More on Mother Friendly Initiative

Why should you care? Because we're on each others team.... remember?
and you should care because I do! Haha, if only it were that easy to win people over to a cause. Maybe you had a wonderful birth in a hospital that went exactly the way you envisioned...I say good for you! That really is awesome!  But I have also talked to many women who have some deep emotional scars about how their birth went, saying they felt like they didn't have a voice, weren't consulted about the things going on with their birth...left in the dark so to say and then "required" a c-section and they weren't really sure why they needed one. I am working on getting these women to do a guest post for me but as you would think its a very sensitive subject for them, very emotional.  My heart hurts for these women....and from me to you- You are NOT a failure! The system failed you.  You should be able to go into any hospital to have a baby and trust that you will be catered to, cared for properly, respected, and consulted not instructed.  Sadly, a lot (not all) hospitals require you to be on the defense it seems.

If its not an important cause for you here's why I think it should be:

April 1st marks the beginning of Cesarean Awareness Month. "Our national cesarean rate of 1 in 3 women is a warning to us all. It’s not that providers should stop performing c-sections—it’s that they should stop pushing interventions and protocols that are known to lead to c-sections." -Cynthia Overgard

Visit http://pathwaystofamilywellness.org/Pregnancy-Birth/better-birthing-its-about-time.html to read "Better Birthing: It's About Time"

_________________

So right there it says 1 in 3 chance of a c-section if you go to a hospital, If we don't try to change something about the "system" in place what does that mean for your daughters and granddaughters? I know C-sections are not the end of the world, but at this rate will future generations even get a choice?

If you are curious about C-section rates by state, currently Texas (where I'm from) is pretty darn high at  35 %.  Louisiana has the highest rate at 40% and Utah the lowest at 22% according to the CDC.  Find out the Cesarean rate of each Hospital in Texas, (its the 2011 study so if your Hospital's name has changed since then it will be under the old name.)

If you plan to have a home birth your chance of needing a C-section is about 5.20% according to this study.  Maybe that's why after 37 years the highest percentage of home births occurred in 2012.  This is why the Mother Friendly Initiative is so important, there are a lot of women who would be more comfortable in a hospital setting but they don't want such a drastic increase in their chance of a c-section, and they don't want pressure to conform to all the hospital guidelines that aren't absolutely necessary.......

Here are 5 hospital procedures that aren't absolutely necessary (with legitimate sources)

I copied the info below from here

Here are the top five myths associated with hospital procedures that change your birth experience.

Myth 1: You need a monitor on your belly the whole time you're in labor.

Fact: You absolutely do not. Intermittent monitoring is shown to be just as effective, and actually allows the woman to focus on things other than her contractions. Consider that women are often made to lie down and stay relatively still with the monitors on as well, and you're put in a position where you have nothing to do but focus on and internalize any pain of contractions.

In fact, constant fetal monitoring often leads to unnecessary concern, and even intervention, including c-sections, so says the American Academy of Family Physicians, not some holistic home birth website, for those of you in doubt. In fact, only monitoring the baby's heart rate and your contractions every 30 minutes during early labor, and every 15 during transition and pushing is the current recommendation, but one that you almost never see actually practiced.

Myth 2: Lying on your back is a good position for pushing.

Fact: It sucks, big time. The only reason women end up on their backs is to make it easier for doctors to get in there. So, really, unless they NEED to be in there, it's a bad move. It's not only shown to reduce the size of the pelvis significantly, but it puts pressure on the vena cava, which reduces blood flow to the baby and your lower body -- why is it not okay during pregnancy, but they tell you to do it for hours on end during labor, and then are surprised at reduced blood flow to the baby?

The National Center for Biotechnology Information states that being upright, in addition to increasing blood flow also makes contractions and labor less painful, faster, easier, with a lot less trauma to the mother's birth canal, minimal to no tearing, and less trauma to the infant as well. It also makes for less postpartum complications, damage to the pelvic floor, incontinence, and in general, a much better, faster, less painful birth.

Also, if you opt for an epidural and can't feel your legs, you can't walk or kneel. So consider that you might not need that if you actually get up off the bed, and that just because you can't feel the pain with an epidural, your baby can, and you will once the drugs wear off. I wish I'd known as much about epidurals as I do now 15 months ago when I had my daughter. I was ashamed of myself for getting it then, but now I really, really wish I hadn't.

So why are 75 percent of births still done with the woman flat on her back? Back to the beginning of this point -- to make it easier for the doctor.

Myth 3: You can't eat or you'll barf it up and aspirate the vomit.

Fact: You wouldn't tell a marathon runner to skip breakfast, would you? Telling a woman about to engage in major physical work not to eat is almost as bad -- except what is at risk here isn't just a race, but two lives. Yes, there has been some concern that with intubation before anesthesia would come vomit, and then aspiration of said vomit.

MedScape discusses a study on the matter that says:

"Aspiration pneumonitis/pneumonia is significantly associated with intubation and ventilation," the study authors conclude. "In modern obstetric practice it is the use of regional anaesthesia, thereby avoiding intubation, rather [than] fasting regimens that is likely to have reduced mortality from aspiration. Although the National Institute for Health and Clinical Excellence has recommended, on the basis of consensus opinion, that women in normal labor may eat/drink in labor, our trial shows that this will not improve their obstetric and neonatal outcomes."

In other words, forcing women not to eat hasn't reduced aspiration -- not shoving tubes down their throats has. In their study, women who ate light meals showed absolutely no difference in anything -- no more vomiting, no more risk than women who were only allowed ice chips or water.

Myth 4: You need to be told when to push.

Fact: Do you need to be told when to poop? You no more need permission and direction to push out your baby than you do to push out a bowel movement. Just as your body uses contractions to move the baby towards the cervix and through it, it moves the baby down the birth canal, too. Your body will tell you what to do. You will feel when you need to push, and you will just work with it. When you feel the need to relax, do it. Push as hard as YOU are comfortable and if someone is yelling to you to push harder or longer than you feel you should, yell at them to shut up.

Pushing to the point of shaking, not breathing (called 'purple pushing' for the color your face turns) and breaking blood vessels in your face is not going to help you. In fact, it can cause the cervix to swell if you're not ready, it can make you exhausted, it can create much more severe tears, and is just a bad idea in general, even according to the World Health Organization.

Drugs can inhibit the feeling of needing to push (or the ability to know if you need to stop), though, but that's a whole 'nother topic all on it's own.

Myth 5: A break in contractions/labor stalling is a bad sign.

Fact: Women can get fully dilated and have the baby ready to go ... and then have a period that has been appropriately nicknamed the "Rest and Be Thankful" stage. It is nature's way of giving you a break after all the work to get your body ready, before the final hurrah. You can also have a break like this earlier in labor as well. Sometimes you can even be in early labor for what ends up being days, often called prodromal labor. We are mammals, first and foremost, and our bodies aren't stupid -- if a woman gets really stressed or really exhausted, often her body will sense that she doesn't have the energy for birth, or deems that it's an unsafe situation and halt labor until mom is rested or calmed. Think of a mother rabbit in labor realizing a predator is nearby -- she NEEDS to get safe before she can birth the babies.

Doctors often start up pitocin here, when the recommended things are anything but that -- squatting, moving around, getting in a bath all are proven safe methods to help the mother relax and get her contractions going in a normal pattern again. In fact, my midwife told me that studies show nipple stimulation and relaxing in water had been shown to be as effective, if not more so, than pitocin. Considering that pitocin is an artificial chemical designed to mock those from things like nipple contraction, it's not exactly a far leap in logic.

If your labor stalls, don't rush for the meds -- relax, move around, have a light meal for energy, try to take a nap. In and of it's own, it is NOT an emergency.

________

Tomorrow I will post responses from a question I asked to some Moms last week- Do you think its important to change the way childbirth is viewed and managed in the United States? Why or Why not? Looking for different views and opinions... If you would like to voice your opinion in this matter you can email your response to 1babybeborn@gmail.com, I would be happy to include your opinion (Even if it differs from mine, lol). ~Kellie

Guest Post Ashlea- Mother Friendly Care

From Kellie: Ashlea is Birth Boot Camp instructor I recently met and she is very knowledgeable about all things birth! She spoke a little about the Mother Friendly initiative and I knew this was something really important for us all to be aware of-  and for our (your) daughters and grand-daughters. For me, the basic premise of this movement is to reinstate the norm to be the natural process of birth and to use science when necessary- not let it completely take over (which it seems to be doing). I would like to see a day when all birth experiences/requests are accepted and welcomed in hospitals. I would like to eliminate pressure to conform to a certain type of care, and where Midwifes were just as accepted as OBGYNS..and covered by insurance.  Rant over? Not hardly, but this is a Guest post, lol, so I really should get to Mrs. Ashlea's post......

Mother-Friendly Care

When I was pregnant in 2013, I never considered researching a midwife or OB/GYN to find out if they were mother friendly. I assumed, insert play on words here, if they are caring for a pregnant woman, they must all be mother friendly.  Not the case at all!  It’s quite telling of an era when you actually have to seek out care-providers who are classified as “mother-friendly”.  Even more shocking, this has to be grounded in evidence based practices; they actually researched what benefited mothers throughout pregnancy and birth.  Naïve, pregnant me thought these were “duh!” moments, but this is not at all the case.  When you stop to reflect on where birth in our country has come from, it is totally amazing that the Coalition for Improving Maternity Services was founded. 

(photo reference: www.truthaboutnursing.org

In the 1900s, approximately 90% of all births took place in the home.  Hospitals were not widely assessable, and mothers were attended by both midwives and doctors.  But from 1910 and 1920, the midwifery model of care was tossed to the side as the medical model of care became prevalent.  Instead of focusing on the physical, psychological, and social well-being of a mother, the medical model is geared toward pathology (identifying what’s wrong) and diagnosing from patient symptoms. Childbirth was no longer considered a normal time in a woman’s life.  Dr. Joseph B. DeLee wrote and published an article in the American Association for Study and Prevention of Infant Mortality (1914-1915) where he (and others) discuss opposition to any movement to perpetuate the careers of midwives.  They are considered a “drag on (obstetric) progress as a science and art” are “not necessary at the present time” and “is a relic of barbarism”. As this field of obstetrics grew and the home birth midwife discredited, fear of childbirth and the pain associated with it helped encouraged women to birth in the hospital.  Today, 99% of U.S. women birth in the hospital (the majority with an obstetrician). 

Simultaneously, “twilight sleep” was introduced, and through a combination of morphine (pain medicine) and scopolamine (amnesiac), a laboring woman would have no memories of giving birth.  Considering this happens about the same time women are fighting for suffrage, it was widely welcomed among upper-class women. These unconscious women were strapped to beds, given a cut in their vagina (episiotomy), and their babies pulled out with forceps.  Today, only few women are unconscious for their births, but many of these practices carry over:

• ·         Laboring  flat on your back
• ·         Interventions to “speed” labor
• ·         Treating mother as the passenger in her birth rather than the driver 

As fewer births took place at home, women weren’t able to see what a natural birth is like from aunts, sisters, and friends.  Soon, women would labor without having ever seen a birth and this created the fear of the unknown. They would most likely not know that the body releases endorphins when a woman labors without drugs.  Naturally released oxytocin crosses the blood-brain barrier and causes the uterus to contract and the endorphins allow you to cope with these contractions.

Fast forward to the modern birth climate:

• ·         The U.S. cesarean rate is 36%.
• ·         The U.S. epidural rate is 76%. 
• ·         The U.S. maternal mortality rate is four times greater for African-American women than for Euro-American women.
• ·         The U.S. spends more money per capita on maternity and newborn care than any other country and falls far behind most industrialized countries in perinatal morbidity and mortality.

Holy cow! Well, as a result, the Coalition for Improving Maternity Services (CIMS) has set out to make a difference. Individuals and national organizations, who are concerned for the care and well-being of mothers, promote a wellness model of care to improve these outcomes (and save money).  I love that CIMS is a group of people working towards the same awesome goal: quality care for mamas and their babies.

There are 10 Steps of the Mother Friendly Childbirth Initiative for a hospital, birth center, or home-birth midwife to fulfill before receiving the CIMS distinction:

A mother-friendly hospital, birth center, or home birth service:

1. Offers all birthing mothers:
• Unrestricted access to the birth companions of her choice, including fathers, partners, children, family members, and friends;
• Unrestricted access to continuous emotional and physical support from a skilled woman—for example, a doula,* or labor-support professional;
• Access to professional midwifery care.
2. Provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.
3. Provides culturally competent care—that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion.
4. Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication), and discourages the use of the lithotomy (flat on back with legs elevated) position.
5. Has clearly defined policies and procedures for:
• collaborating and consulting throughout the perinatal period with other maternity services, including communicating with the original caregiver when transfer from one birth site to another is necessary;
• linking the mother and baby to appropriate community resources, including prenatal and post-discharge follow-up and breastfeeding support.
6. Does not routinely employ practices and procedures that are unsupported by scientific evidence, including but not limited to the following:
• shaving;
• enemas;
• IVs (intravenous drip);
• withholding nourishment or water;
• early rupture of membranes*;
• electronic fetal monitoring;

other interventions are limited as follows:

• Has an induction* rate of 10% or less;†
• Has an episiotomy* rate of 20% or less, with a goal of 5% or less;
• Has a total cesarean rate of 10% or less in community hospitals, and 15% or less in tertiary care (high-risk) hospitals;
• Has a VBAC (vaginal birth after cesarean) rate of 60% or more with a goal of 75% or more.
6. Educates staff in non-drug methods of pain relief, and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.
7. Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.
8. Discourages non-religious circumcision of the newborn.
9. Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding:

1.      Have a written breastfeeding policy that is routinely communicated to all health care staff;

2.      Train all health care staff in skills necessary to implement this policy;

3.      Inform all pregnant women about the benefits and management of breastfeeding;

4.      Help mothers initiate breastfeeding within a half-hour of birth;

5.      Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants;

6.      Give newborn infants no food or drink other than breast milk unless medically indicated;

7.      Practice rooming in: allow mothers and infants to remain together 24 hours a day;

8.      Encourage breastfeeding on demand;

9.      Give no artificial teat or pacifiers (also called dummies or soothers) to breastfeeding infants;

10.  Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics

† This criterion is presently under review.

What can you do to ensure your location/provider is “mother friendly”? In my opinion, take a Birth Boot Camp class. Childbirth education is well worth your time and money.  We cover red flags of care providers and talk about how to be confident when choosing a birth location.  Ask some important questions regarding “standard” procedures: episiotomies, group B strep, pushing positions, and so many more. 

Your baby’s birth day will only happen once.  Carefully and thoughtfully consider your desires.  A mother friendly care provider will respect you, your wishes, and honor the sacredness of your special day.  ~Ashlea

Visit Ashlea's website
http://anindulgentbirth.com/

Going with your gut!

And today I think I'm a motivational speaker.....

Call it whatever you want.....Mothers Intuition, Mothers Instinct.....going with your gut! Learning to do this has served me well.  My husband is a big believer in going with your gut too, the statement "well, what does your gut tell you?" pops up frequently when either of us has a dilemma.

Over the course of pregnancy and becoming a parent you get a TON of unsolicited advice from friends, family, strangers, and even know-it-all-bloggers, lol...whew I could name a few of them! Some of the advice is great and really helps, sometimes you are unsure, and some just sounds ridiculous...this is where I will give you advice to smile and GO WITH YOUR GUT!  Do it with as much confidence as you can as well, there are no take-backs so you might as well not second guess yourself, right? No one knows your body in pregnancy like YOU do, and just the same no one knows your baby like YOU.

Let me tell ya a little story...After we brought our brand new baby boy home, we soon realized this kid would not sleep or nap in his bassinet...ever. While I didn't mind holding my new baby as much as possible sometimes you need to eat, relieve yourself...have free hands for a moment! I didnt know what to do....every time I put him on his back in the bassinet asleep he would wake up screaming.  The first night was the worst! I had an arms reach co-sleeper right next to the bed I thought would be the ideal sleeping arrangement for us....nope, only screaming...I didnt know what to do so I listened to my gut and we spent the first few weeks sleeping like this (see photo)

He slept on my chest on his stomach...most of the time we were skin to skin, which turns out its called "Kangaroo Care"  which is kind of a dumb name if you ask me, but it has many benefits. It was also very convenient for breast feeding.
After a few weeks or maybe months (pregnancy brain) he slept in the bassinet...on his stomach...thats the ONLY way he would sleep, but he had really good neck control so I just had to have faith that he would be okay.  People were concerned about him sleeping on his stomach because "its so dangerous!" My reply would be "ok, well tell HIM that!"

This would be the first of many times I didnt know what the hell I was doing and I just had to use my Mothers Intuition and trust myself.

Its important to listen to your instincts during the labor and birth as well, some things feel right and some just dont and you are the captain of your ship so YOU make the calls....labor positions, possibly feeling rushed by someone...whatever the case may be...If there ever was a time to have a take charge attitude its the birth of your children...

My friend Angie and I were talking about the birth of her daughter and she was sick of being rushed by the Doctor to just do a C-section and her shining moment was when she literally told him to "F-off!" and had that baby 2 pushes later! She is a nurse herself so that probably gave her more confidence to say that to a Doctor than a normal person.  The point is the same though, listen to your instincts!

I know this sounds repetitive, but its true that no one cares about you and your baby more than YOU! I will cut you if you mess with my child! lol. The consequences of your decisions during pregnancy & birth will only affect you & your baby.....Not the Doctor, or Nurse, or whomever... They carry on as usual with their workday and lives.... Just like during my birth when the Doctor suggested a vacuum extraction, and dangled that carrot stick in front of my face, lol...yes, it made the birth faster for all of us, but she was certainly not the one whose body spent months in recovery and healing...it was MY choice and I had to live with the consequences....grrr, and boy did I.

How can you get the confidence to listen to your instincts & know your stuff??....Lets say it together....

EDUCATE YOURSELF!

(does a mic drop and hops of soapbox)


Disclaimer: 
Do I think I'm smarter than a Doctor, no, but I think a good Doctor LISTENS to the momma.....
Do I think I know everything, no....but I'm always learning and it gives me more confidence.