Happy Birthday Asher!

Birth Notes from the Doula’s Perspective
(The official birth story belongs to this couple. I'm sure I left something out, as birth brings so many magical moments)

It was Friday January 15th, 2010 and dad called at 11:44am to let me know that you had lost your mucus plug that morning and had been having irregular contractions. I suggested that you drink some water and rest and let me know what happens. The contractions slow down and pick back up again in the evening. Dad calls me at 7:39pm to let me know that contractions are 5-7 minutes apart. I advise you I will be heading over shortly. I arrive at your home at 8:36pm. You and your daughter Zoë decide to rest on a pallet of pillows on the floor. Contractions slow to about 7-8 minutes apart. You tell me about how Zoë had said earlier “Mommy’s having a contraption” in reference to your labor contractions. We all laugh at how adorable she is. Meanwhile, your IPod is playing the birth playlist you created. Selections included Ani Difranco, Tori Amos, Kings of Leon & Beck. Zoë eventually drifts off to sleep snuggled up to you and dad carries her to bed.

At 10:45pm you move to the birth ball, where you can stay upright through your contractions. You have a few slices of toast with Nutella. After your toast you are feeling tired so I suggest that you try and sleep. You are able to rest in between contractions but move to hands and knees during them because it felt better on your back. In this moment, I catch a glimpse of baby Asher’s feet kicking your belly outward, dad lovingly rubs your belly as the lamp light radiates off your strawberry hair as you smile…gently laboring in peace. It was a beautiful sight.

Dad applies some counter pressure to your back as you breathe deeply and steady, you listen to your bodies urges to move and rock side to side. At 12:05 contractions are 4-5 minutes apart and dad calls a friend to come over to help watch Zoë for the birth. You are upbeat and positive, finding humor in everything. We share stories and laughter as time passes. You lean on the door frame and squat with your contractions, you enjoy the double hip squeeze. You slow dance with dad, resting your head on his body swaying back and forth in your bodies own perfect rhythm.

At 3:09am you decide to try and get some more rest and you lay down for half an hour as I massage your back. At 3:52 you have another piece of toast and you joke that you’d like it if baby would come by morning time because you’d really like some real breakfast!

We leave for the hospital at 5:00am. Contractions were 3-4 minutes apart. At 5:20am you arrive. At 5:42 you are checked and are 7cm! Zoë curls up with you on the side of the hospital bed and holds your hand as you both celebrate your progress.

Dad reminds you of how amazing you are, and says
“You’re a bad mo-fo, Toni!” We all laugh, and agree.

You rotate between sitting on the birth ball and standing positions. At 7:57am you request to get in the tub. You also do a little nipple stimulation to try and get these moving. You get out of the tub around 8:40am and the nurse checks you and stretches your cervix.

You have a moment where you needed to cry, as labor is tiring and emotional work. You find comfort in dad's hugs and our words of affirmation:

“You can do this”, “You are strong and capable”, “You are almost done”

At 10:03pm your water breaks, you get on your hands and knees in the bed, then you start making grunting noise and I know that means its time to page the nurse! When the nurse arrives, she checks you and says“You are delivering this baby now; the doctor is not going to make it!”

You push with only a few contractions and your son, baby Asher is born into the nurses hands at 10:12am, January 16, 2010. Baby Asher needed a little help to get his breathing regulated at first and then he was placed skin to skin on your chest as he explored you with his eyes for the first time.

Congratulations mama! You did amazing!


Hospital Sends Police to Induce "Overdue" Pregnant Mother

Dr. Momma posted a blog about this story from Australia and it really got me thinking...

First off, read the original story first (see below or click link above)

Thankfully, the mom in this story was issued an apology...but this behavior and the increased fire against personal choices in maternity care really has my blood boiling.

I guess if this practice is acceptable in maternity care we should be able to send police to the houses of others who "disobey" medical authority. I don't see many other medical conditions (even though birth really isn't a condition) pressuring police to interfere.

If this is really about the welfare of the unborn child (due to a 0.1% estimated risk of fetal death in all postdates) What about other issues of child welfare regarding health matters?

Maybe the police should start looking at the obesity epidemic and go door to door to "protect" the welfare of our children who are more obese than ever before by monitoring diet and exercise. Does that sound fair? ;) I think not, but lets look a little deeper...

Government statistics below from: http://win.niddk.nih.gov/statistics/#preval

Q: What is the prevalence of overweight and obesity in children and adolescents?

A: While there is no generally accepted definition for obesity as distinct from overweight in children and adolescents, the prevalence of overweight* is increasing for children and adolescents in the United States. Approximately 17.5 percent of children (age 6 to 11) and 17 percent of adolescents (age 12 to 19) were overweight in 2001 to 2004.[6]

Figure 1. Overweight and Obesity, by Age: United States, 1960-2004

Source: CDC/NCHS, Health, United States, 2006

Q: What is the mortality rate associated with obesity?

A: Most studies show an increase in mortality rates associated with obesity. Individuals who are obese have a 10- to 50-percent increased risk of death from all causes, compared with healthy weight individuals (BMI 18.5 to 24.9). Most of the increased risk is due to cardiovascular causes.[1] Obesity is associated with about 112,000 excess deaths per year in the U.S. population relative to healthy weight individuals.[9]

So, let me make sure I am understanding this correctly...a mom is considered to be neglecting her child by wanting them to benefit from the many advantages of letting the pregnancy go full term (as defined by each pregnancy because 38-42 weeks is just an average!) But the mom that contributes to the 10-50% increased of obesity related death by poor diet choices, excessive television and limited recreation isn't neglecting her child enough to get a knock on the door by the police man?

I understand that sometimes, unfortunately social class plays a large role in what we are able to feed our children. Growing up, my mom did the best she could often times going to the food bank. But she always encouraged us to participate in activities that kept us fit (sometimes something as simple as playing outside, riding a bike, etc.) I also know that sometimes despite diet and exercise some children remain obese due to other unavoidable medical causes. I am not talking about you.

I just wanted to draw a comparison between the 0.1% risks of fetal death due to postdate pregnancy and the 10-50% risk of dying of a obesity related condition.

Where should our criminal authority and human service departments draw the line and why are personal choices in maternity care under so much fire?

Here is the original story below By Kate Sikora for Sydney, Australia's The Daily Telegraph

news image pregnant 20100116

Rochelle Allan, with husband Daniel Jones

A HOSPITAL that wants a mother to have her baby induced sent police to her home after she failed to keep an appointment yesterday.

Rochelle Allan, who is reluctant to be induced even though her baby is 12 days overdue, was told by the hospital they intended to go ahead with the procedure when she came in.

But after speaking to her midwife following a visit to the hospital the day before, and being assured her baby was fine, she decided not to attend the hospital the next day.

Now Ms Allan is furious after the two police officers arrived on her doorstep after they were called by
Bathurst Hospital.

Wanting a home birth, Ms Allan, 24, has been under the care of a private midwife and had been attending the hospital daily to monitor the baby's health.

"I couldn't believe it when I saw the police officers at my door," Ms Allan said.

"They told me they had been asked by the hospital to check on my welfare because I had not attended.

"The hospital knew I did not want to be induced and they gave me no medical reason why I should be."

Throughout her pregnancy, Ms Allan and her partner Daniel Jones have been regularly attending the hospital's antenatal clinic for mandatory tests and scans to monitor the baby's progress. A hospital spokeswoman confirmed police were sent to Ms Allan's house to conduct a "welfare check".

The spokeswoman said doctors were worried about the mother as she had previously complied with all appointments.

Ms Allan said that she had decided on having a home birth after a "horrific experience" at the same hospital two years ago when their son Bailey was born.

"I was induced and I spent 48 hours in labour," she said.

"I don't want to go through with that again."

Ms Allan is not against medical intervention and said she would not hesitate to deliver at the hospital if her baby's life was threatened.

"If they had told me that my baby was in danger then I would have the baby in hospital," she said.

"But they could give me no reason and all the tests show that there are no problems."

By late yesterday, Ms Allan had started labor at home and was in the care of her midwife.

This afternoon (
AEDT), Ms Allan received an apology from The Greater Western Area Health Service for the unexpected police visit, saying they just wanted to check she was alright.

"We are sorry if it caused her any distress but our intention was to check on her welfare," area health spokeswoman Sue-Anne Redmond told ABC Radio today.

The health service denied it was trying to pressure Ms Allan into being induced.

Hannah Darlene from the Australian College of Midwives said calling on police to check on patients was not "common practice".

"It doesn't sound like someone who was shunning care in any way and under those circumstances it's certainly not common practice," Ms Darlene told ABC radio.

The incident comes as the debate over the safety of home births continues, with the Federal Government under pressure to change the law to allow midwives insurance if they attend a home birth.

Homebirths Australia secretary Justine Caines said the case demonstrated how women "are too often treated during pregnancy and birth very poorly".

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists president Dr Ted Weaver said women were usually induced 14 days after their due date.

"If the mum did not want to be induced after 14 days then you would conduct extra tests," he said.

"The reason people get worried about going overdue is because there's a slight chance that the baby could die suddenly in
utero for no reason."


Co-sleeping? Risk or Benefit?

After reading Nighttime Parenting
by William Sears I've been motivated to write about co-sleeping. Unfortunately, this practice is often discouraged and frowned upon. This post is not intended to persuade people who are sold on cribs to give them up, but there are certain advantages to co-sleeping that are worth noting. It is common in our society to buy a fancy crib, decorate it with bedding and expect our babies to sleep soundly within its bars. This notion that babies are meant to sleep alone is not shared by most of the world. In an article called Historical Origins of Psychological Objections to Cosleeping, Sarah Tennant writes that:

"Anthropologists link the objections to an increasing sense of individualism in Western society. Whereas the parent-child relationship was once seen as foundational to a family, the spouse-spouse relationship is now prioritised. Along with the fairly modern concept of privacy, and American-stressed values of independence and self-reliance, the model of sleep began to shift to allow parents their own sleeping space. Children were encouraged to "self-soothe" and follow adult (monophasic) sleep patterns, despite infants being wired for polyphasic sleep."

Is it safe?

Let me be clear that I did not plan on co-sleeping from the beginning, I had a big solid wood crib that my father in law bought us and looked forward to using it when we came home from the hospital. However, if Jude woke in the night (which newborns do every 1-3 hours) it would take me a minute to get to him, nurse him upright for 20-45 minutes until he fell back asleep, and then place him back in his crib only to go tiptoe back to the bed and wait for the cycle to repeat. Not to mention, It was un-nerving leaving my new baby alone to sleep. I found myself often checking on him putting my ear up to his chest to make sure he was breathing. It surely didn't feel as comforting and safe as when he slept in my arms. Surely, there had to be a better way of sleep? As soon as we started co-sleeping, it was as if a weight had been lifted. I became a lighter sleeper, yes. I was more in tune with Jude's sleeping patterns and would find myself able to wake if I noticed he wasn't sleeping in the right position (adjacent next to me). It also allowed me to nurse him laying down so I was able to sleep.

I have heard people say "I'm afraid of rolling over on the baby."

If you can show me a woman that has rolled over on her baby I'll show you a woman that is either under the influence, sleeping on a couch (a VERY un-safe form of co-sleeping) or highly obese. Outside of these instances mothers (and even dads) are usually highly aware of their infant's presence.

But don't take my word for it, lets look at some evidence based information...

(From "Cosleeping and Biological Imperatives:" by James McKenna, Ph.D)

"In Japan where co-sleeping and breastfeeding (in the absence of maternal smoking) is the cultural norm, rates of the sudden infant death syndrome are the lowest in the world. For breastfeeding mothers, bedsharing makes breastfeeding much easier to manage and practically doubles the amount of breastfeeding sessions while permitting both mothers and infants to spend more time asleep. The increased exposure to mother's antibodies which comes with more frequent nighttime breastfeeding can potentially, per any given infant, reduce infant illness. And because co-sleeping in the form of bedsharing makes breastfeeding easier for mothers, it encourages them to breastfeed for a greater number of months, according to Dr. Helen Ball's studies at the University of Durham, therein potentially reducing the mothers chances of breast cancer. Indeed, the benefits of cosleeping helps explain why simply telling parents never to sleep with baby is like suggesting that nobody should eat fats and sugars since excessive fats and sugars lead to obesity and/or death from heart disease, diabetes or cancer. Obviously, there's a whole lot more to the story."

"As regards bedsharing, an expanded version of its function and effects on the infant's biology helps us to understand not only why the bedsharing debate refuses to go away, but why the overwhelming majority of parents in the United States (over 50% according to the most recent national survey) now sleep in bed for part or all of the night with their babies."

"That the highest rates of bedsharing worldwide occur alongside the lowest rates of infant mortality, including Sudden Infant Death Syndrome (SIDS) rates, is a point worth returning to. It is an important beginning point for understanding the complexities involved in explaining why outcomes related to bedsharing (recall, one of many types of cosleeping) vary between being protective for some populations and dangerous for others. It suggests that whether or not babies should bedshare and what the outcome will be may depend on who is involved, under what condition it occurs, how it is practiced, and the quality of the relationship brought to the bed to share. This is not the answer some medical authorities are looking for, but it certainly resonates with parents, and it is substantiated by scores of studies."

More on sleeping arrangements (From Dr. Jen4kids.com)

"The choice of where our children sleep affects (and there is research to show all of this): breastfeeding duration, feeding frequency, infant sleep position, arousal patterns, temperature, carbon dioxide levels, crying, heart rate, parental emotional expectations.

Babies who have more skin to skin contact with their parents show better oxygen delivery, less frequent crying, higher temperatures, better weight gain, better digestion and less physiologic markers of infant stress. (It's why kids who are held more have less colic.) So, based on that, it makes sense that more contact with mom and dad makes for a more physiologically sound child."


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