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Posts tagged ‘Birth Stories’

Supporting my Non-Breastfeeding Daughter-In-Law … Part II

Why is that some of the common childhood bumps, bruises or injuries have to happen for the first time when I’M in charge of the baby?? I swear…seriously.. I was right there! Please believe me! 😕

"The perfect Grandmother keeps the infant safe at all times and goes on daily outings..."


This is a continuation of Supporting my Non-Breastfeeding Daughter-In-law Part I

Let me back up a minute. I have been going down to Dave and Sadie’s regularly for help with babysitting my grandson Tommy. I was getting good at being just a grandma and not a nurse. He was growing pretty well even though we all had to put a lot of effort into getting adequate calories into the boy! He was long and lanky. A skinny lightweight. Both his parents are very tall so it may partially be just genetics. He had outgrown some of his feeding issues as he merged into toddler-hood. Then he turned into a finicky picky eater. Through out all this time, Sadie and I were feeling really comfortable with our relationship. At least I know I felt good about it and she told me she did also. We had developed a respect for one another.  She had been relying on me to come and help out from time to time.  I was always so happy to oblige so that I could see Tommy and enjoy some time with him. I remained respectful of how she wished his day should go for example, managing nap-time, playtime outside, meals and how to handle unwanted behavior. She didn’t have a lot of rules at all…just certain things she asked me if I could do to maintain consistency. No Problem. I know she appreciated it. Sometimes my son would call me to tell me that Sadie said I had done a really good job with the baby that day etc..  🙂

Tommy started talking! He mixed some letters in the beginning and came up with my name. Instead of “Grama”… it came out “Manga”! We all loved it and it stuck. Now I am forever… Manga! It is so delightful when when you are recognized and greeted with an excited little voice! And even more delightful when that sweet little boy calls you his own special name! We played lots of different things and I was having a blast!

One day as we were march-dancing to a little song in the living room clapping toys together, I sat down on the couch, getting tired, and Tommy came running towards me, dropped his toy, immediately tripped over said toy– flying face first into the coffee table! Oouch! He hit just under his right eye! He didn’t break the skin and his eye was fine. But darn it! He got hurt 😦  This was the FIRST face bump he had! One time he had bump on the back of his head from falling over a few weeks back and I had overheard Sadie telling one of her friends about it then saying “It did NOT happen while in my care, let me assure you!” I think my son was playing with him at the time. So needless to say, I was a little anxious to let her know what had happened but of course I had to tell her right away. I called her and explained what happened, how he was and that he was letting me hold ice on it while I had a video going and he was having milk. I KNOW she was upset…. what mommy wouldn’t be when something like that happens to their baby when you are at work. She was very good about it, asked me if I could take a picture for her and send it so I did.  Everything was OK… Tommy actually got his fair share of bruises and bumps!

The next one involving me was pretty upsetting. We were at my house, Tommy was in the high chair, his parents just left for dinner. I cleaned Tommy up and got him down. He ran past the sink where my husband was making the dogs dinner (Tommy had been playing with our Chocolate Lab all day) and the dog turned and snapped at Tommy as he went by!  That sweet little angel boy just sat on the floor stunned and didn’t even cry till I picked him up~ horrified~ and left the room to examine him. He had welts of dog teeth around his tender little calf. No broken skin!    Oh.My.God. This. Did. Not. Just….Happen!! Ice, snuggles with Manga, milk, favorite video and phone call to mommy again. They were both very upset but realized it was all an accident.  It was completely gone in a few days. Still. That was beyond sucky. 😕
I think part of learning as you go…as a parent helps you to de-sensitize yourself to some issues or things that you originally thought were such a big priority. You begin to accept some things as they are and not expect that you can have control over all the little things. This may have been what happened to Sadie. I saw her relax on things about which she had previously been so firm. I didn’t tell her I saw this transformation but it was there.

Sadie got pregnant again on their first month of trying!! They told me when we were out to dinner. I saw my son get up and move a lamp above my head saying the light was in his eyes, He sat back down again and said “I don’t think we’re going to make it up for Thanksgiving this year, mom.” “Why?” …I said (That was the one holiday they ALWAYS spent with my family…..) Dave says nonchalantly: “Because- it will interfere with Sadie’s due date.” I jumped up so excited!! (glad he wisely moved that lamp) then they said… “You are the first to find out Manga… we didn’t even tell Sadie’s parents yet!” I felt so honored!!  YAY!

Because I had previously been admonished for saying things in a way which I had felt was “just being  myself” and I obviously crossed the line, I wanted to be especially careful and respectful. There was always an underlying fear for me that I would screw up. I didn’t ask or talk about anything medical. I had learned how to just be a supportive Manga. Life went on, I was babysitting frequently and Sadie was already in to the second trimester.

“I want to make sure I get breastfeeding right this time.” Sadie said to me out of the blue while I was having breakfast with her one morning. “I’ve been reading about it and I want to do a lot of things differently. I don’t want all those people in the hospital. I just want it to be me and Dave and the baby.”  (I was quiet, letting her talk)    “I was really depressed after Tommy was born and I had tried to pump but not really very much so I never had much milk… I was reading you need to pump a lot” ( I felt so bad I didn’t know she had been depressed! She hid so much from me then…I should have seen it!)    Of course I was so happy to hear her say this on her own….  😀      In order to be most supportive, I needed to find out what her wishes and goals were… so that’s what I asked.  Then Sadie replied: “I want the baby to get all breastmilk for as long as possible.. I don’t care if the baby feeds from me or if it’s pumped milk.”… she continued… “I’m kind of afraid that I might not like it….  and I might want to see how much the baby drinks every time after what we went through with Tommy. What do you think?”

I said” You are an amazing woman! Anything you’ve ever put your mind to seems to be what happens! You should be able to do things however you like. I am so sorry you were depressed last time, that must have been so very difficult! (Pause for Hug) I will help you anyway I can if you want.” Sadie said she did want some help figuring out a good book to read and some info on pumping. I was totally happy! It wasn’t so much that Sadie had expressed her interest in breastfeeding (which of course I was over the moon happy about…) but more that she wanted to talk to me about things and wanted my guidance! I felt like we had really reached a milestone!

Once I got back home I got the PERFECT book ready to send her! “Breastfeeding with Comfort and Joy” by Laura Keegan. I had met Laura online and we struck up an immediate friendship. She has the best approach to showing moms how to really have a very comfortable and enjoyable breastfeeding relationship. I have used this book as a teaching aid at work to help moms really visualize what we are discussing. I find it invaluable. Sadie got the book in the mail and read it twice through! She loved it! She started asking me questions a few times a week… referring to the book and looking past her immediate goals to future issues and asking about that! For the first time, after her mother’s negative experience, her own bad experience to the point where she just gave up even trying…. She was now seeing breastfeeding in all it’s beauty! I thank Laura Keegan for this fabulous book! Helping to gently open the eyes of a young women and empower her!

After more discussion, and checking Sadie’s wish list, I decided I would also buy her a high quality pump. She had checked with her hospital to see what they had there and it made sense to stay with the same kind. I got her an Almeda Purely Yours Ultra. We had a little breastfeeding class and pumping info class on a Sunday afternoon. She had Dave set up a little pumping station in their bedroom. All the while, I really only gave her info she asked about, the basics of milk productions and the importance of skin to skin and self attachment. I went into detail on what she wanted and highlighted things that were important for good understanding and good overall management.

Sadie went into labor again at about 38 weeks. My job was to stay at the house with Tommy. I left work early and got down there just after he went to bed. There was a babysitter there who then left and I was all alone…. waiting to hear.  Finally I got a text and a photo… Another boy!! Joseph or “Joey”. The text was from Dave and said “he’s never left Sadie except to get weighed and he’s been nursing a lot already, mom!” I was so happy for them! The next day, Sadie’s dad came to stay with Tommy so I could go over to see the new little family. The plan was for a quick little visit so I didn’t interrupt their alone time. Sadie called then and asked where I was, how far away because the baby was ready to eat and she want me to see if it looked alright. (The surprises kept coming.. I was really honored once again..) I got into the room as she was preparing to feed. She seemed so confident as she positioned herself and Joey. He opened wide and self attached beautifully with a big deep mouthful of breast! Sadie looked blissfully happy, had no pain and was experiencing the positive signs of hormonal surge. Joey began to have a rhythmic deep sucking pattern with audible swallowing. I was able to point out all these positive things to both of them. Like a well rehearsed play, it was as if the perfect script had been well acted!  I would not have believed it could have gone THIS well for them if I didn’t see it myself!! I thought I was going to leave then and she asked if I could stay and help her with the pump to make sure she knew what she was doing with that in case she needed it later… She wanted to pump anytime Joey was not feeding well. He was a great nurser but she pumped anyway so she had an excellent supply!

To get to this point has been a fabulous journey of learning more about myself and learning more about how to be the best support to other moms in my care. Sadie went on to nurse Joey or feed him pumped breast milk exclusively for the first 4 months. She continued to pump and nurse after that but had started to also use formula at times. She did a fabulous job! She is very proud of herself.  One thing she said to me a few weeks ago was that she thinks having her babies, and especially nursing Joey, has really made her feel so much closer to me. *tear**

Then she thanked me for hanging in there…… again……….

Support the mother, Support the mother, Support the mother most important of all!

And the Manga… Support the Manga! Most Manga’s want to to the best for you…

Show us how!

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Happy to be a NICU Nurse Week w/ Video

Happy belated International Day of the Midwife

Happy Nurses Day

Here is a great video on what it means to be a NICU nurse

Here’s some live action of stabilizing a preemie…

Amazing Woman has an Amazing Home Water Birth

Go GINA GO!

I lit my Blessingway candle in the wee hours of the morning when I saw that her labor at home was underway.

I faced the candle in a window towards her home 1500 miles away.

I like how the reflection makes it appear as though the light keeps spreading west towards her…….

sending love and support…..

Not only did she have a VBAC today–

She had a HOME VBAC !!

AND during Cesarean Awareness Month!

Gina of The Feminist Breeder is one of the most courageous women I have ever met!

Yep- I met her! She invited me … little ole me… to her Blessingway in March when I happened to be in town. I was so incredibly excited to meet her and all her fabulous birth team! Yep- I’m in that Blessingway post she did.

Photo of the TFB Blessingway Group

Here’s one of the beads I gave her for her necklace.

ICAN Cesarean Awareness Bead

Congratulations Gina and John!

Welcome Jolene!

But it’s her story to tell……. Head over to her blog and check the coolest EVER live blog birth event. The whole thing can be read and viewed from last night thru til this morning. The audio and video clips are for QuickTime player and each clip may take a few moments to load before you can push play.

I had it on today … at work… in the NICU and took the opportunity to try to educate..

Thanks for sharing Gina!

I am so so happy for you!

Push for Real Changes in our in-hospital Maternity Services

The average consumer may not know what could possibly be helpful in exacting REAL change in our hospital maternity care. I am certainly no expert in this field and would welcome additions or corrections to what I say here….. but I want to offer a little perspective from the inside. Maybe this will help somewhere.

I am a Birth and Breastfeeding Junkie and I am proud. I don’t care if someone recently didn’t like that nomenclature….. That’s what I call myself and how I relate to other like minded individuals. I have a need to know what’s going on in that world.  We junkies read and discuss all the current evidence, all the latest recommendations from the WHO, NIH, CIMS, ICAN, ACOG, AAP, AWHONN, ILCA….. and so many more. We love all birth stories and learn from each other. We educate ourselves. We STAY current. We want informed decisions. We want options. We want this type of evidence-based care available where we live. We advocate for those individuals who may not even know there may be another choice. We want to see the women of America have access to respectful quality services everywhere!

Ok –> that said…. When I see new evidence, research or new recommendations; what I have done over the years to offer up any proposal for process improvement or care delivery change including whatever may be needed to implement these changes… is to collect resources, develop a policy or plan and present to docs, manager and staff. The response is usually positive. Sometimes I get a lot of “smile and nod” and “please hurry up I have other things to do I’m not really listening”…. but mostly positive. Sometimes it’s only positive in that “My you’ve done a lot of research..and Good Job!”  instead of–Yes let’s do this! The changes are not always adopted and there isn’t a total “Buy-In” from everyone to make it a successful total change in practice. Eventually and unfortunately, because these things aren’t monitored, many practitioners go back to their own comfort zone of past [outdated] practices. Arrghh

Project poster inservice example

There must be a better way.

I was sitting in a Professional Practice Committee meeting a few weeks ago listening to a mandatory (did I say Mandatory?) action plan presentation by the Director of Patient Relations/ Patient Satisfaction when it hit me how there may be more avenues for REAL change driven by the consumer than those of us in the trenches. All of the directors (suits) were there and were required to come up with unit-specific mandatory action plans to improve patient satisfaction and positive perceptions of their hospital experience.

She was presenting an action plan based on the latest HCAHPS report.

What is HCAHPS?? Maybe you know- maybe you don’t. Skip over this if you already know.

“The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patients’ perspectives of hospital care. HCAHPS (pronounced “H-caps”), also known as the CAHPS Hospital Survey, is a survey instrument and data collection methodology for measuring patients’ perceptions of their hospital experience. While many hospitals have collected information on patient satisfaction for their own internal use, until HCAHPS there was no national standard for collecting and publicly reporting information about patient experience of care that allowed valid comparisons to be made across hospitals locally, regionally and nationally.

Three broad goals have shaped HCAHPS.

  • First,the survey is designed to produce data about patients’ perspectives of care that allow objective and meaningful comparisons of hospitals on topics that are important to consumers.
  • Second, public reporting of the survey results creates new incentives for hospitals to improve quality of care.
  • Third, public reporting serves to enhance accountability in health care by increasing transparency of the quality of hospital care provided in return for the public investment.

With these goals in mind, the Centers for Medicare & Medicaid Services (CMS) and the HCAHPS Project Team have taken substantial steps to assure that the survey is credible, useful, and practical.” HCAHPS fact Sheet 2010

The reason hospitals are taking these results so seriously is that.. well… I’d like to say they ONLY care about the patient, but they are a business and it comes down to money in reality.

$$$$$$$$$$$$

If a hospital scores fall below a certain number in patient satisfaction… they can lose like 3% of Medicare Reimbursement. That adds up to a lot of money really. You may think that doesn’t apply to Maternity Services but it does, ultimately, because that survey goes out to all adult inpatients. If the scores for satisfaction are low for obstetrics, it can throw off everything, and affect the reimbursement to the facility. That, in turn, can affect how much money is available for overall improvements.

Medicare has also started to cut reimbursement to cover the costs of “preventable” conditions, mistakes and infections resulting from a hospital stay in 2009. That is older news so you may already know about that.

The thing is– what the big two Medicare and Medicaid… [The Centers for Medicare & Medicaid Services (CMS)] often set the bar and other insurance companies follow in the private sector. The 2009 National Health Insurer Report Card may give you more information about what is or is not paid. I don’t know much more about that.

HCAHPS is the first I’ve heard of actual patient satisfaction scores steering reimbursement which is transparent and publicly reported. I have heard many pt satisfaction reports but they were never given this much attention. At least in my hospital.. Perhaps I’ve been too much of a Birth Junkie to notice. 🙂


The other big catalyst for positive change is the new JCAHO Perinatal Core Measure Set. The MotherBaby Summit website has an excellent review of these 5 elements, explains them and provides further references.

There are two new employees who only work on JCAHO compliance and data collection. They are looking at the PC-05 Exclusive Breastmilk Feeding numbers and are not happy…. Well — neither am I !!  I have been trying to do something about that particular issue since 1988 !  Since these are now factors for regulatory compliance as well as patient satisfaction… Now we are going to do something. I am pleased to announce that we are forming a Breastfeeding Task Force!! YAY! We also have a new Pediatric Dept Chair who is a no bullshit we are going to do it kind of guy… so YAY!

Bottom line: The hospital is sitting up and seriously taking notice about the consumers opinion AND how regulatory agencies are now monitoring things have never been monitored before.

  • Action plans are being developed to comply
  • The consumer has more of a voice than ever before

Here’s what you can do

Before the hospital:

  • Have a prenatal interview with your provider… ASK : Do they have current evidence based practices/protocols in place ….. do their standard orders reflect the most current evidence based guidelines and standards of care…. do the dept members all follow these standards. Do the nurses actually follow these orders….
  • Do the same with your pediatric provider
  • If you are not happy with the provider and choose NOT to use them, make sure they know exactly WHY… what were the points which caused you not to choose them.
  • Have a birth plan and discuss it with all providers, nurses and even mail it to the manager where you will deliver. Ask your manager to please make sure your wishes are communicated with the staff.
  • Use words like RESPECT, SATISFACTION, Patient RESPONSE Time JCAHO Core measures.
  • Ask for numbers when you have your interviews.. for instance..what are your CS rates? VBAC rates? What are exclusive breastfeeding rates? If they don’t know, ASK for the name of a hospital person who can help you get that information. I am sure they have the numbers.

In the Hospital:

  • Get the names of those individuals/ midwives/ doctors/ nurses/ etc who were good and those who were poor caregivers in your opinion. Write them down somewhere and why. Specifics help.
  • If you don’t feel your wishes are being honored or disrespected, ASK to speak to a patient representative. There is most likely somebody on hospital staff who has that role and can assist you. Use the words Satisfaction, Respect or what is relevant etc…
  • Ask for options if they are not discussed. Don’t rely on a Birth Plan you made weeks or months ago to be always remembered by everyone. Even if it’s right with your records. Different options may be available that weren’t before. For instance, We recently installed telemetry fetal monitoring allowing for increased mobility. If somebody asked a while ago, we did not have that option. You may have to repeat yourself… esp in a very busy Labor&Delivery or Mother/Baby unit. Sorry. That’s the way it is sometimes. It can get crazy but you are just as important as anyone!

After You Go Home:

  • You will be very busy with your baby and good or bad… your individual experience will be a memory that could fade over time. We still need to hear what you have to say IN WRITING whenever possible.
  • Please Fill out your survey –> it may be long but most are a multiple choice and allow for a write in comment section. Put in the names of the good and the bad!!  Please do it.. then actually mail it
  • Please make written comments. Include names. Specifics help.
  • Please Make Us Accountable. Write a letter to administration (Head of unit, Head of nursing or Head of hospital) include specifics. They HAVE to personally answer to this type of thing first! They get this info long before the surveys. Write for the good or the bad parts of your experience.  Including if you make suggestions. It may be monitored or tracked how many times they receive a comment about a certain issue. Definitely tracked for negatives– especially for specific individuals.
  • Please also write a letter to the Head of OB or Pediatrics Departments and let them know who else you sent the letter to. Include everything from above.
  • If you are certain what you experienced was NOT evidenced based medicine or care…. PLEASE mention exactly what you know.

 

Thanks for reading this, I hope somebody out there takes the time to give the needed feedback which will help mold and improve our care.

Success! You CAN Do it Right with a Preemie!

Short Little Success Story

Recently had to attend a birth for a 34 weeker who had been threatening labor since 32 weeks. She had been given a regimen of steroids and antibiotics per our protocols. The parents had a beautiful birth plan. They wanted Skin to Skin at birth, baby nursing before any separation and were adamantly against formula if at all possible. Both were frightened of the preterm birth, worried for their child’s safe transition and concerned that none of their wishes would be carried out.
I had the opportunity to discuss some of these with the Neonatologist and the parents before the birth. The doc was all for doing as much as they’d wished for at birth (that we could) provided the baby did not require respiratory support…

The baby was delivered hollering at us, alert and pinked up nicely! After observing and examining him for a short period, the doc gave the go ahead for Skin to Skin as long as I could stay and observe. Happy to oblige, I had that 4 LB naked baby up on mom in no time surrounded by her warmth and love.
I did the babies first glucose check (while STS) which was at a great level. Mom proceeded to start latch attempts. The baby did nuzzle and lick the copious colostrum she offered but wasn’t able to accomplish a latch. Vitals were stable, they were snuggling… but by an hour– the Neo was getting antsy. I had to take him in to the NICU with Dad in tow. No resp symptoms. Pink stable and alert. Placed up on the warmer table and connected to all the monitors for observation, he had his second glucose check. We expect it to drop at this time which is the normal nadir. It was however 38 which meant we had to feed. I asked for 5 min. This mom had a copious colostrum flow. The baby was not symptomatic. I had another RN watch him while I scooted back to L&D with a pump and small collecting cups. I figured we may have to hand express because many moms don’t respond to a pump quickly. This mom did respond and in a few minutes we had about 10 ml !!
I took that right in to the NICU leaving mom to finish a pumping session. We syringe fed the 10 ml and a subsequent glucose check was 54. Mom sent in a container of 15 more ml 🙂
They got to have a beautiful experience with their preterm boy who never got any formula … at least not in the NICU before discharge.

Yay!

CIMS urges ACOG –> Remove Barriers to VBAC

Received this email alert and thought I’d pass on thru my blog… and encourage all to take action!

It takes 5 seconds to add your name to the list!

e-CIMS Action Alert Sept. 28, 2010

CIMS Urges ACOG to Remove Additional Barriers to VBAC
Join us in asking ACOG to take steps that will increase VBAC, reduce cesareans, and ultimately avoid unnecessary harms to mothers and infants.

In a Sept. 9, 2010, letter to Dr. Richard Waldman, president of the American College of Obstetricians and Gynecologists (ACOG), CIMS and 18 co-signing organizations urged ACOG to revise its current recommendation that VBACs (vaginal birth after cesarean) should take place in hospitals where emergency cesareans are “immediately available.”

CIMS will collect the names of additional organizations and individuals in support of this request through October 31, 2010, and will send the updated list of co-signers to Dr. Waldman. Add your name or your organization’s name now!

This request follows the March 2010 National Institutes of Health (NIH) Consensus Statement on VBAC, which found that VBAC is a reasonable choice for the majority of affected women. The NIH also reported that the “immediately available” recommendation was not based on strong support from high-quality evidence and had influenced about one-third of hospitals and one-half of physicians to stop providing care for women who wanted to plan a VBAC.

CIMS and the co-signing organizations also urged ACOG to revise its patient education publications and online consumer resources to include comprehensive information on the benefits and risks of cesarean section and VBAC. Without transparency about the short- and long-term benefits and risks of routine repeat cesarean and VBAC, women cannot make a truly informed choice about how they want to give birth.

Additional Information:

CIMS Press Release “CIMS Responds to Promising but Conflicting Revised VBAC Guidelines”

American College of Nurse-Midwives Responds to ACOG’s 2010 VBAC Recommendations (PDF)

Take Action: Add your name or your organization’s name now!

Fabulous Vintage Breastfeeding & Mother’s Day Art

HAPPY

MOTHER’S

DAY !

1859 "Abundance" engraved by T.Vernon

1850 "The Gypsy Mother" engraved by E.Portbury

1840 "The Gypsy Mother" engraved by Greatbach

In the world of childbirth, Mother’s Day is a very special day. I have enjoyed years of watching a women become a mother either for the first time or again and again on this very day. It is always wonderful to share that experience with them.  Fabulously Joyful!

But today, I get to be home, pampered by my hubby and just milling about… I came across some wonderful websites carrying fabulous vintage engravings and various clip art. I absolutely adore antique engravings! I have some framed and others saved for something I’ll get to one day…  😉

This first few photos above are images courtesy of antiqueprints.com depicting mother and children. There are two WONDERFUL Antique Breastfeeding Engravings! These are all steel engravings with hand color in the first two.

The remainder of art below is from a website called “The Graphics Fairy” and all of these photos  are to Karen’s credit over there. Beautiful!

Enjoy!

Victorian "The Mother" engraved by the Illman Brothers

1880's Antique Engraving Children with Cherries

Beautiful old painting of a Mother with Children

Old French post card

NIH Conference on VBAC’S ~ Continuing to Spread the Word

Spreading the word from the NIH VBAC conference….It’s now coming thru via AWHONN Vitals!!!

This is at least a month old news to most birth junkies but….. but I find it encouraging that the news is coming thru from AWHONN (Association of Women’s Health, Obstetric and Neonatal Nurses). There are many many nurses and birth professionals out there that haven’t even heard about this conference. I know the big AWHONN convention is coming up in Nashville June 12th, and possibly this topic will be presented somewhere although late to get on agenda. Sometimes the nurses can help educate the docs…… ya think?

One topic on the Nashville Agenda is:

“SOLUTIONS FOR SURVIVAL: Working where Birth is NOT Considered NORMAL”

Boy~ would I love to go to that presentation!!!!!

From the recent AWHONN newsletter~

“Panel Urges New Look at Caesarean Guidelines”
The New York Times, Denise Grady
A government panel recently took steps that will increase women’s ability to find doctors and hospitals that will let them attempt a normal birth after a previous caesarean section. The recommendations came from a panel at a National Institutes of Health (NIH) conference convened to assess why the rate of vaginal birth after Caesarean section (VBAC) has gone from 28.3% in 1996 to less than 10% today. The repeat surgeries are contributing to the growing rates of C-sections in the U.S., which today account for nearly a third of all deliveries. Repeat C-sections were previously deemed safer due to concerns that the uterine scar would rupture, putting both the mother and the baby at significant risk. According to the chairman of the NIH conference, “We found the use of VBAC is certainly a safe alternative for the majority of women who’ve had one prior” C-section, as long as the incision was horizontal and low on the uterus. Approximately 70% of women who have had C-sections are good candidates for attempting a normal birth, and 60% to 80% of those who try succeed. The government panel urged the American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists to “reassess” their guidelines, which have rendered many clinicians and hospitals unwilling to allow VBACs. The groups’ current guidelines require that surgical and anesthesia teams be “immediately available” during labor if a women has had a prior C-section. Some institutions were unable to comply, and thus banned VBACs altogether.
Link to Article

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.

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.