Teen Violence

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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!

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!

Depression

I have been contemplating depression of late as my second son is doing his own healing from a depressed period this summer. Stemming from a few things, the biggest two being our two moves and the sudden death last fall of his uncle, he struggled with sadness, depression and memories which reminded him of what had changed and that he couldn't bring back. He withdrew to a certain extent from friends as well.

Depression is never an easy time and yet it is almost always a time of growth for that person and those around. Stepping back from life, reflecting on ourselves and our role in society and moving on to a better, clearer worldview is rarely a bad thing. Why then is depression so shunned?

Rather than avoiding the person experiencing this or giving advice such as "get over it" is never the right thing to do. Instead, support that person, talk to him or her and understand where that person is coming from. Refer to someone who can help such as a counsellor or pastor can make a world of difference.

My son and I spent a lot of time talking this summer as he worked through his emotions, his fears, his sadness. I gave him a journal to write in and he has been journalling since June, a huge support for him. We also visited our family physician to rule out any medical concerns such as thyroid. But most of all we talked, or he talked and I listened. He had many questions, quite a few that I could not answer, and that is OK. Knowing that there are not answers to every question is important too.

He still has his moments, but he is loving life now and the sadness is rarely present any more. He also is stronger and our family relationship is more wonderful for working through this together. My husband learned a lot about depression this summer and even found tools he didn't know before in working through and/or supporting someone who is depressed. A growing period for us all, it wasn't easy but it was worth it.

Do you know of someone who you suspect is feeling sad or depressed? Reach out to that person and spend time together, and just listen. It can make a world of difference.

Recovering...

As I slowly find and write what was lost during my JumpDrive mishap, I am finding treasures. One is a narrative by an anonymous midwife called The Vocation of Shiphrah. It discusses the peril Shiphrah faced when opposing the Egyptian pharaoh in Exodus and her own journey to midwifery through the births of her own children. Another is anecdotes, insights and notes from doulas around the world that I have clipped and saved in various locations on my computers.

But mostly, I am realizing that all that was important didn't go missing and what did wasn't something I couldn't replace in some way, shape or form. Sure the Immanuel Healthy Family Ministry business cards will take a bit to redo, the Teen Pregnancy Retreat information I will have to transcribe back into Word and the pictures of the church grounds will have be retaken. And that will wait for another day as I have more important tasks to attend to, like the upcoming Healthy Family Ministry Open House this Sunday and the online workshops I am writing for the Global Birth Institute.

Answer to Prayer

My last blog I eluded to a prayer request regretted. Let me explain what I meant. Our prayer request was simple, to ask if moving to Grande Prairie was by His hand or if God wanted us to stay in Spruce Grove. We prayed during an evening drive to Camrose and His answer was swift.

We were only at Allan’s parents for two hours when both Ryan and Brendan started throwing up from the flu. It came suddenly as we all felt fine all day. We tucked the two boys into bed with a pail at hand and a parent nearby to help if needed. The next morning Allan and Eric became sick with both staying in bed while Ryan and Brendan woke feeling fine. Later that afternoon I too became sick and Breanna didn’t at all.

How does this answer prayer you say? Because this is the very order in which each of us would be affected by a move. Ryan has been experiencing depression from the two fairly quick moves we have made in the last three years and another move would be very difficult for him. Brendan would love his GRIT DS (developmental specialist) who is working one-on-one with him for his language delays as GRIT is only available in the Edmonton area. They would be the most affected, and dramatically at that.

Allan knows that he would be moving to a very difficult store to manage because of the lack of managers and staff… similar to what he is working with now but on a more severe scale. Eric has made some great friendships here, something he wasn’t able to do in Lloydminster because those he did try to befriend were mean and hurtful. Though the move would be challenging, Eric and Allan would do fine after a while.

For me, I would miss Spruce Grove a lot but change refreshes me and I love the challenge. Finally, Breanna likely would not be affected at all because at two, life is an adventure and ties are to family not location. So our answer, quick as it was, was received with a thankful heart, even if it was the flu! The verdict: We will not be moving anytime soon.

Our only lingering concern was the effect turning down a move would have on Allan’s career. Allan’s district manager is OK with that so career concerns are gone, YAY!

When it rains...

I am very glad last weekend is over, I am still recovering and it’s Wednesday! We were anticipating a wonderful visit with Allan's parents at their home over the weekend. Everything was packed and ready to go when Allan returned home from work and we were off as soon as he landed. No sooner had we got on the road and everyone was settled in for the hour and a half drive when Allan told us of his day and the reason he was a bit late. His District Manager called him into his office just as he was leaving to ask him if he wanted to go to Grand Prairie, with a merit raise of course. He also asked that Allan not answer him immediately, but take the weekend to think about it. Great.

So we discussed the pros and cons of each of our options again, praying between discussions as to the path God wanted us to follow. I asked specifically for a strong sign that we wouldn't miss, boy was that something I regret now. We arrived and visited with Allan's parents for the evening, enjoying their company and taking sporadic breaks to arrange sleeping accommodations.

To make a long story short, Brendan and Ryan started throwing up that evening with Allan and Eric joining them first thing the next morning. I held out until the afternoon, just in time for our early drive home (we were planning on staying much longer). We only had to stop once for me to leave my lunch at the roadside, and I fell into bed the second we were home.

Sunday dawned with all of us feeling much better and off we went to church with my PowerPoint promo presentation in hand (on my jumpdrive) to announce Immanuel's Healthy Family Ministry Open House on November 20th. All we had to do was quickly add the soundtrack mp3 and show it during announcements. I was so excited! Alas, not reading instructions when using new equipment, the sound guy configured my jumpdrive, which had all of my current projects and the ENTIRE Healthy Family Ministry file on it. Yes, that means it was gone, including the last booklet in the Canadian Birth Professional series that I had almost completed. Yes I was freaking.

It wasn't a complete disaster, thank God. I opened my laptop to check to see if their computer just couldn't pull up the files and guess what I found? My book! I had been working on it on the laptop, closed the computer without closing down the program and it was all there! It didn’t have the last two hours I had done on Friday on another computer, but what a blessing it was to see it pop up, I tell you.

I have been working head down, bum up since then re-writing what I had lost, namely the PowerPoint presentation, and pulling lost files from different nooks and crannies in various computers, my outgoing email box and so forth. I have the important stuff, it is just to fill in the little things from memory and rewriting from pdf and hardcopy. See you when I come up for air!

Choleric Family

What do you do when you have an extremely choleric family? I am telling you it is not easy and I am finding that some strategies work great while others totally suck.

I have been pondering this as I watch our new GRIT Developmental Specialist working with Brendan. Extremely choleric, he demands that everything be done his way or it isn't done at all. Being that both Allan and I are of the same (or quite similar with me leaning a fair bit towards sanguine and him leaning a tad towards melancholy) we understand his personality and are able to give him the boundaries he needs, nay requires. Too many boundaries and his personality is quashed, leaving him with a mask, usually phlagmatic. Too few boundaries and he runs roughshod over everyone, demanding and beligerent in doing so.

Brendan's DS is a sanguine who wants him to enjoy his time with her, learning as he has fun. While that is awesome in theory, I am seeing this turn into his demanding everything be his way and on his terms (No, I hold my pencil like this) and his DS left wondering how she is going to address his needs within that context and being trampled by his strong personality (I am doing this, leave me alone). I will be having a talk with her about this on Monday (she is off today and tomorrow).

For those of you who may be feeling that this personality stuff is all Greek to you, take this personality test to find out more. Our family falls out like this (stronger personality first):

Allan - Choleric/Melancholy
Connie - Choleric/Sanguine
Eric - Sangine/Choleric
Ryan - Melancholy/Choleric
Brendan - Choleric/Melancholy
Breanna - Choleric/Sanguine

Teen Pregnancy Retreat

One of the products of my time away from my blog was to work with our Immanuel Healthy Family Ministry team. Our brand new birth doula, Deanna, has an incredible vision and heart for supporting mothers, especially teens. Though neither of us were teen mothers, we have been working professionally with women who were teen mothers, all of whom kept and chose to raise their children. Her vision of a Teen Pregnancy Retreat is an incredible one that I am very excited to be a part of and we are working towards funding with our first retreat set for next spring.

Our vision is of a nurturing weekend program providing empowerment, encouragement, and support for pregnant teen mothers. This program is designed to provide informational and emotional supports for expectant mothers between the ages of 12 and 18.

Our program looks to acknowledge each woman’s unique concerns and provide her with a nurturing and supportive retreat atmosphere where she can grown and learn effective ways to manage her current stress and prepare for those she will face in the future. Our vision is to enhance her wellbeing through empowering emotional and educational opportunities, professional prenatal services, nutritious meals, a resource guide and additional gifts. Our goal is to provide as many retreats as needed to allow all interested teen mothers in Parkland county attendance.

Now for the exciting part...

Preliminary Agenda
Friday Evening
Orientation, meet and greet with informal icebreakers, healthy cocktails, room allocation and moving in.

Saturday
Breakfast – nutritious breakfast with two options
Educational/informational sessions:

• Birth doula & Midwife – birth options
• Chiropractor – importance of spinal health during pregnancy
• Dietician – importance of nutrition during pregnancy
• Lactation Counselor – breastfeeding basics

Lunch – soup/salad type light lunch
Relaxation session
Educational/informational sessions:

• Massage therapist – importance of relaxation, touch and alternative therapies
• Counselor – emotional support & recovery
• Postpartum doula – physical support & recovery, baby basics

Dinner – hearty high protein dinner
Pampering session
Blessingway

Sunday

Brunch – nutritious brunch buffet
Glamour/prenatal photography session
High Tea - invite close friend, boyfriend, mother to share tea with

Being a Busy Bee & Career Options

I know I have been quiet, it has been an incredibly busy these last three weeks. ICAN's Strategic Planning Retreat preparation took up the bulk of the first week, the next week I focused on my new position with ICAN as their new International Director along with the online Childbirth Education class I will be teaching through GBI starting in January, while CDA planning and projects took up all of last week.

After a lot of discussion and careful prayer and thought, we have decided to follow our original course of action with Allan pursuing his goal of becoming a Wal-Mart store manager rather than step back and pursue another career. With the huge exception of our builder giving us an attractive offer to join his company before Allan is promoted, which will likely be next spring. If not, then we will move at least twice before we stettle again and those moves will be anywhere in Western Canada, though we do have somewhat of a choice as to where that is.

I am excited about our future, even if I am not ready to move quite yet. I knew that we would have to move at least four times to get to where Allan was able to settle us with Wal-Mart and that is OK. If we veer off that path into home building, that is awesome too. What that will mean for my career I am not certain, but it gives me time to plan and prepare for next year. God has been gracious to our family thus far and I know our future will be bright indeed.

Dilemmas, dilemmas

Wow this week has been an interesting one! Just when we are leaning towards the path of moving home, the Lord adds more reasons for us to stay here and perservere. Now perservere is not a hardship on my part as I love it here, despite the distance from family. Rather it is a test of faith for my husband who is searching for his own occupational answers.

The most exciting reason came in a phone call last week from the GRIT Program director telling us that Brendan has been accepted into their program. GRIT is an acronym for Getting Ready for Inclusion Today and provides one-on-one support in our home and community for Brendan by a team of specialists who support his Developmental Specialist (DS) who is hired to work specifically with his needs. Our interview went wonderfully with the program director on Thursday. Today we will meet their Coordinator and Speech Language Pathologist who will have a play date with Brendan to better assess his needs and he will meet his potential DS tomorrow for a compatibility play date.

Another, less obvious reason, is our ongoing work with our builder. He has several great projects that we have been working on such as building signs (an earlier blog), frost walling, deck railing and so forth. We have turned this into an incentive program for the boys and for ourselves for future things like getting the basement finished, Trileisure Center passes and holidays next summer.

In many ways I have been grieving about potentially losing the work I have been doing with Immanuel and my proposed Healthy Family Ministry (babbled about in several previous blogs). The proposal passed unanimously at church council and I am very excited about our possibly having an amazingly awesome new birth doula join our team from my last training. Our team is almost ready to run with all but one position filled and our launch being planned. I know this ministry will not only sustain itself, but grow without me, I just don't want to leave it this early!

And finally, my own work in training and mentoring doulas, childbirth educators and lactation counsellors. I have access to the perfect facility and my personalized small classes are becoming sought after when the only competition I have is Grant McEwan's birth doula class where 30 students are taught at a time, making the classes very impersonal. Don't get me wrong, I attended their very first doula training class they held and enjoyed it, but I would have given my eye teeth to have the personalized training I am able to provide now.

I should go and clean a bit before the GRIT ladies come today, oh and I have to phone a mentoring doula back. Salut for now.

Work Bliss

How many are able to not only enjoy their job, but love it? I have done many things from sell real estate to working in an autobody shop to management. Diverse occupations as I continued to seek a job that I could tolerate, nevermind like. Only after I moved to mothering did I come upon my dream job, that of teaching aspiring birth professionals. That in itself was an adventure too, moving from my own first birth experience, a traumatic iatrogenic cesarean section, to accredited trainer. Suffice as to say, the journey was an amazing learning adventure and each workshop I teach inspires and fulfills me.

This weekend I taught another accredited childbirth doula workshop, the first step towards certification through the Global Birth Institute. Each student was so amazing and I am humbled by their presence in my class, of their untrusting their first training to me. And diverse! One of my students this weekend was a professional singer, another is a mother of three who just moved to our community three weeks ago, another still is a single professional with two jobs and a wonderful sixteen year old son. We laughed and cried and shared openly about our births, our fears, our frustrations and our biases. We also learned a great deal, me about them and they learned so much about pregnancy, birth, babies and the business skills to help them enjoy their own dream job successfully. We left as friends, all eager to continue sharing and learning and growing. I will continue to support each student as she works towards certification and beyond as her mentor... a role I so love as I see each continue to grow.

I am going to sleep very happy tonight, thanking God for each step that brought me to this dream occupation I have been blessed with.

Mom's Horse of a Different Colour

My Mom has been helping me this weekend, watching over her four grandchildren (aka my herd) so I thought I would tell her of my blog... what blogs are, who my blogging friends are... we had a great conversation! My Mom is a horse lover, so she took the "What Colour Horse are You?" test. Drum roll...


Dark Bay

What Horse Color Are You?

VBAC Bans

I never thought it would happen here, in this amazing, theoretically evidence-based land where we have the priviledge socialized medicine. Maybe I was feeling smug in my theory that given SOGC's lukewarm support of VBAC (vaginal birth after cesarean) and their stance on patient choice caesareans, we would have protection from the rampant VBAC banning hospital crisis in the US.

Not so. The Red Deer Regional Hospital Centre in Alberta has announced that they will not allow VBAC trial of labour after January 1, 2006. What the hell? Does this hospital not realize that a caesarean section is riskier for mothers and babies than a vaginal birth? Do they realize that they cannot legally do this as it infringes on a mother's right to have a normal biological event, even after having a surgical event to extract a previous borne?

I find it ironic that this week a new Canadian study titled Severe Maternal Morbidity in Canada in the CMAJ/JAMC shows clear evidence that the rising caesarean rate has a lot to do with the maternal morbidity risks:

"The most common complications were cardiac arrest or cerebral anoxia -- lack of oxygen to the brain -- after obstetric surgery. There were 2,677 cases, and 37 deaths."

"The rate for uterine rupture increased from 0.58 per 1,000 deliveries, to 0.74 per 1,000. In all, 1,898 women had a ruptured uterus, and four died."

Hmm, 0.014% risk of maternal death from ONE cesarean risk or 0.002% risk of maternal death from a UR, the only VBAC specific risk. Now if we stopped induction/augmentation for VBAC mothers, a proven and huge risk factor for UR in all women, that UR rate would fall back to even lower rates. That does NOT include cesarean risks like...

"... blood clots in veins, respiratory distress syndrome, swelling in the legs, heart attack and severe hemorrhage requiring a hysterectomy [which have] increased 50 per cent or more over the 10-year period."

So, the RDRHC wants to set a precidence. Not without resistance, believe me. I am working on the fuel right now to counteract their VBAC fears, but it likely won't be pretty given that they are investigating a local midwife who does many VBACs, with excellent success I might add. Why do mothers have to combat the fears of physicians when working through their own fears in preparation for their upcoming birth? Welcome to "modern day obstetrics" where birth has been so screwed up by well meaning physicians they are chasing their tails and only traditional midwives can see the truth and light of this normal physiological process.

PS. Is it ironic that this week we have also seen a VBAC mother deliver her baby on the roadside enroute to the hospital because her local hospital didn't allow VBAC TOL. Not to mention, a US hospital (hopefully one of many) who are reversing their decision to ban VBAC TOL because, "choice should not be taken away simply because of potential lawsuits." Can I say something? DUH!!!

Busy in "shop class"

We have had a very fruitful weekend, school project wise. Our eldest is very interested in woodwork and our builder (who built our house last year) commissioned our family to build 20 signs for his company. You may have seen something similar, one sign in front of each residential building site with houses in various stages of construction. These signs are used not only to advertise, but to provide all of the trades the information on the house so they know at a glance the builder number (to ensure the work is being done on the right house), address, the owners, and if this is a spec or custom home.

This is the first ten with the remaining ten waiting for paint (which we will do today and tomorrow). It will be nice to have them finished and moved out of our garage and off of our parking pad.

Next week's class: Deck rail building followed by frost walls. Loads of fun!

What Horse Colour Are You?

Black


What Horse Color Are You?
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One Crisis Per Night, Please

All mothers, all parents know that once a tiny infant joins their family that sleep will be compromised for a while, sometimes a long while. Add more children and the interruptions to sleep multiplies exponentially it seems. Things have going well in the sleep department for a while now that Breanna is usually only waking once per night, something I can deal with most nights. Except when I can't get back to sleep because of something or other on my mind.

Last night was an anomalie and I am thankful for that because it was an adventure! With the kids all tucked into their warm beds by 9:30 I had plenty of time to do sew perineums before I hit the hay. Maybe I should clarify that. I am sewing cloth perineum models that fit over pelvic models for childbirth educators. I make the whole set actually... newborn fetal model, placenta (with membranes and umbilical cord which attaches to the newborns umbilicus), cloth pelvis and perineum. They go perfectly with the knitted uterus my sister's mother-in-law knits for me.

But I digress. I accomplished a lot, all the serging is done and dropped into bed at around 10:30. I was drifting off to sleep when I heard a noise. It was the old familiar noise of scurrying rodent. Having grown up on a farm and been the proud owner of hampsters forever, I knew the sound well and a sense of dread came over me. This noise could only be from one or both of our newly aquired miniature hampsters we had obtained last week, all of four weeks old. So tiny and precious I could hardly say no when we spotted them so we purchased two females. Once home, my husband immediately asked if their being so small would be a problem with their possibly fitting through the bars of the cage. I confidently assured them they would be fine. Right.

I found one in our bedroom and nievely thought she escaped through the slightly bigger gap at the top of the door so I fixed it and was heading back to bed when son #2 came into the kitchen coughing like crazy. Cough medicine down and with him safely tucked back into bed, I returned to bed just as Allan was returning home from work around 11:15. I fell promptly to sleep after talking to him for a short while to be woken by another hampster noise. Ack. This time the little rodent was half way up our curtain between the layers. Houdini was quickly rounded up and I brought her down to her owners who put her in another cage.

I couldn't sleep thinking of what would keep those hampsters caged and suddenly it came to me, the cylindrical metal garbage containers the boys had in their rooms. Tall straight and very smooth sides would ensure no scaling of the perimeter and a hampster cage set on top to ensure safety if that failed. So I headed back down to bring the new plan to the hampster owners. They had found in that time Houdini did indeed squeeze quite easily through the standard width bars on the cage so we put the new plan to the test and wala it worked perfectly.

Back to bed I went, falling quickly to sleep again to be jarred awake by Breanna wanting Mommy. I tucked her back to bed, again I hit the bed... for the fourth time. The screaming wasn't in my dream, Breanna was again awake and I stumbled to her room quickly to avoid awaking the entire house. She was not happy and I walked her quietly in the hall until she calmed down. Ahhh, princess peanut butter was finally to sleep as the dawn promised to unfold. Exhausted I fell into a deep sleep and this time I did get some quality sleep before son #3 came to ask me to play at 7:00. Good morning.

Parenting is not for the weak, or those who need sleep.

Caesareans and such

This has been some week on the issues of caesareans hasn't it? Let's recap.

Monday HealthGrades came out with their "study" on patient choice caesarean rates increasing 36%. Reporter Shapiro concludes his article with, "Our findings of exponential growth in the rates of women receiving Â'patient-choice'” C-sections are consistent with our conclusion in last yearÂ’s report which identified that heightened awareness, increased support and advocacy, and women waiting until they are older to have their first child, are key drivers in the increasing rate of 'patient-choice'” C-sections in the United States. We further anticipate that as these key drivers become more widespread and consensus on the utility of '“patient-choice'” C-sections is achieved, demand and rates will continue to rise. We believe that these findings demonstrate the significant impact of empowerment and consumerism among selected women in the United States."

Not only is this a gross exaggeration, most women who they are finding in their study as "choosing" a caesarean are in fact women seeking a vaginal birth post caesarean who are being coerced into it by their primary caregivers who paint a very bad picture of VBAC risks and place huge fears of uterine rupture on them. Thus they agree to a repeat surgery and are charted as 'patient choice' caesarean section. Believe me I know, I have been there in the hot seat as my obstetrician berates me for my stupidity in wanting to endanger myself and my baby to have a vaginal birth. He went so far as to say, "I can't believe you are sitting here alive one day before your due date, you should have scheduled your caesarean at 38 weeks! You know you are risking your life, don't you?"Thrice sectioned I chose a homebirth for my fourth without the fears placed on me by my physicians and the hospitals. Which NJ physician was it that said any physician can make their patient choose whatever they want simply by how they word their "informed consent" discussion? Welcome to obstetrics where evidence-based medicine is rarely performed. How could it when this is the only normal physiological process which physicians feel the need to meddle with? Midwives, good ones, know that meddling cause problems, unfortunately obstetricians haven't figured this out yet. Do you think it has anything to do with it being a cash cow for allopathic medicine?

But I digress, are you pregnant post-cesarean? Learn more about your options with ICAN's support (pdf).

Tuesday a news article (not online) tells of NC's Genesis Medical Center and Trinity Health Care Systems not banning VBACs citing patient choice and patient rights. Well, one in a thousand who actually care about their patients legal rights? I am impressed.

Wednesday afternoon Britney Spears, terrified of vaginal birth, chose an elective caesarean for the birth of her son at the last minute and is now recovering with her entourage in London.

Thursday Britney's fans reacted with a mixture of elation for her baby boy and anger at her choosing a caesarean out of fear.

Friday rounded out the week with a beautiful segment on CBS's Health Watch with co-anchor Hannah Storm, thrice sectioned mother, who "can personally attest to the pain involved with caesareans." Please watch the streaming video for the best information. It was mentioned that the National Institute of Child Heath and Human Development (NICHD) was doing a study on elective caesareans next year. Hmm, I would love to be a fly on that board room wall!

Let me conclude with the awesome work ICAN has been doing in responding to these with their press releases.

PS. I forgot two things!

Wednesday Reuters reported a new study that showed caesarean can increase risk of milk allergies and ORGYN.com
reported on the potential link between caesareans and newborn cavities as well as well as Model predicts risk of emergency after previous cesarean (you may need to register to read these, but it's free). What a week!

Welcome to Our House

We have been helping neighbours with landscaping this week, in the constant drizzle. Perfect weather for growing sod, not laying it. But we all had a lot of fun and fresh air. Breanna found a great mud puddle and quickly lost her shoes so she could take full advantage of the squishy clay. Then around the house she went to go in the house and waited there somewhat patiently while I finished up. She made a great finger painting on our door as she waited, don't you think?

Family Futures

Tonight my wonderful husband is deciding the fate... er, future of our family. I mentioned our future in a previous blog but tonight I am both extremely apprehensive and excited. We are focused on two options:

1. He has an open offer to re-join his brother's firm in Camrose with a good wage increase, great hours and vacation time and a great job. Going 'back home' is a great opportunity to be near family too, with perks like another new house which we will build this time and so much more.

2. He starts working with our builder as a supervisor and we say in Spruce Grove. We have always wanted our own business and this is the perfect opportunity to learn the building trade with our future being as residential builders. Also a wage increase, the hours we are not sure yet, nor do we know about vacation time, but also a great job. Staying here is also a great option because the kids have great friends here and there are great opportunities for them. Right now they are enrolled in our homeschool groups Sports program, our church's confirmation classes, AWANA and they have a great paper route that the love the income from.

Honestly? I am feeling apprehensive because I am right now really not wanting to move to Camrose. Yes there are so many great parts of this, but I am really... really liking Spruce Grove. I have fallen completely in love with our new church and the opportunities I have had here, both professionally and personally. I have had thrice the friends and business opportunities in the first six months here than I had in 2 1/2 years in Lloydminster or 5 years in Camrose.... well the business opportunities for Camrose, I do indeed have tons of friends there. I had no idea how attached I could get to this beautiful community when I moved here!

I am so trying to be open minded but it is being very tough. Heck if it was my husband's choice he would already have quit his job and moved... but that is because he knows what he will be going back to in terms of job and right now it is SO much better than what he is dealing with at work right now.

I also am feeling resentful because the kids are just starting all of this wonderful stuff in the community this fall and again we will be moving mid-everything... joining any new groups in Camrose after the fact which always puts kids at a disadvantage. We sure learned that the hard way with the last two moves. My biggest frustration I think is leaving my infant Christian prenatal ministry at Immanuel. I am feeling very motherly towards it and am so fearful it will not flourish in my absense. Ah the joys of motherhood, in all its forms!

Comes in Threes

It is a great myth that good or bad, things come in threes. A friend of mine reminded me of that this spring when I discussed the three incredibly positive and excited opinions of the first three people I had discussed my proposed Christian prenatal program too. She added that if three positives were given in short succession that it was an important sign.

Not one to put a lot of weight on this theory, I was pleasantly surprised today to find indeed three very similar and awesome things happened to me, one right after the other, this morning. The first was to pick up my email and to find a warm note from Ann Douglas, fellow speaker and writer, she is the author of the "Mother of All..." series and other excellent books on the perinatal period. Here is her website (one of them). She just returned home from Baby Boom, a baby fair in Ottawa and had a blast. We have been emailing back and forth about speaking in general and upcoming engagements, honourariums and so forth, exciting fun! She answered a few key questions I have been wondering about, an important email for me as a speaker.

I was leisurely skimming email again when I recieved a phone call from Dr. Stonehawker. A wonderful Christian man, he founded the only shared care maternity program in Alberta (midwives work in a hospital setting and are funded through Capital Health through a unique funding program, in a province where midwifery is not funded). The hospital it is based in is a five minute drive from my house and is a very sought after program. Anyway, as a professional member of our church, he was asked to review my Immanuel's Healthy Family Ministry proposal by church council. He took it upon himself to call me to personally congratulate me on the hard work I had done on the proposal, the program itself and how excited he was to see it's inception. He also asked if I had been in contact and had discussed this program the shared care program midwives and staff. I told him that I had talked to most of them, all of whom welcomed it with open arms. They were so excited about it that they asked if they could help promote it within their facility. He closed the conversation with his wanting to sit down with me to learn more about the program and to get to know me better. He has long been an advocate of midwivery and doula support, possibly as a result of his many mission trips as a physician.

Moving on to fixing a Quickbooks glitch, which has kept me from accessing my accounting software for far too long, I finally found the answer on their forums. I had no sooner fixed the problem had it up and running - finally, when Madeleine Hegholz called. A wonderful, passionate and very knowledgable IBCLC, she is also an RN who worked for may years as a postpartum nurse. I have always referred my clients to her first if there was a breastfeeding problem. We caught up on what each other had been doing since I moved away and back again. She told me of the exciting work she has been doing as the president of the Canadian Lactation Consultants Association and her daughters journey towards her own RN degree while I told her of my work with ICAN and my fourth homeborn child who joined our family while I was away. We said our fairwells with her promising me one of her new breastfeeding pillows she had designed and made herself. I can't wait to see it!

This left me pondering if this is a sign from God, that three so incredibly positive things that happened in quick succession, was his answer to my prayers to not leave the birth industry. Hmm.

Navel Gazing

Today has been a day of reflection for me as I recall the day the Two Towers came down in New York. Where were you?

I was home in our first house with our two boys (at the time). I had not slept well and woke up late. It was an "off" day for me, I felt really out of sorts and was making breakfast when my Mom called. Neither of us ever watch TV but she called to tell me to turn on the TV, her voice was strained. Fear seized me and I immediately ran to the TV. I went to ask which channel but every channel had the same images, scared reporters telling us that an airplane had hit one of the twin towers. As I watched I saw the second plane hit and though I kept the boys from watching, it wasn't easy because they saw the concern on my face. I explained what had happened for them to understand what was happening but I kept them from seeing the riveting images, people at the top of the towers, of those who jumped, of the towers coming down, of people running, fear, screaming, terror in the streets. I never asked my Mom what caused her to turn on the TV, but learned later that my sister had called her, her morning exercise routine including kickboxing to a video and she had caught a glimpse of the footage when she turned on her video.

How ironic that I write this as my daughter's favourite DVD Brother Bear is on. The song "No Way Out" playing in the background is almost surreal. But I digress...

Many of us have changed in subtle ways since that day, many of us focusing more closely on relationships than we had before. Others have looked at what we have taken for granted and refocused on the important. Hurricane Katrina has done that again for many of us who were not directly effected. I know I have. I have also learned a lot about myself through navel gazing as I think about these things.

One of my friends blogged on Friday about her own Navel Gazing via a personality test. I took the test this morning as I contemplated how closely her personality matched my husbands (my entire family will be taking this!), and I found myself to be INFP (Introverted iNtuitive Feeling Judging). I know, I didn't have a clue what that really meant either but it seems to be a close fit for me and interesting in light of the above:

Beneath the quiet exterior, INFJs hold deep convictions about the weightier matters of life. Those who are activists -- INFJs gravitate toward such a role -- are there for the cause, not for personal glory or political power.

INFJs are champions of the oppressed and downtrodden. They often are found in the wake of an emergency, rescuing those who are in acute distress. INFJs may fantasize about getting revenge on those who victimize the defenseless. The concept of 'poetic justice' is appealing to the INFJ.

"There's something rotten in Denmark." Accurately suspicious about others' motives, INFJs are not easily led. These are the people that you can rarely fool any of the time. Though affable and sympathetic to most, INFJs are selective about their friends. Such a friendship is a symbiotic bond that transcends mere words.

INFJs have a knack for fluency in language and facility in communication. In addition, nonverbal sensitivity enables the INFJ to know and be known by others intimately.

Writing, counseling, public service and even politics are areas where INFJs frequently find their niche.

How interesting that writing, teaching, counseling, ongoing supportive work with ICAN, and the political minefield of obstetrics (which moves, at times, far away from women's rights, fetal rights, informed consent, and evidence based practice as seen poignantly with the VBAC bans in the US) is so what I am passionately involved in right now.