Sunday, January 31, 2010

Preparing for a natural hospital birth: book and video suggestions

Jane is a college friend of mine who blogs at Seagull Fountain. She has three children and is expecting again. She's thinking of doing things differently this time around. She wrote:
I’ve also been thinking a lot about my desires for a more natural labor this time around. I’ve had three children, three epidurals, two inductions, and until a couple years ago, I thought my labors and deliveries were just about ideal. There were no major complications, no forceps or vacuums or c-sections (and my babies were all healthy, no small consideration).

But my epidurals were never wholly satisfactory. Though I usually started with a “walking” epidural, I have a small scoliosis in my spine that makes the numbness affect only the left side of my body until second and third doses are given and I lie on my right side and end up flat on my back, afraid to so much as shift or I’ll fall off the bed, I’m so numb. This makes for awkward laboring.

I’ve been thinking, since following Rixa’s and Heather’s blogs (and even Dooce’s), and researching more about the effects of medical intervention on labor, that I would love to have a a less-interventioned birth. More importantly — a more prepared, educated birth, a more aware-of-my-options and in-tune-with-my-body birth....

In thinking of my previous labors and births, I have felt ashamed that I took so little responsibility for or control over what happened. That I took as much initiative in childbirth as I did in going for a appendectomy at age fourteen. Why wasn’t I more curious to learn about the actual process, more empowered, more determined to experience, more eager to do it well? Why was I so passive? (I am not a passive person usually.)

So I had a stack of books to read and grand plans to see if I could find a midwife (preferably one who would know of a woman who would let me observe her birth — despite being delivered of three babies myself, I really have no idea what a natural birth would look/be like). Or maybe I would just watch Ricki Lake’s documentary and listen to Hypnobabies.

I volunteered my lending library for her. I pulled a stack of books and movies off my shelf and am trying to make it small enough to fit into a flat-rate Priority Mail box. I have a variety of books, from coffee table ones rich with photos, to anthropological examinations of American birth culture, to advice books. I could also send her my Hypnobabies CDs and packet. For someone in Jane's situation, which books or movies would you suggest?

Here's my list of finalists:

  • Baby Catcher by Peggy Vincent: because it's fun and makes you laugh and, most importantly, shows you what giving birth naturally is like. I felt really well prepared for the sights, sounds, and smells of birth after reading her book. 
  • Adventures in Natural Childbirth: this book is an edited collection of natural birth stories in a variety of settings: unassisted, midwife-attended home births, birth centers, and hospitals. I think reading birth stories is an essential learning tool for pregnant women. 
  • Birth as an American Rite of Passage: The classic anthropological examination of American birth practices by Robbie Davis-Floyd. Some of the early chapters can get a bit theory-heavy, so I suggest skimming those if you find your mind wandering. 
  • Gentle Birth, Gentle Mothering by Sarah J. Buckley: This is the older Australian edition. There's a new American edition out this year that is completely updated and has several new chapters. Still, I love this book because Dr. Buckley combines her passion as a mother with her physician's interest in science and hormones. Some of the topics she discusses (lotus birth, elimination communication) might deter a more mainstream reader but I figure Jane has been reading my blog for a few years now, so nothing will be too much of a surprise. My favorite parts of this book are the chapters examining the hormonal physiology of birth. 
  • Birthing the Easy Way by Sheila Stubbs: hilarious, down-to-earth advice from a mom who's been there & done that, from a "physician distress" c-section to VBACs to accidental unassisted home birth. It's funny and real and isn't preachy or pretentious. 
  • Pushed by Jennifer Block: a fast, journalistic expose of our current maternity care system. 
  • Birthing From Within by Pam England. I loved reading through this even before I was pregnant, looking at the various exercises and art therapy Pam England does to help women access their inner knowledge and strength. 
  • Birth Reborn by Michel Odent: lyrical, moving, and beautiful in its portrayal of how to transform birth in an institutional setting. I come back to this text again and again. 
  • Rediscovering Birth by Sheila Kitzinger: a coffee table book filled with photos and illustrations and moving text about giving birth through time and across cultures.

Movies (limited by what I personally own--most have home birth footage. I wish I owned more movies showing natural hospital births, but she'll have to use YouTube for that.)
  • The Business of Being Born: in her case, I'd say watch it mainly for the birth scenes, so you can get an idea of what an unmedicated labor looks and sounds like
  • Orgasmic Birth: probably my favorite because it shows so many different labors and births
  • Waterborn: 3 home water births, home video quality edited together into a 30 minute film. Mothers catch their own babies for the most part. Two of these births are really quiet.
  • Birth Day by Naoli Vinaver Lopez: short, beautiful film of a midwife's third birth, a water birth at home. I love hearing her narrate what she was thinking and feeling as she labored.
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Saturday, January 30, 2010

It's a water birth at home for Gisele Bundchen

My google reader alerts are going haywire with the news of Gisele Bundchen's home water birth last December. She had a water birth in her penthouse apartment in Boston.

And of course there's the breathless reporting of how she's already back to her pre-baby body in just six weeks. People magazine reported: "Only weeks after giving birth to baby Benjamin, Gisele Bündchen is already back to work – and looking hot as ever....the new mom looked radiant, beautiful and as 'in shape as always, six weeks after the birth of her baby.'"

When I was at the gym this morning, I paged through a recent copy of Women's Health, which featured Ashlee Simpson's and other celebrities' secrets to getting your body back after a baby. They all talk about how they love to eat, how they don't stress about losing the weight...and I'm thinking yeah right, there's no way you can go back to your impossibly slim figure without a crazy amount of exercise and food restriction! At least have the honesty to tell us how much effort goes into taming your newly postpartum body back to its former shape and size--one that most American women can't attain in the first place.
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Wednesday, January 27, 2010

Interview with Debra Pascali-Bonaro, filmmaker of "Orgasmic Birth"

I had the pleasure of interviewing filmmaker Debra Pascali-Bonaro about her recent documentary Orgasmic Birth (please see my review of the film if you haven't yet watched it). After you read the interview, please leave comments, questions, or thoughts about the film, the issues it raises, etc. I'd love to hear from you!

Rixa: Please tell us more about yourself and your background. How did you become interested in childbirth?

Debra: I have always had a fascination with childbirth, even from a young age. I was fortunate to have the birth stories of my great grandmother, grandmother and mother all being very positive. At 16 years old, I volunteered to be a candy striper at a local hospital with the hopes that I could see mothers and babies in labor and delivery. They never let me in, and I would always pass the double doors to labor and delivery and linger, hoping I would get a glimpse of a birth. I first went to Villanova University to be a nurse, thinking this would surely allow me to have time with birthing women. I became very disillusioned when I learned about all the techniques and medicalization of birth, and I transferred to education. When I had my own birth experience, I was shocked how hard I had to fight to have the birth I wanted in the hospital, and this began my journey becoming a childbirth educator, doula, doula trainer and international speaker in maternity care.

Rixa: What prompted you to produce this documentary? 

Debra: The vision to produce Orgasmic Birth: The Best-Kept Secret came to me in a dream. I was consciously very upset with the way the media portrayed birth: always an emergency waiting to happen! I had never considered using the media to give a more accurate message. I didn’t know anything about cameras or making a movie but I awoke one night with a vivid dream of making this film. What I needed to do was clear and my quest began to find the people who would work with me to make it happen. I knew I had only six degrees of separation from the right people. I asked everyone if they knew anyone in film. I took some courses and held my vision strong. The right people began to appear, each bringing their time and talents, and Orgasmic Birth was born. There are so many magical stories about how this happened. This experience has literally taught me to follow my dreams.

Rixa: How have your own birth experiences influenced the way you understand pregnancy and birth? 

Debra: I feel very blessed that I have had three wonderful, challenging and rewarding birth experiences. They surely have contributed to my passion to share about all that is possible in birth so that women and men can make informed decisions: where, with whom, and how they want to birth.

Rixa: I would argue that the title “Orgasmic Birth” does not accurately reflect the film’s core message. I also know that the title has kept many women from seeing the documentary. Why did you choose that title? 

Debra: The title has definitely both helped and hindered; but the overwhelming global awareness of the film is largely due to its controversial title. I really appreciate your review; I feel as you do: that the dictionary definition in the broad sense is how the word “orgasmic” is used in our title. Orgasmic is defined as the “intense or unrestrained excitement” or “a similar point of intensity of emotional excitement.” If you Google the word “orgasmic,” it provides examples such as, “a show reaching an orgasmic peak,” and “the chocolate was orgasmic.” People are using the word “orgasmic” in the broad sense and it is used by the media, but the use of the word “orgasmic” with the word “birth,” has created the greatest challenge. I question why we are so comfortable talking about pain and difficulty with birth. Yet we are uncomfortable to discuss that birth could bring feelings of emotional excitement, pleasure, and bliss. Why does this create such a challenge?

Orgasmic Birth was not our original title; our working title was “an ordinary miracle” and our second title was “ecstatic birth.” But these titles were “safe” and would not have created the media coverage or the great discussion that Orgasmic Birth has created. We do realize that there are some people who have not seen the film because of the title. To them we say, “Please, keep an open mind about what is possible during labor and childbirth.” The title has generated an important awareness on the hormones and sexual nature of birth along with the many alternatives to typical cookie-cutter hospital birth plans. It has also brought an increased awareness among women who are pregnant about the services of doulas and midwives and the many benefits they offer to the process.

Rixa: Would you ever consider changing the title?

Debra: To change the title now, in reaction to those who may be offended by associating the words “Orgasmic” and “Birth,” would be caving in to the uninformed. We need to up the discussion about birth in a new way. If we talk about birth the way we always have, we get the same results. And it is evident that our outcomes are getting worse, not better. I heard someone say that the definition of insanity is doing the same thing and expecting different results, so I don’t want a title that fits our current paradigm. I want people to explore their pre-conceived notions, to take risks, and to see the fullness of what birth can offer. I don’t want to offend anyone; I want every person to have all the information they need to make the best possible choice for themselves and their babies. As Roberta Scaer says, “If you don’t know your options, you don’t have any.”

Bottom line on the title though: the film has actually only been out for one year. Looking back, it’s been a challenging year in some ways, but we’ve also had a year of tremendous strides in the field of childbirth education and awareness. As “Orgasmic Birth” becomes more established as an authoritative resource tool, the recommendations and support continue to grow. The increased awareness and familiarization has helped to dispel many of the original negative title-related impressions we experienced. Not that they don’t continue to arise, but we’ve progressed from the common initially posted feedback of “WTF?!” to where virtually all postings are informed, curious and/or complementary. We believe this positive awareness will continue to grow in the years ahead and negative impressions will continue to diminish as recommendations increase from each wave of new moms.

Rixa: Some women have argued that a focus on orgasmic birth is inherently flawed—that what makes birth so rewarding is overcoming an incredibly challenging experience. For example, one blog reader commented: 
My two births were incredibly, incredibly painful from start to finish—and frankly, the pain is what made my births so meaningful. I was incredibly proud of myself for getting through that kind of pain and not giving up and giving in to drugs. If I'd had a pleasurable and/or orgasmic birth experience, I don't think birth would have been as meaningful, empowering or transforming. Kind of "I'm a woman, and I am STRONG!"
How would you respond to her question?

Debra: I would congratulate her and agree we each need to face our challenges. These rites of passage are what help us define our strengths and ourselves. I could not agree more that is the gift that birth holds for us. I would ask her if, with all her challenges/pain, she had a moment of pleasure — would that have really diminished all of it? Could she not have, as many women do, pain and pleasure at different times and still feel a great sense of pride and accomplishment? If another woman faces her fears and challenges and has pleasure too, why can’t we hold both and honor that each of us has a unique journey? I am always surprised how birth becomes a competition among women. Why do we want to hold other woman to our values and experience? This does not honor our unique abilities. Even with one woman giving birth several times, each birth experience will be different and unique. I would like to see us honor all women’s birth experiences: medicated, undisturbed, c-section, and orgasmic. To acknowledge the full spectrum of possibilities and respect each woman’s decision and journey. That was my goal in sharing many different birth stories in Orgasmic Birth as I know when women are respected, supported and allowed to experience birth in the fullest way they want, there is a sense of pride, strength and wisdom that is attainable by all. As Trisha says in our film: "I am so proud and I don’t mind telling the world I am so proud of myself." This is what I hope all women feel.

Rixa: What would you say to women who did not have an orgasmic or ecstatic birth, especially when it’s something they prepared for but did not experience? 

Debra: I would say that you cannot “plan” for any specific aspect of birth...but rather you create preferences, a vision, and wishes. Do your homework. Has your provider supported births like this before? How often? What are his/her rates of interventions? Is you provider offering the experience you are looking for? Many times we have wishes for birth: it is like going out for Italian food, but finding yourself at a Thai restaurant. Find out what things will help you achieve an easier, orgasmic birth – water, a doula, massage, privacy, darkness, touch, etc. – and make sure these are available to you. Birth does not always go as planned, but I hope with support, respect and nurturing it still can be a special, memorable experience. Birth is stepping outside the confines of ordinary knowing, and allowing ourselves to experience the fullness of the moment. I love this quote:
An Ode to Faith
-by Patrick Overter

When you have come to the edge
Of all the light you know,
Into the darkness of the unknown,
Faith is knowing that
One of two things will happen,
There will be something solid to stand on,
Or you will be taught how to fly.
Rixa: Would you say that orgasmic birth is what we should have, or just something that women can experience?

Debra: I think it is a part of the spectrum of possibilities…something that some women experience. As women are reporting to me, orgasmic births can range from 10 – 20% of all undisturbed births. Add to that, descriptives such as pleasurable, blissful…and that number goes higher. I wonder how many more women would have pleasurable births if they knew it was possible, if they were in a safe, secure environment, and if they hired supportive providers. I would never say any woman should have a specific type of birth experience; this is for her to define for herself and her baby.

Rixa: If there was one thing a woman could do to prepare to make her birthing time orgasmic/ecstatic, what would that be? 

Debra: Have confidence and trust in yourself, your body, and birth. Relax and allow yourself to surrender to the sensations just as you surrender to orgasm. It is in the totally letting go that you can find your way to a pleasurable place, an ecstatic, orgasmic state.

Rixa: What role does the location of birth play in facilitating orgasmic or ecstatic births?

Debra: As Ina May Gaskin, the famous midwife says: “the energy that gets the baby in gets the baby out.” I would agree that an environment that you would find safe and satisfying for a romantic evening is the same environment you will open up easiest for birth…so having said that, each woman must choose the place she feels safe, private and can release her fears and give birth. Many women find this in their own homes, or in a birth center. Sadly today, it is the rare hospital that provides this type of environment to help make birth easier. Hospitals focus on controlling and knowing what is happening every minute so they can intervene. This approach to intimacy would not work. If they were observed by strange people and machines, how many women would relax and enjoy their sexuality? It is possible to create an intimate, safe space in a hospital, and I hope that more hospitals look at what they can do to change the atmosphere and approach of birth to one that honors that birth is a normal, healthy function. Providers should be like a life guard: there when needed, but silent and not disturbing when all is normal. Until this happens, it is rare to have an ecstatic/orgasmic birth in a hospital. Many providers who have seen our film are talking about changes they can make in the hospital to help make ecstatic/orgasmic birth possible.

Rixa: Do you feel that the presence of male partners contributes toward or detracts from women's ability to have ecstatic or orgasmic births?

Debra: This depends on the woman and her relationship with the male partner. In our film, you see many very connected men who, by protecting the space, nurturing and caressing, help the women to have pleasurable, satisfying births. Yet I know of some women who shared their orgasmic birth experiences with me and they were alone or with other women. So I don’t think there is a specific way; it is what a woman feels comfortable and safe with. I believe there are many benefits of a genuinely involved male partner in all phases of pregnancy, from the moment a woman discovers she’s pregnant through childbirth. More and more studies are showing a direct correlation between involved pregnancy partners and involved husbands and fathers. Connected partners create stable families together. That connection doesn’t just happen. Partners need to learn how to grow together into effective parents as they transition from being just a couple into becoming a family. Just like motherhood, fatherhood begins at conception too. Thankfully, there are many emerging resources to help prepare men and couples, as well as resources to help women better understand men.

Rixa: Have you witnessed births in which the mother and her partner come away with wildly different perceptions—perhaps the mother felt it was very empowering, while the father thought it was traumatic and scary, or vice-versa?

Debra: With my role as a doula, I find that if this is happening during birth, I can address the woman and her partner/father’s concerns in the moment, support them, and help them with tools so that in the end they are both more likely to feel positive about their experience. Doulas allow everyone to participate in the way that best serves them, while ensuring they have good information and positive communication with the whole care team. So I have to say, I have not had this experience where after the birth they would feel so differently.

Rixa: Here’s a question from a family physician: “What can a birth attendant do to help promote an ecstatic birth for her clients? When interventions are needed (or, as in my fairly mainstream practice, merely wanted), how can we preserve a woman's ability to feel in control and in charge of her birth?”

Debra: Birth attendants can help by creating as much privacy as women want. Knock before entering the room, so that it is her space. The Lamaze Healthy Birth Practices are important to incorporate for having a pleasurable birth. Allow labor to begin on its own, use freedom of movement to labor in positions that are comfortable, give birth upright and avoid unnecessary interventions like IV’s and continuous monitoring. I would also encourage the use of warm water and doulas as an addition to the team.

I would encourage women to submit their birth preference and to discuss them ahead of time so they have realistic expectations of what is possible and what your style of practice is like. We know that when women participate fully in decision-making, they feel more positive about their birth no matter how it unfolds. I would encourage you and your colleagues to provide the time for women to fully understand their options, including waiting, and all the alternatives. Give women time to discuss their choices whenever possible. Providing women a full range of choices in an environment that supports active, passionate birth is a great start in having an ecstatic birth.

Share your confidence in birth and women’s’ ability to have an ecstatic, orgasmic birth. Providers' beliefs can be felt as women in labor feel the attitudes of all around her. How can she believe in herself when a provider she respects appears nervous, cautious and doubtful?

Rixa: What was your favorite part about making the movie? What is your favorite part *in* the movie?

Debra: My favorite part was filming the births and being a part of birth in this new way. As a doula for 25 years I had attended hundreds of birth, but filming and seeing the whole team and birth in this new way was very special for me. I don’t know that I have a favorite part in the movie. Each person and scene has a very special story and place for me. I would have to say the story that I felt was so important to include that I could not have finished the film without was Helen’s. As a survivor of abuse, her story of how birth transformed and healed her is an important part of our film. Birth can be transformative for every woman. For women with a history of abuse, the way they are cared for, respected, supported and nurtured can offer a special opportunity for healing.

Rixa: What kind of issues/surprises did you run into during the film’s creation?

Debra: Not knowing anything about making a film, the whole process was a learning process and one I really enjoyed. It was full of surprises, most good. The hardest part for me was when the film was finished and I realized I had to learn how to market and distribute a documentary.

Rixa: Did you have a clear vision for the film’s narrative and organization before you started filming?

Debra:  No, I wish I did. But in a documentary you don’t know what the film will be until you film and see what you capture. This truly was a film that was created before our eyes as the stories were born. Of course once we had the stories we did have a vision for the overall message we hoped to weave in, and I feel that came through.

Rixa: How do you feel that your crew and equipment, however discreet, affected the births you filmed?

Debra: Since I filmed most of the births myself (and/or another experienced doula), there was just one person present and she really knew birth. I did everything I could not to disturb the birth in any way. I felt we did not affect the births much if at all. I was called a doula by one couple; you may have noticed that in the film. So, by smiling and offering words of encouragement, by expressing my own belief in the magic and sacredness of birth, I feel I did all I could to honor their experience and not let the camera alter the experience.

Rixa: I am intensely curious about what more “mainstream” audiences thought about your film. Please tell us more about the range of people who have come to screenings, and how they have reacted to your film. 

Debra: Our film has shown in 40 countries now and we have had a very broad range of people who have seen the film, from young teens to great-grandparents. Of all the screenings I have attended, I have had so many positive comments and feedback, with very little criticism. Audiences laugh, cry and feel they have witnessed something they have never thought of or experienced. Many people stand up and share their birth stories, both positive and yes orgasmic. Others wish they had seen the film and known more before giving birth so that they would have made different choices. I find it is those who have not seen the film that offer criticism about the title.

Rixa: What has been the most surprising response to the film?

Debra: Most surprising was a room of physicians who cried. They had a long discussion after about reclaiming ecstatic, sacred birth, as that is what drew them to obstetrics and they feel they have lost in the over-medicalization of birth.

Rixa: What is the most common reaction?

Debra: It is hard to find the most common response. I would have to say it is thankfulness for creating a film that challenges our ordinary beliefs about birth. There is always a thank-you for having so sensitively included Helen’s birth story (she is a survivor of sexual abuse). It is a surprise that many people did not expect in the film and yet that moves them deeply. And lastly the question "what is next?" We are scripting our next film and it is not Orgasmic Birth 2. It is about reducing disparities in maternity care, improving outcomes, reducing costs and increasing satisfaction. We are currently fundraising to begin filming in the U.S, Canada, UK and Mexico. If you would like to donate to our next project, please contact me at

Our book, Orgasmic Birth: Your Guide to a Safe, Satisfying and Pleasurable Birth Experience, is available now for preorder. Coming soon we will have a 52-minute version of the film that will be broadcast in many countries around the world. I am dedicated to continuing to bring our message out to help women and men reclaim birth, to let the secret out that birth can be safe, satisfying, pleasurable even orgasmic.

Thank you very much for your questions and for taking the time to share your thoughts and ideas so that together we can improve care and create awareness of all that is possible in birth.
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Tuesday, January 26, 2010

9 months old!

It seems like I just posted Dio's 8 month update...Here's a picture from today.

He can crawl backwards (while trying to go forwards) and in circles. It's the forward movement part he's still figuring out. Eric said he did it today when I was out of the room. He still loves standing up on the furniture and walking around the house holding onto our fingers.

Dio loves to throw things. Balls, of course, but any object will do. If you give him too much food at a time on his high chair tray, he'll happily toss everything onto the floor. A favorite game involves him standing up holding onto the ottoman, throwing little bean bags onto the floor while Zari puts them back up as fast as she can. He also likes to roll a ball back and forth, his legs making a V with mine.

When he sees us eating, he opens and closes his mouth like a fish, smacking his lips. After a period of only nursing while we were all sick over the holidays, he's back to eating with gusto. Today, for example, he had bananas, apples, bread, dried apricots, black beans, and carrots and potatoes from the beef stew we were eating.

Nights are okay. He goes to bed at 7 pm, and wakes up to nurse around 11 pm, 2 am, and 5 am. Then he's up for the morning around 7-7:30 am. Not terrible, although if he spaced out all of his night nursings to 4 hours apart I wouldn't complain. Dio is such a morning person. He's so excited every morning to be awake: he talks, wiggles, plays with the blinds, scratches my face. As soon as I turn to look at him, he lights up with a huge grin. Zari, on the other hand, usually wakes up looking half comatose, blinking the sleep away.

I have pretty much stopped Zari's afternoon naps, so she goes to bed right at 7 pm too. While I like having both kids nap at the same time, I've decided that I like having the evening time even more (if Zari napps, she won't fall asleep until 8:30 or 9 pm). Dio naps twice a day: around 10 am and 1 pm.
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Monday, January 25, 2010

Hypnobabies home study course giveaway!

Progressive Pioneer--a favorite new LDS mama blogger of mine--is hosting a giveaway of a Hypnobabies home study course. Click here to enter.
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Sunday, January 24, 2010

There's a monster in my oven

...and it looks like this:

This loaf of bread rose so vigorously during baking that a "tongue" burst out of the side. Zari thought it was pretty funny. 

 The toy trunk is the place to be.

Zari's new bike, a classic red Radio Flyer. 
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Friday, January 22, 2010

A mouthful of rocks

In the middle of the night I woke up to a strange sound next to me. A grinding sound, like stones in a rock tumber. What was going on? I didn't recall going to bed with a gastrolith!

It was Dio. He had just discovered his new top tooth and he was grinding his upper and lower teeth together. Zari did the same thing when she was about a year old.

I've been blogging much less frequently over the past month because I was working furiously to meet a deadline for an article (about "Attitudes Towards Home Birth in the U.S." for The Expert Review of Obstetrics & Gynecology). I just submitted it last night! It's such a relief not to have that task hanging over me. The article goes out to reviewers, who submit suggestions for revisions. We're on track for a May publication date. I've been corresponding a lot with Amy Romano as I've been writing. She is co-authoring the updated version of Obstetric Myths Versus Research Realities with Henci Goer (forthcoming from the University of Michigan Press in 2011), including a chapter that examines research on home birth. It's interesting to see how we came to many of the same conclusions, independently of each other.

I've also been really busy working on our new multifamily property: painting, purchasing new appliances, choosing carpet and blinds, etc. Of course I never pay full price for things like carpet or blinds. I'm buying the carpet direct from a manufacturer in Georgia and having it shipped here. I hate having to buy carpet--I'm a wood floor enthusiast--but the wood floors in this multifamily property were painted at some point and it's really hard to refinish them if they've been painted. We've refinished floors probably 5-6 times over the course of our marriage and so we're good at it, but we decided just to replace the old carpets with really nice ones. I'm also getting a commercial/institutional discount on 2" wood plantation blinds from Blinds Chalet. They will still be expensive but will look so much nicer that vinyl miniblinds (or the current bare windows). This is fun but it takes a lot of time to research. My goal is to make the property look like a place we would actually like to live in. Then we have to find good renters, which can be a real challenge in our community. Even people who own their homes often don't take care of them.
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Tuesday, January 19, 2010

History moment: empty-headed midwives

Today's history moment comes from Dr. Eucharius Rösslin's wildly popular pregnancy advice book The Rose Garden for Pregnant Women and Midwives, published in 1513. He never attended a birth or even studied childbirth. But that didn't keep him from writing this lovely poem about baby-killing midwives.
I'm talking about the midwives all
Whose heads are empty as a hall
And through their dreadful negligence
Cause babies' death devoid of sense
So thus we see far and about
Official murder, there's no doubt.
Source: Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank by Randi Hutter Epstein, MD. 
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Sunday, January 17, 2010

More milestones

Dio's two top teeth are coming in. We've noticed an increase in crankiness over the past few days, while the teeth are just cutting through the skin. It's the top teeth that make nursing less comfortable for me. One of those markers that infancy is coming to an end.

Dio is almost crawling (and how long have we been saying that?). Now he'll get up into a crawling position,  rock back and forth, then plop back down on his stomach. Pretty soon he'll figure out the forward movement part and he'll be off! He likes to stand and cruise the furniture and walk around holding our hands, so I don't think he'll crawl for long. Zari was exactly the same way: crawled at 8 months and walked at 10.

Zari is now nursing once every other day or so. She'd happily nurse a lot more if I offered, but I don't. Eric has just started putting her to bed every other night. His original plan was to put her to bed every night but it kind of devolved into us trading off every othernight. I still let Zari nurse as part of our bedtime routine. She only nurses for a minute or so before I take her off. I count to 10 to signal it's time to stop. Eric has been pushing me to wean her. He's feeling that she's getting too old to nurse and that she's overly attached to me (and that the nursing is the root of the attachment). I think that the attachment is more rooted in the fact that I'm the primary caregiver during the day. To me, the nursing is less the cause of the attachment than just a manifestation of it. Weaning just seems so final and abrupt. I know that Zari would be very upset if I told her she was done nursing. On the other hand, she doesn't nurse all that much anyway. I limit how long she can nurse, because if I didn't, she'd just keep going for who knows how long, and it's not that comfortable with a mouth full of teeth and a lazy toddler latch. I fully admit that both Zari and I are still emotionally attached to nursing. For me, it's the last part of what used to be an inseparable physical relationship. So the thought of weaning is a big deal and I don't know if I'm emotionally ready for it yet. I don't know if I'm ready to let go yet.
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Saturday, January 16, 2010

At least the pregnancy police said sorry

We've heard the term "pregnancy police" used figuratively, to mean people who try to police pregnant women's behavior with unsolicited advice or admonishment (such as telling them not to smoke or drink or eat certain foods). But one Australian mum recently had a run in with real live pregnancy police, or Pitocin Police as Jill at The Unnecesarean called it. Her hospital wanted her to be induced because she was 12 days post-dates, but she declined since there was nothing wrong with her or the baby. When she did not show up at her scheduled induction, the hospital sent police to her door.
Rochelle Allan, who is reluctant to be induced even though her baby is 12 days overdue, was told by the hospital they intended to go ahead with the procedure when she came in.

But after speaking to her midwife following a visit to the hospital the day before, and being assured her baby was fine, she decided not to attend the hospital the next day.

Now Ms Allan is furious after the two police officers arrived on her doorstep after they were called by Bathurst Hospital.

Wanting a home birth, Ms Allan, 24, has been under the care of a private midwife and had been attending the hospital daily to monitor the baby's health.

"I couldn't believe it when I saw the police officers at my door," Ms Allan said.
"They told me they had been asked by the hospital to check on my welfare because I had not attended.

"The hospital knew I did not want to be induced and they gave me no medical reason why I should be."

Today, the health authorities responsible for the police visit issued an apology. Emphasis mine.
The Greater Western Area Health Service today offered Ms Allan an apology for the unexpected police visit, saying they just wanted to check she was alright.

"We are sorry if it ... caused her any distress but our intention was to check on her welfare," area health spokeswoman Sue-Anne Redmond told ABC Radio today.

The health service denied it was trying to pressure Ms Allan into being induced.
The irony of this last statement is just about killing me.
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Friday, January 15, 2010

Failure to progress or reason to be patient? A birth story

My sister-in-law "Mary" had her baby a few days ago! You might remember her from our post-screening conversation about Orgasmic Birth. She had a really amazing birth, I think. Although she had to deviate from her original plan toward the end, she was able to use certain interventions to positively affect the outcome of the birth. A few highlights from her birth:
  • She was in labor for over 36 hours
  • She was stalled at 8 cms for 12 hours
  • Her birth plan was followed to a T; the only deviations were ones she chose
  • She had a spontaneous vaginal birth, with total support from her midwives, despite the attending physicians wanting to move to cesarean during her long period of "failure to progress." 
I am thoroughly impressed with her caregivers--the midwife practice at UNC.

So here's the story, reposted with her permission. I call it a SBP birth: Successfully Being Patient!


Thanks everyone for the prayers, support, and congratulations. It has been a pretty intense few days and while I am a little sore, I have never been so incredibly happy.

Warning: I am going to tell about the details of Isaac's birth, so if you don't feel comfortable with technical birth terms like "mucus plug" or "cervix", you might want to skip the story to the pictures below.

As Kent mentioned, the entire labor period was rather long. Sunday night [I think she meant Saturday night] I was really achy, so I moved to the couch in the study which is a little firmer than our bed. Around 7:30 am, I noticed a little gush of liquid from my vagina. A few hours later I called the midwife and she agreed with me that it was probably the mucus plug (I know it sounds gross, but this is the real technical term used to describe the material that keeps the cervix sealed so that the baby in the uterus is protected during pregnancy) which usually comes out 2-3 days before people start having contractions.

I clearly was NOT having contractions, so Kent and I went to Church. Since I looked like I had a beach ball in my stomach and people know my due date was on the 17th, we got lots of good luck wishes from people. One of my 8 year old students from the church class I taught last year was so excited about the pending birth, she had announced to her class at school that her church teacher was about to have a baby--she is pretty cute. I now teach the 6-year-old class at church and part of the lesson was playing "Follow the Leader" which invariable involved several variations of hopping. Although a little uncomfortable, I joined in with the hopping but still experienced no contractions.

Later that I night, I had the intense urge to tidy the living room, bake chocolate chip cookies, cook a nice/huge stew for dinner, and finish up some research that I had been working on in the past week and was planning on meeting with my adviser to discuss the next day. I ended up staying up until 1 am to get this done, and noticed some irregular twinges of discomfort in my lower abdomen.

Monday 3:00 am to 7:00 am: I only slept for about 2 hours because around 3 am, I began to have constant contractions, about 8 to 10 minutes apart. I moved to the couch in the living room because I didn't want to wake Kent (which I didn't--he sleeps like a rock). The rest of the night was spent pacing around the living room and trying to rest on the couch between contractions. It felt like just as I was about to drift into a real sleep, the next contraction would hit. I mostly remember that the house was very cold, noticing that the high school students waiting on the sidewalk in the dark for the school bus in the freezing cold at what seemed a horribly early hour, and watching the progress of dawn through the curtain cracks.

Monday 7:00 am- 6:30 pm: Kent finally woke up and agreed that I probably was in the early stages of labor and should cancel my meeting. I felt the strong need to go to Target to get a bathrobe and other things so we went early in the morning before the contractions got stronger. The rest of the day was a blur of pacing around our little house, grabbing on to desks/door frames/sinks, and moving my hips like a hula dancer to help with the discomfort. Because of the age of the house, the floorboards are a little unstable and squeaky in parts, so I am sure our neighbors in the other units were wondering why their floors were wobbling so much. I ate a bowl of cereal in the morning and a 1/4 cup of tomato soup around lunch, but mostly just drank tons of water. As the day progressed the time between contraction decreased and by 6:30 pm, they were occurring about 3 minutes apart and I was having a hard time talking through them so we decided to head over to the UNC hospital!

Monday 6:30 p.m. - Tuesday 1:00 a.m: We got the the hospital and found out I was only dilated to 4 centimeters (full dilation is 10 centimeters) and I was a little disappointed because I thought I would be further along that that. As we walked toward our delivery room, we passed a group of people touring the maternity ward. (Of course a guy said, "Get a chair for the lady!" when they noticed I was in the middle of a contraction. Obviously he has never been in labor because it is much worse sitting still -- or at least it was for me). The irony of seeing the tour group was that we had been signed up to take our tour of the maternity ward that night at 7pm, but instead we came in for the real deal.

We got situated in the room, talked to the midwife on duty and meet the wonderful nurse who would be periodically monitoring the baby and helping us through the night. My goal was to have a natural childbirth with no medication. The nurse and midwife were very wonderful and supportive of my goal and allowed me to not have an IV, agreed not to ask me to rate my pain (I wanted to focus on the positive), and agreed not to ask me if I wanted pain medication as I outlined in my Birth Plan. And then I began my pacing and swaying-it involved a lot of movement which probably used up a lot of my energy, but it was the only thing that really helped me. I tried to sit and rest when I could, but it was only for a few minutes at a time. I found vocalization to also be a good way to deal with the pain--singing parts of songs, saying random vowel sounds, etc. I sounded really weird, but I didn't care about anything other than getting through the contractions. As the night progressed, I stopped vocalizing and was just really really intense and quiet as I focused on getting through one more contraction.

Around 1 am, the midwife checked and found I was dilated to an eight. I upchucked after one contraction They were all sure that I would probably have my baby within the next few hours.

Tuesday 1:00 am - 7:00 am: Kent was so amazing in letting me hold his hand in a death grip, helping me get out of the seat and onto my feet when a contraction hit, and giving me constant positive encouragement letting me know that I was doing well, etc.

Tuesday 7:00 am -11:00 am: At 7 am, there was a shift change which brought in two new midwives and a new nurse. They were really nice and helped me a lot in getting through the contractions. Their help was even more appreciated because the past night had been really draining on Kent. I don't think he realized how hard it would be to see me in pain, but he really did a great job. To make sure he kept up his energy, he quickly ran down to the cafeteria for breakfast. Unfortunately, the exhaustion and stress hit him hard and his stomach rebelled around 30 minutes after getting back to the room. Luckily, the midwives were so involved in helping me cope with the contractions that this allowed Kent to rest a little on the couch to make sure his stomach could get settled. Around 9 am, my dilation was checked again and it STILL was only at 8 centimeters. 8 hours and no progress! Grrrrrrrr.

I decided that it was time to try some of our options and decided to get an IV to make sure I had enough fluid in my body and have my bag of waters broken in hopes of strengthening the contractions.

After two hours, we checked again and no progress. At this point, I was literally falling asleep standing up. I still felt relatively optimistic, but I knew I was exhausted and my body was physically drained. I talked to the midwives and I decided that I would get an epidural so I could sleep and then get some pitocin to help strengthen the contractions and get this baby out!

Tuesday 11:00 am- 5:31 pm: Getting the epidural was fine and in 20 minutes, the contractions were numbed, I could still feel the sensations but not to the point of pain. I fell asleep almost instantaneously. Kent also got some sleep on the pull out bed. The nurse and midwife let me sleep for 3 or 4 hours (I think) and I woke up with so much energy and feeling so happy and ready for the next part. We checked and the pitocin had helped me dilate to 9 centimeters--everyone cheered. Everything started moving quickly at this point and the next thing I knew was it was time to push! The epidural allowed me to feel when I needed to push and how much the baby was progressing, but the pain was minimal. It seemed like we had to wait a long time between each push, but after about an hour of pushing, Isaac came out. We did it! It was so miraculous. They let me hold him immediately and I remember thinking that he felt so soft and warm. I can't describe the awe and wonder of the moment.

The midwives told me after that the doctors all thought I wouldn't make it and were really pushing for me to have a c-section, but the midwives knew I didn't want this and backed me up 100 percent. Apparently there are many places that tend to perform a c-section after 2 hours of no progression in dilation and that letting it go 4 hours is considered liberal. During my labor, I knew it was taking a while, but I had no idea how long it was actually taking because I was focused on each contraction. There was no past, no future, just now. So it wasn't too bad and I am glad I didn't have people telling me they thought I was taking "too long." I took just the right amount of time for me and was very happy with how things worked out.

During the whole birth process and after, I have felt great peace and a deep happiness. We love Isaac so much. I have loved spending this past day with him watching his squashed newborn eyes open and peer around with a look of bafflement, his soft dark hair, being able to comfort him when he cries, and all the other many little things that make him special. He has a talent for sneaking his hand out of his swaddle blanket--like a baby Houdini.

Thank you for all your love and support!

Kent was about to take a picture of me, but a contraction hit so I stopped smiling and he got this instead. You can't see, but I was wearing Kent's huge green boy scout socks because they were so warm. I really know how to dress stylishly.
A few minutes after birth. That is my hand on the left.

He was so perfect.
Isaac's reaction to life outside the womb.

Isaac loves being snuggled by his papa.

Our little Buddha baby almost 19 hours old
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ACOG & AAP positions on place of birth

ACOG & AAP jointly publish Guidelines for Perinatal Care. The first edition was published in 1983, and the 6th in 2007. I was unable to obtain hard copies of the oldest and most recent editions, but below are excerpts from editions 2, 3, 4, and 5 pertaining to place of birth.

The language doesn't change dramatically from one statement to another. Notice the gradual shifts in wording from the 2nd edition to the 5th. Emphasis mine.

2nd: "...the normal physiologic processes occurring within both mother and fetus….Because a significant proportion of patients ultimately attain high-risk status as a result of intrapartum complications, continuous surveillance of the mother and fetus is essential."
3rd: "in regard to the normal physiologic processes occurring within both mother and fetus….Because a significant proportion of patients may experience intrapartum complications, ongoing surveillance of the mother and fetus is essential."
4th and 5th: "Labor and delivery is a normal physiologic process that most women experience without complications….Because intrapartum complications can arise, sometimes quickly and without warning, ongoing risk assessment and surveillance of the mother and the fetus are essential."

Guidelines for Perinatal Care: 2nd ed., 1988, pp. 60-61

In large measure, the patient’s and the family’s perception of the intrapartum experience is determined by information provided during the antepartum period, particularly in regard to the normal physiologic processes occurring within both mother and fetus….

Intrapartum care should be both personalized and comprehensive. Because a significant proportion of patients ultimately attain high-risk status as a result of intrapartum complications, continuous surveillance of the mother and fetus is essential.

The hospital, including a birth center within the hospital complex, provides the safest setting for labor, delivery, and the postpartum period. The collection and analysis of data on the safety and outcome of deliveries in other settings, such as free-standing centers, have been problematic, as documented by a study conducted by the National Academy of Sciences. Until such data are available, the use of other settings is not encouraged. There may be exceptional geographically isolated situations, however, that require special programs.

Any facility providing obstetric care should have at least the following services available:
• Identification of high-risk mothers and fetuses
• Equipment for continuous fetal heart rate monitoring
• Capabilities to begin a cesarean delivery within 30 minutes of a decision to do so
• Blood and fresh-frozen plasma for transfusion
• Anesthesia on a 24-hour basis
• Radiology and ultrasound examination
• Neonatal resuscitation
• Laboratory testing on a 24-hour basis
• Consultation and transfer agreement
• Nursery
• Data collection and retrieval

Guidelines for Perinatal Care: 3rd ed., 1992, pp. 70-71

In large measure, the patient’s and the family’s perception of the intrapartum experience is determined by information provided during the antepartum period, particularly in regard to the normal physiologic processes occurring within both mother and fetus….

Because a significant proportion of patients may experience intrapartum complications, ongoing surveillance of the mother and fetus is essential. The hospital, including a birth center within the hospital complex, provides the safest setting for labor, delivery, and the postpartum period. The collection and analysis of data on the safety and outcome of deliveries in other settings, such as free-standing centers, have been problematic, as documented by a study conducted by the National Academy of Sciences. Until such data are available, the use of other settings is not encouraged. There may be exceptional geographically isolated situations, however, that require special programs. Any facility providing obstetric care should have the services listed as essential components for a level I hospital (Chapter 1).

Guidelines for Perinatal Care: 4th ed., 1997, pp. 93-94

The goal of all labor and delivery units is safe birth for mothers and their newborns. [The rest of the paragraph talks about how the patient should feel welcome, comfortable, and informed, and how family should participate in the birth experience].

Labor and delivery is a normal physiologic process that most women experience without complications….
Because intrapartum complications can arise, sometimes quickly and without warning, ongoing risk assessment and surveillance of the mother and the fetus are essential. The hospital, including a birth center within the hospital complex, provides the safest setting for labor, delivery, and the postpartum period. The collection and analysis of data on the safety and outcome of deliveries in other settings, such as freestanding centers, have been problematic. The development of approved, well-designed research protocols, prepared in consultation with obstetric departments and their related institutional review boards, is appropriate to assess safety, feasibility, and birth outcomes in such settings. Until such data are available, the use of other settings is not encouraged. There may be exceptional situations, however, such as geographically isolated areas in which special programs are required. [no mention of list of facility requirements in this section]

Guidelines for Perinatal Care: 5th ed., 2002, pp. 125-126

125: The goal of all labor and delivery units is a safe birth for mothers and their newborns. [patient should feel welcome, comfortable, and informed, family should participate]

Labor and delivery is a normal physiologic process that most women experience without complications….
Because intrapartum complications can arise, sometimes quickly and without warning, ongoing risk assessment and surveillance of the mother and the fetus are essential. The hospital, including a birthing center within a hospital complex, provides the safest setting for labor, delivery, and the postpartum period. This setting ensured accepted standards of safety that cannot be matched in a home birthing situation. The collection and analysis of data on the safety and outcome of deliveries in other settings, such as freestanding centers, have been problematic. The development of approved, well-designed research protocols, prepared in consultation with obstetric departments and their related institutional review boards, is appropriate to assess safety, feasibility, and birth outcomes in such settings. Until such data are available, the use of other settings is not encouraged. There may be exceptional situations, however, such as geographically isolated areas in which special programs are required.
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Tuesday, January 12, 2010

Four good things

Four good things happened today.
 #1: Guess?

We bought another house! It's a 1900 Victorian that has been converted into a triplex. There's a large 3-bedroom, 1500 sf apartment on the second floor with all of the original woodwork. Downstairs there's a large 1-bedroom 1000 sf apartment and a 500 sf studio apartment. The property is in great shape; it was renovated by a very good contractor in 2004, so all of the plumbing/electrical/cabinetry/bathroom fixtures are new. We've been looking for a rental property for a very long time now. Every other place we've lived, we've always had some sort of rental property along with our own house. We were extremely depressed at how awful rentals are in this town. I have never seen such trashy, dilapidated places ever in my entire life. No exaggeration. Until we found this one. It sold in 2004 for $140,000. We bought it on foreclosure for $52,000!

The apartments are in move-in condition (except for some normal cleaning) but we want to make them even nicer. We're going to replace all of the carpets, which are in okay shape for being 5 years old, but they are ugly brownish-gray berber that just screams "rental!" We thought of refinishing the hardwood floors underneath, but at some point they were painted. And paint gums up the refinishing equipment. So I think we'll just stick with carpet. We bought all new appliances for the apartments, since there were none provided. The upstairs has stainless steel. I'd like to repaint all of the apartments in rich, warm colors. The walls are fine, but they're boring rental white. I hate white walls.

The wine bottle from our realtor made me laugh, because we don't drink alcohol. But I cook with it, so it will be put to good use. Perhaps coq au vin...? 

#2: We went to the children's museum today and the kids had a blast.

#3. My brother-in-law, who has been unemployed for about a year and a half, just got a job offer today! We are so happy for him--he has five children and has been very stressed trying to make ends meet and make their mortgage payment, etc. I am sure too many people in this economy know exactly what he's been going through.

#4: Another brother-in-law and his wife just had a baby boy this evening! She had a very long labor and I don't know many more details at the moment, but we are so thrilled to hear he has arrived.

So today is a day for lots of smiles. Zari and Dio agree. 

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Monday, January 11, 2010

Vertical birth beds

My last post about the Borning Bed reminded me of a correspondence I had a few months ago with an assistant dean at a large state medical college. He wrote to me:

"I received a request from a public hospital in Peru for a vertical birthing bed. Might you direct me to manufacturers etc. who could help me?"

This was my reply:
I'd love to help out with this.

Two major birth bed manufacturers in the US are Hill-Rom and Stryker Adel. Neither of them are made specifically for vertical birth. However, both of them have squat bars that attach to the bed. If you raise the head of the bed all the way, the woman can kneel backwards, draping the top of her body over the back (see page 4 of the Adel brochure, for example). Still, these beds are mainly used for the typical on-the-back delivery positions. The Ave birthing bed is similar, but I've never seen it used here in the US. Again, it's mainly designed for on-the-back or reclined positions with the legs up, but can be adapted for squatting, hands and knees, or kneeling positions.

Frankly, a fancy bed isn't necessary--and in fact it's a bit of an oxymoron--for upright or vertical birth. The very point of birthing in upright positions is that you aren't lying in a bed. Instead of needing to buy specialized equipment for vertical birth, the hospital will only need to invest in inexpensive, simple devices that facilitate being upright (which can include hands & knees, kneeling, sitting on a birth stool, squatting, or standing). You can also use an existing bed in creative ways, as this handout illustrates. Some simple tools or equipment for upright birth might include:
  • railings or bars mounted on the walls in various heights, to assist with squatting
  • a high surface to lean the upper body on while standing up (such as a countertop, elevated bed, etc)
  • birth balls (also known as exercise balls or yoga balls--large inflatable balls used for sitting on or leaning over when kneeling)
  • a birth stool (such as the deBy birth stool designed by a Dutch midwife or this wooden birth stool with handles)
  • mats or cushions for kneeling on
  • knotted rope mounted from the ceiling, for the mother to hang onto while standing or kneeling
  • large, deep tubs for laboring or birthing in. Some hospitals in the States have installed permanent labor/birth tubs; others use inflatable tubs such as the La Bassine or Birth Pool In A Box (these tubs can be reused if you purchase the disposable liners)
Training the hospital staff will be a much more important task than buying a special bed. The doctors, nurses, and midwives will need to know what upright birth looks like and how to encourage and support women giving birth in upright positions. I'd be happy to talk more with the hospital about this (if someone there speaks English--my only foreign language is French). I have personal experience supporting women as a doula and a midwife's assistant in both hospital and home settings, and most of those births have been upright. I also gave birth to both my children either kneeling or squatting.

I could also know physicians who are used to doing vertical/upright births even when women have epidurals. This takes some practice, since you have to know how to move all the wires and tubes the woman is connected to when she has an epidural, as well as how to support her when she has minimal or no use of her legs. Perhaps the hospital would be interested in talking with them?

Anyway, this has been a long answer to a short question! Let me know if I can be of any other assistance.
 I haven't heard anything back from him yet. I hope the information was useful for the hospital in Peru. Anything else you would suggest for a hospital wishing to implement vertical/upright birth?

ps--to see how vertical births look in one Peru hospital, watch the video and slidehow that accompany the article Peru embraces vertical births to save lives. It's definitely an intimidating, clinical environment in these images--but at the end of the day, all you need is a place to kneel down and something, or someone, to hold on to.
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Friday, January 08, 2010

The Borning Bed

I came across this lovely ad from a 1983 issue of the Journal of Nurse-Midwifery. Doesn't it make you just want to go an experience physiologic childbirth, the Borning way?

Text from the ad reads: 


When we introduced the first contemporary birth chair/childbearing bed, obstetric care was revolutionized.

Borning beds replace separate labor beds, transfer stretchers, birth chairs, delivery tables and recovery beds. Hospitals can now provide safe, comfortable and physiologic childbirth for all families - and at substantially less cost than with the standard OB system.

Borning’s comprehensive care system is labor- and cost-effective. It’s safe and practical. And it’s what modern families want.

Borning makes it all possible with a complete product line for both high- and normal-risk obstetrics and a host of safety and convenience features you won’t find anywhere else.

As you plan to equip your hospital for today’s and tomorrow’s OB care, speak to Borning first. Our experience with over 1,000 hospitals is yours for the asking.

Almost as good as this new birthing-pod from Ave. I can almost see the bullets babies shooting out rapid-fire. Nurse: "Ready, aim, push!"
Doctor: "I hope she doesn't have triplets."

Photo courtesy of Jill at The Unnecesarean.
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Wednesday, January 06, 2010

Free webinar on cesarean scar care

A message from ICAN president Desirre Andrews:

Dear friend of ICAN,

I am very excited to announce our January educational webinar, an online session presented by physical therapist Isa Hererra and intended for anyone who wants to learn cesarean scar care techniques. Whether you are a mom or a health care professional, I encourage you to join us on January 24th at 9:00 pm EST (see below for other time zones) for this fantastic session!

Cesarean Scar Care in the Post-Partum Period

Presented by physical therapist Isa Herrera, MSPT, CSCS, Clinical Director of Renew Physical Therapy in NYC, this great online session will teach and guide you through the basics of cesarean scar care in the post-partum period.

This much-needed class is geared toward new moms and healthcare professionals alike who are looking to understand and implement some real-world techniques to get relief from pain, itching, burning, tingling… and also learn how to restore the abdominal muscles and posture so that you feel like yourself again.

Much of the great material to be included in this webinar is taken from Isa’s new book, Ending Female Pain, A Woman’s Manual. The book has been endorsed by filmmakers Ricki Lake and Abby Epstein, Dr. Jacques Moritz, and most recently by Jill Osborne of the IC-Network and NY Times best-selling author and gynecologist Dr. Christiane Northrup.

Highlights of this webinar include:

  • Understand how to locate scar adhesions and why they are so important to eliminate
  • Learn mobilization and massage techniques for cesareans
  • Restore abdominal function after cesarean with safe abdominal exercises
  • Learn the connection between Diastasis Recti and low back pain and pelvic pain
  • Learn simple yoga stretches for indirect scar mobilization during the early post-partum period

Date: Sunday, January 24, 2010
Time: 9:00 pm EST

Other Time Zones
U.S. Central 8:00 pm
U.S. Mountain 7:00 pm
U.S. Pacific 6:00 pm
Buenos Aires 11:00 pm
GMT - Thursday, January 28 2:00 am
Rome - Thursday, January 28 3:00 am
Istanbul - Thursday, January 28 4:00 am
New Delhi - Thursday, January 28 7:30 am
Tokyo - Thursday, January 28 11:00 am
Canberra - Thursday, January 28 1:00 pm

This webinar is free to ICAN subscribers. If you are not a current subscriber, you may subscribe or renew through the ICAN Bookstore or through your local chapter to attend this and future ICAN webinars for free.

Childbirth Professionals: 1.5 contact hours through ICEA have been applied for. ($5 administrative fee)

Click here to register:


Desirre Andrews
ICAN President
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Tuesday, January 05, 2010


Zari, Dio, and I are all sick (deep, racking cough and fever). So all I've been doing for the past few days is hold sick kids in my lap, read them stories, and nurse. Dio has been exceptionally snuggly and doesn't want to be put down. Just hoping we all feel better's no fun not being able to fall asleep till 2 am because you're coughing so much.

A few things that caught my attention:

Speak up at the NIH Consensus Conference on VBAC this March. Amy Romano at Science & Sensibility discusses some of the issues that will be on the table.

It's Turkey Time--aka time for the Second Annual Turkey Award from the Well-Rounded Mama. This year's award goes to Abe Sauer's article "Fat, Fetuses, and Felonies." You'll be astounded at the outrageous statements Sauer makes about overweight pregnant women.

A lovely unplanned home birth on Christmas Eve. Her father, a family practice doc who does OB, was there to catch the baby. My little sister knows this woman (or of her, at least; they went to the same congregation in Cambridge before she moved).

Sheila Kitzinger discusses the problem with "fairytale expectations" of birth.
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