Garage Sale Fundraiser for Doulas Care
Saturday, September 6 from 9am–3pm
Do you have things you don’t need but are still in good condition? Please consider donating them to the Doulas Care Program fundraising garage sale! Tax-deductible donations accepted on Friday, September 5th, from 1pm–8pm. Drop off at 722 Brooks St. No adult clothing please. Paper or plastic bags, folding tables, and VOLUNTEERS NEEDED! Questions? Or to volunteer, call Barbara Robertson 734-975-6626 or email barbaradlr@aol.com.
The Birth Project
This locally-produced quarterly magazine keeps getting better and better! Thoughtful, inspiring, edgy, informative, funny . . . The Birth Project is the brainchild of local doulas/midwives/childbirth educators/birth activists Kate Stroud, Amanda Topping, and Stacia Proefrock. Read more
Lisa Kane Low recognized as a finalist for the Ann Arbor News’ Citizen of the Year Award
Lisa Kane Low, the new volunteer Executive Director of Doulas Care, has been honored by the Ann Arbor News for her extraordinary commitment to community service for her work with the Doulas Care program. Read more
Kangaroo Mother Care
by Patty Brennan
In the Spring of 2006, I attended a Networking Conference for Community-Based Doula Programs in Chicago Illinois. The conference began with a dynamic presentation on “Kangaroo Mother Care” by Susan Ludington. Dr. Ludington is the author of two books, How to Have a Smarter Baby and Kangaroo Care: The Best You Can Do For Your Preterm Baby. Dr. Ludington’s research on KMC, which has taken her to a number of countries worldwide, has produced a solid evidence base for this practice. The basics of KMC involve removing premature babies from incubators and placing them skin-to-skin, nestled between mother’s breasts. A blanket is used on the baby’s backside to keep her warm or the baby can be tucked inside the mother’s shirt. Even babies with feeding tubes or other medical equipment can receive KMC.
The benefits of KMC include: superior regulation of the baby’s temperature, heart rate, and respirations, a lowering of infection rates, and improved brain maturation. Her research has demonstrated that brain maturation is promoted when the baby is in a deep sleep, a state rarely achieved in the incubator, but consistently experienced with KMC (not a bad idea for full-term babies either!). When KMC was first introduced in Bogotá, Columbia, the infant mortality rate dropped 70% in the first year. Researchers attributed lower infection rates to the fact that maternal antibodies were passed to the baby via the skin. If the baby is cold when placed in KMC, the mother’s body temperature will shoot up rapidly to warm the baby. Once the baby’s temperature normalizes, the mother’s body temperature will return to normal in order to stabilize the baby’s temperature. Furthermore, researchers discovered that each breast is capable of independently regulating body temperature so that, for example, a mother of twins might have different temperatures on different sides of her body, depending upon each baby’s needs. Dual climate control!
Interestingly, dads who participated in KMC were also found to have an internal regulating system – they got restless (humorously referred to as “butt fatigue”) coincident with the baby’s temperature normalizing (often after about 1½ hours of KMC). If KMC was continued at this point, the babies overheated since dads apparently do not have the same capacity to stabilize the baby’s temperature over time.
Additional benefits noted were that babies in KMC do not cry and that there is a zero incidence of SIDS. All in all, fascinating work.
Interview with Kate Stroud
Kate Tells Women: Let Birth Bring Out Your Best
by Cynthia Gabriel
“Oh no! I can’t be pregnant!”
That was the unlikely beginning of Kate Stroud’s journey to becoming a doula, childbirth educator, and bellycast artist.
Today, Kate supports herself professionally by helping women learn to trust their bodies. “I help them de-program from the culture that says birth is harder work than you can do,” she says. She has recently started teaching a childbirth education series at the Center for the Childbearing Year (CCY). The curriculum explains the full spectrum of women’s choices in labor and birth, and prepares women and their partners for the stages of labor and how to manage labor pain. Kate believes that her best gift is in helping women connect with their own inner wisdom. “I can’t teach a woman how to give birth,” says Kate. “She already knows how to do that. I’m just here to help women find out what their bodies already know.” She trusts that if a woman is supported, pregnancy and birth can bring out the strongest and best parts of a woman.
Kate’s journey to this confidence was no yellow-brick road. When Kate found out she had become pregnant on her honeymoon (on her wedding night to be exact), she cried because she knew her life plans were about to change dramatically. She had been on the cusp of moving into a solo artist studio. Together with her musician husband, Donn, she had planned to see the world before settling down. Worse, as an employee of a specialty food store hoping to become a self-employed artist, she had no health insurance to cover the cost of prenatal care and giving birth. Kate felt lonely and without help. Her pregnancy was a whirlwind of chaos and anxiety. She knew she wanted a natural birth and did exhaustive research on-line about the topic, but didn’t know where to turn for support. Until she met Heather, her doula.
Kate got matched with Heather through Doulas Care, a program that provides doulas for low-income families. Heather provided a comforting presence that calmed many of Kate’s fears. Heather was “the best thing that ever happened to me during that pregnancy,” Kate remembers. At the time, Kate had no idea what a doula was. They met when Kate was 38 weeks pregnant and Kate felt immediately reassured. Heather’s presence was “very comforting and supportive” she says. For the first time, Kate felt supported in her ability to achieve the kind of birth she wanted.
Kate was always open to the idea of a natural birth. She was the first among her friends to become pregnant and feels this was a blessing. She didn’t know anyone personally who had experienced a difficult or medicated labor. Her husband had one friend who had a two-hour natural birth.
For most women, Kate included, the most influential story is the story of her own birth. Kate’s mother had two natural births. Her mother’s doctor was from South America and he turned Kate’s brother in utero with a move called an “external version.” External versions are becoming increasingly common in the United States, but for many decades American doctors were not trained in this procedure. In labor with Kate, her second baby, Kate’s mother played gin rummy. She was most comfortable laboring in the hospital bathroom. The nurse was afraid that she would give birth on the toilet, but Kate’s mother waved off her concerns. Kate inherited an attitude that natural birth is normal and straightforward, even if it is also painful and intense.
However, we live in a culture in which natural birth, especially in hospitals, is statistically uncommon. So Kate learned everything she could to address her fears head-on. She laughs that she exhausted her printer doing so much research about pregnancy and birth on-line.
What Kate was most terrified of the first time around was becoming a parent. She teaches classes to pregnant, teenage women in Detroit and found that they shared this attitude. “I’m not afraid of birth,” one woman told her. “I’m afraid of after it comes out!” Kate believes that women with this fear especially benefit from experiencing natural birth because it sets them up to trust themselves, something new mothers “really need to do.”
Kate’s first labor was long and lasted a couple of days. Heather slept on her couch the first night and then went home to her own two kids. Kate labored at home all day in the bathtub. That evening she and Donn checked into the hospital and Heather met them there. Kate was already at seven centimeters. (A woman’s cervix needs to dilate ten centimeters during labor.)
They walked around the hallways of the University of Michigan Hospital. Transition was hard. Transition, the time it takes for a woman’s cervix to dilate the last two centimeters and begin pushing, is often the hardest part of labor. Kate rocked in a rocking chair, feeling overwhelmed after two sleepless nights. “Transition felt spiritual, transcendent. I felt like I was going to the edge and then came back,” she recalls. She remembers Donn on her right, Heather on her left, supporting her. Donn, like most men, was feeling his own strong emotions. He was experiencing his own journey to fatherhood through Kate’s labor. Her memory of Heather is that “she was just always there. She was the one saying, ‘You’re all right.’”
Having Heather was “life-changing,” says Kate. She was inspired to become a doula herself and offer the same compassion and support to other women. When her baby, Sam, was six months old, Kate took a doula training class at the Center for the Childbearing Year. With an infant at home, she started her doula practice slowly, supplementing her income with an evening job and a newspaper route.
Then, three years after Sam was born, Kate became pregnant with her daughter, Ella. This time, she had far more resources, support, and knowledge. She decided to have a homebirth with the midwives of New Moon Midwifery.http://newmoonmidwifery.com/
Ella’s birth felt very different from Sam’s. This time around, she says it was hard and long, but “I came out of it feeling like we make a bigger deal out of birth than we need to.” She found herself naturally drawn to laboring alone this time. When she compares her two birth experiences, she says she’s glad she has had two because “I know every birth is really different.”
Kate is an eclectic blend of a tough, do-it-yourself pioneer woman, a sensitive and spiritually-seeking mother, and an artist. With an ease clearly won from hard work, she balances dreams with practicality. For instance, Kate is willing to wait on her dream to become a midwife until her own children are older. She explains, “I’m in birth for the long haul. I don’t want to get burned out now, when I have two small children to run after.”
Women who seek classes and information at CCY come with a wide variety of experiences, objectives and dreams for their own childbearing year. Kate says that she hopes she can do for other women what Heather did for her, which is “support women in the process of birth” to find their deepest wells of strength.
Being around Kate is inspiring, even if you are not a pregnant woman. Her creative flair permeates her conversations. Her best gift is her own story. From an inauspicious and unconscious beginning of pregnancy, she has transformed herself. She has let birth bring out her best. By being her strong, passionate self, she lends others the courage to be themselves.
Cynthia Gabriel is a doula, writer, and medical anthropologist. She is currently seeking a publisher for her first book, The Best of Both Worlds: Natural Birth in a Hospital. She offers parenting and birth-related classes in Ann Arbor.
Cesarean Birth and Informed Consent
By Alicia Farmer
Two recent studies document the elevated risks to mother and baby of birth by Caesarean section. At the same time, surgical delivery rates continue to rise in the United States. Currently, the national average is at 30 percent. Clearly our culture’s approach to birth does not reflect “evidence-based practice.” There is a gap between knowledge and acquisition of that knowledge by those who need it the most – the expectant couple.
The September 2006 issue of Birth includes an article by Marian F. MacDorman, who works in the Center for Vital Statistics at the Centers for Disease Control. Her research found that newborn babies were more likely to die when born by Caesarean section than by vaginal delivery. Nearly three times more likely. The elevated risk to babies was present even when the study population was controlled for pre-existing medical and socio-economic factors. MacDorman concludes that the hormonal and mechanical process of labor and delivery may better prepare the baby for life outside the womb. She refers to earlier studies that show improved outcomes for babies born vaginally, particularly in the area of respiration:
Labor induces the release of fetal catecholamines and prostaglandins that promote lung surfactant secretion. In addition, epinephrine release during labor, as well as the physical compression of the infant, helps to remove fetal lung fluid and facilitates postnatal lung adaptation. Other risks of cesarean delivery include delayed neurologic adaptation, possible laceration of the infant during the performance of the cesarean surgery, and delayed establishment of breastfeeding.
Babies are not the only ones at increased risk from surgical delivery. In the September 2006 issue of Obstetrics and Gynecology, Dr. Catherine Deneux-Tharaux reports mothers are three and a half times more likely to die if their babies are born by Caesarean section rather than vaginally. Caesarean delivery brings with it a host of associated complications. Dr. Deneux-Tharaux found that the risk of death was primarily caused by “complications of anesthesia, puerperal infection, and venous thromboembolism.” Deneux-Tharaux concludes,
Although cesarean delivery is increasingly perceived as a low-risk procedure, the present study suggests that it is still associated with an increased risk of postpartum maternal death as compared with vaginal delivery, even when performed before labor. This needs to be taken into account by clinicians and women when balancing the risks against the benefits of the different methods of delivery.
Similarly, MacDorman says [emphasis added],
Timely cesareans in response to medical conditions have proved to be life-saving interventions for countless mothers and babies. At present we are witnessing a different phenomenon – a growing number of primary cesareans without a reported medical indication. Although the neonatal mortality rate for this group of low-risk women remains low regardless of the method of delivery, the resulting increase in the cesarean section rate may inadvertently be putting a larger population of neonates at risk for neonatal mortality for reasons that remain uncertain.
It is precisely this kind of information that must be made available to pregnant women. At the Center for the Childbearing Year we will present the risks as well as the benefits of Caesarean delivery and other medical interventions in the birth process. Only when you are aware of your full range of choices, can you make the informed choice that is right for you.
Please share this information with someone you know. The health of women, babies, and families is our highest priority.