Search

Monthly Archives: December 2011

HAPPY NEW YEAR!!!

“Believe in yourself –in the power you have to control your own life, day by day…

Believe in the strength that you have deep inside, and your faith will help show you the way…

Believe in tomorrow and what it will bring — let a hopeful heart carry you through…

For things will work out if you Trust and Believe there’s no limit to what you can do!

The sky’s the limit, so have your happiest year yet!”

                                                                                ~unknown…but sent from Kenny

ALL OF THOSE VAGINAL EXAMS

The other day I posted the following quote on LinkedIn:

 

“You do not need a vaginal exam to have a baby. I am serious. They will still come out.”

                                                                               ~ Mama Birth     http://mamabirth.blogspot.com/

 

 

My new friend,  Jacqueline Levine  , Childbirth Educator/Lactation Consultant at Planned Parenthood, Greater New York City Area, contributed the following in response:

 

• There are some studies that show a link between routine weekly exams and an increase in ROM before labor was meant begin…meaning “PROM”, premature rupture of membranes. Sometimes the natural onset of labor was meant to be only a week or perhaps just days away, but everything was not quite ready. When things aren’t properly ready and labor doesn’t begin because rupture was provoked by the consequences of repeated routine exams, induction must follow, and when that fails as it often must…since the rupture was PREMATURE, right?…cesarean is the only outcome, since a Bishop score to assess cervical readiness at that point is moot. The toothpaste cannot go back into the tube.

Is it worth it to accede to weekly exams when they are weighed against the increased possibility of section? Mothers will ask “Well how do I tell them I don’t want an exam and not have those uncomfortable moments when my doc thinks I’m defying him/her and not letting him do what he always does…” That’s always the problem, but if we role-play with our clients and give them the studies, they often feel confident enough and protective of their health enough to say something like “Oh I just don’t want that exam today, so can we do it next week?” or they can say that they’ve researched this pregnancy very well, mention that there are studies, and ask how the exam will help their health. What will it tell the doc? It’s their right to know and to question, but confidence is the key. We have all been subtly bullied at one time or another by those in positions of authority.
s I believe that we must make an effort to give real meaning to a women’s right to choose (!). Since these exams are neither predictive nor probative, the doc must be able to say something really medically strong to counter the studies. They will often back down…

Here are just a few studies I found:
Relationship of ante partum pelvic examinations to premature rupture of the membranes. Lenahan, JP Jr. Journal Obstetrics Gynecology 1984, Jan:63(1):33-37. I quote from the abstract: “In the 174 patients on whom pelvic examinations were done weekly starting at 37 weeks gestation, the incidence of PROM was 18%, which was a significant increase (P=.001). The primary cesarean section rate was comparable in both groups with PROM; however, the overall primary cesarean rate when PROM occurred was found to be twice that of the remaining population. The study suggests that routine pelvic examinations may a significant contributing factor to the incidence of PROM . Women with uncomplicated pregnancies were randomly assigned to one of two groups. The author theorizes that the probing finger carries up and deposits on the cervix bacteria and acidic vaginal secretions capable of penetrating the mucous plug and causing sufficient low-grade inflammation or sub-clinical infection to rupture membranes. ‘It would therefore seem prudent to recommend that no pelvic examinations be done routinely in the third trimester unless a valid medical indication [sic] exists to examine the cervix … especially since the information gained from these routine examinations is often of little or no benefit to either the physician or the patient.’

Here are others: Histologic chorioamnionitis in pregnancies: implications in preterm rupture of membranes. Department of Obstetrics and Gynecology, Univ. of New Mexico School of Medicine, Albuquerque, and: Medscape Medical News Pelvic Exams Still Common Despite Lack of Scientific Support Arch Intern Med. 2011;171:2053-2054.

Again, women should be able to weigh the risks of routine exams against the possibility of that cascade of interventions that follow on with PROM, interventions that will, at the least, lead to an uncomfortable and harder-to-mange induction and at worst, put our clients on the gurney ride into the operating theatre.

Many thanks to Mama Birth and Jackie !!!

Merry Christmas!!!

Merry Christmas to all of our friends…friends of many years, newly met friends, and those we have yet to know!!! Have a wonderful time on this special day and in the new year that follows!!!

 

  Kenny & Ty

 

 

KNOW YOUR RIGHTS

I just read a very disturbing birth story on FaceBook. It was about how a woman was treated at the hospital.

Unfortunately, this can happen…IF YOU ALLOW IT TO HAPPEN!

Know what your rights are!!

The Rights of Childbearing Women

Taken from ChildbirthConnection.org/rights

* At this time in the United States, childbearing women are legally entitled to those rights.
** The legal system would probably uphold those rights.

1. Every woman has the right to health care before, during and after pregnancy and childbirth.
2. Every woman and infant has the right to receive care that is consistent with current scientific evidence about benefits and risks.* Practices that have been found to be safe and beneficial should be used when indicated. Harmful, ineffective or unnecessary practices should be avoided. Unproven interventions should be used only in the context of research to evaluate their effects.
3. Every woman has the right to choose a midwife or a physician as her maternity care provider. Both caregivers skilled in normal childbearing and caregivers skilled in complications are needed to ensure quality care for all.
4. Every woman has the right to choose her birth setting from the full range of safe options available in her community, on the basis of complete, objective information about benefits, risks and costs of these options.*
5. Every woman has the right to receive all or most of her maternity care from a single caregiver or a small group of caregivers, with whom she can establish a relationship. Every woman has the right to leave her maternity caregiver and select another if she becomes dissatisfied with her care.* (Only second sentence is a legal right.)
6. Every woman has the right to information about the professional identity and qualifications of those involved with her care, and to know when those involved are trainees.*
7. Every woman has the right to communicate with caregivers and receive all care in privacy, which may involve excluding nonessential personnel. She also has the right to have all personal information treated according to standards of confidentiality.*
8.Every woman has the right to receive maternity care that identifies and addresses social and behavioral factors that affect her health and that of her baby.** She should receive information to help her take the best care of herself and her baby and have access to social services and behavioral change programs that could contribute to their health.
9. Every woman has the right to full and clear information about benefits, risks and costs of the procedures, drugs, tests and treatments offered to her, and of all other reasonable options, including no intervention.* She should receive this information about all interventions that are likely to be offered during labor and birth well before the onset of labor.
10. Every woman has the right to accept or refuse procedures, drugs, tests and treatments, and to have her choices honored. She has the right to change her mind.* (Please note that this established legal right has been challenged in a number of recent cases.)
11. Every woman has the right to be informed if her caregivers wish to enroll her or her infant in a research study. She should receive full information about all known and possible benefits and risks of participation; and she has the right to decide whether to participate, free from coercion and without negative consequences.*
12. Every woman has the right to unrestricted access to all available records about her pregnancy, labor, birth, postpartum care and infant; to obtain a full copy of these records; and to receive help in understanding them, if necessary.*
13. Every woman has the right to receive maternity care that is appropriate to her cultural and religious background, and to receive information in a language in which she can communicate.*
14.Every woman has the right to have family members and friends of her choice present during all aspects of her maternity care.**
15.Every woman has the right to receive continuous social, emotional and physical support during labor and birth from a caregiver who has been trained in labor support.**
16.Every woman has the right to receive full advance information about risks and benefits of all reasonably available methods for relieving pain during labor and birth, including methods that do not require the use of drugs. She has the right to choose which methods will be used and to change her mind at any time.*
17.Every woman has the right to freedom of movement during labor, unencumbered by tubes, wires or other apparatus. She also has the right to give birth in the position of her choice.*
18. Every woman has the right to virtually uninterrupted contact with her newborn from the moment of birth, as long as she and her baby are healthy and do not need care that requires separation.**
19. Every woman has the right to receive complete information about the benefits of breastfeeding well in advance of labor, to refuse supplemental bottles and other actions that interfere with breastfeeding, and to have access to skilled lactation support for as long as she chooses to breastfeed.**
20. Every woman has the right to decide collaboratively with caregivers when she and her baby will leave the birth site for home, based on their conditions and circumstances.**

Please see original article for all credits and references: ChildbirthConnection.org/rights

 

 

 

When Is It Time To Go To The Hospital?

A very common, and understandable, question…”When should I go to the hospital?”

I have heard some doctors say when contractions are every 5 minutes. I have also heard the 4-1-1 or 3-1-1 guideline. This means contractions are coming every four (or three) minutes, lasting one minute , for one hour.  And then some doctors have said go anytime…if you are not in labor, they will send you back home.

The best answer I have heard is one a midwife gave…”When home no longer feels like home.” I might add,  listen to your body and do what your instinct tells you to do. And if you are sent home, there is no shame attached!

These are three of my favorite doulas, “60 Second Doulas”. Click on the title above and listen to what they have to say…..

[youtube]http://youtu.be/x2HlkxwBWh8[/youtube]

Stations of Presentation

My clients often hear me asking about the baby’s station.

This is a very well done video that demonstrates the stations and the movement of the baby through mommy’s body.

Click on the above title, turn on your speakers, and enjoy!!!!


[youtube]http://youtu.be/ze53Ep-gwBQ[/youtube]