Parenting Decisions

DOULAS

“If a doula were a drug, it would be unethical not to use it.” John H. Kennel, MD
What is a Doula?
Doula is a Greek word that is loosely translated to mean woman servant. A doula is a trained and experienced, non-medical assistant who provides physical, emotional and informational support and care during pregnancy, childbirth and the postpartum period. She is a professional who is knowledgeable about the progression of labor, pain management, coping techniques, and breastfeeding. She offers continuous support during labor and the immediate postpartum period.

Did you know that Doulas have been show in published studies to provide: 50% in chance of C-section, 60% in use of epidural anesthesia, 30% in use of narcotics (Stodol or Nubain), 40% in use of Pitocin, 25% in the time of labor, 40% in use of forceps and vacuum extraction.

There is also evidence of reduced chances of health complications and hospitalizations of baby and mom; increased chances of successful breastfeeding, reduced incidence of postpartum depression, reduced levels of anxiety, result in more positive birth experience, and mothers feel more in control, safe and secure.

To locate a doula visit
Dona , Alace , Cappa , Doula Network , , My Birth Team , Birthing Naturally

Andrea Robertson is a Childbirth Educator in Australia and recommends the following techniques for advocacy with a hospital birth. A Doula can help advocate these!
1. Coercion of the woman can be avoided if she is unable to make eye contact with those demanding her submission. She will automatically close her eyes if her head is resting on something (perhaps by facing her partner and holding on around his neck), and this also makes it less likely that she will open her eyes to pay attention to the request/demand. In addition, if her back is to the door and to the caregivers, her privacy and concentration are more likely to be maintained.
2. Try to stay off the bed. As soon as she is settled on the bed, she is more likely to take on the role of the patient: passive, submissive, and vulnerable. With her feet on a floor mat (yoga mat) she will be upright, autonomous and more able to take charge. Caregivers unused to being with women who are not reclining on a bed will be momentarily thrown off guard, and they will be forced to try the new approaches, habits and routines being abandoned in the process. The resultant birth will be unique, challenging, and exciting for the parents and remembered by everyone.
Don't turn down the covers on the bed: it is an invitation to get in to bed. The bed also makes a good place to put the open suitcase.
3. The partner or doula should stay with the woman in a physical way. With their eyes on the laboring woman, it will be harder to be coerced into moving the woman into some other position that she does not want to adapt.
4. Create a cozy atmosphere. Turn down the lights and create a cozy, intimate place. It automatically encourages everyone to whisper and tiptoe, which ensures peace and quiet.
5. Move the furniture. The bed has wheels and can be moved off to the side and out of the way.
6. Stay in street clothes while still comfortable. She can change into something looser (not a hospital gown), as labor progresses.
7. Request a bean bag or birth ball upon arriving on the labor ward. Spread out the yoga mat and spread a sheet over it so it's more comfortable.
8. Make sure she stays warm. If clothing becomes restrictive as labor progresses, she can request a warm blanket to cover herself from head to toe. Covering her head to remain warm also makes it easier to maintain concentration in her labor work, by preventing disturbances.
9. Position her bean bag, chair, or yoga mat away from the center of the room. Making her the center of attention will encourage interaction with others, so try to tuck her away in a corner, or behind the bed or door. With her back to the door she is less likely to look up each time someone enters the room.
10. Many women enjoy the privacy that the toilet offers. Staying in the bathroom can also be a way of escaping from the noise and bustle of busy times in the labor ward. An additional benefit is that adults automatically respect the right of those in the bathroom to privacy and are unlikely to disturb them. Be sure to provide her with pillows or blankets to make her comfortable.

HOME BIRTH
Seriously, home birth is amazing and very safe, possibly safer than hospital births?!
homebirth safety study
Homebirth Safety
Birthing options
Birth Reviews
Homebirth Safety
Homebirth
Homebirth

VACCINES
Vaccines is a sensitive topic, but a very big decision that deserves some research and thought before going along with what everyone else seems to be doing. You can read some Mothering discussions if you are wondering Where do I start? or Am I being irresponsible?

My mom, a nurse of over 25 years, freaked out, literally when she found out I was considering delaying shots. While she was visiting me post partum she read “Vaccinations A Thoughtful Parent’s Guide, how to make safe, sensible decisions about the risks, benefits, and alternatives” by Aviva Jill Romm and felt a lot better due to understanding where I was coming from and why. You can also read, “The Vaccine Guide, risks and benefits for children and adults” by Randall Neustaedter OMD and “The Vaccine Book, making the right decision for your child” by Dr. Sears

Government and CDC Finally Agree to do Extensive Research into Vaccine Safety . . . Maybe
For over a decade now most doctors, researchers, and government officials have denied that there could be any link between vaccines and autism. They’ve denied it so vehemently that they’ve refused to adequately study the very idea. Until now. The federal government’s vaccine advisory panel (the National Vaccine Advisory Committee or NVAC) just voted to recommend to the US Dept of Health and Human Services that they and the Centers for Disease Control and Prevention conduct large-scale prospective research trials in groups of vaccinated versus unvaccinated children to determine various theoretical risk factors and possible severe reactions to vaccines, including autism. Learn more about this possibility and read about the
Mercury replaced with more toxins

Do Doctors Have a Financial Incentive to Get Their Patients Fully Vaccinated?
I get a lot of emails from people who wonder if doctors have any sort of financial incentive to get their patients vaccinated. Do we get any sort of bonus from the insurance companies that pay us? I've always thought that the answer to this question was no. I recently found out otherwise.
Learn more about this possibility

Looking for a Vaccine-Friendly Doctor in Your Area?
You may ask yourself, "What is a vaccine-friendly doctor?" Some parents choose not to vaccinate their kids. Others want to partially vaccinate. Some aren't sure what they want to do, and they want help figuring what will be best for their child. If you fit into any of these categories, you may have a hard time finding a doctor. Most doctors kick patients out of their practice for not vaccinating, or for asking too many questions. The doctors listed will have read, or be familiar with, Dr. Bob's book and contacted me to have their practice listed here as a place such patients can come and feel welcome. Let me know when you find them here in PA!

You can also find some interesting info at

People Advocating Vaccine Education and Michigan Opposing Mandatory Vaccines

The National Vaccine Information Center . Theres lots of good information on this site, aimed at giving the full story to parents as they make the choice on whether or not to vaccinate or selectively vaccinate their children.

Dr. Mercola on vaccinations has several pages on his site that inform of the ‘dark side’ of vaccination, something that most people don’t even know exists. Unfortunately, many families find out about the risks of vaccination (and the exemptions out of compulsory vaccination) after their child has been damaged or died.

Med Alerts-linked from NVIC . From a friend of mine Dr. Dan, “I did a quick search on ‘deaths’ reported to the system, and there have been 1796 linked to vaccination added to the database. Unfortunately, I’m sure that this does not represent 100% of deaths linked to vaccination, as many doctors refuse to say it was caused by a vaccine, and attribute an infant’s death to some other pathology. Parents just don’t know about the downside of vaccination, and should make an informed decision based on ALL information…that’s my stance.”

From a friend, Christie..."So from my research I found that there are a few types of the vaccine. The nasal spray form that is a live weakened virus, the multi dose shot that is a dead virus and has thimerosal (mercury) and the single dose shot also a dead virus that does not have thimerosal. There are some other ingredients that can be in the vaccines that do not sound safe called adjuvants (such as squalene and MF59) but those for the most part have not been used in the United States. You can find out if the vaccine has any of these things in it by looking at the product insert that the doctor or whoever administers the shot is happy to show you. The H1N1 vaccine is made the same way as the seasonal flu vaccine but with a different virus but you have to research all the other ingredients in the vaccine to make an informed decision."
And here are the links for the H1N1 vaccine:
CDC on H1N1 This site says that they are doing studies on pregnant women now but have no results yet.

Mommy notes This site is nice because it shows the ingredients in the vaccine.
Also keep in mind that there are alternative routes to consider like Little Mountain Homeopathy

CIRCUMCISION
Personally, we chose not to circumcise our son even though my husband's mom chose to circumcise him. He said, "It is just one conversation I will have with our son about our differences." We have not had any issues and we glad we made the choice we did.
What is infant circumcision? Why is the practice common in U.S. hospitals and not in other countries? What does it remove and how does that affect the child? Does scientific data suggest that circumcision has benefits? What are the potential complications? How does it affect sexuality? Is it a medical procedure or a social surgery? If it's unnecessary surgery, what about contemporary bioethics principles?
Through both a review of scientific literature and a discussion of the human cost of the procedure, this presentation explores these questions from the perspectives of the child, the adult survivor, the parent, and the practitioner.
Ryan McAllister, PhD, is a parent, a biophysicist, an Assistant Professor of Physics and Oncology at Georgetown University, and also a volunteer who supports parents and families. Over the last 10 years he has been studying the medicalization of childbirth in U.S. hospitals. The slides, supplementary material, references and a copy of the video can be downloaded here:
physics.georgetown.edu/~rmca/Elephant_in_the_Hospital/

Watch the video Circumcision, The Elephant in the Room."

Here is what one of my students, Erin who has boy has to say:
"Thought I'd share a lot of the research I did on circumcision. Let me warn you that the first link has some GRUESOME pictures of what can happen when a circumcised boy gets infected with MRSA. So, if you're feeling nauseous, maybe save the first link for another time. The second link just makes me want to cry. The poor kiddo is strapped down and he is obviously distressed. Third link has some short excerpts from numerous studies on circumcision, none of them positive. The fourth link again shows step by step what happens...warning, this link has a lot of disgusting, bloody pictures, however, it is an informative eyeopener. The fifth link is a guide for parents. In this link, they actually explain briefly that circumcision is safer if done in adulthood. In my humble opinion, if its going to be done, it should be done in adulthood, and should be a CHOICE that a man makes for himself. If my son decided to have it done later on, more power to him. I'm not going to mutilate him against his will! The sixth and final link contains links to some printable fact sheets. I really like the one about what the medical profession isn't telling you in regards to preventing urinary tract infections. That was one of my biggest issues with the proponents of circumcision...people kept telling me that the risk of urinary tract infection and penile cancer was much lower if its done. Penile cancer is extremely rare anyway...I relate that kind of reasoning to if someone said all women should have elective mastectomies and hysterectomies just because some of us *might* get those cancers. Ridiculous! The other rationale people have had is "Well, your son will get made fun of for not looking like the other boys." First off, that would qualify as sexual harassment, so no one should be saying anything to my son about his intact penis. Secondly, if other people have nothing better to do than stare at my son's gentalia and ridicule it, they need to find more important things to concern themselves with. Well, its time to get off my soapbox. :)"

1. doctorsopposingcircumcision

2. noharmm

3. Circumcision

4. cirp

5. circinfo

6. Intact

And here are some circumcision sites that might be helpful in the decision making process:
Circumcision
Mothers Against Circumcision
No Circumcision
Birth Psychology

CHIROPRACTIC CARE
Chiropractic Care
As I continue to work in the birth venue, I have the great blessing of meeting such fabulous people. I had a Doctor of Chiropractic in one of my classes and the more I research it and experience it for myself the more convinced I am of alternative health methods for my family. Things like avoiding ear infections and tubes in the ears could be prevented with chiropractic adjustments! Check it out for yourself. The American Chiropractic Association ‘health and wellness library'. It has a good section on otitis media (ear infections), asthma, ADHD and much more, International Chiropractic Pediatric Association, and this section is much like the ACA site, but specific for kids/pregnancy. Also, from the ICPA, this is a good site for general patient questions/education. ICA Pediatrics, or
ICA for Kids and ICA Pediatrics are good sites to check out for Chiropractic and Kids, Pregnancy and Ear Infections. Dr. Jennifer is a friend of a friend and she is a diplomat in pediatric care! Feel free to view her personal site for more information. Pathways is also a good resource.
If you need a great local chiropractor visit
Living Well Chiropractic
OR
Eagle Chiropractic

VBAC
My sister-in-law is considering a VBAC with her T-cut from her first cesarean. I asked a mom who has had two c-sections and a vbac for some information...See her repsonse-
Most cesareans are completed with a low transverse incisions but occasionally a different type of incision is used (inverted T, J, low vertical). An inverted T typically happens when a doctor attempts a low transverse incision but then must make an additional vertical incision due to malpresentation or lack of development of the lower uterine segment. Usually the vertical cut is small and stays in the lower segment of the uterus. These kind of scars are generally considered safe to VBAC although finding a provider may be difficult. I think it would be a good idea if your sister requests a copy of her operative report. Information about the length of the vertical incision might be included. Then she can make an informed decision about what her risk level for a VBAC might be. Sometimes the t extension does go into the fundus or the top of the uterus. This is more representative of a classical incision and is considered riskier. According to the most recent practice bulletin by American College of Gynocology (ACOG) from July 2010, women that have a t-type incision have a higher risk for complications and are "generally not candidates for a planned trial of labor after cesarean (TOLAC). Individual circumstances must be considered in all cases and if a patient presents in advanced labor, the patient and her health care providers may judge it best to proceed with the TOLAC."

Basically, the t incision is generally considered less likely to rupture than a classical incision (made completely in the upper portion of the uterus); however, slightly more likely to rupture than a low transverse incision. The risk of rupture with a low transverse incision is less than 1%. The risk of rupture with a classical incision is 9 to 12%. The risk with a T incision falls somewhere in between. There are not a significant number of studies done on these types of incisions but I've dug up what I can. I attached a study on inverted T and classical incisions. It doesn't talk much about the future pregnancies but does indicate that of the 17 women in the study that had subsequent pregnancies, there were 2 vaginal deliveries without incident, 2 low transverse cesareans in labor, and the remainder were delivered by elective cesarean.

I also found a little statistical information in the Landon study from 2004 which stated that there were 105 women in the study that presented in advanced labor and refused a cesarean that had either an inverted T, J, or classical incision. Of these women, 2 had uterine ruptures (1.9%).

Another study by Scisione 2008 found that there was no significant increase in risk with a T, J, or low vertical incision.

A great resource to connect with other women that have had these types of incisions is www.specialscars.org (they also have a Facebook page).

Lisa H.
ICAN of Pottstown, PA
Chapter Leader

OTHER
Then there are always questions about SLEEP and CRYING...Here is some food for thought Dangers in crying it out