Wednesday, December 24, 2008

Jennifer Block Rocks

Author and Activist Jennifer Block of the amazing book Pushed had her opinion printed in the LA Times today. Midwives deliver America needs better birth care, and midwives can deliver it.

In her article you learn that the number one reason people in the United States are admitted to the hospital is for childbirth.

You got it folks. Not heart attacks, cancer, car accidents. NOPE. Childbirth.

"Six of the 15 most frequent hospital procedures billed to private insurers and Medicaid are maternity-related."

Milbank Memorial Fund, the Reforming States Group and Childbirth Connection have published research findings that show that the medical establishment is NOT following evidence-based best practices.

In the short year and a half I've been a Labor Doula I've witnessed what Ms. Block states: "They are inducing and speeding up far too many labors ." I and my clients have been lucky enough to not have ended up in C-sections thus far. However 1/3rd of all laboring women do end up in a c-section. The World Health Organization states the acceptable level of c-section rates should hover around 10%.

Were you aware that the most common billable materinity procedure is the continous fetal heart monitor? And to this day there are absolutely ZERO studies proving medically that there is any benefit to this procedure yet I can tell you that in the North East it is all too common to require a laboring mother to be hooked up to this loud and scary sounding machine, with a bunch of excuses as to why she must comply. Tsk Tsk...MONEY!

Here's another fact that will knock you out of your seat. Most hospital births cost from $7K-$16K. However the cost of having your baby at a birthing center with a Midwife is around $1600.

And Ms. Block tells us that at those birthing centers, "Mother and baby are more likely to have a normal, vaginal birth; less likely to experience trauma, such as a bad vaginal tear or a surgical delivery; and more likely to breast feed."

Informing you one post at a time.

Sunday, December 14, 2008

Mama Knows Breast...Virtual Nurse In On Facebook

Virtual Nurse In Planned on Facebook
December 12, 2008
Poking around Facebook yesterday, I discovered a little bit of lactivism at work. Apparently, Facebook won't let people post breastfeeding pictures. So some Facebooker's are planning a virtual nurse-in, Saturday, December 27, 2008. They are going to all post breastfeeding pictures at the same time.

To sign up, go to Facebook, and type M.I.L.C. into the search bar. Mothers International Lactation Campaign should pop up.

Here's text of the petition:

Facebook continues to classify breastfeeding photos as obscene content. They continue to arbitrarily remove these photos from member albums and profiles, accompanied by warnings of account termination. This is highly discriminatory and an affront to nursing mothers everywhere. In protest of this, Mothers International Lactation Campaign (M.I.L.C.) has planned a virtual day of protest.

Not only is human lactation responsible for the very survival of our species, it is in no way a sexually explicit, lewd or despicable act. It is also protected by law in most countries, including specifically the state where Facebook is headquartered in the USA.

In protest to the discriminatory and unjust policy of Facebook administration classifying breastfeeding images as obscene content, on December 27th, 2008 M.I.L.C. is asking all of you to change your profile picture for one day, to one which includes an image of a nursing mom.

This could be a picture of you or someone you know nursing a child, it could be a painting or image of a sculpture of a breastfeeding woman, it could also be a photo or image of any nursing mammal....We ask that you include the status line of "Hey Facebook, breastfeeding is not obscene!"

In addition to this 'virtual nurse-in', there will be other events planned around the globe. Please check this page often for regular updates and added information. We will also be including images that you can use for your profile picture on December 27th.

Babies everywhere thank you for your support!!!!!

Monday, December 1, 2008

Your Questions Answered

LadyBanana asked:
"I had not heard of a Doula before knowing you. Just wondering how long they have been around?

Also, as a doula are you ever left alone with a woman in labour?"

Great question! Labor Doulas have been used throughout history. Originally they were our neighbors and family. As we moved into the 20th Century the medical establishment dimished our roles slightly. In the last 20 years we are witnessing a resurgence of professional Labor Doulas.

Yes, we work with the moms often alone or with their partners for many hours. We begin working with our clients during the earlier stages of labor, helping them with comfort techniques for the pain, reminding them to nourish themselves, helping them walk and use natural techniques to encourage their labor to progress.

We usually do not see the doctor or Midwife until it's time for the mom to enter the pushing stages of labor.

Want to ask this doula a question? Leave your query in the comments section.

Sunday, November 23, 2008

Ask A Doula Birth Questions

I'm starting a new weekly segment called: Ask A Labor Doula Birth Questions.

Each week please leave your questions in the comments of this post. At the end of the week I'll choose one question to answer. If your question is picked I'll link back to your blog as well in that post.

Just to whet your appetitite or nudge you for some kinds of things you can ask can ask about book recommendations, doula certification requirements, pricing across the country, stress techniques to get through labor, birth plans, breast feeding questions etc...

Saturday, November 22, 2008

Too Hot Tot Bling

I just found the coolest site for kid gifts. You must check this woman out. Go buy the most awesome fun items for your kids, nieces, nephews, cousins etc...

Here's just one product of her's but there's so much more that will just bring a big smile to your face. These are going to make the most incredible holiday gifts for your babies this year.

I found that incredible blog and store through the following blogger:
From Dates To Diapers


If you are about to give birth PLEASE read this mom's personal birth story on her blog. This is a true account of how birth should be, can be and is normal and can completely happen safely if TIME is given to the mom to let her body work at it's own speed!

Phoebe's Birth Story
My due date was June 8 (or 9, depending on who you ask) and my last appointment with the midwife was Thursday June 12, at which I was told that if I didn't have the baby before my next appointment they were going to schedule an induction for the following week.

Friday, November 21, 2008

Thursday, November 6, 2008

Favorite Quote From Birth Experience

One of my clients exclaimed to her husband right after birth, as the baby started to breast feed, "Look honey he sucks!"

You can't get much funnier than that!

Tuesday, November 4, 2008

Mom Boards Are Biased - Beware

Beware of the mom boards on the Internet as many are used to freely to speak ill about doulas and other birth professionals.

Those boards are full of bias as the moms are the powerhouse behind them and financially support them and get away with murdering the reputations of good professionals without those professionals allowed any recourse.

Remember that when you are only allowed to read one-side of a story you are NOT getting the full information you need to make an educated decision about a birth professional you might be hiring.

Birth is a delicate time in a woman's life. The current medical situation that the doctors and hospitals create often muck up the process and often leave the parents feeling overwhelmed, angry and disappointed. Sadly and too often these bad feelings become misguidedly projected onto the doula and other birth professionals. Then these boards become the attack ground.

When I complained recently about a reply to a post from a mother seeking revenge on a doula she was not happy with, my post was removed and I was accused of flaming the mother, simply by asking that she consider that there are many issues in the birth situation and to give all parties time to heal.

If you are searching for a doula to hire I ask that instead of reading posts from mothers seeking revenge and writing how angry they are, that you instead seek out the posts and stories from those with good birth experiences instead.

Friday, October 31, 2008

When The Birth Situation Leaves The Mother Unhappy With The Doula

Recently I have had the unfortunate knowledge that a mother was not happy with a colleagues doula services. While this is not the usual case it does happen and it will happen.

What I found most disturbing was that the mother decided not only not to speak to or with the doula after the birth to remedy any of the feelings and thoughts she had about the experience they shared, but that she went straight to a popular mom website and listed that doulas first and last name asking any other mother who was even considering using her to contact her first.

This is very worrisome for so many reasons. Even if I were not the passionate and dedicated doula that I am today I would take this stance.

Morally this is very very wrong to do.

Ethically this is very very wrong to do.

So what do you do if you find yourself as the mother in this situation?

First, understand that you just experienced the most dramatic and lifechanging moment in your entire life and with that brings a rush and flood of new feelings. Sometimes that is anger.

Second, write your thoughts and feelings down on paper and do not judge them as you write.


Enjoy your new baby for a few weeks.

Fourth, pick up that paper after a few weeks and see if you still feel the same way about the experience you shared with that doula.

Now whether or not you feel the same or differently, make your post natal appointment with that doula to discuss the birth exprience.

As there are always two sides to every story and we cannot know what the doula was experiencing and processing and deflecting from the mother from the hospital staff, in effect shielding her from, so that it wouldn't further tramatize her experience, it is necessary to have that dialogue and chance for healing the process for both parties.

If you have found yourself in this position I ask that you consider the detrimental results you will impose upon another woman's life by listing your anger about her publically.

Words have a direct result on other people. Those words are in effect the same as taking a sword and cutting off the feet of another human being. Is that really what you want to do and the person you want to be?

Let me end this post by saying that doulas are human beings. We are not perfect. We cannot NOT make mistakes. But we offer nothing medical and those decisions must always be made between you and your medical staff.

What you can expect from your doula during a long labor is that at times she will sleep or hand off duties to your partner/husband. The doula will go for short breaks to replenish her body with food and water and go for bathroom breaks. It is imperitive that we are not exhausted and have the proper energy to help you through a long birth.

I have personally witnessed Midwives sitting in the corner reading books and this is completely normal and proper. Why? Because birth is normal and physiological and the calmness that this one act shows is very important. A doula sitting in the corner while the couple works together achieves the same goal and allows the doula to rest and have energy for when she must jump in and help her client.

There are so many variables we must be the peaceful force through. Speaking with your doula after you had an unhappy experience with her may allow the healing you both need to realize the truth for that day for both experiences.

Please do not publically commit L'oshon Hora.

Friday, October 10, 2008

Noteworthy Relevent Articles and Research Data

Maternity-care failings can be remedied with cost-saving fixes

Back to basics for safer childbirth
Too many doctors and hospitals are overusing high-tech procedures

Milbank Report: Evidence-Based Maternity Care

Go straight to the report

Some straight talk pulled from the report:

Hospital charges for birthing women and newborns excedes ANY other condition.

The average charges for birthing in a hospital range from $7000-$16,000 for a normal vaginal delivery to a complicated c-section.

The average cost for out of hospital birthing centers are around $1624.

Adverse effects of epidurals: immobility, voiding difficulty, sedation, fever, hypotension, itching, longer pushing stages, serious perinial tears. To the baby: rapid heart beat, hyperbilirubinemia, inreased workup for sepsis, and administration of antiobiotics. Many of these things then lead directly to c-sections.

Saturday, October 4, 2008

Miles For Midwives

This Sunday October 5
Sixth Annual Mile For Midwives in Prospect Park Brooklyn.
10am- 2PM
Bartel-Pritchard Square
15th Street and Prospect Park West

5K run/walk and picnic to follow

Friday, September 26, 2008

Amazing Home Birth Video

I have attended a home birth. It was much like you see with this woman. Notice how the Doula is calm and the Midwife is calm and often there isn't much that we must do, but be the calming reassuring presence in the room.

Check out Dad about half way through this video.

As a Doula I realize that homebirth is not for everyone. However, maybe watching this video will help you see how normal and peaceful it really is, rather than the propoganda that is normally heard against it.

Monday, September 8, 2008

The Secrets Your Doctor Keeps From You

Is your healthcare provider making recommendations based on something other than research?

Physician David Newman has written a book about the secrets your doctor keeps from you. Hippocrates' Shadow: Secrets From the House of Medicine

"While patients assume doctors rely on science, "it's not uncommon
for the decisions we make to be entirely based on opinion
," Newman

Newman now trains medical students and residents at Columbia University and St. Luke's/Roosevelt Hospital Center.

Rather than asking leading questions such as do you support breastfeeding (what doctor would say no?) ask more directive questions like: What percentage of your patients ____?

Wednesday, September 3, 2008

Number Two With a Bullet

WASHINGTON, D.C. (September 1, 2008)
In the newest phase of its ongoing effort to deny women the right to choose their maternity care providers and birth settings, the American College of Obstetricians and Gynecologists (ACOG) has announced that eliminating access to midwives who specialize in out-of-hospital birth is now the second most important issue on its state legislative agenda. This move puts restricting access to trained midwives ahead of such critical issues as contraceptive equity, ensuring access to emergency contraception, and the prevention and treatment of perinatal HIV/AIDS.
"ACOG claims to be an advocate of women's health and choice, but when it comes to the right to choose to deliver your baby in the privacy of your own home with a Certified Professional Midwife (CPM) who is specifically trained to provide the safest care possible, ACOG's paternalistic colors bleed through," said Susan M. Jenkins, Legal Counsel for the Big Push for Midwives Campaign. "It is astonishing that an organization that purports to be a champion of
women's healthcare would put a petty turf battle that affects less than one percent of the nation's childbearing women ahead of pressing issues that have an impact on nearly every woman in this country. If this is not dereliction of duty, I can't imagine what is."

In recent years, ACOG has led a well-financed campaign to fight legislative
reforms that would license and regulate CPMs and has now teamed up with the
American Medical Association (AMA) to promote legislation that would prevent
families from choosing to give birth at home. Despite these joint efforts, the
groups have not been successful in defeating the groundswell of grassroots
activism in support of full access to a comprehensive range of maternity care
options that meet the needs of all families.

"Wisconsin is a good example of what ACOG and the AMA are up against," said
Jane Crawford Peterson, CPM, Advocacy Trainer for The Big Push. "Our
bipartisan grassroots coalition of everyday people from across the state managed to
defeat the most powerful and well-financed special interest groups in
Wisconsin, all on an expenses-only budget of $3000 during a legislative session in
which $47 million was spent on lobbying. When you try to deny women the
fundamental and very personal right to choose where and how to give birth, they will
get organized and they will let their elected officials know that
restrictions on those rights cannot stand."

Noting these successes, ACOG has recently launched its own grassroots
organizing effort, calling on member physicians to recruit their patients to
participate in its "Who Will Deliver My Baby?" medical liability reform campaign.

"ACOG itself admits that we're facing a critical shortage of maternity care
providers," said Steff Hedenkamp, Communications Coordinator for the Big
Push. "They certainly realize that medical liability reform is nothing more than
a band aid and that increasing access to midwives and birth settings is
critical to fixing our maternity care system and ensuring that rural, low-income
and uninsured women don't fall through the cracks. Midwives represent an
essential growth segment of the U.S. pool of maternity care providers, but
instead of putting the healthcare needs of women first, ACOG would rather devote
its considerable lobbying budget to a last-ditch attempt to protect its own
bottom line. This is not a happy Labor Day for our nation's mothers and babies."

The Big Push for Midwives
(http://www.thebigpu shformidwives. org/) ) is a nationally coordinated campaign organized
to advocate for regulation and licensure of Certified Professional Midwives
(CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to
push back against the attempts of the American Medical Association and the
American College of Obstetricians and Gynecologists to deny American families
access to safe and legal midwifery care. The campaign plays a critical role in
building a new model of U.S. maternity care delivery at the local and regional
levels, at the heart of which is the Midwives Model of Care, based on the
fact that pregnancy and birth are normal life processes. Media inquiries: Steff
Hedenkamp (816) 506-4630, _steff@thebigpushfo rsteff@theste_
(mailto:steff@thebigpushfor midwives. org) .

The Big Push for Midwives Campaign is fiscally sponsored by Sustainable
Markets Foundation, a not-for-profit organization recognized as tax-exempt under
Internal Revenue Code section 501(c)(3). The mission of the Big Push for
Midwives is to build winning, state-level advocacy campaigns towards successful
regulation and licensure of Certified Professional Midwives (CPMs) in all 50
states, the District of Columbia, and Puerto Rico.

Sustainable Markets Foundation 80 Broad Street, Suite 1600 New York,
NY 10004-2248
The Big Push for Midwives Campaign 2300 M Street, N.W., Suite 800
Washington, D.C. 20037-1434

Everything that is really great and inspiring is created by the individual who can labor in freedom.
Albert Einstein

Tuesday, August 19, 2008

What Is a Midwife?

To learn more about midwifes and decide if this is the right choice for you go here.

Sunday, August 17, 2008

What Is a Doula?

Educating the public at large, I will be giving short definitions every few weeks of what a Doula is.

"A Doula is part of the birth community. She is a trained paraprofessional, not a volunteer looking for certifications."

Tuesday, July 15, 2008

Can I Afford A Doula?

This question is a big one in the doula community and I am sure for those deciding whether or not to hire a doula.

A better question would be can I afford not to hire a doula?

With the c-section rate sky rocketing and the financial burdens that accompany having a c-section it might be seen as penny wise pound foolish not to hire a doula.

The World Health Organization believes that c-section rates should not exceed 15%. Currently the statistics show that 30% of all healthy pregnancies are ending up in c-sections in the United States. Most of them are unnecessary.

In NYC the rate is closer to 50%.

We are one of the most educated generations. Most moms-to-be are going to birthing classes and reading tons of books and yet the c-section rate is climbing.

Acoording to, in 2005 the average cost of a vaginal birth was $5,574 compared to $11,361 for a c-section.

I know I know...YOU aren't paying for it, your insurance company is.

In the June 1, 2008 edition of the NYTimes, writer Denise Grady tells us that many insurance companies are dropping women who have had c-sections because they are pretty much a guarentee that another c-section will be incurred due to the pressure from hospital policy, not medical evidence. So where does having a c-section lead you then?

Aside from the financial aspects of having an unnecessary c-section the physical risks are as follows:

- blood clots, strokes, emergency hysterectomy, infection, long lasting pain, fertility problems, placental problems in later pregnancies such as ectopic or abruptions.
Generally the recovery time is six weeks without complications.

babies -
- breathing problems, surgical injury, reduced breast feeding and asthma in later childhood.

I think it is really amazing just how many books moms today are reading. However, much like reading about how to ride a bike, it's just not the same until you experience the situation.

Childbirth has so many variables today that one cannot possibly be expected to know how to handle them without a trained doula by her side. There's so much pressure to follow what the doctor wants you to do and those of us who have been to many births know that there is very little consistency in what those protocals are. The only consistancy most of us do find is the push to comply with interventions that have a high rate of ending in c-sections.

That is why study after study for more than 30 years have concluded that having a doula with you even when your spouse is available and supportive, halves your chances of having an unnecessary c-section as well as shortening labor time and pain levels.

A great book to get you started on the truth about birth is by Ina May Gaskin called Ina May's Guide to Childbirth.

In NYC currently the average cost of an experienced doula (10 or more births is ) $1500-$3000. A Trained Doula with less than 10 births and/or going for her certification usually charges $500-$800. On Long Island the average charge is $1000-$1500 for an experienced doula.

Doulas visit with you before the baby is born to discuss your birth wishes, work with you from the time active labor starts until one hour after the baby is born, and visit again once to see how you are doing and give you information on postnatal support professionals if needed. Doulas are also on call the two weeks leading up to your due date and take unlimited emails and calls from you.

The average hourly wage for most doulas fees amount to $10-$25 an hour and in most cases about one-weeks salary in the NYC area.

We understand that in some cases for some income levels this is not affordable. If you earn $30K or less in the NYC area these fees can be adjusted. Many doulas will also do volunteer births for teenagers.

For middle income couples a trained doula might be your best option while those earning slightly less might ask for reduced fees or payment plan options. If having a doula with more than 10 births is very important to you then hiring a doula at the higher range of the fee scale will be necessary.

Each doula comes with unique experiences that will be invaluable to your birth of your baby regardless of the experience level of that particular doula.

For more information on my doula services please visit

Friday, July 11, 2008

Jennifer Block Author of the New Book Pushed Responds to ACOG on Home Birth

From the Los Angeles Times

Big Medicine's blowback on home births
Why do U.S. doctors strong-arm women into our standard maternity care system?

By Jennifer Block
July 9, 2008

Jennifer Block the author of "Pushed: The Painful Truth About Childbirth and Modern Maternity Care" wrote an amazing piece in the LA Times on July 9.

Key points from her published piece are as follows: (taken directly from her article)

Her friend in Britian received the following care last year:
  • As a healthy woman with a normal pregnancy, she saw midwives. And one of their first questions to her was, "So, would you like to give birth in the hospital maternity ward or at home?"
  • Britain's national health guidelines call water the safest, most effective form of pain relief. A woman will be helped to give birth in positions that are effective and protective: sitting, squatting, on hands and knees, even standing.

But hospital maternity care in the U.S. is typically not supportive of this process.

  • More than half of women are induced into labor, or it is sped up with artificial hormones; the vast majority of women labor and push in the desultory flat-on-the- back or leaning-back position; and (perhaps not surprisingly) nearly one-third of women end up giving birth through major surgery, the caesarean section.
  • This has led to an epidemic of pre-term births in the United States. A 2006 survey showed that the majority of babies are now born before the spontaneous onset of labor, which leaves them more prone to breathing and feeding difficulties. Caesareans are also contributing to a rising maternal death rate, announced by the Centers for Disease Control and Prevention last year.

The choice to give birth somewhere other than a hospital is backed by sound science. Studies of "low-risk" women in North America planning out-of-hospital births with midwives have found that 95% give birth vaginally with hardly any medical intervention. The largest and most rigorous study to date, published in the British Medical Journal, found that in North America, babies were born at home just as safely as in the hospital.Organized medicine can't believe this.

In a joint statement last year, the Royal College of Obstetricians and Gynecologists and the Royal College of Midwives said, "There is no reason why home birth should not be offered to women at low risk of complications, and it may confer considerable benefits for them and their families."

For the full article please click on the link above.

Thursday, July 10, 2008

Survey of Mothers' Sleep & Fatigue

Texas Tech University Is Searching For Research Participants
"In this survey, we will be asking you some detailed questions about how well you and your baby sleep, where members of your family usually sleep, and how tired you feel on most days. We will also ask you some questions about things that can interfere with sleep. There are very few studies on this important topic, and we will use the results for a research study. There are no benefits to you for completing this survey, but your answers will help us educate providers about the realities you face as a new mother."

Please follow the link above to participate.

Tuesday, July 8, 2008

New Birthing Center Slated To Open In Manhattan

A group of midwifery advocates have banded together to open a new birthing center in Manhattan. This will fill the void of the closing of the Elizabeth Seton Center, which was part of St. Vincent's hospital, which I happen to have first-hand experince in saying is extremely birth and mom friendly.

If I had my pick of hospitals to labor and birth in NYC I personally would choose St. Vincent's for a hospital birth.

The new Birthing Center will be at 30th Street and 7th Avenue to open in 2010.

Apparently some high profile celebs are backing this new center, namely, Ricki Lake, Rosie O’Donnell and Gloria Steinhem.

The Seton Center, part of the Saint Vincent Catholic Medical Centers system, closed in part due to the soaring cost of malpractice insurance for midwives. The new center will require practitioners to purchase their own insurance, with midwives and doctors operating as independent contractors billing insurers directly.

Ricki Lake, Rosie O’Donnell and Gloria Steinhem are helping to raise money for the center. Much of the fundraising is being done through screening of The Business of Being Born, a documentary featuring the home birth of Ms. Lake’s second son. If you have a chance to go and see this documentary please do as it will help create and sustain this incredible new center.

Saturday, July 5, 2008

DONA's Press Release Response to ACOG's Position On Home Birth

In June, you covered Ricki Lake's controversial documentary about home births which instigated a growing battle between the American College of Obstetricians and Gynecologists (ACOG), the American Medical Association (AMA), midwives, and patients.

The conflict is about the perceived safety of home births and the useof Certified Professional Midwives (CPM) or “lay” midwives. Last month, the AMA issued a resolution asking for legislation against homebirths and against “lay” midwives.

As President of DONA International, the oldest and largest association of doulas in the world, we represent the thousands of woman who cherish their ability to choose where they give birth and with whom.We also question the evidence supporting the ACOG and AMA’s statements that “the safest setting for labor, delivery and the immediate post-partum period is in the hospital ….”

The largest, most respected study of home births found that among 5,000 low-risk pregnancies, babies were delivered just as safely at home with a CPM as in a hospital. Currently, twenty-one states license midwives to attend home births, using both CM certified midwives,which the AMA and ACOG recognize and CPM designated midwives, which they do not. Only about one percent of American births take place outside of a hospital. Because most doulas work with midwives and physicians in a hospital setting, DONA International has no financial interest in the outcome of such legislation called for by the AMA. Our interest is in the scientific evidence and in maintaining the conviction that pregnant women, just as all other patients, are intelligent enough to give informed consent.

Debbie Young, President of DONA International

Friday, July 4, 2008

Are you being denied a VBAC?

"I’m a lawyer with the Northwest Women’s Law Center inSeattle. I’m investigating possible legal responses to bans on vaginal birth after cesarean at hospitals in the northwest states Alaska, Idaho, Montana, Washington and Oregon. If you are currently pregnant and want to have a VBAC, but are facing a hospital policy that would require you to have a c-section regardless of whether you want it and regardless of whether it is actually medically necessary, and you are willing to consider working with a lawyer on this, we’d like to talk with you. Please respond to ."

On A More Serious Note

The following story is re-posted with permission from Candid Carrie.
Carrie is a mother of MANY. This is her story of the birth and loss of one of her twins.
When pregnant we never want to think about the possibility of loss, however, sometimes loss comes. Life has a funny way of twisting and turning no matter how much we think we are in control. Carrie shares her thoughts about how friends and family can truly be supportive in these times. Thank you Carrie for allowing me to share your story.

I need to speak about something serious today. I don't do that very often, so bear with me.

A couple of my friends (yes, even if I have never actually met you guys) that I know from blogging have had their lives altered because someone they know experienced the death of a child.

Having been there myself, I thought I would share my experiences with the resulting aftermath and reassure you that there really are some very simple ways that you can show your support during these difficult times.

First of all, let me tell you briefly about my situation. I say briefly because this post isn't really about me as much as how you can help others, but I don't want to leave anyone walking away without understanding where I am coming from here.

November of 1988, I had twins. I delivered at 38 weeks, a boy and a girl, each 18.5 inches and 5 pounds 2 ounces. No, they were not identical twins … one boy, one girl (fraternal twins). Madeleine was first, she came whizzing out, Apgar scores were six and eight and she was gorgeous, absolutely gorgeous.

Travis was next and it didn't go that smoothly. The umbilical cord was wrapped around his neck and my contractions had stopped completely. I was being prepped for a cesarean section, the sedatives were being administered and I told everyone to stop. I said I was delivering this baby now and I did. There were no contractions but I pushed and focused and it was really hard work, but out he came. Apgar scores were two and four. He was whisked down the hall at about six that morning and I held him for the first time at 10:30 that night.

I'll finish the story of Travis quickly, Travis is my nineteen year old son. He graduated from a Catholic boarding school in 2007, one of the top in his class. He finished his first year at Marquette University in Milwaukee Wisconsin this past May. He has played piano for fifteen years. Yes, fifteen years. He has played for schools, for churches, for weddings, for fun, for money, and just for the sheer love of it. He is back this summer working for the fifth year at a Cub Scout camp as a site manager. The only time this glorious child ever caused me any grief was those few minutes before he was born.

Now, back to Madeleine. During the commotion of Travis' birth, I was unaware that Madeleine's situation had changed. She was doing something called "choreatrophy." They weren't sure if it was a seizure or tremors and they decided to send her to a nearby hospital in Milwaukee. She was baptized and left Sheboygan about 10:30 that morning.

Obviously, there is much more to say about that day, but this isn't the time or my purpose.

Madeleine got her first gastrointestinal tube at age 3 months, her first tracheotomy tube was fitted at 13 months. She had twenty-four hour nursing care in our home for all seven years of her life.

Her official autopsy report indicated that had an undiagnosed (means they never really knew what it was) degenerative (means that she was always going down hill) neuromuscular (brain connecting with muscles) disorder (something is definitely not right here).

I have much more to write about Madeleine and I wasn't even quite ready to reveal all of that right now, but I needed to let you know about her to give myself some credibility on this topic

As I stated up front, I want to tell you things that you can do to help parents that have lost a child. This is a list of really simple things that can have a monumental impact on the child's family.

During that first week to ten days after the Madeleine's death, I was flooded with cards and mail (this was before e-mail). I opened and read every single piece and I was overwhelmed. There were cards from people who had lost a child, people who knew someone that had lost a child, people who had children that were born the same day as my child, oodles and oodles of people sent cards and letters.

But, here's what had the biggest impact on me. The cards that came after the two weeks were over. Those were the cards I remember the most vividly. The unexpected cards weren't an "after" thought, they were more of an "I'm still thinking" thought.

I would ask that if you know of someone in this situation, continue to send mail. Real mail, not e-mail. Something tangible, nothing says you care quite like a piece of mail. No need for profound wisdom either, just something simple like "I was thinking about you today" or "I am here if you need me" or anything, even just your name. If you can work something out so that a few people are sending cards on a regular basis, that is fantastic.

You will know when to stop sending the cards because the recipient will probably let you know. I was able to say, "Your cards have meant so much to me, but I am doing much better and I appreciate everything you have done for me." People get to that point at different times.

Another project that means the world is to have one person assigned to collect photographs. Quietly collect as many pictures of their child as you can and there is no need to worry about whether or not they are flattering photographs. Just get them from anyone who may have them. You can use an e-mail or word of mouth for that purpose.

Once you have collected them, put them on either a c.d. or whatever they are called today or set the photographs in an attractive box. Just don't put them in a scrapbook or photo album because that right belongs to the family. Even if you think it would be the sweetest thing to put them in an album, the family may not be ready for that or the family may believe it is therapeutic for them to process the pictures themselves.

After you have finished this project, tell the parents that you have collected all of the photographs that you could find and you will hang on to them until they are ready. I wasn't ready for two years. I never forgot that someone collected the pictures, I just wasn't ready to have them in my possession. Because of Madeleine's condition, she did not photograph well at all. Once she hit three months of age, the disease process sort of took over and altered her appearance. I was grateful to have the pictures collected, I was grateful to have someone holding them for me until I was ready, but my favorite pictures were and always will be of her as an infant.

Now, listen very carefully because this of the utmost importance. Don't underestimate the position of holding something until someone asks for it. If done in the right frame of mind, the keeper of the photographs has a thankless task. A great deal of energy went into the collecting and gathering and once you've made the announcement all you can do is wait for the day you hand them over. That is literally all you can do. To bring it up again would be inappropriate. The parents know you have the pictures, just wait until they are ready to have them in their possession and that works on their timeline, not yours.

Get out your calendar, your date book, your blackberry, whatever it is and record the day the child died. And the day of the funeral. And the child's birthday. Now put another note in the calendar a week before those dates and call your friend at that time. Every year.

Make a phone call and say, "Hey, I know it is getting to be about that time of the year and I want you to know I am available if you need me. It is alright if you don't need me and it is even alright if you call me in the middle of the night while everyone else is sleeping." Follow up with a tangible card and the offer again, include your phone numbers to make it more sincere and easier. And then really be there if you are needed.

I have friends today that never knew my daughter, but they know me and even if they don't know the exact date of the birth or death they are friends that I can trust my emotions with no matter when they surface. My friends also know that we never get tired of hearing our child's name, so please use it. Usually we spent a tremendous amount of time selecting that name and we weren't anywhere near hearing the end of it.

It is a weird club to be part of, parents that have lost children and there are days that we say and think the most ridiculous things but because we belong to that club we need to be forgiven quickly.

And finally, this needs to be said although it shouldn't need to be said. If you never lost a child but have lost a pet and you think you know how the parents feel, trust me … you don't and it is the last thing any family wants to hear is how sad you would be if you lost your dog because your dog is like your child.

Seriously, I've have lost many pets on my life's journey and there isn't any similarity at all. However, all "pain and grief" is relative and the loss of a pet "pain and grief " is genuine and deep and permanent. It just is in a different "pain and grief" category than children

So, I know this is a long post and I do have more ideas and ways to help families but I'll stop for today because I know this is a lot to handle right now and I know when readers stop here this isn't what they really expect.

And if you read to the bottom of this, I admire your tenacity to hang in there. I know it was a tough read.

It is alright if you don't leave a comment, this is awkward and you don't probably don't know what to say. You can close my blog and walk away, but please keep the information with you. I hope you never need to use it.

I do want you to know that it has been twelve years since Madeleine died I have the ability to look backwards and see how all of it lead me to be right here, today, sharing this with you.

Saturday, June 28, 2008

Twins Born Vaginally - A True Birth Story From The Land Down Under

Karen's Birth Story

(Karen at 37 weeks)

On 17 June 1994 I gave birth to my beautiful twin girls in Adelaide, South Australia. It was without question the most wondrously special and memorable day of my life.

I loved every moment of being pregnant and read everything I could get my hands on, concentrating of course on multiple births. I carefully followed the progress of what my babies would look like in utero, their development at each stage of each trimester. I was endlessly fascinated by all of it.

Unfortunately my pregnancy was not without the odd problem. For instance at about 18-28 weeks I was constantly fainting. More or less every time I stood for more than a few minutes I would go down like a ton of bricks. I was hospitalised for a week while they investigated the cause and after exhaustive tests and even being taken by ambulance to a bigger hospital to have a heart scan, they finally found out what the problem was. Apparently my little cherubs liked to snuggle up at the back of my stomach and were in fact lying on a major artery. This would then cut off my blood supply making my blood pressure drop to very low levels, hence the fainting. Once the pregnancy reached 28 weeks they were forced to remain more stationary due to a lack of room and it rarely happened after that.

At 32 weeks I was admitted to hospital with high blood pressure. It was only high for an hour and then returned to normal but from that moment on I was not allowed to leave. They had also discovered that even though I was expecting fraternal twins who were in separate sacs and had separate placentas, somehow one of the babies had too much amniotic fluid and one did not have enough. The doctors required constant monitoring on a daily basis so they could keep an eye on their growth and heart rate. I had a scan every Friday to ensure that both babies were growing and developing at an acceptable rate and all in all I was very well looked after. This was in a public hospital I might add where I had my own private room and I did not see one bill for what turned out to be a 7 week stay.

My doctor was looking after me for my whole pregnancy and certainly all the time I was in hospital. We had many discussions leading up to the big day about my birth plan. All women were encouraged to write a detailed plan of how they would like their birth to happen right down to the music they wanted (which of course they would provide themselves) and who they would like to be present.

My doctor was well aware that it was very important to me to try and deliver my babies vaginally as in all likelihood this would be my only pregnancy. He was more than happy for this to happen as long as all was progressing well without endangering the babies. That of course was without question.

There was only one possible snag to this option and that was that one of the babies was in the breech position. As the pregnancy progressed and the babies starting engaging ready to be born it was obvious that the first baby was head down which made a vaginal birth a more viable option. My doctor was happy for me to try and give birth vaginally but there was one concession he wanted me to make. He wanted an epidural inserted in my back so that if things started to go wrong they could quickly rush me off to theatre and top up the epidural so I would still at least be awake for the birth no matter what the emergency. I considered that to be a fair enough compromise. I was well aware that a multiple birth by its virtue does carry higher risks.

Finally at exactly 38 weeks I awoke at 4.30am with a definite cramping pain and a very damp bed. The first lot of “waters” had broken. I called for the nurse who organised for me to be taken to the delivery room. I had just enough time to call my husband and alert him that the babies were on their way.

Within 20 minutes I stepped off the gurney into the delivery room and hurriedly made my way to the toilet. I got half way there when the second lot of waters broke. Boy…this was happening quickly. It was funny because the doctors and nursing staff who were on the night shift were just finishing when I was brought in and some of them asked if I minded if they stayed around for the birth. I readily agreed although had I known how full the room would become I may have given pause to this decision.

The pains were coming fast and furious and within one hour I was fully dilated and ready to push. The anaesthetist was called in to insert the agreed upon epidural which wasn’t too painful and then I got down to business. As luck would have it David arrived just in time and I now had four obstetricians, two midwives, two pediatricians and their nurses, a couple of student doctors and Craig, my husband. My mum came in for support for Craig but with the crowd that was in there she was quickly out of sight at the back of the room. Yes it was a bit of a sideshow but I didn’t really care at this point.

It quickly became evident that baby number 1 was not making any progress down the birth canal no matter how hard I pushed and on further examination it was discovered that she was actually stuck at the top of the birth canal. The more I pushed, the more stuck she became. Apparently her head was presenting at the wrong angle and so there was no option but to introduce the forceps. I cannot even begin to tell you how horrified I was at the thought but this is where sometimes you have to adapt your plans. Births don’t always go like a well scripted play.

I had an episiotomy to enable them to reach the baby more easily with the forceps and it was at this point I was grateful for them to crank up the epidural. Everything happened so quickly from that moment on and with a couple of good hard pushes my first baby girl was thrust into the world with a lusty cry. They quickly looked her over and after bundling her up she was handed to me for my first glimpse of my precious angel. The rush of pure love I felt for this tiny little human being was indescribable. I had wondered for so long what my babies would look like and here was one of them in my arms strongly objecting to being wrenched out of her warm safe haven.

Before long I was reminded by the doctor that I still had the job ahead of me and baby number 2 was on her way. This was the breech baby and they had hoped that once the first baby had left the premises she may have flipped over the right way but unfortunately she chose to stay right where she was. Again the forceps were introduced and as I pushed and then raised my head I saw two little blue legs sticking up in the air. Within five minutes after Emily’s birth, Chelsea was born at 10.05am. I couldn’t hold her because by now adrenaline had kicked in and I was trembling violently. Chelsea did not make a sound for what seemed like an eternity but once they had suctioned her nose and throat she too gave a hearty cry and I visibly breathed a sigh of relief.

So many emotions were rushing through my body and I was relieved and overjoyed that really it had all gone very well. Emily weighed 4lb 15oz and Chelsea was 4lb 14.5oz. Ironically Emily had been the one with the least amniotic fluid and was the one they expected to be smaller.

They had to spend the first night in the neo natal nursery because their temperatures were a little low but after that first night they spent the rest of our stay with me in my room. I breast fed them both without any problems in fact from the very first try they took to it like ducks to water.

It was indeed my only pregnancy and birth and I felt so grateful that I was able to experience everything as nature intended. As it happened it was necessary for a little intervention from a medical point of view but I didn’t feel cheated by that. It was necessary and I accepted that. Giving birth was a beautiful moving experience and one I wouldn’t trade for the world.

Thursday, June 19, 2008

Safety of Home Births In Question

Over the last 30 years the c-section rate has gone up each year under the care of OBGYN's. Currently we are hovering at a c-section rate of almost 50%.

Under the care of Midwifes, many whom offer home births, the rate of c-sections is 3-4%.

Read the fact sheet regarding the statistics on home birth.

"An obstetrician is a medical specialist who focuses on labor and delivery. Obstetrics is actually a surgical sub-specialty, meaning that an obstetrician attends surgical training and then specializes in the care of pregnant women and in surgeries which are related to labor and delivery, such as Cesarean sections." -Wise

Rates for premature birth have been increasing, and recent studies have connected this increase with the increase in cesarean sections.

Sadly these same OB's who have brought the c-section rate to its highest ever and who have brought premature birth rates to its highest ever are calling for an end to the option of home birth.

Why is the c-section rate so high?

Doctors are denying food and drink during labor, preventing or discouraging mothers from walking and other physical activity during labor, using drugs to "start labor” (ie, induction) or hasten labor (augmentation), not“allowing” mothers to be in a vertical position to push the baby out, using directed breath-holding pushing, are all examples of routine hospital/obstetric practices that have been shown to interfere with the normal process of labor and cause complications, causing harm and not benefits to mother or baby.

All of those methods listed contribute to an exhausted mother who doesn't have the strength to push when the time comes, which leads to uneccessary interventions leading up to c-sections.

Most Midwifes encourage eating and drinking, movement and position changes, and encourage breathing techniques that aid in labor and delivery. And most home birth Midwifes have an extremely low c-section rate and low transfer rate to the hospital.

With the evidence glaringly in favor of mothers and babies fairing better in home birth situations why is it that the AMA is trying to ban this option to laboring mothers?

Ask your physician his or her c-section rate, episiotomy rate, rate of epidural and pitocin as well as the same information for the hospital you plan to birth your child in. Then call a Midwife in your area and ask the same questions. Then decide which seems better for the health of the mother and the baby.