Shelley Scotka

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Lots of families come into my childbirth classes asking how they can reduce their risk of having a cesarean birth. We talk about what the research has clearly indicated, which includes:

-Get good prenatal care, eat well, exercise, go into labor as healthy as possible

-Stay at home during early labor

-Avoid medical interventions, especially induction and continuous fetal monitoring, unless medically indicated.

-If a mom wants an epidural, wait until labor is well established (5cm or more)

-Wait until the baby is low enough before pushing

-Hire a birth doula

One thing that has not come up in the articles or research though is something that needs to happen way before all these things… and that’s CHOOSE A PROVIDER WHO HAS A LOW CESAREAN RATE. My students are often surprised to hear that while our cesarean rates at our local hospital here in Austin typically fall into the “average” range matching the national averages, the rates actually vary greatly from physician to physician. A recent article in the Science and Sensibility blog outlines some research which shows clearly that provider attitudes vary greatly, and that does indeed influence their recommendations when it comes to making decisions about performing a cesarean. https://www.scienceandsensibility.org/blog/providers-support-vaginal-birth?source=1&utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+science-sensibility+%28Science+%26+Sensibility%29

What can you do? Ask your provider about their cesarean rate for low risk, first time moms who have a head down baby at full term. (This is known as the NTSV rate) Find out how this rate compares to the “target” rate of 24%… Ask him/her the reasons they usually do cesareans, and their general attitude about cesareans. You’ll get a feel for things, and if they seem to not be in alignment with your beliefs, you may be better off finding another provider.

From a medical/physical perspective, the postpartum period lasts 6 weeks. From a social/psychological perspective, it’s the first year of motherhood.

In our culture, families tend to get a lot of “attention” the first week or two after a baby is born. Visitors, helpers, meals, etc. Then everyone gets back into their normal routine and mom is left with a baby all on her own, especially after her partner returns to work.  She may feel overwhelmed, isolated (it’s hard to get out when a baby is nursing every 2 hours) have a ton of questions about what’s normal. Her relationship with her partner has changed. Perhaps these days alone with a baby are not what she expected. She’s probably tired- maybe exhausted.  Maybe breastfeeding is going well- maybe not. She can barely fit in time for a meal, let alone a shower or nap. How will she figure out laundry, meals, grocery shopping or cleaning? How can she figure out this baby? How can she keep her sanity?

Postpartum/new mom support group to the rescue! This is the place for new mamas and babies to meet, have honest discussions about what new mothering is like, normalize the emotions during this period, setting up expectations for both moms and partners. This is the place for a good cry. Loving support and encouragement. Discussions about changing relationships, frustrations with family expectations, discovering your “new” self as a new mom.

I encourage new moms to come as early as they can manage it- ideally by week 3 or 4.  I hear often that moms don’t come because “they didn’t get a shower”, or “the baby might cry”, or “I haven’t mastered public breastfeeding yet”, or “I’ll come when things get easier”. This group is for moms well before all that works out! You are welcome in your pajamas or yoga pants, with or without a shower, with a fussy baby. Don’t worry about public breastfeeding- we’re all mamas. This is the space for non-judgemental support, information, and encouragement. You might even make some wonderful friends.

There are several groups in the Austin area. My resources page has local listings. Many are free! Find a group and come on out! If you are on the north side of town, come and see me, every Wednesday at noon at Thrive Chiropractic. https://www.facebook.com/newmamahappyhour/

NEW: I’ll be offering a comprehensive “Birth in a Day” class through Austin-Born doula collective with my colleague Amanda Wyszkowski! We are super excited to partner our collective 30+ years in the birth field to offer FUN and informative classes to first time parents in Austin. Our 1-day comprehensive class will leave you with all the info and tools you need to confidently bring your baby into the world, without having to give up weeks of your time learning the ropes. Austin-Born Childbirth Education

OBGYN North Patients only- Please call the office to register!

Prepared Childbirth (first time parents): Feb and March classes are already full

April 9, 16, 23, 30th 6:30-9pm

April 3, 10, 17, 24 6:30-9pm

April 30, May 7, 14, 21 6:30-9pm

May 1, 8, 15, 22 6:30-9pm

June 4, 11, 18, 25 6:30-9pm

May 29, June 5, June 7, June 12 6:30-9pm

VBAC class (ideal in 2nd trimester):

Sunday 3/25 12:30-3pm

Sunday 5/20 12:30-3pm

Labor Skills (refresher for 2nd/3rd timers):

Sunday 2/25 3:30-6pm

Sunday 3/18 3:30-6pm

Sunday 4/29 3:30-6pm

Sunday 6/24 3:30-6pm

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 Center– Please 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

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?