Healthy Baby Bounty Bag Giveaway

I'm interrupting the regularly scheduled midwifery series to bring you a special giveaway.

Remember this post: Two Hundred Hospitals Nationwide Will Replace Formula Sample Bags With Breastfeeding Support Bags?

Each time I had a baby in the hospital they offered me a free bag with coupons and product samples. They always asked me if I wanted the formula bag or the breastfeeding bag. The "formula" bag was made by Enfamil, a baby formula company, and the "breastfeeding" bag was made by Similac, another formula company! Both bags contained free samples of baby formula along with other coupons and offers.

For a mom who plans to breastfeed exclusively, offering free samples of baby formula undermines her efforts and makes her feel like she is expected to inevitably fail at breastfeeding. The implication is made that eventually she'll need to give her baby formula, so she may as well have some to start with. Who benefits from this type of marketing? Not the babies or the moms.

The Healthy Baby Bounty Bag is a hospital discharge bag designed by Cottonwood Kids specifically for breastfeeding moms. The bag has information, coupons and samples that support breastfeeding, and it includes no formula samples or artificial nipples that could undermine breastfeeding efforts.

So, what does the bag have in it?

The samples are as follows:

• Disposable Nursing Pads
• Milk Storage Bags
• Latch on Tips card
• Mothers Milk Tea
• Diaper Wipes
• Aquaphor Baby Healing Ointment
• Boogie Wipes Anti Viral Tissues
• Sani Hands- Hand Sanitzer
• Sear Portrait Studio Coupon
• Free Gift Card for the mother that gifts can be redeemed on-line. Everyone gets a gift. Prizes include a $5,000 savings bond, free breast pumps nursing pillows and more.

Coupon Book that includes coupons from the following companies

• Lansinoh – Gel Pads
• Lansinoh- Breast Pads
• Lansinoh- Pumps
• Lansinoh- HPA Lanolin Breast Cream
• Lansinoh – Breastmilk Storage Bags
• Bravado Designs Breastfeeding Bras
• Mother’s Milk Organic Tea to promote lactation
• My Brest Friend Nursing Pillows
• Bebe Au Lait Nursing Covers
• Aquaphor Diaper Cream, Shampoo and Healing Ointment
• Sear Portrait Studios Portraits
• Seventh Generation Diapers
• Seventh Generation Wipes
• Seventh Generation Natural Cleaning Products
• Seventh Generation Feminine Care Products
• Boogie Wipes Anti Viral Tissues
• Sani Hands Hand Sanitizer
• Ergo Baby: Ergonomically correct baby carriers
• Baby Stay Asleep: Infant positioning System to help with reflux
• Belly Bar Nutrition Products for Mothers
• Milkscreen Human Milk Banking Association of North America

The coupons themselves add up to over $100.00 in savings.

Plus, the bag itself is designed to be used as a cooler/storage tote for expressed breastmilk.

All you really need to breastfeed your baby is what God gave you, but the free samples, information and support can help as well.

Now comes the fun part... a Healthy Baby Bounty Bag Giveaway!

There are several ways you can enter to win your own bounty bag, and you can do as many of them as you'd like:

• Blog about this giveaway on your blog and include a link to my blog.
• Become a public follower of my blog. If you are already a public follower, please post a comment and let me know so I can confirm it.
• Refer a new public follower to my blog (include the person's blogger name for confirmation). For each referral, you will receive one entry in the giveaway.
• Post about this giveaway on facebook.
• Tweet about this giveaway on Twitter.

There will be 2 winners. For each entry you make, you must post a separate comment on this thread in order to get credit for it. Please include your email address in each comment. If you tweet or post on facebook about this giveaway you may do so once per day during the contest and receive credit for each time, as long as you post a new comment on this thread each time. The giveaway will run 2 weeks, and I plan to announce the 2 winners on March 13. No entries will be accepted after 7pm MST on Friday March 12.

Interviewing Midwives

You can use these suggestions to interview any care giver, doctor or midwife. The first thing to consider when putting together a list of questions, is what you want your birth experience to be. What are your preferences for birth and what do you want to take from your experience? What are you looking for in a care provider? Consider your own personality and that of your partner, and think about the kinds of characteristics you would hope for in your midwife. You might want to write these things down to help you formulate an idea of what to look for and what to ask. You may find that you will have to interview every midwife in your area before you decided on the right one, or you may find the right midwife with the first one you interview. It's a good idea to interview more than one, because you may find one you like better than the first. Some things to think about:

• Talk with the midwife about your birth wishes, and see how open she is to your desires. Writing down your birth wishes or birth plan and taking that with you to the interview will help you stay on track and remember to cover everything. You may also want to bring a notebook with you to write down her answers and your thoughts about them.
  
• How do you feel when talking with her? This is one of the most important things to consider. This person will be monitoring your care throughout your pregnancy, and when it comes time to have a baby she will be in your most intimate space. Having a good rapport with your midwife is going to increase your comfort level and make labor and birth a smooth process. Your partner's comfort level with her is just as important.
  
• How "hands-on" is she? If you are looking for a midwife who will jump in and give you physical support during labor (like counter pressure,massage, etc.) and be at your side throughout the birth, this can be an important question to ask. Some midwives are more laid back and tend to watch and wait more than give active physical support.
• What type of labor support persons does she provide? This includes any attendants, other midwives, midwifery apprentices or doulas she will bring with her to the birth. CNM's in the hospital will not have additional support people other than the nursing staff, but a CPM or DEM attending a home birth may have colleagues or apprentices who attend births with her. If you prefer more support than your midwife will provide, you may want to consider hiring a doula to provide the extra support you desire. My home birth midwife had a group of midwives and apprentices who worked with her, and I was able to choose which people I preferred to have at my baby's birth.
  
• What could necessitate a transfer of care to a physician? If you plan to give birth in a hospital, knowing what red flags will prompt your midwife to transfer your care to a supervising obstetrician can be very helpful. The answer may not differ from one midwife to another, but knowing the possibilities can help you be prepared for any eventuality.
  
• What is her hospital transfer rate? If you are planning a home birth, knowing how often your midwife transfers her clients to the hospital can be helpful in knowing what your chances of transfer could be. Ask her the reasons she would transfer from home to the hospital.
• Is she willing to let you labor or give birth in water? This was high on my list of priorities, but it may be less important to others. I heard a story about a midwife who was unwilling to allow first-time mothers to give birth in the tub, because she didn't want to be "up to her armpits in water" for an extended period of time.

Most questions will vary depending on your specific wishes, including third stage management (whether she routinely gives pitocin to help deliver the placenta or allows the body to expel it naturally), how she would handle a positive Group B Strep screening (antibiotics or other methods), how often she performs an episiotomy, etc. Your birth wishes and questions for the midwife will also depend greatly on your choice of where to give birth.

Don't be afraid to ask a lot of questions and be selective. This is a big decision, and your midwife will work for you, not the other way around.

Susan's Thoughts on Midwives

"I love my midwife who provided care during my last pregnancy during home visits. My body was faster than she was so I caught my own baby, but she was there for the placenta.

"That being said, it is very important for women to understand that their midwife may not be able to make it in time for a planned homebirth, which could be deadly for the baby and the mother. My experience taught me that it would be best to choose a midwife who works within a group practice so that the odds are that someone will be able to get there in time for the L&D (Labor & Delivery). This was not an option for me as the only midwife who would attend a HBAC (Home Birth After Cesarean) in my area is the one that I hired. I didn't feel comfy planning a hospital VBAC (Vaginal Birth After Cesarean), but I had confidence that if there was a reason to transfer that my midwife would be able to provide continuity of care. As it turned out, if I had transfered to hospital I would have been surrounded by strangers with a low VBAC rate so I stuck it out at home. I was blessed that I was in the majority of women who are able to birth without any intervention, but am acutely aware that we are lucky that there were no problems.

"Having a midwife is not a silver bullet, and although every woman deserves her choice of care provider, the fact is that some women will always be safer in the care of an OB. I have learned that autonomy of choice is sacred, and that choosing a cesarean is just as valid as choosing a UC (Unassisted Childbirth). It's just the risks that are skewed. My personal experience with midwifery care drove home the fact that it is more important to support whatever choice that the mother makes than to try and convince her that one way is better than the other based on my personal opinion. Midwives have taught me to support women and their choices."

Rebekah's Home Birth Midwife

by Rebekah

"I had a midwife with my daughter 3 months ago. It was so great! She had such a warm calm nature about herself and it was almost like she could calm you down just by being in the same room, which we know helps when your in labor to be calm.

"Even though my husband and I went through Bradley Classes she was able to recognize when I was either pushing before I was ready or was also able to help me calm down if I couldn't control myself.

"She never acted impatient or upset because my labor took a long time. Total Labor time 21 hrs. and I pushed for 3 hrs.

"One great thing with having a midwife is that you are in your own home.

"With our birth my husband was able to catch our daughter. Then he handed her over to me. We were the only people who held our daughter for her first hours. It was wonderful and such a blessing. He got to cut the cord while she was in my arms.

"It was beautiful experience that I will never forget. I plan on using her again for our next child if she is still a midwife."

Midwife Ina May Gaskin Talks About Natural Childbirth

Different Midwives, Different Experiences - Part 2

How I Met My (home birth) Midwife

by Kaitlin Rose

"The first time I met my (home birth) midwife, I didn't actually meet her that night.

"We were sitting next to each other listening to Suzanne Arms (a natural childbirth advocate) speak. At one point, Suzanne asked us to find a stranger sitting near us to do an exercise with. Since my fiance was sitting to my right, I turned to my left, only to be staring at the back of a bun. The woman to my left had turned to her left, so I was forced to look elsewhere.

"It was that event where I was first made away that home birth was a viable option. I thanked Suzanne afterward as we were about to leave and she pointed out that one of the two midwives in the area who performed home births was sitting next to me. I gasped - those kinds of things really get to me. I love strong coincidences.

"Turns out, I had another link to this woman.

"I hired my doula before hiring my midwife. She teaches a natural childbirth class where I lived, and Eric and I decided we'd like to hire her as our doula within just a few classes.

"Her first birth was at a local hospital, but her second was at home with the midwife whom I was sitting next to. Another connection. This intrigued me.

"In the back of my mind, I knew she was who would be delivering our baby into the world in our home before I ever spoke to her on the phone or had her over for an interview. I had a feeling - much like the "feeling" that I was going to have a natural, uncomplicated, safe and beautiful home birth.

"I couldn't have been more right about the connection I, and my fiance for that matter, felt to our midwife. I felt like I'd known her for years when we met. There was an instant kinship and likability all around.

"During my labor, she blended into the walls, but her presence was such a source of strength and comfort. She let me labor - she let me trust my own process. It was great. She knew just when to appear, such as when she asked how much I had eaten and suggested Eric make me a protein shake. We had talked about that in prior visits and had all necessary essentials stocked and ready.

"When it came to "the moment" - the spontaneous moment I felt like pushing, suddenly, there she was, coaching me on.

"She has delivered over 1,000 babies into her hands. I trusted her, grew to love her, and can't imagine anyone else as my midwife. I'll travel back to Kalamazoo or fly her to where ever I am to ensure she is there."

Kaitlin is a home birth mom who has launched a website all about bringing birth home.

Different Midwives, Different Experiences - Part 1

Even among midwives, experiences can vary greatly depending on the individual and the practices they ascribe to. Kaitlin is a home birth mom who has launched a website all about bringing birth home.

My Experience with Certified Nurse Midwives

by Kaitlin Rose

"I chose to see a group of midwives working at a hospital as well as my home birth midwife for prenatal care (it was a women's service center within the hospital). There were a total of 17 midwives that rotated and were on call for deliveries. Patients could not choose one midwife, they got whoever was on call.

"My very first appointment, the midwife I saw that day said, hi and told me to lay down flat on my back. She set up some things on a little tray and told me, "put your legs up, I'm going to put my fingers inside of you now to check things out." Just like that. No "how are you today," "is this your first pregnancy," "how are you feeling, any morning sickness?" Nothing.

"When that was over, she pulled up my shirt, squirted some jelly on my skin and started checking for the babies heartbeat. All of this was done in complete silence. Uncomfortable. All of a sudden, I heard a little galloping sound come out of the speaker...she pulled away, wrote something down and started cleaning up. I said, "what was that?" in TEARS, and she said, "oh, that was your babies heartbeat." She walked toward the door to leave and I started crying. I was alone. My fiance was working. That was my first time hearing my little girl's heartbeat, first pregnancy... that woman ruined it.

"Every appointment after that was basically the same with a different "midwife" (I don't even like calling them that). My name was called, I stepped on the scale, I waited for the midwife, I was told to lay back, jelly, heartbeat, wipe up, reschedule, goodbye. I hated it.

"When I started seeing my home birth midwife at home... oh my god. The difference was breathtaking. She CARED! I remember the second time she came over I just had an appointment at the women's center the day before and she asked me what position my baby was in. I said, "I don't know, no one has ever felt my baby or belly before." She was in shock. Her hands on my skin felt simply amazing...and she told me what position my little girl was in by such swift motions.

"The very last time I went in for an appointment at the women's center, I got the midwife from the first appointment. It was okay - my fiance was with me for support and he always asked a LOT of questions (he basically initiated a lot of conversation at those appointments because I didn't want to talk to them). He asked that midwife a lot of questions that day and we walked out thankful, GRATEFUL, that we weren't even going to risk the CHANCE of her delivering our child into the world.

"Here's what she had to say:

1. I saw you signed the water birth consent form. I don't do water births. So, you can labor there, but when it comes to delivering your baby, you're going to have to get out (that's verbatim - I could never forget it).

2. I usually always do episiotomies. It's just safer for mom. I've seen women just fall apart down there and it's hard to put them back together (I was pregnant while she was saying this mind you - nice mental images of birth, huh?).

3. You can labor in almost any position you want... I don't know, there's not a lot of room... but laying on your back to deliver your baby is best for you, and for me. It's really hard to deliver babies when women are squatting. I almost always make them turn around.

"I was 36 weeks at this appointment and refused to schedule another, walking out of there feeling SO bad for the women who were patients there. I was, in fact, absolutely furious."

Stay tuned for Part 2!

With Woman - Rachel's Experience

Rachel is a Labor & Delivery Nurse who also blogs about pregnancy and motherhood. Visit her blog.

"Midwife is defined as "with woman", and that definition has played a role in how midwifes view themselves nowadays. I thought I'd just respond to this by relaying a few experiences I've had.

"The one thing I've noticed when working with hospital based midwifes, is that they show a lot of concern for the women's emotional health, regardless of the choices they make. If they have a woman that is going natural, they are there in the room most of the time. They are not just sitting, watching, and waiting. They are actively working with the women in their care. If a woman is using an epidural, they are still usually in the room or close by. They check on them quite often, rather than just relying on the nurse to do so. Very often, the midwifes stays at the nurses desk along with the nurse. And they also very often leave the bed together (no stirrups or leg rests) whether or not the woman has an epidural. They work with ob's, so that there is a sense of continuity of care if something should happen that needs more intervention. All in all I would in general recommend midwifery care for a low risk patient no matter what you are choosing to do with pain control.

"From my own experience using midwifes, I don't remember a lot of how they operated. I do remember feeling much more at peace and calm with my midwifes than I did with a physician. I felt like they were there for me from the onset and through labor. If I had questions, I could talk directly to them. I didn't have to wait for the nurses to decide it was important enough to call them. I also loved having them put my baby up with me after they were born from the get go. I was never made to feel like a medical case at any point.

"One of the hospital midwifes I worked with asked dad if he wanted to catch (the baby). He did and it was a neat experience. The mom had an epidural, but the midwife was still working to keep that connection together. I had just never done that before and I know the family really appreciated it.

"I think one of the neatest experiences I've had in being "with woman", was when I was working with a hospital based midwife. She stayed with the mother the whole time. As the mother was having a natural birth, both of our attention was undeniably on the mother. We watched her movements, tried to understand her needs, and spoke with her where she was at emotionally and physically at that time. I have never before experienced such an intense feeling of teamwork. Not only did we focus on the moms emotional needs, but there was a keen awareness of the need to focus on how the baby was doing also. There was no tension over whether there were too many interventions or not, because we were all on the same page. There was a sense of trust. And while there were some issues that were worrisome, there was no feeling of fear or adrenaline rush. We simply did what we needed to do. I think a lot of this was due to the fact that the focus was on the woman.

"The other time I think of, was when I was laboring with a woman who had intended on going natural. She had become exhausted by the time she got to eight centimeters. A decision was made at that time to get an epidural. She wanted to just have a light one so that she could feel a little bit more when she was pushing. Well, it came down to pushing time, and she pushed and pushed but that little baby just did not want to make his way down. So, me being the natural minded nurse I am, decided that having her push on her back the way I was taught she should, was ridiculous. I knew she was able to move a little bit more and we had lots of help, so we had her role over on her hands and knees and with support she pushed more.

"She eventually was able to push her baby out, but the thing that was most memorable for me, was how I loved working with her to decide how she might be able to push better. I loved supporting her in her desire to push the baby out, and in her desire to try different positions (we even had her squatting on the bed with some support). I loved being able to make sure that her new baby was still ok by holding on the monitor while she pushed instead of having it strapped to her. To me, supporting her in this way was one of the things I love the most about my job."

Types of Midwives

What is a Midwife?

The word midwife means "with woman". A midwife attends prenatal care visits and is present at the birth of your child. She is also there during the post-partum period to provide care as well as advice for mom and baby.

There are three main types of midwives:

Certified Nurse Midwife (CNM)
Trained nurses with additional study in midwifery. Can attend births in hospitals or birthing centers. In some states CNM's also attend home birth. Services are generally covered by insurance, depending on your plan and limitations within it. Is accountable to the hospitals and birthing centers at which they work, and must follow all birth procedures outlined by the AMA, supervising doctors and hospitals.

Certified Professional Midwife (CPM)
A midwife who has passed the North American Registry of Midwives (NARM) competency test and is awarded the CPM Certificate. Only attends out-of-hospital births. Services are sometimes covered by insurance, and many CPM's may be willing to negotiate costs and possibly trade for their services. Depending on individual state laws, CPM's can be licensed and certified with the state, and must follow state laws and guidelines regarding birth procedures, and in some states they have been banned. Sometimes midwives are certified through the state they practice in, and can be referred to as Licensed Midwives (LM).

Direct Entry Midwife
An independent practitioner who has learned the skill of midwifery through study, apprenticeship, a midwifery school or college that is not a nursing program. Only attends out-of-hospital births. Services are almost never covered by insurance, but many DEM's are willing to negotiate costs and possibly trade for their services. DEM's may be licensed or unlicensed. Check with the laws where you live, and make sure you find out your midwife's qualifications when making your choice. If a DEM is unlicensed, it can allow more flexibility in birth procedures because they are not constrained by state guidelines, but it also means she has no legal protection from the state. DEM's are outlawed in some states. DEM's are sometimes also referred to as Lay Midwives.

Certification and licensing are separate. Certification is done through NARM and granted by them. Licensing is handled on a per state basis, and each state has its own licensing laws regarding midwives. A midwife can be certified by NARM and not licensed in her state, and depending on the state laws, a midwife may be licensed but not certified.

In my state Licensed midwives are referred to as LDEM's (Licensed Direct Entry Midwives), and they have received their CPM designation from NARM and registered their licensure with the state. Unlicensed midwives in my state may be referred to as DEM or Traditional Midwife (an uncertified, unlicensed midwife with unspecified training).

How to find a midwife:

First, find out if your state licenses midwives! Then visit MANA, Midwives Alliance of North America.

If there's more than one midwife in your area, you have lots of options! Interviewing perspective midwives is a great way to narrow down your choice and find the best one for you. Birth is all about choice, right down to your care provider. Keep in mind that each midwife is different, and it's important to find the one that is best for you. Some midwives will be more natural-minded and some will lean more on medical interventions, so ask lots of questions and find the one who will fit your needs and desires for birth. Be sure to ask your midwife about her experience, training and/or qualifications to determine if you feel she has what you are looking for.

My own midwife is unlicensed, but she received her midwifery education through an accredited midwifery college and has over 15 years of experience working in home birth midwifery, and also attends hospital births as a doula. I felt her experience and training were sufficient for what I wanted, and the certification was simply a piece of paper when it came to the question of her qualifications. Each midwife is different, and each state has its own laws governing midwives, so please choose carefully.

The Midwifery Model of Care

"The doctor of the future will give no medicine, but will instruct his patient in the care of the human frame, in diet and in the cause and prevention of disease."

- Thomas Alva Edison

For me, this statement embodies the midwifery model of care.

Midwives generally approach birth from the perspective that if it's not broken, don't fix it. Midwives help women approach pregnancy in a holistic fashion: taking into account diet, lifestyle, personal and emotional well-being, and more in helping a pregnant woman stay healthy and low-risk and avoid complications rather than expect them and react to them.

This isn't to say that midwives are ill-equipped to handle problems. They are trained to know what to watch for, and when transfer of care may be needed if something is beyond their scope of practice. Even home birth midwives come to a birth equipped with knowledge as well as tools in case there is a need for it. I was a little surprised when I was in labor with my planned home birth and my midwife showed up with an oxygen tank along with her other tools. She set it aside and never needed to use it, but it was there just in case.

Birth is a natural process, not inherently dangerous

Yes, there are complications that can come up in birth, and there are times when medical intervention is definitely needed. The majority of the time, however, no such intervention is warranted.

According to Grantly Dick-Read in his book "Childbirth Without Fear" 95% of all births are low-risk and require no medical intervention whatsoever.

The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events.

The Midwives Model of Care includes:

• monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
• providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
• minimizing technological interventions and;
• identifying and referring women who require obstetrical attention
  

The application of this model has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

The Midwives Model of Care definition above is Copyright © 1996-2001, Midwifery Task Force, All Rights Reserved.

I've written many times before about midwives. Here is an older blog post that might be of interest:
Differences Between Physician and Midwife - My Personal Reflections

In the coming weeks I will be posting a series of blog posts about midwives, along with some personal experiences and advice from some of my friends. If you have any questions or comments, or would like to share your own experience, please feel free to post a comment below.