The Evidence-Based Parenting Toolbox, aka: How Not To Lose Your Sh*t With Your Kids

Let’s start by talking about the broken neon sign that I discovered last night as I was ushering my kids into bed in anticipation of solitude and wine. This particular neon sign was given to me and my husband when … Continue reading

She’s Still Nursing: A Guide for Family and Friends

If you’re reading this, you probably have a woman in your life that is, you guessed it, still nursing her child (or children). Whether she shared this article with you or you struck out on your own in search of … Continue reading

My Family’s Fight With Food Allergies

It’s every mother’s worst nightmare. Your child is hurting and you can’t fix it. My son, Jaxson, started showing troubling symptoms around one month old. He had bleeding diaper rashes, his skin was covered in eczema, and he cried all … Continue reading

WMC Doula Collective

Whole Mothering Center is pleased to launch the first cooperative doula practice in Southeast Texas! We’ve had this in the works for a while now, and are so happy to be able to share the news with you! WMC is … Continue reading

Educate Before You Procreate

I was unbelievably excited when I found out I was pregnant. After being married for only six months I somehow convinced my husband, who was set on waiting at least a year, to try for a baby. “It’s not like … Continue reading

Renae’s Chronicles of Nausea: A Hyperemesis Story

It might have been after I threw up on my OB’s shoe…again. Or maybe it was when I found myself telling the cold tile floor that it was the only one who loved me. Possibly it was when I described my pee as “Coke…like Yankee Coke, not Sprite-is-Coke-Texas-talk.” Perhaps it was when I had to lift my head out of the toilet to read the positive sign.

Whenever it was, I realized early on that for every “I Didn’t Know I was Pregnant” special there was one like this in which I and everyone within earshot knew I was pregnant every single moment. It was not an auspicious start. After a miscarriage, I developed what I thought was the worst stomach bug ever. My assessment was close in that it was horrible, but the 9 month duration was unexpected.

With my daughter I ate for 2….villages, so when I found myself completely unable to eat this time, I was a bit perplexed. I am awesome at fluffy. I am the only person who could deliver a baby and leave the labor room weighing 10 pounds more. This time though, at six weeks along, I was in my OB’s office playing “name the shade of purple on the ketone stick”, watching the dial of the scale move backwards for the first time in my life and throwing up in his waiting room, scale area, sink, toilet, floor, and shoe in that order.

He prescribed me Zofran which tore at my hippie heart. All my crunchy friends had suggestions. I wore Seabands like Rolexes, drank enough ginger-peppermint tea to float a ship, and tried every trick in the book. It only intensified, and I was now throwing up 15-20 times a day. At eight weeks I went back and was given the diagnosis of Hyperemesis Gravidarum (HG). You might recognize this as the pregnancy illness that Kate Middleton had only without the clothing/make-up/spray tan/hair-holding-back team. My plans for a midwife birth were shot, and I continued to drop weight like a prize fighter. Finally, at 12 weeks, I began to get IV  fluids and was receiving the highest dose possible of several meds.

HG1

 

Nonetheless, my HG was not impressed. I had lost over 15% of my body weight, was throwing up blood from bile burning my throat, my hair was falling out, my veins had collapsed, and I was separating ribs from the constant vomiting. My reaction was deflection via humor: “My bikini career is finally taking off. Pregnancy is an amazing diet. I love the smell of bile in the morning.” My OB’s reaction was a bit more pragmatic and he admitted my miserable ass to the hospital. I was expending too much energy vomiting so I was ordered not to eat or drink anything and was given all my nutrition via IV for several days. As I told my OB, “If you wanted to take me out for drinks, you should have chosen a nicer place.” He wasn’t amused and soon after discharge I was a mess again. This is when my angels arrived: home health. I was given a Zofran pump which meant I had to stab myself daily and have medication going under my skin where I couldn’t throw it up.

 

ZoeFrancisHG

Zoe Francis was my homegirl for a large portion of my 2nd pregnancy. Isn’t she gorgeous?

The tube going into my stomach left delightful bruises, and it actually looked like my baby was trying to kick his way out. Adorable little Alien. Once we got the medication dose right I was closer to “normal morning sickness” with chronic nausea and vomiting several times a day. I was not gaining weight but no longer losing it. I looked like Skeletor, felt like death, and smelled like wine (chronic ketosis). Home health continued until I was 26 weeks pregnant at which time I was able to wean off the pump and fluids.

HG26wks

 

I never got completely off the oral meds, but was able to function most days until the last 3 weeks of pregnancy when it returned with a vengeance. When my water broke I was still wearing pre-pregnancy jeans and weighed less than what I started at.

So, what did I learn from having a disease that only strikes 0.5-2% of all pregnancies?

First of all, some people are horrible. They’ll tell you the meds are killing your baby, that you’re lucky you’re so skinny, or that it’s just psychological. This includes some medical professionals, so arm yourself with information and be prepared for battle. There are some excellent support resources on the internet for pregnant women women who find themselves dealing with HG that include standard HG protocols and tips and tricks from other women whose babies are literally eating them alive. Help HER is an amazing organization that includes support forums, suggested treatment protocols and educates providers on how to most effectively help their patients who have HG. There are also many Facebook groups that act as support forums as well. Hyperemesis Gravidarum (HG) and Hyperemesis Gravidarum Sufferers and Survivors! are the two that I found most helpful.

Another thing I learned is that those experiencing pregnancy complications are often treated only for the physical symptoms and not the psychological ones that can occur. Pregnancy and postpartum depression are absolutely rampant in HG mommies along with anxiety and even PTSD. The disease is horrifically misunderstood and often mismanaged. However, if you’re looking for full neglect, ask what psychological support these mothers are given. Typically it is none. I am very lucky that I had an amazing support structure and natural coping mechanisms, but many are not that fortunate. Ultimately, if you are looking for an effective diet, I can’t recommend HG.

Mac3daysHG

Minion and I at 3 days postpartum. I was SO relieved to be UNpregnant!

I wouldn’t sign up to do it again. In fact, we’ve decided that a permanent birth control situation is the best option for our family. My husband may have been forced undergo surgical intervention to prevent his swimmers from ever finding their way out of the isolation ward they’re now confined to, but we got our adorable little Minion out of the deal and we all made it through relatively intact. 😉

Renae Rose

Lacking a hobby, Renae Rose has spent the last four years pregnant or nursing her daughter Emelyn and son Macallan. She is a full-time teacher at an online charter school. In her spare time, Renae enjoys laughing at her kids’ hijinks and alienating people on Facebook.

RenaeRose

No Name Calling!

Some of you may be aware of the “Big Push for Midwives” campaign that is on-going.

Yesterday, this article came out, talking about how physicians are continuing their anti-midwives smear campaign to the airwaves.

I have to say that when I read this: “During the segment ACOG reiterated its claim, which has been thoroughly debunked by a large and growing body of medical literature, that out-of-hospital delivery is unsafe. Describing women who choose to give birth in private homes and freestanding birth centers as “hedonistic” mothers who knowingly put the lives of their babies at risk for the sake of an “experience” they believe will be like a “spa treatment,” members of the group echoed last year’s position statement claiming that women who choose out-of-hospital deliveries base their decisions on what’s “fashionable” or “trendy.”, I became quite offended.

I don’t know about you, but I make medical decisions for my family based on research. More to the point, on EVIDENCE BASED research.

Though I am not one of the majority of women who have birthed in Southeast Texas via c-section, the alarmingly high rate (43.7% in 2004 and rising) of cesarean births was a primary motivating factor in my decision NOT to birth my second child in a Beaumont hospital. We opted to birth in Houston, a 2 hour drive away.

The nearest hospital is aproximately 7 minutes away from my house. We have an ambulance station less than 2 minutes away… from a “prepared for an emergency” standpoint, birthing at a local hospital would have been ideal. Unfortunately, I know that I cannot have the birth that I want in our hospitals. That leaves me with the options of either birthing at a hospital or birth center in the Houston area, or birthing at home.

I want to clarify that when I say “the birth that I want”, I’m not asking for anyting unreasonable. I want to be able to move around, walk, not be “required” to be strapped to uncomfortable monitors that also “require” that you be fairly still lest the monitor slip and not pick up the baby’s heartbeat. I want to be able to eat something if I get hungry, not be forced to go for 12 or more hours doing the mos intense work I will ever do while letting my body feed on it’s own reserves (which is not ideal for my health or the baby’s). I want to be allowed to make progress without being tied to the clock ( a rate of 1 cm per hour as the hospital’s “policy” requires is outdated! Read this!!), and also without the ‘threat’ of pitocin if my labor is not progressing ‘fast enough’ – and I want the determining factor on ‘fast enoough’ to be out of concern for my baby’s health, not because it’ almost shift change. I want to have only the people that I want around me, privacy and respect for my space and the goings-on within it, not a stranger with cold hands who knocks once and then comes in without my permission and does things that interrupt my process (I’m just going to check your blood pressure – why don’t you get out of the focused mental space you’re clearly in and accomodate me for a minute?). I want to feel loved and respected while I am birthing, not like I am taking too long or that I am burdening you because I don’t want your “policy” to interfere with my birthing.

Knowing what I know now, I want to be in MY space, where *I* call the shots (with the help of my doula, and under the care and advisement of my midwife).

So, that said, why all the fuss about homebirths? Let’s research a bit, shall we?
If you’ve seen “The Business of Being Born”, then this is familiar territory for you. If you haven’t seen it, then I highly recommend that you check it out.

Prior to 1900, ALL babies were born “at home”. Ther wasn’t an alternative, and though there were some losses (as there still are today), the attendants at those births were skilled in assisting a birthing mother use her body’s own work to get the baby out. They knew how to walk and physically support a laboring woman, how to keep her in the mental headspace to accomplish the taxing job of birthing a baby. They were there with hands-on support to guide her emotionally and respect her wishes regarding her own body.

Then comes the new profession of “medicine” and those interested in practicing it. Like mama always said… they call it “practicing” because they haven’t perfected it yet! With the new field of obstetrics, all these highly trained doctors now need patients – but how can they “practice” their craft if all these midwives are taking up all the pregnant women? How did they go about changing that? Unfortunately for us today, the AMA went on a smar campaign to sway the public into believing that “granny midwives” were unskilled. “Unskilled” apparently means “dis not go to medical school”. I know many midwives and doulas and other birth professionals who “did not go to medical school” that I would choose to assist me in the birth of my baby presicely for that reason.

Skip ahead to today. I have heard many people gasp in (awe? horror? shock? admiration?) disbelief when they find out that someone is planning or had a homebirth. Why is that so shocking? Is it as ACOG says, that women today are dumb enough to birth outside the hospital because it is fashionable? Or is there more to it? Do these women know something that ACOG doesn’t? More importantly, I think the real question is, ‘Why is ACOG so desperate as to resort to name-calling in an attempt to discredit women?’.
I love this quote (from the above article):

“ACOG clings to this ridiculous fantasy that women choose to deliver their babies outside of the hospital because they want to be like Ricki Lake, Demi Moore or Meryl Streep and that if women would only watch enough fearmongering stories on morning television they’ll be brainwashed back into hospitals,” said Katherine Prown, Campaign Manager of The Big Push for Midwives. “Insulting our intelligence and promoting policies that deny us choices in maternity care are not exactly winning strategies for stemming the tide of women seeking alternatives to standard OB care.”

You tell ’em, Katherine!

For additional reading, we suggest:
Midwifery: A History by Illysa Foster M. Ed.
Listen to Me Good The Life Story of an Alabama Midwife by Margaret Charles Smith and Linda Janet Holmes
The History of Midwifery and Childbirth in America: A Time Line Prepared by Adrian E. Feldhusen, Traditional Midwife
American Medical Association Apology Sparks Discussion on Race Posted by Christine C.

Home Birth With Midwife As Safe As Hospital Birth: Study

Frequently Asked Questions About Doulas

What is a Doula?

Doulas provide emotional and physical support to a woman and her partner during pregnancy, labor, birth and early postpartum period. They are called many things including: Childbirth Assistant, Labor Support Professional, Birth Assistant, Birth Companion, etc., but the description we like best is “walks with mother”.

Basically, your doula is there to ‘walk’ with you on your journey through pregnancy, childbirth and early mothering to help educate, support and validate the choices you make for your birth and family. In addition, your doula is also available to walk with you as a ‘mother’s helper’ when you need of help or support with your children at other times.

Why do I need a Doula?

According to “Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier and Healthier Birth”, by Kennell, Klaus, and Kennell (1993), having a doula can help reduce your risk of forceps assisted delivery and cesarean section, shorten the length of your labor and decrease requests for pain medications.

Women who have a doula attending them during their labor are:
26% less likely to give birth by cesarean section
41% less likely to give birth with vacuum extraction or forceps
28% less likely to use any pain medications and
33% less likely to be dissatisfied with or negatively rate their birth experience

(Hodnett and colleagues 2004)

Why use a Doula?

In order to have a positive birth experience, most women need continuous labor support. Although Obstetrical Nurses and Midwives are experienced in dealing with a laboring woman’s emotional and physical needs, they can seldom guarantee the support they provide will last throughout the labor – especially in hospital settings where shift changes, coffee breaks, heavy paperwork and busy nights regularly occur. Some OB nurses handle
up to six laboring couples at a time. Midwives may be able to offer more labor support, but they too have clinical duties to which they must attend.

The father or partner may be better able to provide continuous support but usually has little actual experience in dealing with the forces of labor. Even fathers who have had intensive preparation are often surprised that the amount of work involved is often more than enough for two people. Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation.

The laboring mother’s mother or mother-in-law, likewise may be better able to provide continuous support, but her own experiences and knowledge of birth are not always useful to the laboring mother, especially when the laboring mother’s ideals or expectations in childbirth differ from those of her mother or mother-in-law.

A professional doula can help bridge the communication gap between family members and help keep the mother focused on her birth and provide the emotional support to help the mother achieve the birth she wants. A doula can also act as a liaison between the laboring couple and their medical support team.

What is a Doula’s role?

Your doula can be as involved as you want her to be. Before hiring her, your doula will go over the services that she provides and discuss with you your expectations and desires for her role in your birth. It is important to remember that there are limitations to a doula’s role; for example: a doula does not speak for a couple, provide medical or clinical skills or act in any unprofessional manner. Most certifying organizations have Policies of Practice that each doula must follow. The Doulas of the Whole Mothering Center have chosen to certify through Doulas of North America (DONA) (see website link below).

A doula may provide:

  • explanations of medical procedures
  • emotional support
  • advice during pregnancy
  • exercise and physical suggestions to make pregnancy more comfortable
  • help with preparation of a birth plan
  • massage and other non-pharmacological pain relief measures
  • positioning suggestions during labor and birth
  • support for the labor partner so that they can love and encourage the laboring woman
  • help in avoiding unnecessary interventions
  • help with breastfeeding preparation and beginnings
  • a written record of the birth
  • many other services that vary from doula to doula

Will the Doula replace the father?

Some fathers or partners are concerned they may be sidelined or replaced by the Doula during labor. Although individual situations vary, and one should question a prospective doula about her philosophy. Generally the answer to this question is no – she will not replace him. Studies have shown that fathers usually participate more actively during labor in the presence of a Doula than without one. A responsible Doula supports and
encourages the father and enhances his support style rather than replaces him.

When should I hire a Birth Doula?

Retaining the services of a Doula is recommended at any point from the onset of pregnancy that still allows adequate time for the Doula to become a fully integrated member of the labor support team. Ideally, our feeling is that the earlier a Doula is retained, the more time there is to decide what role she will play in your process of becoming a mother.

When should I hire a Postpartum Doula?

Since your Postpartum Doula will be working closely with you and your family in your home, she should ideally be familiar with your family dynamic and the physical layout of your home so enough time should be allowed for all parties involved to be comfortable working closely together. We recommend retaining the services of a Postpartum Doula no later than four weeks before your due date. In some instances, your labor and postpartum
Doula will be the same person so that your relationship with her will already be well established for your postpartum period.

What training does a Doula receive?

There are several certifying organizations through which Doulas may receive part of their training. Additionally, an integral part of a Doula’s training is her own personal pregnancy, birth and mothering experience and the experience she has gained in assisting other mothers as a doula. While many doulas choose to seek certification through a recognized body, certification is not required by any organization or state in the US.

All of our Doulas are certified through or are working towards certification through the nationally recognized doula certification organization of their choice. They also bring with them their own experiences and the insights they’ve gained through working with countless mothers in various other programs and capacities in the Southeast Texas area. Doulas working with the Whole Mothering Center also undergo a period of hands-on
apprentice training with a more experienced Doula during the certification process.

You can find out more about Doula Training and Certification through these agencies:

http://www.DONA.org
http://www.CAPPA.net
http://www.BirthArts.com
http://www.ChildbirthInternational.com

How much does it cost to retain a Doula?

Doula services range in price from area to area and doula to doula. Some of this is based on the experience your doula has, some is based on the going rate in your area.

Birth Doula and Postpartum Doula packages begin at $575.00. We also offer an hourly rate for emergency and after-hours services for postpartum doula work and are happy to work with you on payment arrangements. For those who are experiencing financial hardship, we also offer a sliding scale of fees and are willing to barter for services (ask us for our wish list for ideas of services we’re willing to barter for). One reason we have chosen to offer this service is so that any mother who wishes to have the support of a Childbirth Doula or a Postpartum Doula will have the opportunity to have those services. Our goal is to help support mothers, and we don’t feel that a mother’s options should be based on her ability to pay.

I’ve heard some doctors don’t work with/hospitals have banned doulas.

Yes, that’s true – thankfully, that is not the case in our area. We have yet to come across a care provider in our area who is unwilling to work with a doula and have had positive experiences working with nurses and hospital staff with previous clients. We go out out of our way to form a professional and friendly working relationship with our client’s care providers and to communicate cooperatively and respectfully with each medical professional involved in your care. This works to facilitate a positive experience for you and for our future clients. We don’t believe that doctors or other medical providers are our or your enemy and we don’t treat them as such.

There are some hospitals that don’t ‘allow’ doulas; however, as the mother, you have the right to have whomever you want with you to support your labor. A hospital ‘ban’ on support person violates a mother’s choice and rights, and is unethical. We feel that such bans will surely be challenged.

You can read more about bans here:

Is your question missing from this list? If so, please email us and we will add it!