Monday, July 30, 2012

Pediatricians & Formula Paraphernalia - A Bad Combination

I am sort of bossy, but I try not to tell people how to do their jobs -- unless they are doing them wrong!  I have found myself twice in the last few weeks insisting that my pediatrician's office remove coupons for free formula from their check-out desk.

Let me back up.  When we first moved to the Ft. Worth area seven years ago, we got a reference for a pediatrician, but only stayed there for about a year.  The last straw was when I went to pick up my kids' medical records and -- you might think I'm a bit of a fanatic at this point! -- they asked me to write my kids' names on a pad of paper shaped like a bottle with "Similac" down the side.  I refused to use the paper and asked for a regular piece of paper.

Fast forward:  we've had the same pediatrician for about 5 years until she developed breast cancer.  I never saw any formula anything -- samples, coupons, or notepads!  When she got sick, they brought on a new doctor.  While I think she likes to hear herself talk, at least I didn't see any formula paraphernalia since she joined the practice.

Low and behold, the doctor we used when we first moved here recently joined this practice too and now there are coupons for free formula!  Ugh.

This is not an attack on people that formula feed.  I realize there are a million reasons why someone might want coupons for free formula, but again, that is not the issue at hand.  This post is about the pediatrician and whether or not they should display formula paraphernalia. 

So why is this a problem?  First of all, the biggest problem that I see is that it's NOT pushing breastfeeding.  By the very nature of having the coupons at the check-out, it sends a message to the parents that formula is endorsed by the doctor.  Who can resist a "FREE" coupon for anything?  Breastfeeding is also free, but I don't see a sign anywhere that reminds the parents of this simple fact.

"Please don't offer my mommy formula coupons unless she asks."

It is well documented that breastfed babies have fewer trips to the doctor's office -- something that benefits them for a lifetime, not just as a baby.  When the pediatricians make a comment about never seeing my kids, I always point out that they were exclusively breastfeed with no formula.  I hope they make the connection, but it's funny when you have a teenager sitting on the table.  Do the pediatricians even recognize the difference breastfeeding makes long-term? So the question must be asked -- Do they push formula so they see the kids in the office more often and therefore, make more money?  Just a thought...

When I said something to the receptionist the first time I saw the coupon, I definitely caught her off guard.  She didn't know what to say.  I wasn't letting it go, however, so she told me to hand her the coupons, obviously so she could end the conversation.  I asked if she was just going to put them back out the minute I walked out the door.  Pushy, I know.  While she said no, when I was back a couple weeks later, there they were!

When I said something the next time to a different receptionist, I went into the whole story about being there for 6 years and never seeing anything about formula in the office until the newest doctor came on staff.  Again, silence.  They don't see the problem and they don't know what to say.  How can they not see that this promotes formula-feeding and sabotages the breastfeeding relationship?!

Shortly after I posted about this on the BFBS Facebook page, a reader sent me a link to an Academy of Pediatrics statement on the distribution and display of formula materials in pediatrician offices.  Read it here.  It's all about the reasons why having formula materials in a pediatrician's office is a conflict.  I thoroughly enjoyed reading it and will be setting up an appointment with the head pediatrician to share it.

Several people suggested taking the coupons and throwing them away, but this doesn't solve the problem.  Then the doctors and receptionists think there is such a demand, they just get more.  Correct me if I'm wrong, but I believe there is a kickback from the formula company for distributing the coupons.

I told the last receptionist that since it's an area for "free" items, I'll bring her a stack of Resource Guides for the Tarrant County Birth Network promoting Mother-Friendly maternity care and plenty of great lactation consultants!  Again, silence.

I believe that it is so important that we speak up about the messages doctors send to new and vulnerable mothers.  We cannot expect change to happen and the normalization of breastfeeding to occur unless we advocate for breastfeeding.  If you are reading my blog, birth and breastfeeding have likely had a huge impact on your life.  Don't be afraid to share that, even if it means defending and promoting breastfeeding to your pediatrician. 

Monday, July 23, 2012

Don't Drink the Kool-Aid!

American women have drank the Kool-aid and have been completely brainwashed!  You know the Kool-aid I'm talking about:  The purple Kool-aid says that if the baby doesn't come out in 24 hours, it won't fit and the mom should be sectioned.  The red one says that if a woman is 40 weeks, she is overdue and the baby will die if she isn't induced.  The green Kool-aid says that an epidural is just an epidural.  And the orange one says that a cesarean is safer for mom and baby.  We won't even get to the Kool-aid that tells you that your baby can manipulate you!  The list goes on and on.  I just picked a few from some common American birth myths that I've heard repeated lately.


I just heard this story last night and I have permission to relay it here.  I am appalled that with such great birth choices, women are being sectioned 60% of the time not 20 minutes up the road from me.  Here's the story from the lactation consultant:

Saw another "victim" of Dr. Seligman & MCA (Medical Center of Arlington) today. At 38.5 weeks, her baby hadn't dropped so Dr. S told her they needed to induce on Tuesday and she would probably need a c/s at 39 weeks. After 10 hours on pitocin, baby still hadn't moved down so Dr. S. told her that the baby probably wouldn't fit through her pelvis anyway, so they needed to do a c/s. Baby was born weighing 7lb 4oz, still covered in lanugo and has very little suck reflex. :-( Mom is starting the make the connection that baby was NOT ready to come yet. Said her mom delivered all of her babies at 42 weeks. Oh, and she said that Dr. Seligman's parting comment to her was "Next time we'll just schedule the c/s for 39 weeks and avoid all of this other nonsense." 

This story really touched a nerve with me.  Frankly, her doctor is a complete idiot.  I feel horrible for the mom.  This is some bad Kool-aid she drank, but she trusted her doctor.  Very few don't trust their doctor and end up in the same situation.  He should not be practicing medicine.

What about the woman that labors "too long"?  "It's barbaric to expect a woman to labor for 24 hours without drugs.  Put her out of her misery!  If she's labored that long, surely something is wrong.  She should just have a c-section."  There is another OB at the Medical Center of Arlington in Arlington, TX, Dr. Udell, that tells her "patients" that the only humane way to have a baby is via cesarean.  She laughs if a woman tells her she wants to have an unmedicated birth.  Yes, this OB is a woman, and no, she does not have children.  I only know one woman who has had a vaginal birth with her, and frankly, it's because the labor was so fast, the OB didn't have time to intervene.  Although she did find a way to get her flat on her back despite the mom wanting to be on hands and knees...

I know of another OB in Mansfield, TX that routinely tells her "patients" that "nothing good happens after 40 weeks" and insists on induction at that time.  The baby must have a sticky note with the date circled in red ink on the side of the uterus so it knows just when it is expected.  It will be evicted by 40 weeks if mom is with Dr. W.  It is dangerous to stay pregnant another day!  Induce, induce, induce! 

"An epidural is safe and you are crazy if you don't sign up for one." This Kool-aid tastes so good, mostly because we want it to.  It's just an epidural.  Nevermind the cascading interventions when a mom says she wants "her epidural".  IV fluids, catheterization, blood pressure cuff, continuous electronic fetal monitoring, possible internal fetal monitoring (which includes breaking water - I'll come back to this one in a minute), fever reducer, pitocin, is more likely to have an episiotomy and assisted delivery (forceps/vacuum), and ultimately, she is more likely to have a cesarean.

I just want to mention briefly that I am hearing less and less about internal monitoring.  I honestly believe that we have become too blase about c-sections that everyone is just comfortable with going straight for the cesarean rather than use a more accurate form of monitoring.  Just an observation.

And the cesarean Kool-aid... This is the biggest lie of them all.  "Cesareans are safe -- even safer -- for mom and baby than a vaginal birth."  Shame on anyone who believes this to be an acceptable -- and even preferred -- way to get the baby out.  Women are going in for surgery and have no idea how this will impact them or their baby for the rest of their lives.  Someone always has to jump in and tell me why they had to have a cesarean.  Yes, folks, I am very aware that a cesarean does sometimes save a life and sometimes the baby really can't get out on his/her own.  Very aware.  What is the rate where you live?  What is the cesarean rate at your closest hospital?  You should know these things.  What can you do about it?  We're getting to that.

So many women (and men) feel defeated when it comes to the Kool-aid.  Everyone has drank it.  I think two things have to happen.  We can scream the truth from the rooftops, but that may or may not work.

1)  We have to start with the younger generation.  Don't be afraid to talk about birth with them.  Talk to your sons and daughters.  Just casual conversations.  Tell them about the day they were born, how their birth was amazing and special.  Just hearing different words associated with birth makes the Kool-aid not taste so good when they do hear it in our culture. 

2)  Get involved in making change happen.  You have to open your mouth, or at least get involved and help the people who are opening their mouths!  There is a rally being formed all across the country right now to take place on Labor Day, September 3, 2012.  Go to Improving Birth for details.  There may already be organizers putting a rally together in your community.  If not, YOU DO IT!  Change has to start with someone.  Why not YOU? 

Monday, July 16, 2012

Journal Entry - Ina May's Visit to Fort Worth, July 2012

"Ask Me About Sphincter Law"

The weekend is over and I'm still on a high.  Indulge me in this blog post -- it might read more like a journal entry.  I heard one of our girls describe the weekend as magical, and while it sounds a bit corny, it really was -- magical.  Not just because Ina May was here, but because the entire natural birth community came together.

I have said it before, and I'll say it again:  I am so blessed to live in Ft. Worth with so many midwives and birth centers in operation -- where the birth community is strong, united, and well represented. I am proud to be associated with the Tarrant County Birth Network, where I believe we've had an influence in bringing the birth community together.  We are also grateful to have a wonderful group of CNMs in Fort Worth, the UNT Midwives.  The hospital donated $2000 to TCBN to help cover our facility fee at the Norris Center. Every city in America should have a group of midwives like this in their hospital!

UNT Midwives & Ina May Gaskin

Our Ina May T-shirts were a huge hit.  There is demand for another order, so if you would like to get in on it, go here.  Join our newsletter email and we'll be sending that form out very soon. 

You can still order one!

How it all went down:

Shannon (this was all her idea!) and I picked Miss Ina May up from the airport early afternoon on Friday, and I must admit that it was very stressful driving her from the airport to the B&B in downtown Ft. Worth.  I was seriously concerned about getting into a car accident and going down in history as the person that killed Ina May.  It reminded me of when I had my first baby and was scared some crazy driver would hit me and my precious baby. 

We put her up in the most lovely, elegant bed and breakfast called Etta's Place.  Remarkably, all of our events were within the same city block.  Friday night for dinner, our VIP sponsors  met for dinner with Ina May at Reata. Our name tags rocked!  They were made into lanyards with twine.  We could not have hosted Ina May to Fort Worth (and treated her so well) without our sponsors. It was a fun night with delicious food and wonderful people!

*Funny story*   I made a big deal to Reata about Ina May being vegan and they said they would make her a special plate.  In the end, she ordered the salmon with the crab meat cream sauce!  One of the CNM's at her table almost got into it with her that she had ordered the wrong thing!

Saturday morning we had a book signing and photo opportunity for Birth Network members.  About 125 people attended, representing several cities including DFW area, Houston, Waco, San Antonio, Oklahoma City, and Tulsa.  Ina May was so courteous and chatty, everyone really enjoyed it.

Sarah Brock, acupuncturist, gets her book signed.

We broke for lunch and vendor time for 3 hours, and then nearly 500 people gathered to hear Ina May speak at 3:30.  She talked about a number of topics, including a slide show of a breech birth.  She discussed how she became interested in midwifery and current projects she is working on.  Between events (we kept her busy!) she was working on a blog post for the Huffington Post.

The quilt representing the maternal mortality crisis

She also brought the famous quilt, each square representing a woman who died in childbirth, whose story might not otherwise be told.  She shared some of those stories. 

 She spoke specifically to dads -- we had a few in the audience -- about how they can protect the sacred birthing space of their partner.

Another highlight was Ina May showing us how to do a proper squat.  Don't worry -- the fabulous Ceci-Jane is making a video of the weekend and it will be included!  Stay tuned!

Here's where things get fun:  The TCBN Chapter Leaders -- past, present, and future -- took Ina May to an all-vegan restaurant, Spiral Diner, and had a lovely meal.  We had gotten to know each other a bit over the weekend and things were more casual.  We all had a good time.  Ina May is very funny, says it like it is, rolls with the punches, and really is a delightful person.

TCBN Chapter Leaders - past and present

After dinner, we were driving her back to her B&B, and we came back to Tim McGraw.  (He had been brought up earlier when I told her she needed to work the "stage" like Tim, back and forth.)  She admitted to knowing his name, but couldn't tell me anything he sings.  I asked if she wanted to hear some Tim. Of course she said YES -- who wouldn't? -- and all I had to do was turn up the volume.  So, yes, I rocked out to some Tim McGraw with Ina May in my Sequoia this weekend!  She said she could totally appreciate my groupiness, as long as I respected his family space (like a doula!).  I assured her that I do.  And she said that anytime she hears of Tim McGraw from here on out, she'll think of me.  Nice.

This morning we took her back to the airport and had another casual, candid conversation.  Frankly, we have a policy that "what  happens in the Sequoia stays in the Sequoia."  I'll leave you with the last picture I took with Ina May before we put her on the plane back to TN.  Thanks for rejuvenating our birth community Ina May!  It was an absolute pleasure!

Donna Ryan & Ina May Gaskin, 2012

Saturday, July 7, 2012

Ina May is Coming! Ina May is Coming!

In case you missed the big announcement, the Tarrant County Birth Network is bringing Ina May Gaskin to Fort Worth July 13-14!  We have so many fun events planned while she is here and there are still a few tickets available if you haven't gotten them yet.  This link will give you lots of info about getting tickets, addresses, times, etc.

Dinner with Ina May:
We have an intimate dinner in Ina May's honor being held at Reata on Friday night at 5:30.  These sponsor tickets are $185.  The money raised helped pay our fees to bring Ina May to Fort Worth.  Trust me, she will be treated very well while she is with us.  If you would like to sponsor Ina May's visit and enjoy dinner at Reata with a handful of people -- including Ina May -- there are just a few tickets left, closing Tuesday night, or until sold out.  Buy here.

Book Signing/Meet & Greet:   
On Saturday morning at 10:30, we have a special treat for the members of the Tarrant County Birth Network.  They can purchase a variety of Ina May's books at the event (proceeds benefit TCBN) and have Ina May sign their book.  We will also have a photo opportunity at this time.  Membership of TCBN begins at $25 for a Birth Advocate.  Join TCBN here.  To participate in the book signing -- other than being a TCBN member -- it is free, but you must have a ticket.  Get your ticket here.

FREE Public Speaking Event:  
Come hear Ina May speak on Maternal Mortality on Saturday afternoon at 3:30.  There are 500 tickets available and they are nearly gone.  Get your ticket here.  Without getting too technical, the earlier you arrive, the better wristband you'll get to sit closer.  Walk-ins will be seated at 3:10, so if you have a ticket, you'll need to be there before 3:10.  

There is some down time between the Book Signing and the Speaking Event to grab lunch and check out the vendors and a portion of The Art of Birth exhibit.  Bring your girlfriends and come hang out with us!  Birth Boot Camp will have a booth too!  Come browse through the workbook and check out some of our online classes.

There have also been t-shirts made with the (optional) line on the back "Ask me about sphincter law".  Shirts are $26 or $28.50 depending on if you want the back of the shirt.  They will be available for purchase at the event. 

We are so honored to bring Ina May to Fort Worth.  She truly is the Mother of Modern Midwifery. 

Monday, July 2, 2012

I'm Just Gonna Say It... So Don't Hate Me!

The Farm was great and I believe there will be some great things come out of the First Birth Activists Retreat.   I met so many wonderful people doing amazing things all over North America.  One thing I will point out right now is The National Rally for Change.  There are many cities and states participating on Labor Day.  Find out if your city has signed up to take part in the rally.  If not, consider becoming a coordinator for your city. 

Birth Activism will continue to be a big topic here, but I wanted to talk about something that has been driving me crazy.  A couple of things have led to this blog post.  First, someone sent me a link to a post titled "Mind Your Own Birth" by a CNM.  I hate the title.  But I'll come back to that in a minute.

The other occurrence was after posting on my Facebook page about a 16-year-old girl who found out she's pregnant and was turning to her young friend for advice.  The friend sent me a message and I asked if I could share her question/dilemma.   Let me just say, I am not trying to turn this into a pro-choice or pro-life discussion.  Some people went a little crazy, but as usual, I didn't edit.  Everyone is entitled to their own opinion.

But often it's hard to have an informed opinion when you don't understand all the options and/or information.  Let's go back to this idea of "mind your own birth" for a minute.  When I was pregnant with my first baby, I had never known a single person (at least that I know of) that had given birth without medication.  Hindsight is 20/20, but I have often wondered if I would have been receptive to their message.  I had the epidural, didn't feel a darn thing, narrowly escaped a c-section, and was blissfully unaware of what I had missed out on!  That is, until I had a friend have a drug-free birth. 

There are very good choices that have been placed before me throughout my life by people who love me.  I am so grateful for their positive influence, which includes sharing information.  Again, hindsight is 20/20.

I've talked to dozens of women over the years who say that the reason they sought out an unmedicated birth was because someone else had encouraged them by sharing their stories and experiences.   

Once someone has information about all their options -- the risks and the benefits -- fine.  But don't just assume that just because it's their birth, you can't share your experience about natural birth.  It did strike me as very odd that at the end of her post she said, "Birth is not a competition. You don’t get extra points for going without an epidural, for choosing to breastfeed, or for choosing to avoid labor all together with a primary c-section.  None of these things make you a better woman or mother than anyone else."  No one who chooses natural birth is expecting a medal or doing it because it's a competition.  Evidence has shown time and again that there are risks to epidurals, countless benefits to breastfeeding, and "avoiding labor" and going straight for the c-section is rarely a good idea.  That is what is called a fear-based cesarean.  Oh my word.  OK, maybe just not the midwife for me.  I want someone by my side who gives me correct information and tells me I'm strong.  Not someone who gives me an out before I've even started the race!

As for our sweet little 16-year-old...  I was an idiot when I was 16.  I was in no way capable of making an informed decision had I found myself pregnant at that age.  This girl may be sharp as a tack, but I suspect, as Brad Paisley sings, she "can't see past Friday night."  Several people, in the comments, said that she should make her own decision and not have anyone else's opinions forced upon her. 

I disagree.  She needs someone with more life experience to help her understand all of her options -- the risks and the benefits -- each choice would bring.  Ultimately, it is her choice, but the parents can't be taken out of the equation either.  The entire family would benefit from counseling, if you asked me!  My heart goes out to this girl and her family.  But like it or not, she needs guidance and support.  I hope she finds it.

So, I guess I'm just annoyed with the whole it's-her-life-don't-share-your-opinion attitude that I've seen so much of lately.  Since when did we stop caring about what happens to those around us?  It doesn't have to be a banned-from-baby-showers moment either, but just show you care about the people around you.  

You never know who your life/opinion may touch.  You could change their life for the better all because you shared information or your experiences.