Thursday, February 25, 2010


I'm on Twitter now....check me out - CNMtiffany. I'll be tweeting periodically from work to give you a peak into the life of a midwife.

Nutrition Corner: Vitamins

I was recently emailed by a patient of ours. She is pregnant with her third baby and wants to really make every effort to be healthy. She was wondering what minerals, vitamins, herbs, and spices were safe during pregnancy and in what amounts. I decided to break this down a bit and will talk about vitamins first. A couple posts will follow in the near future with more information about minerals and herbal use during pregnancy. Great questions Amy!

I've always felt that it's a struggle to get everything we need in our daily foods when it comes to minerals and vitamins. Or maybe I'm the one who struggles with that! Anyway, during pregnancy, healthy eating becomes even more critical due to eating 'for two'. Typically a prenatal vitamin (and it doesn't have to be a fancypants one at that!) is adequate for most women coupled with a healthy sensible diet. What follows are the most common minerals and vitamins we need (and why) and the amounts recommended for pregnancy. Keep in mind this is a general overview and that some women may have special needs. Also important to remember - it's better to get most minerals and vitamins from dietary sources as opposed to pill form.

First, a few definitions...
  • Protein - provides the structural base for all new cells and tissues in the mother and baby.

  • Carbs - Source of energy

  • Lipids - Fat....enuff said?

  • RDA - Recommended Daily Allowance


  • Thiamin, riboflavin, and niacin contribute to the production of energy. They are found in almost all foods but exceptionally good sources include whole grains, legumes (beans, etc), organ meats, pork, milk, cheese, lean meats, and leafy green veggies. RDAs respectively are 0.5, 0.6, and 6.6mg per 1000 calories eaten. So if you eat a 2000 calorie a day diet, then you should be getting 1mg a day of thiamin to maintain optimal health.
  • Folic acid is involved in DNA and RNA synthesis so very important for cell growth and division. It was found that having enough folic acid in the diet significantly reduced the liklihood of neural tube defects (NTD) such as spina bifida. It is recommended that women be taking folic acid prior to pregnancy or as soon as pregnancy is known to gain maximal effect. The recommended amount is 0.4mg per day. If a woman has previously had a child with a NTD, then she should be taking 4mg. Orange juice is the largest contributor of folate in America.It can also be found in many foods, however does not absorb as well as the synthetic (pill) form. Go figure!
  • Vitamin B12 is important for the nervous system. Deficiency in this vitamin is rare as it is present in all foods of animal origin (i.e. milk, eggs, meat, liver, cheese) as well as being manufactured by bacteria in the gut. The RDA is 2.2 mcg.
  • Vitamin B6 is another important vitamin involved in protein formation and can affect the nervous system as well. the RDA is 2.2mg per day. Some benefit may be gained in taking this vitamin in high doses (25mg three times a day) for women experiencing extreme nausea and vomiting during early pregnancy. Good sources for this vitamin include wheat, corn, liver, meat, and milk.
  • Vitamin A is involved with reproduction, the immune system, and vision among other things. This is one that you don't want to have too much of as it can be harmful to the growing baby. The RDA is 5000-8000 IU depending on what source you look at. Sources of Vitamin A include animal sources (butterfat, liver, egg yolk) and plant sources (drak green or deep yellow vegetables or fruits, fortified margarine).
  • Vitamin C assists in the formation of connective tissue, skin, tendons, and bones. The RDA is 60mg and this is easily met with dietary intake. Vitamin C rish foods include citrus fruits, papayas, strawberrries, melons, broccoli, potatoes, tomato, cabbage, green or chili peppers.
  • Vitamin D assist the body in maintaining calcium balance and absorption. Adequate intake is 5 mcg (adequate intake is used when insufficient evidence exists to develop an RDA). Most people are able to get adequate Vitamin D from sunlight exposure. Very few foods contain this vitamin. Cod liver oil and some fish (salmon, mackerel) contain high levels.
  • Vitamin E assists in absorption of Vitamin A, is an antioxidant, and is responsible for maintaining cellular membranes. It is extremely rare to be deficient in Vitamin E. The RDA is 15mg. Food sources include nuts, seeds, and vegetable oils. Green leafy veggies and fortified cereals contain significant amounts.
  • Vitamin K is essential for blood clotting. No supplementation is necessary unless a known defieciency (rare). Foods rich in vitamin K include green, leafy vegetables such as spinach, broccoli, asparagus, watercress, cabbage, cauliflower, green peas, beans, olives, canola, soybeans, meat, cereals, and dairy products.

Coming soon.....Minerals!

Wednesday, February 17, 2010

Guest Post: Victoria's Birth

From Katie DiBeneddeto's Journal

Monday October 19th 2009

This morning I met Victoria & Tyner at Baptist for Victoria's induction. We got settled into a room and then a nurse came in to do her IV, which sucked because the nurse couldn't do it. Victoria said this always happens though and they always end up having to get the head nurse to come in. Victoria did appreciate though that the nurse quickly realized she couldn't do it and had no problem bringing in someone else. I felt bad for her though because her poor arm was bruised from the couple sticks that didn't work out. Poor thing! A super sweet older nurse was sent in, and Tiffany! I just love Tiffany. She just has such great energy. This was about noon and Tiffany had office hours from 1 to 5 so I guess she was just stopping by before she had to head over and see other moms. The nurse that was brought in was totally rockin and got the IV in on her first try. I told Victoria that next time she should just straight up say "Look honey, I'm sorry, but I know you're not going to be able to get this IV in. Please just skip even trying, get over yourself and bring in your star nurse ASAP". So anyway, once they got the IV in they started a bag of fluid. Pitocin was started a little after 1.

She managed to stay comfortable for the first few increases and then they just started getting stronger and more regular, but she never lost control. I really admired that about her the whole time. Around 2 o clock or so her in laws came for a visit. They were a super sweet couple - they're in from Corvallis, Oregon. They were very encouraging and didn't really intrude at all. Although they did start sort of obsession over the monitor. I know it's hard for people not to do that, but it's still one of my peeves. I always encourage people to look at the mom - that's your best indicator of what's going on. Plus it messes with your head - like a placebo pill or something - "Oh that was a big number (on the contraction monitor), that must have hurt!" and I'm like...."Well look at her face! She's doing just fine". I guess people just take the monitors so literally sometimes. I guess Tyner was motioning or making faces at Victoria or something to see if she wanted his parents to leave, but she wasn't getting it. But Tyner just said to his parents "So, thanks for visiting..." and then took the hint and left. How refreshing!

Then she wanted to eat lunch and of course at first the nurse said no, but then said she'd ask Tiffany and of course Tiffany said yes - it was so early and she could eat whatever she wanted. So she did. We ordered lunch and it was decent for hospital food. We asked a couple of different people for birth balls and Tyner said he never knew whether or not to keep asking. I said I usually just kept asking until I get it. You never know how many patients they have. Once we got it Victoria wanted to get on it just to practice and get the feel for it before things really got intense. She got on and really liked it. We took turns rubbing her back. It was a really nice time too - I got to hear all about how they met and how he proposed and everything. It was so cute to hear them share all of their stories and I'm sure it was a nice distraction for Victoria. They are a really sweet couple. And he was just the best husband (soon to be anyway...) that I had ever seen. So much non verbal communication. She had to use the bathroom a couple of times and one of the times she had a very intense contraction - being on the toilet was not comfortable at all for her.

Tiffany came back around 5:30 and checked her and she was still a 2. Not that that's bad, but I felt so bad for her. I know she was hoping to have been farther along and I knew she was running out of steam. I kept reminding her that her body was doing so much work that couldn't be measured just by checking her cervix. She was also incredibly congested. It took forever to get sudafed. Our nurse was totally out of it. Then Tiffany went to have dinner and said she'd be back later. Victoria ordered some dinner and Tyner went across the street to get some. I stayed with Victoria. She was back on the ball and I was behind her rubbing her lower back. Her dinner came and she sat up in bed and ate it and had a couple of hard contractions during. She is such a friggin trooper though. Then it was shift change and guess who came in? Rian!! I was psyched! And she remembered me too. She is so great. And she got us sudafed in like 15 minutes. She is so incredible awesome.

Soon after my rice sock became Victoria's best friend. I kept running out to heat it up and then Tyner and I took turns putting pressure on her hip while she was laying on her side. Tyner was so fantastic. I've never seen a sweeter partner. He was perfect. They are so good together. She decided to get some stadol because things were just getting to be too much. The nurse started her out real slow and said she'd give her another dose if she wanted it later. Victoria was hilarious after that. It was like she was drunk. Tyner and I were going to sort of nap, but Victoria was like "I'm being so funny right now and you guys are wasting it napping". She is hilarious. Then she said it didn't make the pain go away, it just made it seem farther away. She said it was like her pain was wrapped up like a present. It was in really pretty paper so that's what made her want to open it, but then she would open it and it would be painful and she would tell it to go away. But then the next one would come and it would be wrapped in pretty paper and the whole cycle started over again. It was hilarious, we were all dying with laughter. She told everyone who came in and I think Tyner even got it on video.

Then she got an epidural a bit later. She was in a lot of pain. It's always hard to watch when it gets to that point. But we talked about it a lot and it was what she really wanted, it wasn't like a spur of the moment for no good reason decision. And she had been at it for so long, she was just out of juice. Anybody would be. The anesthesiologist said I'd be trapped back there (in view of the epidural insertion) and Tiffany said it was ok, I was cool. She's so funny. And it was actually fun to watch from that angle. It's so scary though! I can't believe women so readily do it. After that it took a bit for it to kick in, but she was ok. Then Tyner and I napped on and off after she got comfortable.

We woke up a bit later and then all of the sudden there were a bunch of people in the room. That is never good. Apparently the heart rate was dipping and everyone was getting scared. Then Tiffany said they had to do a c section. Victoria was freaking out - I felt so bad for her. She had to sign all these consent forms really fast. It was a horrible situation. But I totally trust Tiffany so I wasn't questioning the c section - that's a really nice feeling. I know Victoria and Tyner did too. I helped Tyner get suited up and then I grabbed their cameras just in case. I asked Tiff, but she said I wouldn't be allowed in. I followed them anyway. As we were walking out I told Tyner I couldn't come in, but I'd be right outside if they needed anything. They wheeled her in and both Tyner and I had to wait outside for the first little bit. There was one chair and Tyner sat in it. I came and stood next to him and asked how he was doing. He just sort of reached out for me so I moved closer to him and held his head against my chest. He wrapped his arms around my waist and I was just overwhelmed. He was so scared and so vulnerable and it was so sweet the way he had just reached out. It took everything in me not to cry. I just held his head really tight and told him everything would be ok and that I knew that waiting was the hardest part. And I just stood there with him. And we waited. Then Tiffany came out and said the heart rate was steadying so they were just going to observe her for a minute. Then they brought her back into the room! I was soooooo relieved. Tyner went over and kissed her. She was shaking though. i can't imagine how scared she must've been. Tiffany siad it just sucks because in a home birth that would have just been no big deal and may have even gone undetected, which isn't a bad thing because variations in heartrate are normal - but in a hospital, where there's huge accountability you can't ignore a heart rate abnormality because of the off chance of something bad actually happening and then you've got record of a dip in the heart rate and no one did anything. It just sucks. After things calmed down we all dozed again.

Then we woke up and she was 10 and it was time to push. It was about 5'o clock in the morning at this point. They got the squat bar and she used that for a bit. Tiffany was at the edge of the bed and Rian and Tyner were helping her hold her legs. They had to give her oxygen at one point just because she had been pushing and was so out of breath. I was trying to stay coordinated with the camera and the video camera at the same time. She was a great pusher and he came out in no time though. It was amazing. I gave Tyner a big hug and put my hand on Victoria's forehead. He was born at 6:05am Tuesday, October 20th. It was amazing. This will never get old. He was such a sweetheart too. And they didn't go out and tell anyone for a while. It was just the three of them for the first hour and they never took Oliver away. It was fantastic.

After a little while they took him to the warmer to get him cleaned up a bit. Then Jesse came in - Victoria's 12 year old son. That was really sweet. Then they invited the grandparents in. I ordered them breakfast. The grandparents didn't stay for too long which was nice. A new nurse came in though and she was not as cool (but no one is as great as Rian). This nurse helped her breastfeed, which is always hard to watch. I wish people didn't make such a big deal out of it. Jesus, he's been out an hour. He's not going to starve himself. Once they were settled I said my goodbye's and headed home. I never even went to sleep. I was too psyched. What a great birth!

Monday, February 15, 2010

Hospital Birth

I enjoy the blogoshphere. I spend a good bit of time reading blogs. Some of the blogs take a more scientific approach to their content, while others include personal stories of birth (good and bad). I sometimes find myself becoming frustrated and saddened though when I read about women's personal experiences when having a hospital birth.

I find it difficult to wrap my mind around some of the horrible birth experiences I have 'heard'. I didn't have wonderful birth experiences, but wouldn't describe them as horrible or bad either. But some of the stories I see on various blogs are almost unreal seeming. There are cases where legal entities were involved in the care of a woman's pregnancy, confining her to the hospital by court order and others where a woman had to travel 5-6 hours from home to have a VBAC (when she had one already at the very hospital that denied her!). Other cases are of hospital births where women were left feeling, at a minimum, dissatisfied but in some cases, traumatized.

I worked as a labor and delivery nurse for four years, in a tertiary center. This meant that we handled high-risk and low risk, shipping out only those whose babies would require immediate surgery after birth. I know bad stuff happens in the hospital. It can be factory-like, unpleasant, women made to feel powerless and not in control of bodies. I don't deny these things.

What I worry about is the focus on negativity around the hospital birth experience. Until homebirth and OOH birth centers are financially and geographically available to all low-risk women, hospital birth is it for some women. It's the only viable option for whatever reason. I make decent money and have health insurance. But I couldn't afford to pay for a homebirth out of pocket! So all the bad press surrounding hospital birth might be disheartening for those who are destined for the hospital as their birthing backdrop. You know how it goes - everyone's quick to share a bad story, but not a good story :p

There are hospitals....and Phoenix Baptist Hospital (PBH) can't be the only one. We midwives at Bethany Womens attend births at PBH and have been there for several years now. I have seen beautiful births - more than I can count. It is possible to have a wonderful, satisfying hospital birth. Look back at the archives for this blog and you will find a small portion of those stories. So this is why I get frustrated it can be good....even great, in the hospital. We do it all the time.

We encourage women to be a partner in their care. It's not our goal to be the dictator. Instead we want to establish a relationship with women and their families. This is the very first step in having a wonderful experience in the hospital. We truly care about our patients. We didn't become midwives because we wanted to be pulled away from our families and work long hours. No, it's about being with women, empowering women, changing their lives for the better. The five of us are very passionate about this. We RESPECT women. And at the end of the day, I think that makes a big difference. I will tell women when doing a consult for prenatal care. Find someone you trust....if it isn't us, I don't care.....find someone you trust, it's critical.

I hate to see women feel alienated by the very fact that they had a hospital birth. What happened to midwifery being about supporting women...all women... regardless of where they give birth? Who decied that it would be impossible to have a satisfying, enriching experience in the hospital? That this could only occur in the home environment? I think that time spent arguing which is better - hospital or home - is time wasted. Time needs to be spent improving options, educating women, improving hospital birth. The birth community needs to stick together. If we had nearly the coheisiveness of American Congress of OB/GYN (ACOG), we'd probably be a heckuva lot further along in our struggles for women's birth rights/rites.

This stuff with women being forced to abide by court mandates of hospital confinement, etc is outrageous and a slippery slope indeed. But it can be better.....and I see the proof of that all the time.

Fun Fact Corner: Newborn Cries Imitate Language Heard in the Womb

I was glancing through the latest Quickening, which is the quarterly newsletter from the American College of Nurse-Midwives (ACNM), where I came across this little tidbit of info. A study was published in Current Biology (11-09) that found that the melody patterns of babys' cries matched the intonation of the language they most often heard in utero!

Thursday, February 11, 2010

E's Birth Story

I always encourage women to write their birth stories, whether they have them posted here or not. Having a written account of your birth story is such a nice keepsake for years later when details have become fuzzy. I think it's also a nice addition to a baby book. Someday this child will grow up and may be curious about how they arrived in this world. I regret not having written any of my births up - so many little details are lost to me now. And my husband, well, is useless at that sort of thing :p

E was coming in for induction due to having cholestasis (a condition that carries with it a very high risk of stillbirth after 38 weeks gestation). E was actually 38.6 weeks and this would be her fourth child. She had epidurals with the first three and was hoping to have a natural childbirth this time. She was not thrilled about being induced. Fortunately when she arrived that morning and I checked her, she was 3-4/70/-2. So I discussed breaking her water and waiting for labor versus starting pitocin. We both agreed that the ROM (rupture of membranes) was the way to go. I broke her water and sent her off walking.

I left her to her own devices, with instructions to call me when she started getting active. In the meantime I headed off to see postpartum patients and then the office. I checked in by phone a couple times during the afternoon, to be told that she was feeling more contractions and mildly uncomfortable.

I arrived back at the hospital about 5:30pm to find her ordering some dinner. I decided to check her at that point and she was 4/90/-2. I explained that it does take some time for labor to get going after the water breaks. I encouraged her to snack a bit then do some walking. I told her I would go grab some dinner while she did the same.

But then chaos occurred, as it so often does on labor and delivery :) A patient of one of our doctors came up ready to deliver. I was involved with that for about 45 minutes. By the time I finsihed up there, E was getting active. She was no longer interested in eating. The nurse had her get in the tub.

I went to sit with her while she was 'tubbing'. Her husband seemed a little nervous as E was gradually getting more vocal. he sat with other family members in the room. I told E that he was just not used to seeing her like this :) She vocalized her way through each contraction, then rested, even dozing between. At one point she asked me "How will I know it's time?" I told her she would know...her body would just start to push.

Eventually, her husband sat with us in the bathroom. He rubbed her shoulders and poured water on her belly. He seemed to be adjusting to the fact that E's behavior was very normal (I had reassured him several times). He was doing a great job being supportive. At one point she asked if it was too late to get IV pain medicine. I checked her and told her she was 8cms and yes it was too late. She accepted that without any problem.

I encouraged her to change her position in the tub. She moved to her side but after one contraction on her side, she said "The baby is coming! I need to push". We assisted her to the bed. I encouraged her to get in whatever postion she wanted. I re-checked her and she was completely dilated. I told her she could have this baby whenever she was ready.

I had 'warned' her about the ring of fire previously but she was still caught off guard by it I think. She held back a little but then just gathered her strength and pushed her baby right out. We had a bit of a mild shoulder getting stuck, but was quickly relieved and both mom and baby were doing wonderfully.


Hmmm, interesting - has anyone signed up for this? If so, what do you think? I might sign up just to see what sort of info comes through but would love to hear some feedback!

U.S. Chief Technology Officer Announces Launch of First Free Mobile Health Service for Pregnant Women, New Mothers

Technology Companies, Health Professionals, and Federal, State, and Local Agencies
Combine Forces to Provide Free Health Information Via Text Messages

Pregnant women and new mothers will be able to get health information delivered regularly to their mobile phones by text message at no charge under an innovative public service program being launched today by a coalition of mobile phone service providers, health professionals, and Federal, State, and Local agencies.

The new program, called text4baby, is a free mobile information service that provides timely health information to women from early pregnancy through their babies’ first year. The service sends important health tips that are timed to the mother’s stage of pregnancy or the baby’s age.
The new service, announced by U.S. Chief Technology Officer Aneesh Chopra at a health technology conference in Washington, D.C., aims to use one of the most widely used technologies in America—the mobile phone—to promote maternal and child health. Information provided to moms through text4baby will help them take care of their health and give their babies the best possible start in life. Currently in the United States more than 500,000 babies – 1 in every 8 – are born prematurely and an estimated 28,000 children die before their first birthday, a rate among the highest in the industrialized world. Premature babies can face lifelong health and intellectual development problems.

“Text4baby is the first free mobile health service to be taken to scale in the United States,” said Aneesh Chopra, Chief Technology Officer for the U.S. Government. “We know that mobile phones hold tremendous potential to inform and empower individuals,” said Chopra. “Text4baby represents an extraordinary opportunity to expand the way we use our phones, to demonstrate the potential of mobile health technology, and make a real difference for moms and babies across the country.”

Chopra, who also serves as Associate Director for Technology within the White House Office of Science and Technology Policy, introduced the new service in a keynote address at a joint session of the Health IT Summit for Government Leaders, the National Health Information Exchange Summit, and the Eighteenth National HIPAA Summit.

Medical expenses for babies born prematurely average about ten times those for babies born after a full-term pregnancy. All told, premature births cost the Nation tens of billions of dollars—at least $26.2 billion in 2005, according to the U.S. Centers for Disease Control and Prevention.
Ninety percent of Americans have a mobile phone and texting is especially prevalent among women of childbearing age and minority populations, who face higher infant mortality rates.
“Getting connected to prenatal care and other services for a healthy pregnancy is a problem for a lot of women,” said Wanda Jones, Principal Deputy Assistant Secretary for Health at the U.S. Department of Health and Human Services. “Text4baby provides pregnant women and new mothers with a new tool to obtain vital information that is critical to maternal and child health.”
Women who sign up for the service by texting BABY to 511411 (or BEBE for Spanish) receive three free SMS text messages each week timed to their due date or baby’s date of birth. The messages focus on topics critical to the health of moms and babies, including, nutrition, seasonal flu prevention and treatment, mental health issues, risks of tobacco use, oral health, immunization schedules, and safe sleep.

Text4baby messages also connect women to public clinics and support services for prenatal and infant care.

Many U.S. government agencies are involved in the design, outreach, and evaluation of text4baby, and will serve women and babies who learn about their services through the program. These include the Department of Health and Human Services, the Department of Defense Military Health System, and the Office of Science and Technology Policy.

Participating carriers include: Alltel, Assurance Wireless, AT&T, Boost Mobile, Cellular South, Cellcom, Centennial Cellular, Cincinnati Bell, Metro PCS, N-Telos, Sprint Nextel, T-Mobile, U.S. Cellular, Verizon Wireless and Virgin Mobile USA.

Text4baby is an educational program of the National Healthy Mothers, Healthy Babies Coalition
(HMHB), made possible through a public-private partnership that includes more than 100 entities. In addition to the Federal partners listed above, founding partners include HMHB, Voxiva, the CTIA Wireless Foundation, and Grey Health Group. Johnson & Johnson is the Founding Sponsor, and Premier Sponsors include WellPoint, Pfizer, and CareFirst BlueCross BlueShield. The mobile health platform is provided by Voxiva and free messaging services are provided by participating wireless service providers. Implementation partners include BabyCenter, Danya International, Syniverse, Keynote Systems and The George Washington University. Other text4baby partners include national health professional associations; national NGOs; state and local government coalitions from across the country; and MTV Networks.

For more information on text4baby, visit
For more information on OSTP, visit

Fun List of Facts

I was reading 40 Truly Amazing Facts About Babies and thought I would share as some of this stuff was a surprise to me :)

Thursday, February 4, 2010

Nutrition Corner: What Can I Eat?

Pregnancy is an exciting time but also fraught with nutritional dangers around every corner! Or so many well-meaning friends and family members would have you think. It's difficult to determine what's valid information versus unfounded beliefs. So I thought I would put together a little post about the nutritional good, bad, and ugly during pregnancy.

Have you ever heard the phrase "You're eating for two?" Well, yeah, but the second person is initially the size of a walnut - not a full sized grown-up! It only takes about 300 extra calories a day to maintain a pregnancy. In fact, it takes more calories to maintain breastfeeding (about 500 calories) than pregnancy! We don't even expect women in their first trimester to gain much...maybe 5 pounds at most. At this time during the pregnancy, the baby is growing organs and body parts but not so much in size. During the second and third trimester we expect to see slow and steady weight gain, as this is when the baby is really growing in length and weight. Weight gain during pregnancy is based on your weight and height prior to pregnancy - your provider will discuss this with you and monitor throughout the pregnancy.

So what's good to eat????
  • Colorful food is typically a safe bet - this usually means fresh fruits and veggies. Veggies are great for snacks as raw food and also wonderful when cooked - just don't overcook as many veggies lose some of their nutritional value. Be careful to wash fruits and veggies very thoroughly as many are treated with pesticides (which aren't so yummy). If organic foods are a possibility (can be more expensive), this is a great way to avoid pesticides and other chemicals. Removing the skins of veggies and fruits is another way to avoid exposure.
  • Lean meats - protein is critical for your health as well as the development of the baby. Plan to eat lean meats, avoiding red meat as much as possible. Lean meats include pork and chicken. The occasional steak isn't the end of the world :p
  • Other sources of protein include fish (more on this later), nuts, peanut butter, beans (black beans cooked with some salsa or pico de gallo are yummy!).
  • The use of herbs and seasonings can create variety amongst meals.

Not So Good?

  • Let's chat about fish...the March of Dimes website has a wealth of information about nutrition including fish safety. We want you to eat fish because of the health benefits (heart health, mood stability, development of baby's eyes and brain is boosted) however with some caveats. The big concern about fish is the accumulation of mercury, which is toxic in humans. Fish that live long lives (typically big fish) such as sharks, albacore tuna, swordfish, tile fish, etc should be avoided. Regular tuna, such as the canned variety is fine to eat. Fish consumption should be limited to 2-3 times a week, one serving each time. Absolutely no raw fish! Cooked or vegetable sushi is fine.
  • No undercooked meat, poultry, or seafood. Skip the steak tartare while pregnant!
  • Luncheon meats such as hotdogs, turkey, ham, etc should either be avoided or cooked until steaming hot.
  • No lightly cooked eggs...and don't eat raw eggs....ewww gross, who would do that? Just be sure the eggs are thoroughly cooked.
  • Avoid unpasteurized products such as cheese made from unpasteurized milk, unpasteurized milk and any foods made from it, juices.
  • Avoid raw sprouts.
  • Avoid deli foods as they can be contaminated with listeria, even if cooked.

And that pretty much sums of the do's and don'ts of eating when pregnant. Don't freak out if you ate something naughty prior to realizing you shouldn't have - very likely no harm will come of it.




Slowly, we are making our way into the 21st century! We are overcoming handicaps when it comes to internet technology....well, I'm actually dragging some of the others, kicking and screaming (not mentioning any names....Lynnette and Lisa).

We are now the proud owners of a Facebook group page for BWHC :) So, if you are on FB and want to keep up with us, see pics of staff, events, etc then look us up under Bethany Womens Healthcare.

Guest Post: Choosing a Birth Care Provider

~Choosing a Birth Care Provider~

Now that it is 2010 many of us want to concentrate on new beginnings. That may mean getting prepared for a baby. There are many different places to have a baby and a plethora of caregivers to choose from. How do you choose what is right for you? First, know your own personal style. Second, research as much as you can. Third, know your options..because there are a lot of them out there!

Find someone that is a good fit to your personality. For example, do you feel more comfortable around doctors in white suits over more casually dressed but equally knowledgeable and trained midwives? Do you trust yourself before all others or like to hand over all responsibility to someone else? Are you a laid back earthy type or do you prefer going strictly by the book?

Take the time to see what hospitals and/or birthing centers are near. Find out what services they offer in the maternity unit, what their C-Section rate is, what the staff/patient ratio is, and what procedures/policies do they go by.

Connect with your care provider and ask questions. Your care provider may be an MD (medical doctor), a CNM (certified nurse midwife), a CPM (Certified Professional Midwife), a LM (licensed midwife-usually only for a particular state or area), or a DEM (Direct Entry Midwife-through apprenticeship program..though may not be licensed)

A doula or HypnoBirthing practitioner may also be part of your arsenal. A doula in Greek means "woman who serves". HypnoBirthing instructors teach hypnosis for childbirth. Keep in mind neither one is permitted/and or trained to deliver. They are there strictly to be of service to the mom's comfort and to assist w/dad's participation.

See if your care provider is open to you having a birth plan. This is a plan that tells the provider what your wishes are and what procedures you are in favor of or not (keeping in mind, above all else, safety first!) .

It is a good idea to create a birth plan that is adaptable if need be. One big factor is it depends on how healthy your pregnancy has been along the way. A healthy pregnancy tends to lean towards a normal, uncomplicated birth with little to no interventions needed. This allows for more choice and flexibility for all involved. A high risk pregnancy may need extra attention and may call for specific interventions.

So in a nutshell, no matter how or where you choose to birth, the most important thing to remember is be a conscious consumer. Interview those that you desire to assist you during pregnancy and birth.

Your baby will be the most special thing you have--so take the time now and know your options. Research, ask questions and enjoy the process!

Amanda Vermilion
HypnoBirthing Childbirth Educator
Birthing Mothers Budding Babies

I want to thank Amanda for taking the time to send me a blog post!

Here are some additional questions that you may want to ask a provider you are considering....

1. What is your (or the practice's) cesarean section rate?
2. Do you routinely cut episotomies?
3. When do you feel induction of labor is necessary?
4. If applicable - do you support VBACs (vaginal birth after cesarean)?
5. How do you feel about natural childbirth?
6. How do you feel about doulas?
7. Do you provide labor support?

Don't be afraid to ask for a consult with any provider you are considering for care during this special time of your life! We (BWHC) offer free consults where we can answer questions, discuss our practice, and philosophy of care.