Tuesday, August 31, 2010

The Doula Project

Doulas Step Up to Comfort NYC Abortion Patients

Tuesday, August 31, 2010

A doula program in New York City has been giving care and comfort to women undergoing abortions for two years. Among the roughly 1,500 women who have been offered the services, only one woman so far has declined.

NEW YORK (WOMENSENEWS)--One woman was so nervous during her abortion that her sweat soaked through her paper gown.
A second apologized repeatedly for not being ready to have a child.
A third sobbed quietly because she was forced to terminate her pregnancy due to health complications.
During the two years that Lauren Mitchell has attended to the needs of women undergoing abortions, these three patients are among the hundreds she has served.
"Abortion is different for every woman, and though it can be straightforward and simple, it can in some cases be stressful," said Mitchell, co-founder of The Doula Project, a Manhattan-based nonprofit that trains volunteers to support women not only during delivery, but during abortions, too. "Regardless of the circumstances, we're here to help."
Doulas take their name from the Greek word for "caregiver." They typically help women through pregnancy and have become popular in recent decades as expectant mothers' birth plans have begun to include their services; some insurance providers have begun to cover those services, too.
A doula's work, for which she is usually compensated $25 to $35 per hour, ranges from providing parenting-book recommendations to offering guided relaxation and massage during labor. For the first weeks of a baby's life, she may also change diapers and perform housecleaning help.
In 2007, three New York City doulas--Mitchell and her colleagues Mary Mahoney and Miriam PĂ©rez--decided to extend their services not just to women who complete pregnancies, but also to women who terminate them.
They partnered with two Manhattan abortion facilities in August 2008 and began training "abortion doulas" to work there free of charge.
Today, these 45 volunteers chat with patients in waiting rooms, hold their hands when they are on the operating table and provide them with warm blankets and hot water bottles that ease cramps during recovery.
Whether patients experience miscarriage, opt for medical abortion (mifepristone) at home or have the procedure at a clinic, they can decide to work with a doula or not.
Among the New York City women who have been offered this help--more than 1,500--all but one patient has accepted it, said Mitchell.

Replicating the Service

New York appears to be the only state where abortion doula services are available, but doulas in North Carolina and Washington State have their eyes on replicating the service.
"We weren't the first to come up with the idea that an abortion patient should be able to ask for this assistance," said Mitchell. "Nurses, escorts and counselors have long filled this role. But we decided to give it a name and to offer our services in a formal way because of the growing need for them."
Eighty-seven percent of U.S. counties have no abortion provider, and 35 percent of U.S. women live in those counties, reports the Guttmacher Institute, a health policy organization in New York City.
Due to this squeeze, some doctors perform 25 to 30 abortions per day, doing one every 20 minutes in an assembly-line fashion, with little time to chat or offer patients counseling and comfort, pro-choice advocates say.
Though abortion doulas provide support and assistance that is lacking, they take flak from both sides of the abortion divide for doing so. On one hand, they facilitate abortion, which sparks outrage from the anti-choice movement. On the other hand, their work acknowledges that terminating a pregnancy can be difficult, which some pro-choice supporters regard as a political Pandora's box.
On her blog, anti-choice activist Jill Stanek blasted abortion doulas for trying "to legitimize and de-stigmatize abortion by making it a component of maternity."
On the Web site, one anti-choice doula proclaimed, "I am an advocate for moms and babies, and aborting babies is totally opposite from that."

Pro-Choice Pushback Too

"We're also getting pushback from the pro-choice community," said Alison Ojanen-Goldsmith of Seattle's Full Spectrum Doulas, which is preparing to train abortion doulas this fall. "Some pro-choice advocates don't want to admit that abortion patients may need support. They deny it because they're fighting anti-choice rhetoric and its insistence that women are somehow damaged by abortion."
On the progressive Web site, one pro-choice journalist asked, "Are women really so fragile that they need a complete stranger to hold their hand at the doctor's?"
Mahoney, one of The Doula Project's co-founders, said the criticism doesn't interfere with her organization's work.
"This pushback isn't going to stop us from training abortion doulas across the U.S. And it won't distract us from offering our services to the women who need our help," she said.
A woman may want a doula's extra reassurance because she is a teenager who fears her parents' disapproval, or because she is a domestic violence survivor who is hiding her pregnancy from her abusive spouse. A patient may be upset because she is pregnant by a rapist, or mourning because she is pregnant by a man she loves and cannot afford to raise their child.
Some abortion patients do not tell their partners, friends or family members that they are terminating their pregnancies. Even if they do have someone to sit with them through the procedure, that person may not be permitted to do so.
"For security reasons, many clinics do not allow a patient to have a partner or friend with them," said Lauren Guy-McAlpin of the Spectrum Doula Collective in central North Carolina, which hopes to train abortion doulas within the next year.

Precautions Necessary

Security is so tight at the two Manhattan facilities that currently have abortion doulas that these clinics will not release their names in print. They have reason to take precautions. Since 1993, eight abortion clinic workers have been murdered by anti-choice extremists and since 1977 U.S. clinics have suffered more than 6,000 acts of violence, including bomb threats, arson and kidnappings, reports NARAL Pro-Choice America, based in Washington, D.C.
Fear of clinic violence can heighten the anxiety that some patients already feel about having an abortion.
"On top of all this, there can be incredible shame and stigma surrounding abortion, even though this procedure is incredibly common," said Laura G. Duncan, a Brooklyn-based abortion doula. "Our job is to offer patients whatever they need: someone to joke with, someone to cry with, maybe someone to rub their feet."
Half of pregnancies in the United States are unintended, with 40 percent of those ending in abortion. Nearly half of U.S. women--43 percent--have an abortion by the time they are 45, reports the Pro-Choice Public Education Project, a nonprofit in New York City.
"Research indicates that though many women feel relieved following an abortion, 10 to 15 percent have some emotional difficulty afterward," said Ava Torre-Bueno, author of the book "Peace After Abortion" and a licensed social worker who counsels abortion patients in San Diego, Calif.
If patients want to talk after their procedures, abortion doulas may give them their own phone numbers, along with the number of an after-care abortion hotline run by Exhale, a nonprofit group in Oakland, Calif.
Remembering how an abortion doula helped her through a stillbirth two years ago, Rose Ferreira of New York City said, "It's incredible how her kindness made this bearable. She made me realize it was OK to feel frustration and anger at not being able to control this heartbreaking situation. Above all, she helped me feel strong and secure even though I was at first afraid."

Monday, August 30, 2010

Catching up on Great Articles

It turns out that Graduate Assistantship work hours can be a great time to catch up on some birthy blogs! While my workload here at work is light, I am going to post some interesting posts I've noticed recently that are worth a read:

Home Birth... Why I Did It (& I'm Not a Hippie)
Because we have to keep bringing this point home... "I gave birth at home. And no, I’m not a hippie. I’m a college educated, business minded woman"
She writes, "My hope is that by sharing my story, I may encourage at least one mom to do her own research so she can make the best decision for her  childbirth experience... I’m certain almost all women are capable of a  natural birth, and if they take back that right, we will have healthier and happier moms, dads and babies out there."
I posted this one on my personal facebook page and it spurred a big discussion... if only I could get that type of response on here! :)

Women who breastfeed even one month reduce their diabetes risk
This is a hugely important study find, because diabetes is quickly becoming a pandemic thanks to unhealthy eating worldwide.

When Pushing Turns Purple: What's a Doula to Do?
from Birthing Beautiful Ideas... Illustrates the frustrations with the frantic and unnecessary "HOLD YOUR BREATH AND PUSH! 1... 2... 3... 4... 5... 6... 7... 8... 9... 10... AGAIN! HARDER!" that nurses always seem to want to do in labor and delivery.

Volumes: a huge problem Public Health Doula. I find this post fascinating because she explains just how and why many women end up over-feeding their newborns.  She discusses just how much an infant should be eating, why they are being overfed, where the problem stems from, and so on. Over-feeding can lead to, other than trouble with breastfeeding, obesity later in life.

Wednesday, August 25, 2010

Graduate School

Hello! Long time no see!

I apologize that moving and graduate school has taken over my life for the past couple weeks. I have had very little time to keep up with my blogs and the blogs of others! But now I am all moved-in and my classes have begun, so I am hoping to find my routine and be able to update this blog a little more regularly.

So far the program (dual MA Anth and MPH) is going well. Its exciting to be back in the university world and so much fun to be studying Anthropology again. I am also learning a lot about Public Health which is thrilling. There are a ton of subfields that I never knew about, and though there aren't a plethora of students and faculty working on birth-related research, there are some. It is going to be so awesome to hook up with people who are also interested in studying cultural perceptions of breastfeeding, the medicalization of birth, etc etc and just talk and talk with them!

I've nearly decided to do a Biocultural Medical Anthropology concentration for my Anth degree. I've also begun my Graduate Assistantship helping organize a Maternal and Child Health Training Grant. 

I'm the only doula I've come across (surprise surprise) but not the only one interested in prenatal and postpartum health issues, which is great. I haven't begun majorly advertising my doula services in this area yet, because I'm hoping to get a feel for my graduate program this first semester.

Thanks for following along!

Sunday, August 22, 2010

Childbirth Can Be Changed

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever does.”
- Margaret Mead, cultural anthropologist

Friday, August 13, 2010

What's a Doula to Do?

Whats it like for a doula in the hospital setting? What does she have to deal with, exactly? What should she be doing or not doing? The answer will vary depending upon which L&D nurse you ask and at which hospital. It will vary depending on their experience with doulas and what their current moods are.

I know I've been told that I haven't been doing enough simply because I was 'holding the space' and also looked at like I should just keep my mouth shut if I spoke for a mom who was in the middle of a contraction. Its tough to please both the staff and the client, but the focus should always be the client!

This "Montreal Doula" describes how it feels to juggle things in the Labor and Delivery room, and gives some great doula advice!

The "Can do no Right" Doula Blues
If I try to respect a nurse's job by getting out of her way, I can be asked huffily, "Why aren't you helping me?" If I jump in and try to help (change bedding, soiled gowns, etc.) I am often criticized for not doing it properly, or told altogether to not interfere.

I have been told, "I know what I'm doing!" when I remind a resident of the fact that a mother has unusual bleeding during labour when they tell her she can go off the monitor for an hour, and also been told, "If you KNOW she has unusual bleeding, why were you going to let me take her off the monitor? I have visited 6 patients in 15 minutes...if you KNOW the drill, speak up!"

When I've removed a bloody pad from the bathroom floor so as to keep the environment clean, I have been told, "You can't move that! I need to measure the blood loss!" When the next time the situation has arisen and I have left it there for the nurse to assess, I have been told, "Why would you leave that there?! It gets germs all over the place! I thought you liked to keep the environment clean? Jeesh!"

When I have placed a towel under a standing, nude, extremely actively labouring lady to protect the floor from slippery amniotic fluid, it has been yelled at me, "she's going to trip on that's a hazard!" When I have not placed that towel down, I am yelled at, "What are you thinking not putting a towel under her? Don't you know that amniotic fluid on the floor is a hazard?!"

When I have been buzzing for a nurse in a busy hospital to help a 1 hour postpartum lady up to the bathroom to have a much needed pee, I can be asked with scathing indignation, "why wouldn't you just bring her yourself? Isn't your job to tend to her?" And, when I have taken the initiative and just brought the full bladdered lady to the bathroom myself, I have been been told, "You can't take her to the bathroom! What if she faints? I'm responsible!"

If I have shown as much respect for boundaries as possible and asked first before doing anything, I have been advised to stop pestering, to take initiative, and just DO what needs to be done (barring anything considered medical). When I have taken the initiative, I have been told to do nothing without permission.

A doula can be a scapegoat for staff members' frustrations. When things are busy, we can be damned if we do, and damned if we don't. Let the attitude roll off you like water. Don't take it personally. Sense the tone, and do what you think will cause the least tension. If you're wrong, you can rest assured you at least respected your scope of practice, respected your client, and did your best to respect the staff.

I personally have some boundaries I don't cross, even when asked. I will not "just put the lady on the monitor for me..I have another lady about to deliver and don't have time." I will not start "coaching" and counting during the second stage of labour, unless this is what the mother wants. If a staff member wants to assume I'm lazy or don't know what I'm doing because I don't engage in the Purple Pushing Circus, that's fine. I will not "make" my client stop vocalizing and "get control of herself". If she is releasing tension by using her voice and is obviously progressing beautifully, there is no need to change anything. I will continue to just be quietly present if that is what the feel of the labour dictates, not worrying about the whispered comments I hear, "why isn't she DOING anything, like telling her to breathe or anything? Why did they hire her?" I will not be over solicitous to please nurses when I know it's going to get on my client's nerves. I will also not answer, for example, if my client is going to take postpartum Synto by IV or injection, as this is not a call a doula should ever be asked to make. Yet we're asked to speak for our non-communicative clients all the time. I will communicate preferences the client has discussed with me, but I will never speak for her her concerning a split second medical decision!

And yes, sometimes I get eyeballs rolled at me when I gently say, "I'm sorry, but I can't speak for my client." Just like I get eyeballs rolled at me when I offer important information about my client that was not asked by the staff, because I'm not supposed to "speak for" my client (ex. "Mrs. P had a double mastectomy 4 years ago..she has asked me to communicate that she wishes not to be asked if she will be breastfeeding").

I just continue to smile and be kind, not getting caught up in the criticisms and comments. When my clients hold their babies in their arms with huge smiles on their faces and tears in their eyes, shining with gratitude for my having been there for them how they needed me to be, this is all the "reward" for my efforts I need. I have surrendered the need to please everyone on a hospital staff and invest huge efforts in having them like me and approve of my work. You can't please everyone. I serve my clients, and am confident I do nothing inappropriate to endanger them. I respect all boundaries to the best of my abilities, and do my best to reduce tension.

If I am at a birth with a student doula or another colleague and someone takes us aside and says, "why aren't you letting this mother get an epidural? Can't you see she's suffering enough?" we just smile and explain that an epidural is a mother's choice, not ours to make for her, and that she will most certainly have our support if she asks for one. Then when we're alone my student or colleague and I will have a giggle. It's pretty crazy, really. At the same time as being thought of as puppet masters who have omnipotent powers to pull all the strings and have all control over a woman's attitude, sounds, movements, breathing, requests, bodily functions and choices, we are often not thought of as smart enough to even hold a vomit bowl "competently".

Someone needs to make a decision. Is it our "power over our clients" and our seeming omnicience that is perceived as dangerous, or is it our stupidity and ineptitude that endgangers? Better yet, why doesn't someone debunk these misperceptions altogether? We should put up a summary of Klaus and Kennel's studies on the amazing results of having a doula present at a birth on the walls of every hospital room, providing evidence that IN FACT good doulas (not those few doulas actually behaving badly...most that are perceived as behaving badly are in fact not) are the opposite of dangerous. Perhaps this fear of us having the potential to make everything SNAFU in the hospital maternity ward is not actually a testament to our dangerous, witchy natures, but simply a fundamental resistance to the uncharted waters of that unfamiliar, radical thing our clients often want and we support called normal physiological birth! Why not realize that trying to "put us in our places", or sabotage us doesn't hurt doulas (we're used to it, and have thick skin), but the birthing women themselves? They will remember.

Thursday, August 12, 2010

The Great OB

Yes, they do exist!

The Midwife who writes at Birth Sense published a post called "Can We Clone This Guy?" where a real-life Obstetrician answered the questions she suggests every woman ask their pregnancy/birth care provider in a manner that respects natural birth and the patient's autonomy:

I was delighted to receive the following comment from a reader, Dr. Henry Dorn, who answered the questions I suggested asking a physician when you are searching for the right doctor.  Dr. Dorn’s responses were so close to my ideal that I wanted to share them with all of you.  If all of us printed off this response and passed it on to our own doctors, perhaps other physicians would begin to see that modern obstetrics can (and should) include practices that support normal birth.  Thank you,  Dr. Dorn.  I wish there were more OBs like you out there:

I will preface my comments by saying that Pam asked me to answer the 11 questions here, so it’s her fault if I take up too much space! I also have avoided reading the right and wrong answers she included, in order that my answers be more candid. Hopefully I get a few right!
1.  What is your philosophy of pregnancy and birth?
I believe that we should attempt to allow the natural processes to occur as much as possible, since this is how the system seems to work best for most healthy moms. This includes a really healthy diet of whole foods, lots of activity and a safe home environment. If mom and baby are doing well (normal fetal growth, maternal weight gain, fetal movement, etc) then labor should be allowed to progress naturally & spontaneously. Our job as caregivers is to support the normal processes and to identify the outliers, who need medical care for optimal outcome.

2.  How do you define “normal birth”?
Normal birth should include spontaneous labor, uninhibited maternal activity, no medical analgesia, spontaneous pushing, immediate maternal/neonatal contact, cord clamping after pulsation, etc. This should ideally occur in a quiet, safe environment.

3.  Can you give me an example how you typically manage  a normal birth?
As above! After confirming fetal well being, mothers should be encouraged to move and find the positions which feel best to them, have caloric intake, and as little intervention as possible, provided that there are no indications of maternal or fetal distress.

4.  How would you feel if I disagreed with you about a procedure you recommended during labor or birth?
I would explain in detail my position and rationale, but ultimately allow the mother/family to decide what they feel is right for them, as long as neither she nor the baby were in imminent danger, which is rare.

5.  How long will you “allow me” to wait if I go overdue?
That depends on a lot of factors, but assuming all indications show a healthy mom and baby, and the mother and family clearly understand the risks of post term pregnancy, as well as the range of options, there is no absolute limit.
As an example, my wife was not excited about being induced after hearing all of my tales, and went over 43 weeks with our first.
I do recommend close monitoring after 42 weeks however, to determine which babies are continuing to thrive inside mom and which may benefit from delivery.
There is also some evidence that induction of labor after 41 weeks may lower the C Section rate, which I make mother’s aware of, and offer as an option.

6.  What position(s) will you allow me to use when giving birth?
Anything goes. All fours, squatting, on the side… Perhaps there should be a “Mama Sutra”, diagraming all the options! Just don’t ask me to get in a tub.

7.  How do you feel about IVs and continuous fetal monitoring?
I recommend IV access (saline lock) as it allows rapid response to emergencies, which is why women deliver in a hospital in the first place. Trying to start an IV in someone with heavy bleeding and low blood pressure can be very challenging and delay treatment. Healthy moms don’t need to be tied to an IV pole however and can hydrate themselves.
I am not a big fan of continuous fetal monitoring for low risk moms, as it offers limited benefit in terms of improved outcomes, according most studies. Its primary use is to allow nurses to care for more than one patient simultaneously, which is often the case in todays maternity wards.
8.  How do you feel about a woman eating and drinking in labor?
As long as there is no evidence pointing to likely C Section, I think a woman benefits from nutrition in labor, especially when prolonged. The risk of aspiration in an emergency C Section under general anesthesia is fortunately low nowadays, and I explain to moms that this is the chief rationale for restricted intake and let them decide.

9.  What do you recommend a woman do during labor?
Move around, get a massage, listen to soothing music – whatever she feels is most relaxing, as I agree strongly with Ina May Gaskin about the Sphincter Theory of childbirth, which asserts that a woman must be relaxed to let her baby come down most efficiently.

10.  What are your thoughts on pain relief in labor?
It is wholly up to the mom and I do not deny it to anyone, however I explain to moms that epidurals increase the C Section rate, likely by limiting maternal movement, which would normally help a baby move into the best positions for passage thru the pelvis and birth canal. Also, narcotics may be in the baby’s system at birth and interfere with normal functions after birth, including breathing, bonding and feeding.
I have however seen some very anxious women with arrested labor relax following analgesia/anesthesia and delivery shortly thereafter.
As stated earlier, I believe in most cases, the best outcomes occur when we leave things alone, but patient autonomy rules here as well.

11.  How do you feel about cesarean birth?
 A C Section generally takes less time and pays more than vaginal birth and carries far less legal risk. Therefore it is a no-brainer as a business decision. ;-)
However for the mother’s sake and good medicine, it should be reserved for the few women who truly have issues which preclude a vaginal delivery, or in true emergencies. The rate should be well under 10%, and far less for truly healthy women.
That being said, since I support a patient’s autonomy, I would not refuse to do an elective primary C Section if the patient was well informed and rational. There are real risks exclusive to vaginal delivery and these should be included when considering risks, benefits and alternatives.
Just my 2 cents. Hope it’s helpful.
Henry Dorn MD
High Point NC 

Wednesday, August 11, 2010

Generation Y and Birth Choices

Excellent guest post on Science and Sensibility on Culture and Maternity Care.

I'd say the study is pretty spot-on in its observations. Now how will this affect maternity care of this generation's new mothers?

Assessing Interactions Between Culture & Choice
by Katie Fulmer, aspiring medical anthropologist

[Editor's note: This is a guest contribution about the concurrent session at the Normal Labour & Birth International Research Conference titled Assessing Interactions Between Culture and Choice. Priscilla Hall (a second year PhD student at Emory University Woodruff School of Nursing), Esther Shoemaker (a first year PhD student in the Population Health program at the University of Ottawa), and Kathrin Stoll (doctoral fellow at the Centre for Rural Health Research) each presented their research. - AMR]

Thank you Amy and readers for allowing me the great opportunity of contributing my conference analysis to Science & Sensibility.

At no other conference has choosing between concurrent sessions been so difficult. However, from the moment the schedule was posted some weeks ago I knew there was one I had to attend. Assessing Interactions Between Culture & Choice focused on today’s generation of mothers and what shapes their perceptions, experience and consequently choices about birth.

Generation Y women are today’s young mothers and will make up the bulk of midwives’ clients in the approaching years. What shapes their perspectives on pregnancy and birth? And how will their expectations impact the way they choose to give birth?

Demographics and Influences
Generation Y is loosely made up of adults born between the mid 1980s and the mid 1990s In the conference session, we reflected on what influences this generation of women:

1. This generation is extremely comfortable with technology, having craved the “toys that make the noise” including Nintendo/Sega/Xbox game consoles, mini laptops and iPods. The toys of this generation often involve one-on-one interactions with a computer rather than a friend.

2. The “Audit Society” (Power 1997) is the norm for this generation. The 1980s saw an explosion of auditing activity in UK and American society. Teachers chart performance and activities of students, employees audited their own activities for their employers and health workers began recording up to the minute activities of their patients and one another.

3. To this generation “the most desirable women aren’t women at all – they’re girls. The womanly shape, once held in esteem by the Greeks all the way up to pre-Twiggy models is seen as overweight to this generation. Smaller frames, straight figures and other pre-pubescent qualities are idealized by Generation Y women (or at least the media they consume). Not ironically, Gen Y has also been referred to as the Peter Pan Generation.

The first two in this hardly exhaustive list of predictors can help to explain how medicalized birth is quickly being assumed as the norm by today’s women. (And as Dr. Eugene Declercq of Boston University pointed out over lunch, the majority of U.S. women are satisfied with their maternity care.) In fact, as UBC doctoral candidate Esther Shoemaker points out from her mixed methods research of young women and new mothers, “Natural” birth to them does not equal “Normal” to us. Natural birth, to most of the women in her study, is synonymous with vaginal birth. Even if labor was induced, an epidural administered or forceps used, the women who gave birth vaginally experienced their birth as natural. I have witnessed this in my own Generation Y peer group of young mothers.

Further, the majority of those Shoemaker interviewed desired a vaginal birth in their antepartum interview, but also voiced an ambivalence about whether or not they actually would give birth that way when the time came. “If something happens I of course will have a c-section.” Oddly enough, perception of safety was not mentioned but the women said they would default to whatever their individual practitioner suggested.

In some cases reported, the practitioner suggested procedures to the Shoemaker participants that increased the degree of medicalized beyond what they expected for their birth. When this occurred, each of the participants changed their plans for their second birth. They either embraced the medical model completely or rejected the medical model in favor of a physiologic birth. So while they were ambivalent or passive first time mothers, they actively created their birth plans for subsequent children. The finding has important implications for today’s mothers as this was true for all Shoemakers’ participant’s whose birth experience was more medicalized than her birth expectation.
Intriguing findings in the studies:

1. Birth, to this generation, is, as UBC scholar Kathrin Stoll points out, a normal physiological process (71%), inherently risky and filled with “unavoidable complications” which necessitate technological interventions.

2. Of the women Stoll interviewed, 70% worried about how they and/or their partners would perceive their bodies during and after pregnancy.

3. According to Shoemaker, who studied what happened in subsequent births among women whose first births were more medicalized than expected, one of two extremes were common. The women would either fully embrace the medical model (e.g., plan a c-section with all the bells and whistles) or she planned to birth at home with no interventions.

The findings of this session’s speakers are all interesting and important for us as midwives, childbirth educators, and activists. When shaping our message about normal birth it is important to meet women where they are, use their language and respect their experience of the world and their bodies. How will we “market” normal birth as we are privileged to know it to the coming mothers?

Friday, August 6, 2010

Friday Movie for Breastfeeding Week: Whip 'Em Out!

Fabulous PSA video packed with celebs (like Kelly Rutherford, Ali Landry, Lisa Loeb and Constance Marie) and real moms who all have one thing in common: They breastfed their babies and are proud of it!

Thursday, August 5, 2010

Breastfeeding Art Worldwide

The Universal Language

 1897, America

 1950, East Indian

 1925, Arab

1845, American

1900, Madagascar

1835, Japanese

 1900s, Europe

 Now, American, by artist Karen McKendry Minton

 1500, European, by artist Da Vinci

All photos, and more not posted, from Breastfeeding Art

Wednesday, August 4, 2010

Just 10 Steps!

Have you noticed that its World Breastfeeding Week? :) Only 10 steps towards successful breastfeeding and the Baby Friendly Way!

The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding.

 The "Ten Steps to Successful Breastfeeding" are the foundation of BFHI and summarize the maternity practices necessary to support breastfeeding. A maternity facility can be designated 'baby-friendly' when it does not accept free or low-cost breastmilk substitutes, feeding bottles or teats, and has implemented these 10 specific steps to support successful breastfeeding.

The Ten Steps To Successful Breastfeeding

The BFHI promotes, protects, and supports breastfeeding through The Ten Steps to Successful Breastfeeding for Hospitals, as outlined by UNICEF/WHO. The steps for the United States are:

  1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
  2. Train all health care staff in skills necessary to implement this policy.
  3. Inform all pregnant women about the benefits and management of breastfeeding.
  4. Help mothers initiate breastfeeding within a half-hour of birth.
  5. Show mothers how to breastfeed and how to maintain lactation, even if they should be separated from their infants.
  6. Give newborn infants no food or drink other than breast milk unless medically indicated.
  7. Practice rooming-in - allow mothers and infants to remain together - 24 hours a day.
  8. Encourage breastfeeding on demand.
  9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
  10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

There are only 86 Baby-Friendly hospitals and birth centers in the US (as of December 2009).
There are none in Maryland, North Carolina, South Carolina, Kansas, Louisiana, New Mexico, Nevada or Georgia, just to name a few.

Tuesday, August 3, 2010

Breastfeeding Advice 101

As a new doula, I have had a hard time figuring out what to tell new moms immediately postpartum about breastfeeding. What one bit of advice can I tell them to help them out the most? Other than physically helping her with positioning the baby and identifying when the baby is drinking, what can I leave her with that is important to know immediately postpartum?
Here are a few of the most useful bits of advice I can think of for a new mom that will help immensely with breastfeeding:

1. Surround yourself with supportive people. Make sure everyone you encounter encourages your breastfeeding efforts. It can be emotionally and physically rough. You will need every single kind word and reassuring statement from your husband, mother, sister, friend, etc that you can get.

2. Find a lactation consultant. Nursing shouldn't hurt, and if it does, get help with your baby's latch. An LC can answer your questions and help you in ways that your pediatrician who isn't trained in breastfeeding or even your friend who has breastfed before cannot. The best breastfeeding books, while informative, will also often refer you to an LC for help identifying problems.

3. Nurse on Demand. Follow your baby's cues, not the clock, and make sure you're both comfortable. Learn to nurse lying down so you can get lots of rest. The more you nurse, the more milk you'll make. Don't try to be superwoman right after you give birth - someone else can take care of the laundry and cooking!

Anything else you can think of to add? What helped you the most when you were new to breastfeeding?

Monday, August 2, 2010

Wonder Drug

" If a multinational company developed a product that was a nutritionally balanced and delicious food, a wonder drug that both prevented and treated disease, cost almost nothing to produce and could be delivered in quantities controlled by the consumers' needs, the very announcement of their find would send their shares rocketing to the top of the stock market.  The scientists who developed the product would win prizes and the wealth and influence of everyone involved would increase dramatically. 

Women have been producing such a miraculous substance, breastmilk, since the beginning of human existence.  "
-Gabrielle Palmer

Sunday, August 1, 2010

Happy World Breastfeeding Week!

Human Milk is Green! Ecologically Speaking...

It’s a natural, renewable resource and is all the baby needs for the first six months of life.

It requires no resources for packaging, shipping or disposal.

No precious energy is wasted producing artificial baby milk and related products.

No land needs to be deforested for pasture or crop production.

It does not create pollution from the manufacturing of human milk substitutes, bottles, nipples and cans.

It helps space babies by suppressing fertility in the mother.

This message is brought to you by:
La Leche League International
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