Childbirth Education - Think outside the big box location

So let's chat about childbirth education. Of the reported 30% of expecting parents who attend childbirth classes the majority go to the hospital where the birth is planned instead of seeking out independent options. I want to challenge you to think about how strange that is. Does it make sense that the information presented will REALLY be balanced, unbiased and evidence-based? Many protocols and practices used during labor and delivery in the hospital are designed as a one size fits all, no suited to each individual mom and baby. More importantly, they are not designed to suit the usual low-risk mom and baby (the majority of moms and babies are normal and low-risk), but can actually make a mom and baby appear or become high-risk. Some refer to hospital classes as "good patient preparation" classes because of lack of inclusive information. I will admit, that all hospitals do not offer education in this manner, however, in my experience and research many sadly do.

If a car salesman tried to sell you a car and actually insisted you purchase the specific color, make and model he/she decides for you, would you buy it? You would hopefully say no thank you and leave. How dare some one make such a huge decision for you. How long do you research a piece of electronics or a computer, even a cell phone plane before deciding? Even the pair of shoes you are wearing. Did you have to try on several before finding the right pair?

So why not think outside the big box, one size fits all class? Every mom, baby and partner deserve to know the wisdom of birth, understand what is normal and how to stay that way, when the abnormal happens what to do and be a skilled consumer.

There is no re-do here. This time is too important to leave to chance and inadequate education.

This is at the essence of why I teach my own childbirth classes at a location outside the hospital. I am able to freely give full spectrum information without restriction, bias or without the fear of losing my position.

Your birth matters to both you and your baby, to your future fertility, to your confidence as a mother

Below is a list of options available to families all across the US and variations in other countries as well (if if any class types have been overlooked, please let me know and I will add it).

• Independent - philosophy based (CAPPA, Lamaze post-2000, ICEA, CBI, ALACE, Birth Works, Birthing From Within)
• Independent - method based (Bradley, HypnoBirthing, Hypnobabies
• Self education

There are many other great ways to find a class that suits you.

• Ask around in your community
• Attend birth circles, Birth Network, La Leche League and/or ICAN meetings
• Seek out local doula groups and information nights
• Check out sites like Independent Childbirth

Here's to finding the perfect fit and gestating in peace.

Desirre

Individual fit: Who and where you choose during pregnancy and childbirth matter.

Picture this: An expectant mother is preparing for the birth of her baby. She chooses the care provider her friend, co-worker or family member recommended, she is reading the most popular books on pregnancy and birth (she doesn't know there are any others to choose from - everyone is reading these), she cannot help herself as she watches hour upon hour of those baby and birth shows on t.v., people tell her their birth stories and to just get the epidural (after watching those birth shows and hearing THOSE stories she is beginning to think it might just be a good idea). Right now, she is pretty sure she doesn't want to be induced (she heard it hurts more, but knowing when the baby will come is appealing) or have a cesarean but other than that she is leaving it up to her care provider.

Now she starts her childbirth class. This class is based on normal birth and evidence-based practices. Hm those books she was given are SO different than what the instructor says during class. The instructor doesn't even recommend those books but a host of other books and websites. She begins to wonder what her care provider really thinks and believes about birth. Also, what birth philosophy and practices her chosen birth location has.

I have written a list on choosing a care provider and birth location that is right for you. This is too important to make decisions without extra thoughtfulness and investigation. The key to this information is remembering you are the one purchasing a service. Essentially you are hiring a catcher with medical expertise and renting a room to birth your baby (if you are going to the hospital or birth center).

Choosing the place of birth for your baby - It is incredibly important that you understand where you fit best prior to choosing where to birth your baby. Take hospital and/or birth center tour, call and talk to L&D floor, get facts on home birth by talking to home birth midwives, other moms who have had home births, online and in books.

• Does the location offer what is most important to you (tubs, birth balls, wearing own clothing, intermittent monitoring, etc.)?
• What are standard protocols that are followed?
• Does location routinely use methods that turn a low risk mom and baby into high risk patients?
• Are waterbirths available?
• Are birthing stools or non-reclined pushing and delivery positions encouraged?
• What is the no/low intervention rate?
• What is the epidural rate?
• What is the cesarean rate? Does the hospital support VBAC’s?
• Are mom and baby friendly practices used? (no routine interventions, no separation of mom and baby, breastfeeding is the norm, movement in labor is utilized, etc.)

Points to Ponder afterward -

• Will I be able to have the type of birth I truly desire?
• What location will I ultimately feel most comfortable in?
• What location is ultimately safest for my specific needs (I am currently low-risk or high risk)?
• Is insurance or lack of it the reason I am choosing the location?
• Do I have realistic expectations for the location?
• Am I willing to take responsibility for my birth in the location?
• Is staff open to working with a doula?
• Is staff willing to work with natural childbirth practices?
• Are there any compelling reasons to choose one location over another?

Choosing your care provider - Use this as a template for the interview process or to be certain you are of the same philosophy and belief system.

• What is his/her birth philosophy?
• What is philosophy of pregnancy?
• Has provider seen normal labor and birth? How often?
• What percentage of patients have medicalized births?
• How is the "due date" approached? When is “overdue”?
• Will you answer questions over the phone?
• How much time will you spend with me during each appointment?
• What if I hire a doula? Are there restrictions on the doula I may hire? If yes, why?
• Do I need a childbirth class? Breastfeeding class?
  o Are there restrictions on the type of childbirth or breastfeeding class? If so, what and why?
• What routine tests are utilized during pregnancy? What if I decline these tests?
• What are routine intervention rates? (IV, AROM, continuous monitoring, etc.) Cesarean rate? VBAC rate?
• Induction rate? What induction methods are used?
• Is natural, normal labor and birth supported?
• What positions is care provider comfortable catching in? Birth stool? Hand/Knees? Squatting? Standing?
• If I choose an epidural, when can I get it or when is it too late?
• How often is episiotomy used?
• When would forceps/vacuum be used? Which method is CP comfortable with?
• What about a birth plan? Will desires be put into my file at the hospital so the nurse and/or back-up will know what has been agreed to?
• Are there any protocols that are non-negotiable?
• What if I choose to decline something after careful consideration?
• Is an on call rotation utilized or does CP attend all own patients? If there are partners or an on call rotation, do EACH of the others share in the same birth philosophy and approach to birth?

Points to ponder afterward-

• Did you feel immediately comfortable at the interview?
• Were or are questions specifically answered or is the answer “only when necessary” without additional information unless pressed?
• Was or is care provider willing to answer questions in detail without being annoyed?
• If already with a CP, do you feel comfortable and heard at each appointment?
• Is choosing your care provider based on your insurance or lack of insurance?
• What are you willing to do in order to have the birth you really desire? Birth location?
• How much responsibility are you willing to take for the health care decisions for you and your baby?

Cesarean Avoidance - Tips For Every Woman

Yes you DO want to avoid a cesarean whenever possible. Cesarean is MAJOR surgery. It is not just another way to give birth. Both women and babies are well designed to give birth often never needing intervention of any type.

Cesarean can be a life-saving technique and used well for some serious medical conditions, including but may not be limited to placenta previa, HELLP syndrome, uterine rupture, placental abruption, cord prolapse, some breech presentations, true fetal distress, vasa previa and high order multiples.

Approximately 50-67% or more of all cesarean surgeries performed in the U.S. are likely unnecessary or become "necessary" from iatrogenic influences (non-medical inductions, AROM, pitocin augmentation, epidural or spinal anesthesia, "fetal distress", suspected big baby, lack of mobility, continuous fetal monitoring, pushing positions and/or technique).

Here are some tips to help you avoid a cesarean and have a positive vaginal birth.

• Get educated: Book to start with - The Thinking Woman's Guide To A Better Birth by Henci Goer, Ina May's Guide to Childbirth by Ina May Gaskin, The Official Lamaze Guide. Giving Birth with Confidence by Lothian and DeVries. Seek out websites that use evidence-based information and normal birth practice information. TURN off the t.v. from the dramatic birthing shows unless you watch with a discerning eye to figure out what could be done differently and why. Seek out local resources such as La Leche League, Birth Network, Birth Circles and/or a local ICAN chapter to learn from other women. Take a childbirth class that is not a good patient preparation class. Take an independent evidence-based class that gives you tried and true techniques along with the communication skills to use your consumer voice. Study and learn about your rights as a pregnant woman, informed consent/refusal and all the usual interventions and medications (induction, augmentation, AROM, epidural, monitoring, etc.).
• Interview Several Care Providers: You want to find out what the raw data is for inductions, interventions, epidurals, episiotomy, cesareans, VBAC's and so on. It is important to get at the core philosophy of the care provider. Email me at desirre@birthingtouch.com to receive my handout on this.
• Interview several and hire a Doula: You want a doula who will fit into your philosophy of birth and labor/delivery needs. One size does not fit all.
• Use normal birth practices: Stay home as long as possible in labor (if having an away from home birth), choose a care provider who supports and believes in you, use a variety of natural coping techniques, opt out of routine induction, opt out of continuous monitoring unless high risk, opt out of routine augmentation, opt out of routine epidural or narcotic use, opt out of routine pushing position, limit vaginal exams, use mobility, TRUST yourself, LISTEN to your body and baby, accept responsibility for your decisions, BE confident that you are designed for this task.

I hope this has given you a jumping point to go out and birth!

Happy Thanksgiving.

Desirre

http://www.cdc.gov/nchs/data/hestat/prelimbirths05_tables.pdf#1

http://www.ican-online.org/

http://www.lamaze.org/Default.aspx?tabid=171

http://www.birthingtouch.com/

http://www.childbirthconnection.org/

http://www.hencigoer.com/

Sisterhood of the scar - many years post cesarean

Sisterhood of the Scar

Seems a long distance the ivory tower to the ground. The surprise in finding the thorny bushes with burrs that dig deep and puncture again at will? Well meaning onlookers say “Well a hundred years ago you both would have died?” And the farce begins. Stuff it down because it is crazy not to be grateful for the surgeon’s hand. Smile and pretend all the twisted darkness inside doesn’t really exist. The oft daily chore mixed with joy of caring for a baby whom we are unsure is truly our own. The continuing assault during lovemaking when a cringe comes from the depths when a loving and hungry hand brushes the incision site. “How can he think I am beautiful? How can he possibly want this?” Another thing of beauty and perfection quashed underneath the burden of the surgeon’s handprint. Oh no say it hasn’t already been a year. The birthday. THE birthday sounds so exciting but terror strikes. Preparation to be happy, preparation to feel joy. Preparation not to shortchange our amazing gift of a child under the pain of the surgeon’s knife print.

The anticipated day meant to birth us into motherhood and my child into my waiting hands to my craving breasts, I was birthed into the Sisterhood of the Scar forever.

Visuals that make one go................

Ah the joys of video and the web....

http://youtube.com/watch?v=roFVkDV45MM Question CPD
http://youtube.com/watch?v=2dRF4RtdJdo 1 in 3
http://youtube.com/watch?v=lfoR0fAUD34 Becky's Birth
http://youtube.com/watch?v=Am0aykTPL2M&feature=related My Unnecesarean
http://youtube.com/watch?v=aQd0hPHWOlQ&feature=related My HBA2C
http://youtube.com/watch?v=3lYAKu8k_T0&feature=related A Birth Story
http://www.onetruemedia.com/otm_site/view_shared?p=2a4e81fbf0f66accb8afce HBA3C

These are REAL women and families. This is a very real way our current birth climate takes a toll every minute, every hour, every day, every week, the ripple has become a wave.....

Thank you to ICAN http://www.ican-online.org/ and the women of grit who are taking their power back.

Your body. Your birth. Your life. Use them wisely.

Pass them on!

Pax,

Desirre

Language, birth practices and political correctness.

These days political correctness seems to rule the world (at least the United States). We have become so easily offended that we often miss the truth and follow parcels of truth weighted down by vast untruth for someone else to gain from in some way, not for the health and safety of our bodies or our children.

Language matters. Language can affect how we perceive our bodies, our designed in capabilities and our baby. Language has the ability to strengthen confidence or smash it to pieces in one single moment.

Below is a list that is purposed to make you the reader stop and think. Take the almost ho-hum usual and shed new light on it.

Take a scroll down this inaugural blog and tell me what you think?

cesarean = "controlled" uterine rupture (read in Pushed)
planned epidural = planned paralysis
OB = high risk surgical specialist
Family Practitioner/Midwife = low risk normal birth expert
cesarean rate = epidemic
rising induction and cesarean rates = daylight obstetrics (read in Pushed)
induction = forced birth (Ruth Trode)
ACOG = trade union
Formula=stagnant (Ruth Trode)
Breastmilk=life (Ruth Trode)
Failure to progress = failure to wait (Henci Goer?)
Episiotomy = surgical cut
FEAR = a False Education Appearing to be Real (heard from many places)
AROM (artificial rupture of membranes) = artificial readiness of mother
unneccesary cesarean = unnecesarean (heard from many places and Joni)
CPD = care provider distrust

Please email me at desirre@birthingtouch.com if you have a word change up you would like to see on an updated post in the future. For more information on me, go to http://www.birthingtouch.com/.

Thank you to the women of www.independentchildbirth.com for working on this list with me.

Be BOLD, find the truth and spread it!

Until next time,

Desirre