Local Breastfeeding Mishap - Pearls From Sand

We've all heard the stories in our own areas:

https://www.youtube.com/watch?v=ZgmbJso-2-o

"I was nursing my baby when our server came up and asked me to cover up. When I told her I was fine, but thanks for the concern, she picked up my napkin and tried to drape it over my babies face"...

"I was nursing in Target on one of the benches near the dressing rooms. The sales associate asked me to go into the dressing room to nurse. I told her I was fine where I was and my 2 and 4 year old's wouldn't do well in such a small space. She kept insisting and then even left to get a manager to try to get me to move. You could tell she was uncomfortable with my nursing my 2 month old"...

"I was breastfeeding my 4 week old when a nearby patron glared at me, wrinkled their nose in disgust, and told me I should have more class than that. She went on the complain to her friend that I was being slutty and wanted attention. I tried to ignore them but it hurt. Then, to add insult to injury, the manager came up and asked me to please, 'at least' cover up for the comfort of everyone else in the restaurant."

But here's a story of another sort... this morning I saw a story circulating in my feed of a local Houston woman who says she was asked to leave when nursing her baby at a local restaurant. So she moved her nursing into the bathroom.. but the server supposedly followed her in and asked her to leave. So she left to her car. Supposedly. But we don't have necessary information, and rumors abound...

Rumors are swirling that it didn't happen at all.. or that she was trying to nurse in the 21+ club area... or that she was unhappy with her meal... regardless though....

Why do I say supposedly?

• Because the original person it involves is MIA. No one knows who it is.
• The screen shot circulating is "my friend" or "an acquaintance of mine" and then the story"... no actual story from the horse's mouth
• Other breastfeeding mamas have come forward and said they have never had a problem nursing there
• The owners themselves, the woman used to be a breast milk donator for the Texas Children's Hospital Milk Bank
• Employees and security footage supposedly tells another story, and the owners are willing to share it and set the record straight... 

But the biggest reason I don't necessarily believe this really was a situation that even happened? Or at least not the way it was portrayed on social media?

The owners of El Patio ("club no minors") have set up an event to set the record straight, reestablish how family friendly they are, promote breastfeeding education and awareness, show how breastfeeding friendly they are, and give back to their community all in one fell swoop.

From the event's details:

Join us along with pro-breastfeeding community in Houston to help bring awarenes to the importance of breastfeeding and its importance in early childhood.
Breastfeeding is an important start to a child's life. There is a lot of misinformation around breastfeeding and its importance, as well as the support for Mom's to meet their goals. It's hard work!

Many moms don't breastfeed because of their fear or embarrassment of nursing in public, even though they have a legal right to do so. Mothers are frequently shamed when they breastfeed in public.

When word of an incident gets shared, fellow moms and caregivers band together to stand up for them. Mothers are a fierce group! Rarely, stories get twisted and confused, and aren't accurate.

El Patio, recently experienced one of these incidents where our 50 year reputation as a family restaurant was challenged. We are taking the opportunity to give back and help create awareness to this issue. 

Join us for a "Feed In" from 11-3pm on Sunday, December 13th. El Patio will donate 20% of all sales during this time to Mothers' Milk Bank at Austin to support their Houston outreach and efforts.

Please bring your families and friends to help support all mothers in Houston!

To read more information or to attend the event, see here.

I'll update this post as I hear more information, but in the meantime, I have to say, I love this businesses response! They could have simply refuted it and showed their evidence. They could have just made a public apology. They could have just made a public statement... but they are giving back to their community, taking this opportunity to educate their community, and give to a very worthy organization.

So bravo El Patio! I hope to see you on Sunday!

UPDATE:

So I've gotten some disgruntle-mail, people calling me a victim-blamer and a non-supporter of breastfeeding. This is the furthest from the truth... I have been to many nurse-ins, help women breastfeed and extended breastfeed, etc... the problem is that this isn't the norm.. I've never seen a woman not willing to stand by her word that she was attacked for breastfeeding and shamed. I've never seen a case where everyone else is so fired up from a second-hand account. This is classic 'telephone' (you know, the game we played when we were kids).

I believe that one of these is the case:

• there is no woman, someone just wanted to start something
• there IS a woman, but she hasn't come forward because she made it up or the issue wasn't breastfeeding and she was just finding something to complain about (i.e. trying to take a baby into the 21+ section and upset she couldnt)
• there IS a woman, but since making that first accusation, she found out she was wrong and it was a misunderstanding
• there IS a woman and she hasn't come forward yet because she's getting her legal ducks in a row

All that said, even if there IS a woman and this DID really happen, since when is someone guilty until proven innocent? Until I hear it 'from the horses mouth' it's just a second hand story and you cannot refute that.

UPDATE #2: 

So, the restaurant has surveillance footage and testimony from the waitstaff that night. There WAS a woman who had an infant who tried to access the 21+ area, but there wasn't an 'issue'... that same woman was also harassed by someone who was not employed by the restaurant (a patron) for nursing. That person did follow her in the restroom and did come across authoritative. The woman has recanted her story, saying that she thought the patron was a member of the waitstaff. She never intended for the information to get on social media and the friend who's screenshots were shared all over social media never wanted or intended for her information to be shared outside of their private parenting group..

I feel badly for the mom that a PATRON had such an air of authority that she felt shamed from doing something that SHE HAD the authority to do. I feel badly that she UNINTENTIONALLY set off a firestorm. I'm sad that the business was hurt by this story and that there was such a wildfire siege on their business from angry (mislead but understandable) breastfeeding mamas. I am SO HAPPY that they are all choosing to do right - the mother has rescinded her story, the friend has made an apology in the private group, and the business has decided to make the best of and do the most that they can for this incidence. Beauty from ashes, pearls from sand.. I am in love with humanity right now; now if only the people who have made yelp and FB reviews would rescind them.... 

Who's Gonna Pay If I Leave AMA

So a girl walks into a hospital...

Sounds like the start of a joke, yes?

Let's continue...

So, a girl walks into a hospital 'in labor'. She goes through triage, where they separate her from her birth team for 'a quick few minutes'. The check her cervix, she's 3cm. Her water breaks on the table while they're checking her. An hour later, she's 3cm and her contractions have fizzled. Her birth team still hasn't been reunited with her regardless of  her requests for them.

She notifies her nurse of the fact that she's planning on going home, getting freshened up, meet up with her husband, and they'll probably be back sometime later that evening.

The nurse says they can't leave. She says she's going to leave, even if she has to leave AMA.

The doctor says, that, if she leaves the hospital AMA, her insurance won't pay for her care.

I'm here to tell you that that is a lie.

We have a few possible reasons why they would say this:

1. they don't know any better and really believe this is true. After all, this has been perpetuated as an urban medical myth for quite some time. 
2. they know better but use this as a coercive tactic to keep mom at the hospital. 
3. they know better and have every intention of writing in the file to not bill insurance later so mom is footed with the cost in order to 'pay her back' for not following the doctor's orders. 

The truth of the matter is, I have seen all three as reasons in action. Once, I provided proof that insurance would indeed pay for a clients care even if she left at 24 hours postpartum 'AMA'. He was genuinely surprised and happy!

Many other times, I have seen them back pedal defensively when I bring up the same information with clients who want to leave AMA... getting angrier and more coercive.

And yes, I have actually seen it notated on one nurses file electronically after a mom asked the doctor for the paperwork to leave AMA. The doctor went to the nurse, said something in low tones to her, and left the room. The nurse typed in the notes section, "do not bill insurance as patient is leaving AMA". I called her out on it and the nurse blushed the deepest red. The doctor came back in and blamed it on the nurse, who erased the notes. Later, when mom had birthed and received her bill from the hospital, none of the stay had been sent to her insurance claims department; she called her insurance and confirmed. She called the hospital and they attempted to give her the run around about AMA and insurance declination. She had to have her insurance call the hospital to get it covered.

So, bottom line, yes, insurance will still cover you if you check yourself out AMA. For more information see below:

• http://www.ncbi.nlm.nih.gov/pubmed/22331399
• http://thehappyhospitalist.blogspot.com/2011/05/will-my-insurance-pay-if-i-leave.html
• http://www.amednews.com/article/20120705/business/307059997/8/
• http://www.epmonthly.com/whitecoat/2010/05/will-insurance-deny-payment-if-you-leave-ama/
• http://www.uchospitals.edu/news/2012/20120203-billing.html
• http://patients.about.com/od/atthehospital/fl/Choosing-to-Leave-the-Hospital-Against-Medical-Advice.htm

Everything's Negotiable

Everything is negotiable... and the flip side? Nothing's truly mandatory.

Want to know the #1 thing that drives this doula absolutely nutty? The statement, "____ won't/will let me."

Why?

Well, let's see, IT'S YOUR BODY!

Sorry, was that offensive? What is offensive to me is the concept that our medical care providers have control over our health care and our bodies. That is simply not true! 

"Many women are not aware that they have the legal right to make their own decisions about caregivers, place of birth, medical procedures, treatments, drugs, or diagnostic tests for themselves and their babies. Childbearing women are encouraged to become informed about their legal rights to make the choices that best meet their needs." - Patient Rights at VBAC

Well, I am getting ahead of myself... so, what are these rights?

• The consent of a competent woman's husband is never required for her treatment.
• Women have a right to have another woman present during a physical examination.
• Women can refuse to be examined or treated by anyone.
• Women have a right to have the father of the child, or another advocate, present during childbirth and delivery.
• Pregnant women have a right to refuse any medical treatment or drug, including a cesarean section, episiotomy, anesthesia, and pain medication.
• A woman has a right to change her mind about any decision made before or during labor or childbirth.
• A woman and her newborn have a right to remain in a hospital up to 48 hours after a vaginal birth and 96 hours after a cesarean section (your goal, however, should be to get mother and child out of the hospital as soon as it is safe for them to be discharged). - Legal Rights of Pregnant Women from ICAN

Remember that no one is responsible for your healthcare but you. As a parent and woman, you hold the ultimate responsibility for the choices that are made during pregnancy, labor, and postpartum, because you are the one who will be raising the child and have to live with the results of the care you have chosen for them and for your own body.

"American parents are becoming increasingly aware that well-intentioned health professionals do not always have scientific data to support common American obstetrical practices, and that many of these practices are carried out primarily because they are part of medical and hospital tradition." - The Pregnant Patient's Bill of Rights from AIM

With this knowledge, women should start making some of her birthing choices that will affect her birth time during pregnancy. The first step would be considering her options. And the next step is making sure that those options are in line with what she hopes for in birth, and then setting in place her advocates (aka birth team).

For some reason, even when women know what they want out of birth, they don't always choose places or people who will necessarily honor those choices. In those instances, whether it was a bait and switch situation, or mom simply stayed with a practice or place that she knew had policies in place that would not support her choices, it is important that she and her non-birth place-affiliated birth team knows what her rights are.

Every woman has the legal right to informed consent or refusal for every medical treatment that is offered. Even if they say it is policy, that you 'have to', or it is 'non-negotiable'. 

The American Medical Association supports this, “The patient has the right to make decisions regarding the health care that is recommended by his or her physician. Accordingly, patients may accept or refuse any recommended medical treatment.”

The ACOG even says that a woman may decline a physician’s advice or recommendation, even during treatment, based on “religious beliefs, personal preference, or comfort.” Women are entitled to “informed refusal.”

Your legal right to make your own choices for you and your babies health care mean that your treatment in your choice of birth place is your decision. Everything's negotiable, whether or not your medical care provider/place would like to acknowledge it.

• What about when I sign that consent for treatment form at sign in? Even after you sign that form, you have the right to refuse any particular part of that treatment. Picture the cancer ridden person who is given the option of amputation or chemotherapy, even though the doctor believes one course of treatment will get better results. Every step of the journey is your right to refuse or accept.
• What about if I already agreed to an IV, epidural, pitocin, cesarean, or nursery stay? At any time during your care, you can change your mind, decline treatment, or nullify any consent forms. 
• What if they challenge me or threaten me? Then challenge them back and remind them of your rights. If it is really important to you, you have legal rights that they must honor. 

You don't have to go in for that scheduled induction. You don't have to agree to a repeat cesarean. You don't have to consent to continuous fetal monitoring, 'mandatory' nursery stay, or 'mandatory' newborn procedures... even bathing and eye erythromycin.

Be aware though, if you decide to decline any treatment recommended by your care provider, you may be asked to sign an AMA (Against Medical Advice) that states you acknowledge you are taking responsibility for your choices.

Before signing that form, though, you can get a second opinion, as you are always entitled to one. This second opinion may not agree with the first care providers opinion and may save you from having to sign the AMA.

For more information on the Rights of Childbearing Women, see here. Remember, your body, your baby, your right to refuse. 

A Quick History of Medication in Maternal Health Care - (and the Business of Being Born)

originally posted on 5/12/07

Taking the lead from another great blogger I read often - try to find her ;o) - and from a recent viewing of the Business of Being Born - I wanted to touch on the dark blemish of American Obstetrical practice - routine medication for birth. (BTW, it is funny that this was shown as a screening in the midst of a High Risk conference for Vanderbilt - on the heels of a recent development plan).

While watching the Business of Being Born - a WONDERFUL look at childbirth practices in the US - I was struck by one very apparent thing: doctor's know nothing about bodies and birth. They know everything about risk - and, as one OB nurse told me, their job was to take away pain and have a healthy mom - not to get the best outcome.

That mentality was prevalent back in the late 1800's - early 1900's when OB's infiltrated the childbirth field and it is prevalent now. FRIGHTENING! Why is it frightening you say? Let me expound...

Let's start with the advent of anesthesia in general. It all began on October 16, 1846, at the Massachusetts General Hospital in Boston, in a room now called the Etherdome, when William Morton administered the first successful public demonstration of ether anesthetic. This was a great breakthrough for SURGICAL needs, and the news spread around the world quickly. So quickly in fact, that within a month the first modern anesthetics had been given on both ends of Europe, and within six months in Australia and China.

One doctor who heard of the use of ether was James Simpson. Breaking out of his social class, he put himself through medical school and later became the chairman of obstetrics at the University of Edinburgh. He is best known for the forceps which he devised to counter his initial use of ether on maternal patients.

His first maternal patient was a woman whose pelvis was deformed by rickets (a common issue in that time from malnutrition) who delivered on January 17, 1847. These deliveries can be especially difficult because of the manipulation needed to get a baby out of a deformed pelvis.

There was a great concern, though, for this use of ether because of the knowledge that ether often stopped contractions. As well, most babies born from ether-administered mothers had ether-smelling breath, ether smelling placentas, and tires/lethargic/unresponsive babies. So, Dr. Simpson created forceps, to pull babies from their mother's wombs before they were 'too drugged' and to minimize the incidence of failed labors due to ineffective or stalled contractions. Then why was it continued?

To understand the merging of surgical breakthroughs and maternal downfalls, we need to look at the social climate of the time. Two major events were happening: childbirth was taken out of the home and into the hospital (where disease and infection ran rampant), and the feminist movement was on the rise.

"Early feminists campaigned for social reform of all types, for the abolition of slavery and the abolition of the use of alcohol. They were also concerned about improvements in health care, particularly for women and children. They had good reason to be concerned. Although death rates for men and women had been falling throughout the nineteenth century, risks of a woman dying in childbirth had not decreased. In New York City, for example, 15% of deaths of women between the ages of 20 and 40 were related to childbirth. Although deaths from other causes had decreased, deaths from childbirth had not. By 1900, 30% of the deaths of women in this age group were attributed to childbirth." - now remember that those deaths were NOT due to childbirth - but malnutrition causing complications in birth, deliveries being moved to hospitals where illnesses and disease ran rampant, and before the advent of antibiotics - IT HAD NOTHING TO DO WITH MIDWIFERY and THE SAFETY OF HOME BIRTH.

Suffragettes saw maternal health care as a significant area that needed improvements. The only problem is that they focused on the labor of childbirth (pain/discomfort) rather than the true source of the maternal and fetal demise of the time. Not to fault them as the information and scientific breakthroughs were not accomplished yet; in their early industrialized minds, pain equated illness and death.

(Maternal death rates dropped slightly in the US between 1880-90, when doctors rooted out the nature of childbirth fever in relation to cleansing practices in the hospitals. They started washing their hands between women's beds and the death rates dropped. Then, the numbers steadily rose again until 1940, when they dropped once again (steeply and greatly) with the introduction of antibiotics).

Queen Victoria used ether when she delivered Prince Leopold in 1853. From Inside Surgery:

"Queen Victoria went into labor on the morning of April 7, 1853. As her physicians readied her for the birth of Prince Leopold, John Snow positioned a handkerchief moistened with 30 drops of chloroform over her nose and mouth. The Queen had an immediate response to it. Over the next fifty three minutes he reapplied the anesthesia fifteen times, using between 15 and 20 drops each time. The birth was without complication and the child was pronounced healthy, although at the time no one knew that he was afflicted with hemophilia.When accounts of Queen Victoria's labor anesthesia reached the general public, John Snow became an instant sensation and was much in demand by the social elite of London."

The National Twilight Sleep Association was formed in order to support the use of a new maternal anethesiac development begun by a young obstetrical doctor by the name of Carl Gauss. Around 1900, Gauss combined two drugs that had been in the medical armament for a long time to treat childbirth pain. One main component was morphine, used to alleviate pain during surgery. It had, thus far, been avoided in obstetrics because of its effect on the uterus, its effect on the newborn, and its effects on bleeding and infection. The other drug was scopolamine, which causes amnesia - in the past, these had been used as poisons in high doses. Hamlet's father was killed by one of scopolamine's cousins.

Gauss mixed these two drugs and administered them in 'small doses' to his patients - the morphine provided relief from pain while the scopolamine provided the women with amnesia of their labors and what was done to them. The problems? Oh, there are many!!! Scopolamine caused women to lose their inhibitions. They would have no memory of what went on, nor did they realize what was happening, so most of them screamed during labor. They became uninhibited and psychotic. They would thrash about on the bed, causing injuries to their heads. So, their heads were wrapped with blankets or towels, turban-like. They would attempt to claw at the walls or their medical providers, so they were put in straight jackets or their wrists were strapped to the beds. Then, so that they would not fall out of bed, they were put in 'labor cribs' - and were allowed to labor, screaming, tied down, blinded and bound - often in their own urine and feces, and sometimes for days on end, until it was time to birth. The women had no memory of this, the husbands were not allowed in to see their wives, so they didn't know what was happening - and everyone was happy.

Gausses concoction was tried out first in Europe and was found to be less than satisfactory for maternal care. It would probably have died out there had it not been for an infamous article in McClure's magazine. Two female reporter's who were also staunch feminists, accompanied their friend to Germany, where she was traveling to be 'treated by Dr. Gauss'. The woman was administered Twilight Sleep and was ecstatic with it. She simply woke to a baby - with no memory of the labor or birth. The three women decided to liberate American women through Twilight Sleep.

Every woman wanted to have that type of birth. Medical research was not sought as to the safety, and feminist drive demanded quick results. So - the U.S. because predominantly a Twilight nation between the years of 1914-1945 (although my grandmother recounts her story of TS in 1956 and there are reports as late as the 1980's).

Thankfully (and sadly because of what it took) this time in American history quickly collapsed when Frances Carmody died under Twilight Sleep. Although there had been numerous women who had died under Twilight Sleep, she was the wife of a Brooklyn lawyer and happened to also be a huge rally organizer for the Twilight Sleep Campaign. Her husband and her OB assured everyone that her death had nothing to do with Twilight Sleep, but, with a key organizer gone from the game, at the very time she was using something she was promoting, the campaign began to fall apart.

Women began to have windows of remembrance, and by 1948, the baby boom got into full swing and the huge number of women having babies while under Twilight Sleep raised the issue of comfort at a cost. Women began reporting their birth trauma - both physical and emotional/mental. Moms began to speak out. And, in 1958, an article headlined "Cruelty in Maternity Wards" ran in Ladies' Home Journal. It detailed the "tortures that go on in modern delivery rooms.". The response? A flood of women sent the magazine their own horror stories. "I've seen patients with no skin on their wrists from fighting the straps," a nurse from Canada wrote.

"Just let a few husbands in the delivery rooms and let them watch what goes on there," said one reader from Detroit. "That's all it will take — they'll change it!" An Indiana mom claimed, "The whole thing is a horrible nightmare."

Women began desiring and demanding safer births - the OBs were fraught with the problem that they could not guarantee a medicated, but safe, birth. So, in the 1960's and 1970's - many women went back to natural birth. This was short lived, though, as Obstetrician's saw income diminishing... Cue the epidural.

Mothers giving birth in the late 1970s and '80s had more options than ever. They could have a medicated or unmedicated birth. They could deliver in a freestanding birthing center, a hospital, or at home (in most states). They could be attended by a midwife, an obstetrician, or both (in some states). And, through all of these options, they could have their husbands by their side.

What led up to the advent of the epidural? In 1898 German doctor August Bier injected cocaine into his assistant's spinal column. It numbed his lower body, but the next morning he awoke with horrible vomiting and headaches (cue the spinal headache). It took the next 80 years to perfect this. But, by the 1970s, lidocaine was dripped into a tube inserted by needle into a woman's spinal column. By the 1980's, it was all the rage! The hitch? The procedure numbed women to their chests, causing breathing issues and, at times, heart problems.

My question - and the question that Ricki posed in her documentary is this:

What will we find in the near future is the clinically proven downside to epidural births? We NCB advocates already know of the obvious, though seemingly unimportant to many women when compared to an easy labor, risks... But think of it...

- In the late 1880's early 1900's it was chloroform / ether - which inhibited neonatal breathing attempts, caused forceps to be necessary (which caused many horrible scarring issues with babies), maternal reproductive harm, and heart failure routinely.
- In the early to mid 1900's, it was forceps - which were necessitated from the use of 'knock 'em out medications. These scarred women's cervix's, making them incapable of dilating at all or efficiently in later pregnancies, tore ears, noses, and scalps off of babies, and created severe perineal and labial scarring in women. Forceps are still used today!
- In the mid 1920's, it was Twilight Sleep - causing maternal mental, emotional, and physical trauma, more of the same as chloroform did, AND caused a number of incidences of stillbirths.
- In the mid 1950's-60's, it was thalidomide, prescribed to pregnant women routinely - causing the widespread incidence of 'flipper babies' - children who were born with severe malformities, including phocomelia (short limbs and deformed extremities).
- In the 1970's, it was early spinal/epidurals where the needles were too large and the puncture too deep, causing a whopping 50% of women to get debilitating spinal headaches that, at the time, were not treatable.
- In the 1990's, it was Cytotec, used to induce labor (off-label and unapproved). With a HUGE risk rate, it can/did cause stillbirth, neonatal distress, uterine rupture, severe postpartum hemorrhage, and more. Cytotec is still used today!

What do all of these things have in common? NONE of these procedures are tested before they are tried out on pregnant and laboring women. We are used as guinea pigs. So, my, and Ricki's question, again, is: What will we find in the near future is the clinically proven downside to epidural births? And, at what cost?

We have a huge increase in ADHD, ADD, Autism, early and late-onset Jaundice, asthma, and allergies/intolerances... how can we know that these are not a result of our maternal health practices now? We can't. BECAUSE, we are a society driven on comfort and ease rather than health and well-being. Well-being does NOT equate to ease or comfort. And, until we demand better health care, we are doomed to repeat history on different levels - until we learn to choose better for our bodies and our babies and leave the testing to the REAL guinea pigs.

See here and here (pic) for more information on this history.

*Edited to add the great information sent to me by some readers!

The Greater Good

The other day a dear chiropractor friend of mine slipped me a film entitled “The Greater Good” and told me to watch it. I went home, fully intending to be bored into oblivion by a tyrannical or severely biased anti-vaccination documentary. I was pleasantly and completely wrong! 

“The Greater Good” is a well-balanced documentary that follows three families through situations involving 'adverse reactions' from vaccinations. It is interspersed with interviews from numerous medical professionals including vaccine developers, pharmaceutical reps, psychologists, behavioral therapists, and pediatricians.

Although the families stories definitely called to the intrinsically emotional mother in me, the information supplied called to my deeper intellect.

My daughter, Briaunna, also reviewed the movie. This is what she had to say: 

The movie was about vaccinations and how they can affect you, good and bad. My initial reaction was anger and pain for the people who were harmed by the vaccines. Helpless children who get vaccinated with, basically, poison. I liked how people are learning more about vaccines… even though many of them have to learn the hard way in order to teach others. I also like how people are learning the true risks of vaccines. 

Did you know that vaccination does not account for the impressive declines in mortality seen in the first half of the century? It was other medical advancements, including learning to just wash your hands (microbiology).

Lately, people have been giving vaccinations to newborns, which really upsets me because I am a baby freak. Also, parents are required to give 69 doses of 16 different vaccines to children. They also put aluminum and mercury in all of the vaccines. Any form of mercury in the body is toxic and can cause damage. 

Did you know that, after 2010, 85 deaths have been reported, all after taking the Gardasil shot?

The only other thought I have is that the government has gotten too much power over us. They say that if you haven’t given your children all of the required shots, you have to go to court and get your shots…. “Or else”. They think that you will endanger your child’s life if you don’t get them vaccinated, which, of course, is all in the way that you look at it. I see more risk to their lives from taking a vaccination, but that’s just me.. and my right to not get vaccines for me or my babies.

The movie covers the historicity of vaccinations, and give us a rare look into the hearts of those who developed them.

At the same time, we hear from the lawyers who defend those families who have been harmed by vaccinations. 

When asked if they believed the business of vaccinations is involved in conspiracy, one astutely replies, "A conspiracy? Yes! But a conspiracy to do good." So much so, that the risks of vaccinations are minimized through government involvement and media bias in order to promote the 'good' that vaccinations provide to the majority.

"The Greater Good" takes a critical look at the government's involvement in implementing and mandating state-wide vaccinations, as well as how individual states are trumping parental and individual rights.

"If the state can force you to put your life on the line, or your child's life on the line, for any medical intervention, then the state has too much power"

Additionally, the movie takes on the very real, very publicly acknowledged fact that many members of our government council also hold shares in the very pharmaceutical companies that create the vaccines which the state promotes. It is as true as it gets: conflict of interest is: when my politicians have a vested financial interest in vaccination pharmaceutical companies. Or, as the movie states:

"the fox watching the chicken coop"

We are given the stats on individual state's exemptions and the bias in media exposure. We are shown the process to bring a vaccine to the public and how 'fast tracking' a vaccination intended for children was foolish. We are given real risks associated with vaccinations, and given a more in-depth look at the studies used to 'prove' the safety and efficacy of vaccination. 

I was, at times, outraged, and other times saddened... I felt I learned so much, even after having done, what I thought, was thorough research on vaccinations... but there were things that still had me dumbstruck and amazed. Just one example: the placebo used in many of these 'safety and efficacy" studies is aluminum, mercury, or a combination of the two!

Some great quotes from the movie that I hope will pique your interest:

"We know that mercury (thimersal) causes neuro-toxicity, there's no controversy about that. Does it cause autism? It contributes to the damage that leads to autism." - John Green III, MD

"There are studies comparing the hair of autistic and non-autistic children. There is much more mercury in the hair of non-autistic children, showing us, at least in part, that there is some genetic precursor that makes some children more succeptible to autism."

 Would I recommend this movie? A resounding yes! Would my daughter? Well, let's just say she is already inviting her tweenage friends over for a 'movie night' at our place - her idea. I recommend this movie to every family who have children, or who will have children, of vaccination age. 

"The Greater Good" does a wonderful job of promoting this one moral: it is not about having you vaccinate or not vaccinate. It is about ensuring that families know the risks, that the studies regarding vaccinations are fair and accurate, and ensuring that vaccines are made to be and required to be as safe as possible.

To visit them on the web

To visit them on FaceBook

Breech Options

In the last 2 months, I have assisted 3 moms with breech babies. I don't know if it is the weather, the season, the heavens... I have no idea.

I can tell you, though, that there are four breech presentations: footling, kneeling, frank, and complete.

There are also many reasons why a baby might be breech: emotional reasons, short cords, bicornate uteri or other anatomical shape of the womb, maternal ligament or muscular torsion, maternal skeletal subluxations, placental placement, maternal abdominal muscle tone, amniotic fluid levels, or maternal family history all can play a role.  (for more information see here).

I can also tell you that it has given me a lot of time to consider options for women who have breech babies and all the ways we can try to help women know their options.

From about the mid-70's until recently, it used to be no questions asked, breech birth meant cesarean. In the past few months, though, numerous doctors have been questioning this knee-jerk reaction and Canada has published new guidelines for breech birth, as well as has been promoting and producing numerous breech workshops throughout Canada to raise awareness and training for vaginal breech birth.

For the vast majority of U.S. women planning a hospital birth, when they hear the news that they are carrying a breech baby, their doctor or hospital-based midwife will schedule a breech cesarean between 37-39 weeks. There are other options though.

Concisely, here are your choices:

• To have a planned cesarean for breechness
• Working to change babies position from breech to head down (vertex).
• To change providers to one who will deliver breech babies vaginally
• To wait to go into spontaneous labor before checking to see if baby is still breech and then opting for a cesarean. 
• Or a combination of any of these (i.e. work to change babies position from breech to vertex for the last few weeks for pregnancy... but ultimately wait for labor to start on it's own before reassessing babies position and then, if baby is still breech, opt for cesarean).

Elective Cesarean
My readers have heard me harp on them enough to know that I am never a supporter of elective cesarean ( = without medical justification), so I will let someone else do the harping for a change.

"The Coalition for Improving Maternity Services (CIMS) is concerned about the dramatic increase and ongoing overuse of cesarean section. Since 1983, one in five women or more has given birth by this major abdominal surgery. Today, one in four or 25% of women have a cesarean for the birth of their baby. The rate for first-time mothers may approach one in three. Studies show that the cesarean rate could safely be halved.

The World Health Organization recommends no more than a 15% cesarean rate. With a million women having cesarean sections every year, this means that 400,000 to 500,000 of them were unnecessary. No evidence supports the idea that cesareans are as safe as vaginal birth for mother or baby. In fact, the increase in cesarean births risks the health and well being of childbearing women and their babies." - For more information read here.

This is why I am writing this post. I want women to know their options so that they can be  sure that they are in agreement with the majority of American doctors that believe a breech presentation is medical justification for a cesarean. And, if they are not in agreement with them, I want women to know what other options that they have.

Trying to Change Babies Position

The exercises herein outline the least to most aggressive means for encouraging baby to change his/her position to head-down. Easy examples of these types of exercises can range from daily habits (i.e. if mom has low amniotic fluid, drink more, if mom has postural issues, adjust accordingly) to specific methods and practices (chiropractic, manual movement, acupuncture).

Emotional State - The first thing that I touch on when a woman tells me she is carrying a breech baby is her emotional and mental state. The least aggressive means of encouraging baby to turn are emotional/and mental relaxation. Many midwives swear that a large number of babies that are carried breech are in that position for emotional or mental disquiet. 

These can include:

• the mom-to-be fearing becoming a mother
• the mom-to-be and her mother having unresolved conflict
• the mom-to-be not wanting to 'give up' carrying her baby

When a woman is not sure if this might be the reason for her baby's position, I encourage her to spend some time mother-centered journaling. This means that mom would set apart a time where she will not be interrupted to write. She should have water on hand, have recently emptied her bladder, have a few sheets of fresh paper, and a pen. During her journaling, she can ask herself to be honest about her feelings toward her mother, being a mother, and not being pregnant anymore. Then, during her writing time, she will write without pause - freely allowing her words to come from her mind and heart to her pen, no grammatical corrections and no crossing out.

After completing the exercise, she can talk with her midwife, doula, close friend, sister, or partner/spouse to find out how to resolve anything that might have come up during her writing time. Additionally, she can pray, meditate, visualize, and ask baby to turn.

I have watched women get into a warm tub of water in a dark bathroom with nothing but candlelight and, while touching/rubbing their bellies, listening to their bodies, and talking to baby, seen their babies turn vertex.

Beyond emotional and physical relaxation, the most common ways to change babies presentation from breech to vertex is to try positional exercises.

Inversions - the key to inversions are to do them as long as comfortable. These can include table inversions, knee-chest positions, water inversions, or dumping.

Table inversions are just what they sound like, inversions on a table-like surface. Some midwives will combine inversion tables with other methods of working to turn baby's position. This can be done at home on a piece of plywood or ironing board, or on an actual inversion table.

Example of knee-chest position (and moxibustion)

Water Inversion

 

Two examples of dumping

Rebozos - Rebozos give almost any position an added 'umph' by encouraging baby through demonstration of how to wiggle or jiggle into a head-down position. There are two rebozo breech moves in particular. One is a knee-chest combined with ribozo to put pressure on baby's head and encourage them to move. (see picture to the right).

The second is a breech sifting. Follow the position in the picture to the left. Then, with the 'rebozo' in place, have a partner/friend 'sift' your baby. The basic movement is more like a rhythmic step than a swing.  You are not swinging the mothers hips from side to side.  Instead you are slightly pulling one end of the rebozo, then the other, back and forth rather quickly.  This basic movement should be relaxing to mom. This causes a jerk to the baby which encourages movement to the desired position.  

Now, if you make it here without any of the above working, continue to try the positional exercises in conjunction with the methods below as they will increase the odds of one of them working (i.e., try dumping right before the Webster).

Yoga - yoga is body work and, since we are trying to encourage baby's body to move, it makes sense that yoga works well for this purpose. A guest blogger wrote a wonderful article on yoga and how it can help when baby is breech here. Specifically, I love the last picture in that post.

Acupuncture/Moxibustion - You can see an example of moxibustion in the video referenced earlier in this post. This acupuncture technique involves burning moxa sticks over a certain acupressure point on your little toe every day for 10 days. Alternately, this can be done with a fingernail head of a ballpoint pen on that same point on the little toe (BL67). Some report success rates as high as 80%, while others report success as low as 50%. 

Chiropractic Care - There is a chiropractic treatment called the Webster Technique which encourages the mother’s pelvis to become straight and aligned. This would decrease the chance that mom's skeletal alignment 'holds' baby in a breech position. It is very gentle and noninvasive. The success rate for this technique is shown to be anywhere from 75-95%. Additionally, there are other techniques with great success including Bagnell's Technique, Malott's Technique, and others.

Homeopathics - There are some homeopathics, including Pulsatilla and Arnica, that have been shown to encourage a baby to turn head down. These are best used in conjunction with other methods of turning baby vertex. As I am not a licensed homeopath, I encourage you to contact a local herbalist, homeopath, or midwife in your area for more information on their uses, dosages, risks, and contraindications.

Essential Oils - putting some peppermint oil (diluted in coconut or other carrier oil) over babies head has been known to encourage  baby to turn. So have ice packs used the same way.

External Cephalic Version (ECV) - An ECV involves a care provider physically manipulating baby through the mother's abdomen to encourage baby to flip head-down.

Some doctors 'require' that mom have an epidural in place or other relaxation medication (such as morphine or stadol/nubaine/demerol), and most will 'require' that, immediately after the ECV, mom will either be induced (if baby goes head down) or be given a cesarean (if it is not successful). I say 'require' because you can always refuse. An example can be seen here:




Vaginal Breech Birth
There are certain criteria when considering a vaginal breech birth. The very biggest being making sure that your birth team has experience with vaginal breech birth. Additionally, reducing risk for breech vaginal birth includes candidates who meet the following:

• Attempts to turn the breech baby to a head down position were unsuccessful, or not chosen.
• The baby was estimated to be heavier than 5lb 8oz and lighter than 8lb 13 oz.
• The baby was in a frank breech (baby's legs extended up with their feet near their ears) or a complete (or flexed) breech position, ie. baby's legs down, and crossed over. This decreased the chances of complications, such as cord prolapse. Positions are explained in depth in types of breech positions.
• The caregiver was experienced in delivering breech babies vaginally.
• The woman was keen to have a vaginal birth.
• The woman's pelvis is believed to be an adequate size. - Birth.com

Other protocols and guidelines can be read about on Spinning Babies, Birth Light,and the SOGC.

Let Baby Decide
Some women, for whatever their reasons might be, choose not to change providers to one familiar with breech birth. For these women, a good option might be to wait and let baby decide. This simply means that, rather than scheduling an automatic cesarean at 37-39 weeks for breechness, waiting until labor begins on it's own.

At that point, mom can work through early labor, and then, during active labor, reassess baby's position. If baby is still breech, the care provider would go ahead with the cesarean and, if baby has moved into a vertex position, mom can go ahead with labor and birth vaginally.

In Conclusion:
If you happen to be one of the women who get the news that their baby is sitting breech in the womb, know that you do have more options than a scheduled cesarean. Also know that there are women in your area who will love and support you through every option that you have.

If you are specifically in the Houston area and need information on breech-friendly doctors and midwives, just give me a call. I also have a list of midwives and doctors who will do ECV as out-patient (without requiring immediate cesarean or induction afterward), chiropractors familiar with Webster and other breech-turning chiropractic techniques, acupuncturists, and more.

And finally, for encouragement:



Further Reading:
Head's Up
Breech Birth Statistics
Spinning Babies
A Breech in the System
Stand and Deliver: Dance of the Breech

The FDA is Having a Pool Party

www.richmondmidwife.com

And we weren't invited.

This morning I got onto Facebook to read that Barbara Harper posted a note. The information within it floored me.

The FDA has confiscated a shipment of birthing pools and is holding them.

These pools were destined for a company that sells many home birthing supplies that are medical and non-medical, where they would then be distributed to the women who purchased them for a water birth..   

The directives are clear: they will be destroyed or shipped out. Their reasoning? They are stating that birth pools are medical equipment.

The FDA says that birth pools are unregistered/unapproved medical equipment... really? REALLY?

"Got a kiddie pool in your house?  Watch out!  The FDA may be coming after you!   No… seriously, they might be knocking on your door to seize your unregistered medical device! No joke!" - Danielle from Being Pregnant

I think we should flood the FDA with requests to approve all other 'medical equipment', including: birth stools, my kitchen chair, washcloths, regular baths, shower heads, fish nets, submersible pumps, toilet, breast pump, bed, dining room floor, kitchen floor, rocking chair, sofa, ice maker, rice sock, Tingler, rebozo and husband... oh, and let's not forget ME! (not really, but this is my knee-jerk reaction).

"And therefore since one arm of the U.S. government believes that pregnancy is an illness and birth is a medical event and anything that is used during this time is considered a device that needs to be approved by the FDA, what is the next option/choice to go?" - Childbirth Today

This just fumes me... and I hope it does you too!

So, the federal government now consider birth a medical event... As far as I knew, it was state by state whether legislature considered childbirth a medical event or not (i.e. midwives practicing medicine without a license or simply providing a service).

Additionally, the very DEFINITION of medical is: Relating to the science or practice of medicine...

Likewise, the definition of medicine is: The science or practice of the diagnosis, treatment, and prevention of disease (in technical use often taken to exclude surgery), or a drug or other preparation used for the treatment or prevention of disease...

So MEDICAL EQUIPMENT means: equipment related to the science or practice of the science, or practice of the diagnosis, treatment, and prevention, of DISEASE!...

uh... childbirth is NOT A DISEASE!

Laurel Ripple Carpenter quickly got a blog post up and running, seeking to inform others about this issue and to rally support.

According to Barbara Harper, author of Gentle Birth Choices and founder of Waterbirth International, the FDA has seized a shipping container of AquaBorn birthing pools at a dock in Portland, Oregon, and have ordered agents to “inspect and destroy.”

“They claim they are unregistered medical equipment, but they are not providing a way or means to get them registered. In other words, if the medical authorities can’t stop waterbirth, then just have the FDA take away the birth pools,” she explains in a lengthy discussion that began yesterday.

While birth pools are imported to Canada under the category “paddling pools” and some are imported here in the U.S. under the category “sitz baths,” they have no legal standing as medical equipment at this time.

But why would they?  They are purchased or rented for personal use in private homes.  Barbara’s conversation with an FDA official may shed some light on this as a clash of perspectives.  She explains that she was told, “Pregnancy is an illness and birth is a medical event. Therefore, a pool that a woman gives birth in should be classified as medical equipment.”   So what about our toilets, our bathtubs, our showers?  Kiddie pools, horse troughs, hot tubs?  Oh, and what about the fact that pregnancy is *not* an illness?

What the FDA Wants
Martha Blackmore Althouse, owner and manager of Waterbirth Solutions in Beaverton, Oregon, has been interacting with attorneys and the FDA on the issue.  She explains:

The FDA is requiring a 510(k) – PreMarket Authorization – to be turned in for each Inflatable Birth Pool. The problem is that there is no Pre-existing Medical Device – “Predicate” – already approved by the FDA. Hence, potential of years of clinical trials and legal fees that can cost up to a million or more. Obviously not feasible.

One potential loop hole is a “PreAmendment Status” product. If there was anyone in the US using birth pools (yes, troughs, tubs of any kind) prior to May 1978, we can get “Birth Pools” grandfathered in to the FDA as an approved Medical Device. Waterbirth would have permanent legitimacy and could not be questioned any further.

So it seems that there could be a solution to this, but not before enduring a long process full of red tape and bureaucracy.

How to Help
Martha and Barbara need help – specifically, a high profile attorney and support from any midwives who were practicing waterbirth before 1978.

“If you know of anyone practicing waterbirth prior to 1978, please let them know we could use their help,” Martha pleads.  That would be the only way to establish birth pools as eligible to be grandfathered in.  Also, “We need a high profile attorney to highlight the ludicrous nature of this attempt at taking away women’s choices for comfort in labour,” explains Barbara.

This whole thing seems pretty baffling, and I still find myself wondering if it could possibly be real.  But evidently, according to several trusted names in the birth world, it is.  So let’s get on it–Facebook, Twitter, and your whole Rolodex full of powerful connections.  Hit ‘em up.

See the original note here. See the follow up here, then go to Enjoy Birth's Blog to vote on if birth pools should be considered 'medical equipment'.

UPDATE: Here is the followup post. Please help us take what positive action we can to get these birth options back into the hands of the women who need them.

Talk It Out

Many women researching natural birth will hear about the ills of medical providers, their responsibilities and shortcomings towards their patients… but what about YOUR responsibility as a consumer?

A positive consumer understands that, when it comes to healthcare, they are an active participant, having an ethical and personal responsibility to make sure that the medical care provider that they hire will work hard for their choices and beliefs. You heard right, you hire your care provider.

Would you allow a landscaper to make all of the decisions regarding your lawn or would you research what you want your lawn to look like, be like, and produce like? Would you turn your lawn over to that landscaper and, when (s)he let you know their plans, mutely nod even if you didn’t like what was being planned, or would you tell them your expectations and desires, plans and hopes? Likewise, although your lawn might not turn out exactly like you had planned with your landscaper, if you trust them fully, you can trust that it will come as close as your soil and your property allows for.

Consider this: your doctor or midwife has a responsibility to give you factual information, practice unbiased and evidence-based medicine, and to treat you as a whole woman, not simply a patient. They have a responsibility to let you know their policies, procedures, and standards of care – what they expect from you as a patient.

But, as a patient, it is your responsibility to be open and honest with your care provider. Withholding your feelings, beliefs, desires, and fears breed distrust on both sides of the proverbial fence. It is vital that, as a patient, you be able to speak up about your choices regarding your health care, even if you and your care provider do not see eye to eye on some issues.

The relationship that you have with your care provider is not their sole responsibility - it is a two way street. If you are fully open and honest with them and don't feel it is reciprocated, perhaps they are not the caregiver that you want to trust to handle your body and baby during the most vulnerable event of labor and birth.

If you feel they have ulterior motives beyond your health and wellbeing and that of your unborn baby, if they are not fully supportive of your choices (whether or not they agree with your choices), or if you simply do not make a good team (yes, you two are a team), perhaps it is best to look for another care giver. It is never to late to make the change.

For additional information, please take a look at the links below:

• What Type of Care Giver Fits Your Beliefs
• 10 Questions to Ask Before You Have a Baby
• Switching Care Providers in Pregnancy

first posted in 2008

Induction Increases the Risk of C-Section and C-Section increases Newborn Infection

Labor Induction and the Risk of a Cesarean Delivery Among Nulliparous Women at Term, a recent study published with the American College of Obstetrics & Gynecology (July 2010 - Volume 116 - Issue 1 - pp 35-42) gave the following conclusion:

Labor induction is significantly associated with a cesarean delivery among nulliparous women at term for those with and without medical or obstetric complications. Reducing the use of elective labor induction may lead to decreased rates of cesarean delivery for a population.

This makes for even more worrisome fodder, as the study also includes this information:

Labor induction was used in 43.6% of cases, 39.9% of which were elective.

Inductions for 43.6% of cases?! How many inductions are too many?? And, based on the information given just previously, how many of those resulted in maternal or newborn risk?

Another study printed with the National Academy of Sciences researched what microbiota habitat a newborn at birth... depending on their mode of birth. The small study found that:

those born vaginally tended to get colonized by bacteria such as Lactobacillus from the mother's vaginal canal. C-section babies, however, got more Staphylococcus, a type of microbe usually found on the skin and one that sometimes causes nasty infections. - "Babies' First Germs Depend On Type Of Birth", Chao Deng, NPR

So, in conclusion, to lower cesarean rates and increased risk of newborn strep infections, we should stop inducing for mundane reasons. To lower strep infections, lower the risk for newborn death, respiratory distress, incidences of autism and other SENs, and modestly lowered IQ scores, we need to stop inducing so much.

This is only the tip of the iceberg, people. Oh, the tangled web we weave.