This week we get yet another report based on even more research that says less interventions is healthier for moms and babies! And it gives this wonderful visual aid on how to make it happen and how the path is too often and unnecessarily detoured. Guess the top suggestion to avoid more intervention towards a lower risk birth? Have a DOULA for support! There are doulas out there for nearly every budget and make great baby shower gifts when a mother is desiring a safer and healthier birth with personalized support along her journey. Other suggestion is for both the staff and mother to BE PATIENT. :) :) :)
This is such a transitional time of year for many of us! Summer to fall. Warm to cool. Back to school. And for me, back to being on call.
With transition, there is usually some discomfort and anxiety but also excitement. And while I will no doubt miss spending these amazing summer days with my two sons, I send them back to school this week hopeful for a wonderful schoolyear full of new experiences, relationships, and engagement with whatever it is they are learning. And I look forward to the time I'll have more of to reconnect with friends, return to more births (yay!), post partum work (👶👶) and supporting all my truly awesome clients as they prepare for their births and babies and become mothers or new families. My heart is full of love to spread. 💗💗💗 And whether I'm completely ready or not, here we go! I accept this transitional time with all of the feelings it's brings... and hope you are all finding your peace as well. What helps you during these times? For me its quieting my mental to do lists by carving time for yoga, no or little caffeine, eating and drinking lots of good for me stuff, connecting more deeply with my kids and how they're feeling, and always reading with them and alone before bed. What the word mommies? My fellow birth workers?
What does the evidence say about the prevention and treatment of Premature Rupture of Membranes (PROM)?
Evidence Based Birth compiled research for us again on another hugely important topic that seems to effect so many women's births! Just since 2009 when I started doula-ing, I've seen many of the different ways Premature Rupture of Membranes (PROM) is managed by a great variety of care providers and birth locations. Sadly, my own client statistics that I keep show that those who are first time moms are at the most risk for both infection and cesarean birth when PROM is how their labors begin. After many discussions with other birth professionals on this topic and hearing that other midwives and doulas have noticed similar stats for their first time mom clients, I have always had an interest in learning more about PROM. But, as Rebecca, the author of Evidence Based Birth, notes, the research is either lacking or not easy to interpret. Plus, there are so many factors. The largest study TermPROM is discussed in great detail in her article below as are a few other issues surrounding PROM prevention and management.
What can you do as a first time mom? Well, a lot is still unclear. However, the image below is the best take away and one (I believe) everyone can agree on. This tends to be one message I find myself sharing consistently when I teach childbirth classes, am discussing a couple's birth preferences, or am reminding a mom of at the beginning of or during labor. It continues to be backed by evidence... and as usual when talking about any vaginal exam, the benefits are slim to none. Keep outta there!!!
Please share far and wide the image below that Rebecca has made as a great reminder!!!
My mission is to support new doulas by matching their passion with some practical tips and guidance as well as emotional support for all the ups and downs this work may bring. My mission stems from my own experience as a doula. I remember how energetic I was after my doula training! I felt so prepared! As I started taking clients, though, it became clear to me that there was no way any training could cover all the many questions I would have and decisions I would have to make as I jumped into each new experience with all my heart. Like many doulas, I had a passion and growing knowledge for birth and serving women and families, but I was clueless about the business aspect of it. I also found myself surprised to experience a range of emotions after attending some births. This work is wonderful, but it can be quite challenging for a multitude of reasons that one does not really understand until one experiences. Soon I realized that I needed support! There were a few births in the beginning where I felt like I needed a doula to doula me through my doula-ing!!! So, I sought that support out. I pulled advice from many different doulas I met throughout my certification process, I processed the intensity of some births with other birth workers, and I networked with those more experienced. I'd happily refer my clients to those doulas whom I respected. Whether it would be for childbirth classes or some other service those doulas offered that my clients could benefit from, it was also a thank you for talking with me and helping keep me on my path. Through the support of my mentors, I continued to grow into the seasoned doula I am today. Still learning, always, but much more confident in how to run my business, how I’ve defined my role as a doula, and how and when to implement all the wonderful tools I’ve learned along the way. And, most importantly, I STILL LOVE MY JOB... despite the challenges! I have met so many amazing families. My heart has been warmed by the experiences with various care providers and nurses. I have gotten to doula for repeat clients and watch as the moms and their families grow. I want all inspired doulas to have a better chance at having these experiences. I want to help more doulas succeed in their goals of supporting women. I want that for them and for the women we serve. I believe that the more doulas there are, the more women will get to have a doula. As the supply and demand continue to grow, our profession grows. ACOG published this year that there is evidence showing that doulas are a benefit to women's health, specifically as preventative of cesarean delivery.
I know mentorship makes a difference in doulas making a difference. I offer this mentorship one on one and with confidentiality. I promise to give my mentee doulas support from both my head and heart. ~
If you are interested in being a mentee doula, visit here for more information.
If you are interested in hiring a mentee doula, visit here to meet them.
I just loved this article. :) What a summary!
Raising Awareness with Black Breastfeeding Week! Yes, they deserve a special week in world breastfeeding month! :) Please read on if you have a different opinion or don't understand why. Black breastfeeding moms absolutely face more challenges than other mothers in the US AND they need the benefits of breastfeeding even more because they and their babies are even more at risk. If you don't know, read on. Studies, surveys, CDC reports and more support this. "The barriers are financial, cultural, systemic and logistical. When dominant culture women aren’t aware of the challenges that women of color face, that lack of awareness becomes a barrier of its own." And please remember that race matters not just in breastfeeding, but in life... everyday. Whether you think it does or doesn't or should or shouldn't - race impacts everything.
And...Why Ferguson has everything to do with Black Breastfeeding Week
SO CATCHY! "All the...all the babies love it!" :)
...And just because it's relevant to race and the times (not breastfeeding fyi), I have to include this as well as another example of all that is holding us back from moving more towards equality... If you're interested, go for the link below...
I almost cannot bear to hear these stories about mothers dying in the OR due to placenta accreta caused by multiple cesareans. Everyday women are told 1) That a primary cesarean is necessary to birth her baby for some reason. In many (dare I say, most, cases is just UNTRUE. 2) That attempting a VBAC is dangerous. Which is also just UNTRUE and NOT what is recommended by ACOG.
These women are left with option to have no more children or put her LIFE at risk to give birth by more cesarean sections. Which isn't usually explained how risky each subsequent pregnancy becomes. If it's explained, it's usually after her second or third cesarean. What kind of choice is that at that point???
And for a doctor, I imagine it is terrible to lose a baby during a delivery. But, a mother? How do they go on? I'm sure they do everything they can and it must be awful to realize you cannot save her. But we need them to STOP doing all of these unnecessary cesareans! Overmedicalizing birth in the first/second pregnancy is the root cause of mother's hemorrhaging on the operating table a few cesareans later.
Maybe I'm especially emotional hearing of these stories because I lost my mother at age 9. I don't want any other child to endure this kind of loss. And because of my work, I know it can be different. Giving birth doesn't have to be risky. It can be healthy, respected, and trusted in most cases. And, women can be trusted to make their own informed decisions when given the right information based in research and allowing that along with intuition to guide them instead of FEAR...
I don't want to post the stories that have deeply saddened me recently. I know I have other mothers reading, some facing cesareans that have become necessary and possibly complicated and scary pregnancies. Or maybe just like me, a motherless mother who's heart breaks to think of any other mother leaving her children behind. So, instead, if you'd like to read about how another mother managed to survive when facing what became a life threatening pregnancy, read her story included in a previous post below about preventing the primary cesarean. Below is a great video on VBAC.
Today I want to say that ICAN is about supporting the first time mom, too, not just those hoping for a VBAC. It is a great resource for preventing that primary cesarean birth. As is the VBAC facts site and Jen Kamels who runs it and teaches a workshop around the country and online.
Our local ICAN of SEPA:
I'm also linking a story here that offers a great explanation as to why we fight so hard to help mothers avoid their primary (and too often unnecessary) cesareans and to birth vaginally. It details the risks and dangers to mothers of multiple cesareans. This mother is not alone, more and more of these examples are making news because they are becoming more prevalent problems in pregnancies and in the OR. Just to be aware, though, I had tears in my eyes the whole time while reading. She does a great job writing so that the reader can almost feel her fears through what was a very scary experience. To clarify, MOST 1st and even 2nd repeat cesareans will be manageable by most hospitals and with what blood they have on hand for possibility of transfusing...I do not want to scare moms facing a repeat cesarean where they NEED to trust and depend on a doctor to keep them safe, but this story also shows how a mother did her homework to do just that - be in the best place with the best team to make sure she'd be going back home to her kiddos. This was simply the situation she ended up in during her 7th pregnancy. Her placenta became deeply implanted into her uterus and cervix after multiple previous surgeries to her uterus.
As a doula, I never want my clients to have any good answer to the question, 'what else could I have done to prevent my first cesarean?' This is especially important when moms desire a larger family. I have had friends and family members tell me that their doctors never once mentioned to them before, during, or after their first cesarean that they'd need to consider limiting family size due to having that surgical birth and the increased dangers of multiple pregnancies and cesarean births following. And not just that, but that they'd not been offered a chance to VBAC and instead told that it is dangerous to try, safer to schedule ANOTHER cesarean, and just accept having 2 children or at most 3 if she really really wants to risk it, but no more! Women are being told this AFTER their second cesareans when their options are nearly nil at that point! It's infuriating. And sad. More women need doula support through their first pregnancies and births, good information, supportive care providers, and to visit their local ICAN group before having their first babies if we want to stop this trend from continuing. Women need the truth! They need their options! They want to make informed choices!
I recently met a nurse who told me there is a doctor on her floor who frequently says all babies should be born by cesarean and has no problem recommending tube tying after the second to all mothers. I seriously hope he is in the extreme minority. But I have a feeling that while we do have docs who truly believe in the safety of and support less medicalized vaginal birth, the number of docs seeing their norm everyday be cesarean deliveries is increasing by the day. This will just continue to have an effect on moms and babies (physically, mentally, emotionally!!!) if we don't advocate for ourselves and surround ourselves with professional support and evidence based information.
And while I'm thinking of it. Hug another woman today. Love her with that hug, if even for just a few seconds. We don't always know each other's journey.
Read the article here.
This is a MUST READ article for all women. What is referred to as the cornerstone of gynecology, the Annual Exam, has just been outed as completely unnecessary and without any evidence to support it in low risk, asymptomatic women. The article notes reason ACOG has been holding onto it as a 'logical procedure' even though they knew there was no reason according to many years of research, is because 'it can build the patient-doctor relationship.' REALLY?!?!?! It kinda sounds like billions of vaginas have been violated without any purpose, our bodies simply learning tools, while our psyche was often confused over it and negatively effected - we were sometimes embarrassed, humiliated, and hurt. Victims of sexual abuse submitting to speculums and fingers under the premise that it was not just good for their health but necessary!?!?! Er! Maybe next time we should ask our doc if we can examine his/her genitalia and internal organs...ya know, to help deepen our doc-patient relationship.
I imagine that some docs will gladly accept the recommended change in care...many do not want to be up in your vagina actually, especially if it's unnecessary. But, some will really try to hold on to this procedure, for one reason or another I imagine. As a woman and doula, with my own experiences and watching/hearing my clients experiences' with their care providers, I think the the GYN-patient relationship could be better fostered by dialogue during that annual 'check up' in the office. Hopefully with time, we will learn that someone doesn't always have to 'DO' something 'to' us in order to serve us as a care provider.
RIP Marsden Wagner, MD, former perinatologist and perinatal epidemiologist from California and director of Women’s and Children’s Health in the World Health Organization for 15 years. He raised four children as a single father. Marsden was an outspoken supporter of midwifery.
Thank you for your work and words that have inspired so many of us doulas and midwives. Here's one of my favorite clips from the Business of Being Born documentary.
More on Marsden Wagner, who at age 84, passed this April...
Here, Gloria Lemay reflects on her friend and mentor:http://wisewomanwayofbirth.com/marsden-wagner-md-remembered/
Wagner's clip on cytotec from The Business of Being Born:https://www.youtube.com/watch?v=DKZAoEPjHbY
Fish Can't See Water: The Need To Humanize Birth:http://www.drmomma.org/2009/08/fish-cant-see-water-need-to-humanize.html
Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First:http://astore.amazon.com/peacefparent-20/detail/0520256336
Creating Your Birth Plan: The Definitive Guide to a Safe and Empowering Birth:http://astore.amazon.com/peacefparent-20/detail/0399532579
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