Statistics

So, I keep stats on all the births I attend. Mostly to get a general idea of how a doula is contributing in comparison to the averages in my area. Here are mine as of the end of 2009...

* 82% gave birth vaginally
* 18% gave birth by c-section
* 24% received an epidural or other pain medication during labor
* 71% were unmedicated during labor
* 18% were attempted VBACs, with 30% achieving a vaginal birth
* 24% received an episiotomy
* 18% were inductions
* 24% received internal monitoring
* 47% were first time moms

I'm happy with them. I don't really care much about the medication rate, so much as the vaginal birth rate. 18% is great for this area, since in 2006 the rate was around 38%+.

Still waiting on that birth to happen. :)

New Year, New Blogging!

So, I've been slow to begin blogging this year. I've been, well... busy. January was a lovely month, that included the entire household getting the flu. We are well again, mostly.

I am now waiting for the birthing to start! So, here is a rundown of the planned events for February.

8th - Sophia turns 4!!
9th - Client Due Date
10th - Movie and Discussion with Wiregrass Birth Network
12th - Wiregrass Birth Network Outing at Landmark Park from 12-2
14th - Valentines Day!
16th - Birth Network Meeting in Fort Rucker from 10-12
18th - Birth Network Meeting in Dothan from 10-12
19th - Cole turns 2!!
20th - Healthy Pregnancy Class at 2pm
25th - Potential Client Due Date

Busy busy busy.

I suspect my next post will be a birth story! YAY! I'm ready!

A great website

I just found this great website!

Are you using the right type of healthcare provider for your pregnancy? Take this quiz and find out!

http://www.delivermybaby.org/

Shoulder Dystocia

I'm sure most of you have heard of Shoulder Dystocia, but does anyone know much about it, or how it's resolved?

From Wikipedia:

Shoulder dystocia is a specific case of dystocia whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below the pubic symphysis, or requires significant manipulation to pass below the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head. In shoulder dystocia, it is the chin that presses against the walls of the perineum

So, the most common way I've seen this handled in the hospital is by using the McRoberts Manuver, which just means pulling your knees all the way back to your ears... followed by suprapubic pressure. The technique is effective in about 42% of cases. Although McRoberts maneuver and suprapubic pressure are generally safe, it is possible to cause maternal injury by performing them.

Personally, I would like to see more of the Gaskin maneuver, named after Certified Professional Midwife, Ina May Gaskin, which involves moving the mother to an all fours position with the back arched, widening the pelvic outlet. I partially understand why it isn't... most women in the hospital have an epidural, and most likely it is heavy enough that quickly moving to an all fours position is nearly impossible.

BUT, for those mothers that can assume this position, the results are good.

One study found:

The most significant observations of the study were the negative findings. No still births or neonatal deaths were reported. Not a single infant suffered Erb palsy, either transient or permanent, and no newborns experienced seizures, hemorrhage, hypoxic-ischemic encephalopathy, cerebral palsy, or fractured clavicle. No patients required any tocolytic medication during labor. No vaginal, cervical, or uterine lacerations occurred. No women required transfusions. And no cases of postpartum, ileus or pulmonary embolus were reported. Overall, the maternal complication associated with the use of the “Gaskin Maneuver” was 1.2 percent (one case of postpartum hemorrhage, transfusion not required), and the neonatal complication rate was 4.9 percent. . . None of these patients required any additional maneuvers. . . Not only was the Gaskin Maneuver instrumental in relieving shoulder impact in every instance, it is also a non-invasive procedure requiring only a change of maternal position.” The average time needed to assume the position and complete the delivery was 2-3 minutes, with the longest reported interval being 6 minutes.

Cheap Websites?

This is a completely unrelated post, but...

I'm offering to do basic, but nice websites for a great price!

Prices will range from $50 for a basic website with no more than 5 pages, up to $100 for more complicated designs.

You are responsible for securing your domain name and choosing a hosting plan. I will provide your finished website in a zipped folder, which you can upload to your site.

Samples:

www.wiregrassdoulaservices.com
www.aplacetorenew.com

Just for FUN...

Jill at the Unnecesarean is having a contest! So, just for fun, I thought I'd throw in an entry.

When VBAC, meets CBAC...

VBAC = Vaginal Birth after Cesarean
HBAC = Home Birth after Cesarean
WBAC = Water Birth after Cesarean
CBAC = Cesarean Birth after Cesarean

For every woman there is an end to pregnancy. Yes, even for those women who's OB's told them they really would stay pregnant forever if they didn't do X, Y or Z. It's an exciting time, anxiously awaiting the impending birth of their new baby.

But, for a VBAC mom, the end of a pregnancy can be bittersweet. There is endless preparation, reading, praying, hoping and dreaming of the long awaited birth. Will they be able to accomplish this? Are they really broken?

If it ends in another cesarean, what is left of that mom? Peace? Emptiness? Gratitude? Pain? Just another scar?

The nationwide VBAC success rate is around 20 percent. But, if you look more closely, you will find better odds. A VBAC mom who is under the care of a practitioner who regards VBAC as no riskier than any other delivery and chooses to deliver in a setting that does not consider VBAC women "high risk,", her success rate is more like 75-90 percent.

So, what does a VBAC turned CBAC mom do?
- Recognize, honor and accept the feelings of loss or sadness if they are present.
- Share your story and feelings with other CBAC mom's.
- Above all, love yourself and your baby.
- Get help if you need it.