"Dr." Amy to speak at September ACOG conference

I just heard it through the grapevine that the formidable "Dr. Amy" of homebirth hater fame is on the docket to speak at an ACOG conference in September. And not surprisingly, one of her topics is "Everything an obstetrician needs to know about homebirth."

Of course, I don't know personally, but I'm going to take a wild guess that she's never attended a homebirth before. Yet she is probably considered the "expert" source on them, most likely because she squawks the loudest. Never mind what actually comes out of her mouth.

Here are her "credentials," according to the ACOG PDF handout:

Um, no, not exactly. Although I realize that the title "Dr." is often a courtesy after a physician has left practice or retired, this is incredibly misleading. My father-in-law is a retired physician that most people address as "doctor," but he certainly doesn't go around representing himself as a licensed, practicing physician. I would hope those in attendance actually know better when listening to her blather on for an hour about how much she hates homebirth and the women who choose them.

A Google search of her name produced the obvious results referring to her blog and "advocacy." She shows up on a number of websites like Healthgrades, listing a physical address to what would seem an office, but no reviews from actual patients. And when you search her name on the Massachusetts Board of Registration in Medicine database, you come up with this:

She spends countless hours trolling the internetz for every story ever published about homebirth and basically makes all natural birth advocates everywhere out to be liars. Yet she continues to represent herself as a licensed physician who is still practicing medicine. Hypocrisy much?

Since ACOG is trying to set guidelines that offer women the best care while treating them with dignity and respect, I'm not really sure how she fits into their lineup.

According to ACOG's website, they acknowledge that

"Most women have normal conception, fetal growth, labor and birth and require minimal-to-no intervention in the process. Women and their families have different views about childbearing based on their knowledge, experiences, belief systems, culture, and social and family backgrounds." (Really? They really believe that?! Who knew.)

It goes on to explain their idea of what "patient-centered care" means:

""Patient-centered" means that health care providers, and the system they practice within, accept that the values, culture, choices, and preferences of a woman and her family are relevant within the context of promoting optimal health outcomes." 

They also acknowledge that part of that patient-centered care includes having not only a skilled attendant (which can come in other forms besides an OBGYN), but also "supportive resources."

Based on their description, I don't think Dr. Amy fits into their scheme of things at all. Either that, or they're just very out of touch with the way a majority of births are carried out these days. Phrases like "support" and "education" are all relative, when you consider that many patients often get all their information from their physician and trust no one else in the process.

On the surface, healthcare initiatives and much of the jargon ACOG churns out sound great - but when you actually ask women about their experiences, it seems that there is a major disconnect. ACOG itself argues that they feel the hospital is the safest setting for giving birth, but admits that it "respects the right of a woman to make a medically informed decision about delivery." It's clear that Dr. Amy does not. I am really curious to hear how this one is going to play out.

From The SOb's website: What a caring, compassionate and professional
way to promote your "advocacy." Would you want someone this vulgar and
derisive in charge of your care? 

More reading:
The C in ACOG Stands for Castrated 

Your baby, the (normal) "problem sleeper"

There's so much parenting advice out there, some of it really good, and some of it pretty awful. Sometimes it's hard to know what to do, especially if you're a first-time parent, and many times people can make you feel really guilty and pretty horrible for listening to your gut instinct when it comes to raising children.

If there's one thing I learned after having three kids, is that they're all different. As much as the mechanics of babies are the same (yeah, they eat, poop, sleep, repeat) they're not: their personalities begin to emerge early on, and as they grow and learn, you have to tailor your parenting to fit their needs and differences. But I came to the conclusion based on the advice of others, and in observing others and what's considered social norms, that sometimes we think it's the other way around.

Getting your baby on a sleep schedule, whatever that is, is probably a perfect example. People will ask you if your child is a "good baby," which must mean "Are they sleeping through the night yet?" when they're 3-4 months old. I remember with my oldest, as a newborn he would be awake at all hours before I finally thought, What am I doing?! This child should be in bed.  But lucky me - I was spoiled by what I'll call the "Perfect Sleeper."

He slept through the night probably around four months, which I'd say is great (when compared to my other two). If he cried or fussed at night, it usually meant one thing: he'd filled his pants and needed a diaper change.

I can't imagine if I had taken this advice - from the cringeworthy What to Expect website - you know, the book everyone loves to hate. It reads like something out of a Dr. Spock time warp:

"Your baby's bad sleep habits are being rewarded. If your child cries at night to be fed and you feed him, or if he cries because he wants to be held, and you pick him up, then he learns a tricky lesson: Cry and I'll get what I want. But by six months, rest assured he needs neither a nighttime snack nor a cuddle; he's just getting away with that because he can..." (emphasis mine) Healthy full-term babies are capable of fasting for up to 12 hours at night by six months of age..."

Unless, of course, your child is like mine and has just taken a giant dump when he's "supposed" to be sleeping. I mean, really. Every child is different! This is basically assuming that there surely must be something wrong either with your crappy parenting or your child - who can sleep for long stretches but simply doesn't want to. Stop cuddling your child at 2 a.m.! He doesn't need it!

What?!

I don't think there's a parent on Earth who would say, "I really regret spending more time with my kids." Love them, hold them, feed them, rock them - they're only little once.

All kinds of things can mess with their sleep schedule: illness, hunger, emotional needs, or meeting milestones (that always kept my kids up - they were practicing their new skills!). If your child is going through a growth spurt, heck yeah they're going to want to eat in the middle of the night. It may not happen to every kid, but it doesn't mean there's something wrong with yours if it does - it's totally normal!

Fast forward to children #2 and #3 - who probably slept through the night at around 18 months. I very briefly tried the "cry it out" method with my middle, who was having none of it, and just wanted the breast, for crying out loud. It was so much easier to just give it to her, spend the five minutes to nurse, and then both of us would go back to bed. End of story. Is she waking up every three hours to eat now that she's six? No. My youngest was probably the same way, I can't even remember. But somewhere in there I realized something crucial: if I don't change my perspective, especially on nighttime feedings, this is going to get old. Quickly. And I can't afford for that to happen because we've got a lonnnng way to go.

I noticed, especially with my youngest, all he wanted was five more minutes. Just a little longer on mommy's lap, at the breast, and he was okay. The more I tried to rush things because I had something else to do, the more he just wanted that time with me. It was like a way of forcing me to slow down, relax, and listen to him and his needs, instead of demanding that he conform to my schedule.

I'm not going to say it was a bucket of laughs the entire time, but once I started seeing it as less of a nuisance and more of an opportunity to just love my children, it totally changed how I felt about dragging my butt out of bed in the middle of the night to deal with that "problem sleeper." My youngest, who is 4, still occasionally gets up to come to me in the middle of the night, even if it's just to cuddle and fall asleep in my arms, and will gladly go back to his own bed to kick, thrash and roll around as much as he damn well pleases.

And by the way, all of them were breastfed exclusively for six months (my daughter a little longer), and were nursed long-term. All treated much the same in terms of feeding and bedtime routine, all with different results. I know some parents struggle for long periods either getting their children to go to bed, to stay in bed, to sleep alone, etc. - they're all different. No one method is going to work with each and every one of them, and sometimes it will take great feats to get them to just lie. still. for. five. minutes. It will seem, as it did for me for many many many nights up with one baby or another, to be an eternity, and before you know it - poof, it's gone. That's what you should expect.

For much better advice, click here. :)

Mom kicked out of pool for breastfeeding

A mom in Great Britain has staged a nurse-in because she was asked to leave the pool area while nursing recently. The lifeguard asked her to stop because it violated the 'no food and drink' rule. But the thing is, she was physically in the pool when she was asked to stop.

Normally I'm all for breastfeeding your baby wherever, whenever the baby needs to be fed. But I must admit, I find the idea of breastfeeding while in the pool kind of gross - but it has nothing to do with modesty, covering up, exposing the breast or any of that. 

Despite being treated with chemicals,
swimming pools are still pretty
disgusting when it comes to germs and
bacteria. Studies have shown that kids
and adults alike are known to treat it as
a public bathroom.
Photo: analab01/Stock.xchng

I think one person actually unfriended me on FaceBook over posting this article, perhaps misunderstanding my concern and interpreting it that I don't support public breastfeeding. Actually, it's quite the opposite. But I can understand how the pool would be concerned with her nursing there, and they actually stated that she was free to nurse anywhere around the pool area, just not in the water. 

Some mentioned the risks of milk leaking (probably unlikely) and the baby throwing up. In my case, this would've been a reality with my second, who regularly threw up copious amounts and then proceeded to want to nurse all over again. I probably would not have wanted to nurse in the pool, but had I decided to, most likely we would have contaminated the entire area. The cost to treat a pool that's been contaminated is likely quite high because it's a very involved process, involves closing portions of the pool and results in a loss of revenue because no one can swim. 

Despite all the chemicals used, pools apparently are still pretty disgusting. The woman was sitting in the jetted whirlpool area (I'm assuming the baby pool) where probably nearly all of the four-and-under set forego interrupting their play and just simply urinate wherever they are. If you've ever used those "swim diapers," they're pretty much worthless at containing anything. And it's estimated that even 1 in 5 adults pee in the pool. Disgusting!

Not to mention the grossness that's floating: residue from personal care products and sun lotions, body oils, dead skin cells. Yuck. It almost makes you never want to go swimming again, breastfeeding or not. 

It's been estimated that many people don't shower before entering the pool (who knew?) and therefore all kinds of interesting things like e. coli hang out in the filters and everywhere else. Bacterias that can ear infections and skin rashes were found in a majority of public pools, and "pools used primarily by children tested positive 73 percent of the time." Apparently public municipal pools are the worst offenders. 

It's not like your breasts are sterile, but perhaps reducing one more point of contact while nursing is wise, rather than staging a protest to fight for your right to breastfeed in what is quite literally a public bathroom. 

Review: VBAC Facts Class with Jennifer Kamel

Image: VBACFacts.com

This weekend I had the pleasure of attending Jen Kamel's VBAC class "The Truth About VBAC: History, Politics and Stats" in Buffalo, NY. She is amazing - traveling the lecture circuit to present loads of information to both laypeople and birth workers alike.

I've already had a VBAC and I'm "just" a birth advocate, but I highly recommend the class if you can either attend in person or check out the webinar version. Why spend money on a class when I'm not even a birth professional? For philosophical reasons, this was as inspiring as it was educational.

What an opportunity it was to network with local doulas, midwives, advocates and birth professionals! I met new friends, heard and shared stories and exchanged information that not only could I use but pass on to others as well. The presentation was heavy on graphs and charts (Jen's favorite LOL) which is a good thing - putting it all into perspective is important. Without that perspective and information, women are potentially making a life-changing decision with less data and fewer facts, perpetuating the idea that "VBAC is dangerous!" and that it's selfish, foolish or risky to even consider it.

Some important take-away messages that I left that night with:
• Studies are important, as long as you're looking at the big picture. For instance, rupture rates are key, sure; but if the study you're reading doesn't tell you the number of women who had labor induced or augmented, then it's not going to give you all the facts. That is very important information to have - because it can increase the overall risk of rupture. Without it, it can definitely skew your impression of whether it's safe or not. Is your doctor quoting these same studies, that might present data the way he wants it to? Perhaps.

• Ultimately it all comes down to the level of risk that you are willing to accept. One is perceived as inherently safer, or more dangerous, than the other. Why is this? Because one is performed much more frequently than the other, to the point where risks and disadvantages are glossed over and minimized. I've always thought that it's just a shuffling game: you're trading one set of risks for another. You put off the more immediate risks of a VBAC and trade them for the more long-term, cumulative risks of repeat cesarean. If you're not looking at the long-term picture, you may not have all the best information at the time.

Why does a rare but well-publicized uterine rupture (which is not always catastrophic) send up more warning flags than surgical complications after four cesareans? Why are we more afraid of the risk of rupture - which may not even be realized - than we are about cesarean complications, that are becoming increasingly more common as more women have more cesareans?

Jen's presentation may be just the thing to give a VBAC mom the edge when it comes to studies and statistics - and it's downright sad that you even have to walk into a doctor's office defensively posturing yourself with a ream of studies to back up your birth plan. Don't expect your doctor to know all the facts and figures - or to even come close. Jen's information is nothing that you can't already find on your own, it's just painstakingly put together from the same medical journals and articles your doctor has access to - conveniently all in one place. The benefit to you is that the legwork has already been done - which is a big plus when it comes to the virtual sea of data that can be very overwhelming. Kudos to Jen for her hard work and determination!

For a list of upcoming classes and webinars, visit www.vbacfacts.com.