Rally to Improve Birth Scheduled at ANM on Labor Day

By Glenni Lorick, IBCLC

I meet women every week who have been traumatized by birth, who have had their wishes blatantly ignored despite the fact that there were no imminent complications, who have been told they can't have a VBAC, who want the right to give birth THEIR way! In the vast majority of circumstances, pregnancy is a normal condition, not an illness, and childbirth, when allowed to progress normally does not need to be traumatic.

Improving Birth began with a local group of moms in San Diego, CA, but has grown into a worldwide movement of supporters who want to bring evidence-based care and humanity to childbirth. This Labor Day a group of Huntsville moms will gather in front of A Nurturing Moment as part of the international Rally to Improve Birth.What is this all about? According to their website,

This movement isn’t about natural birth vs. medicated birth. It’s not about hospital birth vs. homebirth or birth center birth.

It’s about women being capable of making safer, more informed decisions about their care and that of their babies, when they are given full and accurate information about their care options, including the potential harms, benefits, and alternatives.  It’s about respect for women and their decisions in childbirth, including how, where, and with whom they give birth; and the right to be treated with dignity and compassion.

We are so excited that our local event will be right here in front of A Nurturing Moment this coming Monday from 9:00 am to 11:00 am. You can RSVP here to let the organizers know you are coming! There will be music, refreshments, information tables, and sidewalk chalk for the kids. Just bring your sign, a lawn chair, and your commitment to improve birth in Alabama! 

If you are wondering what to put on your sign, check out this terrific video for some ideas. Even if you had the birth you wanted, you can still advocate on behalf of mothers everywhere. Every mother should have the right to choose where and how she wants to give birth. Informed consent should be automatic, not something that women have to fight for, and every woman should be able to benefit from evidence-based best practices in maternity care.

ANM is Making it a VERY SPECIAL Day

In conjunction with the Rally to Improve Birth, ANM has two very special events going on!

1. Sidewalk Sale - we will have a sidewalk sale with rock-bottom prices on many clearance items as well as rock-bottom prices on in-stock Best Chairs, Britax car seats, Medela Breastpumps and other items. We will also offer on-the-spot financing for chairs, pending credit approval (up to 12 months same as cash).

2. Lemonade Stand - Sarah Bailey's son John has been wanting to have a lemonade stand here for quite a while, so we will have a lemonade stand on Monday! If your child would like a shift working, please email Sarah . The proceeds from the shift your child works will be donated to the charity of his choice!

Please  note that our store hours on Monday will be a little different from normal. We will be open from 9:00 am - 3:00 pm so our employees can spend Labor Day afternoon and evening with their families!

Waiting on the Perfect Timing

Angela at 36 weeks. She is a tremendous inspiration!

By Glenni Lorick, IBCLC
Yesterday morning I listened to a conference call with one of the most inspirational people I know, Angela Loehr Chrysler. She is 38 weeks pregnant, and very ready to have her baby! Yet the focus of her comments was the importance of waiting on the right timing. She summed it up this way: "I believe in God's perfect timing, greatness is in store for you! Remember waiting on His timing is not always easy...but always worth it. Pray through your impatient moments & trust in the journey."

Perfect Timing in Childbirth

When you are at the end of your pregnancy, you are so ready for baby to be born. When a well-meaning doctor offers to schedule an induction, be sure to carefully evaluate the risks. If your body isn't ready to go into labor, then you may end up on the downhill road to major surgery instead of a much safer vaginal delivery. Your baby is also placed at increased risk for temperature instability, hypoglycemia, respiratory distress, apnea and bradycardia, and clinical jaundice.

Every mother who has ever gone into labor naturally at 39, 40, 41 or even 42 weeks knows how challenging it is to wait for your body to be ready. But if you can, as Angela says, pray through your impatient moments and trust in the journey, it will definitely be worth it because your baby will be born when he or she is ready. The likelihood of complications is reduced, and the probability that your baby will be able to breastfeed well is increased.

From The Litter Box

Perfect Timing in Parenting

Often as parents we are eager for our children (especially the first one) to hit the next milestone, whether it is rolling over, crawling, taking a sippy cup, walking or starting to read. But it is so rewarding to just relax and enjoy the ride. You are on an amazing journey with your child; the scenery changes as you move forward, so be sure to drink in every moment. Don't be so focused on the next big step that you miss today's smile or new word. You are the only real expert on your baby, on your toddler, on your child, on your teen, so don't let somebody else's expectations force you and your child into a pace that isn't right for you.

One of the most rewarding things for a parent is seeing your child accomplish great things. A baby gaining weight on his mama's milk is doing something amazing! A toddler learning to put away his toys is accomplishing something really important. A young child sounding out his first words is on the verge of the amazing accomplishment of learning to read. Celebrate the moments of greatness in your child's life. It's a really big deal, so make sure that they know you are proud of them!

Tomorrow is my 9th grade son's awards assembly at school. I don't know what he will receive, but I've been invited, so he's getting something. You better believe I am taking off the afternoon because I want to celebrate his success! Look for ways to celebrate any victory your children have, however big or small it might be.

Perfect Timing in Life

Whether you are a stay-at-home mom, a mom employed outside the home, or a mompreneur, recognizing that the combination of a positive, optimistic attitude and a willingness to wait on the right timing is a critical key to genuine fulfillment. Every person has the potential for greatness. One of my deepest joys at A Nurturing Moment has been to see our moms taking leadership and creating opportunities for other mothers to get help, support and encouragement. These moms are doing great things at the right time in the right place. 

Wherever you are in life, you can do amazing things. Braiding your little girl's hair, nursing your chubby-cheeked little boy, reading "one more" bedtime story to your tired toddler, helping your frustrated fifth grader with her homework, taking cupcakes to lunch at your child's school - all of these are great things! Take just a minute today to enjoy and appreciate all that you are and have. Then smile at the future because you have even greater things to do tomorrow!

Childbirth and Infant Mortality Abroad: The Netherlands

By: Marley Phillips, ANM Intern

Okay folks, let’s talk about the Netherlands. The Netherlands has the 20^th lowest infant mortality rate in the world. Not as impressive as the other countries featured, but I digress. This country has had worldwide recognition for its maternal healthcare, and I wanted to know why. The Netherlands is home to possible the most risqué city in the world, Amsterdam. The country as a whole is known for its sexual promiscuity and frequent visits to the “coffee shop”. With this knowledge, I did not expect the Netherlands to be a very family-friendly place. However, the government strives to take care of expectant mothers and ensure parents and babies are happy and healthy.

The Netherlands requires all citizens to buy approved private insurance plans. Insurance must cover anyone who asks for insurance. Citizens pay flat-rate premiums for all ages and incomes. If people use less than a preset amount of care in a given year, they get a refund. All insurances cover birth, but all insurances may not cover a hospital birth. Insurance also covers the cost of a kraamzorg service, but more about that later.

Holland is known for having the highest rates of homebirth in Europe for decades. We’ve always heard the amazing fairytales of a magical place where women get to choose where they birth. And midwives; oh, midwives for miles and miles! Despite the stories, the Netherlands’ home birth rates have been steadily declining for quite some time, and are now at an all time low of 24%.  Now, 24% may not seem very low to you or I here in America where the home birth rate is less than one percent and absolutely, completely taboo. But, for Holland, this is a staggering drop in numbers. 25 years ago, over 2/3 of women gave birth at home and now less than 1/3 are opting for the same birth experience. So why are so many women running for the hospital these days? According to this news story, some doctors are saying women now want a variety or pain relief and speedy deliveries. Seems like Holland is catching up to the rest of the world’s need for luxury and promptness.

After confirming the pregnancy with a general doctor, doctors can refer a midwife or women can choose their own midwife. The first appointment with a midwife won’t be until around week 12, where the midwife obtains medical history and does screening to assess if a woman would qualify for home birth, or if she should be referred to an obstetrician. The midwife will continue to monitor a patient’s condition to ensure she is the perfect candidate for home birth.

In the first 12 weeks of pregnancy, women should also arrange for a kraamzorg service. What’s a kraamzorg service, you ask? A kraamzorg is a wonderful service offered to new families that provides in-home postnatal care. Along with showing the new parents how to bathe and dress and basic breastfeeding support, the kraamzorg will also do some light cooking and cleaning around the house. The kraamzorg stays for about a week for 4-8 hours per day, depending on the need. Since this is such an amazing service, women are encouraged to find a kraamzorg service by the12^th week of pregnancy because it could be difficult to find an availability.

If a woman opts for homebirth, there’s not much procedure. Labor starts, midwife comes, out pops baby. The only thing is that each bed will require a metal riser to meet safety regulations for delivering a baby. Obviously, there is no type of pain medication when giving birth at home, so if a woman wants that she needs to go to a hospital. Although, I should mention only about 10% of women actually get the pain medication in Holland, and doctors are not too willing to administer it. When pain relief is given, it is usually in the form of an opiate-based liquid on a push-button basis. A midwife will deliver the baby, unless there is some type of abnormality, and most women are released within 24 hours of delivery.

Another option for expectant mothers in the Netherlands is a maternity hotel, or kraamzorghotels. These hotels offer a home birth for women whose home can’t accommodate a birth, or who simply don’t want to stay home. In these hotels, the woman and her husband (or other guest) can stay in luxury and she delivers her baby, and will have a kraamzorg immediately available to help when the baby arrives. Prices weren’t available, but some insurance will cover this. There are also maternity clinics for these women who can’t have or don’t want a home birth. Women may choose this option as a way to be close to hospital amenities in case of emergency, but not actually have to birth in the hospital.

Breastfeeding is heavily encouraged in the Netherlands, although the numbers may not necessarily reflect that. 80% of women initially begin breastfeeding and by 6 months that rate has dropped to 20%. Many women attribute this to feeling unwelcome while feeding in public, as well as returning to work, even though the Dutch have great legislation for breastfeeding moms. The Netherlands has also started putting in breastfeeding cafes around the country. These cafes serve as a place for mothers to meet up and nurse, share stories, give advice, etc. The country is also working on setting up public destinations specifically for nursing moms, so that they may not feel shunned or be asked to leave any establishment while feeding, which has been a hot button issue in recent years.

So, here’s the Netherlands: nothing overly spectacular or groundbreaking happening here. Midwives handle nearly all the deliveries, whether at home or in the hospital, and there is a harmonious system between midwife and obstetrician that is clearly working for this country. Holland maintains a fairly hands-off approach to pregnancy and childbirth, and I am really hoping this country doesn’t follow in the footsteps of the rest of the industrialized world and begin over-medicalizing the natural art of childbirth. Yet, based on these new statistics, the  Netherlands reputation as home birth capital of the world may be quickly fading.

Childbirth and Infant Mortality Abroad: Japan

By: Marley Phillips,

ANM Intern

Japan has the 2^nd lowest infant mortality rate in the world. Japan. This is not some unpopulated country full of billionaire babies, this is Japan. Japan is huge! Gargantuan, actually. So let’s look into how Japan could have possibly achieved such an amazing feat.

Japanese culture holds the social status of the mother EXTREMELY high. Get that baby out of her, and she is back to being a rather unvalued member of society. But, for our purposes she does have a baby inside of her, and the Japanese do not take that lightly. The Japanese culture encourages women to get prenatal care very early into the pregnancy. Pregnant women are supposed to stay off their feet for the first 3 months (FYI, Japanese pregnancy is 10 months), and be very active for the rest of her term. There are many exercise classes offered by hospitals, maternity centers, and gyms specifically for pregnant women. 

Since Japan is the technology capital of the world, there is a lot of emphasis on using technologies in pregnancy. Ultrasounds are done at every appointment. Japanese women have a visit at least every 4 weeks through 23 weeks gestation, every 2 weeks from 24 to 35 weeks, and every week after 36 weeks. That’s a total of 14 doctor’s visits and a total of 14 ultrasounds. And this is a minimum. This was a little surprising to me in light of the research that has come about in recent years pertaining to ultrasound usage.

With obesity rates at just 5% and smoking rates among women 15 years and older at 11%, the Japanese maintain an overall high level of health. The customary diet, which is strictly monitored to only include the healthiest of foods for the baby during pregnancy, can certainly only help the pregnancy and subsequent baby thrive. Side note: the Japanese do not cut out fish while pregnant (even raw fish) and actually encourage eating it multiple times a week.

While these statistics are great, I found something is my research that kind of shocked me, and apparently shocked the citizens of Japan, as well. The (true) poverty rates were released for the first time in a number of years, only to find that 15.7% of the Japanese population is living below the poverty line. That’s not much lower than the United States’ 17.1%. We frequently link  poverty to things such as poor health and being uneducated; in our country, that is often the case. However, if the U.S.A. strived to help women be better educated about pregnancy and childbirth the way Japan government and culture does, our women would make better, educated decisions. Just a thought.

Prenatal Coupons

Like Monaco, Japan has a universal healthcare system that every citizen is entitled to. Unlike Monaco, it does not cover prenatal or postnatal fees. However, when you pay for your services out of pocket, the government will give you a “birth sum allowance” of up to 420,000 yen ($4,417). I also found out via a YouTube channel dedicated to birth in Japan that you get a ton of coupons redeemable for prenatal visits and such. Pretty stinkin’ cool.

            

            There are 3 options for giving birth in Japan: #1) in a hospital, #2) in a maternity clinic, and #3) in a birthing house. All of these places offer pre and postnatal care to women. I should also mention, the minimum stay in any Japanese birthing facility is 5 days for a normal birth. 5 days. Let’s allow that to sink in for a minute… 5 DAYS. That is so amazing. In these 5 days, you will be able to relax with your baby, learn some basic baby maintenance skills such as bathing and swaddling, 

and get breastfeeding support. (Oh yeah, those guys LOVE to breastfeed! More on that later)

The hospital stay will cost you anywhere from 450,000-470,000 yen ($4725-$4935). This is for a vaginal delivery with no drugs, seeing as the Japanese don’t take too kindly to epidurals and cesareans. If a woman wants either of these services, she will have to request it very early in the pregnancy and find a hospital willing to provide such services, which are few and far between in Japan. The cost of a cesarean birth is in between 500,000 and 600,000 yen ($5142-$6170).

The maternity clinic is a physician and midwife run clinic with fewer than 19 beds. This is a little more expensive, but they are little more lenient about position, in room stay, family, visitors, etc. Giving birth in a maternity clinic will cost roughly 480,000-550,000 yen ($5040-$5775), but you’ll have to pay an extra 2,000 yen ($21) to have an adult stay with you. Not a big deal. They’ll also give you tons of goodies when you leave, such as an audio recording of your baby’s first cry, a copy of your baby’s footprints, and pictures of your baby’s birth, and a certificate of your baby’s blood type. And, just for a good laugh, check out this Hello Kitty Maternity Hospital.

          

          Last, but certainly not least, there’s the birthing house. These little houses are run completely by midwives who will conduct your prenatal and postnatal appointments and, of course, catch the baby. Water births are very popular at birthing houses, and they also have plenty of accessories to help make birth comfortable such as a stool shaped like a horse shoe so that you can sit for the birth, and a rope hanging from the ceiling so that you may hold on to squat during delivery. The cost is 496,000 yen ($5208) and 40,000 ($40) extra for a water birth. For the midwives to attend home birth is anywhere from 480,000-500,000 yen ($5040 -$5250).

Now let’s talk about breastfeeding. If you’re reading this post, you probably already know breastfeeding is so much better for a baby than anything else that a baby could possibly be fed.  If you didn’t know, do some research. I have seen some conflicting stories about breastfeeding in Japan. Apparently the hospitals are not very BF friendly. But the Japanese society is so dang supportive of breastfeeding that the lack of hospital support usually won’t deter mothers from at least exclusively breastfeeding for the first month. Exclusive breastfeeding rates in 2010 at one month were 51.6%. At 3 months, 56.8%. The rate of any amount of breastfeeding was 95.4% at one month and 86.8% at 3 months.

The last topic I want to touch on is co-sleeping. Sleeping with a baby is the norm in Japanese culture. Most children sleep with the parents until around age 6. This may be in the bed or on a separate mat or sleeping surface beside the bed. The Japanese technically sleep on futons, but I digress. Japan has one of the highest co-sleeping rates in the world, yet one of the lowest SIDS rates in the world. Interesting, huh? See James McKenna for some interesting research about co-sleeping and much, much more.

So, here it is, a country comparable to the United States that has an extraordinarily low infant mortality rate. And this is how they’ve managed it. Japan has many of the same social and national issues that our great country has, yet they’ve seem to overcome them for the betterment of their mothers and babies. Maybe we, as a society and as a government, can look to Japan as a guide in implementing maternal education and providing better care to improve America’s staggering infant mortality rate.

Childbirth and Infant Mortality Abroad: Monaco

by Marley Phillips, ANM intern                Monaco is the 2^nd smallest country in the world. Bordered by France on 3 sides, this le petite country has a population of about 36,000 people. The population of Madison, AL is about 43,000, just so you have a comparison. Monaco has an unemployment rate of 0% and the highest number of millionaires and billionaires per capita in the world. (I’m beginning to see the appeal…)

So, why am I rambling on about this fairytale oasis full of billionaires and beaches, you ask? I ramble because, in addition to all of these amazing attributes, Monaco also has the lowest infant mortality rate in the world. With only 1.8 out of every 1,000 infants under the age of 1 dying every year, we had to know what in the world (pun intended) is going on across the pond. So, I went researching to find out what Monaco is doing so completely right.

I should articulate before I give you these facts and statistics that, since Monaco is such a microscopic country, I’m not sure if it’s fair that we compare it to the United States. Instead of comparison, let’s call this an insight into another country’s maternal health practices. A trip away from the reality we may know as victims of the USA’s poor maternal healthcare or as advocates for a change in the broken system.

For starters, Monaco has the lowest poverty rate in the world. Poverty rates can seriously affect infant mortality rates for many reasons such as lack of prenatal care, tobacco use, and preexisting conditions like obesity or depression. To follow up on some of these health-related issues, I went searching for Monaco’s smoking and obesity rates. While I could not find data for tobacco use on any national or international organization’s website, I did manage to snag the obesity rates in women ages 15 and older for nearly every country in the world.  Monaco came in with 30%. Not great, but not as bad as the U.S. (48%).

So…What is it like to give birth in Monaco?  There is a government-funded healthcare system available to all citizens and long-term residents, although most residents have a small private insurance claim to cover what the government insurance won’t. There are only 2 hospitals in Monaco, and both offer similar services in the maternity ward. I chose to research The Princess Grace Hospital in Monaco, for no other reason than I adore Grace Kelly. (Side note: if you like celebrity news check out this article reporting Brangelina’s experience with a Monaco birth. Or should I say Monaco’s experience with a Brangelina birth!)

Antenatal services at The Princess Grace Hospital include a midwife who is with you throughout the pregnancy, a tour of the facilities, consultation with an anesthesiologist (if that is the mother’s wishes), pregnancy classes, and information packets explaining options for your childbirth, labor, and follow-up care. During labor, there are both midwifes and obstetricians on staff, although the OBs are only there for high-risk pregnancies or emergency situations. They have all the tools and equipment so that a mother’s birth may be as invasive or hands-off as she chooses. After the baby is born, the mother can stay with the baby for as long as she desires, even throughout the night (it’s kind of sad that I have to say EVEN throughout the night, like it’s an amenity).

The key phrase that I have found in my research of giving birth in Monaco is “if the mother so chooses”. These mothers aren’t pressured or scared into having a certain kind of birth. They are educated and make informed decisions with the medical professionals about what is best for them and for their baby. I know that’s not necessarily a causation for the low infant mortality rates, but it sure can’t hurt to work harmoniously together. *steps off soapbox* Next time, I’m going to feature a country that can actually be compared to the powerhouse that is the United States of America and how we can possibly follow suit to improve our maternal healthcare.   

Women's Rights, Alabama Law and Midwives

For the last several years, an amazing group called the Alabama Birth Coalition has been working

Photo from SoulVegMama

tirelessly to bring about legislative change which will allow Certified Professional Midwives (CPM's) to practice in Alabama. This legislation is important because in many rural counties, women have to drive an hour or more to the nearest hospital with a maternity unit. Families who don't want medical community involvement may end up giving birth at home without any attendant at all. Legalizing CPM's and home birth would offer these women another option. Furthermore, creating legislation that sets forth licensing requirements and regulates the practice of CPM's actually helps to ensure that women choosing home birth receive a high standard of care.

The Opposition 

Opponents of the bill, however, are many and powerful. Unfortunately even within the midwife community, there is sharp disagreement about this legislation. Certified Nurse Midwives (CNM's) sometimes cite the lack of medical training received by CPM's as a reason not to support the bill. Are their concerns legitimate? Certainly the kind of training that CPM's receive is different in nature than that received by CNM's. It is definitely more focused on out-of-the-hospital births. In fact, a candidate cannot even become a CPM without experience in at least 10 births in a non-hospital setting.

While it is true that we do currently have 17 CNM's in the state of Alabama, only a very small handful of them are actually catching babies! Some work in doctor's offices, others teach, but only 3 or 4 hospitals in the state have a CNM delivering babies. Why is that?  Why isn't there a single freestanding birth center in this state? In one word, the answer is MONEY.  Blue Cross, Blue Shield of Alabama, the largest insurance provider in the state, doesn't reimburse for midwife delivery the way they do for a physician delivery...not even close! Plus, the Alabama law is written in such a way that a midwife may only practice under direct supervision of a physician. Essentially, her supervising doctor is supposed to be on the premises when a midwife is delivering. Few doctors are willing to have midwives deliver under those conditions.

The Reality

Dr. Pippa Abston 

Within the medical community here in Alabama, it is common to hear how unsafe home birth is. But is it really? Dr. Pippa Abston, a pediatrician and instructor in the UAB family residency program used to agree with those who opposed home birth. In fact, she was a rather outspoken opponent. However, she began to thoroughly examine this issue, to actually see what a CPM does, and to understand just how badly we need the quality of care in many Alabama communities that a CPM would provide. In fact, Dr. Abston wrote a 5 part series about the importance of CPM's for Alabama women. It will take some time, but if you really care about this issue, you need to read Dr. Abston's excellent series. She has covered everything from the training of  a CPM to the safety issue to the desperate need in our rural counties.

The Root Issue

This is, at it's most fundamental point, a human rights issue. Last Friday evening The Alabama Birth Coalition sponsored a presentation of the film, Freedom For Birth. Take 15 minutes to watch the abbreviated web-version of this film. It details the cases of Hungarian midwife, Agnes Gereb and Hungarian mother, Anna Ternovsky. In 2010, The European Court of Human Rights affirmed that a woman has the right to give birth in the place and manner of her choosing.

Hungarian midwife Agnes Gereb

The United States Supreme Court in the infamous Roe v. Wade decision in 1973 stated that a woman has the right to abort her unborn baby - a decision I don't personally support. However, based on that precedent, it is utterly illogical to say that she doesn't have the right to choose how and where her baby (whom she has chosen not to kill) can be born.  Even in the highly unlikely event that Roe v. Wade were ever reversed, it should be a common-sense decision to view a woman's right to give birth as she pleases as her decision to make. Whether a physician or a competent midwife  performs her prenatal care should be up to her. If a mother has chosen the midwifery model of care, and her midwife realizes that something is amiss, then her midwife should be able to have a collaborative professional relationship with a physician and should be able to stay with the mother throughout  whatever kind of birth the mother needs at that point. Opponents may say that this endangers mothers and babies. However, in the Netherlands where this is the model, the maternal and infant death rate is lower than that of the United States.

A Call to Action

There are many states in this country where women have absolute freedom to give birth in the manner that is most comfortable for them.  Alabama, however, is definitely not one of those states. We would do well to look at the maternity care models in states like Texas, Tennessee,  and New York. Two separate and very important things need to happen legislatively in Alabama:

Hungarian mother Anna Ternovsky

1. CNM's need to be authorized by law to work without direct physician supervision in any birth setting, and insurance reimbursement for their services needs to be mandated.
2. CPM's need to licensed and regulated by the state to ensure that mothers desiring their services are getting the highest possible standard of care. This will stop the mass exodus of birthing mothers to surrounding friendlier states, and allow mothers in the poorest Alabama counties access to local well-trained professional birth support.

Anna Ternovsky was willing to take her fight to the highest court that held jurisdiction over her country.  Will it actually take a mother here beginning that judicial fight to create the changes that must occur? I would hope that our legislators, midwives and physicians will find a way to come together in respectful support of mothers and babies before that happens. However, the Alabama Birth Coalition has been struggling for twelve years to bring about legislative change. Maybe now is the time to seek the kind of judicial ruling that will ensure all mothers have their basic right to give birth as they choose protected.

Someday I would love to see a Free-standing birthing center here in Huntsville where both CNM's and CPM's work together and have healthy collaborative relationships with local physicians. There is absolutely no valid reason why this can't happen. And I believe it will. If all those who are concerned about birth in this state would simply work together, we could lower our infant mortality rate, provide high-quality care to the poorest among us, and make certain that every Alabama mother receives her basic human right to the birth of her choosing.

Grandma Rules

Nicholas turned one today!

by Glenni Lorick, IBCLC
One year ago today my oldest daughter gave me the most amazing gift ever, my first grandchild! I've thought a lot about this marvelous first year of Nicholas' life. I have thoroughly enjoyed watching my daughter be a mother. I love hearing the little voice she saves just for Nicholas. Her face lights up just talking about him. This year has given me a wonderful new appreciation and respect for her.

Here at A Nurturing Moment I work with a lot of young moms - some younger than my daughter and some older. I see many amazing grandmothers come in with their daughters and grandbabies. Most of the time, the grandmother is incredibly supportive of the daughter.

Sometimes, however, I will see a mom who is truly upset because her mother (or perhaps it's her mother-in-law) doesn't think she's doing a good-enough job. I decided to address this issue with a few "Grandma Rules" because it is heartbreaking for the new mother. She really longs for her own mother's approval. Sometimes it's so bad that the new mother feels she has to put some distance between herself and her mother (or mother-in-law.) That just leads to more hurt feelings, misunderstandings and perhaps ugly words.

Grandma's Role

Whether you like it or not, if you're the grandmother, then your job is to support and encourage the mother. Maybe she isn't doing things the way you would do them. SO WHAT??? This is her baby! You had your turn at being a mother, now it's her turn. She is the expert on her baby, not you! Your job is to support and encourage her. If you disagree with something she's doing, it's fine to gently make a suggestion, but then leave her alone. You raised her to be the woman she is, so have some confidence in her abilities!

After 24 hours of labor, Sarah got her epidural and felt great!

I love my daughter very much, but she certainly is not my clone! We have very different views in several areas:

• Childbirth: I am a huge advocate of natural, unmedicated birth. I had a bad epidural experience and three amazing natural births.  Sarah, on the other hand, was all about getting that epidural. She woke up in labor at 3:00 am on May 1 and had progressively stronger contractions throughout the day. We headed to the hospital around midnight. After a horrible night of labor (with her mother who was there to support her snoring loudly on the pull-out bed next to her), she really needed the relaxation the epidural afforded her. It was her choice, and she had the birth she wanted. I was thrilled for her!
• Breastfeeding: I'm a IBCLC and nursed all my kids at least two years. Sarah wanted very much to breastfeed, but because Nicholas  was 7 weeks premature, they didn't get off to a good start. But boy could she pump! She pumped religiously for him for 4 months. At that point she was just ready to be done. I told her how proud I was of her for giving Nicholas 4 months worth of liquid gold. 



Nicholas was just 3lb. 6oz. when he was born
and spent 5 weeks in the NICU.

• Nighttime Parenting: From the time Sarah was 6 months old (and we discovered Dr. Sears) we co-slept. All of our babies were in our bed and we loved it. Nicholas slept in his parents' room for the first few months after he came home, but then they moved him upstairs to his crib where he slept through the night quite well. There were certainly nights when he was in their room, but he seems to really like being in his crib. My daughter is the expert on her baby and knows what he needs.

Nourish Your Relationships

Grandmothers have several very important relationships to nurture.

Spouse:  The first and most important is with grandpa, if he's in the picture. Those who are blessed enough to have made it 25+ years in their marriage need to continue cherishing and building that relationship.

Child: The next critical relationship is the one with your own child. If your daughter is the new mother, she is probably really longing for your support and affirmation. She needs to know that you think she's doing a good job. Remember when mothering was brand new for you? Remember how uncertain you were? Even when she's grown the most important thing you can give your daughter is unconditional love and affirmation.

I love being with my daughter and grandson!

Maybe you didn't breastfeed, but you can still support her in her decision to nurse her baby. If you feel like she's making lifestyle choices that are truly dangerous (drug use, ignoring her baby, etc.) then you absolutely need to confront her and intervene if necessary. But feeding method and parenting style are NOT in the category of dangerous lifestyle choices.

If your son is the new dad, you need to recognize that your daughter-in-law probably has a special bond with her own mother. Allow her to invite you in; don't push your way in. Be there to support and encourage, but don't try to manage their lives. If you do, you may find that you cause serious damage to your relationship with your son.

Grandchild: This is the fun, wonderful relationship where you get to indulge, love and maybe even

spoil your precious grandchild just a little bit. However, be mindful of the boundaries his parents have set. If his mom doesn't want to start solids until he's at least 6 months, then don't try to sneak in a little rice cereal just because you think he's ready for it. If she doesn't want him to have sugar, then don't give him a cookie when he's at your house. If you make an effort to do things her way and respect her parenting method, it will make things much easier on your grandchild. He won't be confused as he gets older.

Grandbaby snuggles rock!

Don't ever say anything negative about either of his parents - even if they're not together any more. Growing up as a child of divorce is hard enough without having a grandparent spouting venom about one of your parents! Your job as a grandparent is to love your grandchild, give him a safe home away from home, and support his parents in all you say and do!

If you follow these simple "Grandma Rules," you'll find yourself surrounded by children who really appreciate you and grandchildren who absolutely adore you! After all, Grandma Rules!!

My Natural Hospital Midwife Birth in Alabama!

Roberta Ress, CNM is the only Certified Nurse Midwife
delivering babies in a hospital setting in North Alabama.

by Anna Bertone, Guest Blogger

When I became pregnant with my first child in May 2012, I was living in Chicago and finishing graduate school. I selected a midwifery practice with privileges to deliver at an “Alternative Birthing Center” within a local hospital. In my view, this was the ideal arrangement because I had support for a natural birth, all of the comfort amenities (tub, ball, peaceful setting), and, if I were to need an emergency procedure, I could be wheeled out the door and down the hall in a matter of seconds.

When work required that my husband and I move to Huntsville in my 8^th month of pregnancy, I was scared and confused by the apparent lack of birthing options in AL. Where were the midwives? The Birthing Centers? The natural birth classes? After days of web searching and phone calls, I spoke with a former CNM (Certified Nurse Midwife) who put me in touch with Roberta Ress, CNM at Carlota OB/GYN practice in Athens. We met for the first time when I was already well into my pregnancy. With that meeting, my hope was restored that a natural birth in a hospital setting is indeed possible in Alabama.

Roberta delivers at Athens-Limestone hospital. She is supported by her OB/GYN practice and the wonderful hospital nurses. My Birth Plan was well received and respected by everyone I came in contact with during and after delivery. 

I won’t pretend that my birth was easy or “ecstatic”, as some women claim. It was eight hours of HARD WORK following a day and a half of sleepless pre-labor. I’m not sure I could have done it without Roberta and the nurses. Some of the nurses had experienced their own natural births. I think this made them even better at encouraging me and knowing what to do (or not to do). For example, no one pushed drugs, or made me feel as though I was up against the clock, or was being too loud. No one complained about how I was chugging coconut water like a shipwrecked sailor the entire time. They brought me mats when I was laboring on the floor, demonstrated the many ways a hospital bed can change to support different positions, attached a bar to the bed, and pointed a fan on me. Roberta coached my breathing when I started to “drown” during transition, and my husband and doula held my hands and assisted me throughout. Carina was born Jan. 14^th at 7:33 AM.

Ladies, I highly recommend hiring a doula. A doula is a friend, an educator, a masseuse, and an experienced mother. Even if you have a husband, partner, or family member present, a doula can show them how to help you best. I worked with Aleah Charney. You can visit her website www.birthingbeautiful.net/.

Thanks to A Nurturing Moment for creating a space for women to connect on issues such as these. I love your services and products!

Anna Bertone

(919)-428-6918        annacbertone@gmail.com

Feel free to call/email me with any questions about Carina’s birth!