Nursing Birth

One Labor & Delivery Nurse’s View From the Inside

Urgent Message from ICAN! Please Spread the Word!! October 18, 2009

Filed under: In The News — NursingBirth @ 10:07 AM
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Hello Everyone!

 

Please check out an urgent message sent from Gretchen Humphries, the Advocacy Director of the International Cesarean Awareness Network (ICAN).  She needs our help to spread the word and send in stories about a most critical healthcare issue:  insurance discrimination.

 

For more information on this story please check out ICAN’s website.

 

Thank You,

 

NursingBirth

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

From: Gretchen Humphries <advocacy@ican-online.org>
Date: Fri, 16 Oct 2009 1

Subject: Urgent request for stories

 

I have sent you this request because of your connections within the Birth
Community. I hope that you will see if there is any way you can assist ICAN
with this request.

 

We have made this request before but now the stakes are really high. Peggy
Robertson
is a woman from CO who testified yesterday before the HELP
committee (the Senate Health Education Labor and Pensions Committee) about
being denied coverage because of a previous cesarean, unless she could prove
she had been sterilized. (We managed to work in a couple of comments about
VBAC bans too! Which got some response from a couple of Senators!)
Senator Mikulski, who chaired that hearing, has asked for more stories
similar to Peggy Robertson’s. Please distribute this request as widely as
you can –

 

ICAN needs stories about discriminatory insurance practices based on a
previous cesarean. This can include but is not limited to demands for
sterilization, restrictions on how soon you can have another pregnancy and
be covered, higher premiums, restrictions on the total amount of benefits
they will pay, excessively high deductibles for maternity care. Even if all
you have is your name, state, contact information (email is fine) and a
description of the circumstances (with the name of the relevant insurance
company(ies) if possible) we can use it. If you have written documentation,
that would be pure gold.

 

There is interest about this at the highest levels of the Federal Govt. and
we will use this to open the discussion on other areas of discrimination
(like VBAC bans, lack of transparency, etc)….so please, take a moment and
get the information to ICAN. You can email me at advocacy@ican-online.org
or you can snail mail to ICAN of Ann Arbor, PO Box 48, Stockbridge, MI
49285.

 

Your story could make a difference that would improve the care available for
millions of women and their babies.

 

Thank You,

 

Gretchen Humphries
Advocacy Director, ICAN
advocacy@ican-online.org
(517) 745-7297

 

Connecticut Docs & Midwives Speak Out For Midwifery! October 16, 2009

Filed under: In The News — NursingBirth @ 9:40 AM
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Yesterday the Connecticut newspaper New Haven Register published an opinion piece entitled “Media out of focus on midwifery” by Holly Powell Kennedy, CNM, Charles J. Lockwood, MD, and Edmund Funai, MD and I have to say, I am very very pleased to read such a focused, well-reasoned, supportive article on birth choice, the safety of homebirth, and the need for hospitals around this country to step up and better meet the needs of birthing families!  And for it to be written by two obstetricians and a certified nurse midwife….its just too good to be true!!

 

Favorite quotes of mine include:

 

  • “Women are not seeking “designer” births. They are looking for humanistic care during pregnancy, labor and birth and are increasingly having difficulty finding that in many hospitals.”

 

  • “It is essential that women are provided with the opportunity to have a supported and safe birth. This means protecting them from preventable harm, and ensuring that clinicians are skilled in appropriate low intervention care and know when it is necessary to intervene.”

 

  • “While midwives and obstetricians will continue to debate the safety and appropriateness of home birth, less controversial is the fact that some women seek to give birth in alternative settings because they do not see hospitals as meeting their needs.”

 

 

Yes, Yes, and YES!

 

Thanks to Christina at the Massachusetts Friends of Midwives Blog posting about this article!  What a great start to my day!!

 

Sign the Petition! Demand Accurate Reporting of ALL Birth Options!! October 1, 2009

Dear Readers,

 

Choices in Childbirth, a NYC based non-for-profit advocacy group whose mission is to improve maternity care by providing the public, especially childbearing women and their families, with the information necessary to make fully informed decisions relating to how, where, and with whom they will give birth, has recently created a petition in response to NBC’s Today Show segment entitled “The Perils of Midwifery” (later changed to “The Perils of Homebirth” and even later taken off the internet all together!!) speaking out against the segment’s inaccurate, fear mongering, sensationalized, and outrageous portrayal of midwife-attended homebirth, of midwives in general, and of the families who chose this option. 

 

Below is the letter attached to the petition.  If you feel the same way please consider SIGNING.   On October 9th, the last day of National Midwifery week, representatives from Choices in Childbirth will deliver the letter and petition to The Today Show at NBC’s headquarters in NYC.  The goal is to get at least 5,000 signatures by October 9th and as of today, the petition already has 3,653!!!

 

Thank you,

 

NursingBirth

 

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Petition Letter:

 

Dear NBC Producers,

    We, the undersigned, collectively voice our deepest concerns over what we believe has been a gross misrepresentation both of midwife-attended homebirth and of the women who choose this option.

 

While empathizing deeply with the McKenzie family and their loss, we are shocked at the way in which NBC’s “Today Show” chose to portray homebirth as dangerous while choosing to ignore ample medical research that demonstrates its safety in the US and in other developed countries around the world. Not only did the producers of the Today Show ignore journalistic due diligence, they also chose to ignore basic rules of fairness by repeatedly citing doctors and the trade union that represents them while denying midwives and their proponents a voice.   This is simply irresponsible journalism, and misleading to your viewers. We expect more from such a well-respected program.

    We stand in support of families who choose to birth their babies at home with a skilled midwife, not for hedonistic reasons, as the Today Show segment so insultingly suggests, but because they truly believe that it is the best option for themselves and their babies. We support women who choose home birth, who are not following a fad, but who are following their hearts and their informed minds to seek a birth that is both safe and healthy. Far from being a recent trend or fashion, midwifery draws on a continuum of knowledge and experience that goes back many centuries. Midwives are well-trained professionals who specialize in normal birth and provide outcomes that are often superior to obstetrician-attended birth. To suggest otherwise is deeply offensive.
   

The Today Show missed an opportunity to discuss why, despite its near universal reliance on hospital-based, physician-attended obstetric care in birth, America has one of the worst infant mortality rates in the developed world. It missed an opportunity to discuss the reasons why highly educated, thoughtful and responsible women are choosing a home birth with a qualified midwife as an alternative to a hospital birth- an option that other countries have proven again and again costs less money, necessitates fewer c-sections, and provides better outcomes for mothers and babies than our system. The Today Show missed an opportunity to ask why the United States spent $86 billion in 2006 on maternity care that left the US with one of the worst infant mortality rates in the developed world and left women and their families asking for more choices in their maternity care.
   

Although every infant death is a terrible tragedy, the real scandal about birth in the US lies not in the death of the McKenzie’s baby alone, but in the fact that 13.6 African American babies die for every thousand live births; an infant mortality rate that is triple that of Denmark or South Korea. What is truly shocking is not that a fraction of women choose home birth, but that our international infant mortality ranking has worsened from 12th in the world in 1960 to 29th in 2004 during the same period that our rates of medical intervention in birth have gone up exponentially- Cesarean section rates alone have more than tripled. 
   

We are passionate about childbirth issues because we know that, like the rest of the healthcare system in this country, there is much room for improvement.  Drawing battle lines between midwives and doctors and terrorizing the public unnecessarily are hardly constructive means to this end. We call on the Today Show to provide the public with the whole story regarding the evidence and viewpoints supporting the choice of midwife-assisted home birth.

 

We call on the Today Show to choose responsible journalism.

 

 

***SIGN THE PETITION***

 

 

Midwife and Author of “Silent Knife” in the News! September 25, 2009

Filed under: In The News — NursingBirth @ 8:46 AM
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So first the USA Today article and now this!  Is it too good to be true?  Is the media finally starting to come around to writing about homebirth without sensationalized headlines, damning quotes from disapproving docs, and horror stories of homebirths gone wrong?  Well if I keep stumbling upon articles like this one from Wicked Local Needham (a companion website to The Needham Times) it certainly won’t be too good to be true! 

 

The article is titled simply: Needham midwife helps moms give birth at home.   Writted by journalist Steven Ryan, the piece highlights homebirth midwife and author of the book Silent Knife: Cesarean Prevention and Vaginal Birth after Cesarean(VBAC) Nancy Wainer of Birth Day Midwifery Care.  The article is absolutely fantastic, not because it is a stunning literary masterpiece, but because it is a simple, well written feature on a homebirth midwife.  Ryan gives a brief history of why Wainer is where she is today, speaks to her many years of experience and education and rounds out the piece with many great quotes from happy and satisfied home birth clients. 

 

My favorite quote was this:

 

“Milly Ramsey described the birth as intense, but doesn’t regret her decision to have the baby naturally and at home.

 

‘I was very comfortable at home,’ Ramsey said. ‘It was intense. I was out of it when he was born but I felt very supported. I felt like I wasn’t alone … The best part was I got to hold him on my belly all slippery and wet and they didn’t take him away. He stayed with me.'”

 

Thank you Wicked Needham Local for a great pick-me-up before I head off to work!  Oh and by the way, LOVE the name of your website!

 

Thanks to Christina at the Massachusetts Friends of Midwives blog and my google reader for alerting me to this article!!

 

USA Today Weighs In On Homebirth September 17, 2009

On Monday, USA TODAY, a national American daily newspaper that has the widest circulation of any newspaper in the U.S., published an article entitled For some women, no place like home for childbirth by Rita Rubin.  As usual, I was worried when I clicked on the link as typically when mainstream media gets a hold on the “home birth debate” it gets ugly.  (Case in point: see The Perils of Midwifery.  Please don’t get me STARTED on that GARBAGE!!)  However Rubin’s article was pretty alright. 

 

First of all the couple highlighted in the piece had a beautiful homebirth experience.  (What?  You mean it wasn’t a horrible regrettable disaster!?!)  Second she actually interviews and quotes a homebirth midwife in the article .(What a novel idea!! You mean it is responsible journalism to actually interview midwives when writing an article on them!)  And thirdly she ends on a positive note with a quote from Alice Bailes, a certified nurse midwife who attends homebirths in Virginia, “We get to see one normal birth after another.”

 

Although the article didn’t get away with writing about home births without quoting ACOG’s mantra “Home deliveries are for pizza”, I think this article did a pretty good job for mainstream media.  Thanks Rubin!  You give me hope!

 

“Major” Momma: Kim Clijsters Wins U.S. Open!! September 14, 2009

Filed under: In The News — NursingBirth @ 6:45 PM
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CONGRATULATIONS to tennis champion Kim Clijsters of Belgium who made history last night after an AMAZING comeback post two year hiatus to become the first unseeded woman to win the  U.S. Open!  The crazy thing is is that Clijsters didn’t even have a ranking coming into this tournament because she hadn’t played enough tournaments to get on the list.  Not only was Clijsters an underdog, but she is a mother and in fact is the first mother to win a major since 1980!

 

However seems like Google’s “Did You Mean” genie is a little bit sexist.  Hahaha!  Look what came up as a suggestion when I searched for this story to link to:

  first mom to win tennis

 

I just love reading about strong, empowered, focused, driven, successful women, and when those women happen to be moms too, it is just the icing on the cake!!  After the match ESPN quoted Clijsters as saying, “It’s the greatest feeling in the world being a mother.  I just can’t wait to spend next the few weeks with [my daughter] and have her routine schedule at home again.” 

 

Being that Clijsters is only two months older than me I have to admit that reading this story is a good kick in the pants for me to step up my workout routine!!  I mean, I know I am no “pro” but I could still stand to shave a few second off my 5K time!!

 

Just a little sprinkle of inspiration for your day!

 

The WORST Idea Since Routine Continuous Fetal Monitoring for Low Risk Mothers September 7, 2009

My husband (being the techie cutie that he is) reads CNET news, a website about computers, the Internet, and groundbreaking technology as part of his morning routine.  The other day, while I was enjoying my Kashi cereal and checking out the latest blog posts on my Google Reader, my husband hollered over to me from his office and said,“Hey Melissa, have you heard of LaborPro?”  Until that moment I was having a pretty good Sunday morning.  I mean, I woke up refreshed and smiling, the sun was shining, and I was looking forward to what I felt was going to be a “good” day at work.  But my attitude quickly turned from happy-go-lucky to blinding rage when he uttered those eight little words. 

(Okay, okay, so I think I am being a bit dramatic.  Maybe blinding rage is a bit strong.  But I was pretty upset!!)

So what is LaborPro and why did it put me into such a tizzy you ask?  According to Trig Medical’s website (the Israeli company that is developing and recently won a Frost & Sullivan Technology Innovation of the Year Award for this GARBAGE), LaborPro is “a novel labor monitoring system that using ultrasound imaging measures continuously and objectively fetal position, presentation and station along with cervical dilatation. LaborPro quantitatively assesses and records vital labor parameters in real-time to enable obstetricians to make informed and accurate decisions throughout the labor process to improve both the quality and cost of obstetric care.”

 

 

 

The website lists LaborPro’s capabilities as able to:  

  • Determine continuous station & position of fetal head by ultrasound imaging,
  • Provide radiation-free pelvimetry & birth canal modeling.
  • Perform one-step computerized “non-invasive” trans-vaginal digital examination (I’ll touch on that in moment)
  • Determine intermittent or continuous accurate measurement of cervical dilatation
  • Record comprehensive labor data recording

 

It also toutes its “unique benefits” as the following: 

  • Non-invasive, precise measurement of station & position
  • Improves assessment of non-progressive labor
  • Supports decision-making before operative delivery
  • User friendly, on-screen display of all labor parameters
  • Enhances patient comfort and sense of security

 

Okay okay okay….Just HOW does it do this you ask?  Well it’s EASY!  (*rolling eyes*)  Well according to the website’s one mintute educational video (check it out here, it’s worth it).  FIRST you have to place “just four little electrodes” externally on the mother’s pelvis in order to continuously assess fetal station and position and also enables the user to “recognize CPD early”.  SECOND you just have to clip (or screw) “just a few position sensors” to the woman’s cervix to accurately and continuously measure cervical dilation.  And THIRD you just have to screw “just a small little electrode” into the baby’s head.

Fetal Scalp Electrode  (notice the little corkscrew tip)

Close up of a fetal scalp electrode, or FSE (notice the little corkscrew tip, that screws into the baby's scalp.)

According to Frost & Sullivan, the organization that awarded Trig Medical for the LaborPro technology writes, “The LaborPro is staff and mother-friendly and requires only basic training in ultrasound usage, obviating the need for an obstetric ultrasound expert,” adds Ms. Prabakar. “Moreover, the technology employs non-invasive, radiation-free pelvimetry as well as a single-step computerised digital examination. All labor progress tracking data including the fetal heart rate monitor are integrated in the LaborPro display and automatically recorded by the system, which helps reduce staff workload.”

 

Oh great!  We only need “basic ultrasound skills” to work it!  (*double eye rolling*)  Here’s a novel idea!  How about every hospital (including my own) in the United States that has a L&D floor actually provide labor support training to their nurses instead!  That would go a lot farther for us than freaking ultrasound skills!! 

(Just for the record, my hospital does NOT include labor support training as part of orientation and we are NOT alone.  At my hospital, if you want to learn how to provide labor support you have to seek out other learning opportunites on your own, like I had to.  But we do get extensive training on how to work and interpret the fetal monitor.  Oh and about 1/3 of our three month orientation is dedicated to learning how to care for a patient who is being induced.  In fact, I had to teach myself how to do intermittent auscultation and hence, I am one of the only nurses that I work with that isn’t “scared” of intermittent auscultation and will actually advocate for it!) 

The most terrifying thing is that although at this time LaborPro is not available in the United States (Oh Hallelujah!!!) there is another company called Barnev based out of Andover, MA that has developed an almost identical product they call BirthTrack™ Continuous Labor Monitoring System which they describe as “a revolutionary continuous labor monitoring technology that provides obstetric caregivers invaluable, precise, objective, real-time information about the physical progress of labor. The BirthTrack System provides tools for a more informed decision making process through which hospitals can reduce the risks and costs of childbirth and assure the safety and comfort of mothers-to-be and their babies.”  I remember hearing about this product a couple of years ago when it was still in “development.”  Well guess what?!  Development is over!!  Marketing here we come!!  (GAG me!)

 

So now there are at least TWO companies that are actively marketing this HORRIFIC, INHUMANE, and OUTRAGEOUS product.  Just wait  until LaborPro makes it to the United States (which according to their website they are actively persuing).  Then they will probably start to compete with eachother!  Now now only will labor & delivery wards around the country have to deal with Similac and Enfamil representatives competing for our money and attention in house (which already makes me sick to my stomach), but now I have to worry about this??!!  THIS IS TERRIFYING!!!

 

I’m telling you right now, I will UP AND QUIT my job and never look back if either LaborPro or BirthTrack EVER  appears in even just one, JUST ONE of my hospital’s labor rooms.  QUIT ON THE SPOT!  And I will make a Hollywood exit too!  A HUGE scene!!!  Hooting and hollering!  You just wait!!  LOL!  As if our moms aren’t already strapped down enough with the often unnecessary and sometimes downright harmful technology we already have.  This is just TOO MUCH TO BEAR!

I have taken care of MANY a laboring woman (often as a result of an induction, mind you) who are connected to:

 (1)  an IV line with IV fluids and Pitocin running through,

(2) an electronic fetal monitor to measure fetal heart rate,

(3) a tocodransducer to measure contraction pattern

(OR a fetal scalp electrode to measure fetal heart rate and an intrauterine pressure catheter to measure contraction frequency and strength),

4) an epidural catheter in the back giving a continuous flow of anethetic and narcotic medications into the spinal column,

(5) a foley catheter in the bladder since it is very rare that one can empty their bladder with an epidural,

(6)  a pulse oximeter to continuously measure blood oxygen level (necessitated by the epidural),

(7) a blood pressure cuff to record one’s blood pressure every 15 minutes since an epidural can drop your blood pressure dangerously low, and finally

(8) if the baby has shown any signs of distress, an oxygen mask for your face!

 

Well I have a message for both Trig Medical and Barnev, LABORING WOMEN DO NOT NEED ANY MORE THINGS SHOVED UP THIER VAGINA!!!!  And furthermore,  CLIPING ANYTHING TO A WOMAN’S CERVIX OR SCREWING ANYTHING INTO A BABY’S HEAD DOES NOT COUNT AS “NON-INVASIVE”!!!  LABORING WOMEN AND BABIES ARE NOT ROBOTS THAT DON’T FEEL ANY PAIN OR DISCOMFORT!!!!  RESEARCH HAS SHOWN TIME AND TIME AGAIN THAT LESS IS MORE WHEN IT COMES TO LABOR FOR HEALTHY MOMS AND BABIES!!!  CONTINUITY OF CARE IS MUCH MORE EFFECTIVE, LESS PAINFUL, LESS INVASIVE THAN ANY “COMPUTERIZED FINGER.”

Furthermore, LaborPro and BirthTrack are a slap in the face to every labor and delivery nurse that cares about giving appropriate, effective, competent, physiological, and compassionate care to childbearing families.   Unfortunately I would bet my hard earned money that at least half of the doctors I currently work with would think that this is a good idea. 

Okay, okay, now that I am all riled up again I have to go to work  😦   Please check out Rixa’s post over at Stand and Deliver about BirthTrack.  It was written about a year ago and I stumbled upon it when I was searching for a picture of a fetal scalp electrode!!

Change has GOT to come!  It’s GOT to!  For the health and wellness of our mothers and babies!!  Remember ladies, YOU actually have more power than ME and all the other L&D nurses out there!!  That’s right!  If you do not hire birth attendants that do not support evidenced based medicine and physiological birth and do not patronize hospitals that do not support a family-centered approach to maternity care then and only then will they start to listen.  You know why?  Because when the customers aren’t comin’, it hits them where it hurts… in their WALLET!!