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Archive for March, 2009

I received a call from my doula student last night, updating me on her clients! I am ever so pleased to report that this woman gave birth non-induced and non-medicated and non-intervened with to a happy, healthy baby on Saturday!

And now for for the rest of the story…the doula met up with them the evening before the scheduled induction, and was really present for their discussion and decision-making process. The doula shared The Problems and Hazards of Induction CIMS information sheet from her doula training manual. Using her wonderful, reflective listening skills, she heard the mom say that she wanted to go into labor on her own, that she did not want to be induced and felt like she might want to switch doctors, but who would “want” her, as she was past her due date. As the parents talked, they realized that they would not go in the next day for the induction and would wait for labor to start on it’s own.

The morning of the now-cancelled induction, the mom started having some contractions! It started to look more and more like active labor. Amazing how removing emotional issues can be freeing for some women and tip them into labor. Alas, the evening saw things slow down and peter out. The parents went to bed and woke up Friday morning with no sign of any labor at all. Discussions with the doula involved re-affirming that her body and her baby knew what to do and that her baby will pick it’s due date and be born when it is ready. Friday night, labor started again, and this time, kept on going, a late night trip to the hospital, several hours in the tub and a wonderful baby landed earthside! Mom gave birth in an upright position, unmedicated and oh so powerful! The doula reports that the parents are thrilled with the experience, so thankful for the support and listening ear of their doula, who helped them to clarify what was important to them.

I was proud of this new doula, and told her so! I am glad that she sought out my help when she felt she needed it, glad she was there for her client and supportive of the couple as they found their way. And oh so happy this mom got to have a wonderful, empowering birth on her own terms.

The most recent class of new birth doulas from Seattle Midwifery School

The most recent class of new birth doulas I have had the privilege of teaching from Seattle Midwifery School


I am so lucky to have the opportunity to teach birth doulas as part of the faculty of the Simkin School for Allied Birth Professions at Seattle Midwifery School. I know I can help one family at a time as a birth doula, but I get the shivers when I think of how many families the doulas I have trained can go on to empower! I always tell my doula students, that if they ever need to bounce ideas off someone, or find themselves “stuck” and need some help, they can call me 24/7. I am always happy to help! I remember what it was like when I was starting out and was grateful for my experienced doula sisters who made themselves available to me. And now in turn, I can do the same! The circle of life continues!

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I have always shared with both my doula clients and my childbirth students that less is more when it comes to baby hygiene products, and bathing your newborn and infant. Reality is, little babes do not get all that dirty, (it’s not like they are crawling through the mud or anything! and what is wrong with mud anyway?) and their skin is ever so sensitive. I have always stated that just plain water is the ONLY product that babies need on their skin and in their hair and on their bottom on a regular basis. And, too much bathing can be drying on their tender newborn skin. If parents feel the need to bathe with a product, the purest, most simple product available is the best, without artificial dyes, without fragrance, free of petroleum products, free of preservatives. Simple is better, plain water is best. Today I read in the Washington Post, that more than half the baby shampoo, lotion and other infant care products analyzed by a health advocacy group were found to contain trace amounts of two chemicals that are believed to cause cancer. Wow! Probable Carcinogens Found in Baby Toiletries will open your eyes to the truth around less is more when it comes to using such products on your gentle newborn.

Clients, Jodi and little Cash enjoy a bath together

Clients, Jodi and little Cash enjoy a bath together

Additionally, I encourage my clients to look into the benefits of delaying the first bath for their newborn. For homebirthers, this is not usually an issue, no one ever seems to be in a rush to bathe the baby, and sometimes many days pass before it moves to the top of the list. In a hospital setting, there is often great pressure by care providers to get the baby bathed, especially if the new family is being moved to a postpartum room elsewhere on the unit. It always seems as if there is a big, master checklist of things that HAVE to happen before the family relocates, and bathing is often right up there. When the bath occurs in the first few hours, mom is not quite physically able to participate as she is still regaining her footing after birthing a human being. The baby will have nursed and settled down, only to be disturbed by this “necessary” activity. Often it is the nurse or nursing assistant who does the bath, with the proud partner standing by and taking pictures, and mama across the room, in the bed, resting. How much nicer if the first bath could be in the arms of a parent, shared bathing in the big, large bathtub, safe in the arms and on the chest of those who love them most. Even better, if this happens at home, after discharge. Over the years, I have heard so many discussions from providers on why the baby needs to be bathed asap, including…”We will have to handle your baby with gloves, until it is bathed…” which I personally think is a good thing in the hospital anyway, bath or no! Also…”We consider your baby a biohazard and will have to post something on the door to your room warning people of this…” which I also think is a good thing, keeps the riffraff out!

My intuition is backed up by the research! Check out this study: Host defense proteins in vernix caseosa and amniotic fluid This study questions the routine use of some newborn procedures. Early bathing of the baby removes vernix, which contains antimicrobial proteins that are active against group B. streptococcus and E. coli. Delaying the bath and keeping the newborn together with his or her mother until breastfeeding is established may prevent some cases of devastating infections caused by these bacteria. The fact that preterm babies tend to have more vernix than babies born at or after 40 weeks might mean that healthy, stable preterm babies derive even greater benefit from staying with their mothers during the immediate newborn period.

Finally, this study illustrates how the normal physiology of pregnancy and fetal development is part of a continuum that extends beyond birth to the newborn period. The place for a newborn is right on his/her mama’s chest, skin to skin, for as long as possible. And letting that vernix work it’s way into the baby’s skin is just added protection from the “big bad outside” that the newborn is becoming familiar with.

Keeping the diaper area clean and dry, washing the baby’s hands and face with warm water several times a day, and the occasional bath safe in the arms of a parent, with just water is all your kidlet needs to get off to a healthy start!

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Helping to get the word about about a valuable resource for women who have experienced birth trauma!

“We are pleased to announce the Solace for Mothers Friends and Advocates Online Community which provides a forum for those who support mothers who have experienced birth trauma, have been impacted by witnessing birth trauma, or want to connect with others to advocate for gentler birth practices.

Solace for Mothers is committed to providing resources and support to professionals and loved ones supporting women through the difficult emotions following a disappointing, hurtful, or violating birth experience. Spouses, family, and friends of mothers who have experienced traumatic births are offered a space to find information, support, and resources through participation in the Friends and Advocates Forum. Birth attendants are also provided with the opportunity to process their own emotions in response to births they have attended. Birth professionals and birth advocates are provided a space to discuss the causes of birth trauma, how policies and programs can be enacted to prevent trauma from occurring to childbearing mothers, and methods of treatment when trauma has occurred.

The Solace for Mothers Friends and Advocates Online Community welcomes birth activists, mothers, families, and professionals, all of whom are stakeholders in providing healthy, safe, and empowering births that enable families to successfully transition to parenthood. Users of the online community are invited to contemplate and discuss the current state of birth and what evidence based practices best support childbearing women, their babies and families. Advocates who are interested in becoming involved in organized efforts to promote these practices are encouraged to participate and share their thoughts.

The Friends and Advocates Online Community can be entered from this site on the Solace website . The forum is made public for browsing and registration is required to post and respond to topics. To view the online community, go to the forum section

Mothers are welcome to participate in the Friends and Advocates role but they are invited to register and participate in the Online Community for Healing Birth Trauma which provides peer support to women who have had traumatic childbearing experiences. Birth professionals, family members, and friends please respect the privacy of the Community for Healing Birth Trauma and register only for the Friends and Advocates Community.

If you have something to say regarding childbirth and want to be a part of a larger conversation, please join us. We are interested to read your stories, thoughts, hopes and goals for the future! Please also feel free to pass this invitation on to organizations and individuals who would be interested in the topics of birth trauma and improving maternity care.

Warmly,

Sharon Storton, Founder of Solace for Mothers, Inc.
Jenne Alderks, Creator and Moderator of Online Communities
Jennifer Zimmerman, Creator and Moderator of Online Communities”

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I had a newer doula call me yesterday for some advice. She had been in a recent doula training class at Seattle Midwifery School and wanted to talk over a current client situation. Her client was less than a week overdue with her second child and her first baby was a vaginal birth with no complications. Her doctor told her that she needed to be induced, sooner rather than later! Like…tomorrow! And when this client inquired as to why, the reasons provided by this surgeon were: 1) most women are done being pregnant by now and just want their bodies back, 2) the baby is only getting bigger and bigger every day, and pretty soon your baby’s head will not be able to fit through your pelvis. Remember, this is a mama who has a “proven” pelvis, meaning that a baby has already found it’s way out through this very same pelvis, that now is getting more and more unable to birth her second baby by the minute! When the client asked about waiting a few more days, the doctor replied that the client could only be induced on days that the doctor was on call, even though this is one practitioner in a large, well established practice with doctors on call 24/7 for the unlikely event that a labor actually starts on it’s own.

Since this multip’s (woman who has already birthed at least one baby) cervix was already dilated and effaced, the method of induction would be pitocin or if the client preferred, they could rupture her membranes. No discussion of the benefits or risks or alternatives of any of these interventions, no discussion of the evidence based research that supports the appropriateness (or not) of these interventions, nor any reason that indicates this induction is based on a valid medical reason.

The parents were confused, scared and nervous. Maybe the obstetrician was right, maybe it was best to induce the next day! They asked for more time to discuss this privately and told the OB they would call with more questions. They called their doula, using her as a resource to help them make this decision. And the doula called me. The more I listened to the comments allegedly made by the doctor, (and I do realize I was receiving this information second-hand!) the more I could feel myself shake my head in disbelief. How is this behavior ethical? Even The American College of Obstetricians and Gynecologists, (a professional organization, mind you, not a research institution) in their own literature and patient pamphlets states what is a valid medical reason for induction! And “wanting your body back” is not on the list! No evidence of improved outcomes following induction of labour for non-diabetic women who are thought to be carrying large babies has been found that warrants an induction for macrosomia in this case.

What is up? Where is the information about informed choice, benefits and risks? Where is the truth? A great resource for anyone facing an induction for non-medically supported reasons (and even for the medically supported ones!) can use the Coalition for Improving Maternity Care Problems and Hazards of Induction as a great guide. CIMS Problems and Hazards of Induction Fact Sheet

An extremely valuable resource was published this fall by some powerhouse organizations, including Childbirth Connections that I think should be required reading for all women of childbearing age, particularly, the pregnant ones: Evidenced Based Maternity Care: What It Is and What It Can Achieve You can read a pdf on-line, or you can order copies for free! What a fantastic resource. If you are a doula, childbirth educator, or other birth professional, consider ordering some for your practice to share with clients!

As for the woman mentioned in the original paragraph, at last report, she has been in early labor since this morning, all on her own and with the support of her partner and doula, waiting for things to pick up! Maybe it was that beautiful full moon over Seattle that “induced” her baby to come! May this baby arrive safely earthside before the moon sets again! phinney_moon

Moonset over the Olympics, from Seattle.  Photo by Karen

Moonset over the Olympics, from Seattle. Photo by Karen

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Another stellar post by The Well-Rounded Mama! A History of VBACs and Cesareans in the USA

ribbon-no-text-full2How this mama finds the time to put all this together and shares her information so freely simply amazes me. I encourage you all to read this well written post, and follow the her links, and you will be amazed at the total lack of evidence based medical practices being applied to women who have birthed by Cesarean and are seeking a different journey this time! Thank you Well-Rounded Mama, for being so well-rounded!

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I just received a heads up that the Northwest Mothers Milk Bank is now open for business and can receive donated breastmilk! Their donor depot is located in Newberg, OR. They are intently looking to open other donor depots in the Northwest, so I expect that we may see one closer to Seattle soon! At this time, they are still getting set up to have milk available for babies in need here in the Northwest. Until that happens, the donor milk will be shipped to their partner, Mothers Milk Bank of Colorado. There was a great article in The Oregonian about this wonderful news that highlighted a premature baby who greatly benefited from donor milk!

I think this is such a great thing, women who have an abundance of milk can share the excess and babies in need can benefit from the absolute best food for them! Northwest Mothers Milk Bank is also working hard to get insurance companies to cover the cost of donated breastmilk, after all, it is just as lifesaving as medication!
baby-nursing
Over the years, I have informally helped clients of mine exchange milk, when a mama needed some extra and other women had a surplus! And I was so awed and appreciative that the women I support are so giving and unselfish with something that they work so hard to produce! I look forward to being able to refer clients to the Northwest Mothers Milk Bank in the future, both as a place to donate extra and a supply for those who need it!

If you are a mama with extra breastmilk, consider contacting the Northwest Mothers Milk Bank and letting them know you have breastmilk to share. And update us here, about the process, so others can be inspired to do the same. It takes a village, I always say, and I am proud to be a part of mine!

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