Tuesday, April 27, 2010

toLabor Doula Training, sponsored by yours truly!

Yes, right here in Erie! ERIE NEEDS DOULAS. I am both delighted and fortunate to be making this training available to women right here in town. The workshop takes place over the course of three days, from June 4-6.

ToLabor is the professional organization formerly known as ALACE, providing the same woman-centered training and certification which has exceeded national standards, bridging technical knowledge with a compassionate personal touch. So here's the scoop:

Is there a desire in you to:

• Help pregnant women and their families recognize what options there are in pregnancy, labor and birth?
• Provide evidence based information for the healthiest maternity care?
• Provide practical suggestions to help pregnant women relax during labor including physical and emotional support?
• Help a woman find her voice in order to advocate for herself and baby?
• Encourage an environment of calm within her team of care providers?
• Offer follow-up support in the postpartum period?

A toLabor Professional Birth Doula provides support for the pregnant woman and her partner, continuous care throughout the labor and birth to help them fully experience their birth.

The workshop includes: an introduction to physical assessments, adding an aspect of experiential learning unavailable in other training programs; these experiential exercises serve to enrich and empower all those who attend our workshops.

Tuition includes: the entire training and certification process, the training workshop, processing your work, the exam, the certificate itself, and activates membership. Before discounts, the total cost is $425. Payment plans are available. Enroll for the workshop 30 days in advance & receive a discount of $30. Past graduates of our training who are current members, may attend a workshop again for only $200. Previous doula training discounts are also available.

Erie PA Birth Doula training June 4 - 6, 2010
Contact Anne 860-922-6439 annetegtmeier[at]yahoo.com
www.tolabor.org 804-320-0607 tolabor[at]gmail.com

Sunday, April 25, 2010

Weekend Movie: Whattock Childbirth? (GRAPHIC)

I admit I was drawn in just because of the name. "Buttock" childbirth? Quoi?

But it sure raises some thoughts about vaginal breech birth, eh? The practice here, from 1987, seems to go against the "hands-off" guidelines - toweling the baby off before the head has emerged, doing a little more manipulation than the ideal, mom being on her back - at least as far as my own understanding of the developing recommendations for reviving vaginal breech (if you're in Canada, at least). The "psychoanalgesia" aspect is interesting, too.

The bottom (har) line is that it went very smoothly indeed, baby is perfectly healthy, and mom seems quite happy with the whole experience, even though it doesn't quite fit with what we're learning are the best practices. This, to me, is quite reassuring, actually. What say you?

Wednesday, April 21, 2010

Happy happy news

It's been a whirlwind around here for the past week, with both my moms in town, the ICAN Film Series I helped organize plus Lily's second birthday party on Sunday, but I had to share the news. Today, which happens to be my own birthday, I got the news that I have received a scholarship for CAPPA's childbirth education certification, doing the distance learning program. Couldn't be better news on a better day.

My inner Hermione rejoices!

Saturday, April 17, 2010

Weekend Movie: And one, and two, and one, two, three!

What a fabulous demonstration of the musculature, eh? I'd never visualized it quite that way - I genuinely feel like I have a deeper understanding of it now.

I'm doing them right this second. Are you?

Thursday, April 15, 2010

"Face of Birth": A documentary on the battle for birth in Australia

I cannot wait to see this, and of course cannot wait until the weekend to share it with you. We have our maternity care struggles in America, that's for sure, hence my very existence here, but Australia has its own unique situation. Here, though there are still states where midwives cannot legally hold licenses, the choice to birth at home is, at least, still protected for the family. In Australia, that choice is at risk of becoming illegal, period. Here's the trailer for "Face of Birth":

Choice in birth is a human rights issue. How can we in the U.S. best stand with the women of Australia on this? I'd love your thoughts.

Wednesday, April 14, 2010

"Birth: It's Positive!"

On the second anniversary of Lily's birth, I'm thrilled to share with you a new volume of uplifting birth stories, one of which is my own. Local ICAN member Gretchen Arnold and midwife Jill Johnson gathered and edited this terrific variety of remembrances, all to raise money for the Erie chapter of ICAN.

Please consider buying this, if not for yourself, it makes a wonderful gift, and the proceeds go to a tremendous cause. As Erie's latest official cesarean rates clocked in at 37.6%, we need all the help we can get!

Wordless Wednesday: Two Years Ago TODAY.

Tuesday, April 13, 2010

A Due Date is Not a Deadline

I'm officially on call for my first birth.

How exciting is that? This is sort of an "unofficial" client, since despite my obsessive independent study, my actual labor support training won't take place until June. It's a long story as to how it came about, which I won't go into for confidentiality reasons, but though I was apprehensive about whether or not it was okay to attend a birth pre-certification, one of the 'senior' doulas in the area encouraged me, saying "You don't need to be certified to hold a woman's hand and bring her a glass of water." True that!

So, as we're heading into the home stretch, the stress and exhaustion of the final weeks of pregnancy are taking their inevitable toll, and mom is anxious to get the show on the road, understandably. Mom's body is gearing up in a number of unmistakable ways, there is no question, and she's a total champ - but there's a lot of stopping and starting and revving up and decelerating, all of which can be so confusing and frustrating. I'm doing my best to reassure her that this is perfectly, absolutely and quintessentially normal, especially for a first time mom. Her due date hasn't even arrived yet, in fact - we have two more days until she's even 40 weeks along, and the hard numbers show that the average length of pregnancy for primips is 41 weeks plus one day.

Yet, I worry that for her, the due date seems like a looming deadline that she has to try to make or even beat, when this couldn't be further from the truth.

When it comes to child development, we know that there is endless variation that all falls within the range of normal. Some babies start teething at 4-5 months, others don't start until 7. Some are crawling by 5 months, some take quite a while longer. Some walk first, some talk first. Sitting up, rolling over, the milestones are endless - and mothers do sometimes get concerned that their babies aren't doing things "on schedule" . . . and they immediately get reassurance from other moms, especially moms with more than one kid, that every child is different and their kid will indeed reach them all in their own good time.

Yet when it comes to pregnancy, we culturally expect every baby to be 'done' at EXACTLY the same time, TO THE DAY?! Makes. No. Sense. Our fixation on one specific, magical date has really done a number on us, so to speak, collectively, to the point where we have come to think of that 40 week delineation not as an estimate but as a deadline. Combine this with a recent study showing that an alarming number of mothers believed the normal length of a pregnancy was 34-36 weeks, fold in an intervention-happy care provider, and add a liberal dash of normal end-of-pregnancy weary impatience, and you have an underbaked recipe for inductions at pandemic levels.

Sorry, my inner food-blogger took over there. Going on: A due "range" is much more realistic, and considering that it can be perfectly healthy two weeks (or sometimes more) in either direction - we really ought to start considering it a 'due month'. Anywhere from 37 or 38 weeks up to 42 weeks can be considered term. Even a "due week" is an improvement. I also like the growing-in-popularity term "guess date" a lot, and am trying to change my own habitual language to use that term more regularly. Now, don't get me wrong, in some cases being truly post-term can be problematic, but this is rare and deserves to be scrutinized on an individual basis, depending on circumstances.

Really think about it. That date is the mid-point on the bell curve of an entire range of days that could be acceptable, not to mention that it is an ESTIMATE in the first place. Hence, its official nomenclature, the Estimated Due Date, a.k.a. EDD. Furthermore, the estimate is itself based on what is often an approximate recollection of LMP. It is a riddle wrapped in a mystery inside an enigma, if you admire Churchill. A mystery wrapped in a riddle inside an enigma, if you liked "JFK". Or a riddle wrapped in an enigma wrapped in a vest, if you're Lisa Simpson. If there was only one thing, only ONE, that I could change about maternity care in this country, the fixation on the singular so-called due date would be a very, very strong contender.

There are a plethora of wonderful resources out there talking about the many advantages to avoiding early inductions, discuss various non-reasons sometimes given to pressure a mom into induction, and in general talking about the vital importance of the final weeks of pregnancy, and I'll share a bunch of them in a minute here, but let me first illustrate one point with a great visual from the March of Dimes:

Quite the difference there, eh? Among the last things to fully develop in pregnancy are the brains and the lungs - two things that I would never want to take any chances with. From a wonderful read titled "Why Every Week of Pregnancy Counts".
New research shows that those last weeks of pregnancy are more important than once thought for brain, lung and liver development. And there may be lasting consequences for babies born at 34 to 36 weeks, now called "late preterm."

A study in the American Journal of Obstetrics and Gynecology in October calculated that for each week a baby stayed in the womb between 32 and 39 weeks, there is a 23% decrease in problems such as respiratory distress, jaundice, seizures, temperature instability and brain hemorrhages.

A study of nearly 15,000 children in the Journal of Pediatrics in July found that those born between 32 and 36 weeks had lower reading and math scores in first grade than babies who went to full term. New research also suggests that late preterm infants are at higher risk for mild cognitive and behavioral problems and may have lower I.Q.s than those who go full term.

What's more, experts warn that a fetus's estimated age may be off by as much as two weeks either way, meaning that a baby thought to be 36 weeks along might be only 34.
Forgive the overzealous marking-up, there, but these are crucial details. Groups like the March of Dimes are getting increasingly concerned about early inductions and scheduled c-sections for this very reason, due to the risk of what is now being called a "late preterm" baby. 36 weeks is an extremely precarious age already- and then what if the "due date" is off, and you've actually got a 34 or 35 weeker? The entirely preventable increase in complications is unconscionable.

As promised, more linkage: Here's a good overall collection of some of the abstracts against induction, and here's more on the inaccuracy of many due dates. Lamaze discusses the pitfalls of babies being born even "a little" too early. And finally, here's a great overall piece from Lamaze on why adhering slavishly to a "due date" is NOT a healthy birth practice. It's worthwhile to bring up early in pregnancy. If any care provider insists on going only by the calendar and applies this cookie-cutter to all his or her patients, I personally would keep looking. To reiterate: there are some valid medical reasons for induction (as with any intervention), but just hitting 40 weeks? Not one of them.

Again with the food bloggering - innie-to-outie belly buttons aside, mama's bellies do not come with pop-out turkey timers.

Sunday, April 11, 2010

Weekend Movie Double Feature: "DOULA!"

(I think that title's best expressed with jazz hands. DOULA!)

Had to sneak in a second movie this weekend, because look! "Doula! The Ultimate Birth Companion" is coming soon!

“DOULA!: THE ULTIMATE BIRTH COMPANION” is a NEW 65 minute documentary film that follows three BIRTH DOULAS as they support three couples before, during and after their births.

The film features actual footage of doula supported births.

We also see POSTNATAL DOULAS providing practical and emotional support to new mums after their babies are born.

Here's a statement by the director and producer:

Hand on heart, I wish I had known about doulas when I gave birth two years ago. I had quite a difficult birth experience (failed inductions followed by a c-section) and I now know that with the help of a doula, it would have been a completely different and much more positive experience.

I found out about doulas after I had made REAL BIRTH STORIES, a documentary series telling the birth stories of five couples who had just become new parents (myself and my partner were one of the couples featured in the series!) None of the parents in Real Birth Stories had hired a doula and in fact, before this point, I had never even heard of a doula and had no idea what doulas do.

I did some research and started to meet some doulas. Every single one was incredibly enthusiastic, caring, warm-hearted, intelligent, knowledgeable and all were absolutely committed to giving expectant parents the best possible experience before, during and after the birth. Then when I filmed my first birth, something clicked. I saw with my own eyes the difference a doula can make. The doula made the birth magical.

The doula prepared the birth environment, made tea for everyone, massaged the mum’s feet, supported the dad, suggested labour positions, reminded the mum to breathe, soothed, comforted, encouraged, phoned the aunt and grandma to come immediately for the imminent birth, took photos and then when the baby came, she made sure the mum, dad and the beautiful new baby spent their first precious few minutes quietly together, uninterrupted as a new family. Then the doula helped the mum deliver the placenta before making up the bed for the new parents to sleep in.

The doula never told the mum or dad what to do but was just absolutely there for them the whole time, doing whatever needed to be done and I believe she was instrumental in giving the parents the birth they both wanted and deserved. The doula made all the difference. And in those few hours, I totally “got” what being a doula was all about.

And that’s why I wanted to make this film. So that other people “get” doulas. To help spread the word about how amazing having a doula can be.
I'm giddy.

Saturday, April 10, 2010

Weekend Movie: Learning Makes It Natural

Nova Scotia, I salute thee. This is possibly the best PSA campaign I've seen for breastfeeding yet.

After a particularly lively week of breastfeeding in the news, this is a breath of fresh air. I love the simplicity and directness and inherent compassion here. In the, um . . . lively comment sections that follow, lactivists are typically accused of understating the potential difficulties of breastfeeding, and overdoing it with the "It's just natural! Thus it comes naturally!" approach. While I might disagree with that characterization in most cases, and there's plenty to discuss in terms of detrimental outside influences, I do think it's a point worth taking into consideration.

So, how perfect is this? It doesn't even get into the benefits of breastfeeding/risks of formula - because really, where to even begin in :33? Instead, the message they send is one of support and understanding, of affirmation that there is indeed a learning dynamic at work, and use wonderful analogies. I particularly like the language one, not only because it really is like learning a language (one that you are learning together with your baby), but also because but also because relationship is fundamental to language.

See, those cats are American lactivists, and that squirrel is this PSA campaign. Or perhaps the nuts are the campaign, and the squirrel represents Nova Scotia mothers? Maybe the nut is breastfeeding itself, and the squirr . . . Point being, DO WANT PLZ.

Tuesday, April 6, 2010

Latching On

I'm already eagerly anticipating Formula Fed America (and Babies, too), as I posted months ago. It just came to my attention that another film is on the way: Latching On.

It already looks more diverse than what we saw of Formula Fed America so far (though I'm still excited and hopeful about that). It's a short one, only 36 minutes total, but this could be an asset when it comes to appeal to the general public. I might be up for watching films on the subject that are the length of Wagner's Ring Cycle (or at least the Lord of the Rings trilogy), but I acknowledge not everyone is a weirdo like me.

The timing of finding this is uncanny - the internet is teeming with awesome on breastfeeding at the moment. The latest study about exclusive breastfeeding for 6 months saving approximately 900 infant lives per year in America (as well as saving 13 billion dollars) has gotten mass media attention. Some coverage has been better than others: the CNN story was pretty great. As was the CBC and CBS. The ABC story, however, featured a doctor doing some sadly familiar hedging and waffling about guilt and blaming the workplace for lack of breastfeeding success - and Elita of Blacktating called out that doctor at, like, superhero lightning speed for being a freakin' Nestle shill, of all the unethical things. HELL YEAH, Elita! Caught 'em red-handed. Best for Babes also does a great job critiquing ABC's financial breakdown.

And in another epic blogosphere-to-the-rescue moment, The Feminist Breeder wrote one of her signature glorious rants about the folly of the common defensive guilt response to any such report on the benefits of breastfeeding. I'm having a hard time selecting just one quote, there's so much win to choose from, but for starters:

Breastfeeding. Saves. Lives.

You know what else saves lives? Car seats. So, why aren’t people spitting mad at the NHTSA for saying that? Why aren’t they leaving thousands of comments on car seat articles saying “But I just couldn’t afford a car seat, why are you trying to make me feel guilty?!?!” Well, maybe it’s because our society will admit that car seats save lives, and we’re willing to give them out free at fire stations and hospitals if we have to because it is that important.

So why aren’t we doing the same for breastfeeding? Why won’t they hand out free breast pumps and visits to a lactation consultant when we know it would save lives and money? Well, I think the obvious answer is that there are breasts involved, and people just lose their minds when female anatomy comes up in conversation.

And then there's this:

The CDC shows that 3/4 of women are initiating breastfeeding in the hospital, but only 13.6% of women are still exclusively breastfeeding at 6 months. What this tells me is that somewhere along the way, they gave up on themselves, and the reason I hear most often is, “But, I tried! I just couldn’t make any milk!”

Here is the cold hard truth ladies: You have been lied to.

If only 13.6% of us could make enough milk, the human race would never have survived. And it’s not your fault. It’s the fault of this system that completely fails mothers and babies, and sabotages a mother’s good intentions. Somewhere along the line, some one told you that you couldn’t make milk, and you believed them because we’ve all grown up in a culture that tells women their bodies aren’t good enough for much of anything except being toys for men. Is it easy to make this milk? No, not always — but neither was bringing that baby into the world and your body did a fine job of that. Think about that. Think hard. Your body created an entire human being inside from nothing more than the joining of two single cells. Your body is a miracle worker. So what leads you to believe that, after creating a whole person with organs and tissue and a beating heart, that your body would call it quits when it came time to feeding this thing? The major problem here is that someone in your life probably put their own ignorance ahead of the short and long term health of you and your baby, and you believed them because women are used to feeling shamed.

I want to tattoo this on my forehead. Or at least paint it on my car, or do something to get it across to as many people as I can.

The red-emphasized part above (my emphasis because I think it's another particularly salient point) reminds me of a thought I had recently on the utter irony of rejecting or diminishing breastfeeding on the grounds of its possible interference with their attractiveness to men.

Let's leave aside the fact that breastfeeding has been proven several times (here's the most recent, as broken down by PhD in Parenting) to have z.e.r.o. effect on the appearance of breasts. Think about the nature of attraction, as in literally the very biology of it. There's no denying that we human mammals tend to find certain traits attractive, collectively, and the basis for much of that attraction when it comes to secondary sex characteristics has to do with seeking a fertile mate that will effectively bear and rear offspring, right?

In other words, from a purely biological standpoint, men are hardwired to find healthy-looking breasts attractive BECAUSE they will likely feed their offspring well. So the idea that breasts should be reserved for male pleasure instead of for feeding babies - the very purpose of their attractiveness to males IN THE FIRST PLACE - is not just tragically ironic, it's utterly preposterous.

Latch on to that.