Fantabulous news for gestational diabetes

Granted, GD is sortof a smoke & mirrors type “disorder” of pregnancy lacking much real science behind current treatment protocols. But this newest information is really stunning.

The researchers found a profound link between serotonin and insulin production. And because serotonin is made from tryptophan — an amino acid that comes from high-protein foods such as milk, eggs, meat and fish — this result also provides a clear link between the amount and type of protein consumed by the mother early in pregnancy and the generation of islet cells needed to protect her against gestational diabetes late in pregnancy, when the fetal caloric needs are highest.

Just as good are the long-term benefits of a high protein diet in early pregnancy. Not only are moms storing up (on a cell level, this has nothing much to do with weight gain) against the development of gestational diabetes in the 3rd trimester, but also against the risk of insulin resistant (Type 2 diabetes) in their long-term future! I mean, WOW!!!

The research indicates that modulators of the serotonin pathway, including drugs, diet and genetic inheritance, may affect the risk of gestational diabetes and, possibly, the long-term risk of developing type 2 diabetes, according to the researchers.

So the midwives ARE onto something with all that talk of protein! 🙂

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VOICES: VBAC Women Share Their Journey

OH, it’s such a beautiful little book! Keep in mind that this is coming from the publisher directly (since it takes about 3 months to get it onto Amazon) so it ***CAN*** take 4 weeks to arrive. It shouldn’t and probably won’t, but I did have to warn you. I SO hate waiting for books!

Voices contains a full chapter of statistics and research surrounding VBAC success rates, real risks vs. fear-based risks, and the TRUTH about the risk of uterine rupture compared to other obstetrical emergencies. I’d like to say that this book was written for women wondering if their care provider is “right” that it is too “risky” to try to VBAC, but doesn’t have time or energy to sift through a mountain of studies or a pile of books that include only a small section on VBAC. It is also written for the woman who knows instinctively that she will have a VBAC and needs to win over a partner or care provider. But…

The real power of this book are the women’s birth stories. They are SO powerful. They are the true, real stories, unedited and unadulterated. They stand on their own. You will be changed by them. If you don’t understand what the “big deal” is about VBAC, then this book is for you as well.

At the end of the day, I believe in women having the right to birth as they choose, on their own power and in the climate and surroundings of their choosing. For women choosing VBAC and for their care givers, this book is a vehicle for those freedoms.

So many women today face VBAC “bans” or so many restrictions on their labors that they walk in the door with one foot in the operating room. Let’s put the TRUTH out there. I believe women are wise – and capable of making decisions based on facts, not fear.

Canadian study supports safety of planned homebirth

This ia really exciting. The study found HERE compares not only planned homebirth vs. planned hospital birth but also throws in planned hospital birth with both physician AND midwife. I often hear, “Well, I had a midwife in the hospital. That’s about the same as a homebirth.” No, it isn’t and here is the support for that position.

Not only are the planned homebirth outcomes better ACROSS THE BOARD, but they are bett with a homebirth midwife vs. a hospital midwife. Really cool info to have when asking or arguing for the safety of planned homebirth. (This booklet from Molly also has some great talking points in it!)

🙂

This just made my day. The canadian system has it’s caveats, no doubt, but the overall theme is that planned homebirth is SAFE with a trained midwife. I could do without the “registered” midwife thrown in there because I think it undervalues the work and safety of trained midwives who refuse to register (and there are many many GOOD reasons to not register). Of course they could not participate in the study and I doubt they were asked to. Afterall, who are they and WHERE are they? That, of course, is a question for another day. 🙂

Domicilary Obstetrics

Here in the US, homebirth midwives normally seek to remove and distinguish themselves from the term “obstetrics”. It conjurs images of sterile green hospital walls, episiotomies, paternalistic care, and the dreaded bed and stirrups of 2nd stage.

I recently came across the term used in a most delightful way at the Homebirth Australia site.. It’s definition most creativily defining what homebirth midwives do:

However, domiciliary obstetrics is the ‘art of invisibility’ and without complications a woman gives birth herself, supported and aided by her midwife. -Jan Pilgrim

I would love to have turned that phrase. “The art of invisibility”. Yes! A watchful eye, careful watching, gentle hands. THIS is the art of the midwife.

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.

Ok, so I cry alot lately…

Get over it. 🙂 This post about mothering made me cry. And cry and cry. We mothers give the best of ourselves to our children, and then still wonder if it’s good enough, all the while fighting the urge to be like “some moms” who put their own desires first and their children’s needs last. Fighting guilt that it would even enter our minds to do such a thing.

I was at a 2 day birth as doula and got back home yesterday. By the time it was all said and done I’d been gone from home for 36 hours. My husband is awesome and came home early to cook supper for them, and see them off to school the next day. I am blessed. Yet the entire time I was gone I was missing HOME. Missing cooking and thinking of laundry, and thinking to myself, “This is for the birds. I’m going to get my RN license and go to work in an OB department, have regular hours and MAKE SOME MONEY.”

I got home before the kids did from school and quickly perused the local college’s nursing department website. I was serious. Then the kids got home, happy to see me, and wanted to know all about the birth.

The baby was born gray. Like-a-gravel-road gray. I got him up and out of the water, did some basic life-support, suctioned him to get him ticked off enough to cry. He did. He pinked up later, with some blow-by oxygen and stimulation. It was an Amish family, with Amish midwives and they weren’t really sure what do do outside of pray and talk to the baby to “Come home baby, stay with us baby.” It is part of their belief system to trust birth. 🙂 No stones. They LIVE what they believe, everyday, whether I or you agree with the chances they take or not. That’s something I admire. They also admired me for knowing what to do for the baby. But I’m no hero. I haven’t even taken my official NRP course yet. I just did what I’d read needed done. (That’s on my list now, you can believe.)

So the baby pinks up, I listen for several more hours to him and watch respirations. They do not wish to transport him. He is good today, though I’ll check in several more times over the next few days. They trust me, so I might be able to pursuade them to take him in if he worsens. Right now he is fine.

And as I related this story to my family, I ended with, “But he’s ok and I’m sorry I was gone for so long. I missed you all so much. I’m not sure I’m going to keep doing this.” Boy, did THAT get an unsuspected reaction!

“But mom!!!! What if you weren’t there! What would have happened to that baby?”

“But mom! You don’t have to worry about us, that’s important work. We’re big enough.”

“Honey, it sounds like you were meant to be there. Sounds like you were doing exactly what you are meant to do.”

So I cried, loved on my family and ate Hamburger Helper that my son cooked while I napped, all tucked in my husbands arms. And felt a little better, though relieved that I don’t have another birth until after this baby comes.

And I think of “baby”. By the time that poor first time mom was done I also thought, “Geesh. I’m gonna go to the hospital, have an epidural and secretly sip cappicinno while I’m in labor like all the other moms.” And I thought again of “baby”. I can’t do it.

I did not choose to homebirth because it’s “in fashion” as some to eloquently assert. I do not choose to homebirth even for my comfort. Because we all know an epidural is usually as “comfortable” as one could get while in labor. I thought of why I chose to birth this baby and home and it’s because of “baby”. Epidurals can and do make baby’s heart rate drop dangerously low, doing who-knows-what to his future cognitive abilities. And then cause a “necessary” cesarean almost half of the time at my local hospital. Bright lights, strangers hands, rough towels and rubbings, suctioning even when it’s not needed, shots and stinging ointment put in baby’s eyes, feet stuck and bled within hours of birth, being jerked swleeping from the womb he knows and loves with no preparation… what does this do to BABY and his introduction to this world? Hurt him physically, I’m sure. But emotionally? Spiritually? What does this first environment TEACH him about our world?

I’m a midwifery student and fairly scientifically minded individual. I realize there are times when ALL of the above are NEEDED FOR THE BABY. But the majority of the time they aren’t. And unless indicated I don’t want to expose my baby to that sort of homecoming.

So I pluck a few feathers from my chest, line my nest with a bit more sacrifice and look forward to welcoming “baby” in late October when the winds are crispy and the leaves are falling. No epidural, no one to clean up the mess for us, no one to cook for us (except family), no one to heave the responsibility of this birth onto but ME. 🙂 For baby. All for baby.

Just about given up…

When quite unexpectedly I happen upon a blog by (of all things) a DOCTOR. 🙂 I love doctors really, truly. I’ve met and known some fabulous ones, wonderfully caring individuals who are stuck doing what they love in a minefeild of insurance risk-assessments and mandatory hospital protocols. My heart goes out to them. Truly. If I were 20 again I would most certainly go to medical school. It would the ultimate test of my belief system, and would surely try me to the core. I like that kind of thing.

Anyway… I digress…

This blog, it had the most beautiful birth story on it, written by a doctor. If all midwives could be SO lucky as to have a collaborating physician like this one. This is the stuff dreams are made of.

A Welcome Surprise

Enjoy.

Missouri Stands for Freedom

In a 5-2 ruling yesterday, Missouri Supreme Court ruled on the constitutionality of a line in a 2007 law legalizing Certified Professional Midwives. Thank goodness.

A sigh of relief. After the ugly political tactics that I’m sure took place last session (I was only there twice but I saw enough…) I am relieved to see that justice did have it’s day afterall.

This issue isn’t about a handful of crunchy, granola eating, Burkenstock wearing women who want to birth their babies at home.

This issue isn’t about hating doctors, hospitals or the medical profession.

This issue isn’t about money, power or control.

This issue isn’t, TRULY, even about midwifery or homebirth at all.

This is is about personal choice and freedom. It is about having the right to exercise CHOICE over our bodies and how they are treated.

And I am glad that the Missouri Supreme Court heard the case for what it was. Doctors neither have the right to “represent patients” nor do they have the right to limit access to healthcare.

Whether or not you, or I,  agree with the philosophy behind homebirth is little more than a side dish in this debate. This issue is about freedom. I am relieved to see that the Missouri Supreme Court stands for those freedoms.

Balance

I was just reading Navelgazing Midwife’s blog entry on the infamous Dr. Amy’s blog regarding her blatant denial of birth trauma. She evidently does not believe it happens, or that the routine things done to women during birth do not effect women in a traumatic way unless there is a history of abuse in her past. Well, that’s a whole ‘nother subject. I’m too stunned by her assertations to reply at this point.

What really struck me was the list the Navergazer put down as hurtful or harmful for women – things said or done to them in labor. Not just by OB’s, Gyn’s, or nurses but also by midwives. It hit me like a ton of bricks. I’ve heard alot of those things said at homebirths. My question is, “When the woman will not cooperate or LISTEN to the beloved “informed consent” statements and will NOT take responsibility for her and her babies well-being, then what do we do? Step back with folded arms and let a baby be harmed?

I heard a story recounted by a fellow midwife of a woman who wanted to “do labor alone”. She wanted to be left alone to labor, had a plan, etc. When labor came however, it was a different story. For hours she fought her contractions. No progress. Then she began to hurt herself. She began biting herself amd hitting her head on the wall. For awhile the midwife watched, not wanting to interrupt or go against the mom’s pointed wishes. At last she cuold take no more of the high pitched screaming, head banging and biting. She intervened. She held the mom’s hands and caught her eyes with hers. She began to match her breathing, helping her cope. The mom said, “Thank you.” In the end, the baby was fine, the woman had only a couple of bite marks to show for her “independent labor” and no concussion.

It seems to me, that in the interest of fairness we need to realize that there will be women in our care as midwives that NEED intervention. I’m not talking about needles and sutures and episiotomies and continuous monitoring. I’m talking about emotional and psychological intervention. Because let’s face it. In our culture here in the midwest birthing is NOT seen as natural and women are NOT brought up to believe they are powerful, life-giving creatures. They are raised to believe they are victims, in need of salvation, by and large and it can take a lifetime of work to undo the belief system that leaves women helpless in the hands of their care providers.

The list of harmful things  Navelgazing Midwife  put out was SO eye-opening. Words are so powerful. They contain life and death. Thanks Navelgazer for putting that up (don’t know where you got it, maybe it’s original, if so… COOL!). Let’s think of healthy ways of saying things, if they need said, as we prepare and work towards a culture of powerful birthing mothers.