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April 5, 2017
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New Fact Sheet Informs Pregnant Women re ACOG Recommendations to Limit Use of Interventions

Childbirth Connection has published “New Professional Recommendations to Limit Labor and Birth Interventions: What Pregnant Women Need to Know,” because, as they diplomatically put it: “Unfortunately, it often takes many years before health care providers reliably carry out the recommendations of professional organizations. So it is important for pregnant women themselves to become informed and take an active role in securing high-quality care for themselves and their babies.”

The fact sheet includes a table summarizing the ACOG Committee Opinion recommendations under the headings “Instead of . . .” and “Many women can benefit from . . . ,” together with additional information expanding on the recommendations in the table. It references other ACOG recommendations supporting delayed cord clamping, skin-to-skin contact, and early breastfeeding and closes with a list of additional resources.

(See also CBU’s analysis of the Committee Opinion itself: “ACOG Endorses Optimal Care — Sort Of.”)

November 11, 2016
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Home Birth Circle – Rochester NY

Home Birth Circle -the 4th Sunday of the month from 1:00-3:00 pm., at Beautiful Birth Choices Studio, N. Winton Ave., Rochester, NY. Please contact them directly for more information. All are welcome (including Dads)!

Join other families in finding out more about home birth. This is the perfect place to have all your questions about home birth answered!

For more information and links to recent research, please see out homebirth page.

Updates will be posted on the events page, and you can visit the facebook page here.

Ryann Reading

November 11, 2016
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Creating a Birth Plan

Rochester Area Birth Network

www.rabn.org

Creating Your Birth Plan

 Why write a birth plan?

As you go through your pregnancy, you may begin to form some ideas about how you would like things to be at your baby’s birth. Care providers and medical personnel deal with many different people, all with different wants and needs. When you write a personalized birth plan outlining what is most important to you, you have created an effective tool for communicating your wishes to your birth attendants so they can help you achieve the kind of birth experience you desire.

Creating your birth plan:

Before writing a birth plan, educate yourself about the options available, and also about the advantages and disadvantages of different interventions and routine procedures (see below for recommended reading). The more you learn, the more likely you are to form a “birth philosophy” that will guide you in writing your birth plan. Find out what the routines and protocols are at your birthplace.

Your birth plan can be short or long, general or specific, but keep it personal. It should be as individual as you are. You may want to use some or all of the suggestions in the attached “Birth Plan Guide “. Keep in mind that a very long and detailed birth plan may be seen as inflexible and demanding. To avoid this while still getting what you want, use a friendly tone, positive language (say “I want…”, not “I don’t want…”), and express your willingness to be flexible should complications arise so long as you are fully informed of risks, benefits and alternatives and allowed to participate in decision making regarding your care. This sends the message that you are a concerned well-informed parent seeking to ensure the safest and most satisfying birth experience possible.

Presenting your birth plan:

Prepare a rough draft of your birth plan and let your midwife or doctor know when you schedule your next visit that you will bringing it in so the two of you can go over it together. You may want to request a longer visit to allow time for discussion without either of you feeling rushed, especially if some of your requests involve foregoing hospital policy regarding certain protocols and procedures. (Your care provider can give permission for you to forego many of these, if she or he is willing, but get it in writing!)

If your care provider is comfortable with your birth plan, terrific! Congratulate yourself on having picked a compatible provider, and make final copies of the plan. Have your doctor or midwife sign it and present it to all backup colleagues for their approval and signature. Make copies and have one put in your office records, one in the pre-registration file at the hospital or birth center, and give one to each of your labor support persons. Bring a few to the hospital or birth center (or have one at home for a home birth) and make sure that they get handed to nurses as needed

If your care provider seems uncomfortable with some of your requests. this is the time to have an honest discussion. Remember this is your baby’s birth, and you deserve to have it your way. If your care provider is not comfortable meeting your needs, and you are not comfortable changing your plans. you have the right to change care providers. As stressful as this may seem, it may be better than finding out during labor that your care provider can’t meet your needs. (It may help to remember that they attend perhaps hundreds of births a year, but this baby will only be born into your family once!)

 

The following books are excellent for anyone desiring informed options for birth, and contain wonderful birth plan ideas, as well as sample birth plans:

Creating Your Birth Plan: The Definitive Guide to a Safe and Empowering Birth
by Marsden Wagner & Stephanie Gunning 2006

 

The Birth Book by William and Martha Sears, 1994

Your Baby. Your Way: Making Pregnancy Decisions and Birth Plans by Sheila Kitzinger, 1987

Birth Plan Guide

In The Birth Book by William and Martha Sears, the authors recommend that you keep your birth plan friendly and personal, and include the following:

Opening paragraph. Introduce you and your partner, your birth philosophy, childbirth preparation.. and any fears, concerns or special help you require.

A list of everyone who will be at your birth. If using a professional labor assistant, list her name and credentials. State your preference that they remain with you at all times.

    Your preferences at time of check-in. Sears and Sears recommend asking for the option to go home if less than 5 centimeters dilated

–   Specify your room preference. State that you want a birthing suite or LDRP room.

–     description of the birth environment you desire. Mention lighting; your own music; no extraneous staff; privacy when desired and attention when needed freedom to vocalize feelings in whatever way helps. Mention comfort measures you plan to use.

Use Positive phrases – rather than saying NO to things, try to phase preferences in the form of a request. (e.g. “We Prefer to avoid…”) This avoids an adversarial atmosphere.

–  No time limits, please. State your preference that you not be hurried or given anxiety-producing time constraint as long as you and the baby are tolerating labor well.

–  State your nutritional needs. Ask for clear juices, water, and light snacks.

–  State your preferences regarding pain relief. If you do not want pain medication at all, request the freedom to use any self-help alternatives you find helpful, and ask that you not be offered medication, that any request should come from you if you change your mind. If you may want to use medication, state your preferences regarding type, and your desire to be informed of risks and benefits of the types available.

–  List your concerns about interventions. Mention electronic fetal monitoring; alternatives to pitocin augmentation; rupturing of membranes; I.V.; vaginal exams. Stress your desire to move freely during labor and use whatever positions you feel comfortable with.

–  List you delivery preferences. Request the freedom to choose whatever position you are comfortable in to deliver (squatting or side lying, for example). Ask for spontaneous pushing when you get the urge. rather than directed pushing. Ask to take the crowning stage slowly and have perineal support to prevent tearing rather than have an episiotomy. Ask that if an episiotomy appears necessary, that you be consulted Request that you or your partner cut the cord, if desired.

–  State preferences for first contact with baby. Ask that the baby be given immediately to the mother if medically stable. State desire to initiate breastfeeding immediately during private time for family bonding, and request that birth attendants and staff leave family alone as long as mother and baby are doing well.

–  State your preferences regarding care of your newborn. Request that routine procedures and exams be delayed until after bonding time, and then to be done in the presence of the mother, in the room if possible. Request rooming in, and keep baby with you skin-to skin. This encourages bonding, breastfeeding, and allows the mother the natural stimulation to help expel the placenta and cut down on bleeding.  State feeding preferences, circumcision or no circumcision, visits with siblings. etc.

For additional information speak to your local childbirth educator. A list of Independent Childbirth Educators can be obtained from Rochester Area Birth Network  ahaas@rabn.org

birthplan

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October 31, 2016
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Midwifery Birth Center Bill – RABN statement of support

Rochester Area Birth Network

A Chapter of Birth Network National, a 501c3 nonprofit organization

Its your birth… Know your options.

www.rabn.org

October 31st, 2016

RE: Passage of S. 4325.“An act to amend the public health law, in relation to midwifery birth centers”

RE: Passage of A.446: “An act to amend the public health law, in relation to midwifery birth centers”

Dear Governor Cuomo:

Rochester Area Birth Network is a chapter of Birth Network National, a 501-c-3 nonprofit

organization founded in 1996 to educate the public about healthy, research-based maternity

care in order to improve it. Our support comes from combination of, consumers, advocates,

midwives, doulas, childbirth educators, lactation professionals and more.

Rochester Area Birth Network fully supports Bill #A446/S4325 and urges you to pass it

during the current Legislative session. In particular we welcome the bill’s language defining

birth centers as midwife-led and allowing licensed midwives to be the clinical director in a

midwifery birth center. Research is clear that midwife-led birth centers are an important

option for childbearing families, and we recognize that the current law has multiple barriers

to creating and operating birth centers.

Rochester Area Birth Network also appreciates that regulations governing midwifery birth

centers are expected to require consultation with key stakeholders and to consider the

standards of state and national professional associations of midwifery birth centers.

We recognize that the Legislative session will end soon, and you have much to do. However,

the sooner this bill is passed into law, the closer we will be to providing the mothers, babies,

and families of New York State the opportunity to access birth centers in their communities.

Respectfully,

Rochester Area Birth Network

The Rochester Area Birth Network Steering Committee:

Scott Hartman, MD        Dianne Cassidy, IBCLC

Nella Goho, LCCE     Amy V. Haas, BCCE

Yasellyn Diaz-Vega, DC     Laura Schwartz, LCCE

Willa Powell, CPA         Molly Deutschbein, LMT, CST

Allison Fleming, DC

www.rabn.org

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October 31, 2016
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Microbirth Film Showing

The Institute for Family-Centered Childbirth would like to invite you to a showing of the ground-breaking film Microbirth!

Saturday November 12th, 2016, from 2 – 4 pm. at Shults  Auditorium , Nazareth College.

Please join us after the film showing for an expert panel discussion.  Three of the foremost researchers in the field will be discussing the film, their work, and the implications for the future of community health.

Included on our panel with be:

– Dr. Mary Caserta, University of Rochester Professor of Pediatrics and Infectious Diseases
– Dr. Rodney Dietert, Cornell University Professor of Immunotoxicology, Author of The Human Superorganism: How the Microbiome is Revolutionizing the Pursuit of a Healthy Life

 

–  Dr. J. Christopher Glantz, University of Rochester Professor of Professor OB/GYN & Public Health    Sciences

Dr. Dietert will be signing books, and they will be available for purchase.

We look forward to seeing you!

The Board of the Institute for Family-Centered Childbirth

https://www.facebook.com/The-Institute-for-Family-Centered-Childbirth-562094707252551/

 

 

 

Birth Rally

August 24, 2016
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Improving Birth Rally – 2016 – Rochester NY

What:  The 2016 Rally for Birth
When:  Monday, September 5th, 2016
Where:  The Tents next to the Olmstead lodge in Highland Park near the Conservatory
Time:  10am to 4 pm
There is a playground close by and there will be fun children’s activities.
What is the Rally for Birth?
Thousands of men, women and children will gather again in the days surrounding Labor Day, (check the map for location and time near you), as part of an international movement. Improving Birth’s “Rally to Improve Birth” will host its 5th annual rally, held simultaneously in locations all across the U.S., and in Canada, Mexico, and Australia.

This movement isn’t about natural birth vs. medicated birth. It’s not about hospital birth vs. homebirth or birth center birth.

It’s about women being capable of making safer, more informed decisions about their care and that of their babies, when they are given full and accurate information about their care options, including the potential harms, benefits, and alternatives. It’s about respect for women and their decisions in childbirth, including how, where, and with whom they give birth; and the right to be treated with dignity and compassion.

For more information about what Evidence-Based Maternity Care is, please click here.

Register on the Facebook Event page.

June 27, 2016
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Refusal of Medically Recommended Treatment During Pregnancy

In June of 2016 The American Congress of Obstetricians and Gynecologists issued a committee opinion on the rights of patients during birth.   Read the complete statement here.

“Recommendations

On the basis of the principles outlined in this Committee Opinion, the American College of Obstetricians and Gynecologists (the College) makes the following recommendations:

  • Pregnancy is not an exception to the principle that a decisionally capable patient has the right to refuse treatment, even treatment needed to maintain life. Therefore, a decisionally capable pregnant woman’s decision to refuse recommended medical or surgical interventions should be respected.
  • The use of coercion is not only ethically impermissible but also medically inadvisable because of the realities of prognostic uncertainty and the limitations of medical knowledge. As such, it is never acceptable for obstetrician–gynecologists to attempt to influence patients toward a clinical decision using coercion. Obstetrician–gynecologists are discouraged in the strongest possible terms from the use of duress, manipulation, coercion, physical force, or threats, including threats to involve the courts or child protective services, to motivate women toward a specific clinical decision.
  • Eliciting the patient’s reasoning, lived experience, and values is critically important when engaging with a pregnant woman who refuses an intervention that the obstetrician–gynecologist judges to be medically indicated for her well-being, her fetus’s well-being, or both. Medical expertise is best applied when the physician strives to understand the context within which the patient is making her decision.
  • When working to reach a resolution with a patient who has refused medically recommended treatment, consideration should be given to the following factors: the reliability and validity of the evidence base, the severity of the prospective outcome, the degree of burden or risk placed on the patient, the extent to which the pregnant woman understands the potential gravity of the situation or the risk involved, and the degree of urgency that the case presents. Ultimately, however, the patient should be reassured that her wishes will be respected when treatment recommendations are refused.
  • Obstetrician–gynecologists are encouraged to resolve differences by using a team approach that recognizes the patient in the context of her life and beliefs and to consider seeking advice from ethics consultants when the clinician or the patient feels that this would help in conflict resolution.
  • The College opposes the use of coerced medical interventions for pregnant women, including the use of the courts to mandate medical interventions for unwilling patients. Principles of medical ethics support obstetrician–gynecologists’ refusal to participate in court-ordered interventions that violate their professional norms or their consciences. However, obstetrician–gynecologists should consider the potential legal or employment-related consequences of their refusal. Although in most cases such court orders give legal permission for but do not require obstetrician–gynecologists’ participation in forced medical interventions, obstetrician–gynecologists who find themselves in this situation should familiarize themselves with the specific circumstances of the case.
  • It is not ethically defensible to evoke conscience as a justification to attempt to coerce a patient into accepting care that she does not desire.
  • The College strongly discourages medical institutions from pursuing court-ordered interventions or taking action against obstetrician–gynecologists who refuse to perform them.
  • Resources and counseling should be made available to patients who experience an adverse outcome after refusing recommended treatment. Resources also should be established to support debriefing and counseling for health care professionals when adverse outcomes occur after a pregnant patient’s refusal of treatment.”

 

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Ethics/Refusal-of-Medically-Recommended-Treatment-During-Pregnancy?IsMobileSet=false

December 28, 2015
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For Low-Risk Pregnancies, Home Births Just as Safe as Hospital

For Low-Risk Pregnancies, Home Births Just as Safe as Hospital

By Kathryn Doyle

|December 22, 2015(Reuters Health) – When women have no major risk factors in pregnancy and give birth with a midwife, their risk of stillbirth, neonatal death or serious injury to the baby are the same whether delivering at home or in a hospital, a new Canadian study finds.

Planned home births were tied to fewer interventions, like resuscitation of the baby or cesarean delivery, the researchers note.

“When studies are well designed and carried out, the data consistently find that when women with midwives in a system of well integrated home and hospital birth care give birth at home, outcomes are similar,” said lead author Dr. Eileen K. Hutton of the Department of Obstetrics and Gynecology and the Midwifery Education Program at McMaster University in Hamilton, Ontario.

“The findings were not surprising but were very reassuring,” Hutton told Reuters Health.

In the province of Ontario, 10% of births are attended by a midwife, and most happen in the hospital, according to the authors. In the U.S., about 8% of births were attended by a midwife in 2003, with most also happening in a hospital.

Hutton and colleagues compared about 11,000 planned home births with 11,000 hospital births in Ontario. More than half of the mothers had given birth before.

These were low risk pregnancies, with no risk factors like maternal alcohol or drug dependency, chronic high blood pressure, type 1 diabetes, gestational diabetes, heart condition, hepatitis B, HIV, anemia unresponsive to therapy, antepartum bleeding, eclampsia, small for gestational age babies or other factors. The authors also excluded premature deliveries, multiple pregnancies and babies who presented as breech.

Two-thirds of those who planned to give birth at home did so, and 97% of those who planned to be in a hospital were in a hospital, according to the report in the Canadian Medical Association journal CMAJ, December 21.

Eight percent of the home-birth group needed emergency services compared to less than 2% in the planned hospital group, but those in the hospital group had more interventions like labor augmentation, assisted vaginal delivery or C-section.

Stillbirth or newborn death happened in 1.5 of every 1,000 home births compared to 0.94 of every 1,000 hospital births.

“Most pregnancies start out as seemingly ‘low-risk,’ but complications may occur or surface along the line as the months pass by,” said Ole Olsen, a senior researcher at the University of Copenhagen in Denmark, who was not part of the new study.

“The ‘challenge’ for a pregnant woman is to stay healthy all the way to term (i.e. 37 weeks), without running into any complications,” Olsen told Reuters Health by email. “My guess is that at least 50% will be that lucky.”

A woman planning a home birth will need several health check-ups with her midwife to make sure that the pregnancy and her mental preparation is developing well, he said.

“In case of any doubt about the status of the pregnancy as low-risk, the midwife will consult with an obstetrician to clarify any precautions related to the specific health concern,” he said.

Most studies have found that home birth is less expensive than hospital birth, even in countries like Canada with universal healthcare, Olsen said.

In England and the Netherlands, qualified midwives are recognized as one of the birth options, and transport and transition from home to hospital are laid out smoothly, Hutton said.

“How that applies to the U.S. depends on jurisdiction, there are some areas where home birth is better integrated than others,” she said.

One of the advantages of home birth is it eliminates the hospital to home transition postpartum – when you have your baby you’re already where you want to be, she said.

SOURCE: http://bit.ly/1ATHfzi

CMAJ 2015.

October 26, 2015
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Mama Sherpas Film showing!

Mama Sherpas Film showing, Saturday,November 7th, 2015, 2 pm, at Nazareth College, Rochester NY. in the Shults Auditorium. Hosted by the Institute for Family-Centered Childbirth. Discussion to follow. Stay tuned for more information, or contact Amy. Go here for the official Flyer.

About The Movie

From executive producers Ricki Lake and Abby Epstein (The Business of Being Born), this topical new documentary, directed by Brigid Maher, examines a growing shift in the birthing industry: the rise of Caesarean sections. With C-section rates dangerously over 30% in America, are midwives the solution? In recent years, the idea of a “collaborative care” practice where doctors and midwives manage women’s care together has begun to gain traction. Research has demonstrated that collaborative care models produce better outcomes for mother and baby, including fewer C-sections. This moving and urgent film provides an intimate lens into how midwives across the country work within and better the hospital system, redefining how the US looks at the birthing process.

http://www.themamasherpas.com/#watch-the-film