Hospital Cuts C-section Rate, Leading to Healthier Babies

Tallahassee Memorial Hospital has decreased the number of preterm births--and thus admissions to neonatal intensive care units and infants with health problems--by cutting elective induction and C-sections over the last three years.

Isn't it nice to read about hospitals drawing the line, once and for all!? Of course... the early delivery rate at this hospital is down from a shocking 44% to a still-above-the-scandalously-high-national-average 37%. Nonetheless, I believe that the drastic reduction in the primary cesarean rate, as well as their continued practice of limiting elective inductions, will keep those numbers in decline.

Another baby lost to Cytotec

Mother loses baby after being given 'abortion' drug to induce labor

Of course Misoprostol is not an 'abortion' drug. It's an ulcer drug. How many mothers and babies have to die before they stop administering it for labor induction? Stop being such money-hungry cowards and develop it properly for labor induction, at least. Stop being lazy and cavalier and properly monitor women if you're going to use an off-label drug to induce labor. So sad, so preventable.

Planted our garden today, and a busy day tomorrow!

I'm not really a gardener. But we have this horrible yard that isn't ever going to grow grass, so we turned it over and I planted vegetables on the sunny side and wildflowers from a can on the shady side. I know it's a little late in the season but... well, we've had a busy spring. I planted watermelon, cantaloupe, 2 kinds of onions, broccoli, 3 kinds of peppers, Swiss chard, zucchini, carrots, and peas. Oh, and in containers on my front porch I have leaf lettuce, basil, mint, coriander, thyme, and tomatoes (the tomato plant is about 2" big so we will see if anything comes of it).

Bon appetit, deer!

And my June client is going to be induced tomorrow so I will have a busy day. She's a great woman and it'll be a pleasure to work with her and her husband -- they make a great pair.

AND, on Saturday I will be observing (and assisting) in a childbirth class... thus fulfilling all my requirements for DONA certification except the essays! Hopefully I can get it all sent out next week! I feel like I started so long ago... Badger was just 3 months old when I attended my training.

Speaking of whom... we think he said a WORD. We think he is saying baa-baa for BALL. He is also signing "more." I guess it's like when you take your car to the mechanic because it's making a funny noise and then it stops... before we are even scheduled for his first speech therapy session, he makes a few nice steps :) I'm certainly not complaining.

Penny Simkin article

Great article about Penny Simkin (even if they do misspell her name in the title bar!)

Looking to nature, doula Penny Simpkin practices the art of delivery

Known as the mother of the doula movement, Simkin has trained thousands of these caregivers to provide physical and emotional support for women during birth — the only intervention scientifically shown to decrease time in labor (by 25 percent) as well as to reduce Cesarean-section rates by a third.

"Birth never changes," Simkin says. "But the way we manage it and the way we think of it has. Right now, we're in a culture of fear around birth."

Women 'unprepared for childbirth'

This has been discussed the past day or two on the blogs hither and yon. Here's one article covering the review of research:
Women 'unprepared for childbirth'

The gist of it is, childbirth educators downplay the pain of labor and women are unprepared for the pain of childbirth.

It's my belief that no matter how well-prepared one is, nothing can prepare you adequately for what labor feels like. I also believe that the typical, default, routine procedures that occur in a hospital birth remove a lot of the natural mechanisms that women laboring may otherwise employ, so that birth is more painful than it may otherwise have been.

In my observations -- the childbirth education I have observed have not de-emphasized pain. The pregnant women I meet realize that there will be pain, and they frequently say in our postpartum meetings that there's nothing that could've prepared them for exactly how it would've been.

What do you think?

Baby Boy P's Birth Story

OK -- I started to write the birth story but it's such a peculiar story that I felt I was violating confidentiality.

So the basics: Mom's water broke Wednesday morning, started labor naturally at the birth center but transfered to hospital Thursday morning for augmentation. Baby born shortly after midnight on Friday. No c-section -- a miracle!

Here's what I took from the birth -- as I concluded their birth story:

This birth was a truly amazing experience for me – although I surely wish it had not been so difficult for [client]! I absolutely learned new things and it was amazing to get to work with three of the midwives, plus the student midwife, in the course of one birth. Seeing the effects of Nubain firsthand was certainly a learning experience and I knew so little about amnioinfusion, and had never heard of a velamentous cord insertion before.

More than any of this, though, I am honored to have been part of this birth because I saw a woman become a mom through hard work and force of will, and a man become a dad as he firmly advocated for his wife. I learned that sometimes one can do everything just absolutely correctly – take all the responsible prenatal steps to ensure the safest, most satisfying, birth – but sometimes things just don't fall into place the way we think they will. However, I saw a couple become a family by staying flexible when they needed to be and remaining firm for the things that truly mattered.

AROM not recommended for shortening of first stage of labor

Amniotomy for shortening spontaneous labor

On the basis of the findings of this review, we cannot recommend that amniotomy be introduced routinely as part of standard labor management and care. We do recommend that the evidence presented in this review be made available to women offered an amniotomy and suggest that it may be useful as a foundation for discussion and any resulting decisions made between women and their caregivers.

I'm glad to see this although I don't think this is news per se. It's still surprising to me when I hear the resident explain to a client "what we'll do" during her uncomplicated, progressing-just-fine labor, including, "And then we'll just break your water." Most of my clients have a strong preference not to have their water broken as a matter of routine if their labors are not stalled out, and the research they've done before labor gives them the confidence to tell the doctor that they don't want their water broken as a routine intervention.