Politically correct? Time to STOP with Birth.

Yes, I said it. There. It is time to stop being politically correct with issues surrounding birth. For way too long we have been polite about the presentation of the facts about the different interventions with human childbirth. We didn't want women who chose interventions to feel bad about their decisions. We didn't want be portrayed as militants or revolutionaries.

Since when does telling the truth make one a militant or revolutionary? It is time to stop candy coating the risks of inductions too early, the risks of using Cytotec as an induction agent, the risks of epidural anesthesia, risks of analgesics, risks of continuous fetal monitoring, cesarean sections....it is time to present the facts as they are presented in the same medical literature that the medical community publishes (but do they read it?).

We in the birthing community - every nurse, midwife, physician, childbirth educator, doula, lactation consultant - must change the focus of our practice to what is evidence-based, not popular based. Some of the practices that parents agree to are actually dangerous or potentially dangerous to the labor and birth and therefore dangerous to the newborn. Need an example? For some women, "term" is defined as 40 weeks, for others it may be 38 weeks or
42 weeks or even 44 weeks. If a woman's body gestates babies to 44 weeks and she is induced at 40 weeks, the baby will be 4 weeks premature and may have to spend time in the NICU. This separates mother from baby, eliminates the benefits of skin to skin contact, and challenges breastfeeding for, perhaps, months. Without prime followup care, this family will have future challenges ~ all because there was an induction too early.

It is difficult to hear the truth.

It is also difficult to embrace the truth and change care practices when we are comfortable with "the way we have always done it". It makes us feel uncomfortable and challenges US.

However, since we are talking about new human lives and new families in our society, I truly believe we need to move beyond OUR issues and do what is best for mothers and babies. It is time we truly do no harm.

Does anyone out there agree?

Healthy People 2010 ~ 15 months & counting

In the US, it is a difficult statistic to swallow...the US maternal mortality rate is rising. The rate rose in 2004 from 12/100,000 to 13/100,000. That was the first rise since 1977 and due, in part to the rise in the cesarean section rate.

But why in a country who boasts about the quality of health care and the nearly continuous use of technology at birth would the maternal mortality rate rise?

According to Dr. Elliot Main, who co-chairs a panel reviewing obstetrics care in California, "As you do thousands and thousands of them (cesarean sections), there's going to be a price."

With infection and blood vessel blockage leading the way as causes of death, we also have to look at the fact that black women are experiencing a maternal death rate THREE TIMES greater than it is for caucasian women. Black women are more susceptible to complications like high blood pressure and are more likely to receive inadequate prenatal care.

What is even more disturbing is that three different studies have indicated that at least 40% of maternal deaths could have been prevented. Obesity has a share in the growing statistic of maternal death - 1/3 of pregnant women were outside of the weight guidelines for healthy pregnancies which puts women at a greater risk of gestational diabetes, preeclampsia and...cesarean sections.

So what should happen?

Perhaps instead of flooding the newswire with reports about Angelina Jolie's "amazing" post-pregnancy body, we need to have more news stories about education for early pregnancy. While some of us who have been in the birth business for years may be weary about saying it all again, the new generation of pregnant women (be they teens or older) may have never read a book or an internet site talking about pregnancy health, good and early prenatal care, or pregnancy nutrition.

And here is another disturbing fact: only 33% of expectant women attend childbirth education classes and get this valuable information albeit sometimes too late. Why is that? I will explore that in my next post.

Hurricanes, Cold Fronts & Motherboards...Oh My!

You know, as I was driving south on 65 toward Atlanta, I wondered why it took so much to keep my Chevy Blazer on the road. Hurricane force winds. But I never imagined what it was doing to Dayton, my home, at the same time. Our town looked like a hurricane hit it - both Ike and a cold front came together and about 90% of our citizens were out of power...some still are. Phones were down, groceries lost produce and freezer/refrig goods, homes were damaged.

Thus, some of the orders on www.birthsource.com will be delayed due to this.

The Waterbirth workshop in Atlanta at South Regional Medical Center was a great success and we met some really wonderful and mother-centered professionals. One the way home, the drive again through the mountains of Tennessee were breath taking. On Thursday morning, upon awakening at home, I turned on my computer only to find the motherboard had DIED. Trying not to panic, I did use my hubbies' computer for some work but went out a purchased a new computer on Friday (have I mentioned my dislike of Vista?) and then purchased a retriever for the data on the old hard drive. That will be transferred tomorrow and then I will be officially good to go again.

Like Morgan Freeman said in "Evan Almighty" - look at all as an opportunity. If you pray for patience, do you think God is going to give you patience? No, He gives you an opportunity. If you pray for abundance, do you think He will give you abundance? No, He gives you an opportunity.

Guess I have been blessed with a lot of opportunities this past 10 days. Sure hope my opportunities calm down for a bit!

Ike Chases Lamaze Attendees!

What happens when you blend Hurricane Ike (or what is left of him) with a cold front? Some hellacious storms that knock the power out of home town Dayton Ohio just some of the Lamaze Conference attendees get home. As we left the hotel, winds were picking up - I mean really.

I was driving south to Atlanta to do a Waterbirth Credentialing workshop on Tuesday with friend Barbara Harper. The wind blew so hard in gusts that at one point I wondered if my Chevy Blazer would stay on the road! Luckily a Starbucks presented itself and I pulled over to wait until some of the wind settled down. Oh, and I had a Grande decaf skinny vanilla latte. LOL!

By the time some of the other attendees arrived back in Dayton, hurricane force winds blew down limbs and whole trees, snapped flag poles, power lines - now some 100,000 Daytonians are without power. Lord only knows when it will be restored.

The weather has quieted and I am safe in Atlanta. I really like driving from Dayton to Atlanta - especially through the mountains of Tennessee. They are so beautiful but especially so when it is just very lightly raining and the clouds are so low you drive through them!

A little R & R for tomorrow......

Louisville!

Well, for Exhibitors, it is the last day of the conference. We have been truly slammed every break which is a good thing! Jim couldn't help me this year as he is going to the MANA conference in October with me . So I took Erin came with me and it has been a great experience for both of us!

Conferences are really nice because you get to see friends that you don't normally get to see: I got to spend some really quality time with my friend Ruth Ancheta whom I met about 20+ years ago when we were both in Southern California. Also here are Colleen and Jana from So. CA and then too a lot of my Canadian sisters like Kathie Lindstrom. Cathy and Julie from Colorado and then all of the Florida people I know from when we were stationed there in the 1980's.

We have alot of down time right now through the lunch hour - but then the last hour when we get truly slammed - no one realizes the exhibits pack up at 5 pm for good! It usually gets fast and furious during that time. Better rest up for it.........

Making a list and checking it twice...thrice

Lists. Thank goodness for lists. Without them, lately, I would not be able to remember a thing!





Especially packing lists. Packing the inventory for the Lamaze conference has been great because we have so much new inventory to bring. I am so excited. And we have a larger corner booth this year ~ room to E-X-P-A-N-D. So if you are in Louisville, stop by our booth and say that you read the Childbirth Today Blog. If you do, you will get a special gift!





I am looking forward to seeing friends, old and new, in Louisville, then it is off to Atlanta to the Waterbirth Credentialing Workshop. Barbara and I will be driving back from Atlanta together, brainstorming and talking about future projects. WOW, that trip will go fast with the two of us projecting about projects....

Hope they have alot of Starbucks on the roads I will be taking!

The Midewin Center ~ another of my projects! (Sigh)

Along side of the Chicago Birth Summit, comes the Midewin Center.

Last fall, while visiting my in-laws, I was watching a PBS special on Native Americans. The "Midewin" was mentioned, described and truly caught my attention. It means "healing" and I immediately thought to myself that I must do something with that word.

At the time, I didn't quite know what that "something" was...until I got the bug to pull together professionals in the community in one place (sound like something else?) for the common good of the public seeking a collaborative practice. Try as I might, the right core of individuals could not come together. Nor could we find the right location for all of us at the right price. Am I asking too much? Am I not listening right to the Big Guy? What am I missing here?

So the idea sat on the back burner of my ever-busy thought stove until the spring when the perfect location came available. However once again, the right core of individuals were not there AND the price was not there. So, again I wait........

Much to my surprise and NOT in sync with MY calendar, the right core group of 5 and the right location AND the right price all came together about 8 weeks ago! Things moved extremely rapidly and everyone but me had quite a sense of peace about it. Retrospectively, now that we are contracted up to our eyeballs for everyone's peace of mind and safety, this is just as it needed to be.

On October 1, The Midewin Center will open with a variety of proactively healthy services. Currently there are some physical renovations to the space being done by contractors and the Core 5 are assembling furniture, art and other necessities for the move-in.

The closer we get to the move-in date, I will be updating you on the progress. Just know that if you live in the Southwestern part of Ohio, you should be excited. Very excited!

Chicago Birth Summit

Several months ago (June 25 post "Coming Together"), I thought about what if all of the leaders of the major childbirth, midwifery and doula organizations came together in one location to answer the evidence-less proclamations of medical organizations.

Well, it appears as if it is going to happen. A meeting room has been secured for November 8 in Chicago - the invitations have been sent, after a Save-the Date note was sent out earlier. The Save-The -Date email receive tremendous response and 99% of every organization emailed, responded positively. We will spend the better part of that Saturday examining the state of maternity care in the US, discussing the enormous impact of childbirth practices on the breastfeeding success of American women, as well as create a response team to the above-mentioned proclamations - there will probably be more.

In the coming weeks, I will post which organizations or individuals have RSVP'd so you can see if your certifying organization is going to be in attendance.

For once, we will be speaking in one voice - nurses, midwives, childbirth educators, doulas - will be together, working together.

It will be interesting to see the progress.......

T-minus18 Days to Lamaze

The Lamaze Conference begins September 11 and I am busy getting new inventory in for the event. This year I have purchased a corner booth so I can inflate the Birth Pool In A Box (or BPIAB) and have it on display. Just a little heavier than hauling your laptop, the BPIAB can be put in the bag after deflating and flung over your shoulder for easy carrying!

Also new this year are Henna Tattoo Kits, Blessing Way Kits, Belly Casting Kits, and Belly Bump Mugs! We have new pens to give out and some real surprises too.

We will have a clearance section where you will find some amazing deals!

New at the booth this year is my daughter Erin! She picked out our new purple and yellow conference shirts. A recent graduate from Xavier University, Erin is trying her hand at conference exhibiting. Oh, she has exhibited before but just at a "show" booth, not at a retail booth. I will be coaching her in the coming days about how slammed we get between the sessions! LOL!

If you are not on our mailing list for the Childbirth Today monthly e-newsletter, sign up today at www.birthsource.com! You will receive money saving coupons to use at the Lamaze Conference!

Well, enough fun. I have to get back to inventory!

No Surprise: How The Media Continues to Look At McConaughey & Childbirth

Well it was no surprise today when the media even took a stab at normal-media-darling Matthew McConaughey when he was talking about he and his partner's recent childbirth experience.

McConaughey and partner plan to plant the placenta ~ a tradition, I might add, of many in this world. Additionally, McConaughey also mentioned he kept time with the contractions by drumming, again another tradition of many in this world.

Too bad the media didn't realize that some have a world view of topics including childbirth. The media is always so considerate of multi-cultural views on topics - apparently only topics THEY want to be multi-cultural about! If a real person(s) such as McConaughey and Camilla want to explore their inner instincts, set a more relaxed mood in childbirth and in the process be a little multi-cultural, it is to the verbal guillotine for them!

To the great surprise of the media, women in the US or even the world are NOT lining up like cattle for elective cesareans. An increasing number of women are seeking out a more gentle birth experience - many are also seeking out alternative or natural childbirth.

Odd isn't it that natural childbirth is considered the alternative and interventive childbirth is considered the tradition. Go figure.

World Breastfeeding Week

Now that World Breastfeeding Week is coming to a close for 2008, I am still distressed at the lack of breastfeeding success in light of all of the celebrations! A recent C.D.C. study showed that in 2005, only 48% of Kentucky babies were breastfed. Compare that to Tennessee at 56.9%, Missouri at 67.5%, and Illinois at 71.2%.

Perhaps it is the Breastfeeding Packs that mothers receive in the hospital that are from formula companies. Is that not an oxymoron? The history of breastfeeding and formula companies is not new, nor is the distaste that breastfeeding proponents have for companies such as Nestle. In 1977, the US began a boycott against Nestle - this boycott had much to do with the way the company marketed breastmilk substitutes to less economically advantaged countries. Formula often has to be diluted with water and in such countries, water is much less safe to drink that here in the US. Among the first to join on in this campaign were Professor and Mrs. Derek Jelliffe, who contributed to establishing the World Alliance for Breastfeeding Action.

Not only is the dilution of formula with tainted water dangerous, but in such poor countries, mothers often use less than the required amount of powder or concentrated formula in an effort to SAVE money. As a result, babies are nutritionally at a severe disadvantage and are 25 times more likely to die of diarrhea and/or inadequate nutrition. Not to mention the fact that these formula fed babies are missing out on the antibodies and immunities that only breastmilk can provide.

Most like mother herself? I don't think so. Breastfeeding is being undermined in this country by formula companies who are sometimes owned by pharmaceutical companies. The seduction lies in the companies offering to pay for seminars for hospital nurses or even worse, construction in hospitals. Therefore, hospitals feel obligated to pass out "breastfeeding bags" provided by formula companies.

Isn't there a way to stop this insanity?

Another Dry Spell :(

Yes, I know I have not updated this thing in another 7 days. My Bad. But I have a good excuse. Two of the Faculty on Advanced Birthing Concepts came up with two new products, which we will debut at the Lamaze Conference. I have been working on those. They are breastfeeding products and I have to say I am really, super excited about them.

Not to mention getting in new inventory for the upcoming conferences: Lamaze and Midwives Alliance of North America. I will be new to the MANA conference and can't wait to see some old friends and make some new ones, some of whom I have met on Facebook.

Speaking of Facebook, do any of you have a Facebook page? It is GREAT fun and wastes entirely too much of my time...but since I am on the computer all of the time anyway, what is another 10 minutes?

Be sure to check out www.thebirthfacts.com - we have had ALOT of great positive feedback about it!!!!!

The Birth Facts

I know, it has been over two weeks since I have updated the Blog. But it is NOT because I have been at rest. Inspired by one of my recent clients, I have created a new website, rather a "baby brother" to www.birthsource.com. The name of the new website is www.thebirthfacts.com . It is a tribute to that new mom and dad's veracity about birth and parenting.

The new site is scheduled to debut on August 1, but YOU get a sneak peak at it now. To my knowledge it is the only website that exists for both expectant parents and birth professionals who want direct links to the research. While still in the infancy stage, it still has quite a few links under each topic area.

Included in the list of topic areas are preeclampsia, inductions, episiotomy, medications and their impact on labor and birth, comfort techniques, water for labor and birth, cesarean sections, pushing/2nd stage of labor, breastfeeding, birth place options and more. Most of the links go directly to the abstract of the original article with the siting of the article present. Other links go to organizations, such as Lamaze, who have carefully crafted position papers, statements or resolutions based on evidence-based information.

It is my hope with this innovative website, more parents AND professionals will have easier access to evidence based information ~ continuing my personal passion to change the conversation about birth!

Let me know your thoughts!

Learning from History

Back in the late 1970's and 1980's, I wrote about the hazards of co-opting childbirth education classes into the hospital. "But it will give women more access to the education" I was told. I, and a handful of others, felt that it would lead to childbirth classes becoming large commercials for the services provided by hospitals. And still today, I hear "In our hospital, we can ..."

What the handful of us thought, about the large commericals, came true for the most part. Also came the watering down of the birthing options until options became a 4 letter word. Where nurses say "Oh, she has a birth plan...now there is an automatic cesarean!"

And now, here we are 30 years later. We have enjoyed the era of "natural childbirth". But while we weren't looking, someone came in and began to address the fears that all women have...fear of the unknown and fear of childbirth. Our support began to be incrementally changed from our husbands or partners to the comfort of medications and technology. Our fear was somewhat pushed aside by the removal of the pain factor by epidurals. We didn't need childbirth classes because the technology would ensure that we would have the best outcomes.

However, what "they" didn't let everyone know was that the US pregnancy outcome rate did NOT improve with the increase technology. What "they" didn't test was the long term side effects of Pitocin, Cytotec or epidural anesthesia. And what "they" didn't understand was that all of the technology interferes with a newborn's natural instinct to snuggle, cuddle and bond with their mothers. And too late, "they" still don't recognize any of these things.

The good news is that SOME of us know the stats, the adverse side effects of technology and medications. And the good news is that we are starting to become a more cohesive group to effectively get the word out. We still do not know all there is to know about birth. But what we DO know is that birth is normal, natural and should be left undisturbed most of the time.

The research backs up what we do know.

And it is time for us to begin listening not only to women but also to the research.

A Coming Together...It is time...

What if all of the leaders of childbirth organizations came together for a summit meeting?

What if leaders came together for a summit to talk about the state of birth in the US?

What if the leaders who attended the summit put away their organizational differences and all focused attention on educating expectant parents?

What if the leaders focused on the increase in cesarean section, increase in inductions, increase in epidural anesthesia and the LACK of change in the maternal/infant mortality/morbidity rates?

What if they dedicated their joint marketing services to educate parents for the next 12 months?

What if the organizations' members rededicated their efforts to present objective and evidence-based information ~ with honesty and truth?

What if all of the efforts work? What if the cesarean rate, induction rate, anethesia rates went down? And WHAT if the maternal/infant mortality/morbidity rates in the US got better?

A Coming Together...It is time...because the time is NOW!

Hospitals/Birth Centers Do Not Have Practices That Promote Breastfeeding

Breastmilk is the perfect food for babies - it is especially designed. It is associated with decreased risk for infant and maternal morbidity and mortality. The US still ranks in the low 20's amongst industrialized countries for infant and maternal morbidity and mortality. That means 27 other countries do things better.

Maternity practices in hospitals and birth centers throughout the intrapartum period, such as ensuring mother-newborn skin-to-skin contact, keeping mother and newborn together, and not giving supplemental feedings to breastfed newborns unless medically indicated, can influence breastfeeding behaviors during a period critical to successful establishment of lactation. Many facilities tout that they "have implemented" practices or are planning to implement such practices...what is so hard?

One hospital administrator told me that it was hard for nurses to change. WHY? If there is evidence to show that certain practices are better for mothers and their babies, it seems to me that a nurse has no business standing in the way of health and well being!

It is 18 months before 2010 and currently only four states (Alaska, Montana, Oregon and Washington) have met all five of the Healthy People 2010 targets for breastfeeding. In a study of 2,687 facilities, 70% of facilities report providing discharge packs containing infant formula samples to breastfeeding mothers. 24% reported giving routine supplements of formula to healthy full-term infants. 30% reported giving glucose water and 15% reported giving water to infants.

If hospitals are good places to have babies, then why do their practices NOT support this assumption? And why are they so slow in making changes?

And why are not more of us more vocal about these facts?

For more information on this study and the statistics, click here.

2008 Water Birth Week!

The week of June 16 - 21 has been designated as 2008 Water Birth Week in Dayton Ohio!

The celebration will focus on the amazing affects of hydrotherapy on labor and birth AND the fact that there are NO side effects on the mother or baby, given an uncomplicated pregnancy/labor!

The celebration will be enhanced by the arrival of Barbara Harper RN, CCE, CD, the international expert on water labor and water birth. She will be speaking at the Dayton Area Labor Support meeting on Thursday evening at 7 pm, speaking at the Waterbirth Credentialing Workshop on Friday June 20- at Miami Valley Hospital and hostessing the Dayton premiere of "Orgasmic Birth" at Wright State University on Saturday June 21 at 7 pm.

At a time when expectant women are looking for alternatives in birth, they are seeking more and more information ~ we are proud to be one of the nation's leaders in birth! Dayton, Ohio.

A Link Between Oxytocin in Labor & Autism?

For nearly 8 years, researchers have been examining oxytocin's capability of crossing the maternal placenta and oxytocin's possibility of crossing an underdeveloped or stressed infantile blood brain barrier at birth, a causal connection between oxytocin excess and behavioral disorders such as autism can be supported from a molecular perspective.

Researchers have done experiments in lab animals, tracing the administration of radioactive oxytocin crossing such "barriers". "Barriers" may not be the right term, as it indicates the fact that there may be obstacles. Few obstacles if any exist in the placenta or blood brain areas.

Conversely, treatment of autism can sometimes include oxytocin!

A 1998 study found significantly lower levels of oxytocin in blood plasma of autistic children. A 2003 study found a decrease in autism spectrum repetitive behaviors when oxytocin was administered intravenously. A 2007 study reported that oxytocin helped autistic adults retain the ability to evaluate the emotional significance of speech intonation.

Clearly, we NEED to explore completely the risks/benefits of medications given to laboring human mothers BEFORE adding them to the routine.


Resources
Modahl C, Green L, Fein D et al. (1998). "Plasma oxytocin levels in autistic children". Biol Psychiatry 43 (4): 270–7.

Hollander E, Novotny S, Hanratty M et al. (2003). "Oxytocin infusion reduces repetitive behaviors in adults with autistic and Asperger's disorders". Neuropsychopharmacology 28 (1): 193–8.

Hollander E, Bartz J, Chaplin W et al. (2007). "Oxytocin increases retention of social cognition in autism". Biol Psychiatry 61 (4): 498–503.

The Importance of Zen

Everyone needs a little time of relaxation, some call it Zen while others call it vegitating. The only place in the universe where I truly feel relaxed and at home is on the beach in Santa Barbara.

There is a unique tranquility here...a place where heaven meets earth...the closest that you can get to God and still be alive. At least for me.

I am thrilled to be here...and for the next 5 days. I will return renewed and refreshed and revitalized. Ah...

FDA Looks at Safety of Meds for Pregnancy/Birth

It has taken the US Food and Drug Administration to come to the conclusion that changes need to be made to the physician labeling of prescription drugs - to better inform expectant mothers (they call them patients as if they are ill, which they are NOT) as well as health care professionals about the risks of medicines used during pregnancy and breastfeeding.

Out of the nearly 6 million pregnancies in the US each year, expectant women take an average of 3-5 prescription drugs during pregnancy, says the FDA. And with the history of medications in the US being given without adequate research (DES, Thalidamide, Cytotec) that have had catastrophic results (or hazardous outcomes), I think it is just about time that adequate labeling WITH adequate research is accessible to all who are considering or do become pregnant.

I am somewhat concerned that it has taken so very long for the FDA to come to this conclusion. In no other part of medicine does something ingested impact two people at the same time. When an expectant mother ingests a medication, it impacts both the mother and the fetus. And why will the increasingly better drug labeling "have a huge impact on public health and well-being for women" (according to Rear Admiral Sandra Kweder MD)? What has not been shared with us so far? What has been kept from us? What have they known and not shared?

For years, the FDA has toyed with maternal and fetal health and well-being. I think this "decision" is long overdue and too little, too late for many couplets.