Birth Movie Screening Event

This a major event including the screening of three amazing childbirth films: Orgasmic Birth, The Business of Being Born, and Pregnant in America, and the producer of Orgasmic Birth will be at the screening as well!

Date: June 13, 2009
Location: Towne Cinema Theaters in American Fork, UT
Cost: $25
What: Screening of Orgasmic Birth, Pregnant in America, The Business of Being Born, Special Guest Speaker, Debra Pascali-Bonaro
Email: moviescreening@rawmelissa.com if you have questions

For more information or to order your ticket you can send an email to the email address listed above, or please visit my doula trainer, Melissa's blog. Feel free to distribute information about this on your own blog, email your friends, and tell everyone you know about this amazing event! We are trying to get the word out to as many people as possible.

Do Hospitals Discourage Breastfeeding?

I believe they do, for many reasons. Unfortunately it can undermine a new mother's will to breastfeed her newborn.

But you don't have to take my word for it. The New Born Baby blog has a recent post about hospitals and the way they handle breastfeeding. It's a really good read, and not too long. In the post they mention the Baby Friendly Initiative. I learned a lot about this initiative when I attended the Utah Doula Association's Conference recently.

The Baby Friendly Initiative is intended to help hospitals transform their infant feeding programs to more fully support breastfeeding and only offer supplemental feeding when medically necessary. This initiative is amazing, and I hope more hospitals will strive to become officially Baby Friendly. Right now, only one hospital in the state of Utah has achieved Baby Friendly status.

One big hurdle for most hospitals is that the formula companies give them free infant formula, which they lose by becoming Baby Friendly. However, the representative from the University of Utah Hospital that spoke at the conference I attended said that they found when they renegotiated their contract with the formula companies they were given lower prices on adult formula and the cost of formula for the hospital as a whole remained the same even though they now have to pay for infant formula. What they thought would be the hardest step turned out to be one of the easiest.

I fully support breastfeeding and the Baby Friendly Initiative. Please take some time to educate yourself about these programs and issues.

New Helpful Blog for Expectant Parents

The Beginning of Motherhood is a blog I follow and enjoy. The author of that blog is also working on a blog specifically designed as a resource for expectant parents in Utah. There is a provider directory and the blog addresses birthing options in Utah. The new blog can be found at: http://utahchildbirth.com/?cat=32.

I am very excited about this. I live in Utah, and when I was making some big decisions at the beginning of this pregnancy, I found it was difficult to find childbirth professionals in my area who are not part of the common "medical community" (not a physician or a midwife working with a physician). This blog should be helpful to anyone else who finds themselves in the same position I was in.

Mothering Magazine Interviews Ricki Lake about The Business of Being Born

I've blogged about this film many times before, but I just have to keep mentioning it, because I think it is so wonderful and informative about childbirth! I was browsing The Business of Being Born website this morning and found that Mothering Magazine interviewed Ricki Lake about the film and her upcoming book, co-written with Abby Epstein. The interview was recorded and is available to listen to on the Mothering Magazine website. It's a wonderful interview, and I was touched by Ricki's passion. I feel the same passion for pregnancy and childbirth, and I applaud Ricki and Abby for the amazing work they are doing to inform the public about childbirth options. Please take a few minutes to listen to the interview, and if you have not seen the documentary film yet, I urge you to get a copy of it and watch it. It could change your life!

Breech Baby (Breech Position or Presentation)

What is Breech?
Breech presentation is when a baby is in a position other than head-down. There are three types of breech presentation. Frank breech is the most common, with the baby's buttocks down and legs straight up toward the face. Complete breech is when the baby is in a sitting position with legs crossed. Footling breech is when the the baby has one or both feet down. The baby's position is checked at each prenatal visit in late pregnancy. By 34 to 36 weeks most baby's have assumed the position they will birth in.

Why is a breech presentation risky?

• The chances of a prolapsed cord increase with a breech baby because the buttocks or feet don't prevent the umbilical cord from being swept below the baby or into the vagina.
  
• When the baby's feet or buttocks are delivered first there is a possibility the head can press on the cord at the cervix and possibly reduce the baby's oxygen supply.
  
• Sometimes the baby's feet or buttocks are small enough that they can be born before the cervix is fully dilated, and the head doesn't have enough room to come out. This could lead to fetal distress and delay the birth of the head.
• Spinal cord injury is also a risk if the baby's head is hyperextended (bent back).

What can be done about a baby in a breech position?
If by 36 weeks your baby is in a breech position, you can try one of the following:

• The breech tilt position: The idea behind this is to tilt your body so that your hips are higher than your head. Ask your caregiver if this is safe for you to do. If you are healthy and the baby is doing well, most caregivers encourage this position. Lie on your baby with your feet flat on the floor. Raise your pelvis and slide firm cushions underneath your buttocks, enough to raise them 10-15 inches above your head. You may need help from your partner or a family member or friend with the pillows. You can also use a flat surface like an ironing board or plank, tilt it by putting one end on a chair and the other end on the floor. Lie down on the board with your head toward the bottom. If it's unsteady at all, have someone help steady it for you. Lie in this position for 10 minutes, 3 times each day at times when your baby is active. It helps encourage the baby to move up away from the birth canal so the baby can move to get into a more favorable head-down position. It's not the most comfortable position, but if you empty your bladder and make sure you don't have a full stomach, it will help ease some discomfort. While you lie in the tilt position, try to relax your abdominal muscles as much as possible and imagine your baby turning a somersault so the head turns toward the cervix. The baby will probably squirm as the head presses into the fundus. There is no medical proof that this method helps turn a baby, but many women swear by it, and it doesn't do any harm. After lying in this position, it's a good idea to assume an upright position to encourage the baby to move back down after being pulled up be gravity.
• Knee-chest position: This position uses the same principles as the breech tilt position, and you may want to try it and see if it's more comfortable for you. For this position, assume a hands and knees position with your knees about shoulder-width apart. Place firm pillows under your pelvis to help hold your hips and pelvis up in that position, and then lower your head and shoulders to the floor. You may want to use a blanket or thin pillow to soften the surface for your head, but be sure to keep your head and shoulders as low to the floor as possible to allow gravity to help pull your baby out of the breech position. Once you're support by enough pillows to keep your pelvis up, you should be able to maintain this position comfortably for 10 minutes or so, also 3 times a day just like the tilt position.
• Use of sound: You can try this by either placing earphones from a music player just above the pubic bone and playing music for the baby when the baby is active. You can also have your partner place his or her head in your lap and talk to the baby. The idea is that babies can hear outside sounds while in the womb, and the baby may reposition itself so that his or her head is down toward the comforting or familiar sound. This method is also completely harmless and comfortable, and many women have reported that it helped turn their baby.

What's the medical approach to turn a breech baby?
If your efforts at home haven't been successful in turning your breech baby, your caregiver may want to try external version. This is done at 37 to 38 weeks. An ultrasound is usually done to determine the exact position of the baby, check how much amniotic fluid is present, and see where the placenta is attached to the uterus. A non-stress test may be done to check the well-being of the baby before or after the version. You may be given a drug to relax your uterus, and some caregivers like to use an epidural to reduce any discomfort. The caregiver uses ultrasound as a guide while he or she presses on your abdomen and tries to manually turn the baby into a head-down position. If the baby shows fetal distress, the procedure is stopped. If the placenta starts to detach from the wall of the uterus, a cesarean section must be done to deliver the baby. Sometimes the version is unsuccessful and the baby does not turn at all. Some babies will turn from the version and then resume a breech position afterward. Studies have shown that external versions are safe and successful about 60% of the time. It can be quite uncomfortable because of the amount of pressure that's used to turn the baby. It can be helpful to have your partner or doula with you to help with breathing techniques and relaxation to give you comfort and allow the caregiver the time needed to turn the baby during the procedure.

Vaginal Birth versus Cesarean Birth for a Breech baby.
It used to be that vaginal breech births were done all the time. Even though there are complications with a vaginal breech birth, it can still be done safely with the right expertise. After the 1970's the overall cesarean section became increasingly common, and doctors began to abandon vaginal breech delivery and use surgery more and more to deliver breech babies. As vaginal breech births declined, fewer doctors learned the techniques to perform a vaginal breech birth. It can be difficult now to find a physician who is willing and has the skills to allow you to birth your breech baby vaginally.

Personal note: I know a woman who interviewed her physician before the birth of her second child. She showed him her birth plan and asked specifically that if the baby were to present in a breech position she be allowed to attempt a vaginal delivery. Her wonderful doctor (who happened to be an older man who had assisted in a multitude of vaginal breech births and has the necessary skills to do so) said that he would love to help her do that. This is rare, and I think it emphasizes the importance of interviewing your caregiver and being clear about your wishes for birth! If your baby is presenting breech and all efforts to turn the baby have been unsuccessful, you may need to prepare yourself for a cesarean birth, as that is the most common method of delivery for breech babies today.

My midwife recently assisted in a vaginal breech birth at a home. She did not have experience with breech delivery, so she called in a senior midwife who knew what to do, and the baby was delivered safely and vaginally. I find it truly amazing what can be done with the right knowledge and approach.

*Information presented can also be found in Pregnancy, Childbirth and the Newborn by Penny Simkin, Janet Whaley and Ann Keppler. This is a fantastic book that I would recommend to all expectant parents.

Upcoming Forum on Breech Birth

My midwife has a monthly forum for all of her pregnant ladies. I'm particularly excited to attend this month's forum this Thursday. One of the moms who has recently given birth had an amazing experience when she birthed her baby breech. Yes, that's right, the baby came out feet or buttocks first! She is going to come and share her birth story with the rest of us, and I'm really excited to hear it.

In past years vaginal breech delivery was not unheard of. I personally have a brother who came out of the birth canal buttocks first. Physicians used to delivery breech babies vaginally all the time, but nowadays the common medical approach to a breech position is to automatically do a cesarean section. In my opinion it's another example of unnecessary surgery, and I'm always thrilled to hear of a baby being born vaginally and safely, especially when there were complications that would have likely elicited medical staff to prep for surgery.

For more information on positioning of the baby, please check my earlier post on posterior babies. Much of the information also applies to breech position. The knee-chest position mentioned in that post is an excellent position for moving the baby out of the birth canal to allow it to move into a more favorable position.

Number of Health Care Organizations In Support of Certified Professional Midwives and Out-of-Hospital Birth Rapidly Increases

I found this information on another Doula's blog and I have been meaning to pass the information on to my readers, and I'm finally getting to it today! I feel this is very important because it impacts each woman's legal right and ability to choose her birth options. Please take some time to read through the articles presented. I'll include a short snippet of each article, along with a link to more information.

"WASHINGTON, D.C. (February 17, 2009)Two major health care organizations have joined the growing number of groups calling on policy makers to increase access to Certified Professional Midwives (CPMs) and out-of-hospital maternity care. Acknowledging the large body of evidence supporting the safety of home delivery with CPMs, who are specifically trained to care for mothers and babies in out-of-hospital settings, nursing and perinatal health care organizations criticized the American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG) resolutions calling for bans on CPMs and home birth. The groups also joined Consumer Reports magazine in highlighting the need for a major overhaul of the U.S. maternity care system." Read more.

"Midwives provide a safe and cost-effective alternative to the current model, where the market is dominated by high-cost, high-tech specialists producing less-than-optimal outcomes,” said Katie Prown of The Big Push for Midwives Campaign.

“Babies delivered by midwives are far less likely to be pre-term or low birth-weight, which are two of the leading causes of neonatal mortality and of the enormous costs associated with
long-term care. Midwives and out-of-hospital birth are an integral component of responsible health care reform, and the AMA and ACOG know this. That’s why they’re fighting so
desperately to protect their turf, even if it means denying women maternity-care options in the process.

"The National Perinatal Association (NPA) added to the growing list of organizations calling on the AMA and ACOG to end their vendetta against midwives and home birth and instead follow the World Health Organization’s (WHO) call to “‘work in a spirit of recognition and respect for each other’s authority, responsibility, ability and unique contribution." Read more.

I am not against doctors, medicine, or hospitals. I am for choices, and each woman's right to choose how and where she gives birth to her baby. In the United States Certified Professional Midwives are authorized to deliver babies in hospitals in all 50 states. However, half of the states of the Union currently forbid midwives from delivering babies out of the hospital. I personally feel we should be given the right to choose our birth method, location, and professional support according to the dictates of our own consciences.

Spread The Cloth Diaper Love

I have always used disposable diapers, but lately I've been getting increasingly frustrated with the cost of buying disposables. My niece uses cloth diapers and raves about how wonderful they are. She uses one size fitted diapers from Bum Genius and her diaper supply cost a one-time investment of just over $400 for these very nice diapers.

Today I ran across a group that works to give cloth diapers to families in need all over the world. They call themselves Miracle Diapers and they have already cloth diapered 1,000 babies in 3 years. They are not currently taking nominations, but I think this is a very worthy cause if you can donate to it or somehow get involved in their work.

Through the Miracle Diapers website I have also found a website with some simple sewing instructions for cloth diapers. You can sew a complete diaper stash for less than $30! If you use old clothes (t-shirts and wool sweaters) you can make a complete set of prefold cloth diapers for about $25. If you prefer fitted diapers, it's possible to make a set for about $42, and flatfolds will cost you about $49 to make the set. The cost is based on buying bundles of t-shirts and wool sweaters from a thrift store, so if you use your own old clothes you can do it for even less.

Cloth diapers are extremely earth-friendly, and over time they can save you a lot of money compared to buying disposable diapers. For example, a box of size 1 Pampers on Amazon.com is about $24.69. Newborns go through about 12 diapers a day, so a month of diapering with disposables will set you back $88.92. This cost will lower when your baby is older and you are changing less often, so you can assume that most older babies will cost around $80 per month. If you diaper for 2.5 years, 30 months, you'll spend around $2400 for one child. A full set of brand new fitted cloth diapers is over $400 and can be reused for each child you have. If you make your own cloth diapers, the cost savings are even more!