Saturday, July 18, 2009

Hi Everyone! This blog is going to be converted to my new blog The Rosie Layne. So, there will be no more actual posts on here. Go over there to follow the new information, interviews, tips and ideas about pregnancy, childbirth, parenting, and random other subjects. A few things that I have lined up:

Interviews with doulas, chiropractors, midwives, VBACs, and parents
Cloth diaper reviews and giveaways
Jewelry reviews and giveaways
Recipes that are easy on the budget and delicious, too
Adoption and Fostering Stories
and lots else

This is really going to be fun!!!

Thursday, June 25, 2009

The Birth Survey

I think we all know that the intervention rate in the US for hospital births is through the roof. My OB with my first pregnancy told me why. My translation of what he said: "First we are typically recommended to administer an IV bag of fluids- it is just hospital protocol. That dilutes the oxytocin in the body, which is controlling the contractions. The contractions slow, become ineffective, or cease completely. Then you are labeled 'failure to progress.' As active managers of labor, we as OBs are required to do something to actively manage and we administer pitocin. The pitocin makes the contractions unbearable, and an epidural is called for. The epidural numbs everything and can slow, stop, or make the contractions ineffective. You are again labeled 'failure to progress' and the pitocin is upped. The baby doesn't always handle the combo of the pitocin and epidural well, and an emergent c-section is performed. It's not a domino effect, it's a bundled effect. An IV and bag of fluid increases the likelihood that you will have a c-section." I asked him what we could do to change this and he said that he didn't know.

We now know how to make these changes. It's called The Birth Survey. The Coalition for Improving Maternity Services has spent years developing a way to create transparency among facilities and providers of maternity care. As of now, in the state of SC, you can call any doctors office or hospital and ask for their c-section and intervention rates and you will be told that that information is a) something that they do not retain, b) something that they do not give out, or c) is too controversial and will not be released. As a consumer of goods and services I have the right to know what those providers' and facilities' intervention rates are because research shows that 'place of birth and provider are the most important variable in predicting patient outcome and morbidity.'

Yes, morbidity. Women are still dying in childbirth in the US. Our c-section rates are over 3 times higher that the World Health Organization's recommendations of 10%, yet our mothers and babies are dying. We have the worst infant mortality rate in the developed nations. One would assume that with greater technology and higher intervention rates, the ratio of death and negative outcomes should be inversely proportionate to the interventions used. So, if the interventions go up, the negative outcomes decline. But it's not. What we are seeing is that as the interventions increase, the negative outcomes either stay the same or increase.

Transparency is an issue whose time has come. 25% of all hospital discharges are maternity related, so it is obvious that this transparency must include maternity care. And just like the Hawthorne Effect shows us in industrial engineering- people who are watched while doing their work do a much better job (you can see it everywhere- at your home, at work, as a laboring woman, as a doctor)- Transparency translates to better care.

The Birth Survey is a comprehensive questionnaire about your prenatal care and birth experience. It is a chance to sing the praises of your healthcare practioners and facilities, or share unpleasant experiences. Then, women who are searching for high quality care can look up each hospital and each individual doctor and practice and make an informed decision based on other women's experiences. I would personally not choose a doctor who had a 60% c-section rate, or a hospital that required an IV 100% of the time. And this is where YOU come in.

If you have had a baby in the last 3 years in the United States and have access to an internet connection, you can help make changes in the maternity care system. All you need is about 30 minutes to fill the survey out. Go to The Birth Survey and click on "Share"... We can change the way maternity care is done in the US, but it will be done one woman, one answer, one click at a time.

Monday, May 11, 2009

Breast is Best

Since I was a little girl watching my mom nurse my baby sister, I knew I would do the same. I had no idea that in the 70s and 80s nursing was no longer in fashion and my mother was breaking rules and choosing to do what was best for us, instead of what was best for her.

It makes me terribly sad to know that even though we have a plethora of information out there regarding the benefits of breastfeeding, some are still choosing to give their infants formula. I do understand that there are circumstances where formula is the only option (a friend of mine's sister with breast cancer just had her son, and he will be formula-fed while she undergoes chemotherapy) but for the rest of us, there just aren't that many good excuses.

If I told you I had a potion that would help to prevent your child from developing allergies, diabetes, obesity, etc- would you give it to your baby? That's what breastmilk is. It helps to prevent so many things because it is packed full of antibodies. It is also much less expensive than formula- a whopping $1200-2500 per year less, in fact, depending on whether you can use the generic store brand or have to go for one of the specialty brands. And not breastfeeding is responsible for annual health-related costs of over $3.6 billion. Breastfeeding is also responsible for releasing a couple of "mothering" hormones- prolactin and oxytocin- which are essential to relaxing and just loving on your baby. And the American Academy of Pediatrics recommends breastmilk as the primary source of nutrition for the first year of baby's life.

Recent studies regarding formulas, and the fact that no one will release brand names, are alarming. For example, one study by the CDC shows that some 15 of the US's most popular formulas have rocket fuel components in them. How is that legal?!?

And even though an article was written recently about the so-called Case Against Breastfeeding, which cited some obscure studies and ignored relevant ones, a retort to that article was written that goes in depth about the benefits of breastfeeding. If the formula companies are claiming that their products are inferior to breastmilk, who are we trying to kid? Formula is an expensive, inferior option.

Studies have shown that the higher a woman's education, the more likely she is to breastfeed her child. And interestingly, in Third World countries, women who breastfeed are assumed to be in poverty. Formula has been presented as the wealthy family's opportunity, which is consumately sad. I had a friend serving as a missionary in Thailand. As she nursed her baby, a woman came to her and said, "Aren't you an American? Don't you have any money?" My friend tried to explain that nursing was better for her baby, but the lady didn't understand because formula is so tied up in the socio-economic status of the country.

Breastfeeding is not easy, though. It takes time and understanding and there is a learning curve involved. It can be painful at time (during the early weeks) and time consuming. But there is nothing sweeter, in my opinion, than a baby at breast. Most states allow nursing in public. My own state of South Carolina legalized it about 3 years ago. Unbelievable, huh? Our culture is so wrapped up in sexuality and the improper usage of breasts that it is hard for people to watch a baby nurse at the breast. An interesting article was written discussing that very thing. I have the personal belief that if you can turn on TV and see a mostly exposed breast and not be offended, I can sit in a restaurant and nurse my baby and you should not be offended.

All in all, breast is best. Thousands of articles about breastfeeding can be cited to prove this. But you will also need some support- from friends, family, and your spouse. Studies have shown that women who are not supported at home will be more likely to quit breastfeeding. And let's not forget about Dad's feelings- he may feel left out due to not being able to quiet and comfort baby. There are lots of things going on emotionally and physically in regard to breastfeeding. Just know that it is the best choice for you and your baby.

Tuesday, May 5, 2009

Rocky Mountain vs. Bum Genius

Several people have asked what I like and dislike about the diapers I carry at my store. So, here goes:

BG Likes:

they have worked out a lot of the "kinks" (ie. wick resistant modification which lessens leaking onto clothes)
they come with an infant insert and a regular insert
they are cute
they have the "one-size" so that baby can grow
they fit babies from 8-35lbs
you can bleach them
inserts can be snapped into different sizes to correlate with the diaper size
look like traditional disposable diapers

BG Dislikes:
velcro sticks to everything
velcro makes the latch side "pilly" and over time doesn't hook and latch as nicely
they take 2-4 weeks to ship out my orders (since I'm a "little guy")
the legs don't work for thinner- legged babies- not tight enough

RM Likes:
work at home mom makes them
made in the USA
easy to order- ships quickly
for a snapping system, they are less expensive ($20w/insert vs. $24.95-BG comparable)
snaps don't attach themselves to anything
they snug tightly around baby's legs to prevent leaking
they fit any shape and size baby- 5lbs to 30lbs
cute color combinations
look like traditional disposable diapers

RM Dislikes:
if baby produces lots of urine, sometimes it will wick onto clothes (but Tracie- the maker- says that you can just place insert in and leave about an inch of room to prevent this)
can't use regular bleach on them- but you can use a color-safe bleach.
they sell out quickly, so sometimes it is hard to place the order
the insert comes in one size- but you can buy your own and buy the diaper only (for $17.95)

Saturday, May 2, 2009

Cloth Diapering- Is It For Me?

If you have been around the more naturally minded community, you have heard of cloth diapering. And let me guarantee you, this is not your grandmother's idea of cloth diapering. While you can still get the plain cloth, fold-it-yourself, secure it with pins, and put a rubber cover over it diapers, your options have widened tremendously. For example, BumGenius and Rocky Mountain Diapers have developed wonderful alternatives to cloth diapering and both have grow-with-your-child systems. BumGenius diapers (their one-size) have the diaper cut out and shaped like a disposable one, and you can flip the front down and secure it with snaps to create the right size for your baby, 8-35lbs. They have super absorbent micro-fiber inserts which are taken out of the diaper when it is wet or soiled, and you wash them all together in the washing machine. And Rocky Mountain has taken snaps to a whole new level, with a wonderful leg adjustment system- fitting babies from 5-30lbs. And if the pocket diapering system is not something you are looking for, Mother-ease has the more traditional diaper plus cover system- an absorbent cloth diaper and then you use a water resistant cover on top.

The Real Diaper Association, advocates for a return to cloth, have staggering statistics regarding disposable diapers. First, the average family will spend approximately $2500 per child during their diapering career. Second, that one child in disposable diapers will generate a ton of non-biodegradable trash during that time. If you are concerned about your pocket or your carbon footprint, then cloth is for you. Another benefit to cloth is for babies with sensitive skin. Disposable diapers don't allow baby's skin to breathe, causing irritations, yeast infections, diaper rash and other not-so-fun, painful ailments. In any of those situations, the research shows that the baby should wear cloth. After having two girls in cloth diapers, I can proudly say that except during teething episodes, we've never had so much as a red spot, much less a diaper rash on either baby's bottom.

You hear that babies are so expensive, right? Well, if you choose to diaper with disposables and formula feed, you are right. If you choose to cloth diaper and breastfeed, the cost is almost negligible. I have spent $600 on both girls for their diapers and zero for formula, making my grand total for food and diapers $600. On average, the consumer spends about $2000 per year on formula. Add that to what disposable diapers cost, and that is a whopping $4500- and add that again to account for another child and you have spent $9000 to my $600. That is $8400 that I can use for groceries, house payments, college savings, or various other things!! If you want to compare just diapers to disposables, you are saving approximately $1800 up to $2300 per child- and that is some serious cash!

So, what is the cloth diaper breakdown? You will spend approximately $20 per cloth diaper. Oh, that is so expensive, right!?!? Well, let's think about it. You can think of disposable diapers as worth a quarter apiece. So, each time you throw one away, you throw away $.25. If your child is average and you change them 8 times per day, that is $2.00 per day that you are spending. In 10 days, you've bought one cloth diaper. In a month, you've bought 3. In 12 months, you've bought 36. And I'm being generous with the numbers. I've had days where my girls have gone through 15 diapers. Not all cloth diapers cost $20 each either.

How many cloth diapers do you need to get started? I would recommend about 24. If you would like to avoid doing diapers 3 times a week, get 36. And remember that you can use them for subsequent children. I have 42 diapers for two children and do diaper laundry 2-3 times a week. Also remember that buying in bulk usually saves you a little bit of money. At my store, buying 10 Rocky Mountain Diapers saves you $1.00 each, and buying 20 saves you $1.50 each. If you buy 12 BumGenius diapers, you save $1.00 each. And then you factor in your detergent- I bought a gallon of Allen's Naturally for $50, but it has lasted 2 years and counting, plus the additional water cost each month (I've calculated approximately $5 additional) and you are still drastically lower than disposables.

All in all, cloth makes sense. It's easy, it's definitely affordable, and you are not destroying the environment while keeping your baby healthy and happy. I would recommend cloth to anyone. If you do laundry anyway, why not add a few extra loads per week. It's not that much! Plus you can check out Diaper Pin for loads of reviews to make the choice that is best for you. Also, feel free to set up a time to come to the store to touch and see how they work...

Monday, April 27, 2009

What is a Birth Center?

It is exciting to live in a day and age where there are several options for you to choose for your baby's birth place. One is your home, the other more obvious choice is the hospital, and finally there is the birth center. Birth centers are divided into two main categories (though there may be others)- there are hospital-owned birth centers staffed by midwives, and there are free standing birth centers owned and run by midwives. Birth centers of all types are inspected randomly by DHEC in South Carolina so you can be sure that they are always up to standard.

A birth center by definition is simply a place other than your home, and outside of the hospital, that is equipped to assist you in birthing your baby. Most birth centers offer the completely natural childbirth option, since they do not have doctors available to administer drugs like Stadol or epidurals. So, if you are choosing a birth center, you may need to take a childbirth preparation class like The Bradley Method. You can also be sure that you will not be encouraged to take any medication during your labor in a birth center. Midwives in general are experts in normal birth, and would love to see you birth your baby in the most natural way possible. Of course, if anything goes awry, your midwife would call emergency transport and get you to the nearest hospital as quickly as possible.

The World Health Organization recommends that midwives attend normal low-risk, healthy births but doesn't necessarily suggest where you are to be attended. But a birth center in your area is a great choice. In Spartanburg and Greenville there are several to choose from. Labors of Love Birth Center is located on Floyd Road Extension, and is about 6 minutes from Spartanburg Regional Hospital. Various other birth centers include Carolina Water Birth and Blessed Births, both located in the Greenville and Simpsonville area. Labors of Love is run by Linda Weaver and Amy Bixby, both licensed midwives with hundreds of healthy babies under their belts.

Why should you choose a birth center? Well, there are several reasons. Many birthing centers offer the huge jacuzzi type tubs to labor in. Studies have shown that water births are less painful than "dry" births and that babies are born more "gently" into the water. A great read for this type of birth is Gentle Birth Choices by Barbara Harper. She provides some significant data about water birth and is convincing about the positive aspects water allows. Another reason to choose a birthing center is if you live more than 30 minutes from a hospital staffed with a 24-hour anesthesiologist and obstetrician. The reason for most hospital transfers is not emergency- it's getting tired of the labor process and choosing to go in for an epidural. If it is 3am, and there is not an anesthesiologist on duty, you don't get your epidural, at least not until he/she arrives. Less commonly, something may go wrong with the baby or mom, and an emergency transport is required. An obstetrician needs to be available immediately for a potential cesearean section upon arrival at the hospital. Again, this isn't a likely outcome, but it is a possibility. A third reason that families choose a birth center is being uncomfortable with the idea of giving birth in their homes. Perhaps they have dogs or live in an apartment or condo. There are not reasons that prevent a home birth, but they can inhibit the natural process if the mother is consumed or distracted by them.

Statistically speaking, birth center births are not safer than home births, unless the home is more than a 30 minute drive from the hospital. If I had had the option of a birth center birth for the first baby, I would have done it in a heart beat. Sometimes it just feels like a more controlled environment since it is a place designated for births. And it is certainly a great option if you are not comfortable giving birth in your home, but don't want the added stress of going to the hospital for your normal, non-medicated birth experience.

I encourage you to do your homework. Interview midwives and tour birth centers. You can always fall back on the hospital. But a birth center will make your natural birth experience so incredibly special!!

Monday, April 20, 2009

Why Would I Choose a Midwife?

The majority of births in the United States happen in an actively managed hospital setting. Active management means that the medical staff has an active role in the labor process- doing vaginal exams, inserting an IV if the patient is hungry or thirsty, augmenting the labor via Pitocin or Cytotec to help speed things up, artificially breaking the amniotic sac... All of these things are active management of labor.

Midwives come from a different philosophy. They understand that the bell curve for pregnancy and labor is massive, with many variations being within the normal range. They care for the emotional and mental (and in some case, spiritual) needs of the mother, in addition to her physical needs. A point I found interesting when I switched from obstetric care to midwifery care was that I was no longer a "patient" but a "client". If you consider what this means, it is monumental. In obstetric care, you are viewed as a person who has a problem, an illness of sorts. You are pregnant and they must monitor you to make sure that you get better. But as a client, you are going to your midwife to continue to make sure everything is going well, as you assume it must be. Midwives are consummate experts when it comes to normality. And with that comes the immediate recognition of abnormality. For example, in banks the forgery department for legal US tender doesn't scrutinize all the variations of the dollar bills. They study the real deal over and over and over, and are able to immediately detect a fake. The same applies in midwifery. Midwives have attended the labors of hundreds of women, from whenever the woman calls them to the baby emerging. So, they have seen the hundreds of variations of normal.

Another difference in midwifery (and this is pronounced "mid-WIF-ery", though some choose to pronounce it "mid-WIFE-ery") is that they don't "deliver" babies. They "catch" babies, so some of them are called "baby catchers." If you think about what that means, it is again, interesting. Why do babies need to be delivered from their mothers' bodies, as if they were dangerous, malignent places? Midwives simply catch the babies who are making an entrance into the world.

Did you know that the majority of babies worldwide are caught by midwives or someone acting as a midwife? Did you know that the World Health Organization recommends that pregnant women who are low-risk and healthy should have midwives as their primary care providers? The statistics are staggering. The United States has the absolute highest mother and infant mortality rates of any of the industrialized countries. In fact, a friend of mine sent me an email about her friend who passed away during childbirth this past week. The routine epidural numbed her from the waist up, instead of the waist down. She went into respiratory distress, had an emergency cesarean section, hemorrhaged and died. It was her fifth child. Do you know who has the lowest maternal and infant death rates in the world? Finland. Why? Well, depending on who you ask, there are various reasons. One may be because Finland doesn't have the high rates of obesity that the US has, and therefore healthier babies are born there. Another may be that premature babies born before 25 weeks aren't counted as infant mortalities, but are considered miscarriages. But the most conclusive reason is because the majority of their births are attended by midwives. When a Finlander calls the hospital to let them know she is in labor, the hospital sends out a team of midwives to assist her. The midwives will transport her to the hospital if she needs to be. Otherwise the babies are born in their own homes. Is that strange? I don't think so. In the US, when a person calls 9-1-1 for an emergency (say he/she is having chest pains) a cardiac surgeon isn't sent out to assess the situation- a trained EMT is. That EMT can determine whether the person is having heartburn, indigestion, or is really having a heart attack. They can administer some oxygen and assist the person, or can immediately transport that individual to the hospital. It makes sense.

Another aspect of midwifery care that differs from obstetric care is the fact that midwives' practices run on a smaller scale than the local OB practice. This means that the amount of time spent on you is greater. My midwife scheduled my appointment for the following month or week at say, 10 am. I showed up at 5 minutes to 10 am, and was seen from 10am to 11am. What in the world takes an hour, you ask? Well, the first 30 minutes were spent in discussion- how I was feeling both physically and emotionally about the pregnancy, how my nutrition was, whether I was doing my Kegel exercises, and any questions I may have were answered. And the last 30 minutes was the "medical" side- the protein check, heart tones, blood pressure, and the like. In my OB practice, my appointment was at 10am. I was seen around 11:30am, and was walking out the door by 11:50am. The care in a midwifery practice is much more personal, more nurturing, more supportive of the natural process- in my opinion.

And finally, midwives don't have the fear of litigation that obstetricians have. Therefore they can feel able to treat you like a well person, instead of a sick person. The decisions that are made for you in an obstetric practice are based on the fear that you will sue them- ie. EFM (constantly listening to the baby's heart beat), IV (giving you liquids because of their non per oris mandate- or nothing by mouth, in the event that you must have an emergency c-section)... all of the interventions that seemingly prevent you from being able to sue them are actually probably creating the problems in the first place! In midwifery practice, you are accepting the fact that there is no medical intervention, but you are placing your trust in your midwife's ability to detect a problem and get you to the appropriate medical care if an emergency arises. A huge North American study was done a few years back that showed the safety of a planned homebirth with a certified birth professional (ie. midwife) versus hospital birth. You should read it.

Are you low-risk and healthy? Are you interested in having a natural childbirth experience? Then you should choose a midwife. There are more and more available and you can interview one within a few days. In the Upstate there are many wonderful women serving pregnant women as midwives. My personal experience has been with Labors of Love- Linda Weaver and Amy Bixby. I cannot sing their praises loudly enough. But there are others out there as well. Your childbirth experience is a once or twice (maybe more!) in a lifetime experience. Your pregnancy, labor, and birth is as special as you are. Find someone who treats you that way!