Pregnant?
Will your Spouse/Partner be deployed when you give birth?
CAPPA/Operation Special Delivery is here for you. Serving all branches of the Military, Reservists and the National Guard.
Founded following the events of September 11, 2001; CAPPA/OSD provides Volunteer Labor Doulas to ALL 50 states and all U.S. military installations and personnel worldwide.
CAPPA Operation Special Delivery Labor Doula Program provides volunteer doulas during wartime to women who are giving birth while their partners are on military deployment. CAPPA/OSD is a non-profit international organization serving military installations worldwide; fully supporting all branches of the United States Armed Forces, Reservists, and National Guard.
CAPPA/OSD trained and certified doulas (another name for childbirth assistant) provide caring support, timely information, and quality education, for women and new families.
How to apply:
You may apply if your spouse or partner will be deployed at the time of your due date.
Call or e-mail CAPPA/OSD Program Director Valerie Staples, CD, CLD, CCCE at (334) 741-9747 and doulaval@bellsouth.net.
Visit http://www.operationspecialdelivery.com/ for more information.
Monday, July 31, 2006
Army of two
Military moms paired with free doulas to help through labor
By Katie Foutz
SUN STAFF
When her husband was away on military service, a woman who was pregnant with her fourth child called doula Val Staples for assistance.
Staples is the program director for Georgia-based Operation Special Delivery, which offers free birthing assistance to women whose partners are deployed, severely injured or killed in the military around their due date. The woman was happy to have help this time around.
"When she had her third child, her husband was deployed then, too," Staples said. "She left her two older children with the neighbors and drove herself to the hospital. This should not be happening. This is why we do this."
The nonprofit Operation Special Delivery is new to Illinois but has served military families in other states since late 2001, Staples said.
"The original idea was that there were some of these women whose husbands were killed in the terrorist attacks and were pregnant," she said. "It's such a terrible time to be alone, and there were so many people volunteering to help, which is why we expanded it to the military."
The volunteers are doulas — people who attend the birthing family before, during and just after the birth of the baby, according to Operation Special Delivery's parent organization, the Childbirth and Postpartum Professional Association. A certified doula is trained to deliver emotional support from home to hospital and be there through the entire labor.
Operation Special Delivery supports all branches of the military and serves all over the world.
To enroll, moms-to-be should contact Operation Special Delivery at (800) 692-2772 or visit www.operationspecialdelivery.com . Staples will match each applicant with a volunteer doula in her area.
If none are available, Staples asks local doulas to volunteer, or she schedules a training session in the area for new doulas. Operation Special Delivery also offers discounts on doula training if military moms want to join the effort. Training typically costs $350, but military moms can train for $150, Staples said.
Fifteen doulas in Illinois work with Operation Special Delivery, and many are in Chicago and the suburbs. Participating Naperville-area doulas did not respond to requests for comment.
To learn about the doulas' impact, visitors to the Operation Special Delivery Web site can read testimonies and view photos. Proud moms and doulas pose with newborns, along with words of thanks.
"Every once in a while, I get thank-you notes from moms," Staples said. "They say, 'You don't know how I worried I was, how grateful I was I didn't have to do this alone.'"
Contact Katie Foutz at kfoutz@scn1.com or (630) 416-5216.
GlossaryDoula: A non-medical professional who attends the birthing family before, during and just after the birth of the baby, according to the Childbirth and Postpartum Professional Association. A certified doula is trained to deliver emotional support from home to hospital and be there through the entire labor.
FYIGeorgia-based Operation Special Delivery has volunteer doulas in Yorkville, New Lenox, South Elgin and other Chicago-area cities and offers doula training. To get information or to enroll, call (800) 692-2772 or visit www.operationspecialdelivery.com . To volunteer, call Val Staples at (334) 703-3025 or e-mail doulaval@bellsouth.net.
Sources: Childbirth and Postpartum Professional Association
www.cappa.net
Military moms paired with free doulas to help through labor
By Katie Foutz
SUN STAFF
When her husband was away on military service, a woman who was pregnant with her fourth child called doula Val Staples for assistance.
Staples is the program director for Georgia-based Operation Special Delivery, which offers free birthing assistance to women whose partners are deployed, severely injured or killed in the military around their due date. The woman was happy to have help this time around.
"When she had her third child, her husband was deployed then, too," Staples said. "She left her two older children with the neighbors and drove herself to the hospital. This should not be happening. This is why we do this."
The nonprofit Operation Special Delivery is new to Illinois but has served military families in other states since late 2001, Staples said.
"The original idea was that there were some of these women whose husbands were killed in the terrorist attacks and were pregnant," she said. "It's such a terrible time to be alone, and there were so many people volunteering to help, which is why we expanded it to the military."
The volunteers are doulas — people who attend the birthing family before, during and just after the birth of the baby, according to Operation Special Delivery's parent organization, the Childbirth and Postpartum Professional Association. A certified doula is trained to deliver emotional support from home to hospital and be there through the entire labor.
Operation Special Delivery supports all branches of the military and serves all over the world.
To enroll, moms-to-be should contact Operation Special Delivery at (800) 692-2772 or visit www.operationspecialdelivery.com . Staples will match each applicant with a volunteer doula in her area.
If none are available, Staples asks local doulas to volunteer, or she schedules a training session in the area for new doulas. Operation Special Delivery also offers discounts on doula training if military moms want to join the effort. Training typically costs $350, but military moms can train for $150, Staples said.
Fifteen doulas in Illinois work with Operation Special Delivery, and many are in Chicago and the suburbs. Participating Naperville-area doulas did not respond to requests for comment.
To learn about the doulas' impact, visitors to the Operation Special Delivery Web site can read testimonies and view photos. Proud moms and doulas pose with newborns, along with words of thanks.
"Every once in a while, I get thank-you notes from moms," Staples said. "They say, 'You don't know how I worried I was, how grateful I was I didn't have to do this alone.'"
Contact Katie Foutz at kfoutz@scn1.com or (630) 416-5216.
GlossaryDoula: A non-medical professional who attends the birthing family before, during and just after the birth of the baby, according to the Childbirth and Postpartum Professional Association. A certified doula is trained to deliver emotional support from home to hospital and be there through the entire labor.
FYIGeorgia-based Operation Special Delivery has volunteer doulas in Yorkville, New Lenox, South Elgin and other Chicago-area cities and offers doula training. To get information or to enroll, call (800) 692-2772 or visit www.operationspecialdelivery.com . To volunteer, call Val Staples at (334) 703-3025 or e-mail doulaval@bellsouth.net.
Sources: Childbirth and Postpartum Professional Association
www.cappa.net
Tuesday, July 18, 2006
Effect of Labor Pain Medication Timing on C-Section
Effect of Labor Pain Medication Timing on Cesarean Section:
New England Journal of Medicine Study, February 2005Summary, Analysis, Concerns
New England Journal of Medicine Study, February 2005Summary, Analysis, Concerns Maternity Wise© visitors are hearing about a new study about the timing of labor pain medication. Many media reports are providing misleading coverage. The Maternity Center Association has prepared the following information
to help visitors interpret this study, which Cynthia Wong and colleagues published in the New England
Journal of Medicine on February 17, 2005. Please see the Maternity Center Association's clear, simple
advice for women about labor pain relief
Effect of Labor Pain Medication Timing on Cesarean Section: NEJM Study, 2/2005
Visit: http://maternitywise.org/nejm_epidural_response.html for the complete summary, analysis, concerns.
New England Journal of Medicine Study, February 2005Summary, Analysis, Concerns
New England Journal of Medicine Study, February 2005Summary, Analysis, Concerns Maternity Wise© visitors are hearing about a new study about the timing of labor pain medication. Many media reports are providing misleading coverage. The Maternity Center Association has prepared the following information
to help visitors interpret this study, which Cynthia Wong and colleagues published in the New England
Journal of Medicine on February 17, 2005. Please see the Maternity Center Association's clear, simple
advice for women about labor pain relief
Effect of Labor Pain Medication Timing on Cesarean Section: NEJM Study, 2/2005
Visit: http://maternitywise.org/nejm_epidural_response.html for the complete summary, analysis, concerns.
Consumer Reports Questions Cesarean Frequency
Summerville, SC (PRWEB)
December 12, 2005
Consumer Reports has named cesarean section number three on its list of “12 Surgeries You May Be Better Off Without.” The recommendation, based on research at the non-profit Rand Corporation, encourages consumers to “check out safer alternatives” before having any of the 12 listed “invasive procedures.” See http://www.consumerreports.org/mg/free-highlights/manage-your-health/needless_surgeries.htm
The number three ranking of cesarean surgery appears just above episiotomy (#4) and hysterectomy (#5) and below angiography (#1) and angioplasty (#2). The recommendation from Consumer Reports Medical Guide comes on the heels of the Centers for Disease Control report showing that the primary cesarean rate in the United States has reached a historical high of 20.6 percent and an overall rate at 29.1 percent in 2004. The latest overall rate reported in Canada is 22.6 percent.
“Women need to be selective consumers and study their birth options,” said Tonya Jamois, president of the International Cesarean Awareness Network (ICAN). “The priority should be to avoid that first cesarean, and if you have a scar on your uterus, educate yourself about vaginal birth after cesarean (VBAC). Twenty years of research shows VBAC to be safer for mother and baby than repeat cesarean surgery.”
According to Consumer Reports Medical Guide, most cesareans are performed because labor is progressing too slowly. The Guide notes that a number of less invasive procedures may be enough to stimulate labor. Consumer Reports encourages women to ask “what percentage of normal deliveries as well as births following a prior cesarean the physician delivers by C-section. Ideally, look for rates below 15 percent in women who haven’t had the procedure and about 60 percent in those who have.”
The guide also states that physicians perform cesareans in the vast majority of women who have already had one. But ACOG, the American College of Obstetricians and Gynecologists (as well as SOGC, the Society of Obstetricians and Gynaecologists of Canada) has published research showing most women could safely try for a VBAC, which would succeed about 70 to 80 percent of the time; and if it does not, a cesarean can take place. Unfortunately, cost concerns and fears over liability have led some physicians and hospitals to ban VBAC and require repeat cesarean.
Consumer Reports also recommends women consider giving birth in a hospital with a certified nurse-midwife, if available, since their births have lower cesarean rates than births with obstetricians.
“Giving birth in a free-standing birth center or at home with a midwife is another option that women should consider," Jamois said. "Midwifery care has been proven to be a safe alternative for most pregnant women. Countries where the majority of babies are born into the hands of midwives, such as The Netherlands, have cesarean rates below 10 percent, and they boast the best maternal and infant health outcomes in the world.”
Those who seek information about preventing a cesarean, or support in recovering from a cesarean, can visit http://www.ican-online.org for more information. In addition to more than 70 local chapters across North America, ICAN hosts an active online discussion group that can serve as a resource for mothers.
About Cesareans: ICAN recognizes that when a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies include: low birth weight; prematurity; respiratory problems; and lacerations. Potential risks to women include: hemorrhage; infection; hysterectomy; surgical mistakes; re-hospitalization; dangerous placental abnormalities in future pregnancies; unexplained stillbirth in future pregnancies and increased rate of maternal death.
Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean.
# # #
December 12, 2005
Consumer Reports has named cesarean section number three on its list of “12 Surgeries You May Be Better Off Without.” The recommendation, based on research at the non-profit Rand Corporation, encourages consumers to “check out safer alternatives” before having any of the 12 listed “invasive procedures.” See http://www.consumerreports.org/mg/free-highlights/manage-your-health/needless_surgeries.htm
The number three ranking of cesarean surgery appears just above episiotomy (#4) and hysterectomy (#5) and below angiography (#1) and angioplasty (#2). The recommendation from Consumer Reports Medical Guide comes on the heels of the Centers for Disease Control report showing that the primary cesarean rate in the United States has reached a historical high of 20.6 percent and an overall rate at 29.1 percent in 2004. The latest overall rate reported in Canada is 22.6 percent.
“Women need to be selective consumers and study their birth options,” said Tonya Jamois, president of the International Cesarean Awareness Network (ICAN). “The priority should be to avoid that first cesarean, and if you have a scar on your uterus, educate yourself about vaginal birth after cesarean (VBAC). Twenty years of research shows VBAC to be safer for mother and baby than repeat cesarean surgery.”
According to Consumer Reports Medical Guide, most cesareans are performed because labor is progressing too slowly. The Guide notes that a number of less invasive procedures may be enough to stimulate labor. Consumer Reports encourages women to ask “what percentage of normal deliveries as well as births following a prior cesarean the physician delivers by C-section. Ideally, look for rates below 15 percent in women who haven’t had the procedure and about 60 percent in those who have.”
The guide also states that physicians perform cesareans in the vast majority of women who have already had one. But ACOG, the American College of Obstetricians and Gynecologists (as well as SOGC, the Society of Obstetricians and Gynaecologists of Canada) has published research showing most women could safely try for a VBAC, which would succeed about 70 to 80 percent of the time; and if it does not, a cesarean can take place. Unfortunately, cost concerns and fears over liability have led some physicians and hospitals to ban VBAC and require repeat cesarean.
Consumer Reports also recommends women consider giving birth in a hospital with a certified nurse-midwife, if available, since their births have lower cesarean rates than births with obstetricians.
“Giving birth in a free-standing birth center or at home with a midwife is another option that women should consider," Jamois said. "Midwifery care has been proven to be a safe alternative for most pregnant women. Countries where the majority of babies are born into the hands of midwives, such as The Netherlands, have cesarean rates below 10 percent, and they boast the best maternal and infant health outcomes in the world.”
Those who seek information about preventing a cesarean, or support in recovering from a cesarean, can visit http://www.ican-online.org for more information. In addition to more than 70 local chapters across North America, ICAN hosts an active online discussion group that can serve as a resource for mothers.
About Cesareans: ICAN recognizes that when a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies include: low birth weight; prematurity; respiratory problems; and lacerations. Potential risks to women include: hemorrhage; infection; hysterectomy; surgical mistakes; re-hospitalization; dangerous placental abnormalities in future pregnancies; unexplained stillbirth in future pregnancies and increased rate of maternal death.
Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean.
# # #
Benefits of Kneeling Position for Delivery
Benefits of the Kneeling Position for Delivery
First-time mothers who give birth in a kneeling position experience less pain than those who deliver in a seated position, researchers in Sweden reported in the journal BJOG last month. The randomized controlled trial found little difference in the length of pushing between the two groups. However, women in a seated position reported a higher level of pain, less comfort giving birth and more frequent feelings of vulnerability and exposure than women in the kneeling position. Women in the kneeling position also reported significantly less pain after delivery than those in the sitting position. Visit tinyurl.com/f3mtv for an abstract of the study.
First-time mothers who give birth in a kneeling position experience less pain than those who deliver in a seated position, researchers in Sweden reported in the journal BJOG last month. The randomized controlled trial found little difference in the length of pushing between the two groups. However, women in a seated position reported a higher level of pain, less comfort giving birth and more frequent feelings of vulnerability and exposure than women in the kneeling position. Women in the kneeling position also reported significantly less pain after delivery than those in the sitting position. Visit tinyurl.com/f3mtv for an abstract of the study.
Group B Strep
Group B Strep Infection in Pregnancy
What is group B strep? Group B strep is a certain kind of bacteria (germ) that lives in the vaginal or rectal areas of 1 out of every 4 or 5 healthy pregnant women. A woman who has group B strep on her skin is said to be "colonized" with this germ. For every 100 colonized women with group B strep who have a baby, 1 or 2 babies are infected with these germs while they're being born and can get sick.
If I have group B strep, what could happen?
Carrying the bacteria in your body when you're pregnant doesn't make you sick. In some cases, though, group B strep germs can multiply inside your body and can cause serious infection. When you are pregnant and have group B strep, your baby could get the germs from you during delivery and get sick. Infected babies need treatment. Your baby will be kept in the hospital some extra days for close watching (observation) if your doctor thinks the baby is infected with strep. Blood tests will be done to see if your baby has group B strep. If your baby has this germ, the doctor will give the baby antibiotics.
How will I know I have group B strep?
Your doctor can do a skin culture to see if you have group B strep on your skin. Your doctor can also do a test on your vagina and rectum to see if it is inside your body. The test is like a Pap smear.
If I'm infected, what can I do?
Your doctor may have you take antibiotics during pregnancy until you give birth. Then, when you're in labor, you can also take antibiotics to kill the germs. If you take antibiotics while you're in labor, the chances are higher that your baby probably won't get this infection.
familydoctor.org
What is group B strep? Group B strep is a certain kind of bacteria (germ) that lives in the vaginal or rectal areas of 1 out of every 4 or 5 healthy pregnant women. A woman who has group B strep on her skin is said to be "colonized" with this germ. For every 100 colonized women with group B strep who have a baby, 1 or 2 babies are infected with these germs while they're being born and can get sick.
If I have group B strep, what could happen?
Carrying the bacteria in your body when you're pregnant doesn't make you sick. In some cases, though, group B strep germs can multiply inside your body and can cause serious infection. When you are pregnant and have group B strep, your baby could get the germs from you during delivery and get sick. Infected babies need treatment. Your baby will be kept in the hospital some extra days for close watching (observation) if your doctor thinks the baby is infected with strep. Blood tests will be done to see if your baby has group B strep. If your baby has this germ, the doctor will give the baby antibiotics.
How will I know I have group B strep?
Your doctor can do a skin culture to see if you have group B strep on your skin. Your doctor can also do a test on your vagina and rectum to see if it is inside your body. The test is like a Pap smear.
If I'm infected, what can I do?
Your doctor may have you take antibiotics during pregnancy until you give birth. Then, when you're in labor, you can also take antibiotics to kill the germs. If you take antibiotics while you're in labor, the chances are higher that your baby probably won't get this infection.
familydoctor.org
Premature Birth
Mon Apr 10, 10:48 AM ET
NEW YORK (Reuters Health) - The medical and environmental risks often associated with premature birth affect the attention abilities of premature children all the way throughout adolescence, researchers report in the journal Child Development.
If evidence already exists to suggest that adolescents born preterm often present deficits in cognitive abilities and school achievements. However, because some preterm children do not present such impairments, researchers have hypothesized that independent factors associated with prematurity might also come into play.
"What we found is that prematurity doesn't affect attention directly, it is rather the medical complications such as breathing problems, and environmental risks -- for instance poor mother-child interaction -- which are often associated with premature birth, that lead to attention deficit," Dr. Michael Lewis, from the University of Medicine and Dentistry of New Jersey in New Brunswick, told Reuters Health.
"That's an important finding because if often we can't affect the medical complications arising from prematurity, we sure can affect the environment in which these children live."
For the study, Lewis's team had 10 adolescents born prematurely perform attention tasks. Using brain imaging, the researchers observed which parts of the brain were activated. The goal was to assess how the different brain regions known to support attention become affected by the children's history of risk factors.
Medical and environmental risk factors aside, premature children did as well on the attention task as their non-premature ones did, the team found. On the other hand, the greater the medical and environmental risk factors, the more likely the attention deficit.
The team found that environmental risks factors tended to affect those areas of the brain associated with verbal ability, whereas medical risks tended to affect areas of the brain associated with motor performance.
"Different kinds of risks affect different areas of the brain," Lewis said, adding that, ultimately, this information could be used to explore the efficacy of potential medications.
SOURCE: Child Development, March/April 2006.
http://news.yahoo.com/s/nm/20060410/hl_nm/preterm_teen_dc
NEW YORK (Reuters Health) - The medical and environmental risks often associated with premature birth affect the attention abilities of premature children all the way throughout adolescence, researchers report in the journal Child Development.
If evidence already exists to suggest that adolescents born preterm often present deficits in cognitive abilities and school achievements. However, because some preterm children do not present such impairments, researchers have hypothesized that independent factors associated with prematurity might also come into play.
"What we found is that prematurity doesn't affect attention directly, it is rather the medical complications such as breathing problems, and environmental risks -- for instance poor mother-child interaction -- which are often associated with premature birth, that lead to attention deficit," Dr. Michael Lewis, from the University of Medicine and Dentistry of New Jersey in New Brunswick, told Reuters Health.
"That's an important finding because if often we can't affect the medical complications arising from prematurity, we sure can affect the environment in which these children live."
For the study, Lewis's team had 10 adolescents born prematurely perform attention tasks. Using brain imaging, the researchers observed which parts of the brain were activated. The goal was to assess how the different brain regions known to support attention become affected by the children's history of risk factors.
Medical and environmental risk factors aside, premature children did as well on the attention task as their non-premature ones did, the team found. On the other hand, the greater the medical and environmental risk factors, the more likely the attention deficit.
The team found that environmental risks factors tended to affect those areas of the brain associated with verbal ability, whereas medical risks tended to affect areas of the brain associated with motor performance.
"Different kinds of risks affect different areas of the brain," Lewis said, adding that, ultimately, this information could be used to explore the efficacy of potential medications.
SOURCE: Child Development, March/April 2006.
http://news.yahoo.com/s/nm/20060410/hl_nm/preterm_teen_dc
Dads can Develop Postpartum Depression
Dads can develop postpartum depression
Fri 24 Jun 2005 01:21 am CSTAUSTIN (myDNA News)
Postnatal depression can affect fathers, too. In fact, the long-term behavioral and emotional development of their child may be effected by postnatal depression.
Doctors at Bristol and Oxford University analyzed records of 8,430 fathers for signs of paternal depression and were surprised at the findings. The analysis showed that eight weeks after the birth of their child, 3.6 percent (303) of fathers appeared to be suffering from depression, with symptoms such as anxiety, mood swings, irritability and feeling hopeless.
Dr. Paul Ramchandani, Oxford psychiatrist, said "We already know the postnatal depression in mothers can affect the quality of maternal care, and is associated with disturbances in children's later social, behavioral, psychological and physical development. While a signification number of men do report depression following the birth of a child, until now the influence of depression in fathers during the early years of a child's life has received scant attention."
To determine the impact of paternal depression researchers interviewed the children when they were three-and-a-half years old. They asked questions to determine if there were any signs of emotion problems, worry, sadness or behavioral problems like hyperactivity. The researchers found a higher rate of problems among boys whose fathers had been depressed than with girls. "It may be that boys are specifically sensitive to the effects of parenting by fathers, perhaps because of different involvement by fathers with their sons."Adolescent children who have depressed fathers, have a higher rate of psychiatric disorders.
Fri 24 Jun 2005 01:21 am CSTAUSTIN (myDNA News)
Postnatal depression can affect fathers, too. In fact, the long-term behavioral and emotional development of their child may be effected by postnatal depression.
Doctors at Bristol and Oxford University analyzed records of 8,430 fathers for signs of paternal depression and were surprised at the findings. The analysis showed that eight weeks after the birth of their child, 3.6 percent (303) of fathers appeared to be suffering from depression, with symptoms such as anxiety, mood swings, irritability and feeling hopeless.
Dr. Paul Ramchandani, Oxford psychiatrist, said "We already know the postnatal depression in mothers can affect the quality of maternal care, and is associated with disturbances in children's later social, behavioral, psychological and physical development. While a signification number of men do report depression following the birth of a child, until now the influence of depression in fathers during the early years of a child's life has received scant attention."
To determine the impact of paternal depression researchers interviewed the children when they were three-and-a-half years old. They asked questions to determine if there were any signs of emotion problems, worry, sadness or behavioral problems like hyperactivity. The researchers found a higher rate of problems among boys whose fathers had been depressed than with girls. "It may be that boys are specifically sensitive to the effects of parenting by fathers, perhaps because of different involvement by fathers with their sons."Adolescent children who have depressed fathers, have a higher rate of psychiatric disorders.
Uterine Rupture During VBAC Trial Of Labor: Risk Factors and Fetal Response
Journal of Midwifery & Women's Health
2003 Nancy O'Brien-Abel, RNC, MN
Abstract: For the woman with a prior uterine scar, neither repeat elective cesarean birth nor vaginal birth after cesarean birth (VBAC) trial of labor (TOL) is risk-free
Informative Excerpts for "Informed Consent" Relative to Trial of Labor /VBAC Decision Making
When VBAC-TOL is successful, it is associated with less morbidity than repeat cesarean birth. However, when VBAC-TOL fails due to uterine rupture, severe consequences often ensue.
(R)enewed controversy about the relative safety of VBAC-TOL has resulted in a rapid decline in the number of women who experience VBAC, falling from 28.3 per 100 women in 1996 to 16.4 per 100 in 2001, a 42% decrease.
Neither repeat cesarean birth nor TOL after cesarean is risk-free for women with a prior uterine scar. When VBAC-TOL is successful, it is associated with less morbidity than repeat cesarean birth.[2-5, 9, 13]
However, when VBAC-TOL results in uterine rupture, neonatal death or permanent neonatal injury can occur even in facilities with immediate access to cesarean birth.
A woman and her health care provider must evaluate the following: 1) risk of complications associated with VBAC-TOL versus repeat elective cesarean birth, 2) capabilities of the birth facility, 3) personal choice, and 4) the probable success rate of VBAC-TOL.
Recent research has better defined factors that influence probable success of VBAC.
Characteristics in a woman's obstetric history (type of uterine scar, single-layer versus double-layer uterine closure, number of prior cesarean births, number of prior vaginal births, interdelivery interval, maternal age, maternal fever following cesarean), in addition to factors related to current labor management (induction or augmentation with prostaglandins and/or oxytocin), have been found to significantly influence uterine rupture rates during VBAC-TOL.
.... the authors concluded that women with a prior low vertical uterine incision are not at increased risk for uterine rupture during TOL compared with women who had a prior low transverse uterine incision.
In a recent, larger, observational cohort analysis, Bujold et al.[35] identified a nearly four-fold increased incidence of uterine rupture during VBAC-TOL in women who had a single-layer closure of the previous lower uterine segment incision compared to women who had a previous double-layer uterine closure
At the time of the initial cesarean, single-layer closure was used in 489 women and double-layer closure in 1491 women. Uterine rupture occurred in 15 (3.1%) of the women with previous single-layer closure and in 8 (0.5%) of the women with a previous double-layer closure (P < .001). On the basis of these findings, the authors recommended that surgeons consider using a double-layer closure technique for women who may subsequently experience a TOL.
Uterine rupture occurred in 1.7% of the women with two or more previous cesareans compared with a uterine rupture incidence of 0.6% in those with only one prior cesarean birth (OR: 3.06; 95% CI: 1.95-4.79; P < .001). However, this retrospective analysis did not control for other aspects of the women's obstetric history or labor management.
Uterine rupture occurred in 1% (3/302) of the women with two or more prior cesareans compared to 0.5% (5/1,110) in the women who had one prior scar on the uterus. More recently, Caughey et al.[37] conducted a retrospective analysis of 3871 women who underwent a VBAC-TOL. The rate of uterine rupture was 3.7% among 134 women in the two-scars group compared to 0.8% in the 3,757 women with one previous uterine scar
After controlling for maternal age, epidural analgesia, oxytocin induction, oxytocin augmentation, use of prostaglandin E2 gel, birth weight, gestational age, type of prior hysterotomy, year of TOL, and prior vaginal delivery, women with two prior cesarean scars were still 4.8 times more likely to experience uterine rupture during VBAC-TOL than women with one prior uterine scar (OR: 4.8; 95% CI: 1.8-13.2).
In summary, women with two or more prior uterine scars have a significantly increased risk of uterine rupture during VBAC-TOL compared to women with only one prior uterine incision.
Although the number of previous cesarean births appears to increase a woman's risk for uterine rupture during a VBAC-TOL, prior vaginal birth appears to be somewhat protective.
For the rest of this article go to: http://www.collegeofmidwives.org/Citations%20or%20text%2002/vbac%20Quotes%20Aug03.htm
Journal of Midwifery & Women's Health
2003 Nancy O'Brien-Abel, RNC, MN
Abstract: For the woman with a prior uterine scar, neither repeat elective cesarean birth nor vaginal birth after cesarean birth (VBAC) trial of labor (TOL) is risk-free
Informative Excerpts for "Informed Consent" Relative to Trial of Labor /VBAC Decision Making
When VBAC-TOL is successful, it is associated with less morbidity than repeat cesarean birth. However, when VBAC-TOL fails due to uterine rupture, severe consequences often ensue.
(R)enewed controversy about the relative safety of VBAC-TOL has resulted in a rapid decline in the number of women who experience VBAC, falling from 28.3 per 100 women in 1996 to 16.4 per 100 in 2001, a 42% decrease.
Neither repeat cesarean birth nor TOL after cesarean is risk-free for women with a prior uterine scar. When VBAC-TOL is successful, it is associated with less morbidity than repeat cesarean birth.[2-5, 9, 13]
However, when VBAC-TOL results in uterine rupture, neonatal death or permanent neonatal injury can occur even in facilities with immediate access to cesarean birth.
A woman and her health care provider must evaluate the following: 1) risk of complications associated with VBAC-TOL versus repeat elective cesarean birth, 2) capabilities of the birth facility, 3) personal choice, and 4) the probable success rate of VBAC-TOL.
Recent research has better defined factors that influence probable success of VBAC.
Characteristics in a woman's obstetric history (type of uterine scar, single-layer versus double-layer uterine closure, number of prior cesarean births, number of prior vaginal births, interdelivery interval, maternal age, maternal fever following cesarean), in addition to factors related to current labor management (induction or augmentation with prostaglandins and/or oxytocin), have been found to significantly influence uterine rupture rates during VBAC-TOL.
.... the authors concluded that women with a prior low vertical uterine incision are not at increased risk for uterine rupture during TOL compared with women who had a prior low transverse uterine incision.
In a recent, larger, observational cohort analysis, Bujold et al.[35] identified a nearly four-fold increased incidence of uterine rupture during VBAC-TOL in women who had a single-layer closure of the previous lower uterine segment incision compared to women who had a previous double-layer uterine closure
At the time of the initial cesarean, single-layer closure was used in 489 women and double-layer closure in 1491 women. Uterine rupture occurred in 15 (3.1%) of the women with previous single-layer closure and in 8 (0.5%) of the women with a previous double-layer closure (P < .001). On the basis of these findings, the authors recommended that surgeons consider using a double-layer closure technique for women who may subsequently experience a TOL.
Uterine rupture occurred in 1.7% of the women with two or more previous cesareans compared with a uterine rupture incidence of 0.6% in those with only one prior cesarean birth (OR: 3.06; 95% CI: 1.95-4.79; P < .001). However, this retrospective analysis did not control for other aspects of the women's obstetric history or labor management.
Uterine rupture occurred in 1% (3/302) of the women with two or more prior cesareans compared to 0.5% (5/1,110) in the women who had one prior scar on the uterus. More recently, Caughey et al.[37] conducted a retrospective analysis of 3871 women who underwent a VBAC-TOL. The rate of uterine rupture was 3.7% among 134 women in the two-scars group compared to 0.8% in the 3,757 women with one previous uterine scar
After controlling for maternal age, epidural analgesia, oxytocin induction, oxytocin augmentation, use of prostaglandin E2 gel, birth weight, gestational age, type of prior hysterotomy, year of TOL, and prior vaginal delivery, women with two prior cesarean scars were still 4.8 times more likely to experience uterine rupture during VBAC-TOL than women with one prior uterine scar (OR: 4.8; 95% CI: 1.8-13.2).
In summary, women with two or more prior uterine scars have a significantly increased risk of uterine rupture during VBAC-TOL compared to women with only one prior uterine incision.
Although the number of previous cesarean births appears to increase a woman's risk for uterine rupture during a VBAC-TOL, prior vaginal birth appears to be somewhat protective.
For the rest of this article go to: http://www.collegeofmidwives.org/Citations%20or%20text%2002/vbac%20Quotes%20Aug03.htm
Making Informed Decisions
Making Informed Decisions
Nicette Jukelevics, MA, ICCE
www.VBAC.com
In pregnancy and childbirth, by communicating openly with your caregiver, together you can make decisions that best meet your needs. You should know that every woman has the right to fully participate in all decisions regarding her own healthcare and that of her unborn child.
This legal doctrine is called the right to informed consent. The World Health Organization, the European Parliament, the American Hospital Association and many other organizations support and endorse the right of women to make their own healthcare decisions in consultation with their caregivers.
In fact, the American Colleges of Obstetricians and Gynecologists (ACOG) supports a woman's right to make healthcare decisions for herself and her unborn child. Physicians must disclose to their patients information about the risks and benefits of any recommended treatment, test, or procedure so that women can make an informed decision.
When a physician has clearly explained the benefits and risks, a woman has the right to choose among the options available to her or refuse them altogether. ACOG states that patients may decline a physician's advice or recommendation, even during treatment, based on "religious beliefs, personal preference, or comfort." Patients are entitled to an "informed refusal."
Labor and BirthAs a mother-to-be, you have the responsibility of obtaining early prenatal care, living a healthy lifestyle, and finding out as much as you can about the process of labor and birth.
You have the right to ask:
How is this helpful to me or my baby?
Are there any risks involved?
Can you recommend a safe alternative?
How will this affect my labor? My baby?
Do I have time to think about this and give you my answer later?
If I choose not to go ahead with this recommendation, what would the consequences be for me and my baby?
How do you feel about my getting a second opinion?
Consenting to Treatment
When you give birth in a hospital or birth center, you are asked to sign a consent to treatment form. Your signature gives permission to the staff to care for you and your baby. Usually this form includes common procedures such as: vaginal exams, fetal monitoring, use of IVs, pain medication, breaking the bag of water, use of forceps or vacuum extractor.
You do not have to agree to everything on the form. You can delete from or add statements to the form. A separate consent is sometimes required for an epidural or for a cesarean section.
You can change your mind at any time by making your wishes known to your caregivers. If you choose not to agree with a treatment or procedure you may be asked to sign a waiver of liability acknowledging that you are taking responsibility for your decisions.
You also have the right to have a copy of your medical records. You may be able to obtain them directly, or they may need to be sent to the caregiver of your choice, depending on the regulations of the community in which you live.
Caregivers may disagree about what is best for pregnancy and childbirth. By becoming actively involved in your care, you are likely to be more satisfied with your decisions.
References
Adapted from The Rights of Patients: The Basic ACLU Guide to Patient Rights by George J. Annas. Southern Illinois University Press; 3rd edition (January 1, 2004).
ACOG June 2000. Informed Refusal. Committee Opinion, Number 237.
Nicette Jukelevics, MA, ICCE
www.VBAC.com
In pregnancy and childbirth, by communicating openly with your caregiver, together you can make decisions that best meet your needs. You should know that every woman has the right to fully participate in all decisions regarding her own healthcare and that of her unborn child.
This legal doctrine is called the right to informed consent. The World Health Organization, the European Parliament, the American Hospital Association and many other organizations support and endorse the right of women to make their own healthcare decisions in consultation with their caregivers.
In fact, the American Colleges of Obstetricians and Gynecologists (ACOG) supports a woman's right to make healthcare decisions for herself and her unborn child. Physicians must disclose to their patients information about the risks and benefits of any recommended treatment, test, or procedure so that women can make an informed decision.
When a physician has clearly explained the benefits and risks, a woman has the right to choose among the options available to her or refuse them altogether. ACOG states that patients may decline a physician's advice or recommendation, even during treatment, based on "religious beliefs, personal preference, or comfort." Patients are entitled to an "informed refusal."
Labor and BirthAs a mother-to-be, you have the responsibility of obtaining early prenatal care, living a healthy lifestyle, and finding out as much as you can about the process of labor and birth.
You have the right to ask:
Can you explain this to me?
Where can I get more information?
Can you write this down? Draw me a picture?
I want to think about this before I make a decision.
I don't feel comfortable with this recommendation.
Is there any else I can do or try?
How is this helpful to me or my baby?
Are there any risks involved?
Can you recommend a safe alternative?
How will this affect my labor? My baby?
Do I have time to think about this and give you my answer later?
If I choose not to go ahead with this recommendation, what would the consequences be for me and my baby?
How do you feel about my getting a second opinion?
Consenting to Treatment
When you give birth in a hospital or birth center, you are asked to sign a consent to treatment form. Your signature gives permission to the staff to care for you and your baby. Usually this form includes common procedures such as: vaginal exams, fetal monitoring, use of IVs, pain medication, breaking the bag of water, use of forceps or vacuum extractor.
You do not have to agree to everything on the form. You can delete from or add statements to the form. A separate consent is sometimes required for an epidural or for a cesarean section.
You can change your mind at any time by making your wishes known to your caregivers. If you choose not to agree with a treatment or procedure you may be asked to sign a waiver of liability acknowledging that you are taking responsibility for your decisions.
You also have the right to have a copy of your medical records. You may be able to obtain them directly, or they may need to be sent to the caregiver of your choice, depending on the regulations of the community in which you live.
Caregivers may disagree about what is best for pregnancy and childbirth. By becoming actively involved in your care, you are likely to be more satisfied with your decisions.
References
Adapted from The Rights of Patients: The Basic ACLU Guide to Patient Rights by George J. Annas. Southern Illinois University Press; 3rd edition (January 1, 2004).
ACOG June 2000. Informed Refusal. Committee Opinion, Number 237.
Monday, July 17, 2006
Significance of Birth to the Mother
Significance of Birth to the Mother
by Michelle Schnaars
It is the opinion of this author that woman who prepare for childbirth, receive labor doula support, and participate in the decision making process have a better birth experience than woman who do not receive childbirth education, labor and birth support, and who do not receive emotional support and encouragement.
I will attempt to show that the decision for labor doula support, the place of birth, and preparation for childbirth can greatly improve the childbirth experience and overall satisfaction. Following the history of childbirth we can see the options of today differ greatly than in years past. We have seen many drugs come and go. The history of obstetrical forceps is long; from approximately 1500 BCE there is evidence of single and paired instruments; Egyptian, Greek, Roman, and Persian writings and pictures refer to forceps. Credit for the invention of the precursor of the modern forceps to be used on live infants goes to Peter Chamberlen (circa 1600) of England. Modifications have led to more than 700 different types and shapes of forceps. In 1745, William Smellie described the accurate application to the occiput, rather than to the pelvis, regardless of the position of the head, which had been performed previously. In 1845, Sir James Simpson developed a forceps that was designed to appropriately fit both cephalic and pelvic curvatures. In 1920, Joseph DeLee further modified that instrument and advocated prophylactic forceps delivery. In an era in which many women labored and delivered under heavy sedation, forceps deliveries became common.
In the past 30 years we have seen the introduction of epidurals, sterile water injections, and a list of drugs that can be overwhelming. Fathers are now more involved in their children’s and their family’s life. They are also a more prominent figure in the birth team. We see father’s presence in the labor and delivery room, in childbirth education classes, at prenatal doctor visits, and father’s participation in the decision making process. With open communication, childbirth education, and labor doula support woman are now able to make decisions for their care and their baby’s care. Women realize they have a responsibility to themselves and their children. They are realizing too that the very place of birth and the people they choose to surround and support them will have an impact on their labor and birth.
The husband’s presence at birth has a significant impact on the birth outcome. Women feel safe, supported and loved when their partner is present at the birth. When a father witnesses the birth of his child he too experiences a stronger, deeper bond with his wife and child. The place of birth also serves to shape the labor and birth experience and ultimately the postpartum experience. A woman’s options are either readily available or she will have to do extensive research to become well educated and ultimately be able to participate in the decision making. Learning about and understanding the process of childbirth will help a woman to cope, help her to adjust, and to make the best decisions for herself and for the baby.
In 1940, Twilight Sleep was introduced. This heavy dose of narcotics and amnesiacs completely incapacitated laboring women and caused women to loose control. Many were literally strapped to their beds to keep them from injuring themselves. Often helmets were placed on the laboring woman to protect her head during ‘wild episodes’ that the drug would bring about; these episodes could lead to severe head trauma. Dads were useless with this kind of labor and delivery, so they were relegated to the waiting room. Most just went home and waited for a phone call that their wife had given birth.
In 1944, Dr. Grantley Dick-Reed wrote Childbirth With-out Fear; Dick-Reed believed that woman could give birth with out being drugged; and as long as they had the support to do so. In 1953, Dr. Fernand Lamaze published his findings about labor and delivery in Russia. Soon women in America wanted Lamaze’s natural childbirth. And in 1970 Dr. Robert Bradley co-founded the Bradley Method of Natural Childbirth. Bradley was significant in bringing the husband into the labor and delivery room. Dr. Bradley realized just how important the husband’s role was (and still is today). He taught couples how to work together to bring about physical and emotional relaxation which he found to be crucial for painless childbirth. He taught couples the process of labor and birth, how to relax physically and emotionally, and how to abdominally breathe. He taught husband’s how to support their wives through labor and birth. He believed that with loving couch-like-support woman would not need drugs, and medical deliveries.
Woman wanted change, they wanted support, and they wanted their husbands with them in the labor and delivery room. Women had finally realized that even though they were expecting a baby, they were indeed consumers; and so they assumed the responsibility of consumers to gain control of their birth experiences.
Natural childbirth methods were popping up all over America, classes were growing by leaps and bounds; and more and more organizations we created to train and certify individuals to keep up with the demand for education, support, and natural –normal childbirth. These individuals, mainly woman, were trained to work with the expectant couples in preparation for the birth event. Organizations such as Lamaze International, The Bradley Method, ALACE, ICEA, DONA, and CAPPA, certified childbirth educators and labor doulas, and still do today. Training people, to support the laboring woman and her companion, to help the mother achieve her wishes for the birth of her child, and to preserve the memory of the birth experience.
There is a definite difference in the management, or appreciation and patience, of labor and birth; and a definite difference in the way women are treated from birth place to birth place and from region to region. Hospital birth is generally a medical procedure and interventions are expected by the medical staff. Birth centers are usually much more “natural birth” friendly and support decisions made by the expectant couple. At a home birth the midwife will encourage the laboring woman to make her own decisions. The woman that chooses to birth at home usually wants an un-medicated labor and birth with little or no monitoring. This woman prefers the “active role” approach to birthing; walking, squatting, hydrotherapy, and birth ball. These same benefits can be found in a birth center; plus birth centers have doctors on call.
Now we see the decision to birth in a hospital, most likely, will lead to some type of “intervention”; (amniotomy, epidural, pitocin, IV, c-section) and most likely the majority of labor will be spent in bed. Hospital medical staff does not easily support the decision for natural birth because they simply do not learn about un-medicated birth in medical school. Mom may find herself bombarded with offers for pain medication. Other hospital interventions include continuous monitoring, IV, and no food or drink in early labor. Because hospitals are under staffed and nurses have many patients, the nurse will not be able to stand by mom’s side during labor. Also labor usually takes several hours or a few days and so the laboring woman will have several nurses throughout the course of her labor; she may find it difficult to “bond” with each nurse, and she may get very little, if any, emotional and physical support.
How a woman is supported through labor and childbirth can change the way she views herself as a laboring women. Is she encouraged to take an active role in her labor? Does her care provider encourage her to make decisions? Is she expected to leave the decisions to her care provider? Some times family members put pressure on mom to comply with hospital or doctors orders because they feel embarrassed if mom speaks her wishes. In any event she is the one who will live with the decisions; whether she chose them directly or indirectly. Now we see the positive effect of labor support, and the negative effect of a lack thereof.
In childbirth education classes parents learn not only changes that occur during labor and birth, they become aware of their options for childbirth and the benefits and risks involved with each procedure; so they may become a more active participant in the decision making process. When the couple attends childbirth education classes together the mother feels supported by her partner, she is encouraged by his participation. Through the classes she gains confidence in her body’s ability to labor and birth in a natural way, and she gains confidence in the decisions that she makes.
Ultimately, the woman’s choices for what types of care she will receive, place of birth, doctor or midwife, labor doula support, natural or medicated birth, or c-section, set the stage for the birth experience and postpartum recovery. Each decision impacts the birth outcome and how she views herself both as a woman and as a mother. These decisions affect her view of relationships; with her husband, children, extended family, and friends. Women remember their birth experiences for the rest of their lives. Yes, there are forgotten details, however some things are remembered with such vivid clarity even years later a woman still remembers and still feels the result of the decisions that were made.
Often a mother feels inadequate if she has had an epidural, or a c-section and these feelings can mount with hormonal changes and lack of sleep. If a woman ended with a birth experience she did not plan on she may feel as though she has missed out on what could have been, and she may experience a type of loss. Postpartum support is very necessary. The new mother needs to be encouraged and her feelings validated; and she needs to talk about the birth experience. Research has shown that a doulas support lowers the chances of a c-section, epidural, and pitocin; research also shows that a doula helps promote family bonding, increases breastfeeding success, and improves the overall birth experience.
The labor doula is an important member of the birth team. Her presence at the birth can give the mother a sense of security. A labor doula provides physical and emotional comfort; she explains medical terminology, and she helps the mother assume various labor positions to bring optimum comfort and facilitate birth. She gives the mother permission to labor and birth in a way that is comfortable and safest for both mom and baby. The labor doula also helps the father to be as active and supportive as he can be to his laboring wife.
Researchers from Case Western Reserve University in 1998 reported the findings of a series of studies designed to examine the effects of labor support by a doula. In six clinical trials, researchers found that providing the support of a doula to women during childbirth decreased caesarian section delivery rates, shortened labor times, and reduced the need for analgesia. In another study at the Department of Pediatrics at the Case Western Reserve University School of Medicine. According to researchers, doula support is an effective, risk-free, non-pharmacologic, and inexpensive pain relief method that may be a viable alternative to epidural analgesia for many women in labor; without the negative side effects and expense of an epidural.
Childbirth education classes and pharmacologic methods of anesthesia and analgesia are not the only variables that have been associated with reduced pain in childbirth. Women with lower levels of anxiety have been found to experience lower levels of pain (Klusman, 1975). Women whose husbands were present at labor and birth reported less pain (Chaney, 1980). Women with lower levels of education (Nettlebladt, Fagerstrom, & Uddenberg, 1976) and younger women (Davenport Slack & Boylan, 1974) reported experiencing more pain in childbirth. Lowe’s (1989, 1991, 1993) significant work confirmed the inverse relationship between a woman’s confidence in her ability to cope with labor and perceived pain during childbirth, the less perceived pain she will have and the better she will cope.
Standley and Nicholson (1980) developed a model for looking at maternal coping during the childbirth experience that depicts the relationship between the psychological, physiologic, and environmental factors that can be tested. The outcome measure were identified as childbirth competence (“a women’s ability to control her behavior and assist in the labor and delivery of her child without showing signs of psychological distress or functional inability”) and postpartum childbirth affect (“how a woman feels physically and emotionally immediately after birth”). The woman’s childbirth competence is influenced by general determinants, such as background and personal characteristics, and factors related to her pregnancy and physical and social environment and her cognitive appraisal of childbirth, which is related to her expectations for childbirth, her phychophysiologic adaptability, and stimuli in the childbirth environment. A woman’s interactions with others in the environment influence her coping ability during childbirth.
A society’s cultural beliefs and values establish the importance of the childbirth experience in that society, what is proper, what should be done, who participates during the childbirth experience, and what their roles should be during childbirth. Cultural beliefs and values significantly influence the woman’s perception of the childbirth experience (Callister et al., 1996; Jordan, 1993; Mead & Newton, 1965)
Whether childbirth can be considered a developmental task for adolescents is questionable and needs to be examined. Mercer (1996) found that as the educational level of the women increased, so did the level of childbirth satisfaction.
Adolescent mothers have a less positive perception of the childbirth experience than older mothers (Mercer, 1986). In addition, Nichols (1992) found that adolescents’ perceptions of the childbirth experience differed markedly from those of adult women. The goal of adolescents was on “survival” in contrast with the adult women’s desire to “master” the experience.
A mother’s personal history helps shape her perception of the childbirth experience. The childbearing woman’s feelings of self, her social support, and the significant life events she has experienced may all affect her childbirth (Areskog et al., 1984; Humenick & Bugen, 1981; Nuckolls, Cassel, & Kaplan, 1972).
Other factors include; a woman’s spiritual beliefs, the personality characteristics of the woman, family influences, society influences.
Finally when a laboring woman is encouraged to become well educated in childbirth, when she has labor doula support, when she is encouraged to assume comfortable birth positions, and when she has had little or no drugs, she feels a sense of success with the birth, and feels empowered by her experience. She relates to her baby, she bonds with her new born, the breastfeeding relationship is improved, and she is more likely to respond in kind to the baby’s needs.
Works Cited
Case Western Reserve University (Researchers John Kennell, M.D., and Susan k. Mcgrath, Ph.D., with Vijay S. Varadaraulu a premedical student at CWRU). 1997-06-04 Source Johns Hopkins Children’s Center. www.sciencedaily.com
Case Western Reserve University School of Medicine. The study was presented at the annual meeting of the Pediatric academic Societies in New Orleans, May 1-5, 1998. http://www.sciencedaily.com/
Husband Coached Childbirth; Robert A. Bradley, M. D. (Bantam trade paperback edition /February 1996)
Childbirth Education: Practice, Research, and Theory; Francine Nichols and Sharron Smith Humenick (Second EditionW. B. Saunders Company 2000)
by Michelle Schnaars
It is the opinion of this author that woman who prepare for childbirth, receive labor doula support, and participate in the decision making process have a better birth experience than woman who do not receive childbirth education, labor and birth support, and who do not receive emotional support and encouragement.
I will attempt to show that the decision for labor doula support, the place of birth, and preparation for childbirth can greatly improve the childbirth experience and overall satisfaction. Following the history of childbirth we can see the options of today differ greatly than in years past. We have seen many drugs come and go. The history of obstetrical forceps is long; from approximately 1500 BCE there is evidence of single and paired instruments; Egyptian, Greek, Roman, and Persian writings and pictures refer to forceps. Credit for the invention of the precursor of the modern forceps to be used on live infants goes to Peter Chamberlen (circa 1600) of England. Modifications have led to more than 700 different types and shapes of forceps. In 1745, William Smellie described the accurate application to the occiput, rather than to the pelvis, regardless of the position of the head, which had been performed previously. In 1845, Sir James Simpson developed a forceps that was designed to appropriately fit both cephalic and pelvic curvatures. In 1920, Joseph DeLee further modified that instrument and advocated prophylactic forceps delivery. In an era in which many women labored and delivered under heavy sedation, forceps deliveries became common.
In the past 30 years we have seen the introduction of epidurals, sterile water injections, and a list of drugs that can be overwhelming. Fathers are now more involved in their children’s and their family’s life. They are also a more prominent figure in the birth team. We see father’s presence in the labor and delivery room, in childbirth education classes, at prenatal doctor visits, and father’s participation in the decision making process. With open communication, childbirth education, and labor doula support woman are now able to make decisions for their care and their baby’s care. Women realize they have a responsibility to themselves and their children. They are realizing too that the very place of birth and the people they choose to surround and support them will have an impact on their labor and birth.
The husband’s presence at birth has a significant impact on the birth outcome. Women feel safe, supported and loved when their partner is present at the birth. When a father witnesses the birth of his child he too experiences a stronger, deeper bond with his wife and child. The place of birth also serves to shape the labor and birth experience and ultimately the postpartum experience. A woman’s options are either readily available or she will have to do extensive research to become well educated and ultimately be able to participate in the decision making. Learning about and understanding the process of childbirth will help a woman to cope, help her to adjust, and to make the best decisions for herself and for the baby.
In 1940, Twilight Sleep was introduced. This heavy dose of narcotics and amnesiacs completely incapacitated laboring women and caused women to loose control. Many were literally strapped to their beds to keep them from injuring themselves. Often helmets were placed on the laboring woman to protect her head during ‘wild episodes’ that the drug would bring about; these episodes could lead to severe head trauma. Dads were useless with this kind of labor and delivery, so they were relegated to the waiting room. Most just went home and waited for a phone call that their wife had given birth.
In 1944, Dr. Grantley Dick-Reed wrote Childbirth With-out Fear; Dick-Reed believed that woman could give birth with out being drugged; and as long as they had the support to do so. In 1953, Dr. Fernand Lamaze published his findings about labor and delivery in Russia. Soon women in America wanted Lamaze’s natural childbirth. And in 1970 Dr. Robert Bradley co-founded the Bradley Method of Natural Childbirth. Bradley was significant in bringing the husband into the labor and delivery room. Dr. Bradley realized just how important the husband’s role was (and still is today). He taught couples how to work together to bring about physical and emotional relaxation which he found to be crucial for painless childbirth. He taught couples the process of labor and birth, how to relax physically and emotionally, and how to abdominally breathe. He taught husband’s how to support their wives through labor and birth. He believed that with loving couch-like-support woman would not need drugs, and medical deliveries.
Woman wanted change, they wanted support, and they wanted their husbands with them in the labor and delivery room. Women had finally realized that even though they were expecting a baby, they were indeed consumers; and so they assumed the responsibility of consumers to gain control of their birth experiences.
Natural childbirth methods were popping up all over America, classes were growing by leaps and bounds; and more and more organizations we created to train and certify individuals to keep up with the demand for education, support, and natural –normal childbirth. These individuals, mainly woman, were trained to work with the expectant couples in preparation for the birth event. Organizations such as Lamaze International, The Bradley Method, ALACE, ICEA, DONA, and CAPPA, certified childbirth educators and labor doulas, and still do today. Training people, to support the laboring woman and her companion, to help the mother achieve her wishes for the birth of her child, and to preserve the memory of the birth experience.
There is a definite difference in the management, or appreciation and patience, of labor and birth; and a definite difference in the way women are treated from birth place to birth place and from region to region. Hospital birth is generally a medical procedure and interventions are expected by the medical staff. Birth centers are usually much more “natural birth” friendly and support decisions made by the expectant couple. At a home birth the midwife will encourage the laboring woman to make her own decisions. The woman that chooses to birth at home usually wants an un-medicated labor and birth with little or no monitoring. This woman prefers the “active role” approach to birthing; walking, squatting, hydrotherapy, and birth ball. These same benefits can be found in a birth center; plus birth centers have doctors on call.
Now we see the decision to birth in a hospital, most likely, will lead to some type of “intervention”; (amniotomy, epidural, pitocin, IV, c-section) and most likely the majority of labor will be spent in bed. Hospital medical staff does not easily support the decision for natural birth because they simply do not learn about un-medicated birth in medical school. Mom may find herself bombarded with offers for pain medication. Other hospital interventions include continuous monitoring, IV, and no food or drink in early labor. Because hospitals are under staffed and nurses have many patients, the nurse will not be able to stand by mom’s side during labor. Also labor usually takes several hours or a few days and so the laboring woman will have several nurses throughout the course of her labor; she may find it difficult to “bond” with each nurse, and she may get very little, if any, emotional and physical support.
How a woman is supported through labor and childbirth can change the way she views herself as a laboring women. Is she encouraged to take an active role in her labor? Does her care provider encourage her to make decisions? Is she expected to leave the decisions to her care provider? Some times family members put pressure on mom to comply with hospital or doctors orders because they feel embarrassed if mom speaks her wishes. In any event she is the one who will live with the decisions; whether she chose them directly or indirectly. Now we see the positive effect of labor support, and the negative effect of a lack thereof.
In childbirth education classes parents learn not only changes that occur during labor and birth, they become aware of their options for childbirth and the benefits and risks involved with each procedure; so they may become a more active participant in the decision making process. When the couple attends childbirth education classes together the mother feels supported by her partner, she is encouraged by his participation. Through the classes she gains confidence in her body’s ability to labor and birth in a natural way, and she gains confidence in the decisions that she makes.
Ultimately, the woman’s choices for what types of care she will receive, place of birth, doctor or midwife, labor doula support, natural or medicated birth, or c-section, set the stage for the birth experience and postpartum recovery. Each decision impacts the birth outcome and how she views herself both as a woman and as a mother. These decisions affect her view of relationships; with her husband, children, extended family, and friends. Women remember their birth experiences for the rest of their lives. Yes, there are forgotten details, however some things are remembered with such vivid clarity even years later a woman still remembers and still feels the result of the decisions that were made.
Often a mother feels inadequate if she has had an epidural, or a c-section and these feelings can mount with hormonal changes and lack of sleep. If a woman ended with a birth experience she did not plan on she may feel as though she has missed out on what could have been, and she may experience a type of loss. Postpartum support is very necessary. The new mother needs to be encouraged and her feelings validated; and she needs to talk about the birth experience. Research has shown that a doulas support lowers the chances of a c-section, epidural, and pitocin; research also shows that a doula helps promote family bonding, increases breastfeeding success, and improves the overall birth experience.
The labor doula is an important member of the birth team. Her presence at the birth can give the mother a sense of security. A labor doula provides physical and emotional comfort; she explains medical terminology, and she helps the mother assume various labor positions to bring optimum comfort and facilitate birth. She gives the mother permission to labor and birth in a way that is comfortable and safest for both mom and baby. The labor doula also helps the father to be as active and supportive as he can be to his laboring wife.
Researchers from Case Western Reserve University in 1998 reported the findings of a series of studies designed to examine the effects of labor support by a doula. In six clinical trials, researchers found that providing the support of a doula to women during childbirth decreased caesarian section delivery rates, shortened labor times, and reduced the need for analgesia. In another study at the Department of Pediatrics at the Case Western Reserve University School of Medicine. According to researchers, doula support is an effective, risk-free, non-pharmacologic, and inexpensive pain relief method that may be a viable alternative to epidural analgesia for many women in labor; without the negative side effects and expense of an epidural.
Childbirth education classes and pharmacologic methods of anesthesia and analgesia are not the only variables that have been associated with reduced pain in childbirth. Women with lower levels of anxiety have been found to experience lower levels of pain (Klusman, 1975). Women whose husbands were present at labor and birth reported less pain (Chaney, 1980). Women with lower levels of education (Nettlebladt, Fagerstrom, & Uddenberg, 1976) and younger women (Davenport Slack & Boylan, 1974) reported experiencing more pain in childbirth. Lowe’s (1989, 1991, 1993) significant work confirmed the inverse relationship between a woman’s confidence in her ability to cope with labor and perceived pain during childbirth, the less perceived pain she will have and the better she will cope.
Standley and Nicholson (1980) developed a model for looking at maternal coping during the childbirth experience that depicts the relationship between the psychological, physiologic, and environmental factors that can be tested. The outcome measure were identified as childbirth competence (“a women’s ability to control her behavior and assist in the labor and delivery of her child without showing signs of psychological distress or functional inability”) and postpartum childbirth affect (“how a woman feels physically and emotionally immediately after birth”). The woman’s childbirth competence is influenced by general determinants, such as background and personal characteristics, and factors related to her pregnancy and physical and social environment and her cognitive appraisal of childbirth, which is related to her expectations for childbirth, her phychophysiologic adaptability, and stimuli in the childbirth environment. A woman’s interactions with others in the environment influence her coping ability during childbirth.
A society’s cultural beliefs and values establish the importance of the childbirth experience in that society, what is proper, what should be done, who participates during the childbirth experience, and what their roles should be during childbirth. Cultural beliefs and values significantly influence the woman’s perception of the childbirth experience (Callister et al., 1996; Jordan, 1993; Mead & Newton, 1965)
Whether childbirth can be considered a developmental task for adolescents is questionable and needs to be examined. Mercer (1996) found that as the educational level of the women increased, so did the level of childbirth satisfaction.
Adolescent mothers have a less positive perception of the childbirth experience than older mothers (Mercer, 1986). In addition, Nichols (1992) found that adolescents’ perceptions of the childbirth experience differed markedly from those of adult women. The goal of adolescents was on “survival” in contrast with the adult women’s desire to “master” the experience.
A mother’s personal history helps shape her perception of the childbirth experience. The childbearing woman’s feelings of self, her social support, and the significant life events she has experienced may all affect her childbirth (Areskog et al., 1984; Humenick & Bugen, 1981; Nuckolls, Cassel, & Kaplan, 1972).
Other factors include; a woman’s spiritual beliefs, the personality characteristics of the woman, family influences, society influences.
Finally when a laboring woman is encouraged to become well educated in childbirth, when she has labor doula support, when she is encouraged to assume comfortable birth positions, and when she has had little or no drugs, she feels a sense of success with the birth, and feels empowered by her experience. She relates to her baby, she bonds with her new born, the breastfeeding relationship is improved, and she is more likely to respond in kind to the baby’s needs.
Works Cited
Case Western Reserve University (Researchers John Kennell, M.D., and Susan k. Mcgrath, Ph.D., with Vijay S. Varadaraulu a premedical student at CWRU). 1997-06-04 Source Johns Hopkins Children’s Center. www.sciencedaily.com
Case Western Reserve University School of Medicine. The study was presented at the annual meeting of the Pediatric academic Societies in New Orleans, May 1-5, 1998. http://www.sciencedaily.com/
Husband Coached Childbirth; Robert A. Bradley, M. D. (Bantam trade paperback edition /February 1996)
Childbirth Education: Practice, Research, and Theory; Francine Nichols and Sharron Smith Humenick (Second EditionW. B. Saunders Company 2000)
These are a few of my favorite links
For a childbirth and/or postpartum professional: www.cappa.net
For Doula wear: http://www.cafepress.com/cappa1
For OSD wear: http://www.cafepress.com/CAPPA_OSD
For Books, videos, etc: www.cuttingedgepress.net
For Books, videos, doula and cbe supplies: http://www.cappa.net/miva/merchant.mv
For Your Tupperware needs: http://my2.tupperware.com/tup-html/O/orderonline-welcome.html
The Birth Center of Delaware: http://www.thebirthcenter.com/
For a Pennsylvania doula and educator: http://multimediamom.com/doula/
Expecting Miracles: http://mysite.verizon.net/vze81dsl/expectingmiracles
Organic childrens clothing: http://store.kidbean.com
CIMS: http://www.motherfriendly.org/MFCI/
For Doula wear: http://www.cafepress.com/cappa1
For OSD wear: http://www.cafepress.com/CAPPA_OSD
For Books, videos, etc: www.cuttingedgepress.net
For Books, videos, doula and cbe supplies: http://www.cappa.net/miva/merchant.mv
For Your Tupperware needs: http://my2.tupperware.com/tup-html/O/orderonline-welcome.html
The Birth Center of Delaware: http://www.thebirthcenter.com/
For a Pennsylvania doula and educator: http://multimediamom.com/doula/
Expecting Miracles: http://mysite.verizon.net/vze81dsl/expectingmiracles
Organic childrens clothing: http://store.kidbean.com
CIMS: http://www.motherfriendly.org/MFCI/
Operation Special Delivery
Operation Special Delivery
by Michelle Schnaars
Operation Special Delivery or OSD for short, is an organization that provides free labor doula services to military families.
The labor doulas of OSD are trained and certified with various organizations; and thier ready to assist you in creating a rewarding birth experience. Most military wives birth without their partner, the OSD doula is a guide to assist the mom, be a constant reasuring presence, and help with breastfeeding after the birth (if mom chooses to breastfeed).
If you are in the Military or your partner is please visit www.operationspecialdelivery.com today and apply for a FREE labor doula.
by Michelle Schnaars
Operation Special Delivery or OSD for short, is an organization that provides free labor doula services to military families.
The labor doulas of OSD are trained and certified with various organizations; and thier ready to assist you in creating a rewarding birth experience. Most military wives birth without their partner, the OSD doula is a guide to assist the mom, be a constant reasuring presence, and help with breastfeeding after the birth (if mom chooses to breastfeed).
If you are in the Military or your partner is please visit www.operationspecialdelivery.com today and apply for a FREE labor doula.
Mothers are Number 1 with the Doula
Mothers are No. 1 with the Doula
By Cara Tabachnick
Michal Glines was pregnant for the first time at 40. A planner by nature, she had a husband, a house in Tucson, Ariz., and a successful career as a landscape designer before deciding to start a family.
But when John was born, she and her 43-year-old husband, Michael Racy, a lobbyist, concluded that no amount of preparation could ready anyone for a child.
“I am a businesswoman with a career,” she said. “Your instinct is to handle the child the way you would handle a business, but it doesn’t work that way.”
Enter the postpartum doula, a combination nurse, mother and information source. Different than the more common birth doulas, who assist during labor and delivery, the postpartum doula arrives after the baby is home to counsel the mother on breast-feeding and swaddling and to dispell old wives' tales. And, most important, the doula keeps a sharp eye out for signs of postpartum depression.
The popularity of postpartum doulas is growing swiftly, said Tracy Wilson Peters, executive director of Childbirth and Postpartum Professional Association, a national organization of doulas and birth experts. While the group does not keep records on the number of working postpartum doulas in the United States, "since 2002, calls to our organization have increased by 31.5 percent,” she said.
Postpartum doulas fill gaps in the traditional family network as women move away from home and establish careers first and start families second.
This group of women in their 30s and 40s tend to be well-educated about childbirth and financially secure, since most doula services, which can cost from $20 to $40 an hour, are not covered by insurance.
“Sometimes new parents feel uncomfortable asking parents for advice or they live far away,” said Nancy Barber, 59, Glines' doula and owner of We Follow the Stork in Tucson.
For most postpartum doulas, the emphasis is on the mother, who they feel needs the most help.
“Mothers need to be mothered so they can have successful babies in society," said Jane Honikman, a founder of Postpartum Support International in Santa Barbara, Calif.
Mothers are often forgotten after the birth, she said, when most of the attention goes to the baby. Some mothers feel overwhelmed or cut off from family and friends after making the transition from career woman to stay-at-home mother.
“The weeks after birth are a real period of isolation in our society,” said Christine Kealy, 60, owner of In a Family Way, a postpartum doula company in New York that caters to urban professionals. “Women are used to doing things well. When a baby comes they are in uncharted water.”
One of her clients, Annika Pergament, a broadcast journalist in her 30s, said, “Little things all of a sudden become huge tasks that you are not sure you can accomplish.”
Allyson Orell, 33, lost her mother to cancer shortly before she decided to start her own family. In the weeks following the birth of her daughter, Julia, now 13 weeks old, she felt isolated and overwhelmed and struggled with depression, even though she had family support near her home in Lantana, Fla.
“I had other relatives around, but it was hard, they all have their own lives,” Orell said. Once she decided to use New Beginnings, a local doula service, Orell said she felt more confident every day.
“Now I wouldn’t have any other children without using a postpartum doula,” she said.
Doulas--the word means woman's servant in Greek--give advice gleaned from experience, training sessions or doctors about how to care for infants in areas like breast-feeding or swaddling.
“Breast-feeding is complicated,” Barber said. “People don’t realize babies have to be positioned right. Little things have to be tweaked.”
“It is a huge, huge life change,” Glines said. “To have someone come and answer all the strange questions I wanted to ask is invaluable.”
A report by DONA International, a nonprofit group with 5,700 members that trains and refers doulas, said new parents who have support and feel secure and cared for are more successful in adapting than those who don’t. And they have greater success in breast-feeding, have more self-confidence and endure less postpartum depression.
“Whenever there are support systems in place, it can be helpful in ameliorating postpartum depression,” said Dr. Paul Gluck, associate clinical professor of OB/GYN at the University of Miami and an expert on postpartum depression.
“It hasn’t been proven or studied yet to have an effect, unlike birth and labor doulas, but it makes sense that using postpartum doulas will help alleviate stress,” he said.
“After all,” added Honikman, the stress center founder, “birth is just a moment in time, but postpartum is forever.”
E-mail: cjt2113@columbia.edu
By Cara Tabachnick
Michal Glines was pregnant for the first time at 40. A planner by nature, she had a husband, a house in Tucson, Ariz., and a successful career as a landscape designer before deciding to start a family.
But when John was born, she and her 43-year-old husband, Michael Racy, a lobbyist, concluded that no amount of preparation could ready anyone for a child.
“I am a businesswoman with a career,” she said. “Your instinct is to handle the child the way you would handle a business, but it doesn’t work that way.”
Enter the postpartum doula, a combination nurse, mother and information source. Different than the more common birth doulas, who assist during labor and delivery, the postpartum doula arrives after the baby is home to counsel the mother on breast-feeding and swaddling and to dispell old wives' tales. And, most important, the doula keeps a sharp eye out for signs of postpartum depression.
The popularity of postpartum doulas is growing swiftly, said Tracy Wilson Peters, executive director of Childbirth and Postpartum Professional Association, a national organization of doulas and birth experts. While the group does not keep records on the number of working postpartum doulas in the United States, "since 2002, calls to our organization have increased by 31.5 percent,” she said.
Postpartum doulas fill gaps in the traditional family network as women move away from home and establish careers first and start families second.
This group of women in their 30s and 40s tend to be well-educated about childbirth and financially secure, since most doula services, which can cost from $20 to $40 an hour, are not covered by insurance.
“Sometimes new parents feel uncomfortable asking parents for advice or they live far away,” said Nancy Barber, 59, Glines' doula and owner of We Follow the Stork in Tucson.
For most postpartum doulas, the emphasis is on the mother, who they feel needs the most help.
“Mothers need to be mothered so they can have successful babies in society," said Jane Honikman, a founder of Postpartum Support International in Santa Barbara, Calif.
Mothers are often forgotten after the birth, she said, when most of the attention goes to the baby. Some mothers feel overwhelmed or cut off from family and friends after making the transition from career woman to stay-at-home mother.
“The weeks after birth are a real period of isolation in our society,” said Christine Kealy, 60, owner of In a Family Way, a postpartum doula company in New York that caters to urban professionals. “Women are used to doing things well. When a baby comes they are in uncharted water.”
One of her clients, Annika Pergament, a broadcast journalist in her 30s, said, “Little things all of a sudden become huge tasks that you are not sure you can accomplish.”
Allyson Orell, 33, lost her mother to cancer shortly before she decided to start her own family. In the weeks following the birth of her daughter, Julia, now 13 weeks old, she felt isolated and overwhelmed and struggled with depression, even though she had family support near her home in Lantana, Fla.
“I had other relatives around, but it was hard, they all have their own lives,” Orell said. Once she decided to use New Beginnings, a local doula service, Orell said she felt more confident every day.
“Now I wouldn’t have any other children without using a postpartum doula,” she said.
Doulas--the word means woman's servant in Greek--give advice gleaned from experience, training sessions or doctors about how to care for infants in areas like breast-feeding or swaddling.
“Breast-feeding is complicated,” Barber said. “People don’t realize babies have to be positioned right. Little things have to be tweaked.”
“It is a huge, huge life change,” Glines said. “To have someone come and answer all the strange questions I wanted to ask is invaluable.”
A report by DONA International, a nonprofit group with 5,700 members that trains and refers doulas, said new parents who have support and feel secure and cared for are more successful in adapting than those who don’t. And they have greater success in breast-feeding, have more self-confidence and endure less postpartum depression.
“Whenever there are support systems in place, it can be helpful in ameliorating postpartum depression,” said Dr. Paul Gluck, associate clinical professor of OB/GYN at the University of Miami and an expert on postpartum depression.
“It hasn’t been proven or studied yet to have an effect, unlike birth and labor doulas, but it makes sense that using postpartum doulas will help alleviate stress,” he said.
“After all,” added Honikman, the stress center founder, “birth is just a moment in time, but postpartum is forever.”
E-mail: cjt2113@columbia.edu
Did You Know?
Did You Know?
In colonial times, childbirth and early postpartum were social events for women. Friends from the community gathered during labor and then at the new mother’s house for the first few weeks of her baby’s life.
They took care of the cooking and cleaning, as well as any older children. This gave the mom a chance to connect with her new baby. But seeing as how you probably can’t talk your friends into camping out at your house and taking care of the chores for several weeks, the next best thing is hiring someone to do it.
In colonial times, childbirth and early postpartum were social events for women. Friends from the community gathered during labor and then at the new mother’s house for the first few weeks of her baby’s life.
They took care of the cooking and cleaning, as well as any older children. This gave the mom a chance to connect with her new baby. But seeing as how you probably can’t talk your friends into camping out at your house and taking care of the chores for several weeks, the next best thing is hiring someone to do it.
Mother’s Little Helpers
These 5 services make life a little easier for new moms. by Koren Wetmore
The first few weeks following your baby’s birth, you may find yourself feeling a little bit overwhelmed.You’re tired, you’re adjusting to new responsibilities and – unless you have a lineup of wise and caring relatives to get you through – you could probably use some outside help.
Well, lucky for you, help is out there – and in some cases, it’s surprisingly affordable.We’ve rounded up five services that offer new moms a little postpartum support. Choose one that’s right for your needs and your budget.
Postpartum Doulas. Doulas may be best known as labor coaches, but they can also help new moms with breastfeeding, newborn care and instruction, mother care and household support. They can go with you on your first trip to the store with your baby, help you set up the nursery or perform other household tasks such as cooking or cleaning. Certified postpartum doulas have received infantand mother-care training through one of three major organizations (DONA, CAPPA or NAPCS).
“When you have a new baby, you’re feeling tired and overworked and not always sure of what you’re doing. A postpartum doula can come in, calm the atmosphere and makes you feel more confident,” says Donna Johnson, executive director of the Childbirth and Postpartum Professional Association (CAPPA).
Cost: $15-$25/hourHow to find: Contact CAPPA,888/MYCAPPA, www.cappa.net; Doulas of North America (DONA), 888/788-DONA; or the National Association of Postpartum Care Services, 800/453-6852.
Baby Nurses. Similar to a postpartum doula, baby nurses help with mother and infant care, but they usually also hold an LVN or RN degree. Some are trained to help with special-needs or premature infants. Baby nurses don’t typically do cleaning or cooking.
“You can learn as much as you want from a prenatal class, but the truth is, nothing really sinks in until you’re at home with your new baby,” says Carolyn Markey, RN, president of the Visiting Nurses Associations o America.“A baby nurse can look at the environment and see what changes need to happen that you didn’t even think about.”
Cost: About $100 per visit (Some insurance providers will cover this cost.)How to find: Contact your local Visiting Nurses Association (www.vnaa.com).
Personal Chefs. Unlike private chefs, who actually live in your home, personal chefs come in to cook on an as-needed basis or to prepare and freeze a number of meals you can conveniently reheat later. They can be hired by the week or by the number of meals (e.g. 20 meals per month). “Many times, the family will bring in a personal chef for the first few weeks so mom can focus on the new baby,” says David MacKay, executive director of the U.S. Personal Chef Association. “If the husband can operate a microwave or conventional oven, he can handle reheating the meals.”
Cost: $12-$15 per person/mealHow to find: www.hireachef.com or call 800/995-2138.
Housekeeping Services. Hand over the heavy-duty bathroom and kitchen cleaning to a housekeeping service. “It’s a relief for new moms to not have to worry about scrubbing the toilet or vacuuming the floor,” says Sarah Smock, marketing director for Merry Maids. “And when someone wants to come over to see your new baby, you don’t have to rush around trying to get the house clean enough for visitors.”
Cost: $65+ per visit How to find: Personal referral or local agency.
Personal Concierge Services. With fees based upon individual needs, companies offering concierge services will run your errands such as grocery shopping, dog walking or picking up dry cleaning. “Carrying those grocery bags and your baby too can be hard. A personal concierge does the shopping for you,” says Rhonnie McCauley, president of Errand Services Biz, a personal concierge service near Boulder, Colo. Not to mention that facing the world requires the occasional shower, which can be surprisingly tough for new moms of newborns. Cost: $15+/hourHow to find: Call 800/934-ICEA (the International Concierge and Errand Association) to locate a service near you.
These 5 services make life a little easier for new moms. by Koren Wetmore
The first few weeks following your baby’s birth, you may find yourself feeling a little bit overwhelmed.You’re tired, you’re adjusting to new responsibilities and – unless you have a lineup of wise and caring relatives to get you through – you could probably use some outside help.
Well, lucky for you, help is out there – and in some cases, it’s surprisingly affordable.We’ve rounded up five services that offer new moms a little postpartum support. Choose one that’s right for your needs and your budget.
Postpartum Doulas. Doulas may be best known as labor coaches, but they can also help new moms with breastfeeding, newborn care and instruction, mother care and household support. They can go with you on your first trip to the store with your baby, help you set up the nursery or perform other household tasks such as cooking or cleaning. Certified postpartum doulas have received infantand mother-care training through one of three major organizations (DONA, CAPPA or NAPCS).
“When you have a new baby, you’re feeling tired and overworked and not always sure of what you’re doing. A postpartum doula can come in, calm the atmosphere and makes you feel more confident,” says Donna Johnson, executive director of the Childbirth and Postpartum Professional Association (CAPPA).
Cost: $15-$25/hourHow to find: Contact CAPPA,888/MYCAPPA, www.cappa.net; Doulas of North America (DONA), 888/788-DONA; or the National Association of Postpartum Care Services, 800/453-6852.
Baby Nurses. Similar to a postpartum doula, baby nurses help with mother and infant care, but they usually also hold an LVN or RN degree. Some are trained to help with special-needs or premature infants. Baby nurses don’t typically do cleaning or cooking.
“You can learn as much as you want from a prenatal class, but the truth is, nothing really sinks in until you’re at home with your new baby,” says Carolyn Markey, RN, president of the Visiting Nurses Associations o America.“A baby nurse can look at the environment and see what changes need to happen that you didn’t even think about.”
Cost: About $100 per visit (Some insurance providers will cover this cost.)How to find: Contact your local Visiting Nurses Association (www.vnaa.com).
Personal Chefs. Unlike private chefs, who actually live in your home, personal chefs come in to cook on an as-needed basis or to prepare and freeze a number of meals you can conveniently reheat later. They can be hired by the week or by the number of meals (e.g. 20 meals per month). “Many times, the family will bring in a personal chef for the first few weeks so mom can focus on the new baby,” says David MacKay, executive director of the U.S. Personal Chef Association. “If the husband can operate a microwave or conventional oven, he can handle reheating the meals.”
Cost: $12-$15 per person/mealHow to find: www.hireachef.com or call 800/995-2138.
Housekeeping Services. Hand over the heavy-duty bathroom and kitchen cleaning to a housekeeping service. “It’s a relief for new moms to not have to worry about scrubbing the toilet or vacuuming the floor,” says Sarah Smock, marketing director for Merry Maids. “And when someone wants to come over to see your new baby, you don’t have to rush around trying to get the house clean enough for visitors.”
Cost: $65+ per visit How to find: Personal referral or local agency.
Personal Concierge Services. With fees based upon individual needs, companies offering concierge services will run your errands such as grocery shopping, dog walking or picking up dry cleaning. “Carrying those grocery bags and your baby too can be hard. A personal concierge does the shopping for you,” says Rhonnie McCauley, president of Errand Services Biz, a personal concierge service near Boulder, Colo. Not to mention that facing the world requires the occasional shower, which can be surprisingly tough for new moms of newborns. Cost: $15+/hourHow to find: Call 800/934-ICEA (the International Concierge and Errand Association) to locate a service near you.
Introduction
Hi my name is Michelle, welcome to my blog. This blog will contain information about pregnancy, childbirth, breastfeeding, and the postpartum period.
Occasionaly there may be other topics covered as determined by events in my personal and professional life. Or if I see a relationship with the above topics.
Please feel welcome to post comments, or questions. If you're looking for resources, information, or referrals please feel welcome to ask. I will do my best to help you find the answers you're looking for.
Sincerely,
Michelle
Occasionaly there may be other topics covered as determined by events in my personal and professional life. Or if I see a relationship with the above topics.
Please feel welcome to post comments, or questions. If you're looking for resources, information, or referrals please feel welcome to ask. I will do my best to help you find the answers you're looking for.
Sincerely,
Michelle
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