Wednesday Wrap Up, 6/5

Wednesday Wrap-Up Graphic - Salt Lake City Private Childbirth ClassesVery passionate article on Selfish Women and their Silly Birth Experiences. I, too, don’t understand why women’s desire for a good experience is often interpreted as “selfish”.

SO darn cute! Birth stories by two year olds.

A great explanation of some of the tricky things about doing research with pregnant women, and how the desire to protect women and babies might actually be hurting them.

I have a pet peeve. I hate the way so much STUFF is marketed to pregnant moms as “must haves!” – so naturally I liked this article “10 things you DON’T need for a new baby”

I work with a lot of labor and delivery nurses. I spend one shift every year shadowing a nurse, and it is exhausting. I really liked this true, positive, yet not glossy list of 40 ways to know you are an L&D Nurse.

A nice compilation of positive quotes and affirmations on birth, from HypnoBirthing Utah.

I have seen a lot of trends in baby names come and go, but never have I seen the trends mapped out like this!

Birth and maternity care in Africa, shown in photos. How different things are!

Today’s video is a little long, but is pretty useful. It’s a recording of a webinar on how to get the most out of your hospital tour:

Review: Beautiful Birth Bundle DVDs

Julie Johnson is a friend of mine, and my very favorite lactation consultant to refer to. I’d heard for years that she had a video on the back burner, so when I recently heard it was done and on the market, I asked if I could have a copy for review!

The full Beautiful Birth Bundle consists of:

  • A set of three DVDs
  • A hospital birth planner
  • A relaxation CD
  • Some essential oils that can be useful during labor

All products are available individually or as a bundle of all of them. I am reviewing the DVD portion of the bundle only. Newsletter subscribers can enter to win a copy of the DVD set, so if you want one, sign up for my newsletter before June 7!

The DVDs come in a set of three, they are labeled A, B and C. None of them have any information on the length of the program, or which information is on which DVD. So let me set it out for you:

Disc A: Childbirth Education

1 hour, 2 minutes

  • What to pack
  • Doulas
  • Timing Contractions
  • Positions
  • Breathing
  • Labor Massage (featuring a licensed massage therapist specializing in pregnancy massage)
  • An OB discussing his views on birth
  • The phases of labor
  • Accupressure

This disc seemed a little disjointed and I would have rearranged the order to make it flow a little better and have the information build up better. I would recommend viewing the phases of labor and timing contractions first, then going back and watching the rest. This way you’ll know what transition is before you hear a discussion of how to breathe through it. I loved how Julie brought in experts in allied fields to teach areas of their expertise, and she had a real couple expecting their first baby there to learn. The couple’s questions and comments felt sincere and unscripted.

Disc B: More childbirth education

46 min

  • When to go to the hospital
  • Welcome to the hospital
  • Options
  • Natural Comfort Measures
  • Epidurals and the medical side
  • Medical Interventions
  • Back Labor
  • Cesareans
  • Pushing
  • Inspiration

I loved how so many of the segments here were filmed in an actual labor and delivery room with actual nurses, doctor and doula. This way, they were able to show how to do many of the techniques using the hospital bed, something often missed in videos on comfort measures.
Some of the included information may not accurately reflect regional differences. For example, when discussing narcotic pain medications, Julie said that there were three options: Stadol, Nubain and Demerol. She also recommended a half dose that would help the mom for approximately 2 hours. However, in my 14 years of doula experience, I have never seen any of the three drugs she listed given to a laboring mom. Almost exclusively, providers in my area prescribe Fentanyl. A half dose of Fentanyl does very little, and a full dose lasts only an hour. Since most of Julie’s doula experience was when she lives in California, and I know this is something that varies regionally, her experience with which narcotics are common is different than mine.
The video shows 2 options for pushing. Coached counted pushing and the tug of war. I enjoyed seeing the contrast between the two, but I would have liked to see others as well, or at least a mention of different pushing techniques that were not in a lithotomy or semi-sitting position.
I liked the inspiration section, where the doctor discussed what he loved about his job and there is a lovely slideshow of women laboring and birthing in a variety of settings.

Disc C: Birth stories

1 hour 9 minutes

  • Preparing for birth
  • Jennifer and Israel
  • Richard and Hope
  • Clint and Krista
  • Introducing Baby

This opens with interviews of couples about their birth stories. Initially I thought it would be only stories told through interviews, and not actually birth footage. Keep watching, there IS birth footage! Some of the audio in the birth footage is hard to hear, but the footage at births has occasional subtitles and some great tips. For example, at one point they are showing a woman laboring through transition, and they have subtitles “5 tips for helping mom through transition” Then, as the dad is providing labor support, subtitles describing what he is doing pop up. It would have been nice to better hear what he is saying when it points out “encourage her” but you see that he is very close, holding her and talking to her.
Earlier in the series, Julie had talked a lot about being in different positions and getting out of the bed, so I was a little disappointed that nearly all of the in-hospital footage was moms lying in the bed. I would have liked to see a lot more active laboring in the hospitals. I loved the last birth shown, where mom did quite a lot of labor at home and doing a lot of different things. The scene where the big sister is rubbing mommy’s back with the massager was so sweet!
All of the birth footage did a good job of showing the clock periodically to give a sense of the passage of time.

Some things I feel are important to a childbirth class that were not covered at all here are:
Everything that happens after the baby comes out. Even the delivery of the placenta was not addressed, and there is no information on skin-to-skin and breastfeeding. While this is not intended to be a breastfeeding course, a discussion of how and when to get the baby to the breast in the first few minutes of life is important.
Midwifery care was not addressed at all. This course is designed for those who are birthing in the hospital, but midwives can and do practice in the hospital setting as well, and are generally a fantastic option for moms planning a hospital birth.
A better discussion of HOW to make decisions in the birth setting. Several times Julie hinted that moms need to decide, that moms need to negotiate, etc. but there was no information on HOW they can do that. Parents need skills! I personally love this handout on that.

Overall, I think this is a great resource, but I don’t know that it is a good replacement for a well designed and facilitated *local* childbirth class. At the very least, it should be supplemented with a tour of the birth place and a list of pointed questions to ask about the way things are done in your area.

You can view a preview of the DVDs here:

Misleading Formula Headlines

Be smart with research!

New study came out this week and made lots of headlines:

Misleading Formula Headlines

The only problem is….you can’t quite say that!

There are a couple reasons why the study should not be applied broadly:

  • The study size was very small, only 38 babies. You simply cannot get good results from that small of a sample.
  • The study was with moms who had a delayed start of mature milk production, not healthy normal moms and babies. It also started “treating” babies at 5% weight loss, below the level that would require treatment.
  • The study was with syringe feeding, not bottles. Bottles introduce a whole set of difficulties that might mean different results.
  • There are many, many other studies out there that say just the opposite. Studies with larger sample sizes and more rigorous research methodology. Any piece of research should be taken in context of all the other information out there.
  • At least one of the researchers is a paid consultant for a formula company, which means there is potential for bias in the research.

Please remember that the sound bytes you hear in the media about research studies are often misleading and at times flat out wrong!

More responses to the study can be found at The Academy of Breastfeeding Medicine and Best for Babes.

If you’d like to learn more about understanding research in general, I recommend my other site,

Wednesday Wrap Up 5/15

Wednsday Wrap Up Graphic - Utah birth doulaGreat article on how to find out if you are a good match with a doula. Most of the answers to these questions are right here on my web site, but nothing replaces a good old fashioned face to face meeting to see if our personalities mesh.
One doctor’s birth plan. I happen to like this birth plan very much!
Nice post on making decisions in birth, from a new blog I discovered this week, Birth By Heart.
A nice debunking of the myth that multiple VBACs are dangerous. In fact, they are far safer than repeated cesareans!
I’ve made good use of all three of the “Three Rs” to help women through birth. Penny Simkin originated the idea, but this article explains it very well.
I like this article on “Getting the Most Out of An Epidural” – it describes well why even moms who plan to use an epidural might want to learn relaxation techniques, and what you can do to have a good epidural experience.
This weeks video is a fun parody of the British hit “Call the Midwife” – with a little bit of Dr. Who thrown in just for kicks. Loved it!

Listening to Mothers III Cover

1st Thoughts on Listening To Mothers 3

Listening to Mothers III CoverIs it geeky that I get excited about things like the new Listening to Mothers III survey? Childbirth Connection released 2 previous versions of the survey in 2002 and 2006 and I found both of them very interesting. The third survey was released this morning, and I’ve been perusing it this morning over breakfast, and beyond. I’ll admit it is nearly lunchtime and I am still in my jammies, still reading….

The survey looked at 2400 mothers who had given birth between July 2011 and June 2012. Interviews were conducted online. The report has quotes from the moms sprinkled throughout –

Some interesting – and somewhat disjointed – tidbits I’ve come across so far:

Contrary to popular myth, the majority of insured births in this country were covered with PRIVATE insurance. (47% of all births) 38% of all births were covered under Medicaid or CHIP (still a large chunk, but not the majority of all births by a long shot). This leaves 15% of births as paid for out of pocket. We had to do this with our first, and it was a difficult burden since we had to pay the full, unadjusted by insurance pricing. Interestingly, mothers who were on Medicaid were “more likely to regularly have group prenatal visits, be medically induced, not have met their birth attendant until the birth, and have their baby spend time in the NICU.”

They asked moms if they had ever held back on asking their providers questions for three common reasons. 30% said they held back because the provider seemed to be in a rush, 23% because they did not want to be perceived as being difficult, and 22% because they knew they wanted care that was different from what the provider was used to. I sure hope that some of those women (especially in the last two categories) went to to switch to a new care provider who they felt more comfortable with. Expectant moms should be able to ask questions and receive the kind of care they want. Especially since more than 3/4 of women reported their care provider as the most important source of information in their pregnancy.

Quote from LTMIIIAs far as births, an unsurprising breakdown on the kinds of providers:
70% OB
10% Midwives
6% Family Practice Doctors

With 61% of them women and 39% men. 64% of women had “their” provider for the birth. 12% had someone they had “met briefly” and 21% had never met the provider who attended their birth.

There was an interesting 7% “Doctor of unknown specialty” – makes me wonder if those women did any research on their providers if they don’t even know what their specialty is!

Only 6% of births were attended by a doula. More than 75% of women knew about doula care, and of those who knew about doula care but did not use a doula, More than 1 in 4 “would have liked” to have doula care. Some work to do there!

A little more than half of first time moms and 17% of moms who had a previous child took childbirth classes. This seems about right to me. Of those who took classes, about half took a traditional series across several weeks, and half took an intensive or crash course over 1 or 2 days.

The internet ranks third in sources of pregnancy information (behind health care provider and childbirth classes). Many women sign up for regular email or text services to provide them with information on pregnancy, birth and parenthood. I’ve seen some pretty bad ones out there, still looking for a service I can comfortably recommend to my clients.
83% of all births (vaginal births and cesareans) use some form of pain medication. 67% of all births were with an epidural. 17% of all births did not use any pain medication.

More than two thirds of all women who births vaginally were lying on their backs to push their baby out. Only 43% of women got out of bed at all once admitted to the hospital. We need to make it easier for moms to move around in labor!

VBAC rate of 14% in all moms who had a previous cesarean. Only 22% of moms told their provider they wanted a repeat cesarean. 48% of women who desired a VBAC were denied that option. This angers me.

One commonly cited reason for the rising cesarean rate is “women are asking for it” – this survey shows 1% of moms do ask for it, and an overall cesarean rate of 31% – so let’s not blame moms for the huge increases!

I find it mind boggling that 8% of women who have a cesarean report an episiotomy as well. Makes me wonder if they understand what an episiotomy is….

In a very similar result to the last survey, 37% of women reported experiencing depression after giving birth, with 17% of them receiving a clinical diagnosis. Far too many women struggle without getting help. We need to make it easier to get help, and remove some of the social stigma.

Some mothers reported feeling pressure to accept induction (15%) cesarean (15%) or epidural (13%)

Only 20% of women understand that 39 weeks is the earliest that should be considered “full term” and that inductions should not be scheduled earlier than that without serious medical reason. Also there was an increase in the rate of women who tried to induce themselves, and those women who tried their own inductions had an increased rate of cesarean. More reason to encourage patience!

A very interesting chart from the full report, found on page 24:

Listening To Mothers III

Of the moms who planned to exclusively breastfeed, HALF were given the free samples of formula that are proven to sabotage breastfeeding. This is a shame and hospitals need to stop.

Average baby’s weight: 7.5 pounds

Having an episiotomy doubled the rate of women who said that perineal pain was a problem postpartum.

I found the questions on decision making (pages 55-59) very interesting, though hard to summarize and explain.

Also interesting were the questions asking about the knowledge of the risks of induction or a cesarean birth. None of the questions had a majority of moms who knew the right answers! Moms are clearly not learning accurate information about the risks of a cesarean.

In the conclusion, the report lists several concerns about care that is common but not evidence based. (page 59) Worth a read!

Quote from the conclusion:

“There was little indication that the maternity care system protects, promotes and supports the intrinsic physiologic capacities of this largely healthy population of women and their fetuses/newborns. Technology-intensive maternity care continues to dominate. Our maternity care system is failing to provide care that many mothers told us they want and that is in the best interest of themselves and their babies.”

If you want to read the survey for yourself, you can download it from Childbirth Connection. The full report is 93 pages, but there is a nice summary of main findings that is much shorter, as well as sub reports on racial disparity, internet usage, the rise in cesareans, and induction of labor.

And now I can look forward to the postpartum survey, Listening to Mothers III: New Mothers Speak Out! which is coming this June.

Wednesday Wrap Up 5/1

Web links on pregnancy, birth, breastfeeding and parenting
Cesarean Awareness Month just concluded, and as part of that, Lamaze International put together another great list of resources and articles. This one focuses on what expectant moms should know beforehand, whether they are planning a cesarean or not.

No one likes to talk about it, but I think as a society, we simply have to. The rate of women dying in childbirth is increasing in the US. This article looks at why, and what can be done about it.

This article from the Atlantic might have some insight on that, too. The Most Scientific Birth

Love this article on taking back your power in birth: Don’t Ask; Just Do

Now here is an amazing VBAC consent form! I love that it addresses both the risks of a VBAC *and* the risks of a repeat cesarean.

Today’s video is a nice demomstration of labor positions. I like the birth stool shown, and wish that more hospitals had one…..and actually USED IT! I have only seen the birth stool used at Park City Hospital.

Wednesday Wrap Up 4/10

Weekly Pregnancy and Birth Links.Very interesting research on the myth that women forget the pain of childbirth. Turns out, they don’t. However, if they had a good experience, over time they remember pain as less intense. But with a bad experience, they remember the intensity more consistently.

Which makes it all the more important that women have a good experience. I share Penny Simkin’s article on what makes for a good experience with all my clients. Chances are, it’s not what you think!

Still think 40 weeks is the normal length of a pregnancy? Research study looking at uncomplicated, uninduced length of pregnancy finds that for first time moms, 41 weeks and 1 day is more like it, and for moms who have birthed before, it is 40 weeks plus 3 days. The 40 week estimate is one that has stuck around since the early 1800s, and it’s possible that changes in society, public health, nutrition, etc. have made it possible for women to carry their babies longer, just like the average life expectancy has improved as well.

Lovely story: How A Midwife Changed My Life

And I came across this interesting article on 5 ways to support active duty military moms

Today’s video is from Penny Simkin, one of my very favorite women. She discusses the difference between experiencing pain and suffering. This is an important distinction, especially for those supporting moms.

Wednesday Wrap-up 3/27

Web links for birthdaySpecial edition of the Wednesday Wrap Up to celebrate MY OWN BIRTHDAY! (And that’s me in the image on the left, wasn’t I cute?)

Fun fact: The hospital where I was born was the very first hospital in the State of California to earn Baby Friendly status, though not until long after I was born there.

Quentin Tarantino, Mariah Carey, Nathan Fillion, and Fergie all share a birthday with me, but I would really love to share a birthday with one of my doula-babies. I’ve been a doula since 1999, and so far, I am 0 for 15, with no one due soon enough to have hope for today. Maybe next year?

I don’t know much at all about my own birth, only that I was born late afternoon and my mom missed the dinner hour in postpartum. They made her wait to eat until the regular breakfast the next day. Thankfully hospitals are better about that now, and moms can generally get food when they need it.

I do know that when I came home from the hospital, my older brother was bitterly disappointed that I was not a puppy!

If you want to do something for me for my birthday, and you’ve worked with me before, you can leave me a testimonial here.

How cool is it that World Doula Week falls on my birthday every year? If I had realized it in time, I would have planned a party!

In honor of World Doula Week, this week’s video is from the Birth Photography Facebook group, and it features doulas and midwives in action, doing what they do best: supporting birthing moms. I have two images included in the slideshow!

Wednesday Wrap-Up 3/20

Web links on pregnancy, birth, breastfeeding and parentingGreat article on the concept of babies learning to self-soothe. And it is not what you think!
Loved this wrap-up of the reasons and risks for the rising cesarean rate. Well documented and honest.
And from another skeptical doctor comes this: Top 10 Signs your Doctor is Planning an Unnecessary Cesarean Section on You
I’ve been saying this for years, nice to hear someone else say it, too! The Big Bad Epidural.
There has been lots of discussion lately about women being forced to have cesareans, after one woman in Florida was threatened with having the police come pick her up for her cesarean! I loved this doctor’s take on the issue.
A little bit of a soapbox issue for me: No More Free Births!
And as I read more from Jodi’s site, I came across this article. I am working with a client who was grappling with some difficult decisions at the time I read it, so it really hit home to me. I have witnessed many women bravely making the choice to take a different path than initially planned when the need arose, even when it disappointed and worried them.
Here is the most amazing, gentle bath of a newborn, for your viewing pleasure:

Wednesday Wrap Up 3/13

Wrap-up of current web linksLoved this article: 6 things your doula wants you to know
And after I read that one, from the same site: 5 Things Your Childbirth Educator Wants You to Know
Makes me think I should write my own list of top ten things….hmmmmmm…..wheels turning!
Another great article about respect and autonomy in birth. “Get Over Yourselves!”
I absolutely loved this article on judgement and birth. Her summary “There is no correct way to birth, or to behave during birth. As women and mothers we are subjected to more than enough judgement from others and ourselves. Perhaps it is time to start nurturing and supporting ourselves and others instead.”
Along a similar line, what does – or does not – give a woman “bragging rights” about her birth?
Lovely article on the “Myth of the Perfect Mother”
What does a doula really do? Great photos of doulas in action!
And since it’s just plain funny….yet makes a good point: labor beds should have an eject button.

Great video – 7 women talking about their 7 different birth experiences:

Birth Photography

Do you use Pinterest?

If so, I have several birth-related boards you might enjoy. You can see all my boards here or pick the individual boards below. Feel free to follow me, and please share your favorite birthy Pinterest boards in the comments!

My Birthy Stuff board is where I pin articles, products, books, and links to resources that I think will be helpful to pregnant women and families as they prepare for an upcoming birth. I also pin articles that might be useful to other doulas, or to parents who want to understand what professional doulas do. You can click on the image below to see that board.

Birthy Stuff Pinterest Board

My birth photography is where I pin some of my own work and the work of other professional birth photographers who inspire me. If you love seeing births of all kinds and the joy that a new baby brings, this might be the board for you!

Birth Photography

And finally, this last board is where I pin the web sites of local midwives, doulas, childbirth educators and lactation consultants that I enjoy working with and refer to as needed. If you live in Utah, you might find it a useful resource.

Utah Birth Professionals

Wednesday Wrap Up 2/27/2013

Wednesday Web Links
While I take notes at the births I attend, and transcribe them for new parents, I always encourage both parents to journal their birth story themselves. What I write will be interesting to the baby as she grows, but what the parents write will be far more meaningful. I loved this article about why parents should write birth stories.
I have always felt that having a doula at a birth can really take pressure off the dad/partner, and reduce the stress so he can be MORE involved and MORE emotionally there than if he was sole support. In fact, some of the most hesitant dads have turned into some of my biggest fans! I loved this article detailing why dads can benefit from a doula.
An excellent article with some practical tips for moms who are survivors of sexual abuse as they plan for their birth.
While I didn’t win, I still think you should check out the winners of the 2012 International Association of Professional Birth Photographers contest. There’s some good stuff there!
And finally, a short video demonstrating the “Moaning Method” for birth. It can be hard for those who have never used it to understand, but making noise, particularly low-toned moans, can provide a lot of relief in labor.