Finger Paintings

Politics and Debt

2011-08-05T07:32:00.004-07:00

I rarely blog on political issues outside of the birth world. Unfortunately, politics do play a part in all of our lives and as much as I love living in Canada, the politics that play out in our southern neighbour very much effect us. I have been watching, with tense regard, the debit crisis the US has gotten itself into.

If the US government were a family, they would have had to face their debt crisis long before now and in doing so, forcing them to make smarter decisions. If the US government were a family, they would be making $58,000 a year, spend $75,000 a year, & have $327,000 in credit card debt. They are currently proposing BIG spending cuts to reduce their spending to $72,000 a year.

What are they not doing? Increasing their income. What do rank and file humans do when we are in such a situation? We get a second job, we find a better job, we work on the side, we do what we have to. We don't ignore the fact that we have to increase our income because we don't want to alienate the fat wallets who could handle more taxes. The US is climbing out of a major recession, everyone needs to pull together to make this work.

Normal citizens also don't get a reprieve from our bank for an additional 15%, au contraire. Banks only think of themselves first, at least the banks who us mere mortals deal with. In the end, this does far more harm than good by allowing the government to avoid facing the truth. In short, they HAVE to do a lot to improve their situation.

What is the definition of insanity? Doing the same thing over and over while expecting different results. Four years from now, without Ralph Klein-like cuts and a true increase in income starting now, they will be so far up the river without a paddle their insane delusions will drown them. Who will they take with them? Canada and Mexico.

Delicious Dreams

2011-07-27T07:44:00.002-07:00

I have loved dreams since I was young. They allow me to explore my psyche and go places I normally would not go. As a teen I had one reoccurring nightmare I couldn't shake. I worked hard to remember my dreams upon waking and that ability has stayed with me. I also learned how to know I was in a dream, if I chose, and how to fall back into a dream at will to change the course or just continue on with that experience. I was able to find out what that nightmare meant and in time it no longer occupied dream space in my slumber. Some of my dreams are wonderful and delicious while others can be painful and even downright terrifying. It's amazing what you learn about yourself by walking through your dreams!

The dream I had is one that has been reoccurring since my ex took away my two oldest sons. I've rarely spend time with them since. I miss them so badly I cry almost every day, but it doesn't change the fact that they no longer live with me. In these dreams, we are living together again, my four children and myself. Sometimes we live with other people who are in our lives, sometimes not. We live in the top of an eight floor condominium project in Hawaii somewhere. Our expansive balcony (wrapping around two sides of our condo) overlooks a large pool on one side with a view of the ocean and the other side looks over the city where we live. I have no idea what city that is, a moot point really. I know the layout of the condo and grounds very well from having lived there in my dreams so long.

In my dream last night we moved down to the third floor condo, what a pain that was. I hate moving and it wasn't fun in our dream either. Our new place had the same layout as our first. It is just closer to the pool and far less windy than the top floor. Actually, that was our main reason for moving, combined with the fact that a family had offered to purchase our condo for more than we had paid, and the lower unit had just come up and was newly renovated. Our Bree's loved our new space and set about making it ours posthaste. Brian and the boys all focused on electrical equipment of course. While they were working on that, Eric and I took a break and had gone up to meet our new neighbours. They were a fantastic couple with two girls we met and a third who wasn't there. We were introducing the girls to other kids in our condo complex when the alarm woke me for work.

I laid in bed for a few minutes letting the experience was over me, how fun it is to spend time as a family again, even if in my dreams.

Summer

2011-07-26T16:27:00.002-07:00

My absolutely favourite season is summer. Hot days, the sound of quaking aspen leaves, the smell of newly mown grass and canola fields blooming. Thunder showers that show the incredible strength of Mother Nature, the sound of birds chirping and bees humming, and watching horses run bucking across the pasture. Long days and lazy evenings sitting on the deck with a drink or watching a fire by moonlight.

Here we are closing in on the end of the second of our three month summers... far too short a season for a summer lover! I dreamt last night that I pursuaded our x's to move to BC with us to indulge my need for a longer summer season. In reality, that wouldn't happen, but it was a wonderful dream to dream.

So I am enjoying every drop I can out of this summer. Motorbike rides with Brian, training Eric's horse, hanging with my sister Tracy at her acreage, and as much time as possible outdoors encouraging the mudhens and dragonflies to eat as many mosquitoes as they can.

Forgetting to Dance

2011-06-27T06:26:00.004-07:00

The last few weeks have been tough and I have been struggling to put my finger on why. I have a new job which I'm really enjoying, had a great week with my two littles, and I'm catching up on a lot of things I haven't had time for. I told a close friend that maybe I need to see I psychologist to work my way through my malaise.

I then thought back to what I have done in the past when I've been down. It brought back a lot of great memories and ideas of things to do this summer, but still no true answer to my question. This morning, after yet another restless sleep, I got up at 4am and started my day. When I came downstairs after a wonderful shower, I turned on some music, something I hadn't done in a long time. Then it hit me, I had forgotten to dance!

After my seperation five years ago I had stuggled to find myself. I did a lot of personal exploration and rediscovered a lot of really great parts of me I had forgotten. During that time, I recaptured my love for music, my love for dance and my athleticism. Sure I felt clumsy and lumbering when I started dancing again, but soon I had the steps down to even the difficult hip hop routines and belly dance moves. I mostly danced in private but that expanded to dancing with my kids and dance dates with friends.

The exercise was great, my body enjoyed it and I loved moving to music, making it my own. But things changed and with less personal time, I started to dance less and less. With less opportunities to dance, I found less reason to. No longer. I am going to again reawaken my love, my need, for dance. Will you join me?

Horsing around

2011-05-14T09:31:00.011-07:00

I have spent several weekends this spring with horses, starting with our Easter weekend at my sister Terri's by Rocky Mountain House.

Here is a picture of my daughter Breanna on Decker and me!

In the picture below is my sister Tracy with her youngest daughter Clare on Rusty and Breanna and I on Decker.

Here Grace (behind me, hiding), Clare and I are on Decker, my sister Terri is on Bonnie and her husband Chuck is on King, their newest addition.

Here I'm riding Decker leading Gee (Taylor's horse), Brianna (Brian's daughter) is riding King and Brian is riding his favourite horse Rusty. The puppy (as of yet unnamed) leading us was born in our garage this winter!

Finally, here is my precious Peanut on Boone! She has a natural seat and did great both on Boone and Decker (who she rode most of Sunday).

Happy Trails!

Sadness

2011-04-18T16:05:00.003-07:00

I have been thinking a lot about the last five years of my life and how it feels like I have been so badly punished for leaving an abusive husband. Raised Christian, it is sometimes hard to see beyond that worldview and the importance the sanctity of marriage is for Christianity.

I now barely make enough money to live, rarely see my two oldest sons, and only have my two babies every other week (at which time I deal with my inability to properly feed, clothe, and entertain them). I left to help us (my kids and I) and I ended up really hurting us all. I don't care about poverty, I just hate the hopelessness.

I had a dream that my kids gave me a bouquet of flowers. They were a little vague about it and when I read the card I knew why. In the card was a set of vehicle keys and a note from my ex saying that the car was mine and anything I wanted if I would come back. My emotional reaction was revulsion at the thought of being with my ex again combined with the sheer excitement of the thought of seeing my kids more often than never. A vehicle, money, stuff... I don't even care. It is my kids, the only thing that I care about. But if being with my kids meant being with my ex, there is no way I could do it. I haven't had a panic attack since I left him and they were very common occurences during our marriage. I simply would not survive it.

The next day I was watching a documentary about one of my favourite bands, Rush. I love Canadian music and even though their fans are mostly male, I have loved their music since forever. I grew up listening to them. Anyway, I learned that Neil Peart, their amazing drummer and lyricist, after losing his only daughter (car accident) and wife (cancer), went on a three year motorbike sabbatical. He drove across the country on his motorbike for three years. After I left and lost my kids, I too did the same. The only difference was that I was on the road for work, I travelled every road in central and northern Alberta as a merchandising rep. Driving through the beautiful country is very healing and I can very much relate to Neil and his travels. I miss the road terribly.

I'm mostly sad. Sad because I can't support my own children. Sad when listening to what my ex says through my childrens words. Sad because I'm not a bigger, better part of their lives. Sad because I miss them so much when I am not with them. Sad.

New Website

2011-04-16T20:06:00.004-07:00

We are having a lot of fun with the design and building of our new site! Please come and see what we have so far and know that we will be adding much, much more. Don't forget, we are also on Facebook!

Our business launch

2011-04-12T04:23:00.003-07:00

We officially launched Labours of Luv by Mother Care on Saturday! We were at the Monster Swap in the TriLeisure Center in Spruce Grove with so many pregnany mommy's. We had a lot of fun, learned a lot and met a lot of wonderful women. I had almost forgotten how fun all of this is, now I can't wait for our upcoming Monster Swap in May. We will officially launch our Rosenthal Perinatal College then, even though we already have students.

Here is my new business card... still tweaking it.

I'm considering changing the font to the same font I have always used for Mother Care. Ah, I love designing... more soon!

Progress

2011-04-03T13:19:00.002-07:00

I have been working hard on the marketing materials for our two companies over the weekend. Business cards, brochures, and websites for both are almost complete. My two business partners will review, critique and correct them before I publish for all to see. I can't wait for next Saturday!

My Birth Journey

2011-03-30T16:08:00.008-07:00

My sister Tracy and I started a small business called Informed Birth Choices in 1996 just after I had taken a Beginning Midwifery course from a local midwife, Noreen Walker. Our company provided doula support and childbirth education to our clients. Unfortunately we had to part ways because of my now ex-husband and his control issues. We chose to own two separate companies, mine newly renamed Mother Care.

Mother Care grew and expanded slowly at first, then picking up speed as we moved into the 21st Century. I provided the same services and expanded into a monthly magazine, a birth catalogue and prenatal/birth photography. My having two children during that time slowed down the services aspect but the birth catalogue kept growing and growing. The newsletter fell by the wayside when we moved to another city (transferred because of my ex-husbands job) but I moved to writing for other birth industry periodicals. My sister Terri and I had joined forces with the photography and she is a truly gifted photographer. I knew that my ex-husband would make it difficult so I asked her to start her own company and I would refer to her, no way for my ex to interfere. She started Terri McKinney Photography which took off and far surpassed our expectations.

Rosenthal Perinatal College was born along with my fourth baby. I had been teaching for other certification organizations and knew that I wanted to provide more than what they were. Our certifications not only are through an accredited post secondary institution, they provide a comprehensive education and a continuing support system for students. We will be relaunching in April, watch for us!

By then the catalogue portion of my company had grown so big I couldn't keep up. As a home-based business, I ran it all from home. I couldn't afford both retail space and childcare for when I was 'at work'. My ex-husband wouldn't allow me to bring an 'employee' into 'his' house so I didn't have a choice. I sold the catalogue, a very sad day.

We moved to Spruce Grove after that and the College did well but I wasn't able to go back to doula support with four children, too busy and too expensive for childcare. Two years later I filed for divorce and put my businesses on the back burner as I dealt with courts, custody issues and working two jobs to pay for child support.

A new decade dawned, five years had passed, and I was approached by two birth professionals who were students from my college. They asked me to start working in birth again, to assist them in their birth journey, to join forces and work together. I contemplated this for six months before deciding as I had to complete a few things before I could dedicate myself to this again.

We are now working hard on bringing Mother Care back, but in a much larger way. We have renamed it Labours of Luv by Mother Care and Rosenthal Perinatal College will once again be teaching and mentoring students. We are launching in April, watch for us!

From the Ashes

2011-03-27T14:16:00.002-07:00

A phoenix is a spectacular mythical bird with brilliant plumage. The phoenix builds a nest of twigs and ends its life by setting itself on fire. From the ashes emerges a new, baby phoenix, life reincarnated. My life very much has paralleled that of a phoenix.

Five years ago I had two choices facing me, the only two options I felt I had. One was to leave my husband of nineteen years and become a single mother of my four precious children. The other was to commit suicide. I could no longer go on living with the abuse and allow my children to suffer. A dear friend talked me out of the latter and my children, in wanting to leave as well, confirmed that the former was the correct choice.

The path was incredibly hard from that summer until now... far more difficult that I could have imagined. More than once I pondered if I had made the correct choice. When the father of your children threatens to kill them then is given primary residency by the courts the following year. When you are kept from your three-year-old daughter by your vengeful ex-husband and forced from your home. When your legal aid lawyer lets you down at every step yet you are unable to afford a lawyer who had your best interest in mind. When you cry yourself to sleep every night knowing the tears flowing in your former home by your children because of the yelling that day.

Today is still difficult. I have my two youngest children every other week and I cherish every moment I have with them. My two oldest are still too afraid to see or talk to me very much because of their fear of their father. I know that fear well and I truly understand why, but it still hurts so badly to not see them grow up into the incredible men they are becoming. I still cry every day.

Today is hopeful. I have a day job that I love. The difficult and treacherous road Richmond Transport Inc. and I have been on is starting to pay off. I started the trucking company to pay for my children's secondary education because I knew I could never afford it with my day job. Two dear friends are pulling me back to the birth world and the work that I love... supporting birthing mothers and the professionals who care for them. More on that later.

Today is exciting. I have met a man who defines what a modern man is. He is all male, broad of shoulder and thin of hip, a perfect specimen. He is a hard worker and loves his job. He had an artistic side, he was a professional musician and continues to hone his love of music. He is an excellent cook and a meticulous housekeeper. He loves his two children. We are enjoying our time together.

Today is healthy. I no longer have panic attacks, a once common thread in my life as I anticipated the wrath of my ex-husband often. I have self-esteem, something I had long forgotten when I was blamed for everything and put down constantly. I now exercise regularly, I eat very healthy and I am loving my fit body.

Today is a new normal. Very busy but balanced. Family is first, always has been and always will be. The rest (work, exercise, etc.) follows behind but with plenty of 'me' time which everyone supports, just as I support their alone time.

This phoenix was in the proverbial ashes for a long time. However the new phoenix I have become is a better, stronger and happier phoenix. I am excited about my future!

I Aspire to be a Phoenix

2008-01-13T12:39:00.000-07:00

Attempting to rise from the ashes of my former life, I realize now that freedom is a precious and fragile thing. I doubt I will ever be out of the grasp of my controlling ex-husband completely as we share four children with all the strings that entails. Right now he is doing everything he can to hurt me and through doing that he is hurting our children.

At times I wonder if staying would have made it easier for them yet I know that they too wanted out of the stress of his controlling and angry ways. Oh how much easier divorce is with two reasonable adults who choose to make good decisions for themselves and their children. I have seen more than one amicable separation work yet I know that is not an option in the aftermath of an abusive relationship. Control is paramount for abusive spouses and if they can't control they become vindictive.. or at least that is the case here.

I miss my kids terribly (one of the ways my ex has found to control is allowing me only very limited access to our children despite the court orders and the children's lawyer's written direction on this issue). An anticipated return to court will hopefully change that. One thing I have learned in this process is that there is no justice in the justice system. I never thought I would have anything in common with Britney Spears, but not seeing our children because of our respective spouses is one of them.

Given that, my new life is so very different and exciting. Deciding whether to stay at the job I am at, changing careers again or going back to school has me delightedly challenged. I have four kids to send to university or college to think about to in the near future, so that too weighs in this decision.

Getting Ready

2007-10-17T12:59:00.000-07:00

ICAN Canada's Stragetic Planning Retreat is coming soon and there is so much prepare for our innaugaural retreat. Thank you to our current board for all the wonderful work you are doing. I am looking forward to expanding our board as we fill the current vacant positions of Secretary, Membership Director, Vice President/Conference Chair, and Public Relations Director.

Travelling Again

2007-09-13T15:35:00.001-07:00

Heading to Cincinnati very early tomorrow morning, I can't wait! Working holiday... spending the entire weekend at a strategic planning retreat as the Int'l Director of the International Caesarean Awareness Network. This organization has done so much for me and I continue on the board as my way of repayment. The volunteer work is truly a labour of love. I'll be home again late Sunday night. Catcha on the flip side.

Maternal Mortality on the Rise

2007-08-25T07:57:00.000-07:00

It was only a matter of time before the statistics showed the effects of the dramatic increase in cesarean surgery rates. We have long known that one of the risks of major abdominal surgery is maternal morbidity and mortality. It was only a matter of time before the increased cesarean rate bode through to the sad fact that more mothers were dying because of it. CP reports:

U.S. women are dying from childbirth at the highest rate in decades, new government figures show. Though the risk of death is very small, experts believe increasing maternal obesity and a jump in caesarean sections are partly to blame.
The U.S. maternal mortality rate rose to 13 deaths per 100,000 live births in 2004, according to statistics released this week by the National Center for Health Statistics - the first time the maternal death rate rose above 10 since 1977.

"There's an inherent risk to C-sections," said Dr. Elliott Main, who co-chairs a panel reviewing obstetrics care in California. "As you do thousands and thousands of them, there's going to be a price."
Excessive bleeding is one of the leading causes of pregnancy-related death, and women with several previous C-sections are at especially high risk, according to a review of maternal deaths in New York. Blood vessel blockages and infections are among the other leading causes.

The New Normal - Ottawa Citizen

2007-08-19T12:50:00.000-07:00

The Ottawa Citizen reported yesterday on how medicalized birth has become the 'new normal' and natural birth is becoming rare in today's society in Canada. The statistics prove this out with an extremely high epidural rate across the nation, a 26% cesarean surgery rate and only 5% of women choosing homebirth. Please take a minute to read this superb article. I found this especially poignant:

One of the most telling anecdotes in [Jennifer Block's] book [Pushed: The Painful Truth About Childbirth and Modern Maternity Care] takes place at Florida Hospital Heartland Medical Centre in Sebring, Florida. When Hurricane Charley hit in 1994, it knocked the power out. The hospital had an emergency generator, but its capacity was limited. So the hospital sent most women home and asked them to come back when they were in active labour.
During the few days following the hurricane, nurses noticed a change in the way babies were being born: most babies made it into the outside world without medical intervention and within hours of their mothers arriving at the hospital; nurses saw no cases of fetal distress or respiratory distress in newborns; and the hospital's C-section rate dropped dramatically -- from more than 29 per cent to 17 per cent (six per cent if several scheduled repeat C-sections were excluded from the stats).
Prior to the storm, most mothers were induced so that their babies would be born during the day, and labours were electronically and chemically managed. Once life returned to normal, a number of nurses quit the hospital, convinced its management of labour was doing more harm than good.

Women in Red

2007-08-18T04:51:00.000-07:00

No I'm not talking about the song Lady in Red (so love that classic... Chris de Burgh is an awesome artist). I'm referring to a new group I've joined called Women in Red Racers:

Women in Red Racers group is a sub-group of the larger Women in Red community. The idea started response to a discussion about accountability and support towards reaching our debt reduction goals. It is now a “racers” group where each person posts their current debts and updates each time they are paid.

This past year has been a challenge financially. Though I have always been financially savvy, this group has a lot of excellent financial strategies that I have learned, and continue to learn, which I am incorporating into my own financial plans. I've always seen budgets, accounting and financial issues as tedious necessities of life, but this group has made the journey fun... even exciting as we work together on our debt. Setting goals and reaching milestones personally and as a group has never been so enjoyable. I encourage you to check it out.

Being kid busy

2007-08-16T05:59:00.000-07:00

The kids and I have had an awesome summer, busy around home and going several times to my sister's outfitting camp west of Rocky Mountain House. My love for horses only increases as I spend time with them again and my kids are catching the horse bug as well. Most of my pictures are in my camera which I accidentally forgot on my last trip to Ontario (it is being returned as you read this) so I hope to have more pictures soon. From my phone camera...

A picture of the view from our 'home away from home' window. Breanna is carrying one of Terri's puppies.

Here is a picture of Eric with his uncle Chuck at the summit after a four hour ride... he loved every second!

Here are five of the first string ready to go first thing in the morning.

Here is Eric in his 'new toy' out at camp.

Ontario Body Awareness Workshops

2007-08-01T13:00:00.000-07:00

My first continuing education workshops held in Ontario were a blast! The one-day Body Awareness workshop I taught is a continuing education course for birth professionals and teaches:

· How to map a pelvis and teach pelvic mapping to parents
· The importance of knowing your pelvic shape and outlet as it pertains to movement and positioning during labour
· To understand and teach techniques to reduce internal pelvic tension - an important factor in second stage failure to progress
· To teach women how to effectively communicate when they experience, feel, hear or see something in labour
· How to communicate effectively through word and touch in response to a birthing mothers needs
· To teach the vital importance of using breath effectively as a focus for reducing tension and restoring themselves
· To understand, be able to teach and use effective new positions to open pelvic outlet diameters as they pertain to the mother’s pelvic shape and vital new birthing techniques to effectively progress labour
· How to teach effective assertiveness to birthing parents

Sudbury and Mississauga where my stops in July. Body Awareness workshops will be held November 3 in Alberta and late next March (dates to be announced) in Ottawa, London and Toronto, Ontario.

I spent several extra days on holiday in Sudbury. The weather was fabulous, the friends I met were amazing and I had a wonderful time. Thanks Ontario!

Cesarean section adhesions linked with delayed delivery

2007-06-01T07:20:00.000-07:00

In the latest AJOG is a retrospective study assessing the risks of pelvic adhesive disease after cesarean section and its impact on delivery.

The study found that 4 percent of women undergoing primary cesarean delivery had documented adhesions. This rose to 46 percent in the 217 women with a second cesarean section, 75 percent of the 64 women undergoing a third cesarean delivery, and 83 percent of the six women undergoing a fourth cesarean section.

The mean time from skin incision to delivery of the infant was 10.7 minutes in a primary delivery, and this lengthened by 5.6, 8.5, and 18.1 minutes for a second, third, and fourth cesarean birth, respectively.

Morales et al conclude: “Each additional cesarean delivery, with the associated increase in the severity of pelvic adhesive disease, delays delivery of the infant and may compromise fetal health.
Morales et al. Cesarean section adhesions linked with delayed delivery. American Journal of Obstetrics and Gynecology 2007; 196: 461.e1-e6”

I found this interesting as I have 'significant adhesions' from my three cesareans and it is well known in obstetrics that any subsequent cesarean delivery is like working through 'cement' (term used by obstetrician friends) because of the scar tissue. I would like to put forward that not only does scar tissue increase delivery time of surgical deliveries, it may have an impact on vaginal delivery as well. If there were pelvic adhesions, could this not possibly slow fetal descent? I can attest to the fact that it can significantly increase pain, what a huge difference in labour pain with adhesions compared to without, so could adhesions have further impact on vaginal as well? Hmm...

It's Official...

2007-04-29T19:10:00.000-07:00

Velocity Web Design has been launched! One of my easiest 'babies' to birth, my new business is well on its way through childhood and growing like crazy. I have been designing websites for years for friends and non-profit organizations I have volunteered for, so why not get paid for it? I love the design aspect and am busy already with two new clients, D&R Engineering and Wild Deuce Retreats & Outfitting.

ICAN Conference

2007-04-26T20:36:00.000-07:00

For those of you who were unable to be there... we all had an awesome time last weekend at ICAN's 25 anniversary conference in Syracuse, New York! To meet all of the former presidents, and spend time with our current and upcoming presidents was an incredible experience. The passion that brought them to ICAN was so apparent and spending so much time with them over the several days we were together was incredibly empowering.

To further enrich the experience, Nancy Wainer, Henci Goer and Mardsen Wagner where also there. Each has had an incredible impact on ICAN in their own right with Nancy's impact on the founding of ICAN, Henci's research wisdom supporting women informationally, and Marsden's role not only with WHO's birth guidelines, but his unflagging pursuit of returning normal birth to women. And that was only the tip of the iceberg, Dr. Mark Langdon brought his wealth of knowledge surrounding VBAMC safety, Gretchen Humphries made everyone cry as she showed the reality of cesarean surgery and... well lets just say every single speaker brought great wisdom to impart on each of us there.

All of that made my contribution pale in comparison... the signing of the affiliation agreement I wrote, with the help of so many, for ICAN's first official affiliate - ICAN Canada! As International Director for ICAN International, I am very proud of this accomplishment for ICAN and am excited about the future growth of ICAN beyond North America. As ICAN Canada president, I am extremely proud of the continued expansion of ICAN Chapters across Canada, bringing much needed support to women in their communities.

I truly cannot wait to spend more time with the board at our upcoming Strategic Planning Retreat and our next conference!

2007-02-06T17:15:00.001-07:00

You paid attention during 74% of high school!

68-84% Pretty good, you know that there are libraries and newspapers, and you remember what you've read. You were a child that wasn't left behind!

Do you deserve your high school diploma?
Create a Quiz

New Normal

2007-01-31T15:32:00.000-07:00

Life is full of lessons, some wonderful and some painful. I am learning a lot and having a lot of fun on this new journey. My new life is taking me back to my roots, to what I knew and love and lived for before my marriage. Horses have once again taken precidence, for a while at least, as I spend a lot of my time helping my sister train horses. Even if I don't continue that, I have been hired by her and her business partner as their new business manager. I have owned/managed businesses for a long time now and though its a completely different field from what I have done thus far, management is managment. I'm not sure where this will lead, but I am loving every second of it!

Given that, Rosenthal is going strong and I am excited about it's future as well. The spring classes are filling as you read this and I cannot wait to teach the spring sessions. I've also been working with several mothers planning VBAC's and it still amazes me how strong women are despite of and as a result of their experiences.

And thanks to everyone who has sent notes, emails, called and left messages. Your thoughts, prayers and support have been so wonderful and have lifted my spirits a lot in the past few months. ~hugs to all~

Hanging In There

2006-11-07T15:38:00.000-07:00

Have you ever noticed that just when you think you have some sort of equilibrium, life goes completely sideways? Ah, but what would live be without surprises and changes anyway! How the heck else would you learn anything if you did nothing but the same old same old?

I won't go into details on my suddenly sideways life since my last post, but know I am learning an awful lot about trust, truth, integrity... and the law. I am so very glad for the incredible friends and family who have surrounded me and are supporting me. This journey is not one I ever thought I would be taking, but indeed I am here. Mistakes were made and we are moving on from those errors. I am hanging in there, trusting that the future will hold it's own reward.

Books I'm Reading...

2006-10-18T12:27:00.000-07:00

In telling you the books I'm reading, I am giving you great insight into my life as it stands today. Some things in my life have changed incredibly and others I continue to hold steadfast to for my and my children's sake.

First up is the incredible second edition of It's My Life Now: Starting Over After an Abusive Relationship or Domestic Violence by Meg Kennedy Dugan & Roger R. Hock (2006). I am not going to explain myself here, just know that I am now separated from the father of my children for the very reason this book is about. This is a very, very difficult situation for me emotionally at this point, though I am doing well now and am feeling stronger. I am thankful for my family, friends and my counselor who have been so supportive through it all.

Second is Electrical Code Simplified: Residential Wiring, Alberta Book 1 by P.S. Knight (2002). In preparation for the future, I am helping my sister finish her basement in case I may need a place to live with the kids. Her and her husband have very graciously offered their basement (1400 sq ft) for us to live in for as long as we need, though it is currently only framed out. Having finished three prior basements (of our three homes we have owned over the years) I know well the work and can do it well. However, its always nice to brush up on the codes to ensure their inspection passes with flying colors. One more day and I will be finished all the electrical so we can have the inspector in and start drywalling. Lots of work, but manual work is good right now, I am feeling invigorated.

Third is Homeschooling the Teen Years: Your Complete Guide to Successfully Homeschooling the 13- to 18- Year- Old by Cafi Cohen (2000). I continue to be committed to homeschooling our children as my boys strongly want to learn at home (my daughter is three and not yet homeschooled). It is an exciting and diverse challenge with my oldest in Grade Ten and third in Grade One. We are having an awesome year thus far and I pray I am able to balance homeschooling again for this term. Which brings me to...

The forth and final book is FrontPage 2003 (The Missing Manual) by Jessica Mantaro (2005). To 'bring in the viable income' I referred to above, I am venturing formally into website design. I have been doing it for years already, having built 8 full sites, both for businesses and non-profit organizations. In the past I have turned down many who have asked me to design, build or improve their sites because of my time constraints and other priorities. Now the income potential of this career is far to lucrative for me to overlook... I may need to support my family as a single mother. I will be leaning on Microsoft FrontPage until I can afford and learn Adobe Dreamweaver... the ultimate website building software (and I love Adobe's other products which I lean on heavily for other applications).

With these great books in hand and my goals clear, the future is bright indeed!

A bit about moi...

2006-10-01T22:14:00.000-07:00

The Basics

Month of birth: July

Any Siblings?: 2

Parents still married?: yes, 40 years this year!

Occupation: College Director/Instructor

Do you like your job?: love it!

Any pets?: no, but would love one

Hair color: dirty blonde

Eye color: blue

Shoe size: 8 1/2

Any Tattoos?: not yet

Any Piercings?: just ears

Current mood: peaceful, happy

Current wardobe choice: my fav jeans, layered white t and sweater

What are you listening to?: Nickelback's The Long Road cd

Who did you last speak with on the phone?: Cory

Last....

Movie you watched: Take the Lead

Magazine you looked at: Oprah

Thing you ate: Sushi

Book you read: Million Dollar Habits by Brian Tracy

T.V. show you watched: Ummm... Dora? lol

Time you cried: today

Took a shower: 8:00 this morning before class

Got a real letter (a.k.a Snail Mail): can't remember

Ate at a restaurant (not fast food): two weeks ago at Olive Garden

CD you bought: Nickelback

What is/was....

The best thing to happen to you today?: teaching my students (they rock!)

Your most prized possession: my fav jeans

Your first vehicle: Chevy truck

Your current vehicle: black Suburban

Your favorite quote: "What doesn't kill you will only make you stronger"

You bedtime (on average): far too late....

Your best trait/characteristic: compassion

Your worst trait/characteristic: impatience

Do You....

Store things under your bed: only extra blankets

Daydream: always

Have a computer at home: yes

Live in the city, suburbs or country: city

Live in a home, apartment, duplex or mobile home: home

Own a cell phone: yes

Have a good luck charm: nope

Collect anything: nope, hate dusting

Attend high school or college: high school and college

Make good grades: scholar

Have You Ever....

Had a surgery?: 3 c/s's, cholecystectomy

Had teeth pulled?: all of my #7's

Broke the law intentionally: does speeding count?

Ran away from home?: nope never

Broke a bone?: does cracked ribs count?

Cheated on a test/exam: hasn't everyone?

Had a friend pass away: not for a long time

Been issued a citation/traffic ticket: umm for speeding!

Been in an auto accident: several, none my fault

Lied to someone: to avoid hurting their feelings

Been lied to: don't know, don't want to know

Your Favourite....

Place to be: beach on a glacier lake in the Rocky's

Place to visit: Ville du Quebec

Place to chill: curled up with a soft blanket on my couch

Hero: My grandfathers, both of whom I miss dearly

Non-Alcoholic drink: cafe mocha

Alcoholic drink: Bacardi Breezers, Baja Tango on the rocks

Type of food: Chinese, Mexican & Italian

Meal/Food dish: a great steak and a baked potato

Dessert: anything lemon or chocolate

Shampoo & Conditioner: Pantene Pro V

Toothpaste: J.A.S.O.N.'s Seafresh

Salad dressing: Italian

Ice cream: hazelnut

Fast food establishment: yuck

Color: burgundy

Season: summer

Holiday: Christmas

Perfume/Cologne: Adrenaline

Video Game: don't have time

T.V. show: again with the no time

Smells: newborn babies, the wind after a lightening storm

Article of clothing: favourite jeans

Book: Roots is still my all time favourite

Children's Book: Dora, my daughter's favourites are my favourites

Candy: Aero

Car: 1997 Grand Prix GTP S

Sideways...

2006-09-17T12:44:00.000-07:00

Sorry everyone, life has taken me on a really wild ride this summer and it's been an incredibly tough time personally. I wish I could say that it was over, but sadly it is far from over. I would like to blog about it, but this isn't a safe place to explore what I am experiencing right now... maybe sometime in the future I will be able to share.

Tomorrow is the turning point though. It is from that point that I either move towards a safe harbour where I can rest and heal with friends/family who will be there to buffer the tide... or I will continue to swirl in the vortex of emotional pain I am currently experiencing. Life is filled with choices and I have to explain and stand by the most difficult decision I have ever made (made earlier this summer) and deal with the consequences. Either way, I will be hurting someone and I cannot tell you how sad that makes me feel.

Catch you on the flip side.

Motherguilt

2006-06-27T17:02:00.000-07:00

My sister and I had a wonderful visit today when she came over with her two children. The combined menagerie, which included several neighbour children, had a blast outside in the heat under the sprinkler while we hid from the heat indoors with her four month old.

Our conversation turned to the huge guilt mother's face with every decision made... birth options, vaccination, breastfeeding, home vs work, daycare vs dayhome, school vs home school... the list is endless. The reason we discussed this was because of her daughter's language testing today which showed her to be mildly delayed in hard sounds and my sister was given several pages of information on how to support her with these sounds. From my experience of having a son with severe receptive and expressive language delays and the incessent testing the so-called experts continue to want him to do, I encouraged her to realize that her daughter's delay in this area was only a very small part of who she was and not to be discouraged by this so that she continues to seek other's opinions about her daughter. She knew what her daughter needed best!

You see, I learned the hard way that my instincts and knowledge about my son were completely accurate... his delays in one area of his life as well as his gifts and talents in other areas. When I sought outside support to supplement my skills in parenting my son, I had no idea the pain it would cause as expert after expert, in their own way, made me doubt my parenting skills by insisting that a structured school environment was what he neede most. Their whole focus was to integrate him into a classroom situation yet their recommendations strangely pointed in the opposite direction... individualized support, calm and structured enviroment, etc. It was in realizing that school was their only paradigm and they could not see outside of that box that I realized the truth, I was doing what was best with my own parenting skills and our decision to homeschool him along with his older brothers who have always been homeschooled. So while we can indeed access outside support, we also have to realize where that expert is coming from and base the accuracy of thier input on that... and to know that we are our children's parents and it is our right to make the best choices for them, despite outside opinions.

A funny thing happened...

2006-06-17T12:13:00.000-07:00

on the way to the awards gala on Thursday. My daughter ate my makeup. Well not quite literally, but she did break it all over my bed and carpet in my room. What a sight that was to find as I went to get ready! She sure looked well made up :-) Ah well, I still had samples from my two minute Mary Kay career last fall so I broke into those. Minus mascara, I was ready to go in no time.

The YWCA Women of Distiontion Awards Gala was fantastic and we thoroughly enjoyed ourselves. My friends Claudia Villeneuve, Chapter Leader of ICAN of Edmonton/Edmonton VBAC Support Assn., Anita Ferrie, a co-nominee in the Advocacy category, and I had a blast. The food was excellent, the people were wonderful and the music was perfect. Neither Anita or I won, we lost to a wonderful woman we met that night, Diane Bergeron.

"Dedicated to her community, Diane Bergeron is a leader and a passionate advocate for people with disabilities. As the co-ordinator for the Premier's Council on the Status of Persons with Disabilities, and founder of the Edmonton Guide Dog Users Group, she is looked upon as one of the city's experts on disability challenges. Working alongside the Executive Director for the CNIB, Diane recently helped draft an updated version of the Blind Persons Rights Act. Despite her being totally blind, Diane's vision has no boundaries."

Congratulations to Diane and all of the award winners and nominees. I was honoured to have been nominated with such an amazing calibre of women. Thank you Claudia for nominating me and all the hard work you did to submit my nomination. You are awesome!

Breastfeeding Length in Canada

2006-06-15T14:55:00.000-07:00

The Globe and Mail's talented reporter Andre Pickard wrote the excellent article Most Mother's Quite Breastfeeding Far Too Soon.

The single most effective way of giving a baby a healthy start in life is breastfeeding.

As a public-health measure, breastfeeding is unparalleled. It is cheap, easy to understand, has no negative side effects and the method is tried and true -- as old as motherhood itself.

Yet, Canada fails abysmally when it comes to providing babies with mother's milk.

Things look good at first: Eighty-five per cent of Canadian women breastfeed their newborn babies, according to Statistics Canada. However, in the weeks after birth, that rate falls off precipitously.

Every major health group, including the World Health Organization, the Canadian Paediatric Society and the Public Health Agency of Canada, recommends that babies be fed breast milk exclusively for the first six months of life, and that breastfeeding should continue as long as possible after the introduction of solid foods. The reasons for this are clear: Breast milk provides all the nutrients, growth factors and immunological factors a baby needs for optimal growth and development (physical and neurological).

more>>

Cesareans in the News

2006-06-13T14:51:00.000-07:00

New Jersey hospital Kimball honored for low rate of C-section births today:

LAKEWOOD — Sumayyah Simone stood in the back of the room, away from the podium, the speakers and the spotlight.
But Simone and pregnant women like her were the reason everyone gathered.

Simone, due to give birth to her second child next month, was the impetus last week for a group of doctors, nurses and midwives to pack themselves into a hallway in Kimball Medical Center's maternity ward and accept an award for good maternity practices.

All because women like Simone want a natural birth.

"There's a trust relationship which I think is really important with a caretaker," said Simone, a 37-year-old Plainfield woman who has a Lakewood doctor monitoring her pregnancy. "When you're in a hospital, you need to trust your doctor."

And when a natural birth is needed or wanted, Kimball Medical Center is among the hospitals of choice.

According to a review of recent state health statistics, the rate of Caesarean-section births at Kimball is the lowest in New Jersey.
more>>

And in South Carolina:

Multiple reasons account for rise in C-sections
By Mike Foley

Back in 1979, when Dr. Kenneth Trofatter began delivering babies in Greenville, the number of women having Caesarean births was about 16 percent.

Last year at Greenville Memorial Hospital, where Trofatter is now the director of maternal-fetal medicine for the University Medical Group, the hospital had 34.6 percent of its births via C-section, a surgical birth method where the baby is removed through an incision in the uterus. Across the country, the Caesarean rate rose to 29.1 percent in 2004 according to the World Health Organization, the latest year for which figures are available.

The end result is higher medical costs, for both private insurers and Medicare, and no end to the debate about the rising numbers of surgeries that some say aren’t always medically necessary. Among his colleagues, Trofatter said, there are two distinct feelings on the issue.
read more>>

Today's higher Caesarean rate raises concerns
Expectant moms must weigh risks, benefits for themselves and baby
By Mike Foley

Among his colleagues in obstetrics, Dr. R.E. Lattimore is an anomaly.
“I probably have one of the lower C-section rates in town,” Lattimore said. “It’s probably 14-16 percent over the long haul.”

The long haul in this case is Lattimore’s career as an ob-gyn in Greenville, now in its 21st year. During those two-plus decades, he’s remained conservative in his approach about unnecessary surgeries, including elective Caesareans.

“I’d prefer not to be on the wrong end of a lawsuit because a woman had an elective C-section and something went wrong,” he said.

While Lattimore said he sees lots of reasons for the ever-increasing number of C-sections, he believes that “everyone would like to see lower C-section rates.” But that’s not happening locally, in South Carolina, in the United States, or around the world.

more>>

Preterm Cesareans Double Uterine Rupture Risk

2006-06-12T21:40:00.000-07:00

Interesting news in OB/GYN News today...

MIAMI BEACH — Women with a history of preterm cesarean delivery are twice as likely to experience uterine rupture during a subsequent vaginal delivery, compared with women who have a history of operative delivery at term, according to a large study.

However, the absolute increased risk of 1% may be acceptable to some women who are considering a trial of labor after a previous cesarean section, Dr. Anthony Sciscione said at the annual meeting of the Society for Maternal-Fetal Medicine.

"The 1% may be too high for some women but acceptable to others." Dr. Sciscione, chief of obstetrics at Crozer-Chester Medical Center in Upland, Pa., and his associates compared 5,839 women with a history of preterm cesarean delivery to 35,528 with a history of term cesarean delivery.

They found the preterm group twice as likely to experience uterine rupture on a subsequent vaginal delivery, compared with the term group (odds ratio 2.05).

The risk was still increased when the researchers controlled for emergency cesarean deliveries (OR 1.73).

"Rate of uterine rupture was highest among those who had a previous preterm delivery and subsequent full-term delivery," said Dr. Sciscione, who presented the findings on behalf of the Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development, Bethesda, Md.

A delivery between 20 weeks of gestation and 36 weeks, 6 days was considered preterm. The two groups were similar, but the prior preterm delivery group was younger (mean 28.6 years versus 29.2 years) and less likely to have private insurance.

Women with a previous preterm cesarean delivery were also more likely to experience earlier uterine rupture (mean 37.2 weeks) than were women with a previous term cesarean (mean 39.1 weeks).

A meeting attendee asked if the women who had uterine rupture earlier were also in labor earlier.

"That is a good question," Dr. Sciscione said. "We looked at that, but the data are not ready yet.

"Further study is needed to define those clinical characteristics which may accompany preterm cesarean delivery that may modify the risk for subsequent uterine rupture," Dr. Sciscione said.

Careforce Lifekeys

2006-06-10T12:59:00.000-07:00

A friend of mine from Australia attends an excitingly dynamic church pastored by Dr. Allan Meyer and Helen Meyer, the founders of Careforce Lifekeys. She recently attended their 2006 Conference and came home supercharged. Her excitement has not only piqued my interest, I will be bringing their programs to our church counsel and the as-of-yet hired Pastoral Assistant who will be overseeing the Healthy Family Ministry program I created and currently coordinate.

Careforce Lifekeys is ground breaking. "Many of God's people struggle with issues that church life needs to effectively address. Lifekeys programs have a vital role to play in brining pastoral care and discipleship to God's people." Instead of avoiding or covering up problems, they instead tackle the very issues ordinary people struggle with every day and the root sources of marriage dysfunction, separation, divource, family breakdown, the destructive forces of shame and guilt, addictive cycles, co-dependence, insecurity, self rejection, grief, depression, chemical dependency, sexual abuse, sexual addiction, easting disorders and more. I am super excited about this and truly cannot wait to learn more about Lifekeys' programs.

VBAC vs ERCS Study

2006-06-09T19:59:00.000-07:00

Kathleen Doheny from HealthDay News reported last week on the Annals of Family Medicine study (full text pdf), Vaginal Birth After Cesarean in California: Before and After a Change in Guidelines. "The number of women who gave birth vaginally after a cesarean delivery has dropped in recent years, but without the expected reduction in infant and maternal death rates, a new study has found." Well, that is indeed a no-brainer for those of us who have a clue about VBAC and Caesarean risks and benefits.

As all good reporters do, she found someone to refute the evidence... there is always someone who has an expert "opinion." Dr. Richard Frieder, an obstetrician-gynecologist at Santa Monica-UCLA Medical Center and a clinical instructor of obstetrics and gynecology at the David Geffen School of Medicine at the University of California, Los Angeles, said the new study has a major flaw. "It doesn't address maternal or fetal complications," he said. He is correct in this regard and goes on to add, "The main complication of VBACs is not death but morbidity, such as blood transfusions, hysterectomy, infection, heart attack, stroke, kidney failure, the baby having low Apgar scores or brain hemorrhage. All they are talking about is how many people lived or died. But they didn't measure complications. If they had looked at complication rates, there would have been a huge difference favoring c-section." Sure there are risks to vaginal birth, but saying that there is a "huge difference"... yeah right, and pigs fly. Please show me the evidence Dr. Frieder.

I have done a lot of research into this very concern and the evidence is clear. Don’t miss Childbirth Connection’s (formerly Maternity Center Association) What Every Pregnant Woman Needs To Know About Cesarean Section booklet for solid, evidence-based facts on cesarean risks.

The study concludes with, "Neonatal and maternal mortality rates did not improve despite increasing rates of repeat cesarean delivery during the years after the ACOG 1999 VBAC guideline revision. Women with infants weighing ≥1,500 g encountered similar neonatal and maternal mortality rates with VBAC or repeat cesarean delivery." Well done doctors, now could we please lean on the idiots at ACOG to reverse their inane butt-protecting VBAC guidelines that have essentially eliminated vaginal birth as an option for most post-caesarean women in the US?

Hospital Birth = Death

2006-06-09T16:20:00.000-07:00

How ironic that after posting this earlier this week, a young mother has died from a magnesium sulfate overdose in Florida. Her son survived and is in another hospital's NICU. How devastating for her family, my prayer are with them.

Announcing...

2006-06-08T21:30:00.000-07:00

I am very proud to announce the opening of my newest endeavour, a new and innovative institution providing comprehensive certification for birth professionals in Canada. Developed from the training workshops provided through Mother Care, Rosenthal Perinatal College was formed out of a need for respected, thorough, and comprehensive certifications for birth and postpartum professionals within Canada, based on Canadian families’ specific needs unique to our country.

Founded on the principles of integrity and strong morals, Rosenthal provides comprehensive, evidence-based certification and continuing education for those seeking careers in the perinatal field. A premier training and certification college, Rosenthal equips students with the knowledge and confidence to support and educate families during the perinatal year. Rosenthal takes pride in their professional standards; their certification requirements are the highest of any certifying organization.

Alberta-based Rosenthal College, with the approval of Alberta Advanced Education’s Private Institutions Branch and in accordance with their regulations, provides quality certification and continuing education. For more information, go to our new website at www.rosenthalcollege.ca.

Hospital Birth = Risk

2006-06-07T19:10:00.000-07:00

Sunday, NBC reported on A routine epidural turns deadly which asks, "did a hospital infection turn the happiest day of their lives into a nightmare?" A mother, amidst the bare minimum of care during her hospital stay, contracted meningitis and died within hours of birthing her son.

What bothers me most is the lack of adequate care this family received, from obstetrical decisions to staff follow through, though this is not unusual. The lack of evidence based or even adequate care is almost universal across North America to families who subject themselves to a hospital birth experience. In their defense though, most don't know what the alternatives (like traditional midwifery care) are, the excellent care and proven safety of those alternatives.

Seriously though, has "modern" (allopathic) medicine not set themselves up to "have the answers" so to speak and then be completely and utterly unable to provide them? Physicians are so confident that they can "deal with the side effects" of so many obstetrical interventions, such as inductions and epidurals, that they have not only become commonplace, many women are not even told of their risks even when being subjected to them.

We as a society have been blinded by the rhetoric and sales pitch so completely that we actually allow modern medicine to provide inadequate and often dangerous care and accept it as normal. No wonder malpractice insurance rates are through the roof. Just to compare the care the above mother received to midwifery support is laughable. Would a midwife "subject" her clients to the same care and even hope to be in business? No she would be in jail.

But obstetrics is only part of this big mess. May 29th, Businessweek article Medical Guesswork revealed, "from heart surgery to prostate care, the health industry knows little about which common treatments really work." Anne, a good friend of mine blogged about this here. I grow more leery every day when I see physicians trained to treat symptoms and be completely oblivious to the causes. I mean seriously, how else could anyone justify surgery as a solution for asthma? Evidence-based practice is a vital and very worthy goal, it's frustrating to see modern medicine miss this by such an incredibly wide margin.

VBAC in the journals: the good, the bad and the ugly

2006-06-07T18:26:00.000-07:00

Over the past couple of days, some interesting press has me thinking. For instance, the lastest Annals of Family Medicine includes a study showing Reducing post-cesarean vaginal births has no effect on mortality:

Although attempted VBAC deliveries fell significantly after the guideline revision, from 24.0 percent beforehand to just 13.5 percent afterwards, neonatal mortality rates per 1000 live births were no different for attempted VBAC deliveries from those for repeat cesarean among neonates weighing at least 1500 g during either of the two study periods.

Neonatal mortality rates for attempted VBAC among neonates weighing less than 1500 g were higher than those for repeat cesarean deliveries. Their conclusion, "We recommend that a balanced presentation of risks and the encouraging outcomes found in this analysis be included in discussions with pregnant patients who have had a previous cesarean section." Excellent advice. Too bad fear of malpractice in the face of ACOG's VBAC guidelines will skew any "discussion" physicians have with expectant mothers so badly that the truth will rarely be seen.

Meanwhile, over at Obstetrics & Gynecology, their latest journal includes Dr. James Scott editorial, Cesarean Delivery on Request: Where Do We Go From Here? in which he concludes with the advice, "Go slow on this for now, be cautious, don’t get caught up in the rhetoric, and individualize until better evidence is available and the ultimate consequences are well known. To do otherwise just might come back to haunt us." (Obstet Gynecol 2006;107:1222-3) To be honest, ACOG has made a lot of decisions that should be haunting them based solely on bettering their members malpractice insurance rates and wallets with complete disregard for maternal-child health or evidence-based practice. But I digress...

O&G also has a brand new study, Maternal Morbidity Associated With Multiple Repeat Cesarean Deliveries which is something anyone knows who works at all with caesarean/vbac mothers, I mean it's simple common sense. Their conclusion, "Because serious maternal morbidity increases progressively with increasing number of cesarean deliveries, the number of intended pregnancies should be considered during counseling regarding elective repeat cesarean operation versus a trial of labor and when debating the merits of elective primary cesarean delivery." (Obstet Gynecol 2006;107:1226–32)

Last but not least, they have the National Institutes of Health State-of-the-Science Conference Statement: Cesarean Delivery on Maternal Request from March 27–29, 2006 outcomes. Their conclusion, "The magnitude of cesarean delivery on maternal request is difficult to quantify. There is insufficient evidence to evaluate fully the benefits and risks of cesarean delivery on maternal request compared with planned vaginal delivery. Any decision to perform a cesarean delivery on maternal request should be carefully individualized and consistent with ethical principles." (Obstet Gynecol 2006;107:1386–97)

Hmm. So ACOG's "decision" to essentially eliminate VBAC Trial of Labour as a viable choice for women in the US is coming back to haunt them. Despite the carefully worded conclusions above, it is becoming more and more obvious to even the ones who have turned a blind eye to the risks of major abdominal surgery for deliveries. The well-touted risk VBAC has of uterine rupture is pailing strongly in the blinding glare of surgical risks with many of them long-term risks in future pregnancies.

Mother's Day Delight

2006-05-21T06:29:00.000-07:00

I know it's been a week, but I had an absolutely superb Mother's Day and have basked in the joy of it since then. Allan was not working (incredibly so, he seems to get all of the holiday shifts it seems) so we planned a day with our families, lunch with my parents and dinner with Allan's parents. However they took a great turn as lunch turned out to be with my Mom's entire family (her mother, her only sister and dh, along with nearly all of my cousins and their families) and dinner turned out to be with all of Allan's family (his siblings and their families). To top it off, it was my Mom's birthday so celebrations abound!

Because of the great turn out, we had lunch at a large restaurant which happened to be having a buffet for Mother's Day. I sat next to my dear Grandmother (furthest right), the matriarch of our family, and across from my favourite cousin-in-law. Originally from Portugal and having grown up in Australia, she is an incredibly fun and optimistic Mom of two sweet and very busy boys. We live in different cities and lean on our husbands to move closer to each other when we are together.

While we were waiting for everyone to arrive someone came up to me said, "Remember me?" It was one of the boys I used to care for in my dayhome which I had when I first started as a doula. He was one of the sweetest boys I ever cared for and though his Mom was concerned about his being "hyperactive" (because of comments from others), we both agreed he was truly just a very busy boy. He is a young man now, all of 12 years old. Sadly his Mom wasn't there, but his Dad and little brother were there... well not so little, he just turned nine himself. His little brother's birth was my first certifying birth! We had an awesome chat and he talked to my boys for a long time too.

No sooner had I finished lunch and was holding one of my cousin's boys when a beautiful young woman came up to me and asked if I knew who she was. Drawing a blank, she introduce herself and I instantly realized that she was one of my teen clients. Behind her were her parents whom I recognized immediately and her two daughters where there also. She had gone on to finish her education degree and is now married. I learned through our discussion that she teaches full time and lives not far from me. I chatted with her and her parents (who are the most wonderful couple), remembering her birth as her mother and I supported her. Talk about icing on the Mother's Day cake to see two of my "doula babies".

We had a BBQ at my in-laws that evening, a wonderful conclusion to the day. They haven't had a BBQ in years because my father-in-law doesn't BBQ, but they purchased one especially for the day so that we could all enjoy the day at their house rather than go to a crowded restaurant where the kids would be bored and the din would make conversation difficult (been there done that last year). One brother-in-law cooked all the hamburgers (including some great buffalo burgers), smokies and more while we all stood or sat around and visited and ate. Summer BBQ's are the best! Next up: Father's Day at another brother-in-law's beautiful place near Drayton Valley. I can't wait...

Can You Say Duh?

2006-05-12T10:21:00.000-07:00

So this mama is concerned about noise pollution...

I am wondering if she has stopped to consider the much larger threat to her unborn of smoking? One of those things that makes you go, duh!

Family Ministry

2006-05-08T13:52:00.000-07:00

I have been reviewing resources for our Family Ministry. Where once I was grappling with writing a whole ministry program while pulling ideas and information from other resources, I am now relaxing and enjoying the search for great ministry programs already in place. Two such programs are Heritage Builder's Family Ministry in Focus and Christianity Today's Children's Ministry both of which have amazing resources and ideas for slightly differing aspects of a family ministry. I want to do so much and am so excited about the possibilities in our church, yet patience is a virtue as we continue to seek a pastoral assistant who will be overseeing our family ministry programs.

Cesarean Art

2006-05-04T10:46:00.000-07:00

Haunting, bold and riveting. Here are two images, with my thoughts below. Don't stop here though, go to Cesarean Art and see through one mother's eyes the effects of surgical delivery.

my first shower
Immediately postpartum, nurses push mothers newly out of surgery to "resume life."
never letting me go
The depression that haunted my every waking moment, every dream, was relentless.

Cesarean Artis the epitomy of how many, if not most, of women who have experienced a caesarean surgery for the birth of their precious children feel. Don't believe me? Ask one of your many friends who have experienced a cesarean.

Total Luxury Spa Package

2006-05-04T09:35:00.000-07:00

For my birthday (which isn't for another two months) my sisters and my mother took me to the Marvel College Edmonton Campus for a Total Luxury Spa Package last week. It was amazing. Starting at 9 am with a spa manicure and pedicure, touted as "a facial for your hands and feet." In addition to treatment of callus and dry heels, nail shaping, cuticle treatment, a relaxing foot and leg massage, finished with your choice of OPI polish, you are treated to exfoliation of the feet and a moisturizing mask followed by a paraffin treatment. Next came a full facial with skin analysis, facial cleansing, deep exfoliation, relaxing face, neck and shoulder massage, facial mask, toner and moisturizer.

A break for a light lunch (included in the package) of our choice of sandwhich, salad and drink was followed by a one hour relaxation massage. Then I enjoyed a detoxifying and purifying body wrap to detoxify the skin, deep cleanse the pores and smooth roughness. Showered off in a wonderful, hot Swiss shower and dove right into a Vichy shower (picture below) touted to "stimulate the internal body systems, circulation, metabolism and enhances lymphatic drainage as well as promote a tremendous sense of relaxation." Wrapping up the afternoon was a detoxifying massage focusing on lymphatic drainage. I cannot tell you how luxurious that whole day was, I was being pampered for seven hours with my sister and mother beside me enjoying similar treatments!

My sisters have long wanted this to be an annual event, I am so ready to join them and tell all of my friends that they need to pamper themselves like this. This should be written into that motherhood contract we fall into when the pregnancy test turns pink!

YWCA Women of Distinction Nomination

2006-05-02T09:22:00.000-07:00

I mentioned briefly here that I was nominated by a great friend for the YWCA Women of Distinction Award in the field of Health, Social Sciences & Social Services. It is moving from the surreal to reality as a wonderful woman from the YWCA of Edmonton called today to book my photo shoot with complimentary hair and makeup for the Edmonton Sun and the YWCA Gala Presentation promotional literature. I am taken aback as the Avonlea Photography Studio is among the most prominent photography studios in Edmonton and Elysium Hair Body Spirit is one of 20 salons in Canada that have become a Schwarzkopf Essential Look concept salon. Look at me, a homeschool mom!

The Awards Gala will be on June 15 at the Northlands Agricom... what on earth am I going to wear for the pictures and the big event?! I have to go call my sister.

Still Swimming

2006-04-21T21:31:00.000-07:00

It has been a while since I blogged, a very long while for me! I have just been very busy with life and working to reduce my being overwhelmed. It's tough trying to save the world (or at least my corner of the world) with only 24 hours in a day! Let me catch you up on life.

I won't deny it, Brendan's assessment sent me reeling. I know I have a lot on my plate, I won't deny it for a minute, but being busy and focused is how I work. Anything less and I am walking around aimlessly trying to find things to do. But it was his assessment that has me re-evaluating me, who I am, how I parent, my other commitments which keep me sane outside of parenting... and then something changed.

Brendan's DS (developmental specialist) whom he works with on a half time basis in our home suddenly was called home (in BC) on a family emergency. We had a week of no support and this week we had a new DS come in to substitute. I cannot tell you how much Brendan's attitude (his behaviours) have improved in the last two weeks! Here we had her coming in to help with his language skills only to have him slide badly behaviourally, and I was blaming myself. Now we never see a temper tantrum (which happened several times a day only two weeks ago) as they declined dramatically in his DS's absence. I won't fault his DS entirely, it is all about personalities and he being a strong choleric was quite simply too much for his DS to handle effectively. She would be wonderful with say a sanguine or phlegmatic child, but not so much with my little livewire. We don't know when she will return and neither does she. His new DS doesn't let him call the shots and it makes all the difference... and I told her supervisor as much. I know we won't be able to keep our new DS (as she is a sub only) but it sure would be nice. Time will tell how this works out.

On the dh's career front, we are not moving and neither are we going into the construction field for the time being. Allan is settling into his new store and working out some major issues he was handed to test him... and he is doing superbly. We now have carpet in our basement (and my office) which I love! Trim and painting the trim... oh and finishing the basement bath and we are done this house, yay! Allan is getting itchy though, he is thinking we need to build again. It hasn't even been two years since this house was built! But he has a point, our house has appreciated almost 100,000 since we purchased it and that is a huge chunk of change we could put on another house :-)

On my career front, I taught two workshops since I last weighed in, the most rewarding job in the world for me! I have also been working hard as president of both the CDA and ICAN/AIIC Canada. Two amazing organizations that are growing so fast in this great country I live in. I know I am going to have to weigh my priorities carefully in working with both organizations, as I can only give so much of my time and energy to volunteer work. But it's so much fun and I love doing it... so I tend to spend more time doing this than I should .

Oh, and one last thing. I haven't mentioned this before, but I love RPG's (role playing games). I have finished Myst, several Tomb Raiders and lots of older ones (I have been a computer geek since I first laid my hands on a computer in high school when the computers were sooooo simpl!). Well my sons... and my husband... and myself, we are all having a blast with the online game Runescape. Be careful, it is highly addictive! If you do or plan to check it out, I am Norse Queen... hailing from my scandinavian roots. See you there when I am between parenting and working and volunteering.

Behavioural Assessments

2006-03-17T21:14:00.000-07:00

In case you have not read my blog for a long time, my third son has language delays which we have addressed with additional support through a program called GRIT (Getting Ready for Inclusion Today) which provides him with a half time DS (developmental specialist) who works with him one on one and who is supported by a team of professionals (speech therapist, occupational therapist, etc.).

One of the concerns of the team leader was our son's behaviour when working with his DS in the beginning, which they have long since dealt with and they are working together well now. In addressing this concern, we were asked if we wanted a behavioural specialist come in and assess their working together. I didn't see a problem with this, our DS was fine with it and our son was used to these type of assessments by now so it wasn't an issue for him. I am always open to ideas too, anything to benefit my children IMO.

Anyway, this very personal and highly recommended assessor came and spent an afternoon unobstrusively watching them, ironically on a day when our son was not very cooperative. His DS and I saw it as an opportunity however to address some of his weaknesses...

Well his return with "answers" was interesting indeed. He basically said that our son had issues that we could not address at home (he knew we planned on homeschooling) and that it would be in his best interest to put him into school and that we should start looking for an appropriate institution soon, given that many open houses would be happening in the near future. At first I was feeling rather gloomy about this, then I realized something... he was hired by GRIT which in essence readies preschoolers with disabilities for school. I had been lead to believe that this assessor worked in the psychology field and in fact he told me he had obtained his masters degree a few year prior. Stupid me, I failed to ask in what field! He handed me his card and guess what? His masters is in education. No wonder he is wanting him to be "corrected" by an institution, he can't see outside of that box. Oh well, lesson learned, for us at least. Don't bother utilizing the professionals unless they are working towards the same goal as you and able to see your vision with an open mind. Otherwise you are wasting their time and yours.

Pre-eclampsia and Calcium link

2006-03-15T10:15:00.000-07:00

How exciting that AJOG has published an article linking nutrition with pre-eclampsia. Of course the study was done in Switzerland (where they obviously see a bigger link between nutrition and the increasingly common problems such as pre-eclampsia, gestational diabetes and so on) as North American physicians have essentially no training and precious little knowledge about the impact of nutrition on expectant mothers.

Calcium supplements reduce pregnancy complications
Source: American Journal of Obstetrics and Gynecology 2006; Not yet available online

Investigating the effect of calcium supplements on pre-eclampisa, its complications, and death linked to the condition.

Calcium supplements could help prevent the serious complications of pre-eclampsia and, in young women, preterm delivery, research suggests.

Although a treatment to prevent pre-eclampsia remains elusive, a link to calcium deficiency has been suggested.

To explore this possibility further, José Villar (World Health Organization, Geneva, Switzerland) and co-workers recruited 8300 women who consumed less than half of the amount of calcium recommended during pregnancy. Half of the women were given a 1.5 g calcium supplement each day, while half received placebo.

The incidence of pre-eclampsia was comparable between the two groups, but rates of eclampsia, other severe complications of pre-eclampsia, and severe gestational hypertension were significantly lower in the supplemented women. The "severe maternal morbidity and mortality index" was also significantly reduced with calcium supplementation, as was neonatal mortality.

In women less than 20 years of age - those at highest risk for low calcium and pre-eclampsia complications - calcium supplements tended to protect against preterm and very preterm delivery.

"This large randomized trial in populations with low calcium intake demonstrates that while supplementation with 1.5 g calcium/day did not result in a statistically significant decrease in the overall incidence of pre-eclampsia, calcium significantly increased the risk of its more serious complications," the team concludes.

I hope that this study and others will not only continue to confirm the unflagging lifelong work that the late obstetrician Dr. Brewer has done on the link between nutrition (especially protein, calcium) and pregnancy induced hypertension (PIH), pre-eclampsia, eclampsia/toxemia and HELLP.

Auschwitz Midwife

2006-03-13T06:02:00.000-07:00

I blogged about the rivetting book Night here and at the back of my mind I have been thinking about a story I read of an Auschwitz midwife the whole time I read it. The tireless work of a Catholic midwife in the depths of hell. I finally found the article, Midwife at Auschwitz. Here is an exerpt:

During her imprisonment, Stanislawa helped deliver over 3,000 babies. But there was something even more remarkable than her trying to cope amidst these hostile conditions. As she explained to her son, the Lagerarzt ordered her to make a report on the infections and mortality rate for mothers and infants. She replied, "I have not had a single case of death, either among the mothers or the newborns." The Lagerarzt's response was a look of disbelief. "He said that even the most perfectly handled clinics of German universities cannot claim such success. In his eyes I read anger and envy." In a self-deprecating manner, Stanislawa attributed this to fact that "the emaciated organisms were too barren a medium for bacteria." However, her children and fellow inmates ascribe this miraculous record to causes more than natural.

Holding Pattern

2006-03-09T10:25:00.000-07:00

If I, no we, continue in this holding pattern I think one of us is going to lose it.

Allan and I have been hanging on here, wanting to provide a bit of stabilization for our children by not moving, again, in following Allan's career. We have turned down two transfer requests to Grande Prairie and instead Allan was moved to the Spruce Grove store, much to our dismay. I know that it sounds ideal because we are like four blocks from the store. But in the grande scheme of things Wal-Mart it wasn't a good move in terms of promotion.

We have been looking at other career options and the one we had been really interested in was construction. But then those of you who read my blog would know about that. We had almost been ready to jump off the big ol' Wal-Mart ship to dive into this opportunity, but Allan's potential employer is concerned that he won't be able to provide the income he wants to give us. He is an incredible man who has become a friend and knows clearly what it is like to raise a family with four children. He did it himself not too long ago, his youngest is in his early 20's.

So, the short story is, if we don't go the construction path very soon, we will be accepting the transfer opportunity to Grande Prairie and putting our eggs in that basket wholeheartedly, without a second job to interfere with Allan's focus on his career. To be honest, I don't care either way as long as the decision is made so we can move in a clear direction, one way or another. Sure I will miss Spruce Grove and all of our friends here if we do move... especially from our homeschool group and church (and Deanna!), but if that is the path, let us forge ahead!

The Horrors of Auschwitz

2006-03-04T14:07:00.001-07:00

I just finished reading the riveting book Night (revised 2006) by Elie Wiesel. Once again I was brought back to Auschwitz and the stark horrors faced by those who were sent to the concentration camps, the work camps, the chimneys. The first time I learned of the attempted extermination of the Jews by Nazi Germans was when I read Corrie Ten Boom's The Hiding Place. It forever changed my perceptions of our world, of justice and humanity.

I still cannot fathom the depths of depravity those in charge were capable of. I am in awe of the strength their victims had and the horrible decisions they faced every day in order to survive emotionally and physically. On Thursday my great friend Deanna and I were talking about the concentration camps and of the opening of Sophie's Choice. As parents we contemplated the thought of having to choose between our children, who lived and who died. I cannot imagine what mothers, fathers, children, and grandchildren must have gone through, knowing their family were murdered by the most horrible means. Choking on gases, shot in the back of the neck, thrown into flaming trenches, and so much worse. I pray our children, our children's children and their children's children never face this evil. Let us ponder together the famous quote from George Santayana:

Those who cannot learn from history are doomed to repeat it.

Predicting Cesareans

2006-03-01T10:59:00.000-07:00

Well, leave it to some bored researchers to try and find the crystal ball answers to why their cesarean rates are so high. Don't look at the obvious, prophilactic induction for postdate pregnancies which is clearly not evidence based, that would be to simple. No, let's look for reasons we can cause more iatrogenic cesarean outcomes!

New risk score predicts cesarean after induction
Source: Obstetrics & Gynecology 2006; 107: 227-33

Simple scoring system may help decision-making when considering induction of labor.

The risk of cesarean delivery after induction of labor can be predicted reasonably accurately using four simple measures, British obstetricians report.

Elisabeth Peregrine and team from University College London Hospitals sought to develop a clinical model for predicting the outcome of labor induction. They evaluated maternal and ultrasound parameters in 267 women at 36 or more weeks of gestation immediately before induction of labor.

The most frequent indication for induction was postdates, and 30 percent of the cohort subsequently required a cesarean delivery.

In logistic regression analysis, four factors emerged as significant predictors of cesarean delivery: parity (odds ratio [OR] = 20.56), body mass index (OR = 6.17), height (OR = 0.94), and ultrasonic transvaginal cervical length (OR = 1.07).

Peregrine's team used these to develop a simple risk scoring system, whereby a score of -65 to -55 indicates a more than 80 percent likelihood of cesarean delivery, and a score of -165 to -146 indicates a less than 1 percent chance.

The model has "reasonably good discriminatory ability," say the investigators, who conclude that it may allow more accurate counseling and better informed consent in the decision-making process when considering induction of labor.

Posted: 22 February 2006

I am receiving the study today via email from LWW because my online access is not working properly, but two of these are no-brainers IMO. Parity and cervical length (aka Bishop's Scores) are obvious. Primips have been proven to gestate longer than multips (average gestation 41 weeks), hello! As for BMI and height, this has piqued my interest greatly, especially in light of all of my maternal female relatives have all given birth very close to 40 weeks and my sister, the only one who is bordering on morbidly obese, who gave birth between 2 and 3 weeks postdates. Hmmm.

The Downward Spiral of Obstetrics

2006-02-28T05:30:00.000-07:00

I have always enjoyed Red State Moron's blog as it is often thought provoking. Last week's posting on defensive medicine touched home as I have seen the ramifications of this in obstetrics. Indeed I commented on it, stating, "As a matter of fact, defensive medicine is seen in almost every facet of obstetrical care. So much so, obstetrics has become so perverse in it's treatment of a normal physiological process, it has obscured the entire birth process."

In my years supporting birthing women and focused on cesarean reduction, I have long pondered the causes for the climbing cesarean rates. I am not talking as much since 2000 when defensive medicine has indeed skyrocketed the cesarean surgery rates as I am in the 1990's when VBAC was a viable option for childbirth. Indeed it is the safest option, by viable I mean readily available to birthing women in North America. This option has quickly disappeared thanks to ACOG's decision to reduce its members liability concerns and make this option only available in high-risk hospitals.

It started innocently enough, physicians trained to save lives stepped into childbirth only when it became a life threatening to mother or baby. Then, as medical schools increased, this role slowly eroded with physicians not finding enough work so they started to see attending normal birth as a way to increase clientele. Putting anyone trained to intervene to save lives in charge of a normal physiological process naturally led to interventions, some believed needed, most only causing more problems. Pain medication, episiotomy and Friedmann's curve were the first red flags of this "support." Birth did not become safer because of this support, indeed it became riskier. Infection and medication side effects took many lives and actually afforded the need of specialists - pediatricians to care for the newborns grossly affected by labour medications and obstetricians to attend to the highest risk mothers.

Which brings us immediately to the next topic, fear. Women historically have not looked forward to labour. It is not a walk in the park and all women knew it hurt, for most it truly set the bar on pain. There was also the fear of death, though (with the noted exception of iatrogenic infection) that is something we face every day, and birth is truly as safe as life gets. Anyway, it grew from the kind of fear one faces when making an important decision (you know, that stressful "I don't know what to do" fear) to paralyzing fear, the kind that leaves you in your tracks, unable to move.

How did this happen? Because we moved from birth as being a normal process all women go through to have children to a "condition" that must be "treated" by a qualified physician. My mother believed that, as did her mother. To do otherwise was indeed not an option without the belief that is was risking the life of mother and baby. I too believed that, engrained as I was with the sales pitch of modern medicine. Congratulations on the marketing campaign, you have indeed captured your intended audience physicians!

Add to that the media who inundate us with the sensationalized perils of medically managed labours on popular reality TV shows, where physicians save all in a single bound after leaving viewers on the edge of their seats with, "will she survive? find out after these messages."

Let us top it off shall we? Almost every obstetrical intervention is not evidence based. Episiotomy, once almost universally done and touted as necessary, has only recently been devalued by physicians... though women have long known its risks and outcomes. EFM (electronic fetal monitoring) was touted to save lives and yet the evidence has only shown that it increases intervention and surgery rates, not benefited babies. Pinnard horns are as reliable, and indeed safer. Heck, there have been NO long term studies on the effects of EFM ultrasound waves on anyone, let alone fetuses. Thalidomide comes sharply to mind too. But we have not learned our lesson, we still have cesarean for breech, almost every induction (very rarely for life-threatening situations), GBS and GD managment during pregnancy and labour, prophilactic cesarean for prior cesarean, prophilactic cesarean for macrosomia... I could go on, but the list is endless. All of these are not based on evidence at all and often the evidence refutes these common interventions.

The fear of facing a medically managed labour is very real. I was naive when I had my first in 1991. I didn't have the Baby Story to show me the fallicy of this option or I most certainly would have feared childbirth much more. No wonder women are requesting elective cesareans!! The alternative to these to options is homebirth, but even that is not always known or even available. Homebirth midwives are too often constrained in their practices, not being "allowed" to catch breech, twin or VBAC babies. I have heard of many women who, in lieu of these options, birth unassisted or travel great distances to find the support they want.

No wonder there is a great fear today, there is a huge downward spiral of non-evidence based defensive medicine happening here. Where will this spiral end?

Exciting Projects

2006-02-27T15:36:00.000-07:00

I need to focus, or at least I tell myself that at least twenty times a day. I also have to realize more fully that I am at heart an idea person and as such find it difficult to not have at least 10 lightbulb moments a day concerning the projects I am working on.

Today I am working on the first affiliation agreement for ICAN as they formally expand to include ICAN/AIIC Canada. As both ICAN International Director and ICAN/AIIC Canada's President, I very much have a vested interest in not only the success of this agreement, but the continued expansion successes of ICAN and the growth of ICAN/AIIC Canada. So many great ideas, enhanced by the input from our current board. I have to sit down and add them to the agreement for our next meeting on Friday.

I also just completed an expansion/renovation proposal for the healing centre and reception area of my church. This is after many hours of discussion with all involved, most of it informally, with awesome ideas as a happy consequence of "visiting." It is very exciting and now that I have the preliminary proposal finished, I can wait and see if it is accepted. Or not. I am more likely to start the interior design plans in anticipation of its acceptance.

There is also the mundane part of parenting life, a visit to our family physician for a referral to a podiatrist for my son, the continuing (and seemingly neverending) saga of potty training, heal insurance forms to be photocopied and submitted, meals to be made and homeschool to be taught. This is all flavoured with a dash of sitting down with son number two and having a heart-to-heart about friends and perspectives and a board game with son number three while daughter number one (child number four) "helps" while greatly hindering.

How is your day going?

2006-02-22T15:22:00.000-07:00

You are Joshua!

Which Old Testament Character are you?
brought to you by Quizilla

Neural Tube Defect Cause

2006-02-22T13:45:00.000-07:00

Again a new study, as I have been noting over the years, reveals nutrition is a critical key to healthy offspring...

Corn mold may have fed NTD outbreak
Source: Environmental Health Perspectives 2006; 114: 237-41

Investigating whether maternal exposure to fumonisin, a mycotoxin that often contaminates corn, increases the risk of neural tube defects in offspring.

Tortillas made from corn containing a toxic mold may have caused the high prevalence of neural tube defects (NTDs) seen on the Mexican-American border in the early 1990s, research suggests.

Scientists have for decades been trying to determine why the incidence of NTDs among Mexican-American women doubled in 1990-1991. No chemical links to the affected infants have been confirmed. But the researchers note that the period began the same crop year as an outbreak in corn mold and that Mexican Americans in Texas consume a lot of corn, largely in the form of tortillas.

To investigate whether a toxin produced by corn mold, fumonisin, may have been responsible for the outbreak, Stacey Missmer (Harvard School of Public Health, Boston, Massachusetts, USA) and colleagues conducted a population-based case-control study.

They found that, after adjusting for confounding factors, a moderate (301-400) compared with a low (100 or less) intake of tortillas during the first trimester of pregnancy was associated with an increased likelihood of having a NTD-affected pregnancy (odds ratio = 2.4). No increased risks were observed, however, with higher intakes.

"Our findings suggest that fumonisin exposure increases the risk of NTD, proportionate to dose, up to a threshold level, at which point fetal death may be more likely," the researchers conclude.

Posted: 16 February 2006

Sick, sick, and sicker

2006-02-16T14:24:00.000-07:00

Sorry I have been so quiet, quite unlike me I know. Well between preparing for the inaugural ICAN/AIIC Canada board meeting and being so sick that to pry me off the couch was a feet neither birth child nor husband could do, I haven't spent much time on the computer. With both of these now mere history (with the noted exception of severely cramped upper back muscles from the coughing and sneezing which nearly loosed my head from its moorings on many an occasion), I am making a brief appearance. Now I am off to get the 2005 finances in order for ICAN/AIIC Canada to give to our ICAN Int'l finance officer... catch you soon at a blog near you!

Prenatal Depression

2006-02-06T14:58:00.000-07:00

It grieves me greatly that newborns are facing withdrawal due to the medications their mothers take. I truly understand the need that some mothers have for treatment of depression, though there are alternatives to SSRI's which many feel are way over prescribed.

Mom's antidepressants hit third of newborns: study
Feb. 6, 2006

CHICAGO (Reuters) - Nearly one in three infants born to women taking anti-depressant drugs exhibit signs of withdrawal and expectant mothers may want to limit the drugs they take, researchers said on Monday.
Symptoms such as high-pitched crying, tremors, gastrointestinal problems and disturbed sleep may show up in the first 48 hours after birth and were more pronounced in infants whose mothers had been taking higher doses.

A closer look at the 37 infants exposed in the womb to paroxetine hydrochloride, sold as Paxil by GlaxoSmithKline, showed the risk of symptoms disappeared if the mother's dosage was less than 20 milligrams daily while the risk was highest among those exposed to 27 milligrams or more.

Thirty percent of the 60 newborns exposed to one of the popular class of drugs known as selective serotonin reuptake inhibitors (SSRIs) in the womb were found to have withdrawal symptoms and the symptoms were classified as severe in 13 percent, said the study by Dr. Rachel Levinson-Castiel of the Children's Medical Center of Israel, in Petah Tiqwa.

Symptoms usually did not peak until after the first day of life but the long-term effects are not known, the study said.

Two of the exposed infants suffered seizures but they did not persist.

Previous studies into the effects of SSRIs on newborns have identified other symptoms such as rapid breathing, bluish skin color from lack of oxygen, feeding difficulties, low blood sugar and jitteriness.

Yet a study published last week by researchers at Massachusetts General Hospital in Boston said women who need an antidepressant cannot depend on hormonal changes in pregnancy to relieve their symptoms so may choose to continue taking the drug.

"Because maternal depression during pregnancy also entails a risk to the newborn, the risk-benefit ratio of continuing SSRI treatment should be assessed," Levinson-Castiel wrote in the journal Archives of Pediatrics and Adolescent Medicine.

Unfortunately, "the long-term effects of in utero exposure to SSRIs have not been demonstrated clearly," not even for those whose symptoms were severe early on, she wrote.

Both studies recommended pregnant women simplify their drug regimen to a single drug at the lowest effective dose.

Pre-eclampsia Concerns

2006-02-01T09:13:00.000-07:00

Having seen the devistating effects of pre-eclampsia and it's much more dangerous cousin HELLP syndrome in my own clientelle, I echo Red State Moron's quest for the holy grail. Yet, outside of mainstream obstetrics, we have seen the dramatic reduction in pre-eclampsia, toxemia and HELLP (not to mention preterm birth, low birth weight and IUGR) in the late Dr. Tom Brewer's practice. Nay, not reduction, elimination of the above.

How on earth did he do this? Simply, it was nutritional counselling and adherance to his guidelines. The stunning results are found here. Ironically, nutrition is virtually ignored in allopathic medicine as having any impact on health. The reason? The easy answer is because nutrition is not taught in medical school beyond a basic level, and certainly not in the depth needed to effect pregnancy outcomes. Physicians cannot provide information on what they don't know. Why are they not taught? Because it isn't ethical to do RTC's based on nutrition because you may be compromising patient health.

Just like it isn't ethical to do RTC's on elective caesarean vs. vaginal birth... either primary or post-caesarean because it knowingly compromises patient health to subject a woman to unnecessary major abdominal surgery for a normal physiological process in the absence of indications. But I digress.

Dr. Brewer's nutritional basics stand up both in his studies and when compared to the newest nutritional studies, guidelines and information available. Midwives have long supported the critical aspect of nutrition, but in North America most women seek obstetricians or family practic physicans (if they can find any who are still catching babies). Interestingly, some obstetricians are now following suit by having nutritional guidelines for patients with excellent results. Notably, Dr. Motha does this in her Gentle Birth Method: The Jeryarani Way. But not nearly enough are doing this or providing any nutritional counselling at all.

I pray that each mother finds either guideline and follows it towards superior outcomes in spite of the lack of obstetrical training and knowledge in the field of nutrition.

We are not moving today!

2006-01-30T12:34:00.000-07:00

God has been gracious today. Allan's evaluation was superb and though his store manager is looking for slight improvements in three fairly minor areas, he is in line for being promoted to a co-manager position soon. That was a no-brainer as Allan has superb management skills and I didn't doubt for a minute that he would not have anything but an excellent eval.

His store manager also asked specifically that he stay in the store because he needs his strong leadership right now. Even though, his district manager did ask if he would transfer to Grande Prairie, which he declined again... mostly because there is no way in heck that we could afford to move there on his wage (even with a raise). It was really a moot point though, given his store managers request, but is a future option for sure.

Ironically his other boss (our builder, who we have been working for part-time) called to ask how the eval went and offered Allan a full-time job until he was able to open a sales position for him this fall. I of course told him when he called to tell me of his eval outcomes.

Wow, the options we have been praying for suddenly all fall in our laps in the same hour. We were asking for a sign as to which path we should travel, following Allan's management career in Wal-Mart or moving to the very lucrative construction/sales career offered by our builder. It seems that the latter is where we may be heading... but at a more leisurely pace which is OK with me.

2006-01-26T19:44:00.000-07:00

I have never participated in a Meme before, so here it goes...

Four jobs I've had:
1. Real Estate Agent
2. Art Gallery Framer
3. Photo store manager
4. Doula

Four movies I'd watch over and over again:
1. Mulan ('cause I have kids. I know every word by heart and it is still good)
2. Sweet Home Alabama (I have no clue why, but I do)
3. Anything with Tom Hanks (what a gifted actor)
4. Anything with Angelina Jolie (again with the gifted thing)

Four places I've lived:
1. Camrose, AB
2. Lloydminster, AB
3. Spruce Grove, AB
4. Kingman, AB (well on a farm just outside of Kingman... where I grew up)

Four websites I visit daily:
1. orgyn.com
2. Focus on the Family
3. Keel the Pot blog
4. Christianity Today (an article called The Baby I'll Never Forget)

Four of my favourite foods:
1. Anything chocolate
2. Mashed new red potatoes with butter and dill
3. Fried chicken, especially KFC
4. A crisp apple pear

Four places I'd rather be right now:
1. Somewhere warm
2. Cleo's with an unlimited budget
3. At a spa, with my sisters and mom
4. In the new house we are designing, I can't wait!

Secondary Infertility Post-Cesarean

2006-01-25T07:48:00.000-07:00

Well it looks like the experts have finally weighed in on secondary infertility after a cesarean delivery.

Subfertility link to cesarean 'may not be causal'
Source: Fertility and Sterility 2006; 85: 90-5

Investigating whether cesarean delivery is independently associated with later subfertility.

The observation that women who undergo a cesarean are less likely to have further pregnancies than other women probably does not reflect a cause-and-effect relationship, research findings suggest.

While it is biologically plausible that the surgery involved in a cesarean section may affect future conception, women who undergo this mode of delivery also differ in many respects from those who do not, including their history of primary infertility, which could confound the association.

For their study, Gordon Smith (Cambridge University, UK) and co-workers studied the relationship of cesarean delivery with later subfertility, with adjustment for potential confounders. They used retrospective data from a cohort study of more than 100,000 women who had their first baby between 1980 and 1984.

Compared with women who had a spontaneous vertex delivery, those who had a planned cesarean section were significantly more likely to not have a second birth during follow-up, with a relative risk of 1.21. Adjustment for maternal and obstetric characteristics, however, attenuated this association to a relative risk of just 1.07, which was no longer significant.

"These data suggest that the association between cesarean birth and subsequent subfertility is more likely to be caused by confounding than by a causal relationship," the researchers conclude.

Well duh. Though some of us certainly do know that despite normal ovulation pre-cesarean and infrequent or no ovulation post-cesarean (though for me it took two cesareans to truly obliterate my ovulation), there are many many women who choose to not have more children because of the negative emotional impact of the surgery. I could list many women whom I have talked to personally who are terrified of another cesarean. Being post cesarean in today's obstetrical quagmire that ACOG has put birthing women in allows only two options, elective repeat cesarean section or homebirth - with or without midwifery care.

Finally, let us never forget the women who cannot become pregnant without it being life-threatening (for instance, a friend of mine experienced embolic thrombosis as a result of cesarean surgery - she risks her life to even fly).

Giving Birth in a Hospital? Think Hard.

2006-01-23T13:48:00.000-07:00

It has long been known by physicians, nurses and mothers alike that obstetrics is practiced a far stretch away from an evidence-based standpoint.

Starting way back in North America when midwives attended most births in the home while physicians pined away in their offices, trying to think up new ways to attract customers, er, patients, physicians thought they had a clue about birth. Or rather, how they could improve birth. It isn't obstetrics that improved birth, to be honest it would be hard stretched to say that the office of obstetrics has caused a great deal of problems. General knowledge of anatomy and physiology, the advancements of hygene, and understanding of infection are what have really increased safety. Let's look at what obstetrics has done...

As much as 100% episiotomy rates at certain times during the last century, and even when it was proven to cause harm or at least not improved outcomes in almost every situation, the rates are shockingly high, as much as 50% or more in some practices.
EFM (electric fetal monitoring) has not only became common in all hospital L&Ds, it is still used today as standard of care despite it's causing highly interventive outcomes (like cesarean section). Even more frustrating, continuous EFM is known to cause complications in labouring mothers because of lack of maternal mobility which is a key aspect in a well-progressing labour.
Anyone who knows me knows I am appauled by the skyrocketing caesarean rate. Over 8% places unnecessary risks to the mother specifically and the baby inadvertently (prematurity and cuts from the scalpel to name only two). Just ask the WHO counsel who recommended a rate of no higher than 10-15%. They know the numbers should be lower but US supporters knew they could not sell such a low number to obstetricians "back home" so they settled on the higher average. Incomprehensible that physicians would knowingly risk patients lives to protect their own liability insurance and their personal time (heaven forbid they lower their patient load and reduce their income!). Equally incomprehensible is the number of hospitals and insurance companies who have contributed to this outrage.
Breech babies born by cesarean instead of vaginally based on one flawed study... knowingly so the minute it was published. Last week a new study refutes the Hannah breech trials and stands behind the safety of vaginal breech birth, yet we have scores of delivering physicians who don't know the basics of leopold maneuvers (relying instead on ultrasound results) nevermind how to catch a frank or footling breech.
Speaking of ultrasound, how can so many things be tested on our unborn without adequate testing like this all-too-common screening tool? No long-term and precious few short-term studies have ever been done on the effacity of ultrasound screening.
Which then brings me to the sheer number of drugs that are "safe" for mothers until proven otherwise. I will not even start counting the number of drugs resulting in birth defects, stillbirth and more that have been used on pregnant women without adequate testing. Just recently we have the new "stop smoking patch" that has been found to cause birth defects and metronidazole causing the very preterm risks it was preported to fix.
Oh, and let us not forget the biggest one, the safety of birth in hospitals. The huge homebirth study published last year in the not only shows the safety of homebirth, it shows the huge risks of hospital birth by contrast. Heck, just last week a young healthy mother gave birth and lost all four of her limbs because of the bacteria she recieved from the hospital she chose to give birth in. Terrifying to me.

Infant Bonding

2006-01-20T10:30:00.000-07:00

In my research for the new online Postpartum Doula workshop I will be teaching, I have been reading a lot about infant bonding. At Birth Psychology I was reading this and was struck by one woman's response:

I had herpes, and they whisked the baby away to intensive care for observation and wouldn't even let me touch him for three whole days. I grieved. I felt that he had died. Finally on the third day I went to the nursery and demanded him. But I felt very little when I got him. I know it's nonsensical, but my emotional feeling was that he had died, and this was someone else. I wanted desperately to love him, and I knew that nursing would be the fastest way to make up for the bonding I had missed, so I made myself nurse him and I hated it for a long time. When I would sit down to nurse him I would feel so impatient I could scream. It took months for me to feel that I was really his mother, and he was really my baby. Finally it did happen, but it was awful for a long time.

Wow. Deja Vu. Here is my story with its parallels:

I had an emergency cesarean section under general anesthesia and while going under I prayed that God would be kind and save my baby as I believed I would not survive. I did survive yet the experience left me detached as a result of the emotional trauma I had experienced. Four hours after I went under the knife, a screaming infant was placed in my arms in my postpartum room. I searched the face of this strange little thing, almost frantically looking for something, anything, that would identify him as my own. It was only when I saw the stork bite on his forehead, the same mark of both my sister and my beloved Grandfather, that I relaxed and a warm flood of love flowed over me. Bonding came quickly as I fell in love with this tiny baby, yet it was a fine thread that could have been easily broken with a far different bonding outcome had I not been able to identify with him.

Theological Breakthrough

2006-01-20T07:08:00.000-07:00

Eric, my eldest, has been struggling with confirmation classes for three reasons. First being that he is older than his classmates (which include his brother), second because he is a kinisthetic learner and third, well he is a firstborn/leader type. Being homeschooled, his leadership has not been supressed to conform to a classroom setting and as such, he doesn't conform well to dry old testament history that he covered extensively in grade school.

After a couple of meetings with our pastor who teaches his class, she suggested we switch gears. Instead of sitting listening to lecture for an hour and a half, having just covered the same material as prep homework, he is instead to only pre-read the biblical text to be covered that day and will be the teachers assistant, doing the board writing, showing journeys on the maps (they are currently covering the exodus) and so forth.

For the first time, he came home so excited yesterday loving confirmation classes! In addition, he talked all the way home about something new. He learned that what we had believed to be the exodus route of the Isrealites through the Sinai Peninsula was indeed wrong.

The Red Sea Crossing shows us that they traveled straight through this area, already occupied by the Egyptians, to the Gulf of Agaba where the read red sea crossing occured (see link for archeological and theological proof).

They then travelled on to Mt. Sinai (Jabal el Lawz) with it's blackened peak.

Mount Sinai was completely in smoke, because the Lord descended upon it in
fire. Exodus 19:18

It has been quite a day of learning and triumph.

Grand Rounds

2006-01-19T12:42:00.000-07:00

Grand Rounds up today at Grunt Doc.

MedBlogs Grand Rounds features the best writing about medical topics in the blogosphere, brought to you weekly with rotating hosts.

Medical Journals and Politics

2006-01-16T18:37:00.000-07:00

Since talking to Henci Goer way back in 2000 about the concerted effort to misalign natural childbirth for the benefit of "daylight obstetrics" in busy obstetrical practices and hospitals, I have been very wary of the press and even trusted medical journals like the New England Journal of Medicine. In 2002 Henci documented her observations in an article printed in Midwifery Today called The Assault on Normal Birth: The OB Disinformation Campaign.

Today, Red State Moron blogs about a very similar concern reported in the Wall Street Journal, but this time we see the NEJM dipping their toes in the Vioxx scandal. The article explains (emphasis mine),

"Accusations aren't the usual fare of august medical journals, so it's worth trying to understand the publication's self-insertion into the Merck litigation. Its extraordinary decision to publish a critical statement about a Vioxx study it ran years ago is being hailed by trial lawyers as the best evidence yet that Merck played fast and loose with its data. Another way to say this is that the New England Journal is joining the ranks of academic publications risking their reputations as non-partisan arbiters of good science in order to rumble in the political tarpits.
The worry here is that the health community and broader public will soon have one less place to find legitimate "science." These publications have viewed themselves as the gold standard in research, using their peer review processes to build reputations for careful and unbiased science on the leading issues of the day. Any suggestion that these publications have an axe to grind -- whether against corporate America, private markets, or specific drugs -- undermines their standing as neutral arbiters. That in turn makes it that much harder to separate good science from the "junk" version. And that truly warrants an "expression of concern."

As Red State Moron suggests (and I agree), "And this is exactly where I think the medical and science blogs will gain an audience, and perhaps respect. As another way of providing "peer review", and as a means of disseminating the information to the public. Because really, how many of you read the NEJM, The Lancet, or JAMA (to name a few)?" Indeed, how many physicians read their own journals, nevermind the patients they serve?

The Maker's Diet by Jordan Rubin

2006-01-16T14:10:00.000-07:00

I rarely take the time to read books outside of homeschooling texts and pregnancy / birth / postpartum related tomes, but this book has been on the back of my mind for a while and I finally have it in my hands to read. I am very impressed with what I have read thus far (granted I am in chapter three only) and it is very much along the same lines as what I have learned and understood about nutrition and the bible, though I am learning tons more.

Rubin's experience with Crohn's was absolutely riveting, if only for that information this book is a keeper. Yet it goes on to explain the basis on which he was cured from Crohn's and how others can achieve health too. I will keep you posted on my thoughts about this book as I continue my reading journey.

Carnival of Homeschooling #2

2006-01-16T13:27:00.000-07:00

For all of you who are homeschooling, are wanting to homeschool or cannot for the life of you figure out why on earth someone would want to homeschoool, I have a treat for you!

Similar to Grand Rounds (the best of medical blogs) the Carnival of Homeschooling #1 and Carnival of Homeschooling #2 are compilations of unschooling gems discovered in the blog-o-sphere by A Typical Homeschool. Read and enjoy.

Life with Sleep Apnea

2006-01-14T15:43:00.000-07:00

As some of you know, my amazing husband Allan was diagnosed with sleep apnea in 2002. Severe obstructive sleep apnea to be exact. The American Sleep Apnea Association explains:

The Greek word "apnea" literally means "without breath." There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep.
Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and herefore untreated, despite the fact that this serious disorder can have significant consequences.
Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.

In essence Allan stops breathing when he is asleep, an average 28 times an hour to be exact, and the carbon dioxide buildup in his bloodstream signals him to wake in order to open his airway to breathe. In contrast to Olga Sen's description of sleep apnea, you do not wake gasping and choking. Rather you are so fatigued you barely gain consciousness in order to breathe, and then go immediately back to sleep, only to wake again in 2 minutes. I watched this over and over, loud snoring then silence (I would count the seconds) then movement and a gasp of air (and a sigh and prayer of thanksgiving from me), followed immediately by snoring. Over and over as we waited weeks for the appointment with a sleep specialist, the sleep clinic, and finally for the CPAP (continuous positive airway pressure) machine which would allow him precious sleep, REM sleep which he has not had for months.

Though the APAP (essentially a CPAP but with autotitration so the air pressure fluctuates as needed in response to his needs) machine provides him with the precious sleep he needs, it is not without frustration. In essence you are sleeping with a nasal mask on your face, which when sealed against your face (no air escaping) works perfectly. But when you move it is easy to cause a gap which increases the pressure which wakes you... often with dry eyes because of the air blowing in your eyes from the gap. Then there is the hose (from machine to mask) getting in the way or crossing your neck so you wake up from a nightmare of snakes wrapped around your neck. Oh, and lets not forget the occasional interruption from sundry children coming in for one reason or another during the night.

Allan is finding sleep hard again and I am concerned about the effect his shift work as a manager has on his apnea (working anywhere from 7 am to 11 pm), the stress of said job has on his sleep patterns, and the frustrations he has had with our local CPAP dealer who has caused a delay in receiving his new machine for months. His doctor equates living with sleep apnea as sleeping every night in a hospital with the constant interruptions and various medical equipment waking you through the night. I can well imagine, and signed out AMA after my third caesarian because I couldn't stand it. I cannot wait until the new treatment methods in development provide a better solution than is available right now. Until then, the APAP is providing Allan with life and for that I am thankful.

A new boy is born

2006-01-11T19:43:00.000-07:00

Congratulations to Dr. Charles on the birth of his first nephew. An eloquent and well written prose of love.

IQ Testing

2006-01-11T14:21:00.000-07:00

One question for all of you. If you decided today to take an IQ test today... oh for whatever reason, and it came back as 132 (cognitive destination = gifted which is only 2.3% of the population), what impact would that have on you?

Grand Rounds Today

2006-01-11T13:46:00.000-07:00

Grand rounds is posted this morning at the Cinical Cases and Images Blog.

Grand Rounds is a weekly summary of the best posts in the medical blogosphere. Pre-Rounds is an article series about the hosts of Grand Rounds on Medscape.com. Nick Genes of Blogborygmi, who writes the Medscape column, is the founder of Grand Rounds and he maintains the archive.

New Blog called quickening

2006-01-09T10:59:00.000-07:00

A great friend of mine, Anne Boyd (who can be found blogging here) and I have been working on a new informational blog called quickening. Our focus is discussing the business of birth and maternal child health.

Birth Biz, where quickening was conceived is an online group at Yahoo!, with 183 (and growing) members.

Come on over, learn with us, and feel free to contribute!

Hail Caesarean

2006-01-06T20:20:00.000-07:00

Since I read this on another blog just after Christmas, the words of this woman have haunted me. Here is a woman, already having experienced her first cesarean iatrogenically because of her physician's impending vacation, pregnant and wanting a vaginal birth. I remember those shoes, I was in them not so long ago after my primary caesarean for the very same reason and so wanting a vaginal birth. I was almost assuming it would be so because I couldn't accept the fact that my body was broken, unable to birth my own child. Denial is not a good thing, especially when you have not given yourself time to grieve.

Now this woman is faced with the financial burden of a possible repeat cesarean following a trial of labour vs. the much lower cost of an elective repeat caesarean section. Couple this with her physician's admitted bias (emphasis mine),

That said, my gynae confesses that he is pro-Caesarean himself. Why? Because it is safer for the mother and the child. However, for first time births, he usually discourages it unless the baby is breach (positioned wrongly) et al. For mothers who have gone under the knife, such as myself, he recommends another Caesarean simply because of safety.

"Honestly speaking, it poses less stress for the doctor as well because we are worried for you, if your wound might rupture, which is very messy. The decision is ultimately still up to you to go elective or vaginal," he told me.

What the hell?! So let me see, I would rather risk mine and my baby's life to give my physician less stress? Let us look at the consequences of an elective caesarean from ICAN shall we?

Risks to the baby from elective cesarean section

Babies delivered by elective cesarean have an increased risk of neonatal respiratory distress syndrome (RDS), a life-threatening condition, and other respiratory problems that may require NICU care.
Babies delivered by elective cesarean have a five-fold increase in persistent pulmonary hypertension (PPH) over those born vaginally.
Babies delivered by elective cesarean are at increased risk of iatrogenic (physician caused) prematurity, usually related to failure to conform to protocols for determining gestational age prior to delivery, or errors in estimating weeks of gestation even with the use of clinical data. Prematurity can have life-long effects on health and well-being, and even mild to moderate preterm births have serious health consequences.
Babies delivered by elective cesarean are cut by the surgeon’s scalpel from two to six percent of the time. Researchers believe these risks to be underreported.

Risks to the mother from elective cesarean section

Up to 30% of women who have a cesarean acquire a postpartum infection. Infections are the most common maternal complication after cesarean section and account for substantial postnatal morbidity and prolonged hospital stay.
Other serious complications for women undergoing cesarean include massive hemorrhage, transfusions, ureter injury, injury to bowels, and incisional endometriosis.
Women who undergo cesarean report much lower levels of health and well-being at seven weeks postpartum than women who have vaginal births.
Women who undergo cesarean section have twice the risk of rehospitalization for reasons such as infection, gallbladder disease, surgical wound complications, cardiopulmonary conditions, thromboembolic conditions, and appendicitis. Rehospitalization has a negative social and financial effect on the family.
Women who undergo cesarean section report less satisfaction than women having vaginal births.
Women undergoing cesarean are at increased risk of hysterectomy in both the current and future pregnancies.
The maternal death rate is twice as high for elective cesarean as for vaginal birth.
In subsequent pregnancies, women with a prior cesarean have higher rates of serious placental abnomalities which endanger the life and health of the baby and the mother.
Women are rarely told that a cesarean places future babies at higher risk.
After cesarean section, women face higher rates of secondary infertility as well as higher rates of miscarriage and ectopic pregnancy.

The only true risk of a vaginal birth after a caesarean is the risk of uterine rupture which is 0.7%. Messy indeed for the physician but rarely life-threatening to either mother or baby. From ICAN's white paper, Issues and Procedures in Women's Health Vaginal Birth After Cesarean (VBAC), "The chance of death for a mother is 7 times higher when delivered by c/section versus vaginally." This alone is why I chose, chose, to have a vaginal birth with each of my children. Though I did end with a caesarean with the next two for different reasons, my fourth was indeed a vaginal birth with no complications at all.

Down Syndrome Revisited

2006-01-06T07:49:00.000-07:00

Down Syndrome has been in the news a lot in recent weeks. The Washington Post reported on First Trimester Screening for Down Syndrome in November and many other reporters have followed suit. My thoughts on Fetal Testing for Down Syndrome looked at the true impact of testing outcomes and Red State Moron had this to say. Now a new report is out through AP, this one at ABC News that has found Down Syndrome more common (emphasis mine):

Down syndrome in the United States is more common than previously thought,
at one case for every 733 live births, according to a new
government report containing what are regarded as the most reliable estimates
yet on the prevalence of 18 types of birth defects.

Previously, Down syndrome, a type of retardation caused by a genetic
mutation, was estimated to occur in a range of one in every 800 live births to
one in every 1,000.

I am absolutely stunned that if 85% of pregnancies are terminated (Red State Moron and I found two studies citing this) after only a positive Down Syndrome screening, then the statistics of 1:733 is way off and indeed Down Syndrome is much more common than the report leads us to believe.

Online Learning

2006-01-05T17:31:00.000-07:00

I love online learning, but then it comes naturally to me as a long-time tekkie, married to someone who is even more of a tekkie than I! I have been learning online since the internet became available and now there are so many great resources, so many great online classes and so much to learn! That is why I am so excited about the Global Birth Institute's new online classroom for training workshops for the certification programs they offer. It isn't really new, the Perinatal Diploma class has been using it for some time for their distance learning component, but it is new for the workshops. It is an excellent option for the many women in rural and remote areas of Canada who contact me on a regular basis asking what their training options are. I look forward to spending some time in "class" as an instructor and student, if you are interested in become a prenatal educator, doula or lactation counsellor, I hope to see you there too!

Big Jar Mayonnaise Mama

2006-01-01T08:44:00.000-07:00

Though I don't have nearly the progeny of either Cheryl or Barbara, I am very proud to be a Big Jar Mayonnaise Mama!

Teen Violence

2005-12-31T08:10:00.000-07:00

I will step aside from my usual blogging on personal and childbirth issues this last day of 2005 and look instead to something that concerns every parent, teen violence. As many of you know Toronto is mourning in the wake of an innocent teen who was slain during a Boxing Day shootout on Yonge street. I personally, as a mother of a just-turned-14-year-old, am concerned about the increasing violence we are seeing in teens today.

In my research, I found that Family First had commissioned Wirthlin Worldwide to conduct a survey of 500 youth between the ages of 13 to 18. The results might surprise you. They found that 54 percent of those teens surveyed agreed, "Violence in music and on TV encourages youth violence." Fully 66 percent of 13-14 year olds were even more convinced that it was a factor. Indeed, the vast majority of teens (86 percent) who agreed that violence in entertainment encouraged youth violence believe "There should be efforts to reduce the amount of violence in music and on TV." How ironic, as teens are by far the largest consumers of popular music and television programs that depict violence.

But that isn't all.

68 percent of our teenagers believe that "Youth are more likely to be violent
and commit crimes when their fathers are absent from the home." Teens also
identify strong marriages as a deterrent to youth violence. Overall 72 percent
agreed that "Mothers and fathers with strong marriages are less likely to have
children or teenagers who are violent and commit crimes." Young teenage boys in
particular seem to be crying out through this survey for a stable home life.
Fully 85 percent of males aged 13-15 surveyed said that strong marriages were
important.

Teens are incredibly perceptive and had solid answers to this dilemma too. Far from recoiling at parental authority and advice from parents, kids see them as an important part of the solution. Their top three solutions, in order are:
1. Parents who commit to marriage and stay involved in their kids' lives.
2. Positive role models who participate in kids' lives.
3. Teaching moral principles to youth.

Let us ponder the conclusion of the survey as we embark on a new year...

Youth violence is a scourge that speaks sadly about the present state of our
culture. But the attitudes of our children should offer us great hope. Far from
being nihilistic, self-absorbed, and operating in a moral vacuum, our kids seem
to have a better grasp of this problem than we might think. The teens we
surveyed identified the root causes of youth violence and several solutions.
Perhaps our first step in curing this cultural cancer is to listen to their
prescriptions.

Happy New Year everyone!!!

Fetal Testing for Down Syndrome

2005-12-30T19:47:00.000-07:00

I will preface this blog post with the fact that my cousin's daughter was born with Down Syndrome, Trisomy 13 to be exact. Yet she is such a joy at four years old! Anyone who has not spent time with a child, or adult, with Down Syndrome... and I mean really spent time with them... has not experienced the joy of innocence, simple happiness that these precious people can bring to your life.

I November, the Washington Post reported on a first trimester screening test for Down Syndrome. Stein reported, "The eagerly awaited study of more than 38,000 U.S. women -- the largest ever conducted -- found that the screening method, which combines a blood test with an ultrasound exam, can pinpoint many fetuses with the common genetic disorder 11 weeks after conception." Fergal D. Malone of the Royal College of Surgeons in Dublin, who led the study published in the Nov. issue of the New England Journal of Medicine, found that 87 percent of Down babies were identified using this earlier method. Wow, that leaves an unlucky 13% with a false positive rate.

Now in a perfect world, this would simply provide parents with additional time to come to terms with their child having Downs Syndrome and prepare accordingly for his or her birth and life. Sadly, this very likely will not be the case. CNSNews reported in April on a Grey Journal study showed, “that many pregnant women receive only negative information from medical professionals when a prenatal diagnosis reveals a potential for giving birth to a baby with Down syndrome.” It went on to explain, “Pro-life groups blame what they call the "culture of death" for the legal system that upheld… abortions on unborn babies thought to have Down syndrome and other birth defects.” This it will be no surprise that, “in recent years, studies have shown the abortion rate of Down syndrome babies is estimated at 80 to 90 percent when prenatal screening reveals the possibility or probability for the condition.” Folks, that is 8 or 9 out of every 10 babies who have been diagnosed, accurately or not, with Down Syndrome.

With that in mind, let me close with a true story. Two of my cousins (sister and brother’s wife) were pregnant at the same time, both had at least three ultrasounds. One was told her baby had downs syndrome and was strongly counseled to abort her baby (they chose not to). The other was told her baby was perfectly healthy. The first cousin's son was perfectly healthy and the second cousin's daughter has downs syndrome… the very cousin I prefaced this post with. Now, if my cousin who had been counseled to abort would have, we would have lost a healthy, normal baby boy and his parents would have suffered the grief of that decision their entire lives.

Coached Breathing Doesn't Work During Pushing

2005-12-30T07:05:00.000-07:00

Reuters reported today what many birth professionals have long known, "Pregnant women coached through their first delivery do not fare much better than those who just do what feels natural." The study, published today in the Gray Journal (American Journal of Obstetrics and Gynecology) found "the difference has little impact on the overall birth, which experts say can take up to 14 hours on average" when "women who were told to push 10 minutes for every contraction gave birth 13 minutes faster than those who were not given specific instructions."

While I doubt that this study will suddenly stop all of the nurses from yelling pushing instructions at mothers who suddenly are found to be at the magical 10 cms dilation, it is important that this information is available for professionals and expectant parents. This procedure of coaching mothers to attempt to forcibly exhale with the nose and mouth closed to the count of 10, taking a deep breath and doing it again is called the Valsalva maneuver. Named after Dr. Antonio Valsalva (1666-1723), the Valsalva maneuver was an original method of inflating the middle ear which is still practiced today. It is also used as a diagnostic tool to evaluate the condition of the heart and is sometimes done as a treatment to correct abnormal heart rhythms or relieve chest pain. Its use in obstetrics started when heavily medicated mothers couldn't feel the urge to push and it was believed the Valsalva maneuver would speed descent of the baby and hasten delivery.

The World Health Organization's Care in Normal Birth, Chapter 4 explains the risks. The practice of encouraging sustained, directed (Valsalva) bearing down efforts during the second stage of labour is widely advocated in many delivery wards. The alternative is supporting the women's spontaneous pattern of expulsive efforts (exhalatory bearing down efforts). These two practices have been compared in several trials (Barnett and Humenick 1982, Knauth and Haloburdo 1986, Parnell et al 1993, Thomson 1993). The spontaneous pushing resulted in three to five relatively brief (4-6 seconds) bearing-down efforts with each contraction, compared with the 10-30 second duration of sustained bearing-down efforts, accompanied by breath holding. The latter method results in somewhat shorter second stages of labour, but may cause respiratory-induced alterations in heart rate and stroke volume. If the woman is lying flat on her back, it may be associated with compression of the aorta and reduced blood flow to the uterus. In the published trials mean umbilical artery pH was lower in the groups with sustained bearing down, and Apgar scores tended to be depressed. The available evidence is limited, but the pattern emerges that sustained and early bearing-down efforts result in a modest decrease in the duration of the second stage, but this does not appear to confer any benefit; it seems to compromise maternal-fetal gas exchange. The shorter spontaneous pushing efforts seem to be superior (Sleep et al 1989). It goes on to state in Chapter 6, under Practices which are Clearly Harmful or Ineffective and Should be Eliminated, "Sustained, directed bearing down efforts (Valsalva manoeuvre) during the second stage of labour (4.4)."

Getting back to today's article, "Women in both groups experienced about the same number of forceps use, Caesarean deliveries and skin tears, among other complications. Less clear was whether extra pushing encouraged by a coach could lead to bladder trouble. In an earlier study, the researchers tested bladder function in 128 of the mothers three months later. While such problems usually resolve on their own over time, women who had been coached had a smaller bladder capacity and felt the urge to urinate more often, they previously found." I also question if Valsalva pushing can also be implicated in causing or aggrivating hemorrhoids. We have all seen mothers with broken blood vessels in her eyes and face from pushing wrongly, universally a result of coached pushing.

The argument for Valsalva pushing is that a mother with a complete epidural and/or intrathecal block cannot feel the urge to push. Certainly her uterus will continue to contract and bring her baby down, but the effects are much more muted when not accompanied by the spontaneous bearing down women's bodies were designed to bring baby into the world most efficiently with. This begs the question, will staff have the patience to allow fetal descent before Valsalva or at least allow a more physiological second stage with open glottis pushing in shorter stints? Rarely in my experience. Turning over patients is always a priority in modern day obstetrics and with high epidural rates, rarely is a woman allowed to "labour down" as we have come to call the time from full dilation until crowning after an epidural placement where the mother is left alone to let her uterus bring baby down. Instead mothers are made to push for hours, exhausted and shaking, while her baby's heart rate dips ever lower because of the lack of oxygen caused by the unnatural pushing efforts of coached breathing. I hope we learn from this that normal physiological second stages work and do not need to be fixed by clocks and coached breathing.

Increased Cesarean Rate for Low-risk Women Contradicts National Goals and Guidelines to Improve Maternal and Infant Health

2005-12-29T08:10:00.000-07:00

The Coalition for Improving Maternity Services (CIMS) is concerned by the continuing escalation of cesareans and by new findings: the increasing cesarean rate in the number of low-risk women who give birth for the first time and in the number of low-risk women who are having repeat operations.

Ponte Vedra Beach, FL (PRWEB) December 27, 2005 -- In 2003 the U.S., cesarean rate reached an all-time high of 27.1%, according to the Centers for Disease Control (CDC). Physicians performed 1.2 million cesarean sections at a cost of $14.6 billion in hospital charges. This cost did not include the physician fees. In 2004 the cesarean rate climbed even higher, to 29.1%.

The Coalition for Improving Maternity Services (CIMS) is concerned by the continuing escalation of cesareans and by new findings: the increasing cesarean rate in the number of low-risk women who give birth for the first time and in the number of low-risk women who are having repeat operations. A low-risk woman is defined as one with a full-term (37 completed weeks of gestation), singleton pregnancy with a vertex presentation (head facing down) and no medical complications at the start of labor.

“Increasing cesarean rates contradict and affect two key national health objectives of the U.S. Department of Health and Human Services,” states CIMS's Chair, Nicette Jukelevics. “Those objectives are to reduce the number of low-risk women who give birth by cesarean and to increase the number of mothers who breastfeed their babies.” In 2003 one in four low-risk women gave birth to their first child by cesarean section, an increase of 30% since 1996. That year the repeat cesarean rate for low-risk women (women eligible to labor for a VBAC) was an alarming 88.7%, an increase of more than 25% since 1996. Healthy People 2010 objective is to reduce first cesareans for low-risk women to 15% and to reduce repeat cesareans to 63%.

Compared to vaginal birth, cesarean delivery compromises womens' health. Complications from cesareans put women at increased risks for infection, hemorrhage, blood clots, bowel obstruction, adhesions and placental problems which can complicate future pregnancy and birth. Women who give birth by cesarean are at higher risk in a subsequent pregnancy. Reduced fertility, preterm birth, low birth weight, and uterine rupture are more likely in a subsequent pregnancy after women give birth by cesarean.

The CDC (Guide to Breastfeeding Interventions) documents the protection, promotion, and support of breastfeeding as a critical public health need. The CDC identified labor analgesics, epidural anesthesia, and cesarean section as maternity practices that have negative effects on breastfeeding. These practices affect the infant's behavior at the time of birth, which in turn affect the infant's ability to suckle in an organized and effective manner at the breast. A cesarean born baby is less likely to be breastfed and to benefit from the positive health outcomes associated with breastfeeding.

The Healthy People 2010 objective is for 75% of mothers to initiate breastfeeding, for 50% to continue exclusive breastfeeding at 6 months, and for 25% to continue breastfeeding until at least 12 months. The increasing cesarean rate puts this objective in jeopardy. The American Academy of Pediatrics Policy Statement, "Breastfeeding and the Use of Human Milk," documents irrefutable advantages for infants, mothers, families, and society from breastfeeding. Advantages include health, nutritional, immunologic, developmental, psychological, social, economic and environmental benefits.

Although the rise in cesareans for low-risk women was seen in women of all ages, and racial or ethnic groups, surprisingly the number of healthy teen mothers who gave birth by cesarean increased by 35% since 1996, greater than all other age groups. In 2003 almost 17% of childbearing women under 20 years of age had a first birth by cesarean.

Given the nationwide lack of maternity care services supporting VBACs in the US, CIMS anticipates that the overwhelming majority of these young women will have repeat operations in a subsequent pregnancy exposing them to continuing health risks and complications they otherwise would not experience with a vaginal birth.

In its ongoing efforts to improve birth outcomes CIMS is sponsoring the Fourth Annual Evidence-based Forum at the Radisson Hotel, Boston, February 23-25, 2006. The three-day event, Mother-Friendly Childbirth: Closing the Gap Between Research and Practice features Dr. Christiane Northrup well known obstetrician and author, and Michelle Lauria, MD of the Northern New England Perinatal Quality Improvement Project, a consortium of maternity care providers, hospitals, and insurers in the states of Vermont and New Hampshire which encourages and supports VBAC.

The Coalition for Improving Maternity Services (CIMS), a United Nations recognized NGO, is a collaborative effort of numerous individuals, leading researchers, and more than 50 organizations representing over 90,000 members. Promoting a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. CIMS developed the Mother-Friendly Childbirth Initiative in 1996. A consensus document recognized as an important model for improving the healthcare and well being of children beginning at birth, the MFCI has been translated into several languages and is gaining recognition around the world. To learn more about the Mother-Friendly Childbirth Initiative, go to http://www.motherfriendly.org.

Contact:Rae Davies, Executive Director
Phone: 1-888-282-CIMS
Fax: 904-285-2120

Lawsuit for Premature Caesarean

2005-12-28T17:07:00.000-07:00

In my promise to peruse obstetrical blogs, I came across Kevin, MD's Blog on prophilactic cesarean for PROM (premature rupture of membranes) & breech presentation. It seems the premature delivery caused the baby adverse health consequences for which her mother is suing the attending physician and the hospital. See Kevin's Blog & NWAnews article for more information.

There are numerous responses to Kevin's blog. Though some go completely off topic, I agree with the inanity of many medical lawsuits and the subsequent CYA tactics physicians and hospitals undertake to reduce their liability risks. Believe me I have heard them all when it comes to obstetrics. But let us look more closely at this case, from my laymans point of view. Mom admits inlabour with PROM. Baby is found breech and mom continues to labour as they call the physician. The physician, upon hearing both ROM & Breech, orders a caesarean over the phone. Now, let us look at the risk/benefit ratio of surgery to vaginal delivery.

Baby is breech, but we don't know actual presentation (frank, footling, complete). There was no infection (already assessed) and an ultrasound four days earlier proved prematurity (reports don't reveal how many weeks gestation). Uumbilical cord prolapse would most certainly have been ruled out (via FHT) as this was not an emergency given the reported reasoning for the surgery. So we have a mother labouring normally preterm with no infection, no cord concerns and a breech presentation. The real risk of a cord concern is now low given that her water has already broken and the cord didn't descend with the waters release. Yes there will always be a risk of nuchal cord, short cord, etc. but these are managable with a skilled attendant.

This leaves one thought. The physician doesn't have the skills to attend a breech delivery. Completely plausible in today's cut-when-breech mindset in obstetrics based on an imperfect Canadian breech trial. I continually find it shocking that even obstetricians don't have breech experience when they are the so-called experts on high risk deliveries. I can somewhat excuse the delivering family practitioners who are unable to gain that vital experience, like I witnessed at a rural Canadian hospital some years ago. My client was sectioned despite her clearly textbook perfect breech labour (no meds, frank breech, quick labour, baby already "bumming" on admitting) by the family physician who was also the head of obstetrics in that hospital. This physicians fear was palatable when ordered her cesarean and he literally ran out of the room after voicing his decision, leaving everyone in the room shocked. Yes physicians are human, I am the first one to admit that. I have seen firsthand the effects of PTSD on attending physicians who had experienced a previous bad outcome. But compassion comes with humanity, especially when in the office of healing, and I am left wondering if the physician in the story above did not have a similar fear or lack of experience. My heart goes out to everyone involved in this sad case.

YWCA Women of Distinction Nomination

2005-12-28T16:23:00.000-07:00

Well the cat is out of the bag, thanks Claudia! I have been nominated for the YWCA's Women of Distinction Award for "significant contribution or outstanding achievement" in Health, Social Sciences & Social Services. I am honoured, humbled and still pinching myself for your thoughtfulness Claudia. I hope to see you too at the Gala Awards in June!

Three Princesses

2005-12-28T09:20:00.000-07:00

Christmas was a blast and the kids had so much fun spending time with their cousins over the holidays. I posted earlier this month about the princess dresses and indeed they were a hit with the three girls. Here are the three princesses with my maternal grandmother Alice Skalin who is soo proud of her great grandchildren, all seventeen of them.

Breanna is in Cinderella's pink ball gown, Olivia is in Snow White's blue ball gown and Taylor is in Sleeping Beauty's magnificent caped gown with the red and blue bodice.

Here is the gang opening presents. Clockwise from top left, Taylor (my youngest sister's daughter), my dad Reg, Eric (my eldest), Grama Skalin, the back ofOlivia's head (my younger sister's daughter), Breanna and me (the back of our heads), and Brendan (my youngest son). To the immediate right of the picture is a couch & chair with my sisters and our collective husbands. Behind the camera are my aunt and uncle (Mom's sister and her husband), my Mom and Ryan (my middle son) who took the picture.

The Spoils of... Partying

2005-12-23T21:14:00.000-07:00

Just look at our little princess, post-Christmas party! Cookie decorating, Piñata breaking and the subsequent stash of candies she has been working steadily through (see bag of candy she is holding and the wrappers strewn over the floor) were only the start. We also played pin the nose on the reindeer, watched a Charlie Brown movie, and she didn't realize she missed the gifts - which we left for tomorrow (so much to do, so little time!). A happy princess indeed.

Quiet Waiting Turns to Feasting

2005-12-22T12:55:00.000-07:00

Advent, a season traditionally reserved for prayer, fasting and anticipation, is quickly closing as we prepare for Christ's Masse, or the celebratory feasts commemorating the birth of Christian Saviour Jesus Christ.

As the eve of Christmas fast approaches, I hope each of you is ready and relaxed. Here, the cookies have been baked by the children with care and the presents are wrapped and stuffed under the tree. The outdoor Christmas lights never did make it up, but the decorating the kids have done inside more than makes up for it. I did get my cards all mailed this year, though some didn't make it out until last week.

Here is the Christmas picture I sent to family this year. It was a challenge indeed to get four children all looking at the right place at the right time with even a semblance of a smile, I hope you like the result! Left to right: Brendan (5 1/2), "pony", Breanna (2 1/2), Eric (14) and Ryan (11 1/2).

As we will be spending time with family and friends over the next few days, I wanted to blog now to avoid missing sending a Christmas message to all of you entirely. Our family would like to wish each of you a wonderful, amazing and peaceful Christmas celebration with your families and an incredible 2006!

Intelligent Design

2005-12-21T04:08:00.000-07:00

Today marks an incredibly sad day in US history as a Pennsylvania judge rules that intelligent design cannot be taught in biology because it smacks of creationism. Intelligent design holds that living organisms are so complex that they must have been created by some kind of higher force. This is in direct contrast to evolutionism, a theory developed by Charles Darwin (1809-1882), whereby man - and everything else - evolved because of random heritable genetic mutations (changes).

Associated Press writer Martha Raffaele reports, "A six-week trial over the issue yielded "overwhelming evidence" establishing that intelligent design "is a religious view, a mere re-labeling of creationism, and not a scientific theory," said Jones, a Republican and a churchgoer appointed to the federal bench three years ago."

OK let's get the facts here. Two scientific theories are in direct contrast to each other. One is stating that we evolved into what we are today and the other stating that a higher force created us. So why not teach both? Simple question. Because one is believed to be a 'religious concept' and as such "violates the constitutional separation of church and state." Wow.

So what you are saying is that simply because one theory is based on our needing to believe in a higher power, my children would not be taught that there are two theories to our existence on earth? Well, there is yet ANOTHER reason I am homeschoooling. I encourage my children to learn to challenge and study and come to their own conclusions, WITHOUT government censuring based on symantics. My 14-year-old is studying Biology this year. We are learning using Apologia's curriculum and exploring both theories. Believe me, he is learning with all the science (or lack thereof) supporting each theory - and no government censuring. It is his right to know.

VBAC Today

2005-12-15T13:40:00.000-07:00

From moment my family physician and an obstetrican decided that a caesarean was needed during my first labour, despite all evidence to the contrary, my whole world has revolved around caesarean and VBAC issues. The trauma I experienced from that decision effects me to this very day, though now it is in positive ways instead of the intensely negative ways it haunted me for years previous. My eldest son's caesarean delivery was fourteen years ago this month and I now see his birth as a blessing.

VBAC (vaginal birth after caesarean) was a viable and even preferrable choice for all women who had experienced a previous caesarean in the 1990s. With the low risk of 7 women in 1000 possibly experiencing a uterine rupture and 5 out of those thousand babies being compromised by complications resulting from a uterine rupture, VBAC was stronly encouraged. A high success rate, especially for women planning an HBAC (home birth after caesarean), ensured a low caesarean rate for women, physicians and institutions.

Then a funny thing happened. Obstetricians in the US found that their promise, to ensure a healthy baby with every pregnancy, was backfiring on them. They found that women, when faced with a fetal demise or compromise were suing the very physician who promised perfection. Interesting how that works. But instead of providing a better educational support system for their patients, they chose to limit their choices... severely.

With an already rising caesarean rate ACOG (american college of obstetricians and gynecologists), the trade union representing US Obstetricians and Gyaecologists, decided that despite the evidence to the contrary women wanting a VBAC could only labour in hospitals equipped with 24-hour ORs. With a primary caesarean rate already over 20% (despite WHO's recommendation that any caesarean rate over 10% increases the risk to both mother and baby because of a surgical delivery) this would automatically skyrocket the caesarean rates and would greatly increase the risks to mothers and babies. Well the CDC just reported an almost 30% caesarean rate in the US and an infant mortality rate so horrible the US ranks at 36th in the world.

Canada is no better, their own caesarean rates are rising right along with the US even though their organization, the SOGC (Society of Obstetricans and Gynaecologists in Canada) is much more evidence based in their guidelines. Given that they rank 22nd, and with socialized medicine, this is deplorable.

Here I am, mired in the statistics of it all, while I watch women shattered by their forced caesareans and yet I also see the miracles women experience in this dire pro-caesarean medical nightmare who have amazing VBAC births.

Case in point, last week a wonderful, well-educated woman went into labour with the complete support of her physician for her planned VBA2C (vaginal birth after two caesareans). Yet upon entering the hospital, she was told she would have to undergo another caesarean simply because her pro-VBAC physician was not on call. She is now recovering from her surgery and the nicked bladder she received because of her unnecessary surgery. She has a lot of healing to do, both physically and emotionally. In the same city another mother scheduled her ERCS (elective repeat caesarean section) based on her scaregiver's fear of uterine rupture which was then placed on her. Upon admitting was found to be in labour and she gave birth vaginally later that day despite her initial decision to birth otherwise (though she was thrilled).

Where is the logic in this? Women fight and fight for their right to birth vaginally, only to be coerced into surgery, or worse, given no choice. It is indeed a sad and scary time for birthing mothers. It is these very mothers that I support. Emotionally, informationally and physically during their pregnancy, after their births. It is their perinatal professionals that I train to support them, educating them about the unique fears and hurdles scarred mothers face. It is my passion to provide that support, information and training. So thank you to my self-focused, arrogant physician who wanted his weekend free the Friday I was in labour with Eric.

Morbid Obesity

2005-12-14T08:12:00.000-07:00

The other night I was watching a documentary on the "750 pound man." I know, I know... I watch so little TV as it is and I am watching that? Well for me it was more of wanting to know what it is that leads a person to morbid obesity and, in the case of John, the person profiled in the documentary, what kept him bed-ridden for 7 years. I mean obviously he had an enabler, but I wanted to know more about the whole dynamics of this. I learned some very interesting things and the answers to many of my questions.

1. What caused him to be bed ridden? I couldn't understand someone simply diving into bed one day and laying there, day after day, growing heavier by the minute. In John's case, he was at home when his knees suddenly gave out on him and he crawled to his bedroom and his bed to heal his knees. His knees never supported him after that.

2. Why didn't he lose weight? I know, the obvious answer right? Well I was surprised at some of the obvious answers to this. First, when a person is bedridden, they have very little control over life and one of the few things they can control is what they eat. Given that someone has to provide for them, emotionally it is a very difficult situation complicated by a level of depression (on everyone's part) and in the case of his enablers, wanting to give him something to help him emotionally too. The second one was even more obvious now that I think about it, a person who doesn't move doesn't use many calories. Once a person is not moving, muscles waste away reducing the caloric expenditure even more. Even a strict diet (which would be devastating emotionally) would yield a very slow weight loss because of the lack of calories expended.

3. Who was supporting him, both financially and well, food-wise? His wife and sister did, both of them wanting the best for him and loving him very much. He had complex health issues which further complicated his condition, the biggest one being diabetes, and they were constantly trying to stabilize his body nutritionally and his blood sugar levels, but were unable to do so. Given that, both of his enablers were obese (not nearly to the extent he was though) and love to them also equaled food. A difficult situation with, I doubt, few supports from the community.

4. Why didn't he exercise? In watching the footage, they home he was in during the documentary (he was living in a nursing home that specialized in obesity) tried to support him with physiotherapist support. But at 750 lbs he was only able to be in one position. His muscles had wasted away and he was no longer able to move much beyond pulling himself with his arms a little. To lay on his back made him breathless because of the crushing weight of his abdominal fat, to the point that his ribs were ready to break. Being in one position (on his left side) made it difficult to exercise at all.

5. And finally, what is morbid obesity? The definition is a BMI (body mass index) of 30 or more which is essentially double your ideal body weight.
I watch as my sister very slowly creeps into obesity as I slowly from the cusp of the very same and I want to help understand better the complex reasons for this so that I can better support her, after her precious baby is born in February that is! What a reason to want a healthier lifestyle than for your children. I know there is more to it than that (like the sleepless nights and constant demands of a newborn that play havoc on even the most dedicated), but I want to be there for her too. I love you sis!!

Family and Community

2005-12-09T12:18:00.000-07:00

I have been thinking about this a lot lately, the dynamics of modern day families. Family togetherness is vitally important to me as I view the family as the first community, from which all relationships develop. A close-knit family teaches children the vital skills of communication, empathy, sharing, and... well, the skills needed to succeed in life.

I have always felt strongly about families being close, including eating together, spending quality time together, and working together. For me, this includes NOT having a TV in every room (where individuals can simply move to another TV set to find the programming they prefer), sharing bedrooms (why do we insist on separate bedrooms for our children when we as parents share a bedroom with or spouse?), and sitting down to share a meal together as much as possible for at least one meal a day. Oh and don't forget doing chores together, cooking together, sharing fewer great toys rather than many seldom-used toys, and playing together.

Well, in our house, things are getting a bit frustrating for me. It started with my learning that my husband is a TV-a-holic. In the almost 20 years since our wedding things have changed a bit, with me relaxing about TV watching and my husband watching less while being more discerning about what he watches. However, it really started to slide with the purchase of a second TV that was for our family room and would be for movies and Game Cube use only (no satellite receiver). I agreed, seeing it as a place we could go as a family and watch a show together with... and allowing me some peace from Game Cube play while working in the kitchen (right off the living room).

Fast forward to today where we have three TVs, a Game Cube, an X-Box (which I railed against to the bitter end because of the violence of the games for this system), and two computers (one a laptop). The worst allowance on my part in all of this was the family room TV moving to our room when we moved here (with an unfinished basement, we had no other place for it). It was with the agreement that it would move out of our room the instant our family room was finished. Yeah right. Allan, the former TV-a-holic has always had difficulty falling asleep and finds TV as a way to relax and allow sleep to come sooner. With his crazy work schedule he often is up until 1 or 2 in the morning unable to sleep, having to work at 7 or 8 the next morning. Well he now says it’s easier to fall asleep while watching TV in our room. I know the reality of that, it doesn't matter where he watches TV, he is still up to the same time... but with the TV in our room, it disturbs my sleep - and I general sleep like a rock. But I can't convince my husband of this and am at a loss, not to mention I can’t lift the darn thing to move it myself.

More importantly, I am also seeing our family spending less time together. Rather than discussing and negotiating about what we will watch or do, individuals gravitate towards their own space, or TV, to do or watch what they want rather than spending time together. I also see how this affects relationships, where a "me" mentality develops rather than a "we" mentality needed for interpersonal relationships. I see this most poignantly in our third son who struggles with language delays and his strong personality providing even more concern as he struggles to communicate.

We will be spending much less time from this point doing individual activities and much more time communicating, negotiating, sharing, and being with one another. And I will do everything I can to move that TV to it's proper place if I have to roll it down the stairs. "If Mom's grumpy (from lack of sleep), ain't nobody happy!"

Pretty Princess

2005-12-07T17:39:00.000-07:00

Yesterday saw my last Christmas shopping journey to Wal-Mart and what insanity that was! Brendan wanted everything he laid his eyes on, to the extreme. Mommy was not a happy camper dealing with his constant whining and only by virtue of this being our last trip did I not leave the store. Eric and Ryan were great, focused on getting what they needed for their "$20 gift" (more on this in a minute) but Breanna kept cart hopping, in and out, from one cart to another (we usually bring two, one for the two littles and one for purchases). That added interest to the frustration, believe me.

This last shopping trip included three dress-up dresses for Breanna, Taylor (my sister's 5 yo daughter) and Olivia (my other sister's 3 yo daughter). Princess dresses to be exact, Cinderella, Snow White and Sleeping Beauty. Breathtaking things they are, all flouncy with a full skirt and crinolines, satin and lace. Well I knew in a heartbeat which one my little princess wanted, the pink one. Cinderella she will be and it will be a very well used dress as she loves to wear her dress up clothes all the time.

Well, Princess Peanut (aka Breanna) found the darn things this morning in my hiding place under my bed. I would have had them wrapped already but I can't find boxes that fit them in all their crinoline wonder. So she quietly and quickly stripped down and doned her new find, so very excited and so very happy. Christmas happens but once a year... well apparently not at our house this year. I didn't have the heart to take it away and immediately plan B was hatched. I would let her wear it today and wrap it to be opened again, and I am sure just as happily.

She changed after lunch, wanting it "cleaned" because of a slight spot of ketchup on the sleeve and I obliged her, putting it carefully in the laundry room per her request. Now to clean and wrap it, along with the other two, quickly before she remembers it again!

Now, about the $20 gift. My family every year has each adult member (my two oldest boys opted in to the fun this year) buys and brings a $20 gift. We put the whole lot into the center of the room and using a deck of cards, go around the room opening each gift as we go through the deck (ace of spaces first, king of hearts last - if we have that many there). Now you have a choice when it is your turn, open an unopened gift or take one of the already open gifts and give an unopened gift to the person you took the gift from. It is loads of fun!

Liberal Government and Day Care Spending

2005-12-06T07:22:00.000-07:00

I rarely discuss politics except with close friends, and never in a heated matter, but with an election coming up things have been interesting. My almost 14-year-old was very excited last week when he read in the news about the GST going from 7% to 5%. I explained to him in somewhat of a nutshell about campaign promises, why we are facing an election in the new year and of course that is tainted by my own beliefs about our current governments, both federal and provincial. I told of promises kept (Klein's debt elimination), blatant lies (Liberal promise to scrap the GST entirely) and the compromises in keeping promises (reduced spending in Alberta) that frustrates us in some ways.

Well, I will not be shy in my dislike of politics and the smoke and mirrors that fog almost every issue. One thing that does piss me off royally is the blatant spending of the Liberals. As we spiral further and further into debt, Martin pledges an additional $6 billion for day care over the next five years. To me this is just another way to further degrade families. Mothers who want so desperately to stay home and parent their children are instead forced to work in order to make ends meet far too often today. Why can't this money go towards families, who can then choose to spend that money as they wish, towards daycare or towards paying bills so that children can have parents instead of surrogates? I know why, because government doesn't trust its citizens to spend that money wisely. Well we need to only look to our federal government for a role model, right? NOT!

I know this is a long-held debate, but I do know that as a stay-at-home mother who makes difficult choices every day that impacts her children because of her lack of income, it isn't fun. Could the Liberals support families for once Paul Martin?

Fake Formula in China

2005-12-06T05:56:00.000-07:00

It deeply grieves me to read of infants who die at the hands of companies who knowingly produce substandard infant formula. It is all about saving a buck and at the expense of the innocent. Yesterday Associated Press reports that two factory officials that produced the nutritionally compromised Lezichun brand formula were jailed.

Yet what grieves me much more is the fact that infants are receiving infant formula at all. In studying the Chinese culture and it's beliefs surrounding the perinatal period, I see many reasons why. But with such a rich history and formula only available in the last 50 years, could they not look back and seek the wisdom of their ancestors? Can they not see that mother's milk is the best for their precious children, especially in light of the huge formula problems that plague their country right now? Twelve infants have died from substandard knock-off formulas. Or in the case of the Guiyang Sanlian Milk Company, repackaging out-of-date formula to keep them on the shelves last year. Heck, even Nestlé was accused of compromising their formula by not using whole milk. Their answer:

Nestlé China pointed out that it deliberately used skimmed milk in its infant formula because whole milk is considered to contain too much protein for young babies to digest. It also said that added fatty acids, minerals and vitamins were a necessary addition to create a balanced nutritional content. AP 18/03/2005

I won't go there in terms of what formula is made of (anyone using or considering using formula should be very well aware of the crap that goes into it) or of Nestlé's own blatant marketing strategies that are compromising babies every day (a great expose on this can be found in Dr. Jack Newman's breastfeeding books). Mother's are "sold" on the idea that formula is just as good, yet in the end can't afford the huge cost of formula .

Mothers and families have to realize the choices they make are important, none more so than those surrounding the beginning of life, as it sets the stage for their child's entire life. Children are resilient, that is a fact, but smart choices by parents is essential for their health and well-being, and none more than during the first three years when brain development is at its peak.

Eating Well

2005-12-04T16:28:00.000-07:00

I am ready to do this, return to a healthier weight. I am just barely tipping the scales of obesity and though am down 10 lbs since moving here (removing stress = less eating), I do have a ways to go. It is funny, but I rarely see myself as heavy, contrary to my husband who has always seen himself as overweight, even when he wasn't. Every dream I have I see myself as slim, flexible, strong and healthy. I have never, ever dreamed of myself overweight and indeed most of my waking days I don't feel overweight at all... unless I am dressing or (shudder) shopping for clothes. Even that has become much easier since I found Cleo (www.cleo.ca) which carries great fitting clothes for my body type (big hips and a small, short waist).

But I digress. Ann Douglas blogged about EATracker, a free nutrition and activity tracker from the Dietitians of Canada. I have had fun playing with it today apparently I eat properly (for the most part) but don't exercise enough. Welcome to being a Canadian in winter. In the same breath, I love exercise. Especially free weights and circuit training (keeps things from being boring). However, I have not been disciplined enough since spring to keep a regular exercise routine together. Given that, being a mom/wife/volunteer/business owner keep me off my laurels enough that I was active enough to get a "green star" today. We shall see what the future holds! Check it out for yourself.

Mediated Learning

2005-11-28T17:37:00.000-07:00

Our homeschool facilitator, during his visit in November, suggested we explore mediated learning for Brendan as he begins grade one next fall. Having just read an introduction in our homeschool newsletter about it, I am very excited about this idea, not just for Brendan but for its implications in assisted learning for all of our children.

In reading about Mediated Learning at www.iclep.org I also came upon an article which further engrained my long-felt thoughts on early detection. Such a key part of our current medical model, "early detection is marked by the fact that the preventive steps to be taken may have iatrogenic effects, but compared to what might happen as the full fledged condition comes to expression, it can be considered a risk well worth taking, and to have a meaningful priority of action." Having seen first-hand the detriment of prophilactic interventions in normal physiological processes like learning and childbirth, I am vitally aware of the risks of 'early detection' as it were.

The article goes on to clarify, "the extension of the early detection model to areas related to the psychological, mental and developmental conditions of the individual creates a large number of questions as to the nature of the effects that early detection may have. There are two types of risk present in early detection. In the first type, produced by the use of minimal signs in order to form a diagnosis, the potential is there to over-attribute the meaning of certain signs..." Wow, how often is this very point seen in both developmental delays and birth? Let us not support the parent/child triad (or diad, if the case may be) by supporting the family, no. We must remove the child to a richer learning environment surrounded by others who have learning difficulties and trained specialists to guide them. Oh, and the earlier the better! The same goes for birth, let us take the smallest symptom or anomaly compared to "average" or "normal" paradigms and we must intervene! What about supportive care of the birthing mother within the wide range of normal?

Does anyone see the reasoning for both separation of a challenged child from the family unit or the constant prophilactic interventions placed on a birthing mother? I see it as two-fold. First it was seen as an improvement to expectant care, scientifically based (or theoretically so) of course. Slowly that evolved to a more potent reason, financial incentives. How can we make money supporting a challenged child or a labouring mother? Certainly not with a family-centered, hands off approach... let us intervene were possible to improve what is happening. But I digress...

Mediated learning can go both ways, but right now it will be a tool for this mother to support her languaged challenged child, born via cesarean section because of his mother's labour being atypical in length, within the family unit. This depite repeated pressures by specialists and society for a more institutionalized approach. Sorry, not in this family! We learned the hard way that institutions, while good in rare occasions, certainly will not be the standard way of doing things here. I am very excited about this opportunity to further support my children as they learn and grow to become strong individuals.

Educational Series

2005-11-24T20:05:00.000-07:00

I am having too much fun, can I make money writing great informational handouts (or white papers or fact sheets, whatever you want to call them)? I just finished writing a complete set of handouts on prenatal exercise which include: Prenatal Exercise Overview, Stretching, Basic Exercises, Pelvis & Lower Back, Pelvic Floor, Abdominal Muscles, Abdominal Muscle Separation, Shoulders & Upper Back, and Legs & Calves. These will be part of my newly envisioned During Your Pregnancy series which will cover the unique experiences pregnancy brings to women. I have also finished Physiological Changes in Pregnancy, Posture, and Relaxation as part of this series with many more to come.

Not to leave it at pregnancy only, I am working on After Your Birth series of which I have fleshed out Postpartum Exercise, and Postpartum Recovery. These too will expand to encompass more great information for after the baby's birth.

The Fallout

2005-11-24T08:15:00.000-07:00

Why is it that every time after a big event, or even a not-so-big event, I have a couple of days down time? I feel like I am coming down with something, and maybe I am. It is amazing how the absense of my favourite hormone, adrenaline, can send me into a funk. Regardless, I have been working on some GREAT information sheets about prenatal exercise, relaxation, the physiological changes of pregnancy, abdominal muscle separation, posture and more.

In talking to the chiropractor, wellness practitioner and massage therapist who I work with, I again heard of the need for women to understand that pregnancy is NOT a time to sit back and relax. Moreso now than ever, exercise is an important... no vital aspect of health and wellness. Not just for maternal health (bone density, spinal health, and increased weight concerns), though that is vital as it is also a direct link to fetal health, but for the pregnancy itself (avoiding PIH & GD) and fetal outcomes (dramatically reduced preterm delivery risk with all that entails). Vital information for moms who need to understand pregnancy is a normal physiological process - while being bombarded by the pathology of pregnancy and birth that oozes from almost every obstetrician I know.

Brain works

2005-11-21T12:45:00.000-07:00

In reading Milliner's Dream today she asked a question, How smart is your right foot? Too much fun in learning how your right and left sides work together. Now try alternating, left foot and right hand or right foot and left hand. In our family some found no connection (foot didn't change direction) and others found they couldn't keep their foot from changing. Our brains are so amazing, some with right/left hemisphere's connected well and some with connections still in progress. Gotta love experiments like this for homeschool psychology and science.

Open House Today!

2005-11-20T14:27:00.000-07:00

Our Immanuel Healthy Family Ministry Open House was today and we had so much fun! Presenting our ministry to our church congregation was our focus today and it was a wonderful way to inform everyone of what we have been working on and the new services available.

A lot of hard work lead up to this event and everyone pulled together beautifully! Linda, Immanuel's massage therapist, was also giving 5 minute massages and had great information on her Infant Massage classes for parents. Rachel's Vineyard (post abortion healing ministry) had a display and even Sandi, our postpartum doula who had a meeting today was able to postpone it and attend. Thus our entire ministry was there to answer questions and celebrate our Open House with all of our friends at Immanuel.

Our tables before the event, there was no way to get pictures after because it was so busy! We forgot the duct tape (the only tape that sticks to cinder blocks) so we had to put our sign on the table and the posters above, but everything else came together beautifully!

Deanna Rennich, our birth doula discusses the finer points of doula support with Cowboy Randy.

Immanuel's Healing Centre also had tables with their information available.

I am so excited about the success of this event and can't wait until our Healthy Family Fair in February when we officially launch our Ministry to the community!