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Archive for the ‘birth’ Category

I was so pleased to read today that the State of Washington is taking away any financial incentive for medical providers who do Cesarean surgeries covered by Medicaid. Almost half the births in Washington are covered by Medicaid and paid for by taxpayers dollars. Now, doctors and hospitals will receive the same payment for an uncomplicated Cesarean surgery as they would for a complicated vaginal birth.

To read a wonderful analysis of the new legislation, check out Carolyn McConnell’s article in CrossCut: Take away the incentives for too many c-sections doctor-money

Maybe the State of Washington can lead the way in reducing the rate of Cesarean sections, saving more than 10,000 women a year from undergoing unnecessary surgical births and supporting the availibility of VBACs in our hospitals, and dare I say, even our birth centers too! While we are at it, let’s make midwifery care available to all low risk women, and send our high risk mamas to the OBs! But hey, that’s a post for another day! A girl can dream, can’t she???

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I read a great blog post today by a Certified Nurse Midwife about the usefulness (or actually, the possible emotional harm!) of vaginal exams prior to the beginning of labor. I think this is a great read and good information to take to heart, and have at times said exactly the same words to both clients and class participants. I already posted this over at the ICAN Seattle blog, ( I am the co-leader of the Seattle Chapter) but felt it was so good, I needed to get it up on my own blog too!

The question I always ask is this…. ‘Will the information gained from THIS vaginal exam change what we are going to do today?’ In your present situation, unless you are considering being induced a vaginal exam is irrelevant. What do I mean irrelevant…it does not change what we are going to do TODAY and things can literally change overnight. Because of this, I encourage you to avoid all vaginal exams until you think you are in labor and are having a labor check or you are preparing for an induction. I encourage you to let go of your current cervical change expectations and focus on getting your mind ready for labor and motherhood. You can go from closed to delivered overnight. It will happen. Don’t start to doubt and don’t start to worry. Your body and your baby know the perfect time to move to birth.

Recently I had a student in a class come to me during a break and ask me if spotting, crampiness and some contractions were normal at 33 weeks. I told her that those symptoms might be a reason to check in with her Health Care Provider, as they might want to rule out pre-term labor. She went on to tell me that she had had an appointment the day before, where a vaginal exam was done, that was fairly painful. 1013-gyno-exams_vg
Ever since then, she had been feeling some contractions and cramps. When asked why the exam was done, she could not tell me, other than her HCP suggested it. I honestly did not know what to say, and wondered to myself if this woman was going to be birthing a 33 weeker because some things got stirred up when they should have left things alone. I did encourage her to check in with the provider, and am pleased to report that after another day, things settled down and she has not yet gone into labor!

Skip over to read this entire blog post by It’s Your Birth Right; Skip This Routine and think about keeping YOUR pants on if you are not in labor!

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Dear Clients,

I am writing this letter to you, my clients, to thank you! Thank you for showing me strength, grace, power and absolute fortitude during the labor and birth of your beautiful daughter. I was honored to witness this fundamental power during your recent birth! It has changed me forever.

I remember when we met to discuss working together at the birth of your baby. You shared your fears, your concerns and your doubts. Tears were shed. As I got to know you, I listened as you expressed your thoughts and self doubts about your own strength. So many things to worry about, so many unknowns.

As you neared the end of your pregnancy, so many deadlines and obstacles arose that required you to prove that you and your baby were doing well. As your due date came and went, you wondered why you were still pregnant, yet you knew that your baby would choose the date of her birth. Balancing doubt and belief became a daily struggle, and you still forged on, waking up each morning, surprised that you were still pregnant. Acceptance and peace settled slowly, and you found your rhythm to wait for your daughter. thank-you

And then, labor started. Contractions regular and intense, starting as midnight drew near, needing to breathe through them and pay attention….this continued, throughout the night, with little sleep, during the day and onwards through a second night. Exhaustion was huge and the question about why things were not progressing? and still you soldiered on! Another day and evening, and then a spontaneous release of water after 48 hours, and things kicked into high gear. Active labor started and you never looked back! Strong contractions dilated your cervix and you found your groove. You got down to the hard work of birthing your baby, without complaint, without question, so calm, so intent and so intentional! The questioning, uncertain woman who expressed doubts during pregnancy was nowhere to be found. In her place, a strong, powerful woman, loose, fluid and laboring. Internal and composed. Accepting and strong.

And when things were at their most intense, you looked inside and found strength to advocate for yourself and your daughter. During the most vulnerable, most intense, final hours, you were composed and grounded! I listened and watched as you found your voice, in a way that few women do, ever in their life, never mind at 9 cm in labor! I was and continue to be in awe of your actions and thoughts and your conversations with your health care providers, speaking your mind and your intent. You are woman who can do anything! I hope that as you reflect back on this experience, you recognize how powerful and capable you are! Your daughter should grow up knowing what a strong, capable woman her mother is, and how lucky she is to have you as her mom.

Thank you for letting me support you and watch you in all your glory, as you brought forth your daughter! I am in awe of your power! Thank you!

Warmly,
Sharon

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I am so excited about the news that The Transparency in Maternity Care Project: The Birth Survey results are now available to everyone! You can search this dynamic database for information on all the providers (OB, CNM, LM, Family Practice) and birth locations specific for your area! You can read how women who have given birth in the past three years at these locations and with these providers rate their satisfaction in many categories! And you too, can rate your provider or birth location as well, sharing the information on your own personal experience. This is just so powerful, that I am giddy with excitement! Consumer information and ratings on maternity care by provider and location is a long time coming. Now, women and their families expecting a baby can make provider and facility selections based on knowledge and information that is current and reported by other consumers with recent experience with those providers and facilities! resultssurveyreport1

Information available includes:

The consumer reviews just launched include:

– Overall ratings and recommendations for birth facilities and care providers
– A seven-item set of questions on providers’ interpersonal and communication skills
– Facility intervention rates
– Information on finding good care.
– A national average of ratings is also displayed to provide comparison with individual ratings.

If you looking for a provider or birth location go here, and click on connect to check out the survey results.

And if you have given birth in the past three years, take a few minutes to share your experience here, by clicking on the share link, so that others may benefit from your recent birth experience. link_pages_survey

I think this is really big, and maybe the beginning of change, women sharing information so that others can make informed choice! A huge thanks have to go out to The Coalition for Improving Maternity Services (CIMS) for making this possible. Check out their fantastic website just jam packed with important information for expectant families!

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The Waiting Game

Being a birth doula involves waiting. Waiting for babies! Babies who come in their own sweet time! Babies who have their own secret, internal clock that we mere mortals can only hope to understand! Here I sit. On call! I am usually on call. I am on call for most of the year, probably 48 out of 52 weeks. What that means is that at any time of day, or night, I can expect a phone call from a client telling me she needs me. Or telling me she doesn’t need me, but just wants to update me. Come now. Come later. What that means is that my phone is always on and always close. What that means is that I need to always be sure to get enough sleep, go to bed at a decent time, so that I can be ready for a 1 AM phone call. I am waiting now. A woman will be asking me to join her soon! This I know, as she is now admitted to a local hospital for an induction after spontaneous rupture of membranes in the pre-dawn hours of yesterday! And no labor, as of yet, so a push to get things rolling. Hopefully, a gentle push. hourglass1

Since the news of yesterday’s events, I have been on “high alert.” High alert, I suppose is more alert than normal, of which I already am always on alert. Is that possible? With every action, with every errand, with every event of my day, I calculate, “What do I need to do, in case I get the call NOW!” Sometimes, this can be exhausting. Very exhausting. Emotionally draining. For the doula and also for her family. Thankfully, I have been doing this for more than 6 years, and my family rolls with the punches well. But, the waiting doesn’t get easier. Not for me, not for the pregnant mama and her family, and not for my own family. Yet, the thrill of the call, the rush to join a laboring woman, the chance to help and witness women trust in their bodies and their babies, to participate in that age old labor dance, that brings a new baby earthside! There is nothing like it! Nothing! And I suppose, that is why many birth professionals do it. Over and Over!

And still I wait. Restless, unable to complete anything, drifting from task to task, unable to really focus, while I wait. So many things still undone, yet I can accomplish almost nothing. Should I go for a walk on this lovely day? Make a yummy casserole for my family to eat this evening, as surely I will be gone? Will I??? Will I be gone? Rest? Nap, in case tonight is a night of no sleep?? Sometimes denial is a good state of mind. Be ready, really ready and then forget about it! Just forget about it! That works for a while, but now as I sit, and wait, I reassure myself that this baby will come like all the others, in its own sweet time! I remind myself of this a million times! And so, it goes. Wait with me, and help me by sharing your own stories of waiting, for babies, for something else? What was your experience like?

As for me, I will go and put together a new, tasty mac and cheese casserole from the Splendid Table’s newest cookbook! And leave it in the fridge, as I suspect my family will be enjoying it this evening without me. Or will they?

Share your stories of waiting for babies with us! Post a comment!

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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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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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