Bob Monteverde is a lactation consultant at West Penn Hospital in Pittsburgh. Of course the first question he answered was the first question most people ask -- how did a guy become a LC? He recounted his time as a pediatric nurse in the military and some twists and turns with different patients and doctors that led him on his path.
I took away a great one-liner -- "It's not nipple feeding, it's breast feeding." I know a lot of women have flat or inverted nipples and some use shields, some pump first to draw out the nipple, but Bob's "Bob-ism" really reinforced what I knew already about the mechanics of breast feeding. If the latch is correct, the baby will draw out the nipple. The nipple shouldn't be anywhere near the front of the mouth (except in passing of course!).
(this is the type of blog post where I just cross my fingers that my dad doesn't read my blog today. Hi Dad!)
Another neat trick -- there's supposedly a pressure point on the baby's palm that triggers the suck reflex, and if mom or dad massage it while the baby's latched on it can encourage sucking. I wonder if that's why babies tend to do that hand-clasping motion so much, especially when they're nursing?
For me, this speaker reinforced my view that although childbirth and breast feeding are a woman's domain, when it comes to supporting those women, it matters a lot more what's in a professionals heart than what's in his skivvies.
Family Centered Maternity Conference: Manny Vallejo
The first speaker at the conference on Saturday was Manny Vallejo, the director of OB Anesthesia at Magee Women's Hospital in Pittsburgh. I have to say, regardless of whether or not I agreed with everything he said -- I have got to give him serious credit for speaking at the conference. I'm sure many would have seen it as nothing less than walking into the lion's den.
It was extraordinarily informative to see the thought process behind protocols at Magee and to learn that the actual policies the hospital has are not as conservative as many of the orders that doctors impose, as far as nourishment in an uncomplicated, unmedicated labor. A tray of clear food/liquid were fine with him up to 8cm. And who wants a cheeseburger in transition, anyway?
The epidural rate at Magee is 89-91% which elicited a groan from many. He rightly pointed out that the Magee also receives many high-risk women from suburban hospitals who have medical issues that warrant an epidural; but he also pointed out that there are 15 year old laboring girls who are terrified. I wanted to ask, well, how about making sure that mom-to-be has a doula? He did list the variety of analgesia Magee had at its disposal, and at the top of the list were Lamaze, birth ball, doulas, etc., and then gas/air, IV meds, and finally the epidural. He recognizes that other forms of pain relief are appropriate.
He also showed a photograph of a woman in labor, who was on her knees in bed, with her hands against the inclined head of the bed, with two women (nurse?) attending to her. (For those playing along, this is a lot like what my labor with Badger looked like.) I, like many others in the room, saw a woman being guided by her body. He saw a patient in pain, and said something to the effect of, "This is what you don't want to see," and that she probably should've gotten an epidural before this point. There is a difference between pain and suffering, and honestly, perhaps he had more background on who that woman was and how she felt in her labor, but I found it very interesting that he saw suffering where others saw the productive pain of labor.
Oh, and for TOLAC (ahem. not my favorite term.), he thought an epidural should be placed, even if "just in case." Aggravated me on many levels, although I did appreciate that he didn't feel that it needed to be utilized, just the catheter put in place.
All in all, a good speaker and we could've asked him questions all day long. He answered most questions in a fairly transparent way.
It was extraordinarily informative to see the thought process behind protocols at Magee and to learn that the actual policies the hospital has are not as conservative as many of the orders that doctors impose, as far as nourishment in an uncomplicated, unmedicated labor. A tray of clear food/liquid were fine with him up to 8cm. And who wants a cheeseburger in transition, anyway?
The epidural rate at Magee is 89-91% which elicited a groan from many. He rightly pointed out that the Magee also receives many high-risk women from suburban hospitals who have medical issues that warrant an epidural; but he also pointed out that there are 15 year old laboring girls who are terrified. I wanted to ask, well, how about making sure that mom-to-be has a doula? He did list the variety of analgesia Magee had at its disposal, and at the top of the list were Lamaze, birth ball, doulas, etc., and then gas/air, IV meds, and finally the epidural. He recognizes that other forms of pain relief are appropriate.
He also showed a photograph of a woman in labor, who was on her knees in bed, with her hands against the inclined head of the bed, with two women (nurse?) attending to her. (For those playing along, this is a lot like what my labor with Badger looked like.) I, like many others in the room, saw a woman being guided by her body. He saw a patient in pain, and said something to the effect of, "This is what you don't want to see," and that she probably should've gotten an epidural before this point. There is a difference between pain and suffering, and honestly, perhaps he had more background on who that woman was and how she felt in her labor, but I found it very interesting that he saw suffering where others saw the productive pain of labor.
Oh, and for TOLAC (ahem. not my favorite term.), he thought an epidural should be placed, even if "just in case." Aggravated me on many levels, although I did appreciate that he didn't feel that it needed to be utilized, just the catheter put in place.
All in all, a good speaker and we could've asked him questions all day long. He answered most questions in a fairly transparent way.
Oh, and if you're visiting... say howdy!
Let me know you've come and read the blog! Tell me when you think I'm full of it, or brilliant, or somewhere in between! Or just say hey!
Conference was a success!
I will write more tomorrow, because I'm about to fall asleep, but the speakers (head of OB anesthesiology at Magee Women's Hospital; a male lactation consultant at West Penn Hospital, and an accupuncturist with the UPMC Center for Integrative Medicine, and of course Jan Mallak) were informative, the energy was great, and I think the VBAC panel went well (I really really have a fear of public speaking so I confess it was a blur). It was terrific to put faces to names, meet new friends, and catch up with doulas, midwives, and childbirth educators from all around Pittsburgh and beyond.
Also, check out Heart & Hands Doula Service's new website!
http://heartandhands.8m.com/
Also, check out Heart & Hands Doula Service's new website!
http://heartandhands.8m.com/
Family Centered Maternity Conference is tomorrow!!!
If you are in the area, come join us tomorrow at Heart and Hands Doula Services Family Centered Maternity Conference. It's at the PPG Chemical Center in Monroeville PA. I am going to be speaking on the VBAC Panel. And MAN am I nervous!
Doctor "believes that women should get an epidural, even before pain starts"
OK, as I have said, hooray for choices in childbirth! But this is just a load of humbug, if you ask me.
Epidurals: Time to stop labouring over 'natural' childbirth
Says Dr Gilbert Grant, director of obstetric anaesthesia at New York University Medical Center:
I guess a few things jump out at me here.
1. The comparison of natural childbirth to surgery to remove something. There's so much in that one sentence that is just mind-boggling. The pain of childbirth does not last 24 hours, in a 24 hour labor. Surely the director of OB anesthesia at NYU Medical Center has heard of a contraction. A contraction does not last 24 hours. They are spaced several minutes apart for the vast expanse of a long labor. It's not constant pain, and the laboring women have time to recover and regroup before the next one. Now, again, surely the good doctor knows mounds more about anesthesia than I do. But isn't one of the purposes behind anesthesia in surgery like an appendectomy, besides the clear benefit of pain control, to keep the patient stationary and not bleeding to death? In the course of a normal labor, which is the apple he compares to the orange of appendectomy, that's not something that's necessary.
2. I'm not saying that there is not an industry around natural childbirth, and I'll believe it's a multi-million dollar industry. But please, do not try to insinuate that it's some avaricious enterprise that's taking advantage of women's fears and charging exorbitant fees. I don't know of anyone who is in this for the money. I sure could be making more money doing almost anything else.
There's also quite a bit further down in the article from Sheila Kitzinger and Michel Odent, which I found balanced this piece.
Shouldn't we stop bickering about whether ALL WOMEN or NO WOMEN should get an epidural? Shouldn't we start thinking about how we can facilitate ALL WOMEN making informed decisions that will leave them with positive, empowered memories of the day they became mothers?
Epidurals: Time to stop labouring over 'natural' childbirth
Says Dr Gilbert Grant, director of obstetric anaesthesia at New York University Medical Center:
"...that women should get an epidural, even before pain starts. According to him, much of the information that women receive is incomplete or inaccurate, and that the lucrative “natural childbirth industry” creates fear and guilt about epidurals. He believes that opposition to anaesthesia during childbirth is the result of a deep-seated misogyny: “There is no other situation in medicine in which pain relief is routinely withheld. No man would be asked to undergo an appendectomy, which lasts about 24 minutes, without pain relief, yet the pain of labour, which can last for more than 24 hours, is viewed as something women have to endure.
"Natural childbirth has become a multimillion-dollar industry. The fear of epidurals is promoted by those who discourage their use - and who have a vested interest in doing so."
I guess a few things jump out at me here.
1. The comparison of natural childbirth to surgery to remove something. There's so much in that one sentence that is just mind-boggling. The pain of childbirth does not last 24 hours, in a 24 hour labor. Surely the director of OB anesthesia at NYU Medical Center has heard of a contraction. A contraction does not last 24 hours. They are spaced several minutes apart for the vast expanse of a long labor. It's not constant pain, and the laboring women have time to recover and regroup before the next one. Now, again, surely the good doctor knows mounds more about anesthesia than I do. But isn't one of the purposes behind anesthesia in surgery like an appendectomy, besides the clear benefit of pain control, to keep the patient stationary and not bleeding to death? In the course of a normal labor, which is the apple he compares to the orange of appendectomy, that's not something that's necessary.
2. I'm not saying that there is not an industry around natural childbirth, and I'll believe it's a multi-million dollar industry. But please, do not try to insinuate that it's some avaricious enterprise that's taking advantage of women's fears and charging exorbitant fees. I don't know of anyone who is in this for the money. I sure could be making more money doing almost anything else.
There's also quite a bit further down in the article from Sheila Kitzinger and Michel Odent, which I found balanced this piece.
Shouldn't we stop bickering about whether ALL WOMEN or NO WOMEN should get an epidural? Shouldn't we start thinking about how we can facilitate ALL WOMEN making informed decisions that will leave them with positive, empowered memories of the day they became mothers?
Looking for Babywearing Recommendations...
What was your favorite way to wear your newborn? I never did except for a few brief times I put the babes in the Bjorn (I have to say, I really liked the dummy-proofness of that!) but I'd like to be better versed in a wider variety so I can recommend them to clients.
I love the mei tai but I never ever felt like a small one was secure.
I love the mei tai but I never ever felt like a small one was secure.
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