Monday, May 07, 2012

Social Media and Childbirth Advocacy


Welcome to Childbirth Today's 2012 Blog Carnival - honoring the busy month of May and all of the celebrations of midwives, nurses, doulas and childbirth educators...AND mothers!  Our next blog carnival entry features a post by Tyler Breunig, one of the next generation of birth professionals and her thoughts about social media & professionalism.


As a fledgling Childbirth Educator, I have been struggling with balancing my responsibility to my clients and my desire to be a change-seeking activist. I believe it is my duty as an educator to provide my clients with the evidence based information necessary to have an empowered birth experience. The catch is that it has to be the birth experience of their choosing. I do not get to decide how, when or where they give birth; no matter my personal opinion on the subject.

In the socially media driven world we live in, how do I balance my obligation to my clients with my inner desire to change the way women in America give birth? 

How do I keep my advocacy from influencing my clients’ decisions?



Women are increasingly turning to social media for answers about pregnancy and childbirth. This means that I need to use these same outlets to reach and teach women. This also means that I need to be aware of the information I am posting, writing about, pinning or tweeting. I have to change the way I use social media when I am using it as an educator. I cannot simply post my opinion without regard for its impact on others.

I will continue to try to find the balance between using social media and advocating for change. I want to reach as many women as possible without exclusion and I will let the evidence speak for itself.



About Me:
I am a mother of two wonderful children and wife to an amazing husband. I am working toward becoming an ICEA certified childbirth educator. I also love to cook and I am an avid reader of mystery novels. Giving birth to my children changed my entire world. I believe every mom-to-be has the right to evidence based childbirth education and an empowered childbirth experience.

Friday, May 04, 2012

2012 Blog Carnival: "We Have To Help"


Welcome to Childbirth Today's 2012 Blog Carnival - honoring the busy month of May and all of the celebrations of midwives, nurses, doulas and childbirth educators...AND mothers!  Our next blog carnival entry features a post by Jeri Layer, a birth professional from Dayton Ohio.



I’ve  spent many years observing the birth process as a doula, and an equal number of years sharing education with expectant mothers of all ages as a childbirth educator.  It has been an interesting and joyful journey.  In the past year, I have discovered a new-found a love and passion for research.  Specifically,  research regarding birth and how we, as women, assume certain positions, accept certain advice, use medications, and yes, become fearful of giving birth. 

My first research project focused simply on the history of positions for giving birth.  Basically what I found out was what I suspected; that historically women assumed upright positions for birth and it was with the event of the use of anesthetics that women were placed upon their back for ease of delivery.  The supine position allowed for the use of forceps which became necessary as women were unconscious with anesthetic and the baby needed to be pulled out of her.   ( Midwiferey Magazine, Summer 2011, June.)

My second research project focused on the use of the electronic fetal monitor.  This project was a more personal look at how I have witnessed the use of  the monitor and the frequency with which it was more accurate than the laboring women when predicting strength of contractions and onset of birth.  The data I collected confirmed  that most women were more accurate than the machine.  Women repeatedly reported the onset of birth long before the monitor picked up the “pattern” and often-times gave birth to the surprise of the medical professionals who have been trained to use and rely on this technology.  (International Doula, Volume 19, issue 3-2011)

Beyond a quest for a better understanding of how we came to practice and believe certain “truth’s” about birth and the medical model we practice here in the Midwest, I found that by doing this research, I can help dispel some of the myths about childbirth that my clients fall prey to. I can offer them facts instead! I can share with them the knowledge that they are the best predictors of how their labor will go, and that they are the best decision makers when it comes to choosing a place, a position, or a provider for their birth journey.  I am able to share stories of ease and comfort during childbirth, rather than scary horror stories (which they hear enough of, right?)

What I would like to invite all of you to do, is to help me with my next project.  As our second blogger stated, we are all on this journey together.  So instead of competing with one another, let’s join forces to help mothers feel safer, calmer, and more informed.  I need your help to offer my clients, as well as yours, the truth about one of their most common fears – the fear that their baby will be too big to come out of their body without help.  Sadly, what I hear mothers reporting (and often times) early on in their pregnancy, is that an ultrasound has measured their baby and it is big.  I hear this at least once a week, from at least 3 to 4 of my 8 to 10 mothers in a class.  While I do not want to increase their fear by making them doubt that their well-meaning care provider is telling them the truth, I do not want to perpetuate their fear either.  So, after some thought, I decided that some solid facts would be the best positive remedy for their fear.  I don’t want to discard the validity of the ultrasound technology, my goal is simply to provide some hope and share some happy endings. 

Here’s how I started my research.  When a mother tells me this news (“I had an ultrasound today and I guess my baby is really big”) or some similar statement, I provide her with my phone number, and ask her if she would mind giving me a call after her baby is born to let me know how much the baby actually weighed.  I also tell her, that with her permission, eventually I would like to share her information if she is agreeable to do so. (This is in written form when the time comes, for all legal purposes including privacy). So far I have a growing number of women that I expect to hear from.  I have results from a handful of women and the results are all the same.  You probably guessed it, the baby is smaller (one baby by 2 pounds) than the ultrasound predicted.   This is not a surprise to me, however, it is disheartening.  Again, not because we shouldn’t trust the ultrasound, but because some mothers will plan a cesarean section based on fear, and often times a woman will agree to an induction based on that same fear.  I never understand the reason for instilling fear into an already somewhat fearful mother-to-be. What is the purpose of telling a mother that her body will probably not be able to deliver what she herself has helped to create? Our bodies are not without knowledge! I am preaching to the choir, right? I know that most of you reading this are very knowledgeable about the birthing women’s abilities, but many birthing mothers are not!  We have to help.

You may wonder why I am choosing to gather research in this manner when I could gather it some other, non-personal way. I want it to be personal and local. I am not looking for a massive study.  I believe that a local (tri-county, tri-state) area would be sufficient to start.
 I want permission from the mother to use her first name or initial or whatever she is comfortable using to share her truth with other expectant mothers.   Names are nicer than numbers at times.

This study may end up providing us all with some simple facts to share.  It may end up being an article, a bigger project, or something that we share with local care providers in a professional and helpful manner.  It may be that it will only help one or two mothers to feel more confident or comfortable.  In my opinion, one or two is enough.  Please help me if you are interested.  My cell number is 937 371-2058.  My email address is jerilayer@woh.rr.com  I will accept information directly from the mother after she delivers.  All I am asking you to do is to pass my name and phone number along if you hear a mom utter those words (big baby + ultrasound).

Remember, this is not about the ultrasound, or the care provider.  Nor is it meant to undermine the machine or the person.  It is to share truth, to offer hope, to provide a sense of empowerment to a fearful mom.   If you would like, I will gladly share information as I go along.  Simply call or email me for an up-do-date version of facts that I have gathered thus far. I am offering and asking, in the doula spirit. 

May you all spread peace and empowerment each day this May and long thereafter.

My bio:  I am Jeri Layer; mother, grandmother, wife, doula and childbirth educator. I have been practicing as a doula and childbirth educator of 16 years with a focus on the younger expectant population.   I have attended over 150 births! I have had a few articles published and am working on a childbirth education manual for teens. I am also an adjunct faculty member at Sinclair Community College in the Life and Health Sciences Division and have taught there for 10 years.  I love taking classes that relate to health, fitness and human development.  I have a passion for research, gardening, sewing and baking (as well as for nurturing my family). 

Thursday, May 03, 2012

Childbirth Today Blog Carnival Guest: Tara Tulley CPM


A New Era Of Maternity Care in the United States
by Tara Tulley CPM, MSW:

I attended the NACPM Symposium in March and also participated in the lobby day in Washington DC. This is my report to the Utah Midwives on the outcome of the conference.

Birth care in the United States has reached a level of crisis. The current system of standard obstetrical care is unsustainable both in delivery of services, and in financial viability. The world wide recession and need for Medicaid and Medicare reform is changing the view of how maternity care is seen by the major players in federally funded programs. For the first time in modern US history midwives are being seriously looked at as a viable and evidence-based solution to both improving the quality of services to pregnant women, while also reducing the per ca pita spending to lower the amount of total GDP being spent on health care. Astoundingly, end-of-life care, and birth care are the largest areas of spending in hospital-based services.

An estimated 43% of annual births in the US are funded by Medicaid, and the cesarean section rate is now over 30%. The United States ranks 41st in maternal mortality and 28st in infant mortality.  Medical Administrators who control which providers are able to access these funds are embarrassed by these numbers. They are seeing the truth that midwives have long held to: American obstetrical standards are not currently using evidence-based practices, yet we spend more than countries on these services then do countries with much better outcomes.

The speaker panel of this historical symposium included: representatives from ACNM, MANA, and NACPM;  Dr Stephen Cha, MD Director of Health for Medicaid and Chip;Dr. Patrick Kelly, Director of the Board on Global Health at the U.S. Institute of Medicine; Dr. Tim Fisher, and obstetrician affiliate of ACOG; and many other key researchers, educators, and midwives who are looking to direct-entry midwives and out-of-hospital birth as a solution to solve the current crisis in maternal in infant health care.

Strong organizational initiatives are moving nationally and globally to unify all midwives and to secure a voice at the table for innovations being discussed in the health care system. There is a great need to create more midwives to fill the gaps in maternal health care and to create the educators and preceptor to train a minimum of 20,000 new midwives in the United States by 2020.

The statistics report given by Ida Darragh, CPM, show that there are about 10,000 CNMs in the United States, 2000 CPM certificates have been issues and 1549 CPMs in active current practice. The UK has about 11,000 registered midwives, and if all of our CNMs and CPMs moved to the UK we would barely meet the need for their minimum recommend number of midwives needed to care for the population of birthing women in the UK. The United States is short at least 20,000 midwives to fill our needs and a number of 30,000 is probably more accurate. By my estimate, this means each state needs to produce 600 new midwives in order to be able to optimally be able to serve women in all settings.

The International Confederation of Midwives (ICM) estimates that the shortage of midwives necessary to reducing maternal health care disparities and infant mortality world-wide of at least 350,000. There is much room for growth, and as a 29th Institution for educating new direct-entry midwives, my organization, Birth Rite Women's Center, and our community midwifery school that has emerged and is evolving has joined the Association of Midwifery Educators (AME) to increase access and funding for midwifery education.

Kristi Ridd-Young, current president of Midwives' College of Utah was voted in as vice-president of the Midwifery Education Accreditation Council (MEAC) board. Kristi and I both committed to working together to make midwifery education more available and accessible in Utah, and working with communities around the nation who are innovators in maternal healthcare and midwifery education.

Susy Meyers, Founder of Seattle School of Midwifery, and current president of NACPM is making headway into making midwifery education available in public colleges and universities in Washington State.

The NACPM symposium included a working day and focus groups to help us decide what needs our joined attention, and what we will do individually to help promote a unified front of midwives in our country. I agreed to join a committee of educators with an AME board to look at how to bring midwifery education to community schools, and access federal funding for education. There is also now a state chapter of NACPM in Utah, and currently I serve as the liaison to help strengthen education and build a strong community of midwives and birth professionals in Utah. I support and am working with our newly reorganized state organization the Utah Midwives' Association (UMWA) to help these initiatives move forward. I have provided links to the reports and numbers given by the speakers at the symposium in the following paragraph:

 Millbank report on evidence-based maternity care and innovations in maternity care, and looking at Crossing the Quality Chasm:
http://www.childbirthconnection.com/

Strong Start Initiative:
http://innovations.cms.gov/initiatives/strong-start/

International Confederation of Midwives standards for core competencies and education for midwives, and State of World's Midwifery Report:
http://www.internationalmidwives.org/

also http://www.midwives2014.org

Looking at adult learning theory and implementation of education models for midwives:
http://www.springerlink.com.content/8129067t81188655

For more of the notes and presentations from specific Speaker session, visit the NACPM Symposium Website:
http://cpmsymposium.com/

Birth Rite Women's Center Focuses on providing education, complete care in emotional, spiritual, and physical health of pregnant women and their families:
http://www.birthritewc.com

Wednesday, May 02, 2012

Childbirth Birth Today Carnival Guest: Michelle Maisonville


Welcome to Childbirth Today's 2012 Blog Carnival - honoring the busy month of May and all of the celebrations of midwives, nurses, doulas and childbirth educators...AND mothers!  Our next blog carnival entry features a post by Michelle Maisonville, a birth professional from Medicine Hat, Alberta Canada.




Look at the artwork to the left.  What do you see?  A mother who has just given birth, of course.  What else do you see?


I see harmony.  I see a small group of women caring for a new mother.  Notice where their faces are turned.  They are not looking toward one another; rather, they are completely focused on the woman in their care.

This is the ideal birthing community.

We are doulas, nurses, midwives, doctors, childbirth educators, lactation consultants, planners, etc.  Regardless of our philosophy, education, or particular walk of life, we all serve the same group.  We serve mothers and their families.

The Social System

Think back to your days in high school.  Who did you spend time with socially?  Were you a jock, a prep, a stoner, a bully, or a nerd?  How did you react or interact with individuals from other social groups?  Did you mock them?  Did you spread rumors?  Did you try to sway others to your way of thinking by putting others down?  Were you a member of an elite clique or did you spend time with "outcasts?" If we are honest, I think many of us can answer "Yes."  While we know that such behavior was not right, it was also characteristic for that age group.  Do we carry this behavior on into adulthood and our professional lives, however? 

As we grow and mature into adulthood, we believe that we outgrow most of the behaviors of our teenage years; yet, more often than not some of our old ways still hang on.  With the surge in social networking over the past decade or so, we now have new outlets to interact with those who believe as we do.  There are millions of groups or clubs or pages for us to join and "like."  Professionally, we've never had access to more resources than we do now and it is very exciting!  It also opens us up to more ways to be critical of one another.

Business

Back in our "real lives," we are developing doula or midwifery practices and childbirth education businesses. We have the opportunity to network with one another through professional associations and our training and certifying bodies.  Do we?  How do we behave when we are introduced to someone who, while our colleague and one who shares our beliefs, is also our business competition.  It is true, birth is a business.  No matter how much we talk about its spiritual nature and the sacredness of the experience, we are, as birth professionals, providing a marketable service.  It is a touchy subject.  Many of us volunteer our services as much as possible.  Truth be told though, we still do have families to support. We require food to give us the energy to work and gas for our vehicles to get us from birth to birth.  So, we have to acquire paying clients.  To acquire clients, we have to market our businesses.  Our relationships with our colleagues in the birth field can and do become strained. 

Getting Caught Up in Competition

I'll let you in on a little secret.  I am so incredibly guilty of this.  I am young (I'd like to think, anyhow) and everyday as a birth professional is a learning process.  Heck, everyday as a human being is a learning process!  Early on, I burnt some bridges.  It does "take two to tango" and there were and are other issues present from all parties involved, but it is there, it is a problem and it is not going away on its own.  To give you a little background, I am almost to fault a rule follower.  I like order.  I like boundaries.  I like direction. I do not, however, like to be told what to do by one person.  I do not like to be treated as a child and, therefore, I have a bit of a problem with authority.  This was one of the reasons I decided to venture out on my own when I received my doula training and begin my own practice.  

It. Was. Rough.

First of all, I had never run a business before.  Not even a little bit.  In my past life I was an administrative assistant for a variety of professional firms, most recently accounting firms.  I definitely had a grasp on professional communication and organization, but economics not so much.  Add to that a dash or two (or three) of self-doubt and lack of confidence and you have a really fun combination.  I was terrified that I would not succeed in business.  I was unable to trust many of my colleagues locally because I thought they did not want me to succeed either.  Some of my fears came from real experiences, but probably the majority of them just came out of my own noggin.

What happened?  I lost sight of my goals.  I forgot why I had become a doula in the first place.  While, yes, I had to try to earn a living from my calling, I had forgotten that it wasn't my colleagues or competition that mattered, it was and is the families in my community.  Whether they chose me to be their doula or not, isn't the important thing that they would know they have a choice to begin with?  

Philosophy and "Real Life"

Here is the bottom line.  We all have different beliefs and values.  Period.  No one person in this world thinks or feels exactly the same as someone else no matter how closely they may be aligned.  That is just the nature of humanity.  We also don't know where any particular individual is in their life.  Sally CBE may feel that epidurals are horrible one day, but the next day she sees that one has been beneficial in a long labor for her client and suddenly sees it isn't as black and white as she once thought.  Jane Doe-oula may have received her training, but then her studies were interrupted because of circumstances in her family life.  Mary Midwife might have small children and not be able to attend a university, so she studies from home to gain knowledge.  

Because we are all different, we can't all fit into a box.  We don't all have cookie cutter lives.  Again, taking my personal choices into account.  I originally trained as a doula with a very well-known organization. It has paved the way for doulas in our part of the world and I respect and admire all of the work done by the group.  I chose, however, to certify with a different body.  First, due to family commitments, and having small children, I was unable to complete all of my requirements within the allotted time frame. Second, I felt I needed a broader education (that encompassed aspects of business, communication and physiology) than what I had received in my earlier studies.  I continued working as a doula to help supplement the costs of my education and, honestly, because I love the work.  On the outside, perhaps this was perceived differently from my colleagues.  They may not have known or understood what was going on in my life, but I know why I made these decisions and they worked for my family.  

Whether you teach Lamaze, Brio, Hypnobabies, or independent classes or are certified through DONA, CAPPA, Childbirth International, or Birth Arts, something that appeals to your personal belief system has drawn you to the organization's philosophy and that makes it the right one for you.  Whether you are certified or still in training, you are still a professional.  Learning takes time and, if you are committed to providing the best care for your clients, it truly never ends. You are definitely worthy of sharing your knowledge with others. Your opinions are valid because they are yours.

Bullying

Does anyone ever want to be called a bully?  We are all guilty of it at some point in our lives.  Whether we're the two-year-old who bites our sister because we don't want to share a toy or we pick apart one of the moms on the playground, we've done it, we do it and we have to stop.  It can be as simple as denouncing someone's credentials or ganging up on them on a Facebook group because they chose to circumcise their son.  It's hurtful and it doesn't do anything to help us accomplish our goals.  

I'm not going to white wash anything here.  We, as birth professionals, are a nasty bunch sometimes.  We have turf wars, we make up our own "truths" about our colleagues and share them widely, we attack those who do not believe as we do, and we engage in fruitless arguments with professionals on the perceived "opposing" side.  We call each other names such as rogue or radical, etc.  We undermine each other.

I have confided in others on occasion without knowing all of the facts.  That can definitely be construed as gossip.  Yup, I am a gossip.  I have hurt others.  I have also felt bullied.  I have been hurt.  I have thought on more than one occasion about throwing in the towel.  I almost have.  Then, I remember, again, why I was called to be a doula.  I was called to serve. 

Serving

A servant is humble.  She puts the needs of others ahead of her own.  She does not have her own agenda.  She brings nothing into a relationship with her but her heart and her hands.  She has the drive to give, not to achieve.  That is the foundation for our work.

Now What?

We don't have to keep fighting with one another.  We have the same goal.  We all want mothers and babies to have a healthy start physically, emotionally and spiritually.  That's it.  That's our focus.  It is really that simple.  Building upon this, where do we go from here?
1.            Let's keep our focus on the families we work with.  
·                     Remind yourself everyday why you were called to be a birth professional.  Take 15 minutes and review the birth stories of your past clients or look through thank you cards.  Whatever it takes to rekindle your passion and realign your priorities.
2.            If there is a new professional in your community, reach out to her.
·                     If she is still training, support her.  If she needs help making connections, provide her with resources.  Do not be afraid of her. There are plenty of babies being born every year and, unless 1984 becomes reality, there will continue to be.
3.            Talk to each other, not about each other.

·                     If you hear something about a colleague, go to the source.  Clear it up. Don't spread gossip. Communication is key.
4.            Think before you speak.
·                     See the graphic to the right.
5.            Finally, be humble.  Say you're sorry.  Make amends.  
·                     If a colleague has hurt you, forgive them.  Learn from the experience, but don't hold a grudge.  It doesn't serve you or your clients.
·                     If you have hurt a colleague, ask for forgiveness.  You don't have to be best friends, but you can support one another.

My Vision

When you have finished reading this post, scroll back up to the beginning and look at the artwork again.  What do you see?  I see our future if we remember our goals and we work together.  The families of the world need us and we need each other. 

 Author's Note:  I've thought long and hard about writing this post.  I know that there may be some of my colleagues reading this.  Actually, I hope there are, because, I want them to know that I am sorry if I have ever caused them any pain.  It isn't all sunshine and roses, but I realize that together we can accomplish more than we can apart.  Let's try again.

Tuesday, May 01, 2012

Blog Carnival! BirthWell LA & Mari Oxenberg

Welcome to Childbirth Today's 2012 Blog Carnival - honoring the busy month of May and all of the celebrations of midwives, nurses, doulas and childbirth educators...AND mothers!  Our first blog carnival entry spotlights a wonderful midwife from Los Angeles, Mari Oxenberg.




Although some people joke “midwife” refers to “that bump in the middle of the wife,” the term stems from Middle English, meaning mid for “together with” and wif for “woman.” So, literally, a midwife assists other women in childbirth. More specifically, both doulas and midwives provide support through the childbirth process– emotional, spiritual, and physical. However, a midwife is medically trained (as a Primary Health Care Provider).

Meet Mari. At 19, she witnessed a friend give birth naturally in a hospital with a nurse-midwife while a professional midwife acted as her doula (labor support person). She said, “It was the most beautiful thing I'd ever seen and tears streamed down my face when the baby girl was brought up to her mother's chest. I knew at that moment that I was going to help women birth.”
This moving experience compelled Mariposa Oxenberg on a life-long journey that has taken her though training as a doula, certification as a registered nurse, a two year homebirth apprenticeship, prenatal yoga teacher training, and a masters from Philadelphia University, in the Science in Nurse-Midwifery.

Many years later, now, a mother herself, Mari lives in beautiful Topanga Canyon where she and her mentor Marina Alzugaray founded Birthwell LA, a complete childbirth service. Using her expertise in homebirth and water birth, Mari strives to guide women though childbirth with love, confidence and grace.

Birthwell LA offers a wide variety of services to support women: midwifery, doula, pap exams, cranial-sacral therapy, acupuncture, medicinal herbal support, Ayurvedic counseling, prenatal yoga, Touch Therapy, pregnancy massage, and preconception and nutritional counseling.
Midwives stress the importance of communication, body awareness, utilizing old world and modern techniques to reduce the risk of childbirth complications. Offering a more personal, holistic approach to pregnancy, midwives honor cultural differences, personal preferences and encourage family participation in birth process.
Homebirths allow women to remain in the comfort of their own home, which decreases the fear which, in turn, can slow down the labor. A clean, non-industrial environment decreases the possibility of acquiring hospital infections and birthing at home is also private: the mother is in her own bed, surrounded by her own things and there is no rush to perform or to deliver on schedule. However, if intervention is needed (like c-sections or pitocin augmentation) for high-risk pregnancy a hospital is a better choice.
The presence of a midwife can diminish the length of labor, the need for pain medication, the use of forceps, and the possibility of a cesarean delivery.
According to Mari, Western medicine often “sees birth as a disease, something that needs medication and hospitalization.” And one of the great down falls of so-called modern medicine is that is “doesn't treat each woman and birth as sacred but rather just another patient to run through the system.” In a modern hospital, many women feel disempowered, ignored or like they have no control over the birth of their own child.
The entire system tends to “traumatize and perpetuate [an] immense fear of childbirth.” Also, medical “interventions can cause damage to women's bodies and increase the risk of future pregnancies.”Bottom line is that the insurance companies are running the show and they control the doctors.”

Mari’s philosophy about pregnancy and birth is that it is a natural process and “when left to her own devices, a woman can birth her babies no problem.”As a midwife, Mari tends to be “hands off and only intervene when really necessary” because she feels “birth professionals do too many vaginal exams.” Keeping intact a mother-to-be’s sense of power, she asserts, “a good midwife can tell how much her lady is dilated by the sounds she makes.” Mari truly believes fear equals pain, and that when “women birth without fear, they move away from painful births in exchange for a very powerful and intensely sensual process.”

Compared to other health professionals, a midwife’s relationship with an expectant mother is more personal, more in tune with life. Birthwell LA offers the following services: hour long prenatal visits, TLC, nutritional counseling, an attitude that birth is a normal life process not a disease, in-home prenatal visits, 24/7 support, the opportunity to have siblings at prenatal visits and at the birth (which is amazing for bonding), all the time women need to ask questions and get proper answers, all the time needed to birth, personalized care and, perhaps most importantly, they encourage women to take responsibility for their bodies, babies, and birth.

Q: Mari, why do you feel, for healthy mothers, home birth is better?
A: Well it's not what I feel, it's what is evidence based that is important and home birth is as safe as a hospital birth for healthy women. My opinion is that women are better taken care of at home and the family bond is stronger at home. Women are respected and their birthing process whatever that may be is allowed to unfold.

Q: How often do you see mothers to be?
A: If they start their care in the first trimester then they typically have about 14 prenatal visits. Then I see them the day after the birth, day 3, day 7, week 2, week 4, and then the final visit at 6 weeks. I am also available to them for their annual well-women care for their PAPS etc. as well as with them for the entire birth process.
During a prenatal checkup, we go over the wellbeing of the mother. This includes her emotional state, her relationship, her diet, her vital signs, her lab work etc. Then we check the baby's heart rate and measure her belly. I also give belly massages and assess the baby’s position and growth.

Q: During labor, do you let mothers to be do whatever they want (eating, position, water)?
A: Yes! Whatever they want. I make suggestions if I see something that might work better or to encourage hydration and nourishment. I am there as their guide through the labor and birth process, but the woman is the director of her show.

Q: After the baby is born, midwives complete the circle and ensure that baby and the new mother are happy and healthy. What happens during a post-natal check up?
A:I assess the well-being of the family, assess the mother and baby. Make sure mother is doing well and baby is healthy. Help with breastfeeding and assess the situation in the home. Observe for any complications and postpartum depression.

Q: Concerns some women have about midwives include emergency situations and birthing complications. What happens if something goes wrong?
A: I don't wait around for bad things to happen, and I am not attached to the location of a birth. I am trained to assess the cues that a birth isn't going well or that the baby is not happy. If I am given any signs that it would be better for the outcome to be in a hospital, we go in.

Q: Have you ever dealt with a casualty?
A: I have dealt with emergency situations at birth. Midwives carry with them drugs to stop bleeding and resuscitation equipment and oxygen. We are trained in neonatal resuscitation and adult CPR.
We carry IV equipment and use dopler's to monitor the baby's heart rate. We also have equipment to assess mother's vital signs. Herbs and homeopathic remedies that aid the labor and birth process.
Q: As a midwife, have you ever missed a birth?
A: Never

Q: How was your baby born?
A: My little Kira was born in our home in the birth pool. It was amazing, and I did not have any pain. More like strong menstrual cramps.  I took a long time to open and I stayed 5 cm for a long time. My midwives began to worry that I wouldn't progress. It was just that the contractions were not strong enough. So they called in an acupuncture therapist, Azita Moallef, and she did an intense treatment on me. Within an hour of her finishing, my labor totally changed and I began to have long strong contractions that began to move the baby down. Moments later I shocked my midwives because I was completely dilated and ready to push. I then got in the pool along with my husband and pushed my baby out in 20 min into her dad's hands. No tearing or anything. The hot water is just so amazing in labor and helps to relax the body so it can open and stretch easily. I would not do it any other way.




Mari Oxenberg, RN, MS, CNM
With a passion for nurturing women and families and a love of babies, Mariposa Oxenberg began her journey into midwifery in 1996 when, after graduating Pine Manor College in Boston, she witnessed a beautiful birth. Mesmerized and enchanted with the miracle of life, she embarked on a path that would take her through the many facets of birth in America with a goal of learning as much as she could. Mari trained at Babies By the Sea Birth Center in Key West Florida where she also founded Birthwell Doula Services and taught prenatal yoga. When her friend and colleague Dr. Kelley Valle became pregnant, she approached Mari with the idea to create a Prenatal Yoga Video so that all women could benefit from the Integral Prenatal Yoga class Mari instructed. Together, they birthed Birthwell Yoga for Pregnancy and Childbirth Preparation which is now featured in the Birthwell Gift Boutique. In 2001, Mari graduated from nursing school in the Florida Keys and moved to the Berkshire mountains in Western Massachusetts where she discovered how to be a “nurse-doula” and navigate hospital protocols while allowing her patients gentle and conscious birth experiences. Mari received her Masters in Science in Nurse-Midwifery in 2010 and acquired a taste for research. Her thesis looked at “The effects of prenatal yoga on perineal integrity in childbirth”. Living in beautiful Topanga Canyon and now a mother herself, she is joined by her mentor Marina Alzugaray, Certified Nurse Midwife,  as they transform Birthwell into a complete childbirth service. Using her expertise to specialize in homebirth and water birth, Mari strives to support and guide women though this most powerful time of their lives with love, confidence and grace so, as they transform through their powerful birth experience, they can be excellent and confident mothers.

Social Media: https://www.facebook.com/BirthwellLosAngeles

Monday, April 30, 2012

Introducing....May ~ a month to come together to celebrate Birth!

We have come along way....and we still have a long way to go. But the strides we've made are strides to be proud of...and sometimes smile at, because they are good common sense!



 

May is Blog Carnival Month!

Yes, only about 24 hours (depending on where you live) until May 1 and that is the beginning of the Childbirth Today Birth Blog Carnival!

So far we have 31 writers pledging their submissions to educate, invigorate and refresh your practice as birth professionals!  These writers are coming from all over the world, from the US, Canada, Australia and more!

There is a lot to celebrate in May!  May 5 is International Day of the Midwife, the week prior to Mother's Day is Childbirth Education Week, and May is Doula Month!  Not to mention, Mother's Day being in May!!

So join us beginning tomorrow, May 1 (in the US, where we are located) for an enjoyable month of guest blogs!

Thursday, April 26, 2012

MS Tag or Q R Code?

OR


There are two similar marketing tools currently available to the tech savvy business person: MS Tags and QR Codes.  While I have covered QR Codes in a previous blog post, I wanted to talk about the MS Tag and compare/contrast the two to give readers a more well rounded view.You are seeing Tags and Codes everywhere, from billboards to magazines to informational/promotional items such as business cards and ads.  But what is a Tag?  The brother/sister team of Tags and Codes are in a family known as NFC or Near Field Communication. Both are scan-able from apps that can be downloaded for iPhones and Droids.  According to Microsoft, "Depending on your choice, you can create a simple campaign delivering a line of text or a phone number, or go further and help people use your mobile site, see a video, download an app, get contact info, and much more. You don't have to worry about them typing in your URL or finding you online – using Tag instantly puts the relevant info at their fingertips."


Why would a birth professional use a Tag or Code?  Here are a few reasons:


1. Keep the look of your business up-to-date with the market that you are trying to reach.  If you are marketing your services to childbearing women, then this demographic does use Tags and QR Codes.  So you should too!


2. Drive more people to your site for services!  Many people have smartphones and can download the apps for reading both Tags and Codes.  So why not let them view your website or Facebook page from their phone?


3. Tags and Codes are free.  In the world of marketing, free is good.  Free is great!  


4. When used as a jpg (or photo), Tags and Codes can be used in a myriad of different ways: from car magnets, to postcards, flyers, bookmarks, etc, helping you to stretch your marketing dollar.


5. Making Tags and Codes take almost no time.  If you have 20 minutes, and are computer savvy, you could make both for your business.


In today's world, a person needs to visit a site 7+ times before they will act on anything the site has to offer.  Increase your visibility today by making a Tag or Code.


To make a Tag, click here http://tag.microsoft.com/my-tags/getting-started.aspx
To make a Code, click here http://www.qrstuff.com/

Tuesday, April 24, 2012

Studies, Practice Changes & Evidence II

Following up on my previous blog regarding examination of studies, I recently came across this website and wanted to pass it on to readers as an excellent resource for beginning to understand research --> http://understandingresearch.com/.



On her site, Andrea Lythgoe talks about her background and how she came to create the website: "Currently I have my own doula and childbirth education business, Pampered Birth, I teach natural childbirth classes at St. Mark's Hospital in Salt Lake City, UT and I teach a history course and a research course for the Midwives College of Utah."


On Understanding Research, Andrea has several great aspects including "Finding Studies" which explores the internet resources available to those looking for studies; "Journals" a comprehensive listing of journals that publish birth research; "Resources" where she listed other valuable research sites such as our The Birth Facts; a dynamic grouping of articles about research and an extensive glossary of terms used in research.


If you are beginning to explore the ins and outs of research and would like to know how to begin, Andrea's site is the place to go!

Monday, April 23, 2012

Studies, Practice Changes and Evidence….OH MY!


When studying statistical data in most medical professions, it is generally accepted that studies have an expiration date.  That is, if a study is older than three or five years, the data is seen as invalid.  The study is too old, times have changed, practices have changed. 

Yet some studies done with the human body, such as labor and birth, may be valid regardless of the date.  Why?  Because depending on the parameters of the study, the subject matter does not change.  The human body does not evolve that quickly to make a study in 1965, for example, out of date.  What may change is the method by which data is discovered – technology changes and thus the data may change. For example, with childbirth education, many of the studies done at the dawn of the natural childbirth movement in the 1960s are still valid today, the parameters are different and if redone, the newer study would include web access and online learning.  The basics may still be applicable.

When discussing evidence-based medicine, the evidence must be current.   US organizations such as ANA (American Nurses Association) , AWHONN (Association of Womens Health Obstetrics and Neonatal Nursing) , ACNM (American College of Nurse Midwives) or ACOG (American College of Obstetricians and Gynecologists)  are charged with the duty to present to their members with the most current practicing standards for creating best practice.  These standards are a compilation of leading edge knowledge/research to be used in the creation or revision of policies, procedures, practice guidelines and also as clinical benchmarks.  Basically, it helps everyone practice from the same playbook.

Gaining evidence is so easy in our technological world.  Just searching for MEDLINE, Cochrane, MIDIRS, Pubmed or CINAHL can provide not only current evidence based information on a topic but in some instances, a historical prospective as well.  Understanding our past and knowing our present helps to provide care that makes a difference.  In these databases, one can also find information from other countries.  While some medical professionals may see evidence from other countries as not applicable to the US due to a variety of confounding factors, the data does give one cause to pause particularly if the country cited has a significantly different maternal morbidity/mortality or infant morbidity/mortality than the US.
 
Education-based professionals such as childbirth educators, lactation consultants and doulas need only to look at studies and dissect them, putting them in lay terms and put them in the hands of expectant and new parents.  In order to have full informed consent, parents need to have the correct information, not what is geographically traditional or “the way we’ve always done it”.  The birth professional, too, is accountable in learning the most current information ~ with the accessibility to the internet, the excuse of “I haven’t heard about that” begins to pale.  A great first step would be to read through information from Childbirth Connection. 

Let’s take breastfeeding for example.  There are multiple resources by just typing in the word breastfeeding into a search engine.  The Surgeon General’s Call to Action is one of the very first pages to come up.  Stuffed full of evidence based research, this is an important read for any perinatal care provider.  Why peri natal care provider?  Because peri indicates the entire spectrum of the childbearing year – if we think that birthing practices or newborn care practices do not impact breastfeeding, think again!  Important to know about also are the HealthyPeople 2020 Objectives for Maternal, Infant and Child.  While many are repeated from 2010 (because the US didn’t meet the goals by 2010), some others have been added.

The evidence for best practice is available.  The next blog will focus on why it takes so long for change to happen and how you might be able to become a catalyst for change in your community.

Tuesday, April 17, 2012

Dads & Doulas ~ Debra Pascali Bonaro

Thanks to Debra Pascali Bonaro of the film "Orgasmic Birth" & Patrick Houser of Fatherstobe.org for this great segment explaining about how Dads and doulas work together in harmony at birth!