Empowering Birth Blog

Great Footling Breech Video

Check out this great video: http://www.homebirth.net.au/2008/04/breech-birth.html.  A great example of hands off the breech.

36 Weeks Pregnant!

Just a quick post to stay I am still here and baby is still inside.  With the upcoming move I barely have a moment to check my email let alone blog.  I am very big and tired but still feeling good.  We shot the virtual tour of my house yesterday, a big load off my plate.  It isn't easy putting a house in immaculate order with two little ones running around! 
Other news...my friend who is a photographer will be photographing the birth so stay tuned for some neat birth pictures.  I have also invited the three wonderful women I apprentice with to the birth.  A bit of a crowd you might say but they don't have to be in the same room with me, and I am not sure if they will all be here since they are all doulas and might be at a birth.  I feel so lucky to be apprenticing with such strong, compassionate, supportive women.  I am looking forward to becoming a midwife with them.
On the apprentice note, I am still attending prenatals with my midwife.  Next week will probably be my last week as I will be 37 weeks and ready to take the last few weeks to relax and nest.

Dutch System of Midwifery Care Works

A new study1 looks at the process of midwifery-led delivery in the Dutch system.   Midwives make either no referral, referral (to an obstetrician) with urgency, or referrals without urgency once a woman is in labor.  The study, which examined 280,000 cases found that the midwifery-led referral system resulted in a small number of urgent referrals (3.6%) and satisfactory neonatal outcomes.  There were fewer referrals among women planning a home (rather then hospital) birth.

1MP Amelink-Verburg, SP Verloove-Vanhorick, RMA Hakkenberg, IME Veldhuijzen, J Bennebroek Gravenhorst, SE Buitendijk (2008) Evaluation of 280 000 cases in Dutch midwifery practices: a descriptive study, BJOG: An International Journal of Obstetrics and Gynaecology 115 (5) , 570–578     doi:10.1111/j.1471-0528.2007.01580.

The Birth Survey

Wouldn't it be great if we could get the inside scoop on birth attendants and their intervention rates etc.?  As a doula, I belong to a listserv and we discuss experiences with doctors but we have no hard data.  For example, we might ask, has anyone had a successful VBAC with doctor x?  We all know that certain hospitals must have high cesarean rates because the moms we attend there tend to have cesareans for questionable reasons, but again, no hard facts.  There is a project out there that aims to collect better information from practitioners so that women will truly have more choice when deciding where and with whom to birth.  Here are the goals of the project as found on their site, The Birth Survey.

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

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

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

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

It is hard to have an empowered birth if you can't get good information!

                    

My Birth Kit is here!

I had my 33 week appointment last week and received my list of supplies.  Many of the supplies are things that you can easily find at Target or borrow from a friend.  At the top of the list is the 1-800 number to call to order your birth kit.  The birth kit includes the supplies for the midwife plus a few things (like one of those cold pads for after the birth) for mom. The kit is here so as soon as I pass the 35 week mark, I am cleared for a home birth, yippee!

Some Babies are Just Big

Two weeks ago my friend birthed her son, lying on her side, 5 days past her estimated due date.  Her baby was 10 pounds 4 ounces.  Now we know mom's apparent "size" doesn't matter, the size that counts is the pelvic inlet and outlet.  My friend should be the poster child for moms who are nervous about big babies because the reality is that too many women with "small hips" worry about big babies.  When not pregnant my friend wears a size 2 and is 118 pounds (she is quite tall, about 5'8).  She has the kind of hips doctors might like to fret about, but we know better.  Immediately after the birth my friend noted, "it wasn't that bad at all."

Now what do you think would have happened if this mom had been told repeatedly before the birth that her baby would be AT LEAST 10 POUNDS!!!!!!! and that she should be concerned about shoulder dystocia....

The Breast Crawl

I heard about the breast crawl at my trip to The Farm last fall but couldn't download the video from breastcrawl.org.  So you can imagine my happiness when I found that the blog Descent Into Motherhood was able to download the video and had placed it on their blog!  Please check out this video and share it with friends.

I think breast-feeding advocates can sometimes be a bit too proactive about initiating breastfeeding.  As a doula, I have felt I must at least attempt to help mom nurse right away because baby is often whisked away for an undetermined amount of time and when returned, has often lost the alertness that a baby has immediately after birth.  The video notes that most babies will master the breastcrawl in 30-60 minutes.  Unfortunately many babies are lucky to get 30 minutes of skin to skin time directly after birth and may get less then that.  Wouldn't it be wonderful if we could put babies right between mom's breasts and hold off on weighing baby etc. until after he/she has initiated breastfeeding, even if that means waiting an hour or more?  Instead of taking the initiative to facilitate a good latch, what if we could let baby find the way by him/her self and step in only if there are problems.

Not Everyone Can Breastfeed

I've been meaning to write this post for awhile.  Writing it is a reminder to be careful about the language I choose, especially when I am passionate about the subject.  By implying in my conversation that breast is best, I have not always been sensitive to moms who are unable to nurse.  I used to teach a mommy and me yoga class and at the end of the class, would encourage women to feel free to nurse their babies during sivasana.  The well-meaning intent was to encourage new moms, nervous about nursing in public, to feel free to nurse in my class. Little did I know that a mom in my class had hypoplastic breasts. "Feel free to feed your child" might have been more inclusive, she noted in a thoughtful email.

Her story...

I had a non-medicated birth of my 9lb, 8 oz lovely at a birthing center and had long planned to nurse my baby.  When he was not pooping at all, lost two pounds, when I pumped and got a half of a drop, I went to several lactation specialists.  On day six of my son's life, I learned the word HYPOPLASIA and that was what I was....unable to produce milk....  For me, nursing was not hard, it was biologically impossible.  This revelation was pretty devastating to this new mom, for sure.  My husband and I opted to use a SNS (supplemental nursing system) - that's right, I had to tape a tube to my breast, fill a container with "artificial milk" - the horror - and feed Sam through those tubes while he latched to my breast.  It was cumbersome and humiliating yet this system bought me time to get a milk supply....or not.  After pumping on the hour, taking at least four herbs, drinking water....my supply was still non-existent.   So, then I got drugs from Canada -  domperidone.  Well, my supply went from three drops up to 5 cc's (no kidding...).  After hundreds of dollars that we could not afford, we still worked with a lactation consultant and continued to pray that my milk ducts would kick out what my son needed.  Then when he was seven weeks old, my mom died.  So, here I am now in NY with this SNS and my replacement meds are stuck at the Canadian border and oh, I have to plan a funeral, greet literally 100's of mourners and then bury my mom.  The supplemental nursing system and thus breastfeeding, my husband and I decided, was not meant to be.  This decision was not the one I would have wanted but seeing my son healthy and having to tend to other needs was my new reality.

While most women are able to nurse their children, approximately 2-5% of the population is unable to breastfeed.  If you have a condition known as hypoplastic or under-developed breasts, you may find breastfeeding very challenging or may not be able to breastfeed.

Fellow breast-feeding mom Moxie provides some good information about Hypoplasia.  Moxie also refers readers to another site that has pictures of hypoplastic breasts and additional information. Please help spread the word.  As my fellow mom noted in her email, many women don't know they have hypoplasia until it is too late.  If you find out before you are pregnant or during pregnancy, you can take steps to help the situation before the baby is born.  And many thanks to the mom in my yoga class who taught me about hypoplasia and reminded me to choose my words with care.

What does a midwife bring to a home birth?

At a dinner party the other night my friend, who recently had her second birth center birth, exclaimed, "Kat, when talking about home birth, you have to clarify that midwives bring the tools available to them at birth centers to a home birth."  Apparently my friend thought that midwives brought little besides their hands to a home birth.  Talking to my mother-in-law last night, it seems she had the same impression as well until a recent conversation clarified things.  I suppose I am so immersed in the midwifery birth world that I forget that what I sometimes view as common knowledge certainly isn't common in our corner of the world.  So here is a picture of some of the equipment a midwife might bring to your house.  As midwife Ronnie Falcao notes in her captions, oxygen tanks are also brought into the house as well.

Don't get me wrong, a midwives hands are VERY important, but she brings a variety of tools to a birth that help her handle emergency situations should the need arise.

Great Free Birth Story!

Check out this beautiful birth story, http://harrietsfreebirth.blogspot.com/.  Birth ain't easy, but it is SO worth it.