OMG (some mature language and a rant)

I am a long standing feminist who used cloth diapers (loved them and loved hanging them out on the line, loved being a wife and loves being a mother/grandmother. I was reading one of my professional journals the other day and almost fell out of my chair. The article is "The Vagina Catalogue: Literature Review and Author Commentary" (Women's Health Care A Practical Journal for Nurse Practitioners July 2009 Vol. 8 No. 7 pp. 26-31)by Marjaneh M. Fooladi.
The article is about the recent evolution in cosmetic vulvovaginal surgery and the social, cultural, economic and emotional aspects of these procedures.
As a midwife I have spent almost 27 years trying to help women (including myself) to learn to accept their bodies. Women are poked at by the media, other women, men, and themselves to view themselves as imperfect if we weigh too much or too little or if that weight is distributed in "the wrong places". Our hair, our skin, our teeth, our breasts, hips and thighs. Health has almost nothing to do with this-when a women is 50 pounds overweight, has prediabetes and borderline high blood pressure and wants her thighs and bottom to be bigger because this is what her man wants I want to scream. When another woman is normal or underweight and still feels fat I sympathise and want to scream.
In the past I've had women tell me their man feels their genetalia is unattractive. I've tried to reassure them that they are normal and he is the one with the problem (I suggest maybe his poor "performance" has little to do with her and a lot to do with him but she is a convenient target.) Now there are people out there selling another way to make us feel bad and suggest ways we can spend our money to meet some nebulous unattainable version of perfection.
Legitimate repair of damage from surgery or childbirth or cancer treatment makes sense. Having your labia enlarged or made smaller because you don't look like the airbrushed picture in a men's magazine is just---I'm screaming. Having a C-Section so your vagina stays "tight" is just---me screaming again. When are women and the people who truly love us going to quit this utter nonsense.
I know this is a rant. I just can't help it. I respect and care for the women I attend and the women who are my friends. It is time for us to stand up and say to ourselves we won't belittle ourselves anymore and we wont' let others belittle us.

Cloth Diapering

Looking back on photos of myself as a baby it's hard not to notice that my mom used cloth diapers. The pictures are kinda funny as I am wrapped in a bulky white cloth with safety pins on each side! Many people think of cloth diapers as a product of the past since disposable diapers came onto the scene. Little did I know (until I became a midwife) that cloth diapering is not a thing of the past! The majority of my clients continue to use the standard disposables, but I have also become very aware that cloth diapering is on the come back! Some names of cloth diapers that I hear in the practice are Bumgenius and Fuzzy Buns! How cute--and funny! Cloth diapering has definitely evolved since I was a baby. There are now cloth diapers that are quite fashionable with Velcro and snaps--instead of the standard safety pin! Also, the new cloth diapers are size adjustable meaning they can grow with the baby. Here is some interesting facts I found out in my research on diapers! You be the judge..:) As always, I am not trying to advocate one way or another...Of course I must say that the new cloth diapers out are incredibly adorable!

The debate over disposable and cloth diapers on the environment is not at all clear cut. The side you come down on in this argument depends on what aspects of the environment you value most. Disposables and cloth diapers each have their own advantages to you and your baby as well as to the environment. So what you choose to do therefore depends on which advantages you value most: convenience, cost, or comfort.

No question, disposable diapers involve less hassle. When your baby gets one wet or dirty, you just take it off, seal it up, and throw it away. Do keep in mind the diaper does have to go some where to disintegrate:) FYI- It is estimated that roughly 5 million tons of untreated waste and a total of 2 billion tons of urine, feces, plastic and paper are added to landfills annually. It takes around 80,000 pounds of plastic and over 200,000 trees a year to manufacture the disposable diapers for American babies alone. Although some disposables are said to be biodegradable; in order for these diapers to decompose, they must be exposed to air (oxygen) and sun. Since this is highly unlikely, it can take several hundred years for the decomposition of disposables to take place, with some of the plastic material never decomposing.

The tape on the sides of disposable diapers makes them generally easier to take off and put on than cloth diapers. (Although Velcro on diaper wraps has made it much easier to change a cloth diaper than it used to be, it's still not as easy as changing a disposable.) Cloth diapers are sometimes unwieldy. No matter how you fold a cloth diaper, you may find it difficult to fit it into a diaper wrap.

You can't just throw away cloth diapers. You need to store them in a diaper pail until your weekly diaper service pick-up or until you have enough to launder. The stench, especially after your baby has begun eating solid foods, can sometimes become overwhelming. Even if you use a diaper service, you'll have to wash the diaper wraps yourself. So cloth diapers require much more hands-on (excuse the expression) dealing with your baby's poop.

The advantages of disposable diapers all center on convenience. Yet cloth diapers offer convenience, too. Parents of babies who wear disposable diapers often run out at inconvenient times. But if you use a cloth diaper service, you'll never need to drop everything at quarter of nine to fetch some diapers before your local store closes. You can order as many cloth diapers as you need every week and have them delivered to your door. Because cloth diapers are so absorbent, they also come in handy in wiping up your baby's spit up and other spills.


As long as you're using a lot of diapers (80 or more each week), a diaper service will probably be less expensive than purchasing disposable diapers. Cost estimates show that disposable diapers will run approximately $50 to $80 per month, using a diaper service will cost approximately $50 to $60 per month and laundering your own cloth diapers will cost slightly less at approximately $25 per month. When the number of diapers you use falls to 60 or less, however, a diaper service is likely to be slightly more expensive due to the base delivery charge. Of course, if you're dedicated enough to buy and wash your own cloth diapers, that's by far the cheapest alternative of all. Most of my clients and friends who use cloth diapers launder their own and say it is really not a big deal!


Babies who wear cloth diapers tend to get diaper rash less often than those who wear disposable diapers. Because it's not always easy to tell how wet a disposable diaper is, babies who wear disposables may sit in their own urine longer than those who wear cloth diapers, and continued contact with urine causes most cases of diaper rash. With cloth diapers, you can always tell how wet your baby is.

For this reason, cloth diapers also make it simpler to monitor your baby's urinary output. If you have any concern at all about how much food your baby is eating, you will find it much easier to keep tabs with cloth diapers.

Finally, cloth diapers probably offer your baby more comfort. If disposable diapers were more comfortable than cotton ones, we would all be wearing paper underwear. Try rubbing a cloth diaper and then the inside of a disposable diaper against your cheek. Which do you prefer?

MIA

I promise I am not missing in action! This month has brought many challenges to the practice. Being that the economy is bad, it unfortunately effects everyone. We are plugging away and the Lord is providing our every step. We have also had a busy month at the practice catching babies! I think, I alone, have delivered 7 this month. God is good! We have many new healthy babies--and mothers. I temporarily took down the blog site to think and to regather my thoughts. In the mean time, I have had many people e-mailing as to where the blog disappeared to! I am so glad to know you guys care! :)Thank you for keeping me encouraged!

Other news..the waiting room has been painted and looks so much better--and cleaner!Several people told me not to bother painting it, but I am so glad we went forth with the project! Special thanks to my friends--Rachel, Jeremy, and Jonathan! We managed to get it painted in 2 days and clean up a massive paint spill on the floor--hehe.:) We also bought some new toys and spruced things up!

I am in the process of doing some research on cloth diapers. I became interested in this subject after watching my best friend, Rachel, use cloth diapers with her last two children Caleb and Anna Felicity. I will be posting a blog about this topic sometime this weekend! The cloth diapers that are out are quite impressive and ingenious!

Baby Boom in the Berg...

Bamberg has been booming in the past week. We have had four babies since Saturday morning and we still have several women who are due as I blog!:) I delivered a beautiful baby boy bright and early on Saturday at 2:30! Gotta love midwife hours! He weighed 6 lbs 8 ounces and had the most beautiful head of blond hair. I had to cervidil his mother for postdates (42 wks) and she lucked out with a 2 plus hour labor! My next came at 6 pm Sunday evening (baby girl) and my third arrived Monday afternoon (another baby boy). It was the first baby for three of the mothers and they worked so hard! Sometimes I stand in awe at how amazing my patients truly are. Leigh caught baby number four yesterday afternoon and it was a girl. So, two boys and two girls!

Other news...I found out last week that I was accepted into the Family Nurse Pracitioner Program at USC. Whoo-hoo! I am really looking forward to starting this challenging program. If I have the dual degree CNM/FNP it will definitely open the doors of opportunity and allow me to see patients that aren't just women's health related. I will start taking classes in August.

Lastly, we are starting to renovate the midwifery waiting room tomorrow! I am still undecided about the color of paint to use on the walls! Any suggestions? I have a feeling that this room is going to take a lot of work. Thankfully, I have amazing friends who are going to help me! I am so blessed to have such good friends. Without their help this endeavor would be IMPOSSIBLE! Pictures to come of our progress...
Anna

Back from Vegas and ready to catch!

I am now back from a 5 day trip to Vegas! My sister (Amy) tied the knot in a very sweet ceremony on Sunday! I was so happy to be there to witness this special event. It is so awesome to see her so in love! I think my favorite part of being in Vegas (besides the wedding) was people-watching. If you like people watching (like myself) then Vegas is the place to go! You see people from all realms of life. Now, that I am back in the berg, I have a feeling I am going to be very busy catching babies! We have a lot of women due and two that are now overdue! I guess they just had to wait on me to get my catcher's mitt ready...here are some pics from the wedding! Two of the pics are my sister and I and there is one of me with my mom!
Anna

How is this for a belly laugh? The pregnant women who decorate their bumps with amazing artwork!

A friend of mine from college recently had someone do some artwork for her belly! The photographs of her baby bump were amazing! Today, I saw this article and thought I would share! It must be becoming more popular! I think I dig it!:)

It's the most exciting time in a woman's life - and, for some, the best way to commemorate the experience of pregnancy is with a painted belly. From a life-like depiction of an unborn baby to goldfish swimming in a bowl, the options for what to paint are limitless.

An increasing number of women are using face paints to decorate their baby bump.
Manufactured to be gentle on the skin, face paints shouldn't stain, although it's advisable to first test any paint on a hidden section of your body to make sure it can be removed easily...

-Anna

Would you like a burrito?

A couple of weeks ago I was making rounds at the hospital on a baby I had delivered a day prior. As I entered the room I noticed the baby was very cranky and experiencing some nicotine withdrawal (as the mother was a smoker throughout the pregnancy). The mother was very frustrated and stated she had recently breastfed and changed the baby's diaper. The baby's arms were flailing as the mother held the baby in her arms. I gently took the baby to examine him and afterwards I swaddled him snuggly. A strange thing then happened--the baby quickly stopped crying. The mother immediately started smiling and took a sigh of relief. She then asked why I was wrapping the baby like a burrito! She couldn't believe that something so simple could have such a large impact on the baby's disposition. I then explained to her that the custom of wrapping babies snugly in light cloths or sheets has been used for centuries. Swaddling also most likely reminds the baby of being in the womb--which is comforting. I remember my travels to Africa and how the mothers that I worked with had the act of swaddling down to an art. They had seen the act of swaddling done as routine and it was an automatic given that you swaddle your newborn. Since being a midwife I have taught my mothers how to swaddle their newborn babies, but haven't stopped to actually research the act of swaddling. I found through research that swaddling has been linked to a decreased risk of SIDS, improved sleep, and reduced crying in the newborn. I also found that research advocates only swaddling for the first two months. Too much swaddling after this age can interfere with muscle development and the normal development of the ball and socket joint of the hip of the baby. Also, a baby starts to turn over around the age of two months so swaddling could become a safety issue.

Here are some detailed instructions on how to properly swaddle a baby:

1. Lay the blanket out on a flat surface in the shape of a diamond.
2. Fold down three or four inches of the top edge of the blanket.
3. Place your baby on the blanket so that his head is overlapping the top edge you turned down.
4. Tuck your baby's right arm into the flap made by the folded down edge of the blanket and the right corner of the blanket. Pull that corner across his body, tucking it behind the opposite side of his back.
5. Bring the bottom corner of the blanket up and tuck it inside the blanket near his chest.
6. Tuck your baby's left arm into the flap made by the folded down edge of the blanket and the left corner of the blanket. Pull that corner across his body, tucking it behind the blanket on his back.

If you have problems swaddling your baby, you can actually buy a swaddling blanket with Velcro flaps to make the procedure easier!

PS I enclosed a picture of my midwife partner, Leigh, swaddling a baby and giving it her sugar thumb!

Anna

The Other Midwife

Happy Mother's Day.

My dear friend Anna gave me a nice mother's day present today. Even though I am not on call we had a family that was due any day. I have assisted this couple in the birth of their other children and really wanted to be with them for this baby. Anna graciously let me midwife for them again even though it was her turn.

The work of giving birth is so astounding. Most of us do labor in the true sense of the word. Most of us also think we can't do it right before we do. As I cupped my hands to receive this child from her body I again remembered the birth of my two sons. As I handed the baby into her waiting arms I again felt the weight of my children on my abdomen, in my arms and always in my heart. As the father cut the cord he started the process of letting their child go. Our children, newborn or grown, here with us or gone, always in out hearts.

There is a new little boy in the world today. Happy Mother's day.

Notes from a father...

In my last blog I mentioned my friends Shaun and Jessica and the previous birth of their daughter, Madison. Shaun recently wrote a paper on breastfeeding for college and shared it with me at a recent OB visit. I thought this paper did an excellent job of pointing out the benefits of breastfeeding! Also, how often do we hear a father's point of view on such an important topic? Read and enjoy...

A Booby For My Baby

By: Shaun L Ratcliff

Is breastfeeding more beneficial for our infants and young children than the use of formulas? Breastfeeding has been around since the dawn of time and is once again a vital part of the lives, health, and development of our children and mothers. My wife and I were both breastfed as infants and all of our children either have been or will be breastfed for their first year at a minimum. A mother's bond between their children is crucial to the well being of the child; this bond is greatly affected through their mother's breast. Science has proven in multiple studies that breastfeeding decreases the likelihood of many diseases, infections, viruses and even Sudden Infant Death Syndrome (SIDS) in the children and the reduction of Breast and Ovarian Cancer in the mother. Although, it may only be a few points, breastfeeding has also shown to increase their child's IQ and cognitive development in comparison to formulas. Breastfeeding is a wonderful, natural, and healthy way of taking care of your children.

Bonding with our children is something that each and every one of us strives to accomplish at some point early in their lives. There is no other bond like the bond of a breastfeeding child and their mother. Mothers have a special bond that can only be achieved through the suckling of a child on its mother's breast; just read what Mrs. Ratcliff said in an interview in December 2008, “to look into her eyes was instant love when she first latched on to me. I knew right then, that there would never be anything that could tear us away from each other. The longer she fed, the happier and healthier she became as she got older.” According to an article on http://www.hugthe/ monkey.com, Warwick University scientists have made a direct correlation between the secretion of a hormone called Oxytocin and the suckling of a mother's breast. This reaction causes a positive feedback loop where the greater the concentration the faster oxytocin is produced and the stronger the emotion there is. So, when your child is breastfeeding your body is releasing hormones faster and faster that tells you to love them more and more and more. Now how can you beat that? More mothers should breastfeed their children because of the many benefits it provides for their children, their family bonding, and the exposure of society to a motherhood pastime.

Sudden Infant Death Syndrome or SIDS has to be one of the most feared early childhood problems in a family after they bring their child home from the hospital. Did you know that just by breastfeeding you can significantly reduce the chances of SIDS occurring in your home? Within the first few hours after delivery a mother's colostrom is letdown as she begins her first few feedings. Colostrom is probably the greatest thing that you can immediately provide for your baby; it has thousands of antibodies from many of the diseases that the mother has been exposed to. According to the American Academy of Pediatrics website, human milk decreases the incidence and severity of diarrhea, lower respiratory infection, ear infections, bacterial meningitis, and urinary tract infections. Studies show a protective effect of breastfeeding against SIDS as well. Cancer is heart wrenching on a family and mortal to many. Breast cancer can take away the self esteem from just about every woman that develops it; but breastfeeding helps to reduce its occurrence as well. According to http://www.cancerresearch.org/, “Breast feeding still lowered breast cancer risk by 4.3% for every year of feeding. There is also a 7% reduction in
risk of breast cancer for each child born.” I don't know of a better way of taking care of our children and our families than to breastfeed. Formulas just don't do the same things as traditional, old fashion booby milk.

Formula fed babies don't get the same nutrients that breast milk gives. Everything that comes from the breast during letdown is natural and is always the perfect amount at the perfect rate and the perfect temperature. So what does that mean; it doesn.t have any of the extra added hormones or whey protein that may come with formula, you won't have to go out and look for that bottle with the nipple designed by someone other than you based on another woman's breast and child, hoping that once you warm the formula it will now be perfect for the baby. Enfamil makes many different specified types of formula for problems such as colic, gas, spitting up; but still, why pay for all of these when breast milk is free, easy, convenient, and more beneficial. Breastfed babies traditionally have a higher IQ than most children and their cognitive development happens at a faster rate, giving them the opportunity to learn more before they enter Kindergarten. There was a study done called Breastfeeding and Child Cognitive Development by Dr Michael S. Kramer, MD; which studied breastfed infants and their IQ scores at the age of 6 on the Wechsler Abbreviated Scales of Intelligence. The study found that the scores for verbal IQ increased up to 14.3 points, 9.1 points for performance IQ and the full-scale IQ was as high as 12.8 points. My daughter is just about 2 years old now, and she has a huge vocabulary. She is using full sentences with proper mannerisms, states what things are and know most of her colors. I contribute a lot of this to breastfeeding and the study cited above can concur. The study also concluded by stating, “Based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development.” I highly recommend that all children are breastfed, if at all possible, for the first twelve months or longer.

Without a shadow of a doubt breastfeeding is the way to go. The overall benefits are just phenomenal. Mothers who are bonding with their children could have a global impact on things like the reduction in crime just by breastfeeding. Sounds farfetched right? Think about it; smarter people commit less crime and secure children who have strong bonds with their parents are more productive in life. Convinced? These breastfed children live healthier lives because of the passage of colostrom and antibodies from the mother to baby. Also, there has been a decreased incidence of breast and ovarian cancer in the mothers as well as the babies well on into adulthood. Breastfeeding increases children's IQ and cognitive development in just a few years; formula doesn't have that same impact on children. Sometimes it may be hard on the mother and it may hurt at first, be persistent and breastfeed. Nowhere else in the world can a child receive these benefits in such enormity than by providing a booby for the baby!

The tree of life...

It's amazing how one day can change everything. We tend to take life for granted not realizing that each day is an amazing gift. I feel like I have experienced one end of the life spectrum, witnessing a birth, and the other end, being death...all in one weeks time. On Friday, I had the awesome opportunity to deliver my friends Shawn and Jessica's baby. I delivered their first baby as well! The birth was beautiful and I can't get over just how stinkin pretty their baby is! What a blessing to be a part of witnessing Shawn and Jessica's family grow. I hope to catch many more for them.:) I am including a picture of Madison!

The day after witnessing this amazing birth I learned the heart-breaking news that my grandmother is dying. She is my best friend and I still think I am in shock. She has played such a vital role in my Christian walk. She has never been in the hospital and lives a very active life--still driving, living by herself, and gardening--at 83 years old. I am so blessed to have been so close to my grandmother for the past 29 years. Imagining life without her is so hard to fathom. My grandmother and I have talked openly about death throughout the years and she is very much at peace about dying. She states she is ready to "graduate." What a healthy way to view death--for we are all graduating if you think about it;) I ask that you guys please remember her in your prayers. My upmost desire is that she will "graduate" without suffering and as peacefully as possible.

Anna

The Other Midwife

Hi everyone, this is Leigh Wood, the other midwife in the Bamberg practice. I am slowly and painfully moving into the 21st century, as this blog is witness. Anna and I have worked together off and on for over 3 years. I've been here in Bamberg ever since I graduated from the MUSC program 1n 1982. I managed to fall into one of the best places to practice midwifery around. Over the years I have worked with so many wonderful people and helped teach midwifery students in their clinical rotations. The best part of being here has been the wonderful families that I have grown to know and love over the years. Just the other day a woman waved me over and asked if I knew her. I did, she was the first woman I assisted in a birth as a new graduate and employee. Now her baby has babies!! I'm catching babies from babies I have caught. That makes me feel old and happy at the same time. Every birth is a blessing and I know what a gift each woman has given me by allowing me to be with her. More later as I get the hang of all this.
Leigh

this and that...

I feel like such a poor blogger being that I haven't blogged in two whole weeks--yikes!!! So sorry! We have been busy here in the "Berg." Last week we had three beautiful births--two of which were first time moms! Congrats to our moms! All of the moms did a fantastic job! I am so proud of them! One of our moms had a marathon labor lasting 18 plus hours--poor thing the baby was persistant OP (sunny-side up) and she stayed at 5 cm for a good 5-6 hours! I am convinced she would have been sectioned at any other hospital. I am so lucky to work for a doctor that gives mothers the benefit of the doubt when they don't stick to a text book type labor. That mother went on to vaginally deliver a beautiful 7lb 4 oz baby boy with no problems! The baby did a long arc rotation on the mother's perineum (basically the baby did a complete turn from sunny-side up to looking down prior to the head being born!). My student Amy (from MUSC) caught the baby and also did a fantastic job! I am including a pic of this mother in today's blog. It looks like May is going to be pretty busy as well. We have one planned water-birth which should be super fun! We have had many patients recently ask if we do water-births at our practice. We most certainly do, the only kicker is you would have to bring your own tub. The good news is the birthing tub kits that are mostly found online are relatively cheap (about $100.00), good quality, and easy to assemble. I have done several water-births and find that the mothers consistently say that the water is great for pain management! Also, if you think about it--the baby lives in a bag of water and being born into the water makes for a very smooth transition from the womb to the outside world.

Welcome our Easter Bunny!

Introducing to you our Easter baby! "Bri" delivered at 0117 this morning! Congrats Latoya Davis! What a beautiful birth!


Abriauna "Bri"weighing 6lbs 13 oz 19 3/4 inches long

Happy Easter!

Just some quick news for your Easter Weekend...

I am on call for the weekend and will be attending Easter Morning Sunrise Service at the Baptist Church here in Bamberg...that's if my current patient that is three days overdue doesn't deliver! It might be nice to have a baby Easter bunny for Easter...:)

Our Lab Tech here at the office, Olivia, has asked me to let everyone know that she is interested in doing some pregnancy/baby photography for anyone who is interested! She is a photographer in training and would love the practice! She has taken some photography courses in the past and is continuting to sharpen her skills! Please let me know if anyone would be interested! She is unsure at the moment about pricing since she is just getting started. She said she is definately reasonable and willing to negotiate!

The Challenges of a Midwife.

The past week has been a hard week. It seems as though when things happen in the OB community they tend to happen in three's. It makes me grimace at the heartache that some of my patient's have experienced this week. Everything seemed to start unraveling at the seams on Thursday night a week ago..actually 3 am Friday morning. I was awakened to a telephone ring from a nurse in the ER. She said a patient of mine was requesting to see me. I figured the news wouldn't be good as the patient was in her 1st trimester of pregnancy. When I entered the ER suite I found my patient sobbing. Before I could embrace her with a hug she handed me a speciman cup. I knew what was in the cup before I made myself look. In the cup was a perfectly formed 8-9 wk fetus. I have never seen something so incredibly intricate and amazingily designed...pure perfection. In school we are trained to catch babies and provide women's healthcare. Why no lecture on how to help a woman cope with a loss of a baby? What about the sad part of nurse midwifery? I know it makes us all (as nurse midwives) sad and uncomfortable to discuss this type of loss but I think it would definately help us in the long run...if nothing else benefit our patients.
Unfortunately, things kept unraveling after Friday. Monday, I found out that one of my home birthing clients lost her full term baby. She delivered in Columbia and there was no clear explanation as to why. On Tuesday, I found out one of my patients was in an accident and too lost her baby. My midwifery partner, Leigh, and our midwifery student, Amy, attended this birth. This wasn't a fun week of midwifery--this was a sad and challenging week. I struggle with what to say....The love that midwives share for their patients (and their unborn babies) can not possibly be put into words on a page.

Wednesday News

First, I would like to thank my moms for submitting birthing stories and pictures for the website! I am in the process of posting these updates! The birthing stories have been amazing and the pictures are simply perfect! I am so blessed! The website is constantly a work in process and I am doing my very best to keep it updated! Continue to keep checking out the website to see these updates! Also, if anyone has any suggestions about additional areas of interest they would like to see on the website or topics for me to blog about please e-mail me. I am up for suggestions!

An exciting tid-bit from here at the midwifery practice! We have two moms (to be) that are pregnant with multiples!:) Leigh and I are getting our catcher's mits ready and praying that our moms will make it full term. Here in Bamberg, we are equipped for twin births if the mothers makes it full term and encounter no complications during the pregnancy course. We do know that one set is identical twin boys. So, please keep these mothers in your prayers!

Some news from me personally...I am debating on going back to Haiti at some point this year. I am not sure if I will financially be able to make this trip, but I am pondering the idea and praying about it! As many of you know, I have a heart for overseas missions. The organization I would be going through would be Midwives for Haiti. This organization works with Haitian midwives--equipping them to safely deliver babies (many of them at home as many of the midwives are very far away from a local hospital and have no transportation.) On my last trip in 2007, I had the opportunity to work with the first graduating class for the organization. The midwives are so eager to learn and desperatley want to be safe and efficient at midwifery. I also had the chance to catch a baby or two which was super fun and exciting! How many American midwives can say they caught a baby...in Haiti! :) Here are some statistics about childbirth in Haiti. In Haiti, 76% of all deliveries are done by non-qualified persons, contributing to the highest infant and maternal mortality in the western hemisphere. 15% of newborns have low birth weight and 25% of the children suffer from chronic malnutrition. The World Health Organization has estimated that the things professional midwives know how to do - preventative prenatal care, handling complications of pregnancy and birth, and teaching nutrition –could totally change these statistics! :) So, (as you can see) this organization is much needed! I am so happy to have had the opportunity to be a part of this organization! I will keep you posted about any possible plans about going back! I am enclosing one of my most favorite pics from my trip back in 2007.

Help Needed!

Ok, so I am winding down my work week and crossing my fingers that I will get to catch a baby this weekend. Funny how you really miss catching after an extended period of time without any births. My midwife partner (Leigh) caught the last two, so now I think it is my turn! I am doing some updates on the website wwww.bambergmidwifery.com (for those of you who read my blog through the blogging website). I am in need of more Bamberg birthing stories. I have had several people through the website e-mail me to tell me how much they enjoyed reading the intimate details of births that have taken place here in Bamberg. If any of my dear patient's are reading--please feel free to submit! Also, I would LOVE to have more pictures to display on the website! So moms and dads get on the ball and e-mail me some pics of your offspring! :) I am attaching a super cool article that was forwarded to me through facebook--please do read!

Article


His big hand holds a tiny one as Robbie Goodrich sings in a deep voice, soothing his infant son Moses. The little guy observes his father's every move, focusing on his lips that produce those comforting sounds. Watching him, one may wonder how much 2-month-old Moses already knows about the bittersweet beginning of his life.

Charles Moses Martin Goodrich was born at 3:26 a.m. Jan. 11 at Marquette General Hospital. Eleven hours after giving birth, his mother Susan Goodrich, 46, died of amniotic fluid embolism - a rare obstetric emergency that is not age-related, Goodrich said. Moses is the Goodrich's second child - Julia was born in 2007 - and Susan's fourth. Still in shock over his wife's death, Goodrich realized he had to figure out a way to feed his newborn son.

"They didn't carry any breast milk," the history professor said about the hospital, so a nurse looked into getting some for Moses. As it turned out, the nearest place to get breast milk was in Kalamazoo, and it would take several days to have it delivered to Marquette.

In the meantime, Goodrich received a phone call from family friend Laura Janowski of Marquette, who was still nursing her fourth child, 1-year-old Emily. In her message, Janowski offered Goodrich to nurse Moses.

"That's when it clicked in my head," he said. "I wanted the baby to be nursed. That's something that Susan would have wanted."

One thing led to another when family friend Nicoletta Fraire of Marquette began organizing a group of women who may want to help feed Moses.

"Basically, a couple of phone calls were enough," she said. "I just had to leave my name and phone number and calls started to come in."

She also made contact with Sally Keskey, founder of the Yooper Nursers - a local breast feeding support group. Within a brief time, nearly 20 women were found who offered to breast-feed Moses. Many of them belong to the support group and had never met the Goodrich family before.

"These women are advocates of breast feeding," Goodrich said.

A schedule was put together with feeding times at 9 a.m., noon, 1:30 , 4 , 6:30 and 8 p.m. Six times a day a different mother has been feeding Moses for the past two months. During the night, Goodrich bottle-feeds his son breast milk that was pumped by the women.

"What amazes me is they are so committed," Fraire said. "They would do it for anyone because they believe in this. They didn't take it lightly and they don't miss a day."

Goodrich added: "It's commitment, passion - it's love. It's an act of love."

What these women are doing "is an example of group cross-nursing," Goodrich explained. "It's organized. That's what you don't find anymore."

Goodrich and Fraire did some research to find similar groups in the United States. They were not successful. They heard of friends sharing their babies, which is called cross-nursing, and of course wet nurses get paid for nursing someone else's baby.

"The first literary reference in western literature to wet nursing is Moses' (biblical) story," Goodrich said.

In the beginning, Goodrich and Fraire discussed whether they should have the women tested to be sure they are healthy. In the end, "we just decided to trust them," Fraire said. "The women deeply care about their health and the health of their babies."

And so far, their trust has been validated. Moses has not been sick since he was born.

"He's getting the strongest mix of antibodies in the county," Goodrich said.

But being fed and healthy aren't the only benefits for Moses, his father said.

"It's about the nurturing aspect, being held," he said. "He is happy. He rarely cries."

Goodrich said having the women come to his house to nurse Moses, often bringing their own children, has been good for him.

"These are deeply caring individuals who spend time and work with me," he said. "They've all treated me with the utmost graciousness and empathy."

Goodrich said, if he can find enough mothers willing to provide breast milk, he hopes to continue nursing Moses until he is a year old.

The battle of the bulge...

Living in the South seems to go hand in hand with obesity. We can't seem to get enough of sweet tea, fried foods, and lots of sweets! I have noticed that in my personal social circle and in my midwifery practice that people are getting bigger--unfortunately, it's not muscle mass they are gaining it's body fat. It is estimated that nearly two-thirds of Americans are considered overweight and one in three are obese, meaning they have a body mass index of 30 or greater. Since more and more Americans are obese we (as midwives) are now beginning to see the effects of obesity on the childbearing woman. Compared with normal-weight women, obese women have a greater risk of developing complications during pregnancy. Their babies are also more likely to be admitted to neonatal intensive care units. I have spent today(during my spare time:) researching the complications of obesity in women's health and childbirth.

To begin with, I found that obesity contributes to infertility. Research has shown that women who were severely obese were 43% less likely to achieve pregnancy than normal-weight women or women who were considered overweight but not obese. While your ovaries are trying to behave and cycle normally, the steady input of estrone (a type of estrogen created from fat cells) will interfere blunting the peaks and valleys of the ovary's function, which ultimately interferes with ovulation and can cause infertility.

Secondly, I found out that women who are obese are more likely to have C-Sections. There are several reasons why obesity increases the chance of a C-section. One of these is a longer labor time. A University of North Carolina at Chapel Hill study showed larger women have naturally longer active labors – defined as the time going from 4 centimeters to 10 – between one and one and a half hours longer. The study goes on to say that many of these women, if allowed to continue to progress, can have successful vaginal births, but many physicians are unaware of this study, so women who could probably deliver vaginally instead end up on the operating table because they exceed the usual time limits for labor. Another reason for C-sections is that larger women also often have larger babies, either because of gestational diabetes, genetic reasons or because of weight gain during pregnancy, and larger babies are more difficult to deliver vaginally.

Thirdly, I found that obesity is linked to neural tube defects. The most common neural tube defect is spina bifida, which is the leading cause of childhood paralysis. The research suggests a doubling of risk for babies born to obese women, compared with those born to normal-weight women. And while folic acid supplementation helps protect against this birth defect, obese women who get enough folic acid are still twice as likely as normal-weight women who also get enough to deliver babies with neural tube defects.

Lastly, I found that obesity is obviously correlated to hypertension and gestaional diabetes during pregnancy.

I now realize that I must make more of an effort in taking a direct approach in assessing my clients healthcare risk. Even though I find myself at times uncomfortable with discussing the topic of obesity, I must do what's best for the wellbeing of my mothers.

Wordless Wednesday

I have been pondering in the past ten days about what I should blog about. I have considered everything from V-BACs to cloth diapers. Rest assured, these topics will eventually be blogged. While seeing a patient today, I realized there is a topic that is much more important to be blogged on. Intially, this question may appear a bit simple and rudimentary. What is a Certified Nurse Midwife? Many people (unfortunately) don't know the answer. Ok, so back to my story about seeing the patient earlier today. Earlier this morning I saw one of my patients from Beaufort. We were talking while I measured her fundus (top of her uterus) and listened to the baby's heartbeat. I could tell that something was bothering her so I questioned what was on her mind. She said she was tired of having to explain to friends and family members what a Certified Nurse Midwife was. I thought to myself, "You and me both!" She said that the simple mention of the name "midwife" automatically had people raising eyebrows and saying, "Oh, yea that sounds really risky" or "I didn't know midwives even existed anymore." At times, (I as a nurse midwife) feel like people think I have a mysterious job or don't just quite "get it." You can alomost see the wheels turning when you explain you deliver babies for a living and provide women's healthcare and you are not an OBGYN. I remember when I was in grad. school at MUSC and my professor Lee Horton told us that there was one thing that we as upcoming Certified Nurse Midwives must get used to--no one will ever truly understand what it is a nurse midwife does. How incredibly true this statement still remains. I feel like everytime someone ask me what I do for a living I have to go into a spill about my job role. How amazingily inviting it is when I meet someone who actually knows what a nurse midwife is! Sometimes I wish I could remain wordless and just present a book entitled, This is What I do . Included in the book would be the following information: No, I am not a Labor and Delivery Nurse, Yes we actually deliver the baby (not the MD, actually the MD isn't usually even there unless we need him ie C-section, assisted deliveries, etc ), Yes I can write prescriptions, yes we still exist, no I don't deliver babies at home (although Licensed Midwives do!), yes I see my own patients, and no I didn't consider going to medical school. Sometimes, it is hard to even put words as a defination to a job title. So much of midwifery is an art--a true longing to be "with woman." I guess my upmost desire would be for the United States to have a better understanding of what midwifery is. So, I guess for that to happen I can't remain wordless....

A Gift.

Two weeks ago for the first time I was involved with the delivery of a baby diagnosed with Down Syndrome. His name was Daniel. Daniel had the strongest spirit and will to live that I have ever experienced in a newly born babe. Daniel is now stable at Richland Hospital. After this amazing experience, I began to think more about what it would be like to have a child with Down Syndrome. My dear friend Mike would like to share with you his personal experience with his beloved Kiernan.

By Mike Burgess:
My son is perfect. He has the most beautiful eyes I’ve ever seen and a smile that could melt the heart of Satan himself. His laugh is infectious and my heart breaks every time he cries. He consumes every free moment I have and manages to soak through every brand of diaper on the market. He can suck down 40 ounces of formula in the course of 24 hours and still have room for his fruits and veggies four times a day. He weighs a ton and doesn’t like to be left alone for more than a few minutes. In my eyes, he’s just like every other infant I’ve ever met, with one small exception: Kiernan has Down syndrome.What does that mean? Nothing, really. He goes to the doctor a little more than other children, and some of his development is a little delayed. Beyond that, I view him no differently than I did my five siblings. He loves to beheld or rocked, and normally he is comatose the minute the car starts moving. If he can hold something, then it invariably ends up in his mouth. He discovered his volume control at the most inopportune moment, cooing at the top of his lungs in the middle of a crowded restaurant. He has learned the game of fetch, knowing that if he throws his toys that daddy will pick them up and give them back to him. For me, he is just a little boy, and the center of his daddy’s universe.And yet, when others find out that he has Down syndrome, they are conflicted. Some extend their apologies. Others babble on about how he “looks so normal”. A third group feels the need to recount a story about the special needs child of a friend of a friend with whom they are acquainted. My favorite, though, are those who respond with a simple “so” or “okay”, and move on. For me, they get it. They realize that yes, things may be a little different for Kiernan, but that’s okay. He’ll grow up just like everyone else. He’ll fall in and out of love, he’ll screw up, he’ll succeed, he’ll be embarrassed by his parents. He’ll go to school, he’ll make friends, and he’ll even make enemies. Most importantly, he’ll live. Ultimately, that’s what we all want: to live life. And that’s what I’ve promised to my son: to help him live his life to the fullest, whatever it takes.

Should I Vaccinate My Baby?

This is the question I am daily asked when seeing my newly born neonate patients. During the past three years I have noticed a progressive fear towards vaccines that seem to be overcoming my new mothers. Being that I see the babies that I deliver for the first couple of months, I have made an effort to more adequately understand vaccines. Here is some interesting information that I have learned. Before I start, I must give a disclaimer and say that I respect and believe that everyone has the right to their own opinion.

I have often wondered where and when vaccines came about. There is kinda a funny story as to where the name "vaccine" actually came from. Vaccines all started in the 1700's with Edward Jenner and a milkmaid. Jenner noticed a relationship between the disease known as "grease" and a disease known as "cow pox." He saw that farmers who treated horses with grease lesions often saw the development of cow pox in their cows, complete with blisters similar to those seen in smallpox infection. Unlike lethal smallpox, however, the cowpox blisters eventually disappeared, leaving only a small scar at the site of each blister. Jenner became intrigued when a milkmaid told him that she could not catch smallpox because she had had cowpox. Jenner then began to notice that there were many people like the milkmaid. With this in mind, Jenner undertook a daring experiment in 1796: he infected a young boy with cowpox in hopes of preventing subsequent smallpox infection. After allowing the boy to recover fully from cowpox, Jenner - in an experiment that would be considered unethical by today's scientific community - intentionally infected the boy with smallpox by injecting pus from a smallpox lesion directly under his skin. As Jenner had predicted, the boy did not contract smallpox.

Ok lets fastforwad to 1999- a cable news network aired a program on which the parents of three-year-old stated that he had developed autism two weeks after receiving measles, mumps and rubella (MMR) vaccine. An American Academy of Pediatrics official explained why there was no reason to believe that a link exists between autism and vaccination. However, dramatic before-and-after videotapes of the child probably had enough impact to persuade many parents to avoid having their children vaccinated. The program's narrator stated there had been "a puzzling jump in the number of children being diagnosed with autism." However, the number being diagnosed may reflect increased reporting of cases rather than an increase in actual incidence.

Some parents of children with autism believe that there is a link between measles, mumps, rubella (MMR) vaccine and autism. Typically, symptoms of autism are first noted by parents as their child begins to have difficulty with delays in speaking after age one. MMR vaccine is first given to children at 12-15 months of age. Since this is also an age when autism commonly becomes apparent, it is not surprising that autism follows MMR immunization in some cases. However, the most logical explanation is coincidence, not cause-and-effect.

If measles vaccine or any other vaccine causes autism, it would have to be a very rare occurrence, because millions of children have received vaccines without ill health effects. The only evidence linking MMR vaccine and autism was published in the British journal Lancet in 1998. An editorial published in the same issue, however, discussed concerns about the validity of the study. Based on data from 12 patients, Dr. Andrew Wakefield (a British gastroenterologist) and colleagues speculated that MMR vaccine may have been the possible cause of bowel problems which led to a decreased absorption of essential vitamins and nutrients which resulted in developmental disorders like autism. No scientific analyses were reported, however, to substantiate the theory. Whether this series of 12 cases represent an unusual or unique clinical syndrome is difficult to judge without knowing the size of the patient population and time period over which the cases were identified. If there happened to be selective referral of patients with autism to the researchers' practice, for example, the reported case series may simply reflect such referral bias. Moreover, the theory that autism may be caused by poor absorption of nutrients due to bowel inflammation is not supported by the clinical data. In at least 4 of the 12 cases, behavioral problems appeared before the onset of symptoms of inflammatory bowel disease. Furthermore, since publication of their original report in February of 1998, Wakefield and colleagues have published another study in which highly specific laboratory assays in patients with inflammatory bowel disease, the posited mechanism for autism after MMR vaccination, were negative for the measles virus.

Hmm...
One question I am asking myself...the known number of Autism cases has been increasing since 1979, but why was there no jump after the introduction of MMR vaccine in 1988? Interesting food for thought..

Ok, so now..what about the Diptheria, Tetanus, and Pertusis vaccine? And the oral polio vaccine? In January 1990, an Institute of Medicine committee examining possible health effects associated with DPT vaccine concluded that there was no evidence to indicate a causal relation between DPT vaccine or the pertussis component of DPT vaccine and autism. Also, data obtained from CDC's Monitoring System for Adverse Events Following Immunization system, showed no reports of autism occurring within 28 days of DPT immunization from 1978-1990, a period in which approximately 80.1 million doses of DPT vaccine were administered in the United States. From January 1990 through February 1998, only 15 cases of autism behavior disorder after immunization were reported to the Vaccine Adverse Events Reporting System. Because of the small number of reports over an 8-year period, the cases reported are likely to represent unrelated chance occurrences that happened around the time of vaccination.

Ok...so now I guess you are thinking I am hard core on vaccinations! Actually, I prefer the more middle of the road approach so to speak....I believe vaccines are very important and have played a tremendous role in limiting many serious diseases in our country. However, more and more parents are concerned and want to take an approach that varies from the regular CDC schedule. I believe that if more and more doctors offer parents such options, we will have better vaccination rates than we are seeing now. Some options for parents...

Don’t give the Hepatitis B vaccine to newborns in the hospital.This shot can cause fever, lethargy, and poor feeding (problems you don’t want to see in a newborn),one could delay this shot until the first two months of life, especially since the disease doesn’t even occur in newborns (it’s a sexually-transmitted disease).

Checking “titers” (blood immunity levels) for various shots before doing boosters. Some kids don’t need some of the booster shots at age 5 years because their original infant series may still be working just fine. While this is a costly and time-consuming approach, some parents prefer it instead of automatically getting all the boosters.

Getting fewer shots at each infant checkup and spreading the shots out over more time. This is the hallmark of Dr. Sear's Alternative Vaccine Schedule. I reallllly like this schedule! The MMR is the most criticized culprits of autism, but this schedule divides them up at 1, 2, and 3 years old.

Limiting large combination shots. Some parents prefer to split some of the combo shots into separate components to decrease the chance of a reaction. While we don’t know if this precaution even helps, it is an option that some doctors like to provide for concerned parents.

The bottom line is that more and more parents want options. If we don’t provide them with options they are comfortable with, more parents will opt out of vaccines altogether. We will then see more and more disease fatalities and complications.

Mother's Millk

I just read the most interesting article that my midwife partner Leigh forwarded to me. The article was a short write-up on Salma Hayek sharing her breast milk. The video can be found on You Tube if anyone is interested. The video shows Salma Hayek breastfeeding a small African child. I have felt a bit discouraged lately about mom's not wanting to breastfeed. Last weekend I so desperatetly tried to persuade one of my clients to breastfeed her newly born baby. Every time I helped the baby to the breast the mother frowned saying, "my baby just doesn't like my milk." Wouldn't it be nice if all the mothers that breastfed could donate some extra milk to give to all the babies that are formula fed? Or, what if it was completely in the norm for people to breastfeed other people's babies? Here are the breastfeeding benefits from head to toe....

Brain. Higher IQ in breastfed children. Cholesterol and other types of fat in human milk support the growth of nerve tissue.

Eyes. Visual acuity is higher in babies fed human milk.

Ears. Breastfed babies get fewer ear infections.

Mouth. Less need for orthodontics in children breastfed more than a year. Improved muscle development of face from suckling at the breast. Subtle changes in the taste of human milk prepare babies to accept a variety of solid foods.

Throat. Children who are breastfed are less likely to require tonsillectomies.

Respiratory system. Evidence shows that breastfed babies have fewer and less severe upper respiratory infections, less wheezing, less pneumonia and less influenza.

Heart and circulatory system. Evidence suggests that breastfed children may have lower cholesterol as adults. Heart rates are lower in breastfed infants.

Digestive system. Less diarrhea, fewer gastrointestinal infections in babies who are breastfeeding. Six months or more of exclusive breastfeeding reduces risk of food allergies. Also, less risk of Crohn's disease and ulcerative colitis in adulthood.

Immune system. Breastfed babies respond better to vaccinations. Human milk helps to mature baby's own immune system. Breastfeeding decreases the risk of childhood cancer.

Endocrine system. Reduced risk of getting diabetes.

Kidneys. With less salt and less protein, human milk is easier on a baby's kidneys.

Appendix. Children with acute appendicitis are less likely to have been breastfed.

Urinary tract. Fewer infections in breastfed infants.

Joints and muscles. Juvenile rheumatoid arthritis is less common in children who were breastfed.

Skin. Less allergic eczema in breastfed infants.

Growth. Breastfed babies are leaner at one year of age and less likely to be obese later in life.

Bowels. Less constipation. Stools of breastfed babies have a less-offensive odor.

Oh, if some of my mothers would just give it a chance...

Exam Room Face-Lift

Thanks to my dear friends Jeremy, Rachel, and Jonathan my exam room is looking better than ever! We managed to pull the wallpaper down (which was NOT an easy feat!) and repaint the room in a beautiful light blue/purple color! Last weekend, we completed the daunting task of painting the trim in a bright white. What a difference a fresh coat of paint makes! I have such good friends! We are now in the process of putting our brains together to create a cost-effective way to give the OB waiting room a face-lift...any ideas!? We will most likely get started on this project next month! I am thinking that we will probably take down the wallpaper and paint the walls in another warm color...also--some new toys, pictures on the walls, and maybe some new chairs...I will keep you posted!

25 random things about me...

1. i have pondered the possibility of doing overseas missions.
2. i have a huge weakness for black babies...i can't help it, black babies are so much more cuter than white babies.
3. i am wearing my converse... at work.
4. my parents gave me a motorcycle in the 6th grade...hence my love for motorcycle riding!
5. i grew up on a farm with cows.
6. i have to have 1 cup of coffee each morning while i watch the NBC today show.
7. i reallly realllly want to be a wife and a mother...
8. i have a weakness for tattoos. i have four. i also have a weakness for tattooed men..hubbba hubbba.
9. i accepted Christ when I was in the 4th grade.
10.when i was in college i dreamed of becoming a full-time roadie for a rock band.
11.i delivered my best friend's baby.
12.i once shared fondue with ina may gaskin. thanks carey.
13.i worked in an arcade in college.
14.i would really like to be someone's valentine.
15.i love the book of philippians.
16.i am currently living in two places.
17.i love weiner dogs.
18.i once gave sarah mclachlan a hug.
19.i was just in the hospital for 6 days for sepsis.
20.i am slightly OCD when it comes to cleaning my house.
21.i sometimes wish i could have dread-locks.
22.my most favorite past-time is to go to concerts.
23.i once assisted with amputaing a leg in africa.
24.i love to eat.
25.my right arm is really sore from playing wii bowling all weekend.

Whoa!

I can't believe it has been almost a month since I have last written! December and January have definately brought life challenges that I certainly did not expect! The bumps in the road all started about two days after my last blog. I had layed down to nap after church on Sunday and awoke to the worst pain I have ever experienced! I could barely walk and found myself vomiting more than I thought humanly possible! After three hours my mom rushed me to the hospital and I was diagnosed with a complete blockage of my left ureter (connecting port between kidney and bladder). The doctor said that since my left kidney was not functioning I would have to have surgery to remove the blockage and have a stent placed. The surgery went beautifully and I was sent home the following day. All was fine until the stent was pulled...that's when things went down hill! I traveled back to Bamberg to return to work a couple hours after the stent removal and I felt so good! It's amazing how your world can be totally rocked in a matter of hours! Literally 8 hours after the removal of the stent I awoke to a fever of 105. I thought I was dying...like something was taking over my body. I couldn't stop shaking and I felt like my head was going to explode! I must stop here and say I have the BEST friends in the world. The Lord is so good! I called my friend Heather at 3am and she drove me to Columbia to meet my mother...who once again rushed me to the hospital. My doctor admitted me and I was later diagnosed with sepsis. Had I gone on much longer in this state, I would have died. I praise God for specialized healthcare providers and for the healthcare in the United States. Long story short, after 6 days in the hospital I am out and feeling better than ever!!! I have a new appreciation for life and also an amazing awareness about how fragile life is! God is so good!

Update on Bamberg...

I started back to work in Bamberg this past Monday. I can't believe it, but this month marks my third year as a Certified Nurse Midwife. I must say, my job never gets old! I have a job that I look forward to going to each and every day. The people I work with are amazing in so many ways. I am so proud to be a part of the ministry they provide for the area. I am also so excited because we are so busy! Our volume has picked up without a doubt and Leigh and I have a very busy year in store! I am so excited! As I look back on the past three years, I think of the first baby I ever delivered as a Certified Nurse Midwife. I also think of all of the special deliveries since....I would like to share some of my memories with you...enjoy!!!! Alot of the mothers in the pictures are now my most dearest friends! I am so blessed!

-Baby-Catcha