Thursday, October 29, 2015

Can a Shot in The Vagina Change Your Life?


Integrated Women's Wellness had an exciting month this month! An important new service has been added to our Center's array of services for women: Platelet Rich Plasma injections (also known as the O-Shot). And yes, it does go you-know-where. Stop cringing. Don't revolt just yet.

Many people are unfamiliar with the what and the why of PRP and have never heard of either PRP (used in various ways, in various areas of the body), or the O-Shot. Up until a couple of months ago, we hadn't either. As a doctor (Glen) and midwife (myself) we have heard time and time again from women struggling with the pain and/or frustration due to sexual problems. Statistically, we know that only a small percentage of women will actually talk about their sexual problems with their care provider (though as a woman and a midwife, I feel more women are much more open with me about sensitive issues such as this). The reasoning behind women being hesitant or resistant in bringing up any sexual dysfunction is multi-faceted: 1) It can be embarrassing. Sex is personal. Relationships and feelings are personal. Talking about your vagina and subjecting your body to be examined- even when needed- can be difficult. I know I sure hate being on the patient side! 2) With the exception of short-term hormone replacement, there are few proven treatment options. Both provider and patient would be discouraged by discussing a problem that has no proven solution- so often times it doesn't get brought up by patient or provider. 3) If indeed hormones are already being used as treatment (or the woman is pre-menopausal), the only solution, per the official recommendation of the American College of Obstetrics and Gynecology, is considered to be psycho-social therapies. 4) For problems with stress urinary incontinence, surgery is often the treatment. Surgery is serious business, with the risk of complications to be considered.

So, what is PRP? It's a specific procedure using blood-derived growth factors to rejuvenate the vagina, and the treatment of urinary incontinence and various sexual problems. It involves drawing a small amount of blood from the patient, spinning it down to separate the plasma that is rich in platelets, and then using this as an injection into the vagina and clitoris. Yes, I just said that. And no, it's not as bad as it sounds. We have, and utilize, numbing cream.

On the first day of doing PRP, Glen had a full day of doing PRP injections. The indications for PRP varied from each patient, including pain with sex, inability to achieve orgasm, vaginal dryness, and stress urinary incontinence. So far, the results have been significant! 

PRP and the O-Shot has been in national news and magazines, hyped up on television and in Hollywood...but...it's now available at Integrated Women's Wellness and changing lives. Though, unlike the cover headlines of Cosmo and other magazines touting it as "Hollywood's new sex trend..." and the "treatment for female impotence," the fact of the matter remains that this non-invasive, all-natural treatment is truly helping women restore sexual function and is treating urinary incontinence.



Thursday, October 1, 2015

Perspective

Perhaps it can be said that the last birth Glen and I attended in Haiti was the perfect birth. Perhaps I shouldn't use the word "perfect." After all, I know as a midwife and as a woman that has given birth, the word 'perfect' in reference to birth is highly subjective...and sensitive.  It wasn't a glorious birth by our standards at home, by any means. If you've read even one other blog post regarding maternity care and birth in Haiti, you will understand this. A typical birth back home takes place in a pristine and beautiful birth room that is private, surrounded in candlelight, endless hot water, a walk-in glass shower, a deep soaker tub, clean instruments and supplies, and...just simply...Calm. Birth in Haiti is quite a different experience. When basic care and a trained birth attendant is the exception and not the norm, it puts all of the other "luxuries" into perspective.

There had been four women all nearing delivery. The mom who had induced an abortion had just delivered. I had just held her one pound baby girl in my hands, holding her as she took her first breath and holding her as she took her last breath. My heart was sad as I processed this. I retreated to the back storage room for a clean place to rest, where I sat and thought in the still quietness. Camille was not feeling well and needed to lay down and rest. As she laid the camping mat down on the storage room floor, she questioned the rat situation. I assured her that there were no rats on the inside of the Labor & Delivery unit. I had only ever seen them on the exterior corridor. I told her I would keep an eye out and let her know if I saw any though.

Awhile later, Glen had gone to make rounds on Labor & Delivery and listen to heart tones. After a bit, he hadn't returned, so I ventured out to see what he was up to. I won't ever forget what I saw and what he said. With hands on the belly of a laboring mom and a big grin on his face, he exclaimed, "Look Love, I'm a doula!" I think of it now, and I smile. The laboring woman wouldn't let him leave her. He had tried to walk away, and she had insisted that he stayed.

The needs of humans are actually quite simple, when you take away the materialistic possessions and perhaps more importantly, the ego. This woman simply needed a human presence; the comfort and touch of someone who cared. The fact that he was a male obstetrician, nearly from another world, made no difference. She was in need. She didn't want to be alone.

I walked over and relieved him of his new-found, slightly awkward doula duties. I placed my hands on her belly, and ever so gently, just touched her. Without hesitance, she grabbed my hands and put them exactly where she needed them to be, getting a reprieve from the pain, with my hands gently rubbing her belly as she had a contraction. As she progressed over the next hour, she would grab my hands and move them to her hips, then the small of her back, telling me with not a single spoken word, that she was having back labor. Occasionally she would look into my eyes and nod her head, as if saying to me, "Yes! That helps so much!"  Isn't it fascinating, certain situations in life where spoken words are irrelevant, when the most insightful, effective form of communication is simply through the eyes and subtle, unintentional body language? Two people, two strangers, connected only by the human experience...one in pain and afraid, the other simply having understanding and compassion, and their connection not extending beyond that simple awareness.

As we pushed with this woman- supporting and encouraging her in birthing her babe, I saw something out of the corner of my eye, running on the floor. "GAAAAHHH!" I nearly jumped 3 feet in the air, hardly an exaggeration. "GLEN! Do you see that?!" I pointed to the mouse that was now contently resting in the center of the L&D floor.

I thought of Camille, sleeping on the floor just a few feet away. "Should we wake Camille and tell her?"

We decided that it was just a mouse, not a rat, and well, I had told Camille that I would wake her if I saw a RAT. All about perspective, right? No need in waking her up unnecessarily. I got a little chuckle at that, but vowed that I would be keeping a good eye on the little guy, to ensure he didn't make his way to the storage room.

The birth would be what we might call "uneventful"...except for the obvious, of course- a child, as well as a mother, was born. As Camille and Sheily (our translator) rested, Glen and I would attend this birth together. We had a language barrier that made verbal communication nearly impossible between us and our patient (without our translator), but even without a language barrier, Glen and I needed just as few words between us. Perhaps that is a benefit of a husband-midwife team. We are confident in the each other's ability; we can read each other's minds simply with subtle looks or gestures.

I don't remember if the baby was a boy or a girl. I don't even remember which one of us "caught" the baby. I remember the calm. I remember the Haitian midwives quietly watching, the intact perineum, cleaning her up, placing the makeshift pad of folded cotton fabric between her legs, and helping her to slowly get dressed. There was no bed for her that night. Imagine that: a woman who just gave birth and yet there is no bed in the entire hospital for her to sleep with her new baby. In the wee hours of the morning- some time after midnight but yet still hours before dawn, freshly dressed and brand-new bundled up life in her arms, she shuffled herself to the entrance of the Labor & Delivery unit, laid down a sheet, and spent the first night with her baby on the cool concrete floor.

And yet, she was beaming with happiness and pride.

Friday, September 25, 2015

Blood, Sweat, & Tears...and Love


Often times in life, we are our biggest critic and our own greatest set-back, allowing idealistic perceptions define what is “good enough,” and inevitably, setting our very own limitations. One of my favorite quotes speaks to this thought- “If you limit your choice only to what seems possible or reasonable, you disconnect yourself from what you truly want, and all that is left is a compromise.” (Robert Fritz)

It is not just the rare occasion in which I feel inadequate myself...Am I good enough? Am I competent enough? Am I worthy enough? Does any of what I'm doing matter? I'm tired...I'm scared...I'm unsure. These are a fraction of my own internal limitations. It is a continual effort to remove my own limitations and push myself past these internal barriers. Yes I am good enough. Yes I am competent enough. Yes I am worthy enough. Yes, this matters.

Last night we arrived on the Labor & Delivery unit to a young woman writhing and moaning loudly in pain. She hardly looked pregnant. When I questioned the Haitian midwife on why the patient was there, I was told that the patient was “4 months” pregnant, and had fallen. As I spoke with the patient and took her vitals, I suspected that the patient may be lying about falling. She had no tenderness, no bruises or abrasions. Induced abortions with Cytotec here are rampant- Cytotec is inexpensive and easily obtainable. Whatever the cause- a fall or an intended abortion- the patient's cervix was dilating and she would no doubt be miscarrying. There was nothing we could do. Soon after our arrival, things became more intense, with it apparent that delivery was imminent. I looked to Glen and said, “I can't do this delivery. Will you please do it?” He asked me why and I answered honestly. “I'm scared. I've never seen or touched such an early baby.” I didn't know what to expect. I didn't know what this baby was going to look like. Would this baby come out intact? Damaged? Bloody, gory? I was afraid I did not know how to serve her well. I had no clue, and the unknown is frightening.

As we were expecting an imminent delivery, we would find out from the patient's family who accompanied her to the hospital that she had indeed taken Cytotec. The loss of this baby was intentional.

Around us, all Hell breaks loose. Four patients, all near delivery, are contained in a small room the size of my master bathroom at home. The walls contain the yelling, screaming, moaning, and shouts to Jesus. “Jesus, I am dying!” is exclaimed into the air.

The patient begins pushing and in two pushes, the baby's butt becomes visible, revealing to us that this baby is breech. Glen delivers the butt, legs, and abdomen, and as this limp baby girl hangs out of her mother, she suddenly wiggles and kicks fiercely. Glen and I both startle. Glen looks at me and states the obvious, “THIS BABY IS ALIVE.”

He delivers the baby's head, and places her in my blanketed hands. I gently place the baby on her mother's abdomen, gently wipe her dry, cradle her body in the blanket, and place my stethoscope over her. Her heart rate is strong and steady at 160 beats per minute, and she is making an effort to breathe.

Her heart pounding strongly.
My heart racing wildly.
I am dripping sweat and nauseous, my stomach contorted, feeling as if it is in my throat.
The stagnant air is relieved by a breeze coming through the window from the storm that is brewing outside.
“Camille, can you close the window? I don't want her to be cold.”
Camille closes the window.
Dripping sweat, my back is aching, I'm leaning over listening to the baby girl's heart beat.

I begin to cry and don't even try to refrain myself. Tears are streaming down my face; big fat tears fall to the already saturated, filthy floor beneath us, joining the mom's blood, sweat, urine, and every other patient's blood, sweat, urine, and vomit. This floor knows my sweat well, and now, my tears join it all. This, THIS, is the definition of Blood, Sweat, & Tears.

I am sweating and crying for this baby, and my heart aches so bad for this baby girl that it could bleed for her as well.

She wasn't just “4 months,” she was probably about 22-23 weeks...but she didn't even have a chance. Not here. I cried as I heard her heart beating because I knew I was the first to hear her heart, and I would also be the last. I cried because she was living. I cried because she was dying. I cried because there was nothing I could do. I cried because this didn't have to happen.

I looked to Glen, me having never done this before and not knowing what to expect. “How long will she live?” He says to me that it could be just a few minutes...or a couple hours.

I look into the mother's eyes and tell her that her baby has a heart beat, but will soon die. I ask her if I can hold the baby up on her chest, and wait. She nods yes. This is a big deal. I tell her that I will continue to listen to the baby's heart and will let her know when it stops beating. I ask her to look at her baby. I ask her to touch her baby. I tell her that I'm so, so, so very sorry. There is so much I could say, but right here, right now, it's not appropriate and it doesn't matter anyhow. I want to pray but my mind is not able to assemble any coherent thoughts. I simply say quietly, over and over, “Lord Jesus, please be with this baby; please be with this mother.” I know The Lord doesn't need my words. He knows my thoughts, and knows what is in my heart.

Slowly, the baby's heart would gradually slow...160...130...120...100...and finally, just simply stopped. Over the course of that baby's hour here on earth, she was against her mother, and in my hands, wrapped in not only a blanket from Alaska, but also wrapped in prayer. I said to the patient, “Your baby's heart has stopped.” She cried. I cried.

Eventually, after I had carried the baby away, I placed the baby on the scale, looked her over, and weighed her. I wrapped her gingerly in her blanket, and then placed her in the box that was given to me.

In the beginning, I doubted myself and my ability to do a good job and serve this mother and her baby well. I was fearful. I felt I lacked the “right” words. But in the end, my own expectations and self-imposed limitations didn't matter. In the end, I gave my blood, sweat, & tears...and love. That mattered.


I took my gloves off, washed my hands, and walked away.

Thursday, September 24, 2015

Reverence for Life

Before I write the story of the last shift, I want to first say this: There are many people who have read this blog and who have subsequently saturated us with thanks and praise, pouring us over with statements of what great things we are doing, how selfless this work is, and how we are doing such phenomenal things. While this praise does indeed lift us up and make us feel good, I want to acknowledge that we are doing nothing special, nothing requiring anything but a love and respect for life, and the heart to care. The word 'altruism' comes to mind, and there are times I wonder if true altruism exists. Don't we all do things for a purpose of our own heart and conscience? I cannot say that volunteering my time does not make me feel “good,” simply. That in itself is a selfish reason.

I've recently finished a book that was very insightful. It gives an understanding of early Haiti, how Haiti came to be the Haiti that it is. Mainly, it is the story of an ordinary man and woman, not much unlike you or me, detailing how these two individuals did extraordinary things in Haiti. This book I speak of is called Song of Haiti, which details the lives of Dr. Larimer and Gwen Mellon. The recurrent theme (and purpose of Larry Mellon and his philosophical mentor, Albert Schweitzer) speaks to what draws me to Haiti: “Reverence for Life.”

What is Reverence for Life? It is recognizing the value of all life, with the fundamental principle of morality being that good consists in maintaining, promoting, and enhancing life. I value my life. I value the life of my children. There is nothing more valuable to me than this. I see my own life and the life of my own children here. We are not so different. I value life and the right to live without pain and suffering- no matter in my own country, or half a world away. I it's because of this that I cannot have a skill that I can share and not share it, which I know will save lives and help to ease suffering.

A little girl at the feeding center


“The fundamental fact of human awareness is this: 'I am life that wills to live in the midst of life that wills to live.' A thinking man feels compelled to approach all life with the same reverence he has for his own.” -Albert Schweitzer






Our evening started off rather eventful, and not in the usual way. We rode to the hospital in the usual fashion, riding on the back of a moto. This is something that I fear dearly. The black and white logical thinker that I am, has mulled over many times the various ways that we could come into harm while in Haiti, and I've concluded that the moto is likely the #1 culprit for injury. Further add that we are most often on motos during dark hours- going to the hospital in the evenings after the sun has set, and returning in the morning, before the sun has fully risen. The darkness adds the factor of limited visibility, in addition to the dirt roads entrenched with large stones, rolling and bumping land, that further creates an unstable journey on two wheels. As we were riding to the hospital, I thought to myself, “I wonder if we are going faster each time, or if I am becoming more paranoid?” It was as if Glen read my mind because as soon as I finished my thought, he says out loud, “It seems like the moto drivers are going even faster than before!” Oh Lord, it wasn't just me. Not 1 minute after that, I look forward and see the single headlight of another moto coming straight at us, both us and him going full moto-speed, directly toward each other. I think, “Oh shit, we are going to die,” and instinctively yell out, “SHIT!” My hands fly up to grab the first thing they could grasp onto to brace myself- that being the drivers neck. As I yelled, “SHIT!” I felt my nails sink into the driver's skin. Thankfully both motos slammed on their brakes, bringing us to a halt right before collision. I am also thankful that SHIT wasn't my last word before I died. I apologized profusely to the moto driver, and even though he spoke no English, I am certain he got the gist of what I was trying to convey, as I tapped his neck and said repeatedly, “So sorry!!!!”

Our view from the back of a moto


Planting my feet firmly on the ground, I was relieved to get off the moto and walk the few hundred feet from the outside gates of the hospital compound, to the entrance of the Maternity Ward. As we walked through the hospital grounds, the sky above was thundering and rain started to fall down on us. I stopped just before the metal gate entrance to the ward, and stood there under the falling water. Even in the dark night with a deep blanket of clouds above, the air here remains thick. The cool rain felt good.

We began our night by making rounds on the antepartum, postpartum, and post-op units. These are each one room units, lined with beds on both sides of the room, each bed numbered on the wall above. The first patients we see is a mom and baby. The baby is about a week old and is being watched for a low-grade fever. The first observation is that the baby is swaddled up tightly with a thick winter blanket. It is hot as hell in here, and no one should be using a blanket, baby included. I have no doubt this is likely contributing to her low-grade fever. We take her vitals and do a full assessment. I see that the baby's diaper is full, and note that it is soft, yellow stool. Just as it should be. I help Grandma change the baby's diaper and discover that this baby girl dressed in all pink, actually has a penis. I laugh at my own assumption, because really, using whatever clothing you have is simply practical.


As we are doing our rounds, one of our favorite Haitian midwives Carmell says to us, “I will let you know if we have anyone in labor come in. I know you like to do deliveries!” I smile at that. I know she likes the help, and she is right- I do like birth.

At 9:50pm I catch a baby- a normal vaginal delivery, a healthy mom and healthy baby. As I am finishing up and helping the new mom get cleaned up, Glen listens to heart tones on another patient who is being induced with misoprostol due to severe hypertension. This mom looks terrible and seems to be very sick. Her whole body is extremely swollen, tight from the fluid that is collected in her body. Her face is so swollen that even her eyelids are puffy. I am certain she is nearly unrecognizable from what she normally looks like. Just looking at the woman is a reminder that hypertension in pregnancy is no joke. It may cost this woman her life, or her baby's life. Glen puts the doppler on and we hear clunk.........clunk..........clunk......................clunk. The baby's heart rate is in the 80s and stays there. They reposition her and continue to monitor baby. There's no oxygen available. The baby continues there, sometimes skipping beats. With this mother's hypertension and severe symptoms, along with misoprostol induction, there is no doubt that this baby has little reserve. Glen checks her to see if we are close to delivery and can somehow expedite it. She's only 3 cm. We know that this baby is not going to tolerate labor much longer. He calls a c-section. It's 9:55pm. The Haitian midwives call the Haitian OB. He's busy and can't come. He says that Glen needs to do the c-section. The midwives hang up and jump into action. Within mere minutes, a foley catheter has been placed and the patient is prepped for surgery. Honestly, I'm dumbfounded. I have never seen anything happen so fast in Haiti. There is true urgency in the room, and I have never before witnessed this in Haitian culture. Maybe I'm naïve, but this is my honest observation. Glen tries to listen to the baby again and can't find heart tones again. Is it because of a positional issue or have we lost the baby? We are all wondering the same thing. He continues to try, and nothing is heard. The clock is ticking...ticking...ticking...we wait and the minutes pass by. The Haitian OB who they previously called cannot get a hold of the anesthesiologist, and neither can they. She isn't answering her phone. Glen can't do a c-section without anesthesia. Tick...tick...tick...the minutes are ticking by, and this baby is dying with each tick. Finally, an ambulance arrives to the hospital, and in the ambulance emerges not a patient, but the anesthesiologist and a scrub tech. How interesting that the ambulance brought them to us. As we would find out, this crew is Cuban and only speaks Spanish.

So there they went, an Anesthesiologist and scrub tech who only speak Spanish, an OB and RN who only speak English, and a Haitian O.R. assistant who only speaks Creole. As Glen leaves he shakes his head and tells us that it is inevitably too late. There is no way this baby is still alive. My chest is heavy as I think that we listened to that baby's heart slow down as it gradually stopped beating altogether. I walk to the storage closet, to where Shelly was, and I ask her (as if she were more insightful than I was on the matter), “Do you think the baby is still alive???” I feel as if I am grasping at straws, wanting some reassurance that this little life is still in existence, that we even have a chance. Not just the he or she has a chance, but that yes, WE, have a chance. This life is valued. This life matters. I don't know the swollen face of the mother from any other random face of the day, and I might never know her baby, but in these fleeting minutes, tick, tick, ticking away, there is Reverence for Life.

Shelly looked at me and answered my question. “I don't know...probably not. But I hope so.”

I would walk away to another mom laying on an exam table who was pushing. I would do this delivery by myself, as Glen and Camille were likely just beginning the c-section. I couldn't help but to think that as one life blazed into the world screaming, one life was ending, coming into the world silent. That is a profound feeling. As Glen and Camille would later tell me, Glen would lift the blue, lifeless baby boy from his mom, hand him to Camille. He was certain this was a lifeless baby he was handing over, and contemplated this as he sutured this mom's very sick body back together.

I had just finished with this mom when Camille entered the room with the tiny bundle in her arms, pressed against her body. I heard her say my name, “Tara.” She called it out firmly, not exclaiming but still, making a statement.

I knew when I heard her that the baby was alive. I asked her, “Is the baby breathing?” The baby was trying to breathe, though not very effectively. The conversation between Camille and I is a blur. I took Camille's stethoscope and placed it over the baby's heart and was surprised to hear a heart galloping away; 140 beats per minute. A couple breathes of PPV and some stimulation and this baby was breathing on his own. My fingers remember what that limp body felt like under my fingers. This baby was not even two pounds. So delicate, so frail. We wrapped up this tiny, flopping body who was now making an effort to breathe, and carried him down the hall to the NICU. A pulse ox was placed and showed that his heart rate was 160 bpm and oxygen saturation was 87%. Astounding. We would leave the baby there, under the care of the NICU team. We walked away having done what we could, leaving him in the care of others who will hopefully do what the can.

Meanwhile, we do an intake assessment on a young and very tiny mom whose water has broken. She is a first time mom, looks to be about 100 pounds, and is about 28 weeks pregnant. There is amniotic fluid everywhere- the exam table is drenched, and as Camille and I speak to her, our shoes are in a sea of in her amniotic fluid. She lays on the exam table, without underwear, her legs spread. Her vulva and legs are dripping with fluid, smeared with mucous and blood. I place my hands on her belly, and see that her abdomen hardly looks pregnant. The untrained eye would likely not suspect this naked abdomen to be a pregnant belly. My sweaty, gloved hands could hardly palpate a baby. Her muscles were taut and solid, her skin and muscles from not having held a baby before. Her vitals were normal and her baby sounded fine. She was not contracting. The Haitian midwife had already completed a vaginal exam and said she was 1cm dilated. I went over to the Haitian midwife and asked if we were staring steroids, to help mature the baby's lungs. She shook her head no. I asked why. She said because the patient was already dilated and it was too late, steroids would not be useful. I felt the need to clarify how dilated this mom was, and asked again. She said 1cm. I had so much to say but recalled a good piece of advice that I had just read in the Midwives for Haiti volunteer manual...the best place for questioning something and to correct or teach, isn't in real time, in the clinical setting. This is, after all, their territory, we are just here to help, and teach by example, or when otherwise appropriate. I walked to the back room where Glen was and explained the situation. He agreed that the mom should get steroids and antibiotics. I asked Shelly how I might say this, to let the midwife know, “This is what we would do at home...” Shelly ended up doing a great job with translating this, and in the end, the midwife was very receptive to it, asked Glen the appropriate medicine and dose, and then said she would do it. [The next day we would find out that this mom would subsequently deliver her 28 week breech baby into the hands of another midwife volunteer with Midwives for Haiti. No one knew if the baby was dead or alive, and when the baby's legs were delivered. Jamie was surprised when they started to move. As I write this, the baby is alive and well in the NICU. I hope those steroids got to where they needed to go.]

We would have another delivery later in the night, and this one wouldn't be easy on use either. I wouldn't have expected anything less. The Haitian midwives were taking care of a mom in labor. I had previously told them to just let us know what we could do to help, that we were available if need be. While pushing with the mom, the midwife heard that the baby's heart rate was having decelerations. It would go from 140 to 80...70...and then slowly recover back to baseline. That's not something that we don't sometimes see. Except then she noticed that the baby began to have repetitive decels that were taking longer and longer to recover, now staying a good bit of time in the 70s and then not recovering. She asked for “Dr. Glen” to come help. At this point we were seeing baby's head at the peak of the push, but not crowning. The Haitian midwife asks if Glen can do an episiotomy, but he explains that this will be useless because the baby isn't to the perineum yet. The midwife nods in undertsanding. I see her contemplating something, and as I open my mouth to offer a suggestion, she says the same thing, but in Creole. “What about a vacuum,” we both ask? Glen looks surprised and says, “Oh, do we even HAVE a vacuum?” Why yes, yes we do. I had seen them in the storage closet. He says ok, and a vacuum is retrieved. He puts it on, mom pushes, and he assists her pushing with the traction of the vacuum. A baby girl is born, screaming.


All in all, a busy two days...reminding us and revealing to us in new ways, how delicately precious life is.

Tuesday, September 22, 2015

A Pot to Piss In...and So Much More


Welcome everyone.  If it doesn't become obvious momentarily, I (Glen) have been handed the reigns for today's blog.  Thankfully, I have had a bit of help with the editing to give it a bit more of a writer's flare.  Never fear, I'll make sure Tara picks back up tomorrow!

I'm glad our first day started off so quickly- it gave Camille a taste of what it could be like. But, this last shift would allow us to sit back and take it all in...and that might not be all good. We started the day off nice and slow, such a difference from yesterday, when we literally walked into two simultaneous deliveries. This shift, we were able to help take care of some of the tasks of a busy ward. Tara and Camille set off with our translator to do vitals. Certainly an eclectic mix of antepartum, postpartum, and post-op moms to be seen. One of the most interesting was a mom admitted from mobile clinic for suspected early labor. (Because she lives so far away, she may end up staying there until she delivers.) On exam, Tara noticed something odd about her lower belly. It was obvious she was pregnant, but her bladder was so protruding that it was noticeable with her laying on her back. Tara expressed concern to me; dare I admit Tara's perplexed concern was somewhat comical. She wasn't quite sure what the problem was, as I don't think she had ever seen a bladder so obviously distended. Upon questioning, the patient stated that she did not feel the need to urinate. Tara palpated her abdomen and felt her bladder. The patient didn't flinch, and appeared to not have any discomfort. Clearly though, she had to pee. But where? In what? There are no restroom facilities anywhere. Remember the saying your mom always used to say...'she ain't got a pot to piss in.' I laugh at this...perhaps that was just MY mom, growing up in rural Kentucky. But, I remember hearing it and it never was quite as vivid as here. We found her 'pot,' which was a large bucket that the family had brought with them. Camille held it under the mom as she stood at the side of her bed (not 2 feet from a postpartum mom and baby couplet) and peed. Nearly filled the bucket. You look around and everyone has their pot to piss in...well, everyone except the birth team. Thankfully Tara and Camille somehow have the capacity to hold their bladders for 12 hours. But...that's a different story.

Just when you think that we have everything, or that you can do anything, you're thrown a curveball. Dr. Celestin had apparently seen this young, first-time mom in his outside office and sent her to L&D to get a D&C due to a miscarriage that had not passed. This patient had had consistent bleeding for 8 days that was not slowing down. D&Cs aren't the most glamorous procedures to do here as they are typically done without much in the way of anesthesia and such an invasive procedure which is normally (back home) done in private, is done here in plain view of everyone. Tonight would be no different, except for one twist. As I'm preparing myself for the procedure, I go to the stand beside the patient and look over my instruments. I expect to see all the usual: speculum, tenaculum, dilators, and a currette. Instead, I see no currette and a plastic iPas device. I've seen this manual suction device before, even thought of buying one for use in the office for miscarriages, but this is not my typical go-to device. And here it is in front of me.Thankfully, it wasn't very difficult and all things considered, the D&C went pretty well. Tara stood by the patient's side, holding her hand and caressing her face to help her relax through it, while Camille assisted with holding a leg. One of the Haitian midwives oversaw, and hopefully now could use the iPas device, should she need to. The best part for me was that at the end, the patient looked to Tara, took her hand, and said (in clear English), “Thank You,” for helping get her through it.

Something is brewing in those clouds

It's never fails to amaze me that women come and go in Labor and Delivery here. Somehow, the midwives keep all of these women straight. One such woman had apparently been there all day. When I asked what her status was, the midwife says, 'Dr. Celestin is coming in to section her at some point.' “Why,” I ask? “Transverse lie and her water is broken.”

I decided to examine the mom myself and confirm that the baby is vertex! The baby is “Cephalique” and shouldn't need a cesarean section. A few hours later, Dr. Celestin comes in and does a vaginal exam and doesn't feel a presenting part and finds the head is the right lower quadrant.

In our discussion about abnormal lie (breech, transverse), I ask if anyone there does versions. A 'version' is a procedure where a baby is manually turned to get it to head down. A fairly common procedure in the states, but not here. I ask why they don't at least try- certainly an attempted version is safer than a potential cesarean section- and am told by Dr Jean Baptiste that they learned in training that versions will cause the placenta to pull away and harm the baby. This just goes to show that you just never know what is common sense and commonplace in one place, may be literally a foreign concept somewhere else.

Eventually, we take the patient back for section. Dr. Celestin jokes in Kreyol that I am the primary and HE will be assisting me. Apparently, not only am I the primary surgeon, but the scrub tech as well. I stock the Mayo stand, prep and drape the patient. Everything, except the sharps, eventually winds up between the mom's legs...placenta, retractors, scissors, blood clots...everything. It isn't exactly the prettiest, but it did get the job done. Camille would join Dr. Celestin and I for the cesarean and be responsible for the baby. After delivery, Camille would take the baby to Tara, who was awaiting in Labor & Delivery. I can't say that the protocol for having an assistant in charge of baby's care has been implemented, but as Tara reminded me, we did get to model this for the Haitian providers. An assigned care provider for baby to company during the surgery, and someone waiting, prepared to assist with care on the ward.

Preparation for the c-section baby

As our 4 year old Adria would say, this baby was a 'fat man' (this is her term of endearment for Callen), at a whopping 8lb 13 oz. Except, apparently it is a curse in Haiti to call a baby 'fat' because those 'fat' babies will then lose weight and not thrive or do well. In doing postpartum rounds, Tara proudly exclaimed, “The baby is so fat!” Our translator had to inform her that she should not say this, since it is not a good thing for he family to be told. Lesson learned. No “fat garcon” or “fat tifi” here!

One of the things about birth that we take for granted back home is that women, and our culture as a whole, value and celebrate the 'birth experience' when the baby is born. It has been my experience that moms and dads often cry when their new baby is born. Emotions are abundant with birth in our own culture. However, birth is not typically a time when Haitian women express emotion. Nor are babies often named at birth. We often get asked regarding this by friends, why it seems as though Haitians seem irreverent for new life. While it may appear this way superficially without understanding Haitian culture, we slowly understand that this is not the case. At the very basis, we need to consider and remember that if a baby is born alive, BIRTH is the first of many hurdles that the baby has to cross to get to adulthood. Enough babies die after birth that it seems recognized that the newborn's life may be short-lived.

A baby girl we assisted with...photo with permission. 
2 kilo budle of love

#clothdiapering


I will admit that I was once perplexed over a total lack of emotion in Haitian people, in birth and in death. But last night changed that. In the overall quietness of the night, a spontaneous commotion erupted within the hospital compound. A woman sprung from the dark, exclaiming, yelping, and wailing, making us question whether she was having a mental breakdown. The exterior hallways within the hospital are as pitch black as the night sky, making visibility in trying to visualize the happenings hardly possibility. In the wee hours of the morning, with wards overflowing with admitted patients and no where but the outside for some patients and their families to sleep, the halls are lined with sleeping bodies. The shrill hysteric outcries of this woman startled all of these slumbered bodies, resulting in a scattering of the people that laid surrounding her. What is going on? What is happening? I am sure these were the questions in everyone's mind, us and Haitian alike. The woman's hysterical screams and outcries continue, as random voices yell to her in the dark. Though we had no idea the specifics of the situation, it was obvious that this woman was grieving. One thing is certain, the translation of loss and grief transcends cultural and language differences. As we would learn from our translator, someone had just died in the ICU. The yelling sounded despaired and grieved, and that it was. This was the first overt display of emotion that I had witnessed in Haiti. Through the pain of labor, the separation of family, the death of a child, nothing we had previously seen provided a glimpse into one's personal feelings of their pain and suffering.

As those of this blog would know, hypertension in Haiti has been rampant in our previous trips. As we take vitals in labor I'm amazed that more often than not, the women have had normal blood pressures. Obviously there has not been a dramatic change in diet, but perhaps an increase in prenatal and intrapartum care availability? This of course is anecdotal... I don't know the answer, but it is very apparent that something is changing. 

Sunrise behind the Midwives for Haiti compound.



Monday, September 21, 2015

Haiti 2015: Day 1 & 2


We arrived into Port-Au-Prince on Saturday afternoon and made the long, winding journey to Hinche by way of the Midwives for Haiti Land Cruiser. I will admit that I was a bit excited about the travel accomodations, as we have always received transportation in the classic, "Pink Jeep." The enclosed air conditioned vehicle was a welcome repreive from our 20 hours of travel from Alaska, and especially knowing how I get with motion sickness. We would, however, find out that the air conditioner isn't functional. Ha! We packed into the back of the Land Cruiser and within about 20 minutes the first passenger was feeling sick. Thankfully, it wasn't me (yet). I got out the peppermint oil from my purse and Glen got out a rag, which we wet and put on the back of the other volunteer's neck. The rest of us rubbed peppermint on the backs of our necks to help us cool down. The cooling sensation felt amazing in the dense heat we were sitting in. Of course not long after that, I was the next victim of the trecherous journey. The constant swerves, bumps, and horns ablaze from other vehicles flashing by was taxing on my senses and internal stamina. I quickly turned 'green,' earning myself a front seat accomodation, right alongside our driver. I laid back in my seat, splashed water on my face, closed my eyes, and let the wind blow in my face. 2 1/2 hours from that point, we had made it safely to Hinche, and I had made it without vomitting...as did Lea, my partner in sickness

Sunday was our first full day here, and the beginning of a night shift at St. Therese. A group of us rode on motos into town and attended church service.
Volunteers Lea and Shelly

After church Glen and Camille (our clinic RN back at home, who joined us this trip) took a tour of Hinche. I stayed behind to rest and gear up for night shift. Camille would return, slightly aghast, telling stories of the food she saw in the open market- fruits, meats, fish, all swarming with flies. She held serious concern for Glen, and made sure to report back that he had been eating these items, without concern for what might subsequently happen from ingesting flies and larvae. Glen assured us that it was delicious and he was fine. 20 minutes later I was downstairs eating a late lunch and Camille came flying into the dining area, wide-eyed, as if she had just seen a ghost. She said to me, very much an exclamation rather than a question (because she already knew the answer), "Tara! WHERE IS DR. ELROD!?" (It's funny to me that more times than not, she still refers to him as 'Doctor Elrod,' rather than Glen.)

Amusingly, I had already heard him from downstairs and knew exactly where he was. He is, afterall, the world's loudest puker. I responded with, "Oh, he's upstairs puking." Camille's eyes were as wide as saucers, and just like that, it pretty much validated Camille's hesitance to consume anything out of the ordinary. But don't worry about Glen...it was delicious...and he's fine. ;-)
Glen trying some dried herring in the marketplace.

We arrived to the hospital shortly after 7:00pm, and within minutes had assisted with two deliveries. The first baby the Haitian midwife delivered, Camille and I would assist, and Glen would subsequently suture the mom's laceration. Camille helped to stimulate the baby and I tied the cord with string. Camille would do the newborn exam and dress the baby, all while Glen and I pushed with the mom 5 feet in front of the first mom who delivered. As Camille was doing the newborn exam, she noticed that it was oozing and had to re-tie it, tighter than what I had tied. Good catch, Camille.

The postpartum mom would lay there on her own delivery table, legs sprawled and perineum torn, raw from just having given birth, quitely observing the other woman preparing to do the same. I stepped over to her and made sure she understood, "We don't want to start to suture you right now, so that we are prepared for this baby. As soon as this baby is born, we will get you sutured and dressed." She smiled and nodded, appreciating the explanation. Camille took her vitals and tended to the baby while Glen and I assisted the other mom. The Haitian midwife charted, and attended to the other packed room of laboring women.
Camille and a new Haitian life
A healthy baby girl

The mom who was pushing had fetal heart tones in the 60s, telling us that baby was not doing well. Glen ruptured the bag of water (and as amnihooks are a luxury, the tool that the Haitian's use to AROM (artificial rupture of membranes) is a needle or the back of the needle cap). The Haitian midwife, Carmelle, joined us in telling the patient to push as hard as she could. "PUSH HARD! KEEP PUSHING, GO ON, PUSH! YES, JUST LIKE THAT...KEEP GOING...GO, GO, GO...PUSH!" These were the sounds now coming from the Maternity Ward. A 2.9 kg baby boy was born, needing stimulation and a couple cuffs of PPV. Mom was expecting a girl and had only brought a girl outfit to put baby in. Not that it would have been the end of the world to dress him up in a pink outfit, but I thought it a better idea to use a baby gift pack. This particular mom had brought a cloth pad but did not have any underwear to put that pad in and keep it in place. I was wishing I had thought to bring a stash of underwear. I think that would be a great addition to our packs next time.

After these two deliveries, we realized that there were no more syringes for Pitocin or Lidocaine, as well as no more Vitamin K. We searched everywhere, and ended up having to resort to putting Pitocin in the 1mL syringes that are typically used for Vitamin K.

7 hours into our shift and it was a bit quiet, with 4 babies delivered and no one imminitently delivering. We all retreated to the storage room, which also doubles as a break room for the midwives and volunteers. We intermittently talked, rested, and checked on the women who remained in Labor & Delivery. Over the course of the night we participated in 4 deliveries, with the Haitian midwife doing another delivery as we rested.

As an outsider coming to Haiti, it is so easy to feel sadness, despair, frustration, and helplessness. Nights like tonight are a welcomed blessing, showing us the good, the life, the hope...A competent and compassionate skilled birth attendant that is the product of Midwives for Haiti. Healthy, term babies. Perhaps it was a smooth initiation to preserve Camille. Either way, it was good to see the good.

In my time here and life since my first trip to Haiti, it seems that the feelings of sadness, despair, frustration, and helplessness are necessary: they are catalysts for change, afterall. Can you imagine a world in which we turn a blind eye and guarded heart to the pain and suffering that exists? Just because it is not happening where we are, does not mean it is not happening. I type that from my laptop and you read that from your computer screen or iphone. Human pain and suffering can be mentally comprehended, but to really GET IT, and act on it...that's a different challenge. More on that later.

Until next time...

Tara







Saturday, August 1, 2015

Haiti 2015: How Can You Help?

Glen and I will be leaving for Haiti in 7 short weeks, and are in need of your support! Our trip to Haiti is one we look forward to but seems to financially add up so quickly for us...the snacks, medical supplies, airfare, the cost of checking our baggage and the cost of volunteer accommodations with Midwives for Haiti. It is something we are able to do, but not without challenge.

So we ask...
Are you able to help? In the next few weeks we will have various ways we will ask for your help and support. 

One of my favorite gifts to take to Haiti has become what I call "Newborn Gift Packs." The packs are ziplock freezer bags which typically consist of a newborn onesie, pair of socks, hat, light blanket, cloth diaper, and cloth pad for Mom. (Note: The cloth diaper and cloth pad do not need to be anything expensive, but even just a thick, absorbent fabric such as cotton or flannel.)
These gift packs have been handed out at mobile clinics throughout Haiti as a way to encourage moms to keep returning for prenatal care. Glen and I have also kept some on hand when we work shifts at the hospital. Inevitably, there are moms who have no clean sheet to deliver on, nor anything for their new babies. 

If you are interested in making some "Newborn Gift Packs," please message me. We will be collecting them, as well as additional supplies, up until September 16th. 
Items do not need to be brand new, but simply in clean, like-new condition. 

If you are interested in purchasing clothing items to be put into gift packs, all L'oved Baby clothing items which are purchased for this cause will be 50% off at Betula Baby (the baby boutique located inside Integrated Women's Wellness & Center for Birth). Simply let us know that your purchase will be donated to our Haiti 2015 trip, and all clothing items purchased for the trip will be 50% off. This would be a great and EASY way to help. If you do not have supplies or the time to put together gift packs, you can purchase items from Betula Baby that we will then put into gift packs and take with us to Haiti. 



Thank you, for whatever support you can give!

[Be sure to follow along our journey by checking the blog, our facebook pages, and @tara_elrod and @thecenterforbirth on Instagram.]

Wednesday, July 22, 2015

#lifeofamidwife: To Teach

Perhaps one of the most oxymoronic aspects of my career as a midwife is my role as a preceptor. It is challenging- outright maddening quite often- but also a source of great inner learning and reward. I try to keep this in mind on the particularly rough, frustrating days when I feel as though I am barreling down a one-way street called Give.

I'm a midwife yet very rarely do I catch a baby. My hands are often not the first hands to touch a fresh new life- they guide and meld the hands of two student midwives as they create and hone their own skill. 


We had a mom recovering from delivery in one birth room, when another mom came in. This patient was a repeat patient of mine, who had had her first baby under mine and Glen's care. When her baby was crowning, I switched places with Mary, moving from between the patient's legs, taking the Doppler in my hand, and switching to the role of monitoring baby. Mary moved in to "catch."
The baby's head is at a full crown and mom's perineum at a full stretch. Mary is nervously touching the baby's head, as if giving a head massage, obviously feeling the need to do something with her hands. We (midwives) often speak of the importance of "sitting on our hands." It's easier said than done for some. 

"Stop," I quietly say, nearly inaudible. 

Mary is oblivious to me. 

The baby's head delivers, direct OA. Mary starts to apply pressure to the baby, gently downward on the baby's head as if to facilitate delivery. 

"Mary...stop," I gently and discreetly say. 

She reminds me of the many physicians (and  yes, even midwives), I have witnessed who apply traction immediately after the delivery of the head, expediting delivery even long before the woman has the next contraction. So many practitioners do this as a means to actively manage (the threat of) a shoulder dystocia, but what it inevitably ends up doing is the opposite. Facilitating delivery prematurely only increases the likelihood of an impaction, as the baby's Cardinal Movements and specific, intricate movements to maneuver through the pelvis are not allowed to be completed, with the baby being brought down into a non-ideal position. Further, it's common for downward traction to be applied while verbally instructing the mother to push even in the absence of a contraction, which is not nearly as powerful as when she pushes with a contraction. 

I see Mary in her I-feel-like-I-should-be-doing-something nervousness, and I think of this. I briefly make eye contact with Shelby and she cocks an eyebrow at me. We can read each other's minds without saying a word. "What in the world is she doing?" I know exactly what Shelby is asking. 

"Stop touching the baby, Mary." I outright, very matter-of-factly say. She catches herself and retracts her hands as if she has laid hands on fire. 

The baby restitutes to the maternal left leg, and with the next contraction, is born. 

These women are legit. It takes a special person to be a student midwife, yet an even more special one to work under Glen and myself. Our expectations are incredibly high, we don't allow room for excuses, and we don't hesitate to say what could be and should be better. If they stick with it, these women have the potential to be two of the very best midwives. 

Later we debrief from the birth- how it went, how we did, what could have been done differently...and Shelby and I make fun of Mary's nervous shenanigans. She's a good sport. We all joke that Shelby is the 'Golden Child.' The joke will be short lived, I'm certain. Soon Mary will be licensed and Shelby will be catching babies. I'm thankful that so far neither of them have flushed a placenta down a toilet or flooded a birth room. I can't think of any student midwife that would do that. ;-) [Reminiscing back to my apprenticeship...]

I think and laugh to myself that an apprenticeship is a special sort of hazing. 

Saturday, June 27, 2015

Haiti 2015

It's official! Glen and I have set the date for our third trip to Haiti, in support of Midwives for Haiti. We will be in Haiti September 19th-26th.

As with our previous two trips, we need and value the support of our family, friends, and community. We appreciate all forms of support- encouraging words, prayer, monetary gifts to help purchase supplies, gifts of comfort items for ourselves to use while volunteering (hand sanitizer, snacks), medical supplies, and basic baby items made into gift packs to hand out during mobile clinic (well as for the families who come to the hospital with nothing) including: a onesie, hat, pair of socks, baby blanket, and cloth diaper.


The single most important factor in ensuring a safe birth for both mother and baby is having a access to care with a skilled birth attendant. While we struggle here in the United States with decreasing the rate of (unnecessary) intervention, there are women and babies dying due to that they do not have the most basic of intervention- a skilled birth attendant.

Please support us as we support Midwives for Haiti in their work to end preventable maternal and infant mortality. All donations may be brought to Integrated Women's Wellness & Center for Birth, now through September 14th. A list of specific needs will be posted and kept updated on a separate blog entry.

With Thankfulness,

Tara Elrod

Friday, June 19, 2015

Humility

Last night after a birth- like after most births I attend- my husband sent me a text that read, "Good job." We had just had a calm, gentle waterbirth, and welcomed a new baby boy.

I'm not sure if my husband's words of praise are a thoughtful effort on his part to lift me or encourage me (no matter how 'easy,' uncomplicated, normal, or short a birth may be, the demands of what it is to be a midwife never change), but he makes sure to share this small praise with me often.

"I didn't do anything," I responded. Truly, this woman required very little of me. I was with her in my simple presence of just Being. My work included monitoring her baby and ensuring the normalcy of what was already naturally occurring.

A conversation stemming from his "good job" ensued. 

"You obviously did do something.  She got there at a great time in her labor, she had a good birth, no complications...You obviously had some part in orchestrating that." Yes, yes I did. But I know that we both already know that. And I recognize who did the most important work (not I). Should I be boastful? Should I be prideful? There is a difference with having pride and being prideful.

I drove home at 2:30 am, the Alaskan sky still glowing with light like the smoldering hot embers of a campfire that continues to persist. I marveled in the beauty of  "summer birth" in Alaska, how easy it is compared to the dead darkness of the desolate winter. Tiredness doesn't cohabitate with Alaskan Summer, and at 2:30 am, it might as well have been 2:30 in the afternoon. I drove marveling over Pioneer Peak, while mulling over the value of Humility. When I got home, I quietly crept into my house, still light from the Midnight Sun and without need of turning on a light, devoured two cold pieces of pizza right out of the box that had sat there all afternoon and night. I crawled into bed beside my sleeping husband and baby, and further contemplated humility; what it means to be humble.


"Humility has nothing to do with depreciating ourselves and our gifts in ways we know to be untrue. Even 'humble' attitudes can be masks of pride. Humility is that freedom from our self which enables us to be in positions in which we have neither recognition nor importance, neither power nor visibility, and even experience deprivation, and yet have joy and delight. It is the freedom of knowing that we are not in the center of the universe, not even in the center of our own private universe." -David Wells

This speaks to midwifery and what I value in my heart. 

Friday, March 6, 2015

Snake Oils: Not Just for Witch Doctors Anymore

As most anyone who follows me, reads this blog, or knows me personally is aware...I'm a midwife. No surprise, eh?! Perhaps your first clue would be the title of this blog...Or the hundreds of photos of beautiful new babes...Or my constant discussion of women's health, family-centered care, and of course, birth. Yes, I would go out on a limb and say it's a bit obvious that not only is being a midwife my "job," but it is my calling.

     I believe that God put me on this earth to be a midwife. During the busy days and long, sleepless nights, pedestaled on the sweet euphoria of welcoming new life, or entrenched in the gut-wrenching lows that birth and life encircle, one thing is certain- I am serving my purpose. When it's challenging, when I question if the sacrifices are worthy of the purpose, when I have doubt- I have continually found peace in my heart, telling me that yes, there is great purpose in what it is to be a midwife and to provide midwifery care. Afterall, what is more important in life than life, itself? How we are born matters. How we give birth matters. How we live, matters.

     I am a midwife. What I am not is a sales person.  For a long time, I have struggled with this very fact. What the heck am I talking about, you ask? What do these two professions have to do with eachother? Nothing, really. That there is my struggle.
In my life as a midwife- as well as a mother, and a wife, and a woman- it is my passion to live, educate, and promote healthy, natural living. Health and wellness, as well as illness, are directly connected to how we live and what we put in our bodies. A key component to wellness for me, and a passion of mine, is Young Living Essential Oils. I use them in my practice. I use them in my everyday life.
  
     Now- perhaps the above paragraph makes more sense. I'm not a salesperson, nor do I want to be perceived as such. Because of this, I have always been so mindful about talking about oils to my patients. No one likes feeling as though they are being sold anything.
And so oils quietly and unobtrusively sit on display for sale in my clinic. I use oils in my midwifery practice, answer questions about them as they are brought up, and host an occasional class...putting it out there...but not really.


     And then a few weeks ago I read a post that stopped me in my tracks and touched my heart. Yes, yes, YES, I nodded to myself, feeling as though the words on the facebook post could have been written specifically for me. This is a glimpse of it:



Fear of What Others Think

     This post spoke to my heart because, just like in my own situation, she speaks of believing in something that is so beneficial and so valuable, yet not being able to share it simply because of the fear of what other people think. The statement that sealed the deal and propelled me out of my shell:
"If they think that (that you are only trying to sell something), they must not really know you." Yes, Gordon...he is wise indeed! ;)
  
     The answer is: If anyone were to be offended or think I am simply trying to sell something, they truly must not know me. They must not be a patient of mine, or a friend. And so on that note...who cares? Further...if I were an herbalist and a midwife, would it not be appropriate for me to promote and sell my herbs? Indeed it would be.

     And so I am here to tell you that I love Young Living Essential Oils. I've done my research on these oils and this company and I stand behind both. The quality and purity of the oils and this business has gained me as a consumer- as a midwife and in my every day life. I use them. I sell them in my clinic.

     And with that- I leave you with some great short videos on what makes Young Living so special- their Seed to Seal site and videos. It says so much!:
seedtoseal.com

    If you have any questions about Young Living Essential Oils or are interested in how you can learn more about using these powerful oils- for wellness, for healing, for replacing toxic household products, now you know that I would love to help you on your journey. From here on out, I plan on being more active with teaching- both one on one and offering community classes. Because, well, it's not flowy skirts, Birkenstocks, and "snake oils." ;-)
How we live (and what we use on our bodies and in our homes) MATTERS.

Tuesday, January 27, 2015

Miss Perception

When we first broke ground on our new office and birth center, we were called several times by people in what seemed to be going toward a community uproar. Why? Because we were building an abortion clinic, that's why. Or so, that was the word on the street. People in our neighborhood called our office. The church across the street called our office. Another midwife in our community was approached about us by inquiring minds in her own church. 

The interesting thing with living in a small community, is that we are all connected. This, for the most part, is a strength and why I love living in a small community. I go on to have repeat clients and help them welcome all of their babies, I take care of friends and family members of previous clients, and we all continue to be further enriched by being deeply and strongly interweaved. However, sometimes- as in the case of the abortion clinic- living in a small community turns comparable to a bad case of The Telephone Game: information is shared, misconstrued, added, subtracted, twisted, contorted, misinterpreted, and passed on as factual truth. 

In the case of the abortion clinic, the truth was: we were- and are- anything but. We take care of women. We help families become families. 

Fast forward to today and on a completely different topic, our office received a phone call from a very upset, and not-so-nice woman. Her phone call really upset one of our receptionists. The woman felt the need to randomly call and speak of "things she had heard." In speaking with our employees about the incident, I contemplated the idea of calling this anonymous woman back to address her statements and provide her with accurate, factual information. Would it do any good? Would it be welcomed? Would it/could it make a difference to this apparent raging-mad woman? Would it just upset me? One of our employees pointed out: if I didn't call- if I just left it as it was- this woman would remain with her inaccurate misunderstandings. Thankfully for caller ID and a thoughtful receptionist, I had her phone number. 

I picked up the phone and called this woman, not knowing what to expect but knowing that my heart was open and I was coming from a place where I wanted to rectify any misinformation. 

The Telephone Game teaches us the power of perception and individual interpretation...stories morph as they go from individual to individual, each unique in perception and interpretation. 

For the anonymous caller, I hope our talk helped- and put this lesson into perspective. 

Tuesday, January 13, 2015

The Birth Center Option

Every week it seems we get more and more calls and emails inquiring about what our care consists of and what exactly a birth center can offer. It is wonderful to see more and more women and families actively researching and wanting to know more about this option. So, I got to thinking I should write a little bit about what we offer and why we are the best. Here goes...


In a time when healthcare consumers are becoming more and more involved in their care and decision-making, an increasing number of families are choosing to give birth not in the hospital, but rather, within a birth center- a homelike facility that revolves around the wellness model of pregnancy and birth.

The increasing number of families choosing to deliver at birth centers may largely be attributed to the increasing number of women desiring to have a natural, unmedicated birth, free of unnecessary intervention. Rather than policies of routine intervention, birth centers are guided by principles of support and prevention.

So you know you want a natural birth? Maybe you don't even know that for sure and are bordering on thinking that it is a wild and crazy idea! The best thing you can do- for yourself and your baby- is to know your options and learn more about what a birth center can offer. As we say around Integrated Women's Wellness...if you don't know your options, then you have none!


Here is what you can expect from a birth center birth with us:


Us

We are a small, intimate practice whose primary focus is providing evidence-based, family-centered care, and truly getting to know each individual person. Unless planned well in advance, you know you will have the same care providers you have seen throughout your pregnancy attending you at your birth. Our patients have the benefit of an integrated model of care, which marries the personalized, wellness model that is midwifery care, with the science of obstetrics.




Tara Elrod, CDM

Glen Elrod, OB/Gyn

Our Rooms

We have two beautiful rooms that we specifically designed to be a cross between the comfort of home and the relaxing space of a luxury hotel. Both birth rooms showcase the scenic photographic art of our local Alaska surroundings (done by a local photographer, Calvin Hall), though each with different decor and its own distinct 'feel.' Both rooms offer a queen-sized family bed, an open-concept shower, and a large tub- both for hydrotherapy as well as the option for waterbirth.
There is no separation from partner, the barricade of a bed rail on a hospital bed, nor a hospital bed that gets "broken down" for a lithotomy-positioned turtle-back delivery.


Support People

Our model of care is that of evidence-based, family-centered care. There is no limit on the number of people allowed to be with you as you give birth or how involved they can be. It is entirely up to the patient. Family members, doulas, and siblings are welcome, as mom so chooses. Siblings and dads are welcomed and encouraged to be active participants in the birth. Also, at Integrated Women's Wellness & Center for Birth, we have two Apprentice Midwives who are also both Certified Doulas, who are able to provide wonderful additional support.

Shelby Larson, Apprentice Midwife and Doula

Mary Yanagawa, Apprentice Midwife and Doula


IVs and Medication

While birth centers are guided by principles of prevention and only appropriate medical intervention, some interventions are available, when indicated. At The Center for Birth, most women do not need to be hooked up to an IV, as they are low-risk and able to eat and drink freely. IVs are available as needed- for hydration, antibiotic administration for GBS, and for blood loss management. While IV pain medications are not available, antibiotics, Pitocin, Methergine, and Cytotec (for the management of a retained placenta or postpartum hemorrhage) are readily available and given as needed. If there is a laceration that needs to be repaired, lidocaine is able to be used for numbing.


Pain Management and Relaxation

Due to possible side effects for mom and baby, analgesic drugs (like IV pain medications) aren't given at The Center for Birth. However, the best kind of pain management comes from the encouragement and freedom of movement, aromatherapy, physical and emotional support, musical therapy, the supportive and calming surroundings, and the use of hydrotherapy in our large walk-in showers, and large tubs. Nearly 90% of the births with Integrated Women's Wellness and Center for Birth are waterbirths, and 99% of moms use water as a means of pain management and relaxation at some point during labor.


A Higher Level of Care (Hospital)

Emergencies are not expected but always anticipated and prepared for. Every clinical person- providers as well as support people- are trained and certified in Neonatal Resuscitation, the treatment of postpartum hemorrhage is possible, and we are located less than one mile from Mat-Su Regional Medical Center, should a hospital transport be necessary.


The birth of a baby- a new life- is a sacred event and a momentous occasion for a family. Consider having your baby in a welcoming, family-centered, and safe environment- our birth center!

AKbirth.com