Wednesday, October 27, 2010

CPM Licensure for Pennsylvania

I was asked to make a consumer presentation to the Pennsylvanian Board of Medicine yesterday on behalf of Certified Professional Midwives for their appeal for licensure. This was my presentation to the Board. It was a very long day and a long trip to Harrisburg, but access to midwife CPM is the right of every woman who desires it.

In February of this year, in attendance with my husband, I delivered a beautiful baby girl. While obtaining care from an obstetrician and preparing to deliver in a hospital, we found that the journey to our baby’s delivery took some unexpected turns. You see, as a board-certified and fellowship-trained physician, I had only been exposed to birth in a hospital setting. I did not realize that there was any other option. However, after much research, reading, and asking questions, at 34 weeks pregnant, we made the decision to have a home birth. Of course, the number one goal for us was safety for me and my baby. I wanted a natural birth, but we discovered that there is a terribly high cesarean rate in the US. The cesarean rate at many of the hospitals in the Philadelphia area alone is higher than 35%, yet the cesarean rate around the world is approximately 10%, partly due to the Midwife Model of Care. A hospital is a good place to be if you are ill or if you need specialized care. After all, it is the place where I have worked for over 15 years. But, pregnancy and birth are natural physiological events. All births do not need to be performed in the hospital. So to my husband and I, the real question about safety was not, “Do we want to have a pleasant birth at home or safe birth in a hospital?” It was “Do we want to birth at home and run the very small risk of an emergency that might, but not necessarily, be handled better in a hospital, or do we wish to give birth in a hospital with its additional stress and the likelihood of an intervention?” It became clear that birthing at home with certified professional midwives was the best choice for us.

We chose to have a home birth with certified professional midwives for other reasons too. Among them were the certified professional midwife’s expertise and specialized training in working outside the hospital setting for birth, the thoroughness of care, the continuity of care, and the postpartum support for both me and my baby. As a health care provider, I make a conscious effort to provide exceptional care for my patients. Therefore, I am in a unique place to evaluate other providers as a health care consumer. I continue to be impressed by the highest professional level of care that I have received from my midwives. Each visit lasted an hour in face to face time of counseling. In each visit, my physical health was addressed in many facets. We went over nutrition, exercise, my psychological health and our preparedness for our baby’s arrival. For continuity, I liked that the same health providers that cared for me during my pregnancy were going to be the same health providers that would be present during the delivery of my child -the same two midwives from beginning to end. There were no shift changes. We saw one of our two midwives at every visit. After the birth of my daughter, the midwives did a home visit every other day and checked in by phone on the other days. They followed us closely for six weeks, providing breastfeeding support and postpartum physical and psychological support. They did well-child visits for my baby. They were available to us on call at any hour. They answered questions every new parent has about her baby. In short, they provided the framework that is so important for the start of a new family.

Of course, we prepared for the upcoming birth in the visits as much as possible. We asked what would happen in the event of an emergency. We saw the emergency equipment that the midwives brought to every birth, and were comforted by the knowledge that our midwives were prepared for transfer to the nearest hospital in case of any problem. In the end, I gave birth in the comfort and safety of my own home, surrounded by people whom I love. In this regard, our daughter was born in a loving place. And I WAS much more comfortable at home. I was not flat on my back, feet in stirrups, attached to catheters, IV’s and monitors. I could walk around until it was time for the actual birth. Lastly, by choosing homebirth, we were immediately part of a larger community. This community consists of other women who have given birth at home. We are urban, educated women, as are our families. We are lawyers, physicians, teachers, engineers and artists. We want the very best for our babies and our families and in larger numbers each year, we are choosing certified professional midwives in our communities as our care providers for planned homebirths.

Sunday, October 24, 2010

MemMem and Dada

Anjali has recently started to talk. At first, we just attributed the sounds as syllabic strings all babies say. But now, it is quite clear what she means. She calls Mama "MemMem" and she calls Papa "Dada". The sounds don't always stop at two syllables so I could be "Memmemmemmem" but it is clearly me and most often "Memmem". She can also say "hi". We are listening for other sounds but haven't been able to identify any others yet. We haven't noticed her sign anything yet, but she clearly knows the sign for milk.

New Skills, by Anjali

Yesterday, I stood multiple times by myself without any support for up to 10 seconds. And today, having never gone up more than 1 stair and never on my own, I now went up an entire flight. In fact, the next time, my mama who went upstairs for one minute, came down to find me already on the 4th stair. She was proud of me but quite concerned. The thing is, my papa returned the IKEA stair gates just yesterday, thinking that we wouldn't be needing them for a while. My friend Uma was here today and she gets up the stairs so maybe I was just watching her to see how it is done. My mama just ordered another gate and my papa put up some stair blockades. I haven't figured out how to get down yet, except for head first. That, my parents tell me, won't quite do.

Wednesday, October 20, 2010

Moo Baa La La La

This is currently Anjali's favorite book. It was given to us by mama's friend Abigail. Anjali looks at us in anticipation as soon as we are going to make an animal sound. She even goes to get the book and bring it over to us to read to her. It makes her smile - EVERY. SINGLE. TIME. And we love reading it to her and looking at the adorable pictures. Now, what else can you ask from a book?

Helping Papa Take Apart The Crib

Anjali, always the perfect helper, was accompanying Papa as he took apart her hardly used crib. Mostly, we used it to contain stuff, rarely to contain Anjali. It just looks like baby jail. Good riddence.

Helping Mama Shred Papers

Such a sweet helper child! As I was demolishing a pile of unnecessary papers, Anjali came by to help. She helped demolish some by ripping them to shreds and attempting to eat them.

Anjali + Itzela

The cuties are growing up! The first time Anjali saw Zela was the a few days after her birth day, literally. Zela is now 14 months old. She is Christy Santoro and Martin Wiley's daughter. Madhavi and Christy were visiting and the girls were having a play date.

Tuesday, October 19, 2010

Anjali Demolishes A Pear

I'll admit, I was skeptical at first. I was about to cut the pear into strips, and even peel it. Mama simply took a bite out of it to get it started. Then Anjali went to town on the thing. I took a small bite just to have a taste. Otherwise, it was all Anjali.

Who says you need teeth to eat a piece of fruit?

Wednesday, October 13, 2010

On The Swings with Uma, by Anjali

Today Uma, our papas and us went to Liberty Lands park and hit the swings. This was Uma's first time. It was my first time going on the big swings while papa wore me in the carrier. Once the little swings were free, we went in those.

In the little swings

In the big swings with our papas

Sunday, October 10, 2010

Bum Genius 4.0

We switched out of our cotton pre-folds with wool Imse Vimse covers to the ultra nice Bum Genius 4.0. That, my friends, is the latest and greatest in the Bum Genius diaper series. We decided to switch out for a couple of reasons. The first was that we needed something that would fit over our daughter's super chunky thighs. Next, we needed something that we could take off fast and was waterproof for nighttime wear. And finally, we needed something that would allow her to stand correctly, not like a cowboy with rickets. So, after a trip to The Nesting House in Mt. Airy, we settled on the Bum Genius. I ordered extra microfiber stuffings from Cotton Babies and we are off and running. At night, we don't even need doublers and liners now. We are glad we used the organic cotton prefolds for as long as we could - we always had fresh ones and I like that they were organic cotton right next to her bum. But now our needs have changed. I would have liked that the inserts were still organic cotton, but I am still happy with these and hope to transition Anjali to organic underwear soon. 

Saturday, October 9, 2010

EC Progress

Anjali is 8 months old. Yesterday, she was playing with her blocks and then stopped and crawled over the potty. I went over to her, picked her up, took off her pants and diaper, went to the big potty (the toilet) and put her on her baby bjorn toilet seat. Then I sat there and started to read a book. I read the book again and then she pooped. She pooped!!!!! Valsalva manuever and all. I ended up reading the book 3 times and then we were done. This is really huge for us. Today, too, she crawled over the potty, Jeremy sat her on it and she peed. Yay!!

Monday, October 4, 2010

Baby Club

Uma, Darla, Olivia, and Anjali

Uma, Olivia and Anjali

Sofas are for tasting

Anjali, Uma and Malcolm
Yesterday, we were invited to our first baby club gathering at Radha and Sheila's house. The synthesizer was a hot item with all 4 babies congregating to it at the same time. The other babies were 11-12 months old and Anjali was the youngest at 8 months. These were the babies from Radha and Sheila's homebirth class. We never took a class as we were late converts. We did the homestudy Hypnobabies. We met little Malcolm for the first time and Ami, Janelle's daughter, came later but there are unfortunately, no pictures of her.

Saturday, October 2, 2010

Leaf Peeping

We took a much needed minivacation to The White Mountains, New Hampshire. It was a beautiful time of year to go as the fall foliage was at its peak. Anjali did really well on the 10 hour car rides both ways. Unfortunately, she really hates the car now. Our emergency music, NRBQ, worked some of the time. We stayed at a wonderful place, The Lodge at Jackson Village, at the foothills of the national forrest. The lodge owners, Dana and Cathi Belcher, were just fantastic hosts with incredible baked goods to share and amazing service. We felt right at home.

The weather was typical autumn - you never know what to expect on any given day, but we did get some good weather to go to Glen Ellis Falls. Our friend Radha lent us his hiking backpack to carry Anjali in. Mama also took alot of pictures of Anjali in her carseat, unfortunately with alot of them of her crying, but she wanted to record those faces too.

Yes, she did this a bit too. Car rides are hard.

Papa is such a jokester with her pants.

Glen Ellis Falls

Tissue paper fun

Stripey pants, courtesy of her cousin Anika

Friday, October 1, 2010

Busy Days

On a very busy day with lots of errands, and a small break to the Tea Room, we took a few pics.