Monday, June 18, 2012

Tips for Becoming a Birth Activist

What an exciting weekend!  We just finished up our first Birth Boot Camp training workshop and it was AWESOME!  The November workshop is almost full, but we still have plenty of room in the September training.  It's just 3 months away, and there are a lot of certification requirements to be completed before the workshop.  I'd recommend it for people who are already birth professionals or have done a lot of the reading previously. 

I have another big weekend coming up.  June 22-24 is a  Birth Activist Retreat  sponsored by Where's My Midwife?  It is being held at The Farm in Tennessee, which is extra exciting because I'll be breathing the same air as Mr. Tim McGraw who lives less than 2 hours from there!  I am going with a couple of my favorite people from the Tarrant County Birth Network.  Really, getting there is half the fun!

I'm probably writing this post prematurely, as I'm sure at the end of next weekend, we will have come up with some great ideas for birth activism.  I just want to take a minute and talk about a couple of things in regards to this topic.

If I am an OB or a lawmaker, I'm thinking I am not going to listen to the "bra-burners" or picketers.  I need evidence and real stories.  I need to connect with the people who are trying to make change, including midwives and families who want birth options.  I have no interest in listening to (or taking seriously) people who are just loud -- demanding that I change my way of thinking.  I would be more apt to listen to people who are professional and rational.

I posted a question on my BFBS Facebook page asking what YOU do to change the culture of birth in your community.  A lot of answers were along the lines of talking to friends and posting on Facebook.  As you are probably well aware, birth is an emotionally charged topic, like politics or religion.  It's hard to bring it up on a personal level, but sometimes doing something on a bigger scale is less "in your face" to your friends and family.  It also has the potential to have a bigger impact, reaching more people.

I believe there are more and more women having amazing births and they want to change the way other women (and men) view birth.  We are seeing an influx of women wanting to become doulas because of this.  Many of them do a couple of births and realize "This is HARD!"  It is hard to be a doula and also have a young family.  Some people make it work and others aren't able to.  I think at the root of it all, however, is wanting to make a difference.  We all want that.

I know I am always touting starting or joining a Birth Network chapter in your area.  It really is a great way to get involved and make a difference.  You don't have to belong to a birth network however.  Some women have hosted a Red Tent event, encouraging women to listen to and tell birth stories.  This can be as simple or elaborate as you would like.

I know it doesn't sound as glamorous, but writing letters to the lawmakers, hospitals, and OBs in your state is a very important -- and real -- way to let them know what their constituents want. Back up your viewpoint with evidence and your experiences.  Birth is consumer driven.  In the 1980's birthing suites became popular and more "homelike" because women demanded it.  Some women were having their babies at home and the hospitals insisted that they were better than home, some even having full-size beds in many rooms.

Holding screenings (with appropriate permission and applicable fees) of various birth movies is something that has gotten a lot of positive attention for natural birth and is relatively easy to pull off.

Organize groups of women -- professionals and pregnant women --  to discuss various topics.  Sometimes giving people a forum is the most effective way to create change.

It is very rewarding to see women and families know their options and make informed decisions. No matter what you decide to do, think about your target audience and the message you want to send to them.  We should be taken seriously.  To be taken seriously, we need to take ourselves seriously.

Please share what you have done in your community that could be duplicated in other areas.  It's all about sharing ideas -- what works and what doesn't.

Until next week, my fellow birth activists!  Off to The Farm!

Monday, June 11, 2012

Guest Post by Robyn Allgood: Spirituality and Childbearing

Last month I wrote a guest post for The Gift of Giving Life, and now we are reciprocating.  Robyn Allgood is one of the authors of a beautiful new book titled "The Gift of Giving Life:  Rediscovering the Diving Nature of Pregnancy and Birth" exploring spirituality, pregnancy, and birth.  It's full of birth stories, including an article Robyn wrote titled "Mother-Centered Baby Showers" full of creative, fresh, and spiritual ideas for the new mother's journey.  Birth Boot Camp training is keeping me super busy, so I haven't had a chance to dive into the book yet, but I am excited to do so.  I may have to wait in line, however, as Allison was ready to rip it from my hands this week when she found out I have a copy!

Thank you, Robyn -- and all the co-authors -- for putting this sacred book together.  It is a treasure.  Banned From Baby Showers readers, there is a coupon code for you at the bottom of Robyn's post.  Don't postpone ordering -- it expires on Father's Day, which is this Sunday!  Yikes!

Spirituality and Childbearing by Robyn Allgood

A little about me: 

I am a mother to five children, doula, childbirth educator, ICAN Chapter Leader, and more recently, coauthor of The Gift of Giving Life: Rediscovering the Divine Nature of Pregnancy and Birth. I will come back to that later but to give you an idea of my journey in childbearing I thought I would share a bit of my story.

In approaching my first birth I was very naive about it all. In my mind, the doctor and hospital would take care of everything and I would take my baby home happy. Right? Well, I took a crash course childbirth class at the hospital in which I remember the nurse/instructor saying that one-third of the women in our class would have a cesarean. I was sure I would not be one of them.

However, after a cascade of interventions, I gave birth by cesarean to a beautiful girl. We struggled to establish breastfeeding. Physical recovery was tough but making sense of what I had experienced emotionally and spiritually was what left me hungering for peace. I knew I wanted more children but I could not imagine doing it that way again. (I have a lot of respect for those women who have had multiple cesarean births.) I read and read and read. I was determined to VBAC.

Long story short, my second birth went so quickly that we did not make it to the hospital. My son was born unassisted at home. It was marvelous. I felt as if heaven had opened and handed me a priceless gift. I have since had three more babies in my home assisted by my loving husband and midwives.

Thus began my journey. Each birth has taught me precious lessons written by the whisperings of the Holy Spirit in the chambers of my heart. I am a changed woman every time I give life.

While physical and mental preparations are key elements for birth, the spiritual aspect should not be overlooked. This study co-authored by Lynn Callister and Inaam Khalaf, “Spirituality in Childbearing Women,” offers important insights into what we experience on a spiritual level as we give life. (Lynn Callister also wrote the forward for our book.) Within the study “the following themes emerged from the data: childbirth as a time to grow closer to God, the use of religious beliefs and rituals as powerful coping mechanisms, childbirth as a time to make religiosity more meaningful, the significance of a Higher Power in influencing birth outcomes, and childbirth as a spiritually transforming experience.”

The Gift of Giving Life includes numerous birth stories in which mothers (and a few fathers) share their spiritual experiences as they have engaged in the process of conception, pregnancy, birth and parenting.  The stories and essays within the book reaffirm childbirth to be a “spiritually transforming experience.”  Rebecca Overson shared on page 253 of our book, “It is in birth, my mother taught me, that a woman must show her trust in herself, her trust in God, and be consciously involved in a deliberate act of creation by giving her heart, might, mind, and strength to what is before her.”

The study by Callister and Khalaf emphasizes the importance of allowing women to share their birth stories with each other, including the spiritual dimensions of them, and not just the facts. In addition, health care providers are encouraged to ask, “Do you have any spiritual beliefs [or religious practices] that will help us provide better care for you during your pregnancy and birth?”

So I am curious, have you ever discussed your religion or spiritual beliefs with your caregiver and shared with them how they can better provide care for you during your pregnancy or birth?

How do you think it would impact the way they care for women, babies and families if we did discuss religious and spiritual beliefs surrounding birth?

Have you ever included religious or spiritual preferences on your birth plan? How was it received?

Have you had the opportunity to share the spiritual side of your birth stories?

I would love to hear your thoughts on this topic.

Visit The Gift of Giving Life site to sign up for their newsletter and to receive a free Meditation MP3 as well as tips to help increase spirituality in your pregnancy and birth.

For my readers here is a coupon code for 10% off a copy of The Gift of Giving Life. Click here and after you add the book to your cart use this coupon code: GWFWXR3F.  This code is good until Father’s Day 2012. 

Monday, June 4, 2012

Group B Strep

Not a catchy title, huh?  It's a test that all pregnant women are offered around 36 weeks.  I'm not going to lie to you, it's not my favorite topic, mostly because I don't like how it's handled, regardless of where you are giving birth. I've been doing a lot of research on GBS lately.  Allow me to share my findings.

What is Group B Strep, or GBS? 
Group B Strep, or GBS, is a bacteria that lives in the intestines, urinary, and genital tracts of many healthy people. It is generally not serious in adults, but can be life-threatening to a newborn. Most adults do not have symptoms, but occasionally will develop an infection, such as a bladder infection or urinary tract infection. 

The Center for Disease Control (CDC) and the American Congress of Obstetricians and Gynecologists (ACOG) recommend that all pregnant women be screened between 35-37 weeks of their pregnancies to determine if they are carriers of GBS. The pregnant woman's vaginal and rectal areas are swabbed during the screening. According to The March of Dimes and the CDC, approximately 25% of pregnant women are found to be colonized with GBS. 

If found positive, antibiotics are administered through an IV during labor. Ideally, antibiotics are given at least 4 hours before the birth. Oral antibiotics given before labor begins has been found to be ineffective, as the bacteria reproduces very rapidly. To date, the only proven strategy to protect a baby from early-onset GBS is IV antibiotics.
Two types of Group B Strep: 
1.  Early-onset GBS:  Can cause pneumonia, sepsis, or meningitis.  Symptoms include fever, trouble breathing, and drowsiness.  Symptoms often begin on the first day.  About half of all GBS infections are early-onset. Babies who develop early-onset GBS are more easily treated than late-onset GBS.
2.  Late-onset GBS:  Usually begins between 7 days and 3 months of age.  Symptoms include fever, coughing, congestion, trouble eating, drowsiness, or seizures.   Treatment of antibiotics during labor does not prevent late-onset GBS.   After birth, baby can get GBS from other people who have the infection.  Babies who develop late-onset GBS are not easily treated and are more likely to die.  At this time, there is no prevention for late-onset GBS.

If left untreated, the chances of a baby developing a GBS infection (born to a GBS-positive mother) is 1 in 200. If the mother does receive antibiotics in labor, however, the odds are 1 in 4000 of the baby developing GBS.

There are three significant risk factors that place a GBS-positive woman at risk for her baby developing Group B Strep: 
1.  Fever during labor
2.  Prolonged rupture of membranes (PROM) - water is broken 18 hours or more prior to delivery
3.  Pre-term labor (PTL) - labor begins prior to 37 weeks

If a woman tests positive (or does not know if she is positive or not) and does not receive antibiotics during labor, her baby will receive antibiotics after he/she is born. 

Written by Donna Ryan, Birth Boot Camp.  Adapted from:
GBS Prevention in Newborns, Centers for Disease Control and Prevention,, May 7, 2012.

Group B Strep Infection, March of Dimes,, March 2010.

What I Think:
Now that the facts are out of the way....  I've seen this handled so many different ways, and to be honest, they all make me feel kinda yucky.  The CDC is working on a vaccine for GBS, so more options will likely one day be available to pregnant women.  

If a woman is having her baby in the hospital, this is pretty cut and dry.  If she tests positive, she'll have antibiotics in labor.  If she has her baby before she has time to have a full round of antibiotics, they'll treat the baby with antibiotics.

But what about the woman birthing outside the hospital? I've seen several women told to follow a certain regimen so she will test negative at 36 weeks -- tricking the test, in my opinion.  Like mentioned above, if GBS is present, it will grown very rapidly.  I've also seen a number of women prescribed a "vaginal wash" which does not necessarily kill the Group B Strep but does reportedly kill the beneficial bacteria in the vagina.  One of the benefits to a baby being born vaginally is being exposed to that beneficial bacteria.

You should be able to have antibiotics, however, regardless of where you are having your baby.  Check with your care provider on her protocol.  

I've written about my personal feelings about antibiotics here before. I'm not a fan unless truly required.  The GBS symptoms in a baby with early-onset GBS are pretty clear, pretty quick.  The antibiotics given in labor will not prevent a baby from developing late-onset GBS.  With that being said, you still cannot ignore the numbers.   The use of antibiotics during labor in a woman who tested positive for Group B Strep significantly decreases the chances of her baby developing Group B Strep.

Personally, I was never tested for Group B Strep with any of my pregnancies.  Knowing what I know now, maybe I would have been.  If I would have tested positive, I can't say what my choice would have been.  And I'm not about to tell you what your choice should be.  The numbers quoted by the CDC and March of Dimes are lower than what I've read elsewhere.  Some areas of the country report as high as 40% of women test positive for GBS. 

Talk to your care provider and to your partner.  As with everything else, do your research.  Make an informed decision.  If you are planning an unmedicated birth, this is but a blip on the radar.  Not a big deal, just something to be aware of and plan accordingly.