My Baby is Coming Soon! My Feelings and Preparations.

My baby's due date is approaching soon. I have two due dates; one based on the first day of my last menstrual period, and the other is based on an ultrasound that was done at 20 weeks gestation. The ultrasound date is 11 days later than the other, and I know that estimated due dates are not always accurate, so we are awaiting the arrival of our baby whenever he decides it's time to come. My obstetrician also admitted to me that ultrasound dates aren't very accurate at 20 weeks, and if we had done an ultrasound earlier, say around 9 weeks, it would have been much more accurate. When someone asks me when the baby is due, I just say "sometime in July". I get some pretty funny looks from them when I don't give an exact date, but I'd rather not focus on a specific day and get myself worked up about it.

My first baby was born 2 days past the due date. My last 3 babies were each born 4 days before the due date. If the pattern holds true with this baby, then I will have a new baby in less than a week! I'm not focusing on that however, and I'm happy to wait until the baby is ready.

We are busily preparing ourselves for his arrival, and we're very excited to be so close to welcoming a new child into our family. We have still been unpacking from our move a few months ago, and we only have a few boxes left to go through. It feels good to be organizing our home and staying busy. I'm especially excited that we're also preparing our home to have the birth take place here. I feel great peace about my decision to birth at home, and I feel ready for the birth.

My midwife gave me a birth kit that she put together with some essentials, such as chux pads (the absorbent pads used in hospitals to catch all the fluids and yucky stuff from the birth - I never knew before that you can buy them from the local store!), latex gloves, cord clamp, herbs for sits baths (for healing after the birth), suction catheter (just in case), gauze pads for cord care after the birth, and more. She told me that most births don't require everything in the kit, but it's better to have more than you need than not enough.

She also gave me a list of things to have on hand for the birth, including: feminine hygiene pads, diapers, towels, wash cloths, sheets, shower curtains (to use under the top bedsheet and under the birthing tub), garbage bags, paper towels, wipes, ice and bowl, crock pot (to hold and keep warm compresses) baby clothes, birth food for mom and everyone who will be there, lots of juice, and ingredients for her wonderful cayenne drink (which she uses to reduce bleeding). Anything else that may be needed for the birth will be brought by the midwife and her attendants, including the birthing tub.

My midwife has several attendants training under her, and I've met tham all. I don't have a specific preference of which attendants come to the birth, so we decided that when the time comes she will call them all and see who is available to come. We could have 2 or more attendants along with our midwife, and I feel good about that, knowing I'll have lots of support along with my husband (who is a wonderful support for me during labor and birth).

My husband has been more involved in preparing the house for this baby, and I think it's because the baby will be born here. I know that he's looking forward to not having to drive to and from the hospital. We're also glad that I won't be separated from the kids for 2 or more days like I was when I gave birth in the hospital. Our youngest is only 18 months old, and I know she'll be happier having me home rather than away from her for such a long time. I feel happy knowing that I will be able to control the atmosphere at the birth, and have all the comforts of home close at hand, and be away from the hustle and chaos of the hospital. I'm really excited about laboring and possibly delivering the baby in the tub (which no hospital in my state will allow), and not feeling like I'm under pressure to perform according to hospital protocol.

When talking about home birth, many people ask about the possibility of something going wrong. Many are afraid of the "what ifs" of birth, and worry that they should be in the hospital "just in case". I have not had any fear about these things. I feel comfortable knowing that 95% of pregnancies and births are low-risk and require no intervention. I've had excellent prenatal care from my midwife throughout the pregnancy, and have not had any complications so far. I will also be surrounded by a team including my midwife (who has 15 years experience with home birth) and her attendants, and they will support me and watch for any possible complications. They know how to handle many surprises at home, and if something more serious were to happen, they would know when a transfer to the hospital may be needed.

All in all, this pregnancy has been wonderful and I'm a little sad for it to be ending, but more overwhelmingly excited to be welcoming a new beautiful baby into our family and home. My family is the most important thing in my life, and I would not trade this life for anything else!

Kasie's Story of Her Unassisted Water Birth

The unassisted home waterbirth of Nikolai Francis~5/5/09

I knew I would be meeting my baby that day around 6:30 a.m. That's when the contractions started coming regularly. It was still early labor, so I was able to get Gabriel and Joseph off to school, and finish up some things around the house. I put in a load of laundry, and swept the floor. Once the boys left for school, around 8:00, Stephen and I got in the shower and I started to have more intense contractions, but still not too bad. We had been planning on going grocery shopping that day, and I briefly contemplated going along, since I'm kind of particular about certain things that I like to buy, but I quickly thought better of it. The contractions were coming faster, every 6-7 minutes, and stronger. This was around 9:30. Stephen, Bobby, and Persephone left for the store at that point. I did the dishes, because I knew that would be the last thing I would want to think about once he was here!

The birth pool was already inflated, so when I was done with the dishes, I started filling it. The water felt amazing! The hardest part was having to get out of the pool and walk to the kitchen to shut the water off when it went cold. I was on my hands and knees to keep my belly underwater, since it hadn't filled enough yet. I was having intense contractions at that point, breathing and moaning through them. Stephen and the kids got home around 10:30, and he was back and forth between checking on me, getting the kids settled, and putting groceries away. Once we had hot water again, he finished filling the pool. I lost track of time around then.

I stayed in the pool for awhile, and started to feel the urge to push. It wasn't constant, so I just went with it, and did what my body was telling me to. I reached in and felt my bag of water bulging, and the baby's head. What an awesome feeling! I continued to push when I felt like it, but after awhile of the baby not coming down at all, I was getting frustrated, and hot from being in the water. Stephen spread some blankets on the bed, opened the window, and helped me out of the pool. The cool air felt good, and I continued to moan through the contractions, pushing when I felt like it, and taking full advantage of the rest in between. In those few short minutes in between contractions, I felt like I was in another world, totally removed from everything around me.

I had expected my water to break on its own, but it hadn't, and it didn't feel like I was making any progress bringing him down. On top of that, I was experiencing very intense back labor, which led me to think that he was posterior (face-up), with the hardest part of his head pressing against my spine. I told Stephen if he did nothing else, I needed him to lay into my lower back, to put all of his weight into it. I told him not to worry about hurting me. The counter pressure was the only thing that brought any relief. I started to get cold then, so I climbed back into the pool. I alternated between moaning and being completely silent with each contraction.

I felt my water bulging again, but couldn't feel the baby's head anymore, so we decided to break it on our own. Stephen sterilized a pair of fingernail clippers and tried to do it himself, but said he couldn't feel what he was doing. I took the clippers, reached inside, pricked the sac, and immediately felt the fluid rushing out. I was on my hands and knees, so I asked Stephen if it was dirty or not, and he said no. All of a sudden, I felt a massive urge to push, and went with it. In between urges, I'm telling Stephen to get the video and digital cameras ready. I remember saying "He's coming, he's coming". and Stephen asking me if he was crowning yet. I was still on my hands and knees, but flipped over when I felt his head crowning. I eased his head out, and what a wonderful feeling! Once his head was born (he was face down, so he must have turned in the birth canal), I checked for a cord around his neck, but there was none. I was just in awe as I held his head in my hands. He was between worlds. His shoulders came in another few pushes, and his body just slid out. There was no pain in the actual pushing, crowning, and birth of his body. It felt good and such a relief!

I brought him up to my chest, and just wept. I'm crying as I type this. As much as I planned and hoped for a wonderful birth experience, I could never have imagined something so beautiful. There are no words to do it justice. I will carry this experience with me for the rest of my life, hold it close to my heart, and be forever thankful that I was able to bring my son into the world in such a peaceful, gentle way.

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The Rights of Childbearing Women

I always talk about how important it is to educate yourself about your options and your rights. This will hopefully clarify what those rights and some options are. I ran across this blog by Doula Momma that lists 20 rights of childbearing women.

This article originally appeared on The Childbirth Connection. Please refer to their article for a list of resources and if you want more information.

"The Rights of Childbearing Women
This statement outlines a set of basic maternity rights that Childbirth Connection has identified and promotes for all childbearing women. It applies widely accepted human rights to the specific situation of maternity care. Although most of these rights are granted to women in the United States by law, many women do not have knowledge of their maternity rights.

Fundamental Problems with Maternity Care in the United States
This statement was developed in response to serious and continuing problems with maternity care in the United States, including:

• The United States is the only wealthy industrialized nation that does not guarantee access to essential health care for all pregnant women and infants. Many women, especially those with low incomes, lack access to adequate maternity care.
• A large body of scientific research shows that many widely used maternity care practices that involve risk and discomfort are of no benefit to low-risk women and infants. On the other hand, some practices that clearly offer important benefits are not widely available in U.S. hospitals.
• Many women do not receive adequate information about benefits and risks of specific procedures, drugs, tests, and treatments, or about alternatives.
• Childbearing women frequently are not aware of their legal right to make health care choices on behalf of themselves and their babies, and do not exercise this right.
  

We must ensure that all childbearing women have access to information and care that is based on the best scientific evidence now available, and that they understand and have opportunities to exercise their right to make health care decisions. Women whose rights are violated need access to legal or other recourse to address their grievances.

The Rights of Childbearing Women
* At this time in the United States, childbearing women are legally entitled to those rights.
** The legal system would probably uphold those rights.

1. Every woman has the right to health care before, during and after pregnancy and childbirth.
2. Every woman and infant has the right to receive care that is consistent with current scientific evidence about benefits and risks.* Practices that have been found to be safe and beneficial should be used when indicated. Harmful, ineffective or unnecessary practices should be avoided. Unproven interventions should be used only in the context of research to evaluate their effects.
3. Every woman has the right to choose a midwife or a physician as her maternity care provider. Both caregivers skilled in normal childbearing and caregivers skilled in complications are needed to ensure quality care for all.
4. Every woman has the right to choose her birth setting from the full range of safe options available in her community, on the basis of complete, objective information about benefits, risks and costs of these options.*
5. Every woman has the right to receive all or most of her maternity care from a single caregiver or a small group of caregivers, with whom she can establish a relationship. Every woman has the right to leave her maternity caregiver and select another if she becomes dissatisfied with her care.* (Only second sentence is a legal right.)
6. Every woman has the right to information about the professional identity and qualifications of those involved with her care, and to know when those involved are trainees.*
7. Every woman has the right to communicate with caregivers and receive all care in privacy, which may involve excluding nonessential personnel. She also has the right to have all personal information treated according to standards of confidentiality.*
8. Every woman has the right to receive maternity care that identifies and addresses social and behavioral factors that affect her health and that of her baby.** She should receive information to help her take the best care of herself and her baby and have access to social services and behavioral change programs that could contribute to their health.
9. Every woman has the right to full and clear information about benefits, risks and costs of the procedures, drugs, tests and treatments offered to her, and of all other reasonable options, including no intervention.* She should receive this information about all interventions that are likely to be offered during labor and birth well before the onset of labor.
10. Every woman has the right to accept or refuse procedures, drugs, tests and treatments, and to have her choices honored. She has the right to change her mind.* (Please note that this established legal right has been challenged in a number of recent cases.)
11. Every woman has the right to be informed if her caregivers wish to enroll her or her infant in a research study. She should receive full information about all known and possible benefits and risks of participation; and she has the right to decide whether to participate, free from coercion and without negative consequences.*
12. Every woman has the right to unrestricted access to all available records about her pregnancy, labor, birth, postpartum care and infant; to obtain a full copy of these records; and to receive help in understanding them, if necessary.*
13. Every woman has the right to receive maternity care that is appropriate to her cultural and religious background, and to receive information in a language in which she can communicate.*
14. Every woman has the right to have family members and friends of her choice present during all aspects of her maternity care.**
15. Every woman has the right to receive continuous social, emotional and physical support during labor and birth from a caregiver who has been trained in labor support.**
16. Every woman has the right to receive full advance information about risks and benefits of all reasonably available methods for relieving pain during labor and birth, including methods that do not require the use of drugs. She has the right to choose which methods will be used and to change her mind at any time.*
17. Every woman has the right to freedom of movement during labor, unencumbered by tubes, wires or other apparatus. She also has the right to give birth in the position of her choice.*
18. Every woman has the right to virtually uninterrupted contact with her newborn from the moment of birth, as long as she and her baby are healthy and do not need care that requires separation.**
19. Every woman has the right to receive complete information about the benefits of breastfeeding well in advance of labor, to refuse supplemental bottles and other actions that interfere with breastfeeding, and to have access to skilled lactation support for as long as she chooses to breastfeed.**
20. Every woman has the right to decide collaboratively with caregivers when she and her baby will leave the birth site for home, based on their conditions and circumstances.**
    

1999, 2006 Childbirth Connection

AMA Resolution Would Seek to Label “Ungrateful” Patients as "Non-Compliant"

I just came across this article regarding a proposed AMA medical billing change that could affect expectant parents' rights to take charge of their prenatal care by jeopardizing their ability to get insurance coverage or seek other care givers by labeling them as "non-complaint". Under this proposed change, I could be labeled as non-compliant by my obstetrician's office simply for not subscribing to the suggested routine of prenatal visits (because I've been doing those with my midwife instead) and choosing not to participate in certain prenatal tests and screens. I would hate for my personal choices in managing my prenatal care to impact my future care options. I've posted the article in its entirety.

Please go to the International Cesarean Awareness Network website to see what you can do to help affect a positive change. I've posted the ICAN article in its entirety:

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

The resolution complains:

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

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

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

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

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

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

• Billing codes that would categorize any disagreement and exercise of autonomy on the part of the patient as “non-compliance” “abuse” or “hostility” could create a pathway for insurance companies to deny coverage to patients
• Use of these labels fails to recognize patients as competent partners with physicians in their own care
• Tagging patients as “non-compliant” fails to recognize that there is not a “one size fits all” approach to care, that different opinions among physicians abound, and that patients are entitled to these very same differences of opinion
• Labeling patients as “non-compliant” may, in fact, be punitive, jeopardizing a patient’s ability to seek out other care providers
  

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

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

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

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

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

The Importance of Prenatal Health Care

Prenatal health care is very important. I found an article in my local news that talks about this:

Importance of 13 Visits to Mom and Baby

I'd like to point out that an expectant mother has the option of going to an obstetrician or a midwife, and the medical care should be adequate from both sources. Both obstetricians and midwives do a urinalysis at each prenatal visit to screen for possible health concerns or complications, as well as check the mother's blood pressure, fundal height measurement, weight gain or loss, and check the baby's heartbeat.

A good obstetrician or midwife will also take time at each visit to talk with the expectant mother about her feelings, her life situation and stressors which might impact her well-being during her pregnancy.

Health care may differ from one care giver to another depending on that caregiver's approach to pregnancy and birth. Obstetricians and Certified Nurse Midwives who practice under the supervision of an OB may be more likely to take a very medical approach by suggesting more screenings and tests than a Certified Professional Midwife or Direct Entry Midwife would. Doctors approach pregnancy and birth as a problem waiting to happen. They spend more time looking for problems, because they are trained to handle emergencies and complications. Midwives generally approach pregnancy and birth by looking at the woman as a whole being and trusting in her body's ability to do what it's designed to do, and less time looking for problems. With this being said, midwives are trained to watch for potential problems and how to handle them if they do come up.

Whether you choose a doctor or a midwife for your prenatal care, and whether you choose to birth in a hospital, birth center or at home, please get the prenatal health care that you need. Learn about the screenings and tests and procedures so that you can make educated decisions about your health care. Remember that the doctor or midwife works for you, and not the other way around.

Informative Birth Story of an Emergency Cesarean

I discovered a blog called Doula Momma, on which the author posted her birth story. It's a very interesting story, with complications I hadn't ever considered before. I love to learn new things about childbirth, and this birth story was very informative to me. This woman had a baby who was presenting face first and unable to descend in the birth canal because his position wouldn't allow it. Please take a few minutes to read her story. While I personally prefer natural unmedicated birth, it's important to remember that we have medical interventions for very good reasons. I try to present all sides of birth because I feel it's important to know the possibilities and options so that you can make informed choices in your own birth.

Click here to read the birth story

Why Estimated Due Dates Are Inaccurate

In the world of obstetrics, a woman's estimated due date is relied upon heavily by prenatal caregivers. However, the accepted method of calculation of the EDD is based on inaccurate data.

This article explains the flaws in the current method and how to more accurately estimate a baby's due date:

The Lie of The EDD: Why Your Due Date Isn't When You Think

"We have it ingrained in our heads throughout our entire adult lives-pregnancy is 40 weeks. The "due date" we are given at that first prenatal visit is based upon that 40 weeks, and we look forward to it with great anticipation. When we are still pregnant after that magical date, we call ourselves "overdue" and the days seem to drag on like years. The problem with this belief about the 40 week EDD is that it is not based in fact. It is one of many pregnancy and childbirth myths which has wormed its way into the standard of practice over the years-something that is still believed because "that's the way it's always been done".

"This theory was originated by Harmanni Boerhaave, a botanist who in 1744 came up with a method of calculating the EDD based upon evidence in the Bible that human gestation lasts approximately 10 lunar months. The formula was publicized around 1812 by German obstetrician Franz Naegele and since has become the accepted norm for calculating the due date."

"Recent research offers a more accurate method of approximating gestational length. In 1990 Mittendorf et Al. undertook a study to calculate the average length of uncomplicated human pregnancy. They found that for first time mothers (nulliparas) pregnancy lasted an average of 288 days (41 weeks 1 day). For multiparas, mothers who had previously given birth, the average gestational length was 283 days or 40 weeks 3 days. To easily calculate this EDD formula, a nullipara would take the LMP, subtract 3 months, then add 15 days. Multiparas start with LMP, subtract 3 months and add 10 days. The best way to determine an accurate due date, no matter which method you use, is to chart your cycles so that you know what day you ovulate."

I've also read about the inaccuracy of estimated due dates in childbirth books such as: Your Best Birth, by Ricki Lake and Abby Epstein and The Thinking Woman's Guide to a Better Birth, by Henci Goer.

More About Cloth Diapers - Plus Some of My Favorite Links

I hope I haven't overwhelmed you with the last post about cloth diapers. It's something I'm really excited about right now and I hope to help others understand that it's not as much work as it seems, and it's rewarding to be able to diaper your child with something that's reusable and doesn't need to be replaced constantly. I have spent thousands of dollars on disposable diapers over the years, and I'm thrilled to be doing something on a smaller budget now that will last a long time.

I mentioned that I'm using prefold cloth diapers. I'm loving these, because I can remove the prefold from the cover when I change my baby's diaper, and I can reuse the cover with a fresh prefold. The only time I need to change the cover itself is if it has become soiled and needs to be washed. I feel this method of cloth diapering is more economical than using AIO (All-In-Ones) or Pockets because there is less to change and wash.

Here is a great website I found that has instructions with LOTS of pictures about how to use prefolds: Green Mountain Diapers: prefolds. They also sell prefolds, and they are incredibly affordable, ranging from $1.17 - $3.00 per diaper (depending on the size).

Green Mountain Diapers offers 5 prefold sizes compared to 3 sizes that most others make. Most other websites about prefolds offer 3 basic sizes: newborn, standard, and toddler. If you plan to make your own prefolds, you can save money by making the 3 basic sizes rather than the 5 that Green Mountain offers. Here are two websites I found that offer prefold patterns and measurements for the 3 basic sizes:

DIY Prefold Diapers
Confessions of a Cloth Diaper Fanatic

Here is the link where you can buy waterproof diaper covers (VERY CUTE) from the same company: Green Mountain Diapers: Diaper Covers. These are more expensive at about $11.00 - $12.25 per cover, but you only need a few covers because you change them less often than the prefolds.

I'm approaching cloth diapering from a low cost perspective, so I plan to make my own cloth diapers and build up a lasting stash. Here is a fantastic site that has free cloth diaper patterns for any type of cloth diaper you might want to make: Fern and Faerie Frugal Diapering. Using old clothes (t-shirts, flannel shirts, old wool sweaters, etc.) you can sew your own diaper stash for $30 or less!

I also found a website with a one-size-fits-most fitted diaper pattern that is designed to fit a child from infant size to toddler: Rita's Rump Cover. Look through each page and pattern to see which would fit your needs the best. The great thing about this pattern is that your child can wear the same diapers from infancy to potty training without having to buy different sizes, and you can use any fabric you choose with minimal closures (1 diaper pin will hold it in place or you can sew in velcro or snaps or use a cover to keep it in place). I plan to use this pattern to make covers for my prefolds, using PUL fabric which is waterproof.

My niece who wrote the letter in my previous post about cloth diapers also did some research about the cost of cloth versus disposable diapers. Here is what she said:

"When I did my research a box of size 1 Pampers on Amazon.com was $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.

"That's $1,976 leftover" (that you save by buying a brand new stash of cloth diapers compared to disposables for 2.5 years). If you make your own diapers, you save even more.

And I haven't even touched upon the benefits to the environment...

All About Cloth Diapers

I recently started using cloth diapers for my toddler, and so far I'm enjoying them. I'm using prefolds diapers with water-tight covers. With disposable diapers my kids always had problems with diaper rash, and with cloth diapers we haven't had any rashes. I don't mind doing the laundry, and my child seems to prefer the cloth because it's softer. She actually brings me her diaper to put on her, and she used to run away from me when I wanted to put a disposable diaper on her. I've used disposable diapers on 4 children over the course of 9 years, and I wish I had tried cloth a long time ago. My main motivation in using cloth is to save money and be more self-sufficient. I want to share with my readers the letter that opened my mind to cloth diapers. My niece wrote this, after much research and practice with cloth diapers. It's long, but I think it's worth the read:

"Dear Friends,

I'm really glad to hear that you're considering using cloth! I actually really love it. I don't know how much you already know about cloth diapering, so I'll go ahead and just give you the crash course. :) The brand that I use is the BumGenius One-Size Pockets.

When it comes to functionality and changing, they work just like disposables, with the convenience of choosing how much absorbency you need in the pocket. (The outer diaper is like a shell with a pocket that you slide the insert and/or insert doubler into for night/newborns.)

The other reason that I chose these specifically is because they are one-size. They have snaps on the front and on the inserts that carry it all the way through about 10 pounds until they are ready to potty train, so you only ever have to buy one stash. There are a few brands out there that have this feature, but after reading a lot of reviews, comparing the features, and asking around in cloth diaper forums online, I decided that these would be the best choice for me. I found this article after I’d already made that decision, and it really reinforced it for me.

Of course, there are a lot of other options out there. The other type that I really considered is an AIO (All In One) because they are the closest thing that you can find to disposables, virtually the same except that you toss one in the trash and the other in the wash. It's similar to the one-size in that they don't require a cover because it's built in, but with the added convenience of not having to stuff the inserts after washing. In the end I decided that was a drawback, because you can't control the absorbency.

Some other options would be the flat fold/birdeye, pre-fold, contour and fitted diapers. Most of these require folding and pinning or using snappis (a safe alternative to pinning, they're plastic snaps that hold it in place) and then using a diaper cover on top of them. They're a bit more work during changes, but they're usually a little cheaper.

Here are a couple sites that explain all the differences pretty well.

Baby Cotton Bottoms
Jardine Diapers

I have about 24 diapers, and I find myself washing every two or three days. Newborns go through about 12 diapers a day, and the number gets fewer as they get older, so I just accounted for a 2 day newborn rotation and knew that I’d be able to wash less frequently as he got older. Most companies recommend that you don’t go beyond 3 or 4 days though, because the smell likes to stick after that. (http://babycottonbottoms.com/how_many_diapers.htm )

I like to stuff my diapers as soon as they come out of the wash so that they’re ready to go when I need them. I keep them in some plastic stacking drawers that I slid underneath a desk with a changing mat on top. Next to the desk is a tall trash can with a foot pedal/lid and cheapo trash bags. They do make diaper genie type things for cloth diapers, but this works just as well so there really is no point.

I take the insert out as soon as the diaper comes off and drop them both into the trash can. (You can’t wash them with the insert in, because it gets all bunched up and doesn’t rinse or dry completely. I learned that the hard way.) I like to stuff the diapers so that the little tag on the insert is at the top, that way you can grab onto it and not the actual insert and avoid getting all “icky”, for lack of a better word.

I usually know that it’s time to wash when the can is almost full and I have about three diapers left in my stash. I’ll just pull out the bag and use it to carry and dump the dirties right into the washing machine, then I’ll put a new bag in the can. The washing instructions for different brands vary slightly, but they’re all pretty close in theory.

First you do a cold wash, using ¼ of the detergent manufacturers recommended amount. This removes the gunk. Then you do a hot wash, again using ¼ of the detergent. This sanitizes and kills anything that is left over. Next you do a final rinse and spin, on whatever temperature you like. This gets rid of all the leftover detergent, because if there’s any left it can make your diapers less absorbent and irritate baby’s skin. Then the diapers go to the dryer, sans any sort of fabric softener or dryer sheets, which can also mess with the diaper. You can add a bit of bleach every once in a while, I do it about once every three weeks. This just helps to freshen up the diapers a bit.

Choosing a detergent when it comes to CD’s is important. A lot of people recommend Dreft or other baby detergents, but they can be so expensive that you’d almost be better just using disposables. Pretty much any detergent that’s hypo-allergenic or marked “free and clear” are good to use. This guarantees that they’re free of pure soap, enzymes, fabric whiteners, fabric brighteners, fabric softeners or anything scented. (All of which can also jack with your absorbency.) Here’s a chart that shows a lot of different options with their pro’s and con’s. I use All Free and Clear and haven’t had any troubles so far.

Another thing that you may occasionally have to do is strip the diapers. If you notice that you’re having absorbency or leaking issues it’s most likely because of A: poor fit or B: you’ve got a bit of detergent build up. It’s easy to fix. You just run a super hot wash without any soap. You may notice bubbles in the water, and that’s a good thing. It’s the soap escaping the diaper. Run one or two hot washes, and then rinse, rinse, rinse. It should solve any problems.

You may be wondering about what to do with the poop. If you breast feed, then don’t have to do anything. Breast milk poo is water soluble, and will get perfectly clean in the wash. (Don’t worry about disinfecting your washer. If the diapers are clean, your washer is clean.) If you use formula or have moved on to solid foods and therefore have solid poops, you’ll just want to knock it into the toilet. You can do the old fashioned dunking in the toilet, or you can invest in a sprayer.

I don’t have one yet, but I plan on getting one as soon as my baby starts producing solids. I’ve shopped around a bit, and this is the one I’m going to go with: http://www.cottonbabies.com/product_info.php?cPath=98&products_id=1228. Pretty much every CD site and user I’ve talked to recommends it. You just hook it up to the water in your toilet and mount it on the wall next to your tank.

Another accessory that I do have is a tote. I have a small one that I toss into my diaper bag. It holds your dirties for you when you’re out and about. A good plastic bag would work just as well, but I like these because they hold in the smell and wetness really well. You can also get a large one for your nursery can.

They also make odor removers that you can use to spray on the diapers or in the pail. I’ve used this one and it works pretty well, though it’s not a necessity. There’s also something out there called dio disks, that sit in the bottom of your pail. Supposedly they work nicely.

Something that I’ve considered using but haven’t had a chance to try yet is a diaper liner. It’s just a thin liner like tissue paper that lies between the diaper and the baby. Most are flushable, so you can use it to just dump the poop into the toilet without having to mess with any water. You have to use one if you need to use any bum rash cream, to protect the diaper from the cream.

The idea with cream is that it creates a slick surface, redirecting wetness from your baby’s bottom. Once the cream comes in contact with the diaper, it does the same thing, redirecting the wetness and causing the diaper to be ruined and lose absorbency. (I’ve just kept a couple disposables on hand to use in case of a rash.)

A side note about rashes and cloth diapers; When I was researching what diapers to use, my mom was VERY against the idea of cloth. Her reasoning was that babies always get more rashes with cloth. In actuality, you just have to change slightly more frequently and pay closer attention than you do with disposables. It’s OBVIOUS when a disposable is wet. Most of them even change color to alert you. With a cloth diaper, you have to actually check it every few hours to see if it’s wet. Also, disposable diapers have a lot of chemicals in them that increase the absorbency, making them last longer than natural fabrics.

If you aren’t alert to what’s happening in the diaper, it can be easy to leave it on too long, thus resulting in a rash. Since I’ve only had one rash since I switched to cloth, and that happening on a day that we were on the road a lot and waited a couple hours too long for a change, I’m pretty convinced that the rashes my mom experienced were because of her own inattention, not because of the diapers themselves. I honestly haven’t noticed that much of a time difference in how long I could leave them on, you just have to pay a bit more attention.

Here are a few other brands that I’ve heard are really good:

gdiapers
Fuzzibunz
Rumparooz

This is the bumgenius customer support page, which covers a lot of issues:

http://www.bumgenius.com/help.php

Here is the cottonbabies website. It’s the company I ordered everything through. They carry a lot of other really great brands too.

And here is the cottonbabies resource page. This is what I always refer to whenever I have a question or can’t remember something:

Finally, here’s where I got my start with cloth diapering. It’s myspace group called Better Baby Buttz, run by the stay-at-home-mom who founded rumparooz. There’s a lot of great information on there, and all the members are moms who use cloth diapers. I’ll often go on there if I have something that’s not working or confusing me, and the ladies are all very nice and helpful!

Best of luck!"

Video About Doulas

This is a really good informative video about doulas, their purpose and role. It's only 3 minutes long. Please feel free to share it with your friends!

Visit msnbc.com for Breaking News, World News, and News about the Economy

Originally posted on Today: Your Healthy Family with Hoda Kotb

Journey Into Motherhood: Inspirational Birth Stories of Natural Birth

This is a book full of inspirational birth stories. It's an e-book, and available for free download here:

Journey Into Motherhood: Inspirational Stories of Natural Birth

Risk to Baby Rises With Repeat C-Sections

This study appears in the June issue of Obstetrics and Gynecology, which all Obstetrician's should be acquainted with.

Click here for the article as it appeared on Yahoo News on May 21, 2009

Here are some highlights from the article:

"Babies delivered by elective, repeat cesarean section delivery are nearly twice as likely to be admitted to the neonatal intensive care unit (NICU) than those born vaginally after the mother has previously had a c-section, a new study finds.

"Nationwide, the c-section delivery rate keeps rising. According to the study authors, by 2006, 31.1 percent of deliveries in the United States were done this way. "'The decision to have your first c-section is very important," [Dr. Alan Fleischman] said.

"There should be a clear medical indication [because] your first may dictate subsequent [delivery methods].'

"Women also need to know that vaginal delivery is possible for many women who have already undergone a c-section, Fleischman said. Some hospitals do not allow vaginal delivery after a prior c-section, however, so he suggested that any woman who is planning on one find out early on what her hospital's policy is."