We’re Listening!

We have several exciting up-dates to share with you, and when we say exciting, we mean super, duper exciting!

First, our first Optimizing Pregnancy group prenatal starts tomorrow night! We’ve been talking about this for weeks, but if you’ve missed the buzz, Optimizing Pregnancy is the coolest new thing. All couples enrolling in maternity care will have an initial consultation with one of our nurse-midwives and a subsequent follow-up visit. Following these two initial visits, all couples will then enter the Optimizing Pregnancy group prenatal sessions. These sessions will continue through the 38th week of pregnancy, after which individual appointments will be provided through the early postpartum period. You’ll return to the group at six weeks to share your experience, and adorable baby, with your new friends!

Each session will offer a plethora of information on topics important to you. We have exciting speakers scheduled, and a multitude of activities that will not only build your knowledge-base, but also allow you to build a stronger relationship as a couple. These sessions allow us, as your midwifery team, to spend far more time with you in a relaxed, joyful environment. We had great success with this model in the past and we’re bursting with excitement to share this opportunity again with our families.

Second, our very next new-and-exciting thing is HUGE!! Really HUGE!! We are completely changing the way we communicate with clients. Yes, you’ve suggested this for a while, but we were challenged in how we could approach communication in a way that upheld the multitude of regulations that protect your privacy and allowed us to spend one-on-one time with clients in the office. Drum roll… please…

We are transitioning to a new Electronic Health Care record that will allow us to communicate via email with our clients! This will allow our clinical team to communicate with you without back-and-forth missed calls. Better even, this new system will allow you to login into our secure system and see your labs or request prescription refills, and even the nurse-midwife’s plan of treatment! Our functional midwifery clients will no longer be over-whelmed with the plethora of information they obtain in their visits, or maybe they still will, but they can sign into their private account and see all our fabulous suggestions and find referral information, nutriceutical advice, and be reminded when they should schedule their follow-up visit.

As if that wasn’t enough, we recently had our credit card merchant evaluated and we were paying far too much in credit card fees so with additional research we identified a better option that not only saves us money, allowing us to extend better care, but the new payment system allows us to provide an itemized statement with each payment! No more calling the office with these requests and waiting for a break in our baby-catching to get your invoice.

We have hired a nutritionist! Yes, we’ve been searching everywhere, reviewing multiple applications, interviewing many but held-fast to our core values – we wanted someone who was functional medicine minded and we finally found her! Brittany Miller RDN is new to our practice and will begin working within our Optimizing Pregnancy classes, as well as offering individual consultations to our clients.

Functional Midwifery is a concept with which many of you are familiar, but unfortunately too many are not. It now comprises about half of our clientele-base. Homebirth is our specialty, but for a multitude of reasons including a growing referral rate due to our high level of success, we are caring for a number of clients who have complex health issues which aren’t being addressed elsewhere. Rather than offer expensive procedures and dangerous pharmaceuticals, we prefer to dig in and discover the underlying issue for complete healing. This is a new mindset, a new paradigm, but is quite empowering for the client and incredible rewarding for us. Due to the growing demand for these services, we will begin offering packages of care similar to maternity packages in areas such as anxiety, infertility, menopause, sexual dysfunction, PCOS, postpartum weight loss, adrenal fatigue, and thyroid management. These wellness packages will be available for both men and women with the bulk of these packages including an educational curriculum. Classes such as detoxification, wellness nutrition, exercise, hormones, accupuncture for infertility, sexual dysfunction, how to shop at the grocery store, reading a food label, reducing stress, and so much more will be offered! Miss Michael and I are currently working through the weight loss program now, addressing both detox and adrenal fatigue issues. We’re living what we preach!

Your feedback has helped us create new policies and implement new and exciting changes, with much more coming beyond those mentioned above… including podcasts, webinars, e-books and even, a new book in 2016! Wowzers! If you’re wondering how you can help, we would LOVE testimonials both for our blog and for upcoming webinars, so if you like to write or prefer to speak, please let us know. We would also love to fill our walls with canvases of our clients. These help make our center more personal, and less clinical…. and, well, you’re all gorgeous!

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Lifetime Imaging Joins the Lafayette Office

Becca Looney contacted us a few weeks ago to introduce herself and her new service to us, and after a few back-and-forth phone calls and visits, we are pleased to announce that Lifetime Imaging will be available in our Lafayette office. If you’re interested in seeing her in our Carmel office, just make it known and she said she would happily join us there as well.

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Becca Looney offers both diagnostic and non-diagnostic ultrasounds in our Lafayette office.

Becca is the owner of Lifetime Imaging. She brings seven years experience as an ARDMS Certified Sonographer. Becca is a graduate of the Southern Illinois University-Carbondale Radiological Science program, and has additional training in ultrasound with certification in abdominal (2008) and obstetrical (2010) scans. Lifetime Imaging is the only independent non-diagnostic provider in Indiana that is owned and operated by an ARDMS licensed sonographer that also offers diagnostic ultrasounds.

Her mission is to ensure you have the best experience during your ultrasound session. As the mother of two boys, she remembers the amazing feeling it brought her own family as she awaited her own births. Becca offers both diagnostic and non-diagnostic ultrasounds, collaborating with a radiology team for review of her diagnostic scans. Our interest is in cost-effective diagnostic scans for our clients who have a medical indication for ultrasound, but Becca does offer speciality packages, such as gender reveal sessions, family time, and 3D/4D scans. Pricing and ultrasound packages can be found here.

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Specialty packages including gender reveal parties and 3D/4D ultrasounds are available.

If you are interested in scheduling an ultrasound with Lifetime Imaging, call (317) 426-0678 to speak with Becca or send her an email here. She will offer appointments in her own office on the southside of Indianapolis (just north of St. Francis’ south location) and in our own Lafayette office, the third Tuesday of each month. Becca can also come to your home with her equipment for an additional fee, within the Indianapolis metro area.

Guest Post: Cindy Lybolt CPM

Cindy Lybolt is a midwife practicing in the northwestern portion of Indiana, the area many local homebirth advocates growl about when speaking of homebirth because to say the hospitals, physicians, and unfortunately even the hospital-based nurse-midwives are unfriendly to homebirth, is quite the understatement. She has persevered and I’ve appreciated that about her.

Quite honestly though, what has endeared me the most to Cindy over the years, has been her earnest desire for truth. She has called me on a number of occasions, when the talk among local birth groups was directed negatively toward myself or my practice, because she wanted to create her own opinion. She asked hard questions and sought truth, and she did so very respectfully even when on the surface it appeared as if I was attacking her own credential.

Cindy is motivated, I believe, not only by her keen intelligence and need to critically evaluate all aspects of an argument, but also by a clear sense of right and wrong. She is confident in her skills as a midwife and understanding of the profession, so isn’t intimidated by the alpha personalities our profession too often caters. We haven’t worked side-by-side, but we have spoken a number of times about complex and controversial issues, and we have attended a handful of midwifery trainings together. Each time I appreciate her contribution, and respect her more as a midwife and sister in Christ.

More recently, Cindy shared her concern about a legislative matter on her personal Facebook page. She offered an intelligent argument, but was responded to with personal attacks. Cindy’s continued discussion addressed prior ambiguities in her position further strengthening her argument. She was on point, objective, and professional; however, the hierarchy within the local midwifery group had been challenged. It takes great intelligence to recognize and appreciate the many complex legislative issues that can and do affect the rights of women, but it requires true courage to stand against the crowd and speak your truth with integrity. For this reason, I asked Cindy to share her thoughts with us in a blog post, unedited. So now I share with you… my colleague, Cindy Lybolt, Certified Professional Midwife.

Licenses, Credentials and Women’s Rights

First, I want to thank Dr Penny Lane for her invitation to write a guest blog. I’ve been able to get to know Penny over the last year or so and I appreciate her willingness to talk, even about difficult subjects. While I’m sure that you can find areas of disagreement between us, I think we have come to a point of respecting and liking each other. I appreciate and value that relationship. Communication and honesty are valuable for the profession of midwifery in Indiana and for consumers. While there are differences in the CPM and the CNM in terms of education and training and in scope of practice, we share a common goal and vision; the improvement of home birth in Indiana and the recognition and preservation of women’s rights in birthing in all environments.

As you may have guessed from the opening statement, I’m a CPM, a certified professional midwife. When I decided to become a midwife at about 50, I choose to go to an accredited college for my didactic work. I know that I am privileged, that at this point in time, several college level programs exist for direct entry midwives. While midwifery schools and programs have always been available in the United States, accessibility was limited. The new age of the internet has opened doors up for education for so many, not just in midwifery but almost all professions. I believe that education and training are tantamount to safe midwifery practices, as well as understanding and staying within your scope of practice. I enjoyed college and the process of college, meeting deadlines, interaction with instructors and other students, critical analysis of my work. The process of education is as important to becoming as the curriculum you study. Though, a complete understanding of anatomy and physiology, of microbiology, pharmacology, all of those areas of study are critical core material for midwives.

I started my apprenticeship in 2006 and wanted very much to be a part of the state midwifery association. I had such great expectations, was almost in awe of the midwives in my state that had been involved in this work for so many years. At that point, I believed in legislation and wanted to be involved in working towards licensure of CPMs in Indiana. My evolution and attitude toward licensure makes even me confused. In school, the threat of jail seemed an unreal risk, with the promise of sweeping through all the states with good licensing laws very real. There was an almost romantic air to the thought of working in an a-legal state. The reality and threat of jail became very real though as I started working as a midwife. The need to have a bail fund hidden and accessible, threats from doctors, those became a reality very quickly. Legality became much more important. I had a few concepts confused at that moment in time. First, I believed autonomy belonged to me; I was an autonomous care provider. I also believed that the movement for licensure and birthing rights was the same fight. Discussions about licensing and our values and bottom lines as midwives started to concern me though. I became worried about what we were willing to compromise and the effect on a woman’s birthing rights for a license. It seemed more and more that our fight was simply about not going to jail. My libertarian bend came out more and more and I was opposed to licensure. I wanted discussion about a decriminalization law, simply recognizing that midwifery is not the practice of medicine and removing the threat of felony charges for being a midwife. I couldn’t even raise a conversation. In fact, almost every opinion or thought I offered was answered with a rebuke from other midwives; that they had already thought about that, it wouldn’t work, they had been doing this legislative work for years, they knew what they were doing, I didn’t understand how politics work. So who were THEY? It took me a while to sort that out also. While I was involved in IMA, the midwifery association, there was a separate organization, Indiana Midwifery Taskforce that handled all legislative work. We would receive reports and requests for money, trying to find out the membership or board of IMT or how to be involved seemed impossible. It became very apparent that a few midwives were very much in control of the legislative effort. Somewhere in that mix, I started to reconsider my feelings about licensure. I started seeing women decide they were midwives with no training, unsafe practices, and the inability or unwillingness within the midwifery community to police ourselves. Legislation for me became more about consumer safety than it was about legality. Women considering home birth were in a position of trying to research midwives, CPMS or more traditional midwives, on their own. Licensure would set standards of training and education as well as accountability within the state. The idea that I could see documentation and a license if I walked into a hair dressers salon started to make me reconsider the state’s responsibility to provide licensure. I was also concerned about how CPMs were being presented to the legislators. There was a constant barrage of misinformation, that CPMs were more trained than CNMs. Rather than establishing our own unique position in the order of birth care providers, we were trying to prove something that wasn’t true.

After this long and convoluted introduction, I want to get to the essence of this blog, the fight for certification of CPMs in Indiana and consumers. Our law was passed in 2013. The very process of passing this legislation was concerning. I do understand how hard this work was and is and that we are very busy with our practice and those involved are volunteers. Having said that, in my experience, backing away and being quiet were the easier options for most of the midwives in the state. When a sponsor was identified, after over 18 years of working on this legislation and with the expense of a lobbyist for at least the last 6 years, there was not a template or proposed bill ready to present to the sponsor. Rather, he was given a copy of an old bill from a previous year that we were unhappy with and knew that we would want to amend as soon as it was offered. In my opinion, even if the midwives were only volunteers, the lobbyist was a paid employee: her job was to make sure that we were prepared. We started from a negative position in our effort. I may not know politics but I know sales, and this is a sales job. You start with your best offer, what you want from the deal, the optimal position and then you negotiate. You never start with your worst offer, something you don’t like and try to negotiate for something better. Deals, in real life and politics, only get worse. Our second mistake, we underestimated our opposition. Senator Pat Miller, chairwoman of the Senate Health Committee, had opposed licensure for years, blocking any attempt at legislation. Our sponsors in the House were never a concern and passing in the House was almost guaranteed. Sen Miller was the stumbling block and suddenly, she wanted to be our sponsor in the Senate. The whole effort with the lobbyist had been to establish a better relationship with Sen. Miller. Yet, when the bill passed from the House to her committee, she stayed up all night working on amendments to make our bill as restrictive as possible. The bill that was passed by her committee and the Senate did not resemble anything we wanted. While the bill was bad, I thought it was still workable. One large omission, it did not contain a clause to grandmother in the existing CPMs in the state. I wanted a conversation prior to going to conference committee, which would allow Sen. Miller more time to correct some glaring mistakes she had made. My concern was that the bill could be made even worse in conference. The conversation was not even allowed, we were going to conference to improve the bill. Remember, deals don’t typically get better, especially if you have no real power in negotiations. The bill came out of conference worse but we now had a grandmothering- in clause. Our choices at this point were to continue forward with a horrid bill that we all hated or to ask our House sponsor to pull the bill. In that conversation, we were all informed that a source within the Attorney General’s office had leaked to the lobbyist that if our bill did not become law, all of us would be receiving cease and desist orders and would face prosecution. Fear became the driving force behind accepting this bill and seeing it become law, not concern about consumers or birthing right, simple fear of jail for midwives. Our next great hope was the midwifery committee; we could keep fighting to improve this law.

Again, appointment to the midwifery committee was a very controlled process. We had a special emergency meeting of almost all CPMs in the state to determine who should be the IMA recommendations for this committee. Surprisingly, the emergency meeting was called after I had shared with another midwife that I intended to submit an application. Pure coincidence, I know. At the meeting, I stated my opinion that we should simply provide the governor with a list of all CPMs in the state and allow anyone interested to submit an application. That was not an acceptable option. Twenty years previously, in a consensus meeting of midwives, certain midwives had been designated for appointment in the event of legislation. This was another consensus meeting and not surprisingly, the decision of who to recommend to the governor matched the decision from twenty years ago perfectly. At the meeting, we were asked if we all agreed to these CPMs being the ones recommended by IMA. I agreed with that. IMA was going to recommend only a few specific midwives and that decision had been made years ago. The meeting wasn’t about real choice, it was more about control. They never asked though for any of the attendees to agree not to submit their application. I would not have agreed to that. After having some time to reflect on our meeting and after attending the ceremonial signing of the bill by the Governor, I decided to go forward with my application. There were a lot of reasons involved in that choice, mostly that I hate bullies and secrecy. I like openness and discussion, I’m not even afraid of disagreement and conflict, if handled calmly and respectfully. Those qualities were not attributes that I was finding in the IMA.

The recommendations of the IMA were appointed to the committee. There’s a longer story that really isn’t relevant here. I’ll gladly share my side of it with anyone interested. The job of the committee is to make recommendations to the medical licensing board for the rules and regulations required to implement this law, the law we had worked for 18 years to get. I don’t think anyone, either legislators or midwives, understood the whole process of the implementation required by the Professional Licensing Agency. In the first year, when the reality of how long the process would take, the midwives on the committee decided to go back to Sen. Miller to see if they could extend the period of grandmothering-in for another year, from June 30, 2014 to June 30, 2015. Sen Miller was willing to do that by adding an amendment to another bill rather than re-opening our law. The problem was that once the PLA knew of their intent to change the law, midwifery committee meetings were suspended until the outcome was known. We lost months of time to work on implementation so that the deadline could be extended. One of the great obstacles in the existing law was and still is the collaboration agreement. When I was still involved in the group, I argued that we could make the agreement workable, if we looked at physicians other than OBs and focused on what is actually required in the law, chart review. For some reason, the midwives on the committee insisted that we had to have an agreement with an OB and that our clients were required to see a physician twice in their pregnancy, as that was what Sen. Miller intended and wanted. There was no way anyone could get that type of an agreement in writing. The committee had a few meetings, in which not much was accomplished. I attended all but the first meeting. The committee midwives claim that almost all of the work is complete. I was there. There is a formidable amount of work to be accomplished and very limited meeting time in which to do it. The attention now went to the collaboration agreement. With their stance, that this clause makes the law unworkable, the decision was made again this year to seek a sponsor and try to change the law. The PLA was informed of that intent and no additional meetings of the committee were scheduled. Again, all work on implementation is at a complete standstill while new legislation is sought.

Our original sponsor from the House, Lehe agreed to sponsor another bill for us. The original writing for the bill changed the requirement for a collaborating physician from the midwife to the client. As a homebirth client, you would be required by law to have a backup OB and to see them at least twice in the pregnancy. After reading the proposed bill online, I talked with my senator, my congressman and set an appointment with Lehe. I pointed out the conflict in the new proposed bill; the clause that allowed a woman to decline any required treatments was still in the law but the new clause that a client must have a back -up physician and see them for two visits did not allow any mechanism for refusal. The version of the law that passed the House committee provided for a very convoluted way for a client to decline. While it would have increased the amount of paperwork for CPMs, it still recognized the autonomy of our clients and their right to refuse any treatment or procedure, including doctor visits. Unfortunately, the Senate committee was not receptive to the elimination of the collaboration agreement. Sen Miller was again our sponsor and allowed a reading of the bill in committee. She then delayed voting on it so that interested parties could work on a compromise. The night before our bill was scheduled for a vote, I received a copy of the ‘compromise amendment’ from a source in the Senate. The compromise was unimaginable. Again, the responsibility for a backup physician was placed on the client; she was to have a backup doctor prior to the first appointment with the midwife. If she had not already seen a physician, at the first appointment I had to request that she call and schedule an appointment within 7 days. If she refused, she had to document the reason for the refusal for me and I would be required to report how many of my clients had refused that first trimester appointment yearly. With a refusal I was allowed to continue care. I did have to inform her though that if she refused the physician visit in the third trimester that I was required by law to discontinue her care and could not attend her birth. I was to give her a copy of her chart and instruct her to go to the closest hospital with an L & D when she went into labor. Or I guess, she could have decided on an unassisted birth if she did not want to go to the hospital. This compromise violated our clients in every way and required that I abandon a client that was non-compliant. I posted on FB as quickly as I could and asked my friends and clients to contact the Senators and beg them to oppose this new amendment.

The amendment was passed in the Senate committee, the bill was defeated. I don’t believe that it was defeated for the correct reasons but it was defeated. Remember, the premise of this attempt was that unless the collaboration agreement was removed, our law was unworkable and could not be implemented. There were two more changes in the proposed bill: another extension of grandmothering-in to June 30, 2017 and a change of language in the required physician supervised births to attendance at physician conducted births.

On the last day of the session, as legislators were hurrying to finish their work and go home for the year, HB 1269 was in conference committee. HB 1269 was a budget bill, dealing with increasing funding for mental health care throughout the state. It was a hard fought and debated bill in the House and Senate that absolutely needed to be passed. The conference committee was made up of members from the House and Senate committees on Health, the same committees that had considered our bill. That morning, a notice was placed on the Indiana Push site that a new amendment was before the conference committee that would add language to our law. The amendment was not available in writing anywhere. I later found out it wasn’t in writing until late in the morning of that last day. It was introduced verbally by either Miller or Clere, I’m not sure which one decided to sponsor to it. I again posted on line, on my FB page, asking friends and clients to contact the involved senators and ask them to oppose the amendment. My opposition was based on the fact that it was not available in writing, that we could not be sure of what was being proposed and that it was attached to a bill that needed to be passed. My fear was that again, client’s rights would be violated and there would be no time to defeat the bill in the Senate or House. I also questioned, with the very current history of the compromise the midwives had devised for our bill, if we could trust their intent with this new amendment, on an unrelated bill.

And so, in our story we finally come to the purpose of this guest blog. My post on my Facebook page drew posts from midwives I haven’t talked to in a very long time. Suddenly, they were on my page, opposing my position, asking my friends and clients to support this amendment. In that exchange, fear and intimidation were again used to try and coerce women into supporting an amendment blindly. The midwives did post the proposed amendment on line, after we could have influenced its passage in the committee. But they did post it, I believe in response to my challenge to allow everyone to read the actual language of the amendment. And the language of the amendment did not change the collaboration agreement significantly. It did however extend the period of grandmothering-in. Before we open the door for commentary, the bill did add language to a clause in the existing law. That clause stated that a woman waived her rights to sue a doctor that was collaborating with her midwife for the mistakes or omissions of the midwife. The new clause expands on that premise, that by seeing a CPM, you waive your right to a malpractice suit with a physician. I have to side track momentarily and discuss law. You cannot be required to waive your rights to a law suit. You have the right and opportunity to sue anyone. Rather like non-competition clauses in a contract, in reality they don’t hold water. No one can limit your ability to work and earn a living. You can agree to it but it’s not binding in court. The same applies to this language, especially if you have seen a physician in the first and third trimester of pregnancy. By seeing the physician, you have become their client. This language does not substantially change the essence of this collaboration agreement. I do not believe it will improve our ability to find physicians willing to enter into this written agreement with us. So moving from law to politics, this is one of the most hated political moves, this trick of slipping in an amendment for a totally unrelated matter on an essential bill. One of the senators referred to this as a poison pill. This political trick, that made no real difference in the collaboration agreement required in our law, made us even more enemies in the Senate. It was a very risky gamble, again, taken by a few midwives without discussion or input from anyone else in the state that this law impacts. Thankfully, it did not impact the rights of our clients. I believe it does reveal the true motivation of the midwives.

In the very beginning of this diatribe, I mentioned two misconceptions that I held: that autonomy belonged to me as a care provider and that the fight for legalization of midwives and birthing rights were the same. I know realize that autonomy has always and must continue to belong only to the birthing woman. I can be an autonomous provider, meaning that I am not under the direct supervision of a physician but I am not autonomous. I should be subject to some rules and regulations. It probably would have been preferable as a profession to establish those rules and regulations and a methodology of enforcing them ourselves, something much stronger than the certification process. We couldn’t figure that out. In that instance, the state truly does have the right and responsibility of regulating us, of setting minimal standards of education and training and providing for accountability. That licensure or regulation though should never affect your autonomy, your rights to decide on your care during pregnancy and birth. The one highlight of our law is that wonderful clause, that a woman has the right to decline any required procedure or treatment. We need to protect that clause at all costs, even at the cost of CPMs not being able to get a certificate. That wonderful clause provides women in Indiana something that has been denied in other states. You are recognized as having the right to decline anything the state may require of me. And for those of you who choose to birth either in a hospital or to birth unassisted, the possibility of unintended consequences should concern you. If it is written into law that women are required to see a physician in the first and third trimester, the possibility exists that an aggressive attorney or CPS case worker could use that law against you if you fail to see an OB during your pregnancy. What happens if a free birther decides to go into the hospital during labor for medical help, could her baby be taken from her by CPS because she violated the law? We won’t know if that is a concern until it occurs.

My second misconception was that the fight for legality of CPMs and the fight for birthing rights for women were the same. Sadly, they aren’t. Midwives weren’t fighting for your rights or even for your options in Indiana. We were simply fighting for legality, at any cost. In our efforts for legislation, we violated every one of our bottom lines. Sadly, that easiness of just going along with the others, the fear that drove this legislation allowed really good midwives to agree to a compromise that would hurt our clients and violate their rights. In speaking out against, I wasn’t suggesting that other midwives didn’t care about their clients. I believe that we all do, why else would choose this job? It was very easy to justify the compromise; all you had to do was see a doctor. What a small price to ask of you, with all that I sacrifice and give to you as your midwife. And if the doctor risked you out of homebirth, I would be legal and could care for other women. Not all women would lose the option of homebirth with a CPM. It would make me sad, but I’d be legal. I was told that we all have to give up something to make this law work. I don’t agree. And if I’m asking you, as my client, to give up something, to forfeit your choices, I should at least be honest and upfront you about what I’m asking. On the Indiana Push site, with the compromise amendment, supporters were simply asked to call their Senators. There was no explanation of what the compromise entailed. While some clients may be willing to see a physician, I have clients that would never agree to that unless there was a true medical need. For some of my clients, finances would have made that impossible. It’s hard to have no insurance or a huge deductible and pay an OB. For some of the midwives in the state, there are no OBs willing to see a client only twice. I know that in my area, that option is not available. I have great OBs that I trust and can transfer to during labor or send in women for a consult, if needed. But the reality of hospital policies and malpractice insurance limits how much they can work with me. I do believe now that the force behind legislation is only working for themselves, for their own interests. This legislative action was about midwives, making us legal, keeping us out of jail. If implementing that law required violating client rights, it appears that was an acceptable cost for most of the midwives in the state. And that’s sad, but it is reality.

So, in this sad tale of legislation and deception, what is the lesson to be learned? As consumers, you need to be aware of what is being proposed and the impact it has on you. While I believe that midwives are wonderful and we build this incredible trust and relationship, we are still humans. Fear can drive us to rationalize how our efforts impact women and their rights in pregnancy and birth. Consumers, birthing women and their families must be involved in any legislative action in their state. You must demand that the state recognize your autonomy and provide safe options for home birth. A strong consumer voice changes the conversation. Unfortunately, in Indiana our law is passed. We now have to deal with the reality of it and find a way to implement it. As consumers, please watch us. Demand that we respect and honor your rights and when we try to compromise them, oppose us. There are going to be continuing fights and efforts, in midwifery committee, in the medical licensing. I can’t guarantee you that someone isn’t going to try again to go back and change this law. There is a strong possibility that several Senators that are very angry may want to reconsider our law next year, without a request from us. For all of those fights, you, as consumers, need to get organized and protect your own interests. As your midwife, I am endorsing your right to oppose me, to make your rights more important than mine. Because as a woman, I want the rights of my daughters and granddaughters protected. Let’s all get involved and fight to truly improve birthing rights and options in our state.

For consumers in Indiana who want to have a voice in preserving true birthing rights of women:
Indiana Home Birth Family Advocacy Facebook page

Essential Oil Summit

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I was offered the incredible opportunity to join Dr. Eric Zielinski in a talk about Using Essential Oils for the Ultimate Birth Experience during the 2015 Essential Oil Online Summit. This is a growing passion of mine, and an area of practice I would love to dig further into both the art and science in effort to better attain the benefits of essential oils during labor and for optimizing health throughout the life cycle.

Essential oil application is a rather new area of study and their utilization in childbirth is even less represented in the literature, so I’ve been challenged to implement them with wisdom. Unfortunately, there are a number of claims by essential oil companies that are extrapolated from single studies that are somewhat stretched or misrepresented, while other statements are entirely fabricated. Publications specific to childbirth and essential oils are largely anecdotal, and of course as the FDA has identified, passionate advocates of essential oils have also touted points that are unsupported (for example that various essential oils can combat ebola).

Using essential oils, in my opinion, is directed a bit by intuition. We know that many citrus oils awaken our attention, woodsy and flowery oils enhance our mood, wintergreen and peppermint relieve pain, and oils similar to oregano combat infection. We can follow our intuition to a degree, especially in labor, because we know what wakes us up, inspires us, or relaxes us and allows us to rest. However, making recommendations from the position of the practitioner must come with some understanding of essential oil chemistry, safe application, and support in the evidence of their efficacy. This has been tougher to discern in my experience, and has proven to be an on-going and intriguing study.

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Dr. Z was kind enough to let me talk a bit about what I do know well, homebirth and midwifery. I’ve exhausted the research on the topic here. I was able to share tips and some of what we do know from the available literature on essential oils in childbirth, and while I do hope the audience will gain some new information or be inspired to utilize essential oils in labor, I am so incredibly appreciative of the culture of intelligent people this summit introduced me to, and has inspired me to dig deeper into the growing body of evidence specific to essential oils.

Please join me in the FREE online essential oil summit!! Register today!!

 

Cloth Diapering 101

Adding cloth diapers to our Red Raspberry Boutique was a combination of fun – we love cloth diapers – and an effort to encourage good stewardship of our earth. Cloth diapers are very earth conscience and without the sacrifice many imagine. They are also better for baby.

Modern cloth diapers are quite the luxury! They are easy to care for and very user-friendly. Even grandma and volunteers in the church nursery can navigate them easily.

There are many reason to choose cloth for your little ones. Not only will you be surprised with their ease of use, but they are so adorable they become addicting! Cloth diapers are less expensive than the investment of using disposable diapers, and you’ll be eliminating further dumping in landfills. Babies love cloth too!

The average family spends approximately $1,600 to $3,000 on disposable diapers from birth to potty training. Cloth diapers offer a wide variety of styles and price ranges. There are one-size diapers that minimize the financial investment, as they fit from newborn through to potty training. Cloth diapers require the investment of about $300 to $1,000 and if you reuse them from child to child, the cost savings is even more significant!

Babies want to wear soft cloths just as we do. Disposables contain many chemicals and toxins, including dioxin which we know to suppress the immune system, cause liver and skin issues, birth defects and even genetic damage in lab animals. It is banned in most countries, but not here in the United States of America. Tributyl-tin (TBT) is also found in disposable diapers, an endocrine toxin, and sodium polyacrylate, the gel-like substance that absorbs wetness and also causes vomiting, staph infections and fever.

The plethora of options however, can be intimidating. We have a cloth diaper expert on staff, Sabrina Hull. I don’t know of anyone who knows more or who gets more excited about cloth diapering. Sabrina offers classes in both our Lafayette and Carmel boutiques each month.

What are my options for choosing cloth diapers?

Cloth diapers have moved beyond pre-folds and pins of past generations. We now have more style choices than I could even list, more than a dozen fabrics, and endless colors, patterns, and prints. Let me discuss a few options for starters.

Pre-foldsThese are rectangular pieces of cloth folded and sewn so the more absorbent material is in the center. Most people who think of cloth diapering envision something similar to pre-folds, and many use these for burp clothes even if they haven’t chosen to use cloth for diapering. The pre-fold itself offers a number of options, from standard length to longer for better absorption or shorter to fit better in covers. There are a variety of blended fabrics, and we’ve recently added a bamboo option to the boutique! The pre-fold requires a diaper cover.

Fitted DiaperThese are essential pre-folds with either snaps or hook and loop (velcro) closures, and elastic in the legs and waist to make it fit better. This diaper also requires a diaper cover.

The pre-fold above is available in what is called, Better-Fit by OsoCozy. It doesn’t need a closure of any type. A diaper cover is sufficient. The snappi however, can be used to secure the pre-fold if extra security is desired or if bunching in the front offers the needed extra padding for little boys. We also offer the traditional OsoCozy which is longer for increased absorbency.

Pocket DiaperThe pocket diaper is similar to an All-In-One (AIO) in that it is a complete diaper with a waterproof exterior. The pocket is for stuffing absorbent material. Why? Having the ability to remove this stuffing, as opposed to the AIO, drastically decreases drying time. This is a huge advantage for the busy momma.

All-In-One (AIO): Every cloth diapering family needs at least a few AIOs in their layette. The AIO diaper is a complete waterproof system, with an absorbent center. It may also have a sewn-in or snap-in soaker. Because they are applied to the newborn as one would a disposable, they are easy to use by care-givers who aren’t familiar with cloth diapering. Grandma may appreciate these!

Diaper CoversThe pre-folds and fitted diapers are the absorbent part of the diaper, both requiring covers. These are the waterproof covers that generations ago were elastic around the waist and legs and pulled up over the cloth diaper pinned in place. Mothers in that day and age were often cleaning rather horrendous messes as they pulled down diapers over baby legs. Not today! Diaper covers are now available in front or side snaps, or hook and loop options.

Choosing Sizes

Each diaper brand will specify the weight of their specific sizes, and if you’re intimidated by the variety of size options, you aren’t alone. Quite basically, you can opt to purchase your diapers in various sizes for a better fit or in a one-size diaper to save money. A more complex explanation would be that one could opt to use pre-folds or fitted diapers, either sized or one-size, and covers that are sized or one-sized. Many companies that offer one-size diapers, also offer a newborn size for the smaller legs and bellies. Some diaper companies offer extra small, small, medium, large and extra large. Some sneak companies, such as Mother Ease offers a medium-large for a better fit in the awkward toddlering stage. Other companies offer size one and size two, while others offer all those options! Again, if you want the cliff notes, consider if you prefer a better fit or a better price.

How do I get started?

We have done a lot of research for you, and continue as the industry changes quickly. Cloth diapers are becoming more popular, so often as they hit the big box stores the quality changes. Our boutique prioritizes those companies with excellent quality, local options, ethical marketing and manufacturing, and many are made by stay-at-homes that stand behind their product guaranteeing satisfaction. Mother Ease for example has a life-time warranty! Eco-posh offers a fitted diaper that is made with plastic water bottles! We are a fan!

My point, please come in to our boutique and let us help you get started. Our class is full of information. Sabrina really is an expert and can assist you in creating the perfect cloth diaper system for your needs.

Briefly, some families prefer all AIOs (either pocket or AIOs), although most prefer a variety of options in their stash. A dozen diapers is the absolute minimum, and will require daily washing to avoid disposable. For a more relaxed laundry schedule, choose two or three dozen.

Dr. Lane’s Personal Experience

My first experience with cloth diapers was with the Mother Ease diapers. These are amazing diapers, and today are available in bamboo! They are a fitted variety that require a cover. They are also a one-size option so we could use them from the newborn stage through toddlering, and from child to child. The covers were particularly wonderful because they offer a size snap which toddlers aren’t as easily able to remove themselves. Motherease prefers the Kind Laundry detergent, and while they offer a lifetime warranty on their diapers, using detergents which are not approved voids the warranty so be cauteous!

My last two children however, I was a busy midwife so took full advantage of a local cloth diaper delivery company. This was divine in every way. We used pre-folds delivered to our door each week, and our own Mother Ease diaper covers. Not even a year later, the company closed and I was shamefully too disappointed and distraught to invest in another stash of cloth diapers. We had completed our family so finished up with the horrid disposables those last few months.

Tips I’ve Learned since Cloth Diapering My Own

My grandson is cloth diapered and so I am still learning lots of great tips. Primarily, it is essential to change diapers as soon as they are wet or soiled. Disposables allow us to delay changes until the diaper is hanging a bit low. They simply absorb so well the urine is mostly pulled away from our little one’s skin. Cloth diapers aren’t as effective in this way, which may cause skin irritation. Let me be clear, the gel in disposables that allows for this imposes its own risk to our little ones and no one should sit or play in their waste so having to change more frequently is certainly not a disadvantage.

If you find your little one requires a diaper cream, no matter which brand you use, and even if it says safe with cloth diapers – use a liner. Micro fleece diapers are particularly sensitive to creams, which most AIO’s and pocket diapers use as an inner fabric. Cotton washes out better, but Kanga Care offers the softest, thinnest diaper liners which are washable that protects your cloth from diaper creams.

Night-time Leaks

Nearly all of my boys seemed to stay quite dry at night, and then upon wakening in the morning unleashed enough urine we all required life jackets if we didn’t wake in time! This prevented the need for thick absorbent diapers, although we did have a few Mother Ease Sandy’s for this purpose. Friends have shared that they would use one-size AIOs or pocket diapers with various liner combinations for heavy night-time wetters.

What other Accessories do I need?

There are lots of fun accessories but very few are absolutely essential, although this is arguable depending on who you ask. The diaper pail is one of the more essential. When I was cloth diapering the question of the day was if one should use a wet pail or dry. I believe families have determined the dry pail to be the exclusive option today.

Wet pails are dangerous, a potential drowning risk, and are heavy! Our family purchased an inexpensive trash can from Target, with a lid, and added a pail liner (similar to a trash bag). We would fill the can and then lift the entire pail liner, turning it inside out and tossing it into the wash with the diapers.

Hanging pails are a great option today. These can hang on a hook or doorknob, and most have some variety of zipper to contain the smell. Of course, diaper pail deodorizers are available.

The wet bag is also handy. These are waterproof and quite stylish bags utilized when traveling. We have one in our family for swim days. Wet bags come in large, medium, and small sizes and have a plethora of uses beyond cloth diapering. Our recommendation is to invest in a few so you always have a clean one available. They will be used throughout child-rearing.

The wet bag is also available in a wet AND dry bag, which allows you to store your clean diapers on one side and soiled on the other. Very handy indeed.

Liners, doublers and inserts are other accessories many families find vital. Doublers lay inside the diaper and offer extra absorbency particularly at night. Inserts are absorbent pads, in multiple layers, and are used to stuff pocket diapers. Disposable liners are brilliant. These pieces of material are placed on top of the diaper interior and not only provide a stay-dry feeling on your baby’s skin, but once they begin eating solid food, they allow for much easier diaper cleaning. Simply flush the liner!

Diaper sprayers are also favorite cloth diapering accessories in many families. These attach discretely to the side of your toilet tank and are used to spray off messy diapers before they go into your diaper pail.

If you choose to cloth diaper, you might also choose to use cloth wipes and a wipe solution. Either pre-soak cloth wipes or use a spray at each diaper change with a cloth diaper, tuck the dirty wipe into the soiled diaper and wash them all together. Planetwise has these brilliant cloth wipe bags that fold over and snap.

What about Laundering my Cloth Diapers?

Once you’ve chosen your diapers and mastered their use, laundry becomes the intimidating factor. Our cloth diaper expert, Sabrina Hull, is designing a Cloth Diapering 202 class for troubleshooting cloth diaper issues, laundering and overcoming the intimidation of wool covers. Stay tuned!

We’ve already discussed how to store soiled diapers. Keep in mind, diaper covers do not need changed with every diaper. When damp, they can typically be wiped down, and changed every few diapers unless they are soiled. Wool diaper covers allow for even more use and laundering only when soiled.

We don’t really need to soak diapers anymore. Simply choose a hanging wet bag or pail, and use some sort of deodorizer such as baking soda, doe-disk, or deodorant stick. Wash one or two dozen diapers at a time with minimal laundry soap. This can build up in diapers and affect their absorbency, so more is not better. Usually about 1/4 cup is adequate. Read your cloth diaper manufacturer’s recommendations. 

Generally speaking, avoid those laundry soaps with the whitening enzymes because they seem to irritate baby skin. Diapers should be washed in hot water to disinfect, and can be pre-soaked or pre-rinsed depending on their degree of soil. Check diaper manufacturer’s instructions again with water temperature, as some recommend first washing on cold, then hot. Exclusively breastfed babies are among the easiest diapers to launder. Just toss them in and let the golden seeds wash down the drain.

Many parents have found that baking soda can help ward off odor, as can lavender oil, melaleuca oil in the wash, or white vinegar during the rinse cycle.

Do not use fabric softener as they can decrease the diaper’s absorbency. Bleach has been frowned upon, although it seems this is becoming a more common recommendation as of late. Soaps can leave a film on the diaper that cause build up, although they are more natural compared to synthetic detergents.

Most diapers can be tumble dried in a machine, and of course, line dried. The sun can also offer a bleaching effect for stains. While line drying is certainly more earth friendly, drying in the electric dryer may further disinfect diapers. Stuffing from pocket diapers should be removed prior to washing and drying.

Cloth diapering is a great deal of fun, offers loads of advantages, and is good for both the earth and your baby. We are here to help you! Attend one of our classes, or just stop in the boutique for guidance.

Redefining Detox

Through the years, many of our clients have asked for advice about detoxifying their bodies. Is it safe during pregnancy, or while breastfeeding? What are our recommended regimens? When is detox recommended and how often should it be repeated?

My recommendations have been limited, as I had not been able to craft an educated response. The literature was scarce so my thoughts were more theoretical. I did not recommend detox during pregnancy or while nursing because shedding toxins during these times may impose risk to the growing fetus or nursing baby. I also had concerns about the motivation behind the desire to detox. Were these women struggling with a unhealthy body image, or were they battling a less understood form of eating disorder? Did they feel they were unclean?

100% of the general population has tested positive for toxic residues in their blood and urine samples

Today, there is more literature to evaluate and true to most all human processes, it appears the answer is a healthy balance. Detoxing can be redefined as tuning up, rather than overhauling the body. We have thought detoxing required fasting, juicing, and other extreme forms of deprivation. The process can be done more gently however, and while bringing the body back into alignment, it can also encourage a mindfulness about wellness.

The liver requires sufficient nutrients to effectively mobilize and clear out the toxins escaping from the body during the detoxification, which would argue that minimum caloric needs must be met. Detoxing isn’t limited to one’s diet either, as a plethora of toxins come from our environment. We breathe these in through the air and invite them into our bodies through our skin.

There are 700 contaminates, most of which are not well-studied, in each person’s body.

Toxins produced internally from the foods we eat are called free radicals. These are generally eliminated through our urine, stool, perspiration and through a form of breathing called, pranayama. Eliminating these toxins to the best of one’s ability can in fact, be a very healthy practice. Every day we should strive to eat a clean diet. After the holidays, or otherwise unhealthy period in one’s life, a mindful and gentle detox regimen might prove beneficial. During weight loss programs, many find that after a early weight loss, they hit a plateau where no further weight loss is achieved. Scientists are now questioning if this results from the release of toxins stored within the adipose tissue, slowing the metabolism. A detox at this time might result in further weight loss.

water pitcher with fruitDetoxification is an invitation to optimize your body’s ability to rid itself of toxins. Not cleaning the body of stored waste can result in disease process, or commonly, inflammatory conditions such as diabetes, thyroid disease, anxiety, and chronic pain. Simple lifestyle changes can enhance the body’s ability to rid itself or stored waste, such as increasing water and eliminating refined sugar and flour. A moderate detox program can rejuvenate your body’s inherent efficiency, establish a healthier baseline and enable your to maintain better wellness choices.

Stay tuned to our website for information on an up-coming class on detoxification!

Independent Practice

As a student of midwifery many years ago, the question of whether I would pursue private practice or seek employment within a larger corporation always poked it nose into my studies. There are pros and cons to both, and certainly while many midwives have a heart for home birth, they haven’t the financial resources, family structure, or community support to invest in the path of private practice. Those of us who do take the leap, often give up retirement, health insurance, vacation, and work largely in isolation. This weekend I attended a management workshop and was reminded of all the beauties of private practice and owning a small retail boutique – we can create necessary changes instantly.

As a nurse in a large tertiary center, I remember being fired up because women were asked to sign informed consents immediately upon arrival for a plethora of procedures that were not being currently considered, may never be necessary, and most importantly did not accompany informed consent! As a nurse, I was suppose to ask every laboring mother to sign a stack of consents, including one for an epidural, another for a cesarean, anesthesia, newborn medications, and even circumcision prior to even learning the gender of the newborn. I adamantly refused to witness a signed informed consent form without a provider actually present to provide the appropriate education. I was rather sternly informed by upper management that my signature as a witness on the informed consent was absolutely required, and was the simple witness to who was signing the form, not of the informed consent process itself. I passionately disagreed, refused to follow procedure, put my job on the line, and ultimately created a league of enemies because remember, I was a nurse cross-training from another hospital. I was in foreign territory and pointing fingers at a procedure that put into question the appropriateness of other nurses who willingly participated. I made clear they were violating the rights of women.

To my favor, I had a long and respected history in this hospital system (although not the same facility) and a manager who was a strong advocate for me (thank-you, Diane). Needless to say, in spite of my own manager sticking her neck out for me and trusting my argument was backed by thorough research, she faced multiple committee appointments, work group deliniations, and agenda priorities that progressed slow enough for JACHO to arrive and determine in their own inspection that this policy was not only inappropriate, but worthy
of several thousand dollars of fines. Admittedly, this validation only served to strengthen the animosity of this nursing staff against me (the nurse from the ‘other’ hospital).

Here is where I could also share the details of my argument with a physician who asked me to administer Cytotec to a woman who had a previous cesarean (yes, I am that old). I was young, but well read. My passionate debate was not appropriate for my chain on the ladder of hierarchy. The night of my refusal this momma suffered a ruptured uterus and ended up in an emergency cesarean. My scheduled reprimand became an invitation to join the hospital’s policy and procedure committee. Sadly, I can write a book on events such as these… adoptive mothers being refused visiting rights, teenagers being refused epidurals because they did not have a parent to provide consent, women not being permitted to leave the building to smoke a cigarette (while not desired, it violated their rights to force them to stay), administering artificial milk to NICU babies rather than providing the milk their mother had pumped, and all the many other violations so many are all too familiar.

Although I appreciate the process required in hospital systems to implement new policy, and it really is quite necessary, it is not unlike asking a massive cruise ship to change course. Forty-five different committees must be consulted, another fifty-five forms need completed, research needs conducted by small groups, and these steps are when everyone is in agreement! When there is debate, these steps are multiple exponentially. Studies have shown that it takes an average of seventeen years to implement changes in practice after professional journals publish new data. Small practices such as my own are more like speed boats. We can evaluate the evidence, and change a policy in a matter of key strokes. We are in the position to do what is right, immediately. This means we are often working outside the standard, which doesn’t mean we are pushing safe boundaries, but rather, we are ahead of the popular understanding of best standards.

As a person strongly convicted about right and wrong, it was exceedingly difficult for me to participate in on-going practices that I knew to be inappropriate simply because what is right, hadn’t been approved by all the necessary committees and department heads. Private practice allows us to extend care to the very best of our knowledge-base.

The other point I have been reminded of is our ability to create a community as a small business. We develop relationships with our clients and genuinely care about their life, beyond their nine months in our practice. Many postpartum visits have made me teary eyed as I hugged couples prior to their walking out the front door. Yes, I have even had fathers say, “I love you,” inadvertently because we had developed a close relationship that was coming to a close seemingly too soon. Certainly we hope families continue to utilize our services for primary care and return for future pregnancies, but I am recognizing that the boutique is a perfect opportunity to nurture those relationships outside of the clinical role we plEvaluationsay as midwives. Our attention, as midwives, has always focused more on the practice because the demands are more vital and well, it is our primary passion, but it is our hope we can bring in some lovely women and men into the boutique to help nurture its growth and ultimately, the growth of our community of families.

We have great vision for a number of amazing classes, support groups, events, resources and jolly good fun. We’re taking ‘baby steps’ however, so we don’t build beyond our ability to do the job well, and remaining true to our commitment to add only to our practice and boutique when we can do so debt free. Currently we are working to tighten up our procedures behind the scenes and make the overall shopping experience easier for the customer, so we aren’t causing any undo frustration, but we are bursting with excitement to share all the new classes we have in development. Our desire to support families, share our passion about healthcare, clean living, and parenting is strong. We are dedicated to improving our services every single day. We can’t thank our clients enough for returning to us, and trusting us with such a precious time in your lives.

Abortifacients

Abortifacients are those herbs that have been historically used to terminate unwanted pregnancies. Women as far back as the Old Testament have utilized these herbs to invite their menses prematurely. Another class of herbs, emmenagogues, have also been utilized as abortifacients, yet not all herbs in this class work in this way.

SageWhile some abortifacients may affect the uterus directly, the bulk of them, quite frankly, work by poisoning the mother and fetus. This is dangerous and no matter one’s position on the abortion debate, herbalists generally do not assist those seeking counsel for this purpose.

Pregnant women often ask Miss Michael and I which herbs or essential oils they should avoid while pregnant, as resources can be confusing, even contradictory. Our practice offers an extensive list specific to both herbs and essential oils to our maternity clients, but briefly, culinary herbs in normal culinary amounts are not generally concerning.

When herbs and essential oils are used in medicinal amounts however, caution should be used and expert counsel sought. Oregano and rosemary should not be used in medicinal doses during pregnancy, or in their essential oil forms internally. Sage can be an abortifacient even in small doses. Essential oils taken internally in the volume required to induce abortion have been associated with increased risk of serious illness and death to the mother.

Dose is the variable in most all poor outcomes associated with herbs and essential oils. Nearly all poor outcomes associated with essential oils are associated with doses 2-3 hundred times the recommended amount. However, some abortifacients and emmenagogues may disrupt a pregnancy in even small amounts.

The following herbs should therefore be avoided in pregnancy, either due to known or theoretical risk:

  • Artemesia spp. (wormwood)
  • Berberis vulgaris (barberry)
  • Caulophyllum thalictroides (blue cohosh)
  • Chelidonium majus (celandine)
  • Chrysanthemi vulgaris (tansy)
  • Cinchona spp. (quina)
  • Crocus sativa (saffron)
  • Dryopteris felix-mas (male fern)
  • Gossypium herbaceum (levant cotton)
  • Juniperis communis (juniper)
  • Mentha pulegium (pennyroyal)
  • Origanum vulgare (oregano)
  • Phytolacca spp. (pokeweed)
  • Rosmarinus officinalis (rosemary)
  • Ruta graveolens (rue)
  • Salvia officinalis (sage)
  • Sanguisorba canadensis (rosaceae)
  • Tanacetum vulgare (common tansy)
  • Thuja accidentalis (white cedar)

Please speak openly with your chosen practitioner about your herbal choices, and seek the counsel of an herbalist for honest, accurate and up-to-date information about herbs, particularly when pregnant.

 

Food For Thought

Food for Thought

"It is much more important to know what sort of patient has a disease than what sort of disease a patient has." Sir William Osler

Food for Thought

Happiness is underrated and critically important to health. Seriously! Unfortunately, many people just have no idea how to be happy. Aviva Romm

Food for Thought

Physicians simply do not have time to be what patients want them to be: open-minded, knowledgeable teachers and caregivers who can hear and understand their needs. Snyderman and Weil

Food for Thought #1

They say that time changes things. But you actually have to change them yourselves. Andy Warhol

Food for Thought

To think is easy. To act is hard. But the hardest thing in the world is to act in accordance with your thinking. Johann Wolfgang von Goether

Food for Thought

"Birth isn’t about avoiding one set of realities in favor of another. It’s about embracing all facets of birth--contradictory, messy, or unpleasant as some might be--as vital to the whole." Rixa Freeze PhD

Food for Thought

Why I appreciate being a certified nurse-midwife, as opposed to choosing another route for midwifery: I feel learning the science is vital so the art of midwifery is safe and effective. Dr. Penny Lane, nurse-midwife

Food for Thought

When the debate is lost, slander becomes the tool of the loser. Socrates

Food for Thought

To accomplish great things, we must not only act but also dream; not only plan, but also believe. Anatole France

Food for Thought

"Science and uncertainty are inseparable companions. Beware of those who are very certain about things. There are no absolute truths in biological sciences - only hypotheses... 'We need to train medical students and residents more in the art of uncertainty and less in the spirit that everything can be known or that it even needs to be known.'" Grimes (1986)

Food for Thought

American physicians are rewarded for doing things to patients, not for keeping them well. Grimes, 1986

Food for Thought

The false idol of technology. "Having a widget screwed into one's scalp has become an American birthright." Grimes, 1986

Food for Thought

"Between 1985 and 1987, a hospital instituted a successful program to reduce its cesarean rate. The rate fell from 18% to 12%, losing the hospital $1 million in revenues - no small sum in those days." Goer & Romano, 2012, p 37

Food for Thought

"Obstetricians are much more likely to perform a cesarean when they wrongly believe the baby weighs 4000 g or more based on sonographic estimates than when the baby actually weighs this much but the obstetrician did not suspect it." Goer & Romaro, 2012, p 35

Food for Thought

"If you play God, you will be blamed for natural disasters." Marsden Wagner (2006)

Food for Thought

An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you know and what you don't. Anatole France

Food for Thought #3

"Birth is not only about making babies. Birth also is about making mothers - strong, competent, capable mothers, who trust themselves and know their inner strength."

Barbara Katz Rothman PhD (1996)

Food for Thought #4

Believe there is always, always, always a way.

When you have exhausted all possibilities, remember this: you haven't. THOMAS EDISON

Food for Thought #5

"All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident." Arthur Schopenhauer

Food for Thought #2

Yet you brought me safely from my mother’s womb and led me to trust you at my mother’s breast.

Psalm 22:9