Tuesday, September 30, 2008
Here are the top 20 Songs from the year you were born:
1. To Sir With Love, Lulu
2. Happy Together, The Turtles
3. Windy, Association
4. Ode To Billie Joe, Bobby Gentry
5. I'm A Believer, The Monkees
6. Light My Fire, The Doors
7. Somethin' Stupid, Nancy Sinatra and Frank Sinatra
8. The Letter, Box Tops
9. Groovin', Young Rascals
10. Kind Of A Drag, Buckinghams
11. Little Bit O' Soul, Music Explosion
12. I Think We're Alone Now, Tommy James and The Shondells
13. Respect, Aretha Franklin
14. I Was Made To Love Her, Stevie Wonder
15. Come Back When You Grow Up, Bobby Vee and The Strangers
16. Sweet Soul Music, Arthur Conley
17. Can't Take My Eyes Off You, Frankie Valli
18. Never My Love, Association
19. Soul Man, Sam and Dave
20. Expressway To Your Heart, Soul Survivors
I tried to come up with more but apparenlty you were the most exciting thing to happen!
Monday, September 22, 2008
If you're interested here's the link to the replies that were received.
From: Stuart J. Fischbein, MD FACOG
To: Douglas H. Kirkpatrick, MD, President, American College of Obstetricians and Gynecologists
Date sent: Monday, June 23, 2008
Douglas H. Kirkpatrick, MDThe American College of Obstetricians and GynecologistsPO Box 96920Washington, DC 20090-2188
I am a practicing OB/GYN in southern California and Fellow of ACOG and recently was informed by midwife colleagues of your recommendation and encouragement for the AMA to lobby Congress for a law banning out of hospital birth. It is disturbing to me that I had to hear of this decision from outside sources and was never approached by my college to see how I or my local colleagues felt about it. I have grave concerns regarding my organization taking such a stand. I think we are all agreed that ACOG has a statement regarding patients’ rights to informed consent and informed refusal. Yet, it seems with every decision our organization moves further away from that basic tenet. ACOG’s little "guideline" paper on VBAC in 2004 where the word readily was changed to immediately has had the chilling effect of doing away with VBAC options at hundreds of hospitals. Not due to patient safety, or the ideal of giving true informed consent but really, let’s be honest, due to fear of litigation. I have seen how patients have become counseled by obstetricians at facilities where VBAC has been banned. They are clearly given a skewed view of the risks of VBAC but rarely told of the risks of multiple surgeries. If you think this is untrue you are, sadly, out of touch with real clinical medicine.
As to out of hospital birthing, please give me the courtesy of an explanation as to the evidenced-based data you used and the process by which an organization which is supposed to represent me came to this conclusion. Any statement saying that it is as simple as patient safety and that one-size fits all hospital births under the "obstetric model" of practice should be applied to all patients is, putting it nicely, not really in line with what best serves all our patients. In many instances, hospitals are not safe, certainly not nurturing and have a far worse track record for disasters than home birth. Even when emergency help is nearby this is true. The focus of all of us in medicine should be on reigning in trial lawyers and tort reform and lobbying Congress for that. The best interest of the college members and the patients we serve would be for my organization to spend its time and energy on something that has true benefit. Removing choices from well-informed patients and caring doctors and midwives is wholly un-American.
So please send me detailed information on how ACOG decided outlawing home birth would be a wise thing to do. You must have conclusive scientific data to take such a drastic stand. Please make it available to me so that I may share it with likeminded colleagues. I would also like to know the process by which this came to pass. Who first raised this issue and why? What committee reviewed all the data and did its due diligence in interviewing those of us with longstanding experience in backing midwives who perform out of hospital births. There must be a clear and concise, non-confidential paper trail you can share with your members. Specific names of committee members who voted for this would be enlightening and I am requesting this information. I would like to know the background and expertise regarding out of hospital birth for each member who had a hand in the decision to go to the AMA.
We live in an odd era where once something is said or recommended by a legitimate organization such as ACOG it has deep ramifications never intended such as becoming fodder for trial lawyers trying to squeeze the lifeblood and dignity out of your members. In this case these ramifications have had the undesirable effect of forcing women to travel hundreds of miles in labor to find a supportive facility. Or even worse, to have them arrive in a VBAC banned hospital and refuse surgery or be coerced into it. Can this be the best we can do for our patients? Remember, your VBAC statement was meant to be only a recommendation but quickly became the rule by which hospital administrators, risk managers and anesthesia departments of smaller hospital banned this option for thousands of women. An option, which in proper hands, was the safe and accepted standard of care for 30 years. In fact, you still have an ACOG VBAC brochure that recommends this option! For those of us working at smaller hospitals where VBAC was banned due to lack of emergency help (anesthesia, OR crews, etc.) there is a big question that has perplexed us that no administrator seems to be willing or able to answer. That question is: "If a hospital cannot handle an emergency c/section for VBACs, and most obstetrical emergencies are for fetal bradycardia, hemorrhage (i.e. abruption) or shoulder dystocia not for ruptured uteri, then how can they do obstetrics at all?" For they seem to still be able to have a maternity ward without in house anesthesia. Will someday ACOG, in their great wisdom but seeming disconnect from reality, make a "recommendation" that little hospitals unable to afford 24-hour coverage stop providing obstetric services all together? Will this better serve women and their communities throughout America?
I am frightened and angered by what you have done in my name. Now I ask you to defend your position in encouraging the AMA to lobby Congress for another restriction on the freedom of choice that belongs to women and their families. Those choices include midwifery and the right to have the most beautiful and life changing event occur wherever best fits their desire. I am baffled that my college thinks this should be a criminal act. Midwives are well trained and required to have obstetrical backup. They have very special relationships with their patients and want the very best outcomes for them. They do not need me or you to police them. We have a habit in out country over the past 40 years of thinking we can legislate out stupidity. All that has done is erode the individual freedoms that belong, by birthright, to each of us. I would hope you trust your Fellows to know their specialty, their colleagues, and what is best for the patient as an individual. These decisions do not belong to politicians or faceless committees. You should have more faith in your members to give balanced informed consent. Again, my recommendation to you is to put all your considerable energy into changing our legal malpractice system. Those of us actually practicing medicine and caring for patients know this to be the greatest threat to the mission and responsibility we have chosen to undertake.
I look forward to your response and possibly the beginning of a meaningful dialogue.
Stuart J. Fischbein, MD
FACOGMedical Advisor, Birth Action Coalition
Sunday, September 21, 2008
Monday, September 15, 2008
I'm so proud of him! It's the only job he's really interviewed for. It sounds like a great fit for him and he's been really excited. Well- as excited as Doug gets about anything.
Good job, Darling!!!
Saturday, September 13, 2008
I'm so excited I could just burst! Doug and I drove up to Kirkland (42 miles away) and Issaquah (51 miles away) to interview the only two women in the area who are willing to assist with a HBAC (home birth after cesarean). They are both wonderful women, with fabulous hearts, doing an amazing thing for women who want the choice of where and how to birth their babies.
It amazes me that at this point that women are still not trusted to have the mind enough to make an educated, informed decision regarding our own health and that of our children. Having a baby at home can have some negative connotations from society and even the medical community. The American College of Obstetrics and Gynecology was recently quoted as saying "They certainly realize that medical liability reform is nothing more than a band aid and that increasing access to midwives and birth settings is critical to fixing our maternity care system and ensuring that rural, low-income and uninsured women don't fall through the cracks.” This is assuming that the only women interested in a natural home birth for their children are the uneducated, poor, and the rather unfortunate souls that just don't have access to the fine medical model that birth has become. Perhaps I'll get down off my soapbox now before I fall and hurt myself.
Anyway, we met with these two generous women for about an hour each (I haven't seen my OB for an hour total since I got pregnant) and discussed our plans for this birth. We talked about my history, my past struggles, and what has brought me to the point of wanting a home birth for our baby. They asked what we wanted to achieve and what our ideal birth was. They offered background of their own experiences and how they would approach our birth and how things would be handled and what their own beliefs about birth was.
This morning I sent off an email (what a digital world we live in) inviting Charlene to share this with us. She just seemed to fit with our philosophy best. She is a wonderful woman, and after only a few minutes I knew that she was the one I wanted to help us. She lives about 60 miles away so she will be traveling quite a distance to help us. She only requested that we call her early when I start laboring. Hopefully Fiona will not choose to make her appearance during peak traffic times! Charlene will come to the house to make sure that she knows how to get here before the Big Day. For anyone that's been here you know it can get tricky - especially at night.
We will continue to see Dr. Fassler for the remainder of the pregnancy. If I should actually go into labor early we want to make sure that we are prepared and are working with a doctor that we are comfortable with. The other midwife we met with said that she and her team have worked with him before and we are lucky to have him. Plus if insurance is going to pay for us to have bi-weekly ultrasounds then I am ALL for it!
This is such an amazing weight off my shoulders. I have been very anxious about this for the last few weeks. Even just waiting once I knew that we had interviews was difficult. I know that Doug and I will be able to bring our baby girl into the world in the best way that we know how. That we will be calm and comfortable in our own home and that we will be in total control of the whole birth. We know what we want and who we want to participate will be honored. That neither the labor nor the birth will be subject to "protocol". The first touch Fiona will feel will be that of her father (who has decided to be the one to "catch"). She will be surrounded only by close friends and family.
Tuesday, September 9, 2008
Having to take the three hour because the one hour came back high is not uncommon - just a really big pain in the arse! So, I'll take my laptop and try to get some work done.
I'm not worried about it other than the huge chunk it's going to take out of tomorrow. Might as well grab the extra iron I need then too. My glucose was high and my iron was a little low - can't we just call it even? Damn.
Monday, September 8, 2008
I do understand every one's concern and I am grateful for it. I know it must have been difficult to stand idly by and watch someone you love struggle and the worry that they will have to go through those things again.
I thought the best way was to answer the questions that I am so often getting. To reassure those that have not yet had the opportunity to voice their concerns, and to calm the minds of those who weren't entirely convinced. In researching my birth options I came across a website from a midwife in Mountain View, California, Ronnie Falcao. In her FAQ section I found a list of questions and answers that I thought I would post here. Hopefully this reassures some people, or at least prompts them to study further.
I would hope that this would go without saying, however, because it has come up SO many times let me say -
Yes, if I do go into pre-term labor I will go to the hospital!! Doug and I would NEVER put our child at risk. This is our decision when (we choose not to think in terms of IF) I am full term and Fiona chooses to make her appearance. Should we encounter the complication of labor before 37 weeks we will be under the best possible care at a near by hospital.
- Is a home birth safe for you and your baby?
Yes, definitely. Evidence has shown that, overall, home birth is safer than a hospital birth for both me and our baby. Some study results follow:
Perinatal mortality rate for home birth was 9.5 per 1000 compared to 20.3 per 1000 for hospital births in California. Mehl LE et al. Outcomes of elective home births: a series of 1146 cases. J Reprod Med 1977.
Neonatal mortality rate for hospital birth in North Carolina was 7 per 1000 and for home birth was 4 per 1000. Burnett CA et al. Home delivery and neonatal mortality in North Carolina. JAMA 1980.
Neonatal mortality at out-of-hospital births in Kentucky from 1981-83 was 3.5 per 1000. Hinds MW, Bergeisen GH, and Allen DT. Neonatal outcome in planned v unplanned out-of-hospital births in Kentucky. JAMA 1985.
“There is no evidence to support the claim that the safest policy is for all women to give birth in the hospital.” Campbell R and MacFarlane A. Place of delivery: a review. Br J Obstet Gynaecol 1986.
Perinatal mortality rate with OBs was 24.3 per 1000 babies. PMR at homebirths was 2.4 per 1000. Eskes TK. Home deliveries in the Netherlands--perinatal mortality and morbidity. Int J Gynaecol Obstet 1992.
One book summed up home birth outcomes as follows: “Excellent outcomes with much lower intervention rates are achieved at home births. This may be because the overuse of interventions in hospital births introduces risks or the home environment promotes problem-free labors.” Goer, Henci. Obstetric Myths vs. Research Realities, 1995.
- Why would you want to have the baby at home when there is high technology available at the hospital?
The short answer: Hospitals are for sick or injured people, and a woman giving birth is not sick or injured. The long answer: Technology used routinely actually causes more problems than it solves. Hospital procedures, including routine IVs, external or internal fetal monitoring, taking nothing by mouth, and episiotomy all increase the risk to both mother and baby. Of course when used appropriately, technology can be life saving. Another couple of incentives to stay away from hospitals: A recent study reported in major media showed that the number one cause of death in hospitals is medical error. Also, a hospital hosts a variety of unpleasant bacteria which you will not find at home.
- What if you or the baby has a problem--what does the midwife do?
My team of midwives is fully experienced with the normal course of labor and birth, so that they are able to identify anything that could be problematic as soon as it comes up. In the event of an emergency, they are certified in infant resuscitation. They carry necessary equipment such as oxygen and medication to control bleeding. They either resolve emergency situations or control them during transfer to a local hospital for care with the backup OB.
- But, didn’t you have a cesarean with Allie? Shouldn’t you be in the hospital?
Being in the hospital is one of the reasons I had a cesarean with Allie. If I go back to the hospital, my risk of cesarean is even higher this time because OBs insist on managing VBAC (vaginal birth after cesarean) as a high risk situation. In most cases the cesarean is actually more risky for both me and our baby. The only increased risk in VBAC is an unlikely uterine rupture. Because rupture is so rare, less common than both prolapsed cord and placenta previa, there is no reason for my labor to be considered more high risk than anyone else’s. If you believe VBAC is too risky, then it follows that every woman should have a cesarean before labor starts. Ridiculous, right?
- But you will feel horrible if something happens to your baby at home!
Of course I will be devastated should something happen to our baby. But, I actually see it just the opposite. If I were in the hospital and something happened, I would feel worse, because I would know that that outcome would have been less likely to happen at home.
- Don’t you think you are taking a big risk by doing something like this?
Life is full of risks, and there are no guarantees of absolute safety in any endeavor. However, we have weighed the risks and benefits of these options over the last few months, and there is no doubt in our minds that home is the better place to be.
- And a final question we hope you will ask-- What can I do to help?
We hope you can see that we have made the best choice for us. Even if you don’t agree with us, we hope that you will respect us enough to support us and not criticize us. We need your support, encouragement, and prayers. Practical help after the baby is born will also be welcomed. Thank you for your love and support!
We understand that the criticism and questions come only from love. So does our decision to birth our baby at home.
Thursday, September 4, 2008
If you got an email and don't want one let me know, if you didn't get an email and want one let me know.
I'm trying to make this as nice as possible and as friendly for everyone as I can. I know I've had a few people tell me they like it and read often (well as often as I'm here anyway) and so I figured I'd play a little bit.
It's funny to think that anyone is interested in anything we've got going on in our Strange Little World (Look at that! Pa Strange's pun-tastic-ness is rubbing off) but I guess they do. Plus I know the pictures are great for everyone to keep track since I'm horrible at passing them along. There just seems to never be enough hours in the day.
Well I've got some work to finish up - let's all ignore the time-stamp for now.
Hugs to all!
First you have to give the trombone a bath:
Then you have to go scare Jane...
Then you have to blow REALLY hard!
Make your face like this...
The Bulldog does not approve!
Neither does Krystyne...
A little instruction...
We have SOUND!!!
So we've convinced Al that maybe trombone might actually be fun. And it's LOUD - so that helps. It was a great time for Doug and Al together. It's something he can help her with. Tonight I go and meet with Mr. Gallagher, the music teacher. She's only one of two girls in the 6th grade band this year.
Tuesday, September 2, 2008
The girls started their first day of the 2008-2009 school year today. It was a long summer and quite the build up to the new school year this time. For the first time since Krystyne was in kindergarten the girls have returned to the same school for a second year. Well, except Allie but that's because she's transitioned into middle school. It was exciting to see who was in the same class from last year, what the new teacher(s) was like and all the fun that comes with a new school year. It was great for them to not be the "new kids" - again. There was squeals of delight from Jane when she learned that Abbey was in her class again this year and the best friends had not been separated. And "Mom can you believe it?!?! Danielle and I don't have ONE class together this year! It's not FUNNY!!!" from Krystyne as she learned that she would in fact be separated from her absolute BFF! Allie was thrilled to recognize so many people and to have her friends back. She's rolling in a little less excited but with much more happening.
Allie will be taking middle school by the horns, if somewhat reluctantly. Mom's "1 year of an instrument rule" is not going over well. For Al that means playing the trombone in the school band. Doug keeps trying to explain that the other kids aren't going to make fun of her and there are a LOT more opportunities for trips and missing other classes when you're in band. So far she's not going for it. Since 6th graders can do all of the after-school sports without trying out really, she'll be doing track (starts tomorrow), basketball, volleyball and soccer this year. She's only mildly excited about them. But, this year is the only year that they allow that so it's good exposure. Plus it'll widen her social circle a little bit. I think the key with Al this year will be to keep her active.
Krystyne has already immersed herself in a leadership club. It gives her the opportunity to showcase her bubbly personality and talk the ear off of half the school. LOL. She is also going to find out about softball - since surprising herself that she could actually be good at it since a BBQ game of catch with Doug. She's looking forward to a fun filled year. Like with all of them she is in a transition phase and finding where she fits in. Especially after finding out that she was the product of her mother's very own after school special. She actually took the news of her "genetic differences" in stride and with surprising maturity. Even going so far as deciding to tell her sisters about it herself. The news has definitely strengthened our bond. While we both have our moments I think she recognizes now my push for her to do and see everything she can and to make not only good, but great decisions. Doug's desire to adopt her has also brought them closer together. It was a casual mention that neither are big to talk about. It just is. The offer is there. Nothing more, nothing less. When the time is right for both of them. But I have noticed the most subtle of shifts in their relationship. It makes my heart sing.
Jane is just Jane. Bubbly, exuberant and loving as ever. On her own in the mornings and at school this year she is determined and excited for her new adventure. She is every bit of her worldly 8 years and getting closer to 40 by the day. "THIS year we get to use the electric pencil sharpener - we weren't allowed to do that LAST year". The twelve weeks between second and third grade is a lifetime, a growing time, a time to mature. Most things being punctuated with a flip of her blond hair or a bat of her big blue eyes. Decisions are monumental and could affect the rest of her whole life! Or at least until next week.
Well, I'm off to bed myself. The girls aren't the only ones up at the ungodly crack of dawn.
Luckily Krysty knows how to make coffee.