National Midwifery Week

Excitement galore!!!

October 7 thru 13 is National Midwifery Week!!!

It's a time to celebrate midwives across the country...hooray!  As you may or may not know midwife means with woman.  It's our great joy, honor and pleasure to be with women as they journey through their lives...including but not limited to their pregnancies, labor and birth. 

We just spent the weekend up in Payson on our annual midwife retreat.  It was invigorating to spend so much time with my midwife partners.  The passion and dedication to women and midwifery was so apparent and contagious. I know all the midwives in our group do not consider our occupation a job or career but rather  a calling.  We are proud to be midwives and we take that calling very seriously.  In doing so we also celebrate all our clients as well- mothers, daughters, sisters, grandmothers and aunts who have birthed and/or supported women who have birthed.  So this week let me call all women to celebrate ourselves.  

One way to celebrate ourselves is to care for ourselves.  Below is a pledge we can all take that encourages us to be active participants in the type of health care we receive.  We must value who we are and recognize the importance of us in the lives of our families and friends.  We are needed by our families and by society. 

Everyone deserves the type of healthcare we desire and to be active participants in healthcare decisions. So in honor of National Midwifery Week and women everywhere I strongly encourage you to take the following pledge along with all the women in your life.  Make caring for yourself one of your callings, value yourself as much as you value all the other women in your life...cause we value each and every one of you.

Thanks for all the support you've given us midwives at Bethany Women's Health Care and  all the support you've given every other woman in your life. Have a wonderful week!

Take charge of knowing what your options are—it’s your body and your health. Make a promise to yourself today to be the most informed health care consumer you can be. You deserve it! I promise to take control of my own health. I will make decisions for myself based on facts and the type of care that means the most to me in maintaining my health. I promise to better understand the choices I have in managing my health care. I will learn more about my personal health preferences and explore the care options available that can best meet my health needs. I promise to be an active decision maker in my care. Medical procedures performed on my body without my knowledge or understanding are not acceptable. I promise to put my health first. I will educate myself on ways to improve or maintain my high standard of health and talk to my care provider about how they can help me meet these goals. I promise to improve my health care experience. I will become informed about different health care providers and approaches to care and use this information to improve my own experience as a health care consumer. I promise to encourage others to take charge of their health. I am a force for change and will inspire my friends and family to better their own health through awareness and action. Sign your pledge by filling in the information below. Your information will not be shared with third parties. | Privacy Policy First Name:  Last Name:  *Email  State: Zip Code:   Check if you would like to receive women's health news and Our Moment of Truth™ updates from the American College of Nurse-Midwives.

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Reflecting on the road with Lynnette

Today as I was leaving the Y after doing my 30 minutes on the bike I saw a former patient working out on the elliptical machine, "trying to lose her last few pounds of pregnancy weight" :) . Her baby is already 3 months old and she's, of course, madly in love with him. We talked briefly, mostly she thanked me for the care she received during her pregnancy and birth. She mentioned that with her first birth in Michigan she couldn't do what we were able to do here, and she was thankful that our kind of care was available to her.

We frequently hear from women who are thankful for care where they can labor freely without being tethered to the monitors, where they can use the tub for comfort, where IVs are not mandatory, and where their requests are acknowledged and implemented whenever possible, including getting the epidural (if that's part of their plan).

Today as my husband and I drive north past Flagstaff toward the Grand Canyon with all this beauty around me, those words of gratitude come back to me. I'm always amazed and grateful when I can "get outta town", but today the gratitude that's touching my heart is toward the strong, beautiful women who put their trust in us to guide them through their pregnancies and births. It' s such a gift to us to be allowed to accompany them through such a personal and intimate time in their lives, and I am truly awed and thankful to them for the lessons they teach me.

I also feel gratitude toward Bethany Women's Healthcare and Phoenix Baptist for providing the opportunity for Certified Nurse-Midwives to practice. Unfortunately, as many women know, midwifery care is very limited. I've been lucky enough to be with this practice for12 years and it's easy for me to forget how very lucky I am. I work in a very diverse practice, with wonderful supportive partners and truly beautiful women who seek care from us. Can life get any better? So, as I look at all this natural beauty surrounding me -the Vermillion Cliffs, the Colorado River and the Grand Canyon -I'm also reminded of the natural beauty of pregnancy, birth, and all the strong women I've had the pleasure of spending any time with during the past 12 years. Thank you for your trust, and the lessons you've taught me.

Pregnant Patients' Bill of Rights...by Lynnette

     All healthcare providers get into this profession for their own reasons. Over the years I've considered my own reasons and have come to the conclusion my strongest passion is to give personal, individualized care. A pet peeve of mine is when a rational reason cannot be given for doing a procedure, or when something is being done for the convenience of a provider rather than comfort of the patient, or just because "it's what we always do". 

     When people are in the hospital the combination of being in unfamiliar territory and the attitude of care providers that they are the experts makes it difficult for patients to voice their individual requests. Women deserve and have the right to care that they are actively involved in formulating. The pregnant women's bill of rights defines those rights. !

     As the third trimester advances most women settle into the reality of the work they have before them and start preparing for the birth of their baby. Part of that preparation involves dealing with questions about what is going to happen at the hospital. Unfortunately, birth has been hidden away in hospitals for years now and has become a medical event where many families feel they lose control over decisions about their care. Many women have never been a "patient" in the hospital prior to labor and the institutional aspects of a hospital takes them out of their comfort zone. That along with the feeling that nurses and doctors are "experts" who deal with birth everyday so they must know what's best for them make women more willing to hand over control or less likely to question "routine " procedures. Often procedures are just "done" without fully informed consent or explanation- IV starts, continuous monitoring, withholding solid food, limiting ambulation. Knowing your rights will enable you to assert your rights when it comes to procedures you may or may not want or need!

     In addition many providers are so busy in the office there is very little time during visits to ask questions or discuss what the birth will actually be like. Women need to remember that as consumers, paying for the services they are there to get, they have the right to have input in their care. Women also need to keep in mind their provider is in charge of their care, not the hospital staff or institution. Nurses are carrying out orders from the provider, so it is essential that you've discussed and participated in the formulation of the plan of care for you labor, birth, newborn care and postpartum care. You along with your provider make the decisions for yourself and your newborn after you obtained informed consent from your provider. Keep in mind that the consents you sign as you enter the hospital are very broad and that you the right to question and amend those consents. 

     The Alliance for the Improvement of Maternity Services (AIMS) has outlined the Pregnant Patient's bill of rights. It's an important document that all pregnant women should read and consider as they prepare for birth. Birth should not be a "one size fits all" event. It's a very individualized, very personal experience that will be remembered for a lifetime. Women and their partners should have input into their care and the bill or rights helps to ensure they are given informed consent regarding procedures so they can have that input, knowing also that plans may need to be changed under various circumstances. But knowing your rights will strengthen your ability to deal with changes as they arise. The bill of rights gives you freedom in making choices for you and your baby that are aligned with your personal desires to make your birth something to happily anticipated and remember with satisfaction. Please follow this link to read and learn more about the Bill of Rights. www.aimsusa.org/ppbr.htm

Skin 2 Skin

From Kate Paxton...

Early this morning, I was called to a birth of young woman.  Her labor had progressed significantly and it became obvious she would inevitably deliver her baby at just 33 weeks and 5 days.  We called in one of my favorite Neonatology Nurse Practitioners (NNP) – she’s aware of the need to evaluate and help babies transition as smoothly as possible.  Now this kind little boy – Brannon – helped us tremendously by flinging out his tiny arms and giving a nice big howl.  I placed the baby onto the mother’s abdomen and he continued to cry and transition well – allowing us to delay clamping or cutting the cord, so he could get all the extra blood he could from his placenta.  The mother was able to speak with the baby and welcome him to this world.

Perhaps the sweetest moment of every birth is that moment when the baby arrives and snuggles up, babies chest to mother's chest, in mother’s arms.  This moment is not just a nice scene – there’s a lot of science to support the practice of skin-to-skin contact in the immediate postpartum period.

My favorite way to help a baby transition to the “extrauterine environment” – that’s science-speak for ‘the world outside the womb’ – is to deliver the baby to the mother’s abdomen.  As long as the babe is stable, this allows for delayed cord clamping and skin-to-skin contact.  Delayed cord clamping has been shown to result in improved iron status of babies up to even six months of age.  The baby can obtain about a fifth of its blood volume through placental transfusion following the birth – and this may make a big difference in the health and well-being of a baby.  For preterm babies – like little Brannon this morning  - delaying cord clamping for even a short time can help the babies transition more smoothly.  The World Health Organization Reproductive Health Library and the Cochrane review suggest delayed cord clamping is the standard for care of stable infants.

As we allow the cord to pulse oxygen-rich blood into the baby, who is using his lungs to breathe air for the very first time, a lovely place to put that baby is on the mother’s chest.  In a Chochrane review of over 30 studies, the research showed “that babies interacted more with their mothers, stayed warmer, and cried less. Babies were more likely to be breastfed, and to breastfeed for longer, if they had early skin-to-skin contact. Babies were also, possibly, more likely to have a good early relationship with their mothers, but this was difficult to measure.”  The WHO Reproductive Health Library described the ideal situation – that “early skin-to-skin contact (SSC) begins immediately after birth by placing the naked newborn baby prone on the mother’s bare chest.”  This library also reviewed a great number of studies and found that SSC after birth helped reduce crying, improve the mother-infant interaction, keeps the baby warm, and helps the mother successfully breastfeed.

The International Breastfeeding Center lists a number of benefits of SSC from birth to the first hour: The baby…
•  Is more likely to latch on

•  Is more likely to latch on well

•  Maintains his body temperature normal better even than in an incubator

•  Maintains his heart rate, respiratory rate and blood pressure normal

•  Has higher blood sugar

•  Is less likely to cry

•  Is more likely to breastfeed exclusively and breastfeed longer

•  Will indicate to his mother when he is ready to feed

Although we understand how special these first moments are on an intuitive level, there are untold numbers of hormonal and sensory interactions occurring in these precious moments – perhaps areas available for future research.  Until then, we can trust that there’s good science to support these midwifery practices.  Mothers should be encouraged to hold, smell, kiss and snuggle their newborns on their own chest, with direct skin to skin contact.  This is the time when mothers are learning their baby’s cues and babies are learning their mother’s environment.  So, consider these practices when writing your birth plan.  The midwives at Bethany Womens Healthcare are happy to support these practices for your birth.