I'm Pregnant, Now What?? Choices in Childbirth

It finally happen. The double pink line or the "+" appeared on the test. You are pregnant!! Congratulations!

Now what?!?!

After you've celebrated and shared the news, the next call you make is to your doctor to schedule your first appointment. It makes sense right? This is the doctor you've been seeing for your well woman visits and you do plan on giving birth at the closest hospital, right? That's what you should do, right? It's what everyone does, right?

Not that your doctor who you've been seeing for the last few years won't deliver your baby and not that you won't go to the hospital that is 5 minutes from your home, but you have other options. This is your birth and you DO have choices.

Did you know that you do not have to deliver laying on your back like you see in the movie?

Did you know that you can and it is often helpful to move throughout labor?

Did you know that there are trained healthcare professionals that specialize in normal childbirth?

Did you know that you do not have to have constant electronic fetal monitoring?

Did you know that the hospital is not the only option you have to give birth?

Take as much time deciding which stroller your baby will ride in as who will be apart of your healthcare team when he or she is born.

The Coalition for Improving Maternity Services has put together 10 questions to ask your healthcare providers that might help you as you explore your birth options. The questions include everything from who can be with you while you give birth to what you can expect while you are in labor.

Learn your options. Educate yourself. Become empowered so that you can make the best decisions for you and your family.

Foto Friday

I'm starting a regular series called Foto Friday where weekly I will share images capturing pregnancy, birth and babies. It is with great pleasure that I start my series by sharing a photograph taken by my friend Amy Goalen and displayed on the cover of her new book Mother's Milk. Amy's photographs are truly special capturing the intimacy and quiet moments between mothers and their babies in a snapshot of their breastfeeding journey. The photographs are stunning and are accompanied by words from the mothers themselves detailing their breastfeeding relationship. Mother's Milk can be purchased through Blurb.com.

Less Restrictive Guidelines for VBAC

With the cesarean section rate in our country reaching an alarming 31% The American College of Obstetricians and Gynecologists (ACOG) has issued new guidelines in hopes to allow greater access to vaginal birth after cesarean (VBAC). In a statement issued today, ACOG says:

"The current cesarean rate is undeniably high and absolutely concerns us as ob-gyns," said Richard N. Waldman, MD, president of The College. "These VBAC guidelines emphasize the need for thorough counseling of benefits and risks, shared patient-doctor decision making, and the importance of patient autonomy. Moving forward, we need to work collaboratively with our patients and our colleagues, hospitals, and insurers to swing the pendulum back to fewer cesareans and a more reasonable VBAC rate."

The World Health Organization (WHO) recommends that for the best maternal and fetal outcomes that cesarean rates in industrialized countries should be no more than 10-15%. ACOG's recommendation is a step in the right direction to allowing more women the choice of a VBAC. While it moves us forward, we still need to keep the doors of communication open between women and their doctors and fully support their childbirth options. You can find the full text of the press release from ACOG here.

Celebrating Memorial Day & Doula-ing for Our Troops

While you are enjoying your time off, grilling with family and friends or relaxing at the beach, take a moment to remember our brave men and women who put their lives on the line everyday for our freedom. They do so without hesitation and with great sacrifice. I have family and friends who have served in the armed forces and I am a proud volunteer doula with Operation Special Delivery. OSD provides doulas for pregnant moms whose husbands or partners are deployed or have been severely injured serving our country. If you or someone you know is pregnant and their spouse is deployed please visit Operation Special Delivery to learn more about the program. If you don't qualify for OSD, I do offer a discount for military families. It's just my small way of saying thank you for all that you do!

Mother & Baby Friendly Cesarean

The United States cesarean section rate is rising at an alarming pace. While we need to educate ourselves about and discourage the use of unnecessary cesareans, the medical necessity of the procedure has allowed for healthy outcomes for countless mothers and babies. (me to be included!)

For those mothers and babies that medically require delivery by cesarean I argue that we should explore the option of a mother/baby friendly experience. The Natural Cesarean: A Woman-Centred Technique (pdf file) is an article published in the BJOG: An International Journal of Obstetrics and Gynaecology exploring the option of the parents being active participants in the birth of their baby.

What would a mother/baby friendly cesarean look like? According to the authors of the article:

• The drape would be lowered and the mother's headed elevated so that she may witness the birth.
• The partner would be allowed to observe as well
• Baby would be allowed to slowly emerge helping to expel liquid from its lungs as it would during a vaginal birth
• Rest of delivery is allowed to occur passively as the uterus continues to contract
• Clamping of the cord is done in front of both parents and the partner is permitted to cut if desired
• Baby is brought between the mother's breasts for immediate skin to skin contact and offered a chance to suckle
• Baby is allowed to remain on mother's chest until the surgery is complete. Procedures (labeling, Vitamin K, etc.) that can be completed in this position are.
• Once surgery is complete, partner accompanies baby for weighing and remaining procedures
• Upon completion of procedures, baby is immediately returned to mother for skin-to-skin contact

A cesarean section is major abdominal surgery. This birth experience is not suitable for all cesarean births, but I think, as suggested by the authors of the article, this option can be explored for non emergent situations. The International Cesarean Awareness Network has also written details about how to have a family centered cesarean.

If your medical situation dictates that a cesarean is the safest way to deliver your baby discuss your options with your doctor.

Don't Be Quiet - Share Your Amazing Birth Story!

You know if you're pregnant everyone has some advice for you. How you should do this or how you should do that. The other thing that often happens is that you will start to hear more birth stories. Not to make lite of the individuals who have had difficult births or things they wish they could change about their experience, but I think it's time to celebrate our amazing births.

If you had an inspirational birth tell your story. Don't be shy. Share what made your birth experience incredible. It doesn't have to be the birth you dreamed of or the one that was carefully laid out in your birth plan, but share it nonetheless. Your words of wisdom could help to empower and inspire other women throughout their pregnancy.

Don't be quiet. SHARE your amazing birth story!

Here. I'll start.......

While the birth of my twins was by no means the birth I thought I was going to have when I found out I was pregnant, it was very empowering. I went into labor on my own, I was able to see them being born via c-section and I had the support of my husband and amazing nurses that I had gotten to know during my antepartum stay in the hospital. If you wish to read the birth story of my twins visit my Twins Make 5 Blog. My experience was empowering because I was educated about my pregnancy and birth options and I strongly advocated to let my body and my boys make the decision about when they were going to come.

Pregnant? Consider a Midwife

Our Bodies Ourselves has posted a video on their blog asking the question "Why Choose a Midwife?" The video is mainly being used to address legislation in Massachusetts governing midwives, but it has the added benefit of detailing the benefits of the midwifery model of care.

Parts of the video are drawn from Natural Born Babies which is told by 10 mothers describing their journey to have a natural childbirth. The video is amazing! I promise I'm not just saying that because I'm biased having worked with Executive Producer, Lorri Walker at South Coast Midwifery & Women’s Health Care or having had the blessed opportunity to serve as doula to the family who helped direct the film. If you are pregnant and are looking for a healthcare provider these films will give you pause and a reason to consider hiring a midwife.