Apparently I'm on a posting roll tonight...
Did you know that CBS Midwifery in Manhattan posts all their stats for the previous year? An excerpt from 2009's:
Vaginal deliveries 80 = 88%
Normal spontaneous vaginal 76= 95%
Vacuum extraction 4 = 5%
Vaginal births after previous C/S 8 successful out of 9 attempts = 88%
Furthermore, they deliver babies at the in-hospital birth center at St. Luke's Roosevelt. A common complaint I have heard from doulas is that their clients expect to use the birth center, and are either risked out before labor ever begins, and sometimes during labor and then they are sent to L&D. Or they get there and are told the birth center is full. So I liked even more that the midwives make that piece transparent too:
Women who wanted Birth Center and were eligible at term = 68
43 - delivered Birth Center = 63%
24 - Transferred to Labor & Delivery in labor = 35%
1- Birth Center full- had to deliver on L&D = 2%
They also provide stats on degrees of perineal trauma, meds, reasons for c-sections...
Imagine if every practice did this! How amazing would it be to be able to compare this information when looking for a care provider?
What are practices out there that you know of that make some or most of their stats available to consumers?
Tuesday, July 27, 2010
Doula memories
I've been puttering around today, catching up on some of the things I put off while getting ready for the exam. Some of my friends have been talking birth stories/birth plans lately and we talked a bit about wanting positive hospital birth stories since there are so many scary ones out there and yet there CAN be such lovely births at the hospital.
I started thinking about a birth I attended back when I was in AmeriCorps and went searching through my old birth stories (we wrote one up for each birth we attended, and when I left I kept a copy of all of mine and am SO glad I did - they are wonderful to look back through) to find what I wrote about it at the time. And I cannot for the life of me find it. I must have missed it when I was making my copies.
So, without that sheet of paper I can't remember all the information about the birth, like whether mom had an epidural or not, what # baby this was for her, even whether baby was a boy or girl! But I do remember that the family had a few older children, some of whom were present, and that they were very positive, friendly people - I really enjoyed being at the birth with them. There was a recently hired (but experienced) midwife at this hospital that I hadn't worked with before* and she was the midwife on all day as mom labored and I worked with her.
As the birth grew nearer, and mom was working hard and pushing, the midwife beckoned the dad over to where she was keeping an eye on the perineum. Baby began to crown and she said to dad, "Come here. Give me your hands." As the baby's head emerged, she laid his hands on the baby's head and guided him in catching his own baby - the first person ever to lay hands on his child. I watched his eyes widen, his face about to split apart with a smile as he did it. Together they handed baby to mom and she cuddled her new baby as they got baby cleaned off.
Afterwards, dad was just glowing, literally bouncing around the room, still unable to wipe that huge grin off his face. "Did you see that?" he kept asking everyone there. "Did you see what I did? That was amazing! It was AMAZING!"
It was even neater - to me - because these were not people who had sought out midwives to get greater control over the birth process. They were community health center patients who just needed quality affordable prenatal care, and ended up working with midwives because that's who did the births for the CHC at that hospital. And they were handed this really amazing gift of participating more fully in their child's birth.
Later the midwife told me that she had been watching me work with the mom all day, and had been going to offer ME the chance to help catch the baby, but could tell how excited the dad would be to do it. I was bowled over by that! I told her I was so glad she had the dad catch. I was just there for one day, but I hope that every year on this baby's birthday, that dad is still telling his child the story of how he helped catch him/her, and how proud he was to do it.
So that's your wonderful hospital birth story of the day, courtesy of my free association skills!
*Do any other doulas have the experience with new-to-the-system midwives that they're such a breath of fresh air? They haven't gotten trampled down by the system yet, they're not looking over their shoulders at the nurse who might "turn them in", they're just practicing how they want to practice. That's not to say that experienced midwives who know how to work the system aren't fabulous and valuable and just as subversive in their own ways - if not more - but being with a new midwife can be so...liberating.
I started thinking about a birth I attended back when I was in AmeriCorps and went searching through my old birth stories (we wrote one up for each birth we attended, and when I left I kept a copy of all of mine and am SO glad I did - they are wonderful to look back through) to find what I wrote about it at the time. And I cannot for the life of me find it. I must have missed it when I was making my copies.
So, without that sheet of paper I can't remember all the information about the birth, like whether mom had an epidural or not, what # baby this was for her, even whether baby was a boy or girl! But I do remember that the family had a few older children, some of whom were present, and that they were very positive, friendly people - I really enjoyed being at the birth with them. There was a recently hired (but experienced) midwife at this hospital that I hadn't worked with before* and she was the midwife on all day as mom labored and I worked with her.
As the birth grew nearer, and mom was working hard and pushing, the midwife beckoned the dad over to where she was keeping an eye on the perineum. Baby began to crown and she said to dad, "Come here. Give me your hands." As the baby's head emerged, she laid his hands on the baby's head and guided him in catching his own baby - the first person ever to lay hands on his child. I watched his eyes widen, his face about to split apart with a smile as he did it. Together they handed baby to mom and she cuddled her new baby as they got baby cleaned off.
Afterwards, dad was just glowing, literally bouncing around the room, still unable to wipe that huge grin off his face. "Did you see that?" he kept asking everyone there. "Did you see what I did? That was amazing! It was AMAZING!"
It was even neater - to me - because these were not people who had sought out midwives to get greater control over the birth process. They were community health center patients who just needed quality affordable prenatal care, and ended up working with midwives because that's who did the births for the CHC at that hospital. And they were handed this really amazing gift of participating more fully in their child's birth.
Later the midwife told me that she had been watching me work with the mom all day, and had been going to offer ME the chance to help catch the baby, but could tell how excited the dad would be to do it. I was bowled over by that! I told her I was so glad she had the dad catch. I was just there for one day, but I hope that every year on this baby's birthday, that dad is still telling his child the story of how he helped catch him/her, and how proud he was to do it.
So that's your wonderful hospital birth story of the day, courtesy of my free association skills!
*Do any other doulas have the experience with new-to-the-system midwives that they're such a breath of fresh air? They haven't gotten trampled down by the system yet, they're not looking over their shoulders at the nurse who might "turn them in", they're just practicing how they want to practice. That's not to say that experienced midwives who know how to work the system aren't fabulous and valuable and just as subversive in their own ways - if not more - but being with a new midwife can be so...liberating.
IBCLC exam over!
DONE!! It was so hard to get to sleep the night before last. I kept thinking "I just wish I could take the test RIGHT NOW and get it over with." I woke up at 5 am and couldn't get back to sleep (which beats my classmate who woke up at 4 am and a study partner who claimed she didn't sleep all night). But once we were at the test center, in line waiting to show our IDs to register for the test, I wanted to slow down and let it all sink in for a moment. My dream, getting to sit for the IBCLC exam, coming true - it's still a little hard to believe.
Now it's all over but the waiting...for the results. I understand in principle why it takes IBLCE sooo long to get the test results back to us. But the end of October? In practice, this is very hard. (It's obviously payback for all my whining and moaning about the GRE being on a computer, and set up so you couldn't skip questions you weren't sure about and go back to them later. While I am VERY glad I could go back on the IBCLC exam - I think I went through both morning and afternoon test booklets at least 3 times each re-reading every question - I have to admit it was pretty nice to get the GRE results instantly.)
And while I think I did reasonably well on the exam, it's so easy to doubt. What if I fail it by a question? What if all the questions I challenged were the ones I got RIGHT? What am I going to tell people November 1st if I fail? I pingpong back and forth between guarded optimism and the prospect of having to actually admit to people that it didn't turn out the way I'd hoped. If you all could do me a favor and forget that I ever took this exam, and not ever ask me about it again, just in case - thanks!
Now it's all over but the waiting...for the results. I understand in principle why it takes IBLCE sooo long to get the test results back to us. But the end of October? In practice, this is very hard. (It's obviously payback for all my whining and moaning about the GRE being on a computer, and set up so you couldn't skip questions you weren't sure about and go back to them later. While I am VERY glad I could go back on the IBCLC exam - I think I went through both morning and afternoon test booklets at least 3 times each re-reading every question - I have to admit it was pretty nice to get the GRE results instantly.)
And while I think I did reasonably well on the exam, it's so easy to doubt. What if I fail it by a question? What if all the questions I challenged were the ones I got RIGHT? What am I going to tell people November 1st if I fail? I pingpong back and forth between guarded optimism and the prospect of having to actually admit to people that it didn't turn out the way I'd hoped. If you all could do me a favor and forget that I ever took this exam, and not ever ask me about it again, just in case - thanks!
Thursday, July 22, 2010
LC Exam minus 3
ACOG lessens (kinda) restrictions on VBACS, stories are written on shackling during labor, and posts are written on the delicate balance to strike when calling out misinformation in "failed" lactation stores, and I don't have time to write about any of it because am studying for the IBCLC exam which is happening! on! Monday!
I am anxious. I am taking practice tests and reviewing flashcards. I am reviewing chapters on immunology and jaundice and developmental milestones. I am arguing with the answers on the practice tests. I am carpooling to the exam with some other test-takers and we have already plotted out our route to avoid the main highway because what if a tractor-trailer jackknifes and we are stuck in traffic and OMFG WE MISS THE TEST. As you can see, I am ready for this to be done!
So if you see me posting on this blog or anyone else's in the next few days, tell me to go back to studying! And in the meantime click the links above for some awesomeness...
I am anxious. I am taking practice tests and reviewing flashcards. I am reviewing chapters on immunology and jaundice and developmental milestones. I am arguing with the answers on the practice tests. I am carpooling to the exam with some other test-takers and we have already plotted out our route to avoid the main highway because what if a tractor-trailer jackknifes and we are stuck in traffic and OMFG WE MISS THE TEST. As you can see, I am ready for this to be done!
So if you see me posting on this blog or anyone else's in the next few days, tell me to go back to studying! And in the meantime click the links above for some awesomeness...
Thursday, July 15, 2010
Michelle Obama on the importance of breastfeeding
From Michelle Obama's speech at the NAACP National Convention, July 12:
And finally, it’s one thing we can think about, is working to make sure that our kids get a healthy start from the beginning, by promoting breastfeeding in our communities. (Applause.) One thing we do know is that babies that are breastfed are less likely to be obese as children, but 40 percent of African American babies are never breastfed at all, not even during the first weeks of their lives.
And we know this isn’t possible or practical for some moms, but we’ve got a WIC program that’s providing new support to low-income moms who want to try so that they get the support they need.
And under the new health care legislation, businesses will now have to accommodate mothers who want to continue breastfeeding once they get back to work. (Applause.) Now, the men, you may not understand how important that is. (Laughter.) But trust me, it’s important to have a place to go.
I also heard recently that Michelle Obama's office has been talking to national breastfeeding organizations about incorporating breastfeeding support/advocacy into their "Let's Move" campaign. So exciting that she is finally talking about this!
Via Blacktating.
And finally, it’s one thing we can think about, is working to make sure that our kids get a healthy start from the beginning, by promoting breastfeeding in our communities. (Applause.) One thing we do know is that babies that are breastfed are less likely to be obese as children, but 40 percent of African American babies are never breastfed at all, not even during the first weeks of their lives.
And we know this isn’t possible or practical for some moms, but we’ve got a WIC program that’s providing new support to low-income moms who want to try so that they get the support they need.
And under the new health care legislation, businesses will now have to accommodate mothers who want to continue breastfeeding once they get back to work. (Applause.) Now, the men, you may not understand how important that is. (Laughter.) But trust me, it’s important to have a place to go.
I also heard recently that Michelle Obama's office has been talking to national breastfeeding organizations about incorporating breastfeeding support/advocacy into their "Let's Move" campaign. So exciting that she is finally talking about this!
Via Blacktating.
Wednesday, July 14, 2010
Alert, someone is wrong on the Internet!
Some discussion going on in the comments at Science and Sensibility's post on the new meta-analysis of home birth in AJOG. Aaaand I let myself get drawn in. Funny how that happens when I have about six other projects I could be working on. I trace it to a moment of intrigue when one of the commenters stated that the Netherlands has poorer perinatal outcomes than the rest of Europe both at home and in the hospital because there are so many midwives that there isn't enough emergency OB care/neonatal services even in the hospital. All those midwives, taking up space, and just no room for OBs or pediatricians! So I went and looked around for some published evidence on that, and all I found was a BMJ summary of a Dutch government report that recommended, among other things, better emergency OB availability in small community hospitals. I responded pointing out that the U.S. also lacks immediate emergency OB care in many small community hospitals and we can't really attribute that to a surplus of midwives. But heck, maybe this commenter knew something I didn't? Maybe they spent years as a maternity nurse in the Netherlands! Maybe they speak fluent Dutch and this is all over the Dutch perinatal literature! Who knows!
Sadly, the reply to that was basically a lot of name-calling accusing, apparently, all midwives everywhere of being shameful liars. I know, I know. Having (hopefully) extricated myself, I'll slink back to studying for the IBCLC exam. Eleven more days, ack!
In the meantime, if anyone has any actual insights over this whole Dutch emergency OB care thing, I'd be curious to know.
Sadly, the reply to that was basically a lot of name-calling accusing, apparently, all midwives everywhere of being shameful liars. I know, I know. Having (hopefully) extricated myself, I'll slink back to studying for the IBCLC exam. Eleven more days, ack!
In the meantime, if anyone has any actual insights over this whole Dutch emergency OB care thing, I'd be curious to know.
Monday, July 12, 2010
Breastfeeding support for women in the military
Just came across this site: Breastfeeding in Combat Boots. The website and the associated book answer questions like:
o How do I get breastfeeding off to a good start in only six short weeks?
o Can I pump while in the desert for training exercises?
o Is my pump allowed onboard ship?
o Do I need to pump and dump if I’ve been exposed to JP-8?
Questions like "Can I breastfeed while I'm in uniform?" might never occur to someone who's never been associated with the military and even those who are probably don't have a ready answer! If you are a mom on active duty in the military, or someone who works near a base or in a military hospital, take a look - you can even join the discussion on the forums.
o How do I get breastfeeding off to a good start in only six short weeks?
o Can I pump while in the desert for training exercises?
o Is my pump allowed onboard ship?
o Do I need to pump and dump if I’ve been exposed to JP-8?
Questions like "Can I breastfeed while I'm in uniform?" might never occur to someone who's never been associated with the military and even those who are probably don't have a ready answer! If you are a mom on active duty in the military, or someone who works near a base or in a military hospital, take a look - you can even join the discussion on the forums.
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