New Blog at Mothering.com

BBBD's co-author Jennifer Margulis has a brand new gig blogging for Mothering.com.

The blog is called MOTHERING OUTSIDE THE LINES. Here's a list of the posts so far:


The Waiting Game









Liberated From Prenatal "Care"

Beware of the Pregnant Jail Breaker

Don't Eat My Broccoli













The American Prejudice Against Large Families


People's Reactions When I Tell Them That I'm Pregnant











And You Thought YOUR Belly Was Big














On Being Pregnant For (Probably) The Last Time

Help Your Wife Tie Her Shoes

There are lots of ways for fathers to be involved in pregnancy. The more you bond with your wife, the closer you'll feel to your new baby once he or she is born.

New Doula in Ashland, Oregon

Our friend, Jenny Johnson, has started a doula service in Ashland, Oregon, for pregnant couples looking for a kind and calm birth attendant to be with them during labor.

Here's her announcement:

I am excited to announce that I am now offering my services as a birth doula in the Rogue Valley! After learning and studying as an apprentice with homebirth midwives, giving birth to my four children, and completing the Doulas of North America training workshop, I am ready to serve my community in this capacity.

I offer emotional and physical support throughout the childbearing year. My services include prenatal meetings, continuous support throughout labor and birth, and postpartum visits as well.

I share information with clients about various topics relating to pregnancy, birth and the care of new babies.

Jenny Johnson
sistermoon@ashlandhome.net
(541) 482-6064

Ashland, Oregon Resources for Pregnant Women Who Want to Stay Fit

A front page article in yesterday's Tidings, written by co-author Jennifer Margulis, lists the many ways pregnant women can stay fit in Ashland, Oregon.

Here's an excerpt from the article:

A new study conducted by researchers in Norway has discovered yet another benefit to exercise for pregnant women: In addition to keeping moms-to-be healthy, exercising while pregnant also helps keeps down the birth weight of the newborn.

The study, published in the October issue of "Obstetrics & Gynecology," tracked the outcomes of over 35,000 singleton births in Norway and found that regular exercise — at least three times a week — reduces the chances of giving birth to an excessively big baby by 23-28 percent.

Too-big babies (the scientific name for this is "fetal macrosomia") have been linked to increases in birth complications, including post-partum hemorrhages, C-sections, and low Apgar scores.

Although the authors of the study report that fetal macrosomia seems to be on the rise and that the numbers of pregnant women who exercise regularly are on the decline, that does not seem to be the case in Ashland. where it is common to see pregnant women bicycling, walking, swimming, and doing yoga.

"Women who get plenty of exercise during pregnancy benefit in innumerable ways," said Sheryl Grunde, owner of www.honoringthemother.com, who teaches prenatal and postnatal yoga classes in Ashland. Grunde, 33, also offers pay-what-you-can massage for pregnant women and works as a doula (a trained birth assistant) at Ashland Community Hospital.

"Healthy, regular metabolism, a strong heart and low blood pressure, and the ability to breathe deeply are some benefits to exercise that come to mind," Grunde said.

The list of Ashland, Oregon resources at the bottom of the article are as follows:

**Prenatal yoga classes cost $12 (less for a punch card) and take place on at the Ashland Yoga Center (at Fourth and A streets) Wednesdays from 6 to 7:15 p.m. Contact instructor Sheryl Grunde at 541-951-7474 or sheryl@honoringthemother.com for more information. Grunde also teaches postpartum mom and baby yoga classes at The Studio at Fourth and B streets on Mondays at 10:45 a.m. Participants must pre-register for this six-week class. Focus is on core strength, stretching, and baby play.

**Prenatal swim classes at the Ashland YMCA, free for members or $10 (for a guest pass to the Y), are Mondays, Wednesdays and Fridays from 5 to 6 p.m. Contact the YMCA at 482-9622 for more information.

**Ashland Community Hospital offers an early pregnancy class ($10), a prenatal yoga class ($10), a four-week basic childbirth education series ($50, which includes a book), waterbirth and doulas class, breastfeeding, and a four-week monthly infant massage class, as well as a free one-day class for siblings-to-be and a free new parents group that meets Wednesdays from 1 to 3 p.m. For more information call the birth center at 201-4210.

Pregnancy and Poison Oak

Poison oak grows shrubby and close to the ground and it's hard to imagine that a plant this innocuous looking could cause so much damage but if you have a bad immune reaction to it and you also happen to be pregnant (or your wife, more likely, is pregnant), prepare to suffer for a long time.

According to a midwives, doctors, and naturopaths, poison oak is so much worse when pregnant than in real life. In real life it's horrible (though some people only get mild cases or have no reaction at all). In pregnancy you can expect the site of the infection to swell up like someone inflated your body part, to ooze yellow pus, to itch uncontrollably, and to take WEEKS AND WEEKS AND WEEKS (did we say weeks) TO GO AWAY.

If your pregnant wife gets poison oak, try to be very very nice to her.

The best thing is prevention -- of course. But, duh, you knew that already and you wouldn't be reading this if you didn't get it.

After that, what? Really bad cases are treated with an injection of steroids or orally taken steroids (prednazone is the steroid of choice) but you can't take those if you are pregnant unless your reaction is so severe you are in a death grip because these steroids are known to be toxic to fetuses.

They are also toxic to adults.

Our friend was out hiking. He pet a dog on the trail (animals don't react to the urushiol that makes humans so sick) and then went to relieve himself in the woods. He used his hand to guide the stream, and ended up with poison oak on his johnson. Ouch. The doc gave him a shot in the butt. It helped the poison oak infection but also gave him 'roid rage, turning him from a mild mannered never-raises-his-voice peace-loving dude into a screaming angry freak who got a red card in a soccer match.

Not the kind of medicine you want your fetus absorbing.

But don't believe anything you read on the Internet about poison oak because ... IT DOESN'T WORK. None of it works. Not to be negative or anything but if your wife gets poison oak, hunker down for a lot of pain, a lot of really awful itching, and almost no relief of any kind.

Cold compresses do help, especially ice.

We tried two homeopathic remedies -- Apis and the classic poison oak one, Rhus Tox. They did nothing.

Benadryl taken orally or applied topically helped a little. But only long enough to sleep comfortably until the drug wore off and then the infection--actually it's an overactive immune response the urushiol itself isn't the problem--took over again and sleep was gone. Think hours and hours of itchy agony.

Technu only helps if you apply it when you are exposed. You can try it. The fumes will make a pregnant woman woozy and nauseous but do nothing to help the poison oak.

Also, expect it to spread, because it will. All over your poor spouse's body. From the site of the infection it will migrate systemically to other places. If you get it on your leg, expect it to show up on your index finger.

It's so awful.

And you are in for at least three weeks of agony.

After the initial wound was superating for days, we gave in and used a topical steroid cream that offered some relief and seemed to help the reaction slow down. The small print on the label information said it is KNOWN to be secreted by the liver and to be TOXIC TO RAT FETUSES but the doctor said it was worth it or we would end up in the hospital. Maybe the baby we're expecting will be born with two heads. Let's hope not.

Try other stuff. Search the internet. Get your bed filthy with baking soda goop and calamine. But the best thing is really ice cold water, plenty of rest, a non-inflammatory diet, tons of vitamin C, and a hugely generous serving of patience.

You're in for a long haul. We're right there with you.

Marriage Less Important Than Prenatal Bonding

There's a fascinating new study published in the December issue of the Journal of Marriage and Family about the importance for dads to bond with their babies in the prenatal period in order to establish a stable family life and continue being an involved parent.

As reported in a News Bulletin on Mothering.com:

In their analysis, Cabrera and her colleague, Jay Fagan at Temple University, found that fathers involved during pregnancy were significantly more likely to remain involved in raising their child at three-years-old.

"The unmarried father is much more likely either to maintain or move into a more committed relationship if he's involved before the birth, and that's the critical difference," Cabrera says.

"As you might expect, research has consistently shown that creating a stable home life predicts whether a father will be an active participant in raising the child, but what we've learned here is that the prenatal months are when that kind of family structure is most likely to coalesce."

New Resource For Moms and Dads who Miscarry

Our writerly friend Katie Allison Granju has started a blog about miscarriage called The Miscarriage Blog.

Here's the link.

Hopefully you won't need it. But if you do ever need it, it's there.

Baby, You're Home--Great Article on Home Birth in the NYT

There's a long detailed article on home birth in the New York Times "Home and Garden" section. It's really inspiring. We say to all expectant couples -- consider a home birth. They are on the rise, even in New York City, and the people who are having them are onto something: birth doesn't need to be a medicalized and invasive experience.

Even if you have your baby in the hospital, try to stay home as long as you can. Don't go in until your wife literally feels that she cannot bear the pain one more second. That way, they'll be kind and attentive to you in the hospital and they won't try to hurry the labor along.

We have a friend who called her midwife and said her water broke. Her midwife said, "rent two movies, and watch them all the way through, then call me back and we'll see if you're ready to come to the hospital." They did. The laboring wife doesn't remember anything about the movies, but she was so far along when she got to the hospital that she was treated like royalty.

If you want to read more about home birth, here's an article about home birth in western Massachusetts by Jennifer Margulis, first published in Valley Kids:

Pregnant? Consider Having Your Baby at Home

By JENNIFER MARGULIS
Special to Valley Kids

GREENFIELD — When Florence-resident Kirsten Kowalski-Lane got pregnant with her second child, she decided she wanted to try having a home birth. Her son, William, was born in Cooley-Dickinson Hospital, which is down the street from her house. Her son’s birth went well. “The midwives were lovely,” Kowalski-Lane, who is the Director of the Parenting Center in Northampton—a drop-in center that offers support for children of parents ages 0-5—remembers, “Everything was very normal.”

But, despite the fact that she had no complaints about the hospital or her birth attendants, Kowalski-Lane knew that she wanted to do things differently the second time. “I realized how much of the birth I was in control of,” she explains, “I could have had him anywhere.” This realization, that birth was a normal, natural process that needed no drastic medical intervention, encouraged Kowalski-Lane to consider alternative s to a conventional hospital birth. In addition, she did not like the hit or miss way it was the midwife or doctor on call at the hospital who would deliver her baby. “I wanted to have a different kind of relationship with the person or people who delivered my child,” she continues, “a closer relationship.”

Convincing her husband Jon Lane and her family was not as easy. “It was a good month that Jon needed to think about it,” says Kowalski-Lane, whose baby, Grace Margaret Anne Lane, was born at home on May 17th, 2002. The couple met twice with the River Valley Midwives, a group of home birth midwives that has been delivering babies in the Valley since the late 1970s. Although they initially hid the fact that they had decided to have a home birth from Jon’s family (and from Kirsten’s older sister who is a doctor), Jon’s grandmother was thrilled when she found out her great grand child was born at home. “She told us that she was born at home, and she turned out just fine,” explains Kowalski-Lane. “Now Jon is very proud that we did this. He tells everyone!”

Like Kirsten Kowalski-Lane, many Valley women are deciding to have their babies at home. According to Terri Nash, the River Valley midwife who caught Grace, there are 6 home birth midwives in active practice and approximately 50 babies born at home here in the Valley each year. In Massachusetts 1-2% of all babies born, approximately 800 babies in total, are born at home.

“The number one reason that we get is that it feels right to women,” explains Nash who is a Certified Professional Midwife, or CPM. “It is natural. Women do not menstruate or procreate in the hospital...Why should they have their baby there?”

Home birth midwives, Nash explains, work closely with area hospitals. They exercise great caution and, if anything goes wrong during labor, they accompany their clients to the hospital and stay with them, as their advocates, during the birth. But, although they have a “cooperative relationship with...local nurse midwives and hospitals,” according to Nash, home birth midwives do things differently from obstetric nurses, midwives, and doctors. Prenatal visits are an hour long, some take place in the client’s own home, parents have access to a lending library of books and videos about birth, and the midwives come as soon as the mother starts labor or feels the need to have them there. They stay with the new mother and baby for 3-4 hours after the birth, and they follow up with postpartum visits at the client’s home 1 day and 2 days later and office check-ups 1 week , 3 weeks, and 6 weeks later.

“They lead you through the process,” reiterates Kowalski-Lane, who was impressed by how the River Valley Midwives took their time with her and treated her with interest and respect. “Even though I had already had a baby, I appreciated it. You don’t feel like part of a factory.”

The first time Kowalski-Lane met Terri Nash and Jharna Harvey-Amai, she sensed their approach was different. “I felt so good in their presence,” remembers Kowalski-Lane , “I wasn’t even under their care but I felt cared for.”

During her pre-natal visits the connection Kowalski-Lane felt with her midwives deepened, “They were really interested in me...in who I am. They wanted to really get to know me,” says Kowalski-Lane who remembers one time when she arrived to an appointment late and stressed out. “My blood pressure was high,” she says, “I had been rushing around.” Nash invited her to sit down, made her a cup of tea, and gave her a head and neck massage. When her blood pressure was measured again it was back within normal levels.

Even some Valley health care providers are themselves choosing to have their babies at home. “Up to a third of the people who come to are practice are health care professionals,” says Nash, who remembers one birth that was progressing slowly. The father, a doctor, and the mother, a nurse practitioner, had been laboring for several hours. When Nash checked she realized that the baby’s head was asynclinic, or tilted, and that the position of the head was obstructing labor. She instructed the mother to walk up and down the stairs, which she did, with her husband by her side. The head resolved and the labor progressed quickly after that.

Nash remembers the husband’s surprise that the difficulty could be resolved so easily with so little intervention: “He said, ‘oh my god! Why didn’t I learn this in medical school?!’”

Other techniques that home birth midwives use to avoid medical intervention work just as well. If a woman is 14 days past her due date American doctors will induce labor using potentially harmful drugs or hormones, like pitocin, to get labor started. The River Valley Midwives use a different technique. “We have had 98% success with a combination of herbs and acupuncture,” says Nash, who explains that the first-time mother will go into labor, on average, ten days past her due date, a fact that means that she only has a four-day window before medical procedures are recommended. Instead of sending a client to the hospital, River Valley Midwives refers their clients to local acupuncturists to get labor started. One acupucturist, Amy Mager, has five children, four of whom were born at home. “If those [the herbs and the acupuncture] do not work, then we kick in with castor oil...and we have had a 100% success rate,” says Nash.

The cost of a home birth? Less than half of a typical hospital birth. “More and more insurance companies are covering home births,” says Nash, “because they are realizing how much cheaper it is.” River Valley Midwives charges a universal fee of $2,800 which, if paid by 36 weeks, is reduced to $2,300, and they are willing to make private arrangements with clients who have financial difficulties. A conventional hospital birth costs about $5,000, often more, depending on the interventions.

“I'm saddened by the stories of women who had hospital births and have negative feelings about their birth experience,” says Kirsten Kowalski-Lane. “My advice to women in general is to realize that birth is normal and safe. It's your experience, make it what you want it to be. Home birth is the optimal, it's how we should be treated.”