Compromise... finally

Wednesday morning I got up at 6 a.m., showered & got myself ready, ate breakfast, got Blondie & Kitty up and dressed and was out of the door by 7 a.m. We made it to the Capitol & parked around 7:35 and got to the committee meeting room around 7:40. I was surprised when we walked in the room that none of the midwives were there and the bill sponsor was not there either. Usually all of the major players are there in the room before I get there. About 10 minutes to 8:00 some of the House staff came into the room to get set up for the meeting and were surprised to find the room half full already. I heard one of the staff comment that usually there is no one in the room when she arrives and very few people there even when the meeting starts. From what I could tell the majority of people were midwife supporters, but still no midwives. By 8 a.m. most of the committee members were there and the chair spoke and said that he had just been informed that the UMA and LDEMs were in the middle of discussions to come up with a compromise bill to present to the committee. He said that they would wait for about 10-15 minutes for them to show up. So we sat around and waited for about 15 minutes and then the chair decided to bring the committee to order to discuss what to do. Someone got on the phone with someone from the negotiations and was told that it would take about 15-20 minutes to get the new substitute typed & printed up. So the committee decided to "saunter" until about 8:30 at which time there would hopefully be a bill to discuss.

At around 8:25 the midwives walked in and a few minutes later I recognized some of the UMA representatives. They then passed around a new substitute version of the bill and both sides testified to the committee that it was truly a compromise bill that both sides agreed to and that they would not present any more legislation on the issue until the trial period to gather statistics was over in the year 2011.

Overall I think that it is a good bill and definitely the best one that we have seen so far (that the UMA agrees to). The bill does not change anything for unlicensed midwives, but it does limit somewhat the scope of practice for licensed midwives (LDEMs). It looks like expectant moms can see an LDEM if she has had a previous C-section (VBAC) if she signs a waiver. The bill does not allow women to see an LDEM if they are expecting twins or if the baby is in the breech position at birth. That is how I understand the bill. I could tell that there were several doctors in the room who were NOT happy to see the section about VBACs in there. The truth is that there is a less than 1% risk of uterine rupture in a VBAC case and I think that women should have the right to choose their risks - either a VBAC at home or most likely a repeat C-section in the hospital - neither of which is going to be risk-free.

Now the goal is to have it pass out of the House and then back to the Senate for concurrence. Hopefully this is the end of it for at least 3 more years (at which time I will most likely be finished having kids). :0)

Supreme Court Case in Missouri

There was a law passed last year in Missouri to legalize the practice of certified professional midwives (CPMs) attending homebirths in the state. After the law was passed and before it went into effect, the Missouri State Medical Association (MSMA) organized a well-financed challenge to the new law and was granted a temporary restraining order. Now the case is going to be heard on March 5 to decide if they will overturn the restraining order or not. This is a huge case for midwives in Missouri and I would hope that each of you will keep them in your thoughts & prayers. To read more details about the case you can read the following media alert from Missouri:

MEDIA ALERT
Missouri Supreme Court to hear Midwives Law Appeal
Court grants motion by coalition of midwife advocates to file a `friend of the court' brief for Mar. 5 hearing

(Jefferson City, MO) – The Missouri Supreme Court will hear arguments to reconsider the permanent injunction on the state's new midwifery law at 9:30 a.m. on Wednesday, March 5 at the Cole County Courthouse, 301 E High Street. A coalition of state and national midwife supporters, midwives and home birth families, led by Friends of Missouri Midwives (FOMM) and mobilized for the appeals process, has learned that the Court has granted their motion to file an amicus curiae (friend of the court) brief, submitted by:
* Citizens for Midwifery (CfM)
* Midwives Alliance of North America (MANA)
* National Association of Certified Professional Midwives (NACPM)
* Our Bodies Ourselves
* The National Birth Policy Coalition (NBPC)

The amicus brief submitted by the coalition supports the lifting of the midwives law injunction and makes the case that increasing access to trained and qualified Certified Professional Midwives (CPMs) and out-of-hospital birth is beneficial to Missouri citizens. In seeking to provide such access, Missouri is following the wisdom of a growing number of states recognizing the benefit of authorizing CPMs, who provide safe and high quality care, to practice.

"If the Supreme Court lifts the injunction, this law will permit CPMs to provide high quality, cost-effective care that will benefit Missouri's citizens and fill some significant gaps in the state health care system," said Susan Jenkins, legal counsel to the midwives coalition and steering committee member of National Birth Policy Coalition. "Home birth among low-risk women attended by CPMs does not jeopardize the health of mothers or infants, is authorized in 22 states, and is supported by many highly regarded international and professional organizations."

Mary Ueland, Grassroots Coordinator for Friends of Missouri Midwives, says she hopes the Court will rule to decriminalize Certified Professional Midwives and remove the threat of prosecution to professional midwives who assist families who choose out-of-hospital birth. "Missouri shouldn't drag it's feet when it comes to allowing mothers to have safer and healthier
births options."

The new Missouri Midwifery law was supposed to take effect Aug. 28, 2007, but the Missouri State Medical Association (MSMA) organized a well-financed challenge to the new law and was granted a temporary restraining order on July 3. Then on Aug. 8, Circuit Court Judge Patricia Joyce, who serves on the Board of Directors for St. Mary's Health Center in Jefferson City, disallowed the Certified Professional Midwives provision contained within HB818 regarding portability and accessibility of health insurance.

Judge Joyce ruled the provision was unconstitutional and unrelated to health insurance, despite hearing from Assistant Attorney General John K. McManus and Midwifery Coalition attorney Jim Deutsch that decriminalizing midwifery does indeed relate to health insurance as they recalled that the Missouri Supreme Court has already ruled health insurance is interdependent on health services, and the two subjects are related.

During the Circuit Court appeal to Judge Joyce on Aug. 2, Deutsch cited nine other states where Medicaid covers home births attended by Certified Professional Midwives and many others where CPMs receive private insurance reimbursement. Both McManus and Deutsch argued that families obviously cannot get health insurance reimbursement for their midwives if their providers are considered felons by the state. They agreed that legalizing Certified Professional Midwives is a first step to home birth families being able to have their maternity care providers covered by insurance. They also cited the lower cost of midwifery care, which in turn could encourage insurance companies to lower their rates for healthy women.

"We're seeing a strong shift in support of professional midwives as families become more aware of the benefits of CPMs, as well as more alert to skyrocketing c-section rates," Laurel Smith, President of Friends of Missouri Midwives, said. "Beyond the additional risks for mothers and babies that c-sections create, what effect does a c-section rate of more than 30 percent have on our insurance premiums, and how reliant are doctors and hospitals on these increasing revenues?"

Missouri is part of The Big Push for Midwives Campaign, a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care.

The case defendants and midwifery supporters who are listed on the appeal to the Missouri Supreme Court include:

* Friends of Missouri Midwives (FoMM). A nonprofit organization representing the interests of Missouri families who choose to have safe, alternative, out-of-hospital childbirth options. FoMM was created to support, promote and protect the rights of Missouri families to make choices about how, where, and with whom their babies will be born and to promote access to the midwifery model of care. Contact: Laurel Smith 636-209-1033.

* Kelly & Dallion Rehm, and Eric & Jessica Kerr. Two families that were expecting babies to be born after Aug. 28, 2007, the day the new law was to take effect. They were planning home births with legal, well-trained CPM's. When the new law was struck down, they had to choose between breaking the law, birthing at home without a trained attendant or the expense and interventions of a hospital birth. Contact: Kelly & Dallion Rehm 417-777-8005, Eric & Jessica Kerr 314-962-1143 or 314-248-0952

* Columbia Community Birth Center, Kim James, CPM; Ivy White, CPM; and Dr. Elizabeth Allemann, MD. Columbia Community Birth Center is the only licensed birth center in the state of Missouri. The Center is a place where families give birth in a comfortable home-like setting. James and White received their CPM credentials in 1995. Ivy White says, "As a natural childbirth specialist and professional, to have the freedom and recognition to legally practice in my state is a dream that I share with my midwife colleagues in Missouri. It wrenches my heart that there are families who long for midwifery care, and I cannot give it to them." Contacts: CCBC 573-447-2700; Ivy White 573-356-1059; Kim James 573-424-9115; Elizabeth Allemann 573-268-6946.

* Missouri Midwives Association. An organization dedicated to promotion, protection, support and education for midwives in Missouri. "Generally, parties who want to join a suit want to be on the plaintiff's side. We are an unusual group with an unusual dedication to our cause. We have joined the State of Missouri as co-defendants so we can have a say in what evidence the court will consider, and ensure our victory," says Debbie Smithey, President of the Missouri Midwives Association. Contact: Mary Ueland 417-543-4258.

Media inquiries about the Missouri Supreme Court case should be directed to Mary Ueland at (417) 543-4258. Media inquiries about The Big Push for Midwives Campaign should be directed to Steff Hedenkamp at (816) 506-4630.

Friends of Missouri Midwives
Missouri Midwives Association
Show-Me Freedom in Healthcare
Free the Midwives
The Big Push for Midwives

Another committee meeting

Well, the bill has been put on the agenda for tomorrow's committee meeting (House of Representatives Health & Human Services Committee). It is the only item on the agenda for a 1 hour meeting (and this is the last day of committee meetings). It was originally on the agenda for last Friday but then was removed so we thought that it would just be sent to the House Floor for a floor vote. I think that this is a good thing because I know that several of the committee members are on our side. The meeting is at 8 a.m. (again) so I will be getting up bright & early to go with my 2 little ones. Stay tuned tomorrow for the outcome of the meeting...

Another trip to the Capitol

This morning DH & I (with Blondie & Kitty) went up to the Capitol to talk to our Representative about the midwife bill. Three years ago I talked to her about the original bill and she had some concerns about it but she never contacted me with any questions and ultimately voted against passing the bill. Today DH decided to go into work late so he could come with me and maybe the two of us together could make a difference. We had to drive around a few times before we found a place to park and then we had to wait a few minutes because she was presenting a bill on the floor right when we got there. After her bill was voted on we sent a note in to her and a few minutes after that she came out looking for us. We only had a few minutes to talk with her because unfortunately it was a busy time on the house floor for voting on bills. They kept ringing the bill to vote and she would have to leave us to go cast a vote on another bill. I think the meeting went pretty well and we told her a few of our concerns about the bill and we mentioned another representative in the house that is working on a substitute bill for the midwives. Our representative said that the substitute sponsor sits right behind her and that she would talk with her about it. So, hopefully she will at least vote for the substitute and then we don't care if it passes or dies at that point (except that if it passes then this might be the last year that we have to deal with the whole issue). Now we just need to send her a "thank-you" email for taking some time out of her day to speak to us.

From what I understand the House of Representatives is currently prioritizing bills and they will not get to any Senate bills until Wednesday or Thursday. Hopefully today was the last trip I will have to make up to the Capitol - the session ends Wednesday, March 5.

Views on Childbirth - part 2

Before I had any kids I had never even thought about or heard about homebirth. When I became pregnant with M&M I heard about a group of certified nurse midwives (CNMs) through some people in my BYU married student ward. They were located in American Fork and reported to be really good. Since I have never been crazy about too many doctors during my short lifetime the idea sounded intriguing to me and they were covered by my insurance plan. So I made an appointment to attend an introductory meeting where they meet with groups of expectant parents and talk about their practice, insurance, hospitals, etc. I think that that was the first place that I heard any mention about homebirth. One of the midwives that was conducting the meeting talked briefly about their beliefs about childbirth - how it was a natural process and that it was even safely done at home. The other thing that happened around this time is that I started immersing myself in childbirth websites on the internet. There were quite a few that I found that had birth stories that people had written and submitted for others to read. I became fascinated with reading other people's experiences. The one thing that struck me the most while reading birth stories was the marked difference between women who gave birth in the hospital with an epidural versus those who had natural, drug-free births. It was amazing to me the difference in attitude of these women. The women who gave birth without drugs had such positive views on their births and felt so empowered by the whole experience. Even more amazing were the experiences of women who gave birth at home, where they were in their own element and in control. I was increasingly saddened though by the numerous stories of women who chose to give birth in the hospital and through the process of hospital "procedures" were subjected to intervention after intervention which ultimately led to a C-section to "save" the baby.

At first I wasn't even interested in the homebirth part until I read more about it and the safety of it (but that came later on). I was also introduced to the idea of waterbirth which some stories also mentioned. More than anything though I quickly knew that I wanted a natural birth. I wanted to be able to have full feeling of my body & what it was trying to tell me during each stage of the birth process. I wanted to be able to walk & move around. I wanted to be fully awake & drug-free when I welcomed my baby into the world - to feel the natural high that comes after childbirth. I also wanted my baby to be drug-free and alert after birth. Another reason drug-free was appealing to me is that I have never been crazy about taking drugs for anything (even over-the-counter medicine) - I have to be pretty miserable before I will even take some Tylenol or ibuprofen. So the idea of being able to go through childbirth drug-free was very appealing to me in that aspect as well.

When I mentioned natural childbirth to DH, he thought that I was absolutely crazy. He felt that we have hospitals & drugs for a reason and didn't think that I could ever manage the pain associated with childbirth. He even said that in the scriptures you read that childbirth is meant to be hard & painful - so why would you not want drugs... Needless to say I was a little disheartened by this but I wasn't ready to give up yet. At one of my appointments one of the CNMs asked me if I was planning on taking a childbirth class. I mentioned that I wasn't too crazy about taking one offered at the hospital and was somewhat interested in natural childbirth. So she gave me the name and phone number of someone she knew who she thought was teaching some independent natural childbirth classes. I called the phone number and the lady who answered said that she wasn't teaching at that time but she knew someone else who was and gave me another name & phone number (it turns out that the first lady I talked to is now my midwife - I made the connection several years later).

So DH & I attended natural childbirth classes with one other couple through an independent instructor. DH & I absolutely loved the class & it was a real eye opener for both of us - but especially for DH. We learned about the whole process of childbirth and what the body goes through at each of the various stages. We also learned what the cause of pain in childbirth is and how to try and cope with it. I learned most of all that childbirth is almost more of a psychological battle than a physical one - so much of what a woman experiences can be changed by how she views the whole process in her mind. The reason we feel pain is because we are afraid and trying to control something that our body can do on its own. The less you fear the process and give in to your body the less pain you will experience (this is definitely hard to do). After attending a few classes, DH was converted to the idea of natural childbirth and we were both determined to have as natural a birth as we possibly could.

DH is in print!

Finally after 3 attempts at sending in a submission to the Reader's Forum of our paper (Deseret Morning News), one of his submissions was printed. DH has been trying over the past week & a half to get the paper to print a submission about the midwife amendments bill that is currently before the Utah legislature. We had pretty much given up that they would print one of his articles when I sat down this morning to eat some breakfast, opened up the paper & there it was! Here is the article that was printed:

UMA a monopoly run amok
Published: Friday, Feb. 22, 2008 12:53 a.m. MST

The Utah Medical Association has shown a disturbing trend to misrepresent, distort and outright lie when it suits its purposes. In the ongoing saga of SB93 (sponsored by Sen. Margaret Dayton) — the midwife bill only but a small number of people care about — the UMA feels it can do whatever it wants. Despite requests from the legislators that the UMA work together with the midwives, it has demanded, made promises and then substituted its own bill ignoring midwives outright. This is a monopoly run amok.

Childbirth Books

Here are some books that I would recommend for anyone to read that is currently pregnant. The first two books are geared more towards the process of birth and how to have a safe, positive birth. The third book is a very enlightening look at how childbirth has evolved over the history of our country. It's more of a study on anthropology and how we came to the current views on childbirth. This one isn't necessarily for someone who is pregnant but can be read by anyone interested in childbirth.

1. The Birth Book by Dr. William Sears & Martha Sears
I love this book! It looks at all options available for childbirth and talks about the births of each of their children (9 I think). I also LOVE their book The Baby Book for the first two years of your baby's life.

2. Gentle Birth Choices by Barbara Harper
I don't have a copy of this book but it is one on my list to buy. If I recall correctly it talks a lot about alternative choices to a hospital birth and making your experience "gentle" for the baby. It also talks about waterbirth.

3. Birth as an American Rite of Passage by Robbie E. Davis-Floyd
I also don't have a copy of this book but it is another one on my list to buy. I loved reading about how we have evolved as a country in the aspect of childbirth and how that evolution isn't necessarily a good thing for us as childbearing women. It's a book that definitely makes you think and take a look at the medical community a little bit differently.

Views on Childbirth - part 1

I want to start out my series on childbirth with a brief overview. This is what I wrote down to say in the Senate committee meeting if I had had the opportunity to speak:

My husband & I have 4 beautiful children & are currently expecting our 5th. I first heard about homebirth when I was pregnant with my first child. When I mentioned the idea to my husband he thought I was absolutely crazy. So we compromised with our first and she was born naturally with a certified nurse-midwife (CNM) in the hospital. When I became pregnant with my second child I mentioned homebirth again to my husband and he agreed.

My husband & I are probably some of the last people you would ever think would choose homebirth. We are both very logical & technical people and we each have college degrees in computer science. We would not have made the decision if we didn't know that it was a safe option for me and I have been blessed with having an experienced & very competent midwife.

Now you will be told numerous horror stories of homebirths gone bad, but I have yet to hear any that involve any of these midwives who are licensed under Utah law. I can also tell you that for every homebirth horror story, I have heard more than 10 times that number of hospital births gone bad that are usually the result of unnecessary procedures and interventions - births that should have been low-risk, uncomplicated deliveries.

While this bill does not have any factors that would "risk" me out, I know that it would severely limit the number of clients that my midwife could take and would force many of these women out of business or force them to give up their license and the ability to carry some important and possibly life-saving drugs with them.

I want you to know that I love my children. I love this baby that I am currently carrying and for the medical community to say or even insinuate that I don't want a safe, positive outcome for myself and my baby is hurtful. We as mothers & fathers & midwives want nothing less than good outcomes and will do all in our power to ensure that - even if it means transferring to a hospital under a physician's care.

I urge you to see this bill for what it really is - the medical community trying to exert power & control over these professionals who they feel are infringing on their territory.

Please vote "no" on this bill. Thank you for your time.

More snow!!

We finally had some warmer weather earlier this week (we made it close to 50 degrees) and the snow was almost gone from our back yard and then we still had big piles in the front where it had been shoveled. Yesterday afternoon though we got another dumping of snow with lots of wind and more snow drifts. DH had to go up to Salt Lake in the afternoon for a meeting and it took him 1 1/2 hours to get home afterwards in a commute that normally takes between 30 & 45 minutes. I got the kids up for school this morning and off to the bus stop and they came back about 5 minutes later saying that someone had come out and told them that school was delayed 2 hours - in Utah?!? That is definitely something I would expect in Virginia where I grew up, but not here in Utah...

In the meantime, I have been suffering from a horrible head cold these last couple of days. I woke up Monday morning with a slight cough & runny nose which has steadily been getting worse throughout the week. Tuesday evening I skipped Enrichment because I felt so tired. I've been going to bed around 10 every night this week. Then it got pretty bad Tuesday night - at one point I woke up and was freezing to death and then I woke up a couple of hours later sweating like crazy - definitely a sign of a fever. Yesterday I felt pretty miserable with a headache and just feeling completely wiped out. It doesn't help that I'm 7 months pregnant either. Somehow I managed to get some laundry done, but that was about it. I was supposed to help out with a Valentine's party in Luke's class today but I called the mom in charge of the party and told her that I wasn't going to be able to make it. I slept better last night and I feel a little bit better today but I still have a constant headache and a cough and stuffed-up nose. I think my fever is almost gone which is a good thing - the highest I measured was 100 degrees. Now I just hope that no one else gets it...

Kid-friendly recipe

Here is a no-bake cookie recipe that M&M got at school last year. This is something that she can make herself without any help from me. The only problem that she has sometimes are her siblings wanting to help and picking at the batter whenever she turns away... She made a batch of them on Saturday and we were eating them so quickly that I had her make some more on Sunday since my parents & sister M & her fiance R were coming over. They're also great for me because they don't have chocolate - which causes me a lot of heartburn right now...

No Bake Peanut Butter Treats
Makes 4 dozen

1 cup peanut butter
1 cup powdered sugar
1/2 cup milk
1 teaspoon vanilla extract
2 cups oats (quick or old fashioned, uncooked)
2 cups (any combination of) raisins, diced dried mixed fruit, miniature marshmallows, shredded coconut, chopped peanuts, chocolate chips or M&Ms

1. In large bowl, combine peanut butter, sugar, milk and vanilla; mix well. Stir in oats and remaining ingredients.
2. Drop by rounded teaspoonfuls onto wax paper. Let stand until firm. Store tightly covered.


Our favorite combination so far is 1 cup miniature marshmallows with 1 cup white chocolate chips.

Patients' Rights

Here is a great article on patients' rights (focusing primarily on childbirth) that I recently read. This has a lot to do with what the Utah Medical Association is trying to impose on us as citizens of the state with the proposed midwife amendments bill. I have thought a lot about the topic and have been asked recently why I made the decision to give birth at home. Stay tuned for a series of blog entries on how DH & I came to the decision and then the birth stories of our four kids. In the meantime read this article for some food for thought:

Consumer First, Patient Second
Finding the right care provider for your pregnancy and birth
By Sherry L. Payne RN BSN

I had a long conversation with my friend, Pam, the other night. She is in her final month of pregnancy, with her first baby, who is in breech position. Her physician is suggesting a cesarean. If attempts to turn the baby are unsuccessful, she will consider a homebirth in order to avoid the surgery. I urged her to let her doctor know her thinking. Woman are often unwilling to have a frank discussion with their caregivers about their wants and desires. I reminded my friend that she selected this provider (or group of providers) and that she is paying them to be competent partners in this process. During a crisis is not the time to start doing things behind their backs but tell them exactly what you plan to do and why and listen to their feedback (but take it with a grain of salt- they don't have the final say- you do). I think this approach is important because it preserves the integrity of the relationship. Physicians and midwives are not mind readers. They need to know and understand what type of care clients desire, or what they don't want and why. Otherwise they'll just continue to think women are happy with the care they are getting.
Think about this question: What is the role of your pregnancy and birth care provider? Is it to manage your pregnancy, labor and birth for you? Is it to take care of you during pregnancy and birth? Is it to deliver your baby for you? Is it to ensure that you have a healthy baby? May I make the audacious statement that all these things are in your own power to do. When I hear statements like, “my doctor won’t LET me do that” or “my doctor says I can TRY that and see how it goes” it tells me how out of balance the care provider is with the care receiver. It is not the proper role of any physician or midwife to tell you how to have your baby (or where, or when). Receivers of health care must adopt a more pro-active consumer role in their own healthcare delivery. Nowhere is this more obvious in healthcare than in obstetrics where as a labor and delivery nurse, I have seen care providers of all types routinely bully, control, and dominate their patients. Your care provider should be a competent guide through the process. He or she is not your daddy. They can’t tell you what you will or won’t do throughout your pregnancy, labor, and birth. They can suggest what they think is best, but the final course of action should be up to you.
This does not mean that a caregiver does not have the right to define their parameters for care. If a midwife only wants to take vegetarian mothers as clients, that’s her prerogative. If you happen not to be a vegetarian and really want this midwife to care for you, then you have a choice to make. The same is true for physicians. If their parameters of care include routine epidurals, episiotomies for all their patients, routines IVs, etc. then that is their place of comfort in giving care. If you don’t want any of those things, you’d be much better off finding a different physician than trying to convert this one to your way of thinking, because you’re asking them to take themselves out of their comfort zone to care for you. It’s important that as consumers of healthcare, women understand the pressures that come to bear upon care providers.
Consumers greatly underestimate the role litigious threat has had on healthcare. One of the reasons obstetrics has become so defensive in practice is because the threat of a lawsuit hangs heavily over their heads. Now some medical lawsuits are well deserved, others frivolous, yet taken together their impact has changed healthcare, and not for the better. Obstetricians are more likely than physicians in any other specialty to be sued for malpractice. This alone has changed the way they approach birth- the way they approach you. Midwives don’t get sued nearly as much, but they are still confronted with the ever growing threat. If you think your relationship with your caregiver is built on trust- well, this may be an idea whose time has passed. Trusting patients is a luxury most physicians find they can no longer afford. Many malpractice attorneys and nurse-attorneys make their livings teaching healthcare professionals how not to get sued. It boils down to defensive practice. This translates into taking all precautions, ordering all the tests, acting the moment something appears amiss. If all else fails, there is always the ultimate medical intervention for a birth at risk- perform a cesarean section. This, among other reasons, is why the cesarean rate has risen to 30% and above. Birth has not suddenly become more dangerous, the practice of delivery babies has.
This is why it is so important to know your own philosophy of birth AND your care provider’s philosophy of birth. It will be far more productive to find a caregiver that agrees with your philosophy of care than to try to convert someone because you like them. Don’t just hope you’ll be the exception or that things will go well- you won’t be and they won’t. Liking your caregiver is not sufficient criteria for choosing him or her.
As consumers you’ve got to do your homework. Get referrals from friends and family, asking them WHY they think this person is so great. Listen to their birth stories- do you want yours to mirror theirs? Google them and find out about them, go to those rating sites and see if someone has left comments about your particular caregiver. Ask your caregiver directly for client testimonials or references. Ask directly for their cesarean and induction rates. (If they won’t give them to you, that’s a red flag). Your ultimate goal should be to find the caregiver, be it physician or midwife, OB or family practice, that is right for you.

Sidebar
Questions to ask your potential care provider
What is your philosophy of birth? (They may have it in written form-even better.)
What are your practice protocols? (What do they do routinely for every patient?)
How many births do you do a month? (Will they be available for you?)
Do you attend your own patients or do I get whoever is on call for your practice group? (This is more the rule now than the exception.)
Will I have an opportunity to meet all the physicians and or midwives in your practice?
Will they abide by any agreements made by you and I?
Which settings do you practice in? (Hospitals, home, birthcenters, etc)
How do you feel about ____________________ (epidurals, episiotomies, routine IVs, or conversely birth balls, squatting, or loud verbalizations – you’d be amazed by how many providers think the birthing woman should be quiet)
What are your parameters for inductions? (What medical or non-medical criteria do they use to decide?)
How available are you (or your staff) for questions between and during appointments?

Florida trip

I have been putting off posting anything about our trip to Florida because I knew that it would be a longer blog entry than usual and I haven't wanted to put forth the effort yet. I need to just sit down though, bite the bullet and get something posted before I forget everything, so here goes (I hope I don't leave out too much):

January 11-16
DH & I flew out of Salt Lake early Friday morning. My parents came over early and my mom stayed with the kids while my dad drove us to the airport. I had to do two sets of packing since my kids were going to be staying at my parents' house while we were gone. We had a fairly long layover in Albuquerque, NM so we had time to get some lunch. We arrived in Orlando in the evening and then got our luggage and rental car. It took us about 45 minutes to get to the condo resort we were staying at. After we unloaded our luggage we left to find a grocery store so we could buy something for dinner and then breakfast the next day.

Saturday we slept in a little and then drove out to Tan & Chez's apartment. We spent the day with them and went to the Kennedy Space Center in the afternoon. It was a pretty neat place to visit but we unfortunately missed the bus tour that takes you out to the actual launch pad. We realized too late that the last tour left not too long after we got to the space center. So we just walked around the complex there and DH & Tan rode a flight simulator that simulates a shuttle launch (Chez & I couldn't go on it because it had pregnancy restrictions). Chez & her son C & I were able to watch them on some T.V. screens in a viewing area, but we were disappointed to see that neither of them showed any reaction to the ride whatsoever... We also watched a couple of neat 3-D IMAX movies and we attended a briefing by one of NASA's employees who talked about the future of the space shuttle program. On the way home we stopped at a restaurant for dinner. The weather was absolutely beautiful on Saturday.

On Sunday we met Tan, Chez & C at their church building and attended their ward with them. It was pouring by the time we left the church building - but luckily that was the only day it rained during our stay. After church we went back to Tan & Chez's apartment and had dinner and spent the day there with them. We really enjoyed spending time with their family & were very grateful for their wonderful hospitality. DH & I played the Nintendo Wii for the first time and got to box each other. The Wii was a lot of fun to play and I could see the kids (even the younger ones) getting into some of the games. We will probably look at purchasing one in the future. I felt particularly bad for Chez with her pregnancy though. I don't envy her for living in a part of the country with warm winters. She was just getting to the point where her ankles were swelling & I was fearful that I would have the same problem before I left Florida. Other than that she looked great being 8 months pregnant (super skinny with a basketball belly). I also think nephew C was glad when we finally left because we weren't giving him the attention that he wanted and he didn't have anyone his age to play with.

On Monday & Tuesday we went to Disney World. All I can say is that tickets are EXPENSIVE! We almost spent as much per ticket for 2 days that we spent for each of our plane tickets to Orlando. We spent Monday morning & early afternoon in Magic Kingdom and then spent the rest of the day in Epcot. Magic Kingdom is what I think of when I think of Disney World - with Cinderella's castle and all the main animated Disney characters. We think that it was a little more crowded than usual for that time of year because the annual Disney World marathon took place the day before on Sunday. We saw quite a few people that had marathon shirts on. Luckily though we didn't have to wait in line too long for anything. There were a few rides there that I couldn't go on since I was pregnant which was unfortunate, but we found enough to occupy us.

Epcot wasn't quite as exciting as I had heard that it would be. Maybe part of the problem is that we were trying to do as much as we could while we were there and so didn't necessarily take the time to enjoy some of the exhibits. We ate dinner in the Epcot World Showcase area and right when we came out there was a group of Chinese acrobat performers getting ready to start a program there on the sidewalk so we stopped to see them perform. They were very talented and we were able to get some of it on video. That evening we stayed for the Epcot World Showcase night show, IllumiNations, around the lake. It was a neat show with fireworks. Weather wise it was a great day. We were a little cool in the morning with short-sleeved shirts on so when we made our way over to Epcot we went out to our car in the parking lot and got our jackets.

Tuesday we spent the day at Hollywood Studios (formerly known as MGM Studios). This was my favorite of the 3 parks that we visited. We knew beforehand the big shows that we wanted to hit and so we made sure that we got there in plenty of time for those shows. There is an Indiana Jones Stunt show and then a Lights, Motors, Action! show that demonstrated how some of the high-speed chases are done in the movies.
There were a couple of rides that I made DH go on by himself since I couldn't go on them. He enjoyed them but it's not quite the same having to wait in line by yourself and not having someone to talk to and share the experience with.

We stayed for the night show at Hollywood Studios called Fantasmic which was a show over water again with some parts of it being displayed on water being sprayed into the air - pretty neat. Apparently it was a little scary for some kids in the audience though. Tuesday was even cooler than Monday had been so we wore our jackets the whole day. One funny thing that happened this day was that we had bought the ingredients to make ourselves sub sandwiches to take with us each day to eat for lunch. So at lunch time we were sitting down on a bench eating our sandwiches and a family came up to us and asked where we had gotten them because they were looking for something similar to buy in the park.


Wednesday was our real wild card day. Our plane to go back to Salt Lake wasn't scheduled to leave until about 4:50 in the afternoon and we had to be checked out of our condo by 10 a.m. So we had several hours to spend doing something - but not enough to go to one of the major theme parks. Tan & Chez had suggested a couple of things to do and so we ended up taking an airboat ride and then we stopped at Gatorland on our way to the airport. Both were somewhat expensive but sometimes you just have to fork out the money - especially when you might not have another chance to do something like this again.

The airboat ride was pretty neat. The boat just skims along the top of the water/marsh and the driver points out different wildlife along the way. It was pretty noisy & windy. There were lots of birds that we saw and we even got to see a alligator (from a reasonable distance). The driver said that it was a pretty big one from what he could tell. He said that you can determine the length of alligators by the distance between their eyes and the tip of their nose (each inch is equal to about 1 foot of alligator). The one that we saw was about an 8-9 foot alligator. The other neat thing that happened during the airboat ride was when we were stopped to look at some birds and the driver pointed out an osprey that was flying up in the air. He talked about how they will fly around and then dive into the water to catch fish. Right after he said that the osprey tucked up it's wings into a dive and dove straight into the water and came out with a fish. It was pretty amazing to see - too bad it happened too fast to get it on video though. We also unfortunately ended up being on the wrong side of the boat to get very many good pictures of anything... (The trees in the picture above are Cypress trees with Spanish Moss hanging from them.)

Gatorland is one of those tourist locations where you have to pay just to get admission to the park and then anything else at the park costs extra - you can pay extra to buy food for the alligators or birds, you can pay extra to get your picture taken on the back of an alligator, you can pay extra to get an up-close encounter & feed a group of alligators, you get the idea... We were able to get some amazing pictures of some birds & alligators though. The park is basically a marshy area that has a boardwalk going around it where you can view the alligators and other wildlife. We also saw a "Gator Wrestling" show where one of the workers came out and demonstrated some things with one of the alligators in the park. The most amazing part we saw was when the worker turned the alligator on his back and they essentially go to sleep in this position. He even yelled right in the alligator's face and it didn't even move a muscle.

After Gatorland we tried to navigate through Orlando to the airport without having to take any toll roads. DH definitely had something about taking any toll roads while we were there if there was any way we could avoid it. The only toll we ended up taking was from the airport to the condo on the first day. I think overall it took us a bit longer to get to our destinations, but DH had the satisfaction of saving a dollar or two each trip.

The kids did great with my parents and it didn't even seem like they missed us much. M&M & Luke were enrolled in swim lessons that my parents took them to several of the mornings that we were gone and they had a Saturday primary activity, Blondie's ballet class & M&M's tumbling class. I think that all of the activities helped keep my parents from going totally crazy in the house with the kids. On Sunday the kids went to my parents' ward (which luckily for them meets at 1 p.m.). They said that the kids were fine for my dad for the first part of Sacrament Meeting (my mom is the organist) and then my mom was able to come down and sit with them. Blondie had my dad color in her new coloring book with her and my dad said that a lady who had been sitting behind them told him afterwards that she was just in tears watching them color together. They also took the kids sledding several times at a nearby park that has a steep hill. They had a few small snow storms while we were gone and since it was so cold the whole time there was plenty of snow around from previous storms. I also had bought some little things for the for the kids and wrapped them to be opened each day - which I think the kids really looked forward to.

We tried to call the kids each night so we could talk to them. We only missed Sunday night because we didn't get back from Tan & Chez's until after midnight (which was after 10 Utah time). At first my parents tried putting the kids on the phone 2 at a time but we couldn't hear a thing anyone was saying like that and it was hard to tell who was talking (they sound very similar on the phone). I would usually ask Luke if he was behaving and not driving Grandma crazy and a couple of times he was pretty honest and said that he we was driving her crazy... I am definitely grateful for my parents for putting up with the kids for so long. The only thing that was somewhat bothersome for them was that Blondie had a cough the whole time she was there and my mom was giving her some cough medicine for it. She also took a nap almost every day which is very unusual for her. They also had Kitty wandering at night a few times and would find her asleep in the hallway between the bedrooms downstairs and then she would sleep in really late into the morning...

It was definitely a temperature shock to come from temperatures in the 60s-70s and then to land at the Salt Lake airport in our short sleeves at a whopping 17 degrees. You could even see your breath walking up the jetway from the airplane to the airport. We got back to our house a little after 10 p.m. and Kitty unfortunately was asleep already. Blondie gave her dad a great big hug - I actually think that she's the one that missed us the most. The next day Kitty even slept in and I finally went in to her room after the other kids were awake and just stood there for a minute looking at her and she opened her eyes and saw me. As soon as she saw me she sat up in bed and said, "Mommy" and gave me a good big hug.

I was somewhat nervous with spending two days walking around Disney World and on my feet the whole time that my feet and ankles would be swollen by the end of our visit but I faired amazingly well. The bottoms of my feet were a little sore (especially if I had to stand in one spot for a while) but other than that I felt just fine and wasn't even terribly tired at the end of each day (and no swelling).

Overall the trip was a lot of fun. I always felt like I was forgetting something whenever we would get ready to go somewhere but it was also nice to not have to haul the kids around, especially when we had to wait in line for things. There were definitely times (at Walt Disney World especially) where DH and I would talk about which of the kids would have enjoyed the ride or show that we just experienced. We are talking about possibly taking a trip to Disneyland in the next year or two (it would definitely be cheaper because we would be able to drive and from what I understand the park is a lot smaller & easier to navigate with young kids).

Bill moves forward, unfortunately...

Unfortunately the midwife amendments bill passed out of the Senate committee and was sent to the Senate floor to be voted on. There was some good that came out of the committee meeting though - in fact it went better than the midwives were expecting. There is an awesome Senator on the committee who asked some great questions about the bill and is completely on our side but his view was unfortunately outvoted 2-3. I was debating on Wednesday night whether or not I would go because I would need to get Blondie & Kitty up early again and I wanted to be out of the door by 6:45 a.m. to be sure that I got there on time and could get a seat. It's also even more work since I'm in my 7th month of pregnancy. Finally right before I went to bed though I made the decision that I needed to make the effort and be there to support my midwife and our cause - plus this doesn't happen every day. I also knew that this bill would be first on the agenda so it would definitely be heard and that I would be able to leave right afterwards and get home earlier than I did on Tuesday.

So I got up Thursday morning at 6 a.m. and while I was getting myself ready DH got up and said that he would stay home and watch the girls for me so that I wouldn't have to haul them along. We had been waffling somewhat on our schedule for Thursday because of the committee meeting at the capitol and then the Family & Church History Department of the church (which DH works for) was having its annual department meeting at 1:30 that afternoon down in Salt Lake that employees & spouses were invited to attend. So since DH works down in Utah county he decided to do some work from home in the morning so that he could watch the girls for me and then we would go together to the department meeting in the afternoon.

Well, I left at 6:45 for the committee meeting and I got there in record time. I was at the Capitol and had found a parking space by 7:20 so I sat in the car for a little while and took some time to write down some thoughts in case I had the opportunity to speak to the committee.

Unfortunately they only let three people speak who opposed the bill and I wasn't one of them. My midwife spoke (who is the head of the LDEM board), our sponsor of the original licensing bill from the House of Representatives, Jackie Biskupski, spoke and then a homebirthing mom spoke. Rep. Biskupski said that she had spoken with the Senate President about this bill and he said that he wanted some results this year so that this issue doesn't keep appearing each year. The legislators are definitely getting sick of seeing our group each year and having to listen to the same issues each year.

The Utah Medical Association (UMA) and LDEMs had a meeting scheduled yesterday afternoon to try and work out their differences and they are in the process of trying to work out a compromise between the two groups. I'm actually somewhat fearful of the concessions that the midwives are going to have to make to appease the UMA.

The committee chair from the meeting said that he would vote to pass the bill out of committee under the assumption that the two groups would meet and hopefully work out any differences and come up with an amendment to the bill that could then be voted on by the Senate.

I'm glad that I went to the committee meeting but I was somewhat frustrated with some of the opinions of the medical community and the committee members (my senator included). There was a rules process set up in statute when the original bill passed 3 years ago and the rules set up have been working. The UMA could have objected to any of the rules that were proposed, but their representative on the rule-making board decided to not show up to any of the meetings.

If anyone wants to listen to the audio file of the committee meeting, click on this link and then pick the date February 7, 2008:
Senate Health & Human Services Committee Meetings

Latter-day prophets

On Monday we had a family home evening lesson on our latter-day prophets. We talked about President Hinckley passing away last week and that President Monson was now the new prophet. I printed out a picture of President Monson and then I got out the pictures of the other latter-day prophets and had Kitty hang them on the wall out of order (she was the lesson helper on Monday). Then we had the kids take turns trying to match the names with the correct pictures (Blondie was even able to identify a couple of them without help). We also tried to tell the kids a little bit about each one. Then we put the pictures in order and sang the Latter-day Prophets song from the Children's Songbook a couple of times. The kids really enjoyed doing this and expressed interest in being able to identify the prophets so I think we will have future family home evenings on this topic.

Nothing today

The midwife bill was on the agenda today for a committee meeting and they didn't get to it. I got up super early and left with Blondie & Kitty so that we could be there by 8:00. We ended up being a little late and the room was jam packed so I sat out in the hall until they got further down on the agenda and some space cleared up in the conference room. After the meeting ended the girls & I walked over to the main Capitol building which was recently opened after some extensive renovations. We walked around the building a little and then I went up to the Senate chambers and sent in a message to my senator. I'm still not sure where he stands on the issue. After that we walked back to the car and dropped the family calendar off at my sister's apartment - she was just diagnosed with strep throat so we didn't stay at all. Then we went over to the dealership where we bought our minivan to get the oil changed. On the way home I stopped at the elementary school to vote. All I can say is that it has been a very long day and I am very tired. I crashed on the couch for a little while after we got home.

The midwife bill is first on the agenda for Thursday morning at 8 a.m...

Bill sent to committee

The midwife amendments bill that has been proposed in the Utah senate has now been sent to the Senate Health and Human Services Committee and is on the agenda for tomorrow morning. Blondie has a ballet class, but I think we will skip it this once and attend the committee meeting. I think the more people we get to show up the better it looks for us - so the legislators sees that this bill will affect many average people who really care. I am composing a letter to my senator right now - who just happens to be the committee chair of this committee. I am told that of the 5 members on the committee, two are definitely in favor of it, two are pretty sure against it and the 5th one we are unsure of (my senator). He told the midwife group 3 years ago that he would vote in favor of the original bill if they needed his vote and then voted against it because we didn't need his vote (it was very close though). I'll let you know how things go tomorrow...

Even in Utah...

...they cancel church because of snow.

We were hammered with a snowstorm & strong winds last night into this morning. The stake president at first just canceled all classes and we were going to have Sacrament Meeting (since it's last), but then they ended up canceling the whole meeting because it kept snowing and the wind kept blowing and they couldn't get the parking lots cleared out (it finally stopped around 11). I wish we had found out a little sooner though because we have church at 9 a.m. and I already had everyone up and dressed before we got word about the cancellation. Since we only live about 1 1/2 blocks from the church it seems pretty strange to have it canceled. My parents' stake also canceled church meetings today.
DH has been outside for over an hour now trying to get our driveway & sidewalks cleared - it is over 2 feet deep in some places so I'm not sure if we could have even made it out of our driveway in our cars. DH got a snowblower for Christmas and in some places it is higher than the top of the snowblower.
Since the wind was blowing so much there are huge snowdrifts in some areas and in other areas the ground is almost bare. In this picture of our swingset you can see almost bare ground over near our neighbor's house, but our swingset & back porch are completely covered with snow.
In this picture you can see bare patches of ground on our back lawn and then you can see the snow covering over half of our 6 ft tall fence.

Luke turns 7!

Luke Skywalker celebrated his 7th birthday on Friday. We just had a family party this year which ended up being pretty small & low key. My parents & sister were both fighting sicknesses and weren't able to come over so it was just our family of 6. DH ended up going to a doctor's appointment after work so we didn't do too much until he got home from that around 6:30. Luke opened a couple of presents from us before school and then after DH got home from the doctor's we went out to Carl's Jr for dinner (Luke wanted to go there because they have an indoor playland.
The kids had a lot of fun playing there and then we stopped at the store on the way home to pick up a prescription for DH and some ice cream. After we got home, Luke opened the rest of the presents from us and the girls and then the ones from DH's parents. Next we had cake & ice cream and then Luke played his new Gamecube game, Sonic Heroes, for a little while before bedtime.


On Saturday I took Luke to Target to get some Transformers with the birthday money he was given. We still plan on taking him to Nickelcade sometime to play on the arcade games there (that's what he wanted to do for his birthday). I was hoping to go on Saturday but with DH not feeling 100% and the funeral proceedings of Pres. Hinckley that we watched, we decided to postpone it for another day. Saturday evening my parents dropped by to give Luke the presents from them. All in all I think he had a good birthday and is definitely enjoying his new Transformer toys & Sonic Heroes...