Cesarean Rates at U.S. Hospitals

Before selecting a hospital because of fancy birthing suites, your doctor delivers there, or even proximity to your home, I would advise you to research their cesarean rates. Cesareanrates.com provides valuable stats and information that could help you make a decision that could mean the different between a vaginal or cesarean birth.

You'll find:
*State cesarean rates from 1990-2010
*Cesarean rates, induction, usage of vacuum or forceps and more for individual hospitals by state
*A list of which hospitals in the state allow vaginal birth after cesarean

Often the greatest way to prevent something from happening is to avoid putting yourself in a risky situation. Make sure wherever you decide to give birth you feel safe and comfortable with their staff, policies, statistical history.

Newborn Birth Injuries: The Untold Story

As an advocate of natural childbirth, I strive to educate women on their bodies and how to best work with them during labor. So many complications present themselves because of induction, epidurals, and medical providers anxious to "treat" labor instead of working with it.

This video portrays the sad reality of brachial plexus birth injuries and how to prevent them. Two keys that I took from this video: Choose your health care provider carefully, and stay off your back.

Informed Consent

Labor is unpredictable and different for every woman. Even a first, second, and third labor for the same woman will be completely different experiences. Depending on where you choose to give birth, your health care provider, how your labor is progressing, and how you are coping with it, you may be offered a variety of interventions. These could include drugs (such as pitocin or an epidural), mother procedures (such as an episiotomy or cesarean), or infant procedures (such as eye ointment or immediate cord clamping).

I would suggest taking the time while you're pregnant to learn about common procedures. However, in the moment, you may not remember everything you learned or may be reacting on emotions or medical advice. Remember, this is your birth, your body, and your baby. Oftentimes one intervention will lead to another. Anytime a procedure or intervention is suggested, it is wise to ask questions before agreeing.

Referencing Husband-Coached Childbirth by Dr. Robert Bradley, listed are some questions to ask.

1. Is the mother okay?
2. Is the baby okay?
3. What is the problem?
4. What are we afraid might happen?
5. If we choose this procedure or drug(s), what other things will be necessary?
6. How much time do we have?
7. Could this be normal?
8. What other choices do we have?

Some situations, such as true fetal distress, may require you to make a decision quickly. However, much of the time you can ask questions then talk privately to your partner or support person about what you truly want to do. In the end, you want to feel comfortable with your decisions and look back on your birth experience with no regrets.

Marcy's birth testimonial about being flexible with your birth plan

I met Aubrey by chance. I was chatting with a friend of a friend about my birth plan. I wanted a natural birth but I wouldn't be able to attend a birth class and had only read books about the process. She suggested I meet her friend Aubrey who was a doula. I jumped at the chance to speak with a doula about what kinds of services she could offer.

When my husband and I met Aubrey we knew we wanted to work with her. She was so positive and encouraging. I had some concerns about how well I would cope during the natural labor process and wanted to be able to have access to an epidural if needed. Aubrey was very supportive and helped me come up with a birth plan. She also showed me really helpful moves to cope with labor.

When the big day arrived my mother, my husband and Aubrey were all there as support. We fell into a rhythm of helping my body get ready for this baby. There were times during the labor process when I couldn't articulate what I needed to cope but Aubrey intuitively knew what I needed and when. She was a great help for my husband, giving him direction to help comfort me.

After 14 hours of laboring naturally, I chose to have medication. Though there is some relief with an epidural, there are times when the pressure felt a lot like pain. You'll need those precious coping techniques to handle labor when the medication wears off and you have to wait for the doctor to arrive to administer more.

Aubrey was fantastic at reminding me about my birth plan, answering my questions about laboring in a hospital, helping me cope with labor (both medicated and unmedicated) and empowering me as a woman.

For these reasons I will always recommend a doula for every kind of birth.

My mother told me afterwards how she will recommend a doula for my other sisters. There was a scary moment during the birth of her grandchild when she decided she really is ill-equipped to help support a laboring daughter when she was so terrified herself. She was so grateful for Aubrey and her calm and knowledgeable demeanor.

Birth Class December 3

Saturday, December 3, 2011 will be my first birth class in the Phoenix area since moving here. I am very excited to get to know new women and help them prepare for a positive birth experience. This course benefits anyone interested in birth, planning to become pregnant, or already pregnant.

As listed in the sidebar, we will cover the following items:

* The birth process
* Hospitals, birth centers, and home birth options
* Choosing an obstetrician or midwife
* Pre-labor signs
* Doulas and how they can help
* Recognizing and coping with labor
* Comfort measures, breathing techniques
* Common interventions and how they can affect labor
* Complications, cesareans, and VBACs
* Your rights as a woman in labor
* Newborn care
* Breastfeeding
* Recognizing baby blues and postpartum depression

Again, the date is Saturday, December 3 from 10 a.m. to 2 p.m. This will be held at my Phoenix home by Desert Ridge. To register, contact Aubrey at 801-657-8050 or email aubrey@calmingbirth.blogspot.com. Cost is $75/couple (you and your support person).

Testimonial from Ashley about her VBAC

Although I only met Aubrey a few days before my delivery, I felt an instant connection to her. I just knew she would help me achieve my goals with my labor and delivery. She was so happy and helpful through everything, especially as she applied different techniques to help lessen the pain as I was having contractions. It was so nice to have her give me emotional support and encouragement during the difficult periods.

I wanted to dilate to at least a 6 before I was given my epidural, and I do not think I would have been able to do this without Aubrey there. Looking back, there were several times when she actively helped make sure my birth plan was followed. My husband also really appreciated her assistance as she helped him to understand the best ways to help me while we were at the hospital.

Aubrey was constantly at my side to coach me through labor and tell me things that were beneficial. I cannot express how much I feel like she helped me have a successful labor and delivery! I was able to follow my birth plan and my delivery went SO well in large part because of her!

Testimonial from Ayla about her natural birth

My name is Ayla Simmons and I am 18 years old. I've known Aubrey for almost a year now. I soon got pregnant after I met her. When I was about 6 1/2 months pregnant she told me she was a doula and that she would love to help me with my birth if I would like her to. At first I had no clue what a doula was. I was told they're like a birthing instructor. I told her I would love her help.

She helped me through my labor and I don't think I could have done it without her. She helped me relax and be calm and not get stressed out. Having a doula made my experience with a natural birth a very positive and moving one. I think a doula is a very wise choice. It is worth every moment. On July 8th I had a baby girl and named her Oakley. She was 6 pounds 1 ounce.

Love, Ayla and Oakley

Two beautiful births

Within a week and a half, two of my girls had their babies. I have another girl due this week so my phone doesn't leave my side. I feel so privileged to have witnessed the births of these two beautiful baby girls: Oakley and Eva. And I love being a doula. It is the most rewarding job.

Oakley was born at Orem Community Hospital. Her mom desired and achieved a natural, unmedicated birth. I was by her side for seven hours of contractions, beginning at three minutes apart. Counter pressure on her knees, deep breathing, lots of ice, and constant encouragement helped her make it through. She was so strong and bravely faced each contraction. Her baby was even posterior, and the doctor turned her as she crowned. This mom is young and I was so proud of her for setting her mind to what she wanted out of her birth experience, and making it happen. When I returned home at 8:30 in the morning after pulling an all-nighter, my husband asked me if I still want to be a doula. My answer: of course!

Eva was born at American Fork Hospital. Her mom wanted a VBAC since her first birth was cesarean. She had the goal of making it to six centimeters before getting an epidural, and she totally did it. We walked outside (with her husband), slow danced, pushed on her back, put counter pressure on her knees, kept her constantly drinking, and had her labor on a birth ball. Her midwives were very supportive of letting her body labor at its own pace, and they told us their patients never have a cesarean for "failure to progress." When it was time to push, we had a mirror brought into the room. Eva was born after 35 minutes of pushing. I saw something amazing: her umbilical cord broke after she came out because it was so short (about a foot long). I didn't know cords could be that short! Noah's was at least a couple feet long. Incredible. The midwife had never seen a cord break like that either. And on a side note, only one in five VBACs in Utah are successful. I'm so glad we beat the odds.

Let's just say I am loving this. Both of my clients have told me they didn't think they would've been able to cope with labor if they wouldn't have had me there, and they have adamantly stated they will always have a doula at their births from now on.

My midwife, Rebecca Williams, wrote this to me in an email when I told her about my first birth experience as a doula:

If we keep making a difference, even one birth at a time...the world will be a better place.

Amen.

Alternative language

If words like contraction, birth canal, or pain make you feel uncomfortable, try using substitute words during labor instead. Encourage those around you to use your list of alternative words to help you stay relaxed and comfortable with the birth process. Here are some examples of common substitutes:

Contraction: rush, wave, tightening
Pain: discomfort, pressure
Birth canal: birth passage
Dilating: opening

The words you hear during labor can help or hinder your mental process. Surround yourself with people who will constantly tell you what a good job you're doing, how strong you are, how every rush/wave brings your baby closer to you, and how your body is meant to open and birth your baby. And don't forget to tell yourself the same things in preparation for the big day — a little personal pep talk is always a good idea.

Delayed cord clamping

While babies are in the womb, they are supplied oxygen-rich blood from the placenta through the umbilical cord. Their lungs are filled with fluid which keeps the blood vessels constricted, preventing blood from flowing into the lungs. During labor, the pressure of contractions and passing through the birth canal forces the fluid up and out of babies' lungs, so by the time they're born, the lungs are mostly clear of all fluid.

After birth, the baby's lungs fill with blood, and he/she starts breathing oxygen on its own. But there is still a blood supply making its way back to the baby through the umbilical cord. This is your baby's blood. As long as the cord is left to finish pulsing on its own, and not clamped or cut until afterward, your baby receives back 21% of its final blood volume. Three quarters of this transfusion occurs within the first minute after birth. The average length of cord clamping is 17 seconds.

This extra blood from delayed cord clamping increases a baby's iron, which is especially valuable if anemia is a concern.

This extra blood from delayed cord clamping increases a baby's iron, which is especially valuable if anemia is a concern. A study conducted in Sweden, and published in the British Medical Journal, found that babies whose cords were clamped at least three minutes after birth had higher iron levels at four months of age than babies whose cords were clamped immediately; these babies also had fewer cases of neonatal anemia. The authors of the study concluded that delayed cord clamping "should be considered as standard care for full-term deliveries after uncomplicated pregnancies."

A study was published in Midwifery Today E-News stating: "To study the effect of delayed cord clamping on infant iron status, 69 newborn infants were randomly assigned to three groups at the time of delivery: 1) cord clamping immediately after delivery; 2) clamping when the cord stopped pulsating, at around one minute after deliver with the infant placed at the level of the placenta; 3) clamping when the cord stopped pulsating, with the infant placed below the level of the placenta. Two months after delivery, infants in the groups with delayed cord clamping had significantly higher packed cell volume values and hemoglobin concentrations. Less infants were anemic: the percentage of infants with packed cell volume lower than 33% was 88% in group 1 compared with 42% in group 2 and 55% in group 3." (The Kangaroo, 2nd Quarter 1999, a supplement to Child Health Dialogue, Issue 15)

Obviously there are situations when the baby may require immediate care following birth, and delayed cord clamping is not an option. However, it is something worth considering if it's a possibility.

If you are interested in learning more about saving your baby's cord blood (which is full of stem cells that can help should your child get leukemia), check out Cord Blood Registry (click on the name).Saving cord blood requires clamping the cord soon after birth, so delayed cord clamping isn't an option. Look into your options and decide what is best for you and your baby.