Archive for the ‘Shelley’s Blog’ Category

OBGYN North (their patients only- call the office to register) Classes are on a first come, first served basis and have limited space, so it’s recommended that you sign up early!

Prepared CB June 5, 12, 19, 26 6:30-9pm

Prepared CB June 6, 13, 20, 27 6:30-9pm

VBAC Class June 4, 12:30-3pm

Labor Skills June 25, 3:30-6pm

Prepared CB July 10, 17, 24, 31 6:30-9pm

Prepared CB July 11, 18, 25, Aug 1 6:30-9pm

VBAC July 23 12:30-3pm

Prepared CB Aug 7, 14, 21, 28 6:30-9pm

Prepared CB Aug 8, 15, 22, 29 6:30-9pm

Labor Skills Aug 27 3:30-6pm

OBGYN North/Natural Beginning Patients: Classes may be added as the need arises. Please call front desk to register/check on availability or be put on a waiting list for a new class! 

Prepared Childbirth series  evenings 6:30-9pm

Tuesdays March 7, 14, 21, 28 (full)

Mondays April 3, 10, 17, 24 (full)

Tuesdays May 2, 9, 16, 23

Mondays June 5, 12, 19, 26

 

Prepared VBAC:

Sunday Mar 26, 12:30-6pm (full)

Sunday June 4, 12:30-6pm

 

Labor Skills Class:

Sunday Feb 26 12:30-6pm (full)

Sunday Feb 26 3:30-6pm (full)

Sunday April 30 3:30-6pm

Sunday June 25 3:30-6pm

 

St Davids North Austin Medical CenterPlease call Parent Ed 512-544-4226 to check on availability and register:

Reality Childbirth Classes:

Sat March 3 and Sun March 4 10am-4pm each day

Sat April 8 and Sun April 9 10am-4pm each day

Sat May 6 and Sat May 13 10am-4pm each day

Sat June 3 and Sat June 10 10am-4pm each day

VBAC class, PlannedCesarean Class, and Advanced Coping Skills classes are also offered regularly. Call for schedule.

Any Baby Can – Wednesday evenings 6:30-9pm. Call 512-454-3743 or register online www.anybabycan.org

March 1, 8, 22, 29 (no class spring break)

May 3, 10, 17, 24

Are you an expectant mama or a mama with a new baby? Do you have questions about birth, babies, breastfeeding, motherhood? Want to share your story, learn from others? Is motherhood exactly what you expected? Or not? Do you just need some adult interaction with other mamas? No matter your reason, we are here.

New Mama Happy Hour is a FREE support group hosted by birth and postpartum doulas just for you. We meet every Wednesday from noon to 1:15pm at Thrive Chiropractic, located at 15501 Ranch Road 620 N. ste 1200 Austin 78717. (just west of Mesa Rosa restaurant) Come as you are- no makeup, yoga pants and all. Bring a snack for yourself- or not. Older sibs are welcome but we do not provide childcare. Just a space to chat, laugh, listen, and offer non-judgemental support for those of you taking this journey from pregnancy into motherhood.

Juicy topics include sleep (or lack thereof), normal newborn behavior and development, going back to work/childcare, emotions, changes in our family/relationships, older sibling adjustment and more! If you have questions, contact me. 512-468-8526

 

I get regular inquiries regarding class dates and times. Here they are through December:

At OBGyn North (their patients only) Call their office to register: 512-425-3825

Prepared Childbirth (4 week series for first time parents) Evenings 6:30-9pm:

July

Mondays 7/11, 7/18, 7/25, 8/1

Tuesdays 7/12, 7/19, 7/26, 8/2

Aug

Mondays 8/8, 8/15, 8/22, 8/29

Tuesdays 8/9, 8/16, 8/23, 8/30

Sept

Mondays 9/12, 9/19, 9/26, 10/3
Tuesdays 9/6, 9/13, 9/20, 9/27
Oct
Mondays 10/10, 10/17, 10/24, no class 10/31, 11/7
Tuesdays 10/4, 10/11, 10/18, 10/25
Nov
No Monday class
Tuesdays 11/1, 11/8, 11/15, no class 11/22, 11/29
Dec
Mondays 11/28, 12/5, 12/12, 12/19
No Tuesday class
_______________________________________________________________________________
VBAC class
Sunday 8/7 12:30-3pm
Sunday 10/2 12:30-3pm
Sunday 12/11 12;30-3pm
_______________________________________________________________________________
Labor Skills class
Sunday 8/7 3:30-6pm
Sunday 9/11 3;30-6pm
Sunday 10/2 3:30-6pm
Sunday 11/6 3:30-6pm
Sunday 12/11 3:30-6pm
________________________________________________________________________________
4 week series at Any Baby Can Wednesday evenings 6:30-9pm in English every other month: call 512-454-3743
July 6, 13, 20, 27 (will be taught by a colleague of mine)
Sept 7, 14, 21, 28
Nov 2, 9, 16 and 30 (no class 11/23)
 ______________________________________________________________________________
I also teach Reality Childbirth at North Austin Medical Center through St Davids Healthcare once a month, call the Parent Education department 512-544-4226 to register:
Aug 6 and 13th, 10am-4pm
Sept 10 and 17th, 10am-4pm
Oct 1 and 8th, 10am-4pm
Nov 5 and 12th, 10am-4pm
Dec 3 and 4th, 10am-4pm
Other specialty classes (Advanced Coping Skills, Planned Cesarean Class and VBAC class are available as well, call Parent Education for schedule and availability)

For the first time, expectant parents can easily find out the cesarean rates for their local hospitals!! The Leap Frog Group http://www.leapfroggroup.org/c-section did a voluntary survey to hospitals nationwide to determine cesarean rates by state. The numbers are so interesting! Overall, the National rate remains about 33%. The Leap Frog Group adopted the rate of 23.9% as an acceptable rate as proposed  by the HealthyPeople.gov 2020 initiative http://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives.

Texas as a state (based on the reporting hospitals) is running #29 with a 29.8%. Here are our local hospitals rankings:

St Davids South Austin 39.3%

St Davids North Austin 34.3%

Seton Medical Center 31.5%

Seton Hayes 31.3%

St Davids Medical Center 30.5%

Seton Northwest 28.2%

St Davids Round Rock 27.6%

St Davids Georgetown 23.9%

Seton Williamson 22%

Scott & White Round Rock 16.4%

Cedar Park Regional, Lakeway Regional, and Seton Southwest declined to respond.

Interesting notes: Hospital with the LOWEST c-section rate in Texas is the Doctors Hospital at White Rock Lake in Dallas with an amazing 12.6%!! The Texas hospital with the highest rate is Covenant Medical Center in Lubbock with an embarrassing 52.9%

 

 

 

 

Having worked with women now for nearly 20 years, I can honestly say, in my very “unscientific” way, that women change when they give birth. Really change.

Every woman who has been there knows what I’m talking about. We feel differently, we think differently, we act differently. My friend/former client Cathy O’Neill, one of the authors of “Babyproofing Your Marriage” calls it the “Mommy Chip”. Well, scientists seems to have finally “found” the Mommy Chip!

This article outlines what we’ve “known” and “seen” for years- a change in how our brain works, likely to be related to the hormones of pregnancy, birth, lactation and postpartum.

Helping moms through the initial changes  physically and emotionally seems even more critical, in getting parenthood off to a good balanced start. Our culture has forgotten the 40 days of “lying in” that is so prevalent in many parts of the world– where a woman does nothing for 40 days postpartum (that’s nearly 6 weeks!) but care for her baby. She is nurtured and fed. Her home, husband, and other children are cared for, so she can rest, nurse, and get to know her new baby. This support allows a woman to “give in” to the Mommy Chip urges, heal physically, and gently adjust to the new change in her family.

Sometimes this help comes from family, friends, and neighbors, but not everyone has those resources. When they don’t (and sometimes even when they do) a postpartum doula can be a lifesaver. Postpartum doulas are specifically trained to assist the family during this transitional time, helping the mother with breastfeeding, her baby, and her household. A doula will help build a woman’s confidence so that eventually she feels more and more capable to handle things on her own. A doula may make recommendations, offer suggestions, or provide resources to a new family to smooth the transition. She may teach skills, such as babywearing. She may educate, on baby care and breastfeeding, baby safety in the home, or self care. She may validate a mother’s feelings, or choices in parenting. She may nurture the Mommy Chip.

Studies indicate as many as one in six women suffer from some kind of postpartum mood disorder (PPMD) such as depression or anxiety. Could we greatly reduce these numbers, and the severity of some cases if we provided better care to mothers during this critical time?

 

The American College of Obstetricians and Gynecologists in their most recent bulletin Read the Article Here reviewed the statistics for primary cesareans over the years, and has concluded that… hold onto your hats folks… that we are doing too many! We need to be taking action to reduce the primary cesarean rate, which will of course reduce the repeat cesarean rate, bringing the numbers down significantly. One main topic in the article is about being patient. In previous years, we’ve “called it a section” after too many hours (often 2) with no progress. The new recommendation is to BE MORE PATIENT and wait before making those decisions. When we do, we see more vaginal deliveries without compromising the health of the baby. Who knew!?

The other BIG NEWS– at the very end of the article, it states:  “Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery (111). Given that there are no associated measurable harms, this resource is probably underutilized.”

Probably underutilized? Probably.

 

I am thrilled to say I have partnered with OBGYN North to offer in house childbirth classes for their patients. These classes, which have been customized to fit with the philosophy and style of their practice, will be perfect for first time as well as experienced parents. They will be suitable for those delivering at the hospital OR birth center!

Prepared Childbirth: A 4 week series for first time parents, which will help you understand what is labor, practice a variety of ways to cope with labor pain including breathing, relaxation, positions, massage, visualizations and more. Also included is a discussion of medical interventions- why, when, and how to decide.  What if you decide on an epidural? What is a cesarean becomes needed? We’ll cover it all, even a short and fun discussion about what to expect during the postpartum period.

Preparing to VBAC: A one time 2.5 hour workshop designed for those who are wanting to have a Vaginal Birth After Cesarean. This workshop reviews the most up to date literature on the safety and outcomes of VBAC, as well as helps women and their partners understand what they can do physically and emotionally to create the best odds for success.

Labor Skills: A one time 2.5 hour workshop for those who just want to work on labor skills for birth. Ideal for 2nd or 3rd time parents who want a “refresher” or for those who need to expand their “skill set” for labor. Lots of hands on with breathing, relaxation, positions, touch and massage, acupressure, and how to deal with challenges in labor.

For more info and find out how to register:

http://obgynnorth.blogspot.com/2014/01/in-house-childbirth-classes-exclusively.html

Of course you probably know by now that I am a strong advocate for normal physiologic birth. However, even the most “crunchy” of us agree that there are times when a cesarean birth is absolutely the right choice. For those families who need a cesarean, they too deserve to birth surrounded by compassion, joy and gentleness. Yes, it’s major surgery. But still the birth of a baby, of a family. Particularly when planned ahead of time, in a non-emergent situation, a more family centered approach is working in other parts of the country, and can work here too. You just might have to ask for it! If you know you need a Cesarean in advance, consider taking my Planned Cesarean Birth Class.

What is Family Centered Cesarean Birth? How is it different from the routine Cesareans we have been doing?

Routine Cesareans typically go down like this: Mom goes into the OR to get prepped for surgery. Her one support person enters when it’s time for the surgery to begin. The doctor delivers the baby within about 5 minutes and the baby immediately goes to a warmer with a nurse for assessment and suctioning. Usually after a few minutes, if the baby is doing well, they swaddle the baby and allow the support person to bring the baby to mom for a quick meeting. They might be able to enjoy a whole 5-10 minutes together before a helpful nurse says “Ok Dad, let’s take that baby over to nursery”. The chosen support person and baby are escorted to nursery where Baby gets a more thorough assessment, basic meds (eye ointment and vitamin K shot) and sometimes a bath. Meanwhile, mom has been left “alone” in the OR so the medical staff can complete the repair portion of the surgery, which typically takes 30 minutes. During this time it’s not unusual for an anesthesiologist give the mother “something to help her relax” which makes her sleepy and she typically “checks out” during this period. She’s taken to the Recovery Room where she’s monitored closely following the surgery. When she is alert and ready for baby, they will re-unite mom with her support person and baby. (Typically 1-1.5 hrs after the birth, but there can be delays)  If there is time, she may be able to hold and/or breastfeed her baby in Recovery before being moved again to Postpartum.

Family Centered Cesarean Birth takes a slightly different approach. Recognizing it’s still a surgical procedure, but instead of just thinking about the efficiency of the hospital and staff, there is focus on the EXPERIENCE of the family. It starts the same, with the chosen support person at the mother’s head as the surgery begins. The mother may listen to music or her partners voice to keep her calm and relaxed. The doctor may allow the surgical screen to be lowered at the time of birth so both mother and her partner can see the baby emerge. They may have even allowed another support person (doula or midwife) to be present to offer emotional support and to explain what is happening during the procedure, and/or to take pictures. The baby is dried off and suctioned if necessary but quickly taken to the mother where she can hold her baby skin to skin across her chest. Her arms are as free as possible so she can touch and hold her baby. The baby stays on the mother, covered in warm blankets as the repair takes place, allowing the family to get to know each other. Instead of using medications to aid the mother in discomforts of the surgery, the partner, doula or midwife may encourage the mother to use deep breathing/visualization or other natural methods to cope. That person may also offer touch and massage, even aromatherapy to distract from some of the unpleasant smells and sensations related to the surgery. The family stays together throughout the entire surgery and goes into the Recovery Room together, where baby is typically ready to breastfeed, since there has been no separation.

What are the results of Family Centered Cesarean Birth (FCCB)? Families that have a much greater satisfaction with their birth experience, and memories and pictures of the first few moments they met their baby. Babies benefit from the immediate skin to skin have higher APGARS at 5 minutes, and transition better in general. Their respiration is normal, they stay warmer, and their glucose levels are stabilized. (Particularly helpful in gestationally diabetic mothers) Babies breastfeed much better and more easily when there has been no separation.

How can you get a FCCB in Austin? For a small number of practices in town, this is their new “norm”. For the rest, you’ll have to ask. Bring it up with your provider ahead of time– especially if you are higher risk for a cesarean birth. It does require some minor changes in where staff is (Baby Nurse stays in the OR instead of heading back to Nursery) but is well worth the work. Want to see how it’s done? Check this out: Family Centered Cesarean Video

How does a doula really make a difference?
Results from different studies have all suggested that having a doula reduces the overall cesarean rate by 50%, Pitocin use by 40% and requests for epidurals by 60%. The use of a doula also showed a major reduction in the length of labor due to fewer stress hormones being produced in the laboring woman’s body.

The Doula Book © 2002; Klaus, Marshall, Klaus and Kennell.