KCdoula's blog

How American is our Medical Association?

Wed, 25 Jun 2008 09:43:29 -0400

or
AMA Plans to Remove Mother's Choice

We've seen Mother's choices restricted in the past:
Little or no access to midwifery care
Food restricted during labor
Pushing in the lithotomy position
No Option for Vaginal Birth After Cesarean
- Just to name a few.

Now, the AMA is adding another item to their list - Outlawing Homebirth!

At their recent annual meeting, the AMA stated that:
"That our American Medical Association only advocate in legislative and regulatory arenas for the licensing of midwives who are certified by the American College of Nurse-Midwives." In plain terms, this means that the AMA will only support hospital midwives, or CNMs.

Breastfeeding Officer

Sat, 07 Jun 2008 23:25:57 -0400

A few weeks ago, I received an inspiring photograph of a police officer breastfeeding a baby. She is in uniform, but it is unzipped and unbuttoned, in order to nourish this tiny baby. The woman looks worried and the scene around her is filled with chaos. She is in an earthquake shelter, with people and blankets everywhere.

Many thousands of families were affected by the recent earthquake in China. It had been estimated that 50,000 people were killed. In the shelters, there wasn't enough dry food for babies.

The officer in the photograph was breastfeeding two babies when interviewed and had actually fed 8 babies over the last two days. Five babies were orphans, and 3 babies had mothers who were unable to nurse. The officer was quoted as saying, "My babies are babies, other people's babies are all momma's babies."

CIMS New Website

Sat, 07 Jun 2008 23:24:09 -0400

CIMS, the Coalition for Improving Maternity Services, is a fabulous resource for parents and practitioners who are seeking information on healthy maternity care.

In the 1990s, CIMS formed with the mission "to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This evidence-based mother-, baby-, and family-friendly model focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs."

Perhaps you're wondering what Mother-Friendly or Baby-Friendly care entails? You can read the Mother-Friendly Childbirth Initiative on the new CIMS website, http://www.motherfriendly.org/.

April is Cesarean Awareness Month!

Tue, 01 Apr 2008 19:31:35 -0400

At this point, we probably all know at least a few women who have successfully given birth by cesarean. So why is it a concern?

A few things that are coming to mind are:

Subsequent pregnancies can be affected by a cesarean birth. It is not common, but it is possible for the placenta to attach over scar tissue in the uterus, leading to complications.

Breastfeeding is more difficult for mothers/babies who have a cesarean birth. Is it the medication? Time apart? Physical discomfort? IV Fluids? A combination of factors?
It takes longer for the milk to come in with a cesarean birth, which can cause the baby to lose weight and then receive supplementation with formula, which interferes with nursing.

Finding a provider who will help you to have a Vaginal Birth After Cesarean(VBAC). If you are pregnant and had a cesarean for your previous birth, be sure to ask your potential care provider right away about VBAC, because there are care providers out there who refuse to "allow" them. How will your provider help you to have a vaginal birth? Do they encourage women to have a VBAC? Or encourage them to have another surgery?

A general problem that I have with the Cesarean Trend:
20-40% of women's bodies have NOT CHANGED in some drastic way that would not permit vaginal birth. It is the way that we TREAT women's bodies that HAS CHANGED.

Planting Seeds of Fear

Tue, 04 Mar 2008 09:31:46 -0500

Recently, I heard this story:

A woman chose a doctor for her prenatal care. The doctor told her that because she has red hair, she is probably going to need a c-section.

This woman is having her first baby. She is young, healthy, eats well and exercises daily.

Her doctor is planning major surgery without any evidence that it is needed. The mother was not even in her third trimester or in labor.

She was able to see through this man's plans to plant seeds of fear in her mind and she changed providers. That is great news. But why aren't doctors held accountable to provide evidence based care?

Have you Hugged a Midwife Today?

Tue, 18 Dec 2007 13:40:01 -0500

Midwives make gentle birth possible.
Midwives are care givers, health care providers and counselors.
Midwives share knowledge of natural healing and support our transitions to parenthood.
Midwives are activists, working women, daughters and mothers.
Midwives are steadfast, nurturing all that birth can be.

Have you hugged a Midwife today?

Babies Need Time to Breastfeed

Wed, 28 Nov 2007 09:33:43 -0500

Recently, I attended a birth of a baby who was born a month early. She had good muscle tone and a strong cry. The extra staff members that came to examine her agreed that she was healthy. So when the mother was finished with the placenta, I suggested that the time was right for breastfeeding. We talked about proper alignment and tried several positions. The mother squeezed some colostrum from her nipple and let the baby taste it. We waited for the baby to open her mouth wide enough, mother poised with areola ready. The baby latched on - hooray! - then let go. Ok, let's try that again.....And again....the baby was sucking one time and releasing her latch.

We stimulated the reflex point in the roof of her mouth as a reminder that it's time to suckle. Once she got the hang of it, I took my finger away. The mother was ready to get the baby latched on. This time she stayed. I felt triumphant, watching this little creature nurse and seeing her mother's worries slip away.

Within minutes - like 5 - the nurse came and insisted that she take the baby upstairs to the nursery. She said, "Well, it's been an hour, so I need to take your baby. They're going to be looking for your baby upstairs." The mother, who was exhausted and probably didn't realize how long the baby had actually nursed or how long it takes to get your baby back from the nursery, pulled the baby off of the breast and handed her right over to the nurse.

There is nothing happening in the nursery that is more important than giving each baby sufficient time to breastfeed, even if a nurse is expecting a new patient. What matters most is whether or not the baby was given as much time as she needed for breastfeeding. Baths, eye ointment, injections, measurements; these are not things that need to happen immediately following birth. Breastfeeding is known to be most successful when it begins within the first hour after birth. If the first hour is taken with procedures, then mother and baby need more time.

Non-emergency newborn care is fairly simple: When the baby is born, make sure he is warm and dry and breathing. Then feed him. Everything else can wait!

Is it Safe to Eat Fish during Pregnancy?

Wed, 21 Nov 2007 09:43:28 -0500

At this time of year, we all have food on our minds.
One question that pregnant women and mothers of small children frequently ask is,"Is it Safe to Eat Fish?"

There are many health benefits of eating good quality fish. The fish oil supports brain function and steadies the emotions. Women who consume fish or fish oil regularly during pregnancy have a lower rate of postpartum depression. Fish oil is also good for treating joint inflammation and ADD.

The following link offers a handy tool for consumers. The Monterey Bay Aquarium's Seafood Watch program has created a printable business card sized list of safe fish, moderately safe fish and fish to avoid eating.

You're Not Going to Get a Medal for This

Wed, 14 Nov 2007 08:27:13 -0500

Are you a mother who has heard this before?
I have heard it said many times, to laboring women that I was supporting as a doula.

Wouldn't you like to know who started it? Exactly who was it that thought this would be a cute thing to say to women? And more importantly, why do people continue to diminish a laboring woman's efforts in this way?

Usually, if someone is going to say it, it's when a woman is struggling with her decision to use medication in labor. Maybe she is considering an epidural and the nurse is trying to validate her feelings. Or maybe the nurse is already preparing for the mother to receive the medication and she chimes. "You know, you're not going to get a medal for this!"

So here is the mother, working really hard in labor, and in walks a relative stranger, just waiting for the moment to use her line. Just waiting to tell this mother that her efforts are not worthwhile and will not be acknowledged.

I have never heard anyone say this to the mothers who choose medication in advance, or to those who are already feeling the anesthesia.

I wish that the people who use this line would listen to what they're saying. It's dis-respect-ful to not acknowledge the challenging work that women do in labor. We should be supportive, rather than dis-courage-ing mothers whose goal is to have as few interventions as possible. And if they are choosing medication, we can be supportive of the work that they have done so far.

Not only that, these hardened nurses are mistaken about the medals. Mothers do receive a medal when they give birth! It weighs about 7 or 8 pounds and wants to be fed.

Nursing Mothers Needn't Worry About Sag

Fri, 09 Nov 2007 11:27:38 -0500

Sometimes women or their husbands are concerned that breastfeeding will ruin a mother's breasts. A recent article, "Nursing Mothers Needn't Worry About Sag," published by the Wall Street Journal, addresses this question. Dr. Rinker from the University of Kentucky may offer good news for those who are concerned: breastfeeding does not cause sagging breasts. However, I must say that while reading this article, my mind launches into feminist mode.

First of all, how does using a body part for it's proper function ruin it?
Does anyone ask if breathing will ruin one's lungs, or if walking will ruin one's feet?

Great Reasons for Transparency in Maternity Care

Wed, 07 Nov 2007 08:34:04 -0500

We can easily find information on the national and state cesarean rate, the use of pitocin, incidence of episiotomy or other interventions. We know that physician attended births involve more technology and frequent use of interventions compared to midwife attended births. Despite the increased use of technology and interventions, the outcomes for mother and baby do not improve. For healthy women, midwifery care leads to the best outcomes.

Is it possible that parents need access to information about each provider, in order to have a really clear picture of how they prefer to handle pregnancy, labor and birth?