Tuesday, December 23, 2008

Sunshine on my shoulders...

...makes me happy!

And even more now that I read about a study conducted by Boston University School of Medicine researchers. It appears that vitamin D can prevent cesarean births! I've fallen in love with vitamin D over the last few years as I've learned more and more about all the ways the "sunshine vitamin" improves our health and well-being, so when I saw this new study's findings, I couldn't believe it! ANOTHER reason to love vitamin D?! Are you kidding me?!

In a news release about the study, Dr. Michael Holick, director of the General Clinical Research Center, a professor of medicine, physiology and biophysics, and an assistant professor of medicine, explains, "In our analysis, pregnant women who were vitamin D-deficient at the time of delivery had almost four time the odds of Caesarean birth than women who were not deficient" (US News and World Report, "Vitamin D Deficit in Pregnancy Tied to Caesarean Risk").

Apparently vitamin D deficiency is tied with decreased muscle performance and strength, so it makes sense that women with low levels would struggle through the taxing muscle-endurance feat of childbirth.

These findings have made me ecstatic, but they've also got me pondering. For so long I've believed that the birth process is perfectly designed... that nearly all complications arise from medical interference in the process. But this study has shed some light (no pun intended) on a percentage of those complicated births. I guess I can't blame the medical establishment for everything... dang it! ;-) The truth is that multiple factors are always involved.

Even so, I still believe that even most vitamin D-deficient women can give birth normally. Chances are it will just take their bodies longer. And that's where the medical establishment steps in. 'Cause they're not typically very patient with those long labors, so interventions are introduced (pitocin, epidurals, instrumental or surgical deliveries). Women with muscle weakness aren't guaranteed a cesarean birth, but their weak muscles will stack the odds against them... at least in the hospital.

All the more reason I'm glad I live in the Valley of the Sun... where even the winters are sunny and pleasant. And all the more reason to get out into that gorgeous weather and exercise. 'Cause anything I can do to strengthen my body is going to improve my odds of a smooth and problem-free delivery!

Friday, December 12, 2008

Baby stuff I really didn't need

We've started getting a few things for the new baby, so I have baby stuff on the brain. And it got me thinking about all the baby paraphernalia that seem so essential when you're pregnant for the first time but really aren't necessary at all. Obviously everyone's different, but here's my personal list of useless baby stuff...

1) Changing tables. What a ludicrous waste of money and space. (I never bought one, thank goodness.) We got by just fine with a towel (for leaks) on the floor or on our bed. My goal was always to not leave my bed for night-time feedings and diaper changes... none of this going to a changing table in the middle of the night. They may be nice to store all the diapers and wipes, but a closet or cupboard works just as well.

2) Baby lotion. We got bottles and bottles of the stuff for baby shower gifts as first-time parents. And, guess what? I think I still have most of them in a box somewhere... or gave them away to other new parents... you know, let's spread the useless wealth, right? Here's the reality... babies have lusciously soft skin as it is, and baby lotion may actually be harmful.

3) Pacifiers and bottles. I realize that these are life-savers (or absolutely essential) for many moms, but they were useless for me. My babies simply wouldn't take any size or shape of pacifier (except our pinkie fingers or my own real-life nipples). And they wouldn't take bottles either... and, trust me, we wasted a lot of money trying different brands and styles in search of "the one." In the end, it was just easier to breastfeed exclusively... and the good news was that we never had to break our children of their binkie or bottle addiction. What happened to all those useless bottles and pacifiers we gathered back in the day? They turned into "toys."

4) Baby wash and wash cloths. This kind of goes with #2. Babies really don't get very dirty until they start eating real food and playing in the dirt. And, even then, plain old water will usually get them clean. My first baby had very sensitive skin (eczema), so we couldn't use any soaps on her body anyway. And, since our second always bathed with our first, we just carried on avoiding soaps. The only thing we really ever used the wash cloths for was to cover up private parts for bath photos. And we have tons of those wash cloths... sitting uselessly in the linen closet. Please don't buy me any for my new baby. Please.

5) Rocking chairs. I should preface this by saying that the wooden rocker I had wasn't very comfortable, but I really just didn't use it. It was awkward to nurse in, so I just nursed on the couch or on my bed. Plus it just didn't make sense to get up out of bed and sit in a chair for night-time feedings. If I could have a really comfy upholstered recliner/rocker, I think I just might actually use it. But anything else would sit in the corner empty.

Did you find these things useful or useless? Any more you can think of?

Thursday, December 11, 2008

Health insurance exec calls for fewer c-sections

Check out this terrific opinion piece in the New Jersey Times--"Pre-term Cesarean Birth," by Michael McGuire, CEO of United Health Care of New Jersey. I love it. Especially his concluding paragraphs:
"There is a broader principle at work here, and it's called evidence-based medicine. . . . If health-care insurance companies and medical caregivers work together, we can identify from real-world evidence the best practices for a wide variety of medical conditions. As we can see in the case of early elective C-Sections, using evidence-based guidelines in medical care will lead to healthier outcomes for patients.

"And it's a funny thing about health care: Virtually everything that makes people healthier, be it preventive care or evidence-based guidelines, reduces the overall cost of providing health care, because it leads to healthier people, including babies, who use fewer health-care resources."

Like midwifery care! Hmm... evidence-based medicine... what a novel idea! ;-)

Friday, December 5, 2008

Hmmmm

"Since out-of-hospital midwives can help healthy low-risk women give birth safely to healthy babies with only 3 to 4% cesarean sections, why do hospital-based obstetricians find it necessary to perform cesarean sections on 19% or more of healthy low-risk women?" (Citizens for Midwifery fact sheet--"Out-of-Hospital Midwifery Care: Much Lower Rates of Cesarean Sections for Low-Risk Women")

Good question.

"A Woman Who Serves"

Doulas rock. I want to be this lady when I grow up.

Thursday, December 4, 2008

Meet my midwives

Today was my first check-up with my new midwives, Mary and Nedra. I'm just loving these ladies, and loving that I get to have two birth attendents for the price of one! Not only are they personable, fun, and great with my kids, but they are also excellent midwives. I think you'd be hard-pressed to find any doctor or midwife with stats as impressive as theirs.

Mary, the senior of the two, has been practicing as a midwife for over 28 years. She graduated from the Arizona School of Midwifery in 1980 and has attended over 2000 births. Nedra has been attending birthing women for about nine years as a doula and apprentice midwife and received her midwifery license in March. Now check these numbers out:

C-section rate 1-3%
Hospital transfer rate 2% (for women like me who've given birth before)
Perineal tears "almost never" (maybe once a year they have a woman who needs stitches, approx 1.5%)
Infant deaths None (excluding those with defects incompatible with life)
Maternal deaths None

Can you believe those numbers?! Pretty incredible. The only bad outcome these midwives have ever seen occurred not because of a mistake on their part but simply because the parents refused to transfer to the hospital until it was too late (as a result, their baby's health was compromised). Since that time, Mary and Nedra have adopted a policy to only accept clients who agree ahead of time in writing that they will transfer if it becomes necessary. And I happily signed that agreement!

You might remember this post explaining the extremely painful tearing I sustained when my first daughter was born. When Mary told me how anal retentive they are about preventing tears and that they "almost never" have a client who needs stitches, I think I heard the heavenly choruses singing "Hallelujah!" I am determined that I will give birth to my baby boy without tearing, and it's such a relief to know that my midwives will be doing everything they can to facilitate that goal!

I also love how kid-friendly their office is. They have the coolest wooden toys and puzzles (some with babies inside mommys' tummies), and they have given both of my girls a balloon at each visit. Here they are at our visit today...I love that "midwife" is a regular word in my girls' vocabulary and that it is easy for me to include them in the pregnancy process because of the efforts my midwives make to welcome young children into their office. I love that they get to hear the baby's heartbeat regularly and are already comfortable with Mary and Nedra. So, when their little brother is born, there won't be any strangers coming into our home. Just two women they will already know and love.

I am so thrilled to have chosen Mary and Nedra as my midwives. I know my baby and I are in the hands of remarkable women.

Wednesday, December 3, 2008

More good news about exercise

The studies keep rolling in... prenatal exercise is so worth it! The New York Times reported Monday about a small Brazilian study showing that regular prenatal exercise significantly reduced the need for pain medication during labor--"only 27 percent of the exercisers, compared with 65 percent of the controls, requested pain medication during labor"(click here for the full article). Here's the study's abstract.

Speaking of exercise... I'm supposed to be running a 5K this Saturday morning. And my Thanksgiving holiday vacation really threw off my exercise routine... yikes. Gotta get back on the ball!

Tuesday, December 2, 2008

Easing my conscience

This study makes me feel a lot better about "forgetting" to take prenatal vitamins (except for maybe once a month or so). The truth is I've just never felt good about taking them. I prefer to get my vitamins from real foods. So it's not that I didn't get plenty of folic acid in my early pregnancy. I did--peas, broccoli, greens, cereals, etc. Just not from pills.

I'd be interested to see whether folic acid from real food sources has the same negative effect on infants? I'd wager NO. Anyway... I've never been very good about taking prenatal vitamins and my kids have avoided asthma and have never had respiratory tract infections. Interesting.

gDiapers?

My friend, Sarah, told me about gDiapers today. In fact, she's so sweet she's going to buy me a "starter kit" for the new baby. Love you, Sarah! I've tried the cloth diapering thing off and on, but they really are such a pain to clean. We've mostly used disposables for my girls. But I like the concept of the gDiapers... all the eco-friendliness of a cloth diaper, but with flushable liners! No stinky garbage even! Check them out!