Our Thanksgiving cheer has been extended this year: the day after the holiday, we received confirmation that Northwest Arkansas will have a birth center next year!

Dr. Cara Osborne, CNM, MSN, SD, and assistant professor at the U of A School of Nursing; and Shannon Bedore, MBA, are the founders of the Birth Center of NWA, which will be housed in a facility at Village on the Creeks scheduled for completion in February.  The five Mercy Family Practice physicians who specialize in obstetrics will be providing backup, a key factor since it is a legal requirement in Arkansas for a birth center to have official obstetrical backup.  Dr. Osborne hopes that the center will be able to begin taking clients by the end of the first quarter, but the actual date will depend on when the Arkansas Department of Health finalizes licensure approval for the facility.

The Birth Center of NWA plans to start with two Certified Nurse-Midwives on staff, as well as a lactation consultant, who will be available for both birth center and home visits.  Other services will include prenatal education, lactation education, and breastpump rentals.  Their model of care will follow the principle that women have ownership of their own health; for example, each birth center client will own her electronic health records (EHR) and be able to share them with her doula or anyone else she chooses.

Dr. Osborne thanked our members and supporters for their grassroots efforts and personal requests to encourage NWA care providers to work toward mother- and baby-friendly care.  She said that your voices have paved the way for Mercy to see the demand in this area for a birth center, and to recognize the business sense in supporting the Birth Center of NWA.

We know that this birth center is long-awaited and will be an amazing resource for women and families in Northwest Arkansas.  According to Childbirth Connection, The U.S. National Birth Center Study (involving nearly 12,000 women receiving care in 84 out-of-hospital birth centers) found that compared to similar, low-risk women giving birth in hospitals, the birth center group experienced:

• lower rates of invasive procedures and restrictions
• no maternal deaths
• a similar mortality rate for babies between 20 weeks of pregnancy and four weeks after birth
• half the likelihood of a cesarean section

Childbirth Connection also explains, “The pooled evidence about home-like settings finds that they involve less use of pain medications, less use of medication to stimulate labor (pitocin), greater mobility in labor, fewer fetal heart abnormalities, and greater satisfaction with care.”

March update: The Birth Center of Northwest Arkansas is now a BirthNetwork NWA professional member!  Pending their license to open their doors, they are taking consultations by phone.  You can learn more about their midwives, location, and practice, as well as contact them for an appointment, via their website.  And if you want regular updates or just want to support them, be sure to like them on Facebook.

Welcome to our newest professional member, Dr. Meghann Sherman of New Hope Functional Chiropractic!

Dr. Meghann was born and raised “up north” in Ludington, Michigan.  She attended Michigan State University and graduated in 2006 with a Bachelor of Science Degree in Nutritional Sciences.  Following graduation she relocated to Austin, Texas, where she worked as a Wellness Coach and Chiropractic Assistant.  It was in Austin that she realized the power of chiropractic.  It did not take long for her to set her sights on becoming a Doctor of Chiropractic herself.  She graduated from Parker College of Chiropractic (now Parker University) in April 2011 and immediately relocated to Northwest Arkansas to start practicing.

“I am excited to become a wellness leader in my new community and I cannot wait to spread the word of chiropractic to Northwest Arkansas.”

Dr. Meghann’s smile, kind heart and subtle adjusting techniques allow her patients to feel comfortable and “at home” when they are under her care.

She has undergone clinical training in the following areas:

• Functional nutrition
• Functional neurology
• Pediatrics
• Active therapeutic movement
• Therapeutic exercise
• Functional rehabilitation
• Kinetic rehabilitation with active motion
• Kinesiology taping
• Postural correction

Dr. Meghann is trained and certified to perform the Webster’s Technique through the International Chiropractic Pediatric Association.

Services offered at her practice include spinal adjustments for expectant mothers to create an environment that allows for a safe and natural birth. She also provides nutritional and lifestyle advice to promote optimal health and function.

“We have a genuine respect for the process of natural birthing.  Chiropractic adjustments allow the nervous system to function at an optimal level.  When an expectant mother’s nervous system is free of interference, her inner wisdom allows for a safe and easy delivery without the use of external intervention.”

To contact Dr. Meghann, visit her professional member profile.

Are you concerned about gestational diabetes (GD) or the glucose tolerance test (GTT) used to screen for GD?  There are a couple of paths you can follow in the research on this subject.  We hope this post will help you get started.

One research path looks at lab results and suggests that the standard method of screening is inaccurate and/or unrealistic.  After all, even the least health-wise pregnant woman is unlikely to fast for 12 hours (overnight or otherwise), then have nothing but a large sugary drink on an empty stomach, and then wait another 3 hours before eating anything.  In fact, to do so on any normal day would be considered taking very poor care of her health.  The Cochrane Review of GD testing methods suggests that at the very least, testing after a meal or even a candy bar gets the same lab results, with fewer side effects.  Some care providers may also offer (or accept) the option of testing blood sugar at home each day for several days, two or three hours after a meal.

Another research path looks at outcomes such as birth weights and maternal and infant health.  This path suggests that the concept of GD as a disease is faulty in itself.  Not that blood sugar during pregnancy should be ignored (for example, urine can be tested for sugar as well as other markers at every prenatal appointment), but that “the practical advice one can give to women carrying the label of ‘gestational diabetes’ should be given to all pregnant women, another reason to question the practical benefits of such a diagnosis. This advice concerns lifestyle, particularly nutrition and physical activity.” (Michel Odent)

Dr. Michel Odent, the French researcher quoted above, famously calls GD “a diagnosis looking for a disease.” Odent’s article was published originally in The Journal of Prenatal & Perinatal Psychology and Health.

Henci Goer (Author of The Thinking Woman’s Guide to a Better Birth) offers some pros and cons of being screened for GD, as well as detailed options for following up a GD diagnosis.
She also offers a detailed history of the GD diagnosis and its validity.

As you should already know, we are not physicians or midwives, and this blog is not intended as medical advice.  As always, the decision of what tests and screenings to perform during pregnancy, and what to do with the results, is yours.
We at BirthNetwork believe that

Announcing a new birth community nearby!  Straight from the founder’s pen:

Hi ladies!

Your neighbors to the south have some very exciting news! We would like to announce the founding of the Arklahoma Birth Community. This network is a resource and a place of support for pregnant, nursing, and interested moms in Fort Smith and the surrounding area. We believe pregnancy and birth are an important start to nurturing happy, healthy families. A positive birth experience begins with becoming fully informed about your options. We strive to provide helpful resources for natural, healthy maternity and baby care.

For more information come check us out at www.arklahomabirth.blogspot.com. We are also on Facebook as Arklahoma Birth Community.

On the website there is a directory for local care providers and resources. If you serve Fort Smith and the surrounding area with a birth, baby, or health related specialty, please contact us with your information at arklahomabirth@gmail.com.

We would like to thank Birth Network NWA and the Birth Junkies for being a huge help in the past. Often women looking for information in Fort Smith have been assisted by your members and we appreciate you ladies for bridging the gap. Arklahoma Birth Community will give you a place to direct questions and we look forward to growing as a local resource.

Press Release: NWA Hospitals Adopt New VBAC Policies

Once a cesarean—next time a normal delivery

Northwest Arkansas—Following new guidelines released by the American College of Obstetricians and Gynecologists (ACOG) in July 2010, the Northwest Medical system has begun supporting the option of vaginal delivery for women who have had a previous cesarean section (known as vaginal birth after cesarean, or VBAC).

The ACOG recommendations state that VBAC is a safe and reasonable option for most women, including some women with multiple previous cesareans, twins, and unknown uterine scars. ACOG also states that respect for patient autonomy requires that even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced, nor can care be denied if a woman declines a repeat cesarean during labor.

Northwest’s specific policies state that a woman is eligible for TOLAC if she has had one or two prior cesareans with low-transverse or low-vertical uterine incisions; that women expecting twins can be eligible; and that eligibility is not affected by whether a woman is scheduled for induction or prefers to wait for labor to begin on its own.

Mercy hospital administration has also stated that they will begin following the new VBAC guidelines, with specific criteria being formalized this month “in order for us to offer TOLAC safely at Mercy. We encourage women to discuss this with their physician.” Washington Regional Medical Center has not yet officially responded to the new guidelines, although Angela Watson, a coleader with ICAN (International Cesarean Awareness Network) of NWA, is hopeful that WRMC will also institute a policy change.

According to Watson, “In other VBAC-supportive hospitals in the U.S., at least 75% of women with one or two prior cesareans who attempt VBAC are successful. This high success rate shows that repeat cesareans are unnecessary for the majority of women. Based on this and other best-practice research evidence from all over the world, we have been working for several years to encourage local hospitals to lift their restrictions against VBAC. We are thrilled to see NWA women being offered the option of avoiding the risks and difficult recovery of a repeat cesarean.” Watson herself traveled to Fort Smith in December of 2009 in order to deliver her second baby via VBAC.

Says Genet Jones, a coleader with BirthNetwork of NWA, “This is a very positive and mother-friendly policy change, and we hope it leads more women and their providers into open discussions not only about VBAC, but about the many other evidence-based maternity and newborn care practices recommended by organizations such as Lamaze International, BirthNetwork National, La Leche League International, and the Coalition for Improving Maternity Services.”

For more information about the benefits of VBAC for mothers, babies, and future pregnancies, as well as about maternity care practices that women can request to increase the likelihood of successful vaginal delivery, contact ICAN of NWA or BirthNetwork NWA.

An interesting new study has found that “for-profit hospitals in California are performing cesarean sections at higher rates than nonprofit hospitals.

A database compiled from state birthing records revealed that, all factors considered, women are at least 17 percent more likely to have a cesarean section at a for-profit hospital than at one that operates as a non-profit. A surgical birth can bring in twice the revenue of a vaginal delivery.

In addition, some hospitals appear to be performing more C-sections for non-medical reasons—including an individual doctor’s level of patience and the staffing schedules in maternity wards, according to interviews with health professionals.”

Research has told us for some time now that your chance of ending up with a C-section has a lot to do with which doctor and hospital you choose. Yet women continue to choose their doctor based on who their insurance covers, and unfortunately, (and I hear this often) which hospital has the biggest, prettiest birthing suites. In fact, that’s what the hospitals in NW Arkansas seem to promote most of all. A large sign on I-540 stood for some time marketing an area hospital as “the Beverly Hills of Birthing Centers.” Really? Well, I hear they do a lot of surgery in Beverly Hills.

If you are really interested in the best birth for you and your baby, do your research. Not all doctors and hospitals are created equal. Ask what the c-section rate is when you are deciding where to go, then compare. You owe it to yourself. I have a pretty good feeling that California isn’t the only place where money is made on unnecessary c-sections.

May’s Pickles & Ice Cream Circle was last week and was all about siblings at births: whether to include them, how to include them, why to include them. We started out with a panel of moms and experts, but with several moms in the audience who also had great experiences to share, we dispensed completely with formality and had a great roundtable of stories, plans, and advice.

One recurring theme was an encouragement to leave the choice open to your child, not just ahead of time, but during the birth. As long as you would like to have your child(ren) at your birth, or even if you aren’t sure and want to see how things go, you can let them move in and out of the room as they choose and as their level of interest, the time of day, and other factors guide them.

Every mother advised that the easiest way to keep things flexible is to have a caretaker available just for your children, so that if they are ever uncomfortable or just plain bored or tired, they have their own familiar person to tend to their needs so that you and your caretakers can stay focused on you and your labor. One mama specified in her birth plan that her kids were to be kept happy, because what would break her focus more than hearing another of her babies cry? She said she knew the plan worked, because her daughter came in to give her a kiss and had frosting breath–the kids and their caretaker were having a birthday cake for the new baby’s birthday!

We also heard about an older daughter who was staying with grandparents and could not make it to the hospital in time due to weather, and an older son who was just in another room playing during the birth because no one came and got him. Both were truly disappointed to miss the moment of birth, so their mothers advised telling caretakers ahead of time that if your older children have floated out of the room to do something else, someone should let them know when birth is imminent.

The second theme of the evening was that having your older children with you can be a positive experience, not just for them, but also for you. We heard several stories of even very young children offering their mothers encouragement, gentle touch, and understanding. What a lovely experience for a woman who is becoming a mother all over again!

Several moms observed that being present and included in the process of a younger sibling’s birth helped their older children make a smooth transition to having a new member in the family, which is a plus for everyone.

A mother of four talked about the contrast between being separated from her older children for at least 24 hours for births two and three, and having her children come in from the waiting room just a few minutes after her fourth was born. Even though they were not present for much of the labor or for the moment of birth, she felt that they were more part of the process, and she particularly enjoyed the smoother introduction and not being separated as a family.

Of course, if you want to include your children at your birth, you probably want to begin that process during your pregnancy. Not only does this help prepare for the “big day,” but it also helps your children understand why you already might need more down time, fewer strong smells, and so on. One experienced mother also mentioned that letting older children be involved in your pregnancy and birth can lead naturally and comfortably to an age-appropriate explanation of the birds and the bees.

Several moms agreed that including your children at prenatals can help them understand the process, give them a time to ask questions, and help them get comfortable with your care provider ahead of time. Moms also recommended books geared toward children, such as the home-birth tale Welcome with Love (also titled Hello Baby, depending on the country of printing) by Jenni Overend. Unfortunately, that particular book appears to be out of print in the U.S., so we’d love to hear your own suggestions for kid-friendly books about pregnancy and birth!

If you are interested in attending our next Pickles & Ice Cream Circle, check out our calendar. If you have questions or are looking for resources, you can also visit our website for contact info and a resource library.