Paste your Google Webmaster Tools verification code here

Category Archives: Hospital Birth

Research Checklist Ideas for Pregnancy, Labor, Birth and the Postpartum Period

Looking for ideas on things to know about pregnancy, labor, birth and the postpartum period but don’t really know where to start? Here is a great research checklist to give you a starting point for the things you should research for your pregnancy, labor, birth and postpartum care. Just click on the link below:

Research Checklist

 

Research Checklist

Posted in After Birth, Home Birth, Hospital Birth, Labor, Pregnancy.

22 Questions to ask while touring the maternity ward

Here are some questions to ask while touring the maternity ward:

1. What is the Cesarean Rate?
2. What is the Episiotomy Rate?
3. Do you have time limits on how long I can labor before intervention is suggested?
4. Do you automatically administer pitocin after birth? What if I don’t want it?
5. What birthing tools do you provide or allow? (birthing balls, birth stool, shower, tub, birth bars, etc.
6. What is the procedure for IVs when admitted? (Automatically start heplock vs wait until needed)
7. Do you allow women to eat and drink during labor?
8. What is your policy on cord clamping? If I want to delay, will you respect my wishes?
9. Do you allow immediate skin-to-skin before you do your routine checks on baby?
10. What does your routine checks of baby consist of?
11. Do you provide breastfeeding support? Is there a lactation consultant on staff?
12. How many visitors can I have at one time after birth?
13. How many people can I have in the room during the birth?
14. Do you allow women to move around the room freely during labor to help relieve pain?
15. Do you allow different positions for birth other than on my back in the bed? ( Standing up, hands and knees, squatting, etc)
16. Can my baby stay in the room with me at all times?
17. What are your policies on fetal monitoring? (intermittent or continuous) If continuous, is it wireless so I can still move around during labor?
18. What are the maternal and infant mortality rates?
19. If I need a C-Section, can my partner be in the room?
20. If I have a C-Section, do you allow immediate skin-to-skin?
21. Do you have students or residents? If so, how involved are they/could they be in my birth experience? What procedures do you allow them to do?
22. How often do you do vaginal exams?

Posted in General, Hospital Birth, Labor, Pregnancy.

My reflections on reading Born in the USA by Mardsen Wagner

Reading Born in the USA by Mardsen Wagner was very overwhelming and I was surprised by most of his points including the fact that the American Congress of Obstetricians and Gynecologists (ACOG) is not regulated or given responsibility to set the standards it does, the fact that off-label and against-label drug use by doctors is tolerated, why the US does not have regulations or required standards on recording and investigating maternal mortality, and the fact that doctors are surprised and complain about the “litigation crisis” while continuing to put into practice the things that result in litigation.

I have heard of ACOG several times before reading Born in the USA. It has been mentioned in other books and articles I have read as well as brought up in conversations when talking about home birth and specifically water birth. I was under the impression that ACOG was a very important organization that had the responsibility of setting standards for care providers. Much to my surprise, thanks to this book, I know the truth about ACOG. While they are a very important group (to doctors) no government agency has given them the responsibility and right to see such standards and have care providers be reprimanded if they practice against these standards and statements. How did they get so much power? I know there are several care providers out there that don’t agree with the way ACOG does things but they fear speaking out because they do have so much power and fear it would have negative effects on their careers. We need more people like Wagner to speak out with confidence against ACOG in order to overcome this organization that claims to care about the health of our country.

The tolerance of off-label and against-label drug use by doctors such as using Cytotec to induce labor, absolutely blows my mind! How is this even legal? Wagner mentions several studies that have been done that suggest Cytotec is not safe to use for labor induction and it says right on the bottle that this drug should NOT be used on pregnant women. Doctors have been using this drug for years against label and there have been so many cases with negative outcomes, and yet they continue with this practice. We need to make this illegal! I work in real estate doing appraisals for bank loans and for realtors when a house goes up for sale. I was discussing with my boyfriend the other day how ridiculously regulated the real estate market is compared to our health care system, specifically our maternal health care system. There are so many rules, standards, and regulations on how to put together an appraisal on a house and to make sure your appraisal is not misleading and contains 100% accurate information, but yet our doctors and nurses have a very relaxed system and very little accountability.  It’s insane to me that more effort is put into making sure a house sale is legit and fair but yet obstetricians don’t have to or are not being reprimanded for not ensuring women are making informed choices about their health and are giving them drugs without their knowledge that are known to be dangerous and cause adverse effects.

The frustration about the use of Cytotec and the fact that doctors are giving women drugs without informed consent, including Pitocin among others, brings me to my awe that doctors are surprised with this “litigation crisis” and the raises in cost for malpractice insurance. Litigation isn’t just from the use of drugs but from all of the interventions that women feel they have no control over whether it be the doctors and nursing staff don’t tell the woman what they are doing or they impose an intervention on them against their will or without true informed consent. To this day, these care providers are still allowing and suing these practices. They blame their patients for having such high malpractice insurance and need to use some intervention to avoid litigation but it’s those very interventions that the care providers are getting sued for using. If care providers took the time to create a trusting relationship with their patients (clients) and truly gave them informed consent, their patients would not be taking them to court, or at least much less often. They need to allow for better communication and explain all of the benefits and risks of every option, and when there is a negative outcome, they need to be accountable to it and keep open communication with the families about what the possible cause was instead of making it so hard for them to figure out what happened.

When a poor outcome does arise and a mother dies, which sometimes you just can’t avoid, what are the chances that it would accurately reported or recorded at all? According to Ina May Gaskin, the CDC has admitted that maternal deaths are severely underreported. I do not understand why making sure maternal deaths are investigate and accurately reported is not a priority. We have one of the worst maternal mortality rates in the industrialized world and there seems to be no real effort in changing that, at least not from the medical model of care standpoint. They just keep focusing on how the latest technology should prevent negative outcomes but continue to be blind to the fact that using those technologies and continuing to intervene in one of the most natural processes of life, is actually what is causing those outcomes and insane mortality rates. We know that these rates can be much better by just looking at other countries and researching their systems. It makes me so sad that women and families are not respected enough to be worthy of investigation if they die during the childbearing cycle but yet the justice system can spend weeks, months, or even years on other death related events such as murders or even accidental deaths while on the job. Without these deserving investigations on maternal mortality, that should be a no brainer, the maternal health care system will be extremely difficult to improve because we won’t have the data to show where exactly needs improving and how we can make change. Putting in place regulations on reporting and investigation maternal death should be at the top of our health care system’s priority list.

It is ever so clear the need for change in our maternal health care system. Midwives are definitely a necessity in bring about the right change but without concern and dedication from other care providers such as OB/GYNs, the change will be very difficult. We won’t give up though. The need for midwives is growing and the number of midwives is growing. The health care system will be forced to work with us and they will eventually come to realize the need for change. Midwives can and do change the world!

Posted in General, Home Birth, Hospital Birth.

What is a Doula?

doula baby

 

 

Definition: a woman who is trained to assist another woman during childbirth and who may provide support to the family after the baby is born.

The word “doula” comes from the Greek meaning “a woman who serves”.

Studies show that in doula attended births:

*Labors are shorter

*Babies are healthier

*There are fewer complications

*Breastfeeding is more successful

*Spontaneous vaginal birth is more likely

*Less likely to need or ask for pain medications

*Less likely to have a Cesarean Section, vacuum or forceps-assisted birth

 

There are 2 different types of Doulas: Birth Doula and Postpartum Doula

Birth Doulas – Offer education and assist women in planning and carrying out their birth plans and expectations. They stay with the women throughout labor and offer emotional support, help with physical discomforts, creats an open line of communications between the women, her partner, and her care provider.

Postpartum Doulas – Offer education and support on things related to after birth such as breastfeeding, physical and emotional recovery, newborn care, bonding, light housekeeping and meal preparation. Research shows that families transition much easier with a good support team including a doula.

 

DOULA DO’S AND DONT’S

Do’s:

*Prepare and educate women and families for birth

*Help create a birth plan that includes expectations, wants and needs, and things you are uncomfortable with

*They help create a safe space allowing comfort, open communications between families and care providers, and emotional support

*They are advocates for mothers and partners during labor and childbirth

 

Dont’s:

*They are NOT medical professionals and therefore do NOT offer or perform any medical services such as exams, fetal heart monitoring, medical diagnosis, deliver babies, etc.

*They do NOT judge you or decisions you make

 

How much does a Doula cost?

Fees can be anywhere from $400-$1000 depending on the individual doula and the services she provides.

 

 

RESOURCES

http://www.dona.org/mothers/

http://americanpregnancy.org/planningandpreparing/postpartumdoula.html

http://www.mindbodygreen.com/0-11595/what-is-a-doula-and-why-you-should-have-one-during-after-birth.html

http://ssbdoula.weebly.com/birth-services.html

http://evidencebasedbirth.com/the-evidence-for-doulas/

 

 

Posted in After Birth, Home Birth, Hospital Birth, Labor, VBAC, Water Birth. Tagged with , , , , , , , , , , .

8 Common Hospital Interventions You CAN Avoid

 

Doctor and Patient

There are several common hospital interventions that ARE avoidable. Contrary to common belief, the hospital staff doesn’t always have your best interest at heart, and they are not always right. I have no problem admitting that hospitals can save lives when an emergency occurs, but they often try and do intervene even if it isn’t necessary.

Some of the most common interventions during a hospital birth include:

* Epidural – injections results in loss of sensation including pain by blocking the transmission of impulses through nerve fibers in or near the spinal cord. More than 75% of women receive an epidural at some point during labor.

* Pitocin – synthetic oxytocin used to promote uterine contraction and speed up labor.

* Continuous Electronic Fetal Monitoring – external and internal monitoring systems that track the heart rate of your baby during labor. Studies show that continuous monitoring does not have better outcomes than intermittent monitoring and may increase the chances of having an unplanned Cesarean Section.

* Urinary Catheters – some care providers push to give you a catheter during labor so you don’t have to worry about going to the bathroom during labor. However, having a catheter restricts your movement and usually means you cant leave your bed. Movement and position changes is very helpful during labor especially if you are progressing slowly. It encourages your baby to get into the right position for birth, and if you are attached to a catheter, your chances of being able to move around and change positions is slim to none.

* Artificial Rupture of Membranes – Also known as breaking the water. Some care providers push for this in order to promote labor progression, however, studies show that there are no more better outcomes than if you would let the membranes rupture on their own. Your water does not have to break for you to go into labor. Some babies are even born still inside the caul.

* Directed Pushing – History shows directed pushing started when women were extremely medicated and needed help knowing when to push. Most care providers still today like to direct you when to push and when not to even if you are having a natural birth. Your body knows when it should push and your contractions do most of the work for you.  However, if you receive an epidural you lose almost all feelings below your chest, so during labor if you cant feel your body, its very hard to know when to push. Avoiding an epidural will help avoid being directed to push.

* Episiotomy – A cut made in the tissues between a women’s vagina and anus. Studies show that 30-35% of women receive an episiotomy and many studies show that they do not improve outcomes of 3rd-4th degree tears. Some studies show that an episiotomy increases the chances of having a 3rd or 4th degree tear. An option to avoid episiotomy include using a warm compress or rubbing olive oil or against the women’s perineum.

* Cesarean Section – a surgical procedure with an incision made through a women’s abdomen and uterus in order to deliver their baby/babies. Today, 1 out of 3 women are having a Cesarean Section with numbers rising!

 

Ways to avoid these common interventions:

* While searching for your care provider, ask what their statistics are on each of these interventions and learn their procedures and policies. You may run into a provider that has policies and procedures that do not match your expectations and wants. This is where you have to do a little work. KEEP SEARCHING. Find a provider that is best for YOU. Just because ONE care provider does not share the same views as you, does not mean that another provider wont. You DO have options, you may just have to work to find the right one.

* Before you give birth at the provider of your choice, take a tour, learn your way around where you will be giving birth, and ask as many questions as you can think of at the time. I would suggest spending a few days coming up with questions ahead of time and ask anymore you may think of while you are on a tour.

* Hire a birth doula. They will be your support throughout the whole process from finding the right care provider to helping you have the birth experience that you want. Studies show “Overall, women who received continuous support were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births, and C-sections. In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth.”

* Write a birth plan. Include everything you want your birth to be, what interventions you want to avoid and which ones you are okay with, how you want to labor, etc. Don’t forget to write a plan for emergencies as well. You want to be as prepared as possible, whether you plan on giving birth in hospital, birth center, or at home. Going over the “just in case” scenarios is always a good idea for you and your family.

* Once you write your birth plan, make sure everyone that you plan on being involved with your birth knows exactly what you want and expect. Not only your family and birth supporter like your doula, but also your care provider. It is important that they know your expectations and what you are and are not comfortable with.

It is your right to be well informed about anything having to do with your healthcare. You can avoid a lot of unnecessary interventions by just being informed about what could happen and why. You have the right as a patient to just say NO! In the end, it is your body, your right, and your responsibility to take control of your healthcare. 

 

 

Resources:

http://chriskresser.com/natural-childbirth-v-epidural-side-effects-and-risks

http://www.fitpregnancy.com/pregnancy/labor-delivery/common-interventions-during-labor-delivery

http://givingbirthwithconfidence.org/2010/07/practices-that-promote-healthy-birth-avoid-interventions-that-arent-medically-necessary/comment-page-1/

http://chriskresser.com/natural-childbirth-vi-pitocin-side-effects-and-risks

http://www.webmd.com/baby/news/20050826/episiotomy-rates-too-high-say-experts

Posted in Hospital Birth, Labor.

Wise Words on Home Birth vs Hospital Birth from an OB/GYN Herself!

Here is a great article from OB/GYN Aviva Romm, who was once a Midwife and incorporates the midwifery model of care into her practice today. She makes some very interesting points and explains why she chose to have her four children at home and why she would still choose home births today. I have posted a few quotes from her article but please, go read the whole article! 

 http://avivaromm.com/choosing-home-birth

 

 

There are very real health reasons for women to consider birthing at home.  These include mom’s safety, baby’s safety, and the economic sustainability of our health care system.”

“Now, having been through obstetrics training I can honestly say that I’d feel even more concerned about having my baby in the hospital – unless absolutely medically necessary.”

“There are not only immediate risks to the mother; we know that babies born by cesarean section miss out on the benefits of exposure to the vaginal flora that they’d otherwise come in contact with if born vaginally – and this lack of exposure can predispose a baby to disrupted gut flora and significant consequent health problems. Additionally, babies born by cesarean get a dose of antibiotics before birth via mom’s system, adding to the double hit on gut flora!”

“Obstetric Evidence Is Reliable Only 30% of the Time”

I wasn’t brave at all – I was simply terrified of having my babies in the hospital!”

“I was just having a baby, not an emergency appendectomy! I didn’t want all of these potentially dangerous interventions for something that was almost always natural and safe. It sort of reminds me of those commercials for a medication for something benign like a foot fungus. You know, you’ve got a little athlete’s foot so treat it with something that can cause “heart problems, coma, and death.” It’s just overkill for something that’s usually just not that big a deal in a healthy person.”

“As a midwife I’d observed the loss of autonomy that too often occurred when a woman set foot in the hospital – the transformation that occurred with the ritual of shedding her “real person” clothes in favor of the hospital johnnie, and with it the shift of going from being an independent, capable woman into “a patient” – which culturally equates with being dependent, helpless, and sick – qualities that are a far cry from feeling empowered and strong”

Posted in Home Birth, Hospital Birth. Tagged with , , , , , , , , , , .