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Interesting stuff...
This was taken from the CIMS newsletter, here

ACOG Issues Controversial New Guidelines for Induction of Labor 

The American College of Obstetricians and Gynecologists (ACOG) recently revised its 2003 guidelines for induction of labor.  The ACOG Practice Bulletin, Number 107, published in the August 2009 issue of Obstetrics & Gynecology serves as a resource to help medical practitioners make decisions about appropriate methods of cervical ripening and induction of labor and their effectiveness.  At least two of the ACOG recommendations, inducing labor for "psychosocial" (non-medical) reasons and cervical ripening with the synthetic prostaglandin misoprostol (trade name Cytotec), differ from labor induction practice guidelines issued by the Society of Obstetricians and Gynaecologists of Canada (SOGC) and the National Institute for Clinical Excellence (NICE), which drafts clinical guidelines in the U.K.
Induced labor puts women and babies at risk.  Compared to women who go into labor on their own, women who have an elective induction are at increased risk for intrapartum fever, instrumental birth, cesarean section, and are more likely to use analgesia including epidurals. Babies are at risk for irregular heart rate patterns, shoulder dystocia, neonatal phototherapy to treat jaundice, neonatal resuscitation and admission to a neonatal intensive care unit.  These risks are documented in CIMS' "Evidence Basis for the Ten Steps of Mother-Friendly Care" (see Step 6, pages 42-43).  According to the white paper "Idealized Design of Perinatal Care" published by the Institute for Healthcare Improvement, "Based on a review of U.S. medical malpractice claims, [the labor-inducing drug] oxytocin is involved in more than 50 percent of the situations leading to birth trauma."
These complications of labor also impact mother-infant attachment and the initiation and continuation of breastfeeding.  See "Breastfeeding is Priceless" (PDF). 
Although ACOG approves of "psychosocial" induction, NICE clinical guidance (PDF) warns that induction of labor has a significant impact on the health of women and their babies; it should be clinically justified and should not routinely be offered on maternal request except under extraordinary circumstances.  SOGC advises that there is no benefit to elective induction (PDF).  Because it is associated with potential complications, elective induction should be discouraged and only provided after women have been fully informed of the risks and of the inaccuracy of establishing gestational age.  ACOG approves of inducing labor at 39 weeks while SOGC states gestational age should be at least 41 completed weeks, and NICE guidelines state induction for non-medical reason can be considered at or after 40 weeks.
Misoprostol, an inexpensive synthetic prostaglandin, was developed and is marketed to prevent and treat gastric and duodenal ulcers.  The use of misoprostol for cervical ripening and induction of labor (off-label use) is approved by ACOG, but not recommended by either SOGC or NICE.  Misoprostol, also known as PG1, is not approved by the manufacturer for use in pregnancy (PDF).  Misoprostol is associated with excessive uterine contractions, fetal heart abnormality, hemorrhage, hysterectomy, and sometimes fetal death.  Both SOGC and NICE recommend its use be restricted to clinical trials.  For a more detailed discussion of the use of misoprostol for induction of labor, see Science & Sensibility.com. 
Nearly one in four births in the U.S. is induced (PDF) and according to the Agency for Healthcare Research and Quality (AHRQ), although it is not entirely clear what proportion of these inductions are elective (i.e. without a medical indication), the overall rate of induction of labor is rising faster than the rate of pregnancy complications that would lead to a medically-indicated induction.  According to Childbirth Connection's report, "Evidence-Based Care: What it Is and What It Can Achieve," the most common gestational age at birth among single babies in the U.S. is now 39 weeks rather than 40 weeks.

Consumer information on induction of labor is available from:

I find it interesting that the guidelines that our country uses are at odds with those used by Canada and the UK, and yet those countries have better maternal and infant mortality rates than we do. Am I the only one that sees a connection there?

If they say social pressure is not a good reason for induction, and they say that babies fare better when mother goes into labor on her own, and they say that mother fares better when allowed to go into labor on her own, and they remind us that the drug commonly used in US inductions is not approved for use in pregnancy... yet ACOG allows (if not encourages) all of those things... and THEY have better outcomes, it would seem to me that ACOG would be adopting some of those same policies when they update, rather than continuing to go in the opposite direction.

Current Mood: annoyedannoyed
14 August 2009 @ 10:02 am

Poll #1443821 The Birth Poll

Do you think that there should be a focus on more vaginal births in Southeast Texas? (to clarify - VAGINAL... not necessarily "all natural" or unmedicated for the purposes of this poll)

yes - vaginal birth has advantages to mom and baby that c-sections cannot duplicate
no - c-sections are just as safe as vaginal birth
I don't know

What kind of birth(s) did you have?


What is your opinion of hospital-based childbirth education/preparation courses?

I think they're a great option that is just as useful as an out-of-hospital course.
I think they're allright, but a mother would still need additional information to be prepared for her birth.
I think they're mainly designed to teach women how to be a "good patient", not give birth.
other (please comment and let us know!!)

When it comes to supporting elective, non-medically indicated c-section, I..

support the woman's choice, period.
don't feel like I can support c-section without medical indication.
am on the fence about it. I see advantages and disadvantages to both, but fall more on the "no" side.
am on the fence about it. I see advantages and disadvantages to both, but fall more on the "yes" side.
other (please comment and let us know what you think!)
Thanks for sharing your thoughts with us!
Current Mood: inquisitive
10 August 2009 @ 11:53 am

Whole Mothering Center could not function without our passionately dedicated volunteers. Though we have an ever changing list of women who work with us to help bring our mission to life, we're extremely grateful to those who are able to work wth us, even for short periods of time.

Current Volunteers:

Amber Barron
(amber's picture here)

Amber is happy to announce she will soon be celebrating her first official year of
motherhood! Before becoming a mom, Amber attended and graduated from
Hyles-Anderson Baptist college in Crown Point, IN where she spent her free time
volunteering as a counselor and tutor to the inner-city Chicago kids. She was very
involved in music and art and offered guitar lessons from her dorm room. She took a
semester off to work in Arteaga-Coahila, Mexico home-schooling missionary children and
offering bi-lingual piano lessons.

After discovering she was expecting, Amber began to notice a pattern of unsatisfactory
birthing experiences in the women she knew in the Beaumont area, which led her to start
questioning the maternity care/practices in the area and looking for alternatives. With the
help and support of Whole Mothering Center staff, she gave birth to a beautiful baby boy
in 2008 at St. Elizabeth Hospital and has been and continues to be successfully

Amber has been blessed with a supportive and loving husband who has given her the
opportunity to be a work-at-home mom. Her goal as a mother is to keep an open mind
and to make the most informed decisions possible by relying on research and
outcome-based evidence, professional opinions, and personal observations.

Amber believes that the birth experience has a long-term effect on mom and baby alike.
Her experience, coupled with knowledge of the experiences of those around her, has
fostered a firm belief that having relevant information and alternative options can lead to
a positive and empowering birth experience. Her success with breastfeeding has led her
to begin studying and training to be a lactation consultant, and feels that help and
support are a vital part of this success and seeks to offer it to any and every mom in
their journey through motherhood.

Anissa Eddie

(Check back for Anissa's bio - coming soon!)

Anna Sites

(bio coming soon!!)

Special thanks to the following ladies for their dedication and support in the past:

Dawn Reda, Tabatha Goynes & Anna Locke
Current Mood: thankfulthankful
12 November 2008 @ 10:19 pm
This post is dedicated to the myriad questions that breastfeeding mothers may have about breast pumps,
from 'do I need one" to 'which one is right for me'. If you have a question that is not answered on this page,
contact us!

Do I need a breast pump?
The answer depends on your circumstances. For most women who will be with their babies, the answer is
no. For women who will be away from their babies for work, school or due to other circumstances (such as
an ill baby in the NICU), the answer is yes. There are, of course circumstances in which a 'stay at home'
mother may need or want a pump (such as a mother with milk supply issues or when Mom want to go out
without the baby), and a few mothers who have a lot of separation from their babies may not need a pump
(such as an extremely overabundant milk supply coupled with a baby who has adjusted his routines to only
nurse when mother is present). Individual mileage varies!

For the stay at home mother, having a manual or small battery operated pump on hand is nice and can be
useful to help with things like engorgement, helping to boost production or handling small trips away from
baby. Lately, there has been a marketing program to help convince breastfeeding mothers that they
a pump. For the most part though, if you're going to be with your baby, a pump is not a 'must have'.

What kind of pump do I need?
The type of pump you need depends on why, how often and for how long you need to pump. A mother who
is usually at home with her baby will need a different pump than a mother who is working or going to
school. If time is important, think about selecting a double pumping breast pump instead of a single one.
Pumping both breasts at once can save you time
and can be more effective. Below are a list of breast
pumps from Medela and suggestions for when they work best. Ameda/Egnell also makes quality pumps
and has a similar pump style and function (however, WMC recommends Medela products).

If you are planning to go to school or work part-time, or you're going away without your baby for a few days (for occasional or short term pumping): Mini Electric, Double Mini Electric,
Manual harmony Pump, Manual Spring Express, Manual Electric (this pump contains the parts needed to upgrade to an electric pump).

If you are planning on working or going back to school full-time, or you're going away without your baby for a week or more (pumping 2-3 times a day or more and for long term pumping): Pump-N-Style (looks like a shoulder bag
or backpack), Hands-fee Pump, Lactina Select (for rent only), Classic Medela Pump (for rent only), Symphony Pump (for rent only).

If you have a preterm baby who is unable to breastfeed yet and you need to keep up your milk supply, you
will need to pump every 2-4 hours daily: Lactina Select (for rent only), Classic Medela Pump (for rent only)

or Symphony Pump (for rent only)
, *Pump-N-Style (can be used if Lactina, Classic or Symphony Pumps
are unavailable).

How often should I pump?
How often depends on several factors, including (but not limited to) your baby's gestational age, mother's number of days postpartum, baby's health, individual milk production and goals. We recommend talking to a lactation
professional about your individual situation, however a rule of thumb is every 2-3 hours from the beginning of one pumping session to the beginning of the next. Pump until you have had at least one let-down per breast (at least 20 minutes), and for 5 minutes after your breasts stop dripping.

I'm planning a weekend away from my baby. What's the best type of pump for
If your baby is still nursing regularly, you will need to pump as if you were nursing (at least every 3 hours)
to maintain your milk supply. It often take a woman a while to 'learn' to let down for a pump, so we recommend pumping at least once per day for up to a week before you leave to help your body adjust. For a short trip, a manual pump may be enough, though you may find that renting an electric pump is faster and more productive.

My doctor told me to pump and see how much milk I am making.
Read this: A breast pump will NEVER tell you 'how much' milk you're making.

A breast pump is only capable of telling you how much milk the pump is able to get out of your breast. Your
healthy, full-term baby is much more efficient at the breast than any pump on the market. Many women
have been discouraged - some to the point of needlessly supplementing or stopping breastfeeding
altogether - because of this directive. If you're in doubt about your milk supply or your body's ability to
produce milk, we encourage you to contact a lactation specialist
, breastfeeding educator or LLL Leader.

My baby is in the Neo-natal Intensive Care Unit (NICU). Do I need to pump?
YES! For all babies, colostrum and breast milk is the optimum mix of nutrients and antibodies at the right time. For babies who are ill or in the NICU, providing your baby with your milk is even more important. Many neonatal pediatricians or specialists will recommend augmenting your milk with a supplement designed to help your baby gain weight, which is usually fine, however we do recommend that mothers of NICU babies be adamant that their baby be fed their own pumped milk. Doing everything you can to help your baby, especially breastfeeding (or feeding your baby your own milk) is something that only you can do for your baby.

I'm planning to/exclusively pumping and feeding my milk to my baby via bottle. What should I know?
Exclusively pumping is a great way to ensure that your baby gets only your milk, but it is very time consuming and requires a LOT of dedication and effort. Exclusively pumping has been described as "all the work of breastfeeding, AND all the work of bottle feeding combined!". Most mothers who chose to pump would say that they had rather their baby been able to feed directly from the breast. However, in some cases it is unavoidable, and it is becoming more common form mothers to pump exclusively by choice. Support will be key in helping to address concerns specific to exclusively pumping mothers as well as those shared with moms feeding from the breast. Here are some links to help get you started:
Kellymom - Pumping & Bottle Feeding
Kellymom - Exclusively Pumping
Exclusively Pumping
Exclusively Pumping Rules - A mother-to-mother blog support site by Jen, Amy & Christine

Did you know?

W.I.C. will provide a breast pump and nursing bras to qualifying mothers free of charge! In addition,
breastfeeding mothers are allowed additional produce & other items not available to other clients.
Talk to your WIC Breastfeeding Support Person now!
WIC Offices in Jefferson Co.

Breast Pump Rentals & Sales in Beaumont

Nature's Way Breast Pumps  (Medela Products & Accessories)
Debbie Maxwell
2655 N 9th St
Beaumont, TX 77703
(409) 898-8417

Walson, Inc (Ameda Products & Rentals)
50 N 11th St
Beaumont, TX 77702
(409) 835-3091

A note about breast pumps: Please do not buy a breast pump that is made by a company that also manufactures or promotes infant formula! We encourage you to fully research all of your options and all
breast pumps and related products before making a purchase.

Additional Links:
Work & Pump
KellyMom - Milk Expression Tips & Pump Information
PumpingMoms.org including the PumpMoms Yahoo Group

Current Mood: pumped!

What is a Doula?

Doulas provide emotional and physical support to a woman and her partner during pregnancy, labor, birth and early postpartum period. They are called many things including: Childbirth Assistant, Labor Support Professional, Birth Assistant, Birth Companion, etc., but the description we like best is "walks with mother".

Basically, your doula is there to 'walk' with you on your journey through pregnancy, childbirth and early mothering to help educate, support and validate the choices you make for your birth and family. In addition, your doula is also available to walk with you as a 'mother's helper' when you need of help or support with your children at other times.

Why do I need a Doula?

According to "Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier and Healthier Birth", by Kennell, Klaus, and Kennell (1993), having a doula can help reduce your risk of forceps assisted delivery and cesarean section, shorten the length of your labor and decrease requests for pain medications.

Women who have a doula attending them during their labor are:
  • 26% less likely to give birth by cesarean section
  • 41% less likely to give birth with vacuum extraction or forceps
  • 28% less likely to use any pain medications and
  • 33% less likely to be dissatisfied with or negatively rate their birth experience

(Hodnett and colleagues 2004)

Why use a Doula?

In order to have a positive birth experience, most women need continuous labor support. Although Obstetrical Nurses and Midwives are experienced in dealing with a laboring woman's emotional and physical needs, they can seldom guarantee the support they provide will last throughout the labor - especially in hospital settings where shift changes, coffee breaks, heavy paperwork and busy nights regularly occur. Some OB nurses handle
up to six laboring couples at a time. Midwives may be able to offer more labor support, but they too have clinical duties to which they must attend.

The father or partner may be better able to provide continuous support but usually has little actual experience in dealing with the forces of labor. Even fathers who have had intensive preparation are often surprised that the amount of work involved is often more than enough for two people. Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation.

The laboring mother's mother or mother-in-law, likewise may be better able to provide continuous support, but her own experiences and knowledge of birth are not always useful to the laboring mother, especially when the laboring mother's ideals or expectations in childbirth differ from those of her mother or mother-in-law.

A professional doula can help bridge the communication gap between family members and help keep the mother focused on her birth and provide the emotional support to help the mother achieve the birth she wants. A doula can also act as a liaison between the laboring couple and their medical support team.

What is a Doula's role?

Your doula can be as involved as you want her to be. Before hiring her, your doula will go over the services that she provides and discuss with you your expectations and desires for her role in your birth. It is important to remember that there are limitations to a doula's role; for example: a doula does not speak for a couple, provide medical or clinical skills or act in any unprofessional manner. Most certifying organizations have Policies of Practice that each doula must follow. The Doulas of the Whole Mothering Center have chosen to certify through Doulas of North America (DONA) (see website link below).

A doula may provide:

  • explanations of medical procedures
  • emotional support
  • advice during pregnancy
  • exercise and physical suggestions to make pregnancy more comfortable
  • help with preparation of a birth plan
  • massage and other non-pharmacological pain relief measures
  • positioning suggestions during labor and birth
  • support for the labor partner so that they can love and encourage the laboring woman
  • help in avoiding unnecessary interventions
  • help with breastfeeding preparation and beginnings
  • a written record of the birth
  • many other services that vary from doula to doula

Will the Doula replace the father?

Some fathers or partners are concerned they may be sidelined or replaced by the Doula during labor. Although individual situations vary, and one should question a prospective doula about her philosophy. Generally the answer to this question is no - she will not replace him. Studies have shown that fathers usually participate more actively during labor in the presence of a Doula than without one. A responsible Doula supports and
encourages the father and enhances his support style rather than replaces him.

When should I hire a Labor Doula?

Retaining the services of a Doula is recommended at any point from the onset of pregnancy that still allows adequate time for the Doula to become a fully integrated member of the labor support team. Ideally, our feeling is that the earlier a Doula is retained, the more time there is to decide what role she will play in your process of becoming a mother.

When should I hire a Postpartum Doula?

Since your Postpartum Doula will be working closely with you and your family in your home, she should ideally be familiar with your family dynamic and the physical layout of your home so enough time should be allowed for all parties involved to be comfortable working closely together.  We recommend retaining the services of a Postpartum Doula no later than four weeks before your due date. In some instances, your labor and postpartum
Doula will be the same person so that your relationship with her will already be well established for your postpartum period.

What training does a Doula receive?

There are several certifying organizations through which Doulas may receive part of their training. Additionally, an integral part of a Doula's training is her own personal pregnancy, birth and mothering experience and the experience she has gained in assisting other mothers as a doula. While many doulas choose to seek certification through a recognized body, certification is not required by any organization or state in the US.

All of our Doulas are certified through or are working towards certification through the nationally recognized doula certification organization of their choice. They also bring with them their own experiences and the insights they've gained through working with countless mothers in various other programs and capacities in the Southeast Texas area. Doulas working with the Whole Mothering Center also undergo a period of hands-on
apprentice training with a more experienced Doula during the certification process.

You can find out more about Doula Training and Certification through these agencies:


How much does it cost to retain a Doula?

Doula services range in price from area to area and doula to doula. Some of this is based on the experience your doula has, some is based on the going rate in your area.

At the Whole Mothering Center, B
irth Doula packages begin at $450.00, and Postpartum Doula packages begin at $350.00. We also offer an hourly rate so that you can "create your own" package of services. In some cases, we can base our fees on income. One reason we have chosen to offer this service is so that any mother who wishes to have the support of a Childbirth Doula or a Postpartum Doula will have the opportunity to have those
services. Our goal is to help support mothers, and we don't feel that a mother's options should be based on
her ability to pay.

Is your question missing from this list? If so, please
email us and we will add it!

This film begins with dialouge as soon as it starts, so be ready to listen (make sure your speakers are on). 

 This was sent to me by a friend this morning (thanks, Jeannette) from Midwifery Today's E-News: 

This spring, I had a Master's student, Ragan Cohen, who wrote about why and how to prevent cesareans. Then she took it the next step and learned how to make a YouTube! She interviewed moms who had both vaginal and cesarean deliveries. Ragan would like the video to be used in the birth community—in your childbirth classes, clinics, classrooms, whatever. Here is everything you'd want to know in 5 minutes flat. Enjoy! http://www.youtube.com/watch?v=EZy0JPtubiQ

— Cynthia B. Flynn, CNM, PhD
Associate Professor of Nursing,
Seattle University

I'd like to add my thanks to Ms. Cohen for her efforts in creating this video, and for allowing to to be shared so openly! 


Current Location: Beaumont, TX
28 July 2008 @ 11:28 pm
One of the first things I tell new moms is that "though breastfeeding is a natural process, that doesn't always mean that it's going to come naturally". In truth, MANY new mothers have trouble in the first couple of weeks. The good news is that in the vast majority of cases, when properly supported, most mothers will find that the troubles and diffculties have subsided by around the six week mark. While that may seem like a long time, think about it this way - how long does it take you to fully develop a new talent? From that point of view, six weeks (and usually less than that) is a relatively short time!

La Leche League International, who is considered the "world authority" on breastfeeding, calls the process of nursing a baby an "art". Like most artisans, the area of expertise requires intense study and focus to master. Unlike other forms of art, breastfeeding requires not only that mother catch on to what should be happening, but also requires baby to catch on as well. If one partner in the breastfeeding relationship is not "getting it", then it can take longer to master.

There are several things you can do to help get breastfeeding off to a good start.

Prepare during your pregnancy!
     One of the best things that you can do for your breastfeeding relationship with your baby is to get educated and informed on what is within the range of "normal" before your baby gets here. That way, if things do start to seem overwhelming, you know where to go to for good information and support. A great source of support is SETXPlaygroup in Beaumont. The majority of moms there are breastfeeding moms, so you have a wide base of knowledge and experience to lean on. The group meets weekly and has a chat list that is open 24/7, so you have a listening ear or shoulder to cry on at all hours. Plus, the more you interact with these women, the better friends you become and the srtonger your support network becomes. Another great group for pregnant moms is La Leche League of Beaumont. They meet each month and getting to know the local Leaders can be a big help if you need assistance in the early weeks. One of the best breastfeeding resources out there is www.KellyMom.com. This website is FULL of everything you'd ever want to know about breastfeeding, from getting started to weaning.
  • La Leche League International is a nonprofit, nonsectarian organization dedicated to providing information, support, and encouragement to women who want to breastfeed. La Leche League of Beaumont meets each month to provide the same for women in our area. All women, whether they are currently breastfeeding, pregnant or simply interested in breastfeeding, are welcome to come to our meetings or call our Leaders, regardless of whether or not you have beastfed, how long you have or if you plan to

    Leader Contact Information
    Amity 755-3273
    Heather 347-1245
    or email
    beaumontlll-owner@yahoogroups.com for information.

Take a Class! 
     At some point towards the end of your pregnancy, take the time to attend a comprehensive breastfeeding education course with your partner. Though both WIC and the hospital may give an overview to breastfeeding, neither take the time to evaluate what your knowledge base is and make sure to fill in the gaps. A comprehesive course will ensure that you know what to expect, what is normal and that you will know where to go for help if you need it. Whole Mothering Center offers a breastfeeding class that is comprehensive and easy to understand. It covers all the basics and goes over some troubleshooting tips for first time parents as well. St. Elizabeth Hospital also offers a breastfeeding class, as do WIC Offices in Jefferson Co..

Hire a doula!  
     This may sound like we're tooting our own horn, so to speak, but a doula is an essential part of the birth team. Many doulas are also breastfeeding specialists, with both professional training as well as personal experience that can be essential in helping a new mother feel as though she is doing things "right". Your birth doula will make sure that your baby is latched on before she leaves, and your postpartum doula is available to make sure that things continue going well (or can be there for hands-on help if they're not). Doulas are sometimes covered by insurance, and WMC offers a sliding scale for low-income women. We believe that an inablity to pay should not limit your choices when it comes to your birth! Contact us today for a FREE consultation!

Get Support!  
     Many new mothers don't give much thought to how their friends or family can affect breastfeeding, and it is an important thing to address. If your mother or your friends have had negative or unsuccessful breastfeeding experiences, they may not be the support you need while you are nursing your child. Surrounding yourself with women who have positive breastfeeding experiences and who are up to date with current breastfeeding information can be a factor that determines whether or not you meet your breastfeeding goals. SETXPlaygroup, La Leche League of Beaumont, API Support Group of SETX - all of these groups are full of women with tons of breastfeeding experience and are almost without fail willing to help.

Get professional help if you need it!
     A professional lactation counselor or peer counselor can help with most 'normal' breastfeeding difficulties, such as sore nipples, difficulty in latching, sleepy baby, slow weight gain, engorgement, over or under supply of milk, pumping, nursing through pregnancy and/or tandem nursing, etc.
     An IBCLC (International Board Certified Lactation Consultant*) may be needed when you have major complications that you'd like to work through, such as a cleft lip or palate, breastfeeding after breast surgery, NICU babies, adoptive nursing, severe jaundice, etc.

Local breastfeeding professionals:
  • Heather Thomas, Breastfeeding Educator & LLL Leader

  • Christus St. Elizabeth Hospital Breastfeeding Warmline:
    409.899.8523 or toll free 1.800.810.2829
    Lori Wenner, IBCLC and Stacie Jones, IBCLC
* International Board of Lactation Consultant Examiners

Additional Resources

Breast Pump Sales & Rentals in Beaumont
Nature's Way Breast Pumps  (Medela Products & Accessories)
Debbie Maxwell
2655 N 9th St
Beaumont, TX 77703
(409) 898-8417

Walson, Inc (Ameda Products & Rentals)
50 N 11th St
Beaumont, TX 77702
(409) 835-3091

A note about breast pumps: Please do not buy a breast pump that is made by a company that also manufactures or promotes infant formula! We recommend fully researching any breast pump or
product before making a purchase.

www.kellymom.com - General, all purpose breastfeeding resource. Easy to use SEARCH feature.
www.lalecheleague.org La Leche League International (Find your local group)

www.safefetus.com If mom needs to take a medcation while pregnant or nursing, she can look the drug up on this site and see if it is "safe" to take.

WMC's "Information for Moms Who Pump!" page

Breastfeeding Resources for Women of Color:
Black Breastfeeding Blog was created by Jennifer James as a way to reach black mothers who are currently breastfeeding or who want to breastfeed in the future.

Mocha Milk All things related to breastfeeding and the African-American woman. General breastfeeding information, issues specific to African-Americans (and biracial and
other minorities), support, research and encouragement.

TTC & Nursing - for mothers who are trying to conceive while breastfeeding
Pregnant & Nursing - for mothers who are pregnant and still breastfeeding
TNL - Tandem Nursing List - for mothers who are nursing more than one child at a time
Extended Nursing - for mothers who are nursing past 1 year of age

"Is this safe?" (herbs and medications)
Could We Have Thrush? (yeast/candida infection)
Breastfeeding & Guilt
"Normal is a Very Scary Word" by Diane Wiessinger, RN, IBCLC
The Risks of Infant Formula Feeding
Supplementation of the Breastfed Baby "Just One Bottle Won't Hurt"---or will it? by Marsha Walker, RN,
The Advantages of Formula by Kate Hallberg
What Every Parent Should Know About Formula by Katie Allison Granju
Katherine Dettwyler, PhD - A Natural Age of Weaning
Thomas Hale, R.Ph, PhD. - Breastfeeding Pharmacology
What if I Want to Wean My Baby?
The Real Issue of Breastfeeding Goes Beyond Mere Guilt by Cynthia Good Mojab, MS
World Alliance for Breastfeeding Action
Night Weaning: 12 Alternatives for the "all-night Nurser"
Katherine Dettwyler, PhD - A Natural Age of Weaning
Thomas Hale, R.Ph, PhD. - Breastfeeding Pharmacology
What if I Want to Wean My Baby?
The Real Issue of Breastfeeding Goes Beyond Mere Guilt by Cynthia Good Mojab, MS
World Alliance for Breastfeeding Action
Night Weaning: 12 Alternatives for the "all-night Nurser"

 Recommended Reading

Texas Milk Banks

Texas Children's Hospital Lactation Program &
Mother's Own Milk Bank

Lactation Program / Milk Bank West Tower, Room 445
Telephone number 832-824-6120
Referral Fax Number 832-825-3633  

Mother's Own Milk Bank
Days / Times Daily, (including weekends and holidays)
8 a.m. to 5 p.m.
(After hours, contact the lactation consultant on call through
the page operator at 832-824-2099.)  

Lactation Support
Assistant Director Nancy Hurst, R.N., D.S.N.(c), I.B.C.L.C.
E-mail nmhurst@texaschildrenshospital.org

Mother's Milk Bank
900 E. 30th Street, Suite 214
Austin, TX 78705

phone 512-494-0800
fax 512-494-0880
toll-free 1-877-813-MILK

email: info@mmbaustin.org
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The following is Wikipedia's entry on "informed consent":
"Informed consent is a legal condition whereby a person can be said to have given consent based upon an appreciation and understanding of the facts and implications of an action. The individual needs to be in possession of relevant facts and also of his or her reasoning faculties, such as not being mentally retarded or mentally ill and without an impairment of judgment at the time of consenting. Such impairments might include illness, intoxication, insufficient sleep, and other health problems."

I wonder how often, though, informed consent is actually and truly obtained for medical procedures and interventions during chidlbirth? I know for a fact, for example, that during my last birth, the admitting nurse CERTAINLY didn't obtain my informed consent before stripping my membranes. She actually explained to me WHILE she was examining me that she was was "loosening things up a bit", but never that stripping of my membranes could likely introduce infection that might be risky to my baby during a vaginal delivery before ASKING if I'd like to have it done. My attending doctor didn't obtain my INFORMED consent when proposing to break my bag of waters. He didn't tell me that one of the reasons that many women choose NOT to rupture their membranes is that it sometimes leads to fetal distress. Anyone want to venture a guess as to what happened as soon as my membranes were ruptured (aka: water broken)? My baby's heartrate began having decelerations during each contraction. He began exhibiting signs of fetal distress. Was the fact that that was a possible outcome included in the list of pros and cons discussed with me PRIOR to the procedure (i.e. informed consent)? In fact, were ANY cons disclosed? No. Not one. In fact, the only thing that was eluded to was that we "needed" to get things moving along. I don't remember being given any reason, just that we "needed" to. It wasn't until after the procedure that things went south. REAL QUICK. Less than 20 minutes later, my child was forceably ripped from my body through an incision in my abdomen and my doctor was the hero who had saved the day. Never mind that things were proceeding normally before the AROM (artificial rupture of membranes). Never mind that NO OTHER procedures were attempted, much less suggested, to remedy the situation. The FIRST course of action was c-section................or, as I was informed, we'd likely BOTH die horribly. Again, was true INFORMED consent given? Was I told of the risk of infection or the risk or hemmorage or the risk of any of the other PLENTY of things that can go wrong during a c-section? You guessed it. NEVER  ONCE.

My problem with procedures being performed without true informed consent is that the patient isn't armed with all the information they need to be able to effectively assess their risk during each procedure. My decisions weren't based on factual and proven risks and I know, after talking with lots of mothers lately, that it's pretty routinely done that way. I'm actually pregnant with another child and have, in fact, taken the intiative to inform myself. I've drawn up a birth plan and enlisted a support team who are totally on board with what it is that I want out of this birth and don't doubt that none of them will hesitate to obtain my informed consent for any proposed procedure. 

I encourage each of you to force your medical providers into a position of disclosure of ALL the possible risks and benefits of each procedure they propose. 

Here are some interesting tidbits concerning informed consent:

  • Sometimes health care workers refer to the consent form itself as an informed consent. This is not quite accurate. Informed consent is the process or action that takes place as you learn about and consider a treatment before you agree to it. Your signature on the form is taken to be evidence that this took place. In other words, if you don't feel FULLY informed, DON'T SIGN THE CONSENT. Once you've signed it, you're as good as legally informed whether or not you're ACTUALLY informed.                                                                                                                                              
  • Even when there are no other accepted medical treatment options, it is still your right as a competent adult to refuse to have a treatment that you do not want. But once you sign the consent form, it is considered to be your formal, legal agreement that you are okay with the plan or procedure that is listed on the form unless you revoke (take back) your consent before treatment is given. The doctor or facility will usually give you a copy of the consent form, but they keep the original as a legal record that you agreed to the treatment. In other words, once you DO sign the consent, you have no recourse unless you revoke it BEFORE a procedure is performed. You have, after all, signed that you understand and have been informed of ALL possible risks.

  • For informed consent to take place, the information that is shared must be understood. This responsibility is shared by the patient, since the doctor won't know what you don't understand until you ask about it. The patient must have the chance to consider the information and ask questions. In other words, be certain that you understand exactly what is to be performed and what risks are involved before signing because after you sign, you can't say that you weren't informed that a negative outcome was possible. You've signed that you WERE informed.

  • Informed consent requires disclosure of "material" (significant or important) information that will help the patient make an informed choice. The law defines material information in 2 ways; in terms of your health provider's responsibility and in terms of patient responsibility. Your health care provider's responsibility is limited to telling you those things that a health professional practicing in your community would tell you under the same or similar circumstances. Patient responsibility, however, and a patient-oriented standard of disclosure, is different. It means that the health provider is required to make known all the facts, risks, and alternatives that a reasonable person in the patient's situation would consider important in deciding whether to have a recommended treatment. In other words, you carry the majority of the burden of ensuring that you have given informed consent, not the doctor. His only burden of proof is obtaining your signature. He assumes that if you sign the consent, you're informed.

  • Part of the informed consent process includes allowing you to ask questions about other treatments that may help you or other options that may offer you something that you prefer. You may choose other options, even if they are not as well proven as the one your doctor recommends or prefers. This is the part where you bring to the table all the research you've done BEFORE the proposed procedure and suggest alternatives that you'd like to try first. Examples might include changing laboring positions to encourage quicker labor progression as opposed to using medicinal augmentation, having a hep lock placed as opposed to a continuous IV line or intermittent fetal monitoring as opposed to continuous so long as everybody's doing well.

  • If you are competent to make your own medical decisions, you have the right to refuse any and all medical treatment and diagnostic procedures. Even if not treating the disease or condition means that a patient will die, US courts have affirmed the right of patients to reject treatment. If you have decided to refuse treatment or diagnostic tests, the health provider may inform you of the risks or likely outcomes of this choice. This is called informed refusal. The doctor or facility may ask you to sign a form that states you received this information, and that you still choose not to be treated. If you do not wish to sign, the doctor may ask witnesses to sign that you were so informed in order to protect himself.

As much as informed consent is talked about in medical circles, it's sometimes unclear how to go about making sure you are being given the whole laundry list of pros and cons when actually having "the" conversation with your doctor. Here is a list of of some good talking points to consider when discussing procedures and interventions:

  • What is my diagnosis (the medical name for the illness I have) and what does that mean for my pregnancy and/or labor?
  • How serious is my diagnosis? (There should be a diagnosis for any recommended course of action.) 
  • What methods of treatment/procedures are recommended?
  • Are there other treatment options/procedures we should consider? If so, what are they?
  • What benefits for myself and my child would you expect from the recommended treatments/procedures and other options?
  • What are the risks to myself and my child or complications of the recommended treatment/procedure and the other treatment/procedure options?
  • Are there discomforts for myself and my child that may be caused by the treatment/procedure?
  • What are all the possible side effects of the treatment/procedure to myself and my child -- immediate, short-term, and long-term?
  • How will having the treatment/procedure affect my normal process of labor?
  • How would having not having treatment/procedure affect my normal process of labor?
  • Is there a time frame that you are willing to delay the treatment/procedure in an effort for the condition to normalize on its own?
  • Can you suggest any natural alternatives to the treatment/procedure that might be as effective?

Once you have gone through the process of becoming informed, the decision must be made as to whether you will follow your doctor's recommendation and proceed with his suggested treatment. Your doctor should give you ample time and not resort to bullying and unethical treatment to sway your decision. Assuming that you've been informed of the risks of denying treatment, the risks shouldn't have to be repeated to you unless you specifically ask for them to be. Generally, there is time for a private discussion between yourself and your spouse of other support person even in an emergency situation. Ask for 5 minutes alone to regroup and assess what risk is acceptable to you and what risk you aren't willing to consider. 

One important point to remember is that your doctor is obligated to continue his care of you regardless of your decision. According to ICAN (ican-online.org), professional ethical guidelines state that a physician may only drop you from his care after giving you 30 days notice. This means that if you are within 30 days of your likely delivery date, your care provider cannot terminate your care. In addition, if you are pregnant and are outside of that 30 day time frame, your provider must give you a referral and ensure you are transferred to a specific provider. Physicians who fail to meet these guidelines may be charged with patient abandonment, which is grounds for malpractice and constitutes a violation of ethical conduct that could result in loss of licensure.

In addition, a hospital may not refuse to admit you or treat you even if you refuse a procedure that is deemed necessary by them or their doctors. This includes hospitals who have "banned" VBAC (vaginal birth after cesarean) even if you refuse a cesarean section. The federal Emergency Medical Treatment and Active Labor Act (EMTALA) requires hospitals to admit women in active labor and to abide by their treatment decisions until after the baby and placenta are delivered. The act was originally designed to prevent hospitals from "dumping" patients who couldn’t pay but has since been widely used to hold hospitals accountable for violating other patient rights, including the right to refuse treatment. If your hospital threatens to perform a cesarean despite your refusal, notify them that they are in violation of your rights under EMTALA and that you plan to file a complaint. To find out where to report an EMTALA violation, go to MedLaw.

Understanding informed consent is a huge first step in ensuring that you get the birth experience you want especially in a birth culture like our local one. When you realize that YOU are the person who calls the shots in your medical treatment (or lack thereof), you become empowered in a way that you never realized before that you could be. In that scenario, doctors, nurses and hospitals become exactly what they were always intended to be - consultants who are being paid for their professional medical opinions. They have no more power over what happens to you than you give them. The "god" complex that has grown to become associated with doctors is one WE have handed to them through our own lack of education and blind trust that they always have our best interests at heart. As much as I truly believe that there aren't very many doctors who would cause intentional harm to their patients, I also know that sometimes their primary motivation is to avoid litigation even if it means suggesting a course of action that might not be at all what their patient would have chosen given access to all the information.

~ Amy

**Portions of this blog were directly quoted from ICAN (ican-online.org) and the American Cancer Society website (cancer.org).

Current Mood: chatty
14 April 2008 @ 01:02 pm

You may ask yourself "Why do they have a page dedicated to talking about c-sections?" Our goal witin writing this post is to bring awareness to the rising number of c-sections that are performed on women each year in Southeast Texas, and in the US, and to educate women about the serious risks that result from routine use of what is designed as an emergency procedure.

Research shows that there is an increase in postpartum depression, postpartum psychosis and post-traumatic stress disorder in women who have had c-sections. Many of our friends and clients have had c-sections for various reasons and we feel that this is an area that really calls for more support from peers and professionals. This is particularly important in light of the fact that the c-section rate for Jefferson County is over 43% (2004).

The information in this post is designed to help women understand what factors can increase their risk of c-section, what having a c-section might mean for them and what options they have for pregnancies after a c-section, and to support them throughout their experiences no matter what the circumstances.We realize that some of our positions on birth and maternity care are unpopular. We feel that this quote explains our position better than we could:"A truth's initial commotion is directly proportional to how deeply the lie was believed. When a well-packaged web of lies has been sold gradually to the masses over generations, the truth will seem utterly preposterous and its speaker, a raving lunatic." - Dresden James

Click here to return to the Pregnancy page.

Interested in VBAC in Southeast Texas? With local hospitals placing a (illegal and unethical)  "ban" on VBACs, what can you do? CLICK HERE!

APRIL is  Cesarean Awareness Month!


What is a cesarean section (c-section)?
A caesarean section (cesarean section), or c-section, is a form of childbirth in which a surgical incision is made through a mother's abdomen and uterus to deliver one or more babies. It should only be performed when a vaginal delivery would put the baby's or mother's life or health at risk.

Why might I have a c-section?
Usually, a woman's medical care provider will recommend a c-section when one or more factors present
themselves, however different providers may disagree about when a cesarean is required. For example,
while one obstetrician may feel that a woman is too small to deliver her baby, another or a midwife might
well disagree. Similarly, some care providers may be much quicker to cite "failure to progress" than others.
Disagreements like this help to explain why cesarean rates for some physicians and hospitals are much
higher than are those for others. The medico-legal restrictions on vaginal birth after cesarean (VBAC),
have also increased the cesarean rate.

You can find a list of medically indicated reasons for c-sections
here. A discussion of other factors that may
prompt an OB to recommend c-section can be found

"Obstetricians and hospitals have found that high-intervention birth, warranted or not, is very profitable. So
there is a tremendous financial incentive to bypass the clinically optimal approach, and opt for convenience
and profit. For example, many hospitals across the country have eliminated facility-based midwifery
practices simply because the low-intervention approach, while clinically sound, does not bring in as many
- Tonya Jamois, president of ICAN


What factors can impact or increase the risk of having a c-section?

This is hardly an exhaustive list, but some factors may include:

  • maternal health complications
  • fetal health considerations
  • history of sexual abuse
  • inadequate prenatal care
  • lack of education about birth and the issues that surround it
  • not knowing what the variations on normal are in childbirth
  • choosing to birth in a hospital

  • continuous fetal monitoring
  • staying in bed during labor
  • having epidural or spinal block
  • having pain relieving drugs
  • going to the hospital 'too early'
  • allowing 'too frequent' internal examination
  • lack of confidence or self-esteem
  • lack of support
  • thinking of pregnancy & birth as an illness or a medical event
  • thinking of c-section as 'normal'
  • not asking your OB what his or her c-section rate is
  • having lots of friends who have had c-sections

"Epidurals rip women off of an opportunity to experience themselves as competent adults." - Margaret Egeland, CNM

"Technology has turned the fetus into a patient, reducing the mother to being the 'maternal environment' and preventing attachment until after the ultrasound has shown the fetus to be 'normal'." - Jennifer Hall

Can I have a vaginal birth after having a c-section (VBAC)c-section?

For most women, the answer is YES, YOU CAN! Vaginal birth after cesarean, even after repeat cesarean, is not only possible but it is usually SAFER for both mother and baby and safer for future pregnancies as well. As in all things, there are some instances where VBAC carries more risk than a repeat c-section, but those instances are fewer than you may think. Each mother should ask questions about her previous cesarean(s) and learn what the circumstances were that led to the cesarean section recommendation in order to make decisions based on what best fits her needs. Discussing your previous birth(s) with your care provider and getting a second and/or third opinion from another type of care provider is always a good idea as well!

"If I don't know my options, I don't have any." - Diana Korte

Why should I consider VBAC?

Repeat cesarean has been proven to be more dangerous than VBAC (childbirthconnection.org). Additionally, women who have successfully had a VBAC report that they have a better postpartum experience. Few women would choose major abdominal surgery that requires a lengthy recovery period over a natural process that has fewer risks, a shorter recovery period (mothers are often able to perform most tasks within hours or days of birth) and statistically better outcomes.

"Quite interestingly, the highest rate of VBAC is in women who have experienced both vaginal and cesarean births and given the choice, decide to deliver vaginally." American Pregnancy.org

"Reluctant doctors like to believe that they haven't much influence over their patients, but that is clearly not the case. Several studies have found that when doctors genuinely encouraged women to have VBACs, most of them did, and when they said nothing or acted neutral, most women didn't. Finally, when obstetricians discouraged VBAC in women who wanted to try it, none of them did.
"A study of interactions between women and obstetricians offers an explanation. It described three levels of increasing power imbalance: In the first, you fight and lose; in the second you don't fight because you know you can't win. However, in the highest level of power differential, your preferences are so manipulated that you act against your own interests, but you are content. Elective repeat cesarean exemplifies that highest level." -
Henci Goer, Thinking Woman's Guide to a Better Birth




Unfortunately, at this time there are no practitioners in Southeast Texas who offer VBAC as an option that we know of. If your Southeast Texas OB offers VBAC, please contact us so that we may get in touch with him or her about adding him or her to this section.

If you would like to help bring VBAC back to Southeast Texas, we urge you to write a letter to your practitioner and to the local hospitals. We are currently working on an online petition to help address the issue of VBAC in Southeast Texas, among other things.

At this time, our recommendation for women interested in VBAC is to contact a Houston-area midwife listed on our
Pregnancy page.

Current Mood: empowered
25 March 2008 @ 09:57 pm
There are a wide variety of qualifications that I personally look for in a care provider. First among them are personality, their interest in me and what things are important to me during the course of our visit, personal views, education, wisdom and experience.Recently, the topic of "experience" has been called into question. Is experience alone enough to call yourself "qualified" to offer care or support to another person? I think that depends, in part, on what each individual person deems necessary in order to feel supported. It also depends on what the care provider feels is her responsibility to provide her clients. For conversations sake, let's limit this to the medical and related fields surrounding the pregnant and new mother, shall we?For some women, seeing "OB/GYN" behind a doctor's name is the ultimate in "qualified". Another may require "CNM" following her midwife's name in order to feel that her care provider is qualified. Still another woman may rely not so much on the official certifications, but on the recommendation of her close friends or family members, and so may choose a lay midwife to attend her birth. Still other mothers eschew traditional care providers altogether and choose to rely on their own previous experience and education to see them through their birthing experience.All of these views and preferences have value.Still another area of care for the pregnant woman and family is in doula services. Though not new in theory or practice, doulas are relatively new to this area. Many women aren't familiar with the term "doula". If you're not, a doula as usually defined today means a professional labor support person who works with the expectant mother and her family to help her achieve the birth she wants. A postpartum doula provides care to the new family and often helps with breastfeeding and light housekeeping - both are sort of a "mother to the new mother" role. This type of service becomes more and more important in today's cultures where women live far from their own mothers or other relatives and few companies have adequate paternal leave policies.So back to the topic at hand - we were talking about "qualifications". Many doulas are certified through nationally (and internationally) recognized programs. Two of the largest and most recognized associations are Doulas of North America (DONA), Childbirth and Postpartum Professional Association (CAPPA). Both these and other certifying bodies have extensive requirements, including educational workshops, childbirth education, reading and writing portions, a review of one's own birthing processes and some also require breastfeeding education as well.Many care providers are called into service positions that care for expectant and new mothers because of their own experiences. Either things went swimmingly and they are eager to help other mothers have the same type of experience, or there was something that didn't go as they had planned and their mission has become to help other mothers avoid the same kinds of situations and outcomes. Both pathways call dedicated and caring women. There is no doubt that certification has a certain level of expected education or experience, and to many, those letters instill confidence that the care provider has at least a minimum of education, experience and skill. But the flip side of that is that every class has a "smart kid" and a "not-so-smart kid". There's really no way of telling which end of the spectrum your provider falls at. A certified care provider of any type may have done only the bare minimum to pass the certification exam or process, but have virtually no other experience!Please don't think that I discount certification - if I didn't think it was important, then I wouldn't be working towards my own certifications as a doula, childbirth educator and IBCLC. As I said, many women are "called" to these types of professions because of their own experiences. I am one such woman, and in between raising my two children, I completed La Leche League International's Leader Accreditation training in 2003 and completed a Breastfeeding Educator's course in 2005 because I felt that the additional training afforded by these agencies would enhance my skills and knowledge . I continue to work with numerous mothers, both in person and over the phone to provide breastfeeding support, and spend time with many of those women in their homes acting as an uncertified postpartum doula. My time with them has no less value because I am not yet certified as a postpartum doula, rather, I feel that this experience enhances my training.My point is that we shouldn't allow ourselves to be blinded by the certification and miss that an equally qualified but uncertified care provider may be more compatible with our personal ideals or philosophies. Each individual mother and couple must find the care providers that meet their needs, whatever they are. In that capacity, Whole Mothering Center is completely dedicated to providing resources t women and families in Southeast Texas. It is my goal, if I personally cannot hep you, to help you find someone who can. 

~ Heather
Current Location: Beaumont, TX