I rarely cry at births but  this ,6lb. 9oz. 18″, peanut of a girl brought together two of the most loving families I’ve ever seen! When it came time for four uncles, one aunt, three grandparents, two new parents and one new baby girl to say goodbye for the night, everyone congratulated each other, everyone hugged and everyone was bursting with love . It was beautiful! It is the welcome each baby deserves.

I will keep this birth in my heart as one of the most loving days I’ve ever witnessed. Truly an honor to have been apart of it!

After a good long (and difficult) labor momma and baby met and then promptly fell asleep in each others arms. Lovely!

I’m honored to carry the memory of this birth as my last one in Austin before the big move to the golden coast of California!

I hope you are all enjoying World Breastfeeding Week!

While I doubt my Austin blog following is very high, I still feel the need to share my big news with y’all!

I (Linda/ Miranda Birth Services) will be moving back to Santa Rosa, Ca at the end of August. I will still support a handful of clients a month and on settling back into life with my family and friends that I left behind several years ago to become southern. Santa Rosa is where I fell in love with helping families and first worked as a doula! I’m thrilled to be getting back to my roots!

Austin, thanks for three great years! I will miss you. California here I come!

love to all,

Linda, the Doula

ACOG Affirms Vaginal Delivery After C-section

	By Charles Bankhead, Staff Writer, MedPage Today July 22, 2010
	MedPage Today Action Points The American College of Obstetricians and Gynecologists has clarified and expanded its support for a trial of labor and vaginal delivery after previous cesarean delivery. The updated guidelines state that vaginal delivery after C-section is safe for most women with two previous low transverse uterine scars, twin deliveries, and unknown uterine scars may be appropriate candidates for a trial of labor.
	Review Most women who have a cesarean section can safely attempt a vaginal delivery in a subsequent birth, according to updated guidelines from the American College of Obstetricians and Gynecologists (ACOG). Some women with a history of two prior C-sections may also be candidates for a trial of labor. Thorough evaluation and counseling related to risks and benefits are essential, given that a failed trial of labor after C-section confers more risk than elective repeat cesarean. A trial of labor after cesarean section carries a small risk of uterine rupture, which represents a medical emergency. As such, it should take place whenever possible at a facility with the resources for an emergency cesarean section, according to the ACOG guidelines. “These VBAC [vaginal birth after cesarean] guidelines emphasize the need for thorough counseling of benefits and risks, shared patient-doctor decision making, and the importance of patient autonomy,” ACOG president Richard N. Waldman, MD, said in a statement. Expressing ACOG’s concern about the 30% rate of cesarean delivery, Waldman added, “moving forward, we need to work collaboratively with our patients and our colleagues, hospitals, and insurers to swing the pendulum back to fewer cesareans and a more reasonable VBAC rate.” Published as a “Practice Bulletin” in the August issue of Obstetrics & Gynecology, the guidelines reaffirm ACOG’s longstanding position that most women can attempt a trial of labor after one prior cesarean birth and should be counseled about VBAC. The update expands the list of potential candidates. “The college guidelines now clearly say that women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a trial of labor,” bulletin co-author Jeffrey L. Ecker, MD, of Massachusetts General Hospital in Boston, said in a statement. As many as 80% of appropriately selected patients have successful VBAC, avoiding the morbidity, prolonged recovery, and cost associated with cesarean delivery. Moreover, women who have multiple cesarean deliveries have increased rates of future complications and morbidity, including hysterectomy, bowel and bladder injury, transfusion, infection, and placental abnormalities. The guidelines also clarify ACOG’s position about facilities’ ability to provide emergency cesarean delivery in the event of an unsuccessful trial of labor. “Given the onerous medical liability climate for Ob/Gyns, interpretation of the college’s earlier guidelines led many hospitals to refuse allowing VBACs altogether,” said Waldman. “Our primary goal is to promote the safest environment for labor and delivery, not to restrict women’s access to VBAC.” Women, in consultation with their physicians, may still plan for a trial of labor after cesarean delivery in facilities that might not have immediate access to the resources for obstetric emergencies. However, the planning should include a thorough discussion of local healthcare facilities and resources and the possibility of increased risk, said bulletin co-author William A. Grobman, MD, of Northwestern University in Chicago. Hospitals that lack immediate access to emergency services should have a clear process for bringing together the necessary resources as quickly as possible, Grobman added. The Practice Bulletin was developed by the Committee on Practice Bulletins — Obstetrics of the American College of Obstetricians and Gynecologists. No financial disclosures were listed for members of the committee. Primary source: Obstetrics & Gynecology Source reference: American College of Obstetricians and Gynecologists “Vaginal birth after previous cesarean delivery” Obstet Gynecol 2010; Practice Bulletin No. 115.

“Baby Gear Guru” Jamie Grayson!

, to share what he’s listening to with his gorgeous little nieces!

Hey there! These are just a few songs I am currently enjoying with my new twin nieces. They seem to dig them–you can only hear “Mary Had a Little Lamb” so many times….

“One” by U2 and Mary J Blige (love this cover)

“Take Your Mama Out Tonight” by The Scissor Sisters

“Love Today” by Mika

“Ain’t No Way” by Aretha Franklin

“Respect” by Erasure

“Little Sister” by Rufus Wainwright

“Telling Me Lies” by Linda Rondstadt Dolly Parton and Emmylou Harris

“Always on My Mind” by Willie Nelson

“Hello, Darlin’” by Conway Twitty

“Bicycle” by Queen

“I Want to Hold Your Hand” from the Across the Universe Soundtrack

“The First Time Ever I Saw Your Face” by Roberta Flack

“Shake a Tail Feather” by Tina and Ike Turner

“Me and Mr Jones” by Amy Winehouse

“You Don’t Own Me” from the First Wives’ Club Soundtrack Featuring Bette Midler, Diane Keaton and Goldie Hawn

“How Will I Know?” by pre-crack Whitney Houston

“Will You be There?” by Michael Jackson

“Your Song” by Elton John

“A Case of You” by kd lang

“Get Happy” by Judy Garland

“Freedom” by George Michael

“The Promise” by When in Rome (Napoleon Dynamite Soundtrack)

“Come Sail Away” by Styx

“It’s All Your Fault” by Pink

We listen to a lot of tunes!!!!

–
Jamie Grayson
“Best Baby Gear Guru”–New York Magazine 2010
Member of the International Baby Planner Association
Gear Guy for StrollerTraffic.com

That my friends, is the way to get your baby started on the musical education they deserve! Many thanks to Jamie for giving us the hip newborns music primer! You can stalk him at:

TheBabyGuyNYC.com
Twitter: @thebabyguynyc
Facebook.com/TheBabyGuyNYC

Seriously, go stalk him…he’s wonderful!

love. Linda

Here’s a shot of the best loved baby boy on the planet!

CTDA’s aim is to:

• Raise the community’s awareness of Doulas, and their MANY benefits for new/expecting families

  

• Maintain a listing of local Birth and Postpartum Doulas
• Peer networking and continuing Education opportunities for local Doulas

Each of CTDA’s doulas has agreed to follow a certain Scope of Practice and Code of Ethics. Having met them personally I can say that you’d be lucky to have any one of these fine women serve your family!

CTDA hosts free community events fairly regularly, Every 1st Tuesday of the month you can find a handful of these awesome women host a FREE Breastfeeding 101 class at Babies R Us . Recently, we also hosted a fantastic Doula Share, in which dozens of doulas spent the afternoon hosting free classes (everything from baby wearing to infant cpr) for new/expectant parents! Look for more to come from this wonderful organization!

For the techies among you, you can follow them on Twitter or ‘like’ them on Facebook

But where do you find great Doulas and how do you choose one that’s right for you?

Finding a Doula:

There are several organizations that certify Doulas.
They typically have a searchable directory of members in your area. DONA International , for example, lets you search their directory by state and type of doula (birth or postpartum).

Local Doula groups might also be a helpful starting place to begin your search.
They can be made up of doulas from varying organizations and may or may not have a set scope of practice that they all abide by. Luckily, in Austin (and our surrounding area) we have the Central Texas Doula Association
There might be something similiar in your community!

Ask friends for reccommendations!
If they loved their doula they will be happy to share that information! Even if they’ve never used one they might know doulas who are also their massage therapists, chiropractors, yoga teachers, or friends! Poke around and see who in your community is also a doula, you might be surprised!

You can always try Doula Match . Think of it as the “eharmony” of finding a doula. Nifty profiles showcase experience, a photo, and testimonials.
Yelp! might also have some reviews of local doulas but look for them in the “midwife” section as they aren’t able to designate them any other way.

Choosing a Doula:

Narrow the Field-
Once you’ve gathered some names of Doulas you are interested in try to limit the number of Doulas you interview! Talking to 2-3 that you feel drawn to (or 4 tops!) is plenty to keep track of. More than that can feel overwhelming to remember (even with notes) and harder to recall the feeling you had when you talked with her a certain doula.

Check Availability-
Is this Doula going to be around for your birth? Go ahead and ask to be sure! It will save you the heartache of finding someone you love only to find out they will be on vacation or already are booked up! You may find a Doula who is busy but has a great back-up doula and might be willing to have a couple of clients due around the same time.

Experience with your Situation and Hopes-
You must figure out whether or not your birth goals or postpartum needs match with her experience. Does you Doula have experience supporting breastfeeding mothers of multiples? Has she supported familes at a waterbirth? Might she have experience helping moms have a medicated hospital births? If this is not apart of her background, is she willing to work with you anyway? You might be her first family having a homebirth and it could still be a wonderful experience for you all! Just make sure that you are up front about what you need from your doula.

What about Cost?!-
This is an important aspect in choosing a Doula. The cost of services should not be the most important factor. Although it IS a factor that should be considered. Be realistic. What can you afford? Would your doula be willing to take payments, have your friends and family contribute to your doula fund in lieu of onsies with obnoxious sayings? Doulas want to work with familes that want to work with them! Be honest about your financial situation and ask about your options. Doulas are notoriously nice people. If they can’t accomodate you at a rate you can afford they might be able to suggest someone equally as fabulous who can!

Good Chemistry-
It’s important in choosing the person that you are inviting into your family,for a short period of time, that you have some kind of spark! A doula enters the sacred space of a birthing mother or the life of your family with a newborn. Do you feel a sense of trust with a doula you’ve just interviewed? She might be a new doula who “just feels right” to you or an experienced doula whose warmth makes you feel calmer in her presence. Whatever part of you goes back to a feeling that this person “fits”, GO WITH THAT FEELING! It does not matter that your best friend used another doula, that you met the most experienced doula intown but didn’t click, or that a doula seems perfect but hasn’t had children. Doulas, like expecting families, come from all kinds of different backgrounds, have unique personalities and varying belifes. If YOU feel like you can trust a certain doula and relax knowing she will be there for you, you’ve found a winner!

I hope you find the Doula that’s right for you!

Happy Birthing and Happy New Baby!

love.
Linda