Archive for the ‘birth center’ Category

Comfort Tips for a Hospital Labor and Delivery

Friday, August 14th, 2009

No matter how a hospital room is decorated, it is still a hospital room and not your home.  It smells different, sounds different, looks different, you name it not your home.

What can you do to make is more comfortable for your labor and delivery?

  • Labor at home as long as possible and arrive when you are deep into active labor (unless there is a medical reason to arrive earlier)
  • Wear your own clothing the whole time – nothing says “patient” like the hospital gown
  • A bathing suit top to wear while in the shower or tub
  • A binsi or bathing suit cover to wear while laboring
  • Bring your own pillow case or pillow – as long as they can be washed in hot water and a disinfectant after
  • Have your own toiletry items
  • Bring your own snacks and drinks – again it is what you are used to
  • Bring photos or cards to put around the room that you love to look at
  • Bring your own music
  • Aromatherapy to mask birth smells or abate nausea such as lavendar, orange, and/or peppermint
  • Your own non-food use crock pot to make hot compresses
  • Favorite blanket or soothie type item that helps you relax
  • A roll or two of your own toilet paper if you are particular or have sensitive parts
  • Your favorite lotion
  • A your husband or partner will not be with you, have a shirt or other worn so you can have the scent around
  • Any religious or spiritual materials that help you focus on the task at hand
  • Bring your own birth ball to use
  • Surround yourself with the colors that create peace, safety and comfort
  • Think outside the norm and bring flowers, herbs or other items from your garden

Though you cannot have a home birth in the hospital, you can make it more comfortable and to your liking.  You ARE renting the space while you are there.

Preparing For Birth – A sample low-intervention birth plan

Thursday, August 13th, 2009

A birth plan is a tool to express your desires and needs for birth and initial postpartum, as well as, to make sure that you and your provider are on the same page.  Your birth plan should be brief (no more than one page) and only have the bullet point information that is specific to your care and desire or not usually done by your care provider or birth location.

Discuss with your care provider prior to labor and bring a copy with you to your birth location.  Remember it is not a legal document that your location of delivery or care provider must adhere to.

Here is a sample plan for an out of the home birth:

Birth Needs and Desires for: _______________________. Care Provider:____________________________________.

Estimated Due Date: ____________________________.

Labor

I am planning on a no to low-intervention natural birth.  I plan on being mobile, lightly snacking, drinking orally, and having ___________ present.   I understand that intermittent monitoring of me and my baby will be necessary.  I want to be fully consented for any procedure that may come up and fully participate in the medical care for myself and my baby.  I understand that there is pain management available to me, I will ask for it if I so desire.

  • I plan on wearing my own clothing. I will ask for a gown if I change my mind.
  • I would like a saline lock in lieu of an IV
  • In the event of an induction and/or augmentation is medically necessitated-
    • Ripening – Foley Catheter instead of Cytotec (misoprostol)
    • Pitocin – A very slowly increased dosage
    • AROM – will only consent to if an internal fetal monitor is a must.
  • Delayed cord clamping for at least 5 minutes (baby can receive oxygen or other helps while still attached to me).

Postpartum and Baby Care

  • Request that my baby is on my belly or chest for assessments and warmth (even oxygen can be given on me)
  • Delayed bathing
  • Delaying vaccinations including eye ointment and vitamin k.
  • Exclusive breastfeeding, no pacifiers, sugar water, or formula
  • No separation from me unless absolutely medically necessary not just protocol.

Cesarean: In the event a cesarean becomes necessary and is not a true emergency requiring general anesthesia.  I would like to keep the spirit of my plan A to plan C so the delivery can be as family centered and intimate as possible.

  • Only essential lighting
  • Only essential conversation related to the surgery and delivery
  • Lower sterile drape or have a mirror present so I may see my baby emerge
  • Only one arm strapped down so I may touch my baby
  • Pictures and video
  • Aromatherapy as I desire for comfort, abate nausea and to mask surgical odors
  • Baby to stay with me continuously in OR and recovery
  • If baby must leave OR for treatment, my partner/spouse goes with baby and I would like my ____________ to stay with me so I am never alone.
  • Breastfeed in OR and/or recovery
  • Delayed immunizations
  • Delayed washing and dressing of baby
  • No separation from me except what is absolutely medically necessary

Choosing your birth location – A tip sheet

Monday, August 10th, 2009

Choosing the place of birth for your baby – It is incredibly important that you understand where you fit best prior to choosing where to birth your baby. Take hospital and/or birth center tour, call and talk to L&D floor, get facts on home birth by talking to home birth midwives, other moms who have had home births, online and in books. Being intellectually safe is not the same as being safe. Know the facts before you choose.

· Does the location offer what is most important to you (tubs, birth balls, wearing own clothing, intermittent monitoring, fetascope monitoring, etc.)?

· What are standard protocols and practices that are followed? Is individualized care a norm there or is cookie cutter style?

· Is water birth available?

· Are birthing stools or non-reclined pushing and delivery positions encouraged?

· What are the no/low intervention rates? These numbers are tracked monthly.

· What is the induction, epidural, cesarean rate? Are VBAC’s supported and encouraged?

· Are mom and baby friendly practices used? (no routine interventions, no separation of mom and baby, breastfeeding is the norm, movement in labor is utilized, doula accompaniment is accepted, labor induction rates are low, etc.)

· What if I choose to decline an intervention, medication or procedure? Will my decisions be respected? Are patient’s rights taken seriously?

Points to Ponder afterward

· Will I be able to have the type of birth I truly desire?

· What location will I ultimately feel most comfortable in physically, emotionally and spiritually?

· What location is ultimately safest for my specific needs (I am currently a low-risk or high risk)?

· Is insurance or lack of it the reason I am choosing the location?

· Do I have realistic expectations for the location?

· Am I willing to take responsibility for my birth in the location?

· Is staff open to working with a doula or natural birth?

· Are there any compelling reasons to choose one location over another?

Interviewing your care provider for pregnancy and birth – A tip sheet.

Monday, August 10th, 2009

Choosing your care provider: Use this as a template for the interview process or to discern you are of the same philosophy and belief system with current OB or Hospital/Birth Center Midwife.

· What is birth philosophy? What is philosophy of pregnancy?

· What makes up majority of experience in practice? Has provider seen normal labor and birth? How often?

· How is the “due date” approached? When is “full term”? When is “overdue”?

· Will questions be answered over the phone?

· How much time will be spent with me during each appointment?

· What if I hire a doula? Are there restrictions on the doula I may hire? If yes, why?

· Are there restrictions on the type of childbirth or breastfeeding class I take? If so, what and why?

· What routine tests are utilized during pregnancy? What if I decline these tests?

· What are intervention rates? (IV, AROM, continuous monitoring, episiotomy, etc.) Cesarean rate? VBAC rate? Induction rate? What induction methods are used? When are forceps/vacuum used? These numbers are tracked.

· What positions is care provider comfortable catching in? Birth stool? Hand/Knees? Squatting? Standing? Water? How often do patients deliver in positions other than “c” position?

· If I choose an epidural, when can I get it or when is it too late?

· What about a birth plan? Does CP agree with them or not?

· Is an on call rotation utilized or does CP attend all own patients? Will back-up or on-call CP honor the requests we have agreed on?

· Are there any protocols that are non-negotiable? If you cannot refuse – you are not consenting.

· What if I choose to decline a recommended procedure or intervention? Will my decision be respected?

· How long is provider with patients during labor?

Points to ponder afterward:

· Did you feel immediately comfortable and respected at the interview? If already with a CP, do you feel comfortable, respected and heard at each appointment?

· Was or is care provider willing to answer questions in detail without being annoyed?

· Is choosing your care provider based on your insurance or lack of insurance?

· What are you willing to do in order to have the birth you really desire? Birth location?

· How much responsibility are you willing to take for the health care decisions for you and your baby?

Increasing your opportunity for a vaginal birth in a cesarean stricken culture.

Tuesday, August 4th, 2009

Today the cesarean rate is an alarming 31.8% (CDC 2007 preliminary data).  Only a maximum of 15%  of birthing women should be having cesarean deliveries in order to keep mortality (death) and morbidity (poor outcomes) to the healthiest levels according to the World Health Organization. With the staggering discrepancy in what should be and what is, you NEED to care about this topic.  You could have a questionable cesarean like so many others.

It is important that you the childbearing woman understand how to have the healthiest birth for you and your baby which is most often a no-to-low intervention vaginal birth.

When a cesarean occurs for a truly medical and/or life saving reason it is necessary and the benefits far outweigh the consequences for mom and baby.  The cesareans that occur for other than truly medical and/or life saving reasons are often not necessary or became necessary due to external influence that skewed the labor and delivery outcome (routine induction, epidural,  impatience by provider, mal-position of baby, staying in bed during labor, routine continuous monitoring, pushing in one position, lack of food and water during labor, routine augmentation of labor, lack of support, etc.)

Below is a list of ways to promote having a vaginal birth even if you have already had a baby this information needs to be known.

  • Take the ICAN webinar on cesarean prevention.
  • Interview before choosing your care provider – you are doing the hiring! Know his or her statistics.  If you do not get a clear answer, that is a RED flag.  You need individualized care. ou and your baby deserve no less.
  • Interview both midwives and OB’s.
  • Research your chosen birth location well.  There are other options outside of the hospital – home and birth center.
  • Hire a doula who shares your philosophy and is comfortable with the type of birth you desire. Some searchable places for a doula are: www.cappa.net, www.dona.org, and www.alldoulas.com.
  • Without medical reason standing in the way, labor at home into active labor if traveling to a hospital or birth center.  Well established labor upon arrival to the hospital or birth center decreases the opportunity for interventions, medications, and cesareans.
  • Get educated! Take a childbirth class that promotes confidence, consumer awareness (knowing rights and responsibilities), and evidence-based practices. A “good patient” class is not what you want to take.  READ books that share positive stories and good information.  A few of the searchable sites are: www.cappa.net, www.independentchildbirth.com, www.lamaze.org, and www.ican-online.org.
  • Turn off your TV – stop watching the dramatic birth shows.  They are not real.
  • Use mobility in labor.
  • Drink and snack in labor.
  • Say NO to routine interventions – meaning interventions or medications without a true medical reason. These can include, IV with fluid running, artificial rupture of membranes, continuous monitoring, wearing of hospital gown, and vaginal exams.
  • Say no the the epidural completely or at the earliest at 6 cm’s dilated.
  • Push and deliver in positions other than the reclined or “C” position unless that feels good and baby is coming well that way.
  • Only have those around you who will support what you need and desire in labor and birth. When you close your eyes who is there with you in your labor “cave”? Who doesn’t fit well there?
  • Study yourself for what comforts, assures, and adds to your feeling of safety.
  • Eat healthy and exercise during pregnancy.
  • Read What Every Woman Needs to Know About Cesarean Section – http://www.childbirthconnection.org/article.asp?ck=10164
  • For more information on Cesarean recovery and support, VBAC education and support, and Cesarean prevention go to www.ican-online.org.
  • Bottom line – take your money and walk if you are not being listened to and treated as a partner in your care.

The Doula Seed

Sunday, July 26th, 2009

Whenever I am asked why I am a doula, I need to stop and think for a moment.  My response every time is that as a doula I am filling the gap (along with others)  that is missing in today’s transient and autonomous society. When I respond, I am thinking of the days when girls and young women learned the ways of pregnancy to all things postpartum at the feet of their grandmothers, aunts, sisters, cousins, and other women in their community.  What a beautiful and age old scene that is.

Then that scene brings me to my own journey in becoming a doula.  Here is my “why” story.

Living without my own mother since I was 10 years old, I yearned for the mentoring and teaching that I am called to act upon in my life’s work.   Even without my mother, I was blessed to grow up around some other women who modeled breastfeeding, cloth diapering, and natural birth for me.

I also think of the journey that brought me to being a doula for real.

I had an epiphany one day almost 25 years ago when a close friend and I were waiting for the bus to get home from work.  She described her birth – left by her partner during pregnancy, her mother refused to come since she was unwed, and she was at an overtaxed county hospital where the staff was barely in the room to support her.  She was utterly alone and scared.  My heart broke for her and her daughter. No woman should ever be alone to fend for herself under those circumstances.  EVER.  In looking back, I can say at that moment my doula heart seed was planted though it would be years before the seed came to full bloom.

Fast forward a couple of years and I had a knack for mamas and babies.  I could help a baby latch and mom grow confidence in breastfeeding.  I knew how to calm a mama when she was tired and at her wit’s end. I understood the pregnant mama and could easily encourage.  I was invited to attend a birth of a family member I was very close to.  She delivered in a freestanding birth center.  It was an amazing natural birth with very little requirement of her except to labor and birth.  An atmosphere of encouragement, freedom, and calm. I will say it was one of the most comfortable places I have ever been in my skin supporting her.  I didn’t understand the job I had done with her, but it was good.  I think I was on a birth high for weeks.  The doula seed was beginning to ferment.

I attended birth along the way for friends and other family, assisted in breastfeeding and talking through general pregnancy issues. Mind you I hadn’t had my own children, was educated and worked in fields that had nothing to do with birth.  I loved the mamas and families that I knew.  When I started having my own family, it seems the mojo went into high gear.  I was asked questions all the time about many things pregnancy, birth and breastfeeding related, no matter where the place or situation.  Even my husband began fielding calls when I wasn’t home from friends who needed baby help.  The doula seed was slowly sprouting.

When my dear youngest boy weaned himself, I began wondering OKAY now what am I going to do while maintaining being a SAHM? My sister-friend “J” found the CAPPA website and told me I needed to take the trainings and then I could really support the families in my community as an extension of what I was already doing.  Get the education she said.  I went to the site, spoke to my husband at length and took the leap.   Three trainings in 5 months.  Then I began to to seek out clients, put together curriculum, and found a local doula group to join.  The doula seed exploded into a blossom of great fragrance about me.

I ill not say the work is easy. Anything worth any value is not.  From the prenatal meeting, to the birth while looking into a mother’s eyes encouraging her down the path so many have walked before, to the early postpartum time in assisting with breastfeeding, attachment and family health, I am honored and blessed doubly.  Participating in the most intimate time possible, witnessing the transformation that so often occurs in a woman (and her huband/partner/family), and hearing that first sound of life when her baby “speaks” is beyond description.  A miracle takes place each and every time.

The doula blossom has deep roots now.  On occasion it needs some pruning, soil treatment, and large doses of sunshine as all beautiful plants need to maintain health and well-being.  Still it is very good.

Useful items for labor and delivery

Wednesday, July 22nd, 2009

I am often asked what someone needs to take to the hospital or birth center.   I am going for items that may not be normally thought of along with some tried and true items. Wherever a mother is going to have her baby – it is her space, her labor cave as it were.  Now for a hospital or birth center birth painters tape could be a good idea for some items on the list as not to mark up the walls.

Appealing to the senses: Items that speak to sight, touch, sound, smell, and taste.  Try and figure out where the items fit!

  • Pillow case that smells like you or your partner, really like your normal normal environment.  I eschew the thought of taking an actual pillow outside your home simply for the germs that are anywhere else you may deliver.
  • Your own clothing:
    • For her: robe, a sports bra, bikini top, tank top – something that can get wet and not be ruined.  Two piece outfit, a Binsi or bathing suit cover skirt.  Sandals, slippers, socks or flip flops.
    • For him/labor partner: sweats, shorts, pajamas, hoodie, pullover, socks, underwear – items other than just a pair of jeans.  Swim trunks in case she wants you in the shower or labor tub with her. Nakedness outside of a homebirth is generally reserved for the laboring woman. Flip flops or other waterproof foot covers.
  • A favorite blanket
  • Essential oils or scented lotion.
  • Pictures of other children, pets, favorite vacation, anything that is her happy place in thought, spirit and mind.
  • Flashlight and/or night lights to give subtle low light illumination.
  • Posters or phrases to put on the wall.
  • Music – soft, slow, upbeat, fast – whatever is relaxing for the individual.
  • Lip balm
  • Mints and lollipops
  • Toothbrushes and toothpaste
  • Colored items that soothe and encourage.
  • Affirmation cards or cd’s
  • Scripture or encouraging religious texts
  • Fresh herbs.
  • A cooler with easy to digest foods  for her- smoothies, yogurt, ices, peanut butter sandiwches, protein bars…..
  • A cooler with his favorite foods and drinks (again remember the toothbrush)
  • Special symbolic or religious pieces
  • Phone numbers of those who can encourage, pray, etc.
  • Something to cover the clock with.
  • your labor doula

Finally some of the inangibles that are not items:

  • Quiet
  • Peacefulness
  • Courage
  • Strength
  • Patience
  • Trust
  • Faith
  • Calm
  • Connectedness
  • Love
  • Joy
  • Excitement
  • Patience (not a typo)
  • Openness
  • Willingness

Be blessed and to all those who are pregnant – I hope for you to gestate peacefully.

Reprinting of Open letter to ACNM

Sunday, July 19th, 2009

Below is a reprinting of an open letter written to ACNM after a special alert notice.  Women and families no matter what insurance or lack thereof should be able to have access to any and all midwifery care.  Consumers CAN make appropriate choices for their own care.
As a consumer the idea of shutting out one group, is akin to hacking away at a vital, useful appendage.  It take ALL the limbs whenever possible for the body to work well.  Curtailing one from being recognized offers more imbalance in our maternity system and limits what families have available.  Is this the sort of step that ultimately leads to that vital limb being cut-off completely not just injured?  There is room for ALL types of midwifery care from the direct-entry to the ACNM.
TO: Open Letter to the ACNM Board of Directors and Executive Director

FROM: Geradine Simkins, CNM, MSN, MANA Board President

RE: ACNM Opposition to Federal Recognition for the CPM

DATE: July 17, 2009

I am a CNM and a member of the ACNM and I say very emphatically-not in my name! I do not support your recent decision to publicly and aggressively oppose the efforts of a broad-based coalition of six national midwifery and consumer organizations seeking federal recognition of the Certified Professional midwife. Your position, to me, is indefensible.

Lack of Evidence
For an organization of professionals that values evidence, I find it inexcusable that you have chosen an action that the evidence does not support.

  • There is no evidence to support your claim that the majority of CPMs are not properly qualified to practice.
  • There is no evidence to support the position that CPMs in general have poorer outcomes than CNMs or CMs.
  • There is no evidence to support the position that CPMs trained though apprenticeship and evaluated for certification through the Portfolio Evaluation Process (PEP) of NARM have different outcomes than CPMs trained in MEAC-accredited schools.
  • And there is no evidence to support the notion that a midwife with a Master’s Degree has better outcomes than one without that level of higher education.

The evidence we do have on the CPM credential indicates that the midwives holding this credential are performing well, have good outcomes, and are saving money in maternity care costs. The growing number of women choosing CPMs suggests that women value the care provided by CPMs. If future research should demonstrate the PEP process is unsafe or not cost-effective, then that would be the time to reassess and restructure the process.

Differing Values
We, as midwives, have values that underpin our professional practice. We cherish and honor those values. You have stated that your board made its decision because ACNM strongly values formal standardized education, and opposes federal recognition of CPMs who have not gone through an accredited program. I can accept that you strongly value standardized education.  However, I strongly value multiple routes of midwifery education for a variety of reasons.

There is something important, powerful and valuable in a training process in which the student midwife or apprentice is educated in a one-on-one relationship with a preceptor and her clients in the community, as opposed to the tertiary setting where student midwives do not follow women throughout the childbearing year, and may never experience continuity of care or individualized care. In addition, by preserving multiple routes of entry into the profession, we are able to educate more midwives. We need more midwives! If health care reforms were to produce an adoption of the midwifery model of care as the gold standard this year, we could not possible supply “a midwife for every mother.”

Impact of Taking a Stand
By publicly and actively opposing federal recognition of CPMs as Medicaid providers, in addition to taking a stand about formal education, you are also taking a stand (willingly or inadvertently) for decreased access to midwifery care, for diminished choice for women to choose their maternity care providers and place of birth, and for restricted access to the profession. Is it worth it to sacrifice several things you value, just so you can take a stand for one thing you value? Is it possible for you as an organization to value something, but also realize that it is not the only valid way? Is it possible for you to respect the diversity of pathways to midwifery that the CPM represents? Standing aside on a potentially divisive issue does not require the ACNM to sacrifice any of its standards. It simply requires the ACNM to respect the standards of another part of the profession of midwifery.

Disingenuous Claims
It is disingenuous of ACNM to state in its Special Alert to ACNM Members on July 15, 2009, “ACNM’s decision to oppose this initiative followed unsuccessful attempts by ACNM and MAMA Campaign leaders to reach a compromise that both organizations could support…” There was no formal process or interaction, no negotiations, and no attempt at collaboration between ACNM leaders and MAMA Campaign leaders. There was one phone conversation in which the ACNM representative stated there was only one concession they would accept: federal recognition only for gradates of MEAC-accredited programs; this is not a compromise. The MAMA Campaign, of course, is promoting all CPMs to receive federal recognition as Medicaid providers, not just some CPMs.

Furthermore, it is disingenuous to suggest the World Health Organization (WHO) document sets a standard that has been embraced around the world.  In fact, the WHO developed global standards for midwifery education without the input of the International Confederation of Midwives (ICM), an international partner of the WHO. The majority of members of the task force that developed the standards were not even midwives. There was not widespread input regarding the document nor targeted input by midwives. In response to this oversight, the ICM passed a resolution at the June 2008 Council meeting in Glasgow Scotland (I was there!) to develop global midwifery standards. A task force has since been convened and all member organizations (which includes MANA and ACNM) will be able to give input to the standards developed by the ICM. Generally, when the ICM develops a document that might supplant an existing WHO document  (as was the case in the international definition of a midwife), the ICM document is eventually incorporated by the larger international community. This will be a long process and any new document will not be ratified by ICM until the next Council meeting in 2011.

Lack of Vision
What offends me most-as a CNM, an ACNM member, a member of the MANA/ACNM Liaison Committee, and the President of the Midwives Alliance-is the lack of vision this decision represents.

Why not embrace diversity and support innovation? Why not bring the turf wars to an end? Why not unite under the banner of midwifery and the values that we share in common? Why not set aside our differences and recognize that we are all midwives? Why not recognize that the work we do is more important than the credentials we hold? Why not support one another within the profession, because diversity is our strength not our weakness?

What We Do Matters
The healthcare debate has been in progress in Washington DC for over a decade, but never before has the possibility of real change been as promising as it is now. Now is the time when we may have a real opportunity to effect unprecedented changes in maternal and child health care that will have long-lasting affects for mothers, infants, families and communities. Women deserve high quality maternity care, affordable care, and equal access to care. Women deserve options in maternity care providers and in their place of birth. Vulnerable and underserved women deserve to have disparities in health care outcomes eliminated, and they deserve to have barriers removed that limit services, providers and reimbursement for maternity care.

Expanding the pool of qualified Medicaid providers to include CPMs will help address the plight of so many women around the country who receive poor quality maternity care or do not have access to care at all. We need to lower the cesarean rate and increase VBACs. We need to lower infant and maternal mortality and morbidity rates in the U.S. We need to offer women the opportunity to believe in their bodies again and to give birth powerfully and in their own time. We need to welcome babies gently into the world. We need to give the experiences of pregnancy and birth back to families. We need to support women to breastfeed and help shelter the process of maternal-infant bonding. These are the real issues. These are the things we deeply value. Midwives are the solution that can address each of these vital issues. All midwives and midwifery organizations united, together, working toward these common goals, could produce these kinds of improvements in maternity care. We do not have to think together; but we must pull together!

In Conclusion
I repeat to you-not in my name. As an ACNM member, I will not comply with your requested action; I will actively oppose it and encourage others to do join me in doing so. Your position on CPMs does not represent what I value, what I hope for, and what I work untold hours to achieve. I have written this letter at the urging of the fourteen members of the MANA Board of Directors. Seven of the Board members are CPMs, four are CNMs, one is a CPM/CNM, one is a CM, and one is a DEM. They represent a true cross-section of the midwives in practice in this nation. We stand for diversity, tolerance, and unity among midwives and within the profession of midwifery. We advocate and work for a midwife for every mother, in every village, city, tribe, and community in this country and across the globe.

Sincerely,

Geradine Simkins-CNM, MSN, President

MANA Board of Directors

Maria Iorillo-CPM, 1st Vice President
Christy Tashjian-CPM, 2nd Vice President
Angy Nixon-CNM, MSN, Secretary
Audra Phillips-CPM, Treasurer
Pam Dyer Stewart-CPM, Region 1
Regina Willette-CM, Region 2
Tamara Taitt-DEM, PhDc Region 3
Sherry DeVries-CPM, CNM Region 4
Elizabeth Moore-CPM, Region 5
Colleen Donovan-Batson-CNM, Region 6
Dinah Waranch-CNM, Region 9
Cristina Alonso-CPM, Region 10 Mexico
Michelle Peixnho-CPM, Midwives of Color Section


ICAN’s response to ACOG and AABC statements

Thursday, February 7th, 2008

Redondo Beach, CA, February 7, 2008: The International Cesarean Awareness Network (www.ican-online.org) would like to publicly condemn both the AABC (American Association of Birth Centers) and the ACOG (The American College of Obstetricians and Gynecologists) for their statements* this week that limit not only women’s choices in birth but imply that birth is a fashion trend rather than a safety concern.

Since VBAC is the biological normal outcome of a pregnancy after cesarean, ICAN encourages women to get all of the facts about vaginal birth and elective cesarean before making a choice. This decision should not include weighing the choices of your doctor’s malpractice payments but only be a concern of the mother, her baby and their health and safety.

Since some mothers will make the choice to give birth outside of the hospital, we encourage the AABC to not cave into ACOG’s demands that all women give birth in a hospital facility with a surgical specialist, but instead allow women to make their own choices about care providers, birth settings and risk factors. ICAN respects the intelligence of modern women and accepts that the amount of information available about VBAC and elective repeat cesarean should serve as informed consent.

ICAN further encourages the governments of individual states to look closely at their cesarean rates (31.1% national cesarean rate as of 2006) and the informed consent laws that apply and help women to reach a standard of care that lowers the risks of major surgery and the risks of elective or coerced cesarean without medical indication. Women and children should not bear the brunt of malpractice risks being conveyed into physical, mental, emotional and spiritual health risks in order to protect their physicians.

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. There are more than 94 ICAN Chapters across North America, which hold educational and support meetings for people interested in cesarean prevention and recovery.

* AABC statement: http://www.birthcenters.org/files/file.php?id=2&file=file&file_type=file_type
ACOG statement: http://www.acog.org/from_home/publications/press_releases/nr02-06-08-2.cfm

ACOG believes in limiting your birth choices

Thursday, February 7th, 2008

The American College of Obstetricians and Gynecologists (ACOG) released a statement yesterday reiterating its stance that women should not deliver their babies at home among other chafing comments. The statement is linked here: http://www.acog.org/from_home/publications/press_releases/nr02-06-08-2.cfm.

So ACOG with an Executive Board of 24 with various districts and committees underneath, believes it is allowed to dictate for the millions of women each year where they are to deliver their babies (hm two days ago the American Association Birth Centers decided not to revisit allowing VBAC’s in order to appease ACOG).

Personally and professionally, I am appalled that a group that sets out to provide excellence in care for women throughout the childbearing years, has continued to band together and make policy that negatively affects the entirety of childbearing women in the US (through lobbyists, self-serving studies and treating the healthy full-term pregnant woman as a hostile host to her baby).

Amazingly most women and babies are low risk in pregnancy and birth. These women and babies can be cared for by family practitioners, midwives (CNM’s, licensed, registered and direct entry) or by the mothers themselves who choose to take the highest level of responsibility and birth unassisted. If a mother or baby become high risk, she is sent to an OB/GYN for care. If things unexpectedly occur in birth, often the issues can be handled safely by a skilled provider outside of the hospital environment.

Today the usual standard of care many women receive (non-medical induction, continuous monitoring, epidural, non-medical cesarean) by ACOG members actually make the low risk mom and baby high risk. These practices increase complication rates and the need for more intervention than would occur normally in birth. Essentially the abnormal becomes normal.

By continuing to support and utilize care providers who believe we should only deliver our babies in the hospital or accredited birth center, we are allowing our decision making to be undermined, being limited in our parenting choices and putting ourselves and babies in the path of unnecessary iatrogenic risk. Not all ACOG members believe we should be limited and do offer a great service, however, they do belong to and pay dues to an organization that does.

Buyer beware.

Spread the news. Don’t ignore the truth.

Pax,

Desirre