REFRESHER CLASS ANNOUNCEMENT

August 10, 2009

2 night childbirth refresher is scheduled for Sunday August 19th and Sunday August 23rd. 7:30-9:30 pm.

Please contact Carrie@birthteacher.com to register.


Childbirth Classes

May 5, 2009

I’d be a fool if I didn’t post my next series of Childbirth Classes here!!

Beginning Tuesday 5/12-6/16. We’re metting at 7:30pm at my home. I will have several guest speakers this time. This 6 week series will be a “mixed bag” of both home and hospital birthers.

please see the website for more detail. It’s been recently updated: www.birthteacher.com

zraesboy23


First C-section

May 5, 2009

I’ve recently attended my first C-section as a doula and it was quite the event.

The mama and her family worked so hard and for so long, but as it is in many places and with induced births (even the medically necessary ones) sometimes a surgical birth is necessary.

Parents are doing well, baby is a ray of light. Everyone is recovering!

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Home births ‘as safe as hospital’

April 16, 2009

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

http://news.bbc.co.uk/2/hi/health/7998417.stm

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

Home births have long been debated amid concerns about their safety.

UK obstetricians welcomed the study – published in the journal BJOG – but said it may not apply universally.

The number of mothers giving birth at home in the UK has been rising since it dipped to a low in 1988. Of all births in England and Wales in 2006, 2.7% took place at home, the most recent figures from the Office for National Statistics showed.

The research was carried out in the Netherlands after figures showed the country had one of the highest rates in Europe of babies dying during or just after birth.

FROM THE TODAY PROGRAMME

More from Today programme

It was suggested that home births could be a factor, as Dutch women are able and encouraged to choose this option. One third do so.

But a comparison of “low-risk” women who planned to give birth at home with those who planned to give birth in hospital with a midwife found no difference in death or serious illness among either baby or mother.

“We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife,” said Professor Simone Buitendijk of the TNO Institute for Applied Scientific Research.

“These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth.”

Hospital transfer

Low-risk women in the study were those who had no known complications – such as a baby in breech or one with a congenital abnormality, or a previous caesarean section.

Nearly a third of women who planned and started their labours at home ended up being transferred as complications arose – including for instance an abnormal fetal heart rate, or if the mother required more effective pain relief in the form of an epidural.

The NHS is simply not set up to meet the potential demand for home births

Louise Silverton
Royal College of Midwives

But even when she needed to be transferred to the care of a doctor in a hospital, the risk to her or her baby was no higher than if she had started out her labour under the care of a midwife in hospital.

The researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

While stressing the study was the most comprehensive yet into the safety of home births, they also acknowledged some caveats.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background – the risk of complications is higher in both these groups.

The study did not compare the relative safety of home births against low-risk women who opted for doctor rather than midwife-led care. This is to be the subject of a future investigation.

Home option

But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.

Women need to be counselled on the unexpected emergencies which can arise during labour and can only be managed in a maternity hospital

RCOG

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was “a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

“However, to begin providing more home births there has to be a seismic shift in the way maternity services are organised. The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital.

“There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies.”

The Royal College of Obstetricians and Gynaecologists (RCOG) said it supported home births “in cases of low-risk pregnancies provided the appropriate infrastructures and resources are present to support such a system.

But it added: “Women need to be counselled on the unexpected emergencies – such as cord prolapse, fetal heart rate abnormalities, undiagnosed breech, prolonged labour and postpartum haemorrhage – which can arise during labour and can only be managed in a maternity hospital.

“Such emergencies would always require the transfer of women by ambulance to the hospital as extra medical support is only present in hospital settings and would not be available to them when they deliver at home.”

The Department of Health said that giving more mothers-to-be the opportunity to choose to give birth at home was one of its priority targets for 2009/10.

A spokesman said: “All Strategic Health Authorities (SHAs) have set out plans for implementing Maternity Matters to provide high-quality, safe maternity care for women and their babies.”


MOre MOthers Opting to Eat their Own Placentas

March 20, 2009

http://cbs4.com/health/mothers.eat.placenta.2.908100.html

Giving birth can take a toll on new mothers, especially after the baby arrives. Studies have shown nearly a quarter of all new moms experience some degree of postpartum depression. To combat the symptoms, some women have chosen a controversial approach – the ingestion of the human placenta.

Sage Khouerie admitted she was concerned about giving birth after the age of 40. So the 41-year old chose to ingest her placenta to avoid postpartum symptoms; the action of doing so is called placentaphagy.

“I was 40 when I delivered. I thought ‘Wow, this could be a little tougher on me than a younger woman and I want to be open to anything that would make it easier’,” said Khouerie.

The placenta, an organ about the size of a dinner plate, delivers nutrients from the mother to the child during gestation. Some mothers have chosen to eat it after childbirth, while others have cooked it and ground it into pill form.

Naeemah Jones is a doula (an assistant who provides various forms of non-medical support in the childbirth process) who helps new moms understand the benefits of the process. She feels ingestion of the placenta can decrease the negative symptoms that can occur after childbirth.

“Hair loss, a very small amount of breast milk,” said Jones, “(placentaphagy) helps produce more breast milk, it get the balance of the hormones together, it’s like a happy pill for the moms.”

Laura Taylor, 36, has three children but only chose to ingest her placenta after giving birth to her third child.

“So when I took them this time, I never had such a wonderful recovery after having a baby,” said Taylor.

While most mammals eat their own placenta, no studies have been done on the health benefits of human placentaphagy. Still, it’s growing in popularity. Jones says “now new parents are doing their homework, they are finding out they have choices.”

Research has shown that the practice is safe as long as mothers ingest their own placenta. There are some alternative medicines that include human placentas but those should be avoided due to a high risk factor.

(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)


Consumer Reports On Maternity Care

March 3, 2009

Back to basics for safer childbirth
Too many doctors and hospitals are overusing high-tech procedures

http://www.consumerreports.org/health/medical-conditions-treatments/pregnancy-childbirth/maternity-care/overview/maternity-care.htm

Noninvasive measures can mean better outcomes for baby and Mom.When it’s time to bring a new baby into the world, there’s a lot to be said for letting nature take the lead. The normal, hormone-driven changes in the body that naturally occur during delivery can optimize infant health and encourage the easy establishment and continuation of breastfeeding and mother-baby attachment. Childbirth without technical intervention can succeed in leading to a good outcome for mother and child, according to a new report. (Take our maternity-care quiz to test your knowledge.)
“Evidence-Based Maternity Care: What It Is and What It Can Achieve,” co-authored by Carol Sakala and Maureen P. Corry of the nonprofit Childbirth Connection analyzed hundreds of the most recent studies and systematic reviews of maternity care. The 70-page report was issued collaboratively by Childbirth Connection, the Reforming States Group (a voluntary association of state-level health policymakers), and Milbank Memorial Fund, and released on Oct. 8, 2008.

Overuse of high-tech measures

The report found that, in the U.S., too many healthy women with low-risk pregnancies are being routinely subjected to high-tech or invasive interventions that should be reserved for higher-risk pregnancies. Such measures include:

Inducing labor. The percentage of women whose labor was induced more than doubled between 1990 and 2005
Use of epidural painkillers, which might cause adverse effects, including rapid fetal heart rate and poor performance on newborn assessment tests
Delivery by Caesarean section, which is estimated to account for one-third of all U.S births in 2008, will far exceed the World Health Organization’s recommended national rate of 5 to 10 percent
Electronic fetal monitoring, unnecessarily adding to delivery costs
Rupturing membranes (“breaking the waters”), intending to hasten onset of labor
Episiotomy, which is often unnecessary
In fact, the current style of maternity care is so procedure-intensive that 6 of the 15 most common hospital procedures used in the entire U.S. are related to childbirth. Although most childbearing women in this country are healthy and at low risk for childbirth complications, national surveys reveal that essentially all women who give birth in U.S. hospitals have high rates of use of complex interventions, with risks of adverse effects.

The reasons for this overuse might have more to do with profit and liability issues than with optimal care, the report points out. Hospitals and care providers can increase their insurance reimbursements by administering costly high-tech interventions rather than just watching, waiting, and shepherding the natural process of childbirth.

Convenience for health care workers and patients might be another factor. Naturally occurring labor is not limited to typical working hours. Evidence also shows that a disproportionate amount of tech-driven interventions like Caesarean sections occur during weekday “business hours,” rather than at night, on weekends, or on holidays.

Underuse of high-touch, noninvasive measures

Many practices that have been proven effective and do little to no harm are underused in today’s maternity care for healthy low-risk women. They include:

Prenatal vitamins
Use of midwife or family physician
Continuous presence of a companion for the mother during labor
Upright and side-lying positions during labor and delivery, which are associated with less severe pain than lying down on one’s back
Vaginal birth (VBAC) for most women who have had a previous Caesarean section
Early mother-baby skin-to-skin contact
The study suggests that those and other low-cost, beneficial practices are not routinely practiced for several reasons, including limited scope for economic gain, lack of national standards to measure providers’ performance, and a medical tradition that doesn’t prioritize the measurement of adverse effects, or take them into account.


Doulas on the Edge

February 7, 2009

Doula work is rewarding.

Doula work can be difficult.

But doula work is non-clinical and non-invasive.

When I became a doula for military wives in the early 1980’s, the word doula was just a Greek word for the most favored woman in the ancient Greek household. It had not yet been linked to a trained (and often certified) woman who gives informational, educational and physical support to laboring women and their families. Today, after 24 years of practicing as a doula and seven years as a doula trainer for DONA, it disturbs me to hear stories of how my fellow colleagues have stretched…and in some cases stepped outside of the scope of practice of being a doula.

By mutual definition of “doula” of the major organizations now training and certifying doulas (such as ICEA and DONA), doulas perform no clinical tasks such as altering IV drips, rearranging electronic fetal monitors, or performing vaginal exams. Yet doulas in many communities contact us expressing fears of “doulas on the edge” performing such tasks in their communities. What are the implications of these actions and are there any safety nets for either the clients or medical professionals who experience the actions of such “doulas on the edge?”

The implications of such actions is that even though one doula in a community chooses to step outside the bounds of accepted practice, all doulas in that community will feel the repercussions for a long time…months, years. And this ripple affect is difficult to stop!

Women enter the doula profession for many reasons: they have a passion for birth; they have had wonderful birth experiences and would like to “give back” to others so that they may have equally as wonderful experiences; they desire to enter the nursing or midwifery field in the future but choose doula work now as a stepping stone; OR they have a conscious (or unconscious) agenda of saving women from the medical community.

Does this sound harsh or blunt? Probably so. However this last reason for choosing doula work is a stepping stone for becoming a doula on the edge. Armed with a little information/knowledge and a whole lot of attitude, these doulas on the edge chip away at the acceptance that others have worked so hard to attain. They strain relationships between physicians and doulas, nurses and doulas, the public and doulas and each other.

Doula organizations have a Scope of Practice and Code of Ethics that their certified members are expected to follow. It is vital that doulas be held accountable when they step outside of the Scope and Code. If a non-conflictive conversation with the “doula on the edge” does not produce positive responses, contacting that doula’s certifying organization is the next step. Many of the organizations have grievance committees that are activated when a situation arises. Having the committee examine the situation and make recommendations/sanctions to the doula relieves the local doula community of this potentially explosive responsibility and hopefully helps the doula in question to get back on the right track.

Dealing with people that are negative or passive are some of the most challenging relationships. It is not always possible to correctly identify the reason(s) for someone’s poor behavior and so speculation can often lead to additional conflict. In your doula community, try to develop potential solutions for resolving a problem BEFORE it happens. Try to maintain a positive attitude about the person or the situation and this will help you to manage conflict with confidence…resulting in a positive outcome for all!

http://www.birthsource.com/scripts/article.asp?articleid=71


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