Laurie Stern, one of the wonderful nurses who works with newborns at our hospitals posted this info on FaceBook. Thank you Laurie! Although those of us who have been working with moms and babies as long as we have were convinced of these things already it is nice to have science back up what our hearts have always known. Every mother knows if she listens with her heart that our babies thrive on being close to us.
Groundbreaking new research shows that a strong emotional bond between a mother and her baby may help prevent diseases, boost immunity, and enhance a child's IQ
By Patty Onderko, Parenting
A must read for prospective parents!
More on a similar topic: How pheromones, those mysterious chemicals we exude when attracting love, affect our babies in the first hour of life.
The Science Behind Baby Bonding
How the chemical connection a mom has with her baby within the first hour of birth sets the tone for their relationship and helps determine the future emotional and physical health of the child for decades to come.
By Patty Onderko, Babytalk
Read this before birthing!
Friday, April 30, 2010
Thursday, April 29, 2010
Healthy Beginnings/Healthy Choices
Getting Your Pregnancy Off to a Great Start!
This is a new 3 class series focusing on pregnancy as opposed to labor & birth. For maximum benifit it should be taken as early as possible during pregnancy.
Healthy Beginnings for Baby
Viewing pregnancy as a state of health
Understanding the building blocks of a great pregnancy
Nurturing ourselves and our babies through nutrition & exercise
Making better choices
How our choices early in pregnancy can affect third trimester complications
What is getting in our way?
Unlocking the mystery of prenatal care
Healthy Beginnings for a Family
Bridging the gap between men & women's journeys through pregnancy
Enriching your relationship during this special time
Using communication & understanding to build strong bonds
A window into the miracle of creation
Healthy Choices for our Births
Freeing yourself to create the birth you want
How Did We Get Here?
Understanding how our past & our present influence our choices in childbirth.
Homebirth as the standard for normal birth & why
Issues of safety vs. risk
Your choice; doctor or midwife?
Components of a positive birth
Positive births can happen everywhere
This is a new 3 class series focusing on pregnancy as opposed to labor & birth. For maximum benifit it should be taken as early as possible during pregnancy.
Healthy Beginnings for Baby
Viewing pregnancy as a state of health
Understanding the building blocks of a great pregnancy
Nurturing ourselves and our babies through nutrition & exercise
Making better choices
How our choices early in pregnancy can affect third trimester complications
What is getting in our way?
Unlocking the mystery of prenatal care
Healthy Beginnings for a Family
Bridging the gap between men & women's journeys through pregnancy
Enriching your relationship during this special time
Using communication & understanding to build strong bonds
A window into the miracle of creation
Healthy Choices for our Births
Freeing yourself to create the birth you want
How Did We Get Here?
Understanding how our past & our present influence our choices in childbirth.
Homebirth as the standard for normal birth & why
Issues of safety vs. risk
Your choice; doctor or midwife?
Components of a positive birth
Positive births can happen everywhere
Wednesday, April 28, 2010
An Example of the Wonder of Birth
Welcome Little Slugger!Some births are so full of surprises they confound even the "professionals". Thank you Baby Ryan for reminding all of us that labor and pain are not one and the same and that birth is new every day.
Sunday, April 25, 2010
Where Does a Dad Fit into the Picture?
To my love, my partner, my son’s father this is for all the things you didn’t do.Begging Elizabeth Barrett Browning’s pardon…
“How Do I Love Thee? Let Me Count the Ways”
My husband never said, “Wouldn’t it be easier to use formula?”
My husband never looked at my small breasts and said, “Are you sure you can make enough milk?”
My husband never said, “If we used bottles I could help out more.”
My husband never said, “If we used bottles I could feel closer to Joe.”
My husband never said, “Are you sure you know what you are doing?”
My husband never said, “My mother didn’t breastfeed me and I turned out fine.”
My husband never said, “My dad’s really uncomfortable with you nursing. Maybe you shouldn’t nurse while we are visiting my parents.”
My husband never said, “He’s too attached to you. He needs to learn how to be independent.”
My husband never said, “I want my wife back.”
My husband never said, “I want my life back.”
My husband never said, “What are you doing taking Joe to the barn? It is too dirty and dangerous there for an infant.”
My husband never said, “You’re going back to teaching riding? But Joe is only 5 weeks old. You can’t go away all day. What if he won’t take these bottles of breastmilk while you are gone? What am I to do?”
My husband never said, “I don’t think I can do this.”
My husband never said, “I don’t want to do this.”
My husband never said, “I don’t want my talking, walking son to breastfeed. It’s perverted.”
My husband never said, “The pediatrician said you can’t know if Joe has a dairy sensitivity. I believe the doctor. He is the expert.”
My husband never questioned my commitment or ability to breastfeed our son. He felt that it was the very best choice for my son’s health and future development. If he sometimes thought I didn’t know what I was doing he never let it show. He has always been my devoted partner in the great adventure of parenthood.
**************************************************
Six days after my son was born we left our tiny rented house in Shell Beach for our first family walk. The love I felt for the tiny bundle I was carrying in the Snugli Sack on my chest was overpowering. I had never felt such a strong emotion. As we walked back from the ocean’s edge I confessed to him my need for his help.
“I’m going to need your help because I’m never going to be able to let him go. I love him too much.”
“What do you mean?” he answered.
“Well you know how I feel about all my animals and that is nothing compared to how I feel about him. Can you imagine how devastated I would be if Spot walked in one day and said, ‘Well I’m going now. Thanks for taking care of me.’
“I know” he said.
“I mean I understand that the goal is to raise him so he CAN go away and I want to be a good parent. I want him to be successful and grow up to be independent, but it feels wrong. I don’t know if I can do it.” I added.
Putting his arm around me he replied, “I’ll help you”.
And he has. He has allowed me to be free to focus on nurturing and closeness while he has lead each step of Joe’s moving away from us. He has been the rock I can lean on. He creates an ever enlarging safety net under Joe so that I feel ok about letting him go. Whether it is scouting, or backpacking, or hiking to the top of Mount Whitney, I know I can count on Mike. Now college and on to traveling in Europe, I know I can count on Mike. He stood by my side when I gave Joe a hug and said good bye after dropping him off for his freshman year at college. He knew how hard that moment was for me. Then he drove for 3 days to get us home while I sank into a deep sadness. He was patient with me; waiting to see what would happen next. And what happened next was that I learned I could live without my son, although it still feels as if part of me is missing. And I also learned once again how much I love my husband.
To my husband on Father’s Day,
How Do I love Thee? Let Me Count the Ways..."
By Elizabeth Barrett Browning
How do I love thee? Let me count the ways.
I love thee to the depth and breadth and height
My soul can reach, when feeling out of sight
For the ends of Being and ideal Grace.
I love thee to the level of everyday's
Most quiet need, by sun and candle-light.
I love thee freely, as men strive for Right; Click here to read a birth story which includes
I love thee purely, as they turn from Praise. this amazing dad!
I love thee with a passion put to use
In my old griefs, and with my childhood's faith.I love thee with a love I seemed to lose
With my lost saints, --- I love thee with the breath,
Smiles, tears, of all my life! --- and, if God choose,
I shall but love thee better after death.
Tuesday, April 20, 2010
Health-care legislation increases birth options: Women covered by Medicaid are insured for delivery at birth centers as well as hospitals
Publised in the SLO New Times April 14, 2010
Picked up by the American Association of Birth Centers for their web site.
BY JENNIFER STOVER
A provision in the new legislation for health care gives women more latitude to decide where, how, and with what kind of professional they will give birth, and may lead to a birth center finally being established in San Luis Obispo.
Most Americans don’t know that 42 percent of all births in the United States are paid through Medicaid reimbursement. Thanks to the passage of the health-care bill, women so insured will have a choice of how they spend that money. Section 2301 includes full Medicaid reimbursement for free-standing birth centers, certified nurse midwives working in hospitals or birth centers, and certified professional midwives (CPMs) working in birth centers. Women can continue to choose a hospital birth with a doctor or midwife, but now they can choose to birth at a licensed out-of-hospital birth center attended by midwives instead.
The average cost of a birth-center birth is approximately one-fifth of a doctor-attended hospital delivery, a huge potential savings to Medicaid: Consider that the typical hospital birth costs approximately $20,000 and the cost can climb to $60,000 for a cesarean birth. Not all women will want to birth naturally without pain medication in birth centers. Not all women are appropriate candidates for birthing with midwives in birth centers. But if only 5 percent of the 4.3 million women in this country who give birth annually choose this option, it would mean millions of dollars saved each year.
For 28 years, local women have been asking now-retired Certified Nurse Midwife Linda Seeley why we don’t have this option. She explained, “A lot of women don’t want to have their babies at home, but also don’t want to be in a hospital. A birth center is usually located close to a hospital but not in a hospital.” After General Hospital closed, Seeley was part of San Luis Obispo General Hospital Foundation’s attempt to start up a birth center. She continued, “A center is more intimate, the women themselves are more in control of what happens. There is more satisfaction and lower stress. It is well known that the lower the stress, the better the outcomes.”
We have no out-of-hospital birth centers in the county. Atascadero midwife Edana Hall, CPM, who is licensed by the California Medical Board, said she is “cautiously optimistic this could lead to the opening of a birth center in San Luis.”
Tiffany Dietrich, a naturopathic doctor and midwife who recently moved to San Luis Obispo, explained that in the greater Seattle area where she recently practiced there are two birth centers. The fact that Medicaid in Washington State already paid for out-of-hospital birth-center births is part of what made that possible.
“When Medicaid pays for something, eventually the insurance companies also begin to pay,” Dietrich said. “It’s a good time to open a community birth center here. Our culture is changing. Out-of-hospital births are on the rise due to media exposure, such as The Business of Being Born, the documentary by Ricki Lake.
“What is happening in Washington State shows that birth centers are a successful model of care for women and babies—as well as financially—for the birth center and Medicaid,” she added.
Jessica Elliott relocated from Morro Bay to Oregon, where Medicaid and insurance companies already pay for out-of-hospital births. She echoed Dietrich: “There are currently three birth centers located in the Portland area where CPMs attend births.”
Elliott, a participant in an intensive clinical training for midwifery at the Andaluz Waterbirth Center, continued, “We do anywhere from 20 to 30 births a month, but demand is growing. The center recently had to hire two new midwives to keep up.”
Last June, a panel of local professionals who work with children and birthing women met with Congresswoman Lois Capps’ district representative, Betsy Umhofer, to present information about the merits of midwifery and out-of-hospital births. She listened to us carefully and relayed our information to Capps, who, as vice chairman of the Health Committee, was in Washington, D.C., working on the legislation that just passed.
After the signing ceremony, Congresswoman Capps issued this statement about this important section of the health-care bill: “I know that bringing a new life into the world can be the most profound moment of a woman’s life. And I am proud that this new legislation will afford women more choices regarding the setting in which this momentous occasion can occur. One of the many important provisions in the new health-care reform legislation is the increased access to care in a variety of settings, including for women who choose to obtain prenatal care and deliver their babies in freestanding birth centers. I was proud to support this provision that assures these centers Medicaid reimbursement for providing this important service in promoting women’s health.”
Jennifer Stover, the president of Birth and Baby Resource Network in San Luis Obispo, is a childbirth educator and doula.
Send comments via the editor at econnolly@newtimesslo.com.
Picked up by the American Association of Birth Centers for their web site.
BY JENNIFER STOVER
A provision in the new legislation for health care gives women more latitude to decide where, how, and with what kind of professional they will give birth, and may lead to a birth center finally being established in San Luis Obispo.
Most Americans don’t know that 42 percent of all births in the United States are paid through Medicaid reimbursement. Thanks to the passage of the health-care bill, women so insured will have a choice of how they spend that money. Section 2301 includes full Medicaid reimbursement for free-standing birth centers, certified nurse midwives working in hospitals or birth centers, and certified professional midwives (CPMs) working in birth centers. Women can continue to choose a hospital birth with a doctor or midwife, but now they can choose to birth at a licensed out-of-hospital birth center attended by midwives instead.
The average cost of a birth-center birth is approximately one-fifth of a doctor-attended hospital delivery, a huge potential savings to Medicaid: Consider that the typical hospital birth costs approximately $20,000 and the cost can climb to $60,000 for a cesarean birth. Not all women will want to birth naturally without pain medication in birth centers. Not all women are appropriate candidates for birthing with midwives in birth centers. But if only 5 percent of the 4.3 million women in this country who give birth annually choose this option, it would mean millions of dollars saved each year.
For 28 years, local women have been asking now-retired Certified Nurse Midwife Linda Seeley why we don’t have this option. She explained, “A lot of women don’t want to have their babies at home, but also don’t want to be in a hospital. A birth center is usually located close to a hospital but not in a hospital.” After General Hospital closed, Seeley was part of San Luis Obispo General Hospital Foundation’s attempt to start up a birth center. She continued, “A center is more intimate, the women themselves are more in control of what happens. There is more satisfaction and lower stress. It is well known that the lower the stress, the better the outcomes.”
We have no out-of-hospital birth centers in the county. Atascadero midwife Edana Hall, CPM, who is licensed by the California Medical Board, said she is “cautiously optimistic this could lead to the opening of a birth center in San Luis.”
Tiffany Dietrich, a naturopathic doctor and midwife who recently moved to San Luis Obispo, explained that in the greater Seattle area where she recently practiced there are two birth centers. The fact that Medicaid in Washington State already paid for out-of-hospital birth-center births is part of what made that possible.
“When Medicaid pays for something, eventually the insurance companies also begin to pay,” Dietrich said. “It’s a good time to open a community birth center here. Our culture is changing. Out-of-hospital births are on the rise due to media exposure, such as The Business of Being Born, the documentary by Ricki Lake.
“What is happening in Washington State shows that birth centers are a successful model of care for women and babies—as well as financially—for the birth center and Medicaid,” she added.
Jessica Elliott relocated from Morro Bay to Oregon, where Medicaid and insurance companies already pay for out-of-hospital births. She echoed Dietrich: “There are currently three birth centers located in the Portland area where CPMs attend births.”
Elliott, a participant in an intensive clinical training for midwifery at the Andaluz Waterbirth Center, continued, “We do anywhere from 20 to 30 births a month, but demand is growing. The center recently had to hire two new midwives to keep up.”
Last June, a panel of local professionals who work with children and birthing women met with Congresswoman Lois Capps’ district representative, Betsy Umhofer, to present information about the merits of midwifery and out-of-hospital births. She listened to us carefully and relayed our information to Capps, who, as vice chairman of the Health Committee, was in Washington, D.C., working on the legislation that just passed.
After the signing ceremony, Congresswoman Capps issued this statement about this important section of the health-care bill: “I know that bringing a new life into the world can be the most profound moment of a woman’s life. And I am proud that this new legislation will afford women more choices regarding the setting in which this momentous occasion can occur. One of the many important provisions in the new health-care reform legislation is the increased access to care in a variety of settings, including for women who choose to obtain prenatal care and deliver their babies in freestanding birth centers. I was proud to support this provision that assures these centers Medicaid reimbursement for providing this important service in promoting women’s health.”
Jennifer Stover, the president of Birth and Baby Resource Network in San Luis Obispo, is a childbirth educator and doula.
Send comments via the editor at econnolly@newtimesslo.com.
Saturday, April 17, 2010
Mothering as a Spiritual Quest
Below is a quote by Dr. Sarah Buckley,MD which I saw posted on FaceBook today. It immediately rang true for me and expressed a piece of mothering I have always felt. Who is really doing the growing; our children or ourselves? For me this was indistinguishable.
"In our society, mothering is often seen as a chore — a time in our lives
when we are unintellectual, and unproductive. There is, however, a radically different point of view,shared by many in other cultures, that sees mothering as a women's spiritual practice, and our babies as our teachers. We have the opportunity in mothering, as never before, to practise devotion, awareness, selflessness, and
unconditional love through our daily mothering tasks. Our intellectual
capacities may (or may not) be diminished, but our hearts and instincts
can bloom, and we can practise the mindfulness that allows us to be
totally in the present — in love with our babies and children — which is
where they are. Blessed be the babies."
I would love to share your thoughts on this quote with other about-to-be-mothers. Please post a comment.
This came from a new resource, a blog site about many issues in gentle parenting practices. To read about Elimination Communication, The Circumcision Decision, Baby Wearing, The No Cry Sleep Solution and many other topics visit:http://www.drmomma.org/2009/07/mothering-mindfulness-and-babys-bottom.html.
Thank you to Pacha for posting this and for being a mindful mother.
"In our society, mothering is often seen as a chore — a time in our lives
when we are unintellectual, and unproductive. There is, however, a radically different point of view,shared by many in other cultures, that sees mothering as a women's spiritual practice, and our babies as our teachers. We have the opportunity in mothering, as never before, to practise devotion, awareness, selflessness, and
unconditional love through our daily mothering tasks. Our intellectual
capacities may (or may not) be diminished, but our hearts and instincts
can bloom, and we can practise the mindfulness that allows us to be
totally in the present — in love with our babies and children — which is
where they are. Blessed be the babies."
I would love to share your thoughts on this quote with other about-to-be-mothers. Please post a comment.
This came from a new resource, a blog site about many issues in gentle parenting practices. To read about Elimination Communication, The Circumcision Decision, Baby Wearing, The No Cry Sleep Solution and many other topics visit:http://www.drmomma.org/2009/07/mothering-mindfulness-and-babys-bottom.html.
Thank you to Pacha for posting this and for being a mindful mother.
Monday, April 5, 2010
More Good News about Breastfeeding
In today's Tribune is a wire story about breastfeeding.The results of a study published today in the Journal Pediatrics says if 90% of babies were breastfed exclusively for the first six months of their lives it could save billions of dollars and 900 babies lives. An article on La Leche League International's web site talks about a different study published in 2009, "a group of infants fed artificial milk had $68,000 in health care costs in a six-month period, while an equal number of nursing babies had only $4,000 worth. In Brazil, where medical care is not readily available, an artificially fed baby is 14 times more likely to die than an exclusively breastfed baby, and at least four times more likely to die than an infant receiving both mother's milk and artificial milk." Why? Because of all the childhood and life time diseases that breast-feeding protects kids from, such as, asthma, diabetes, ear infections and even Sudden Infant Death Syndrome. They don't even factor in the psychological issues for mom, baby and bonding which lead to less postpartum depression, better relationships and less child abuse and neglect.
And that doesn't even factor in the health benefits for the moms! Dr. Alicia Dermer says in an article for La Leche League, "Breastfeeding reduces risk factors for three of the most serious diseases for women-female cancers, heart disease, and osteoporosis-without any significant health risks." Choosing to breast-feed will also reduce your chance of developing high blood pressure and diabetes. In another LLL article researcher Dr. Eleanor Bimla Schwarz, an assistant professor of medicine, epidemiology, obstetrics, gynecology and reproductive sciences, said: "Breastfeeding is an important part of the way women's bodies recover from pregnancy. There are certain hormonal and physiological changes the body expects to go through after pregnancy and when those changes don't happen, that leaves certain body systems in a precarious way. The longer a mother nurses her baby, the better for both of them."
This may be new information for some people but the local women who work with nursing moms and babies have known this for many years. I heard about all the health benefits 20 years ago sitting in a breastfeeding class at General Hospital given by Kathleen Huggins. She is our local breastfeeding guru and author of several books on the topic, including one that I referenced often during my nursing era, The Nursing Mother's Companion. She also started the Breastfeeding Warm Line and currently owns Simply Mama in downtown SLO. Understanding the health impact of breastfeeding is one of the reasons the midwives and nurses at General Hospital worked so hard to become Baby Friendly Certified by the World Health Organization. To be certified a hospital must actively promote breastfeeding in their practices and give out no "freebies" from formula companies. Then our other hospitals followed suit and became very pro-breastfeeding. Because of the great local support for breastfeeding in our hospitals and out our county has had a fantastic breastfeeding rate for years. At times we have been at the 90% mark promoted in this new study when women first leave our hospitals.
Breastfeeding is the most important thing you can do for your child's immediate and long term health!
Local Warm Line: telephone help, classes and one-on-one support: 541-Baby.
La Leche League: For the best breast-feeding resources available on the planet
Local La Leche League: group and individual support and counseling
To check out the articles I quoted
Good For Moms Too: What does the April 2009 Journal, Obstetrics and Gynaecology have to say
A Well-Kept Secret: Breast-feeding's Benefits for Mothers
Breastfeeding Saved My Child's Life: One mother's story
Nursing the World Back to Health: A great article about the connection between breast-feeding, the environment and saving our planet
And that doesn't even factor in the health benefits for the moms! Dr. Alicia Dermer says in an article for La Leche League, "Breastfeeding reduces risk factors for three of the most serious diseases for women-female cancers, heart disease, and osteoporosis-without any significant health risks." Choosing to breast-feed will also reduce your chance of developing high blood pressure and diabetes. In another LLL article researcher Dr. Eleanor Bimla Schwarz, an assistant professor of medicine, epidemiology, obstetrics, gynecology and reproductive sciences, said: "Breastfeeding is an important part of the way women's bodies recover from pregnancy. There are certain hormonal and physiological changes the body expects to go through after pregnancy and when those changes don't happen, that leaves certain body systems in a precarious way. The longer a mother nurses her baby, the better for both of them."
This may be new information for some people but the local women who work with nursing moms and babies have known this for many years. I heard about all the health benefits 20 years ago sitting in a breastfeeding class at General Hospital given by Kathleen Huggins. She is our local breastfeeding guru and author of several books on the topic, including one that I referenced often during my nursing era, The Nursing Mother's Companion. She also started the Breastfeeding Warm Line and currently owns Simply Mama in downtown SLO. Understanding the health impact of breastfeeding is one of the reasons the midwives and nurses at General Hospital worked so hard to become Baby Friendly Certified by the World Health Organization. To be certified a hospital must actively promote breastfeeding in their practices and give out no "freebies" from formula companies. Then our other hospitals followed suit and became very pro-breastfeeding. Because of the great local support for breastfeeding in our hospitals and out our county has had a fantastic breastfeeding rate for years. At times we have been at the 90% mark promoted in this new study when women first leave our hospitals.
Breastfeeding is the most important thing you can do for your child's immediate and long term health!
Local Warm Line: telephone help, classes and one-on-one support: 541-Baby.
La Leche League: For the best breast-feeding resources available on the planet
Local La Leche League: group and individual support and counseling
To check out the articles I quoted
Good For Moms Too: What does the April 2009 Journal, Obstetrics and Gynaecology have to say
A Well-Kept Secret: Breast-feeding's Benefits for Mothers
Breastfeeding Saved My Child's Life: One mother's story
Nursing the World Back to Health: A great article about the connection between breast-feeding, the environment and saving our planet
Tuesday, March 30, 2010
A Salute to the Nurses and Midwives of General Hospital
Yesterday I attended Lois Capps' thank you rally for people who helped to get the health care bill passed. It was held in the parking lot of the Community Health Care buildings across from the old General Hospital building. It was a surreal experience standing there looking at that building where so many babies were caught by Certified Nurse Midwives over the years and hearing Representative Capps speaking about a bill I passionately hope will encourage an upswing in the numbers of women receiving midwifery care in this country.
I couldn't really concentrate on what she was saying because my mind kept wandering over and walking the halls of that ugly old building thinking of all the uninsured babies born there over the years. Remembering the excitement of being present at the first hospital waterbirth in the county in one of their rooms. Thinking about the wonderful nurses and midwives who worked so hard at General Hospital over the years to create our most pro-natural hospital birthing option in the county. They always led the way, clearing a path for our other hospitals to follow; from postpartum family rooming in to birthing chairs, from the creation of the breastfeeding warm line to birthing tubs. Perhaps their most important contribution was becoming certified by the World Health Organization as a "baby friendly hospital".
It was a bittersweet moment thinking about the General Hospital nurses and midwives trying so hard to create a free-standing birth center within the shell of a building the county supervisors left behind and knowing the new health care reform might breath life back into their dream. How fitting to be listening to Congresswoman Capps, a former nurse, who has continued caring and fighting for women and children her whole life. It shouldn't surprise me. During my career I've met so many "Nurse Hathaways" walking the halls of our hospitals. Women who truly care about making things better for birthing women and their babies.
Although I was invited to attend this event I didn't actually work on getting passage of the legislation. Instead I worked on making sure birthing women's voices were represented in the bill. Women all over the country were similarly working through two grass roots organizations, the Mama Campaign and Childbirth Connections. I'm working on a piece that I hope will come out in the Women's Press about my experience with Lois Capps and the democratic process. Stay tuned.
Here is the article: Adrift on the Ocean of American Democracy.
I couldn't really concentrate on what she was saying because my mind kept wandering over and walking the halls of that ugly old building thinking of all the uninsured babies born there over the years. Remembering the excitement of being present at the first hospital waterbirth in the county in one of their rooms. Thinking about the wonderful nurses and midwives who worked so hard at General Hospital over the years to create our most pro-natural hospital birthing option in the county. They always led the way, clearing a path for our other hospitals to follow; from postpartum family rooming in to birthing chairs, from the creation of the breastfeeding warm line to birthing tubs. Perhaps their most important contribution was becoming certified by the World Health Organization as a "baby friendly hospital".
It was a bittersweet moment thinking about the General Hospital nurses and midwives trying so hard to create a free-standing birth center within the shell of a building the county supervisors left behind and knowing the new health care reform might breath life back into their dream. How fitting to be listening to Congresswoman Capps, a former nurse, who has continued caring and fighting for women and children her whole life. It shouldn't surprise me. During my career I've met so many "Nurse Hathaways" walking the halls of our hospitals. Women who truly care about making things better for birthing women and their babies.
Although I was invited to attend this event I didn't actually work on getting passage of the legislation. Instead I worked on making sure birthing women's voices were represented in the bill. Women all over the country were similarly working through two grass roots organizations, the Mama Campaign and Childbirth Connections. I'm working on a piece that I hope will come out in the Women's Press about my experience with Lois Capps and the democratic process. Stay tuned.
Here is the article: Adrift on the Ocean of American Democracy.
Monday, March 29, 2010
Good Newsweek Article on V-BACS
Why don't more doctors support a woman's desire to birth naturally after a previous c-section? This is the question posed in a recent Newsweek article. Claudia Kalb does a good job explaining the relationship between the ACOG guidlines for V-BAC, hospital & doctor liability, the latest research put forward by the National Intstitute of Health, and where a woman's choice fits into it all.
http://www.newsweek.com/id/235317.
Thanks to our local chapter leader of International Cesarean Awareness Network for bringing this article to my attention.
http://www.newsweek.com/id/235317.
Thanks to our local chapter leader of International Cesarean Awareness Network for bringing this article to my attention.
Wednesday, March 24, 2010
The Day President Obama Signed the Health Care Bill
Published in the SLO Tribune on Friday March 26, 2010
Hidden in the thousands of pages of the Health Care Bill that President Obama signed into law were some items very few people were aware of that will effect women all across the country. They target issues concerning maternity care and they have the power to change our beliefs about where, how and with whom women should be giving birth in our country.
Did you know forty-two % of all births in the U.S. are paid for through Medicaid reimbursement? Now women will have a choice of how they use that money. They can continue to choose to birth in a hospital with a doctor but they can also choose to have a Certified Nurse Midwife attend them in a hospital, or they could attend them at an out of hospital birth center. Another option is to have a Certified Professional Midwife attend them at an out of hospital birth center. This doesn’t just represent more freedom for women to choose the birth the want it also represents a huge cost savings to the Medicaid budget. The average hospital birth with a doctor attending costs approximately $20,000. It skyrockets to $60,000 for a cesarean section birth. With our national cesarean section rate climbing every day this is a serious chunk of change. On the other hand the average cost for a birth center birth is approximately ¼ of that or $5000. Not all women should be birthing in birth centers with midwives but if just 5% of women choose this option it will mean millions of dollars a year saved.
Did you know until today they was no widespread standardized assessment of the maternity care being offered in this country? Statistics relating to the benefits and risks of current practices in use today, such as, induction of labor, medication to speed labor, or drugs for pain relief were not being kept in a national database. Over time this data base will yield important information for women and their care providers. Helping them base their care on informed choices.
Did you know women were being denied health care coverage because they had given birth by cesarean section? This was being labeled a pre-existing condition which ruled them out of further care. On top of that the current stance of the American College of Obstetricians and Gynecologists about vaginal birth after cesarean section makes it impossible for many women in the U.S. to do anything except have a repeat cesarean section for all future births. Until today women were faced with the choice of letting their insurance company limit the size of their family or pay about $60,000 per child.
Did you know until today your insurance company could deny you care simply because you were pregnant? Stopping this practice has the potential of effecting millions of women and babies. Guaranteeing access to quality maternity care impacts not just this generation but the next as well.
Thank you to Representative Capps for working to pass this important legislation for women and babies. When asked about this piece of the bill she said, "I know that bringing a new life into the world can be the most profound moment in a woman’s life. And I am proud that this new legislation will afford women more choices regarding the setting in which this momentous occasion can occur. One of the many important provisions in the new health reform legislation is the increased access to care in a variety of settings, including for women who choose to obtain prenatal care and deliver their babies in freestanding birth centers. I was proud to support this provision that assures these centers Medicaid reimbursement for providing this important service in promoting women’s health."
Hidden in the thousands of pages of the Health Care Bill that President Obama signed into law were some items very few people were aware of that will effect women all across the country. They target issues concerning maternity care and they have the power to change our beliefs about where, how and with whom women should be giving birth in our country.
Did you know forty-two % of all births in the U.S. are paid for through Medicaid reimbursement? Now women will have a choice of how they use that money. They can continue to choose to birth in a hospital with a doctor but they can also choose to have a Certified Nurse Midwife attend them in a hospital, or they could attend them at an out of hospital birth center. Another option is to have a Certified Professional Midwife attend them at an out of hospital birth center. This doesn’t just represent more freedom for women to choose the birth the want it also represents a huge cost savings to the Medicaid budget. The average hospital birth with a doctor attending costs approximately $20,000. It skyrockets to $60,000 for a cesarean section birth. With our national cesarean section rate climbing every day this is a serious chunk of change. On the other hand the average cost for a birth center birth is approximately ¼ of that or $5000. Not all women should be birthing in birth centers with midwives but if just 5% of women choose this option it will mean millions of dollars a year saved.
Did you know until today they was no widespread standardized assessment of the maternity care being offered in this country? Statistics relating to the benefits and risks of current practices in use today, such as, induction of labor, medication to speed labor, or drugs for pain relief were not being kept in a national database. Over time this data base will yield important information for women and their care providers. Helping them base their care on informed choices.
Did you know women were being denied health care coverage because they had given birth by cesarean section? This was being labeled a pre-existing condition which ruled them out of further care. On top of that the current stance of the American College of Obstetricians and Gynecologists about vaginal birth after cesarean section makes it impossible for many women in the U.S. to do anything except have a repeat cesarean section for all future births. Until today women were faced with the choice of letting their insurance company limit the size of their family or pay about $60,000 per child.
Did you know until today your insurance company could deny you care simply because you were pregnant? Stopping this practice has the potential of effecting millions of women and babies. Guaranteeing access to quality maternity care impacts not just this generation but the next as well.
Thank you to Representative Capps for working to pass this important legislation for women and babies. When asked about this piece of the bill she said, "I know that bringing a new life into the world can be the most profound moment in a woman’s life. And I am proud that this new legislation will afford women more choices regarding the setting in which this momentous occasion can occur. One of the many important provisions in the new health reform legislation is the increased access to care in a variety of settings, including for women who choose to obtain prenatal care and deliver their babies in freestanding birth centers. I was proud to support this provision that assures these centers Medicaid reimbursement for providing this important service in promoting women’s health."
Tuesday, March 23, 2010
E-Mail Correspondence with Congresswoman Capps
Here is the e-mail I sent to Betsy Umhofer, Representative Capps' local Liaison and Congresswoman Capps' reply.
Dear Ms. Umhofer,
I would like to thank you and Representative Capps for your work on the Health Care Bill, especially the part that includes Medicaid reimbursement for Certified Nurse Midwives & Certified Professional Midwives working in out of hospital birth centers. Your work will provide quality maternity care for many women in our community who seek out of hospital birth experiences. I have written a piece about the legislation on my blog: http://slolaboroflovedoula.blogspot.com/2010/03/historic-health-care-bill-for-women.html.
I am currently working on an opinion piece about it for either New Times or Women’s Press. Would Congresswoman Capps care to send a quote about why she supported this piece of the overall bill and what she hopes will come from it?
Here is Congresswoman Capps' reply
"I know that bringing a new life into the world can be the most profound moment in a woman’s life. And I am proud that this new legislation will afford women more choices regarding the setting in which this momentous occasion can occur. One of the many important provisions in the new health reform legislation is the increased access to care in a variety of settings, including for women who choose to obtain prenatal care and deliver their babies in freestanding birth centers. I was proud to support this provision that assures these centers Medicaid reimbursement for providing this important service in promoting women’s health."
Dear Ms. Umhofer,
I would like to thank you and Representative Capps for your work on the Health Care Bill, especially the part that includes Medicaid reimbursement for Certified Nurse Midwives & Certified Professional Midwives working in out of hospital birth centers. Your work will provide quality maternity care for many women in our community who seek out of hospital birth experiences. I have written a piece about the legislation on my blog: http://slolaboroflovedoula.blogspot.com/2010/03/historic-health-care-bill-for-women.html.
I am currently working on an opinion piece about it for either New Times or Women’s Press. Would Congresswoman Capps care to send a quote about why she supported this piece of the overall bill and what she hopes will come from it?
Here is Congresswoman Capps' reply
"I know that bringing a new life into the world can be the most profound moment in a woman’s life. And I am proud that this new legislation will afford women more choices regarding the setting in which this momentous occasion can occur. One of the many important provisions in the new health reform legislation is the increased access to care in a variety of settings, including for women who choose to obtain prenatal care and deliver their babies in freestanding birth centers. I was proud to support this provision that assures these centers Medicaid reimbursement for providing this important service in promoting women’s health."
More Great News About the Health Care Legislation!
This just e-mailed to me from Childbirth Connection, another group that worked hard to get important items for women and babies included in this bill.
Dear Friend, On Sunday, March 21, the House of Representatives took a courageous and giant step toward a better health care system for America’s women, babies and families with the passage of the Patient Protection and Affordable Care Act. This legislation will make a significant difference in the lives of millions of women, babies and families by expanding access to health insurance, ending insurance industry practices that discriminate against women, and improving the quality and cost of health care.
Childbirth Connection worked hard over the last year to ensure that the special needs of women and babies were considered in health care reform. We are happy to report that our efforts resulted in provisions in the bill for measuring and reporting on the quality of adult health care covered by Medicaid. Because Medicaid pays for about 42% of births in the country, this provision offers important opportunities for using performance measurement to improve the quality and value of maternity care. Childbirth Connection is committed to ensuring that the new performance measurement program gives appropriate attention to childbearing women and newborns. We will work on implementation with the Centers for Medicare and Medicaid Services and other stakeholders.
This accomplishment would not have been possible without the support of many individuals and organizations committed to significant improvements in maternity care access and quality. Special thanks to Representatives Elliot Engel and Lois Capps, as well as the staffs of the House Energy & Commerce and Senate Finance Committees for supporting these important quality improvement provisions. We also thank the many national organizations and countless individuals who advocated for these provisions.
Other provisions in the bill that will benefit women and babies include:
Health insurance coverage for women before, during and between pregnancies
Medicaid reimbursement for licensed caregivers offering services in licensed birth centers
Medicaid reimbursement of the birth center facility fee
100% reimbursement of Certified Nurse-Midwives’ services in Medicare Part B
Elimination of denial of insurance coverage due to pre-existing conditions such as being pregnant, having had a cesarean section, or being a victim of domestic violence
Workplace protections for nursing mothers
Screening for postpartum depression
Prenatal and postpartum nurse home visits for low-income, first-time families and their children Coverage for a range of preventive services including screening for diabetes and heart disease.
This is all great news for women and families, but there’s still more to do. Please contact your senators (click on “Web Form”) and ask them to pass the reconciliation bill to further strengthen health care reform provisions.
With the President’s signing of the Patient Protection and Affordable Care Act into law today, please join with Childbirth Connection in celebrating the path-breaking provisions that will be carried out in the weeks, months and years ahead.
Best wishes,
Maureen Corry
Executive Director
Childbirth Connection
Dear Friend, On Sunday, March 21, the House of Representatives took a courageous and giant step toward a better health care system for America’s women, babies and families with the passage of the Patient Protection and Affordable Care Act. This legislation will make a significant difference in the lives of millions of women, babies and families by expanding access to health insurance, ending insurance industry practices that discriminate against women, and improving the quality and cost of health care.
Childbirth Connection worked hard over the last year to ensure that the special needs of women and babies were considered in health care reform. We are happy to report that our efforts resulted in provisions in the bill for measuring and reporting on the quality of adult health care covered by Medicaid. Because Medicaid pays for about 42% of births in the country, this provision offers important opportunities for using performance measurement to improve the quality and value of maternity care. Childbirth Connection is committed to ensuring that the new performance measurement program gives appropriate attention to childbearing women and newborns. We will work on implementation with the Centers for Medicare and Medicaid Services and other stakeholders.
This accomplishment would not have been possible without the support of many individuals and organizations committed to significant improvements in maternity care access and quality. Special thanks to Representatives Elliot Engel and Lois Capps, as well as the staffs of the House Energy & Commerce and Senate Finance Committees for supporting these important quality improvement provisions. We also thank the many national organizations and countless individuals who advocated for these provisions.
Other provisions in the bill that will benefit women and babies include:
Health insurance coverage for women before, during and between pregnancies
Medicaid reimbursement for licensed caregivers offering services in licensed birth centers
Medicaid reimbursement of the birth center facility fee
100% reimbursement of Certified Nurse-Midwives’ services in Medicare Part B
Elimination of denial of insurance coverage due to pre-existing conditions such as being pregnant, having had a cesarean section, or being a victim of domestic violence
Workplace protections for nursing mothers
Screening for postpartum depression
Prenatal and postpartum nurse home visits for low-income, first-time families and their children Coverage for a range of preventive services including screening for diabetes and heart disease.
This is all great news for women and families, but there’s still more to do. Please contact your senators (click on “Web Form”) and ask them to pass the reconciliation bill to further strengthen health care reform provisions.
With the President’s signing of the Patient Protection and Affordable Care Act into law today, please join with Childbirth Connection in celebrating the path-breaking provisions that will be carried out in the weeks, months and years ahead.
Best wishes,
Maureen Corry
Executive Director
Childbirth Connection
Historic Health Care Bill for Women, Maternity Care and Midwives
I just watched President Obama sign into law the health care bill. People may disagree about this bill and what it means for our future. I'm not going to discuss the total bill. What is important to me is something few people are aware of. Buried in this bill is a very important piece of legislation that speaks directly to women & midwives. Because of the passage of this bill women on Medicaid can now seek midwifery care from both a Certified Nurse Midwife or a Certified Professional Midwife and birth their babies in out of hospital birth centers. This is a huge step forward for CPMs in their desire to be acknowledged as birth professionals providing safe care for healthy moms and babies during birth. It will make birth centers more financially viable due to Medicaid reimbursement and therefore will lead to more birth centers being opened and more out of hospital births occurring. This is greatly needed at this time in our country to balance the current medical birth climate and bring down the huge cost of maternity care.
I was very proud to watch our Representative, Congresswoman Lois Capps, at the signing ceremony. I would like to thank her for her dedication and work, for her caring about women's health issues and for her support of midwives & midwifery. I would like to thank the women who cared enough to take the time to sit down with me and Betsy Umhofer, Rep. Capps local liaison, and present to her why she should support this important piece of legislation: Jessica Elliott, past president of BBRN & current midwife in training, Edana Hall, Licensed Midwife, Miday Johnson, Certified Nurse Midwife, Megan Bochum, past local International Cesarean Awareness Network leader and student midwife, Janet Murphy, Cal Poly Child Development Specialist, and Stephanie Wilson, LMST and SLO-Child Abuse Prevention Council Postpartum Depression Specialist. It was women like this all around the country speaking up that made this moment in our history happen. Congratulations!
I was very proud to watch our Representative, Congresswoman Lois Capps, at the signing ceremony. I would like to thank her for her dedication and work, for her caring about women's health issues and for her support of midwives & midwifery. I would like to thank the women who cared enough to take the time to sit down with me and Betsy Umhofer, Rep. Capps local liaison, and present to her why she should support this important piece of legislation: Jessica Elliott, past president of BBRN & current midwife in training, Edana Hall, Licensed Midwife, Miday Johnson, Certified Nurse Midwife, Megan Bochum, past local International Cesarean Awareness Network leader and student midwife, Janet Murphy, Cal Poly Child Development Specialist, and Stephanie Wilson, LMST and SLO-Child Abuse Prevention Council Postpartum Depression Specialist. It was women like this all around the country speaking up that made this moment in our history happen. Congratulations!
Monday, March 22, 2010
A Victory for Mothers and Babies!
I am too busy to write but there has been lots of important news about birth lately in the news. Here is the latest as of this morning. . .
This is an e-mail sent to me from the Mama Campaign, an organization that is dedicated to getting women more access to quality midwifery care in all birth settings.
Midwives and mothers, babies and families, are victors today! With the passage of the Senate health care reform bill in the U.S. House of Representatives on Sunday, March 21, and the signature of the President in the coming days, several provisions that will significantly benefit mothers and babies will now be the law of the land! These provisions will increase access to birth options for low-income women across the country, and will improve the quality of maternity care for all women in the years to come. The MAMA Campaign is proud to have had a role in improving conditions for midwives and mothers in this landmark legislation. The following are now law:
MAMA Campaign’s “partial victory”:
*Senator Cantwell’s provision that will have the effect of requiring Medicaid reimbursement for licensed CPMs offering services in licensed birth centers
*American Association of Birth Center’s provision that mandates Medicaid reimbursement of the birth center facility fee
*Childbirth Connection’s provision requiring quality assessment and improvement measures specific to maternity care
*American College of Nurse Midwives’ equitable reimbursement act for Certified Nurse Midwives
*Giving birth, having a cesarean section, or being the victim of domestic abuse will no longer be considered pre-existing conditions and used to deny insurance coverage to women!
What Happens Now With This Legislative Process?Last night, the House of Representatives passed the Senate health care reform bill that contains the above provisions and the President will sign this bill into law in the coming days. The House also passed a companion reconciliation bill, popularly called a “side car" or "fix it”, to address the House’s concerns about the Senate bill. This companion bill now goes to the Senate for consideration. It is expected that debate will begin in the Senate on Tuesday, and that Republicans will introduce a number of amendments, with debate taking several days. The Senate will be considering this bill under the reconciliation process which requires a simple majority to pass, and Democrats appear confident that they have the votes to pass this bill in the Senate.
Thank You for Your Role in This Victory!Thank you to each and every one of you who supported the MAMA Campaign and these provisions for women and families. Every letter that you wrote and every dollar that you gave made a difference! We look forward to working with you this year as the MAMA Campaign continues the effort to cover all CPM services in all settings in the Federal Medicaid program.Moving Beyond Health Care Reform- MAMA Continues to Fight for CPMsMAMA continues to be on the move for midwives and mothers in Washington, D.C!
The MAMA Campaign Steering Committee met in Washington, D.C. two weeks ago, March 5th – 7th, to evaluate the campaign to date and to re-commit to working together to achieve our central goal: to amend the Social Security Act to require the reimbursement of all CPM services in the Federal Medicaid program. On March 5th, 8th & 9th, steering committee members met with 35 Congressional offices on behalf of midwives and mothers. It was clear in these visits that our policy gained significant support in 2009 in key offices and that this support can be leveraged as we move forward in 2010.
You will be hearing from us over the next weeks and months, asking for your input, your engagement and your support as MAMA continues to do our part to improve maternity care in the U.S. and to increase women’s access to Certified Professional Midwives.
Thank Your Legislators!If your Senators and Congress Members voted for health care reform, including the provisions for women and families, please write to them to thank them. If your legislators voted against health care reform, please write to ask them to ensure in Federal legislation that women have access to Certified Professional Midwives, a high-quality, low-cost option. As always, your legislators need to hear from you on behalf of midwives and mothers!
Support Your MAMA! In celebration of the passage of our “partial victory” and in support of our on-going work to cover all CPM services in all settings in the Federal Medicaid program, please consider donating to the MAMA Campaign today!If you have any questions, concerns or comments please contact the campaign at mailto:info@mamacampaign.org..
This is an e-mail sent to me from the Mama Campaign, an organization that is dedicated to getting women more access to quality midwifery care in all birth settings.
Midwives and mothers, babies and families, are victors today! With the passage of the Senate health care reform bill in the U.S. House of Representatives on Sunday, March 21, and the signature of the President in the coming days, several provisions that will significantly benefit mothers and babies will now be the law of the land! These provisions will increase access to birth options for low-income women across the country, and will improve the quality of maternity care for all women in the years to come. The MAMA Campaign is proud to have had a role in improving conditions for midwives and mothers in this landmark legislation. The following are now law:
MAMA Campaign’s “partial victory”:
*Senator Cantwell’s provision that will have the effect of requiring Medicaid reimbursement for licensed CPMs offering services in licensed birth centers
*American Association of Birth Center’s provision that mandates Medicaid reimbursement of the birth center facility fee
*Childbirth Connection’s provision requiring quality assessment and improvement measures specific to maternity care
*American College of Nurse Midwives’ equitable reimbursement act for Certified Nurse Midwives
*Giving birth, having a cesarean section, or being the victim of domestic abuse will no longer be considered pre-existing conditions and used to deny insurance coverage to women!
What Happens Now With This Legislative Process?Last night, the House of Representatives passed the Senate health care reform bill that contains the above provisions and the President will sign this bill into law in the coming days. The House also passed a companion reconciliation bill, popularly called a “side car" or "fix it”, to address the House’s concerns about the Senate bill. This companion bill now goes to the Senate for consideration. It is expected that debate will begin in the Senate on Tuesday, and that Republicans will introduce a number of amendments, with debate taking several days. The Senate will be considering this bill under the reconciliation process which requires a simple majority to pass, and Democrats appear confident that they have the votes to pass this bill in the Senate.
Thank You for Your Role in This Victory!Thank you to each and every one of you who supported the MAMA Campaign and these provisions for women and families. Every letter that you wrote and every dollar that you gave made a difference! We look forward to working with you this year as the MAMA Campaign continues the effort to cover all CPM services in all settings in the Federal Medicaid program.Moving Beyond Health Care Reform- MAMA Continues to Fight for CPMsMAMA continues to be on the move for midwives and mothers in Washington, D.C!
The MAMA Campaign Steering Committee met in Washington, D.C. two weeks ago, March 5th – 7th, to evaluate the campaign to date and to re-commit to working together to achieve our central goal: to amend the Social Security Act to require the reimbursement of all CPM services in the Federal Medicaid program. On March 5th, 8th & 9th, steering committee members met with 35 Congressional offices on behalf of midwives and mothers. It was clear in these visits that our policy gained significant support in 2009 in key offices and that this support can be leveraged as we move forward in 2010.
You will be hearing from us over the next weeks and months, asking for your input, your engagement and your support as MAMA continues to do our part to improve maternity care in the U.S. and to increase women’s access to Certified Professional Midwives.
Thank Your Legislators!If your Senators and Congress Members voted for health care reform, including the provisions for women and families, please write to them to thank them. If your legislators voted against health care reform, please write to ask them to ensure in Federal legislation that women have access to Certified Professional Midwives, a high-quality, low-cost option. As always, your legislators need to hear from you on behalf of midwives and mothers!
Support Your MAMA! In celebration of the passage of our “partial victory” and in support of our on-going work to cover all CPM services in all settings in the Federal Medicaid program, please consider donating to the MAMA Campaign today!If you have any questions, concerns or comments please contact the campaign at mailto:info@mamacampaign.org..
Sunday, March 21, 2010
Deciding about Giving Vitamin K to Your Newborn?
This is a topic most parents don't even know they should be making a decision about. Instead it simply happens as part of the routine procedures birthing moms and their newborns are subjected to within a hospital setting. Over the years some of my clients have opted out of doing Vitamin K in any form. When I first became involved in the birth community the home birth midwives were not giving Vitamin K at all. Now most of these same midwives have begun giving oral Vitamin K. Conversely to ask that your newborn not receive Vitamin K injection within the first moments of life created quite a stir in our local hospitals when I started going to births. It had to be OK'd by the pediatrician with the parents signing an "against medical advice form." These days our local nurses feel comfortable with delaying the injection for close to 2 hours and will not try too hard to dissuade you if you are refusing it out right. You need to talk this over thoroughly with your midwife or OB and pediatrician ahead of time. Licensed Midwife, Edana Hall told me some local pediatricians will not do a circumcision unless the newborn has recieved injectible rather than oral vitamin K. If you are planning to circumcise your son before you leave the hospital it is recommended he receive a vitamin K injection. If you are thinking about refusing the Vitamin K all together, I would encourage you to wait until after the birth to make a final decision. Some of the risk factors can occur during the birth process and should weigh into your final decision.You need to do more research. Here is a link to an informative article a past client sent me about this topic. Dr. Mercola explains the reason to give Vitamin K to your newborn. He includes a list of risk factors which would make it more important for your individual baby. He also explains why it should not be done by injection. He discusses the science proving the effectiveness of oral Vitamin K and how it should be given. There is also some explanation of using supplementation of the breastfeeding mother's diet with oral Vitamin K as a delivery method for the baby.
http://articles.mercola.com/sites/articles/archive/2010/03/27/high-risks-to-your-baby-from-vitamin-k-shot-they-dont-warn-you-about.aspx
Thanks Marilyn!
Thursday, February 4, 2010
Rise in California Maternal Death Rate Linked to Cesarean Sections: Why Aren't They Telling Us?
My brother, Richard, alerted me to an article in the San Francisco Chronicle yesterday with the head line "Pregnancy Related Death Rate on the Rise". It turns out a task force headed up by a scientist in the California Department of Public Health started a study back in 2006. There were gasps from the audience and basic disbelief when they reported their findings at an American College of Obstetricians and Gynecologists' conference in 2007. The attending doctors seemed to think it was implausible that in this day and age with all our current technology we could possibly be getting worse outcomes for mothers. (A side note is that we are also getting worse outcomes for our babies. The rate of "premature" babies that end up in our neonatal intensive care units is growing too!) They don't seem to see or perhaps they don't want to see that there is actually a link between the increase in technological birth and the bad outcomes. In 2008 a second study confirmed the initial study's findings.
And here it is 2010 and the California Department of Public Health has still not released this study to the public. In other words the very people, who most need to know about this study, the women every day who are getting cut open to give birth in our country, are being kept in the dark. We continue to be sold the myth that a cesarean birth is completely safe, even in some ways preferable to a vaginal birth. Our culture continues to promote the idea of choosing dates and scheduling inductions or cesareans without even any labor at all. Women continue to think this is a safe way to escape the pain of labor. Do you think this would be happening if women were advised by their doctors that their chance of DYING while giving birth would more than DOUBLE if they are induced or schedule a cesarean?
Although the study's findings have still not been released, a California Task Force has begun pilot projects to bring down the death rate. What are they doing? Encouraging the reduction of the induction rate! Why? Because studies show that an induction DOUBLES your chances of "needing" to have your baby come by major abdominal surgery.
In 2002 the Medical Director at one Orange County hospital instituted new guidelines for elective inductions; no inductions before 41 weeks of pregnancy. That means no scheduling an induction because that’s when Grandma will be in town or because the next week your O.B. is going on vacation. It also means women don't get to their 39 week prenatal visit and have the doctor cheerily inform them that they will put them on the schedule to be induced if they haven't had their baby by week 40. From my own experience I can tell you how critical that last week is for moms' bodies to prepare for labor. Their body chemistry is slowly building toward a perfect hormonal balance to begin and support a labor that will progress until their baby is born.
And what has happened at the Orange County hospital? They have fewer babies who need to spend their first days in a neonatal intensive care unit separated from their parents instead of bonding and breastfeeding at home. They have fewer maternal hemorrhages which is the leading cause of death for mothers during the birth process. And they have fewer emergency hysterectomies which is what they have to do to save her life if a woman is bleeding to death. The hospital has also seen its profits go down. Full O.R.s and neonatal units, and longer hospital stays for recovering moms equal big bucks. Remember having a baby by cesarean surgery is at a minimum twice as expensive.
Here it is by the numbers ladies:
California Maternal Death Rate 1996: 5.6 mothers die per 100,000 live births.
2006: 16.9 mothers die per 100,000 live births.
California's rate is even worse than the national rate which is 13.3. My guess as to why we are higher is a deadly combination of cultural factors, fear of liability by doctors and Hollywood stars fueling a "too posh to push" mentality.
Here is a question I would like answered. Where does the fact that we have gone back to the “once a cesarean always a cesarean” policy fit into this picture? How can a woman be an informed consumer when choosing between the risks of having a repeat cesarean versus the risks of trying for a vaginal birth after a cesarean if they are keeping the facts about the risks from us?
So if someone is recommending to you to schedule an induction simply because you are at week 40, or you are thinking about just picking a day for your baby's birth by signing up for a trip to the Operating Room, don't make your decision lightly because your life may depend on the decision you make. Consider first do you have any other indications that your health or your baby's health needs you to take this risky step? Is your blood pressure too high? Is your baby no longer growing or showing other clear signs of being in distress? Women will often be frightened by stories of healthy placentas magically turning into degrading placentas the moment they are at 40 weeks plus 1 day. Yes, all placentas will begin to break down at some point. For some women it will start at week 38 and for others at week 43. The only way to know about your placenta is to monitor the health of your baby through nonstress tests and ultrasound. Remember there are times when the very best choice for you and your baby is an induction or cesarean surgery but only if there are clear indications of current risk.
Read "Bodie's Birth" to hear a couples' story of a necessary cesarean section and how our system should work.
And here it is 2010 and the California Department of Public Health has still not released this study to the public. In other words the very people, who most need to know about this study, the women every day who are getting cut open to give birth in our country, are being kept in the dark. We continue to be sold the myth that a cesarean birth is completely safe, even in some ways preferable to a vaginal birth. Our culture continues to promote the idea of choosing dates and scheduling inductions or cesareans without even any labor at all. Women continue to think this is a safe way to escape the pain of labor. Do you think this would be happening if women were advised by their doctors that their chance of DYING while giving birth would more than DOUBLE if they are induced or schedule a cesarean?
Although the study's findings have still not been released, a California Task Force has begun pilot projects to bring down the death rate. What are they doing? Encouraging the reduction of the induction rate! Why? Because studies show that an induction DOUBLES your chances of "needing" to have your baby come by major abdominal surgery.
In 2002 the Medical Director at one Orange County hospital instituted new guidelines for elective inductions; no inductions before 41 weeks of pregnancy. That means no scheduling an induction because that’s when Grandma will be in town or because the next week your O.B. is going on vacation. It also means women don't get to their 39 week prenatal visit and have the doctor cheerily inform them that they will put them on the schedule to be induced if they haven't had their baby by week 40. From my own experience I can tell you how critical that last week is for moms' bodies to prepare for labor. Their body chemistry is slowly building toward a perfect hormonal balance to begin and support a labor that will progress until their baby is born.
And what has happened at the Orange County hospital? They have fewer babies who need to spend their first days in a neonatal intensive care unit separated from their parents instead of bonding and breastfeeding at home. They have fewer maternal hemorrhages which is the leading cause of death for mothers during the birth process. And they have fewer emergency hysterectomies which is what they have to do to save her life if a woman is bleeding to death. The hospital has also seen its profits go down. Full O.R.s and neonatal units, and longer hospital stays for recovering moms equal big bucks. Remember having a baby by cesarean surgery is at a minimum twice as expensive.
Here it is by the numbers ladies:
California Maternal Death Rate 1996: 5.6 mothers die per 100,000 live births.
2006: 16.9 mothers die per 100,000 live births.
California's rate is even worse than the national rate which is 13.3. My guess as to why we are higher is a deadly combination of cultural factors, fear of liability by doctors and Hollywood stars fueling a "too posh to push" mentality.
Here is a question I would like answered. Where does the fact that we have gone back to the “once a cesarean always a cesarean” policy fit into this picture? How can a woman be an informed consumer when choosing between the risks of having a repeat cesarean versus the risks of trying for a vaginal birth after a cesarean if they are keeping the facts about the risks from us?
So if someone is recommending to you to schedule an induction simply because you are at week 40, or you are thinking about just picking a day for your baby's birth by signing up for a trip to the Operating Room, don't make your decision lightly because your life may depend on the decision you make. Consider first do you have any other indications that your health or your baby's health needs you to take this risky step? Is your blood pressure too high? Is your baby no longer growing or showing other clear signs of being in distress? Women will often be frightened by stories of healthy placentas magically turning into degrading placentas the moment they are at 40 weeks plus 1 day. Yes, all placentas will begin to break down at some point. For some women it will start at week 38 and for others at week 43. The only way to know about your placenta is to monitor the health of your baby through nonstress tests and ultrasound. Remember there are times when the very best choice for you and your baby is an induction or cesarean surgery but only if there are clear indications of current risk.
Read "Bodie's Birth" to hear a couples' story of a necessary cesarean section and how our system should work.
Wednesday, February 3, 2010
Bodie's Birth: An Example of How Our System Should Work
I am going to tell you the story of Bodie's birth because it is a good example of how I wish our system always worked. When I first spoke to Bodie's Mom she was looking for childbirth classes with someone who believed in natural childbirth and would be supportive of her choice to birth at home with a Licensed Midwife. We started the group classes at the end of October and I quickly learned what a sweet, intelligent woman she is.
Bodie's parents were seeing Edana Hall, L.M. for their prenatal care and planning a beautiful and peaceful birth at their home in Pismo Beach. Being a medical professional herself she was very clear on her reasons for wanting a homebirth. She explained, "Having worked in hospitals I can tell you they are a great place for sick people but if you aren't sick you don't want to go there. I'm not sick. I'm just pregnant."
As time passed I secretly began to hope I would be invited to their birth. I love going to homebirths. With all the hospital births I do, homebirths help me stay grounded to how women really birth. Even the "natural" births I help create at the hospital are not as empowering for the birthing women. I was sure this couple was preparing for a really special birth.
The first sign that everything might need to go a different direction was just over the horizon. Both her midwife and I had some concern about the baby's size and growth rate. We both had done the right thing and counseled the mom on her diet and she conscientiously made changes in her eating patterns. Her midwife also encouraged her to slow down at work and in life and focus on growing a healthy baby and Bodie's Mom did the right thing and followed her advice.
Eventually as the weeks passed and the baby's growth seemed to be slowing down in spite of the Mom's diligence her midwife did the right thing and sent her to Dr. Cedars, a local perinatologist, for testing. He discovered that the baby was in an alarmingly low birth weight percentile for the number of weeks gestation. Could her dates be wrong? No, Bodie's Mom was sure of her dates.
When the Midwife was told what the tests revealed she immediately did the right thing and told Bodie's Mom she was no longer a good "candidate" for a homebirth. Only healthy women with healthy babies should be giving birth at home. Bodie was no longer considered healthy. She gave the Mom the name of an O.B. for her to get in touch with right away.
Bodie's Mom chose to work with Dr. Yin. At her first appointment Dr. Yin did the right thing and explained to the parents about the need to monitor Bodie much more closely than another baby from now until he was born. Although understandably frightened they agreed that careful watching was necessary.
Putting aside her dreams of a homebirth was difficult even though she completely understood the gravity of the situation. Transitioning to the idea of a hospital birth was also scary. Her Midwife recommended she hire a Doula to guide her through this changing landscape and stand by her side. Bodie's Mom called me. I was invited to her birth but it wasn't going to be the birth I had been wishing for her.
Dr. Yin did the right thing when she advised Bodie's Mom to take it one week at a time. Perhaps things would turn around and the baby would do ok until closer to her due date. She might then be taken out of the high risk category. We hoped it would work out this way and Bodie could be born at French Hospital.
We worked together on things she could do safely and naturally at home to promote her body to move towards an inducible state. It began working and she began off and on to have mild contractions. But there came a day when through the appropriate use of technology it became clear it was riskier for Bodie to continue inside the womb than outside.
So Bodie's Parents did the right thing and checked into Sierra Vista Hospital where they have a Neonatal Intensive Care Unit at the level that Bodie might need. Mom was already having mild contractions. Her Doctor did the right thing by trying a different approach to the induction than simply hooking her up right away to pitocin. I worked with the parents and we did lots of walking the halls together. At one point I stopped by the nurses' station to speak to their nurse. I explained I wanted her to know that once Bodie's Mom was in a more active labor I knew she was going to need to be monitored much more frequently than usual. The nurse was pleasantly surprised I felt that way. I expressed my concern about Bodie and my understanding that I knew he might not deal with the stress of real labor well.
Unfortunately that is exactly what happened. Shortly after starting into a more active labor pattern Bodie's heart rate was alarmingly up. This is a clear indication of stress. Our nurse hurried into the room and gave Mom oxygen, had her lie on her left side which is a position that is easier for the Mom to get oxygenated blood through to her baby, and called Dr. Yin. I explained what was going on to Bodie's parents and tried to began to prepare them for the emotional transition that their son might need to be born surgically. Lots of healthy babies have "funny" heart tones at times during labor and are born just fine vaginally but we all knew Bodie wasn't a healthy baby.
By the time the Doctor arrived the heart rate was back in the normal range. She wasn't alarmist and instead did the right thing by taking a let's wait and see approach. She stayed close by at the nurses' station where she could watch Bodie on the heart monitor. But it wasn't long before Bodie's heart rate began to climb again and it was clear how he needed to be born. I explained again to Bodie's Parents why this was now the safest option for their baby. Dr. Yin seemed surprised I was supportive of a cesarean.
What the medical staff didn't seem to realize is that an experienced Doula should know the difference between how healthy babies respond to labor and a compromised baby. A good Doula should champion staying the low tech natural path as long as the mom and baby are healthy. If mom or baby aren't healthy a Doula's role changes. She becomes a conduit for information about what is going on around the couple, since often the staff need to act quickly and don't have time to fill in all the details for the parents. The staff also doesn't have time to deal with the parents emotions but a good Doula meets that need as well. When plans change their is always fear mixed with grief that needs to be addressed. Life changes very quickly at that point.
So we all went to the O.R., Bodie's Mom first to be "prepped" while I waited behind with Bodie's Dad. This is a particularly difficult time for fathers. Very soon Bodie was out and it became clear there had been multiple issues contributing to Bodie's tiny size, none of which could have been prevented by anything his Mom could have done. There is nothing different that would have happened if she had chosen to see a Doctor for prenatal care or planned a birth in a hospital. Ultimately no matter what path she chose it would have lead her to that moment.
I am happy to report that beautiful Bodie has doubled in size in the few weeks since his birth. He is healthy and getting stronger everyday and so is his Mom.
This is how I wish our system always worked. This is how it is done in the Netherlands and they consistently have better outcomes than the U.S. All women are initially seen by Midwives. They assess them and determine if they need to plan a hospital birth with an O.B. or with a Midwife, or if they will be birthing at home with a Midwife. Each time prenatal care is given they are re-evaluating. Is she still a homebirth "candidate". If at anytime leading up to the birth or during the birth she is no longer a "candidate" they turn care over to the appropriate care provider. This care provider continues to work with the midwife and accords her the professional respect she deserves. After all she did the right thing. Thank yous to Edana Hall, L.M., Dr. Cedars, Perinatalogist, and Dr. Elain Yin, O.B. for their quality care of Bodie and his Mother. I want to say an individual thank you to Dr. Yinn who took the time to get me re-connected with my mom down in the Recovery Room.
Monday, February 1, 2010
Diane's Poem
December 25, 1997
Jennifer,
When I try to put into words what we have achieved together, it seems so simple that the intensity is lost. I am left with emotions and the process which words can not recreate. Metaphors and poetry will have to suffice. . .
Jennifer,
When I try to put into words what we have achieved together, it seems so simple that the intensity is lost. I am left with emotions and the process which words can not recreate. Metaphors and poetry will have to suffice. . .
Thank you for offering your strength,
you became a safe harbor in a storm.
Thank you for seeing my vision
and allowing me to face my dragon
and ride it through the fire.
Thank you for sharing my excitement,
the magic of anticipation as the journey began.
Thank you for understanding each transformation,
as I became a person I did not know,
in a body no longer mine.
Thank you for cleansing my spirit,
as my body flowed from every pore.
Thank you for singing my song with me
and guiding it's harmony to follow nature's melody.
Wishing you love and peace this Christmas & New Year,
Diane
Lisa Ann & Tracy's Gift
November 13, 2004
Dear Jennifer,
Over the past few months, we have tried to think of some gift that would precisely express our deep appreciation for your part in our son's birth. Any item we could think of minimized this expression. We would like instead, for this letter, a gift of the heart, to serve our purpose.
The work you did with us prior to Grant's arrival was an important part of our journey. You partnered with us in structuring our dream by getting us ready for the most monumental event of our lives. In the birthing classes we learned valuable information, imparted to us with tender care. Our personal meetings with you brought all three of us closer. The teaching we received about what to expect, how to prepare, how to ready ourselves as a couple, was invaluable. Though our birthing experience was surprising, we were as well prepared as possible thanks to your excellent instruction. But the word "instruction" doesn't speak to the heart you put into your work. You are so much more than a teacher and coach.
Our birthing experience was powerful and precipitous. We know it would have gone much differently had you not been a part. You kept us on track, you remembered our requests, and you honored the reality of what we were experiencing. We couldn't have asked for anything more than what you gave. You gave of yourself Jennifer and we can never equally repay you.
We believe that when we look into our son's bright, alert, attentive eyes-that you are partly responsible for that look. You kept us drug free! That is true even before the delivery as you worked with Lisa Ann on some health issues. You gave us an honorable birth. You walked with Lisa Ann into an inferno and helped her find a place she could survive. You steadied Tracy as he looked on as his son tore into the world much more frighteningly than we could have imagined. You maintained our dignity as you worked with us to create the birth you rememberd we wanted. In your own words, you gave us as much of our dream as you could.
You have become much more than a birthing coach. You are a friend. whatever paths our lives take, you will always have a special place in ours. How can we look at our son without remembering you? You have a gift and what you do is an artform. We know you put your heart and soul; into it and we want to recognize you for this immense effort.
Thank you Jennifer, for your part in Grant's arrival. Thank you for your care in the hospital and in the days afterward. Thank you for your continued presence in our lives. You are an angel.
With loving gratitude,
Lisa Ann & Tracy
Dear Jennifer,
Over the past few months, we have tried to think of some gift that would precisely express our deep appreciation for your part in our son's birth. Any item we could think of minimized this expression. We would like instead, for this letter, a gift of the heart, to serve our purpose.
The work you did with us prior to Grant's arrival was an important part of our journey. You partnered with us in structuring our dream by getting us ready for the most monumental event of our lives. In the birthing classes we learned valuable information, imparted to us with tender care. Our personal meetings with you brought all three of us closer. The teaching we received about what to expect, how to prepare, how to ready ourselves as a couple, was invaluable. Though our birthing experience was surprising, we were as well prepared as possible thanks to your excellent instruction. But the word "instruction" doesn't speak to the heart you put into your work. You are so much more than a teacher and coach.
Our birthing experience was powerful and precipitous. We know it would have gone much differently had you not been a part. You kept us on track, you remembered our requests, and you honored the reality of what we were experiencing. We couldn't have asked for anything more than what you gave. You gave of yourself Jennifer and we can never equally repay you.
We believe that when we look into our son's bright, alert, attentive eyes-that you are partly responsible for that look. You kept us drug free! That is true even before the delivery as you worked with Lisa Ann on some health issues. You gave us an honorable birth. You walked with Lisa Ann into an inferno and helped her find a place she could survive. You steadied Tracy as he looked on as his son tore into the world much more frighteningly than we could have imagined. You maintained our dignity as you worked with us to create the birth you rememberd we wanted. In your own words, you gave us as much of our dream as you could.
You have become much more than a birthing coach. You are a friend. whatever paths our lives take, you will always have a special place in ours. How can we look at our son without remembering you? You have a gift and what you do is an artform. We know you put your heart and soul; into it and we want to recognize you for this immense effort.
Thank you Jennifer, for your part in Grant's arrival. Thank you for your care in the hospital and in the days afterward. Thank you for your continued presence in our lives. You are an angel.
With loving gratitude,
Lisa Ann & Tracy
Birth & Baby Resource Network’s Parenting Night
Confused by all the conflicting advice in baby books and parenting manuals? Looking for a way to raise children with close family ties while nurturing their independence? Come learn how to integrate the principles of Attachment Parenting into the current American family culture. This will be an informal evening of sharing and discussion with other parents giving practical advice and common sense tips. Hear about the why, how, and how did that work out for you on these topics: family bed, baby wearing, pediatric alternative health care, baby led weaning, elimination communication, breastfeeding beyond a year, homeschooling, positive discipline and more. Do you need support for making any of these “different” choices for your children? Join BBRN on Tuesday February 23 at 7 p.m. at the San Luis Obispo YMCA, 1020 Southwood Blvd. This event is part of BBRN’s free monthly education nights. Go to www.bbrn.org to find the month’s topic. Babies and children are always welcome!
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