Do your kids have off this week?

"Why, no, they don't. Making children work is what I do for fun."

Since this week is traditionally a school holiday, I had at least three people this week ask if my kids had the week off school. To which I was happy to say that, no, I was mostly making them stick with the normal routine.

At bedtime, the kids have been listening to Tim read through the book of Matthew. He's also reading them C.S. Lewis' The Last Battle (they're almost finished). Today, we read a couple of the "Sir Cumference" books from the library.

Patrick managed to do lessons three through nine in Saxon Math 6/5 this week. Delilah did three lessons in CLE Math 204. Both of them practiced math on http://www.ixl.com/

James is completely obsessed with playing checkers and does so at every opportunity. I'm counting it as math in his homeschool log.

On Wednesday, Patrick took part in a Lego building contest at the Dewitt Library:

 He enjoyed himself, and the other three kids didn't whine too much while we waited for him.

I've been reading The Thinking Woman's Guide to a Better Birth, one of the required reading books on my BirthWorks CBE reading list. Hopefully, next week I'll be able to report that I wrote the book report about it.

Doulas: The Essential Ingredient

Enjoy DONA International's new video about birth doulas!

"Mothers remember their birth experience." - Penny Simkin

DONA International is one of many organizations that offer doula training and certification. Other good options for people who are interested in becoming a doula (or parents who want to find a doula) are:

CAPPA http://www.cappa.net/

BirthWorks http://www.birthworks.org/

Birth Arts International http://www.birtharts.com/

Personally, I have taken the DONA Birth Doula training and the BirthWorks Childbirth Educator training. I welcome questions from aspiring doulas and prospective clients about my training.

We actually did science this week!

That sounded like a better title than my recent "Homeschooling Week of ..." posts. This week, we did a lot of science. We got a Magic School Bus science kit from Barnes & Noble last week. So this week we've been working on the experiements that came with the kit, in addition to reading library books about the different body systems and watching DVDs about the human body.

Patrick, Ben, James and Delilah in front of the poster that came with our science kit. It's a kid-sized poster of the inside of the body that came with stickers to label different body parts (like the ulna and radius).

The bone from our first experiment. Patrick asked the butcher at Wegman's for some bone, which he was happy to provide. We soaked the bone in vinegar overnight and made observations about what happened. Tim made the point that now if our kids ever become serial killers, they'll know how to dispose of the bodies.

This one is our "ball and socket joint" experiment. We talked about which joints in the body are ball and socket joints and felt how they worked with our ping pong ball/construction paper model.

Another homeschooling event this week was that Patrick's new math books arrived. He's starting Saxon 6/5, which says that it's for your average sixth grader or advanced fifth grader. He did the first two lessons and decided that it's too easy. Here's hoping it gets harder and I don't have to buy something else yet.

Doula stuff has been slow this week, which is probably why we got schoolwork done every day. All I really did was update my availability on http://www.doulamatch.net/ and hang out at http://www.alldoulas.com/ (if you're a doula, you can register there too). I am "on call" right now to babysit for a doula friend when her client goes into labor and  I have ambitious plans for marketing myself in January.

Are you a doula or aspiring midwife looking to learn things?

Have you looked into Gloria Lemay's online Midwifery 101 class? http://www.glorialemay.com/blog/

The classes are Thursday nights at 10pm Eastern time. You can pay for a class at a time as  it fits into your schedule. So far, I've attended the Common Obstetric Problems class and the Prenatal Clinic Visit class. I enojoy Gloria's teaching style (and her accent).

Here are a couple of my notes from the Prenatal Clinic class:

"At beginning of the visit ask mom if she has to pee, offer her a drink. Ask moms how they would rate their own diets, what is important to them about this baby's birth, what would they like to be different or the same from their last birth?"

"A high resting pulse can indicate anemia. Give moms lists of iron rich foods."

"Doing pelvic exams doesn't give useful information about when she's going to have the baby."

I'm signed up for the class on January 6th and looking forward to it.

Homeschooling Week of 12/13 - 12/17

What a long, crazy week. Between homeschooling, me working and James being sick, this week has been more than a little bit psycho.

Patrick finished CLE 4th grade math this week, scoring 100% on the final test. He'd been dragging out getting it finished and was happy to be done. He also did a couple of pages in Math Skills 5 and Key to Fractions. Delilah continues to work on CLE Math 2. James did a couple of pages in Counting With Numbers.

The older two kids both worked on letter writing for language arts. Delilah wrote to her email buddy from the Well-Trained Mind boards and worked on revising a thank you letter to a friend. Delilah has started reading The Best Christmas Pageant Ever and thinks that it's hillarious.

Patrick did a couple of lessons in CLE Bible Elective 1 and worked on chapter 21 in Latin for Children A.

All of the kids had fun with our new science kit, "Magic School Bus Inside the Human Body."

Wednesday afternoon, all of the kids went to the homeschool PE class at the YMCA and the older two had their swim lessons on Thursday.

On Tuesday night, Tim and the kids set up our little Christmas tree and I got this card-worthy picture of Ben:

Ben

Between Wednesday and Thursday, James had three different doctor's appointments. Since September, he's had this cough that just won't go away. We saw our family doctor Wednesday night, a chiropractor Thursday morning and a naturopath ( http://www.manliusnaturalhealth.com/ )Thursday afternoon. The family doctor said that he thinks it sounds like asthma and sent us home with a nebulizer and a couple of prescriptions. The chiropractor and naturopath both suggested dietary changes and supplements to treat the asthma.

James' nebulizer

Luckily, James doesn't seem to mind using the nebulizer. I've been learning a lot this week about allergies and asthma. There are so many different recommendations of what to do for a kid with asthma that it's hard to know where to start.

Last night, I "went" to the Prenatal Clinic Visit class in Gloria Lemay's online Midwifery 101 series. That was a nice break after our busy week.

Another Service I Provide

Yesterday, on http://www.alldoulas.com/, I found a link to this great article that breaks down the process for doulas who want to help their clients try to get reimbursed by their insurance. There were doulas there on the message board who shared that they had been able to get families money from their insurance companies.

http://childbirthtoday.blogspot.com/2010/08/unraveling-3rd-party-reimbursement-for.html

I was suprised to learn that at least twenty different insurance companies have paid out some or all of the fee that families paid their doula.

Last night, I got my NPI (National Provider Indentification) number so that families who use me as their doula can try for insurance reimbursement after the birth.

Just another thing that makes my doula services awesome :)

Tomorrow, the world...

Ben, adjusting his sling

The investment that I'm making now towards the parenting of my future grandhchildren is the brainwashing, er, teaching of their parents.

Each of my children were nursed until they were preschoolers, slept with us as babies and were always being worn or carried by someone. Stronger immune system, less crying, reduced risk of SIDS and higher IQ aside, the reason that we've chosen to parent the way we have is because I want things like natural birth, breastfeeding, baby wearing and homeschooling to become the norm rather than being "alternative" choices.

When Delilah says that she doesn't know why people would want to go to the hospital to have a baby if they aren't sick or Patrick points out to me that wearing a backpack and sitting at a desk is bad for kids' backs and those school kids are going to need a chiropractor, it gives me hope that they'll be saying those same sorts of things to the person they marry. Whether Delilah chooses to have her baby at home, in a birth center, or at a hospital, she's being raised with a consumer mentality that will mean that she'll be comfortable telling a caregiver that she's not going to pay them if they can't get with the program. And hopefully one day, Patrick's children will have the option to choose where they want to do their learning.

Thinking about it makes me want to have more children. Even if my four only have 2-3 children apiece, that's ten or more granchildren, followed by generations of healthy, positive, balanced people :)

That, or my kids, in an act of rebellion, will all end up as public school teachers who take their kids to McDonald's after work. Shoot.

An afternoon of S&M

Mmmmmmmmmmmmm....

Sales and marketing is quite possibly my third favorite thing to do, after attending births and taking the kids out to eat so people can compliment their behavior.

After church today, I dragged my four well-behaved children to the library and printed out flyers for this season's Doula Connection Meet & Greet nights. We made 150 copies at OfficeMax and left one there for the pregnant lady who works in the copy center.

Between 3:00 and 5:30pm, I managed to drop flyers off at 28 businesses on Rt 11 in North Syracuse, including but not limited to Speedy Greens, Fitness and Dance of CNY, Olde Wicker Mill, Tim Horton's (where I explained to the cashier what a doula is), Dominos (who taped the flyer in their window), Panera Bread, Moe's and Sprint.

It was so much fun going to all those (28!) businesses, telling them about our group and what doulas do, even more fun than when I was a telemarketer in high school. I really can't wait to do it again... on Tuesday.

If you have any questions about our group, our doula open house nights or finding yourself a doula in Syracuse, check out http://www.cnydoulaconnection.com/

Homeschooling: Week of 11/29-12/3

For Bible this week, the kids have been listening to Tim read through the book of Matthew. Patrick also did one lesson in CLE Bible Elective 1.

In math, James did four pages in Counting With Numbers. Delilah did lessons 8-10 in CLE Math 203 and pages 92-94 in Singapore Math Practice 1A. Patrick finished CLE Math 409 and did lessons 1-4 in CLE Math 410. He also did ch. 9 & 10 in Life of Fred: Fractions. All three of them practiced math on http://www.ixl.com/

Patrick measuring the dining room for a math assignment

We had an embarassingly light week in Language Arts. Patrick did one page in Writing Skills 5. Delilah did p. 52-55 in Writing Skills 2 and picked a couple of things to do in First Language Lessons. James practiced the alphabet and made a picture with alphabet stickers to use for practice.

We all went to art class at Miss Donna's house on Monday. On Tuesday, the kids watched "Molly: An American Girl." We've been reading the Molly books for the book club at the Manlius library (which we missed this week because Ben was sick).

James at art class

We've started learning about invertebrates in science and are reading about them in the Usborne Pocket Nature guide.

Patrick did ch. 18 and 19 in Latin for Children A this week.

Patrick, Delilah, James and Ben all went to the homeschool P.E. class at the YMCA on Wednesday. Only Delilah went to swimming Thursday night. The boys didn't want to go, so I let them stay home with Tim.

In Mom-schooling this week, I read Giving Birth: A Journey Into the World of Mothers and Midwives. It was a page-turner, at least for people who are into birth. The author examined the different kinds of midwives (CNM, CPM, CM, DEM) and the different settings in which they serve families. During her research, the author got pregnant and chose to use a midwife she had met while writing the book, so we also get to hear about that relationship. One thing that stood out was her mentioning that many of the midwives she interviewed "knew" that midwifery was the path they wanted to take. Some of them felt like they had always known and for some of them there was a point where they realized that was what they wanted to pursue, but all of them knew that midwifery was calling them somehow. I also read ch. 2 of The Doula Advantage, which covers some of the research on doula care and how having a doula can contribute to a safer, more satisfying birth.

Delilah at art class



What is your birth experience worth?

After every birth I've attended, my husband has pointed out that I don't charge nearly enough. He's right. Considering the amount of time that I've put into learning about pregnancy, birth, breastfeeding and newborn care, then taking into account the number of hours that I put in with each couple I work with, I don't make very much money.

What I do is a lot more than just staying with someone while they're in labor. I meet with each couple 3-4 times before the birth of their baby. The prenatal meetings are a combination of getting to know each other and an individualized childbirth education class. The idea is that these visits help the couple feel comfortable with me (important for when you're in labor) and also cover any questions that they have about the birth process.

In terms of the birth, I have to be close to Syracuse for weeks before (and sometimes weeks after) their due date. Until their baby is born, I am "on-call," phone in my pocket. I have to be prepared to head out at any time, with babysitters on standby for my kids. There has to be gas in my car and money in my wallet. I have to be completely sober and relatively well-rested. There's a lot that goes into being ready for someone to call.

When they call me, I make arrangements for the kids, grab my bag and head off to either their house or whatever hospital they're on their way to. Then I stay with them through labor, getting the mom drinks, rubbing her back or feet, suggesting different positions, reminding both parents of things they wanted to try and helping mom's partner support her. I stay whether labor is six hours or two days and I've been to some long labors.

About a week after the birth, I make another home visit. Then we talk about the birth experience and I try to answer any questions that the parents have about the birth, basic baby care and breastfeeding. If they need referrals to anyone for breastfeeding help, postpartum support, etc, I give them people to call or books to read. And the families that I work with know that at any point, whether it's six weeks postpartum or six months, that they can call me when they have questions.

In our area, the going rate for all of this seems to be anywhere from $250-600. I don't think that's nearly enough. When you break down what a doula makes, between the prenatal visits, the birth and the postpartum visit, it's rarely more than $15/hr. Take out paying the babysitter, gas, parking at the hospital and hospital cafeteria food and that's not very much money.

You can read review after review on doulamatch.net about how awesome people's doulas were, how they got parents through when they thought they couldn't do it, guided them through rough patches like the sherpa leading you up a mountain. Yet these same professionals are making slightly more than my babysitter.

What do you think? If you had a doula, what did you pay her? What do you think doulas should be charging?

Waiting on a Woman

When I decided to pursue being a doula, I knew that it would make my life less predictable. It has certainly done that. I've had several clients who gave birth a month before they were "due" and several go well past their due dates. One (that's right, one) lady has had her baby in the week of her estimated due date.

Lately, I've been waiting on a lady who I really did not expect to go past the estimated due date. Yet here we are, with her over a week past "due" and me heading six hours away for the Thanksgiving weekend/friends' wedding. With everyone else having birthed weeks before or after when their babies were expected, I shouldn't have been suprised by this one coming later than expected.

Enter the doula networking group. This is a time when I am grateful to be part of a group of women who attend births and work with pregnant women. I called a couple of the ladies from our group and, as much as I don't like the idea of not being the one there, I can know that there will be people available for her when I'm away.

When we talk to clients and other doulas about our group, part of what we tell them is that we back each other up. This is what that means. It means that when you, the doula, have a client who you swore would have had her baby already, but is still pregnant when you have commitments out of town, there are people who will be there for her when you can't.

Hopefully, right after I've fallen asleep tonight, my phone will ring. I'll head over to be with her, the baby will be born and I'll get back home before the rest of my family wakes up. Then I can sleep in the van while Tim drives us to Baltimore. That's what I would like to have happen. If not though, the Doula Connection has us covered.

Holiday Giveaway

Hello readers!

From Saturday, November 20th to Friday, December 11th, I will be running a holiday giveaway!

One lucky winner will win a calendar from http://www.beautyofmothering.com/ and a copy of What Your Pediatrician Doesn't Know Can Hurt Your Child by Susan Markel, M.D.

You can learn more about Dr. Markel and her new book at http://www.attachmentparentingdoctor.com/attachmentparentingbook.html

There are several ways to enter:

1. Become a follower of my blog (and post that you did)

2. Find my facebook page, "Syracuse Natural Parenting Support," become a fan and post it here

3. Find my doula group's facebook page, "CNY Doula Connection," become a fan and post it here

3. Visit http://www.cnydoulaconnection.com/ and post something here that you learned about doulas or our group

4. Visit http://www.attachmentparentingdoctor.com/ and share something that Dr. Markel says about breastfeeding.

Doula Open House in Syracuse on December 9th!

The CNY Doula Connection will be hosting an information night for expectant parents on December 9th from 6-8pm at Cicero United Methodist Church. Bring your questions about pregnancy, birth and nursing! Parents will also have the opportunity to chat with different doulas and make an appointment for a free consultation with a birth or postpartum doula.

The Doula Connection boasts a well-educated group of women, including two lactation consultants, a licensed massage therapist, a midwifery student, childbirth educators and most importantly, women who have experienced birth and love nurturing families through the transition to parenthood.

Light refreshments will be served. This valuable event is free to attend.

Cicero United Methodist Church is located at 8416 Brewerton Rd, Cicero, NY 13039.

For more information, check out www.cnydoulaconnection.com or email cnydoulaconnection@gmail.com

Homeschooling Everyone

Our week was fairly productive considering that while I was away at a birth all day Monday and Tuesday, apparently my husband told the babysitters that the kids didn't have to do schoolwork. That threw our homeschool plans off a little bit because the children had an unexpected four day weekend.

Wednesday morning, I took the kids to a field trip to the Temple Society of Concord in downtown Syracuse. For Delilah's American Girl (history) book club last month, the kids had read through the "Rebecca" books. Since Rebecca is the only Jewish American Girl character, our group went to the temple to learn more about Judiasm. I also took the kids to our homeschool P.E. class at the Y Wednesday afternoon.

http://www.templeconcord.org/

We stayed home Thursday and tried to get a decent amount of schoolwork/housework done, my attempt to make up for the past three days of the kids not accomplishing much. Patrick and Delilah both worked on their CLE Math books and their Writing Skills workbooks. Delilah had fun writing short stories, mostly about Halloween.

James had speech at the school this morning. We all dropped him off and went to Wegman's to get our grocery shopping done with one less child. Patrick and Delilah both worked on their CLE Math books again when we got home. After lunch, we went to a friend's house for art class, then to the YMCA so I could work out while the kids played in the babysitting rooms.

Here's the picture that Delilah drew while we were at the Y:

She says that someone there asked if she could draw dragons. It looks to me like she can.

Aside from attending a two-day birth, I also had a meeting of the CNY Doula Connection where we talked for hours about birth, doula-ing, and everything else we could think of. We watched a DVD that one of the ladies brought with her, called "It's My Body, My Baby, My Birth," which I'll probably end up purchasing to share with people:

http://itsmybodymybabymybirth.com/Home.html

I've started reading Rediscovering Birth by Sheila Kitzinger. It's another one of the required reading books on the BirthWorks Childbirth Educator reading list. I'm hoping to get through it this weekend so I can get them my book report about it.

If you're into birth, you'll recognize these people...

The members of the BirthWorks advisory board form a pretty impressive cast. Michel Odent, paradigm-changing doctor and author of perhaps a dozen books about birth and oxytocin. Elizabeth Davis, midwife, teacher and author of Heart and Hands (a midwifery textbook. Jan Trittenden of Midwifery Today and Ina May Gaskin, to name a few.

Is it really Friday already?

Wow. I'm having trouble believing that it's really been five days since I posted about my BirthWorks certification stuff coming in the mail. This week, I wrote two of the essays that I need to do for my certification and talked with my reviewer briefly on the phone. I have one more autobiographical essay to write before I start on writing the book reports, but I have started reading Birth Reborn by Michel Odent and have been carrying it around with me for when I have a free moment.

This week was a really productive week as far as homeschooling goes. Husband Tim is still reading through the book of Exodus with the kids and he's also reading to them from C.S. Lewis' book The Last Battle at bedtime.

In math, Patrick got four lessons done in CLE Math 408 and did two pages in Math Skills 5. Delilah did three lessons in CLE Math 202 and two pages in Singapore's Math Practice 1A. James did a couple of pages in Counting With Numbers. I got a couple of books from the library about adding money, mainly for Delilah, but all of the kids have been interested in them.

Patrick and Delilah have both been working through the Writing Skills workbooks for their grades. James did two pages in Adventures in Reading. On Monday, Patrick and Delilah wrote letters to friends in Baltimore.

For history this week, we read ch. 11 in Story of the World (ancient Africa) and also a couple of library books about Africa and African stories.

Patrick also worked on Latin and Spanish this week.

Patrick, Delilah and James all had their homeschool P.E. class at the Y on Wednesday afternoon. James had his speech theapy at the school on Monday and Friday. We went to the library on Tuesday and Thursday.

Today, the kids voted against doing anything academic because it was the Friday before Halloween. They did still read with Daddy though.

Down the BirthWorks Path...

By now, everyone has heard all about the BirthWorks Childbirth Educator workshop that I attended in Syracuse October 8-10th. Last week, I paid for my Childbirth Education Certification packet. Today it arrived, along with my copy of Birth Reborn by Dr. Michel Odent.

So far, I'm happy with choosing the BirthWorks organization as a path to becoming a Childbirth Educator. I'm looking at their "Statement of Beliefs" that I need to sign and send back to the BirthWorks International office and I can't find anything that I disagree with.

The BirthWorks beliefs are as follows:

1. The knowledege about how to give birth already exists inside every woman. Women's bodies are designed to give birth.
2. The nutrition of a pregnant woman has a great impact on the health of her baby from its life as a fetus through adulthood and that breast milk provides the optimum nutrition for the newborn baby.
3. A woman will labor best wherever she feels the safest and most secure. For some that may be a hospital. For others it may mean at home or in an alternative birthing center.
4. Birth is one of the greatest challenges life has to offer and provides an opportunity for personal growth.
5. While a cesarean section may be necessary at times, the current rate is too high.
6. In most cases, VBAC (vaginal birth after cesarean) is a safer alternative to routine repeat cesarean.
8. A woman in labor deserves an environment in which her privacy, autonomy, and emotional security is protected, and her mobility is encouraged.
9. Expectant parents should have access to infomation they need about obstetrical procedures. They should participate in decisions regarding the judicious use of obstetrical medications and procedures.
10. A woman's beliefs influence her birth. Exploring beliefs heightens self-awareness, serving as a catalyst for positive change.
11. The emotions of a birthing woman have profound effects on the birth outcome. Women must be allowed to express all their birth-related feelings.
12. The practice of Human Values builds character and instills confidence in birth and life.
13. Love is the foundation upon which positive birthing begins, and that one must have love of oneself before being able to love others.

Tomorrow, I'll be mailing my signed copy off to the BirthWorks office, completing Step One in the ten tep childbirth education certification process. As I go through the process, I'll continue to post updates. My goal throughout is not just to become certified as a childbirth educator, but also to use what I'm learning to serve my doula clients here in Syracuse.

Homeschooling Report, Week of 10/22

Over on The Well Trained Mind discussion board, there is a thread where the homeschooling families link to their blogs and post a weekly report. I'm going to try to do ours' more often. So, here is our week:

Mom (Liz)

Started reading Guerilla Marketing by Jay Levinson. It's all about marketing your business without spending money. I've also been reading Unassisted Childbirth by Laura Shanley

Patrick

Did 4 pages in Math Skills 5 (Harcourt) and 2 lessons from CLE Math 4. Did 7 pages in Math Skills 5 (Harcourt) and 2 pages in Sentences to Paragraphs bk 3. Worked on chapter three in the Spanish for Children A workbook.

Delilah

Did 4 pages in Singapore Math Practice 1A and 2 lessons in CLE Math 2. Did 10 pages in Math Skills 2.

James

Did 6 pages in Counting With Numbers. Had speech therapy at the school on Monday and Friday. Worked on speech homework with Mom.

Together

Read chapter 10 in Story of the World I. Watched lesson 3 on Spanish for Children DVD. On Monday, we had an art lesson at our friend Donna's house. All three kids went to the homeschool P.E. class at the Y on Wednesday and Patrick and Delilah had swim lessons at the Y on Thursday. Thursday afternoon, we went to the American Girl book club at the library. All of the kids watched a DVD about writing to communicate. Dad has been reading through the book of Exodus with everyone at bedtime.

Homeschooling Myself

I've posted about my reading (and book buying) hobby before. Today, I'm going to talk about homeschooling.

This is the sixth year that I've homeschooled my children, who are now aged 10, 7, 5 and 3. Additionally, this fall, I've started keeping a Learning Log for myself in relation to my doula/CBE/midiwfery studies. The official name right now is the "Fall 2010 Reading Log." Originally, I was just going to keep track of what I read, but I'm also logging workshops/classes I attend and relevant DVDs I watch.

For the week of October 11-17th, I:

- Attended the BirthWorks Childbirth Educator training workshop. This was a wonderful experience, spending the weekend talking about BirthWorks philosophy and childbirth education

- Read all of Active Birth by Janet Balaskas (which I think is a valuable read for expectant parents and birth professionals alike)

- Watched "Special Women" DVD

- Read ch. 1 & 2 of Nurturing the Family: A Guide for Postpartum Doulas

What I really like about my "Learning Log" is that I can go back at the end of the week, month, season or year and see how much I've taken in. Looking back at the entries in September when I was reading Diary of a Midwife and Children at Birth brings back what I got out of those books. It's a reminder of what I've gotten out of each reading session.

I'm enjoying homeschooling myself almost as much as I enjoy homeschooling my kids. Hopefully, all the time I put in now will be an asset to me when I am finally at the point in life when midwifery school is something I can do.

Meet the Doulas!

This week, there will be two opportunities for pregnant moms and their partners to come meet the ladies of the CNY Doula Connection:

Dessert with the Doulas
Cicero United Methodist Church
8416 Brewerton Rd
Wednesday, October 13th
6:30-8pm

Donuts and Doulas
Cicero Library
8686 Knowledge Ln, Cicero
Saturday, October 16th
10-11:30am

For more information, you can email cnydoulaconnection@gmail.com or stop by at one of our events!

Only two more days!

It's almost Christmas! No, my birthday! No, actually there's just two more days to go until the BirthWorks Childbirth Educator training here in Syracuse! I'm pretty excited.

For those of you who aren't familiar with BirthWorks, they train childbirth educators and doulas. They have a good deal of information to offer, even to those who are already trained through another organization.

Eventually, I'll be certified as a BirthWorks Childbirth Educator.

The Childbirth Educator training covers:

1.BirthWorks philosphies of childbirth

2.The systems approach to wholistic health care

3.The impact of emotional learning that makes Birth Works a unique program

4.Human values as the foundation of all decision-making

5.Pelvic bodywork and postural alignment advantageous to the baby in helping to prevent a dysfunctional labor

6.The art of discovering belief systems and changing them if necessary

7.Group facilitation and communication techniques through role plays

8.Setting a supportive atmosphere for classes

9.Components of labor, privacy, pain, and vocalization

10.Comfort measures for labor and labor positions

11.Guilt, blame, and judgment issues as they pertain to birthing

12.Vaginal birth after cesarean (VBAC) and cesarean decision making

13.Multi-sensory visualization

14.Grieving and healing

15.Presentation of class topics and wise use of audiovisuals
 
For more information, you can visit http://www.birthworks.org/

"Diary of a Midwife"

I did finally finish reading Diary of a Midwife by Juliana van Olphen-Fehr. It took longer than I expected because, while the book was fairly interesting, it didn't grip me the way that Baby Catcher had. For me, it wasn't one of those books where I absolutely had to stay up all night to finish it because I couldn't put it down.

The book moved along slowly, a chronicle of how the author became a midwife and the various struggles that she had to deal with, both personally and politically. Her experiences with working in hospitals, both before she became a midwife and after, were painful to read. The level at which the hospital system dehumanized the women who had turned to it for care was disheartening, though not suprising in the least. Story after story of women's voices being ignored and their bodies not being respected illustrated why Juliana became a midwife. She realized that midwifery was the key to providing women with the care that they so badly needed.

Each birth story in her book is unique, each house, each family different. The beauty of midwifery and homebirth blossoms as the book goes on, showing the reader that there is, in fact, a different way. A better way, for women and their families.

At each turn, the system that Juliana has removed herself from, the system of medical childbirth, tries its best to stop her from providing the individualized care that is the trademark of a midwifery service. The Department of Health in her county asks her to do initial prenatal appointments for clients who will be delivering at the hospital, but refuses to allow midwifery patients to recieve care there. Doctor after doctor refuses to back up her mothers. Despite the small number of mothers who choose homebirth, what she offers is seen as a threat by "the establishment."

Even though the book moved along more slowly than other midwifery books that I've read, I would still recommend it for ladies who are interested in the birth field.

What does a doula do?

This past Sunday, at the "Yeah, Baby!" expo in Syracuse, NY, I was asked the question over and over... "What does a doula do?"

The short answer is that a birth doula is a trained labor assistant who does whatever the laboring mother or her family needs during the birth of their baby and a postpartum doula is a woman who helps the new family make the transition to parenthood or eases the entry of the next baby into the family.

Often, people will assume that they don't need a doula because their partner will be at the birth or because they have family around who can help after the baby is born. I'm thinking, perhaps, that this is because doulas are still a relatively new thing and people don't see how a doula could help them.

When I'm with a family at their birth, there is a lot that I do. I provide information, about the birth process, about the different birth options, about comfort measures and what has helped other moms. I remind them that they are a customer, a consumer, who is paying for a service from the hospital, midwife or doctor. In doing that, I hope to empower them to make informed choices and feel that the are in control. Physically, I'm there to hold their hands, rub backs and feet, tell them that they can do this and that they will make it through.

Most importantly, I'm there continuously. From the time that they call me to tell me "it's time," I stay with them. While your doctor or midwife might have other moms in labor or office hours to attend to, your doula just has you.

At the birth of Ben, our fourth baby, I had two student midwives who served as doulas for me. They walked with me, spent time with us, rubbed my back, kept getting me drinks, went to the snowball stand for me and made suggestions like using the shower for relief during transition and stayed after the birth to make sure we were settled in. Even though Ben was my fourth baby, my fourth natural birth and I was having him at home, their support made my birth experience better.


If anyone didn't "need" a doula, it was me. I had this birth thing under control. I was a seasoned pro. Having them there made the atmosphere more relaxed and peaceful. His birth really was an enjoyable time for me. Having a doula at your birth can enhance your the birth experience for you.


DONA International shares about studies on doulas and birth: http://www.dona.org/mothers/why_use_a_doula.php

So if you're in Syracuse, NY or the surrounding areas and are looking for a doula to attend your birth, feel free to email me at naturalparentingsupport@hotmail.com to set up a free consultation.

In all my free time...

When I'm not at doula network meetings, meeting with clients, attending births, getting ready for the "Yeah, Baby!" expo or wasting time at mothering.com, I'm probably reading. I've always loved reading. It's less strenuous than housecleaning and less boring than sleeping.

The books on the shelf in the picture are my small collection of books about doula-ing, midwifery, pregnancy, childbirth and breastfeeding. On the shelves pictured: I've got:

The Doula Book
The Doula Advantage
The Birth Partner
Special Women
Nurturing the Family: The Guide for Postpartum Doulas
MotherTouch DVD
Gentle Birth Choices DVD
Healthy Birth Your Way DVD
Giving Birth DVD
The Complete Book of Pregnancy and Childbirth
Pregnancy, Childbirth and the Newborn
Midwifery & Childbirth in America
Paths to Becoming a Midwife
Spiritual Midwifery
Sisters on a Journey: Portraits of American Midwives
Baby Catcher
Giving Birth by Catherine Taylor
Vaginal Politics: A Midwife's Story
Diary of a Midwife by Juliana van Olphen-Fehr
Heart & Hands: A Midwife's Guide to Pregnancy and Birth by Elizabeth Davis
Birthsong Midwifery Workbook
Active Birth by Janet Balaskas
Mother's Intention: How Belief Shapes Birth
Childbirth Without Fear by Grantley Dick-Read
Husband-Coached Childbirth by Robert Bradley
Natural Childbirth the Bradley Way
Gentle Birth Choices by Barbara Harper
Immaculate Decpetion II by Suzanne Arms
Birthing From Within
The Baby Book by Sears
The Breastfeeding Book by Sears
The Ultimate Breastfeeding Book of Answers
Nursing Mother, Working Mother
Mothering Multiples
Old issues of Midwifery Today
Binder from DONA training
 
And that's not even counting the ones that I have out from the ICAN library and the public library, and my own books that are in other parts of my house that didn't make it into the picture. This October will make it ten years and eight months that I've been reading voraciously about pregnancy, birth, breastfeeding, nutrition, positive discipline and homeschooling. Ever since I found out I was pregnant with my oldest, I've made a study of childbearing and rearing.
 
My first doula client (who ended up being the third birth I attended) was someone I met when I was reading The Doula Book on the elliptical machine at the YMCA. She asked me if I was a doula, I told her that I was working on my DONA certification and I ended up getting to attend her birth. The important lesson I learned that day was "Take the Doula Books to Public Places." Now, whenever I get a new one, I read it at the Y.
 
The benefit to my clients, I believe, is that when they hire me, they're hiring someone who's probably read the answer to their question somewhere and even has that book to lend them. I have a working library both in my head and on my shelf.
 
Today, I added to my collection when a member of the Syracuse Attachment Parenting yahoo group listed a bunch of books for sale. She had been considering a career in midwifery and I guess it just didn't work out that way. I hope she'll know that her books are going to be well-loved and read over and over again.
 
One of the books I got today was Diary of a Midwife by Juliana van Olphen-Fehr. I'm planning to start reading it sometime tonight, so look for a review here in the next couple of days.

Getting Baby Into Position

While my 9 year old and 7 year old were in their swim lessons at the YMCA today, I was sitting on the bleachers reading a copy Optimal Foetal Positioning that I have out on loan from the Syracuse ICAN chapter. A lot of it was things that I'd heard before, having taken the Bradley childbirth classes when I was pregnant with my second.

One thing I hadn't remembered though, was that the cervix actually needs to open wider than 10cm to properly accomodate a posterior baby. With an anterior baby (facing mom's spine) the presenting part of the baby's head is 9.5cm and with a posterior baby (facing mom's front), the presenting part of the head that needs to get through the cervix is 11.5cm. Now, a cervix can and will stretch much more than the 10cm that we hear about in the childbirth classes, but it sounds to me like this may be one of the reasons that pushing out a posterior baby can take more time.

Additionally, moms who go into labor with a posterior baby often report having increased back pain, known as "back labor." This can be a challenge to cope with.

Optimal Foetal Positioning talks a lot about posture and the fact that how we go about our daily routines, things like the way we sit and the kinds of furniture we use, can affect the positions of the babies we carry.

The following video clip talks about what moms can do during pregnancy (before labor begins) to encourage their baby into an anterior postition:




During pregnancy, I'd also recommend that moms see a chiropractor who is trained in and experienced with the Webster technique. The ICPA has this to say:  "The Webster Technique is a specific chiropractic analysis and adjustment that reduces interference to the nerve system and balances maternal pelvic muscles and ligaments. This in turn reduces torsion in the uterus, a cause of intra-uterine constraint of the baby and allows for optimal fetal positioning in preparation for birth."

If you are in labor and find that your baby is posterior, there are things you can do to encourage him or her to get into a better postion:

• Walk up and down stairs, sideways if possible
• Try an Abdominal Lift during contractions
• Do chair lunges (with a partner for support)
• Lean forward over a birth ball
• Sit on the toilet with one foot raised on a stool

One reason to have a doula, both during the actual labor and talking to your doula in the weeks leading up to birth, is that a well-educated doula will have this information. She can offer you information on getting your baby into the best position for birth before you actually go into labor and she can help you work with your body while you're in labor so that you're using the most effective positions to help your baby descend through the birth canal.

If you're in Syracuse, New York or nearby and have questions about how a doula can help you, feel free to email me at naturalparentingsupport@hotmail.com

How do you do it?

In past blog posts, I've mentioned that I have four children who I homeschool. That would be on top of working 15-40 hours a week (depending on the week). Usually when people ask me how I do it, I give the obvious answer, "not sleeping." The truth is that it actually takes more coordination and organization than that, but I'm trying to avoid talking about the amount of work that I put into my life.

This week, my work schedule looked like this:

Monday 12-2pm: Prepare for panel tomorrow; email donors about "Yeah, Baby!"
Tuesday 6-9pm @ Birth Plan Panel at Dewitt Community Library
Wednesday 8:30-11:30am CNY Breastfeeding Connection meeting, 6:30pm-12 CNY Doula Connection mtg
Thursday 9-9:30am Work emails, 10:30-11:45am Mtg w/new client
Friday 12:30-1:30pm Picked up donation. 2:30-3pm Online work (emails, website, etc).

My kids' scheduled activities looked like this:

Monday 9:30am 5yo speech therapy @ school, 11am 5yo Doctor's Appt.
Wednesday 9:30am 5yo speech therapy @ school, 2pm Homeschool PE class at YMCA for 9yo, 7yo and 5yo
Thursday 1pm Homeschool Group Activity, 5pm swim lessons for 9yo and 7yo
Friday 9:30am 5yo speech therapy @ school

In between all of those things, I've done all of the homeschooling with them, the math, language arts, history, science, Bible, Spanish... I also have to do the normal everyday mom things, like, dress kids, brush kids' teeth, give vitamins, read to kids, try to get 3 yo to use potty, bug kids to clean up toys, get short kid a cup from the cabinet, get the little kids the PlayDoh...

All of this works out because of 1) a patient, accomodating husband, 2) a long list of babysitters and 3) extremely flexible, well-behaved children. It's far from easy and coordinating having children with a job that has non-traditional hours has taken time. I'm still figuring out what works for us and what activities are really worth doing.

Months ago, a friend from Baltimore asked me on the phone if I had subscribed to Working Mother magazine yet and I said that I wasn't "that" mom. I didn't think of myself as a working mom. I was still looking at myself as a stay at home mom who had a part-time job. Over the past couple months, I've started to realize that that's no longer the case. I am a working mom who homeschools her children. While my husband does most of the childcare because of of weird schedule, we do also have childcare help.

Being a doula and a homeschooling mom is tough, and I'm not giving up either role.

Come on out tonight!

Tonight at seven o'clock, I will be on a birth planning panel discussion at the Dewitt Community Library, located in Shoppingtown Mall. You do need to call the library to register if you're interested in attending.

The Eagle Bulletin has this to say:

"Hospitals now compete to see who can provide the most user-friendly birth suites, some with whirlpool baths, wallpaper and interior decorating. Fathers and families are now an integral part of the birthing process, complete with video cameras.

Having a birth plan has been seen as a helpful way for the mother to stay in touch with her needs from labor and delivery to bringing her child home. It’s also a way to coordinate family and medical service providers on delivery day.

One local service provider, Elizabeth Baer, is a DONA-trained birth doula who attends births in Syracuse and the surrounding area. Owner of Natural Parenting Support Services, Cicero, and a founding member of the CNY Doula Connection, cnydoulaconnectin.com, she has four children and has studied pregnancy, birth and breastfeeding extensively.

Baer will be part of a special Planning Your Birth Plan panel discussion on from 7 to 8 p.m. Tuesday Sept. 14 at the DeWitt Community Library, ShoppingTown Mall, Entrance No. 3 in DeWitt. Free and open to the public, the discussion will be followed by an opportunity for questions. Light refreshment and door prizes will be provided by dessertherapyl.com."
 
http://cnylink.com/news/view_news.php?news_id=1284138935

Seven years ago...

Delilah

August 31, 2003. Delilah Rose Baer, our second child, was born at the Baltimore Birth Center.

The night before, at two days past the "due date," I was feeling impatient. I know I'm not supposed to put any stock in dates, but my first was born at 39 weeks, and I really thought she would be out by then. Tim and I went out to dinner at the One World Cafe in Baltimore. When we got home, we did the thing that makes babies (me thinking it sometimes helps get labor going), then Tim and Patrick went to bed and I stayed up reading on the MotheringDotCommune message boards.

I tried some accupressure points that were supposed to cause contractions, hoping it would do something. Around midnight, I started having contractions, which settled into a regular pattern of every four to six minutes. I walked around our apartment, posted on MDC about how I thought I might be in labor, laid down to see if the contractions would keep going if I rested (they did). A few hours into it, I woke Tim up and told him we should go to the birth center.

At the birth center, the midwife on call checked and told me that I was only about 4cm. We stayed at the birth center for about an hour and she said that I should go home and call them back when things picked up. I was not happy about that plan, but we headed home, stopping at Dunkin Donuts on the way home for the guys to get breakfast. Sitting in the car having contractions was not a fun thing to do. Pretty much as soon as we got home, the contractions started getting more intense and closer together. About an hour later, we got back in the car and headed to the birth center.

My mom met us at the birth center so that she could take Patrick (then almost three years old) back to her house for the day. I distinctly remember her needing to use the bathroom at the birth center and me telling her that no, she needed to just take him now. (She did get to use the bathroom). My friend Alexis, who was about five months pregnant with her first, joined us there around the same time.

Evelyn was now the midwife on call and she had a student midwife there with her. We hung out for a little bit, then I got into the tub, hoping it would help me deal with the contractions. It helped so much that I decided not to get out. I hadn't been planning on a waterbirth, but the tub ended up being the place where I was the most comfortable and was the place where Delilah was born.

She was born on a Sunday morning, before the service at Horizon, the church we were attending, would have started. Tim asked if he could go to church and tell everyone, since I had Alexis with me. We told him no, that he was going to have to skip church. He did get to go pick up pizza for us, which was just the right thing after having a baby.

That baby is seven years old today. She is the big sister to two little brothers (James and Benjamin). She is starting second grade as a homeschooled student this year. Not suprisingly, she has developed my love for pregnancy, birth and babies. She likes the "baby shows" on TLC and Discovery Health, plays "having a baby" with friends, and says she wants to be a doula or a midwife when she grows up.

I'm grateful to the people who ran the now-closed birth center, who gave me the birth experience I needed. To the poor student midwife, who I kicked out of the room when I didn't want people in there, I'm kind of sorry. If you had found something to do other than just stand in the corner and watch, I might have let you stay. To my mom, thanks for taking Patrick and for putting up with me when I was being unreasonable. To Tim, who agreed to have another baby and to let me choose the birth I wanted. To Alexis, who was there with us. Thanks, everybody.

BirthWorks Discounts!

BirthWorks has sent me a list of discounts that they're offering to people who want to attend the Childbirth Educator training in Syracuse October 8-10th:

Join Now and Receive Discounts!*

BirthWorks Doula & Educator Workshops:

$45 off within three months
$35 off within two months
$15 off within one month

And/Or

Bring a friend and each receive $20 off workshop fee

Dual Doula Certification Discount

Receive 20% off certification fee if currently certified by another national doula certification program.

Must send proof of certification.

BirthWorks Modified Childbirth Educator Certification

Receive 15% discount if currently certified by another national childbirth education certification program.

Must send proof of current certification.

BirthWorks Dual Program Discount

If you are currently in a BirthWorks certification program (childbirth educator/doula) and joining a second BirthWorks program, receive $50 off your certification fee.

*Contact the BirthWorks office 1-888-TO BIRTH(862-4784) to receive discounts. All discounted fees are nonrefundable.

Answering the Call

Eight o'clock Thursday morning, my phone rang. A lady, who had emailed me days prior looking for a doula, was in labor. We hadn't met. I had things to do. I wasn't "on-call," as I didn't have any clients who were due soon, but there was a need.

We talked a little on the phone and I realized that if I didn't go, it was entirely possible that she would be having this baby alone. In a hospital, yes, but without someone who was there to support her. So I chose to literally... answer the call.

I got people to watch my children, called my husband to let him know I was leaving, stopped to put gas in the van and drove the hour from Syracuse to Watertown, to the hospital to sit with her. And sit I did. I stayed from 10am Thursday morning until 4am Friday morning. Thankfully, her husband was able to come Thursday evening, and the two of us supported her through the birth of their baby. Driving home Friday morning, I thought about how I felt called to support women and their families during this life-changing experience.

What I did was something that doulas all over the world do every day. Someone calls, needing support, and they go.

Penny Simkin, who may well be considered the mother of the doula profession, teaches her doulas that how a woman feels during her labor, how she's supported is something that she never forgets. Details of the memory may change over time, but the feelings stay the same. What I do, and what doulas the world over do, is try to protect that memory, to help women and their partners feel nurtured, supported, empowered and loved.

I'm grateful for other doulas. The ones who started years ago when the idea of labor support was unheard of. The ones who are practicing today. Who serve families who can afford to pay and those who can't. Who can make teen moms feel like they're being taken seriously. Who hold the hands of moms who are in the hospital alone. Who serve dads by getting them a drink and suggesting ways to help their partner. Who show hospitals and OBs that quietly supporting laboring women makes a difference in birth outcomes. Who "answer the call."

We Always Knew Women Were Amazing

This video, from the Mother's Advocate website, shows us ancient images of women giving birth. Throughout history, women have given birth with the assistance of other women. Only recently has birth taken place in hospitals, with male doctors. It is my belief that in most instances, the best place for a woman to give birth is at home or in a freestanding birth center, with midwives and doulas in attendance.

Good Things Are Happening!

Things are really picking up with the CNY Doula Connection group! We had a good planning meeting this past Wednesday; we managed to work on our brochure and plan several fall events. We're definitely going to be at the "Yeah Baby!" Expo at the Holiday Inn in Liverpool on September 26th, so come see us there. After the event, we've scheduled two outreach events for potential clients to hang out with us and meet our members.

A new doula who just moved to the area was at the meeting. She needs two more births so she can send in her DONA certification and is interested in helping teen moms. If you know a mom in Syracuse who could use some extra support for her birth, let me know and I'll get you her info.

Our next business meeting is Wednesday, August 25th. It is open to any local, independant doulas (not affiliated with a doula agency) who may be interested in joining our network. If you are a doula who is interested in attending, you can email cnydoulaconnection@gmail.com

Today, Doula Chris Herrera and I are heading up to Watertown to have lunch with a group of pregnant mamas. They'll be able to ask us their pregnancy and birth questions and learn about what the Doula Connection has to offer. Hopefully, some of them will be interested in our services.

The other exciting thing is that in just under eight weeks, BirthWorks Childbirth Educator training is coming to Syracuse. You can learn more about becoming a BirthWorks educator and how to sign up for the workshop by visiting http://www.birthworks.org/ I'll be attending, along with other local Birth Professionals.

All sorts of ways to find me...

This afternoon I got a call from a lady who found my contact info at http://www.greenpeople.org/ Their site is an online directory of eco-friendly products and services. I have a listing there because as a doula, I promote and support people who are interested in natural birthing and parenting.

In the past 30 days, at http://www.doulamatch.net/ my name has appeared in search results 52 times. My profile there has been viewed 12 times and 4 people have clicked on the link for my website.

www.mothering.com/discussions is the web's largest parenting discussion board. My business listing in their WAHMarket forum has been viewed 1,499 times.

At http://www.drmoz.com/NYdoulasinnewyork.html I have one of the big listings.

On facebook, you can find me by searching for Syracuse Natural Parenting Support. At the present, my page has 62 "likers."

All of these are ways that I make my presence known online. Most of them are free.

I've also bought ad space in the Holistic Resource Guide and Family Times. Buying ad space isn't something that I do regularly, but recently I've been offered good deals to do so.

As a transplant to the Syracuse area, a concern I had was how people would find me. I almost joined up with the local doula agency because of this concern. After I met with the owner of the agency, I knew that I didn't want to work under someone else. If I had chose to work with the agency, clients wouldn't be able to call me first; they would have to call the agency and talk to the owner/other doula, who would most likely end up with their business. I wanted people to be able to contact me directly.

To avoid having to work for someone else (and pay them a big chunk of what I make), I've put a lot of effort into marketing. If there's somewhere online that I can place an ad, I do it. Everyone I run into ends up hearing about the work I do and if they know someone who's pregnant, I put a business card in their hand. Two of my recent clients were ladies that I met at the YMCA.

If you're a doula whose business needs a pick-me-up, make sure that you're utilizing every available free advertising resource. Tell everyone you know that you "still have room for clients in the fall." Make friends with local childbirth instructors, yoga teachers, LLL leaders, etc. And most of all, don't be shy about telling people why you love what you do.

Sweet Little Repeats!

The organizers of the Sweet Little Repeats consignment sale are being kind enough to allow me to have an information table at their sale at the East Area YMCA at the end of this month.

Please come out to see me, hang out, shop the sale.

If you have things to get rid of and want to be a consigner, you can sign up at http://www.sweetlittlerepeats.com/

The sale is August 27-29th.

BirthWorks

For the next step in my education, I'm tossing around the idea of becoming certifed as a childbirth educator through an organization called BirthWorks. I'm definitely going to take their training workshop, as I think they offer a lot of information that I could use with clients.

Need a Little Mothering?

Who doesn't love Mothering? The support for natural family living, the huge online discussion board, the lack of infant formula advertising, the pictures of natural births... I could go on and on. I've been reading Mothering magazine since the summer of 2002 and I'm still a fan.

http://www.mothering.com/

Mothering covers a range of topics, such as:

• homeschooling
• healthy eating
• home birth
• natural hospital birth
• doulas
• vaccinations
• gender issues
• the latest natural living news
• VBAC

So, I am having a contest and giving away a one-year subscription to Mothering magazine.

The most obvious way to enter:

- Post "I need Mothering!" with your email address (broken up, if you like)

More ways to get entries:

- Become a follower of my blog and add another comment on this post

- Post about the contest on your blog

- Like my facebook business page, Syracuse Natural Parenting Support and leave a post here saying that you did

- Like my doula group's facebook page, the CNY Doula Connection, and leave a post here saying that you did it

The lucky winner will be announced August 31. 2010.

We Need a New "Due" Something-or-Other

After watching yet another episode of "A Baby Story" tonight where a couple decided to induce labor because the mom was 41 weeks along, I'm thinking we need a new way to express when a baby is due. Like an "arrival month" or a "possible week or birth." I know, those aren't good enough, but there's got to be something. Something that clearly communicates that we have no idea what day this baby's supposed to be born, but we're guessing it's probably in July.

The words the parents on the show tonight were powerful and really communicated that they felt like their baby had failed to arrive on time. "My due date was a week ago." "She's 8 days past her due date now." The beginning of the show was them keeping track of how late the baby was.

As the episode went on, they were at the hospital for the induction, she "failed to progress," the doctor told her that either the baby was too big or her pelvis was too small (not that the induction wasn't working) and proceeded to do a C-section that resulted in the birth of a 6 pound, 9 ounce baby (not too big, I'd think). It got me that the doctor assumed that there was either something wrong with the baby or the woman, not the way they were going about things. Nobody said, "Hey! Maybe you just weren't ready to have the baby and that's why you're not progressing!"

The show tonight illustrated how we need to move away from the idea that there is an actual day by which the baby is due. Healthcare providers who work with these moms need to step back and let the pregnancy be, as long as everything is going well with mom and baby.

Whether you're 38 weeks or 42, when your body goes into labor on its own is generally the time that your baby is ready to be born. I personally had three babies at 39 weeks and one at 40+3. I've attended births where the moms were 42+5 weeks and 41+1 weeks. Babies finish gestating on their own schedule.

My question is: What should be call the new "due" thing? What is a good way to tell people about when the baby will arrive without planting the idea of a date in the heads of parents and providers?

More than One? Oh my God!!!

Ok, so maybe they're not saying it out loud, but from the way some people react when you tell them that you're having more than one baby, you would think that you were about to explode. Although twin births in the US are now up to 3 in 100, many medical providers are still treating moms of twins like they could not possibly have a healthy pregnancy or a natural birth.

I am lucky enough to have a doula client right now who is pregnant with twins. In order to better serve them, I've been doing lots of research on twin pregnancy, natural birth with multiples and breastfeeding twins. It turns out that when parents educate themselves and use caregivers who support their choices, it iscompletely possible for them to experience healthy pregnancies with natural births and to breastfeed successfully.

The catch here is that, unfortunately, parents will likely not achieve the results they desire by simply leaving their care in the hands of doctors and hospital policies. Many OBs are more comfortable with delivering twins by Cesarean and will encourage parents to consider surgical birth. Some hospitals require that twins be born in the operating room, even if mom is planning on delivering vaginally, so that a Cesarean can be performed quickly. There are doctors who try to require mothers to have an epidural placed so that they are ready to do surgery if they decide to. The C-section rate for twin births with obstetricians is roughly 50%. Bottom line: If you are having your babies in a hospital with an OB, they are most likely planning to perform a Cesarean.

It is up to you to educate yourself about your choices for your birth, write a birth plan, talk with your partner about what you want,and hire a doula who will help advocate for you. Some parents who want a natural birth decide to use the services of a doula and give birth in the hospital, while some decide to have their baby at home with the help of a midwife.

Pregnancy Today's article, "A Guide to Vaginal Twin Birth," has this to offer:

"•Choose a doctor who is committed to natural childbirth and comfortable doing breech deliveries.


•Maintain an excellent nutritional intake, including a liter of water a day, which will contribute to the health of the twins and help to avoid complications.

•Have a midwife, doula or other supportive birth professional in attendance at the delivery.

•Stay upright and mobile during labor as much as possible and make sure that the hospital supports this option. You should be able to eat, drink and walk while in labor.

•Be informed about possible medical interventions. Read, research and ask questions before and throughout your pregnancy.

•Show up for the delivery armed with a birth plan and discuss it with your doctor/midwife in advance.

•Believe in your own power to give birth to two babies naturally and without surgical intervention. If you can visualize something, it is more likely to happen that way."
 
Some good resources that I've found for couples who are expecting twins are:

Spirital Midwifery by Ina May Gaskin- has a short but incredibly valuable section on multiple births.

Mothering Multiples: Breastfeeding and Caring for Twins (or more)

Mothering Magazine's Discussion Board

International Cesarean Awareness Network

And finally, a lovely twin birth video, the way every family should get to experience it:

Tattoo Marketing

"I love your tattoo! Did you get it when you were pregnant?"

"Actually, I got it because I'm a doula."

"A what?"

"A doula. I help moms when they're having a baby, during labor. Pretty much whatever they want me to do, like rubbing their feet or making a sandwich."

"That's cool. What a great job."

The tat in question is new. I got it the last week of June, when Melissa kicked Tim and I out the house and watched the kids for us. I showed the tattoo guy the picture from my doula facebook page and told him that I wanted it to be an outline, like my nursing mom tat. I'd been wanting to get it done for a while, and after I had it I felt like I had finally gotten something that had been missing.

What I didn't think of is the tattoo being a conversation starter, since I'm generally pretty covered and it's on my back. But yesterday, I was at the kiddie pool at the East Y with James and Ben while Patrick and Delilah were having their swim lesson, so I had on a tank top and a shorter skirt. Since the lady saw my tattoo and liked it, I got to talk about my doula work.

Lesson: I need more tank tops.

Doula Networking Fun!

The next meeting of the CNY Doula Connection, the new doula networking group in Central New York, is coming up on July 14th. Our business meeting will be from 6:30-8pm, with plenty of time afterwards for socializing. We are meeting at the Barnes & Noble cafe at the Barnes & Noble in Clay, NY on Rt 31.

I can't say enough good things about the group. We are a doula networking group, with a yearly membership fee. We don't take a percentage of what you make or charge you per birth. Your income is your business, not ours'. We have monthly meetings for networking, socializing and planning our marketing. We do marketing events as a group and are starting to make a presence for ourselves in the community.

If you're a doula who wants to know more about our group, you can email cnydoulaconnection@gmail.com Membership is open to independant doulas who attend births in Central New York.

Induction Musings: The Bishop Score

Is your doctor recommending inducing labor? Have they told you what your Bishop Score is? No, you say? I didn't think so. A Bishop Score is a tool that can be used to give an idea of how sucessful an induction will be in terms of it resulting in a vaginally born baby. Generally, when I ask parents if their OB has told them their Bishop Score before induction, they will look confused and say no.

I believe that doctors don't share this information for two reasons. One: a less informed patient is a more compliant patient. The less you know, the less you argue with the experts. Two: at the end of the day, it doesn't matter to them if the baby comes out vaginally or surgically. They still get paid.

Here's what you need to know: The Bishop Score is a group of measurements that can be used to determine if an induction would be sucessful or if it would be better to wait or to try cervical ripening methods before doing things like breaking your water or using pitocin.

The Bishops Score generally follows this scale:
Score   Dilatation      Effacement       Station        Position       Consistency
0          closed              0 – 30%             -  3            posterior               firm
1          1-2 cm              40 -50%              -2             mid-position    moderately firm
2          3-4 cm               60 -70%            -1,0            anterior                soft
3           5+ cm               80+%                 +1,+2

A point is added to the score for each of the following:
Preeclampsia
Each prior vaginal delivery

A point is subtracted from the score for:
Postdates pregnancy
Nulliparity
Premature or prolonged rupture of membranes

cesarean rates: first time mothers ---  women with past vaginal deliveries

scores of 0 – 3:   45%                                     7.7%
scores of 4 - 6:    10%                                     3.9%
scores of 7 - 10: 1.4%                                      .9%

In other words, the closer to 10 your score is, the more likely it is that your induction will end with a vaginal birth. The lower the score, the more your risk for a surgical birth increases.
 
If your doctor is talking induction, ask them "What is my Bishop score? What are the benefits of inducing now? What are the risks of waiting? What if I want to wait?"
 
Bishop score stats taken from http://www.amazingpregnancy.com/

Induction Musings Part 2- How 'bout we Don't?

Reasons to Not Induce Labor... or... Please Just Let the Baby Be

Before I get to the reasons to induce labor, I have to touch on some reasons that people induce labor, when really, it would be better to just keep gestating.

Please, for the love of God, ignore your OB advising you to induce labor because:

1. You're 39 weeks pregnant, so why not?
2. You're 40 weeks pregnant, so why not?
3. You're 41 weeks pregnant, so we have to.
4. You're 42 weeks pregnant, so we have to.
5. The baby will be TOO BIG, and never come out.
6. Your doctor is the one on call that day.
7. You're tired of being pregnant.

Let's address each of those:

1. Being 39 weeks doesn't mean your baby is ready to come out. The last couple weeks in utero baby works on the sucking reflex, so more time in means better breastfeeding.
2. Congratulations! You're 40 weeks. A good marker to make it to, gestationally speaking, but not a reason to evict the baby. See my last post for more about how we got the "40 weeks" number.
3. 41 weeks. This is frustrating, but normal. Since doula training, I've read over and over again that the average first pregnancy is 41 weeks. That would mean that most first babies need that "extra" time.
4. 42 weeks. Goodness, at this point, your OB is threatening to come to your house and hook up the pitocin, the birth center says they won't take you and all of your relatives are calling. It's annoying, but it seems your baby is just not ready to come out.
5. The first two births I went to featured 9lb and 9.5lb babies. The baby WILL come out. And really, there's no way for your doctor to determine if the baby will fit until you're actually pushing the baby out (unless you have a misshapen pelvis).
6. Ah, the "I want my doctor to be there." First of all, inducing labor the day your doctor is on call doesn't mean they'll be present because the labor could take longer than their shift. Secondly, they really only show up when you start pushing anyway, at which point the kindly nurses, your partner and your doula have done all the real work of helping you through labor.
7. At the end of pregnancy, aren't we all. Even I tried most of the "natural" ways of starting labor. The good news is that if you go out to dinner, go to a movie, clean your house, etc, eventually whatever you're doing will be interrupted by you going into labor on your own.

Waiting for your baby to decide that it's time to come can be extremely hard, especially if you do have a doctor who is offering induction, but you have to weigh the risks of induction against the benefits of having your baby a day or a week before you would have anyway.

Induction Musings Part 1- The "Due Date"

Lately, I've been reading a lot about the medical induction of labor. Reading about when and why parents should consider induction and about when it's best to wait and "let the baby decide."

Generally, what happens is that somewhere between 37 and 42 weeks, the baby will send out a hormone that tells your body that it's time to let the baby come out. Your cervix will start to soften and thin out in preparation for beginning to dilate. Uterine contractions will kick in and the the baby will move lower in the pelvis as the cervix opens up to allow the baby through the birth canal. In a normal, healthy mother (and a great number of unhealthy ones) this process will start when the baby and the woman's body are both ready for birth.

In 1830, a doctor named Franz Naegele invented the way that due dates are calculated. Doctors, who love numbers and being able to measure things, still use his formula today. The issue here is that the "due date" gives us a rough estimate of when a baby might decide to make his or her apearance. There are several factors that will affect how accurate a due date is, such as the length of that woman's menstrual cycle and how long the individual baby needs to mature.

Now, since doctors like measurements so very much, what tends to happen is that an OB will look at a "due date" as the actual date by which the baby needs to have arrived. If the baby continues inside the womb past the date that they've decided on, doctors will start to get nervous and begin talking to expectant parents about "inducing labor." Some doctors even want to talk induction before the "due date," because once a baby is considered full-term, they are more comfortable getting the baby out of the uterus (an environment that they can't control) and into the hospital where they can assess, measure, and test.

One thing that obstetricians in our area seem to do as a rule is to begin doing ultrasounds and non-stress tests once a mother hits 40 weeks. What they then do is tell parents that they have to come in to the office anywhere from every 2-4 days for more testing to make sure that everything's ok, creating the atmosphere for convincing parents that continuing a pregnancy at this length of gestation is risky and something that needs to be closely monitored. What seems to be the norm at these appointments is that the doctor will work on talking the parents into a medical induction.

Doctors will say things like:

"So, when do we want to schedule the induction?"

"If you go home now, I can't be held responsible for what happens."

"You'll be begging me to get that baby out of you be 39 weeks."

"I let you go this long." (OB to a mom who was 41 weeks)

"Because your cervix is lousy."

Quotes taken from My OB Said What?

To sum it up, the "due date" is a good predictor of what month you may end up having your baby, since it falls in the middle of the four week time span when most babies tend to make their appearance. Being 40 weeks, 41 weeks or 42 weeks along is not a medical reason for induction. It just means that your pregnancy isn't over and your baby is still maturing. If you choose an OB (and even some midwives do it) as your care provider and you go past 40 weeks, you need to be prepared to deal with pressure to induce labor.

In the coming posts, I'll be writing more about real reasons for induction, the Bishop score, natural ways of encouraging labor and handling when you are the one who is "post-dates."