Not On Call!

Last night I was up until 2:30 AM reading...and it was a wonderful wonderful thing.

It's not something I can indulge in too often, because more often than not I am...

On. Call.

What does that mean? That means that one of my doula clients is within two weeks of her due date, and there is a possibility that I could be called to a birth. At anytime. So I need to be ready. All. The. Time.

First of all, I need to make sure my doula bag is packed and ready to go. Ipod and camera battery charged. Extra batteries. Everything cleaned and sanitized from the last birth I attended.

Then, for every day I'm on call I need to make sure that I have:

(a) last-minute childcare available
(b) someone to transport my children to activities
(c) something easy in the freezer that my teens or husband can cook for dinner

Then I think through my plans for the day. I need to make sure that I am not straying too far from home - if a client calls me, I need to be able to get there within a reasonable amount of time.

Any appointments, meetings, plans, etc. need to be made with the caveat that "I might get called to a birth and need to cancel."

If there is a birthday or holiday when I'm on call, there is always the possibility that I will miss it because I am at a birth.

My birth supplies and birthball live in the back of my van. If my husband wants to take my van, he needs to make sure my supplies are taken out.

I don't drink alcohol when I'm on call, because you never know when someone might go into labor.

I can't take sleeping pills of any kind either.

And the hardest part for me -

I need to make sure I get to bed at a decent hour - it is a Bad Bad Thing when you stay up until 2:00 AM, and then get a phone call at 2:30 AM that someone is in labor, and need to leave and possibly not be back for 24 hours.

This summer, I've had a lot of births. I've been on call constantly since early June. We even went away in the middle of June, making sure we didn't go very far and we took two cars, knowing I might have to come back for a birth....and I did.

But NOW....my last August mom had her baby last week. My mid-September mom has already had her baby, and my late September mom is a couple of weeks away from me being on call for her.

So in the meantime, I am staying up late and drinking wine and making plans that I know I probably won't have to change.

In two weeks, I'll be on call again, and that's ok. If I were not on call much longer than that, I would be itching to get back....but in the meantime, I am so much enjoying the Not On Call Life.

Be part of "The Birth Survey":share your experiences to create a better birthing world.

It seems for every consumer decision there is a resource available to rate and review options. However, when it comes to choosing a healthcare provider and facility for our births we are left only with a list from our insurance provider and the limited experiences of family and friends who may or may not have similar birth priorities. Many of us forget that as pregnant women we are consumers; we are being provided a service. It is our right to shop around for a careprovider and facility that suits our wants and needs.

You wouldn’t request Chinese food at an Italian restuarant yet many women find themselves making incompatible requests when it comes to their births. For instance, a woman who feels strongly about avoiding episiotomy would do well in not choosing a doctor who performs them on 95% of first time moms. Similarly, a woman who wants freedom of movement through her labor will find herself frustrated and restricted at a facility that insists on continuous fetal monitoring.

Now thanks to CIMS (Coalition for Improving Maternity Services), you will be able to find reviews on all your local options. Have you given birth in the past 3 years? If so, please be part of building this amazing resource by taking the survey. By sharing your experience, you can help fellow mothers have their *best births* and also help providers and facilities improve their quality of care.

http://www.thebirthsurvey.com/

Book Recommendation: Journey Into Motherhood by Sheri L Menelli

Description: A collection of 48 positive, natural and varied birth stories including: first births, subsequent births, hospital births, home births, unassisted births, water births and VBACs as told by the mothers themselves. After each story, there is section titled: A Mother's Guidance where the woman relays what helped her most in achieving her positive birth as well as occasional notes from the author.

Why all pregnant women should read this book...
The biggest obstacle the average woman must overcome in having a positive birth is not pain or unforseen complications but rather fear.Thanks to unsolicited horror stories, overly dramatic documentary shows and inaccurate birth portrayals in movies, women have lost confidence in their bodies' innate ability to give birth. This book is an antidote for fear as it casts birth in a different light-birth as a transforming, an exhilirating, and even a healing life event.

In reading these stories women can build confidence and begin to prepare and look forward to one of the most memorable days of their lives.

New Jersey's High Cesarean Rate

NJ has the dubious honor of having the highest cesarean rate in the country, at 39%.

The following is a list of Central NJ hospitals. I have listed the 1997 cesarean rate for each of these hospitals, followed by the 2007 rate, as compiled by Somerset County ICAN. What a difference 10 years can make.....


CentraState 25% 48%

Riverview 23% 43%

JerseyShore 27% 42%

St. Peter's 25% 39%

Somerset 22% 39%

Robert Wood Johnson 23% 37%

JFK Medical Center 23% 37%

Princeton Med Center 19% 33%

Monmouth Med Center 24% 27%


Now what strikes me as interesting is that all of these hospitals have a similar socio-economic demographic for their patients. So what is so different about the moms at, for example, Centrastate, where they have almost twice the risk of delivering their babies surgically than the moms who deliver at Monmouth?? And with cesarean rates almost doubled from 10 years ago, what is the world is so different about women having babies now as opposed to 10 years ago? And the rise in the cesarean rate has not made birth any safer; it has not decreased infant or maternal mortality rates. Instead, it has increased the risks both to mother and baby.

If you look online, you can find lists like this one:
19 Ways to Avoid an Unnecessary Cesarean

(which actually has some good suggestions and tips)

However, if your doctor has a high cesarean rate, don't think that s/he is going to be all that comfortable with allowing your labor to continue if it deviates the slightest bit from what s/he feels is a "normal" labor.

What can a mom looking to avoid an unnecessary cesarean do then? One very important thing to do, as Peggy O'Mara at Mothering magazine puts it, is to "ask your practitioner what his or her individual cesarean rate is. Ask what the rate is for the practice. Ask about other interventions and how they compare to evidence or federal guidelines. If the question is balked at or not taken seriously, be cautious. Don't become a statistic. Individuals or practices proud of their statistics will be familiar with them and tell them to you in an instant. "

If a cesarean is suggested, a mom can ask any questions that she has, get any information that she needs, and take the time to make the decision (barring a medical emergency of course) so that if she decides to have a cesarean birth, she is comfortable with that decision.

However, if a mom is NOT comfortable with that decision, and if mom and baby are not having any medical issues, and the mom wants to have a trial of labor or else give her labor more time (again, barring any medical emergencies of course) - why not give her the chance to either try to have a successful vaginal birth, or else come to the conclusion for herself that a cesarean is inevitable.

Confessions of a Doll-napper...

It was never my intention to become a doll-napper just part of the job. It began quite innocently the day I brought home 3 20in dolls to use in our classes. I didn't expect my 4yo son, Tyler, to become attached. He promptly named them: Grace, Perry, and Harry. Grace and Perry were identical and the typical Gerber-baby fare but Harry stood out, with his mischievous squinty eyes and subtle smile. It was love at first sight.

From that day on Harry was Tyler's baby. He came with us to the supermarket, birthday parties, Babies R Us (where I was persuaded to buy him a pair of sandals)...Tyler took excellent care of him-washing his face and hands, feeding him, always securing him with a seatbelt while in the car and changing him into pjs before tucking him in each night.

Then came Class 6-the Parenting class..
There were 4 couples in the class-we needed all the dolls we could get, there was just no way around it. I had to "borrow" Harry-what choice did I have? Unfortunately Tyler didn't agree. Running late and expecting some resistance (I learned this back when I asked to borrow his lunchbox for our breastfeeding class), I thought I could perhaps borrow Harry without Tyler knowing. It was noon and Harry was still in bed, I'd bring him back in a few hours and Tyler would be none the wiser, right? Wrong.

I scooped Harry out of bed, stripped him (in prep for class) and placed him with the others in my trunk. I was so close...but I had forgotten a poster and while I ran back into the house to get it Tyler (who had been playing with his sister infront of the house) walked by the open trunk and spotted Harry. There was his beloved Harry, naked in a huge ziplock bag with those other dolls...the horror! He promptly rescued him just as I came outside. A chase ensued. A chase through a sprinkler, in which Harry was dropped. Now naked Harry was also wet and streaked with mud.

I begged, I bribed, but it was no use-Tyler would not let me have him. I am not proud of what happened next, but what choice did I have? I was running late, I had 4 couples, I *needed* that doll! So I hurried into the house, put on Flushed Away, handed him an ice cream cone, lifted the now-forgotten-Harry off the lawn and ran like he!! Into the car and away we went.

I got quite the "talking to" when we arrived home and I have since purchased enough dolls that this shouldn't happen again. My doll-napping days are over.

So is this blog active? Or what?

Jessica and I started this blog to talk about the "behind the scenes" of starting a new childbirth education/doula business.

And business has been booming! Which is good! But our busyness has us putting this blog on the back burner, with both of us thinking, "Soon, I'll write a blog post" And then we blink and another month is gone.

So what have we been up to since the last blog post, three months ago??

WELL...since April we have, among other things....

• Attended ten births between the two of us
• Taught 3 complete childbirth education series
• Bought so much foam posterboard and 3M adhesive squares at Staples that they go and grab it for us when they see us coming (not really....but they should!)
• Updated the website approximately 6 times
• Scheduled out our childbirth classes for the rest of 2008
• Had 10 brainstorming meetings
• Talked on the phone to each other approximately 157 times

All this, plus raising our kids (did I mention we each have 5 kids??)


SO...this is the Official Announcement that The Blog is Back! You can look forward to hearing more about the interesting stuff that happens here at Your Best Birth!