Baby Steps Blog

September 2, 2010

Thoughtful Thursday: Choosing the right doctor or midwife for you

Filed under: Classes,Education,Pregnancy and Birth — Tags: doctor, informed consent, midwife, ob — mcasserly @ 4:35 pm

Are all care providers create equal? No.

At the beginning of a pregnancy we tend to choose a care provider based on distance from our homes or work place or on the recommendation of a family member or friend. Many assume that all care providers are pretty much the same because for many women pregnancy is the first time we’ve sought out a specialist.

This was definitely the case for me when I was pregnant with my daughter. I already knew I wanted a midwife and so I opened up my insurance booklet and chose a group pretty much at random.

As my pregnancy went on I learned that not all care providers used the same protocols or even had the same philosophies. That was a real eye opener! It turns out that doctors and midwives are as human as the rest of us. Products of their training, experience, and even their upbringings. Some are more laid back and let the birth process unfold on its own – others choose to manage the process with multiple procedures from start to finish. And on top of that, I had my own thoughts and feelings about the birth process. I finally realized that I needed to find someone who could balance being the guardian of the process while sharing my birth philosophy and respecting my autonomy. It is totally possible! Make a list of the things that are most important to you and prioritize them. Discuss these things with your care provider. If you find that you are having to give up or compromise more than you want, then find another care provider! Every birth is important and special – you don’t have to settle. I changed care providers twice before I found the one that was right for me. And I had a wonderful birth experience!

Here are some questions to help get you started. These are excerpted from our Intuitive Birth Guidebook. The Intuitive Birth class is filled with comprehensive information about birth to help you navigate the current system. We go into great detail about choosing the right care provider for you. Carefully choosing a care provider is not limited to people seeking an unmedicated birth. Providers and women are completely individual so it’s important for every woman to find a doctor or midwife she is comfortable with.

How often do you attend unmedicated births?

Ask for a percentage of total births. 80-90% of women opt for an epidural in labor, so many doctors have very little experience with natural birth. Unmedicated births are very different from medicated births and require different skills.

Natural birth, in this case, means no Pitocin, no pain medication, and no unnecessary interventions.

Minimum requirements for an average birth?

Do they insist on an IV or hep lock?

If they require the electronic fetal monitor, how often and for how long?

Do they allow eating and drinking during labor?

Vaginal exams:

There is rarely a medical reason to have these at all during pregnancy and labor.

At what point does your birth team start doing exams during pregnancy, and how often during labor? How do they feel about your declining them?

Induction/augmentation rates & reasons:

How often (%) do they induce or augment labor?

For what reasons do they usually induce?

How long will they “allow” a pregnancy to continue?

At what point do they usually augment during a long labor?

How do you manage long labors with ruptured membranes (broken bag of water)?

At what point do they recommend Pitocin? Antibiotics?

How long can a woman labor with ruptured membranes before a cesarean is recommended?

What is your cesarean section rate?

The World Health Organization recommends a maximum of 10% for low-risk populations, and 15% when high-risk populations are included.

Nationally, the cesarean rate was 32.3% in 2008.

Your practice’s cesarean rate is your risk of having a cesarean, whether you truly need one or not.

What is your episiotomy rate?

The recommendation for episiotomy (a cut to the perineum to enlarge the birth canal) is that they should be done only in emergencies.

They cause many problems for women and shorten second stage only slightly.

The rate of episiotomies should be very low. They are more common in first time moms, so if this is your first baby ask the rate for first time moms.

Find out more about Intuitive Birth here:

Intuitive Birth

Baby Steps offers natural and prepared childbirth classes, breastfeeding classes and support, and doula services in the metro Atlanta area. Current locations include East Point, Douglasville, Marietta, Kennesaw, Buckhead, Sandy Springs, Lawrenceville, and Decatur. If these locations are not convenient for you we also offer private, in-home classes on your schedule. Contact us for more information. babysteps@babystepsonline.net

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July 5, 2010

A new option for childbirth classes

Filed under: Classes,Education,Pregnancy and Birth — Tags: atlanta childbirth class, intuitive birth — laurafields @ 8:16 am

Baby Steps is excited to announce a new option for our Intuitive Birth class. Previously, the class has been offered as a 9-week group class that meets for 2 hours per week, or a private class that meets for 4 weeks. Our newest option is a 6-week class that meets for 3 hours per week. This will give couples who’ve waited too long to sign up for the longer class a chance to fit in a full, comprehensive natural birth class. The content is the same; the only change is the distribution of hours over the course of the series.

The first class like this will be offered this Sunday, the 11th, in Decatur. We have another in Douglasville beginning on July 25, as well as several of our standard 9-weeknight classes coming up. As always, there is also the option of a private class if none of these will fit your schedule.

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July 2, 2010

Does Baby Steps push (homebirth, unassisted birth, not vaccinating…fill in the blank)

Filed under: Classes,Education,Pregnancy and Birth — Tags: childbirth, childbirth class, homebirth — laurafields @ 11:41 am

Anytime a company or person becomes semi-well known, there will be rumors about them. It’s just the way of the world, and something we must all accept as an unpleasant side effect of being successful. Mostly, when I hear things about Baby Steps, I hear that our classes are thorough, that we present information and support individual choice. Occasionally, I hear (usually from people who have never observed or taken one of our classes), “You know, they really push ___________________.” The blank might be homebirth, unassisted birth, not vaccinating, or whatever.

I understand how these rumors start. I’m one of the founders of Baby Steps, and my 2nd child was born at home unassisted. Yep, we planned it that way. I loved that birth experience and wouldn’t do it any other way at this point. I’m not afraid to share my birth story with people who are interested in reading it (it’s in our birth stories section if you’re one of those people). In our Intuitive Birth class, we discuss homebirth as a valid, safe option. That is, homebirth attended by a trained midwife. In our class, we do not include planned unassisted birth in the curriculum at any point. Were we to have a student planning one, we would be supportive, just as we’re supportive of the 80% or so of our students planning hospital births. The only time unassisted birth comes up in our class is when we talk about what to do in the very unlikely instance that your labor goes so fast that you don’t make it to your birth place (or, if you’re planning a homebirth, your midwife doesn’t make it to your house). If ever there is a study done on unassisted birth that proves it to be safe, maybe we’ll consider an addition to our curriculum. However, our goal is to provide evidence-based information. The evidence supports the safety of homebirth with a skilled birth attendant, so that is the information we provide.

In the United States, 99% of births take place in the hospital. Studies on homebirth have shown that for low risk women, it’s just as safe as the hospital but with fewer interventions. Almost all women who take our Intuitive Birth class are planning a natural birth and want few interventions. We want them to think about birth place and birth attendant very carefully. That is, we don’t want them to choose hospital birth by default. Therefore, we provide information about homebirth so that they can make a conscious choice. We also discuss birth attendant in great detail, since too often we pick an OB off an insurance list based on proximity to our houses, without giving much thought to whether that OB (or midwife) will support us in the kind of birth we hope to have. Sometimes, we have students decide to plan a homebirth after our class. Sometimes, they decide to stay with the hospital. We don’t care which they choose – we’re just happy to know that when they chose, they had all the information they needed to decide what was best for them. We only want the best for our students, and we know that the ONLY person who can define “best” is the individual woman who will be giving birth, with input from her partner.

As a group, doulas and childbirth educators tend to be pro-homebirth, anti-circumcision, pro-attachment parenting, pro-breastfeeding. And sure, there will be a handful who push their preferences on others. For the most part, though, what we hope for is a world where parents are able to make their own choices with the full support of us (their childbirth educators & labor support), their birth attendants, and their pediatricians. For us it’s not about what the parents choose, but THAT THEY GET TO CHOOSE FOR THEMSELVES.

So if you hear that Baby Steps pushes _________________, don’t believe it. If you’re a pregnant woman, come take our class and find out for yourself. If you’re a doula, you’re welcome to observe a series as long as there’s space. We try to be supportive of other childbirth educators and doulas. We believe wholeheartedly that we’re all working towards a common goal: to improve the lives of families. We see this not as a competition, but as a collaboration. Above all else, we believe in the absolute necessity of supporting women and their partners in making their own decisions for their families, based on a thorough understanding of all the relevant facts.

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June 16, 2010

A childbirth class for Father’s Day?

Filed under: Classes,Education,Parenting,Pregnancy and Birth — Tags: birth, childbirth class, father's day — laurafields @ 7:01 am

We often think of a childbirth class as something that moms-to-be need, and that dads-to-be are dragged to with varying degrees of reluctance. Often, that’s how the dads themselves see it before class starts. In my experience, however, by the time the class is over most dads are at least as happy as their partners that they took the class.

Often, when a woman is pregnant, she watches birth videos on YouTube. She reads books about labor and birth and all that comes along with that. She talks to her friends and family members about their experiences with labor. By the time she starts the class, she’s got a foundation knowledge upon which to build. Sometimes, dads do their own research, but often they go with the flow, assuming that she will do the work and all he has to do is show up and hold her hand. Anyone who’s ever attended a birth knows there’s a lot more to labor support than that! Moms and dads both leave a good childbirth class feeling prepared and confident. Taking the class together helps them solidify their values regarding birth, such as what type of pain medications might be acceptable, what newborn procedures they should allow and which should they waive, and where they might be willing to compromise should the need arise. A class gives dads the tools they need to be truly involved and helpful during the births of their babies, a bonding experience for the whole family that lasts a lifetime.

If you’re a dad and you took a childbirth class during your partner’s pregnancy, please post a comment and let us know how the class helped you!

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May 3, 2010

Being the birth partner – what do you need to know?

Filed under: Books,Classes,Education,Pregnancy and Birth — Tags: birth, childbirth, childbirth class, doula, homebirth, labor, natural, partner — laurafields @ 11:42 am

This is a great article with some rules for birth partners to follow. Yes, daddies-to-be, that means you. This is a great starting point for learning how to support your partner during her labor. Another great source is The Birth Partner, Second Edition by Penny Simkin. It’s very important that you understand the process of labor and birth, that you have some general ideas about how you might offer your partner comfort during labor, and that you know her wishes for her birth experience extremely well. A comprehensive childbirth class can make a huge difference in how both you and your partner experience labor together, and hiring a doula will give you an extra set of hands and the benefit of someone experienced to help you when the going gets rough. You can find several doulas on the Baby Steps website, as well as through the Georgia Birth Network.

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December 4, 2009

Is an epidural right for your labor?

Filed under: Classes,Pregnancy and Birth — Tags: birth, c-section, cesarean, childbirth, class, doula, epidural, homebirth, induction, midwife, natural — laurafields @ 11:25 am

The majority of American women choose to have an epidural during labor and birth. Like most interventions, an epidural can be an important tool when used judiciously. Occasionally, it can help prevent other complications. However, an epidural has its own risks, and women should be aware of these risks to themselves and their babies well before labor begins. These risks include:

Alteration of labor hormones and the entire course of a natural labor, often necessitating other interventions, like Pitocin to speed labor up, which have their own risks
Sudden drop in blood pressure
A need for catheterization
Itching
Nausea and vomiting
Breathing difficulties
Increased risk of postpartum hemorrhage
Severe headache
Rare, life-threatening complications for the mother
Changes in the baby’s heart rate, sometimes making a c-section necessary
Maternal fever, which can cause low Apgar scores in the baby, poor muscle tone, and in increased need for resuscitation, as well as prolonged hospital stays.

There are no long-term studies of the neurological effects of epidurals on infants. Links have been found between epidurals and neurological issues and breastfeeding problems. This article by Sarah J. Buckley has a thorough discussion of the risks of epidurals, complete with citations.

Some women choose to get an epidural because of fear of labor pain. This is a normal response in our culture, which does not place value on experiencing labor. Hospitals are often set up in a way that makes labor uncomfortable for women who are not medicated. But there are many things you can do to have a comfortable, safe birth without medication:

Take a comprehensive childbirth class.
Hire a doula! Doulas have proven statistical benefits.
Choose your birth attendant very carefully. Your birth attendant should be comfortable attending natural births, and 100% supportive of natural birth.
Avoid induction without medical cause, which makes labor more painful and increases the risk to your baby.
Consider having a homebirth, which has been proven to be just as safe as hospital birth, with lower intervention rates and higher maternal satisfaction.

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November 26, 2009

Baby Steps now has classes in Douglasville

Filed under: Classes,Pregnancy and Birth — Tags: birth, Breastfeeding, childbirth, Classes, Douglasville, doulas — babystepsonline @ 7:28 pm

We will be offering our first Douglasville Intuitive Birth class beginning on December 6. You can read more about Intuitive Birth on our website, www.babystepsonline.net.

Class location:

Planet Chiropractic

2971 Fairburn Road
Douglasville, GA 30135
(770) 783-1799
http://www.myplanetchiro.com

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