So there is a voluntary recall by Sanofi Pasteur for vaxes for the h1N1 vaccine. Just wanted to put this out as an alert for anyone who might be considering getting the vax.
And, here is a site that lists all the ingrediants in vaccines. http://www.vaccinesafety.edu/package_inserts.htm
Wednesday, December 16, 2009
Sunday, December 13, 2009
trimming a tree today...
So today we put up our tree. I'm not one of those uber organized moms who gets her Christmas decorations up the day after Thanksgiving, though I certainly wish I was.
My mother is one of those. She's had her tree up for some time now, and I'm sure that her house is all aglow with Christmas. That's one of the wonderful things about my mother. She always went all out for every season, and it made our house so sweet and homey. I honestly don't know how she did it some years, we had so very little many, many times. But, she did.
Not that I haven't had some Christmas in my house already. I have an amarillis that's about to blossom that I've been nurturing for the past couple weeks, and some pointsettias on either side of the fireplace, as well as Christmas linens on the table. I am one who "needs" a little Christmas. I don't care for Thanksgiving, but Christmas I can get into.
Anyhow, today we put up our tree. My three year old can't wait. She is so excited today, knowing that there is a tree out on top of our jeep, waiting to be brought inside and decorated. She really wanted Daddy and I to get our act together and do it last night, but that was just not going to be happening when we made it home at 9 last night from our weekly errand running.
Merry Christmas this holiday season! I wonder if I'll have a Christmas baby this year. It's entirely possible, I have one lady who is due on Christmas Eve. Should be interesting!
My mother is one of those. She's had her tree up for some time now, and I'm sure that her house is all aglow with Christmas. That's one of the wonderful things about my mother. She always went all out for every season, and it made our house so sweet and homey. I honestly don't know how she did it some years, we had so very little many, many times. But, she did.
Not that I haven't had some Christmas in my house already. I have an amarillis that's about to blossom that I've been nurturing for the past couple weeks, and some pointsettias on either side of the fireplace, as well as Christmas linens on the table. I am one who "needs" a little Christmas. I don't care for Thanksgiving, but Christmas I can get into.
Anyhow, today we put up our tree. My three year old can't wait. She is so excited today, knowing that there is a tree out on top of our jeep, waiting to be brought inside and decorated. She really wanted Daddy and I to get our act together and do it last night, but that was just not going to be happening when we made it home at 9 last night from our weekly errand running.
Merry Christmas this holiday season! I wonder if I'll have a Christmas baby this year. It's entirely possible, I have one lady who is due on Christmas Eve. Should be interesting!
Friday, December 11, 2009
post dates pregnancies...
I have had the privilege of being with a few beautiful women who trusted their bodies so completely that going "past" their due dates was not of any concern to them. That magical due date puts so much pressure on women. But truthfully, a woman is not "overdue" until she is past 42 weeks. A term pregnancy is 37-42 weeks. That is the norm. For a first time mom, it is most likely that she will carry closer to 42 weeks.
For moms that pass their due dates, I offer the standard obstetrical care, getting BFP's, NST's, etc. but many of my moms decline these services. I have no problem with that as long as baby's heartrate is sounding good at prenatals, there doesn't seem to be a sudden decrease in fluid, and mom is reporting lots of movement from baby. These are excellent indicators clinically of baby's health. For many women, a 10 month pregnancy is normal for her, and inducing her earlier can cause more problems than what it solves.
I wanted to share this article from an e-news issue of Midwifery Today, my favourite Midwifery Periodical. If you don't subscribe and you are a doctor, midwife, doula, or are someone interested in natural birth practices from around the world, I would recommend that you do subscribe.
http://www.midwiferytoday.com/enews/enews0811.asp
Postdates Pregnancies
Postdates, by themselves, are not associated with poor outcomes. A pregnancy that continues long after the due date or in conjunction with poor fetal growth or developmental abnormalities has an increased risk of stillbirth. If growth restriction and birth defects are not present, no statistical increase in risk is seen until a pregnancy reaches 42 weeks and no significant risk exists until past 43 weeks. The primary "evidence" of a sharp rise in stillbirth after 40 weeks—often misquoted as "double at 42 weeks and triple at 43 weeks"—seems to come from one study based on data collected in 1958.(1)
The first question one should ask is whether neonatal mortality statistics from the 1950s should be compared to modern statistics, since labor anesthetics and forceps rates were very different. Early labor monitoring was scanty and prenatal monitoring not yet developed. The McClure-Brown report shows a rise in stillbirth from 10/1000 at 40 weeks to about 18/1000 at 42 weeks. Yes, that is nearly double. But think about those numbers. Even the beginning point is nearly ten times the modern mortality rate. Either modern delivery methods are vastly different or something is wrong with the data collection. This study should be updated by research conducted at least in this century! Modern statistics show an almost flat rate of stillbirth from 40 weeks to 42, with a slight rise at 43 weeks (all numbers being close to 1/1000).(2)
It is true that the stillbirth and fetal distress rates rise more sharply after 43 weeks, but it is also true that in less than 10% of births at 43 weeks do babies suffer from postmaturity syndrome (more than 90% show no signs). We should react to this rise by monitoring postdate pregnancies carefully and inducing if problems arise. But the rise in problems at 43 weeks does not imply a similar risk at 42 and 41 weeks. Postmaturity syndrome is a continuum. It becomes more likely as weeks progress past the due date but does not start on the due date. And the risks must be compared to the risks of interventions. Induction is not risk free. In addition to the risks of prematurity, induced labors have higher rates of cesarean section, uterine rupture, cord prolapse, meconium aspiration, fetal distress, neonatal jaundice, maternal hemorrhage and even the rare but disastrous amniotic fluid embolism.
Large studies have shown that monitoring pregnancy while waiting for spontaneous labor results in fewer cesareans without any rise in the stillbirth rate. One retrospective study of almost 1800 postterm (past 42 weeks) pregnancies with reliable dates compared this group with a matched group delivering "on time" (between 37 and 41 weeks). The perinatal mortality was similar in both groups (0.56/1000 in the postterm and 0.75/1000 in the on-time group). The rates of meconium, shoulder dystocia and cesarean were almost identical. The rates of fetal distress, instrumental delivery and low Apgar were actually lower in the postdate group than in the on-time group.(3)
When a group of researchers conducted a case-matched review of nearly 300 postdate pregnancies, they concluded that the increased rate of obstetric and neonatal interventions "does not appear to be a result of underlying pathology associated with postterm pregnancy." They suggest that "a lower threshold for clinical intervention in pregnancies perceived to be 'at risk' may be a significant contributing factor." In other words, the perceived risk is greater than the actual risk and can become a self-fulfilling prophecy!(4)
— Gail Hart, excerpted from "A Timely Birth," Midwifery Today Issue 72
For moms that pass their due dates, I offer the standard obstetrical care, getting BFP's, NST's, etc. but many of my moms decline these services. I have no problem with that as long as baby's heartrate is sounding good at prenatals, there doesn't seem to be a sudden decrease in fluid, and mom is reporting lots of movement from baby. These are excellent indicators clinically of baby's health. For many women, a 10 month pregnancy is normal for her, and inducing her earlier can cause more problems than what it solves.
I wanted to share this article from an e-news issue of Midwifery Today, my favourite Midwifery Periodical. If you don't subscribe and you are a doctor, midwife, doula, or are someone interested in natural birth practices from around the world, I would recommend that you do subscribe.
http://www.midwiferytoday.com/enews/enews0811.asp
Postdates Pregnancies
Postdates, by themselves, are not associated with poor outcomes. A pregnancy that continues long after the due date or in conjunction with poor fetal growth or developmental abnormalities has an increased risk of stillbirth. If growth restriction and birth defects are not present, no statistical increase in risk is seen until a pregnancy reaches 42 weeks and no significant risk exists until past 43 weeks. The primary "evidence" of a sharp rise in stillbirth after 40 weeks—often misquoted as "double at 42 weeks and triple at 43 weeks"—seems to come from one study based on data collected in 1958.(1)
The first question one should ask is whether neonatal mortality statistics from the 1950s should be compared to modern statistics, since labor anesthetics and forceps rates were very different. Early labor monitoring was scanty and prenatal monitoring not yet developed. The McClure-Brown report shows a rise in stillbirth from 10/1000 at 40 weeks to about 18/1000 at 42 weeks. Yes, that is nearly double. But think about those numbers. Even the beginning point is nearly ten times the modern mortality rate. Either modern delivery methods are vastly different or something is wrong with the data collection. This study should be updated by research conducted at least in this century! Modern statistics show an almost flat rate of stillbirth from 40 weeks to 42, with a slight rise at 43 weeks (all numbers being close to 1/1000).(2)
It is true that the stillbirth and fetal distress rates rise more sharply after 43 weeks, but it is also true that in less than 10% of births at 43 weeks do babies suffer from postmaturity syndrome (more than 90% show no signs). We should react to this rise by monitoring postdate pregnancies carefully and inducing if problems arise. But the rise in problems at 43 weeks does not imply a similar risk at 42 and 41 weeks. Postmaturity syndrome is a continuum. It becomes more likely as weeks progress past the due date but does not start on the due date. And the risks must be compared to the risks of interventions. Induction is not risk free. In addition to the risks of prematurity, induced labors have higher rates of cesarean section, uterine rupture, cord prolapse, meconium aspiration, fetal distress, neonatal jaundice, maternal hemorrhage and even the rare but disastrous amniotic fluid embolism.
Large studies have shown that monitoring pregnancy while waiting for spontaneous labor results in fewer cesareans without any rise in the stillbirth rate. One retrospective study of almost 1800 postterm (past 42 weeks) pregnancies with reliable dates compared this group with a matched group delivering "on time" (between 37 and 41 weeks). The perinatal mortality was similar in both groups (0.56/1000 in the postterm and 0.75/1000 in the on-time group). The rates of meconium, shoulder dystocia and cesarean were almost identical. The rates of fetal distress, instrumental delivery and low Apgar were actually lower in the postdate group than in the on-time group.(3)
When a group of researchers conducted a case-matched review of nearly 300 postdate pregnancies, they concluded that the increased rate of obstetric and neonatal interventions "does not appear to be a result of underlying pathology associated with postterm pregnancy." They suggest that "a lower threshold for clinical intervention in pregnancies perceived to be 'at risk' may be a significant contributing factor." In other words, the perceived risk is greater than the actual risk and can become a self-fulfilling prophecy!(4)
— Gail Hart, excerpted from "A Timely Birth," Midwifery Today Issue 72
Thursday, December 10, 2009
Breastmilk should be drunk at the same time of day that it was expressed.
So, another interesting article on breastfeeding. Makes sense actually, as breastmilk is a living organism, adapted to your child, to its needs hour by hour, day by day. Fascinating how we ladies are put together to know just how to provide for our children.
Tuesday, December 8, 2009
Lotus birthing and homebirth in the news...
Thought this was a pretty decent article about homebirth and lotus birthing.
Let's clear up a few things that the doc says in the video.
First, Lotus birthers clean the placenta so it is no longer "bloody". It is then very liberally salted and treated with various herbs so that it isn't smelly and won't allow for the breeding of germs. Secondly, whether or not the doc thinks it's "gross" is beside the point. Lastly, it is also not a danger to the baby to let the cord stop pulsating before clamping and cutting it. Honestly, it's common sense to leave the cord alone and let the baby get all of it's blood and its extra oxygen and iron reserves and not rob the baby of that.
Check out http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/ for more current information on this.
So, while Lotus birthing may be a more extreme option of natural birthing, it is never the less the woman's right to do so. I haven't had a client yet choose this, but if she did, I'd support her.
Let's clear up a few things that the doc says in the video.
First, Lotus birthers clean the placenta so it is no longer "bloody". It is then very liberally salted and treated with various herbs so that it isn't smelly and won't allow for the breeding of germs. Secondly, whether or not the doc thinks it's "gross" is beside the point. Lastly, it is also not a danger to the baby to let the cord stop pulsating before clamping and cutting it. Honestly, it's common sense to leave the cord alone and let the baby get all of it's blood and its extra oxygen and iron reserves and not rob the baby of that.
Check out http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/ for more current information on this.
So, while Lotus birthing may be a more extreme option of natural birthing, it is never the less the woman's right to do so. I haven't had a client yet choose this, but if she did, I'd support her.
Friday, December 4, 2009
Happy Holidays!
Merry Christmas, Happy Hanakkuh, etc. etc. etc. I serve such a diverse group of people that I'll have to just wish everyone a happy holiday and that is not to offend anyone, but rather to avoid my having to list every single type of celebration happening this time of year. We celebrate Christmas here at the McFarland household, with an appropriate nod to the festival of lights, which is the celebration that Christ himself would have been partaking of this time of year.
Made it through Thanksgiving, which is not my favourite holiday (I hate Turkey!), and now looking forward to Christmas! I love Christmas. I love the decorating, I love the presents for my children, and this time of year, I don't mind it if it snows so much as other times of the winter. I enjoy the music, and the nostalgic movies, and all the gooshy feelings that it stirs up.
This is also a time for reflection. It has been a very, very busy year here at my practice. I need to take a count but I believe that at year's end I will have attended about forty mamas? Perhaps it was a few more or a few less, I'm not exactly sure, but it has been a fruitful year. It has been a year of growth, and a year of change.
I added a wonderful assistant/apprentice to my practice in the early months of the year, and she is now ready to spread her wings and fly on her own. I think she'll be ready to sit for her exam in the early spring, hopefully NY state will co operate and help her achieve that. NY has a reputation for making their midwife hopefuls wait for months and even years before allowing them to sit for the exam. So here's hoping that Lisa is able to become certified and licensed very soon!
I also started seeing clients at my other assistant's home in Quakertown. My practice has begun to really flourish in the Lehigh Valley area and for that I am also grateful. My assistant in Quakertown is my longtime friend Wendy. We've known each other for twenty years and her father is an amazing chiropractor who has a practice in Perkasie. Wendy works with her Dad a couple days a week and also sells Mary Kay (shameless plug for my friend here :-) ).
And now in December I am adding another apprentice. As Lisa prepares to start her own practice and perhaps take over the Northernmost part of my current practice, I need someone else to accompany me to births. My new apprentice's name is Monica. She's an EMT and is a midwifery student. She's also a doula. She attended a hbac with me in August and was a wonderful assett.
I look forward to the New Year, and to all the New Beginnings and new challenges that it will bring. This past year taught me many lessons and brought me so many opportunities to grow. Every mama and every baby were beautiful, and strong, and amazing in their own special ways.
I am also grateful for the doctors who shall remain nameless for legal reasons, but who know who they are. These two docs see my patients when I need a second opinion, or testing that I can't provide. They take on transfers of women that they barely know and don't ever judge them or me for their decisions. You are both amazing people that I am so humbled to know and work with. There is a special place in heaven for you.
God bless us, everyone.
Made it through Thanksgiving, which is not my favourite holiday (I hate Turkey!), and now looking forward to Christmas! I love Christmas. I love the decorating, I love the presents for my children, and this time of year, I don't mind it if it snows so much as other times of the winter. I enjoy the music, and the nostalgic movies, and all the gooshy feelings that it stirs up.
This is also a time for reflection. It has been a very, very busy year here at my practice. I need to take a count but I believe that at year's end I will have attended about forty mamas? Perhaps it was a few more or a few less, I'm not exactly sure, but it has been a fruitful year. It has been a year of growth, and a year of change.
I added a wonderful assistant/apprentice to my practice in the early months of the year, and she is now ready to spread her wings and fly on her own. I think she'll be ready to sit for her exam in the early spring, hopefully NY state will co operate and help her achieve that. NY has a reputation for making their midwife hopefuls wait for months and even years before allowing them to sit for the exam. So here's hoping that Lisa is able to become certified and licensed very soon!
I also started seeing clients at my other assistant's home in Quakertown. My practice has begun to really flourish in the Lehigh Valley area and for that I am also grateful. My assistant in Quakertown is my longtime friend Wendy. We've known each other for twenty years and her father is an amazing chiropractor who has a practice in Perkasie. Wendy works with her Dad a couple days a week and also sells Mary Kay (shameless plug for my friend here :-) ).
And now in December I am adding another apprentice. As Lisa prepares to start her own practice and perhaps take over the Northernmost part of my current practice, I need someone else to accompany me to births. My new apprentice's name is Monica. She's an EMT and is a midwifery student. She's also a doula. She attended a hbac with me in August and was a wonderful assett.
I look forward to the New Year, and to all the New Beginnings and new challenges that it will bring. This past year taught me many lessons and brought me so many opportunities to grow. Every mama and every baby were beautiful, and strong, and amazing in their own special ways.
I am also grateful for the doctors who shall remain nameless for legal reasons, but who know who they are. These two docs see my patients when I need a second opinion, or testing that I can't provide. They take on transfers of women that they barely know and don't ever judge them or me for their decisions. You are both amazing people that I am so humbled to know and work with. There is a special place in heaven for you.
God bless us, everyone.
Friday, May 8, 2009
Day of the midwife BBQ tomorrow and tough week gone by...
I'll post pictures afterwards, but tomorrow I am having what will become an annual tradition. A barbecue for like minded people in the Lehigh Valley/Pocono Mountain region to gather and celebrate midwives and holistic birthing options. This year nothing special planned, just food and fun and fellowship. If we end up watching a birth movie, I would not be surprised, but it's not "on the agenda".
There have been an additional three babies born safely at home since my last entry, and one mama transferred to the hospital during delivery and the baby born there.
Sadly,the baby of the mama who had to be transferred had a congenital kidney defect that also affected lung development and did not tarry long on this earth. My heart is heavy and full of sorrow for these fine parents who lost their angel. I was blessed to have met them, and to have served them as their midwife for the last few months of her pregancy. I loved hearing this mama's laugh, watching our daughters play together, and making plans for her birth and for her daughter's upcoming birthday party. It never makes sense when a baby passes, and I pray now daily for my clients that they will know peace and joy again.
For more information on congenital birth defects, please contact the March of Dimes for information on testing, options for treatments, and how you can support research efforts. http://www.marchofdimes.com/
If you have lost a child to miscarriage, stillbirth, or in the newborn period, here are some helpful links:
http://www.ivf.com/misc.html
http://www.gentlebirth.org/archives/griefLoss.html
http://www.handonline.org/parents/index.html
There have been an additional three babies born safely at home since my last entry, and one mama transferred to the hospital during delivery and the baby born there.
Sadly,the baby of the mama who had to be transferred had a congenital kidney defect that also affected lung development and did not tarry long on this earth. My heart is heavy and full of sorrow for these fine parents who lost their angel. I was blessed to have met them, and to have served them as their midwife for the last few months of her pregancy. I loved hearing this mama's laugh, watching our daughters play together, and making plans for her birth and for her daughter's upcoming birthday party. It never makes sense when a baby passes, and I pray now daily for my clients that they will know peace and joy again.
For more information on congenital birth defects, please contact the March of Dimes for information on testing, options for treatments, and how you can support research efforts. http://www.marchofdimes.com/
If you have lost a child to miscarriage, stillbirth, or in the newborn period, here are some helpful links:
http://www.ivf.com/misc.html
http://www.gentlebirth.org/archives/griefLoss.html
http://www.handonline.org/parents/index.html
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