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NBC’s “The Office” sends Positive Message to America for Birth and Breastfeeding

I haven’t ever sat through a whole episode of The Office….    maybe that’s why I didn’t ever really like it.  Perhaps I just didn’t “get” it!  This is a smart and funny show. Last night, they had a large viewing audience and great forum to send a positive message to America. They delivered… in a big way! This was a planned hospital birth so I am mentioning what I thought was positive about the reality of how this was portrayed.

Here’s what I liked:

  • Insurance issues … very real for some and guides some of parents decisions
  • Calm approach to early labor …no need to rush to the hospital with first contraction
  • Could be that she just wants another night in hospital but still comes off as a calm early labor
  • Many people in the Office were crazy & nervous except the mom –Pam
  • Pam feasts and enjoys the food while contracting..nobody said you better not eat!
  • I don’t think ever I heard epidural or C-Section mentioned!! (YAY)
  • Dwight decides he wants a baby and makes a contract including the “baby will be breastfed for the first 6 months” after-which he plans to feed some weird stuff but HEY… at least he indicated exclusive breastfeeding to start…right?
  • Pam still doesn’t want to go to hospital when her water broke
  • She showed a real but pretty brief fear of really “doing this” and becoming a parent
  • She didn’t have her ipod w/ birth music.. but this showed she was really planning and preparing for her birth
  • Pushed her baby out! YAY
  • I don’t think I EVER heard epidural or C-Section mentioned!! (I know I already said that but still— 🙂  No talk of interventions!)
  • Breastfeeding was the NORM in this episode! I did not SEE a bottle even though it was mentioned. The roommate was ALSO breastfeeding!
  • Trouble latching in the beginning is a common situation… It didn’t stop Pam
  • THE NURSE! Oh. My. God.!!! What a TRUE portrayal of the inept ignorant rude comments made by the nursing staff at many many hospitals!! (even mine.. but I’m working on that) Good for Pam to question her and stick her plan.
  • A male Lactation Consultant!
  • The fact that they used a Lactation Consultant…. YAY!
  • Great support from new dad Jim… even though it was funny how his facial expressions were not supportive of a male lactation consultant! (did we see the birth attendant? don’t remember)
  • They reach over in the middle of night and grab the wrong baby to breastfeed… I’m sorry—> that was really funny, I hope it didn’t offend any one. It’s not like a nurse gave Pam the wrong baby……
  • They have common new parent issues ie diapering, car seat, not feeling ready to go home etc…
  • Breastfeeding works out at the end of the show and Pam looks incredibly peaceful and happy… 🙂

The funky cover –> hey..it worked for her so really–who cares..?? I didn’t feel like that was a big part of the overall message IMHO.

My rating : Big A+

After the show– I find out via twitter that I actually know the writer and supervising producer! So cool!

(I work with his father who is an excellent Pro-Breastfeeding Pediatrician!)

😎 Psych 😎

What did you think?? The episode is called “The Delivery”. If you haven’t seen it, you can catch it online here.

For Expectant Families… your “Due Date”…

Hi everyone! Happy New Year!

I have been very very busy over these past months and I’ve spent very little time on the computer….. many of you have had the same situation. Thanks to all of you who keep checking my blog anyway!

I’m here now to talk about one of my big concerns.

Your due date…

Every single year around the holidays, we have a surge of elective, social induction requests.  Here are some comments we occasionally may hear each year around this time on an L&D unit:

“Please, please induce me so I can have the baby and be home for Christmas…please!”

“I’m only 2 1/2 weeks from my due date anyway so I’m ready…”

“I can’t have this baby on Christmas day..I just can’t…you HAVE to help me!!”

“I’m so tired of being pregnant and I have so much to do…can’t you do SOMETHING and make me have this baby today??” (37weeks)

“I really really need another tax deduction this year… ” (heard quite often!)

“Please do something so this baby is born by the end of December…I’ll even have a C/S if you want.”

“Can you induce me while my family is all here?? Please??”

Young pregnant women~ Please don’t do something crazy for a special delivery date.

Please!

Please educate yourself about the risks of induction and the risks of late preterm births.

PATIENCE

“A little patience now adds up to long-term health benefits for your new baby.”

I have received this following information from the Mother-Friendly childbirth community.

I felt it was well worth sharing……..

This is an excerpt from a newsletter from the CIMS ~ Coalition for Improving Maternity Services.

Please read, check out their website link above and the other resources listed below the letter.

Thanks so much!

“For Expectant Families

What you need to know about your due date and late preterm birth

A little patience now adds up to long-term health benefits for your new baby.

You’re not alone if you’re secretly (or openly!) hoping that your baby will get here sooner rather than later.  But when it comes to your due date, it’s important to understand what it represents, what it does not represent, and the potentially serious consequences of agreeing to an induction or c-section before your baby is ready to be born.

Mayri Sagady Leslie, CNM, MSN, clinical faculty at Yale University School of Nursing, recently penned an insightful post for Lamaze International’s Science and Sensibility blog.  In “Beyond Due Dates: How Late is Too Late,” we’re reminded that, despite widespread belief that EDD stands for ‘due date’, it actually stands for ‘estimated date of delivery’!  Mayri writes, “No matter what you call that date on the calendar, it is nothing more than a formula derived from statistical averages which says that sometime within a range of 4-5 weeks your baby will probably be born.  Smack dab in the middle of that range is one of days on which the labor may start.  Yet when it comes to dates in our life, few take on more significance than this one.”

Appreciating this fact is something of considerable consequence when it comes to the immediate and long-term health of your baby.  There is mounting evidence that only the baby should have the right to choose her/his birthday.  Two recent reports add to this evidence.

The CDC’s National Center for Health Statistics recently reported a 20% increase in the nation’s late preterm (34 to 36 weeks ) birth rate from 1990 to 2006.  The report also cites alarming increases in the number of late preterm births among births for which labor was induced as well as among births that were delivered by c-section.  The report cautions, “…it is becoming increasingly recognized that infants born late preterm are less healthy than infants born later in pregnancy.  Late preterm babies are more likely than term babies to suffer complications at birth such as respiratory distress; to require intensive and prolonged hospitalization; to incur higher medical costs; to die within the first year of life; and to suffer brain injury that can result in long-term neurodevelopment problems.”

March of Dimes 2009For the March of Dimes, prematurity is an extremely important public health issue.  The March of Dimes launched a multimillion dollar, multiyear campaign in 2003 to prevent premature birth and raise awareness of its serious consequences.  Last month, the March of Dimes released its annual Premature Birth Report Card.  Sadly, for the second consecutive year, the U.S. earned only a ‘D’ grade, “demonstrating that more than half a million of our nation’s newborns didn’t get the healthy start they deserved.”

We know you’re anxious to meet your baby.  It’s perfectly understandable too if you’re just plain tired of being pregnant.  We just want to remind you that a little patience now adds up to long-term health benefits for your new baby.

Learn more:

  • Beyond Due Dates: How Late is Too Late” by Mayri Sagady Leslie on Lamaze International’s Science & Sensibility blog.
  • Born a Bit Too Early: Recent Trends in Late Preterm Births” a NCHS Data Brief from the CDC.
  • U.S. Gets A “D” For Preterm Birth Rate” press release from the March of Dimes.”
  • America Scores a “D” on the Premature Birth Report Card

    _

    Hello Everyone

    I haven’t disappeared… I’ve just been too busy outside for computer time!

    This is a copy of a letter I received today trying to

    spread the word

    about Prematurity in this country……

    Today is the release of the second annual Premature Birth Report Card, and I wanted you to hear the news from me: America receives a “D.” As a country, we are failing to give our babies the healthy start they deserve.

    Your state has received its own report card. I’m afraid you’ll agree we have a long way to go. In fact, before the end of this year, more than half a million babies will be born too soon, some very sick.

    It’s Prematurity Awareness Day® — the day when we’re all focused on the terrible toll of premature birth on babies and families. The report card reminds us how urgent the problem is. But with the support of people like you, we can continue to fund lifesaving research and programs.

    If you haven’t already, I hope you’ll visit our Web site and join the fight for preemies.

    Warmly,

    Dr. Jennifer L. Howse

    President

    Our Cesarean Section Rates still Below the National Average

    002I had checked out a post by Jill from Unnecesarean reviewing ICAN’s Press release on the rising Cesarean Rate and how mom’s really don’t realize or recognize how they can reduce their risk for a surgical delivery. It is very good informative post. It’s just totally shameful and pathetic that one third of our nation’s babies are brought in to this world with a surgical delivery! I’ve been present for thousands of births. I remember when the doctors were under pressure to keep their C/S rates down under 20%!! They had to go under peer review when they hit individual rates over 16%. Those days are over.

    I have seen many different changes in the field of obstetrics, I am embarrassed that our national rates are now this high! I don’t feel that this is an advancement in maternal fetal obstetrical care. It feels like such a cop out most of the time when you are there in the trenches experiencing the “call” for a C/S time after time for “failure to progress”; “failure to descend”; “arrest of dilitation” etc…etc..

    I came across the perinatal statistics and thought I’d share.

    Here are our Actual Cesarean Section Rates so far this year January thru September

    for nearly 750 births:

    • Total C-Section Rate =   25.8% (monthly range 16.9% to 34.4%)
    • Primary C-Section Rate =  16.4%  (monthly range 12.5% to 23.6%)
    • Primary Rate in labor =    13.4%  (monthly range 8.9%  to 20.0%)

    Our average is about a quarter of the births falling below the national average of a third… for now. Can we keep this up?? I hope so. I really hope so. I hope we can even lower it! With a NICU coming in and sicker patients to go along with that… I am hopeful to just keep it where it is. I will do my best to help educate women, co-workers and the doctors I work with.


    We Deliver? How about we make it a better delivery?

    permission from CartoonStock

    permission from CartoonStock

    Our Maternity Services

    Need Help!

    The Maternal Child care delivery system in this country as a whole needs vast improvement. All of these 10 steps as well as the 10 steps to ensure optimal successful  breastfeeding are very important.

    These items are sadly grossly misconstrued or ignored by many facilities offering maternity services in this country. I have been having the same discussions and occasional arguments with co-workers  lately on this battle of the newborn baby staying in the moms room overnight!!! I know~ it is a no brainer to those of you who read, research and understand. Many of my co-workers still defend their philosophy that the baby needs to come into the nursery at night so the mom can sleep!!  Many argue with me about labor positions and inductions!! AARRGGHH! I won’t get into our details right now…….

    What I have here for you today is NOT new info but I recently reviewed it again as I was searching for evidence to back my discussions with staff. If you haven’t placed this information in your workplace to nudge some resistant peers, I urge you to do so!

    This document : THE COALITION FOR IMPROVING MATERNITY SERVICES:
    EVIDENCE BASIS FOR THE TEN STEPS OF MOTHER-FRIENDLY CARE
    can show you research studies or data which support the ten steps below.

    The 10 steps for Mother-Friendly Care from CIMS {Coalition for Improving Maternity Services} taken from their website…..are:

    Ten Steps of the Mother-Friendly Childbirth Initiative
    For Mother-Friendly Hospitals, Birth Centers,* and Home Birth Services

    To receive CIMS designation as “mother-friendly,” a hospital, birth center, or home birth service must carry out the above philosophical principles by fulfilling the Ten Steps of Mother-Friendly Care.

    A mother-friendly hospital, birth center, or home birth service:

    1. Offers all birthing mothers:
      • Unrestricted access to the birth companions of her choice, including fathers, partners, children, family members, and friends;
      • Unrestricted access to continuous emotional and physical support from a skilled woman—for example, a doula,* or labor-support professional;
      • Access to professional midwifery care.
    2. Provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.
    3. Provides culturally competent care—that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion.
    4. Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication), and discourages the use of the lithotomy (flat on back with legs elevated) position.
    5. Has clearly defined policies and procedures for:
      • collaborating and consulting throughout the perinatal period with other maternity services, including communicating with the original caregiver when transfer from one birth site to another is necessary;
      • linking the mother and baby to appropriate community resources, including prenatal and post-discharge follow-up and breastfeeding support.
    6. Does not routinely employ practices and procedures that are unsupported by scientific evidence, including but not limited to the following:
      • shaving;
      • enemas;
      • IVs (intravenous drip);
      • withholding nourishment or water;
      • early rupture of membranes*;
      • electronic fetal monitoring;
      • Has an induction* rate of 10% or less;†
      • Has an episiotomy* rate of 20% or less, with a goal of 5% or less;
      • Has a total cesarean rate of 10% or less in community hospitals, and 15% or less in tertiary care (high-risk) hospitals;
      • Has a VBAC (vaginal birth after cesarean) rate of 60% or more with a goal of 75% or more.
    7. other interventions are limited as follows:

    8. Educates staff in non-drug methods of pain relief, and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.
    9. Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.
    10. Discourages non-religious circumcision of the newborn.
    11. Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding:
      1. Have a written breastfeeding policy that is routinely communicated to all health care staff;
      2. Train all health care staff in skills necessary to implement this policy;
      3. Inform all pregnant women about the benefits and management of breastfeeding;
      4. Help mothers initiate breastfeeding within a half-hour of birth;
      5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants;
      6. Give newborn infants no food or drink other than breast milk unless medically indicated;
      7. Practice rooming in: allow mothers and infants to remain together 24 hours a day;
      8. Encourage breastfeeding on demand;
      9. Give no artificial teat or pacifiers (also called dummies or soothers) to breastfeeding infants;
      10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics

    † This criterion is presently under review.

    I endorse these steps. You can visit their website to also endorse.

    Kathy from Woman to Woman Childbirth Education wrote about the CIMS press release on the Need for Transparency regarding the rising C/S rates. Excellent information is discussed here by the CIMS and I enjoyed the discussion between Kathy and RealityRounds.

    I also would urge you all to visit and give information to The Birth Survey.

    How is your birth place measuring up to these initiatives?

    Let’s all continue to make this a better world

    in which to give birth!!

    A Full Moon doesn’t always bring lots of babies

    Full Moon Flight

    A Full Moon Flight?

    We had a Full Moon this past weekend. October 4th– according to my calender.  Over the past 35+ years in this business, it has been my experience that the full moon does NOT bring all the babies! We had just one baby born this whole weekend….  and hardly any labor checks. It was eery Quiet. (The “Q” word. Something we only say after our shift!)85902615

    The weekend before, however, is another story! We had 13 deliveries during the 2 day wkend and L&D was packed most days during the whole week leading up to this full moon! We had to use a lot of overflow rooms for evals and non-stress tests. Everywhere I turned, it was crazy busy.. and not just in L&D. It seems we get more babies with high bilirubins, more early babies with transitional breathing problems and other little issues whenever we have high census!

    In my experience, I have seen the most babies born either on a new moon or the week of waxing or waning of the full moon and not on the actual full moon.  Is it like that where you work?? I would really like to know the experiences of other L&D nurses.

    So tell me—  what happens in your world?

    No VBAC’s Banned: So Far so Good

    iStock_000004564778Small My little hospital is not one of those hospitals which has banned VBAC’s.

    We’ve been doing VBAC’s since 1984. Here is our first VBAC story. You may have read and heard that some places had specific policies against a mother attempting a VBAC.  There is really only a small percentage of women who truly are not a good candidate for a vaginal delivery after a cesarean. (Having a previous vertical incision in the uterus for example). There are several places a mother can go to for facts, scientific research, honest information and support if her provider or hospital has denied her an opportunity to VBAC. If this has happened to you, it will be important to do your homework, get the facts and have a really good conversation with your provider. It is important to make an informed choice weighing your benefits and any potential risks.

    We do just under a thousand deliveries a year.

    From January through July 2009~

    We had a 100% successful VBAC rate!!!!

    We had 2 mom’s last month that ended up having to go for a cesarean after labor began. I don’t know all the numbers but I had looked over the perinatal data sheets yesterday and I was so very happy to see how we were doing.

    Let’s hope we keep it up!

    😉

    Are YOU an Activist? Healthy People 2020 Public Meeting Announcements

    developinghp2020

     

    ARE you an activist?

    Do you want to have input or learn more??

    What do you know about the Healthy People 2010 National Objectives ……. and how the breastfeeding goals haven’t been met?

     

    The PLAN ~ The GOAL:

    (From the Healthy People website:)

    Healthy People 2010 challenges individuals, communities, and professionals, indeed all of us to take specific steps to ensure that good health, as well as long life, are enjoyed by all.

     Healthy People 2010 objectives for breastfeeding in early postpartum period, at 6 months, and 12 months are 75%, 50%, and 25%, respectively. Healthy People 2010 objectives for exclusive breastfeeding through 3 and 6 months of age are 40% and 17%, respectively

     

      So how are we doing???

    From the CDC website regarding Breastfeeding Data:

    Breastfeeding rates have improved since 1999, but fall short of Healthy People 2010 objectives regarding duration and exclusivity. Among children born in 2006, 74% initiated breastfeeding, whereas 43% were breastfeeding at 6 months and 23% at 12 months of age. Approximately 33% of infants born in 2006 were exclusively breastfed through 3 months of age, and 14% were exclusively breastfed for 6 months.

     

    Check the CDC website above for a complete evaluation of how we measure up. I am so happy for thoses states who actually accomplished these objectives! There are some that exceed these goals and others who are really behind. I think because of this, the national picture as a whole is misleading, reflecting an average of a lot of highs and lows. It doesn’t show a true picture for those areas struggling.  I want to learn more to help my area move up towards the goals.

    What can we do to improve and work towards accomplishing these goals ????

     I got this important email letter today and promptly registered to go the meeting in Philadelphia on November 7th.  I want to learn all that I can about what goes into the planning and possibly what more I can do at my local level to help meet the breastfeeding objectives. From the US Lactation Consultant Association:

     

    During October and November the Department of Health and Human Services (DHHS) will conduct public meetings in Kansas City (Kansas), Philadelphia (Pennsylvania), and Seattle (Washington) on draft objectives for Healthy People 2020. The public will have an opportunity to comment on the draft objectives at the public meetings, and on the public comment Web site. The comments received will then be used to revise the objectives appropriately. We hope that you will consider attending if you live near one of these sites. We will coordinate work on this with the US Breastfeeding Committee. This presents a wonderful opportunity to have our voices heard on national policy-making relative to breastfeeding.

    I’m not public speaker, I am interested in policy making for the HP2020.

    I want to go and learn from my well respected colleagues.

    Check it out! Click on the HP 2020 icon at the top of the post!

    Babies EVERYWHERE! Wordless Wednesday

    Babies Everywhere!!

    Babies Everywhere!!

    I got this greeting card a while back and I adore it.

    1950’s to 1960’s style maternity outing…

    cloth diapers and outfits

    Partial of the inscription inside reads:

    “Whatever you’ve got,  bet your glad it’s not this!”

    (Credit—> Shoebox division Hallmark)