Wednesday, September 24, 2014

Report from the AABC Birth Institute

Special thanks to former LaneCoFBC Board Member Katharine Gallagher for her report on last week's Birth Institute in Washington, DC.

September 20, 2014

Greetings Lane County Friends of the Birth Center!

Thanks for asking me to write about attending the annual American Association of Birth Center’s Birth Institute in Washington, DC. I attended as a board member for the Commission on the Accreditation of Birth Centers. I joined this board a few years ago and it’s been a great chance to build on the positive advocacy experience of participating with the LaneCoFBC consumer group.

It’s an exciting time for birth centers and the communities they serve. There are now 270 freestanding birth centers in the United States in 37 states and DC. This represents growth of 38% since early 2010 when there were 195 birth centers in the US. The word is definitely spreading about the quality, outcomes and consumer satisfaction with birth-center and midwifery care.

The AABC Birth Institute is an action-packed couple of days. The fun kicked off with a day of lobbying. Following a morning briefing by the AABC federal lobbyist, I hopped on a bus with birth center midwives, nurses, administrators, owners and supporters from around the country to visit our elected officials on Capitol Hill. I met with staff from Congressman DeFazio’s and Senators Wyden and Merkley’s offices.

Lobby day was a great chance to share information about critical issues and to highlight important accomplishments. I especially liked providing information about the AABC Strong Start for Mothers Initiative. Strong Start is a four-year demonstration project for reducing preterm birth using the birth center model of care. The Center for Medicare and Medicaid funded this grant and the PeaceHealth Nurse Midwifery Birth Center is one of the demonstration sites.

At the Birth Institute, I also previewed the brand new movie “Microbirth.” This short documentary presents and discusses current scientific research on epigenetics. The potential inter-generational consequences that may result from the interruption of physiologic birth are explored. If ever there was a film to caution against unnecessary intervention in childbirth, this is it.  

What’s a conference for and by birth center professionals and supporters without a visit to an area birth center? Having the chance to visit Birth Care and Women’s Health in Alexandria, Virginia was terrific fun. It’s a beautiful birth center right in the heart of a busy urban corridor.  

In the midst of all this excitement are board meetings for the CABC. Giving my time to this organization allows me to see first hand the infinite ways in which diverse and always-evolving birth centers use accreditation to flourish through accountability. These birth centers are the lynchpin to the continued rising profile and reach of birth centers within the maternity care system. Check CABC out to learn more about the exciting important work it does to support growth of the birth center movement.

Monday, August 18, 2014

Lissa's Beautiful Hospital Birth

Elisabeth's birth story
by Lissa
Photo by Deborah Louie

I researched the options for the safest and most fulfilling way of giving birth.  I decided a midwife at a birth center was what I wanted. I wanted skin-to-skin time, no drugs, breastfeeding only and no stress of a hospital. As my pregnancy came to an end, I was at 41 weeks and still had not gone into labor.  After discussion with my midwife and husband, we decided to begin induction.  That night found me in a hospital, exactly the place I wanted to avoid.  I personally hate hospitals.

After monitoring the baby, we were unable to proceed as we had originally counseled with the midwife.  Instead, my induction plan required an IV catheter, which was also a hated and dreaded affair.  Placing the catheter fulfilled all my negative expectations as I had difficult veins.  A restless night later, there was still very little contractions and I was not in labor.  Another induction technique was used and failed.  Finally, we decided to induce with pitocin.  It was 24 hours since checking into the hospital and 10pm at night that the pitocin was started.  I think I was able to rest an hour before the contractions began coming too strong.  Waking up my husband to help with counter pressure, I began a night I will never forget yet find details hard to remember.

The contractions came each time harder than the last.  I attempted to ride them like waves as the birthing class explained.  It is much easier said than done, however with the encouragement of my mom, husband and labor nurse I found a rhythm.  I remember finally releasing and giving into the whims of my body in the blessed jacuzzi, better termed the "aqua-dural".  At that moment, I had no other recollection beyond my contractions but the intense pain dulled and I felt I could indeed do this!

After awhile I opted to have my water broken as I was getting exhausted and was ready for the end.  My cervix was very slow to dilate.  I was only at 7cm when the midwife broke my bulging sac.  The rest seems a blur as I attempted not to push but often could not override my body. Finally, only dilated to 9cm, the midwife said it was safe to push.  I have never felt so relieved! Ten minutes later, there was a baby girl laying on my stomach.  She wasn't breathing.  I remember thinking she was so slimy, followed by asking over and over if anyone could tell if she was breathing.  I didn't want to panic, but I was worried and no one was responding to me as all focus was directed to my non-breathing child.  The midwife had her cord cut and Elisabeth whisked away to be resuscitated in record time.  Laying in bed getting sutured, I would get reports from nurses that Elisabeth was intubated (a breathing tube placed so they could breathe for her), then sent to the NICU, and finally extubated and crying.

A pediatrician came and gave us the report of her status and instructed us that we would not be able to hold our baby for 3 days as she would be in a cooling therapy with intravenous feeding to avoid brain damage. (She took 7 minutes to begin breathing on her own during her resuscitation.)  I went home without a baby recognizing my entire birth plan had been tossed out the window with the exception of being able to labor without drugs.

Three days later, I held my baby girl for the first time and began breastfeeding that day.  I have never felt such a rush of pure joy.  It was a trying and exhausting 5 days total of being in the NICU for Elisabeth and for us but we got through it with the support of God, family, and the wonderful staff.  It has only solidified the pure joy of giving life to a wonderful baby who thankfully is completely healthy.  It was an experience I would never give up thanks to my midwife and birth-center support prior to and during my labor.

Did you have your baby with the Peace Health midwives? 
We would love to hear your story too!

Friday, August 15, 2014

Hannah's Beautiful Hospital Birth

Thank you to blogger hmv for sharing the story of her daughter's birth at Riverbend with the Peace Health midwives. You can read more about Hannah at her blog: "The Lighthearted Life of hmv"

My Birth Story
by Hannah

My birth story has been hard to write.  The experience of giving birth was many things I expected -joyous, exciting, intense- and many things I did not -emotionally draining and even traumatic.  Many people told me that you cannot predict what your birth will be like and to expect some changes in the plan.  But that kind of advice doesn't really help prepare you, and I guess that's the point.

As many of you know, I prepared for a birth without medication using a technique of self-hypnosis.  We took an intensive birth preparation class called HypnoBabies, which I really liked.  Essentially, the class teaches you how to use deep relaxation, similar to meditation, to "turn off" your body when you need to and to focus on relaxing through the contractions.  Many women who used this technique said that they had pain-free births, and on average, women have shorter labors and fewer complications.  It was also a really nice way to prepare for birth because Jake and I would do practice exercises together that help you let go of fear and just relax.  Can't complain about that.  The actual reality of the birth experience was a little different.  But we'll get to that.

Ultimately, I wanted a healthy birth without interventions so that baby and I would be as safe and healthy as possible.  I think it's a common misconception that women who want a natural birth are martyring themselves for some heroic purpose.  I'm not anti-drugs; I love Advil and I've never gotten a prescription that I didn't fill immediately.  But I researched all-things birth for a long time and decided that the best thing I could do for me and the baby would be to use what nature gave me and avoid interventions.  Epidurals and pain meds are not 100% safe for mom or baby, they often lead to more and more interventions, and I have a close friend who recently endured one of the worse epidural-related I was motivated.

But on to the story.  Stories are better with pictures, so here we go...

My sister Amy Lou getting my birth hair ready.

My water broke at 8am on Wednesday, August 10th.  I had an appointment that morning at 8:30am at the PeaceHealth Nurse Midwifery Birth Center.  I'd been getting all my prenatal care there, and I highly recommend it.

Unfortunately, when I looked down to see that water was spilling out of me, I also saw that it was not clear.  I yelled to Jake in the kitchen, "I think my water just broke."  He came in and was a little confused too - to be honest, it kind of looked like I was just losing control of my bladder.  But I wasn't.  The discoloration was due to meconium in the water, which is the baby's first poo and is supposed to happen after they're born (ick).  It can be a sign of fetal distress ... or it can just happen because you are 6 days overdue (my situation).

Click here to read the rest of the story


Did you have your baby with the Peace Health midwives?
We would love to hear your story too!

Wednesday, April 30, 2014

One Birth, Many Stories: Jeni's Beautiful C-Section Birth

One birth, many stories
By Jeni 

When I talk to people about the birth of my son, many hear the story and remark, “Wow, it’s almost like you had two birth experiences—one natural birth and one c-section birth!” I often make a joke about how others should be jealous of my two-for-one bargain birth. And indeed, it’s true: some days it feels like that, two totally different birth experiences. But as I’ve thought back on the birth over the past two years and tried and tried again to write Jack’s birth story, I realized that it is (of course) one birth—one event—but many, many ways of telling the story. And all of them are true.

The short version.

I went into labor almost two weeks early, and my back labor continued over the course of 26 hours. After pushing for over four hours at the birth center when the baby wouldn’t turn, the contractions slowed. We transferred to the hospital for medicine to speed up the contractions. This didn’t work, and we decided to have a c-section birth. Our son Jackson Gale was born, beautiful and healthy.

The middle of the night version.

Did I push hard enough? Maybe I didn’t push hard enough. Did I go on enough walks? Maybe I should have walked more. We didn’t have a doula. Should we have had a doula? An epidural? A birth tub at home?

The advice from a friend whose natural birth I envied and to whom I needed to confess my natural birth shame version.

I did what I needed to do for my baby. I am an amazing mom. I will get rid of that guilt right away: it isn’t serving me. I am an amazing mom!

The version after hearing from another friend who had a c-section and described the procedure as making her feel powerful, like Athena being ripped from Zeus’s head:

I am a birth warrior! I AM MYTH EMBODIED!

The “don’t tell the birth story to my friends who are pregnant, it will infect them with bad luck and Ina May says not to listen to bad birth stories so be quiet” version.

“Oh, it’s fine. It didn’t go as planned, but we were so grateful Jack is happy and healthy! How are you feeling?”

The probably true (right?) version.

We had our best shot possible at a natural birth, which is what we wanted: we prepared well, had no complications during pregnancy, and went into the experience without fear. And we were given great care; we felt that our needs were respected and we were never bullied or pressured into procedures we didn’t want. It’s just that this birth required different tools and didn’t end the way we had planned.

The version from the surgical notes obtained from the midwives (excerpted).

The baby’s position was occiput posterior. After external maternal expulsion efforts were unsuccessful, the patient consented to a caesarean section.

The long long long version, so I don’t forget.

Click here to read the full story of Jack's birth 

 Did you have your baby with the Peace Health midwives?
We would love to hear your story too!

Tuesday, April 29, 2014

Kara's Beautiful (Epic!) VBAC

In honor of Cesarean Awareness Month we are so pleased to share the story of Kara's incredible VBAC (Vaginal Birth after Cesarean). 

By Kara

I've been planning to write this for a while now... and I have ideas for a more fun and entertaining version, but this will do for now... 

After waking up around 7:00 AM and being sure my water had sprung a slow leak, I called our midwifery clinic and was assured I was just in very early labor and all was well. I had an appointment scheduled for a check up that afternoon anyway, so as long as there were no major changes, she said they’d see me at 3. We spent the running errands and dropping Riley off for a sleep over with his buddy Ty while I had mild and manageable contractions. At our check up the midwife on duty found that I was at 2 cm and she was sure Gus would be born in the next 24 hours. 

We went home and watched a movie, ate and generally hung out… all the while my contractions were really starting to pick up. We timed them for a few hours and while they were still manageable, they were in the range our midwives wanted us to call and come in for… this being a VBAC and all. So we arrived at the hospital around midnight and I was still just 2 cm. After 12 hours of walking around, monitoring, and overall labor icky-ness I was still only at 2 cm and declared to be in prodromal labor (super fun topic to Google) and given a shot of morphine while our midwife talked the OB on call into letting us go home. 

We arrived home and I crashed for a few hours. JD went to get Riley and we all settled in for the night… well - they settled in and those pesky contractions decided to pay me another visit. I was determined not to go back to the hospital until I was ready to push (and contemplating giving birth in our X-terra on the way) so I spent the night laboring in and out of the shower and on the birth ball. At about 5:00 AM, after tearing our bathroom sink half off the wall, I finally woke JD, called a friend to come stay with Riley until my mom could get there and we headed back to the hospital. 

At 6:40 AM I was back in a labor and delivery room with the same wonderful nurse from hospital stay #1, Tammy, at our side, midwife Pat reporting for duty… and dilated to… 3 cm. “You’re kidding %$#^*&! me” I groaned. 3 cm. Wow. SO… they started some Pit and I was up walking around, hanging out on the birth ball, etc. trying to relax and get things GOING. At 10:15 I was at 4. Pat broke my water so they could place an internal monitor on Gus’s little head because I was moving a LOT and they had a hard time keeping tabs on him as they are required to for VBACs. I got in the shower, out of the shower and started throwing up. Great!!! I thought, I must be at that magical point I’d heard and read about… barfing then pushing, awesome. Wrong. At 12:25 I was only at 7 cm. But it was progress… real progress and I could see the light at the end of the tunnel. I tried out the Jacuzzi tub for all of 5 minutes and hated it, spent more time on the birth ball and squat bar. At 3:00 PM I was 8 cm. 

Then, Pat finally said those words, “You really need to rest, I think you should get an epidural.” I was crushed but so thankful all at once. I’d made it SO far, but was terrified of being to tired to push when I needed to. At 3:40 I got an epidural and after 56 hours of labor with only a few hours of “rest” I was about to doze off and on for a few hours. At 4:10 PM I was still at the 8 cm from an hour, no progress. At 6:00 PM I was 9 cm and at 7:40 I was FINALLY FINALLY FINALLY ready to push. 

For the next 59 minutes, supported by my amazing husband and our beloved midwife I pushed my heart out. When Pat finally said those words I’d been dying to hear, “His head’s out!” I was done. Or so you’d think. But… his shoulder got stuck. In that horrifying and unbelievable 60 seconds I pushed my hardest, an army of nurses descended to push and shove on the outside of my belly and Pat ultimately reached in and helped pull Gus out.

He was a blueberry, not breathing. They took him to the little table and started giving him oxygen. His heart rate was always strong but it took him another minute before he took his first breath. His APGARS were 2 at one minute and then 9 at 5 minutes! They brought him to me and he latched on right away. He was so amazing and beautiful and BIG. While Pat sewed me up, we nursed and got to do introductions to Dad. I finally couldn’t stand it any longer and told them I had to know how much he weighed! Pat guessed 8 ½ or 9 lbs but… drum roll… he was 10 lbs 2.2 oz!!! 

He is a miracle. I am stronger than I ever thought I could be. It was an insane 60 + hour ride, but I wouldn’t change it or him for anything. Do I wish for a slightly shorter version of his labor for next time (and a slightly smaller baby), sure… but we are quite a team, Gus Gus and I.


Did you have your baby with the Peace Health midwives? 
We would love to hear your story too!

Monday, April 28, 2014

Evynne's Beautiful C-Section Birth

In honor of Cesarean Awareness Month we are so pleased to share the story of this recent, beautiful c-section birth. Welcome to the world Ashland, and thanks to his parents Peter and Evynne for sharing their incredible story with us. We are thrilled you all are part of our Birth Center Family.

Did you have your baby with the Peace Health midwives? 
We would love to hear your story too!

Tuesday, April 24, 2012

Friends requests re-evaluation of policy barring women from laboring at birth center at or past 41 wks pregnancy

In its capacity as the consumer advisory group to the PeaceHealth Nurse Midwifery Birth Center, Lane County Friends of the Birth Center recently sent the following letter. It expresses concern over and requests a re-evaluation of the new policy barring women from laboring at the birth center at or past 41 weeks pregnancy. 

Ms. Michele Peters-Carr, CNM
PeaceHeatlh Nurse Midwifery Birth Center
353 Deadmond Ferry Road
Springfield, OR  97477

April 12, 2012

Dear Michele:

On behalf of the Friends of the Birth Center consumer advisory group, I am writing to express concern about the new policy prohibiting pregnant women at or past 41 weeks from laboring at the Nurse Midwifery Birth Center. Since May 2011, several families have expressed their surprise and displeasure at losing access to a much-anticipated and planned-for out-of-hospital birth.

As a consumer advisory group, Friends of the Birth Center has the following specific concerns regarding the development and implementation of this new policy.
  • We have the impression that the decision-making process resulting in this change was set not by Birth Center midwives but rather for them. The Commission for the Accreditation of Birth Center requires that birth centers operate as independent practices with the necessary autonomy and authority to develop evidence-based standards for care.
  • The new policy runs counter to the 42-week standard (with increased surveillance) for out-of-hospital birth set by the Commission for the Accreditation of Birth Centers.
  • The Birth Center already has a thorough surveillance protocol for monitoring women at and beyond 41 weeks to identify risks making a birth center birth unwise. This protocol is consistent with evidence-based practice.
  •  The policy is not supported by the literature. All the references in the attached review confirm that risk rises with advancing gestational age. The issue that arises is not risk but rather how much risk is too much for out-of-hospital birth. The risk at 41 weeks is less than the risk of many other complications occurring in normal pregnancy.  Almost all of the referenced studies endorse expectant management with antenatal testing. This was the policy employed by the Nurse Midwifery Birth Center before May 2011.
In the more than 25 years since its inception, the Birth Center has developed a well-deserved reputation for excellence in practice. Its outcomes meet and exceed state, national and international standards and benchmarks. In light of this, we would like to encourage a re-evaluation of the current policy.

We encourage a return to a decision-making process that both respects the authority of the midwives, as providers, to oversee the development of standards of care and facilitates collaboration between them and  specialists. Such a policy would incorporate rather than override the preferences and values of pregnant women. If there is relevant new information, this can be incorporated into the decision-making and consent process already in place to support and aid women in making decisions about their care.

We appreciate the opportunity to share our concerns. We are optimistic that a review of the above items will facilitate a worthwhile discussion resulting in a satisfactory conclusion for all involved. Having the opportunity to be included would be most welcome by the Friends of the Birth Center

Katharine Gallagher, Chair 

Consumer Advisory Group Members
Maria Alisa Blum
Anna Chorlton Connelly
Katharine Gallagher
Lynn Kane

Emeritus Members
Eleanor Vandegrift
Karen Guillemin
Kathy Lynn
Renee Bailey

Kathi Levell, PHMG Executive Director, Planning
John Wire, PHMG Manager of Women's Services
Lane County Friends of the Birth Center blog (

encl: Post-date literature review

Post-date literature review
  • The American College of Obstetricians and Gynecologists (green journal) June 2003  Labor Induction Versus Expectant Management for Postterm Pregnancies: A Systematic Review With Meta-analysis
  •  American Family Physician May 15 2005 volume 71, number 10  Management of Pregnancy Beyond 40 Weeks' Gestation
  •  Journal of Midwifery and Women's Health Sept/Oct 2009  Comparison of Induction of labour and Expectant Management in Postterm pregnancy: A Matched Cohort Study
  • Journal of Perinatal medicine 38 (2010)  Recommendations and guidelines for perinatal practice  Guidelines for the Management of Postterm Pregnancy
  • Medscape reference 3/25/2011 author Aaron Caughey MD  Postterm Pregnancy
  • SOGC Clinical Practice Guideline  No. 214, September 2008  Guidelines for the Management of Pregnancy at 41+0 to 42+0 Weeks