Sunday, April 7, 2013

Cookies and Breastfeeding

Yes, Cookies Can Help Breastfeeding

There are usually so many questions about breastfeeding and what can help build your milk supply. Well, ladies-- here is a very sweet enjoyable way to do that.
Promote your sweet tooth--


TRY THEM YOU WILL LIKE THEM.

1 cup butter
1 cup sugar
1 cup firmly packed brown sugar
4 tablespoons water
2 tablespoons flax seed meal
2 eggs
1 teaspoon vanilla
2 cups flour
1 teaspoon baking soda
1 teaspoon salt
3 cups oats
1 cup chocolate chips
2 -4 tablespoons brewer's yeast
Directions:

1
Preheat oven to 350°.
2
Mix the flaxseed meal and water and let sit for 3-5 minutes.
3
Beat butter, sugar, and brown sugar well.
4
Add eggs and mix well.
5
Add flaxseed mix and vanilla, beat well.
6
Sift together flour, brewers yeast, baking soda, and salt.
7
Add dry ingredients to butter mix.
8
Stir in oats and chips.
9
Scoop onto baking sheet.
10
Bake for 12 minutes.
11
Let set for a couple minutes then remove from tray.

Read more at: http://www.food.com/recipe/oatmeal-chocolate-chip-lactation-cookies-by-noel-trujillo-192346?oc=linkback

Friday, March 22, 2013


44 Questions For Your Midwife

by SVEA BOYDA-VIKANDER on JANUARY 1, 2013
Written by Svea
Just last week I had the privilege of meeting with two fantastic midwives. Recommended by a friend, they are the women I hope will accompany me through my second pregnancy and delivery. They are kind, empathetic, knowledgeable, and funny. Exciting!
When I told my husband the news, he had a lot of questions. Most of them (“How much does it cost?” and “Do they know what they’re doing?”) I could answer. But some, I couldn’t. Hubby wanted to know exactly what they would do in an emergency – “Tell me about a time when things didn’t go well. What did you do?” and, “Have you ever lost a baby? Why?”
I got all defensive and said that well, I had asked the questions thought were important, and I’m pretty informed about birth and doesn’t he respect anything to do with intuition? Then I got mad and started defending the scientific realities of emotional support (emotionally supported births are not just happier, they’re healthier!) and he said something about how he’s always the one asking the hard questions and it turned into a whole late night conversation that, I guess, we’d been needing to have for a while.
But anyway, I thought I’d share some of the questions I asked in the interview. The query of what to ask a potential midwife used to come up a lot on the BWF support group (and probably does now on the BWF Fans group, but I’m left out because I’m not on Facebook, *sniff*); some of the items below are taken from those conversations. I personally think that ‘goodness of fit’ is the best thing to look for, but we all have to decide what that means for ourselves. The first few are the questions I asked (and the answers that made me so happy).
  1. I plan to refuse almost all vaginal checks. Like, maybe I’ll allow one. What do you think about this? (they don’t check unless the mama requests it! woot!) 
  2. Are you familiar with other ways of assessing dilation(yes, e.g. vocalization)
  3. Do you deliver breech? Do you deliver all kinds of breech? Do you have training and experience in this kind of delivery? If not, do you have a midwife you would refer me to if the baby had not turned? (No, but a neonatologist who trained under a midwife in Chile works at a hospital nearby and he does)
  4. Do you have experience with turning babies, not hospital version-style? (Yes – almost 100% success rate)
  5. At what point would I get ‘risked out’ of your practice, e.g. how many weeks ‘overdue’ could I go before you transferred my care to a doctor? (As long as baby’s healthy, as indicated by Non-Stress Tests, you can stay with us) 
  6. What do you do in the case of a nuchal cord?
  7. Speaking of cords, we intend to do delayed cord clamping. What do you think about this?
  8. How long have you been practicing midwifery?
  9. Why did you become a midwife?
  10. What is your training/education/certification?
  11. Will you deliver the baby, or will you assist me in birthing him/her/them?
  12. Do you have experience and recommendations for prenatal nutrition?
  13. Do you deliver twins?
  14. Are you connected to a natural birth/natural parenting community I could get to know?
  15. Do you do the Gestational Diabetes screening? Is there an extra cost associated with it? Do you ‘allow’ your clients to eat a specific meal before the test, or do you make them swallow a sickeningly sweet orange drink?
  16. Do you continue to see clients with Gestational Diabetes, or do you refer them to an obstetrics practice?
  17. How much do you charge, and by what date would the full amount be due?
  18. Do you accept payment plans? What is your refund policy if we decide to switch care providers?
  19. How often do your clients succeed in having their health insurance provider reimburse them?
  20. Do you work with doulas?
  21. Do you work with birth photographers?
  22. Who is your back-up pair of hands/midwifery assistant? When can I meet him/her?
  23. What is your hospital transfer rate?
  24. Do you do routine episiotomies? Do you do any episiotomies?
  25. What equipment do you bring with you to a birth? Are you legally allowed to carry Pitocin (for rare post-birth hemorrhaging)? Do you?
  26. Are you trained in neonatal resuscitation?
  27. How many births do  you take on per month/year?
  28. Are you planning any vacations, trips, major surgeries, or other events that would interfere with your attendance at the birth?
  29. I am an abuse survivor and this may affect my experience. Do you have training in counseling or other trauma-healing work?
  30. What kind of postpartum care do you offer?
  31. Do you do placenta encapsulation? Is there an extra charge?
  32. Do you facilitate water birth?
  33. What methods of pain management do you recommend?
  34. My partner has x, y, z fears about home birth. How have you dealt with this in the past?
  35. What is your preferred method of communication, prenatally (phone, email, text)?
  36. Midwifery is a challenging profession, and often a labour of love. What can I do to make this experience easiest for both of us?
  37. Have you had any loss (baby or mother)? Why and what happened?
Also, here are some questions I asked myself after the visit:
  1. Would you be friends with these people? Why/Why not? (Yes. I hope we become friends)
  2. Does either remind you of your mother? How do you feel about this? (Not much – and only in the best ways)
  3. Were you able to ask all the questions you wanted to? Why/Why not? (No – I didn’t ask about hospital transfer rate because I already felt that we’re on the same page)
  4. How did you feel about the birth when talking with them, compared to how you feel about it normally? More or less excited, more or less anxious? (More excited! Not anxious at all)
  5. Was the visit enjoyable? (I didn’t want it to end)
  6. If there were other family members present, what was their experience of the interaction? (My husband was at work but they were kind to my toddler and flexible with his needs)
  7. Did you sense that either was intimidated by your birth nerdiness and stance as an educated consumer? (Nah, we’re all passionate about birth, why would that be a problem?)
While it doesn’t make sense to ask a potential midwife all of these questions in an interview, this is also by no means an exhaustive list. You can pick and choose according to your own needs and wishes. And add your own – if you have a suggestion, please let us know in the comments and I will add it above.
*All photography in this post by NHance Photography
Posted by Birth Without Fear

Thursday, March 21, 2013

Treating Group B Strep During Pregnancy

Treating Group B Strep During Pregnancy

Let's begin with what is Group B Strep:

Definition:
Group Beta-Streptococci is a bacteria found in up to 40% of women. It originates in the intestinal tract, but because of the close proximity between the rectum and the vagina, if a mother has intestinal/rectal colonization she will most likely have vaginal colonization. Genital colonization can cause symptoms, but rarely results in maternal illness. It can carry significant risks for the baby, however, if he or she becomes colonized and develops an infection from the bacteria. Overall neonatal infection rate is 1-4/1000.

HOW DOES GBS AFFECT THE BABY?
Babies are not normally affected by the bacterium; but, approximately 50% of babies born to GBS colonized women acquire surface colonization at delivery. Although most babies do not develop problems, the incidence of invasive neonatal GBS infection is approximately 1‐3 cases per 1,000 live births. GBS can cause sepsis (blood infection), meningitis (infection of the fluid and lining around the brain) and pneumonia in the newborn and is characterized as either early‐onset (occurring in infants less than 7 days of age) or late-onset (occurring in infants greater than 7 days of age). The incidence of early‐onset disease is approximately 2 cases (range 1.3 to 3.7) per 1000 live births; the incidence of late‐onset disease is about 0.7 to 1.0 per 1000. Approximately 15% of early cases are fatal, whereas late‐onset disease is associated with about a 7% to 10% mortality.

 

RECOMMENDED MEDICAL TREATMENT FOR GBS
Women identified as colonized with GBS are treated with prophylactic intravenous (IV) antibiotics during labor.

Now, if you are like me, and allergic to all the antibiotics they would use to treat GBS, or you would rather not subject yourself, and your baby to a heavy dose of antibiotics, then here are a few known ways to treat it naturally. First, here comes the legal stuff:

I, nor any of the members of The Doula House L.L.C., are medical providers. We are simply providing you with natural information. What you choose to do with that information is up to you. Feel free to talk to your care provider about the options suggested here.

WHAT CAN BE DONE NATURALLY?
The natural way to treat GBS is to start with increasing the good bacteria...give it a fighting chance to defeat the bad bacteria. The easiest way is to start with fermented foods such as yogurt and kefir. Now, if you are dairy sensitive you can choose to use sauerkraut, kombucha, or a great probiotic. Continue to take your fermented food, or probiotic supplement, every day. You can start this at the beginning of your pregnancy to help prevent GBS, or use it as part of your treatment plan.
Second thing you need to do is to kill of the bad bacteria in the vagina, and the rectum if your GBS is really bad. Now, I am about to give you a time tested remedy, and at first you might think I am crazy (about half the women who read this will, at first) You are going to take ½ C extra virgin olive oil, 1 tsp (teaspoon) tea tree oil (melaleuca oil) and 1 ½ tsp garlic oil. Mix all three together, and then get a small tampon. You want to use a small tampon because it will swell up with the oils! Dip the tampon in your oil mixture until it is thoroughly soaked and insert it into the vagina for 2 hours up to two times a day. You won't want to be running around doing to much since it will feel funny, and it will smell like garlic. The garlic and the tea tree oil will kill the GBS, much faster than just doing the probiotics and kefir.
You will want to do this every day for two weeks and then ask to be retested. If your GBS test comes back negative, you will want to continue the protocol until baby is born, but using the tampon only once a day instead of twice. If your GBS test comes back positive, you can continue with the protocol and try again in another week. Talk with your care provider about your options.
For the record, with this protocol I have never had a mother have a GBS positive test after the two weeks.

You can also increase your Vitamin C and Zinc intake to boost your immune system. You should also consider decreasing or eliminating sugar, since sugar helps bacteria to grow.

Happy Birthing!
The Doula House L.L.C.

Friday, March 1, 2013

Putting a price on something that is priceless (for a birthing mom)

What should you pay your doula? (and if you are a doula, what should you be charging?!)

I love attending births. Aside from my family and running, it is one of my greatest pleasures to assist a mother to have her baby. I love helping families to born.
Salt Lake City, UT, is full of doulas, women helping women to have babies. Even though we have a great doula organization, there is some debate about how much a doula should be paid for her work.

Have you ever asked yourself, “why do doulas charge so much?” And honestly, I hope to show doulas why they are worth so much more then most of them charge.

Aside from the cost of education, books, workshops, continued education, and advertising (website, cards, brochures), we also take into consideration the time that it takes for all of these as well as out of pocket expenses.
Let’s just break down one of my packages in terms of time that I spend with my moms during the course of their pregnancy, labor, and postpartum:

Pregnancy and Labor Package

  • Initial consultation meeting – Approx. 2 hours
  • Two prenatal meetings Approx. 4 hours
  • ASAP telephone, text, and email support during contact hours (8am-8pm) Average 6 hours
  • 24/7 on call within 2 weeks of your estimated due date – I'll talk on call rate low down
  • Around the clock Labor and Birth support once labor has begun – 12 hours (average)
  • Immediate postpartum support of approximately 2-3 hours, or until the baby has nursed successfully and the family is settled – 2-3 hours
  • One postpartum visit to discuss your birth, share photos, dote over your new arrival, discuss options for additional support (breastfeeding, cloth diapering, baby wearing, etc.) – Approximately 2 hours
With these approximations, we’re looking at about 29 hours of support from your doula.

On Call
Now, there is a low hourly rate the professionals charge in addition to their hourly rate, which works about to range from $.15-$30 per hour. If we go with the conservative amount of $.15 an hour for 2 weeks, which is the average amount from 37-42 weeks gestation for a mom. This works out to be $51

Travel

The average trip I make to meet with clients is approximately 35 miles one way.
  • Trip time (based on 5 trips) – 10 hours
  • Gas costs (based on 35 miles one way – 5 trips) – $55

Childcare & Food Costs

  • Childcare – Approximately $150 per client including visits and birth
  • Food During Birth – Approximately $10 depending on the length of birth

Miscellaneous Costs

  • Materials for Clients – Approximately $20

Total Time and Out of Pocket Expenses

  • Time – 39 hours
  • Childcare – $150
  • Food – $10
  • Gas – $55
  • Misc – $20
  • On-Call - $51
$286 in total expenses

Let’s do the Math

Doula Fee – $300 – this is the low end in Utah.
Less Expenses - (-$286)
Remainder applied towards hours of work (39) - $14 (this is what the doula is getting paid)
Approximately $.36 per hour

Doula Fee – $500 – average in Utah
Less Expenses – (-$286)
Remainder applied toward hours of work (39) – $214 (this is what the doula is getting paid)
Approximately $5.49 per hour - this is not even minimum wage


Doula Fee – $700
Less Expenses -(-$286)
Remainder applied toward hours of work (39) - $414 (this is what the doula is getting paid)
Approximately $10.61 per hour


Doula Fee – $900
Less Expenses - (-$286)
Remainder applied toward hours of work (39) - $614
Approximately $15.74 per hour


Now according to Living Wage, the living wage for Salt Lake City, UT is $19.05.
“The living wage shown is the hourly rate that an individual must earn to support their family.” (according to http://livingwage.mit.edu)

So, in order for me to get paid the minimum living wage for SLC:


Doula Fee – $1050
Less Expenses - (-$286)
Remainder applied toward hours of work (39) - $764
Approximately $19.58 per hour


Again, this is based on my time and expenses. Of course, over the duration of my time with a client, I can spend more or less one on one time. This is all approximations.
In the grand scheme of things, you’re paying for an invaluable service during your pregnancy, labor, and birth. The difference a doula can make during this time is often priceless. The least that can be done is pay her asking fee.

Do you think that an OB or midwife would lower his/her costs if a mom told him/her that the fees just are not in their family’s budget? 
 
Doulas are a valuable asset to a mom’s birth team. Our time is also valuable – just ask our kids (and the electric company who won’t waive our monthly bill because it doesn’t fit into our budgets!)!



And in all of these expenses, I did not list the advertizing time and money that a doula spends, I did not list the addition times I end up at a moms house helping with breastfeeding. All of these are extra costs that I have, that I did not factor in to all of this.
What I am hoping by posting this article is that those who are looking to hire a doula can understand why it is so important to be willing to understand why she has listed her prices where she has.
And secondly, I hope to help all those doulas out there who are unsure of what they should charge for their time and energy, that they are worth more than they think.