GRN: How Consumers Can Help Birth Centers Become A Reality for Every Community

The National Birth Center Study II Hello Friends, While the whole nation has been watching the cesarean section rate and cost of maternity care climb ever-higher, midwife-led birth centers have been providing low-risk women with a safe, low-cost model of care with excellent outcomes and a c-section rate orders of magnitude lower than the national average. The long-awaited National Birth Center Study II (Stapleton et al., 2013), published today in The Journal of Midwifery and Women’s Health (the journal of the American College of Nurse Midwives), reported on outcomes of over 15,000 women planning to give birth at birth centers around the country between the years of 2007 and 2010. The American Association of Birth Centers has published an excellent summary of the study results for consumers. Briefly, the main results showed: 84% of women who started labor at the birth center, had their babies at the birth center. 94% of women had vaginal births (whether they remained at the birth center or transferred to a hospital), with no evidence of compromised outcomes for babies.   (That is, only 6% of women who started labor at a birth center had a cesarean birth.) The national average is 32.8%. According to the authors, the national c-section rate for low-risk women comparable to this sample is 27%. The fetal and neonatal death rate was extremely low and comparable to what has been reported in other studies of low-risk populations. Why is this study important for consumers to know about? The overall number of birth centers has been growing over the last ten years. However, if you Google the phrase, “birth center closing,” you will see story after story of communities around the country despairing as their birth centers were closing their doors for all sorts of reasons. In some states, the regulations for birth centers represent barriers to getting them started. In others, the financial or physician back-up structure was not sustainable. The loss of birth centers leaves significant gaps in the continuum of care options for women, leaving them to choose care that is not optimally suited to their situation. The solution to lowering the cesarean section rate and the astronomical maternity care costs in this country will be multifaceted, for sure. Today we have been given empirical evidence that support for birth centers, with their low-cost and excellent outcomes, should be a substantial piece of the equation. What Can You Do? If you already have a birth center in your community: Support it! Send them love today on Facebook, host a fundraiser, become their champion. If your community does not have a birth center: Read the article and the consumer summary and share them on social media. Host a meeting to gather energy, information, and support. Learn about birth center regulations in your state and what the potential barriers may be. Send a copy of the article to local doctors and hospital administrators. As Amy Romano of Childbirth Connection said in her Transforming Maternity Care post, “Birth centers have met their moment.” For midwife-led birth centers to thrive in the U.S., they need consumer champions. That's you! How do you plan to support midwife-led birth centers? Tell us on Facebook and Twitter today and please share this message widely! Yours in safe and respectful maternity care, Lauren Korfine, PhD, & The CfMidwifery Team References Stapleton, S.R., Osborne, C., and Illuzzi, J. (2013). Outcomes of care in birth centers: Demonstration of a Durable Model. Journal of Midwifery and Women’s Health, January/February, 2013.

LEARN MORE ABOUT CFM SIGN UP HERE TO RECEIVE GRASSROOTS NEWS MESSAGES! SHARE WITH OTHERS IN YOUR AREA! Feel free to forward and share on facebook with friends, family and colleagues SEND US NEWS! If you find news, resources, or other valuable information that you think should be posted on the Grassroots Network, please send it to info@cfmidwifery. org... with "For the grassroots network" in the subject line. We will definitely consider using them! LEARN ABOUT CfM! Check out our website Check out our blog Like us on Facebook Follow us on Twitter GET INVOLVED! Are you interested in volunteering with some dynamic women in a supportive environment? Help CfM promote the Midwives Model of Care! We have many ways to get more involved. Get in touch with us! DONATE! CfM couldn't do it without your support. Make your contribution here!

Postpartum Survival Tips

“In western society, the baby gets attention while the mother is given lectures. Pregnancy is considered an illness; once the ‘illness’ is over, interest in her wanes. Mothers in ‘civilized’ countries often have no or very little help with a new baby. Women tend to be home alone to fend for themselves and the children. They are typically isolated socially & expected to complete their usual chores…while being the sole person to care for the infant…” –Milk, Money, & Madness

I recently shared this quote on my Facebook page and a reader responded expressing her fear at preparing to face this exact situation. I responded that it is an unfortunately realistic fear and suggested she check out some resources for postpartum planning that might help work through the fear as well as plan for a nurturing postpartum instead of a stressful one. She then responded that she has a very minimal local support system and that got me thinking about postpartum survival tips for when one’s local support system is limited…

My ideas:

•  Suggest to your out of town friends and family that they contribute to a “babymoon” for you and all pitch in to hire a postpartum doula.
• Tactfully remind people that even if they’re too far away to bring you a meal, they can certainly call up a local restaurant and order a delivery for you! I think a lot of us forget that is an option for a long distance family member (that we would bring food to if they were local). In my experience, getting enough food is a huge issue postpartum! I remember long distance friends having babies a variety of times and wishing I was close enough to bring them dinner. Duh. Many restaurants do, in fact, deliver food!
• Be your own “best friend” by preparing and freezing meals and snacks now. I know I sound obsessed with food, but it is totally one the hardest things to take care of postpartum, but so important!
• Put together a mama survival kit for yourself that you can then open up when you need it. Some ideas here and more ideas of variable quality here.
• If you don’t have a sense of community work, actively work on building one—go to La Leche League meetings, Holistic Moms Network, Mothers of Preschoolers, Attachment Parenting International, or other mothers’ groups. Go BEFORE you have your baby if you can.

Other ideas for helpers:

• In addition to my idea of ordering delivery for a postpartum family as a way of bringing them dinner long distance, is to order a dinner through the mail via the business Spoonful of Comfort. They will send fresh chicken soup, rolls, cookies, and a baby present via Priority Mail (packed with freezer packs). I send it with a note saying, “this is me, bringing you dinner!” Friendly tip from unfortunate personal experience: if you are doing this for a friend make SURE you enter THEIR address as the shipping address and not your OWN address, or you will then be forced to enjoy their postpartum meal and feel like a total idiot at the same time.
• Don’t forget about other meals—breakfast = awesome. Muffins = awesome.
• Pay it forward–I think sometimes people feel like they don’t know someone well enough to bring them food, or maybe they even do a mental “tally” and think, “well, she won’t be bringing me food ever, so why should I take time to bring it to her” or, “she didn’t make anything for me when I had my last baby, so I’m off the hook on this one.” When I had Alaina, a mother who had literally JUST moved to town and that I had not yet met, sent a hot breakfast casserole to me (that my lovely doula delivered to my lovely mother at the snowy end of my gravel road).  I think of that generosity when I bring a postpartum meal to a mama from whom I will never end up getting a reciprocal meal. Who cares. She needs it. You can do it!
• Another doula commented on my post: “Do you know a mom that is about to have a baby? Or maybe a momma who just gave birth recently? Don’t even ‘offer’ just show up with a bucket of cleaning supplies, a bag of healthy food, and maybe something nice for her. Go tuck her in bed with baby, and get to work on her home.. When she wakes, she has nothing to do but nurse that baby. (If she has other kids, delegate chores with them, if to young, call mutual friends to sit for them! Our Mom’s need this, up through 6-9weeks pp, Mom’s need help, even longer for some. There is a reason the US has the highest Post Partum Depression issues in the developed world… Create your community! DO IT!” I would add that if you do not know mom well, do not plan to engage in a deep cleaning project and stay for a long time doing such project.

I also posted to the Citizens for Midwifery Facebook page asking for contributions for postpartum survival tips when your local support system is limited. What beautiful, helpful women we have on that page! While I didn’t get many suggestions specifically for minimal local support systems, I did get a nice collection of survival tip ideas:

• Trust your own instincts. Many women have great advice but if your heart is telling you something else, go with it.
• Craniosacral therapy… one session for you and one for the baby.
• In addition to lots of suggestions to hire a postpartum doula, there were lots and lots and lots of shout-outs for placenta encapsulation. I echo it myself.
• Get out of the house alone! For me, it’s been crucial to my sanity to leave my home, by myself, even if only for an hour or two between nursings. Just a Target run was therapeutic!
• Kangaroo care for high needs babies.
• Lots of mentions of it being okay to accept help and okay to ask for help.
• A lot of new moms get really overwhelmed by family and friends coming by to see baby, and it’s important for them to remember that they can always put out a sign that says “mom and baby sleeping!” (even if they aren’t) anytime they need a break.
• Watch only positive stuff without violence on TV (cooking shows, home improvement) as regular TV is really violent for new mamas and she may be watching more with all the nursing/healing.
• Have homemade high protein frozen meals (and snacks) in the freezer before birth so anyone can warm them up for the household after birth. If breastfeeding, get much more rest than you think you need from day one to ensure an abundant milk supply (*note from Molly: it is true that prolactin receptors are “laid down” during the first days of breastfeeding. Breastfeeding “early and often” makes sure that there are an ample supply of receptors in your brain.)
• Have a sign up sheet for family and friends to choose which chores to help with, gift certificates to a cleaning service, stocking up on disposable plates and dinnerware…
• A new mommy group can be a life saver. Just knowing that other mommies are going through the same thing help
• Food registries such as mealtrain and mealbaby. Not enough families know about these amazing and free services. (*note from Molly: we often use Care Calendar locally.)
• Plan ahead and freeze several of your favorite freeze-able meals. Let the clothes be a little wrinkled. Use paper and plastic ware instead of worrying over dishes. Stay laying down first 3 days postpartum (preferably naked: it gives a certain message and is better for baby anyway) and the first week stay in pajamas. Enjoy frequent rest times, even if you can’t sleep.
• Baby wearing….lots of time in bed, sleeping cuddling and feeding babe skin to skin…brest friend nursing pillow
• Send a subliminal message to the limited visitors you’ll have (set limits early with partner) by wearing your robe for several weeks
• Eat well, accept all offers of help and food, get out of the house alone!
• I loved getting meals brought by friends, but I didn’t always want to socialize. So, someone to run interference, or maybe a drop-off location for leaving food. (*note from Molly: my doula was the perfect person for this job.)
• Ask for help! No one will know what you need if you don’t speak up.
• Don’t go without showering for more than four or five days. Brush your teeth once a day no matter what, even if it ends up being at a weird time. Take your vitamins/ herbal supplements/tea. HYDRATE! Nap with baby if you need to, arrange childcare for older siblings sometimes, but also listen to your instincts—one of my worst baby blues moments was with my third when my older two were gone and I wanted them home!
• LOVE yourself, nap when you can , Yes you are doing it right, No it’s no ones business (breastfeeding/cosleeping/pumping etc.) allow opinions and advice to slide off, drink lots of water , eat small snacks/meals, love your baby look into their beautiful eyes and connect, skin to skin whenever even with dad or siblings (safely) cherish these moments they don’t last forever, the laundry will get done, the dishes will be get cleaned …
• Take a “babymoon”. Put on a robe when someone comes to the door–even if you have real clothes underneath. Sleep when the baby sleeps. Don’t answer the phone. Remember, self-care is essential for you to be able to care for your baby.
• I loved having herbal soaked pad (frozen) to wear afterwards, felt soooo good. Have easy one-handed snacks available and a BIG water bottle.
• In those last few months of pregnancy I prepare meals to freeze (I start about month 5 or 6). I make up 6 weeks worth of dinners (they always last longer since we have a great church family and friends that bring us meals). After baby is born I can put 2-3 dinners in the refrigerator (to thaw) a few days before I need them. Then all I have to do is pop one in the oven and BAM….dinner’s ready. I love “Don’t Panic, Dinner’s In The Freezer” I & II. The recipes are amazing and all freeze well. Hope that helps!
• Skin-to-skin in bed for as long as possible; 40 days of rest, recuperation, establishing breastfeeding, bonding, limited visitors, and limited activity; drink when the baby nurses; sleep when the baby sleeps; nurse on demand; learn to wear your baby; and use a peri bottle when peeing! A postpartum herb bath and massage are nice, too.
• Hot water bottle for afterpains
• Placenta encapsulation and WishGarden Herbs ReBalance tincture!
• Chiropractic adjustments, ASAP
• Call in your mom. My mom’s job after my second was born was to keep me fed and to spend some quality time with my older child.
• Drag oneself outside and BREATHE!
• Water…..hot tub, shower, steam, pool, raindrops, snow, sauna, bath, river, stream, ocean, lake! If you can, immerse yourself, if you cannot, imagine yourself floating
• Lots of water, lots of protein and healthy fats, placenta encapsulation and low expectations of anything other than bonding time with baby.
• Don’t try to impress others with how quickly you can get up and going, even if you can, just take it easy!!!!
• It’s not in the asking for help; its in the accepting…

Surround her with support!

Check out these previous posts:

Mothers Matter–Creating a Postpartum Plan

Planning for Postpartum

Some reminders for postpartum mamas & those who love them

and a great one for helpers written by my own doula:

The Incredible Importance of Postpartum Support

And, remember…

“The first few months after a baby comes can be a lot like floating in a jar of honey—very sweet and golden, but very sticky too.”

–American College of Nurse-Midwives

This post is crossposted at Talk Birth.

Grassroots News: $40 Million Going Towards Early Inductive Election, Prematurity

Hello Friends,

The US Department of Health and Human Services (HHS) has launched a campaign called the “Strong Start Initiative,” which is designed to decrease the number of preterm births occurring every year. Babies born prematurely are more likely than babies born at full term to experience a vast array of medical complications both in infancy and across the lifespan. In order to reverse a 20 year trend of increasing rates of prematurity, the HHS has announced the availability of $40 million in grant money for programs that are exploring ways to reduce prematurity through improved prenatal care.

The “Strong Start Initiative” will focus on reducing early elective inductions, which are labors that are induced prior to 39 weeks and without any medical indication. The rate of early elective inductions has increased dramatically over the past decade and is associated with poorer outcomes for babies and increased obstetrical interventions, including cesarean section. Reversing this trend can improve the health of babies and reduce unnecessary medical intervention in birth.

In addition to creating conditions for healthier births and babies, the Strong Start Initiative has the potential to save considerable health care costs that are typically associated with preterm births. The HHS will partner with the March of Dimes, the American Congress of Obstetricians and Gynecologists, and other organizations to implement this campaign.

To learn more about current research on early elective inductions, see the recent Citizens for Midwifery article.
To learn more about the “Strong Start Initiative,” read the full press release.

Warmly,

Lauren Korfine & The CfM Team

Happy New Year!

When I began writing this blog for Citizens for Midwifery, one of my goals was to be collaborative in terms of networking with other maternity care activists across the country. To me, that means giving acknowledgement, praise, and congratulations to other organizations that are making a real difference and to sharing ideas, credit, and resources with each other. It makes complete sense to me to create a climate in which organizations are mutually supportive of one another, rather than in competition with one another. To that end, I'd like to highlight the year-end fundraising requests of some great organizations working on behalf of mothers, babies, motherbabies, midwifery, women's health, or birth activism. There are many worthy organizations out there working tirelessly on behalf of the women in this country and beyond our borders. I hope you will help to support any or all of them in some way so that we can greet 2012 with a strong camaraderie as our complementary efforts to improve maternity care continue to survive, thrive, and blossom into hopeful and beautiful fullness. To make a donation to Citizens for Midwifery, please visit this link and become, at minimum, a "citizen" supporter yourself!

CIMS shares some great information:

This year has been an eventful one for maternity care advocates. Ina May Gaskin, noted midwife and author of Spiritual Midwifery and Birth Matters won the Right Livelihood Award, (also known as the “Alternative Nobel Prize”) for 'outstanding vision and work on behalf of our planet and its people'. Robin Lim, an American midwife working in Indonesia, won the CNN Hero of the Year award. Ricki Lake and Abby Epstein released their new film “More Business of Being Born.”

The Coalition for Improving Maternity Services (CIMS) has had an eventful year as well. With the end of the grant funding that CIMS was fortunate to have for the past few years, CIMS is now transitioning into a leaner organization and we are sharpening our focus more than ever on improving maternity care and promoting the principles of the Mother-Friendly Childbirth Initiative (MFCI).

In March, CIMS-along with the Breastfeeding and Feminism Symposium-co-hosted our Forum “Reframing Birth and Breastfeeding-Moving Forward” in Raleigh, North Carolina. Forum attendees were privileged to hear cutting edge presentations on a wide variety of the latest topics in birth and breastfeeding from stellar speakers such as:

• Eugene Declercq, PhD, MBA, Boston University School of Public Health, “Where We Stand in Improving Maternity Care, Blue Print for Action”
• Penny Simkin, noted Author, Doula, Childbirth Educator, Birth Counselor, "What's New With Doulas? Challenges and Opportunities"
• Bettina Lauf Forbes and Danielle Rigg, Co-Founders, Best for Babes Foundation, “Changing Frames: Giving Breastfeeding a Makeover”
• Geradine Simkins, CNM, MSN, current President of Midwives Alliance of North America, "What Matters to Women, Matters to Midwives”
• Kirsti Kreutzer, Doula, Filmmaker, one of the founders of “Where’s My Midwife?” "Social Media and Activism: 'Where's My Midwife?' Calls For a Revolution"

As always, the CIMS Forum facilitated many exchanges of ideas and professional learning from leaders in their fields. (Click here to learn more about what sessions were offered or to purchase audio recordings from the Forum). CIMS was also honored to host two luncheons for CIMS’ Organizational Members, and facilitate discussions for collaborative learning and sharing ideas between many of the major birth organizations from around the country.

The Mother-Friendly model of care continues to set the standard for maternity care across the United States. CIMS is proud to continue to grow and promote The Birth Survey, which has amassed a huge database of women's birth experiences that are invaluable to researchers and care providers and encourages women and their families to seek out Mother-Friendly maternity care.

You can be a part of the growth and positive change in maternal infant health by partnering with CIMS as we continue to be a voice for Mother-Friendly care. If you haven’t already, won’t you join us by either becoming a member or making a tax-deductible donation to CIMS before the end of this year?

Thank you for all that you do to improve and promote Mother-Friendly care!

I also heard from the women at National Association of Mother's Centers (make sure to check out their 12 Days of Christmas video!)

What are you grateful for this year? Perhaps it's the birth of a new baby, or the purchase of a new home, the start of a new job, or maybe the giggles of your kids or grandkids.

For many mothers across the country, being grateful for the Mothers' Center is at the top of their list this year. They are thankful they have a place where they can come to share in the joys and challenges of motherhood and gain friendship, support and sisterhood during what can be one of the most isolating experiences of our lives.

If you are feeling grateful for your family this year, please consider making a donation in honor of that gratitude to the National Association of Mothers' Centers. With your help, we can continue our work helping mothers across the country.

And as a holiday treat - we've created this short video:A Mother's 12 Days of Christmas. Enjoy!

Choices in Childbirth is another amazing favorite of mine. I'm in love with their Guide to a Healthy Birth. Seriously. In love.

As you make your year-end chartiable contributions, please consider a gift to support Choices in Childbirth in our endeavor to improve maternity care by ensuring that women and families have access to the full range of birth options and helping women make informed decisions about childbirth. To ensure that your gift is tax-deductible for 2011, make a secure online contribution by December 31.

Thank you for your dedication to healthy birth.

P.S. Are you on Facebook? Join our Cause and start your own Holiday Wish Fundraising Page to benefit CiC!

Also, we love the Transforming Maternity Care initiative of Childbirth Connection!

As the year comes to an end, we want to say one last thank you to everyone who has remained passionate about transforming maternity care in 2011. As we wrote last week, our efforts are starting to pay off.

Let's keep this momentum going in 2012. We have the collective vision, and we know how to get there. Leaders and legislators are listening and women are activated because they know they deserve better.

There's still time to make a tax-deductible donation to support Childbirth Connection. Every dollar counts and every dollar will be used to transform maternity care.

CfM Board member Hillary and I both have our pictures on the cover of the newest edition of the women's health classic, Our Bodies, Ourselves:

"We want women to say: I read a book and it changed my life."

That's how our Turkish partner, Mavi Kalem, approached the challenge of creating Bedenlerimiz Biziz, the first Turkish adaptation of Our Bodies, Ourselves.

Slated for release in 2012, this new edition explores the social norms and laws, traditional practices and religious edicts that make it difficult for Turkish women and girls to exercise their health and human rights.

This holiday season, please give as generously as you can — $100, $250, or more — to Our Bodies Ourselves.

Your generous contribution sustains our legacy of educational activism on behalf women and girls in every region of the world.

For donations of $150 or more, we will send a signed copy of the new U.S. edition of Our Bodies, Ourselves, selected by Library Journal as one of the Best Books of 2011. Keep it for yourself or share it with friends, your local library, or community health clinic.

La Leche League has a long history of advocacy for mothers and babies and they are close to meeting their year-end fundraising campaign goal:

We have one last challenge match on the table! Between now and December 31st all donations will be matched dollar-for-dollar up to $5,000! Gifts can be made either online or by mail.

We already have an original challenge of all gifts being matched dollar-for-dollar up to $100,000, so any gift you make this last week of our campaign will go three times as far in helping mothers and babies.

These are just a handful of the many high quality organizations out there working on behalf of compatible purposes. We wish them all the best in 2012!

May the dawning of 2012 find you with warm hearts, treasured companionship, and lots of love. And, may women, babies, and families have access to quality maternity care and healthy birth choices throughout the world.

--
Molly
CfM Blogger