Mark Sloan is a pediatrician and writes about birth and newborns from a unique perspective not often seen in the world of pregnancy and birth books. Sloan has meticulously researched the book.

Birth

You’ll be pulled in immediately as Sloan recounts his own introduction to birth during medical school. From there Birth Day tackles how our own vaginal birth process differs from that of the higher primates – and give possible reasons for why we developed such a complex process of birthing. I differ in opinion from Sloan on some of these issues; however his arguments are well-reasoned and interesting to read. Sloan also discusses the history of vaginal birth and positions used during birth in this chapter.

The second chapter moves into a description of that almost-imperceptible transition babies go through – moving from a fetus living in the water-world of the womb to a newborn snuggled in the airy world of his or her mother’s arms. You’ll find this chapter fascinating. Again, Sloan will keep you turning pages as he weaves the stories of two babies into the factual information.

In the third chapter Sloan discusses cesarean birth. This chapter is really well done. Sloan presents lots of information on the history of cesarean then moves into what the surgery looks like in modern times. The book does a great job of explaining how and why cesarean birth may be necessary for some women and babies – while also acknowledging and speculating on just why the cesarean rate is currently so high.

Pain Relief – Past and Present

Chapter 4 is titled “B.E. (Before Epidurals)” and it’s a fascinating chapter! Sloan has done a good job researching the use of pain medications during childbirth. It’s very interesting to look back at where we’ve come from – and the book moves right into where we are now in Chapter 5. Sloan continues to explore childbirth pain relief from a modern perspective. You may be surprised to learn that in our epidural-dominated world there are other options – including options available outside the US that well, you just can’t get here.

I believe in natural childbirth, but even I have to wonder why some of these relatively effective and possibly less detrimental options are not really available to more women. As Sloan states, ours is a culture of epidurals.

Birth Day does take time to discuss five non-drug methods of pain relief during childbirth. It does a fair job with this, even discussing water for labor pain relief. Sloan does not bring up the issue of water birth (where the baby is actually born underwater) – in fact, he never comments on other birthing alternatives like birth center or home births and how they may affect labor pain or the perception of it.

Doulas are discussed – in a fair amount of detail. Sloan is a fan of doulas, and for good reason. He spells those reasons, all supported by research, out in Birth Day. He also discusses the history of birth attendants.

On Daddies and Babies

There’s a chapter devoted just to Daddies. My husband greatly enjoyed it. We both found it really interesting that new dads (and dads to be) actually go through hormonal changes during their mates’ pregnancies.

The final section of the book covers the cuddly result of pregnancy – the babies. Sloan covers much of the research done on what babies can and can’t perceive with their sense while in the womb, and in the newborn and infant period. It’s interesting reading, though a little drier than earlier chapters of the book!

A chapter covering the “baby worth rearing” is included here. I greatly enjoyed this chapter, which discusses how the current infant “rating” system – the APGAR – came to be. I also found the peek into modern-day pediatrics with its newborn procedure flow-charts to be fascinating.

The last chapter in the book does an inch-by-inch guided tour of the newborn. This chapter has become a favorite “inside joke” of my husband and me because it discusses possible reasons for babies to be pretty generic (Sloan theorizes it’s probably so a man would continue to raise a baby that may not have biologically been his own). Accusations of our own “generic baby” (who with flaming red hair is not exactly “generic”) fly regularly through the house (along with laughter).

But the chapter in itself is a great ending to the book, providing the now expected fascinating tidbits of information on why babies may look like they do, why your science teachers got some things wrong, and other interesting facts.

Sloan does use this chapter to address circumcision. He does a great job tackling this extremely controversial subject. He gives a lot of historical information, good references, and a balanced discussion.

A Real Page-Turner

All in all Birth Day is an excellent read. There were a few parts of it I found myself feeling may be over the top – my views and Sloan’s do differ. But as I stated early in the review, it all gives food for thought.

The entire book is well-written in a consistent and engaging style. Birth Day keeps you turning pages! Because it does discuss some heavier pregnancy and newborn issues you may want to avoid reading it in your third trimester. But otherwise pick it up for an enjoyable and really fascinating read!

I know this is going to differ based on what country you’re in, and where in that country you’re located.  Midwifery regulations are so different all over the world.

I’m in the United States so my experience of midwifery care is different than what a woman will experience in Canada, the UK, or elsewhere.

But here in the US midwives come in a few different varieties.  There are certified nurse-midwives who go through nursing school and then get additional training in birth.  There are also some states that license midwives based upon guidelines the state has determined; often these midwives are “lay midwives” meaning they’ve not gone through nursing or medical school.  They have, however, trained extensively.  There are also midwives who are not licensed and are lay midwives.  Some of them seek and independent certification which makes them certified professional midwives.  To get this certification they must pass rigorous testing (learn more at The North American Registry of Midwives).

So what are my thoughts on this?  I definitely think that women called to be midwives should not be required to go through nursing school first.  I  may be biased because neither of my midwives have gone the nursing route.  But in reality, in the US at least, most women who choose home birth are going to give birth with a “lay midwife” because most certified nurse-midwives deliver only in hospitals or birth centers.  Very few attend births at home.

I think that a lay midwife can and (in general) will know birth as well as a certified nurse-midwife.  They train extensively under midwives in the oldest way to learn a trade – apprenticeship.  A midwife will have attended many, many births before she begins to see clients on her own.

As for my thoughts on licensing:  I do not think a woman must be licensed to be a competent midwife.  However, I am in favor of licensing such as the Certified Professional Midwife licensing.  I believe it gives a level of assurance to the family seeking a midwife’s services.  It causes the midwife to keep current with studies, techniques, and literature.  It shows accountability and professionalism.

State (or national) licensing varies and at times it can be a hindrance – some states may say that women seeking a VBAC (vaginal birth after cesarean) cannot attempt a home delivery with a state licensed midwife.  Others say no twins.  A midwife who doesn’t follow state protocols for things could be penalized severely.  However, in general state licensing again provides a measure of reassurance to the family.  It creates accountability for the midwife, and can help bring midwives together into a unified network.

I am, in general, in favor of licensing midwives and I feel good about midwives who seek to be licensed in some way.  There are sometimes restrictions placed on these midwives that they (or their clients) would rather not have.  But in general licensing is a good thing from the viewpoint of the client.

Of course there will always be unlicensed lay midwives.  There will always be unassisted childbirth.  Women have the freedom to choose what they want.  But I do think that licensing is generally a good thing for families, and a good thing for midwives.

If you have an opinion (if you’re a woman using/considering a midwife, or if you’re a midwife) feel free to comment on this thread or contact me

More on eating well! During pregnancy (and lactation and preconception) you need to be eating a really nutrient-dense diet. Children also need lots of nutrition packed into all their meals – in fact, there’s not much room for empty calories.

So even if you’re not dieting (don’t diet when you’re pregnant or nursing an infant!) low-carb can help you make sure you aren’t filling up on carbs that aren’t nourishing you – or your kids.

Enter my Real Food Wednesday snack today: Braised Marrow on Raw Milk Cheese.

Marrow is a very nutrient dense food that is happily regaining popularity stateside.  In the UK it’s often eaten just spread on toast.  I decided to braise ours for a little more flavor.

It turned out well – yum!

You need:

• Bone Marrow (I used thin cut slices of beef marrow because these are a good size for the kids; they’re cut about the size of scallops.  You could also use 3-inch pieces of marrow and serve the cheese on the side)
• Salted Water (optional)
• Coconut flour
• Salt and Pepper to taste
  
• Braising fat (I used tallow, I think next time I’ll use coconut oil, or a coconut oil/butter mix)
• Raw milk cheese, sliced (about 1oz slices are perfect for pregnancy, slightly thinner for kids)

1. Pop marrow out of bones.  Reserve bones for stock-making!

2. Soak the marrow in salt water to draw out most of the blood, if so desired.  I skipped this step but you may want to.

3. Dry marrow well.  Mix flour, salt, and pepper.  A few tablespoons of flour will be good unless you’re doing a lot.  Roll marrow segments until completely coated.

4. Heat your fat.  I did mine on medium and next time I will probably do just below medium heat.  Braise marrow segments until coating is crispy and lightly browned.

5.  Place one marrow segment on each cheese slice.  Spread if desired – my kids wanted theirs spread.  I just ate mine as braised

This snack was a hit with the kiddos, which is good since it’s very good for them!

Mine came out a little more browned than I would have liked but they were still tasty. This recipe could also be done without the breading, or with the marrow dipped in a little buttermilk and then breaded lightly. It’s very nice to bite into the soft warm marrow and the taste goes along well with the tangy raw milk cheese! I served up milk with our snack as well.

A good variation that is not low-carb is to serve on a lightly toasted soaked grain bread. A strong flavored sourdough or rye would be best!

Visit Kelly the Kitchen Kop for more low-carb recipes from this Real Food Wednesday!

A parting picture of Galen (10 weeks now!), who made this post possible by snoozing through the entire process

Baby sounds good and I’m growing well, fundal height is right about on schedule. Fundal height is the measurement from your pubic bone to the top of your uterus. It’s usually right about even with how many weeks along you are.

Our baby’s heartbeat was in the 150’s. I don’t remember exactly what it was though. Scott remembers the heartbeat better than I. He remembered that it was lower last time. It’s interesting how variable fetal heartbeat can be and still be all in the range of “normal.”

We were also able to get baby position determined today! Baby is head down (stay baby stay!), but he’s also posterior. Posterior babies are often responsible for “back labor” which is usually hard labor. Posterior is when the baby’s back is along your back, and his/her tummy is facing your front (pictures on this page).

What does this mean for me? It means a lot of not leaning back in my chairs, lol. It’s thought that leaning back in chairs makes babies want to recline back right along with you Doing yoga positions on all fours, such as the pelvic rock, are also good. I’m hoping swimming is good too, as I’d like to do a lot of that in the next few weeks :p

But the past few days I’ve gotten a lot of pampering. I ordered some things from one of my favorite mama-pampering companies – Earth Mama Angel Baby. One of the things I got was the Organic Body Butter and I am so pleased with it. I prefer a butter to an oil feel for my own baby belly and this one does not disappoint. It’s all natural and good for my growing baby belly. It has a nice, refreshing smell and it leaves my skin feeling so, so soft and nourished.

Its been nice to rub it over my belly in the mornings and evenings and just take a moment to enjoy the feel and the smell, and to think about my growing baby.

The other thing we’ve been doing is going swimming! There are perks to living a few blocks away from a lake with a nice park and beach! I can’t believe how much better I feel after spending some time in the water. It’s so nice to have the weight of my belly taken away, and the aches subside.

I’ll admit to being the #1 nag about “can we go swimming?!” I’m worse than the kids (who are still all processing how to swim…but love playing in the shallows). But I love going out farther to the buoys where I can kneel and just let the water take all my weight. I feel all my soreness just melt away.

Last night as I went to sleep I could feel the very gentle lake waves rolling around me – a sensation I haven’t felt in a very long time. It’s a pleasant memory from trips to the beach in my own childhood, and it always came after a fun time in the water.

If you have any way to swim during pregnancy I highly recommend it. I haven’t been able to until this pregnancy and I was really missing something! I’ll be sad when the water gets too cold for swimming near my due date!

We are actually getting through it though and both of us are actually reading the materials. Reading separately and then going over together in the evening seems to be working well for us. Having the books in .pdf format is nice too.

Aside from the logistics and laughter (which isn’t a bad thing ) we’re still working through the initial part of the PK, which is breathing. Last night we went over using breath to relax different parts of the body.

I particularly enjoyed one exercise and found it helpful. I’ve done practice with directed relaxation and breath before – where you breath in deeply and focus on relaxing one area of your body (sometimes after you’ve tensed it first). But this PK activity suggested breathing through relaxation in your pelvis – feeling it open up and expand as you breathed into it.

I liked this exercise (not sure how much Scott got out of it lol) because I think it’ll be a good focus to have during birth, and even now during Braxton-hicks contractions. I want to keep that area open and relaxed so my body and baby can do the work they need to opening up and navigating through all the muscles, bone, and cartilage that sit in the pelvis. I’ve been practicing it throughout today and can honestly say it’s never an area I’ve focused on opening during my relaxation practice. I’m glad for the practical ideas and well-written materials that come with the Pink Kit :p

Back to my Pink Kit Walkthrough

And well, babies have that lovely stuff called meconium for the first several days. Yes, I am vain enough not to want that on my nice cloth diapers :p It’s close to impossible to get out of things!

Normally for the first week of my babies’ lives I’ve used whatever diapers someone gave me. But this time around I decided I wanted to splurge on some disposable diapers I was really ok with. So I decided to go with Tushies gel-free diapers. I’ve been told they are a bit bulky, which I don’t mind because I’m used to cloth diapers. And they’re only for the first week, so the meconium passes and so he still only has cotton next to his skin.

Anyways, I decided to order them from Diapers.com because a friend said they have good prices on “eco-disposables.” I also got a nice first-time user discount – a very nice one!! I only ended up paying $6 for my package of diapers (and that included shipping). They offer free shipping on big orders. I’ll probably use them again if we need to order disposables for a trip or something. They have tons of different brands (including Huggies and Pampers :p) I thought I’d share the love with my discount – use code MILK9773 to get $10 off your first order! They also carry the Tushies and other “natural” wipes.

And wow. I’m actually ordering baby stuff now to get ready for the birth. I’m down to my monthly “to-buy-to-get-ready-for-baby” lists….I can’t believe how fast this is flying by. Wow.

I love it and at the same time I am in awe. Part of me still doesn’t grasp how I can have assisted in creating new life. I feel very honored to have invited a baby into my life and to have had this little soul answer. I’m eager to meet the baby and at the same time I really love being pregnant.

It’s incredible how far along I already am. My favorite forums have already put up the “March 2009 Due Date Club” – wow! It seems it was just a few days ago that my due date club was being added. And now there are women expecting babies in March of ‘09!

I felt the baby kicking above my belly button yesterday. And when I sit I can feel baby pressure against my lungs. I can’t believe he’s already getting that big. I most certainly look pregnant now and I can’t really “suck it in” anymore if I want to look less pregnant :p This is pleasing to me because all you want in the early weeks is to show. But at the same time I think I still have months to go and how big am I actually going to get!!!

But I want a good strong baby. A nice fat one :p I’m working really hard on my nutrition now because the baby is starting to pad up and get fat. I find that I am getting hungry a lot more, which is good since I’m eating three meals and three snacks a day to help get in all my nutrients. I do sometimes splurge though, before you go thinking I’m some sort of nature mama saint I had a Milky Way and Burger King this week (oh the shock and horror of it, a hero has fallen!) I do think it’s ok to indulge once in awhile. I just don’t make it a habit :p

And I’m excited because we start our Pink Kit work in just a few short weeks. Wow. Childbirth preparation already! I’ve been reading tons of birth stories lately and have even taken some time to start visualizing birth situations and thinking about what I want.

It’s really an amazing privilege to be pregnant. I’m so glad I get to experience it   And I need to get to work on that Baby List stuff!!!

As per the heartburn thus far I have found that milk seems to help some.  My pregnancy tea also helps a bit.  I’m not sure what it is in the tea that’s helping because I don’t have the box right in front of me.  But milk can help provide a gentle coating to your stomach and throat.  That relieves heartburn.  Problem with milk is that it makes heartburn worse for some women!  I’m glad it helps me.

I have some more heartburn help ideas you may want to peruse if its causing your problems too.

I notice it seems to bother me the most late evening after supper.  I may try eating less at supper and then eating a slightly bigger snack later.  Or perhaps a bigger afternoon snack with a lighter supper.  I’ve been eating an “after dinner” snack a bit before bed every night since I’m really wanting to make sure my protein intake is high right now.  I think I’m doing well with that, need to improve on my veggies though!

Other than heartburn and lots of baby movements I’m just tired right now.  There is so much coming up for us in the next few weeks and I’ll be glad to see them through.  One of the things is my redesign project for Natural birth and Baby Care and for this blog.  I’m excited about that!

Ok, I’ll keep it short today!

Today I’m going to take a bit of a different track and talk about your overall vision for what you want in your life (and in the lives of your children). But I felt it was important to start with the practical. This is for a couple of reasons: first, I gave a solid step-by-step framework that makes logical sense. You can follow it. Secondly, you are a mortal being with a mortal body (though many of us moms think we have to be superwomen). But point is, no matter what other beliefs you hold the first way you’re going to relate to your world is through your body. Your body takes the action that achieves your goals. You are going to go ahead and do something no matter how challenging that is.

An Overall Dream

Ok. That said, I do think it’s important to have an overall idea of what you want. Your goals helped you start to grasp just what you want. They give you a very concrete way to define what you want and begin working on getting it. Your “vision” or “dream” encompasses what you want your goal setting to lead to. It’s important to know what end you’re working to. This is where you can get a little more open-ended.

One of my dreams is to have a peaceful, clean home. I want it to be welcoming to me and I want to enjoy being in it. I want to enjoy cooking in my kitchen. And I want my husband to come home at night to a house that’s clean and looks nice – and provides him with a place to relax after working hard. I want my children to have a good example of a clean and well-functioning household. I want my home to be a place they’re happy to bring their friends to and a place their friends enjoy being.

That’s a lot to define out and if I look at it just like that, it’s overwhelming. How do I take my cluttered house and small kitchen and create that haven of peace and relaxation??? That’s where the concrete goals come in. Sometimes you can achieve a goal without having a bigger end-result in mind. I could probably say I want to organize my house just “because” and get it done. But it helps a lot to know I’m working towards that clean house my family will enjoy, and that will do good for all of my family’s state of mind.

Gaining Definition as a Mother

Mulling over your dreams and vision is important to your mothering as well. Parenting can be very hard work. When you’re up to your ears in dirty diapers, screaming toddlers, morning sickness, and sulky school children it can be very, very hard to figure out why you’re even bothering with all of this. And if you want to change it (so you don’t have screaming toddlers and sulky school children) it can be very hard to see any sort of place to start. So you need to sit back and develop a vision for yourself as a mother and for your children. Dream for them.

If you don’t really get a break from your children – and believe me, I know how this is – you need to steal some time. Put the kids behind a baby gate and go get in the shower. Go for a drive with them all strapped in their car seats. Call grandma for a couple of hours. Put a table full of so much food in front of them it will be 30 minutes before they stop to take a breath. Do something so you can sit back and think. And think about where you are at now. Think about where you want to be. Don’t be specific and goal-oriented right now. Dream. Think about how you envision yourself as a mother. Think about how you’d like your children to be.

When I say that, don’t think about how you want them to be personality-wise. No matter what I do, I’m never going to change my social chatterbox into a reserved, quiet child. It’s not going to happen. But you can dream about how you’d like your days with them to go. About how you’d like them to behave on outings. I’m pretty sure you’re going to want to have mostly peaceful days of being with them. So go ahead and dream about that. Think about the kind of people you want them to be. This is really helpful. Do you want your children to grow up to be good people? Young men and women who have strong values, are willing to work hard and help others? Do you imagine them growing to be smart and cheerful? I do.

I also picture my daughter growing to be a happy and fulfilled mother. I picture my sons growing to be dedicated fathers who are willing to work hard for their families. These are things I desire very deeply. They’re a vision I have for my children.

Now take that dream – the dream of what you’d like your children to become, and look at yourself. Measure yourself against that dream. It’s very revealing isn’t it?! I want my daughter to grow to be a happy mother. But there have been times when she’s seen me be a pretty exhausted, frustrated, and burnt-out mother. I want my children to be hard workers, but there are times I complain about household chores (then fuss at them when they do the same about theirs!) Your vision for your children can help you define your vision for yourself. The kind of person you’d like to be.

Making the Vision Reality

Of course there are some things you can’t control. You can’t control (completely) the influence of others in their life. But you can control you. You can dream for them and for yourself, and you can take action. So sit down and figure out what you’d like for yourself, your home, your children. Put that vision in your head.

I’ll give you one more example from my own life:

I picture the time after my new baby is born to be a wonderful time. A time when the baby is content and curled up with me or Scott. Where I have a week or so to relax completely and be with my baby, and a couple weeks after that when I really don’t have to do very much. I imagine that there are good meals to help me recover and nourish the babe, and to keep the rest of the family content. I picture my house staying pretty neat and clean. There are lots of things to engage the older children during this time when their normal schedule is somewhat disrupted. Overall, it is a happy and peaceful time.

Big vision. A lovely one, too, in my not so humble opinion It’s a “vision that motivates.” It’s important to have dreams and vision like this as you are mothering. Dream up some of your own to help you through those tough times. And use them to build your goals. Remember that you are a mortal, physical being, and you relate to the world through your mortal and physical body. You can dream dreams and develop visions. They’ll help you. They’ll motivate you and give you focus. But do remember they’re a starting point. To make my postpartum dream come true I need to take that dream and create some goals (like organizing my house!), and then I need to work on those. Then I’ll see that dream manifest. And it will be a very, very, nice one.

You can do the same thing with your dreams. You can take them and create goals. You can break down your goals into steps, put them into your schedule and work on them. And you’ll see that vision realized, and that dream will happen.