: #eeeeee; color: #333333; display: inline; font-size: 13px;"><br />
</span></i></span></div><div class="separator" style="clear: both; text-align: center;"><span style="background-color: #eeeeee;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/roFVkDV45MM?feature=player_embedded' frameborder='0'></iframe></span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span class="text_exposed_show" style="background-color: #eeeeee; color: #333333; display: inline; font-size: 13px;"><br />
</span></i></span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span class="text_exposed_show" style="background-color: #eeeeee; color: #333333; display: inline; font-size: 13px;">________________________________________________________________________</span></i></span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span class="text_exposed_show" style="background-color: #eeeeee; color: #333333; display: inline; font-size: 13px;"><br />
</span></i></span></div><div style="line-height: 18px; text-align: left;"><span style="background-color: #eeeeee;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span style="color: #333333; font-size: 13px;">Did you know that being overweight puts you at higher risk for a cesarean? But it isn't for the reason you think. Many health care providers (of all kinds - not just OBs!) hold the belief that an overweight women cannot be healthy. Overweig</span><span class="text_exposed_show" style="color: #333333; display: inline; font-size: 13px;">ht women are often labeled with "Gestational Diabetes", even if their numbers are fine, and one higher blood pressure reading at term can have talk of induction begin. Women have been told that their vagina was "too fat" to give birth, that their baby would be huge because they were huge, or that they simply would not be able to push their baby out due to their size.<br />
<br />
Having a cesarean if you are obese increases your risks dramatically. Obese women are at much higher risks of infection, issues with anesthesia, and blood clots. Taking steps to avoid one is key. </span></i></span> </span></div><div style="line-height: 18px; text-align: left;"><span style="font-family: Georgia, 'Times New Roman', serif;"><i><span class="text_exposed_show" style="background-color: #eeeeee; color: #333333; display: inline; font-size: 13px;"><br />
</span></i></span></div><div style="line-height: 18px; text-align: left;"><h2 style="color: #666666; font-size: 16px; line-height: normal; margin-bottom: 0px; text-align: -webkit-auto;"><span style="font-family: Georgia, 'Times New Roman', serif; font-weight: normal;"><a href="http://www.ourbodiesourselves.org/book/companion.asp?id=21&compID=125" style="background-color: #eeeeee;">Women of Size and Cesarean Sections: Tips for Avoiding Unnecessary Surgery</a></span></h2></div>BirthkeeperMidwiferyhttp://www.blogger.com/profile/17905162180422319691noreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-10891488431046873852012-01-11T16:32:00.000-08:002012-01-11T16:33:05.002-08:00FREE Waterbirth Information Night - Cedar City<div style="text-align: center;"><span style="color: #999999; font-size: large;">Back by popular demand: </span></div><br />
<div style="text-align: center;"><span style="color: #3d85c6; font-family: Georgia, 'Times New Roman', serif; font-size: x-large;">FREE Waterbirth Information Night! </span></div><div style="text-align: center;"><span style="color: #ea9999; font-size: large;">Saturday, February 25th at 6:00pm</span></div><div style="text-align: center;"><span style="font-size: large;"><a href="http://www.braunbooks.com/">Braun Books</a> - 25 N. Main St. Cedar City, Utah </span></div><div style="text-align: center;"><span style="font-size: large;"><br />
</span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_6bHn_zVrK4QE5Va5aoK65L3qZU7cbyhWErfdOpC8g79XWcqRd9Jxf01SeTfdIhujLNv50eaPePN5ccyKLvYo7jC2z9GwKS__I42B7P_xIxJqWPqmN6iW_QSfItteL7q4wDyR-NDaENQ/s1600/3ma3od3l65X15R35S5b453b9e6bc11acd17a1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_6bHn_zVrK4QE5Va5aoK65L3qZU7cbyhWErfdOpC8g79XWcqRd9Jxf01SeTfdIhujLNv50eaPePN5ccyKLvYo7jC2z9GwKS__I42B7P_xIxJqWPqmN6iW_QSfItteL7q4wDyR-NDaENQ/s1600/3ma3od3l65X15R35S5b453b9e6bc11acd17a1.jpg" /></a></div><div style="text-align: center;"><span style="font-size: large;"><br />
</span></div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><span style="color: #999999; font-size: large;">Come to find out <b>WHY</b> and <b>HOW</b> birthing in water can help to Reduce Pain, Give Your Baby the Most Gentle Birth, Reduce the Risk of Tearing, and Reduce the Length of Labor.</span></div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><span style="font-size: large;">Free information packets, Free Food, and Free Giveaways!</span></div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><span style="font-size: large;">For more information please email: <span style="color: #ea9999;">BirthkeeperMidwifery@gmail.com </span></span></div><div style="text-align: center;"><span style="font-size: large;">or visit the Facebook Event page at: <a href="https://www.facebook.com/events/271303672934465/">Waterbirth Info Cedar</a></span></div>BirthkeeperMidwiferyhttp://www.blogger.com/profile/17905162180422319691noreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-14208235245380615182011-11-12T12:31:00.000-08:002011-11-12T12:31:20.317-08:00HeartbrokenYesterday was 11/11/11. A big thing in numerology, I'm told. Lucky numbers. Matching numbers. What did some parents-to-be do on this date? They scheduled their child's birth to fall on it. :( <br />
<br />
It happens every year. Last year I even heard of women who were planning home births, inducing at home in order to give birth on the "lucky" date. This is a travesty. Babies are literally forced out of their mother's womb before they are ready for life on the outside, because their parents want them to have a "cool" birth date. <br />
<br />
There is even an Obstetrician in Des Moines who offered <i>monetary compensation<b></b></i> for families who scheduled their delivery yesterday. I wonder how many of those babies ended up in the NICU. <br />
<br />
Do the doctors who encourage or allow elective inductions and cesareans for a "lucky" date, caution about the risks involved in doing so? Do they mention the risk of NICU admission due to their baby not being ready for life on the outside? I know that when I was being scared into my first cesarean, 7 1/2 years ago, the OB not ONCE mentioned that it was a risk. He was too busy coercing us into agreeing. My son spent 9 days in the NICU, and I was flabbergasted when the neonatologist assigned to my son, told us that respiratory distress is *the* most common risk of elective cesarean section. <br />
<br />
Today I was told that <i>six<b></b></i> babies were admitted into our tiny, local NICU yesterday. I am waiting to hear if we will be able to find out how many were due to induction or cesarean for yesterday's date. This is inexcusable, and it is heartbreaking.BirthkeeperMidwiferyhttp://www.blogger.com/profile/17905162180422319691noreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-71306653284020266812011-11-09T11:13:00.000-08:002011-11-09T11:13:11.485-08:00Caution: Choose CarefullyA woman thought she had chosen her care provider carefully. One whom she thought would facilitate the peaceful, calm, beautiful birth that she envisioned for her first baby. She was comfortable with her care provider, confident that she would have the type of birth that she was dreaming about. <br />
<br />
Then, at the end of pregnancy she is bombarded with stress from her care provider. Pressure to undergo tests that weren't based on evidence of anything going awry. A strict dietary change, which she needed to report to her care provider. When her water breaks and there is no labor yet, her care provider is unable to follow evidence based research, and have patience as long as mother and baby are doing well. Care provider talks heavily and often of intervention. Begins forcing induction techniques on the mother. The care provider's nervousness exudes from every action, in turn causing stress on the family. Soon the mother is able to force-start her labor, even though her intuition tells her that everything was fine. Her care provider ordered the birthing woman's mother to get out. When it came to pushing, she wasn't given an option of birthing anywhere but on her back. Her care provider instructed people to hold and pull her legs all the way back, while roughly hooking fingers into the mother's vagina to stretch and pull. Stretch and pull. Mom kicks at her care provider's hands, and says, “This hurts. Please stop.” Her care provider continues, saying that if mom doesn't want to tear, this is what needs to occur. Baby is born. Yet, it isn't the calm and beautiful meeting that either parent had hoped for. Within minutes, the care provider was pulling roughly on the umbilical cord, even though the mother said it hurt. Pulling tore the placenta off of the uterine wall, and heavy bleeding began. Before the family knew it, the care provider was gone, citing fatigue. The husband was left to worry about his wife's bleeding, and his child's breathing, without the professional that they had paid for. <br />
<br />
For those of you who know the difference between home and hospital birth, this sounds like a hospital birth. It wasn't. This was birth at home. With a Midwife. Unfortunately, just hiring a Midwife to attend a home birth does not guarantee you a peaceful, safe, calm birthing experience. And there are things you can look for in the interview, and in the prenatal process. The problem for most families is that they blindly trust in their care provider. They don't question, and they don't do independent research. And the Midwives that I know of that have caused these kinds of birthing scenarios are extremely smooth with how they present things. It is almost a grooming technique. They tell you exactly what you want to hear. If you question things, they have a well-thought-out reason for why they will intervene in an otherwise healthy pregnancy, labor, or birth. <br />
<br />
Red Flags in a Midwife: <br />
<br />
*She has strict requirements for what you can and cannot do for your own birth. For example, she has the rule that you cannot birth on your own bed. You must birth in water (if she “lets” you actually birth in water – does not pull you out when you start pushing), or on the floor. This is controlling, not evidence based, and quite frankly – disturbing. There is nothing evidence based about not allowing a woman to birth in her own bed. A birthing woman should be able to birth wherever and however she chooses. Period. <br />
<br />
*She becomes visibly nervous over things that are within normal or normal variation. A professional, experienced, and competent Midwife will make the family feel at ease, even if she internally feels nervous about something. This is the time for her to do research, collaborate with a peer, and then make a calm recommendation if evidence shows a reason to step in. <br />
<br />
*She starts doing or wanting to do vaginal exams in the end of your pregnancy. Whatever reason she may give you, this is NOT evidence based. It holds no purpose whatsoever. It will not tell you when you will give birth, how well your labor will progress, or how baby is doing. <br />
<br />
*You begin to feel like less of a peer with your Midwife, and more of a submissive party. You view your Midwife as an absolute authority figure who shouldn't be questioned, or one who will “disallow” you to do something. Your Midwife is your SUPPORT during a physiologic event in your life. Not your authority. <br />
<br />
*She begins to come up with reasons why the things you may desire, or have planned for your birth, are not going to work out. For example – birthing in water. If she mentions that she “may have to pull you out” of the water for pushing, HUGE red flag. If she mentions that your partner or the person whom you have chosen to catch your baby can do so only with her help, huge red flag. There is nothing special about a Midwife's hands. She can sit back and carefully watch, and step in if there are any issues. Otherwise, she doesn't need to be involved. <br />
<br />
*She answers, “We'll have to see how things are going...” in response to your desires for your birth. <br />
<br />
<br />
And finally, for those of you who may be questioning what the heck happened during your birth...if your Midwife: <br />
<br />
*Had you begin techniques to soften and prepare your cervix.<br />
<br />
*Pressured you to begin intervention in your otherwise normal, healthy pregnancy.<br />
<br />
*Began induction techniques because your waters released and labor didn't start yet, even though you and baby were not showing any signs or symptoms of infection. <br />
<br />
*Was nervous during your labor – didn't seem like she was confident with what was occurring. <br />
<br />
*Didn't allow you to birth anywhere but on the floor.<br />
<br />
*Discouraged waterbirth, birth on your bed, or someone else from catching your baby. (including YOU!) <br />
<br />
*Did multiple vaginal exams either without you asking, or because she had convinced you that they were necessary to assess progress and safety. <br />
<br />
*Had you push before you felt the urge – your body will undeniably begin pushing on its own without any effort from you.<br />
<br />
*Kept asking if you felt like pushing. A Midwife worth her salt knows that if you have to ask, mom definitely does not feel like pushing. Then mom wonders why she doesn't have to push yet. Is something wrong? When will I feel like pushing? <br />
<br />
*Roughly applied perineal massage and stretching. If she told you that this is how to keep from tearing. If she told you that this was necessary. If she wouldn't stop when you mentioned how it hurt, was uncomfortable, or you didn't like it. Doing perineal stretching and massage is not evidence based. Research has shown that it does not reduce the risk of tearing, especially since the position that mom is in for this, is the LEAST optimal position for birth. <br />
<br />
*Spoke to you in a controlling way. “Give me that baby!”, “You can either get down to business and REALLY push, and have this baby soon. Or you can keep going like this for hours.”<br />
<br />
*Pulled on your placenta instead of waiting for the third stage to complete physiologically. By doing so, she put you at high risk for uterine and cervical prolapse, not to mention hemorrhage.<br />
<br />
*Left shortly after your birth. A Midwife should remain in your home for a MINIMUM of two to three hours after birth. The first hour after birth is VITAL to mother-baby bonding, and should not be disrupted by newborn examination, birth certificate worksheets, or anything else if all has gone well. The time after birth is to assure that mom and baby are doing well, that they are snuggled into bed, that baby is nursing well, mom has eaten, and everything is cleaned up.<br />
<br />
<br />
If she did any of the above, she did not practice in a safe, evidence based manner. <br />
<br />
Overall, your Midwife should practice in a way that supports evidence based research and protocols. Not fear based, and definitely not control based. Women are perfectly capable of birthing out in the middle of the forest without anyone else around. They definitely do not need an overbearing, controlling Midwife to step in and make things unsafe. <br />
<br />
Ask for the contact information of her last 3 clients. Ask them questions about their birth. Ask them about the demeanor of the Midwife during pregnancy, labor, birth, and postpartum. Ask about her transfer rate. Does she end up taking a lot of her clients in to the hospital? Call the hospital. Talk to the nurses. What is the reputation of the Midwife there?<br />
<br />
If you have seen any of these red flags and feel it is too late to switch, it's not. Call around. Explain your situation. Make other arrangements for your birth, instead of continuing with these red flags, and possibly putting yourself, your baby, and your birth experience at risk. <br />
<br />
Be careful with your choice in care provider. There are no do-overs in birth, and you will always remember the way that you were made to feel during your birthing process. Always remember that YOU are the one in charge of your birth. You hire your care provider – they work for you....not the other way around.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-2812644624461892322011-04-05T11:17:00.000-07:002011-04-05T11:18:30.768-07:00FREE Waterbirth Information Night*~*Join us for a FREE Waterbirth Information Night on <br /> Saturday, April 30th from 5-9pm in St. George!*~*<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxOaYFRDgG8rFZ5Mi5-nTAkuUDR_wHsNDC7NKu8iRWAM6MUeOv5PjZbvQVMvlZsXFbmazJ71CAbtPIWfN8o25e3CKHyE6em4K-UiV5ei3TFxhYbHGVE5Ps1oEfVLu7hKaQTjHf5G6vH1E/s1600/9423_146275362142_662612142_3119811_5638697_n.jpg"><img style="float:center; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 310px; height: 204px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxOaYFRDgG8rFZ5Mi5-nTAkuUDR_wHsNDC7NKu8iRWAM6MUeOv5PjZbvQVMvlZsXFbmazJ71CAbtPIWfN8o25e3CKHyE6em4K-UiV5ei3TFxhYbHGVE5Ps1oEfVLu7hKaQTjHf5G6vH1E/s320/9423_146275362142_662612142_3119811_5638697_n.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5592164326825638338" /></a><br /><br />Have you ever wondered about the science behind giving birth in water? Have you heard myths about baby not being able to breathe, or gravity not helping in water?<br />Come with any and all questions! <br /><br />Free food, giveaways, information packets and more ... <br /><br />Visit the <a href="http://www.joyfulbirthservices.com/Events.php">Events</a> page for more information. Hope to see you there! <br /><br />Find additional information and RSVP on our <a href="http://www.facebook.com/event.php?eid=174641239254711">Facebook Event Page</a><br /><br />Date: Saturday, April 30th<br />Time: 5:00-9:00pm<br />Location: Sage Hills Yoga Studio in St. George<br />Cost: FREEUnknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-80108579120585254392011-02-24T18:37:00.000-08:002011-02-24T18:38:20.074-08:00Prenatal Yoga in Southern UtahMandala Mom ~MotherBaby Services~ is offering prenatal yoga classes three times a week at Sage Hills. First class is free! <br /><br />From the Facebook page, <a href="http://www.facebook.com/profile.php?id=19700068#!/pages/Mandala-Mom-MotherBaby-Services-St-George-Utah/131606616900435?v=wall">MandalaMom ~MotherBaby Services~</a>: <br /><br />Prenatal yoga is offered three times per week at Sage Hills: Tuesday at 6 pm, Thursday at 9:30 am, and Saturday at 10:45 am. Please arrive a few minutes early to your first class, wear comfortable clothes, and bring a bottle of water and a yoga mat. Mats are also available for rent for $1/class. Your introductory prenatal class is <span style="font-weight:bold;">free</span>.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-19760674358564201552010-05-31T13:33:00.000-07:002010-05-31T14:00:08.315-07:00"Do You Feel Like Pushing?"When I hear that a woman has hired a Midwife to attend her birth in her home, and then hear of all of the unnecessary interactions or interventions that were done, I want to cry and scream and throttle someone all at the same time. I'm not sure if Midwives have had the Medical model ( as opposed to what they should have - the Midwifery model ) drilled into their training, or if they haven't learned how to sit back and simply <span style="font-style:italic;">observe</span>. But either way, it is robbing women of the experience that they could have in a home birth. <br /><br />Recently I have heard several times of Midwives asking their clients, who are busy in transition, "Do you feel like pushing?", and I want to scream. If you have to ask your client whether or not she feels like pushing, you have your answer. If she's not beginning to grunt and push, then NO! She doesn't feel like pushing. I'm not sure whether some Midwives believe that certain clients will be an anomaly and never get the urge to push, keeping baby inside forever unless the Midwife does not step in and save the day by asking. I'm not sure what the reason behind this is. But it is not only unnecessary, it is interfering with mom's groove in labor. Now you have a client who is thinking, "<span style="font-style:italic;">Do</span> I feel like pushing? Maybe I don't know when to push." You have now taken her out of her body, where she was happily laboring ( okay, maybe not all "happily", lol ) and into her head with concern or questions. <br /><br />Guess what? You can learn so much by simply sitting back and observing. This goes for vaginal exams, pushing, whether or not baby is okay ( <span style="font-style:italic;">without</span> touching, rubbing, suctioning, talking, etc ), and any other unnecessary interference in labor. <br /><br />And ladies? If you have a Midwife who asks you this question, please tell her that YOU will let her know when you are ready to push, and to please stop interfering. Though, I would recommend finding out prenatally how your Midwife practices. Ask to get in contact with previous clients. Ask them how the Midwife was during their birth. Make sure that you have a truly "With Woman" Midwife, and not one that is fearful of birth or who over medicalizes it. Out of the last 10 clients, how many have ended up in the hospital? Make sure you have a Midwife who respects and honors your wishes. If you ever find out that your Midwife does not ALLOW ( or even has PREFERENCES ) you to birth in a certain way, such as on your bed or in water .... find someone else. This is a violation of your rights, and shouldn't be imposed on you.Unknownnoreply@blogger.com3tag:blogger.com,1999:blog-4386369536975942935.post-86289108708958583142010-05-20T10:28:00.000-07:002010-05-20T10:55:23.251-07:00What Happens in a Home Birth?Many times I have people wonder what's so different about a Home Birth. How is it different than giving birth in the hospital? How is it better? <br /><br />I have listed my 10 reasons for giving birth at home before (added below), but it doesn't walk you through what a Home Birth can really be like, step by step. <br /><br />First of all, my prenatals usually last, on average, an hour long. I use the time to really get to know the family. Birth is such an intimate time in a family's life. If I am going to be a part of it, I want them to feel like they really know me, and vice-versa. We not only go over the clinical diagnostic that are done at an OB office (Blood pressure, fundal height, baby's heartbeat, check urine), but we also go over nutrition (which is vital in preventing things in pregnancy), as well as the emotional well being of mom. I want to make sure that any concerns or questions are fully addressed in each and every prenatal. As we get closer to 40 weeks, we will go over any specific birth wishes (candle light, waterbirth set up, music, etc) and make sure that all supplies have been gathered and are ready. We speak about when to call me in labor, and what the family wants my roll to be. Am I catching, or is dad or a sibling? I have absolutely no problems with someone else catching. And unlike some Midwives, I do not require a "three handed catch". I trust that dad will catch baby perfectly fine without my help. ;) <br /><br />There are some Midwives in the area who do not "allow" clients to birth on their own bed, or "allow" clients to birth in the water. I see this as a gross violation of personal choice in birth. I am happy to catch baby (if I am even the one catching!) in whatever place mom chooses for her birth. My desire is to see women take charge of their births, and not ask me for "permission" with what they can do with their body and baby. I am simply there as a lifeguard of sorts - to make sure that labor and birth progress safely. <br /><br />At the last birth I attended, I was called in the afternoon to be given a "heads up" that mom was in labor. She and her husband were going to try to go on about the day as normal, and call me when things really picked up. I got a call back at about 10pm, with a request to come soon. I gathered my supplies and headed out. When I arrived, the birthing room (in this case, the bathroom) was such a beautiful scene. Mom was laboring in her tub. Lights off, candles lit around the tub and bathroom. Dad was playing his guitar and singing to mom. It was such a sweet setting. Mom was smiling, excited for the day to have arrived. With her permission, I checked on baby's heartrate, and asked how she was doing. (In between contractions, of course.) When I knew everything was good, I retreated downstairs, telling them to call if they needed anything. They had it all under control, and wanted the intimacy of the two of them laboring alone. I only went back up every so often to check on baby, and retreated back downstairs. I don't do any vaginal exams unless I feel there is something going off that needs this tool. And it isn't often that I feel this way. ;) <br /><br />At about 2am, mom decided to try to get some rest. Contractions were slowing down and she was tired. We all fell asleep for a bit, until I was woken up at about 2:50 with sounds of her starting to push. They called me back upstairs. From the time that mom's body got serious about pushing, to the time baby was born, was a mere 6 minutes. She did BEAUTIFULLY! She caught her breath, gathered up her baby, and snuggled her. I made sure baby's color and tone were good, and then didn't touch baby again for an hour. Because baby was breathing perfectly, crying quietly, and her tone was great ... I didn't need to interfere with touching baby. This was mom and dad's time, and didn't need to be interrupted. An hour after birth, I did the full newborn exam and checked mom for tears. Not ONE! :) I made sure mom and baby were nursing without any problems, cleaned up everything from the birth, and left the new family to snuggle up together and sleep. <br /><br />It may not sound like I did much. I usually don't. When a mom is healthy and has had a healthy, low risk pregnancy, the best thing to do is as little as possible during labor and birth. Interrupting the process continually can hinder the birth. Vaginal exams are unnecessary the vast majority of time, and should be avoided. Unless mom and dad need the extra support, they should be given as much time as desired to be alone. They created the baby alone, they should be given the opportunity to labor alone. Now, I have had families that have wanted me more involved. I have kept mom company, rubbed many backs, and have even slow-danced in labor with mom. I am happy to fill whatever roll the family wants me in - even if that means doing nothing at all. <br /><br />This is the difference of Home Birth. There aren't unknown people (nurses) walking in and out of your room without permission. There are not beeping machines or an uncomfortable bed. There aren't any IVs, or limited spaces in which dad is allowed to go. There aren't any restrictions to how/where mom births, or how many/little people in attendance. All newborn exams are done on the bed with mom, not across the room or in a separate area. Baby never leaves mom's site (unless dad is showing baby off to family that may be in another room). <br /><br />Birth should be a beautiful, intimate time for a family. <br /><br />Ten Reasons (and there are many, many more than ten!) To Birth At Home: <br /><br /><br />10. You remain an autonomous woman throughout labor and birth. You're not treated as a sick person, you don't have to put on a hospital gown, and you're not told what to do.<br /><br />9. Your husband/partner can take breaks as needed, and he's in his own home. He doesn't have to wander the halls to look for a vending machine or a cafeteria. He can even play video games. ( The big plus to my husband )<br /><br />8. You can eat and drink as you wish. You are not restricted to ice chips, you are actually encouraged to eat healthy, protein-filled snacks and meals.<br /><br />7. You don't have an IV. In a home birth, you drink as your source of hydration. There is no IV placed in your hand, and you are free from that cumbersome IV pole.<br /><br />6. There are fewer complications at home. This is from multiple studies done over multiple decades. At home, fewer ( next to zero ) episiotomies are done. In the hospital, some have a nearly 80% episiotomy rate. At home, fewer babies need help breathing at birth ( 17 times LOWER risk at home ). At home, shoulder dystocia is less likely, even for those HUGE babies. ( even though the HUGE babies are not the ones at more risk for this, despite the myths ) At home, fewer moms hemorrhage. At home, fewer moms tear.<br /><br />5. There is never a risk of mixing up babies. There is only one brand new baby at home ( well, 2 if twins ), and you know he's yours.<br /><br />4. There is never a risk of mixing up medications. There are no medications, but even if there were there would be no possibility of getting someone else's meds, and dying.<br /><br />3. There are no drugs. Now, this may seem like a bad thing to some women, but it's a good thing for EVERY baby. A baby born without drugs, is a healthier baby. You don't put baby at risk for drug-related conditions at birth, when there are no drugs to begin with. And without an epidural, you're not at risk for the myriad complications to both mom AND baby that come with one.<br /><br />2. As many, or as few people can be in the room with you when you birth. From children to grandparents and anyone in between. And, anyone you wish can catch the baby. It makes birth what it should be - a family event.<br /><br />1. You are giving your baby the greatest gift of all - a non-interventive, drug-free, peaceful, safe birth...and on your terms, not a surgeon's. There are no birth do-overs, so why not give your baby the best birth possible?Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-69341267247633003922010-05-20T09:16:00.000-07:002010-05-20T09:56:07.544-07:00Just reduced feesI firmly believe that having a Home Birth should be an affordable option for all women who desire to have a safe, gentle birth on their terms. With the way that the economy is, and seeing that so many women rely on Medicaid in Southern Utah ... I wanted to make Home Birthing an even more affordable option. <br /><br />My full home birth fee is now $1500. I give an additional $200 discount for women who can prove eligibility for Medicaid, bringing the fee down to $1300. I also offer up to $400 in trade/barter services. Which means, if you qualify for Medicaid AND have something to trade or barter, ( Do you sew? Do you sell tupperware/candles/etc? Is your husband a mechanic or handyman? ) it brings the cash price down to $900. <br /><br />What do my services include? <br /><br />* Full prenatal care <br />* Available 7 days a week for questions/concerns <br />* All In-Home prenatals ( if you live within 50 miles of me )<br />* Waterbirth tub at no additional fee <br />* Book lending library <br />* Labor / Birth and up to 4 hours with you after birth<br />* Post partum visits at 24 hours, 3 days, 7 days, 2 weeks, and 6 weeks<br />* FULL 24/7 breastfeeding support <br /><br /><br />I "specialize" in VBACs, as this is very near and dear to my heart, being a VBAC mama myself. I also will attend twin births, as long as the pregnancy has been healthy and normal. <br /><br />Initial consultations are FREE. Give me a call and schedule one today! <br /><br /><a href="http://www.joyfulbirthservices.com">Joyful Birth Services Website</a><br />435-272-3025Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-51235155383921381282010-03-21T09:31:00.001-07:002010-03-21T09:31:48.148-07:00What Pitocin Does to Your BabyI understand that most women don't know what pitocin does to a baby. I was one of those women, 8 years ago, when I happily had my labor augmented with pitocin to "move things along". If I knew what I know now, I never would have put my baby through that hell. It is my goal to bring about awareness of what this drug does to babies, and why we should avoid it unless it is an emergency.<br /><br />Studies have found that in recent years, up to 3 out of 4 inductions weren't even medically indicated. Being a few days, or even a week past your due date is not a medical indication for induction. Being tired of being pregnant is not a medical indication for induction. Suspecting that baby is getting big, is not a medical indication for induction. Having fast or slow labors is not an indication for induction. Even ACOG themselves, along with many other national and world-wide health organizations have acknowledged that the high number of inductions and augmentations that are done is out of control.<br /><br />I know the question that is on your mind - "If it's not safe, why would my doctor do it?", or for the already defensive "MY doctor wouldn't do it if it weren't safe!".<br /><br />Well, doctors know it's not safe. That's why they have to monitor you and the baby much more closely when pitocin is involved. If mom has pitocin and an epidural, they will often insert *internal* monitors to have a closer look at how baby is doing. They understand that the drug can be very risky for baby, and that's why a good chunk of pitocin induced or augmented labors end up with baby in distress to one degree or another. A pit labor is HORRIBLE for baby. It puts baby through completely unnaturally strong contractions, which is why it often leads to distress. And before any mom says "My baby was fine!" - don't even comment. Just count your blessings. Most babies are NOT fine. Even if baby ends up fine in the end, most pitocin drugged babies are not fine during labor.<br /><br />Pitocin is actually not recommended for pregnant women. It was never intended to be an elective labor induction drug. It is not even approved by the FDA for elective ( again, that's 3 out of 4 inductions! ) induction or augmentation! And the saddest part is, in an artificial labor, mom doesn't get the glorious dump of natural oxytocin - also known as the "love" hormone - as women do who have natural labors.<br /><br />What can you do? Be patient. Understand that a due date is simply an estimation, and that normal gestation length is all the way up to 42 *completed* weeks. Be patient and understand that labor ONLY begins when baby and your body are ready. If you choose to induce before then, you are literally trying to force your baby out - forcefully. Remember that YOU hired your care provider. They cannot force you to induce if you get to 41/42 weeks. You have the right to say NO! Remember that your baby is a tiny little being that needs your protection - be gentle with him! Each baby only gets one birth. Please do the best you can to provide a safe, gentle birth for each baby. Each intervention that you allow in labor has the potential to imprint negatively on baby. Let's take care with our precious blessings! <br /><br />From the FDA website:<br /><br /><br />For the fetus or neonate it can cause:<br /><br />Due to induced uterine motility:<br />Bradycardia<br />Low Apgar scores at five minutes<br />Premature ventricular contractions and other arrhythmias<br />Neonatal jaundice<br />Permanent CNS or brain damage<br />Neonatal retinal hemorrhage<br />Fetal death<br />Neonatal seizures have been reported with the use of Pitocin.<br /><br /><br />From Jennifer Block's Website:<br /><br />When your uterus contracts, the baby and umbilical cord essentially get a squeeze, and little oxygen passes through to the baby until the contraction is over. Labor is essentially sprint-training. Spontaneous labor generally starts off slow, allowing you and the baby to get acclimated. Pitocin, on the other hand, takes you from zero to 60 all at once. Your body’s contractions start slow and build; artificial contractions can hit like a gale force wind. And if staff are not careful, they can be too strong and last too long — the technical term is hyperstimulation — causing the baby to be deprived of oxygen. Most babies turn out fine, but some don’t. Consider this: in nearly half of malpractice suits involving damage to the baby, synthetic oxytocin is cited as the culprit.<br /><br /><br />A video clip from Ricki Lake's The Business Of Being Born: <br /><br /><object width="480" height="385"><param name="movie" value="http://www.youtube.com/v/3fPauJEy7fc&hl=en_US&fs=1&rel=0"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/3fPauJEy7fc&hl=en_US&fs=1&rel=0" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="480" height="385"></embed></object>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-84909391947388124152010-01-12T15:34:00.001-08:002010-01-12T15:34:27.374-08:0010 Childbirth Myths1. "Before cesareans, women were dying all the time in childbirth."<br /><br />* Yes, there were high maternal and infant mortality rates before we had the tools for a "safe" cesarean. But the main factors that contributed to this, are often unknown or not researched by women. "In the early 19th century, doctors would go catch babies without first washing their hands and, worse, would do so after performing autopsies on patients who had died from childbirth fever. This not only assured transmission, but biased that transmission so that the most virulent forms of the organism (i.e., those that killed women while they were still in the hospital) would be transmitted." ( Germ Theory of Disease ) The first antibiotic wasn't created until the 1920's. Even then, the use of penicillin didn't become widespread until the 1940's. So if the Aseptic Technique didn't become known until the late 19th century, and we didn't have access to antibiotics until the 1940's, how is it hard to understand that women and babies were dying more so because of the spread of disease, rather than the inability to birth safely without a cesarean. I have no doubt that some women and babies died because of not being able to get the baby out fast enough...but that really does take a back seat to disease, if you look at things correctly according to the history of medicine and what we've learned. It wasn't just women and newborns dying...it was a widespread thing during that time. Older children were lost to disease, men, and non-pregnant women alike. In Wales in 1838, the death rate from the Measles was 70.49 per 100,000. By 1968 when the Measles Vaccine came to use, the death rate was down to 0.11 per 100,000. My point in bringing up the measles? To show that the GENERAL death rates were very high before we had the Aseptic Technique, Antibiotics, and Vaccinations. Should we be afraid to go out in public where other people will be coughing, sneezing, and breathing around us because the disease rate was very high over a century ago? Of course not. Same reason that women should not be afraid to give birth because the maternal and infant mortality rates were high.<br /><br />In my previous posting of this, I also mentioned pelvic deformities from the use of corsets. This WAS a factor in women's inability to pass the very baby she grew, because when girls began binding their waists and hips from a young age, it DID change their pelvic structures. This may have been seen in the prominent families only, but it was still a factor. I can't help but believe as well ( and feel free to write me off on a person belief, lol ) that labor and birth would be a hell of a lot more painful if your pelvis suffered from years of binding.<br /><br /><br />2. "I have to be induced because my baby is getting too big."<br /><br />* The accuracy of ultrasound for detecting macrosomia seems to run between 50% to 65% or so. This is VERY low accuracy to be telling a woman that her baby is getting too big to birth safely. From Kmom's Website:<br /><br /> Pollack et al. (1992) found that only 64% of the babies estimated to be macrosomic (big) actually were. Levine et al. (1992) found that HALF of the ultrasound predictions of fetal weight were incorrect. Delpapa and Mueller-Heubach (1991) found that 77% of ultrasound fetal weight predictions exceeded actual birthweight and only 48% were even within 500g (about one pound) of the actual birth weight. Furthermore, 23% were more than 1 pound overestimated, and 50% of the babies predicted to be macrosomic weren't macrosomic at all. <br /><br /><br /><br />Late in pregnancy, ultrasonography just isn't an accurate way of estimating the size of the baby, when it comes down to the decision of forcing a baby out before he's ready, or heading to the OR. And regardless of baby's size, you'll never know what you can do until you try. ; ) Had someone told me 4 years ago, when I was scared into my c-section for "suspected macrosomia" ( he was only 8.8lbs and spent 9 days in the NICU for severe respiratory distress from the c-section ), that I would go on to deliver a 10.10 posterior baby ( in my home no less, no meds )...I would have told them that they were crazy. That it is impossible to deliver a baby that big without a cesarean, or major damage in the least. ( I had only one stitch, by the way )<br /><br />I also think that women don't know that the pelvic girdle is NOT a fixed, solid structure. During pregnancy and labor, a hormone called Relaxin softens the ligaments that join the surrounding pelvic bones. The degree of pelvic expansion achieved will vary depending on the factors in an individual woman's labor. For example, squatting increases the opening of the pelvic outlet considerable, compared with the lithotomy position. It will also depend on whether or not mom was induced. ( The hormone is still there, but an induction is a mean of trying to evict a baby who is not ready ) There are factors that come into play, but there are ways of increasing the pelvic outlet size to facilitate a vaginal delivery. Baby's heads are made to mold as well.<br /><br /><br /><br /><br />3. "I had to have a c-section because my baby's cord was around his neck, and he could have DIED!"<br /><br />* I am saddened to hear this from women. Obstetricians are doing a great job of justifying the reason for the cesarean, by throwing in things like this. Approximately 1 in 3 babies are born with at least a 1x nuchal cord ( wrapped around the neck ). I personally have been present for the delivery of a baby who had a 3x nuchal cord, wrapped not only around the neck, but across the shoulders as well. She was born quite safely at home. While studies DO show a higher incidence of fetal bradycardia ( heartbeat of less than 100bpm ), they show no significant difference in the APGAR scores in babies with a nuchal cord, compared to those without. Interesting. ; )<br /><br />From The Journal Of Family Practice:<br /><br /> Several studies have shown that this cord compression results in reduced blood flow to the fetus and subsequent changes in the umbilical artery blood gases.[3,25,31-33] If compression is high enough to occlude the artery, the fetus is unable to exchange carbon dioxide adequately, resulting in hypercapnia and subsequent acidosis. Acidosis is significantly more common in newborns with nuchal cords.[33] This acidosis is of a "mixed" (68%) or a pure respiratory (23%) type and is corrected quickly by prompt ventilation of the newborn.<br /><br /> Paradoxically, despite the higher incidence of bradycardia and acidosis, the Apgar score is not dramatically affected. The present study was unable to demonstrate a significant difference in the mean 1-minute Apgar score between the two groups, although the nuchal cord group did tend to have a larger percentage of infants born with a score of less than 7. This difference was absent at 5 minutes after birth when the second Apgar score was given, suggesting that any possible effect is only transient. Similar findings by other suggest that nuchal cords are not a major cause of fetal asphyxia.<br /><br /> It is interesting to note that the Apgar scores in the nuchal cord group of this study were comparable to those of the control group, despite the much higher occurrence of fetal distress noted during labor. It may be that the Apgar score is a better indicator of the newborn's health at the time of birth than the fluctuations in heart rate noted during labor.<br /><br /><br /><br /><br />4. "Once your water breaks, you HAVE to deliver within 24 hours."<br /><br />*<br /><br /> A retrospective cohort study of women delivering at two New York City hospitals between 1988 and 1990 was conducted to assess the outcomes of two kinds of management for PROM. The patient populations of the two hospitals were similar. One institution practiced induction of labor if spontaneous labor had not begun within 12 hours of rupture of the bag of waters; the other hospital, with nurse-midwifery management ( not ignorant DEMs we're talking about! ;) ), admitted the women but did not induce unless signs of infection occurred.<br /> The records of 909 women with PROM at term were reviewed. Those who were managed conservatively experienced one-third the rate of cesarean sections, with no increase in intrauterine or neonatal infections. Though the expectant management women spent as long as five days in the hospital, the average hospital stay was only a half-day longer than those who were managed with early induction. -Journal of Nurse-Midwifery, Vol. 38 No. 3, May/June 1993<br /><br /><br /><br />A HUGE factor in acquiring an infection when premature rupture of membranes has occured, is the number of vaginal exams done after the water has broken. With each exam done, the risk of infection is increased. In keeping the risk of infection at it's lowest, it is important to keep everything out of the vagina - even gloved hands. Unfortunately, this doesn't happen often in the hospital.<br /><br />Morales WJ and Lazar AJ. Expectant management of rupture of membranes at term. South Med J 1986; 79(8): 955–958.<br /><br /> Women with term uncomplicated pregnancies (including women with previous cesarean) and PROM who were not in labor were randomly assigned to expectant management (monitoring for infection or fetal distress) (N=167) or induction (N=150). No digital exams were done until active labor. Most (85%) began labor within 48 hours. Women randomized to induction had internal electronic fetal monitoring and pressure catheter. "Failed induction" was defined as failure to enter active-phase labor after 12 hours of regular contractions.<br /><br /> The cesarean rate was 7% for women managed expectantly compared with 21% for induced women. No cesarean was done for failure to progress in expectantly managed multiparas versus a 15% cesarean rate for this cause in induced multiparas. Infection rates after cesarean section (24% versus 5% [no p value]) reflected the "well-documented significant increase in postpartum endometritis after abdominal delivery." Intrapartum infection and endometritis rates after vaginal birth were increased in the induced population (12% versus 4%, p <0.01). No infant in either group was infected. "These findings...support the observation that, contrary to previously accepted belief, prolonged interval between rupture of membranes and delivery does not increase the maternal and neonatal infection rate. Rather, with PROM the interval from digital examination to delivery is the critical parameter in the incidence of infection."<br /><br /><br /><br />5. "Once a Cesarean, Always a Cesarean."<br /><br />* This used to be true, but mainly because doctors were using classical incisions ( vertical ) during cesareans, instead of the low transverse that is done now. With a classical incision, the incision stems upward into the uterus, where it contracts. The lower segment usually does not contract as hard as the upper segment. The main risk in a VBAC ( Vaginal Birth After Cesarean ) is a Uterine Rupture ( where the uterus opens ). This risk is approximately 0.3-0.7%. Which means that in a VBAC, you have a 99.3-99.7% chance of NOT rupturing, if you don't induce labor. When you induce, the risk of rupture is increased. The risk of a cord prolapse, which is a life-threatening emergency for baby, in ANY labor is up to 2%. Does that mean that no woman should take the risk of ANY vaginal birth, and all should be c-sections? Of course not. So then why do women believe that the *LESS THAN 1%* risk is too high? Mostly because their doctors ( One thing that many women don't know - OBs are trained *surgeons* ) play up the risks of VBAC, and underplay the risks of cesareans. A VBAC is not only a viable option to consider, but one that is encouraged by all of the major health organizations, including ACOG ( American College of Obstetrics and Gynecology ).<br /><br /><br />6. "It's not a big deal to induce, as long as you're 'term'".<br /><br />* Well, this depends on what you consider to be a big deal. According to every recommendation there is, induction of labor SHOULD NOT be done unless the risk of remaining pregnant FAR outweigh the many risks that come with an induction...and suspected macrosomia doesn't fall into this category, not even according to ACOG. Sadly, the majority of women induce out of convenience ( wanting to have baby by a certain date, wanting to get an additional tax credit before the new year - and YES...I've heard this more times than I can count! ) or because they have been told their baby is getting "too big", or because they're tired of being pregnant.<br /><br /><br />From the AAFP:<br /><br /><br /> The Epidemiology of Induction Has Changed. The increase in the frequency of term labor induction has been well established,2-4 yet the change in incidence rates varies considerably by indication. Macrosomia has increased the most as an indication, 22.5-fold since 1980, despite evidence that induction for suspected macrosomia has shown potential benefit only in women with type 1 diabetes mellitus.5,6 Post-term pregnancy, the most common reason for labor induction (10 percent of live births), had only a 2.3-fold increase. Of note, induction rates have shown large variations across maternal classes, with higher induction rates being found in white, non-Hispanic women (25.3 percent), women with more than 12 years of education (24.6 percent), and women with private insurance (24.5 percent).2 Higher induction rates are found in community hospital settings (increased elective inductions), compared with university or federally controlled hospitals (increased inductions because of medical conditions).8<br /><br /> Elective Induction of Labor Is More Common. The rationale for elective induction is mutual convenience, allowing a pregnant woman to handle logistic issues such as child care and transportation, and to know that her expected birth attendant will be present for delivery. Given that most induced births occur between 10 a.m. and 8 p.m., it is reasonable to presume that the physician and staff will be alert and better able to respond to an emergency. However, elective induction is not without potential risks, including iatrogenic prematurity, uterine hyperstimulation, nonreassuring fetal heart rate tracing, and greater likelihood of operative delivery, shoulder dystocia, and postpartum hemorrhage. While these complications are rare in multiparous women, nulliparous women have significantly higher rates of cesarean delivery, instrumented delivery, epidural analgesia, and neonatal intensive care unit admission.9,10 Because the risk of cesarean delivery with elective induction is potentially as high as 2.8 times that for spontaneous labor, it is difficult to advocate elective induction in a nulliparous woman.10-12 <br /><br /><br /><br />Technically and Ethically, care providers are NOT supposed to be inducing for ANY reason other than true medical necessity. But an induction of labor is more convenient for them as well, because it can be scheduled according to their liking, and it's much easier to proceed to a cesarean if the induction is taking too long.<br /><br />Elective inductions also increase the risk of Iatrogenic Prematurity ( Physician caused prematurity ).<br /><br />From PubMed:<br /><br /> Flaksman RJ, Vollman JH, Benfield DG.<br /><br /> In a series of 1,000 newborn infants referred to a regional neonatal center, 32 iatrogenically preterm infants were identified. All had been delivered following elective termination of uncomplicated, apparently term pregnancies, without prior documentation of fetal lung maturity or ultrasonic determination of fetal biparietal diameter. Associated acute morbidity included asphyxia neonatorum in 10, respiratory distress syndrome in 24, and pneumothorax or pneumomediastinum in nine patients. One infant died. Hospital costs totaled $150,643, for a mean of $4,701 per patient. The unexpected premature births were associated with major parental grief reactions and alterations in their daily activities, Iatrogenic prematurity is a major regional health care problem which, when viewed on a national basis, may affect thousands of newborn infants and their families annually. Our data suggest the need for more accurate assessment of fetal maturity, before elective termination of pregnancy, by well-established techniques.<br /><br /><br /><br />7. "Epidurals don't pass to the baby, they're not risky."<br /><br />* Dentists usually will not administer anesthetics to pregnant women. Doctors caution against using even the most mild of medications. Doctors warn against smoking in pregnancy, drinking in pregnancy, and consuming unhealthy food. Babies who are born after epidural births are more likely to need resuscitation, more likely to be lethargic, more likely to have lower apgar scores, and LESS likely to be breastfeeding at 6 months of age. Epidurals have a very high risk of causing BP problems in mom - causing the need for a c-section. Epidurals often cause labor to slow or stall completely, which then facilitates the need for pitocin. Pitocin often causes the baby to go into distress, along with the cocktail in the epidural, and then facilitates the need for a c-section. Epidurals lead to the interventions of an IV, continuous monitoring ( which have up to a 95% error rate...meaning that up to 95% of the babies who were c-sectioned for "fetal distress" were perfectly fine and not in distress at all. ), pitocin. Epidural births often end in the need for an instrumental delivery. Epidurals often take away the ability to push effectively, combined with the fact that you're on your back, or in a half-sitting position, pushing a baby UP over the pubic bone.<br /><br />Risks of Epidurals ( The full summary can be found HERE ):<br /><br />* Limited Mobility - 100%<br />* Low Blood Pressure - up to 50%<br />* Fever, mom - up to 24%<br />* Urinary Retention - up to 68%<br />* Post Partum Urinary Incontenence - 27% with an epidural, 13% without<br />* Shivering - 33%<br />* Nausea - up to 30%<br />* Vomiting - up to 13%<br />* Itching - between 8-100% ( varying degrees )<br />* Backache Immediately After Birth - 53%<br />* Incomplete Pain Relief - up to 25%<br />* Slower 1st Stage of Labor - up to 4.8 hours longer<br />* Longer 2nd Stage ( pushing ) - up to 55 minutes longer<br />* Instrumental Delivery - up to 80%. 6 out of 9 studies indicate that less than 50% of women with an epidural had a spontanious vaginal delivery.<br />* Fever in the baby ( that result in a sepsis work up ) - 30%<br />* Fetal Distress - 10-15%<br />* Malpositioned Baby - up to 26%<br />* Lower Apgar Scores- up to 17%<br />* Baby Having to Endure Sepsis Work Up ( which includes spinal tap ) - up to 34%<br />* Baby Being Treated with Antibiotics - up to 15%<br />* Effects on Breastfeeding - Women who used epidurals were less likely to still be breastfeeding at 6 months. ( 30% vs. 50% )<br />* Cesarean - 2-3 times as likely with an epidural.<br /><br /><br />8. "I had to be induced because they found low fluid."<br /><br />* The modern route of action for this is completely backwards. Amniotic fluid is essentially the baby's urine after the 36 week mark. ( http://gynob.com/amniotic.htm ) If you're not drinking enough water, the baby is not able to process the amniotic fluid. When low fluid is found via u/s the practice is SUPPOSED to be to have the woman go home, drink at least 2 liters of water, and have the fluid levels re-checked by a *different* technician ( readings can be off depending on who's doing it as well! ) within 24 hours. Studies have shown that oral re-hydration is a perfectly acceptable method of increasing amniotic fluid, as well as effective. of the time, the fluid levels will have gone up. In those that don't, the practice is SUPPOSED to be to have her repeat above, and see what levels are again, by a diff. technician. If the levels still ARE low ( under 5 ), then it should be left up to the mom, will FULL INFORMED consent to make a decision. She should have time to go home and research, without being pressured. Sometimes this will necessitate an induction, but there are better ways to go about an induction without bombarding your baby with drugs. ( Foley catheter induction, no drugs, no pain meds...go from there ).<br /><br />From PubMed:<br /><br /> One approach to treating oligohydramnios during labor is to perform an amniotomy followed by amnioinfusion to increase the fluid inside the uterus.[5] However, if expectant management is desired, maternal hydration can increase the AFI. Oral or IV maternal hydration has been studied as a treatment for oligohydramnios in women with otherwise healthy term pregnancies.[5] In the second trimester of pregnancy, the majority of the amniotic fluid is produced through fetal urine production and is reabsorbed through fetal swallowing. Amniotic fluid is also reabsorbed via the fetal lungs and by the placenta.[15,16] Maternal hydration and maternal osmolarity affect the amount of amniotic fluid available to the fetus for urine production and reabsorption near term.[15,17] In a systematic review, Hofmeyr[5] found that amniotic fluid volume is increased in women who have reduced or normal AFI and who drank 2 liters of water or who received IV hypotonic hydration; isotonic IV hydration had no measurable effect.[5] The amniotic fluid volume, assessed 6 hours later, was shown to increase by an average effect size of 2.01 (95% CI, 1.43-2.60) with oral hydration, and 2.3 (95% CI, 1.36-3.24) with a hypotonic IV solution. While no clinically important outcomes were assessed in any of these trials, hydration is a simple, inexpensive, and noninvasive method that may apply to clinical situations. Leeman and Almond[3] reported an increase of 30% in the AFI in women who consumed 2 liters of water 2 to 5 hours before repeat ultrasound, compared to women who were not orally hydrated. They recommend that maternal hydration should be considered before retesting the AFI 2 to 6 hours later, in cases of isolated oligohydramnios.<br /><br /><br /><br />9. "Stripping Membranes is perfectly harmless."<br /><br />* During a membrane sweep, the care provider inserts his/her fingers into the cervix, hooks the finger in between the cervix and the amniotic sac ( if even possible...most women that request this aren't barely a fingertip dilated ), and sweeps all around in between the two. On top of being EXTREMELY uncomfortable, and often painful, this does NOT guarantee induction of labor. This poses the risk of infection, because the care provider is pushing vaginal bacteria up INTO the cervix, and in between the cervix and sac. There is also the added risk of weakening the lining of the amniotic sac, causing the waters to break prematurely. If *this* happens, which is not uncommon, then you're on the clock. Your body wasn't naturally ready for labor, so it'll probably take the longer of the scenarios described a few paragraphs above regarding the time limit on water breaking...and your care provider usually WILL be quicker to add intervention. After all, it *started* with intervention. ; )<br /><br />10. "I pushed for hours and my baby would not come out. I NEEDED a c-section."<br /><br />* Unfortunately, Cephalopelvic Disproportion ( CPD ) is widely misdiagnosed. According to the American College of Nurse Midwives( for those of you who believe that you don't count as a midwife unless you're a CNM ), CPD occurs in only 1 out of 250 pregnancies. If you have been diagnosed with CPD, this does not automatically mean that you will have this problem in future deliveries. According to a study published by the American Journal of Public Health, over 65 % of women who had been diagnosed with CPD in previous pregnancies, were able to deliver vaginally in subsequent pregnancies. And as seen in many, many women on the ICAN list...often go on to deliver *LARGER* babies than the baby that was sectioned out of them for "CPD". ; ) ( A beautiful montage from the women of ICAN...although not scientific I know. ) But with an epidural rate of as high as 85-95% in some hospitals...you're not often going to see a woman be able to get up and get into a good squat, or into the hands and knees position. Some with a "Walking Epidural", but not the average woman with an epidural.<br /><br />Another issue brought up ( Thank you Heather! ) is a malposition in the baby. This isn't often talked about when you're under the care of an OB, because unfortunately palpation seems to be a lost art. I ask women ALL THE TIME who are under the care of an OB, what position their baby is in. They say "Head down". I ask if they know which way the baby is facing, etc...and they say no and look at me like I've got two heads. Malposition can be a HUGE factor in a woman unable to push her baby out. Malpositions are usually more common with induced labors - especially when AROM is involved, and labor where mom is in bed with an epidural instead of up and moving around. I think that Optimal Fetal Positioning ( OFP ) should be a part of EVERY pregnant woman's education prenatally. There are women who have done everything "right" ( IMO, and the opinion of many midwives ) - made sure that their diet was nutritious, planned a natural birth with minimal to none intervention, avoided drugs, stayed mobile, pushed with the urge....and STILL ended up pushing for hours and ending in a cesarean. Malposition can play a serious role in a cesarean becoming necessary, but is often simply labeled "CPD".<br /><br />A wonderful site to learn about OFP is Spinning Babies.<br /><br />There are so many, many other myths that can and should be dispelled. So many women believe what they are told, instead of doing the research for themselves. If you'd like to learn more about Obstetrical myths, there is an EXCELLENT book by Henci Goer. "Obstetrical Myths Versus Research Realities". Every myth dispelled is referenced by medical study. These are not opinions, they are backed my medical research. Maybe sometime soon I will add to this list. : )Unknownnoreply@blogger.com4tag:blogger.com,1999:blog-4386369536975942935.post-57335640344061755602009-12-30T13:54:00.001-08:002009-12-30T13:55:37.641-08:00Incentives for Cesarean Delivery?!My stomach just lurched. Did you hear it? Some people tend to believe that my remarks about hospitals and doctors pushing cesareans are either paranoid or blatantly wrong. I ask you - if a hospital *wasn't* trying to make money off of this, why would they offer an open house with refreshments and door prizes?<br /><br />It makes me absolutely ill to think of major abdominal surgery being talked about with such levity. "The one place where getting a 'C' is never average." ( Can't you just hear the airy laugh to go with that statement? )<br /><br />This is a hospital in Ogden, touting it's newly opened Cesarean Wing. Aren't hospitals supposed to be making effort to REDUCE the number of cesareans performed? And I can assure you that they wouldn't have an open house complete with snacks and prizes if they were ONLY targeting the high risk women who NEED a cesarean to save the lives of their babies. That would be too small a number to open up a new wing in the hospital.<br /><br />Where is their birth center wing, complete with birthing tubs, birth balls, and birth stools? Ah, but there isn't any money in drug-free, intervention-free birth. It's all about the surgery. The cesarean wing is complete with nice shiny flat screen TVs as well. Too bad mom will likely be in a drug haze and won't get to experience her "soothing, homelike ambiance" with said flat screen TV. :shrug: And don't forget to mention the state-of-the-art NICU that the cesarean babies will need, since we know that the majority of cesarean babies end up in the NICU for one reason or another. Coincidence? I don't think so.<br /><br />Here is the ad for the open house:<br /><br />New C-Section Wing Open House. You're Invited Dec. 18, 2-5 P.M.<br />The One Place Where Getting a `C' Is Never Average<br />The first of its kind in Utah, a dedicated hospital wing for C-section<br />births at Ogden Regional Medical Center in Weber County. Please make plans<br />to join us for light refreshments, tours, prizes and more, as we unveil the<br />beautiful Cesarean Suites at the Family Birth Place that feature:<br /><br />- Eight, brand new, special C-Section/postpartum suites<br />- Single-room maternity care<br />- Newborn / Transitional nursery<br />- An attentive staff, specialized in caring for surgical patients<br />- Larger-than-normal hospital rooms (about 1 ½ times bigger)<br />- A soothing, homelike ambiance with a very nice bed, flat screen TV,<br />Wi-Fi access, chair sleeper, and more<br />- Fully equipped rooms to handle any emergency for mother or baby<br />- Ronald McDonald Family Room<br /><br />Call for more information at 801-479-2546.<br />*http://www.ogdenregional.com/our-services/service-detail.dot?id=38273*<br /><br />Disgusted yet? Outraged yet?<br /><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6VvUoZqfER4_Ch5Y2xS8WWY5xy9ti2yER7krGr5vY334bh9RiB3bJSaX6jt4eNiiZx8bQrtnpxLNjhF9x9TLCi-JCYBPegzcKP0LI0XNxaJ35oIZU4doPXnO5D15ZfQXZmwqSfrlsPXU/s1600-h/cesarean.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6VvUoZqfER4_Ch5Y2xS8WWY5xy9ti2yER7krGr5vY334bh9RiB3bJSaX6jt4eNiiZx8bQrtnpxLNjhF9x9TLCi-JCYBPegzcKP0LI0XNxaJ35oIZU4doPXnO5D15ZfQXZmwqSfrlsPXU/s320/cesarean.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5421151162052130898" /></a>Unknownnoreply@blogger.com17tag:blogger.com,1999:blog-4386369536975942935.post-74340638267999922552009-11-16T09:33:00.000-08:002009-11-16T09:34:57.727-08:00My Baby's Birthday, and My HBAC AnniversaryFour years ago today, I gave birth to my youngest child Megan. It was a triumph on multiple levels, as I had a cesarean with my second child, and was told that I would surely kill Megan or die myself if I "attempted" a VBAC. You see, I am prone to having larger babies ( those of you who have met my husband understand, lol ), I was closed with a single layer of suturing instead of double after the cesarean, *and* I got pregnant with her less than a year after my cesarean. I was told that all of these lined up would mean certain uterine rupture. The OBs who had agreed to "let me try", all gave me a gestation limit of 40 weeks. They all said that it would be an automatic repeat cesarean if I got to that point with no signs of labor in sight. And if she was looking to be "too big", it would be an automatic repeat cesarean. Basically, if I looked at them funny it would be an automatic repeat cesarean. It took some women from ICAN ( International Cesarean Awareness Network ) to challenge by beliefs about childbirth, for me to even look in a different direction.<br /><br />Like most people, I believed that doctors know best. After all, they go to medical school for years and years, and HAVE to know all there is to know. It took me a while to learn that Obstetricians are NOT trained in natural birth. Most go through their entire residency without seeing a single truly natural birth, with the exception of the mom who walks in ready to push ... and even then everyone freaks out. Obstetricians subscribe to the belief that childbirth is a pathology, not physiology. Now, there are certainly exceptions to the rule ... just as not everyone home birth Midwife is trusting of the birth process, or best for mom and baby. But it took me from the beginning of my pregnancy, until 33 weeks, of research to come to this epiphany.<br /><br />If there is one thing that I can tell women who have had a cesarean, and were told that either their body failed them ( pelvis is too small, labor was too long, cervix didn't open enough, body got too tired ), or their baby failed them ( baby too big, baby didn't come soon enough ) ... is to research their butt off. Because it is so much easier for a care provider to tell a woman that her body didn't work right, rather than to admit that baby and body just weren't ready, or that he/she ( the care provider ) unnecessarily intervened in the process, causing it to spiral into the operating room.<br /><br />At 33 weeks I started calling Midwives. I was turned down by many. I was starting to lose hope of giving my daughter a better birth, because I knew it wasn't going to happen in the hospital. I was down to one last name ... and thankfully, God had us matched perfectly. Brenda is an amazing Midwife who serves women who need it the most, especially when many others would turn them away. Without her, not only would I not have given Megan a better birth, but I also wouldn't be the Midwife I am today.<br /><br />I will premise my birth story by saying that four years ago, I wasn't where I am now in my beliefs about birth. There are certainly a few things that I would do differently. I do NOT advocate castor oil inductions by any means. Nor do I advocate artificial rupture of membranes. At the time, having my midwife break my water was a blessing. I was starting to pass out. But in my own practice, I have not yet found a valid reason to break the bag of waters ... leaving things to occur naturally in their own timing.<br /><br />Now, without further ado, Megan's birth story. My triumphant ( and HARD! ) HBAC.<br /><br />Megan Ohana Fiscer<br />November 16, 2005<br />10 lbs 10 ozs, 23" long<br /><br /><br /><br />I had been doing the yucky prodromal labor think for what felt like forever. I had almost 6 weeks of contractions that would get so regular and start getting more intense, that I was sure it was "it" a few times. Even had my poor midwife drive out here in the middle of the night which ended up being for nothing. I had regular contractions all through the night on the 10th and called Brenda at about 4am. She came and when she checked me at 8:30 or so, I was a mere 2cm and not effaced much. Megan was also floating high still. I was crushed. Jeramy had the day off and since his grandmother had come up to help with the kids, we decided to go walking that evening to see if it would help anything. I had horrible pressure on my cervix and ended up passing some bloody show. Nothing more though.<br /><br />The pressure on my cervix changed to a stabbing pain anytime I was doing anything other than sitting, so on Monday the 14th we decided to go walk around a shopping center that is a mile around. The pain was awful, but I wasn't having any contractions at all. I asked Jeramy to stay home on Tuesday because of the pain, and to help around the house. That evening I decided to call Brenda to see if we could try castor oil in the morning. ( Added note: At the point of Megan’s birth, I wasn’t at the point where I really believed that birth was best left alone … I still had a LOT to learn! ) The pain was really awful, and I was having an incredibly hard time getting around after my kids and doing much of anything. I was also a week past my due date and more than a little miserable ( I know, bad reason to try castor oil...but I felt I couldn't take it anymore ).<br /><br />Right after I got the go ahead from her for the cocktail in the morning, I used the restroom and had at least 3 tissues full of mucous. I called her back to give her the heads up, as I went into labor the same night I passed mucous like that with Noah. I decided to go to Walmart to get some laundry detergent and some needed things and then came home and took a shower. I had been having very small contractions on and off all day, but not much of anything. After the shower, I began having really strong contractions all of a sudden. I went in to lay down to see if they were staying...and they only got stronger. Stronger to the point where when Jeramy checked on me I was in tears. I said it was time to call Brenda. He wanted me to make sure it was really time so she didn't come out again for nothing. I assured him it was! Jeramy filled up the tub, which I went back and forth from because I kept getting too warm. She got here at about 1 or so...and by that time I had already told Jeramy I wasn't sure I could do it. The contractions were very intense and I couldn't imagine it just getting worse. I was also afraid of how far I had progressed...not wanting to hear 3cm or so. When Brenda checked me I was happy to find myself at 5, and she could actually stretch me to 6cm. I tried getting back into the tub, but only ended up getting too hot again. I decided to go lie down in bed to try to cope with everything. I did okay for a while, until things got REALLY intense, at which point I would lose it when a contraction peaked and start shaking my head hard saying I couldn't do it. Brenda was amazing in helping me relax through some of them, reminding me to relax my entire body and even asked if she could pray over me...which I welcomed gladly. Back labor was awful, and my poor husband tried applying counter pressure when I almost felt like I jumped out of my skin...it didn't feel good at all, it only intensified things. I got up and labored on the toilet for a bit which felt good for a while, but then let out a grunt when it felt good to bear down. This alarmed Brenda, and she and Jeramy got the bed prepared. They got the shower liner under the sheet and the chux pads out on the bed. She decided to check me again to see if I was complete, but I was only at 7-8cm. The pressure was awful and I felt like I was having one big contraction and was starting to feel like I was going to pass out, instead of breaks in between. After lots of discussion, we decided to go ahead and break my water, and that helped TREMENDOUSLY. I was able to relax and sleep in between contractions somehow. By this point I had gotten REALLY vocal and was having a hard time relaxing during contractions at all. I started feeling pushy again, and when checked I was complete with just a little lip. Brenda said if I was feeling the urge to push, she could help move the lip out of the way. I began pushing and that became an exhausting experience. When I would push, burning pain would radiate through my hips. It felt amazing once I was really pushing effectively, but at the beginning of each push it hurt horribly. I was really becoming exhausted, and Brenda had me change to a side-lying position to push which seemed to be helping, but still not as effective. She suggested the toilet again, but I didn't think I could get up to it. So I rolled over and got on hands and knees and tried that way. Now I was REALLY screaming that I couldn't do it...I was too tired. Jeramy and Brenda kept reassuring me that I could, but I really needed to push. I was the only one that could get her out, and I needed to do it now. I ended up pushing more in a sitting/squatting position and even bit poor Jeramy's hand during one big push. Megan started crowning and I had never felt a burning sensation like that in my life. I was sure everything was going to split wide open. I remember the feeling of Brenda stretching me to keep me from tearing, hurting pretty badly as well. But getting her head out was the hardest. Brenda kept telling me I needed to push through the burning and get her out now, as she had been in that spot for a while and her head was kind of stuck behind my pubic bone. Megan was also going back up in between pushes because I couldn't hold it. So I pushed through the burning and felt her head come out, and then very quickly the rest of her slid right out. It was an amazing feeling.<br /><br />I relaxed my entire body, still in that squatting position, onto the pillows in front of me. My hair was soaked with sweat and I was exhausted beyond belief, and also incredibly relieved that she was out. I smiled up at my husband and told him that I could feel her kicking against my thighs. They had me roll over, and Jeramy got to hand her to me, but had to be careful since the cord was short. She was beautiful. The first thing I noticed was how long her fingers were. She was so calm and alert. Jeramy was beaming and told me I did it and how proud he was of me. We waited for the cord to stop pulsating and then Brenda clamped and Jeramy cut. I spent some time admiring her, and then Jeramy took Megan out to the livingroom to meet her brother and sister and great grandma so that I could deliver the placenta. It wasn't hard at all, I just pushed and it came out easily. That also felt really good to get out. I was still burning quite a bit, but was laying back and relaxing knowing that the hard work was done.<br /><br />Jeramy came back in with Megan, and I latched her on to nurse. She latched on immediately and did so very well. I asked if we could weigh her and get measurements...I was so anxious to see! When Megan was born, Brenda said she thought she was a good 8 1/2-9 lbs. Well, Jeramy was the one to weigh her, and he got wide eyed and asked Brenda if what he was seeing was correct. She looked at the scale and got the same look on her face! He then announced 10 lbs 10 ounces and I couldn't believe it. Furthermore, I couldn't believe when Brenda measured her and she was 23 inches long. I knew my belly had been huge, but never imagined she'd come near to 11 pounds. Jeramy went out and announced it to his grandma, who couldn't believe it either.<br /><br />Brenda checked me for tears, and said it looked like I had one up towards my labia, and then one on my perenium and she could sew me up after I got cleaned up and showered. I tried twice to get up and shower, but while sitting on the toilet I almost passed out after the burning from peeing. So I was sent back to bed until I could get some fluids in and some toast. When I did take a quick shower and get back into bed a few hours after Megan was born, Brenda checked me to find that by me laying with legs together for so long, I was already starting to heal naturally. She had to really look for the tear she found before on my perenium, and she said there were only a few slits up towards my labia from the skin stretching, and those would heal on their own. As for the perenium, she numbed me, which didn't take too well...and I cried through the single stitch she put in. She said one would be enough along with me keeping my legs closed for a while. I was relieved not to have to endure another stitch. She gave me my instructions and a big hug and kiss and left us to our new family.<br /><br />Recovery has been amazingly fast in comparison to both my previous vaginal birth, and the cesarean. It's amazing how things work perfectly when done naturally. My system didn't have to get over any drugs being pumped into me, or soreness from an episiotomy and stitches. Compared to a lot of homebirth stories I have read, I didn't feel mine went as smoothly, and I definitely didn't cry out that I would do it again after all was said and done...but it WAS beautiful. It was beautiful that my baby was handled gently at birth, not rubbed down and tagged with plastic and handed from one unfamiliar hand to another. She was treated peacefully and gently, and for that alone I would go through the pain all over again.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJ6pONg4fh4IzQ4WrtWX5hlDU_APP28d3IcPbhB_z1R3QaT9KYP0nVUDdV95-Nsg5wq7WavDJmzCCDX90GYC8YrNrb30yNDMtlzer_2slYao3jpuKlq4YXbpdxJtbL2LABzvsTgMUUsN8/s1600/MegansBirth.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 230px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJ6pONg4fh4IzQ4WrtWX5hlDU_APP28d3IcPbhB_z1R3QaT9KYP0nVUDdV95-Nsg5wq7WavDJmzCCDX90GYC8YrNrb30yNDMtlzer_2slYao3jpuKlq4YXbpdxJtbL2LABzvsTgMUUsN8/s320/MegansBirth.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5404756237387385314" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoBS5ggCEdWqppwmGg2kIsMtDbEI3gVxFrLOHhsB5cQ5_9aAFINKx8kjB6q8O_O-MKq7PMufsAJ6SrP5L9b8cCJcdVP9DaWRBHFcR5gqoVlqw6xPmRKtG0PHYfFM5JzcxYHixjfagfaSw/s1600/MeganOhana.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 219px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoBS5ggCEdWqppwmGg2kIsMtDbEI3gVxFrLOHhsB5cQ5_9aAFINKx8kjB6q8O_O-MKq7PMufsAJ6SrP5L9b8cCJcdVP9DaWRBHFcR5gqoVlqw6xPmRKtG0PHYfFM5JzcxYHixjfagfaSw/s320/MeganOhana.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5404756233500239826" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZTJcVBqWDapcGVM6Bhs8VYbk-y2nkgsuvUm8snsYXym8ctGoV6hU5M96L5XQSxGpZnThUyeNA2eKDWBCIi5ESIhAIoHtRjW4e6dOrrV8d91eQK6bWnDaB-77H9pKbyBJz5xY8c0O1Zyk/s1600/MeganInWater.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 263px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZTJcVBqWDapcGVM6Bhs8VYbk-y2nkgsuvUm8snsYXym8ctGoV6hU5M96L5XQSxGpZnThUyeNA2eKDWBCIi5ESIhAIoHtRjW4e6dOrrV8d91eQK6bWnDaB-77H9pKbyBJz5xY8c0O1Zyk/s320/MeganInWater.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5404756226755533426" /></a>Unknownnoreply@blogger.com2tag:blogger.com,1999:blog-4386369536975942935.post-5411918591983685582009-11-06T08:32:00.001-08:002009-11-06T08:44:30.673-08:00New Reason to Birth At Home : H1N1Because of the H1N1 scare, Hospitals in Southern Utah are limiting visitors to only *2* pre-designated visitors for the entire duration of a patient's stay. This means that if you have older children, they will not be allowed to visit mom, or see their new sibling until mom goes home. Other members of the family will also not be allowed to visit, unless they are one of the two people allowed when mom was admitted. <br /><br />This is from Dixie Regional Medical Center: <br /><br /><blockquote>With the emergence of H1N1 cases earlier this year infection control professionals are anticipating a busy flu season. To keep the hospital as safe as possible for patients, Dixie Regional asks that all visitors be at least 15 years old. Children ages 14 and under frequently transmit viruses. Because the risk of H1N1 is higher for pregnant women and youth, on the 400 East Campus (where<br />women’s and children’s services are based) <span style="font-weight:bold;">patients are also asked to designate two visitors for the length of their stay.</span><br />We have not seen a marked increase in flu cases yet, but believe it is wise to be proactive about potential spread of illness. Thank you for your support as we balance the desire for visitors to see loved patients with patient safety concerns. Further visitation restrictions may be implemented this fall or winter, if there is a significant increase in the number of patients being hospitalized with influenza. For more information about influenza or the most current updates on H1N1, please visit the Southwest Utah Public Health Department website: www.swuhealth.org. For more information about visitation at Dixie Regional, please call 251.2108. </blockquote><br /><br />When you birth at home, not only is the risk to baby and mom GREATLY reduced of contracting an illness ( common when visiting hospitals, after all, they *are* full of sick people! ), but mom is also allowed to have as many or as few people as she wishes to be present for her birth. Family centered birth is very important for families to grow and bond together. Don't cut your children or other loved ones out of your birth plan because of the flu season. Birth at home. :)Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-4386369536975942935.post-27059576539746759332009-10-17T12:54:00.000-07:002009-10-17T12:55:25.921-07:005 Reasons to Avoid Induction of LaborThe Risk of Inducing Labor<br /><br />By Robin Elise Weiss, LCCE, About.com<br /><br /><br />The induction of labor can be done for many reasons, including many valid medical reasons. However, the rise in the rate of social inductions, or elective inductions is on the rise. As the induction rate rises there are more babies and mothers placed at risk for certain complications. Here are five risks of induction that you may not know about:<br /><br /> 1. Increased risk of abnormal fetal heart rate, shoulder dystocia and other problems with the baby in labor.<br /> Labor induction is done by intervening in the body's natural process, typically with powerful drugs to bring on contractions or devices that are used to break the water before labor starts. Both of these types of induction can cause the baby to react in a manner that is called fetal distress as seen by fetal monitoring.<br /><br /> The nature of induction like contractions may also be more forceful than natural labor. This can cause your baby to assume or stay in an unfavorable position for labor making labor longer and more painful for the mother. It can also increase the need for other interventions as well.<br /><br /> 2. Increased risk of your baby being admitted to the neonatal intensive care unit (NICU).<br /> Babies who are born via induction have not yet sent signals to the mother to start labor. This means that they simply aren't yet ready to be born. This risk is worth it if the baby or mother's lives are in danger, but simply to take this risk for elective reasons may not be well advised.<br /><br /> When a baby is in the intensive care unit there is less ability for you to be with your baby or to hold your baby. Breastfeeding usually gets off to a rocky start as well. This can usually be avoided by giving birth when your body and baby say it is time.<br /><br /> 3. Increased risk of forceps or vacuum extraction used for birth.<br /> When labor is induced babies tend to stay in unfavorable positions, the use of epidural anesthesia is increased and therefore the need to assist the baby's birth via the use of forceps and vacuum extraction is also increased.<br /><br /> 4. Increased risk of cesarean section.<br /> Sometimes labor inductions don't take, but it's too late to send you home, the baby must be born. The most common cause of this is that the bags of waters has been broken, either naturally or via an amniotomy. Since the risk of infection is greater, your baby will need to be born via c-section.<br /><br /> A cesarean in an induced labor is also more likely for reasons of malpresentation (posterior, etc.) as well as fetal distress.<br /><br /> 5. Increased risks to the baby of prematurity and jaundice.<br /> Induction can be done before your baby is ready to be born, because your due date is off or because your baby simply needed more time in the womb to grow and mature their lungs. Your baby may also be more likely to suffer from jaundice at or near birth because of the induction. This can lead to other medical treatments as well as stays in the hospital for your baby.<br /><br /> Being born even a week or two early can result in your baby being a near term or late preterm infant. This means that your baby is likely to have more trouble breathing, eating and maintaining temperature.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-64622264947388762672009-09-29T14:09:00.000-07:002009-09-29T14:43:12.983-07:00Birth Services in Southern UtahHave you ever been curious about home birth? Have you had those "what if..." questions? <br /><br />Have you ever been curious about waterbirth? <br /><br />Have you had a cesarean, and were told you have to have another? <br /><br />A great thing to do, is to ask questions, and interview multiple care providers. I offer free initial consultations, in which you can ( and are encouraged to! ) ask any and all questions you can think of. And the great part is, there is no obligation to hire me as your Midwife. Sometimes the first step is being able to ask all of the questions you are curious about. Like, what happens if an emergency arises? <br /><br />Home Birth is a safe, healthy alternative for low risk women who want to birth on their terms and in their own environment. For reasons why home birth is safe and a great option, read the last post ( <a href="http://joyfulbirthservices.blogspot.com/2009/09/10-reasons-to-birth-at-home.html">10 Reasons to Birth at Home</a> )<br /><br />If you'd like to check out the services that I offer, you can go here: <a href="http://www.joyfulbirthservices.com">Joyful Birth Services</a><br /><br />And to schedule a free initial consultation, email me at JoyfulBirthServices@gmail.com, or call 435-216-5411Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-90458095881799571092009-09-19T10:16:00.000-07:002009-09-19T10:29:27.427-07:0010 Reasons to Birth At HomeMany people still see home birthing as weird, crazy, or even dangerous. These same people usually don't take the time to research it, and see *why* women choose to birth at home. ( Well, other than the assumed crazy, paranoid reasons )<br /><br />So, why don't we take a look at 10 simple reasons to birth at home. I could probably list 100 of them, but I'll start with 10. ;) <br /><br />10. You remain an autonomous woman throughout labor and birth. You're not treated as a sick person, you don't have to put on a hospital gown, and you're not told what to do.<br /><br />9. Your husband/partner can take breaks as needed, and he's in his own home. He doesn't have to wander the halls to look for a vending machine or a cafeteria. He can even play video games. ( The big plus to my husband )<br /><br />8. You can eat and drink as you wish. You are not restricted to ice chips, you are actually <span style="font-style:italic;">encouraged</span> to eat healthy, protein-filled snacks and meals. <br /><br />7. You don't have an IV. In a home birth, you drink as your source of hydration. There is no IV placed in your hand, and you are free from that cumbersome IV pole. <br /><br />6. There are fewer complications at home. This is from multiple studies done over multiple decades. At home, fewer ( next to zero ) episiotomies are done. In the hospital, some have a nearly 80% episiotomy rate. At home, fewer babies need help breathing at birth ( 17 times LOWER risk at home ). At home, shoulder dystocia is less likely, even for those HUGE babies. ( even though the HUGE babies are not the ones at more risk for this, despite the myths ) At home, fewer moms hemorrhage. At home, fewer moms tear. <br /><br />5. There is never a risk of mixing up babies. There is only one brand new baby at home ( well, 2 if twins ), and you know he's yours. <br /><br />4. There is never a risk of mixing up medications. There <span style="font-style:italic;">are</span> no medications, but even if there were there would be no possibility of getting someone else's meds, and dying. <br /><br />3. There are no drugs. Now, this may seem like a <span style="font-style:italic;">bad</span> thing to some women, but it's a <span style="font-style:italic;">good<span style="font-weight:bold;"></span></span> thing for EVERY baby. A baby born without drugs, is a healthier baby. You don't put baby at risk for drug-related conditions at birth, when there are no drugs to begin with. And without an epidural, you're not at risk for the myriad complications to both mom AND baby that come with one. <br /><br />2. As many, or as few people can be in the room with you when you birth. From children to grandparents and anyone in between. And, anyone you wish can catch the baby. It makes birth what it should be - a family event. <br /><br />1. You are giving your baby the greatest gift of all - a non-interventive, drug-free, peaceful, safe birth...and on <span style="font-style:italic;">your</span> terms, not a surgeon's. There are no birth do-overs, so why not give your baby the best birth possible?Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-37936737524439964152009-09-14T09:20:00.000-07:002009-09-14T09:22:00.481-07:00Just beautiful! Woman sings at 10cm in labor...I thought I would share this, even though it is a hospital birth. This woman has a beautiful voice, and had her nurse/doctor in tears. The video had ME in tears. <br /><br /><object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/r-eW2miJN7U&color1=0xb1b1b1&color2=0xcfcfcf&feature=player_embedded&fs=1"></param><param name="allowFullScreen" value="true"></param><param name="allowScriptAccess" value="always"></param><embed src="http://www.youtube.com/v/r-eW2miJN7U&color1=0xb1b1b1&color2=0xcfcfcf&feature=player_embedded&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" allowScriptAccess="always" width="425" height="344"></embed></object>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-43935574976257920952009-08-29T18:25:00.001-07:002009-08-29T18:25:53.467-07:00Postdates: Separating Fact from FictionWhat is one of the first things that a pregnant woman hears once she reaches 40 weeks? <br /> <br />“When will your doctor induce you?”<br /><br /><br />Is there evidence behind this practice to support the routine induction of pregnancies that go beyond 40-41 weeks? What are the usual assumptions and beliefs surrounding this? <br /><br />• There is a higher risk of the baby being born still<br />• The placenta will stop functioning<br />• There will be a decrease in amniotic fluid<br />• The baby will grow too large<br /><br />We are going to take a look at the validity of these claims and beliefs, and compare them with what the research has to say. After all, your doctor would never do anything that wasn’t in your or your baby’s best interest, correct? <br />The first things to really look at are the definitions of the two key words with the pregnancy that goes past 40 weeks. Postdates, and Postmaturity. But is it accurate to start with these terms at 40 weeks?<br /><br />• <span style="font-weight:bold;">Postdates</span> – Defined as a pregnancy that goes beyond 42 weeks, based on LMP. The problem with this is that it’s not the same for every woman. Due dates are calculated depending on LMP, but does not usually take into account a woman who has shorter or longer than 28 day cycles. The pregnancy wheel that is commonly used by doctors and midwives, is based on 28 day cycles. If you have a longer cycle, days will need to be added to your EDD ( Estimated Due Date ). This is rarely done however, and women who have longer cycles are held to the same due date estimation as women with shorter cycles. So on paper, you might be 42 weeks according to the estimated due date, when in actuality you would only be 41 weeks. A more accurate way of dating pregnancy is by solidly known conception dates. <br /><br />• <span style="font-weight:bold;">Postmaturity</span> – Postmaturity, or Postmaturity Syndrome (PMS) can only be diagnosed after delivery and is defined as a postdates pregnancy accompanied with a combination of the following newborn assessments:<br /><br />a) No lanugo ( fine body hair )<br />b) Long nails<br />c) Abundant hair on head<br />d) Calcified fetal skull<br />e) Hanging or wrinkled skin, with the appearance of weight loss<br />f) Dehydrated<br />g) Peeling skin<br /><br />Postmaturity Syndrome also only affects <span style="font-style:italic;">less than 10%</span> of pregnancies that go beyond 43 weeks. The vast majority of pregnant women do not go beyond 42 weeks with correct dates. Some studies show that less than 3% of women go beyond 43 weeks. So if the risk of postmaturity is less than 10% of pregnancies that go beyond 43 weeks, and the percentage of women who go beyond 43 weeks is less than 3% - how big of a risk is it really? <br /><br />The problem with assessing risk for postmaturity is that modern Obstetrics, and even modern Midwifery, tends to treat all women as equal in pregnancy. Seldom is personal or familial gestation history taken into account, or abnormal cycle and ovulation schedules. These things are important to consider! How healthy would a midwife’s policy of inducing at 41 weeks , be for a woman who has a personal or familial history of going to 44 weeks? We are talking about potentially trying to induce a baby who will be 3 weeks “early” according to their own biological gestation clock. And if the induction “fails”? It will likely result in stress for both mother and baby and lead to more invasive intervention, and possibly a cesarean. <br /><br />The condition of a baby and placenta all depends on the health and personal history of the mother, as well as the health of the baby – at any gestation. A placenta does not begin to deteriorate automatically beyond 42 or 43 weeks. A placenta can begin to deteriorate at 36 weeks, once again, depending on the health and over all well being of the mother and baby. I have often heard the fear in women of “placental deterioration” after 40 weeks. But as it has been seen, this has nearly nothing to do with length of gestation, as much as it has to do with overall health and maturity of the individual pregnancy and baby. I personally have seen a baby born at 43 weeks, solid dates, absolutely covered in vernix and attached to a very healthy placenta. In contrast, I attended the birth of a 37 week baby who had dry, wrinkly skin, and a calcified and very old looking placenta. <br /><br />Other important factors include unhealthy habits and complications such as: <br /><br />• Smoking<br />• Alcohol<br />• Drugs<br />• Diabetes ( Mellitus, NOT Gestational )<br />• Hypertension<br /><span style="font-weight:bold;"><br />When did 40 weeks become the magical number?</span><br /><br />The interesting part in the discussion of postdates, postmaturity, and all that it involves, is the thought that 40 weeks is some sort of magical number. In the past, there was a general “due month”. Women were given an estimation of when they would deliver, based on the known fact that normal gestation is anywhere from 37 to 42 weeks. So when did 40 weeks become this magical number that women fret over and worry once they go beyond it? It has always been that 40 weeks is the general time frame when babies were “due”. But it wasn’t until a study by McClure-Brown came out with date collected from 1958, that showed the perinatal mortality rate doubled from 40 weeks to 42 weeks – from 10/1000 to 20/1000. So it might be logical to assume that inducing labor before 42 weeks would cut back the risk of stillbirth, correct? <br />The problem is, this study is inaccurate and too old to continue to be of use. Modern obstetrics contradicts the findings in the study published in 1963. And yet, the findings continue to be cited. If we accepted the outcomes in the McClure study, we would also have to accept a 10/1000 mortality rate at 40 weeks! And we know that is not correct. We know that in the 1950s, the majority of women were put under general anesthesia, or twilight sleep, and forceps were commonly used. <br />Modern Obstetric research actually shows there to be not much of a difference in perinatal mortality rates between 38 and 42 weeks, with a decline in between. <br />An identically set-up chart to the 1963 study, published in 1982 ( Williams, Creasy ) reads: <br /><br />• 7/1000 at 38 weeks<br />• 6/1000 at 40 weeks<br />• 8/1000 at 41 weeks<br />• 9/1000 at 42 weeks<br />• 10/1000 at 43 weeks<br />• 11/1000 at 44 weeks<br /><br />A graph from 1987 statistics ( Eden, Sefert ) shows: <br /><br />• 6/1000 at 38 weeks<br />• 2/1000 at 40 weeks<br />• 2.3/1000 at 41 weeks<br />• 3/1000 at 42 weeks<br />• 4/1000 at 43 weeks<br />• 7/1000 at 44 weeks<br /><br />So according to the second set of statistics gathered above, women were at higher risk of stillbirth at 38 weeks, than they were at 42. Interesting! In the first set, there was only a steady increase, resulting in a very small risk increase. Is the slightly increased risk worth the myriad risks that come with labor induction? <br /><br />A large study done by Weinstein, et al. , compared nearly 1,800 reliably dated post-term pregnancies with a matched group of on-time deliveries ( between 37 and 41 weeks ). The outcomes were surprising. Perinatal mortality was similar in both groups ( 0.56 / 1000 in the post-term and 0.75 / 1000 in the on-time group ). The rates of meconium, shoulder dystocia, and cesarean were almost identical. <span style="font-style:italic;">What was most interesting, however, was that the rates of fetal distress, instrumental delivery and low Apgar scores were actually lower in the post-term group than in the on-time group. </span><br /><br /><br /><span style="font-weight:bold;"><br />What about the Amniotic Fluid?</span><br /><br />There is a flawed belief that the amniotic fluid will somehow begin to “run out” beyond 40 weeks. There is a belief that women will have a “dry” birth. Let’s start with some basics. <br />What is amniotic fluid? <br /><br />• Beyond 36 weeks, amniotic fluid is comprised of mostly fetal urine. When the baby’s kidneys are functioning properly, the baby will continuously produce and process amniotic fluid. The fluid is swallowed by the baby, and then urinated out, once processed by the kidneys. <br /><br />As long as the mother is adequately hydrated, and there are no congenital abnormalities in the baby, the baby will continue to create amniotic fluid until birth. Whether this be at 37 weeks, or 44. If decreased amniotic fluid is suspected through palpation, an ultrasound can be done to measure the volume found. However, this is not an exact science, as the volume found can – and usually will – vary from ultrasound technician to ultrasound technician, and can also sometimes be dependent on baby’s position. If the levels are found to be on the low side, evidence based protocols suggest having mom orally re-hydrate and return within 24 hours for another AFI ( Amniotic Fluid Index ), preferably by a different technician. This has shown repeatedly to have improved outcomes, versus immediate induction for low AFI levels. <br />A study published in the Journal of Reproductive Medicine found a significant increase in amniotic fluid after maternal oral rehydration, as well as intravenous hydration, with neither one better than the other. In all, 62.5% and 44.0% demonstrated improved AFI levels. <br /><br /><span style="font-weight:bold;">What if the baby grows too large?</span><br /><br />First, who defines “too large”? What is “too large” for one woman, might be the next woman’s smallest baby size. The most important thing to remember is that there is no fool proof way of knowing whether or not your body can naturally birth a baby of whatever size, until you have tried. Ultrasound has a 20% error rate in either direction, and many women have allowed an induction after being told that their baby would be nearly 10 pounds, only to give birth to an 8 pound baby. And, there is no reason for a woman to doubt her ability to birth a 10 pound baby unless she tries. I, for one, never would have believed that I could have birthed my nearly 11 pound baby, especially because I was told that I could not safely birth my 8 ½ pound baby that I was scared into a cesarean with. You never know until you give it a full chance. <br />Women are often told that a baby will gain approximately a ½ pound per week in the end of pregnancy. However, this is simply an approximation. Once again, this is NOT the same for every woman, or for every baby. <br /><br />According to a fetal growth rate chart comprised by four studies , a baby will only put on approximately 0.56 pounds – that’s just over half of a pound – between 40 weeks and 43 weeks. And since we’ve shown that most women go into labor before 43 weeks, it can be assumed that it is even less than that. Babies hit a plateau with weight gain around 40 weeks. So really, is there a huge concern to be had over a baby being birthable at 40 weeks, but not at 42 if we’re talking about less than half of a pound? And, does less than half of a pound change the shoulder width or head size of a baby? Hardly. It may give baby chubbier cheeks, or chubbier buns, but will not change the overall structure of the baby, making baby automatically “too large” to birth between those two weeks. <br /><br /><span style="font-weight:bold;">When Should Monitoring a “Post Dates” Pregnancy Begin? </span><br /><br />This may be different for each individual pregnancy, each individual woman, which makes cookie cutter policies surrounding post dates, arbitrary. To begin, we have now shown that according to research, doctors, and all basic “rules” that a pregnancy is not even considered postdates until after 42 weeks. Not 40. So if the pregnancy is not postdates until 40 weeks, why do doctors often begin Non-Stress Tests ( NSTs ), Biophysical Profiles ( BPPs ), and Amniotic Fluid Index ( AFI ) at 40 weeks? It goes back to the very flawed study from 1963. <br /><br />It is up to each individual woman to decide if she is comfortable waiting on monitoring, but if a woman understands that there is virtually no risk difference from 38 weeks to 42 weeks, it should clarify that testing before 42 weeks is mainly unnecessary unless other pregnancy complications are present (i.e. Hypertension, Diabetes Mellitus, IUGR suspicion, Congenital Abnormalities ). <br /><br />So, let’s take a look at what type of monitoring is available, and how effective they are in finding possible problems. <br /><br />• <span style="font-weight:bold;">Biophysical Profile ( BPP )</span> – A BPP checks fetal body tone, fetal movement, amniotic fluid volume, and fetal “breathing” practices. Each of these are given a score, and then it is added up to give an overall score. A high score of 8-10 usually shows a baby in good health, while a baby who scores 0-4 indicates a baby who needs to be more closely monitored, or needs to be outside of the womb. Scores in between will usually come with more monitoring, including another BPP within 24 hours. <br /><br />According to Enkin et al., in A Guide to Effective Care in Pregnancy: <br />There is some evidence that these tests can detect pregnancies in which there is 'something wrong,' <span style="font-style:italic;">but less evidence that their use improves outcome</span>, or can eliminate the additional risk of post-term pregnancy. The only controlled trial shows no advantages of complex fetal monitoring with computerized cardiotocography, amniotic fluid index, assessment of fetal breathing tone, and gross body movements over simple monitoring with standard cardiotocography and ultrasound measurement using maximum amniotic fluid pool depth.<br /><br />So as you can see, even the detailed testing may not prevent issues that may arise. <br />According to several studies that researched the accuracy of the BPP, the false positive rates were quite high, resulting in unnecessary induction or further monitoring. <br /><br />One in particular showed a 21.3% false positive rate for the BPP, and a 39.3% false positive rate for the Non-Stress Test ( NST ). More studies have shown much higher false positive rates for the Non-Stress Test, which is the most common for women who go beyond 40 weeks in care under an Obstetrician.<br /><br />• <span style="font-weight:bold;">Amniotic Fluid Index ( AFI )</span> – An AFI is basically a mini Biophysical Profile. It measures the maximum amniotic fluid pool depth in the uterus. However, as was shown in the beginning of this article, the AFI in a pregnancy can be contingent on several factors. Being dehydrated can lessen the AFI found. The baby’s position can affect how much amniotic fluid is seen. The skill of an ultrasonographer can make a difference in the AFI level found. <br />It was also shown that AFI levels can be improved with maternal oral rehydration. Often in modern obstetrics, this protocol is ignored, and induction is recommended very much against proven evidence. <br /><br />•<span style="font-weight:bold;"> Non-Stress Test ( NST )</span> – The NST is the most commonly used test with women who go beyond 40/41 weeks pregnant, under the average Obstetric care. An NST is electronic fetal monitoring for contractions, fetal heart rate variability, and overall heart rate strength. If a baby is found to be sleeping, stimulation is often used in the form of vibration, a cold drink with sugar ( such as orange juice or soda ), or palpation stimulation. <br /><br />The NST comes with the highest false positive rates of all of the tests, which is why it has become a controversial test amongst some groups. <br />Studies have been done that conclude anywhere from a 50%-75% false positive rate on average, sometimes reaching as high as 80-90%. False positives will lead to more testing, more stress, and possibly unnecessary intervention in the pregnancy. <br />Conclusion <br /><br />Facts: <br />• A pregnancy is NOT “Postdates” until after 42 weeks. <br />• The risk of stillbirth is nearly a flat line between 38 weeks and 43.<br />• Amniotic fluid is dependent on maternal hydration, in the absence of congenital abnormalities.<br />• A baby’s weight virtually plateaus after 40 weeks. <br /><br />Some things to think about :<br />• If I am not “overdue” until after 42 weeks, should I allow testing or intervention before this point? <br />• If NSTs come with very high false-positive rates, is it a test worth submitting to? <br />• If my baby will not put on much weight within a 3 week period, is it logical to worry about my baby being “too large” within a probable 2 week period? <br /><br />Please, please always do your own research. Question what you are told - and go study the subject – regardless of whether your OB, Midwife, Family Member, or Friends are the ones giving you the information. Make informed decisions, and take charge of your prenatal care! <br /><br /><br />_______________________________________________________________________________________<br /><br /> McClure-Browne, J.C. 1963. Comparison of perinatal mortality rates versus gestational age through the past three decades. Postmaturity, Am J Obstet Gynecol 85: 573–82.<br /> Journal of Fetal Medicine 1996 Sep-Oct. 5(5): 293-97. Expectant Management of Post-Term Patients: Observations and Outcome. Weinstein D. et al. <br /> Journal of Reproductive Medicine 2000 volume 4 pp 337-340. Effect of Oral and intravenous hydration on oligohydramnios. CHANDRA P. C.; SCHIAVELLO H. J. ; LEWANDOWSKI M. A. ;<br /> (1)Doublet PM, Benson CB, Nadel AS, et al: "Improved birth weight table for neonates developed from gestations dated by early ultrasonography." Journal of Ultrasound Medicine. 16:241, 1997.<br />(2)Hadlock FP, Shah YP, Kanon DJ, et al. "Fetal crown rump length: Reevaluation of relation to menstrual age with high resolution real-time US Radiology." 182:501, 1992.<br />(3)Usher R, McLean F. "Intrauterine growth of live-born Caucasian infants at sea level: Standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation." Pediatrics. v.74, 1969.<br />(4)Wigglesworth JS. Perinatal Pathology, Second Edition. W.B. Saunders Company. 1996. page 24.<br /> Hassan S. Kamel, Ahmed M. Makhlouf, Alaaeldin A. Youssef. Gynecol Obstet Invest 1999; 47: 223-228<br /> Evertson LR, Gauuthier RJ, Schifrin BS, et al., Antepartum fetal heart rate testing. I. Evolution of the non-stress test. Am J Obstet Gynecol 1979;133:29-33<br /> Miller, David A MD; Rabello, Yolanda A MSEd; Paul, Richard H. MD. Americal Journal of Obstet and Gynec. 174(3):812-817, March 1996.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4386369536975942935.post-31673878118028083452009-08-29T17:49:00.000-07:002009-08-29T17:50:27.785-07:00Welcome to Joyful Birth Services Blog!Thanks for stopping by! This is going to be my spot for birth news, studies, birth stories, and event notices.<br /><br />If you got here from my Midwifery website, welcome! If you don’t know anything about that, go visit www.joyfulbirthservices.com. I am a Traditional Midwife, new to Southern Utah. I am passionate about giving babies a safe, gentle, and peaceful birth. This does not often happen in the hospital. And so many moms will say “I will see how this birth goes, and then if all is well, have my next at home. ” Unfortunately, you will only have THIS baby once. There are no birth do-overs. Doesn’t *every* baby deserve a peaceful birth?<br /><br />I hope you enjoy this blog … I will be updating the look of it as soon as I can find the template I had picked out for it. Keep an eye out for news, new studies, and event notices!<br /><br />Please email if you ever have any question about me or the services that I provide. joyfulbirthservices@gmail.com<br /><br />Happy browsing!Unknownnoreply@blogger.com0