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From Epidurals To Home Birth- Meet Instructor Hailie in Abilene, TX

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Birth class couples after playing a game to learn how epidurals work in Hailie’s birth class!

We are excited to share with you a series of articles highlighting our diverse group of birth instructors. These are the amazing women who are doing real work trying to make birth better for women and their families all over the world. Today we introduce Hailie Wolfe, a birth teacher in Abilene, TX, mother of five (and kinda famous You-Tuber) who has birthed in so many different ways. In fact, one of her birth videos is featured in our classes! We love Hailie and we are sure you will too. Thanks and enjoy!

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First, could you introduce yourself? Tell us a little bit about your own birth experiences and how they influenced your desire to teach birth classes.

My name is Hailie Wolfe and I own Country Bumpkin Birth Services in Abilene, TX. I have five children – four of them were born in the hospital; three of which were medicated and one was unmedicated.

My medicated births were very standard hospital births. There were several things that I didn’t like about those experiences, but it was years before I realized that how I was made to feel for those births really DID matter. I had some wonderful nurses, but oddly enough, the one I remember most was the one who treated me terribly and that makes me sad. I was given routine episiotomies. I was given the highest pitocin drip on more than one occasion. I thought all of this was “normal”.

When I became pregnant with my 4th child, I decided I wanted to do things differently. At the time, we planned for #4 to be our last baby and I didn’t want to miss out on the opportunity to experience birthing naturally. I came to view it almost as a rite of passage I had missed out on because of my ignorance during my previous pregnancies. When I gave birth naturally, I finally understood WHY it was so important. I had an easy postpartum recovery for the very first time. I was on a birth high for days and felt very empowered.

I enjoyed birth so much that it influenced our decision to add another baby to the family. My fifth child, a surprise breech birth, was born at home in my bath tub. You can watch her birth video here: https://www.youtube.com/watch?v=oFabMR4sg5g

I was able to have a natural birth with self education, but the whole time I was pregnant with my 4th child I wished there was an accessible class where I could get the information in one place. That inspired me to become a Birth Boot Camp instructor. I wanted women in my community to have easy access to this important information. 

What first got you interested in the realm of birth?

Looking back, I always have had an interest in birth itself. I remember as a teenager being really into watching shows about birth on the Discovery Channel and being disappointed when they didn’t actually show the baby come out. When we had to watch The Miracle of Life in high school health class, I was secretly excited to see what it would look like for a baby to come out.

I’d like to say that I was so inspired by birth that I went into the medical field after high school, but that would be a lie. I didn’t want to go to nursing school because I didn’t want to wipe butts or clean up puke – no gross stuff for me. I don’t know why I didn’t realize that was in the job description for motherhood, because I signed up for that without concern! I became an elementary teacher where I wiped noses and pulled teeth. What can I say? I have a mothers’ stomach.

The point that REALLY got me interested in pursuing birth work was when I went through a very painful induction with my third child and had a terrible recovery. When I decided to go natural with my fourth and I had such a wonderful experience – that was when I really discovered my passion sharing birth with others.

What are your particular passions concerning birth?

Over the last few months, I’m becoming increasingly interested in reaching disengaged dads. I hear birth workers constantly blast dads for thinking birth classes, doulas, etc. are a waste of money. It hits home for me because my husband was one of those dads. He pretty much agreed to hire a doula just to make me happy – but then seeing was believing for him. He was amazed at how much better the experience was when we birthed with a doula. I want to figure out how to reach the skeptical dads like my husband, and I want to reach them before their wives are insisting on having a doula because they’ve been through a bad experience. I’m preparing to host a Doula Dad night soon so that my husband can speak to other dads about the benefits of having a doula. I’m hopeful that hearing another dad’s perspective will encourage others to be more open about birth preparation.

There are lots of different birth educator training programs out there. Why did you choose Birth Boot Camp?

I actually have a dear friend, Megan Martin, who teaches classes in Burleson, TX. When I voiced my interest in Birth Boot Camp she really encouraged me to go for it. I didn’t even do very much research on other programs. The organization is very transparent about their beliefs, which perfectly align with my own birth philosophy. It is clear, concise, and complete, and those are attributes that will truly prepare couples for birth. I knew early on that it was the right program for me to teach

Tell us a little about your Birth Boot Camp training experience. Where did you train? What did you like about it?

I attended Birth Boot Camp instructor training in July 2013 in Grapevine, Texas. I really enjoyed getting to meet and gain knowledge from other woman across the country who share the same passion as me. I love my children with my whole heart, but it was refreshing to stimulate my brain for a few days alongside a great group of ladies.

During my hotel stay for the training, I was roomates with Lauren McClain, creator of MyBreechBaby.org. She taught me so much about breech birth during break times and when we’d stay up late chatting. I remember thinking how great it was that I was learning all this new breech information in preparation for teaching other moms. I never would have dreamed that I would personally be putting all that information to use when I delivered my own surprise breechling just three weeks later. I will never forget Lauren.

How is teaching your own classes going for you? What do you enjoy most about it? 

Each series I’ve taught has gone great! The part I enjoy most is getting to connect with couples and share information that I wish I had known earlier in my birthing years. It makes me feel like I am making a difference. It is also incredibly enjoyable to see dads gradually become more and more engaged in birth preparations. Over the 10 weeks it gets very “real” for them. It’s a neat process to watch.

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Hailie with her youngest baby, born at home.

In what ways did the Birth Boot Camp teacher training help prepare you for teaching actual classes?

I was really nervous at instructor training when we had to individually teach a specific topic. It was reminiscent of my elementary teaching days when the principal would come in for observations; judgement from colleagues can be intimidating. BUT, it was completely judgement free with lots of constructive feedback and I even learned new information from some of the other trainees during their presentations.

I also really liked that we practiced relaxation exercises and labor positions in groups. You’d be surprised how difficult it can be to read aloud using a “yoga voice” for the first time ever. It was great practice, though! I was 36 weeks pregnant at the time, so it was super relaxing to be the guinea pig for some of those – I felt like I was getting pampered at the spa!

Tell us a little about your students. How do you believe childbirth education is having a positive impact on them? 

I feel like my students are benefiting so much just from hearing about all the choices they will be making for in preparation for their births. My students almost always leave with a list of questions for their care provider that they would have otherwise never known to ask . I truly feel that it’s also helping the dads be able to connect with the pregnancy on a more meaningful level. As the series progresses, I notice dads becoming more confident in their ability to make joint birth decisions,  and also more confident in their ability to be a good support to their wife on the day of baby’s arrival. Seeing the friendships develop between the couples is great too.

To close, tell us how you see natural childbirth education having a positive impact? Why does this work matter to you?
Specifically in my community, where we have a 37% cesarean rate, I am hopeful that my empowered students will go out into the community and share the impact that education had on their births. I really feel this will lead to more and more couples investing in their births and having more positive experiences. Also, when we as women are educated, we can hold our doctors accountable and at a higher standard. This is the first step in lowering the astronomical cesarean rate in the Big Country.

Where can we find you?
A few different places, actually! Come visit me. I LOVE communicating with moms and dads who are interested in birth!
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Rock Your Natural Birth…at the Hospital! – Guest Post By Lauren Rauseo

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Today we have a guest post from Lauren Rauseo. A mother of three and author of the recently published book, “Natural Birth for the Mainstream Mama,” we are excited to share her thoughts on some basic things that can help you have an amazing natural birth in a hospital. Her book just happens to mention us as a possible childbirth education option and we couldn’t be more pleased! As you can see, she gives some great advice for getting the birth you want in the hospital, and she manages to do it in a funny, approachable and readable manner. Check out a review of Lauren’s book here and find it on Amazon.

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So you are planning a natural birth. You imagine dimmed lighting and quiet music as you labor, and a peaceful entrance for your baby. The thought of monitors, drugs and a doctor shouting, “Push!” at your va-jay-jay gives you the heebie-jeebies. Maybe you don’t see yourself popping this kid out on your living room sofa, but you long for a more home-like experience.

While the hospital offers comfort that you’re in the right place in the event of an emergency, it also brings a few challenges when preparing for an intervention-free birth. Follow these five tips so that you achieve your goal to go au naturale at the hospital.

1. Choose your hospital and care provider wisely.

This is, hands-down, the most important piece of advice you’ll get. Even if you’ve been with your OB/GYN since you got your first period, you need to interview him like you two just met. What is his C-section rate? What were the reasons for his last 10 surgical births? And since you never know who will be on call on the big day, are the other providers in the practice aligned philosophically? Don’t forget to find out what the hospital policies are as well. How long can your water be broken before the baby needs to be born? Are you allowed freedom of movement during labor? Are different positions encouraged for pushing? What are the monitoring requirements for a low-risk delivery?

Listen to not only what he is saying, but also how he is saying it. If your hunch is that he is not supportive of natural birth, then he probably isn’t. Even if your due date is close, it’s never too late to find a care provider that’s more in line with your birth plan. Consider switching to a midwife. Her expertise lies in trusting a woman’s body to do what it was physiologically designed to do, and not looking for crisis at every turn (but don’t worry; she can recognize warning signs when there is something that requires attention).

If your care provider truly believes in your body’s ability, your natural birth has a much better chance of happening. Your job is to find that care provider.

2. Assemble a supportive team.

Now that you have the right medical crew lined up, you can rest assured that you wont be offered interventions during your birth unless it’s absolutely necessary. (Half the battle has been won already!) But that doesn’t mean you won’t be asking for an epidural yourself when you’ve been in labor for 24 hours and you’re only 4 centimeters dilated.

That’s why you need your birth peeps cheering you on! First, make sure your partner in life is on board with all this natural jazz from the get-go. You both need to see eye-to-eye on your goals, and he’ll need to stand strong as your advocate that day.

But maybe even more important will be your doula, or labor coach. She’s a non-medical birth professional who actually knows what she’s doing and how to be helpful to you in your time of need. She’s seen a lot of these natural births go down, so she’ll know when it’s time to go to the hospital, how much counter pressure to apply to your hips, and why getting on all fours may help baby into a better position.

3. Make a commitment.

Have you ever said you’re going to decide whether you’ll get up early to exercise when your alarm goes off? How often does that strategy work? I’m guessing never. You must commit to your decision and eliminate the option to hit snooze. Likewise, when someone asks you if you’re going to have a natural birth, your answer should be simply, “Yes.” If yours is, “Well, I’m going to see how it goes,” then you have commitment work to do. You need to walk into this adventure with 100 percent confidence that you will do it.

Repeat after me. “My body was made to birth this baby. It will be hard, but I trust this process. I am about to have the best day ever!”

4. Retrain your brain.

Maybe you’re afraid of committing to this because you are terrified of birth! This isn’t surprising. You’ve been trained to be afraid of this event your entire life. How many times have you heard, “Childbirth is awesome! You’re going to love it!”? Zero. Mostly, you’ve been listening to women regale horror stories, and you’ve been watching ridiculous TV that exaggerates the risks and hyperbolizes the pain of childbirth in the name of ratings. You need to stop all that crap. Immediately.

Instead, surround yourself with women who have positive birth stories to share. There are plenty out there! Common themes will include a supportive midwife, an inspirational doula, lots of movement, infrequent (or no) cervical checks, intermittent monitoring, mother-led pushing, immediate skin-to-skin with baby, and overall, an environment where the mother’s voice was heard and respected.

Go places where there are others who are also preparing themselves for an empowering birth. Try a natural-focused childbirth class, and stay away from hospital-based classes, as those will likely center on risks and interventions. Read natural birth blogs and follow them on social media for constant bursts of inspiration. Once you’re in the right frame of mind, it’s easy to commit to your goal. Don’t fear for this birth; get excited for it!

5. Be patient and relax.

Patience begins while you’re still pregnant. Perhaps 41 weeks pregnant. Remember, your baby knows when to be born. Once labor does begin, trust me, you’ll be glad you refined this skill. Your doula will use comfort measures to help you during labor. Maybe she’ll rub your back, let you squeeze her hand, or read birth affirmations aloud. But none of that will help if you’re tense and working against your contractions. In order for your cervix to open, you need to totally let go and release the tension from your body. Think savasana at the end of a yoga class times a hundred; that’s how relaxed you should be. Practice often so that you’ll be able to bring yourself into relaxation more easily on the big day.

Each contraction only lasts one minute or less, even during the hardest part. And I know you can do anything for one minute. Never think about how much longer you have to go. Just breathe into this one contraction you’re having right now.

So there you have it! Are you ready to rock this natural hospital birth? Remember, every moment of this journey is fleeting, and each minute that goes by brings you one step closer to the prize: Your baby. Come on now, you got this.

If you like what you read here, get the whole book, Natural Birth for the Mainstream Mama, in paperback or ebook. http://www.amazon.com/Natural-Birth-Mainstream-Mama-practical-ebook/dp/B00I3448X0


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Lauren Rauseo is a work-from-home mom to Dylan, Liv and Fiona. Her favorite things are going for walks with the kids to collect “treasures” and singing in the car, and she isn’t afraid to admit that Starbucks, manicures, wine and yoga make the list too. Now that she’s done birthing her own brood, she has moved on to sharing her enthusiasm for natural birth with others through her book, “Natural Birth for the Mainstream Mama: A practical guide to achieving a drug-free birth in a hospital setting”, available on Amazon (http://www.amazon.com/Natural-Birth-Mainstream-Mama-practical/dp/1494415321). You can follow Lauren at www.facebook.com/MainstreamMama.

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Doula Myth: I Don’t Need A Doula, My Nurse Will Help Me!

 

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Today we are excited to share a guest post from an incredibly experienced doula and one of the driving forces behind our very own Birth Boot Camp DOULA program, Maria Pokluda. Maria’s words of wisdom on the importance of and difference between both a doula and a labor and delivery nurse are so important.  Enjoy reading, and share with your pregnant friends!

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I attended a birth recently at a local hospital. When we arrived at the hospital the nurse greeted us and did all the right things: she asked for the couple’s birth plan, she told them that everything on their birth plan looked acceptable and she smiled as they talked about their plans. She was a great nurse and this couple (who took a Birth Boot Camp class) did go on to have a pretty amazing natural birth many hours later. As the nurse was leaving at shift change, she mentioned that she was excited to have seen a natural delivery because she had only seen ONE other natural birth in the SIX years she had been working as a labor and delivery nurse. I am still stunned by her comment and I think (and hope) that her experience is not reflective of all nurses who work in labor and delivery rooms. However, the fact is that it is neither a nurse’s primary job nor the focus of her training to help couples have a natural birth.

All couples birthing at a hospital will have a labor nurse, and I frequently get asked why a couple would need a doula since they will have this nurse to help them while they are at the hospital. Labor and Delivery nurses are a wonderful resource, however they have the clinical duties of monitoring baby and mom, the charting that is part of today’s medical care and they also have other patients – how many depends on the time of day and how a particular hospital staffs the floor. All of these other roles can limit the amount of time a nurse has to spend taking care of mom’s physical and emotional needs, but perhaps more importantly, most are simply not trained in helping women who are planning a natural birth and many don’t see natural births all that often.  If one sees medicated births day in and day out, that becomes the norm and a couple planning a natural birth will seem unusual.

In a study examining pregnant women’s expectations, first time mothers anticipated that their nurse would spend 53% of her time offering physical comfort, emotional support, information, and advocacy. However studies have shown that the actual amount of time an obstetrical nurse spends doing these things is closer to 6%*. With hospital interventions at an all-time high, nurses may want to do these things for women, but the reality is that they have to spend a lot of time just managing medical concerns and hospital policies. In fact until a women starts to push, nurses do not usually spend time in the labor room but rather monitor remotely at the nurses’ station. In my own experience as a doula, it is not unusual to attend a whole labor and never see the nurse touch mom in a non-clinical manner. She may move fetal monitors, take a woman’s temperature or feel her cervix by placing her fingers in mom’s vagina but never touch the mom outside of these tasks.

On the other hand, a doula’s primary focus is on the laboring couple. Her continuous care allows for her to respond quickly, make recommendations based on how labor is unfolding and provide immediate emotional and physical support. A doula sees natural birth all the time. She is familiar with the sights and sounds of normal labor and can often anticipate what a woman will want as she labors. She is trained to suggest position changes, relaxation methods and comfort measures. If a couple has taken a great birth preparation class they will have confidence and information, but that does not replace having someone there to answer questions and provide ongoing encouragement. A doula does not have to analyze a fetal heartbeat, administer antibiotics or enforce hospital policies.

The relationship between an expectant couple and their doula is also different than with their nurse whom they generally meet the day of delivery. The doula has likely been working with the couple prenatally and often has been laboring with a couple in their home prior to arriving at the hospital. The doula will know the couple’s desires, their concerns and even the dynamics of the couple’s relationship.  She knows if a relative is someone that should be in the labor room. She knows that mom wants to have the cute nursing bra on for pictures even if she says she doesn’t care at the time. A doula is there through as many shift changes as it takes which offers stability when other faces may be changing and a doula will stay with a laboring woman so her partner can get coffee, check on older children or get some food. In the weeks after the baby is born, the doula is available to talk, to answer questions, and to process concerns.

Despite all the things I just listed that doulas do, a nurse’s role is just as important. The way most hospitals operate means that the labor nurse is the primary liaison between a couple and their care provider. She will be the one calling the OB and passing along the details of the labor, she will be the one that makes ongoing analysis of baby’s wellbeing.  In the rare event that something needs immediate medical attention, it may seem as though the OB is swooping in to save the day…but it will be the nurse that calls the OB to come. Part of a nurse’s training is being a patient advocate. The American Nurses Association includes in its definition of nursing  “advocacy in the care of individuals, families, communities, and populations.” Nurses can advocate for a couple’s expressed treatment preferences which is a very distinct and different role from that of a doula who can help couples express preferences, consider options and facilitate communication, but not actually advocate for a couple or act as a liaison.

I remember working with an excellent nurse at one birth where the care provider and the couple were in disagreement of the use of a routine intervention that was part of hospital policy.  The nurse pulled a chair up to the bed and told the laboring couple exactly what their options were, what could be expected to happen with each choice and how to say no in a manner that would be most respected by the care provider.  She also took it one step further and told the couple that she would speak to the care provider on their behalf and that she could be the one that told the care provider that they had declined. While this may not be a common scenario, a nurse can choose to do this as part of her job; a doula cannot.

The roles of the labor nurse and the doula will overlap in some areas which actually works out well as very few couples will complain about extra support, but they also have marked differences. Ideally the roles should complement each other, which is why laboring couples need both. With a great nurse and a great doula a couple can expect to have an empowering birth.

 

Maria Pokluda has been a doula serving the Dallas/Ft. Worth area since 2004.   She has a Masters in Political Science and while she finds that slightly funny, she feels her degree helps her work with all types of people and she can now appreciate those statistics classes as she reads the research about evidenced practices in maternity care.  In the last 10 years, Maria has attended hundreds of births, helped form Dallas Birth Network and in 2013 and 2014,  she was voted Best Doula by North Texas Child Magazine. (Maria has recently co-written the Birth Boot Camp Doula program and can’t wait to start training Birth Boot Camp Doulas.)   Maria has been married to Brian for 18 years and they have 4 children, each with a very different birth story ranging from one with all the bells and whistles in a hospital to a homebirth.  

* Tumblin A, Simkin P. Pregnant women’s perceptions of their nurse’s role during labor and delivery. Birth. 2001;28(1):52–56. [PubMed]

 

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Registered Nurse and Natural Birth Instructor- Meet Shazia!

Birth Boot Camp now has over 100 instructors spanning from coast to coast in the United States and a couple in other countries (and more to come!) We simply adore our birth instructors and are so glad they have taken this leap with us to help make birth better through education. Because there are so many of them now we are eager to introduce them to you! Our instructors are diverse in every way imaginable but have one thing in common- they were changed by birth and they want to share that power with you. Our birth teachers know that YOU can have an amazing birth. They know it.

Today I am pleased to introduce you to Shazia Lackey, one of our very first certifying birth teachers. She teaches birth classes in Arlington, TX. Below is an interview with this amazing woman. Check her out!

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First, could you introduce yourself? Tell us a little bit about your own birth experiences and how they influenced your desire to teach birth classes.

Hi! I’m Shazia Lackey. I have one son and am currently pregnant with my second. I had my first baby in 2011 with the help of a Certified Nurse Midwife (CNM). It was a great birth experience that set me up for an easy postpartum recovery. I also successfully nursed my son until he was 23 months. I know that my unmedicated birth set us up for breastfeeding success! Not to mention my son and I being healthy and complication-free, my birth was incredibly empowering! I knew I wanted to help other moms achieve that experience with their own births!

What first got you interested in the realm of birth?

I have been a registered nurse since 2008. I was fortunate that I had amazing instructors at the University of Texas at Arlington School of Nursing. One of my professors was even a CNM! I learned so much about evidence based birth practices during my time in nursing school that I knew it was the best option for me and my baby. My husband and I prepared for a natural birth by taking a comprehensive birth class. I was empowered by my own birth experience and I wanted to help other couples with their journey preparing for birth!

What are your particular passions concerning birth?

I am passionate about giving moms and dads all of the information that they need so they can make their own decisions to ensure the best birth possible. I also love that couples who prepare and plan for a natural birth are more likely to be successful meeting their breastfeeding goals. I am a huge breastfeeding advocate. I nursed my son for 23 months and have served on the lactation committee at a local pediatric hospital for the last 2 years. I have the privilege in my nursing career of helping other moms nurse their babies as a breastfeeding resource nurse for my department at work. I also am beginning to help lead a local mom to mom breastfeeding support group! I utilize this passion to help each and every one of my Birth Boot Camp students succeed with breastfeeding.

There are lots of different birth educator training programs out there. Why did you choose Birth Boot Camp?

Birth Boot Camp covers EVERYTHING! While my husband and I were well prepared for birth, I do feel that we missed out on some crucial information during our comprehensive birth class. I love that Birth Boot Camp also covers pregnancy, breastfeeding, postpartum, and newborn care. I also love the up-to-date and modern material we use to teach Birth Boot Camp curriculum.

Tell us a little about your Birth Boot Camp training experience. Where did you train? What did you like about it?

I trained to become a Birth Boot Camp instructor in April 2013 in Texas. I loved getting extensive information to help me teach my classes and be successful as an instructor. I also loved getting to network with other birth professionals from all over!

How is teaching your own classes going for you? What do you enjoy most about it?

I have been teaching for a little over a year now and am currently teaching my 5th class series. I love it! I love getting to know each couple during the 10 week series and especially love hearing about their great birth experiences! Many of my students have stayed in touch and I enjoy seeing their babies grow and helping moms with breastfeeding and newborn care!

In what ways did the Birth Boot Camp teacher training help prepare you for teaching actual classes?

I loved that I met moms at instructor training who have had all types of birth experiences! It was so helpful to hear their stories. I take much of what I learned from them and incorporate that into my teaching. For example, I haven’t had a home birth myself, but through the experiences of other instructors, I can confidently prepare my students who are planning a home birth.

Tell us a little about your students. How do you believe childbirth education is having a positive impact on them?

I have taught 17 couples since I became certified last year. I have seen first time moms achieve amazing, empowering birth experiences. I have seen second or third time moms finally get the birth experience they deserve! I have even seen moms who have had complications during birth and were well-prepared to handle them and still went on to have a great birth!

One of my second time moms was adamant about having a better birth this time around and her husband was totally not on board. He came to class each week but rolled his eyes and even fell asleep a few times! She ended up having an amazing birth experience! At our class reunion, her husband was a completely changed man! I have seen women be moved and changed from their birth experience, but never a dad! It was amazing. He spoke about her birth experience with such passion. He admitted that he was totally skeptical going in to birth and afterwards said he tells all of his friends and coworkers with pregnant wives to take Birth Boot Camp! He was especially impressed with his wife’s postpartum recovery. He said it was amazing how much faster she bounced back after her birth than the first time. He also said he felt he bonded instantly with this baby that he attributes to being involved in the birth instead of sitting on the sidelines the first time around.

To close, tell us how you see natural childbirth education having a positive impact? Why does this work matter to you?

Our maternity care in the United States is suffering! Many women believe that all of the interventions are “necessary” and birth is painful and awful. I have encountered many women who have thought I was completely nuts for telling them my birth was amazing and their birth can be too. Natural childbirth education is not only preparing moms and dads to achieve a natural birth, but also to empower and encourage other women around them to do the same!

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Where can we find you?

I teach classes in Arlington, TX. You can find my class schedule and contact information at www.AboveBeyondBirth.com

And you can hear from Shazia on our You Tube channel!


https://www.youtube.com/watch?v=7jsktW5weiU&list=UU9VTK51bWOJ5o0S5A0h8VWw

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Should I Circumcise My Baby? Guest Post By Dr Adrienne Carmack, Urologist

We are honored today to share a guest post from Dr Adrienne Carmack, a board certified Urologist and mother of three who is also a strong voice in the growing tide of medical personnel questioning and challenging the common practice of routine infant circumcision. Dr Carmack has also recently published a book detailing her fascinating story as she questioned much that she had been taught when it came time to make decisions for her own family regarding parenting, birthing and breastfeeding. 

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Should I circumcise my baby?

When I began my training as a urologic surgeon in 2003, I believed, and repeated, the recommendations of national medical societies such as the American Academy of Pediatrics: circumcision is the parents’ choice because there are risks and benefits that are nearly equal. I remember saying that there were good reasons to do and to not do it, and that I would just leave the choice to my husband, since he was the one with a penis.

Well, that changed. I learned of female genital mutilation (FGM), frequently referred to as female circumcision. Some forms of FGM are very extreme, and not at all analogous to circumcision, such as removing the entire clitoris and most of the labia and suturing the vaginal opening closed. But there is a spectrum, with some cultures practicing FGM in a way that is like male circumcision, such as cutting the clitoral hood to make it bleed or removing some of the skin covering the clitoris.

When I learned of FGM, it really got me thinking about newborn male circumcision. By this time, I’d witnessed a handful of newborn circumcisions, and, anesthesia or not, it was not a pretty sight. The baby cried, there was blood, the penis swelled and was tender for days, many of the babies were brought back in by worried parents because of the amount of swelling and pain they seemed to be experiencing. And, I saw many, many baby boys who had to have surgery when they were older because their circumcisions had not healed well.

I began to do my own research on male circumcision. What I found has led me to believe that the guidelines by medical societies that say it’s the parents’ choice are frankly unethical and untruthful. The most basic tenet of medical practice, one which all doctors swear to before they are granted their degree, is “First, Do No Harm.” The truth is, circumcision is harmful. And, the purported benefits, which supposedly balance out or even outweigh the harm, are quite small.

The cited benefits for circumcision include reducing the risk of urinary tract infection in the first year of life, decreasing the transmission of sexually transmitted infections, and reducing the risk of penile cancer. All of these potential benefits are based on science which is highly debatable, and definitely not clear cut. I’m not going to go into the data here, but a quick Internet search will show you many potential flaws in this data.

Even if we assumed it were true, however, in the case of a healthy infant, none of these potential benefits justify harm. First, none of these diseases are going to happen absolutely to all intact infants. They are risks, and they are low. If the risk of UTI is 1%, that means 99 boys must be circumcised to prevent 1 boy from getting a UTI, which, for most babies, is not a major life-threatening illness. Sexually transmitted infections are far better prevented by use of barriers, abstinence, and careful selection of sexual partners. And penile cancer is effectively reduced by simple hygiene.

The risk for a circumcision being needed later is similarly inadequate to justify routine newborn circumcision. Most conditions that I see that require circumcision at a later date are due to manipulation by parents or physicians that is not necessary, or occur much later in life as a consequence of other medical problems that are poorly managed, such as diabetes. (We no longer remove appendixes when a patient is having unrelated surgery, even though the patient may develop appendicitis later. We respect that any surgery, as low risk as it may be, is still a big deal, and that the appendix probably has an unrecognized role.)

All of these risks are theoretical risks that could happen if circumcision is not performed. Let’s look at the real risks that do happen when the intervention of circumcision is undertaken—some very clear violations of First, Do No Harm ethics.

Many people argue that circumcision is not harmful. Many grown men say they don’t remember it and their penises work fine (although many are also speaking out sharing the opposite experience). Many people tell stories of circumcisions they don’t believe were traumatic, that their baby boys “tolerated” well, or “slept through.”

If you’re considering circumcising your boy, the first step you should take is to watch a video of a routine newborn circumcision. There are plenty on YouTube. Watch one, and then say that it’s not harmful. It hurts and it is a terrible thing to expose a new baby to when born.

Most potential circumcision complications are uncommon, just as are the diseases which circumcision is proposed to lessen, but they do occur. Babies die from circumcisions, babies bleed and have to be taken to surgery, babies get infections, babies have too much skin removed, babies have too little skin removed and develop scarring that has to be surgically corrected later on, babies suffer pain during and after the circumcision, babies have damaged urethras, and some babies have even lost their entire penis.

More importantly, the reason for “First, Do No Harm” is that we are creating potential problems where none exist. We are also intervening with nature. The foreskin is present for a reason. It has been proven to be full of nerve endings and is widely recognized as an important erogenous part of the penis, just like the clitoris is an important part of the female genitalia. (See “Male circumcision decreases penile sensitivity as measured in a large cohort” published by Bronselaer et al in BJU International in 2013.)

The foreskin is not just a piece of skin; it is a highly developed anatomic sensory organ. It also protects the head of the penis and the urethral opening, both very sensitive tissues that are best kept covered until the child is able to retract his foreskin himself. (He does not need his mother’s or his doctor’s help to do this.)

Remember that a healthy foreskin is just that. There is no need to remove it any more than there is a need to remove a healthy appendix (even though the child might suffer appendicitis later, might have to have surgery later, might even die from the appendicitis). The foreskin has important roles and is there for many reasons.

Circumcision is traumatic, and this cannot be denied. If you are considering circumcision, please, watch some videos, read stories by grown men who had “uncomplicated” circumcisions and are not happy, and reconsider taking actions that are painful and that interfere with nature when there is no problem to begin with.

Dr Carmack's recently published book.
Dr Carmack’s recently published book.

Adrienne Carmack, M.D. is a board-certified urologic surgeon, a practicing physician, and a natural birth and breastfeeding advocate. During her urologic training, she discovered that US medical studies on circumcision are profoundly flawed.

Driven to learn the truth, Adrienne reviewed international medical research first on circumcision and then on natural birth and breastfeeding. She realized that most American birth practices are founded, not on fact-based science, but on current cultural norms.

Adrienne believes that all parents have a right to know the medical facts around birth rights, which she defines as the rights of mothers and children to experience safe, natural births free of unnecessary interventions.

As a doctor, she supports medical intervention when it is appropriate and necessary. However, she has made it her life’s work to free parents and children from the unnecessary medicalization of normal life events.

Adrienne completed her urology residency at the University of Miami in 2007, surgery internship at Vanderbilt in 2003, and medical school at Texas A&M in 2002. She is on the Board of Medical Advisers of Intact America and is a member of Doctors Opposing Circumcision.

She is the mother of two girls and a boy, all of whom were born outside of a hospital and breastfed and none of whom were circumcised.

You can find her book, “Reclaiming My Birth Rights” HERE.

More info about circumcision from our instructors:

Basic Facts About Circumcision by Rachael Hope (Washington State)

If My Girls Had Been Boys by Dani Long (Germany)

Circumcision Regrets by Cori Gentry (Salinas, CA)

And an Interview with Dr Carmack

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