Saturday, February 28, 2009

New to the Sidebar: Popular Posts

I've been blogging here for a little less than a year: my first post was on April 30th, 2008. I am amazed at the amount of traffic this blog has produced, though I realize it is small peanuts in bigtime blogging world.

Back in March 2008, I had 380 unique visitors, averaging 14 visitors a day. 86 people visited my Class Information page. I'd been thinking about writing a blog, but hadn't really thought seriously about it. Then my sister Michelle went to the Midwifery Today conference in 2008. She went to one a session on marketing and came back to tell me how much of impact blogging can have on web traffic, and I decided to do it. And my web traffic increased enormously: for February 2009, I've had 1620 unique visitors, averaging 95 visitors a day. 138 people have visited my Class Information page this month.

And, of course, lots of people have accessed information from previous blog entries as well. My most popular blog posts seem to divide into two groups: those about prenatal nutrition and those about birth choices.

I've decided to link to these popular posts on the side bar, and here they are in this post, too:

Good Breakfasts

Choosing Prenatal Vitamins

Omega 3 Fatty Acids

Eating Protein in Pregnancy

Meals to Freeze



Offered Midwife-led Care

Choosing a Care Provider & Place

What are My Choices?

Where is Birth Going?

My most popular searches are things like "breakfast for pregnant women" and "graphic clips of vaginal childbirth" and "how to choose a prenatal vitamin".

There's always a search or two on colostrum and tandem nursing, and I'm so glad that maybe my post Tandem Nursing and Colostrum will be useful to a pregnant mom who continues breastfeeding. I just read a Mothering Q&A on colostrum & tandem nursing which might be helpful too.

And ones about specific foods: is Cesear salad okay? eggs benedict? a butter roll?

And a weird and/or disturbing one like: "birth babies - po*n" (!!)

Finally, there's a bunch about Maine, where to find birth classes, midwives, doulas, breastfeeding support. I'm thrilled that someone might connect with a midwife or doula or breastfeeding group that will help them on their birth & parenting journey by visiting my site.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Sunday, February 22, 2009

The Blue Cotton Gown: A Midwife's Memoir

I just finished The Blue Cotton Gown: A Midwife's Memoir, by Patrician Harman this weekend. It was an excellent memoir - very well-written and full of moving stories, both the author's story and the stories of the women she saw in her practice as a midwife.

Because this is a "midwife's memoir", I think some readers may be expecting lots of birth stories. There aren't many, in fact, just a handful, which emphasizes two important issues.

First, midwives can provide care during the entire spectrum of a woman's life - from her first gynecological check-up to discussions about menopause. Midwives do a lot more than attend births!

Second, not all midwives (or obstetricians, or family practice doctors) can afford to provide obstetrical care. Harman writes, "when the cost of medical-liability insurance almost doubled, we looked at what it would cost to continue obstetrics, and we couldn't break even. Bringing new life into the world in a gentle way was our calling, but a calling we could no longer afford" (206). For a more in-depth review of the book, and discussion of the issues in it, read Jo's review at The Modernity Ward.

When I was discussing the fact that the gender part of my recent post on Dell received more attention than the midwife part, she said - "oh! you could rewrite that part to show how a real midwife would handle the situation!"

Coincidentally, one of the few birth stories in The Blue Cotton Gown does just that:
"So we push... And we push... For two hours, we push. It's a group effort.

We try every position the nurse and I can think of. 'Can't we just do a C-section?' Nathan [the dad] asks, eyeing the tracing as the fetal heart rate dips into the nineties, then bounces back to 150 again, a nice normal baseline. 'Maybe he's too big.' That thought has crossed my mind too, but it's not time to give up yet.

'Come on, let's get back to work. We're missing some of these contractions. Here, Jeannie, pull on my hands. Pull!' An hour later, when Tom [OB, Harman's husband] returns from the OR, he enters the birthing room as if he means business, and I'm glad to see him.

'How you doin?' he asks Jeannie and shakes hands with Nathan. 'Getting tired?' I catch his eye and glace toward the monitor. The decelerations are steeper now but always returning quickly to baseline.

Another big contraction and Jeannie grabs her butt then flops back in bed, trembling. 'I don't think i can do this!' After two days of labor and three hours of pushing, the young woman is spent.

'Ready for some help?' Tom asks, slipping into a long green sterile gown. Terry, the RN, uncovers the delivery table and places the vacuum extractor, a modern alternative to forceps, near the corner. Clearly, she thinks it's time.

'You bet I'm ready!' says Jeannie. 'Is this finally gonna happen?'

Though the extractor, which comes with a soft plastic suction cup, is less risky than metal forceps, it's not without danger. It can cause bruising, laceration, a hematoma, or worse, a shoulder dystocia . . .

Dr. Harman parts the labia. 'This may hurt a little,' he warns as he applies the vacuum cup to the fetal head.

I center my attention. 'Okay, Jeannie. Tom can't pull the baby out by himself. That would be too much strain on the little neck. You've got to push as hard as you can and soon you'll be holding your little one.'

But I'm wrong. Each time Dr. Harman pulls, the head moves only a quarter inch. Once, the vacuum slips off. Then again it slips off. And again. The head is crowning now, and by protocol, the provider gets only three tries with the extractor; any more may cause damage. Tom lays the mechanical device aside, then sits on the stool between Jeannie's legs, checking the vagina for stretch. Neither of us routinely does episiotomies - in fact, rarely, if ever - but I can tell he's thinking about it. Nathan stares numbly at the top of his baby's bruised head.

I reach over and pour a little oil, which the nurse has placed on the delivery table, over Tom's fingers as he massages the vaginal opening; our gloved hands touch and he smiles. Our last delivery together. Shoulder to shoulder.

When the monitor shows a good contraction, I lean over the bed and whisper to Jeannie, 'This is it, babe! One more push. You're on your own now, no vacuum extractor. The head's almost out.' With valor, the worn-out woman pulls back her legs once again. Nathan gets into position, holding her head, and I bend over, showing more optimism than I feel, to help Tom support the perineum.

Imperceptibly, there's a shift, and the fetal head dips below the pubic bone. There's no stopping Jeannie now. All at once, the baby rotates a quarter turn and hurtles into Tom's waiting hands. I place the wet squirming bundle in Jeannie's outstretched hands, cord still attached. 'Thank you,' she cries, 'Thank you, everyone. My baby! My baby girl.' Nathan is sobbing. There are tears in Tom's eyes. Our last delivery together" (209-11).
This is obviously a much different scenario than the vacuum-assisted birth on Private Practice. Mom works for hours to push her baby out: they try lots of different positions, lots of encouragement and support, tolerance of variations of normal in the fetal heart tones. I do wish the author had included more of the informed consent conversation that I'm assuming happened. And I'm assuming that lots of the positions they worked through earlier were more upright ones, but that these last pushes happened with mom on her back because they were using the vacuum extractor as a last resort.

I'll be back on a regular schedule again now that we've recovered our power. This has been a record for how long it's taken me to write a post - I started this one over the weekend, but since we lost power when it snowed 18" on Sunday, I haven't been able to get back to it!

I keep repeating to myself: Spring is coming! Spring is coming!!

More posts coming soon!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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More on Midwifery and Gender

Well, we're two down (the little guy & I are both through the stomach bug) and two to go here and the suspense is high: are we through with Pukefest the Third, or is this day of non-sickness only an intermission? So, while I have the chance:

Interestingly, the comments and emails I've received on this blog and the family blog where I cross-posted the Private Practice entries have all been about gender and midwifery, not about the indignation I personally felt when seeing a "midwife" provide the kind of care Dell offered the laboring woman.

The gender issue seems a little like sleight of hand to me - here look: a male midwife!! Ignore the fact that Dell is not practicing actual midwifery. Since we've been in an ongoing old-school Star Wars movie marathon, the other comparison that comes to mind is the Jedi Mind Trick: we're post-gender here at Private Practice, look at sexy sensitive Dell delivering this baby!! Ignore the fact that Dell is performing a risky procedure without informed consent!

Let me clarify my feelings on the gender issue. I think men should be able to become midwives or ob/gyn doctors, just like women should be able to become midwives or ob/gyn doctors. Like I said previously, I wonder about the market for a male midwife. I think there is a significant overlap of "women who seek midwifery care because they perceive it to be more woman-centered" with "women who want a female care provider because they perceive her to be more woman-centered" (picture a Venn diagram here, if you would) and therefore, I would be curious as to how many women who fall into both of these categories might actively choose a male midwife. This is hard to debate because at least here in the United States, there are very, very few male midwives.

There's a much more important sleight of hand that women need to be aware of when they choose a care provider: the tendency to make assumptions about a care provider because she is a woman or he is a man OR because one is a midwife and one is a doctor. Get to know your provider! Neither gender nor training & credentials guarantee certain philosophies or care practices. If you can't get to know your provider, because you're seeing so many different partners in a practice or because (s)he doesn't bother to sit down during your appointments, that gives you some very valuable information.

Some men, as OBs, family practice doctors, or midwives provide excellent, evidence-based, woman-centered care. The country doctor in Lady's Hand, Lion's Heart (my review), Navelgazing Midwife's Dr. Wonderful, and Michel Odent come immediately to mind.

On the other hand, some women, as OBs, family practice doctors, or midwives, do not provide woman-centered care, instead relying on routines that are not evidence-based and can even be degrading.

Is it more shocking when a woman provides care like this? I don't know if it should be, but I've definitely heard, in tones of betrayal and disappointment, "well... I thought because she was a woman she'd __________________________." or "I thought because she was a midwife she'd __________________________."

A care provider's gender or training does not automatically guarantees a certain kind of care. There are certainly trends that midwifery care and OB care follow, but there are certainly midwives who tend to practice more from a medical model and OBs who tend to practice more from a midwifery model. Personally, I think gender offers even less certainty than training and credentials. Does this make me suspicious, or only a careful consumer?

How did you decide on a care provider? How much did the credential as midwife or OB or family practice doctor come into play? How much did gender matter to you? Did your care meet your expectations?

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Wednesday, February 18, 2009

Private Practice: Dell the "Midwife"

I've decided there are three issues I want to address from the "Acceptance" Private Practice show: Dell as a midwife; electronic fetal monitoring & fetal heart tones; and informed consent in general & regarding the vacuum extractor in particular. I haven't gotten to this until now because my little guy woke up with a stomach bug at 2am, and was in rough shape all morning. Thankfully he seems okay now.

So I'm really curious about how you all feel about Dell as a midwife. In case you missed it, I outlined the show I'm discussing in my previous post, Private Practice: "Acceptance".

First, there's the whole gender issue - should men be midwives?? That's not going to be the focus of this post... I guess I think men should be able to become midwives if they want, but I'm wondering how many women would choose to have a male midwife? Is there really a market for male midwives? Clearly male midwives are rare - I don't know of any practicing in Maine.

Anyway, I think Dell's character is an interesting foil for Addison, in that he portrays some stereotypically feminine characteristics while she portrays some stereotypically masculine ones. While the gender issue may be one that the producers/writers are trying to challenge viewers with by having Dell pursue midwifery, gender is not the important issue for me.

Feel free to leave a comment re: your feelings on male midwives (especially you, Michelle, since you actually received care from a male midwife).

The real issue for me is that viewers are watching Dell, a "midwife", act in ways that are not at all based in reality in terms of midwifery care. Dell, the "midwife", has a woman birthing her baby flat on her back. The first solution proposed when the baby might be experiencing difficulty is a risky, technological one. As a "midwife" he is being trained by Addison, a high-tech neonatal surgeon and obstetrician, and Naomi, a high-tech fertility specialist and obstetrician. What???

People. That is NOT midwifery.

This is not to say that there might be some in-real-life midwives who prefer working with women in the lithotomy position (flat on back), and who use lots of technology. Unfortunately, there are midwives like that; some people call them "medwives". The frustrating thing is that when mainstream media calls Dell as a midwife, it makes it even harder for people to understand the real differences between the Midwifery Model of Care and the Medical Model of Care. Dell's care of that birthing mom in "Acceptance" is not Midwifery Model care!

Here's a link to the excellent Childbirth Connection page on midwifery care. Below is their discussion on the Midwifery Model of Care and the Medical Model of Care:
"Views of the childbearing process and of appropriate care for childbearing women vary. Two contrasting perspectives are often called the "Midwifery Model of Care" and the "Medical Model of Care." There are striking differences in the two models. These differences can have a great impact on your experience and outcomes.

Here are some contrasts between the two models:

Midwifery Model of Care
Focus on health, wellness, prevention
Labor/birth as normal physiological processes
Lower rates of using interventions
Mother gives birth
Care is individualized

Medical Model of Care
Focus on managing problems and complications
Labor/birth as dependent on technology
Higher rates of using interventions
Doctor delivers baby
Care is routinized

Naturally, the midwifery model describes the practice of many midwives, and the medical model describes the practice of many doctors. But many caregivers combine elements of both. It is possible, but less common, to find doctors whose practice most closely resembles the midwifery model of care and midwives whose practice most closely resembles the medical model.

Thinking about these different views can help you to understand your own values and ideas about pregnancy and birth, and can help you select a caregiver who is compatible with your needs and values. Many women have a clear preference for one or the other of these models."
Did anything in the above information describe Dell's care as seen in that minute-long birth story seem like to fit into the Midwifery Model of Care? If so, I missed it.

The thing is, I know I'm judging harshly - it's just a television show, and it's buyer beware. It's a drama, not a documentary. I get that. But to have Dell say at the end of the show:
Dell: You know what? I think I might be a pretty good midwife.

Violet: Yeah. I think you are.
really bothers me. Because that birth was not good midwifery care, in my opinion at least.

TV Guide offers some excerpts from an interview with Shonda Rimes, the executive producer of Private Practice, about the show's season two. Rimes says, "I want to find a way to make his midwifery stories interesting and compelling." I have a starting point: how about making Dell a real midwife?

So! What do you think?

Finally, here are two related posts, with lots of website & book suggestions: Choosing a Care Provider & Birth Place and Questioning Safety.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle
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Tuesday, February 17, 2009

Private Practice: "Acceptance"

I don't watch much television - for the most part, I'd much rather read. Especially because it seems like so much on tv is crime drama, and watching shows that feature violence against women & children just doesn't feel like entertainment for me - more like fodder for anxiety & nightmares. So! There are a few things I watch, like American Idol... The Office... 24... And Private Practice: I like the characters, the drama, and school or medical dramas have always been my favorites (I still miss Boston Public and Everwood). Does anyone else watch it?

I'm wondering because the show two weeks ago, "Acceptance", just about made me do my crazy-shriek and wake up the kids when I watched it. We had it on tape, and I thought: now this, THIS *#$&($#, would be perfect to show in my classes when I talk about informed consent looks like - or doesn't look like. And I planned to blog about it. But then we taped over it. And I didn't want to blog it without a transcript because I started thinking, well, maybe it wasn't as bad as I thought.

Then I taught an early pregnancy class through our local continuing education department (if you're local, look for this class in the Monmouth/Winthrop continuing ed course offerings) and both of the families who attended had seen this show, and brought up the vacuum extractor. And that got me thinking again about how this show might seem to someone who was watching it as strictly entertainment, without the critical-thinking part of their brain on high alert. I know I don't watch most tv ready to jump up & down with the crazy-shriek of "how could they do that??" primed.

Then I thought of looking on the ABC page to see if they have free past episodes, and they do! So I could type out a transcript of this tiny scene, just to make sure it was as bad as I thought: it's four minutes into the episode, which can be viewed here.

The characters are:
Dell (the office manager/midwife-in-training),
Addison (neonatal surgeon/OB)
Laboring mom
Worried dad

The scene is in the Private Practice birthing room.
Dell & Addison are in scrubs.
Mom & Dad are in scrubs with hair coverings.
Mom is covered in blue drapes so she & Dad can’t see anything.
Mom is flat on her back, hooked up to fetal monitor.

4:00

Mom: “AAHHHGGGG!!”
Dad: “Why is it taking so long?”

Dell (hushed voice to Addison): “She’s still at +2”

Dad: “What does that mean?”

Addison: “It means that labor is not progressing and the baby has variable decels. We’re going to need to perform an assisted delivery to help guide the baby out. It’s VEEEERRRY safe. Dell would you prep the vacuum extractor please.”

Mom: “The vacuum WHAT?”

Dad: “It’s going to be fine honey.”

Dell (whispered aside to Addison: “I’ve never done one of these!”

Addison (aside to Dell): “It’s okay. I’ll guide you through it. ‘Kay. Place the cuff directly on the vertex. Good.”

Addison (to parents): “Now Maggie, when I tell you, I need you to push as hard as you can and while you push we will take the baby out. Okay?”

Mom gives a nod with scared look on her face.

Addison: “Okay.”

Addison: “Ready… and push!”

Mom: “AARRRRGGH!!!!”

Addison: “That’s great, Maggie. The baby’s crowning.”

Mom: “Take it out take it out take it out.”

Mom: “AAGH.”

Crying.

Dell: “It’s a girl. A baby girl.”

Addison: “Congratulations!”

Dell (aside to Addison): “Discoloration on her head?”

Addison (aside to Dell): “Hematoma. Happens sometimes with vacuum delivery.”

Dell (aside to Addison): “Her apgar is low.”

Addison (aside to Dell): “Dell. Don’t worry. It’s fine. You did great.”
Anybody else see huge red flags?

In case you want to read a summary of the whole show, here's a link to a Yahoo summary. Here are the most relevant parts of the summary, for my purposes:
Dell and Addison are continuing the delivery. The father wants to know what's taking so long, and Addison tells him the labor's not progressing (still at "plus-2") and that the baby has "variable D cells," [sic - decels, or declerations in fetal heart rate] so they are going to have to help guide the baby out through assisted delivery. She instructs Dell to get the vacuum extractor, a term that freaks the mom out -- as it would any sane woman. Dell has never used one of these, but Addison has him do it anyway. It basically looks like Dell is holding onto a hose and pulling it out of the woman, which I guess is what's happening, but the other end of the hose is attached to the baby's head. The baby's out before we know it, and Dell's freaking out about the shape of the baby's head. Um, seriously? Has he never seen a newborn baby, because I am no expert, but I have seen several of them with crazy head shapes. That's because heads are too big to fit through a hole that size [!!!!] so they get misshapen. Addison tells him it's normal to have a head like that with a vacuum delivery, but he's still worried. She tells him not to. He worries some more.

. . .

Dell comes in to Violet's office and sits next to her on the couch . . . He tells her he thinks he might be a pretty good midwife, and she says she thinks he is. It's a really sweet moment, and I'm glad Dell got it, even if his story seemed sort of insignificant otherwise.
I'll post more tonight or tomorrow. We're off to the children's museum to watch a presentation on "scales and tales" and then to a friend's house for some sledding.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Monday, February 16, 2009

Safer Bottle Feeding

I've already written about safety & children's products in several times, with lots of links in my Pregnancy Awareness Month: Week Three - Nutrition & Green Living and Toxins in Children's Toys and Products posts.

The third Z Report on BPA was available last September, and full of very useful information re: BPA (bisphenol A) in children's feeding products, especially bottles & sippy cups. I hadn't noticed their wallet-sized card before - it lists BPA-free bottles, sippys, pacifiers, and tableware. What a fantastic resource!

So I'm revisiting this because I just read an email with a link to this website, EWG's Guide to Infant Formula and Baby Bottles: Guide to Baby-Safe Bottles & Formula, which discusses how to make bottle-feeding as safe as possible. There's a one-page poster pdf and an executive summary that explains the findings regarding BPA in formula packaging. Explore the site for additional information, BPA in Formula -- How Harmful? as well as ways to Take Action!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Friday, February 13, 2009

Birth Video/Documentary Contest!

Announcing a birth video/documentary contest! $1000 prize!
From Birth Matters Virginia : Birth Matters Virginia (an organization that works to promote an evidence-based model of maternity care) is soliciting 4-7 minute educational videos about birth. The first-place winner will receive a cash prize of $1000. Second place $500 and an "honorable mention" prize of $100 will also be awarded. The deadline for entering the contest is Mother's Day, May 10, 2009.

Guest judges include: Ricki Lake and Abby Epstein, acclaimed producers of the Business of Being Born and Sarah J. Buckley., MD, international birth expert and author of Gentle Birth, Gentle Mothering. Ricki, Abby, and Sarah will join a consumer-based panel of judges who will be evaluating the tone, educational content, creativity and more. You don't have to be a professional to enter and you don't have to be from Virginia. We'd love to get videos from mothers, fathers, filmmakers, film students, birth advocates, and anyone else who is interested in birth or film or wants to win $1000.

As the national rate of c-sections surpasses 30% and the U.S. ranks 41st in terms of maternal mortality, it is more important than ever for women and their partners to be educated about the options they have during pregnancy and birth. Birth Matters Virginia advocates "evidence-based" maternity care, which simply means using the best available research on the safety and effectiveness of specific practices to help guide maternity care decisions and to facilitate optimal outcomes in mothers and newborns.

There are a lot of ways to approach that topic, and we're looking forward to the variety of entries.

For rules and to see how to enter, please visit http://www.birthmattersva.org/videocontest.html

You can also join our Facebook group to get updates about the contest and exchange ideas with other participants at
http://www.facebook.com/group.php?gid=73753459808

And if you have questions, email Sarah at Richmond@birthmattersva.org

Even if you don't plan to make a video or submit an entry, please pass this email on to everyone you can think of, post it on your blog, your Facebook page, Twitter, whatever you can think of! The more people submit videos, the more will be out there on YouTube and we could use all the help we can get spreading the word.
If anyone wants to leave a link to their favorite online video(es), I'd love to see them! Or leave a link to the birth video you're submitting to this contest. I think it's so important to expand the vision of safe birth choices. Films can be a very powerful medium to use to show that birth choices include more than the "infotainment" found on TLC's birth dramas!!

An aside: the name of this group, Birth Matters Virginia, reminds me of the famous letter to the editor, "Yes, Virginia, there is a Santa Claus". In my head, I couldn't help but reading the organization's name as "Yes! Birth DOES matter, Virginia". Anyway, what a fantastic opportunity to spread the word!!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Thursday, February 12, 2009

It's a Boy!

I have two children - a girl and a boy. My daughter was born first, and I was so excited to have a little girl: dresses, braids, someone who might notice new earrings. It's not that I didn't want to have a little boy, too... it's just that I was hoping, in my heart of hearts, to have a little girl first.

There was another reason, too: circumcision. I read & thought and thought & read about pregnancy and birth... and then I discussed, discussed, discussed choices I had for birth with my partner, my care provider, my family & friends. I didn't know what I thought about circumcision, beyond the gut feeling that I didn't want to do anything that would hurt my newly born child. My husband didn't know what to think either, other than he had been circumcised, so it seemed to him that it would be an okay choice to make for our son. But! Since Madelyn is a girl, we didn't have to hash it out, and I could focus on learning about birth and breastfeeding. Thus, in addition to my joy of having my little girl, I was also relieved.

Well, when I got pregnant again, it was with my son Owen. I already had learned a lot about birth and postpartum, and was ready to tackle investigating circumcision and the process of explaining my uneasiness to my husband. I had always said - hey, I don't have a penis, this is a decision I'll defer to him on. But when it came down to the fact that he favored circumcision, I realized I couldn't just go with the flow on this one after all (hardly surprising - me not going with the flow!).

So I asked him - please look at some of the research I've done, and then make an educated, informed decision, like we've tried to do all along regarding medical care and parenting choices. Reluctantly, he agreed. I did some research, shared it with him, and did the best I could to give him the space to make his decision.

I wish that I could have shared this excellent website, It's a Boy, with him then - it's factual, non-confrontational, not full of upsetting pictures or biased propaganda one way or the other, and answers the most common questions about circumcision.

Another good resource is this video, The Prepuce, on the Doctors Opposing Circumcision website. It is a clinical take on this issue instead of an emotional one.

I've listened to a lot of clients confront this issue - some couples have been in agreement, others not; some have decided to keep their sons intact and others have decided to circumcise. In fact, one of the dads in a class I taught about a year ago, blogged about the decision process: Circumcision Decision to Circumcision - The Decision to Circumcision - The Final Post - be sure to read the comments, too! So, I try to answer questions and point families to unbiased, understandable information, and then I let it go.

I'm so happy to have this new website to add to my list of resources!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Tuesday, February 10, 2009

Lady's Hands, Lion's Heart

Every once in a while I begin reading a book and think to myself, "Self: You are going to be really sad when this is done. Pace yourself. As much as you want to read & read & read it, savor it instead."

I knew after the first few pages of Lady's Hands, Lion's Heart: A Midwife's Saga that I would love it. And I did: the birth stories, of course, and also the inspiration of Carol Leonard's life... how hard she worked to make a difference, and how much she learned and loved along the way.

There are so many people to whom I would recommend this book, starting with my sister, since she is trying to figure out how to pursue her own dreams of entering midwifery. Also: Anyone who is interested in birth stories. Anyone who enjoys memoirs. Anyone interested in excellent writing that is hilarious, poignant, fascinating, thought-provoking. Anyone who is curious about the difference one person can make. Anyone who works with mothers and babies during the birth year. It's a fast, delicious read that really tests the reader's ability to slow down & savor it.

I will definitely be adding Lady's Hands, Lion's Heart to my childbirth education library the next time I made updates, and buying it for my sister. It's available to borrow through the Maine inter-library loan system (now that I've finally returned it ;-). To buy it, go online to Bad Beaver Publishing. Amazon.com also has it, and that's where I will probably be on the lookout for used copies.

Here's an excerpt from a review by Pamela Victor,
"Lady’s Hands, Lion’s Heart has it all. It’s part memoir, part American history, part textbook, part spiritual journey, part love story. Carol Leonard relays her life story as a midwife, a mother, a wife and a health care activist from 1975 (the year her son was born) to 1987 (the year of her deepest, darkest time.) The yarn that winds seamlessly thorough this book is the moment of birth. As a midwife who has delivered hundreds of babies, Carol Leonard tells the best birth stories! By their very nature, birth stories are the ultimate adventure tales, full of fraught emotion and drama that would make any Hollywood producer envious. Danger, romance, mystery, comedy and sometimes, sadly, tragedy – Leonard’s stories will keep you turning the pages with anticipation."
There's also a review from Citizens of Midwifery on the Bad Beaver Publishing website and all nine reviews on amazon.com were five stars. Also, don't miss the sample story on the order page - just click on any of the links to the book to read it!

Lady's Hands, Lion's Heart: A Midwife's Saga
by Carol Leonard
published by Bad Beaver Publishing in 2008.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Friday, February 6, 2009

Prenatal Vitamin & Iron Supplements Recalled

Well, in case the link to Survey Data on Lead in Women and Children's Vitamins in my How to Choose a Prenatal Vitamin post wasn't disturbing enough...

I just read in a Raising Maine post by Gooddogz that some prenatal vitamins were just recalled by the FDA. But of course you knew that already, right?? Because of all the press coverage that information has already received. Not.

Here's the list:

Prescription Iron Supplement Products:

Chromagen® Caplet
Chromagen® FA Caplet
Chromagen® Forte Caplet
Encora® Capsule
Niferex® Gold Tablet
Niferex® 150 Forte Capsule
Repliva 21/7® Tablet

Prescription Prenatal Vitamin Products:

PreCare® Chewable Tablet
PreCare® Conceive Tablet
PreCare Premier® Tablet
PremesisRx® Tablet
PrimaCare® Capsule/Tablet
PrimaCare® Advantage™ Capsule/Tablet
PrimaCare® ONE Capsule

courtesy of this press release: Voluntary Nationwide Recall Of Prescription Prenatal and Iron Supplements .

And there's more!

Prescription Prenatal Vitamin Products:

Advanced NatalCare® Tablets
Advanced-RF NatalCare® Tablets
Cal-Nate™ Tablets
CareNatal™ DHA Tablets
ComBgen Tablets
ComBiRx™Tablets
NataCaps Capsules
NatalCare Gloss Tablets
NatalCare PIC Tablets
NatalCare PIC Forte Tablets
NatalCare Plus Tablets
NatalCare Rx Tablets
NatalCare Three Tablets
NataTab FA Tablets
NataTab RX Tablets
NutriNate® Chewable Tablets
NutriSpire™ Tablets
Prenatal MR 90 FE Tablets
Prenatal MTR w/Selinium Tablets
Prenatal Rx 1 Tablets
Prenatal Z, Advanced Formula Tablets
Ultra NatalCare Tablets

Prescription Iron Supplement Products:

Anemagen Caplets
Anemagen Forte Caplets
Conison™ Capsules
Fe-Tinic™ 150 Forte Capsules

from this press release: Voluntary Nationwide Recall Of Prescription Prenatal and Iron Supplements .

For more of my blog posts on vitamins and supplements, click on the nutrition tag below.

Feel free to pass this information on in whatever way makes sense to you!

Oh, and I'm writing this amid stacks of seed catalogs and lists of seeds. While I can't grow my own vitamins, it's recalls and information like this that makes me feel so lucky to be able to feed my family from my garden!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Thursday, February 5, 2009

Postpartum Links: Listening and Healing

More postpartum posts to follow, once I'm post-whirlwind-trip-to-Boston and have caught up around here! Until then:

The Power of Listening

I love this quote in the recent Midwivery Today E-newsletter on communication, from Dr. Rachel Remen:
"The most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention.... A loving silence often has far more power to heal and to connect than the most well-intentioned words."
Obviously this relates to all times of our lives, but I think it is especially pertinant during labor and birth. Just listening to a mom talking about how much labor hurts is validating: she may not be asking someone to "fix" it - she just needs someone to hear her. There's a terrific segment on this excellent video, which I highly recommend (and keep in my lending library!): Gentle Birth Choices. And "We Ain't Broke, Don't Fix Us" is a great blog entry on this topic.

Listening during the postpartum period can also be incredibly valuable. I recently read about a study re: the power of listening for postpartum moms, on a RaisingMaine blog . For more information, read "Peer Phone Calls Prevent Postpartum Depression in at-Risk Mothers". The article explains that,
"Phone calls from volunteer mothers who overcame postpartum depression prevent depressive symptoms in at-risk mothers, a Canadian study shows.

"Mothers who received this support were at half the risk of depressive symptoms 12 weeks after delivery," says study leader Cindy-Lee Dennis, PhD, Canada research chair in perinatal community health at the University of Toronto.

It's the first big study to show that postpartum depression can be prevented without intensive home care, Dennis says.

The study included 701 women at risk of postpartum depression. Half got standard postnatal care and half got peer support. With standard care, 25% of the mothers had significant depressive symptoms 12 weeks after delivery. About half as many women who got peer support -- 14% -- had such symptoms."
Another place to listen and be listened to, and that offers peer support, is the New Mothers Support Circle I'm hosting here in Winthrop, on 2nd and 4th Thursdays - this month we're getting together on February 12th and February 27th.

Perineal Healing

Another Midwifery Today E-newsletter that fits with entry focuses on Postpartum Perineal Healing, with some great tips from Elizabeth Davis:
"Physicians commonly have women return for a checkup at six weeks postpartum to assess the healing of the perineum and to make recommendations for contraception, as appropriate. But most women are told little or nothing about how to care for the perineum in the interim, or how to watch for warning signals of infection like swelling or inflammation. Pain is an important signal of problems too, but it may go unnoticed if a woman is taking painkillers during the first few days, the most critical time for healing.

I suggest that women use ice packs for 24 hours to reduce swelling, and then switch to sitz baths several times daily using hot water with selected herbs. Nothing speeds healing faster than heat, and soaking is far superior to topical application as it more deeply stimulates circulation. Fresh ginger is a good addition to the solution; it helps relieve the itching that often occurs as stitches dissolve and the skin heals.

Here is how I recommend women take a sitz bath: Grate a 3- to 4-inch piece of ginger root into a large pot of water; simmer twenty minutes; strain and divide into two portions. Save one for later in the day, and dilute the first with water in a sitz bath. After soaking for twenty minutes, thoroughly dry the perineum and expose to air or sunlight for another 10 minutes before putting on a fresh pad (or use a hair dryer to speed the process). If the perineum feels at all sticky, use aloe vera gel to dry and soothe the tissues. Avoid vitamin E or other oil-based ointments until the skin is healed over, as these tend to keep edges from closing."
The Mother-Hero

For dessert, read this thought-provoking article from Birthing From Within's Pam England, "Mother-Hero on the Hudson".

We are strong! Listen, and be listened to.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Sunday, February 1, 2009

Postpartum Life: True or False?

In honor of the new postpartum support group I'm facilitating, the New Mother's Support Circle, I'm going to be doing a series of posts on postpartum life.

Here's how the media portrays postpartum life: glowing new mom (who is also clean, thin, wearing clean clothes, relaxed, and looking not-exhausted) holding peacefully sleeping (and also clean! wearing white!!) newborn.



I'm not saying that it's not a gorgeous picture - it is. And there may be some moments like that during the babymoon. But this picture, also beautiful, is a whole lot more realistic:



What's the harm in fantasizing about exhibit A? I love this quote from Jennifer Louden's Pregnant Woman's Comfort Book, and think it sums up a lot about why the postpartum period can be a hard one for many women:
"It is the lack of permission to feel conflicted, inadequate, sad, angry, bored, or irritable as well as grateful, rapturous, tingling with life, and intoxicated with love that makes the postpartum period unnecessarily difficult and lonely".
So for what it's worth: here's permission - and encouragement! - to come share what's wonderful as well as what's really hard with other new moms this Thursday!

And if you can't join us in person, leave a comment! What's been one of the most beautiful moments during your babymoon period? What's been one of the most challenging?

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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