Sweet Pea Births

Chandler, Arizona

Sweet Pea Births

...celebrating every swee​t pea their birth

Blog

Q&A with SPB: Midwifery Care

Posted on May 5, 2015 at 7:49 PM Comments comments (264)
Happy International Day of the Midwife to the midwives of the world.

Facebook image - source: KNOW YOUR MIDWIFE

We are so blessed with so many amazing midwives in our birth community.  Here is a little more about why Sweet Pea Births advocates for midwifery care to be an available option to all birthing families:










~~~
Here is a little more about the different ways a health practioner can certify to become a midwife - excerpt from THIS article:

There are two types of midwife in the United States:
**Nurse-midwives are educated and licensed as nurses first, and then complete additional education in midwifery. They are known as Certified Nurse-Midwives (CNMs). CNMs are licensed to practice in all 50 states. They are usually licensed in individual states as Nurse Practitioners (NPs).
**Direct-entry midwives are educated or trained as midwives without having to become nurses first. They may be Certified Professional Midwives (CPMs) or Certified Midwives (CMs). The legal status and requirements for direct-entry (non-nurse) midwives vary from state. They are usually licensed in individual states as Licensed Midwives (LMs) or Registered Midwives (RMs). The Midwives Alliance of North America tracks the laws and regulations in each state for direct-entry midwives.

For a good explanation of the way a midwife is different from a doula read this excerpt from the bump:
"A midwife is…a health care provider and a doula is more of a childbirth coach. You might choose to have a midwife instead of an OB for prenatal care and to deliver your baby — midwives can deliver babies in hospitals, birthing centers or even in your home. A doula, on the other hand, doesn’t replace your healthcare practitioner but rather can add extra services, such as helping you with techniques to manage pain during labor and even providing support and help during baby’s early days." 

A midwife's main scope of practice is the health and well-being of the Mother and the Baby.  She is doing "watchful waiting" through the pregnancy and birth, ensuring that everything is proceeding and staying healthy and low-risk.  If things start to vary or complications develop, depending on the midwife and whether they are home- or hospital-based, they may encourage the family to seek co-care or transfer care to an obstetrician who is trained to manage pregnancy that is moving away from low-risk.  

In the Phoenix, Arizona area, home birth families have the choice of doing co-care with Certified Nurse Midwives in the hospital setting, and still maintaining the midwifery model of care.  This allows for families to continue with "watchful waiting" and preserve their autonomy as consumers of healthcare.

Why hire a midwife?
The first study to compare birth outcomes between midwifery and obstetrical care was published in 1998.  Here are the conclusions:

"After controlling for a wide variety of social and medical risk factors, the risk of experiencing an infant death was 19 percent lower for births attended by certified nurse midwives than for births attended by physicians. The risk of neonatal mortality (an infant death occurring in the first 28 days of life) was 33 percent lower, and the risk of delivering a low birthweight infant was 31 percent lower. Mean birthweight was 37 grams heavier for the certified nurse midwife attended than for the physician attended births. Low birthweight is a major predictor of infant mortality, subsequent disease, or developmental disabilities.

Certified nurse midwives attended a greater proportion of women who are at higher risk for poor birth outcome: African Americans, American Indians, teenagers, unmarried women, and those with less than a high school education. Physicians attended a slightly higher proportion of births with medical complications. However, birth outcomes for certified nurse midwives were better even after sociodemographic and medical risk factors were controlled for in statistical analyses."

Excerpt from http://www.cdc.gov/nchs/pressroom/98news/midwife.htm

For the study abstract, click HERE
To read the study, click HERE

Is homebirth safe?
There are several studies that have been conducted around the world that show midwifery is safe - find a reference list HERE.  The big question remained: would outcomes be comparable in the US, where we do not practice socialized medicine?

The MANA study found that:
"Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively."
~Excerpt from THIS article




Are you curious about midwifery care??
Here are some posts where we share our birth journey with midwives:

Midwives Make a House Call - Third Trimester

Preparing for our Homebirth - Third Trimester







Link List
1998 Midwifery Study
http://www.cdc.gov/nchs/pressroom/98news/midwife.htm
http://jech.bmj.com/content/52/5/310.abstract?sid=52c15f2a-a71c-45d5-a827-c403cb953fa1
http://jech.bmj.com/content/52/5/310.full.pdf+html?sid=52c15f2a-a71c-45d5-a827-c403cb953fa1

MANA Homebirth Study
http://mana.org/blog/home-birth-safety-outcomes

Homebirth Studies Reference Page
http://mana.org/research/section-a-best-available-studies-grouped-by-design-level-of-evidence

Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
The material included in this blog and video is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog and video contain information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained in this video and on our blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.
 


The Family-Centered Cesarean

Posted on April 30, 2015 at 9:40 AM Comments comments (4)
For today...another one from the archives, originally published in April 9, 2013.  Updated April 30, 2014 to include information about microbiome seeding; and a gentle cesarean checklist of options to review with your provider and prepare for a cesarean birth journey.

A "Family-Centered" cesarean?  A "gentle" cesarean?  A procedure that is Woman and MotherBaby-centered?  What?  Did you just read that correctly?  

Yes, you did.  There is a "new" trend in cesareans that is hitting the mainstream consciousness here in the United States.

While a lot of the focus during Cesarean Awareness Month tends to center on Vaginal Birth After Cesarean (VBAC), I also want to acknowledge that a VBAC is not the choice that all mothers want to make.  Here is an option for mothers who know they want, or are considering, a repeat cesaran birth.  It is also an option if a healthy, low-risk labor starts to change it's course and there is time for non-emergent cesarean.

I have linked to THIS post about a "natural" cesaran more than once in previous posts, and today I want to be a little more specific about what a "natural" cesarean is and why a family might opt for this.

To quote the article:
"The natural cesarean, or family centered cesarean, is a procedure developed in the UK which takes a “woman centered” approach to the surgery that now accounts for one third of all births in America, a cesarean. This approach to a c-section incorporates many important aspects of a vaginal birth, parent participation for one."

A family-centered, or natural cesarean strives to capture these components of a vaginal birth:

  • Mother watches the birth of her child by having the surgical screen lowered at the time of delivery
  • Baby is delivered slowly so that they can get some benefit from uterine contractions to clear fluid from the lungs and nasal passages
  • Immediate skin-to-skin contact between mother and baby
  • Delayed cord clamping
  • Breastfeeding soon after birth
  • Continuous contact between mother and baby
  • "Seeding" of the mother's microbiome - read more about that HERE and HERE.

The idea of "seeding the microbiome" is a new concept.  Here is a quote from THIS article:
There is a difference between the microbiome of a baby born vaginally compared to a baby born by c-section (Azad, et al. 2013Penders et al. 2006Prince et al. 2014). During a vaginal birth the baby is colonised by maternal vaginal and faecal bacteria. Initial human bacterial colonies resemble the maternal vaginal microbiota – predominately Lactobacillus, Prevotella and Sneathia. A baby born by c-section is colonised by the bacteria in the hospital environment and maternal skin – predominately Staphylocci and C difficile. They also have significantly lower levels of Bifidobacterium and lower bacterial diversity than vaginally born babies. These differences in the microbiome ‘seeding’ may be the reason for the long-term increased risk of particular diseases for babies born by c-section.
~Rachel Reed, Midwife Thinking

And one from THIS article:
  • In the event of a c-section, be proactive. Mamas, we know this recommendation is not without its “icky-factor," but WOW it makes perfect sense when you think about it, and some believe it will be a standard recommendation in the future. Here goes: if your baby is born via c-section, consider taking a swab of your vaginal secretions and rubbing it on your baby’s skin and in her/his mouth. I know, ick. But when babies traverse the birth canal, they are coated in and swallowing those secretions/bacteria in a health-promoting way, so all you’re doing is mimicking that exposure. Don’t be afraid to ask your midwife or OB to help you collect the vaginal swabs—or do it yourself, if you’re comfortable. You have all the available evidence on your side.
    ~Michelle Bennet, MD, mamaseeds blog

So while your initial reaction might be one of surprise and disgust, think about it.  Please take a minute to read both of the excerpted articles and have a discussion with your partner and your care provider before you make up your mind one way or another.

Here are some of the benefits that are causing mothers to request this kind of cesarean option:
  • Less traumatic birth experience
  • Moms get to *see the birth* of their baby
  • Greater sense of satisfaction in regards to their birth
  • Establishment of the MotherBaby dyad immediately after the birth
  • Better breastfeeding outcomes
  • Someone who had an emergency cesarean with a previous child and does not feel comfortable with anything other than a repeat cesarean
  • A family with a known complication who wants to allow labor to start on the day of baby's choosing, but knows they will have a cesarean delivery
  • A family who planned a natural birth and had their course of labor  change before they were in an emergent situation

If you would like to have a conversation with your care provider about planning for a gentle cesaean as your birth plan or "just in case" plan, HERE is a list of options for you to discuss with them, provided by ICAN of Phoenix chapter leader Jenni Froment.  

I also want to mention: these are evidence-based recommendations.  If your care provider scoffs at you and laughs you out of the room, thank them very much for their time and go have a conversation with another provider in your area.  Your local ICAN chapter or ICAN international are great resources for respectful, family-centered providers.

What do you think?
Please leave us a comment - it will be moderated and posted.  *I think* that the amount of traffic you so generously generate has led to a lot of spam posting.  In an effort to keep the spam to a minimum, I am taking the time to moderate comments now.   

Link List:
http://www.youtube.com/watch?v=m5RIcaK98Yg

ARTICLES
ICAN
http://blog.ican-online.org/2012/04/14/the-family-centered-cesarean/

MIDWIFE THINKING
http://midwifethinking.com/2014/01/15/the-human-microbiome-considerations-for-pregnancy-birth-and-early-mothering/

MAMASEEDS
http://mamaseeds.com/blog/antibiotics/how-seed-your-baby-healthy-microbiome-last-lifetime/

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.



Q&A with SPB: Healthy Pregnancy How-to

Posted on March 17, 2015 at 4:31 AM Comments comments (0)
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
Today's VLOG is all about the things that you *can* control in the very unplannable process of pregnancy, labor, birth and the childbearing year.











LINKS

What can you control?
1. Pay attention to your nutrition
This is just as important for the father as it is for the mother.  A better diet creates higher quality sperm, and a well-nourished mother can feed her growing embryo-fetus-baby as it develops from zygote stage through pregnancy.  A breastfeeding mother is also growing her infant's brain - mindful nutrition is just as important after the Birth-Day.

HERE is the pregnancy nutrition program that we teach in The Bradley Method®.

2. Engage in an exercise program
Your ability to give birth does not hinge on whether or not you are an exercise fanatic before you conceive.  A mother who wants to prepare her belly, back and bottom to give birth can follow a pregnancy-specific exercise program. Even doing a few minutes a day of this low-impact, low-stress program can be a game-changer for mamas and their overall strength as they go into their labor.  


 
What can you influence?
1. Your experience
You have the responsibility to choose the right care provider and the right birth setting for you.  If you have a nagging feeling that persists, or if you see/hear/feel red flags at your prenatal appointments that your provider is not right for you, GO WITH IT.  Believe in yourself and your instinct.  Ask people you respect and who felt supported in their births who they chose and why...and then, maybe take a risk! Go on some interviews to see if maybe you want to make a switch.

2. Relaxation and Pain Coping
We do not know what kind of labor card you are going to draw.  What we do know is that all labors and births can benefit from mindfulness.  Whether you have a natural birth, a cesarean birth, or anything in between, there is a surrender.  There is a point when you will have to dig deep and say YES to the journey that you are on. 

There are many ways to prepare for your journey - HERE is an info sheet that explores the variety of classes available to birthing families.

What is part of the journey?
The rest of your story is entirely up to your baby, your body, and The Fates.  A story is about to unfold - and what a story it will be.  However you birth, that day is one day in the rest of your lives as a family.  Be open to the experience, look for the joys, and also watch for the surprises.  

It is in the unexpected and the trials that growth and transformation happen...a transformation that is necessary as we experience a rite of passage.  Before children, you are you.  After they are in your lives, you are now Mother, Father, or which ever name you choose for yourself.

I wish you a childbearing year that surprises you, grows you, and leads you to discover more about yourself than you knew when you started.



Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.




Q&A with SPB: Changing Locations During Labor

Posted on February 10, 2015 at 3:15 PM Comments comments (175)
I taped my first vlog this morning!!

When to go to the birthplace is a common question we get from our students, who are still primarily choosing to birth in a hospital setting. This information is also applicable if you are transferring to a birth center or having a non-emergent homebirth transfer.

A non-emergent transfer is the most common type of transfer when it happens in a homebirth setting.  The midwife and patient decide together that the family wants a different kind of observation if they feel things might be shifting away from healthy and low-risk.  

So, with that being said, here is today's Q&A:


























Do you prefer to read about it?  Check out these blog posts from our archive:

Kudos and thanks to Jen McClellan at Plus Size Birth whose message to "Capture Motherhood" has inspired me to be okay in front of the camera again.  This adventure into "vlogging" would not have been possible without her support and encouragement <3

What tips would you share with a family who wants more information about making the trip from home to their birth place?


Disclaimer:  
The material included in this blog and video is for informational purposes only.  It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog and video contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained in this video do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

Suggestions for an effective labor rehearsal

Posted on July 25, 2014 at 11:45 AM Comments comments (2)
Originally published February 2011 ~ Updated July 25, 2014

The class topic last night was first stage labor.  This stage is characterized by a progressive intensification of the sensations in labor.  A mom will experience her contractions, or her “surges”, getting increasingly stronger and longer with less time between them, as she gets closer to the pushing phase of her labor.

Why do a "labor rehearsal" when labor is so unpredictable?? Mostly to train you and your partner into some "muscle memory".  By practicing different positions and reminding yourself when/why they are effective, that body of knowledge is more readily accessed when you are in labor.  Even if you forget your "playbook", you have some tools that you can use without referring back to a print-out of labor positions. (Although, HERE is one that I share with students.  I used it to prepare for our births and often use it as a reference in our classes.)
 
We had our couples do an active labor rehearsal.  As a reminder to them, and as a practice tool for anyone reading this who is striving for a natural labor, here are our tips on having a good labor rehearsal.

 
1. Have a good guide at your fingertips.

The Bradley Method® class first stage labor rehearsal - classes convenient to Chandler, Tempe, Ahwatukee, Mesa, Gilbert, Scottsdale and Payson ArizonaWe have the advantage of a student workbook with illustrations to follow.  There are also resources out on the Internet with ideas for different positions to open the inlet of the pelvis to make room for baby.  The key is to try all the different positions.  Try to practice at least two simulated contractions every day, and you will find that you will have put your body in the different positions before you start labor. 

This is important for the following reasons: You will know if you can do them – if it hurts, maybe it’s time to do more stretching, or find other positions that have similar benefits without being uncomfortable.  You can also start making a list of the ones that feel really good, keeping in mind that this list may change as you are progressing through labor.
 

2.  Once you are in a position, don’t change it or move around during a contraction.

The Bradley Method® class first stage labor rehearsal - classes convenient to Chandler, Tempe, Ahwatukee, Mesa, Gilbert, Scottsdale and Payson ArizonaAgain, the key is to simulate labor.  Once mom starts having stronger surges, she will be physically unwilling or unable to move while she is having a contraction.  So train your muscle memory the right way from the beginning. 

That’s not to say that you will stick to one position during the course of your labor.  It’s likely that there are several positions that you will try, and you may eventually gravitate to a few that seem to be the most effective.
 
3.  If mom has to go to the bathroom, someone needs to go with her.
In actual labor, a coach or one of the assistant coaches must always stay with mom.  She is in a vulnerable time, PLEASE stay by her side.  If mom is not comfortable having you in the bathroom, getting over the emotional hurdle will be better dealt with outside of labor.  It sounds weird, maybe?  It is possible that emotional barriers can keep labor from progressing.  Who would want bathroom issues to extend the amount of time you are having contractions?  Another thought: why delay meeting your baby?
                      
This is what we personally experienced: if you leave mom alone, she may fall – this could drastically alter the course of your labor.  Additionally, there is no guaranteed labor pattern – just because you have been having surges 5 minutes apart and you think she has five minutes before her next contraction doesn’t mean she should “go” alone.  If she starts having contractions on the commode, she isn’t going to be able to move.  It is possible, since the bladder is emptied, that the contractions will feel stronger after she has voided since it has made room for baby to descend, and she will want your help handling the stronger sensations.  From our own personal experience, I know we hit “transition” in the bathroom in 2 of our 3 labors.  It was a good thing to have someone with me to help me manage the mental gearshift and the sensations.

4.  Coaches need to practice multi-tasking with every simulated contraction.

The Bradley Method® class first stage labor rehearsal - classes convenient to Chandler, Tempe, Ahwatukee, Mesa, Gilbert, Scottsdale and Payson Arizona
Coaches, you have a good job during labor.  You are the person that can make all the difference in mom’s confidence in herself and her ability to birth.  Prepare by working out your “athlete” at home and learning how to be the best coach for your team well before labor starts. 

Regarding such things as touch, music and environment: do you know her likes? Dislikes?  Do you know which relaxation techniques work for her?  Can you massage, talk, and time her contractions simultaneously? 

If you answered no to any of these questions, then we encourage you to start finding the answers!  And practice until you are doing several things at once without having to think too much about what you need to be doing to keep your partner completely relaxed through her labor.
 
5.  Watch mom’s key tension indicators.
The three main areas where mom will hold tension are her face (especially the jaw and brow areas), her hands and her feet.  Can you do the checkpoints in #4 and observe her for relaxation, too?  Most coaches need lots of help learning to do all these things at the same time.  You can find an assistant coach who is there to help support coach as he strives to do all these things.  Or, the assistant can help the coach to get mom as relaxed as possible so her body can get down to the business of having the baby.  The more efficient her labor, the sooner you will all be holding your baby in your arms.
 
The Bradley Method® class first stage labor rehearsal - classes convenient to Chandler, Tempe, Ahwatukee, Mesa, Gilbert, Scottsdale and Payson ArizonaA key thought is PRACTICE MAKES PREPARED.  As in all things where we seek to succeed, good practice leads to better results versus going in without any prior mental or physical preparation.  As labor has mental, physical and emotional aspects, we really encourage our students to allocate time every day to train their muscles and minds for the challenge of labor.
 
Some other tidbits from class:
TRANSITION
No first stage labor rehearsal in class is complete without a discussion about "transition", the time between the active stage and the pushing stage of labor.  Although it might be an emotional time, transition is a good thing – it means your labor is almost over. 

Question directed at Bruss: Which one of your labors had the worst transition?
Answer:  There was not really a worst. You need to look for signs and prepare yourself ahead of time, prepare yourself now. Since transition occurs at the end of labor and you are caught up with the whole process of labor, know what to look for.  There will be distinct signs and they are different for everybody.  In our case, Krystyna got really abrupt.  Up to that point, she would communicate with “this feels”…or, “please try”… transition was marked with, “I told you not to do that!”
 
I also reminded our class of a birth story they had heard where the couple’s only sign was a physical sign: mom started burping out of the blue, and it lasted a little while.  When she calmly announced, “I think I have to push”, it turns out she really and truly was ready without having the self-doubt or the pendulum swing of emotions.  (For the whole story, go to http://www.youtube.com/watch?v=fDI61YWV5G0 )
 
HOSPITAL CARE
We were lucky enough to have two nurses join our class last night.  They were attending as assistant coaches-in-training for one of our moms.  I took advantage of the situation to ask the nurses who makes the best patient.  My goal was to illustrate the point that you are the labor you bring with you, especially in a hospital situation.  We encourage our students to write a birth plan to use as a communication tool, and to use positive communication (important at all birth venues).  The idea is that you are all on the same team and you wouldn’t be there if you didn’t feel some element of safety in the hospital.  As long as labor is progressing without complications, a couple is reasonable in their requests, and the care provider has signed off on the birth plan, it should not be difficult to have the hospital staff support your choice to have a natural labor.

Question:  Who makes the best patients, or who are the patients that are the easiest to work with?
Answer:  They are willing to work with patients who want to work with them.  They also appreciate patients who respect their medical training.  When it comes to requests, i.e. birth plans; patients who are nice get their way!
 
PRACTICE MAKES PREPARED
I want to encourage you to make the effort to practice what you want to happen on your baby’s birth-day.  We encourage our couples to do ten minutes in the morning before they get started on their day, and right before bed at night.  What better way to help mom feel safe, secure and stress-free?  She can go about her day knowing that she and baby are important enough to merit the time.  At night, she will sleep better after a good relaxation session.

We can attest to the fact that yes, it is hard to find the time.  In reality, you don’t find time – you have to make the time available.  It is worth it – even if you end up with interventions, the fact that you gave it your best effort makes for a labor that you can look back on with an element of pride.  The natural labor and birth you want is a reality – and the more you practice, the more likely you are to achieve the birth story you want for your family. 

There is another element to a successful labor beside preparation – and that is a well-rested team – and that is a post for another day.  Happy Practicing!!
 
 
Disclaimer:
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

 

It's Not A Plan, It's A Journey

Posted on January 28, 2014 at 7:09 PM Comments comments (102)
It feels so cliché to say, “the journey” these days – the words have been overused and applied to just about everything from meaningful life events to car commercials.

When it comes to your child’s birth, those words are just about right.  Some of us travel a long road through fertility hurdles to achieve pregnancy, then there is the journey through the trimesters and different milestones of pregnancy, and finally, the act of birthing that leads you down to the new path of parenthood.

Our current class has just started working on their birth plans.  When we teach that class, we give them a long list of options to consider, and talk about what they are and what their choices around those items might be.

Then we tell them to do their homework and that in actual labor, they will need to be flexible.  At the end of the day, the birth plan is not a blueprint.  It is an outline of the wishes you want for your birth if things stay healthy and low-risk from start to finish.

Our experience after the birth of our four children, and as instructors, has taught us that the real importance of writing a birth plan is the process: you and your partner sitting down to learn about your options in birth.  Whether you are birthing at home, a birth center or a hospital, we always recommend Henci Goer’s Thinking Woman’s Guide to a Better Birth.  She very clearly defines interventions, offers the pros and the cons, and shares the research to back up her position.

We encourage both parents to be involved.  Coaches, this is not one of the details to leave to Mama.  If she writes it alone, and you have no idea why she prioritized things the way she did, then how on earth can you make a decision about your child’s birth if and when she gets to a place where she will not or cannot speak up for herself anymore?  It is vitally important for both parents to know the priorities in birth for those times when decisions need to be made and Mama needs a voice to advocate for her and for Sweet Pea.

Write your birth plan, and consider it as a work in progress.  You will have a discussion (or two or three) with your care provider to get their input on what is realistic given your birth space and your care team.  Once it’s representative of what you want and what your care team can provide, print several copies and keep at least one in the vehicles you drive.  You can read in more detail about birth plans HERE

Then do everything you can to control the things you can control about pregnancy and birth.  I outlined them in yesterday’s post.  In a nutshell, they are eat well, exercise, education about pregnancy, birth and normality in birth, avoid harmful substances, and practice relaxation every day.  You will learn all about those things in a Bradley™ class.  Realistically, The Bradley Method® is not for everyone.  Whichever childbirth preparation method you use, seek training in all of those areas to keep your pregnancy as healthy and low-risk as possible.

You do everything right.  You arrive at your Birth-Day.  The unexpected happens and your birth includes several interventions, maybe even a cesarean birth.  Did you just fail your Bradley™ or other childbirth class?

NO.

Your stellar nutrition built a strong, healthy baby.  It has made you a stronger mama.  As I heard in my Bradley Method® training from an obstetrician: the physical trauma of a cesarean is equivalent to a fatal car crash.  The only reason cesareans are not fatal is because trained surgeons in a sterile operating theatre perform them, and all precautions are taken to deliver a healthy mom and a healthy baby out of the operating room.* Your good nutrition makes it possible to withstand and recover from the physical trauma: whether it’s flushing drugs out of your system and/or surgery. Your body and immune system are much better equipped than someone who paid no attention to nutrition in pregnancy.

Your exercise regimen will also improve your physical profile.  This physical strength will also be an asset if you are recovering from interventions and/or the trauma of surgery.

Your education about natural childbirth will fill your toolbox with information to use as you labor.  Your education about normalcy in birth will help you identify when things have started to change out of healthy and low risk, and give you the tools to make an informed consent decision after having a dialogue with your care provider.  I am happy to say that very few, if any, of our students feel like their interventions happened “to” them.  They agreed to interventions or surgery after exhausting all their tools, all their questions, and coming to the shared decision that their Sweet Pea’s birth story was meant to be that way for the best Healthy Mom, Healthy Baby outcome.

Your avoidance of harmful substances means that your baby is having the healthiest start possible.  That is a gift you can celebrate no matter how they enter the world.

Your daily practice of relaxation is a great habit that will serve you well into parenthood.  Finding stillness may help ease your remorse about the variations in your birth.  They are great tools to use and fall asleep when your baby is sleeping: really, do it! Everything else can wait while you bond with your baby and catch some rest between marathon nursing sessions as they grow in their first month.  As your children age and start to explore their boundaries, deep breathing and calmness are phenomenal tools to have at your disposal – trust me on that one!!

However your birth story goes, remember and treasure all the things that went well.  These are the things that your birth plan cannot capture.   
  • Did you and your partner labor well up to the point your wish list deviated? 
  • Did you get to preserve some elements of your natural birth: low lights, immediate skin-to-skin, breastfeeding soon after birth? 
  • Did your child benefit from delayed cord-clamping? 
  • What did your Sweet Pea look like – smell like – feel like? 
  • When did your eyes lock in instant recognition? 
  • How did it feel to kiss this amazing creation of love and miracles? 
  • When did you and your partner share a kiss of joy as you welcomed your newest family member?

Remember that The Birth Plan is not set in stone.  It is a piece of paper that outlines your wishes after your long journey through conception, pregnancy and labor.  You cannot capture all the wishes, hopes and dreams on one side of 8.5x11 inches of paper.  You can record what you want to happen as long as your labor and delivery stay healthy and low risk. 

The rest of the journey is up to you.  We hope it will be an empowered, deliberate journey to the Healthy Mom, Healthy Baby birth of your Sweet Pea.

*The risk of complications for pregnancy and surgery increases with each cesarean.  If you had a cesarean, we encourage you to seek education about the possibility of a VBAC.  ICAN is a great place to start.

Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson

Upcoming Events: August 12 to 16, 2013

Posted on August 11, 2013 at 7:49 AM Comments comments (163)
Looking for something to do with your family this week?  Cassandra and I are posting events and classes in our respective geographic areas…look for us…maybe we will see you there!!

Do you have an event that you would like to add to our upcoming events calendar?  Scroll down to the end of this post for more information.

Disclaimer:  A listing here does not imply nor signify endorsement by Sweet Pea Births, or our families.

These are events for expecting families, and families with newborns to 6 months old.  There are some great get-out-of-the-house opportunities for work-at-home mamas.  For more family - toddler fun, visit our listing at Sweet Pea Families.

MONDAY, AUGUST 12, 2013
Where are you going to be today?  Let us know and offer us some ideas for next week :)

TUESDAY, AUGUST 13, 2013
La Leche League – Tempe  
LLL is an international, nonprofit, nonsectarian organization dedicated to providing education, information, support, and encouragement to women who want to breastfeed. All women, especially pregnant and nursing mothers, are welcome to attend our meetings. For more info and the full meeting notice please visit: http://www.lllofaz.org/
Desert Cross Lutheran Church @ 9:30 am
8600 S McClintock Dr. (Just north of Warner Rd)
Tempe, AZ

Smart Play: Newborns (birth to 4 months old)
Who knew there was actually a science to the most beneficial techniques to use when interacting with your baby to help their brain develop? In this class, participants will learn how play affects their child’s lifelong brain development, what toys/activities are best for their child at this age, and how to look at a toy and instantly see its developmental benefits. Babies welcome and encouraged!  These are some of the techniques Brie shared on Channel 3’s “Your Life A to Z” on her June 27th appearance!  Class costs $10 per person or $12 per couple.  To register for this class, call 480-299-1154 or visit www.babybasics4u.com
Baby Town  @ 9:30am-10:30am
3787 S. Gilbert Rd.  
Gilbert, AZ
480-299-1154

Smart Play: Babies (4-6 months old)  
Who knew there was actually a science to the most beneficial techniques to use when interacting with your baby to help their brain develop? In this class, participants will learn how play affects their child’s lifelong brain development, what toys/activities are best for their child at this age, and how to look at a toy and instantly see its developmental benefits. Babies welcome and encouraged!  These are some of the techniques Brie shared on Channel 3’s “Your Life A to Z” on her June 27 appearance!  Class costs $10 per person or $12 per couple.  To register for this class, call 480-299-1154 or visit www.babybasics4u.com
Baby Town  @ 11:00 am – 12:00 pm
3787 S. Gilbert Rd.  
Gilbert, AZ
480-299-1154 

Pottery Barn Kids Story Time
Kids of all ages are invited to story time every Tuesday at 11:00 am.  Members receive an official book club passport at their first story time, plus a special gift after attending five story times.  To locate a store near you, click HERE http://www.potterybarnkids.com/customer-service/store-locator.html
Store Near You @ 11:00 – 11:30 am
Chandler Fashion Center
3111 West Chandler Blvd
Chandler, AZ 85226
(480) 899-7155
Scottsdale Fashion Square
7014 e. Camelback Road
Scottsdale , AZ 85251
(480) 423-3813

Homebirth Circle 
Come join the beautiful space and share thoughts about life, babies and love.  The circle is open to any adult and lap babies only.  Feel free to bring a healthy snack to share.
Freedom and The Seed Office @ 12:00 pm – 2:00 pm
123 Baseline Rd, Suite 205
Tempe, AZ  
480-528-1689

Fish Feeding
Come see an 18,500 gallon freshwater aquarium that offers an up-close view of trophy-sized catfish, bass, striper and blue gill.  Feeding includes an informative presentation about the fish.  Saturdays and Sundays at 2:00pm and Tuesdays at 6:00pm.  Also, every day kids can help us feed the trout in our Trout Stream at 1:30pm.
Bass Pro Shop Trout Stream @ 1:30 pm
Bass Pro Shop Aquarium @ 6:00 pm
1133 N Dobson Rd
Mesa 85201
602-606-5600

WEDNESDAY, AUGUST 14, 2013
Blossoming Moms Breastfeeding and Postpartum Support
Pregnant moms are welcome too! 
Facilitator: Michelle Hottya 818-606-5687
Blossom Birth and Wellness Center @ 11:00 am
2928 N 16th Place
Phoenix, AZ 85016     

Dignity Healthcare Breastfeeding Support Group
Group meets every Wednesday with the exception of major holidays… For more information, please call the ResourceLink toll-free 1 (877) 728-5414, Monday through Friday from 8 am to 5:30 pm
Chandler Regional Medical Center's @ 11:00 am to 12:30 pm
1955 W Frye Rd
Chandler, AZ 85224

Inn Mommies: Breastfeeding Support and Snugglers Group 
Birth to six months: This group for expecting and new mommies and open to women giving birth at home, at Babymoon Inn or in a hospital and is facilitated by Amey Clark, RN. For more info visit http://babymooninn.com/community/
Babymoon Inn @ 1:00 pm
202 East Morris Drive
Phoenix, AZ  
(602) 314-7755  

Phoenix Public Market
“our Open-Air Market is a natural gathering place that celebrates neighborhoods and the neighbors. It offers an eclectic high-quality mix of: Fresh in-season fruits and vegetables, produce, flowers, jams, baked goods, dried beans, free-range eggs and honey, live plants and unique local arts and crafts, tasty hot foods, music, and more.
Open Air Market @ 5:00 pm – 8:00 pm
721 N Central
Phoenix, AZ    

CALIFORNIA
The Little Car Show 
A display of little cars benefiting the Veterans Transition Center. Downtown Pacific Grove.  For more information visit www.marinamotorsports.org or the Chamber of Commerce HERE
Downtown PG @ 12:00 am to 5:00 pm
584 Central Avenue
Pacific Grove, CA 93950 
Contact: John Moulton 484-1966

La Leche League Meeting – Pacific Grove
LLL is an international, nonprofit, nonsectarian organization dedicated to providing education, information, support, and encouragement to women who want to breastfeed. All women, especially pregnant and nursing mothers, are welcome to attend our meetings. For more info and the full meeting notice please visit http://lllnorcal.org/groups/MontereyPeninsulaCA.html
Parent's Place @ 5:00pm
1025 Lighthouse Ave
Pacific Grove, CA

THURSDAY, AUGUST 15, 2013
Where are you going to be today?  Let us know and clue us in for next week :)

FRIDAY, AUGUST 16, 2013
Barnes & Noble Storytime
If You Were a Panda Bear by Wendell and Florence Minor:  If you were a Panda bear, guess what you would wear? A black-and-white suit and eye patches-how cute! You'd be very shy; you'd eat lots of bamboo. Then you'd take a long nap. What a good thing to do! Join us to learn about bears of all types!
Store Near You @ 10:30 AM
Chandler Fashion Mall
3111 W. Chandler Blvd #2054
Chandler, AZ 85226
480-792-1312

Dignity Healthcare Breastfeeding Support Group
Every Friday with the exception of major holidays… For more information, please call the ResourceLink toll-free 1 (877) 728-5414, Monday through Friday from 8 am to 5:30 pm
Mercy Gilbert Medical Center @ 10:00 am to 11:30 am
3555 S Val Vista Dr.
Gilbert, AZ 85297

Free Outdoor Concert – Tempe
Bring the family out to enjoy great live music performed by a variety of musicians.  Choose from two stages of entertainment.  For more information click HERE
Tempe Marketplace @ 7:00 pm
2000 E Rio Salado Pkwy
Tempe 85281
480-966-9338

Free Outdoor Concert – N. Phoenix/Scottsdale

Bring the family out to enjoy great live music performed by a variety of musicians.  Choose from two stages of entertainment.  For more information click HERE
Desert Ridge Marketplace @ 7:00 – 9:00 pm
21001 N Tatum Blvd
Phoenix 85050
480-513-7586

Free Concert - Chandler
Dmitri Matheny Group featuring Clairdee! 
First introduced to jazz audiences in the 1990s as the protégé of Art Farmer, Matheny has matured into “one of the jazz world’s most talented horn players” [San Francisco Chronicle], a leading figure on the international jazz scene and one of the most prolific musicians of his generation.  Celebrated for his warm tone, soaring lyricism and masterful technique, American musician DMITRI MATHENY has been lauded as “the first breakthrough flugelhornist since Chuck Mangione” [San Jose Mercury News].
**No tickets required; all shows are FREE.  All seating is first come, first served.  Doors open at 6:30pm, and seating starts at 7pm.  Suggested donations: $5/person, $10/family.**
Chandler Center for the Arts @ 7:30 P.M. 
250 N. Arizona Ave. 
Chandler, AZ

CALIFORNIA
Celebrate the Outdoors: Making Tracks
Throughout the month of August, MY Museum celebrates the outdoors with a special activity every Friday! Join us August 16th and make tracks! Learn how to distinguish the footprints of our furry and feathered friends in the Peninsula. Fun for all and free with admission.  For more information and admission prices, visit http://www.mymuseum.org/plan/calendar/
Monterey County Youth Museum @ 3:30 pm – 4:30 pm
425 Washington Street
Monterey, CA 93940


Do you have an event you want to add to our list?  We are happy to list your event in our weekly blog posts.  Any event, class, support group or meeting that fits into our philosophy of pregnancy, childbirth and parenting will be considered for our listing.  We reserve the right to decline requests that do not promote healthy families and peaceful parenting.

To submit your event:
Please follow this format (same as above).  Anything that is not "copy-paste" ready may not be posted - it will depend on how much time I have between homeschooling and loving on four littles.  If I don’t sleep, it seriously impedes my ability to be a peaceful mama, and that is not fun for anybody.  Thank you for understanding!  

Submit your event information to:
krystyna {at} sweetpeabirths {dot} com

Information to send me:
Event Name
Description & Cost
Location Name & Time
Address
Contact Phone Number

For more family - toddler fun, visit our listing at Sweet Pea Families


Please leave us a comment - it will be moderated and posted. 


Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.



Two Paths to One Truth

Posted on June 4, 2013 at 7:28 AM Comments comments (138)
The final open meeting of the Midwifery Scope of Practice committee was held yesterday, June 3, 2013.  The whole time I have been attending or watching the livestream recordings, there has been a nagging thought that was tugging on my brain.

The Director of Health Services wrote THIS blog post that really helped me clarify the thought that had been rolling around in my head, and I couldn’t quite pin it down until I read his post:

Excerpt:
“In the draft rules, there are a handful of tests that women need to take if she wants to have Licensed Midwifery services.  These tests (HIV, Hepatitis B, blood glucose, and blood Rh factor) are the only way for the midwife to establish that the birth will be low risk and safe for the health of the newborn and mom.  The mom-to-be can still refuse the tests, but that means she wouldn’t be able to have a Licensed Midwife present during the home-birth because it wouldn’t be possible to determine if the birth is low-risk and suitable for a home delivery.”
       ~Will Humble, Arizona Department of Health Services Director

Here is an excerpt from the comment I left him:

"The ADHS is approaching birth as something that needs to be established as “low-risk” in order to proceed at home. Those of us who have had a homebirth, and the care providers who support us, have a belief that pregnancy and birth are low-risk from the outset.

The medical model wants birth to be proven safe; the midwifery model believes birth is safe until it is proven otherwise. We will continue to go around and around about what is best for mothers and babies until some sort of resolution is found between those two disconnected approaches to pregnancy and birth."

The good news is: thanks to the public outcry against the mandatory testing, that part of the rules and regulations is being left alone for the most part to stand as it was.  Some minor updates are being made to take account new information about infectious disease since the rules were last updated in 1999.  For the most part, consumers and midwives were happy with the verbal agreement reached by the committee about how testing is going to be written in the updated rules.

Sadly, the issue of the "Us Versus Them" mentality that exists between the medical model and the midwifery model has not been resolved.  Here are two interactions that happened at the June 3, 2013 Midwifery Scope of Practice Meeting that clearly illustrate the disconnected paradigms in two approaches to one fact of life: Birth Happens.

1.) The medical community does not understand the scope of midwifery training.
Transcript of video (http://www.livestream.com/azdhs) starting at time stamp 13:18
Maria Manriquez, MD, FACOG, President of ACOG Arizona: “In your explanation, that’s then inferring that you continue care of the neonate.  Does that imply that you are not providing the infant with a pediatrician or a doctor of it’s own at the appropriate time?  Correct me; I am assuming you are not implying that you then become the provider for the newborn?  You are practicing out of scope of practice! You’re not pediatricians or lay pediatricians!” 

Wendi Cleckner, CPM, points out that on page 24 of the May 24, 2013 version of the rules, the parameters of a midwife’s care for the newborn are clearly stated.  (There are 16 different clinical observations a midwife must make about the newborn, and if necessary, protocols for referrals that she will follow that are in the best interest of the baby, before she can say her role in that infant’s care is complete.)

Janice Bovee, CNM, MSN, “Midwifery, including Certified Professional Midwives and Certified Nurse Midwives, in our programs, and in our training; we include mother’s pregnancy, intrapartum care, birth, postpartum care and care of the newborn.  We are trained in that.  That is part of the midwifery model.”

Thank you, Janice for defining the scope of practice for midwives for Dr. Manriquez and anyone else who is unclear about exactly what midwives are trained to do.  A midwife is trained to practice in the home setting, so she must assume some of the care that a pediatrician would perform in the hospital setting because childcare is not in the obstetrical job description.  Whether she works in the home, a birth center or a hospital, a midwife is willing, capable, and knowledgeable in the care of both the mother and the neonate as part of her scope of practice every day of the week.

(Side note: can you see how midwives start to lower the cost of healthcare in this simple illustration?  One person caring ably for two people, instead of two people caring for two people.)

2.) The medical community does not understand the rigors of midwifery training.  The fact that practitioners of midwifery care are not learning to do surgery does not mean that their training is inconsequential. 
The second exchange, that occurs at time stamp 26:23 of the meeting:
Maria Manriquez, MD, FACOG, President of ACOG Arizona: “Is there any room for demonstrating actual; I know that you’re at least, that’s what Wendi has communicated, that you have to demonstrate physical competency?  So, all of the physician providers have to demonstrate competency.  So what physical competency is demonstrated by licensed midwives?  So there’s an exam, there’s NARM certification, but it doesn’t spell out specifically what and who signs off on that particular practitioner.”

Wendi Cleckner, CPM: “That’s what we’re adopting as the CPM process, is NARM.  The national organization does all of that and there is a clinical aspect; that you are in front of a qualified examiner who takes you through scenarios, you have to work on models, you have to demonstrate your clinical skills in front of them, and then they pass or fail you.”

Maria Manriquez: “We break it down even more specific.  So you can be knowledge, medical knowledge approved but not clinical, and vice versa.  So, is there an opportunity to have that information?”

Wendi Cleckner: “It’s on the website of NARM.”

Maria Manriquez: “So on the website, I could go and look you up and see that you had passed both the medical knowledge portion and the (unintelligible)?”

Wendi Cleckner: “If I did not pass all the sections, I would not be a CPM.  You would not be certified, you would not get your license, if you didn’t pass all the sections.”

Mary Langlois, CPM: “You also have to pass an apprenticeship.  So, you have a preceptor who is designated to oversee your competency.  So you’re taught by the preceptor, and the preceptor also does skills check offs and oversees you and helps you manage the deliveries.  So not only do you have to complete the clinical side, and then you would have to complete all your documentation, you take it to NARM, you take the practical examination, you pass that, then you take the written.”

I especially love Mary’s comment because it reminds us that the midwifery model is personal not just to the woman receiving care, but also to the woman who is providing the care.  Another women who saw her passion, helped her hone her skills, and took the time to teach her.  She was not taught in an amphitheater setting, and not in a residency program designed to weed out the weak links, but in the intimate, person-to-person knowledge transfer, one or two students at a time.

Without too much extrapolation, I think it is easy to see that the medical model of training looked at the eons-old midwifery model of knowledge transfer and sterilized it to suit the needs of the medical community.  If we are honest with ourselves, we need to ask ourselves what the conflict is really about. 

Is it really about the safety of the mothers and the babies, or is it the continual push of one system against another?  One system still trying to prove it’s soaring above the other one that is merely trying to stay grounded and true to its roots.

As Bradley™ teachers, Bruss and I recognize that there is real value brought to the table by both knowledge sets.  We help couples find a path to stay healthy and low-risk so that they a variety of birth options available to them.  If they want midwifery care at home or at a birth center, great!  If they want midwifery care in the hospital – fantastic!  If they feel comfortable with the obstetrical approach, we know there are care providers that support natural birth.  They have choices. 

Although very seldom, occasionally there are developments that move a couple’s pregnancy or birth out of the healthy and low-risk category wherever they are seeking care.  We want those couples to have specialized obstetrical care so that they, too, can have a Healthy Mom, Healthy Baby outcomes like their low-risk counterparts.

Director Humble and his team are in the unique position of being able to set the tone and the groundwork for collaborative care to really take root in the United States.  It is our hope and prayer that a peaceful, respectful and collaborative model of care will be pioneered in the state of Arizona. 

Please leave us a comment - it will be moderated and posted. 
*I think* that the amount of traffic you so generously generate has led to a lot of spam posting.  In an effort to keep the spam to a minimum, I am taking the time to moderate comments now.
 
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.



Rights For Homebirth - May 2013 Update

Posted on May 17, 2013 at 8:56 AM Comments comments (98)

The final Midwifery Scope of Practice Meeting was held on Wednesday, May 15, 2013.  It is now time for the families of Arizona, and anyone else who believes that compassionate care is a human right’s issue for the mother and the baby to take a stand.

You can click on the links below to read a copy of the current draft rules and to see Wednesday’s proceedings:
Most Recent Draft: http://1.usa.gov/YZw4Xt
Most Recent Meeting: http://bit.ly/104ZtKT

Here is my statement on the Arizona Department of Health Services Website:
In addition to agreeing wholeheartedly with Allyson Fernstrom's statement below, I want to direct the committee to THIS brief article with references if they want to dig deeper:
 
As the article and study succinctly show, "FTP" and "CPD" in the 21st century are mostly iatrogenic.  "Watchful waiting" IS the midwifery model of care in the hospital, in the birth center and in the home setting.  Many midwives have less than a 15% cesarean rate (defined as an "acceptable" rate by the WHO) in their practices because they do not intervene until necessary.  This does not mean emergency; read: most of these are non-emergent and appropriate.
 
At this point in our history, 99% of births are still occurring in the hospital setting (read more HERE), and a vast majority of those women are still under the OB model of care: the "do something to help this along" model.  A 32.8% cesarean rate calls into question the common practices that are being forced on women.  It should not surprise us that some of these women are demanding a different model of care with subsequent pregnancies.
 
It is unreasonable to essentially punish women who are seeking compassionate care after feeling abused in the traditional care system by doctors who subscribe to a different philosophy about birth.  By including FTP and CPD in the final version of the rules and regulations, you are essentially providing a VBAC option on paper without providing a VBAC option that will be a choice for the majority of the consumers who are now faced with choosing unassisted births instead of facing the trauma they faced in a previous birth.
 
Before a final draft is approved, I implore Dir. Humble to attend a home birth.  See what it is we are talking about.  Really understand why we are so passionate about this cause, and why we believe that birth is a fundamental human right and a woman's rights issue.  We are not asking for the sun, the moon and the stars.  We simply want you to understand the power of birth, and why we want our care providers to have all the tools they need at their disposal if we choose a home birth setting. 
 
Midwives have the ability, the training, and the knowledge to bring babies safely into the world without compromising the health of the mother.  They believe that mothers care about the life they carry within them, and will do their research when it comes time to choose or decline procedures.  Midwives also know how to recognize non-reassuring patterns and when it is time to safely transfer to a different birth setting in the rare cases that complications do arise.
 
I advocate for midwives to be free to choose the clients that they feel they have the training to care for, be that VBAC, breech, or mothers of multiples.  As an informed consumer, I ask for the state to certify that the women who offer this care are educated in the care and management of those labors.  Along with this, I trust that midwives will have the opportunity to continue their education so that they can assist at VBAC, breech and multiples births once they have completed training in those areas.  I am glad to see that there is a review process to keep midwives accountable for their decisions, none of which will be made lightly because at midwives care deeply about the women and the children that they serve. 
 
Dir. Humble, you have the opportunity to lead here and set a new standard for the great state of Arizona.  Please take it.
 
Respectfully,
Krystyna Robles-Bowman
Mother of 4
Chandler, AZ
 
Statement from Allyson Fernstrom:
"I am extremely grateful to see that VBAC is still included in the drafts. I believe this is a huge step in the right direction. It shows that the department is listening to the concerns of the consumers. I appreciate that more options are being opened up to the growing number of women who desire to achieve a VBAC. However, I have GREAT concern with some of the conditions suggested. It currently reads that a midwife can not attend a VBAC if their was a diagnosis of "failure to dilate" or cephalopelvic insufficiency". I heard in the last meeting that it is supposed to read "failure to progress". That does not make the problem better. Failure to progress, failure to dilate and cephalopelvic insufficiency/disproportion are ALL unacceptable. There is NO literature to support this rule. Listen to the members of the committee, including those from the medical community, who have mentioned may times that FTP is over diagnosed. FTP only tells you that a mother did not progress. It did not tell you WHY she did not progress. What if there was failed induction? What if it is an emotional issue that stalled labor? What if the baby was in a poor positioning? Maybe the care provider followed the Friedman's Curve, which does NOT allow the typical mother enough time to labor to full dilation? There are too many variables in play. A woman should not be excluded from attempting a VBAC because she had a failed induction, an emotional block, a baby in a poor position, an impatient care provider, etc. Because the diagnosis of FTP does NOT explain WHY the woman had a cesarean section, it should NOT be used to determine whether or not she is capable of vaginal delivery. CPD is also highly disputed in the literature. It is difficult to ever give a TRUE diagnosis of CPD. The testing is unreliable. FTP and CPD are subjective, over diagnosed and would be completely inappropriate in the rules. Director Humble mentioned that if he allows VBAC, he does not want to make it so restrictive that no one can do it. Leaving in FTP and CPD would essentially make it impossible for most VBAC clients to qualify for a homebirth VBAC. Consumers and members of the committee have been asking from the beginning that this be removed from the rules. Listen to these important stakeholders!"

Do you want to get involved?  Please do!!

There is a peaceful Rights For Birth rally being planned for today and Monday in the Phoenix area – click HERE for all the details.

Do you want to submit your own comment?
Click HERE for to make a direct public comment.

Let me be clear that I do not believe that OB's are bad people.  I simply disagree with the birth paradigm under which many of them practice.  I am forever grateful for their skill set as surgeons when it is an appropriate and needed use of their considerable skill in the operating theater.

Do you believe birth is a human right and/or a woman's rights issue?  Why or why not?
Please leave us a comment - it will be moderated and posted. 
*I think* that the amount of traffic you so generously generate has led to a lot of spam posting.  In an effort to keep the spam to a minimum, I am taking the time to moderate comments now.
 
Disclaimer:
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.
Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.


 

Coach's Corner: Why Take Childbirth Classes?

Posted on March 12, 2013 at 4:37 AM Comments comments (0)
The information shared in a Bradley Method® class helps a couple do a Benefit-Risk analysis with each other, and their care team, "if or when" they come to a decision point in their labor.  When used wisely and at an optimal time, interventions, procedures and/or drugs can be used appropriately.  They become tools that facilitate a "Healthy Mom, Healthy Baby" outcome.  If you are not educated about or prepared for some of the risks, you may end up wishing you had known a little more.

My opinion is that for parents-to-be, birth education is a highly recommended component of birth preparation.  It does not, by any means, replace  a competent, caring medical team.  What birth education does do is prepare you to actively participate as an *educated* consumer in the pregnancy and birth of your children.

Best,
Bruss

Please leave us a comment - it will be moderated and posted.  *I think* that the amount of traffic you so generously generate has led to a lot of spam posting.  In an effort to keep the spam to a minimum, I am taking the time to moderate comments now. ~KRB

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.