3 Doulas

Rememberance of Things Past

By Jenny Gillespie

 

Some of us have read Marcel Proust's Rememberance of Things Past.  For the author, the link to his childhood was the smell of baked "Madeleines"....

 

A pheromone (from Greek phero "to bear" + hormone from Greek "impetus") is a secreted or excreted chemical factor that triggers a social response in members of the same species.  Pheromones are chemicals capable of acting outside the body of the secreting individual to impact the behavior of the receiving individual.

Taken from Wikipedia

 

As a labor support doula and childbirth educator, one of the things I remind my moms and dads about is the importance of relaxation and deep breathing during labor. 

Well, I learned something recently while I was at a birth:  The importance of pheremones and the magic of smell.  This is what happened:

Mom had been in labor on and off for two days and, when we arrived at the hospital in the middle of the night, she had been experiencing contractions every 5-6 minutes or so.  The "slow deep" breathing had worked very well for her up until then.  When we were still home she rested, ate small meals, took a shower, and sat on the birth ball.  She had been inhaling deeply and slowly exhaling, moving and rocking. She was in a groove. 

Once she was admitted to Labor and Delivery, her contractions picked up.  She grabbed her husband and brought his face close to hers and said: " Breathe with me." As he moved in close, she buried her face in the crook of his neck, and began to breathe in deeply.  With every breath she took, I could see the tension releasing.  Every time she smelled her husband's skin, she was more at peace, more confident, more relaxed.  When each contraction subsided, she would slowly open her eyes, focus on us, and smile. "Wow" she would say, "That felt great!"  With each new contraction, she would reach for her husband and hug him tightly,  breathing in his smell.  Her labor continued, and with each contraction that passed, I would remind her she was one contraction closer to meeting her baby.

There is a rhythm and ritual that women work out during their labor and I witness this with every birth that I attend.  With this birth, the simple act of smelling her loved one made this mom feel safe, secure, and in control.  It was a beautiful sight.

 

 

Book Give Away at Enjoy Birth!

By: Mandy Schutt

One of my favorite bloggers, Sheridan Ripley (fellow Hypnobabies instructor and doula in OC!) is offering a book give away for birth professionals...and boy is this a book birth pros need! It was written by an amazing doula in Tennessee, who is making big waves in the birthing scene there. "Keep The Fires Burning" gives tips for birth professionals to avoid burn-out...and if you have been in this field for any length of time, burn out- be it on a grand scheme or small scale- has likely reared it's ugly (and tired!) little head!

Check out her give-away if you are a birth professional interested in this great read, and if not, please still check out www.enjoybirth.com , because quite frankly, Sheridan has got a whole lotta good going on there. (Including links to another blog she has put together with over 250 birth stories! Hello!? What mom doesn't need THAT!?)

 

 

Ina May's Books: Betcha Can't Read Just One!

By Mandy Schutt  

I picked up my first Ina May book back when I was just learning about birth and wanted to become a doula. The title of the book was, Ina May’s Guide to Childbirth. It was a treasure trove. May wrote about the raw, magnificent beauty of birth, in particular natural birth. She wrote about the physiology, chemistry, and anatomy of birth. She had this Biology flunk-out drawn into her pages as I’ve never been before. She was brilliant and passionate and I wanted to know more!

What makesIna May’s books so great is not just the scientific and historical aspects of her writing but the fact that she includes real birth stories in her books. They aren’t gussied up by ghost writers or edited to literary perfection, they are written by every day women, some who write well and some who just write with sincerity…it doesn’t really matter because as a reader you can see their stories unfold. Seeing these births in the mind’s eye is an incredibly powerful experience for western women who have, for the most part, seen birth as a certain way (screaming, painful, traumatic, a means to an end, doctor dominated, fearful, etc.) and have come to believe that this sort of birth experience is an inevitable part of becoming a mother. We NEED positive birth stories in this society.

Since that first life-altering Ina read, I’ve had the opportunity to read her other books, and even voyage to Tennessee to see the infamous “The Farm” with my own two eyes. One of my dearest, oldest friends is now receiving prenatal care at The Farm and will birth there this coming July. The Farm is a community that dates back to the early 70s when a group of hippies (Ina May included) bought a parcel of land and decided to live there together. Ina May was an English Major, with no medical training. She tells of her midwife metamorphosis in more detail in her first book, Spiritual Midwifery (first published in 1977 and peppered with terms like, “far out”, “psychedelic” and many a reference to "aura color"). She caught her first baby with the help of a pocket guide and quickly realized two things: being in the presence of a birthing woman was indeed a spiritual experience and she really should try to learn more about birth than what was in the contents of her pocket guide. And so she did…years later Ina May became a CPM (Certified Professional Midwife), wrote five books, teaches OBs and midwives across the globe, has developed the “Gaskin Maneuver” to aid babes with shoulder dystocia, appears in many well-known documentaries, is known as, “The Mother of Authentic Midwifery”, and still runs a birthing center on The Farm with a--- wait for it--- cesarean section rate of under 2%.

Wha? Huh? Come again?

Yes, that’s right under 2%.  (The national average for low-risk mothers is around 20%.)

Ina May’s newest book, Birth Matters, which she was working on when I visited The Farm, two summers ago, has now been released. As I read through the first few chapters, once again I am drawn to her words with deep passion and awe. Gaskin has written this book specifically for modern mothers of today- we who have grown accustomed to technology and fearful of natural birth.

If I had a nickel for every women that I have spoken to who said,

“…and then I read this book by Ina May.”

Or

“…but that all changed when I read this one book by Ina May.”

In truth, sometimes I have more than a nickel, because her books have challenged so many expecting mothers to become educated, supported, encouraged, liberated; which often leads them to me in search of a childbirth educator or doula.  I just sent my sister, “Ina May’s Guide to Childbirth”, she’s 19 weeks pregnant. When someone asks me for recommendations of a good pregnancy read, I always send them to Ina May, after all she’s sent plenty of women to me!

If you’re pregnant or want to be pregnant some day or if you are just curious about the hows and whys and ifs of birth in general, check out Ina May’s Guide to Childbirth or Birth Matters. Regardless of how little or how much you know about birth, Ina May’s books are an mind-opening delight.

Ina’s first name is pronounced “eye-nuh”. She's now in her 70s and fantastic as ever! For more Ina info, see: Ina May's Biography, The Farm Midwives, Ina May's Safe Motherhood Quilt Project.

 

When Should I Stop Nursing My Baby?

By: Mandy Schutt

 

My daughter is eighteen months old and is still an avid breast feeder.

I’ve lost track of how many times I’ve been asked,

“Are you still nursing her?” ("Yep!")

“How long do you plan on doing that?” (“Until it stops working for either one of us.”)

“Aren’t you afraid she will nurse until she’s in school?” ("Nope.")

I'm all about parental soul searching, and that almost always means-especially for us western mamas- attempting to slough off cultural opinions and expectations and deciding what is best for us as an individual.

While most of us are aware that breast is best, the question often still remains, “But for how long?”

 The American Academy of Pediatrics (AAP) recommends that breastfeeding continue for at least 12 months, and thereafter for as long as mother and baby desire. The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond. What us Americans consider “extended nursing” is, in truth, just the norm in many other countries.

My personal take as a someone who is pretty well educated on birth, breastfeeding, babies, and- possibly even more importantly- been exposed to breastfeeding relationships in many, many other countries is: "What's the rush?"

…BUT then again, I'm one of those crazy nuts who believes that there is really nothing we need to "train" our children (aka baby mammals) to do. I believe by the default factor of being animals, we instinctively know a heck of a lot more than we, as intellectual beings, give ourselves credit for. Do we need to socialize our children so that they learn things like manners, language appropriate for various settings, sharing, and all that jazz? Of course we do, but in my mind “training” and “socializing” are two very different things.

I also think that, for some reason when it comes to nursing, we polarize our children. We find it acceptable for a child to learn to walk anywhere between 10 and 16 months. One 1yr old might have a very extensive vocabulary, while another child says nothing at the same age. In the same way, some children show clear signs that they are done with the breast at around a year while others don’t show those signs until they are toddlers.

Whenever I work with a client who consults me on a parenting issue they are struggling with, one of my first questions to them is, “Why do you believe that is or is not the right thing to do?”

Their response to that usually answers their own question…and the trick is that there is no right or wrong answer! For example, to the question of how long a mother should wait to wean, one mother might answer,

“I believe it’s the right thing to do now because I’m exhausted all the time and am beginning to really dislike the chore of breastfeeding my baby.”

While another might answer:

“Because my mother used to make fun of women who breastfed their toddlers, so I've always thought it was the wrong thing to do.”

While yet another might answer:

“We both still enjoy nursing so much but I’m I'm worried my baby will want to do it forever!”

You can imagine that there may be a very different “correct” path the above answers would lead a mother to take! Is one mother “more right” than the other? I don’t think so. My choice has been to allow my daughter to self-wean. I reserve the right to change my mind at anytime should something in my life change and create a need for us to close out breastfeeding relationship.

 Here is what Dr. Sears says on the subject of self-lead weaning:

Weaning is not a negative term, nor is it something that you do to a child. Weaning is a journey from one relationship to another. The Hebrew word for wean is gamal, meaning "to ripen." In ancient times, when children were breastfed until two or three years of age, it was a joyous occasion when a child weaned. It meant the child was filled with the basic tools of the earlier stages of development and secure and ready to enter the next stage of development. A child who is weaned before his time may show anger, aggression, habitual tantrum-like behavior, anxious attachment to caregivers, and an inability to form deep and intimate relationships. We call these traits diseases of premature weaning…

Former Surgeon General, Dr. Antonia Novello, proclaimed: "It's the lucky baby, I feel, who continues to nurse until he's two." A baby's sucking need lessens sometime between nine months and three years. The age at which this need lessens is individual, yet very few babies are emotionally filled and ready to wean before a year. Have confidence in your intuition.

 Full article here.

For my daughter, nursing is still a very important comfort measure. She is an inquisitive, happy toddler and loves to explore! Often this exploration leads to tumbles, scrapes, and tears. Other times it’s just plain old exhaustion that sets in and causes her emotions to fluctuate. During these tough times, she wanders back to mama for the comfort she finds through nursing. Additionally, breastfeeding has provided me with an unequivocal tool for solving my baby’s problems. Does she need a distraction? Hungry? Bored? Feeling overwhelmed? Sleepy and cranky? My breasts continue to be a solution for all of these sorts of scenarios.

I’m thankful that my body still provides my child a safe place to center herself and “reset”. I am okay with using my breasts as “instruments of peace” so to speak! Until my child is verbal and cognitively developed enough for my words and touch to do the same thing that my breasts do now, (and maybe even beyond, though I will need to assess that when the time comes) I feel that the choice to continue nursing is the perfect one for me. My milk provided her with essential nutrients in the first year and now they provide her with essential emotional comforts. Is this not just as important?

I admire any mother who will take the time to question the societal pressures of parenting and standardized expectations to do some real soul-searching on issues such as extended breastfeeding. There really isn’t a wrong or right answer; there is just a personal answer. You know your child and yourself better than anyone! When you allow yourself that truth, decisions like the one about when to wean, become a whole lot easier!

Why I Love the Dads and Support Partners!!.

 

By Jenny Gillespie

 

 

I am a certified childbirth educator.  I teach private classes, group classes, I volunteer at a pregnancy clinic and also at a maternity home in my neighborhood in Venice, CA. Once a month, on a Saturday, I teach an all-day intensive class in a hospital in Orange County. 

I have been a labor support doula for over 10 years now, and am new to formally teaching, but i really love it.  I especially love the dads and partners who accompany women to these classes.  At times they find themselves out of their comfort zone, as the topics are not necessarily beer-in-hand conversations.  But at the end of the day, dads-to-be and partners leave the class with a new-found respect and admiration for the women carrying their babies.

My all day intensive in the OC is long.  It lasts from 9:00 AM to 4:00 PM, and i cover all aspects of labor and delivery.  About 12 to 14 couples attend these classes.

The class is set up in a U shape, and in the back of the room is a long table with juice, water, coffee, tea, bagels, and muffins.  Upon their arrival, couples look a little apprehensive as they case the room, and the funny thing is that every time it's the same scenario: the early birds always sit as far away from me as possible.  The front seats  remain free until the last two couples have arrived, and then the dads have this horrified look on their faces as they realize they will be seated right in front of me!

As an icebreaker, after i have introduced myself, I have each couple introduce the couple seated next to them.  I give the class about 5 minutes or so, to get acquainted, and then we go around the room.  It's the most fun of the whole day: the room buzzes with "hi, I'm John and this is my wife Kathy," or "no way! That's our same due date!"  I hear "wow, a girl! How cute! Her name is Desiree?  Aaawwwww."  The room feels warmer, more friendly, almost comfortable.  We make a tally of how many girls are expected, how many boys, and how many surprises.  The first topic is GBS testing (first letter in girl, boy, surprise!).

In class, I cover the labor process, pain management techniques, breathing and relaxation, and i show a movie or two.  Some topics leave little to the imagination.

At first, there is a short anatomy lesson.  We fill out a diagram and go over the important stuff:

• How women's breasts get larger in preparation for lactation (faces redden a little)
• How the uterus grows ("wow, it gets THAT big?)
• What is a cervix (can i use it in Scrabble?)
• The birth canal (AKA the vagina)
• Why there is the mucus plug.  Collective gasp from the dads.  "The mucus what?"  The shy Dad in the back of the room slowly raises his hand, clears his throat, and asks, "hmmmmm...so what do we DO with it?" "Noth
  ing," I reply, "just flush it."  I tell the class it can be released when there is cervical change.  Some women see it, some women don't.  The whole room breathes a sigh of relief.
• What happens to mom's bladder "It's definitely compromised," I say.  "No kidding," responds a dad, who looks around and adds, "whenever we go anywhere, she's already already checked out where the rest room is."
• I finish up with the rectum.  I mention that a sign of pre-labor could be diarrhea.  The bowels empty in preparation for the birth of the baby.  "The pushing part of labor," I continue, "feels like pooping out a grapefruit."  "Oh, no!"  Noses wrinkle, moms look embarrassed, dads cough and look at the ceiling, and everyone's position shifts a little. 

Ok.  Break time

After the lunch break, the couples come back revitalized, and we go over breathing and relaxing techniques.  I will also have birthing scenarios and will often get a volunteer dad to help me out.  The reason why I love the dads and partners so much, is that they earnestly participate in the class.  They start out a little shy and reluctant to jump in, but by the end of the day, they are way more open, eager to practice the breathing and relaxation, and leave high-fiving and congratulating each other!  I love it!

 

 



 

 

 

Why Taking Your Hypnobabies Childbirth Education Class Early Is A Smart Move

By: Mandy Schutt

 

Many times expecting moms begin researching their childbirth education options toward the beginning of their pregnancy expecting to enroll in a class that is close to their estimated due date (I like to call it a “guess date” since it’s a pretty general date. First time moms go an average of 8 days past their given due date!)

So, as a Hypnobabies instructor, I often receive calls and email from moms who are looking to enroll in a class that is in the almost distant future. This is a great plan for a lot of childbirth education courses but Hypnobabies is a little different.

 

Why? Well, there are several reasons why it might be best to take a Hypnobabies Childbirth Hypnosis class earlier in one’s pregnancy but I’m going to address two of them here.

1. The Hypnobabies Childbirth Hypnosis class consists of six wonderfully dense classes that are simply jam-packed with childbirth education. To name a few: pregnancy nutrition, cord-clamping issues, care provider choice, medications used in childbirth, partner support, doulas, newborn appearances, breastfeeding, skin to skin contact, and many, many more. For a more extensive list of topics covered, click here.

 

With all of this new information available for new moms and dads to further research and study, some parents actually discover that their birthing plan begins to change a little (or a lot!) and taking the class early allows them to arrange these changes in a timely, non-stressful manner.  For example, parents will learn in class about what a doula does and may be interested in hiring one for their birth. Taking the class early on would allow time to interview several doulas and choose the one that best fits their needs and personality. After learning about cord clamping parents may want to discuss this thoroughly with their care provider to see where she stands on the issues and then include their wishes on the birth plan. After learning about the importance of choosing a care provider that you feel comfortable with and who supports all your birthing wishes parents may choose a completely different care provider. Taking the class early and making changes early can eliminate a lot of hassle with medical institutions and insurance companies.

 

2. An important element of Hypnobabies that is not offered in many other childbirth education courses is that of hypnosis. When one begins to understand how hypnosis works and how well it works when practiced consistently, it’s easy to see why taking the class earlier in pregnancy can be extremely beneficial. Imagine knowing that you are going to run a marathon in six months. You wouldn’t wait until the very last minute to start training, you would start as early as possible to prepare for the big event knowing that the stronger your body is when you run the marathon, the easier it will be for you. This is similar to how hypnosis for birth works. The stronger the mind is, the easier it will be to use on your birthing day. Having time and dedication to practice hypnotic concepts after the six week Hypnobabies course has finishes is very beneficial indeed!

 

We've Come a Long Way Baby... The coping scale

By jenny Gillespie

 

This is the continuation of my last post:

Ok... so a lot of things have changed, some have not. 

 

 

Then: Nurse enters labor room with her trusted clipboard:" Hi sweetie, I am back..how's your pain level on a scale from 1 to 10?  1 being no pain and 10 being the worst pain ever?

Now: The nurse has been furiously typing on her computer for a while now and right after asking what you ate for lunch looks up with a concerned look and asks "how's your pain level on a scale from 1 to 10?  1 being no pain and 10 being the worst pain ever?"

Mom: (Both then and Now):  Looks up after a slow, measured breath: "Well, I don't really know. What do you mean?  Is it going to get worse? And what else is in that cute closet over there the one with the Chux pads and extra gowns (the nice, old, faded vintage ones)? Got any leather straps I could bite down on?"

Ok back to the pain scale.  On a scale from 1 to 10 how's the pain? etc etc..Every delivery room nurse asks that same question.  How arbitrary is that? 

Some delivery rooms actually have a cartoon-like poster attached to the wall with a cute lady's face.  The pain scale goes something like this:

1 her face is yellow and she's smiling

2 her face is orange and she's looking a little surprised

3 her face is greenish and she is looking blank

4 her face is blue-ish and she is frowning

etc..

10 her face is red, she is crying, and smoke is coming out of her ears

Nurse: goes back to her typing, after mom has had two back to back contractions that needed all of her concentration and support from her partner and her doula. She asks the same question again: "Your pain, sweetie... on a scale from 1 to 10?"  Mom asks:" Well how bad is it going to get?  If this is already painful, what's in store for me?"

Nurse: looks concerned and says:"Ok.  Let's say it's a 5.  Is that OK?" 

Mom: "Ok. Sure, why not.  It's a 5" and she takes a slow deep breath.

In my opinion it's not about the pain scale, it is about the coping scale.  On a scale from 1 to 10: 1 mom is coping well and 10 she is not coping at all. 

This is when labor support is crucial.  Women are much more able to cope with their contractions and with the challenges of labor if they have constant companionship.  A labor partner is there to ensure that mom takes each contraction one at a time, that she relaxes in between the surges and that her needs are met.  The fear-tension-pain cycle makes the labor more painful.  The more a woman is afraid, the more tense she is, the more painful the contractions feel.  With labor support, a woman is better able to cope.  As she copes, she will relax, as she relaxes, she will move and sway rhythmically, lessening the challenge of her labor.

By predicting the laboring woman's needs, protecting her space, and keeping the environment peaceful and quiet, a labor doula will help mom to cope.  The doula will ease mom's fear, mom will feel a lot less tense, and her pain will be more manageable.

 In short, it's all about coping!  I was at a birth just last week, and as mom was pushing with each surge, the nurse actually asked her: "So how's your pain level",  we (mom, her husband, her doctor and I) all gasped... and no one said anything.

We've Come a Long Way baby

By jenny Gillespie

Ok, so most of you reading this probably don't remember ever seeing the slogan for the Virginia Slims add campaign: "You've Come a Long Way Baby!".  Well that slogan comes to mind when I think of how far hospital births have come.... 

Gone are the days when newborns were whisked away from their mothers and taken to the nursery so that mom "can rest".  Babies would inevitably be brought back to mom with a tell tale milk mustache, and I am not talking breastmilk!  Twenty five years ago, the nurseries were packed with babies all lined up by the viewng window so that proud dads could show off baby to visiting family and friends.  Today the nurseries look deserted, they are quiet, why?  because baby is with mom, where she belongs.

Gone are the days...

Ok, I am jumping ahead of myself here, I want to go back a step to Labor and Delivery.

Twenty five years ago, when my first baby was born the delivery room was a very different place from what it is today.  A lot has changed since then, and as a doula for over ten years I welcome those changes..Things aren't perfect, but they are much better!

Some differences between then and now:

Then..If I"d hired a doula, the nurse would have told her to wait in the parent's lounge!  "It's too crowded in here! mom doesn't need you, I am here, I have done this for 30 years, she's in good hands"

Now.. "Oh I see you have a doula, hi there! let me show you where the ice machine is" (some things will never change).

Then..If I had given the nurse my birth preferences (typed up on my manual type writer), her response would have been :" Pffft, you don't need this, I KNOW exactly what you need, now hop into bed and be a good girl, I'll be right back with the enema..."

Now.. "Ok these are your preferences right?  Let's go over these together"

Then.. The nurse's response to my tentative attempt at bending the rules: "walk around, oh no no that is absolutely out of the question... a shower, well our delivery rooms don't have those, you should have taken one at home"

Now.. The response goes something like " Let's see how everything goes...Does dad have trunks?  We don't like seeing naked dads around here!  too scary!!"

Then.. The nurse takes baby and says: "I'll be right back with a clean, nice smelling baby!"

Now.."Congratulations Mommy, let's put this little one on your chest, skin to skin is the best thing for both of you"

Anyway the list goes on..But some things don't change... Check in tomorrow to find out what habits are hard to break!!

 

 

The Unconsidered Risks of C-Sections

By: Mandy Schutt

I love cesareans! I mean it, I really love them. I appreciate that they can be done today when a hundred years ago, mothers and babies were dying for reasons that can now be solved by a common procedure. Along with cesareans, I love triple bypass surgery (this procedure saved the life of my grandfather), kideny transplants (this procedure saved the lives of two of my young students when I was an elementary school teacher) and I even love oral surgery (I've assisted with several of these  when doing aide work abroad and seen how much relief they can bring). So, yes I will proudly state that I am a fan of the cesarean.

Here's what I'm not a fan of: The fact that today in America one out of every three births is a surgical procedure. The World Health Organization recommends that the cesarean rate in industrialized countries should be between 10 and 15%. The newest studies find that we are just about doubling that.

What I'm even less of a fan of is how we as a society have bitten into this as being acceptable. Imagine finding out that the rate of kidney removal was double what it should be: wouldn't we ask questions about why this is happening, who's making money from it, and how the problem can be fixed? If double the amount of kidney surgeries were being performed that cut open and manipulate a persons' insides for no reason, we'd be outraged! We'd hopefully be suspicious going in for a routine physical and hearing from our doctor that kidney surgery was necessary. Wouldn't we start doing research? Get a second opinion?

Of course, kidney transplants are extremely necessary in some cases, much like cesareans, but wouldn't we want to be 100% certain of this necessity before we went under the knife?

I could go on and on about the surgical dangers involved in cesareans, but those facts are all relatively easy to find simply by using the google box at the top of your computer screen. In reality, a cesarean IS a major surgery, with risks involved but in all honesty, most women who have them come out alive and eventually physically healhty. In my opinion, it's time for birth activists to lay this approach aside and address cesarean risks from an entirely differrent angle. Let's examine some new criteria that address the other-perhaps lesser explored- down sides of cesarean delivery:

LOST MOTHER-INFANT BONDING:When a woman labors and gives birth naturally her body creates the highest amount of Oxytocin (aka "the love hormone") that it ever has. Remember those butterflies you got in your stomach when your first boyfriend helpd your hand? Or the feeling you got when looking at your soul mate accross a crowded room? That's Oxytocin at work! When a mother is not allowed to hold her baby after a cesarean and when her body has been flooded with drugs for surgery, that precious moment of mother-child bonding accompanied by the Oxytocin high, is lost forever. Most mothers after the surgery are able to see their newborns for mere seconds before they are swept away to be bundled up while the mother is stitched back up. Often it is more than an hour's time before mother and newborn are reunited.

DIFFICULTY BREASTFEEDING: When a mother exits surgery, she has been heavily drugged and has several tubes attached to her on various parts of her body. This makes mom groggy, often sleepy (I've seen mothers so sleepy, they can hardly keep their eyes open to take in the beauty of thier new baby), and unable to confidently feel or control their arms enough to hold thier child while attempting to breastfeed. Additionally, the hormones that create the milk ejection reflex, have been interfered with through medication necessary for surgery.

NO SKIN TO SKIN CONTACT: After a cesarean section, a mother is still in surgery. She is not able to hold her infant. Instead of receiving that wonderful skin to skin contact, we now know is so important, the child is instead taken out of the mother's sight (most often, out of the room) and is in the hands of unfamiliar nurses.

The above cesarean risks are rarely discussed when women are contemplating the pros and cons of a cesarean. While a mother may be able to come to grips with the idea of a longer recovery, hightened chance of infection, and even surgery for herself, when she is made aware of the additional psychological and physiological risks that can affect her newborn, she may not be as obliged to go under the knife. Certailny, there are situations when a cesarean is an appropriate, life-saving measure, but true emergency c-sections are few and far between.

I encourage every woman of child-bearing age to sincerely educate themselves on the risks and appropriateness of cesarean sections BEFORE you are in labor and on the spot to make an uneducated decision that will not only affect your baby, but your future birthing options as VBACs are becoming more difficult to come by.  A great place to start this research is at ICAN's site dedicated to cesarean awareness.

 

Newborn Sleepy-Time Tip

By: Mandy Schutt

 

Before having their own babies, many moms imagine staying at home with their newborns to be a relatively easy gig. The imaginary mothering scenario goes something like this:

1. Nurse baby.

2. Baby falls asleep.

3. Put baby in bassinet.

4. Have a couple hours of time to sleep/make dinner/work from home/email/etc.

Many moms instead find the first few months after giving birth to be anything but easy. The realistic mothering scenario can often go like this:

1. Nurse baby

2. Baby falls asleep

3. Put baby in bassinet

4. Baby wakes up crying.

5. Nurse baby again

6. Baby falls asleep

7. Baby wakes up crying.

Repeat from step one and then add in step 4b: "Mom joins baby in crying" 

As a postpartum doula, I’ve seen this scene time and again. As the hours, days, weeks, drag on mom’s exhaustion escalates creating for a rough postpartum experience.

There are some times when the baby’s crying is caused by a larger problem ranging from colic to gas bubbles to rash. But most of the time when I am with a mom on the verge of tears, I am able to help her solve the problem by a few pretty simple techniques that which recreate the womb environment. We must remember that newborns are called newborns for a reason; they are newly born and used to being inside warm, calm, bouncy tight-quarters (aka “the womb”).  Recreating this familiar environment for an infant can be most comforting.

A snug swaddle can work wonders with a fussy infant. Be sure that Baby is in a clean diaper, is not over or under dressed (sometimes in hot CA days, a baby may benefit from being almost naked under the swaddle), and then swaddling the little one in a proper-and I repeat, PROPER- swaddle. A swaddle is not just a quick burrito wrap in a blanket. Many moms think they are swaddling but in fact are wrapping the blanket just tight enough to annoy the baby and create a sort of tactile over-stimulation, which is exactly opposite of what a good swaddle should do.

Here’s a helpful video of a dad (I find dad’s are usually pretty awesome at swaddling once they learn technique) swaddling a 5 day old…and don’t get me started on how deliciously gorgeous the baby model is in this video. A. DOR.A. BLE. In the video, the dad mentioned “The Happiest Baby On The Block”. Personally, I’m a fan of most aspects of this program and use it often while working with new parents.

Most of the time babes are not crazy about the swaddling process so I tell parents to take a deep breath right before doing it, to continue talking to their baby, explaining what they are doing, “Mommy is just making you all cozy in this swaddle, it’s just going to be a little longer and then we can cuddle again…”and NOT rushing through the process. If swaddling is a new skill, this is especially important to remember. While it may seem that you need to move fast to get through the steps faster, this usually results in a sloppy swaddle and in the end is much more frustrating.

Once baby is swaddled, bouncing is helpful. To do this easily, parents can hold baby while sitting and bouncing on an exercise ball or jauntily walking. Bouncing is often much more effective than rocking.

Keep in mind that it usually takes time for an infant to fall asleep. Most babies need at least twenty minutes of comforting and lulling before they are in a deep sleep. This can seem like forever to an exhausted parent, but hang in there. Once Baby is no longer twitching, and their eyes have stopped fluttering, they are in a deep state of sleep and can usually manage to be put down for a snooze…parents should follow suit if at all possible.

For more information on how to perfect the swaddle as well as other baby-calming techniques, check out The Happiest Baby on the Block program. If you are interested in a Happiest Baby class or consult, contact Mandy Schutt.

 

What's Your Hospital's Cesarean Rate?

By Mandy Schutt

 

A recent study that took a look at the astronomical cesarean section rates in California came to a very un-shocking conclusion:

Women who give birth at non-profit hospitals have a significantly lower c-section rate.

I’m talking, in some cases, significantly lower.

For example, at Kaiser Permanente Redwood City Medical Center (a non-profit hospital) new moms had a 9% chance of having a cesarean. While a mom at Los Angeles Community Hospital had a 47% (yes, you read that right, forty-seven percent) chance of having a cesarean.

The study showed that some hospitals located very close to the other, so serving the same population, had drastically different cesarean rates depending on well, the amount of money they would make from performing a surgical birth.

As quoted by California Watch, Desirre Andrews, president of the International Cesarean Awareness Network, a nonprofit that would like to see C-sections only in cases of medical need said, "This data is compelling and strongly suggests, as many childbirth advocates currently suspect, that there may be a provable connection between profit and the cesarean rate," said

Wondering what the Cesarean rates are at your local hospital? Find out here.  

Okay, so let’s say that you just found out that your hospital and/or doctor have a higher c-section rate than you're comfortable with. (Remember to always make this one of your first questions when vetting obstetricians!)

What next?

You are not stuck! You have options- yes, even up until the actual birth of your child! Regardless of insurance issues, you have choices. Of course, it’s easier and more enjoyable if you change care providers early on but I’ve heard of mothers literally firing their OBs as they are giving birth! Your first step might be to:

-speak with your doula about your concerns and see what sort of local connections and resources she can offer to assist you

-contact your local ICAN chairperson, they will be happy to walk you through your options

-call your insurance and see if you can simply change care-providers (you would then seek out your ideal care provider and begin seeing them) a lot of times it’s just that easy!

Through the entire process of finding your ideal hospital and care provider, keep the following in mind:

The World Health Organization recommends that the cesarean rate in any country should not exceed 15%. If your hospital or care giver has a rate higher than this, it very well may be a red flag.

 Download your Southern CA Cesarean Primer here.