Busy, busy month!

My business partners and I have been extremely busy keeping up with all the "Snowmageddon babies" that were conceived during our back-to-back-to-back blizzards of last February! On November 10th and 11th, we did four births in under 36 hours! That might be a new record for our partnership!!

So...... my personal belated congratulations to the couples I worked with:

Jia and Matt, who gave birth to a baby girl, Leila, on November 11 at their home; it was a lovely homebirth for their second baby, and a personal victory for Jia, as her first labor two years ago had been long and difficult. This one was sweet and rewarding!

Kristina and John, who birthed their baby, Katherine, at our birthing center on November 16. This was their first baby, and Kristina did an AMAZING job of staying relaxed and calm all the way through the birth process! Good job, mama!!

And just yesterday, Ksenia and Adam gave birth -- after an EXTREMELY long labor -- to their beautiful little girl, Anastasia at our birth center in Virginia. I'm so incredibly proud of her; she was in ACTIVE labor for nearly 44 hours (71 hours total if you include early labor!) -- and she never ONCE asked to be taken to the hospital. This was a difficult struggle of a birth, and she did it!! Congratulations to this lovely family!

On top of all of this have been my interviews with a new childbirth organization to potentially be hired as a regional representative/teacher trainer. I had a first interview on Tuesday and was called back on Friday for a second, follow-up interview. I don't know when I'll know for sure whether or not I got the position, but I'm hopeful! More information to follow on that soon, hopefully!!

I'm being very bad today -- skipping church!! -- but after being away from my house for about 40 hours and hardly sleeping in two nights, I needed a break today!!

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2nd VBAC for Carole!

Congratulations to Carole and Ross, who welcomed baby Asher into their family this evening! This was Carole's second successful VBAC, and I was incredibly blessed to work with these two fabulous people. Getting to see their four older daughters (two biological, two adopted) arrive at the hospital afterwards to meet their new brother was absolutely priceless! What a joy! Welcome to the world, little boy -- and thank you to the whole family for allowing me to be part of such a special day.

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Happy Birth-Day......

....to baby Lorenzo, born this evening at 5:08 pm to parents Holly and Chris (and big brother Jake)!  Lovely homebirth of an 8 lb., 11 oz., 22" long baby boy! Parents and baby are happy, healthy, and doing well -- midwives and birth assistants could do with a bit more sleep!!  :) 

Welcome to the world, little boy!!

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Birth Announcement!!

We interrupt this series of Honduran posts to announce the birth of beautiful little Chesed Joy -- I was told her name refers to God's covenant kindness!! She was born Monday evening around 8 pm after only a four hour labor, and weighed in at 7 pounds, 1 ounce. Congratulations to the parents, Laura and Joel, and big sister, Grace. Welcome to the world, little girl!!

Welcome to the world!

With the beginning of the school year, recovering from the last wedding, and planning for my upcoming trip to Honduras, I haven't had much of an opportunity to write lately.  However, I just needed to say -- welcome to the world, baby Andrew (born at home Friday, Sept. 17, weighing in at 8 lbs., 14 oz.) and baby Zoey (born last night, Sept. 19, at the birth center, 8 lbs. 12 1/2 oz.)  Thanks to their wonderful families for allowing me to be part of their birth!

And now to get some of those postpartum visits done (and catch up on some SLEEP!!!)

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The dresses have arrived -- and so have all the babies!!

Such a busy, busy week -- no time for writing, just SURVIVAL!  I've had a birth last Wednesday PM into Thursday AM; another one late Thursday PM into Friday AM; and then another in the early hours of Monday!  So many babies!! 

While I was at Friday's birth, Morgan texted me to let me know that the wayward bridesmaids' gowns had finally arrived!!  One day, when I've got more time and I'm feeling a bit calmer, I will have to write in detail about our ordeal with House of Brides.  For now, it will suffice to say that they will NEVER get a good recommendation from me for future clients.  The order placed with them was by far the most stressful part of the wedding planning, and I can't believe how unhelpful they were. 

Other wedding plans are going well; food is selected and will be ordered shortly; Solomon's mom has the plans for the rehearsal dinner well under control; we're working on lots of little tiny details, but all in all, I think things are going OK.  Either we're pretty well-organized or I'm missing something major that will come crashing down soon!!!  I don't feel terribly stressed about anything, so that is GOOD!!!  I still need to find time to go dress shopping for ME, but other than that, things are going pretty well!

Bryanna texted yesterday and sent pictures of her apartment in Abilene.  It sounds like they're getting settled quickly and making some new friends, so it's all good.  Hope their cat Patches is settling in, too -- that cat does NOT like change in her life.

And I think I need to be off and hitting the road...... need to get to the library today, need to take care of ordering some items, need to meet with Solomon's mom about some things -- AND Vacation Bible School is going on this week at our church in the evenings.  Never a dull moment!!

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Random streams of consciousness.......

I keep thinking I should post something, but nothing "major" or "interesting" seems to be happening right now...... just so much "life stuff"....... So, here are random thoughts........

Wedding planning....... blah...... how is that girls who are so excited to be bridesmaids can't find the time to get their measurements to me to order dresses?  Yikes....... time marches on and I KNOW alterations will be needed, but I can't seem to be able to light a fire under these gals and get them moving......

However, I really am enjoying the time spent with Morgan on planning the wedding, and we've had fun going shopping and working on-line, putting together wedding registries.  It's fun to watch the joy she has in planning her own home -- brings back fond memories of that time in my life, so many years ago.....

My nephew Russell is getting married in October to a gal in Honduras.  I found out that it will cost less than $400 to get there -- I wonder if I'll have any money left over after Morgan's wedding to be able to go to that one??  And if I go, I could make their wedding cake too....... Of course, that idea had me thinking about things I might have to bring along -- cake pans, icing decorating tools, cake mixes..... hmmmmmm...... if I brought along two pound bags of powdered sugar, I wonder if TSA folks would suspect me of smuggling cocaine INTO Honduras and check all my luggage??  (that thought definitely got me giggling!!)

I got a box of flowers last week from a client who had her baby last year.  It was her baby's first birthday and she sent me the most beautiful note along with the flowers; it read: "Pam, a year ago, you helped bring our baby Jack safely into this world. Thank you so much for your unflagging spirit that night. Every day, Jack is an amazing gift! Best regards, CS & HS"  Wow....... it's moments like that that help me remember why I do this job; most of my clients are amazing, wonderful people, and every time I see a baby born, I'm witnessing a miracle -- there's just no other way to describe it.

Nelson's talking about finally installing the wood flooring in the upstairs of the house.  We bought it last year; it's been sitting in the garage, waiting for the time and $$$ to install it, but now with the wedding coming up and potentially hoardes of people to come through our house in the next few months, he's decided it might be time to step things up a bit.  YAY!!!  I hope this finally happens......

Nelson went to the hardware store last night; I don't even know what he went to get, but he came home with a beautiful new orchid plant for me!  It's got fairly small flowers that are a very deep purple color, and the flowers have a long throat on them.  I'll have to take some pictures and post them.

Our choir from the homeschool group had their year-end performance last Thursday, and as usual, pulled it all together at the last minute!!  They did a great job!  I love playing the piano for these kids -- they're just so much fun to work with.  Now the band/orchestra concert comes up in two more weeks -- I need to keep Mackenzie busy practicing that violin!!  And she's been sick for the last few days, but no time to let up on practicing now, with the concert coming up -- I'm such a MEAN mom!!

Taxes -- now there's another random thought......  I just can NOT seem to get myself motivated to work on these this year and now Tax Day looms.  Guess I'm filing an extension of time for now!!  It's sure not going to get done in the next two days!!

It's also getting close to the end of the school year, which is prime time for selling old homeschooling materials.  I have SO MUCH stuff to get rid of -- and I'd love to make some money off of them -- but organizing it all is just one more thing in my ever-growing list of things that need to be done.  So much stuff, so little time.....   I need to clone myself three or four times in order to catch up......  It's like that T-shirt I saw:  "God put me on this earth to accomplish a certain number of things -- and right now, I'm so far behind, I'll NEVER die!!"  That's me.....

At least my paperwork for the homeschooling program is up-to-date....... One thing's done, anyway!!  Now if I could just find the surface on my desk..... such a mess....... maybe that ought to be today's project......

I suppose I've now frittered away enough time on the computer, rambling on and on....... Back to real life!!  Mackenzie's Pioneer Girls group is going bowling this afternoon, and we've got a LOT to get finished before we leave.  'Bye for now.......

A nice, big baby!!

Congratulations to my client, H, who gave birth to her third child (first daughter) last night.  This gorgeous "little" girl weighed in at a hefty 10 pounds, 12 ounces!!  Mom and baby are doing very well!!

Yes, the female body can do some pretty amazing things!!!

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Two babies and a nasty saleswoman!

My day in a nutshell.....

I got called to CH's birth shortly after midnight; this was a fast birth of a baby girl born at 1:45 am, weighing 8 lbs., 11 oz.  The whole thing would've been great if it hadn't been for normal hospital stupid policies......

While in postpartum with her, my cell phone went off again. This time, it was ES in labor. She was absolutely WAILING in the background. Said goodbye to C, turned on the GPS and headed over to the birth center. Arrived around 5 AM (???), baby girl born at 8:31 AM, 7 lbs., 11 oz.

E left the center at 11:40, we finished cleaning by 12:30!!! We were MOVING!!!

I got home around 1:15, picked up Mackenzie and headed to Columbia to go to a bridal shop. Morgan was SUPPOSED to call and make arrangements for us to go; unfortunately, she didn't do it. So I showed up there and was met by a VERY snooty, nasty saleswoman who wanted absolutely nothing to do with us because we didn't have an appointment. Now keep in mind this store has only been open three weeks and there was NOBODY in the store..... This gal couldn't be bothered at all to help us. In fact, she kept giving us the evil eye, as if we were there to steal all her dresses. Right -- like who can march out of a store with a bridal gown or bridesmaid dress hidden under their clothes????

Finally we left there and went to Morgan's friend's house to use the computer and see if there was another bridal store in the area we could check out.  Unfortunately, almost everything was closed on a Monday..... sigh again.....

I finally gave up, bought food at Boston Market, came home and ate dinner, and have done almost nothing since then. I'm basically killing time until it's late enough to go to bed.

Finishing up some paperwork and then time for some zzzzzzzzz's........ G'nite everyone!

So, so, soooooo tired.........

Working as a birth assistant or a midwife is never easy under any circumstances -- long, unpredictable, irregular hours, limited sleep, births full of euphoria, births full of stress.  It's a constant whirlwind of driving, sleepless nights, and extremes in emotions.  It gets hard physically as I get older, and it makes me wonder how much longer I'll be able to do this job.

Just in the last five days:

Thursday AM, I was picking up carpool kids to go to our homeschool co-op (where I also co-teach two classes) when one of the midwives called and said we had a client in labor.  I told her I'd send my partner Lori, since Thursdays are a difficult day for me, and also because I already had a car full of children!!!  Just about the time I got to the co-op classes, the midwife called back and said, "I need somebody there now!!  She's starting to push!  Where are you?"  Fortunately, I was only about 10 miles or so away, so I dropped off the kids, called Lori and told her to head back home, I was taking this one!!  I arrived at 8:38 AM; the midwife arrived at 8:43 AM; the baby arrived at 8:47 AM!!!  Wow.........  followed by a hemorrhage and a baby who needed just a bit of help in getting started.  All really was fine, it just was a long, tiring morning.  And we still had violin lessons that afternoon and other errands to run..... a full, busy day.

Friday, I was supposed to take Morgan to college for her class.  However, she woke up with a migraine and decided to stay in bed.  Fine by me -- I needed some rest and a day without so much running around.  However, that changed when my hubby called in mid-afternoon, said there'd been a change in work schedules, and he would be flying in that evening from Georgia.  While it was nice to hear he was coming home, my house was a disaster, I had an already scheduled six-hour meeting with the midwives the next day (our annual training, OSHA review, practicing emergency drills, etc), plus I'd scheduled Morgan's appointment for the new hairdo -- AND Mackenzie was getting sick.  Didn't matter -- Nelson still wanted to come home.  So I spent the rest of the afternoon/evening cleaning house in preparation for his arrival.

His flight was supposed to leave Atlanta around 10 PM, arrive at BWI shortly before midnight.  However, it had been snowing heavily up north all day long, and the previous leg of his flight had originated in Pittsburgh.  His plane ended up leaving Atlanta nearly an hour and a half late.  There was no way I could sit up and wait for him -- I needed to get up at 7 AM for my meeting, and at this point, he probably wouldn't be arriving home until 1:30 or 2 AM.  When I woke in the AM, he was asleep.  I gave him a quick hug, said goodbye, and told him I'd see him in the evening.  I left for the meeting, came back in the late afternoon, swapped cars with him (got a quick hug!), and took Morgan for her 'do.  As I was coming back, I got a phone call from my partner -- we had TWO clients in labor and we both needed to get going..... sigh........ I got home, swapped cars with Nelson again, and apologized for all the craziness -- but what could I do about it?

The birth I went to turned out to be long, slow, tedious.  I arrived around 8 PM; the midwife, the student midwife and I took turns sitting with the client most of the night and trying to catch catnaps when it was our turn to rest.  I got very little rest, because I was trying to curl up and sleep on a small love seat!!

By mid-morning on Sunday, I knew there was no way I was going to be home before Nelson flew back to Georgia -- his flight was leaving at 1:30, and my client was nowhere close to birthing.  I had to call and regretfully tell him that I wouldn't get to see him, and I hoped he would have a safe flight back to Georgia.  He wasn't too pleased, but what could I do??  Plus Mackenzie was now home alone and getting sicker..... sigh......

My client's labor just kept stalling, and by late afternoon, the decision was made to transfer to the hospital.  The client, her husband, their extended family, the midwife and the student midwife all headed off to the hospital.  I stayed behind to clean the birth center -- a long job, mostly because I was exhausted at this point.

I couldn't sleep in Monday AM -- had to take Morgan to college, so I dropped her off and went to Costco to buy a few necessary items (mostly dog food!!) and do some pricing on possible wedding foods.  During this time, I got a call from the midwife that our client had finally birthed around 2:30 AM (Monday morning) and she'd had a TEN POUND, SEVEN OUNCE baby boy!!  Wow!!!  I also spoke with my client who'd birthed on Thursday about all the nursing troubles she was having.  I tried to offer her some ideas and suggestions -- I hope something will help.

I came back home, did some school work with a now very sick Mackenzie and tried to get some things done around the house.  Tired, tired, tired, moving too slowly.  I took a short nap in the evening, which was the wrong thing to do -- then I couldn't get to sleep at bedtime!!  I stayed up doing things around the house and finally told myself that this was ridiculous around 1:15 AM.  I NEEDED to be in bed.

So of course, what happened?  At 2:30 AM, one of the midwives called me.  She had another client in labor and the birth assistant was sick -- could I come help?  Uh...... yeah, sure, I guess.......... I'm DYING, but I guess that doesn't matter........!!  I drove all the way to Falls Church, VA (nearly 50 minutes non-rush hour) and by the time I arrived, the "labor" had slowed WAY down.  Thankfully, we only stayed a few hours before deciding this wasn't the real thing, and headed back home.  I arrived at 7 AM, and was able to sneak in quietly enough that I didn't disturb the dogs too much.  I just plopped on the sofa and went to sleep for two hours until the dogs and Mackenzie got up.  Later I slept about another hour, and right now, I'm so tired, I can barely see to type!!  I think I'm going to set Mackenzie up with some independent schoolwork and go take another nap......

And I'm back on call again at 10 PM -- pray for me!!!  Oh, to be 25 again.......!!!

A bouncing baby boy!

I really don't have the time (or energy!) to blog much right now. I had NO -- ZERO -- ZIP -- NADA -- ZILCH -- sleep last night due to a marathon birth. But I'm happy to report that at 9:41 AM, my client gave birth to a gorgeous 10 lbs., 8 oz. baby boy!! Wow!!! What a gal!!

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A GREAT nickname for a New Year's Day Baby!

I attended the birth of a beautiful baby girl today, born at 9:21 AM. As the midwife and I were filling out the paperwork afterwards, she commented on the great birth date -- January 1, 2010 or 01-01-10. Dad thought about it for a second and said, "We can call her the 'Binary Baby'"!!

Welcome to the world, little Lily Marie!!

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The count is rising......

It's not the end of the year yet, but I decided to do some quick tallying anyway. Here's my baby count thus far --

January -- 2
February -- 3
March -- 3
April -- 2
May -- 4
June -- 5
July -- 1
August -- 2
September -- 3
October -- 7!!
November -- 2 (thus far!!)

So I'm up to 32 births attended for the year, and we've still got quite a few left for November and December. It's been a busy year!!

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ANOTHER birth this week????

I was called to another birth last night, and unfortunately, this one didn't end up going as smoothly as the others from this week. The mom got to 9 cms. rapidly, then just couldn't seem to get to 10. After the midwife helped her eliminate ("reduce") the last bit of cervix, she started pushing -- and she was a pushing CHAMP!! But this baby would NOT descend, and after she started passing a lot of meconium and the baby's heart tones started dropping rather low -- AND the baby was still not descending -- the decision was made to transfer to the hospital. So -- outcome is a healthy baby girl, 8 lbs., 4 oz., delivered by c-section this AM, presenting in a posterior position with the cord around her neck twice! I'm very grateful that God made is quite obvious that this baby NEEDED to be born via c-section; there's no second-guessing on this birth. The right decision was made at the right time, and everyone is healthy and happy. (Well, maybe not the midwife and I, who are exhausted and punchy!!!)

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Babies, babies, and more babies!!

My partner Lori left for vacation this week. I was more than a bit concerned, because we had FIVE clients due in a 9-day span -- due dates were the 11th, 12th, 15th, 19th and 20th, I believe. However, all but one were first time moms, and they usually tend to go overdue, so Lori thought that it wouldn't be TOO bad while she was gone..... HAH!!

She left Friday afternoon. By Saturday mid-morning, I'd received calls that TWO of our clients might be in labor -- uh-oh, not a good thing. By nighttime, they were both contracting about every 3-4 minutes, and it looked like I needed to make a decision. I could be at one birth or the other, but not both. I called my friend and former partner, Audrey, to see if she'd like to attend one of the births. No good -- the hospital she's working out was SWAMPED with people in labor, and they'd asked her to come in and help on her day off!! (Babies popping out there too!!) I called another birth assistant, but she didn't return my calls. Finally, one of the midwives started helping me make calls, and we managed to find someone who could go to the other birth at the birth center.

Around 11:45, the midwife called me back, and said that she hoped she hadn't made a bad call, as the 2nd client had phoned and said it seemed like her labor was slowing down. At that point, I really didn't care. I figured I'd go to sleep and they'd call me when they needed me. So I was absolutely shocked to be awakened by a call at 12:25: "Hey, Pam, this is J....... the baby is OUT and we can't reach the midwife.... what do we do?" Holy cow -- is this a JOKE?? Not funny!!!

But it was true! The client had tried to lay down for a while, but couldn't get comfortable; got up and walked around a bit, then decided she needed to use the bathroom -- and 10 minutes later gave birth to a cute little baby girl!!! Unbelievable birth for a first-time mom!!

The midwife and I arrived within the 1/2 hour, checked on everyone, cleaned things up, made sure all was well, and helped with breastfeeding before leaving around 4:30 AM.

While there, the midwife told me that my first client had gone to the birth center, been checked and was only 2 cms., so they sent her back home. I called the client's husband on my way home to check in and told him I'd be available for them now. So I was surprised (and not very pleased) to hear later that the clients returned to the center around 6:30 AM, and the midwife had the back-up attend instead of calling me in. I hope the client was OK with working with a birth assistant she'd never met before......

It turned out to be an extremely long, drawn-out birth, and it was probably a good thing I didn't go. The baby was not born until 5 AM Monday, meaning she'd been in labor over 30 hours. The baby's head was positioned very crookedly (called "asynclitic") and it took a lot of position changes and a lot of labor to get her head to move. However, ultimately, it did, and the client gave birth at the center to an 8 lb., 9 oz. baby girl!! Good for her!! I hear she's quite proud of herself, as she should be -- what a good job!

So on Tuesday at 3 AM, my phone rang again -- this time from the clients having baby #2. They wanted to give me a heads-up that she might be in labor. Good -- I'm going right back to sleep until you call again, thank you!! Around 5 AM,, they called again, said labor had continued, and the midwife wanted to get there before the AM rush hour traffic. So a quick shower, change my clothes, grab my bags, and I'm on my way!! I arrived around 6:30 AM, and we had a cute little baby boy at 10:30 AM! Nice, easy, straight-forward birth with clients who were very self-sufficient!! What a nice way to begin a day!!

So the total is 3 babies in 58 hours -- not bad!! Now, if at least one or both of the remaining October clients will wait until Lori returns.....

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Pray for Baby Oliver

My job, while usually fun, exciting and rewarding (though often exhausting!) does have its share of nail-biting moments, moments of despair (such as the loss of baby Logan this past summer), and times of worry. Right now is one of those "times of worry".

We had a client give birth on Monday night -- a very straightforward birth for the most part, especially for a first-time mother. Mother and baby left the birth center and went home about 5 hours later. Therefore, I was quite surprised when the midwife called me the next afternoon to tell me that the baby was in the NICU. He was EXTREMELY jaundiced, especially for being less than 18 hours old. Most pediatricians don't start to really worry about the bilirubin count until it's hitting 16 - 18; Oliver's was 26. That's terribly high by any standard.

Oliver was immediately sent to the hospital, and last night underwent a complete transfusion of all his blood. It turns out he and the mother had a blood incompatibility issue which set all this off; hopefully with the very quick treatment he received, he will have no long-term damage from this. But what a way to start off life with a new baby....... Please be praying for parents P & M and their new baby Oliver.

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A big, bouncy, baby GIRL!!!

Thankfully, after returning from NYC, I got a full night's sleep, only to be awakened at 7:30 AM with a call from a client in early labor. I headed off to her house about an hour later -- no rush, because things were just getting started. Her first two children were being watched by grandma and grandpa, who were wonderful with the children, and were also wonderful about making sure that the midwife and I were well-fed and taken care of! Great folks!!

The client's first two babies were both in the 8 pound range, so were we all surprised when out came a NINE POUND, TWELVE OUNCE baby!! Gorgeous baby; great, smooth birth; happy parents; loving siblings; hours spent in a lovely house with a beautiful view overlooking the Severn River; fabulous weather -- what more could we ask from such a fantastic day??!!

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Babies, babies, babies!!!

It's funny how often my partners and I seem to have "clumps" of births. You'd think the births should spread out randomly over the calendar, but it rarely seems to happen that way. This week has probably been the busiest week we have ever experienced in our partnership.

Baby #1 -- (and the longest of the births) -- Monday at midnight until baby boy was born at 4:17 AM on WEDNESDAY!!! (and I was the birth assistant who got to attend this marathon!!)

Baby #2 -- client came into the birth center around 4 AM Tuesday, and baby was born around 4:45 AM!!! WOW!!! My partner, Lori, got to attend a birth that was speedy!

Baby #3 -- client called for midwife and Lori to come on Tuesday evening. Lori and midwife were there about 40 minutes before baby was born -- another quick one!!

Baby #4 -- client called for midwife and my partner Audrey to come on Tuesday evening. I don't have exact times, but I know the client called around 6 pm and the baby was born by 9 PM -- so yet another speedster!

Baby #5 -- While I was sleeping off my exhaustion on Wednesday afternoon, another client called!! Audrey went to the birth center and baby was born about 1 1/2 hours after arrival.

So.......... FIVE babies in less than 40 hours -- I think that ought to be some kind of record! And I just got off the phone with Lori, who is on her way to yet ANOTHER home birth right now. If this baby is born before midnight, it will be six babies born in less than 3 days.

Did somebody forget to pass out the memo that the full moon was two weeks ago??
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NEED..........MORE............SLEEP...........zzzzzzzzzzzzz.....

My two partners, Audrey and Lori, both ended up going out of town for a week at the same time, leaving me home with a full load of clients and praying like crazy that it would work out. And I guess it HAS worked out -- somewhat -- in the sense that at least I haven't had two in labor at the same time yet!!! My schedule over the last few days:

Friday night into Saturday AM -- up until 4 AM waiting for a thoughtless teenager (who shall remain nameless) to decide to come home after going out with friends for the evening...... that in itself is a whole 'nother story!!

Saturday AM -- woken up at 6:45 AM by the puppy, who desperately needed a potty break! Then up for several hours working on finishing up the packing for my youngest daughter, as she was leaving for camp (River Valley Ranch) on Sunday after church. I was moving at a leisurely pace -- partially because I was pretty on top of getting things ready early and partially because I was tired from lack of sleep!! In the early afternoon, I got a call that a client might be in labor -- uh, oh -- time to go get a nap -- QUICK!!! Off to bed for several hours, then up to work on the packing again. At which point I got a call from the midwife: "Need you here -- NOW!!! So I dropped everything, threw the not-yet-complete packing list at my husband, and ran out the door!!

Got the birth center; the mom was completely dialated and beginning to push -- YIPPEE!!! Baby was born shortly after 9 PM, no problems at all. Client went home shortly after midnight and I was home and in bed by around 2:30 AM. Now I was pretty tired........

But....... I had to get up first thing in the AM for church. On any other Sunday, I might've considered staying home and sleeping off the birth; but on this day, the plan was to leave directly from church to take our daughter to camp. So -- off we went to church, then directly to camp, which is about a 1 hour, 20 minute drive north of us, right on the MD/PA state line. We arrived around 2 pm, got her checked in, bed made up, and all that kind of stuff, and then drove back home. I actually nodded off in the car several times on the way home -- I was pretty tired.

Arrived home around 6 pm, and at 6:30 pm (I'm NOT kidding!!), I got a call that ANOTHER client might be in labor........oh, my....... off to the sofa to lay down and rest. Please, God -- could this MAYBE be a false alarm??!! Nope -- at 10:30 I got the call to come to the birth center -- and to PLEASE hurry...... I arrived at the birth center at 11:10 PM. The client's car was parked all cross-ways across the driveway; the backdoor to the center was unlocked and ajar; the entrance foyer at the bottom of the steps was strewn with clothing and messy chux pads -- OH, NO!!! I went running up the stairs, only to hear the midwife calling out, "Hey, Pam!! She had the baby a few minutes ago!!" Again, thankfully, all was well, though it was an incredibly fast turn of events!! Mom, dad, and baby went home around 2AM. But the midwife and I were VERY tired and feeling a bit punchy, and it took us quite a while to get things cleaned up and organized. After that, we sat around and talked for about 45 minutes. Why??? I don't know...... I think we were both too tired to be thinking straight!!

I reached home around 5:30 AM and since I knew my husband would be getting up shortly, I decided to rest on the sofa and not wake him up. When he left for work, I got up and went to bed. Unfortunately, I was woken by a phone call at 9:45 AM from my oldest daughter, who needed a ride home from class..... blah......... I told her I'd get there whenever I could and she'd just better sit tight!! I ended up not picking her up until almost noon -- I just could NOT get myself moving.

After coming home and eating and trying to wake myself out of the stupor I was in, I got a phone call at 2:30 that -- can you believe it?? -- ANOTHER client might be in labor???? HELP -- I'm drowning..... Off to bed for another nap. I think I slept about 4 hours before getting up, eating dinner, and just trying to take it easy.

The call from the midwife to come to this birth (at the client's home in Alexandria, Virginia) came around 9 PM. Off to Virginia again -- 3rd trip to Alexandria in three days. My car ought to be able to make that trip on autopilot, don't you think?? Beautiful baby girl was born at 4:30 AM today; mom and baby are doing well.

And me??? I am BEYOND tired...... is there a stronger word than "exhausted"??!! I got about 4 1/2 hours of sleep this AM into the mid-afternoon. Hopefully, I can to bed early tonight and try to get my body back into the correct time zone!!!

Unfortunately, I still have a client who is now 4 days overdue! PLEASE, God -- no more births, at least not tonight!!!

I guess I'm a "non-compliant", "ungrateful" patient!!

This was sent to me a little while ago, and I just had to share. If asking questions, wanting to be informed before consenting to a procedure, or thinking about alternatives to a first opinion makes me "non-compliant" and "ungrateful"........well, I guess I've got two new character traits!! Read and see if you feel like you need to take action.

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If you don't like the idea of being officially labeled "non-compliant" or "ungrateful" for questioning your physician, then go to http://www.ama-assn.org/ama/pub/about-ama/our-people/the-federation-medicine/state-medical-society-websites.shtml, click on the link for your state AMA and contact them. Let them know that this proposal is unacceptable. Voting is next week.


AMA Resolution Would Seek to Label "Ungrateful" Patients
http://ican-online.org/news/ican-online

AMA Resolution Would Seek to Label “Ungrateful” Patients

Redondo Beach, CA, June 11, 2009 - At the American Medical Association’s (AMA) Annual Meeting next week, delegates will vote on a resolution which proposes to develop CPT (billing) codes to identify and label “non-compliant” patients (1)

The resolution complains:

“The stress of dealing with ungrateful patients is adding to the stress of physicians leading to decreased physician satisfaction.”

“This resolution is alarming in its arrogance and its failure to recognize, or even pay lip service to, patient autonomy,” said Desirre Andrews, the newly elected president of the International Cesarean Awareness Network (ICAN).

If approved, the resolution could hold implications for women receiving maternity care. For pregnant women seeking quality care and good outcomes, “non-compliance” is often their only alternative to accepting sub-standard care. Physicians routinely order interventions like induction, episiotomy, or cesarean section unnecessarily.

Liz Dutzy, a mother from Olathe, Kansas, delivered her first two babies by cesarean and was told by her obstetrician that she needed another surgical delivery. “My doctor told me that I needed to have a cesarean delivery at 39 weeks, or my uterus would rupture and my baby would die.” She sought out another care provider and had a healthy and safe intervention-free {home} birth at 41 weeks and 3 days gestation.

A recent report by Childbirth Connection and The Milbank Memorial Fund, called “Evidence-Based Maternity Care: What It Is and What It Can Achieve ,” (2) shows that the state of maternity care in the U.S. is worrisome, driven largely by a failure of care providers to heed evidence-based care practices. For most women in the U.S., care practices that have been proven to make childbirth easier and safer are underused, and interventions that may increase risks to mothers and babies are routinely overused. The authors of the report point to the “perinatal paradox” of doing more, but accomplishing less.

The resolution proposed by the Michigan delegation of the AMA could threaten patient care and patient autonomy for several reasons:

• Billing codes that would categorize any disagreement and exercise of autonomy on the part of the patient as “non-compliance” “abuse” or “hostility” could create a pathway for insurance companies to deny coverage to patients

• Use of these labels fails to recognize patients as competent partners with physicians in their own care

• Tagging patients as “non-compliant” fails to recognize that there is not a “one size fits all” approach to care, that different opinions among physicians abound, and that patients are entitled to these very same differences of opinion

• Labeling patients as “non-compliant” may, in fact, be punitive, jeopardizing a patient’s ability to seek out other care providers

The resolution also fails to address how it would implicate patients navigating controversial issues in medical care, like vaginal birth after cesarean (VBAC). While a substantive body of medical research demonstrates that VBAC is reasonably safe, if not safer, than repeat cesareans, most physicians and hospitals refuse to support VBAC. (3) The language in the resolution suggests that patients who assert their right to opt for VBAC could be tagged as non-compliant, even though their choice would be consistent with the medical research.

“The reality is that the balance of power in the physician-patient relationship is decidedly tipped towards physicians. The least patients should have is the right to disagree with their doctors and not be labeled a ‘naughty’ patient,” said Andrews.

About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death.

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. ICAN has 110 chapters in North America and Europe, which hold educational and support meetings for people interested in cesarean prevention and recovery.

(1) Resolution 710 “Identifying Abusive, Hostile or Non-Compliant Patients”
(2) Evidence-Based Maternity Care: What It Is and What It Can Achieve
(3) http://www.ican-online.org/ican-in-the-news/trouble-repeat-cesareans