Celebrate Birth!

Cord Clamping

Recently, I saw this incredible blog post on the internet of these fantastic photos of an umbilical cord. I am asked about "delayed cord clamping" often. I offer 2 bits of advice...#1 educate yourself on delayed cord clamping and #2 talk to YOUR caregiver!

Where can you find information?  For starters you can check out this fantastic blog (see below). You can also visit an evidence-based website devoted to the Midwifery Model of Care at:

http://midwifeinfo.com/articles/cord-clamping--please-wait

 

ALSO a great YouTube video explaining what "delayed cord clamping" is and why you should ask your caregiver to wait by Penny Simkin:

 

http://www.youtube.com/watch?v=W3RywNup2CM

 

The blog is:

http://www.nurturingheartsbirthservices.com/blog/?p=1542

THE FOLLOWING PICTURES WERE TAKEN OVER A PERIOD OF ABOUT 15 MINUTES – BABY WAS ATTACHED THE ENTIRE TIME….

 

Informed Consent-Questions to ask your caregiver

Making Informed Health Care Decisions

Nicette Jukelevics, MA, ICCE

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 health care 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 health care decisions in consultation with their caregivers. 

  

As 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?

 

   Your caregiver will give you information and advice. You will probably feel better about making decisions regarding tests, procedures, or treatments if you ask your caregiver a few questions:

  

§  How is this helpful to my baby or me? 

§  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 my baby and me? 

§  How do you feel about my getting a second opinion?   

  

When you give birth in a hospital or birth center, you are asked to sign 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 and always required for a cesarean delivery. 

  

 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.    

  

What do you need to know to give informed consent?

ü  What is being recommended to you?
Is this a test, a medication or a procedure? Is this a one time event, or will it require several visits or administrations?

ü  Why is this being recommended?
Is this something that is recommended to everyone, or is there a reason to believe it will be helpful in your situation?

ü  What is this expected to do?
Is this going to relieve a problem, improve your health, manage discomfort or something else? In short, what should be different after you receive this.

ü  What are the risks of this?
The list of risks will vary with every procedure and medication. Do not accept the answer, "There is no risk involved." Every procedure has a risk, many procedures have a very small risk and it is easy to see that the benefits outweigh the risks, but that doesn't mean there is no risk.
It is also important to remember that some risks are not "physical." There may be no physical risk to wearing a hospital gown, but many women report that it changed the way they felt. So there is an emotional risk involved in wearing a hospital gown.

ü  What are the other options and their risks?
There is always another option, even if it is just to do nothing. Remember that the other options have risks too.

ü  What will we do if this doesn't have its desired effect?
No procedure, medication or intervention (natural or medical) is 100% guaranteed to work. What will be the next step if you decide to go ahead, and it doesn't work. How will having used it change the other options available to you?

Great websites to check out...

http://www.pennysimkin.com/index.htm

http://www.hencigoer.com/

 

Great book to read to become more informed:

 
The Thinking Woman's Guide to a Better Birth by Henci Goer

 

Adapted from The Rights of Patients:The Basic ACLU Guide to Patient Rights by George J. Annas . 1992. Totowa, New Jersey:Humana Press.

Circumcision...what do I do?

The information is intended for general consumer understanding and education only and is not intended to be, and is not provided as, a substitute for professional medical advice, diagnosis or treatment.

This topic has been brought to my attention from clients of mine that have asked for resources on the issue. So I decided to do some research to try and find evidence-based information on both sides of the issue. Here are some great websites I found. I found a site that is "against" circumcision, one "for" circumcision, and one that shows pros and cons in a nice and easy-to-read chart. I even found a site that has some videos that shows you the procedure.

 

When this subject is brought to my attention I tell my clients 3 things...

1. Reaearch BOTH sides of the issue

2. Watch the procedure

3. Make a desicion that is best for your son

 

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Here is a website that is "against" circumcision:

http://www.nocirc.org/

What you need to know...

1. No national or international medical association recommends routine circumcision.
2. Only the USA circumcises the majority of newborn boys without medical or religious reason.
3. Medicalized circumcision began during the 1800s to prevent masturbation, which was believed to cause disease.
4. Today's parents are learning that the foreskin is a normal, protective, functioning organ.
5. Today's parents realize circumcision harms and has unnecessary risks.
6. Circumcision denies a male's right to genital integrity and choice for his own body

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Here is a website that is "for" circumcision:

http://www.circinfo.net/

The benefits of circumcision include:

• Decrease in physical problems involving a tight foreskin.

• Lower incidence of inflammation of the head of the penis.

• Reduced urinary tract infections.

• Fewer problems with erections, especially at puberty.

• Decrease in certain sexually transmitted infections (STIs) such as HIV, HPV, genital herpes, syphilis and other micro-organisms in men and their partner(s).

• Almost complete elimination of invasive penile cancer.

• Decrease in urological problems generally.

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Here is a website with both the "Pros and Cons" of circumcision:

http://www.homiegfunk.com/RIC2.htm

Pro Routine Infant Circumcision	Con Routine Infant Circumcision
Routine Infant Circumcision is performed because it has many health benefits.	Routine Infant Circumcision has no health benefits and is performed for cosmetic, social reasons.
Truth: Routine Infant Circumcision, or RIC, has no proven health benefits, though the American Academy of Pediatrics acknowledges that there might be some potential benefits. The AAP and other medical organisations consider RIC to be a cosmetic social custom rather than a necessary surgery.
RIC is not painful; anesthesia is used and even still it happens very quickly, and is just a snip.	RIC is painful. The anesthesia does not give adequate pain relief and is only used by a small percentage of doctors.
Truth: While an infant's foreskin is considerably smaller than an adult foreskin, studies show that the procedure is more painful for infants. One reason for this is that the foreskin on an infant is fused to the glans of the penis and must be torn free in order to be removed. In adults, the foreskin is no longer fused. Also, adults may use stronger painkillers during and after the procedure, which infants do not receive due to the risks of anesthesia on infants. Studies indicate that only 4% of infants actually receive anesthesia because the risks it brings.
RIC lessens the chance of urinary tract infections.	RIC is a dramatic way to treat an infection, when it can be treated with antibiotics.
Truth: According to some studies, circumcision decreases the risk of UTIs in the first year of life. Studies are, however, very conflicting. Most studies show little or no statistical difference. Also, the risk of UTIs in males is extremely low and can be treated safely with antibiotics.
Circumcised males are more visually appealing, and will not have to worry about getting made fun of in the locker room, or by a girlfriend.	Teach self esteem, not surgery.
Truth: In America, circumcised males were more common, and studies show that among women, cut men were viewed as more appealing. However, in recent years, the rates between children that are cut and intact are very similar, showing that intact males will not be in the minority in the future. In the rest of the world, intact men are valued more and are in the majority. Over 80% of the world's males are intact.
Children are often circumcised so they will look like their fathers.	Male infants do not need penises that "look like" their fathers.
Truth: Studies show that male children neither know or care about the circumcision status of their father.
Circumcision lowers STD rates and the rate of cervical cancer in women.	Circumcision is NOT protection against these things.
Truth: Studies are very conflicting on these issues. The American Cancer Society says that circumcision is not a valid way to protect against either of these problems, and does not lessen risk. Both can be prevented with safe sex or abstinence.
Circumcision lowers the risk of penile cancer.	Penile cancer is very rare and treatable for uncut men.
Truth: In America, circumcision is correlated with a lower risk of penile cancer. However, in many countries it is associated with a higher risk, indicating that circumcision has little to do with penile cancer rates and that factors such as smoking and sexual habits are the important issues. Also, if an intact man has penile cancer on his foreskin, he will be circumcised as treatment. If a cut man gets penile cancer, his penis will be partially or completely amputated.
The benefits or circumcision outweigh the risks.	There are no benefits; only risks.
Truth: There are no proven benefits of circumcision. Some possible benefits, such as protection from infection or from penile cancer are counteracted by the risks: a child is just as likely to get an infection from a circumcision wound as there are from a UTI, and is just as likely to die from penile cancer as he is from circumcision complications.
Circumcision does not affect sexual function.	Circumcision severely hinders sexual function
Truth: While one study suggests that there is no sensitivity difference, circumcision removes the thousands of nerves, including the frenulum, which is the most sensitive part of the male body. Also, without the protection of the foreskin, the glans kernatises over the years to protect from abrasion, burying nerves under up to 10 layers of lightly callused skin. The foreskin's gliding mechanism during intercourse is lost upon circumcision.
Doctors would not support RIC if it wasn't necessary or healthy.	Doctors support RIC for the money that they make from it.
Truth: Most doctors do not support RIC and all admit it is not medically necessary; America is the only country that routinely circumcises infants. Whether these doctors do it for monetary reasons is debatable; most claim that they do it because there is a demand to circumcision for social reasons.
Infants will not remember being circumcised	Even though infants will not remember the trauma, RIC is still a violation of their rights.
Truth: Infants will not remember being circumcised, but several recent studies suggest that there is a high correlation between Post-Traumatic Stress Disorder and circumcision. Furthermore, even babies that appear to "sleep" through circumcision show elevated heart rate, blood pressure, difficulty breathing and bodily stress, indicating that the sleep-reaction may in-fact be shock, which can cause lasting effects on an infants body and mind.
No man in his right mind would ever complain about being circumcised, though many intact men chose to get cut.	It is better to have the choice that an intact man has, than to not have the choice, the way an unhappily cut man does.
Truth: Most intact men do NOT chose to get cut later; the circumcision rate among intact men is less than .5% percent in America. In other countries, it is even lower. Also, due to recent information about circumcision, there is a large movement of cut men seeking to restore their lost foreskin through non-surgical and surgical methods. There are no statistics on this underground movement, though the network contains several mailing lists each with nearly a thousand members, and a recent book about restoration sold over 20,000 copies. There are also currently several lawsuits from men who are upset at being circumcised without their consent as infants.

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Here is a website that has access to videos on circumcision:

http://www.circumcisionquotes.com/video.html

I hope this helps! 

 

Prenatal Yoga-Women Circling Women

   

Prenatal Yoga

Join Our Birth Circle!

Whole Birth Yoga uses adapted yoga poses to teach mindfulness, highlighting the importance of awareness on the breath and body. Classes teach pain management techniques and relaxation skills, and utilize meditation, visualization, and group support.

 

photograph courtesy of Magic Box Photography

Stacy Holden is a certified Whole Birth Prenatal Yoga Instructor. She is actively involved in the birth community. She has received training as a birth doula, and is an accredited La Leche League Leader.  A mother of three, Stacy loves sharing with others the challenges and joys of birth and motherhood. 

Please visit www.womencirclingwomen.com to find out all of the great community events Stacy has to offer!

Northland Birth Network

I have been an active member since fall of 2007.

Our Mission:

The NBN is an action-based, non-profit community organization of birth professionals and consumers who offer support, education, and evidence-based information about normal birth practices as defined by the Coalition for Improving Maternity Services (CIMS statement) and Lamaze Institute for Normal Birth. We serve families in Duluth, Minnesota and Superior, Wisconsin and the surrounding areas.

www.northlandbirthnetwork.org

Craniosacral Therapy-Northern Lights Wellness

Debra E McLaughlin is a Birth Doula, Educator, and Student Midwife. Northern Lights Wellness provides gentle care for all ages. Specializing in care for pregnant mothers and infants.

www.northernlightswellness.com