Continuous Support Doula

A is for. . . .Answers to Insurance Questions

2012-02-05T22:02:00.000-05:00

Very occasionally, I will have client(s) reimbursed by their insurance for my service(s). I cannot promise that you will be successful, but one can always try. If you hire me and are successful in getting reimbursed, I would love to hear how you accomplished it, and what insurance you have (if you don't mind my knowing).

Z is for. . . .ze picture says a thousand words

2012-01-31T14:38:00.000-05:00

Here it is.

Y sounds like the word: Why?

2012-01-31T14:08:00.001-05:00

Ukelele sounds like it starts with the letters: Y O U.

It is 16 inches by 32 inches. It is propping up my ukulele, above a door, with room to spare. I look up: Oh why do I have a ------- with no glass?

Can you guess what it is?

A riddle.

X is for. . . .Examples of Payment

2012-01-31T02:40:00.000-05:00

I believe in paying professionals their full worth, if possible. Some examples may be: paying their rate in full in the form of: cash, a gift, a donation, a trade, a service, with some craft or skill of your own, with kindness, with a testimonial for their business website, or they may refer a client to you, and the list can go on. . . .

This payment need not be timely. This payment need not be over and above the agreed upon price. And in some cases, the debt may be forgiven.

W is for. . . .When do You Hire Your Doula

2011-12-13T11:43:00.000-05:00

Hiring your doula needs to happen before you go into labor, we know that. But how soon is too soon? It seems that there is no definitive answer, but typically I find that women hire me from about 33 weeks of pregnancy up to 1-2 weeks from their expected due date. Sometimes they decide to have a doula at their birth after they begin attending or having finished a childbirth preparation class. It is recommended that women attend a childbirth prep class begin your classes at the start of your third trimester of pregnancy (about 29 weeks, or about 7 months pregnant), so that you would finish about 4 weeks before your due date.

And once, I was even called to a birth much, much later - the client was in labor - without having been previously hired, or even taking an in-person meeting with the client.

Some women contact me at the beginning of their second trimester of pregnancy. It could be that the excitement of expecting is too great, they want to get started putting things in order, and they want to leave nothing until the last minute. They want to begin building a relationship with their doula because they need the time to share their hopes and dreams, to spend their energies building community. The baby's first kicks, flutters really, may be felt as early as 16 weeks, but will be felt during the second trimester of pregnancy. Some mothers having felt them, are inspired to start their preparations in earnest. For some women, feeling those first kicks means so much more, if they have experienced previous losses.

It could simply be also, that due to the very fast pace of life in the New York area, they haven't been able to really connect with their care provider(s) (Midwife / OB) in a way that makes them feel completely prepared emotionally. They know that medically or clinically they will be well cared for, but the women who contact me earlier in pregnancy are usually in need of more attentive care and emotional support. They want community. They want a listening ear. They want support through a time in their lives that is special and difficult and magical, all at the same time.

It is an honor to get the call, whether earlier or later. But please call before you have gone into labor!

V is for. . . .various paths to parenting

2011-11-01T03:10:00.000-04:00

I've been struck by how parents share so much, regardless of how they came to be parents. Whether biological children, or adopted, or step-parenting, parents are made. . . .

I see so many sweet qualities in new parents: they are excited to have the child, they are happy, a bit nervous, unsure of how the path unfolds, seeking community, thrilled with the child, feeling immense responsibility, wanting guidance, hoping to share their world with the child, and praying the world shares with their child. . . .

Making the decision to have a child is momentous. It is to decide forever to have your heart go walking around outside your body. (Elizabeth Stone)

U is for. . . . Unemployment, unfortunately

2011-08-12T23:18:00.000-04:00

For clients:

I am happy to make a payment plan in the case of unemployment. This is much preferred over lowering my rate(s). Though I have offered volunteer services to teenagers or the homeless. I do believe that there is a doula for everyone who wants one. And that the work we do as doulas is important work, traditionally women's work, and it is both a labor (excuse the pun) of love, and well - work.

For doulas:

I hear from time to time, of a doula serving a family at a birth, free of charge. And even doulas doing free postpartum work. I don't support this idea, in general - unless in the case of a teenager / homeless family. And I've also heard of free doulas who do not get the call to attend the birth. Think about it, a woman who does not pay you, is not planning to call you.

As for postpartum work, I don't get requests from teenagers / homeless families. Many of my requests come from families whose baby's birth I have attended, for pay. Others come from doulas I know who are themselves unavailable.

Typically families wanting postpartum services have a variety of services available to them, services that they happily, or as a necessity pay for: food delivery, takeout food, laundry, babysitting their older children, cleaning services, etc. As of 2011, a New York babysitting service I know charges a minimum of 20 dollars an hour, plus fees, and expects you to tip the babysitter for good service.

Doulas, think about your skill level, the costs of keeping your skills up to date, the market rates for doulas, other helpers and services - and what they charge, when setting your rate(s). Think also about the other work you do, and what rate you command in the job market outside of doula work. It can be hard for a woman to assert herself, and say this is my rate. The doula profession does not advance, and you do no favors to other doulas, when you yourself assign too low a value to the work that you do.

Remember also, that your skills as a doula may be valued in the volunteer work that you may do. Volunteering in your local WIC office, offering a couple of teenagers or homeless families pro bono services as a birth doula can be fantastically rewarding. Exchange or barter your doula services for services you need, so you can continue your paid work as a doula. If we treat our work as deserving of compensation, we are honoring women and their families for the work that they do, both inside and outside of the home. And I suggest that you have every client submit your bill for insurance reimbursement. I've heard that women may find it easier to use their health care FSA (Flexible Spending Account) for doula services.

My family has know unemployment. And unemployment is a fact of life, in our world. But New York City affords wonderful opportunities, and unemployment can change, in well - "a New York Minute". Still, as a doula, student of childbirth education, and wife to a fantastically skilled musician, I have this suggestion,

For doulas, and everyone else:

Save! No, not 10%, but 25%

Having that cushion can really make a difference. Until, in a New York minute, you are working, again. Suggestions for part-time and supplemental income for doulas, and others - will be shared in a future post.

T is for. . . .The Learning Curve

2011-08-05T01:37:00.001-04:00

Nice article on The Learning Curve of Breastfeeding. Daniell Rigg, JD, CLC says it well: http://www.bestforbabes.com/pdf/best-for-babes-learning-curve-09102008.pdf

Nursing my daughter, I had this experience:

Beginning to nurse my new daughter was easy, natural. She was born "naturally" at Elizabeth Seton, on 14th St. A birth center, then affiliated with St. Vincent's hospital. She latched on not too long after she was born, and it felt like she didn't let go, until the following morning. Breastfeeding continued to go well. Her pediatrician visits went well, and her Dr. said she was "Perfect!"

But some weeks later, breastfeeding seemed not as easy as it had been. Members of my family had lost a child. I was reminded of it, as I complained about how breastfeeding suddenly had become difficult - as my husband and I visited with a lactation consultant. What right had I to complain about nipples being sore? When that baby was gone?

My pediatrician was satisfied with my baby's weight gain. She nursed well at home. Outside of my home - I couldn't get comfortable. I burst into tears. The LC reviewed my baby's weight gain. She felt it was pretty close to on track, but she wanted us to work with her to make feedings more efficient. We had come to see her because of sore nipples. She suggested a couple of things that we could try to get better weight gain. We could pump after each feeding, and supplement with my own milk. And, we could use a bit of formula, for now, until my pumping could produce milk to use. She gave me suggestions to heal my nipples.

Well, we got right on it. As she showed me how to use a Supplemental Nursing System, my husband ran out to get some formula, and we worked on my DD's latching on.

After that lactation appointment, I did some research. I read a TON of articles from La Leche League. I went to meetings all over New York City. And a few weeks later, I took my daughter to her pediatrician appointment. We had a good talk with the Doctor. He helped us with our concerns. He took time to really listen to us. He was very reassuring. My pediatrician asked to see how my daughter nursed. He told me: "Perfect. Just Perfect".

And that very day, nursing my daughter didn't hurt any more. We got better and better at it, with all the practicing we did. I Freestyled: I nursed laying down, with a pillow, with several pillows, in the sling (comes in handy for uncomfortable Father-in-Law) and even standing up! And then, looking back, I realized I had done it. I'll never forget her birth, 10 years ago. And I'll always treasure the gift of nursing her.

S is for. . . .Story - Your Baby's Story

2011-07-29T19:21:00.001-04:00

Eight years ago now, I attended my first birth doula training with Ilana Stein. Ilana was an enormous personality, and truly gifted (I'll tell you about my experience with her, in another post). She recommended that we write out our client's birth story for them as part of birth doula service.

The more that I think about this, the more I think that it is a bad idea. Sure, for practical reasons - how do I support, support, support and report, at the same time?

But also because a woman's birth story belongs to her. And no one else. Except her baby.

R is for. . . .Ricki Lake, of course!

2011-07-24T00:13:00.000-04:00

So many women who call me to ask for my service as a doula talk with me about "The Business of Being Born". I am familiar with a midwife featured in the film. But I first heard from a fellow Murray Hill neighbor, years ago, now - she had to tell me. . . . upon hearing that I was a doula - did you know that the actress Ricki Lake is a doula?

Ricki Lake's movie definitely has been seen by a ton of pregnant women in New York City. A pregnant friend of mine talked with me about "The Business of Being Born" - and she appeared to be terrified. I had to talk her down!

The second movie wants to answer commonly asked questions, such as this one:

What is the difference between a midwife and a doula?

Thank you! I get this question a lot. Ricki Lake did fundraising for her second pic, money was raised in mid-July. So it is on! Can't wait to see this one, and see if it is met with a lot less fear. I really hope so - because Ricki Lake did have a homebirth, like I did. And I don't think that she distrusts birth.

I'm glad that Ricki Lake is giving this another go - there is definitely value in The Business of Being Born, but just like Orgasmic Birth, a movie I often recommend, doulas, breastfeeding, and a whole lot more is not explored anywhere near in depth. And that is a problem of focus - you just can't cover the whole spectrum of birth and postpartum in a movie, but I'd love to see someone try! I think that Orgasmic Birth does a much better job of depicting the dance of labor, and I recommend it over BOBB. But watch whatever you want to. I will be reviewing More Business of Being Born, soon.

Q is for Quenching Your Thirst

2011-07-16T18:05:00.001-04:00

Just found a yummy frozen treat. These would be great in labor! Yummy, and easy to hold in the hand. And they are shelf-stable until you put them in the freezer.

P is for Pudding

2011-07-14T02:17:00.000-04:00

Banana pudding, to be precise. Organic, and from a box. German brand, I think. I had to make a treat. After virtuously cooking up some CSA kale :)

Take that, Park Slope Food Co-opers! Yes, we have CSAs in Manhattan. Organic groceries and local groceries like Fairway. Trader Joe's and Whole Foods are here, too. And sometimes I still visit an old, old, favorite, Integral Yoga Natural Foods. It was either at IYI Natural Foods or the Yoga Institute, that I first had Kale. And the first time I shopped for Organic beans, lentils grains, and flowers - from bulk bins. Good times, and lots of lentil soup. Don't tell the yogis, but my BFF's mom showed me how to kick my lentils up ten thousand notches, (sliced hot dogs, but I used Organic :)

Made veggie kale tonight. Used a recipe from Mark Bittman's "How to Cook Everything". I recommend the book, highly. It is much more useful than "The Joy of Cooking".

Tomorrow zucchini bread, I think.

O is for the Obvious Reason Why I am Hired

2011-07-13T22:54:00.000-04:00

I've often been told:

It's obvious why you are hired as a doula!

It is - and it isn't. That is to say that natural childbirth is not the one and only priority for women and their families who hire me. Often families want to make birth plans, but be open to detours from their plans - if that is what is in the best interest of their baby.

More important to many is my experience with a particular hospital's doctors or midwives. Other times it is because I am the doula that they connect with, and they cannot see themselves hiring another. For others, my home birth experience and familiarity with New York homebirth midwives is very valuable.

Whatever the reason(s), I'm glad to be of service.

N is for "Natural" Childbirth

2011-05-20T02:45:00.002-04:00

Let's face it, there is nothing "natural" about New Yorkers. We don't p**p in the woods, we don't hunt and eat what we kill (vegetarians don't pick their own), and we believe in general that we CAN improve on nature.

So why do we love "natural" childbirth? And what, exactly do we mean when we say we want "natural" childbirth? Do we want to do it like the SNL skit, in a yurt?

Let us just call it what it is, natural childbirth =
vaginal birth without drugs. A couple need not become hippies to accomplish this, do not need to travel to a yurt, but childbirth education might help. And so much depends on their chosen care provider and birth place.

The skit was really smart, I've been to several childbirth education classes, as an expectant mother, and in preparation for doula / childbirth educator training, and the SNL cast really got it right. Modern videos with high production values of natural birth are rare, for several reasons: couples want their privacy during childbirth, but also because at this time, most births are happening in hospitals, where natural births are rarely ever seen, and some birthing women and their families are told that they are not allowed to film the birth.

But search for "birth" in Youtube, and you will find many examples of natural birth. And some not so natural, like Monty Python :)

Natural births are not happening in great numbers in NYC hospitals. See for yourself Click here to see the stats.

M is for Mothering, competitive and otherwise

2011-03-22T01:25:00.000-04:00

We've all heard talk about the Mommy Wars. But what about an online magazine and discussion forum for mothers and others, called Mothering? Mothering Magazine was available at Whole Foods, but now has gone virtual, and is only available online. I bought a few copies many years ago, at a health food store, and became a member of Mothering.commune to chat with other moms. I did enjoy the magazine, I found it to be very well-researched, and the articles on baby wearing, breastfeeding, and babies enchanted me. And for the first time I met women who were mothering in ways that I had not seen before, and it was a true education. It felt like I was not alone, but one of many mothers going through similar things.

Mothering.com felt like a second home to me, and a source of inspiration, but how did my friends in real life feel? Most of my RL friends were unaware of the existence of the Mothering Magazine dimension. But one friend of mine felt angry at Mothering, she said that it touted impossible ideals. She felt venomous towards what she called the "Mothering Magazine mindset". She said that she did everything right, and that she hated Mothering Magazine, that she was not a failure, and that Mothering was full of, well, you know. . . .

What did she hate? She felt judged for her birth experience, for not avoiding an epidural, for having failed somehow. She was really very hard on herself, I think she was unjustly hard on herself. She saw a failure, but that isn't what I saw: I saw a really caring mother, a strong woman, a beautiful person, who had a difficult birth, and was blessed with a beautiful child. A really fantastic kid. But she was focusing on the birth, where so much was simply out of her control. I don't know if she still feels that way, we have kind of lost touch. Perhaps time has dimmed the hurt, but not the feeling of being lied to, of being "promised" a different birth experience than she had.

Buying a magazine ideal, subscribing to an online forum, taking the best childbirth prep classes, hiring the best doula, even becoming a childbirth professional does not guarantee a fantastic birth experience. There really is no "winning" in mothering or birthing. We aren't competing against anyone but ourselves. There are no gold medals. Meeting with a group of doulas and expectant mothers today, I was reminded to focus my work with women, not just on the facts of their birth, or birth plan - no one can predict or orchestrate a birth - but on her journey: how does she want to grow - and what does she want to take away from her birth experience, so that the goal is not did she accomplish her birth plan, but a goal such as: what did she accomplish? was she empowered? was she listened to? what did she learn?

L is for Labor, of course.

2011-03-21T22:27:00.000-04:00

Why is labor so different for everyone? No two women seem to do it the exact same way. And if asked to rate labor pain on a scale from 0 to 10, you will get every number on the scale, if you ask enough women. I don't really have to ask, since as soon as I tell a woman that I am a doula, she tells me her birth story. But I like that :) After all the labors I have attended, experienced or heard of, I cannot even begin to speculate about why. Maybe there is no why?

K is for. . . .Kid care

2011-01-17T05:26:00.005-05:00

Are you a doula with children? How do you do it? Please share your strategies and resources.

I'm fortunate to have a very supportive husband, regular babysitters, and neighbors willing to babysit - sometimes with very short notice - allowing me to work as both a labor and postpartum doula. And I have backup, too - in the form of Sitters Studio. Have you
used Sitters Studio? Aren't they the best? I have not been payed to promote Sitters Studio, I just really wanted tosuggest them as a terrific New York babysitting resource. The ArtSitters who we have met are consistently enthusiastic and professional and I'd recommend them highly :) to the New York birth and postpartum doulas I work with, and clients alike.

J is for "Jaundice"

2011-01-08T19:19:00.000-05:00

Jaundice: Why do doulas and their clients need to know about it? Because jaundice phobia on the part of parents and healthcare providers often creates obstacles to successful breastfeeding.

I've just found a lovely article about after the birth. . . .

2010-11-11T10:45:00.001-05:00

http://www.glorialemay.com/blog/?p=34

What about after the birth? Many, many, many clients and friends who have consulted with me about birth preparation had absolutely no plan for after the birth. Many had never cared for a newborn before. And others just had no idea how much help they would need, not only with baby care, but for themselves. A truly wonderful doula (and soon-to-be-midwife) shared this article with me, and I need to share it with you. This article does a wonderful job describing the new parents' possible needs.

Home Birth

2010-10-20T00:10:00.001-04:00

Yes, I love attending home birth. I've had one of my own, and attended others. There are several home birth midwives that I refer to in New York City.

Good candidate for VBAC?

2010-09-13T06:23:00.000-04:00

So, are you having a second baby, and hoping to avoid a cesarean? Wondering what chance you have of having a baby without surgery, this time?

Find out more: A Woman's Guide to VBAC

F is for. . . .Familes I have not worked for

2010-08-26T03:03:00.000-04:00

No, I'm not talking about my clients or potential clients. But I will put this out there: I have not yet worked with any observant Jewish families. I am not Jewish. As I understand it, there are Jewish families who prefer non-Jewish doulas. Because of Shabbat observation, families may prefer a doula who is not Jewish. Their doula would be free of observing Shabbat. . . .

Doulas who observe Shabbos may want to check out Journeymama's post: Serving as a doula on Shabbat. Of course if you are a doula or have questions about doulas, and their role in your home and you are Jewish, then you would want to check with your Rabbi.

Question for my doula readers: Have you worked with a Jewish family that preferred you because you were or weren't Jewish? Why do you think that is?

E is for Early Labor

2010-08-08T22:30:00.000-04:00

Early labor is typically not painful, but like most things birth, never say never. Some women do experience painful early labors. Early labor beginning in the evening is a common occurrence, and my suggestion is to try to rest, if you can. Contact your care provider as instructed, and try to do restful activities, if you cannot sleep.

Early labor is not the time to overdo things. Remember to eat and drink and relax. They don't call it labor for nothing; labor is work, and you will need your energy. Some suggestions for restful activities (always check with your care provider, if you have questions or clinical concerns):

Take a bath.
Rest or sleep if you can.
Arrange photos in a photo album.
Take a walk, but don't run a marathon :)
Sit and relax, watch TV in a comfy place.
Don't forget to eat / drink.
Draw a picture.
Play cards or game with your partner.
Get a manicure.
Go to the hairdresser.
Write in your journal.
Shop online.
Dream about your baby, and imagine your baby as a 3 year-old. . . .suggestion from my daughter, 9yo
See a movie (something funny, if possible)

Don't forget to call your care provider, and ask when they want to hear from you again, if you forgot their instructions.
Make arrangements for child care if you are responsible for caring of children.
Do light tidying, this is not the time to clean your cabinets.

And of course, call your doula :)

Readers: What did YOU do in early labor? Doulas?

Directions for Packing Your Hospital Suitcase

2010-07-31T18:52:00.001-04:00

Question: Doulas and New Parents - what did you bring?

In addition to my comments below, I recommend mother and partner both keep a copy of Penny Simkin's 4 Questions Card, and I keep one, myself. The questions are neutral and really help the clients figure things out WITH their clinicians. It is informed choice.

I found this list on a New York Hospital's website ( I am not giving identifying information)

My comments are in [BOLD]

For Mom: During Labor
1.    Wash Cloths - the hospital can't provide washcloths, after all they are charging you or your insurance?
2.    Pillows - again, why? I guess they have 1 pillow, but why not a bunch more? Why can't the hospitals afford them? Is it because they pay their staff too much? Nurses, please tell me :)
3.    Picture for a focal point
4.    Lip balm or chap stick
5.    Sour lollipops, mouthwash, icepops, Gatorade or any clear liquids - nice, there was a time that Gatorade wasn't encouraged. I bring Tootsie Roll Pops :)
6.    Toothbrush and toothpaste - I bring toothbrushes and toothpaste for everybody - you can get 12 for a dollar, again, can't the hospital provide? I guess not. . . .
7.    Tennis balls, rolling pin or “Freeze It” ice packs for counter pressure - cold is easy to get in a hospital, bring a sweater!
8.    Mother's eyeglasses (in case contacts are removed)
9.    Hairbrush, rubber bands/barrettes for long hair - My daughter's dance studio used to provide bands. . . .
10.    Snacks for the coach - because the laboring mother will NOT be eating! Oy.
11.    Change for the vending machines - My nurse friend tells me hospitals in the UK offer you tea. . . .
12.    Camera (videos are not permitted) - Why? Why no videos? Your birth is a momentous occasion!
13.    Birthing ball (if preferred) - Some hospitals have these, but apparently not this one - your doula will more than likely have one

For Mom: Postpartum
1.    Slippers and a bathrobe - Good for walking the halls in labor, moving in upright positions: walking, squatting, walking the stairs can help move labor along
2.    Two nightgowns, short if you have them, opening down the front if you are breast feeding - Long nightgowns can be messy, due to postpartum lochia (bleeding) avoid them, if you can. Please note that almost any top can be pulled up from the waist, allowing you to breastfeed. I suggest avoiding buttons if you can - if you can't get a large enough top to pull up, without unbuttoning - it is more modest.
3.    Two bras. If you are breast feeding, buy two different styled nursing bras during the last                    month of your pregnancy. - Actually, bras are not necessary :) of course they can make some women more comfortable - get them as your breast size increases - they can be several different sizes, after a few months many women go gradually to a size closer to their original, pre-pregnant size - you'll see them on the way "down". I suggest that my clients do NOT buy pregnancy bras if they are planning to breastfeed - they are not functional. Best to buy nursing bras, since you will be using them, later :)
4.    Shower cap and rubber thongs for the shower. - OK.
5.    Toilet articles - This means shampoo, soap, moisturizer, makeup, etc.
6.    Pen or pencil - Bring a few, they can disappear. . . .
7.    A few dollars for sundries - Yeah, bring money - but not too much. . . .
8.    No valuable jewelry or large sums of money - I guess hospital security cannot be everywhere. . . .
9.    Street clothes for the ride home. They should be loose fitting as you will not have your figure                    back. - In other words: You will be holding your baby, and you will STILL look pregnant!
10.    The hospital will provide sanitary pads and disposable underpants. - The disposable underwear isn't too bad - grab a bunch. You may want your own sanitary pads; there are several that I recommend.
11.    Your own pillow (2 if breastfeeding) - Don't forget your "My Brest Friend", the Boppy just doesn't cut it.

For Your Baby: At Discharge
1.    Undershirt - Onesies, bring 3 or 4, discharge can take HOURS.
2.    He/she will wear home a disposible diaper supplied by the hospital. - use your own, if you want.
3.    A, dress, stretch suit or kimono. - Stretch suit = onesie - a kimono is a t-shirt that ties Asian-style, across the front, a VERY cute look. And don't forget: pants!
4.    Sweater, hat and heavy blanket or bunting for cold weather. - Warm coat / or jacket, if driving home, you can get a zip-up bunting for your carseat. Wearing your baby on public transit can keep them warm, too - if you wear them under your coat. While safer to use a carseat, they are not required to be used in NYC taxis.
5.    Receving blanket. - If you have a baby shower, you will likely get a gazillion of these.
6.    Large cloth diaper for a bib. - Keep the baby blankets that you don't like for this purpose, or get flat, or birdseye diapers, in Conway's, a cheapie children's store, in NYC. Remember Conway's when you potty-train, they've got cheapie potty training seats that fit over adult toilets.
7.    Car Seat - This is only necessary if you drive, or are leaving in a car. Otherwise, you don't need them. Some parents like to use them in taxis or car services, or friends' cars - and that's great!

Comparing Experiences

2010-07-31T17:14:00.000-04:00

Your experience as a parent is a winding road, full of surprises, full of learning and growth for all.

And I want to share with you that motherhood or parenthood is NOT a competition. There is no use in us competing in our experiences; there is just no way to "win". My skill lies in helping you make your own best choices as a family, and those choices will be different for each and every one of us.

B is for "Better Mom"

2010-07-26T18:02:00.006-04:00

Weird experience today: I saw a mom buy some Tilex. TRULY obnoxious stuff. I bought a big box of baking soda. I told her I mix it with soap to clean the tub. She said "you're a better mom than me". I was a bit put off - I mean by this standard, her grandmother and great-grandmother, and mine, and all of their friends were better moms than her - Tilex didn't exist in past generations.

Anyhoo, here is my recipe:

Squirt a handful size splat of:
Dr. Bronner's (any kind, including Sal Suds, if using Sal Suds, a smaller amount)
OR
Shampoo you don't like anymore
OR
Mild soap or dish detergent

WITH:

Baking soda, and rub them together in the tub - then scrub away with the paste. If it is not pasty, simply add more soap or baking soda.

This stuff usually rinses clean, but if you have any remaining soap scum, then do a vinegar rinse. Just put some vinegar in a good quality spray bottle, or apply the vinegar liberally to a sponge or rag, and the soap scum disappears.

If you are pregnant, or responsible for a young child, then you really want to use old-fashioned or natural cleaners. Not only do you not want to feel ill, you can't afford to be down with kids in the house. And no one wants to expose kids to this stuff. . . . .

Some other not too toxic cleaners are:

Soft Scrub
Comet
Bartender's Friend
Borax
Soap
Vinegar

For more info on these and other cleaners, get a copy of "Clean House Clean Planet" - it really isn't hard or expensive, I promise. FlyLady gave me the shampoo idea - and yes, SLS can be some interesting stuff too, but "waste not, want not".

Readers: What are your clean house tricks, and are you a "Better Mom"?

A is for....Advocacy

2010-07-13T23:25:00.004-04:00

When I interview with clients I make it very clear that I do not speak to clinicians on their behalf. I do support my client in their choices, whatever form they take. And as an information professional, I'm really good at offering my clients evidence-based information, helping them to make their own best choices.

It would not do anyone any good if I stepped in and made clinical decisions for them. And, not only would it be unwelcome, but it would be unnecessary. I can be helpful when I don't say anything. In fact, the language of labor can be song, movement, directed gaze, gentle touch. It is rhythm, relaxation, and ritual. In research described in a previous version of "The Doula Book" titled: "Mothering the New Mother" studies were done where doulas said not one word. Afterward, the newly delivered mothers described the silent doulas as their "angel" and similar language. Births were less complicated in the doula-supported groups, and outcomes better than in the births without doulas present. The support I give is unconditional, and I hope I am described as an angel.

Z is for. . . .Ze reason for this blog

2010-06-27T18:04:00.002-04:00

As a birth doula, postpartum doula, and a chilbirth educator in training, this blog is a wonderful exercise in sharing with you. I haven't gotten too many comments, and would really love some from you. And I am working on adding interviews with doulas, so if you are a doula and want to be interviewed, please contact me at: tessa.morales at gmail.com to be interviewed for this New York doula blog.

Y is for. . . .You get what you get, and you don't get upset

2010-06-26T05:28:00.002-04:00

I first heard:

"You get what you get, and you don't get upset."

at a child's birthday party, from a really great clown.

And this phrase really comes in handy when a toddler wants a red, not blue lollipop or something similar.

But I think we do mothers a disservice when we ask them to feel the same way about the birth of their child. We know that mothers remember their births, many, many years later. The birth of a child is an unforgettable memory, it really is. And so it is really, really important to have a meaningful dialog with our clinicians. To give them valuable input about the way that we want to be treated. To give them a critique, with both suggestions for improvement, and compliments, when earned. I hope that you will take my post to heart, and complete The Birth Survey, today.

X is for. . . .the X factor

2010-05-28T01:09:00.005-04:00

What is X except a placeholder for the unknown. In algebra we find "x". So that lead me to ask:
What is the X factor of childbirth? Why don't we yet know what causes a woman to go into labor? How does her body know how to do it? How does a baby know it is time to come out? It is a mystery, a complete and total mystery, though there are theories. Still, labors are routinely induced ahead of the natural schedule. Does this mean induction is safe?

Here is more information on inductions, and how and why they are done: http://www.childbirth.org/articles/labor/induction.html

And from the March of Dimes: http://www.milesforbabies.org/pnhec/240_20203.asp

Do you readers have any experience with inductions? Are they ever a good idea?

What if I have to have a cesearean?

2010-05-22T09:10:00.002-04:00

If you have to have a cesarean, then we doulas want you to have the best cesarean possible. Is that a contradiction? Don't doulas just help with natural childbirth? The answer is, no. Doulas are interested in your having the best birth possible for you. Every woman will define that differently. Every pregnancy, every baby is different. Sometimes clinical concerns mean that a medically managed birth is suggested. And sometimes that means a cesarean birth is the result.

Some of you may know that a cesarean is the plan before the baby comes, and others will find that a cesarean birth is performed as a life-saving plan. Some of you may want to be prepared well in advance, "just in case".

V is for Vaginas: "multi-use works of evolutionary perfection"

2010-04-24T04:00:00.004-04:00

I just read a blog post by Erica Lyon that I thought was brilliant, and brilliantly obvious, but necessary - crazily enough at a time where almost 1 in 3 women are having cesarean deliveries:

If we're going to take back birth, we need to start understanding why it's a good idea to have a baby come out of our vagina - both for our body and for the baby. Our vaginas are multi-use works of evolutionary perfection, and women need to have equal access to doctors and midwives who are skilled and trained to birth babies out of them.

written by Erica Lyon of Realbirth. Last accessed 4/12/2010 at: http://bigbookofbirth.typepad.com/realbirth/2008/09/trying-to-take-back-childbirth.html

That is just a kick-ass statement: women have vaginas that are perfection. Sounds very Vagina-monologues, huh? Read more, here.

U is for Unassisted Childbirth

2010-04-11T03:52:00.002-04:00

Unassisted Childbirth or UC is the practice of giving birth without the help of a medical professional. Without the help of a Doctor, OB, or Midwife.

As a doula I will encourage you to communicate with your caregiver about when to call them and have them present in your labor and delivery. I will support you in labor, but I offer non-medical support, only.

As a doula I will absolutely NOT support the practice of UC. Although there are no laws in New York that I am aware of prohibiting the practice of unassisted childbirth, I feel VERY strongly that I cannot offer my services as a DONA-trained doula at a UC birth. Not that anyone has ever asked me, I just feel that I really need to state my position. And Unassisted Childbirth starts with U. I like the discipline of choosing to blog by the alphabet, it is challenging at times, and fun.

T is for Thoughts on Breastfeeding Styles

2010-04-07T01:51:00.002-04:00

Is there one right way to feed a baby? This is something that I'd thought a lot about, recently. I guess the only truly important thing is that the baby is fed :) In the United States, this is typically formula feeding, formula in a bottle.

What is formula? Did you know that up until recently, formulas were prescribed by doctors? Each doctor had their recommended formula recipe.

My mother probably fed me a homemade formula made from canned milk. After she breastfed me for 3 days. God bless her, she did her best. Came down with a fever and was told to stop breastfeeding. Probably she had mastitis, which we now know is best cured by rest, and ironically, breastfeeding.

And what about breastfeeding? Lately I've thought that I really have no right whatsoever to tell a woman what to do with her breasts. If she wants to breastfeeding for a few days, weeks, or months, then it really is her choice. But does the baby have the right to breastfeed? Of course the decision is made by the mother, not the baby. But when we think about the baby's right to breastfeed, it puts the related subject of nursing-in-public in a different light. . . .

It is really hard to be a trend-setter. To be out there, however discreetly, nursing your baby, when very few babies are. I saw a new mother at one of those chain cafes, you know-the-one with Pain in the name? Anyhoo, she nursed her baby, and I don't know if she felt uncomfortable, or if it was her mother, the baby's grandmother who initiated a big effort to adjust the nursing mother's shawl, so as to cover the baby getting mama's milk. This really sends a message, I think. Shawl or no shawl, there wasn't much skin to be seen - it seemed to me that no one would have known or cared if the baby was nursing at her mother's breast, why the big fuss? Funny that breastfeeding should be a trend, huh? I mean we wouldn't have survived as human beings without it, and yet. . . .

Don't know if I can really share concern about breastfeeding modesty, it just doesn't seem to be wrong to me, because we human beings are mammals? Because babies are born to be breastfed. Now, I can see that there are many women who are sensitive to criticism, and who, for whatever reason, maybe their own personal modesty, are not going to breastfeed in public. But whether a mother nurses 100% or something short of that, I love it when babies get breast milk, because babies really love it.

The baby was really cute. And looked very content after nursing.

So some are modest when breastfeeding, even wearing Hooter Hiders, or the like. As a doula I want to say that I support you 100% whether you decide to cover up, or not while breastfeeding. I do think that covering up can attact more attention, but honestly, if it means that baby will get mama's milk, I can totally support that.

Some parents have an end date in mind when deciding to stop nursing their babies, or wean them. Others follow babies cues, allowing them to "self-wean". I have been the unnoticed observer of women describing schedules for their babies first foods. And there are tons of opinions on when babies should drink from a bottle, eat their first solid foods, or wean. And what those first foods should be, and in what order. For those of us who follow the new standards, it can be shocking to hear how "early", or how "late" someone else thinks a baby should eat! But where did the grandmothers get their information on infant feeding from? They got lots of information from the doctors of their time, and from the traditions that they grew up with. And everyone seems to have strong opinions. . . .

Now when I suggest ideas for infant feeding, (because I am not a doctor, I do not prescribe breastfeeding or formula schedules) I offer the families I work for evidence-based information on feeding methods. This information can be found through the good doctors: AAP (American Academy of Pediatrics), La Leche League, and baby books such as those written by Dr. Sears and his peers. There is room in the suggestions from experts to express your own style, and, so long as baby is fed - you will have my support.

S is for Support

2010-04-04T14:23:00.003-04:00

Continuous support for women during childbirth
Continuous support in labour increased the chance of a spontaneous vaginal birth, had no identified adverse effects and women were more satisfied.

I would say that the same could be said about postpartum support:

Continuous support after baby arrives increases the chance of smooth transition to life with baby, with no adverse effects and a more satisfying parental experience!

So you want to be a doula? Do you feel that you want to support families? Number one truth to know about support? It is her birth. Her baby. Obviously for adopting families, it is the adopting persons baby. What does support look like? Well one aspect of support is that it is continuous. Often a birth doula is the support person who is there from the early stages of labor, and for a few hours / days / weeks later in the form of postpartum support. It is no accident that I have named my doula service Continuous Support Doula. What else does CS stand for? Common Sense. Every scientific study that I have ever seen has supported the assumption that women need and benefit from support during childbirth. Fathers also benefit from having a doula at their birth, and in the early days with baby.

My own partner has always both jokingly and quite seriously said to me "get the women". And by that he meant that he appreciates having a helpful hand around when a new baby joins our family. If asked, he would tell anyone he knows to hire a doula. Having had the support, we are now able to offer support to both our family, and to others in the community.

Often doulas specialize in either birth or postpartum work. Ideally I'd like to offer both, to offer truly "continuous support" in the role of both birth and postpartum doula, maybe for the same client. Not every client needs both, some have wonderful support for themselves and baby after the birth, and that's fine! For many women today, support falls apart after baby, and they are left to care for a new baby for the FIRST time, and by themselves. Labor support is fantastically important too, but let's not anyone forget that the result of labor is a baby, and a family that needs at least a little rest and recuperation.

R is for the Risks of Cesarean Section

2010-03-25T01:06:00.003-04:00

The Risks of Cesarean Section
A Coalition for Improving Maternity Services Fact Sheet
© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.
1500 Sunday Dr Ste 102, Raleigh, NC 27607 | Tel: 919-863-9482 | www.motherfriendly.org
Cesarean section is the most common major surgical procedure performed in the United States. The Coalition for Improving Maternity Services (CIMS) is concerned about the dramatic increase and ongoing overuse of cesarean section. The surgical procedure poses short- and long-term health risks to mothers and infants, and a scarred uterus poses risks to all future pregnancies and deliveries. For these reasons, CIMS recommends that cesarean surgery be reserved for situations when potential benefits clearly outweigh potential harms. The cesarean rate can safely be less than 15 percent84 and 11 percent or less in low-risk women giving birth for the first time,28 yet, in 2007 the U.S. cesarean rate was 32 percent.30 When cesarean surgery rates rise above 15 percent health outcomes for mothers and babies worsen,5 and increasing numbers of scheduled cesareans are contributing to the rising number of late-preterm births.2,6
Cesarean rates have been rising for all women in the United States regardless of medical condition, age, race, or gestational age,52 and while the number of first cesareans performed without medical indication is increasing, no evidence supports the beliefs that these elective cesareans represent maternal request cesareans or that the rise in elective first cesareans has contributed significantly to the overall increase in cesarean rates.52 Elective first cesarean at physician request may, however, play a significant role,39 and the rise in elective repeat surgeries, which has climbed by more than 40 percent in the last ten years, certainly does.64 Although 70 percent of women or more who plan a vaginal birth after cesarean (VBAC) can birth vaginally and avoid the complications of repeat cesarean surgeries,28 almost all women today have a repeat operation because most doctors and many hospitals refuse to allow VBAC.20,35,54
A cesarean can be a life-saving operation, and some babies would not be born vaginally under any circumstances; however, it is still major surgery. Women have a legal right to know the risks associated with their treatment and the right to accept or refuse it.14 CIMS encourages childbearing women to take advantage of their rights and to find out more about the risks of cesarean section so they can make informed decisions about how they want to give birth.
What are the potential harms of cesarean surgery compared with vaginal birth?
Health outcomes after a cesarean may be worse because medical problems may lead to surgery. This fact sheet, however, is based on research that determined excess harms arising from the surgery itself. In other words, women with a healthy pregnancy who have a cesarean rather than a vaginal birth are at increased risk for the following complications as are their babies:
Potential Harms to the Mother
Compared with vaginal birth, women who have a cesarean are more likely to experience:
• Accidental surgical cuts to internal organs.53,60,72
• Major infection.43,48
• Emergency hysterectomy (because of uncontrollable bleeding).38,48,83
• Complications from anesthesia.28
• Deep venous clots that can travel to the lungs (pulmonary embolism) and brain (stroke).28,48
• Admission to intensive care.58
Coalition for Improving Maternity Services (CIMS) Fact Sheet February 2010
The Risks of Cesarean Section Page 2
© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.
• Readmission to the hospital for complications related to the surgery.18,28
• Pain that may last six months or longer after the delivery.19 More women report problems with pain from the cesarean incision than report pain in the genital area after vaginal birth.19
• Adhesions, thick internal scar tissue that may cause future chronic pain, in rare cases a twisted bowel, and can complicate future abdominal or pelvic surgeries.19
• Endometriosis (cells from the uterine lining that grow outside of the womb) causing pain, bleeding, or both severe enough to require major surgery to remove the abnormal cells.27
• Appendicitis, stroke, or gallstones in the ensuing year.18,46,47,50 Gall bladder problems and stroke may be because high-weight women and women with high blood pressure are more likely to have cesareans.
• Negative psychological consequences with unplanned cesarean. These include:
o Poor birth experience, overall impaired mental health, and/or self-esteem.12
o Feelings of being overwhelmed, frightened, or helpless during the birth.20
o A sense of loss, grief, personal failure , acute trauma symptoms, posttraumatic stress, and clinical depression.37
• Death.12,22
Potential Harms to the Baby
Compared with vaginal birth, babies born by cesarean section are more likely to experience:
• Accidental surgical cuts, sometimes severe enough to require suturing.1,28
• Being born late-preterm (34 to 36 weeks of pregnancy) as a result of scheduled surgery.6
• Complications from prematurity, including difficulties with respiration, digestion, liver function, jaundice, dehydration, infection, feeding, and regulating blood sugar levels and body temperature.25,26 Late-preterm babies also have more immature brains,63 and they are more likely to have learning and behavior problems at school age.25,26
• Respiratory complications, sometimes severe enough to require admission to a special care nursery, even in infants born at early term (37 to 39 weeks of pregnancy).28 Scheduling surgery after 39 completed weeks minimizes, but does not eliminate, the risk.31,32
• Readmission to the hospital.25
• Childhood development of asthma,3,78 sensitivity to allergens,61 or Type 1 diabetes.11
• Death in the first 28 days after birth.51
Potential Harms to Maternal Attachment and Breastfeeding
Failure to breastfeed has adverse health consequences for mothers and babies. Breastfeeding helps protect mothers against postpartum depression, Type 2 diabetes, high blood pressure, heart disease, ovarian and pre-menopausal breast cancer, and osteoporosis later in life.36,71 Breastfeeding helps protect babies against ear infections, stomach infections, severe respiratory infections, allergies, asthma, obesity, Type 1 and Type 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis (a severe, life-threatening intestinal infection).15,36
• Women who have unplanned cesareans are more likely to have difficulties forming an attachment to their babies.23
• Women who have cesareans are less likely to have their infants with them skin-to-skin (cradled naked against their bare chest) after the delivery.20 Babies who have skin-to-skin contact interact more with their mothers, stay warmer, and cry less. When skin-to-skin, babies are more likely to be breastfed early and well, and to be breastfed for longer. They may also be more likely to have a good early relationship with their mothers, but the evidence for this is not as strong.16,57
• Women are less likely to breastfeed.21,44
Coalition for Improving Maternity Services (CIMS) Fact Sheet February 2010
The Risks of Cesarean Section Page 3
© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.
Potential Harms to Future Pregnancies
With prior cesarean, women and their babies are more likely to experience serious complications during subsequent pregnancy and birth regardless of whether they plan repeat cesarean or vaginal birth. The likelihood of serious complications increases with each additional operation.28
Compared with prior vaginal birth, prior cesarean puts women at increased risk of:
• Uterine scar rupture. Planning repeat cesarean reduces the excess risk, but it is not completely protective.8,49,55,75
• Infertility, either voluntary (doesn’t want more children) or involuntary (can’t have more children).7,12,56,70,74,79,80
• Cesarean scar ectopic pregnancy (implantation within the cesarean scar), a condition that is life-threatening to the mother and always fatal for the embryo.67
• Placenta previa (placenta covers the cervix, the opening to the womb), placental abruption (placenta detaches partially or completely before the birth), and placenta accreta, (placenta grows into the uterine muscle and sometimes through the uterus, invading other organs), all of which increase the risk for severe hemorrhage and are potentially life-threatening complications for mother and baby.17,28,85
• Emergency hysterectomy.42,53
• Preterm birth and low birth weight.6,40,65,73,76
• A baby with congenital malformation or central nervous system injury12 due to a poorly functioning placenta.
• Stillbirth.28,29,40,65,76
Cesarean Surgery and Pelvic Floor Dysfunction
Cesarean proponents claim that cesarean surgery will prevent pelvic floor dysfunction, but it offers little or no protection once healing is complete and no protection in later life.12 Moreover, risk-free measures such as engaging in exercises to strengthen the pelvic floor or losing weight can often improve or relieve stress urinary incontinence (loss of urine with pressure on the pelvic floor such as with exercise, laughing, sneezing, or coughing).9,12
• Cesarean surgery does not protect against sexual problems,4,33,41 gas or stool incontinence,10,59 or urge urinary incontinence (loss of urine after sudden need to void).10,13,24,62,82
• Cesarean surgery does not protect against severe stress urinary incontinence.62,82 As many as one more woman in six having vaginal birth may experience stress urinary incontinence of some degree, mostly minor, at six months or more after birth.10,13,24,62,82
• Perhaps one more woman in twenty having vaginal birth will experience symptomatic pelvic floor prolapse (muscle weakness causes the internal organs to sag downwards).45,66,77,81 With three or more vaginal births, this number may be as high as one more woman in ten.66 However, many other factors, including smoking, hysterectomy, hormone replacement therapy, constipation, irritable bowel syndrome, and urinary tract infections are also associated with pelvic floor prolapse.
Cesarean Section, Care Providers and Place of Birth
To reduce the risk of cesarean surgery, CIMS encourages women to seek providers and hospitals with low cesarean rates (15% or less) and those that support VBAC. Women can access this data from their state health departments. They can also access hospital-specific cesarean rates and rates for other birth interventions for several states at www.thebirthsurvey.com and a listing of hospitals that do or do not support VBAC from the International Cesarean Network at http://ican-online.org/vac-ban-info.
Coalition for Improving Maternity Services (CIMS) Fact Sheet February 2010
The Risks of Cesarean Section Page 4
© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.
Healthy women at low risk for complications should also know that choosing midwifery care or giving birth in a birth center or at home can lower their risk for cesarean section.68,69 Having a doula reduces the likelihood of a cesarean as well.34
This fact sheet was co-authored by Henci Goer, BA and Nicette Jukelevics, MA, ICCE.
© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.
This fact sheet is endorsed by the following organizations (as of Feb. 2010). Academy of Certified Birth Educators, Birth Matters Virginia, BirthNet of Albany NY, BirthNetwork National, Birth Network of Santa Cruz, Birth Works International, Childbirth Connection, Choices in Childbirth, Citizens for Midwifery, DONA International, International Childbirth Education Association, Lamaze International, The Lawton and Rhea Chiles Center for Healthy Mothers and Babies, Midwives Alliance of North America, National Association of Certified Professional Midwives, North American Registry of Midwives, Perinatal Education Associates, Reading Birth and Women’s Center, The Tatia Oden-French Memorial Foundation, toLabor: The Organization of Labor Assistants for Birth Options and Resources.
References:
1. Alexander, J. M., Leveno, K. J., Hauth, J., Landon, M. B., Thom, E., Spong, C. Y., et al. (2006). Fetal injury associated with cesarean delivery. Obstet Gynecol, 108(4), 885-890.
2. Analysis shows possible link between rise in c-sections and increase in late preterm birth. (12/16/08). Retrieved 11/12/09, from http://www.marchofdimes.com/aboutus/22684_48910.asp
3. Bager, P., Wohlfahrt, J., & Westergaard, T. (2008). Caesarean delivery and risk of atopy and allergic disease: Meta-analyses. Clin Exp Allergy, 38(4), 634-642.
4. Barrett, G., Peacock, J., Victor, C. R., & Manyonda, I. (2005). Cesarean section and postnatal sexual health. Birth, 32(4), 306-311.
5. Betran, A. P., Merialdi, M., Lauer, J. A., Bing-Shun, W., Thomas, J., Van Look, P., et al. (2007). Rates of caesarean section: Analysis of global, regional and national estimates. Paediatr Perinat Epidemiol, 21(2), 98-113.
6. Bettegowda, V. R., Dias, T., Davidoff, M. J., Damus, K., Callaghan, W. M., & Petrini, J. R. (2008). The relationship between cesarean delivery and gestational age among us singleton births. Clin Perinatol, 35(2), 309-323, v-vi.
7. Bhattacharya, S., Porter, M., Harrild, K., Naji, A., Mollison, J., van Teijlingen, E., et al. (2006). Absence of conception after caesarean section: Voluntary or involuntary? BJOG, 113(3), 268-275.
8. Blanchette, H., Blanchette, M., McCabe, J., & Vincent, S. (2001). Is vaginal birth after cesarean safe? Experience at a community hospital. Am J Obstet Gynecol, 184(7), 1478-1484; discussion 1484-1477.
9. Bo, K. (2009). Does pelvic floor muscle training prevent and treat urinary and fecal incontinence in pregnancy? Nat Clin Pract Urol, 6(3), 122-123.
10. Borello-France, D., Burgio, K. L., Richter, H. E., Zyczynski, H., Fitzgerald, M. P., Whitehead, W., et al. (2006). Fecal and urinary incontinence in primiparous women. Obstet Gynecol, 108(4), 863-872.
11. Cardwell, C. R., Stene, L. C., Joner, G., Cinek, O., Svensson, J., Goldacre, M. J., et al. (2008). Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: A meta-analysis of observational studies. Diabetologia, 51(5), 726-735.
12. Childbirth Connection. (2004). Harms of cesarean versus vaginal birth: A systematic review. Retrieved 4/17/2004, from http://childbirthconnection.org/article.asp?ck=10271
13. Chin, H. Y., Chen, M. C., Liu, Y. H., & Wang, K. H. (2006). Postpartum urinary incontinence: A comparison of vaginal delivery, elective, and emergent cesarean section. Int Urogynecol J Pelvic Floor Dysfunct.
14. Coalition for Improving Maternity Services. (2007). Step 2: Provides accurate, descriptive, statistical information about birth care practices. J Perinat Educ, 16(1), 20S-22S.
15. Coalition for Improving Maternity Services. (2009). Breastfeeding is priceless: There is no substitute for human milk, a cims fact sheet. Retrieved 11/12/09, from http://www.motherfriendly.org/pdf/BreastfeedingisPricelessMarch2009.pdf
16. Crenshaw, J. (2009). Healthy birth practices from lamaze international. #6: Keep mother and baby together-it’s best for mother, baby, and breastfeeding. Retrieved 2009, from http://www.lamaze.org/Portals/0/carepractices/CarePractice6.pdf
17. Daltveit, A. K., Tollanes, M. C., Pihlstrom, H., & Irgens, L. M. (2008). Cesarean delivery and subsequent pregnancies. Obstet Gynecol, 111(6), 1327-1334.
18. Declercq, E., Barger, M., Cabral, H. J., Evans, S. R., Kotelchuck, M., Simon, C., et al. (2007). Maternal outcomes associated with planned primary cesarean births compared with planned vaginal births. Obstet Gynecol, 109(3), 669-677.
19. Declercq, E., Cunningham, D. K., Johnson, C., & Sakala, C. (2008). Mothers' reports of postpartum pain associated with vaginal and cesarean deliveries: Results of a national survey. Birth, 35(1), 16-24.
20. Declercq, E., Sakala, C., Corry, M. P., & Applebaum, S. (2006). Listening to mothers ii: Report of the second national u.S. Survey of women's childbearing experiences. New York: Childbirth Connection.
21. Declercq, E., Sakala, C., Corry, M. P., & Applebaum, S. (2008). New mothers speak out:. National survey results highlight women's postpartum experiences. . New York: Childbirth Connection.
Coalition for Improving Maternity Services (CIMS) Fact Sheet February 2010
The Risks of Cesarean Section Page 5
© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.
22. Deneux-Tharaux, C., Carmona, E., Bouvier-Colle, M. H., & Breart, G. (2006). Postpartum maternal mortality and cesarean delivery. Obstet Gynecol, 108(3), 541-548.
23. DiMatteo, M. R., Morton, S. C., Lepper, H. S., Damush, T. M., Carney, M. F., Pearson, M., et al. (1996). Cesarean childbirth and psychosocial outcomes: A meta-analysis. Health Psychol, 15(4), 303-314.
24. Ekstrom, A., Altman, D., Wiklund, I., Larsson, C., & Andolf, E. (2008). Planned cesarean section versus planned vaginal delivery: Comparison of lower urinary tract symptoms. Int Urogynecol J Pelvic Floor Dysfunct, 19(4), 459-465.
25. Engle, W. A., & Kominiarek, M. A. (2008). Late preterm infants, early term infants, and timing of elective deliveries. Clin Perinatol, 35(2), 325-341, vi.
26. Engle, W. A., Tomashek, K. M., & Wallman, C. (2007). "Late-preterm" infants: A population at risk. Pediatrics, 120(6), 1390-1401.
27. Goer, H. (May 11, 2009). Do cesareans cause endometriosis? Why case studies and case series are canaries in the mine. Science and Sensibility, 11/12/2009, from http://www.scienceandsensibility.org/?p=147
28. Goer, H., Sagady Leslie, M., & Romano, A. (2007). Step 6: Does not routinely employ practices, procedures unsupported by scientific evidence. J Perinat Educ, 16(1), 32S-64S.
29. Gray, R., Quigley, M., Hockley, C., Kurinczuk, J., Goldacre, M., & Brocklehurst, P. (2007). Caesarean delivery and risk of stillbirth in subsequent pregnancy: A retrospective cohort study in an english population. BJOG, 114(3), 264-270.
30. Hamilton, B. E., Martin, J. A., & Ventura, S. J. (2009). Births: Preliminary data for 2007. Natl Vital Stat Rep, 57(12), 1-23.
31. Hansen, A. K., Wisborg, K., Uldbjerg, N., & Henriksen, T. B. (2007). Elective caesarean section and respiratory morbidity in the term and near-term neonate. Acta Obstet Gynecol Scand, 86(4), 389-394.
32. Hansen, A. K., Wisborg, K., Uldbjerg, N., & Henriksen, T. B. (2008). Risk of respiratory morbidity in term infants delivered by elective caesarean section: Cohort study. BMJ, 336(7635), 85-87.
33. Hicks, T. L., Goodall, S. F., Quattrone, E. M., & Lydon-Rochelle, M. T. (2004). Postpartum sexual functioning and method of delivery: Summary of the evidence. J Midwifery Womens Health, 49(5), 430-436.
34. Hodnett, E., Gates, S., Hofmeyr, G., & Sakala, C. (2007). Continuous support for women during childbirth. Cochrane Database Syst Rev(3), CD003766.
35. International Cesarean Awareness Network. (Feb 20, 2009). New survey shows shrinking options for women with prior cesarean. from http://www.ican-online.org/ican-in-the-news/trouble-repeat-cesareans
36. Ip, S., Chung, M., Raman, G., Chew, P., Magula, N., DeVine, D., et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep)(153), 1-186.
37. Jukelevics, N. (2008). Understanding the dangers of cesarean birth. Westport, CT: Praeger Publishers.
38. Kacmar, J., Bhimani, L., Boyd, M., Shah-Hosseini, R., & Peipert, J. (2003). Route of delivery as a risk factor for emergent peripartum hysterectomy: A case-control study. Obstet Gynecol, 102(1), 141-145.
39. Kalish, R. B., McCullough, L., Gupta, M., Thaler, H. T., & Chervenak, F. A. (2004). Intrapartum elective cesarean delivery: A previously unrecognized clinical entity. Obstet Gynecol, 103(6), 1137-1141.
40. Kennare, R., Tucker, G., Heard, A., & Chan, A. (2007). Risks of adverse outcomes in the next birth after a first cesarean delivery. Obstet Gynecol, 109(2 Pt 1), 270-276.
41. Klein, M. C., Kaczorowski, J., Firoz, T., Hubinette, M., Jorgensen, S., & Gauthier, R. (2005). A comparison of urinary and sexual outcomes in women experiencing vaginal and caesarean births. J Obstet Gynaecol Can, 27(4), 332-339.
42. Knight, M., Kurinczuk, J. J., Spark, P., & Brocklehurst, P. (2008). Cesarean delivery and peripartum hysterectomy. Obstet Gynecol, 111(1), 97-105.
43. Koroukian, S. M. (2004). Relative risk of postpartum complications in the ohio medicaid population: Vaginal versus cesarean delivery. Med Care Res Rev, 61(2), 203-224.
44. Labbok M, & Taylor E. (2008). Achieving exclusive breastfeeding in the united states. Washington D.C.: United States Breastfeeding Committee.
45. Larsson, C., Kallen, K., & Andolf, E. (2009). Cesarean section and risk of pelvic organ prolapse: A nested case-control study. Am J Obstet Gynecol, 200(3), 243 e241-244.
46. Lin, S. Y., Hu, C. J., & Lin, H. C. (2008). Increased risk of stroke in patients who undergo cesarean section delivery: A nationwide population-based study. Am J Obstet Gynecol, 198(4), 391 e391-397.
47. Liu, S., Heaman, M., Joseph, K. S., Liston, R. M., Huang, L., Sauve, R., et al. (2005). Risk of maternal postpartum readmission associated with mode of delivery. Obstet Gynecol, 105(4), 836-842.
48. Liu, S., Liston, R. M., Joseph, K. S., Heaman, M., Sauve, R., & Kramer, M. S. (2007). Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. CMAJ, 176(4), 455-460.
49. Loebel, G., Zelop, C. M., Egan, J. F., & Wax, J. (2004). Maternal and neonatal morbidity after elective repeat cesarean delivery versus a trial of labor after previous cesarean delivery in a community teaching hospital. J Matern Fetal Neonatal Med, 15(4), 243-246.
50. Lydon-Rochelle, M., Holt, V. L., Martin, D. P., & Easterling, T. R. (2000). Association between method of delivery and maternal rehospitalization. JAMA, 283(18), 2411-2416.
51. MacDorman, M. F., Declercq, E., Menacker, F., & Malloy, M. H. (2008). Neonatal mortality for primary cesarean and vaginal births to low-risk women: Application of an "intention-to-treat" model. Birth, 35(1), 3-8.
52. MacDorman, M. F., Menacker, F., & Declercq, E. (2008). Cesarean birth in the united states: Epidemiology, trends, and outcomes. Clin Perinatol, 35(2), 293-307, v.
53. Makoha, F. W., Felimban, H. M., Fathuddien, M. A., Roomi, F., & Ghabra, T. (2004). Multiple cesarean section morbidity. Int J Gynaecol Obstet, 87(3), 227-232.
54. Martin, J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Menacker, F., Kirmeyer, S., et al. (2007). Births: Final data for 2005. Natl Vital Stat Rep, 56(6), 1-103.
Coalition for Improving Maternity Services (CIMS) Fact Sheet February 2010
The Risks of Cesarean Section Page 6
© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.
55. McMahon, M. J., Luther, E. R., Bowes, W. A., Jr., & Olshan, A. F. (1996). Comparison of a trial of labor with an elective second cesarean section. N Engl J Med, 335(10), 689-695.
56. Mollison, J., Porter, M., Campbell, D., & Bhattacharya, S. (2005). Primary mode of delivery and subsequent pregnancy. BJOG, 112(8), 1061-1065.
57. Moore, E., Anderson, G., & Bergman, N. (2007). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev(3), CD003519.
58. National Institute for Clinical Excellence. (April 2004). Caesarean section, clinical guideline. Retrieved 12/18/09, from http://www.nice.org.uk/nicemedia/pdf/CG013fullguideline.pdf
59. Nelson, R. L., Westercamp, M., & Furner, S. E. (2006). A systematic review of the efficacy of cesarean section in the preservation of anal continence. Dis Colon Rectum, 49(10), 1587-1595.
60. Nisenblat, V., Barak, S., Griness, O. B., Degani, S., Ohel, G., & Gonen, R. (2006). Maternal complications associated with multiple cesarean deliveries. Obstet Gynecol, 108(1), 21-26.
61. Pistiner, M., Gold, D. R., Abdulkerim, H., Hoffman, E., & Celedon, J. C. (2008). Birth by cesarean section, allergic rhinitis, and allergic sensitization among children with a parental history of atopy. J Allergy Clin Immunol, 122(2), 274-279.
62. Press, J. Z., Klein, M. C., Kaczorowski, J., Liston, R. M., & von Dadelszen, P. (2007). Does cesarean section reduce postpartum urinary incontinence? A systematic review. Birth, 34(3), 228-237.
63. Raju, T. N., Higgins, R. D., Stark, A. R., & Leveno, K. J. (2006). Optimizing care and outcome for late-preterm (near-term) infants: A summary of the workshop sponsored by the national institute of child health and human development. Pediatrics, 118(3), 1207-1214.
64. Repeat c-sections climb by more than 40 percent in 10 years. . (April 15, 2009). AHRQ News and Numbers Retrieved 11/13/09, from http://ww.ahrq.gov/new/nn/nn041509.htm
65. Richter, R., Bergmann, R. L., & Dudenhausen, J. W. (2006). Previous caesarean or vaginal delivery: Which mode is a greater risk of perinatal death at the second delivery? Eur J Obstet Gynecol Reprod Biol, 132(1), 51-57.
66. Rortveit, G., Brown, J. S., Thom, D. H., Van Den Eeden, S. K., Creasman, J. M., & Subak, L. L. (2007). Symptomatic pelvic organ prolapse: Prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol, 109(6), 1396-1403.
67. Rotas, M. A., Haberman, S., & Levgur, M. (2006). Cesarean scar ectopic pregnancies: Etiology, diagnosis, and management. Obstet Gynecol, 107(6), 1373-1381.
68. Sagady Leslie, M., & Romano, A. (2007). Appendix: Birth can safely take place at home and in birthing centers. J Perinat Educ, 16(1), 81S-88S.
69. Sagady Leslie, M., & Storton, S. (2007). Step 1: Offers all birthing mothers unrestricted access to birth companions, labor support, professional midwifery care. J Perinat Educ 16(1), 10S-19S.
70. Saisto, T., Ylikorkala, O., & Halmesmaki, E. (1999). Factors associated with fear of delivery in second pregnancies. Obstet Gynecol, 94(5 Pt 1), 679-682.
71. Schwarz, E. B., Ray, R. M., Stuebe, A. M., Allison, M. A., Ness, R. B., Freiberg, M. S., et al. (2009). Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol, 113(5), 974-982.
72. Silver, R. M., Landon, M. B., Rouse, D. J., Leveno, K. J., Spong, C. Y., Thom, E. A., et al. (2006). Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol, 107(6), 1226-1232.
73. Smith, G. C., Pell, J. P., & Dobbie, R. (2003). Caesarean section and risk of unexplained stillbirth in subsequent pregnancy. Lancet, 362(9398), 1779-1784.
74. Smith, G. C., Wood, A. M., Pell, J. P., & Dobbie, R. (2006). First cesarean birth and subsequent fertility. Fertil Steril, 85(1), 90-95.
75. Spong, C. Y., Landon, M. B., Gilbert, S., Rouse, D. J., Leveno, K. J., Varner, M. W., et al. (2007). Risk of uterine rupture and adverse perinatal outcome at term after cesarean delivery. Obstet Gynecol, 110(4), 801-807.
76. Taylor, L. K., Simpson, J. M., Roberts, C. L., Olive, E. C., & Henderson-Smart, D. J. (2005). Risk of complications in a second pregnancy following caesarean section in the first pregnancy: A population-based study. Med J Aust, 183(10), 515-519.
77. Tegerstedt, G., Miedel, A., Maehle-Schmidt, M., Nyren, O., & Hammarstrom, M. (2006). Obstetric risk factors for symptomatic prolapse: A population-based approach. Am J Obstet Gynecol, 194(1), 75-81.
78. Thavagnanam, S., Fleming, J., Bromley, A., Shields, M. D., & Cardwell, C. R. (2008). A meta-analysis of the association between caesarean section and childhood asthma. Clin Exp Allergy, 38(4), 629-633.
79. Tollanes, M. C., Melve, K. K., Irgens, L. M., & Skjaerven, R. (2007). Reduced fertility after cesarean delivery: A maternal choice. Obstet Gynecol, 110(6), 1256-1263.
80. Tower, C. L., Strachan, B. K., & Baker, P. N. (2000). Long-term implications of caesarean section. J Obstet Gynaecol, 20(4), 365-367.
81. Uma, R., Libby, G., & Murphy, D. J. (2005). Obstetric management of a woman's first delivery and the implications for pelvic floor surgery in later life. BJOG, 112(8), 1043-1046.
82. van Brummen, H. J., Bruinse, H. W., van de Pol, G., Heintz, A. P., & van der Vaart, C. H. (2007). The effect of vaginal and cesarean delivery on lower urinary tract symptoms: What makes the difference? Int Urogynecol J Pelvic Floor Dysfunct, 18(2), 133-139.
83. Whiteman, M. K., Kuklina, E., Hillis, S. D., Jamieson, D. J., Meikle, S. F., Posner, S. F., et al. (2006). Incidence and determinants of peripartum hysterectomy. Obstet Gynecol, 108(6), 1486-1492.
84. World Health Organization. (2009). Monitoring emergency obstetric care: A handbook. France: World Health Organization.
85. Yang, Q., Wen, S. W., Oppenheimer, L., Chen, X. K., Black, D., Gao, J., et al. (2007). Association of caesarean delivery for first birth with placenta praevia and placental abruption in second pregnancy. BJOG, 114(5), 609-613.
About the Risks of Cesarean Section
A Checklist for Expectant Mothers to Read During Pregnancy
© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.
1500 Sunday Dr Ste 102, Raleigh, NC 27607 | Tel: 919-863-9482 | www.motherfriendly.org
Birth is a normal, natural, process and the vast majority of women can have safe, normal, vaginal births. There are health conditions where a cesarean birth is necessary for the well being of the mother or her baby. However, more and more mothers these days are giving birth by cesarean section for non-medical reasons. A cesarean poses risks as well as benefits for mother and baby, and should not be undertaken lightly. This educational material is provided by the Coalition for Improving Maternity Services (CIMS) to help all expectant parents become better informed about the risks of cesarean section.
To give the expectant mother time to reflect on this information and consider the impact of cesarean surgery on her health and the health of her baby, care providers are encouraged to introduce and discuss this evidence-based information throughout pregnancy and no later than at 32-34 weeks. The expectant mother is encouraged to take the form home, read and initial the statements, discuss the information with her partner, and raise any questions or concerns she may have with her care provider. The form may then be placed in her chart.
Expectant Mother’s Name: _________________________________________________
Care Provider’s Name: ____________________________________________________
A cesarean section is an operation by which a baby is born by making a cut in the mother’s lower abdominal wall (abdominal incision) and a cut in her uterus (uterine incision). I understand that a cesarean operation may be more dangerous than a vaginal birth for my baby and me.
POSSIBLE PROBLEMS FOR ME WITH A CESAREAN AS COMPARED TO A VAGINAL BIRTH:
1._____ I am more likely to have more blood loss and a longer recovery time.
2._____ I am more likely to have accidental surgical cuts to my bladder, bowel, or gastrointestinal tract.
3._____ I am more likely to have a serious infection in my incision, uterus, or bladder.
4._____ I am more likely to have thick scarring (adhesions) inside my abdomen that may cause chronic pain years after my cesarean. This scarring can make any future abdominal operation I may need more difficult.
5._____ I may have uncontrolled bleeding and need an emergency hysterectomy (removal of the uterus) if the bleeding cannot be stopped.
6._____ I am more likely to have complications from anesthesia.
7._____ I am more likely to develop serious and life-threatening blood clots that can travel to my lungs (pulmonary embolism) or my brain (stroke).
8._____ I am more likely to be admitted to intensive care.
9._____ I am more likely to need to return to the hospital for complications from the cesarean operation.
10._____ I am more likely to feel pain and/or numbness at the site of the operation for several months after my surgery.
11._____ I am less likely to breastfeed successfully. I may lose out on the health benefits of breastfeeding for myself, including: weight loss, reduced risks of cancers, heart disease, diabetes, and osteoporosis.
12._____ I am less likely to have a satisfactory birth experience. I am more likely to have emotional problems such as post-partum depression and post-traumatic stress. Many women experience a profound sense of happiness after a normal birth that flows naturally into bonding with the baby and breastfeeding.
13._____ I am more likely to die.
Coalition for Improving Maternity Services (CIMS) Fact Sheet February 2010
About The Risks of Cesarean Section: A Checklist For Expectant Mothers To Read During Pregnancy Page 2
© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.
POSSIBLE PROBLEMS WITH A CESAREAN FOR ME WITH A FUTURE PREGNANCY AS COMPARED TO A VAGINAL BIRTH:
14._____ I am more likely to have trouble becoming pregnant again.
15._____ I am more likely to have complications in a future pregnancy due to the scar in my uterus. If the new placenta attaches over my previous scar, it is more likely to cause serious problems, including: serious bleeding, placenta coming in front of the baby (placenta previa), placenta growing into or even through the wall of the womb (placenta accreta), miscarriage, or pre-term birth.
16._____ I am more likely to have a baby with a congenital malformation, central nervous system injury, or low birth weight due to problems with the placenta.
17._____ I am more likely to have a stillbirth.
18._____ I am more likely to require major surgery to remove cells from the lining of my uterus that may grow outside my womb (endometriosis).
19._____ Since it is difficult to find a physician or hospital supportive of a vaginal birth after a cesarean (VBAC), I am more likely to have a repeat cesarean for the birth of all my future children, although a vaginal birth after a cesarean birth is usually safe. Each additional operation I have increases the odds for complications.
20._____ Research shows that having a cesarean will not protect me from urine, gas, or stool incontinence in the future, or from future sexual problems.
21._____ I may not be able to get healthcare coverage since some insurance providers consider a cesarean to be a pre-existing condition.
POSSIBLE PROBLEMS FOR MY BABY:
1._____ My baby is more likely to be born prematurely if the cesarean surgery is performed anytime before labor begins. A premature baby is more likely to experience the following:
• -admission to the intensive care nursery
• -trouble breastfeeding, digesting food, and regulating body temperature
• -developing jaundice
• -brain development problems and difficulties in learning in school
2._____ My baby is more likely to face complications from anesthesia and postpartum pain medication.
3._____ My baby is more likely to be accidentally cut during surgery.
4._____ My baby is more likely to have breathing difficulties since labor contractions clear the lungs.
5._____ If I agree to a scheduled cesarean, it is normally best to wait for labor to begin before performing the operation.
6._____ My baby is more likely to have difficulty breastfeeding. My baby is less likely to benefit from skin-to-skin contact with me and is less likely to get the health benefits from breastfeeding including: reduced risk for asthma, allergies, respiratory infections, Type 1 diabetes, childhood leukemia, and SIDS (sudden infant death syndrome). If I do have a cesarean, I can request special care to help me and my baby breastfeed successfully before I am discharged from the hospital.
I have read and discussed this information with my care provider.
Expectant Mother’s Signature: _______________________________ Date: ________________
Care Provider’s Signature: __________________________________ Date: ________________
This information is provided for expectant mothers and their care providers by the Coalition for Improving Maternity Services (CIMS). CIMS strongly recommends that cesarean surgery be reserved for situations when potential health benefits clearly outweigh the risks. Please see the The Risks of Cesarean Section, a CIMS Fact Sheet for the references that support this form, available as a free download from www.motherfriendly.org.

Q is for Q & A Coming Soon, but First: Cesearean Births Are at an all-time high

2010-03-24T12:02:00.003-04:00

New York Times
Health

Caesarean Births Are at a High in U.S.

By DENISE GRADY

Published: March 23, 2010

Nearly one in three children in the United States are born by Caesarean section.

Cesearean Births are at an all-time high. Here is a free link: http://topnews.us/content/214169-us-registers-record-number-caesarean-births-2007

What are our cultural issues? Is it fear? Fear of birth? Access to technology? Something else?

P is for Pretty People who breastfeed

2010-02-24T01:46:00.028-05:00

When breastfeeding my child, (that's me and my child on the left) I became very interested in meeting other women who breastfed.

The ONLY time I had ever seen a baby breastfeed was at a backyard picnic of my step-mother's teacher friends, when I was about 9 or 10 years old. I had NEVER seen a baby nurse. I thought that it was kinda cool, though - but it would be well over a decade until I saw another breastfeeding baby. My step-mother was a bit snarky, she very clearly felt that the breastfeeding mom was behaving a bit inappropriately. Like she felt that nursing in public (NIP) wasn't cool.

Now there are TONS of babies in my family. I babysat often. I babysat for neighborhood kids, too. Always loved babies, but never saw a baby breastfeed in "public". Breastfeeding is of course a natural thing, but breastfeeding and babies, (unlike bottles and babies) - wasn't natural to me, because I just had no experience with it, until having and nursing my own. This is common in the United States - we just aren't a breastfeeding culture.

So it fascinated me to meet people in real life who breastfed their babies. I met breastfeeding moms at a hospital breastfeeding group, and later at La Leche League. Then I found others online, through Mothering.com and Breastfeeding.com.

But not everyone I knew was similarly fascinated. People I met at work, family, other friends seemed to express interest in breastfeeding, but were often dismissive, or even slightly repulsed. Very often they were critical. My favorite retort used to be: "Breastfeeding was good enough for the baby Jesus". Substitute Moses, Buddha, etc. whenever appropriate. PETA had a campaign using the baby Jesus / Madonna imagery. . . .

In the American culture often the famous are our "Gods". Now I don't feel that movie stars should necessarily be role models, but when famous women actresses breastfeed, it is just a wonderful endorsement for mama's milk, these famous women and in some cases - their male partners are waxing ecstatic about nursing their babies, and the word is getting out about how wonderful breastfeeding babies can be. And it gets attention.

I'm not asking women to compare themselves to famous breastfeeders. I certainly don't want to imply that you have to be pretty, or rich, or famous to breastfeed, but we all know that marketing works. And marketing of artificial baby milk (ABM) has been HUGE in our country. Just read "Milk, Money Madness" if you want to know more.

Or simply notice a few telling things about our popular culture:

* The beloved Barbie doll has no areola, she can't nurse a baby. . . .more on Barbie in another post. . . .the pregnant and delivering Barbie
* Popular ads for a baby / family movie time at my local theater depicted baby bottles in their posters, but no babies - the bottles are just assumed to represent babies
*Over and over again, ads and marketing aimed towards parents feature baby bottles. What about putting baby pics in the ads? I mean - babies are adorable!
* Baby-shower stuff: wrapping paper, gift bags, decorations, greeting cards, are COVERED with images of baby bottles

So when famous actresses - "Pretty People" such as Keely Shaye Smith, Angelina Jolie are pictured on the covers of magazines

breastfeeding their babies, looking like the Madonna and child, it is a beautiful picture. An idealized or airbrushed image to be sure - but these images are few and far between on the streets, or even the backyards of America. Mama's milk - good enough. . . .for the Pretty People, and this regular woman, too.

Click here for more breastfeeding celebrities. And for pics of non-famous breastfeeding moms, click here.

O is for Orgasmic Birth

2010-01-03T19:15:00.005-05:00

So we are onto "O". Some may roll their eyes that birth can be orgasmic, or pain-free. But none disagree that birth is an everyday miracle. I couldn't not tell you all about "Orgasmic Birth". I attended a fantastic DONA doula training with Debra Pascali-Bonaro of "Orgasmic Birth". She is so amazing, SO knowledgeable, and one of the most positive folks that I met.

She has won numerous awards for her work. But she isn't the first to discover orgasms in birth. Ina May Gaskin, the world-famous midwife, "discoverer" of the Gaskin-maneuver did share with us in her books that women she knew had orgasms when they had their babies. And NO, they didn't all have them on the commune - they had them in the hospitals, with PEOPLE watching, no less! I can't say that I've had orgasms during the birth of my two children, but I have no doubt that it is possible. And in addition, I will assert that it IS possible to have a pain-free birth. Something that many childbirth education teachers do NOT assert. Now of course there are no promises - labor is different for every woman, and every baby. But I think it is just wonderful that there are birth gurus out there telling the truth. Birth doesn't have to be scary. It is not always Mt. Everest. The birth mountain is MEANT to be climbed. And it can even feel good.

N is for Nurturing

2009-12-30T19:34:00.006-05:00

It may come as a surprise to many of you who are not originally from New York City, but I find NYC to be incredibly nurturing. Yes, nurturing. As a mother, I am often the recipient of help getting my stroller up and down the subway stairs. Yes, though I do carry my baby quite a bit, and consider myself quite the babywearing expert :)

But this week, while in line for ice skating in Bryant Park, a complete stranger held my very heavy toddler. She literally said that she wanted to help me, that she knew what it was like. . . . now accepting help does NOT mean I'm not a strong mama. It does NOT mean I'm weak in any way, just needing a few minutes break. Like many of my doula clients, I have no grandma to help me. No great extended family. And like Blanche DuBois, I do sometimes "rely on the kindness of strangers". From a mother from Namibia, no less! Yes, that country that Angelina Jolie went to, to escape from the papparazi. I only wish I got that Namibian woman's number!

What's YOUR City as nurturer story?

M is for Milkface.com and Motherwear (see link below)

2009-12-15T14:49:00.010-05:00

Milkface is a FANTASTIC website. Especially wonderful are their nursing bras (pricey, even with the Canadian to U.S. Dollar exchange rate, but beautiful). Even better are their nursing tops, many of them are by Boob. The Boob nursing tops are just fantastic. They fit well, but most are not TOO clingy. They've got a fantastic hoodie that has kept my middle covered and warm, and allowed me to nurse my little one discretely. But they also feel fashionable and hip. With my first child, nursing attire looked much like the stuff at Motherwear, but now we've really got incredible choices :) Motherwear is great for the very early postpartum period, where you may want a looser fitting top, though they do offer a variety of fits. And the Motherwear bras are a bit more affordable. A gift certificate to Motherwear is just fantastic, because their customer service is good, and they offer quite a lot for the new mother / dad. Also check out the Motherwear blog.

My suggestions for pregnant and postpartum moms is to get fitted for a bra by me, if they like - or by a pro at Bloomingdale's, then order nursing bras online from Milkface.com. Of course Bloomies now carries Elle MacPherson's "Maternelle" nursing bra, a bra that I personally LOVE. It is very supportive, comfortable and comes in a range of colors, some discontinued, but may be found also in new, untried condition on EBay (I snagged one in a pretty lavender color, recently). I don't know how many nursing bras Bloomingdale's carries at this time, but they have wonderful bra fitters. I have lots more info for you on nursing bras and nursing tops in posts to come.

L is for Lying-In

2009-11-09T05:57:00.006-05:00

So what is "Lying in" ? Well, American women giving birth in the earlier part of the 20th Century (and before) observed a period of time after childbirth called "Lying in". The new mother stayed in bed, other people fed her, showed her newborn care. She did NOTHING for the household for a period of weeks. Sometimes this period of time was observed in the hospital. Grandmothers, if asked - will tell you that they spent much more than just 2 days in the hospital, after having a baby.

In Sally Placksin's "Mothering the New Mother: Women's Feelings and Needs After Childbirth a Support and Resource Guide", Sally offers tons of practical suggestions for a woman who is today navigating the postpartum period. It is worth a read! It may just save your sanity to know that as a new mother, many of us need guidance and support, and that up until recently, there have been traditions in place to provide it. She shares with us historical and cultural perspectives that really are eye-opening.

As a new mother I really loved this book (I had read an earlier edition) - I really felt that I wasn't alone as I read this book. Just reading first-hand accounts from new mothers was invaluable information for me. Yes, as individual women we are so different - but many of our feelings are similar. Many of us are left to go it alone. We are far from our families. Many women don't even know we are in need of any help. At the time I first read this book for instance, I didn't know that doulas existed. This book definitely describes the real need for skilled help for new mothers. Our government just passed Health Care legislation. We need to be sure that support services such as the ones listed in this book are part of our plans for new mothers.

Buy it Here

Share your own customer images

Look inside this book

Start reading Mothering the New Mother on your Kindle in under a minute. Don’t have a Kindle? Get your Kindle here.

Mothering the New Mother: Women's Feelings and Needs After Childbirth a Support and Resource Guide (Paperback)

K is for "Kangaroo" Care

2009-11-08T21:54:00.004-05:00

It's been a long time since I posted, August was beautiful - went to Puerto Rico for the first time in my adult life. It was SO beautiful. The rest of August, September and October just FLEW by: Back to School, Back to Work. . . .

I've been dutifully reading all the books for my DONA postpartum doula certification, and was struck almost dumb by the very obvious truth that "Nurturing the Family: The Guide for Postpartum Doulas" 2002 by Jacqueline Kelleher presents: kangaroo care can benefit ALL babies. I remember reading about Kangaroo care programs in the 1990's. Hospitals were using kangaroo care for premature babies; "preemies". "Skin to skin" contact was definitely encouraged when I had my first baby, but I only ever remember a childbirth educator we took a class with ever mentioning "Skin to skin" contact, and its benefits.

For just a little bit about Kangaroo care, see this Wikipedia entry: Kangaroo Care

J is for Japanese doulas. . . .

2009-07-18T15:43:00.002-04:00

But NOT just Japanese! You may find Japanese doulas, American doulas, European doulas, you name it, on a number of websites, here are just a few:

DONA
Metro Doula Group
Doula Match .net

The above are just a few websites that may help you to find your doula. In addition, ask your midwife / doctor / nurse / childbirth educator for a recommendation to a doula. There is a doula for EVERY woman who wants one. Some doulas charge market rates, others can be more accommodating to the budget-conscious.

Of course you don't have to hire a doula who speaks your native language, or looks like you. But if you do want to, I assure you that I have met doulas from many cultures, who come from all over the world - you are sure to find one that you like, if you look.

I is for ICEA

2009-07-14T15:39:00.002-04:00

From ICEAs website:

The International Childbirth Education
Association (ICEA) is a professional
organization that supports educators and
health care professionals who believe in
freedom of choice based on knowledge of
alternatives in family-centered maternity and
newborn care.

ICEA is a good place to start for finding a childbirth education class or furthering your education as a professional. They have really good articles and evidence based information. I suggest contacting a doula in your area for referrals to childbirth education classes in your area, or you can contact a childbirth educator in your area directly, using the ICEA website. While I don't think that there is one correct way to have a baby, I also would NEVER suggest that a pregnant woman and her family / partner / friend / support take a birth class in a hospital. That is to say: I suggest that you take a childbirth education class anywhere except a hospital. In my experience, the hospital education class teaches you the hospital procedure. Yes, they may teach "breathing". They may have pillows, and exercises, but they do not have the time nor inclination to educate. They must be politically correct about the options that they introduce. These options must match the hospital's services and policies. If you must take the hospital class, please also take an out-of-hospital class - you will emerge more prepared.

A friend of mine took a class out of hospital, and it was not only cheaper, but she said that she found it to be much more thorough. Because the class must present numerous options for comfort measures, pain relief, and partner education. The people attending the class were delivering their babies in hospitals, birth center, or home. Some knew they wanted an epidural, some knew they didn't want one, some didn't know what they wanted. In short, the class was geared for everyone, not just one hospital's, Dr.'s or midwife's clients. And so the breadth of information offered was far greater, and more varied. More questions were posed by the out of hospital attendees, and more answers were given, without regard to contradicting individual care providers, Dr.s, midwives, or hospital or birth center staff.

Hudson Valley Milk Bank

2009-07-02T16:30:00.001-04:00

Just found out about Hudson Valley Milk Bank

It is a breastmilk bank for moms who need to supplement. While most babies do not need to be supplemented, this bank is invaluable for mothers who find that they need to supplement for a myriad of reasons.

The milk bank works with several hospitals. They work with hospital NICUs of course (Neonatal Intensive Care Units). But they will provide donor breastmilk for seemingly any reason, provided that you have a Dr.'s Rx. They do not seem to mind if healthy, full-term infants receive their milk such as when a mother who needs to supplement simply wants to provide their baby with breastmilk, instead of formula. They seem to be experiencing no lack of inventory, at the moment. For local residents, donor breastmilk may be picked up. They do ship overnight as well.

G is for a Good Birth, a Safe Birth

2009-07-02T11:43:00.001-04:00

I had a client who just LOVED this book. She was from another country, and probably needed this heads up. Birth in the United States is unique, to say the least. For a developed country our stats are dismal. Funny, but we don't think about this much.

F is for Flylady

2009-06-30T06:26:00.001-04:00

Flylady is to home organization like what Richard Simmons is to the critically obese: reassuring, expert and motivating. I think I was BO (Flylady speak for Born Organized), but found myself maybe er not soooo maybe organized as I had been before a newborn graced our home. Flylady and her "baby steps" kept me on track, kept our family in clean laundry, food, and reasonably clean.

Now her emails can become overwhelming, so some may want to stick to visiting her website for motivation, instead of subscribing to her automatic emails.

Maybe I seem to be off topic? OK, so Flylady isn't directly related to pregnancy and postpartum, but there are lots of suggestions to be found on her website about organizing while pregnant, with a new baby, and more :)

FLY is an acronym meaning: Finally Loving Yourself. What a wonderful message we send to others, when we first love ourselves. OK, I'm stepping off my soap box now. Enjoy.

E is for Ellen Chuse Childbirth

2009-06-29T11:31:00.001-04:00

Ellen Chuse is a wonderful, wise woman. Ellen Chuse offers childbirth education classes, what she calls "Mothers Meetings", postpartum support and counseling.

2009-06-28T16:27:00.002-04:00

DONA www.dona.org is the premier organization for doulas, both for birth doulas, and postpartum doulas.

Doulas are worth EVERY penny. But not on Frasier. Remember the hilarious episode on Frasier, the one with the hippy-dippy, ass of a doula? Frasier Season 11: "Match Game" I have to dispell the myth that doulas have their own agenda. I have NEVER met such an opinionated doula in real life! Doulas will work with you, wherever you are at. Doulas work everywhere. We accompany you in hospitals. We attend home births. Doulas have accompanied their clients to ceasereans. Wherever and however you birth, you will get your doula's unconditional support, no matter what. A doula's job is to make your experience better. But her job is not to make your experience hers. Remember, Frasier was excellent TV, but it is NOT real life.

Doulas come from all kinds of backgrounds and walks of life, some hippy types to be sure, but not always. I became a doula thanks to the wonderful doulas I have met, and thanks also to doulas I have hired and worked with. My first doula was European, and already a mother herself. The second birth doula I hired was VERY experienced, not that it mattered, she only worked for 2 hours! Good thing my second was a homebirth :)

So you sorta knew that birth doulas existed, but did you know that there are doulas who offer postpartum assistance? For parents who don't want or need a baby nurse, who really want to figure out how to parent, for unconditional support in their parenting choices, a postpartum doula is a fantastic gift for new parents. For my first, I had the pleasure of hiring the most wonderful postpartum doula, ever. She is now in training to be a nurse, so I can't refer her. But if you want a fantastic postpartum doula, you cannot do better than Ruth Callahan's experienced doulas at Ruth Callahan's Doula Care Postpartum Service Doula Care

C is for Choices in Childbirth

2009-06-17T03:08:00.002-04:00

I can't say enough good things about this group! Choices in Childbirth

Their mission:

Our mission is to improve maternity care by providing the public, especially childbearing women and their families, with the information necessary to make fully informed decisions relating to how, where, and with whom they will give birth.

I like the book "Birthing From Within" that relates a story about picking chili peppers. In it, a farmer asks how hot of a pepper the buyer wants. Shouldn't birthing women know what they want? Of course we do. But where do we start? Choices in Childbirth is a terrific jumping off point, providing questions to ask, and really great research based information.

2009-06-17T02:34:00.002-04:00

Breastfeeding. Where to start?

Having trained as a Reference Librarian, I've wanted to compile a "List of Lists" for pregnancy, breastfeeding and postpartum for a looonnnnnng time. So here I go. Let's start at B, with one of my favorites:

www.breastfeeding.com - GREAT site. Fantastic online community.