STBA group meeting!

This week Friday at 1:30pm in CC.

Email me for details

www.southtexasbirthadvocates.gmail.com

Maternity Care in the Rio Grande Valley-From one Mother to Another

Maternity Care in the Rio Grande Valley-From one Mother to Another

I am Nicole Hoff but I am better known as "Mommy", "The Birth Lady," or "The Boob Lady." I have my Bachelors in Maternal and Child Health, am a Certified Doula (a certified professional that assists mothers during pregnancy, childbirth, and the postpartum period), a Certified Childbirth Educator, an International Board Certified Lactation Consultant, and a Midwife Apprentice. As a mother and healthcare professional in private practice in Harlingen, I have helped families from all walks of life, from each end of the Valley, during a special time in their life.

Despite good-hearted intentions of many dedicated and educated health professionals, the maternity care system across the US, including the Rio Grande Valley of South Texas, has many shortcomings. A recent report by Childbirth Connection and The Milbank Memorial Fund, called "Evidence-Based Maternity Care: What It Is and What It Can Achieve," explains why the state of maternity care in the U.S. is worrisome. The care practices that have been proven to make childbirth easier and safer are underused, and the many interventions that may increase risks to mothers and babies are routinely overused. The report points to the "perinatal paradox" of doing more, but accomplishing less. I have witnessed this first hand in the Valley and I am truly worried.

Every year Valley women are suffering in silence from birth trauma that results from their treatment during labor and delivery of their child. The feelings of their negative experiences are overwhelming, and sometimes so much so that they suffer from major depression afterwards. Some women consider it "birth rape", especially if they had instruments or hands placed inside them without their consent. Because of my education and experience, I feel that I know misinformation, maltreatment, and abuse in this field when I see it. I have had the honor of attending many amazingly beautiful births here, but I think some of my "birth stories" at local hospitals would surprise you and many would just sicken you. I wish I could forget each and every demoralizing abuse these mothers and babies faced, but some were just so shocking they will always linger in my memory.

I want to put these following phrases I have heard over the years out there in the open so our community can know what is taking place. I think everyone involved in birth needs to read these, so that they can be more attuned to what they are saying and what type of care they are providing. These are just a few phrases from the many well-intentioned nurses, doctors, staff, breastfeeding "helpers", and childbirth "educators" I have heard but I will never repeat. While some of these phrases could have the correct time and place to be said and may really hold true for a mother, there have been more times that I have heard them said when it was inappropriate or not factual than when really necessary. Mothers have been mistreated, lied to, given incorrect information, coerced, manipulated or deceived so that one will be obedient and go along with treatments, and have had procedures done when there was no reason or consent to perform them. Different locations, different staff, same ABUSE.

From their lips, to my ears, to my typing fingers:

Was this a planned baby or just a mistake?
I'm a rough doctor, but I know what I am doing.
You don't need labor support.
No one can birth naturally.
C-sections don't hurt.
Wow, you're huge, you need to get that baby out now!
You're too small for this big baby!
You're seriously pregnant again?
Be quiet. Hush. Shhh. You're too loud!
Our hospital is best- even with over 50% c-section rate.
Your spouse/mom/doula can't come in with you.
We throw away birth plans.
We laugh at birth plans.
You're too sick/weak/tired for birthing your baby.
OB: I only come to catch the baby.
Give up and go with the c-section.
You can't have a VBAC (vaginal birth after c-section).
That won't work!
You can't...
Since you have medicaid...
I only speak English, this is America!
You're worrying me, stop that.
I have to do this to you because...
That's not important. Forget about it.
I don't have time. I've got other patients.
That's normal. I see that all the time.
You're wearing me out
I'm not here for you, it's just my job.
Good girl.
C-sections are safer and better for you and baby.
You're not strong enough.
That's in the past, move on.
Don't move.
I can't help it if you don't understand.
Oh relax!
You're fine!
Hold your pee and poop!
You can't get up!
No time to explain this to you.
Oh gross!
Sit still. Lay still. Be still.
Why would you want that?
Well that's a first!
You ask too many questions!
You have to do what I say.
I know your body better than you do.
Only 1 person allowed in room.
I'm cutting you open.
Push now even if not ready.
It doesn't matter what you need.
Oops! We....
Your epidural didn't work because you....
Let's induce now at 37-38 weeks.
Hurry up!
Start pitocin she's not progressing.
You have to be alone for 2 hrs.
I'm taking your baby away for 4 hrs.
You have no choice.
Even if you say no, I must...
Ob:Plan a c-section or induction for when I'm in town.
Ob:I know what's best, not you! Who is the doctor here?
You're here so I can't let you leave.
Just get pain meds already!
You can't do this anymore!
You're not pushing right!
Spread your legs! Wider!
Lay flat even if it hurts.
Did you pay your deductible yet?
I cut you even though you didn't want it.
You will hurt your baby unless...
Emergency c-section was you're fault.
I forgot to wear gloves.
Your baby needs a bath, it may have swine flu.
Your baby is dirty.
The doctor decides...
Your baby needs more than your breastmilk.
Your breasts won't work.
I have to hurt you.
I forgot and fed your baby for you.
Formula is better.
You need a catheter!
You need pain meds!
You need an IV!
You need pitocin!
You need monitoring!
You need to just chill out!
Your baby doesn't like that.
You can't go to the nursery.
You're not dilating fast enough.
I got you too drugged up to hold baby.
The baby needs the nursery more than he needs you.
Epidurals have no side effects.
You're not breathing right.
We can't do that for you.
We do this because it works for us.
Your doctor won't be here for you after all.
Follow our rules.
We have policies and protocols.

Now you know why video cameras are not allowed in labor rooms! They would be too embarrassed to let this get out, and honestly I am embarrassed for them. This list doesn't even include the sighing, eye rolling, storming out, finger pointing, paper waving, bribing, rough handling, withholding, lack of privacy, lack of respect, and other abuses. Because such practice and sayings have become routine, few maternity providers consider them abusive or inherently inappropriate.

It needs to stop... but I fear it won't.

Still, someone needs to speak up for these moms and babies and I hope someone out there cares. No local maternity professionals or hospitals have responded yet to my plea to contact me about ways to end this system of poor care. And no one has apologized to these mothers or babies-many who feel traumatized by past births. I would like to apologize for them and my apologies go out to the mothers that have had this abuse, and my hope for you is that you find healing and closure.

I will get some harsh feedback from this letter and some will deny the existence this abuse to mothers or believe that I am exaggerating, but this is because misconduct is rarely reported. I know that, sure, some births go "fine" and there are a handful of "good" staff out there, and hospitals are "working hard to accommodate mothers". I have seen that too, just not often enough to right a passionate letter about it. Maybe someone will respond wanting to know how to help make the birth experience better? The answer is easy! Birth professionals need to empower women to prevent birth trauma. Give her control through education, support, and your time. Don't make decisions for her, make them with her. Show her that she is valued and that you will give her your all to give her the best birth for her. Treat her with respect and give her privacy. Ask permission anytime you are performing an intervention, treatment, or even touching her. If she asks you to stop, do so immediately, and always explain what you are doing in detail. Above all, listen to her, and show her that you care about her AND her baby. No one deserves to be treated any differently than this, especially when in pain, when in need, and at a precious event in life.

Attention-RGV Families: You're not free from serious risks at Valley hospitals when giving birth. You will hear many of these phrases above, whether you believe it or not, it is a sad fact. The c-section rate is high in our area. You risk so many interventions that can lead to a c-section or a sick mom and baby. You face the risk of unnecessary induction, which can turn out to be too early or fail and lead to a c-section. It is a fact that you will receive care from some, if not all staff, that have amazing skills but lack natural/ normal childbirth and breastfeeding education. I have seen this at about every Valley hospital location. You will probably be made to do what they say and not what you need or want. You become their property and your baby becomes their responsibility!

There is an alternative. Escape from this abuse. There are a number of different ways for you to have a safe, happy, and healthy birth. Here are the four most common:

* With an "enlightened" doctor at a hospital
* With an "enlightened" midwife at a hospital
* With a midwife at a birthing center. Locally: Holy Family Birth Center in Weslaco.
* With a midwife at home. Locally: Beth Overton, CPM who does all prenatal care and home birth.

Seek many options, weigh the risks and benefits, and choose the birth plan that works best for you. If you are considering a natural childbirth, you should definitely educate yourself, consider taking a childbirth class not associated with a hospital or similar natural childbirth class. You really can have a beautiful birth experience even if you have your baby in a hospital, but you need to find a doctor or midwife and doula who will support you in your point of view, and you need some training to help you prepare yourself.

Attention-Doctors, staff, hospitals: If you think this isn't happening in your birth facility or practice? Prove me wrong. Show me your true support of these women and babies. Hire me as a Doula to be on staff and respected at your birth facility or clinic for 1 month. Allow video cameras into your center and take evaluations from your patients. Not brave enough for that? Show me the information on how these phrases and this type of "care" you are providing helps mothers and babies. Are you that "enlightened" doctor or midwife out there that can help Valley families, then contact me and let me know and I would be happy to share that information.

For now I, as a Valley mother and maternal and child health professional, will continue to advocate and support Valley families, and I hope that I will no longer continue to see and hear mothers and babies being abused at what should be the most joyous time of their life.

Contact me for more information.
www.BlessedBirthDay.com
nicole@blessedbirthday.com
956-245-1787

Nicole: We hear you! I love this letter and I will bring it to the attention of our group- again and again! Thank you for sharing your time and talent with us and for advocating for our honored, birthing mothers.

-Carrie

A call for stories

We believe that the birth process is a monumental experience in which a mother should be honored, valued, respected and revered. And yet, we continue to hear stories that express a number of grievances encountered by Moms during their births. Some mothers experience unfair treatment, cause for complaint, disrespect and even abuse during their birth process.

Because a birth may be a rare or even a solitary experience for one woman, she may not pursue official reprimand for any injustice she suffers. However, this choice of inaction proffers a disservice to the women who come after her and encounter similar unregulated affronts.

So we make a call for stories. Stories that explain the grievances you or others may have experienced throughout a mother's pregnancy or birth experience; stories that necessitate action for a higher level of respect and ethical practice among our medical care givers.

We hope that by gathering a collection of stories, we may better unite as one voice. Though we may not be able to change what we have experienced in the past, we may be able to create better, safer circumstances for our sisters that follow us into their time of delivery and initiation into motherhood. This is an open invitation to all mothers, fathers, family members, doulas, medical caretakers or anyone involved in the birth process who wishes to better honor or better advocate for the birthing mothers of our community.

Please email SouthTexasBirthAdvocates@gmail.com

"Maternal mortality across the world"

Thanks Beth, for bringing this article to our attention!

The video and full text can be seen at

http://news.bbc.co.uk/2/hi/americas/8325685.stm

Maybe we should consider this information as we look at the rates of c-sections in our own South Texas area. Is a c-section always the safest option?

Important Notice: We have an STBA meeting TOMORROW at 11am. If anyone is interested in attending this meeting or future meetings, pleaseemail southtexasbirthadvocates@gmail.com

"The US spends more money on mothers' health than any other nation in the world, yet women in America are more likely to die during childbirth than they are in most other developed countries, according to the OECD and WHO. The BBC's Laura Trevelyan has been trying to find out why.

Four million American women give birth every year, and about 500 die during childbirth or from pregnancy-related complications.

In the richest nation in the world, giving birth is more risky than you would think.

"No American woman should die from childbirth in 2009, we can definitely do a lot better," says Dr Michael Lu, Associate Professor of Obstetrics at the University of California, Los Angeles (UCLA).

In New Jersey, Jim Scythes is bringing up his two-year-old daughter Isabella on his own.

His wife, Valerie, died from blood clots shortly after giving birth to Isabella by Caesarean section.

Jim still cannot believe that Valerie died after giving birth, here in America.

"When Isabella walked for the first time, I sat on the floor and cried, because Valerie should have been there. I believe this could have been prevented and now my daughter will never know her mother."

MATERNAL MORTALITY One woman dies every minute during childbirth, yet almost all of these deaths are preventable. In 2001, the UN set itself the goal of slashing maternal mortality by 75% by 2015, but it is nowhere near meeting that target. Health ministers from around the world are meeting in Ethiopia to work out how to make up for lost ground. The BBC is publishing a series of reports to mark the occasion.

So why are women in America more likely to die during childbirth than they are in most other developed nations?

The answers are complex. A healthcare system which leaves what Dr Lu estimates are 17 million women of child-bearing age without health insurance could be one factor.

Obesity, poverty and the high rate of C-sections in America all play a part.

Dr Lu says about half of American women are entering pregnancy overweight. "Obesity is a major risk factor for pregnancy-related complications.

"First we need to improve the health of women before they get pregnant, and second we need to improve the quality of maternal care in America."

Shocking story

The Centres for Disease Control (CDC) in Atlanta is the US government agency that collects national statistics on the numbers of women dying during childbirth.

Dr Bill Callaghan of the CDC says the latest maternal mortality data suggests one in four to one in five women who die have heart disease, or diseased blood vessels.

To the extent that we don't explain racial disparity in pregnancy-related mortality, we're going to have difficulty making headway into it Dr Bill Callaghan Centers for Disease Control

Could that be due to women being overweight? I asked. "It could be," replies Dr Callaghan, "the obesity epidemic has not spared women of reproductive age."

Dr Bill McCool, at the University of Pennsylvania's School of Nursing, points out that America is far above the World Health Organization's goal of a 15% C-section rate.

"Surgery of any kind has risk," he says, and a C-section is, "still the riskiest way to have a baby.

"In the US, almost one third of women have that procedure for delivery of their baby."

...

the full text of the article can be found at

http://news.bbc.co.uk/2/hi/americas/8325685.stm

Career Fairs

TUESDAY, SEPTEMBER 15, 2009

Career Fairs

We are collecting literature from different midwifery schools, doula schools, and childbirth education schools. If you would like to attend any of these or bring display materials to present, please email southtexasbirthadvocates@gmail.com

These are the dates that we have so far:
Alice High School - Sept. 24 6-8pm
Kingsville High School - Sept. 23 2-4pm in gym
Port Aransas High School - Oct 2 12:51 - This one will actually be held during a careers class.
Sinton High School - Nov 24 - Waiting for more info to come in mail
Flour Bluff High School - March 11 - Waiting for more info to come in mail

MONDAY, JUNE 15, 2009

Natural Family Planning and Physiological Births - by Ann Craigs

Ann has come up with our first real "guest" blog. Thank you Ann! Here it is:

It’s fun to see people’s eyes grow wide when I mention my six physiological births. Four were attended by outsiders and two were assisted by my husband. It’s sad to me however, that when I discuss physiological family planning, people are unaware of what I mean. I learned about natural childbirth from a high school class. I learned about natural family planning from a book.

Not knowing what in the world the title of the book meant, I checked out Breastfeeding and Natural Child Spacing. It was from La Leche League during the time that I was nursing my first baby. The author, Sheila Kippley, absolutely fascinated me.

Did anyone really space babies like this these days? I almost dismissed the idea; I am a nurse and had never heard of such a thing. Now, skip ahead with me a couple of months. Try to imagine my amazement to discover that my breastfeeding pattern, labeled “ecological breastfeeding” by Kippley, was hormonally keeping my monthly fertility cycles away.

My cute baby nursed frequently day and night. We took a nap together each day, plus delayed solids and liquids until around six months. Since my son hated pacifiers, swings, babysitters and schedules, we avoided them. I nicely went without any menstrual spotting or bleeding for over a year.

Although women breastfeed differently, all these very specific behaviors, named “Seven Standards” by Kippley, usually result in impressive, eco-friendly child spacing. I repeated these special circumstances with all my children. Sheila’s 2008 book, The Seven Standards of Ecological Breastfeeding has newer research that should definitely be in nursing school courses. However, the book is written for ordinary moms. I have met many women for years, who are equally pleased with this as I am.

I next learned a broader form of ‘physiological’ family planning. When the breastfeeding infertility stops, I monitor my temperature and cervical signs daily. If not planning a child, we abstain on the fertile days and enjoy marital intimacy on the naturally infertile days. I feel so clean being patch-free, pill-free, shot-free, and latex-free. It’s similar to birthing without drugs, devices, and interventions. I am very respectful of my husband who ‘two-steps’ with me on this. Just as behaviors indicate different stages of labor, so my body signs, jotted down quickly on a chart, indicate my phases of fertility and infertility.

I am indebted to Sheila’s husband, John, as well. This couple just published a slim 2009 book, Natural Family Planning, The Complete Approach. I got a coil-bound version, perfect for home study. In addition to charting, breastfeeding, and special situations, one chapter explains why some use this for moral reasons and another chapter has true stories of how this has improved women’s childbearing years. To preview it, see a free downloadable form at www.nfpandmore.org.

Ann enjoys all her children, physical and spiritual, that she has been around over the years while volunteering as a nurse, breastfeeding counselor and NFP instructor. She enjoys fishing and knitting and wouldn't trade her life for anyone's - well, maybe trade with a midwife :) Recent highlights in her life include the first grandbaby, plus seeing John and Sheila Kippley receive an honorary doctorate from Franciscan University , both events in the winter of 2008.

FRIDAY, JUNE 5, 2009

STBA Meeting Minutes-

In attendance: Aletha Craft, Ann Craig, RN, Liz Derry, LVN, Mercy Eizenga, LM, Carrie Kimmel, Beth Overton, CPM, LM

Items Discussed:

Articles to be published on the South Texas Birth Advocates (STBA) blog would be added at the discretion of Carrie Kimmel who maintains the blog.

It was requested that all in attendance write an article for the blog.

The group worked on a mission statement. Wording wasn’t decided on, but everyone agreed that it should include that we want to educate and emower women and promote physiological birth.

It was agreed that our main goal is too promote the education of women about physiological birth.

Discussed were ways to achieve this examples were to have viewings of Orgasmic Birth, The Business of Being Born, or other documentaries and doing Career Days in schools and various Health Fairs.

The First viewing of Orgasmic Birth will be held at Aletha’s house on July 14^th at 3pm. The location and expense for holding a larger scale viewing was discussed as well.

Aletha would also try to locate information regarding local health fairs.

Mercy’s assignment was to start calling the local high schools and colleges about attending career days were we would have information on becoming midwives, doulas, childbirth eduation instructors, etc.

SATURDAY, MAY 23, 2009

STBA Pictures

Here are some photos of our first meeting in April. We all gathered on a Tuesday morning at Coffee Waves in Corpus.

SATURDAY, MAY 2, 2009

What is a "physiological birth"?

A friend emailed me the following question:

Hi Carrie,
What do you mean by "physiological birth"? e.g. with no anesthetic drugs/epidural, etc.? without inducing the birth with tocolytic drugs? or do you mean birth in a bathtub? or giving birth in a football player starting position vs. lithotomy position? or something else entirely?

My response:

I'd like to pose the question to the blog readers:

Physiological is a descriptive word used to depict something as normal and natural... Is a birth with no anesthetic drugs/epidural normal and natural? What about births that are induced by tocolytic drugs? Are they normal? Are pools of water or half clad squatting women normal and natural in childbirth?

What do you think?

Physiology... The word.

Physiology: The branch of biology that deals with the normal functions of living organisms and their parts.

Physiological adj

-New Oxford American Dictionary

The term physiological comes from two Greek words physis + logia, nature + logic (study, science).

phys·i·ol·o·gy

Function: noun

Etymology: Latin physiologia natural science, from Greek, from physi- + -logia -logy

Date: 1615

1 : a branch of biology that deals with the functions and activities of life or of living matter (as organs, tissues, or cells) and of the physical and chemical phenomena involved — compare anatomy 2 : the organic processes and phenomena of an organism or any of its parts or of a particular bodily process

phys·i·o·log·i·cal

Variant(s): or phys·i·o·log·ic \-jik\

Function: adjective

Date: 1814

FRIDAY, MAY 1, 2009

Aloha Advocates!

I am looking for advocates who are willing to publish a post or write a comment on one of the following topics/questions. I would also like to hear your priority list for the potential blog topics. Let me know (in the comment section of this post) which topic is most important to you.

Thank you!

-Carrie

1. What is the best way to achieve a physiological birth at your hospital?

(Directed to hospital administrators in the Corpus Christi area)

2. What are doula services?

(Directed to a doula and a mother who has received doula services)

3. What is hypnobirthing and does it really work?

4. How can Yoga help you achieve a physiological birth?

5. What are some of the national issues at hand concerning options for mothers who want a physiological birth?

6. What are students health care professionals learning in the labor and delivery wards of our hospitals?

7. What are the different types of midwifery certifications?

8. In what ways are OB/GYNs trained to provide mothers with a normal and natural birth?

9. A day in the life of a labor and delivery nurse here in the Corpus Christi Area

10. A day in the life of a delivering doctor here in the Corpus Christi Area

11. A day in the life of a midwife here in the Corpus Christi Area

These are just a few topics/questions I plan to explore. I would love suggestions for more!

3 COMMENTS:

Beth Overton, CPM said...

I love the new blog! You did a great job. I can't wait to see how it grows over the next few months. Thanks for doing this! ~ Beth

MARCH 31, 2009 4:46 PM

Liz Derry, LVN said...

I am so excited about this group! I can't wait to have our next meeting. I can really see things changing for the good for women and their families in South Texas.

APRIL 11, 2009 8:07 PM

Mercy Eizenga, LM said...

You are doing a great job. I love the photos of you.

MAY 12, 2009 7:27 PM