Friday, November 26, 2010

Photovoice project: Giving marginalized populations a voice through photography!

I see some powerful photovoice projects involving marginalized pregnant women in the United States, as well as around the world. This is a project I have been brewing for about a year now, and I would love to see it come to fruition. A community based participatory approach to giving voice to those who aren't heard in our culture and abroad. Most of the women that I have worked with as a doula have had access to healthcare and the means to pay for or access a doula, but there are many who do not have these basic needs during their pregnancies and births. Beyond that the birthing culture and system in the US is failing even women who do have access to care. If we could give them a voice through photography how powerful could that be?? It could also be powerful to give voice to midwives and women birthing at home- to show, and perhaps compare, the way that birth is seen and done in this culture and the other birth options that are safe, effective, and available!

Check out the Video!

Check out the website!

Wednesday, November 24, 2010

Repost: NYT article on the risks of Artificial Rupture of the Membranes

This is a repost of a New York Times article from 2007 I recently read thanks to another doula. 


A large review of studies suggests that a common procedure in labor, intentionally breaking the water, has no effect in reducing the labor time or assuring the baby’s health.

The procedure, sometimes called amniotomy, involves rupturing the amniotic membranes to speed contractions. The procedure has been in use for at least 250 years, although its popularity has varied.

The researchers reviewed 14 randomized controlled trials involving almost 5,000 women and found little evidence for any benefits. Amniotomy did not shorten the length of labor, decrease the need for the labor-stimulating drug oxytocin, decrease pain, reduce the number of instrument-aided births or lead to serious maternal injury or death.

The report, published Oct. 17 [2007] in The Cochrane Reviews, did find that the procedure might be associated with an increase in Caesarean sections and a reduced risk of a lower reading on the Apgar scale, which rates the baby’s condition at birth. But neither finding was statistically significant.

“We advise women whose labors are progressing normally to request their waters be left intact,” said the lead author, Dr. Rebecca Smyth, a research associate at the University of Liverpool. “There is no evidence that leaving the waters intact causes any problems, and there is not sufficient evidence to suggest any benefit to either themselves or their baby.”

A comment: This is very interesting to read seeing as I have yet to attend a hospital birth where amniotomy (AROM) wasn't seen as necessary, or at least strongly suggested. I've even spoken with some family members who, even after given birth a few times, didn't know that the bag of waters could break on their own because a doctor has always done it for them!

Not only may there be some risks to AROM being a standard procedure, but there are many instances where keeping the bag intact can help a great deal. If the baby is not in an ideal position, keeping her in the amniotic sac can help to have her gently adjust to a more ideal position and ease back labor. It is also less painful for the mother to have the bags intact because it adds a bit of a buffer between baby and pelvis. Not to mention the decrease in chances of infection when the bag is still present.

As with any procedure in birth, it is wise to educate yourself and to talk to your care provider about the risks, benefits, and alternatives. In the end, it's your decision! If there is no medical necessity for a procedure-standard as it may be-you can always say you'd rather not have it done. In the case of AROM, the alternative is so simple: Just wait! 

Sunday, November 21, 2010

Many New Faces

It was great to meet so many new people all in one day!

Between the SF Birth and Baby Fair and the East Bay Meet the Doula event, we're both really tired, but it was worth it.

We love talking about the benefits of having a doula with couples still trying to decide of a doula is right for them and Grandmoms who've never heard of doulas! 

Just wanted to put out there that if you are due early in the new year, it's a great idea to start interviewing doulas before the upcoming holidays arrive and things start to get crazy for all involved :-)

We're gearing up for a busy week before Thanksgiving. Hope everyone has a safe and happy holiday week full of things to be thankful for.