Big things…

come in small packages they say. But they come in big packages too. One of the “big packages” that comes with midwifery care is the apprenticeship model of learning. It’s not enough to read about, “practice”, and then take a test to become a midwife. The apprenticeship model includes hundreds of hours following around an experienced midwife, asking questions, packing bags, asking more questions, practicing, seeing, watching, being still and in the background, being in the front and center of the action, sitting in the other room, and sometimes (finally) gloving up and being ready to catch a baby! And only THEN do we “take the test”! 🙂

I’m so thankful for the midwives that were willing to see me through my apprenticeship. To be willing to be available for a student is almost like adopting a child. Even if they don’t need that much from you in terms of actual TEACHING, you are putting your name on the line – saying that you are responsible for what they do and don’t do correctly, being willing to be accountable for your actions and theirs as well is a big commitment and I’m thankful for those who took that responsibility for me. The gift is immeasurable in it’s enormity and I will forever be thankful. This is one of those things that you simply must be willing to do if you become a midwife. “Each one teach one” is not only a cool slogan – it’s a way of life for quality midwives: to train up women in traditional midwifery care while balancing the political and legal challenges that factor in to everything we do.

With that being said, I’m pleased to announce the addition of two more students into the Dar a Luz family of Student Midwives! I’ll be posting introductions and photos as soon as their preliminary requirements have been met. To current clients, you may be meeting these women soon at prenatal and postpartum visits. Future clients in the northland area – you are in for a treat. I’m expanding my services in the area (that means LOCAL prenatal care!) to accommodate these students learning needs and offering a significant discount for those of you willing to participate in this process. Rest assured, I am still the one accountable for your care and YOU are in charge of what the students do and do NOT do for your care. It can be individualized for your level of comfort with the student. However, I can promise you that the students who work with me work VERY hard to be ready for this phase of their training. And they are ready or I wouldn’t put my neck out there for them. 🙂

If you are interested in promoting quality midwifery care and would like more information on working with a student midwife under supervision please give me a call for more information! Kelly @660-383-6059

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Rant or Rave?

I just have to put this out there – to the universe, families I serve, etc. etc.

BIRTH BELONGS TO WOMEN and FAMILIES. It does not belong to midwives, obstetricians, anesthesiologists, etc. etc. etc. I get so tired of hearing about all the hoops pregnant and birthing mothers are made to jump through – “You must do XYZ at weeks 1, 2 and 3. And of course an ultrasound at 20 weeks to confirm dates and make sure baby is ok. Oh, and the quad screen. Of course you’ll want that.” FEAR, fear… FEAR.

Poor mother is sitting  there stunned, shocked, frightened, bullied… certainly with a continual onslaught of emotional and physical affronts during her pregnancy she will experience some – SOME – hiccup in her labor or birth. If we treated animals this way while pregnant entire species would die out and become extinct.

Sigh. Remember Mama: you are the ONLY PERSON ultimately responsible for your womb-baby. You carry her, you feed and nourish him. You ALONE birth this person into the outside world. Choose carefully those whom you would invite on your journey.

Get your art on…

 

 

 

 

 

 

 

My tween daughter says this all the time, in reference to my choice of clothing. I don’t know what she’s talking about for sure, but I think it has something to do with my mostly drab and boring wardrobe. That’s not, however, what I’m referring to!

I’m hosting what I hope to be the FIRST annual art show here in Missouri to benefit Missouri birth centers and out-of-hospital midwives. SO… GET YOUR ART ON!

If you are a midwife, doula,mother, father, brother, sister, grandma, grandpa… you get the point… and have created or think you might want to create a piece of art to commemorate one of “those” moments in the mother-baby-birth world, PLEASE consider participating. The art may be shown only and returned, offered for sale, or donated for auction later that evening.

(which is free of course complete with those fancy-schmancy tiny finger cakes that taste good but are much too small?)

And here’s the FUN part (I get to get a new dress for this!!!! Errr…. wait a minute… maybe that’s not such a….):

A formal, black tie event will follow the public art viewing! The evening event promises to be full of fun, probably at my expense 🙂 , and ticket sales will benefit what I hope to be the beginning of a free-standing birth center in the Warrensburg/Sedalia area (look for an announcement later on this!). The art auction proceeds will benefit my wonderful preceptor/friend/midwife extraordinaire Rachel Williston of A Mother’s Love Birth Center.

Tickets to the event are going to be little over-priced, like any decent fundraising event is, but will be worth EVERY SINGLE PENNY if you want to see options for birthing women in our state broadened and every woman served by the Midwifery Model of Care! I promise you the food will be amazing, hormone-free, locally grown fare, and there is talk of some fabulous door prizes as well.

If you would like an invitation to the evening’s event, please drop me a line at birthbeautifully [at] gmail [dot] com with your postal address and I will get one in the mail to you pronto!

Click HERE for a flyer and entry form if you have art to share… and come on… EVERYBODY has a little art in there! So get your art on and share it with the world!

Boy oh boy…. CASTOR OIL

Of all my posts on this blog, the one that has stirred the most controversy is the one on Castor Oil for Induction. The article I posted wasn’t even a blog post, but a short synopsis of the research I did to support MY POSITION on the effectiveness of castor oil as an induction method.

Just today I received a rather snarky response to the article claiming that I “didn’t effectively research” and was “one-sided” putting women who might read it and “not do their own research” at risk. Oh, and that I cited an article/study that was irrelevant to the use of CO as it relates to induction. I cited many articles, many more than one, and AGAIN: I was writing this article as an assignment. I had to SUPPORT my position. And I did just that.

Geesh. I’ll approve the comment, of course, all in fairness, but I think the author went a BIT too far in her umm…. criticism? of my post.

Listen, it’s a free world out there. I post my thoughts and positions relating to birth on this blog ‘cuz it’s mine. 🙂 You are free to comment, critique, whatever. Just be fair. And remember that is IS my blog, and as such I can post MY thoughts and positions on it.

SO I will say again: I do not believe castor oil is safe for use on a scarred uterus (ie: VBAC), and may cause some really funky labor patterns in any woman’s uterus. Bottom line: I believe that induction disrupts that wonderful chemical symphony that the body (and the baby) creates to begin labor WHEN IT IS TIME. So whether it’s castor oil, prostaglandins, Cytotec, WHATEVER, fundamentally I believe it changes the energy that surrounds a birth when compared to one that begins spontaneously.  And ***I*** believe it changes it for the worst, not the better.

And again, I’m a US citizen and am entitled to post just that: my beliefs. And for the record, they are based on MOUNTAINS of research, not a “whim” and certainly not without a great deal of care and thought as to the possible implications my beliefs might have on others who read them.

I will be quite transparent: I do not believe induction is safe, healthy, natural or any of the other commonly used adjectives that commonly surround it. I believe induction is sometimes warranted, but within very limited parameters and with VERY careful consideration given to the implications of that decision. I do believe a woman has the right to choose it, but also believe she should be fully informed.

And since “anyone can google castor oil induction” and find out how to do it with little information provided on the risks, I thought a balanced response to that information was in order. 🙂

So… hit delete, or whatever you want to do – that’s cool (free country after all) but don’t accuse me of being cavalier with information that just might save someone’s life and the life of their baby. Because I certainly am not.

On my soapbox again…

I just can’t believe it… I don’t WANT to believe it. That midwives (the “guardians of normal birth”) are using cytotec (also known as misoprostyl) to induce labor at home. The fact that they are using it in hospitals doesn’t shock me, makes me mad, but I just add it to their list of sins again women and babies. Nothing new there. But midwives… sweet, caring, lovely homebirth midwives. Thinking this doesn’t harm anyone. I hear it over and over again, “I’ve used it judiciously for years and have never seen a problem with it.”

Well good for you. Tell my blog-friend Anne that you’ve never had a problem with it’s use. That you’ve never seen a baby die from it, or a mother die or lose her uterus from it. Good for you. Put some flowers on her baby’s grave and say, “Well, we don’t know for SURE that cytotec caused her death.” That you have played the tables and had good luck doesn’t change the fact that this is a potentially dangerous drug that you are using for an OFF-LABEL situation. There are no safe dosing limits or instructions, no risks to inform your clients of because the company that makes cytotec has no intentions of marketing it for obstetrical use. I doubt their lawyers would allow them to. Too much of a liability perhaps?

Here is a quote about misoprostyl that sums up my own position and one that, I believe, should be taken by all birth workers:

Belinda Phipps, chief executive of the National Childbirth Trust, said she was “absolutely incredulous” that any hospital would give the drug to women outside of clinical trials.
She said: “This drug is not licensed for use in labour, and the NICE guidance is categorical on that point. In this country, misoprostol should only be used in labour if the baby is already dead, or after the birth, because otherwise the risks are simply too great.” [ click here for the newspaper story ]

I’m not likely to stop beating this drum for awhile yet. In fact, you might want to cover your ears because frankly? I plan on beating it louder.

Ok, so… Wow. This makes me SO mad.

ACOG issues bulletin allowing women to drink in labor. Finally.

Yeah, really? Permission to drink in labor? While it has been a long time coming and I am thankful for the thousands of women who will now be allowed to drink during the hardest marathon-work of their lives (duh). Come on!!!!! Are we serious???

Grown women, being treated like little children has long gotten my goat. Now ACOG is losening the reins a bit and ALLOWING women to “drink modest amounts” in labor? Really?

Geesh. Let’s put those same OB/GYN’s (male and female) on a 12 hour marathon race and not give them anything but ice chips. I wonder how many would be able to finish the race. And no food either. Seriously. This really REALLY gets me going.

Is this common sense (finally) prevailing or is it a token crumb of freedom being offered to women who refuse to play by “the rules”?

I wonder.

Normally I wouldn’t bother

But. This article on homebirth is so full or errors and misinformation that I was naturally peeved. But as I read the comments I see that the point had been very well stated and perhaps this author would try again after doing some real resarch (not an interview with an OBGYN and present it as factual).

And then.

!!!

The comments (6 of them) disappeared before my very eyes. How interesting! Let’s bombard the site with comments so the author will get the point, even if not she chooses not to publish them.

Does this sort of thing remind you of anyone? 😉

Who’da thunk it?

A WOW news release on MedLine this morning regarding the safety of planned homebirths. Get this:

All of the outcomes studied occurred with comparable frequency in the planned home and hospital birth groups. These included intrapartum death (0.03% vs. 0.04%), intrapartum and neonatal death within 24 hours of birth (0.05% vs. 0.05%), intrapartum and neonatal death within 7 days (0.06% vs. 0.07%), and neonatal admission to an intensive care unit (0.17% vs. 0.20%).

[My note: actually, the numbers show slightly better outcomes at home. 😉 ]
“As far as we know, this is the largest study into the safety of home births,” the authors note. The findings, they conclude, indicate that with proper services in place, home births are just as safe as hospital births for  low-risk women.  ~ BJOG 2009;116:1177-1184

NOw of course this is a “foreign” publication (British Journal of Gynecology) so I don’t know how much credibility it will get here in the trenches, but WOW. Very cool that the news is getting out there to US med students and physicians!

Interesting turn of phrase

Interesting. Hmmm… Note the recent practice bulletin by ACOG regarding induction of labor:

“A physician capable of performing a cesarean should be readily available any time induction is used in the event that the induction isn’t successful in producing a vaginal delivery,” Dr. Ramin concluded. “These guidelines will help physicians utilize the most appropriate method depending on the unique characteristics of the pregnant woman and her fetus.”

Obstet Gynecol. 2009;114:386-397.

Ok, so all we need is “a physician capable of performing a cesarean” to be “readily available” should an induction be “unsuccessful”. Interesting. But for a VBAC “trial of labor” hospitals should have “immediate access” to anesthesiologists? Hmmm….

And on the use of oxytocin: “The main adverse effects of oxytocin are dose-related uterine tachysystole and category II or category III FHR tracings.”

But for  nipple stimulation, which is often a labor augmentor (if you want to medical-ize it) used by midwives at home births, the risks include “uterine tachysystole with FHR decelerations and increased trend in perinatal death.”

Interesting isn’t it? That oxytocin doesn’t carry a risk of perinatal death but NIPPLE STIMULATION does?

Interesting indeed.