So much for the textbook......

Labor is different for every woman, but occasionally, someone really breaks the mold. With permission, I share the story of my client, S.

S is a strong, energetic young woman having her first baby. She and her husband quickly became dear to my heart. Upon her labor beginning, like a good girl, she went for a beautiful walk in the park with her hubby, and called me when the contractions became a little closer. I told her that by listening to her, I did think she was in early labor and that she would be having her baby soon(meaning in the next couple of days). This went on all day. I went to an early morning birth, then had to take my toddler to the doctor, and decided to run over and check on her. She was frustrated. The contractions had been going on all day with no apparent change.

By the time I arrived, there were no clues that she was in active labor. Many times, contractions will slow down or even stop when I show up...then they pick up again. She would casually mention that she was having a contraction between our topics of conversation. With a loving smirk, I told her husband to call me when she stopped talking so much, that we would know then that it was time to get really serious. I also gave her some homeopathics just to see if it would help. After about an hour....I left thinking it would be a while.

I got home and took a much needed hot bath. The baby born that day had pulled me out of bed at 5am. I had also been at a birth the day before that...LOL. I was hoping for a few hours of sleep. But S's husband called me back before my hair was even dry. He said she had not stopped talking....rather...she had begun yelling and cursing and had droppped to her hands and knees on the floor. I told him to ask her what she felt like we needed to do....mamma instincts know. She said we should go to the hospital and out the door I went to meet them there.

Upon arriving, she was still chatty. She did stop talking for a contraction, but I did not see the seriousness and the concentration that I normally see in active labor. Usually, toward delivery, mom will stop talking even in between contractions....other than to say, "water" or "bathroom" or "hurts here." She and hubby didn't even bring the bags in out of the car because they had convinced themselves on the way to the hospital that this might not even be real labor. LOL Imagine all of our surprise when the nurse announced that she was 9cm.

There are always exceptions to the rule and she was one. But, it proves that mamma instincts will always tell you the right thing to do. It was time to go - even though she wasn't exhibiting the textbook signs. And by the way, she never did get quiet and contemplative. She never stopped cracking jokes and smiling. She made it look easy. And she made me stop looking so hard for absolutes.......

ACOG gets a big surprise.....

This is what happens when women speak up for their rights to the birth they want. I love it!


Issued: August 31, 2009

Viral Internet Campaign Exposes Bogus Research on the "Problem" of Increased Demand for Midwife Care

If you have difficulty viewing this message, please visit the PushNewsroom.

Thousands of Activists Nationwide Force Physician Group to Scrub Its Website

FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (August 31, 2009) – In under 18 hours, a viral internet campaign targeted at the American College of Obstetricians and Gynecologists (ACOG) forced the group to take down a public plea asking its members to submit anecdotal, anonymous data about patients who planned out-of-hospital deliveries. According to the request, which was originally linked from ACOG's home page, the professional trade association for OB/GYNs is "concerned" about the "problem" of growing numbers of women seeking out-of-hospital maternity care.

"Just follow the money," said Steff Hedenkamp of The Big Push for Midwives Campaign. "ACOG does not want to continue losing patients to Certified Professional Midwives and out-of-hospital birth, so they're telling members to send in more of the same old tall tales that far too many OBs love to scare women with. Well, we have news for ACOG8
0it's not working."

The campaign to expose the physician group's plans began on Facebook and Twitter and rapidly drew thousands of women to ACOG's website, where they submitted their own data about their healthy deliveries in private homes and in freestanding birth centers throughout the country. In response, ACOG moved quickly to scrub its website and placed its request for unsourced data from members behind a password-protected firewall.

"This was almost as fun as last year's campaign pressuring the American Medical Association to back off from its ridiculous claim that Ricki Lake is responsible for the increase in out-of-hospital deliveries," said Sabrina McIntyre, mother of two. "The AMA and ACOG seem to forget that women are capable of making rational, informed decisions about our maternity care providers and birth settings. We don't appreciate fear-mongering tactics meant to try and scare us away from using safe and cost-effective, community-based alternatives to our current maternity care system."

Analysts familiar with ACOG expect the group to use the anecdotal data collected from members to support its ongoing state and federal lobbying campaigns aimed at denying women access to out-of-hospital maternity care and Certified Professional Midwives, who are specially trained to provide it. "ACOG admits in its own documents that they've been forced to use 'hardball tactics' against women who are advocating for choices in maternity care," said Hedenkamp. "Frankly, this latest stunt of theirs to troll for 'fresh' folklore reek
s of desperation. "

The Big Push for Midwives Campaign represents thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push includes educating national policymakers about the reduced costs and improved outcomes associated with out-of-hospital birth and advocating for including the services of Certified Professional Midwives in health care reform. Media inquiries: Katherine Prown (414) 550-8025, katie@thebigpushfor midwives. org

###

The Big Push for Midwives Campaign | 2300 M Street, N.W., Suite 800
Washington, D.C. 20037-1434 | TheBigPushforMidwiv es.org

The wonder of it all........

I believe birth really is more art than science. If you gather a group of 25 women and ask them what a contraction feels like, you will get 25 different explanations. If you ask them about their birth experience, you will get 25 very different impressions.

I think what is missing today in modern obstetrics is the recognition that women want a birth experience. Some women want an unmedicated birth and some want the epidural when they walk through the door, but they all want their experience to be miraculous and sacred. Sometimes a woman doesn't even realize how important this is to her until she has a birth that is less than satisfying.

A woman in labor is a masterpiece. Left to her own, she will usually find her "groove". I love the moment when a woman finds that. At a recent birth I attended, I walked in to hear mom singing a song about Greek letters and such. I later found out this was her sorority song. When the contractions were difficult, her "groove" was to sing that song and it worked to move her through the process. Another client quietly rocked and chanted, "Good things are happening down there" over and over again. It is beautiful. It is art. Mom is painting her birth experience. We need to respect her canvas.....her space. Let her create.

Labor calls a woman to reach deep within herself and be completely strong and completely vulnerable all at the same time. When a woman's labor stalls for a bit and technology is rushed to her side to "make things happen", then we diminish her work. We, in essence, tell her that what she is doing just isn't enough. Her masterpiece doesn't meet the expectations.

Pregnancy is not a disease and labor is not a condition to be managed. It is a process.....a journey. As long as we continue to "manage" birth instead of allowing a life to enter the world in the same miraculous way that it is created, then women will continue to feel dissatisfied with themselves and their birth. They may not be able to tell you exactly why they feel this "void", after all, they have a healthy baby and that's the goal....right? We must recognize that it is so much more than that. It is an image, a work of art, that will linger in a woman's mind for the rest of her life. She will look at it many times. She will attempt to interpret it. She will ask others to look at it and give their opinion. She will either see it as her most beautiful work, or she will consider it to be lacking.

What is a doula?

I get this question all the time. It's a funny word, really(prounouced doo-luh). This is quoted from the DONA website(www.dona.org):

The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

People ask me, "Do you deliver the baby?" I say, "No, I'm just along for the ride." It sounds trite, but really I am.

Mom is on a journey that she has been traveling for 9 months. She has read books, she has talked to countless friends who have explained their births in detail(for better or worse)and she has poured over her gift registry trying to decide which of the 300 stroller models is the safest, best and cutest. She is driving this ride!!!

Along comes labor. It starts slow and builds. Mom and dad call me. I come over and watch mom's demeanor. I give her a reassuring smile every time she looks at me so that she will know she is doing everything right. I chat with dad, assure him that he is going to do fine also. And we all let the process unfold. I step in with a suggestion or a back rub if needed. Sometimes I remind mom to breathe or to relax. I reassure mom and dad at each stage that what she is feeling is normal and that she can do this. I provide a constant presence so dad can update family, grab a bite to eat, or just go to the bathroom! I help parents navigate the decisions about interventions and procedures so that they feel they can make informed decisions. And, of course, I fetch ice and sprite and coffee for dad at 2am and all those "practical" things.

At the end of the day, my goal is not that my clients feel they couldn't have done it without me. Rather, I hope they feel like THEY did it, and I just made the ride a little easier.

Chirpractic Care During Pregnancy

This was an article posted by a chiropractor from Asheville, NC who was a speaker at my doula training. I know and trust a local chiropractor, www.beyondwellnesscc.com , for my clients and friends. Check it out!


Chiropractic Care in Pregnancy

One of the most exciting times in a woman’s life is when she finds out that she is expecting a baby. Chiropractic care during pregnancy can be a valuable addition to a Mom’s prenatal care. A properly functioning spine and nervous system is an important part of a wellness pregnancy. In addition to the noticeable changes your pregnancy will cause your body, pregnancy can cause subtle changes in the musculoskeletal system—changes your Chiropractor is able to detect and correct.

The position of your growing baby will cause your center of gravity to shift, and your spine will naturally alter itself to accommodate this change. As a result, you may experience low back and pelvic pain. The increase in hormones during pregnancy can also cause ligaments, cartilage, and even bones to soften and become more pliable. Pelvic bones may even become displaced or fixated. Since your hips will need to spread to accommodate the delivery of your baby, fixated pelvic bones can lead to complications during delivery.

A bone or vertebra that is slightly out-of-place can create nerve irritation, which can and will interfere with your body’s communication system. By using special or modified techniques during your pregnancy, your Family Wellness Chiropractor can restore the function of your nervous system, improve your overall wellness, and increase your comfort during your pregnancy and delivery.
In fact, research has shown that:

84% of pregnant women treated by Chiropractors received profound relief from low back pain

Women who received Chiropractic care had nearly a 25% reduction in the average labor time and a 33% reduction for women carrying multiples

Postpartum pain was relieved in 90 of 120 moms that had been under regular Chiropractic care

During your pregnancy, your Doctor of Chiropractic can do the following:

Correct vertebral misalignment and relieve nerve interference with gentle adjustments.
Help ensure that pelvic bones are properly aligned, contributing to a shorter and easier delivery.
Re-establish the natural position and mobility of the joints.
Provide freedom from interference of normal nerve energy.
Decrease the likelihood of your fetus being in the wrong position during the last trimester.

Many Mothers have come to understand the vital role that Chiropractic care plays in a healthy pregnancy. The benefits of a Chiropractic adjustment offer more than just low back pain relief. The spinal adjustments have also helped them feel healthier during the pregnancy, decreased morning sickness, facilitated in shorter labor and delivery times, and increased overall sense of well being. Dr. Alisha Davis is dedicated to providing you with the absolute best in family wellness care. So take a moment today to discuss any concerns you may have regarding a wellness pregnancy and delivery and learn about the many benefits of Chiropractic care for you and your baby.

Dr. Alisha Davis, DC, DACCP

Are you an ungrateful patient? Ask the AMA!

AMA Resolution Would Seek to Label “Ungrateful” Patients

Redondo Beach, CA, June 11, 2009 - At the American Medical Association’s (AMA) Annual Meeting next week, delegates will vote on a resolution which proposes to develop CPT (billing) codes to identify and label “non-compliant” patients (1)

The resolution complains:

“The stress of dealing with ungrateful patients is adding to the stress of physicians leading to decreased physician satisfaction.”

“This resolution is alarming in its arrogance and its failure to recognize, or even pay lip service to, patient autonomy,” said Desirre Andrews, the newly elected president of the International Cesarean Awareness Network (ICAN).

If approved, the resolution could hold implications for women receiving maternity care. For pregnant women seeking quality care and good outcomes, “non-compliance” is often their only alternative to accepting sub-standard care. Physicians routinely order interventions like induction, episiotomy, or cesarean section unnecessarily.

Liz Dutzy, a mother from Olathe, Kansas, delivered her first two babies by cesarean and was told by her obstetrician that she needed another surgical delivery. “My doctor told me that I needed to have a cesarean delivery at 39 weeks, or my uterus would rupture and my baby would die.” She sought out another care provider and had a healthy and safe intervention-free {home} birth at 41 weeks and 3 days gestation.

A recent report by Childbirth Connection and The Milbank Memorial Fund, called “Evidence-Based Maternity Care: What It Is and What It Can Achieve ,” (2) shows that the state of maternity care in the U.S. is worrisome, driven largely by a failure of care providers to heed evidence-based care practices. For most women in the U.S., care practices that have been proven to make childbirth easier and safer are underused, and interventions that may increase risks to mothers and babies are routinely overused. The authors of the report point to the “perinatal paradox” of doing more, but accomplishing less.

The resolution proposed by the Michigan delegation of the AMA could threaten patient care and patient autonomy for several reasons:

• Billing codes that would categorize any disagreement and exercise of autonomy on the part of the patient as “non-compliance” “abuse” or “hostility” could create a pathway for insurance companies to deny coverage to patients

• Use of these labels fails to recognize patients as competent partners with physicians in their own care

• Tagging patients as “non-compliant” fails to recognize that there is not a “one size fits all” approach to care, that different opinions among physicians abound, and that patients are entitled to these very same differences of opinion

• Labeling patients as “non-compliant” may, in fact, be punitive, jeopardizing a patient’s ability to seek out other care providers

The resolution also fails to address how it would implicate patients navigating controversial issues in medical care, like vaginal birth after cesarean (VBAC). While a substantive body of medical research demonstrates that VBAC is reasonably safe, if not safer, than repeat cesareans, most physicians and hospitals refuse to support VBAC. (3) The language in the resolution suggests that patients who assert their right to opt for VBAC could be tagged as non-compliant, even though their choice would be consistent with the medical research.

“The reality is that the balance of power in the physician-patient relationship is decidedly tipped towards physicians. The least patients should have is the right to disagree with their doctors and not be labeled a ‘naughty’ patient,” said Andrews.

About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death.

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. ICAN has 110 chapters in North America and Europe, which hold educational and support meetings for people interested in cesarean prevention and recovery.

(1) Resolution 710 “Identifying Abusive, Hostile or Non-Compliant Patients”
(2) Evidence-Based Maternity Care: What It Is and What It Can Achieve
(3) http://www.ican-online.org/ican-in-the-news/trouble-repeat-cesareans


If you don't like the idea of being officially labeled "non-compliant" or "ungrateful" for questioning your physician, then go to http://www.ama-assn.org/ama/pub/about-ama/our-people/the-federation-medicine/state-medical-society-websites.shtml , click on the link for your state AMA and contact them. Let them know that this proposal is unacceptable. Voting is next week.

Are you really overdue?

It is becoming routine for doctors to induce patients at 41.5 weeks in this area. Inductions have not increased favorable outcomes for women in the US. Is is possibly because 41.5 weeks isn't really 41.5 weeks? Read this article before you accept that you are "overdue."

http://www.associatedcontent.com/article/1047180/the_lie_of_the_edd_why_your_due_date.html