I need ideas and help and suggestions! I feel like I have tried them all, but I am sure I haven't.
But guess what? I need your help. As a practitioner I can't find everything. Mammograms can't find everything. Who knows your body the best? YOU DO! You are the one who is ultimately responsible for your body. You are the one who lives with yourself and your breasts every day. You are the one who has the ability to do a self breast exam monthly.
I think I will put a little more trust in this Arizona hospital system... They are definitely trying to make birth safer for women and babies.
Arizona hospitals are taking a stricter stance on doctors and mothers who want to deliver babies before full term.
Banner Health is the latest to join a growing number of hospitals that are informing doctors and expectant mothers that they will no longer schedule deliveries before 39 weeks of pregnancy unless there is a medical reason to do so.
Hospitals are citing medical research that shows even the last few weeks of a full-term pregnancy are critical for a newborn's development. Babies who are born at 39 or 40 weeks are more likely to have improved brain, lung and eye development as well as lower risk of death compared with babies born earlier.
The change marks a cultural shift for Phoenix-area obstetricians and expectant mothers who have grown accustomed to planning births due to schedules, convenience, family visits or other non-medical reasons.
More than one dozen Valley hospitals have taken a hard stance, no longer scheduling elective Caesarean sections or inducing labor before 39 weeks.
"We've sort of gotten into this habit (of scheduling deliveries)," said Dr. Ken Welch, an obstetrician and Banner Estrella's chief medical officer. "We have gotten very good at inducing labor. Just because we can do it doesn't mean we should do it."
Banner Health will stop scheduling elective C-sections or inducing births for pre-term babies beginning July 18. Banner's decision will impact 19 hospitals in Arizona and other states.
Other Valley hospitals, including Scottsdale Healthcare, Abrazo Health Care and Catholic Healthcare West, already have made the switch.
The new policies will likely affect a significant number of mothers-to-be in metro Phoenix.
Local experts estimate that such convenience births represent 20 to 30 percent of all deliveries at some Valley hospitals.
Banner Health said that 42 percent of babies born at its hospitals last year were delivered before 39 weeks. Those deliveries covered the spectrum of births, including medically necessary births and natural births that occurred before full term. It included elective C-sections or early inductions of labor, although hospital representatives said they did not have reliable data on the number of such early, elective births.
The rate of Caesarean births climbed steadily over the past decade. About one out of three births in the United States are delivered via C-section. In Arizona, 26.2 percent of all births were by C-section in 2007, up from 16.1 percent in 1996, according to Centers for Disease Control and Prevention statistics.
Hospitals that already have targeted the early, elective births said that reaction has been mixed among doctors and patients. Some doctors have said they've successfully induced labor or performed C-sections before 39 weeks and saw no reason to change.
"There has been a transition," said Dr. BJ Johnson, chairman of the board of trustees for Arizona Perinatal Trust, which certifies Arizona hospitals with labor and delivery wards.
"Initially, there was some significant pushback from the doctors."
Johnson said doctors have become more receptive to the policy after they reviewed medical data and told their patients about the new hospital policies. It also has emboldened doctors pressured by patients who want to schedule a birth.
"They changed their culture and basically moved forward and informed patients this is policy now," Johnson said.
When doctors need to intervene early for medical reasons, they will still be free to do so.
Banner Health cited nearly two dozen medical reasons that would prompt an early delivery. Some common medical reasons could include high blood pressure, kidney disease, pre-eclampsia or placenta previa, a condition in which the placenta is too close to the cervix.
Organizations such as the American Congress of Obstetricians and Gynecology, Joint Commission and March of Dimes have advocated that the medical community adhere to the 39-week standard.
The March of Dimes, a non-profit that promotes baby health, has launched a public-awareness campaign that encourages hospitals, doctors and patients to follow the standards.
The group believes that if expectant mothers see the evidence for the benefits of full-term births, they'll be willing to wait a little longer rather than pressure their doctors for an early birth.
Of particular concern to the March of Dimes and physician organizations is the rise in the number of "late pre-term" births between 34 and 36 weeks. They believe the likely culprit is elective early births.
The March of Dimes' "2010 Premature Birth Report Card" gave Arizona a "D" and estimated that 12.9 percent of births in this state were premature, higher than the national target rate of 7.6 percent. Other factors contribute to premature births, such as a mother's health and habits; and availability of medical insurance can be a factor, too, paying for needed health care before and during a pregnancy.
One complicating factor is getting an accurate estimate on the fetus' age. If a mother-to-be does not get an ultrasound during the first trimester, it becomes more difficult to accurately gauge the fetus' age, said Dr. Michael Foley, Scottsdale Healthcare's chief medical officer.
"The size of the baby doesn't necessarily reflect the maturity," Foley said. "A baby may in fact be 40 weeks and only measure 36 weeks."
Still, those final weeks can be critical for a newborn's development. Full-term babies are less likely to have hearing, vision, feeding or birth-weight problems. Those final weeks of a pregnancy also give the lungs, eyes and brain enough time to fully develop.
Babies born early are more likely to spend time in a neonatal intensive-care unit, which can be expensive for the parents
In rare cases, those final weeks can be the difference between life and death. Babies born at 39 weeks or later were 50 percent less likely to die than babies who were born earlier, according to a study in the June 2011 issue of the medical journal Obstetrics and Gynecology.
"The ones that are 37 weeks have twice the amount of problems of babies at 39 or 40 weeks," Welch said. "If I am looking at my child or grandchild, I want to have the best odds of them doing well."
Reach the reporter at ken.alltucker@arizonarepublic.com or 602-444-8285.
Here is a picture of a birth stool. You use it, well, like a toilet. Did I just say that? Well, I guess I did. Often when you push or bear down to birth your baby we tell women to push like they are pooping. Well guess what? Pooping lying down is hard to do- how many times in our adult lives have we pooped lying down??? How many times have we pooped, lying on our backs and holding our legs up by our ears? Do you get the picture yet? It is hard to teach some women how to push effectively if we teach them to push like they are pooping.GETTING STARTED
Ready to go with cloth diapers? Here is how many of each item you will need:
When considering the amounts to buy, take into account the age of your baby. Newborns and infants will need 10 to 12 changes a day. Toddlers will need 8 to 10. Most cloth diaperers wash diapers every 2 or 3 days.
If you decide to try fitted cloth diapers be sure to try a sampling before investing in a large number of any one brand. Fitted diapers vary quite a bit in size and fit from baby to baby.
Your cloth diapering system can be all one type of diaper or a combination of pre-folds, fitted, and even all-in-ones.
WASHING INSTRUCTIONS
Wash and dry new cloth diapers 5 to 10 times to remove chemicals. This will also increase the absorbancy of your cloth diapers. Do not worry if you notice that your cloth diapers "quilt up" during this process. This is normal.
The washing instructions are for a full load of cloth diapers. You may include nylon and polyester diapers covers in this load. Handwash all wool covers.
Overnight Soak Method
REMOVING URINE SMELL
Include baking soda when washing or soaking your cloth diapers.
If you use baking soda in the wash or soak, make sure to use vinegar in the rinse, This will help restore the pH of the cloth diapers. Otherwise your baby may end up with diaper rash.
According to Vicki Lansky author of Baking Soda : Over 500 Fabulous, Fun and Frugal Uses You've Probably Never Thought of, baking soda works with liquid detergents to whiten and brighten laundry. It does not boost powder detergents.
VINEGAR IN THE WASH
Many parents have complained that using vinegar in the wash leaves their diapers remaining smelly. Actually it is more effective to use baking soda in the wash and add vinegar to the rinse. See our washing recommendations for more information.
Hint: Consider using vinegar in the rinse cycle of all your laundry, not just the diapers load. Also consider buying distilled white vinegar by the gallon for general household cleaning. Melodie Moore's book, Vim & Vinegar, is a wonderful resource for learning how to use vinegar to replace expensive cleaners for floors, refrigerators, furniture, laundry, copper and stubborn stains.
WET PAIL AND DRY PAIL METHODS
There are 3 basic methods for storing wet and soiled cloth diapers, wet pail, dry pail and wet/dry pail.
FASTENING PRE-FOLD CLOTH DIAPERS
Fastening is the biggest challenge with pre-folds.
FOLDING PRE-FOLD CLOTH DIAPERS
Here are two methods:
WHY AREN'T MY NEW NATURAL CHINESE PREFOLDS ABSORBENT?
Cotton has a naturally occuring wax in it. Since your natural Chinese prefolds are not bleached during manufacture, the wax is not removed. To remove the wax, you must wash your prefolds in VERY hot water. Here are some tips for those whose water may seem to be not quite hot enough. Try Tide. We do not recommend Tide for daily use because it is harsh, but it does seem to help remove this natural wax more quickly. Turn up your water heater for a few washes or add boiling water to your washer to raise the water temperature. We have also had some moms boil their diapers with great success! The number of washes needed to remove the wax will vary. If your water is very hot and you use Tide and you have city water which is chlorinated, you may only need to wash once. In other cases, you may need to wash a few more times. Rest assured, this natural wax will always come out! Contributed by Joyce of Katie's Kisses
Midwife-assisted births can offer mothers more control over the delivery.
DETROIT — Steve Lucero drew in his first look at his baby girl under the ripples of water of the birthing tub at Hutzel Women's Hospital, her thick dark hair wafting gently as she began the descent from her mother's body.
The lights were dimmed in the delivery room. Jess Lucero dipped her fingers into the 100-degree water, until — at 10:20 p.m. March 12 — Aviana Cessalee's feather-soft 6 pounds and 15 ounces eased into the world.
There was no rush from attending staff. No bright lights and bustle. Nothing — except for the soft blue light inside the tub and Avi's intake of air as she lay on her mother's chest.
Jess Lucero, a 26-year-old doctoral student at Wayne State University, was ecstatic: "I gave birth, I delivered my baby. It wasn't delivered for me. It was wonderful."
Jennifer Kelley, 32, a bubbly nurse-midwife who had monitored and encouraged the Luceros in the last hour, cleaned out Avi's nose and mouth, then stepped away for the new family of three, Steve Lucero said.
The Luceros are among a steady percentage of moms who each year choose a midwife-assisted birth over a traditional medical approach. Midwife-assisted births can offer mothers more control over the delivery, a more personal relationship between patient and caregiver, and the option of fewer medical interventions.
Midwives attended 317,626 births in the United States in 2008, or about 7.5 percent of overall births. Of those midwife-assisted births, nine of 10 were delivered in hospital settings, according to the National Center for Health Statistics.
Jess Lucero said the midwife who helped her through her pregnancy, Mary Lewis, 68, who also heads the Wayne State University Physician Group's midwifery program, was "warm and wonderful."
"She always took time in my appointments to really sit with me and answer questions and make me feel like I'm not being paranoid. She was very maternal," Lucero said.
The mother-midwife partnership is often forged in first names and easy conversations about health and nutrition and pregnancy rather than through titles and quick conversations on an examination table.
LaCynthia Davis, 41, who gave birth to her fifth child May 12 at Hutzel, carried her midwife's personal cell number with her.
The relationship between mom and nurse-midwife feels more like a friendship, said Davis and her midwife, Mary Milkey.
"This is the difference for me" between midwives and a delivery room doctor, said Milkey, 36, a mother of three. During her own prenatal visits, Milkey said, " I felt like I was going to chat with a friend."
She added with a laugh: "When all my prenatal visits were over, I felt like we were breaking up."
Certainly, there are doctors who provide that type of personal interaction. But midwife philosophy is based on it. It's a holistic, personal approach to pregnancy rooted in the belief that birth is one of the most empowering moments for parents.
That understanding and control, in turn, brings the baby into a calmer world — whether the mother is on a hospital bed, being soothed by a warm shower, or trying to relax in a birthing tub as the Luceros chose.
Some moms want more control, fearing they'll be simply a number in a traditional medical setting. Or they worry they'll lose control against what they see as unnecessary drugs and medical interventions.
With one in three babies now born by cesarean section, many believe that traditional medicine is too quick with drugs and a scalpel.
"The evidence supports that many interventions today are overused. Births in the United States are over medicinized," said Eileen Ehudin Beard, senior practice adviser at American College of Nurse-Midwives.
"As women become more educated consumers and evidence comes out at the normalcy of birth," she said, they feel many interventions are "not only not necessary but also deleterious."
But what about the pain?
First, midwives can deliver pain meds. From time to time, a woman does opt for pain relief, especially first-time, anxious mothers.
For Davis, her midwife helped control anxiety and pain.
"I guess it was all natural. It was a mind thing. When the pain comes you just made a noise, breathed and go with it," she said. "I made a decision, and everyone knew I was going to stick with it."
Milkey provided Davis' prenatal care, so both were thrilled when Milkey was available for the birth.
Inside the Hutzel delivery room, Davis' partner, Ali Watson, pulled up a stool at Davis' side and held her hand throughout the pain. Milkey stepped in only when necessary, offering words of support and progress reports.
"There's a saying that midwives catch babies," Milkey said later. "And we do. Really, Mom" is in control.
— — —
WHAT DO DIFFERENT MIDWIFE CERTIFICATIONS MEAN?
The expertise, education and credentials for midwives — even where they can legally attend a birth — varies, though most births now occur in the hospitals with certified nurse-midwives.
Knowing these differences can help consumers find the right fit.
Certified Nurse-Midwives: They usually deliver in a hospital or birthing center, though some also work in homes. They are registered nurses who have advanced training in a program accredited by the Accreditation Commission for Midwifery Education.
More can be found at www.midwife.org.
Direct-entry Midwives: They generally deliver in homes, and their education varies.
Some direct-entry midwives are Certified Professional Midwives who have met competency-based standards set by the North American Registry of Midwives. For more information, visit www.narm.org.
Some direct-entry midwives are not licensed at all, in part, because the paperwork would not authorize them to practice in some states, anyway. In other states, laws prohibit them altogether, said Willa Powell, president of the Citizens for Midwifery. Her group wants nationwide acceptance of certification for midwives.
The lack of recognition can create a "buyer-beware scenario," says Powell, and it reduces the options for women.
In worst cases, midwives attending home deliveries illegally may hesitate before seeking out a doctor in an emergency, fearing legal trouble.
Just 27 states license Certified Professional Midwives, and Michigan is not among them.
For more information on differences in midwives and state laws, visit www.cfmidwifery.org.
New Episodes Premiere Weekdays at 2/1c |
  About the Show  A Baby Story takes viewers on an intimate and emotional journey by profiling couples' experiences from the final weeks of pregnancy through the first weeks of a new life. A Baby Story would not have been right for my birth.Enough of my ranting about the show- I don't trust it. You may if you wish., just please keep your eyes open and educate yourself- Watching A Baby Story should not replace childbirth classes!! |
My labor nurses were AMAZING! It did help that they were close friend's who I previously worked with when I was working at the hospital. My darling nurse April, missed my birth with Cara. I called her when I was on my way to the hospital. She got in her car at the same time and she came in a few minutes after I had welcomed my sweet girl earthside. 
By Robin Elise Weiss, LCCE, About.com Guide
Photo (c) iStockPhoto
Here are some things I've been meaning to share with you about our upcoming birth:
Love,
Your Daughter or Daughter-in-law
