Though most hospitals have “birth centers”, they are really nothing more than the labor and delivery floor where births take place. The only freestanding birth center in Colorado is the Mountain Midwifery Center.  MMC is owned and run by Tracy Ryan, CNM  along with 4 other main midwives along with supporting staff.

What is a birth center? From the MMC site: “A Birth Center is designed to be a “Maxi-Home” not a “Mini-Hospital.” Here we strive to allow women to labor and birth in a true home-like environment while providing one-on-one care that helps ensure superior mom and baby outcomes. The Birth Center is not just pretty birth rooms, it is an education-intensive program of care. From your first visit through the birth of your baby and beyond, the Birth Center is designed to facilitate healthy choices for families.”

Located about an hour from Colorado Springs in Englewood, the birth center is a fantastic location to birth.  Check it out!

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?

I have been invited to share with you an intimate and challenging (and graphic) journey of a mother from an unexpected primary cesarean, physician decided repeat cesarean and a home water birth after those two cesareans.

Before you watch it, take a deep breath and have an open mind. A box of tissues may be in order as well.

Cesarean vs. VBAC: A Dramatic Difference from Alexandra Orchard on Vimeo.

Watch how a baby is delivered in a cesarean birth and see the dramatic difference of what both the mother and baby experience in a home water birth after cesarean.

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Thank you Alex for allowing me to share your story!  Many blessings to you and yours.

For more information on cesarean recovery, support, prevention and VBAC information go to www.ican-online.org.

CHOOSING YOUR MIDWIFE: INTERVIEW QUESTIONS

· What is your birth philosophy?
· What is your training? Are you certified? If yes, with whom and why? If no, why not?
· Are you licensed in the state of _____?
· What is your scope of practice?
· When would you find it necessary to go outside your scope of practice?
· Are there any circumstances (physical, emotional, and/or spiritual) would you not take a woman as a patient?
· When would you risk out a patient?
· What is your style of practice (laid back, hands on, managing)?
· How much time will be spent with me during each appointment? Do you come to my home or do I come to your office?
· At what intervals will you see me during pregnancy?
· What can I expect at a prenatal visit?
· What routine tests are utilized during pregnancy? What if I decline these tests?
· What routine herbs or supplements do you like your patients taking during pregnancy?
· At what point in labor do you normally arrive?
· What positions are you comfortable catching in? Birth stool? Hand/Knees? Squatting? Standing? Water?
· What do you do in the event a complication arises during labor or birth? When would you transfer a patient?
· Do you ever do episiotomies? If yes, when, why and how often?
· How are post-dates (post-42 weeks) handled in your practice?
· Do you ever encourage induction by pharmaceutical, herbal, AROM or other natural means? If yes, please describe.
· Do you have a partner or an assistant?
· Who would attend me if you are ill, had an emergency or are at another birth?
· Briefly please describe the types of births you are most and least experienced with.
· What if I hire a doula? Are there restrictions on the doula I may hire? If yes, why? What is your perception of the role of a doula at a homebirth?

Points to ponder afterward:

· Did you feel immediately comfortable and heard at the interview?
· Was MW willing to answer questions in detail without being annoyed?
· Are you comfortable with her scope of practice?
· Are her expectations of you reasonable?
· Are your expectations of her reasonable?
· Are you able to take full responsibility for your decisions with this midwife?

All Rights Reserved Desirre Andrews Birthing Touch 2008

I far too often hear women saying “My insurance doesn’t cover the location, provider, type of birth I REALLY want. Well it will be okay anyway, won’t it?.” Or “We just bought XXXXX and cannot afford to pay for care out of pocket.”

I wonder what are you willing to do to have the childbirth you deeply desire? It seems in other aspects of life when there is something we really want, somehow we find the time, money, etc. to attain it. Childbirth IS that important. Investing in what will help you achieve a normal birth can be preventative of unwanted interventions and cesarean.

Below is a list of ways to find the money for the birth center, family practitioner, home birth midwife, out of network provider, doula, independent childbirth class, waterbirth or whatever your heart is set upon to help in preparation and delivery of your baby.

A list of practical ways to find the money you need:

1) In lieu of traditional baby shower gifts (honestly much of the stuff is unnecessary to having a baby except for a good baby wearing item) – ask for a group gift of the provider or location payment (or at least monies to get you well on your way).

2) Trim down your budget – do you need the highest satellite or cable package, forgo eating out or picking up expensive drinks, forgo weekly entertainment expenses, have a yard sale or post on community boards all the items you do not use (your home will be much less cluttered for it), what about your cellular service – trim back if possible, sell your car and buy something less expensive, forgo expensive hair cuts or other beauty maintenance

3) Ask for family and friends to donate to your XXXXX fund.

4) Petition your insurance company to add XXXX provider or location to their provider list.

5) Figure out all your co-pays and see if you are really spending more or close to the same anyway for what you don’t really want and can actually afford the care you really desire.

6) Set-up payment schedules with provider or location – often care can be paid for over the time of your pregnancy in increments.

7) Do you have a barter to offer? Try it!

8) Move to a lower cost home to save in rent or mortgage. Hey even moving in with family temporarily can work. Extended support is often a blessing.

9) Open a 125k flexible medical spending account (thanks to my DH for reminding me about this). This money comes out of your paycheck pre-tax and you can get reimbursed for out-of-pocket medical expenses in one calendar year, it lowers your taxable income and helps you attain what you want.

Sometimes sacrifice is needed. Sometimes just a bit of trimming. Being under the thumb of insurance or lack thereof doesn’t have to define your options. Get creative. There is almost ALWAYS a way. It is worth it to you and your baby.

Merry Christmas! Desirre

So let’s chat about childbirth education. Of the reported 30% of expecting parents who attend childbirth classes the majority go to the hospital where the birth is planned instead of seeking out independent options. I want to challenge you to think about how strange that is. Does it make sense that the information presented will REALLY be balanced, unbiased and evidence-based? Many protocols and practices used during labor and delivery in the hospital are designed as a one size fits all, no suited to each individual mom and baby. More importantly, they are not designed to suit the usual low-risk mom and baby (the majority of moms and babies are normal and low-risk), but can actually make a mom and baby appear or become high-risk. Some refer to hospital classes as “good patient preparation” classes because of lack of inclusive information. I will admit, that all hospitals do not offer education in this manner, however, in my experience and research many sadly do.

If a car salesman tried to sell you a car and actually insisted you purchase the specific color, make and model he/she decides for you, would you buy it? You would hopefully say no thank you and leave. How dare some one make such a huge decision for you. How long do you research a piece of electronics or a computer, even a cell phone plane before deciding? Even the pair of shoes you are wearing. Did you have to try on several before finding the right pair?

So why not think outside the big box, one size fits all class? Every mom, baby and partner deserve to know the wisdom of birth, understand what is normal and how to stay that way, when the abnormal happens what to do and be a skilled consumer.

There is no re-do here. This time is too important to leave to chance and inadequate education.

This is at the essence of why I teach my own childbirth classes at a location outside the hospital. I am able to freely give full spectrum information without restriction, bias or without the fear of losing my position.

Your birth matters to both you and your baby, to your future fertility, to your confidence as a mother

Below is a list of options available to families all across the US and variations in other countries as well (if if any class types have been overlooked, please let me know and I will add it).

• Independent – philosophy based (CAPPA, Lamaze post-2000, ICEA, CBI, ALACE, Birth Works, Birthing From Within)
• Independent – method based (Bradley, HypnoBirthing, Hypnobabies
• Self education

There are many other great ways to find a class that suits you.

• Ask around in your community
• Attend birth circles, Birth Network, La Leche League and/or ICAN meetings
• Seek out local doula groups and information nights
• Check out sites like Independent Childbirth

Here’s to finding the perfect fit and gestating in peace.

Desirre

Picture this: An expectant mother is preparing for the birth of her baby. She chooses the care provider her friend, co-worker or family member recommended, she is reading the most popular books on pregnancy and birth (she doesn’t know there are any others to choose from – everyone is reading these), she cannot help herself as she watches hour upon hour of those baby and birth shows on t.v., people tell her their birth stories and to just get the epidural (after watching those birth shows and hearing THOSE stories she is beginning to think it might just be a good idea). Right now, she is pretty sure she doesn’t want to be induced (she heard it hurts more, but knowing when the baby will come is appealing) or have a cesarean but other than that she is leaving it up to her care provider.

Now she starts her childbirth class. This class is based on normal birth and evidence-based practices. Hm those books she was given are SO different than what the instructor says during class. The instructor doesn’t even recommend those books but a host of other books and websites. She begins to wonder what her care provider really thinks and believes about birth. Also, what birth philosophy and practices her chosen birth location has.

I have written a list on choosing a care provider and birth location that is right for you. This is too important to make decisions without extra thoughtfulness and investigation. The key to this information is remembering you are the one purchasing a service. Essentially you are hiring a catcher with medical expertise and renting a room to birth your baby (if you are going to the hospital or birth center).

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.

• Does the location offer what is most important to you (tubs, birth balls, wearing own clothing, intermittent monitoring, etc.)?
• What are standard protocols that are followed?
• Does location routinely use methods that turn a low risk mom and baby into high risk patients?
• Are waterbirths available?
• Are birthing stools or non-reclined pushing and delivery positions encouraged?
• What is the no/low intervention rate?
• What is the epidural rate?
• What is the cesarean rate? Does the hospital support VBAC’s?
• 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, etc.)

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?
• What location is ultimately safest for my specific needs (I am currently 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?
• Is staff willing to work with natural childbirth practices?
• Are there any compelling reasons to choose one location over another?

Choosing your care provider – Use this as a template for the interview process or to be certain you are of the same philosophy and belief system.

• What is his/her birth philosophy?
• What is philosophy of pregnancy?
• Has provider seen normal labor and birth? How often?
• What percentage of patients have medicalized births?
• How is the “due date” approached? When is “overdue”?
• Will you answer questions over the phone?
• How much time will you spend with me during each appointment?
• What if I hire a doula? Are there restrictions on the doula I may hire? If yes, why?
• Do I need a childbirth class? Breastfeeding class?
  o Are there restrictions on the type of childbirth or breastfeeding class? If so, what and why?
• What routine tests are utilized during pregnancy? What if I decline these tests?
• What are routine intervention rates? (IV, AROM, continuous monitoring, etc.) Cesarean rate? VBAC rate?
• Induction rate? What induction methods are used?
• Is natural, normal labor and birth supported?
• What positions is care provider comfortable catching in? Birth stool? Hand/Knees? Squatting? Standing?
• If I choose an epidural, when can I get it or when is it too late?
• How often is episiotomy used?
• When would forceps/vacuum be used? Which method is CP comfortable with?
• What about a birth plan? Will desires be put into my file at the hospital so the nurse and/or back-up will know what has been agreed to?
• Are there any protocols that are non-negotiable?
• What if I choose to decline something after careful consideration?
• Is an on call rotation utilized or does CP attend all own patients? If there are partners or an on call rotation, do EACH of the others share in the same birth philosophy and approach to birth?

Points to ponder afterward–

• Did you feel immediately comfortable at the interview?
• Were or are questions specifically answered or is the answer “only when necessary” without additional information unless pressed?
• Was or is care provider willing to answer questions in detail without being annoyed?
• If already with a CP, do you feel comfortable and heard at each appointment?
• 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?

Ah the joys of video and the web….

http://youtube.com/watch?v=roFVkDV45MM Question CPD
http://youtube.com/watch?v=2dRF4RtdJdo 1 in 3
http://youtube.com/watch?v=lfoR0fAUD34 Becky’s Birth
http://youtube.com/watch?v=Am0aykTPL2M&feature=related My Unnecesarean
http://youtube.com/watch?v=aQd0hPHWOlQ&feature=related My HBA2C
http://youtube.com/watch?v=3lYAKu8k_T0&feature=related A Birth Story
http://www.onetruemedia.com/otm_site/view_shared?p=2a4e81fbf0f66accb8afce HBA3C

These are REAL women and families. This is a very real way our current birth climate takes a toll every minute, every hour, every day, every week, the ripple has become a wave…..

Thank you to ICAN http://www.ican-online.org/ and the women of grit who are taking their power back.

Your body. Your birth. Your life. Use them wisely.

Pass them on!

Pax,

Desirre

These days political correctness seems to rule the world (at least the United States). We have become so easily offended that we often miss the truth and follow parcels of truth weighted down by vast untruth for someone else to gain from in some way, not for the health and safety of our bodies or our children.

Language matters. Language can affect how we perceive our bodies, our designed in capabilities and our baby. Language has the ability to strengthen confidence or smash it to pieces in one single moment.

Below is a list that is purposed to make you the reader stop and think. Take the almost ho-hum usual and shed new light on it.

Take a scroll down this inaugural blog and tell me what you think?

cesarean = “controlled” uterine rupture (read in Pushed)
planned epidural = planned paralysis
OB = high risk surgical specialist
Family Practitioner/Midwife = low risk normal birth expert
cesarean rate = epidemic
rising induction and cesarean rates = daylight obstetrics (read in Pushed)
induction = forced birth (Ruth Trode)
ACOG = trade union
Formula=stagnant (Ruth Trode)
Breastmilk=life (Ruth Trode)
Failure to progress = failure to wait (Henci Goer?)
Episiotomy = surgical cut
FEAR = a False Education Appearing to be Real (heard from many places)
AROM (artificial rupture of membranes) = artificial readiness of mother
unneccesary cesarean = unnecesarean (heard from many places and Joni)
CPD = care provider distrust

Please email me at desirre@birthingtouch.com if you have a word change up you would like to see on an updated post in the future. For more information on me, go to http://www.birthingtouch.com/.

Thank you to the women of www.independentchildbirth.com for working on this list with me.

Be BOLD, find the truth and spread it!

Until next time,

Desirre