better beginnings

Thursday, July 19, 2012

Building Blocks for Birth

Building Blocks for Birth is a comprehensive prepared childbirth class. If you have never attended a childbirth class or perhaps just the short one at the hospital, you probably have quite a few questions.  Let's see if we can answer some here.  If you have any other questions, feel free to contact us.  

What happens in the class?
The course includes 18 hours of class time, plus about the same amount of time of homework (don't worry, it's not hard - no tests).   We promise to keep each class informative, enjoyable, and relevant. Each evening includes videos, discussion, relaxation, and laughing. Each class series is tailored to meet the specific needs of the attendees.  There are major topics that we always cover: Healthy Pregnancy, Understanding the Stages of Labor, Relaxation & Massage, Support Tips & Tools, Common Interventions, Birth Plans, Communicating with Care Providers, Planning for Breastfeeding, and Early Parenting.

Who attends the class? 
We encourage the expecting mom to attend all of the classes with anyone who plans to support you in labor.  This may be your husband, mother, sister and/or friend.  If you do not plan to have anyone with you at your baby's birth, that is fine. You can attend the class without a partner--even better, have one of us as your doula.   

Our classes usually have 2 to 5 couples from a variety of backgrounds. Some are expecting their first, others already have children. Some of our clients are planning a VBAC (vaginal birth after cesarean), a natural birth, or have a medical condition that makes their pregnancy higher risk than average.  All of our clients share common desires—to better understand labor & birth and be prepared for the many decision that await them.    

Our clients not infrequently travel quite some distance to attend our class.  If this class is a good fit for you, it is worth the drive from Mobile, Hattiesburg, or Slidell.  

How much does the class cost and what does that include?
The class costs $250.  That includes 18 hours of class time, usually with 2 instructors/facilitators.  You will receive 2 books to keep and make your own: The Official Lamaze Guide: Giving Birth with Confidence and Prepared Childbirth: The Family Way.  We also build a binder full of articles and images that complement our in-class topics.  Additionally, you will have access to our comprehensive library with books on a variety of topics, including: fertility, pregnancy, birth, breastfeeding, & parenting. As a client, you are welcome to contact us with questions or concerns throughout the remainder of your pregnancy.

After attending the class, we invite you to repeat the class at anytime in the future for NO CHARGE.  That could be stopping in for one session at the end of your pregnancy (for a re-cap) or attending the full series again with your next pregnancy.  

What if I can't afford the cost of the class? 
We firmly believe that preparing for the birth of your child by building knowledge, practicing skills, and developing a plan is critical to a happy, healthy, and empowered birth.  At a cost of $250, this class is a fantastic value. I took a peek over at the Babies R Us website and the average price of the top selling strollers is over $200.  If attending this class is important to you and your budget doesn’t allow for a $250 expense, we have some ideas to help.
  • Gift Registry:  This class is more important that half the things on your gift registry.  Add us to your registry.  Here is a great site that lets you register at your favorite stores, merge the registries online, and add things like our classes and doula services.
  • Payment Plan: Talk to us about a payment plan, we can most likely work something out based on your specific situation.
  • Bartering: If you have a service or product we could us, we may be open to exchanging.
  • Discount:  We offer a limited number of discounts each year.  We may be able to reduce the price of the class if you are truly in need. 

I'm still not sure if this class is for me? 
There are a couple of things we can offer to help.  We would love to meet with you in person for a free consultation.  When we meet, we are happy to answer any questions you may have and hope you have that “good fit” feeling.  If not, no hard feelings—really.  We offer these services to benefit our larger community and want you to get the most out of it.

Also, if you attend the first class and feel that it is just not what you are looking for, you can cancel and we will refund your money, minus the cost of materials.  (You must notify us that you want to cancel within 24 hours of the first class). 

I really want to attend the class, but my husband is not as interested.
It is normal for you to be soaking up everything baby-related you can get your hands on—good, bad, and otherwise.  You are, after all, constantly reminded of the life growing within your tummy with all of the kicks and wiggles.  Most husbands are not too excited about going to class, and some downright don't want to go.  We understand.  However, if he plans to be with you in labor and birth, he needs to prepare almost as much as you do.  He at least needs to know enough to be calm and supportive, both physically and emotionally.  You will need your “rock.”  As we said earlier, we keep the class fun.  We won't put anyone on the spot or ask anyone to do something they don't feel comfortable with.  We have had excellent feedback from the daddies that have attended our class. Watching the love of their life, in labor can be scary for dad.  We don't try and turn him into a doula, but we do work to eliminate the fear and validate his need to protect you in constructive ways. Our class prepares him, so that he knows what to realistically expect and can best support you.


{If you are a childbirth educator, doula or midwife or other birth professional or are a student in one of these fields, you are welcome to audit our class.  Please contact us to discuss}

Thursday, July 12, 2012

Hospital Plan v. Your Plan


Why You Need Independent Childbirth Classes

Hospital childbirth classes are usually free.  They cover hospital policy, mention comfort measures like breathing and massage, discuss the standard procedures when you arrive at the hospital, and let you know when you can get pain medication.  You see a labor and delivery room on a general tour.  Basically, they tell you what to expect when you arrive at the hospital.  They merely scratch the surface of labor and birth.

Is that really enough?  Nope, that isn’t enough for any anyone.   Even if you are certain you want an epidural.  In fact, your pain control preferences hardly factor into what a good birth class is about. That is just one of the many decision you make about the care of you and your baby.  Sure, we discuss various pharmaceutical pain management options , and there are important things for you to know.  The real “meat” is knowing the benefits, risks, and alternatives of ANY option and owning the decisions you make. 

The hospital in collaboration with the doctor you have chosen has a plan. They do this several times a day, day in and day out, so in many ways they are on autopilot.  If X happens, then do Y.  If you don’t educate yourself, you are not able to be an active participant.  You are put into the “assembly line” even if you’ve been dreaming of a natural birth for months.  There are a few different “combo meals” for this one—like a normal vaginal birth (maybe with tearing or an episiotomy), an assisted (forceps or ventouse) birth, or a cesarean.  Maybe you get off to a good start breastfeeding.  Maybe your baby doesn’t latch well.  Maybe the “good” lactation nurse is there.  Maybe not. 

You’re completely at their mercy and mostly in the dark. 

Even if you aren’t “into” birth, how your child enters the world is important.  A lot of moms are left feeling like something is missing after one of these “would-you-like-fries-with-that” births.  You know deep inside that it’s more important, that you are an individual, but the system caring for you gives you a number and moves you on down the line. They are just doing their job. 

At better beginnings, we know that the doctors and nurses as individuals are genuinely good people who have your best interest in mind, but frankly, the stats reveal a different big picture view.  The United States rates of cesarean surgery, maternal morbidity, maternal mortality, and postpartum depression are all too high for everyone’s standards.  Our breastfeeding rates are dangerously low.  Our maternity care system in the US is not working as well as it should.  Amongst other nations, we rank in the upper 20s—not the top 5 or even top 10.  It is up to you to take charge of your health and demand the very best care, backed by the latest evidence.

You can have an empowering, healthy birth in this same system, with the same caregivers present, with the same people supporting you.  You just have to do some work ahead of time. 

Here’s the heart of the matter: your care provider, your birth, the things that happen at the hospital are all choices—YOUR CHOICEs.  You have the opportunity to make informed decisions and actively participate in ALL of the choices made about your care unless a true emergency arises.  Even then, you can still have a say, but you have to know how and when to speak up.

If you are a healthy person expecting a healthy baby, you don’t HAVE to do any prenatal testing.  You don’t HAVE to be induced.  You don’t HAVE to push at 10 cm.  You don’t HAVE to have an episiotomy.  You don’t HAVE to have a cesarean.   Your baby doesn’t HAVE to go to the nursery.  You don’t HAVE to do anything.  Honestly.  You decide what is best based on your knowledge and consultation with your trusted care providers.  You’re paying for it, after all.  

You also have to know how to cope with labor, regardless of your pain management preferences.  What if your epidural wears off or doesn’t work?  What if you’re having lots of contractions and they won’t admit you?  What if you get to the hospital too late in labor for any medication?  What if you need or have to have a cesarean? 

Knowing how to relax yourself, slow and deepen your breath, and having people with you who know how to support you calmly benefits you and your baby in any of those situations.  Knowing how to stay cool and express yourself well are good skills for life.  Period.

In our classes, you’ll learn how to make YOUR plan, not a one-size-fits-all method or hospital default.  You’ll learn how to keep yourself healthy so that you can have all of the options available when it’s time to give birth.  You will learn what options are realistic at every step and come to understand that it is important to be flexible and stay open to change.  You and your support will learn to advocate for you and your new baby.  This is part clarifying what is most important to you and part communicating with your caregivers (doctor and nurses).   Again, life skills—what’s your goal, and how do you reach it?

You’ll write a birth plan—not to tell the doctor and hospital staff how to do their job, but aiming to avoid the slippery slope of interventions that go along with the hospital default.  It will politely and succinctly express your preferences and expectations.  It will guide the conversations you have with your doctor prenatally.

Building Blocks for Birth is a real class to prepare real people for real birth.  You are too important for a fast food birth.  We want you to be confident, realistic, and prepared to get what you want in the setting you’ve chosen.  Did I mention that it’s all your choice?  You can leave your care provider at any point, or even leave the hospital in labor and go to a different hospital where you’ll be treated with more respect.  After all, nobody likes poor customer service.  You’d speak up if you ordered a burger and got a burrito instead.

Thursday, July 5, 2012

RESOURCES: Water for Labor & Birth

The Benefits of Water for labor & Birth
Greater comfort and mobility. The mother has much greater ease and freedom to move spontaneously and to change position to assist the descent of the baby. Read more...


Cochrane Summaries: Immersion in water for Labor and Birth
This review includes 12 trials (3243 women). Water immersion during the first stage of labour significantly reduced epidural/spinal analgesia requirements, without adversely affecting labour duration, operative delivery rates, or neonatal wellbeing. One trial showed that immersion in water during the second stage of labour increased women's reported satisfaction with their birth experience. Read more...

Waterbirth and GBS
The literature provides a single case of early onset newborn Group B Strep (GBS) among 4432 waterbirths, suggesting that low-risk women who give birth in water may have a far lower rate of newborn GBS than women who have a dry birth. Read more...

Waterbirth International
Support in water is one of the most beneficial things that can be offered to a woman in labor.  The water provides a calming influence and a peaceful relaxed atmosphere. Women report that they enjoy their labors and find that the water allows complete freedom of movement and deep concentration. Read more...


A note about our "Resources" pages: We offer these resources as one step of your informed decision-making process.  Each mother and each circumstance are unique.  There is no one "right" way.  One article or study does not an informed decision make.  Read more.  Research more.  Talk openly with your carefully chosen care provider and those who will support you.  Then, make the decision that is right for you.

RESOURCES: Newborn Protocols

Newborn Protocols

Clamping the Umbilical Cord
Academic Grand Rounds Presentation on the benefits of delayed cord clamping.  Watch video here...
Understanding blood volume and cod clamping Watch video here...

The First Bath
"The power of vernix is truly astounding.  Its main benefits are its various antimicrobial properties, which help protect a newborn against a wide variety of infections.  A secondary benefit is that vernix is highly moisturizing." Read more here....

Maternal Separation Stresses the Baby
A woman goes into labor, and gives birth. The newborn is swaddled and placed to sleep in a nearby bassinet, or taken to the hospital nursery so that the mother can rest. Despite this common practice, new research published in Biological Psychiatry provides new evidence that separating infants from their mothers is stressful to the baby.  Read more...

Effect of Delivery Room Routines on Success of First Breastfeed 
72 infants delivered normally were observed for 2 h after birth. In the separation group (n = 34), the infant was placed on the mother's abdomen immediately after birth but removed after about 20 min for measuring and dressing  Read more...


A note about our "Resources" pages: We offer these resources as one step of your informed decision-making process.  Each mother and each circumstance are unique.  There is no one "right" way.  One article or study does not an informed decision make.  Read more.  Research more.  Talk openly with your carefully chosen care provider and those who will support you.  Then, make the decision that is right for you.








RESOURCES: How Birth Happens


Babies aren't simply pushed out, they must make several turns to make it through mother's pelvis, called "Cardinal Movements" see more...

Emotional Map of Labor
If any of you have ever read any books on the Bradley Method for childbirth, you may have heard of the emotional signposts that a woman experiences during labor. Unfortunately, this is a concept that is not very widespread, and I think that it should be because it’s extremely valuable! What are the emotional signposts of labor? Read more... 

The Labor Environment
The June 2009 issue of Birth contains the results of a pilot study gauging the effects of modifying the labor room to encourage mobility, reduce stress and anxiety, and discourage routine medical intervention. Investigators randomly allocated 62 healthy women in spontaneous labor to either a modified room or the standard labor room. Read more... 

Pain in Labour: Your Hormones Are Your Helpers
Researchers such as French surgeon and natural birth pioneer Michel Odent believe that if we can be more respectful of our mammalian roots, and the hormones that we share, we can have more chance of a straightforward birth ourselves. Read more...

A note about our "Resources" pages: We offer these resources as one step of your informed decision-making process.  Each mother and each circumstance are unique.  There is no one "right" way.  One article or study does not an informed decision make.  Read more.  Research more.  Talk openly with your carefully chosen care provider and those who will support you.  Then, make the decision that is right for you.


RESOURCES: Breastfeeding & the Law

Mississippi Laws


Miss. Code Ann. § 13-5-23 (2006) provides that breastfeeding mothers may be excused from serving as jurors. (SB 2419)
Miss. Code Ann. § 17-25-7/9 (2006) prohibits any ordinance restricting a woman's right to breastfeed and provides that a mother may breastfeed her child in any location she is otherwise authorized to be. (SB 2419)
Miss. Code Ann. § 43-20-31 (2006) requires licensed child care facilities to provide breastfeeding mothers with a sanitary place that is not a toilet stall to breastfeed their children or express milk, to provide a refrigerator to store expressed milk, to train staff in the safe and proper storage and handling of human milk, and to display breastfeeding promotion information to the clients of the facility.
Miss. Code Ann. Ch. 1 § 71-1-55 (2006) prohibits against discrimination towards breastfeeding mothers who use lawful break time to express milk.
Miss. Code Ann. § 97-29-31 and § 97-35-7et seq. (2006) specifies that a woman breastfeeding may not be considered an act of indecent exposure, disorderly conduct, or disturbance of the public space.

Federal Law
The Patient Protection and Affordable Care Act (“Affordable Care Act”) amended section 7 of the Fair Labor Standards Act (“FLSA”) to require employers to provide reasonable break time for an employee to express breast milk for her nursing child for one year after the child’s birth each time such employee has need to express the milk. Employers are also required to provide a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk. Read More...


A note about our "Resources" pages: We offer these resources as one step of your informed decision-making process.  Each mother and each circumstance are unique.  There is no one "right" way.  One article or study does not an informed decision make.  Read more.  Research more.  Talk openly with your carefully chosen care provider and those who will support you.  Then, make the decision that is right for you.

RESOURCES: Going Past Your "Due Date," Post term

Post Term

Low Fluid Levels.  "Oligohydramnios occurs in 4% of pregnancies, according to Medscape. This is in fact, a fairly rare condition. However, it is one of the big reasons we hear so often for "necessary" induction. Why is something that is in fact fairly rare so common?" Read more....

What will it take to stop the inductions for too little amniotic fluid?  This is largely a wrong diagnosis based on ultrasound.  Women are having their births wrecked by midwives and doctors who believe that Biophysical Profile is a valid testing method.  Read more.... 

The American College of Obstetrics and Gynecology (ACOG)
What to Expect After Your Due Date? A postterm pregnancy is one that lasts 42 weeks or longer. The most common cause of postterm pregnancy is an error in calculating the due date. Read more...

ACOG Practic Bulletin
Postterm pregnancy, by definition, refers to a pregnancy that has extended to or
beyond 42 weeks of gestation (294 days, or estimated date of delivery [EDD]
+14 days). Accurate pregnancy dating is critical to the diagnosis.  Antenatal surveillance and induction of labor are 2 widely used strategies that theoretically may decrease the risk of an adverse fetal outcome; maternal risk factors for postterm pregnancy also should be considered. The purpose of this document is to examine the evidence and provide recommendations about these 2 management strategies.  Read more...

A note about our "Resources" pages: We offer these resources as one step of your informed decision-making process.  Each mother and each circumstance are unique.  There is no one "right" way.  One article or study does not an informed decision make.  Read more.  Research more.  Talk openly with your carefully chosen care provider and those who will support you.  Then, make the decision that is right for you.