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Archive for January, 2009

Snow.  I love it.  Not because I ski or do any winter sports (I don’t).  Despite living in a village in West Africa for two years a few degrees north of the equator (yes, there is such a thing as “Africa-hot”), I’m not a fan of hot weather.  When there’s snow there are sweaters.  Comfy clothes.  Love them.

What I love more about winter is snow days.  I’m writing this while watching my two “big girls” play the Wii.  It’s funny, I wasn’t a fan of video games for them before the Wii, but it’s a great way to get them to move their bodies and work together (and we grown-ups love it, too!).  Thinking about the babies I see at Mothers & Company each day, I realize that every stage of their lives is so special.  Caring for a baby is amazing–the coos and little smiles and so many firsts.  It’s also challenging (as we all know).  Every week seems different with kids.   I’m no longer nursing a baby or helping a toddler put her clothes on, but I’m in a new phase of motherhood–raising a citizen, an actual person!  Seeing them interact, witnessing how conversations with them change as their brain develops and they observe and learn from life–wow!  I wonder what they’ll be like when they grow up and also wonder what else I can do to ensure they’ll be who they are meant to be.  Nurturing a life at every stage.  What a gift parenthood is!

They’re doing yoga now, some of the same moves that a bunch of us mommas were doing yesterday at MoCo’s Mom & Baby Yoga.  I’m sore today, but ready to yoga with them.  That’s where the bonding and parenting is…just in the everyday interactions and activities.  Maybe we’ll head out to do some snow angels a little later…you might, too!

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Check out the MetroMamas Know Blog…and mymetromama.com.  It’s a local resource for parents in Central MA.

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Help Women Give Birth with Support, Information and Confidence!  Become a Birth Doula (certified by DONA International)?

Come to Mothers & Company for a DONA Birth Doula Training in May!

DONA’s Founder and the Mother of All Doulas (as I affectionately call her), Penny Simkin, is coming to Central Massachusetts!  She and the North Shore’s beloved and super-experienced doula and doula trainer Carolyn Ogren are leading a Birth Doula Training on May 16 & 17th (and then Penny will lead a Birth Doula Trainer Training on May 18th–for more information on that, contact jeanette@mothersandcompany.com)!

Now’s the chance for people who live in Central MA, CT, NH, VT, NY to come to Central Massachusetts instead of trekking into Boston!  Hosted by Mothers & Company (MoCo), the workshop will take place in the very comfortable Cyprian Keyes Golf Club (also the current location of MoCo), in Boylston, MA.  This location is a quick 10 minute drive from Worcester, so the training will be listed on the DONA website as taking place in Worcester.  If you need a hotel nearby, contact Jeanette Mesite Frem at 617.686.0052 or jeanette@mothersandcompany.com for suggestions.  Please spread the word!!!!  And register early!  (And if you live nearby and are interested in hosting an attendee, please let me know.)

DONA Birth Doula Training
Trainers:  Penny Simkin and Carolyn Ogren
Dates:  May 16 & 17, 2009
Location:  Mothers & Company, 2nd floor of Cyprian Keyes Golf Club in Boylston (just outside of Worcester), MA
Fee:  $400, includes course materials, continental breakfast, healthy buffet lunch with vegetarian options and snacks.
See dona.org for prerequisites and requirements for certification.
NOTE:  one of the prerequisites for attending is to observe a 12-hour childbirth class.  Please call MoCo to find out whether it’s possible to observe on our our classes, or call local hospitals and/or childbirth educators.  IF you do not have the opportunity to attend a series before May 16th, contact Jeanette at jeanette@mothersandcompany.com to find out about a one-day Basics of Childbirth class she will be offering for an additional fee one or two weeks beforehand for just doula trainees.  This Basics class would be required if you haven’t observed a series beforehand, but would NOT fulfill your childbirth class observation requirement for certification.  If you live far away, however, contact me to talk to me about this issue.

Please forward this to your friends, clients, etc….and Penny would love to see more older women joining the program, too!  Tell grandmothers, aunts…

Thanks!

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Just wanted to share this great opinion piece by Author Jennifer Block–I’ve met her and read her excellent book!  And in this piece, she puts forth an interesting idea for turning this country around so that women and babies will be healthier before/during/after birth.

From the Los Angeles Times
Opinion
Midwives deliver
By Jennifer Block

December 24, 2008

Some healthcare trivia: In the United States, what is the No. 1 reason people are admitted to the hospital? Not diabetes, not heart attack, not stroke. The answer is something that isn’t even a disease: childbirth.

Not only is childbirth the most common reason for a hospital stay — more than 4 million American women give birth each year — it costs the country far more than any other health condition. Six of the 15 most frequent hospital procedures billed to private insurers and Medicaid are maternity-related. The nation’s maternity bill totaled $86 billion in 2006, nearly half of which was picked up by taxpayers.

But cost hasn’t translated into quality. We spend more than double per capita on childbirth than other industrialized countries, yet our rates of pre-term birth, newborn death and maternal death rank us dismally in comparison. Last month, the March of Dimes gave the country a “D” on its prematurity report card; California got a “C,” but 18 other states and the District of Columbia, where 15.9% of babies are born too early, failed entirely.

The U.S. ranks 41st among industrialized nations in maternal mortality. And there are unconscionable racial disparities: African American mothers are three times more likely to die in childbirth than white mothers.

In short, we are overspending and under-serving women and families. If the United States is serious about health reform, we need to begin, well, at the beginning.

The problem is not access to care; it is the care itself. As a new joint report by the Milbank Memorial Fund, the Reforming States Group and Childbirth Connection makes clear, American maternity wards are not following evidence-based best practices. They are inducing and speeding up far too many labors and reaching too quickly for the scalpel: Nearly one-third of births are now by caesarean section, more than twice what the World Health Organization has documented is a safe rate. In fact, the report found that the most common billable maternity procedures — continuous electronic fetal monitoring, for instance — have no clear benefit when used routinely.

The most cost-effective, health-promoting maternity care for normal, healthy women is midwife led and out of hospital. Hospitals charge from $7,000 to $16,000, depending on the type and complexity of the birth. The average birth-center fee is only $1,600 because high-tech medical intervention is rarely applied and stays are shorter. This model of care is not just cheaper; decades of medical research show that it’s better. Mother and baby are more likely to have a normal, vaginal birth; less likely to experience trauma, such as a bad vaginal tear or a surgical delivery; and more likely to breast feed. In other words, less is actually more.

The Obama administration could save the country billions by overhauling the American way of birth.

Consider Washington, where a state review of licensed midwives (just 100 in practice) found that they saved the state an estimated $2.7 million over two years. One reason for the savings is that midwives prevent costly caesarean surgeries: 11.9% of midwifery patients in Wash- ington ended up with C-sections, compared with 24% of low-risk women in traditional obstetric care.

Currently, just 1% of women nationwide get midwife-led care outside a hospital setting. Imagine the savings if that number jumped to 10% or even 30%. Imagine if hospitals started promoting best practices: giving women one-on-one, continuous support, promoting movement and water immersion for pain relief, and reducing the use of labor stimulants and labor induction. The C-section rate would plummet, as would related infections, hemorrhages, neonatal intensive care admissions and deaths. And the country could save some serious cash. The joint Milbank report conservatively estimates savings of $2.5 billion a year if the caesarean rate were brought down to 15%.

To be frank, the U.S. maternity care system needs to be turned upside down. Midwives should be caring for the majority of pregnant women, and physicians should continue to handle high-risk cases, complications and emergencies. This is the division of labor, so to speak, that you find in the countries that spend less but get more.

In those countries, a persistent public health concern is a midwife shortage. In the U.S., we don’t have similar regard for midwives or their model of care. Hospitals frequently shut down nurse-midwifery practices because they don’t bring in enough revenue. And although certified nurse midwives are eligible providers under federal Medicaid law and mandated for reimbursement, certified professional midwives — who are trained in out-of-hospital birth care — are not. In several state legislatures, they are fighting simply to be licensed, legal healthcare providers. (Californians are lucky — certified professional midwives are licensed, and Medi-Cal covers out-of-hospital birth.)

Barack Obama could be, among so many other firsts, the first birth-friendly president. How about a Midwife Corps to recruit and train the thousands of new midwives we’ll need? How about federal funding to create hundreds of new birth centers? How about an ad campaign to educate women about optimal birth?

America needs better birth care, and midwives can deliver it.

Jennifer Block is the author of “Pushed: The Painful Truth About Childbirth and Modern Maternity Care.”

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Best Practices in Maternity Care Not Widely Used in the United States

WASHINGTON (January 7, 2009)—Despite best evidence, health care providers continue to perform routine procedures during labor and birth that often are unnecessary and can have harmful results for mothers and babies. The Centers for Disease Control’s (CDC) most recent release of birth statistics reveals that the rate of cesarean surgery, for example, is on the rise to 31.1% of all births—50% greater than data from 1996. This information comes on the heels of The Milbank Report’s Evidence-Based Maternity Care, which confirms that beneficial, evidence-based maternity care practices are underused in the U.S. health care system.
Research indicates that routinely used procedures, such as continuous electronic fetal monitoring, labor induction for low-risk women and cesarean surgery, have not improved health outcomes for women and, in fact, can cause harm. In contrast, care practices that support a healthy labor and birth are unavailable to or underused with the majority of women in the United States.
Beneficial care practices outlined by Evidence-Based Maternity Care, a report produced by a collaboration of Childbirth Connection, the Reforming States Group and the Milbank Memorial Fund, could have a positive impact on the quality of maternity care if widely implemented throughout the United States. Suggested practices include to:
Let labor begin on its own.
Walk, move around, and change positions throughout labor.
Bring a loved one, friend, or doula to support you
Avoid interventions that are not medically necessary
Choose the most comfortable position to give birth and follow your body’s urges to push
Keep your baby with you – it’s best for you, your baby and breastfeeding.

“Lamaze is alarmed by the current rate of cesarean surgery, and furthermore, by the overall poor adherence to the beneficial practices outlined above in much of the maternity care systems in the United States,” says Lamaze International President Pam Spry, PhD, CNM, FACNM, LCCE. “We are continuing to work to provide women and care providers with evidence-based information to improve the quality of care.”
Lamaze International has developed six care practice papers that are supported by research studies and represent “gold-standard” maternity care. When adopted, these care practices have a profound effect—instilling confidence in the mother, and facilitating a natural process that results in an active, healthy baby. Each one of the Lamaze care practices is cited in theEvidence-Based Maternity Care report as being underused in the U.S. maternity care system.
Debra Bingham, MS, RN, DrPH(c), Chair of the Lamaze International Institute for Normal Birth says, “As with any drug, we need to be sure that women and their babies receive the right dose of medical in terventions. In the United States we are giving too high a dose of cesarean sections and other medical interventions which are causing harm to women and their babies. Yet there are many countries where life saving medical interventions are under dosed which can also cause harm. Every woman and her baby needs and deserves the right dose of medical interventions during childbirth.”
The research is clear, when medically necessary, interventions, such as cesarean surgery, can be lifesaving procedures for both mother and baby, and worth the risks involved. However, in recent years, the rate of cesarean surgeries cause more risks than benefits for mothers and babies. Cesarean surgery is a major abdominal surgery, and carries both short-term risks, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as percreta and accreta, which can lead to excessive bleeding, bladder injury, a hysterectomy, and maternal death. Cesarean surgery also increases harm to babies including women giving birth prior to full brain development, breathing problems, surgical injury and difficulties with breastfeeding.
For more information on the Six Care Practices that Support Normal Birth, finding a health care provider and how to give birth with confidence, visit www.lamaze.org.
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About Lamaze International
Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area networks, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers. For more information about Lamaze International and the Lamaze Institute for Normal Birth, visit www.lamaze.org.

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Here’s an interesting article that suggests that pushing your baby or toddler in a stroller that faces inward is better for their development and for parent-child interaction than facing away…this article was sent to us by a proud poppa and MoCo client, Jerome Anderson (thanks!).

Interesting to consider.  I’ve also heard the same about carrying babies in slings/front carriers, but haven’t yet seen a study on that (if anyone knows of one or more, please send!)

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Awww...mimicking Mommy
Awww…mimicking Mommy

If you’ve ever…

a) been curious about how exactly your breasts produce milk

b) wanted to help your friend or family member when she was struggling to breastfeed her newborn baby

c) considered becoming a lactation consultant and wondered how to start

d) considered becoming a doula or childbirth educator and want to get a day full of amazingly rich information on breastfeeding

…then attending a Basics of Breastfeeding workshop is for you!

The Boston Association for Childbirth Education’s Nursing Mothers Council is presenting

The Basics of Breastfeeding

February 7th, 8:30-4:30 at the Allen Riddle Building of Newton Wellesley Hospital

Speakers
Margi Coggins, CNM IBCLC: Anatomy and Physiology
Kathy Abbott,IBCLC: Skin-to-Skin and Baby-led Latch
Kate Reist, CNM,IBCLC: Medications and Breastmilk
Morgan Kennedy Henderson. IBCLC: Common Problems, Suggestions and When to Refer
Robin Snyder-Drummond, CCE CD(DONA) CLC: Postpartum Adjustment and Family Dynamics

This will be a very good overview and update for anyone who is beginning to work with expectant families, or already is involved with
new mothers and their babies. Postpartum and early breastfeeding is a very sensitive time. Having consistent and accurate information is
crucial for new families.

Contact BACE to register: http://www.bace-nmc.org or call 617-244-5102. You can register online at the website.  Please let BACE know you heard about it through MoCo, thanks.  And please tell any medical professionals that you know…it’s perfect for them, too!

$60 members $70 non-members.  Earn BACE credits. Lamaze CEU’s still pending (DONA accepts Lamaze).

Join MoCo Momma Jeanette and a few of the Associate Mommas and enjoy a day at this high-quality training, where you’ll have the chance to ask a lot of questions and take copious notes and be better prepared to help other women succeed at breastfeeding.  Note:  this training is NOT
a lactation consultant training nor does it qualify you to be a “breastfeeding counselor”, but it does provide you with the basic information to help women and know when and how to refer them to lactation consultants.  You’ll also learn how you can further your professional education to become a breastfeeding counselor and, if you are interested, a lactation consultant.

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