keeper

Jwk, I'm not making a case. I'm not debating circumcision with you, because it's a pointless debate. Sarah

The stories I've heard about older boys and men "needing" to be circumcized always revolve around an infection under the foreskin. The thing I don't understand is why the docs needed to treat infection with amputation, when antibiotics work fine for most other infections. I think when the majority of doctors thought a circumcized member was the "normal" and "healthier" of the two, they're first inclination when seeing a problem with intact foreskin was to cut it off. I think it would be a rare doc nowadays who would do the same. My first boy was circumcized because of my fear of him needing to be done later. Fast forward eight years and a lot of research later, we've left our second son intact and I've let my 8 year old know why and that I wish I could go back and undo the decision I made with him. I have friends who think I'm weird to have my boys "different." I'm not going to circumcize Michael just so he'll be like Ray...because frankly, it's not like they're sitting around naked, comparing their memberes all the time, anyway! Sarah

You're right about one thing. I don't agree with you. Sarah

Deb, somehow, I'm not surprised at all that you're a fan of Cascade and Spiritual Midwifery. :) Sarah

I've had three of my five at home and currently in an apprenticeship as a lay midwife. I am certified in neonatal resuscitation and am learning all of the skills I'd need to know in the event of a complication. Skilled midwives can stabilize a woman for transport and can handle certain complications at home with great success. The statistics are very much in favor of homebirth in the low risk population. I also believe a woman has the intuition necessary to know where she should give birth. One of my friends was a die hard homebirther, but chose to have her third in the hospital because she just didn't feel right. She was where she needed to be when her baby needed immediate surgery. I pray fervently with each birth and am willing to birth in a hospital if that is what I feel needs to happen. I think that knowledge is available to all women. Sarah

Just an FYI. There are many OB's out there now who do NOT do exams during the last weeks of pregnancy. Most of ours where I work do NOt do them. trends have changed in that arena. Not in my area, lol. Most women don't bat an eye either!

I'm not going, but I wish I could. I had planned on it, but we got a huge influx of Spring due dates and can't leave our mommies. Just wanted to wish you luck and hope you have a wonderful, educational conference! Sarah Wife to Aaron, Mom to five, Doula/Apprentice Midwife

My preceptor is not insured. She is very up front about her training, experience, and lack of licensure. When newly pregnant couples come for an initial consult, they are given her informed consent packet which outlines in detail things such as the status of midwifery in our state, her education, her philosophies about births, as well as her limits and boundaries in regards to risk. There is a page that lays out the fee and the services provided, and there is a release of liability. She is very conservative about whom she will take on, and her success record reflects that. She's cared for me through two pregnancies, and I haven't gotten the firm green light for homebirth until the very end of both because of my anemia. I work hard to brings my levels up, because the responsibility is mine, and I know she'll ship me off to the OB who does dual care with me, lol. She does the standard 13 (or more for postdates) prenatal appointments and can order labwork and ultrasounds. At prenatals, we monitor all the usual: heart tones, weight, urine, fundal height, blood pressure, etc. About the only thing we don't do is the lady partsl exams doctors require during the last trimester. She'll do a lady partsl exam if it's warranted (preterm labor, 41+ weeks), but otherwise, no. Sarah Wife to Aaron, Mom to five, Doula/Apprentice Midwife

There are also different types of lay midwives, though the names vary by area. Certified Professional Midwives get a degree from a MEAC accredited school of midwifery AND do clinical work in an apprenticeship. They take the NARM test and receive certification. Traditional Midwives work one on one with an experienced midwife, doing home study and attending births in an apprenticeship. These midwives are not licensed or certified but are no less skilled. I'm six months into a three year apprenticeship as a traditional midwife. I do plan on pursuing NARM certification, however, so I can work in states that require it for licensure.

Landonsles, I had a friend who had had four episiotomies and went on to have only a skin tear in her fifth birth that required only two stitches. My preceptor midwife has seen good results with clients rubbing rose oil into their scars prior to labor. She never cuts women and in six months working with her, she has only needed to suture one woman. (For smaller skin tears, including mine, she uses prepared seaweed to hold the skin together.) Sarah

It is my understanding that while the uterus can push the baby out all on its own, the urge is there when the head descends low enough to put pressure on the anal sphincter. So most women who can feel it WILL push because the urge is overwhelming. Anecdotally, I've had five babies. I was told to push at 10 cms with the first three and pushed in a semi reclined position. No epidural and babies were born in under 30 minutes. With my two youngest, I waited for the urge and pushed in hands/knees and got them out much faster and with considerably less pain. My 3 month old was over ten pounds, btw. re: Perineal massage. I've also read that prenatal perineal massage, done by the mother in the weeks preceding birth, can lower the incidence of tears while second stage massage can make tears worse. I don't know the statistics, but I have done prenatal perineal massage and did not tear until my ten pounder, and with that one, it was only a small skin tear that healed without stitching. Sarah

I had OB care in addition to midwifery care the last two months of my last pregnancy on a "just in case" basis. I had pregnancy complications that were all resolved before the birth, so I went on to have a successful homebirth after all. What I learned was that in order to see an OB in my town, it meant spending a minimum of 1 hour in a waiting room and at least another half hour in an examining room for a whole five minutes with the OB. And that was on a good day. There were days I was there for three hours..for a scheduled appointment. My other children had to be put in day care for my visits, so I had that expense, plus copays. If I hadn't had insurance, a second car, a dependable and cheap (at $7 per hour) sitter, and the money to cover the copays, I might have been one of those women who ignore it altogether. It's a lot to dish out for five minutes of "looks like everythings on track...." Don't get me wrong. I understand completely how important prenatal care is. The average woman, or the uninformed and poor? Maybe not. Sarah

I observed this presentation at my third homebirth as an apprentice. The mom had a slightly crooked spine and uneven hips (probably congenital), and I'm sure that had some bearing on the baby's presentation. The cervix dilated unevenly, with a firm lip for many hours. Labor seemed to ebb and flow and baby was constantly moving to find a way down. Heart tones were good throughout and mom was tolerating labor well, (as well as any woman does), so we just worked with her on changing positions often and helping that little boy descend. She got the urge to push, but still had the lip, so my preceptor had to manually dilate it away, using evening primrose oil to soften it, while I worked with mom to keep her from bearing down. She pushed in several different positions, but squatting was the most effective. Her baby boy was born with a caput on the right side of his head, but otherwise all was well. It was a difficult labor, but not impossible. She would have been sectioned in the hospital. I'm sorry to hear you had such a rough birth and of your continued pain. I hope you are able to get some help soon and can move ahead to a full recovery. Sarah

I observed this presentation at my third homebirth as an apprentice. The mom had a slightly crooked spine and uneven hips (probably congenital), and I'm sure that had some bearing on the baby's presentation. The cervix dilated unevenly, with a firm lip for many hours. Labor seemed to ebb and flow and baby was constantly moving to find a way down. Heart tones were good throughout and mom was tolerating labor well, (as well as any woman does), so we just worked with her on changing positions often and helping that little boy descend. She got the urge to push, but still had the lip, so my preceptor had to manually dilate it away, using evening primrose oil to soften it, while I worked with mom to keep her from bearing down. She pushed in several different positions, but squatting was the most effective. Her baby boy was born with a caput on the right side of his head, but otherwise all was well. It was a difficult labor, but not impossible. She would have been sectioned in the hospital. I'm sorry to hear you had such a rough birth and of your continued pain. I hope you are able to get some help soon and can move ahead to a full recovery. Sarah

Boulergirl, my sentiments exactly. Sarah