Wednesday, July 29, 2009

Men...Misunderstood

It seems every few years, I need a good reminder that men and women are very different from each other. I long for a Godly husband, a man to rule and protect the family, to guide me and be my accountability partner. Often, I find myself discouraged and I am realizing more and more, I simply misunderstand my husband... I misunderstand the differences between how the Lord created man, and how he created women.

I was taught to be independent and although I sought out that man that would stand by me and protect me, I hadn't a clue that I was asking for the impossible. I wanted a dominate man that would not dominate me. After a few years of marriage and miles of misunderstandings, I asked myself, "How does one submit if the husband won't stand up?" and "Do I have enough trust for that sort of dependency on my husband?" This is a struggle, I believe, most all women in our society face. We are taught to be feminists.

A fabulous Christian counselor has drawn our attention back to communicating in a Godly way.
Mike and I argue. We disagree and we can be disrespectful of each other. He has a great deal of anxiety and recently we've learned he also suffers from significant attention deficit disorder which means he communicates even less than the average man because he can't get all his thoughts together. Can you imagine! I have an enormous thorn in my side as well - pride. I could argue with the pope, so needless to say misunderstandings rum rampit in the Lane household. We both work reverently however, to forgive and to allow the Lord to mold us into a couple after His own heart.

I hold in my hand the key to a happy, joyful marriage. This happiness comes from doing completely opposite of what the world will say to do. When we submit as the Bible tells us to, when we accept our husbands as having dominion over us and our family, when wives accept that they belong to their husbands, the journey towards happiness has just begun.

Gardasil

My opinion on vaccinations are complex and not thoroughly developed, but I don't agree with immunizing babies against sexually transmitted diseases, assuming their parents are responsible and educated enough to return the children to their practitioner when they are preteens. Clearly, we are pushing a multitude of vaccinations into our tiny babies because we can't count on parents to return to the office after that first year of well-baby visits.

Gardasil has had a great deal of media attention and created a great deal of controversy. Most recently I received a caution regarding its use as women were dying following injection. After introducing any new vaccine, I am not eager to be one of the first guinea pigs, nor would I volunteer my children.

I need to research the validity of this thought, but recently a midwife shared with me her opposition to Gardasil because states the vaccine can transmit the HPV virus to the recipent; however, a Pap smear can not. She also states that cervical cancer is very slow growing (which it is prodominantly but not exclusively), very treatable and a Pap smear every three years would find its presence. Even after having received the Gardasil one would need to continue Pap smears so why risk exposure to HPV, or death, when you can simply be diligent about cervical cancer screening which poses no risk. Interesting...

Tuesday, July 28, 2009

Wednesday's Menu


I am behind. We had some Italian Wedding Soup this week from Emily. Fabulous! We definitely need to get a recipe from her, although I don't know that I could make it that good. Keely made rice and chicken today.

Wednesday - sauteed cherry tomatoes (because we have an over-abundance from the garden), rice and chicken. We might eat at the carnival in the evening, although that is so bad for you and never seems to feel you up...although you feel awful afterwards.

We are roasting our cherry tomatoes now. I'll let you know how they turn out but since we have so many and can't seem to give enough away, I thought we'd cut them in half and bake them until they caramelize a bit. Then we can use them like dried tomatoes in salads, pastas or with chicken in rice. I suppose we can freeze them as well.

Of course, Keely is making another batch of zucchini bread. Everyone loves it, but she has grown to hate making it. I am hoping at some point, the boys will stop gorging it and we can freeze some for the winter.

I think we'll make some squash soup tomorrow too, which we've never had before, but I am not much of a creamy soup person in the summer. We might freeze this for a cold evening.

I am going to roast a chicken tomorrow, so we can fill these recipes. It is a stored away organic chicken I got a few months ago for pennies.
Thursday - Cucumber and Chicken Salad with croissants; broccoli and chicken braid (recipe from Cindi)

Friday - Gyro's with Cucumber Sauce (from the garden); eggplant Parmesan (recipe from Amy)

We have a ton of cucumbers, which is sort of ironic because I ate almost two a day towards the end of my pregnancy. Now that our garden is producing them, I am not so interested in them. Keely tasted marinated cucumbers somewhere, so we're going to try that recipe. That doesn't at all sound good to me though. Thursday's menu is much more my style.

Sunday, July 26, 2009

Not Practicing Medicine

I am reorganizing the financial and arbitration agreement for the practice and have been provided numerous contracts other midwives throughout the nation use. As I read through their agreements and on the tail of the previously mentioned Fox59 episode, I am reminded of a peculiar situation midwifery presents birthing families.

As each of you know, the misconceptions are enormous. All midwives are viewed by the public as the same. Homebirth is also judged as equal no matter who attends, or if anyone at all attends. However, based on the circumstances homebirth can be the absolute most dangerous birthing scenario or the absolute safest. Understanding the variables is essential in discerning the risk, yet because homebirth is so incredibly unfamiliar to most everyone, it is a rare educated individual that has any idea what variables to assess in effort to make an appropriate judgment.

One particular variable that has always intrigued me was the manner in which a direct entry midwife can represent her role. Indiana offers no definition or license outside of Nurse Midwifery, so direct entry midwives can tailor their explanation to either boast their position beyond their scope, giving families false assurance, or naively underestimate their role in belief they will escape prosecution or malpractice. Our society understands the healthcare provider, or the birth attendant, as the person designated to keep their birth safe. They are the life-guard of prenatal care and birth. This would include assessing and identifying risks that fall outside of the norm, defined in Indiana as the practice of medicine and/or the practice of nursing.

The midwives referred to in the Fox59 episode are direct entry midwives. They are accused of malpractice, as their persecutors seem to state they made erroneous assumptions and failed to identify a fatal risk to mom and baby. The authorities additionally question if they were practicing medicine without a license.

Here is the irony. Direct entry midwives in our state are all aware that they practice outside the law, yet they have conviction that women should be provided the right to choose who they want to attend their birth. (I agree.) They also have the conviction that pregnancy and birth are normal human events and are not in themselves medical events requiring physician management as a disease state does. (I agree.) For this reason, the position many direct entry midwives take is that they are not practicing medicine. They are simply attending the birth and leave the diagnosis, assessments, and medical management to the physicians when required. This also frees them from liability and hopefully, criminal prosecution.

While families agree with the two points above that I too agree with, these aren't in reality why families hire a direct-entry midwife. Families seek a homebirth because they desire a safe birth (Boucher, 2009). They hire a midwife to be that third party who facilitates a safe birth. Are they getting their money worth in hiring a direct entry midwife?

Just as we ask obstetricians to step out of their role when we put them in the position of caring for a laboring mother without significant medical risk, we too ask our direct entry midwives to step out of their role when they assume primary care of a pregnant and laboring mother. Clients of direct entry midwives most often have not had a thorough head-to-toe assessment; therefore, have not had an efficient risk assessment for homebirth at the onset of their pregnancy. Very few seek out an assessment by a qualified healthcare provider prior to initiating care with a non-nurse midwife.

Their informed consent regarding prenatal testing is often shared with the risk of becoming aware of a condition that the midwife does not have resources or education to support; therefore the unknown (and not currently causing symptoms) may completely alter their otherwise beautiful birth plan. This unfortunate reality removes the essence of informed consent because it is provided from a biased view point and persuades the client. Obstetricians are guilty of the same, but from the opposite end of the spectrum.

Maybe most importantly, because direct entry midwives have gained the entire portion of their experience and training, whatever that might be, in the home, they lack sufficient experience in managing birth emergencies. The reality is, when birth is left alone, most always it proceeds without incident. This is ultimately how all non-interventive midwives can boast about fabulous outcomes and how those attending births with absolutely no training or experience can achieve better outcomes than our highly-trained and highly-interventive hospital physicians.

Direct entry midwives should have little experience suturing, resuscitating, placing IVs, anchoring foleys, assessing a non-reassuring fetal heart tone pattern and so forth. A direct entry midwife, or any midwife, that claims excellence in anyone of these areas should cause you great concern. However, again, the irony is that it is this purpose that families really desire the attendance of a midwife - in case something goes wrong.

Indiana holds the practice of midwifery without a license as a criminal offense so not only have families hired a midwife with little emergency management experience and the inability to identify high-risk pregnancy concerns (logistically or otherwise), they have also hired a midwife that if caught attending the birth or providing prenatal care could serve several years in prison, so in many situations would simply abandon her post. Do you think your midwife would go to jail for you?

I am conflicted in whether I support direct entry midwifery. I have come to know many direct entry midwives that hold a plethora of knowledge and expertise. I will also share that the vast majority of those midwives are believers and have a calling. They are God-fearing. Meaning, these midwives are real gems and not at all the norm. If practicing in Indiana, they would be working outside the will of God. The Lord values education, self-discipline, wisdom and accountability.

Knowing what I know about pregnancy and birth, I simply can't imagine not seeking higher education prior to ever stepping into the role of a midwife. Knowing what I know about professionalism, I find graduate education an absolute necessity for practice within the field. Knowing what I know about emergency birth and hospital policies, I value greatly the hospital experience I attained prior to stepping into the role of a homebirth midwife. Knowing the price a mother pays when she looses a child, my personal conviction is that homebirth should only be attended by a Certified Nurse Midwife. Knowing what I know about democracy and biblical principle, birthing families should be made well aware of the complex issues associated with choosing their birth attendants, but ultimately given the freedom to make a choice we would not otherwise make our self.

Saturday, July 25, 2009

First Place

Keely and Gus won first place, Grand Champion, this morning in agility!!

Fox 59 News and Midwives

http://www.facebook.com/ext/share.php?sid=115945603016&h=bLJnG&u=S7Rbt&ref=nf

I have so many comments about this and it is already 0200. I'll have to share at another time, but I welcome your comments.

Friday, July 24, 2009

Forgotten Funnies...

I have so many funnies to share and just as I feared, I have forgotten the vast majority of them from the last few weeks. Here are a few...

Keely
4-H has been interesting this year. Keely is once again in dogs, specifically showmanship, agility, obedience, and drill team. She attends practices twice a week for at least two hours each evening. A few weeks ago, the weekend Simon was making his entrance, Keely and Gus participated in their preliminary judging and Gus was priced second place in obedience. They missed showmanship because of our labor, but because of these placings, Keely was quite confident she could bring home grand champion in at least one or the other during the final judging.

Saturday, both she and Gus had to arrive at the fair at 8:00 AM. For those of you that know us well, you know that we rarely see this time of day...if ever. Gus absolutely LOVES 4-H and the mere mention of the word and he is bouncing around the house in hysterics. The combination of him being exhausted at eight AM, his excitement and unfortunately, the change in his potty routine, caused a major mishap during his showmanship showing first thing Saturday morning.

He refused to let Keely place his feet and head properly and in spite of her attempt to calm him and make him obedient as the dogs lined up for judging, Gus "fouled" the ring. This can disqualify a dog and since Keely was the first to be judged, not only did she have to calm her dog and clean up the mess, she had to do so while the entire event was put on hold for her to complete the task. She then had to skip through a few judging points that Gus refused to obey for and proceeded to the trotting...again, he was out of control. Gus was bouncing, kicking his feet and making the mats slide, so Keely was pulling his leash and watching him constantly so she didn't fall. Both of these are point deductions. Unfortunately, they also caused Keely to run directly into the judge's table full force.

As if she wasn't already flustered enough, all their papers and belongings went flying off the table. One judge stood up and walked around the table to give Keely a hug, telling her to take a deep breath because she was clearly about to ball up in tears. They were not disqualified. The judge's were merciful, but she did come in last place. Heartbroken, she scored behind participants that didn't even know the rules or how to show their dogs. We are all getting lots of laughs though, as this sort of thing would only happen to Keely which is exactly what each of her friends said as soon as she left the ring.

Noah
A few days postpartum, I was not moving around well, so I asked Noah if he would run to my bedroom and grab me a pair of underwear. He came down with my abdominal flattening underwear and said those were the only pair I had clean. Having just had a cesarean there was no way I was putting those on (they were barely tolerable on a good day). I told him I couldn't wear those and I was sure there were other pairs in my drawers. He said the other pairs have a skinny part at the bottom and he didn't think I wanted those. All I could think of was the dental floss underwear some teenagers choose to wear and which I have never owned or desired to step into...clearly, I had none of these in my drawer. "What?"

"I'll show you!" He immediately returns holding the proof that I had dental floss underwear in my drawer... my sports bra hanging up-side down. Ahh..Ha...Ha...ROTFLMAO!!!

"Noah, turn that up-side down." He immediately realized it was my bra and he lowered it in humiliation, then looked up at me begging, "Don't put that on your blog, Mom!!!"

Samuel
Mike and I are continually amazed by Samuel. He is me through and through. He has a fire in him I can completely empathize with and while some people are thoroughly annoyed and overwhelmed by his personality, many others can see his genuine, heartfelt passion and realize he is absolutely adorable through and through... a real gem.

One day as he was nursing he was looking up to me with the most clear, beautiful eyes and then he detached and asked, "Mom, can I bite your nipple?" Laughing...NO! Thanks for asking, Samuel.

"Mom, can I pull your hair?" No! Remembering myself asking the neighbor boy if I could bite him and when he said yes and I dug my teeth in (very satisfying), I was completely distraught and convinced everyone hated me since I got into trouble!

"Can I break your nose?" You already did a year ago, Samuel, and you may not do it again!

"Shit bad word, Mom?" Yes, don't say that, Samuel. "What?! Shit a bad word?!" Yes, Samuel.

"Stupid bad word, Mom?" Yes, Samuel. Now hush.

My nipple, hair and nose remained safe that afternoon. However, a few days later we went to a friend's house to play cards after cooking hot dogs on the fire. I am a bit nervous now that I have more children than I have arms and Samuel was the one that I really kept my eyes on. I told him repeatedly to be careful and stay back. He asked, "That burn me, Mom?" Yes, Samuel. "Can I touch it?" No!

Then the next day the family spent some time in the garden. I was feeding Simon and multi-tasking so at some point, I must have applied to much pressure to my overfull boob and squirt milk all over Simon's head. I hadn't done that for a few kids and because I have a very peculiar humor and found this funny, I had to share with Mike. The kids came running and Samuel says, "EWWW!" Then..."Can I lick it, Mom?" Mike and I just started laughing because he truly is the craziest kid. He waited for an answer. He was serious. I said, "Sure," and he did just that. He lapped his tongue along the side of Simon's head and then returned to the garden to pick green beans. Nut.

I am a Biker...Almost


He did it! He bought me a bike! I haven't a clue how to ride one, rather drive one, but I suppose I'll learn. I don't have a picture of the actual motorcycle, but it is a mini-VMAX like Mike's. They were only made for two years, 86 & 87. Mine is an 86 Yamaha Fazor. They also only made red, but Mike knows a guy who knows a guy and is going to fix me up with a new paint job. I was searching the internet for ideas on paint jobs and found some *fancy* bikes. Wow! I'll have to share those pictures at another time because they are saved on the kid's computer, but wow! I am thrilled Mike is happy about my having a bike although I am still sick at my stomach about doing something so risky as a mother with young children, but I also think it would be so amazing to just ride with a group of friends on a fabulous breezy evening...assuming I can learn to drive it because I could barely stand it up the other day.


I have been scripted. If someone asks me what it is, I can say either Yamaha Fazor or FZX 700 and people in the know should understand. The 700 part is the size of the engine, but I haven't a clue what FZX means or if I can remember that long enough to share with anyone that might be impressed. I also know if someone asks me about the cylinders that I have "four straight on a 45 degree angle." I asked Mike if that would make me sound like a dork and he gave me much more information and lost me completely...something about a chain...which oddly enough it does have just like a bicycle. That might mean something to you. I just know it is quieter and smoother than Mike's big fancy bike...but not yet as good lookin.

Wednesday, July 22, 2009

The Student Loan Documentary - Ideablob

I have always argued that not only would support of Nurse Midwifery be a fabulous answer for our national debt, but so would student loan forgiveness. The number one reason American's are hospitalized in our nation is for childbirth and with nearly 40% of them receiving cesarean sections, our national healthcare system is in crisis and this doesn't address the cost associated with the morbidity that follows these, most often, unnecessary major medical procedures.

However, as a now entrepreneur within the healthcare industry, I am attempting to find a balance between being a frugal provider and respecting the financial needs of my practice and family. Midwives hold high priority for cost effectiveness and eliminating unnecessary tests goes a long way in this regard. However, my own professional fee has been a challenge. Not only do I need to charge enough to cover costs, but I need to consider additional fees associated with my practicing independently.

I have no health insurance. I have no retirement. I have no malpractice insurance. I have no professional licensure reimbursement. No one pays for my continuing education. I have no vacation, sick pay, bereavement, medical leave or maternity leave. I also have no reimbursement for student loans which total $90,000, at a monthly expense of more than $700.00. My current fee does not provide coverage for this expense and while I am pennies compared to hospital practices, clients still struggle to pay my current expense and insurance companies fight and argue each penny.

Everyone wants high level care, yet no one wants to pay for it. Healthcare is viewed as a human right and therefore, not worth the elbow grease required to obtain it. Unfortunately, midwives are unable to practice independently because they simply can't afford their student loan debt. Many others don't pursue graduate studies because they haven't the money or ability to obtain student loans.

Debt forgiveness would go along way in improving both the national healthcare crisis and national debt. It would allow many of us to prosper that otherwise have our passions and visions pinned under a lifetime of debt we struggle monthly to pay. It would additionally allow us to forgive and/or negotiate with clients that struggle to meet their financial responsibility, as we would have grace to negotiate with. Ideablog is an interesting blog that highlights and rewards cleaver business ideas. I have recently voted for the student loan documentary and encourage you as well, to offer your own vote.

Idea: Default: the Student Loan Documentary - Ideablob: where ideas grow

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Tuesday, July 21, 2009

The CDC is considering recommending circumcision for baby boys.
Help Intact America demand a truthful statement about circumcision.
Make a tax-deductible gift to support our campaign today!

The United States leads the industrialized world in male circumcision – a risky and unethical surgery that no medical society recommends. Intact America has fought successfully to lower rates of circumcision over the past decades, but today there's a new threat to our progress: the U.S. government is considering recommending circumcision for baby boys. Intact America is responding with an aggressive campaign for a truthful statement on circumcision.
Please support our efforts by donating today!

This is a critical moment in the movement to stop the routine circumcision of newborn boys. To be successful, Intact America is determined to recruit 50 new donors by midnight on July 23.
Without our campaign, the Centers for Disease Control and Prevention (CDC) may base its decision on flawed studies that ignore the risks and ethics of circumcision. A recommendation in favor of circumcision by the CDC, the foremost expert on public health in the U.S., would be a serious setback.
Help us protect baby boys by making a tax-deductible contribution right now.

We are working nonstop to make sure that decision-makers at the CDC hear about the harms of circumcision, by:
Launching a broad-scale public education campaign to spread accurate information on the risks and ethics of circumcision – online and offline;
Providing activists and educators with the support they need to organize in their communities;
Educating medical professionals about circumcision at events around the country; and,
Working with the media to promote our campaign.
But we can't do it without your help.
Changing the way America thinks about circumcision starts with a truthful statement from the CDC.
Please donate today – and help us promote our message at this critical moment.

Georganne Chapin
Executive Director, Intact America
www.intactamerica.org

Intact America PO Box 8516 Tarrytown, NY 10591

Menu...Blessed with Food

I have yet to post about the fabulous BlessingWay Amy threw for me several months ago now. At that event she asked those invited to bring a frozen meal and had them stacked in a box in my van before I left. Wow, were we blessed.

We received a chicken casserole from Chelsea - fabulous.
Cookies were devoured before even the birth, I think from Heather.
Pancakes were eaten up quickly, also from Heather.
A bread from Amy, which we ate a few weeks ago.
We received several lasagnas, all which were fabulous, but none were marked.
Franny brought us a HUGE amount of chicken noodle soup, which we just finished yesterday.
We had vegie meals from Rixa, a fabulous chicken and rice meal from Dana, and so many more...some still to go!

I can't thank you all enough! This is absolutely a necessity, I now believe, for surviving the last few weeks of pregnancy and early days postpartum. I believe I'll create some sort of direction sheet for my clientele to offer their own support groups. What an encouragement and life saver this was for us.

Whoever made lasagna in the blue casserole dish...we have it clean for ya!

Exercise

The kids and I took a walk today, about half-an-hour. I am hoping to get something else in today... maybe abdominal exercizes.

Monday, July 20, 2009

ACNM and CPMs

"It has come to our attention that members of Congress will beasked to consider an amendment providing federal recognitionunder the Social Security Act (SSA) of Certified ProfessionalMidwives (CPMs). On behalf of the American College of NurseMidwives (ACNM), I am writing to infom you that ACNM opposed thisrecognition because individuals holding the CPM credential lack auniform minimum standard of accredited academic education."

Read on here regarding ACNM's letter to Congress, requesting they deny anyrecognition of CPMs.

Fazor

Mike and I were talking the other day... honestly, I haven't a clue what caused us to have this conversation, but I shared with him that I thought once the boys were a bit older and I knew Keely would be old enough to care for them if I/we died, that I would like to have a motorcycle of my own.

*Light bulb*
I do remember the spark... Mike owned an amazing truck when we first met. I wish I had a digital picture to show you. He purchased a Toyota truck and completely rebuilt it with a Chevy engine and built it up for show. A few months after we met, he entered it in the World of Wheels in Indianapolis and won first place. It was nice and he cherished it.

A few years later, we had Noah and with four children needed a bigger automobile. However, we were completely broke. Mike sold his truck and we purchased a mini-van. I have felt sick about it ever since and so has he. It was a topic we weren't allowed to speak about.
This past week Mike and Noah saw his old truck sitting in the tiny little car dealership here in Thorntown. He was devastated as he is the type of guy that just doesn't think about it and somehow fools himself into thinking he then has no anxiety about it, so having it nearly in his front yard was a bit much to bear.
I told him if he wanted it to go down to the dealership and ask them how much they wanted for it. The truck is now nineteen years old. How much could it be? I told him I would buy it for him, so Noah immediately jumped on his bike and rode down there, returning with a phone number of the owner. The next day Mike stopped by and discovered they wanted $7,500. He didn't want it at that price. I was shocked.

Not wanting him to regret this, I have continued to pester him about it. He repeatedly says he would love it, but at that price he'd prefer to have a full-size truck he could drive his kids around in. Hum... then I asked him if he had the choice, would he sale his bike for it. After all, he originally had a VMAX when he was 21 and sold it for the truck. Then for his fortieth birthday, we bought his VMAX for his birthday because he always regretted selling the bike in the first place. Riding his new VMAX, he seemed as if he had found his youth again, although I had really hoped to find his truck for him. Would he sale it again? Nope.

All of this made me think about men and their cars and how they can reflect their personalities and mean so much to them. Most all men could immediately name the car they would purchase if they had all the money in the world. Mike has never said a Toyota/Chevota. I think he was passionate about this truck but because he dedicated so much time to it, not because it was his ultimate dream car.

Anyway, I began visioning myself spending days with him on bike rides much more so than at car shows polishing a truck we really couldn't drive for fun because it might get a bug splattered on the expensive paint job. A long story short... he has already picked out a bike for me. The Yamaha Fazer 700. I told him I didn't want a standard run-of-the-mill starter bike, but something interesting, something I could handle, something unique. He loves his VMAX and remembered they had made a smaller version of it for a few years and has been in search of one for the last few days. I think he's found it... a 1987 Yamaha Fazer 700.

He'll have a few years to work on it and soop it up for me! Simon is only four weeks old and I am not nearly brave enough to ride a bike and leave them all behind. Personally, I think Mike enjoys the tinkering more than the riding anyway, so this will be another great past-time for Mike to spend his time on for a few years. Then we'll be picking out matching leather jackets in our old age!

Sunday, July 19, 2009

More Pictures

Rarely do we get a nice smile out of Noah! This was an accident, I am sure!

He sleeps. How precious.


Simon sleeps. How precious. How chubby and adorable. I could just bite him!

Beautiful! How cute are they. These two are real buddies! Samuel will tell me a story of Noah putting sand in his eyes after hours of playing in the back yard and then I'll ask, "What did Keely do," and he'll say, "Sissy love me." The other day Keely was at a dog show and Samuel got in trouble. Mike made him sit in time out and Samuel said, "Can we go pick up Sissy? Time for Sissy come home."

Prayers

I have amazing friends! Thanks so much for the prayers. My blisters aren't gone, but they are completely pain free!! I am really surprised. I feel completely recovered (from blisters and surgery) and am really eager to get fit.

Rachel and Dana, two of my fabulous birth assistants, have worked to create a fitness/nutrition group prenatal program and I am thrilled. I have always had a heart for fitness and to everyone's shock and surprise my initial major at Purdue University was exercise science. I had dreams of owning my own gym and being a personal trainer. Many pounds later, I am interested in being a good steward of this body and a better model of wellness.

I have lost eleven pounds in the last three weeks, which isn't too bad for me. I tend to retain weight the first few months after having a baby. However, I have never weighed this much postpartum either. Lots of work ahead of me, but my fitness level concerns me even more than my weight.

Thanks for the prayers!

Friday, July 17, 2009

ACNM's position on Direct Entry Midwifery

July 15, 2009 Special Alert to ACNM Members: Recent Developments Related to Attempts to Provide Federal Recognition to All CPMs As we enter into the critical next few weeks of federal health reform debate, ACNM continues to devote unprecedented resources to our legislative agenda: reimbursemen t equity for CNMs and CMs; recognition of CNMs and CMs as primary care providers; inclusion of maternity and newborn care as guaranteed minimum benefits; increased funding for graduate nursing education and loan repayment programs available to CNMs and CMs; funding for women’s medical home demonstration projects; and other exciting opportunities. We have made remarkable strides in gaining congressional support and we will need to maintain an aggressive presence to achieve victory on this ambitious agenda that will dramatically enhance access to midwifery care in the US. These are exciting times! In this whirlwind of legislative activity, ACNM also faces situations in which we must articulate the values and principles of our organization in ways we’ve not been called upon to do in the past. This week, ACNM expressed to members of Congress our opposition to federal recognition of certified professional midwives (CPMs) who have not successfully completed an accredited formal education program, as covered practitioners under the Social Security Act for the purpose of providing services under Medicare or Medicaid. We did so in response to the recent legislative activities of the Midwives and Mothers in Action (MAMA) Campaign (http://www.mamacamp aign.org/), a coalition working to gain federal recognition of all CPMs. ACNM’s decision to oppose this initiative followed unsuccessful attempts by ACNM and MAMA Campaign leaders to reach a compromise that both organizations could support, and significant reflection by the ACNM Board of Directors regarding the mission (http://www.midwife. org/about. cfm) and fundamental principles of our organization. Read ACNM’s letter to Congress on CPM legislation at http://www.midwife. org/documents/ ACNMreMinimumEdu cationalStdsforM idwives.pdf. ACNM’s Position ACNM’s official position is that recognition as a professional midwife in the US requires (1) successful completion of a formal education program accredited by an agency recognized by the US Department of Education; (2) national certification; and (3) licensure in the state in which services are provided. This position was explicitly articulated in ACNM’s January 2008 ACNM Issue Brief, “Midwifery Certification in the United States.” Through this statement, for the first time, ACNM recognized the value of the accredited education pathway and certification processes developed by the CPM community, while also clarifying that ACNM does not support apprentice pathways to certification. This position was re-evaluated, slightly revised, and re-issued as an official ACNM Position Statement in March 2009 (http://www.midwife. org/siteFiles/ position/ MidwiferyCertifi cation_in_ the_United_ States_3_ 31_09.pdf ). A motion to further revise the position statement to soften ACNM’s position regarding the need for formal education was made at the second business meeting of the recent ACNM 54th Annual Meeting, but was defeated by a majority of the ACNM membership present. CNMs in the US have supported formal university-based education for more than 80 years. ACNM’s intensive engagement this year in federal health care reform as well as our work with the multi-disciplinary Coalition for Patient Rights (http://www.patients rightscoalition. org/) has further reinforced our commitment to these principles. In fact, our current efforts to secure primary care status for CNMs and CMs in federal legislation have been hampered by a perceived lack of formal educational standards in the midwifery profession. Moreover, ACNM does not believe that lesser standards of education should apply for midwives who are attending home births. In fact, because home birth midwives are frequently working independently with reduced access to consultation with other health care professionals, we believe that they should be among the most highly trained maternity care providers. There is no precedent for extending federal recognition under the SSA to a class of health care providers who lack a formal education from an accredited health care program or institution. ACNM believes that doing so at this time would be inconsistent with the standards and oversight processes that are well established and provide a critical level of quality assurance in the health professions in the US. The Lack of Uniform Educational Standards in the CPM Credential While some CPMs have graduated from an academic program accredited by the Midwifery Education Accreditation Council (MEAC), others have completed apprentice programs with no minimum educational requirement or qualified faculty oversight. At least half of the 1400 current CPMs have been trained through apprentice routes, according to CPM leaders. The CPM credential is conferred by the North American Registry of Midwives (NARM). Like the vast majority of certifying bodies, including the American Midwifery Certification Board (AMCB), NARM is accredited by the National Organization for Competency Assurance’s National Commission for Certifying Agencies. Accreditat ion of the certifying body, however, is not the same as requiring graduation from a formal accredited educational program prior to taking the certification exam. Midwifery in the Global Context The value of formal, accredited education in the health professions is universally recognized. Just this year, the World Health Organization (WHO) issued new standards calling for initial education of midwives at the bachelor’s level from accredited institutions with qualified midwifery faculty. As a nation with a well-developed health care infrastructure, the US should lead the way in professional standards—not accept a lesser standard for midwifery than any other health care profession. The WHO standards are located at http://www.who. int/hrh/nursing_ midwifery/ hrh_global_ standards_ education. pdf. In Closing ACNM sincerely applauds the progress that the CPM community has made in moving toward a framework of professional standards and processes for CPM education and credentialing. However, the lack of a uniform standard of accredited formal education remains a critical missing component. Until the CPM credential includes this uniform educational standard, ACNM must oppose federal recognition of CPMs without the above credentials. ACNM leaders appreciate that this is a challenging and even emotional issue for many ACNM members who value the passionate energy that CPMs have helped to generate for midwifery and out-of-hospital birth. We understand that many of our members work with CPMs directly or in other ways. We strongly support the right of women to have choices in childbirth and that the current maternity care system does not always meet their needs. In many venues on the federal and state level, ACNM works to support these choices and to improve the maternity care system and enhance the availability of high-quality midwifery care to all women in all settings. ACNM looks forward to the day when there is one unified profession of midwifery, with unified standards for education and credentialing, working toward common goals. In the meantime, we continue to maintain our long-held standards for academic preparation and clinical practice and we will continue our dialogue with our CPM colleagues in the interest of one day attaining that goal. Continue to look for news on ACNM legislative priorities in ACNM’s Quick e-news and the ACNM web site in the coming weeks and months as Congressional leaders work to enact federal health care reform. ACNM has been and continues to be well represented in Washington and through our hard-working Government Affairs Committee and federal lobbyist Patrick Cooney, who have worked tirelessly to build congressional support to enhance access to midwifery care. ACNM members wishing to express their views on this or other federal legislative issues are encouraged to contact ACNM at leadership@acnm. org. Click here to unsubscribe8403 Colesville Road, Suite 1550, Silver Spring, MD 20910

A Treat for Being so Patient...


It is funny as Mike and I look at our genetics...
  • All the kids have had red hair, with Keely and Samuel the fairest and most copper colored.
  • Keely and Noah had my nose, possibly Lyric, and Samuel and Simon have Mike's.
  • Simon potentially looks the most like me. Lyric looks the most like Mike.
  • Keely is the most different than me in personality. Samuel is the most alike me.
  • Simon potentially has Mike's temperment, definitely Noah. Keely is most different.
  • Lyric was the only one to have Mike's pointy elbows and toes webbed to the tip top.
  • Mysterious genes - where'd they come from? Lyric had a dimpled chin, which we haven't seen in our family. Noah has a dimple in his cheek. Simon's ears are very different than everyone elses, although they do fold over and stick like the rest of them!

Thus far...

  • Keely walked first and talked last.
  • Samuel crawled first and had the greatest vocabulary.
  • Noah was the quietest baby and Samuel the loudest.
  • Samuel is the toughest and Noah the most sensitive.
  • Keely lost all her teeth early and Noah has yet to loose all his!
  • Simon weighed the most and Keely the least. Samuel and Lyric were nearly the same.
  • Noah had the most drugs in labor, and Samuel and Lyric the least.
  • Noah was breastfed the longest and Lyric the least...although mom lactated the least with Keely.

Thursday, July 16, 2009

Canning

Mike and I are a bit unusual. I've already shared that given the opportunity to do anything in our free time, we typically choose to work in the garden or on the house. Likewise, we like to can, and we did just this for many, many hours this week.

New to us, was canning pickles, which we mastered quickly...more than fifty cans! We have spears, slices, whole pickles and even side-sliced sandwich pickles like the ones from Steak-n-Shake. Maybe I spoke too soon regarding our mastering the pickles. We have yet to taste them, but I'll keep you posted.

We also tried pickled green beans. This does not in anyway sound tasty to me, but we had to try them. The jar on the left however, is peach honey and yes, we mastered this. After peeling the peaches below that we also canned, we used the peaches to make peach juice and then peach honey. Fabulous! Mike has already eaten almost an entire jar on his own.


The peaches taste fabulous, but they don't look so great. Suggestions?


I can't wait to taste these! And yes... I did crave pickles during Simon's pregnancy... the small cruncher pickles.



U-Pick

We don't let him leave the house without sun screen anymore, and a hat. For those of you praying, his eye biopsy came back negative, but now he has a fast growing area on his lip and a slower one on his scalp. Please keep praying! Anyway...U-pick.

Samuel and Noah really enjoyed themselves...what boy can resist climbing trees or ladders?

We all visited our first U-pick farm, which should be a crime since we live right down the road from a fabulous U-pick farm... Stuckey's Farm. They had ready to pick - pickles, cherries and green beans. Having already canned nine jars of green beans and having a few left from last year, we chose pickles without having any knowledge how to pickle. In only a few minutes, we had more than fifty pounds and no idea how we were going to carry all that back to our van, with a baby, a toddler, a whiney ten-year-old, and a burning hot teenager. I will admit, after bending over to pick a few cucumbers myself, I got a little light-headed. I'll show the fruits of our labor in the next posting, but besides pickles, we picked a small bag of cherries.
Sneak peek at our youngest picker...!

Monday, July 13, 2009

Labor Pictures

Let me say, I never ever share pictures of myself in any scenario, so I must be delirious to share these! However, they are what they are - I am huge. I am bringing sexy back though, in a few months! Be prepared.

This was a huge sign my body was having difficulty getting into real labor. Had I been in a productive pattern, Samuel would not have been anywhere near me. His energy would have been way too much. My water broke at 7 am, Saturday morning, as I laid in bed. I reached back and swat Mike awake. He quickly ran around the bed to see how he could help and we both became quite astonished at just how much fluid continued to flow. It was clear but there were buckets and buckets of it. The fluid crawled up my back and was clear down to the end of the bed. I was too afraid to move and have the umbilical cord sail out, so Mike ran down stairs and grabbed my doppler so we could assess baby. The next fifteen minutes of monitoring gave me enough reassurance that I could head to the bathroom to clean up a bit, and call my midwife.


Noah was a sweety the entire day. He will be great labor support for his wife. The midwife arrived about 10:30am, just as I was telling my birth assistants they should head back to class because I had a strong feeling labor was hours away. Paula had been teaching a DONA course and had skipped out to support me and two of my assistants were in her class as well.

In the past, my water has broken and within an hour or two, contractions started strong and hard, and within the next hour I was birthing. It had been three hours and I was on the front porch swinging with only the occasional contraction. I was alert and very engaged in all that was going on around me. Excited. Not at all in labor and knew it. The midwife went directly up-stairs to take a good long nap, after checking on mom and baby.


Mike and I continued to "labor"... We napped. We walked outside. Mike took Keely to her dog show. He picked her up...second place in obedience! We got in the tub. We sat on the ball and sang worship songs, along with some Cindy Lauper and Beatles. He was by my side the entire day and was sweet and persevering into the evening. At some point, the contractions were persistent enough and hurt enough that Laura, the midwife, called Paula and the gang to join us.
Dana arrived soon after the initial call and began setting up. My contractions were really only present and strong when it was just Mike and I, which our midwife quickly recognized and so as the birth assistants arrived, she coroalled them in the living room with her so my body could try and figure out a pattern. Mike and I really needed this reassurance, that we still needed each other and could depend on each other. It was a fabulous day laying back in his arms.
At some point, I heard Rachel, Barbie and Emily join us as well. They each said Hi, and then retreated into another room. Mike and I could hear their laughter, which gave me great comfort. I knew they were here if I needed them and I also knew they were enjoying themselves and not fretting or irritated at the duration of my "labor."


Samuel was true to himself and was as ornery as ever! As the day progressed, clear fluid continued. Baby was active and sounded fabulous. Keely cooked lunch - fried rice and steak, which I could barely stand to smell in the tub, so again, we retreated to my office to sit on the ball and listen to praise music...all from my blog. Thus far, my desires for this birth had been fulfilled abundantly.
This was the only birth in which I received both my antibiotic doses for GBS prophylaxis. Then we pulled the IV and gave up future doses since it was really the fault of a nurse who didn't wash her hands that caused my daughter to become ill. (I've been negative every pregnancy and ironically, she became ill at three weeks of age right after a newborn died in the NICU of GBS disease...per CDC guidelines, I still need to be treated.)
At some point in the afternoon, I thought I saw meconium during one of my potty trips. The next trip, I was sure. Then a few hours later, some black meconium presented. I thought, "hum..." I showed the midwife and we both went, "Hum..." Listened to heart tones and all was well. "Hum..." That seemed to pass and fluid was again clear. I sort of figured the meconium was locked in a huge plug of mucous which all seemed to come with the meconium. We continued.
I'd rest thirty minutes with nothing but peace and then an enormous four minute contraction that would nearly make me panic would come, reassuring me that yes, my body realizes it needs to labor. Then nothing. Then maybe I'd get ten close ones, but not really hard ones. Then nothing for a long while. Then another four minute, really hard one and then nothing. Every now and then I'd say, I think we're getting there. It will happen tonight. Then I'd question myself.
I reminded myself that I tell all my mothers that every labor and birth is different and it doesn't mean anything is wrong. I just had to trust and persevere. I did and I enjoyed myself, with my husband holding me and my daughter watching on, with a smile.
Later, we went to bed and my midwife suggested a shot of Benedryl for a sort of therapeutic rest. Not too long later, I awoke with a horrendous contraction that brought fear and near panic into me...again, my body attempting to make a go of this. Searching for comfort, I headed to the toilet and once the contraction had ended and I'd taken a deep breath to move past that one, I noticed something on my hand, on the edge of the toilet and then oh no...in the toilet. No, baby was not in the toilet, but I had just realized, my baby was breech. My horrendously long and strong contraction had squeezed the poop right out of my little one.
I asked someone to awake the midwife and have her check me for the first time to verify positioning. She had done Leopold's earlier but like each and everyone that had checked previously (except my dear friend Cindi), she had questioned, but then confidently concluded baby was vertex. She began her cervical exam and I was surprised how tender I was. Never have I been uncomfortable with an exam and I honestly found it very peculiar when I'd check a laboring mom and she would squirm all over the bed. I wonder if this was because I had "labored" so long. My cervix was high as well and only five centimeters, which it likely had been for a week or more. She admitted to not feeling breech bums before, but was confident this was a soft tush. Then she looked at me with a huge sigh. "What do you want to do?"

Saturday, July 4, 2009

Monday's Menu


Mike and I watched the documentary, The Beautiful Truth, last night and I think he was inspired. We sat starving today in town waiting on the kids finish watching the parade, debating for two hours if we should walk into CVS and buy a bag of chips or not. He crumbled and bought a bag of Frito-Lay BBQ chips because he didn't see "MSG" anywhere on the label, and was comforted by the "natural oils" and absence of "transfats." However, I easily located monosodium glutamate and busted his bubble. He realized we were going to starve and live a miserable life. I realized, I really need to plan ahead and be creative. Afterall, we spend all sorts of money and energy growing our own fruits and vegetables and even purchase our food from Farm Fresh, which a good portion ends up in the dump because we still eat out too much.
Anyway, Mike is grilling up some organic bacon for a spinach salad. Keely is baking peach cobbler from organic peaches and wheat flour. Noah is snapping peas and then plans to grill some waffles with blueberries. I am cleaning the refrigerator, chopping, freezing and looking up recipes (sneaking my thoughts onto the blog).
We have leek and ten plums that I am not sure what to do with! I think I'll make cinnamon, plum jam! Unfortunately, I think we're out of ham hocks, which I had planned to have with the green beans Noah is snapping. This evening we'll have hambergers (from the cow we had butchered and absolutely LOVE) and green beans.
Monday - Blueberry Waffles; T-bone steak with foil potatoes and peach cobbler.
Tuesday - Blueberry Waffles; Red Lobster - two home visits up in Merriville today!
Wednesday - Oatmeal with organic raisins; Tuna Noodle Casserole
Thursday - Blueberry Waffles; Mushroom, leek, chicken sausage and tortellini soup. We have lots of mushrooms from farm fresh too, so this should be fabulous at helping us clean out the refrigerator!
Friday - Oatmeal with organic raisins; spinach salad with boiled eggs, bacon and sprouts; enchiladas.
Saturday - Bacon, farm fresh eggs, and whole wheat toast;

Thursday, July 2, 2009

Afterbirth for Dinner - Really, Really cute story on the choice to "eat" one's placenta after birth.

Wednesday, July 1, 2009

The Eckert Escapades: GIVE-A-WAY!!!

The Eckert Escapades: GIVE-A-WAY!!!

I thought we were guessing birth weight and I was a shoe-in for winning! Ha! My vote is 30 pounds for Sam (because my Samuel is 33 pounds) and 22 pounds for Joseph. Your little ones are much more petite than my own (thinking I still guessed too high).

10 Commandments of a Good Birth

A good midwife is worth her weight in gold if you want a good birth experience. Shop carefully and pay her well.
Thou shalt eat a healthy diet: 80-100 grams of protein, salt food to taste and lots of fruits and veggies and eat seafood; and be happy.
Trust Birth, trust yourself. You can do it.
Prenatal care is what you do between your visits to your care provider. Eat well. Love lots. Reduce stress. Your baby will appreciate it!
Homebirth: the gold standard. If possible, stay home for your birth. Birth centers are a good option, too. When necessary, hospitals save lives.
Avoid unnecessary technology like the plague. It may be the plague - including ultrasound (Dopplers and scans) during pregnancy!
Just say no to drugs and intervention.
Your body is perfectly designed to carry, grow and birth your baby. If that isn’t enough, your body can feed your baby too!!
Birth Works; let it. Know that you can do it. It is an awesome and important step to motherhood - a miracle you can achieve.
Thou shalt breastfeed your baby for as long as possible. The health benefit for motherbaby is unsurpassed by any other act. Breast is best.
Jan Tritten
Midwifery Today