Birth

Dr. Hartung takes Higher Risk Pregnancies to Woodwinds Hospital

Dear Birthing Community of the Twin Cities Greater Metropolitan Area and Chicago and wherever Women have traveled from to give birth with Dr. Dennis Hartung at Hudson Hospital of Hudson, WI.

Several of you have asked me to let you know what Denny has to say about this. He’s emailed Emme and she’s shared that message. Today Denny and I were able to talk on the phone and he’s asked me to share these primary points:

There were no bad outcomes.

There has been no sanction of practice.

Hudson Hospital participated in a policy review on nursing care and some physician practice policies. The good birth outcomes supported by Dr. Denny, his nurses and colleagues were not included in the decision made following a recommendation Hudson Hospital instituting strict policies. Water births for instance will have many more restrictions. VBAC women will have continuous monitoring with OR staff in house.

 

Newborns will be given all tests and procedures.

The reason breech vaginal birth is suspended is because not all the physicians in Denny’s group agree to his attending VBB. The review board recommended to stop breech birthing until all the physicians agree to reinstitute VBB. The strategic public letter sent out by Hudson on the 7th of

March also mentions refusal of homebirth transports.

Denny informs them that refusing a patient at the door is illegal. But even if a homebirth family comes in, I noted, and as the letter describes, the new Hudson policy is to refuse patient informed consent and informed refusal. The letter implied physicians want to do everything they can for the mother and babies, regardless of family choice, this is implied in the letter.

Denny is concerned about patients’ rights to choose between interventions and procedures that have conflicting data and, thus, no assured result. So that if a woman declines an antibiotic for GBS or a cesarean for breech she should have that right since the data isn’t weighed in the favor of the intervention.

He’s not sure the administration understands the implications of instituting strict and restrictive policies at Hudson. 1/2 of Denny’s patients come from the Twin Cities. The other OBs, John Sousa and Alissa Lynch (sp) receive an overflow of his patients, and the Pediatricians receive a higher income simply because some of the group income is shared among them. Everyone there has benefited from the family-friendly care that has been given at Hudson Hospital. Dr. Hartung’s presence has benefited Hudson Hospital greatly.

Denny will hope to care for women having Breech, VBAC and/or Twins at Woodwinds now. (If I may, this seems to be an inconvenience for him, but a benefit for us in the Twin Cities!)

Denny also asked, with deep sincerity, please don’t make your social network initiative about him, he said this is about women’s right to informed care and how policies not based on evidence based care or the parent’s choices disrespect women and families. 

Robbi Hegelberg asked in the letter to area homebirth midwives and birth centers for questions to be directed to her at 715-531-6012. I suppose they will also see it after they project their 2013 income and then find that without Denny’s right to practice evidence based care that their patient numbers will drop dramatically. (That’s a little personal note!)

Dennis Hartung will continue to work at Hudson Hospital while increasing his presence at Woodwinds Hospital in Woodbury to meet the needs of his patients living in the Twin Cities area.

 

Dr. Hartung welcomes families to his care in Woodwinds, and Jeanette Schwartz, Lead Nurse at Woodwinds is happy to welcome him to come there more frequently. Laura France is the Director of Obstetrics. At Woodwinds, each Doctor makes their own practice decisions, as he understands it at this time. FYI, Denny doesn’t practice  at Regions or Joe’s.

Please don’t say things that might give Hudson any reason to sanction Denny Hartung for libel. (I know you won’t.) That’s important because it could very well come back on him, and this insight is not coming from me. I know you will be fair without name calling or blaming. Robbi and the other board members need to hear why we won’t be referring hospital birthing parents to Hudson any longer, that refusing informed consent and informed refusal is in violation of a woman’s right as a patient and as a human being, and I could go on, but I’m staying diplomatic here. Volumes of mail, calls, emails, and social network posts will make a difference. For those of you inclined, please say prayers, send victorious thoughts and/or light candles for Dennis Hartung. Denny very much appreciates this support from the community and in return he, too, is devoted to all of us, serving the birthing community with all his heart.

Kandace in Lakeville

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Doctors, Choices, Homebirths

The Ties that Bind: How Belief Creates Birth Realities
 

http://www.midwiferytoday.com/articles/ties.asp

© 2003 by Kim Wildner. All rights reserved.

[Editor’s note: This article first appeared in Midwifery Today Issue 68, Winter 2003.]

There is a story told of a baby elephant in Tibet (1) tied about the ankle with a rope. The rope would not hold an adult elephant, but it holds the baby tight even as it struggles to free itself. The baby resigns itself to the fact that it cannot move outside of the parameters of the rope, no matter how hard it tries.

Eventually, the elephant reaches adulthood, the same little rope about his ankle. Now, little effort would be required to snap the rope and walk away, but the elephant doesn’t even bother to try. He is bound only by his belief that he is unable to escape, which is just as effective as his captors.

Women giving birth today have more options than ever before, yet perceive very few. Information is available in unprecedented quantities at the touch of a fingertip, yet erroneous beliefs impact decision-making more than cold, hard facts.

Women believe that birth is a dangerous medical event. The fact is that normal birth is safer than many things we do each day without a thought (2).

Women believe that U.S. technology makes birth safe. The fact is that birth is much safer in countries where technology is more appropriately utilized (3).

Worse yet, women are often not making decisions at all. Like the elephant that cannot conceive that he has the power to walk away, women simply do not see the options before them.

A mother called me regarding private childbirth classes. During the course of the discussion, she explained that she wasn’t even sure the classes would help her, as she was planning a VBAC (vaginal birth after cesarean) and doubted it would “work.” Further discussion revealed that her doctor was insisting on certain “conditions” in order to “attempt” this VBAC.

  • The mother would be induced if she went “over due,” as determined by an ultrasound (4).
  • The mother would be induced if her baby got “too big,” as determined by an ultrasound estimation (5).
  • The mother must deliver between 7:00 a.m. and 5:00 p.m. when an anesthesiologist would be on hand. If that looked unlikely, induction or augmentation would be required. If she did not dilate steadily and quickly she would be augmented with Pitocin or Cytotec. If she were still laboring near the end of her given time frame, surgery would be inevitable (6).
  • The mother must labor with an epidural (7).

The reason for these restrictions was that the American College of Obstetricians and Gynecologists (ACOG) had issued new “guidelines” for VBAC, supposedly from a study that “proved” VBAC was unsafe (8).

However, what the study showed was that “obstetrically managed VBAC” was unsafe. The factors that made VBAC unsafe were mainly—hold on to your seat—pharmaceutical induction agents that are known to cause uterine rupture in non-scarred uteri (9). In other words, any woman in labor who gets them, not just VBAC mothers. Instead of investigating the drugs, which are not FDA-approved for nonmedical indications, the recommendation became to put restrictions on VBAC that bring about the very conditions that are singular to the drug/VBAC combination, not the VBAC itself. That “logic” is just lost on me, but it’s beside the point, anyway.

The story of the elephant mentioned above doesn’t parallel the illogic of ACOG; it parallels the thinking of the mother who contacted me. She was quite distraught that she probably wouldn’t be able to meet all of the conditions set by the doctor. She was right. She had as much control over them as she has over the tides, the moon or the sun.

She asked me if I thought she had a bad doctor. She asked me what I thought about the hospital policies. She asked me if she should change hospitals or doctors. None of this is my call to make, even if I knew her or her doctor, which I didn’t. I told her I thought she had some tough decisions to make. As a childbirth educator, I could provide her with the information she needed to weigh in order to make a sound decision, which I did. I gave her several book recommendations and links to studies showing the conditions she was being asked to meet were not only impossible, but flew in the face of science and plain old common sense.

I reminded her that the criteria for making sound decisions must include determining if the choice she was being asked to make was based on facts (it wasn’t), if it was in her and her baby’s best interest (it wasn’t) or if it would improve her experience (it wouldn’t) (10).

I heard from her again at a later date. She had read some of the material and she was getting anxious about her predicament because she didn’t feel she had any options. She ended her communication with the thought that she would probably just go with whatever her doctor wanted because, “What choice do I have?”

She didn’t believe she had options, so she didn’t have any. Perception is reality. While I refused to make her decisions for her, I felt I had given her enough information to broaden her options.

She could:

  • Present scientific references that challenge her doctor’s conditions and request that he provide evidence to support his stance.
  • Request that the hospital base its policies on the safety of her and her baby instead of concern over its liability.
  • If either or both refuse, find a doctor who did practice evidence-based care.
  • If one could not be found in her area she could
    • Choose a homebirth midwife;
    • Choose the nearest freestanding birthing center;
    • Choose a hospital/doctor in a neighboring county;
    • Choose to go out of state to somewhere like The Farm in Tennessee, where she could stay and safely birth her baby.

Granted, not all of these are easy choices to make, but other mothers have made them. It is not only the right, but also the responsibility, of women to ensure that the options they are offered are safe and in the best interest of their babies. If not, they need to seek new options. I’m sure there are others I haven’t thought of, but the point is she certainly not only had a choice, but several. The data I provided on evidence-based care and safe birth did nothing to illuminate this mother’s options because it wasn’t about facts, it was about belief.

In the last few months, I have received two other calls that illustrate this point just as well.

The first call came from a mother who had talked about hiring a midwife for her second birth because of her disappointing first birth. The first time around, she had done beautifully with HypnoBirthing® for most of the birth. Her caregivers had raised several red flags, however, during the course of her pregnancy, giving her warning that they would say what she wanted, then do what they wanted. Still, for some reason she thought it would be different for her. (There seems to be a common belief among pregnant women that somehow they will magically be able to change their caregivers when others have failed.)

Predictably, at the very end, the caregivers did what they promised they wouldn’t: they coached her to “purple push”—that horrid, harmful purple-faced pushing seen on those awful birthing shows. Amidst the yelling and counting, she couldn’t stay focused on “breathing the baby down,” not to mention the fact that she was afraid for her baby. They had promised they would only do this if it were necessary “for the sake of the baby.” The baby was never in peril. The mother (predictably) tore badly, which meant her early months of mothering were consumed with physical and emotional pain. Energy that should have gone to her child was wasted on trying to heal a relationship that struggled through the stress of a sexless existence.

In the years it took her to recuperate from this betrayal, she insisted she would have a homebirth with a midwife for the next baby. However, once she actually got pregnant, she went to an in-hospital birthing center, which started right away with routine ultrasounds scheduled at eight, 12 and 20 weeks. Knowing the suspected risks of ultrasound, this made her uncomfortable, but she was staying with the center because she said, “I have no choice. My insurance doesn’t cover homebirth.” Even if changing providers was impossible—though I believe nothing is impossible with enough determination—she still had choices. She could refuse the routine technology and let it be known that if there was a legitimate medical indication that could be substantiated (they had given her a “medical” reason for the intervention that, with a little research, was shown to be nonsense), she would surely cooperate for the sake of her baby.

Her insurance didn’t cover homebirth. That’s because it didn’t originate to help people get better care; it originated to help doctors get paid. Regardless, the co-pay for her hospital birth-center birth was about the same as what a homebirth midwife charges. If this woman ends up having surgery, the co-pay will be much more, not to mention the ripple effect of what it will cost during her recovery and in subsequent births, and the emotional toll.

She believed she had no choice, so she had no choice. Perception is reality.

The second call that illustrates this idea came from a woman who commissioned me to do some birth art for her. During the time I spent with the woman, she expressed anxiety about the fact that her doctor was starting to talk induction. She had read about the dangers of nonmedically indicated induction and wanted to avoid it “at all costs.”

She was a healthy woman with a healthy baby, two weeks away from her estimated delivery date, which could be as much as four weeks from actually delivering. She enjoyed being pregnant and had a lovely support system in her husband and family. Her doctor’s only reasoning behind mentioning induction was that she “looked about ready.”

This mother’s vehemence in her insistence that she wanted to avoid this intervention was impressive, but it didn’t translate into action. When I asked what she was going to do to avoid the induction, she replied, “I guess I’ll just have to do it. I don’t really have a choice.”

Have you any idea how often these words pass over an expectant mother’s lips?

Women always have a choice. The question is not whether they have a choice, but are they willing to make a choice. Changing a belief system, especially one that’s held collectively, like ideas about birth in the U.S., is a subject too complex for one article. I spend a great deal of time discussing how to identify our faulty assumptions so that we may make better birthing decisions in my book, Mother’s Intention: How Belief Shapes Birth (August 2003).

Even if a woman doesn’t instantly revise her beliefs about birth, the only factors that should have any importance are these: whether her choices are based on fact, if they are in her best interest and if they affect her experience positively or negatively. She need not concern herself with what is good for the hospital or doctor. Her only responsibility is to look out for the child, and by extension, herself.

<!– –>Kim Wildner is the author of Mother’s Intention: How Belief Shapes Birth (Harbor & Hill Publishing). She has been a childbirth professional for 12 years, holding certification with ALACE and the HypnoBirthing® Institute. She has one homeborn daughter.

Notes

  1. This universally understood story has many variations, with different locations and even different animals.
  2. Mortality statistics for motor vehicle accidents, heart disease, unintentional injury, cancer, HIV and other causes of death can be found at www.cdc.gov/nchs.
  3. The U.S. is rated 27th in the world for infant mortality and 13th in the world for maternal mortality (see www.savethechildren.org/mothers/report_2003/ for more information on the 2000 State of the World’s Mothers report).
  4. Ultrasound is only accurate to within two weeks on either side of an estimated due date. Only about 5 percent of babies are actually born on their “due date.” See www.birthsource.com/articlefile/Article86.html.
  5. Ultrasound is no more accurate than an educated guess at fetal weight. It is only accurate to within two pounds on either side of the actual weight. Considering that most obstetricians consider a normal eight-pound baby to be “too big,” if they induce because ultrasound estimates the baby is nearing eight pounds, the baby could really be only 5 lbs., 15 oz.
  6. See www.obgyn-wolfson.org.il/Content/Articles/ArticlePDF/AriclePDF655.pdf and www.midwiferytoday.com/enews/enews0326.asp.
  7. See www.childbirth.org/articles/episec.html.
  8. ACOG and other caregivers are now using a study found in the July 5, 2001 issue of the New England Journal of Medicine to suggest that VBAC is unsafe. See http://content.nejm.org/content/vol345/issue1/index.shtml.
  9. Visit www.hencigoer.com/articles and www.ican-online.org, where there are many articles that attest to the truth of this statement.
  10. Decision-making criteria adapted from Dr. Phil McGraw. See www.drphil.com/advice/advice.jhtml?contentId=1055_litmuslogic.xml.

References

  • Baum, J.D. et al. (2002, March). Clinical and Patient Estimation of Fetal Weight vs. Ultrasound Estimation. Journal of Reproductive Medicine 47 (3):194–98.
  • Lydon-Rochelle, M. et al. (2001, July 5). Risk of Uterine Rupture During Labor Among Women with a Prior Cesarean Delivery. New England Journal of Medicine 345 (1): 3–8.
  • U.S. Dept. of Health and Human Services. Maternal Child Health Bureau. (2001). Child Health USA 2001. Washington D.C.: Health Resources and Services, p. 22.

RELATED POSTS:
Everything You Need to Know About a Home Birth
Vaginal Birth After Cesarean – Make an Informed Choice

Everything You Need to Know About a Home Birth

WHY A HOME BIRTH?
When my husband I found out we were pregnant we simply basked in the wonder of growing humans in other humans. Miracles. I had had a baby 10 years previous in the hospital with a midwife so I wasn’t without some experience. It was funny, though, at about 10 weeks pregnant I said, “Babe, maybe we should get some prenatal care going…I should try to find someone.” And my husband said, “Do we really have to have the baby in a hospital? Can’t we just have our baby at home?” So it was with my husband’s initiative that lead us on the home birth path…and now we’re on a home birth high horse especially after having experienced both a hospital and a homebirth.

HOW TO FIND YOUR BIRTHING MIDWIVES
It is a matter of being your own advocate. Medical doctors generally don’t attend home births. Some midwives attend home births and some don’t.

USE THE INTERNET
Find the local midwifery services in your area. Googling “Homebirth midwives in [YOUR TOWN]” will likely lead to a local midwifery group. Set up appointments and interview a few midwifes until you find the one that fits best for you.

BIRTH KITS
Most midwives will have you purchase a birth kit for the big day. These kits can be bought on-line. You midwife might have a specific place they like to order from so talk to them about what you should get. Here is a sample birth kit and some on-line places to order from.

A Sample Birth Kit Includes:
10-23×24 Underpads, Economy
5-23×24 Underpads, Economy
2-40×60 Plastic Backed Sheets
1-Peri Bottle
1-Stockinette Newborn Hat
6-2.7gram Packets Sterile Lubrication
2-Plastic Cord Clamps
1-Paper Tape Measure
12-Alcohol Prep Pads
2-Flex Straws
1-Dozen Sanitary Pads
12-Sterile 4×4 Gauze Pads
1-Bulb Syringe 2.5 ounces
1-Mesh Brief
3-Pairs Sterile Gloves
6-Single Sterile Gloves
1-4 ounce Povidone Solution
1-“Welcome” Birth Certificate
1-Disposable Footprinter

http://www.midwifesupplies.com/Home-Birth-Kits-PEA0059-p-BirthKits.html
http://inhishands.com/

A SAMPLE CHECK LIST OF THINGS NEEDED FOR A HOME BIRTH
From http://pregnancy.about.com/od/homebirth/a/supplylist.htm

  • A bottle of isopropyl rubbing alcohol (70%)
  • A pint of 91% alcohol (or 99% alcohol, grain alcohol, or 180 proof Golden Grain
  • Cotton balls
  • A plastic drop cloth or plastic sheet (an old shower curtain or large plastic table cloth works wonderfully)
  • Plastic trash bags (AT LEAST 4 large) dark colored
  • 2 fitted bed sheets to fit your bed
  • 2 flat bed sheets to fit your bed (4 flat sheets is acceptable)
  • 4 bath towels
  • 4 wash cloths
  • 8 receiving blankets
  • Large mixing type bowl
  • Small mixing type bowl (prefer bowls not be glass)
  • Working flashlight and extra batteries
  • Extra toilet paper (at least 2 6-roll packs)
  • Several kinds of juice (at least one citrus and 1 non-citrus)
  • One extra bag of ice
  • Protein you like that is easy to fix (peanut butter, cheese, or eggs for example)
  • Clothes for you for after the birth (gown and panties)
  • Clothes for the baby (2 pair socks or booties, 2 onesies, 2 sleepers)
  • Diapers for the baby
  • Large cookie sheet
  • Silver duct tape (preferably new roll)
  • Thermometer (if digital, include probe covers)

We organized the kit and all the extra supplies she requested (towels, washcloths, etc) into 2 large Rubbermaid bins and stored them under a 4 foot table we set up in our room – also requested by midwife.  Once labor started, we made up the bed with plastic and a new set of sheets.  We purchased a roll of clear plastic, self-sticking carpet protector (like they use in model homes) and covered our carpeted bedroom floor with it.

Another mom was caught off guard with a 36 week labor and delivery:

We’d wanted a water birth at home but our little one arrived 4 weeks earlier than we thought so we were truly unprepared. In fact, the birth kit that we ordered arrived via UPS about 3 hours after our baby was born. Fortunately our midwives always have a birth kit on hand just for these types of situations.

DO YOU GO TO A REGULAR DOCTOR’S OFFICE FOR YOUR CHECK-UPS IF YOU ARE HAVING A HOME BIRTH?
Whether or not visits are in the midwives’ office or at your house likely depends on the midwife you choose.

  • If you choose prenatal screening or to have an ultrasound this would occur in a clinic and you will need a referral from your midwife for the procedure.

PEOPLE YOU MIGHT WANT PRESENT AT YOUR HOME BIRTH

  • Midwives
  • A doula
  • Back-up midwife (probably already arranged by your midwifery group)
  • Friends
  • Family

If there are other children in your family, you might arrange to have a friend or family member be on-call to care for the child or children during the birth.

WHEN TO CALL THE MIDWIVES
You and your midwives will discuss at what point they would expect for you to call them in. If you have a doula, she can help you with this decision as well. Some laboring at home before the arrival of the midwife is normal.

When my water broke and I had started having semi-regular contractions, we called the midwife.  She came over within an hour or so because she happened to be in the area. 

WHO ASSISTED YOU WITH LABOR?
My husband and my midwives helped take me through all my rushes. We chose to call them rushes instead of labor since the word labor had some negative connotations for me. My daughter also helped with kind words, nice touches, and videotaping her brother’s birth, announcing the gender and the name!

WHAT WOULD YOU LIKE TO TELL SOMEONE CONSIDERING A HOME BIRTH?
I knew of women having their babies in places other than hospitals, but I honestly thought they were super hippies willing to have their babies in the woods, gnawing off the umbilical cord and eating the placenta on the spot. I had no idea that, for instance, where our home is situated has one of the highest rates of homebirths in the city.

It is SO much safer than hospital birthing. You can have your baby right at home and then you’re right there in your nest where you need to be. A home birth is intense and powerful. You don’t need to have a fancy house or apartment. You don’t need to have a clean house. There will be blood, there will be fluids, but the midwives know what they’re doing and they’ll clean up! Women need to know they can do it! People planning a home birth need to know that birth in a hospital is an odd new trend…birthing at home is the normal way to bring babies into the world. Women have been birthing babies in their “nests” since the beginning of time. In my opinion, hospitals have it all backwards and actually make birth harder. Home birth is simple. It un-complicates a very natural process.

ADVICE AND TIPS FOR THE HOME BIRTH

  • I would have planned a little earlier so I could have had a water birth.
  • I think I would have done a little more mental hypno-birthing preparation before my home birth.
  • I would also have liked to watch some home births on video.
  • We made the HUGE mistake of not hiring a doula!
  • Tour your local hospital in the event you need to transfer.
  • I also ate a high protein diet in an attempt to avoid pre-eclampsia and thus a birth too early for staying at home. 
  • I did pre-natal yoga and visited the chiropractor, though both not as often as I should have all during pregnancy and definitely not enough during those last few crucial weeks.

WATER BIRTHS AT HOME
Besides being a great comfort measure, a water birth can offer the following and more:

  • diminish stress hormones (called catecholamines) which increase pain and slow labor
  • reduce pain by increasing the body’s production of natural pain relievers (endorphins)
  • ease involuntary muscular tension, and enhance relaxation during and between contractions
  • lower blood pressure within minutes and decrease edema (swelling),
  • promote better circulation and increase the efficiency of uterine contractions
  • increase mobility so that it is easier to change positions to aid the progress of labor, especially when a woman is becoming tired

http://www.geneabirth.com/waterbirth.htm

If you want to have a water birth at home you will need to rent a BIRTHING TUB. Check with your birthing center or midwife to see where you can rent a birthing tub locally. Some birthing centers and midwife organizations will rent tubs, too.

In the Twin Cities these organizations will bring the tubs to your home, give you the instructions as to how to set it up, and will take the tub down for you after the birth. They also supply a list of things you will need for tub rental.

http://www.waterbirthresources.com/
http://bywaterbirth.com/
http://www.geneabirth.com/waterbirth.htm

BIRTHING STOOL

It is common for women giving birth at home to rent a birthing stool. They are made in all shapes and sizes. The above stool is a handcrafted wood stool.

 “A birthing stool is a stool which has been specifically designed for use during childbirth. It allows a woman to sit or squat while giving birth with support to help her if she begins to feel fatigued. Many advocates of natural birth support the use of a birthing stool, which may also be called a birth support stool or a birth stool. Such stools are available from companies which provide equipment to midwives, and they can also be handmade; some people have chosen to make their own to personalize the labor and delivery process.”

The concept of sitting or squatting during labor is ancient, and widely practiced in many cultures, and the use of the birthing stool is also quite old. A birthing stool is designed to bear up to a substantial amount of weight and pressure, and it is usually low to the ground so that a laboring mother can plant her feet firmly. Most importantly, a birthing stool has a hole in the middle, allowing a midwife to monitor the progress of the labor and providing a space for the baby to slide through.”

http://www.wisegeek.com/what-is-a-birthing-stool.htm

Your midwives might be able to advise you on were to go locally or on-line for this as well.

Video on the Birthing Stool: http://www.youtube.com/watch?v=RrXR7dK4Y2k

HOME VERSUS HOSPITAL: HANDLING POSSIBLE COMPLICATIONS

This labor and birth was way harder than my first due to what turned out to be a crooked (asynclitic) baby.  I know one thing for SURE—I would not have been as comfortable in a hospital as I was at home to birth in so many different positions, to walk around, to be naked, get in and out of tub, to vocalize, etc.  I think we would have had a very different outcome for this birth if we had NOT been at home.

I actually had some bleeding 3 days before I gave birth and because I was only 36 weeks, my midwives instructed me to meet them at the hospital because early bleeding could mean placenta previa…and if it was placenta previa I would need an emergency c-section. Placenta previa occurs when the placenta grows in the lower part of the womb and covers the cervix. This is very bad as you cannot push the life-giving placenta out first since both baby and mother would likely die. I hadn’t had any ultrasounds during my pregnancy, but I had to have one to ensure the placement of the placenta was at a safe location. It was. And even while I spent 10 hours in the hospital in contractions at only 36 weeks…I opted to return to my home though the MD there strongly advised me to remain at the hospital to have my baby. But I chose to voluntarily discharge. I felt like royalty walking out of the OB floor waving at the labor and delivery nurses as they stood with jaws dropped at a woman walking OUT of the hospital while in labor. 

FOR THE SIBLINGS

http://www.midwifesupplies.com/Were-Having-A-Homebirth-KM0050-p-BirthKits.html

 

LOCAL MINNESOTA BIRTH CENTERS AND MIDWIVES

Many thanks to Barbara Morgan and Claire DeBerg for their assistance with this article and for sharing their home birthing experiences and knowledge!

What is a Doula and Why Do I Need One?

So you’re having a baby? Great! You’ve decided on a doctor or a midwife, you’ve been taking your prenatal vitamins and you may even be starting to think about the birth itself. You’re in the beginning stages of developing a team of people who are going to support you through the birth process.

Regardless of whether you planning on delivering your baby home, at a birthing center or at a hospital, one of these people you might consider having present at your birth to support you is a DOULA.

A DOULA? WHAT IS A DOULA?
In essence, a doula is a fancy word for an old concept. In cultures all over the world, women attend births. Women have assisted other women in giving birth for thousands of years. With the onset of industrialization and the tendency for birth to be a medical procedure, rather than a naturally occurring event, the concept of a birthing assistant has fallen by the wayside. In recent years, the idea of employing women to attend births has come back into favor and thus enters the doula.

A doula (usually a woman) is a person who assists women with the birthing process. A birth doula is “a supportive companion professionally trained to provide physical and emotional support during labor and birth…She provides continuous support, beginning during early or active labor, through birth, and for approximately two hours following the birth. The doula offers help and advice on comfort measures such as breathing, relaxation, movement, positioning, and massage. She also assists families with gathering information about the course of labor and their options. Her most critical role is providing continuous emotional reassurance and comfort.”

http://www.transitiontoparenthood.com/ttp/Doula/doulahome.htm

Some hospitals are even starting to provide doulas to women when they come to the hospital in labor, but this is rare. Woodwinds Hospital, a local hospital in MN, has a volunteer program providing this service called Doulas at Woodwinds.

WHAT DOES A DOULA COST?
Most doulas charge a flat rate for the entire pregnancy and delivery and all services rendered during this time. As I recall, the cost generally ranges from somewhere around $800.00 – $1,500.00. (Just an estimate.)

WHAT DO YOU GET FOR THE COST?
Doulas general provide services for three purposes: (a) prenatal visits, (b) delivery of the baby, and (c) postnatal visits. The doulas are on call during your birth and will be there regardless of the day or the time of day, unless they have informed you otherwise. The frequency and content of the visits may vary from doula to doula so be sure to ask lots of questions when interviewing your doulas.

1. Doulas usually do a few prenatal visits and will help you prepare a birth plan. They will talk to you about what you want during your labor and delivery and go over some of the choices you might have (types of pain relief, cord cutting, membrane stripping, etc.)

2. Doulas come to your house when you start to go into labor regardless of where you plan on giving birth. Their philosophy is geared towards laboring at home for as long as possible. If you go into labor quickly and are delivering at a hospital they will come as soon as you are admitted and will stay with you until the baby comes and for a few hours afterwards. Their rate includes your entire labor even if you labor for 48 hours, God forbid. If you deliver your baby in your home or in a birthing center, they would do the same thing, only in those places instead.

3. They also make one or two visits to your home after the baby has gone home with you. They will assist with breastfeeding, comforting your baby and adjusting to being a mom, if it’s your first time.

WHAT IS THE ROLE OF A DOULA DURING THE BIRTH?
The role of the doula is to assist the birthing mother with whatever it is that she needs. She is like a personal assistant. If you want her to clear the room of people, she will do that. If she wants you to get your husband or partner to help out or give a massage, she will do that. Basically she is at your beck and call throughout the labor. She will help you find good positions to labor in and will be very active or play a background role depending on what you want. If your partner is actively involved in the delivery she might provide gentle suggestions on helping you through the labor and delivery. Her main role is to act as your advocate and to see that you are getting your needs met such that the delivery is as comfortable as it possible can be.

If you end up having a Cesarean the doula can also enter the operating room. They usually have a limit on how many extra people can be there so you may have to choose between your birthing partner, if you have one, and the doula.

DO DOULAS HAVE MEDICAL TRAINING?
Doulas are not medically trained in the traditional sense. They do come with tons of knowledge about birth and labor and will provide you with suggestions about when to rest and when to move around and what positions you might try during labor. However, they are trained not to communicate with the medical staff directly regarding your medical condition. They will prompt you to communicate to the medical staff about a wish or desire that you had (such as not wanting the cord cut or skin-to-skin contact, etc.).

HOW DO I GO ABOUT FINDING THE RIGHT DOULA FOR ME?
1. The hospital where you are delivering may have a list of doulas that you can contact. In addition, you can read about them on the web (they may have their own websites) and if they look like someone you are interested in they will meet with you so that you can see if you like them and if you want to hire them.

2. On-line directories such as this one: http://doulanetwork.com/directory/Minnesota/ may be available in your area as well.

3. In Minnesota we have something called the Childbirth Collective and they have a “Meet the Doulas” night. It’s a great thing because you can meet a bunch of doulas all at one time and if you see one you like you can try to get an appointment set up for a meet and greet to see if you want to hire them.

From their website: The Childbirth Collective is a “collective of birth professionals who support women and families during the childbearing year. Perhaps you are looking for a birth doula, midwife, birth photographer, massage therapist or a postpartum doula. The Childbirth Collective is the place to connect with a growing and passionate community that cares about how you birth.”

Regardless of where you find your doula, make sure you interview a few so that you are comfortable with the one you choose. She is going to see you through one of the most challenging and amazing experiences of your life. Liking your doula will only make it a more positive experience.

WHAT ARE THE BENEFITS OF A DOULA?

From: “What is a Doula?

  • Reduces the need for forceps or vacuum extractor by 41%
  • Reduces need for Cesarean by 26%
  • Decreases medical intervention in labor
  • Reduces use of pain medication by 28%
  • Reduces dissatisfaction with birth by 33%
  • Reduces length of labor

Six weeks after birth, mothers who had doulas were:

  • Less anxious and depressed
  • Had more confidence with baby
  • More satisfied w/ partner
  • More likely to be breastfeeding

Homebirth Midwifery Care, Birth and Postpartum Doula Support and Massage Therapy Center http://www.geneabirth.com/

These two women look they provide a wonderful array of services. They provide Midwifery services, Doula services and Birth Massage.

They will also assist in at-home births for VBAC women, also known as the HBAC (Home Birth After Cesarean).

Awesome!

The massage service includes a two and a half hour massage during your labor with a certified prenatal massage therapist. Their massage therapist has also been a doula for eleven years and can guide you with the best positions to be in for early and active labor. The service includes meeting with the therapist to discuss the type of massage you would like to use in labor, and picking out the scents/s you would like to use in labor. She will then make an oil using Young Living Oils that you will bring home with you. In labor, the massage therapist will come to your home or visit you at the hospital/birth center for a two and a half hour massage that will help you to enter your labor in a calm and centered place. This massage is specifically tailored to you and your needs. She can come at any point during your labor, but early labor is usually the best.

NOTE: I know that for you around the country this particularly birth center might not be a possibility but perhaps there are other birth centers in your area that offer similar services. It’s good to know that places like this exist.

Additional Resources:

What is a Doula? (http://www.dona.org/mothers/index.php)
DONA International (http://www.dona.org/)
What is a Doula? (www.transitiontoparenthood.com/ttp/Doula/doulahome.htm)

Early Delivery (Prior to 38 weeks) May Lead to Delays in Reading and Math

As I’ve mentioned in previous posts, my first OB wanted to do a C-section at 36 weeks because of a previous uterine surgery. I bascially ended up going against her advice and delivering full term. You can read about it here. My daughter appeared at 42 weeks exactly so a 36 week delivery would have been six weeks earlier. The article below caught my eye and what I read was shocking! Academic acheivement scores in math and writing are lower for children born at 37 weeks versus 38-41?

Incredible. Read on.

Christina

Kids born just 2 weeks early have lower reading and math scores

https://singlemomontherun.wordpress.com/wp-admin/post-new.php
(accessed July 10, 2012)

Compiled by , Deseret News

Published: Monday, July 9 2012 11:12 a.m. MDT

Children born just two weeks early exhibit lower academic performance in reading and math, according to a new study published this month in Pediatrics.

“The evidence from this study would suggest that elective induction of birth should be approached cautiously,” said lead study author Dr. Kimberly Noble, assistant professor of pediatrics at Columbia University Medical Center and New York-Presbyterian Hospital. “The data suggest that children born at 37 or 38 weeks may have problems with reduced school achievement later on.” Noble encourages parents to be cautious before choosing an early birth for non-medical reasons.

Past research has indicated that babies born before 37 weeks are more likely to have difficulties in the academic sphere, Noble said. The widely held assumption that the development of babies between 37 and 41 weeks is indistinguishable may be inaccurate, she wrote.

“The study looked at data from more than 128,000 births of single babies born between 37 and 41 weeks, the span considered full term,” U.S. News reported. “When the children reached third grade, the researchers examined their scores on standardized tests to see if their delivery date suggested a difference in learning ability. They concluded that it did.”

Led by researchers at Columbia University Medical Center and New York-Presbyterian Hospital, the study is “among the first to look at academic achievement among children considered full term,” according to the Wall Street Journal.

“The math and reading scores of children born technically at full-term — 37 to 38 weeks’ gestation — lagged slightly behind their peers born just a little later, at 39, 40 or 41 weeks.”

Children born at 37 weeks had a 23 percent increased risk of moderate reading impairment compared to those born at the full 41 weeks. Of those children, 11.8 percent “born in week 37 had a mild reading impairment compared with average children their age versus 10.4 percent of children born in weeks 40 and 41, while 2.3 percent of kids born at week 37 had a severe reading impairment compared with 1.8 percent of those born in weeks 40 and 41,” the Wall Street Journal reported.

Experts have been unable to determine the exact cause of these academic struggles. “Perhaps there is something about the uterine environment that supports brain development in a favorable way in the last month of pregnancy and perhaps gets disrupted by earlier birth,” said Noble.

“While Noble acknowledges that her study could not determine why the babies were born before 39 weeks — such as whether the moms had voluntarily decided to induce labor, or whether an underlying medical condition prompted the earlier birth — the findings add to the evidence that the traditional definition of full-term pregnancy may need revision,” Time reported.

“The results should help both mothers and doctors appreciate that not all ‘term’ infants are the same,” she says, especially when it comes to cognitive outcomes later in life; those couple of weeks between 37 and 39 weeks may make a bigger difference than previously thought. “As with many other good things in life, therefore, delaying delivery may be worth the wait,” she added.

Rachel Lowry is a reporter intern for the Deseret News.

Related Posts:

Vaginal Birth After Cesarean – Make an Informed Choice
Skin-to-Skin Contact Following a Cesarean

High Needs Babies: Read Dr. Sears

My baby was most definitely a High Needs Baby. I think it would have been helpful if I had known about these types of babies before I had here! The only way to soothe her was to hold her and to swaddle her. The sling is still the best way to get her to settle down because she simply gets too overstimulated. The sling is our miracle worker and she is three!

Choosing a Pediatrician: It’s Like Going on a Date!

When my baby was about six weeks old my pediatrician told me that my baby shouldn’t be nursing for more than twenty minutes per breast. More than twenty minutes, she informed me, and “She is using you as a pacifier.” What? She’s using me as a pacifier? Is that bad? Hello, parenting decision. And here I thought she was eating. “But maybe she’s just hungry…,” I mumbled. 

“No. She’s using you as a pacifier.”  There was no hesitation; no ands, ifs, or buts about it. It was definitive. My child was using me. I was being used.

Later, when my child was about six months old, this same pediatrician informed me that my baby no longer needed to be nursing at night. “A baby this old has no need to be nursing at night any more. She can sleep through the night just fine. If you continue to nurse her at night like you are now, she’ll be yours for life.”

What did that mean, she’ll be mine for life? Isn’t she already mine for life? Did she mean that my baby will still be wanting to nurse as a teenager? I didn’t get it. The only think I could figure is that she wasn’t in favor of long-term nursing. That then raised  more questions for me. How long did I want to nurse at night? Isn’t that for the baby to decide? I was confused and my baby’s doctor wasn’t making it very easy for me to wrestle with these tough parenting issues. She was giving flat out advice and that style just wasn’t working for me.

It was at this point that I realized my doctor and I needed to break up. I would do it gently. “It’s all about me. It has nothing to with you. Really!” The fact that we probably didn’t really see eye-to-eye on some pretty important parenting practices was a big part of the problem, but even bigger was the fact that I didn’t feel there was space in the examining room for my opinions. And what did I know? This was my first baby. I didn’t feel very confident in disagreeing with her and there was no room for conversation or objection or even curiosity. I simply didn’t feel comfortable in our relationship anymore. And counseling clearly wasn’t an option.

The pediatrician-parent relationship is a complex and important relationship, especially for the first-time parent. During those really early months of your baby’s life a zillion questions come up about caring for this new little being. And the books just don’t have the answers. (Either that or you’re too sleep deprived or petrified to read them.) So who do you turn to? Your pediatrician. Your pediatrician and the clinic where you have those appointments every week. And don’t kid yourself—in between those appointments, you’ll end up calling about anything from a pimply butt to a red face. Maybe she has the measles! Maybe it’s a life threatening rash! I’d better call the doctor.

Choosing a doctor before the baby comes is one of the most important things you will do prior to giving birth. As soon as that baby is out of the womb she already has about ten doctor’s appointments lined up that she’ll need to go to over the course of the next couple of months. During those first visits the doctor will be direclty and indirectly evaluating you as a parent and whether that baby is thriving in your care: Where does the baby sleep? How long does she sleep? What is she eating? How much is she eating? How much does the baby weigh? How much has she gained since I saw her a week ago? Is she breastfeeding or bottlefeeding? How much and for how long?

And then the big question: “Your baby is scheduled for three vaccinations this visit. Do you want to give them all?”

Because of all the decision-making that goes into parenting and caring for your baby, you need to find a doctor that fits your personality, your parenting style and your expectations of a physician. You and your doctor might not agree on every issue but hopefully you will enter into a relationship with someone who will  listen and honor your decisions as a parent while giving you the information you need to make informed choices. Most importantly, you will want to find someone you like as a person and whose opinion you respect.

I initially chose the doctor that I did because she seemed to be a pretty liberal doctor and was open to a delayed vaccination schedule. However, six months after the baby was born we split up because of irreconcible differences. The marriage was annuled. Our views on breastfeeding seemed to differ pretty radically and our communication didn’t feel like a two way street.

If you and your doctor have radically different ideas about how to care for a baby, it might not be a good fit. It’s kind of like going on a first date. You may think you’re in it for the long haul but as you find out more about the potential partner, your opinion may change over time. If you can get it right the first time, it can make things a little bit easier.

Part of the reason this relationship with your doctor is so important is because parenting requires loads of on-the-fly decisions regarding your baby’s health and well-being. In addition to the “What do I do right this second?” decisions, it also involves the questions about “How do I want to parent my child over the next year or two years?” Some of these decisions will be about issues that you will want to run by your doctor. When do I introduce solids? When do I stop breastfeeding? Is it safe to co-sleep with an infant? How long should a breastfeeding session last? These are topics that you’re going to want to discuss openly and honestly with your pediatrician, and the more comfortable you feel with your doctor, the better. Every doctor has their views on raising children and if your doctor’s methods are drastically different from what you want and care about, you won’t be getting the most out of the relationship.

Looking back on the process of choosing a pediatrician, I realize that I grossly underestimated the importance of finding a doctor that I liked as a person and whom I would respect.

When you pick a pediatrician you want to pick someone to whom you really want to go for advice; someone who will be open to hearing your opinions and point of view; and someone whose opinion you will trust. You want someone you can stay with for years to come. Find a pediatrician to walk down the aisle with and one with whom you can work, both in sickness and in health!

Vaginal Birth after Caesarean – The Key is Finding the Right Doctor and Hospital

The article below states that: “Most doctors or hospitals don’t have access to 24/7 hospital coverage by physician services in obstetrics, gynecology, anesthesia, neonatology with a neonatal intensive care unit, operating room availability for emergent Caesarean deliveries, massive blood banking and expert nursing.”

When I delievered my baby as a VBAC, at the age of 41, I did so in a small hospital in a small town, about 20 miles from the closest NICU. My doctor told me that their hospital had recently become approved for VBACs. My understanding of his explanation was that certain measures had to be taken in order to be allowed to perform VBACs. For instance, an anesthesiologist needed to be present in the hospital at all times in case of an emergency C-section. Hudson Hospital, where I delivered, did not have a neonatal intensive care unit (NICU). I was told that if a baby were to need immediate care it would be transferred to a hospital with these facilities.

A friend of mine gave birth to her second and third child vaginally in a birthing center in Wisconsin, attended by midwives, after having had her first child via Cesarean. Although I did not see the birthing center myself, I was told it was across the street from a hospital in the case of a need for emergent care.

She ended up giving birth the first time by Cesarean due to a diagnosis of “failure to progress.” She told me that she believes had she been in a hospital that her second two babies would also have been delivered by Cesarean. She believes that the midwives were more tolerant of a longer labor and helped while she progressed through the early stages of labor.

Here is the article to which I was referring:

Vaginal birth after c-section is option for women, not for some doctors, hospitals.

ScienceDaily (May 11, 2012) — Melissa Lunsford wants a vaginal delivery for her fourth child. Following a series of Caesarean and vaginal deliveries for her other children, she couldn’t find a doctor or a hospital willing to give her the vaginal birth option for her current pregnancy.

Unfortunately, too many women like Lunsford face the same challenge, says an advocate of vaginal births after Caesarean (VBAC) from Ben Taub General Hospital, one of the top VBAC-delivery hospitals in Texas.

“For some clinicians and hospitals, the prospect of offering a trial of labor after a Caesarean delivery is too risky. While risks exist, the possibility of delivering vaginally is still a viable option for many women,” says Dr. Christina Marie Davidson, chief, Obstetrics and Gynecology Services, Ben Taub General Hospital, and assistant professor, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine.

Finding a physician and hospital that offers VBAC procedures can be difficult. Most doctors or hospitals don’t have access to 24/7 hospital coverage by physician services in obstetrics, gynecology, anesthesia, neonatology with a neonatal intensive care unit, operating room availability for emergent Caesarean deliveries, massive blood banking and expert nursing. At the Harris County Hospital District, the health system that operates Ben Taub General Hospital and Lyndon B. Johnson General Hospital, the Women and Infant Services has all medical coverage needed to make VBACs a viable option for women even after more than one Caesarean delivery.

In fact, Ben Taub and LBJ hospitals share the state’s highest VBAC rates of all hospitals, respectively 27.86 percent and 29.58 percent, according to a 2009 report by the Texas State Department of Health Services. The rates of Ben Taub and LBJ hospitals are routinely three times higher than the national VBAC rate of 8 percent.

“We believe women should have that choice. We can’t guarantee that they’ll have a VBAC delivery every time, but we can certainly plan for it,” Davidson says.

Factors associated with an increased likelihood for a successful VBAC include:

• Not facing a similar condition for the previous Caesarean

• Successful vaginal delivery or VBAC in past

• Previous Caesarean not for cervix complications or infant not descending through birth canal

• Labor starts on its own

• Younger than 35 years of age

After being repeatedly told of the inherent risks and dangers, Lunsford sought answers and comfort on the Internet. Her research of successful testimonials gave her hope. She next began an arduous search for a VBAC-friendly doctor.

“Everyone I talked to, including my friends, basically told me it was silly to think of delivering vaginally again after a Caesarean. But, it is important to me and something I knew I wanted,” she says.

After contacting 10 doctors to deliver her baby, Lunsford finally found Davidson, who not only had the expertise, but who’s also an impassioned supporter of VBACs.

“Women who choose to have a vaginal birth after Caesarean should have that option and not be discouraged because of a lack of knowledge or resources,” Davidson adds.

For Lunsford, the chance to deliver her son as naturally as possible is worth the effort.

“It is important to me and important to my entire healthcare team,” she says.

I Have Two Names Now: Mommy and Christina

To My Daughter, on Her Third Birthday

Three years and two days ago, I had one name: Christina.

I wore it and I wore it well. I studied, I worked and I played. I danced and climbed mountains and ran like the wind. I was free and there was no one to stop me. I loved life and it loved me.

But then one July a little seed was planted inside me and it grew. It grew and it grew and it grew. That little seed was you.

Then forty-two weeks later, on the nose, with a big belly about to explode, out you came, quicker than I thought. No long labor, no deliberation. It was time and the doctors and nurses knew, even before I did.

Faster than I could blink an eye you were in the world. And there you were. They held you up and I saw you over the sheet. You were a baby. My baby! I couldn’t believe my eyes. 

They measured you and weighed you and then they brought you to me. They put you naked on my chest, just as I had asked, right next to the sheet that separated you and me from the men and women that had so carefully and attentively brought you into the world.

You cried and suckled and took to the world like it was yours to keep.

You stayed beside me while I healed. I never let you out of my sight. You lay on me and in the crook of my arm while I nursed you, watched you sleep, and nursed you some more. I learned how to swaddle you and to change your diaper and to feed you. I learned how to care for you.

Most importantly, I kept you next to me as much as I could. Not only had I read all of the books but I knew in my heart that that was where you belonged.

The little you, who was also a big part of me, lay beside me for four long days before I could take you home. 

At first I was uncertain about this new, crying being who needed so much from me and without a pause. Is this what I had wanted? Is this what I had asked for? Is this what I had expected?

Despite all the preparation, I did not feel prepared.

Oh sure, I had the co-sleeper and the swings and the bottles and the bibs and the onesies. It was all there. But somehow you can’t buy the one thing that one really needs: Experience.

I don’t think one can ever be truly prepared for what lies beyond the birth of a first child.

People had told me my life would change but I didn’t believe them. How can a little baby like that be so much work, I’d ask? My life will be the same; I’ll just have a baby along for the ride from now on.

They would just shake their head and smile. They knew it could not be explained. And they knew I was in for a shock.

After some time of getting used to you, I started to change.

“Here, give her to me. I know what to do,” I’d say to those who didn’t know.

We worked together—she at being in the world, and me at learning to give 100% of myself to someone other than myself.

We’ve seen some good times and some bad times. We’ve worked through some smiles and some tears. I’ve watched as she’s reached many milestones – usually without any help from me. I’ve had many sleepless nights and have cleaned up a number of messes in the middle of those long seemingly endless times. I’ve seen her grow from a little baby, into a toddler, and soon into a little girl.

After three years, I think I have finally made the transition.

Yes, it has taken that long.

Up until a few months ago, I was only known as “Momma!” “Momma!” “Momma!” Usually with arms stretched high. “Up!” she’d demand.

A few weeks ago, for the first time, my little girl looked at me and said something like “Mommy, what you doing?”

My heart melted. I almost cried.

Where had she learned this word? Where did “Mommy” come from? I knew it was me, but I still couldn’t believe it….Me? Mommy? Yes, I am Mommy!

So now I have two names: Christina AND Mommy.

And there are some things Mommy knows how to do better than Christina could have ever done them.

Mommy knows how to choose a cloth diaper, fit it, change it, and clean it.

Mommy knows how to call the doctor in the middle of the night and how to put a wheezing baby on the phone.

Mommy knows how to put an infant and a toddler to the breast.

Mommy knows how to soothe a colicky baby like nobody’s business! I lovingly refer to her as “The Baby Whisperer.”

Mommy knows how to give really big hugs and how to kiss really little toes.

Mommy knows what it’s like to have a baby sleep on her chest all night long while keeping one eye open, just in case.

Mommy knows that a cookie can fix just about anything and that a song can soothe most of what ails.

And Christina knows a thing or two, too.

Christina isn’t climbing rocks much these days. Christina isn’t running as fast as the wind anymore.

But Christina knows that special feeling of having a baby kick the inside of her stomach, and that amazing “thump, thump” when the doctor checks for a heartbeat.

Christina also knows what it’s like to go to work every day while still remembering that there’s a very little girl out there who needs her Mommy.

And Christina knows when it’s time to take her baby from some other caring adult just because her girl will only be soothed by her.

And, most importantly, Christina knows to bend down when she picks her baby girl up from school because there she’ll be, a little girl now, grinning from ear to ear, running towards her, reaching out, calling “Mommy, Mommy!”

And Christina knows, that no matter how much she may miss parts of who she used to be, the little girl who calls her Mommy fills an amazing spot in her heart that no one else can ever replace.

Happy birthday, Baby Girl.

Love, Your Mommy.

The Newborn Latch: Instructional Breastfeeding Video

http://snbsonline.net/id11.html

Image

On this site there is a series of three videos with a male physician teaching the mother how to get her baby to latch on. The videos are wonderful. (It will say 1 of 3, 2 of 3, and 3 of 3 for a total of three mini videos in the series. Each are about 3-4 minutes long.)

One of the things that this physician says is that he has worked around the world in Africa and South America. He states that in these countries the babies are on the breast for hours but in North America people become horrified if a mother is nursing for more than 20 mintues a side. This is actually something that my doctor had advised me against as well. Inform yourself about the possibilities related to breastfeeding. He also states that mothers aren’t taught how to properly breastfeed while in the hospital and promotes more education around breastfeeding properly.

Here is information in a text form if you like from a website I found.

http://www.childfun.com/breastfeeding/latch.shtml

“Attaching the baby to the breast correctly is the first and most important step towards successful breastfeeding. The vast majority of breastfeeding problems are caused by improper latch-on (the second leading cause of breastfeeding problems is feeding on a schedule instead of on demand). Here are some problems that incorrect latch-on may cause:

  • Sore nipples. These result when the baby holds just the nipple in her or his mouth instead of opening up her or his mouth wide and taking in a good mouthful of breast tissue.
  • The baby cannot milk the breasteffectively unless she or he is latched on properly. The milk reservoirs are located behind the nipple under the areola. A baby who is sucking on just the nipple cannot compress the milk reservoirs to get the milk out. This may lead to:
    • Engorgement. Your milk comes in and the baby can’t remove it from the breast. Your breasts can become engorged.
    • Mastitis. Engorgement that is left untreated can lead to plugged milk ducts and mastitis. The treatment for engorgement is emptying the breast. If your baby does not latch on correctly, she or he cannot empty the breast.
    • Poor weight gain. If your baby does not latch on correctly, she or he does not get enough milk. Furthermore, most of the milk she or he gets will be the thin foremilk. Your baby may fail to thrive.
    • Insufficient milk. Your breasts make more milk as they are emptied. Milk left in the breast tells your body to slow down milk production. If your baby is not latching on properly, you may lose your milk supply.

OK, so it’s really important to latch the baby on properly. Fortunately, it’s not very hard (although it takes practice; it might take anywhere from a few days to two months for your baby to become a pro at this). Here are a few things to pay attention to:

  • Take full advantage of your baby’s rooting reflex.
    • The rooting reflex has two parts: turning and opening the mouth.
      1. When you touch your baby’s cheek or lip lightly, she or he will turn her or his head towards the touching object.
      2. She or he will also open her or his mouth really wide, as in a big yawn.
      3. Soon, your baby will learn that your breasts are her or his source of comfort and nourishment, and she or he will turn her or his head from side to side and open her or his mouth whenever she or he wants to nurse.
    • If your baby is already facing your nipple, you can just tickle her or his lip with your nipple until she or he opens up really wide.
    • If the baby is facing away from the breast, tickle her or his cheek with your nipple When she or he turns toward your breast, tickle the lip with your nipple.
    • Make sure you continue tickling until your baby opens up reallywide. Don’t try to attach a baby whose mouth is only slightly open, or you might have sore nipples and all the other problems associated with improper latch-on.
    • A very common mistake is to try to push and turn a baby’s head towards your breast. The rooting reflex makes the baby want to turn towards the pushing object. Many people interpret this to mean that the baby is turning away from the breast. They say the baby “rejects” the breast, and resort to artificial feeding. Don’t fall into this trap! Just tickle the baby’s cheek with your nipple, and she or he will turn towards the breast.
    • When the baby opens up really wide, pull him towards your breast all the way to your chest. It’s important to pull the baby close to make sure she or he gets a good mouthful of breast instead of just the nipple.
  • When a baby is correctly latched on:
    • Her or his lips should be flanged out, not sucked in. You should be able to see the inner surfaces of the lips on your breast.
    • Her or his tongue should be covering the lower gum. You can see this by pulling the lower lip slightly out.
    • Her or his cheeks should not be dimpled. Dimpled cheeks during sucking indicate poor latch-on and suction.
    • Her or his nose should be touching your breast. If the baby’s nose is away from your breast, she or he is sucking on just the nipple. You’ll have sore nipples, and the baby won’t get enough milk.
  • You might wonder whether you should hold your breast with one hand while you are breastfeeding.
    • You can hold your breast to make it easier for the baby to latch on.
    • If you do, make sure your thumb and fingers are well behind the areola.
    • Many people do a good job of keeping the thumb way back, but they put their fingers too close to the areola, just behind the nipple. Avoid this! Your baby needs to take in as much breast tissue as she or he can comfortably fit into her or his mouth. If your hand is too close to the nipple, the baby will just take the nipple in. You’ll get sore nipples.
    • Avoid the “scissor hold” in which you hold your breast between your index finger and ring finger. This style of holding the breast very often causes the baby to latch on to the nipple instead of to the breast.
    • Use the “C” or “U” hold, where you form a C or U shape with your thumb and fingers (as if you are holding a water glass). Hold your breast so that its compressed shape is in line with the baby’s open mouth (remember, you are doing this to make it easy for the baby to take in as much of the breast tissue as possible).
    • You can also hold and lift your breast to bring it to the level of the baby’s mouth. This is useful for mothers with large soft breasts.
    • You don’t need to worry about pulling the breast back from the baby’s nose to let the baby breathe. Babies’ faces are made for nursing. They can breathe with no problems with their faces smushed right into your breast. Pulling the breast away from the baby can lead to improper latch-on and sore nipples.
    • If you have flat or inverted nipples that stand out when you squeeze the areola, hold your breast so your nipple protrudes until your baby is latched on.
    • Once the baby is latched on and nursing, you can usually let go of the breast.
    • If your baby is able to latch on correctly without your holding your breast, you don’t need to hold it. Women with smaller breasts are more likely to be able to nurse a young baby without holding the breast. As your baby grows, you’ll probably find that you won’t need to hold your breast, no matter how large or soft it may be.
  • If your baby is not latched on correctly, remove her or him from the breast and try again. You should keep trying until the baby gets it right, even if you have to try twenty times. Pretty soon, your baby will learn to latch on properly, and will be able to do it without any help.”

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https://singlemomontherun.com/2012/05/25/my-breastfeeding-story/
https://singlemomontherun.com/2012/06/17/choosing-a-pediatrician-its-like-going-on-a-date-2/