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Read Time: 7 minutes You know that show "What Not to Wear"? Well, this is my version of that show... only it's a blog post, not a TV show... and it's about reading material, not clothes... ... ... Every "Don't Read" is explained and critiqued in detail, and then I provide three alternate options for "Instead Read". These three alternatives are broken down into three sub-categories: Citizen (for the average Joanne, safe to give at a baby shower without offending), Seeker (for the one who is definitely looking into her options but not sure what she wants), and Sold (she knows, she has researched, she is a proactive consumer, it's hard to offend this chic). So, without further ado, I give you WHAT NOT TO READ: DON'T READ: What to Expect When You Are Expecting - while learning to crawl, my second-born found and proceeded to rip every page out of my copy of WTEWYAE. She had the right idea. This book is chock full of enough scare-tactics and medical promotions to frighten and confuse any mama-to-be right into a panic attack (if not premature labor). I have never seen so many women turned into anxious balls of nervous wreckage after reading this book. Although it contains a lot of relevant educational material, it is delivered in such a way that women are not brought into that knowledge in an empowering and positive way; but instead leads women to believe that there are so many cautions, tests, deviations, and alternatives that something is bound to happen, just wait. Empower and educate, it does not. There are many better options. INSTEAD READ:

• (Citizen) Conception, Pregnancy, and Birth - Miriam Stoppard compiled this easy to read walk through of everything from ovulation to breastfeeding. Filled with beautiful photographs and illustrations, it is user-friendly and educational. She treats pregnancy as beautiful, normal, and natural - allowing women to look at themselves in awe. The sections on birth provide step by step information on the stages as well as coping techniques/positions and possible interventions.
• (Seeker) Pregnancy, Childbirth, and the Newborn - Penny Simkin co-authors this book, which is a much more thorough and in-depth educational piece than it's counterpart above. It deals much more with variations, interventions, medications, and the like while also continuing to provide this information in a non-threatening, non-frightening light. She remains factual without becoming intimidating or sentimental. Some key components that make this a great book: the role of the birth partner, charts on interventions/risks/benefits, and emotional and physical landmarks of pregnancy/labor/birth and postpartum.
• (Sold) Having a Baby, Naturally - This book is similar to the two above, without the illustrations and photographs of the first and without the non-biased POV (they explain, in detail, their slant and reasoning for natural) of the second. This book is a great companion for homebirth mamas or women who are already more 'crunchy-minded'. In particular, I love that they devote a full section to the expectant father. This is a GREAT resource for natural pregnancy, birth, and parenting, but only for those who are already set on that path.

DON'T READ: Planning for Pregnancy Birth and Beyond - basic. boring. Those are the two key words I can come up with for this particular book. It is written to be very hospital/intervention/test-friendly, giving you lots of good topics, but very hospital childbirth class-like advice. It is written like a text book and not very easy of a reference. PFPB&B definitely writes from the model of pregnancy as a medical condition/event. INSTEAD READ:

• (Citizen) The Pregnancy Book - Similar to my review below, this book is an easy read, never talking over their audience, but providing practical, fun, medical, and optional information in a month by month setting. It is a good pregnancy guide, but when it comes to birth, I defer to my recommendations below.
• (Seeker) The Thinking Woman's Guide to a Better Birth - A very in-depth look at interventions, medications, and birth, as well as a hard look at the obstetrical system, this book dissects the medical research to give sound, well-rounded information. This book can be hard to digest, but arms women with an arsenal of information to make informed decisions on just about everything they might encounter during labor and birth.
• (Sold) Gentle Birth, Gentle Mothering - Written by Dr. Sarah J Buckley, this book is fully balanced with information on intuitive birthing and parenting, and evidence-based birthing and parenting. She takes the best of maternal/ancestral wisdom and medical/research wisdom and combine the two to give an insightful look into gentle birth and gentle mothering.

DON'T READ: Easy Labor: Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth - although the authors give well-rounded information on both the medical and non-medical means of pain relief for labor and birth, I felt it was a bit of an overplay on how painful labor and birth was - revisiting pain repeatedly, over-sensationalizing it. They also downplay the risks and side effects of epidurals, while also downplaying the effectiveness of alternate comfort measures; which, as a result, champions medical pain relief options. End result, "Hi, birth is painful, REALLY painful. Non-medical pain relief is ok, but man, just you wait, yer going to want your epidural". INSTEAD READ:

• (Citizen) Your Best Birth - Ricki Lake's new book, YBB gives great advise on options, all your options, in a non-biased, non-confrontational way. She presents all concepts of labor and birth, including choosing your doctor or midwife, your birthplace, writing a birth plan, and how to become a proactive consumer in your healthcare. It is not as in-depth as some of the other books, but it definitely gets women thinking, just like her informational documentary, "The Business of Being Born"
• (Seeker) The Birth Book - Dr. William Sears gives you the good, the bad, the ugly, the best - all in very readable format and without the scare tactics. He gives you the options as well as the risks and benefits of each - no sugar coating it. There is adequate information on various childbirth options, plenty of birth stories to peruse, and no lack of information - this book helps women to become educated to their options without having an obvious bias, treating them as individual's, proactive consumers in their own healthcare options.
• (Sold) Birthing From Within - Pam England outlines a childbirth preparation by means of discovery; viewing childbirth as a journey, an opportunity to tap into a new woman, the mother. She teaches that, through self discovery, letting go of birth baggage, and learning about the emotional journey of childbirth, a woman can have a truly fulfilling birth experience. This is put on my Sold list as it can come across as rather hippy-liberal.

DON'T READ: The Best Birth: Your Guide to the Safest, Healthiest, and Most Satisfying Labor and Delivery - I can honestly not find one good thing to say about this book. She poo-poos on any birth except a hospital, Obstetrician assisted birth, she touts that the only thing that the medical community is interested in is a healthy mom and baby, the book is extrememly post-modernistic, idolizes the medical community as 'doctor know's best', and seeks to undermine the assistance of a doula or other childbirth professional stating that 'you already have the only doula you need' (she wastes a whole section on why she would NOT recommend a doula - calling them trendy). She teaches that childbirth methods (goals, plans, preparation) only lead to guilt and miss sight of the real goal: a healthy mom and baby. Though I agree with her end-goal, our path to get there is completely different. She teaches abdication and compliance to hospital policy rather than research and becoming your own informed, educated, proactive consumer. INSTEAD READ:

• (Citizen) The Official Lamaze Guide - written in a similar vein to Natural Childbirth The Bradley Way, this book differs in that it focuses a great deal on birth when allowed to unfold naturally, how to encourage that, what can disrupt that, Lamaze coping techniques, and how to assimilate personal strengths/traits into the birthing room.
• (Seeker) Natural Childbirth The Bradley Way - Susan McCutcheon writes this book in a way that some consider it a childbirth preparation class without the classroom. It outlines the reasons for a natural birth, the anatomy and physiology of pregnancy, labor, and birth, the emotional as well as physical signposts of labor and birth, and teaches a number of relaxation techniques and positions for labor and birth, all while encouraging husband's to be active participants and assistants.
• (Sold) Ina May's Guide To Childbirth - Ina May challenges the cultural assumption that childbirth is a medical, frightening, and painful experience by providing a whole section of amazing childbirth stories that turn your preconceived notions on their heads. In addition, she gives honest, effective, and logical instruction, without getting methodical, on ways to help progress and assist in the labor and birthing process.

Other Great Reads: Birth - the Surprising History of How We Were Born Birth as an American Rite of Passage The Birth Partner Immaculate Deception A Child Is Born Spiritual Midwifery Heart and Hands Supernatural Childbirth The Joy of Natural Childbirth Active Birth Gentle Birth Choices The Lord of Birth And there you have it - my official "What Not To Read" list, with alternatives - of course. I look forward to your own critiques as well in the comments and feel free to share with others.

Tags: Education Doula Childbirth Parenting

We talk a lot about pregnancy and birth on this blog, but what about after baby comes? There are so many options to consider before baby even makes her arrival, from vaccination and circumcision, to breastfeeding and diapering, there are so many things to work through. This post will, hopefully, set you on a course to helping navigate all of the choices in early parenting that you will be faced with. Immediately after birth, you will have some choices to make. These choices include circumcision, vaccinations, routine baby care, and breastfeeding. We will take a look at each of these and I will provide links to additional online sources after each one. Cord Clamping Cord Clamping tends to occur immediately after birth. Doctors want this to occur for a number of reasons: to hasten the birth of the placenta (traction on the cord stump), to finish a patient's care quickly, to be able to separate baby from mom to complete newborn assessment and routine procedures, and because they may fear jaundice as a result of delayed clamping. Let's address the last reason first because it is the only important one, the rest are only for convenience of the doctors: regular physiological jaundice results from delayed clamping, whereas other types of jaundice (premature, breastfed, or Rh) are not due to delayed clamping. There are many reasons to WAIT (even if it is only for 2-3 minutes) to cut the cord. The blood in the placenta rightfully belongs to the baby, and babies not receiving this blood have the deal with the equivalent of a major blood loss or hemorrhage at birth. It is estimated that early clamping deprives the baby of 54 to 160 ml of blood, which represents up to half of a baby’s total blood volume at birth. To prevent anemia, the iron in the cord blood is vital to babies early health. Babies benefit from the increased oxygen available to them from cord-blood while waiting to take their first breaths. Earlier cord iclamping increases the incidence of respiratory distress syndrome. The last cord blood acts as a source of nourishment that protects infants against the breakdown of body protein. For more information see below: PubMed Cord Issues JAMA Reuters Erythromycin This is the eye goop that they put in baby's eyes right after birth. This ointment is an antibiotic given to prevent ill effects of Chlamydia, Syphilis, or gonorrhea, so if a mother knows she does not have these infections, she might choose to refuse this intervention all together. BTW, if you or someone you know is expecting to give birth in the next 4 months, you may want to doubly consider skipping this treatment because there is a shortage of the Erythromycin eye ointment that is normally used for newborns, so many birth facilities are using substitute ointments without warning parents that there are increased risks of the side effects associated with Erythromycin. If a parent (mother or father) has an allergy to antibiotics in this class, a baby's risk for side effects/allergic reactions increases. The ointment does cause the eyelids to become red and puffy for about 12-24 hours, as well as blurring their vision. Risks include: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; diarrhea; stomach pain, as well as less severe reactions (blurred vision, skin irritation, peeling). The ointment is not supposed to sting the eyes. Many families who choose to have the erythromycin applied to their baby's eyes choose to wait for 2 hours postpartum, so that early infant/mother bonding can occur without inhibition of cloudy vision. See below for more information: Drugs.com Clinical Trials Vitamin K Injection The vitamin K injection is a routine injection given to all newborns. This is because babies are born, for the most part, without Vitamin K, a component necessary for blood clotting, so that cells can divide and multiply during gestation. Historically, newborns began getting Vit K shots when circumcision and forceps deliveries became routine. Additionally, at that time they found that some babies suffered from HDN (blood clotting disorder - brain bleeds). We now know that there are two types of HDN: Early onset "Classic" HDN (also called Vitamin K Deficiency Bleeding) occurs in the first week of life. It is an iatrogenic condition, meaning that it is caused by medical care:

• premature clamping/cutting of the umbilical cord deprives babies of up to 40% of their natural blood volume, including platelets and other clotting factors
• the use of vacuum extractor or forceps often causes bruising or internal bleeding, which uses up the baby's available clotting factors
• the use of antibiotics inhibits the baby's generation of clotting factors

Late-onset HDN (true HDN) occurs in specific circumstances:

• maternal medications interfere with vitamin K, such as anticonvulsants, anticoagulants, and antibiotics
• infant antibiotic use
• infant liver disorders (more prevelant when there is a history of liver disorders)
• infant diarrhea, hepatitis, cystic fibrosis (CF), celiac disease, and alpha1-antitrypin deficiency

In these situations, if your baby is born by vacuum or forceps assistance, or if you are planning ton have your newborn circumcised before discharge, Routine Vit K is wise. OTOH, the other side of the debate is that babies are born without Vit K for a reason. Levels are adequate by 8 days after birth (the same day that Jewish/Christian God said to circumcise Hebrew boys), but they continue to increase for the first six weeks of life. Studies show that there is an increase risk of childhood leukemia in children who have received the vitamin K shot as newborns, erythrocyte aggregation, jaundice and kernicterus, flushing, sweating, a sense of chest constriction, peripheral vascular collapse, and nerve or muscle damage at the injection site. Other options are to use oral Vit K drops throughout the first few weeks of life (to baby), or increase maternal diet of green leafy veggies or vit K supplement to transfer from breastmilk to baby. See below for more information: Administration of Vit K To Newborns To Inject Or Not Making Informed Choices PKU The Newborn Screening Test (aka PKU test) is an analysis of the baby's blood to look for evidence of certain genetic diseases or inborn errors of metabolism. The test is performed by collecting a blood sample from the baby onto special paper, which is then sent to a laboratory for analysis of red blood cells, hormones and metabolic by-products to assess whether the findings are outside the normal range. This is "law" in every state (I believe, verification of your personal state is appreciated) although you have a right to refuse any treatment or test. Typically, baby is taken to the nursery, the heel is warmed with a heat pack, and then the nurse or doctor will perform a heel stick and collect blood samples from the heel. Alternatives are: to refuse the test outright, to require babies collection to be done in your presence, while nursing or soothing, or to use a more humane device. There is low risk of infection, a small risk of nerve damage at the collection site, and the risk of the breastfeeding relationship being disrupted and/or emotional trauma. See below for more information: Newborn Screening Test Medline Newborn Screening March of Dimes Newborn Screening Breastfeeding Breastfeeding is an option for every woman who gives birth. Breastmilk is the best nutrition for a newborn/baby. It is normal and natural, BUT many women encounter obstacles along the way because, even though it is normal and natural, it is not always easy. Some hurdles that might be encountered: nipple confusion, low milk production, inverted nipples, mastitis, tongue tie, high cleft, plugged ducts, and engorgement. Nearly all breastfeeding hurdles can be overcome by support, lactation consultation, special attention or apparatus'/treatments, perseverance, and encouragement. Breastfeeding success can be inhibited by: premature introduction of a bottle or pacifier, formula supplementation or introduction, medications of mom or baby, prematurity, or recovery (from cesarean or other surgery). Avoiding these situations, if possible, can greatly increase your breastfeeding success. Benefits of breastfeeding to baby include:

• Less chance of obesity - Longer periods of breastfeeding greatly reduce the risk of being overweight in adulthood as well as reduces the risk of adolescent obesity.
• Healthy teeth, eyes, and ears - Formula-fed babies tend to run a higher risk of jaw misalignment and are more likely to need orthodontic work as they get older. Breastfeeding improves the development of facial muscles and the shape of the palate. Breastfeeding reduces the incidence of ear infections and vision problems.
• Overall Health - breastfed babies have a reduced risk of severe upper respiratory infections, wheezing, pneumonia and influenza. They have less risk of diarrhea, gastrointestinal infections and constipation. Formula feeding carries a four fold increase in risk for SIDS.
• Intelligence/Coping - breastfed babies tend to score higher on IQ tests and cognition testing. Breastfed babies also tend to be more vertical in the corporate world later in life. A recent study indicates that breastfed children cope better with stress later in life. The bonding rather than the breast milk is a likely explanation.
• Later Life - Formula-fed babies have a raised risk of heart disease, juvenile/type 1 diabetes, and multiple sclerosis. Recent research indicated that breastfeeding can postpone allergies and asthma. Breastfeeding may also play a role in preventing digestive diseases, such as ulcerative colitis and Crohn's disease, as well as childhood cancers including leukemia. Other studies indicate a reduce risk for both eczema, food allergy, and respiratory allergy--throughout childhood and adolescence.

Benefits to Mom:

• Less Fatigue - women who nurse report being better rested, less stressed, and more content. This is because of a number of factors and include: no need to prepare formula/bottles, the ability to readily access nourishment for a child during nighttime feedings (which allows a woman to do this as second nature and not fully rouse), the hormone prolactin releases olfactorily, soothing a stressed mama and family members and promotes a feeling of overall well being.
• Weight Loss - While nursing, you will burn an additional 500+ calories every day. So, unless you continue to "eat for two", the breastfeeding may help you loose weight. The 'spare tire' around a woman's waist is actually a 'milk store' a fatty deposit that nature gave women to sustain her milk production in hard times. Women who nurse tend to loose more of this spare tire, which would otherwise continue to be a 'problem area' throughout her life.
• Uterine Health - The hormone oxytocin, which is released in your body during breastfeeding, helps the contraction of your uterus back to normal. Besides looking pregnant for a shorter time period after giving birth, this also means that you may have a shorter postpartum bleeding. Some studies suggest that this also reduces uterine risks later in life including prolapsed uterus, the rate/necessity of hystorectomies, and the like.
• Cancers and Longterm Health- Some studies indicate that the risk of getting both breast and ovarian cancer is reduced through breastfeeding. Some studies even indicate of lower incidence of osteoporosis later in life among women that have breastfed.

Breastmilk contains:

• Protein in breast milk is mostly whey, which is easier to digest than casein (main protein in cow's milk). Protein of breast milk has high amounts of amino acid taurine, which has an important role in the development of the brain and the eyes.
• Fats - These fats are nearly self-digesting, since breast milk also contains the enzyme lipase, which breaks down the fat. Fat is the main source of calories for babies, something babies need to continue postpartum growth and development. Also, fat in human milk has large amounts of omega-3 fatty acids, important for brain development.
• Vitamins and minerals - in human milk are bioavailable-meaning they get absorbed well. Breast milk contains substances that enhance the absorption of minerals and vitamins.
• Stem Cells - Breast milk is the only adult tissue where more than one type of stem cell has been discovered. That is very unique and implies a lot about the impressive bioactivity of breast milk and the consequential benefits to the breastfed infant (see this article for more great information)
• Immune boosters. breastmilk continually passes millions of white blood cells to baby to help baby fight off all kinds of diseases. Also, when mother is exposed to a germ, she makes antibodies to that germ and gives these antibodies to her infant via her milk. Breast milk also contains factors that prevent microbes from attaching, and a long list of other antiviral, antibacterial and antiparasitic factors.

"Even more amazing, if a baby contracts an illness that mom has not been exposed to previously, he will transfer this organism through his saliva to the breast, where antibodies are manufactured on site and then sent back to baby via the milk to help him cope. ... Mothers who wean their babies from the breast during the first and even second and third years of life often notice that their child becomes sick more than before, or for the first time." Examining the Evidence for Cue feeding of Breastfed Infants by Lisa Marasco and Jan Barger

• Hormones and enzymes. Breast milk has lots of digestive enzymes, and also many hormones. These all contribute to the baby's well being.

See below for more information:

Dr. Sears on Breastfeeding

Womans Health

Vaccinations Vaccinations definitely have benefits, and there are stark risks as well. This, like circumcision, is a touchy subject.

The wonderful thing is, there are options. Your options include selective vaccination, delayed vaccinations, and no vaccinations.

Some things to consider when making your decision:

• Immunizations provide long-term immunity, not lifetime immunity.
• Breast-feeding protects the child from diseases (excluding pertussis) through the mother’s immunity. Some advocates of delayed vaccination state to wait until baby is weaned.
• Vaccination protection: typically, the 1st shot in a series provides full immunity to 70% of the population. The 2nd shot in the series brings it up to 80% & the 3rd to 90% of the population.
• All vaccines carry some risks, these risks are compounded the more vaccines a body recieves.
• The polio vaccine has been shown to, in some cases, cause polio.
• The mumps vaccine has been shown to, in some cases, cause meningitis, febrile convulsions and epilepsy.
• The HPV vaccine has been shown to cause high incidences of: death, paralysis, thrombosis, lupus, blood clots, fainting, stroke, siezures, long term dissabilities, and there is a question as to, longterm, if it will cause infertility issues.
• Questions as to vaccines correlating with the increased incidence of autism in developed countries routinely vaccinating.
• Vaccines can cause allergic reactions/sensitivities to certain foods like eggs & gelatin as well as certain medications (antibiotics). While preexisting severe allergies to eggs, gelatin or antibiotics can result in severe deadly reactions to a vaccine containing these substances.
• Consider the risks of contracting the disease in your decision to immunize your child. High risks include overseas travel, frequent plane or bus travel, day care or school, or your personal job exposure to vaccination diseases.

There are many options, and I recommend families reviewing the evidence for what is the best for their families.

See below for more information:

Center For Optimal Health

NVIC

Dr. Sears and Vaccinations

Circumcision Circumcision is a very touchy subject for families. There are pros and cons on each side of the fence and has to be a subject/decision that families are confident in BEFORE it is performed. If, for any reason, there is dissension over circumcision, it is best to NOT have it done until all parties are in agreement. Culturally and religiously, there are arguments in favor of the procedure. As a routine surgery, the AAP discourages it.

Complications can arise, and do in about 3% of all circumcisions, and include: rash or irritation, poor cosmetic appearance, bleeding (hemorrhage) and/or infection, and complications due to faulty surgical technique (Buried penis (also called denudation - penile shaft buried below the surface of the pubic skin), Chordee (abnormal downward bend of the penis), Meatal stenosis (narrowing of the urine channel [urethra] at the top of the penis), Skin bridges (foreskin reattaching to the glans), and Penectomy (accidental partial or complete penile removal)).

It is a permanent procedure that cannot be reversed and is often times not covered by insurance. The procedure takes anywhere from 5-15 minutes.

The procedure- The baby is placed on his back with his arms and legs restrained and the penis and surrounding area are cleaned. A local anesthetic (e.g., cream applied to the skin, injection to the shaft or base of the penis) is used to prevent pain. Anesthetic cream takes effect in about 20-40 minutes. The injection takes less time to work, but the aftereffects may last longer. Sometimes the baby is given a sweetened pacifier to reduce stress (sweetie). The foreskin is pulled down (retracted) from the head of the penis and clamped in place using a metal or plastic ring. If a metal ring is used, the foreskin is cut off and the ring is removed. An antibiotic cream is applied and the penis is wrapped in loose gauze. Healing usually takes 5 to 7 days. If a plastic ring (called a Plastibell) is used, the foreskin is slit and wrapped back around the ring. A piece of thread (suture) is tied around the cut foreskin, pushing it into a groove in the plastic. This is left on the penis for 5 to 7 days, after which it falls off, leaving a completely healed circumcision. An antibiotic cream is applied to the penis.

There are DEFINITE benefits to leaving the prepuce intact, and would refer you to the video below for a full disclosure of that. Please take the moment to watch this video, whether or not you choose to circumcise, so as to be fully educated and make an informed decision about the process.

Several studies have been performed to find out if there is a medical benefit to infant circumcision. The American Academy of Pediatrics (AAP) says the benefits of circumcision are not significant enough to recommend circumcision as a routine procedure and that circumcision is not medically necessary. A recent AAP report stated that circumcision does offer some benefit in preventing urinary tract infections in infants (which is easily treatable with antibiotics and occurs less often when the foreskin (prepuce) is left alone (not retracted to clean)). Circumcision also offers some benefit in preventing penile cancer in adult men. However, this disease is very rare in all men, whether or not they have been circumcised. Circumcision may reduce the risk of sexually transmitted diseases. Although a man's sexual practices (e.g., if he uses condoms, if he has more than one partner, etc.) has more to do with STD prevention than whether or not he is circumcised. Study results are mixed about whether circumcision may help reduce the risk of cervical cancer in female sex partners, although this information is again skewed as to the male partners sexual practices as the cervical cancer is often a result of HPV.

Other arguements are social pressures: wanting a child to look like his father or male role model, not wanting a child to be made fun of growing up, wanting a child to 'fit in'. These arguments, IMHO, are not solid enough to base a decision to alter another persons reproductive organs on. No two penis' look alike, so the 'look like his father' argument is null and void - a child will have no issues with this discrepency as long as the father does not show any angst regarding his sons penis. The last two arguments are becoming a non-issue as more and more American males are not being circumcised. America, Canada, and the Middle East are the only locations where circumcision is prevelant, rate of incidences in the order listed.

Finally, taking into consideration all of the above information, we would be wise to think twice about the implementation of this procedure routinely.

See below for more information:

Family Doctor

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Well, I hope that the above information arms families with the starting point to begin to make the earliest choices for their children's healthcare. For more great reading, see below: Parenting and Baby Care Online Resources:

• 365
• Transition to Parenthood
• Real Savvy, All About Moms
• Dr. Sears
• Kelly Mom
• Mothering

Books:

• The Baby Book, Sears
• Mothering the New Mother, Placksin
• The Year After Childbirth, Kitzinger
• You and Your Newborn Baby, Linda Todd
• The Happiest Baby on the Block, Dr. Harvey Karp
• The Year After Childbirth, Sheila Kitzinger
• Your Amazing Newborn, Marshall and Phyliss Klaus

Breastfeeding Online Resources:

• BFLRC - mostly for the professional
• Transition to Parenthood
• Kelly Mom
• ProMom
• La Leche League International
• Breastfeeding

Books:

• The Nursing Mother’s Companion, Kathleen Huggins
• *The Womanly Art of Breastfeeding, Anwar Fazal
• The Breastfeeding Book, Sears
• Nursing Mother, Working Mother, Gale Prior
• So That’s What They’re For! Breastfeeding Basics, Janet Tamaro
• The Ultimate Breastfeeding Book of Answers, Newman and Pitman

Maternal Support, PTSD, and Birth Trauma Online Resources:

• Post Partum Support International - for help postpartum
• Depression After Delivery - for help postpartum
• Solace For Mothers - support for traumatic birth
• TABS - support for traumatic birth and PTSD
• Birth Crisis - for birth healing

Books:

• This Isn't What I Expected: Overcoming Postpartum Depression, Karen Kleiman
• The Postpartum Husband, Sandra Poulin
• The Mother-To-Mother Postpartum Depression Support Group, Sandra Poulin

My hope is that every woman can be confident of her educated decisions as a mother! Here's to full and informed consent (refusal).

Tags: Doula Parenting Infant Care

One of my favorite Black History figures is the African-American writer, editor, and activist, Frederick Douglass. Douglass, like many during that time, was born into slavery, but decided, rather than die in slavery as well, he would run away to the North. He beat all odds and succeeded in making it North and there, made more than one drop in the sea of American History.

Tags: Childbirth Education

A few weeks ago I decided to ask Barbara Herrera, one of the midwives that I follow on the blogsphere, to be a guest on my blog. She is better known in the online community as the Navelgazing Midwife. She is an LM (CA) and CPM in San Diego, CA and continues to write thought provoking, controversial, and timeless articles on women's healthcare, history, and advocacy. I invite you to pull up a chair and enjoy learning just a little more about the Navelgazing Midwife. What led you to midwifery?

I wasn't led; I was dragged into it. Growing up, I never liked kids. They were messy, noisy and stank; I didn't want anything to do with babies. But, starting when I was 18, friends began asking me to help them when they were having their babies. After I'd been to a few, I thought I should learn a thing or two. It wasn't until after I had my second baby, at home, that I was bitten by the birth bug. Once I got going, there was no stopping me!

What does midwifery mean to you?

I serve women. Midwifery is serving women. The mission gets all jumbled up with the law, insurance, odd educations, inept midwives, overbearing doctors, interminable technology and minimal societal support. Those of us who keep moving forward despite the obstacles *really* want to be midwives. It isn't an easy "occupation" (calling?).

What is your hope for all women you attend?

There's an underlying belief that midwives empower women, that we have the key to helping them find their inner strengths, giving them the power to transform their lives. In reality, women empower themselves. Simply by choosing to birth at home, to hire a midwife, to remove themselves from The System... all of these actions are her empowering gifts. She gives them to herself. My hope for women is they discover and, if possible, embrace aspects of themselves they never knew existed before. Tapping into these previously unknown strengths buoys us along as mothers, as parents. It is not uncommon for women to remember their laborious journey and be able to take another deep breath and say, "Okay, I did that, I can do this."

I notice that you help women in the hospital setting too. What are your feelings on hospital vs. home birth?

People do like to say "home versus hospital" as if it is a contest, one that will be won by whoever has the best/most natural/least interventive/most (or least) painful/etc. birth experience. There is a birth place for everyone. For most women in our culture, that place is a hospital. The latest statistics seem to show out-of-hospital births are increasing, but they are still a fraction of those hospital birthing mamas. I support women wherever they choose to birth. I really enjoy working with hospital birthing women. It's totally different than my homebirth clients, but the joy is identical.

What types of situations would lead you to transfer a woman to the hospital?

I use the term "transfer" if we go to the hospital in a car. A "transport" is going by ambulance. There are far fewer reasons to transport than to transfer since those are absolute emergencies. A postpartum hemorrhage, a baby that needs more than basic resuscitation and a baby's heart tones (while the baby is still in the uterus) that do not resolve are the most common reasons for a transport. A transfer is slower, less urgent and can be because progress in labor has stopped, because mom wants pain medication or if her blood pressure begins climbing. I also have no experience delivering breech babies, so would transport for a surprise breech (and I have).

Do you stay with women during transfers/transports and, if so, what is the vibe you get from the medical institution during these transfers?

Absolutely! Any midwife who leaves her client is unethical as far as I'm concerned. If she cannot stay because of legalities, then she needs to have a doula go with mom. Sending a mom into the hospital without support is cruel. In all the years of transferring and transporting women, I have had really good relationships with the nurses and doctors -except for one doctor/hospital. I acknowledge that the hospital staff will be wary of me, probably won't know me and will probably distrust my charting. I meet them where they are. I answer each question as it comes to me, even if it is the same one 10 times. I know that the fewer the waves, the better the care for my client. I would do anything to help her; I can take anything the hospital dishes out. As long as they are kind to my client, I don't care how they are to me.

Do you "take on" "high risk" women? If so, which do you take on and which don't and how do you treat their 'risks'?

Ah, but risk is in the eye of the beholder, isn't it? To some midwives, a woman with Gestational Diabetes is too high a risk for her to take on, whereas another midwife (me) has no problem with the diabetic, but won't take a mom pregnant with twins. Our skill sets are different, we all excel in different areas. Knowing our skills and our limitations is vital as a midwife. Our law is pages long outlining who we are legally permitted to accept as clients. With informed consent, a midwife with specialized skills is able to accept someone who falls into the (legally) "high risk" category. For me, the main complications that I am not able to attend to, merely because of lack of skill/education, are breeches and twins. I can refer a client to another midwife who does do them at home, someone with more skill and education than I have in those particular situations. If women have specific questions... post-dates, large babies, prolonged rupture of membranes, high blood pressure... these sorts of things are worked out on a case-by-case basis. Little of midwifery is absolute.

What is your view on childbirth itself?

That's an interesting question to ask a midwife. I work with clients to allow birth to unfold as it is supposed to, as it is meant to, to not try and write a script that will, 100% of the time, not be followed. As a midwife and care provider, I believe I am required to do the same... to allow birth to unfold in front of me without my manipulating the experience for the woman/baby/family. I am hired as a consultant with years of experience, a woman who has specific skills to keep mom and baby safe if things step out of the realm of normal. I use my skills when they are called for and sit back quietly when things are moving along perfectly fine without my help. Childbirth is magical, base, gritty, loud, fills the senses to the brim and is shared by millions and millions of women around the world -and a connection with mothers from all of time. Birth is as we make it - and what it makes us.

What is your view on the state of women's health care in the U.S.?

Oh, don't make me cry! I've worked with migrant and inner city teens and have listened as women share their stories of medical neglect, of not having insurance so putting aside even very serious illnesses, of women who don't know how to maneuver through the maze of free-care offerings. It's just all so sad. Women who have one type of insurance who are strapped into a birth location or a birth provider they want nothing to do with and women who fall in the inbetween... no insurance, but make too much for any assistance. Oh, my. It's just all so sad.

What would you like to see changed at a national level and how do you see this being accomplished?

Well, of course I'd love to see Licensed Midwives be a part of the healthcare team around the US... nationally recognized... not parcelled out into state legislatures. I'd love to be able to take Medicaid/MediCal. I'd love to have hospital privileges. It's going to take an enormous shift in the medical model in order to accommodate the specific niche an LM/CPM can offer. Increasing the number of midwifery organizations in our country, lobbying and educating the public as well as those in control (docs, hospital administrators, insurance companies) all move us incrementally forward. While I can see this lovely, idyllic world in my head, I don't quite know how to traverse to it with my feet. But, I keep trying.

Who am I? Over the years, I've added dabs of skills, interests and hobbies to my basic skeleton of woman. I'm a mom of four kids (first born in the hospital, second at home, third in the car, and the fourth is a life-long step-child), all grown and all the dearest friends a mom could ask for. My spouse Sarah and I met in 1986 (when my youngest was 2 days old and she was 7 months pregnant) and are still so in love. We've gotten legally married each time we were able to, this last time seeming to still be legal (as of today). I'm vocally pro-choice, tend to write controversial posts and articles and apparently enjoy rocking people's boats. I love writing, have been published a number of times and have been doing amateur photography for 20+ years, but sold my first photo to "Mothering Magazine" last year. I love teaching and spend a great deal of time teaching student midwives and apprentices (as well as birth junkies) via my blog and in Facebook. The Internet has transformed every aspect of my life. To end where I started... I serve women. That's what I do and who I am. I serve women.

Thank you Barb for your time! You can find Barbara both at her blog here, as well as her professional website here.